Characterization and regulation of the Resistance-Nodulation-Cell Division-type multidrug efflux pumps MdtABC and MdtUVW from the fire blight pathogen Erwinia amylovora

PubMed Central

2014-01-01

Background The Gram-negative bacterium Erwinia amylovora is the causal agent of the devastating disease fire blight in rosaceous plants such as apple, pear, quince, raspberry, and cotoneaster. In order to survive and multiply in a host, microbes must be able to circumvent the toxic effects of antimicrobial plant compounds, such as flavonoids and tannins. E. amylovora uses multidrug efflux transporters that recognize and actively export toxic compounds out of the cells. Here, two heterotrimeric resistance-nodulation-cell division (RND)-type multidrug efflux pumps, MdtABC and MdtUVW, from E. amylovora were identified. These RND systems are unusual in that they contain two different RND proteins forming a functional pump. Results To find the substrate specificities of the two efflux systems, we overexpressed the transporters in a hypersensitive mutant lacking the major RND pump AcrB. Both transporters mediated resistance to several flavonoids, fusidic acid and novobiocin. Additionally, MdtABC mediated resistance towards josamycin, bile salts and silver nitrate, and MdtUVW towards clotrimazole. The ability of the mdtABC- and mdtUVW-deficient mutants to multiply in apple rootstock was reduced. Quantitative RT-PCR analyses revealed that the expression of the transporter genes was induced during infection of apple rootstock. The polyphenolic plant compound tannin, as well as the heavy metal salt tungstate was found to induce the expression of mdtABC. Finally, the expression of the mdtABC genes was shown to be regulated by BaeR, the response regulator of the two-component system BaeSR, a cell envelope stress response system that controls the adaptive responses to changes in the environment. Conclusions The expression of MdtABC and MdtUVW is induced during growth of E. amylovora in planta. We identified the plant polyphenol tannin as inducer of mdtABC expression. The reduced ability of the mdtABC- and mdtUVW-deficient mutants to multiply in apple rootstock suggests that the efflux pumps are involved in resistance to plant antimicrobials, maybe including flavonoids, which were identified as substrates of both pumps. Furthermore, we found that the mdtABC operon belongs to the regulon of the two-component regulator BaeR suggesting a role of this RND transporter in the cell envelope stress response of E. amylovora. PMID:25012600

Formation pressure testing at the Mount Elbert Gas Hydrate Stratigraphic Test Well, Alaska North Slope: Operational summary, history matching, and interpretations

USGS Publications Warehouse

Anderson, B.; Hancock, S.; Wilson, S.; Enger, C.; Collett, T.; Boswell, R.; Hunter, R.

2011-01-01

In February 2007, the U.S. Department of Energy, BP Exploration (Alaska), and the U.S. Geological Survey, collected open-hole pressure-response data, as well as gas and water sample collection, in a gas hydrate reservoir (the BPXA-DOE-USGS Mount Elbert Gas Hydrate Stratigraphic Test Well) using Schlumberger's Modular Dynamics Formation Tester (MDT) wireline tool. Four such MDT tests, ranging from six to twelve hours duration, and including a series of flow, sampling, and shut-in periods of various durations, were conducted. Locations for the testing were selected based on NMR and other log data to assure sufficient isolation from reservoir boundaries and zones of excess free water. Test stages in which pressure was reduced sufficiently to mobilize free water in the formation (yet not cause gas hydrate dissociation) produced readily interpretable pressure build-up profiles. Build-ups following larger drawdowns consistently showed gas-hydrate dissociation and gas release (as confirmed by optical fluid analyzer data), as well as progressive dampening of reservoir pressure build-up during sequential tests at a given MDT test station.History matches of one multi-stage, 12-h test (the C2 test) were accomplished using five different reservoir simulators: CMG-STARS, HydrateResSim, MH21-HYDRES, STOMP-HYD, and TOUGH. +. HYDRATE. Simulations utilized detailed information collected across the reservoir either obtained or determined from geophysical well logs, including thickness (11.3. m, 37 ft.), porosity (35%), hydrate saturation (65%), both mobile and immobile water saturations, intrinsic permeability (1000 mD), pore water salinity (5 ppt), and formation temperature (3.3-3.9 ??C). This paper will present the approach and preliminary results of the history-matching efforts, including estimates of initial formation permeability and analyses of the various unique features exhibited by the MDT results. ?? 2010 Elsevier Ltd.

Mindful decision making and inhibitory control training as complementary means to decrease snack consumption.

PubMed

Forman, Evan M; Shaw, Jena A; Goldstein, Stephanie P; Butryn, Meghan L; Martin, Lindsay M; Meiran, Nachshon; Crosby, Ross D; Manasse, Stephanie M

2016-08-01

Obesity is largely attributable to excess caloric intake, in particular from "junk" foods, including salty snack foods. Evidence suggests that neurobiological preferences to consume highly hedonic foods translate (via implicit processes) into poor eating choices, unless overturned by inhibitory mechanisms or interrupted by explicit processes. The primary aim of the current study was to test the independent and combinatory effects of a computerized inhibitory control training (ICT) and a mindful decision-making training (MDT) designed to facilitate de-automatization. We randomized 119 habitual salty snack food eaters to one of four short, training conditions: MDT, ICT, both MDT and ICT, or neither (i.e., psychoeducation). For 7 days prior to the intervention and 7 days following the intervention, participants reported on their salty snack food consumption 2 times per day, on 3 portions of their days, using a smartphone-based ecological momentary assessment system. Susceptibility to emotional eating cues was measured at baseline. Results indicated that the effect of MDT was consistent across levels of trait emotional eating, whereas the benefit of ICT was apparent only at lower levels of emotional eating. No synergistic effect of MDT and ICT was detected. These results provide qualified support for the efficacy of both types of training for decreasing hedonically-motivated eating. Moderation effects suggest that those who eat snack foods for reasons unconnected to affective experiences (i.e., lower in emotional eating) may derive benefit from a combination of ICT and MDT. Future research should investigate the additive benefit of de-automization training to standard weight loss interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Semi-automatic volume measurement for orbital fat and total extraocular muscles based on Cube FSE-flex sequence in patients with thyroid-associated ophthalmopathy.

PubMed

Tang, X; Liu, H; Chen, L; Wang, Q; Luo, B; Xiang, N; He, Y; Zhu, W; Zhang, J

2018-05-24

To investigate the accuracy of two semi-automatic segmentation measurements based on magnetic resonance imaging (MRI) three-dimensional (3D) Cube fast spin echo (FSE)-flex sequence in phantoms, and to evaluate the feasibility of determining the volumetric alterations of orbital fat (OF) and total extraocular muscles (TEM) in patients with thyroid-associated ophthalmopathy (TAO) by semi-automatic segmentation. Forty-four fatty (n=22) and lean (n=22) phantoms were scanned by using Cube FSE-flex sequence with a 3 T MRI system. Their volumes were measured by manual segmentation (MS) and two semi-automatic segmentation algorithms (regional growing [RG], multi-dimensional threshold [MDT]). Pearson correlation and Bland-Altman analysis were used to evaluate the measuring accuracy of MS, RG, and MDT in phantoms as compared with the true volume. Then, OF and TEM volumes of 15 TAO patients and 15 normal controls were measured using MDT. Paired-sample t-tests were used to compare the volumes and volume ratios of different orbital tissues between TAO patients and controls. Each segmentation (MS RG, MDT) has a significant correlation (p<0.01) with true volume. There was a minimal bias for MS, and a stronger agreement between MDT and the true volume than RG and the true volume both in fatty and lean phantoms. The reproducibility of Cube FSE-flex determined MDT was adequate. The volumetric ratios of OF/globe (p<0.01), TEM/globe (p<0.01), whole orbit/globe (p<0.01) and bone orbit/globe (p<0.01) were significantly greater in TAO patients than those in healthy controls. MRI Cube FSE-flex determined MDT is a relatively accurate semi-automatic segmentation that can be used to evaluate OF and TEM volumes in clinic. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Rigorous covariance propagation of geoid errors to geodetic MDT estimates

NASA Astrophysics Data System (ADS)

Pail, R.; Albertella, A.; Fecher, T.; Savcenko, R.

2012-04-01

The mean dynamic topography (MDT) is defined as the difference between the mean sea surface (MSS) derived from satellite altimetry, averaged over several years, and the static geoid. Assuming geostrophic conditions, from the MDT the ocean surface velocities as important component of global ocean circulation can be derived from it. Due to the availability of GOCE gravity field models, for the very first time MDT can now be derived solely from satellite observations (altimetry and gravity) down to spatial length-scales of 100 km and even below. Global gravity field models, parameterized in terms of spherical harmonic coefficients, are complemented by the full variance-covariance matrix (VCM). Therefore, for the geoid component a realistic statistical error estimate is available, while the error description of the altimetric component is still an open issue and is, if at all, attacked empirically. In this study we make the attempt to perform, based on the full gravity VCM, rigorous error propagation to derived geostrophic surface velocities, thus also considering all correlations. For the definition of the static geoid we use the third release of the time-wise GOCE model, as well as the satellite-only combination model GOCO03S. In detail, we will investigate the velocity errors resulting from the geoid component in dependence of the harmonic degree, and the impact of using/no using covariances on the MDT errors and its correlations. When deriving an MDT, it is spectrally filtered to a certain maximum degree, which is usually driven by the signal content of the geoid model, by applying isotropic or non-isotropic filters. Since this filtering is acting also on the geoid component, the consistent integration of this filter process into the covariance propagation shall be performed, and its impact shall be quantified. The study will be performed for MDT estimates in specific test areas of particular oceanographic interest.

PERSPECTIVES ON MULTIDISCIPLINARY TEAM PROCESSES AMONG HEALTHCARE EXECUTIVES: PROCESSES THAT FACILITATE TEAM EFFECTIVENESS.

PubMed

Landry, Amy; Erwin, Cathleen

2015-01-01

Multidisciplinary teams (MDTs) are used in healthcare organizations to address both clinical and managerial functions. Despite their prevalence, little is known about how team processes work to facilitate effectiveness among MDT leadership teams. This study explores perceptions of MDT participation experienced by organizational leaders in healthcare organizations in the United States. A survey of American College of Healthcare Executives members was conducted to assess involvement and perceptions of MDTs among health care management professionals. Descriptive statistics, independent T-Tests and Chi-square analyses were used to examine participation in MDTs, perception of MDT processes, and the association of participation and perceived processes with employee and organizational characteristics. The survey yielded a sample comprised of 492 healthcare executive or executive-track employees. An overwhelming majority indicated participation in MDTs. The study identified team processes that could use improvement including communication, cooperation, and conflict resolution. The study provides evidence that can help guide the development of training programs that focus on providing managerial leaders with strategies aimed at improving communication, coordination, and conflict resolution that will improve the effectiveness of MDT functioning in healthcare organizations.

The cancer multi-disciplinary team from the co-ordinators’ perspective: results from a national survey in the UK

PubMed Central

2012-01-01

Background The MDT-Coordinators’ role is relatively new, and as such it is evolving. What is apparent is that the coordinator’s work is pivotal to the effectiveness and efficiency of an MDT. This study aimed to assess the views and needs of MDT-coordinators. Methods Views of MDT-coordinators were evaluated through an online survey that covered their current practice and role, MDT chairing, opinions on how to improve MDT meetings, and coordinators’ educational/training needs. Results 265 coordinators responded to the survey. More than one third of the respondents felt that the job plan does not reflect their actual duties. It was reported that medical members of the MDT always contribute to case discussions. 66.9% of the respondents reported that the MDTs are chaired by Surgeons. The majority reported having training on data management and IT skills but more than 50% reported that they felt further training is needed in areas of Oncology, Anatomy and physiology, audit and research, peer-review, and leadership skills. Conclusions MDT-Coordinators’ role is central to the care of cancer patients. The study reveals areas of training requirements that remain unmet. Improving the resources and training available to MDT-coordinators can give them an opportunity to develop the required additional skills and contribute to improved MDT performance and ultimately cancer care. Finally, this study looks forward to the impact of the recent launch of a new e-learning training programme for MDT coordinators and discusses implications for future research. PMID:23237502

The application of mechanical diagnosis and therapy in lateral epicondylalgia

PubMed Central

Maccio, Joseph R.; Fink, Sarah; Yarznbowicz, Richard; May, Stephen

2016-01-01

Background lateral epicondylalgia (LE) is a musculoskeletal diagnosis that causes pain and dysfunction in the lateral aspect of the elbow. Mechanical diagnosis and therapy (MDT) is an orthopaedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained end-range movement. There has been no investigation of the association between MDT and patients diagnosed with LE. Case description this report presents three patients matching the currently accepted diagnostic criteria for LE, two with a diagnosis of lateral epicondylitis (tennis elbow) from a medical doctor. These patients were classified and treated by a diplomat of MDT and two third-year doctoral students of physical therapy using MDT. Outcomes short- and long-term (one year) outcomes were excellent, demonstrating rapid abolishment of symptoms and return to prior levels of function in 3–6 visits between 11–59 days. Patients demonstrated the ability to prevent and manage reoccurrence of symptoms independently without seeking further health care. Discussion this case series raises questions about whether or not the pathologies traditionally associated with the aetiology of LE are actually at fault. Moreover, it raises questions about the utility of special tests typically utilized to identify those structures. The series provides preliminary evidence that MDT may be capable of providing effective short- and long-term outcomes in the management of LE. Level of Evidence: 4 PMID:27559286

Transforaminal epidural steroid injections followed by mechanical diagnosis and therapy to prevent surgery for lumbar disc herniation.

PubMed

van Helvoirt, Hans; Apeldoorn, Adri T; Ostelo, Raymond W; Knol, Dirk L; Arts, Mark P; Kamper, Steven J; van Tulder, Maurits W

2014-07-01

Prospective cohort study. To report the clinical course of patients with MRI-confirmed lumbar disc herniation-related radicular noncentralizing pain who received transforaminal epidural steroid injections (TESIs) and mechanical diagnosis and therapy (MDT). Noncentralizing symptoms in patients with lumbar disc herniation are associated with poor outcome. Commonly used treatments for these patients include TESIs and MDT. No study has evaluated the outcome of combining both strategies. Consecutive candidates for herniated lumbar disc surgery with noncentralizing chronic pain were eligible. Patients received TESIs followed by MDT. The primary outcomes were pain severity in the leg, disability (Roland-Morris Disability Questionnaire for Sciatica), and global perceived effect (GPE). Outcomes were measured at baseline, discharge, and 12 months. Linear mixed-models and McNemar's tests were used to analyze outcome data. Sixty-nine patients receive TESIs. After TESIs, symptoms were resolved completely in 11 patients (16%). In these patients, symptom resolution was maintained at 12 months. A second subgroup of 32 patients (46%) reported significantly less pain after TESIs and showed centralization with MDT reassessment (significant reductions in leg pain and disability [P < 0.001]) and a satisfaction rate of 90% at 12 months. A third subgroup of 11 patients (16%) reported significantly less pain after TESIs but still showed noncentralization with MDT reassessment (significant reductions in leg pain and disability [P < 0.05] and a satisfaction rate of 50% at 12 months). A fourth subgroup of 15 patients (22%) did not respond on TESIs and received an operative intervention. The results indicate that a course of TESIs followed by MDT may be able to avoid surgery in a substantial proportion of candidates for herniated lumbar disc surgery. Wiley Periodicals, Inc.

What is a virtual multidisciplinary team (vMDT)?

PubMed Central

Munro, A J; Swartzman, S

2013-01-01

Background: Multidisciplinary team meetings (MDTs), also known as tumour boards or multidisciplinary case conferences, are an integral component of contemporary cancer care. There are logistical problems with setting up and maintaining participation in these meetings. An ill-defined concept, the virtual MDT (vMDT), has arisen in response to these difficulties. We have, in order to provide clarity and to generate discussion, attempted to define the concept of the vMDT, outline its advantages and disadvantages, and consider some of the practical aspects involved in setting up a virtual MDT. Methods: This is an unstructured review of published evidence and personal experience relating to virtual teams in general, and to MDTs in particular. Results: We have devised a simple taxonomy for MDTs, discussed some of the practicalities involved in setting up a vMDT, and described some of the potential advantages and disadvantages associated with vMDTs. Conclusion: The vMDT may be useful for discussions concerning rare or unusual tumours, or for helping guide the assessment and management of patients with uncommon complications related to treatment. However, the vMDT is a niche concept and is currently unlikely to replace the more traditional face-to-face MDT in the management of common tumours at specific sites. PMID:23756866

Secondary multidrug efflux pump mutants alter Escherichia coli biofilm growth in the presence of cationic antimicrobial compounds.

PubMed

Bay, Denice C; Stremick, Carol A; Slipski, Carmine J; Turner, Raymond J

2017-04-01

Escherichia coli possesses many secondary active multidrug resistance transporters (MDTs) that confer overlapping substrate resistance to a broad range of antimicrobials via proton and/or sodium motive force. It is uncertain whether redundant MDTs uniquely alter cell survival when cultures grow planktonically or as biofilms. In this study, the planktonic and biofilm growth and antimicrobial resistance of 13 E. coli K-12 single MDT gene deletion strains in minimal and rich media were determined. Antimicrobial tolerance to tetracycline, tobramycin and benzalkonium were also compared for each ΔMDT strain. Four E. coli MDT families were represented in this study: resistance nodulation and cell division members acrA, acrB, acrD, acrE, acrF and tolC; multidrug and toxin extruder mdtK; major facilitator superfamily emrA and emrB; and small multidrug resistance members emrE, sugE, mdtI and mdtJ. Deletions of multipartite efflux system genes acrB, acrE and tolC resulted in significant reductions in both planktonic and biofilm growth phenotypes and enhanced antimicrobial susceptibilities. The loss of remaining MDT genes produced similar or enhanced (acrD, acrE, emrA, emrB, mdtK, emrE and mdtJ) biofilm growth and antimicrobial resistance. ΔMDT strains with enhanced antimicrobial tolerance also enhanced biofilm biomass. These findings suggest that many redundant MDTs regulate biofilm formation and drug tolerance. Copyright © 2016 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Prisoners' views about the drugs problem in prisons, and the new Prison Service drug strategy.

PubMed

Gore, S M; Bird, A G; Cassidy, J

1999-09-01

Three hundred and seventy-five out of 575 prisoners (222/299 drug users and 153/267 non-users) who responded to a self-completion health care questionnaire at two prisons in 1997 commented on drugs in prisons. One hundred and forty-eight out of 176 responses expressed negative opinions about mandatory drugs testing (MDT), and 107 said that MDT promoted switching to or increased use of heroin/hard drugs'. Sixty-two prisoners suggested that more help/counselling was needed for drug users, 52 segregation of drug users/drug-free wings, and 50 more security on visits/in corridors after medication. The new Prison Service drug strategy has revised random MDT. It targets those who supply drugs, and supports those who want to stop using drugs, and accords with prisoners' views about the heroin problem in prisons.

The antiviral effects of RSV fusion inhibitor, MDT-637, on clinical isolates, vs its achievable concentrations in the human respiratory tract and comparison to ribavirin.

PubMed

Kim, Young-In; Pareek, Rajat; Murphy, Ryan; Harrison, Lisa; Farrell, Eric; Cook, Robert; DeVincenzo, John

2017-11-01

Respiratory syncytial virus (RSV) viral load and disease severity associate, and the timing of viral load and disease run in parallel. An antiviral must be broadly effective against the natural spectrum of RSV genotypes and must attain concentrations capable of inhibiting viral replication within the human respiratory tract. We evaluated a novel RSV fusion inhibitor, MDT-637, and compared it with ribavirin for therapeutic effect in vitro to identify relative therapeutic doses achievable in humans. MDT-637 and ribavirin were co-incubated with RSV in HEp-2 cells. Quantitative PCR assessed viral concentrations; 50% inhibitory concentrations (IC 50 ) were compared to achievable human MDT-637 and ribavirin peak and trough concentrations. The IC 50 for MDT-637 and ribavirin (against RSV-A Long) was 1.42 and 16 973 ng/mL, respectively. The ratio of achievable peak respiratory secretion concentration to IC 50 was 6041-fold for MDT-637 and 25-fold for aerosolized ribavirin. The ratio of trough concentration to IC 50 was 1481-fold for MDT-637 and 3.29-fold for aerosolized ribavirin. Maximal peak and trough levels of oral or intravenous ribavirin were significantly lower than their IC 50 s. We also measured MDT-637 IC 50 s in 3 lab strains and 4 clinical strains. The IC 50 s ranged from 0.36 to 3.4 ng/mL. Achievable human MDT-637 concentrations in respiratory secretions exceed the IC 50 s by factors from hundreds to thousands of times greater than does ribavirin. Furthermore, MDT-637 has broad in vitro antiviral activity on clinical strains of different RSV genotypes and clades. Together, these data imply that MDT-637 may produce a superior clinical effect compared to ribavirin on natural RSV infections. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

[Comparative study of the efficacy of larva therapy for debridement and control of bacterial burden compared to surgical debridement and topical application of an antimicrobial].

PubMed

Contreras-Ruiz, José; Fuentes-Suárez, Adán; Arroyo-Escalante, Sara; Moncada-Barron, David; Sosa-de-Martínez, María Cristina; Maravilla-Franco, Ernesto; Domínguez-Cherit, Judith Guadalupe

2016-10-01

Maggot debridement therapy (MDT) is the use of medical grade maggots of the fly Lucilia sericata for wound debridement. Recent observations show that MDT decreases bacterial burden as well. Venous ulcers are the most commonly seen in wound clinics and require, besides adequate treatment of venous hypertension, proper wound bed preparation with debri dement of necrotic tissue and control of potential infections. To evaluate the efficacy of MDT in venous ulcers a randomized controlled trial was designed to compare MDT to surgical debridement and topical application of silver sulfadiazine (SSD) in 19 patients for 4 weeks. The study variables were area reduction, wound bed characteristics, pain, odor, anxiety and bacterial burden using quantitative tissue biopsies. MDT was effective as surgical debridement associated with topical SDD in the debridement of the wound and in reducing its size. A significant difference was observed in the reduction of bacterial burden in favor of the MDT group. Odor and anxiety increased in the MDT group without any difference in the pain intensity between groups. In conclusion, this study suggests that MDT is as effective as surgical debridement for the debridement of necrotic tissue and promote wound healing in venous ulcers and better at reducing bacterial burden.

A prospective analysis of implementation of multi-disciplinary team decisions in breast cancer.

PubMed

English, Rachel; Metcalfe, Chris; Day, James; Rayter, Zenon; Blazeby, Jane M

2012-09-01

Multi-disciplinary teams (MDTs) management of patients with cancer is mandatory in the United Kingdom, and auditing team decision-making by examining rates of decision implementation and reasons for nonimplementation may inform this practice. Consecutive breast cancer MDT decisions, subsequent decision implementation, and reasons for nonimplementation were prospectively recorded. Factors associated with nonimplementation of the MDT decision were analyzed with logistic regression. Of 289 consecutive MDT decisions involving 210 women, 20 (6.9%, 95% CIs 4.3%-10.5%) were not implemented. Most changed MDT decisions did so because of patient preferences (n = 13, 65%), with the discovery of new clinical information (n = 3) and individual doctor's views (n = 4) also leading to decision nonimplementation. MDT decisions were significantly less likely to be adhered to in patients with confirmed malignant disease compared to those with benign or 'unknown' disease categories (p < 0.001) and MDT decisions in older patients were significantly more likely not to be implemented than in younger patients (p = 0.002). Auditing nonimplementation of MDT recommendations and examining reasons for changed decisions is a useful process to monitor team performance and to identify factors that need more attention during the MDT meeting to ensure that the process makes optimal patient centered decisions. © 2012 Wiley Periodicals, Inc.

The value of multidisciplinary team meetings within an early pregnancy assessment unit.

PubMed

Bharathan, Rasiah; Farag, Mena; Hayes, Kevin

2016-08-01

This is the first study to ascertain the value of multidisciplinary team (MDT) meetings within an early pregnancy assessment unit (EPAU). Our national telephone survey identified that in the United Kingdom, overall 37% of EPAU utilise regular MDT meetings. Secondary and tertiary hospitals are just as likely to hold regular MDT meetings. The participants in our interview study expressed the principal benefits of regular MDT meetings as communication, education and effective stress management. The perceived additional benefits included improved care quality, better patient experience and enhanced team cohesion. During the meetings, at least, one representative from every tier of staffing was present. The caseload of the MDT meeting comprised ectopic pregnancies and pregnancies of unknown location. We propose a number of research studies, which would build on this study. Such efforts will help enhance the effectiveness of the MDT-based EPAU service.

A systematic review of maggot debridement therapy for chronically infected wounds and ulcers.

PubMed

Sun, Xinjuan; Jiang, Kechun; Chen, Jingan; Wu, Liang; Lu, Hui; Wang, Aiping; Wang, Jianming

2014-08-01

This study aimed to systematically evaluate maggot debridement therapy (MDT) in the treatment of chronically infected wounds and ulcers. We performed a meta-analysis referring to the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We searched for published articles in the following databases: PubMed, Web of Science, Embase, Wanfang (Chinese), and the China National Knowledge Infrastructure (CNKI). The latest search was updated on March 14, 2014. For dichotomous outcomes, the effects of MDT were expressed as the relative risk (RR) and 95% confidence interval (CI). For continuous outcomes with different measurement scales, we calculated the standardized mean difference (SMD). The pooled effects were estimated using a fixed effect model or random effect model based on the heterogeneity test. Subgroup analyses were performed according to the types of wounds or ulcers. MDT had a significantly increased positive effect on wound healing compared with conventional therapies, with a pooled RR of 1.80 (95% CI 1.24-2.60). The subgroup analysis revealed that the combined RRs were 1.79 (95% CI 0.95-3.38) for patients with diabetic foot ulcers (DFU) and 1.70 (95% CI 1.28-2.27) for patients with other types of ulcers. The time to healing of the ulcers was significantly shorter among patients treated with MDT, with a pooled SMD of -0.95 (95% CI -1.24, -0.65). For patients with DFU, the SMD was -0.79 (95% CI -1.18, -0.41), and for patients with other types of ulcers, the SMD was -1.16 (95% CI -1.63, -0.69). MDT not only shortened the healing time but also improved the healing rate of chronic ulcers. Therefore, MDT may be a feasible alternative in the treatment of chronic ulcers. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Random mandatory drugs testing of prisoners: a biassed means of gathering information.

PubMed

Gore, S M; Bird, A G; Strang, J S

1999-01-01

Our objective was to develop and test a methodology for inferring the percentage of prisoners currently using opiates from the percentage of prisoners testing positive for opiates in random mandatory drugs testing (rMDT). The study used results from Willing Anonymous Salivary HIV (WASH) studies (1994-6) in six adult Scottish prisons, and surveys (1994-5 and 1997) in 14 prisons in England and Wales. For Scottish prisons, the percentage of prisoners currently using opiates was determined by assuming, with varying empirical support, that: current users of opiates in prison were 1.5 times as many as current inside-injectors; and current inside-injectors were 0.75 times as many as ever injectors in prison. We also assumed that current inside-users' frequency of use of opiates (by any route) was equal to the frequency of inside-injecting by current inside-injectors in Aberdeen and Lowmoss Prisons in 1996, namely six times in 4 weeks. We assumed that some scheduling of heroin-use prior to weekends takes place, so that only 50% of current inside-users of opiates would test positive for opiates in rMDT: these assumptions allow us to arrive at WASH-based expectations for the total percentage of prisoners testing positive for opiates in rMDT. For England and Wales, a multiplier of 118/68 was applied which was derived from prisoners' interviews, to convert the results from ever inside-injectors, as determined by WASH studies, to the percentage of current inside users of opiates. We made the same assumptions on frequency of inside-use of opiates as in dealing with the Scottish results. We expected 202.7 opiate positive results in April to September 1997 in rMDTs at six adult prisons in Scotland, 226 were observed. We expected 227.0 at a set of 13 adult prisons and one other in England and Wales; 211 were observed. Further testing of the methodology for prisons in England and Wales will be possible when 1997 WASH data are released. So far, the methodology has performed well. From it, we infer that 24% of inmates at the six adult prisons in Scotland were current inside-users of opiates, compared to 11% at the 14 adult prisons where survey data were available in England and Wales. The corresponding April to September 1997 percentage of opiate positives in rMDT were: 13% (results from the six Scottish prisons) and 5.4% (results from 14 prisons in England and Wales), a two-fold under-estimate of % current users of opiates in prison (24% and 11%). Planning of drug rehabilitation places for prisoners should thus be based on twice the percentage of prisoners testing opiate positive in rMDT. This correction factor of two should be kept under review.

An evaluation of treatment decisions at a colorectal cancer multi-disciplinary team.

PubMed

Wood, J J; Metcalfe, C; Paes, A; Sylvester, P; Durdey, P; Thomas, M G; Blazeby, J M

2008-10-01

It is mandatory for treatment decisions for patients with colorectal cancer to be made within the context of a multi-disciplinary team (MDT) meeting. It is currently uncertain, however, how to best evaluate the quality of MDT decision-making. This study examined MDT decision-making by studying whether MDT treatment decisions were implemented and investigated the reasons why some decisions changed after the meeting. Consecutive MDT treatment decisions were prospectively recorded. Implementation of decisions was studied by examining hospital records. Reasons for changes in MDT decisions were identified. In all, 201 consecutive treatment decisions were analysed, concerning 157 patients. Twenty decisions (10.0%, 95% confidence interval 6.3-15.2%) were not implemented. Looking at the reasons for nonimplementation, nine (40%) related to co-morbidity, seven (35%) to patient choice, two changed in light of new clinical information, one doctor changed a decision and for one changed decision, no reason was apparent. When decisions changed, the final treatment was always more conservative than was originally planned and decisions were more likely to change for colon rather than rectal cancer (P = 0.024). The vast majority of colorectal MDT decisions were implemented and when decisions changed, it mostly related to patient factors that had not been taken into account. Analysis of the implementation of team decisions is an informative process to monitor the quality of MDT decision-making.

Rapid detection of pandemic influenza in the presence of seasonal influenza

PubMed Central

2010-01-01

Background Key to the control of pandemic influenza are surveillance systems that raise alarms rapidly and sensitively. In addition, they must minimise false alarms during a normal influenza season. We develop a method that uses historical syndromic influenza data from the existing surveillance system 'SERVIS' (Scottish Enhanced Respiratory Virus Infection Surveillance) for influenza-like illness (ILI) in Scotland. Methods We develop an algorithm based on the weekly case ratio (WCR) of reported ILI cases to generate an alarm for pandemic influenza. From the seasonal influenza data from 13 Scottish health boards, we estimate the joint probability distribution of the country-level WCR and the number of health boards showing synchronous increases in reported influenza cases over the previous week. Pandemic cases are sampled with various case reporting rates from simulated pandemic influenza infections and overlaid with seasonal SERVIS data from 2001 to 2007. Using this combined time series we test our method for speed of detection, sensitivity and specificity. Also, the 2008-09 SERVIS ILI cases are used for testing detection performances of the three methods with a real pandemic data. Results We compare our method, based on our simulation study, to the moving-average Cumulative Sums (Mov-Avg Cusum) and ILI rate threshold methods and find it to be more sensitive and rapid. For 1% case reporting and detection specificity of 95%, our method is 100% sensitive and has median detection time (MDT) of 4 weeks while the Mov-Avg Cusum and ILI rate threshold methods are, respectively, 97% and 100% sensitive with MDT of 5 weeks. At 99% specificity, our method remains 100% sensitive with MDT of 5 weeks. Although the threshold method maintains its sensitivity of 100% with MDT of 5 weeks, sensitivity of Mov-Avg Cusum declines to 92% with increased MDT of 6 weeks. For a two-fold decrease in the case reporting rate (0.5%) and 99% specificity, the WCR and threshold methods, respectively, have MDT of 5 and 6 weeks with both having sensitivity close to 100% while the Mov-Avg Cusum method can only manage sensitivity of 77% with MDT of 6 weeks. However, the WCR and Mov-Avg Cusum methods outperform the ILI threshold method by 1 week in retrospective detection of the 2009 pandemic in Scotland. Conclusions While computationally and statistically simple to implement, the WCR algorithm is capable of raising alarms, rapidly and sensitively, for influenza pandemics against a background of seasonal influenza. Although the algorithm was developed using the SERVIS data, it has the capacity to be used at other geographic scales and for different disease systems where buying some early extra time is critical. PMID:21106071

Multidrug resistance protein MdtM adds to the repertoire of antiporters involved in alkaline pH homeostasis in Escherichia coli

PubMed Central

2013-01-01

Background In neutralophilic bacteria, monovalent metal cation/H+ antiporters play a key role in pH homeostasis. In Escherichia coli, only four antiporters (NhaA, NhaB, MdfA and ChaA) are identified to function in maintenance of a stable cytoplasmic pH under conditions of alkaline stress. We hypothesised that the multidrug resistance protein MdtM, a recently characterised homologue of MdfA and a member of the major facilitator superfamily, also functions in alkaline pH homeostasis. Results Assays that compared the growth of an E. coli ΔmdtM deletion mutant transformed with a plasmid encoding wild-type MdtM or the dysfunctional MdtM D22A mutant at different external alkaline pH values (ranging from pH 8.5 to 10) revealed a potential contribution by MdtM to alkaline pH tolerance, but only when millimolar concentrations of sodium or potassium was present in the growth medium. Fluorescence-based activity assays using inverted vesicles generated from transformants of antiporter-deficient (ΔnhaA, ΔnhaB, ΔchaA) E. coli TO114 cells defined MdtM as a low-affinity antiporter that catalysed electrogenic exchange of Na+, K+, Rb+ or Li+ for H+. The K+/H+ antiport reaction had a pH optimum at 9.0, whereas the Na+/H+ exchange activity was optimum at pH 9.25. Measurement of internal cellular pH confirmed MdtM as contributing to maintenance of a stable cytoplasmic pH, acid relative to the external pH, under conditions of alkaline stress. Conclusions Taken together, the results support a role for MdtM in alkaline pH tolerance. MdtM can therefore be added to the currently limited list of antiporters known to function in pH homeostasis in the model organism E. coli. PMID:23701827

Multidrug resistance protein MdtM adds to the repertoire of antiporters involved in alkaline pH homeostasis in Escherichia coli.

PubMed

Holdsworth, Scarlett R; Law, Christopher J

2013-05-23

In neutralophilic bacteria, monovalent metal cation/H+ antiporters play a key role in pH homeostasis. In Escherichia coli, only four antiporters (NhaA, NhaB, MdfA and ChaA) are identified to function in maintenance of a stable cytoplasmic pH under conditions of alkaline stress. We hypothesised that the multidrug resistance protein MdtM, a recently characterised homologue of MdfA and a member of the major facilitator superfamily, also functions in alkaline pH homeostasis. Assays that compared the growth of an E. coli ΔmdtM deletion mutant transformed with a plasmid encoding wild-type MdtM or the dysfunctional MdtM D22A mutant at different external alkaline pH values (ranging from pH 8.5 to 10) revealed a potential contribution by MdtM to alkaline pH tolerance, but only when millimolar concentrations of sodium or potassium was present in the growth medium. Fluorescence-based activity assays using inverted vesicles generated from transformants of antiporter-deficient (ΔnhaA, ΔnhaB, ΔchaA) E. coli TO114 cells defined MdtM as a low-affinity antiporter that catalysed electrogenic exchange of Na+, K+, Rb+ or Li+ for H+. The K+/H+ antiport reaction had a pH optimum at 9.0, whereas the Na+/H+ exchange activity was optimum at pH 9.25. Measurement of internal cellular pH confirmed MdtM as contributing to maintenance of a stable cytoplasmic pH, acid relative to the external pH, under conditions of alkaline stress. Taken together, the results support a role for MdtM in alkaline pH tolerance. MdtM can therefore be added to the currently limited list of antiporters known to function in pH homeostasis in the model organism E. coli.

Availability and feasibility of structured, routine collection of comorbidity data in a colorectal cancer multi-disciplinary team (MDT) setting.

PubMed

Abukar, A A; Ramsanahie, A; Martin-Lumbard, K; Herrington, E R; Winslow, V; Wong, S; Ahmed, S; Thaha, M A

2018-05-03

Availability of comorbidity assessment at multi-disciplinary team (MDT) discussions is cornerstone in making the MDT process more robust and decisive in optimising treatment and improving quality of survivorship. Comorbidity assessments using tools, such as the ACE-27 questionnaire would aid in optimising the decision-making process at MDTs so that treatment decisions can be made without delay. This study determined the availability of comorbidity data in a CRC MDT and the feasibility of routine comorbidity data collection using the validated ACE-27 questionnaire. Secondary aims determined the optimal time and method of collecting comorbidity data. A retrospective mapping exercise (phase I; 6-months) examined the availability of comorbidity data within the MDT. Phase II prospectively collected comorbidity data using ACE-27 for a 3-month period following a short pilot. In phase I, 73/135 (54%) patients had comorbidity data readily available informing the MDT discussion; 62 patients lacked this information. After a review of the patient records, it was clear that 41 of these 62 also had comorbidities and 21 out of the 135 had ≥ 2 major system disorders. Common referral sources to the MDT were surgical outpatient clinics (42%) and the endoscopy unit (13%). The average lead-time from referral to MDT discussion was 14 days. In phase II, an ACE-27 questionnaire was prospectively administered in 50 patients, mean age 54 years (range 20-84). Male: female ratio 26:24. Average time to administer ACE-27 was 4.8 min (range 1-15). The phase I study confirmed the widely acknowledged view of poor comorbidity data availability within a CRC MDT. Phase II demonstrated the feasibility of routinely collecting comorbidity data using ACE-27.

Mdt1 Facilitates Efficient Repair of Blocked DNA Double-Strand Breaks and Recombinational Maintenance of Telomeres▿

PubMed Central

Pike, Brietta L.; Heierhorst, Jörg

2007-01-01

DNA recombination plays critical roles in DNA repair and alternative telomere maintenance. Here we show that absence of the SQ/TQ cluster domain-containing protein Mdt1 (Ybl051c) renders Saccharomyces cerevisiae particularly hypersensitive to bleomycin, a drug that causes 3′-phospho-glycolate-blocked DNA double-strand breaks (DSBs). mdt1Δ also hypersensitizes partially recombination-defective cells to camptothecin-induced 3′-phospho-tyrosyl protein-blocked DSBs. Remarkably, whereas mdt1Δ cells are unable to restore broken chromosomes after bleomycin treatment, they efficiently repair “clean” endonuclease-generated DSBs. Epistasis analyses indicate that MDT1 acts in the repair of bleomycin-induced DSBs by regulating the efficiency of the homologous recombination pathway as well as telomere-related functions of the KU complex. Moreover, mdt1Δ leads to severe synthetic growth defects with a deletion of the recombination facilitator and telomere-positioning factor gene CTF18 already in the absence of exogenous DNA damage. Importantly, mdt1Δ causes a dramatic shift from the usually prevalent type II to the less-efficient type I pathway of recombinational telomere maintenance in the absence of telomerase in liquid senescence assays. As telomeres resemble protein-blocked DSBs, the results indicate that Mdt1 acts in a novel blocked-end-specific recombination pathway that is required for the efficiency of both drug-induced DSB repair and telomerase-independent telomere maintenance. PMID:17636027

Stress and Pore Pressure Measurement in IODP Riser Drilling: An Example from Expedition 319, Kumano Basin offshore SW Honshu, Japan

NASA Astrophysics Data System (ADS)

Saffer, D. M.; McNeill, L. C.; Byrne, T. B.; Araki, E.; Flemings, P. B.; Conin, M.; Eguchi, N. O.; Takahashi, K.; Toczko, S.; Boutt, D. F.; Doan, M.; Kano, Y.; Ito, T.; Lin, W.

2009-12-01

In summer 2009, Integrated Ocean Drilling Program (IODP) Expedition 319 drilled a 1600 m deep riser borehole (Site C0009) in the Kumano Basin offshore SW Japan, to investigate the properties, structure and state of stress in the hanging wall above the subduction plate boundary. The first riser-based scientific drilling in IODP history allowed us to make several new scientific measurements including in situ stress magnitude, pore pressure and permeability using the Modular Formation Dynamics Tester (MDT) wireline tool, and measurement of minimum stress magnitude from Leak-off Tests (LOT). In addition, continuous monitoring of mud weight, mud gas, annular pressure, and mud losses provided data to constrain formation pore fluid pressure and stress. At Site C0009, we conducted 2 LOTs below a casing shoe at 708.6 m depth and 11 successful MDT measurements, including 9 single probe tests to measure pore pressure and fluid mobility and 2 dual packer tests: 1 to measure permeability by a drawdown test, and 1 to measure in situ stress. Measured pore pressures are approximately hydrostatic to 1463.7 m depth. We observed only minor gas shows when drilling ahead (as in-place methane was liberated from the rock at the bit) but little or no gas during pipe connections. This indicates that the borehole mud pressure exceeded the formation pore pressure, and is consistent with the MDT measurements. Permeabilities range from ~10-16 m2 - 10-14 m2, and the observed variation is consistent with lithologic changes defined in gamma ray logs. The MDT measurement at 874.3 mbsf and the LOT at 708.6 m yield values for the least principal stress of 34.8 MPa and 30.2 MPa, respectively. Both are less than the vertical stress (Sv) computed from density logs. Partial mud circulation losses occurred when the borehole mud pressure exceeded the leak-off stress measured at the base of the casing shoe; this provides an additional indirect constraint on Shmin magnitude. Mud pressure slightly in excess of the leak-off stress may have also generated poorly-developed drilling-induced tensile fractures (DITF) observed in resistivity image logs between ~750 - 1000 m. From the presence of DITF, Shmin measurements, and assuming a rock tensile strength of 1 MPa, we determine that SHmax is 35.1 MPa for the MDT stress measurement, and 30.2 MPa for the LOT. Using the MDT measurement of Shmin, the resulting principal stress magnitudes define a strike-slip faulting regime with effective stresses of Shmax’ = 14 MPa, Sv' = 7.3 MPa, and Shmin’ = 6.4 MPa. In contrast, using the LOT measurement of Shmin, the stress magnitudes indicate a normal faulting regime in which Sv’ = 6.2 MPa, Shmax’ = 2.8 MPa, and Shmin’ = 2.6 MPa.

The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom

PubMed Central

Punshon, Geoffrey; Endacott, Ruth; Aslett, Phillippa; Brocksom, Jane; Fleure, Louisa; Howdle, Felicity; Masterton, Morven; O’Connor, Anita; Swift, Adrian; Trevatt, Paul; Leary, Alison

2017-01-01

Purpose: United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study. Design: The study consisted of a national survey with descriptive statistics and thematic analysis. Methods: A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT. Results: Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients’ wishes to be expressed. Conclusions: Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients’ nonmedical needs. PMID:28594672

The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom.

PubMed

Punshon, Geoffrey; Endacott, Ruth; Aslett, Phillippa; Brocksom, Jane; Fleure, Louisa; Howdle, Felicity; Masterton, Morven; O'Connor, Anita; Swift, Adrian; Trevatt, Paul; Leary, Alison

United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study. The study consisted of a national survey with descriptive statistics and thematic analysis. A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT. Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients' wishes to be expressed. Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients' nonmedical needs.

Clostridium difficile multidisciplinary team root cause analysis: impact on clinical care and circumvention of financial penalties posed by clinical commissioning groups, but at what cost?

PubMed

Saeed, Kordo; Petridou, Christina; Gray, Hazel; Dryden, Matthew; Davis-Blues, Karen; Lucero, Sheryl; Parker, Natalie; Keyser, Taryn; Matthews, Tanya; Cortes, Nick; Kidd, Stephen; Thomas, Claire; Peacock, Heather; Hornzee, Joanna; Wake, Bruce

2018-03-01

In Hampshire Hospitals NHS Foundation Trust, in addition to an on-the-spot investigation into hospital-onset Clostridium difficile infection (CDI) by the infection prevention team, a multidisciplinary team root cause analysis (MDT-RCA) forum has been developed. The MDT-RCA aims to deliver a more thorough investigation into individual cases and the recommendation of cases to the clinical commissioning groups (CCG) appeals panel against potential financial penalties (£10,000 per breached case). We mainly aimed to investigate the financial impact of MDT-RCAs to the Trust. Over two years, 84 cases of hospital-onset CDI cases were reviewed by the MDT-RCA forum. Among this cohort, no additional learning outcomes were identified by the MDT-RCAs over those that were found by on-the-spot investigations. In total, 543 staff members attended the MDT-RCAs at a potential cost to the Trust of £23,795.74-£51,670.10. The Trust appealed against financial penalties for 27 cases and 14 were successful, i.e. £140,000 would have been avoided had targets been breached by 14 cases. However, targets were only breached by two cases, meaning only £20,000 in fines was avoided. Deducting this from the total costs of the MDT-RCA meant the Trust lost £3,795.74-£31,670.10. Over the two years reviewed, the MDT-RCA proved to be costly to the Trust, with no additional learning or quality improvement measures identified.

EVALUATION AND TREATMENT OF A PATIENT DIAGNOSED WITH ADHESIVE CAPSULITIS CLASSIFIED AS A DERANGEMENT USING THE MCKENZIE METHOD: A CASE REPORT.

PubMed

Bowser, Ashley; Swanson, Brian T

2016-08-01

The McKenzie Method of mechanical diagnosis and therapy (MDT) is supported in the literature as a valid and reliable approach to the management of spine injuries. It can also be applied to the peripheral joints, but has not been explored through research to the same extent. This method sub-classifies an injury based on tissue response to mechanical loading and repeated motion testing, with directional preferences identified in the exam used to guide treatment. The purpose of this case report is to demonstrate the assessment, intervention, and clinical outcomes of a subject classified as having a shoulder derangement syndrome using MDT methodology. The subject was a 52-year-old female with a four-week history of insidious onset left shoulder pain, referred to physical therapy with a medical diagnosis of adhesive capsulitis. She presented with pain (4-7/10 on the visual analog scale [VAS]) and decreased shoulder range of motion that limited her activities of daily living and work capabilities (Upper Extremity Functional Index (UEFI) score: 55/80). Active and passive ranges of motion (A/PROM) were limited in all planes. Repeated motion testing was performed, with an immediate reduction in pain and increased shoulder motion in all planes following repeated shoulder extension. As a result, her MDT classification was determined to be derangement syndrome. Treatment involved specific exercises, primarily repeated motions, identified as symptom alleviating during the evaluation process. The subject demonstrated significant improvements in the UEFI (66/80), VAS (0-2/10), and ROM within six visits over eight weeks. At the conclusion of treatment, A/PROM was observed to be equal to the R shoulder without pain. This subject demonstrated improved symptoms and functional abilities following evaluation and treatment using MDT methodology. While a cause-effect relationship cannot be determined with a single case, MDT methodology may be a useful approach to the examination, and potentially management, of patients with shoulder pain. This method offers a patient specific approach to treating the shoulder, particularly when the pathoanatomic structure affected is unclear. 4.

A Literature Review and Analysis of Mode Deactivation Therapy

ERIC Educational Resources Information Center

Apsche, Jack A.

2010-01-01

This article is a review of articles, chapters and current research examining Mode Deactivation Therapy. Current applications of MDT suggest that mindfulness is a core component of MDT, as well as acceptance, defusion and validation, clarification and redirection of the functional alternative beliefs. These components are the core of MDT and a…

Mode Deactivation Therapy (MDT) Family Therapy: A Theoretical Case Analysis

ERIC Educational Resources Information Center

Apsche, J. A.; Ward Bailey, S. R.

2004-01-01

This case study presents a theoretical analysis of implementing mode deactivation therapy (MDT) (Apsche & Ward Bailey, 2003) family therapy with a 13 year old Caucasian male. MDT is a form of cognitive behavioral therapy (CBT) that combines the balance of dialectical behavior therapy (DBT) (Linehan, 1993), the importance of perception from…

Technology and medication errors: impact in nursing homes.

PubMed

Baril, Chantal; Gascon, Viviane; St-Pierre, Liette; Lagacé, Denis

2014-01-01

The purpose of this paper is to study a medication distribution technology's (MDT) impact on medication errors reported in public nursing homes in Québec Province. The work was carried out in six nursing homes (800 patients). Medication error data were collected from nursing staff through a voluntary reporting process before and after MDT was implemented. The errors were analysed using: totals errors; medication error type; severity and patient consequences. A statistical analysis verified whether there was a significant difference between the variables before and after introducing MDT. The results show that the MDT detected medication errors. The authors' analysis also indicates that errors are detected more rapidly resulting in less severe consequences for patients. MDT is a step towards safer and more efficient medication processes. Our findings should convince healthcare administrators to implement technology such as electronic prescriber or bar code medication administration systems to improve medication processes and to provide better healthcare to patients. Few studies have been carried out in long-term healthcare facilities such as nursing homes. The authors' study extends what is known about MDT's impact on medication errors in nursing homes.

Analysis of decision making at a multidisciplinary head and neck tumor board incorporating evidence-based National Cancer Comprehensive Network (NCCN) guidelines.

PubMed

Shah, Bhartesh A; Qureshi, Muhammad M; Jalisi, Scharukh; Grillone, Gregory; Salama, Andrew; Cooley, Timothy; Zaner, Ken; Sakai, Osamu; Truong, Minh Tam

2016-01-01

To evaluate incorporation of National Cancer Comprehensive Network (NCCN) guidelines in decision making at a head and neck cancer (HNC) multidisciplinary tumor board (MDT) at an urban academic medical center. A retrospective study of 176 HNC patients was performed. The extent to which MDT decisions and subsequent patient care incorporate NCCN guidelines was evaluated. A total of 173 (98.3%) HNC patients received MDT recommendations according to NCCN guidelines. Of the 159 patients treated, 153 (96.2%) received treatment according to NCCN guidelines. The MDT recommended the highest available evidence-based NCCN category guideline in 78.0%. Subsequent treatment using the same or higher category MDT recommendation occurred in 87.0% of patients. Evaluation of patients at an MDT using NCCN guidelines incorporates the highest level of evidence in approximately 80% of patients and translates well into subsequent care. Incorporation of the highest available NCCN guideline may be improved, although management should be individualized. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Evaluating the impact of an integrated multidisciplinary head & neck competency-based anatomy & radiology teaching approach in radiation oncology: a prospective cohort study

PubMed Central

2014-01-01

Background Modern radiation oncology demands a thorough understanding of gross and cross-sectional anatomy for diagnostic and therapeutic applications. Complex anatomic sites present challenges for learners and are not well-addressed in traditional postgraduate curricula. A multidisciplinary team (MDT) based head-and-neck gross and radiologic anatomy program for radiation oncology trainees was developed, piloted, and empirically assessed for efficacy and learning outcomes. Methods Four site-specific MDT head-and-neck seminars were implemented, each involving a MDT delivering didactic and case-based instruction, supplemented by cadaveric presentations. There was no dedicated contouring instruction. Pre- and post-testing were performed to assess knowledge, and ability to apply knowledge to the clinical setting as defined by accuracy of contouring. Paired analyses of knowledge pretests and posttests were performed by Wilcoxon matched-pair signed-rank test. Results Fifteen post-graduate trainees participated. A statistically significant (p < 0.001) mean absolute improvement of 4.6 points (17.03%) was observed between knowledge pretest and posttest scores. Contouring accuracy was analyzed quantitatively by comparing spatial overlap of participants’ pretest and posttest contours with a gold standard through the dice similarity coefficient. A statistically significant improvement in contouring accuracy was observed for 3 out of 20 anatomical structures. Qualitative and quantitative feedback revealed that participants were more confident at contouring and were enthusiastic towards the seminars. Conclusions MDT seminars were associated with improved knowledge scores and resident satisfaction; however, increased gross and cross-sectional anatomic knowledge did not translate into improvements in contouring accuracy. Further research should evaluate the impact of hands-on contouring sessions in addition to dedicated instructional sessions to develop competencies. PMID:24969509

Understanding the dynamics of superparamagnetic particles under the influence of high field gradient arrays

NASA Astrophysics Data System (ADS)

Barnsley, Lester C.; Carugo, Dario; Aron, Miles; Stride, Eleanor

2017-03-01

The aim of this study was to characterize the behaviour of superparamagnetic particles in magnetic drug targeting (MDT) schemes. A 3-dimensional mathematical model was developed, based on the analytical derivation of the trajectory of a magnetized particle suspended inside a fluid channel carrying laminar flow and in the vicinity of an external source of magnetic force. Semi-analytical expressions to quantify the proportion of captured particles, and their relative accumulation (concentration) as a function of distance along the wall of the channel were also derived. These were expressed in terms of a non-dimensional ratio of the relevant physical and physiological parameters corresponding to a given MDT protocol. The ability of the analytical model to assess magnetic targeting schemes was tested against numerical simulations of particle trajectories. The semi-analytical expressions were found to provide good first-order approximations for the performance of MDT systems in which the magnetic force is relatively constant over a large spatial range. The numerical model was then used to test the suitability of a range of different designs of permanent magnet assemblies for MDT. The results indicated that magnetic arrays that emit a strong magnetic force that varies rapidly over a confined spatial range are the most suitable for concentrating magnetic particles in a localized region. By comparison, commonly used magnet geometries such as button magnets and linear Halbach arrays result in distributions of accumulated particles that are less efficient for delivery. The trajectories predicted by the numerical model were verified experimentally by acoustically focusing magnetic microbeads flowing in a glass capillary channel, and optically tracking their path past a high field gradient Halbach array.

