Comparison of active-learning strategies for motivational interviewing skills, knowledge, and confidence in first-year pharmacy students.

PubMed

Lupu, Ana M; Stewart, Autumn L; O'Neil, Christine

2012-03-12

To compare 3 strategies for pharmacy student learning of motivational interviewing skills, knowledge of motivational interviewing principles, and confidence in and attitudes toward their application. Following a motivational interviewing lecture, first-year students were randomized to perform practice activities (written dialogue, peer role-play, or mock-patient counseling activities). Motivational interviewing skills, knowledge, confidence, and attitudes were measured. All students demonstrated improvement in skills, knowledge, and confidence. Students in the mock-patient counseling group demonstrated significantly better motivational interviewing skills during practice and trended toward higher scores on the summative evaluation. They also demonstrated a significant improvement in knowledge compared with that of the written dialogue group during practice. Feedback at the end was generally positive, with students expressing recognition for the value of motivational interviewing. Students demonstrated their best performance of motivational interviewing during assessments using interactions with mock or standardized patients.

Triglycidylamine Crosslinking of Porcine Aortic Valve Cusps or Bovine Pericardium Results in Improved Biocompatibility, Biomechanics, and Calcification Resistance

PubMed Central

Connolly, Jeanne M.; Alferiev, Ivan; Clark-Gruel, Jocelyn N.; Eidelman, Naomi; Sacks, Michael; Palmatory, Elizabeth; Kronsteiner, Allyson; DeFelice, Suzanne; Xu, Jie; Ohri, Rachit; Narula, Navneet; Vyavahare, Narendra; Levy, Robert J.

2005-01-01

We investigated a novel polyepoxide crosslinker that was hypothesized to confer both material stabilization and calcification resistance when used to prepare bioprosthetic heart valves. Triglycidylamine (TGA) was synthesized via reacting epichlorhydrin and NH3. TGA was used to crosslink porcine aortic cusps, bovine pericardium, and type I collagen. Control materials were crosslinked with glutaraldehyde (Glut). TGA-pretreated materials had shrink temperatures comparable to Glut fixation. However, TGA crosslinking conferred significantly greater collagenase resistance than Glut pretreatment, and significantly improved biomechanical compliance. Sheep aortic valve interstitial cells grown on TGA-pretreated collagen did not calcify, whereas sheep aortic valve interstitial cells grown on control substrates calcified extensively. Rat subdermal implants (porcine aortic cusps/bovine pericardium) pretreated with TGA demonstrated significantly less calcification than Glut pretreated implants. Investigations of extracellular matrix proteins associated with calcification, matrix metalloproteinases (MMPs) 2 and 9, tenascin-C, and osteopontin, revealed that MMP-9 and tenascin-C demonstrated reduced expression both in vitro and in vivo with TGA crosslinking compared to controls, whereas osteopontin and MMP-2 expression were not affected. TGA pretreatment of heterograft biomaterials results in improved stability compared to Glut, confers biomechanical properties superior to Glut crosslinking, and demonstrates significant calcification resistance. PMID:15631995

The use of six sigma in health care management: are we using it to its full potential?

PubMed

DelliFraine, Jami L; Wang, Zheng; McCaughey, Deirdre; Langabeer, James R; Erwin, Cathleen O

2014-01-01

Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations. The authors identified 310 articles on SS published in the last 15 years. However, only 55 were empirical peer-reviewed articles, 16 of which reported the correct use of SS. Only 7 of these articles included statistical analyses to test for significant changes in quality of care, and only 16 calculated defects per million opportunities or sigma level. This review demonstrates that there are significant gaps in the Six Sigma health care quality improvement literature and very weak evidence that Six Sigma is being used correctly to improve health care quality.

The use of six sigma in health care management: are we using it to its full potential?

PubMed

DelliFraine, Jami L; Wang, Zheng; McCaughey, Deirdre; Langabeer, James R; Erwin, Cathleen O

2013-01-01

Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations. The authors identified 310 articles on SS published in the last 15 years. However, only 55 were empirical peer-reviewed articles, 16 of which reported the correct use of SS. Only 7 of these articles included statistical analyses to test for significant changes in quality of care, and only 16 calculated defects per million opportunities or sigma level. This review demonstrates that there are significant gaps in the Six Sigma health care quality improvement literature and very weak evidence that Six Sigma is being used correctly to improve health care quality.

Pallidal stimulation in children: comparison between cerebral palsy and DYT1 dystonia.

PubMed

Marks, Warren; Bailey, Laurie; Reed, Maryann; Pomykal, Angela; Mercer, Mary; Macomber, David; Acosta, Fernando; Honeycutt, John

2013-07-01

The authors compared the outcomes of 17 children aged 7 to 15 years with DYT1 dystonia or cerebral palsy following deep brain stimulation. While patients with cerebral palsy presented with significantly greater motor disability than the DYT1 cohort at baseline, both groups demonstrated improvement at 1 year (cerebral palsy = 24%; DYT1 = 6%). The group as a whole demonstrated significant improvement on the Barry-Albright Dystonia Scale across time. Gains in motor function were apparent in both axial and appendicular distributions involving both upper and lower extremities. Gains achieved by 6 months were sustained in the cerebral palsy group, whereas the DYT1 group demonstrated continued improvement with ongoing pallidal stimulation beyond 18 months. Young patients with dystonia due to cerebral palsy responded comparably to patients with DYT1 dystonia. The severity of motor impairment in patients with cerebral palsy at baseline and follow-up raises the issue of even earlier intervention with neuromodulation in this population to limit long-term motor impairments due to dystonia.

Using Systematic Feedback and Reflection to Improve Adventure Education Teaching Skills

ERIC Educational Resources Information Center

Richardson, Rick; Kalvaitis, Darius; Delparte, Donna

2014-01-01

This study examined how adventure educators could use systematic feedback to improve their teaching skills. Evaluative instruments demonstrated a statistically significant improvement in teaching skills when applied at an outdoor education center in Western Canada. Concurrent focus group interviews enabled instructors to reflect on student…

The Effect of Ramelteon on Heartburn Symptoms of Patients With Gastroesophageal Reflux Disease and Chronic Insomnia: A Pilot Study.

PubMed

Jha, Lokesh K; Fass, Ronnie; Gadam, Rakshith; Maradey-Romero, Carla; Nasrollah, Laya; Hershcovici, Tiberiu; Quan, Stuart F; Dickman, Ram

2016-02-01

There is a bidirectional relationship between gastroesophageal reflux disease (GERD) and sleep. It has been demonstrated that antireflux treatment can improve sleep quality in GERD patients with nighttime reflux. Patients with heartburn and/or regurgitation ≥3 times/week and insomnia for ≥3 months were included. Patients were assessed at baseline with the demographic, GERD symptom assessment scale, Epworth sleepiness scale, Berlin sleep apnea, Pittsburgh sleep quality index, and the Insomnia severity index questionnaires. Subjects underwent an upper endoscopy followed by pH testing. Subsequently, subjects were randomized, in a double-blind, placebo-controlled trial, to receive either ramelteon 8 mg or placebo before bedtime for 4 weeks. During the last week of treatment, subjects completed a daily GERD symptom and sleep diary and underwent actigraphy. Sixteen patients completed the study, 8 in each arm (mean age and M/F were 48.5 vs. 57.8 y, and 8/0 vs. 6/2, respectively). Patients who received ramelteon demonstrated a statistically significant decrease in symptom score as compared with those who received placebo for daytime heartburn (-42% vs. -29%), nighttime heartburn (-42% vs. 78%), 24-hour heartburn (-42% vs. -3%), and 24-hour acid regurgitation (-26% vs. 19%) (all P<0.05). Insomnia severity index score was significantly reduced in patients receiving ramelteon as compared with placebo (-46% vs. -5%, P<0.05). Ramelteon group also demonstrated a significant improvement in sleep efficiency and sleep latency, as compared with placebo, P<0.05). No significant adverse events were observed with ramelteon. Ramelteon significantly improved symptoms in patients with GERD. In addition, ramelteon significantly improved patients' sleep experience. Further studies are needed in the future (NCT01128582).

Field Test Results of Using a Nacelle-Mounted Lidar for Improving Wind Energy Capture by Reducing Yaw Misalignment (Presentation)

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

Fleming, P.; Scholbrock, A.; Wright, A.

2014-11-01

Presented at the Nordic Wind Power Conference on November 5, 2014. This presentation describes field-test campaigns performed at the National Wind Technology Center in which lidar technology was used to improve the yaw alignment of the Controls Advanced Research Turbine (CART) 2 and CART3 wind turbines. The campaigns demonstrated that whether by learning a correction function to the nacelle vane, or by controlling yaw directly with the lidar signal, a significant improvement in power capture was demonstrated.

Gait and balance of transfemoral amputees using passive mechanical and microprocessor-controlled prosthetic knees.

PubMed

Kaufman, K R; Levine, J A; Brey, R H; Iverson, B K; McCrady, S K; Padgett, D J; Joyner, M J

2007-10-01

Microprocessor-controlled knee joints appeared on the market a decade ago. These joints are more sophisticated and more expensive than mechanical ones. The literature is contradictory regarding changes in gait and balance when using these sophisticated devices. This study employed a crossover design to assess the comparative performance of a passive mechanical knee prosthesis compared to a microprocessor-controlled knee joint in 15 subjects with an above-knee amputation. Objective measurements of gait and balance were obtained. Subjects demonstrated significantly improved gait characteristics after receiving the microprocessor-controlled prosthetic knee joint (p<0.01). Improvements in gait were a transition from a hyperextended knee to a flexed knee during loading response which resulted in a change from an internal knee flexor moment to a knee extensor moment. The participants' balance also improved (p<0.01). All conditions of the Sensory Organization Test (SOT) demonstrated improvements in equilibrium score. The composite score also increased. Transfemoral amputees using a microprocessor-controlled knee have significant improvements in gait and balance.

Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review.

PubMed

Schoeppe, Stephanie; Alley, Stephanie; Van Lippevelde, Wendy; Bray, Nicola A; Williams, Susan L; Duncan, Mitch J; Vandelanotte, Corneel

2016-12-07

Health and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. This systematic review examined the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour in children and adults. Systematic literature searches were conducted in five databases to identify papers published between 2006 and 2016. Studies were included if they used a smartphone app in an intervention to improve diet, physical activity and/or sedentary behaviour for prevention. Interventions could be stand-alone interventions using an app only, or multi-component interventions including an app as one of several intervention components. Outcomes measured were changes in the health behaviours and related health outcomes (i.e., fitness, body weight, blood pressure, glucose, cholesterol, quality of life). Study inclusion and methodological quality were independently assessed by two reviewers. Twenty-seven studies were included, most were randomised controlled trials (n = 19; 70%). Twenty-three studies targeted adults (17 showed significant health improvements) and four studies targeted children (two demonstrated significant health improvements). Twenty-one studies targeted physical activity (14 showed significant health improvements), 13 studies targeted diet (seven showed significant health improvements) and five studies targeted sedentary behaviour (two showed significant health improvements). More studies (n = 12; 63%) of those reporting significant effects detected between-group improvements in the health behaviour or related health outcomes, whilst fewer studies (n = 8; 42%) reported significant within-group improvements. A larger proportion of multi-component interventions (8 out of 13; 62%) showed significant between-group improvements compared to stand-alone app interventions (5 out of 14; 36%). Eleven studies reported app usage statistics, and three of them demonstrated that higher app usage was associated with improved health outcomes. This review provided modest evidence that app-based interventions to improve diet, physical activity and sedentary behaviours can be effective. Multi-component interventions appear to be more effective than stand-alone app interventions, however, this remains to be confirmed in controlled trials. Future research is needed on the optimal number and combination of app features, behaviour change techniques, and level of participant contact needed to maximise user engagement and intervention efficacy.

Weed Identification Field Training Demonstrations.

ERIC Educational Resources Information Center

Murdock, Edward C.; And Others

1986-01-01

Reviews efforts undertaken in weed identification field training sessions for agriprofessionals in South Carolina. Data over a four year period (1980-1983) revealed that participants showed significant improvement in their ability to identify weeds. Reaffirms the value of the field demonstration technique. (ML)

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part three: aerobic exercise programs.

PubMed

Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A; Mizusaki Imoto, Aline; Toupin-April, Karine; Westby, Marie; Álvarez Gallardo, Inmaculada C; Gifford, Wendy; Laferrière, Lucie; Rahman, Prinon; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Shallwani, Shirin Mehdi; Aburub, Ala'; Bennell, Kim L; Van der Esch, Martin; Simic, Milena; McConnell, Sara; Harmer, Alison; Kenny, Glen P; Paterson, Gail; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; McLean, Linda

2017-05-01

To identify effective aerobic exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). The five high-quality studies included demonstrated that various aerobic training exercises are generally effective for improving knee osteoarthritis within a 12-week period. An aerobic exercise program demonstrated significant improvement for pain relief (Grade B), physical function (Grade B) and quality of life (Grade C+). Aerobic exercise in combination with strengthening exercises showed significant improvement for pain relief (3 Grade A) and physical function (2 Grade A, 2 Grade B). A short-term aerobic exercise program with/without muscle strengthening exercises is promising for reducing pain, improving physical function and quality of life for individuals with knee osteoarthritis.

Targeting L-Selectin to Improve Neurologic and Urologic Function After Spinal Cord Injury

DTIC Science & Technology

2015-10-01

demonstrated locomotor recovery in mice receiving 40mg/kg DFA up to 3 hours following spinal cord injury -We demonstrated improved locomotor recovery...health, as evaluated by body weight -We identified no added locomotor recovery due to multiple, successive doses of DFA. Moreover, additional doses...bladder function Significance: We have identified robust locomotor recovery in both mild and severe spinal cord injured mice that received DFA up

EGFR-Targeted Adenovirus Dendrimer Coating for Improved Systemic Delivery of the Theranostic NIS Gene

PubMed Central

Grünwald, Geoffrey K; Vetter, Alexandra; Klutz, Kathrin; Willhauck, Michael J; Schwenk, Nathalie; Senekowitsch-Schmidtke, Reingard; Schwaiger, Markus; Zach, Christian; Wagner, Ernst; Göke, Burkhard; Holm, Per S; Ogris, Manfred; Spitzweg, Christine

2013-01-01

We recently demonstrated tumor-selective iodide uptake and therapeutic efficacy of combined radiovirotherapy after systemic delivery of the theranostic sodium iodide symporter (NIS) gene using a dendrimer-coated adenovirus. To further improve shielding and targeting we physically coated replication-selective adenoviruses carrying the hNIS gene with a conjugate consisting of cationic poly(amidoamine) (PAMAM) dendrimer linked to the peptidic, epidermal growth factor receptor (EGFR)-specific ligand GE11. In vitro experiments demonstrated coxsackie-adenovirus receptor-independent but EGFR-specific transduction efficiency. Systemic injection of the uncoated adenovirus in a liver cancer xenograft mouse model led to high levels of NIS expression in the liver due to hepatic sequestration, which were significantly reduced after coating as demonstrated by 123I-scintigraphy. Reduction of adenovirus liver pooling resulted in decreased hepatotoxicity and increased transduction efficiency in peripheral xenograft tumors. 124I-PET-imaging confirmed EGFR-specificity by significantly lower tumoral radioiodine accumulation after pretreatment with the EGFR-specific antibody cetuximab. A significantly enhanced oncolytic effect was observed following systemic application of dendrimer-coated adenovirus that was further increased by additional treatment with a therapeutic dose of 131I. These results demonstrate restricted virus tropism and tumor-selective retargeting after systemic application of coated, EGFR-targeted adenoviruses therefore representing a promising strategy for improved systemic adenoviral NIS gene therapy. PMID:24193032

Augmenting CPT to Improve Sleep Impairment in PTSD: A Randomized Clinical Trial

PubMed Central

Galovski, Tara E.; Mott, Juliette; Blain, Leah M.; Elwood, Lisa; Gloth, Chelsea; Fletcher, Thomas

2015-01-01

Objective Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory following treatment for PTSD. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy; CPT). Method Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. Results After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Conclusion Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. Public Health Significance: This study suggests that hypnosis may be a viable treatment option in a stepped-care approach for treating sleep impairment in individuals suffering from PTSD. PMID:26689303

Propulsion system-flight control integration and optimization: Flight evaluation and technology transition

NASA Technical Reports Server (NTRS)

Burcham, Frank W., Jr.; Gilyard, Glenn B.; Myers, Lawrence P.

1990-01-01

Integration of propulsion and flight control systems and their optimization offers significant performance improvements. Research programs were conducted which have developed new propulsion and flight control integration concepts, implemented designs on high-performance airplanes, demonstrated these designs in flight, and measured the performance improvements. These programs, first on the YF-12 airplane, and later on the F-15, demonstrated increased thrust, reduced fuel consumption, increased engine life, and improved airplane performance; with improvements in the 5 to 10 percent range achieved with integration and with no changes to hardware. The design, software and hardware developments, and testing requirements were shown to be practical.

Efficacy, safety, and improved tolerability of travoprost BAK-free ophthalmic solution compared with prior prostaglandin therapy

PubMed Central

Henry, J Charles; Peace, James H; Stewart, Jeanette A; Stewart, William C

2008-01-01

Purpose To evaluate the efficacy, safety and tolerability of changing to travoprost BAK-free from prior prostaglandin therapy in patients with primary open-angle glaucoma or ocular hypertension. Design Prospective, multi-center, historical control study. Methods Patients treated with latanoprost or bimatoprost who needed alternative therapy due to tolerability issues were enrolled. Patients were surveyed using the Ocular Surface Disease Index (OSDI) to evaluate OSD symptoms prior to changing to travoprost BAK-free dosed once every evening. Patients were re-evaluated 3 months later. Results In 691 patients, travoprost BAK-free demonstrated improved mean OSDI scores compared to either latanoprost or bimatoprost (p < 0.0001). Patients having any baseline OSD symptoms (n = 235) demonstrated significant improvement after switching to travoprost BAK-free (p < 0.0001). In 70.2% of these patients, symptoms were reduced in severity by at least 1 level. After changing medications to travoprost BAK-free, mean intraocular pressure (IOP) was significantly decreased (p < 0.0001). Overall, 72.4% preferred travoprost BAK-free (p < 0.0001, travoprost BAK-free vs prior therapy). Travoprost BAK-free demonstrated less conjunctival hyperemia than either prior therapy (p < 0.0001). Conclusions Patients previously treated with a BAK-preserved prostaglandin analog who are changed to travoprost BAK-free have clinically and statistically significant improvement in their OSD symptoms, decreased hyperemia, and equal or better IOP control. PMID:19668762

Macro vs micro level surgical quality improvement: a regional collaborative demonstrates the case for a national NSQIP initiative.

PubMed

Tepas, Joseph J; Kerwin, Andrew J; deVilla, Jhun; Nussbaum, Michael S

2014-04-01

The Florida Surgical Care Initiative (FSCI) is a quality improvement collaborative of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) and the Florida Hospital Association. In the wake of a dramatic decrease in complications and cost documented over 15 months, we analyzed the semiannual measures reports (SAR) to determine whether this improvement was driven by specific institutions or was a global accomplishment by all participants. Reports from NSQIP were analyzed to determine rank change of participants. Odds ratio (OR) of observed-to-expected incidence of the 4 FSCI outcomes (catheter-associated urinary tract infection [CAUTI], surgical site infection [SSI], colorectal, and surgery in patients older than 65 years) were used to assess individual and group performance. Data from SAR 2 (October 2011 to April 2012) were compared with data from SAR 3 (May to July 2012). Poorly performing hospitals were tracked to determine evidence of improvement. Individual facility performance was evaluated by determining proportion of hospitals showing improved rank across all measures. Fifty-four hospitals were evaluated. SAR 2 reported 28,112 general and vascular surgical cases; SAR 3 added 10,784 more. The proportion of institutions with OR < 1 for each measure did not change significantly. Only urinary tract infection and colorectal measures demonstrated increased number of hospitals with OR < 1. Each institution that was a significant negative outlier in SAR 2 demonstrated improvement. Three of 54 hospitals demonstrated improvement across all 4 measures. Of 15 hospitals with improved performance across 3 measures, all included elderly surgery. The increase in quality achieved across this population of surgical patients was the result of a quality assessment process driven by NSQIP rather than disproportionate improvement of some raising the bar for all. The NSQIP process, applied collaboratively across a population by committed institutions, produces dramatic results. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

[Evaluation on a demonstration project of ecological restoration of ditches at Qianwei Village of Chongming County, Shanghai].

PubMed

Zhou, Xiang-Xiang; Zhang, Li-Quan; Yuan, Lian-Qi

2008-02-01

By using biological slope-protection techniques, oxidation pond system, and zeolite treatment system, a demonstration project of ecological restoration of ditches at the Qianwei Village of Chongming County in Shanghai was implemented, and an evaluation on the project was made via a runoff simulation experiment and the measurements of the parameters soil shear strength, biodiversity, and ditch water quality. The results showed that covering the dich slopes with shrub could significantly increase soil shear strength, compactness and moisture content, and the formed vegetation had significant effects on retarding runoff and removing TSS (P < 0.05). Applying live fascines could significantly increase soil shear strength and TSS removal rate (P < 0.05), but its effects on increasing soil compactness and moisture content and retaining runoff were not significant. After the implement of the demonstration project, the total N and P concentrations in ditch water decreased significantly, habitat quality and aesthetic value of ditch slope improved, and biodiversity enhanced greatly. The integration of the biological techniques with other ecological restoration measures could stabilize ditch slope, improve ditch habitat quality, and restore the ecological environment of the ditches.

Effects of Nordic walking on physical functions and depression in frail people aged 70 years and above.

PubMed

Lee, Han Suk; Park, Jeung Hun

2015-08-01

[Purpose] This study investigated the effects of Nordic walking on physical functions and depression in frail people aged 70 years and above. [Subjects] Twenty frail elderly individuals ≥70 years old were assigned to either a Nordic walking group (n=8) or general exercise group (n=10). [Methods] The duration of intervention was equal in both groups (3 sessions/week for 12 weeks, 60 min/session). Physical function (balance, upper extremity strength, lower extremity strength, weakness) and depression were examined before and after the interventions. [Results] With the exception of upper extremity muscle strength, lower extremity strength, weakness, balance, and depression after Nordic walking demonstrated statistically significant improvement. However, in the general exercise group, only balance demonstrated a statistically significant improvement after the intervention. There were significant differences in the changes in lower extremity muscle strength, weakness and depression between the groups. [Conclusion] In conclusion, Nordic walking was more effective than general exercise. Therefore, we suggest that Nordic walking may be an attractive option for significant functional improvement in frail people over 70 years old.

Placental Mesenchymal Stromal Cells Rescue Ambulation in Ovine Myelomeningocele

PubMed Central

Brown, Erin G.; Lankford, Lee; Keller, Benjamin A.; Pivetti, Christopher D.; Sitkin, Nicole A.; Beattie, Michael S.; Bresnahan, Jacqueline C.; Farmer, Diana L.

2015-01-01

Myelomeningocele (MMC)—commonly known as spina bifida—is a congenital birth defect that causes lifelong paralysis, incontinence, musculoskeletal deformities, and severe cognitive disabilities. The recent landmark Management of Myelomeningocele Study (MOMS) demonstrated for the first time in humans that in utero surgical repair of the MMC defect improves lower limb motor function, suggesting a capacity for improved neurologic outcomes in this disorder. However, functional recovery was incomplete, and 58% of the treated children were unable to walk independently at 30 months of age. In the present study, we demonstrate that using early gestation human placenta-derived mesenchymal stromal cells (PMSCs) to augment in utero repair of MMC results in significant and consistent improvement in neurologic function at birth in the rigorous fetal ovine model of MMC. In vitro, human PMSCs express characteristic MSC markers and trilineage differentiation potential. Protein array assays and enzyme-linked immunosorbent assay show that PMSCs secrete a variety of immunomodulatory and angiogenic cytokines. Compared with adult bone marrow MSCs, PMSCs secrete significantly higher levels of brain-derived neurotrophic factor and hepatocyte growth factor, both of which have known neuroprotective capabilities. In vivo, functional and histopathologic analysis demonstrated that human PMSCs mediate a significant, clinically relevant improvement in motor function in MMC lambs and increase the preservation of large neurons within the spinal cord. These preclinical results in the well-established fetal ovine model of MMC provide promising early support for translating in utero stem cell therapy for MMC into clinical application for patients. Significance This study presents placenta-derived mesenchymal stromal cell (PMSC) treatment as a potential therapy for myelomeningocele (MMC). Application of PMSCs can augment current in utero surgical repair in the well-established and rigorously applied fetal lamb model of MMC. Treatment with human PMSCs significantly and dramatically improved neurologic function and preserved spinal cord neuron density in experimental animals. Sixty-seven percent of the PMSC-treated lambs were able to ambulate independently, with two exhibiting no motor deficits whatsoever. In contrast, none of the lambs treated with the vehicle alone were capable of ambulation. The locomotor rescue demonstrated in PMSC-treated lambs indicates great promise for future clinical trials to improve paralysis in children afflicted with MMC. PMID:25911465

Heart failure patient adherence: epidemiology, cause, and treatment.

PubMed

Corotto, Paul S; McCarey, Melissa M; Adams, Suzanne; Khazanie, Prateeti; Whellan, David J

2013-01-01

Poor adherence to therapeutic regimens is a significant impediment to improving clinical outcomes in the HF population. Typical rates of adherence to prescribed medications, low-sodium diets, and aerobic exercise programs remain lower than that needed to decrease morbidity and mortality associated with HF. Factors contributing to poor adherence include multiple comorbidities, clinical depression, and decreased cognitive functioning. HF education and programs to enhance self-management skills have improved patient quality of life but have yet to decrease mortality or rehospitalization rates significantly. Telemonitoring to improve adherence behaviors and self-management interventions within broader HF management programs have demonstrated significant clinical improvements in this population. Copyright © 2013 Elsevier Inc. All rights reserved.

Cycling induced by electrical stimulation improves motor recovery in postacute hemiparetic patients: a randomized controlled trial.

PubMed

Ambrosini, Emilia; Ferrante, Simona; Pedrocchi, Alessandra; Ferrigno, Giancarlo; Molteni, Franco

2011-04-01

This study assessed whether cycling induced by functional electrical stimulation (FES) was more effective than passive cycling with placebo stimulation in promoting motor recovery and walking ability in postacute hemiparetic patients. In a double-blind, randomized, controlled trial, 35 patients were included and randomized to receive FES-induced cycling training or placebo FES cycling. The 4-week treatment consisted of 20 sessions lasting 25 minutes each. Primary outcome measures included the leg subscale of the Motricity Index and gait speed during a 50-meter walking test. Secondary outcomes were the Trunk Control Test, the Upright Motor Control Test, the mean work produced by the paretic leg, and the unbalance in mechanical work between paretic and nonparetic legs during voluntary pedaling. Participants were evaluated before training, after training, and at 3- to 5-month follow-up visits. No significant differences were found between groups at baseline. Repeated-measures ANOVA (P<0.05) revealed significant increases in Motricity Index, Trunk Control Test, Upright Motor Control Test, gait speed, and mean work of the paretic leg after training and at follow-up assessments for FES-treated patients. No outcome measures demonstrated significant improvements after training in the placebo group. Both groups showed no significant differences between assessments after training and at follow-up. A main effect favoring FES-treated patients was demonstrated by repeated-measures ANCOVA for Motricity Index (P<0.001), Trunk Control Test (P=0.001), Upright Motor Control Test (P=0.005), and pedaling unbalance (P=0.038). The study demonstrated that 20 sessions of FES cycling training significantly improved lower extremity motor functions and accelerated the recovery of overground locomotion in postacute hemiparetic patients. Improvements were maintained at follow-up.

HEALTH SIGNIFICANCE OF PULMONARY FUNCTION TESTS

EPA Science Inventory

As the sensitivity and precision of functional tests improves, we become increasingly able to measure responses to pollutant exposures with little, if any, demonstrable health significance. Proper interpretation of such functional responses generally requires an ability to evalua...

Augmenting cognitive processing therapy to improve sleep impairment in PTSD: A randomized controlled trial.

PubMed

Galovski, Tara E; Harik, Juliette M; Blain, Leah M; Elwood, Lisa; Gloth, Chelsea; Fletcher, Thomas D

2016-02-01

Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory after treatment. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy [CPT]). Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Pilot study demonstrating effectiveness of targeted education to improve informed consent understanding in AIDS clinical trials.

PubMed

Sengupta, Sohini; Lo, Bernard; Strauss, Ronald P; Eron, Joseph; Gifford, Allen L

2011-11-01

Assessing and improving informed consent understanding is equally important as obtaining consent from participants in clinical trial research, but developing interventions to target gaps in participants' informed consent understanding remains a challenge. We used a randomized controlled study design to pilot test an educational intervention to improve actual informed consent understanding of new enrollees in the Adult AIDS Clinical Trial Group (AACTG). Questionnaires were administered to 24 enrollees to assess their baseline understanding on eight elements of informed consent associated with AIDS clinical trials. Enrollees who scored 18/21(85%) or less were randomly assigned to in-person, targeted education (intervention), or delayed education (control). Two follow-up assessments were administered. Repeated measures ANOVA was performed to determine intervention effectiveness in improving actual informed consent understanding over time. Actual understanding improved at the immediate post-intervention time point with a significant score difference of 2.5 when comparing the intervention and delayed groups. In addition, there was a significant score difference of 3.2 when comparing baseline to three-month follow-up for the two groups, suggesting a statistically significant intervention effect to improve actual understanding of the basic elements of informed consent. The findings demonstrated that one-time targeted education can improve actual informed consent understanding one week after the intervention, but retention of these concepts may require periodic monitoring to ensure comprehension throughout the course of a clinical trial.

Effects of Animal-Assisted Activities with Guinea Pigs in the Primary School Classroom

PubMed Central

O’Haire, Marguerite E.; McKenzie, Samantha J.; McCune, Sandra; Slaughter, Virginia

2013-01-01

This study investigated the effects of a classroom-based animal-assisted activities (AAA) program with guinea pigs on the social functioning of primary school children. We hypothesized that participants in the experimental condition (n = 64), compared with a waitlist control group (n = 64), would demonstrate improvements in social functioning following the program. Parents and teachers used the Social Skills Rating System (SSRS) to evaluate the social skills and problem behaviors of 128 participating children (age range = 4.8 to 12.7 years) before and after an 8-week period. Teachers also rated academic competence at both time points. Children who participated in the AAA program demonstrated significantly greater improvements in social functioning than their control group peers, as defined by greater increases in social skills (teacher SSRS) and decreases in problem behaviors (parent and teacher SSRS). There were no significant differences between the groups in academic competence. AAA participants demonstrated significant increases in social skills and decreases in problem behaviors from pre- to post-program on the teacher version of the SSRS. Control group participants did not show significant changes on these measures. These findings suggest that an AAA program with guinea pigs may be a feasible addition to the primary school classroom in order to improve social functioning. Further component analysis will be necessary to determine whether the animal is the active ingredient in AAA programs of this nature. PMID:24265514

A pilot study: mindfulness meditation intervention in COPD.

PubMed

Chan, Roxane Raffin; Giardino, Nicholas; Larson, Janet L

2015-01-01

Living well with chronic obstructive pulmonary disease (COPD) requires people to manage disease-related symptoms in order to participate in activities of daily living. Mindfulness practice is an intervention that has been shown to reduce symptoms of chronic disease and improve accurate symptom assessment, both of which could result in improved disease management and increased wellness for people with COPD. A randomized controlled trial was conducted to investigate an 8-week mindful meditation intervention program tailored for the COPD population and explore the use of breathing timing parameters as a possible physiological measure of meditation uptake. Results demonstrated that those randomized to the mindful meditation intervention group (N=19) had a significant increase in respiratory rate over time as compared to those randomized to the wait-list group (N=22) (P=0.045). It was also found that the mindful meditation intervention group demonstrated a significant decrease in level of mindfulness over time as compared to the wait-list group (P=0.023). When examining participants from the mindful meditation intervention who had completed six or more classes, it was found that respiratory rate did not significantly increase in comparison to the wait-list group. Furthermore, those who completed six or more classes (N=12) demonstrated significant improvement in emotional function in comparison to the wait-list group (P=0.032) even though their level of mindfulness did not improve. This study identifies that there may be a complex relationship between breathing parameters, emotion, and mindfulness in the COPD population. The results describe good feasibility and acceptability for meditation interventions in the COPD population.

A pilot study: mindfulness meditation intervention in COPD

PubMed Central

Chan, Roxane Raffin; Giardino, Nicholas; Larson, Janet L

2015-01-01

Living well with chronic obstructive pulmonary disease (COPD) requires people to manage disease-related symptoms in order to participate in activities of daily living. Mindfulness practice is an intervention that has been shown to reduce symptoms of chronic disease and improve accurate symptom assessment, both of which could result in improved disease management and increased wellness for people with COPD. A randomized controlled trial was conducted to investigate an 8-week mindful meditation intervention program tailored for the COPD population and explore the use of breathing timing parameters as a possible physiological measure of meditation uptake. Results demonstrated that those randomized to the mindful meditation intervention group (N=19) had a significant increase in respiratory rate over time as compared to those randomized to the wait-list group (N=22) (P=0.045). It was also found that the mindful meditation intervention group demonstrated a significant decrease in level of mindfulness over time as compared to the wait-list group (P=0.023). When examining participants from the mindful meditation intervention who had completed six or more classes, it was found that respiratory rate did not significantly increase in comparison to the wait-list group. Furthermore, those who completed six or more classes (N=12) demonstrated significant improvement in emotional function in comparison to the wait-list group (P=0.032) even though their level of mindfulness did not improve. This study identifies that there may be a complex relationship between breathing parameters, emotion, and mindfulness in the COPD population. The results describe good feasibility and acceptability for meditation interventions in the COPD population. PMID:25767382

19. Randomized Controlled Trial of a Neurosteroid Intervention in Schizophrenia

PubMed Central

Marx, Chris; Naylor, Jennifer; Kilts, Jason; Allan, Trina; Smith, Karen; Szabo, Steven; Wagner, Ryan; Buchanan, Robert; Keefe, Richard; Shampine, Lawrence

2017-01-01

Abstract Background: Neurosteroids are endogenous molecules synthesized de novo in brain, adrenals, and other tissues. They demonstrate pleiotropic actions that are highly relevant to the neurobiology of schizophrenia. Clozapine markedly elevates neurosteroids in rodent hippocampus, potentially contributing to its superior therapeutic efficacy. Clinical evidence from a randomized controlled trial (RCT) conducted in Singapore suggests that pregnenolone significantly enhances functional capacity (as demonstrated by improvements in the UPSA Total Score and UPSA Communication Subscale Score) and that neurosteroid changes posttreatment predict therapeutic response (Marx et al 2014; Psychopharmacology). We thus conducted an RCT investigating adjunctive pregnenolone in schizophrenia. Methods: After a 2-week placebo lead-in, 88 participants with schizophrenia were randomized to pregnenolone (n = 42) or placebo (n = 46) for 8 weeks. Neurosteroids were quantified at baseline and posttreatment by mass spectrometry. Functional end points included the UPSA Total Score and UPSA Communication Subscale. Cognitive end points included the MCCB Composite Score and MCCB Subscales. Modified intent-to-treat analyses were conducted. Results: Participants randomized to the pregnenolone group did not outperform placebo on the UPSA Total Score or MCCB Composite Score. However, the pregnenolone group demonstrated significantly greater improvement in the UPSA Communication Subscale compared to participants randomized to placebo (P = .034), replicating prior RCT findings from Singapore. Elevations in pregnenolone post-treatment also predicted improvements in UPSA Total Score (r = .373; P = .039), again replicating prior efforts. In addition, the pregnenolone group demonstrated significantly greater improvement in the MCCB Verbal Learning Subscale compared to placebo (P = .023). Pregnenolone did not outperform placebo in the BACS Composite Score, SANS Total Score, or PANSS Total Score. Pregnenolone was well tolerated. Conclusion: Treatment with pregnenolone appears to improve functional capacity in a US population with schizophrenia, as assessed by the UPSA Communication Subscale and also supported by a significant positive correlation between pregnenolone changes and UPSA Total Score improvements—thus replicating findings from a prior RCT conducted in Singapore. Pregnenolone may also improve verbal memory. Given the positive correlation between pregnenolone increases posttreatment and UPSA Total Score improvements, it is possible that higher doses of pregnenolone may be clinically efficacious, and that neurosteroid quantification has biomarker potential for the predication of therapeutic response. Additional dose-finding investigations will be required to test these hypotheses. A pregnenolone decanoate formulation is currently in preclinical development.

Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment: results from a 2-year follow-up study.

PubMed

Davis, Seth N P; Bergeron, Sophie; Binik, Yitzchak M; Lambert, Bernard

2013-12-01

Provoked vestibulodynia (PVD) is a prevalent genital pain syndrome that has been assumed to be chronic, with little spontaneous remission. Despite this assumption, there is a dearth of empirical evidence regarding the progression of PVD in a natural setting. Although many treatments are available, there is no single treatment that has demonstrated efficacy above others. The aims of this secondary analysis of a prospective study were to (i) assess changes over a 2-year period in pain, depressive symptoms, and sexual outcomes in women with PVD; and (ii) examine changes based on treatment(s) type. Participants completed questionnaire packages at Time 1 and a follow-up package 2 years later. Visual analog scale of genital pain, Global Measure of Sexual Satisfaction, Female Sexual Function Index, Beck Depression Inventory, Dyadic Adjustment Scale, and sexual intercourse attempts over the past month. Two hundred thirty-nine women with PVD completed both time one and two questionnaires. For the sample as a whole, there was significant improvement over 2 years on pain ratings, sexual satisfaction, sexual function, and depressive symptoms. The most commonly received treatments were physical therapy, sex/psychotherapy, and medical treatment, although 41.0% did not undergo any treatment. Women receiving no treatment also improved significantly on pain ratings. No single treatment type predicted better outcome for any variable except depressive symptoms, in which women who underwent surgery were more likely to improve. These results suggest that PVD may significantly reduce in severity over time. Participants demonstrated clinically significant pain improvement, even when they did not receive treatment. Furthermore, the only single treatment type predicting better outcomes was surgery, and only for depressive symptoms, accounting for only 2.3% of the variance. These data do not demonstrate the superiority of any one treatment and underscore the need to have control groups in PVD treatment trials, otherwise improvements may simply be the result of natural progression. © 2013 International Society for Sexual Medicine.

The Effectiveness of Teachers' Use of Demonstrations for Enhancing Students' Understanding of and Attitudes to Learning the Oxidation-Reduction Concept

ERIC Educational Resources Information Center

Basheer, Ahmad; Hugerat, Muhamad; Kortam, Naji; Hofstein, Avi

2017-01-01

In this study we explored whether the use of teachers' demonstrations significantly improves students' understanding of redox reactions compared with control group counterparts who were not exposed to the demonstrations. The sample consisted of 131 Israeli 8th graders in middle schools (junior high school). Students' attitudes and achievements as…

The Langley Wind Tunnel Enterprise

NASA Technical Reports Server (NTRS)

Paulson, John W., Jr.; Kumar, Ajay; Kegelman, Jerome T.

1998-01-01

After 4 years of existence, the Langley WTE is alive and growing. Significant improvements in the operation of wind tunnels have been demonstrated and substantial further improvements are expected when we are able to truly address and integrate all the processes affecting the wind tunnel testing cycle.

Strength training for a child with suspected developmental coordination disorder.

PubMed

Menz, Stacy M; Hatten, Kristin; Grant-Beuttler, Marybeth

2013-01-01

Children with developmental coordination disorder (DCD) demonstrate difficulty with feedforward motor control and use varied compensatory strategies. To examine gross motor function changes following strength training in a child with motor control difficulties. A girl aged 6 years 11 months, with apraxia and hypotonia, and demonstrating motor delays consistent with DCD. Twenty-four strength training sessions were completed using a universal exercise unit. Postintervention scores significantly improved on the Bruininks-Oseretsky test of motor proficiency, second edition, and the Canadian occupational performance measure scores and raised the developmental coordination disorder questionnaire, revised 2007, scores above the range where DCD is suspected. Nonsignificant changes in strength were observed. Improved function and significant gains in manual coordination were observed following blocked practice of isolated, simple joint movements during strength training. Improved motor skills may be because of effective use of feedforward control and improved stabilization. Strength training does not rehearse skills using momentum, explaining nonsignificant changes in locomotor or locomotion areas.

Electrokinetic stringency control in self-assembled monolayer-based biosensors for multiplex urinary tract infection diagnosis.

PubMed

Liu, Tingting; Sin, Mandy L Y; Pyne, Jeff D; Gau, Vincent; Liao, Joseph C; Wong, Pak Kin

2014-01-01

Rapid detection of bacterial pathogens is critical toward judicious management of infectious diseases. Herein, we demonstrate an in situ electrokinetic stringency control approach for a self-assembled monolayer-based electrochemical biosensor toward urinary tract infection diagnosis. The in situ electrokinetic stringency control technique generates Joule heating induced temperature rise and electrothermal fluid motion directly on the sensor to improve its performance for detecting bacterial 16S rRNA, a phylogenetic biomarker. The dependence of the hybridization efficiency reveals that in situ electrokinetic stringency control is capable of discriminating single-base mismatches. With electrokinetic stringency control, the background noise due to the matrix effects of clinical urine samples can be reduced by 60%. The applicability of the system is demonstrated by multiplex detection of three uropathogenic clinical isolates with similar 16S rRNA sequences. The results demonstrate that electrokinetic stringency control can significantly improve the signal-to-noise ratio of the biosensor for multiplex urinary tract infection diagnosis. Urinary tract infections remain a significant cause of mortality and morbidity as secondary conditions often related to chronic diseases or to immunosuppression. Rapid and sensitive identification of the causative organisms is critical in the appropriate management of this condition. These investigators demonstrate an in situ electrokinetic stringency control approach for a self-assembled monolayer-based electrochemical biosensor toward urinary tract infection diagnosis, establishing that such an approach significantly improves the biosensor's signal-to-noise ratio. © 2013.

Neuromuscular electrical stimulation of the cricothyroid muscle in patients with suspected superior laryngeal nerve weakness.

PubMed

Guzman, Marco; Rubin, Adam; Cox, Paul; Landini, Fernando; Jackson-Menaldi, Cristina

2014-03-01

In this retrospective case study, we report the apparent clinical effectiveness of neuromuscular electrical stimulation (NMES) in combination with voice therapy (VT) for rehabilitating dysphonia secondary to suspected superior laryngeal nerve (SLN) weakness in two female patients. Both patients failed or plateaued with traditional VT but had significant improvement with the addition of NMES of the cricothyroid muscle and SLN using a VitalStim unit. Stimulation was provided simultaneously with voice exercises based on musical phonatory tasks. Both acoustic analysis and endoscopic evaluation demonstrated important improvements after treatment. In the first patient, the major change was obtained within the primo passaggio region; specifically, a decrease in voice breaks was demonstrated. In the second patient, an improvement in voice quality (less breathiness) and vocal range were the most important findings. Additionally, each patient reported a significant improvement in their voice complaints. Neuromuscular laryngeal electrical stimulation in combination with vocal exercises might be a useful tool to improve voice quality in patients with SLN injury. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Investigation of the potential for direct compaction of a fine ibuprofen powder dry-coated with magnesium stearate.

PubMed

Qu, Li; Zhou, Qi Tony; Gengenbach, Thomas; Denman, John A; Stewart, Peter J; Hapgood, Karen P; Gamlen, Michael; Morton, David A V

2015-05-01

Intensive dry powder coating (mechanofusion) with tablet lubricants has previously been shown to give substantial powder flow improvement. This study explores whether the mechanofusion of magnesium stearate (MgSt), on a fine drug powder can substantially improve flow, without preventing the powder from being directly compacted into tablets. A fine ibuprofen powder, which is both cohesive and possesses a low-melting point, was dry coated via mechanofusion with between 0.1% and 5% (w/w) MgSt. Traditional low-shear blending was also employed as a comparison. No significant difference in particle size or shape was measured following mechanofusion. For the low-shear blended powders, only marginal improvement in flowability was obtained. However, after mechanofusion, substantial improvements in the flow properties were demonstrated. Both XPS and ToF-SIMS demonstrated high degrees of a nano-scale coating coverage of MgSt on the particle surfaces from optimized mechanofusion. The study showed that robust tablets were produced from the selected mechanofused powders, at high-dose concentration and tablet tensile strength was further optimized via addition of a Polyvinylpyrrolidone (PVP) binder (10% w/w). The tablets with the mechanofused powder (with or without PVP) also exhibited significantly lower ejection stress than those made of the raw powder, demonstrating good lubrication. Surprisingly, the release rate of drug from the tablets made with the mechanofused powder was not retarded. This is the first study to demonstrate such a single-step dry coating of model drug with MgSt, with promising flow improvement, flow-aid and lubrication effects, tabletability and also non-inhibited dissolution rate.

Case Comparison of Response To Aquatic Exercise: Acute versus Chronic Conditions.

ERIC Educational Resources Information Center

Mobily, Kenneth E.; Mobily, Paula R.; Lessard, Kerry A.; Berkenpas, Molly S.

2000-01-01

Describes the effects of individualized aquatic exercise programs on people with knee impairments. An adolescent athlete with an acute injury demonstrated significant functional improvement. A 33-year-old with arthritis demonstrated only marginal progress. Comparison of cases relative to valid data collection methods and response to aquatic…

Assessment of the efficacy of second life, a virtual learning environment, in dental education.

PubMed

El Tantawi, Maha M A; El Kashlan, Mona K; Saeed, Yasmin M

2013-12-01

This study assessed the efficacy of Second Life (SL) in delivering lectures and demonstrating clinical procedures. Sixteen students in a dental school in Alexandria, Egypt, volunteered to participate in SL to learn about topical fluoride through lectures and YouTube videos demonstrating the application of fluoride gel. This was followed by face to face (F2F) sessions about pits and fissures sealant including lectures and F2F demonstration. Knowledge improvement was assessed by pre- and posttests; practical skills were assessed by a checklist; and percent scores were calculated. The relation between these scores and some background variables was assessed. Students' satisfaction with and perceptions of SL were also assessed. Knowledge improved significantly after both SL and F2F experiences (p<0.0001 for both). There were no significant differences between SL and F2F in knowledge improvement or skills percent scores (p=0.16 and 0.26, respectively). Knowledge improvement was significantly related to previous experience with SL and previous year grade (p=0.02 and 0.007, respectively) but not to gender. Practical skills scores were not related to any of these three variables. Satisfaction with SL experience was high and not affected by any of the three variables, and the experience was perceived positively. This study suggests that SL can complement traditional F2F teaching, especially for underachieving students and in higher education institutions with problems of increasing numbers of students and limited space.

Enhancement of Electrical Properties of Nanostructured Polysilicon Layers Through Hydrogen Passivation.

PubMed

Zhou, D; Xu, T; Lambert, Y; Cristini-Robbe; Stiévenard, D

2015-12-01

The light absorption of polysilicon planar junctions can be improved using nanostructured top surfaces due to their enhanced light harvesting properties. Nevertheless, associated with the higher surface, the roughness caused by plasma etching and defects located at the grain boundary in polysilicon, the concentration of the recombination centers increases, leading to electrical performance deterioration. In this work, we demonstrate that wet oxidation combined with hydrogen passivation using SiN(x):H are the key technological processes to significantly decrease the surface recombination and improve the electrical properties of nanostructured n(+)-i-p junctions. Nanostructured surface is fabricated by nanosphere lithography in a low-cost and controllable approach. Furthermore, it has been demonstrated that the successive annealing of silicon nitride films has significant effect on the passivation quality, resulting in some improvements on the efficiency of the Si nanostructure-based solar cell device.

Reynolds averaged turbulence modelling using deep neural networks with embedded invariance

DOE PAGES

Ling, Julia; Kurzawski, Andrew; Templeton, Jeremy

2016-10-18

There exists significant demand for improved Reynolds-averaged Navier–Stokes (RANS) turbulence models that are informed by and can represent a richer set of turbulence physics. This paper presents a method of using deep neural networks to learn a model for the Reynolds stress anisotropy tensor from high-fidelity simulation data. A novel neural network architecture is proposed which uses a multiplicative layer with an invariant tensor basis to embed Galilean invariance into the predicted anisotropy tensor. It is demonstrated that this neural network architecture provides improved prediction accuracy compared with a generic neural network architecture that does not embed this invariance property.more » Furthermore, the Reynolds stress anisotropy predictions of this invariant neural network are propagated through to the velocity field for two test cases. For both test cases, significant improvement versus baseline RANS linear eddy viscosity and nonlinear eddy viscosity models is demonstrated.« less

Reynolds averaged turbulence modelling using deep neural networks with embedded invariance

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

Ling, Julia; Kurzawski, Andrew; Templeton, Jeremy

There exists significant demand for improved Reynolds-averaged Navier–Stokes (RANS) turbulence models that are informed by and can represent a richer set of turbulence physics. This paper presents a method of using deep neural networks to learn a model for the Reynolds stress anisotropy tensor from high-fidelity simulation data. A novel neural network architecture is proposed which uses a multiplicative layer with an invariant tensor basis to embed Galilean invariance into the predicted anisotropy tensor. It is demonstrated that this neural network architecture provides improved prediction accuracy compared with a generic neural network architecture that does not embed this invariance property.more » Furthermore, the Reynolds stress anisotropy predictions of this invariant neural network are propagated through to the velocity field for two test cases. For both test cases, significant improvement versus baseline RANS linear eddy viscosity and nonlinear eddy viscosity models is demonstrated.« less

Learning to re-appraise the self during video feedback for social anxiety: Does depth of processing matter?

PubMed

Orr, Elizabeth M J; Moscovitch, David A

2010-08-01

Video feedback (VF) with cognitive preparation (CP) has been widely integrated into cognitive-behavioral therapy (CBT) protocols for social anxiety disorder (SAD) due to its presumed efficacy in improving negative self-perception. However, previous experimental studies have demonstrated that improvements in negative self-perception via VF+CP do not typically facilitate anxiety reduction during subsequent social interactions - a troubling finding for proponents of cognitive models of social anxiety. We examined whether VF+CP could be optimized to enhance participants' processing of corrective self-related information through the addition of a post-VF cognitive review (CR). Sixty-eight socially anxious individuals were randomly assigned to perform two public speeches in one of the following conditions: a) exposure alone (EXP); b) CP+VF; and c) CP+VF+CR. Those in the CP+VF+CR condition demonstrated marginally significant reductions in anxiety from speech 1 to speech 2 relative to those who received EXP - an improvement not shown for those in the CP+VF condition. Furthermore, only those who received CP+VF+CR demonstrated significant improvements in self-perception and performance expectations relative to EXP. Decreases in anxiety among participants who received CP+VF+CR relative to EXP were fully mediated by improvements in self-perception. Implications are discussed in the context of cognitive models of social anxiety and mechanisms of exposure-based learning. Copyright 2010 Elsevier Ltd. All rights reserved.

Testimony psychotherapy in Bosnian refugees: a pilot study.

PubMed

Weine, S M; Kulenovic, A D; Pavkovic, I; Gibbons, R

1998-12-01

The authors sought to describe the use of the testimony method of psychotherapy in a group of traumatized adult refugees from genocide in Bosnia-Herzegovina. The subjects were 20 Bosnian refugees in Chicago who gave written informed consent to participate in a case series study of testimony psychotherapy. All subjects received testimony psychotherapy, averaging six sessions, approximately 90 minutes, weekly or biweekly. Subjects received standardized instruments for posttraumatic stress disorder (PTSD), depression, traumatic events, global functioning, and prior psychiatric history. The instruments were administered before treatment, at the conclusion of the treatment, and at the 2- and 6-month follow-ups. The posttreatment assessments demonstrated significant decreases in the rate of PTSD diagnosis, PTSD symptom severity, and the severity of reexperiencing, avoidance, and hyperarousal symptom clusters. Depressive symptoms demonstrated a significant decrease, and there was a significant increase in scores on the Global Assessment of Functioning Scale. Two-month and 6-month follow-up assessments demonstrated further significant decreases in all symptoms and an increase in scores on the Global Assessment of Functioning Scale. This pilot study provides preliminary evidence that testimony psychotherapy may lead to improvements in PTSD and depressive symptoms, as well as to improvement of functioning, in survivors of state-sponsored violence.

Jet engine applications for materials with nanometer-scale dimensions

NASA Technical Reports Server (NTRS)

Appleby, J. W., Jr.

1995-01-01

The performance of advanced military and commercial gas turbine engines is often linked to advances in materials technology. High performance gas turbine engines being developed require major material advances in strength, toughness, reduced density and improved temperature capability. The emerging technology of nanostructured materials has enormous potential for producing materials with significant improvements in these properties. Extraordinary properties demonstrated in the laboratory include material strengths approaching theoretical limit, ceramics that demonstrate ductility and toughness, and materials with ultra-high hardness. Nanostructured materials and coatings have the potential for meeting future gas turbine engine requirements for improved performance, reduced weight and lower fuel consumption.

Jet engine applications for materials with nanometer-scale dimensions

NASA Technical Reports Server (NTRS)

Appleby, J. W., Jr.

1995-01-01

The performance of advanced military and commercial gas turbine engines is often linked to advances in materials technology. High performance gas turbine engines being developed require major material advances in strength, toughness, reduced density and improved temperature capability. The emerging technology of nanostructured materials has enormous potential for producing materials with significant improvements in these properties. Extraordinary properties demonstrated in the laboratory include material strengths approaching theoretical limit, ceramics that demonstrate ductility and toughness, and material with ultra-high hardness. Nanostructured materials and coatings have the potential for meeting future gas turbine engine requirements for improved performance, reduced weight and lower fuel consumption.

ALA Pretreatment Improves Waterlogging Tolerance of Fig Plants

PubMed Central

An, Yuyan; Qi, Lin; Wang, Liangju

2016-01-01

5-aminolevulinic acid (ALA), a natural and environmentally friendly plant growth regulator, can improve plant tolerance to various environmental stresses. However, whether ALA can improve plant waterlogging tolerance is unknown. Here, we investigated the effects of ALA pretreatment on the waterlogging-induced damage of fig (Ficus carica Linn.) plants, which often suffer from waterlogging stress. ALA pretreatment significantly alleviated stress-induced morphological damage, increased leaf relative water content (RWC), and reduced leaf superoxide anion (O2⋅¯) production rate and malonaldehyde (MDA) content in fig leaves, indicating ALA mitigates waterlogging stress of fig plants. We further demonstrated that ALA pretreatment largely promoted leaf chlorophyll content, photosynthetic electron transfer ability, and photosynthetic performance index, indicating ALA significantly improves plant photosynthetic efficiency under waterlogging stress. Moreover, ALA pretreatment significantly increased activities of leaf superoxide dismutase (SOD) and peroxidase (POD), root vigor, and activities of root alcohol dehydrogenase (ADH), and lactate dehydrogenase (LDH), indicating ALA also significantly improves antioxidant ability and root function of fig plants under waterlogging stress. Taken together, ALA pretreatment improves waterlogging tolerance of fig plants significantly, and the promoted root respiration, leaf photosynthesis, and antioxidant ability may contribute greatly to this improvement. Our data firstly shows that ALA can improve plant waterlogging tolerance. PMID:26789407

Outcomes of rotigotine clinical trials: effects on motor and nonmotor symptoms of Parkinson's disease.

PubMed

Lyons, Kelly E; Pahwa, Rajesh

2013-08-01

Rotigotine transdermal system is a nonergot, 24-hour dopamine agonist approved for the treatment of early and advanced Parkinson's disease (PD). Recent studies have demonstrated significant improvements with rotigotine in motor function in early PD and significant improvements in daily off-time and motor function in advanced PD. In addition to motor improvements, nonmotor symptoms have been shown to be improved with rotigotine in both early and advanced PD. Rotigotine has been shown in large, controlled studies to be safe and efficacious for the treatment of motor and some nonmotor symptoms of early and advanced PD. Copyright © 2013 Elsevier Inc. All rights reserved.

Assessing Demographic Differences in Patient-Perceived Improvement in Facial Appearance and Quality of Life Following Rhinoplasty

PubMed Central

Schwitzer, Jonathan A.; Albino, Frank P.; Mathis, Ryan K.; Scott, Amie M.; Gamble, Laurie; Baker, Stephen B.

2015-01-01

Background As rhinoplasty patient demographics evolve, surgeons must consider the impact of demographics on patient satisfaction. Objectives The objective of this study was to identify independent demographic predictors of differences in satisfaction with appearance and quality of life following rhinoplasty utilizing the FACE-Q patient-reported outcome instrument. Methods Patients presenting for rhinoplasty completed the following FACE-Q scales: Satisfaction with Facial Appearance, Satisfaction with Nose, Social Function, and Psychological Well-being. Higher FACE-Q scores indicate greater satisfaction with appearance or superior quality of life. Pre- and post-treatment scores were compared in the context of patient demographics. Results The scales were completed by 59 patients. Women demonstrated statistically significant improvements in Satisfaction with Facial Appearance and quality of life while men only experienced significant improvement in Satisfaction with Facial appearance. Caucasians demonstrated statistically significant improvement in Satisfaction with Facial Appearance and quality of life while non-Caucasians did not. Patients younger than 35 years old were more likely to experience enhanced Satisfaction with Facial Appearance and quality of life compared with patients older than 35 years old. Patients with income ≥$100,000 were more likely to experience significant increases in Satisfaction with Facial Appearance and quality of life than patients with incomes <$100,000. Conclusions In an objective study using a validated patient-reported outcome instrument, the authors were able to quantify differences in the clinically meaningful change in perception of appearance and quality of life that rhinoplasty patients gain based on demographic variables. The authors also demonstrated that these variables are potential predictors of differences in satisfaction. Level of Evidence 3 Therapeutic PMID:26063837

Assessing Demographic Differences in Patient-Perceived Improvement in Facial Appearance and Quality of Life Following Rhinoplasty.

PubMed

Schwitzer, Jonathan A; Albino, Frank P; Mathis, Ryan K; Scott, Amie M; Gamble, Laurie; Baker, Stephen B

2015-09-01

As rhinoplasty patient demographics evolve, surgeons must consider the impact of demographics on patient satisfaction. The objective of this study was to identify independent demographic predictors of differences in satisfaction with appearance and quality of life following rhinoplasty utilizing the FACE-Q patient-reported outcome instrument. Patients presenting for rhinoplasty completed the following FACE-Q scales: Satisfaction with Facial Appearance, Satisfaction with Nose, Social Function, and Psychological Well-being. Higher FACE-Q scores indicate greater satisfaction with appearance or superior quality of life. Pre- and post-treatment scores were compared in the context of patient demographics. The scales were completed by 59 patients. Women demonstrated statistically significant improvements in Satisfaction with Facial Appearance and quality of life while men only experienced significant improvement in Satisfaction with Facial appearance. Caucasians demonstrated statistically significant improvement in Satisfaction with Facial Appearance and quality of life while non-Caucasians did not. Patients younger than 35 years old were more likely to experience enhanced Satisfaction with Facial Appearance and quality of life compared with patients older than 35 years old. Patients with income ≥$100,000 were more likely to experience significant increases in Satisfaction with Facial Appearance and quality of life than patients with incomes <$100,000. In an objective study using a validated patient-reported outcome instrument, the authors were able to quantify differences in the clinically meaningful change in perception of appearance and quality of life that rhinoplasty patients gain based on demographic variables. The authors also demonstrated that these variables are potential predictors of differences in satisfaction. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Influence of learning style on instructional multimedia effects on graduate student cognitive and psychomotor performance.

PubMed

Smith, A Russell; Cavanaugh, Catherine; Jones, Joyce; Venn, John; Wilson, William

2006-01-01

Learning outcomes may improve in graduate healthcare students when attention is given to individual learning styles. Interactive multimedia is one tool shown to increase success in meeting the needs of diverse learners. The purpose of this study was to examine the effect of learning style and type of instruction on physical therapy students' cognitive and psychomotor performance. Participants were obtained by a sample of convenience with students recruited from two physical therapy programs. Twenty-seven students volunteered to participate from Program 1. Twenty-three students volunteered to participate from Program 2. Gregorc learning styles were identified through completion of the Gregorc Style Delineator. Students were randomly assigned to one of two instructional strategies: 1) instructional CD or 2) live demonstration. Differences in cognitive or psychomotor performance following instructional multimedia based on learning style were not demonstrated in this study. Written examination scores improved with both instructional strategies demonstrating no differences between the strategies. Practical examination ankle scores were significantly higher in participants receiving CD instruction than in participants receiving live presentation. Learning style did not significantly affect this improvement. Program 2 performed significantly better on written knee and practical knee and ankle examinations. Learning style had no significant effect on student performance following instruction in clinical skills via interactive multimedia. Future research may include additional measurement instruments assessing other models of learning styles and possible interaction of learning style and instructional strategy on students over longer periods of time, such as a semester or an entire curriculum.

76 FR 35864 - Proposed Priority; Special Demonstration Programs-National Technical Assistance Projects To...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

... have national significance and improve the performance of State vocational rehabilitation (VR) agencies... that State VR agencies and their partners, need national TA opportunities to improve program management and to keep informed about current effective and promising practices and research in the field of VR...

76 FR 50474 - Special Demonstration Programs-National Technical Assistance Projects To Improve Employment...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... its vocational rehabilitation (VR) programs. We intend the priority to increase the transfer... the field of rehabilitation that have national significance and to improve the performance of State VR... Technical Assistance and Continuing Education (TACE) centers, and State VR agencies. For example, the...

Historical return on investment and improved quality resulting from development and mining of a hospital laboratory relational database.

PubMed

Brimhall, Bradley B; Hall, Timothy E; Walczak, Steven

2006-01-01

A hospital laboratory relational database, developed over eight years, has demonstrated significant cost savings and a substantial financial return on investment (ROI). In addition, the database has been used to measurably improve laboratory operations and the quality of patient care.

Work Life Improvements for Home Care Workers: Impact and Feasibility.

ERIC Educational Resources Information Center

Feldman, Penny Hollander

1993-01-01

Evaluated four work life demonstration projects designed to upgrade home aide employment, reduce turnover, and increase continuity of care. Found that projects reduced worker turnover in experimental groups from 10 to 44 percentage points. Where it was measured, continuity of care also significantly improved. Local political, economic, and…

Eagle-Picher Industries Sodium Sulfur Program

NASA Technical Reports Server (NTRS)

Silvey, Ronald L.

1993-01-01

Viewgraphs of the sodium sulfur program are presented. Sodium sulfur low earth orbit (LEO) cells are described. Topics covered include cell sizes, areas of improvement, and NaS cell testing. Sodium sulfur cell and battery designs continue to evolve with significant improvement demonstrated in resistance, rechargeability, cycle life, energy density, and electrolyte characterization.

Improving education for the management of contrast reactions: an online didactic model.

PubMed

Niell, Bethany L; Vartanians, Vartan M; Halpern, Elkan P

2014-02-01

Radiologists could improve their knowledge of contrast reaction management. The aim of this study was to evaluate to what degree the implementation of a didactic module resulted in improved technologist, nurse, and physician knowledge and comfort levels regarding the appropriate management of adverse reactions to contrast media. After institutional review board approval was obtained, nurses, technologists, and physicians involved in contrast administration were required to complete the educational module. Premodule and postmodule assessments were designed online. Each assessment included knowledge-based questions regarding the appropriate management of different types of contrast reactions, as well as questions regarding each respondent's comfort level with the treatment of various types of adverse contrast reactions. Comfort level was measured using a 6-point, Likert-type scale. Premodule and postmodule assessment scores were compared using McNemar's test. After module completion, physicians demonstrated a statistically significant improvement in knowledge regarding the proper administration route, concentration, and dose of intramuscular epinephrine. Physicians demonstrated significantly increased comfort with the administration of intramuscular epinephrine to adult and pediatric patients after module completion (P < .05). Module completion resulted in statistically significant improvements in respondents' comfort levels with the treatment of an adverse reaction to contrast media, although 19% of personnel still reported feeling uncomfortable after completing the module. Didactic instruction in contrast reaction management results in improved knowledge and comfort levels for physicians, nurses, and technologists. However, a significant percentage of personnel still reported feeling uncomfortable treating an adverse contrast reaction after module completion, suggesting that didactic instruction alone may be inadequate. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation

PubMed Central

Tavakoli, Mitra; Mitu-Pretorian, Maria; Petropoulos, Ioannis N.; Fadavi, Hassan; Asghar, Omar; Alam, Uazman; Ponirakis, Georgios; Jeziorska, Maria; Marshall, Andy; Efron, Nathan; Boulton, Andrew J.; Augustine, Titus; Malik, Rayaz A.

2013-01-01

Diabetic neuropathy is associated with increased morbidity and mortality. To date, limited data in subjects with impaired glucose tolerance and diabetes demonstrate nerve fiber repair after intervention. This may reflect a lack of efficacy of the interventions but may also reflect difficulty of the tests currently deployed to adequately assess nerve fiber repair, particularly in short-term studies. Corneal confocal microscopy (CCM) represents a novel noninvasive means to quantify nerve fiber damage and repair. Fifteen type 1 diabetic patients undergoing simultaneous pancreas–kidney transplantation (SPK) underwent detailed assessment of neurologic deficits, quantitative sensory testing (QST), electrophysiology, skin biopsy, corneal sensitivity, and CCM at baseline and at 6 and 12 months after successful SPK. At baseline, diabetic patients had a significant neuropathy compared with control subjects. After successful SPK there was no significant change in neurologic impairment, neurophysiology, QST, corneal sensitivity, and intraepidermal nerve fiber density (IENFD). However, CCM demonstrated significant improvements in corneal nerve fiber density, branch density, and length at 12 months. Normalization of glycemia after SPK shows no significant improvement in neuropathy assessed by the neurologic deficits, QST, electrophysiology, and IENFD. However, CCM shows a significant improvement in nerve morphology, providing a novel noninvasive means to establish early nerve repair that is missed by currently advocated assessment techniques. PMID:23002037

A novel redox-active metalloporphyrin reduces reactive oxygen species and inflammatory markers but does not improve marginal mass engraftment in a murine donation after circulatory death islet transplantation model

PubMed Central

Bruni, Antonio; Pepper, Andrew R.; Gala-Lopez, Boris; Pawlick, Rena; Abualhassan, Nasser; Crapo, James D.; Piganelli, Jon D.; Shapiro, A. M. James

2016-01-01

ABSTRACT Islet transplantation is a highly effective treatment for stabilizing glycemic control for select patients with type-1 diabetes. Despite improvements to clinical transplantation, single-donor transplant success has been hard to achieve routinely, necessitating increasing demands on viable organ availability. Donation after circulatory death (DCD) may be an alternative option to increase organ availability however, these organs tend to be more compromised. The use of metalloporphyrin anti-inflammatory and antioxidant (MnP) compounds previously demonstrated improved in vivo islet function in preclinical islet transplantation. However, the administration of MnP (BMX-001) in a DCD islet isolation and transplantation model has yet to be established. In this study, murine donors were subjected to a 15-min warm ischemic (WI) period prior to isolation and culture with or without MnP. Subsequent to one-hour culture, islets were assessed for in vitro viability and in vivo function. A 15-minute WI period significantly reduced islet yield, regardless of MnP-treatment relative to yields from standard isolation. MnP-treated islets did not improve islet viability compared to DCD islets alone. MnP-treatment did significantly reduce the presence of extracellular reactive oxygen species (ROS) (p < 0 .05). Marginal, syngeneic islets (200 islets) transplanted under the renal capsule exhibited similar in vivo outcomes regardless of WI or MnP-treatment. DCD islet grafts harvested 7 d post-transplant exhibited sustained TNF-α and IL-10, while MnP-treated islet-bearing grafts demonstrated reduced IL-10 levels. Taken together, 15-minute WI in murine islet isolation significantly impairs islet yield. DCD islets do indeed demonstrate in vivo function, though MnP therapy was unable to improve viability and engraftment outcomes. PMID:27220256

A novel redox-active metalloporphyrin reduces reactive oxygen species and inflammatory markers but does not improve marginal mass engraftment in a murine donation after circulatory death islet transplantation model.

PubMed

Bruni, Antonio; Pepper, Andrew R; Gala-Lopez, Boris; Pawlick, Rena; Abualhassan, Nasser; Crapo, James D; Piganelli, Jon D; Shapiro, A M James

2016-07-03

Islet transplantation is a highly effective treatment for stabilizing glycemic control for select patients with type-1 diabetes. Despite improvements to clinical transplantation, single-donor transplant success has been hard to achieve routinely, necessitating increasing demands on viable organ availability. Donation after circulatory death (DCD) may be an alternative option to increase organ availability however, these organs tend to be more compromised. The use of metalloporphyrin anti-inflammatory and antioxidant (MnP) compounds previously demonstrated improved in vivo islet function in preclinical islet transplantation. However, the administration of MnP (BMX-001) in a DCD islet isolation and transplantation model has yet to be established. In this study, murine donors were subjected to a 15-min warm ischemic (WI) period prior to isolation and culture with or without MnP. Subsequent to one-hour culture, islets were assessed for in vitro viability and in vivo function. A 15-minute WI period significantly reduced islet yield, regardless of MnP-treatment relative to yields from standard isolation. MnP-treated islets did not improve islet viability compared to DCD islets alone. MnP-treatment did significantly reduce the presence of extracellular reactive oxygen species (ROS) (p < 0 .05). Marginal, syngeneic islets (200 islets) transplanted under the renal capsule exhibited similar in vivo outcomes regardless of WI or MnP-treatment. DCD islet grafts harvested 7 d post-transplant exhibited sustained TNF-α and IL-10, while MnP-treated islet-bearing grafts demonstrated reduced IL-10 levels. Taken together, 15-minute WI in murine islet isolation significantly impairs islet yield. DCD islets do indeed demonstrate in vivo function, though MnP therapy was unable to improve viability and engraftment outcomes.

Quality Improvement Initiatives in Inflammatory Bowel Disease.

PubMed

Berry, Sameer K; Siegel, Corey A; Melmed, Gil Y

2017-08-01

This article serves as an overview of several quality improvement initiatives in inflammatory bowel disease (IBD). IBD is associated with significant variation in care, suggesting poor quality of care. There have been several efforts to improve the quality of care for patients with IBD. Quality improvement (QI) initiatives in IBD are intended to be patient-centric, improve outcomes for individuals and populations, and reduce costs-all consistent with "the triple aim" put forth by the Institute for Healthcare Improvement (IHI). Current QI initiatives include the development of quality measure sets to standardize processes and outcomes, learning health systems to foster collaborative improvement, and patient-centered medical homes specific to patients with IBD in shared risk models of care. Some of these programs have demonstrated early success in improving patient outcomes, reducing costs, improving patient satisfaction, and facilitating patient engagement. However, further studies are needed to evaluate and compare the effects of these programs over time on clinical outcomes in order to demonstrate long-term value and sustainability.

Second-generation compound for the modulation of utrophin in the therapy of DMD

PubMed Central

Guiraud, Simon; Squire, Sarah E.; Edwards, Benjamin; Chen, Huijia; Burns, David T.; Shah, Nandini; Babbs, Arran; Davies, Stephen G.; Wynne, Graham M.; Russell, Angela J.; Elsey, David; Wilson, Francis X.; Tinsley, Jon M.; Davies, Kay E.

2015-01-01

Duchenne muscular dystrophy (DMD) is a lethal, X-linked muscle-wasting disease caused by lack of the cytoskeletal protein dystrophin. There is currently no cure for DMD although various promising approaches are progressing through human clinical trials. By pharmacologically modulating the expression of the dystrophin-related protein utrophin, we have previously demonstrated in dystrophin-deficient mdx studies, daily SMT C1100 treatment significantly reduced muscle degeneration leading to improved muscle function. This manuscript describes the significant disease modifying benefits associated with daily dosing of SMT022357, a second-generation compound in this drug series with improved physicochemical properties and a more robust metabolism profile. These studies in the mdx mouse demonstrate that oral administration of SMT022357 leads to increased utrophin expression in skeletal, respiratory and cardiac muscles. Significantly, utrophin expression is localized along the length of the muscle fibre, not just at the synapse, and is fibre-type independent, suggesting that drug treatment is modulating utrophin transcription in extra-synaptic myonuclei. This results in improved sarcolemmal stability and prevents dystrophic pathology through a significant reduction of regeneration, necrosis and fibrosis. All these improvements combine to protect the mdx muscle from contraction induced damage and enhance physiological function. This detailed evaluation of the SMT C1100 drug series strongly endorses the therapeutic potential of utrophin modulation as a disease modifying therapeutic strategy for all DMD patients irrespective of their dystrophin mutation. PMID:25935002

Co-registration of ultrasound and frequency-domain photoacoustic radar images and image improvement for tumor detection

NASA Astrophysics Data System (ADS)

Dovlo, Edem; Lashkari, Bahman; Choi, Sung soo Sean; Mandelis, Andreas

2015-03-01

This paper demonstrates the co-registration of ultrasound (US) and frequency domain photoacoustic radar (FD-PAR) images with significant image improvement from applying image normalization, filtering and amplification techniques. Achieving PA imaging functionality on a commercial Ultrasound instrument could accelerate clinical acceptance and use. Experimental results presented demonstrate live animal testing and show enhancements in signal-to-noise ratio (SNR), contrast and spatial resolution. The co-registered image produced from the US and phase PA images, provides more information than both images independently.

Neuromuscular training improves performance and lower-extremity biomechanics in female athletes.