Evaluating the impact of an integrated multidisciplinary head & neck competency-based anatomy & radiology teaching approach in radiation oncology: a prospective cohort study.

PubMed

D'Souza, Leah; Jaswal, Jasbir; Chan, Francis; Johnson, Marjorie; Tay, Keng Yeow; Fung, Kevin; Palma, David

2014-06-26

Modern radiation oncology demands a thorough understanding of gross and cross-sectional anatomy for diagnostic and therapeutic applications. Complex anatomic sites present challenges for learners and are not well-addressed in traditional postgraduate curricula. A multidisciplinary team (MDT) based head-and-neck gross and radiologic anatomy program for radiation oncology trainees was developed, piloted, and empirically assessed for efficacy and learning outcomes. Four site-specific MDT head-and-neck seminars were implemented, each involving a MDT delivering didactic and case-based instruction, supplemented by cadaveric presentations. There was no dedicated contouring instruction. Pre- and post-testing were performed to assess knowledge, and ability to apply knowledge to the clinical setting as defined by accuracy of contouring. Paired analyses of knowledge pretests and posttests were performed by Wilcoxon matched-pair signed-rank test. Fifteen post-graduate trainees participated. A statistically significant (p < 0.001) mean absolute improvement of 4.6 points (17.03%) was observed between knowledge pretest and posttest scores. Contouring accuracy was analyzed quantitatively by comparing spatial overlap of participants' pretest and posttest contours with a gold standard through the dice similarity coefficient. A statistically significant improvement in contouring accuracy was observed for 3 out of 20 anatomical structures. Qualitative and quantitative feedback revealed that participants were more confident at contouring and were enthusiastic towards the seminars. MDT seminars were associated with improved knowledge scores and resident satisfaction; however, increased gross and cross-sectional anatomic knowledge did not translate into improvements in contouring accuracy. Further research should evaluate the impact of hands-on contouring sessions in addition to dedicated instructional sessions to develop competencies.

Group cognitive remediation therapy for chronic schizophrenia: A randomized controlled trial.

PubMed

Tan, Shuping; Zou, Yizhuang; Wykes, Til; Reeder, Clare; Zhu, Xiaolin; Yang, Fude; Zhao, Yanli; Tan, Yunlong; Fan, Fengmei; Zhou, Dongfeng

2016-07-28

Individual-level cognitive remediation therapy (CRT) has been shown to be effective for cognitive improvement and social function amelioration. Here, we aimed to test the efficacy of group-based CRT in Chinese subjects with schizophrenia. One-hundred and four inpatients were randomly assigned to either 40 sessions of small-group CRT therapy or therapeutic contact-matched Musical and Dancing Therapy (MDT). Cognitive and social functioning, as well as clinical symptoms, were evaluated over the course of treatment. Specifically, cognitive function was evaluated using a battery of cognitive measurements, clinical symptoms were evaluated using the Positive and Negative Syndrome Scale, and social function was evaluated using the Nurse's Observation Scale for Inpatient Evaluation-30. All patients were evaluated pre- and post-treatment. Forty-four individuals in the CRT group and 46 in the MDT group completed all of the planned treatments and analyses. Cognitive functions, especially cognitive flexibility and memory, showed significant improvement in the CRT group over the course of the study. The MDT group also showed improvement in several cognitive flexibility assessments, but the degree of improvement was significantly greater in the CRT group. Several social-function factors exhibited a significant improvement in the CRT group, but not in the MDT group. Cognitive function improvement correlated positively with social function without predicting social function change. We conclude that group-based CRT is an effective and promising therapy. Copyright © 2016. Published by Elsevier Ireland Ltd.

SU-E-T-396: Dosimetric Accuracy of Proton Therapy for Patients with Metal Implants in CT Scans Using Metal Deletion Technique (MDT) Artifacts Reduction

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

Li, X; Kantor, M; Zhu, X

2014-06-01

Purpose: To evaluate the dosimetric accuracy for proton therapy patients with metal implants in CT using metal deletion technique (MDT) artifacts reduction. Methods: Proton dose accuracies under CT metal artifacts were first evaluated using a water phantom with cylindrical inserts of different materials (titanium and steel). Ranges and dose profiles along different beam angles were calculated using treatment planning system (Eclipse version 8.9) on uncorrected CT, MDT CT, and manually-corrected CT, where true Hounsfield units (water) were assigned to the streak artifacts. In patient studies, the treatment plans were developed on manually-corrected CTs, then recalculated on MDT and uncorrected CTs.more » DVH indices were compared between the dose distributions on all the CTs. Results: For water phantom study with 1/2 inch titanium insert, the proton range differences estimated by MDT CT were with 1% for all beam angles, while the range error can be up to 2.6% for uncorrected CT. For the study with 1 inch stainless steel insert, the maximum range error calculated by MDT CT was 1.09% among all the beam angles compared with maximum range error with 4.7% for uncorrected CT. The dose profiles calculated on MDT CTs for both titanium and steel inserts showed very good agreements with the ones calculated on manually-corrected CTs, while large dose discrepancies calculated using uncorrected CTs were observed in the distal end region of the proton beam. The patient study showed similar dose distribution and DVHs for organs near the metal artifacts recalculated on MDT CT compared with the ones calculated on manually-corrected CT, while the differences between uncorrected and corrected CTs were much pronounced. Conclusion: In proton therapy, large dose error could occur due to metal artifact. The MDT CT can be used for proton dose calculation to achieve similar dose accuracy as the current clinical practice using manual correction.« less

Quality assessment of decision-making in colorectal cancer multidisciplinary meetings.

PubMed

Seretis, Charalampos; Mankotia, Rajnish; Goonetilleke, Kolitha; Rawstorne, Edward

2014-01-01

The quality of decision-making in the colorectal multidisciplinary team (MDT) meetings can significantly affect the quality of care delivered to patients with colorectal cancer. We performed a prospective study to assess the quality of the MDT meetings in a specialized colorectal unit using an externally observational validated tool. An externally validated observational tool, the Colorectal Multidisciplinary Team Metric for Observation of Decision-Making (cMDT-MODe), was used to assess the quality of clinical decision-making in 64 cases. Although case history information presented by the responsible surgeon was rated high (4.4/5), the quality of radiological and histopathological information regarding each patient's case which was available at the time was less adequate, scoring 3.9/5 and 3.8/5, respectively. Moreover, the precise knowledge of patients' personal views and circumstances was a field requiring further improvement. In a general overview however, the quality and extent of the available information enabled the MDT to provide a clear recommendation regarding the patients' treatment plans in 87.5% of the cases. The cMDT-MODe tool can be used to prospectively audit the quality of clinical decision-making in the colorectal MDT meetings and highlight the fields of potential improvement.

Multidisciplinary team management in thoracic oncology: more than just a concept?

PubMed

Powell, Helen A; Baldwin, David R

2014-06-01

Multidisciplinary team (MDT) management in thoracic oncology has been introduced over the past two decades with the aim of improving outcomes for patients. While MDT management has become the standard of care in some countries, not all healthcare systems have adopted this practice. In this article we review the history and implementation of MDT care in thoracic oncology and explore the evidence for, and challenges associated with, this system of working. There are many advantages of an MDT both to the patient, the clinicians and the wider population, but it is difficult to demonstrate a beneficial effect on outcomes such as treatment rates or survival given the substantial number of coexistent changes in the management of thoracic malignancies over the same time period. There are also some disadvantages associated with MDT working, particularly the costs of setting up the service and the time commitment from each of the healthcare professionals involved. Barriers to effective MDT working include poor attendance by some specialists, inadequate preparation and poor quality information about the patient. Variation in quality of MDTs has been reported so it is important that practice is monitored and areas for improvement identified. ©ERS 2014.

Practice Patterns Regarding Multidisciplinary Cancer Management and Suggestions for Further Refinement: Results from a National Survey in Korea.

PubMed

Lee, Yun-Gyoo; Oh, Sukjoong; Kimm, Heejin; Koo, Dong-Hoe; Kim, Do Yeun; Kim, Bong-Seog; Lee, Seung-Sei

2017-10-01

This study was conducted to explore the process and operation of a cancer multidisciplinary team (MDT) after the reimbursement decision in Korea, and to identify ways to overcome the major barriers to effective and sustainable MDTs. Approximately 1,000 cancer specialists, including medical oncologists, surgical oncologists, radiation oncologists, pathologists, and radiologists in general hospitals in Koreawere invited to complete the survey. The questionnaire covered the following topics: organizational structure of MDTs, candidates for consulting, the clinical decision-making initiative, and responsibility for dealing with legal disputes. We collected a total of 179 responses (18%) from physicians at institutions where an MDT approach was active. A surgical oncologist (91%), internist (90%),radiologist (89%),radiation oncologist (86%), pathologist (71%), and trainees (20%) regularly participated in MDT operations. Approximately 55% of respondents stated that MDTs met regularly. In cases of a split opinion, the physician in charge (69%) or chairperson (17%) made the final decision, and most (86%) stated they followed the final decision. About 15% and 32% of respondents were "very satisfied" and "satisfied," respectively, with the current MDT's operations. Among 38 institutional representatives, 34% responded that the MDT operation became more active and 18% stated an MDT was newly implemented after the reimbursement decision. The reimbursement decision invigorated MDT operations in almost half of eligible hospitals. Dissatisfaction regarding current MDTs was over 50%, and the high discordance rates regarding risk sharing suggest that it is necessary to revise the current system of MDTs.

In situ stress and pore pressure in the Kumano Forearc Basin, offshore SW Honshu from downhole measurements during riser drilling

NASA Astrophysics Data System (ADS)

Saffer, D. M.; Flemings, P. B.; Boutt, D.; Doan, M.-L.; Ito, T.; McNeill, L.; Byrne, T.; Conin, M.; Lin, W.; Kano, Y.; Araki, E.; Eguchi, N.; Toczko, S.

2013-05-01

situ stress and pore pressure are key parameters governing rock deformation, yet direct measurements of these quantities are rare. During Integrated Ocean Drilling Program (IODP) Expedition #319, we drilled through a forearc basin at the Nankai subduction zone and into the underlying accretionary prism. We used the Modular Formation Dynamics Tester tool (MDT) for the first time in IODP to measure in situ minimum stress, pore pressure, and permeability at 11 depths between 729.9 and 1533.9 mbsf. Leak-off testing at 708.6 mbsf conducted as part of drilling operations provided a second measurement of minimum stress. The MDT campaign included nine single-probe (SP) tests to measure permeability and in situ pore pressure and two dual-packer (DP) tests to measure minimum principal stress. Permeabilities defined from the SP tests range from 6.53 × 10-17 to 4.23 × 10-14 m2. Pore fluid pressures are near hydrostatic throughout the section despite rapid sedimentation. This is consistent with the measured hydraulic diffusivity of the sediments and suggests that the forearc basin should not trap overpressures within the upper plate of the subduction zone. Minimum principal stresses are consistently lower than the vertical stress. We estimate the maximum horizontal stress from wellbore failures at the leak-off test and shallow MDT DP test depths. The results indicate a normal or strike-slip stress regime, consistent with the observation of abundant active normal faults in the seaward-most part of the basin, and a general decrease in fault activity in the vicinity of Site C0009.

Booster Test for Space Launch System Rocket

NASA Image and Video Library

2016-06-26

The test area where the second and final qualification motor (QM-2) test for the Space Launch System’s booster is seen Sunday, June 26, 2016, at Orbital ATK Propulsion Systems test facilities in Promontory, Utah. The test is scheduled for Tuesday, June 28 at 10:05 a.m. EDT (8:05 a.m. MDT). Photo Credit: (NASA/Bill Ingalls)

Experimental and theoretical studies of implant assisted magnetic drug targeting

NASA Astrophysics Data System (ADS)

Aviles, Misael O.

One way to achieve drug targeting in the body is to incorporate magnetic nanoparticles into drug carriers and then retain them at the site using an externally applied magnetic field. This process is referred to as magnetic drug targeting (MDT). However, the main limitation of MDT is that an externally applied magnetic field alone may not be able to retain a sufficient number of magnetic drug carrier particles (MDCPs) to justify its use. Such a limitation might not exist when high gradient magnetic separation (HGMS) principles are applied to assist MDT by means of ferromagnetic implants. It was hypothesized that an Implant Assisted -- MDT (IA-MDT) system would increase the retention of the MDCPs at a target site where an implant had been previously located, since the magnetic forces are produced internally. With this in mind, the overall objective of this work was to demonstrate the feasibility of an IA-MDT system through mathematical modeling and in vitro experimentation. The mathematical models were developed and used to demonstrate the behavior and limitations of IA-MDT, and the in vitro experiments were designed and used to validate the models and to further elucidate the important parameters that affect the performance of the system. IA-MDT was studied with three plausible implants, ferromagnetic stents, seed particles, and wires. All implants were studied theoretically and experimentally using flow through systems with polymer particles containing magnetite nanoparticles as MDCPs. In the stent studies, a wire coil or mesh was simply placed in a flow field and the capture of the MDCPs was studied. In the other cases, a porous polymer matrix was used as a surrogate capillary tissue scaffold to study the capture of the MDCPs using wires or particle seeds as the implant, with the seeds either fixed within the polymer matrix or captured prior to capturing the MDCPs. An in vitro heart tissue perfusion model was also used to study the use of stents. In general, all the results demonstrated that IA-MDT is indeed feasible and that careful modification of the MDCP properties and implant properties are fundamental to the success of this technology.

Physical and functional outcomes following multidisciplinary residential rehabilitation for prearthritic hip pain among young active UK military personnel

PubMed Central

Coppack, Russell J; Bilzon, James L; Wills, Andrew K; McCurdie, Ian M; Partridge, Laura K; Nicol, Alastair M; Bennett, Alexander N

2016-01-01

Background There are no studies describing the clinical outcomes of a residential, multidisciplinary team (MDT) rehabilitation intervention for patients with prearthritic hip pain. The aim of this cohort study was to describe the functional and physical outcomes of multidisciplinary residential rehabilitation for UK military personnel with prearthritic hip pain. Methods Participants (N=40) with a mean age of 33 years referred to a specialist residential rehabilitation centre completed a comprehensive multidisciplinary residential intervention. The main outcome measures were mean pain, physical function (modified shuttle test (MST) and Y-balance test), hip range of motion (HROM) and a patient-reported outcome measure (The Copenhagen Hip and Groin Outcome Score, HAGOS). All scores for symptomatic hips were taken at baseline and post-treatment. Results There were improvements in the Y-balance test and HROM following rehabilitation. There were significant improvements in mean difference (T1-to-T2) for Y-balance scores (15.8 cm, 95% CI 10.7 to 20.9, p<0.001), HROM (6.5° increase in hip flexion, 95% CI 4.6 to 9.4, p<0.001) and hip internal rotation (4.6°, 95% CI 2.7 to 6.6, p<0.001). Scores for HAGOS, pain, MST and functional activity assessment showed no improvement. Conclusions Among UK military personnel with prearthritic hip pain, MDT residential rehabilitation resulted in improvements in a functional Y-balance test, hip flexion and internal rotation. The study suggests short-term benefits across some outcomes for the current UK military approach to MDT residential rehabilitation. PMID:27900174

Physical and functional outcomes following multidisciplinary residential rehabilitation for prearthritic hip pain among young active UK military personnel.

PubMed

Coppack, Russell J; Bilzon, James L; Wills, Andrew K; McCurdie, Ian M; Partridge, Laura K; Nicol, Alastair M; Bennett, Alexander N

2016-01-01

There are no studies describing the clinical outcomes of a residential, multidisciplinary team (MDT) rehabilitation intervention for patients with prearthritic hip pain. The aim of this cohort study was to describe the functional and physical outcomes of multidisciplinary residential rehabilitation for UK military personnel with prearthritic hip pain. Participants (N=40) with a mean age of 33 years referred to a specialist residential rehabilitation centre completed a comprehensive multidisciplinary residential intervention. The main outcome measures were mean pain, physical function (modified shuttle test (MST) and Y-balance test), hip range of motion (HROM) and a patient-reported outcome measure (The Copenhagen Hip and Groin Outcome Score, HAGOS). All scores for symptomatic hips were taken at baseline and post-treatment. There were improvements in the Y-balance test and HROM following rehabilitation. There were significant improvements in mean difference (T1-to-T2) for Y-balance scores (15.8 cm, 95% CI 10.7 to 20.9, p<0.001), HROM (6.5° increase in hip flexion, 95% CI 4.6 to 9.4, p<0.001) and hip internal rotation (4.6°, 95% CI 2.7 to 6.6, p<0.001). Scores for HAGOS, pain, MST and functional activity assessment showed no improvement. Among UK military personnel with prearthritic hip pain, MDT residential rehabilitation resulted in improvements in a functional Y-balance test, hip flexion and internal rotation. The study suggests short-term benefits across some outcomes for the current UK military approach to MDT residential rehabilitation.

Multidisciplinary team working across different tumour types: analysis of a national survey.

PubMed

Lamb, B W; Sevdalis, N; Taylor, C; Vincent, C; Green, J S A

2012-05-01

Using data from a national survey, this study aimed to address whether the current model for multidisciplinary team (MDT) working is appropriate for all tumour types. Responses to the 2009 National Cancer Action Team national survey were analysed by tumour type. Differences indicate lack of consensus between MDT members in different tumour types. One thousand one hundred and forty-one respondents from breast, gynaecological, colorectal, upper gastrointestinal, urological, head and neck, haematological and lung MDTs were included. One hundred and sixteen of 136 statements demonstrated consensus between respondents in different tumour types. There were no differences regarding the infrastructure for meetings and team governance. Significant consensus was seen for team characteristics, and respondents disagreed regarding certain aspects of meeting organisations and logistics, and patient-centred decision making. Haematology MDT members were outliers in relation to the clinical decision-making process, and lung MDT members disagreed with other tumour types regarding treating patients with advanced disease. This analysis reveals strong consensus between MDT members from different tumour types, while also identifying areas that require a more tailored approach, such as the clinical decision-making process, and preparation for and the organisation of MDT meetings. Policymakers should remain sensitive to the needs of health care teams working in individual tumour types.

Maggot debridement: an alternative method for debridement.

PubMed

Gottrup, Finn; Jørgensen, Bo

2011-01-01

Debridement is an essential component to promote healing in a problem wound. Several techniques are available including maggot debridement therapy (MDT). To describe the efficacy of MDT for treating problem wound especially diabetic foot ulcers. The topic is elucidated from different points of view: the mode of action, when to use, use in a practice, clinical results, and discussing the problem of creating evidence for the clinical effect. Literature and own results demonstrate that MDT is a safe method with few side effects. Maggot debridement therapy is as good as or better than conventional often surgical debridement, is more selective than surgical debridement, decreases time to healing and stay of patients in the ward, and may decrease the risk of major amputations. However, the evidence of these effects of MDT on the highest level is presently lacking. A detailed description of how to use MDT in practice is provided including a visual demonstration in a video. In spite of lacking clinical evidence, MDT clinical experience strongly suggests that this technique is effective and safe. It can be used for most types of problem wounds, but our indication is primarily diabetic foot ulcers, because of its selectivity for debriding necrotic dead tissue. It may be a valuable alternative surgical/sharp debridement.

Maggot Debridement: An Alternative Method for Debridement

PubMed Central

Gottrup, Finn; Jørgensen, Bo

2011-01-01

Debridement is an essential component to promote healing in a problem wound. Several techniques are available including maggot debridement therapy (MDT). Objective: To describe the efficacy of MDT for treating problem wound especially diabetic foot ulcers. Methods: The topic is elucidated from different points of view: the mode of action, when to use, use in a practice, clinical results, and discussing the problem of creating evidence for the clinical effect. Results: Literature and own results demonstrate that MDT is a safe method with few side effects. Maggot debridement therapy is as good as or better than conventional often surgical debridement, is more selective than surgical debridement, decreases time to healing and stay of patients in the ward, and may decrease the risk of major amputations. However, the evidence of these effects of MDT on the highest level is presently lacking. A detailed description of how to use MDT in practice is provided including a visual demonstration in a video. Conclusion: In spite of lacking clinical evidence, MDT clinical experience strongly suggests that this technique is effective and safe. It can be used for most types of problem wounds, but our indication is primarily diabetic foot ulcers, because of its selectivity for debriding necrotic dead tissue. It may be a valuable alternative surgical/sharp debridement. PMID:21776326

Impact of the lung oncology multidisciplinary team meetings on the management of patients with cancer.

PubMed

Ung, Kim Ann; Campbell, Belinda A; Duplan, Danny; Ball, David; David, Steven

2016-06-01

Multidisciplinary team (MDT) meetings are increasingly regarded as a component of multidisciplinary cancer care. We aimed to prospectively measure the impact of MDT meetings on clinicians' management plans for lung oncology patients, and the implementation rate of the meeting recommendations. Consecutive patient cases presented at the weekly lung oncology MDT meetings were prospectively enrolled. Investigators compared the clinicians' management plans pre-meeting with the consensus plans post-meeting. The meeting was considered to have an impact on management plans if ≥1 of the following changes were detected: tumor stage, histology, treatment intent or treatment modality, or if additional investigations were recommended. Investigators reviewed hospital patient records at 4 months to determine if the meeting recommendations were implemented. Reasons for non-implementation were also recorded. Of the 55 eligible cases, the MDT meeting changed management plans in 58% (CI 45-71%; P < 0.005). These changes included: additional investigations (59%), or changes in treatment modality (19%), treatment intent (9%), histology (6%) or tumor stage (6%). The meeting recommendations were implemented in 72% of cases. Reasons for non-implementation included deteriorating patient performance status, clinician's preference, the influence of new clinical information obtained after the meeting or patient decision. MDT meetings significantly impact on the management plans for lung oncology patients. The majority of MDT recommendations (72%) were implemented into patient care. These findings provide further evidence to support the role of MDT meetings as an essential part of the decision-making process for the optimal multidisciplinary management of patients with cancer. © 2014 Wiley Publishing Asia Pty Ltd.

A national survey of pain clinics within the United Kingdom and Ireland focusing on the multidisciplinary team and the incorporation of the extended nursing role.

PubMed

Kailainathan, Pungavi; Humble, Stephen; Dawson, Helen; Cameron, Fiona; Gokani, Shyam; Lidder, Gursimren

2018-02-01

Inconsistencies in the availability and quality of pain service provision have been noted nationally, as have lengthy waiting times for appointments and lack of awareness of the Pain Clinic role. The 2013 NHS England report stated that specialist pain services must offer multispecialty and multidisciplinary pain clinics. This national survey of multidisciplinary pain service provision in the United Kingdom and Ireland provides a snapshot of pain service provision in order to review and highlight what variations exist in multidisciplinary team (MDT) provision and working patterns. A common perception among clinicians is that financial pressures have led to alternate ways of staff utilisation with variable degrees of success. The survey included 143 pain clinics, focusing principally on MDT working patterns, MDT composition and adoption of the extended role. The results identified that the majority of Pain Clinics utilise the MDT approach. However, provision of critical components such as regular MDT meetings is highly variable as is the composition of the MDT itself and also working patterns of the individual clinicians. The survey reports the successful use of the extended roles for specialist nurses in follow up clinics. In contrast, the survey highlights that a large proportion of clinicians surveyed have reservations about both the effectiveness and the safety of utilising specialist nurses in the extended role to see new referrals of complex pain patients to pain clinics. This survey underlines the essential requirement for incorporation of greater MDT working locally and nationally and allocation of appropriate resources to facilitate this.

Determinants of treatment plan implementation in multidisciplinary team meetings for patients with chronic diseases: a mixed-methods study

PubMed Central

Raine, Rosalind; Xanthopoulou, Penny; Wallace, Isla; Nic a’ Bháird, Caoimhe; Lanceley, Anne; Clarke, Alex; Livingston, Gill; Prentice, Archie; Ardron, Dave; Harris, Miriam; King, Michael; Michie, Susan; Blazeby, Jane M; Austin-Parsons, Natalie; Gibbs, Simon; Barber, Julie

2014-01-01

Objective Multidisciplinary team (MDT) meetings are assumed to produce better decisions and are extensively used to manage chronic disease in the National Health Service (NHS). However, evidence for their effectiveness is mixed. Our objective was to investigate determinants of MDT effectiveness by examining factors influencing the implementation of MDT treatment plans. This is a proxy measure of effectiveness, because it lies on the pathway to improvements in health, and reflects team decision making which has taken account of clinical and non-clinical information. Additionally, this measure can be compared across MDTs for different conditions. Methods We undertook a prospective mixed-methods study of 12 MDTs in London and North Thames. Data were collected by observation of 370 MDT meetings, interviews with 53 MDT members, and from 2654 patient medical records. We examined the influence of patient-related factors (disease, age, sex, deprivation, whether their preferences and other clinical/health behaviours were mentioned) and MDT features (as measured using the ‘Team Climate Inventory’ and skill mix) on the implementation of MDT treatment plans. Results The adjusted odds (or likelihood) of implementation was reduced by 25% for each additional professional group represented at the MDT meeting. Implementation was more likely in MDTs with clear goals and processes and a good ‘Team Climate’ (adjusted OR 1.96; 95% CI 1.15 to 3.31 for a unit increase in Team Climate Inventory (TCI) score). Implementation varied by disease category, with the lowest adjusted odds of implementation in mental health teams. Implementation was also lower for patients living in more deprived areas (adjusted odds of implementation for patients in the most compared with least deprived areas was 0.60, 95% CI 0.39 to 0.91). Conclusions Greater multidisciplinarity is not necessarily associated with more effective decision making. Explicit goals and procedures are also crucial. Decision implementation should be routinely monitored to ensure the equitable provision of care. PMID:24915539

Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

PubMed

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients' attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind.

Changes in Cytokines, Sensory Tests, and Self-reported Pain Levels After Manual Treatment of Low Back Pain.

PubMed

Degenhardt, Brian F; Johnson, Jane C; Fossum, Christian; Andicochea, Chad T; Stuart, Melissa K

2017-07-01

Unbalanced 3-factor design with repeated measures on 1 factor. To determine the effect of manual treatment (MT) on cytokine and pain sensations in those with and without low back pain (LBP). Evidence suggests that MT reduces LBP but by unknown mechanisms. Certain cytokines have been elevated in patients with LBP and may be affected by MT. Participants aged 20-60 years with chronic LBP or without LBP were recruited and randomly assigned to MT, sham ultrasound treatment, or no treatment groups. Venous blood samples were collected and pain levels assessed at baseline, 1 hour later, and 24 hours later. Blood was analyzed for interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and C-reactive protein. Pain levels were measured by pressure pain threshold (PPT), mechanical detection threshold (MDT), dynamic mechanical allodynia, and self-report. Forty (30 women, age 36±11 y) participants completed the study, 33 with LBP (13 MT, 13 sham ultrasound treatment, and 7 no treatment) and 7 without LBP. Participants with or without LBP could not be differentiated on the basis of serum cytokine levels, PPT, or MDT (P≥0.08). There were no significant differences between the groups at 1 hour or 24 hours on serum cytokines, PPT, or MDT (P≥0.07). There was a significant decrease from baseline in IL-6 for the no treatment (LBP) group (P=0.04), in C-reactive protein for the sham ultrasound treatment group (P=0.03), in MDT for all 3 LBP groups (P≤0.02), and in self-reported pain for the MT and sham ultrasound treatment groups (P=0.03 and 0.01). Self-reported pain was reduced with MT and sham ultrasound treatment 24 hours after treatment, but inflammatory markers within venous circulation and quantitative sensory tests were unable to differentiate between study groups. Therefore, we were unable to characterize mechanisms underlying chronic LBP.

Efficiency analysis of diffusion on T-fractals in the sense of random walks.

PubMed

Peng, Junhao; Xu, Guoai

2014-04-07

Efficiently controlling the diffusion process is crucial in the study of diffusion problem in complex systems. In the sense of random walks with a single trap, mean trapping time (MTT) and mean diffusing time (MDT) are good measures of trapping efficiency and diffusion efficiency, respectively. They both vary with the location of the node. In this paper, we analyze the effects of node's location on trapping efficiency and diffusion efficiency of T-fractals measured by MTT and MDT. First, we provide methods to calculate the MTT for any target node and the MDT for any source node of T-fractals. The methods can also be used to calculate the mean first-passage time between any pair of nodes. Then, using the MTT and the MDT as the measure of trapping efficiency and diffusion efficiency, respectively, we compare the trapping efficiency and diffusion efficiency among all nodes of T-fractal and find the best (or worst) trapping sites and the best (or worst) diffusing sites. Our results show that the hub node of T-fractal is the best trapping site, but it is also the worst diffusing site; and that the three boundary nodes are the worst trapping sites, but they are also the best diffusing sites. Comparing the maximum of MTT and MDT with their minimums, we find that the maximum of MTT is almost 6 times of the minimum of MTT and the maximum of MDT is almost equal to the minimum for MDT. Thus, the location of target node has large effect on the trapping efficiency, but the location of source node almost has no effect on diffusion efficiency. We also simulate random walks on T-fractals, whose results are consistent with the derived results.

The Step approach to Message Design and Testing (SatMDT): A conceptual framework to guide the development and evaluation of persuasive health messages.

PubMed

Lewis, Ioni; Watson, Barry; White, Katherine M

2016-12-01

This paper provides an important and timely overview of a conceptual framework designed to assist with the development of message content, as well as the evaluation, of persuasive health messages. While an earlier version of this framework was presented in a prior publication by the authors in 2009, important refinements to the framework have seen it evolve in recent years, warranting the need for an updated review. This paper outlines the Step approach to Message Design and Testing (or SatMDT) in accordance with the theoretical evidence which underpins, as well as empirical evidence which demonstrates the relevance and feasibility of, each of the framework's steps. The development and testing of the framework have thus far been based exclusively within the road safety advertising context; however, the view expressed herein is that the framework may have broader appeal and application to the health persuasion context. Copyright © 2015 Elsevier Ltd. All rights reserved.

Invasive placental disease: the impact of a multi-disciplinary team approach to management.

PubMed

Smulian, John C; Pascual, Ana-Liza; Hesham, Helai; Qureshey, Emma; Bijoy Thomas, M; Depuy, Amy M; Flicker, Amanda B; Scorza, William E

2017-06-01

To determine the impact of a structured multi-disciplinary management strategy on clinical outcomes in women with invasive placental disease (IPD). This was a retrospective cohort study of consecutive women having peripartum hysterectomies with IPD over seven years. For the most recent three years, a structured multidisciplinary team (MDT) reviewed each suspected case, created a management plan, and implemented that plan. Outcomes were compared between cases delivered prior to and after the MDT process was started. There were 47 pregnancies with IPD, of which 31 (66.0%) were suspected antenatally and 40 (85.1%) had a prior uterine surgery. An MDT approach was performed in 19 (40.4%) cases. In the MDT group, there were longer operative times (260 min versus 181 min, p = 0.0001), less blood loss (1200 mL versus 2500 mL, p = 0.009), less administration of blood products (47.4% versus 85.7%, p = 0.005), and higher intraoperative lowest mean arterial pressures (MAPs) (57 mmHg versus 48 mmHg, p = 0.002, when compared to the No-MDT (n = 28) approach. No differences were found for other outcomes. Clinically meaningful improvements of less blood loss, fewer transfusions, and higher intraoperative MAPs suggest that MDT cases were more stable intraoperatively, which over a larger number of patients, should translate into improved outcomes.

Global mean dynamic topography based on GOCE data and Wiener filters

NASA Astrophysics Data System (ADS)

Gilardoni, Maddalena; Reguzzoni, Mirko; Albertella, Alberta

2015-04-01

A mean dynamic ocean topography (MDT) has been computed by using a GOCE-only gravity model and a given mean sea surface (MSS) obtained from satellite altimetry. Since the used gravity model, i.e. the fifth release of the time-wise solution covering the full mission lifetime, is truncated at a maximum harmonic degree of 280, the obtained MDT has to be consistently filtered. This has been done globally by using the spherical harmonic representation and following a Wiener minimization principle. This global filtering approach is convenient from the computational point of view but requires to have MDT values all over the Earth surface and therefore to fill the continents with fictitious data. The main improvements with respect to the already presented results are in the MDT filling procedure (to guarantee that the global signal has the same covariance of the one over the oceans), in the error modelling of the input MSS and in the error estimation of the filtered MDT and of the corresponding geostrophic velocities. The impact of GOCE data in the ocean circulation global modelling has been assessed by comparing the pattern of the obtained geostrophic currents with those computed by using EGM2008. Comparisons with independent circulation data based on drifters and other MDT models have been also performed with the aim of evaluating the accuracy of the obtained results.

Booster Test for Space Launch System Rocket

NASA Image and Video Library

2016-06-26

The test area where the second and final qualification motor (QM-2) test for the Space Launch System’s booster is seen through the window of a camera bunker, Sunday, June 26, 2016, at Orbital ATK Propulsion Systems test facilities in Promontory, Utah. The test is scheduled for Tuesday, June 28 at 10:05 a.m. EDT (8:05 a.m. MDT). Photo Credit: (NASA/Bill Ingalls)

Testing and evaluation of recovered traction sanding material.

DOT National Transportation Integrated Search

2013-04-01

The Montana Department of Transportation (MDT) is searching for a solution to the accumulation of traction sand that is applied to Montana highways every winter. An analysis of reuse and recycle options for salvaged traction sand was conducted using ...

Maggot Debridement Therapy in Disaster Medicine.

PubMed

Stadler, Frank; Shaban, Ramon Z; Tatham, Peter

2016-02-01

When disaster strikes, the number of patients requiring treatment can be overwhelming. In low-income countries, resources to assist the injured in a timely fashion may be limited. As a consequence, necrosis and wound infection in disaster patients is common and frequently leads to adverse health outcomes such as amputations, chronic wounds, and loss of life. In such compromised health care environments, low-tech and cheap wound care options are required that are in ready supply, easy to use, and have multiple therapeutic benefits. Maggot debridement therapy (MDT) is one such wound care option and may prove to be an invaluable tool in the treatment of wounds post-disaster. This report provides an overview of the wound burden experienced in various types of disaster, followed by a discussion of current treatment approaches, and the role MDT may play in the treatment of complex wounds in challenging health care conditions. Maggot debridement therapy removes necrotic and devitalized tissue, controls wound infection, and stimulates wound healing. These properties suggest that medicinal maggots could assist health care professionals in the debridement of disaster wounds, to control or prevent infection, and to prepare the wound bed for reconstructive surgery. Maggot debridement therapy-assisted wound care would be led by health care workers rather than physicians, which would allow the latter to focus on reconstructive and other surgical interventions. Moreover, MDT could provide a larger window for time-critical interventions, such as fasciotomies to treat compartment syndrome and amputations in case of life-threatening wound infection. There are social, medical, and logistic hurdles to overcome before MDT can become widely available in disaster medical aid. Thus, research is needed to further demonstrate the utility of MDT in Disaster Medicine. There is also a need for reliable MDT logistics and supply chain networks. Integration with other disaster management activities will also be essential. In the aftermath of disasters, MDT could play an important role facilitating timely and efficient medical treatment and improving patient outcomes. Existing social, medical, and logistic barriers will need to be overcome for MDT to be mainstreamed in Disaster Medicine.

Utilization of mechanical diagnosis and therapy (MDT) for the treatment of lumbar pain in the presence of known lumbar transverse process fractures: a case study

PubMed Central

Elenburg, J. L.; Foley, B. S.; Roberts, K.; Bayliss, A. J.

2016-01-01

Background Spinal fractures are typically considered a contraindication to mechanical diagnosis and therapy (MDT). Objective and importance The purpose of this case study is to illustrate how MDT was used safely and effectively to treat lumbar pain in a patient with multiple lumbar transverse process fractures. Clinical presentation The subject was a 24-year-old female with left L2-5 transverse process fractures, sustained 10 weeks prior in a pedestrian versus motor vehicle accident. Intervention (and technique) After collaboration with her physiatrist, an MDT examination revealed a presentation consistent with the lumbar derangement syndrome. Conclusion After three visits, utilizing patient generated forces with the extension principle of treatment, her pain, Oswestry disability index (ODI) score, and function all improved. PMID:27559276

A Process of Multidisciplinary Team Communication to Individualize Stroke Rehabilitation of an 84-Year-Old Stroke Patient.

PubMed

Hiragami, Fukumi; Hiragami, Shogo; Suzuki, Yasuo

Previously, we have used a multidisciplinary team (MDT) approach to individualize rehabilitation of very old stroke patients as a means to establish intervention points for addressing impaired activities of daily living (ADL). However, this previous study was limited because of a lack in describing the communication process over time. This case study characterized the MDT communication process in the rehabilitation of an 84-year-old patient over the course of 15 weeks. The MDT consisted of 3 nurses, 1 doctor, 6 therapists, and the patient/families. Meetings (15 minutes each) were held at 4, 6, 8, and 15 weeks following the patient's admission. To individualize the rehabilitation, the communication process involved gaining knowledge about ADL impairments, sharing assessments, providing treatment options, and reflecting on desired treatment outcomes-a process termed KATR. The knowledge, assessment, treatment, and reflection (KATR) process established intervention points focusing on specific ADL impairments. The team members focused the interventions on the impaired ADL identified in the KATR process, and individualized rehabilitation was generated from the MDT information-sharing knowledge. In the initial meeting (Week 4), intervention points derived from the KATR process focused on rehabilitation of self-care impairments. These impairments improved by Week 15. By the last meeting, the MDT intervention points focused on mobility impairments. Having an organized communication process (i.e., KATR) facilitates individualization of rehabilitation without lengthy and frequent MDT meetings and enhances the quality of rehabilitation after a stroke.

Results from an exploratory study to identify the factors that contribute to success for UK medical device small- and medium-sized enterprises.

PubMed

Hourd, P C; Williams, D J

2008-07-01

This paper reports the results from an exploratory study that sets out to identify and compare the strategic approaches and patterns of business practice employed by 14 UK small- and medium-sized enterprises to achieve success in the medical device sector of the health-care industry. An interview-based survey was used to construct individual case studies of the medical device technology (MDT) companies. A cross-case analysis was performed to search for patterns and themes that cut across these individual cases. Exploratory results revealed the heterogeneity of MDT companies and the distinctive features of the MDT innovation process that emphasize the importance of a strategic approach for achieving milestones in the product development and exploitation process and for creating value for the company and its stakeholders. Recognizing the heterogeneity of MDT companies, these exploratory findings call for further investigation to understand better the influence of components of the MDT innovation process on the commercialization life cycle and value trajectory. This is required to assist start-up or spin-out MDT companies in the UK and worldwide to navigate the critical transitions that determine access to financial and consumer markets and enhance the potential to build a successful business. This will be important not only for bioscience-based companies but also for engineering-based companies aiming to convert their activities into medical devices and the health- and social-care market.

Booster Test for Space Launch System Rocket

NASA Image and Video Library

2016-06-26

The quench system arm and nozzle are seen at the test area where the second and final qualification motor (QM-2) test for the Space Launch System’s booster will take place, Sunday, June 26, 2016, at Orbital ATK Propulsion Systems test facilities in Promontory, Utah. The test is scheduled for Tuesday, June 28 at 10:05 a.m. EDT (8:05 a.m. MDT). Photo Credit: (NASA/Bill Ingalls)

Rapid resolution of chronic shoulder pain classified as derangement using the McKenzie method: a case series

PubMed Central

Aytona, Maria Corazon; Dudley, Karlene

2013-01-01

The McKenzie method, also known as Mechanical Diagnosis and Therapy (MDT), is primarily recognized as an evaluation and treatment method for the spine. However, McKenzie suggested that this method could also be applied to the extremities. Derangement is an MDT classification defined as an anatomical disturbance in the normal resting position of the joint, and McKenzie proposed that repeated movements could be applied to reduce internal joint displacement and rapidly reduce derangement symptoms. However, the current literature on MDT application to shoulder disorders is limited. Here, we present a case series involving four patients with chronic shoulder pain from a duration of 2–18 months classified as derangement and treated using MDT principles. Each patient underwent mechanical assessment and was treated with repeated movements based on their directional preference. All patients demonstrated rapid and clinically significant improvement in baseline measures and the disabilities of the arm, shoulder, and hand (QuickDASH) scores from an average of 38% at initial evaluation to 5% at discharge within 3–5 visits. Our findings suggest that MDT may be an effective treatment approach for shoulder pain. PMID:24421633

The role and structure of the multidisciplinary team in the management of advanced Parkinson’s disease with a focus on the use of levodopa–carbidopa intestinal gel

PubMed Central

Pedersen, Stephen W; Suedmeyer, Martin; Liu, Louis W C; Domagk, Dirk; Forbes, Alison; Bergmann, Lars; Onuk, Koray; Yegin, Ashley; van Laar, Teus

2017-01-01

A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson’s disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa–carbidopa intestinal gel (carbidopa–levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies. PMID:28115853

Principles of Carbon Catabolite Repression in the Rice Blast Fungus: Tps1, Nmr1-3, and a MATE–Family Pump Regulate Glucose Metabolism during Infection

PubMed Central

Hartline, David; Quispe, Cristian F.; Madayiputhiya, Nandakumar; Wilson, Richard A.

2012-01-01

Understanding the genetic pathways that regulate how pathogenic fungi respond to their environment is paramount to developing effective mitigation strategies against disease. Carbon catabolite repression (CCR) is a global regulatory mechanism found in a wide range of microbial organisms that ensures the preferential utilization of glucose over less favourable carbon sources, but little is known about the components of CCR in filamentous fungi. Here we report three new mediators of CCR in the devastating rice blast fungus Magnaporthe oryzae: the sugar sensor Tps1, the Nmr1-3 inhibitor proteins, and the multidrug and toxin extrusion (MATE)–family pump, Mdt1. Using simple plate tests coupled with transcriptional analysis, we show that Tps1, in response to glucose-6-phosphate sensing, triggers CCR via the inactivation of Nmr1-3. In addition, by dissecting the CCR pathway using Agrobacterium tumefaciens-mediated mutagenesis, we also show that Mdt1 is an additional and previously unknown regulator of glucose metabolism. Mdt1 regulates glucose assimilation downstream of Tps1 and is necessary for nutrient utilization, sporulation, and pathogenicity. This is the first functional characterization of a MATE–family protein in filamentous fungi and the first description of a MATE protein in genetic regulation or plant pathogenicity. Perturbing CCR in Δtps1 and MDT1 disruption strains thus results in physiological defects that impact pathogenesis, possibly through the early expression of cell wall–degrading enzymes. Taken together, the importance of discovering three new regulators of carbon metabolism lies in understanding how M. oryzae and other pathogenic fungi respond to nutrient availability and control development during infection. PMID:22570632

Ground penetrating radar (GPR) analysis : Phase I.

DOT National Transportation Integrated Search

2009-11-01

"The objective of this work is to evaluate the feasibility of expanding the MDT's Ground Penetrating : Radar (GPR) program to a broader range of pavement evaluation activities. Currently, MDT uses GPR in : conjunction with its Falling Weight Deflecto...

Assessing the effectiveness of Montana's vehicle occupant protection program.

DOT National Transportation Integrated Search

2015-02-01

The purpose of this project was to quantitatively evaluate the relationships between MDT's occupant protection program : activities and seat restraint usage throughout Montana, in an effort to clarify how MDT's occupant protection programs may : affe...

2016 availability and disparity study : final report.

DOT National Transportation Integrated Search

2016-07-01

The study examined whether there was a level playing field for minority- and women-owned firms in the Montana transportation : contracting marketplace and for MDT contracting. This information helps MDT set an overall goal for Disadvantage Business :...

Ride specification review for the Montana Department of Transportation

DOT National Transportation Integrated Search

2006-08-01

This report covers the activities that were performed to enhance the current Montana Department of Transportation (MDT)ride specification for flexible pavements. The project team reviewed the MDT ride specification for flexible pavements and compared...

New high-precision drift-tube detectors for the ATLAS muon spectrometer

NASA Astrophysics Data System (ADS)

Kroha, H.; Fakhrutdinov, R.; Kozhin, A.

2017-06-01

Small-diameter muon drift tube (sMDT) detectors have been developed for upgrades of the ATLAS muon spectrometer. With a tube diameter of 15 mm, they provide an about an order of magnitude higher rate capability than the present ATLAS muon tracking detectors, the MDT chambers with 30 mm tube diameter. The drift-tube design and the construction methods have been optimised for mass production and allow for complex shapes required for maximising the acceptance. A record sense wire positioning accuracy of 5 μm has been achieved with the new design. In the serial production, the wire positioning accuracy is routinely better than 10 μm. 14 new sMDT chambers are already operational in ATLAS, further 16 are under construction for installation in the 2019-2020 LHC shutdown. For the upgrade of the barrel muon spectrometer for High-Luminosity LHC, 96 sMDT chambers will be contructed between 2020 and 2024.

Low back pain: an assessment using positional MRI and MDT.

PubMed

Hedberg, Karen; Alexander, Lyndsay A; Cooper, Kay; Hancock, Elizabeth; Ross, Jenny; Smith, Francis W

2013-04-01

Current guidelines advise against the use of routine imaging for low back pain. Positional MRI can provide enhanced assessment of the lumbar spine in functionally loaded positions which are often relevant to the presenting clinical symptoms. The purpose of this case report is to highlight the use of positional MRI in the assessment and classification of a subject with low back pain. A low back pain subject underwent a Mechanical Diagnosis and Therapy (MDT) assessment and positional MRI scan of the lumbar spine. The MDT assessment classified the subject as "other" since the subjective history indicated a possible posterior derangement whilst the objective assessment indicated a possible anterior derangement. Positional MRI scanning in flexed, upright and extended sitting postures confirmed the MDT assessment findings to reveal a dynamic spinal stenosis which reduced in flexion and increased in extension. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development and validation of a new screening questionnaire for dysphagia in early stages of Parkinson's disease.

PubMed

Simons, Janine A; Fietzek, Urban M; Waldmann, Annika; Warnecke, Tobias; Schuster, Tibor; Ceballos-Baumann, Andrés O

2014-09-01

Dysphagia in patients with Parkinson's disease (PD) significantly reduces quality of life and predicted lifetime. Current screening procedures are insufficiently evaluated. We aimed to develop and validate a patient-reported outcome questionnaire for early diagnosis of dysphagia in patients with PD. The two-phased project comprised the questionnaire, diagnostic scales construction (N = 105), and a validation study (N = 82). Data for the project were gathered from PD patients at a German Movement Disorder Center. For validation purposes, a clinical evaluation focusing on swallowing tests, tests of sensory reflexes, and fiberoptic endoscopic evaluation of swallowing (FEES) was performed that yielded a criteria sum score against which the results of the questionnaire were compared. Specificity and sensitivity were evaluated for the detection of noticeable dysphagia and for the risk of aspiration. The Munich Dysphagia Test - Parkinson's disease (MDT-PD) consists of 26 items that show high internal consistency (α = 0.91). For the validation study, 82 patients, aged 70.9 ± 8.7 (mean ± SD), with a median Hoehn & Yahr stage of 3, were assessed. 73% of patients had dysphagia with noticeable oropharyngeal symptoms (44%) or with penetration/aspiration (29%). The criteria sum score correlated positively with the screening result (r = 0.70, p < 0.001). The MDT-PD sum score classified not noticeable dysphagia vs. risk of aspiration (noticeable dysphagia) with a sensitivity of 90% (82%) and a specificity of 86% (71%), and yielded similar results in cross-validation, respectively. MDT-PD is a valid screening tool for early diagnosis of swallowing problems and aspiration risk, as well as initial graduation of dysphagia severity in PD patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Young drivers' engagement with social interactive technology on their smartphone: Critical beliefs to target in public education messages.

PubMed

Gauld, Cassandra S; Lewis, Ioni M; White, Katherine M; Watson, Barry

2016-11-01

The current study forms part of a larger study based on the Step Approach to Message Design and Testing (SatMDT), a new and innovative framework designed to guide the development and evaluation of health communication messages, including road safety messages. This four step framework is based on several theories, including the Theory of Planned Behaviour. The current study followed steps one and two of the SatMDT framework and utilised a quantitative survey to validate salient beliefs (behavioural, normative, and control) about initiating, monitoring/reading, and responding to social interactive technology on smartphones by N=114 (88F, 26M) young drivers aged 17-25 years. These beliefs had been elicited in a prior in-depth qualitative study. A subsequent critical beliefs analysis identified seven beliefs as potential targets for public education messages, including, 'slow-moving traffic' (control belief - facilitator) for both monitoring/reading and responding behaviours; 'feeling at ease that you had received an expected communication' (behavioural belief -advantage) for monitoring/reading behaviour; and 'friends/peers more likely to approve' (normative belief) for responding behaviour. Potential message content targeting these seven critical beliefs is discussed in accordance with the SatMDT. Copyright © 2016 Elsevier Ltd. All rights reserved.

A single-component multidrug transporter of the major facilitator superfamily is part of a network that protects E scherichia coli from bile salt stress

PubMed Central

Paul, Stephanie; Alegre, Kamela O; Holdsworth, Scarlett R; Rice, Matthew; Brown, James A; McVeigh, Paul; Kelly, Sharon M; Law, Christopher J

2014-01-01

Resistance to high concentrations of bile salts in the human intestinal tract is vital for the survival of enteric bacteria such as E scherichia coli. Although the tripartite AcrAB–TolC efflux system plays a significant role in this resistance, it is purported that other efflux pumps must also be involved. We provide evidence from a comprehensive suite of experiments performed at two different pH values (7.2 and 6.0) that reflect pH conditions that E . coli may encounter in human gut that MdtM, a single-component multidrug resistance transporter of the major facilitator superfamily, functions in bile salt resistance in E . coli by catalysing secondary active transport of bile salts out of the cell cytoplasm. Furthermore, assays performed on a chromosomal ΔacrB mutant transformed with multicopy plasmid encoding MdtM suggested a functional synergism between the single-component MdtM transporter and the tripartite AcrAB–TolC system that results in a multiplicative effect on resistance. Substrate binding experiments performed on purified MdtM demonstrated that the transporter binds to cholate and deoxycholate with micromolar affinity, and transport assays performed on inverted vesicles confirmed the capacity of MdtM to catalyse electrogenic bile salt/H+ antiport. PMID:24684269

Integration of leprosy in general health system vis-à-vis leprosy endemicity, health situation and socioeconomic development: observations from Chhattisgarh & Kerala.

PubMed

Pandey, Aparna; Rathod, Harish

2010-06-01

This study looked at the integration of leprosy services in the GHS in context of health and socioeconomic situations using predefined indicators. It also looked at clients' perception of MDT services. The Indian states of Chhattisgarh and Kerala, which are at two extremes in leprosy endemicity, health situation and socioeconomic development, have been compared using predefined integration indicators related to the training of health workers, availability of MDT services, maintenance of MDT stock and involvement of Sub-centres in leprosy care. Data was collected by surveys of health facilities, sub-centres and communities in the two states, during 2006-2007. Information was collected by interviewing health personnel and clients, checking of records and on the spot observations using specifically designed formats. Results showed that integration is more inclusive in Chhattisgarh and has reached up to Sub-centre level. Both the community and health systems are sensitive and responsive to leprosy as it is perceived to be a major public health threat. But in Kerala, despite integration, it continues as a vertical programme with dependence on specialists and districts hospitals for diagnosis and treatment. MDT stock management is even poorer. Clients' perception towards MDT services are similar in both states.

Purification of a Multidrug Resistance Transporter for Crystallization Studies

PubMed Central

Alegre, Kamela O.; Law, Christopher J.

2015-01-01

Crystallization of integral membrane proteins is a challenging field and much effort has been invested in optimizing the overexpression and purification steps needed to obtain milligram amounts of pure, stable, monodisperse protein sample for crystallography studies. Our current work involves the structural and functional characterization of the Escherichia coli multidrug resistance transporter MdtM, a member of the major facilitator superfamily (MFS). Here we present a protocol for isolation of MdtM to increase yields of recombinant protein to the milligram quantities necessary for pursuit of structural studies using X-ray crystallography. Purification of MdtM was enhanced by introduction of an elongated His-tag, followed by identification and subsequent removal of chaperonin contamination. For crystallization trials of MdtM, detergent screening using size exclusion chromatography determined that decylmaltoside (DM) was the shortest-chain detergent that maintained the protein in a stable, monodispersed state. Crystallization trials of MdtM performed using the hanging-drop diffusion method with commercially available crystallization screens yielded 3D protein crystals under several different conditions. We contend that the purification protocol described here may be employed for production of high-quality protein of other multidrug efflux members of the MFS, a ubiquitous, physiologically and clinically important class of membrane transporters. PMID:27025617

Air quality analysis of MDT transportation improvements, cost-effectiveness analysis of the MACI Program.

DOT National Transportation Integrated Search

2004-03-01

"Under TEA-21, part of Montana's CMAQ apportionment is dedicated to Missoula and at the direction of the : Montana Transportation Commission, the Montana Department of Transportation (MDT) directs the remainder of : the CMAQ apportionment to areas in...

Air quality analysis of MDT transportation improvements : cost-effectiveness analysis of the MACI program.

DOT National Transportation Integrated Search

2004-03-01

Under TEA-21, part of Montana's CMAQ apportionment is dedicated to Missoula and at the direction of the : Montana Transportation Commission, the Montana Department of Transportation (MDT) directs the remainder of : the CMAQ apportionment to areas in ...

Patients’ Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings

PubMed Central

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

Background The contribution of patients’ non-medical characteristics to individual physicians’ decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients’ non-medical characteristics are presented at MDT meetings and how this information may affect the team’s final medical decisions. Design Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians’ verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. Results In the final sample of patients’ records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient’s age and his/her “likeability” were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients’ non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. Limitations The design of the study made it difficult to draw definite cause-and-effect conclusions. Conclusion The Social Representations approach suggests that patients’ non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians’ everyday professional practice. The links observed between patients’ attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind. PMID:27167521

Optimal Geoid Modelling to determine the Mean Ocean Circulation - Project Overview and early Results

NASA Astrophysics Data System (ADS)

Fecher, Thomas; Knudsen, Per; Bettadpur, Srinivas; Gruber, Thomas; Maximenko, Nikolai; Pie, Nadege; Siegismund, Frank; Stammer, Detlef

2017-04-01

The ESA project GOCE-OGMOC (Optimal Geoid Modelling based on GOCE and GRACE third-party mission data and merging with altimetric sea surface data to optimally determine Ocean Circulation) examines the influence of the satellite missions GRACE and in particular GOCE in ocean modelling applications. The project goal is an improved processing of satellite and ground data for the preparation and combination of gravity and altimetry data on the way to an optimal MDT solution. Explicitly, the two main objectives are (i) to enhance the GRACE error modelling and optimally combine GOCE and GRACE [and optionally terrestrial/altimetric data] and (ii) to integrate the optimal Earth gravity field model with MSS and drifter information to derive a state-of-the art MDT including an error assessment. The main work packages referring to (i) are the characterization of geoid model errors, the identification of GRACE error sources, the revision of GRACE error models, the optimization of weighting schemes for the participating data sets and finally the estimation of an optimally combined gravity field model. In this context, also the leakage of terrestrial data into coastal regions shall be investigated, as leakage is not only a problem for the gravity field model itself, but is also mirrored in a derived MDT solution. Related to (ii) the tasks are the revision of MSS error covariances, the assessment of the mean circulation using drifter data sets and the computation of an optimal geodetic MDT as well as a so called state-of-the-art MDT, which combines the geodetic MDT with drifter mean circulation data. This paper presents an overview over the project results with focus on the geodetic results part.

Clinical Oxidative Stress during Leprosy Multidrug Therapy: Impact of Dapsone Oxidation

PubMed Central

Schalcher, Taysa Ribeiro; Borges, Rosivaldo S.; Coleman, Michael D.; Batista Júnior, João; Salgado, Claudio G.; Vieira, Jose Luiz F.; Romão, Pedro R. T.; Oliveira, Fabio R.; Monteiro, Marta Chagas

2014-01-01

This study aims to assess the oxidative stress in leprosy patients under multidrug therapy (MDT; dapsone, clofazimine and rifampicin), evaluating the nitric oxide (NO) concentration, catalase (CAT) and superoxide dismutase (SOD) activities, glutathione (GSH) levels, total antioxidant capacity, lipid peroxidation, and methemoglobin formation. For this, we analyzed 23 leprosy patients and 20 healthy individuals from the Amazon region, Brazil, aged between 20 and 45 years. Blood sampling enabled the evaluation of leprosy patients prior to starting multidrug therapy (called MDT 0) and until the third month of multidrug therapy (MDT 3). With regard to dapsone (DDS) plasma levels, we showed that there was no statistical difference in drug plasma levels between multibacillary (0.518±0.029 µg/mL) and paucibacillary (0.662±0.123 µg/mL) patients. The methemoglobin levels and numbers of Heinz bodies were significantly enhanced after the third MDT-supervised dose, but this treatment did not significantly change the lipid peroxidation and NO levels in these leprosy patients. In addition, CAT activity was significantly reduced in MDT-treated leprosy patients, while GSH content was increased in these patients. However, SOD and Trolox equivalent antioxidant capacity levels were similar in patients with and without treatment. These data suggest that MDT can reduce the activity of some antioxidant enzyme and influence ROS accumulation, which may induce hematological changes, such as methemoglobinemia in patients with leprosy. We also explored some redox mechanisms associated with DDS and its main oxidative metabolite DDS-NHOH and we explored the possible binding of DDS to the active site of CYP2C19 with the aid of molecular modeling software. PMID:24465659

WHO Multidrug Therapy for Leprosy: Epidemiology of Default in Treatment in Agra District, Uttar Pradesh, India

PubMed Central

Kumar, Anil; Girdhar, Anita; Chakma, Joy Kumar; Girdhar, Bhuwneswar Kumar

2015-01-01

Aim. To study the magnitude of default, time of default, its causes, and final clinical outcome. Methods. Data collected in active surveys in Agra is analyzed. Patients were given treatment after medical confirmation and were followed up. The treatment default and other clinical outcomes were recorded. Results. Patients who defaulted have comparable demographic characteristics. However, among defaulters more women (62.7% in PB, 42.6% in MB) were seen than those in treatment completers (PB 52.7% and MB 35.9%). Nerve involvement was high in treatment completers: 45.7% in PB and 91.3% in MB leprosy. Overall default rate was lower (14.8%) in ROM than (28.8%) in standard MDT for PB leprosy (χ 1 2 = 11.6, P = 0.001) and also for MB leprosy: 9.1% in ROM compared to 34.5% in MDT (χ 1 2 = 6.0, P = 0.015). Default rate was not different (28.8% versus 34.5%, P > 0.05) in both types of leprosy given MDT. Most patients defaulted at early stage of treatment and mainly due to manageable side effects. Conclusion. The default in standard MDT both for PB and MB leprosy was observed to be significantly higher than in ROM treatment. Most defaults occurred at early stage of treatment and major contribution of default is due to side effects like drowsiness, weakness, vomiting, diarrhea, and so forth, related to poor general health. Although about half of the defaulters were observed to be cured 2.2% in PB-MDT and 10.9% of MB-MDT developed disability. This is an issue due to default. Attempts are needed to increase treatment compliance. The use of specially designed disease related health education along with easily administered drug regimens may help to reduce default. PMID:25705679

Are multidisciplinary teams in secondary care cost-effective? A systematic review of the literature

PubMed Central

2013-01-01

Objective To investigate the cost effectiveness of management of patients within the context of a multidisciplinary team (MDT) meeting in cancer and non-cancer teams in secondary care. Design Systematic review. Data sources EMBASE, MEDLINE, NHS EED, CINAHL, EconLit, Cochrane Library, and NHS HMIC. Eligibility criteria for selecting studies Randomised controlled trials (RCTs), cohort, case–control, before and after and cross-sectional study designs including an economic evaluation of management decisions made in any disease in secondary care within the context of an MDT meeting. Data extraction Two independent reviewers extracted data and assessed methodological quality using the Consensus on Health Economic Criteria (CHEC-list). MDTs were defined by evidence of two characteristics: decision making requiring a minimum of two disciplines; and regular meetings to discuss diagnosis, treatment and/or patient management, occurring at a physical location or by teleconferencing. Studies that reported on the costs of administering, preparing for, and attending MDT meetings and/or the subsequent direct medical costs of care, non-medical costs, or indirect costs, and any health outcomes that were relevant to the disease being investigated were included and classified as cancer or non-cancer MDTs. Results Fifteen studies (11 RCTs in non-cancer care, 2 cohort studies in cancer and non-cancer care, and 2 before and after studies in cancer and non cancer care) were identified, all with a high risk of bias. Twelve papers reported the frequency of meetings which varied from daily to three monthly and all reported the number of disciplines included (mean 5, range 2 to 9). The results from all studies showed mixed effects; a high degree of heterogeneity prevented a meta-analysis of findings; and none of the studies reported how the potential savings of MDT working may offset the costs of administering, preparing for, and attending MDT meetings. Conclusions Current evidence is insufficient to determine whether MDT working is cost-effective or not in secondary care. Further studies aimed at understanding the key aspects of MDT working that lead to cost-effective cancer and non-cancer care are required. PMID:23557141

Mode Deactivation Therapy (MDT) Comprehensive Meta-Analysis

ERIC Educational Resources Information Center

Apsche, Jack A.; Bass, Christopher K.; DiMeo, Lucia

2011-01-01

MDT provides an empirically based treatment for adolescents with behavioral problems such as anger, oppositional defiant and sexual and physical aggression (Apsche & DiMeo, 2010). It offers therapists a more efficient and timely intervention that positively effects recidivism rates (Apsche, Bass & Murphy, 2004). Based on Cognitive Behavioral…

Assessing the Treatment Effects in Apraxia of Speech: Introduction and Evaluation of the Modified Diadochokinesis Test

ERIC Educational Resources Information Center

Hurkmans, Joost; Jonkers, Roel; Boonstra, Anne M.; Stewart, Roy E.; Reinders-Messelink, Heleen A.

2012-01-01

Background: The number of reliable and valid instruments to measure the effects of therapy in apraxia of speech (AoS) is limited. Aims: To evaluate the newly developed Modified Diadochokinesis Test (MDT), which is a task to assess the effects of rate and rhythm therapies for AoS in a multiple baseline across behaviours design. Methods: The…

Microgrid Design Toolkit (MDT) User Guide Software v1.2.

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

Eddy, John P.

2017-08-01

The Microgrid Design Toolkit (MDT) supports decision analysis for new ("greenfield") microgrid designs as well as microgrids with existing infrastructure. The current version of MDT includes two main capabilities. The first capability, the Microgrid Sizing Capability (MSC), is used to determine the size and composition of a new, grid connected microgrid in the early stages of the design process. MSC is focused on developing a microgrid that is economically viable when connected to the grid. The second capability is focused on designing a microgrid for operation in islanded mode. This second capability relies on two models: the Technology Management Optimizationmore » (TMO) model and Performance Reliability Model (PRM).« less

Lustre Distributed Name Space (DNE) Evaluation at the Oak Ridge Leadership Computing Facility (OLCF)

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

Simmons, James S.; Leverman, Dustin B.; Hanley, Jesse A.

This document describes the Lustre Distributed Name Space (DNE) evaluation carried at the Oak Ridge Leadership Computing Facility (OLCF) between 2014 and 2015. DNE is a development project funded by the OpenSFS, to improve Lustre metadata performance and scalability. The development effort has been split into two parts, the first part (DNE P1) providing support for remote directories over remote Lustre Metadata Server (MDS) nodes and Metadata Target (MDT) devices, while the second phase (DNE P2) addressed split directories over multiple remote MDS nodes and MDT devices. The OLCF have been actively evaluating the performance, reliability, and the functionality ofmore » both DNE phases. For these tests, internal OLCF testbed were used. Results are promising and OLCF is planning on a full DNE deployment by mid-2016 timeframe on production systems.« less

[¹⁸F]Altanserin and small animal PET: impact of multidrug efflux transporters on ligand brain uptake and subsequent quantification of 5-HT₂A receptor densities in the rat brain.

PubMed

Kroll, Tina; Elmenhorst, David; Matusch, Andreas; Celik, A Avdo; Wedekind, Franziska; Weisshaupt, Angela; Beer, Simone; Bauer, Andreas

2014-01-01

The selective 5-hydroxytryptamine type 2a receptor (5-HT(2A)R) radiotracer [(18)F]altanserin is a promising ligand for in vivo brain imaging in rodents. However, [(18)F]altanserin is a substrate of P-glycoprotein (P-gp) in rats. Its applicability might therefore be constrained by both a differential expression of P-gp under pathological conditions, e.g. epilepsy, and its relatively low cerebral uptake. The aim of the present study was therefore twofold: (i) to investigate whether inhibition of multidrug transporters (MDT) is suitable to enhance the cerebral uptake of [(18)F]altanserin in vivo and (ii) to test different pharmacokinetic, particularly reference tissue-based models for exact quantification of 5-HT(2A)R densities in the rat brain. Eighteen Sprague-Dawley rats, either treated with the MDT inhibitor cyclosporine A (CsA, 50 mg/kg, n=8) or vehicle (n=10) underwent 180-min PET scans with arterial blood sampling. Kinetic analyses of tissue time-activity curves (TACs) were performed to validate invasive and non-invasive pharmacokinetic models. CsA application lead to a two- to threefold increase of [(18)F]altanserin uptake in different brain regions and showed a trend toward higher binding potentials (BP(ND)) of the radioligand. MDT inhibition led to an increased cerebral uptake of [(18)F]altanserin but did not improve the reliability of BP(ND) as a non-invasive estimate of 5-HT(2A)R. This finding is most probable caused by the heterogeneous distribution of P-gp in the rat brain and its incomplete blockade in the reference region (cerebellum). Differential MDT expressions in experimental animal models or pathological conditions are therefore likely to influence the applicability of imaging protocols and have to be carefully evaluated. © 2013.

Comparing Multiple Discrepancies Theory to Affective Models of Subjective Wellbeing

ERIC Educational Resources Information Center

Blore, Jed D.; Stokes, Mark A.; Mellor, David; Firth, Lucy; Cummins, Robert A.

2011-01-01

The Subjective Wellbeing (SWB) literature is replete with competing theories detailing the mechanisms underlying the construction and maintenance of SWB. The current study aimed to compare and contrast two of these approaches: multiple discrepancies theory (MDT) and an affective-cognitive theory of SWB. MDT posits SWB to be the result of perceived…

Correlates of Parental Differential Treatment: Parental and Contextual Factors during Middle Childhood

ERIC Educational Resources Information Center

Atzaba-Poria, Naama; Pike, Alison

2008-01-01

The current study examined whether parental and contextual risk factors contribute to mothers' and fathers' differential treatment (MDT/FDT) when accounting for sibling dyad characteristics. Also explored was whether family type (single mothers vs. 2 parents) moderated the links between the parental and contextual correlates and MDT. One hundred…

Mode Deactivation Therapy (MDT): A Theoretical Case Analysis on a Suicidal Adolescent

ERIC Educational Resources Information Center

Apsche, Jack A.; Siv, Alexander M.

2005-01-01

This case study presents a case study of the effectiveness of Mode deactivation therapy (MDT) (Apsche, Bass, Jennings, Murphy, Hunter, and Siv, 2005) with an adolescent male, with reactive conduct disorder, PTSD and 8 lethal suicide attempts. The youngster was hospitalized four times for suicide attempts, three previous placements in residential…

Nonlinear diffusion filtering of the GOCE-based satellite-only MDT

NASA Astrophysics Data System (ADS)

Čunderlík, Róbert; Mikula, Karol

2015-04-01

A combination of the GRACE/GOCE-based geoid models and mean sea surface models provided by satellite altimetry allows modelling of the satellite-only mean dynamic topography (MDT). Such MDT models are significantly affected by a stripping noise due to omission errors of the spherical harmonics approach. Appropriate filtering of this kind of noise is crucial in obtaining reliable results. In our study we use the nonlinear diffusion filtering based on a numerical solution to the nonlinear diffusion equation on closed surfaces (e.g. on a sphere, ellipsoid or the discretized Earth's surface), namely the regularized surface Perona-Malik model. A key idea is that the diffusivity coefficient depends on an edge detector. It allows effectively reduce the noise while preserve important gradients in filtered data. Numerical experiments present nonlinear filtering of the satellite-only MDT obtained as a combination of the DTU13 mean sea surface model and GO_CONS_GCF_2_DIR_R5 geopotential model. They emphasize an adaptive smoothing effect as a principal advantage of the nonlinear diffusion filtering. Consequently, the derived velocities of the ocean geostrophic surface currents contain stronger signal.

A combined mean dynamic topography model - DTU17cMDT

NASA Astrophysics Data System (ADS)

Knudsen, P.; Andersen, O. B.; Nielsen, K.; Maximenko, N. A.

2017-12-01

Within the ESA supported Optimal Geoid for Modelling Ocean Circulation (OGMOC) project a new geoid model have been derived. It is based on the GOCO05C setup though the newer DTU15GRA altimetric surface gravity has been used in the combination. Subsequently the model has been augmented using the EIGEN-6C4 coefficients to d/o 2160. Compared to the DTU13MSS, the DTU15MSS has been derived by including re-tracked CRYOSAT-2 altimetry also, hence, increasing its resolution. Also, some issues in the Polar regions have been solved. The new DTU17MDT has been derived using this new geoid model and the DTU15MSS mean sea surface. Compared to other geoid models the new OGMOC geoid model has been optimized to avoid striations and orange skin like features. The filtering was re-evaluated by adjusting the quasi-gaussian filter width to optimize the fit to drifter velocities. The results show that the new MDT improves the resolution of the details of the ocean circulation. Subsequently, the drifter velocities were integrated to enhance the resolution of the MDT. As a contribution to the ESA supported GOCE++ project DYCOT a special concern was devoted to the coastal areas to optimize the extrapolation towards the coast and to integrate mean sea levels at tide gauges into that process. The presentation will focus on the coastal zone when assessing the methodology, the data and the final model DTU17cMDT.

Should centralized histopathological review in penile cancer be the global standard?

PubMed

Tang, Vincent; Clarke, Laurence; Gall, Zara; Shanks, Jonathan H; Nonaka, Daisuke; Parr, Nigel J; Elliott, P Anthony; Clarke, Noel W; Ramani, Vijay; Lau, Maurice W; Sangar, Vijay K

2014-09-01

To assess the role of centralized pathological review in penile cancer management. Newly diagnosed squamous cell carcinomas (SCC) of the penis, including squamous cell carcinoma in situ (CIS), from biopsy specimens were referred from 15 centres to the regional supra-network multidisciplinary team (Sn-MDT) between 1 January 2008 and 30 March 2011. Biopsy histology reports and slides from the respective referring hospitals were reviewed by the Sn-MDT pathologists. The biopsy specimens' histological type, grade and stage reported by the Sn-MDT pathologist were compared with those given in the referring hospital pathology report, as well as with definitive surgery histology. Any changes in histological diagnosis were sub-divided into critical changes (i.e. those that could alter management) and non-critical changes (i.e. those that would not affect management). A total of 155 cases of squamous cell carcinoma or CIS of the penis were referred from 15 different centres in North-West England. After review by the Sn-MDT, the histological diagnosis was changed in 31% of cases and this difference was statistically significant. A total of 60.4% of the changes were deemed to be critical changes that resulted in a significant change in management. When comparing the biopsy histology reported by the Sn-MDT with the final histology from the definitive surgical specimens, a good correlation was generally found. In the present study a significant proportion of penile cancer histology reports were revised after review by the Sn-MDT. Many of these changes altered patient management. The present study shows that accurate pathological diagnosis plays a crucial role in determining the correct treatment and maximizing the potential for good clinical outcomes in penile cancer. In the case of histopathology, centralization has increased exposure to penile cancer and thereby increased diagnostic accuracy, and should therefore be considered the 'gold standard'. © 2013 The Authors. BJU International © 2013 BJU International.

Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance

PubMed Central

Patkar, Vivek; Acosta, Dionisio; Davidson, Tim; Jones, Alison; Fox, John

2012-01-01

Objectives The cancer multidisciplinary team (MDT) meeting (MDM) is regarded as the best platform to reduce unwarranted variation in cancer care through evidence-compliant management. However, MDMs are often overburdened with many different agendas and hence struggle to achieve their full potential. The authors developed an interactive clinical decision support system called MATE (Multidisciplinary meeting Assistant and Treatment sElector) to facilitate explicit evidence-based decision making in the breast MDMs. Design Audit study and a questionnaire survey. Setting Breast multidisciplinary unit in a large secondary care teaching hospital. Participants All members of the breast MDT at the Royal Free Hospital, London, were consulted during the process of MATE development and implementation. The emphasis was on acknowledging the clinical needs and practical constraints of the MDT and fitting the system around the team's workflow rather than the other way around. Delegates, who attended MATE workshop at the England Cancer Networks' Development Programme conference in March 2010, participated in the questionnaire survey. Outcome measures The measures included evidence-compliant care, measured by adherence to clinical practice guidelines, and promoting research, measured by the patient identification rate for ongoing clinical trials. Results MATE identified 61% more patients who were potentially eligible for recruitment into clinical trials than the MDT, and MATE recommendations demonstrated better concordance with clinical practice guideline than MDT recommendations (97% of MATE vs 93.2% of MDT; N=984). MATE is in routine use in breast MDMs at the Royal Free Hospital, London, and wider evaluations are being considered. Conclusions Sophisticated decision support systems can enhance the conduct of MDMs in a way that is acceptable to and valued by the clinical team. Further rigorous evaluations are required to examine cost-effectiveness and measure the impact on patient outcomes. The decision support technology used in MATE is generic and if found useful can be applied across medicine. PMID:22734113

Regional long-term production modeling from a single well test, Mount Elbert Gas Hydrate Stratigraphic Test Well, Alaska North Slope

USGS Publications Warehouse

Anderson, B.J.; Kurihara, M.; White, M.D.; Moridis, G.J.; Wilson, S.J.; Pooladi-Darvish, M.; Gaddipati, M.; Masuda, Y.; Collett, T.S.; Hunter, R.B.; Narita, H.; Rose, K.; Boswell, R.

2011-01-01

Following the results from the open-hole formation pressure response test in the BPXA-DOE-USGS Mount Elbert Gas Hydrate Stratigraphic Test Well (Mount Elbert well) using Schlumberger's Modular Dynamics Formation Tester (MDT) wireline tool, the International Methane Hydrate Reservoir Simulator Code Comparison project performed long-term reservoir simulations on three different model reservoirs. These descriptions were based on 1) the Mount Elbert gas hydrate accumulation as delineated by an extensive history-matching exercise, 2) an estimation of the hydrate accumulation near the Prudhoe Bay L-pad, and 3) a reservoir that would be down-dip of the Prudhoe Bay L-pad and therefore warmer and deeper. All of these simulations were based, in part, on the results of the MDT results from the Mount Elbert Well. The comparison group's consensus value for the initial permeability of the hydrate-filled reservoir (k = 0.12 mD) and the permeability model based on the MDT history match were used as the basis for subsequent simulations on the three regional scenarios. The simulation results of the five different simulation codes, CMG STARS, HydrateResSim, MH-21 HYDRES, STOMP-HYD, and TOUGH+HYDRATE exhibit good qualitative agreement and the variability of potential methane production rates from gas hydrate reservoirs is illustrated. As expected, the predicted methane production rate increased with increasing in situ reservoir temperature; however, a significant delay in the onset of rapid hydrate dissociation is observed for a cold, homogeneous reservoir and it is found to be repeatable. The inclusion of reservoir heterogeneity in the description of this cold reservoir is shown to eliminate this delayed production. Overall, simulations utilized detailed information collected across the Mount Elbert reservoir either obtained or determined from geophysical well logs, including thickness (37 ft), porosity (35%), hydrate saturation (65%), intrinsic permeability (1000 mD), pore water salinity (5 ppt), and formation temperature (3.3-3.9 ??C). This paper presents the approach and results of extrapolating regional forward production modeling from history-matching efforts on the results from a single well test. ?? 2010 Elsevier Ltd.

Regional long-term production modeling from a single well test, Mount Elbert Gas Hydrate Stratigraphic Test Well, Alaska North Slope

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

Anderson, Brian J.; Kurihara, Masanori; White, Mark D.

2011-02-01

Following the results from the open-hole formation pressure response test in the BPXA-DOE-USGS Mount Elbert Gas Hydrate Stratigraphic Test Well (Mount Elbert well) using Schlumberger's Modular Dynamics Formation Tester (MDT) wireline tool, the International Methane Hydrate Reservoir Simulator Code Comparison project performed long-term reservoir simulations on three different model reservoirs. These descriptions were based on 1) the Mount Elbert gas hydrate accumulation as delineated by an extensive history-matching exercise, 2) an estimation of the hydrate accumulation near the Prudhoe Bay L-pad, and 3) a reservoir that would be down-dip of the Prudhoe Bay L-pad and therefore warmer and deeper. Allmore » of these simulations were based, in part, on the results of the MDT results from the Mount Elbert Well. The comparison group's consensus value for the initial permeability of the hydrate-filled reservoir (k = 0.12 mD) and the permeability model based on the MDT history match were used as the basis for subsequent simulations on the three regional scenarios. The simulation results of the five different simulation codes, CMG STARS, HydrateResSim, MH-21 HYDRES, STOMP-HYD, and TOUGH+HYDRATE exhibit good qualitative agreement and the variability of potential methane production rates from gas hydrate reservoirs is illustrated. As expected, the predicted methane production rate increased with increasing in situ reservoir temperature; however, a significant delay in the onset of rapid hydrate dissociation is observed for a cold, homogeneous reservoir and it is found to be repeatable. The inclusion of reservoir heterogeneity in the description of this cold reservoir is shown to eliminate this delayed production. Overall, simulations utilized detailed information collected across the Mount Elbert reservoir either obtained or determined from geophysical well logs, including thickness (37 ft), porosity (35%), hydrate saturation (65%), intrinsic permeability (1000 mD), pore water salinity (5 ppt), and formation temperature (3.3–3.9 °C). Finally, this paper presents the approach and results of extrapolating regional forward production modeling from history-matching efforts on the results from a single well test.« less

The Impact of a Hepatobiliary Multidisciplinary Team Assessment in Patients with Colorectal Cancer Liver Metastases: A Population-Based Study.

PubMed

Engstrand, Jennie; Kartalis, Nikolaos; Strömberg, Cecilia; Broberg, Mats; Stillström, Anna; Lekberg, Tobias; Jonas, Eduard; Freedman, Jacob; Nilsson, Henrik

2017-09-01

Assessing patients with colorectal cancer liver metastases (CRCLM) by a liver multidisciplinary team (MDT) results in higher resection rates and improved survival. The aim of this study was to evaluate the potentially improved resection rate in a defined cohort if all patients with CRCLM were evaluated by a liver MDT. A retrospective analysis of patients diagnosed with colorectal cancer during 2008 in the greater Stockholm region was conducted. All patients with liver metastases (LM), detected during 5-year follow-up, were re-evaluated at a fictive liver MDT in which previous imaging studies, tumor characteristics, medical history, and patients' own treatment preferences were presented. Treatment decisions for each patient were compared to the original management. Odds ratios (ORs) and 95% confidence intervals were estimated for factors associated with referral to the liver MDT. Of 272 patients diagnosed with LM, 102 patients were discussed at an original liver MDT and 69 patients were eventually resected. At the fictive liver MDT, a further 22 patients were considered as resectable/potentially resectable, none previously assessed by a hepatobiliary surgeon. Factors influencing referral to liver MDT were age (OR 3.12, 1.72-5.65), American Society of Anaesthesiologists (ASA) score (OR 0.34, 0.18-0.63; ASA 2 vs. ASA 3), and number of LM (OR 0.10, 0.04-0.22; 1-5 LM vs. >10 LM), while gender ( p  = .194) and treatment at a teaching hospital ( p  = .838) were not. A meaningful number of patients with liver metastases are not managed according to best available evidence and the potential for higher resection rates is substantial. Patients with liver metastatic colorectal cancer who are assessed at a hepatobiliary multidisciplinary meeting achieve higher resection rates and improved survival. Unfortunately, patients who may benefit from resection are not always properly referred. In this study, the potential improved resection rate was assessed by re-evaluating all patients with liver metastases from a population-based cohort, including patients with extrahepatic metastases and accounting for comorbidity and patients' own preferences towards treatment. An additional 12.9% of the patients were found to be potentially resectable. The results highlight the importance of all patients being evaluated in the setting of a hepatobiliary multidisciplinary meeting. © AlphaMed Press 2017.

SU-F-J-175: Evaluation of Metal Artifact Reduction Algorithms in Computed Tomography and Their Application to Radiation Therapy Treatment Planning

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

Norris, H; Rangaraj, D; Kim, S

Purpose: High-Z (metal) implants in CT scans cause significant streak-like artifacts in the reconstructed dataset. This results in both inaccurate CT Hounsfield units for the tissue as well as obscuration of the target and organs at risk (OARs) for radiation therapy planning. Herein we analyze two metal artifact reduction algorithms: GE’s Smart MAR and a Metal Deletion Technique (MDT) for geometric and Hounsfield Unit (HU) accuracy. Methods: A CT-to-electron density phantom, with multiple inserts of various densities and a custom Cerrobend insert (Zeff=76.8), is utilized in this continuing study. The phantom is scanned without metal (baseline) and again with themore » metal insert. Using one set of projection data, reconstructed CT volumes are created with filtered-back-projection (FBP) and the MAR and the MDT algorithms. Regions-of-Interest (ROIs) are evaluated for each insert for HU accuracy; the metal insert’s Full-Width-Half-Maximum (FWHM) is used to evaluate the geometric accuracy. Streak severity is quantified with an HU error metric over the phantom volume. Results: The original FBP reconstruction has a Root-Mean-Square-Error (RMSE) of 57.55 HU (STD=29.19, range=−145.8 to +79.2) compared to baseline. The MAR reconstruction has a RMSE of 20.98 HU (STD=13.92, range=−18.3 to +61.7). The MDT reconstruction has a RMSE of 10.05 HU (STD=10.5, range=−14.8 to +18.6). FWHM for baseline=162.05; FBP=161.84 (−0.13%); MAR=162.36 (+0.19%); MDT=162.99 (+0.58%). Streak severity metric for FBP=19.73 (22.659% bad pixels); MAR=8.743 (9.538% bad); MDT=4.899 (5.303% bad). Conclusion: Image quality, in terms of HU accuracy, in the presence of high-Z metal objects in CT scans is improved by metal artifact reduction reconstruction algorithms. The MDT algorithm had the highest HU value accuracy (RMSE=10.05 HU) and best streak severity metric, but scored the worst in terms of geometric accuracy. Qualitatively, the MAR and MDT algorithms increased detectability of inserts, although there is a loss of in-plane resolution near the metallic insert.« less

Two-year experience of multi-disciplinary team (MDT) outcomes for brain metastases in a tertiary neuro-oncology centre.

PubMed

Loh, Daniel; Hogg, Florence; Edwards, Penelope; MacColl, Jillian; Brogna, Christian; Bhangoo, Ranjeev; Ashkan, Keyoumars; Vergani, Francesco

2017-08-24

Brain metastases (BMs) are the most common intracranial tumour in adults and form a significant proportion of the neuro-oncology workload. Their management has progressed significantly in the last few decades but a gold-standard evidence-based management strategy has not been defined to date and several guidelines based on available evidence exist to support clinical decision-making. This paper evaluates the decision-making process of the neuro-oncology multi-disciplinary team (MDT) in a tertiary neuro-oncology centre over a two-year period. A retrospective review of all patients with BM discussed in the MDT was conducted. Data on patient demographics, tumour characteristics and MDT decision were collected from the MDT database, clinical notes and imaging studies. Patients were stratified into the three recursive partitioning analysis (RPA) classes and according to the graded prognostic assessment (GPA) score. MDT decisions were analysed by RPA class and for GPA score as well as single versus multiple BM. There were 362 patients with BM, representing 22% of the total cases discussed at the MDT. Decision-making was largely consistent with available guidelines. A concrete treatment decision was reached in 77.5% of patients and 32.2% of these received neurosurgical input. More patients with solitary BM underwent surgery compared to multiple BM (p = 0.001), and more patients in RPA classes I and II had surgical resection compared to class III (p = 0.005 and 0.001, respectively). Surgical patients also had higher GPA scores compared to palliative patients (p = 0.005). A greater absolute number and proportion of patients in RPA class II vs. class I underwent neurosurgical intervention. These patients were stratified into class II because of their age but would otherwise have been placed into class I. Survival data were available for 195 patients (53.8%) at 1 year post MDT discussion. A pattern of declining survival was observed along RPA classes which was statistically significant (p = 0.0025). Median survival was 4.7 (0-41), 3.7 (0-23), and 2.5 (range 0-24) months for RPA class I, II and III respectively. A similar pattern that did not reach statistical significance was found between GPA scores (p = 0.101). Median survival was 3 (0-13), 4.6 (range 0-41), and 4.6 (0-35) months for GPA scores 0-1.0, 1.5-2.5 and 3-4.0, respectively. Patient selection was generally in accordance to RPA class and GPA scoring, with the exception of surgery offered to elderly patients: this can be explained by the increasing number of otherwise fit patients as population ages.

A One Year Study of Mode Deactivation Therapy: Adolescent Residential Patients with Conduct and Personality Disorders

ERIC Educational Resources Information Center

Murphy, Christopher J.; Siv, Alexander M.

2011-01-01

This case study is to evaluate the effectiveness of Mode Deactivation Therapy (MDT) implementation in a child and adolescent residential treatment unit and provide preliminary effectiveness data on MDT versus treatment as usual (TAU). This case study compared the efficacy of two treatment methodologies for adolescent males in residential treatment…

Family Mode Deactivation Therapy in a Residential Setting: Treating Adolescents with Conduct Disorder and Multi-Axial Diagnosis

ERIC Educational Resources Information Center

Apsche, Jack A.; Bass, Christopher K.; Zeiter, J. Scott; Houston, Marsha Ann

2008-01-01

Mode Deactivation Therapy (MDT) has been shown to be an effective treatment for a variety of adolescent disorders including emotional dysregulation, behavioral dysregulation, physical aggression, sexual aggression, and many harmful symptoms of anxiety and traumatic stress. MDT Family Therapy has been effective in reducing family disharmony in case…

Maggot Debridement Therapy in the Treatment of Complex Diabetic Wounds

PubMed Central

Herrington, Mark T; Swenor, Karen M; Eron, Lawrence J

2011-01-01

The growth and aging of the population of Hawai‘i with a high incidence of diabetes mandates a need for more effective strategies to manage the healing of complicated wounds. Maggot debridement therapy (MDT) is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure. Maggot debridement therapy is an effective treatment of diabetic wounds. PMID:22162609

Multi-disciplinary team for early gastric cancer diagnosis improves the detection rate of early gastric cancer.

PubMed

Di, Lianjun; Wu, Huichao; Zhu, Rong; Li, Youfeng; Wu, Xinglong; Xie, Rui; Li, Hongping; Wang, Haibo; Zhang, Hua; Xiao, Hong; Chen, Hui; Zhen, Hong; Zhao, Kui; Yang, Xuefeng; Xie, Ming; Tuo, Bigung

2017-12-06

Gastric cancer is a frequent malignant tumor worldwide and its early detection is crucial for curing the disease and enhancing patients' survival rate. This study aimed to assess whether the multi-disciplinary team (MDT) can improve the detection rate of early gastric cancer (EGC). The detection rate of EGC at the Digestive Endoscopy Center, Affiliated Hospital, Zunyi Medical College, China between September 2013 and September 2015 was analyzed. MDT for the diagnosis of EGC in the hospital was established in September 2014. The study was divided into 2 time periods: September 1, 2013 to August 31, 2014 (period 1) and September 1, 2014 to September 1, 2015 (period 2). A total of 60,800 patients' gastroscopies were performed during the two years. 61 of these patients (0.1%) were diagnosed as EGC, accounting for 16.44% (61/371) of total patients with gastric cancer. The EGC detection rate before MDT (period 1) was 0.05% (16/29403), accounting for 9.09% (16/176) of total patients with gastric cancer during this period. In comparison, the EGC detection rate during MDT (period 2) was 0.15% (45/31397), accounting for 23% (45/195) of total patients with gastric cancer during this period (P < 0.05). Univariate and multivariate logistic analyses showed that intensive gastroscopy for high risk patients of gastric cancer enhanced the detection rate of EGC in cooperation with Department of Pathology (OR = 10.1, 95% CI 2.39-43.3, P < 0.05). MDT could improve the endoscopic detection rate of EGC.

Australian contemporary management of synchronous metastatic colorectal cancer.

PubMed

Malouf, Phillip; Gibbs, Peter; Shapiro, Jeremy; Sockler, Jim; Bell, Stephen

2018-01-01

This article outlines the current Australian multidisciplinary treatment of synchronous metastatic colorectal adenocarcinoma and assesses the factors that influence patient outcome. This is a retrospective analysis of the prospective 'Treatment of Recurrent and Advanced Colorectal Cancer' registry, describing the patient treatment pathway and documenting the extent of disease, resection of the colorectal primary and metastases, chemotherapy and biological therapy use. Cox regression models for progression-free and overall survival were constructed with a comprehensive set of clinical variables. Analysis was intentionn-ton-treat, quantifying the effect of treatment intent decided at the multidisciplinary team meeting (MDT). One thousand one hundred and nine patients presented with synchronous metastatic disease between July 2009 and November 2015. Median follow-up was 15.8 months; 4.4% (group 1) had already curative resections of primary and metastases prior to MDT, 22.2% (group 2) were considered curative but were referred to MDT for opinion and/or medical oncology treatment prior to resection and 70.2% were considered palliative at MDT (group 3). Overall, 83% received chemotherapy, 55% had their primary resected and 23% had their metastases resected; 13% of resections were synchronous, 20% were staged with primary resected first and 62% had only the colorectal primary managed surgically. Performance status, metastasis resection (R0 versus R1 versus R2 versus no resection), resection of the colorectal primary and treatment intent determined at MDT were the most significant factors for progression-free and overall survival. This is the largest Australian series of synchronous metastatic colorectal adenocarcinoma and offers insight into the nature and utility of contemporary practice. © 2016 Royal Australasian College of Surgeons.

Remote magnetic targeting of iron oxide nanoparticles for cardiovascular diagnosis and therapeutic drug delivery: where are we now?

PubMed Central

Bietenbeck, Michael; Florian, Anca; Faber, Cornelius; Sechtem, Udo; Yilmaz, Ali

2016-01-01

Magnetic resonance imaging (MRI) allows for an accurate assessment of both functional and structural cardiac parameters, and thereby appropriate diagnosis and validation of cardiovascular diseases. The diagnostic yield of cardiovascular MRI examinations is often increased by the use of contrast agents that are almost exclusively based on gadolinium compounds. Another clinically approved contrast medium is composed of superparamagnetic iron oxide nanoparticles (IONs). These particles may expand the field of contrast-enhanced cardiovascular MRI as recently shown in clinical studies focusing on acute myocardial infarction (AMI) and atherosclerosis. Furthermore, IONs open up new research opportunities such as remote magnetic drug targeting (MDT). The approach of MDT relies on the coupling of bioactive molecules and magnetic nanoparticles to form an injectable complex. This complex, in turn, can be attracted to and retained at a desired target inside the body with the help of applied magnetic fields. In comparison to common systemic drug applications, MDT techniques promise both higher concentrations at the target site and lower concentrations elsewhere in the body. Moreover, concurrent or subsequent MRI can be used for noninvasive monitoring of drug distribution and successful delivery to the desired organ in vivo. This review does not only illustrate the basic conceptual and biophysical principles of IONs, but also focuses on new research activities and achievements in the cardiovascular field, mainly in the management of AMI. Based on the presentation of successful MDT applications in preclinical models of AMI, novel approaches and the translational potential of MDT are discussed. PMID:27486321

The use of Mechanical Diagnosis and Therapy (MDT) in patients with lower urinary tract symptoms (LUTS): case series.

PubMed

Wu, Di; Rosedale, Richard

2018-02-26

Lower urinary tract symptoms (LUTS) are highly prevalent among men over the age of 40. Even though associations between lumbar spine conditions and LUTS have been documented in the literature, no studies have detailed a specific lumbar assessment and classification process, and the related treatment effects in patients with LUTS. In this case series, we present three male patients with LUTS as primary complaints, who were evaluated and treated with Mechanical Diagnosis and Therapy (MDT) for the lumbar spine. The duration of their symptoms was between 4 months and 7 years. Urogenital pathologies were ruled out for all patients. The Chronic Prostatitis Symptom Index was used as a functional outcome measure. All patients were classified as having lumbar derangements. Treatment of derangements with directional preference exercises resulted in the improvement of their LUTS, with clinically significant improvements (56.0%-77.4%) in functional outcome measures over an average of six sessions. Preliminary indications suggest that these LUTS cases may possibly have had a lumbar spine origin and "mechanical" nature. Therefore, they may be within the scope of MDT assessments and interventions. With careful monitoring of symptoms, MDT may serve as a screening tool and conservative treatment option.

Transforaminal epidural steroid injections influence Mechanical Diagnosis and Therapy (MDT) pain response classification in candidates for lumbar herniated disc surgery.

PubMed

van Helvoirt, Hans; Apeldoorn, Adri T; Knol, Dirk L; Arts, Mark P; Kamper, Steven J; van Tulder, Maurits W; Ostelo, Raymond W

2016-04-27

Prospective cohort study. Although lumbar radiculopathy is regarded as a specific diagnosis, the most effective treatment strategy is unclear. Commonly used treatments include transforaminal epidural steroid injections (TESIs) and Mechanical Diagnosis & Therapy (MDT), but no studies have investigated the effectiveness of this combination. MDT differentiates pain centralization (C) from non-centralization (NC), which indicates good vs. poor prognostic validity respectively. The main aims were 1) to determine changes in Mechanical Diagnosis and Therapy (MDT) pain response classifications after transforaminal epidural steroid injections (TESIs) in candidates for lumbar herniated disc surgery and 2) to evaluate differences in short and long term outcomes for patients with different pain response classifications. Candidates for lumbar herniated disc surgery were assessed with a MDT protocol and their pain response classified as centralizing or peripheralizing. For this study,only patients were eligible who showed a peripheralizing pain response at intake. All patients then received TESIs and were reassessed and classified using the MDT protocol, into groups according to pain response (resolved, centralizing, peripheralizing with less pain and peripheralising with severe pain). After receiving targeted treatment based on pain response after TESIs, ranging from advice, MDT or surgery, follow-up assessments were completed at discharge and at 12 months. The primary outcomes were disability (Roland-Morris Disability Questionnaire [RMDQ] for Sciatica), pain severity in leg (visual analogue scale [VAS], 0-100) and global perceived effect (GPE). Linear mixed-models were used to determine between-groups differences in outcome. A total of 77 patients with lumbar disc herniation and peripheralizing symptoms were included. Patients received an average of 2 (SD 0.7) TESIs. After TESIs, 17 patients (22%) were classified as peripheralizing with continuing severe pain.These patients underwent surgery and were not further evaluated. Eleven (14%) patients were classified as resolved, 37 (48%) as centralizing with significant less pain, and 12 (16%) as peripheralizing with significant less pain. None of these patients underwent surgery. Resolved and centralizer subgroups had better outcomes in terms of VAS and RMDQ than the non-operated peripheralizers at discharge and at 12 months. The succes rates (GPE) for the resolved, centralizing, and peripheralizing with less pain patients were 100%, 100% and 33% respectively at short term, and 100%, 92% and 50% respectively at long term. After TESIs, a peripheralizing pain pattern changed to resolved or centralizing in 62% of the patients. For the non-operated patients, those with a centralising pattern after TESIs reported better pain and disability outcomes than those with peripheralizing pattern at short and long term.

The value of physical performance measurements alongside assessment of sarcopenia in predicting receipt and completion of planned treatment in non-small cell lung cancer: an observational exploratory study.

PubMed

Collins, Jemima T; Noble, Simon; Chester, John; Davies, Helen E; Evans, William D; Farewell, Daniel; Lester, Jason F; Parry, Diane; Pettit, Rebecca; Byrne, Anthony

2018-01-01

The presence of muscle mass depletion is associated with poor outcomes and survival in cancer. Alongside muscle mass, assessment of muscle strength or physical performance is essential for the diagnosis of sarcopenia. Non-small cell lung cancer (NSCLC) is a prevalent form of cancer with high mortality, and Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) is commonly used to assess patients' suitability for treatment. However, a significant proportion of patients with good PS are unable to complete multidisciplinary team (MDT)-planned treatment. Little is known about the ability of objective measurements of physical performance in predicting patients' ability to complete MDT-planned treatment and outcomes in NSCLC. We sought to establish whether physical performance, utilising the short physical performance battery (SPPB), alongside muscle mass measurements, was able to predict receipt and completion of MDT-planned treatment, with a focus on chemotherapy in NSCLC. Participants with NSCLC treated through a single lung cancer MDT and ECOG PS 0-2 were recruited and the following assessed: body composition [bioelectrical impedance (BIA) and whole body dual-energy X-ray absorptiometry (DXA) in a subset], physical performance (SPPB), PS and nutritional status. We recorded receipt and completion of chemotherapy, as well as any adverse effects, hospitalisations, and treatment delays. We included a total of 62 participants with NSCLC, and in 26 of these, the MDT-planned treatment was chemotherapy. Participants with earlier stage disease and weight loss of <10% were more likely to complete MDT-planned treatment (p < 0.001 and p < 0.05). Patients with a higher total SPPB score were more likely to complete more cycles of chemotherapy as well as the full course. Quicker gait speeds and sit-to-stand times were associated with completion of three or more cycles of chemotherapy (all p < 0.05). For every unit increase in SPPB score, there was a 28.2% decrease in adverse events, hospitalisations and delays of chemotherapy (incidence rate ratio 0.718, p = 0.001), whilst ECOG PS showed no correlation with these outcomes. Assessing physical performance by SPPB is quick and simple to do in clinical settings and may give better indication of likely chemotherapy treatment course completion than muscle mass alone and ECOG PS. In turn, this may identify specific targets for early functional intervention and impact on MDT decision-making and prudent use of resources.

Medical Surveillance Monthly Report (MSMR). Volume 4, Number 2, February/March 1998

DTIC Science & Technology

1998-03-01

comment: Leprosy is a chronic disease, caused by Mycobacterium leprae , that affects the skin and peripheral nerves of human hosts. Individuals with...untreated infections shed M. leprae in high concentrations in their nasal secretions; however, transmission from infected to uninfected persons generally...Individuals infected with M. leprae quickly become noninfectious after initiating multiple drug therapy (MDT). Thus, aggressive case finding linked to MDT

Sustained analgesic effect of clonidine co-polymer depot in a porcine incisional pain model.

PubMed

Wilsey, Jared T; Block, Julie H

2018-01-01

Previous research suggests that the α 2 adrenergic agonist clonidine, a centrally acting analgesic and antihypertensive, may also have direct effects on peripheral pain generators. However, aqueous injections are limited by rapid systemic absorption leading to off target effects and a brief analgesic duration of action. The aim of this study was to examine the efficacy of a sustained-release clonidine depot, placed in the wound bed, in a pig incisional pain model. The depot was a 15 mm ×5 mm ×0.3 mm poly(lactide-co-caprolactone) polymer film containing 3% (w/w) clonidine HCl (MDT3). Fifty-two young adult mix Landrace pigs (9-11 kg) were divided into seven groups. All subjects received a 6 cm, full-thickness, linear incision into the left lateral flank. Group 1 served as a Sham control group (Sham, n=8). Group 2 received three placebo strips (PBO, n=8), placed end-to-end in the subcutaneous wound bed before wound closure. Group 3 received one MDT3 and two PBO (n=8), Group 4 received two MDT3 and one PBO (n=8), and Group 5 received three MDT3 (n=8). Positive control groups received peri-incisional injections of bupivacaine solution (Group 6, 30 mg/day bupivacaine, n=8) or clonidine solution (Group 7, 225 µg/day, n=4). The surgical procedure was associated with significant peri-incisional tactile allodynia. There was a dose-dependent effect of MDT3 in partially reversing the peri-incisional tactile allodynia, with maximum pain relief relative to Sham at 72 hours. Daily injections of bupivacaine (30 mg), but not clonidine (up to 225 µg), completely reversed allodynia within 48 hours. There was a statistically significant correlation between the dose of MDT3 and cumulative withdrawal threshold from 4 hours through the conclusion of the study on day 7. These data suggest that a sustained-release clonidine depot may be a viable nonopioid, nonamide anesthetic therapy for the treatment of acute postsurgical nociceptive sensitization.

Maggot Debridement Therapy of Infected Ulcers: Patient and Wound Factors Influencing Outcome – A Study on 101 Patients with 117 Wounds

PubMed Central

Steenvoorde, Pascal; Jacobi, Cathrien E; Van Doorn, Louk; Oskam, Jacques

2007-01-01

INTRODUCTION It has been known for centuries that maggots are potent debriding agents capable of removing necrotic tissue and slough. In January 2004, the US Food and Drug Administration decided to regulate maggot debridement therapy (MDT). As it is still not clear which wounds are likely or unlikely to benefit from MDT, we performed a prospective study to gain more insight in patient and wound characteristics influencing outcome. PATIENTS AND METHODS In the period between August 2002 and December 2005, patients with infected wounds with signs of gangrenous or necrotic tissue who seemed suited for MDT were enrolled in the present study. In total, 101 patients with 117 ulcers were treated. Most wounds were worst-case scenarios, in which maggot therapy was a treatment of last resort. RESULTS In total, 72 patients (71%) were classified as ASA III or IV. In total, 78 of 116 wounds (67%) had a successful outcome. These wounds healed completely (n = 60), healed almost completely (n = 12) or were clean at least (n = 6) at last follow-up. These results seem to be in line with those in the literature. All wounds with a traumatic origin (n = 24) healed completely. All wounds with septic arthritis (n = 13), however, failed to heal and led in half of these cases to a major amputation. According to a multivariate analysis, chronic limb ischaemia (odds ratio [OR], 7.5), the depth of the wound (OR, 14.0), and older age (≥ 60 years; OR, 7.3) negatively influenced outcome. Outcome was not influenced by gender, obesity, diabetes mellitus, smoking, ASAclassification, location of the wound, wound size or wound duration. CONCLUSIONS Some patient characteristics (i.e. gender, obesity, smoking behaviour, presence of diabetes mellitus and ASA-classification at presentation) and some wound characteristics (i.e. location of the wound, wound duration and size) do not seem to contra-indicate eligibility for MDT. However, older patients and patients with chronic limb ischaemia or deep wounds are less likely to benefit from MDT. Septic arthritis does not seem to be a good indication for MDT. PMID:18201474

Improving the quality of vascular surgical discharge planning in a hub centre

PubMed Central

Wariyapola, C; Littlehales, E; Abayasekara, K; Fall, D; Parker, V; Hatton, G

2016-01-01

Introduction Discharge planning improves patient outcomes, reduces hospital stay and readmission rates, and should involve a multidisciplinary team (MDT) approach. The efficacy of MDT meetings in discharge planning was examined, as well as reasons for delayed discharge among vascular surgical inpatients. Methods Dedicated weekly MDT meetings were held on the vascular ward in Royal Derby Hospital for three months. Each patient was presented to the discharge planning meeting and an expected date of discharge was decided prospectively. Patients who were discharged after this date were considered ‘delayed’ and reasons for delay were explored at the next meeting. Results Overall, 193 patients were included in the study. Of these, 42 patients (22%) had a delayed discharge while 29 (15%) had an early discharge. The main reasons for delay were awaiting beds (30%), social (14%) and medical (45%). In 64%, the cause for delay was avoidable. Two-thirds (67%) of all delays were >24 hours. This totalled 115 bed days, of which 67 could have been avoided. However, 32 bed days were saved by early discharge. This equates to a net loss of 35 bed days, at a net cost of £2,936 per month or £35,235 per year. The MDT meetings also improved the quality of discharge planning; the variability between expected and actual discharge dates decreased after the first month. Conclusions Discharge planning meetings help prepare for patient discharge and are most effective with multidisciplinary input. The majority of delayed discharges from hospital are preventable. The main causes are awaiting transfers, social services input and medical reasons (eg falls). There is an obvious financial incentive to improve discharge planning. The efficiency of the MDT at discharge planning improves with time and this should therefore be continued for best results. PMID:26924480

Improving the quality of vascular surgical discharge planning in a hub centre.