PubMed

Myer, Gregory D; Ford, Kevin R; Palumbo, Joseph P; Hewett, Timothy E

2005-02-01

The purpose of this study was to examine the effects of a comprehensive neuromuscular training program on measures of performance and lower-extremity movement biomechanics in female athletes. The hypothesis was that significant improvements in measures of performance would be demonstrated concomitant with improved biomechanical measures related to anterior cruciate ligament injury risk. Forty-one female basketball, soccer, and volleyball players (age, 15.3 +/- 0.9 years; weight, 64.8 +/- 9.96 kg; height, 171.2 +/- 7.21 cm) underwent 6 weeks of training that included 4 main components (plyometric and movement, core strengthening and balance, resistance training, and speed training). Twelve age-, height-, and weight-matched controls underwent the same testing protocol twice 6 weeks apart. Trained athletes demonstrated increased predicted 1 repetition maximum squat (92%) and bench press (20%). Right and left single-leg hop distance increased 10.39 cm and 8.53 cm, respectively, and vertical jump also increased from 39.9 +/- 0.9 cm to 43.2 +/- 1.1 cm with training. Speed in a 9.1-m sprint improved from 1.80 +/- 0.02 seconds to 1.73 +/- 0.01 seconds. Pre- and posttest 3-dimensional motion analysis demonstrated increased knee flexion-extension range of motion during the landing phase of a vertical jump (right, 71.9 +/- 1.4 degrees to 76.9 +/- 1.4 degrees ; left, 71.3 +/- 1.5 degrees to 77.3 +/- 1.4 degrees ). Training decreased knee valgus (28%) and varus (38%) torques. Control subjects did not demonstrate significant alterations during the 6-week interval. The results of this study support the hypothesis that the combination of multiple-injury prevention-training components into a comprehensive program improves measures of performance and movement biomechanics.

Improved perception of music with a harmonic based algorithm for cochlear implants.

PubMed

Li, Xing; Nie, Kaibao; Imennov, Nikita S; Rubinstein, Jay T; Atlas, Les E

2013-07-01

The lack of fine structure information in conventional cochlear implant (CI) encoding strategies presumably contributes to the generally poor music perception with CIs. To improve CI users' music perception, a harmonic-single-sideband-encoder (HSSE) strategy was developed , which explicitly tracks the harmonics of a single musical source and transforms them into modulators conveying both amplitude and temporal fine structure cues to electrodes. To investigate its effectiveness, vocoder simulations of HSSE and the conventional continuous-interleaved-sampling (CIS) strategy were implemented. Using these vocoders, five normal-hearing subjects' melody and timbre recognition performance were evaluated: a significant benefit of HSSE to both melody (p < 0.002) and timbre (p < 0.026) recognition was found. Additionally, HSSE was acutely tested in eight CI subjects. On timbre recognition, a significant advantage of HSSE over the subjects' clinical strategy was demonstrated: the largest improvement was 35% and the mean 17% (p < 0.013). On melody recognition, two subjects showed 20% improvement with HSSE; however, the mean improvement of 7% across subjects was not significant (p > 0.090). To quantify the temporal cues delivered to the auditory nerve, the neural spike patterns evoked by HSSE and CIS for one melody stimulus were simulated using an auditory nerve model. Quantitative analysis demonstrated that HSSE can convey temporal pitch cues better than CIS. The results suggest that HSSE is a promising strategy to enhance music perception with CIs.

The effect of the national demonstration project Healthy Respect on teenage sexual health behaviour.

PubMed

Tucker, Janet S; Fitzmaurice, Ann E; Imamura, Mari; Penfold, Suzanne; Penney, Gillian C; Teijlingen, Edwin van; Shucksmith, Janet; Philip, Kate L

2007-02-01

As part of the independent evaluation of Healthy Respect (a national demonstration project to improve teenage sexual health in Scotland) this study examined the effect of the school-based sexual health education intervention comprising multiprofessional classroom delivery and alongside drop-in clinics on teenage sexual behaviour outcomes. Before-and-after cross-sectional surveys of secondary school pupils (average age 14 years and 6 months) were used in 10 Healthy Respect intervention schools in Lothian region and 5 comparison schools without intervention in Grampian region (2001 and 2003). By 2003, the proportion of pupils in Lothian feeling confident about getting condoms and using condoms properly significantly increased, more Lothian pupils (particularly boys) showed improved knowledge about condoms being protective against sexually transmitted infections. No further evidence of improved knowledge, attitudes, or intentions was evident after the intervention. Pupils in Lothian remained more likely to think using a condom would be embarrassing (especially girls), would reduce sexual enjoyment (especially boys), and intentions about condom use (as closer predictors of actual behaviour change) showed no significant improvement. More Lothian ( approximately 24%) than Grampian ( approximately 19%) pupils report having had sexual intercourse at age <16 years, both before and after the intervention, with no evidence of a significant reduction in Lothian by 2003. Overall differences in attitudes to condom use by gender were noted. Findings remain consistent in both unadjusted and adjusted comparisons. These findings demonstrate limited impact on sexual health behaviour outcomes, and raise questions about the likely and achievable sexual health gains for teenagers from school-based interventions.

Well-being, health, and productivity improvement after an employee well-being intervention in large retail distribution centers.

PubMed

Rajaratnam, Augustine S; Sears, Lindsay E; Shi, Yuyan; Coberley, Carter R; Pope, James E

2014-12-01

To evaluate changes in well-being, biometric, and productivity indicators after a well-being intervention. Biometric and self-reported outcomes were assessed among 677 retail distribution center employees before and after a 6-month well-being intervention. Despite lower well-being at baseline compared to an independent random sample of workers, program participants' well-being, productivity, body mass index, systolic blood pressure, and total cholesterol improved significantly after the intervention, whereas the decline in diastolic blood pressure was not significant. Moreover, participants' specific transition across well-being segments over the intervention period demonstrated more improvement than decline. There is evidence that programs designed to improve well-being within a workforce can be used to significantly and positively impact employee health and productivity, which should result in reduced health care costs, improved employee productivity, and increased overall profitability.

Utilization of Portable Radios to Improve Ophthalmology Clinic Efficiency in an Academic Setting.

PubMed

Davis, Alexander S; Elkeeb, Ahmed M; Vizzeri, Gianmarco; Godley, Bernard F

2016-03-01

Improvement in clinic efficiency in the ambulatory setting is often looked at as an area for development of lean management strategies to deliver a higher quality of healthcare while reducing errors, costs, and delays. To examine the benefits of improving team communication and its impact on clinic flow and efficiency, we describe a time-motion study performed in an academic outpatient Ophthalmology clinic and its objective and subjective results. Compared to clinic encounters without the use of the portable radios, objective data demonstrated an overall significant decreases in mean workup time (15.18 vs. 13.10), room wait (13.10 vs. 10.47), and decreased the total time needed with an MD per encounter (9.45 vs. 6.63). Subjectively, significant improvements were seen in careprovider scores for patient flow (60.78 vs. 84.29), getting assistance (61.89 vs. 88.57), moving patient charts (54.44 vs. 85.71), teamwork (69.56 vs. 91.0), communications (62.33 vs. 90.43), providing quality patient care (76.22 vs. 89.57), and receiving input on the ability to see walk-in patients (80.11 vs. 90.43). For academic purposes, an improvement in engagement in patient care and learning opportunities was noted by the clinic resident-in-training during the pilot study. Portable radios in our pilot study were preferred over the previous method of communication and demonstrates significant improvements in certain areas of clinical efficiency, subjective perception of teamwork and communications, and academic learning.

Computer-Based Enhancements for the Improvement of Learning.

ERIC Educational Resources Information Center

Tennyson, Robert D.

The third of four symposium papers argues that, if instructional methods are to improve learning, they must have two aspects: a direct trace to a specific learning process, and empirical support that demonstrates their significance. Focusing on the tracing process, the paper presents an information processing model of learning that can be used by…

Evaluation of a Pain Management Education Program and Operational Guideline on Nursing Practice, Attitudes, and Pain Management.

PubMed

Bonkowski, Sara L; De Gagne, Jennie C; Cade, Makia B; Bulla, Sally A

2018-04-01

Nurses lack adequate pain management knowledge, which can result in poorly managed postsurgical pain. This study aimed to develop, implement, and evaluate pain management education and operational guidelines to improve nursing knowledge and pain management. This quality improvement project employed convenience samples of surgical oncology nurses and postoperative patients. The intervention involved an online module, live education, and operational guideline for pain management. Nurses completed pre- and postintervention practice and attitudes surveys. Random chart reviews of intravenous narcotic administrations the day before discharge were completed to evaluate whether narcotic administration changed after intervention. Readmissions and Hospital Consumer Assessment of Healthcare Providers and Systems data were collected to determine whether the intervention influenced patient satisfaction. A statistically significant improvement in nursing practice and intravenous narcotic administrations demonstrated changes to pain management practices employed by the nursing staff. Although not statistically significant, fewer pain-related readmissions occurred postintervention. Findings demonstrate that targeted pain management continuing education, paired with operational guidelines, improves nursing practice and decreases intravenous narcotic administrations prior to discharge. J Contin Educ Nurs. 2018;49(4):178-185. Copyright 2018, SLACK Incorporated.

Factoring local sequence composition in motif significance analysis.

PubMed

Ng, Patrick; Keich, Uri

2008-01-01

We recently introduced a biologically realistic and reliable significance analysis of the output of a popular class of motif finders. In this paper we further improve our significance analysis by incorporating local base composition information. Relying on realistic biological data simulation, as well as on FDR analysis applied to real data, we show that our method is significantly better than the increasingly popular practice of using the normal approximation to estimate the significance of a finder's output. Finally we turn to leveraging our reliable significance analysis to improve the actual motif finding task. Specifically, endowing a variant of the Gibbs Sampler with our improved significance analysis we demonstrate that de novo finders can perform better than has been perceived. Significantly, our new variant outperforms all the finders reviewed in a recently published comprehensive analysis of the Harbison genome-wide binding location data. Interestingly, many of these finders incorporate additional information such as nucleosome positioning and the significance of binding data.

Significant effect of NSP-ase enzyme supplementation in sunflower meal-based diet on the growth and nutrient digestibility in broilers.

PubMed

Bilal, M; Mirza, M A; Kaleem, M; Saeed, M; Reyad-Ul-Ferdous, Md; Abd El-Hack, M E

2017-04-01

The response of broiler chickens to 3 levels of sunflower meal and 2 levels of NSP-ase enzyme combination (with and without) was investigated in 3 × 2 factorial arrangement under complete randomized design (CRD). A total of 240 Hubbard broiler chicks were fed on practical mash diets having 2950 kcal of ME and 21% CP from 1 to 42 days of age. The BW gain was not significantly reduced when 25% SFM was added in the diets during 1 to 42 days of age. Supplementation of NSP-ase in broiler diets (day 1-42 overall) demonstrated non-significant differences (p < 0.05) across the treatments in terms of FI and BWG. The difference in feed:gain at 15% or 20% SFM was observed to be non-significant. Replacement of SBM with SFM or inclusion of SFM at higher level (25%) increased/deteriorated FCR. The addition of exogenous NSP-ase showed a significant improvement (p < 0.01) in feed:gain. The improvement was clearly demonstrated when SFM was added to the experimental diet at 15% or even 20%. Supplementation of NSP-ase at the 25% inclusion level could not, however, sustain the beneficial effect, which was possibly due to excessively high dietary CF. No difference was noted across the treatments regarding carcass response. Relative gizzard weight and intestinal weight were observed to be improved in birds consuming higher levels of SFM (p = 0.00). The digestibility of CF was observed to improve when SFM was used at 20% and 25% in the diets. No improvement in the digestibility of CF was observed with NSP-ase supplementation, which meant other factors were clearly involved. Supplementation of NSP-ase improved FCR up to 20% SFM. At 25% SFM, no improvement in the digestibility of CF was observed with NSP-ase supplementation. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

CF6 jet engine performance improvement: High pressure turbine roundness

NASA Technical Reports Server (NTRS)

Howard, W. D.; Fasching, W. A.

1982-01-01

An improved high pressure turbine stator reducing fuel consumption in current CF6-50 turbofan engines was developed. The feasibility of the roundness and clearance response improvements was demonstrated. Application of these improvements will result in a cruise SFC reduction of 0.22 percent for new engines. For high time engines, the improved roundness and response characteristics results in an 0.5 percent reduction in cruise SFC. A basic life capability of the improved HP turbine stator in over 800 simulated flight cycles without any sign of significant distress is shown.

JT8D-15/17 High Pressure Turbine Root Discharged Blade Performance Improvement. [engine design

NASA Technical Reports Server (NTRS)

Janus, A. S.

1981-01-01

The JT8D high pressure turbine blade and seal were modified, using a more efficient blade cooling system, improved airfoil aerodynamics, more effective control of secondary flows, and improved blade tip sealing. Engine testing was conducted to determine the effect of these improvements on performance. The modified turbine package demonstrated significant thrust specific fuel consumption and exhaust gas temperature improvements in sea level and altitude engine tests. Inspection of the improved blade and seal hardware after testing revealed no unusual wear or degradation.

Improvement of mechanical strength and osteogenic potential of calcium sulfate-based hydroxyapatite 3-dimensional printed scaffolds by ε-polycarbonate coating.

PubMed

Kim, Beom-Su; Yang, Sun-Sik; Park, Ho; Lee, Se-Hwan; Cho, Young-Sam; Lee, Jun

2017-09-01

Powder-based three-dimensional (3D) printing is an excellent method to fabricate complex-shaped scaffolds for tissue engineering. However, their lower mechanical strength restricts their application in bone tissue engineering. Here, we created a 3D-printed scaffold coated with a ε-polycaprolactone (PCL) polymer solution (5 and 10 w/v %) to improve the mechanical strength of the scaffold. The 3D scaffold was fabricated from calcium sulfate hemihydrate powder (CaSO 4 -1/2 H 2 O), transformed into hydroxyapatite (HAp) by treatment with a hydrothermal reaction in an NH 4 H 2 PO 4 solution. The surface properties and composition of the scaffold were evaluated using scanning electron microscopy and X-ray diffraction analysis. We demonstrated that the 3D scaffold coated with PCL had an improved mechanical modulus. Coating with 5 and 10% PCL increased the compressive strength significantly, by about 2-fold and 4-fold, respectively, compared with that of uncoated scaffolds. However, the porosity was reduced significantly by coating with 10% PCL. In vitro biological evaluation demonstrated that MG-63 cells adhered well and proliferated on the 3D scaffold coated with PCL, and the scaffold was not cytotoxic. In addition, alkaline phosphatase activity and real time polymerase chain reaction demonstrated that osteoblast differentiation also improved in the PCL-coated 3D scaffolds. These results indicated that PCL polymer coating could improve the compressive strength and biocompatibility of 3D HAp scaffolds for bone tissue engineering applications.

Randomized controlled trial of exercise interventions to improve sleep quality and daytime sleepiness in individuals with multiple sclerosis: A pilot study.

PubMed

Siengsukon, Catherine F; Aldughmi, Mayis; Kahya, Melike; Bruce, Jared; Lynch, Sharon; Ness Norouzinia, Abigail; Glusman, Morgan; Billinger, Sandra

2016-01-01

Nearly 70% of individuals with multiple sclerosis (MS) experience sleep disturbances. Increasing physical activity in people with MS has been shown to produce a moderate improvement in sleep quality, and exercise has been shown to improve sleep quality in non-neurologically impaired adults. The purpose of this pilot randomized controlled trial study was to examine the effect of two exercise interventions on sleep quality and daytime sleepiness in individuals with MS. Twenty-eight individuals with relapsing-remitting or secondary progressive MS were randomized into one of two 12-week exercise interventions: a supervised, moderate-intensity aerobic exercise (AE) program or an unsupervised, low-intensity walking and stretching (WS) program. Only individuals who were ≥ 70% compliant with the programs were included in analysis ( n  = 12 AE; n  = 10 WS). Both groups demonstrated a moderate improvement in sleep quality, although only the improvement by the WS group was statistically significant. Only the AE group demonstrated a significant improvement in daytime sleepiness. Change in sleep quality and daytime sleepiness was not correlated with disease severity or with change in cardiovascular fitness, depression, or fatigue. The mechanisms for improvement in sleep quality and daytime sleepiness need further investigation, but may be due to introduction of zeitgebers to improve circadian rhythm.

The MiPACQ Clinical Question Answering System

PubMed Central

Cairns, Brian L.; Nielsen, Rodney D.; Masanz, James J.; Martin, James H.; Palmer, Martha S.; Ward, Wayne H.; Savova, Guergana K.

2011-01-01

The Multi-source Integrated Platform for Answering Clinical Questions (MiPACQ) is a QA pipeline that integrates a variety of information retrieval and natural language processing systems into an extensible question answering system. We present the system’s architecture and an evaluation of MiPACQ on a human-annotated evaluation dataset based on the Medpedia health and medical encyclopedia. Compared with our baseline information retrieval system, the MiPACQ rule-based system demonstrates 84% improvement in Precision at One and the MiPACQ machine-learning-based system demonstrates 134% improvement. Other performance metrics including mean reciprocal rank and area under the precision/recall curves also showed significant improvement, validating the effectiveness of the MiPACQ design and implementation. PMID:22195068

The MiPACQ clinical question answering system.

PubMed

Cairns, Brian L; Nielsen, Rodney D; Masanz, James J; Martin, James H; Palmer, Martha S; Ward, Wayne H; Savova, Guergana K

2011-01-01

The Multi-source Integrated Platform for Answering Clinical Questions (MiPACQ) is a QA pipeline that integrates a variety of information retrieval and natural language processing systems into an extensible question answering system. We present the system's architecture and an evaluation of MiPACQ on a human-annotated evaluation dataset based on the Medpedia health and medical encyclopedia. Compared with our baseline information retrieval system, the MiPACQ rule-based system demonstrates 84% improvement in Precision at One and the MiPACQ machine-learning-based system demonstrates 134% improvement. Other performance metrics including mean reciprocal rank and area under the precision/recall curves also showed significant improvement, validating the effectiveness of the MiPACQ design and implementation.

The Patient Safety Leadership Academy at the University of Pennsylvania: the first cohort's learning experience.

PubMed

Wurster, Angela B; Pearson, Kathy; Sonnad, Seema S; Mullen, James L; Kaiser, Larry R

2007-01-01

We based the Patient Safety Leadership Academy (PSLA) on the premise that improving management skills could improve patient safety and employee satisfaction. Fellows completed baseline surveys on leadership skills knowledge, patient safety knowledge, and program goals. They completed the same surveys 7 months later at the final PSLA session. The fellows also completed a survey assessing how PSLA improved expertise and comparing PSLA to other patient safety learning opportunities. Matched pairs t tests were used to compare baseline and postprogram results. Baseline scores indicated appropriateness of focusing on leadership, with average leadership knowledge (2.48) significantly lower than patient safety knowledge (3.22). For patient safety, postprogram results were significant for 8 of 10 questions. All results were significant for leadership. Fellows also rated skills covered by the curriculum on a scale of 1 to 10. For all areas, the median score for knowledge gained was 7. When compared with other patient safety learning experiences, participants rated PSLA as 4 or 5, where 1 indicated the other experience much more valuable and 5 much more valuable. PSLA demonstrates that leadership skills are perceived as important by physicians and managers in surgical areas. This study demonstrated that a leadership skills approach to patient safety training could improve knowledge in specific leadership areas and general patient safety.

Simultaneous heavy metals removal and municipal sewage sludge dewaterability improvement in bioleaching processes by various inoculums.

PubMed

Shi, Chaohong; Zhu, Nengwu; Shang, Ru; Kang, Naixin; Wu, Pingxiao

2015-11-01

The heavy metals content and dewaterability of municipal sewage sludge (MSS) are important parameters affecting its subsequent disposal and land application. Six kinds of inoculums were prepared to examine the characteristics of heavy metals removal and MSS dewaterability improvement in bioleaching processes. The results showed that Cu, Zn and Cd bioleaching efficiencies (12 days) were 81-91, 87-93 and 81-89%, respectively, which were significantly higher than those of Fe-S control (P < 0.05) and blank control (P < 0.01). The bioleaching boosted by the prepared inoculums could also significantly enhance MSS dewaterability (P < 0.01). The centrifugal dehydration efficiency of MSS rose from 73.00 to 90.00% at day 12. Microscopic observations and energy dispersive spectrum analysis demonstrated that the dewaterability improvement might be attributed to the changes of sludge structure from flocculent to obvious granular and the formation of secondary minerals mainly consisting of iron, oxygen and sulfur elements. The results above demonstrated that bacterial consortium enriched from acid mine drainage (AMD) was suitable to boost sludge bioleaching for heavy metals removal and dewaterability improvement. It also suggested that the synergy of sulfur/ferrous-oxidizing bacteria (SFOB) enriched from AMD and the cooperation of exogenous and indigenous SFOB significantly promoted bioleaching efficiencies.

Reduced ventilation-perfusion (V/Q) mismatch following endobronchial valve insertion demonstrated by Gallium-68 V/Q photon emission tomography/computed tomography.

PubMed

Leong, Paul; Le Roux, Pierre-Yves; Callahan, Jason; Siva, Shankar; Hofman, Michael S; Steinfort, Daniel P

2017-09-01

Endobronchial valves (EBVs) are increasingly deployed in the management of severe emphysema. Initial studies focussed on volume reduction as the mechanism, with subsequent improvement in forced expiratory volume in 1 s (FEV 1 ). More recent studies have emphasized importance of perfusion on predicting outcomes, though findings have been inconsistent. Gallium-68 ventilation-perfusion (V/Q) photon emission tomography (PET)/computed tomography (CT) is a novel imaging modality with advantages in spatial resolution, quantitation, and speed over conventional V/Q scintigraphy. We report a pilot case in which V/Q-PET/CT demonstrated discordant findings compared with quantitative CT analysis, and directed left lower lobe EBV placement. The patient experienced a significant improvement in 6-min walk distance (6MWD) without change in spirometry. Post-EBV V/Q-PET/CT demonstrated a marked decrease in unmatched (detrimental) V/Q areas and improvement in overall V/Q matching on post-EBV V/Q-PET/CT. These preliminary novel findings suggest that EBVs improve V/Q matching and may explain the observed functional improvements.

Gut-directed hypnotherapy for irritable bowel syndrome: piloting a primary care-based randomised controlled trial

PubMed Central

Roberts, Lesley; Wilson, Sue; Singh, Sukhdev; Roalfe, Andrea; Greenfield, Sheila

2006-01-01

Background In western populations irritable bowel syndrome (IBS) affects between 10% and 30% of the population and has a significant effect on quality of life. It generates a substantial workload in both primary and secondary care and has significant cost implications. Gut-directed hypnotherapy has been demonstrated to alleviate symptoms and improve quality of life but has not been assessed outside of secondary and tertiary referral centres. Aim To assess the effectiveness of gut-directed hypnotherapy as a complementary therapy in the management of IBS. Design of study Randomised controlled trial. Setting Primary care patients aged 18–65 years inclusive, with a diagnosis of IBS of greater than 6 weeks' duration and having failed conventional management, located in South Staffordshire and North Birmingham, UK. Method Intervention patients received five sessions of hypnotherapy in addition to their usual management. Control patients received usual management alone. Data regarding symptoms and quality of life were collected at baseline and again 3, 6, and 12 months post-randomisation. Results Both groups demonstrated a significant improvement in all symptom dimensions and quality of life over 12 months. At 3 months the intervention group had significantly greater improvements in pain, diarrhoea and overall symptom scores (P<0.05). No significant differences between groups in quality of life were identified. No differences were maintained over time. Intervention patients, however, were significantly less likely to require medication, and the majority described an improvement in their condition. Conclusions Gut-directed hypnotherapy benefits patients via symptom reduction and reduced medication usage, although the lack of significant difference between groups beyond 3 months prohibits its general introduction without additional evidence. A large trial incorporating robust economic analysis is, therefore, urgently recommended. PMID:16464325

Endolymphatic sac surgery versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral definite Meniere's disease.

PubMed

Albu, Silviu; Babighian, Gregorio; Amadori, Maurizio; Trabalzini, Franco

2015-12-01

This study aims to compare the outcomes of patients with Meniere's disease submitted to either endolymphatic mastoid shunt (ES) or tenotomy of the stapedius and tensor tympani muscles (TSTM). This is a retrospective chart review of patients treated with ES or TSTM between 2000 and 2010 and followed up for at least 12 months. The main outcomes were represented by: (1) vertigo class, hearing stage and functional level according to the American Academy of Otolaryngology-Head and Neck Surgery criteria; (2) adjustment of dizziness handicap inventory (DHI) and (3) complete and substantial vertigo control using the Kaplan-Meier survival method. Sixty-three patients met the inclusion criteria: 34 underwent ES and 29 TSTM. The baseline demographic characteristics, the hearing stage, the functional level, the DHI and hearing levels were not different between the two groups. No significant difference in vertigo class was demonstrated: 66 % of TSTM patients attained class A compared to 44 % in the ES group (p = 0.14). Kaplan-Meier survival curves specific to class A showed significant differences, favoring TSTM (log-rank test, p = 0.022). TSTM patients demonstrated significantly improved functional level (p = 0.0004) and improved DHI scores (p = 0.001). Eight ES patients (25 %) demanded a second surgical attempt compared to none in the TSTM. Aural fullness was significantly improved in TSTM group (p = 0.01), while the difference in tinnitus improvement was non-significant. Hearing preservation was significantly better in TSTM group (p = 0.001). TSTM is a safe surgical procedure, with significant vertigo control rates, and important hearing preservation rates. More patients and longer follow-up are needed to support our preliminary findings.

Neovascularity in patellar tendinopathy and the response to eccentric training: a case report using Power Doppler ultrasound.

PubMed

McCreesh, Karen M; Riley, Sara J; Crotty, James M

2013-12-01

This report describes the case of an amateur soccer player with chronic patellar tendinopathy who underwent ultrasound imaging before and after engaging in an 8-week programme of eccentric exercise. On initial assessment, greyscale ultrasound imaging demonstrated tendon thickening and reduced echogenicity, while Power Doppler imaging demonstrated a large amount of neovascularity. After 8 weeks of an eccentric loading programme, the patient reported significantly improved symptoms and functional scores, while follow-up imaging demonstrated improvement in the echo appearance of the tendon and complete resolution of the neovascularity. The association between neovascularity and symptoms in tendinopathy research is conflicting, with a paucity of research in the area of patellar tendinopathy. While further research is needed to clarify the significance of greyscale and Power Doppler ultrasound changes in relation to symptoms in patellar tendinopathy, ultrasound imaging was shown to be a useful adjunct to diagnosis and outcome assessment in this case. Copyright © 2012 Elsevier Ltd. All rights reserved.

Joint Optics Structures Experiment (JOSE)

NASA Technical Reports Server (NTRS)

Founds, David

1987-01-01

The objectives of the JOSE program is to develop, demonstrate, and evaluate active vibration suppression techniques for Directed Energy Weapons (DEW). DEW system performance is highly influenced by the line-of-sight (LOS) stability and in some cases by the wave front quality. The missions envisioned for DEW systems by the Strategic Defense Initiative require LOS stability and wave front quality to be significantly improved over any current demonstrated capability. The Active Control of Space Structures (ACOSS) program led to the development of a number of promising structural control techniques. DEW structures are vastly more complex than any structures controlled to date. They will be subject to disturbances with significantly higher magnitudes and wider bandwidths, while holding higher tolerances on allowable motions and deformations. Meeting the performance requirements of the JOSE program requires upgrading the ACOSS techniques to meet new more stringent requirements, the development of requisite sensors and acturators, improved control processors, highly accurate system identification methods, and the integration of hardware and methodologies into a successful demonstration.

Accelerated remyelination during inflammatory demyelination prevents axonal loss and improves functional recovery.

PubMed

Mei, Feng; Lehmann-Horn, Klaus; Shen, Yun-An A; Rankin, Kelsey A; Stebbins, Karin J; Lorrain, Daniel S; Pekarek, Kara; A Sagan, Sharon; Xiao, Lan; Teuscher, Cory; von Büdingen, H-Christian; Wess, Jürgen; Lawrence, J Josh; Green, Ari J; Fancy, Stephen Pj; Zamvil, Scott S; Chan, Jonah R

2016-09-27

Demyelination in MS disrupts nerve signals and contributes to axon degeneration. While remyelination promises to restore lost function, it remains unclear whether remyelination will prevent axonal loss. Inflammatory demyelination is accompanied by significant neuronal loss in the experimental autoimmune encephalomyelitis (EAE) mouse model and evidence for remyelination in this model is complicated by ongoing inflammation, degeneration and possible remyelination. Demonstrating the functional significance of remyelination necessitates selectively altering the timing of remyelination relative to inflammation and degeneration. We demonstrate accelerated remyelination after EAE induction by direct lineage analysis and hypothesize that newly formed myelin remains stable at the height of inflammation due in part to the absence of MOG expression in immature myelin. Oligodendroglial-specific genetic ablation of the M1 muscarinic receptor, a potent negative regulator of oligodendrocyte differentiation and myelination, results in accelerated remyelination, preventing axonal loss and improving functional recovery. Together our findings demonstrate that accelerated remyelination supports axonal integrity and neuronal function after inflammatory demyelination.

Effects of Lecture, Teacher Demonstrations, Discussion and Practical Work on 10th Graders' Attitudes to Chemistry and Understanding of Electrolysis.

ERIC Educational Resources Information Center

Thompson, Jerome; Soyibo, Kola

2002-01-01

Investigates whether the use of the combination of lecture, teacher demonstrations, class discussion, and student practical work in small groups significantly improved experimental subjects' attitudes to chemistry and understanding of electrolysis more than their control group counterparts who were not exposed to practical work. Examines whether…

Perception of Nonverbal Social Cues by Regular Education, ADHD, and ADHD/LD Students.

ERIC Educational Resources Information Center

Hall, Cathy W.; Peterson, Andrea D.; Webster, Raymond E.; Bolen, Larry M.; Brown, Michael B.

1999-01-01

Study examined ability of attention deficit hyperactive disorder (ADHD) children with and without learning disability to perceive nonverbal social cues. ADHD/LD children demonstrated significant difficulty in comparison to their peers in effectively perceiving paralanguage cues. This group also showed significant improvement on the Postures and…

Simulation-Based Cryosurgery Training: Variable Insertion-Depth Planning in Prostate Cryosurgery

PubMed Central

Sehrawat, Anjali; Keelan, Robert; Shimada, Kenji; Wilfong, Dona M.; McCormick, James T.; Rabin, Yoed

2015-01-01

A proof-of-concept for an advanced-level computerized training tool for cryosurgery is demonstrated, based on three-dimensional cryosurgery simulations and a variable insertion-depth strategy for cryoprobes. The objective for system development is twofold: to identify a cryoprobe layout in order to best-match a planning isotherm with the target region shape, and to verify that cryoprobe placement does not violate accepted geometric constraints. System validation has been performed by collecting training data from 17 surgical residents, having no prior experience or advanced knowledge of cryosurgery. This advanced-level study includes an improved training-session design, in order to enhance knowledge dissemination and elevate participant motivation to excel. In terms of match between a planning isotherm and the target region shape, results of this demonstrate trainee performance improvement from 4.4% in a pretest to 44.4% in a posttest over a course of 50 minutes of training. In terms of combined performance, including the above geometrical match and constraints on cryoprobe placement, this study demonstrates trainee performance improvement from 2.2% in the pretest to 31.1% in the posttest. Given the relatively short training session and the lack of prior knowledge, these improvements are significant and encouraging. These results are of particular significance, as they have been obtained from a surgical resident population, which are exposed to the typical stress and constraints in advanced surgical education. PMID:26546576

Moderation of age, sex, and ethnicity on psychosocial predictors of increased exercise and improved eating.

PubMed

Annesi, James J

2013-01-01

Although research indicates that treatment-induced improvements in self-regulation, mood, and self-efficacy significantly predict increased exercise and improved eating, moderation by participants' personal characteristics is largely unknown. Severely obese adults (N = 414; 47% White, 53% African American) volunteered for a behavioral exercise and nutrition treatment and demonstrated significant within-group improvements in self-efficacy for exercise, self-regulation for exercise, mood, self-efficacy for controlled eating, self-regulation for controlled eating, exercise volume, and fruit and vegetable intake over 26 weeks. After testing age, sex, and race/ethnicity as possible moderators of the prediction of changes in exercise volume and fruit and vegetable consumption by changes in self-regulation, mood, and self-efficacy, only age significantly moderated change in volume of exercise. Implications for theory and treatment were discussed.

The effectiveness of an exercise programme on dynamic balance in patients with medial knee osteoarthritis: A pilot study.

PubMed

Al-Khlaifat, Lara; Herrington, Lee C; Tyson, Sarah F; Hammond, Alison; Jones, Richard K

2016-10-01

Dynamic balance and quiet standing balance are decreased in knee osteoarthritis (OA), with dynamic balance being more affected. This study aimed to investigate the effectiveness of a group exercise programme of lower extremity muscles integrated with education on dynamic balance using the Star Excursion Balance test (SEBT) in knee OA. Experimental before-and-after pilot study design. Nineteen participants with knee OA attended the exercise sessions once a week for six weeks, in addition to home exercises. Before and after the exercise programme, dynamic balance was assessed using the SEBT in the anterior and medial directions in addition to hip and knee muscle strength, pain, and function. Fourteen participants completed the study. Dynamic balance on the affected side demonstrated significant improvements in the anterior and medial directions (p=0.02 and p=0.01, respectively). The contralateral side demonstrated significant improvements in dynamic balance in the anterior direction (p<0.001). However, balance in the medial direction did not change significantly (p=0.07). Hip and knee muscle strength, pain, and function significantly improved (p<0.05) after the exercise programme. This is the first study to explore the effect of an exercise programme on dynamic balance using the SEBT in knee OA. The exercise programme was effective in improving dynamic balance which is required in different activities of daily living where the patients might experience the risk of falling. This might be attributed to the improvement in muscle strength and pain after the exercise programme. Copyright © 2016 Elsevier B.V. All rights reserved.

Temporal stability of music perception and appraisal scores of adult cochlear implant recipients.

PubMed

Gfeller, Kate; Jiang, Dingfeng; Oleson, Jacob J; Driscoll, Virginia; Knutson, John F

2010-01-01

An extensive body of literature indicates that cochlear implants (CIs) are effective in supporting speech perception of persons with severe to profound hearing losses who do not benefit to any great extent from conventional hearing aids. Adult CI recipients tend to show significant improvement in speech perception within 3 mo following implantation as a result of mere experience. Furthermore, CI recipients continue to show modest improvement as long as 5yr postimplantation. In contrast, data taken from single testing protocols of music perception and appraisal indicate that CIs are less than ideal in transmitting important structural features of music, such as pitch, melody, and timbre. However, there is presently little information documenting changes in music perception or appraisal over extended time as a result of mere experience. This study examined two basic questions: (1) Do adult CI recipients show significant improvement in perceptual acuity or appraisal of specific music listening tasks when tested in two consecutive years? (2) If there are tasks for which CI recipients show significant improvement with time, are there particular demographic variables that predict those CI recipients most likely to show improvement with extended CI use? A longitudinal cohort study. Implant recipients return annually for visits to the clinic. The study included 209 adult cochlear implant recipients with at least 9 mo implant experience before their first year measurement. Outcomes were measured on the patient's annual visit in two consecutive years. Paired t-tests were used to test for significant improvement from one year to the next. Those variables demonstrating significant improvement were subjected to regression analyses performed to detect the demographic variables useful in predicting said improvement. There were no significant differences in music perception outcomes as a function of type of device or processing strategy used. Only familiar melody recognition (FMR) and recognition of melody excerpts with lyrics (MERT-L) showed significant improvement from one year to the next. After controlling for the baseline value, hearing aid use, months of use, music listening habits after implantation, and formal musical training in elementary school were significant predictors of FMR improvement. Bilateral CI use, formal musical training in high school and beyond, and a measure of sequential cognitive processing were significant predictors of MERT-L improvement. These adult CI recipients as a result of mere experience demonstrated fairly consistent music perception and appraisal on measures gathered in two consecutive years. Gains made tend to be modest, and can be associated with characteristics such as use of hearing aids, listening experiences, or bilateral use (in the case of lyrics). These results have implications for counseling of CI recipients with regard to realistic expectations and strategies for enhancing music perception and enjoyment.

Depression following traumatic brain injury: Impact on post-hospital residential rehabilitation outcomes.

PubMed

Lewis, Frank D; Horn, Gordon J

2017-01-01

A need exists to better understand the impact of depression on functional outcomes following TBI. To evaluate the prevalence and severity of depression among a large group of chronic TBI adults; to determine the impact of depression on outcomes of post-hospital residential rehabilitation programs; and to assess effectiveness of post-hospital residential rehabilitation programs in treating depression. 820 adults with moderate to severe traumatic brain injury (TBI) were assigned to one of four groups based on MPAI- 4 depression ratings: (1) Not Depressed, (2) Mildly Depressed, (3) Moderately Depressed, and (4) Severely Depressed. Functional status was assessed at admission and discharge with the MPAI-4 Participation Index. Differences among groups were evaluated using conventional parametric tests. Rasch analysis established reliability and validity of MPAI-4 data. Rasch analysis demonstrated satisfactory construct validity and internal consistency (Person reliability = 0.89-0.92, Item reliability = 0.99). Of the 820 subjects, 39% presented with moderate to severe depressive symptoms at admission, These subjects demonstrated significantly higher MPAI-4 Participation scores than the mild and not depressed groups. Depressed groups realized significant improvement in symptoms, but, those remaining depressed at discharge had significantly greater disability than those who improved. Depressive symptoms had a deleterious impact on outcome. Remediation of symptoms during rehabilitation significantly improved outcomes.

Playing to your skills: a randomised controlled trial evaluating a dedicated video game for minimally invasive surgery.

PubMed

Harrington, Cuan M; Chaitanya, Vishwa; Dicker, Patrick; Traynor, Oscar; Kavanagh, Dara O

2018-02-14

Video gaming demands elements of visual attention, hand-eye coordination and depth perception which may be contiguous with laparoscopic skill development. General video gaming has demonstrated altered cortical plasticity and improved baseline/acquisition of minimally invasive skills. The present study aimed to evaluate for skill acquisition associated with a commercially available dedicated laparoscopic video game (Underground) and its unique (laparoscopic-like) controller for the Nintendo®Wii U™ console. This single-blinded randomised controlled study was conducted with laparoscopically naive student volunteers of limited (< 3 h/week) video gaming backgrounds. Baseline laparoscopic skills were assessed using four basic tasks on the Virtual Reality (VR) simulator (LAP Mentor TM , 3D systems, Colorado, USA). Twenty participants were randomised to two groups; Group A was requested to complete 5 h of video gaming (Underground) per week and Group B to avoid gaming beyond their normal frequency. After 4 weeks participants were reassessed using the same VR tasks. Changes in simulator performances were assessed for each group and for intergroup variances using mixed model regression. Significant inter- and intragroup performances were present for the video gaming and controls across four basic tasks. The video gaming group demonstrated significant improvements in thirty-one of the metrics examined including dominant (p ≤ 0.004) and non-dominant (p < 0.050) instrument movements, pathlengths (p ≤ 0.040), time taken (p ≤ 0.021) and end score [p ≤ 0.046, (task-dependent)]. The control group demonstrated improvements in fourteen measures. The video gaming group demonstrated significant (p < 0.05) improvements compared to the control in five metrics. Despite encouraged gameplay and the console in participants' domiciles, voluntary engagement was lower than directed due to factors including: game enjoyment (33.3%), lack of available time (22.2%) and entertainment distractions (11.1%). Our work revealed significant value in training using a dedicated laparoscopic video game for acquisition of virtual laparoscopic skills. This novel serious game may provide foundations for future surgical developments on game consoles in the home environment.

Study and program plan for improved heavy duty gas turbine engine ceramic component development

NASA Technical Reports Server (NTRS)

Helms, H. E.

1977-01-01

Fuel economy in a commercially viable gas turbine engine was demonstrated through use of ceramic materials. Study results show that increased turbine inlet and generator inlet temperatures, through the use of ceramic materials, contribute the greatest amount to achieving fuel economy goals. Improved component efficiencies show significant additional gains in fuel economy.

Repeated Measures in Case Studies Relating Social Competence and Weight Loss in Two Obese Adolescents

ERIC Educational Resources Information Center

Meyer, Sonia Beatriz; Barbosa, Debora Regina

2007-01-01

In individual behavior therapy two clients were evaluated using behavior categories created by the therapist. Both clients were observed to improve in terms of social competence. One demonstrated a significant inverse correlation between improvement of social competence and weight loss during treatment (16 sessions) and lost weight. The other…

Repeated Measures in Case Studies Relating Social Competence and Weight Loss in Two Obese Adolescents

ERIC Educational Resources Information Center

Meyer, Sonia Beatriz; Barbosa, Debora Regina

2009-01-01

In individual behavior therapy two clients were evaluated using behavior categories created by the therapist. Both clients were observed to improve in terms of social competence. One demonstrated a significant inverse correlation between improvement of social competence and weight loss during treatment (16 sessions) and lost weight. The other…

Cost per RN hired.

PubMed

Hoffman, F M

1985-02-01

Costs of recruiting, hiring, and training new staff members can be significant. This article demonstrates a method for analyzing the components of these costs to target areas where improved efficiency can lead to lower costs.

Diet, Exercise and Health

MedlinePlus

... of much hype regarding it’s supposed effects on cognition and memory. Some studies have shown that some ... of 30 days each, demonstrated significant improvements in cognition, verbal skills, motor coordination and in an overall ...

Near-Infrared Spectroscopy Enhances Intravascular Ultrasound Assessment of Vulnerable Coronary Plaque: A Combined Pathological and In Vivo Study.

PubMed

Puri, Rishi; Madder, Ryan D; Madden, Sean P; Sum, Stephen T; Wolski, Kathy; Muller, James E; Andrews, Jordan; King, Karilane L; Kataoka, Yu; Uno, Kiyoko; Kapadia, Samir R; Tuzcu, E Murat; Nissen, Steven E; Virmani, Renu; Maehara, Akiko; Mintz, Gary S; Nicholls, Stephen J

2015-11-01

Pathological studies demonstrate the dual significance of plaque burden (PB) and lipid composition for mediating coronary plaque vulnerability. We evaluated relationships between intravascular ultrasound (IVUS)-derived PB and arterial remodeling with near-infrared spectroscopy (NIRS)-derived lipid content in ex vivo and in vivo human coronary arteries. Ex vivo coronary NIRS and IVUS imaging was performed through blood in 116 coronary arteries of 51 autopsied hearts, followed by 2-mm block sectioning (n=2070) and histological grading according to modified American Heart Association criteria. Lesions were defined as the most heavily diseased 2-mm block per imaged artery on IVUS. IVUS-derived PB and NIRS-derived lipid core burden index (LCBI) of each block and lesion were analyzed. Block-level analysis demonstrated significant trends of increasing PB and LCBI across more complex atheroma (Ptrend <0.001 for both LCBI and PB). Lesion-based analyses demonstrated the highest LCBI and remodeling index within coronary fibroatheroma (Ptrend <0.001 and 0.02 versus all plaque groups, respectively). Prediction models demonstrated similar abilities of PB, LCBI, and remodeling index for discriminating fibroatheroma (c indices: 0.675, 0.712, and 0.672, respectively). A combined PB+LCBI analysis significantly improved fibroatheroma detection accuracy (c index 0.77, P=0.028 versus PB; net-reclassification index 43%, P=0.003), whereas further adding remodeling index did not (c index 0.80, P=0.27 versus PB+LCBI). In vivo comparisons of 43 age- and sex-matched patients (to the autopsy cohort) undergoing combined NIRS-IVUS coronary imaging yielded similar associations to those demonstrated ex vivo. Adding NIRS to conventional IVUS-derived PB imaging significantly improves the ability to detect more active, potentially vulnerable coronary atheroma. © 2015 American Heart Association, Inc.

An Automated, Adaptive Framework for Optimizing Preprocessing Pipelines in Task-Based Functional MRI

PubMed Central

Churchill, Nathan W.; Spring, Robyn; Afshin-Pour, Babak; Dong, Fan; Strother, Stephen C.

2015-01-01

BOLD fMRI is sensitive to blood-oxygenation changes correlated with brain function; however, it is limited by relatively weak signal and significant noise confounds. Many preprocessing algorithms have been developed to control noise and improve signal detection in fMRI. Although the chosen set of preprocessing and analysis steps (the “pipeline”) significantly affects signal detection, pipelines are rarely quantitatively validated in the neuroimaging literature, due to complex preprocessing interactions. This paper outlines and validates an adaptive resampling framework for evaluating and optimizing preprocessing choices by optimizing data-driven metrics of task prediction and spatial reproducibility. Compared to standard “fixed” preprocessing pipelines, this optimization approach significantly improves independent validation measures of within-subject test-retest, and between-subject activation overlap, and behavioural prediction accuracy. We demonstrate that preprocessing choices function as implicit model regularizers, and that improvements due to pipeline optimization generalize across a range of simple to complex experimental tasks and analysis models. Results are shown for brief scanning sessions (<3 minutes each), demonstrating that with pipeline optimization, it is possible to obtain reliable results and brain-behaviour correlations in relatively small datasets. PMID:26161667

Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial

PubMed Central

Campos de Oliveira, Laís; Gonçalves de Oliveira, Raphael; Pires-Oliveira, Deise Aparecida de Almeida

2015-01-01

[Purpose] The aim of the present study was to determine the effects of Pilates on lower leg strength, postural balance and the health-related quality of life (HRQoL) of older adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age, 64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks. The following evaluations were performed before and after the interventions: isokinetic torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group analysis, the EG demonstrated significant improvement in all variables. In the inter-group analysis, the EG demonstrated significant improvement in most variables. [Conclusion] Pilates exercises led to significant improvement in isokinetic torque of the knee extensors and flexors, postural balance and aspects of the health-related quality of life of older adults. PMID:25931749

Replication of a Prospective Randomized Controlled Trial of Resource Facilitation to Improve Return to Work and School After Brain Injury.

PubMed

Trexler, Lance E; Parrott, Devan R; Malec, James F

2016-02-01

To determine the extent to which previous findings on the effectiveness of resource facilitation to impact return to work and school could be replicated. Randomized controlled trial. Outpatient rehabilitation clinic. Outpatients with acquired brain injury (N=44). Fifteen months of resource facilitation services. A revised version of the Vocational Independence Scale and the Mayo-Portland Adaptability Inventory-4 Participation Index. Participants randomized to the resource facilitation group demonstrated a significant advantage in terms of rate and timing of return to productive community-based work relative to control participants. When examining only return to competitive work (and not return to school), 69% of the resource facilitation group was able to return compared with 50% of the control participants. Analyses of measures of participation in household and community activities revealed that both groups improved significantly over the 15-month study period, but no significant advantage for either group was demonstrated. This study replicates the positive impact of resource facilitation in improving productive community-based activity, including competitive employment and volunteering in the community. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Text Messaging Improves Participation in Laboratory Testing in Adolescent Liver Transplant Patients.

PubMed

McKenzie, Rebecca B; Berquist, William E; Foley, Megan A; Park, K T; Windsheimer, Jered E; Litt, Iris F

In solid organ transplant patients, non-participation in all aspects of the medical regimen is a prevalent problem associated with adverse consequences particularly in the adolescent and young adult (AYA) age group. This study is the first to evaluate the feasibility, utility and impact of a text messaging (TM) intervention to improve participation in laboratory testing in adolescent liver transplant patients. AYA patients, aged 12 to 21 years, were recruited for a prospective pilot trial evaluating a TM intervention delivered over a 1-year period. The intervention involved automated TM reminders with feedback administered according to a prescribed laboratory testing frequency. Participation rate in laboratory testing after the intervention was compared to the year prior. Patient responses and feedback by text and survey were used to assess feasibility, acceptability and use of the intervention. Forty-two patients were recruited and 33 patients remained enrolled for the study duration. Recipients of the TM intervention demonstrated a significant improvement in participation rate in laboratory testing from 58% to 78% (P<.001). This rate was also significantly higher than in non-intervention controls (P=.003). There was a high acceptability, response rate and a significant correlation with reported versus actual completion of laboratory tests by TM. TM reminders significantly improved participation in laboratory testing in AYA liver transplant patients. The intervention demonstrated feasibility, acceptability, and use with a high proportion of patients who engaged in and perceived a benefit from using this technology.

Comparing preseason frontal and sagittal plane plyometric programs on vertical jump height in high-school basketball players.

PubMed

King, Jeffrey A; Cipriani, Daniel J

2010-08-01

The primary purpose of this study was to evaluate whether frontal plane (FP) plyometrics, which are defined as plyometrics dominated with a lateral component, would produce similar increases in vertical jump height (VJH) compared to sagittal plane (SP) Plyometrics. Thirty-two junior varsity and varsity high-school basketball players participated in 6 weeks of plyometric training. Players participated in either FP or SP plyometrics for the entire study. Vertical jump height was measured on 3 occasions: preintervention (baseline), at week 3 of preparatory training, and at week 6 of training. Descriptive statistics were calculated for VJH. A 2-way analysis of variance (ANOVA) with repeated measures was used to test the difference in mean vertical jump scores using FP and SP training modalities. Results showed a significant effect over time for vertical jump (p < 0.001). Moreover, a significant time by protocol interaction was noted (p < 0.032). A 1-way ANOVA demonstrated that only the SP group demonstrated improvements over time, in VJH, p < 0.05. The FP group did not improve statistically. The data from this study suggest that FP plyometric training did not have a significant effect on VJH and significant improvement in VJH was seen in subjects participating in SP plyometrics thus reinforcing the specificity principle of training. However, coaches should implement both types of plyometrics because both training modalities can improve power and quickness among basketball players.

High-performance and environmentally stable planar heterojunction perovskite solar cells based on a solution-processed copper-doped nickel oxide hole-transporting layer.

PubMed

Kim, Jong H; Liang, Po-Wei; Williams, Spencer T; Cho, Namchul; Chueh, Chu-Chen; Glaz, Micah S; Ginger, David S; Jen, Alex K-Y

2015-01-27

An effective approach to significantly increase the electrical conductivity of a NiOx hole-transporting layer (HTL) to achieve high-efficiency planar heterojunction perovskite solar cells is demonstrated. Perovskite solar cells based on using Cu-doped NiOx HTL show a remarkably improved power conversion efficiency up to 15.40% due to the improved electrical conductivity and enhanced perovskite film quality. General applicability of Cu-doped NiOx to larger bandgap perovskites is also demonstrated in this study. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

Albrecht H. Mayer

Asea Brown Boveri (ABB) has completed its technology based program. The results developed under Work Breakdown Structure (WBS) 8, concentrated on technology development and demonstration have been partially implemented in newer turbine designs. A significant improvement in heat rate and power output has been demonstrated. ABB will use the knowledge gained to further improve the efficiency of its Advanced Cycle System, which has been developed and introduced into the marked out side ABB's Advanced Turbine System (ATS) activities. The technology will lead to a power plant design that meets the ATS performance goals of over 60% plant efficiency, decreased electricitymore » costs to consumers and lowest emissions.« less

Assessing the evidence of Six Sigma and Lean in the health care industry.

PubMed

DelliFraine, Jami L; Langabeer, James R; Nembhard, Ingrid M

2010-01-01

Popular quality improvement tools such as Six Sigma and Lean Systems (SS/L) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether these 2 quality improvement tools actually improve health care quality. The authors conducted a comprehensive literature review to assess the empirical evidence relating SS/L to improved clinical outcomes, processes of care, and financial performance of health care organizations. The authors identified 177 articles on SS/L published in the last 10 years. However, only 34 of them reported any outcomes of the SS/L projects studied, and less than one-third of these articles included statistical analyses to test for significant changes in outcomes. This review demonstrates that there are significant gaps in the SS/L health care quality improvement literature and very weak evidence that SS/L improve health care quality.

Epithelial expression of cytokeratins 15 and 19 in vitiligo.

PubMed

Saleh, Fatma Y; Awad, Sherif S; Nasif, Ghada A; Halim, Christein

2016-12-01

Cytokeratins (CK) belong to the family of intermediate filament proteins, and among them specific epithelial keratins are considered markers for stem cells activation. This study aims to investigate the expression of CK15 and CK19 as possible stem cell markers in vitiligo during phototherapy. The study was conducted on vitiligo patients receiving narrow-band ultraviolet therapy. Immunohistochemical staining for CK15 and CK19 was carried out, and clinical follow-up continued for 4 weeks. Of 28 patients, CK15 expression was demonstrated in 17 cases (61%) while CK19 expression was demonstrated in 11 cases (39%). Cells expressing positive staining were demonstrated in follicular and interfollicular epithelium. Expression was clearly demonstrated in patients younger than 20 years old, with shorter disease duration, with disease stability, and with normally pigmented hairs. Expression of cytokeratins was significantly correlated to improvement of vitiligo lesions. CK15 and CK19 are expressed in vitiligo during UV repigmentation in the follicular and interfollicular epithelium. This expression of cytokeratins was significantly correlated to improvement and can be considered valuable tool to monitor stem cells stimulation for the sake of the repigmentation process in vitiligo. © 2016 Wiley Periodicals, Inc.

Advanced technology for reducing aircraft engine pollution

NASA Technical Reports Server (NTRS)

Jones, R. E.

1973-01-01

Combustor research programs are described whose purpose is to demonstrate significantly lower exhaust emission levels. The proposed EPA regulations covering the allowable levels of emissions will require a major technological effort if these levels are to be met by 1979. Pollution reduction technology is being pursued by NASA through a combination of in-house research, contracted progams, and university grants. In-house research with the swirl-can modular combustor and the double-annular combustor has demonstrated significant reduction in the level of NO(x) emissions. The work is continuing in an attempt to further reduce these levels by improvements in module design and in air-fuel scheduling. Research on the reduction of idle emissions has included the conversion of conventional duplex fuel nozzles to air-assisted nozzles and exploration of the potential improvements possible with fuel staging and variable combustor geometry.

Effectiveness of a School-based Academic Asthma Health Education and Counseling Program on Fostering Acceptance of Asthma in Older School-age Students with Asthma

PubMed Central

Kintner, Eileen K.; Cook, Gwendolyn; Marti, C. Nathan; Gomes, Melissa; Meeder, Linda; Van Egeren, Laurie A.

2014-01-01

Purpose The purpose was to evaluate the effectiveness of the academic asthma education and counseling SHARP program on fostering psychosocial acceptance of asthma. Design and Methods This was a phase III, two-group, cluster randomized, single-blinded, longitudinal study. Students from grades 4 and 5 (N = 205) with asthma and their caregivers completed surveys at pre-intervention and at 1, 12, and 24 months post-intervention. Analysis involved multilevel modeling. Results All students demonstrated significant improvement in aspects of acceptance; students in SHARP demonstrated significant improvement in openness to sharing and connectedness with teachers over students in the control condition. Practice Implications The SHARP program offers a well-tested, effective program for psychosocial acceptance of asthma, which is welcomed by schools. PMID:25443593

Improving the performance of galloping micro-power generators by passively manipulating the trailing edge

NASA Astrophysics Data System (ADS)

Noel, J.; Yadav, R.; Li, G.; Daqaq, M. F.

2018-02-01

Recent trends in distributed sensing networks have generated significant interest in the design of scalable micro-power generators. One such device exploits the galloping oscillations of a prism to harness energy from a moving fluid. Performance of galloping harvester's depends on the flow patterns around the prism, which, in turn, depend on its geometry and the Reynolds number of the flow. In this letter, we demonstrate that the useful range of the galloping instability can be extended by attaching a rigid splitter plate to the rear face of the prism. The plate provides a secondary flow reattachment point, which serves to improve the oscillation amplitude and power output of the generator. Experimental results demonstrate as much as 67% power enhancement for some prism geometries and a significant reduction in the cut-in wind speed of the generator.

Effectiveness of Basic Life Support Training for Middle School Students.

PubMed

Aloush, Sami; Tubaishat, Ahmad; ALBashtawy, Mohammed; Suliman, Mohammad; Alrimawi, Intima; Al Sabah, Ashraf; Banikhaled, Yousef

2018-01-01

Bystander cardiopulmonary resuscitation improves survival after out-of-hospital cardiac arrest. This study aimed to assess the effectiveness of a basic life support (BLS) educational course given to 110 middle school children, using a pretest posttest design. In the pretest, students were asked to demonstrate BLS on a manikin to simulate a real-life scenario. After the pretest, a BLS training course of two sessions was provided, followed by posttest on the same manikin. Students were assessed using an observational sheet based on the American Heart Association's BLS guidelines. In the pretest, students showed significant weakness in the majority of guidelines. In the posttest, they demonstrated significant improvement in their BLS skills. BLS training in the middle school was effective, considering the lack of previous skills. It is recommended that BLS education be compulsory in the school setting.

Greatly improved 3C-SiC p-n junction diodes grown by chemical vapor deposition

NASA Technical Reports Server (NTRS)

Neudeck, Philip G.; Larkin, David J.; Starr, Jonathan E.; Powell, J. A.; Salupo, Carl S.; Matus, Lawrence G.

1993-01-01

This paper reports the fabrication and initial electrical characterization of greatly improved 3C-SiC (beta-SiC) p-n junction diodes. These diodes, which were grown on commercially available 6H-SiC substrates by chemical vapor deposition, demonstrate rectification to -200 V at room temperature, representing a fourfold improvement in reported 3C-SiC diode blocking voltage. The reverse leakage currents and saturation current densities measured on these diodes also show significant improvement compared to previously reported 3C-SiC p-n junction diodes. When placed under sufficient forward bias, the diodes emit significantly bright green-yellow light. These results should lead to substantial advancements in 3C-SiC transistor performance.

Predicting Differential Response to EMG Biofeedback and Relaxation Training: The Role of Cognitive Structure.

ERIC Educational Resources Information Center

Hart, James D.

1984-01-01

Analyzed treatment outcome data for 102 headache patients who had been assigned randomly to receive either EMG biofeedback (N=70) or relaxation training (N=32). Analysis demonstrated that relaxation training was significantly more effective than biofeedback and that mixed headache patients improved significantly less than either migraine or…

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs.

PubMed

Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A; Mizusaki Imoto, Aline; Toupin-April, Karine; Westby, Marie; Álvarez Gallardo, Inmaculada C; Gifford, Wendy; Laferrière, Lucie; Rahman, Prinon; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Shallwani, Shirin Mehdi; Aburub, Ala'; Bennell, Kim L; Van der Esch, Martin; Simic, Milena; McConnell, Sara; Harmer, Alison; Kenny, Glen P; Paterson, Gail; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; McLean, Linda

2017-05-01

To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance ( p < 0.5) and clinical importance (⩾15% improvement). The 26 high-quality studies identified demonstrated that various strengthening exercise programs with/without other types of therapeutic exercises are generally effective for improving knee osteoarthritis management within a six-month period. Strengthening exercise programs demonstrated a significant improvement for pain relief (four Grade A, ten Grade B, two Grade C+), physical function (four Grade A, eight Grade B) and quality of life (three Grade B). Strengthening in combination with other types of exercises (coordination, balance, functional) showed a significant improvement in pain relief (three Grade A, 11 Grade B, eight Grade C+), physical function (two Grade A, four Grade B, three Grade C+) and quality of life (one Grade A, one Grade C+). There are a variety of choices for strengthening exercise programs with positive recommendations for healthcare professionals and knee osteoarthritis patients. There is a need to develop combined behavioral and muscle-strengthening strategies to improve long-term maintenance of regular strengthening exercise programs.

A Transferrable Belief Model Representation for Physical Security of Nuclear Materials

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

David Gerts

This work analyzed various probabilistic methods such as classic statistics, Bayesian inference, possibilistic theory, and Dempster-Shafer theory of belief functions for the potential insight offered into the physical security of nuclear materials as well as more broad application to nuclear non-proliferation automated decision making theory. A review of the fundamental heuristic and basic limitations of each of these methods suggested that the Dempster-Shafer theory of belief functions may offer significant capability. Further examination of the various interpretations of Dempster-Shafer theory, such as random set, generalized Bayesian, and upper/lower probability demonstrate some limitations. Compared to the other heuristics, the transferrable beliefmore » model (TBM), one of the leading interpretations of Dempster-Shafer theory, can improve the automated detection of the violation of physical security using sensors and human judgment. The improvement is shown to give a significant heuristic advantage over other probabilistic options by demonstrating significant successes for several classic gedanken experiments.« less

Environment dominates over host genetics in shaping human gut microbiota.

PubMed

Rothschild, Daphna; Weissbrod, Omer; Barkan, Elad; Kurilshikov, Alexander; Korem, Tal; Zeevi, David; Costea, Paul I; Godneva, Anastasia; Kalka, Iris N; Bar, Noam; Shilo, Smadar; Lador, Dar; Vila, Arnau Vich; Zmora, Niv; Pevsner-Fischer, Meirav; Israeli, David; Kosower, Noa; Malka, Gal; Wolf, Bat Chen; Avnit-Sagi, Tali; Lotan-Pompan, Maya; Weinberger, Adina; Halpern, Zamir; Carmi, Shai; Fu, Jingyuan; Wijmenga, Cisca; Zhernakova, Alexandra; Elinav, Eran; Segal, Eran

2018-03-08

Human gut microbiome composition is shaped by multiple factors but the relative contribution of host genetics remains elusive. Here we examine genotype and microbiome data from 1,046 healthy individuals with several distinct ancestral origins who share a relatively common environment, and demonstrate that the gut microbiome is not significantly associated with genetic ancestry, and that host genetics have a minor role in determining microbiome composition. We show that, by contrast, there are significant similarities in the compositions of the microbiomes of genetically unrelated individuals who share a household, and that over 20% of the inter-person microbiome variability is associated with factors related to diet, drugs and anthropometric measurements. We further demonstrate that microbiome data significantly improve the prediction accuracy for many human traits, such as glucose and obesity measures, compared to models that use only host genetic and environmental data. These results suggest that microbiome alterations aimed at improving clinical outcomes may be carried out across diverse genetic backgrounds.

Nicergoline improves dysphagia by upregulating substance P in the elderly.

PubMed

Nakashima, Taku; Hattori, Noboru; Okimoto, Mafumi; Yanagida, Jitsuro; Kohno, Nobuoki

2011-07-01

Dysphagia induces silent aspiration, which is a known risk factor for aspiration pneumonia in the elderly. Dysphagia is associated with impaired substance P secretion. Because nicergoline was recently reported to enhance substance P secretion, it may improve dysphagia by upregulating substance P; however, roles for nicergoline in this process have not been demonstrated. We therefore compared the effects of nicergoline on serum substance P and dysphagia with the effects of imidapril, an angiotensin-converting enzyme (ACE) inhibitor whose efficacy in improving dysphagia and preventing pneumonia has been previously demonstrated.We randomly assigned 60 elderly patients with both dysphagia and a previous history of pneumonia to receive either imidapril (5 mg/d; n = 30) or nicergoline (15 mg/d; n = 30) for 6 months. Primary outcomes were the effects of these drugs on the substance P level and dysphagia 4 weeks after the start of treatment. Secondary outcome was the effect of these drugs on pneumonia recurrence during the 6 months of treatment.Significant elevations of serum substance P were obtained by both medications after 4 weeks of treatment. Patients whose dysphagia was improved showed significantly increased serum levels of substance P. There was no statistically significant difference in the overall proportion of patients who showed improvements in dysphagia and pneumonia recurrence with imidapril or nicergoline treatment. Nicergoline, but not imidapril, seemed to be more effective at improving dysphagia and elevating serum substance P in patients with dementia.In conclusion, nicergoline has a comparable effect to ACE inhibitors for improving dysphagia. Nicergoline might be a novel regimen for the treatment of dysphagia in the elderly who are not treatable with ACE inhibitors.

Expression of heterologous non-oxidative pentose phosphate pathway from Bacillus methanolicus and phosphoglucose isomerase deletion improves methanol assimilation and metabolite production by a synthetic Escherichia coli methylotroph

DOE PAGES

Bennett, R. Kyle; Gonzalez, Jacqueline E.; Whitaker, W. Brian; ...

2017-12-05

Synthetic methylotrophy aims to develop non-native methylotrophic microorganisms to utilize methane or methanol to produce chemicals and biofuels. We report two complimentary strategies to further engineer a previously engineered methylotrophic E. coli strain for improved methanol utilization. First, we demonstrate improved methanol assimilation in the presence of small amounts of yeast extract by expressing the non-oxidative pentose phosphate pathway (PPP) from Bacillus methanolicus. Second, we demonstrate improved co-utilization of methanol and glucose by deleting the phosphoglucose isomerase gene ( pgi), which rerouted glucose carbon flux through the oxidative PPP. Both strategies led to significant improvements in methanol assimilation as determinedmore » by 13C-labeling in intracellular metabolites. As a result, introduction of an acetone-formation pathway in the pgi-deficient methylotrophic E. coli strain led to improved methanol utilization and acetone titers during glucose fed-batch fermentation.« less

Flight Test Comparison of Different Adaptive Augmentations for Fault Tolerant Control Laws for a Modified F-15 Aircraft

NASA Technical Reports Server (NTRS)

Burken, John J.; Hanson, Curtis E.; Lee, James A.; Kaneshige, John T.

2009-01-01

This report describes the improvements and enhancements to a neural network based approach for directly adapting to aerodynamic changes resulting from damage or failures. This research is a follow-on effort to flight tests performed on the NASA F-15 aircraft as part of the Intelligent Flight Control System research effort. Previous flight test results demonstrated the potential for performance improvement under destabilizing damage conditions. Little or no improvement was provided under simulated control surface failures, however, and the adaptive system was prone to pilot-induced oscillations. An improved controller was designed to reduce the occurrence of pilot-induced oscillations and increase robustness to failures in general. This report presents an analysis of the neural networks used in the previous flight test, the improved adaptive controller, and the baseline case with no adaptation. Flight test results demonstrate significant improvement in performance by using the new adaptive controller compared with the previous adaptive system and the baseline system for control surface failures.

Expression of heterologous non-oxidative pentose phosphate pathway from Bacillus methanolicus and phosphoglucose isomerase deletion improves methanol assimilation and metabolite production by a synthetic Escherichia coli methylotroph

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

Bennett, R. Kyle; Gonzalez, Jacqueline E.; Whitaker, W. Brian

Synthetic methylotrophy aims to develop non-native methylotrophic microorganisms to utilize methane or methanol to produce chemicals and biofuels. We report two complimentary strategies to further engineer a previously engineered methylotrophic E. coli strain for improved methanol utilization. First, we demonstrate improved methanol assimilation in the presence of small amounts of yeast extract by expressing the non-oxidative pentose phosphate pathway (PPP) from Bacillus methanolicus. Second, we demonstrate improved co-utilization of methanol and glucose by deleting the phosphoglucose isomerase gene ( pgi), which rerouted glucose carbon flux through the oxidative PPP. Both strategies led to significant improvements in methanol assimilation as determinedmore » by 13C-labeling in intracellular metabolites. As a result, introduction of an acetone-formation pathway in the pgi-deficient methylotrophic E. coli strain led to improved methanol utilization and acetone titers during glucose fed-batch fermentation.« less

Quality-of-life outcomes in patients who underwent subcutaneous immunotherapy and sublingual immunotherapy in a real-world clinical setting.

PubMed

Schwanke, Theresa; Carragee, Eugene; Bremberg, Maria; Reisacher, William R

2017-09-01

To compare changes in quality of life (QOL) that resulted from sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) in a real-world clinical setting. SLIT is established as a viable alternative to SCIT for the treatment of allergic rhinitis. Although comparative trials are increasingly available, few studies have examined QOL outcomes between these two treatments. One hundred and five participants who underwent immunotherapy for airborne allergies were enrolled in this prospective, single-center study. Forty participants completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at initiation of therapy, after 6 months, and after 1 year of therapy. Only patients with complete time points were included in the ultimate analysis. Twenty-nine of these participants underwent SCIT and 11 underwent SLIT. The effects of age, sex, and asthma history were also examined. The participants in both groups demonstrated improvements in QOL regarding allergic rhinoconjunctivitis over the study period. However, the change in the RQLQ score from both baseline to 6 months and baseline to 1 year was only statistically significant in the SCIT group (p = 0.002, 6 months and 1 year). The participants in the SCIT group also demonstrated statistically significant improvement from baseline to 1 year in the specific domains of practical and emotional functioning, nasal symptoms, non-nasal/eye symptoms, and sleep. After 1 year, both SCIT and SLIT demonstrated a minimally important difference from baseline in the overall RQLQ score. Age <35 years in the SCIT group had a significant positive impact on QOL improvement (p = 0.038). Although improvements in QOL were noted in both groups, changes in overall scores and the majority of domains only achieved statistical significance in the SCIT group. A small study population and difficulties adhering to immunotherapy dosing schedules in the SLIT group may be contributing factors.

Microbiologic evaluation of microfiber mops for surface disinfection.

PubMed

Rutala, William A; Gergen, Maria F; Weber, David J

2007-11-01

Recently, health care facilities have started to use a microfiber mopping technique rather than a conventional, cotton string mop to clean floors. The effectiveness of microfiber mops to reduce microbial levels on floors was investigated. We compared the efficacy of microfiber mops with that of conventional, cotton string mops in 3 test conditions (cotton mop and standard wringer bucket, microfiber mop and standard wringer bucket, microfiber system). Twenty-four rooms were evaluated for each test condition. RODAC plates containing D/E Neutralizing Agar were used to assess "precleaning" and "postcleaning" microbial levels. The microfiber system demonstrated superior microbial removal compared with cotton string mops when used with a detergent cleaner (95% vs 68%, respectively). The use of a disinfectant did not improve the microbial elimination demonstrated by the microfiber system (95% vs 95%, respectively). However, use of disinfectant did significantly improve microbial removal when a cotton string mop was used (95% vs 68%, respectively). The microfiber system demonstrated superior microbial removal compared with cotton string mops when used with a detergent cleaner. The use of a disinfectant did not improve the microbial elimination demonstrated by the microfiber system.

A clinical study on the usefulness of autologous plasma filler in the treatment of nasolabial fold wrinkles.

PubMed

Choi, Young-Jun; Kim, Han-Saem; Min, Joon Hong; Nam, Jae-Hui; Lee, Ga-Young; Kim, Won-Serk

2017-06-01

Recently, the efficacy of autologous plasma filler for the reduction of facial wrinkles has been demonstrated. The aim of our study is to validate the efficacy and safety of autologous plasma filler in treating nasolabial fold wrinkles. Twenty Korean patients with moderate-to-severe nasolabial fold wrinkles were enrolled. The patients were treated with one session of autologous plasma filler. The wrinkle improvement effects were evaluated at 1-week, 4-week, 8-week, and 12-week after the treatment. Three assessment methods were applied. First, two independent dermatologists assessed cosmetic results using a 5-point wrinkle assessment scale. Second, global aesthetic improvement score was used for assessment of the final cosmetic results. Third, patient satisfaction was surveyed. Also, the adverse effects associated to treatment were observed. Mean age of the patients was 44.5 years. The average 5-point wrinkle assessment scale score was significantly improved at 1, 4, 8, and 12 weeks after treatment, comparing to before treatment (p < 0.01). The patients' average global aesthetic improvement score also indicated better cosmetic outcomes. The clinical improvement with sufficient patients' satisfaction and no significant adverse events demonstrated that novel autologous plasma filler could be considered as efficient and safety treatment option for nasolabial fold wrinkles.

Governance Practices in an Era of Healthcare Transformation: Achieving a Successful Turnaround.

PubMed

Sondheim, Samuel E; Patel, Dipesh M; Chin, Nicole; Barwis, Kurt; Werner, Julie; Barclay, Alexus; Mattie, Angela

This article illustrates the successful application of principles established by the American Hospital Association (AHA) to foster hospital transformations (). We examined a small community hospital's successful transition from one emergency care center (ECC) physician group to another and the methods by which significant improvements in outcomes were achieved. The foundation of this transformation included a generative governance style at the board level, a shared governance model at the employee level, a renewed sense of employee and physician engagement, and a sense of individual accountability. Outcomes included improved communication, a more unified vision throughout the ECC (which led to improved efficiency and accountability among staff), improved metrics, and a positive impact on the community's perception of care. Press Ganey scores and ECC operational metrics demonstrated significant increases in patient satisfaction and decreases in wait times for seven operational metrics. These data serve as a proxy for the transformation's success. Structured interviews revealed an increase in employee satisfaction associated with the transition. The positive outcomes demonstrate the importance of the AHA-articulated governance principles. The AHA recommendations for a superior value-based care model closely align with the methods illustrated through Bristol Hospital's successful transformation. Other institutions can apply the lessons from this case study to drive positive change and improve patient care.

Using Trial Vocal Fold Injection to Select Vocal Fold Scar Patients Who May Benefit From More Durable Augmentation.

PubMed

Carroll, Thomas L; Dezube, Aaron; Bauman, Laura A; Mallur, Pavan S

2018-02-01

Clinical indications for vocal fold injection augmentation (VFI) are expanding. Prior studies demonstrate the benefit of trial VFI for select causes of glottic insufficiency. No studies have examined trial VFI for glottic insufficiency resulting from true vocal fold (TVF) scar. Retrospective chart review of patients who underwent trial VFI for a dominant pathology of TVF scar causing dysphonia. Patients who subsequently underwent durable augmentation were identified. The primary study outcome was the difference in Voice Handicap Index-10 (VHI-10) score from pretrial VFI to post-durable augmentation. Twenty-eight patients underwent trial VFI for TVF scar, 22 of whom reported a positive response. Fifteen of 22 subjects who underwent durable augmentation had viable data for analysis. Mean VHI-10 improved from 26.9 to 18.6 ( P < .05), for a delta VHI-10 of 8.3, or 30.9% improvement. Twelve of the 15 (80%) showed a clinically significant improvement (delta VHI-10 >5). A trial VFI is a potentially useful, low-risk procedure that appears to help the patient and clinician identify when global augmentation might improve the voice when vocal fold scar is present. Patients who reported successful trial VFI often demonstrated significant improvement in their VHI-10 after subsequent durable augmentation.

Innovative integrative bedside teaching model improves tutors’ self-assessments of teaching skills and attitudes

PubMed Central

Gat, Itai; Pessach-Gelblum, Liat; Givati, Gili; Haim, Nadav; Paluch-Shimon, Shani; Unterman, Avraham; Bar-Shavit, Yochay; Grabler, Galit; Sagi, Doron; Achiron, Anat; Ziv, Amitai

2016-01-01

Introduction Patient bedside is the ideal setting for teaching physical examination, medical interviewing, and interpersonal skills. Herein we describe a novel model for bedside teaching (BST) practiced during tutor training workshop and its resulting effect on practitioners’ self assessment of teaching skills and perceptions. Methods One-day tutor training workshop included theoretical knowledge supplementation regarding tutors’ roles as well as implementing practical tools for clinical education, mainly BST model. The model, which emphasizes simultaneous clinical and communication teaching in a stepwise approach, was practiced by consecutive simulations with a gradual escalation of difficulty and adjusted instruction approaches. Pre- and post-workshop-adjusted questionnaires using a Likert scale of 1 to 4 were completed by participants and compared. Results Analysis was based on 25 out of 48 participants who completed both questionnaires. Significantly improved teaching skills were demonstrated upon workshop completion (mean 3.3, SD 0.5) compared with pre-training (mean 2.6, SD 0.6; p<0.001) with significant increase in most examined parameters. Significantly improved tutor's roles internalization was demonstrated after training completion (mean 3.7, SD 0.3) compared with pre-workshop (mean 3.5 SD 0.5; p=0.002). Discussion Successful BST involves combination of clinical and communication skills. BST model practiced during the workshop may contribute to improved teaching skills in this challenging environment. PMID:26894587

Impact of nurse-led behavioural counselling to improve metabolic health and physical activity among adults with mental illness.