PubMed

Wariyapola, C; Littlehales, E; Abayasekara, K; Fall, D; Parker, V; Hatton, G

2016-04-01

Introduction Discharge planning improves patient outcomes, reduces hospital stay and readmission rates, and should involve a multidisciplinary team (MDT) approach. The efficacy of MDT meetings in discharge planning was examined, as well as reasons for delayed discharge among vascular surgical inpatients. Methods Dedicated weekly MDT meetings were held on the vascular ward in Royal Derby Hospital for three months. Each patient was presented to the discharge planning meeting and an expected date of discharge was decided prospectively. Patients who were discharged after this date were considered 'delayed' and reasons for delay were explored at the next meeting. Results Overall, 193 patients were included in the study. Of these, 42 patients (22%) had a delayed discharge while 29 (15%) had an early discharge. The main reasons for delay were awaiting beds (30%), social (14%) and medical (45%). In 64%, the cause for delay was avoidable. Two-thirds (67%) of all delays were >24 hours. This totalled 115 bed days, of which 67 could have been avoided. However, 32 bed days were saved by early discharge. This equates to a net loss of 35 bed days, at a net cost of £2,936 per month or £35,235 per year. The MDT meetings also improved the quality of discharge planning; the variability between expected and actual discharge dates decreased after the first month. Conclusions Discharge planning meetings help prepare for patient discharge and are most effective with multidisciplinary input. The majority of delayed discharges from hospital are preventable. The main causes are awaiting transfers, social services input and medical reasons (eg falls). There is an obvious financial incentive to improve discharge planning. The efficiency of the MDT at discharge planning improves with time and this should therefore be continued for best results.

Implementation of a lung cancer multidisciplinary team standardised template for reporting to general practitioners: a mixed-method study

PubMed Central

Collett, Gemma K; Brown, Clare M; Shaw, Tim J; White, Kahren M; Beale, Philip J; Anderiesz, Cleola; Barnes, David J

2017-01-01

Objectives Few interventions have been designed that provide standardised information to primary care clinicians about the diagnostic and treatment recommendations resulting from cancer multidisciplinary team (MDT) (tumour board) meetings. This study aimed to develop, implement and evaluate a standardised template for lung cancer MDTs to provide clinical information and treatment recommendations to general practitioners (GPs). Specific objectives were to (1) evaluate template feasibility (acceptability, appropriateness and timeliness) with GPs and (2) document processes of preimplementation, implementation and evaluation within the MDT setting. Design A mixed-method study design using structured interviews with GPs and qualitative documentation of project logs about implementation processes. Setting Two hospitals in Central Sydney, New South Wales, Australia. Participants: 61 GPs evaluated the template. Two lung cancer MDTs, consisting of 33 clinicians, and eight researchers participated in template development and implementation strategy. Results The MDT-reporting template appears to be a feasible way of providing clinical information to GPs following patient presentation at a lung cancer MDT meeting. Ninety-five per cent of GPs strongly agreed or agreed that the standardised template provided useful and relevant information, that it was received in a timely manner (90%) and that the information was easy to interpret and communicate to the patient (84%). Implementation process data show that the investment made in the preimplementation stage to integrate the template into standard work practices was a critical factor in successful implementation. Conclusions This study demonstrates that it is feasible to provide lung cancer MDT treatment recommendations to GPs through implementation of a standardised template. A simple intervention, such as a standardised template, can help to address quality gaps and ensure that timely information is communicated between tertiary and primary care healthcare providers. PMID:29288182

What Do Clinicians Consider when Assessing Chronic Low Back Pain? A Content Analysis of Multidisciplinary Pain Centre Team Assessments of Functioning, Disability, and Health.

PubMed

Bagraith, Karl S; Strong, Jenny; Meredith, Pamela J; McPhail, Steven M

2018-05-22

Beyond expert suggestions as to the appropriate subject matter for chronic pain assessments, little is known about the actual content of multidisciplinary pain centre (MPC) clinical assessments. The International Classification of Functioning, Disability and Health Low Back Pain Core Set (ICF LBP-CS) provides a universal language to support the consistent description of LBP-related assessments across disciplines within multidisciplinary teams (MDT). This study sought to map the content of MPC clinical assessments to the ICF to: 1) identify and compare the content of clinical MDT assessments using a cross-disciplinary framework and, 2) examine the content validity of the LBP-CS. A qualitative examination of MPC team clinical assessments of CLBP was undertaken. MDT (pain medicine, psychiatry, nursing, physiotherapy, occupational therapy, and psychology) assessments were audio-recorded and transcribed. Concepts were extracted from transcripts using a meaning condensation procedure and then linked to the ICF. Across seven MDT assessments, comprised of 42 discipline-specific assessments and 241,209 transcribed words, 8596 concepts were extracted. Contextual factors (i.e., the person and environment), except for physiotherapy, accounted for almost half of each discipline's assessments (range: 49% - 58%) Concepts spanned 113 second-level ICF categories, including 73/78 LBP-CS categories. Overall, the findings revealed novel insights into the content of MPC clinical assessments that can be used to improve healthcare delivery. ICF-based assessment profiles demonstrated unique contributions from each discipline to CLBP assessment. Finally, users of the LBP-CS can be confident that the tool exhibits sound content validity from the perceptive of MDT assessments of functioning, disability, and health.

Maggot debridement therapy promotes diabetic foot wound healing by up-regulating endothelial cell activity.

PubMed

Sun, Xinjuan; Chen, Jin'an; Zhang, Jie; Wang, Wei; Sun, Jinshan; Wang, Aiping

2016-03-01

To determine the role of maggot debridement therapy (MDT) on diabetic foot wound healing, we compared growth related factors in wounds before and after treatment. Furthermore, we utilized human umbilical vein endothelial cells (HUVECs) to explore responses to maggot excretions/secretions on markers of angiogenesis and proliferation. The results showed that there was neo-granulation and angiogenesis in diabetic foot wounds after MDT. Moreover, significant elevation in CD34 and CD68 levels was also observed in treated wounds. In vitro, ES increased HUVEC proliferation, improved tube formation, and increased expression of vascular endothelial growth factor receptor 2 in a dose dependent manner. These results demonstrate that MDT and maggot ES can promote diabetic foot wound healing by up-regulating endothelial cell activity. Copyright © 2016. Published by Elsevier Inc.

Radiologist participation in multi-disciplinary teams in breast cancer improves reflective practice, decision making and isolation.

PubMed

Alcantara, S B; Reed, W; Willis, K; Lee, W; Brennan, P; Lewis, S

2014-09-01

This study aims to explore Australian radiologists' experiences of participating in breast cancer multi-disciplinary team (MDT) meetings to identify enablers and barriers to participation as well their perception of confidence and patient care. Qualitative methods incorporating observation and interviews were used. Twenty-one breast cancer MDT meetings were observed across Sydney to study the dynamics of the meetings, the level of participation by radiologists and their most important interactions. Qualitative semi-structured interviews were conducted with 10 radiologists participating in these meetings regarding participation, educational opportunities and improvements to work practices. Radiologists' participation in breast cancer MDT meetings is influenced by the type of meeting they attend with higher levels of participation and a more dominant 'valued' role being evident in pre-interventional meetings. The key themes to emerge from the data include the importance of 'sharing experiences', the 'radiologist-pathologist relationship' and the value of 'continuing participation'. Radiologists believed their confidence in their clinical decision making increased when there was immediate feedback from pathologists. This study highlights the benefits of radiologists regularly participating in breast cancer MDT meetings in terms of continuing professional education resulting from collegial experiential learning. Radiologists' perceived patient care and workplace isolation were improved by sharing experiences with other cancer care colleagues. © 2013 John Wiley & Sons Ltd.

Mathematical decision theory applied to land capability: a case study in the community of madrid.

PubMed

Antón, J M; Saa-Requejo, A; Grau, J B; Gallardo, J; Díaz, M C; Andina, Diego; Sanchez, M E; Tarquis, A M

2014-03-01

In land evaluation science, a standard data set is obtained for each land unit to determine the land capability class for various uses, such as different farming systems, forestry, or the conservation or suitability of a specific crop. In this study, we used mathematical decision theory (MDT) methods to address this task. Mathematical decision theory has been used in areas such as management, finance, industrial design, rural development, the environment, and projects for future welfare to study quality and aptness problems using several criteria. We also review MDT applications in soil science and discuss the suitability of MDT methods for dealing simultaneously with a number of problems. The aim of the work was to show how MDT can be used to obtain a valid land quality index and to compare this with a traditional land capability method. Therefore, an additive classification method was applied to obtain a land quality index for 122 land units that were compiled for a case study of the Community of Madrid, Spain, and the results were compared with a previously assigned land capability class using traditional methods based on the minimum requirements for land attributes. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Capture Efficiency of Biocompatible Magnetic Nanoparticles in Arterial Flow: A Computer Simulation for Magnetic Drug Targeting.

PubMed

Lunnoo, Thodsaphon; Puangmali, Theerapong

2015-12-01

The primary limitation of magnetic drug targeting (MDT) relates to the strength of an external magnetic field which decreases with increasing distance. Small nanoparticles (NPs) displaying superparamagnetic behaviour are also required in order to reduce embolization in the blood vessel. The small NPs, however, make it difficult to vector NPs and keep them in the desired location. The aims of this work were to investigate parameters influencing the capture efficiency of the drug carriers in mimicked arterial flow. In this work, we computationally modelled and evaluated capture efficiency in MDT with COMSOL Multiphysics 4.4. The studied parameters were (i) magnetic nanoparticle size, (ii) three classes of magnetic cores (Fe3O4, Fe2O3, and Fe), and (iii) the thickness of biocompatible coating materials (Au, SiO2, and PEG). It was found that the capture efficiency of small particles decreased with decreasing size and was less than 5 % for magnetic particles in the superparamagnetic regime. The thickness of non-magnetic coating materials did not significantly influence the capture efficiency of MDT. It was difficult to capture small drug carriers (D<200 nm) in the arterial flow. We suggest that the MDT with high-capture efficiency can be obtained in small vessels and low-blood velocities such as micro-capillary vessels.

Effect of hyperbaric oxygen on the growth and development of medicinal maggots.

PubMed

Sherman, Ronald A; Khavari, Borna; Werner, Darryl

2013-01-01

Some wound care therapists use both maggot debridement therapy (MDT) and hyperbaric oxygen (HBO2) therapy to treat non-healing wounds. Some practitioners have reported success using both MDT and HBO2 therapy concurrently; others have not. To begin evaluating the utility of using MDT and HBO2 therapy concurrently, we assessed the effects of hyperbaric oxygen (HBO2) on maggot growth and development, as a surrogate for debridement capacity. Replicate sets of medical-grade blowfly larvae were placed on liver-agar wound models and exposed to HBO2 at 2.0 atmospheres absolute (atm abs) for 90 minutes on 0 (control), 1, 2 or 3 sequential days. The effects of HBO2 exposure were quantified by measuring the maggots' subsequent growth and development. Exposure to HBO2 was most lethal to young larvae (second instars), but not to older larvae (third instars). There was no dose-relationship between the number of HBO2 treatments and rate of larval survival. Our findings suggest that maggot therapy and HBO2 therapy may be administered concurrently, as long as the larvae are not too immature (that is, as long as they are beyond the second instar) by the time they take their first dive. A clinical trial evaluating the clinical benefits of concurrent HBO2 therapy and MDT is warranted.

Developmental changes in autonomic responses are associated with future reward/punishment expectations: A study of sympathetic skin responses in the Markov decision task.

PubMed

Hosaka, Hiromi; Aoyagi, Kakuro; Kaga, Yoshimi; Kanemura, Hideaki; Sugita, Kanji; Aihara, Masao

2017-08-01

Autonomic nervous system activity is recognized as a major component of emotional responses. Future reward/punishment expectations depend upon the process of decision making in the frontal lobe, which is considered to play an important role in executive function. The aim of this study was to investigate the relationship between autonomic responses and decision making during reinforcement tasks using sympathetic skin responses (SSR). Nine adult and 9 juvenile (mean age, 10.2years) volunteers were enrolled in this study. SSRs were measured during the Markov decision task (MDT), which is a reinforcement task. In this task, subjects must endure a small immediate loss to ultimately get a large reward. The subjects had to undergo three sets of tests and their scores in these tests were assessed and evaluated. All adults showed gradually increasing scores for the MDT from the first to third set. As the trial progressed from the first to second set in adults, SSR appearance ratios remarkably increased for both punishment and reward expectations. In comparison with adults, children showed decreasing scores from the first to second set. There were no significant inter-target differences in the SSR appearance ratio in the first and second set in children. In the third set, the SSR appearance ratio for reward expectations was higher than that in the neutral condition. In reinforcement tasks, such as MDT, autonomic responses play an important role in decision making. We assume that SSRs are elicited during efficient decision making tasks associated with future reward/punishment expectations, which demonstrates the importance of autonomic function. In contrast, in children around the age of 10years, the autonomic system does not react as an organized response specific to reward/punishment expectations. This suggests the immaturity of the future reward/punishment expectations process in children. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Synoptic backgrounds of the widest wildfire in Mazandaran Province of Iran during December 11-13, 2010

NASA Astrophysics Data System (ADS)

Ghavidel, Yousef; Farajzadeh, Manuchehr; Khaleghi Babaei, Meysam

2016-12-01

In this paper, atmospheric origins of the widest wildfire in Mazandaran province on 11-13th of December, 2010 have been investigated. Data sets of this research include maximum daily temperature (MDT), minimum relative humidity (MRH) of terrestrial stations, dynamic and thermodynamic features of the atmosphere, Gridded data sets of Self-Calibrated Palmer drought severity index (SCPDSI) and global drought dataset standardized precipitation-evapotranspiration index (SPEI) and data related to the time and the extent of the wildfire. The ``environmental to circulation'' approach to synoptic classification has been used to investigate relationships between local-scale surface environment (wildfire) and the synoptic-scale atmospheric circulation conditions. Results of study show that during the 3-day wide wildfire, the average of MDT and the MRH was significantly different from the long-term average. During the aforementioned wildfire, the average of MDT in Mazandaran province was 26 °C and the average of MRH was reported 35 %. The long-term average of MDT and the MRH in Mazandaran province during 3 days of wildfire was 12.3 °C and 68 %, respectively. Therefore, the MDT has a positive abnormality of 13.7 °C and the MRH has a negative abnormality of 33 %. In addition, monthly SCPDSI and SPEI indicated severe drought conditions at December 2010 in Mazandaran. Analysis of SLP maps shows that during the 3-day fire, a pressure center of 1110 hPa on Persian Gulf and a very low-pressure center on Turkey and Asia Minor were created. Normally, this event has caused the pressure gradient and warm and dry air advection from Arabian Peninsula to higher longitudes, particularly Mazandaran province. Consequently, the MDT increased and the wildfire of Mazandaran forest took place in an area of 220 ha. Zonal wind maps signify the weakness of Zonal wind and meridional wind maps show the southern direction of meridional wind flow during the wide wildfire. Moreover, Omega maps prove that during the aforementioned wildfire, the Omega flow has been positive and the warm air flow has subsidence. This made the infusion of warm air and increased the MDT substantially and consequently the wildfire occurrence was facilitated. Temperature advection maps showed that in the level of 1000 hPa, the warm air blowing source is originated from Arabian Peninsula, in the level of 850 hPa from the Arabian Peninsula and Iraq and in the level of 700 and 500 hPa from Ethiopia, Arabian Peninsula and Iraq. The Hybrid-Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model outputs confirm the synoptic mechanisms for the discussed wildfire.

Hydraulic Fracture Measurements at Site C0009 of IODP Expedition 319, NanTroSEIZE

NASA Astrophysics Data System (ADS)

Kano, Y.; Ito, T.; Lin, W.; Flemings, P. B.; Boutt, D. F.; Doan, M.; McNeill, L. C.; Byrne, T.; Saffer, D. M.; Araki, E.; Eguchi, N. O.; Takahashi, K.; Toczko, S.; Scientists, E.

2009-12-01

The drilling vessel Chikyu completed the first riser-drilling in IODP history to a depth of 1603 mbsf (meter below seafloor) at Site C0009 in the landward Kumano forearc basin in the Nankai convergent margin, Japan.To measure in situ stress we performed two types of hydraulic fracturing: 1) as part of routine drilling operations, we estimated least principle stress from a leak off test (LOT); and 2) we used Schlumberger’s dual wireline packer, the Modular Dynamics Tester (MDT). Two LOT’s were performed at the base of 20 inch casing (703.9 mbsf) as a part of standard drilling operations; the outer annulus was closed by the blowout preventor (BOP), fluid was pumped at a constant rate of 2.3 m3/s, and pressure was measured at the cement pumps. The leak-off pressures were interpreted to lie at the break in slope in a graph of pressure vs volume-pumped. These values were found to be 30.22 and 30.25 MPa. These leak off pressure is interpreted to record fluids entering hydraulic fractures and is approximately the the least principal stress. There is considerable uncertainty in picking the slopes of the lines to determine the least principal stress (S3). The MDT dual packer tests were carried out at depth of 873.7 and 1532.7 mbsf. The dual packer module isolates a 1-m section of the borehole for testing. Zones free from pre-existing fractures and with near circular hole shape were chosen for the stress measurements. In the HF test at 873.7 m, the pressure cycle was repeated 5 times maintaining flow rate of 20 cm3/s. Periods of each cycles were 80-300 s. We determined the instantaneous shut in pressure to be 34.8 MPa. In the test at 1532.7 m, only one pressure cycle with a flow rate of 20 cm3/s was maintained, which yielded an instantaneous shut in pressure of 41.6 MPa. We interpret the shut-in pressure to record the least principal stress (S3). We do not know the orientation of fractures which were induced or activated by hydraulic fracturing, because no borehole images were taken after the HF tests. S3 at both test depths is less than Sv (the overburden stress). The stress ratio, K = (S3-Ph)/(Sv-Ph) where Ph is the hydrostatic pressure (calculated assuming a pore fluid density of 1023 kg/m3), was 0.44 for LOT and were 0.82 and 0.44, for MDT.

Analysis of formation pressure test results in the Mount Elbert methane hydrate reservoir through numerical simulation

USGS Publications Warehouse

Kurihara, M.; Sato, A.; Funatsu, K.; Ouchi, H.; Masuda, Y.; Narita, H.; Collett, T.S.

2011-01-01

Targeting the methane hydrate (MH) bearing units C and D at the Mount Elbert prospect on the Alaska North Slope, four MDT (Modular Dynamic Formation Tester) tests were conducted in February 2007. The C2 MDT test was selected for history matching simulation in the MH Simulator Code Comparison Study. Through history matching simulation, the physical and chemical properties of the unit C were adjusted, which suggested the most likely reservoir properties of this unit. Based on these properties thus tuned, the numerical models replicating "Mount Elbert C2 zone like reservoir" "PBU L-Pad like reservoir" and "PBU L-Pad down dip like reservoir" were constructed. The long term production performances of wells in these reservoirs were then forecasted assuming the MH dissociation and production by the methods of depressurization, combination of depressurization and wellbore heating, and hot water huff and puff. The predicted cumulative gas production ranges from 2.16??106m3/well to 8.22??108m3/well depending mainly on the initial temperature of the reservoir and on the production method.This paper describes the details of modeling and history matching simulation. This paper also presents the results of the examinations on the effects of reservoir properties on MH dissociation and production performances under the application of the depressurization and thermal methods. ?? 2010 Elsevier Ltd.

Lung cancer treatment rates and the role of the lung cancer nurse specialist: a qualitative study

PubMed Central

Redman, Judy; McDonnell, Ann; Borthwick, Diana; White, John

2015-01-01

Objectives This qualitative study examines how the Lung Cancer Nurse Specialist (LCNS) role operates and why they may be able to increase access to treatment. Setting 4 Hospital NHS Foundation Trusts in England. Design A multiple case study design using semistructured interviews, observation and Framework Analysis techniques. Participants Four LCNSs, comprised the ‘cases’. Twenty four clinicians who worked with the LCNS participated in individual interviews. Six LCNSs took part in a group interview and 60 lung cancer multidisciplinary team (MDT) members and co-ordinators were observed in the MDT meeting. Results The LCNS is crucial within the MDT and can act as a catalyst to patient access to treatment. The study identified the clinical activity (assessment, managing symptoms, psychological support and information provision) and role characteristics that can facilitate treatment access. These characteristics are the LCNS's presence across the patient pathway, acting as the ‘hub’ of the MDT, maintaining a holistic patient focus and working to an advanced level of practice. The findings indicate how factors may have a cumulative impact on treatment access. Conclusions If UK patient with lung cancer survival rates are to improve in line with comparable countries, we need to employ every advantage. This study demonstrates how the LCNS role may open doors to positive patient outcomes, including treatment. Further research is required to explore patients’ experiences, decision-making and attitudes to treatment. PMID:26685023

Use of surface drifters to increase resolution and accuracy of oceanic geostrophic circulation mapped from satellite only (altimetry and gravimetry)

NASA Astrophysics Data System (ADS)

Mulet, Sandrine; Rio, Marie-Hélène; Etienne, Hélène

2017-04-01

Strong improvements have been made in our knowledge of the surface ocean geostrophic circulation thanks to satellite observations. For instance, the use of the latest GOCE (Gravity field and steady-state Ocean Circulation Explorer) geoid model with altimetry data gives good estimate of the mean oceanic circulation at spatial scales down to 125 km. However, surface drifters are essential to resolve smaller scales, it is thus mandatory to carefully process drifter data and then to combine these different data sources. In this framework, the global 1/4° CNES-CLS13 Mean Dynamic Topography (MDT) and associated mean geostrophic currents have been computed (Rio et al, 2014). First a satellite only MDT was computed from altimetric and gravimetric data. Then, an important work was to pre-process drifter data to extract only the geostrophic component in order to be consistent with physical content of satellite only MDT. This step include estimate and remove of Ekman current and wind slippage. Finally drifters and satellite only MDT were combined. Similar approaches are used regionally to go further toward higher resolution, for instance in the Agulhas current or along the Brazilian coast. Also, a case study in the Gulf of Mexico intends to use drifters in the same way to improve weekly geostrophic current estimate.

A new approach to managing patients with problematic metal hip implants: the use of an Internet-enhanced multidisciplinary team meeting: AAOS exhibit selection.

PubMed

Berber, Reshid; Pappas, Yannis; Khoo, Michael; Miles, Jonathan; Carrington, Richard; Skinner, John; Hart, Alister

2015-02-18

Over one million patients worldwide are estimated to have a metal-on-metal hip arthroplasty. To improve the management of these patients and reduce surgeon uncertainty regarding decision-making, we designed an Internet-enhanced multidisciplinary team (iMDT) working approach. From August 2012 to April 2014, the iMDT discussed 215 patients with 266 metal-on-metal hip arthroplasties. Of these, 236 primary arthroplasties (132 hip resurfacing and 104 total hip) were analyzed. The remaining thirty cases involved problematic revised hips and were therefore excluded. The possible recommendations of the iMDT were monitoring, further investigation, or surgery. The concordance between the recommendation and the actual management was used to assess the usefulness of this approach in reducing uncertainty in surgeon-level decision-making. The median Oxford Hip Score was 35 (range, 4 to 48), and median cobalt and chromium levels in whole blood were 3.54 ppb (range, 0.18 to 161.46 ppb) and 3.17 ppb (range, 0.20 to 100.67 ppb), respectively. Magnetic resonance imaging revealed abductor muscle atrophy in ninety-two (39%) of the hips and a pseudotumor in eighty (34%). The iMDT recommended monitoring of 146 (61.9%) of the hips, further investigation of thirty (12.7%), and surgery in sixty (25.4%). The actual outcome was concordant with the recommendation in 211 (91.7%) of the hips. Our iMDT approach to the metal-on-metal hip burden combines the tacit knowledge of an expert panel, regulatory guidance, and up-to-date evidence to improve decision-making among surgeons. The high level of concordance between the recommendation and the actual outcome, combined with the feasibility of the methods used, suggest that this method effectively reduces uncertainty among surgeons and may lead to improved patient outcomes. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Multidisciplinary care model for HIV improves treatment outcome: a single-centre experience from the Middle East.

PubMed

Elgalib, Ali; Al-Sawafi, Halima; Kamble, Bina; Al-Harthy, Saud; Al-Sariri, Qamra

2018-05-24

Multidisciplinary team (MDT) care models have been shown to improve clinical outcomes among HIV patients. We aim to assess the impact of adopting MDT approach in a tertiary HIV clinic in Muscat, Sultanate of Oman. We introduced MDT approach in our HIV centre in January 2016 where existing team members (counsellors, nurses, social workers, pharmacists and doctors) worked together, through care pathways, to support patients as they go through the HIV care continuum from diagnosis to viral suppression. Notes were reviewed for demographics and clinical data. The primary outcome was HIV viral load (VL) suppression (<20, < 200 and < 1000 copies/ml) in measurements by December 2015 and June 2017. In December 2015, 253 patients were in care; 98.4% (249/253) were on antiretroviral therapy (ART). Median age was 41 years and 70% were males. Median baseline CD4 was 204. In June 2017, 294 were in care with similar patient characteristics to those in care in 2015. The majority, 95.9% (282/294), were on ART; 8 of whom started ART within 3 months, hence excluded from the VL analysis. Overall, VL < 200 and < 1000 rates increased from 71.9% and 78.7% in 2015 to 90.5% and 95.6% in 2017, with relative risk (RR) (95% CI) of 1.26 (1.15-1.37) and 1.21 (1.13-1.30), respectively; p value < 0.0001 for both. In a sub-analysis of 214 patients who were in care in 2015 and remained in care in 2017, VL < 200 and < 1000 rates increased from 78.5% and 85% in 2015 to 90.2% and 94.4% in 2016, with RR (95% CI) of 1.15 (1.06 to 1.25) and 1.11 (1.04-1.18), respectively; p values of 0.0010 for both. MDT approach has significantly improved treatment outcome for existing patients and those who have attended our services since the introduction of the MDT model.

Reducing health inequalities in people with learning disabilities: a multi-disciplinary team approach to care under general anaesthesia.

PubMed

Clough, S; Shehabi, Z; Morgan, C

2016-05-27

Background There remains significant inequality in health and healthcare in people with learning disabilities (LD). A lack of coordination and the episodic nature of care provision are contributory factors. Recognising the need to improve outcomes for this group, we evaluate a multi-disciplinary team (MDT) approach to care whereby additional medical procedures are carried out under the same episode of general anaesthesia (GA) as dental treatment for people with severe LD. This is the first published evaluation of its kind in the UK.Aim To evaluate the need and outcomes of an MDT approach to care among people with severe LD receiving dental treatment under GA.Method One hundred patients with severe LD and behaviour that challenges attended Barts Health Dental Hospital for dental assessment and subsequent treatment under GA. Details of failed or forthcoming medical interventions were determined. Where appropriate, care was coordinated with the relevant medical team.Findings Twenty-one percent (n = 21/100) had recent medical interventions attempted that had been abandoned, and 7.0% (n = 7/100) had future investigations or treatment planned under GA with medical specialties. An MDT approach was indicated in 28.0% (n = 28/100). For such complex cases, a successful MDT outcome was achieved in 89.3% (n = 25/28). This included ophthalmological/orthoptic, ENT and gastroenterological interventions in addition to medical imaging.Conclusion An MDT approach to care for people with LD offers improved patient-centred outcomes in addition to financial and resource efficiency. It requires a high level of cooperation between specialties, with consideration of the practicalities of a shared surgical space and equipment needs. Re-shaping of services and contractual flexibility are essential to support the future implementation of MDTs and to ensure long-term sustainability. Adoption of a holistic culture in the care of this vulnerable patient group is encouraged.

Cancer multidisciplinary team meetings in practice: Results from a multi-institutional quantitative survey and implications for policy change.

PubMed

Rankin, Nicole M; Lai, Michelle; Miller, Danielle; Beale, Philip; Spigelman, Allan; Prest, Gabrielle; Turley, Kim; Simes, John

2018-02-01

Multidisciplinary care is advocated as best practice in cancer care. Relatively little is documented about multidisciplinary team (MDT) meeting functioning, decision making and the use of evidence to support decision making in Australia. This descriptive study aimed to examine team functioning, the role of team meetings and evidence use in MDTs whose institutions are members of Sydney Catalyst Translational Cancer Research Centre. We designed a structured 40-item survey instrument about topics that included meeting purpose, organization, resources and documentation; caseload estimates; use of evidence and quality assurance; patient involvement and supportive care needs; and open-ended items about the MDTs strengths and weaknesses. Participants were invited to participate via email and the survey was administered online. Data were analyzed using descriptive and comparative statistics. Thirty-seven MDTs from seven hospitals participated (100% response) and represented common (70%) and rare tumor groups (30%). MDT meeting purpose was reported as treatment (100%) or diagnostic decision making (88%), or for education purposes (70%). Most MDTs based treatment decisions on group consensus (92%), adherence to clinical practice guidelines (57%) or other evidence-based medicine sources (33%). The majority of MDTs discussed only a proportion of new patients at each meeting emphasizing the importance of educational aspects for other cases. Barriers exist in the availability of data to enable audit and reflection on evidence-based practice. MDT strengths included collaboration and quality discussion about patients. MDT meetings focus on treatment decision making, with group consensus playing a significant role in translating research evidence from guidelines into clinical decision making. With a varying proportion of patients discussed in each MDT meeting, a wider audit of multidisciplinary care would enable more accurate assessments of whether treatment recommendations are in accordance with best-practice evidence. © 2017 John Wiley & Sons Australia, Ltd.

International open trial of uniform multidrug therapy regimen for leprosy patients: Findings & implications for national leprosy programmes

PubMed Central

Manickam, Ponnaiah; Mehendale, Sanjay M.; Nagaraju, Bathyala; Katoch, Kiran; Jamesh, Abdul; Kutaiyan, Ramalingam; Jianping, Shen; Mugudalabetta, Shivakumar; Jadhav, Vitthal; Rajkumar, Prabu; Padma, Jayasree; Kaliaperumal, Kanagasabai; Pannikar, Vijayakumar; Krishnamurthy, Padabettu; Gupte, Mohan D.

2016-01-01

Background & objectives: Uniform therapy for all leprosy patients will simplify leprosy treatment. In this context, we evaluated six-month multidrug therapy (MDT) currently recommended for multibacillary (MB) patients as uniform MDT (U-MDT) in a single-arm open trial under programme conditions. Primary objective was to determine efficacy to prevent five-year cumulative five per cent relapse. Secondary objectives were to assess acceptability, safety and compliance. Methods: Newly detected, treatment-naive leprosy patients were enrolled in India (six sites) and P. R. China (two sites). Primary outcome was clinically confirmed relapse of occurrence of one or more new skin patches consistent with leprosy, without evidence of reactions post-treatment. Event rates per 100 person years as well as five-year cumulative risk of relapse, were calculated. Results: A total of 2091 paucibacillary (PB) and 1298 MB leprosy patients were recruited from the 3437 patients screened. Among PB, two relapsed (rate=0.023; risk=0.11%), eight had suspected adverse drug reactions (ADRs) (rate=0.79) and rate of new lesions due toreactions was 0.24 (n=23). Rates of neuritis, type 1 and type 2 reactions were 0.39 (n=37), 0.54 (n=51) and 0.03 (n=3), respectively. Among MB, four relapsed (rate=0.07; risk=0.37%) and 16 had suspected ADR (rate=2.64). Rate of new lesions due to reactions among MB was 1.34 (n=76) and rates of neuritis, type 1 and type 2 reactions were 1.37 (n=78), 2.01 (n=114) and 0.49 (n=28), respectively. Compliance to U-MDT was 99 per cent. Skin pigmentation due to clofazimine was of short duration and acceptable. Interpretation & conclusions: We observed low relapse, minimal ADR and other adverse clinical events. Clofazimine-related pigmentation was acceptable. Evidence supports introduction of U-MDT in national leprosy programmes. [CTRI No: 2012/ 05/ 002696] PMID:28256460

International open trial of uniform multidrug therapy regimen for leprosy patients: Findings & implications for national leprosy programmes.

PubMed

Manickam, Ponnaiah; Mehendale, Sanjay M; Nagaraju, Bathyala; Katoch, Kiran; Jamesh, Abdul; Kutaiyan, Ramalingam; Jianping, Shen; Mugudalabetta, Shivakumar; Jadhav, Vitthal; Rajkumar, Prabu; Padma, Jayasree; Kaliaperumal, Kanagasabai; Pannikar, Vijayakumar; Krishnamurthy, Padabettu; Gupte, Mohan D

2016-10-01

Uniform therapy for all leprosy patients will simplify leprosy treatment. In this context, we evaluated six-month multidrug therapy (MDT) currently recommended for multibacillary (MB) patients as uniform MDT (U-MDT) in a single-arm open trial under programme conditions. Primary objective was to determine efficacy to prevent five-year cumulative five per cent relapse. Secondary objectives were to assess acceptability, safety and compliance. Newly detected, treatment-naive leprosy patients were enrolled in India (six sites) and P. R. China (two sites). Primary outcome was clinically confirmed relapse of occurrence of one or more new skin patches consistent with leprosy, without evidence of reactions post-treatment. Event rates per 100 person years as well as five-year cumulative risk of relapse, were calculated. A total of 2091 paucibacillary (PB) and 1298 MB leprosy patients were recruited from the 3437 patients screened. Among PB, two relapsed (rate=0.023; risk=0.11%), eight had suspected adverse drug reactions (ADRs) (rate=0.79) and rate of new lesions due toreactions was 0.24 (n=23). Rates of neuritis, type 1 and type 2 reactions were 0.39 (n=37), 0.54 (n=51) and 0.03 (n=3), respectively. Among MB, four relapsed (rate=0.07; risk=0.37%) and 16 had suspected ADR (rate=2.64). Rate of new lesions due to reactions among MB was 1.34 (n=76) and rates of neuritis, type 1 and type 2 reactions were 1.37 (n=78), 2.01 (n=114) and 0.49 (n=28), respectively. Compliance to U-MDT was 99 per cent. Skin pigmentation due to clofazimine was of short duration and acceptable. We observed low relapse, minimal ADR and other adverse clinical events. Clofazimine-related pigmentation was acceptable. Evidence supports introduction of U-MDT in national leprosy programmes. [CTRI No: 2012/ 05/ 002696].

14821AT LANCE, Missile Number 2419, Round Number 349APT, 12 May 1980.

DTIC Science & Technology

1980-05-01

WSTRUCTIONUREPOT DCUMNTAIONPAG EPORE COMPLEMON PORN REPORT NUMBER 2GOTACCESSION NO S. RECIPIENT’S CATALOG NUMBER TDR 1148 __7 0_____T___ ~. *.~----...,S. TYPE OF...Data at 0815 MDT ---------- 4 4. White Sands Desert Site (WSD) Significant Level Data at 0815 MDT ------------------------------------ 5 5. WSD Upper...humidity, dew point (0 C), density (gm/n,3), Wind direction and speed, and cloud cover were made at the LC-39 Met Site at T-0 minutes. (2) Monitor of

Role of cellulose ether polymers on ibuprofen release from matrix tablets.

PubMed

Vueba, M L; Batista de Carvalho, L A E; Veiga, F; Sousa, J J; Pina, Maria Eugénia

2005-08-01

Cellulose derivatives are the most frequently used polymers in formulations of pharmaceutical products for controlled drug delivery. The main aim of the present work was to evaluate the effect of different cellulose substitutions on the release rate of ibuprofen (IBP) from hydrophilic matrix tablets. Thus, the release mechanism of IBP with methylcellulose (MC25), hydroxypropylcellulose (HPC), and hydroxypropylmethylcellulose (HPMC K15M or K100M) was studied. In addition, the influence of the diluents lactose monohydrate (LAC) and beta-cyclodextrin (beta-CD) was evaluated. Distinct test formulations were prepared containing: 57.14% of IBP, 20.00% of polymer, 20.29% of diluent, 1.71% of talc lubricants, and 0.86% of magnesium stearate as lubricants. Although non-negligible drug-excipient interactions were detected from DSC studies, these were found not to constitute an incompatibility effect. Tablets were examined for their drug content, weight uniformity, hardness, thickness, tensile strength, friability, porosity, swelling, and dissolution performance. Polymers MC25 and HPC were found to be unsuitable for the preparation of this kind of solid dosage form, while HPMC K15M and K100M showed to be advantageous. Dissolution parameters such as the area under the dissolution curve (AUC), the dissolution efficiency (DE(20 h)), dissolution time (t 50%), and mean dissolution time (MDT) were calculated for all the formulations, and the highest MDT values were obtained with HPMC indicating that a higher value of MDT signifies a higher drug retarding ability of the polymer and vice-versa. The analysis of the drug release data was performed in the light of distinct kinetic mathematical models-Kosmeyer-Peppas, Higuchi, zero-, and first-order. The release process was also found to be slightly influenced by the kind of diluent used.

Microgrid Design Toolkit (MDT) Technical Documentation and Component Summaries

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

Arguello, Bryan; Gearhart, Jared Lee; Jones, Katherine A.

2015-09-01

The Microgrid Design Toolkit (MDT) is a decision support software tool for microgrid designers to use during the microgrid design process. The models that support the two main capabilities in MDT are described. The first capability, the Microgrid Sizing Capability (MSC), is used to determine the size and composition of a new microgrid in the early stages of the design process. MSC is a mixed-integer linear program that is focused on developing a microgrid that is economically viable when connected to the grid. The second capability is focused on refining a microgrid design for operation in islanded mode. This secondmore » capability relies on two models: the Technology Management Optimization (TMO) model and Performance Reliability Model (PRM). TMO uses a genetic algorithm to create and refine a collection of candidate microgrid designs. It uses PRM, a simulation based reliability model, to assess the performance of these designs. TMO produces a collection of microgrid designs that perform well with respect to one or more performance metrics.« less

Phylogenomics and antimicrobial resistance of the leprosy bacillus Mycobacterium leprae.

PubMed

Benjak, Andrej; Avanzi, Charlotte; Singh, Pushpendra; Loiseau, Chloé; Girma, Selfu; Busso, Philippe; Fontes, Amanda N Brum; Miyamoto, Yuji; Namisato, Masako; Bobosha, Kidist; Salgado, Claudio G; da Silva, Moisés B; Bouth, Raquel C; Frade, Marco A C; Filho, Fred Bernardes; Barreto, Josafá G; Nery, José A C; Bührer-Sékula, Samira; Lupien, Andréanne; Al-Samie, Abdul R; Al-Qubati, Yasin; Alkubati, Abdul S; Bretzel, Gisela; Vera-Cabrera, Lucio; Sakho, Fatoumata; Johnson, Christian R; Kodio, Mamoudou; Fomba, Abdoulaye; Sow, Samba O; Gado, Moussa; Konaté, Ousmane; Stefani, Mariane M A; Penna, Gerson O; Suffys, Philip N; Sarno, Euzenir Nunes; Moraes, Milton O; Rosa, Patricia S; Baptista, Ida M F Dias; Spencer, John S; Aseffa, Abraham; Matsuoka, Masanori; Kai, Masanori; Cole, Stewart T

2018-01-24

Leprosy is a chronic human disease caused by the yet-uncultured pathogen Mycobacterium leprae. Although readily curable with multidrug therapy (MDT), over 200,000 new cases are still reported annually. Here, we obtain M. leprae genome sequences from DNA extracted directly from patients' skin biopsies using a customized protocol. Comparative and phylogenetic analysis of 154 genomes from 25 countries provides insight into evolution and antimicrobial resistance, uncovering lineages and phylogeographic trends, with the most ancestral strains linked to the Far East. In addition to known MDT-resistance mutations, we detect other mutations associated with antibiotic resistance, and retrace a potential stepwise emergence of extensive drug resistance in the pre-MDT era. Some of the previously undescribed mutations occur in genes that are apparently subject to positive selection, and two of these (ribD, fadD9) are restricted to drug-resistant strains. Finally, nonsense mutations in the nth excision repair gene are associated with greater sequence diversity and drug resistance.

Design of an eMonitor system to transport electronic patient care report (ePCR) information in unstable MobileIP wireless environment.

PubMed

Giovanni, Mazza G; Shenvi, Rohit; Battles, Marcie; Orthner, Helmuth F

2008-11-06

The eMonitor is a component of the ePatient system; a prototype system used by emergency medical services (EMS) personnel in the field to record and transmits electronic patient care report (ePCR) information interactively. The eMonitor component allows each Mobile Data Terminal (MDT) on an unreliable Cisco MobileIP wireless network to securely send and received XML messages used to update patient information to and from the MDT before, during and after the transport of a patient.

Design of Drug Delivery Methods for the Brain and Central Nervous System

NASA Astrophysics Data System (ADS)

Lueshen, Eric

Due to the impermeability of the blood-brain barrier (BBB) to macromolecules delivered systemically, drug delivery to the brain and central nervous system (CNS) is quite difficult and has become an area of intense research. Techniques such as convection-enhanced intraparenchymal delivery and intrathecal magnetic drug targeting offer a means of circumventing the blood-brain barrier for targeted delivery of therapeutics. This dissertation focuses on three aspects of drug delivery: pharmacokinetics, convection-enhanced delivery, and intrathecal magnetic drug targeting. Classical pharmacokinetics mainly uses black-box curve fitting techniques without biochemical or biological basis. This dissertation advances the state-of-the-art of pharmacokinetics and pharmacodynamics by incorporating first principles and biochemical/biotransport mechanisms in the prediction of drug fate in vivo. A whole body physiologically-based pharmacokinetics (PBPK) modeling framework is engineered which creates multiscale mathematical models for entire organisms composed of organs, tissues, and a detailed vasculature network to predict drug bioaccumulation and to rigorously determine kinetic parameters. These models can be specialized to account for species, weight, gender, age, and pathology. Systematic individual therapy design using the proposed mechanistic PBPK modeling framework is also a possibility. Biochemical, anatomical, and physiological scaling laws are also developed to accurately project drug kinetics in humans from small animal experiments. Our promising results demonstrate that the whole-body mechanistic PBPK modeling approach not only elucidates drug mechanisms from a biochemical standpoint, but offers better scaling precision. Better models can substantially accelerate the introduction of drug leads to clinical trials and eventually to the market by offering more understanding of the drug mechanisms, aiding in therapy design, and serving as an accurate dosing tool. Convection-enhanced drug delivery (CED) is a technique used to bypass the BBB via direct intracranial injection using a catheter driven by a positive pressure gradient from an infusion pump. Although CED boasts the advantage of achieving larger drug distribution volumes compared to diffusion driven methods, difficulty in predicting drug spread and preventing backflow along the catheter shaft commonly occur. In this dissertation, a method for predicting drug distributions in the brain using diffusion tensor imaging (DTI) data is employed to show how small variations in catheter placement can lead to drastically different volumes of drug distribution in vivo. The impact that microfluid flow has on deformable brain phantom gel is studied in order to elucidate the causes of backflow, and the results are used to develop backflow-free catheters with safe volumetric flow rates up to 10 ?l/min. Through implementation of our backflow-free catheter designs, physicians will be able to target specific regions of the brain with improved accuracy, increased drug concentration, and larger drug distribution geometries. Intrathecal (IT) drug delivery involves direct drug infusion into the spinal canal and has become standard practice for treating many CNS diseases. Although IT drug delivery boasts the advantage of reduced systemic toxicity compared to oral and intravenous techniques, current IT delivery protocols lack a means of sufficient drug targeting at specific locations of interest within the CNS. In this dissertation, the method of intrathecal magnetic drug targeting (IT-MDT) is developed to overcome the limited targeting capabilities of standard IT drug delivery protocols. The basic idea behind IT-MDT is to guide intrathecally-injected, drug-functionalized magnetic nanoparticles (MNPs) using an external magnetic field to diseased regions within the spinal canal. Cerebrospinal fluid (CSF) transport phenomena are studied, and in vitro human spine surrogates are built. Experiments are run on the in vitro human spine model to determine the feasibility of IT-MDT and to develop novel treatment therapies. Computer simulations are performed to optimize magnetic field placement and/or implant design for generating high gradient magnetic fields, as well as to study how these fields aid in therapeutic nanoparticle localization. Large collection efficiencies of MNPs were achieved during in vitro IT-MDT and implant-assisted IT-MDT experiments with concentration levels nearly nine times that of the control when no magnetic field was present. Testing different magnetizable implants showed that implant design is a key factor in achieving the largest MNP collection efficiency within the targeting region. Knowledge gained from the in vitro IT-MDT experiments and simulations will be used in the future to develop IT-MDT methods in animals and humans.

Comparative release studies on suppositories using the basket, paddle, dialysis tubing and flow-through cell methods I. Acetaminophen in a lipophilic base suppository.

PubMed

Hori, Seiichi; Kawada, Tsubasa; Kogure, Sanae; Yabu, Shinako; Mori, Kenji; Akimoto, Masayuki

2017-02-01

The release characteristics of lipophilic suppositories containing acetaminophen (AAP) were examined using four types of dissolution methods: the basket, paddle, dialysis tubing (DT) and flow-through cell (FTC) methods. The suitability of each apparatus for quality control in AAP compounded suppositories was evaluated using statistical procedures. More than 80% of the drug was released over 60 min in all the release methods studied, with the exception of the basket method. Reproducible and faster release was achieved using the paddle method at 100 and 200 rpm, whereas poor release occurred with the basket method. The mean dissolution time (MDT), maximum dissolved quantity of AAP at the end of the sampling time (Q) and dissolution efficiency (DE) were calculated by model-independent methods. The FTC method with a single chamber used in this study was also appreciable for AAP suppositories (Q of 100%, MDT of 71-91 min and DE of 75-80%). The DT apparatus is considered similar to the FTC apparatus from a quality control perspective for judging the release properties of lipophilic base suppositories containing AAP. However, even the single chamber FTC used in this study has potential as an in vitro drug release test for suppositories. The comparative dissolution method is expected to become one of the valuable tools for selecting an adequate dissolution test.

Formalising multidisciplinary peer review: developing a haematological malignancy-specific electronic proforma and standard operating procedure to facilitate procedural efficiency and evidence-based clinical practice.

PubMed

Trotman, Judith; Trinh, Jimmy; Kwan, Yiu Lam; Estell, Jane A; Fletcher, Julie; Archer, Kate; Lee, Kenneth; Foo, Kerwin; Curnow, Jennifer; Bianchi, Alessandra; Wignall, Lynda; Verner, Emma; Gasiorowski, Robin; Siedlecka, Elizabeth; Cunningham, Ilona

2017-05-01

Multidisciplinary team (MDT) meetings aimed at facilitating peer review have become standard practice in oncology. However, there is scant literature on the optimal structure and conduct of such meetings. To develop a process for formal peer review of patients with haematological malignancies and to audit any resulting changes made to the management recommendations of the treating physician. A standard operating procedure (SOP) for MDT meetings was developed essentially to integrate clinical peer review with weekly pathology and radiology meetings. The centrepiece is the electronic submission of a patient-specific proforma (Microsoft InfoPath) prior to the meeting. It serves as the template for presentation, discussion and recording of recommendations and conclusions. The final verified document is stored in the electronic patient record, and a copy is sent to the general practitioner. The proposed management plans were compared to the consensus recommendations of the meeting for the first 4 years since inception. Both SOP and proforma underwent continual improvements. These provided the framework for the conduct of a robust weekly MDT meeting for peer review of the management of patients with haematological malignancies. On 20% of occasions, patient management plans were altered to optimise patient care as a direct consequence on peer review at the MDT. Our streamlined process, in its ultimate format, has provided a mature and efficient forum for formal peer review in a genuine multidisciplinary environment. Both initial data and informal feedback support its ongoing activity as an integral component of delivering quality patient care. © 2016 Royal Australasian College of Physicians.

Inter-examiner classification reliability of Mechanical Diagnosis and Therapy for extremity problems - Systematic review.

PubMed

Takasaki, Hiroshi; Okuyama, Kousuke; Rosedale, Richard

2017-02-01

Mechanical Diagnosis and Therapy (MDT) is used in the treatment of extremity problems. Classifying clinical problems is one method of providing effective treatment to a target population. Classification reliability is a key factor to determine the precise clinical problem and to direct an appropriate intervention. To explore inter-examiner reliability of the MDT classification for extremity problems in three reliability designs: 1) vignette reliability using surveys with patient vignettes, 2) concurrent reliability, where multiple assessors decide a classification by observing someone's assessment, 3) successive reliability, where multiple assessors independently assess the same patient at different times. Systematic review with data synthesis in a quantitative format. Agreement of MDT subgroups was examined using the Kappa value, with the operational definition of acceptable reliability set at ≥ 0.6. The level of evidence was determined considering the methodological quality of the studies. Six studies were included and all studies met the criteria for high quality. Kappa values for the vignette reliability design (five studies) were ≥ 0.7. There was data from two cohorts in one study for the concurrent reliability design and the Kappa values ranged from 0.45 to 1.0. Kappa values for the successive reliability design (data from three cohorts in one study) were < 0.6. The current review found strong evidence of acceptable inter-examiner reliability of MDT classification for extremity problems in the vignette reliability design, limited evidence of acceptable reliability in the concurrent reliability design and unacceptable reliability in the successive reliability design. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psycho acoustical Measures in Individuals with Congenital Visual Impairment.

PubMed

Kumar, Kaushlendra; Thomas, Teenu; Bhat, Jayashree S; Ranjan, Rajesh

2017-12-01

In congenital visual impaired individuals one modality is impaired (visual modality) this impairment is compensated by other sensory modalities. There is evidence that visual impaired performed better in different auditory task like localization, auditory memory, verbal memory, auditory attention, and other behavioural tasks when compare to normal sighted individuals. The current study was aimed to compare the temporal resolution, frequency resolution and speech perception in noise ability in individuals with congenital visual impaired and normal sighted. Temporal resolution, frequency resolution, and speech perception in noise were measured using MDT, GDT, DDT, SRDT, and SNR50 respectively. Twelve congenital visual impaired participants with age range of 18 to 40 years were taken and equal in number with normal sighted participants. All the participants had normal hearing sensitivity with normal middle ear functioning. Individual with visual impairment showed superior threshold in MDT, SRDT and SNR50 as compared to normal sighted individuals. This may be due to complexity of the tasks; MDT, SRDT and SNR50 are complex tasks than GDT and DDT. Visual impairment showed superior performance in auditory processing and speech perception with complex auditory perceptual tasks.

Correlates of violence in Guinea's Maison Centrale Prison: a statistical approach to documenting human rights abuses.

PubMed

Osborn, Ronald E

2010-12-15

Les Mêmes Droits Pour Tous (MDT) is a human rights NGO in Guinea, West Africa that focuses on the rights of prisoners in Maison Centrale, the country's largest prison located in the capital city of Conakry. In 2007, MDT completed a survey of the prison population to assess basic legal and human rights conditions. This article uses statistical tools to explore MDT's survey results in greater depth, shedding light on human rights violations in Guinea. It contributes to human rights literature that argues for greater use of econometric tools in rights reporting, and demonstrates how human rights practitioners and academics can work together to construct an etiology of violence and torture by state actors, as physical violence is perhaps the most extreme violation of the individual's right to health. Copyright © 2010 Osborn. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

The McDermitt Caldera, NV-OR, USA: Geologic mapping, volcanology, mineralization, and high precision 40Ar/39Ar dating of early Yellowstone hotspot magmatism

NASA Astrophysics Data System (ADS)

Henry, C. D.; Castor, S. B.; Starkel, W. A.; Ellis, B. S.; Wolff, J. A.; Heizler, M. T.; McIntosh, W. C.

2012-12-01

The irregularly keyhole-shaped, 40x30 to 22 km, McDermitt caldera formed at 16.35±0.03 Ma (n=4; Fish Canyon sanidine = 28.201 Ma) during eruption of a zoned, aphyric, mildly peralkaline rhyolite to abundantly anorthoclase-phyric, metaluminous dacite (McDermitt Tuff, MDT). Intracaldera MDT is locally strongly rheomorphic and, where MDT and caldera floor are well-exposed along the western margin, contains abundant megabreccia but is a maximum of ~450 m thick. If this thickness is representative of the caldera, intracaldera MDT has a volume of ~400 km3. Outflow MDT is currently known up to 13 km south of the caldera but only 3 km north of the caldera. Maximum outflow thickness is ~100 m, and outflow volume is probably no more than about 10% that of intracaldera MDT. The thickness and volume relations indicate collapse began very early during eruption, and most tuff ponded within the caldera. Outflow is strongly rheomorphic where draped over paleotopography. Late, undated icelandite lavas and domes are probably residual magma from the caldera chamber. Resurgence is expressed as both a broad, symmetrical dome in the north part and a fault-bound uplift in the south part of the caldera. Mineralization associated with the caldera includes Zr-rich U deposits that are indistinguishable in age with the McDermitt Tuff, Hg, Au, Ga, and Li-rich intracaldera tuffaceous sediments. Although formed during probable regional extension, the caldera is flat-lying and cut only at its west and east margins by much younger, high-angle normal faults. The caldera formed in an area of highly diverse Cenozoic volcanic rocks. The oldest are 39 and 46 Ma metaluminous dacite lavas along the northwest margin. Coarsely plagioclase-phyric to aphyric Steens Basalt lavas crop out around the west, northwest, and northeast margin. An anorthoclase-phyric, low-Si rhyolite lava (16.69±0.02 Ma) that is interbedded with probable Steens lavas northeast of the caldera and a biotite rhyolite lava dome (16.62±0.02 Ma) in the west floor of the caldera are the oldest middle Miocene silicic rocks near the caldera. Other pre-caldera rocks are a mix of variably peralkaline, distal ignimbrites; biotite rhyolite domes and lavas; and variably peralkaline rhyolite lavas that were emplaced between about 16.50 and 16.36 Ma. Silicic volcanism around the McDermitt caldera is some of the oldest of the Yellowstone hotspot track, but two known calderas in NW Nevada and unidentified sources of distal ignimbrites near McDermitt are older than the McDermitt caldera. Initial hotspot silicic volcanism occurred over a large area across NW Nevada, SE Oregon, and SW Idaho.

Availability analysis of the traveling-wave maser amplifiers in the deep space network. Part 1: The 70-meter antennas

NASA Technical Reports Server (NTRS)

Issa, T. N.

1992-01-01

The results of the reliability and availability analyses of the individual S- and X-band traveling-wave maser (TWM) assemblies and their operational configurations in the 70-meter antennas of NASA's Deep Space Network (DSN) are described. For the period 1990 through 1991, the TWM availability parameters for the Telemetry Data System are: mean time between failures (MTBF), 930 hr; mean time to restore services (MTTRS), 1.4 hr; and the average availability, 99.85 percent. In previously published articles, the performance analysis of the TWM assemblies was confined to the determination of the parameters specified above. However, as the mean down time (MDT) for the repair of TWM's increases, the levels of the TWM operational availabilities and MTTRS are adversely affected. A more comprehensive TWM availability analysis is presented to permit evaluation of both MTBF and MDT effects. Performance analysis of the TWM assemblies, based on their station monthly failure reports, indicates that the TWM's required MTBF and MDT levels of 3000 hr and 36 to 48 hr, respectively, have been achieved by the TWM's only at the Canberra Deep Space Station (DSS 43). The Markov Process technique is employed to develop suitable availability measures for the S- and X-band TWM configurations when each is operated in a two-assembly standby mode. The derived stochastic expressions allow for the evaluation of those configurations' simultaneous availability for the Antenna Microwave Subsystem. The application of these expressions to demonstrate the impact of various levels of TWM maintainability (or MDT) on their configurations' operational availabilities is presented for each of the 70-m antenna stations.

The impact of a dedicated multidisciplinary team on the management of early rectal cancer.

PubMed

Vaughan-Shaw, P G; Wheeler, J M D; Borley, N R

2015-08-01

Local excision of early rectal cancer (ERCa) offers comparable survival and reduced operative morbidity compared with radical surgery, yet it risks an adverse oncological outcome if performed in the wrong setting. This retrospective review considers the impact of the introduction of a specialist early rectal cancer multidisciplinary team (ERCa MDT) on the investigation and management of ERCa. A retrospective comparative cohort study was undertaken. Patients with a final diagnosis of pT1 rectal cancer at our unit were identified for two 12-month periods before and after the introduction of the specialist ERCa MDT. Data on investigations and therapeutic interventions were compared. Nineteen patients from 2006 and 24 from 2011 were included. In 2006, 12 patients underwent MRI and four transrectal ultrasound (TRUS) examination, while in 2011, 18 and 20, respectively, received MRI and TRUS. In 2006 four patients underwent incidental ERCa polypectomy, with all having a positive resection margin leading to anterior resection. In 2011 only one case with a positive margin following extended endoscopic mucosal resection was identified. Definitive local excision without subsequent resection occurred in two patients in 2006 and in 16 in 2011. The study demonstrates an improvement in preoperative ERCa staging, a reduction in margin positivity and an increase in the use of local excision following the implementation of a specialist ERCa MDT. The increased detection of rectal neoplasms through screening and surveillance programmes requires further investigation and management. A specialist ERCa MDT will improve management and should be available to all practitioners involved with patients with ERCa. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

Establishing a Multidisciplinary Head and Neck Clinical Pathway: An Implementation Evaluation and Audit of Dysphagia-Related Services and Outcomes.

PubMed

Messing, Barbara Pisano; Ward, Elizabeth C; Lazarus, Cathy; Ryniak, Keri; Kim, Melissa; Silinonte, Jessica; Gold, Dorothy; Thompson, Carol B; Pitman, Karen T; Blanco, Ray; Sobel, Ryan; Harrer, Karen; Ulmer, Karen; Neuner, Geoffrey; Patel, Kruti; Tang, Mei; Lee, Gregory

2018-06-19

Head and neck cancer (HNC) guidelines recommend regular multidisciplinary team (MDT) monitoring and early intervention to optimize dysphagia outcomes; however, many factors affect the ability to achieve these goals. The aims of this study were to explore the barriers/facilitators to establishing and sustaining a MDT HNC care pathway and to examine the dysphagia-related speech-language pathology (SLP) and dietetic components of the pathway. Using the Consolidated Framework for Implementation Research (CFIR), a mixed methods study design was used to evaluate an established MDT HNC pathway. Ten MDT members provided perceptions of facilitators/barriers to implementing and sustaining the pathway. Patients attending the SLP and dietetic components of the pathway who commenced treatment between 2013 and 2014 (n = 63) were audited for attendance, outcome data collected per visit, and swallowing outcomes to 24-month post-treatment. Dysphagia outcomes were compared to a published cohort who had received intensive prophylactic dysphagia management. Multiple CFIR constructs were identified as critical to implementing and sustaining the pathway. Complexity was a barrier. Patient attendance was excellent during treatment, with low rates of non-compliance (< 15%) to 24 months. Collection of clinician/patient outcome tools was good during treatment, but lower post-treatment. Dysphagia outcomes were good and comparable to prior published data. The pathway provided patients with access to regular supportive care and provided staff opportunities to provide early and ongoing dysphagia monitoring and management. However, implementing and sustaining a HNC pathway is complex, requiring significant staff resources, financial investment, and perseverance. Regular audits are necessary to monitor the quality of the pathway.

A pre-post test evaluation of the impact of the PELICAN MDT-TME Development Programme on the working lives of colorectal cancer team members

PubMed Central

2010-01-01

Background The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members. Methods The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course. Results Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance. Conclusions Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further. PMID:20587062

A pre-post test evaluation of the impact of the PELICAN MDT-TME Development Programme on the working lives of colorectal cancer team members.

PubMed

Taylor, Cath; Sippitt, Joanna M; Collins, Gary; McManus, Chris; Richardson, Alison; Dawson, Jeremy; Richards, Michael; Ramirez, Amanda J

2010-06-29

The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members. The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course. Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance. Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further.

[Leprosy reactions in discharged patients following cure by multidrug therapy].

PubMed

Souza, Linton Wallis Figueiredo

2010-01-01

Reactional states are the main cause of nerve lesions and incapacities provoked by leprosy. Retrospective study aimed at verifying the frequency of leprosy reactions in discharged patients following cure by multidrug therapy (MDT). Among patients who presented reactions during treatment, 35.5% continued after MDT; of those that did not present during treatment, only 12.7% presented after discharge; 63.4% multibacillary patients presented during and 31.7% after; 27.7% paucibacillary patients presented during and 8.3% after. A direct proportional relation exists between the presence of reactions during and after treatment. Multibacillary clinical forms present a greater frequency of reactions during and after cure.

Determining Coastal Mean Dynamic Topography by Geodetic Methods

NASA Astrophysics Data System (ADS)

Huang, Jianliang

2017-11-01

In geodesy, coastal mean dynamic topography (MDT) was traditionally determined by spirit leveling technique. Advances in navigation satellite positioning (e.g., GPS) and geoid determination enable space-based leveling with an accuracy of about 3 cm at tide gauges. Recent CryoSat-2, a satellite altimetry mission with synthetic aperture radar (SAR) and SAR interferometric measurements, extends the space-based leveling to the coastal ocean with the same accuracy. However, barriers remain in applying the two space-based geodetic methods for MDT determination over the coastal ocean because current geoid modeling focuses primarily on land as a substitute to spirit leveling to realize the vertical datum.

Construction of a smart medication dispenser with high degree of scalability and remote manageability.

PubMed

Pak, JuGeon; Park, KeeHyun

2012-01-01

We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT). In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

Visualization of superparamagnetic nanoparticles in vascular tissue using XμCT and histology.

PubMed

Tietze, Rainer; Rahn, Helene; Lyer, Stefan; Schreiber, Eveline; Mann, Jenny; Odenbach, Stefan; Alexiou, Christoph

2011-02-01

In order to increase the dose of antineoplastic agents in the tumor area, the concept of magnetic drug targeting (MDT) has been developed. Magnetic nanoparticles consisting of iron oxide and a biocompatible cover layer suspended in an aqueous solution (ferrofluid) serve as carriers for chemotherapeutics being enriched by an external magnetic field after intra-arterial application in desired body compartments (i.e., tumor). We established an ex vivo model to simulate in vivo conditions in a circulating system consisting of magnetic iron oxide nanoparticles passing an intact bovine artery and being focused by an external magnetic field to study their distribution in the vessel. Micro-computed X-ray tomography (XμCT) and histology can elucidate the arrangement of these particles after application. XμCT-analysis has been performed on arterial sections after MDT in order to determine the distribution of the nanoparticles. These measurements have been carried out with a cone X-ray source and corresponding histological sections were stained with Prussian blue. It could be shown that combining XμCT and histology offers the opportunity for a better understanding of the mechanisms of nanoparticle deposition in the vascular system after MDT.

Building the multidisciplinary team for management of patients with hepatocellular carcinoma.

PubMed

Naugler, Willscott E; Alsina, Angel E; Frenette, Catherine T; Rossaro, Lorenzo; Sellers, Marty T

2015-05-01

Optimal care of the patient with hepatocellular carcinoma (HCC) necessitates the involvement of multiple providers. Because the patient with HCC often carries 2 conditions with competing mortality risks (cancer and underlying cirrhosis), no single provider is equipped to deal with all of these patients' needs adequately. Multidisciplinary teams (MDTs) have evolved to facilitate care coordination, reassessments of clinical course, and nimble changes in treatment plans required for this complex group of patients. Providers or sites that elect to manage patients with HCC thus are increasingly aware of the need to build their own MDT or communicate with an established one. The availability of new communication technologies, such as teleconferencing or teleconsultation, offers the possibility of MDT expansion into underserved or rural areas, as well as areas such as correctional facilities. Although the availability of resources for HCC patient care varies from site to site, construction of an MDT is possible in a wide spectrum of clinical practices, and this article suggests a blueprint for assembly of such collaboration. Research strategies are needed to explain how MDTs improve clinical outcomes so that MDTs themselves can be improved. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

3-D trajectory model for MDT using micro-spheres implanted within large blood vessels

NASA Astrophysics Data System (ADS)

Choomphon-anomakhun, Natthaphon; Natenapit, Mayuree

2016-09-01

Implant assisted magnetic drug targeting (IA-MDT) using ferromagnetic spherical targets implanted within large blood vessels and subjected to a uniform externally applied magnetic field (H0) has been investigated and reported for the first time. The capture areas (As) of magnetic drug carrier particles (MDCPs) were determined from the analysis of particle trajectories simulated from equations of motion. Then, the effects of various parameters, such as types of ferromagnetic materials in the targets and MDCPs, blood flow rates, mass fraction of the ferromagnetic material in the MDCPs, average radii of MDCPs (Rp) and the strength of H0 on the As were obtained. Furthermore, the effects of saturation magnetization of the ferromagnetic materials in the MDCPs and within the targets on the As were analyzed. After this, the suitable strengths of H0 and Rp for IA-MDT designs were reported. Dimensionless As, ranging from 2 to 7, was obtained with Rp ranging from 500 to 2500 nm, μ0H0 less than 0.8 T and a blood flow rate of 0.1 m s-1. The target-MDCP materials considered are iron-iron, iron-magnetite and SS409-magnetite, respectively.

Analyzing the Effects of Climate Factors on Soybean Protein, Oil Contents, and Composition by Extensive and High-Density Sampling in China.

PubMed

Song, Wenwen; Yang, Ruping; Wu, Tingting; Wu, Cunxiang; Sun, Shi; Zhang, Shouwei; Jiang, Bingjun; Tian, Shiyan; Liu, Xiaobing; Han, Tianfu

2016-05-25

From 2010 to 2013, 763 soybean samples were collected from an extensive area of China. The correlations between seed compositions and climate data were analyzed. The contents of crude protein and water-soluble protein, total amount of protein plus oil, and most of the amino acids were positively correlated with an accumulated temperature ≥15 °C (AT15) and the mean daily temperature (MDT) but were negatively correlated with hours of sunshine (HS) and diurnal temperature range (DTR). The correlations of crude oil and most fatty acids with climate factors were opposite to those of crude protein. Crude oil content had a quadratic regression relationship with MDT, and a positive correlation between oil content and MDT was found when the daily temperature was <19.7 °C. A path analysis indicated that DTR was the main factor that directly affected soybean protein and oil contents. The study illustrated the effects of climate factors on soybean protein and oil contents and proposed agronomic practices for improving soybean quality in different regions of China. The results provide a foundation for the regionalization of high-quality soybean production in China and similar regions in the world.

X-ray Absorption Spectroscopy Systematics at the Tungsten L-Edge

PubMed Central

2015-01-01

A series of mononuclear six-coordinate tungsten compounds spanning formal oxidation states from 0 to +VI, largely in a ligand environment of inert chloride and/or phosphine, was interrogated by tungsten L-edge X-ray absorption spectroscopy. The L-edge spectra of this compound set, comprised of [W0(PMe3)6], [WIICl2(PMePh2)4], [WIIICl2(dppe)2][PF6] (dppe = 1,2-bis(diphenylphosphino)ethane), [WIVCl4(PMePh2)2], [WV(NPh)Cl3(PMe3)2], and [WVICl6], correlate with formal oxidation state and have usefulness as references for the interpretation of the L-edge spectra of tungsten compounds with redox-active ligands and ambiguous electronic structure descriptions. The utility of these spectra arises from the combined correlation of the estimated branching ratio of the L3,2-edges and the L1 rising-edge energy with metal Zeff, thereby permitting an assessment of effective metal oxidation state. An application of these reference spectra is illustrated by their use as backdrop for the L-edge X-ray absorption spectra of [WIV(mdt)2(CO)2] and [WIV(mdt)2(CN)2]2– (mdt2– = 1,2-dimethylethene-1,2-dithiolate), which shows that both compounds are effectively WIV species even though the mdt ligands exist at different redox levels in the two compounds. Use of metal L-edge XAS to assess a compound of uncertain formulation requires: (1) Placement of that data within the context of spectra offered by unambiguous calibrant compounds, preferably with the same coordination number and similar metal ligand distances. Such spectra assist in defining upper and/or lower limits for metal Zeff in the species of interest. (2) Evaluation of that data in conjunction with information from other physical methods, especially ligand K-edge XAS. (3) Increased care in interpretation if strong π-acceptor ligands, particularly CO, or π-donor ligands are present. The electron-withdrawing/donating nature of these ligand types, combined with relatively short metal–ligand distances, exaggerate the difference between formal oxidation state and metal Zeff or, as in the case of [WIV(mdt)2(CO)2], exert the subtle effect of modulating the redox level of other ligands in the coordination sphere. PMID:25068843

X-ray absorption spectroscopy systematics at the tungsten L-edge.

PubMed

Jayarathne, Upul; Chandrasekaran, Perumalreddy; Greene, Angelique F; Mague, Joel T; DeBeer, Serena; Lancaster, Kyle M; Sproules, Stephen; Donahue, James P

2014-08-18

A series of mononuclear six-coordinate tungsten compounds spanning formal oxidation states from 0 to +VI, largely in a ligand environment of inert chloride and/or phosphine, was interrogated by tungsten L-edge X-ray absorption spectroscopy. The L-edge spectra of this compound set, comprised of [W(0)(PMe3)6], [W(II)Cl2(PMePh2)4], [W(III)Cl2(dppe)2][PF6] (dppe = 1,2-bis(diphenylphosphino)ethane), [W(IV)Cl4(PMePh2)2], [W(V)(NPh)Cl3(PMe3)2], and [W(VI)Cl6], correlate with formal oxidation state and have usefulness as references for the interpretation of the L-edge spectra of tungsten compounds with redox-active ligands and ambiguous electronic structure descriptions. The utility of these spectra arises from the combined correlation of the estimated branching ratio of the L3,2-edges and the L1 rising-edge energy with metal Zeff, thereby permitting an assessment of effective metal oxidation state. An application of these reference spectra is illustrated by their use as backdrop for the L-edge X-ray absorption spectra of [W(IV)(mdt)2(CO)2] and [W(IV)(mdt)2(CN)2](2-) (mdt(2-) = 1,2-dimethylethene-1,2-dithiolate), which shows that both compounds are effectively W(IV) species even though the mdt ligands exist at different redox levels in the two compounds. Use of metal L-edge XAS to assess a compound of uncertain formulation requires: (1) Placement of that data within the context of spectra offered by unambiguous calibrant compounds, preferably with the same coordination number and similar metal ligand distances. Such spectra assist in defining upper and/or lower limits for metal Zeff in the species of interest. (2) Evaluation of that data in conjunction with information from other physical methods, especially ligand K-edge XAS. (3) Increased care in interpretation if strong π-acceptor ligands, particularly CO, or π-donor ligands are present. The electron-withdrawing/donating nature of these ligand types, combined with relatively short metal-ligand distances, exaggerate the difference between formal oxidation state and metal Zeff or, as in the case of [W(IV)(mdt)2(CO)2], exert the subtle effect of modulating the redox level of other ligands in the coordination sphere.

Theoretical and numerical investigations towards a new geoid model for the Mediterranean Sea - The GEOMED2 project

NASA Astrophysics Data System (ADS)

Barzaghi, Riccardo; Vergos, Georgios S.; Albertella, Alberta; Carrion, Daniela; Cazzaniga, Noemi; Tziavos, Ilias N.; Grigoriadis, Vassilios N.; Natsiopoulos, Dimitrios A.; Bruinsma, Sean; Bonvalot, Sylvain; Lequentrec-Lalancette, Marie-Françoise; Bonnefond, Pascal; Knudsen, Per; Andersen, Ole; Simav, Mehmet; Yildiz, Hasan; Basic, Tomislav; Gil, Antonio J.

2016-04-01

The unique features of the Mediterranean Sea, with its large gravity variations, complex circulation, and geodynamic peculiarities have always constituted this semi-enclosed sea area as a unique geodetic, geodynamics and ocean laboratory. The main scope of the GEOMED 2 project is the collection of all available gravity, topography/bathymetry and satellite altimetry data in order to improve the representation of the marine geoid and estimate the Mean Dynamic sea surface Topography (MDT) and the circulation with higher accuracy and resolution. Within GEOMED2, the data employed are land and marine gravity data, GOCE/GRACE based Global Geopotential Models and a combination after proper validation of MISTRAL, HOMONIM and SRTM/bathymetry terrain models. In this work we present the results achieved for an inner test region spanning the Adriatic Sea area, bounded between 36o < φ < 48o and 10o < λ < 22o. Within this test region, the available terrain/bathymetry models have been evaluated in terms of their contribution to geoid modeling, the processing methodologies have been tested in terms of the provided geoid accuracy and finally some preliminary results on the MDT determination have been compiled. The aforementioned will server as the guide for the Mediterranean-wide marine geoid estimation. The processing methodology was based on the well-known remove-compute-restore method following both stochastic and spectral methods. Classic least-squares collocation (LSC) with errors has been employed, along with fast Fourier transform (FFT)-based techniques, the Least-Squares Modification of Stokes' Formula (KTH) method and windowed LSC. All methods have been evaluated against in-situ collocated GPS/Levelling geoid heights, using EGM2008 as a reference, in order to conclude on the one(s) to be used for the basin-wide geoid evaluation.

Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach.

PubMed

Mao, Feng; Dong, Yi; Ji, Zhengbiao; Cao, Jiaying; Wang, Wen-Ping

2017-01-01

Aim. To investigate the value of contrast-enhanced ultrasound (CEUS) guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT) decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6) who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US) guidance group ( n = 75). All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3%) and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm) nonenhanced necrotic areas. More inner (20.0% versus 6.7%) and surrounding (18.3% versus 2.7%) major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%). The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%). Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.

Twenty five years follow up of MB leprosy patients retreated with a modified MDT regimen after a full course of dapsone mono-therapy.

PubMed

Jing, Zhichun; Zhang, Renbao; Zhou, Doahai; Chen, Jiakeun

2009-06-01

The relentless emergence of dapsone resistance amongst M. leprae threatened leprosy control programmes, and increased the relapse rate of patients cured with dapsone monotherapy. The study aimed to analyse the effect on the relapse rate of dapsone-cured multibacillary (MB) leprosy patients, of re-treatment, using a multidrug therapy (MDT) regimen which differed from the WHO recommended regimen. 794 MB leprosy patients who had been released from treatment after dapsone monotherapy were selected, amongst them 657 were re-treated for 1 year using the modified multidrug therapy regimen (mMDT) including rifampicin, clofazimine and dapsone, and 137 patients were observed as control cases. The regimen was well tolerated with good compliance: 620 patients completed re-treatment with mild side effects and a low incidence of leprosy reactions. There was a statistically significant difference between the relapse rates of re-treated and control groups (chi squaredf = 57.44, P < 0.001). Furthermore, the relapses in the re-treated group were significantly more likely to be later than those in the control group (t = 25.62, P < 0.001). Re-treatment with this modified regimen is acceptable and can reduce the risk of early relapse in dapsone-cured patients. The problem of persisters causing late relapse is likely to remain.

Growth and Survival of Bagged Lucilia sericata Maggots in Wounds of Patients Undergoing Maggot Debridement Therapy.

PubMed

Cičková, Helena; Cambal, Marek; Kozánek, Milan; Takáč, Peter

2013-01-01

Maggot debridement therapy (MDT) is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n = 52), which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment. Survival of maggots after a 48-h cycle of MDT ranged between 63.6 and 82.7%. Maggots in venous ulcers had on average 9-19% higher mortality than maggots within traumatic, ischemic, and diabetic ulcers. Length of larvae after 48 h cycle of MDT reached on average 7.09-9.68 mm, and average width varied between 1.77 and 2.26 mm. Larvae in venous ulcers were significantly smaller after 48 h, but not after 72 h treatment compared to the other wound types. Further studies should be aimed to identify other patient-associated factors which might influence growth and survival of the larvae during maggot debridement therapy.

Multispectral decomposition for the removal of out-of-band effects of visible/infrared imaging radiometer suite visible and near-infrared bands.

PubMed

Gao, Bo-Cai; Chen, Wei

2012-06-20

The visible/infrared imaging radiometer suite (VIIRS) is now onboard the first satellite platform managed by the Joint Polar Satellite System of the National Oceanic and Atmospheric Administration and NASA. It collects scientific data from an altitude of approximately 830 km in 22 narrow bands located in the 0.4-12.5 μm range. The seven visible and near-infrared (VisNIR) bands in the wavelength interval between 0.4-0.9 μm are known to suffer from the out-of-band (OOB) responses--a small amount of radiances far away from the center of a given band that can pass through the filter and reach detectors in the focal plane. A proper treatment of the OOB effects is necessary in order to obtain calibrated at-sensor radiance data [referred to as the Sensor Data Records (SDRs)] from measurements with these bands and subsequently to derive higher-level data products [referred to as the Environmental Data Records (EDRs)]. We have recently developed a new technique, called multispectral decomposition transform (MDT), which can be used to correct/remove the OOB effects of VIIRS VisNIR bands and to recover the true narrow band radiances from the measured radiances containing OOB effects. An MDT matrix is derived from the laboratory-measured filter transmittance functions. The recovery of the narrow band signals is performed through a matrix multiplication--the production between the MDT matrix and a multispectral vector. Hyperspectral imaging data measured from high altitude aircraft and satellite platforms, the complete VIIRS filter functions, and the truncated VIIRS filter functions to narrower spectral intervals, are used to simulate the VIIRS data with and without OOB effects. Our experimental results using the proposed MDT method have demonstrated that the average errors after decomposition are reduced by more than one order of magnitude.

Assessing performance of gravity models in the Arctic and the implications for polar oceanography

NASA Astrophysics Data System (ADS)

Thomas, S. F.; McAdoo, D. C.; Farrell, S. L.; Brozena, J. M.; Childers, V. A.; Ziebart, M. K.; Shepherd, A.

2014-12-01

The circulation of the Arctic Ocean is of great interest to both the oceanographic and cryospheric communities. Understanding both the steady state and variations of this circulation is essential to building our knowledge of Arctic climate. With the advent of high inclination altimeter missions such as CryoSat and ICESat, it is now feasible to produce Mean Dynamic Topography (MDT) products for the region, which allow a comprehensive investigation of geostrophic currents. However, the accuracy of these products is largely limited by our knowledge of the marine geoid in the Arctic. There are a number of publicly available gravity models commonly used to derive the geoid. These use different combinations of available data (satellite gravimetry, altimetry, laser ranging, and in-situ) and are calculated using different mathematical techniques. However, the effect of these differences on the real world performance of these models when used for oceanographic studies in the Arctic is not well known. Given the unique problems for gravimetry in the region (especially data gaps) and their potential impact on MDT products, it is especially important that the relative performance of these models be assessed We consider the needs of the "end user" satellite oceanographer in the Arctic with respect to gravimetry, and the relationship between the precision of gravity data and the accuracy of a final MDT/current velocity product. Using high-precision aerogravity data collected over 3 years of campaigns by NASA's Operation IceBridge we inter-compare 10 of the leading gravity models and assess their performance in the Arctic. We also use historical data from campaigns flown by the US Naval Research Laboratory (NRL) to demonstrate the impact of gravity errors on MDT products. We describe how gravity models for the region might be improved in the future, in an effort to maximize the level at which Arctic currents may be resolved.

Geographic and socioeconomic factors in patients with malignant pleural mesothelioma in New South Wales and their impact upon clinical outcomes.

PubMed

Linton, Anthony; Soeberg, Matthew; Broome, Richard; Kao, Steven; van Zandwijk, Nico

2017-07-01

Whilst the impact of clinicopathological factors on the prognosis of malignant pleural mesothelioma (MPM) is well understood, socioeconomic and geographic factors have received less attention. We analysed the relationship between geographic and socioeconomic factors upon survival and treatment provision in a large series of patients with MPM. We assessed MPM patients awarded compensation between 2002 and 2009 with additional MPM incidence data from the New South Wales (NSW) Cancer Registry. The impact of geographic remoteness, distance from oncological multidisciplinary team (MDT) and Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) upon survival, clinical features and treatment received was analysed. We identified 910 patients (67% residing in major cities; 92% <50 km from MDT). Median overall survival was 10.0 months. On multivariate analysis, age >70 (hazard ratio (HR) = 1.39), male gender (HR =1.36), non-epithelioid histological subtype (HR = 2.18) and IRSAD status by decreasing quintile (HR = 1.06) were independent prognostic factors. There was no significant advantage for patients residing in major cities (10.6 months vs 8.8 months; P = 0.162) or within 50 km of MDT (10.3 months vs 7.8 months; P = 0.539). Patient's geographic location and distance to MDT did not impact chemotherapy, adjuvant radiotherapy or extrapleural pneumonectomy provision. Socioeconomically disadvantaged patients were significantly less likely to receive chemotherapy (37.4% vs 54.8%; P = 0.001). This study provides evidence for differences in the treatment and survival according to socioeconomic status for compensated MPM patients in NSW. Further research is warranted to seek additional explanations for the differences noted by comparing the treatments and outcomes of compensated and non-compensated MPM patients in NSW. © 2017 Asian Pacific Society of Respirology.

Determination of Mean Dynamic Topography (MDT) to Bridge Geoid and Mean Sea Surface Height (SSH) with a New Elliptic Equation

NASA Astrophysics Data System (ADS)

Chu, P. C.

2016-12-01

Mean dynamic topography (MDT, η) bridges the geoid and the mean sea surface (from satellite altimetry) and constrains large scale surface geostrophic circulations. It can be estimated from either satellite or underwater ocean temperature (T) and salinity (S) data. Satellite altimeter measures sea surface height (SSH) with high precision and unique resolution above a reference ellipsoid (not geoid). Two Gravity Recovery and Climate Experiment (GRACE) satellites launched in 2002, provide data to compute the marine geoid [called the GRACE Gravity Model (GGM)] (see website: http://www.csr.utexas.edu/grace/). The MDT is the difference of altimetry-derived mean SSH and the mean marine geoid (using GGM or pre-GRACE gravity model such as EGM96). A major difficulty arises that the spatial variations in mean SSH and marine geoid are approximately two orders of magnitude larger than the spatial variations in η.The second approach (using T, Sdata) is based on geostrophic balance, which is at the minimum energy state in the linear Boussinesq primitive equations with conservation of potential vorticity. In this paper, a new elliptic equation, -[∂x(gh/f2)∂xη+∂y(gh/f2)∂yη]+η = (g/f2)(∂C/∂x-∂B/∂y)is derived to determine MDT with H the water depth, g the gravitational acceleration, and coefficients (B, C) depend on 3D mean temperature (T) and salinity (S) data. Numerical approach transforms the elliptic equation into a set of well-posed linear algebraic equations of η at grid points. The solution for the North Atlantic Ocean (100oW-6oW, 7oN-72oN) on 1oX1ogrids with the coefficients (B, C) calculated from the three-dimensional (T, S) data of the NOAA National Centers for Environmental Information (NCEI) World Ocean Atlas 2013 version 2 (http://www.nodc.noaa.gov/OC5/woa13/woa13data.html) and H from the NOAA ETOPO5 (https://www.ngdc.noaa.gov/mgg/fliers/93mgg01.html), compares well with the difference (also considered as the MDT) between the time-averaged SSH and the geoid from the NASA/JPL (http://gracetellus.jpl.nasa.gov/data/dot/). Further application of this elliptic equation method on the high-precision altimetry measurements of SSH such as the Surface Water and Ocean Topography (SWOT) is also presented.

Daily Mean Temperature and Urolithiasis Presentation in Six Cities in Korea: Time-Series Analysis.

PubMed

Chi, Byung Hoon; Chang, In Ho; Choi, Se Young; Suh, Dong Churl; Chang, Chong Won; Choi, Yun Jung; Lee, Seo Yeon

2017-06-01

Seasonal variation in urinary stone presentation is well described in the literature. However, previous studies have some limitations. To explore overall cumulative exposure-response and the heterogeneity in the relationships between daily meteorological factors and urolithiasis incidence in 6 major Korean cities, we analyzed data on 687,833 urolithiasis patients from 2009 to 2013 for 6 large cities in Korea: Seoul, Incheon, Daejeon, Gwangju, Daegu, and Busan. Using a time-series design and distributing lag nonlinear methods, we estimated the relative risk (RR) of mean daily urolithiasis incidence (MDUI) associated with mean daily meteorological factors, including the cumulative RR for a 20-day period. The estimated location-specific associations were then pooled using multivariate meta-regression models. A positive association was confirmed between MDUI and mean daily temperature (MDT), and a negative association was shown between MDUI and mean daily relative humidity (MDRH) in all cities. The lag effect was within 5 days. The multivariate Cochran Q test for heterogeneity at MDT was 12.35 (P = 0.136), and the related I² statistic accounted for 35.2% of the variability. Additionally, the Cochran Q test for heterogeneity and I² statistic at MDHR were 26.73 (P value = 0.148) and 24.7% of variability in the total group. Association was confirmed between daily temperature, relative humidity and urolithiasis incidence, and the differences in urolithiasis incidence might have been partially attributable to the different frequencies and the ranges in temperature and humidity between cities in Korea. © 2017 The Korean Academy of Medical Sciences.

Analysis and evaluation of the moral distress theory.

PubMed

Wilson, Melissa A

2018-04-01

Moral distress is a pervasive problem in nursing resulting in a detriment to patient care, providers, and organizations. Over a decade ago, the moral distress theory (MDT) was proposed and utilized in multiple research studies. This middle range theory explains and predicts the distress that occurs in a nurse because of moral conflict. The research findings born from this theory have been substantial. Since inception of this theory, moral distress has been extensively examined which has further elaborated its understanding. This paper provides an analysis and evaluation of the MDT according to applicable guidelines. Current understanding of the phenomenon indicates that a new theory may be warranted to better predict, treat, and manage moral distress. © 2017 Wiley Periodicals, Inc.

Highway project cost estimating and management.

DOT National Transportation Integrated Search

2009-02-01

"This report provides detailed information about the project objectives, deliverables, and findings. The project team : thoroughly reviewed the Montana Department of Transportation (MDT) structure, operations, and current procedures as : related to M...

Research peer exchange.

DOT National Transportation Integrated Search

2005-10-01

The Montana Department of Transportation hosted a research management peer exchange October 3-7, 2005. The : objectives of the peer exchange were to: identify strengths, challenges, and opportunities for the information services : component of MDT...

Elder Abuse FAQS

MedlinePlus

... investigate potential elder abuse cases Caption: Multidisciplinary Team Technical Assistance Center (MDT TAC) Prev Play Pause Next ... Office of the Inspector General Open Government Plain Writing USA.gov BusinessUSA Footer Menu Justice First Column ...

Montana Highway Reconfiguration Study

DOT National Transportation Integrated Search

2005-02-01

"The 2001 Montana State legislature and Governors Office directed the Department (MDT) to conduct a study : examining the economic impact of reconfiguring the States major two-lane highways. To achieve this overall goal, : the Governor created ...

Focal Dystonia in Hemiplegic Upper Limb: Favorable Effect of Cervical Microsurgical DREZotomy Involving the Ventral Horn - A Report of 3 Patients.

PubMed

Sindou, Marc; Georgoulis, George

2016-01-01

Focal dystonia in hemiplegic upper limbs is poorly responsive to medications or classical neurosurgical treatments. Only repeated botulinum toxin injections show efficacy, but in most severe cases effects are transient. Cervical DREZ lesioning, which has proven efficacious in hyperspasticity when done deeply (3-5 mm) in the dorsal horn, may have favorable effects on the dystonic component when performed down to, and including, the base of the ventral horn (5-6 mm in depth). Three patients underwent deep cervical microsurgical DREZotomy (MDT) for focal dystonia in the upper limb. Hypertonia was reduced, and sustained dystonic postures were suppressed. Residual motor function (hidden behind hypertonia) came to the surface. Cervical MDT may be a useful armamentarium for treating refractory focal dystonia in the upper limb. © 2016 S. Karger AG, Basel.

Magnetic field-assisted gene delivery: achievements and therapeutic potential.

PubMed

Schwerdt, Jose I; Goya, Gerardo F; Calatayud, M Pilar; Hereñú, Claudia B; Reggiani, Paula C; Goya, Rodolfo G

2012-04-01

The discovery in the early 2000's that magnetic nanoparticles (MNPs) complexed to nonviral or viral vectors can, in the presence of an external magnetic field, greatly enhance gene transfer into cells has raised much interest. This technique, called magnetofection, was initially developed mainly to improve gene transfer in cell cultures, a simpler and more easily controllable scenario than in vivo models. These studies provided evidence for some unique capabilities of magnetofection. Progressively, the interest in magnetofection expanded to its application in animal models and led to the association of this technique with another technology, magnetic drug targeting (MDT). This combination offers the possibility to develop more efficient and less invasive gene therapy strategies for a number of major pathologies like cancer, neurodegeneration and myocardial infarction. The goal of MDT is to concentrate MNPs functionalized with therapeutic drugs, in target areas of the body by means of properly focused external magnetic fields. The availability of stable, nontoxic MNP-gene vector complexes now offers the opportunity to develop magnetic gene targeting (MGT), a variant of MDT in which the gene coding for a therapeutic molecule, rather than the molecule itself, is delivered to a therapeutic target area in the body. This article will first outline the principle of magnetofection, subsequently describing the properties of the magnetic fields and MNPs used in this technique. Next, it will review the results achieved by magnetofection in cell cultures. Last, the potential of MGT for implementing minimally invasive gene therapy will be discussed.

Successful management of a complicated clinical crisis: A patient with left-sided endocarditis and secondary hemophagocytic lymphohistiocytosis: a rare case report and literature review.

PubMed

Xu, Peipei; Zeng, Hui; Zhou, Min; Ouyang, Jian; Chen, Bing; Zhang, Qiguo

2017-12-01

Hemophagocytic lymphohistiocytosis (HLH) secondary to methicillin-resistant Staphylococcus epidermidis (MRSE)-related left-sided infectious endocarditis had never been reported before. In the last decade, daptomycin, a novel lipopeptide antibiotic, showed its excellent role in anti-Gram-positive bacteria, including soft tissue infection, bloodstream and deep tissueinfection. An Asian women under sever condition due to the cooccurrence of HLH and MRSE-related endocarditis while also be allergic to vancomycin. The patient was cured by high-dose daptomycin monotheraphy, HLH-2004 protocol and cardiothoracic surgery to remove the valve at last, and was obviously benefit from the endeavor of a multidisciplinary team (MDT) strategy. IE was made on March 27according to the modified Duke criteria. HLH was diagnosed too. The patient was cured by high-dose daptomycin monotheraphy, HLH-2004 protocol and cardiothoracic surgery to remove the valve at last, and was obviously benefit from the endeavor of a multidisciplinary team (MDT) strategy. The patient was healthy andstable when we published this case. This case proves high-dose daptomycin monotheraphy could be used as an effective alternative regimen for vancomycin in treating MRSE-related left-sided endocarditis and highlight the importance of early diagnosis and appropriate management for HLH. Furthermore, our work suggests an MDT model as a practical strategy in managing similar clinical situation. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Implementation and consistency of Heart Team decision-making in complex coronary revascularisation.

PubMed

Pavlidis, Antonis N; Perera, Divaka; Karamasis, Grigoris V; Bapat, Vinayak; Young, Chris; Clapp, Brian R; Blauth, Chris; Roxburgh, James; Thomas, Martyn R; Redwood, Simon R

2016-03-01

A multidisciplinary team (MDT) approach for decision-making in patients with complex coronary artery disease (CAD) is now a class IC recommendation in the European and American guidelines for myocardial revascularisation. The aim of this study was to evaluate the implementation and consistency of Heart Team HT decision-making in complex coronary revascularisation. We prospectively evaluated the data of 399 patients derived from 51 consecutive MDT meetings held in a tertiary cardiac centre. A subset of cases was randomly selected and re-presented with the same clinical data to a panel blinded to the initial outcome, at least 6 months after the initial discussion, in order to evaluate the reproducibility of decision-making. The most common decisions included continued medical management (30%), coronary artery bypass grafting (CABG) (26%) and percutaneous coronary intervention (PCI) (17%). Other decisions, such as further assessment of symptoms or evaluation with further invasive or non-invasive tests were made in 25% of the cases. Decisions were implemented in 93% of the cases. On re-discussion of the same data (n=40) within a median period of 9 months 80% of the initial HT recommendations were successfully reproduced. The Heart Team is a robust process in the management of patient with complex CAD and decisions are largely reproducible. Although outcomes are successfully implemented in the majority of the cases, it is important that all clinical information is available during discussion and patient preference is taken into account. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Evaluating Montana's ITEEM : successes and lessons for Eco-logical

DOT National Transportation Integrated Search

2011-01-01

Up until the late 1990s, the Montana Department of Transportation (MDT) performed environmental mitigation for transportation projects on an individual-project basis. Similar experiences at State Departments of Transportation (DOTs) nationwide have s...

Highway construction on-the-job training program review.

DOT National Transportation Integrated Search

2007-05-01

"This study provides information about the experiences of trainees, contractors, Montana Department of : Transportation (MDT) field staff, and other state DOT staff in their states On-the-Job Training (OJT) Program. : Obtaining this information is...

Rockfall Hazard Process Assessment : [Project Summary

DOT National Transportation Integrated Search

2017-10-01

The Montana Department of Transportation (MDT) implemented its Rockfall Hazard Rating System (RHRS) between 2003 and 2005, obtaining information on the state's rock slopes and their associated hazards. The RHRS data facilitated decision-making in an ...

Determination of Arctic sea ice thickness in the winter of 2007

NASA Astrophysics Data System (ADS)

Calvao, J.; Wadhams, P.; Rodrigues, J.

2009-04-01

The L3H phase of operation of ICESat's laser in the winter of 2007 coincided for about two weeks with the cruise of the British submarine Tireless where upward-looking and multibeam sonar systems were mounted, thus providing the first opportunity for a simultaneous determination of the sea ice freeboard and draft in the Arctic Ocean. ICESat satellite carries a laser altimeter dedicated to the observation of polar regions, generating accurate profiles of surface topography along the tracks (footprint diameter 70m), which can be inverted to determine sea-ice freeboard heights using a "lowest level" filtering scheme. The procedure applied to obtain the ice freeboard F=h-N-MDT (where h is the ICESat ellipsoidal height estimate, N is the geoid undulation and MDT is the ocean mean dynamic topography) for the whole Arctic basin (with the exception of points beyond 86N) consisted of a high-pass filtering of the satellite data to remove low frequency effects due to the geoid and ocean dynamics (the geoid model ArcGP with sufficient accuracy to allow the computation of the freeboard was very recently made available). The original tide model was replaced by the tide model AOTIM5 and the tide loading model TPXO6.2. The inverse barometer correction was computed. As there are no MDT models with enough accuracy, it is necessary to identify leads of open water or thin ice to allow the interpolation of the ocean surface, using surface reflectivity and waveform shape. Several solutions were tested to define the ocean surface and the computed freeboard values were interpolated on a 5x5 minute grid, where the submarine track was interpolated. At the same time, along-track single beam upward-looking sonar data were recorded using an Admiralty pattern 780 echo sounder carried by the Tireless, from where we have generated an ice draft profile of about 8,000km between Fram Strait and the North coast of Alaska and back. The merging of the two data sets provides a new insight into the present Arctic sea ice thickness distribution while a comparison with results obtained by previous submarines cruises and previous phases of operations of ICESat allows a fresh evaluation of the rate of sea ice thinning.

Livability for Montana transportation.

DOT National Transportation Integrated Search

2012-03-01

The concept of livability is not new to Montana or the Montana Department of Transportation (MDT). Helping build great places in great environments has long been embedded in the departments mission, and even the state constitution. In light of the...

Speed limits set lower than engineering recommendations.

DOT National Transportation Integrated Search

2016-08-01

The purpose of this project is to provide the Montana Department of Transportation (MDT) with a better understanding of the : operational and safety impacts of setting posted speed limits below engineering recommended values. This practice has been :...

FFY 2007 annual report for the Montana Department of Transportation Research Programs

DOT National Transportation Integrated Search

2008-01-01

The Montana Department of Transportation (MDT) conducts research to discover, develop, or extend knowledge needed to operate, maintain, and improve the statewide multimodal transportation system. Specific goals include: evaluation and advancement of ...

Rockfall Hazard Process Assessment : Implementation Report

DOT National Transportation Integrated Search

2017-10-01

The Montana Department of Transportation (MDT) commissioned a new research program to improve assessment and management of its rock slope assets. The Department implemented a Rockfall Hazard Rating System (RHRS) program in 2005 and wished to add valu...

Mean Dynamic Topography of the Arctic Ocean

NASA Technical Reports Server (NTRS)

Farrell, Sinead Louise; Mcadoo, David C.; Laxon, Seymour W.; Zwally, H. Jay; Yi, Donghui; Ridout, Andy; Giles, Katherine

2012-01-01

ICESat and Envisat altimetry data provide measurements of the instantaneous sea surface height (SSH) across the Arctic Ocean, using lead and open water elevation within the sea ice pack. First, these data were used to derive two independent mean sea surface (MSS) models by stacking and averaging along-track SSH profiles gathered between 2003 and 2009. The ICESat and Envisat MSS data were combined to construct the high-resolution ICEn MSS. Second, we estimate the 5.5-year mean dynamic topography (MDT) of the Arctic Ocean by differencing the ICEn MSS with the new GOCO02S geoid model, derived from GRACE and GOCE gravity. Using these satellite-only data we map the major features of Arctic Ocean dynamical height that are consistent with in situ observations, including the topographical highs and lows of the Beaufort and Greenland Gyres, respectively. Smaller-scale MDT structures remain largely unresolved due to uncertainties in the geoid at short wavelengths.

The Black Hills-Rapid City flood of June 9-10, 1972: A description of the storm and flood

USGS Publications Warehouse

Schwarz, Francis K.; Hughes, L.A.; Hansen, E.M.; Petersen, M.S.; Kelly, Donovan B.

1975-01-01

Almost all the flood peaks occurred between 2230 MDT on June 9 and 0100 MDT on June 10, 1972, in a flood belt about 40 miles long and 20 miles wide along the eastern slopes of the Black Hills. This belt extended from Sturgis, S. Dak., on the north to Hermosa, S. Dak., on the south, with Rapid City near the center. To document the flood, peak discharge determinations were made at 49 sites. Records show that about 13,000 acre-feet of water flowed through Rapid City during the 2 days of flooding. At one point during the night of June 9, the floodwaters rose about 3.5 feet in 15 minutes. Coming off the slopes of the Black Hills, the flood peak traveled the 22 miles between Deer Creek and Rapid City in about 3.5 hours.

Challenges beyond elimination in leprosy.

PubMed

Naaz, Farah; Mohanty, Partha Sarathi; Bansal, Avi Kumar; Kumar, Dilip; Gupta, Umesh Datta

2017-01-01

Every year >200,000 new leprosy cases are registered globally. This number has been fairly stable over the past 8 years. The World Health Organization has set a target to interrupt the transmission of leprosy globally by 2020. It is important, in terms of global action and research activities, to consider the eventuality of multidrug therapy (MDT) resistance developing. It is necessary to measure disease burden comprehensively, and contact-centered preventive interventions should be part of a global elimination strategy. Drug resistance is the reduction in effectiveness of a drug such as an antimicrobial or an antineoplastic in curing a disease or condition. MDT has proven to be a powerful tool in the control of leprosy, especially when patients report early and start prompt treatment. Adherence to and its successful completion is equally important. This paper has reviewed the current state of leprosy worldwide and discussed the challenges and also emphasizes the challenge beyond the elimination in leprosy.

Thermal and mechanical quantitative sensory testing in Chinese patients with burning mouth syndrome--a probable neuropathic pain condition?

PubMed

Mo, Xueyin; Zhang, Jinglu; Fan, Yuan; Svensson, Peter; Wang, Kelun

2015-01-01

To explore the hypothesis that burning mouth syndrome (BMS) probably is a neuropathic pain condition, thermal and mechanical sensory and pain thresholds were tested and compared with age- and gender-matched control participants using a standardized battery of psychophysical techniques. Twenty-five BMS patients (men: 8, women: 17, age: 49.5 ± 11.4 years) and 19 age- and gender-matched healthy control participants were included. The cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), mechanical detection threshold (MDT) and mechanical pain threshold (MPT), in accordance with the German Network of Neuropathic Pain guidelines, were measured at the following four sites: the dorsum of the left hand (hand), the skin at the mental foramen (chin), on the tip of the tongue (tongue), and the mucosa of the lower lip (lip). Statistical analysis was performed using ANOVA with repeated measures to compare the means within and between groups. Furthermore, Z-score profiles were generated, and exploratory correlation analyses between QST and clinical variables were performed. Two-tailed tests with a significance level of 5 % were used throughout. CDTs (P < 0.02) were significantly lower (less sensitivity) and HPTs (P < 0.001) were significantly higher (less sensitivity) at the tongue and lip in BMS patients compared to control participants. WDT (P = 0.007) was also significantly higher at the tongue in BMS patients compared to control subjects . There were no significant differences in MDT and MPT between the BMS patients and healthy subjects at any of the four test sites. Z-scores showed that significant loss of function can be identified for CDT (Z-scores = -0.9±1.1) and HPT (Z-scores = 1.5±0.4). There were no significant correlations between QST and clinical variables (pain intensity, duration, depressions scores). BMS patients had a significant loss of thermal function but not mechanical function, supporting the hypothesis that BMS may be a probable neuropathic pain condition. Further studies including e.g. electrophysiological or imaging techniques are needed to clarify the underlying mechanisms of BMS.

Comparison of mounting methods for the evaluation of fibers by phase contrast microscopy.

PubMed

Lee, Eun Gyung; Pang, Thomas W S; Nelson, John; Andrew, Mike; Harper, Martin

2011-07-01

The objectives of this study were to evaluate mounting methods for fiber examination of air sample filters by phase contrast microscopy (PCM) and to evaluate differences in fiber counts that might be due to fiber movement. Acetone/triacetin (AT) with various amounts of triacetin and acetone/Euparal (AE) where the mounting medium was placed between the cleared filter wedge and the coverslip were tested as a function of time. Field sample slides collected from a taconite iron-ore processing mill, a tremolitic talc-ore processing mill, and from around a crusher in a meta-basalt stone quarry were prepared with relocatable coverslips to revisit the same field areas on the slides. For each slide, three or four field areas were randomly selected and pictures were taken every 2 weeks to determine any sign of fiber movement over time. For 11 AT slides (named as AT-3.5) prepared with 3.5 μl of the mounting medium according to the NIOSH 7400 method, no fiber movements were detected over 59 weeks. On the other hand, AT slides prepared with larger quantities (10, 15, and 20 μl) of the mounting medium (named as AT-10) and AE slides prepared with ∼10 μl mounting medium showed fiber movement from the eighth day at the earliest. Fiber movement began earlier for the slides mounted with excess triacetin than for those mounted with Euparal. The sample slide storage method, either vertically or horizontally, did not seem to accelerate fiber movement. Additionally, two other modified methods, dimethylformamide solution/Euparal (mDE) and dimethylformamide solution/triacetin (mDT), were also prepared where the mounting medium was placed between the cleared filter wedge and the glass slide. The findings of fiber movements were similar; when 3.5 μl of triacetin was used for the mDT slides, fiber movements were not detected, while fibers on slides prepared with 10 μl triacetin (mDT-10) moved around. No fiber movements were observed for the mDE slides at any time during 59 weeks. Once fiber movement started, fibers moved over distances measured from 4 μm and up to >1000 μm within 22 weeks. However, since then, no further fiber movements have been observed in any field sample slides. Additional sample slides, two Amosite and two chrysotile, were prepared from Union for International Cancer Control (UICC) samples using the AT method with 5 μl triacetin mounting medium. Fiber movements were also observed in these samples; chrysotile fibers began to migrate in 3 weeks, while Amosite fiber movement started after 3 months. Although fiber movement was observed for the AT-10, AE, and mDT-10 sample slides, fiber counts were not significantly different from AT-3.5 and mDE samples that exhibited no fiber movement. Although fiber counts would not be significantly changed by fiber movement, the type and amount of mounting medium for sample slide preparation remains critical for issues such as quality assurance and training of analysts by revisiting the same fibers.