PubMed

Fraser, Sarah J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W

2018-04-01

The life expectancy of adults with mental illness is significantly less than that of the general population, and this is largely due to poor physical health. Behavioural counselling can improve physical health indicators among people with non-communicable disease. This repeated-measures, single-group intervention trial evaluated the effects of a 19-week behavioural counselling programme on metabolic health indicators and physical activity levels of outpatient adults with mental illness. Sixteen participants completed the intervention that comprised individual face-to-face counselling sessions with a registered nurse every 3 weeks, and progress reviews with a medical practitioner every 6 weeks. Assessment included self-report and objective measurement of physical activity, and measures of blood pressure and anthropometry. Statistically-significant changes were demonstrated between baseline and post intervention for participants' waist circumference (P = 0.035) and waist-to-height ratio (P = 0.037). Non-significant improvements were demonstrated in weight and physical activity. The findings indicated that adults with mental illness can engage in a nurse-led behavioural counselling intervention, with improvements in some metabolic health measures after 19 weeks. It is recommended that behavioural counselling programmes for adults with mental illness be sustained over time and have an 'open door' policy to allow for attendance interruptions, such as hospitalization. © 2017 Australian College of Mental Health Nurses Inc.

Improving the numerical integration solution of satellite orbits in the presence of solar radiation pressure using modified back differences

NASA Technical Reports Server (NTRS)

Lundberg, J. B.; Feulner, M. R.; Abusali, P. A. M.; Ho, C. S.

1991-01-01

The method of modified back differences, a technique that significantly reduces the numerical integration errors associated with crossing shadow boundaries using a fixed-mesh multistep integrator without a significant increase in computer run time, is presented. While Hubbard's integral approach can produce significant improvements to the trajectory solution, the interpolation method provides the best overall results. It is demonstrated that iterating on the point mass term correction is also important for achieving the best overall results. It is also shown that the method of modified back differences can be implemented with only a small increase in execution time.

DASHBOARDS & CONTROL CHARTS EXPERIENCES IN IMPROVING SAFETY AT HANFORD WASHINGTON

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

PREVETTE, S.S.

2006-02-27

The aim of this paper is to demonstrate the integration of safety methodology, quality tools, leadership, and teamwork at Hanford and their significant positive impact on safe performance of work. Dashboards, Leading Indicators, Control charts, Pareto Charts, Dr. W. Edward Deming's Red Bead Experiment, and Dr. Deming's System of Profound Knowledge have been the principal tools and theory of an integrated management system. Coupled with involved leadership and teamwork, they have led to significant improvements in worker safety and protection, and environmental restoration at one of the nation's largest nuclear cleanup sites.

Teacher coaching supported by formative assessment for improving classroom practices.

PubMed

Fabiano, Gregory A; Reddy, Linda A; Dudek, Christopher M

2018-06-01

The present study is a wait-list controlled, randomized study investigating a teacher coaching approach that emphasizes formative assessment and visual performance feedback to enhance elementary school teachers' classroom practices. The coaching model targeted instructional and behavioral management practices as measured by the Classroom Strategies Assessment System (CSAS) Observer and Teacher Forms. The sample included 89 general education teachers, stratified by grade level, and randomly assigned to 1 of 2 conditions: (a) immediate coaching, or (b) waitlist control. Results indicated that, relative to the waitlist control, teachers in immediate coaching demonstrated significantly greater improvements in observations of behavior management strategy use but not for observations of instructional strategy use. Observer- and teacher-completed ratings of behavioral management strategy use at postassessment were significantly improved by both raters; ratings of instructional strategy use were significantly improved for teacher but not observer ratings. A brief coaching intervention improved teachers' use of observed behavior management strategies and self-reported use of behavior management and instructional strategies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Antifungal Efficacy of Caspofungin (MK-0991) in Experimental Pulmonary Aspergillosis in Persistently Neutropenic Rabbits: Pharmacokinetics, Drug Disposition, and Relationship to Galactomannan Antigenemia

PubMed Central

Petraitiene, Ruta; Petraitis, Vidmantas; Groll, Andreas H.; Sein, Tin; Schaufele, Robert L.; Francesconi, Andrea; Bacher, John; Avila, Nilo A.; Walsh, Thomas J.

2002-01-01

The antifungal efficacy, pharmacokinetics, and safety of caspofungin (CAS) were investigated in the treatment and prophylaxis of invasive pulmonary aspergillosis due to Aspergillus fumigatus in persistently neutropenic rabbits. Antifungal therapy consisted of 1, 3, or 6 mg of CAS/kg of body weight/day (CAS1, CAS3, and CAS6, respectively) or 1 mg of deoxycholate amphotericin B (AMB)/kg/day intravenously for 12 days starting 24 h after endotracheal inoculation. Prophylaxis (CAS1) was initiated 4 days before endotracheal inoculation. Rabbits treated with CAS had significant improvement in survival and reduction in organism-mediated pulmonary injury (OMPI) measured by pulmonary infarct score and total lung weight (P < 0.01). However, animals treated with CAS demonstrated a paradoxical trend toward increased residual fungal burden (log CFU per gram) and increased serum galactomannan antigen index (GMI) despite improved survival. Rabbits receiving prophylactic CAS1 also showed significant improvement in survival and reduction in OMPI (P < 0.01), but there was no effect on residual fungal burden. In vitro tetrazolium salt hyphal damage assays and histologic studies demonstrated that CAS had concentration- and dose-dependent effects on hyphal structural integrity. In parallel with a decline in GMI, AMB significantly reduced the pulmonary tissue burden of A. fumigatus (P ≤ 0.01). The CAS1, CAS3, and CAS6 dose regimens demonstrated dose-proportional exposure and maintained drug levels in plasma above the MIC for the entire 24-h dosing interval at doses that were ≥3 mg/kg/day. As serial galactomannan antigen levels may be used for therapeutic monitoring, one should be aware that profoundly neutropenic patients receiving echinocandins for aspergillosis might have persistent galactomannan antigenemia despite clinical improvement. CAS improved survival, reduced pulmonary injury, and caused dose-dependent hyphal damage but with no reduction in residual fungal burden or galactomannan antigenemia in persistently neutropenic rabbits with invasive pulmonary aspergillosis. PMID:11751105

Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with psoriatic arthritis and current skin involvement: a phase III, randomised, controlled trial (PALACE 3)

PubMed Central

Edwards, Christopher J; Blanco, Francisco J; Crowley, Jeffrey; Birbara, Charles A; Jaworski, Janusz; Aelion, Jacob; Stevens, Randall M; Vessey, Adele; Zhan, Xiaojiang; Bird, Paul

2016-01-01

Objective To evaluate apremilast treatment in patients with active psoriatic arthritis, including current skin involvement, despite prior therapy with conventional disease-modifying antirheumatic drugs and/or biologic agents. Methods Patients (N=505) were randomised (1:1:1) to placebo, apremilast 20 mg twice daily, or apremilast 30 mg twice daily. Rescue therapy with apremilast was designated at week 16 for placebo patients not achieving 20% improvement in swollen and tender joint counts. At week 24, the remaining placebo patients were then randomised to apremilast 20 mg twice daily or 30 mg twice daily. The efficacy and safety of apremilast were assessed over 52 weeks. Results At week 16, significantly more patients receiving apremilast 20 mg twice daily (28%) and 30 mg twice daily (41%) achieved 20% improvement in American College of Rheumatology response criteria versus placebo (18%; p=0.0295 and p<0.0001, respectively), and mean decrease in the Health Assessment Questionnaire-Disability Index score was significantly greater with apremilast 30 mg twice daily (−0.20) versus placebo (−0.07; p=0.0073). In patients with baseline psoriasis body surface area involvement ≥3%, significantly more apremilast 30 mg twice daily patients achieved 50% reduction from baseline Psoriasis Area and Severity Index score (41%) versus placebo (24%; p=0.0098) at week 16. At week 52, observed improvements in these measures demonstrated sustained response with continued apremilast treatment. Most adverse events were mild to moderate in severity; the most common were diarrhoea, nausea, headache and upper respiratory tract infection. Conclusions Apremilast demonstrated clinically meaningful improvements in psoriatic arthritis and psoriasis at week 16; sustained improvements were seen with continued treatment through 52 weeks. Apremilast was generally well tolerated and demonstrated an acceptable safety profile. Trial registration number NCT01212770. PMID:26792812

Effect of a mobile health, sensor-driven asthma management platform on asthma control.

PubMed

Barrett, Meredith A; Humblet, Olivier; Marcus, Justine E; Henderson, Kelly; Smith, Ted; Eid, Nemr; Sublett, J Wesley; Renda, Andrew; Nesbitt, LaQuandra; Van Sickle, David; Stempel, David; Sublett, James L

2017-11-01

Asthma inflicts a significant health and economic burden in the United States. Self-management approaches to monitoring and treatment can be burdensome for patients. To assess the effect of a digital health management program on asthma outcomes. Residents of Louisville, Kentucky, with asthma were enrolled in a single-arm pilot study. Participants received electronic inhaler sensors that tracked the time, frequency, and location of short-acting β-agonist (SABA) use. After a 30-day baseline period during which reference medication use was recorded by the sensors, participants received access to a digital health intervention designed to enhance self-management. Changes in outcomes, including mean daily SABA use, symptom-free days, and asthma control status, were compared among the initial 30-day baseline period and all subsequent months of the intervention using mixed-model logistic regressions and χ 2 tests. The mean number of SABA events per participant per day was 0.44 during the control period and 0.27 after the first month of the intervention, a 39% reduction. The percentage of symptom-free days was 77% during the baseline period and 86% after the first month, a 12% improvement. Improvement was observed throughout the study; each intervention month demonstrated significantly lower SABA use and higher symptom-free days than the baseline month (P < .001). Sixty-nine percent had well-controlled asthma during the baseline period, 67% during the first month of the intervention. Each intervention month demonstrated significantly higher percentages than the baseline month (P < .001), except for month 1 (P = .80). A digital health asthma management intervention demonstrated significant reductions in SABA use, increased number of symptom-free days, and improvements in asthma control. ClinicalTrials.gov Identifier: NCT02162576. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Application of remotely sensed land-use information to improve estimates of streamflow characteristics, volume 8. [Maryland, Virginia, and Delaware

NASA Technical Reports Server (NTRS)

Pluhowski, E. J. (Principal Investigator)

1977-01-01

The author has identified the following significant results. Land use data derived from high altitude photography and satellite imagery were studied for 49 basins in Delaware, and eastern Maryland and Virginia. Applying multiple regression techniques to a network of gaging stations monitoring runoff from 39 of the basins, demonstrated that land use data from high altitude photography provided an effective means of significantly improving estimates of stream flow. Forty stream flow characteristic equations for incorporating remotely sensed land use information, were compared with a control set of equations using map derived land cover. Significant improvement was detected in six equations where level 1 data was added and in five equations where level 2 information was utilized. Only four equations were improved significantly using land use data derived from LANDSAT imagery. Significant losses in accuracy due to the use of remotely sensed land use information were detected only in estimates of flood peaks. Losses in accuracy for flood peaks were probably due to land cover changes associated with temporal differences among the primary land use data sources.

Time domain topology optimization of 3D nanophotonic devices

NASA Astrophysics Data System (ADS)

Elesin, Y.; Lazarov, B. S.; Jensen, J. S.; Sigmund, O.

2014-02-01

We present an efficient parallel topology optimization framework for design of large scale 3D nanophotonic devices. The code shows excellent scalability and is demonstrated for optimization of broadband frequency splitter, waveguide intersection, photonic crystal-based waveguide and nanowire-based waveguide. The obtained results are compared to simplified 2D studies and we demonstrate that 3D topology optimization may lead to significant performance improvements.

NetMHCpan-3.0; improved prediction of binding to MHC class I molecules integrating information from multiple receptor and peptide length datasets.

PubMed

Nielsen, Morten; Andreatta, Massimo

2016-03-30

Binding of peptides to MHC class I molecules (MHC-I) is essential for antigen presentation to cytotoxic T-cells. Here, we demonstrate how a simple alignment step allowing insertions and deletions in a pan-specific MHC-I binding machine-learning model enables combining information across both multiple MHC molecules and peptide lengths. This pan-allele/pan-length algorithm significantly outperforms state-of-the-art methods, and captures differences in the length profile of binders to different MHC molecules leading to increased accuracy for ligand identification. Using this model, we demonstrate that percentile ranks in contrast to affinity-based thresholds are optimal for ligand identification due to uniform sampling of the MHC space. We have developed a neural network-based machine-learning algorithm leveraging information across multiple receptor specificities and ligand length scales, and demonstrated how this approach significantly improves the accuracy for prediction of peptide binding and identification of MHC ligands. The method is available at www.cbs.dtu.dk/services/NetMHCpan-3.0 .

Profile of apalutamide in the treatment of metastatic castration-resistant prostate cancer: evidence to date.

PubMed

Chong, Julio T; Oh, William K; Liaw, Bobby C

2018-01-01

Advances in therapies have led to the approval of six therapeutic agents since 2004, each demonstrating overall survival benefit in randomized studies, and these have significantly improved the outlook for men facing metastatic castration-resistant prostate cancer (CRPC). More recently, efforts have been directed at trying to effect change at earlier phases of the disease. Apalutamide (ARN-509), a second-generation androgen receptor antagonist, recently received approval in the nonmetastatic (M0) CRPC space. Similar to enzalutamide, apalutamide inhibits the binding of androgen to androgen receptor (AR), nuclear translocation of the androgen-AR complex, and binding of AR transcription complex to DNA-binding sites and transcription elements. Phase I and II trial experience demonstrates the safety and tolerability of apalutamide, as well as its efficacy in effecting prostate-specific antigen response and radiographic-free survival in CRPC. US Food and Drug Administration approval in M0 CRPC was granted following positive results from the phase III SPARTAN study, where apalutamide demonstrated significant improvements in metastasis-free survival and time to symptomatic progression as compared to placebo.

Temporal Stability of Music Perception and Appraisal Scores of Adult Cochlear Implant Recipients

PubMed Central

Gfeller, Kate; Jiang, Dingfeng; Oleson, Jacob; Driscoll, Virginia; Knutson, John F.

2010-01-01

Background An extensive body of literature indicates that cochlear implants are effective in supporting speech perception of persons with severe to profound hearing losses who do not benefit to any great extent from conventional hearing aids. Adult CI recipients tend to show significant improvement in speech perception within 3 months following implantation as a result of mere experience. Furthermore, CI recipients continue to show modest improvement as long as 5 years post implantation. In contrast, data taken from single testing protocols of music perception and appraisal indicate that CIs are less than ideal in transmitting important structural features of music, such as pitch, melody and timbre. However, there is presently little information documenting changes in music perception or appraisal over extended time as a result of mere experience. Purpose This study examined two basic questions: 1) Do adult CI recipients show significant improvement in perceptual acuity or appraisal of specific music listening tasks when tested in two consecutive years? 2) If there are tasks for which CI recipients show significant improvement with time, are there particular demographic variables that predict those CI recipients most likely to show improvement with extended CI use? Research Design A longitudinal cohort study. Implant recipients return annually for visits to the clinic. Study Sample The study included 209 adult cochlear implant recipients with at least 9 months implant experience before their first year measurement. Data collection and analysis Outcomes were measured on the patient’s annual visit in two consecutive years. Paired t-tests were used to test for significant improvement from one year to the next. Those variables demonstrating significant improvement were subjected to regression analyses performed to detect the demographic variables useful in predicting said improvement. Results There were no significant differences in music perception outcomes as a function of type of device or processing strategy used. Only familiar melody recognition (FMR) and recognition of melody excerpts with lyrics (MERT-L) showed significant improvement from one year to the next. After controlling for the baseline value, hearing aid use, months of use, music listening habits after implantation and formal musical training in elementary school were significant predictors of FMR improvement. Bilateral CI use, formal musical training in high school and beyond, and a measure of sequential cognitive processing were significant predictors of MERT-L improvement. Conclusions These adult CI recipients as a result of mere experience demonstrated fairly consistent music perception and appraisal on measures gathered in two consecutive years. Gains made tend to be modest, and can be associated with characteristics such as use of hearing aids, listening experiences, or bilateral use (in the case of lyrics). These results have implications for counseling of CI recipients with regard to realistic expectations and strategies for enhancing music perception and enjoyment. PMID:20085197

Performance enhancement of pentacene-based organic thin-film transistors using 6,13-pentacenequinone as a carrier injection interlayer

NASA Astrophysics Data System (ADS)

Fan, Ching-Lin; Lin, Wei-Chun; Chen, Hao-Wei

2018-06-01

This work demonstrates pentacene-based organic thin-film transistors (OTFTs) fabricated by inserting a 6,13-pentacenequinone (PQ) carrier injection layer between the source/drain (S/D) metal Au electrodes and pentacene channel layer. Compared to devices without a PQ layer, the performance characteristics including field-effect mobility, threshold voltage, and On/Off current ratio were significantly improved for the device with a 5-nm-thick PQ interlayer. These improvements are attributed to significant reduction of hole barrier height at the Au/pentacene channel interfaces. Therefore, it is believed that using PQ as the carrier injection layer is a good candidate to improve the pentacene-based OTFTs electrical performance.

A residency clinic chronic condition management quality improvement project.

PubMed

Halverson, Larry W; Sontheimer, Dan; Duvall, Sharon

2007-02-01

Quality improvement in chronic disease management is a major agenda for improving health and reducing health care costs. A six-component chronic disease management model can help guide this effort. Several characteristics of the "new model" of family medicine described by the Future of Family Medicine (FFM) Project Leadership Committee are promulgated to foster practice changes that improve quality. Our objective was to implement and assess a quality improvement project guided by the components of a chronic disease management model and FFM new model characteristics. Diabetes was selected as a model chronic disease focus. Multiple practice changes were implemented. A mature electronic medical record facilitated data collection and measurement of quality improvement progress. Data from the diabetes registry demonstrates that our efforts have been effective. Significant improvement occurred in five out of six quality indicators. Multidisciplinary teamwork in a model residency practice guided by chronic disease management principles and the FFM new model characteristics can produce significant management improvements in one important chronic disease.

Glycopyrronium once-daily significantly improves lung function and health status when combined with salmeterol/fluticasone in patients with COPD: the GLISTEN study—a randomised controlled trial

PubMed Central

Frith, Peter A; Thompson, Philip J; Ratnavadivel, Rajeev; Chang, Catherina L; Bremner, Peter; Day, Peter; Frenzel, Christina; Kurstjens, Nicol

2015-01-01

Background The optimal use of various therapeutic combinations for moderate/severe chronic obstructive pulmonary disease (COPD) is unclear. The GLISTEN trial compared the efficacy of two long-acting anti-muscarinic antagonists (LAMA), when combined with an inhaled corticosteroid (ICS) and a long-acting β2 agonist (LABA). Methods This randomised, blinded, placebo-controlled trial in moderate/severe COPD patients compared once-daily glycopyrronium (GLY) 50 µg, once-daily tiotropium (TIO) 18 µg or placebo (PLA), when combined with salmeterol/fluticasone propionate (SAL/FP) 50/500 µg twice daily. The primary objective was to determine the non-inferiority of GLY+SAL/FP versus TIO+SAL/FP on trough FEV1 after 12 weeks. An important secondary objective was whether addition of GLY to SAL/FP was better than SAL/FP alone. Results 773 patients (mean FEV1 57.2% predicted) were randomised; 84.9% completed the trial. At week 12, GLY+SAL/FP demonstrated non-inferiority to TIO+SAL/FP for trough FEV1: least square mean treatment difference (LSMdiff) −7 mL (SE 17.4) with a lower limit for non-inferiority of −60 mL. There was significant increase in week 12 trough FEV1 with GLY+SAL/FP versus PLA+SAL/FP (LSMdiff 101 mL, p<0.001). At 12 weeks, GLY+SAL/FP produced significant improvement in St George's Respiratory Questionnaire total score versus PLA+SAL/FP (LSMdiff −2.154, p=0.02). GLY+SAL/FP demonstrated significant rescue medication reduction versus PLA+SAL/FP (LSMdiff −0.72 puffs/day, p<0.001). Serious adverse events were similar for GLY+SAL/FP, TIO+SAL/FP and PLA+SAL/FP with an incidence of 5.8%, 8.5% and 5.8%, respectively. Conclusions GLY+SAL/FP showed comparable improvements in lung function, health status and rescue medication to TIO+SAL/FP. Importantly, addition of GLY to SAL/FP demonstrated significant improvements in lung function, health status and rescue medication compared to SAL/FP. Trial registration number NCT01513460. PMID:25841237

Educational videos for practitioners attending Baby Friendly Hospital Initiative workshops supporting breastfeeding positioning, attachment and hand expression skills: Effects on knowledge and confidence.

PubMed

Wallace, Louise M; Ma, Yuanying; Qiu, Li Qian; Dunn, Orla M

2018-04-26

UNICEF Baby Friendly Initiative (BFHI) is the global standard for maternity and community services requiring all practitioners to be trained to support mothers in the essential skills of supporting positioning and attachment, and hand expression. These studies aim to rigorously assess knowledge in nurses, midwives, and doctors in these skills, tested before and after watching short videos demonstrating these skills. Practitioners were attending BFHI education, and the video study was additional. In Phase 1 clinicians in England were randomised to one of two videos (practitioner role play or clinical demonstration). The results showed improvements in knowledge and confidence, and a preference for clinical demonstration by mothers and infants. The clinical demonstration video was evaluated in China in Phase 2 where expert trainers viewed the video after completing the BHFI workshop, and in Phase 3 practitioners viewed the video before the BHFI workshop. Phase 2 with expert trainers only showed improvement in knowledge of hand expression but not positioning and attachment. In Phase 3 clinicians showed improved knowledge for both skills. In all Phases there were statistically significant improvements in confidence in practice in both skills. Viewing short videos increased knowledge, particularly about teaching hand expression, and confidence in both skills. Copyright © 2018. Published by Elsevier Ltd.

Update from C3RS lessons learned team : four demonstration pilots.

DOT National Transportation Integrated Search

2014-07-01

The Federal Railroad Administration (FRA) believes that, in addition to process and technology innovations, human-factors-based solutions can significantly contribute to improving safety in the railroad industry. To test this assumption, FRA implemen...

Omega-3 fatty acid therapy dose-dependently and significantly decreased triglycerides and improved flow-mediated dilation, however, did not significantly improve insulin sensitivity in patients with hypertriglyceridemia.

PubMed

Oh, Pyung Chun; Koh, Kwang Kon; Sakuma, Ichiro; Lim, Soo; Lee, Yonghee; Lee, Seungik; Lee, Kyounghoon; Han, Seung Hwan; Shin, Eak Kyun

2014-10-20

Experimental studies demonstrate that higher intake of omega-3 fatty acids (n-3 FA) improves insulin sensitivity, however, we reported that n-3 FA 2g therapy, most commonly used dosage did not significantly improve insulin sensitivity despite reducing triglycerides by 21% in patients. Therefore, we investigated the effects of different dosages of n-3 FA in patients with hypertriglyceridemia. This was a randomized, single-blind, placebo-controlled, parallel study. Age, sex, and body mass index were matched among groups. All patients were recommended to maintain a low fat diet. Forty-four patients (about 18 had metabolic syndrome/type 2 diabetes mellitus) in each group were given placebo, n-3 FA 1 (O1), 2 (O2), or 4 g (O4), respectively daily for 2 months. n-3 FA therapy dose-dependently and significantly decreased triglycerides and triglycerides/HDL cholesterol and improved flow-mediated dilation, compared with placebo (by ANOVA). However, each n-3 FA therapy did not significantly decrease high-sensitivity C-reactive protein and fibrinogen, compared with placebo. O1 significantly increased insulin levels and decreased insulin sensitivity (determined by QUICKI) and O2 significantly decreased plasma adiponectin levels relative to baseline measurements. Of note, when compared with placebo, each n-3 FA therapy did not significantly change insulin, glucose, adiponectin, glycated hemoglobin levels and insulin sensitivity (by ANOVA). We observed similar results in a subgroup of patients with the metabolic syndrome. n-3 FA therapy dose-dependently and significantly decreased triglycerides and improved flow-mediated dilation. Nonetheless, n-3 FA therapy did not significantly improve acute-phase reactants and insulin sensitivity in patients with hypertriglyceridemia, regardless of dosages. Copyright © 2014. Published by Elsevier Ireland Ltd.

Improvement in Generic Problem-Solving Abilities of Students by Use of Tutor-less Problem-Based Learning in a Large Classroom Setting

PubMed Central

Klegeris, Andis; Bahniwal, Manpreet; Hurren, Heather

2013-01-01

Problem-based learning (PBL) was originally introduced in medical education programs as a form of small-group learning, but its use has now spread to large undergraduate classrooms in various other disciplines. Introduction of new teaching techniques, including PBL-based methods, needs to be justified by demonstrating the benefits of such techniques over classical teaching styles. Previously, we demonstrated that introduction of tutor-less PBL in a large third-year biochemistry undergraduate class increased student satisfaction and attendance. The current study assessed the generic problem-solving abilities of students from the same class at the beginning and end of the term, and compared student scores with similar data obtained in three classes not using PBL. Two generic problem-solving tests of equal difficulty were administered such that students took different tests at the beginning and the end of the term. Blinded marking showed a statistically significant 13% increase in the test scores of the biochemistry students exposed to PBL, while no trend toward significant change in scores was observed in any of the control groups not using PBL. Our study is among the first to demonstrate that use of tutor-less PBL in a large classroom leads to statistically significant improvement in generic problem-solving skills of students. PMID:23463230

Correction of rotational distortion for catheter-based en face OCT and OCT angiography

PubMed Central

Ahsen, Osman O.; Lee, Hsiang-Chieh; Giacomelli, Michael G.; Wang, Zhao; Liang, Kaicheng; Tsai, Tsung-Han; Potsaid, Benjamin; Mashimo, Hiroshi; Fujimoto, James G.

2015-01-01

We demonstrate a computationally efficient method for correcting the nonuniform rotational distortion (NURD) in catheter-based imaging systems to improve endoscopic en face optical coherence tomography (OCT) and OCT angiography. The method performs nonrigid registration using fiducial markers on the catheter to correct rotational speed variations. Algorithm performance is investigated with an ultrahigh-speed endoscopic OCT system and micromotor catheter. Scan nonuniformity is quantitatively characterized, and artifacts from rotational speed variations are significantly reduced. Furthermore, we present endoscopic en face OCT and OCT angiography images of human gastrointestinal tract in vivo to demonstrate the image quality improvement using the correction algorithm. PMID:25361133

Photographic image enhancement

NASA Technical Reports Server (NTRS)

Hite, Gerald E.

1990-01-01

Deblurring capabilities would significantly improve the scientific return from Space Shuttle crew-acquired images of the Earth and the safety of Space Shuttle missions. Deblurring techniques were developed and demonstrated on two digitized images that were blurred in different ways. The first was blurred by a Gaussian blurring function analogous to that caused by atmospheric turbulence, while the second was blurred by improper focussing. It was demonstrated, in both cases, that the nature of the blurring (Gaussian and Airy) and the appropriate parameters could be obtained from the Fourier transformation of their images. The difficulties posed by the presence of noise necessitated special consideration. It was demonstrated that a modified Wiener frequency filter judiciously constructed to avoid over emphasis of frequency regions dominated by noise resulted in substantially improved images. Several important areas of future research were identified. Two areas of particular promise are the extraction of blurring information directly from the spatial images and improved noise abatement form investigations of select spatial regions and the elimination of spike noise.

Effectiveness of a 10-week tier-1 response to intervention program in improving fine motor and visual-motor skills in general education kindergarten students.

PubMed

Ohl, Alisha M; Graze, Hollie; Weber, Karen; Kenny, Sabrina; Salvatore, Christie; Wagreich, Sarah

2013-01-01

This study examined the efficacy of a 10-wk Tier 1 Response to Intervention (RtI) program developed in collaboration with classroom teachers to improve the fine motor and visual-motor skills of general education kindergarten students. We recruited 113 students in six elementary schools. Two general education kindergarten classrooms at each school participated in the study. Classrooms were randomly assigned to the intervention and control groups. Fine motor skills, pencil grip, and visual-motor integration were measured at the beginning of the school year and after the 10-wk intervention. The intervention group demonstrated a statistically significant increase in fine motor and visual-motor skills, whereas the control group demonstrated a slight decline in both areas. Neither group demonstrated a change in pencil grip. This study provides preliminary evidence that a Tier 1 RtI program can improve fine motor and visual-motor skills in kindergarten students. Copyright © 2013 by the American Occupational Therapy Association, Inc.

Graduate students' teaching experiences improve their methodological research skills.

PubMed

Feldon, David F; Peugh, James; Timmerman, Briana E; Maher, Michelle A; Hurst, Melissa; Strickland, Denise; Gilmore, Joanna A; Stiegelmeyer, Cindy

2011-08-19

Science, technology, engineering, and mathematics (STEM) graduate students are often encouraged to maximize their engagement with supervised research and minimize teaching obligations. However, the process of teaching students engaged in inquiry provides practice in the application of important research skills. Using a performance rubric, we compared the quality of methodological skills demonstrated in written research proposals for two groups of early career graduate students (those with both teaching and research responsibilities and those with only research responsibilities) at the beginning and end of an academic year. After statistically controlling for preexisting differences between groups, students who both taught and conducted research demonstrate significantly greater improvement in their abilities to generate testable hypotheses and design valid experiments. These results indicate that teaching experience can contribute substantially to the improvement of essential research skills.

Unique method for controlling device level overlay with high-NA optical overlay technique using YieldStar in a DRAM HVM environment

NASA Astrophysics Data System (ADS)

Park, Dong-Kiu; Kim, Hyun-Sok; Seo, Moo-Young; Ju, Jae-Wuk; Kim, Young-Sik; Shahrjerdy, Mir; van Leest, Arno; Soco, Aileen; Miceli, Giacomo; Massier, Jennifer; McNamara, Elliott; Hinnen, Paul; Böcker, Paul; Oh, Nang-Lyeom; Jung, Sang-Hoon; Chai, Yvon; Lee, Jun-Hyung

2018-03-01

This paper demonstrates the improvement using the YieldStar S-1250D small spot, high-NA, after-etch overlay in-device measurements in a DRAM HVM environment. It will be demonstrated that In-device metrology (IDM) captures after-etch device fingerprints more accurately compared to the industry-standard CDSEM. Also, IDM measurements (acquiring both CD and overlay) can be executed significantly faster increasing the wafer sampling density that is possible within a realistic metrology budget. The improvements to both speed and accuracy open the possibility of extended modeling and correction capabilities for control. The proof-book data of this paper shows a 36% improvement of device overlay after switching to control in a DRAM HVM environment using indevice metrology.

A systematic review of the Ayurvedic medicinal herb Bacopa monnieri in child and adolescent populations.

PubMed

Kean, James D; Downey, Luke A; Stough, Con

2016-12-01

Clinicians utilise critical research to advance their knowledge when prescribing standard and alternative therapies for developmental disorders. Recent research has reported that the traditional Ayurvedic medicine Bacopa monnieri may improve cognitive outcomes in adult populations; however, few studies have investigated its benefits in younger cohorts. The aim of the current review is to systematically assess and critically summarize clinical trial outcomes and safety of Bacopa and its effects on the cognition and behaviour in children and adolescents. PubMed, Scopus, Cochrane Library, Google and CINAHL were searched up to August 2015 for trials investigating Bacopa monnieri in child and adolescent populations. There were no restrictions in study design. Cognitive and behavioural outcomes were grouped into validated constructs and effect sizes were calculated for all significant data to allow for direct comparisons. Five studies met inclusion criteria for this review. The results demonstrated significant consistent improvements in the language behaviour cognitive domain and in a number of the memory sub-domains. Significant improvements were also seen in hyperactivity and attention-deficit domains. Overall outcome data demonstrated small to medium effect sizes (mean d=0.42). Safety and tolerability data was well reported for 80% of studies with only 2.3% of all participants reporting mild side-effects. This review highlights the safe use of Bacopa monnieri in child and adolescent populations for improving elements of cognition as well as behaviour and attention-deficit domains. However, there is a significant need for replicated study designs and stringent statistical analysis to validate these outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Improving in the fasting, but not the postprandial, glucose level is associated with reduction of plasma d-ROMs level in patients with type 2 diabetes.

PubMed

Ohara, Makoto; Watanabe, Kentaro; Suzuki, Tatsuya; Sekimizu, Ken-ichi; Motoyama, Masayuki; Ishii, Kazuhito; Sawai, Keisuke; Nakano, Hiroshi; Oba, Kenzo; Mizuno, Kyoichi

2013-01-01

This study aimed to evaluate the relationship between improvement of glucose metabolism and plasma levels of diacron-reactive oxygen metabolites (d-ROMs) in patients with type 2 diabetes. As the first daily profile, the plasma levels of glucose and d-ROMs were determined on admission. Then, after treatment to lower plasma glucose levels, the second daily profile of these levels was evaluated. Fasting plasma glucose (FPG), the total area under the curve (AUC) of the daily plasma glucose profile (AUCDP), the AUC of the postprandial plasma glucose levels (AUCPP), the AUC of the daily plasma d-ROMs profile (AUCd-ROMs), the coefficient of variation (CV) of plasma glucose (CVPG), and the mean amplitude of glycemic excursions (MAGE) were calculated. The relationship between the improvement of glucose metabolism and that of oxidative stress in patients with type 2 diabetes was evaluated. The second determinations of FPG, AUCDP, AUCPP, MAGE, and AUCd-ROMs were significantly lower than those of the first determinations, but no significant difference was observed in CVPG. Linear regression analysis demonstrated significant associations between the changes in AUCd-ROMs and the changes in both FPG and AUCDP, whereas no significant association was observed between the change in AUCd-ROMs and the change in AUCPP, CVPG, or MAGE. This study has demonstrated that improvement of the FPG level, but not of the postprandial glucose level, is associated with a reduction of the plasma level of d-ROMs in patients with type 2 diabetes.

The use of an exclusion-based risk-assessment model for venous thrombosis improves uptake of appropriate thromboprophylaxis in hospitalized medical patients.

PubMed

Bagot, C; Gohil, S; Perrott, R; Barsam, S; Patel, R K; Arya, R

2010-08-01

Venous thromboembolism is a common condition in hospitalized medical patients. Numerous studies have demonstrated that low molecular weight heparin significantly reduces this risk but, despite this, the use of thromboprophylaxis remains poor. To evaluate the use of an exclusion based risk-assessment model (RAM) for venous thrombosis in improving the uptake of appropriate thromboprophylaxis in hospitalized medical patients. A survey with a subsequent audit cycle of three separate audits over 36 months. 497 hospitalized patients with acute medical conditions on general medical wards were audited at a secondary care centre in London, UK. The survey and subsequent audits were performed by reviewing the notes and medication charts of medical patients, prior to the launch of the RAM and at 12, 28 and 36 months following its introduction. Prior to launching the RAM, 49% of hospitalized medical patients received appropriate thromboprophylaxis. This did not change 12 months after the RAM was introduced but increased significantly to 71% following formal education of the health care professionals involved in thromboprophylaxis prescription. This improvement was maintained as demonstrated by a subsequent audit 8 months later (75.9%). The introduction of a simple exclusion-based RAM for venous thrombosis in medical patients significantly improved delivery of thromboprophylaxis. The successful uptake of the RAM appears to have been dependent on direct education of those health carers involved in its use. A similar exclusion-based model used nationally could have a significant impact on the burden of VTE currently experienced in the UK.

A prospective, randomized, double-blind study, comparing unirradiated to irradiated white blood cell transfusions in acute leukemia patients

PubMed Central

Freireich, E J; Lichtiger, B; Mattiuzzi, G; Martinez, F; Reddy, V; Kyle Wathen, J

2013-01-01

A prospective, randomized double-blind study comparing the effects of irradiated and unirradiated white blood cells was conducted in 108 acute leukemia patients with life-threatening infections, refractory to antibiotics. The study demonstrated no significant improvement in 30-day survival or overall survival. Transfusion of unirradiated white cells did not compromise the patient's opportunity to undergo allogeneic stem cell transplant, nor the success rate or overall survival after allogeneic transplant. The important positive finding in this study was that the unirradiated white cells produced a significantly higher increment in circulating granulocytes and in a higher proportion of patients granulocyte count exceeded 1000 per microliter, approaching normal concentrations. The increase in the number and the improved survival of the unirradiated granulocytes suggest that this procedure might potentially be a method to improve the utility of granulocyte transfusions and merits further investigation. The study demonstrated non-inferiority for unirradiated white cells. There were no harmful effects such as graft-versus-host disease, indicating that such studies would be safe to conduct in the future. PMID:23072780

A pre- and post-treatment evaluation of vision-related quality of life in uveitis

PubMed Central

Rathinam, SR

2008-01-01

Aim: To study the effect of treatment on vision-related quality of life (VR-QOL) in uveitis patients. Materials and Methods: Interviewer-administered questionnaire-based evaluation of visual function and VR-QOL in Tamil-speaking adult patients with active uveitis at presentation and follow-up by the same interviewer. Results: Ninety-eight patients participated in this study. There was a statistically significant improvement in VR-QOL in all the scales following treatment (P < 0.001). Patients with chronic uveitis showed better improvement upon treatment than patients with acute uveitis. The visual symptoms scale showed moderate gains following treatment (effect size 0.56). Persons with bilateral disease had poorer mean scores compared to those with unilateral disease. Visual acuity was closely correlated with VR-QOL scores. Conclusion: The VR-QOL measurement has shown that it is sensitive to demonstrate the problems of patients with uveitis irrespective of their demographic profile. The scores improved significantly in patients with uveitis following treatment and have shown close correlation to visual acuity thus demonstrating that VR-QOL is effective in assessing the response to treatment. PMID:18579990

Effects of prolonged agmatine treatment in aged male Sprague-Dawley rats.

PubMed

Rushaidhi, M; Zhang, H; Liu, P

2013-03-27

Increasing evidence suggests that altered arginine metabolism contributes to cognitive decline during ageing. Agmatine, decarboxylated arginine, has a variety of pharmacological effects, including the modulation of behavioural function. A recent study demonstrated the beneficial effects of short-term agmatine treatment in aged rats. The present study investigated how intraperitoneal administration of agmatine (40mg/kg, once daily) over 4-6weeks affected behavioural function and neurochemistry in aged Sprague-Dawley rats. Aged rats treated with saline displayed significantly reduced exploratory activity in the open field, impaired spatial learning and memory in the water maze and object recognition memory relative to young rats. Prolonged agmatine treatment improved animals' performance in the reversal test of the water maze and object recognition memory test, and significantly suppressed age-related elevation in nitric oxide synthase activity in the dentate gyrus of the hippocampus and prefrontal cortex. However, this prolonged supplementation was unable to improve exploratory activity and spatial reference learning and memory in aged rats. These findings further demonstrate that exogenous agmatine selectively improves behavioural function in aged rats. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

Optics measurement algorithms and error analysis for the proton energy frontier

NASA Astrophysics Data System (ADS)

Langner, A.; Tomás, R.

2015-03-01

Optics measurement algorithms have been improved in preparation for the commissioning of the LHC at higher energy, i.e., with an increased damage potential. Due to machine protection considerations the higher energy sets tighter limits in the maximum excitation amplitude and the total beam charge, reducing the signal to noise ratio of optics measurements. Furthermore the precision in 2012 (4 TeV) was insufficient to understand beam size measurements and determine interaction point (IP) β -functions (β*). A new, more sophisticated algorithm has been developed which takes into account both the statistical and systematic errors involved in this measurement. This makes it possible to combine more beam position monitor measurements for deriving the optical parameters and demonstrates to significantly improve the accuracy and precision. Measurements from the 2012 run have been reanalyzed which, due to the improved algorithms, result in a significantly higher precision of the derived optical parameters and decreased the average error bars by a factor of three to four. This allowed the calculation of β* values and demonstrated to be fundamental in the understanding of emittance evolution during the energy ramp.

Using distributed partial memories to improve self-organizing collective movements.

PubMed

Winder, Ransom; Reggia, James A

2004-08-01

Past self-organizing models of collectively moving "particles" (simulated bird flocks, fish schools, etc.) have typically been based on purely reflexive agents that have no significant memory of past movements. We hypothesized that giving such individual particles a limited distributed memory of past obstacles they encountered could lead to significantly faster travel between goal destinations. Systematic computational experiments using six terrains that had different arrangements of obstacles demonstrated that, at least in some domains, this conjecture is true. Furthermore, these experiments demonstrated that improved performance over time came not only from the avoidance of previously seen obstacles, but also (surprisingly) immediately after first encountering obstacles due to decreased delays in circumventing those obstacles. Simulations also showed that, of the four strategies we tested for removal of remembered obstacles when memory was full and a new obstacle was to be saved, none was better than random selection. These results may be useful in interpreting future experimental research on group movements in biological populations, and in improving existing methodologies for control of collective movements in computer graphics, robotic teams, particle swarm optimization, and computer games.

Positioning performance improvements with European multiple-frequency satellite navigation - Galileo

NASA Astrophysics Data System (ADS)

Ji, Shengyue

2008-10-01

The rapid development of Global Positioning System has demonstrated the advantages of satellite based navigation systems. In near future, there will be a number of Global Navigation Satellite System (GNSS) available, i.e. modernized GPS, Galileo, restored GLONASS, BeiDou and many other regional GNSS augmentation systems. Undoubtedly, the new GNSS systems will significantly improve navigation performance over current GPS, with a better satellite coverage and multiple satellite signal bands. In this dissertation, the positioning performance improvement of new GNSS has been investigated based on both theoretical analysis and numerical study. First of all, the navigation performance of new GNSS systems has been analyzed, particularly for urban applications. The study has demonstrated that Receiver Autonomous Integrity Monitoring (RAIM) performance can be significantly improved with multiple satellite constellations, although the position accuracy improvement is limited. Based on a three-dimensional urban building model in Hong Kong streets, it is found that positioning availability is still very low in high-rising urban areas, even with three GNSS systems. On the other hand, the discontinuity of navigation solutions is significantly reduced with the combined constellations. Therefore, it is possible to use cheap DR systems to bridge the gaps of GNSS positioning, with high accuracy. Secondly, the ambiguity resolution performance has been investigated with Galileo multiple frequency band signals. The ambiguity resolution performance of three different algorithms is compared, including CAR, ILS and improved CAR methods (a new method proposed in this study). For short baselines, with four frequency Galileo data, it is highly possible to achieve reliable single epoch ambiguity resolution, when the carrier phase noise level is reasonably low (i.e. less than 6mm). For long baselines (up to 800 km), the integer ambiguity can be determined within 1 min on average. Ambiguity validation is crucial for any ambiguity resolution algorithm using searching method. This study has proposed to use both Ellipsoidal Integer Aperture (EIA) estimator and R-ratio test for ambiguity validation. Using real GPS data and simulated Galileo data, it has been demonstrated that the new method performs better than the use of EIA or the R-ratio test alone, with much less ambiguity mis-fixed rate.

A Metamaterial-Inspired Approach to RF Energy Harvesting

NASA Astrophysics Data System (ADS)

Fowler, Clayton; Zhou, Jiangfeng

2016-03-01

We demonstrate an RF energy harvesting rectenna design based on a metamaterial perfect absorber (MPA). With the embedded Schottky diodes, the rectenna converts captured RF energy to DC currents. The Fabry-Perot cavity resonance of the MPA greatly improves the amount of energy captured and hence improves the rectification efficiency. Furthermore, the FP resonance exhibits a high Q-factor and significantly increases the voltage across the Schottky diodes. This leads to a factor of 16 improvement of RF-DC conversion efficiency at ambient intensity level.

A Metamaterial-Inspired Approach to RF Energy Harvesting

NASA Astrophysics Data System (ADS)

Fowler, Clayton; Zhou, Jiangfeng

We demonstrate an RF energy harvesting rectenna design based on a metamaterial perfect absorber (MPA). With the embedded Schottky diodes, the rectenna converts captured RF energy to DC currents. The Fabry-Perot cavity resonance of the MPA greatly improves the amount of energy captured and hence improves the rectification efficiency. Furthermore, the FP resonance exhibits high Q-factor and significantly increases the voltage across the Schottky diodes. This leads to a factor of 16 improvement of RF-DC conversion efficiency at ambient intensity level.

Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes.

PubMed

Fransen, Marlene; Nairn, Lillias; Winstanley, Julie; Lam, Paul; Edmonds, John

2007-04-15

To determine whether Tai Chi or hydrotherapy classes for individuals with chronic symptomatic hip or knee osteoarthritis (OA) result in measurable clinical benefits. A randomized controlled trial was conducted among 152 older persons with chronic symptomatic hip or knee OA. Participants were randomly allocated for 12 weeks to hydrotherapy classes (n = 55), Tai Chi classes (n = 56), or a waiting list control group (n = 41). Outcomes were assessed 12 and 24 weeks after randomization and included pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (Medical Outcomes Study Short Form 12 Health Survey [SF-12], version 2), psychological well-being, and physical performance (Up and Go test, 50-foot walk time, timed stair climb). At 12 weeks, compared with controls, participants allocated to hydrotherapy classes demonstrated mean improvements (95% confidence interval) of 6.5 (0.4, 12.7) and 10.5 (3.6, 14.5) for pain and physical function scores (range 0-100), respectively, whereas participants allocated to Tai Chi classes demonstrated improvements of 5.2 (-0.8, 11.1) and 9.7 (2.8, 16.7), respectively. Both class allocations achieved significant improvements in the SF-12 physical component summary score, but only allocation to hydrotherapy achieved significant improvements in the physical performance measures. All significant improvements were sustained at 24 weeks. In this almost exclusively white sample, class attendance was higher for hydrotherapy, with 81% attending at least half of the available 24 classes, compared with 61% for Tai Chi. Access to either hydrotherapy or Tai Chi classes can provide large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA.

[Evaluation on intervention measures of comprehensive control for parasitic diseases in demonstration plot of Xiangyun County].

PubMed

Wen-Juan, Li; Shao-Rong, Chen; Yan-Hong, Li; Wen, Fang; Chun-Rong, Ke; Li-Bo, Wang

2011-10-01

To evaluate the effect of comprehensive intervention measures to control and prevent parasitic diseases in the demonstration plot of Xiangyun County, so as to provide the evidence for establishing appropriate measures of parasitic diseases control and prevention. The baseline data of soil-transmitted nematode infections were obtained in 2006. A series of intervention measures, including health education, deworming, drinking water improvement,latrine improvement, and environment reconstruction, were performed for three years and the effect of the comprehensive intervention measures was evaluated by the national expert group in 2009. The awareness rate of parasitic disease knowledge of residents in 2009 (86.96%) was significantly higher than that in 2006 (35.20%) (Chi2 = 122.95, P < 0.01). The passing rate of resident health behavior in 2009 (97.10%) was significantly higher than that in 2006 (48.00%) (Chi2 = 122.95, P < 0.01). The general infection rate of parasites in 2009 (2.47%) was significantly lower than that in 2006 (19.14%) (Chi2 = 162.88, P < 0.01). Of soil-transmitted nematode infections, the infection rates of Ascaris lumbricoides in both 2006 and 2009 were the highest and the rates were 18.74% and 2.08%, respectively. In the demonstration plots for parasitic diseases control and prevention of Xiangyun County, the effect of the comprehensive intervention measures which take health education as the forerunner and give priority to control source of parasite infection is remarkable. The measures implemented can achieve the purpose to reduce the infection rates of parasites and improve human health.

Spontaneous and drug-induced remission of alcoholic organic brain syndrome: clinical, psychometric, and neurophysiological studies.

PubMed

Saletu, B; Saletu, M; Grünberger, J; Mader, R

1983-09-01

The spontaneous and drug-induced remission of alcoholic organic brain syndrome was studied in a double-blind, placebo-controlled trial. Forty patients with alcoholic organic brain syndrome (OBS) were randomly assigned to a 6-week treatment with either placebo or piridoxilate, a reciprocal salt between two stereoisomers of the glyoxylic acid-substituted piridoxine. Clinical, psychometric, and computer-assisted spectral analyses of the electroencephalogram (EEG) were carried out in weeks 0, 2, 4, and 6. Piridoxale-5-phosphate (PLP) blood level determination and laboratory investigations were performed before therapy and also in weeks 4 and 6. Both groups of patients demonstrated significant clinical improvement over 6 weeks of treatment, but the improvement in the piridoxilate-treated group was significantly greater than that in the placebo group. This conclusion was also confirmed by psychometric tests demonstrating a greater improvement in attention, concentration, attention variability, tapping, visual and numerical memory, and aftereffect (Archimedean spiral) in the piridoxilate than in the placebo group. Spectral analysis of the EEG showed an increase in alpha and a decrease in fast beta activities in both groups, while delta activity was attenuated only in the piridoxilate-treated group. The latter was found to be significantly correlated with the improvement in psychopathology. The present data confirm previous predictions about the encephalotropic and psychotropic properties of piridoxilate; these predictions were based on pharmaco-EEG trials in the elderly that suggested vigilance-improving qualities of piridoxilate. The reversible alcoholic OBS appears to be a suitable model for the assessment of therapeutic efficacy of nootropic drugs.

Longitudinal effects of a collegiate strength and conditioning program in American football.

PubMed

Stodden, David F; Galitski, Hayes M

2010-09-01

The purpose of this study was to examine the longitudinal effects of a strength and conditioning program on selected body composition and performance data over 4 consecutive years of training. Body mass, percent body fat, lean body mass, proagility (18.3 m shuttle), 36.6-m (40-yd) sprint, bench press, chin-ups, vertical jump, and power index data for 84 National Collegiate Athletic Association division IA collegiate football players were examined. In addition to examining data on all athletes, data were analyzed on specific groups categorized by position. Groups were categorized as (a) skill (wide receivers, defensive backs, and running backs), (b) big skill (linebackers, kickers, tight ends, quarterbacks, and specialists), and (c) line (offensive and defensive linemen). Data on each individual performance criteria were analyzed using pairwise t-tests to indicate changes from year to year. Results for all participants showed that the greatest number of significant improvements among test parameters occurred during the first year of training. Years 2-4 of training demonstrated inconsistent improvement among the test parameters. Bench press performance significantly improved throughout 4 years of training among all participants. Data analysis from specific position groups also revealed the greatest number of significant improvements occurred during the first year of training. Overall, the results of this study clearly demonstrate that the greatest rate of improvement in the selected performance parameters occurred during the initial year of the strength and conditioning program. This study provides valuable information for coaches to establish appropriate progression and program variation guidelines for athletes over consecutive years of training.

Alignment of an interprofessional student learning experience with a hospital quality improvement initiative.

PubMed

Fowler, Terri O; Wise, Holly H; Mauldin, Mary P; Ragucci, Kelly R; Scheurer, Danielle B; Su, Zemin; Mauldin, Patrick D; Bailey, Jennifer R; Borckardt, Jeffrey J

2018-04-11

Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational education in the values and information of their chosen profession is critical, interprofessional learning follows a continuum from formal education to practice. The continuum increases in significance and complexity as learning becomes more relationship based and dependent upon the ability to navigate complex interactions with patients, families, communities, co-workers, and others. Integrating IPE into collaborative practice is critical to enhancing students' experiential learning, developing teamwork competencies, and understanding the complexity of teams. This article describes a project that linked students with a hospital-based quality-improvement effort to focus on the acquisition and practice of teamwork skills and to determine the impact of teamwork on patient and quality outcome measures. A hospital unit was identified with an opportunity for improvement related to quality care, patient satisfaction, employee engagement, and team behaviours. One hundred and thirty-seven students from six health profession colleges at the Medical University of South Carolina underwent TeamSTEPPS® training and demonstrated proficiency of their teamwork-rating skills with the TeamSTEPPS® Team Performance Observation Tool (T-TPO). Students observed real-time team behaviours of unit staff before and after staff attended formal TeamSTEPPS® training. The students collected a total of 778 observations using the T-TPO. Teamwork performance on the unit improved significantly across all T-TPO domains (team structure, communication, leadership, situation monitoring, and mutual support). Significant improvement in each domain continued post-intervention and at 15-month follow-up, improvement remained significant compared to baseline. Student engagement in TeamSTEPPS® training and demonstration of their reliability as teamwork-observers was a valuable learning experience and also yielded an opportunity to gather unique, and otherwise difficult to attain, data from a hospital unit for use by quality managers and administrators.

Maintenance of improved lipid levels following attendance at a cardiovascular risk reduction clinic: a 10-year experience

PubMed Central

Pearson, Glen J; Olson, Kari L; Panich, Nicole E; Majumdar, Sumit R; Tsuyuki, Ross T; Gilchrist, Dawna M; Damani, Ali; Francis, Gordon A

2008-01-01

Background: Specialty cardiovascular risk reduction clinics (CRRC) increase the proportion of patients attaining recommended lipid targets; however, it is not known if the benefits are sustained after discharge. We evaluated the impact of a CRRC on lipid levels and assessed the long-term effect of a CRRC in maintaining improved lipid levels following discharge. Methods: The medical records of consecutive dyslipidemic patients discharged ×6 months from a tertiary hospital CRRC from January 1991 to January 2001 were retrospectively reviewed. The primary outcome was the change in patients’ lipid levels between the final CRRC visit and the most recent primary care follow-up. A worst-case analysis was conducted to evaluate the potential impact of the patients in whom the follow-up lipid profiles post-discharge from the CRRC were not obtained. Results: Within the CRRC (median follow-up = 1.28 years in 1064 patients), we observed statistically significant improvements in all lipid parameters. In the 411 patients for whom post-discharge lipid profiles were available (median follow-up = 2.41 years), there were no significant differences observed in low-density lipoprotein-cholesterol, total cholesterol (TC), or triglycerides since CRRC discharge; however, there were small improvements in high-density lipoprotein-cholesterol (HDL-C) and TC:HDL ratio (p < 0.05 for both). The unadjusted worst-case analysis (653 patients with no follow-up lipid profiles) demonstrated statistically significant worsening of all lipid parameters between CRRC discharge and the most recent follow-up. However, when the change in lipid parameters between the baseline and the most recent follow-up was assessed in this analysis, the changes in all lipid parameters were significantly improved (p < 0.05). Conclusions: This study demonstrates that a CRRC can improve lipid levels and suggests that these benefits are sustained once patients are returned to the care of their primary physician. PMID:19183763

Combined effects of astragalus soup and persistent Taiji boxing on improving the immunity of elderly women.

PubMed

Song, Qing-Hua; Xu, Rong-Mei; Zhang, Quan-Hai; Shen, Guo-Qing; Ma, Ming; Zhao, Xin-Ping; Guo, Yan-Hua; Wang, Yi

2014-01-01

To observe the combined effects of astragalus soup and persistent Taiji boxing on improving the immunity of women of advanced years. 120 elderly women lacking daily exercise were chosen as the study subjects. By using the table of random numbers, they were then divided into the control group and the experiment group, consisting of 60 each. The control group practiced Taiji boxing for 45 minutes twice a day. The experiment group did the same, and, in addition, took astragalus soup after each boxing. Indexes related to physical immunity of the two groups were observed and compared when they were first chosen, when the alternative treatment was applied three, six and twelve months later, respectively. The two groups demonstrated no significant differences in general data and research indexes when chosen (P > 0.05). Three months after the two groups were chosen and treated differently, the control group demonstrated no significant improvement while most indexes of the experiment group improved considerably (P > 0.05). After six months, the related indexes of both groups improved substantially (P < 0.05) and the improvement with the experiment was even clearer (P < 0.05). Twelve months later, the improvement with the experiment group was more noticeable (P < 0.01 or P < 0.05). In a relatively short period of three months, Taiji boxing produces no noticeable effect on the improvement of immunity in elderly women. However, when they resume the exercise for another three months and longer, Taiji boxing has a noticeable advantage and the effect is the most favorable when it is combined with astragalus soup.

A systematic review to evaluate the effectiveness of carnitine supplementation in improving walking performance among individuals with intermittent claudication.

PubMed

Delaney, Christopher L; Spark, J Ian; Thomas, Jolene; Wong, Yew Toh; Chan, Lok Tsung; Miller, Michelle D

2013-07-01

To evaluate the evidence for the use of carnitine supplementation in improving walking performance among individuals with intermittent claudication. Systematic review. An electronic search of the literature was performed using MEDLINE (PubMed), Scopus, Cochrane Central Register of Controlled Trials and The Cochrane Library from inception through to November 2012. Search terms included peripheral arterial disease, intermittent claudication and carnitine. Reference lists of review articles and primary studies were also examined. Full reports of published experimental studies including randomized controlled trials and pre-test/post-test trials were selected for inclusion. A quality assessment was undertaken according to the Jadad scale. A total of 40 articles were retrieved, of which 23 did not meet the inclusion criteria. The 17 included articles reported on a total of 18 experimental studies of carnitine supplementation (5 pre-test/post-test; 8 parallel RCT; 5 cross-over RCT) for improving walking performance in adults with intermittent claudication. For pre-test/post-test studies, 300-2000 mg propionyl-L-carnitine (PLC) was administered orally or intravenously for a maximum of 90 days (7-42 participants) with statistically significant improvements of between 74 m and 157 m in pain free walking distance and between 71 m and 135 m in maximal walking distance across 3 out of 5 studies. Similarly, PLC (600 mg-3000 mg) was administered orally in 7 out of 8 parallel RCTs (22-485 participants), the longest duration being 12 months. All but one of the smallest trials demonstrated statistically significant improvements in walking performance between 31 and 54 m greater than placebo for pain free walking distance and between 9 and 86 m greater than placebo for maximal walking distance. A double-blind parallel RCT of cilostazol plus 2000 mg oral L-carnitine or placebo for 180 days (145 participants) did not demonstrate any significant improvement in walking performance. Of 5 cross-over RCTs (8-20 participants), 4 demonstrated significant improvements in walking performance following administration of 300-6000 mg L-carnitine or PLC. Compared to placebo, pain free walking distance and maximal walking distance improved by 23-132 m and 104 m respectively following carnitine intervention. Most trials demonstrated a small or modest improvement in walking performance with administration of PLC or L-carnitine. These findings were largely independent of level or quality of evidence, while there was some evidence that intravenous administration was more effective than oral administration and those with severe claudication may achieve greater benefits than those with moderate claudication. Routine carnitine supplementation in the form of PLC may therefore be a useful adjunct therapy for management of intermittent claudication. Further research is warranted to determine the optimal form, duration, dose and safety of carnitine supplementation across the spectrum of peripheral arterial disease severity and its effect with concurrent supervised exercise programs and best medical therapy. These studies should be supplemented with cost effectiveness studies to ensure that the return on the investment is acceptable. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

Spin exercise improves semantic fluency in previously sedentary older adults.

PubMed

Nocera, Joe R; McGregor, Keith M; Hass, Chris J; Crosson, Bruce

2015-01-01

Studies suggest improvements of neurocognitive function among older adults who undergo aerobic exercise training. This study sought to examine the impact of an aerobic exercise intervention on verbal fluency in sedentary older adults. Twenty community-dwelling older adults were recruited and enrolled in either a spin exercise group or a control condition. Participants were evaluated with an estimated V02max test and on measures of letter, category, and switching verbal fluency both before and after a 12-week intervention period. Spin exercise resulted in a significant improvement in category (semantic) verbal fluency when compared with the control group (15% vs. 2% increase, respectively; P = .001). Spin exercise also resulted in a significant improvement in estimated V02max (P = .005). Also important, the spin exercise group demonstrated a high level of adherence (mean adherence = 82.5%). Spin exercise can be an effective mode of aerobic exercise to improve semantic fluency in previously sedentary older adults.

Making Patient Risk Visible: Implementation of a Nursing Document Information System to Improve Patient Safety.

PubMed

Wang, Panfeng; Zhang, Hongjun; Li, Baohua; Lin, Keke

2016-01-01

The aims of this study were to develop a nursing information system (NIS), enhance the visibility of patient risk, and identify challenges and facilitators to adoption of the NIS risk assessment system for nurse leaders. This article describes the function of a nursing risk assessment information system, and the results of a survey on the risk assessment system. The results suggested that quality of information processing in nursing significantly improved patient safety. Nurses surveyed demonstrated a high degree of satisfaction, with saving time and improving safety. The nursing document information system described was introduced to improve patient safety and decrease risk. The application of the system has greatly enhanced the efficiency of nursing work, and guides the nurses to make an accurate, comprehensive and objective assessment of patient information, contributing significantly to further improvement in care standards and care decisions.

Functional Assessment and Intervention by Nursing Assistants in Hospice and Palliative Care Inpatient Care Settings: A Quality Improvement Pilot Study.

PubMed

Mueller, Karen; Hamilton, Gillian; Rodden, Betheny; DeHeer, Hendrick D

2016-03-01

This study assessed the impact of a nursing assistant-led functional intervention in an urban hospice. Thirty-three patients participated. A physical therapist trained 4 nursing assistants to assess 4 basic functional activities at admission and discharge and to provide daily activity training to intervention group participants. Control group participants were assessed at admission and discharge and received the usual standard of care. Both groups improved. The intervention group participants demonstrated significant improvement in the Timed up and Go test as well as their self-reported ability to achieve goals on the Patient-Specific Functional Scale. Control group participants made significant improvements in the ability to move from supine to sit in bed. These findings suggest that nursing assistants can provide activity-based assessment and intervention leading to improved function among patients in hospice. © The Author(s) 2014.

Improved physical fitness correlates with improved cognition in multiple sclerosis.

PubMed

Beier, Meghan; Bombardier, Charles H; Hartoonian, Narineh; Motl, Robert W; Kraft, George H

2014-07-01

To determine whether there is an association between improvements in objective measures of physical fitness and performance on cognitive tests in people with multiple sclerosis (MS). Post hoc correlational analysis in which people demonstrating physical improvement were compared with those not demonstrating physical improvement. Individuals with MS residing in the community. Adults with clinically confirmed MS (N=88) who participated in a controlled trial of a telephone-based health promotion intervention, chose to work on exercise, and completed the pre- and postintervention assessments. Participants were measured for strength (isokinetic dynamometer), aerobic fitness (bicycle ergometer), and cognition (Paced Auditory Serial Addition Test [PASAT], Trail Making Test [TMT]) at baseline and 12 weeks later. Change in fitness was calculated by subtracting each participant's baseline score from the outcome score, and then transforming the difference to a z score. Individuals with a z score ≥1 on any fitness measure were placed in the physically improved group (n=25). All others were in the physically not improved group (n=57). After controlling for covariates (age, sex, ethnicity, education, disease activity, MS type), there was a significant group-by-time interaction, suggesting that cognitive functioning changed over time based on level of fitness. Participants in the physically improved group demonstrated improved performance on measures of executive functioning after 12 weeks of exercise. The results of this study lend support to the hypothesis that change in fitness is associated with improved executive functioning in people with MS. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Critical Analysis of Cluster Models and Exchange-Correlation Functionals for Calculating Magnetic Shielding in Molecular Solids.

PubMed

Holmes, Sean T; Iuliucci, Robbie J; Mueller, Karl T; Dybowski, Cecil

2015-11-10

Calculations of the principal components of magnetic-shielding tensors in crystalline solids require the inclusion of the effects of lattice structure on the local electronic environment to obtain significant agreement with experimental NMR measurements. We assess periodic (GIPAW) and GIAO/symmetry-adapted cluster (SAC) models for computing magnetic-shielding tensors by calculations on a test set containing 72 insulating molecular solids, with a total of 393 principal components of chemical-shift tensors from 13C, 15N, 19F, and 31P sites. When clusters are carefully designed to represent the local solid-state environment and when periodic calculations include sufficient variability, both methods predict magnetic-shielding tensors that agree well with experimental chemical-shift values, demonstrating the correspondence of the two computational techniques. At the basis-set limit, we find that the small differences in the computed values have no statistical significance for three of the four nuclides considered. Subsequently, we explore the effects of additional DFT methods available only with the GIAO/cluster approach, particularly the use of hybrid-GGA functionals, meta-GGA functionals, and hybrid meta-GGA functionals that demonstrate improved agreement in calculations on symmetry-adapted clusters. We demonstrate that meta-GGA functionals improve computed NMR parameters over those obtained by GGA functionals in all cases, and that hybrid functionals improve computed results over the respective pure DFT functional for all nuclides except 15N.

Spacing and lag effects in free recall of pure lists.

PubMed

Kahana, Michael J; Howard, Marc W

2005-02-01

Repeating list items leads to better recall when the repetitions are separated by several unique items than when they are presented successively; the spacing effect refers to improved recall for spaced versus successive repetition (lag > 0 vs. lag = 0); the lag effect refers to improved recall for long lags versus short lags. Previous demonstrations of the lag effect have utilized lists containing a mixture of items with varying degrees of spacing. Because differential rehearsal of items in mixed lists may exaggerate any effects of spacing, it is important to demonstrate these effects in pure lists. As in Toppino and Schneider (1999), we found an overall advantage for recall of spaced lists. We further report the first demonstration of a lag effect in pure lists, with significantly better recall for lists with widely spaced repetitions than for those with moderately spaced repetitions.

Rehearsal significantly improves immediate and delayed recall on the Rey Auditory Verbal Learning Test.

PubMed

Hessen, Erik

2011-10-01

A repeated observation during memory assessment with the Rey Auditory Verbal Learning Test (RAVLT) is that patients who spontaneously employ a memory rehearsal strategy by repeating the word list more than once achieve better scores than patients who only repeat the word list once. This observation led to concern about the ability of the standard test procedure of RAVLT and similar tests in eliciting the best possible recall scores. The purpose of the present study was to test the hypothesis that a rehearsal recall strategy of repeating the word list more than once would result in improved scores of recall on the RAVLT. We report on differences in outcome after standard administration and after experimental administration on Immediate and Delayed Recall measures from the RAVLT of 50 patients. The experimental administration resulted in significantly improved scores for all the variables employed. Additionally, it was found that patients who failed effort screening showed significantly poorer improvement on Delayed Recall compared with those who passed the effort screening. The general clear improvement both in raw scores and T-scores demonstrates that recall performance can be significantly influenced by the strategy of the patient or by small variations in instructions by the examiner.

Improving resident performance on standardized assessments of medical knowledge: a retrospective analysis of interventions correlated to American Board of Surgery In-Service Training Examination performance.

PubMed

Buckley, Elaine Jayne; Markwell, Stephen; Farr, Debb; Sanfey, Hilary; Mellinger, John

2015-10-01

American Board of Surgery In-Service Training Examination (ABSITE) scores are used to assess individual progress and predict board pass rates. We reviewed strategies to enhance ABSITE performance and their impact within a surgery residency. Several interventions were introduced from 2010 to 2014. A retrospective review was undertaken evaluating these and correlating them to ABSITE performance. Analyses of variance and linear trends were performed for ABSITE, United States Medical Licensing Examination (USMLEs), mock oral, and mock ABSITE scores followed by post hoc analyses if significant. Results were correlated with core curricular changes. ABSITE mean percentile increased 34% in 4 years with significant performance improvement and increasing linear trends in postgraduate year (PGY)1 and PGY4 ABSITE scores. Mock ABSITE introduction correlated to significant improvement in ABSITE scores for PGY4 and PGY5. Mock oral introduction correlated with significant improvement in PGY1 and PGY3. Our study demonstrates an improvement in mean program ABSITE percentiles correlating with multiple interventions. Similar strategies may be useful for other programs. Copyright © 2015 Elsevier Inc. All rights reserved.

Community-based peer-led diabetes self-management: a randomized trial.

PubMed

Lorig, Kate; Ritter, Philip L; Villa, Frank J; Armas, Jean

2009-01-01

The purpose of this study is to determine the effectiveness of a community-based diabetes self-management program comparing treatment participants to a randomized usual-care control group at 6 months. A total of 345 adults with type 2 diabetes but no criteria for high A1C were randomized to a usual-care control group or 6-week community-based, peer-led diabetes self-management program (DSMP). Randomized participants were compared at 6 months. The DSMP intervention participants were followed for an additional 6 months (12 months total). A1C and body mass index were measured at baseline, 6 months, and 12 months. All other data were collected by self-administered questionnaires. At 6 months, DSMP participants did not demonstrate improvements in A1C as compared with controls. Baseline A1C was much lower than in similar trials. Participants did have significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels (P < .01). They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP intervention participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy (P < .01). There were no significant changes in utilization measures. These findings suggest that people with diabetes without elevated A1C can benefit from a community-based, peer-led diabetes program. Given the large number of people with diabetes and lack of low-cost diabetes education, the DSMP deserves consideration for implementation.

Clinical presentation and outcome of dogs treated medically or surgically for thoracolumbar intervertebral disc protrusion.

PubMed

Crawford, A H; De Decker, S

2017-06-10

To date, few studies have investigated the clinical characteristics of thoracolumbar intervertebral disc protrusion (IVDP). The aim of this retrospective study was to evaluate the presentation and outcome of dogs receiving medical or surgical treatment for thoracolumbar IVDP. Eighty-four dogs were included, with a median age of 9.4 years. German shepherd dogs and Staffordshire bull terriers were the most common breeds. Significantly more surgically treated dogs (n=53) had neurological deficits and were non-ambulatory, compared with medically treated (n=31). Outcome data were available for 27 of 31 medically managed dogs; 11 initially improved, 7 remained stable and 9 deteriorated. Of 18 dogs that initially improved or stabilised, 10 (55.6 per cent) demonstrated recurrence of clinical signs within 12 months of diagnosis. Outcome data were available for 45 of 50 surgically treated dogs that survived to hospital discharge; 34 improved, 9 remained stable and 2 deteriorated following surgery. Of 43 dogs that improved or stabilised with surgical treatment, 11 (25.6 per cent) demonstrated recurrence of clinical signs within 12 months of surgery. Overall, significantly more surgically treated dogs (71.1 per cent) had a successful outcome, consisting of sustained clinical improvement of more than 12 months duration, compared with medically treated dogs (29.6 per cent). British Veterinary Association.

Respiratory muscle endurance after training in athletes and non-athletes: A systematic review and meta-analysis.

PubMed

Sales, Ana Tereza do N; Fregonezi, Guilherme A de F; Ramsook, Andrew H; Guenette, Jordan A; Lima, Illia Nadinne D F; Reid, W Darlene

2016-01-01

The objectives of this systematic review was to evaluate the effects of respiratory muscle training (RMT) on respiratory muscle endurance (RME) and to determine the RME test that demonstrates the most consistent changes after RMT. Electronic searches were conducted in EMBASE, MEDLINE, COCHRANE CENTRAL, CINHAL and SPORTDiscus. The PEDro scale was used for quality assessment and meta-analysis were performed to compare effect sizes of different RME tests. Twenty studies met the inclusion criteria. Isocapnic hyperpnea training was performed in 40% of the studies. Meta-analysis showed that RMT improves RME in athletes (P = 0.0007) and non-athletes (P = 0.001). Subgroup analysis showed differences among tests; maximal sustainable ventilatory capacity (MSVC) and maximal sustainable threshold loading tests demonstrated significant improvement after RMT (P = 0.007; P = 0.003 respectively) compared to the maximal voluntary ventilation (MVV) (P = 0.11) in athletes whereas significant improvement after RMT was only shown by MSVC in non-athletes. The effect size of MSVC was greater compared to MVV in studies that performed both tests. The meta-analysis results provide evidence that RMT improves RME in athletes and non-athletes and MSVC test that examine endurance over several minutes are more sensitive to improvement after RMT. Copyright © 2015 Elsevier Ltd. All rights reserved.

Optical clearing of skin enhanced with hyaluronic acid for increased contrast of optoacoustic imaging

NASA Astrophysics Data System (ADS)

Liopo, Anton; Su, Richard; Tsyboulski, Dmitri A.; Oraevsky, Alexander A.

2016-08-01

Enhanced delivery of optical clearing agents (OCA) through skin may improve sensitivity of optical and optoacoustic (OA) methods of imaging, sensing, and monitoring. This report describes a two-step method for enhancement of light penetration through skin. Here, we demonstrate that topical application of hyaluronic acid (HA) improves skin penetration of hydrophilic and lipophilic OCA and thus enhances their performance. We examined the OC effect of 100% polyethylene and polypropylene glycols (PPGs) and their mixture after pretreatment by HA, and demonstrated significant increase in efficiency of light penetration through skin. Increased light transmission resulted in a significant increase of OA image contrast in vitro. Topical pretreatment of skin for about 30 min with 0.5% HA in aqueous solution offers effective delivery of low molecular weight OCA such as a mixture of PPG-425 and polyethylene glycol (PEG)-400. The developed approach of pretreatment by HA prior to application of clearing agents (PEG and PPG) resulted in a ˜47-fold increase in transmission of red and near-infrared light and significantly enhanced contrast of OA images.

Effectiveness of a caregiver education program on providing oral care to individuals with intellectual and developmental disabilities.

PubMed

Fickert, Nancy A; Ross, Diana

2012-06-01

Caregivers who work in community living arrangements or intermediate care facilities are responsible for the oral hygiene of individuals with intellectual and developmental disabilities. Oral hygiene training programs do not exist in many organizations, despite concerns about the oral care of this population. The purpose of this study was to determine the effectiveness of a caregiver educational program. This study used a quasi-experimental one-group pretest/posttest design with repeated measures to describe the outcomes of an educational program. Program participants demonstrated oral hygiene skills on each other while being scored by a trained observer, after which they completed an oral hygiene compliance survey. After three months, a follow-up included the same posttest, demonstration of oral hygiene skills, and repeat of the compliance survey. Paired-sample t-tests of oral hygiene knowledge showed a statistically significant improvement from pretest to posttest and from pretest to three-month posttest. Oral hygiene skills and compliance improved. Results demonstrate evidence that caregiver education improves knowledge, skill, and compliance in oral hygiene. Further studies are required to demonstrate the value of providing oral hygiene education and training for caregivers of individuals with intellectual and developmental disabilities.

Improving Exclusive Breastfeeding in an Urban Academic Hospital.

PubMed

Ward, Laura P; Williamson, Susan; Burke, Stephanie; Crawford-Hemphill, Ruby; Thompson, Amy M

2017-02-01

Breastfeeding has many well-established health benefits for infants and mothers. There is greater risk reduction in health outcomes with exclusive breastfeeding (EBF). Our urban academic facility has had long-standing low EBF rates, serving a population with breastfeeding disparities. We sought to improve EBF rates through a Learning Collaborative model by participating in the Best Fed Beginnings project. Formal improvement science methods were used, including the development of a key driver diagram and plan-do-study-act cycles. Improvement activities followed the Ten Steps to Successful Breastfeeding. We demonstrated significant improvement in the median adherence to 2 process measures, rooming in and skin-to-skin after delivery. Subsequently, the proportion of infants exclusively breastfed at hospital discharge in our facility increased from 37% to 59%. We demonstrated an increase in sustained breastfeeding in a subset of patients at a postpartum follow-up visit. These improvements led to Baby-Friendly designation at our facility. This quality improvement initiative resulted in a higher number of infants exclusively breastfed in our patient population at "high risk not to breastfeed." Other hospitals can use these described methods and techniques to improve their EBF rates. Copyright © 2017 by the American Academy of Pediatrics.

Nail involvement in patients with moderate-to-severe alopecia areata treated with oral tofacitinib.

PubMed

Lee, Ji Su; Huh, Chang-Hun; Kwon, Ohsang; Yoon, Hyun-Sun; Cho, Soyun; Park, Hyun-Sun

2018-05-07

A few anecdotal case reports demonstrated that tofacitinib improved nail changes associated with AA. To investigate nail changes in patients with AA treated with tofacitinib and evaluate the relationship between nail and hair responses to tofacitinib. This is a retrospective study of 33 adult patients with moderate-to-severe AA treated with oral tofacitinib monotherapy for at least 4 months. Fifteen patients had nail involvement and demonstrated more severe hair loss than those without nail involvement (p = .040). However, there was no significant difference in hair regrowth between two groups. Of 15 patients with nail involvement, 11 (73.3%) showed improvement regardless of type of nail change; the first improvement was observed at a median of 5 months (range, 1-11) after administration. Nail improvement was associated with neither initial severity of hair loss nor hair response to tofacitinib. Nail improvement tended to occur later than hair regrowth. Oral tofacitinib monotherapy improves nail involvement associated with AA. Nail involvement is not a poor prognosis factor in hair regrowth with tofacitinib treatment and there is no evident relationship between nail and hair responses.

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

PubMed Central

El Emam, Dalia Sabry; Farag, Rania Kamel; Abouelkheir, Hossam Youssef

2016-01-01

Aim. To compare objective and subjective outcome after simultaneous wave front guided (WFG) PRK and accelerated corneal cross-linking (CXL) in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods. 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results. All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P < 0.001). A significant improvement was observed in keratometric and Q values. The improvement in all parameters was stable till the end of follow-up. Likewise, no significant difference was determined in between the 2 groups in any of recorded parameters. Subjective data revealed similarly significant improvement in both groups. Conclusions. WFG PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure. PMID:28127465

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation.

PubMed

Abou Samra, Waleed Ali; El Emam, Dalia Sabry; Farag, Rania Kamel; Abouelkheir, Hossam Youssef

2016-01-01

Aim . To compare objective and subjective outcome after simultaneous wave front guided (WFG) PRK and accelerated corneal cross-linking (CXL) in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods . 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results . All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P < 0.001). A significant improvement was observed in keratometric and Q values. The improvement in all parameters was stable till the end of follow-up. Likewise, no significant difference was determined in between the 2 groups in any of recorded parameters. Subjective data revealed similarly significant improvement in both groups. Conclusions . WFG PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure.

Changes in body weight and metabolic indexes in overweight breast cancer survivors enrolled in a randomized trial of low-fat vs. reduced carbohydrate diets.

PubMed

Thomson, Cynthia A; Stopeck, Alison T; Bea, Jennifer W; Cussler, Ellen; Nardi, Emily; Frey, Georgette; Thompson, Patricia A

2010-01-01

Overweight status is common among women breast cancer survivors and places them at greater risk for metabolic disorders, cardiovascular morbidity, and breast cancer recurrence than nonoverweight survivors. Efforts to promote weight control in this population are needed. The objective of this research was to evaluate the effect of low-fat or low-carbohydrate diet counseling on weight loss, body composition, and changes in metabolic indexes in overweight postmenopausal breast cancer survivors. Survivors (n = 40) were randomized to receive dietitian counseling for a low-fat or a reduced carbohydrate diet for 6 mo. Weight and metabolic measures, including glucose, insulin, HbA1c, HOMA, lipids, hsCRP, as well as blood pressure were measured at baseline, 6, 12 and 24 wk. Dietary intake of fat and carbohydrate was reduced by 24 and 76 g/day, respectively. Weight loss averaged 6.1 (± 4.8 kg) at 24 wk and was not significantly different by diet group; loss of lean mass was also demonstrated. All subjects demonstrated improvements in total/HDL cholesterol ratio, and significant reductions in HbA1c, insulin, and HOMA. Triglycerides levels were significantly reduced only in the low-carbohydrate diet group (-31.1 ± 36.6; P = 0.01). Significant improvements in weight and metabolic indexes can be demonstrated among overweight breast cancer survivors adherent to either a carbohydrate- or fat-restricted diet.

Quality improvement in childhood obesity management through the maintenance of certification process.

PubMed

Huang, Jeannie S; Chun, Stanford; Sandhu, Amanpreet; Terrones, Laura

2013-11-01

To assess the Health and Obesity: Prevention and Education (HOPE) Curriculum Project, a web-based clinician education program that promotes appropriate screening, prevention, and management of weight among youth by pediatric practitioners, based on the 2007 Expert Committee recommendations. The project currently provides Maintenance of Certification (MOC) Part 4 credit through the American Board of Pediatrics. Participants identified themselves to the HOPE MOC Part 4 program. Enrollees were required to complete all continuing medical education modules (10.5 hours). Knowledge acquisition and self-reported confidence levels related to screening, prevention, and management practices of pediatric obesity were measured using preknowledge and postknowledge questionnaires. Participants were also required to perform a quality improvement project and submit practice performance data from repeated medical chart reviews over time. Knowledge acquisition, self-efficacy, and practice performance data were analyzed using repeated-measures analyses. The 51 participants demonstrated significant improvements in knowledge acquisition and self-efficacy scores after viewing individual modules. In addition, participants demonstrated significant improvements in measured clinical compliance with recommended practices over time. Participation in the HOPE MOC Part 4 program appeared to improve knowledge acquisition, self-efficacy, and physician compliance with recommended practice recommendations for the screening, prevention, and management of pediatric obesity. Further data are required to determine whether such practice-based improvements translate into actual reduction in patient weight and/or reduction in health-related costs related to overweight and obesity in youth. Copyright © 2013 Mosby, Inc. All rights reserved.

Role of Google Glass in improving patient satisfaction for otolaryngology residents: a pilot study.

PubMed

Son, E; Halbert, A; Abreu, S; Hester, R; Jefferson, G; Jennings, K; Pine, H; Watts, T

2017-04-01

To demonstrate the feasibility and efficacy of the Google Glass as a tool to improve patient satisfaction and patient-physician communication for otolaryngology residents in the outpatient clinic setting. The primary outcome of the study was to improve patient satisfaction scores based on physician communication-related questions from Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. Prospective randomised trial. Tertiary care hospital. To evaluate the effect on patient satisfaction, five residents were recorded using the Google Glass in an outpatient clinic setting by 50 randomised patients. Modified surveys based on the CG-CAHPS survey were completed by patients at the conclusion of each clinic encounter. The recorded videos were evaluated by two independent faculties. Summarised data and video were distributed to each resident for review as the intervention. The residents were recorded again by 45 additional patients with evaluation by patients and faculties. After intervention, the scores from faculty surveys regarding patient satisfaction including the subject of better explanations (P > 0.001), listening carefully (P > 0.001), addressing patient questions (P > 0.001), displaying respect (P > 0.001) and spending adequate time (P = 0.0005) all significantly improved, as well as overall performance (P = 0.014). The scores from patient surveys did significantly improve. This study demonstrates the improvements in patient satisfaction and patient-physician communication can be achieved with the use of Google Glass as a first-person recording device in the outpatient otolaryngology clinic setting. © 2016 John Wiley & Sons Ltd.

Service innovation: a comparison of two approaches for physical screening of psychiatric inpatients.

PubMed

Harrison, Mark Richard; McMillan, Catherine Frances; Dickinson, Timothy

2012-06-01

Psychiatric medications have clear links to obesity, diabetes, dyslipidaemia, hypertension, hyperprolactinaemia and movement disorders. These disorders are a common cause of morbidity and mortality in psychiatric patients but physical screening by health services is often haphazard. We report the findings of an audit of physical screening across two hospital wards. Each ward undertook a process of service improvement. One ward modified the admissions proforma and the other developed a discharge screening clinic. The effectiveness of each of these interventions was then compared through a reaudit of practice across both wards. At baseline, screening was performed inconsistently and infrequently. On average, the modified admissions proforma increased screening rates by 4.7% compared to 30.7% for discharge screening clinics. The discharge screening clinic demonstrated statistically significant improvements in screening rates and effectively delivered health promotion advice. Discharge screening clinics are significantly more likely than improved admissions procedures to detect clinically significant abnormalities. If these abnormalities are detected and treated then the long-term physical health of psychiatric patients may be improved.

Impact of electronic health record clinical decision support on the management of pediatric obesity.

PubMed

Shaikh, Ulfat; Berrong, Jeanette; Nettiksimmons, Jasmine; Byrd, Robert S

2015-01-01

Clinicians vary significantly in their adherence to clinical guidelines for overweight/obesity. This study assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. The study team programmed a point-of-care alert linked to a checklist and standardized documentation templates to appear during health maintenance visits for overweight/obese children in an outpatient teaching clinic and compared outcomes through medical record reviews of 574 (287 control and 287 intervention) visits. The results demonstrated a statistically significant increase in the diagnosis of overweight/obesity, scheduling of follow-up appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity. Although clinical guideline adherence increased significantly, it was far from universal. It is unknown if modest improvements in adherence to clinical guidelines translate to improvements in children's health. However, this intervention was relatively easy to implement and produced measurable improvements in health care delivery. © 2014 by the American College of Medical Quality.

Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients.

PubMed

Carmack Taylor, Cindy L; Demoor, Carl; Smith, Murray A; Dunn, Andrea L; Basen-Engquist, Karen; Nielsen, Ingrid; Pettaway, Curtis; Sellin, Rena; Massey, Pamela; Gritz, Ellen R

2006-10-01

Active for Life After Cancer is a randomized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program (Lifestyle) for prostate cancer patients to improve quality of life (QOL) including physical and emotional functioning compared to a group-based Educational Support Program and a Standard Care Program (no group). A total of 134 prostate cancer patients receiving continuous androgen-ablation were randomly assigned to one of the three study conditions. Results indicated no significant improvements in QOL at 6 or 12 months. Both group-based programs were positively received and yielded good attendance and retention. Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity. Despite these improvements, no significant changes were found for most physical activity measures. Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients.

34 CFR 200.43 - Restructuring.

Code of Federal Regulations, 2010 CFR

2010-07-01

...— (1) Makes fundamental reforms to improve student academic achievement in the school; (2) Has..., such as a private management company, with a demonstrated record of effectiveness, to operate the... arrangement that makes fundamental reforms, such as significant changes in the school's staffing and...

Functional Communication Training

ERIC Educational Resources Information Center

Durand, V. Mark; Moskowitz, Lauren

2015-01-01

Thirty years ago, the first experimental demonstration was published showing that educators could improve significant challenging behavior in children with disabilities by replacing these behaviors with forms of communication that served the same purpose, a procedure called functional communication training (FCT). Since the publication of that…

EXAMINATIONS AND THE ADVANCEMENT OF TEACHING.

ERIC Educational Resources Information Center

BENSON, ARTHUR L.

FUNCTIONS OF PROFESSIONALLY PREPARED, OBJECTIVE, STANDARDIZED TESTS FOR TEACHERS AND PROSPECTIVE TEACHERS, FOR NATIONWIDE USE, ARE DESCRIBED. THESE ARE (1) ADVANCING THE PRESERVICE PREPARATION OF TEACHERS BY DEMONSTRATING SIGNIFICANT TEST-SCORE DIFFERENCES AMONG STUDENTS FROM VARIOUS INSTITUTIONS, (2) IMPROVING CERTIFICATION OR LICENSING POLICIES…

Litopenaeus vannamei hemocyanin exhibits antitumor activity in S180 mouse model in vivo

PubMed Central

Aweya, Jude Juventus; Zheng, Zhou; Zhong, Mingqi; Chen, Jiehui; Wang, Fan

2017-01-01

Hemocyanin is a multifunctional glycoprotein, which also plays multiple roles in immune defense. While it has been demonstrated that hemocyanin from some mollusks can induce potent immune response and is therefore undergoing clinical trials to be used in anti-tumor immunotherapy, little is currently known about how hemocyanin from arthropods affect tumors. In this study we investigated the anti-tumor activity of hemocyanin from Litopenaeus vannamei on Sarcoma-180 (S180) tumor-bearing mice model. Eight days treatment with 4mg/kg bodyweight of hemocyanin significantly inhibited the growth of S180 up to 49% as compared to untreated. Similarly, histopathology analysis showed a significant decrease in tumor cell number and density in the tissues of treated mice. Moreover, there was a significant increase in immune organs index, lymphocyte proliferation, NK cell cytotoxic activity and serum TNF-α level, suggesting that hemocyanin could improve the immunity of the S180 tumor-bearing mice. Additionally, there was a significant increase in superoxide dismutase (SOD) activity and a decrease in the level of malondialdehyde (MDA) in serum and liver, which further suggest that hemocyanin improved the anti-oxidant ability of the S180 tumor-bearing mice. Collectively, our data demonstrated that L. vannamei hemocyanin had a significant antitumor activity in mice. PMID:28854214

Safety and efficacy evaluation of tretinoin cream 0.02% for the reduction of photodamage: a pilot study.

PubMed

Kircik, Leon H

2012-01-01

Clinical studies as well as histologic data maintain that tretinoin improves the appearance of photodamage; however, the long-term benefits of tretinoin 0.02% in moderate to severe photodamage have not been established. We performed independent assessments to demonstrate the long-term safety and efficacy of tretinoin emollient cream 0.02% for moderate to severe facial photodamage. A single-center, open-label, single-group observational study followed 19 patients over 52 weeks. Efficacy assessments consisted of the Glogau Photodamage Classification Scale and severity grading of photodamage signs and symptoms. Facial photography and biopsies were taken from three subjects at baseline and final visits. Tolerability was assessed by the investigator. Twelve patients completed 52 weeks of treatment. Mean change in Glogau photodamage demonstrated statistically significant differences at 3, 6, 9, and 12 months (P<.0005). All patients with moderate to severe photodamage had improved to mild photodamage status by 9 months. Statistically significant improvements (P<.05) were observed at all time points for fine wrinkling, tactile roughness, and mottled hyperpigmentation as well as for lentigines at 6, 9, and 12 months and telangiectasia at 12 months. Biopsy samples revealed microscopic improvement in photodamage. Tretinoin cream 0.02% was generally well-tolerated, with few subjects experiencing adverse events. Our pilot study is limited by lack of control and the small study sample. Tretinoin cream 0.02% was safe and effective for moderate to severe photodamage of facial skin and demonstrated sustainable benefits over an entire year based on the clinically validated Glogau classification system and expert visual grading analysis.

Incorporating Early Learning Strategies in the School Improvement Grants (SIG) Program: How Three Schools Integrated Early Childhood Strategies into School Turnaround Efforts to Improve Instruction for All Students

ERIC Educational Resources Information Center

Connors-Tadros, Lori; Dunn, Lenay; Martella, Jana; McCauley, Carlas

2015-01-01

A significant body of research shows that achievement gaps evident in persistently low-performing schools, in many instances, manifest prior to children entering kindergarten. High-quality early learning programs have proven to demonstrate positive effects on closing academic gaps both for individual children and in the aggregate for the school.…

Improving client satisfaction and clinic revenues through systems simulation: the case of a university nutrition clinic.

PubMed

Thompson, R C; Scammon, D L

1994-01-01

A client-responsive strategy was developed based upon input from nutrition clinic personnel, administrators, and clients. Systems simulation identified the strategy most likely to lead to client satisfaction while also meeting the needs of clinic personnel and administration. The strategy was subsequently introduced into the clinic and patient satisfaction and operating revenues were monitored following implementation. Both measures of impact demonstrated significant improvement.

Autologous tenocyte implantation into shoulder tendon pathology in an elite swimmer.

PubMed

Schwab, Laura M; Blanch, Peter; Young, Mark

2018-01-01

The use of novel bioengineer treatment techniques such as Autologous Tenocyte Implantation (ATI) have shown promising improvements in both pain ratings and functional outcomes in elbow, gluteal and shoulder tendon pathology. This case will review the injury timeline of ATI intervention in an elite male swimmer with subscapularis tendon pathology and investigate whether ATI has a concomitant healing effect associated with improved functional outcomes. A palmaris longus tendon biopsy was performed and cells were expanded by in-vitro culture. Autologous tenocytes were injected into the subscapularis site identified. Three blinded radiologists reported on pre and post shoulder MRIs using the same 3T MRI protocol. A validated rating scale for severity of tendinopathy (0-3) and degree of tear (0-3) was used and hand-held Dynamometry (HHD) strength was recorded. Independent blinded radiology review demonstrated a significant reduction in tear size and improved tendon morphology. IR strength on HHD returned to baseline strength levels post ATI (231-253N) 6 weeks post intervention. The athlete returned to full training (volume and intensity) pain free and international level competition at 4 months post ATI. An athlete who had previously undergone unsuccessful conservative management demonstrated significant improvement in function and in tendon morphology post intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

Acute Exercise Improves Motor Memory Consolidation in Preadolescent Children

PubMed Central

Lundbye-Jensen, Jesper; Skriver, Kasper; Nielsen, Jens B.; Roig, Marc

2017-01-01

Objective: The ability to acquire new motor skills is essential both during childhood and later in life. Recent studies have demonstrated that an acute bout of exercise can improve motor memory consolidation in adults. The objective of the present study was to investigate whether acute exercise protocols following motor skill practice in a school setting can also improve long-term retention of motor memory in preadolescent children. Methods: Seventy-seven pre-adolescent children (age 10.5 ± 0.75 (SD)) participated in the study. Prior to the main experiment age, BMI, fitness status and general physical activity level was assessed in all children and they were then randomly allocated to three groups. All children practiced a visuomotor tracking task followed by 20 min of rest (CON), high intensity intermittent floorball (FLB) or running (RUN) with comparable exercise intensity and duration for exercise groups. Delayed retention of motor memory was assessed 1 h, 24 h and 7 days after motor skill acquisition. Results: During skill acquisition, motor performance improved significantly to the immediate retention test with no differences between groups. One hour following skill acquisition, motor performance decreased significantly for RUN. Twenty-four hours following skill acquisition there was a tendency towards improved performance for FLB but no significant effects. Seven days after motor practice however, both FLB and RUN performed better when compared to their immediate retention test indicating significant offline gains. This effect was not observed for CON. In contrast, 7 days after motor practice, retention of motor memory was significantly better for FLB and RUN compared to CON. No differences were observed when comparing FLB and RUN. Conclusions: Acute intense intermittent exercise performed immediately after motor skill acquisition facilitates long-term motor memory in pre-adolescent children, presumably by promoting memory consolidation. The results also demonstrate that the effects can be accomplished in a school setting. The positive effect of both a team game (i.e., FLB) and running indicates that the observed memory improvements are determined to a larger extent by physiological factors rather than the types of movements performed during the exercise protocol. PMID:28473761

Is progression-free survival a more relevant endpoint than overall survival in first-line HR+/HER2- metastatic breast cancer?

PubMed

Forsythe, Anna; Chandiwana, David; Barth, Janina; Thabane, Marroon; Baeck, Johan; Shor, Anastasiya; Tremblay, Gabriel

2018-01-01

Hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-), metastatic breast cancer (MBC) accounts for 73% of all MBCs. Endocrine therapy (ET) is the basis of first-line (1L) therapy for patients with HR+/HER2- MBC. Novel therapies have demonstrated improvements in progression-free survival (PFS) compared to ET. The clinical relevance of PFS is being debated, as there is no proven direct correlation with overall survival (OS) benefit to date. We reviewed studies of HR+/HER2- MBC to assess PFS and other factors that influence OS and treatment response, and health-related quality of life (HRQoL). The Embase ® , Medline ® , and Cochrane databases were systematically searched to identify studies in adult women with HR+/HER2- MBC, published between January 2006 and January 2017, and written in English. Phase II and III randomized controlled trials (RCTs), observational, and retrospective studies were included. Seventy-nine RCTs were identified: 58 (73%) in the 1L+ setting and 21 (27%) in second-line or greater settings. PFS hazard ratios (HRs) were reported in 61 (77%) studies; 31 (39%) reported significant PFS improvements. OS was reported in 44 (41%) studies; 12 (15%) reported significant OS improvements. Significant improvements in both PFS and OS were reported in only 6 (8%) studies (1 Phase II; 5 Phase III). Patients with HER2- MBC received, on average, ≥5 lines of therapy, with no consistent treatment pathway. Baseline characteristics, prior therapies, and the type and number of post-progression therapies significantly impacted OS. PFS, response rates, and HRQoL decreased with each line of therapy (EuroQol 5 Dimensions: 0.78 1L vs. 0.70 post-progression). Few RCTs in HR+/HER2- MBC have demonstrated significant improvements in OS. Factors other than choice of 1L therapy impact OS, including post-progression therapies, which cannot be controlled in RCTs. This study emphasizes the importance of PFS improvement in 1L treatment of HR+/HER2- MBC.

Improving ECG Competence in Medical Trainees in a UK District General Hospital

PubMed Central

McAloon, Christopher; Leach, Helen; Gill, Simrat; Aluwalia, Arun; Trevelyan, Jasper

2014-01-01

Background Competency in electrocardiogram (ECG) interpretation is central to undergraduate and postgraduate clinical training. Studies have demonstrated ECGs are interpreted sub-optimally. Our study compares the effectiveness of two learning strategies to improve competence and confidence. Method A 1-month prospective randomized study compared the strategies in two cohorts: undergraduate third year medical students and postgraduate foundation year one (FY1) doctors. Both had blinded randomization to one of these learning strategies: focused teaching program (FTP) and self-directed learning (SDL). All volunteers completed a confidence questionnaire before and after allocation learning strategy and an ECG recognition multiple choice question (MCQ) paper at the end of the learning period. Results The FTP group of undergraduates demonstrated a significant difference in successfully interpreting “ventricular tachycardia” (P = 0.046) and “narrow complex tachycardia” (P = 0.009) than the SDL group. Participant confidence increased in both learning strategies. FTP confidence demonstrated a greater improvement than SDL for both cohorts. Conclusion A dedicated teaching program can improve trainee confidence and competence in ECG interpretation. A larger benefit is observed in undergraduates and those undertaking a FTP. PMID:28392875

Should they stay or should they go now? Exploring the impact of team familiarity on interprofessional team training outcomes.

PubMed

Joshi, Kavita; Hernandez, Jessica; Martinez, Joseph; AbdelFattah, Kareem; Gardner, Aimee K

2018-02-01

Although simulation is an effective method for enhancing team competencies, it is unclear how team familiarity impacts this process. We examined how team familiarity impacted team competencies. Trainees were assigned to stable or dynamic teams to participate in three simulated cases. Situation awareness (SA) data was collected through in-scenario freezes. The recorded performances were assessed for clinical effectiveness (ClinEff) and teamwork. All data are reported on a 1-100% (100% = perfect performance) scale. Forty-six trainees (23 General Surgery; 23 Emergency Medicine) were randomized by specialty into stable (N = 8) or dynamic (N = 7) groups. Overall changes from Sim 1 to Sim3 were 12.2% (p < 0.01), -1.1% (ns), and 7.1% (p < 0.01) for SA, ClinEff, and Teamwork, respectively. However, improvements differed by condition, with stable teams reflecting improvements in ClinEff (15.2%; p < 0.05), whereas dynamic team ClinEff improvement (8.7%) was not significant. Both groups demonstrated improvements in teamwork (stable = 9%, p < 0.05; dynamic = 4.9%, p < 0.05). Teams who continued to work together demonstrated increased improvements in clinical effectiveness and teamwork, while dynamic teams only demonstrated improvements in teamwork. Copyright © 2017 Elsevier Inc. All rights reserved.

Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: a systematic review and meta-analysis.

PubMed

Plotnikoff, Ronald C; Costigan, Sarah A; Williams, Rebecca L; Hutchesson, Melinda J; Kennedy, Sarah G; Robards, Sara L; Allen, Jennifer; Collins, Clare E; Callister, Robin; Germov, John

2015-04-01

To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies.

Feasibility demonstration of a road vehicle fueled with hydrogen-enriched gasoline

NASA Technical Reports Server (NTRS)

Hoehn, F. W.; Dowdy, M. W.

1974-01-01

Evaluation of the concept of using hydrogen-enriched gasoline in a modified internal combustion engine in order to make possible the burning of ultralean mixtures. The use of such an engine in a road vehicle demonstrated that the addition of small quantities of gaseous hydrogen to gasoline resulted in significant reductions in exhaust emissions of carbon monoxide and nitrogen oxides as well as in thermal efficiency improvements of the engine performance.

[Effectiveness of cognitive-behavioral therapy in childhood anxiety disorders in a university psychiatric outpatient clinic].

PubMed

Goletz, Hildegard; Yang, Young-Im; Suhr-Dachs, Lydia; Walter, Daniel; Döpfner, Manfred

2013-07-01

Only few studies have examined whether the efficacy of cognitive-behavioral therapy for childhood anxiety disorders as demonstrated in randomized controlled trials (RCTs) generalizes to clinical practice. This study examines the effectiveness of cognitive-behavioral therapy for juvenile anxiety disorders under routine care conditions in a university-based psychiatric outpatient clinic. 92 children and adolescents with parent-ratings regarding anxiety and comorbid symptoms and 61 children and adolescents with self-ratings regarding anxiety and comorbid symptoms were treated with cognitive-behavioral interventions. Pre/post mean comparisons, effect sizes, and the clinical significance of changes in symptoms were examined. The effect size for reduction of anxiety symptoms was .81 for children whose parents had completed the rating scale and .79 for children who had filled in a self-rating scale. Effect sizes for reduction of comorbid symptoms varied between .37 and .84 for parent ratings and between .21 and .62 for self-ratings. The percentage of children and adolescents who achieved clinically significant improvements in anxiety symptoms was 55.1 % according to the parent ratings and 65.7 % according to the children's self-ratings. More than 50 % of parents and children reported clinically significant improvements in comorbid symptoms. Significant reductions in both anxiety and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile anxiety disorders in a university psychiatric outpatient clinic. The effect sizes for anxiety symptoms were found to be comparable to the effect sizes reported in RCTs. Similarly, clinically significant improvements were as frequent as the rates of remission of anxiety symptoms reported in RCTs.

Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study.

PubMed

Malaguarnera, Mariano; Risino, Corrado; Cammalleri, Lisa; Malaguarnera, Lucia; Astuto, Marinella; Vecchio, Ignazio; Rampello, Liborio

2009-07-01

Our earlier study has demonstrated that the administration of L-acetylcarnitine (LAC) improves neurological symptoms and serum parameters in hepatic coma. The aim of this work has been to evaluate the efficacy of the LAC and branched chain amino acids (BCAA) versus BCAA, administered in intravenous infusion, in patients with cirrhotic hepatic coma. Forty-eight highly selected patients were enrolled in the study and, after randomization, received blindly LAC+BCAA (n=24) versus BCAA (n=24). The two groups were similar in age, sex, pathogenesis of cirrhosis, and severity of liver disease. The comparison between values before and after LAC planned treatment showed statistical significant differences in neurological findings, evaluated by the Glasgow Scale, ammonia serum levels, blood urea nitrogen, and EEG. After 60 min of the study period, the LAC+BCAA treated patients compared with BCCA treated showed a significant decrease of ammonia serum levels: 41.20 versus 10.40 mumol P<0.05. After 1 day of the study period, the LAC+BCAA treated patients compared with BCCA treated patients showed a significant increase of Glasgow's score: 3.60 versus 1.50 score P<0.05; a significant decrease of ammonia serum levels: 63.30 versus 27.00 mumol P<0.01; a significant improvement of EEG cps/s: 2.70 versus 0.6 P<0.001. No side-effects were observed in our study series. Our study demonstrated that the administration of BCAA supplemented with LAC might improve neurological symptoms and serum ammonium levels in selected cirrhotic patients with hepatic coma.

Wave-Rotor-Enhanced Gas Turbine Engine Demonstrator

NASA Technical Reports Server (NTRS)

Welch, Gerard E.; Paxson, Daniel E.; Wilson, Jack; Synder, Philip H.

1999-01-01

The U.S. Army Research Laboratory, NASA Glenn Research Center, and Rolls-Royce Allison are working collaboratively to demonstrate the benefits and viability of a wave-rotor-topped gas turbine engine. The self-cooled wave rotor is predicted to increase the engine overall pressure ratio and peak temperature by 300% and 25 to 30%. respectively, providing substantial improvements in engine efficiency and specific power. Such performance improvements would significantly reduce engine emissions and the fuel logistics trails of armed forces. Progress towards a planned demonstration of a wave-rotor-topped Rolls-Royce Allison model 250 engine has included completion of the preliminary design and layout of the engine, the aerodynamic design of the wave rotor component and prediction of its aerodynamic performance characteristics in on- and off-design operation and during transients, and the aerodynamic design of transition ducts between the wave rotor and the high pressure turbine. The topping cycle increases the burner entry temperature and poses a design challenge to be met in the development of the demonstrator engine.

The effect of nightly nasal CPAP treatment on underlying obstructive sleep apnea and pharyngeal size.

PubMed

Collop, N A; Block, A J; Hellard, D

1991-04-01

Nasal continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA). It is usually prescribed for nightly use; however, recent studies show that patients often do not wear the appliance consistently. Previous studies have also suggested that nasal CPAP may improve a patient's underlying OSA even when the mask is not in place. We investigated 12 men with OSA to see if nasal CPAP used nightly for six weeks would improve their underlying sleep-disordered breathing. We also studied pharyngeal volumes measured using magnetic resonance imaging and a computer-controlled digitizing pad. Patients with more severe OSA had improvement after six weeks; however, they still demonstrated significant OSA. Patients with less severe OSA did not have significant change. We were unable to show a significant difference in any patient's awake pharyngeal volumes. We conclude that patients with OSA should be encouraged to wear their nasal CPAP machines regularly.

The Effects of the Nintendo Wii Exercise Program on Chronic Work-related Low Back Pain in Industrial Workers.

PubMed

Park, Ji-Hyuk; Lee, Sang-Heon; Ko, Dae-Sik

2013-08-01

[Purpose] The purpose of this study was to investigate the effects of a Nintendo Wii exercise program on chronic work-related LBP compared with stability exercise. [Methods] Twenty-four workers participated in this study. All of the participants were diagnosed with chronic LBP by a physician. Participants were randomly assigned to three groups: a control group (CG), lumbar stabilization exercise group (LSE), and Nintendo Wii exercise group (NWE). Participants were treated 3 times a week for 8 weeks. Each session lasted 30 minutes. [Results] The results demonstrated that exercise programs improved significantly physical functions related to LBP. In health-related QOL, the Nintendo Wii exercise program significantly improved both the mental and physical health composites, but other groups had significant improvement only in the physical health composite. [Conclusion] The Nintendo Wii exercise program could be a biopsychosocial intervention for work-related LBP in factory workers.

The Effects of the Nintendo Wii Exercise Program on Chronic Work-related Low Back Pain in Industrial Workers

PubMed Central

Park, Ji-Hyuk; Lee, Sang-Heon; Ko, Dae-Sik

2013-01-01

[Purpose] The purpose of this study was to investigate the effects of a Nintendo Wii exercise program on chronic work-related LBP compared with stability exercise. [Methods] Twenty-four workers participated in this study. All of the participants were diagnosed with chronic LBP by a physician. Participants were randomly assigned to three groups: a control group (CG), lumbar stabilization exercise group (LSE), and Nintendo Wii exercise group (NWE). Participants were treated 3 times a week for 8 weeks. Each session lasted 30 minutes. [Results] The results demonstrated that exercise programs improved significantly physical functions related to LBP. In health-related QOL, the Nintendo Wii exercise program significantly improved both the mental and physical health composites, but other groups had significant improvement only in the physical health composite. [Conclusion] The Nintendo Wii exercise program could be a biopsychosocial intervention for work-related LBP in factory workers. PMID:24259899

The role of visualization in learning from computer-based images

NASA Astrophysics Data System (ADS)

Piburn, Michael D.; Reynolds, Stephen J.; McAuliffe, Carla; Leedy, Debra E.; Birk, James P.; Johnson, Julia K.

2005-05-01

Among the sciences, the practice of geology is especially visual. To assess the role of spatial ability in learning geology, we designed an experiment using: (1) web-based versions of spatial visualization tests, (2) a geospatial test, and (3) multimedia instructional modules built around QuickTime Virtual Reality movies. Students in control and experimental sections were administered measures of spatial orientation and visualization, as well as a content-based geospatial examination. All subjects improved significantly in their scores on spatial visualization and the geospatial examination. There was no change in their scores on spatial orientation. A three-way analysis of variance, with the geospatial examination as the dependent variable, revealed significant main effects favoring the experimental group and a significant interaction between treatment and gender. These results demonstrate that spatial ability can be improved through instruction, that learning of geological content will improve as a result, and that differences in performance between the genders can be eliminated.

Efficacy and Safety of Doxepin 1 mg, 3 mg, and 6 mg in Adults with Primary Insomnia

PubMed Central

Roth, Thomas; Rogowski, Roberta; Hull, Steven; Schwartz, Howard; Koshorek, Gail; Corser, Bruce; Seiden, David; Lankford, Alan

2007-01-01

Study Objectives: To evaluate the efficacy and safety of doxepin 1, 3, and 6 mg in insomnia patients. Design: Adults (18-64 y) with chronic primary insomnia (DSM-IV) were randomly assigned to one of four sequences of 1 mg, 3 mg, and 6 mg of doxepin, and placebo in a crossover study. Treatment periods consisted of 2 polysomnographic assessment nights with a 5-day or 12-day drug-free interval between periods. Efficacy was assessed using polysomnography (PSG) and patient-reported measures. Safety analyses included measures of residual sedation and adverse events. Measurements and Results: Sixty-seven patients were randomized. Wake time during sleep, the a priori defined primary endpoint, was statistically significantly improved at the doxepin 3 mg and 6 mg doses versus placebo. All three doses had statistically significant improvements versus placebo for PSG-defined wake after sleep onset, total sleep time, and overall sleep efficiency (SE). SE in the final third-of-the-night also demonstrated statistically significant improvement at all doses. The doxepin 6 mg dose significantly reduced subjective latency to sleep onset. All three doxepin doses had a safety profile comparable to placebo. There were no statistically significant differences in next-day residual sedation, and sleep architecture was generally clinically preserved. Conclusions: In adults with primary insomnia, doxepin 1 mg, 3 mg, and 6 mg was well-tolerated and produced improvement in objective and subjective sleep maintenance and duration endpoints that persisted into the final hour of the night. The side-effect profile was comparable to placebo, with no reported anticholinergic effects, no memory impairment, and no significant hangover/next-day residual effects. These data demonstrate that doxepin 1 mg, 3 mg, and 6 mg is efficacious in improving the sleep of patients with chronic primary insomnia. Citation: Roth T; Rogowski R; Hull S; Schwartz H; Koshorek G; Corser B; Seiden D. Efficacy and safety of doxepin 1 mg, 3 mg, and 6 mg in adults with primary insomnia. SLEEP 2007;30(11):1555-1561. PMID:18041488

Nicergoline in senile dementia of Alzheimer type and multi-infarct dementia: a double-blind, placebo-controlled, clinical and EEG/ERP mapping study.

PubMed

Saletu, B; Paulus, E; Linzmayer, L; Anderer, P; Semlitsch, H V; Grünberger, J; Wicke, L; Neuhold, A; Podreka, I

1995-02-01

In a double-blind, placebo-controlled study on the therapeutic efficacy and central effects of nicergoline, an ergot alkaloid with metabolic, antithrombotic and vasoactive action, 112 patients with mild to moderate dementia, diagnosed according to DSM III-R criteria (MMS 13-25), living in pensioners' homes, were included. Fifty-six were subdiagnosed as senile dementia of the Alzheimer type (SDAT), 56 as multiinfarct dementia (MID), based on computed tomography and Hachinski scores (< or = 49 SDAT, > or = 7 MID). They received, after 2 weeks' run-in period (placebo), randomized for 8 weeks either 2 x 30 mg nicergoline (NIC) or 2 x 1 placebo (PLAC) orally. The four subgroups (SDAT/NIC. SDAT/PLAC, MID/NIC, MID/PLAC; 4 x 28 patients) were comparable in regard to age and sex. Only four, four, four and two patients of the respective groups did not finish the study for minor reasons. Confirmatory statistical analysis demonstrated in the target variable-the Clinical Global Impression (CGI)-a significant superiority of Global Impression (CGI)-a significant superiority of NIC over PLAC in both the SDAT and MID groups. Global improvement (CGI item 2) was seen in both nicergoline subgroups (3 and 3), while no changes occurred under placebo (4 and 4, respectively). The responder versus non-responder ratio was in the SDAT/NIC group 16/8, versus 8/16 in the SDAT/PLAC group (chi 2 = 4.1, P = 0.04); in the MID/NIC group 17/7, versus 7/19 in the MID/PLAC group (chi 2 = 7.96, P < 0.005). Furthermore, there was a significant improvement of the Mini-Mental State and the SCAG score in both the MID and SDAT group after 8 weeks of nicergoline, which was significantly superior to the minimal improvement or no change in placebo-treated SDAT and MID patients. EEG mapping demonstrated in NIC-treated SDAT and MID patients a significant decrease in delta and theta, increase in alpha 2 and beta activity and an acceleration of the centroid of the total power spectrum as compared with pretreatment, while opposite changes occurred in PLAC-treated SDAT and MID patients. The differences between PLAC and NIC reached the level of statistical significance. Event-related potential (ERP) recordings demonstrated a significantly shortened P300 latency under NIC treatment in both SDAT and MID patients, while there was a trend towards lengthening under PLAC. Thus, nicergoline improved vigilance and information processing at the neurophysiological level, which leads at the behavioural level to clinical improvement both in degenerative and vascular dementia.

Impact of Breast Reader Assessment Strategy on mammographic radiologists' test reading performance.

PubMed

Suleiman, Wasfi I; Rawashdeh, Mohammad A; Lewis, Sarah J; McEntee, Mark F; Lee, Warwick; Tapia, Kriscia; Brennan, Patrick C

2016-06-01

The detection of breast cancer is somewhat limited by human factors, and thus there is a need to improve reader performance. This study assesses whether radiologists who regularly undertake the education in the form of the Breast Reader Assessment Strategy (BREAST) demonstrate any changes in mammography interpretation performance over time. In 2011, 2012 and 2013, 14 radiologists independently assessed a year-specific BREAST mammographic test-set. Radiologists read a different single test-set once each year, with each comprising 60 digital mammogram cases. Radiologists marked the location of suspected lesions without computer-aided diagnosis (CAD) and assigned a confidence rating of 2 for benign and 3-5 for malignant lesions. The mean sensitivity, specificity, location sensitivity, JAFROC FOM and ROC AUC were calculated. A Kruskal-Wallis test was used to compare the readings for the 14 radiologists across the 3 years. Wilcoxon signed rank test was used to assess comparison between pairs of years. Relationships between changes in performance and radiologist characteristics were examined using a Spearman's test. Significant increases were noted in mean sensitivity (P = 0.01), specificity (P = 0.01), location sensitivity (P = 0.001) and JAFROC FOM (P = 0.001) between 2011 and 2012. Between 2012 and 2013, significant improvements were noted in mean sensitivity (P = 0.003), specificity (P = 0.002), location sensitivity (P = 0.02), JAFROC FOM (P = 0.005) and ROC AUC (P = 0.008). No statistically significant correlations were shown between the levels of improvement and radiologists' characteristics. Radiologists' who undertake the BREAST programme demonstrate significant improvements in test-set performance during a 3-year period, highlighting the value of ongoing education through the use of test-set. © 2016 The Royal Australian and New Zealand College of Radiologists.

Monetary Incentive Effects on Event-Based Prospective Memory Three Months after Traumatic Brain Injury in Children

PubMed Central

Pedroza, Claudia; Chapman, Sandra B.; Cook, Lori G.; Vásquez, Ana C.; Levin, Harvey S.

2011-01-01

Information regarding the remediation of event-based prospective memory (EB-PM) impairments following pediatric traumatic brain injury (TBI) is scarce. Addressing this, two levels of monetary incentives were used to improve EB-PM in children ages 7 to 16 years with orthopedic injuries (OI, n = 51), or moderate (n = 25), and severe (n = 39) TBI at approximately three months postinjury. The EB-PM task consisted of the child giving a specific verbal response to a verbal cue from the examiner while performing a battery of neuropsychological measures (ongoing task). Significant effects were found for Age-at-Test, Motivation Condition, Period, and Group. Within-group analyses indicated OI and moderate TBI groups performed significantly better under the high-versus low-incentive condition, but the severe TBI group demonstrated no significant improvement. These results indicate EB-PM can be significantly improved at three months postinjury in children with moderate, but not severe, TBI. PMID:21347945

Agonist anti-GITR antibody significantly enhances the therapeutic efficacy of Listeria monocytogenes-based immunotherapy.

PubMed

Shrimali, Rajeev; Ahmad, Shamim; Berrong, Zuzana; Okoev, Grigori; Matevosyan, Adelaida; Razavi, Ghazaleh Shoja E; Petit, Robert; Gupta, Seema; Mkrtichyan, Mikayel; Khleif, Samir N

2017-08-15

We previously demonstrated that in addition to generating an antigen-specific immune response, Listeria monocytogenes (Lm)-based immunotherapy significantly reduces the ratio of regulatory T cells (Tregs)/CD4 + and myeloid-derived suppressor cells (MDSCs) in the tumor microenvironment. Since Lm-based immunotherapy is able to inhibit the immune suppressive environment, we hypothesized that combining this treatment with agonist antibody to a co-stimulatory receptor that would further boost the effector arm of immunity will result in significant improvement of anti-tumor efficacy of treatment. Here we tested the immune and therapeutic efficacy of Listeria-based immunotherapy combination with agonist antibody to glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR) in TC-1 mouse tumor model. We evaluated the potency of combination on tumor growth and survival of treated animals and profiled tumor microenvironment for effector and suppressor cell populations. We demonstrate that combination of Listeria-based immunotherapy with agonist antibody to GITR synergizes to improve immune and therapeutic efficacy of treatment in a mouse tumor model. We show that this combinational treatment leads to significant inhibition of tumor-growth, prolongs survival and leads to complete regression of established tumors in 60% of treated animals. We determined that this therapeutic benefit of combinational treatment is due to a significant increase in tumor infiltrating effector CD4 + and CD8 + T cells along with a decrease of inhibitory cells. To our knowledge, this is the first study that exploits Lm-based immunotherapy combined with agonist anti-GITR antibody as a potent treatment strategy that simultaneously targets both the effector and suppressor arms of the immune system, leading to significantly improved anti-tumor efficacy. We believe that our findings depicted in this manuscript provide a promising and translatable strategy that can enhance the overall efficacy of cancer immunotherapy.

[Comparative study of two treatment methods for acute periodontal abscess].

PubMed

Jin, Dong-mei; Wang, Wei-qian

2012-10-01

The aim of this short-term study was to compare the clinical efficacy of 2 different methods to treat acute periodontal abscesses. After patient selection, 100 cases of acute periodontal abscess were randomly divided into two groups. The experimental group was treated by supra- and subgingival scaling, while the control group was treated by incision and drainage. A clinical examination was carried out to record the following variables: subjective clinical variables including pain, edema, redness and swelling; objective clinical variables including gingival index(GI), bleeding index(BI), probing depth(PD),suppuration, lymphadenopathy and tooth mobility. The data was analyzed with SPSS 19.0 software package. RESULES: Subjective clinical variables demonstrated statistically significant improvements with both methods from the first day after treatment and lasted for at least 30 days(P<0.05), but the results of experimental group showed much better than the control group 1 day and 7 days after treatment. 30 days after treatment, there was no significant difference between the two groups in pain and swelling improvement(P>0.05), but the experimental group showed more improvement in edema and redness than the control group(P<0.05).On improving objective variables, the experimental group showed significant improvement in GI,BI,PD and suppuration 1 day after treatment(P<0.05).After 7 days, all objective clinical variables in the experimental group improved significantly(P<0.05) in the control group, there were significant improvements in GI,suppuration,lymphadenopathy and tooth mobility(P<0.05) but the four variables of the experimental group showed more improvement than the control group(P<0.05).After 30 days, all objective clinical variables improved significantly in both groups as compared to baseline, but in the experimental group, improvements were more significant regarding to GI,BI,PD,suppuration and tooth mobility(P<0.05). The method of supra- and subgingival scaling was rapid and effective in treatment of acute periodontal abscesses.

Can video games be used to predict or improve laparoscopic skills?

PubMed

Rosenberg, Bradley H; Landsittel, Douglas; Averch, Timothy D

2005-04-01

Performance of laparoscopic surgery requires adequate hand-eye coordination. Video games are an effective way to judge one's hand-eye coordination, and practicing these games may improve one's skills. Our goal was to see if there is a correlation between skill in video games and skill in laparoscopy. Also, we hoped to demonstrate that practicing video games can improve one's laparoscopic skills. Eleven medical students (nine male, two female) volunteered to participate. On day 1, each student played three commercially available video games (Top Spin, XSN Sports; Project Gotham Racing 2, Bizarre Creations; and Amped 2, XSN Sports) for 30 minutes on an X-box (Microsoft, Seattle, WA) and was judged both objectively and subjectively. Next, the students performed four laparoscopic tasks (object transfer, tracing a figure-of-eight, suture placement, and knot-tying) in a swine model and were assessed for time to complete the task, number of errors committed, and hand-eye coordination. The students were then randomized to control (group A) or "training" (i.e., video game practicing; group B) arms. Two weeks later, all students repeated the laparoscopic skills laboratory and were reassessed. Spearman correlation coefficients demonstrated a significant relation between many of the parameters, particularly time to complete each task and hand-eye coordination at the different games. There was a weaker association between video game performance and both laparoscopic errors committed and hand-eye coordination. Group B subjects did not improve significantly over those in group A in any measure (P >0.05 for all). Video game aptitude appears to predict the level of laparoscopic skill in the novice surgeon. In this study, practicing video games did not improve one's laparoscopic skill significantly, but a larger study with more practice time could prove games to be helpful.

Dalfampridine Effects Beyond Walking Speed in Multiple Sclerosis

PubMed Central

Fjeldstad, Cecilie; Suárez, Gustavo; Klingler, Michael; Henney, Herbert R.; Rabinowicz, Adrian L.

2015-01-01

Background: Dalfampridine extended release (ER) improves walking in people with multiple sclerosis (MS), as demonstrated by walking speed improvement. This exploratory study evaluated treatment effects of dalfampridine-ER on gait, balance, and walking through treatment withdrawal and reinitiation. Methods: Dalfampridine-ER responders, based on Timed 25-Foot Walk (T25FW) assessment before study entry, were included in this open-label, three-period, single-center study. Period 1: on-drug evaluations performed at screening and 1 week after screening. Period 2: dalfampridine-ER withdrawal and off-drug evaluations (days 5 and 11). Period 3: dalfampridine-ER reinitiation/final on-drug evaluation (day 15). Primary outcome variables: NeuroCom composite scores for gait and balance; balance was evaluated if gait changes were significant. Secondary variables: individual NeuroCom scores, walking speed (T25FW) and distance (2-Minute Walk Test [2MWT]), and balance (Berg Balance Scale [BBS]). Results: All 20 patients completed the study: mean age, 53.1 years; mean MS duration, 11.3 years; mean time taking dalfampridine-ER, 315.3 days. NeuroCom gait composite scores worsened during period 2 relative to period 1 and improved during period 3; the mean ± SD difference in gait composite scores on drug was 4.03 ± 1.51 points (P = .015). Balance composite scores did not change significantly. Improvements were observed for off-drug versus on-drug for T25FW (0.36 ft/sec, P < .001), 2MWT (25.4 ft, P = .006), and BBS (1.7 points, P = .003). Safety profile was consistent with previous studies. Conclusions: Significant improvements in gait, walking speed, distance, and balance were demonstrated by dalfampridine-ER reinitiation after a 10-day withdrawal period. PMID:26664333

Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review.

PubMed

Secginli, Selda; Nahcivan, Nursen O; Gunes, Gussun; Fernandez, Ritin

2017-08-01

Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self-examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women. To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women. A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center. Twenty-three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One-to-one education demonstrated no significant difference in BSE rates at 6-month and 12-month follow-up. However, one-to-one education demonstrated significant differences in CBE and mammography rates at the 3-month follow-up. The use of group education comprising a multicomponent intervention demonstrated an increase in breast-screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a "dose response." © 2017 Sigma Theta Tau International.

Resveratrol Improves Myocardial Perfusion in a Swine Model of Hypercholesterolemia and Chronic Myocardial Ischemia

PubMed Central

Robich, Michael P.; Osipov, Robert M.; Nezafat, Reza; Feng, Jun; Clements, Richard T.; Bianchi, Cesario; Boodhwani, Munir; Coady, Michael A.; Laham, Roger J.; Sellke, Frank W.

2010-01-01

Introduction Resveratrol may provide protection against coronary artery disease. We hypothesized that supplemental resveratrol will improve cardiac perfusion in the ischemic territory of swine with hypercholesterolemia and chronic myocardial ischemia. Methods and Results Yorkshire swine were fed either a normal diet (control, n=7), a hypercholesterolemic diet (HCC, n=7), or a hypercholesterolemic diet with supplemental resveratrol (100 mg/kg/day orally, HCRV, n=7). Four weeks later, an ameroid constrictor was placed on the left circumflex artery. Animals underwent cardiac magnetic resonance imaging and coronary angiography 7 weeks later, prior to sacrifice and tissue harvest. Total cholesterol was lowered about 30% in HCRV animals (p<0.001). Regional wall motion analysis demonstrated a significant decrease in inferolateral function from baseline to 7 weeks in HCC swine (p=0.04). There was no significant change in regional function in HCRV swine from baseline to 7 weeks (p=0.32). Tissue blood flow during stress was 2.8 fold greater in HCRV swine when compared to HCC swine (p=0.04). Endothelial dependent microvascular relaxation response to Substance P was diminished in HCC swine which was rescued by resveratrol treatment (p=0.004). Capillary density (PECAM-1 staining) demonstrated fewer capillaries in both HCC and HCRV swine v. control swine (p=0.02). Immunoblot analysis demonstrated significantly greater expression in HCRV v. HCC swine of the following markers of angiogenesis: VEGF (p=0.002), peNOS(ser1177)(p=0.04), NFkB (p=0.004), and pAkt(thr308)(p=0.001). Conclusion Supplemental resveratrol attenuates regional wall motion abnormalities, improves myocardial perfusion in the collateral dependent region, preserves endothelial dependent coronary vessel function, and upregulates markers of angiogenesis associated with the VEGF signaling pathway. PMID:20837905

Inhaled nitric oxide improves short term memory and reduces the inflammatory reaction in a mouse model of mild traumatic brain injury.

PubMed

Liu, Ping; Li, Yong-Sheng; Quartermain, David; Boutajangout, Allal; Ji, Yong

2013-07-19

Although the mechanisms underlying mild traumatic brain injury (mTBI) are becoming well understood, treatment options are still limited. In the present study, mTBI was induced by a weight drop model to produce a closed head injury to mice and the effect of inhaled nitric oxide (INO) was evaluated by a short term memory task (object recognition task) and immunohistochemical staining of glial fibrillary acidic protein (GFAP) and CD45 for the detection of reactive astrocytes and microglia. Results showed that mTBI model did not produce brain edema, skull fracture or sensorimotor coordination dysfunctions. Mice did however exhibit a significant deficit in short term memory (STM) and strong inflammatory reaction in the ipsilateral cortex and hippocampus compared to sham-injured controls 24h after mTBI. Additional groups of untreated mice tested 3 and 7 days later, demonstrated that recognition memory had recovered to normal levels by Day 3. Mice treated with 10ppm INO for 4 or 8h, beginning immediately after TBI demonstrated significantly improved STM at 24h when compared with room air controls (p<0.05). Whereas mice treated with 10ppm INO for 24h showed no improvement in STM. Mice treated with INO 10ppm for 8h exhibited significantly reduced microglia and astrocyte activation compared with room air controls. These data demonstrate that mTBI produces a disruption of STM which is evident 24h after injury and persists for 2-3 days. Treatment with low concentration or short durations of INO prevents this memory loss and also attenuates the inflammatory response. These findings may have relevance for the treatment of patients diagnosed with concussion. Copyright © 2013 Elsevier B.V. All rights reserved.

Greater Proptosis Is Not Associated With Improved Compressive Optic Neuropathy in Thyroid Eye Disease.

PubMed

Nanda, Tavish; Dunbar, Kristen E; Campbell, Ashley A; Bathras, Ryan M; Kazim, Michael

2018-05-18

Despite the paucity of supporting data, it has generally been held that proptosis in thyroid eye disease (TED) may provide relative protection from compressive optic neuropathy (CON) by producing spontaneous decompression. The objective of this study was to investigate this phenomenon in patients with bilateral TED-CON. We retrospectively reviewed the charts of 67 patients (134 orbits) with bilateral TED-CON at Columbia-Presbyterian Medical Center. Significant asymmetric proptosis (Hertel) was defined as ≥ 2 mm. Significant asymmetric CON was defined first, as the presence of an relative afferent pupillary defect. Those without an relative afferent pupillary defect were evaluated according to the TED-CON formula y = -0.69 - 0.31 × (motility) - 0.2 × (mean deviation) - 0.02 × (color vision) as previously established for the diagnosis of TED-CON. A difference in the formula result ≥ 1.0 between eyes was considered significant. Patients were then divided into 4 groups. Forty-one of 67 patients demonstrated asymmetric CON (29 by relative afferent pupillary defect, 12 by formula). Twenty-one of 67 patients demonstrated asymmetric proptosis. Only 5 of 12 (41.6%) of the patients who had both asymmetric proptosis and asymmetric CON (group 1) showed greater proptosis in the eye with less CON. Twenty-nine patients (group 2) showed that asymmetric CON occurred despite symmetrical proptosis. Seventeen patients (group 3), showed the inverse, that asymmetric differences in proptosis occurred with symmetrical CON. Despite commonly held assumptions, our results suggest that greater proptosis is not associated with improved TED-CON. Combining groups 1 to 3-all of which demonstrated asymmetry of either proptosis, CON, or both-91.4% of patients did not show a relationship between greater proptosis and improved CON.

Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial.

PubMed

Braekken, Ingeborg H; Majida, Memona; Ellström Engh, Marie; Bø, Kari

2015-02-01

Pelvic floor muscle training (PFMT) has level 1 evidence of reducing the size and symptoms associated with pelvic organ prolapse (POP). There is scant knowledge, however, regarding whether PFMT has an effect on sexual function. The aim of the trial was to evaluate the effect of PFMT on sexual function in women with POP. In this randomized controlled trial, 50 women were randomized to an intervention group (6 months of PFMT and lifestyle advice) and 59 women were randomized to a control group (lifestyle advice only). Participants completed a validated POP-specific questionnaire to describe frequency and bother of prolapse, bladder, bowel, and sexual symptoms and answered a semi-structured interview. No significant change in number of women being sexually active was reported. There were no significant differences between groups regarding change in satisfaction with frequency of intercourse. Interview data revealed that 19 (39%) of women in the PFMT group experienced improved sexual function vs. two (5%) in the control group (P<0.01). Specific improvements reported by some of the women were increased control, strength and awareness of the pelvic floor, improved self-confidence, sensation of a "tighter" vagina, improved libido and orgasms, resolution of pain with intercourse, and heightened sexual gratification for partners. Women who described improved sexual function demonstrated the greatest increases in pelvic floor muscle (PFM) strength (mean 16 ± 10 cmH2 0) and endurance (mean 150 ± 140 cmH2 0s) (P<0.01). PFMT can improve sexual function in some women. Women reporting improvement in sexual function demonstrated the greatest increase in PFM strength and endurance. © 2014 International Society for Sexual Medicine.

Exercise training for intermittent claudication.

PubMed

McDermott, Mary M

2017-11-01

The objective of this study was to provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease (PAD). This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. Multiple randomized clinical trials demonstrate that supervised treadmill exercise significantly improves treadmill walking performance in people with PAD and intermittent claudication symptoms. A meta-analysis of 25 randomized trials demonstrated a 180-meter increase in treadmill walking distance in response to supervised exercise interventions compared with a nonexercising control group. Supervised treadmill exercise has been inaccessible to many patients with PAD because of lack of medical insurance coverage. However, in 2017, the Centers for Medicare and Medicaid Services issued a decision memorandum to support health insurance coverage of 12 weeks of supervised treadmill exercise for patients with walking impairment due to PAD. Recent evidence also supports home-based walking exercise to improve walking performance in people with PAD. Effective home-exercise programs incorporate behavioral change interventions such as a remote coach, goal setting, and self-monitoring. Supervised treadmill exercise programs preferentially improve treadmill walking performance, whereas home-based walking exercise programs preferentially improve corridor walking, such as the 6-minute walk test. Clinical trial evidence also supports arm or leg ergometry exercise to improve walking endurance in people with PAD. Treadmill walking exercise appears superior to resistance training alone for improving walking endurance. Supervised treadmill exercise significantly improves treadmill walking performance in people with PAD by approximately 180 meters compared with no exercise. Recent evidence suggests that home-based exercise is also effective and preferentially improves over-ground walking performance, such as the 6-minute walk test. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The Comparison of Thyroarytenoid Muscle Myectomy and Type II Thyroplasty for Spasmodic Dysphonia.

PubMed

Nomoto, Masaki; Tokashiki, Ryoji; Hiramatsu, Hiroyuki; Konomi, Ujimoto; Motohashi, Rei; Sakurai, Eriko; Toyomura, Fumimasa; Ueda, Yuri; Inoue, Shun; Tsukahara, Kiyoaki; Suzuki, Mamoru

2015-07-01

Surgical treatments for adductor spasmodic dysphonia include bilateral thyroarytenoid muscle myectomy (TAM) and type II thyroplasty (TPII), both of which are commonly performed. The present study aimed to compare the effects of TAM and TPII. Retrospective study. Subjects were 30 and 35 patients who underwent TAM and TPII, between March 2008 and November 2012. Voice quality was evaluated based on "voice handicap index 10 (VHI10)" and auditory impressions before and 6 months after surgery using five parameters: "strangulation," "interruption," "tremor," "grade," and "breathiness." Comparison of the two procedures revealed significant improvements in VHI10, strangulation, interruption, and tremor, and a significant decline in breathiness after surgery. In particular, VHI10 was improved by more than six points in 90% of patients with TAM, and 96% with TPII. No significant difference was observed between the severities of two procedures preoperatively. Comparison of each postoperative score between the two procedures revealed that TAM significantly improved strangulation, interruption, and tremor, and significantly worsened breathiness, with no significant difference in VHI10. Scatter plots (x: preoperative scores; y: postoperative scores) and regression lines of evaluation items demonstrated that TAM is more effective than TPII in severe cases. Compared with TPII, TAM tends to improve strangulation, interruption, and tremor; however, it tends to worsen breathiness postoperatively. Postoperative VHI10 scores did not differ significantly between the two procedures. Given favorable improvement rates, both surgical procedures were considered effective. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Nutraceuticals in the management of osteoarthritis : a critical review.

PubMed

Ragle, Ryan L; Sawitzke, Allen D

2012-09-01

Osteoarthritis (OA) is a chronic, highly prevalent and disabling disease that is expected to increase in prevalence secondary to longer life expectancy and a disproportionately aging population. Treatment of OA is only marginally effective and has been focused primarily on symptom control using weight loss, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, intra-articular steroids or viscosupplementation, topical NSAIDs and analgesics, diacerein (an oral interleukin-1β inhibitor) and finally joint replacement surgery. The use of nutraceuticals in the treatment of OA is common, and scientific studies examining the effects of nutraceuticals on the pathogenesis and treatment of OA are increasing. This review examines the efficacy and safety of select nutraceuticals for the treatment of OA. The reviewed nutraceuticals include glucosamine, chondroitin, collagen hydrolysates (CHs) and avocado-soybean unsaponifiables (ASUs). There have been several clinical trials examining the efficacy of these products and the results demonstrate significant heterogeneity. Significant improvements in pain, function and structural outcomes have been shown for some of the treatment arms or subgroups of patients, but the effects are not consistent across the studies. Glucosamine, chondroitin and the two in combination have been the most extensively studied. Significant improvement in pain and functional indices and a decrease in the loss of joint space width were demonstrated in some but not all studies. CHs showed significant improvement in pain and functional indices for several subgroups of patients, but these findings were not pervasive amongst the treatment arms. ASU has demonstrated positive results with respect to decreased NSAID use in several studies and functional and pain end points in most of the reviewed studies; however, in the two studies examining structural end points, the results were mixed. The safety of these nutraceuticals has been demonstrated across all of the reviewed trials, and there were no significant issues with tolerance. Given the good safety profile of nutraceuticals, the marginal efficacy of conventional treatments, the high prevalence and rate of disability from OA and the possible benefit of nutraceuticals to patients with OA, use of nutraceuticals in select patients is appropriate. An overall recommendation to use nutraceuticals in the treatment of all patients with OA is not strongly supported by the available data. Future studies should focus on standardization of symptomatic and structural outcome measures, be of longer duration and pay careful attention to the content of the investigational product.

Immunobiotic Lactobacillus jensenii as immune-health promoting factor to improve growth performance and productivity in post-weaning pigs.

PubMed

Suda, Yoshihito; Villena, Julio; Takahashi, Yu; Hosoya, Shoichi; Tomosada, Yohsuke; Tsukida, Kohichiro; Shimazu, Tomoyuki; Aso, Hisashi; Tohno, Masanori; Ishida, Mitsuharu; Makino, Seiya; Ikegami, Shuji; Kitazawa, Haruki

2014-06-19

Immunoregulatory probiotics (immunobiotics) have been proposed to improve piglets' immune system to avoid intestinal infections and reduce unproductive inflammation after weaning. Previously, it was demonstrated that Lactobacillus jensenii TL2937 (LjTL2937) attenuated the inflammatory response triggered by activation of Toll-like receptor 4 (TLR-4) in porcine intestinal epithelial (PIE) cells and antigen presenting cells (APCs) from porcine Peyer's patches (PP). In view of the critical importance of PIE-APCs interactions in the regulation of intestinal immune responses, we aimed to examine the effect of LjTL2937 on activation patterns of APCs from swine PPs in co-cultures with PIE cells. In addition, we investigated whether LjTL2937 was able to beneficially modulate intestinal immunity of piglets after weaning to improve immune-health status. Stimulation of PIE-APCs co-cultures with LjTL2937 increased the expression of MHC-II, CD80/86, IL-10, and Bcl-3 in CD172a+CD11R1- and CD172a+CD11R1high APCs. In addition, the TL2937 strain caused the upregulation of three negative regulators of TLR4 in PIE cells: MKP-1, Bcl-3 and A20. These changes significantly reduced the inflammatory response triggered by TLR4 activation in PIE-APCs co-cultures. The in vivo experiments using castrated male piglets (crossbreeding (LWD) with Landrace (L), Large Yorkshire (W) and Duroc (D))of 3 weeks of age demonstrated that feeding with LjTL2937 significantly reduced blood complement activity and C reactive protein concentrations while no changes were observed in blood leukocytes, ratio of granulocytes to lymphocyte numbers, macrophages' activity and antibody levels. In addition, treatment with LjTL2937 significantly improved growth performance and productivity, and increased carcass quality. We demonstrated that the use of immunobiotics strains like LjTL2937, as supplemental additives for piglets feedings, could be used as a strategy to maintain and improve intestinal homeostasis; that is important for the development of the pig and for health and performance throughout the productive life of the animal.

Immunobiotic Lactobacillus jensenii as immune-health promoting factor to improve growth performance and productivity in post-weaning pigs

PubMed Central

2014-01-01

Background Immunoregulatory probiotics (immunobiotics) have been proposed to improve piglets’ immune system to avoid intestinal infections and reduce unproductive inflammation after weaning. Previously, it was demonstrated that Lactobacillus jensenii TL2937 (LjTL2937) attenuated the inflammatory response triggered by activation of Toll-like receptor 4 (TLR-4) in porcine intestinal epithelial (PIE) cells and antigen presenting cells (APCs) from porcine Peyer’s patches (PP). Objective In view of the critical importance of PIE-APCs interactions in the regulation of intestinal immune responses, we aimed to examine the effect of LjTL2937 on activation patterns of APCs from swine PPs in co-cultures with PIE cells. In addition, we investigated whether LjTL2937 was able to beneficially modulate intestinal immunity of piglets after weaning to improve immune-health status. Results Stimulation of PIE-APCs co-cultures with LjTL2937 increased the expression of MHC-II, CD80/86, IL-10, and Bcl-3 in CD172a+CD11R1- and CD172a+CD11R1high APCs. In addition, the TL2937 strain caused the upregulation of three negative regulators of TLR4 in PIE cells: MKP-1, Bcl-3 and A20. These changes significantly reduced the inflammatory response triggered by TLR4 activation in PIE-APCs co-cultures. The in vivo experiments using castrated male piglets (crossbreeding (LWD) with Landrace (L), Large Yorkshire (W) and Duroc (D))of 3 weeks of age demonstrated that feeding with LjTL2937 significantly reduced blood complement activity and C reactive protein concentrations while no changes were observed in blood leukocytes, ratio of granulocytes to lymphocyte numbers, macrophages’ activity and antibody levels. In addition, treatment with LjTL2937 significantly improved growth performance and productivity, and increased carcass quality. Conclusions We demonstrated that the use of immunobiotics strains like LjTL2937, as supplemental additives for piglets feedings, could be used as a strategy to maintain and improve intestinal homeostasis; that is important for the development of the pig and for health and performance throughout the productive life of the animal. PMID:24943108

Description of Selected Algorithms and Implementation Details of a Concept-Demonstration Aircraft VOrtex Spacing System (AVOSS)

NASA Technical Reports Server (NTRS)

Hinton, David A.

2001-01-01

A ground-based system has been developed to demonstrate the feasibility of automating the process of collecting relevant weather data, predicting wake vortex behavior from a data base of aircraft, prescribing safe wake vortex spacing criteria, estimating system benefit, and comparing predicted and observed wake vortex behavior. This report describes many of the system algorithms, features, limitations, and lessons learned, as well as suggested system improvements. The system has demonstrated concept feasibility and the potential for airport benefit. Significant opportunities exist however for improved system robustness and optimization. A condensed version of the development lab book is provided along with samples of key input and output file types. This report is intended to document the technical development process and system architecture, and to augment archived internal documents that provide detailed descriptions of software and file formats.

Enhancement of CNT/PET film adhesion by nano-scale modification for flexible all-solid-state supercapacitors

NASA Astrophysics Data System (ADS)

Kang, Yu Jin; Chung, Haegeun; Kim, Min-Seop; Kim, Woong

2015-11-01

We demonstrate the fabrication of high-integrity flexible supercapacitors using carbon nanotubes (CNTs), polyethylene terephthalate (PET) films, and ion gels. Although both CNTs and PET films are attractive materials for flexible electronics, they have poor adhesion properties. In this work, we significantly improve interfacial adhesion by introducing nanostructures at the interface of the CNT and PET layers. Simple reactive ion etching (RIE) of the PET substrates generates nano-scale roughness on the PET surface. RIE also induces hydrophilicity on the PET surface, which further enhances adhesive strength. The improved adhesion enables high integrity and excellent flexibility of the fabricated supercapacitors, demonstrated over hundreds of bending cycles. Furthermore, the supercapacitors show good cyclability with specific capacitance retention of 87.5% after 10,000 galvanostatic charge-discharge (GCD) cycles. Our demonstration may be important for understanding interfacial adhesion properties in nanoscale and for producing flexible, high-integrity, high-performance energy storage systems.

Preparation and evaluation of solid dispersion of atorvastatin calcium with Soluplus® by spray drying technique.

PubMed

Ha, Eun-Sol; Baek, In-hwan; Cho, Wonkyung; Hwang, Sung-Joo; Kim, Min-Soo

2014-01-01

The aim of the present study was to investigate the effect of Soluplus® on the solubility of atorvastatin calcium and to develop a solid dispersion formulation that can improve the oral bioavailability of atorvastatin calcium. We demonstrated that Soluplus® increases the aqueous solubility of atorvastatin calcium. Several solid dispersion formulations of atorvastatin calcium with Soluplus® were prepared at various drug : carrier ratios by spray drying. Physicochemical analysis demonstrated that atorvastatin calcium is amorphous in each solid dispersion, and the 2 : 8 drug : carrier ratio provided the highest degree of sustained atorvastatin supersaturation. Pharmacokinetic analysis in rats revealed that the 2 : 8 dispersion significantly improved the oral bioavailability of atorvastatin. This study demonstrates that spray-dried Soluplus® solid dispersions can be an effective method for achieving higher atorvastatin plasma levels.

Status of nickel/zinc and nickel/iron battery technology for electric vehicle applications

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

Yao, N.P.; Christianson, C.C.; Elliott, R.C.

1980-01-01

Significant progress in nickel/zinc and nickel/iron technology has been made towards achieving the battery technical performance goals necessary for widespread use of these battery systems in electric vehicle applications. This progress is reviewed. Nickel/zinc module test data have shown a specific energy of nearly 70 Whr/kg and a specific power of 130 W/kg. However, cycle life improvements are still needed (presently demonstrated capability of 120 cycles) and are expected to be demonstrated during 1980. Nickel/iron modules have demonstrated a specific energy of nearly 50 Wh/kg and a specific power of 100 W/kg. Indications are that improved performance in these areasmore » can be shown during 1980. Nickel/iron modules cycle lives of 300 have been achieved during early 1980 and testing continues. Energy efficiency has been improved from less than 50% to over 65%. Cost reduction (both initial and operating) continues to receive major emphasis at developers of both nickel/zinc and nickel/iron batteries in order to achieve the lowest possible life cycle cost to the battery user.« less

Peer Education Versus Computer-Based Education: Improve Utilization of Library Databases Among Direct Care Nurses.

PubMed

Gonzalez, Roxana; O'Brien-Barry, Patricia; Ancheta, Reginaldo; Razal, Rennuel; Clyne, Mary Ellen

A quasiexperimental study was conducted to demonstrate which teaching modality, peer education or computer-based education, improves the utilization of the library electronic databases and thereby evidence-based knowledge at the point of care. No significant differences were found between the teaching modalities. However, the study identified the need to explore professional development teaching modalities outside the traditional classroom to support an evidence-based practice healthcare environment.

Engineering of Neuron Growth and Enhancing Cell-Chip Communication via Mixed SAMs.

PubMed

Markov, Aleksandr; Maybeck, Vanessa; Wolf, Nikolaus; Mayer, Dirk; Offenhäusser, Andreas; Wördenweber, Roger

2018-06-06

The interface between cells and inorganic surfaces represents one of the key elements for bioelectronics experiments and applications ranging from cell cultures and bioelectronics devices to medical implants. In the present paper, we describe a way to tailor the biocompatibility of substrates in terms of cell growth and to significantly improve cell-chip communication, and we also demonstrate the reusability of the substrates for cell experiments. All these improvements are achieved by coating the substrates or chips with a self-assembled monolayer (SAM) consisting of a mixture of organic molecules, (3-aminopropyl)-triethoxysilane and (3-glycidyloxypropyl)-trimethoxysilane. By varying the ratio of these molecules, we are able to tune the cell density and live/dead ratios of rat cortical neurons cultured directly on the mixed SAM as well as neurons cultured on protein-coated SAMs. Furthermore, the use of the SAM leads to a significant improvement in cell-chip communications. Action potential signals of up to 9.4 ± 0.6 mV (signal-to-noise ratio up to 47) are obtained for HL-1 cells on microelectrode arrays. Finally, we demonstrate that the SAMs facilitate a reusability of the samples for all cell experiments with little re-processing.

Enhanced antitumoral activity of doxorubicin against lung cancer cells using biodegradable poly(butylcyanoacrylate) nanoparticles

PubMed Central

Melguizo, Consolación; Cabeza, Laura; Prados, Jose; Ortiz, Raúl; Caba, Octavio; Rama, Ana R; Delgado, Ángel V; Arias, José L

2015-01-01

Doxorubicin (Dox) is widely used for the combined chemotherapy of solid tumors. However, the use of these drug associations in lung cancer has low antitumor efficacy. To improve its efficacious delivery and activity in lung adenocarcinoma cells, we developed a biodegradable and noncytotoxic nanoplatform based on biodegradable poly(butylcyanoacrylate) (PBCA). The reproducible formulation method was based on an anionic polymerization process of the PBCA monomer, with the antitumor drug being entrapped within the nanoparticle (NP) matrix during its formation. Improved drug-entrapment efficiencies and sustained (biphasic) drug-release properties were made possible by taking advantage of the synthesis conditions (drug, monomer, and surfactant-agent concentrations). Dox-loaded NPs significantly enhanced cellular uptake of the drug in the A549 and LL/2 lung cancer cell lines, leading to a significant improvement of the drug’s antitumoral activity. In vivo studies demonstrated that Dox-loaded NPs clearly reduced tumor volumes and increased mouse-survival rates compared to the free drug. These results demonstrated that PBCA NPs may be used to optimize the antitumor activity of Dox, thus exhibiting a potential application in chemotherapy against lung adenocarcinoma. PMID:26715840

Nutrient recycling of lipid-extracted waste in the production of an oleaginous thraustochytrid.