Social marketing to eliminate leprosy in Sri Lanka.

PubMed

Williams, P G; Dewapura, D; Gunawardene, P; Settinayake, S

1998-01-01

Leprosy is a chronic infectious disease which, if untreated, can lead to permanent and progressive nerve damage and thus to deformities of the limbs, eyes, and face. People with leprosy have long been ostracized by society. The clinical signs of leprosy include insensitive skin lesions and thickened peripheral nerves. Untreated infectious leprosy cases are the main source of infection, transmitting the disease through nasal secretions. People with low cell-mediated immunity are at risk of developing clinically active leprosy irrespective of gender, age, or social class. The World Health Organization (WHO) has, since 1982, recommended multiple drug therapy (MDT) against leprosy, an approach capable of curing the disease within 1 year and interrupting its transmission. According to WHO, leprosy is currently a public health problem in 55 countries and more than 20% of the estimated 1.15 million cases of leprosy worldwide remain undetected. Although Sri Lanka was the first country in South Asia to provide MDT to all registered leprosy patients, first making it available in 1984, the disease continues to be transmitted due to the large number of undetected cases in the country. An ongoing social marketing program was therefore launched in 1990 by the local health ministry and the Novartis Foundation for Sustainable Development to eliminate leprosy from Sri Lanka. The program encourages people with suspicious skin lesions to seek diagnosis and care, teaches health care providers to recognize leprosy and refer cases for treatment, and helps the general public to understand that leprosy is just a normal disease. The socially marketed product is MDT, provided free-of-charge by the Novartis Foundation to all leprosy patients.

Time until diagnosis of clinical events with different remote monitoring systems in Implantable Cardioverter-Defibrillator patients.

PubMed

Söth-Hansen, Malene; Witt, Christoffer Tobias; Rasmussen, Mathis; Kristensen, Jens; Gerdes, Christian; Nielsen, Jens Cosedis

2018-05-24

Remote monitoring (RM) is an established technology integrated into routine follow-up of patients with implantable cardioverter-defibrillator (ICD). Current RM systems differ according to transmission frequency and alert definition. We aimed to compare time difference between detection and acknowledgement of clinically relevant events between four RM systems. We analyzed time delay between detection of ventricular arrhythmic and technical events by the ICD and acknowledgement by hospital staff in 1.802 consecutive patients followed with RM during September 2014 - August 2016. Devices from Biotronik (BIO, n=374), Boston Scientific (BSC, n=196), Medtronic (MDT, n=468) and St Jude Medical (SJM, n=764) were included. We identified all events from RM webpages and their acknowledgement with RM or at in-clinic follow-up. Events occurring during weekends were excluded. We included 3.472 events. Proportion of events acknowledged within 24 hours was 72%, 23%, 18% and 65% with BIO, BSC, MDT and SJM, respectively, with median times of 13, 222, 163 and 18 hours from detection to acknowledgement (p<0.001 for both comparisons between manufacturers). Including only events transmitted as alerts by RM, 72%, 68%, 61% and 65% for BIO, BSC, MDT and SJM, respectively were acknowledged within 24 hours. Variation in time to acknowledgement of ventricular tachyarrhythmia episodes not treated with shock therapy was the primary cause for the difference between manufacturers. Significant and clinically relevant differences in time delay from event detection to acknowledgement exist between RM systems. Varying definitions of which events RM transmits as alerts are important for the differences observed. Copyright © 2018. Published by Elsevier Inc.

Numbness in clinical and experimental pain--a cross-sectional study exploring the mechanisms of reduced tactile function.

PubMed

Geber, Christian; Magerl, Walter; Fondel, Ricarda; Fechir, Marcel; Rolke, Roman; Vogt, Thomas; Treede, Rolf-Detlef; Birklein, Frank

2008-09-30

Pain patients often report distinct numbness of the painful skin although no structural peripheral or central nerve lesion is obvious. In this cross-sectional study we assessed the reduction of tactile function and studied underlying mechanisms in patients with chronic pain and in healthy participants exposed to phasic and tonic experimental nociceptive stimulation. Mechanical detection (MDT) and pain thresholds (MPT) were assessed in the painful area and the non-painful contralateral side in 10 patients with unilateral musculoskeletal pain. Additionally, 10 healthy participants were exposed to nociceptive stimulation applied to the volar forearms (capsaicin; electrical stimulation, twice each). Areas of tactile hypaesthesia and mechanical hyperalgesia were assessed. MDT and MPT were quantified adjacent to the stimulation site. Tactile hypaesthesia in pain patients and in experimental pain (MDT-z-scores: -0.66+/-0.30 and -0.42+/-0.15, respectively, both p<0.01) was paralleled by mechanical hyperalgesia (MPT-z-scores: +0.51+/-0.27, p<0.05; and +0.48+/-0.10, p<0.001). However, hypaesthesia and hyperalgesia were not correlated. Although 9 patients reported numbness, only 3 of them were able to delineate circumscript areas of tactile hypaesthesia. In experimental pain, the area of tactile hypaesthesia could be mapped in 31/40 experiments (78%). Irrespective of the mode of nociceptive stimulation (phasic vs. tonic) tactile hypaesthesia and hyperalgesia developed with a similar time course and disappeared within approximately 1 day. Hypaesthesia (numbness) often encountered in clinical pain can be reproduced by experimental nociceptive stimulation. The time course of effects suggests a mechanism involving central plasticity.

Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases

PubMed Central

Bührer-Sékula, Samira; Benjak, Andrej; Loiseau, Chloé; Singh, Pushpendra; Pontes, Maria A. A.; Gonçalves, Heitor S.; Hungria, Emerith M.; Busso, Philippe; Piton, Jérémie; Silveira, Maria I. S.; Cruz, Rossilene; Schetinni, Antônio; Costa, Maurício B.; Virmond, Marcos C. L.; Diorio, Suzana M.; Dias-Baptista, Ida M. F.; Rosa, Patricia S.; Matsuoka, Masanori; Penna, Maria L. F.; Cole, Stewart T.; Penna, Gerson O.

2017-01-01

Background Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monitor recurrent cases for drug resistance and to distinguish between relapse and reinfection as a means of assessing therapeutic efficacy. All three objectives can be reached with single nucleotide resolution using next generation sequencing and bioinformatics analysis of Mycobacterium leprae DNA present in human skin. Methodology DNA was isolated by means of optimized extraction and enrichment methods from samples from three recurrent cases in leprosy patients participating in an open-label, randomized, controlled clinical trial of uniform MDT in Brazil (U-MDT/CT-BR). Genome-wide sequencing of M. leprae was performed and the resultant sequence assemblies analyzed in silico. Principal findings In all three cases, no mutations responsible for resistance to rifampicin, dapsone and ofloxacin were found, thus eliminating drug resistance as a possible cause of disease recurrence. However, sequence differences were detected between the strains from the first and second disease episodes in all three patients. In one case, clear evidence was obtained for reinfection with an unrelated strain whereas in the other two cases, relapse appeared more probable. Conclusions/Significance This is the first report of using M. leprae whole genome sequencing to reveal that treated and cured leprosy patients who remain in endemic areas can be reinfected by another strain. Next generation sequencing can be applied reliably to M. leprae DNA extracted from biopsies to discriminate between cases of relapse and reinfection, thereby providing a powerful tool for evaluating different outcomes of therapeutic regimens and for following disease transmission. PMID:28617800

Ridership impacts of South Florida's EASY smart card.

DOT National Transportation Integrated Search

2013-07-01

Smart card-based Automated Fare Collection Systems (AFCS) are being increasingly deployed in transit systems across the US. Miami-Dade Transit (MDT) has recently deployed such a system branded as the EASY Card. The South Florida Regional Transportati...

Rockfall Hazard Process Assessment : Final Project Report

DOT National Transportation Integrated Search

2017-10-01

After a decade of using the Rockfall Hazard Rating System (RHRS), the Montana Department of Transportation (MDT) sought a reassessment of their rockfall hazard evaluation process. Their prior system was a slightly modified version of the RHRS and was...

Traveler safety policy paper : TranPlan 21, amended in 2007

DOT National Transportation Integrated Search

2007-01-01

This policy paper describes the current initiatives and potential policy goals and actions that the Montana Department of Transportation (MDT) could implement to improve public safety on the State's public roadways. these goals and actions were adopt...

Evaluation of the Lewis and Clark travel and tourism information kiosk

DOT National Transportation Integrated Search

2003-12-08

Interactive touch screen kiosks can be a useful access point for people seeking tourism information. The Montana Department of Transportation (MDT) has successfully installed a network of traveler information kiosks under the Greater Yellowstone Regi...

Ridership impacts of South Florida's EASY smart card : [summary].

DOT National Transportation Integrated Search

2013-07-01

Transit agencies across the U.S. increasingly are replacing electronic fare reading systems with Advanced Fare Collection (AFC) or smart card systems. In 2009, Miami-Dade Transit (MDT) was the first Florida transit agency to deploy AFC, branded...

A comparison of multidisciplinary team residential rehabilitation with conventional outpatient care for the treatment of non-arthritic intra-articular hip pain in UK Military personnel - a protocol for a randomised controlled trial.

PubMed

Coppack, Russell J; Bilzon, James L; Wills, Andrew K; McCurdie, Ian M; Partridge, Laura; Nicol, Alastair M; Bennett, Alexander N

2016-11-08

Non-arthritic hip disorders are defined as abnormalities of the articulating surfaces of the acetabulum and femur before the onset of osteoarthritis, including intra-articular structures such as the acetabular labrum and chondral surfaces. Abnormal femoroacetabular morphology is commonly seen in young men who constitute much of the UK military population. Residential multidisciplinary team (MDT) rehabilitation for patients with musculoskeletal injuries has a long tradition in the UK military, however, there are no studies presenting empirical data on the efficacy of a residential MDT approach compared with individualised conventional outpatient treatment. With no available data, the sustainability of this care pathway has been questioned. The purpose of this randomised controlled trial is to compare the effects of a residential multidisciplinary intervention, to usual outpatient care, on the clinical outcomes of young active adults undergoing treatment for non-arthritic intra-articular hip pain. The trial will be conducted at the Defence Medical Rehabilitation Centre, Headley Court, UK. One hundred military male participants with clinical indicators of non-arthritic intra-articular hip pain will be randomly allocated to either: (1) 7-day residential multidisciplinary team intervention, n = 50; (2) 6-week physiotherapist-led outpatient intervention (conventional care), n = 50. Measurements will be taken at baseline, post-treatment (1-week MDT group; 6-weeks physiotherapy group), and 12-weeks. The primary outcome measures are the function in daily living sub-scale of the Copenhagen Hip and Groin Outcome Score (HAGOS), the physical function subscale of the Non-arthritic Hip Score (NAHS), and VAS pain scale. Secondary outcomes include objective measures of physical capacity and general health. An intention-to-treat analysis will be performed using linear and mixed models. This study will be the first to assess the efficacy of intensive MDT rehabilitation, versus conventional outpatient care, for the management of non-arthritic hip pain. The results from this study will add to the evidence-base and inform clinical practice for the management of intra-articular non-arthritic hip pain and femoroacetabular impingement in young active adults. ISRCTN Reference: ISRCTN 59255714 dated 11-Nov-2015.

The role of boundary spanners in delivering collaborative care: a process evaluation.

PubMed

Hunt, Carianne M; Spence, Michael; McBride, Anne

2016-07-29

On average, people with schizophrenia and psychosis die 13-30 years sooner than the general population (World Psychiatry 10 (1):52-77, 2011). Mental and physical health care is often provided by different organisations, different practitioners and in different settings which makes collaborative care difficult. Research is needed to understand and map the impact of new collaborative ways of working at the primary/secondary care interface (PloS One 7 (5); e36468). The evaluation presented in this paper was designed to explore the potential of a Community and Physical Health Co-ordinator role (CPHC) (CPHCs were previously Care Co-ordinators within the Community Mental Health Team, Community in the title CPHC refers to Community Mental Health) and Multi-Disciplinary Team (MDT) meetings across primary and community care, with the aim of improving collaboration of mental and physical health care for service users with Severe Mental Illness (SMI). Data collection took place across five general practices (GPs) and a Community Mental Health Team (CMHT) in the Northwest of England, as part of a process evaluation. Semi-structured interviews were conducted with a purposive sample of GP staff (n= 18) and CMHT staff (n=4), a focus group with CMHT staff (n=8) and a survey completed by 13 CMHT staff, alongside cardiovascular risk data and MDT actions. Framework analysis was used to manage and interpret data. The results from the evaluation demonstrate that a CPHC role and MDT meetings are effective mechanisms for improving the collaboration and co-ordination of physical health care for SMI service users. The findings highlight the importance of embedding and supporting the CPHC role, with an emphasis on protected time and continuing professional roles and integrating multiple perspectives through MDT meetings. Considering the importance of physical health care for SMI service users and the complex environment, these are important findings for practitioners, researchers and policy makers in the field of primary care and mental health. There is an increasing focus on integration and collaborative working to ensure the delivery of quality care across the whole patient pathway, with a growing need for professionals to work together across service and professional boundaries. The introduction of a two pronged approach to collaboration has shown some important improvements in the management of physical health care for service users with SMI.

Steep cut slope composting : field trials and evaluation : project summary report.

DOT National Transportation Integrated Search

2011-04-01

This project is a continuation of earlier work performed by Montana State University (Jennings et al. 2007) evaluating compost application on, and incorporation into, soils on steep cut slopes for the Montana Department of Transportation (MDT). The e...

Montana Highway Safety Improvement Program : an RSPCB Peer Excahnge

DOT National Transportation Integrated Search

2011-05-01

This report provides a summary of a peer-to-peer (P2P) videoconference sponsored by the Montana Department of Transportation (MDT) and the Federal Highway Administration (FHWA) Office of Safety. The videoconference format provided a low-cost opportun...

Montana rest area usage : data acquisition and usage estimation.

DOT National Transportation Integrated Search

2011-02-01

The Montana Department of Transportation (MDT) has initiated research to refine the figures employed in the : estimation of Montana rest area use. This work seeks to obtain Montana-specific data related to rest area usage, : including water flow, eff...

Evaluation of the Montana Department of Transportation's research project solicitation, prioritization, and selection process

DOT National Transportation Integrated Search

2008-05-01

The Montana Department of Transportation (MDT) contracted the Bureau of Business and Economic Research at the University of Montana Missoula to conduct research to determine how other states solicit, prioritize, and select research problem statem...

Determining the current rates of motor fuel tax evasion for the State of Montana.

DOT National Transportation Integrated Search

2006-11-01

"The report uses data collected through interviews with neighboring states and provincial tax administrators as well as : audit, enforcement and collections data provided by the Montana Department of Transportation (MDT) to determine : the extent and...

Strategic Enterprise Architecture Design and Implementation Plan for the Montana Department of Transportation

DOT National Transportation Integrated Search

2016-08-01

The purpose of this research report is to develop a Strategic Enterprise Architecture (EA) Design and Implementation Plan for the Montana Department of Transportation (MDT). Information management systems are vital to maintaining the States transp...

Speed limits set lower than engineering recommendations : project summary report.

DOT National Transportation Integrated Search

2016-08-01

The Montana Department of Transportation (MDT) generally ensures that posted speed limits are set in accordance with engineering recommendations, which means that speed limits are typically set such that they are about equal to the observed 85th-perc...

Ground penetrating radar (GPR) analysis : Phase II field evaluation.

DOT National Transportation Integrated Search

2011-10-01

"The objective of this work was to evaluate the feasibility and value of expanding the MDT's Ground : Penetrating Radar (GPR) program to pavement design and rehabilitation, and to network level : evaluation. Phase I of this project concluded that in ...

Development of high-performance concrete mixtures for durable bridge decks in Montana using locally available materials.

DOT National Transportation Integrated Search

2005-03-01

"The Montana Department of Transportation (MDT) is performing research to develop a cost-effective, indigenous highperformance : concrete (HPC) for use in bridge deck applications. The investigation was divided into two tasks: 1) : identification of ...

75 FR 56627 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

..., IYR, MDT, MGM, NLY, NVDA, NWSA, ORCL, PFE, QCOM, QQQQ, SBUX, SH, SLV, SMH, SSO, SYMC, TBT, TSM, TXN... order routing behavior that selects CBSX as the first destination. The changes will take effect on...

Vaginal Construction and Treatment Providers' Experiences: A Qualitative Analysis.

PubMed

Roen, Katrina; Creighton, Sarah M; Hegarty, Peter; Liao, Lih-Mei

2018-06-01

To investigate specialist clinicians' experiences of treating vaginal agenesis. Semi-structured interviews. Twelve hospitals in Britain and Sweden. Thirty-two health professionals connected to multidisciplinary teams (MDTs) including medical specialists and psychologists. Theoretical thematic analysis of recorded verbatim data. The gynecologist and psychologist interviewees share certain observations including the importance of psychological readiness for and appropriate timing of treatment. Three overlapping themes are identified in our theoretical analysis of the MDT clinicians' talk: (1) the stigma of vaginal agenesis and the pressure to be "normal" can lead patients to minimize the time, effort, physical discomfort, and emotional cost inherent in treatment. (2) Under pressure, treatment might be presented to patients with insufficient attention to the potential psychological effect of the language used. Furthermore, the opportunity to question what is "normal" in sex is generally not taken up. It can be challenging to help the women to transcend their medicalized experiences to come to experiencing their bodies as sexual and enjoyable. (3) The reality of treatment demands, which are not always adequately processed before treatment, can lead to discontinuation and even disengagement with services. The MDT clinicians in this study emphasized the importance of psychological input in vaginal construction. However, such input should proactively question social norms about how women's genitalia should appear and function. Furthermore, rather than steering patients (back) to treatment, the entire MDT could more explicitly question social norms and help the women to do the same. By shifting the definition of success from anatomy to personal agency, the clinical focus is transformed from treatment to women. Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Comparison between geodetic and oceanographic approaches to estimate mean dynamic topography for vertical datum unification: evaluation at Australian tide gauges

NASA Astrophysics Data System (ADS)

Filmer, M. S.; Hughes, C. W.; Woodworth, P. L.; Featherstone, W. E.; Bingham, R. J.

2018-04-01

The direct method of vertical datum unification requires estimates of the ocean's mean dynamic topography (MDT) at tide gauges, which can be sourced from either geodetic or oceanographic approaches. To assess the suitability of different types of MDT for this purpose, we evaluate 13 physics-based numerical ocean models and six MDTs computed from observed geodetic and/or ocean data at 32 tide gauges around the Australian coast. We focus on the viability of numerical ocean models for vertical datum unification, classifying the 13 ocean models used as either independent (do not contain assimilated geodetic data) or non-independent (do contain assimilated geodetic data). We find that the independent and non-independent ocean models deliver similar results. Maximum differences among ocean models and geodetic MDTs reach >150 mm at several Australian tide gauges and are considered anomalous at the 99% confidence level. These differences appear to be of geodetic origin, but without additional independent information, or formal error estimates for each model, some of these errors remain inseparable. Our results imply that some ocean models have standard deviations of differences with other MDTs (using geodetic and/or ocean observations) at Australian tide gauges, and with levelling between some Australian tide gauges, of ˜ ± 50 mm . This indicates that they should be considered as an alternative to geodetic MDTs for the direct unification of vertical datums. They can also be used as diagnostics for errors in geodetic MDT in coastal zones, but the inseparability problem remains, where the error cannot be discriminated between the geoid model or altimeter-derived mean sea surface.

Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case–cohort study

PubMed Central

Maher, Toby M.; Kolb, Martin; Poletti, Venerino; Nusser, Richard; Richeldi, Luca; Vancheri, Carlo; Wilsher, Margaret L.; Antoniou, Katerina M.; Behr, Jüergen; Bendstrup, Elisabeth; Brown, Kevin; Calandriello, Lucio; Corte, Tamera J.; Crestani, Bruno; Flaherty, Kevin; Glaspole, Ian; Grutters, Jan; Inoue, Yoshikazu; Kokosi, Maria; Kondoh, Yasuhiro; Kouranos, Vasileios; Kreuter, Michael; Johannson, Kerri; Judge, Eoin; Ley, Brett; Margaritopoulos, George; Martinez, Fernando J.; Molina-Molina, Maria; Morais, António; Nunes, Hilario; Raghu, Ganesh; Ryerson, Christopher J.; Selman, Moises; Spagnolo, Paolo; Taniguchi, Hiroyuki; Tomassetti, Sara; Valeyre, Dominique; Wijsenbeek, Marlies; Wuyts, Wim; Hansell, David; Wells, Athol

2017-01-01

We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts. A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (κw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the C-index. A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (κw=0.65, IQR 0.53–0.72, p<0.0001) than academic physicians (κw=0.56, IQR 0.45–0.65, p<0.0001) or physicians with access to multidisciplinary team (MDT) meetings (κw=0.54, IQR 0.45–0.64, p<0.0001). The prognostic accuracy of academic physicians with >20 years of experience (C-index=0.72, IQR 0.0–0.73, p=0.229) and non-university hospital physicians with more than 20 years of experience, attending weekly MDT meetings (C-index=0.72, IQR 0.70–0.72, p=0.052), did not differ significantly (p=0.229 and p=0.052 respectively) from the expert panel (C-index=0.74 IQR 0.72–0.75). Experienced respiratory physicians at university-based institutions diagnose IPF with similar prognostic accuracy to IPF experts. Regular MDT meeting attendance improves the prognostic accuracy of experienced non-university practitioners to levels achieved by IPF experts. PMID:28860269

Introduction of a new ward round approach in a cardiothoracic critical care unit.

PubMed

Shaughnessy, Liz; Jackson, Jo

2015-07-01

Francis (2013) described inconsistent ward rounds and failures to conduct ward rounds properly as contributing factors to the poor care seen at the Mid Staffordshire Foundation Trust. He suggested that the absence of a nurse at the bedside had clear consequences for communication, ward round efficiency and patient safety. He recommended that nurses should be actively involved in ward rounds and linked this to high quality patient care. To share an experience of introducing a ward round checklist, a bedside nurse verbal summary and the development of standard operating procedure for Ward Rounds in cardiothoracic critical care unit to improve patient safety and care. Semi structured interviews of six registered nurses. A questionnaire to 69 registered nurses. An electronic questionnaire sent to 23 members of the MDT. An observational audit of seven ward rounds reviewing 69 patients. 97% of nurses agreed that verbal summarizing had improved clarity and 90% felt that it had improved patient care. 87% of the MDT respondents stated that they had noticed an improvement in the attendance of the bedside nurse at the ward round review. The ward round checklist reduced omissions. Communication with patients during ward rounds was an area which needed to be improved. The introduction of a new ward round approach and audit of its practice has enabled an improvement in the quality of patient care by: Giving more opportunity for the nurse to participate and feel part of the ward round. Reduction of omissions through the use of a ward round checklist. Improved clarity among the MDT by the use of bedside nurse verbal summarizing of the plan of care. Nurses' full participation in ward rounds is essential to ensure effective communication and enhance patient safety. © 2015 British Association of Critical Care Nurses.

Rectal cancer staging: focus on the prognostic significance of the findings described by high-resolution magnetic resonance imaging

PubMed Central

2013-01-01

Abstract High-resolution (HR) magnetic resonance imaging (MRI) has become an indispensable tool for multidisciplinary teams (MDTs) addressing rectal cancer. It provides anatomic information for surgical planning and allows patients to be stratified into different groups according to the risk of local and distant recurrence. One of the objectives of the MDT is the preoperative identification of high-risk patients who will benefit from neoadjuvant treatment. For this reason, the correct evaluation of the circumferential resection margin (CRM), the depth of tumor spread beyond the muscularis propria, extramural vascular invasion and nodal status is of the utmost importance. Low rectal tumors represent a special challenge for the MDT, because decisions seek a balance between oncologic safety, in the pursuit of free resection margins, and the patient’s quality of life, in order to preserve sphincter function. At present, the exchange of information between the different specialties involved in dealing with patients with rectal cancer can rank the contribution of colleagues, auditing their work and incorporating knowledge that will lead to a better understanding of the pathology. Thus, beyond the anatomic description of the images, the radiologist’s role in the MDT makes it necessary to know the prognostic value of the findings that we describe, in terms of recurrence and survival, because these findings affect decision making and, therefore, the patients’ life. In this review, the usefulness of HR MRI in the initial staging of rectal cancer and in the evaluation of neoadjuvant treatment, with a focus on the prognostic value of the findings, is described as well as the contribution of HR MRI in assessing patients with suspected or confirmed recurrence of rectal cancer. PMID:23876415

Rectal cancer staging: focus on the prognostic significance of the findings described by high-resolution magnetic resonance imaging.

PubMed

Dieguez, Adriana

2013-07-22

High-resolution (HR) magnetic resonance imaging (MRI) has become an indispensable tool for multidisciplinary teams (MDTs) addressing rectal cancer. It provides anatomic information for surgical planning and allows patients to be stratified into different groups according to the risk of local and distant recurrence. One of the objectives of the MDT is the preoperative identification of high-risk patients who will benefit from neoadjuvant treatment. For this reason, the correct evaluation of the circumferential resection margin (CRM), the depth of tumor spread beyond the muscularis propria, extramural vascular invasion and nodal status is of the utmost importance. Low rectal tumors represent a special challenge for the MDT, because decisions seek a balance between oncologic safety, in the pursuit of free resection margins, and the patient's quality of life, in order to preserve sphincter function. At present, the exchange of information between the different specialties involved in dealing with patients with rectal cancer can rank the contribution of colleagues, auditing their work and incorporating knowledge that will lead to a better understanding of the pathology. Thus, beyond the anatomic description of the images, the radiologist's role in the MDT makes it necessary to know the prognostic value of the findings that we describe, in terms of recurrence and survival, because these findings affect decision making and, therefore, the patients' life. In this review, the usefulness of HR MRI in the initial staging of rectal cancer and in the evaluation of neoadjuvant treatment, with a focus on the prognostic value of the findings, is described as well as the contribution of HR MRI in assessing patients with suspected or confirmed recurrence of rectal cancer.

A multidisciplinary audit of clinical coding accuracy in otolaryngology: financial, managerial and clinical governance considerations under payment-by-results.

PubMed

Nouraei, S A R; O'Hanlon, S; Butler, C R; Hadovsky, A; Donald, E; Benjamin, E; Sandhu, G S

2009-02-01

To audit the accuracy of otolaryngology clinical coding and identify ways of improving it. Prospective multidisciplinary audit, using the 'national standard clinical coding audit' methodology supplemented by 'double-reading and arbitration'. Teaching-hospital otolaryngology and clinical coding departments. Otolaryngology inpatient and day-surgery cases. Concordance between initial coding performed by a coder (first cycle) and final coding by a clinician-coder multidisciplinary team (MDT; second cycle) for primary and secondary diagnoses and procedures, and Health Resource Groupings (HRG) assignment. 1250 randomly-selected cases were studied. Coding errors occurred in 24.1% of cases (301/1250). The clinician-coder MDT reassigned 48 primary diagnoses and 186 primary procedures and identified a further 209 initially-missed secondary diagnoses and procedures. In 203 cases, patient's initial HRG changed. Incorrect coding caused an average revenue loss of 174.90 pounds per patient (14.7%) of which 60% of the total income variance was due to miscoding of a eight highly-complex head and neck cancer cases. The 'HRG drift' created the appearance of disproportionate resource utilisation when treating 'simple' cases. At our institution the total cost of maintaining a clinician-coder MDT was 4.8 times lower than the income regained through the double-reading process. This large audit of otolaryngology practice identifies a large degree of error in coding on discharge. This leads to significant loss of departmental revenue, and given that the same data is used for benchmarking and for making decisions about resource allocation, it distorts the picture of clinical practice. These can be rectified through implementing a cost-effective clinician-coder double-reading multidisciplinary team as part of a data-assurance clinical governance framework which we recommend should be established in hospitals.

Radiotherapy access in Belgium: How far are we from evidence-based utilisation?

PubMed

Lievens, Y; De Schutter, H; Stellamans, K; Rosskamp, M; Van Eycken, L

2017-10-01

Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed. AUPs and advised radiotherapy were calculated overall and by cancer type for 110,810 unique cancer diagnoses in 2009-2010. Radiotherapy utilisation was derived from reimbursement data and distinguished between palliative and curative intent external beam radiotherapy (EBRT) and/or brachytherapy (BT). Sensitivity analyses regarding the influence of the follow-up period, the survival length and patient's age were performed. Advised radiotherapy was calculated based on broad treatment categories as reported at MDT meetings. The overall AUP of 37% (39% including BT) was lower than the OUP of 53%, but in line with advised radiotherapy (35%). Large variations by tumour type were observed: in some tumours (e.g. lung and prostate cancer) AUP was considerably lower than OUP, whereas in others there was reasonable concordance (e.g. breast and rectal cancer). Overall, 84% of treatments started within 9 months following diagnosis. Survival time influenced AUP in a cancer type-dependent way. Elderly patients received less radiotherapy. Although the actually delivered radiotherapy in Belgium aligns well to MDT advices, it is lower than the evidence-based optimum. Further analysis of potential barriers is needed for radiotherapy forecasting and planning, and in order to promote adequate access to radiotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Mediator Kinase Module Restrains Epidermal Growth Factor Receptor Signaling and Represses Vulval Cell Fate Specification in Caenorhabditis elegans.

PubMed

Grants, Jennifer M; Ying, Lisa T L; Yoda, Akinori; You, Charlotte C; Okano, Hideyuki; Sawa, Hitoshi; Taubert, Stefan

2016-02-01

Cell signaling pathways that control proliferation and determine cell fates are tightly regulated to prevent developmental anomalies and cancer. Transcription factors and coregulators are important effectors of signaling pathway output, as they regulate downstream gene programs. In Caenorhabditis elegans, several subunits of the Mediator transcriptional coregulator complex promote or inhibit vulva development, but pertinent mechanisms are poorly defined. Here, we show that Mediator's dissociable cyclin dependent kinase 8 (CDK8) module (CKM), consisting of cdk-8, cic-1/Cyclin C, mdt-12/dpy-22, and mdt-13/let-19, is required to inhibit ectopic vulval cell fates downstream of the epidermal growth factor receptor (EGFR)-Ras-extracellular signal-regulated kinase (ERK) pathway. cdk-8 inhibits ectopic vulva formation by acting downstream of mpk-1/ERK, cell autonomously in vulval cells, and in a kinase-dependent manner. We also provide evidence that the CKM acts as a corepressor for the Ets-family transcription factor LIN-1, as cdk-8 promotes transcriptional repression by LIN-1. In addition, we find that CKM mutation alters Mediator subunit requirements in vulva development: the mdt-23/sur-2 subunit, which is required for vulva development in wild-type worms, is dispensable for ectopic vulva formation in CKM mutants, which instead display hallmarks of unrestrained Mediator tail module activity. We propose a model whereby the CKM controls EGFR-Ras-ERK transcriptional output by corepressing LIN-1 and by fine tuning Mediator specificity, thus balancing transcriptional repression vs. activation in a critical developmental signaling pathway. Collectively, these data offer an explanation for CKM repression of EGFR signaling output and ectopic vulva formation and provide the first evidence of Mediator CKM-tail module subunit crosstalk in animals. Copyright © 2016 by the Genetics Society of America.

Annual and semiannual variations of the geomagnetic field at equatorial locations

USGS Publications Warehouse

Campbell, W.H.

1981-01-01

For a year of quiet solar-activity level, geomagnetic records from American hemisphere observatories located between about 0?? and 30?? north geomagnetic latitude were used to compare the annual and semiannual variations of the geomagnetic field associated with three separate contributions: (a) the quiet-day midnight level, MDT; (b) the solar-quiet daily variation, Sq; (c) the quiet-time lunar semidiurnal tidal variation, L(12). Four Fourier spectral constituents (24, 12, 8, 6 h periods) of Sq were individually treated. All three orthogonal elements (H, D and Z) were included in the study. The MDT changes show a dominant semiannual variation having a range of about 7 gammas in H and a dominant annual variation in Z having a range of over 8 gammas. These changes seem to be a seasonal response to the nightside distortions by magnetospheric currents. There is a slow decrease in MDT amplitudes with increasing latitude. The Sq changes follow the patterns expected from an equatorial ionospheric dynamo electrojet current system. The dominant seasonal variations occur in H having a range of over 21 gammas for the 24 h period and over 12 gammas for the 12 h period spectral components. The higher-order components are relatively smaller in size. The Sq(H) amplitudes decrease rapidly with increasing latitude. Magnetospheric contributions to the equatorial Sq must be less than a few per cent of the observed magnitude. The L(12) variation shows the ionospheric electrojet features by the dominance of H and the rapid decrease in amplitude with latitude away from the equator. However, the seasonal variation range of over 7 gammas has a maximum in early February and minimum in late June that is not presently explainable by the known ionospheric conductivity and tidal behavior. ?? 1981.

Value of Supraregional Multidisciplinary Review for the Contemporary Management of Testicular Tumors.

PubMed

Purshouse, Karin; Watson, Robert A; Church, David N; Richardson, Charlotte; Crane, Gemma; Traill, Zoe; Sullivan, Mark; Roberts, Ian; Browning, Lisa; Turner, Gareth; Parameshwaran, Vishnu; Johnson, Joseph; Chitnis, Meenali; Protheroe, Andrew; Verrill, Clare

2017-02-01

Testicular cancers are an uncommon and highly curable group of tumors that are typically managed by specialist multidisciplinary teams (MDTs). Although recent guidelines have emphasized the importance of tumor prognostic factors in predicting recurrence and personalizing therapy in early-stage disease, the role of central pathology review in determining these factors is unclear. We compared the referral histopathology reports with those obtained after expert central review for all cases reviewed by the UK Thames Valley Cancer Network testicular tumor MDT from August 2004 to September 2012. For cases in which the findings differed, we recorded the effect of the alteration on the estimates of patient prognosis and predicted clinical management using international (European Society of Medical Oncology [ESMO]) and local guidelines. The histopathology reports were altered after central review in 129 of 465 cases (27.7%) referred to the testicular tumor MDT during the study period. These resulted in changes in the estimation of prognosis for 42 patients (9.0% total), with a predicted affect on management according to the ESMO guidelines in 30 cases (6.5%). These proportions were broadly similar for both seminoma and nonseminoma, although the reasons for the discrepancies differed between the 2 (principally errors in categorization of rete testis invasion in seminoma and of lymphovascular invasion in nonseminoma). Changes to the tumor type were uncommon (2 cases). Central MDT review results in frequent, clinically relevant alterations to testicular tumor histopathology reports for testicular tumors. The results of our study demonstrate the importance of specialist MDTs to inform patient-centered care and ensure best practice in the management of these uncommon cancers. Copyright © 2016 Elsevier Inc. All rights reserved.

Progression of leprosy disability after discharge: is multidrug therapy enough?

PubMed Central

Sales, Anna Maria; Campos, Dayse Pereira; Hacker, Mariana Andrea; da Costa Nery, José Augusto; Düppre, Nádia Cristina; Rangel, Emanuel; Sarno, Euzenir Nunes; Penna, Maria Lucia Fernandes

2013-01-01

Objective To evaluate the risk factors related to worsening of physical disabilities after treatment discharge among patients with leprosy administered 12 consecutive monthly doses of multidrug therapy (MDT/WHO). Methods Cohort study was carried out at the Leprosy Laboratory in Rio de Janeiro, Brazil. We evaluated patients with multibacillary leprosy treated (MDT/WHO) between 1997 and 2007. The Cox proportional hazards model was used to estimate the relationship between the onset of physical disabilities after release from treatment and epidemiological and clinical characteristics. Results The total observation time period for the 368 patients was 1 570 person-years (PY), averaging 4.3 years per patient. The overall incidence rate of worsening of disability was 6.5/100 PY. Among those who began treatment with no disability, the incidence rate of physical disability was 4.5/100 PY. Among those who started treatment with Grade 1 or 2 disabilities, the incidence rate of deterioration was 10.5/100 PY. The survival analysis evidenced that when disability grade was 1, the risk was 1.61 (95% CI: 1.02–2.56), when disability was 2, the risk was 2.37 (95% CI 1.35–4.16), and when the number of skin lesions was 15 or more, an HR = 1.97 (95% CI: 1.07–3.63). Patients with neuritis showed a 65% increased risk of worsening of disability (HR = 1.65 [95% CI: 1.08–2.52]). Conclusion Impairment at diagnosis was the main risk factor for neurological worsening after treatment/MDT. Early diagnosis and prompt treatment of reactional episodes remain the main means of preventing physical disabilities. PMID:23937704

γ-Aminobutyric acid (GABA) oral rinse reduces capsaicin-induced burning mouth pain sensation: An experimental quantitative sensory testing study in healthy subjects.

PubMed

Zhang, Y; Wang, K; Arendt-Nielsen, L; Cairns, B E

2018-02-01

In burning mouth patients, analgesia after oral administration of clonazepam may result from modulation of peripheral γ-aminobutyric acid (GABA) receptors. The effect of oral administration of test solutions (water, 0.5 mol/L or 0.05 mol/L GABA, 1% lidocaine) was investigated for the amelioration of pain and sensitivity induced by application of capsaicin (1%, 2 min) to the tongue of thirty healthy male and female subjects in this four-session, randomized, placebo-controlled, double-blinded, cross-over study. Intra-oral quantitative sensory testing was used to assess cold (CDT), warm (WDT) and mechanical (MDT) detection thresholds as well as mechanical (MPT) and heat (HPT) pain thresholds. Capsaicin-induced pain intensity was continuously rated on a 0-10 electronic visual analogue scale (VAS). The area under the VAS curve (VASAUC) after rinsing was calculated for each solution. Capsaicin application on the tongue evoked burning pain with a peak of 4.8/10, and significantly increased CDT and MDT while significantly decreasing WDT, HPT, and MPT. The VASAUC was significantly smaller after oral rinse with 0.05 mol/L GABA, 0.5 mol/L GABA, and 1% lidocaine than after oral rinse with water. Rinse with 0.5 mol/L or 0.05 mol/L GABA were similarly effective in decreasing VASAUC. Rinsing with either 1% lidocaine, 0.5 mol/L or 0.05 mol/L GABA also significantly attenuated the effects of capsaicin on WDT and HPT in a treatment independent manner. There were no sex-related differences in these effects of GABA. Capsaicin-induced burning tongue pain and decreases in WDT and HPT can be ameliorated by rinsing the mouth with lidocaine and GABA solutions. Rinsing the mouth with an oral GABA containing solution ameliorated burning pain and increased heat sensitivity produced by application of capsaicin to the tongue. This finding suggests that GABA can act as a local analgesic agent in the oral cavity. © 2017 European Pain Federation - EFIC®.

Sourcing made easy.

PubMed

2005-09-01

MDT Sourcing is a free online service for buyers seeking the range of services used in the design, manufacture and marketing of finished medical devices. Take up of the service has been good since its launch earlier this year. Some of the latest requests for quotations are outlined here.

Research management peer exchange hosted by the Montana Department of Transportation, May 4-8, 1997.

DOT National Transportation Integrated Search

1997-05-01

The objectives of the peer exchange process were to: : learn how the Montana Department of Transportation manages and conducts research; : share information among members of the exchange team and customers of MDT Research : involved in the pe...

Montana Department of Transportation Research Peer Exchange : Implementation, Performance Measures, and the Value of Research

DOT National Transportation Integrated Search

2018-01-01

The Montana Department of Transportation (MDT) Research Program hosted a peer exchange in Helena, Montana, from September 12-14, 2017. The objective for the peer exchange was to explore best practices on implementation, performance measures, and the ...

78 FR 42551 - Sunshine Act Meeting Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

....m., MDT, and it will be followed by the meeting of the Board of Directors which will commence..., 2013 1. Governance and Performance Review 8:30 a.m. Committee 2. Board of Directors \\*\\ Please note... business 10. Consider and act on adjournment of meeting [[Page 42552

Numerical simulation of magnetic nanoparticles targeting in a bifurcation vessel

NASA Astrophysics Data System (ADS)

Larimi, M. M.; Ramiar, A.; Ranjbar, A. A.

2014-08-01

Guiding magnetic iron oxide nanoparticles with the help of an external magnetic field to its target is the principle behind the development of super paramagnetic iron oxide nanoparticles (SPIONs) as novel drug delivery vehicles. The present paper is devoted to study on MDT (Magnetic Drug Targeting) technique by particle tracking in the presence of magnetic field in a bifurcation vessel. The blood flow in bifurcation is considered incompressible, unsteady and Newtonian. The flow analysis applies the time dependent, two dimensional, incompressible Navier-Stokes equations for Newtonian fluids. The Lagrangian particle tracking is performed to estimate particle behavior under influence of imposed magnetic field gradients along the bifurcation. According to the results, the magnetic field increased the volume fraction of particle in target region, but in vessels with high Reynolds number, the efficiency of MDT technique is very low. Also the results showed that in the bifurcation vessels with lower angles, wall shear stress is higher and consequently the risk of the vessel wall rupture increases.

TELEMAM: a cluster randomised trial to assess the use of telemedicine in multi-disciplinary breast cancer decision making.

PubMed

Kunkler, I H; Prescott, R J; Lee, R J; Brebner, J A; Cairns, J A; Fielding, R G; Bowman, A; Neades, G; Walls, A D F; Chetty, U; Dixon, J M; Smith, M E; Gardner, T W; Macnab, M; Swann, S; Maclean, J R

2007-11-01

The TELEMAM trial aimed to assess the clinical effectiveness and costs of telemedicine in conducting breast cancer multi-disciplinary meetings (MDTs). Over 12 months 473 MDT patient discussions in two district general hospitals (DGHs) were cluster randomised (2:1) to the intervention of telemedicine linkage to breast specialists in a cancer centre or to the control group of 'in-person' meetings. Primary endpoints were clinical effectiveness and costs. Economic analysis was based on a cost-minimisation approach. Levels of agreement of MDT members on a scale from 1 to 5 were high and similar in both the telemedicine and standard meetings for decision sharing (4.04 versus 4.17), consensus (4.06 versus 4.20) and confidence in the decision (4.16 versus 4.07). The threshold at which the telemedicine meetings became cheaper than standard MDTs was approximately 40 meetings per year. Telemedicine delivered breast cancer multi-disciplinary meetings have similar clinical effectiveness to standard 'in-person' meetings.

Using drawing tests to explore the multidimensional psychological aspects of children with cancer.

PubMed

Hatano, Yutaka; Yamada, Miwa; Nakagawa, Kanae; Nanri, Hiromi; Kawase, Masatoshi; Fukui, Kenji

2014-10-01

In seeking to understand how life-threatening illness affects children psychologically, projective testing may be beneficial, particularly when attempting to identify psychological problems in younger adolescents. The advantages of projective testing are that it does not depend on patients' verbal ability and is not invasive. Three cancer inpatients from Kyoto Prefectural University of Medicine, aged between 10 and 16 years old, participated in the study. Projective testing was used to measure the depth of participants' distress and included a tree-drawing test, a person-drawing test and a free drawing test. Results from the tree- and person-drawing tests indicated energy loss, anxiety and a sense of emptiness. However, results from the free drawing test suggested that the children had hope and a desire to recover from their illness. The combination of drawing tests in this study may increase the understanding of the internal psychological difficulties faced by children hospitalized with cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

28. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

28. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. AIR COOLED TEST STAND. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

Montachusett Area Regional Transit Authority (MART) automatic vehicle location and mobile data terminal (AVL/MDT) pilot program report

DOT National Transportation Integrated Search

2003-02-14

The Montachusett Area Regional Transit Authority (MART) MART was established in 1978 to provide public transportation to the 18 Massachusetts communities. MART fixed-route service operates with 26 buses. Its paratransit services are more extensive, a...

25. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

25. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. ELEVATIONS, RIGHT AND LEFT PORTIONS, TEST CELLS 5-12. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

24. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

24. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. ELEVATIONS, CENTRAL PORTION AND TEST CELLS 1-4. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

26. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

26. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. CROSS-SECTION, CENTRAL PORTION AND TEST CELLS 1-4. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

9. Credit JPL. Photographic copy of drawing, engineering drawing showing ...

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

9. Credit JPL. Photographic copy of drawing, engineering drawing showing structure of Test Stand 'A' (Building 4202/E-3) and its relationship to the Monitor Building or blockhouse (Building 4203/E-4) when a reinforced concrete machinery room was added to the west side of Test Stand 'A' in 1955. California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering 'Electrical Layout - Muroc, Test Stand & Refrigeration Equipment Room,' drawing no. E3/7-0, April 6, 1955. - Jet Propulsion Laboratory Edwards Facility, Test Stand A, Edwards Air Force Base, Boron, Kern County, CA

Mentored Discussions of Teaching: An Introductory Teaching Development Program for Future STEM Faculty

ERIC Educational Resources Information Center

Baiduc, Rachael R.; Linsenmeier, Robert A.; Ruggeri, Nancy

2016-01-01

Today's science, technology, engineering, and mathematics (STEM) graduate students and postdoctoral fellows are tomorrow's new faculty members; but these junior academicians often receive limited pedagogical training. We describe four iterations of an entry-level program with a low time commitment, Mentored Discussions of Teaching (MDT). The…

Family Mode Deactivation Therapy Results and Implications

ERIC Educational Resources Information Center

Apsche, Jack A.; Bass, Christopher K.

2006-01-01

This article highlights the inclusion of Mode Deactivation Therapy as a treatment modality for families in crisis. As an empirically validated treatment, Mode Deactivation Therapy has been effective in treating a wide variety of psychological issues. Mode Deactivation Therapy, (MDT) was developed to treat adolescents with disorders of conduct…

Mediation Analysis of Mode Deactivation Therapy (Reanalysis and Interpretation)

ERIC Educational Resources Information Center

Bass, Christopher K.; Apsche, Jack A.

2013-01-01

A key component of Mode Deactivation Therapy (MDT) is the development of self-awareness and regulatory skills by the client with the aim of helping adolescent males with conduct disordered behaviors, including sexually inappropriate behaviors and emotional dysregulation. The goal includes altering specific behaviors to fall within socially…

Chemoinformetrical evaluation of dissolution property of indomethacin tablets by near-infrared spectroscopy.

PubMed

Otsuka, Makoto; Tanabe, Hideaki; Osaki, Kazuo; Otsuka, Kuniko; Ozaki, Yukihiro

2007-04-01

The purpose of this study was to use near-infrared spectrometry (NIR) with chemoinformetrics to predict the change of dissolution properties in indomethacin (IMC) tablets during the manufacturing process. A comparative evaluation of the dissolution properties of the tablets was performed by the diffused reflectance (DRNIR) and transmittance (TNIR) NIR spectroscopic methods. Various kinds of IMC tablets (200 mg) were obtained from a powder (20 mg of IMC, 18 mg of microcrystalline cellulose, 160 mg of lactose, and 2 mg of magnesium stearate) under various compression pressures (60-398 MPa). Dissolution tests were performed in phosphate buffer, and the time required for 75% dissolution (T75) and mean dissolution time (MDT) were calculated. DRNIR and TNIR spectra were recorded, and the both NIR spectra used to establish a calibration model for predicting the dissolution properties by principal component regression analysis (PCR). The T75 and MDT increased as the compression pressure increased, since tablet porosity decreased with increasing pressure. Intensity of the DRNIR spectra of the compressed tablets decreased as the compression pressure increased. However, the intensity of TNIR spectra increased along with the pressure. The calibration models used to evaluate the dissolution properties of tablets were established by using PCR based on both DRNIR and TNIR spectra of the tablets. The multiple correlation coefficients of the relationship between the actual and predictive T75 by the DRNIR and TNIR methods were 0.831 and 0.962, respectively. It is possible to predict the dissolution properties of pharmaceutical preparations using both DRNIR and TNIR chemoinformetric methods. The TNIR method was more accurate for predictions of the dissolution behavior of tablets than the DRNIR method. (c) 2007 Wiley-Liss, Inc.

The Mobile Dosimetric Telescope - A Small Size Active Personal Dosimeter for Application at High Altitudes and Onboard the International Space Station

NASA Astrophysics Data System (ADS)

Ritter, B.; Marsalek, K.; Berger, T.; Burmeister, S.; Reitz, G.; Heber, B.

2012-12-01

The radiation environment at cruising altitudes, as well as in Low Earth Orbit - like on the International Space Station - differs significantly from the natural radiation environment on Earth. Especially in Low Earth Orbit it poses one of the main health risks for long duration human missions. Therefore, it is essential to monitor the properties of the radiation field in such environments. The Mobile Dosimetric Telescope MDT, is a small size battery driven personal dosimeter based on silicon detector technology that has been developed to observe absorbed dose and dose rate in real time. Two silicon diodes are arranged in a telescope configuration, which allows the measurement of the ionizing constituents of the radiation field and partially the neutral contribution to the dose. The absorbed dose is obtained by considering every particle in either of the detectors. Particles traversing both diodes are detected as coincidence events that enable to derive linear energy transfer (LET) spectra. From these the quality factor of the field is determined, which is necessary for the estimation of the dose equivalent. The detection range of the device covers energy depositions from minimal ionizing particles up to relativistic heavy ions. Calibrations of the detector system have been performed with various radioactive sources and with heavy ions at the Heavy Ion Medical Accelerator (HIMAC) facility at the National Institute for Radiological Sciences (NIRS) in Chiba, Japan. Additionally, the MDT has been successfully tested onboard aircraft. The results of these measurements are in good agreement with those from other radiation detectors. The presentation will focus on data taken during long haul flights in the northern hemisphere.

Implementing a Pro-forma for Multidisciplinary Management of an Enterocutaneous Fistula: A Case Study.

PubMed

Samad, Sohel; Anele, Chukwuemeka; Akhtar, Mansoor; Doughan, Samer

2015-06-01

Optimal management of patients with an entercocutaneous fistula (ECF) requires utilization of the sepsis, nutrition, anatomy, and surgical procedure (SNAP) protocol. The protocol includes early detection and treatment of sepsis, optimizing patient nutrition through oral and parenteral routes, identifying the fistula anatomy, optimal fistula management, and proceeding to corrective surgery when appropriate. The protocol requires multidisciplinary team (MDT) coordination among surgeons, nurses, dietitians, stoma nurses, and physiotherapists. This case study describes a 70-year-old man who developed an ECF subsequent to a laparotomy for a small bowel obstruction. Following a period of ileus, 16 days post laparotomy the patient developed a high-output (2,000 mL per day) fistula. The patient also became pyrexial with raised inflammatory markers, requiring antibiotic treatment. Following development of his ECF, he was managed using the SNAP protocol for the duration of his admission; however, in implementing this protocol with this patient, clinicians noted fluid charts were inadequate to allow effective management of the variables. Thus, a new pro-forma was created that encompassed fluid balance, nutritional status, and pertinent blood test results, as well as perifistular skin condition, medication, and documentation of management plans from the MDT team. The pro-forma was recorded daily in the patient notes. Following implementation of the pro-forma and the SNAP protocol, the patient recovered well clinically over a period of 4 weeks with a decrease in his fistula output to 300-500 mL per day, and he was discharged with plans for further corrective surgery to resect the fistula and for bowel re-anastomoses. Although fluid charts are readily available, they do not include all pertinent variables for optimal management of patients with an ECF. Further research is needed to validate the pro-forma and evaluate its effect on patient outcomes.

21. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

21. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. SECOND FLOOR PLAN, RIGHT AND LEFT END PORTIONS, TEST CELLS 5-12. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

18. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

18. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. FIRST FLOOR PLAN, CENTRAL PORTION AND TEST CELLS 1-4. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

27. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

27. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. CROSS-SECTION, RIGHT AND LEFT END PORTIONS, TEST CELLS 5-12. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

22. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

22. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. THIRD FLOOR AND ROOF PLAN, CENTRAL PORTION AND TEST CELLS 1-4. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

16. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

16. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. BASEMENT FLOOR PLAN, CENTRAL PORTION AND TEST CELLS 1-4. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

17. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

17. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. BASEMENT FLOOR PLAN, RIGHT AND LEFT END PORTIONS, TEST CELLS 5-12. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

20. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

20. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. SECOND FLOOR PLAN, CENTRAL PORTION AND TEST CELLS 1-4. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

19. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

19. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. FIRST FLOOR PLAN, RIGHT AND LEFT END PORTIONS, TEST CELLS 5-12. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

Cultural and age differences of three groups of Taiwanese young children's creativity and drawing.

PubMed

Wei, Mei-Hue; Dzeng, Annie

2013-06-01

This study investigated the cultural and age effects on children's overall creativity and drawing. 1,055 children ages 6 to 8 from three groups--urban and rural Taiwanese children and Taiwanese children of immigrant mothers, all in public schools--were given a creativity test, a people-drawing test, and a free-drawing test. The results showed that the older Taiwanese children scored higher than the young Taiwanese children on people-drawing and free-drawing, but not overall creativity. Drawing and creativity scores increased in accordance with age. In the six-year-old group, a group difference was found only on the scale of people-drawing. Urban Taiwanese children in the eight-year-old group scored higher than the other two groups of children on creativity and free-drawing. Results are discussed in terms of educational opportunities.

Clock-drawing test and unilateral spatial neglect.

PubMed

Ishiai, S; Sugishita, M; Ichikawa, T; Gono, S; Watabiki, S

1993-01-01

We investigated the ability of 25 patients with left unilateral spatial neglect to make a clock face by putting numbers inside a printed circle. Impairment seen in this clock-drawing test did not parallel neglect severity as judged by results of the line-cancellation and line-bisection tests, as well as the copying of a daisy. The score for clock drawing correlated highly with the verbal WAIS score. Most neglect patients with a verbal IQ of 87 or more could draw a clock face fairly well and used planning in placing the numbers 12, 3, 6, and 9 before the others. In clock drawing, verbal intelligence may compensate for left unilateral spatial neglect. We therefore recommend use of the line-cancellation and line-bisection tests, as well as the copying test, but do not recommend use of the clock-drawing test in the diagnosis of left unilateral spatial neglect.

1. Photographic copy of original engineering drawing for Test Stand ...

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

1. Photographic copy of original engineering drawing for Test Stand 'C.' California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering 'New Test Stand Plan -- Edwards Test Station' drawing no. E18/2-3, 18 January 1957. - Jet Propulsion Laboratory Edwards Facility, Test Stand C, Edwards Air Force Base, Boron, Kern County, CA

23. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

23. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. THIRD FLOOR AND ROOF PLAN, RIGHT AND LEFT END PORTIONS, TEST CELLS 5-12. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

Scoring and Classifying Examinees Using Measurement Decision Theory

ERIC Educational Resources Information Center

Rudner, Lawrence M.

2009-01-01

This paper describes and evaluates the use of measurement decision theory (MDT) to classify examinees based on their item response patterns. The model has a simple framework that starts with the conditional probabilities of examinees in each category or mastery state responding correctly to each item. The presented evaluation investigates: (1) the…

The Incidence of Training-Related Job Placement of Draper Vocational Trainees: A Preliminary Report.

ERIC Educational Resources Information Center

Gwozdecki, Joseph; And Others

A preliminary survey of trainees' pre- and postrelease interactions with the State Employment Service (ES) was conducted by the Experimental Manpower Laboratory for Corrections (EMLC) as part of an overall evaluation of Manpower Development and Training (MDT) program effectiveness at Draper Correctional Center, Elmore, Alabama. Measures of the…

NORAD & U.S. Northern Command

Science.gov Websites

NORAD and USNORTHCOM Change of Command is tomorrow at 9 a.m. MDT. Watch it o... Twitter Logo N&NC Academic Engagement Opportunities N&NC Volunteer Student Internship Program Arctic Edge 2018 Sgt - Because N&NC are joint commands the commander can be from any US military branch. @USArmy@usairforce

Role of the cell envelope stress regulators BaeR and CpxR in control of RND-type multidrug efflux pumps and transcriptional cross talk with exopolysaccharide synthesis in Erwinia amylovora.

PubMed

Pletzer, Daniel; Stahl, Antje; Oja, Anna Elisabeth; Weingart, Helge

2015-08-01

The purpose of this study was to identify the role of the cell envelope stress-sensing systems BaeSR and CpxARP in regulation of multidrug efflux and exopolysaccharide synthesis in Erwinia amylovora. We have previously reported that BaeR activates transcription of the RND-type efflux pumps AcrD and MdtABC. In this study, we found that a cpxR-deficient mutant was highly susceptible to β-lactams, aminoglycosides and lincomycin, whereas a baeR mutant showed no change in antimicrobial sensitivity. However, overexpression of BaeR in a mutant lacking the major RND pump AcrB increased resistance of E. amylovora to several compounds that are not substrates of AcrD or MdtABC. Furthermore, we observed that overexpression of BaeR significantly increased amylovoran production. Moreover, the expression of RND-type efflux pumps was changed in regulatory mutants of exopolysaccharide production. Our data suggest that BaeSR and CpxARP regulate additional mechanisms, beside efflux, which are responsible for antimicrobial resistance of E. amylovora.

The Dynamics of Agglomerated Ferrofluid in Steady and Pulsatile Flows

NASA Astrophysics Data System (ADS)

Williams, Alicia; Stewart, Kelley; Vlachos, Pavlos

2007-11-01

Magnetic Drug Targeting (MDT) is a promising technique to deliver medication via functionalized magnetic particles to target sites in the treatment of diseases. In this work, the physics of steady and pulsatile flows laden with superparamagnetic nanoparticles in a square channel under the influence of a magnetic field induced by a 0.6 Tesla permanent magnet is studied. Herein, the dynamics of ferrofluid shedding from an initially accumulated mass in water are examined through shadowgraph imaging using two orthogonal cameras. Fundamental differences in the ferrofluid behavior occur between the steady and pulsatile flow cases, as expected. For steady flows, vortex ring shedding is visualized from the mass, and periodic shedding occurs only for moderate mass sizes where the shear forces in the flow interact with the magnetic forces. At Reynolds numbers below 500 with pulsatile flow, suction and roll up of the ferrofluid is seen during the low and moderate periods of flow, followed by the ejection of ferrofluid during high flow. These shadowgraphs illustrate the beauty and richness of ferrofluid dynamics, an understanding of which is instrumental to furthering MDT as an effective drug delivery device.

Case report of a pituitary thyrotropin-secreting macroadenoma with Hashimoto thyroiditis and infertility.

PubMed

Li, Jiaqi; Li, Jianwei; Jiang, Shu; Yu, Ruichao; Yu, Yerong

2018-01-01

Thyrotropin-secreting adenoma (TSHoma) is rare, diagnosis and treatment are often delayed if the condition coexists with Hashimoto thyroiditis. The enlarged pituitary adenoma may eventually induce panhypopituitarism, infertility, or the compression of optic nerves and optic chiasma. This patient was a 36-year-old man who had been referred to the pituitary disease multidisciplinary team (MDT) of the West China Hospital, due to infertility. Examinations revealed pituitary thyrotropin-secreting macroadenoma. We conducted trans-sphenoidal surgery. Human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) were used for reproductive reconstruction after surgery. This patient successfully fathered a child. To date, the multidisciplinary team treatment of TSHoma was rare, TSHomas are often misdiagnosed as macroadenomas, because the clinical features are varied and it often takes a long time to be diagnosed. So the purpose of this case report is to attract attention to the manifestation of increased thyroid stimulating hormone (TSH) concentration and discuss MDT treatment for TSH-secreting adenoma. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Drug resistance patterns in Mycobacterium leprae isolates from relapsed leprosy patients attending The Leprosy Mission (TLM) Hospitals in India.

PubMed

Lavania, Mallika; Jadhav, Rupendra S; Chaitanya, Vedithi Sundeep; Turankar, Ravindra; Selvasekhar, Abraham; Das, Loretta; Darlong, Famkima; Hambroom, Ujjwal K; Kumar, Sandip; Sengupta, Utpal

2014-09-01

Implementation of multidrug therapy (MDT) in leprosy control programmes has significantly reduced the global prevalence of the disease in the last two decades. After many years of use of MDT, it is expected that drug resistance in Mycobacterium leprae may emerge. This is a major concern, especially during the stage of elimination. In the present study, slit-skin smears were collected from 140 leprosy relapse cases from different Leprosy Mission hospitals across India. DNA extracted from 111 (79%) of these samples was analysed for the genes associated with drug resistance in M. leprae. More than 90% of the patients relapsed as multibacillary (MB) cases. In our study, four (3.6%) of the DNA samples analysed showed mutations associated with rifampicin resistance. We also observed that mutations associated with resistance to dapsone and ofloxacin were observed in 9 (8.1%) of the DNA samples each; two samples had both dapsone and ofloxacin resistance. Further surveillance and appropriate interventions are needed to ensure the continued success of chemotherapy for leprosy.

Exploratory study of the relations between spatial ability and drawing from memory.

PubMed

Czarnolewski, Mark Y; Eliot, John

2012-04-01

Test scores of 119 students, attending either a public four-year college or a technical school, were related to their proportionality and detail drawing scores on the Memory for Designs Test. In regression models, the ETS Maze Tracing, Eliot-Price Mental Rotations, and Bender-Gestalt tests were consistent predictors of proportionality scores, with the latter two tests uniquely related to these. The ETS Shapes Memory Test and the Form Board Test were the strongest predictors for detail accuracy scores. The Shapes test predicted proportionality when the CTY Visual Memory Test BB was excluded. The models then provided support for the hypothesis that drawing designs from memory, a critical skill in drawing, regardless of whether one focuses on accuracy for proportionality scores or for detail scores, is jointly related to the measures of recognition, production, and traditional spatial ability measures. This study identified multifaceted skills in drawing from memory.

Silver Drawing Test of Cognitive Skills and Adjustment. Drawing What You Predict, What You See, and What You Imagine.

ERIC Educational Resources Information Center

Silver, Rawley

This manual is a revision of the manual originally published in 1983. Since then it has been discovered that stimulus drawing tasks, like the Drawing from Imagination subtest of the Silver Drawing Test of Cognitive and Creative Skills (SDT), can be used to screen for depression and emotional adjustment. New research findings are the basis for…

Visuoconstructional Impairment in Subtypes of Mild Cognitive Impairment

PubMed Central

Ahmed, Samrah; Brennan, Laura; Eppig, Joel; Price, Catherine C.; Lamar, Melissa; Delano-Wood, Lisa; Bangen, Katherine J.; Edmonds, Emily C.; Clark, Lindsey; Nation, Daniel A.; Jak, Amy; Au, Rhoda; Swenson, Rodney; Bondi, Mark W.; Libon, David J.

2018-01-01

Clock Drawing Test performance was examined alongside other neuropsychological tests in mild cognitive impairment (MCI). We tested the hypothesis that clock-drawing errors are related to executive impairment. The current research examined 86 patients with MCI for whom, in prior research, cluster analysis was used to sort patients into dysexecutive (dMCI, n=22), amnestic (aMCI, n=13), and multi-domain (mMCI, n=51) subtypes. First, principal components analysis (PCA) and linear regression examined relations between clock-drawing errors and neuropsychological test performance independent of MCI subtype. Second, between-group differences were assessed with analysis of variance (ANOVA) where MCI subgroups were compared to normal controls (NC). PCA yielded a 3-group solution. Contrary to expectations, clock-drawing errors loaded with lower performance on naming/lexical retrieval, rather than with executive tests. Regression analyses found increasing clock-drawing errors to command were associated with worse performance only on naming/lexical retrieval tests. ANOVAs revealed no differences in clock-drawing errors between dMCI versus mMCI or aMCI versus NCs. Both the dMCI and mMCI groups generated more clock-drawing errors than the aMCI and NC groups in the command condition. In MCI, language-related skills contribute to clock-drawing impairment. PMID:26397732

Screening for cognitive dysfunction in Huntington's disease with the clock drawing test.

PubMed

Terwindt, Paul W; Hubers, Anna A M; Giltay, Erik J; van der Mast, Rose C; van Duijn, Erik

2016-09-01

The aim of the study is to investigate the performance of the clock drawing test as a screening tool for cognitive impairment in Huntington's disease (HD) mutation carriers. The performance of the clock drawing test was assessed in 65 mutation carriers using the Shulman and the Freund scoring systems. The mini-mental state examination, the Symbol Digit Modalities Test, the Verbal Fluency Test, and the Stroop tests were used as comparisons for the evaluation of cognitive functioning. Correlations of the clock drawing test with various cognitive tests (convergent validity), neuropsychiatric characteristics (divergent validity) and clinical characteristics were analysed using the Spearman's rank correlation coefficient. Receiver-operator characteristic analyses were performed for the clock drawing test against both the mini-mental state examination and against a composite variable for executive cognitive functioning to assess optimal cut-off scores. Inter-rater reliability was high for both the Shulman and Freund scoring systems (ICC = 0.95 and ICC = 0.90 respectively). The clock drawing tests showed moderate to high correlations with the composite variable for executive cognitive functioning (mean ρ = 0.75) and weaker correlations with the mini-mental state examination (mean ρ = 0.62). Mean sensitivity of the clock drawing tests was 0.82 and mean specificity was 0.79, whereas the mean positive predictive value was 0.66 and the mean negative predictive value was 0.87. The clock drawing test is a suitable screening instrument for cognitive dysfunction in HD, because it was shown to be accurate, particularly so with respect to executive cognitive functioning, and is easy and quick to use. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

59. Historic elevation and detail drawing of Building 202 test ...

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

59. Historic elevation and detail drawing of Building 202 test cell, June 29, 1955. NASA GRC drawing no. CE-101341 (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 202, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Analysis of time taken to discuss new patients with head and neck cancer in multidisciplinary team meetings.

PubMed

Mullan, B J; Brown, J S; Lowe, D; Rogers, S N; Shaw, R J

2014-02-01

Multidisciplinary team (MDT) meetings have an important role in the management of head and neck cancer. Increasing incidence of the disease and a drive towards centralised meetings on large numbers of patients mean that effective discussions are pertinent. We aimed to evaluate new cases within a single high volume head and neck cancer MDT and to explore the relation between the time taken to discuss each case, the number of discussants, and type of case. A total of 105 patients with a new diagnosis of head and neck malignancy or complex benign tumour were discussed at 10 head and neck cancer MDT meetings. A single observer timed each discussion using a stopwatch, and recorded the number of discussants and the diagnosis and characteristics of each patient. Timings ranged from 15 to 480 s (8 min) with a mean of 119 s (2 min), and the duration of discussion correlated closely with the number of discussants (rs=0.63, p<0.001). The longest discussions concerned patients with advanced T stage (p=0.006) and advanced N stage (p=0.009) disease, the elderly (p=0.02) and male patients (p=0.05). Tumour site and histological findings were not significant factors in the duration of discussion. Most discussions on patients with early stage tumours were short (T1: 58% less than 60s, mean 90) and fewer people contributed. Many patients, particularly those with early stage disease, require little discussion, and their treatment might reasonably be planned according to an agreed protocol, which would leave more time and resources for those that require greater multidisciplinary input. Further studies may highlight extended discussions on patients with head and neck cancer, which may prompt a review of protocols and current evidence. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Effects of multidisciplinary teams and an integrated follow-up electronic system on clinical pharmacist interventions in a cancer hospital.

PubMed

Aziz, Muhammad Tahir; Rehman, Tofeeq Ur; Qureshi, Sadia; Andleeb, Sidrah

2017-12-01

Background The aim of drug therapy is to attain distinct therapeutic effects that not only improve patient's quality of life but also reduce the inherent risks associated with the therapeutic use of drugs. Pharmacists play a key role in reducing these risks by developing appropriate interventions. Whether to accept or reject the intervention made by the pharmacist is a relevant consultant's decision. Objective To evaluate the impact of electronic prompts and follow-up of rejected pharmacy interventions by clinical pharmacists in an in-patient setting. Setting Shaukat Khanum Cancer Hospital & Research Center, Lahore, Pakistan. Method The study was conducted in two phases. Data for 3 months were collected for each phase of the study. Systematic and quantifiable consensus validity was developed for rejected interventions in phase 1, based on patient outcome analyses. Severity rating was assigned to assess the significance of interventions. Electronic prompts for follow-on interventions in phase 2 were then developed and implemented, including daily review via a multidisciplinary team (MDT) approach. Main outcome measure Validity of rejected interventions, acceptance of follow-on interventions before and after re-engineering the pharmacy processes, rejection rate and severity rating of follow-on interventions. Result Of a total of 2649 and 3064 interventions that were implemented during phase 1 and phase 2, 238 (9%) and 307 (10%) were rejected, respectively. Additionally, 133 (56%) were inappropriate rejections during phase 1. The estimated reliability between pharmacists regarding rejected interventions was 0.74 (95% CI of 0.69, 0.79, p 0.000). Prospective data were analysed after implementing electronic alerts and an MDT approach. The acceptance rate of follow-on interventions in phase 2 was 60% (184). Conclusion Electronic prompts for follow-on interventions together with an MDT approach enhance the optimization of pharmacotherapy, increase drug rationality and improve patient care.

The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study

PubMed Central

Lauche, Romy; Cramer, Holger; Hohmann, Claudia; Choi, Kyung-Eun; Rampp, Thomas; Saha, Felix Joyonto; Musial, Frauke; Langhorst, Jost; Dobos, Gustav

2012-01-01

Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Index (NDI), mechanical detection (MDT), vibration detection (MDT), and pressure pain thresholds (PPT) were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi) during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: −17.9 mm VAS, 95%CI −29.2 to −6.6; PM: −19.7, 95%CI −32.2 to −7.2; PaDi: −1.5 points on NRS, 95%CI −2.5 to −0.4; all P < 0.05) and higher quality of life than WL (SF-36, Physical Functioning: 7.5, 95%CI 1.4 to 13.5; Bodily Pain: 14.9, 95%CI 4.4 to 25.4; Physical Component Score: 5.0, 95%CI 1.4 to 8.5; all P < 0.05). No significant effect was found for NDI, MDT, or VDT, but TG showed significantly higher PPT at pain-areas than WL (in lg(kPa); pain-maximum: 0.088, 95%CI 0.029 to 0.148, pain-adjacent: 0.118, 95%CI 0.038 to 0.199; both P < 0.01). Conclusion. A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP. PMID:22203873

Hurricane Odile

NASA Image and Video Library

2017-12-08

At about 10:45 p.m. Mountain Daylight Time (MDT) on September 14, 2014, Hurricane Odile made landfall as a Category 3 storm near Cabo San Lucas, Mexico. According to the U.S. National Hurricane Center, Odile arrived with wind speeds of 110 knots (204 kilometers or 127 miles per hour). The storm tied Olivia (1967) as the strongest hurricane to make landfall in the state of Baja California Sur in the satellite era. The Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA’s Terra satellite acquired this natural-color view of the storm at about noon MDT on September 14, when it was still southeast of the Baja California peninsula. Unisys Weather reported that the Category 4 storm had maximum sustained wind speeds of 115 knots (213 kilometers per hour) at the time. Odile had weakened to a Category 2 hurricane by 6 a.m. MDT on September 15. The storm was expected to continue weakening as it moved up the peninsula and over the area’s rough terrain, according to weather blogger Jeff Masters. Meteorologists noted that while damaging winds posed the biggest threat in the short term, inland areas of the U.S. Southwest could face heavy rainfall by September 16. The rain expected from Odile came one week after the U.S. Southwest experienced flash floods from the remnants of Hurricane Norbert. According to weather and climate blogger Eric Holthaus, those floods did little to relieve the area’s ongoing drought. NASA image by Jeff Schmaltz, LANCE/EOSDIS Rapid Response. Caption by Kathryn Hansen. Instrument(s): Terra - MODIS Read more: earthobservatory.nasa.gov/IOTD/view.php?id=84378&eocn... NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Magnetically assisted intraperitoneal drug delivery for cancer chemotherapy.

PubMed

Shamsi, Milad; Sedaghatkish, Amir; Dejam, Morteza; Saghafian, Mohsen; Mohammadi, Mehdi; Sanati-Nezhad, Amir

2018-11-01

Intraperitoneal (IP) chemotherapy has revived hopes during the past few years for the management of peritoneal disseminations of digestive and gynecological cancers. Nevertheless, a poor drug penetration is one key drawback of IP chemotherapy since peritoneal neoplasms are notoriously resistant to drug penetration. Recent preclinical studies have focused on targeting the aberrant tumor microenvironment to improve intratumoral drug transport. However, tumor stroma targeting therapies have limited therapeutic windows and show variable outcomes across different cohort of patients. Therefore, the development of new strategies for improving the efficacy of IP chemotherapy is a certain need. In this work, we propose a new magnetically assisted strategy to elevate drug penetration into peritoneal tumor nodules and improve IP chemotherapy. A computational model was developed to assess the feasibility and predictability of the proposed active drug delivery method. The key tumor pathophysiology, including a spatially heterogeneous construct of leaky vasculature, nonfunctional lymphatics, and dense extracellular matrix (ECM), was reconstructed in silico. The transport of intraperitoneally injected magnetic nanoparticles (MNPs) inside tumors was simulated and compared with the transport of free cytotoxic agents. Our results on magnetically assisted delivery showed an order of magnitude increase in the final intratumoral concentration of drug-coated MNPs with respect to free cytotoxic agents. The intermediate MNPs with the radius range of 200-300 nm yield optimal magnetic drug targeting (MDT) performance in 5-10 mm tumors while the MDT performance remains essentially the same over a large particle radius range of 100-500 nm for a 1 mm radius small tumor. The success of MDT in larger tumors (5-10 mm in radius) was found to be markedly dependent on the choice of magnet strength and tumor-magnet distance while these two parameters were less of a concern in small tumors. We also validated in silico results against experimental results related to tumor interstitial hypertension, conventional IP chemoperfusion, and magnetically actuated movement of MNPs in excised tissue.

The Effect of Cartooning Instruction in a Full-Inclusive Setting on Rural Children's Performances on the Goodenough-Harris Drawing Test: Selected Case Studies.

ERIC Educational Resources Information Center

Elrod, G. Franklin; Obringer, S. John

Many researchers have attempted to link children's drawings to intelligence. The Goodenough-Harris Draw-a-Man (DAM) and Draw-a-Woman (DAW) test has been accepted as an indicator of intelligence. This study, via examination of specific cases, explored the effect that instruction in drawing cartoons had on the DAM and DAW performance of 16…

13. Historic drawing of rocket engine test facility layout, including ...

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

13. Historic drawing of rocket engine test facility layout, including Buildings 202, 205, 206, and 206A, February 3, 1984. NASA GRC drawing number CF-101539. On file at NASA Glenn Research Center. - Rocket Engine Testing Facility, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Older age relates to worsening of fine motor skills: a population-based study of middle-aged and elderly persons.

PubMed

Hoogendam, Yoo Young; van der Lijn, Fedde; Vernooij, Meike W; Hofman, Albert; Niessen, Wiro J; van der Lugt, Aad; Ikram, M Arfan; van der Geest, Jos N

2014-01-01

In a population-based study of 1,912 community-dwelling persons of 45 years and older, we investigated the relation between age and fine motor skills using the Archimedes spiral-drawing test. Also, we studied the effect of brain volume on fine motor skills. Participants were required to trace a template of a spiral on an electronic drawing board. Clinical scores from this test were obtained by visual assessment of the drawings. Quantitative measures were objectively determined from the recorded data of the drawings. As tremor is known to occur increasingly with advancing age, we also rated drawings to assess presence of tremor. We found presence of a tremor in 1.3% of the drawings. In the group without tremor, we found that older age was related to worse fine motor skills. Additionally, participants over the age of 75 showed increasing deviations from the template when drawing the spiral. Larger cerebral volume and smaller white matter lesion volume were related to better spiral-drawing performance, whereas cerebellar volume was not related to spiral-drawing performance. Older age is related to worse fine motor skills, which can be captured by clinical scoring or quantitative measures of the Archimedes spiral-drawing test. Persons with a tremor performed worse on almost all measures of the spiral-drawing test. Furthermore, larger cerebral volume is related to better fine motor skills.

Ethnic Differences in the Goodenough-Harris Draw-a-Man and Draw-a-Woman Tests.

ERIC Educational Resources Information Center

Dugdale, A. E.; Chen, S. T.

1979-01-01

The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 school children in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. Journal availability: British Medical Journal, 1172 Commonwealth Ave., Boston, MA 02134. (Author)

41. INDEX OF ALL TAN 629 HANGAR DRAWINGS IN THE ...

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

41. INDEX OF ALL TAN 629 HANGAR DRAWINGS IN THE RALPH M. PARSONS SERIES OF DRAWINGS OF THE FLIGHT ENGINE TEST FACILITY. RALPH M. PARSONS DRAWING NUMBER: 1229-2 ANP/GE 5-100. DATED MARCH 15, 1957. - Idaho National Engineering Laboratory, Test Area North, Hangar No. 629, Scoville, Butte County, ID

29. Photocopy of engineering drawing, May, 1941 (original drawing located ...

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

29. Photocopy of engineering drawing, May, 1941 (original drawing located at Fairchild Air Force Base, Civil Engineering Building, Civil Engineering vault). ENGINE TEST CELL BUILDING. 19508 RENOVATION OF FIRST FLOOR, CENTRAL PORTION. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

4. This photographic copy of an engineering drawing shows the ...

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

4. This photographic copy of an engineering drawing shows the plan and details for Test Stand "G" and the placement of the vibrator. California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering: "Vibration Test Facility-Bldg E-72, Floor & Roof Plans, Sections, Details & Door Schedule," drawing no. E72/2-5, 21 May 1964. California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering: engineering drawings of structures at JPL Edwards Facility. Drawings on file at JPL Plant Engineering, Pasadena, California. - Jet Propulsion Laboratory Edwards Facility, Test Stand G, Edwards Air Force Base, Boron, Kern County, CA

Persistent negative illness perceptions despite long-term biochemical control of acromegaly: novel application of the drawing test.

PubMed

Tiemensma, Jitske; Pereira, Alberto M; Romijn, Johannes A; Broadbent, Elizabeth; Biermasz, Nienke R; Kaptein, Adrian A

2015-05-01

Patients with acromegaly have persistent complaints despite long-term biochemical control. Drawings can be used to assess patients' perceptions about their disease. We aimed to explore the utility of the drawing test and its relation to illness perceptions and quality of life (QoL) in patients after long-term remission of acromegaly. A cross-sectional study was conducted to evaluate the utility of the drawing test. A total of 50 patients after long-term remission (mean±s.e.m., 16±1.2 years) of acromegaly were included in this study. Patients completed the drawing test (two retrospective drawings of their body perception before acromegaly and during the active phase of acromegaly, and one drawing on the current condition after long-term remission), Illness Perception Questionnaire-Revised, Physical Symptom Checklist, EuroQoL-5D, and AcroQoL. Patients perceived a dramatic change in body size during the active state of the disease compared with the healthy state before the awareness of acromegaly. Patients reported that their body did not completely return to the original proportions after long-term remission. In addition, larger drawings indicated more negative consequences (P<0.05), a higher score on emotional representations (P<0.05), and more perceived symptoms that were attributed to acromegaly (P<0.01). Larger drawings also indicated more impaired QoL, especially disease-specific QoL (all P<0.05). There are strong correlations among the drawing test, illness perceptions, and QoL. The drawing test appears to be a novel and relatively easy tool to assess the perception of patients after long-term remission of acromegaly. The assessment of drawings may enable health care providers to appreciate the perceptions of patients with long-term remission of acromegaly, and enable discussion of symptoms and remission. © 2015 European Society of Endocrinology.

Establishment of Interdisciplinary Child Protection Teams in Turkey 2002-2006: Identifying the Strongest Link Can Make a Difference!

ERIC Educational Resources Information Center

Agirtan, Canan A.; Akar, Taner; Akbas, Seher; Akdur, Recep; Aydin, Cahide; Aytar, Gulsen; Ayyildiz, Suat; Baskan, Sevgi; Belgemen, Tugba; Bezirci, Ozdecan; Beyazova, Ufuk; Beyaztas, Fatma Yucel; Buken, Bora; Buken, Erhan; Camurdan, Aysu D.; Can, Demet; Canbaz, Sevgi; Canturk, Gurol; Ceyhan, Meltem; Coskun, Abdulhakim; Celik, Ahmet; Cetin, Fusun C.; Coskun, Ayse Gul; Dagcinar, Adnan; Dallar, Yildiz; Demirel, Birol; Demirogullari, Billur; Derman, Orhan; Dilli, Dilek; Ersahin, Yusuf; Esiyok, Burcu; Evinc, Gulin; Gencer, Ozlem; Gokler, Bahar; Hanci, Hamit; Iseri, Elvan; Isir, Aysun Baransel; Isiten, Nukhet; Kale, Gulsev; Karadag, Ferda; Kanbur, Nuray; Kilic, Birim; Kultur, Ebru; Kurtay, Derya; Kuruoglu, Asli; Miral, Suha; Odabasi, Aysun B.; Oral, Resmiye; Orhon, Filiz Simsek; Ozbesler, Cengiz; Ozdemir, Dilsad Foto; Ozkok, M. Selim; Ozmert, Elif; Oztop, Didem B.; Ozyurek, Hamit; Pasli, Figen; Peksen, Yildiz; Polat, Onur; Sahin, Figen; Sahin, Ahmet Rifat; Salacin, Serpil; Suskan, Emine; Tander, Burak; Tekin, Deniz; Teksam, Ozlem; Tiras, Ulku; Tomak, Yilmaz; Tumer, Ali Riza; Turla, Ahmet; Ulukol, Betul; Uslu, Runa; Tas, Fatma V.; Vatandas, Nilgun; Velipasaoglu, Sevtap; Yagmur, Fatih; Yagmurlu, Aydin; Yalcin, Songul; Yavuz, Sukruye; Yurdakok, Kadriye

2009-01-01

Objectives: The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year…

How Does the Supply Requisitioning Process Affect Average Customer Wait Time Onboard U.S. Navy Destroyers?

DTIC Science & Technology

2013-06-01

17  D.  NAVAL TACTICAL COMMAND SUPPORT SYSTEM .........................17  1.  Operational Maintenance Management System–Next Generation...Management .......................................................................................21  4.  Method ...Business Administration MDT Mean Down Time MTBM Mean Time Between Maintenance NAVSUP Naval Supply Systems Command NC Not Carried NIS Not in Stock

Prostanoid Production by Lipopolysaccharide-Stimulated Kupffer Cells

DTIC Science & Technology

1985-05-01

RONALD D. NELSONJt RUDOLPH J. ROETHEL, B.S.,t AND MITCHELL P. FINK, M.D.t *lrored Fores~ Radiwhwlogy Research Instt ute, . ineNcerIi’nv Bethesda. Var viand ...Multip~ le system 19. Knook, D. L., and Sleyster. E. Ch. Preparation and organ failure. Suv.k. C/in North-I ier. 63: 315, 1993. characterization of

78 FR 32001 - Public Notice for a Change in Use of Aeronautical Property and Long-Term Lease Approval at...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

... International Airport approved Airport Layout Plan (ALP). There is to be no sale or transfer of property rights... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Public Notice for a Change in Use of Aeronautical Property and Long-Term Lease Approval at Harrisburg International Airport (MDT), Middletown, PA...

GUIDE FOR COURSE OF STUDY FOR WAITER, WAITRESS, INFORMAL, WAITER, WAITRESS, COUNTER ATTENDANT, FOOD SERVICE WORKER.

ERIC Educational Resources Information Center

MCDONOUGH, FRANCES S.

MATERIAL IN THIS GUIDE IS FOR TEACHER USE IN TRAINING PROGRAMS FOR FOOD SERVICE WORKERS. IT WAS ORGANIZED AND WRITTEN BY A CURRICULUM DEVELOPMENT SPECIALIST FOR MANPOWER DEVELOPMENT TRAINING (MDT) ASSISTED BY INSTRUCTORS IN THE FIELD. THE GENERAL OBJECTIVE IS TO DEVELOP ABILITIES, UNDERSTANDINGS, ATTITUDES, AND INTERESTS NEEDED FOR ENTRY LEVEL…

Older Age Relates to Worsening of Fine Motor Skills: A Population-Based Study of Middle-Aged and Elderly Persons

PubMed Central

Hoogendam, Yoo Young; van der Lijn, Fedde; Vernooij, Meike W.; Hofman, Albert; Niessen, Wiro J.; van der Lugt, Aad; Ikram, M. Arfan; van der Geest, Jos N.

2014-01-01

Introduction: In a population-based study of 1,912 community-dwelling persons of 45 years and older, we investigated the relation between age and fine motor skills using the Archimedes spiral-drawing test. Also, we studied the effect of brain volume on fine motor skills. Methods: Participants were required to trace a template of a spiral on an electronic drawing board. Clinical scores from this test were obtained by visual assessment of the drawings. Quantitative measures were objectively determined from the recorded data of the drawings. As tremor is known to occur increasingly with advancing age, we also rated drawings to assess presence of tremor. Results: We found presence of a tremor in 1.3% of the drawings. In the group without tremor, we found that older age was related to worse fine motor skills. Additionally, participants over the age of 75 showed increasing deviations from the template when drawing the spiral. Larger cerebral volume and smaller white matter lesion volume were related to better spiral-drawing performance, whereas cerebellar volume was not related to spiral-drawing performance. Conclusion: Older age is related to worse fine motor skills, which can be captured by clinical scoring or quantitative measures of the Archimedes spiral-drawing test. Persons with a tremor performed worse on almost all measures of the spiral-drawing test. Furthermore, larger cerebral volume is related to better fine motor skills. PMID:25309436

Clock Drawing Test and the diagnosis of amnestic mild cognitive impairment: can more detailed scoring systems do the work?

PubMed

Rubínová, Eva; Nikolai, Tomáš; Marková, Hana; Siffelová, Kamila; Laczó, Jan; Hort, Jakub; Vyhnálek, Martin

2014-01-01

The Clock Drawing Test is a frequently used cognitive screening test with several scoring systems in elderly populations. We compare simple and complex scoring systems and evaluate the usefulness of the combination of the Clock Drawing Test with the Mini-Mental State Examination to detect patients with mild cognitive impairment. Patients with amnestic mild cognitive impairment (n = 48) and age- and education-matched controls (n = 48) underwent neuropsychological examinations, including the Clock Drawing Test and the Mini-Mental State Examination. Clock drawings were scored by three blinded raters using one simple (6-point scale) and two complex (17- and 18-point scales) systems. The sensitivity and specificity of these scoring systems used alone and in combination with the Mini-Mental State Examination were determined. Complex scoring systems, but not the simple scoring system, were significant predictors of the amnestic mild cognitive impairment diagnosis in logistic regression analysis. At equal levels of sensitivity (87.5%), the Mini-Mental State Examination showed higher specificity (31.3%, compared with 12.5% for the 17-point Clock Drawing Test scoring scale). The combination of Clock Drawing Test and Mini-Mental State Examination scores increased the area under the curve (0.72; p < .001) and increased specificity (43.8%), but did not increase sensitivity, which remained high (85.4%). A simple 6-point scoring system for the Clock Drawing Test did not differentiate between healthy elderly and patients with amnestic mild cognitive impairment in our sample. Complex scoring systems were slightly more efficient, yet still were characterized by high rates of false-positive results. We found psychometric improvement using combined scores from the Mini-Mental State Examination and the Clock Drawing Test when complex scoring systems were used. The results of this study support the benefit of using combined scores from simple methods.

1. Photographic copy of engineering drawing showing structure of Test ...

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

1. Photographic copy of engineering drawing showing structure of Test Stand 'B' (4215/E-16), also known as the 'Short Snorter.' California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering 'Structural Addition - Bldg. E-12, Edwards Test Station,' drawing no. E12/1-1, 8 August 1957. - Jet Propulsion Laboratory Edwards Facility, Test Stand B, Edwards Air Force Base, Boron, Kern County, CA

26. "TEST STAND, STRUCTURAL, FOUNDATION PLAN." Specifications No. ENG043535572; Drawing ...

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

26. "TEST STAND, STRUCTURAL, FOUNDATION PLAN." Specifications No. ENG-04-353-55-72; Drawing No. 60-0912; sheet 25 of 148; file no. 1320/76. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

Statistical tests for whether a given set of independent, identically distributed draws comes from a specified probability density.

PubMed

Tygert, Mark

2010-09-21

We discuss several tests for determining whether a given set of independent and identically distributed (i.i.d.) draws does not come from a specified probability density function. The most commonly used are Kolmogorov-Smirnov tests, particularly Kuiper's variant, which focus on discrepancies between the cumulative distribution function for the specified probability density and the empirical cumulative distribution function for the given set of i.i.d. draws. Unfortunately, variations in the probability density function often get smoothed over in the cumulative distribution function, making it difficult to detect discrepancies in regions where the probability density is small in comparison with its values in surrounding regions. We discuss tests without this deficiency, complementing the classical methods. The tests of the present paper are based on the plain fact that it is unlikely to draw a random number whose probability is small, provided that the draw is taken from the same distribution used in calculating the probability (thus, if we draw a random number whose probability is small, then we can be confident that we did not draw the number from the same distribution used in calculating the probability).

Characteristics of the tree-drawing test in chronic schizophrenia.

PubMed

Kaneda, Ayako; Yasui-Furukori, Norio; Saito, Manabu; Sugawara, Norio; Nakagami, Taku; Furukori, Hanako; Kaneko, Sunao

2010-04-01

A tree-drawing test acts as both a projective psychological examination as well as a supplementary psychodiagnostic tool. There is little information relating the characteristics of schizophrenia and the tree-drawing test. The present study compared the structural and morphological differences in the results of the tree-drawing test between schizophrenic patients and healthy individuals, as well as between schizophrenic patients who responded well to treatment and those who responded poorly. The subjects included 202 chronic schizophrenic patients and 113 healthy individuals. The schizophrenic patients were categorized as 'good responders' or 'poor responders' based on their response to medical treatments. The tree-drawing test was performed on all subjects. The tree drawn by each subject was analyzed structurally and morphologically. There were significant differences between the trunk and branches drawn by schizophrenic patients and those drawn by healthy controls. There were no significant differences between the good responders and the poor responders in any aspect of the tree drawings. Multiple regression models showed that the ratio of the tree area to the total area of the drawing paper, the width of the trunk, the trunk base opening, and the size of the branch ends were significantly associated with schizophrenia. The present study suggests that the trees drawn by schizophrenic patients are significantly different from those drawn by healthy individuals, but among schizophrenic patients, it is difficult to distinguish between good responders and poor responders using the tree-drawing test.

Diagnosis of the OCD Patients using Drawing Features of the Bender Gestalt Shapes

PubMed Central

Boostani, R.; Asadi, F.; Mohammadi, N.

2017-01-01

Background: Since psychological tests such as questionnaire or drawing tests are almost qualitative, their results carry a degree of uncertainty and sometimes subjectivity. The deficiency of all drawing tests is that the assessment is carried out after drawing the objects and lots of information such as pen angle, speed, curvature and pressure are missed through the test. In other words, the psychologists cannot assess their patients while running the tests. One of the famous drawing tests to measure the degree of Obsession Compulsion Disorder (OCD) is the Bender Gestalt, though its reliability is not promising. Objective: The main objective of this study is to make the Bender Gestalt test quantitative; therefore, an optical pen along with a digital tablet is utilized to preserve the key drawing features of OCD patients during the test. Materials and Methods: Among a large population of patients who referred to a special clinic of OCD, 50 under therapy subjects voluntarily took part in this study. In contrast, 50 subjects with no sign of OCD performed the test as a control group. This test contains 9 shapes and the participants were not constraint to draw the shapes in a certain interval of time; consequently, to classify the stream of feature vectors (samples through drawing) Hidden Markov Model (HMM) is employed and its flexibility increased by incorporating the fuzzy technique into its learning scheme. Results: Applying fuzzy HMM classifier to the data stream of subjects could classify two groups up to 95.2% accuracy, whereas the results by applying the standard HMM resulted in 94.5%. In addition, multi-layer perceptron (MLP), as a strong static classifier, is applied to the features and resulted in 86.6% accuracy. Conclusion: Applying the pair of T-test to the results implies a significant supremacy of the fuzzy HMM to the standard HMM and MLP classifiers. PMID:28462208

Diagnosis of the OCD Patients using Drawing Features of the Bender Gestalt Shapes.

PubMed

Boostani, R; Asadi, F; Mohammadi, N

2017-03-01

Since psychological tests such as questionnaire or drawing tests are almost qualitative, their results carry a degree of uncertainty and sometimes subjectivity. The deficiency of all drawing tests is that the assessment is carried out after drawing the objects and lots of information such as pen angle, speed, curvature and pressure are missed through the test. In other words, the psychologists cannot assess their patients while running the tests. One of the famous drawing tests to measure the degree of Obsession Compulsion Disorder (OCD) is the Bender Gestalt, though its reliability is not promising. The main objective of this study is to make the Bender Gestalt test quantitative; therefore, an optical pen along with a digital tablet is utilized to preserve the key drawing features of OCD patients during the test. Among a large population of patients who referred to a special clinic of OCD, 50 under therapy subjects voluntarily took part in this study. In contrast, 50 subjects with no sign of OCD performed the test as a control group. This test contains 9 shapes and the participants were not constraint to draw the shapes in a certain interval of time; consequently, to classify the stream of feature vectors (samples through drawing) Hidden Markov Model (HMM) is employed and its flexibility increased by incorporating the fuzzy technique into its learning scheme. Applying fuzzy HMM classifier to the data stream of subjects could classify two groups up to 95.2% accuracy, whereas the results by applying the standard HMM resulted in 94.5%. In addition, multi-layer perceptron (MLP), as a strong static classifier, is applied to the features and resulted in 86.6% accuracy. Applying the pair of T-test to the results implies a significant supremacy of the fuzzy HMM to the standard HMM and MLP classifiers.

Insights into targeting young male drivers with anti-speeding advertising: An application of the Step approach to Message Design and Testing (SatMDT).

PubMed

Lewis, I; White, K M; Ho, B; Elliott, B; Watson, B

2017-06-01

In Australia, young drivers aged 17-25 years comprise 13% of the population yet account for 22% of all road deaths with young males over-represented in such trauma. Speeding represents a major contributing factor and advertising campaigns have long focused on promoting anti-speeding messages in the effort to reduce drivers' speeds. Positioned within a larger program of research aimed at developing, piloting, and evaluating a range of theoretically-informed anti-speeding messages, the current study reports results relating to the final phase of the research, the evaluation. Six messages were devised in accordance with the guiding framework, the Step approach to Message Design and Testing ([SatMDT]; Lewis et al., 2016) and based on the findings emerging from earlier qualitative and quantitative studies within the program of research. N=938 licensed drivers (n=455 males, 48%) aged 17-62 years completed an online survey. To ensure a controlled test of the persuasiveness of the message content, the messages were presented in an audio-based format and thus were devoid of potential confounds, such as images. The messages sought to address a particular belief (i.e., behavioural, normative, control) and to focus either on emphasising the positive aspects which make speeding less likely or challenging the negative aspects which make speeding more likely. Thus, key to this evaluation was to test the persuasiveness of the message content in terms of the particular belief and focus it was addressing. Participants were randomly assigned to either the Control condition (i.e., no exposure to a message) or the Intervention condition (i.e., exposed to one of the six messages presented as an audio-recorded message within the survey). Persuasiveness was assessed via a range of outcome measures including both direct (i.e., third-person perceptions, message rejection) as well as indirect measures (i.e., intentions, willingness to speed). Age, gender, and message type were independent variables (IVs), together with issue involvement as a covariate (or IV) in the study's analyses. Overall, positive persuasive effects, and a relative absence of any negative, dissuasive effects, were found for two messages, Glass Cars and The Lift. These messages addressed the same salient belief, control beliefs, with the former emphasising the factors which discourage speeding and the latter message challenging those factors which encourage speeding. The implications of the findings are discussed in terms of the insights they offer for the key content of future anti-speeding messages. Copyright © 2017 Elsevier Ltd. All rights reserved.

12. Historic plot plan and drawings index for rocket engine ...

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

12. Historic plot plan and drawings index for rocket engine test facility, June 28, 1956. NASA GRC drawing number CE-101810. On file at NASA Glenn Research Center. - Rocket Engine Testing Facility, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

What a Successful Solar Market Can Do for You | State, Local, and Tribal

Science.gov Websites

Can Do for You The Solar Technical Assistance Team (STAT) 2012 webinar series was developed for state policymakers and staff. Wednesday, July 18, 2012, 12-1 p.m. MDT This overview of the STAT webinar series gives jobs, air quality, and reduction in grid congestion). The discussion includes examples of jurisdictions

Multiprofessional education to stimulate collaboration: a circular argument and its consequences.

PubMed

Roodbol, Petrie F

2010-01-01

The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE) or multidisciplinary training (MDT) seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance.

Herpes simplex virus: 'to disclose or not to disclose.' An exploration of the multi-disciplinary team's role in advising patients about disclosure when diagnosed with genital herpes simplex virus.

PubMed

Caulfield, Pauline; Willis, Diane

2017-07-01

The first UK prosecution for genital herpes simplex virus (HSV) transmission in 2011 attracted strong criticism from medical experts. To address the dearth of research on the topic, this study aimed to explore the nature of advice given to patients by the multidisciplinary team (MDT) in the West of Scotland on HSV disclosure to partners. Ten semi-structured interviews with members of the MDT were conducted and the interviews were analysed using Burnard's Thematic Content Analysis. Four themes emerged which explored practitioners' knowledge of HSV and their feelings regarding the emotional aspects of the diagnosis on clients including the challenges of discussing disclosure. Within this framework, participants' attitudes to the legal prosecution were also surveyed. This study revealed that participants had good knowledge about HSV. Furthermore, participants believed disclosure to be the patient's choice and had not altered their practice to advise disclosure to all partners in accordance with local protocol. However, there was a general consensus that disclosure was not required due to the prevalence of HSV and prevalence was used to dissipate emotional reactions to HSV diagnosis.

58. Historic plan, section, and detail drawing of Building 202 ...

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

58. Historic plan, section, and detail drawing of Building 202 test cell, June 29, 1955. NASA GRC drawing no. CE-101340 (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 202, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Clock Drawing as a Screen for Impaired Driving in Aging and Dementia: Is It Worth the Time?

PubMed Central

Manning, Kevin J.; Davis, Jennifer D.; Papandonatos, George D.; Ott, Brian R.

2014-01-01

Clock drawing is recommended by medical and transportation authorities as a screening test for unsafe drivers. The objective of the present study was to assess the usefulness of different clock drawing systems as screening measures of driving performance in 122 healthy and cognitively impaired older drivers. Clock drawing was measured using four different scoring systems. Driving outcomes included global ratings of safety and the error rate on a standardized on-road test. Findings revealed that clock drawing was significantly correlated with the driving score on the road test for each of the scoring systems. However, receiver operator curve analyses showed limited clinical utility for clock drawing as a screening instrument for impaired on-road driving performance with the area under the curve ranging from 0.53 to 0.61. Results from this study indicate that clock drawing has limited utility as a solitary screening measure of on-road driving, even when considering a variety of scoring approaches. PMID:24296110

Clock drawing as a screen for impaired driving in aging and dementia: is it worth the time?

PubMed

Manning, Kevin J; Davis, Jennifer D; Papandonatos, George D; Ott, Brian R

2014-02-01

Clock drawing is recommended by medical and transportation authorities as a screening test for unsafe drivers. The objective of the present study was to assess the usefulness of different clock drawing systems as screening measures of driving performance in 122 healthy and cognitively impaired older drivers. Clock drawing was measured using four different scoring systems. Driving outcomes included global ratings of safety and the error rate on a standardized on-road test. Findings revealed that clock drawing was significantly correlated with the driving score on the road test for each of the scoring systems. However, receiver operator curve analyses showed limited clinical utility for clock drawing as a screening instrument for impaired on-road driving performance with the area under the curve ranging from 0.53 to 0.61. Results from this study indicate that clock drawing has limited utility as a solitary screening measure of on-road driving, even when considering a variety of scoring approaches.

The Draw-an-Archaeologist Test

ERIC Educational Resources Information Center

Renoe, Susan

2003-01-01

The Draw-an-Archaeologist Test (DART) is an easy way to elicit students' conceptions about archaeology and can be adapted to other subject matter. When implemented as the first activity of an archaeology unit, it provides a starting point for introducing archaeology and addressing students' misconceptions about it. In this drawing activity,…

Multidisciplinary team approach to traumatic spinal cord injuries: a single institution's quality improvement project.

PubMed

Alizo, Georgina; Sciarretta, Jason D; Gibson, Stefanie; Muertos, Keely; Holmes, Sharon; Denittis, Felicia; Cheatle, Joseph; Davis, John; Pepe, Antonio

2018-04-01

A stepwise multidisciplinary team (MDT) approach to the injured trauma patient has been reported to have an overall benefit, with reduction in mortality and improved morbidity. Based on clinical experience, we hypothesized that implementation of a dedicated Spinal Cord Injury Service (SCIS) would impact outcomes of a patient specific population on the trauma service. The trauma center registry was retrospectively queried, from January 2011 through December 2015, for patients presenting with a spinal cord injury. In 2013, a twice weekly rounding SCIS MDT was initiated. This new multidisciplinary service, the post-SCIS, was compared to the 2011-2012 pre-SCIS. The two groups were compared across patient demographics, mechanism of injury, surgical procedures, and disposition at discharge. The primary outcome was mortality. Secondary endpoints also included the incidence of complications, hospital length of stay (HLOS), ICU LOS, ventilator free days, and all hospital-acquired infectious complications. Logistic regression and Student's t test were used to analyze data. Ninety-five patients were identified. Of these patients, 41 (43%) pre-SCIS and 54 (57%) post-SCIS patients were compared. Mean age was 46.9 years and 79% male. Overall, adjusted mortality rate between the two groups was significant with the implementation of the post-SCIS (p = 0.033). In comparison, the post-SCIS revealed shorter HLOS (23 vs 34.8 days, p = 0.004), increased ventilator free days (20.2 vs 63.3 days, p < 0.001), and less nosocomial infections (1.8 vs 22%, p = 0.002). While the post-SCIS mean ICU LOS was shorter (12 vs 17.9 days, p = 0.089), this relationship was not significant. The application of an SCIS team in addition to the trauma service suggests that a structured coordinated approach can have an expected improvement in hospital outcomes and shorter length of stays. We believe that this clinical collaboration provides distinct specialist perspectives and, therefore, optimizes quality improvement. Level of evidence Epidemiologic study, level III.

Children's Drawings.

ERIC Educational Resources Information Center

Burgess, Ann W.; Hartman, Carol R.

1993-01-01

This paper reviews the literature on projective drawing tests and child sexual abuse, focusing on children's drawings as an associative tool for memory. The use of the event drawing series, which is a series of seven drawings by a child that graphically present the child's thinking about a specific event, is discussed. (JDD)

Drawing out Critical Thinking: Testing the Methodological Value of Drawing Collaboratively

ERIC Educational Resources Information Center

Knight, Linda; Zollo, Lyn; McArdle, Felicity; Cumming, Tamara; Bone, Jane; Ridgway, Avis; Peterken, Corinna; Li, Liang

2016-01-01

Early childhood research has long established that drawing is a central, and important activity for young children. Less common are investigations into the drawing activity of adults involved in early childhood. A team of adult early childhood researchers, with differing exposures and familiarities with drawing, experimented with intergenerational…

Unpacking Race, Culture, and Class in Rural Alaska: Native and Non-Native Multidisciplinary Professionals' Perceptions of Child Sexual Abuse

ERIC Educational Resources Information Center

Bubar, Roe; Bundy-Fazioli, Kimberly

2011-01-01

The purpose of this study was to unpack notions of class, culture, and race as they relate to multidisciplinary team (MDT) professionals and their perceptions of prevalence in child sexual abuse cases in Native and non-Native rural Alaska communities. Power and privilege within professional settings is significant for all social work professionals…

Multiprofessional education to stimulate collaboration: a circular argument and its consequences

PubMed Central

Roodbol, Petrie F.

2010-01-01

The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE) or multidisciplinary training (MDT) seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance. PMID:21818197

A Comparison of Two Treatment Studies: CBT and MDT with Adolescent Male Sex Offenders with Reactive Conduct Disorder and/or Personality Traits

ERIC Educational Resources Information Center

Apsche, Jack A.; Bass, Christopher K.; Murphy, Christopher J.

2004-01-01

This paper compares the results of two separate published studies regarding adolescent males with conduct disorders and/or personality disorders/traits. Both studies were published in the Behavior Analyst Today, Vol. 3, No. 4, Vol 5, No. 1, respectively. The concept is to evaluate two treatment research studies that represent "the best" practices…

Clinical usefulness of the clock drawing test applying rasch analysis in predicting of cognitive impairment.