PubMed

Lowrey, Joshua; Brooks, Marianne S; Armenta, Roberto E

2016-05-01

Improving the economics of microalgae production for the recovery of microbial oil requires a comprehensive exploration of the measures needed to improve productivity as well as to reduce the overall processing costs. One avenue for cost reduction involves recycling the effluent waste water remaining after lipid extraction. This study investigates the feasibility of recycling those wastes for growing thraustochytrid biomass, a heterotrophic microalgae, where wastes were generated from the enzymatic extraction of the lipids from the cell biomass. It was demonstrated that secondary cultures of the tested thraustochytrid grown in the recycled wastes performed favorably in terms of cell and oil production (20.48 g cells L(-1) and 40.9 % (w/w) lipid) compared to the control (13.63 g cells L(-1) and 56.8 % (w/w) lipid). Further, the significant uptake of solubilized cell material (in the form of amino acids) demonstrated that the recycled waste has the potential for offsetting the need for fresh medium components. These results indicate that the implementation of a nutrient recycling strategy for industrial microalgae production could be possible, with significant added benefits such as conserving water resources, improving production efficiency, and decreasing material inputs.

Pharmacological attempts to improve the bioavailability of oral etoposide.

PubMed

Joel, S P; Clark, P I; Heap, L; Webster, L; Robbins, S; Craft, H; Slevin, M L

1995-01-01

Etoposide demonstrates incomplete and variable bioavailability after oral dosing, which may be due to its concentration and pH-dependent stability in artificial gastric and intestinal fluids. The use of agents that may influence etoposide stability and, thereby, bioavailability, was investigated in a number of clinical studies. Drugs that influence the rate of gastric emptying, while modulating the time of drug absorption, did not significantly alter the etoposide area under the concentration-time curve (AUC) or bioavailability. Specifically, metoclopramide had little effect on the etoposide absorption profile and did not significantly alter the AUC (AUC with etoposide alone, 68.4 +/- 20.3 micrograms ml-1 h, versus 74.3 +/- 25.9 micrograms ml-1 h with metoclopramide), suggesting that in most patients the drug is already emptied rapidly from the stomach. In contrast, propantheline produced a dramatic effect on etoposide absorption, delaying the time of maximal concentration tmax from 1.1 to 3.5 h (P < 0.01), but again without a significant improvement in drug AUC or bioavailability across the 24-h study period (AUC with etoposide alone 78.3 +/- 19.1 micrograms ml-1 h, versus 88.1 +/- 23.6 micrograms ml-1 h with propantheline). The effect of these drugs on the absorption of oral paracetamol, a drug included in the study as a marker of gastric emptying, was exactly the same as that found for etoposide, with no change in AUC being observed after metoclopramide or propantheline administration but a significant delay in tmax being seen on co-administration with etoposide and propantheline. The co-administration of ethanol or bile salts (agents that significantly improved the stability of etoposide in artificial intestinal fluid) with oral etoposide similarly had no effect on improving the etoposide AUC or reducing the variability in AUC, suggesting that drug stability in vivo was not affected by these agents. In the third study the co-administration of cimetidine had no effect on the pharmacokinetics of oral or i.v. etoposide, despite the previous observation that etoposide stability was markedly improved at pH 3-5 as compared with pH 1 in artificial gastric fluid. This series of studies, designed to investigate factors that improved etoposide stability in laboratory studies, failed to demonstrate any potentially useful improvement in AUC or bioavailability in the clinical setting.

The effects of Clinical Pilates exercises on patients with shoulder pain: A randomised clinical trial.

PubMed

Atılgan, Esra; Aytar, Aydan; Çağlar, Aslıcan; Tığlı, Ayça Aytar; Arın, Gamze; Yapalı, Gökmen; Kısacık, Pınar; Berberoğlu, Utku; Şener, Hülya Özlem; Ünal, Edibe

2017-10-01

The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of Brain-Computer Interface-controlled Functional Electrical Stimulation Training on Shoulder Subluxation for Patients with Stroke: A Randomized Controlled Trial.

PubMed

Jang, Yun Young; Kim, Tae Hoon; Lee, Byoung Hee

2016-06-01

The purpose of this study was to investigate the effects of brain-computer interface (BCI)-controlled functional electrical stimulation (FES) training on shoulder subluxation of patients with stroke. Twenty subjects were randomly divided into two groups: the BCI-FES group (n = 10) and the FES group (n = 10). Patients in the BCI-FES group were administered conventional therapy with the BCI-FES on the shoulder subluxation area of the paretic upper extremity, five times per week during 6 weeks, while the FES group received conventional therapy with FES only. All patients were assessed for shoulder subluxation (vertical distance, VD; horizontal distance, HD), pain (visual analogue scale, VAS) and the Manual Function Test (MFT) at the time of recruitment to the study and after 6 weeks of the intervention. The BCI-FES group demonstrated significant improvements in VD, HD, VAS and MFT after the intervention period, while the FES group demonstrated significant improvements in HD, VAS and MFT. There were also significant differences in the VD and two items (shoulder flexion and abduction) of the MFT between the two groups. The results of this study suggest that BCI-FES training may be effective in improving shoulder subluxation of patients with stroke by facilitating motor recovery. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Quality of life improvement in HIV-1 patients treated with raltegravir in a real-life observational study: RACING.

PubMed

Spire, Bruno; Nait-Ighil, Lella; Pugliese, Pascal; Poizot-Martin, Isabelle; Jullien, Vincent; Marcelin, Anne-Geneviève; Billaud, Eric

2017-01-01

Good efficacy and safety of raltegravir in person living with HIV was demonstrated in clinical trials over five years, but real-life data, particularly about quality of life (QoL), are lacking. QoL was evaluated over time in adult patients first treated or switched to regimens containing raltegravir in an observational cohort study. Patient QoL was evaluated using the Fatigue Impact Scale (FIS) and the HIV Symptom Index (HSI). Data were collected at baseline and at 1, 3, 6, 12, 18, and 24 months. Baseline FIS and HSI subscores were compared with the scores at each visit using the paired Wilcoxon test. The impact of time, sociodemographic and medical variables upon patient-perceived fatigue and symptoms was also assessed using mixed multivariate models. From baseline, all FIS and HSI subscores improved significantly after one month of treatment. In addition, psychosocial FIS subscores and both the frequency of bothersome symptoms and HSI subscores improved significantly at each visit. Physical FIS subscores also improved significantly, except at month 18, whereas both cognitive and total FIS subscores improved only after 6 months and 24 months, respectively. In multivariate analysis, employment was independently associated over time with improved improvement in both FIS and HSI subscores. Patient QoL improved significantly over a 24-month period of treatment with a raltegravir-containing regimen. FIS and HSI are sensitive tools to measure the impact of new antiretroviral combinations on a patient's perception of QoL.

Assessing Motor Skill Competency in Elementary School Students: A Three-Year Study.

PubMed

Chen, Weiyun; Mason, Steve; Hypnar, Andrew; Bennett, Austin

2016-03-01

This study was to examine how well fourth- and fifth-grade students demonstrated motor skill competency assessed with selected PE Metrics assessment rubrics (2009). Fourth- and fifth-grade students (n = 1,346-1,926) were assessed on their performance of three manipulative skills using the PE Metrics Assessment Rubrics during the pre-intervention year, the post-intervention year 1, and the post-intervention year 3. Descriptive statistics, independent t-test, ANOVA, and follow-up comparisons were conducted for data analysis. The results indicated that the post-intervention year 2 cohort performed significantly more competent than the pre-intervention cohort and the post-intervention year 1 cohort on the three manipulative skill assessments. The post-intervention year 1 cohort significantly outperformed the pre-intervention cohort on the soccer dribbling, passing, and receiving and the striking skill assessments, but not on the throwing skill assessment. Although the boys in the three cohorts performed significantly better than the girls on all three skills, the girls showed substantial improvement on the overhand throwing and the soccer skills from baseline to the post-intervention year 1 and the post-intervention year 2. However, the girls, in particular, need to improve striking skill. The CTACH PE was conducive to improving fourth- and fifth-grade students' motor skill competency in the three manipulative skills. This study suggest that PE Metrics assessment rubrics are feasible tools for PE teachers to assess levels of students' demonstration of motor skill competency during a regular PE lesson. Key pointsCATCH PE is an empirically-evidenced quality PE curricular that is conducive to improving students' manipulative skill competency.Boys significantly outperformed than girls in all three manipulative skills.Girls need to improve motor skill competency in striking skill. PE Metrics are feasible assessment rubrics that can be easily used by trained physical education teachers to assess students' manipulative skill competency.

Assessing Motor Skill Competency in Elementary School Students: A Three-Year Study

PubMed Central

Chen, Weiyun; Mason, Steve; Hypnar, Andrew; Bennett, Austin

2016-01-01

This study was to examine how well fourth- and fifth-grade students demonstrated motor skill competency assessed with selected PE Metrics assessment rubrics (2009). Fourth- and fifth-grade students (n = 1,346-1,926) were assessed on their performance of three manipulative skills using the PE Metrics Assessment Rubrics during the pre-intervention year, the post-intervention year 1, and the post-intervention year 3. Descriptive statistics, independent t-test, ANOVA, and follow-up comparisons were conducted for data analysis. The results indicated that the post-intervention year 2 cohort performed significantly more competent than the pre-intervention cohort and the post-intervention year 1 cohort on the three manipulative skill assessments. The post-intervention year 1 cohort significantly outperformed the pre-intervention cohort on the soccer dribbling, passing, and receiving and the striking skill assessments, but not on the throwing skill assessment. Although the boys in the three cohorts performed significantly better than the girls on all three skills, the girls showed substantial improvement on the overhand throwing and the soccer skills from baseline to the post-intervention year 1 and the post-intervention year 2. However, the girls, in particular, need to improve striking skill. The CTACH PE was conducive to improving fourth- and fifth-grade students’ motor skill competency in the three manipulative skills. This study suggest that PE Metrics assessment rubrics are feasible tools for PE teachers to assess levels of students’ demonstration of motor skill competency during a regular PE lesson. Key points CATCH PE is an empirically-evidenced quality PE curricular that is conducive to improving students’ manipulative skill competency. Boys significantly outperformed than girls in all three manipulative skills. Girls need to improve motor skill competency in striking skill. PE Metrics are feasible assessment rubrics that can be easily used by trained physical education teachers to assess students’ manipulative skill competency. PMID:26957932

Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder.

PubMed

Walker, Daniel J; Mason, Oren; Clemow, David B; Day, Kathleen A

2015-01-01

Attention-deficit/hyperactivity disorder (ADHD) is a CNS disorder that has its onset in childhood, but often persists into adulthood. There is growing recognition that adult ADHD can result in multiple negative consequences for individuals. ADHD is also often associated with a number of comorbid psychiatric disorders. Atomoxetine (ATX), a nonstimulant, selective noradrenergic reuptake inhibitor, was approved in the United States in 2002 for the treatment of ADHD in children and adolescents, as well as adults. We review here the safety and efficacy of ATX in adults with ADHD, including data in special populations, functional outcomes, as well as provider and patient real-world perceptions. We searched the databases Embase, MEDLINE and PsycINFO using the terms 'ADHD' and 'adult' and 'ATX' capturing publications from January 1, 1998, to March 27, 2014. Only publications in English were considered. ATX demonstrated significantly greater improvement than placebo (PBO) on the Conners Adult ADHD Rating Scale-Investigator rated:Screening Version (CAARS-Inv:SV) in all trials (N = 6; total score difference ranged from -3.5 to -5.5). For long-term trials using the CAARS-Inv:SV, ATX demonstrated significantly greater improvement than PBO in three of four trials (total score differences ranged from -0.1 to -6.0). In short-term studies, ATX showed significantly greater improvement than PBO on the Adult ADHD Quality-of-Life scale total score in three of three studies, but results were mixed on the Sheehan Disability Scale. Three studies of ATX have reported statistically significant improvement (compared with PBO) on the Behavior Rating Inventory of Executive Function-Adult Version Self Report scale. The most common adverse events (occurring in ≥ 10% of patients taking ATX) were nausea, dry mouth, decreased appetite, insomnia and fatigue. ATX is an important treatment option for the right patient. ATX can provide long-term, consistent symptom relief and functional improvement for adults with ADHD.

Development, evaluation, and demonstration of a tractor trailer intelligent communication and power link

DOT National Transportation Integrated Search

1998-01-01

Technology offers a significant potential to improve the productivity and safety of the motor carrier industry. To date, the application of new technology to commercial vehicles has been limited to single unit trucks and truck tractors because of con...

Lubricant Formulations to Enhance Engine Efficiency in Modern Internal Combustion Engines

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

Cheng, Wai; Wong, Victor; Plumley, Michael

2017-04-19

The research program presented aimed to investigate, develop, and demonstrate low-friction, environmentally-friendly and commercially-feasible lubricant formulations that would significantly improve the mechanical efficiency of modern engines without incurring increased wear, emissions or deterioration of the emission-aftertreatment system.

Academic Enhancement Site

ERIC Educational Resources Information Center

DeJong, Judith A.; Holder, Stanley R.

2006-01-01

This off-reservation boarding school serves over 600 students in grades 4-12; approximately 85% of the students reside in campus dormitories. After having documented significant improvement on a number of outcomes during a previous High Risk Youth Prevention demonstration grant, the site submitted a Therapeutic Residential Model proposal,…

Children's Perception, Production, and Description of Musical Expression.

ERIC Educational Resources Information Center

Rodriguez, Carlos Xavier

1998-01-01

Investigates whether children can demonstrate awareness of musical expression by discriminating between expressive and mechanical music fragments, performing similar songs, and describing the fragments and songs. Indicates task improvement with age, significant differences between kindergarten and fourth-grade scores in perception and description,…

FIELD DEMONSTRATION STUDIES OF SURFACTANT-ENHANCED SOLUBILIZATION AND MOBILIZATION AT HILL AIR FORCE BASE, UTAH

EPA Science Inventory

Surfactant-enhanced subsurface remediation can dramatically improve contaminant removal rates compared to the traditional pump-and-treat technology. Surfactants can be used to significantly enhance the solubilization of non-aqueous phase liquids (NAPL) constituents, or they can b...

Polyoxovanadate-alkoxide clusters as multi-electron charge carriers for symmetric non-aqueous redox flow batteries.

PubMed

VanGelder, L E; Kosswattaarachchi, A M; Forrestel, P L; Cook, T R; Matson, E M

2018-02-14

Non-aqueous redox flow batteries have emerged as promising systems for large-capacity, reversible energy storage, capable of meeting the variable demands of the electrical grid. Here, we investigate the potential for a series of Lindqvist polyoxovanadate-alkoxide (POV-alkoxide) clusters, [V 6 O 7 (OR) 12 ] (R = CH 3 , C 2 H 5 ), to serve as the electroactive species for a symmetric, non-aqueous redox flow battery. We demonstrate that the physical and electrochemical properties of these POV-alkoxides make them suitable for applications in redox flow batteries, as well as the ability for ligand modification at the bridging alkoxide moieties to yield significant improvements in cluster stability during charge-discharge cycling. Indeed, the metal-oxide core remains intact upon deep charge-discharge cycling, enabling extremely high coulombic efficiencies (∼97%) with minimal overpotential losses (∼0.3 V). Furthermore, the bulky POV-alkoxide demonstrates significant resistance to deleterious crossover, which will lead to improved lifetime and efficiency in a redox flow battery.

Implementation of a Thick-Film Composite Li-Ion Microcathode Using Carbon Nanotubes as the Conductive Filler

NASA Technical Reports Server (NTRS)

Lin, Qian; Harb, John N.

2004-01-01

This paper describes the development of a thick-film microcathode for use in Li-ion microbatteries in order to provide increased power and energy per area. These cathodes take advantage of a composite porous electrode structure, utilizing carbon nanotubes (CNT) as the conductive filler. The use of carbon nanotubes was found to significantly reduce the measured resistance of the electrodes, increase active material accessibility, and improve electrode performance. In particular, the cycling and power performance of the thick-film cathodes was significantly improved, and the need for compression was eliminated. Cathode thickness and CNT content were optimized to maximize capacity and power performance. Power capability of >50 mW/sq cm (17 mA/sq cm) with discharge capacity of >0.17 mAh/sq cm was demonstrated. The feasibility of fabricating thick-film microcathodes capable of providing the power and capacity needed for use in autonomous microsensor systems was also demonstrated.

Health management and controls for earth to orbit propulsion systems

NASA Technical Reports Server (NTRS)

Bickford, R. L.

1992-01-01

Fault detection and isolation for advanced rocket engine controllers are discussed focusing on advanced sensing systems and software which significantly improve component failure detection for engine safety and health management. Aerojet's Space Transportation Main Engine controller for the National Launch System is the state of the art in fault tolerant engine avionics. Health management systems provide high levels of automated fault coverage and significantly improve vehicle delivered reliability and lower preflight operations costs. Key technologies, including the sensor data validation algorithms and flight capable spectrometers, have been demonstrated in ground applications and are found to be suitable for bridging programs into flight applications.

Management of onychomycosis and co-existing tinea pedis.

PubMed

Lipner, Shari R; Scher, Richard K

2015-05-01

Onychomycosis is a common nail infection that often co-exists with tinea pedis. Surveys have suggested the diseases co-exist in at least one third of patients, although actual numbers may be a lot higher due to significant under-reporting. The importance of evaluating and treating both diseases is being increasingly recognized, however, data on improved outcomes, and the potential to minimize re-infection are limited. We review a recent post hoc analysis of two large studies treating mild to moderate onychomycosis with efinaconazole topical solution, 10%, demonstrating that complete cure rates of onychomycosis are significantly improved when any co-existing tinea pedis is also treated.

CH3NH3I post-treatment improves the performance of perovskite solar cells via eliminating the impure phases

NASA Astrophysics Data System (ADS)

Liang, Jingjing; Liang, Chunjun; Zhang, Huimin; Sun, Mengjie; Liu, Hong; Ji, Chao; Zhang, Xuewen; Li, Dan; He, Zhiqun

Organic-inorganic halide perovskites are currently generating extensive interest for applications in solar cells. The perovskite morphology and composition have significant roles in solar cells. Impure phases, which will influence the performance of solar cells, are inevitably present in the film of perovskite. We found that another MAI deposition on the previous perovskite could ameliorate the film. The post-deposited MAI participates in the reconstruction of the perovskite, leading to reduced amount of impure phase, increased grain size, increased absorption and significantly improved power conversion efficiency. The results demonstrate a treatment approach to fabricate efficient planar heterojunction perovskite solar cells.

Online pre-race education improves test scores for volunteers at a marathon.

PubMed

Maxwell, Shane; Renier, Colleen; Sikka, Robby; Widstrom, Luke; Paulson, William; Christensen, Trent; Olson, David; Nelson, Benjamin

2017-09-01

This study examined whether an online course would lead to increased knowledge about the medical issues volunteers encounter during a marathon. Health care professionals who volunteered to provide medical coverage for an annual marathon were eligible for the study. Demographic information about medical volunteers including profession, specialty, education level and number of marathons they had volunteered for was collected. A 15-question test about the most commonly encountered medical issues was created by the authors and administered before and after the volunteers took the online educational course and compared to a pilot study the previous year. Seventy-four subjects completed the pre-test. Those who participated in the pilot study last year (N = 15) had pre-test scores that were an average of 2.4 points higher than those who did not (mean ranks: pilot study = 51.6 vs. non-pilot = 33.9, p = 0.004). Of the 74 subjects who completed the pre-test, 54 also completed the post-test. The overall post-pre mean score difference was 3.8 ± 2.7 (t = 10.5 df = 53 p < 0.001). While subjects with all levels of volunteer experience demonstrated improvement, only change among first time marathon volunteers was significantly different from the others. Subjects reporting all degree/certification levels demonstrated improvement, but no difference in improvement was found between degree/certification levels. In this follow-up to the previous year's pilot study, online education demonstrated a long-term (one-year) increase in test scores. Testing also continued to show short-term improvement in post-course test scores, compared to pre-course test scores. In general, marathon medical volunteers who had no volunteer experience demonstrated greater improvement than those who had prior volunteer experience.

Phosphatidylserine containing omega-3 Fatty acids may improve memory abilities in nondemented elderly individuals with memory complaints: results from an open-label extension study.

PubMed

Vakhapova, Veronika; Cohen, Tzafra; Richter, Yael; Herzog, Yael; Kam, Yossi; Korczyn, Amos D

2014-01-01

The present study is an open-label extension (OLE) aimed at evaluating the effect of 100 mg/day of phosphatidylserine enriched with docosahexaenoic acid (PS-DHA) on cognitive performance in nondemented elderly individuals with memory complaints. From the participants who completed the core study, 122 continued with a 15-week OLE. Efficacy was assessed using a computerized tool and the Clinical Global Impression of Change (CGI-C) rating scale. A significant improvement in sustained attention and memory recognition was observed in the PS-DHA naïve group, while the PS-DHA continuers maintained their cognitive status. Additionally, a significant improvement in CGI-C was observed in the naïve group. The results demonstrate that consumption of 100 mg/day of PS-DHA might be associated with improving or maintaining cognitive status in elderly subjects with memory complaints.

Intensive Sensorimotor Arm Training Mediated by Therapist or Robot Improves Hemiparesis in Patients With Chronic Stroke

PubMed Central

Volpe, Bruce T.; Lynch, Daniel; Rykman-Berland, Avrielle; Ferraro, Mark; Galgano, Michael; Hogan, Neville; Krebs, Hermano I.

2016-01-01

Investigators have demonstrated that a variety of intensive movement training protocols for persistent upper limb paralysis in patients with chronic stroke (6 months or more after stroke) improve motor outcome. This randomized controlled study determined in patients with upper limb motor impairment after chronic stroke whether movement therapy delivered by a robot or by a therapist using an intensive training protocol was superior. Robotic training (n = 11) and an intensive movement protocol (n = 10) improved the impairment measures of motor outcome significantly and comparably; there were no significant changes in disability measures. Motor gains were maintained at the 3-month evaluation after training. These data contribute to the growing awareness that persistent impairments in those with chronic stroke may not reflect exhausted capacity for improvement. These new protocols, rendered by either therapist or robot, can be standardized, tested, and replicated, and potentially will contribute to rational activity-based programs. PMID:18184932

Teaching school teachers to recognize respiratory distress in asthmatic children.

PubMed

Sapien, Robert E; Fullerton-Gleason, L; Allen, N

2004-10-01

To demonstrate that school teachers can be taught to recognize respiratory distress in asthmatic children. Forty-five school teachers received a one-hour educational session on childhood asthma. Each education session consisted of two portions, video footage of asthmatic children exhibiting respiratory distress and didactic. Pre- and posttests on general asthma knowledge, signs of respiratory distress on video footage and comfort level with asthma knowledge and medications were administered. General asthma knowledge median scores increased significantly, pre = 60% correct, post = 70% (p < 0.0001). The ability to visually recognize respiratory distress also significantly improved (pre-median = 66.7% correct, post = 88.9% [p < 0.0001]). Teachers' comfort level with asthma knowledge and medications improved. Using video footage, school teachers can be taught to visually recognize respiratory distress in asthmatic children. Improvement in visual recognition of respiratory distress was greater than improvement in didactic asthma information.

Upgrades for the CMS simulation

DOE PAGES

Lange, D. J.; Hildreth, M.; Ivantchenko, V. N.; ...

2015-05-22

Over the past several years, the CMS experiment has made significant changes to its detector simulation application. The geometry has been generalized to include modifications being made to the CMS detector for 2015 operations, as well as model improvements to the simulation geometry of the current CMS detector and the implementation of a number of approved and possible future detector configurations. These include both completely new tracker and calorimetry systems. We have completed the transition to Geant4 version 10, we have made significant progress in reducing the CPU resources required to run our Geant4 simulation. These have been achieved throughmore » both technical improvements and through numerical techniques. Substantial speed improvements have been achieved without changing the physics validation benchmarks that the experiment uses to validate our simulation application for use in production. As a result, we will discuss the methods that we implemented and the corresponding demonstrated performance improvements deployed for our 2015 simulation application.« less

Improving depth resolutions in positron beam spectroscopy by concurrent ion-beam sputtering

NASA Astrophysics Data System (ADS)

John, Marco; Dalla, Ayham; Ibrahim, Alaa M.; Anwand, Wolfgang; Wagner, Andreas; Böttger, Roman; Krause-Rehberg, Reinhard

2018-05-01

The depth resolution of mono-energetic positron annihilation spectroscopy using a positron beam is shown to improve by concurrently removing the sample surface layer during positron beam spectroscopy. During ion-beam sputtering with argon ions, Doppler-broadening spectroscopy is performed with energies ranging from 3 keV to 5 keV allowing for high-resolution defect studies just below the sputtered surface. With this technique, significantly improved depth resolutions could be obtained even at larger depths when compared to standard positron beam experiments which suffer from extended positron implantation profiles at higher positron energies. Our results show that it is possible to investigate layered structures with a thickness of about 4 microns with significantly improved depth resolution. We demonstrated that a purposely generated ion-beam induced defect profile in a silicon sample could be resolved employing the new technique. A depth resolution of less than 100 nm could be reached.

Establishment and outcomes of a model primary care pharmacy service system.

PubMed

Carmichael, Jannet M; Alvarez, Autumn; Chaput, Ryan; DiMaggio, Jennifer; Magallon, Heather; Mambourg, Scott

2004-03-01

The establishment and outcomes of a model primary care pharmacy service system are described. A primary care pharmacy practice model was established at a government health care facility in March 1996. The original objective was to establish a primary pharmacy practice model that would demonstrate improved patient outcomes and maximize the pharmacist's contributions to drug therapy. Since its inception, many improvements have been realized and supported by advanced computer and automated systems, expanded disease state management practices, and unique practitioner and administrative support. Many outcomes studies have been performed on the pharmacist-initiated and -managed clinics, leading to improved patient care and conveying the quality-conscious and cost-effective role pharmacists can play as independent practitioners in this environment. These activities demonstrate cutting-edge leadership in health-system pharmacy. Redesign has been used to improve consistent access to a medication expert and has significantly improved the quality of patient care while easing physicians' workload without increasing health care costs. A system using pharmacists as independent practitioners to promote primary care has achieved high-quality and cost-effective patient care.

Balloon aortic valvuloplasty to improve candidacy of patients evaluated for transcatheter aortic valve replacement.

PubMed

Arsalan, Mani; Khan, Samir; Golman, Jake; Szerlip, Molly; Mahoney, Cecile; Herbert, Morley; Brown, David; Mack, Michael; Holper, Elizabeth M

2018-02-01

Evaluate the role of balloon aortic valvuloplasty (BAV) in improving candidacy of patients for transcatheter aortic valve replacement (TAVR). Patients who are not candidates for TAVR may undergo BAV to improve functional and clinical status. 117 inoperable or high-risk patients with critical aortic stenosis underwent BAV as a bridge-to-decision for TAVR. Frailty measures including gait speed, serum albumin, hand grip, activities of daily living (ADL); and NYHA functional class before and after BAV were compared. Mean age was 81.6 ± 8.5 years and the mean Society of Thoracic Surgeons predicted risk of mortality was 9.57 ± 5.51, with 19/117 (16.2%) patients non-ambulatory. There was no significant change in mean GS post-BAV, but all non-ambulatory patients completed GS testing at follow-up. Albumin and hand grip did not change after BAV, but there was a significant improvement in mean ADL score (4.85 ± 1.41 baseline to 5.20 ± 1.17, P = 0.021). The number of patients with Class IV congestive heart failure (CHF) was significantly lower post BAV (71/117 [60.7%] baseline versus 18/117 [15.4%], P = 0.008). 78/117 (66.7%) of patients were referred to definitive valve therapy after BAV. When evaluating frailty measures post BAV, we saw no significant improvement in mean GS, however, we observed a significant improvement in non-ambulatory patients and ADL scores. We also describe improved Class IV CHF symptoms. With this improved health status, the majority of patients underwent subsequent valve therapy, demonstrating that BAV may improve candidacy of patients for TAVR. © 2017, Wiley Periodicals, Inc.

Cognitive Training for Improving Executive Function in Chemotherapy-Treated Breast Cancer Survivors

PubMed Central

Kesler, Shelli; Hosseini, S. M. Hadi; Heckler, Charles; Janelsins, Michelle; Palesh, Oxana; Mustian, Karen; Morrow, Gary

2013-01-01

Difficulties with thinking and problem solving are very common among breast cancer survivors. We tested a computerized cognitive training program for 41 breast cancer survivors. The training program was associated with significant improvements in thinking and problem-solving skills. Our findings demonstrate potential for our online, home-based cognitive training program to improve cognitive difficulties among breast cancer survivors. Background A majority of breast cancer (BC) survivors, particularly those treated with chemotherapy, experience long-term cognitive deficits that significantly reduce quality of life. Among the cognitive domains most commonly affected include executive functions (EF), such as working memory, cognitive flexibility, multitasking, planning, and attention. Previous studies in other populations have shown that cognitive training, a behavioral method for treating cognitive deficits, can result in significant improvements in a number of cognitive skills, including EF. Materials and Methods In this study, we conducted a randomized controlled trial to investigate the feasibility and preliminary effectiveness of a novel, online EF training program in long-term BC survivors. A total of 41 BC survivors (21 active, 20 wait list) completed the 48 session training program over 12 weeks. The participants were, on average, 6 years after therapy. Results Cognitive training led to significant improvements in cognitive flexibility, verbal fluency and processing speed, with marginally significant downstream improvements in verbal memory as assessed via standardized measures. Self-ratings of EF skills, including planning, organizing, and task monitoring, also were improved in the active group compared with the wait list group. Conclusions Our findings suggest that EF skills may be improved even in long-term survivors by using a computerized, home-based intervention program. These improvements may potentially include subjective EF skills, which suggest a transfer of the training program to real-world behaviors. PMID:23647804

High-fidelity hybrid simulation of allergic emergencies demonstrates improved preparedness for office emergencies in pediatric allergy clinics.

PubMed

Kennedy, Joshua L; Jones, Stacie M; Porter, Nicholas; White, Marjorie L; Gephardt, Grace; Hill, Travis; Cantrell, Mary; Nick, Todd G; Melguizo, Maria; Smith, Chris; Boateng, Beatrice A; Perry, Tamara T; Scurlock, Amy M; Thompson, Tonya M

2013-01-01

Simulation models that used high-fidelity mannequins have shown promise in medical education, particularly for cases in which the event is uncommon. Allergy physicians encounter emergencies in their offices, and these can be the source of much trepidation. To determine if case-based simulations with high-fidelity mannequins are effective in teaching and retention of emergency management team skills. Allergy clinics were invited to Arkansas Children's Hospital Pediatric Understanding and Learning through Simulation Education center for a 1-day workshop to evaluate skills concerning the management of allergic emergencies. A Clinical Emergency Preparedness Team Performance Evaluation was developed to evaluate the competence of teams in several areas: leadership and/or role clarity, closed-loop communication, team support, situational awareness, and scenario-specific skills. Four cases, which focus on common allergic emergencies, were simulated by using high-fidelity mannequins and standardized patients. Teams were evaluated by multiple reviewers by using video recording and standardized scoring. Ten to 12 months after initial training, an unannounced in situ case was performed to determine retention of the skills training. Clinics showed significant improvements for role clarity, teamwork, situational awareness, and scenario-specific skills during the 1-day workshop (all P < .003). Follow-up in situ scenarios 10-12 months later demonstrated retention of skills training at both clinics (all P ≤ .004). Clinical Emergency Preparedness Team Performance Evaluation scores demonstrated improved team management skills with simulation training in office emergencies. Significant recall of team emergency management skills was demonstrated months after the initial training. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Polymer optical fiber compound parabolic concentrator tip for enhanced coupling efficiency for fluorescence based glucose sensors

PubMed Central

Hassan, Hafeez Ul; Nielsen, Kristian; Aasmul, Soren; Bang, Ole

2015-01-01

We demonstrate that the light excitation and capturing efficiency of fluorescence based fiber-optical sensors can be significantly increased by using a CPC (Compound Parabolic Concentrator) tip instead of the standard plane-cut tip. We use Zemax modelling to find the optimum CPC tip profile and fiber length of a polymer optical fiber diabetes sensor for continuous monitoring of glucose levels. We experimentally verify the improved performance of the CPC tipped sensor and the predicted production tolerances. Due to physical size requirements when the sensor has to be inserted into the body a non-optimal fiber length of 35 mm is chosen. For this length an average improvement in efficiency of a factor of 1.7 is experimentally demonstrated and critically compared to the predicted ideal factor of 3 in terms of parameters that should be improved through production optimization. PMID:26713213

Improvement of Sol-Gel Derived PbZrxTi1-xO3 Film Properties Using Thermal Press Treatment

NASA Astrophysics Data System (ADS)

Kaneda, Toshihiko; Kim, Joo-Nam; Tokumitsu, Eisuke; Shimoda, Tatsuya

2010-09-01

A thermal press treatment was introduced in the sol-gel process of PbZrxTi1-xO3 (PZT) thin films for the first time and the crystalline and electrical characteristics of the PZT films were investigated. The thermal press treatment was applied to the amorphous PZT gel film before crystallization annealing. It is found that the crystalline orientation and grain size of the PZT film fabricated with the thermal press treatment are different from those of the film fabricated by the conventional sol-gel process without the thermal press treatment, even though the crystallization conditions are exactly the same. It is demonstrated that the electrical properties, especially leakage current density and breakdown field, are significantly improved for the PZT film fabricated with the thermal press treatment. Furthermore, we also demonstrate that the fatigue property is improved by introducing the thermal press treatment.

Emergency Preparedness Education for Nurses: Core Competency Familiarity Measured Utilizing an Adapted Emergency Preparedness Information Questionnaire.

PubMed

Georgino, Madeline M; Kress, Terri; Alexander, Sheila; Beach, Michael

2015-01-01

The purpose of this project was to measure trauma nurse improvement in familiarity with emergency preparedness and disaster response core competencies as originally defined by the Emergency Preparedness Information Questionnaire after a focused educational program. An adapted version of the Emergency Preparedness Information Questionnaire was utilized to measure familiarity of nurses with core competencies pertinent to first responder capabilities. This project utilized a pre- and postsurvey descriptive design and integrated education sessions into the preexisting, mandatory "Trauma Nurse Course" at large, level I trauma center. A total of 63 nurses completed the intervention during May and September 2014 sessions. Overall, all 8 competencies demonstrated significant (P < .001; 98% confidence interval) improvements in familiarity. In conclusion, this pilot quality improvement project demonstrated a unique approach to educating nurses to be more ready and comfortable when treating victims of a disaster.

A case study detailing key considerations for implementing a telehealth approach to office ergonomics.

PubMed

Ritchie, Catherine L W; Miller, Linda L; Antle, David M

2017-01-01

Telehealth approaches to delivering ergonomics assessment hold great potential to improve service delivery in rural and remote settings. This case study describes a telehealth-based ergonomics service delivery process, and compares in-person and telehealth-based ergonomics approaches at an Alberta-based non-profit advocacy group. This project demonstrates that telehealth approaches to ergonomics do not lead to significantly different scoring outcomes for assessment of ergonomics issues, when compared to in-person assessments. This project also outlines the importance of live real-time video conferencing to improving communication, attaining key assessment information, and demonstrating ergonomic adjustments. However, some key considerations of bandwidth and hardware capabilities need to be taken into account. Key communication strategies are outlined to improve rapport, maintain employee confidentiality, and reduce client anxiety around telehealth ergonomics assessments. This project provides further support for telehealth approaches to office ergonomics, and outlines some key implementation strategies and barriers that should be considered.

Polymer optical fiber compound parabolic concentrator tip for enhanced coupling efficiency for fluorescence based glucose sensors.

PubMed

Hassan, Hafeez Ul; Nielsen, Kristian; Aasmul, Soren; Bang, Ole

2015-12-01

We demonstrate that the light excitation and capturing efficiency of fluorescence based fiber-optical sensors can be significantly increased by using a CPC (Compound Parabolic Concentrator) tip instead of the standard plane-cut tip. We use Zemax modelling to find the optimum CPC tip profile and fiber length of a polymer optical fiber diabetes sensor for continuous monitoring of glucose levels. We experimentally verify the improved performance of the CPC tipped sensor and the predicted production tolerances. Due to physical size requirements when the sensor has to be inserted into the body a non-optimal fiber length of 35 mm is chosen. For this length an average improvement in efficiency of a factor of 1.7 is experimentally demonstrated and critically compared to the predicted ideal factor of 3 in terms of parameters that should be improved through production optimization.

Visible-light-sensitive titanium dioxide nanoplatform for tumor-responsive Fe2+ liberating and artemisinin delivery

PubMed Central

Zhang, Huijuan; Zhang, Hongling; Zhu, Xing; Zhang, Xiaoge; Chen, Qianqian; Chen, Jianjiao; Hou, Lin; Zhang, Zhenzhong

2017-01-01

Artemisinin is a kind of Fe2+-dependent drugs. Artemisinin and Fe2+ co-transport systems can improve its anti-tumor effect. In this study, a visible light-sensitive nanoplatform (HA-TiO2-IONPs/ART) was developed. Detailed investigation demonstrated that HA-TiO2-IONPs/ART could realize Fe2+ and artemisinin synchronous co-delivery and tumor-responsive release. This feature enhanced the anti-tumor efficiency of artemisinin significantly. In vitro results proved that hyaluronic acid modification could improve the biocompatibility, dispersion stability and cytophagy ability of nanocarriers. Furthermore, this drug delivery system could generate reactive oxygen species under visual light irradiation. In vitro and in vivo experiments demonstrated that HA-TiO2-IONPs/ART combining with laser irradiation displayed the best anti-tumor efficacy. This study affords a promising idea to improve the curative efficiency of artemisinin analogs for cancer therapy. PMID:28938592

Culturally competent interventions for Hispanic adults with type 2 diabetes: a systematic review.

PubMed

Whittemore, Robin

2007-04-01

Culturally competent interventions have been developed to improve outcomes for Hispanic adults with type 2 diabetes. The purpose of this systematic review is to synthesize the research on culturally competent interventions for this vulnerable population. A systematic approach was used to locate empirical reports (n = 11). Interventions were multifaceted with the majority demonstrating significant improvements in clinical outcomes, behavioral outcomes, and diabetes-related knowledge. Culturally competent interventions have the potential to improve outcomes in Hispanic adults with type 2 diabetes. However, improvements were modest and attrition was moderate to high in many studies. Addressing linguistic and cultural barriers to care are important beginnings to improving health outcomes for Hispanic adults with type 2 diabetes.

Short Duration Base Heating Test Improvements

NASA Technical Reports Server (NTRS)

Bender, Robert L.; Dagostino, Mark G.; Engel, Bradley A.; Engel, Carl D.

1999-01-01

Significant improvements have been made to a short duration space launch vehicle base heating test technique. This technique was first developed during the 1960's to investigate launch vehicle plume induced convective environments. Recent improvements include the use of coiled nitrogen buffer gas lines upstream of the hydrogen / oxygen propellant charge tubes, fast acting solenoid valves, stand alone gas delivery and data acquisition systems, and an integrated model design code. Technique improvements were successfully demonstrated during a 2.25% scale X-33 base heating test conducted in the NASA/MSFC Nozzle Test Facility in early 1999. Cost savings of approximately an order of magnitude over previous tests were realized due in large part to these improvements.

Impact of online education on intern behaviour around joint commission national patient safety goals: a randomised trial.

PubMed

Shaw, Tim J; Pernar, Luise I; Peyre, Sarah E; Helfrick, John F; Vogelgesang, Kaitlin R; Graydon-Baker, Erin; Chretien, Yves; Brown, Elizabeth J; Nicholson, James C; Heit, Jeremy J; Co, John Patrick T; Gandhi, Tejal

2012-10-01

To compare the effectiveness of two types of online learning methodologies for improving the patient-safety behaviours mandated in the Joint Commission National Patient Safety Goals (NPSG). This randomised controlled trial was conducted in 2010 at Massachusetts General Hospital and Brigham and Women's Hospital (BWH) in Boston USA. Incoming interns were randomised to either receive an online Spaced Education (SE) programme consisting of cases and questions that reinforce over time, or a programme consisting of an online slide show followed by a quiz (SQ). The outcome measures included NPSG-knowledge improvement, NPSG-compliant behaviours in a simulation scenario, self-reported confidence in safety and quality, programme acceptability and programme relevance. Both online learning programmes improved knowledge retention. On four out of seven survey items measuring satisfaction and self-reported confidence, the proportion of SE interns responding positively was significantly higher (p<0.05) than the fraction of SQ interns. SE interns demonstrated a mean 4.79 (36.6%) NPSG-compliant behaviours (out of 13 total), while SQ interns completed a mean 4.17 (32.0%) (p=0.09). Among those in surgical fields, SE interns demonstrated a mean 5.67 (43.6%) NPSG-compliant behaviours, while SQ interns completed a mean 2.33 (17.9%) (p=0.015). Focus group data indicates that SE was more contextually relevant than SQ, and significantly more engaging. While both online methodologies improved knowledge surrounding the NPSG, SE was more contextually relevant to trainees and was engaging. SE impacted more significantly on both self-reported confidence and the behaviour of surgical residents in a simulated scenario.

Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study.

PubMed

Bressington, Daniel; Mui, Jolene; Hulbert, Sabina; Cheung, Eric; Bradford, Stephen; Gray, Richard

2014-02-27

People with severe mental illness have significantly poorer physical health compared to the general population; previous health screening studies conducted outside Asian countries have demonstrated the potential in addressing this issue. This case series aimed to explore the effects and utility of integrating an enhanced physical health screening programme for community dwelling patients with severe mental illness into routine clinical practice in Hong Kong. This study utilises a consecutive prospective case series design. The serious mental illness Health Improvement Profile (HIP) was used as a screening tool at baseline and repeated at 12 months follow-up. A total of 148 community-based patients with severe mental illness completed the study. At one year follow-up analysis showed a significant improvement in self-reported levels of exercise and a reduction in the numbers of patients prescribed medications for diabetes However, mean waist circumference increased at follow-up. In addition to the statistically significant results some general trends were observed, including: a lack of deterioration in most areas of cardiovascular risk; a reduction in medicines prescribed for physical health problems; and general improvements in health behaviours over the 12 month period. The findings demonstrate that using the HIP is feasible and acceptable in Hong Kong. The results of the enhanced physical health-screening programme are promising, but require further testing using a randomised controlled trial design in order to more confidently attribute the improvements in well-being and health behaviours to the HIP. ISRCTN12582470.

Patients with knee osteoarthritis demonstrate improved gait pattern and reduced pain following a non-invasive biomechanical therapy: a prospective multi-centre study on Singaporean population.

PubMed

Elbaz, Avi; Mor, Amit; Segal, Ganit; Aloni, Yoav; Teo, Yee Hong; Teo, Yee Sze; Das-De, Shamal; Yeo, Seng Jin

2014-01-02

Previous studies have shown the effect of a unique therapy with a non-invasive biomechanical foot-worn device (AposTherapy) on Caucasian western population suffering from knee osteoarthritis. The purpose of the current study was to evaluate the effect of this therapy on the level of symptoms and gait patterns in a multi-ethnic Singaporean population suffering from knee osteoarthritis. Fifty-eight patients with bilateral medial compartment knee osteoarthritis participated in the study. All patients underwent a computerized gait test and completed two self-assessment questionnaires (WOMAC and SF-36). The biomechanical device was calibrated to each patient, and therapy commenced. Changes in gait patterns and self-assessment questionnaires were reassessed after 3 and 6 months of therapy. A significant improvement was seen in all of the gait parameters following 6 months of therapy. Specifically, gait velocity increased by 15.9%, step length increased by 10.3%, stance phase decreased by 5.9% and single limb support phase increased by 2.7%. In addition, pain, stiffness and functional limitation significantly decreased by 68.3%, 66.7% and 75.6%, respectively. SF-36 physical score and mental score also increased significantly following 6 months of therapy (46.1% and 22.4%, respectively) (P < 0.05 for all parameters). Singaporean population with medial compartment knee osteoarthritis demonstrated improved gait patterns, reported alleviation in symptoms and improved function and quality of life following 6 months of therapy with a unique biomechanical device. Registration number NCT01562652.

Examination of the effect of changing to azilsartan from candesartan in renal transplant patients.

PubMed

Ishii, T; Yasuda, M; Saito, Y; Mori, Y; Hayashi, T; Uemura, H; Nose, K; Nishioka, T

2014-01-01

Azilsartan, an angiotensin receptor blocker (ARB), was administered to renal transplant recipients to investigate the safety and antihypertensive effect in addition to its ARB-characteristic organ-protective effect. The subjects were 20 patients (18 males, 2 females; baseline serum creatinine 2.39 ± 1.33 mg/dL) responding poorly to candesartan, who suffered albuminuria (>0.3 g/g creatinine) and hypertension (>140/90 mm Hg) following renal transplantation. Three months after candesartan was switched to azilsartan 20 mg/d, blood pressure, creatinine-corrected urinary albumin excretion, urinary L-type acid binding protein, urinary 8-hydroxydeoxyguano-sine, serum creatinine, and estimated glomerular filtration rate were evaluated. Thirteen patients received cyclosporine (65.0%) and 7 received tacrolimus (35.0%). Another hypertensive (calcium antagonist) agent was combined in 7 (35.0%). Systolic blood pressure significantly decreased from 139.5 mm Hg (baseline) from 128.7 mm Hg (at 3 months), whereas no significant changes were observed for diastolic blood pressure. The percentage of patients achieving the target level of antihypertensive effect (blood pressure < 130/80 mm Hg) significantly improved from 30.0% (baseline) to 70.0% (at 3 months). No significant changes were observed in renal graft function, oxidative stress marker level, or biochemical examination findings. Sufficient antihypertensive effect was demonstrated soon after switching to azilsartan. However, no significant change was found in renal damage markers. Long-term study must be conducted to confirm the protective effect azilsartan on the transplanted kidney, as found with candesartan. The safety of azilsartan was demonstrated. If the transplanted kidney protection is demonstrated, this drug is expected to contribute to the improved long-term prognosis of renal transplant recipients. Copyright © 2014 Elsevier Inc. All rights reserved.

Pilot Study Evaluating a Practice-Based Learning and Improvement Curriculum Focusing on the Development of System-Level Quality Improvement Skills

PubMed Central

Tomolo, Anne M; Lawrence, Renée H; Watts, Brook; Augustine, Sarah; Aron, David C; Singh, Mamta K

2011-01-01

Background We developed a practice-based learning and improvement (PBLI) curriculum to address important gaps in components of content and experiential learning activities through didactics and participation in systems-level quality improvement projects that focus on making changes in health care processes. Methods We evaluated the impact of our curriculum on resident PBLI knowledge, self-efficacy, and application skills. A quasi-experimental design assessed the impact of a curriculum (PBLI quality improvement systems compared with non-PBLI) on internal medicine residents' learning during a 4-week ambulatory block. We measured application skills, self-efficacy, and knowledge by using the Systems Quality Improvement Training and Assessment Tool. Exit evaluations assessed time invested and experiences related to the team projects and suggestions for improving the curriculum. Results The 2 groups showed differences in change scores. Relative to the comparison group, residents in the PBLI curriculum demonstrated a significant increase in the belief about their ability to implement a continuous quality improvement project (P  =  .020), comfort level in developing data collection plans (P  =  .010), and total knowledge scores (P < .001), after adjusting for prior PBLI experience. Participants in the PBLI curriculum also demonstrated significant improvement in providing a more complete aim statement for a proposed project after adjusting for prior PBLI experience (P  =  .001). Exit evaluations were completed by 96% of PBLI curriculum participants who reported high satisfaction with team performance. Conclusion Residents in our curriculum showed gains in areas fundamental for PBLI competency. The observed improvements were related to fundamental quality improvement knowledge, with limited gain in application skills. This suggests that while heading in the right direction, we need to conceptualize and structure PBLI training in a way that integrates it throughout the residency program and fosters the application of this knowledge and these skills. PMID:22379523

Pilot study evaluating a practice-based learning and improvement curriculum focusing on the development of system-level quality improvement skills.

PubMed

Tomolo, Anne M; Lawrence, Renée H; Watts, Brook; Augustine, Sarah; Aron, David C; Singh, Mamta K

2011-03-01

We developed a practice-based learning and improvement (PBLI) curriculum to address important gaps in components of content and experiential learning activities through didactics and participation in systems-level quality improvement projects that focus on making changes in health care processes. We evaluated the impact of our curriculum on resident PBLI knowledge, self-efficacy, and application skills. A quasi-experimental design assessed the impact of a curriculum (PBLI quality improvement systems compared with non-PBLI) on internal medicine residents' learning during a 4-week ambulatory block. We measured application skills, self-efficacy, and knowledge by using the Systems Quality Improvement Training and Assessment Tool. Exit evaluations assessed time invested and experiences related to the team projects and suggestions for improving the curriculum. The 2 groups showed differences in change scores. Relative to the comparison group, residents in the PBLI curriculum demonstrated a significant increase in the belief about their ability to implement a continuous quality improvement project (P  =  .020), comfort level in developing data collection plans (P  =  .010), and total knowledge scores (P < .001), after adjusting for prior PBLI experience. Participants in the PBLI curriculum also demonstrated significant improvement in providing a more complete aim statement for a proposed project after adjusting for prior PBLI experience (P  =  .001). Exit evaluations were completed by 96% of PBLI curriculum participants who reported high satisfaction with team performance. Residents in our curriculum showed gains in areas fundamental for PBLI competency. The observed improvements were related to fundamental quality improvement knowledge, with limited gain in application skills. This suggests that while heading in the right direction, we need to conceptualize and structure PBLI training in a way that integrates it throughout the residency program and fosters the application of this knowledge and these skills.

Cycling induced by electrical stimulation improves muscle activation and symmetry during pedaling in hemiparetic patients.

PubMed

Ambrosini, Emilia; Ferrante, Simona; Ferrigno, Giancarlo; Molteni, Franco; Pedrocchi, Alessandra

2012-05-01

A randomized controlled trial, involving 35 post-acute hemiparetic patients, demonstrated that a four-week treatment of cycling induced by functional electrical stimulation (FES-cycling) promotes motor recovery. Analyzing additional data acquired during that study, the present work investigated whether these improvements were associated to changes in muscle strength and motor coordination. Participants were randomized to receive FES-cycling or placebo FES-cycling. Clinical outcome measures were: the Motricity Index (MI), the gait speed, the electromyography activation of the rectus femoris and biceps femoris, and the mechanical work produced by each leg during voluntary pedaling. To provide a comparison with normal values, healthy adults also carried out the pedaling test. Patients were evaluated before, after training, and at follow-up visits. A significant treatment effect in favor of FES-treated patients was found in terms of MI scores and unbalance in mechanical works, while differences in gait speed were not significant (ANCOVA). Significant improvements in the activation of the paretic muscles were highlighted in the FES group, while no significant change was found in the placebo group (Friedman test). Our findings suggested that improvements in motor functions induced by FES-cycling training were associated with a more symmetrical involvement of the two legs and an improved motor coordination.

Effectiveness of the Pasos Adelante chronic disease prevention and control program in a US-Mexico border community, 2005-2008.

PubMed

Staten, Lisa K; Cutshaw, Christina A; Davidson, Christopher; Reinschmidt, Kerstin; Stewart, Rosie; Roe, Denise J

2012-01-01

Pasos Adelante is a lifestyle intervention program facilitated by community health workers (promotores) targeting chronic disease prevention and control in Mexican Americans. Initial studies of Pasos Adelante indicated significant improvements in self-reported nutrition and physical activity. This study examined whether Pasos Adelante participants living in a US border community showed improvements in selected physiological measures after participating in the program and whether changes were maintained at 3-month follow-up. The program took place in 12-week sessions from January 2005 to May 2008 and included walking groups and education targeting nutrition and physical activity. Questionnaires, anthropometric measures, and laboratory tests were conducted at baseline (n = 305), conclusion of program (n = 254), and 3-month follow-up (n = 221). Participants demonstrated decreases in body mass index (P = .04), waist and hip circumference (P < .001), diastolic and systolic blood pressure (P < .001), and total cholesterol (P = .008) from baseline to program conclusion. No values worsened significantly between program conclusion and follow-up, except systolic blood pressure. Glucose levels improved between conclusion and follow-up (P = .01). These results support the initial findings of improvements in participants' self-reported physical activity and nutrition patterns through changes in objective measures. This evidence-based program demonstrates the potential for a promotores-facilitated chronic disease prevention and control program to improve physical health and targets both primary and secondary prevention in Hispanic communities and organizations.

Advancing career counseling and employment support for survivors: an intervention evaluation.

PubMed

Davidson, M Meghan; Nitzel, Camie; Duke, Alysondra; Baker, Cynthia M; Bovaird, James A

2012-04-01

The purpose of this research was to conduct a replication-based and extension study examining the effectiveness of a 5-week career group counseling intervention, Advancing Career Counseling and Employment Support for Survivors (ACCESS; Chronister, 2008). The present study was conducted in a markedly different geographic region within a larger community as compared with the original investigation conducted by Chronister and McWhirter (2006). Women survivors of intimate partner violence (N = 73) participated in ACCESS, with career-search self-efficacy, perceived career barriers, perceived career supports, anxiety, and depression assessed at preintervention, postintervention, and 8-week follow-up. Women survivors demonstrated significant improvements in career-search self-efficacy and perceived career barriers at postintervention. Moreover, these same improvements were maintained at the 8-week follow-up assessment with the addition of significant improvements in perceived future financial supports, anxiety, and depression compared with preintervention scores. This work replicates the initial findings regarding the effectiveness of ACCESS with respect to career-search self-efficacy (Chronister & McWhirter, 2006) as well as extends the initial research to include improvements in perceived career barriers and perceived career supports. Moreover, the present study extends the work to include the mental health outcomes of anxiety and depression; results demonstrated improvements in these areas at 8-week follow-up. This investigation begins to fill a critical need for evaluated career-focused interventions for the underserved population of women survivors of intimate partner violence.

Grassland management regimens reduce small-scale heterogeneity and species diversity of beta-proteobacterial ammonia pxidizer populations.

PubMed

Webster, Gordon; Embley, T Martin; Prosser, James I

2002-01-01

The impact of soil management practices on ammonia oxidizer diversity and spatial heterogeneity was determined in improved (addition of N fertilizer), unimproved (no additions), and semi-improved (intermediate management) grassland pastures at the Sourhope Research Station in Scotland. Ammonia oxidizer diversity within each grassland soil was assessed by PCR amplification of microbial community DNA with both ammonia oxidizer-specific, 16S rRNA gene (rDNA) and functional, amoA, gene primers. PCR products were analysed by denaturing gradient gel electrophoresis, phylogenetic analysis of partial 16S rDNA and amoA sequences, and hybridization with ammonia oxidizer-specific oligonucleotide probes. Ammonia oxidizer populations in unimproved soils were more diverse than those in improved soils and were dominated by organisms representing Nitrosospira clusters 1 and 3 and Nitrosomonas cluster 7 (closely related phylogenetically to Nitrosomonas europaea). Improved soils were only dominated by Nitrosospira cluster 3 and Nitrosomonas cluster 7. These differences were also reflected in functional gene (amoA) diversity, with amoA gene sequences of both Nitrosomonas and Nitrosospira species detected. Replicate 0.5-g samples of unimproved soil demonstrated significant spatial heterogeneity in 16S rDNA-defined ammonia oxidizer clusters, which was reflected in heterogeneity in ammonium concentration and pH. Heterogeneity in soil characteristics and ammonia oxidizer diversity were lower in improved soils. The results therefore demonstrate significant effects of soil management on diversity and heterogeneity of ammonia oxidizer populations that are related to similar changes in relevant soil characteristics.

Is group singing special? Health, well-being and social bonds in community-based adult education classes

PubMed Central

Pearce, Eiluned; Launay, Jacques; Machin, Anna; Dunbar, Robin I.M.

2016-01-01

Evidence demonstrates that group singing improves health and well-being, but the precise mechanisms remain unknown. Given that cohesive social networks also positively influence health, we focus on the social aspects of singing, exploring whether improvements in health and well-being are mediated by stronger social bonds, both to the group as a whole (collective-bonding) and to individual classmates (relational-bonding). To do so, seven newly-formed community-based adult education classes (four singing, N=84, and three comparison classes studying creative writing or crafts, N=51) were followed over seven months. Self-report questionnaire data on mental and physical health, well-being, and social bonding were collected at Months 1, 3 and 7. We demonstrate that physical and mental health and satisfaction with life significantly improved over time in both conditions. Path analysis did not show any indirect effects via social bonding of Condition on health and well-being. However, higher collective-bonding at timepoint 3 significantly predicted increased flourishing, reduced anxiety and improved physical health independently of baseline levels. In contrast, relational-bonding showed no such effects, suggesting that it is feeling part of a group that particularly yields health and well-being benefits. Moreover, these results indicate that singing may not improve health and well-being more than other types of activities. Nonetheless, these findings encourage further work to refine our understanding of the social aspects of community-based adult education classes in promoting health, well-being and community cohesion. PMID:27867282

Is group singing special? Health, well-being and social bonds in community-based adult education classes.

PubMed

Pearce, Eiluned; Launay, Jacques; Machin, Anna; Dunbar, Robin I M

Evidence demonstrates that group singing improves health and well-being, but the precise mechanisms remain unknown. Given that cohesive social networks also positively influence health, we focus on the social aspects of singing, exploring whether improvements in health and well-being are mediated by stronger social bonds, both to the group as a whole (collective-bonding) and to individual classmates (relational-bonding). To do so, seven newly-formed community-based adult education classes (four singing, N =84, and three comparison classes studying creative writing or crafts, N =51) were followed over seven months. Self-report questionnaire data on mental and physical health, well-being, and social bonding were collected at Months 1, 3 and 7. We demonstrate that physical and mental health and satisfaction with life significantly improved over time in both conditions. Path analysis did not show any indirect effects via social bonding of Condition on health and well-being. However, higher collective-bonding at timepoint 3 significantly predicted increased flourishing, reduced anxiety and improved physical health independently of baseline levels. In contrast, relational-bonding showed no such effects, suggesting that it is feeling part of a group that particularly yields health and well-being benefits. Moreover, these results indicate that singing may not improve health and well-being more than other types of activities. Nonetheless, these findings encourage further work to refine our understanding of the social aspects of community-based adult education classes in promoting health, well-being and community cohesion.

Citicoline Treatment Improves Measures of Impulsivity and Task Performance in Chronic Marijuana Smokers: A Pilot BOLD fMRI Study

PubMed Central

Gruber, Staci A.; Sagar, Kelly A.; Dahlgren, Mary Kathryn; Gonenç, Atilla; Conn, Nina A.; Winer, Jeffrey P.; Penetar, David; Lukas, Scott E.

2015-01-01

Objective Citicoline is an endogenous nucleotide that has historically been used to treat stroke, traumatic brain injury, and cognitive dysfunction. Research has also shown that citicoline treatment is associated with improved cognitive performance in substance-abusing populations. We hypothesized that marijuana (MJ) smokers who received citicoline would demonstrate improvement in cognitive performance as well as increased neural efficiency during tasks of cognitive control relative to those who received placebo. Method The current study tested this hypothesis by examining the effects of citicoline in treatment-seeking chronic MJ smokers. In an 8-week double-blind, placebo-controlled study, 19 MJ smokers were randomly assigned via a double-blind procedure to the citicoline (8 Males, 2 Females) or placebo group (9 Males, 0 Females). All participants completed fMRI scanning at baseline and after 8 weeks of treatment during two cognitive measures of inhibitory processing, the Multi Source Interference Test (MSIT) and Stroop Color Word Test, and also completed the Barratt Impulsiveness Scale (BIS-11), a self-report measure of impulsivity. Results Following the 8 week trial, MJ smokers treated with citicoline demonstrated significantly lower levels of behavioral impulsivity, improved task accuracy on both the MSIT and Stroop tasks, and exhibited significantly different patterns of brain activation relative to baseline levels and relative to those who received placebo. Conclusions Findings suggest that citicoline may facilitate the treatment of MJ use disorders by improving the cognitive skills necessary to fully engage in comprehensive treatment programs. PMID:26658924

Teaching and assessing resident competence in practice-based learning and improvement.

PubMed

Ogrinc, Greg; Headrick, Linda A; Morrison, Laura J; Foster, Tina

2004-05-01

We designed, implemented, and evaluated a 4-week practice-based learning and improvement (PBLI) elective. Eleven internal medicine residents from 2 separate residency programs participated in the PBLI elective and 22 other residents comprised a comparison group. Residents in each group had similar pretest Quality Improvement Knowledge Application Tool scores; but after the PBLI elective, participant scores were significantly higher. Also, participants' self-assessed ratings of PBLI skills increased after the rotation and remained elevated 6 months afterward. In this curriculum, residents completed a project to improve patient care and demonstrated their knowledge on an evaluation tool in a way that was superior to nonparticipants.

Teaching and Assessing Resident Competence in Practice-based Learning and Improvement

PubMed Central

Ogrinc, Greg; Headrick, Linda A; Morrison, Laura J; Foster, Tina

2004-01-01

We designed, implemented, and evaluated a 4-week practice-based learning and improvement (PBLI) elective. Eleven internal medicine residents from 2 separate residency programs participated in the PBLI elective and 22 other residents comprised a comparison group. Residents in each group had similar pretest Quality Improvement Knowledge Application Tool scores; but after the PBLI elective, participant scores were significantly higher. Also, participants’ self-assessed ratings of PBLI skills increased after the rotation and remained elevated 6 months afterward. In this curriculum, residents completed a project to improve patient care and demonstrated their knowledge on an evaluation tool in a way that was superior to nonparticipants. PMID:15109311

Impact of Asynchronous Training on Radiology Learning Curve among Emergency Medicine Residents and Clerkship Students

PubMed Central

Pourmand, Ali; Woodward, Christina; Shokoohi, Hamid; King, Jordan B; Taheri, M Reza; King, Jackson; Lawrence, Christopher

2018-01-01

Context Web-based learning (WBL) modules are effectively used to improve medical education curriculum; however, they have not been evaluated to improve head computed tomography (CT) scan interpretation in an emergency medicine (EM) setting. Objective To evaluate the effectiveness of a WBL module to aid identification of cranial structures on CT and to improve ability to distinguish between normal and abnormal findings. Design Prospective, before-and-after trial in the Emergency Department of an academic center. Baseline head CT knowledge was assessed via a standardized test containing ten head CT scans, including normal scans and those showing hemorrhagic stroke, trauma, and infection (abscess). All trainees then participated in a WBL intervention. Three weeks later, they were given the same ten CT scans to evaluate in a standardized posttest. Main Outcome Measures Improvement in test scores. Results A total of 131 EM clerkship students and 32 EM residents were enrolled. Pretest scores correlated with stage of training, with students and first-year residents demonstrating the lowest scores. Overall, there was a significant improvement in percentage of correctly classified CT images after the training intervention from a mean pretest score of 32% ± 12% to posttest score of 67% ± 13% (mean improvement = 35% ± 13%, p < 0.001). Among subsets by training level, all subgroups except first-year residents demonstrated a statistically significant increase in scores after the training. Conclusion Incorporating asynchronous WBL modules into EM clerkship and residency curriculum provides early radiographic exposure in their clinical training and can enhance diagnostic head CT scan interpretation. PMID:29272248

Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions.

PubMed

Choudhary, Dnyanraj; Bhattacharyya, Sauvik; Bose, Sekhar

2017-11-02

Cognitive decline is often associated with the aging process. Ashwagandha (Withania somnifera (L.) Dunal) has long been used in the traditional Ayurvedic system of medicine to enhance memory and improve cognition. This pilot study was designed to evaluate the efficacy and safety of ashwagandha (Withania somnifera (L.) Dunal) in improving memory and cognitive functioning in adults with mild cognitive impairment (MCI). A prospective, randomized, double-blind, placebo-controlled study was conducted in 50 adults. Subjects were treated with either ashwagandha-root extract (300 mg twice daily) or placebo for eight weeks. After eight weeks of study, the ashwagandha treatment group demonstrated significant improvements compared with the placebo group in both immediate and general memory, as evidenced by Wechsler Memory Scale III subtest scores for logical memory I (p = 0.007), verbal paired associates I (p = 0.042), faces I (p = 0.020), family pictures I (p = 0.006), logical memory II (p = 0.006), verbal paired associates II (p = 0.031), faces II (p = 0.014), and family pictures II (p = 0.006). The treatment group also demonstrated significantly greater improvement in executive function, sustained attention, and information-processing speed as indicated by scores on the Eriksen Flanker task (p = 0.002), Wisconsin Card Sort test (p = 0.014), Trail-Making test part A (p = 0.006), and the Mackworth Clock test (p = 0.009). Ashwagandha may be effective in enhancing both immediate and general memory in people with MCI as well as improving executive function, attention, and information processing speed.

Engineering novel targeted nanoparticle formulations to increase the therapeutic efficacy of conventional chemotherapeutics against multiple myeloma

NASA Astrophysics Data System (ADS)

Ashley, Jonathan D.

Multiple myeloma (MM) is a hematological malignancy which results from the uncontrolled clonal expansion of plasma cells within the body. Despite recent medical advances, this disease remains largely incurable, with a median survival of ˜7 years, owing to the development of drug resistance. This dissertation will explore new advances in nanotechnology that will combine the cytotoxic effects of small molecule chemotherapeutics with the tumor targeting capabilities of nanoparticles to create novel nanoparticle formulations that exhibit enhanced therapeutic indices in the treatment of MM. First, doxorubicin was surfaced conjugated onto micellar nanoparticles via an acid labile hydrazone bond to increase the drug accumulation at the tumor. The cell surface receptor Very Late Antigen-4 (VLA-4; alpha4beta1) is expressed on cancers of hematopoietic origin and plays a vital role in the cell adhesion mediated drug resistance (CAM-DR) in MM. Therefore, VLA-4 antagonist peptides were conjugated onto the nanoparticles via a multifaceted procedure to actively target MM cells and simultaneously inhibit CAM-DR. The micellar doxorubicin nanoparticles were able to overcome CAM-DR and demonstrated improved therapeutic index relative to free doxorubicin. In addition to doxorubicin, other classes of therapeutic agents, such as proteasome inhibitors, can be incorporated in nanoparticles for improved therapeutic outcomes. Utilizing boronic acid chemistry, bortezomib prodrugs were synthesized using a reversible boronic ester bond and then incorporated into liposomes. The different boronic ester bonds that could be potentially used in the synthesis of bortezomib prodrugs were screened based on stability using isobutylboronic acid. The liposomal bortezomib nanoparticles demonstrated significant proteasome inhibition and cytotoxicity in MM cells in vitro, and dramatically reduced the non-specific toxicities associated with free bortezomib while maintaining significant tumor growth inhibition in vivo. Carfilzomib, another proteasome inhibitor, was embedded into the lipid bilayer of liposomes to improve its therapeutic efficacy. VLA-4 antagonist peptides were also incorporated to facilitate MM cell targeting and uptake. The liposomal carfilzomib nanoparticles demonstrated improved therapeutic index and synergy with doxorubicin compared to free carfilzomib. These nanoparticle formulations can significantly improve the efficacy of the respective therapeutic agents and have an immense potential to positively impact the treatment of MM providing for improved patient outcomes.

Association of β-defensin copy number and psoriasis in three cohorts of European origin

PubMed Central

Stuart, Philip E; Hüffmeier, Ulrike; Nair, Rajan P; Palla, Raquel; Tejasvi, Trilokraj; Schalkwijk, Joost; Elder, James T; Reis, Andre; Armour, John AL

2012-01-01

A single previous study has demonstrated significant association of psoriasis with copy number of beta-defensin genes, using DNA from psoriasis cases and controls from Nijmegen and Erlangen. In this study we attempted to replicate that finding in larger new cohorts from Erlangen (N = 2017) and Michigan (N = 5412), using improved methods for beta-defensin copy number determination based on the paralog ratio test (PRT), and enhanced methods of analysis and association testing implemented in the CNVtools resource. We demonstrate that the association with psoriasis found in the discovery sample is maintained after applying improved typing and analysis methods (p = 5.5 × 10−4, OR = 1.25). We also find that the association is replicated in 2616 cases and 2526 controls from Michigan, although at reduced significance (p = 0.014), but not in new samples from Erlangen (1396 cases and 621 controls, p = 0.38). Meta-analysis across all cohorts suggests a nominally significant association (p = 6.6 × 10−3/2 × 10−4) with an effect size (OR = 1.081) much lower than found in the discovery study (OR = 1.32). This reduced effect size and significance on replication is consistent with a genuine but weak association. PMID:22739795

Effects of brief mindful acceptance induction on implicit dysfunctional attitudes and concordance between implicit and explicit dysfunctional attitudes.

PubMed

Keng, Shian-Ling; Seah, Stanley T H; Tong, Eddie M W; Smoski, Moria

2016-08-01

Mindfulness-based interventions have been shown to be effective in alleviating depressive symptoms. While much work has examined the effects of mindfulness training on subjective symptoms and experiences, and less is known regarding whether mindfulness training may alter relatively uncontrollable cognitive processes associated with depressed mood, particularly implicit dysfunctional attitudes. The present study examined the effects of a brief mindful acceptance induction on implicit dysfunctional attitudes and degree of concordance between implicit and explicit dysfunctional attitudes in the context of sad mood. A total of 79 adult participants with elevated depressive symptoms underwent an autobiographical mood induction procedure before being randomly assigned to mindful acceptance or thought wandering inductions. Results showed that the effect of mindful acceptance on implicit dysfunctional attitude was significantly moderated by trait mindfulness. Participants high on trait mindfulness demonstrated significant improvements in implicit dysfunctional attitudes following the mindful acceptance induction. Those low on trait mindfulness demonstrated significantly worse implicit dysfunctional attitudes following the induction. Significantly greater levels of concordance between implicit and explicit dysfunctional attitudes were observed in the mindful acceptance condition versus the thought wandering condition. The findings highlight changes in implicit dysfunctional attitudes and improvements in self-concordance as two potential mechanisms underlying the effects of mindfulness-based interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Requirements for an Advanced Low Earth Orbit (LEO) Sounder (ALS) for Improved Regional Weather Prediction and Monitoring of Greenhouse Gases

NASA Technical Reports Server (NTRS)

Pagano, Thomas S.; Chahine, Moustafa T.; Susskind, Joel

2008-01-01

Hyperspectral infrared atmospheric sounders (e.g., the Atmospheric Infrared Sounder (AIRS) on Aqua and the Infrared Atmospheric Sounding Interferometer (IASI) on Met Op) provide highly accurate temperature and water vapor profiles in the lower to upper troposphere. These systems are vital operational components of our National Weather Prediction system and the AIRS has demonstrated over 6 hrs of forecast improvement on the 5 day operational forecast. Despite the success in the mid troposphere to lower stratosphere, a reduction in sensitivity and accuracy has been seen in these systems in the boundary layer over land. In this paper we demonstrate the potential improvement associated with higher spatial resolution (1 km vs currently 13.5 km) on the accuracy of boundary layer products with an added consequence of higher yield of cloud free scenes. This latter feature is related to the number of samples that can be assimilated and has also shown to have a significant impact on improving forecast accuracy. We also present a set of frequencies and resolutions that will improve vertical resolution of temperature and water vapor and trace gas species throughout the atmosphere. Development of an Advanced Low Earth Orbit (LEO) Sounder (ALS) with these improvements will improve weather forecast at the regional scale and of tropical storms and hurricanes. Improvements are also expected in the accuracy of the water vapor and cloud properties products, enhancing process studies and providing a better match to the resolution of future climate models. The improvements of technology required for the ALS are consistent with the current state of technology as demonstrated in NASA Instrument Incubator Program and NOAA's Hyperspectral Environmental Suite (HES) formulation phase development programs.

An improved Multimodel Approach for Global Sea Surface Temperature Forecasts

NASA Astrophysics Data System (ADS)

Khan, M. Z. K.; Mehrotra, R.; Sharma, A.

2014-12-01

The concept of ensemble combinations for formulating improved climate forecasts has gained popularity in recent years. However, many climate models share similar physics or modeling processes, which may lead to similar (or strongly correlated) forecasts. Recent approaches for combining forecasts that take into consideration differences in model accuracy over space and time have either ignored the similarity of forecast among the models or followed a pairwise dynamic combination approach. Here we present a basis for combining model predictions, illustrating the improvements that can be achieved if procedures for factoring in inter-model dependence are utilised. The utility of the approach is demonstrated by combining sea surface temperature (SST) forecasts from five climate models over a period of 1960-2005. The variable of interest, the monthly global sea surface temperature anomalies (SSTA) at a 50´50 latitude-longitude grid, is predicted three months in advance to demonstrate the utility of the proposed algorithm. Results indicate that the proposed approach offers consistent and significant improvements for majority of grid points compared to the case where the dependence among the models is ignored. Therefore, the proposed approach of combining multiple models by taking into account the existing interdependence, provides an attractive alternative to obtain improved climate forecast. In addition, an approach to combine seasonal forecasts from multiple climate models with varying periods of availability is also demonstrated.

Reexamining the iconic dihadron correlation measurement demonstrating jet quenching

NASA Astrophysics Data System (ADS)

Nattrass, Christine

2018-03-01

Early measurements at the BNL Relativistic Heavy Ion Collider (RHIC) demonstrated jet quenching through the suppression of pairs of high momentum hadrons. These dihadron correlations have a large correlated background. As understanding of the background improved, it was recognized in the field that a significant term was omitted from the background and several dihadron correlation results were quantitatively and qualitatively incorrect. The original measurements demonstrating jet quenching have not been revisited. These measurements are repeated in this paper in a kinematic range similar to the original measurement using publicly available data, applying current knowledge about the background. The new results are qualitatively consistent with the previous results, demonstrating complete suppression of the away side within uncertainties.

Wii-Fit for Improving Gait and Balance in an Assisted Living Facility: A Pilot Study

PubMed Central

Padala, Kalpana P.; Padala, Prasad R.; Malloy, Timothy R.; Geske, Jenenne A.; Dubbert, Patricia M.; Dennis, Richard A.; Garner, Kimberly K.; Bopp, Melinda M.; Burke, William J.; Sullivan, Dennis H.

2012-01-01

Objectives. To determine the effects on balance and gait of a Wii-Fit program compared to a walking program in subjects with mild Alzheimer's dementia (AD). Methods. A prospective randomized (1 : 1) pilot study with two intervention arms was conducted in an assisted living facility with twenty-two mild AD subjects. In both groups the intervention occurred under supervision for 30 minutes daily, five times a week for eight weeks. Repeated measures ANOVA and paired t-tests were used to analyze changes. Results. Both groups showed improvement in Berg Balance Scale (BBS), Tinetti Test (TT) and Timed Up and Go (TUG) over 8 weeks. However, there was no statistically significant difference between the groups over time. Intragroup analysis in the Wii-Fit group showed significant improvement on BBS (P = 0.003), and TT (P = 0.013). The walking group showed a trend towards improvement on BBS (P = 0.06) and TUG (P = 0.07) and significant improvement in TT (P = 0.06). Conclusion. This pilot study demonstrates the safety and efficacy of Wii-Fit in an assisted living facility in subjects with mild AD. Use of Wii-Fit resulted in significant improvements in balance and gait comparable to those in the robust monitored walking program. These results need to be confirmed in a larger, methodologically sound study. PMID:22745909

Advanced techniques for determining long term compatibility of materials with propellants

NASA Technical Reports Server (NTRS)

Green, R. L.

1972-01-01

The search for advanced measurement techniques for determining long term compatibility of materials with propellants was conducted in several parts. A comprehensive survey of the existing measurement and testing technology for determining material-propellant interactions was performed. Selections were made from those existing techniques which were determined could meet or be made to meet the requirements. Areas of refinement or changes were recommended for improvement of others. Investigations were also performed to determine the feasibility and advantages of developing and using new techniques to achieve significant improvements over existing ones. The most interesting demonstration was that of the new technique, the volatile metal chelate analysis. Rivaling the neutron activation analysis in terms of sensitivity and specificity, the volatile metal chelate technique was fully demonstrated.

Progress in the utilization of an oxide-dispersion-strengthened alloy for small engine turbine blades

NASA Technical Reports Server (NTRS)

Beatty, T. G.; Millan, P. P.

1984-01-01

The conventional means of improving gas turbine engine performance typically involves increasing the turbine inlet temperature; however, at these higher operational temperatures the high pressure turbine blades require air-cooling to maintain durability. Air-cooling imposes design, material, and economic constraints not only on the turbine blades but also on engine performance. The use of uncooled turbine blades at increased operating temperatures can offer significantly improved performance in small gas turbine engines. A program to demonstrate uncooled MA6000 high pressure turbine blades in a GTEC TFE731 turbofan engine is being conducted. The project goals include demonstration of the advantages of using uncooled MA6000 turbine blades as compared with cast directionally solidified MAR-M 247 blades.

Lasting effects of short-term training on preschoolers' street-crossing behavior.

PubMed

Albert, Rachel R; Dolgin, Kim G

2010-03-01

Can short-term training improve preschoolers' knowledge of road-crossing concepts as well as behavior in a real traffic situation? Forty children, aged four to five years, were assigned to one of four conditions (game, story, song, and control). Each condition participated in four 15-min classroom-based lessons over four weeks. Two assessments measuring knowledge of street-crossing concepts and one assessment measuring behavior on a real street were used to evaluate performance at baseline and one week and six months post-training. Children in all three experimental conditions showed a significant improvement over the control on the two conceptual assessments. Only children in the game condition significantly improved their behavior on the street-crossing assessment. Furthermore, children in all three experimental conditions retained the same levels of improvement at the six-month follow-up. These results demonstrate that one hour of training can create lasting improvements on preschool children's conceptual knowledge of traffic safety and road-crossing behavior on a real street. Copyright 2009 Elsevier Ltd. All rights reserved.

A surgical skills laboratory improves residents' knowledge and performance of episiotomy repair.

PubMed

Banks, Erika; Pardanani, Setul; King, Mary; Chudnoff, Scott; Damus, Karla; Freda, Margaret Comerford

2006-11-01

This study was undertaken to assess whether a surgical skills laboratory improves residents' knowledge and performance of episiotomy repair. Twenty-four first- and second-year residents were randomly assigned to either a surgical skills laboratory on episiotomy repair or traditional teaching alone. Pre- and posttests assessed basic knowledge. Blinded attending physicians assessed performance, evaluating residents on second-degree laceration/episiotomy repairs in the clinical setting with 3 validated tools: a task-specific checklist, global rating scale, and a pass-fail grade. Postgraduate year 1 (PGY-1) residents participating in the laboratory scored significantly better on all 3 surgical assessment tools: the checklist, the global score, and the pass/fail analysis. All the residents who had the teaching laboratory demonstrated significant improvements on knowledge and the skills checklist. PGY-2 residents did not benefit as much as PGY-1 residents. A surgical skills laboratory improved residents' knowledge and performance in the clinical setting. Improvement was greatest for PGY-1 residents.

The New Three Rs: Research, Reading, and Results. Breakthrough to Literacy[TM].

ERIC Educational Resources Information Center

McGraw-Hill Companies, New York, NY. Educational and Professional Publishing Group.

Research in school districts throughout the United States shows that children who use "Breakthrough to Literacy" achieve significant and lasting improvement in their reading skills. At virtually every site studied where implementation criteria were met, children who participated in "Breakthrough" demonstrated marked increases…

The effect of self-selected complementary therapies on cancer patients' quality of life and symptom distress: A prospective cohort study in an integrative oncology setting.

PubMed

Stomski, N J; Petterson, A; Kristjanson, L; Lobb, E A; Phillips, M; Williams, A; Morrison, P; Joske, D

2018-04-01

To examine the effectiveness of a multifaceted complementary therapies intervention, delivered in a systematic manner within an Australian public hospital setting, on quality of life and symptom distress outcomes for cancer patients. Adults receiving treatment for any form of cancer were eligible to participate in this study. Self-referred participants were offered a course of six complementary therapy sessions. Measures were administered at baseline, and at the third and sixth visit. The primary outcomes were quality of life and symptom distress. Linear mixed models were used to assess change in the primary outcomes. In total, 1376 cancer patients participated in this study. The linear mixed models demonstrated that there were significant improvements in quality of life and significant reductions in symptom distress over six sessions. Body-based therapies demonstrated significantly superior improvement in quality of life over counselling, but no other differences between therapies were identified. Reduced symptom distress was not significantly associated with any particular type of therapy. A self-selected complementary therapies intervention, provided in an Australian public hospital by accredited therapists, for cancer patients significantly mproved quality of life and reduced symptom distress. The effect of this intervention on quality of life has particular salience, since cancer impacts on many areas of people's lives and impairs quality of life. Copyright © 2018 Elsevier Ltd. All rights reserved.

Polysialylated N-Glycans Identified in Human Serum Through Combined Developments in Sample Preparation, Separations and Electrospray ionization-mass spectrometry

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

Kronewitter, Scott R.; Marginean, Ioan; Cox, Jonathan T.

The N-glycan diversity of human serum glycoproteins, i.e. the human blood serum N-glycome, is complex due to the range of glycan structures potentially synthesizable by human glycosylation enzymes. The reported glycome, however, is limited by methods of sample preparation, available analytical platforms, e.g., based upon electrospray ionization-mass spectrometry (ESI-MS), and software tools for data analysis. In this report, several improvements have been implemented in sample preparation and analysis to extend ESI-MS glycan characterization and to provide an improved view of glycan diversity. Sample preparation improvements include acidified, microwave-accelerated, PNGase F N-glycan release, and sodium borohydride reduction were optimized to improvemore » quantitative yields and conserve the number of glycoforms detected. Two-stage desalting (during solid phase extraction and on the analytical column) increased the sensitivity by reducing analyte signal division between multiple reducing-end-forms or cation adducts. On-line separations were improved by using extended length graphitized carbon columns and adding TFA as an acid modifier to a formic acid/reversed phase gradient which provides additional resolving power and significantly improved desorption of both large and heavily sialylated glycans. To improve MS sensitivity and provide gentler ionization conditions at the source-MS interface, subambient pressure ionization with nanoelectrospray (SPIN) has been utilized. When method improvements are combined together with the Glycomics Quintavariate Informed Quantification (GlyQ-IQ) recently described1 these technologies demonstrate the ability to significantly extend glycan detection sensitivity and provide expanded glycan coverage. We demonstrate application of these advances in the context of the human serum glycome, and for which our initial observations include detection of a new class of heavily sialylated N-glycans, including polysialylated N-glycans.« less

Assessing the Hydrologic Performance of the EPA's Nonpoint Source Water Quality Assessment Decision Support Tool Using North American Land Data Assimilation System (Products)

NASA Technical Reports Server (NTRS)

Lee, S.; Ni-Meister, W.; Toll, D.; Nigro, J.; Guiterrez-Magness, A.; Engman, T.

2010-01-01

The accuracy of streamflow predictions in the EPA's BASINS (Better Assessment Science Integrating Point and Nonpoint Sources) decision support tool is affected by the sparse meteorological data contained in BASINS. The North American Land Data Assimilation System (NLDAS) data with high spatial and temporal resolutions provide an alternative to the NOAA National Climatic Data Center (NCDC)'s station data. This study assessed the improvement of streamflow prediction of the Hydrological Simulation Program-FORTRAN (HSPF) model contained within BASINS using the NLDAS 118 degree hourly precipitation and evapotranspiration estimates in seven watersheds of the Chesapeake Bay region. Our results demonstrated consistent improvements of daily streamflow predictions in five of the seven watersheds when NLDAS precipitation and evapotranspiration data was incorporated into BASINS. The improvement of using the NLDAS data is significant when watershed's meteorological station is either far away or not in a similar climatic region. When the station is nearby, using the NLDAS data produces similar results. The correlation coefficients of the analyses using the NLDAS data were greater than 0.8, the Nash-Sutcliffe (NS) model fit efficiency greater than 0.6, and the error in the water balance was less than 5%. Our analyses also showed that the streamflow improvements were mainly contributed by the NLDAS's precipitation data and that the improvement from using NLDAS's evapotranspiration data was not significant; partially due to the constraints of current BASINS-HSPF settings. However, NLDAS's evapotranspiration data did improve the baseflow prediction. This study demonstrates the NLDAS data has the potential to improve stream flow predictions, thus aid the water quality assessment in the EPA nonpoint water quality assessment decision tool.

Low Data Drug Discovery with One-Shot Learning.

PubMed

Altae-Tran, Han; Ramsundar, Bharath; Pappu, Aneesh S; Pande, Vijay

2017-04-26

Recent advances in machine learning have made significant contributions to drug discovery. Deep neural networks in particular have been demonstrated to provide significant boosts in predictive power when inferring the properties and activities of small-molecule compounds (Ma, J. et al. J. Chem. Inf. 2015, 55, 263-274). However, the applicability of these techniques has been limited by the requirement for large amounts of training data. In this work, we demonstrate how one-shot learning can be used to significantly lower the amounts of data required to make meaningful predictions in drug discovery applications. We introduce a new architecture, the iterative refinement long short-term memory, that, when combined with graph convolutional neural networks, significantly improves learning of meaningful distance metrics over small-molecules. We open source all models introduced in this work as part of DeepChem, an open-source framework for deep-learning in drug discovery (Ramsundar, B. deepchem.io. https://github.com/deepchem/deepchem, 2016).

Enhanced direct-drive implosions with thin high-Z ablation layers.

PubMed

Mostovych, Andrew N; Colombant, Denis G; Karasik, Max; Knauer, James P; Schmitt, Andrew J; Weaver, James L

2008-02-22

New direct-drive spherical implosion experiments with deuterium filled plastic shells have demonstrated significant and absolute (2x) improvements in neutron yield when the shells are coated with a very thin layer ( approximately 200-400 A) of high-Z material such as palladium. This improvement is interpreted as resulting from increased stability of the imploding shell. These results provide for a possible path to control laser imprint and stability in laser-fusion-energy target designs.

Cognitive Training and Transcranial Direct Current Stimulation for Mild Cognitive Impairment in Parkinson's Disease: A Randomized Controlled Trial

PubMed Central

Gasson, Natalie; Johnson, Andrew R.; Booth, Leon; Loftus, Andrea M.

2018-01-01

This study examined whether standard cognitive training, tailored cognitive training, transcranial direct current stimulation (tDCS), standard cognitive training + tDCS, or tailored cognitive training + tDCS improved cognitive function and functional outcomes in participants with PD and mild cognitive impairment (PD-MCI). Forty-two participants with PD-MCI were randomized to one of six groups: (1) standard cognitive training, (2) tailored cognitive training, (3) tDCS, (4) standard cognitive training + tDCS, (5) tailored cognitive training + tDCS, or (6) a control group. Interventions lasted 4 weeks, with cognitive and functional outcomes measured at baseline, post-intervention, and follow-up. The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12614001039673). While controlling for moderator variables, Generalized Linear Mixed Models (GLMMs) showed that when compared to the control group, the intervention groups demonstrated variable statistically significant improvements across executive function, attention/working memory, memory, language, activities of daily living (ADL), and quality of life (QOL; Hedge's g range = 0.01 to 1.75). More outcomes improved for the groups that received standard or tailored cognitive training combined with tDCS. Participants with PD-MCI receiving cognitive training (standard or tailored) or tDCS demonstrated significant improvements on cognitive and functional outcomes, and combining these interventions provided greater therapeutic effects. PMID:29780572

Intranasal insulin treatment of an experimental model of moderate traumatic brain injury.

PubMed

Brabazon, Fiona; Wilson, Colin M; Jaiswal, Shalini; Reed, John; Frey, William H; Byrnes, Kimberly R

2017-09-01

Traumatic brain injury (TBI) results in learning and memory dysfunction. Cognitive deficits result from cellular and metabolic dysfunction after injury, including decreased cerebral glucose uptake and inflammation. This study assessed the ability of intranasal insulin to increase cerebral glucose uptake after injury, reduce lesion volume, improve memory and learning function and reduce inflammation. Adult male rats received a controlled cortical impact (CCI) injury followed by intranasal insulin or saline treatment daily for 14 days. PET imaging of [18F]-FDG uptake was performed at baseline and at 48 h and 10 days post-injury and MRI on days three and nine post injury. Motor function was tested with the beam walking test. Memory function was assessed with Morris water maze. Intranasal insulin after CCI significantly improved several outcomes compared to saline. Insulin-treated animals performed better on beam walk and demonstrated significantly improved memory. A significant increase in [18F]-FDG uptake was observed in the hippocampus. Intranasal insulin also resulted in a significant decrease in hippocampus lesion volume and significantly less microglial immunolabeling in the hippocampus. These data show that intranasal insulin improves memory, increases cerebral glucose uptake and decreases neuroinflammation and hippocampal lesion volume, and may therefore be a viable therapy for TBI.

Assessment of behavioral mechanisms maintaining encopresis: Virginia Encopresis-Constipation Apperception Test.

PubMed

Cox, Daniel J; Ritterband, Lee M; Quillian, Warren; Kovatchev, Boris; Morris, James; Sutphen, James; Borowitz, Stephen

2003-09-01

To develop and test a scale for parent and child, evaluating theoretical and clinical parameters relevant to children with encopresis. Encopretic children were hypothesized to have more bowel-specific, but not more generic, psychological problems, as compared with nonsymptomatic control children. In addition, mothers were also believed to be more discerning than children. The Virginia Encopresis-Constipation Apperception Test (VECAT) consists of 9 pairs of bowel-specific and 9 parallel generic drawings. Respondents selected the picture in each pair that best described them/their child. It was administered to encopretic children (N = 87), nonsymptomatic siblings (N = 27), and nonsymptomatic nonsiblings (N = 35). The mothers of all the participants also completed the VECAT. Encopretic children were retested 6 and 12 months posttreatment with Enhanced Toilet Training. The VECAT demonstrated good test-retest reliability and internal consistency. Encopretic children and their mothers reported more bowel-specific, but not more generic, problems. Bowel-specific scores improved significantly posttreatment only for those patients who demonstrated significant symptom improvement. Mothers were significantly more discerning than children. The VECAT is a reliable, valid, discriminating, and sensitive test. Bowel-specific problems appear to best differentiate children with and without encopresis.

Treatment of the alcoholic organic brain syndrome: double-blind, placebo-controlled clinical, psychometric and electroencephalographic mapping studies with modafinil.

PubMed

Saletu, B; Saletu, M; Grünberger, J; Frey, R; Anderer, P; Mader, R

1993-01-01

In a double-blind study 40 abstinent hospitalized male patients with an alcoholic organic brain syndrome (OBS; ICD 9: 291.2) were treated for 6 weeks with either placebo or 200 mg modafinil b.i.d. Modafinil (CRL 40476) is a vigilance-promoting, putative central alpha 1-adrenergic agonist with a pharmacological profile quite different from that of amphetamine. Clinical investigations demonstrated that the spontaneous remission of the alcoholic OBS was augmented and accelerated by modafinil, which was found significant as compared with placebo by confirmatory statistics in the target variable, the Clinical Global Impression scale. The drug was well tolerated. Psychometric tests revealed significant improvement of the noopsyche after modafinil as compared with placebo, while the thymopsyche and psychophysiological measurements were not affected. Electroencephalographic mapping showed significant differences between the central effects of modafinil and placebo indicating an improvement of vigilance under modafinil. Typical vigilance-promoting properties were seen after acute drug administration, were less evident before the morning dose after chronic treatment but re-occurred after super-imposed daily drug administration. Thus, our clinical, psychometric and neurophysiological investigations in alcoholic OBS patients demonstrated a therapeutic effect of modafinil in the early phase of abstinence.

Evaluation of tablet PC as a tool for teaching tooth brushing to children.

PubMed

Salama, F; Abobakr, I; Al-Khodair, N; Al-Wakeel, M

2016-12-01

This study evaluated the effect of a single time tooth brushing instruction using video on a tablet PC (Apple iPad) compared to operator presentation using jaw model for plaque removal. This cross-sectional study included a convenience sample of 100 children divided into two groups. For Group 1 brushing was demonstrated to the child by the operator with the use of a jaw model. This demonstration was videotaped for subsequent use in Group 2 using a tablet PC (Apple iPad). Plaque index was recorded before and after demonstration of the assigned method of teaching tooth brushing. The results showed a significant difference using the two methods. The difference between the mean plaque index values with the jaw model and tablet PC at baseline and after tooth brushing represented 17.27% (50% improvement) and 11.56% (34% improvement) respectively. Boys showed a 18.3%. higher improvement in tooth brushing compared to girls. Seventy-five percent of the children reported using tablet computers in their daily life. CONCLUSION Teaching children by using a jaw model was more effective in improving plaque index score than using video on tablet PC by 16%. Both methods of tooth brushing teaching were fully accepted by all children.

Improving management of type 2 diabetes in South Asian patients: a systematic review of intervention studies

PubMed Central

Bhurji, N; Javer, J; Gasevic, D; Khan, N A

2016-01-01

Objectives Optimal control of type 2 diabetes is challenging in many patient populations including in South Asian patients. We systematically reviewed studies on the effect of diabetes management interventions targeted at South Asian patients with type 2 diabetes on glycaemic control. Design Systematic review of MEDLINE, EMBASE and CINAHL databases for randomised controlled trials (RCTs) and pre-post-test studies (January 1990 to February 2014). Studies were stratified by where interventions were conducted (South Asia vs Western countries). Participants Patients originating from Pakistan, Bangladesh or India with type 2 diabetes. Primary outcome Change in glycated haemoglobin (HbA1c). Secondary end points included change in blood pressure, lipid levels, anthropomorphics and knowledge. Results 23 studies (15 RCTs) met criteria for analysis with 7 from Western countries (n=2532) and 16 from South Asia (n=1081). Interventions in Western countries included translated diabetes education, additional clinical care, written materials, visual aids, and bilingual community-based peers and/or health professionals. Interventions conducted in South Asia included yoga, meditation or exercise, community-based peers, health professionals and dietary education (cooking exercises). Among RCTs in India (5 trials; n=390), 4 demonstrated significant reductions in HbA1c in the intervention group compared with usual care (yoga and exercise interventions). Among the 4 RCTs conducted in Europe (n=2161), only 1 study, an education intervention of 113 patients, reported a significant reduction in HbA1c with the intervention. Lipids, blood pressure and knowledge improved in both groups with studies from India more often reporting reductions in body mass index and waist circumference. Conclusions Overall, there was little improvement in HbA1c level in diabetes management interventions targeted at South Asians living in Europe compared with usual care, although other outcomes did improve. The smaller studies in India demonstrated significant improvements in glycaemic and other end points. Novel strategies are needed to improve glycaemic control in South Asians living outside of India. PMID:27098819

Music-supported therapy (MST) in improving post-stroke patients' upper-limb motor function: a randomised controlled pilot study.

PubMed

Tong, Yanna; Forreider, Brian; Sun, Xinting; Geng, Xiaokun; Zhang, Weidong; Du, Huishan; Zhang, Tong; Ding, Yuchuan

2015-05-01

Music-supported therapy (MST) is a new approach for motor rehabilitation of stroke patients. Recently, many studies have demonstrated that MST improved the motor functions of post-stroke patients. However, the underlying mechanism for this effect is still unclear. It may result from repeated practice or repeated practice combined with musical stimulation. Currently, few studies have been designed to clarify this discrepancy. In this study, the application of "mute" musical instruments allowed for the study of music as an independent factor. Thirty-three post-stroke patients with no substantial previous musical training were included. Participants were assigned to either audible music group (MG) or mute music group (CG), permitting observation of music's independent effect. All subjects received the conventional rehabilitation treatments. Patients in MG (n = 15) received 20 extra sessions of audible musical instrument training over 4 weeks. Patients in CG (n = 18) received "mute" musical instrument training of the same protocol as that of MG. Wolf motor function test (WMFT) and Fugl-Meyer assessment (FMA) for upper limbs were utilised to evaluate motor functions of patients in both groups before and after the treatment. Three patients in CG dropped out. All participants in both groups showed significant improvements in motor functions of upper limbs after 4  weeks' treatment. However, significant differences in the WMFT were found between the two groups (WMFT-quality: P = 0.025; WMFT-time: P = 0.037), but not in the FMA (P = 0.448). In short, all participants showed significant improvement after 4 weeks' treatment, but subjects in MG demonstrated greater improvement than those in CG. This study supports that MST, when combined with conventional treatment, is effective for the recovery of motor skills in post-stroke patients. Additionally, it suggests that apart from the repetitive practices of MST, music may play a unique role in improving upper-limb motor function for post-stroke patients.

Directed educational training improves coding and billing skills for residents.

PubMed

Benke, James R; Lin, Sandra Y; Ishman, Stacey L

2013-03-01

To determine if coding and billing acumen improves after a single directed educational training session. Case-control series. Fourteen otolaryngology practitioners including trainees each completed two clinical scenarios before and after a directed educational session covering basic skills and common mistakes in otolaryngology billing and coding. Ten practitioners had never coded before; while, four regularly billed and coded in a clinical setting. Individuals with no previous billing experience had a mean score of 54% (median 55%) before the educational session which was significantly lower than that of the experienced billers who averaged 82% (median 83%, p=0.002). After the educational billing and coding session, the inexperienced billers mean score improved to 62% (median, 67%) which was still statistically lower than that of the experienced billers who averaged 76% (median 75%, p=0.039). The inexperienced billers demonstrated a significant improvement in their total score after the intervention (P=0.019); however, the change observed in experienced billers before and after the educational intervention was not significant (P=0.469). Billing and coding skill was improved after a single directed education session. Residents, who are not responsible for regular billing and coding, were found to have the greatest improvement in skill. However, providers who regularly bill and code had no significant improvement after this session. These data suggest that a single 90min billing and coding education session is effective in preparing those with limited experience to competently bill and code. Copyright © 2012. Published by Elsevier Ireland Ltd.

Evaluating an integrated approach to clinical quality improvement: clinical guidelines, quality measurement, and supportive system design.

PubMed

Cretin, S; Farley, D O; Dolter, K J; Nicholas, W

2001-08-01

Implementing clinical practice guidelines to change patient outcomes presents a challenge. Studies of single interventions focused on changing provider behavior demonstrate modest effects, suggesting that effective guideline implementation requires a multifaceted approach. Traditional biomedical research designs are not well suited to evaluating systems interventions. RAND and the Army Medical Department collaborated to develop and evaluate a system for implementing guidelines and documenting their effects on patient care. The evaluation design blended quality improvement, case study, and epidemiologic methods. A formative evaluation of implementation process and an outcome evaluation of patient impact were combined. Guidelines were implemented in 3 successive demonstrations targeting low back pain, asthma, and diabetes. This paper reports on the first wave of 4 facilities implementing a low back pain guideline. Organizational climate and culture, motivation, leadership commitment, and resources were assessed. Selected indicators of processes and outcomes of care were compared before, during, and after guideline implementation at the demonstration facilities and at comparison facilities. Logistic regression analysis was used to test for guideline effects on patient care. Process evaluation documented varied approaches to quality improvement across sites. Outcome evaluation revealed a significant downward trend in the percentage of acute low back pain patients referred to physical therapy or chiropractic care (10.7% to 7.2%) at demonstration sites and no such trend at control sites. Preliminary results suggest the power of this design to stimulate improvements in guideline implementation while retaining the power to evaluate rigorously effects on patient care.

A video-based lifestyle intervention and changes in coronary risk.

PubMed

Aldana, Steven G; Greenlaw, Roger L; Diehl, Hans A; Merrill, Ray M; Salberg, Audrey; Englert, Heike

2008-02-01

If population-wide improvements in nutrition and physical activity behavior are to be made, behavior change interventions must use a variety of media. This study examines whether participation in a facilitator-based video version of the Coronary Health Improvement Project could significantly reduce coronary risk. A total of 28 video classes conducted in worksite, medical and community settings were used to teach 763 middle-aged adults, ages 30-79 years, about healthy lifestyles. Four to 8 weeks after baseline, follow-up measures were taken. Demographic and biometric data [body weight, body mass index (BMI), blood lipids, blood pressure and fasting blood glucose] were gathered. The class participants were evaluated in aggregate and showed significant improvements in body weight, BMI, resting heart rate, total cholesterol, low-density lipoprotein, triglycerides and fasting blood glucose. Males demonstrated greater improvement than females, and individuals with higher baseline health risks experienced the greatest reductions in risk. This video lifestyle change program appears to help participants make important lifestyle changes. For individuals empowered to make better choices regarding diet and exercise, significant improvements occurred in most coronary risk factors in as little as 4-6 weeks.

Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease Due to Meibomian Gland Disease.

PubMed

Steven, Philipp; Augustin, Albert J; Geerling, Gerd; Kaercher, Thomas; Kretz, Florian; Kunert, Kathleen; Menzel-Severing, Johannes; Schrage, Norbert; Schrems, Wolfgang; Krösser, Sonja; Beckert, Michael; Messmer, Elisabeth M

2017-11-01

Meibomian gland disease is generally accepted as the leading cause for evaporative dry eye disease (DED). In a previous study, perfluorohexyloctane, a semifluorinated alkane, has been demonstrated to significantly increase tear film breakup time and to reduce corneal fluorescein staining in patients with evaporative DED, thereby vastly reducing dry eye-related symptoms. This study was set up to evaluate perfluorohexyloctane in a larger population of patients with Meibomian gland dysfunction. Seventy-two patients with Meibomian gland disease and associated dry eye received 1 drop of perfluorohexyloctane 4 times daily during an observational, prospective, multicenter, 6-8-week study. Clinical assessment included best-corrected visual acuity, intraocular pressure, Schirmer test I, tear film breakup time, anterior and posterior blepharitis assessment, number of expressible Meibomian glands, meibum quality and quantity, ocular surface fluorescein staining, lid margin and symptom assessment, and Ocular Surface Disease Index (OSDI © ). From the 72 patients recruited, 61 completed the trial per protocol. Nine patients did not apply the medication as recommended and 2 patients were lost to follow-up. Tear film breakup time, corneal and conjunctival fluorescein staining, number of expressible Meibomian glands, and severity of anterior and posterior blepharitis significantly improved after 6-8 weeks of perfluorohexyloctane application. In addition, symptoms improved as demonstrated by a significant decrease of OSDI-values from 37 (±13) to 26 (±16). In concordance with previous findings, 6-8 weeks of topical application of perfluorohexyloctane significantly improves clinical signs of Meibomian gland disease and associated mild to moderate DED.

Acoustic Analysis and Electroglottography in Elite Vocal Performers.

PubMed

Villafuerte-Gonzalez, Rocio; Valadez-Jimenez, Victor M; Sierra-Ramirez, Jose A; Ysunza, Pablo Antonio; Chavarria-Villafuerte, Karen; Hernandez-Lopez, Xochiquetzal

2017-05-01

Acoustic analysis of voice (AAV) and electroglottography (EGG) have been used for assessing vocal quality in patients with voice disorders. The effectiveness of these procedures for detecting mild disturbances in vocal quality in elite vocal performers has been controversial. To compare acoustic parameters obtained by AAV and EGG before and after vocal training to determine the effectiveness of these procedures for detecting vocal improvements in elite vocal performers. Thirty-three elite vocal performers were studied. The study group included 14 males and 19 females, ages 18-40 years, without a history of voice disorders. Acoustic parameters were obtained through AAV and EGG before and after vocal training using the Linklater method. Nonsignificant differences (P > 0.05) were found between values of fundamental frequency (F 0 ), shimmer, and jitter obtained by both procedures before vocal training. Mean F 0 was similar after vocal training. Jitter percentage as measured by AAV showed nonsignificant differences (P > 0.05) before and after vocal training. Shimmer percentage as measured by AAV demonstrated a significant reduction (P < 0.05) after vocal training. As measured by EGG after vocal training, shimmer and jitter were significantly reduced (P < 0.05); open quotient was significantly increased (P < 0.05); and irregularity was significantly reduced (P < 0.05). AAV and EGG were effective for detecting improvements in vocal function after vocal training in male and female elite vocal performers undergoing vocal training. EGG demonstrated better efficacy for detecting improvements and provided additional parameters as compared to AAV. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Demonstration of Three Corrosion-Resistant Sustainable Roofing Systems

DTIC Science & Technology

2013-06-01

will significantly im- prove upon the performance of the original roofing systems . Improvement of energy efficiency, drainage , and other attributes...Sustainable Roofing Systems Final Report on Project F08-AR02 Co ns tr uc tio n En gi ne er in g R es ea rc h La bo ra to ry David M. Bailey...CERL TR-13-7 June 2013 Demonstration of Three Corrosion-Resistant Sustainable Roofing Systems Final Report on Project F08-AR02 David M. Bailey

Thermally tunable silicon racetrack resonators with ultralow tuning power.

PubMed

Dong, Po; Qian, Wei; Liang, Hong; Shafiiha, Roshanak; Feng, Dazeng; Li, Guoliang; Cunningham, John E; Krishnamoorthy, Ashok V; Asghari, Mehdi

2010-09-13

We present thermally tunable silicon racetrack resonators with an ultralow tuning power of 2.4 mW per free spectral range. The use of free-standing silicon racetrack resonators with undercut structures significantly enhances the tuning efficiency, with one order of magnitude improvement of that for previously demonstrated thermo-optic devices without undercuts. The 10%-90% switching time is demonstrated to be ~170 µs. Such low-power tunable micro-resonators are particularly useful as multiplexing devices and wavelength-tunable silicon microcavity modulators.

A Multi-scale, Multi-Model, Machine-Learning Solar Forecasting Technology

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

Hamann, Hendrik F.

The goal of the project was the development and demonstration of a significantly improved solar forecasting technology (short: Watt-sun), which leverages new big data processing technologies and machine-learnt blending between different models and forecast systems. The technology aimed demonstrating major advances in accuracy as measured by existing and new metrics which themselves were developed as part of this project. Finally, the team worked with Independent System Operators (ISOs) and utilities to integrate the forecasts into their operations.

Lactobacillus rhamnosus GG treatment improves intestinal permeability and modulates inflammatory response and homeostasis of spleen and colon in experimental model of Pseudomonas aeruginosa pneumonia.

PubMed

Khailova, Ludmila; Baird, Christine H; Rush, Aubri A; Barnes, Christopher; Wischmeyer, Paul E

2017-12-01

Recent clinical trials and in vivo models demonstrate probiotic administration can reduce occurrence and improve outcome of pneumonia and sepsis, both major clinical challenges worldwide. Potential probiotic benefits include maintenance of gut epithelial barrier homeostasis and prevention of downstream organ dysfunction due to systemic inflammation. However, mechanism(s) of probiotic-mediated protection against pneumonia remain poorly understood. This study evaluated potential mechanistic targets in the maintenance of gut barrier homeostasis following Lactobacillus rhamnosus GG (LGG) treatment in a mouse model of pneumonia. Studies were performed in 6-8 week old FVB/N mice treated (o.g.) with or without LGG (10 9  CFU/ml) and intratracheally injected with Pseudomonas aeruginosa or saline. At 4, 12, and 24 h post-bacterial treatment spleen and colonic tissue were collected for analysis. Pneumonia significantly increased intestinal permeability and gut claudin-2. LGG significantly attenuated increased gut permeability and claudin-2 following pneumonia back to sham control levels. As mucin expression is key to gut barrier homeostasis we demonstrate that LGG can enhance goblet cell expression and mucin barrier formation versus control pneumonia animals. Further as Muc2 is a key gut mucin, we show LGG corrected deficient Muc2 expression post-pneumonia. Apoptosis increased in both colon and spleen post-pneumonia, and this increase was significantly attenuated by LGG. Concomitantly, LGG corrected pneumonia-mediated loss of cell proliferation in colon and significantly enhanced cell proliferation in spleen. Finally, LGG significantly reduced pro-inflammatory cytokine gene expression in colon and spleen post-pneumonia. These data demonstrate LGG can maintain intestinal barrier homeostasis by enhancing gut mucin expression/barrier formation, reducing apoptosis, and improving cell proliferation. This was accompanied by reduced pro-inflammatory cytokine expression in the gut and in a downstream organ (spleen). These may serve as potential mechanistic targets to explain LGG's protection against pneumonia in the clinical and in vivo setting. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Evaluation of an audiological rehabilitation program for spouses of people with hearing loss.

PubMed

Preminger, Jill E; Meeks, Suzanne

2010-05-01

Since the psychosocial effects of hearing loss are different in the spouse (SP) than in the person with hearing loss (PHL), it seems reasonable that rehabilitation programs designed for PHLs may need to be adapted to benefit SPs. To evaluate the effectiveness of training in communication strategies and psychosocial exercises for SPs of PHLs by determining whether SPs who completed the group class had improved mood, reduced stress, improved marital communication, and greater awareness of their partners' hearing loss-related quality of life (HL-QOL) in comparison with SPs who did not participate in a group class. Additionally, to determine whether PHLs of SPs who participated in a group audiological rehabilitation (AR) class had significantly improved mood, reduced stress, improved marital communication, and better HL-QOL scores in comparison with PHLs whose SPs did not participate in a group class. A randomized controlled study. A total of 72 individuals participated in the study, 36 PHLs and 36 SPs. The PHLs were hearing aid users or cochlear implant users; the SPs had normal or near normal hearing. PHLs in the control group participated in a traditional group AR program while their SPs received no treatment. PHLs in the experimental group also participated in a traditional group AR program while their SPs participated in a treatment program designed for SPs of PHLs. Classes consisted of 90 min sessions meeting once a week for four weeks. All participants completed questionnaires measuring HL-QOL (the SPs filled out third-party reports of HL-QOL), stress, mood (positive affect and negative affect), and communication in the marriage. Scales were completed three times: prior to the AR program, within two weeks after completing the AR program, and 6 mo later. SP awareness of their PHL's HL-QOL was measured by comparing preclass and 6 mo scores with reported critical difference values. Preclass, postclass and 6 mo data were examined with repeated measures ANOVAs. All SPs reported significant improvements in third-party HL-QOL between the preclass and postclass visit. At the 6 mo visit, these reports remained consistent in the control SPs but declined in the experimental SPs. Awareness of HL-QOL in PHLs was improved in SPs who participated in AR classes and remained consistent in SPs who did not. All SPs demonstrated a trend (moderate effect sizes) for decreased stress and decreased negative affect after they and/or their partners completed the AR program. All PHLs demonstrated significant improvements in HL-QOL, significant reductions in stress, significant decreases in negative affect, and significant improvements in marital communication. There were no differences in outcome across the experimental and control PHLs. When PHLs participate in an AR program, they receive significant improvements in QOL (quality of life). Congruence (as defined by similar scores) between SP and PHL assessments of HL-QOL improved in the experimental group, suggesting that the principal impact of the AR program on SPs was improved understanding of PHL experiences with hearing loss. American Academy of Audiology.

Does correction of preoperative coronal imbalance make a difference in outcomes of adult patients with deformity?

PubMed

Daubs, Michael D; Lenke, Lawrence G; Bridwell, Keith H; Kim, Yongjung J; Hung, Man; Cheh, Gene; Koester, Linda A

2013-03-15

Retrospective study with prospectively collected outcomes data. Determine the significance of coronal balance on spinal deformity surgery outcomes. Sagittal balance has been confirmed as an important radiographic parameter correlating with adult deformity treatment outcomes. The significance of coronal balance on functional outcomes is less clear. Eighty-five patients with more than 4 cm of coronal imbalance who underwent reconstructive spinal surgery were evaluated to determine the significance of coronal balance on functional outcomes as measured with the Oswestry Disability Index (ODI) and Scoliosis Research Society outcomes questionnaires. Sixty-two patients had combined coronal (>4 cm) and sagittal imbalance (>5 cm), while 23 patients had coronal imbalance alone. Postoperatively, 85% of patients demonstrated improved coronal balance. The mean improvement in the coronal C7 plumb line was 26 mm for a mean correction of 42%. The mean preoperative sagittal C7 plumb line in patients with combined coronal and sagittal imbalance was 118 mm (range, 50-310 mm) and improved to a mean 49 mm. The mean preoperative and postoperative ODI scores were 42 (range, 0-90) and 27 (range, 0-78), for a mean improvement of 15 (36%) (P = 0.00001; 95% CI, 12-20). The mean Scoliosis Research Society scores improved by 17 points (29%) (P = 0.00). Younger age (P = 0.008) and improvement in sagittal balance (P = 0.014) were positive predictors for improved ODI scores. Improvement in sagittal balance (P = 0.010) was a positive predictor for improved Scoliosis Research Society scores. In patients with combined coronal and sagittal imbalance, improvement in sagittal balance was the most significant predictor for improved ODI scores (P = 0.009). In patients with preoperative coronal imbalance alone, improvement in coronal balance trended toward, but was not a significant predictor for improved ODI (P = 0.092). Sagittal balance improvement is the strongest predictor of improved outcomes in patients with combined coronal and sagittal imbalance. In patients with coronal imbalance alone, improvement in coronal balance was not a factor for predicting improved functional outcomes.

Enhancing army analysis capability for warfighter protection: TRADOC-RDECOM M&S decision support environment collaboration

NASA Astrophysics Data System (ADS)

Athmer, Keith; Gaughan, Chris; McDonnell, Joseph S.; Leach, Robert; Davis, Bert; Truong, Kiet; Borum, Howard; Leslie, Richard; Ma, Lein

2012-05-01

The development of an Integrated Base Defense (IBD) is a significant challenge for the Army with many analytical gaps. The IBD problem space is complex, with evolving requirements and a large stakeholder base. In order to evaluate and analyze IBD decisions, the Training & Doctrine Command (TRADOC) Maneuver Support Center of Excellence (MSCoE) led and continues to lead a series of IBD focused experiments and wargames. Modeling and Simulation (M&S) significantly contributes to this effort. To improve IBD M&S capabilities, a collaborative demonstration with the Research, Development and Engineering Command's (RDECOM's) M&S Decision Support Environment (MSDSE) was held in September 2011. The results of this demonstration provided key input to MSCoE IBD related concepts and technologies. Moreover, it established an initial M&S toolset that will significantly improve force protection in combat zones and Army installations worldwide by providing leaders a capability to conduct analysis of defense and mission rehearsals. The demonstration was executed with a "human in the loop" Battle Captain, who was aided by mission command assets such as Base Expeditionary Targeting and Surveillance Sensors-Combined (BETSS-C). The Common Operating Picture was populated and stimulated using Science & Technology (S&T) M&S, allowing for a realistic representation of physical phenomena without the need for real systems. Novel methods were used for simulation orchestration, and for initializing the simulations and Opposing Force (OPFOR) activities. Ultimately, this demonstration showed that the MSDSE is suitable to support TRADOC IBD analyses and that S&T M&S is ready to be used in a demanding simulation environment. This paper will highlight the event's outcomes and lessons identified.

Mindfulness-Based Stress Reduction in Women with Overweight or Obesity: A Randomized Clinical Trial.

PubMed

Raja-Khan, Nazia; Agito, Katrina; Shah, Julie; Stetter, Christy M; Gustafson, Theresa S; Socolow, Holly; Kunselman, Allen R; Reibel, Diane K; Legro, Richard S

2017-08-01

To evaluate the feasibility and cardiometabolic effects of mindfulness-based stress reduction (MBSR) in women with overweight or obesity. Eighty-six women with BMI ≥ 25 kg/m 2 were randomized to 8 weeks of MBSR or health education and followed for 16 weeks. The primary outcome was the Toronto Mindfulness Scale. Secondary outcomes included the Perceived Stress Scale-10, fasting glucose, and blood pressure. Compared to health education, the MBSR group demonstrated significantly improved mindfulness at 8 weeks (mean change from baseline, 4.5 vs. -1.0; P = 0.03) and significantly decreased perceived stress at 16 weeks (-3.6 vs. -1.3, P = 0.01). In the MBSR group, there were significant reductions in fasting glucose at 8 weeks (-8.9 mg/dL, P = 0.02) and at 16 weeks (-9.3 mg/dL, P = 0.02) compared to baseline. Fasting glucose did not significantly improve in the health education group. There were no significant changes in blood pressure, weight, or insulin resistance in the MBSR group. In women with overweight or obesity, MBSR significantly reduces stress and may have beneficial effects on glucose. Future studies demonstrating long-term cardiometabolic benefits of MBSR will be key for establishing MBSR as an effective tool in the management of obesity. © 2017 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Reversal of progressive necrotizing vasculitis with intravenous pulse cyclophosphamide and methylprednisolone.

PubMed

Fort, J G; Abruzzo, J L

1988-09-01

We describe a patient with polyarteritis nodosa who, despite therapy with daily doses of oral prednisone and cyclophosphamide, developed acute renal failure. Renal histopathologic examination demonstrated crescentic glomerulonephritis. Treatment with intravenous pulse cyclophosphamide and methylprednisolone resulted in clinical improvement and significant recovery of renal function.

A procedure for estimating the frequency distribution of CO levels in the micro-region of a highway.

DOT National Transportation Integrated Search

1979-01-01

This report demonstrates that the probability of violating a "not to be exceeded more than once per year", one-hour air quality standard can be bounded from above. This result represents a significant improvement over previous methods of ascertaining...

Long-Term Effects of Neurofeedback Treatment in Autism

ERIC Educational Resources Information Center

Kouijzer, Mirjam E. J.; de Moor, Jan M. H.; Gerrits, Berrie J. L.; Buitelaar, Jan K.; van Schie, Hein T.

2009-01-01

Previously we demonstrated significant improvement of executive functions and social behavior in children with autism spectrum disorders (ASD) treated with 40 sessions of EEG neurofeedback in a nonrandomized waiting list control group design. In this paper we extend these findings by reporting the long-term results of neurofeedback treatment in…

Beyond "Job-Embedded": Ensuring That Good Professional Development Gets Results

ERIC Educational Resources Information Center

National Institute for Excellence in Teaching, 2012

2012-01-01

Two recent studies by Biancarosa et al. and by Saunders et al. have finally demonstrated that "job-embedded, sustained professional development" can significantly improve student achievement. But there's a catch. In both studies, effective professional development (PD) strategies were successful only under certain circumstances or only in some…

Cognitive Strategies and Skill Acquisition in Musical Performance.

ERIC Educational Resources Information Center

McPherson, Gary E.

1997-01-01

Reports on a longitudinal study of high school instrumentalists that examined the development of four distinct types of musical performance (playing by ear, playing from memory, sight reading, and improvising) over three years. Reveals a significant improvement in these skills while also demonstrating changes in aural and creative activities. (CMK)

Treatment of Test Anxiety by Cue-Controlled Relaxation and Systematic Desensitization

ERIC Educational Resources Information Center

Russell, Richard K.; And Others

1976-01-01

Test-anxious subjects (N=19) participated in an outcome study comparing systematic desensitization, cue-controlled relaxation, and no treatment. The treatment groups demonstrated significant improvement on the self-report measures of test and state anxiety but not on the behavioral indices. The potential advantages of this technique over…

Treatment of Test Anxiety by Cue-Controlled Desensitization and Study-Skills Training.

ERIC Educational Resources Information Center

Lent, Robert W.; Russell, Richard K.

1978-01-01

Compared relative effectiveness of two multicomponent strategies in the treatment of test anxiety. Test-anxious students were assigned to groups. Within-group changes between pre- and post-testing favored multicomponent treatments. Between groups, both desensitization treatment programs demonstrated significant improvement over no-treatment on…

Systematically Evaluating the Effectiveness of Quality Assurance Programmes in Leading to Improvements in Institutional Performance

ERIC Educational Resources Information Center

Lillis, Deirdre

2012-01-01

Higher education institutions worldwide invest significant resources in their quality assurance systems. Little empirical evidence exists that demonstrates the effectiveness (or otherwise) of these systems. Methodological approaches for determining effectiveness are also underdeveloped. Self-study-with-peer-review is a widely used model for…

Bring out the Brilliance: A Counseling Intervention for Underachieving Students

ERIC Educational Resources Information Center

Berger, Carolyn

2014-01-01

This study evaluated the impact of a small group counseling intervention designed for students who underachieve. The results of the study demonstrated significant improvement for ninth- and tenth-grade underachieving students in the areas of organizational skills, time management, and motivation. The author discusses implications and…

Data-Enhanced Leadership. The Soul of Educational Leadership Series. Volume 7

ERIC Educational Resources Information Center

Blankstein, Alan M.; Houston, Paul D.; Cole, Robert W.

2010-01-01

Offering key concepts about how the informed use of data can translate into highly effective school leadership, this seventh volume in "The Soul of Educational Leadership" series demonstrates how educational leaders can apply data strategically to strengthen school leadership and significantly improve professional learning, students' learning…

Principals and the Politics of Resistance to Change

ERIC Educational Resources Information Center

Starr, Karen

2011-01-01

Governments hold principals accountable for leading and managing significant change for school improvement, primarily demonstrated through enhanced student test results. Research evidence suggests, however, that schools are slow to change, that many individuals are resistant to major change and that school reforms are often cursory or short lived.…

Least-Squares Adaptive Control Using Chebyshev Orthogonal Polynomials

NASA Technical Reports Server (NTRS)

Nguyen, Nhan T.; Burken, John; Ishihara, Abraham

2011-01-01

This paper presents a new adaptive control approach using Chebyshev orthogonal polynomials as basis functions in a least-squares functional approximation. The use of orthogonal basis functions improves the function approximation significantly and enables better convergence of parameter estimates. Flight control simulations demonstrate the effectiveness of the proposed adaptive control approach.

Improved Li/BCX (thionyl chloride) cells for space applications

NASA Technical Reports Server (NTRS)

Clark, W. D. K.; Ebel, S. J.; Eberhard, D. P.; Takeuchi, E. S.

1988-01-01

New NASA requirements for the screening of lithium cells for space applications involve thermal soaks at elevated temperatures (149 C). The BCX DD and C size cells have been redesigned to pass this test with only marginal losses in capacity as was done previously for the D cells. In addition, the pressure increases in cells subjected to this high temperature environment have been characterized showing that the earlier designs failed this exposure due to lack of void volume. An improve BCX chemistry has been demonstrated which significantly improves voltage delay problems encountered after partial discharge and storage of the cells.

Language Comprehension in Language-Learning Impaired Children Improved with Acoustically Modified Speech

NASA Astrophysics Data System (ADS)

Tallal, Paula; Miller, Steve L.; Bedi, Gail; Byma, Gary; Wang, Xiaoqin; Nagarajan, Srikantan S.; Schreiner, Christoph; Jenkins, William M.; Merzenich, Michael M.

1996-01-01

A speech processing algorithm was developed to create more salient versions of the rapidly changing elements in the acoustic waveform of speech that have been shown to be deficiently processed by language-learning impaired (LLI) children. LLI children received extensive daily training, over a 4-week period, with listening exercises in which all speech was translated into this synthetic form. They also received daily training with computer "games" designed to adaptively drive improvements in temporal processing thresholds. Significant improvements in speech discrimination and language comprehension abilities were demonstrated in two independent groups of LLI children.

Protein-engineered block-copolymers as stem cell delivery vehicles

NASA Astrophysics Data System (ADS)

Heilshorn, Sarah

2015-03-01

Stem cell transplantation is a promising therapy for a myriad of debilitating diseases and injuries; however, current delivery protocols are inadequate. Transplantation by direct injection, which is clinically preferred for its minimal invasiveness, commonly results in less than 5% cell viability, greatly inhibiting clinical outcomes. We demonstrate that mechanical membrane disruption results in significant acute loss of viability at clinically relevant injection rates. As a strategy to protect cells from these damaging forces, we show that cell encapsulation within hydrogels of specific mechanical properties will significantly improve viability. Building on these fundamental studies, we have designed a reproducible, bio-resorbable, customizable hydrogel using protein-engineering technology. In our Mixing-Induced Two-Component Hydrogel (MITCH), network assembly is driven by specific and stoichiometric peptide-peptide binding interactions. By integrating protein science methodologies with simple polymer physics models, we manipulate the polypeptide chain interactions and demonstrate the direct ability to tune the network crosslinking density, sol-gel phase behavior, and gel mechanics. This is in contrast to many other physical hydrogels, where predictable tuning of bulk mechanics from the molecular level remains elusive due to the reliance on non-specific and non-stoichiometric chain interactions for network formation. Furthermore, the hydrogel network can be easily modified to deliver a variety of bioactive payloads including growth factors, peptide drugs, and hydroxyapatite nanoparticles. Through a series of in vitro and in vivo studies, we demonstrate that these materials may significantly improve transplanted stem cell retention and function.

Local delivery of FTY720 in PCL membrane improves SCI functional recovery by reducing reactive astrogliosis.

PubMed

Wang, Junjuan; Wang, Jiaqiu; Lu, Ping; Cai, Youzhi; Wang, Yafei; Hong, Lan; Ren, Hao; Heng, Boon Chin; Liu, Hua; Zhou, Jing; Ouyang, Hongwei

2015-09-01

FTY720 has recently been approved as an oral drug for treating relapsing forms of multiple sclerosis, and exerts its therapeutic effect by acting as an immunological inhibitor targeting the sphingosine-1-phosphate (S1P) receptor subtype (S1P1) of T cells. Recently studies demonstrated positive efficacy of this drug on spinal cord injury (SCI) in animal models after systemic administration, albeit with significant adverse side effects. We hereby hypothesize that localized delivery of FTY720 can promote SCI recovery by reducing pathological astrogliosis. The mechanistic functions of FTY720 were investigated in vitro and in vivo utilizing immunofluorescence, histology, MRI and behavioral analysis. The in vitro study showed that FTY720 can reduce astrocyte migration and proliferation activated by S1P. FTY720 can prolong internalization of S1P1 and exert antagonistic effects on S1P1. In vivo study of SCI animal models demonstrated that local delivery of FTY720 with polycaprolactone (PCL) membrane significantly decreased S1P1 expression and glial scarring compared with the control group. Furthermore, FTY720-treated groups exhibited less cavitation volume and neuron loss, which significantly improved recovery of motor function. These findings demonstrated that localized delivery of FTY720 can promote SCI recovery by targeting the S1P1 receptor of astrocytes, provide a new therapeutic strategy for SCI treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Training to Improve Hearing Speech in Noise: Biological Mechanisms

PubMed Central

Song, Judy H.; Skoe, Erika; Banai, Karen

2012-01-01

We investigated training-related improvements in listening in noise and the biological mechanisms mediating these improvements. Training-related malleability was examined using a program that incorporates cognitively based listening exercises to improve speech-in-noise perception. Before and after training, auditory brainstem responses to a speech syllable were recorded in quiet and multitalker noise from adults who ranged in their speech-in-noise perceptual ability. Controls did not undergo training but were tested at intervals equivalent to the trained subjects. Trained subjects exhibited significant improvements in speech-in-noise perception that were retained 6 months later. Subcortical responses in noise demonstrated training-related enhancements in the encoding of pitch-related cues (the fundamental frequency and the second harmonic), particularly for the time-varying portion of the syllable that is most vulnerable to perceptual disruption (the formant transition region). Subjects with the largest strength of pitch encoding at pretest showed the greatest perceptual improvement. Controls exhibited neither neurophysiological nor perceptual changes. We provide the first demonstration that short-term training can improve the neural representation of cues important for speech-in-noise perception. These results implicate and delineate biological mechanisms contributing to learning success, and they provide a conceptual advance to our understanding of the kind of training experiences that can influence sensory processing in adulthood. PMID:21799207

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

Rhinefrank, Kenneth; Lamb, Bradford; Prudell, Joseph

This Project aims to satisfy objectives of the DOE’s Water Power Program by completing a system detailed design (SDD) and other important activities in the first phase of a utility-scale grid-connected ocean wave energy demonstration. In early 2012, Columbia Power (CPwr) had determined that further cost and performance optimization was necessary in order to commercialize its StingRAY wave energy converter (WEC). CPwr’s progress toward commercialization, and the requisite technology development path, were focused on transitioning toward a commercial-scale demonstration. This path required significant investment to be successful, and the justification for this investment required improved annual energy production (AEP) andmore » lower capital costs. Engineering solutions were developed to address these technical and cost challenges, incorporated into a proposal to the US Department of Energy (DOE), and then adapted to form the technical content and statement of project objectives of the resulting Project (DE-EE0005930). Through Project cost-sharing and technical collaboration between DOE and CPwr, and technical collaboration with Oregon State University (OSU), National Renewable Energy Lab (NREL) and other Project partners, we have demonstrated experimentally that these conceptual improvements have merit and made significant progress towards a certified WEC system design at a selected and contracted deployment site at the Wave Energy Test Site (WETS) at the Marine Corps Base in Oahu, HI (MCBH).« less

Impacts of Community-Based Natural Resource Management on Wealth, Food Security and Child Health in Tanzania.

PubMed

Pailler, Sharon; Naidoo, Robin; Burgess, Neil D; Freeman, Olivia E; Fisher, Brendan

2015-01-01

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-in-differences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than recently-established CBNRM areas. Our results show significant improvements in household food security in CBNRM areas compared with non-CBNRM areas, but household wealth and health outcomes in children are generally not significantly different. No one CBNRM governance regime demonstrates consistently different welfare outcomes than the others. Wealthy households benefit more from CBNRM than poor households and CBNRM benefits appear to increase with longer periods of implementation. Perhaps evidence of CBNRM benefits is limited because CBNRM hasn't been around long enough to yield demonstrable outcomes. Nonetheless, achieving demonstrable benefits to rural populations will be crucial for CBNRM's future success in Tanzania.

Impacts of Community-Based Natural Resource Management on Wealth, Food Security and Child Health in Tanzania

PubMed Central

Pailler, Sharon; Naidoo, Robin; Burgess, Neil D.; Freeman, Olivia E.; Fisher, Brendan

2015-01-01

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-in-differences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than recently-established CBNRM areas. Our results show significant improvements in household food security in CBNRM areas compared with non-CBNRM areas, but household wealth and health outcomes in children are generally not significantly different. No one CBNRM governance regime demonstrates consistently different welfare outcomes than the others. Wealthy households benefit more from CBNRM than poor households and CBNRM benefits appear to increase with longer periods of implementation. Perhaps evidence of CBNRM benefits is limited because CBNRM hasn’t been around long enough to yield demonstrable outcomes. Nonetheless, achieving demonstrable benefits to rural populations will be crucial for CBNRM’s future success in Tanzania. PMID:26186210

Effects of a 6-month exercise program pilot study on walking economy, peak physiological characteristics, and walking performance in patients with peripheral arterial disease.

PubMed

Crowther, Robert G; Leicht, Anthony S; Spinks, Warwick L; Sangla, Kunwarjit; Quigley, Frank; Golledge, Jonathan

2012-01-01

The purpose of this study was to examine the effects of a 6-month exercise program on submaximal walking economy in individuals with peripheral arterial disease and intermittent claudication (PAD-IC). Participants (n = 16) were randomly allocated to either a control PAD-IC group (CPAD-IC, n = 6) which received standard medical therapy, or a treatment PAD-IC group (TPAD-IC; n = 10) which took part in a supervised exercise program. During a graded treadmill test, physiological responses, including oxygen consumption, were assessed to calculate walking economy during submaximal and maximal walking performance. Differences between groups at baseline and post-intervention were analyzed via Kruskal-Wallis tests. At baseline, CPAD-IC and TPAD-IC groups demonstrated similar walking performance and physiological responses. Postintervention, TPAD-IC patients demonstrated significantly lower oxygen consumption during the graded exercise test, and greater maximal walking performance compared to CPAD-IC. These preliminary results indicate that 6 months of regular exercise improves both submaximal walking economy and maximal walking performance, without significant changes in maximal walking economy. Enhanced walking economy may contribute to physiological efficiency, which in turn may improve walking performance as demonstrated by PAD-IC patients following regular exercise programs.

A Pilot Study for Evaluation of Digital Systems as an Adjunct to Sphygmomanometry for Undergraduate Teaching

PubMed Central

Sharma, Renuka; Kapoor, Raj

2016-01-01

Objectives: Blood pressure estimation is a key skill for medical practitioners. It is routinely taught to undergraduate medical students using an aneroid sphygmomanometer. However, the conceptual understanding in the practical remains limited. We conducted the following study to evaluate the efficacy of digital data acquisition systems as an adjunct to the sphygmomanometer to teach blood pressure. Methods: Fifty-seven first-year medical students participated in the study. An MCQ test of 15 questions, consisting of 10 conceptual and five factual questions, was administered twice – pre- and post-demonstration of blood pressure measurement using a digital data acquisition system. In addition, qualitative feedback was also obtained. Results: Median scores were 7 (6 - 8) and 3 (1.5 - 4) in pre-test sessions for conceptual and factual questions, respectively. Post-test scores showed a significant improvement in both categories (10 (9 - 10) and 4 (4 - 4.5), respectively, Mann-Whitney U test, p < 0.0001). Student feedback also indicated that the digital system enhanced learning and student participation. Conclusions: Student feedback regarding the demonstrations was uniformly positive, which was also reflected in significantly improved post-test scores. We conclude that parallel demonstration on digital systems and the sphygmomanometer will enhance student engagement and understanding of blood pressure measurement. PMID:27660735

Whey Protein Concentrate WPC-80 Improves Antioxidant Defense Systems in the Salivary Glands of 14-Month Wistar Rats.

PubMed

Falkowski, Mateusz; Maciejczyk, Mateusz; Koprowicz, Tomasz; Mikołuć, Bożena; Milewska, Anna; Zalewska, Anna; Car, Halina

2018-06-17

Whey protein concentrate (WPC) is characterized by powerful antioxidant properties, but its effect on redox homeostasis of salivary glands of aging organisms is still unknown. In this study, we are the first to evaluate the antioxidant barrier of salivary glands of 14-month Wistar rats fed WPC-80. Total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), activities of glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT) as well as concentrations of reduced glutathione (GSH) are estimated in the submandibular and parotid glands of rats administered WPC-80 intragastrically for a period of 7 and 14 days. We demonstrate a significant increase in GSH, GPx and SOD in the salivary glands of rats fed WPC-80 for 14 days and a significant increase in TAS, GPx and SOD in the parotid glands of rats fed WPC-80 for 7 days compared to control rats. The beneficial effects of WPC-80 on salivary glands are also demonstrated by lower TOS and OSI in the parotid glands of rats fed WPC-80 compared to the submandibular glands. In summary, we demonstrate that WPC-80 improves redox homeostasis in salivary glands, particularly in the parotid glands of old rats.

Using the Teach-Back Method in Patient Education to Improve Patient Satisfaction.

PubMed

Centrella-Nigro, Andrea M; Alexander, Catherine

2017-01-01

This quasi-experimental research study used two similar nursing units to test the effects of teach back on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. A pretest-posttest design tested 24 nurses' knowledge, attitudes, and beliefs about teach back. Education specialists provided a 1-hour teaching session on teach back to all nurses in the intervention unit. A significant improvement in knowledge scores in the pretest-posttest was found using paired t tests (p = .002). Qualitative analysis of nurses' comments demonstrated strong support for teach back in the post-test. The HCAHPS scores were not significantly improved in the intervention unit when compared with the control unit. More research needs to be conducted to determine the effectiveness of teach back on HCAHPS scores. J Contin Educ Nurs. 2017;48(1):47-52. Copyright 2017, SLACK Incorporated.

An approximate model for cancellous bone screw fixation.

PubMed

Brown, C J; Sinclair, R A; Day, A; Hess, B; Procter, P

2013-04-01

This paper presents a finite element (FE) model to identify parameters that affect the performance of an improved cancellous bone screw fixation technique, and hence potentially improve fracture treatment. In cancellous bone of low apparent density, it can be difficult to achieve adequate screw fixation and hence provide stable fracture fixation that enables bone healing. Data from predictive FE models indicate that cements can have a significant potential to improve screw holding power in cancellous bone. These FE models are used to demonstrate the key parameters that determine pull-out strength in a variety of screw, bone and cement set-ups, and to compare the effectiveness of different configurations. The paper concludes that significant advantages, up to an order of magnitude, in screw pull-out strength in cancellous bone might be gained by the appropriate use of a currently approved calcium phosphate cement.

Using Puppets to Teach Schoolchildren to Detect Stroke and Call 911.

PubMed

Sharkey, Sonya; Denke, Linda; Herbert, Morley A

2016-08-01

To overcome barriers to improved outcomes, we undertook an intervention to teach schoolchildren how to detect a stroke and call emergency medical services (EMS). We obtained permission from parents and guardians to use an 8-min puppet show to instruct the fourth, fifth, and sixth graders about stroke detection, symptomatology, and calling EMS. A pretest and three posttests-one immediately following the presentation, one at 3 months, and a third at 6 months-were administered. Responses from 282 students were evaluable. Significant improvements (p < .001) in knowledge were found through all posttests in identifying what parts of the body stroke affected and through the first two posttests in recognizing symptoms stroke victims experienced. Students demonstrated at pretest a high awareness of EMS and 911 (97.5%) and showed slight, but not significant, improvement over time. © The Author(s) 2016.

Improving UV resistance and virulence of Beauveria bassiana by genetic engineering with an exogenous tyrosinase gene.

PubMed

Shang, Yanfang; Duan, Zhibing; Huang, Wei; Gao, Qiang; Wang, Chengshu

2012-01-01

Insect pathogenic fungi like Beauveria bassiana have been developed as environmentally friendly biocontrol agents against arthropod pests. However, restrictive environmental factors, including solar ultraviolet (UV) radiation frequently lead to inconsistent field performance. To improve resistance to UV damage, we used Agrobacterium-mediated transformation to engineer B. bassiana with an exogenous tyrosinase gene. The results showed that the mitotically stable transformants produced larger amounts of yellowish pigments than the wild-type strain, and these imparted significantly increased UV-resistance. The virulence of the transgenic isolate was also significantly increased against the silkworm Bombyx mori and the mealworm Tenebrio molitor. This study demonstrated that genetic engineering of B. bassiana with a tyrosinase gene is an effective way to improve fungal tolerance against UV damage. Copyright © 2011 Elsevier Inc. All rights reserved.

Emphasizing the process of science using demonstrations in conceptual chemistry

NASA Astrophysics Data System (ADS)

Lutz, Courtney A.

The purpose of this project was to teach students a method for employing the process of science in a conceptual chemistry classroom when observing a demonstration of a discrepant event. Students observed six demonstrations throughout a trimester study of chemistry and responded to each demonstration by asking as many questions as they could think of, choosing one testable question to answer by making as many hypotheses as possible, and choosing one hypothesis to make predictions about observed results of this hypothesis when tested. Students were evaluated on their curiosity, confidence, knowledge of the process of science, and knowledge of the nature of science before and after the six demonstrations. Many students showed improvement in using or mastery of the process of science within the context of conceptual chemistry after six intensive experiences with it. Results of the study also showed students gained confidence in their scientific abilities after completing one trimester of conceptual chemistry. Curiosity and knowledge of the nature of science did not show statistically significant improvement according to the assessment tool. This may have been due to the scope of the demonstration and response activities, which focused on the process of science methodology instead of knowledge of the nature of science or the constraints of the assessment tool.

Increasing the Understanding and Demonstration of Appropriate Affection in Children with Asperger Syndrome: A Pilot Trial

PubMed Central

Sofronoff, Kate; Eloff, Johann; Sheffield, Jeanie; Attwood, Tony

2011-01-01

The study was conducted to examine relationships between affectionate behavior in children with Asperger syndrome and variables likely to influence its expression (e.g., tactile sensitivity, social ability). It also evaluated the impact of a cognitive behavioral intervention that aimed to improve a child's understanding and expression of affection. Twenty-one children, aged 7 to 12 years, participated in the trial. The results showed significant correlations between measures of affection and tactile sensitivity and social ability. After attending the 5-week program, parents identified significant increases in the appropriateness of children's affectionate behavior both towards immediate family and people outside the immediate family, despite reporting no significant changes in their child's general difficulties with affectionate behavior. There was a significant improvement in children's understanding of the purpose of affection. The findings are discussed as well as the limitations of the study. PMID:22937243

Atomic Layer Deposition Al2O3 Coatings Significantly Improve Thermal, Chemical, and Mechanical Stability of Anodic TiO2 Nanotube Layers

PubMed Central

2017-01-01

We report on a very significant enhancement of the thermal, chemical, and mechanical stability of self-organized TiO2 nanotubes layers, provided by thin Al2O3 coatings of different thicknesses prepared by atomic layer deposition (ALD). TiO2 nanotube layers coated with Al2O3 coatings exhibit significantly improved thermal stability as illustrated by the preservation of the nanotubular structure upon annealing treatment at high temperatures (870 °C). In addition, a high anatase content is preserved in the nanotube layers against expectation of the total rutile conversion at such a high temperature. Hardness of the resulting nanotube layers is investigated by nanoindentation measurements and shows strongly improved values compared to uncoated counterparts. Finally, it is demonstrated that Al2O3 coatings guarantee unprecedented chemical stability of TiO2 nanotube layers in harsh environments of concentrated H3PO4 solutions. PMID:28291942

Advanced Power Electronics Components

NASA Technical Reports Server (NTRS)

Schwarze, Gene E.

2004-01-01

This paper will give a description and status of the Advanced Power Electronics Materials and Components Technology program being conducted by the NASA Glenn Research Center for future aerospace power applications. The focus of this research program is on the following: 1) New and/or significantly improved dielectric materials for the development of power capacitors with increased volumetric efficiency, energy density, and operating temperature. Materials being investigated include nanocrystalline and composite ceramic dielectrics and diamond-like carbon films; 2) New and/or significantly improved high frequency, high temperature, low loss soft magnetic materials for the development of transformers/inductors with increased power/energy density, electrical efficiency, and operating temperature. Materials being investigated include nanocrystalline and nanocomposite soft magnetic materials; 3) Packaged high temperature, high power density, high voltage, and low loss SiC diodes and switches. Development of high quality 4H- and 6H- SiC atomically smooth substrates to significantly improve device performance is a major emphasis of the SiC materials program; 4) Demonstration of high temperature (> 200 C) circuits using the components developed above.

A systematic review of health literacy interventions for people living with HIV

PubMed Central

Perazzo, Joseph; Reyes, Darcel; Webel, Allison

2017-01-01

Health literacy significantly impacts health-related outcomes among people living with HIV. Our aim was to systematically review current literature on health literacy interventions for people living with HIV. The authors conducted a thorough literature search following the PRISMA statement and the AMSTAR checklist as a guide, and found six studies that met inclusion/exclusion criteria. The majority of these interventions were designed to improve HIV treatment adherence as well as HIV knowledge and treatment-related skills, with one study focusing on e-Health literacy. Several of the studies demonstrated trends toward improvement in medication adherence, but most did not achieve statistical significance primarily due to methodological limitations. Significant improvements in knowledge, behavioral skills, and e-Health literacy were found following interventions (p = 0·001–0·05). Health literacy interventions have the potential to promote HIV-related knowledge, behavioral skills, and self-management practices. More research is needed to assess the efficacy of interventions to promote a variety of self-management practices. PMID:26864691

Generator Dynamic Model Validation and Parameter Calibration Using Phasor Measurements at the Point of Connection

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

Huang, Zhenyu; Du, Pengwei; Kosterev, Dmitry

2013-05-01

Disturbance data recorded by phasor measurement units (PMU) offers opportunities to improve the integrity of dynamic models. However, manually tuning parameters through play-back events demands significant efforts and engineering experiences. In this paper, a calibration method using the extended Kalman filter (EKF) technique is proposed. The formulation of EKF with parameter calibration is discussed. Case studies are presented to demonstrate its validity. The proposed calibration method is cost-effective, complementary to traditional equipment testing for improving dynamic model quality.

Advanced titration to treat a floppy epiglottis in selective upper airway stimulation.

PubMed

Heiser, Clemens

2016-09-01

The following report presents a case of a patient with high residual apnea-hypopnea index at 6 months following implantation of an upper airway stimulation device who improved significantly after advanced titration via drug-induced sedated endoscopy by changing the electrode configuration for stimulation from bipolar to monopolar. This case demonstrates the utility of postsurgical advanced titration to optimize programming settings for improved clinical outcomes. Laryngoscope, 126:S22-S24, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Testing the standard model by precision measurement of the weak charges of quarks.

PubMed

Young, R D; Carlini, R D; Thomas, A W; Roche, J

2007-09-21

In a global analysis of the latest parity-violating electron scattering measurements on nuclear targets, we demonstrate a significant improvement in the experimental knowledge of the weak neutral-current lepton-quark interactions at low energy. The precision of this new result, combined with earlier atomic parity-violation measurements, places tight constraints on the size of possible contributions from physics beyond the standard model. Consequently, this result improves the lower-bound on the scale of relevant new physics to approximately 1 TeV.

Strategies to implement maternal vaccination: A comparison between standing orders for midwife delivery, a hospital based maternal immunisation service and primary care.

PubMed

Krishnaswamy, Sushena; Wallace, Euan M; Buttery, Jim; Giles, Michelle L

2018-03-20

Maternal vaccination is a safe and effective strategy to reduce maternal and neonatal morbidity and mortality from pertussis and influenza. However, despite recommendations for maternal vaccination since 2010, uptake remains suboptimal. Barriers to uptake have been studied widely and include lack of integration of vaccination into routine pregnancy care and access to vaccination services. Standing orders for administration of vaccines without the need for a physician review or prescription have been demonstrated to improve uptake as part of multi-model interventions to increase antenatal influenza and post-partum pertussis vaccination. Monash Health is a university-affiliated, public healthcare network in Melbourne, Australia providing maternity services across three hospitals. In this study we compared three different immunisation models - an immunisation nurse-led immunisation service, standing orders for midwife-administered pertussis vaccination within pregnancy care clinics, and delivery by general practitioners in primary care. Uptake of maternal pertussis vaccine was measured as recorded in the state-wide perinatal data collection tool. Uptake improved significantly at all three hospitals over the study period with the most significant change (39% to 91%, p < .001) noted at the hospital where standing orders were introduced. Our study highlights the diversity of immunisation service models available in maternity care settings. We demonstrated significant improvement in uptake of maternal pertussis vaccination with introduction of midwife-administered vaccination but each maternity service should consider the model best suited to their needs. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Chinese Chan-based mind-body intervention for patients with depression.

PubMed

Chan, Agnes S; Wong, Queenie Y; Sze, Sophia L; Kwong, Patrick P K; Han, Yvonne M Y; Cheung, Mei-Chun

2012-12-15

Given the recent growing interest and encouraging findings in studies of alternative treatments for depression, the present randomized controlled trial study aimed to compare the effect of a newly developed Chinese Chan-based Dejian Mind-Body Intervention (DMBI) with the Cognitive Behavioral Therapy (CBT) on improving depressive symptoms in patients with depression. Seventy-five participants diagnosed with major depressive disorder were randomly assigned to receive either 10-session CBT or DMBI, or placed on a waitlist. Pre-post measurements included record of anti-depressants treatment, ratings by psychiatrists who were blinded to the experimental design and self-report on mood measures, and performance in a cognitive test tapping concentration ability. Both the CBT and DMBI groups demonstrated significantly reduced overall depressive syndrome after intervention at large effect size (0.93-1.10). Furthermore, the DMBI group (p<0.05), but not the CBT or waitlist groups, demonstrated significant reduction in intake of anti-depressants, and significant improvement in specific depression-related symptoms including difficulty in concentration (p=0.002), and problems in gastrointestinal health (p=0.02) and overall sleep quality (p<0.001). This study has provided some evidence for the short-term effect of the DMBI on Chinese population. Its long-term effect on a larger sample and on Caucasian population warrants further investigation. The present findings suggest that a Chinese Chan-based Mind-Body intervention has positive effects on improving mood and health conditions of individuals with depression. Copyright © 2012 Elsevier B.V. All rights reserved.

Overlay accuracy fundamentals

NASA Astrophysics Data System (ADS)

Kandel, Daniel; Levinski, Vladimir; Sapiens, Noam; Cohen, Guy; Amit, Eran; Klein, Dana; Vakshtein, Irina

2012-03-01

Currently, the performance of overlay metrology is evaluated mainly based on random error contributions such as precision and TIS variability. With the expected shrinkage of the overlay metrology budget to < 0.5nm, it becomes crucial to include also systematic error contributions which affect the accuracy of the metrology. Here we discuss fundamental aspects of overlay accuracy and a methodology to improve accuracy significantly. We identify overlay mark imperfections and their interaction with the metrology technology, as the main source of overlay inaccuracy. The most important type of mark imperfection is mark asymmetry. Overlay mark asymmetry leads to a geometrical ambiguity in the definition of overlay, which can be ~1nm or less. It is shown theoretically and in simulations that the metrology may enhance the effect of overlay mark asymmetry significantly and lead to metrology inaccuracy ~10nm, much larger than the geometrical ambiguity. The analysis is carried out for two different overlay metrology technologies: Imaging overlay and DBO (1st order diffraction based overlay). It is demonstrated that the sensitivity of DBO to overlay mark asymmetry is larger than the sensitivity of imaging overlay. Finally, we show that a recently developed measurement quality metric serves as a valuable tool for improving overlay metrology accuracy. Simulation results demonstrate that the accuracy of imaging overlay can be improved significantly by recipe setup optimized using the quality metric. We conclude that imaging overlay metrology, complemented by appropriate use of measurement quality metric, results in optimal overlay accuracy.

The effectiveness of a peer support camp for siblings of children with cancer.

PubMed

Sidhu, Ranita; Passmore, Anne; Baker, David

2006-10-15

Siblings of children with cancer have higher levels of psychological stress and adaptational difficulties compared to siblings of healthy children and children with other chronic illness. This is the first study to report on the mental health of Australian siblings of children with cancer and examines the effects of a therapeutic peer support camp-Camp Onwards, as an intervention. A protocol, designed to reduce levels of distress, improve social competence, and improve knowledge about the impact of cancer and its treatment was developed. Siblings (n=26) 8-13 years were assessed using standardised self-report measures pre and post intervention and at -8 weeks follow-up with: the Behaviour Assessment for Children (BASC) (Reynolds & Kamphaus, 1992), Self Perception Profile for Children (SPP-C) (Harter, 1985), Sibling Perception Questionnaire (SPQ) (Carpenter & Sahler, 1991). Change was measured using paired t tests. At pre-test, 40% of the sample demonstrated increased levels of emotional distress when compared to the normal population. Post intervention, siblings reported lower levels of distress demonstrated by decreased anxiety (P=0.01) and positive changes in the Self Report of Personality [BASC] (P=0.00). Improved social competence was noted in the interpersonal domain of the SPQ (P=0.01) and also greater social acceptance scores on the SPP-C (P=0.01). Improved knowledge about the impact of cancer and its treatment was evidenced by significant reductions in the fear of disease domain on the SPQ (P=0.01). Siblings who attended Camp Onwards demonstrated improved mental health outcomes that were sustained at follow-up, demonstrating its effectiveness as an intervention strategy in supporting sibling adjustment. Copyright (c) 2005 Wiley-Liss, Inc.

Nurses' knowledge and perception of delirium screening and assessment in the intensive care unit: Long-term effectiveness of an education-based knowledge translation intervention.

PubMed

Hickin, Sharon L; White, Sandra; Knopp-Sihota, Jennifer

2017-08-01

To determine the impact of education on nurses' knowledge of delirium, knowledge and perception of a validated screening tool, and delirium screening in the ICU. A quasi-experimental single group pretest-post-test design. A 16 bed ICU in a Canadian urban tertiary care centre. Nursing knowledge and perception were measured at baseline, 3-month and 18-month periods. Delirium screening was then assessed over 24-months. During the study period, 197 surveys were returned; 84 at baseline, 53 at 3-months post education, and 60 at the final assessment period 18-months post intervention. The significant improvements in mean knowledge scores at 3-months post intervention (7.2, SD 1.3) were not maintained at 18-months (5.3, SD 1.1). Screening tool perception scores remained unchanged. Improvements in the perception of utility were significant at both time periods (p=0.03, 0.02 respectively). Physician value significantly improved at 18-months (p=0.01). Delirium screening frequency improved after education (p<0.001) demonstrating a positive correlation over time (p<0.01). Multifaceted education is effective in improving delirium knowledge and screening; however, without sustained effort, progress is transient. Education improved perceived tool utility and over time utility perception and physician value improved. Copyright © 2017 Elsevier Ltd. All rights reserved.

Constructing an adaptive care model for the management of disease-related symptoms throughout the course of multiple sclerosis--performance improvement CME.

PubMed

Miller, Aaron E; Cohen, Bruce A; Krieger, Stephen C; Markowitz, Clyde E; Mattson, David H; Tselentis, Helen N

2014-01-01

Symptom management remains a challenging clinical aspect of MS. To design a performance improvement continuing medical education (PI CME) activity for better clinical management of multiple sclerosis (MS)-related depression, fatigue, mobility impairment/falls, and spasticity. Ten volunteer MS centers participated in a three-stage PI CME model: A) baseline assessment; B) practice improvement CME intervention; C) reassessment. Expert faculty developed performance measures and activity intervention tools. Designated MS center champions reviewed patient charts and entered data into an online database. Stage C data were collected eight weeks after implementation of the intervention and compared with Stage A baseline data to measure change in performance. Aggregate data from the 10 participating MS centers (405 patient charts) revealed performance improvements in the assessment of all four MS-related symptoms. Statistically significant improvements were found in the documented assessment of mobility impairment/falls (p=0.003) and spasticity (p<0.001). For documentation of care plans, statistically significant improvements were reported for fatigue (p=0.007) and mobility impairment/falls (p=0.040); non-significant changes were noted for depression and spasticity. Our PI CME interventions demonstrated performance improvement in the management of MS-related symptoms. This PI CME model (available at www.achlpicme.org/ms/toolkit) offers a new perspective on enhancing symptom management in patients with MS.

Effect of Tai Chi Exercise Combined with Mental Imagery Theory in Improving Balance in a Diabetic and Elderly Population.

PubMed

Alsubiheen, Abdulrahman; Petrofsky, Jerrold; Daher, Noha; Lohman, Everett; Balbas, Edward

2015-10-10

One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40-80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week for 8 weeks. Each session was one hour long. Measures were taken using a balance platform test, an Activities-specific Balance Confidence (ABC) Scale, a one leg standing test (OLS), functional reach test (FRT) and hemoglobin A1C. These measures were taken twice, pre and post-study, for both groups. Both groups experienced significant improvements in ABC, OLS, FRT (P<0.01) after completing 8 weeks of TC exercise with no significant improvement between groups. Subjects using the balance platform test demonstrated improvement in balance in all different tasks with no significant change between groups. There was no significant change in HbA1C for the diabetic group. All results showed an improvement in balance in the diabetic and the control groups; however, no significant difference between the groups was observed. Since the DM group had more problems with balance impairment at baseline than the control, the diabetic group showed the most benefit from the TC exercise.

Reexamining the iconic dihadron correlation measurement demonstrating jet quenching

DOE PAGES

Nattrass, Christine

2018-03-28

We report that early measurements at the BNL Relativistic Heavy Ion Collider (RHIC) demonstrated jet quenching through the suppression of pairs of high momentum hadrons. These dihadron correlations have a large correlated background. As understanding of the background improved, it was recognized in the field that a significant term was omitted from the background and several dihadron correlation results were quantitatively and qualitatively incorrect. The original measurements demonstrating jet quenching have not been revisited. These measurements are repeated in this paper in a kinematic range similar to the original measurement using publicly available data, applying current knowledge about the background.more » Finally, the new results are qualitatively consistent with the previous results, demonstrating complete suppression of the away side within uncertainties.« less

Reexamining the iconic dihadron correlation measurement demonstrating jet quenching

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

Nattrass, Christine

We report that early measurements at the BNL Relativistic Heavy Ion Collider (RHIC) demonstrated jet quenching through the suppression of pairs of high momentum hadrons. These dihadron correlations have a large correlated background. As understanding of the background improved, it was recognized in the field that a significant term was omitted from the background and several dihadron correlation results were quantitatively and qualitatively incorrect. The original measurements demonstrating jet quenching have not been revisited. These measurements are repeated in this paper in a kinematic range similar to the original measurement using publicly available data, applying current knowledge about the background.more » Finally, the new results are qualitatively consistent with the previous results, demonstrating complete suppression of the away side within uncertainties.« less

Preoperative Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) for Patients Undergoing Hip Arthroscopy: Indices Are Predictive of Magnitude of Improvement in Two-Year Patient-Reported Outcomes.

PubMed

Chandrasekaran, Sivashankar; Vemula, S Pavan; Lindner, Dror; Lodhia, Parth; Suarez-Ahedo, Carlos; Domb, Benjamin G

2015-08-19

Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) has been used in the detection of chondropathy. Our study aimed to determine whether dGEMRIC indices are predictive of two-year patient-reported outcomes and pain scores following hip arthroscopy. Between August 2008 and April 2012, sixty-five patients (seventy-four hips) underwent primary hip arthroscopy with preoperative dGEMRIC and a minimum of two years of follow-up. Exclusion criteria were previous hip surgery, slipped capital femoral epiphysis, inflammatory arthropathy, Legg-Calvé-Perthes disease, and arthritis of >1 Tönnis grade. Patients were classified in two groups on the basis of a dGEMRIC cutoff of 323 msec, which was one standard deviation (SD) below the study cohort mean dGEMRIC index of 426 msec. Patient-reported outcome tools used included the modified Harris hip score (mHHS), the Nonarthritic Hip Score (NAHS), the Hip Outcome Score Activities of Daily Living (HOS-ADL), and the Hip Outcome Score Sport-Specific Subscale (HOS-SSS) as well as a visual analog scale (VAS) for pain and a patient satisfaction score. There were sixty-four hips that met the inclusion criteria; fifty-two (81.3%) had a minimum of two years of follow-up. Twelve of the sixty-four hips had a dGEMRIC index of <323 msec (Group 1), and fifty-two hips had a dGEMRIC index of ≥323 msec (Group 2). There was no significant difference between the groups with respect to age, sex, and body mass index. There was no significant difference between the groups in mean preoperative patient-reported outcome scores and the VAS for pain. At the two-year follow-up, Group 1 had significant improvement in the mHHS, whereas Group 2 demonstrated significant improvement in all patient-reported outcome scores and the VAS. The improvement in all patient-reported outcome scores was significantly larger for Group 2 compared with Group 1. There was no significant difference in patient satisfaction between groups and no significant correlation between dGEMRIC indices and the patient-reported outcome measures. Patients with a dGEMRIC index of ≥323 msec (less than one SD below the cohort mean) demonstrated significantly greater improvement in patient-reported outcome scores and the VAS for pain after hip arthroscopy. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Final Technical Report. Project Boeing SGS

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

Bell, Thomas E.

Boeing and its partner, PJM Interconnection, teamed to bring advanced “defense-grade” technologies for cyber security to the US regional power grid through demonstration in PJM’s energy management environment. Under this cooperative project with the Department of Energy, Boeing and PJM have developed and demonstrated a host of technologies specifically tailored to the needs of PJM and the electric sector as a whole. The team has demonstrated to the energy industry a combination of processes, techniques and technologies that have been successfully implemented in the commercial, defense, and intelligence communities to identify, mitigate and continuously monitor the cyber security of criticalmore » systems. Guided by the results of a Cyber Security Risk-Based Assessment completed in Phase I, the Boeing-PJM team has completed multiple iterations through the Phase II Development and Phase III Deployment phases. Multiple cyber security solutions have been completed across a variety of controls including: Application Security, Enhanced Malware Detection, Security Incident and Event Management (SIEM) Optimization, Continuous Vulnerability Monitoring, SCADA Monitoring/Intrusion Detection, Operational Resiliency, Cyber Range simulations and hands on cyber security personnel training. All of the developed and demonstrated solutions are suitable for replication across the electric sector and/or the energy sector as a whole. Benefits identified include; Improved malware and intrusion detection capability on critical SCADA networks including behavioral-based alerts resulting in improved zero-day threat protection; Improved Security Incident and Event Management system resulting in better threat visibility, thus increasing the likelihood of detecting a serious event; Improved malware detection and zero-day threat response capability; Improved ability to systematically evaluate and secure in house and vendor sourced software applications; Improved ability to continuously monitor and maintain secure configuration of network devices resulting in reduced vulnerabilities for potential exploitation; Improved overall cyber security situational awareness through the integration of multiple discrete security technologies into a single cyber security reporting console; Improved ability to maintain the resiliency of critical systems in the face of a targeted cyber attack of other significant event; Improved ability to model complex networks for penetration testing and advanced training of cyber security personnel« less

60 seconds to survival: A pilot study of a disaster triage video game for prehospital providers.

PubMed

Cicero, Mark X; Whitfill, Travis; Munjal, Kevin; Madhok, Manu; Diaz, Maria Carmen G; Scherzer, Daniel J; Walsh, Barbara M; Bowen, Angela; Redlener, Michael; Goldberg, Scott A; Symons, Nadine; Burkett, James; Santos, Joseph C; Kessler, David; Barnicle, Ryan N; Paesano, Geno; Auerbach, Marc A

2017-01-01

Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. Participants recorded their demographics and highest EMS training level and were randomized to play 60S (intervention) or serve as controls. At baseline, all participants completed a live school-shooting simulation in which manikins and standardized patients depicted 10 adult and pediatric victims. The intervention group then played 60S at least three times over the course of 13 weeks (time 2). Players triaged 12 patients in three scenarios (school shooting, house fire, tornado), and received in-game performance feedback. At time 2, the same live simulation was conducted for all participants. Controls had no disaster training during the study. The main outcome was improvement in triage accuracy in live simulations from baseline to time 2. Physicians and EMS providers predetermined expected triage level (RED/YELLOW/GREEN/BLACK) via modified Delphi method. There were 26 participants in the intervention group and 21 in the control group. There was no difference in gender, level of training, or years of EMS experience (median 5.5 years intervention, 3.5 years control, p = 0.49) between the groups. At baseline, both groups demonstrated median triage accuracy of 80 percent (IQR 70-90 percent, p = 0.457). At time 2, the intervention group had a significant improvement from baseline (median accuracy = 90 percent [IQR: 80-90 percent], p = 0.005), while the control group did not (median accuracy = 80 percent [IQR:80-95], p = 0.174). However, the mean improvement from baseline was not significant between the two groups (difference = 6.5, p = 0.335). The intervention demonstrated a significant improvement in accuracy from baseline to time 2 while the control did not. However, there was no significant difference in the improvement between the intervention and control groups. These results may be due to small sample size. Future directions include assessment of the game's effect on triage accuracy with a larger, multisite site cohort and iterative development to improve 60S.

Impact of short-chain galactooligosaccharides on the gut microbiome of lactose-intolerant individuals.

PubMed

Azcarate-Peril, M Andrea; Ritter, Andrew J; Savaiano, Dennis; Monteagudo-Mera, Andrea; Anderson, Carlton; Magness, Scott T; Klaenhammer, Todd R

2017-01-17

Directed modulation of the colonic bacteria to metabolize lactose effectively is a potentially useful approach to improve lactose digestion and tolerance. A randomized, double-blind, multisite placebo-controlled trial conducted in human subjects demonstrated that administration of a highly purified (>95%) short-chain galactooligosaccharide (GOS), designated "RP-G28," significantly improved clinical outcomes for lactose digestion and tolerance. In these individuals, stool samples were collected pretreatment (day 0), after GOS treatment (day 36), and 30 d after GOS feeding stopped and consumption of dairy products was encouraged (day 66). In this study, changes in the fecal microbiome were investigated using 16S rRNA amplicon pyrosequencing and high-throughput quantitative PCR. At day 36, bifidobacterial populations were increased in 27 of 30 of GOS subjects (90%), demonstrating a bifidogenic response in vivo. Relative abundance of lactose-fermenting Bifidobacterium, Faecalibacterium, and Lactobacillus were significantly increased in response to GOS. When dairy was introduced into the diet, lactose-fermenting Roseburia species increased from day 36 to day 66. The results indicated a definitive change in the fecal microbiome of lactose-intolerant individuals, increasing the abundance of lactose-metabolizing bacteria that were responsive to dietary adaptation to GOS. This change correlated with clinical outcomes of improved lactose tolerance.

Impact of short-chain galactooligosaccharides on the gut microbiome of lactose-intolerant individuals

PubMed Central

Azcarate-Peril, M. Andrea; Ritter, Andrew J.; Savaiano, Dennis; Monteagudo-Mera, Andrea; Anderson, Carlton; Magness, Scott T.; Klaenhammer, Todd R.

2017-01-01

Directed modulation of the colonic bacteria to metabolize lactose effectively is a potentially useful approach to improve lactose digestion and tolerance. A randomized, double-blind, multisite placebo-controlled trial conducted in human subjects demonstrated that administration of a highly purified (>95%) short-chain galactooligosaccharide (GOS), designated “RP-G28,” significantly improved clinical outcomes for lactose digestion and tolerance. In these individuals, stool samples were collected pretreatment (day 0), after GOS treatment (day 36), and 30 d after GOS feeding stopped and consumption of dairy products was encouraged (day 66). In this study, changes in the fecal microbiome were investigated using 16S rRNA amplicon pyrosequencing and high-throughput quantitative PCR. At day 36, bifidobacterial populations were increased in 27 of 30 of GOS subjects (90%), demonstrating a bifidogenic response in vivo. Relative abundance of lactose-fermenting Bifidobacterium, Faecalibacterium, and Lactobacillus were significantly increased in response to GOS. When dairy was introduced into the diet, lactose-fermenting Roseburia species increased from day 36 to day 66. The results indicated a definitive change in the fecal microbiome of lactose-intolerant individuals, increasing the abundance of lactose-metabolizing bacteria that were responsive to dietary adaptation to GOS. This change correlated with clinical outcomes of improved lactose tolerance. PMID:28049818

High Performance Carbon Nanotube Yarn Supercapacitors with a Surface-Oxidized Copper Current Collector.

PubMed

Zhang, Daohong; Wu, Yunlong; Li, Ting; Huang, Yin; Zhang, Aiqing; Miao, Menghe

2015-11-25

Threadlike linear supercapacitors have demonstrated high potential for constructing fabrics to power electronic textiles (eTextiles). To improve the cyclic electrochemical performance and to produce power fabrics large enough for practical applications, a current collector has been introduced into the linear supercapcitors to transport charges produced by active materials along the length of the supercapacitor with high efficiency. Here, we first screened six candidate metal filaments (Pt, Au, Ag, AuAg, PtCu, and Cu) as current collectors for carbon nanotube (CNT) yarn-based linear supercapacitors. Although all of the metal filaments significantly improved the electrochemical performance of the linear supercapacitor, two supercapacitors constructed from Cu and PtCu filaments, respectively, demonstrate far better electrochemical performance than the other four supercapacitors. Further investigation shows that the surfaces of the two Cu-containing filaments are oxidized by the surrounding polymer electrolyte in the electrode. While the unoxidized core of the Cu-containing filaments remains highly conductive and functions as a current collector, the resulting CuO on the surface is an electrochemically active material. The linear supercapacitor architecture incorporating dual active materials CNT + Cu extends the potential window from 1.0 to 1.4 V, leading to significant improvement to the energy density and power density.

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure.

PubMed

Roy, Sanjoy; Hammond, Jeffrey; Panish, Jessica; Shnoda, Pullen; Savidge, Sandy; Wilson, Mark

2015-01-01

This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAP ™ Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p < 0.00001). Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p < 0.001). Scores in five of the six sources of stress were significantly lower for mechanical fixation. Mechanical fixation with ETHICON SECURESTRAP ™ Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure.

Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

PubMed Central

Roy, Sanjoy; Hammond, Jeffrey; Panish, Jessica; Shnoda, Pullen; Savidge, Sandy; Wilson, Mark

2015-01-01

Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p < 0.00001). Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p < 0.001). Scores in five of the six sources of stress were significantly lower for mechanical fixation. Conclusions. Mechanical fixation with ETHICON SECURESTRAPTM Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure. PMID:26240834

Compensated second-order recoupling: application to third spin assisted recoupling†

PubMed Central

Giffard, Mathilde; Hediger, Sabine; Lewandowski, Józef R.; Bardet, Michel; Simorre, Jean-Pierre; Griffin, Robert G.; De Paëpe, Gaël

2015-01-01

We consider the effect of phase shifts in the context of second-order recoupling techniques in solid-state NMR. Notably we highlight conditions leading to significant improvements for the Third Spin Assisted Recoupling (TSAR) mechanism and demonstrate the benefits of resulting techniques for detecting long-distance transfer in biomolecular systems. The modified pulse sequences of PAR and PAIN-CP, Phase-Shifted Proton Assisted Recoupling (AH-PS-PAR) and Phase-Shifted Proton-Assisted Insensitive Nuclei Cross Polarization (ABH-PS-PAIN-CP), still rely on cross terms between heteronuclear dipolar couplings involving assisting protons that mediate zero-quantum polarization transfer between low-γ nuclei (13C–13C, 15N–15N, 15N–13C polarization transfer). Using Average Hamiltonian Theory we show that phase inversion compensates off-resonance contributions and yields improved polarization transfer as well as substantial broadening of the matching conditions. PS-TSAR greatly improves on the standard TSAR based methods because it alleviates their sensitivity to precise RF settings which significantly enhances robustness of the experiments. We demonstrate these new methods on a 19.6 kDa protein (U–[15N, 13C]-YajG) at high magnetic fields (up to 900 MHz 1H frequency) and fast sample spinning (up to 65 kHz MAS frequency). PMID:22513727

Automated target classification in high resolution dual frequency sonar imagery

NASA Astrophysics Data System (ADS)

Aridgides, Tom; Fernández, Manuel

2007-04-01

An improved computer-aided-detection / computer-aided-classification (CAD/CAC) processing string has been developed. The classified objects of 2 distinct strings are fused using the classification confidence values and their expansions as features, and using "summing" or log-likelihood-ratio-test (LLRT) based fusion rules. The utility of the overall processing strings and their fusion was demonstrated with new high-resolution dual frequency sonar imagery. Three significant fusion algorithm improvements were made. First, a nonlinear 2nd order (Volterra) feature LLRT fusion algorithm was developed. Second, a Box-Cox nonlinear feature LLRT fusion algorithm was developed. The Box-Cox transformation consists of raising the features to a to-be-determined power. Third, a repeated application of a subset feature selection / feature orthogonalization / Volterra feature LLRT fusion block was utilized. It was shown that cascaded Volterra feature LLRT fusion of the CAD/CAC processing strings outperforms summing, baseline single-stage Volterra and Box-Cox feature LLRT algorithms, yielding significant improvements over the best single CAD/CAC processing string results, and providing the capability to correctly call the majority of targets while maintaining a very low false alarm rate. Additionally, the robustness of cascaded Volterra feature fusion was demonstrated, by showing that the algorithm yields similar performance with the training and test sets.

Synthesis of Non-uniformly Pr-doped SrTiO3 Ceramics and Their Thermoelectric Properties

PubMed Central

Mehdizadeh Dehkordi, Arash; Bhattacharya, Sriparna; Darroudi, Taghi; Zeng, Xiaoyu; Alshareef, Husam N.; Tritt, Terry M.

2015-01-01

We demonstrate a novel synthesis strategy for the preparation of Pr-doped SrTiO3 ceramics via a combination of solid state reaction and spark plasma sintering techniques. Polycrystalline ceramics possessing a unique morphology can be achieved by optimizing the process parameters, particularly spark plasma sintering heating rate. The phase and morphology of the synthesized ceramics were investigated in detail using X-ray diffraction, scanning electron microcopy and energy-dispersive X-ray spectroscopy. It was observed that the grains of these bulk Pr-doped SrTiO3 ceramics were enhanced with Pr-rich grain boundaries. Electronic and thermal transport properties were also investigated as a function of temperature and doping concentration. Such a microstructure was found to give rise to improved thermoelectric properties. Specifically, it resulted in a significant improvement in carrier mobility and the thermoelectric power factor. Simultaneously, it also led to a marked reduction in the thermal conductivity. As a result, a significant improvement (> 30%) in the thermoelectric figure of merit was achieved for the whole temperature range over all previously reported maximum values for SrTiO3-based ceramics. This synthesis demonstrates the steps for the preparation of bulk polycrystalline ceramics of non-uniformly Pr-doped SrTiO3. PMID:26327483

Non-descanned multifocal multiphoton microscopy with a multianode photomultiplier tube

PubMed Central

Cha, Jae Won; Yew, Elijah Y. S.; Kim, Daekeun; Subramanian, Jaichandar; Nedivi, Elly; So, Peter T. C.

2015-01-01

Multifocal multiphoton microscopy (MMM) improves imaging speed over a point scanning approach by parallelizing the excitation process. Early versions of MMM relied on imaging detectors to record emission signals from multiple foci simultaneously. For many turbid biological specimens, the scattering of emission photons results in blurred images and degrades the signal-to-noise ratio (SNR). We have recently demonstrated that a multianode photomultiplier tube (MAPMT) placed in a descanned configuration can effectively collect scattered emission photons from each focus into their corresponding anodes significantly improving image SNR for highly scattering specimens. Unfortunately, a descanned MMM has a longer detection path resulting in substantial emission photon loss. Optical design constraints in a descanned geometry further results in significant optical aberrations especially for large field-of-view (FOV), high NA objectives. Here, we introduce a non-descanned MMM based on MAPMT that substantially overcomes most of these drawbacks. We show that we improve signal efficiency up to fourfold with limited image SNR degradation due to scattered emission photons. The excitation foci can also be spaced wider to cover the full FOV of the objective with minimal aberrations. The performance of this system is demonstrated by imaging interneuron morphological structures deep in the brains of living mice. PMID:25874160

Proposed Criteria for the Use of Low-Dose Vitamin K Supplementation in Patients Using Vitamin K Antagonists: A Literature Review of a Clinical Controversy.

PubMed

Evans, Christy E; Getchell, Katerine E; Ivy, Delaney R

2018-04-01

Vitamin K antagonists (VKAs) have been used for decades to prevent thromboembolic events, but can be burdensome to patients based on numerous factors impacting anticoagulation control. Low-dose vitamin K supplementation has been theorized to improve anticoagulation control in patients on VKAs that may be vitamin K deficient. The objective of this literature review is to propose criteria for implementing low-dose vitamin K supplementation in patients on VKAs. The CHEST 2012 antithrombotic guidelines recommended against routine use of vitamin K supplementation in patients on VKAs. An observational study and three randomized controlled trials pertaining to this recommendation were evaluated. A literature review was also performed on other studies looking at the impact of low-dose vitamin K supplementation on anticoagulation control through a search in PubMed and the Cochrane Database of Systematic Reviews. One retrospective and two prospective studies were reviewed. Six of the seven studies demonstrated a non-statistically significant trend in data supporting improvement in anticoagulation control with low-dose vitamin K supplementation. While many of the studies did not achieve significant results, the majority demonstrated a trend in support of the improvement of anticoagulation control with low-dose vitamin K supplementation in patients on VKAs.

Laser-only Adaptive Optics Achieves Significant Image Quality Gains Compared to Seeing-limited Observations over the Entire Sky

NASA Astrophysics Data System (ADS)

Howard, Ward S.; Law, Nicholas M.; Ziegler, Carl A.; Baranec, Christoph; Riddle, Reed

2018-02-01

Adaptive optics laser guide-star systems perform atmospheric correction of stellar wavefronts in two parts: stellar tip-tilt and high-spatial-order laser correction. The requirement of a sufficiently bright guide star in the field-of-view to correct tip-tilt limits sky coverage. In this paper, we show an improvement to effective seeing without the need for nearby bright stars, enabling full sky coverage by performing only laser-assisted wavefront correction. We used Robo-AO, the first robotic AO system, to comprehensively demonstrate this laser-only correction. We analyze observations from four years of efficient robotic operation covering 15000 targets and 42000 observations, each realizing different seeing conditions. Using an autoguider (or a post-processing software equivalent) and the laser to improve effective seeing independent of the brightness of a target, Robo-AO observations show a 39% ± 19% improvement to effective FWHM, without any tip-tilt correction. We also demonstrate that 50% encircled energy performance without tip-tilt correction remains comparable to diffraction-limited, standard Robo-AO performance. Faint-target science programs primarily limited by 50% encircled energy (e.g., those employing integral field spectrographs placed behind the AO system) may see significant benefits to sky coverage from employing laser-only AO.

Synthesis of Non-uniformly Pr-doped SrTiO3 Ceramics and Their Thermoelectric Properties.

PubMed

Mehdizadeh Dehkordi, Arash; Bhattacharya, Sriparna; Darroudi, Taghi; Zeng, Xiaoyu; Alshareef, Husam N; Tritt, Terry M

2015-08-15

We demonstrate a novel synthesis strategy for the preparation of Pr-doped SrTiO3 ceramics via a combination of solid state reaction and spark plasma sintering techniques. Polycrystalline ceramics possessing a unique morphology can be achieved by optimizing the process parameters, particularly spark plasma sintering heating rate. The phase and morphology of the synthesized ceramics were investigated in detail using X-ray diffraction, scanning electron microcopy and energy-dispersive X-ray spectroscopy. It was observed that the grains of these bulk Pr-doped SrTiO3 ceramics were enhanced with Pr-rich grain boundaries. Electronic and thermal transport properties were also investigated as a function of temperature and doping concentration. Such a microstructure was found to give rise to improved thermoelectric properties. Specifically, it resulted in a significant improvement in carrier mobility and the thermoelectric power factor. Simultaneously, it also led to a marked reduction in the thermal conductivity. As a result, a significant improvement (> 30%) in the thermoelectric figure of merit was achieved for the whole temperature range over all previously reported maximum values for SrTiO3-based ceramics. This synthesis demonstrates the steps for the preparation of bulk polycrystalline ceramics of non-uniformly Pr-doped SrTiO3.

Impact of Remote Monitoring on Clinical Outcomes.

PubMed

Varma, Niraj; Ricci, Renato Pietro

2015-12-01

Follow-up of patients with cardiac implantable electronic devices is challenging due to both their increasing volume and technical complexity coupled to increasing clinical complexity of recipient patients. Remote monitoring (RM) offers an opportunity to resolve some of these difficulties by improving clinic efficiencies and providing a mechanism for device monitoring and patient management. Several recent randomized clinical trials and registries have demonstrated that RM may reduce in-hospital visit numbers, time required for patient follow-up, physician and nurse time, and hospital and social costs. Furthermore, patient retention and adherence to follow-up schedule are significantly improved by RM. Continuous wireless monitoring of data stored in the device memory with automatic alerts allows early detection of device malfunctions and of events, such as atrial fibrillation, ventricular arrhythmias, and heart failure suitable for clinical intervention. Early reaction may improve patient outcome. RM is easy to use and patients showed a high level of acceptance and satisfaction. Implementing RM in daily practice may require changes in clinic workflow. New organizational models promote significant efficiencies regarding physician and nursing time. Data management techniques are under development. Despite these demonstrable advantages of RM, adoption still remains modest, even in health care systems incentivized to use this follow-up method. © 2015 Wiley Periodicals, Inc.

Shoulder function and anatomy in complete obstetric brachial plexus palsy: long-term improvement after triangle tilt surgery

PubMed Central

Karicherla, Priyanka; Mahmooduddin, Faiz

2010-01-01

Purpose Untreated complete obstetric brachial plexus injury (COBPI) usually results in limited spontaneous recovery of shoulder function. Older methods used to treat COBPI have had questionable success, with very few studies being published. The purpose of the current study was to examine the results of triangle tilt surgery on shoulder function and development in COBPI individuals. Methods This study was conducted as a retrospective chart review. Inclusion criteria were COBPI patients that had undergone the triangle tilt procedure from 2005 to 2009 and were between the ages of 9 months and 12 years. COBPI was defined as permanent injury to all five nerve roots (C5–T1), with significant degradation in development and function of the hand. Twenty-five patients with a mean age of 5 (0.75–12) years were followed up clinically for more than 2 years. Results The triangle tilt procedure resulted in demonstrable clinical enhancements with appreciable improvements in shoulder function, glenoid version, and humeral head congruity. There was a significant increase in the overall Mallet score (2.4 points, p < 0.0001) following surgical correction in patients that were followed up for more than 2 years. Conclusions The results of this study demonstrate that COBPI patients who develop SHEAR and medial rotation contracture deformities can benefit from the triangle tilt surgery, which improves shoulder function and anatomy across a range of pediatric ages. Despite these patients presenting late for surgery in general (5 years), significant improvements were observed in their glenohumeral (GH) dysplasia and their ability to perform shoulder and arm movements following surgery. PMID:20473676

A randomized study assessing the efficacy of communication skill training on patients' psychologic distress and coping: nurses' communication with patients just after being diagnosed with cancer.

PubMed

Fukui, Sakiko; Ogawa, Keiko; Ohtsuka, Masao; Fukui, Naoshi

2008-09-15

Although studies have shown the usefulness of improving health professionals' communication skills by training, to the authors' knowledge none have demonstrated the efficacy of communication skill training (CST) for health professionals in terms of improving patient outcomes. This study aimed to assess the efficacy of CST for nurses in improving psychologic distress and coping among patients after being informed of a cancer diagnosis. Nurses who mainly provide patients with psychologic and informational support after being informed of their cancer diagnosis by physicians at a cancer screening center were randomly assigned to either an experimental or a control group; patients were supported by either group of nurses. Patient selection criteria were: age >18 years with gastric, colorectal, or breast cancer that was not in advanced stage. Intervention consisted of 3 1-on-1 nurses' interviews (on the day of, 1 week after, and 1 month after diagnosis). Efficacy was assessed through patients' psychologic distress and coping by administering the Hospital Anxiety and Depression Scale (HADS) and Mental Adjustment to Cancer scale (MAC), at 3 time points (1 week, 1 month, and 3 months after diagnosis). Eighty-nine patients participated. Repeated measures analysis of variance demonstrated a significant group-by-time decrease in patients' psychologic distress on HADS (P = .03), and significant group-by-time increase in fighting spirit and decrease of fatalism (P = .01 and P = .04, respectively), in addition to significant between-group difference of anxious preoccupation on the MAC (P = .003). Support by nurses who completed the CST program was found to reduce psychologic distress and improved coping long term among patients informed of their cancer diagnosis. (c) 2008 American Cancer Society.

Development and evaluation of a new alcohol-based surgical hand scrub formulation with persistent antimicrobial characteristics and brushless application.

PubMed

Hobson, D W; Woller, W; Anderson, L; Guthery, E

1998-10-01

Since the introduction in the 1970s of surgical hand scrub formulations that contain 4% chlorhexidine gluconate (CHG), new surgical scrub formulations that have improved efficacy, persistence, or significantly improved use characteristics have not been forthcoming. In addition, the manufacturer's labeling for popular hand scrub products generally requires scrub times in excess of 6 minutes, whereas current practical needs call for products with substantially shorter scrub times. A new alcohol-based surgical scrub formulation, which has ingredients that provide emollient, surfactant, and antimicrobial persistence characteristics to complement the rapid and broad-spectrum antiseptic qualities of alcohol, has been developed in an effort to address these current practical needs. The relative efficacy of a new alcohol-based surgical scrub formulation that contains ingredients that provide surfactant and antimicrobial persistence characteristics was compared with that of commercial 4% CHG and 7.5% povidone iodine (PVPI) formulations with use of human subjects. Hand antimicrobial count sampling was performed by using standardized "glove juice" methodology. The efficacy and persistence results of the new formulation showed statistically significant improvement over both CHG and PVPI at a substantially lessened scrub time (3 minutes). In addition, use of the new formulation without a scrub brush produced results statistically similar to 3-minute applications with either a brush or a sponge. The new alcohol-based formulation demonstrates promise as a new surgical hand scrub formulation with antimicrobial and use characteristics that are significantly improved over current CHG and PVPI formulations. These studies demonstrate the suitability of this formulation for use as a surgical hand scrub and for brushless application.

Combined rTMS and virtual reality brain-computer interface training for motor recovery after stroke

NASA Astrophysics Data System (ADS)

Johnson, N. N.; Carey, J.; Edelman, B. J.; Doud, A.; Grande, A.; Lakshminarayan, K.; He, B.

2018-02-01

Objective. Combining repetitive transcranial magnetic stimulation (rTMS) with brain-computer interface (BCI) training can address motor impairment after stroke by down-regulating exaggerated inhibition from the contralesional hemisphere and encouraging ipsilesional activation. The objective was to evaluate the efficacy of combined rTMS  +  BCI, compared to sham rTMS  +  BCI, on motor recovery after stroke in subjects with lasting motor paresis. Approach. Three stroke subjects approximately one year post-stroke participated in three weeks of combined rTMS (real or sham) and BCI, followed by three weeks of BCI alone. Behavioral and electrophysiological differences were evaluated at baseline, after three weeks, and after six weeks of treatment. Main results. Motor improvements were observed in both real rTMS  +  BCI and sham groups, but only the former showed significant alterations in inter-hemispheric inhibition in the desired direction and increased relative ipsilesional cortical activation from fMRI. In addition, significant improvements in BCI performance over time and adequate control of the virtual reality BCI paradigm were observed only in the former group. Significance. When combined, the results highlight the feasibility and efficacy of combined rTMS  +  BCI for motor recovery, demonstrated by increased ipsilesional motor activity and improvements in behavioral function for the real rTMS  +  BCI condition in particular. Our findings also demonstrate the utility of BCI training alone, as shown by behavioral improvements for the sham rTMS  +  BCI condition. This study is the first to evaluate combined rTMS and BCI training for motor rehabilitation and provides a foundation for continued work to evaluate the potential of both rTMS and virtual reality BCI training for motor recovery after stroke.

Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program.

PubMed

de Lima Sanches, Priscila; de Mello, Marco Túlio; Elias, Natália; Fonseca, Francisco Antonio Helfenstein; de Piano, Aline; Carnier, June; Oyama, Lila Missae; Tock, Lian; Tufik, Sergio; Dâmaso, Ana Raimunda

2011-02-01

The aim of this study was to verify whether a 1-year interdisciplinary weight-loss program improved common carotid artery intima-media thickness (IMT) and whether insulin resistance and/or inflammation (as measured by the markers plasminogen activator inhibitor type-1 and adiponectin) might underlie obesity in adolescents. A group of 29 post-pubescent obese adolescents were submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery IMT was determined ultrasonographically. Body composition, blood pressure (BP), glycemia, insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile and adipokine concentrations were analyzed before and after the intervention. The interdisciplinary weight-loss program promoted a significant improvement in body composition, insulin concentration, HOMA-IR, lipid profile, BP and inflammatory state, in addition to significantly decreasing the common carotid artery IMT. Furthermore, this study demonstrated that the difference between baseline and final values of HOMA-IR (ΔHOMA-IR) was negatively correlated with concomitant changes in the adiponectin concentration (Δadiponectin; r=-0.42; P=0.02) and positively correlated with changes in common carotid artery IMT (Δcarotid IMT; r=0.41; P=0.03). Multiple regression analysis adjusted by age, cardiovascular risk factors and inflammatory markers showed that ΔHOMA-IR was an independent predictor of significant changes in common carotid artery IMT. This investigation demonstrated that an interdisciplinary weight-loss program promoted a reduction of the common carotid artery IMT in obese Brazilian adolescents, and the improvement of HOMA-IR was an independent predictor of carotid IMT changes in this population.

Advances in the management of multiple sclerosis spasticity: recent clinical trials.

PubMed

Fernández, Oscar

2014-01-01

Most patients with multiple sclerosis (MS) experience spasticity as the clinical course evolves. Associated symptoms include (often painful) spasms, urinary dysfunction and sleep disturbances. THC:CBD oromucosal spray (Sativex®) is approved for symptom improvement in adult patients with moderate to severe MS-related spasticity who have not responded adequately to other antispasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy. In pivotal clinical trials of THC:CBD oromucosal spray, a meaningful proportion of patients with treatment-resistant MS spasticity achieved clinically relevant improvement with active treatment versus placebo. The utility of a 4-week trial of therapy to identify patients who respond to treatment was demonstrated in an enriched-design study. THC:CBD oromucosal spray was well tolerated in these studies, with no evidence of effects typically associated with recreational cannabis use. In a subsequent post approval clinical trial, THC:CBD oromucosal spray had no statistically significant effect on cognition and mood compared with placebo. Moreover, after 50 weeks' treatment, approximately two-thirds of patients, physicians and caregivers reported improvement from baseline in spasticity based on global impressions of change. Key Messages: In phase III clinical trials, approximately one-third of MS patients with treatment-resistant spasticity had a clinically relevant and statistically significant response to THC:CBD oromucosal spray. In addition to a reduction in spasticity, responders experienced meaningful relief from associated symptoms. THC:CBD oromucosal spray was generally well tolerated and efficacy was maintained over the longer term. A post-approval clinical trial indicated no effect of THC:CBD oromucosal spray on cognition or mood after 50 weeks of use. © 2014 S. Karger AG, Basel.

Impact of online education on intern behaviour around Joint Commission National Patient Safety Goals: A randomised trial

PubMed Central

TJ, Shaw; LIM, Pernar; SE, Peyre; JF, Helfrick; K, Vogelgesang; E, Graydon-Baker; Y, Chretien; EJ, Brown; J, Nicholson; JJ, Heit; JP, Co; TK, Gandhi

2014-01-01

Purpose To compare the effectiveness of 2 types of online learning methodologies for improving the patient-safety behaviours mandated in the Joint Commission National Patient Safety Goals (NPSG). Methods This randomized controlled trial was conducted in 2010 at Massachusetts General Hospital (MGH) and Brigham & Women’s Hospital (BWH) in Boston USA. Incoming interns were randomised to either receive an online Spaced Education program (SE) consisting of cases and questions that reinforce over time, or a program consisting of an online slide show followed by a quiz (SQ). The outcome measures included NPSG-knowledge improvement, NPSG-compliant behaviors in a simulation scenario, self reported confidence in safety and quality, program acceptability and program relevance. Results Both online learning programs improved knowledge retention. On four out of seven survey items measuring satisfaction and self reported confidence, the proportion of SE interns responding positively was significantly higher (p<0.05) than the fraction of SQ interns. SE interns demonstrated a mean 4.79 (36.6%) NPSG-compliant behaviors (out of 13 total), while SQ interns completed a mean 4.17 (32.0%) (p=0.09). Among those in surgical fields, SE interns demonstrated a mean 5.67 (43.6%) NPSG-compliant behaviors, while SQ interns completed a mean 2.33 (17.9%) (p=0.015). Focus group data indicates that SE was more contextually relevant than SQ and significantly more engaging. Conclusion While both online methodologies improved knowledge surrounding the NPSG, SE was more contextually relevant to trainees and engaging. SE impacted more significantly on both self reported confidence and the behaviour of surgical residents in a simulated scenario. PMID:22706930

Overcoming the research-to-practice gap: A randomized trial with two brief homework and organization interventions for students with ADHD as implemented by school mental health providers.

PubMed

Langberg, Joshua M; Dvorsky, Melissa R; Molitor, Stephen J; Bourchtein, Elizaveta; Eddy, Laura D; Smith, Zoe R; Oddo, Lauren E; Eadeh, Hana-May

2018-01-01

To evaluate the effectiveness of 2 brief school-based interventions targeting the homework problems of adolescents with attention-deficit/hyperactivity disorder (ADHD)-the Homework, Organization, and Planning Skills (HOPS) intervention and the Completing Homework by Improving Efficiency and Focus (CHIEF) intervention, as implemented by school mental health providers during the school day. A secondary goal was to use moderator analyses to identify student characteristics that may differentially predict intervention response. Two-hundred and eighty middle school students with ADHD were randomized to the HOPS or CHIEF interventions or to waitlist, and parent and teacher ratings were collected pre, post, and at a 6-month follow-up. Both interventions were implemented with fidelity by school mental health providers. Participants were pulled from elective periods and sessions averaged less than 20 min. Participants in HOPS and CHIEF demonstrated significantly greater improvements in comparison with waitlist on parent ratings of homework problems and organizational skills and effect sizes were large. HOPS participants also demonstrated moderate effect size improvements on materials management and organized action behaviors according to teachers. HOPS participants made significantly greater improvements in parent- and teacher-rated use of organized actions in comparison with CHIEF, but not on measures of homework problems. Moderation analyses revealed that participants with more severe psychopathology and behavioral dysregulation did significantly better with the HOPS intervention as compared to the CHIEF intervention. Brief school-based interventions implemented by school providers can be effective. This type of service delivery model may facilitate overcoming the oft cited research-to-practice gap. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Hip arthroscopy versus open surgical dislocation for femoroacetabular impingement

PubMed Central

Zhang, Dagang; Chen, Long; Wang, Guanglin

2016-01-01

Abstract Background: This meta-analysis aims to evaluate the efficacy and safety of hip arthroscopy versus open surgical dislocation for treating femoroacetabular impingement (FAI) through published clinical trials. Methods: We conducted a comprehensive literature search using PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials databases for relevant studies on hip arthroscopy and open surgical dislocation as treatment options for FAI. Results: Compared with open surgical dislocation, hip arthroscopy resulted in significantly higher Nonarthritic Hip Scores (NAHS) at 3- and 12-month follow-ups, a significant improvement in NAHS from preoperation to 3 months postoperation, and a significantly lower reoperation rate. Open surgical dislocation resulted in a significantly improved alpha angle by the Dunn view in patients with cam osteoplasty from preoperation to postoperation, compared with hip arthroscopy. This meta-analysis demonstrated no significant differences in the modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, or Hip Outcome Score-Sport Specific Subscale at 12 months of follow-up, or in complications (including nerve damage, wound infection, and wound dehiscence). Conclusion: Hip arthroscopy resulted in higher NAHS and lower reoperation rates, but had less improvement in alpha angle in patients with cam osteoplasty, than open surgical dislocation. PMID:27741133

Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement

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

Mothiram, Ursula; Brennan, Patrick C; Robinson, John

2013-12-15

Following X-ray exposure, radiographers receive immediate feedback on detector exposure in the form of the exposure index (EI). To identify whether radiographers are meeting manufacturer-recommended EI (MREI) ranges for routine chest, abdomen and pelvis X-ray examinations under a variety of conditions and to examine factors affecting the EI. Data on 5000 adult X-ray examinations including the following variables were collected: examination parameters, EI values, patient gender, date of birth, date and time of examination, grid usage and the presence of implant or prosthesis. Descriptive statistics were used to summarize each data set and the Mann–Whitney U test was used tomore » determine significant differences, with P < 0.05 indicating significance for all tests. Most examinations demonstrated EI values that were outside the MREI ranges, with significantly higher median EI values recorded for female patient radiographs than those for male patients for all manufacturers, indicating higher detector exposures for all units except for Philips digital radiography (DR), where increased EI values indicate lower exposure (P = 0.01). Median EI values for out of hours radiography were also significantly higher compared with normal working hours for all technologies (P ≤ 0.02). Significantly higher median EI values were demonstrated for Philips DR chest X-rays without as compared to those with the employment of a grid (P = 0.03), while significantly lower median EI values were recorded for Carestream Health computed radiography (CR) chest X-rays when an implant or prosthesis was present (P = 0.02). Non-adherence to MREIs has been demonstrated with EI value discrepancies being dependent on patient gender, time/day of exposure, grid usage and the presence of an implant or prosthesis. Retrospective evaluation of EI databases is a valuable tool to assess the need of quality improvement in routine DR.« less

Behavioral intervention for problem behavior in children with fragile X syndrome.

PubMed

Moskowitz, Lauren J; Carr, Edward G; Durand, V Mark

2011-11-01

Parents and professionals typically report problem behavior as a significant concern for children with fragile X syndrome. In the present study, the authors explored whether behaviorally based interventions would result in a reduction in problem behavior and an improvement in quality of life for 3 children with fragile X syndrome and their families. A multiple baseline design was used to demonstrate intervention effects for specific high-priority contexts (i.e., bedtime, running errands, and toileting). A multicomponent intervention plan was developed to teach the parents and child to effectively cope with the particular context. After intervention, there were substantial improvements in problem behavior and family quality of life within the given contexts. Results of this study demonstrated the effectiveness of behavioral intervention for children with fragile X syndrome.

Demonstration of organic volatile decomposition and bacterial sterilization by miniature dielectric barrier discharges on low-temperature cofired ceramic electrodes

NASA Astrophysics Data System (ADS)

Kim, Duk-jae; Shim, Yeun-keun; Park, Jeongwon; Kim, Hyung-jun; Han, Jeon-geon

2016-04-01

Nonthermal atmospheric-pressure plasma discharge is designed with low-temperature cofired ceramic (LTCC) electrodes to achieve dielectric barrier surface discharge (DBSD). The environmental requirement (below 0.05 ppm) of the amount of byproducts (ozone and NO x ) produced during the process was met by optimizing the electrode design to produce a high dielectric barrier discharge for low-voltage (∼700 V) operation and minimizing the distance between electrodes to improve the plasma discharging efficiency. The concentrations of volatile organic compounds (VOCs) within interior cabins of commercial vehicles were significantly reduced after 1-h treatment to improve air quality cost-effectively. This atmospheric-pressure plasma process was demonstrated for the sterilization of Escherichia coli to prevent food poisoning during the preservation of food in refrigerators.

Rapid and Programmable Protein Mutagenesis Using Plasmid Recombineering.

PubMed

Higgins, Sean A; Ouonkap, Sorel V Y; Savage, David F

2017-10-20

Comprehensive and programmable protein mutagenesis is critical for understanding structure-function relationships and improving protein function. There is thus a need for robust and unbiased molecular biological approaches for the construction of the requisite comprehensive protein libraries. Here we demonstrate that plasmid recombineering is a simple and robust in vivo method for the generation of protein mutants for both comprehensive library generation as well as programmable targeting of sequence space. Using the fluorescent protein iLOV as a model target, we build a complete mutagenesis library and find it to be specific and comprehensive, detecting 99.8% of our intended mutations. We then develop a thermostability screen and utilize our comprehensive mutation data to rapidly construct a targeted and multiplexed library that identifies significantly improved variants, thus demonstrating rapid protein engineering in a simple protocol.

Propulsion system-flight control integration-flight evaluation and technology transition

NASA Technical Reports Server (NTRS)

Burcham, Frank W., Jr.; Gilyard, Glenn B.; Myers, Lawrence P.

1990-01-01

Integration of propulsion and flight control systems and their optimization offering significant performance improvement are assessed. In particular, research programs conducted by NASA on flight control systems and propulsion system-flight control interactions on the YF-12 and F-15 aircraft are addressed; these programs have demonstrated increased thrust, reduced fuel consumption, increased engine life, and improved aircraft performance. Focus is placed on altitude control, speed-Mach control, integrated controller design, as well as flight control systems and digital electronic engine control. A highly integrated digital electronic control program is analyzed and compared with a performance seeking control program. It is shown that the flight evaluation and demonstration of these technologies have been a key part in the transition of the concepts to production and operational use on a timely basis.

Individualised Expert Feedback is Not Essential for Improving Basic Clinical Skills Performance in Novice Learners: A Randomized Trial.

PubMed

Phillips, Alexander W; Matthan, Joanna; Bookless, Lucy R; Whitehead, Ian J; Madhavan, Anantha; Rodham, Paul; Porter, Anna L R; Nesbitt, Craig I; Stansby, Gerard

To determine whether unsupervised video feedback (UVF) is as effective as direct expert feedback (DEF) in improving clinical skills performance for medical students learning basic surgical skills-intravenous cannulation, catheterization, and suturing. Feedback is a vital component of the learning process, yet great variation persists in its quality, quantity, and methods of delivery. The use of video technology to assist in the provision of feedback has been adopted increasingly. A prospective, blinded randomized trial comparing DEF, an expert reviewing students' performances with subsequent improvement suggestions, and UVF, students reviewing their own performance with an expert teaching video, was carried out. Medical students received an initial teaching lecture on intravenous cannulation, catheterization, and suturing and were then recorded performing the task. They subsequently received either DEF or UVF before reperforming the task. Students' recordings were additionally scored by 2 blinded experts using a validated proforma. A total of 71 medical students were recruited. Cannulation scores improved 4.3% with DEF and 9.5% with UVF (p = 0.044), catheterization scores improved 8.7% with DEF and 8.9% with UVF (p = 0.96), and suturing improved 15.6% with DEF and 13.2% with UVF (p = 0.54). Improvement from baseline scores was significant in all cases (p < 0.05). Video-assisted feedback allows a significant improvement in clinical skills for novices. No significant additional benefit was demonstrated from DEF, and a similar improvement can be obtained using a generic expert video and allowing students to review their own performance. This could have significant implications for the design and delivery of such training. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Resistance training with creatine monohydrate improves upper-body strength in patients with Parkinson disease: a randomized trial.

PubMed

Hass, Chris J; Collins, Mitchell A; Juncos, Jorge L

2007-01-01

Persons with Parkinson disease (PD) exhibit decreased muscular fitness including decreased muscle mass, muscle strength, bioenergetic capabilities and increased fatigability. This purpose of this investigation was to evaluate the therapeutic effects of resistance training with and without creatine supplementation in patients with mild to moderate PD. Twenty patients with idiopathic PD were randomized to receive creatine monohydrate supplementation plus resistance training (CRE) or placebo (lactose monohydrate) plus resistance training (PLA), using a double-blind procedure. Creatine and placebo supplementation consisted of 20 g/d for the first 5 days and 5 g/d thereafter. Both groups participated in progressive resistance training (24 sessions, 2 times per week, 1 set of 8-12 repetitions, 9 exercises). Participants performed 1-repetition maximum (1-RM) for chest press, leg extension, and biceps curl. Muscular endurance was evaluated for chest press and leg extension as the number of repetitions to failure using 60% of baseline 1-RM. Functional performance was evaluated as the time to perform 3 consecutive chair rises. Statistical analyses (ANOVA) revealed significant Group x Time interactions for chest press strength and biceps curl strength, and post hoc testing revealed that the improvement was significantly greater for CRE. Chair rise performance significantly improved only for CRE (12%, P=.03). Both PLA and CRE significantly improved 1-RM for leg extension (PLA: 16%; CRE: 18%). Muscular endurance improved significantly for both groups. These findings demonstrate that creatine supplementation can enhance the benefits of resistance training in patients with PD.

Glove use among hairdressers: difficulties in the correct use of gloves among hairdressers and the effect of education.

PubMed

Oreskov, Katia W; Søsted, Heidi; Johansen, Jeanne D

2015-06-01

Hand eczema is frequent among Danish hairdressers, and they are advised to use gloves as protection. However, studies indicate that a significant proportion use gloves inappropriately. To determine whether hairdressers and apprentices use protective gloves in the correct way, and to determine whether a demonstration of correct use could cause an improvement. Forty-three hairdressers and apprentices were asked to perform a hair wash while wearing gloves. The shampoo used was contaminated with an ultraviolet (UV) trace material. Two rounds of hair washing were carried out by each person, interrupted by a demonstration of how to use gloves correctly. Photographs were taken to compare UV contamination before and after the demonstration. All of the participants (100%) had their hands contaminated during the first round; the area ranged between 0.02 and 101.37 cm(2) (median 3.62 cm(2)). In the second round, 55.8% were contaminated (range 0.00-3.08 cm(2) ; median 0.01 cm(2)). The reduction in contaminated skin areas was statistically significant (p < 0.001), proving an effect of the glove demonstration. There were no significant differences between hairdressers and apprentices. Hairdressers and apprentices lack knowledge on how to handle gloves correctly. A short demonstration of correct glove use made a significant difference in the skin protection provided by gloves. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

PubMed

Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

Rilonacept in the treatment of subacromial bursitis: A randomized, non-inferiority, unblinded study versus triamcinolone acetonide.

PubMed

Carroll, Matthew B; Motley, Spencer A; Wohlford, Susanna; Ramsey, Bryan C

2015-12-01

Subacromial bursitis is caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament and acromion. While multiple cytokines are implicated, interleukin-1 beta appears to play a prominent role. Rilonacept, an interleukin-1 trap, may be an alternative to corticosteroid injection for the management of this condition. This single center, randomized, non-inferiority, unblinded study recruited 33 subjects over 9 months. Twenty subjects received 160mg intrabursal injection of rilonacept and 13 received a 6mL mixture of lidocaine, bupivacaine, and 80mg triamcinolone acetonide. QuickDASH, subject reported pain, and adverse events were recorded at time of injection, 2 days later, 2 weeks later, and 4 weeks later. Primary outcome was improvement in QuickDASH 4 weeks post-injection. Secondary outcomes were improvement in subject reported pain and occurrence of adverse events at 4 weeks. Both study groups were equally matched for age, gender, ethnicity, and site of bursa injection. Both medications demonstrated a statistically significant improvement in QuickDASH 4 weeks post-injection, but triamcinolone acetonide injection offered greater improvement (P=0.004). Both medications demonstrated improvement in subject reported pain but between group comparison at 4 weeks showed that triamcinolone was superior (P=0.044). No statistically significant differences in adverse events were noted between groups, but subjects who received rilonacept experienced more episodes of diarrhea and headache. While improvement in QuickDASH and pain was noted with a single intrabursal injection of rilonacept at 4 weeks, injection with triamcinolone acetonide was more efficacious. This trial was registered with www.clinicaltrials.gov (NCT01830699). Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

PubMed Central

2011-01-01

Background The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Results Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. Conclusions A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes. PMID:21824386

Dermatomal somatosensory evoked potential demonstration of nerve root decompression after VAX-D therapy.

PubMed

Naguszewski, W K; Naguszewski, R K; Gose, E E

2001-10-01

Reductions in low back pain and referred leg pain associated with a diagnosis of herniated disc, degenerative disc disease or facet syndrome have previously been reported after treatment with a VAX-D table, which intermittently distracts the spine. The object of this study was to use dermatomal somatosensory evoked potentials (DSSEPs) to demonstrate lumbar root decompression following VAX-D therapy. Seven consecutive patients with a diagnosis of low back pain and unilateral or bilateral L5 or S1 radiculopathy were studied at our center. Disc herniation at the L5-S1 level was documented by MRI or CT in all patients. All patients were studied bilaterally by DSSEPs at L5 and S1 before and after VAX-D therapy. All patients had at least 50% improvement in radicular symptoms and low back pain and three of them experienced complete resolution of all symptoms. The average pain reduction was 77%. The number of treatment sessions varied from 12 to 35. DSSEPs were considered to show improvement if triphasic characteristics returned or a 50% or greater increase in the P1-P2 amplitude was seen. All patients showed improvement in DSSEPs after VAX-D therapy either ipsilateral or contralateral to the symptomatic leg. Two patients showed deterioration in DSSEPs in the symptomatic leg despite clinically significant improvement in pain and radicular symptoms. Overall, 28 nerve roots were studied before and after VAX-D therapy. Seventeen nerve root responses were improved, eight remained unchanged and three deteriorated. The significance of DSSEP improvement contralateral to the symptomatic leg is emphasized. Direct compression of a nerve root by a disc herniation is probably not the sole explanation for referred leg pain.

New Flexible Silicone-Based EEG Dry Sensor Material Compositions Exhibiting Improvements in Lifespan, Conductivity, and Reliability

PubMed Central

Yu, Yi-Hsin; Chen, Shih-Hsun; Chang, Che-Lun; Lin, Chin-Teng; Hairston, W. David; Mrozek, Randy A.

2016-01-01

This study investigates alternative material compositions for flexible silicone-based dry electroencephalography (EEG) electrodes to improve the performance lifespan while maintaining high-fidelity transmission of EEG signals. Electrode materials were fabricated with varying concentrations of silver-coated silica and silver flakes to evaluate their electrical, mechanical, and EEG transmission performance. Scanning electron microscope (SEM) analysis of the initial electrode development identified some weak points in the sensors’ construction, including particle pull-out and ablation of the silver coating on the silica filler. The newly-developed sensor materials achieved significant improvement in EEG measurements while maintaining the advantages of previous silicone-based electrodes, including flexibility and non-toxicity. The experimental results indicated that the proposed electrodes maintained suitable performance even after exposure to temperature fluctuations, 85% relative humidity, and enhanced corrosion conditions demonstrating improvements in the environmental stability. Fabricated flat (forehead) and acicular (hairy sites) electrodes composed of the optimum identified formulation exhibited low impedance and reliable EEG measurement; some initial human experiments demonstrate the feasibility of using these silicone-based electrodes for typical lab data collection applications. PMID:27809260

Nutrition education intervention for college female athletes.

PubMed

Abood, Doris A; Black, David R; Birnbaum, Rachel D

2004-01-01

To evaluate the efficacy of a nutrition education intervention for college female athletes to improve nutrition knowledge, build self-efficacy with respect to making healthful dietary choices, and improve dietary intake. A pretest-posttest control group design was implemented. A women's soccer team (n =15) and a women's swim team (n = 15) were randomly assigned to experimental and control groups, respectively. The intervention focused on nutrition knowledge, self-efficacy in making healthful dietary choices, and dietary practices to demonstrate treatment effect. Dependent variables were nutrition knowledge, self-efficacy, and dietary practices. Independent variables were group assignment. The Mann-Whitney U test was used to analyze the results between groups, and the Fisher exact probability test was used to detect differences between groups in the number of positive dietary changes. Treatment participants significantly improved nutrition knowledge, self-efficacy (P <.05), and the overall number of positive dietary changes (P <.03). This study reduces the paucity of nutrition education intervention research among athletes and demonstrates the ability to increase not only nutrition knowledge, which is typically reported, but also self-efficacy and improvement in overall positive dietary changes during an 8-week intervention.

New Flexible Silicone-Based EEG Dry Sensor Material Compositions Exhibiting Improvements in Lifespan, Conductivity, and Reliability.

PubMed

Yu, Yi-Hsin; Chen, Shih-Hsun; Chang, Che-Lun; Lin, Chin-Teng; Hairston, W David; Mrozek, Randy A

2016-10-31

This study investigates alternative material compositions for flexible silicone-based dry electroencephalography (EEG) electrodes to improve the performance lifespan while maintaining high-fidelity transmission of EEG signals. Electrode materials were fabricated with varying concentrations of silver-coated silica and silver flakes to evaluate their electrical, mechanical, and EEG transmission performance. Scanning electron microscope (SEM) analysis of the initial electrode development identified some weak points in the sensors' construction, including particle pull-out and ablation of the silver coating on the silica filler. The newly-developed sensor materials achieved significant improvement in EEG measurements while maintaining the advantages of previous silicone-based electrodes, including flexibility and non-toxicity. The experimental results indicated that the proposed electrodes maintained suitable performance even after exposure to temperature fluctuations, 85% relative humidity, and enhanced corrosion conditions demonstrating improvements in the environmental stability. Fabricated flat (forehead) and acicular (hairy sites) electrodes composed of the optimum identified formulation exhibited low impedance and reliable EEG measurement; some initial human experiments demonstrate the feasibility of using these silicone-based electrodes for typical lab data collection applications.

Freight Wing Trailer Aerodynamics Final Technical Report

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

Sean Graham

2007-10-31

Freight Wing Incorporated utilized the opportunity presented by a DOE category two Inventions and Innovations grant to commercialize and improve upon aerodynamic technology for semi-tuck trailers, capable of decreasing heavy vehicle fuel consumption, related environmental damage, and U.S. consumption of foreign oil. Major project goals included the demonstration of aerodynamic trailer technology in trucking fleet operations, and the development and testing of second generation products. A great deal of past scientific research has demonstrated that streamlining box shaped semi-trailers can significantly reduce a truck’s fuel consumption. However, significant design challenges have prevented past concepts from meeting industry needs. Freight Wingmore » utilized a 2003 category one Inventions and Innovations grant to develop practical solutions to trailer aerodynamics. Fairings developed for the front, rear, and bottom of standard semi-trailers together demonstrated a 7% improvement to fuel economy in scientific tests conducted by the Transportation Research Center (TRC). Operational tests with major trucking fleets proved the functionality of the products, which were subsequently brought to market. This category two grant enabled Freight Wing to further develop, test and commercialize its products, resulting in greatly increased understanding and acceptance of aerodynamic trailer technology. Commercialization was stimulated by offering trucking fleets 50% cost sharing on trial implementations of Freight Wing products for testing and evaluation purposes. Over 230 fairings were implemented through the program with 35 trucking fleets including industry leaders such as Wal-Mart, Frito Lay and Whole Foods. The feedback from these testing partnerships was quite positive with product performance exceeding fleet expectations in many cases. Fleet feedback also was also valuable from a product development standpoint and assisted the design of several second generation products intended to further improve efficiency, lower costs, and enhance durability. Resulting products demonstrated a 30% efficiency improvement in full scale wind tunnel tests. The fuel savings of our most promising product, the “Belly Fairing” increased from 4% to 6% in scientific track and operational tests. The project successfully demonstrated the economic feasibility of trailer aerodynamics and positioned the technology to realize significant public benefits. Scientific testing conducted with partners such as the EPA Smartway program and Transport Canada clearly validated the fuel and emission saving potential of the technology. The Smartway program now recommends trailer aerodynamics as a certified fuel saving technology and is offering incentives such as low interest loans. Trailer aerodynamics can save average trucks over 1,100 gallons of fuel an 13 tons of emissions every 100,000 miles, a distance many trucks travel annually. These fuel savings produce a product return on investment period of one to two years in average fleet operations. The economic feasibility of the products was validated by participating fleets, several of which have since completed large implementations or demonstrated an interest in volume orders. The commercialization potential of the technology was also demonstrated, resulting in a national distribution and manufacturing partnership with a major industry supplier, Carrier Transicold. Consequently, Freight Wing is well positioned to continue marketing trailer aerodynamics to the trucking industry. The participation of leading fleets in this project served to break down the market skepticism that represents a primary barrier to widespread industry utilization. The benefits of widespread utilization of the technology could be quite significant for both the transportation industry and the public. Trailer aerodynamics could potentially save the U.S. trucking fleet over a billion gallons of fuel and 20 million tons of emissions annually.« less

The Immediate Effect of Sildenafil on Right Ventricular Function in Patients with Heart Failure Measured by Cardiac Magnetic Resonance: A Randomized Control Trial

PubMed Central

Durães, André Rodrigues; Borges, Sirlene Mendes; Aras, Roque

2015-01-01

Background Studies have demonstrated that phosphodiesterase 5 (PDE5) inhibition is associated with right ventricle (RV) functional improvement in patients with primary pulmonary hypertension. This study aims to demonstrate the immediate impact of Sildenafil, a PDE5 inhibitor, on RV function, measured by cardiovascular magnetic resonance (CMR), in patients with heart failure (HF). Methods We conducted a randomized double-blind controlled trial. Inclusion criteria: diagnosis of HF functional class I-III; left ventricle ejection fraction < 35%. Patients underwent CMR evaluation and were then equally randomly assigned to either 50 mg of Sildenafil or Placebo groups. One hour following drug administration, they were submitted to a second scan examination. Results 26 patients were recruited from a tertiary reference center in Brazil and 13 were allocated to each study group. The median age was 61.5 years (50–66.5 years). Except for the increase in RV fractional area change following the administration of sildenafil (Sildenafil [before vs. after]: 34.3 [25.2–43.6]% vs. 42.9 [28.5–46.7]%, p = 0.04; Placebo [before vs. after]: 28.1 [9.2–34.8]% vs. 29.2 [22.5–38.8]%, p = 0.86), there was no statistically significant change in parameters. There was no improvement in left ventricular parameters or in the fractional area change of the pulmonary artery. Conclusion This study demonstrated that a single dose of Sildenafil did not significantly improve RV function as measured by the CMR. Trial Registration ClinicalTrials.gov NCT01936350 PMID:25793988

Neural reorganization accompanying upper limb motor rehabilitation from stroke with virtual reality-based gesture therapy.

PubMed

Orihuela-Espina, Felipe; Fernández del Castillo, Isabel; Palafox, Lorena; Pasaye, Erick; Sánchez-Villavicencio, Israel; Leder, Ronald; Franco, Jorge Hernández; Sucar, Luis Enrique

2013-01-01

Gesture Therapy is an upper limb virtual reality rehabilitation-based therapy for stroke survivors. It promotes motor rehabilitation by challenging patients with simple computer games representative of daily activities for self-support. This therapy has demonstrated clinical value, but the underlying functional neural reorganization changes associated with this therapy that are responsible for the behavioral improvements are not yet known. We sought to quantify the occurrence of neural reorganization strategies that underlie motor improvements as they occur during the practice of Gesture Therapy and to identify those strategies linked to a better prognosis. Functional magnetic resonance imaging (fMRI) neuroscans were longitudinally collected at 4 time points during Gesture Therapy administration to 8 patients. Behavioral improvements were monitored using the Fugl-Meyer scale and Motricity Index. Activation loci were anatomically labelled and translated to reorganization strategies. Strategies are quantified by counting the number of active clusters in brain regions tied to them. All patients demonstrated significant behavioral improvements (P < .05). Contralesional activation of the unaffected motor cortex, cerebellar recruitment, and compensatory prefrontal cortex activation were the most prominent strategies evoked. A strong and significant correlation between motor dexterity upon commencing therapy and total recruited activity was found (r2 = 0.80; P < .05), and overall brain activity during therapy was inversely related to normalized behavioral improvements (r2 = 0.64; P < .05). Prefrontal cortex and cerebellar activity are the driving forces of the recovery associated with Gesture Therapy. The relation between behavioral and brain changes suggests that those with stronger impairment benefit the most from this paradigm.

The Safety and Efficacy of Treatment With a 1,927-nm Diode Laser With and Without Topical Hydroquinone for Facial Hyperpigmentation and Melasma in Darker Skin Types.

PubMed

Vanaman Wilson, Monique J; Jones, Isabela T; Bolton, Joanna; Larsen, Lisa; Fabi, Sabrina Guillen

2018-04-13

The nonablative, fractional, 1,927-nm diode laser is theoretically a safe and effective treatment for hyperpigmentation and melasma in darker skin and may potentiate topical cosmeceutical delivery. To evaluate the use of a nonablative, fractional, 1,927-nm diode laser with and without topical 2% hydroquinone (HQ) cream for moderate-to-severe facial hyperpigmentation in Fitzpatrick skin Types III-V. Forty adults underwent 4 laser treatments at 2-week intervals and were randomized to daily application of 2% HQ cream or moisturizer. Follow-ups were conducted 4 and 12 weeks after the final laser treatment. Hydroquinone and moisturizer groups demonstrated Mottled Pigmentation Area and Severity Index improvements of approximately 50% at post-treatment Weeks 4 and 12. Blinded investigator-assessed hyperpigmentation and photodamage improved significantly for both the groups at post-treatment Weeks 4 and 12. Subject satisfaction improved significantly in both the groups by post-treatment Week 4. Although investigator-rated Global Aesthetic Improvement Scale scores were significantly better in the HQ group at post-treatment Week 12, satisfaction was higher among those using moisturizer. No adverse events were noted. The nonablative, fractional, 1,927-nm diode laser produced significant improvement in hyperpigmentation in Fitzpatrick skin Types III-V by 4 weeks, with maintenance of results at 12 weeks after treatment even without HQ.

Materials Approach to Fuel Efficient Tires

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

Votruba-Drzal, Peter; Kornish, Brian

2015-06-30

The objective of this project was to design, develop, and demonstrate fuel efficient and safety regulation compliant tire filler and barrier coating technologies that will improve overall fuel efficiency by at least 2%. The program developed and validated two complementary approaches to improving fuel efficiency through tire improvements. The first technology was a modified silica-based product that is 15% lower in cost and/or enables a 10% improvement in tread wear while maintaining the already demonstrated minimum of 2% improvement in average fuel efficiency. The second technology was a barrier coating with reduced oxygen transmission rate compared to the state-of-the-art halobutylmore » rubber inner liners that will provide extended placarded tire pressure retention at significantly reduced material usage. A lower-permeance, thinner inner liner coating which retains tire pressure was expected to deliver the additional 2% reduction in fleet fuel consumption. From the 2006 Transportation Research Board Report1, a 10 percent reduction in rolling resistance can reduce consumer fuel expenditures by 1 to 2 percent for typical vehicles. This savings is equivalent to 6 to 12 gallons per year. A 1 psi drop in inflation pressure increases the tire's rolling resistance by about 1.4 percent.« less

Folate Receptor Targeted Polymeric Micellar Nanocarriers for Delivery of Orlistat as a Repurposed Drug against Triple Negative Breast Cancer

PubMed Central

Paulmurugan, Ramasamy; Bhethanabotla, Rohith; Mishra, Kaushik; Devulapally, Rammohan; Foygel, Kira; Sekar, Thillai V; Ananta, Jeyarama S; Massoud, Tarik F; Joy, Abraham

2015-01-01

Triple negative breast cancer (TNBC) is a recalcitrant malignancy with no available targeted therapy. Off target effects and poor bioavailability of the FDA approved anti-obesity drug orlistat hinder its clinical translation as a repurposed new drug against TNBC. Here we demonstrate a newly engineered drug formulation for packaging orlistat tailored to TNBC treatment. We synthesized TNBC-specific folate receptor targeted micellar nanoparticles (NPs) carrying orlistat, which improved the solubility (70-80 μg/ml) of this water insoluble drug. The targeted NPs also improved the delivery and bioavailability of orlistat to MDA-MB-231 cells in culture and to tumor xenografts in nude mouse model. We prepared HEA-EHA copolymer micellar NPs by copolymerization of 2-hydroxyethylacrylate (HEA) and 2-ethylhexylacrylate (EHA), and functionalized them with folic acid and an imaging dye. Fluorescence activated cell sorting (FACS) analysis of TNBC cells indicated a dose dependent increase in apoptotic populations in cells treated with free orlistat, orlistat NPs, and folate-receptor targeted Fol-HEA-EHA-orlistat NPs in which Fol-HEA-EHA-orlistat NPs showed significantly higher cytotoxicity than free orlistat. In vitro analysis data demonstrated significant apoptosis at nanomolar concentrations in cells activated through caspase 3 and PARP inhibition. In vivo analysis demonstrated significant antitumor effects in living mice after targeted treatment of tumors, and confirmed by fluorescence imaging. Moreover, Folate receptor targeted Fol-DyLight747-orlistat NPs treated mice exhibited significantly higher reduction in tumor volume compared to control group. Taken together, these results indicate that orlistat packaged in HEA-b-EHA micellar NPs is a highly promising new drug formulation for TNBC therapy. PMID:26553061

Pediatric functional constipation treatment with Bifidobacterium-containing yogurt: a crossover, double-blind, controlled trial.

PubMed

Guerra, Paula V P; Lima, Luiza N; Souza, Tassia C; Mazochi, Vanessa; Penna, Francisco J; Silva, Andreia M; Nicoli, Jacques R; Guimarães, Elizabet V

2011-09-14

To evaluate the treatment of pediatric functional chronic intestinal constipation (FCIC) with a probiotic goat yogurt. A crossover double-blind formula-controlled trial was carried out on 59 students (age range: 5-15 years) of a public school in Belo Horizonte, MG, Brazil, presenting a FCIC diagnostic, according to Roma III criteria. The students were randomized in two groups to receive a goat yogurt supplemented with 10(9) colony forming unit/mL Bifidobacterium longum (B. longum) (probiotic) daily or only the yogurt for a period of 5 wk (formula). Afterwards, the groups were intercrossed for another 5 wk. Defecation frequency, stool consistency and abdominal and defecation pain were assessed. Both treatment groups demonstrated improvement in defecation frequency compared to baseline. However, the group treated with probiotic showed most significant improvement in the first phase of the study. An inversion was observed after crossing over, resulting in a reduction in stool frequency when this group was treated by formula. Probiotic and formula improved stool consistency in the first phase of treatment, but the improvement obtained with probiotic was significantly higher (P = 0.03). In the second phase of treatment, the group initially treated with probiotic showed worsening stool consistency when using formula. However, the difference was not significant. A significant improvement in abdominal pain and defecation pain was observed with both probiotic and formula in the first phase of treatment, but again the improvement was more significant for the group treated with B. longum during phase I (P < 0.05). When all data of the crossover study were analyzed, significant differences were observed between probiotic yogurt and yogurt only for defecation frequency (P = 0.012), defecation pain (P = 0.046) and abdominal pain (P = 0.015). An improvement in defecation frequency and abdominal pain was observed using both supplemented and non-supplemented yogurt, but an additional improvement with B. longum supplementation was obtained.

Enhancing State Medical Home Capacity through a Care Coordination Technical Assistance Model.

PubMed

Berry, Susan; Barovechio, Patti; Mabile, Emily; Tran, Tri

2017-10-01

Introduction A practice-based care coordination (CC) model was developed by Louisiana's Title V Children's Special Health Services (CSHS) program to meet the overwhelming needs of the New Orleans post-Katrina population. The pilot clinic demonstrated an improvement in medical home (MH) capacity over the course of 3 months. The purpose of the current study is to evaluate the replicability of the model and sustainability of MH improvement over at least 2 years, while identifying factors that may modify the effect of the intervention. Methods The CSHS CC model utilizing a practice based care coordinator was implemented in 15 academic primary care pediatric clinics. Increase in MH capacity was determined using the MH Index-Short Version (MHI-SV) tool. Results The analysis of the MHI-SV scores for the ten clinics with >2 years of data demonstrated a significant improvement with each of the ten MHI-SV indicators. The mean clinic MHI-SV score improved from 19.70 to 34.15 on a scale of 10-50. Characteristics associated with the greatest MHI score improvement were rural geographic location, having an electronic health record, and using social workers or nurses as care coordinators. Characteristics associated with lower MHI scores were physician or care coordinator turnover and using stand-alone databases rather than tracking CC activities within the central patient record. Conclusion This study provides a flexible framework for implementing CC services in pediatric, family medicine, and medicine-pediatric practices, and demonstrates the value of CC as a driver for improvement in medical home capacity.

Cross-training in hemispatial neglect: auditory sustained attention training ameliorates visual attention deficits.

PubMed

Van Vleet, Thomas M; DeGutis, Joseph M

2013-03-01

Prominent deficits in spatial attention evident in patients with hemispatial neglect are often accompanied by equally prominent deficits in non-spatial attention (e.g., poor sustained and selective attention, pronounced vigilance decrement). A number of studies now show that deficits in non-spatial attention influence spatial attention. Treatment strategies focused on improving vigilance or sustained attention may effectively remediate neglect. For example, a recent study employing Tonic and Phasic Alertness Training (TAPAT), a task that requires monitoring a constant stream of hundreds of novel scenes, demonstrated group-level (n=12) improvements after training compared to a test-retest control group or active treatment control condition on measures of visual search, midpoint estimation and working memory (DeGutis and Van Vleet, 2010). To determine whether the modality of treatment or stimulus novelty are key factors to improving hemispatial neglect, we designed a similar continuous performance training task in which eight patients with chronic and moderate to severe neglect were challenged to rapidly and continuously discriminate a limited set of centrally presented auditory tones once a day for 9 days (36-min/day). All patients demonstrated significant improvement in several, untrained measures of spatial and non-spatial visual attention, and as a group failed to demonstrate a lateralized attention deficit 24-h post-training compared to a control group of chronic neglect patients who simply waited during the training period. The results indicate that TAPAT-related improvements in hemispatial neglect are likely due to improvements in the intrinsic regulation of supramodal, non-spatial attentional resources. Published by Elsevier Ltd.

High Aspect Ratio Semiconductor Heterojunction Solar Cells

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

Redwing, Joan; Mallouk, Tom; Mayer, Theresa

2013-05-17

The project focused on the development of high aspect ratio silicon heterojunction (HARSH) solar cells. The solar cells developed in this study consisted of high density vertical arrays of radial junction silicon microwires/pillars formed on Si substrates. Prior studies have demonstrated that vertical Si wire/pillar arrays enable reduced reflectivity and improved light trapping characteristics compared to planar solar cells. In addition, the radial junction structure offers the possibility of increased carrier collection in solar cells fabricated using material with short carrier diffusion lengths. However, the high junction and surface area of radial junction Si wire/pillar array devices can be problematicmore » and lead to increased diode leakage and enhanced surface recombination. This study investigated the use of amorphous hydrogenated Si in the form of a heterojunction-intrinsic-thin layer (HIT) structure as a junction formation method for these devices. The HIT layer structure has widely been employed to reduce surface recombination in planar crystalline Si solar cells. Consequently, it was anticipated that it would also provide significant benefits to the performance of radial junction Si wire/pillar array devices. The overall goals of the project were to demonstrate a HARSH cell with a HIT-type structure in the radial junction Si wire/pillar array configuration and to develop potentially low cost pathways to fabricate these devices. Our studies demonstrated that the HIT structure lead to significant improvements in the open circuit voltage (V oc>0.5) of radial junction Si pillar array devices compared to devices fabricated using junctions formed by thermal diffusion or low pressure chemical vapor deposition (LPCVD). In addition, our work experimentally demonstrated that the radial junction structure lead to improvements in efficiency compared to comparable planar devices for devices fabricated using heavily doped Si that had reduced carrier diffusion lengths. Furthermore, we made significant advances in employing the bottom-up vapor-liquid-solid (VLS) growth technique for the fabrication of the Si wire arrays. Our work elucidated the effects of growth conditions and substrate pattern geometry on the growth of large area Si microwire arrays grown with SiCl4. In addition, we also developed a process to grow p-type Si nanowire arrays using aluminum as the catalyst metal instead of gold. Finally, our work demonstrated the feasibility of growing vertical arrays of Si wires on non-crystalline glass substrates using polycrystalline Si template layers. The accomplishments demonstrated in this project will pave the way for future advances in radial junction wire array solar cells.« less

A simulation study of harmonics regeneration in noise reduction for electric and acoustic stimulation.

PubMed

Hu, Yi

2010-05-01

Recent research results show that combined electric and acoustic stimulation (EAS) significantly improves speech recognition in noise, and it is generally established that access to the improved F0 representation of target speech, along with the glimpse cues, provide the EAS benefits. Under noisy listening conditions, noise signals degrade these important cues by introducing undesired temporal-frequency components and corrupting harmonics structure. In this study, the potential of combining noise reduction and harmonics regeneration techniques was investigated to further improve speech intelligibility in noise by providing improved beneficial cues for EAS. Three hypotheses were tested: (1) noise reduction methods can improve speech intelligibility in noise for EAS; (2) harmonics regeneration after noise reduction can further improve speech intelligibility in noise for EAS; and (3) harmonics sideband constraints in frequency domain (or equivalently, amplitude modulation in temporal domain), even deterministic ones, can provide additional benefits. Test results demonstrate that combining noise reduction and harmonics regeneration can significantly improve speech recognition in noise for EAS, and it is also beneficial to preserve the harmonics sidebands under adverse listening conditions. This finding warrants further work into the development of algorithms that regenerate harmonics and the related sidebands for EAS processing under noisy conditions.

Electrokinetic Stringency Control in Self-Assembled Monolayer-based Biosensors for Multiplex Urinary Tract Infection Diagnosis

PubMed Central

Liu, Tingting; Sin, Mandy L. Y.; Pyne, Jeff D.; Gau, Vincent; Liao, Joseph C.; Wong, Pak Kin

2013-01-01

Rapid detection of bacterial pathogens is critical toward judicious management of infectious diseases. Herein, we demonstrate an in situ electrokinetic stringency control approach for a self-assembled monolayer-based electrochemical biosensor toward urinary tract infection diagnosis. The in situ electrokinetic stringency control technique generates Joule heating induced temperature rise and electrothermal fluid motion directly on the sensor to improve its performance for detecting bacterial 16S rRNA, a phylogenetic biomarker. The dependence of the hybridization efficiency reveals that in situ electrokinetic stringency control is capable of discriminating single-base mismatches. With electrokinetic stringency control, the background noise due to the matrix effects of clinical urine samples can be reduced by 60%. The applicability of the system is demonstrated by multiplex detection of three uropathogenic clinical isolates with similar 16S rRNA sequences. The results demonstrate that electrokinetic stringency control can significantly improve the signal-to-noise ratio of the biosensor for multiplex urinary tract infection diagnosis. PMID:23891989

Synthesis of Nanodiamond-Daunorubicin Conjugates to Overcome Multidrug Chemoresistance in Leukemia

PubMed Central

Man, Han B.; Kim, Hansung; Kim, Ho-Joong; Robinson, Erik; Liu, Wing Kam; Chow, Edward Kai-Hua; Ho, Dean

2013-01-01

Nanodiamonds (NDs) are promising candidates in nanomedicine, demonstrating significant potential as gene/drug delivery platforms for cancer therapy. We have synthesized ND vectors capable of chemotherapeutic loading and delivery with applications towards chemoresistant leukemia. The loading of Daunorubicin (DNR) onto NDs was optimized by adjusting reaction parameters such as acidity and concentration. The resulting conjugate, a novel therapeutic payload for NDs, was characterized extensively for size, surface charge, and loading efficiency. A K562 human myelogenous leukemia cell line, with multidrug resistance conferred by incremental DNR exposure, was used to demonstrate the efficacy enhancement resulting from ND-based delivery. While resistant K562 cells were able to overcome treatment from DNR alone, as compared with non-resistant K562 cells, NDs were able to improve DNR delivery into resistant K562 cells. By overcoming efflux mechanisms present in this resistant leukemia line, ND-enabled therapeutics have demonstrated the potential to improve cancer treatment efficacy, especially towards resistant strains. PMID:23916889

Effectiveness of a two-phase cognitive rehabilitation intervention for severely impaired schizophrenia patients.

PubMed

Silverstein, Steven M; Hatashita-Wong, Michi; Solak, Beth Anne; Uhlhaas, Peter; Landa, Yulia; Wilkniss, Sandra M; Goicochea, Claudia; Carpiniello, Kelly; Schenkel, Lindsay S; Savitz, Adam; Smith, Thomas E

2005-06-01

Several small-N, uncontrolled reports have demonstrated that the behavioral technique of attention shaping has significantly increased attention span among severely ill schizophrenia patients. In this study, we evaluated the effectiveness of using an individually administered intervention for improving sustained attention, Attention Process Training (APT), followed by an attention-shaping procedure within the context of an ongoing skills training group. Patients were randomly assigned to receive either the APT and attention-shaping sequence (n = 18) or equivalent hours of treatment in the same intensive behavioral rehabilitation program (n = 13). Results indicated dramatic improvements in attentiveness in the cognitive rehabilitation condition compared with the control condition, which demonstrated essentially no change in attentiveness over the 12 weeks of treatment. The attention-shaping intervention appeared to account for the majority of the effect. In contrast to the observational data, performance on neuropsychological tests was unaffected by the cognitive interventions. This two-phase intervention demonstrated effectiveness in promoting attentive behavior among chronic schizophrenia patients with severe attentional impairment.

Effects of equivalent series resistance on the noise mitigation performance of piezoelectric shunt damping

NASA Astrophysics Data System (ADS)

Lai, Szu Cheng; Sharifzadeh Mirshekarloo, Meysam; Yao, Kui

2017-05-01

Piezoelectric shunt damping (PSD) utilizes an electrically-shunted piezoelectric damper attached on a panel structure to suppress the transmission of acoustic noise. The paper develops an understanding on the effects of equivalent series resistance (ESR) of the piezoelectric damper in a PSD system on noise mitigation performance, and demonstrates that an increased ESR leads to a significant rise in the noise transmissibility due to reduction in the system’s mechanical damping. It is further demonstrated with experimental results that ESR effects can be compensated in the shunt circuit to significantly improve the noise mitigation performance. A theoretical electrical equivalent model of the PSD incorporating the ESR is established for quantitative analysis of ESR effects on noise mitigation.

Clinical Use of Deferoxamine in Distraction Osteogenesis of Irradiated Bone

PubMed Central

Momeni, Arash; Rapp, Scott; Donneys, Alexis; Buchman, Steven R.; Wan, Derrick C.

2016-01-01

The deleterious effects of radiotherapy, including hypovascularity and hypocellularity, have made distraction of irradiated bones challenging. Animal studies, however, have demonstrated adjunctive measures such as the administration of deferoxamine to significantly improve bone regeneration across irradiated distraction gaps. In this report, we demonstrate, for the first time, enhanced bone formation following deferoxamine application in a patient following distraction of a previously irradiated maxilla. CT imaging of the pterygomaxillary buttress on the side of administration revealed significantly increased bone area and density relative to the contralateral buttress. This is the first presentation of clinical deferoxamine use to promote bone formation following irradiated bone distraction and highlights the promise for this adjunctive measure to make outcomes after distraction of irradiated bone more reliable. PMID:27171947

A Module on Death and Dying to Develop Empathy in Student Pharmacists

PubMed Central

Olin, Jacqueline L.; Thornton, Phillip L.; Dolder, Christian R.; Hanrahan, Conor

2011-01-01

Objective To implement an integrated module on death and dying into a 15-week bioethics course and determine whether it increased student pharmacists’ empathy. Design Students participated in a 5-week death and dying module that included presentation of the film Wit, an interactive lecture on hospice, and a lecture on the ethics of pain management. Assessment Fifty-six students completed the 30-item Balanced Emotional Empathy Scale (BEES) before and after completing the module and wrote a reflective essay. Students demonstrated an appreciation of patient-specific values in their essay. Quantitative data collected via BEES scores demonstrated significant improvement in measured empathy. Conclusion A 5-week instructional model on death and dying significantly increased student empathy. PMID:21769147

History and current state of immunotherapy in glioma and brain metastasis.

PubMed

McGranahan, Tresa; Li, Gordon; Nagpal, Seema

2017-05-01

Malignant brain tumors such as glioblastoma (GBM) and brain metastasis have poor prognosis despite conventional therapies. Successful use of vaccines and checkpoint inhibitors in systemic malignancy has increased the hope that immune therapies could improve survival in patients with brain tumors. Manipulating the immune system to fight malignancy has a long history of both modest breakthroughs and pitfalls that should be considered when applying the current immunotherapy approaches to patients with brain tumors. Therapeutic vaccine trials for GBM date back to the mid 1900s and have taken many forms; from irradiated tumor lysate to cell transfer therapies and peptide vaccines. These therapies were generally well tolerated without significant autoimmune toxicity, however also did not demonstrate significant clinical benefit. In contrast, the newer checkpoint inhibitors have demonstrated durable benefit in some metastatic malignancies, accompanied by significant autoimmune toxicity. While this toxicity was not unexpected, it exceeded what was predicted from pre-clinical studies and in many ways was similar to the prior trials of immunostimulants. This review will discuss the history of these studies and demonstrate that the future use of immune therapy for brain tumors will likely need a personalized approach that balances autoimmune toxicity with the opportunity for significant survival benefit.

Service tough composite structures using the Z-direction reinforcement process

NASA Technical Reports Server (NTRS)

Freitas, Glenn; Magee, Constance; Boyce, Joseph; Bott, Richard

1992-01-01

Foster-Miller has developed a new process to provide through thickness reinforcement of composite structures. The process reinforces laminates locally or globally on-tool during standard autoclave processing cycles. Initial test results indicate that the method has the potential to significantly reduce delamination in carbon-epoxy. Laminates reinforced with the z-fiber process have demonstrated significant improvements in mode 1 fracture toughness and compression strength after impact. Unlike alternative methods, in-plane properties are not adversely affected.

The economic potential of CT scanners for hardwood sawmills

Treesearch

Donald G. Hodges; Walter C. Anderson; Charles W. McMillin

1990-01-01

Research has demonstrated that a knowledge of internal log defects prior to sawing could improve lumber value yields significantly. This study evaluated the potential economic returns from investments in computerized tomographic (CT) scanners to detect internal defects in hardwood logs at southern sawmills. The results indicate that such investments would be profitable...

Moving the Learning of Teaching Closer to Practice: Teacher Education Implications of School-Based Inquiry Teams

ERIC Educational Resources Information Center

Gallimore, Ronald; Ermeling, Bradley A.; Saunders, William M.; Goldenberg, Claude

2009-01-01

A 5-year prospective, quasi-experimental investigation demonstrated that grade-level teams in 9 Title 1 schools using an inquiry-focused protocol to solve instructional problems significantly increased achievement. Teachers applying the inquiry protocol shifted attribution of improved student performance to their teaching rather than external…

Anthraquinone with tailored structure for a nonaqueous metal-organic redox flow battery.

PubMed

Wang, Wei; Xu, Wu; Cosimbescu, Lelia; Choi, Daiwon; Li, Liyu; Yang, Zhenguo

2012-07-07

A nonaqueous, hybrid metal-organic redox flow battery based on tailored anthraquinone structure is demonstrated to have an energy efficiency of ~82% and a specific discharge energy density similar to those of aqueous redox flow batteries, which is due to the significantly improved solubility of anthraquinone in supporting electrolytes.

Improving Students' Study Habits by Demonstrating the Mnemonic Benefits of Semantic Processing

ERIC Educational Resources Information Center

Bugg, Julie M.; DeLosh, Edward L.; McDaniel, Mark A.

2008-01-01

This article describes an in-class exercise that illustrates the advantage of semantic over nonsemantic study habits. The exercise includes a survey of students' current study strategies, followed by the presentation of an abbreviated version of Craik and Tulving's(1975) classic levels-of-processing experiment. We observed significant benefits of…

Suppressing NOM access to controlled porous TiO2 particles enhances the decomposition of target water contaminants

EPA Science Inventory

Suppressing access of natural organic matter (NOM) to TiO2 is a key to the successful photocatalytic decomposition of a target contaminant in water. This study first demonstrates simply controlling the porous structure of TiO2 can significantly improve the selective oxidation.

Autonomy and Accountability in the Regulation of the Teaching Profession: A South African Case Study

ERIC Educational Resources Information Center

Jansen, Jonathan D.

2004-01-01

This article examines the struggles of the South African government to establish school-wide evaluation policies within post-apartheid institutions. It is demonstrated that even when such evaluation policies promise teacher development and whole-school improvement, there is significant resistance to government intervention in the school…

Safety and effectiveness of adalimumab in a clinical setting that reflects Canadian standard of care for the treatment of rheumatoid arthritis (RA): results from the CanACT study.

PubMed

Haraoui, Boulos; Cividino, Alfred; Stewart, Jacqueline; Guérette, Benoît; Keystone, Edward C

2011-11-17

This multicenter, open-label, prospective, single cohort study evaluated the effectiveness and safety of adalimumab in a clinical setting reflecting the Canadian standard of care for the treatment of patients with rheumatoid arthritis (RA). Patients ≥ 18 years of age with a history of active RA ≥ 3 months and fulfilling Canadian requirements for biological therapy received adalimumab 40 mg subcutaneously every other week for 12 weeks. Pre-study DMARD treatment regimens, corticosteroids, or NSAIDs were allowed throughout the study. The primary effectiveness outcome measure was the mean change in 28-joint disease activity score (DAS28) from baseline to Week 12. Secondary measures included the proportion of patients achieving joint remission (DAS28 < 2.6) and low-disease activity (DAS28 < 3.2) at Week 12, and European League Against Rheumatism (EULAR: moderate and good) and American College of Rheumatology (ACR: ACR20, 50, and 70) responses, as well as responses in ACR core components at Weeks 4, 8, and 12. Subgroup analysis included a comparison of patients naïve to biological DMARD (BDMARD) therapy versus BDMARD-experienced patients. Safety was assessed in terms of adverse and serious adverse events. A total of 879 patients (mean disease duration > 12 years) were enrolled; 772 (87.9%) completed the 12-week period. Adalimumab treatment was associated with rapid and sustained improvements in the signs and symptoms of RA. Significant improvements in mean DAS28 score were observed as early as Week 4. After 12 weeks of adalimumab treatment, 15.3% and 28.9% of patients achieved clinical remission and low-disease activity, respectively. Similarly, significant improvements in ACR core components were observed as early as Week 4, with continued improvements occurring through 12 weeks. Patients naïve to BDMARD therapy demonstrated numerically greater clinical responses when compared with patients who had experienced prior BDMARD therapy, although both subgroups were associated with significant improvements from baseline. The rates and types of adverse events, as well as the results of laboratory measures, demonstrated that adalimumab was generally safe and well-tolerated. This study demonstrated that, under conditions reflective of the normal clinical practice in Canada, adalimumab is an effective and safe treatment for patients with RA. NCT00649545.

Case Management to Reduce Cardiovascular Disease Risk in American Indians and Alaska Natives With Diabetes: Results From the Special Diabetes Program for Indians Healthy Heart Demonstration Project

PubMed Central

Jiang, Luohua; Manson, Spero M.; Beals, Janette; Henderson, William; Pratte, Katherine; Acton, Kelly J.; Roubideaux, Yvette

2014-01-01

Objectives. We evaluated cardiovascular disease (CVD) risk factors in American Indians/Alaska Natives (AI/ANs) with diabetes in the Special Diabetes Program for Indians Healthy Heart (SDPI-HH) Demonstration Project. Methods. Multidisciplinary teams implemented an intensive case management intervention among 30 health care programs serving 138 tribes. The project recruited 3373 participants, with and without current CVD, between 2006 and 2009. We examined data collected at baseline and 1 year later to determine whether improvements occurred in CVD risk factors and in Framingham coronary heart disease (CHD) risk scores, aspirin use, and smoking status. Results. A1c levels decreased an average of 0.2% (P < .001). Systolic and diastolic blood pressure, low-density lipoprotein (LDL) cholesterol, and triglyceride levels decreased, with the largest significant reduction in LDL cholesterol (∆ = −5.29 mg/dL; P < .001). Average Framingham CHD risk scores also decreased significantly. Aspirin therapy increased significantly, and smoking decreased. Participants with more case management visits had significantly greater reductions in LDL cholesterol and A1c values. Conclusions. SDPI-HH successfully translated an intensive case management intervention. Creative retention strategies and an improved understanding of organizational challenges are needed for future Indian health translational efforts. PMID:25211728

The discrepancy between subjective and objective measures of sleep in older adults receiving CBT for comorbid insomnia.

PubMed

Lund, Hannah G; Rybarczyk, Bruce D; Perrin, Paul B; Leszczyszyn, David; Stepanski, Edward

2013-10-01

To examine the effect of cognitive-behavioral therapy for insomnia (CBT-I) on the underreporting of sleep relative to objective measurement, a common occurrence among individuals with insomnia. Pre-treatment and post-treatment self-report measures of sleep were compared with those obtained from home-based polysomnography (PSG) in 60 adults (mean age = 69.17; 42 women) with comorbid insomnia. The self-report data were published previously in a randomized controlled trial demonstrating the efficacy of CBT-I compared with a placebo treatment. Self-report measures significantly underestimated sleep at pre-treatment and CBT-I led to a correction in this discrepancy. There were no significant changes in PSG after CBT-I. Path analysis showed that an increase in an objective proxy measure of sleep quality (i.e., decreased stage N1 sleep) after CBT-I was significantly related to improvements in self-report of sleep, with full mediation by reductions in discrepancy. This is the first CBT-I outcome study to analyze discrepancy changes and demonstrate that these changes account for a significant portion of self-report outcome. In addition, improved sleep quality as measured by a decrease in percentage of stage N1 sleep following treatment may be one mechanism that explains why sleep estimation is more accurate following CBT-I. © 2012 Wiley Periodicals, Inc.

Benefits of Time Correlation Measurements for Passive Screening

NASA Astrophysics Data System (ADS)

Murer, David; Blackie, Douglas; Peerani, Paolo

2014-02-01

The “FLASH Portals Project” is a collaboration between Arktis Radiation Detectors Ltd (CH), the Atomic Weapons Establishment (UK), and the Joint Research Centre (European Commission), supported by the Technical Support Working Group (TSWG). The program's goal was to develop and demonstrate a technology to detect shielded special nuclear materials (SNM) more efficiently and less ambiguously by exploiting time correlation. This study presents experimental results of a two-sided portal monitor equipped with in total 16 4He fast neutron detectors as well as four polyvinyltoluene (PVT) plastic scintillators. All detectors have been synchronized to nanosecond precision, thereby allowing the resolution of time correlations from timescales of tens of microseconds (such as (n, γ) reactions) down to prompt fission correlations directly. Our results demonstrate that such correlations can be detected in a typical radiation portal monitor (RPM) geometry and within operationally acceptable time scales, and that exploiting these signatures significantly improves the performance of the RPM compared to neutron counting. Furthermore, the results show that some time structure remains even in the presence of heavy shielding, thus significantly improving the sensitivity of the detection system to shielded SNM.

Polyoxovanadate-alkoxide clusters as multi-electron charge carriers for symmetric non-aqueous redox flow batteries† †Electronic supplementary information (ESI) available. See DOI: 10.1039/c7sc05295b

PubMed Central

VanGelder, L. E.; Kosswattaarachchi, A. M.; Forrestel, P. L.

2018-01-01

Non-aqueous redox flow batteries have emerged as promising systems for large-capacity, reversible energy storage, capable of meeting the variable demands of the electrical grid. Here, we investigate the potential for a series of Lindqvist polyoxovanadate-alkoxide (POV-alkoxide) clusters, [V6O7(OR)12] (R = CH3, C2H5), to serve as the electroactive species for a symmetric, non-aqueous redox flow battery. We demonstrate that the physical and electrochemical properties of these POV-alkoxides make them suitable for applications in redox flow batteries, as well as the ability for ligand modification at the bridging alkoxide moieties to yield significant improvements in cluster stability during charge–discharge cycling. Indeed, the metal–oxide core remains intact upon deep charge–discharge cycling, enabling extremely high coulombic efficiencies (∼97%) with minimal overpotential losses (∼0.3 V). Furthermore, the bulky POV-alkoxide demonstrates significant resistance to deleterious crossover, which will lead to improved lifetime and efficiency in a redox flow battery. PMID:29675217

Current controversies in pediatric urologic robotic surgery.

PubMed

Trevisani, Lorenzo F M; Nguyen, Hiep T

2013-01-01

Minimally invasive surgeries such as conventional laparoscopic surgery and robotic assisted laparoscopic surgery (RALS) have significant advantages over the traditional open surgical approach including lower pain medication requirements and decreased length of hospitalization. However, open surgery has demonstrated better success rates and shorter surgery time when compared to the other modalities. Currently, it is unclear which approach has better long-term clinical outcomes, greater benefits and less cost. There are limited studies in the literature comparing these three different surgical approaches. In this review, we will evaluate the advantages and disadvantages of RALS compared to conventional laparoscopic surgery and open surgery for commonly performed pediatric urological procedures such as pyeloplasty, ureteral reimplantation, complete and partial nephrectomy, bladder augmentation and creation of continent catheterizable channels. Although it is not yet possible to demonstrate the superiority of one single surgical modality over another, RALS has been shown to be feasible, well tolerated and advantageous in reconstructive urological procedures. With experience, the outcomes of RALS are improving, justifying its usage. However, cost remains a significant issue, limiting the accessibility of RALS, which in the future may improve with market competition and device innovation.

Digital media and sexually transmitted infections.

PubMed

Gilliam, Melissa; Chor, Julie; Hill, Brandon

2014-10-01

Digital media, including the Internet, social networking sites, text messaging, and mobile applications, are ubiquitous among adolescents and young adults. These platforms enable users to obtain important information on a multitude of health topics, they may facilitate risk-taking behaviors, and they can be key components of health interventions. The purpose of this article is to review the recent literature on digital media and sexually transmitted infections, discussing their role in potentiating and reducing risk. This review demonstrates adolescents' use of digital media to gather information on health topics and discusses significant privacy concerns regarding using media to explore sexual health information. Although several studies demonstrate an association between social media and increased sexual risk-taking behaviors, this relationship is not fully understood. Digital media-based interventions are increasingly being developed to either reduce risk or improve management of sexually transmitted infections. As greater numbers of adolescents use digital media, the potential for these platforms to influence sexual risk-taking behaviors is significant. Additional research is needed to better understand the impact of digital media on sexually transmitted infection risk and to develop social media-based interventions to improve sexually transmitted infection outcomes.

Fermentation of Saccharomyces cerevisiae - Combining kinetic modeling and optimization techniques points out avenues to effective process design.

PubMed

Scheiblauer, Johannes; Scheiner, Stefan; Joksch, Martin; Kavsek, Barbara

2018-09-14

A combined experimental/theoretical approach is presented, for improving the predictability of Saccharomyces cerevisiae fermentations. In particular, a mathematical model was developed explicitly taking into account the main mechanisms of the fermentation process, allowing for continuous computation of key process variables, including the biomass concentration and the respiratory quotient (RQ). For model calibration and experimental validation, batch and fed-batch fermentations were carried out. Comparison of the model-predicted biomass concentrations and RQ developments with the corresponding experimentally recorded values shows a remarkably good agreement for both batch and fed-batch processes, confirming the adequacy of the model. Furthermore, sensitivity studies were performed, in order to identify model parameters whose variations have significant effects on the model predictions: our model responds with significant sensitivity to the variations of only six parameters. These studies provide a valuable basis for model reduction, as also demonstrated in this paper. Finally, optimization-based parametric studies demonstrate how our model can be utilized for improving the efficiency of Saccharomyces cerevisiae fermentations. Copyright © 2018 Elsevier Ltd. All rights reserved.

Improving collaborative learning in online software engineering education

NASA Astrophysics Data System (ADS)

Neill, Colin J.; DeFranco, Joanna F.; Sangwan, Raghvinder S.

2017-11-01

Team projects are commonplace in software engineering education. They address a key educational objective, provide students critical experience relevant to their future careers, allow instructors to set problems of greater scale and complexity than could be tackled individually, and are a vehicle for socially constructed learning. While all student teams experience challenges, those in fully online programmes must also deal with remote working, asynchronous coordination, and computer-mediated communications all of which contribute to greater social distance between team members. We have developed a facilitation framework to aid team collaboration and have demonstrated its efficacy, in prior research, with respect to team performance and outcomes. Those studies indicated, however, that despite experiencing improved project outcomes, students working in effective software engineering teams did not experience significantly improved individual achievement. To address this deficiency we implemented theoretically grounded refinements to the collaboration model based upon peer-tutoring research. Our results indicate a modest, but statistically significant (p = .08), improvement in individual achievement using this refined model.

A comparison of medium-chain and long-chain triglycerides in surgical patients.

PubMed Central

Jiang, Z M; Zhang, S Y; Wang, X R; Yang, N F; Zhu, Y; Wilmore, D

1993-01-01

Available lipid emulsions made from soybean or safflower oil are classified as long-chain triglycerides (LCT). In contrast, medium-chain triglyceride (MCT) emulsions have different physical properties and are metabolized by other biochemical pathways. To compare the differences between these two fat emulsions, the authors studied 12 surgical patients and 6 volunteers. These subjects were randomly assigned to receive parenteral nutrition with MCT or LCT emulsion. Measurement of arterial and venous concentration differences across the forearm demonstrated that muscle utilization was significantly improved with MCT administration. There was also a trend toward improved nitrogen balance in the MCT group, and less weight loss in the postoperative period also was observed in this group. During the fat clearance test, the serum ketone concentrations were significantly higher in the MCT than the LCT group. The improvement in nitrogen retention may be associated with increasing ketone and insulin levels. Fat emulsions containing 50% MCT are safe for use in parenteral nutrition and may provide an alternate fuel that improves protein metabolism. PMID:8439215

Treatment of Dysphagia with Pyridostigmine Bromide in a Patient with the Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome

PubMed Central

Lee, Kwang Lae; Lim, Oh Kyung; Park, Ki Deok

2012-01-01

A 24-year-old male developed bulbar palsy, ophthalmoplegia, ptosis, and shoulder weakness bilaterally 2 weeks after he had experienced an upper respiratory infection. The electrodiagnostic study demonstrated axonal polyradiculoneuropathy. The repetitive nerve stimulation study (RNS) showed no significant decrement of the compound muscle action potentials (CMAPs). The videofluoroscopic swallowing study (VFSS) showed severe impairment of the pharyngeal phase of swallowing. He was diagnosed as having the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. The patient's dysphagia was not improved for 3 months. A follow up RNS showed a significant decrement of the CMAPs. Pyridostigmine bromide was tried to improve the dysphagia. The patient showed immediate improvement of his dysphagia on the VFSS after the trial with pyridostigmine bromide. Pyridostigmine bromide was given before each meal for 8 days and he showed continuous improvement of his dysphagia. The follow up VFSS after 3 months showed complete recovery of dysphagia. PMID:22506249

Treatment of Dysphagia with pyridostigmine bromide in a patient with the pharyngeal-cervical-brachial variant of guillain-barré syndrome.

PubMed

Lee, Kwang Lae; Lim, Oh Kyung; Lee, Ju Kang; Park, Ki Deok

2012-02-01

A 24-year-old male developed bulbar palsy, ophthalmoplegia, ptosis, and shoulder weakness bilaterally 2 weeks after he had experienced an upper respiratory infection. The electrodiagnostic study demonstrated axonal polyradiculoneuropathy. The repetitive nerve stimulation study (RNS) showed no significant decrement of the compound muscle action potentials (CMAPs). The videofluoroscopic swallowing study (VFSS) showed severe impairment of the pharyngeal phase of swallowing. He was diagnosed as having the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. The patient's dysphagia was not improved for 3 months. A follow up RNS showed a significant decrement of the CMAPs. Pyridostigmine bromide was tried to improve the dysphagia. The patient showed immediate improvement of his dysphagia on the VFSS after the trial with pyridostigmine bromide. Pyridostigmine bromide was given before each meal for 8 days and he showed continuous improvement of his dysphagia. The follow up VFSS after 3 months showed complete recovery of dysphagia.

Feasibility of cognitive remediation therapy for adults with autism spectrum disorders: a single-group pilot study.

PubMed

Okuda, Tomoko; Asano, Kenichi; Numata, Noriko; Hirano, Yoshiyuki; Yamamoto, Tetsuya; Tanaka, Mari; Matsuzawa, Daisuke; Shimizu, Eiji; Iyo, Masaomi; Nakazato, Michiko

2017-01-01

Set-shifting (SS) difficulties and weak central coherence (CC) are commonly associated with autism spectrum disorders (ASD). Cognitive remediation therapy (CRT) aims to improve such cognitive processing; however, there are no reports on CRT for patients with ASD. This pilot study aimed to provide preliminary evidence to support the use of CRT for individuals with ASD and provide data to inform future studies. Nineteen individuals with ASD were recruited and administered a series of neuropsychological and questionnaire measures to examine cognitive function and clinical outcomes such as anxiety and depression. Participants received CRT, and cognitive function and clinical variables were re-evaluated at postintervention and after 3 months. The participants demonstrated significant improvement in CC and anxiety at postintervention, which was maintained at 3-month follow-up. Although SS scores had improved with a large effect size, this was not statistically significant. CRT improved CC and anxiety scores for individuals with ASD, suggesting that CRT is an effective treatment for individuals with ASD.

The American Society for Clinical Pathology resident in-service examination: does resident performance provide insight into the effectiveness of clinical pathology education?

PubMed

McKenna, Barbara J

2007-06-01

The resident in-service examination in pathology is an in-training exercise that is taken by virtually all pathology residents in the United States as well as by some participants in Canada, Ireland, and Lebanon. Although all of the anatomic pathology topics in the examination, with only one exception-forensic pathology, show significant improvement in scores over the 4 years of residency training, three areas of clinical pathology training (laboratory administration, clinical chemistry, and microbiology) show significantly lower improvement in performance over the years of residency training. By contrast, transfusion medicine, hematopathology and the special topics section of the examination all demonstrate improved performance by residents over time. While the reason behind these differences must remain speculative at this time, these findings suggest that measures to improve effectiveness in clinical pathology training might be suggested by examining the differences between residency training practices between higher and lower performing areas of clinical pathology.

Short-Term Efficacy of a "Sit Less, Walk More" Workplace Intervention on Improving Cardiometabolic Health and Work Productivity in Office Workers.

PubMed

Lin, Yun-Ping; Lin, Chiu-Chu; Chen, Meei-Maan; Lee, Kwo-Chen

2017-03-01

The aim of this study was to test the short-term efficacy of the Sit Less, Walk More (SLWM) workplace intervention. This was a quasi-experimental design. A total of 99 office workers from two workplaces participated in this study. The 12-week intervention included five components: monthly newsletters, motivational tools, pedometer challenge, environmental prompts, and walking route. The comparison group received monthly newsletters only. Generalized estimating equation analyses showed that the intervention group demonstrated significant improvements in weight (P = 0.029), waist circumference (P = 0.038), diastolic blood pressure (P < 0.001), walking (P < 0.001), moderate-intensity physical activity (P = 0.014), and total physical activity (P = 0.003) relative to the comparison group. A significant improvement in lost-productivity was observed in both groups (P = 0.003 to 0.008). The SLWM workplace intervention can improve worker health and lost-productivity.

Grain-refining heat treatments to improve cryogenic toughness of high-strength steels

NASA Technical Reports Server (NTRS)

Rush, H. F.

1984-01-01

The development of two high Reynolds number wind tunnels at NASA Langley Research Center which operate at cryogenic temperatures with high dynamic pressures has imposed severe requirements on materials for model construction. Existing commercial high strength steels lack sufficient toughness to permit their safe use at temperatures approaching that of liquid nitrogen (-320 F). Therefore, a program to improve the cryogenic toughness of commercial high strength steels was conducted. Significant improvement in the cryogenic toughness of commercial high strength martensitic and maraging steels was demonstrated through the use of grain refining heat treatments. Charpy impact strength at -320 F was increased by 50 to 180 percent for the various alloys without significant loss in tensile strength. The grain sizes of the 9 percent Ni-Co alloys and 200 grade maraging steels were reduced to 1/10 of the original size or smaller, with the added benefit of improved machinability. This grain refining technique should permit these alloys with ultimate strengths of 220 to 270 ksi to receive consideration for cryogenic service.

Improvement of Quantitative Measurements in Multiplex Proteomics Using High-Field Asymmetric Waveform Spectrometry.

PubMed

Pfammatter, Sibylle; Bonneil, Eric; Thibault, Pierre

2016-12-02

Quantitative proteomics using isobaric reagent tandem mass tags (TMT) or isobaric tags for relative and absolute quantitation (iTRAQ) provides a convenient approach to compare changes in protein abundance across multiple samples. However, the analysis of complex protein digests by isobaric labeling can be undermined by the relative large proportion of co-selected peptide ions that lead to distorted reporter ion ratios and affect the accuracy and precision of quantitative measurements. Here, we investigated the use of high-field asymmetric waveform ion mobility spectrometry (FAIMS) in proteomic experiments to reduce sample complexity and improve protein quantification using TMT isobaric labeling. LC-FAIMS-MS/MS analyses of human and yeast protein digests led to significant reductions in interfering ions, which increased the number of quantifiable peptides by up to 68% while significantly improving the accuracy of abundance measurements compared to that with conventional LC-MS/MS. The improvement in quantitative measurements using FAIMS is further demonstrated for the temporal profiling of protein abundance of HEK293 cells following heat shock treatment.

MRI-guided brachytherapy

PubMed Central

Tanderup, Kari; Viswanathan, Akila; Kirisits, Christian; Frank, Steven J.

2014-01-01

The application of MRI-guided brachytherapy has demonstrated significant growth during the last two decades. Clinical improvements in cervix cancer outcomes have been linked to the application of repeated MRI for identification of residual tumor volumes during radiotherapy. This has changed clinical practice in the direction of individualized dose administration, and mounting evidence of improved clinical outcome with regard to local control, overall survival as well as morbidity. MRI-guided prostate HDR and LDR brachytherapy has improved the accuracy of target and organs-at-risk (OAR) delineation, and the potential exists for improved dose prescription and reporting for the prostate gland and organs at risk. Furthermore, MRI-guided prostate brachytherapy has significant potential to identify prostate subvolumes and dominant lesions to allow for dose administration reflecting the differential risk of recurrence. MRI-guided brachytherapy involves advanced imaging, target concepts, and dose planning. The key issue for safe dissemination and implementation of high quality MRI-guided brachytherapy is establishment of qualified multidisciplinary teams and strategies for training and education. PMID:24931089

Auxetic hexachiral structures with wavy ligaments for large elasto-plastic deformation

NASA Astrophysics Data System (ADS)

Zhu, Yilin; Wang, Zhen-Pei; Hien Poh, Leong

2018-05-01

The hexachiral structure is in-plane isotropic in small deformation. When subjected to large elasto-plastic deformation, however, the hexachiral structure tends to lose its auxeticity and/or isotropy—properties which are desirable in many potential applications. The objective of this study is to improve these two mechanical properties, without significantly compromising the effective yield stress, in the regime with significant material and geometrical nonlinearity effects. It is found that the deformation mechanisms underlying the auxeticity and isotropy properties of a hexachiral structure are largely influenced by the extent of rotation of the central ring in a unit cell. To facilitate the development of this deformation mechanism, an improved design with wavy ligaments is proposed. The improved performance of the proposed hexachiral structure is demonstrated. An initial study on possible applications as a protective material is next carried out, where the improved hexachiral design is shown to exhibit higher specific energy absorption capacity compared to the original design, as well as standard honeycomb structures.

Metamorphic III–V Solar Cells: Recent Progress and Potential

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

Garcia, Ivan; France, Ryan M.; Geisz, John F.

Inverted metamorphic multijunction solar cells have been demonstrated to be a pathway to achieve the highest photovoltaic (PV) conversion efficiencies. Attaining high-quality lattice-mismatched (metamorphic) semiconductor devices is challenging. However, recent improvements to compositionally graded buffer epitaxy and junction structures have led to the achievement of high-quality metamorphic solar cells exhibiting internal luminescence efficiencies over 90%. For this high material quality, photon recycling is significant, and therefore, the optical environment of the solar cell becomes important. In this paper, we first present recent progress and performance results for 1- and 0.7-eV GaInAs solar cells grown on GaAs substrates. Then, an electroopticalmore » model is used to assess the potential performance improvements in current metamorphic solar cells under different realizable design scenarios. The results show that the quality of 1-eV subcells is such that further improving its electronic quality does not produce significant Voc increases in the four-junction inverted metamorphic subcells, unless a back reflector is used to enhance photon recycling, which would significantly complicate the structure. Conversely, improving the electronic quality of the 0.7-eV subcell would lead to significant Voc boosts, driving the progress of four-junction inverted metamorphic solar cells.« less

Improvements in brain and behavior following eradication of hepatitis C.

PubMed

Kuhn, Taylor; Sayegh, Philip; Jones, Jacob D; Smith, Jason; Sarma, Manoj K; Ragin, A; Singer, Elyse J; Albert Thomas, M; Thames, April D; Castellon, Steven A; Hinkin, Charles H

2017-08-01

Despite recent advances in treatment, hepatitis C remains a significant public health problem. The hepatitis C virus (HCV) is known to infiltrate the brain, yet findings from studies on associated neurocognitive and neuropathological changes are mixed. Furthermore, it remains unclear if HCV eradication improves HCV-associated neurological compromise. This study examined the longitudinal relationship between neurocognitive and neurophysiologic markers among healthy HCV- controls and HCV+ adults following successful HCV eradication. We hypothesized that neurocognitive outcomes following treatment would be related to both improved cognition and white matter integrity. Participants included 57 HCV+ participants who successfully cleared the virus at the end of treatment (sustained virologic responders [SVRs]) and 22 HCV- controls. Participants underwent neuropsychological testing and, for a nested subset of participants, neuroimaging (diffusion tensor imaging) at baseline and 12 weeks following completion of HCV therapy. Contrary to expectation, group-level longitudinal analyses did not reveal significant improvement in neurocognitive performance in the SVRs compared to the control group. However, a subgroup of SVRs demonstrated a significant improvement in cognition relative to controls, which was related to improved white matter integrity. Indeed, neuroimaging data revealed beneficial effects associated with clearing the virus, particularly in the posterior corona radiata and the superior longitudinal fasciculus. Findings suggest that a subgroup of HCV+ patients experienced improvements in cognitive functioning following eradication of HCV, which appears related to positive changes in white matter integrity. Future research should examine whether any additional improvements in neurocognition and white matter integrity among SVRs occur with longer follow-up periods.

Idaho National Laboratory Integrated Safety Management System FY 2013 Effectiveness Review and Declaration Report

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

Hunt, Farren

2013-12-01

Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for Fiscal Year (FY) 2014. Results of the FY 2013 annual effectiveness review demonstrate that the INL’s ISMS program is “Effective” and continually improving and shows signs of being significantly strengthened. Although there have been unacceptable serious events in themore » past, there has also been significant attention, dedication, and resources focused on improvement, lessons learned and future prevention. BEA’s strategy of focusing on these improvements includes extensive action and improvement plans that include PLN 4030, “INL Sustained Operational Improvement Plan, PLN 4058, “MFC Strategic Excellence Plan,” PLN 4141, “ATR Sustained Excellence Plan,” and PLN 4145, “Radiological Control Road to Excellence,” and the development of LWP 20000, “Conduct of Research.” As a result of these action plans, coupled with other assurance activities and metrics, significant improvement in operational performance, organizational competence, management oversight and a reduction in the number of operational events is being realized. In short, the realization of the fifth core function of ISMS (feedback and continuous improvement) and the associated benefits are apparent.« less

Histone deacetylase inhibitor significantly improved the cloning efficiency of porcine somatic cell nuclear transfer embryos.

PubMed

Huang, Yongye; Tang, Xiaochun; Xie, Wanhua; Zhou, Yan; Li, Dong; Yao, Chaogang; Zhou, Yang; Zhu, Jianguo; Lai, Liangxue; Ouyang, Hongsheng; Pang, Daxin

2011-12-01

Valproic acid (VPA), a histone deacetylase inbibitor, has been shown to generate inducible pluripotent stem (iPS) cells from mouse and human fibroblasts with a significant higher efficiency. Because successful cloning by somatic cell nuclear transfer (SCNT) undergoes a full reprogramming process in which the epigenetic state of a differentiated donor nuclear is converted into an embryonic totipotent state, we speculated that VPA would be useful in promoting cloning efficiency. Therefore, in the present study, we examined whether VPA can promote the developmental competence of SCNT embryos by improving the reprogramming state of donor nucleus. Here we report that 1 mM VPA for 14 to 16 h following activation significantly increased the rate of blastocyst formation of porcine SCNT embryos constructed from Landrace fetal fibroblast cells compared to the control (31.8 vs. 11.4%). However, we found that the acetylation level of Histone H3 lysine 14 and Histone H4 lysine 5 and expression level of Oct4, Sox2, and Klf4 was not significantly changed between VPA-treated and -untreated groups at the blastocyst stage. The SCNT embryos were transferred to 38 surrogates, and the cloning efficiency in the treated group was significantly improved compared with the control group. Taken together, we have demonstrated that VPA can improve both in vitro and in vivo development competence of porcine SCNT embryos.

Mobile Assessment and Treatment for Schizophrenia (MATS): A Pilot Trial of An Interactive Text-Messaging Intervention for Medication Adherence, Socialization, and Auditory Hallucinations

PubMed Central

Granholm, Eric; Ben-Zeev, Dror; Bradshaw, Kristen R.; Holden, Jason L.

2012-01-01

Mobile Assessment and Treatment for Schizophrenia (MATS) employs ambulatory monitoring methods and cognitive behavioral therapy interventions to assess and improve outcomes in consumers with schizophrenia through mobile phone text messaging. Three MATS interventions were developed to target medication adherence, socialization, and auditory hallucinations. Participants received up to 840 text messages over a 12-week intervention period. Fifty-five consumers with schizophrenia or schizoaffective disorder were enrolled, but 13 consumers with more severe negative symptoms, lower functioning, and lower premorbid IQ did not complete the intervention, despite repeated prompting and training. For completers, the average valid response rate for 216 outcome assessment questions over the 12-week period was 86%, and 86% of phones were returned undamaged. Medication adherence improved significantly, but only for individuals who were living independently. Number of social interactions increased significantly and a significant reduction in severity of hallucinations was found. In addition, the probability of endorsing attitudes that could interfere with improvement in these outcomes was also significantly reduced in MATS. Lab-based assessments of more general symptoms and functioning did not change significantly. This pilot study demonstrated that low-intensity text-messaging interventions like MATS are feasible and effective interventions to improve several important outcomes, especially for higher functioning consumers with schizophrenia. PMID:22080492

Clinical trial: phase 2 study of lubiprostone for irritable bowel syndrome with constipation.

PubMed

Johanson, J F; Drossman, D A; Panas, R; Wahle, A; Ueno, R

2008-04-01

Analyses of a trial in constipated patients indicated that lubiprostone may be an effective treatment for irritable bowel syndrome with constipation. To assess the efficacy and safety of three lubiprostone doses for irritable bowel syndrome with constipation. 195 irritable bowel syndrome with constipation patients received daily doses of 16 [8 microg twice daily (b.d.)], 32 (16 microg b.d.) or 48 microg (24 microg b.d.) lubiprostone or placebo b.d. for 3 months. Gastrointestinal parameters were recorded in diaries daily by patients. After 1 month, lubiprostone showed significantly greater improvements in mean abdominal discomfort/pain scores vs. placebo (P = 0.023). After 2 months, all lubiprostone groups showed significantly greater improvements in mean abdominal discomfort/pain scores (P < or = 0.039). After 3 months of treatment, the improvement in each lubiprostone arm was greater than placebo, but the test for trend was no longer significant. Treatment with lubiprostone showed significantly higher rates of gastrointestinal adverse events (P = 0.020), especially diarrhoea and nausea. Lubiprostone significantly improved gastrointestinal symptoms of irritable bowel syndrome with constipation at all doses. Higher doses of lubiprostone, especially the 48 microg/day group, were associated with more gastrointestinal adverse events. From these data, the 16 microg/day dose demonstrated the optimal combination of efficacy and safety. These results warrant further study of lubiprostone for treatment of irritable bowel syndrome with constipation patients.

How to Measure and Interpret Quality Improvement Data.

PubMed

McQuillan, Rory Francis; Silver, Samuel Adam; Harel, Ziv; Weizman, Adam; Thomas, Alison; Bell, Chaim; Chertow, Glenn M; Chan, Christopher T; Nesrallah, Gihad

2016-05-06

This article will demonstrate how to conduct a quality improvement project using the change idea generated in "How To Use Quality Improvement Tools in Clinical Practice: How To Diagnose Solutions to a Quality of Care Problem" by Dr. Ziv Harel and colleagues in this Moving Points feature. This change idea involves the introduction of a nurse educator into a CKD clinic with a goal of increasing rates of patients performing dialysis independently at home (home hemodialysis or peritoneal dialysis). Using this example, we will illustrate a Plan-Do-Study-Act (PDSA) cycle in action and highlight the principles of rapid cycle change methodology. We will then discuss the selection of outcome, process, and balancing measures, and the practicalities of collecting these data in the clinic environment. We will also introduce the PDSA worksheet as a practical way to oversee the progress of a quality improvement project. Finally, we will demonstrate how run charts are used to visually illustrate improvement in real time, and how this information can be used to validate achievement, respond appropriately to challenges the project may encounter, and prove the significance of results. This article aims to provide readers with a clear and practical framework upon which to trial their own ideas for quality improvement in the clinical setting. Copyright © 2016 by the American Society of Nephrology.

Objective Integrated Assessment of Functional Outcomes in Reduction Mammaplasty

PubMed Central

Passaro, Ilaria; Malovini, Alberto; Faga, Angela; Toffola, Elena Dalla

2013-01-01

Background: The aim of our study was an objective integrated assessment of the functional outcomes of reduction mammaplasty. Methods: The study involved 17 women undergoing reduction mammaplasty from March 2009 to June 2011. Each patient was assessed before surgery and 2 months postoperatively with the original association of 4 subjective and objective assessment methods: a physiatric clinical examination, the Roland Morris Disability Questionnaire, the Berg Balance Scale, and a static force platform analysis. Results: All of the tests proved multiple statistically significant associated outcomes demonstrating a significant improvement in the functional status following reduction mammaplasty. Surgical correction of breast hypertrophy could achieve both spinal pain relief and recovery of performance status in everyday life tasks, owing to a muscular postural functional rearrangement with a consistent antigravity muscle activity sparing. Pain reduction in turn could reduce the antalgic stiffness and improved the spinal range of motion. In our sample, the improvement of the spinal range of motion in flexion matched a similar improvement in extension. Recovery of a more favorable postural pattern with reduction of the anterior imbalance was demonstrated by the static force stabilometry. Therefore, postoperatively, all of our patients narrowed the gap between the actual body barycenter and the ideal one. The static force platform assessment also consistently confirmed the effectiveness of an accurate clinical examination of functional impairment from breast hypertrophy. Conclusions: The static force platform assessment might help the clinician to support the diagnosis of functional impairment from a breast hypertrophy with objectively based data. PMID:25289256

Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide.

PubMed

Ghahramanlou-Holloway, M; Bhar, S S; Brown, G K; Olsen, C; Beck, A T

2012-06-01

Cognitive therapy has been found to be effective in decreasing the recurrence of suicide attempts. A theoretical aim of cognitive therapy is to improve problem-solving skills so that suicide no longer remains the only available option. This study examined the differential rate of change in problem-solving appraisal following suicide attempts among individuals who participated in a randomized controlled trial for the prevention of suicide. Changes in problem-solving appraisal from pre- to 6-months post-treatment in individuals with a recent suicide attempt, randomized to either cognitive therapy (n = 60) or a control condition (n = 60), were assessed by using the Social Problem-Solving Inventory-Revised, Short Form. Improvements in problem-solving appraisal were similarly observed for both groups within the 6-month follow-up. However, during this period, individuals assigned to the cognitive therapy condition demonstrated a significantly faster rate of improvement in negative problem orientation and impulsivity/carelessness. More specifically, individuals receiving cognitive therapy were significantly less likely to report a negative view toward life problems and impulsive/carelessness problem-solving style. Cognitive therapy for the prevention of suicide provides rapid changes within 6 months on negative problem orientation and impulsivity/carelessness problem-solving style. Given that individuals are at the greatest risk for suicide within 6 months of their last suicide attempt, the current study demonstrates that a brief cognitive intervention produces a rapid rate of improvement in two important domains of problem-solving appraisal during this sensitive period.

Executive Function Deficits in Children with Attention-Deficit/Hyperactivity Disorder and Improvement with Lisdexamfetamine Dimesylate in an Open-Label Study

PubMed Central

Turgay, Atilla; Ginsberg, Lawrence; Sarkis, Elias; Jain, Rakesh; Adeyi, Ben; Gao, Joseph; Dirks, Bryan; Babcock, Thomas; Scheckner, Brian; Richards, Cynthia; Lasser, Robert

2010-01-01

Abstract Objective To assess the effects of lisdexamfetamine dimesylate (LDX) on executive function (EF) behaviors in children with attention-deficit/hyperactivity disorder (ADHD). Methods This observational, open-label, 7-week, dose-optimization study of LDX (20–70 mg/day) in children with ADHD evaluated efficacy with the ADHD Rating Scale IV; safety measures included adverse events (AEs). EF was assessed with the Behavior Rating Inventory of Executive Function (BRIEF). Post hoc analyses examined BRIEF scores by sex, ADHD subtype, comorbid psychiatric symptoms, and common treatment-emergent AEs (TEAEs). ADHD Rating Scale IV scores were assessed in subjects categorized by baseline BRIEF global executive composite T scores with clinically significant (≥65) or not clinically significant (<65) impairment in EF. Results Mean (standard deviation) change from baseline to endpoint for BRIEF of −17.9 (12.5) for Global Executive Composite, −15.4 (12.6) for Behavioral Regulation Index, and −17.6 (12.3) for Metacognition Index demonstrated improvement with LDX (pooled doses; p < 0.0001 for all). Improvements in BRIEF scores were seen regardless of sex, ADHD subtype, comorbid psychiatric symptoms, common TEAEs, or baseline EF impairment category. TEAEs included decreased appetite, decreased weight, irritability, insomnia, headache, upper abdominal pain, and initial insomnia. Conclusions Improvements were demonstrated in EF behaviors and ADHD symptoms with LDX. LDX safety profile was consistent with long-acting stimulant use. PMID:21186969

Aiming for excellence - A simulation-based study on adapting and testing an instrument for developing non-technical skills in Norwegian student nurse anaesthetists.

PubMed

Flynn, Fiona M; Sandaker, Kjersti; Ballangrud, Randi

2017-01-01

There is increasing focus on building safety into anaesthesia practice, with excellence in anaesthesia as an aspirational goal. Non-technical skills are an important factor in excellence and improved patient safety, though there have been few systematic attempts at integrating them into anaesthesia nursing education. This study aimed to test the reliability of NANTS-no, a specially adapted behavioural marker system for nurse anaesthetists in Norway, and explore the development of non-technical skills in student nurse anaesthetists. The pre-test post-test design incorporated a 10-week simulation-based programme, where non-technical skills in 14 student nurse anaesthetists were rated on three different occasions during high-fidelity simulation, before and after taking part in a training course. NANTS-no demonstrated high overall inter-rater reliability (ICC = 0.91), high test-retest reliability (ICC = 0.94) and good internal consistency (Cronbach's α of 0.85-0.92). A significant improvement was demonstrated across all categories of non-technical skills, with greatest improvements between the first and third and second and third sessions. There was also a significant improvement in two categories between the first and second sessions. NANTS-no is therefore suitable for assessing non-technical skills during simulation training in anaesthesia nursing education. More research is needed to validate its use in clinical practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Combining task-evoked and spontaneous activity to improve pre-operative brain mapping with fMRI

PubMed Central

Fox, Michael D.; Qian, Tianyi; Madsen, Joseph R.; Wang, Danhong; Li, Meiling; Ge, Manling; Zuo, Huan-cong; Groppe, David M.; Mehta, Ashesh D.; Hong, Bo; Liu, Hesheng

2016-01-01

Noninvasive localization of brain function is used to understand and treat neurological disease, exemplified by pre-operative fMRI mapping prior to neurosurgical intervention. The principal approach for generating these maps relies on brain responses evoked by a task and, despite known limitations, has dominated clinical practice for over 20 years. Recently, pre-operative fMRI mapping based on correlations in spontaneous brain activity has been demonstrated, however this approach has its own limitations and has not seen widespread clinical use. Here we show that spontaneous and task-based mapping can be performed together using the same pre-operative fMRI data, provide complimentary information relevant for functional localization, and can be combined to improve identification of eloquent motor cortex. Accuracy, sensitivity, and specificity of our approach are quantified through comparison with electrical cortical stimulation mapping in eight patients with intractable epilepsy. Broad applicability and reproducibility of our approach is demonstrated through prospective replication in an independent dataset of six patients from a different center. In both cohorts and every individual patient, we see a significant improvement in signal to noise and mapping accuracy independent of threshold, quantified using receiver operating characteristic curves. Collectively, our results suggest that modifying the processing of fMRI data to incorporate both task-based and spontaneous activity significantly improves functional localization in pre-operative patients. Because this method requires no additional scan time or modification to conventional pre-operative data acquisition protocols it could have widespread utility. PMID:26408860

Clinical roundtable monograph: new and emerging treatments for advanced prostate cancer.

PubMed

George, Daniel J; Kantoff, Philip W; Lin, Daniel W

2011-06-01

Historically, the treatment of metastatic castration-resistant prostate cancer (CRPC) has been limited to chemotherapeutic regimens that did not improve patient survival. In 2004, clinical studies began to demonstrate significant improvements in patient outcomes, including overall survival, with docetaxel versus mitoxantrone chemotherapy. Since these pivotal trials, the combination of docetaxel plus prednisone has become a standard of care for patients with metastatic CRPC. However, the limited survival benefit achieved with this regimen prompted several investigations into the development of alternative therapeutic options. Recent advances have now led to an unprecedented number of new drug approvals within the past year, providing many new treatment options for patients with metastatic CRPC. Sipuleucel-T, considered a new paradigm in cancer treatment, is the first such immunotherapeutic agent approved by the US Food and Drug Administration. Other successes include abiraterone acetate, the first androgen biosynthesis inhibitor, and cabazitaxel, a novel microtubule inhibitor, both of which have demonstrated improved survival following docetaxel failure. The bone-targeting agent denosumab, also recently approved in this setting, offers these patients significant improvement in the prevention of skeletal-related events. The data supporting the approval of each of these agents are described in this monograph, as are current approaches in the treatment of metastatic CRPC and ongoing clinical trials of novel treatments and strategies. The experts also discuss several of the issues regarding the introduction of these novel agents into clinical practice for metastatic CRPC patients.

The use of a daily goals sheet to improve communication in the paediatric intensive care unit.

PubMed

Phipps, Lorri M; Thomas, Neal J

2007-10-01

To assess the impact of the implementation of a daily goals sheet upon nursing perception of communication in an academic, tertiary care paediatric intensive care unit (PICU). Prospective, longitudinal, before-and-after intervention surveys. University affiliated 12-bed PICU. Bedside nurses. A questionnaire was administered to PICU nurses addressing their perception of communication. Following this questionnaire, the use of a daily goals sheet was instituted. A second questionnaire was administered one year later. Mann-Whitney Rank Sum Test was used to compare differences of the graded outcome variables. The primary outcome was the perception of communication taken from a nursing perspective. Eighty-five percent of nurses felt the daily goals sheet led to improved communication between physicians and nurses in the PICU. All questions related to communication demonstrated a positive influence of the goals sheet, with the perception of the PICU staff working as a team reaching statistical significance (p=0.05). The perception of the care of one surgical service being attending physician directed also significantly improved after the institution of the goals sheet (p=0.04). The institution of a daily goals sheet led to an improvement in nursing perception of communication. Future studies are required to determine if this change in process has a demonstrable effect on health care outcomes of critically ill children, or whether this tool can have the same beneficial effects in other academic and non-academic PICUs.

Usability of virtual-reality simulation training in obstetric ultrasonography: a prospective cohort study.

PubMed

Burden, C; Preshaw, J; White, P; Draycott, T J; Grant, S; Fox, R

2013-08-01

To assess the usability of virtual-reality (VR) simulation for obstetric ultrasound trainees. Twenty-six participants were recruited: 18 obstetric ultrasound trainees (with little formal ultrasonography training) and eight certified experts. All performed five sequential VR-simulated crown-rump length (CRL) scans in a single session and three repetitions of biparietal diameter (BPD), occipitofrontal diameter (OFD) and femur length (FL) measurements. Outcome measures included mean percentage deviation from target for all measurements. Time taken to perform each type of scan was recorded. The mean percentage difference for the first scan was significantly greater for the trainee group than for the expert group for BPD (P = 0.035), OFD (P = 0.010) and FL (P = 0.008) and for time taken for the first CRL (P < 0.001) and fetal biometry (including BPD, OFD and FL measurements) scan (P < 0.001), demonstrating that trainees were initially significantly less accurate and less efficient. Over subsequent scans, the trainees became more accurate for all measurements with a significant improvement shown for OFD and FL (P < 0.05). The time taken for trainees to complete CRL and fetal biometry scans decreased significantly (all P < 0.05) with repetition, to near-expert efficiency. All participants were able to use the simulator and produce clinically meaningful biometry results. With repetition, beginners quickly approached near-expert levels of accuracy and speed. These data demonstrate that obstetricians with minimal experience can improve their ultrasonographic skills with short-phase VR-simulation training. The speed of improvement suggests that VR simulation might be useful as a warm-up exercise before clinical training sessions in order to reduce their impact on clinical service. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Chromium picolinate enhances skeletal muscle cellular insulin signaling in vivo in obese, insulin-resistant JCR:LA-cp rats.

PubMed

Wang, Zhong Q; Zhang, Xian H; Russell, James C; Hulver, Matthew; Cefalu, William T

2006-02-01

Chromium is one of the few trace minerals for which a specific cellular mechanism of action has not been identified. Recent in vitro studies suggest that chromium supplementation may improve insulin sensitivity by enhancing insulin receptor signaling, but this has not been demonstrated in vivo. We investigated the effect of chromium supplementation on insulin receptor signaling in an insulin-resistant rat model, the JCR:LA-corpulent rat. Male JCR:LA-cp rats (4 mo of age) were randomly assigned to receive chromium picolinate (CrPic) (obese n=6, lean n=5) or vehicle (obese n=5, lean n=5) for 3 mo. The CrPic was provided in the water, and based on calculated water intake, rats randomized to CrPic received 80 microg/(kg.d). At the end of the study, skeletal muscle (vastus lateralis) biopsies were obtained at baseline and at 5, 15, and 30 min postinsulin stimulation to assess insulin signaling. Obese rats treated with CrPic had significantly improved glucose disposal rates and demonstrated a significant increase in insulin-stimulated phosphorylation of insulin receptor substrate (IRS)-1 and phosphatidylinositol (PI)-3 kinase activity in skeletal muscle compared with obese controls. The increase in cellular signaling was not associated with increased protein levels of the IRS proteins, PI-3 kinase or Akt. However, protein tyrosine phosphatase 1B (PTP1B) levels were significantly lower in obese rats administered CrPic than obese controls. When corrected for protein content, PTP1B activity was also significantly lower in obese rats administered CrPic than obese controls. Our data suggest that chromium supplementation of obese, insulin-resistant rats may improve insulin action by enhancing intracellular signaling.

Efficacy of paraffin wax bath for carpal tunnel syndrome: a randomized comparative study

NASA Astrophysics Data System (ADS)

Ordahan, Banu; Karahan, Ali Yavuz

2017-12-01

Carpal tunnel syndrome (CTS) is the most frequently diagnosed neuropathy of upper extremity entrapment neuropathies. We aimed to investigate the effectiveness of paraffin therapy in patients with CTS. Seventy patients diagnosed with mild or moderate CTS were randomly divided into two groups as splint treatment (during the night and day time as much as possible for 3 weeks) alone and splint (during the night and day time as much as possible for 3 weeks) + paraffin treatment (five consecutive days a week for 3 weeks). Clinical and electrophysiological assessments were performed before and 3 weeks after treatment. The patients were assessed by using visual analog scale (VAS) for pain, electroneuromyography (ENMG), and Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ). The significant improvement was found in VAS scores in both groups when compared with pretreatment values ( p < 0.05). There was no significant improvement in functional capacity score ( p > 0.05), whereas a significant improvement was noted in the BCTQ symptom severity scale score in the splint group ( p < 0.05). Significant improvements were demonstrated in both scorers in the combined treatment group. Similarly, significant improvements were found in the combined treatment group in terms of motor and sensory distal latency, sensory amplitude, and median sensory nerve velocity ( p < 0.05). There was no significant change in electrophysiologic parameters in the splint group ( p > 0.05), and the difference in these parameters between the groups was statistically significant ( p < 0.05). In conclusion, using splinting alone in patients with CTS is an effective treatment for reducing symptoms in the early stages. Paraffin treatment with splint increases the recovery in functional and electrophysiological parameters.

Depression Screening in Chronic Disease Management: A Worksite Health Promotion Initiative.

PubMed

Jensen, Elizabeth; Dumas, Bonnie P; Edlund, Barbara J

2016-03-01

This pilot project aimed to improve depression symptoms and quality-of-life measures for individuals in a worksite disease management program. Two hundred forty-three individuals were invited to participate, out of which 69 enrolled. The participants had a history of diabetes, hypertension, or hyperlipidemia, and demonstrated depression using the Patient Health Questionnaire-9 (PHQ-9). The project consisted of counseling sessions provided every 2 to 4 weeks by a family nurse practitioner. PHQ-9 scores and those of an instrument that measures quality of life, the Veteran's Rand-12 (VR-12), were compared pre-intervention and post-intervention to evaluate the effectiveness of the project. PHQ-9 and VR-12 Mental Health Component (MHC) scores improved significantly after 3 months of nurse practitioner-led individual counseling sessions. This project demonstrated that depression screening and therapeutic management, facilitated by a nurse practitioner, can improve depression and perceived quality of life in individuals with hypertension, hyperlipidemia, or type 2 diabetes. © 2015 The Author(s).

Improvements in flight table dynamic transparency for hardware-in-the-loop facilities

NASA Astrophysics Data System (ADS)

DeMore, Louis A.; Mackin, Rob; Swamp, Michael; Rusterholtz, Roger

2000-07-01

Flight tables are a 'necessary evil' in the Hardware-In-The- Loop (HWIL) simulation. Adding the actual or prototypic flight hardware to the loop, in order to increase the realism of the simulation, forces us to add motion simulation to the process. Flight table motion bases bring unwanted dynamics, non- linearities, transport delays, etc to an already difficult problem sometimes requiring the simulation engineer to compromise the results. We desire that the flight tables be 'dynamically transparent' to the simulation scenario. This paper presents a State Variable Feedback (SVF) control system architecture with feed-forward techniques that improves the flight table's dynamic transparency by significantly reducing the table's low frequency phase lag. We offer some actual results with existing flight tables that demonstrate the improved transparency. These results come from a demonstration conducted on a flight table in the KHILS laboratory at Eglin AFB and during a refurbishment of a flight table for the Boeing Company of St. Charles, Missouri.

Controlling the corrosion and cathodic activation of magnesium via microalloying additions of Ge

PubMed Central

Liu, R. L.; Hurley, M. F.; Kvryan, A.; Williams, G.; Scully, J. R.; Birbilis, N.

2016-01-01

The evolution of corrosion morphology and kinetics for magnesium (Mg) have been demonstrated to be influenced by cathodic activation, which implies that the rate of the cathodic partial reaction is enhanced as a result of anodic dissolution. This phenomenon was recently demonstrated to be moderated by the use of arsenic (As) alloying as a poison for the cathodic reaction, leading to significantly improved corrosion resistance. The pursuit of alternatives to toxic As is important as a means to imparting a technologically safe and effective corrosion control method for Mg (and its alloys). In this work, Mg was microalloyed with germanium (Ge), with the aim of improving corrosion resistance by retarding cathodic activation. Based on a combined analysis herein, we report that Ge is potent in supressing the cathodic hydrogen evolution reaction (reduction of water) upon Mg, improving corrosion resistance. With the addition of Ge, cathodic activation of Mg subject to cyclic polarisation was also hindered, with beneficial implications for future Mg electrodes. PMID:27350286

Immediate improvement of motor function after epilepsy surgery in congenital hemiparesis.

PubMed

Pascoal, Tharick; Paglioli, Eliseu; Palmini, André; Menezes, Rafael; Staudt, Martin

2013-08-01

Hemispherectomy often leads to a loss of contralateral hand function. In some children with congenital hemiparesis, however, paretic hand function remains unchanged. An immediate improvement of hand function has never been reported. A 17-year-old boy with congenital hemiparesis and therapy-refractory seizures due to a large infarction in the territory of the middle cerebral artery underwent epilepsy surgery. Intraoperatively, electrical cortical stimulation of the affected hemisphere demonstrated preserved motor projections from the sensorimotor cortex to the (contralateral) paretic hand. A frontoparietal resection was performed, which included a complete disconnection of all motor projections originating in the sensorimotor cortex of the affected hemisphere. Surprisingly, the paretic hand showed a significant functional improvement immediately after the operation. This observation demonstrates that, in congenital hemiparesis, crossed motor projections from the affected hemisphere are not always beneficial, but can be dysfunctional, interfering with ipsilateral motor control over the paretic hand by the contralesional hemisphere. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Acceptance and Commitment Therapy modules: Differential impact on treatment processes and outcomes.

PubMed

Villatte, Jennifer L; Vilardaga, Roger; Villatte, Matthieu; Plumb Vilardaga, Jennifer C; Atkins, David C; Hayes, Steven C

2016-02-01

A modular, transdiagnostic approach to treatment design and implementation may increase the public health impact of evidence-based psychosocial interventions. Such an approach relies on algorithms for selecting and implementing treatment components intended to have a specific therapeutic effect, yet there is little evidence for how components function independent of their treatment packages when employed in clinical service settings. This study aimed to demonstrate the specificity of treatment effects for two components of Acceptance and Commitment Therapy (ACT), a promising candidate for modularization. A randomized, nonconcurrent, multiple-baseline across participants design was used to examine component effects on treatment processes and outcomes in 15 adults seeking mental health treatment. The ACT OPEN module targeted acceptance and cognitive defusion; the ACT ENGAGED module targeted values-based activation and persistence. According to Tau-U analyses, both modules produced significant improvements in psychiatric symptoms, quality of life, and targeted therapeutic processes. ACT ENGAGED demonstrated greater improvements in quality of life and values-based activation. ACT OPEN showed greater improvements in symptom severity, acceptance, and defusion. Both modules improved awareness and non-reactivity, which were mutually targeted, though using distinct intervention procedures. Both interventions demonstrated high treatment acceptability, completion, and patient satisfaction. Treatment effects were maintained at 3-month follow up. ACT components should be considered for inclusion in a modular approach to implementing evidence-based psychosocial interventions for adults. Copyright © 2015 Elsevier Ltd. All rights reserved.