PubMed

Yoo, Doo Han; Lee, Jae Shin

2016-07-01

[Purpose] This study examined the clinical usefulness of the clock drawing test applying Rasch analysis for predicting the level of cognitive impairment. [Subjects and Methods] A total of 187 stroke patients with cognitive impairment were enrolled in this study. The 187 patients were evaluated by the clock drawing test developed through Rasch analysis along with the mini-mental state examination of cognitive evaluation tool. An analysis of the variance was performed to examine the significance of the mini-mental state examination and the clock drawing test according to the general characteristics of the subjects. Receiver operating characteristic analysis was performed to determine the cutoff point for cognitive impairment and to calculate the sensitivity and specificity values. [Results] The results of comparison of the clock drawing test with the mini-mental state showed significant differences in according to gender, age, education, and affected side. A total CDT of 10.5, which was selected as the cutoff point to identify cognitive impairement, showed a sensitivity, specificity, Youden index, positive predictive, and negative predicive values of 86.4%, 91.5%, 0.8, 95%, and 88.2%. [Conclusion] The clock drawing test is believed to be useful in assessments and interventions based on its excellent ability to identify cognitive disorders.

Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey.

PubMed

Karayannis, Nicholas V; Jull, Gwendolen A; Hodges, Paul W

2012-02-20

Several classification schemes, each with its own philosophy and categorizing method, subgroup low back pain (LBP) patients with the intent to guide treatment. Physiotherapy derived schemes usually have a movement impairment focus, but the extent to which other biological, psychological, and social factors of pain are encompassed requires exploration. Furthermore, within the prevailing 'biological' domain, the overlap of subgrouping strategies within the orthopaedic examination remains unexplored. The aim of this study was "to review and clarify through developer/expert survey, the theoretical basis and content of physical movement classification schemes, determine their relative reliability and similarities/differences, and to consider the extent of incorporation of the bio-psycho-social framework within the schemes". A database search for relevant articles related to LBP and subgrouping or classification was conducted. Five dominant movement-based schemes were identified: Mechanical Diagnosis and Treatment (MDT), Treatment Based Classification (TBC), Pathoanatomic Based Classification (PBC), Movement System Impairment Classification (MSI), and O'Sullivan Classification System (OCS) schemes. Data were extracted and a survey sent to the classification scheme developers/experts to clarify operational criteria, reliability, decision-making, and converging/diverging elements between schemes. Survey results were integrated into the review and approval obtained for accuracy. Considerable diversity exists between schemes in how movement informs subgrouping and in the consideration of broader neurosensory, cognitive, emotional, and behavioural dimensions of LBP. Despite differences in assessment philosophy, a common element lies in their objective to identify a movement pattern related to a pain reduction strategy. Two dominant movement paradigms emerge: (i) loading strategies (MDT, TBC, PBC) aimed at eliciting a phenomenon of centralisation of symptoms; and (ii) modified movement strategies (MSI, OCS) targeted towards documenting the movement impairments associated with the pain state. Schemes vary on: the extent to which loading strategies are pursued; the assessment of movement dysfunction; and advocated treatment approaches. A biomechanical assessment predominates in the majority of schemes (MDT, PBC, MSI), certain psychosocial aspects (fear-avoidance) are considered in the TBC scheme, certain neurophysiologic (central versus peripherally mediated pain states) and psychosocial (cognitive and behavioural) aspects are considered in the OCS scheme.

Magnetic particle capture for biomagnetic fluid flow in stenosed aortic bifurcation considering particle-fluid coupling

NASA Astrophysics Data System (ADS)

Bose, Sayan; Banerjee, Moloy

2015-07-01

Magnetic nanoparticles drug carriers continue to attract considerable interest for drug targeting in the treatment of cancer and other pathological conditions. Guiding magnetic iron oxide nanoparticles with the help of an external magnetic field to its target is the basic principle behind the Magnetic Drug Targeting (MDT). It is essential to couple the ferrohydrodynamic (FHD) and magnetohydrodynamic (MHD) principles when magnetic fields are applied to blood as a biomagnetic fluid. The present study is devoted to study on MDT technique by particle tracking in the presence of a non uniform magnetic field in a stenosed aortic bifurcation. The present numerical model of biomagnetic fluid dynamics (BFD) takes into accounts both magnetization and electrical conductivity of blood. The blood flow in the bifurcation is considered to be incompressible and Newtonian. An Eulerian-Lagrangian technique is adopted to resolve the hemodynamic flow and the motion of the magnetic particles in the flow using ANSYS FLUENT two way particle-fluid coupling. An implantable infinitely long cylindrical current carrying conductor is used to create the requisite magnetic field. Targeted transport of the magnetic particles in a partly occluded vessel differs distinctly from the same in a regular unblocked vessel. Results concerning the velocity and temperature field indicate that the presence of the magnetic field influences the flow field considerably and the disturbances increase as the magnetic field strength increases. The insert position is also varied to observe the variation in flow as well as temperature field. Parametric investigation is conducted and the influence of the particle size (dp), flow Reynolds number (Re) and external magnetic field strength (B0) on the "capture efficiency" (CE) is reported. The difference in CE is also studied for different particle loading condition. According to the results, the magnetic field increased the particle concentration in the target region. Analysis shows that there exists an optimum regime of operating parameters for which deposition of the drug carrying magnetic particles in a target zone on the partly occluded vessel wall can be maximized. The results provide useful design bases for in vitro set up for the investigation of MDT in stenosed blood vessels.

Transport and Magnetization in Bad Metals Itinerant Ferromagnets

NASA Astrophysics Data System (ADS)

Klein, Lior

1997-03-01

While much attention has been given to the study of itinerant ferromagnets that are good metals (k_Fl >> 1), very little is known about the transport properties of itinerant ferromagnets in the badly metallic limit (k_Fl= \\cal O ). Here we present our study of the pseudo-cubic perovskite SrRuO3 which is in the limit of k_Fl= \\cal O (1) in its purest form (e.g. single crystals) and is also an itinerant ferromagnet with Tc ~ 160 K. We findfootnote L. Klein, J. S. Dodge, C. H. Ahn, G. J. Snyder, T. H. Geballe, M. R. Beasley, and A. Kapitulnik, Phys. Rev. Lett. 77, 2774 (1996); L. Klein, J. S. Dodge, C. H. Ahn, J. W. Reiner, L. Mieville, T. H.Geballe, M. R. Beasley, and A. Kapitulnik, J. Phys. Condens. Matter 8, 10111 (1996). that while the magnetic properties of SrRuO3 in the paramagnetic phase, near the ferromagnetic phase transition and at low temperatures are normal and similar to those of iron or nickel, the transport properties sharply deviate from those of good metallic ferromagnets: a) As Tarrow T_c^+ the temperature derivative of the magnetic part of the resistivity, dρ _m/dT, diverges with an exponent on the order of 1, an order of magnitude larger than the expected specific heat exponent of ~ 0.1. b) While the critical behavior of dρ _m/dT around Tc is usually found to be symmetric, very weak divergence of dρ _m/dT is observed as Tarrow T_c^-. c) At low temperatures ρ rapidly increases in correlation with the magnetization instead of the usually observed T^2 dependence. d) At T < 4 K for low-residual-resistivity films, and at higher temperatures for high-residual-resistivity films, Kondo-like resistivity minima are observed. We conjecture that the distinct transport behavior of SrRuO3 is related to its being a 'bad metal' in the k_Fl= \\cal O (1) limit, and discuss the possible relevance of our results to the unusual transport properties of other 'bad metals' such as high-temperature superconductors, fullerenes and organic conductors.

Rhythm and Melody Tasks for School-Aged Children With and Without Musical Training: Age-Equivalent Scores and Reliability.

PubMed

Ireland, Kierla; Parker, Averil; Foster, Nicholas; Penhune, Virginia

2018-01-01

Measuring musical abilities in childhood can be challenging. When music training and maturation occur simultaneously, it is difficult to separate the effects of specific experience from age-based changes in cognitive and motor abilities. The goal of this study was to develop age-equivalent scores for two measures of musical ability that could be reliably used with school-aged children (7-13) with and without musical training. The children's Rhythm Synchronization Task (c-RST) and the children's Melody Discrimination Task (c-MDT) were adapted from adult tasks developed and used in our laboratories. The c-RST is a motor task in which children listen and then try to synchronize their taps with the notes of a woodblock rhythm while it plays twice in a row. The c-MDT is a perceptual task in which the child listens to two melodies and decides if the second was the same or different. We administered these tasks to 213 children in music camps (musicians, n = 130) and science camps (non-musicians, n = 83). We also measured children's paced tapping, non-paced tapping, and phonemic discrimination as baseline motor and auditory abilities We estimated internal-consistency reliability for both tasks, and compared children's performance to results from studies with adults. As expected, musically trained children outperformed those without music lessons, scores decreased as difficulty increased, and older children performed the best. Using non-musicians as a reference group, we generated a set of age-based z-scores, and used them to predict task performance with additional years of training. Years of lessons significantly predicted performance on both tasks, over and above the effect of age. We also assessed the relation between musician's scores on music tasks, baseline tasks, auditory working memory, and non-verbal reasoning. Unexpectedly, musician children outperformed non-musicians in two of three baseline tasks. The c-RST and c-MDT fill an important need for researchers interested in evaluating the impact of musical training in longitudinal studies, those interested in comparing the efficacy of different training methods, and for those assessing the impact of training on non-musical cognitive abilities such as language processing.

Rhythm and Melody Tasks for School-Aged Children With and Without Musical Training: Age-Equivalent Scores and Reliability

PubMed Central

Ireland, Kierla; Parker, Averil; Foster, Nicholas; Penhune, Virginia

2018-01-01

Measuring musical abilities in childhood can be challenging. When music training and maturation occur simultaneously, it is difficult to separate the effects of specific experience from age-based changes in cognitive and motor abilities. The goal of this study was to develop age-equivalent scores for two measures of musical ability that could be reliably used with school-aged children (7–13) with and without musical training. The children's Rhythm Synchronization Task (c-RST) and the children's Melody Discrimination Task (c-MDT) were adapted from adult tasks developed and used in our laboratories. The c-RST is a motor task in which children listen and then try to synchronize their taps with the notes of a woodblock rhythm while it plays twice in a row. The c-MDT is a perceptual task in which the child listens to two melodies and decides if the second was the same or different. We administered these tasks to 213 children in music camps (musicians, n = 130) and science camps (non-musicians, n = 83). We also measured children's paced tapping, non-paced tapping, and phonemic discrimination as baseline motor and auditory abilities We estimated internal-consistency reliability for both tasks, and compared children's performance to results from studies with adults. As expected, musically trained children outperformed those without music lessons, scores decreased as difficulty increased, and older children performed the best. Using non-musicians as a reference group, we generated a set of age-based z-scores, and used them to predict task performance with additional years of training. Years of lessons significantly predicted performance on both tasks, over and above the effect of age. We also assessed the relation between musician's scores on music tasks, baseline tasks, auditory working memory, and non-verbal reasoning. Unexpectedly, musician children outperformed non-musicians in two of three baseline tasks. The c-RST and c-MDT fill an important need for researchers interested in evaluating the impact of musical training in longitudinal studies, those interested in comparing the efficacy of different training methods, and for those assessing the impact of training on non-musical cognitive abilities such as language processing. PMID:29674984

Art Instruction and the Goodenough-Harris Drawing Test in Fifth-Graders

ERIC Educational Resources Information Center

Burns, Carolyn J.; Velicer, Wayne F.

1977-01-01

The experiment assessed the effect of ordinary school art instruction in human figure drawing on scores of the Goodenough-Harris Drawing Test. Subjects consisted of 44 fifth-grade students. No differences were found in the control group between pretest and posttests. The treatment group showed significant gains on both posttests. (Author)

Sustainability of integrated leprosy services in rural India: perceptions of community leaders in Uttar Pradesh.

PubMed

Raju, M S; Rao, P S S

2011-01-01

As part of a community-based action research to reduce leprosy stigma, village committees were formed in 3 hyper endemic states of India. From a total of 10 village committees with nearly 200 members from Uttar Pradesh, a systematic random sample of 69 men and 23 women were interviewed in-depth regarding their views on sustainability of integrated leprosy services, as currently adopted. Their recommendations were also sought for further enhancement. Percentages were computed and compared for statistical significance using the z-normal test. The findings show that less than 50% of the respondents were confident that the present trend in voluntary early reporting for MDT and management of complications was adequate to sustain the integrated leprosy services. There were no differences by men or women members and they felt that lack of proper facilities, training and orientation of staff are most influencing factors. Many suggestions were given for improving the sustainability.

Evaluation of acetylated moth bean starch as a carrier for controlled drug delivery

PubMed Central

Singh, Akhilesh V.; Nath, Lila K.

2012-01-01

The present investigation concerns with the development of controlled release tablets of lamivudine using acetylated moth bean starch. The acetylated starch was synthesized with acetic anhydride in pyridine medium. The acetylated moth bean starch was tested for acute toxicity and drug–excipient compatibility study. The formulations were evaluated for physical characteristics like hardness, friability, % drug content and weight variations. The in vitro release study showed that the optimized formulation exhibited highest correlation (R) value in case of Higuchi kinetic model and the release mechanism study proved that the formulation showed a combination of diffusion and erosion process. There was a significant difference in the pharmacokinetic parameters (Tmax, Cmax, AUC, Vd, T1/2 and MDT) of the optimized formulation as compared to the marketed conventional tablet Lamivir®, which proved controlled release potential of acetylated moth bean starch. PMID:22210486

Imitation, Inspiration, and Creation: Cognitive Process of Creative Drawing by Copying Others' Artworks

ERIC Educational Resources Information Center

Okada, Takeshi; Ishibashi, Kentaro

2017-01-01

To investigate the cognitive processes underlying creative inspiration, we tested the extent to which viewing or copying prior examples impacted creative output in art. In Experiment 1, undergraduates made drawings under three conditions: (a) copying an artist's drawing, then producing an original drawing; (b) producing an original drawing without…

Girls in detail, boys in shape: gender differences when drawing cubes in depth.

PubMed

Lange-Küttner, C; Ebersbach, M

2013-08-01

The current study tested gender differences in the developmental transition from drawing cubes in two- versus three dimensions (3D), and investigated the underlying spatial abilities. Six- to nine-year-old children (N = 97) drew two occluding model cubes and solved several other spatial tasks. Girls more often unfolded the various sides of the cubes into a layout, also called diagrammatic cube drawing (object design detail). In girls, the best predictor for drawing the cubes was Mental Rotation Test (MRT) accuracy. In contrast, boys were more likely to preserve the optical appearance of the cube array. Their drawing in 3D was best predicted by MRT reaction time and the Embedded Figures Test (EFT). This confirmed boys' stronger focus on the contours of an object silhouette (object shape). It is discussed whether the two gender-specific approaches to drawing in three dimensions reflect two sides of the appearance-reality distinction in drawing, that is graphic syntax of object design features versus visual perception of projective space. © 2012 The British Psychological Society.

Investigation of Psychometric Properties of the Test for Creative Thinking-Drawing Production: Evidence from Study in Latvia

ERIC Educational Resources Information Center

Kalis, Emils; Roke, Liga; Krumina, Indra

2016-01-01

The Test for Creative Thinking-Drawing Production (TCT-DP) is designed as an effective drawing-based instrument for measuring creative potential. Many studies report adaptation efforts in other cultures pointing out good psychometric properties of the instrument nonetheless revealing also some trouble spots. The present study includes adaptation…

3. "TEST STAND NO. 13, EXCAVATION PLAN & SECTIONS." Specifications ...

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

3. "TEST STAND NO. 1-3, EXCAVATION PLAN & SECTIONS." Specifications No. ENG 04-353-50-10; Drawing No. 60-0906; no sheet number within title block; D.O. SERIES 1109/10. Stamped: AS BUILT. No revisions or revision dates. Last work date on this drawing "Checked by EAG, 1/31/49." Though this drawing is specific to Test Stand 1-3, it also illustrates the general methods used for excavation design and retaining wall construction at Test Stand 1-5. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-3, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

7. PHOTOCOPY, PLANS, ELEVATIONS, AND SECTION DRAWING FOR MISSILE TEST ...

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

7. PHOTOCOPY, PLANS, ELEVATIONS, AND SECTION DRAWING FOR MISSILE TEST AND ASSEMBLY BUILDING. - NIKE Missile Base SL-40, Missile Test & Assembly Building, South end of launch area, northeast of Generator Building No. 3, Hecker, Monroe County, IL

Comparison of clock drawing with Mini Mental State Examination as a screening test in elderly acute hospital admissions.

PubMed Central

Death, J.; Douglas, A.; Kenny, R. A.

1993-01-01

Clock drawing is a quick, easy to remember test that is well received by patients. It is a good screening test for Alzheimer's disease in the outpatient setting. We evaluated its usefulness compared with the standard Mini Mental State Examination (MMSE) in elderly acute medical and surgical hospital admissions. Within 48 hours of admission, 117 patients over 70 years old were administered the MMSE and asked to draw a clock. Using the MMSE as the standard, clock drawing had a sensitivity of 77% and a specificity of 87%. Patients with discrepant scores were then further evaluated. The findings suggest that normal clock drawing ability reasonably excludes cognitive impairment or other causes of an abnormal MMSE in elderly acute medical and surgical hospital admissions, where cognitive impairment is common and frequently missed. PMID:8255833

Variational Data Assimilation for the Global Ocean

DTIC Science & Technology

2013-01-01

ocean includes the Geoid (a fixed gravity equipotential surface ) as well as the MDT, which is not known accurately enough relative to the centimeter...scales, including processes that control the surface mixed layer, the formation of ocean eddies, meandering ocean J.A. Cummings (E3) nography Division...variables. Examples of this in the ocean are integral quantities, such as acous^B travel time and altimeter measures of sea surface height, and direct

Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature.

PubMed

Soukup, Tayana; Lamb, Benjamin W; Arora, Sonal; Darzi, Ara; Sevdalis, Nick; Green, James Sa

2018-01-01

In many health care systems globally, cancer care is driven by multidisciplinary cancer teams (MDTs). A large number of studies in the past few years and across different literature have been performed to better understand how these teams work and how they manage patient care. The aim of our literature review is to synthesize current scientific and clinical understanding on cancer MDTs and their organization; this, in turn, should provide an up-to-date summary of the current knowledge that those planning or leading cancer services can use as a guide for service implementation or improvement. We describe the characteristics of an effective MDT and factors that influence how these teams work. A range of factors pertaining to teamwork, availability of patient information, leadership, team and meeting management, and workload can affect how well MDTs are implemented within patient care. We also review how to assess and improve these teams. We present a range of instruments designed to be used with cancer MDTs - including observational tools, self-assessments, and checklists. We conclude with a practical outline of what appears to be the best practices to implement (Dos) and practices to avoid (Don'ts) when setting up MDT-driven cancer care.

Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature

PubMed Central

Soukup, Tayana; Lamb, Benjamin W; Arora, Sonal; Darzi, Ara; Sevdalis, Nick; Green, James SA

2018-01-01

In many health care systems globally, cancer care is driven by multidisciplinary cancer teams (MDTs). A large number of studies in the past few years and across different literature have been performed to better understand how these teams work and how they manage patient care. The aim of our literature review is to synthesize current scientific and clinical understanding on cancer MDTs and their organization; this, in turn, should provide an up-to-date summary of the current knowledge that those planning or leading cancer services can use as a guide for service implementation or improvement. We describe the characteristics of an effective MDT and factors that influence how these teams work. A range of factors pertaining to teamwork, availability of patient information, leadership, team and meeting management, and workload can affect how well MDTs are implemented within patient care. We also review how to assess and improve these teams. We present a range of instruments designed to be used with cancer MDTs – including observational tools, self-assessments, and checklists. We conclude with a practical outline of what appears to be the best practices to implement (Dos) and practices to avoid (Don’ts) when setting up MDT-driven cancer care. PMID:29403284

Psychological Features and Their Relationship to Movement-Based Subgroups in People Living With Low Back Pain.

PubMed

Karayannis, Nicholas V; Jull, Gwendolen A; Nicholas, Michael K; Hodges, Paul W

2018-01-01

To determine the distribution of higher psychological risk features within movement-based subgroups for people with low back pain (LBP). Cross-sectional observational study. Participants were recruited from physiotherapy clinics and community advertisements. Measures were collected at a university outpatient-based physiotherapy clinic. People (N=102) seeking treatment for LBP. Participants were subgrouped according to 3 classification schemes: Mechanical Diagnosis and Treatment (MDT), Treatment-Based Classification (TBC), and O'Sullivan Classification (OSC). Questionnaires were used to categorize low-, medium-, and high-risk features based on depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-21 Items); fear avoidance (Fear-Avoidance Beliefs Questionnaire); catastrophizing and coping (Pain-Related Self-Symptoms Scale); and self-efficacy (Pain Self-Efficacy Questionnaire). Psychological risk profiles were compared between movement-based subgroups within each scheme. Scores across all questionnaires revealed that most patients had low psychological risk profiles, but there were instances of higher (range, 1%-25%) risk profiles within questionnaire components. The small proportion of individuals with higher psychological risk scores were distributed between subgroups across TBC, MDT, and OSC schemes. Movement-based subgrouping alone cannot inform on individuals with higher psychological risk features. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Optic nerve involvement in a borderline lepromatous leprosy patient on multidrug therapy.

PubMed

Prabha, Neel; Mahajan, Vikram K; Sharma, Surinder K; Sharma, Vikas; Chauhan, Pushpinder S; Mehta, Karaninder S; Abhinav, C; Khatri, Gaytri; Chander, Bal; Tuli, Rajiv

2013-12-01

Amidst the plethora of ocular complications of leprosy, involvement of the posterior segment or optic nerve is extremely rare. The mechanism of optic neuritis in leprosy is poorly understood. A 47 year-old man presented with a single lesion suggestive of mid-borderline (BB) leprosy over left periorbital region; the histology showed borderline lepromatous (BL) leprosy with a BI of 3+. After initial improvement with WHO MDT-MB and prednisolone (40 mg/d) he developed sudden and painless diminished vision in the left eye, about 3 weeks later. His visual acuity was 6/9 in the left and 6/6 in the right eye, and there was left optic disc edema, hyperemia and blurred disc margins. Treatment with prednisolone (60 mg/d) along with WHO MDT-MB continued. A month later he returned with painless diminished vision in the other eye as well. Visual acuity was 6/6 in the right and 6/12 in the left eye, and there was right optic disc edema and left optic disc atrophy. CT of the head and MRI of the brain were normal. Inflammatory edema of the orbital connective tissue or other surrounding structures, or direct infiltration of vasa nervosa with resultant vascular occlusion leading to optic nerve ischemia, seems the most plausible explanation of optic nerve involvement in this case.

Ethnic differences in the Goodenough-Harris draw-a-man and draw-a-woman tests.

PubMed

Dugdale, A E; Chen, S T

1979-11-01

The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 schoolchildren in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. The standard scores of the Chinese children averaged 118 in the DAM and 112 in the DAW tests. These scores were significantly better than the American standards. Malay children scored significantly lower than Chinese, and Tamil children scored lower again. The nutritional status of the children had no influence on the scores. Chinese and Tamil children scored better in the DAM than the DAW, while in Malay boys the reverse was true. Malay children tended to emphasise clothing in the DAM, but Chinese and Tamil children scored better on items relating to facial features and body proportions. The Goodenough-Harris draw-a-person tests are obviously not culture-free, but the causes of ethnic differences have not been elucidated.

Pregnancy test

MedlinePlus

For the urine test, you urinate into a cup. For the blood test, the health care provider uses a needle and syringe to draw blood from your vein into a tube. Any discomfort you might feel from the blood draw will only last a few seconds.

Cultural Differences and Similarities in Responses to the Silver Drawing Test in the USA, Brazil, Russia, Estonia, Thailand, and Australia.

ERIC Educational Resources Information Center

Silver, Rawley

2003-01-01

Summarizes cross-cultural studies of cognitive skills, emotions, and self-images found in responses to drawing tasks by children, adolescents, and adults. Its aim is to find out whether cultural differences in scores on the Silver Drawing Test can illuminate cultural preferences and contribute to cultural practices. (Contains 21 references.) (GCP)

Culture, Perception, and Artistic Visualization: A Comparative Study of Children's Drawings in Three Siberian Cultural Groups

ERIC Educational Resources Information Center

Istomin, Kirill V.; Panáková, Jaroslava; Heady, Patrick

2014-01-01

In a study of three indigenous and non-indigenous cultural groups in northwestern and northeastern Siberia, framed line tests and a landscape drawing task were used to examine the hypotheses that test-based assessments of context sensitivity and independence are correlated with the amount of contextual information contained in drawings, and with…

Review of Recent Literature on Figure Drawing Tests as Related to Research Problems in Art Education

ERIC Educational Resources Information Center

McWhinnie, Harold J.

1971-01-01

McFee's perception-delineation theory is supported. Major methodological problems of the psychological research presented are in the area of set and the control of specific art materials. Among the conclusions: figure drawing may not be culture fair; a person trained in visual arts should be employed in research using figure drawing tests. (VW)

Detailed Drawings for the Force Balance Test Apparatus

EPA Pesticide Factsheets

The American Society of Mechanical Engineers (ASME)/Canadian Standards Association (CSA) Joint Harmonization Task Force on water-efficient showerheads used the force balance test apparatus shown in these drawings.

261. Photocopy of drawing (1976 electrical drawing by the Space ...

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

261. Photocopy of drawing (1976 electrical drawing by the Space and Missile Test Center, VAFB, USAF) FLOODLIGHT PLAN FOR LAUNCH PAD AREA, SHEET E9 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Facial expression drawings and the full cup test: valid tools for the measurement of swelling after dental surgery.

PubMed

Al-Samman, A A; Othman, H A

2017-01-01

Assessment of postoperative swelling is subjective and depends on the patient's opinion. The aim of this study was to evaluate the validity of facial expression drawings and the full cup test and to compare their performance with that of other scales in measuring postoperative swelling. Fifty patients who had one of several procedures were included. All patients were asked to fill in a form for six days postoperatively (including the day of operation) that contained four scales to rate the amount of swelling: facial expression drawings, the full cup test, the visual analogue scale (VAS), and the verbal rating scale (VRS). Seven patients did not know how to use some of the scales. However, all patients successfully used the facial expression drawings. There was a significant difference between the scale that patients found easiest to use and the others (p<0.008). Fourteen patients selected facial expression drawings and five the VRS. The results showed that the correlations between the scales were good (p<0.01). Facial expression drawings and the full cup test are valid tools and could be used to assess postoperative swelling interchangeably with other scales for rating swelling, and some patients found facial expression drawings were the easiest to use. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Quantitative assessment of drawing tests in children with dyslexia and dysgraphia.

PubMed

Galli, Manuela; Cimolin, Veronica; Stella, Giacomo; De Pandis, Maria Francesca; Ancillao, Andrea; Condoluci, Claudia

2018-05-07

Drawing tests in children diagnosed with dyslexia and dysgraphia were quantitatively compared. Fourteen children with dysgraphia, 19 with dyslexia and 13 normally developing were asked to copy 3 figures: a circle, a square and a cross. An optoelectronic system allowed the acquisition of the drawing track in three-dimensions. The participants' head position and upper limb movements were measured as well. A set of parameters including movement duration, velocity, length of the trace, Range of Motion of the upper limb, was computed and compared among the 3 groups. Children with dyslexia traced the circle faster than the other groups. In the cross test, dyslexic participants showed a reduced execution time and increased velocity while drawing the horizontal line. Children with dyslexia were also faster in drawing certain sides of square with respect to the other groups. Copyright © 2018 Elsevier B.V. All rights reserved.

4. PHOTOCOPY OF DRAWING (1976 STRUCTURAL AND ELECTRICAL DRAWING BY ...

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

4. PHOTOCOPY OF DRAWING (1976 STRUCTURAL AND ELECTRICAL DRAWING BY THE SPACE AND MISSILE TEST CENTER, VAFB, USAF) STRUCTURAL AND ELECTRICAL DIAGRAM FOR EQUIPMENT STORAGE BUILDING, SHEET S-26 - Vandenberg Air Force Base, Space Launch Complex 3, Storage Shed, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

6. Photocopy of drawing (1976 structural drawing by the Space ...

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

6. Photocopy of drawing (1976 structural drawing by the Space and Missile Test Center, VAFB, USAF) FLOOR PLAN, ELEVATIONS, SECTIONS, AND DETAILS FOR THE PYROTEST AND STORAGE BUILDING, SHEET S22 - Vandenberg Air Force Base, Space Launch Complex 3, Pyrotechnic Shed, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

168. Photocopy of drawing (1979 civil engineering drawing by the ...

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

168. Photocopy of drawing (1979 civil engineering drawing by the Space and Missile Test Center, USAF) NITROGEN AND HELIUM PUMPING SYSTEM INSTALLATION SITE PLAN, SHEET 511-C-1 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

198. Photocopy of drawing (1976 structural drawing by the Space ...

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

198. Photocopy of drawing (1976 structural drawing by the Space and Missile Test Center, VAFB, USAF) FIRE RESISTIVE COATING PLAN AND ELEVATION FOR THE MST, SHEET S25 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

273. Photocopy of drawing (1976 structural drawing by the Space ...

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

273. Photocopy of drawing (1976 structural drawing by the Space and Missile Test Center, VAFB, USAF) PLANS, ELEVATIONS, AND DETAILS OF THE CAMERA TOWERS, SHEET S20 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

199. Photocopy of drawing (1976 structural drawing by the Space ...

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

199. Photocopy of drawing (1976 structural drawing by the Space and Missile Test Center, VAFB, USAF) STRUCTURAL DETAILS FOR THE MST STAND-TALKERS SHELTER, SHEET S24 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Behind the Veil: Mandala Drawings by Dementia Patients.

ERIC Educational Resources Information Center

Couch, Janet Beaujon

1997-01-01

Examines the Mandala (circular) drawings of elderly patients diagnosed with dementia in order to explore the drawings' role in artmaking and patients' internal processes. Categorized drawings using the MARI Card Test (a projective psychological instrument). Describes the six MARI stages drawn most frequently and colors used most often. (RJM)

Development and Field Test of the Modified Draw-a-Scientist Test and the Draw-a-Scientist Rubric

ERIC Educational Resources Information Center

Farland-Smith, Donna

2012-01-01

Even long before children are able to verbalize which careers may be interesting to them, they collect and store ideas about scientists. For these reasons, asking children to draw a scientist has become an accepted method to provide a glimpse into how children represent and identify with those in the science fields. Years later, these…

33. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING GENERAL ...

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

33. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING GENERAL SITE PLAN AND RELATIONSHIP BETWEEN FLIGHT ENGINE TEST AREA TO ADMINISTRATION AND MAINTENANCE AREA, RAILROAD TRACKS AT SCALE OF 1 INCH TO 400 FEET. RALPH M. PARSONS DRAWING NUMBER: 1229-2 ANP/GE 5-101. DATED MARCH 15, 1957. - Idaho National Engineering Laboratory, Test Area North, Hangar No. 629, Scoville, Butte County, ID

Drawing as a Generative Activity and Drawing as a Prognostic Activity

ERIC Educational Resources Information Center

Schwamborn, Annett; Mayer, Richard E.; Thillmann, Hubertina; Leopold, Claudia; Leutner, Detlev

2010-01-01

In this study, 9th-grade students (N = 196) with a mean age of 14.7 years read a scientific text explaining the chemical process of doing laundry with soap and water and then took 3 tests. Students who were instructed to generate drawings during learning scored higher than students who only read on subsequent tests of transfer (d = 0.91),…

Tow Tank Dynamic Test Rig Drawings and Bill of Materials for the Aquantis 2.5 MW Ocean Current Generation Device

DOE Data Explorer

Swales, Henry; Banko, Richard; Coakley, David

2015-06-03

Aquantis 2.5 MW Ocean Current Generation Device, Tow Tank Dynamic Test Rig Drawings and Bill of Materials. This submission contains information on the equipment for the scaled model tow tank testing. The information includes hardware, test protocols, and plans.

Understanding Elementary Astronomy by Making Drawing-Based Models

NASA Astrophysics Data System (ADS)

van Joolingen, W. R.; Aukes, Annika V. A.; Gijlers, H.; Bollen, L.

2015-04-01

Modeling is an important approach in the teaching and learning of science. In this study, we attempt to bring modeling within the reach of young children by creating the SimSketch modeling system, which is based on freehand drawings that can be turned into simulations. This system was used by 247 children (ages ranging from 7 to 15) to create a drawing-based model of the solar system. The results show that children in the target age group are capable of creating a drawing-based model of the solar system and can use it to show the situations in which eclipses occur. Structural equation modeling predicting post-test knowledge scores based on learners' pre-test knowledge scores, the quality of their drawings and motivational aspects yielded some evidence that such drawing contributes to learning. Consequences for using modeling with young children are considered.

Clock face drawing test performance in children with ADHD.

PubMed

Ghanizadeh, Ahmad; Safavi, Salar; Berk, Michael

2013-01-01

The utility and discriminatory pattern of the clock face drawing test in ADHD is unclear. This study therefore compared Clock Face Drawing test performance in children with ADHD and controls. 95 school children with ADHD and 191 other children were matched for gender ratio and age. ADHD symptoms severities were assessed using DSM-IV ADHD checklist and their intellectual functioning was assessed. The participants completed three clock-drawing tasks, and the following four functions were assessed: Contour score, Numbers score, Hands setting score, and Center score. All the subscales scores of the three clock drawing tests of the ADHD group were lower than that of the control group. In ADHD children, inattention and hyperactivity/ impulsivity scores were not related to free drawn clock test scores. When pre-drawn contour test was performed, inattentiveness score was statistically associated with Number score while none of the other variables of age, gender, intellectual functioning, and hand use preference were associated with that kind of score. In pre-drawn clock, no association of ADHD symptoms with any CDT subscales found significant. In addition, more errors are observed with free drawn clock and Pre-drawn contour than pre-drawn clock. Putting Numbers and Hands setting are more sensitive measures to screen ADHD than Contour and Center drawing. Test performance, except Hands setting, may have already reached a developmental plateau. It is probable that Hand setting deficit in children with ADHD may not decrease from age 8 to 14 years. Performance of children with ADHD is associated with complexity of CDT.

Towards a Delamination Fatigue Methodology for Composite Materials

NASA Technical Reports Server (NTRS)

OBrien, Thomas K.

2007-01-01

A methodology that accounts for both delaminaton onset and growth in composite structural components is proposed for improved fatigue life prediction to reduce life cycle costs and improve accept/reject criteria for manufacturing flaws. The benefits of using a Delamination Onset Threshold (DOT) approach in combination with a Modified Damage Tolerance (MDT) approach is highlighted. The use of this combined approach to establish accept/reject criteria, requiring less conservative initial manufacturing flaw sizes, is illustrated.

[Pay more attention to the standardized oncologic assessment of gastric cancer prior to starting therapy].

PubMed

Ji, Jiafu; Shan, Fei

2015-02-01

With the development of specialized gastric cancer oncology, multidisciplinary treatment(MDT) model has been widely accepted and implemented. Reasonable combination of comprehensive therapy and individualized treatment can really benefit patients, but its premise is comprehensive and detailed assessment of the tumor. We must pay more attention to the standardized oncologic assessment of gastric cancer prior to starting therapy, including staging, resectability assessment, and the pathological and molecular features.

Accounting for Unexpected Test Responses through Examinees' and Their Teachers' Explanations

ERIC Educational Resources Information Center

Petridou, Alexandra; Williams, Julian

2010-01-01

Researchers have developed indices to identify persons whose test results "misfit" and are considered statistically "aberrant" or "unexpected" and whose measures are consequently potentially invalid, drawing the test's validity into question. This study draws on interviews of pupils and their teachers, using a sample…

3. PHOTOCOPY OF DRAWING (1976 CIVIL ENGINEERING DRAWING BY THE ...

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

3. PHOTOCOPY OF DRAWING (1976 CIVIL ENGINEERING DRAWING BY THE SPACE AND MISSILE TEST CENTER, VAFB, USAF) PARTIAL SITE PLAN, EQUIPMENT STORAGE BUILDING, PARKING AREA OVERLAY, AND NEW ROAD, SHEET C4 - Vandenberg Air Force Base, Space Launch Complex 3, Storage Shed, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

264. Photocopy of drawing (1977 piping drawing by the Space ...

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

264. Photocopy of drawing (1977 piping drawing by the Space and Missile Test Center, VAFB, USAF) NITROGEN AND HELIUM PUMPING SYSTEMS INSTALLATION SITE PLAN AND DETAILS, SHEET 3 OF 9 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

259. Photocopy of drawing (1976 piping drawing by the Space ...

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

259. Photocopy of drawing (1976 piping drawing by the Space and Missile Test Center, VAFB, USAF) PLANS, SECTIONS, AND DETAILS OF THE DELUGE WATER SYSTEM FOR THE FLAME BUCKET, SHEET P-17 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

181. Photocopy of drawing (1973 architectural drawing by the Space ...

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

181. Photocopy of drawing (1973 architectural drawing by the Space and Missile Test Center, VAFB, USAF) SITE PLAN, SECTIONS, AND DETAILS FOR THE FUEL TANK RETAINING WALL, SHEET 27A OF 53 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Design and Drawing for Production. Syllabus. Field Test Edition II.

ERIC Educational Resources Information Center

New York State Education Dept., Albany.

This syllabus, which replaces the New York State Education Department publication "Mechanical Drawing and Design," is intended for use in teaching a high school course in design and drawing for production. The materials included in the guide reflect a shift away from the conventional methods of teaching design and drawing to a greater…

Photocopy of original drawing showing Building 3 layout (drawing located ...

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

Photocopy of original drawing showing Building 3 layout (drawing located at NAWS China Lake, Division of Public Works). J.T. STAFFORD-J.H. DAVIES-H.L. GOGERTY: DISPENSARY, CONNECTING CORRIDORS, FLOOR PLAN, ELEVATIONS, AND DETAILS - Naval Ordnance Test Station Inyokern, Dispensary, Main Site, Lauritsen Road at McIntyre Street, Ridgecrest, Kern County, CA

Photocopy of original drawing showing Wing E (drawing located at ...

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

Photocopy of original drawing showing Wing E (drawing located at NAWS China Lake, Division of Public Works). J.T. STAFFORD-J.H. DAVIES-H.L. GOGERTY: SICK OFFICERS QUARTERS, FLOOR PLAN AND ELEVATIONS - Naval Ordnance Test Station Inyokern, Dispensary, Main Site, Lauritsen Road at McIntyre Street, Ridgecrest, Kern County, CA

Photocopy of original drawing showing Wing A (drawing located at ...

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

Photocopy of original drawing showing Wing A (drawing located at NAWS China Lake, Division of Public Works). J.T. STAFFORD-J.H. DAVIES- H.L. GOGERTY: DISPENSARY, SICK CALL AND ADMINISTRATION, FLOOR PLAN AND ELEVATIONS - Naval Ordnance Test Station Inyokern, Dispensary, Main Site, Lauritsen Road at McIntyre Street, Ridgecrest, Kern County, CA

Photocopy of original drawing showing Wing B (drawing located at ...

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

Photocopy of original drawing showing Wing B (drawing located at NAWS China Lake, Division of Public Works). J.T. STAFFORD-J.H. DAVIES-H.L. GOGERTY: DISPENSARY, SURGICAL AND OBSTETRICAL, FLOOR PLAN AND ELEVATIONS - Naval Ordnance Test Station Inyokern, Dispensary, Main Site, Lauritsen Road at McIntyre Street, Ridgecrest, Kern County, CA

Children's Human Figure Drawings: Clinical and Cultural Considerations.

ERIC Educational Resources Information Center

Thakur, P. S.

This paper considers the psychological aspects of children's drawings. The utility of the Draw a Person Test (DAPT) for different types of pscyhological research is discussed, and the non-intellectual and cultural factors of the DAPT are described. Suggestions on the administration, scoring, and interpretation of drawings are given. The next two…

What Does the DAP:IQ Measure?: Drawing Comparisons between Drawing Performance and Developmental Assessments.

PubMed

Rehrig, Gwendolyn; Stromswold, Karin

2018-01-01

Human figure drawing tasks such as the Draw-a-Person test have long been used to assess intelligence (F. Goodenough, 1926). The authors investigate the skills tapped by drawing and the risk factors associated with poor drawing. Self-portraits of 345 preschool children were scored by raters trained in using the Draw-a-Person Intellectual Ability test (DAP:IQ) rubric (C. R. Reynolds & J. A. Hickman, 2004). Analyses of children's fine motor, gross motor, social, cognitive, and language skills revealed that only fine motor skill was an independent predictor of DAP:IQ scores. Being a boy and having a low birth weight were associated with lower DAP:IQ scores. These findings suggest that although the DAP:IQ may not be a valid measure of cognitive ability, it may be a useful screening tool for fine motor disturbances in at-risk children, such as boys who were born at low birth weights. Furthermore, researchers who use human figure drawing tasks to measure intelligence should measure fine motor skill in addition to intelligence.

10. "ARCHITECTURAL, SECTIONS AND DETAILS." Specifications No. ENG043535572; Drawing No. ...

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

10. "ARCHITECTURAL, SECTIONS AND DETAILS." Specifications No. ENG-04-353-55-72; Drawing No. 60-09-12; sheet 23 of 148; file no. 1320/74. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A Terminal Room, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

The inner formal structure of the H-T-P drawings: an exploratory study.

PubMed

Vass, Z

1998-08-01

The study describes some interrelated patterns of traits of the House-Tree-Person (H-T-P) drawings with the instruments of hierarchical cluster analysis. First, according to the literature 1 7 formal or structural aspects of the projective drawings were collected, after which a detailed manual for coding was compiled. Second, the interrater reliability and the consistency of this manual was tested. Third, the hierarchical cluster structure of the reliable and consistent formal aspects was analysed. Results are: (a) a psychometrically tested coding manual of the investigated formal-structural aspects, each of them illustrated with drawings that showed the highest interrater agreement; and (b) the hierarchic cluster structure of the formal aspects of the H-T-P drawings of "normal" adults.

Evaluating young children's cognitive capacities through computer versus hand drawings.

PubMed

Olsen, J

1992-09-01

Young normal and handicapped children, aged 3 to 6 years, were taught to draw a scene of a house, garden and a sky with a computer drawing program that uses icons and is operated by a mouse. The drawings were rated by a team of experts on a 7-category scale. The children's computer- and hand-produced drawings were compared with one another and with results on cognitive, visual and fine motor tests. The computer drawing program made it possible for the children to accurately draw closed shapes, to get instant feedback on the adequacy of the drawing, and to make corrections with ease. It was hypothesized that these features would compensate for the young children's limitations in such cognitive skills, as memory, concentration, planning and accomplishment, as well as their weak motor skills. In addition, it was hypothesized that traditional cognitive ratings of hand drawings may underestimate young children's intellectual ability, because drawing by hand demands motor skills and memory, concentration and planning skills that are more developed than that actually shown by young children. To test the latter hypothesis, the children completed a training program in using a computer to make drawings. The results show that cognitive processes such as planning, analysis and synthesis can be investigated by means of a computer drawing program in a way not possible using traditional pencil and paper drawings. It can be said that the method used here made it possible to measure cognitive abilities "under the floor" of what is ordinarily possible by means of traditionally hand drawings.

49 CFR 572.161 - General description.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Weighted Child Test Dummy § 572.161 General description. (a) The Hybrid III Six-Year-Old Weighted Child Test Dummy is defined by drawings and specifications containing the following materials: (1) “Parts List and Drawings, Part 572 Subpart S, Hybrid III Weighted Six-Year Old Child Test Dummy (H-III6CW...

Short term oxygen therapy effects in hypoxemic patients measured by drawing analysis.

PubMed

Fiz, José Antonio; Faundez-Zanuy, Marcos; Monte-Moreno, Enrique; Alcobé, Josep Roure; Andreo, Felipe; Gomez, Rosa; Manzano, Juan Ruiz

2015-03-01

Chronic hypoxemia has deleterious effects on psychomotor function that can affect daily life. There are no clear results regarding short term therapy with low concentrations of O2 in hypoxemic patients. We seek to demonstrate, by measuring the characteristics of drawing, these effects on psychomotor function of hypoxemic patients treated with O2. Eight patients (7/1) M/F, age 69.5 (9.9) yr, mean (SD) with hypoxemia (Pa O2 62.2 (6.9) mmHg) performed two drawings of pictures. Tests were performed before and after 30 min breathing with O2. Stroke velocity increased after O2 for the house drawing (i.e. velocity 27.6 (5.5) mm/s basal, 30.9 (7.1) mm/s with O2, mean (SD), p<0.025, Wilcoxon test). The drawing time 'down' or fraction time the pen is touching the paper during the drawing phase decreased (i.e. time down 20.7 (6.6) s basal, 17.4 (6.3) s with O2, p<0.017, Wilcoxon test). This study shows that in patients with chronic hypoxemia, a short period of oxygen therapy produces changes in psychomotor function that can be measured by means of drawing analysis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

FAST BUS Test Box (LAIKA) (Engineering Materials)

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

Not Available

1983-01-01

The assembly drawing AD 135-518-00-RO, and the drawings referenced thereon, provide the data and specifications for constructing the LAIKA Test Box. Some drawings are not available, although they are listed on the material lists included. The assembly is a manual tester for FAST BUS modules, both masters and slaves. FAST BUS signals are generated by means of switches or push buttons and provide the state of the bus lines by lighting LED's. The box acts as either a master or slave - depending upon the module under test. It also acts as an ATC to test the arbitration logic ofmore » a master or ATC device.« less

The Bender Gestalt Test with the Human Figure Drawing Test for Young School Children. A Manual for Use with the Koppitz Scoring System.

ERIC Educational Resources Information Center

Koppitz, Elizabeth Munsterberg

Presented is a manual for scoring the Bender Gestalt Test and the Human Figure Drawing Test for screening and diagnostic uses with emotionally disturbed, brain damaged, or perceptually handicapped 5- to 11-year-old children. Given are suggestions for administering and scoring the Bender test which examines distortion of shape, rotation,…

[Neuropsychiatric background of severe drawing disturbances].

PubMed

Molnár, Gábor

2008-01-01

Drawing ability is a primary human skill, which first appeared in the paleolithic art. In spite of this fact, neuropsychology of drawing has been a neglected subject of brain research. In the Crisis Intervention Department at the Budapest Social Center (Hungary), five patients with local brain lesions were identified, who had severe drawing disturbances. This was defined when the form representation in the House-Tree-Person drawing test was was not maintained and was associated with altered figure-perception. Patients were underwent detailed neurological, mental and neuropsychological assessment. Computer tomography of the head was performed at different hospitals in Budapest. House-Tree-Person drawing test was used, which was complemented with copy and visual memory tasks (with Rey-picture), as well as with spontaneous drawing, if it was necessary. Severe drawing disturbances were found in patients with severe right frontal, right temporo-parietal, diffuse right fronto-parieto-temporal, left occipito-temporal lesions and with bilateral basal ganglia lesions with enlarged ventriculi. Impairment of copying figures was sometimes seen without associated impairment of drawing on verbal instructions. Visual memory, visual images in long-term memory, visual analysis, the ability of adequat placement of parts into the whole representation, visuomotor transfer and perhaps the motor drawing programs could be altered separately. Severe drawing disturbance might occur with perfectly maintained writing capabilities. The data indicated that drawing ability requires the intact activity of nearly the whole brain, but it also includes several subfunctions, which could be altered relatively separately.

The occurrence of reactions and impairments in leprosy: experience in the leprosy control program of three provinces in northeastern Thailand, 1987-1995 [correction of 1978-1995]. I. Overview of the study.

PubMed

Schreuder, P A

1998-06-01

This paper is the first in a series of three reports on the occurrence of reactions and impairments in leprosy in Thailand. This first paper gives a general overview about the methodology of the study, some epidemiological observations, delay in detection, multidrug therapy (MDT) completion rates and relapses. The other two papers report on: II. Reactions and III. Neural and Other Impairments. This study was carried out from 1987 until 1995 in three neighboring provinces in northeastern Thailand. A population-based, prospective cohort study. All 640 newly diagnosed leprosy patients in the three provinces, registered between October 1987 and September 1990, were included [420 paucibacillary (PB) and 220 multibacillary (MB)]. This group was followed up (actively and passively) until the end of 1995. Patients were found by active and passive case finding. All new, untreated leprosy patients from the area were enrolled and started on the World Health Organization (WHO) MDT (WHO/MDT) regimen. A vertical control service was run by specialized leprosy workers. During treatment the patients received their monthly doses at home. During surveillance the patients were followed up once a year by a special team. Patients were questioned about delay in detection. Treatment completion rates were calculated. The occurrence of reactions and neural and other impairments at the beginning of, during and after treatment was ascertained. After treatment, the occurrence of late reactions and relapses was recorded. A higher frequency of leprosy was found among the male patients, especially in the MB group. However, in the PB group a higher female/male ratio was found in the age group 55 years and older. There was an increase in the detection rate from the youngest age group to the age group 55 years and older, which showed the highest detection rate. Treatment completion rates were high, 95% in both in the PB and MB treatment groups. About 50% of the new cases reported a delay between onset and registration of 1 year or more. By 1995, 93% of the original patient group was still available for follow up. By the end of 1995, 8 PB and 2 MB relapses were recorded.

Leprosy reactions in postelimination stage: the Bangladesh experience.

PubMed

Mowla, M R; Ara, S; Mizanur Rahman, A F M; Tripura, S P; Paul, S

2017-04-01

Leprosy reactions are immunologically mediated conditions and a major cause of disability before, during and after multidrug therapy (MDT). Little data have been published on the epidemiology of leprosy reactions in Bangladesh. To describe the pattern and prevalence of leprosy reactions in the postelimination stage. A descriptive retrospective cross-sectional study was carried out in Chittagong Medical College Hospital using the registered records of patients in the period between 2004 and 2013. Of the 670 patients with leprosy, 488 (73.38%) were males and 182 (27.37%) were females. The prevalence of reaction was in 300 (44.78%) patients with a male:female ratio of 3.55 : 1. The age-specific cumulative reaction cases at >40 years were 115 (38.33%) among all age groups. The prevalence of reaction was found to be in 166 (55.33%) patients for the reversal reaction, 49 (16.57%) for the erythema nodosum leprosum (ENL) and 85 (28.33%) for the neuritis. Borderline tuberculoid was most common (106, 35.33%)in the reversal reaction group, while lepromatous leprosy was most common (37, 12.33%) in ENL group. More than half of the patients (169, 56.33%) had reactions at the time of presentations, while 85 (28.33%) and 46 (15.33%) patients developed reaction during and after MDT, respectively. The reversal reaction group presented with ≥six skin lesions in 96 (57.83%) patients and ≥two nerve function impairments (NFIs) in 107 (64.46%) patients. The ENL was present chiefly as papulo-nodular lesions in 45 (91.84%) patients followed by pustule-necrotic lesions in four (8.16%), neuritis in 33 (67.35%), fever in 24 (48.98%), lymphadenitis in six (12.24%), arthritis in five (10.20%) and iritis in two (4.08%). Bacterial index ≥3 had been demonstrated in 34 (60.71%) patients in ENL group. The incidence of leprosy reaction seemed to be more than three times common in borderline tuberculoid (52.33%) group than in lepromatous leprosy (14%) group. Reactions with NFI and disability still occur among multibacillary patients during and after MDT. Early detection and management of leprosy reaction are very important in preventing disability and deformity, and patients should be educated to undergo regular follow-up examinations. Developing reinforced new therapies to curb leprosy reactions is crucial for improving leprosy healthcare services. © 2016 European Academy of Dermatology and Venereology.

7. PHOTOCOPY OF DRAWING (UNDATED PLAN AND SCHEDULE DRAWING BY ...

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

7. PHOTOCOPY OF DRAWING (UNDATED PLAN AND SCHEDULE DRAWING BY THE DEPARTMENT OF THE AIR FORCE, SPACE AND MISSILE TEST CENTER) MATERIAL SPECIFICATIONS AND GENERAL NOTES FOR INTERIOR FINISHING FOR BUILDING 762-A, SHEET A4 - Vandenberg Air Force Base, Space Launch Complex 3, Technical Support Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

278. Photocopy of drawing (1978 structural electrical drawing by the ...

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

278. Photocopy of drawing (1978 structural electrical drawing by the Space and Missile Test Center, VAFB, USAF) DETAILS, SECTION, AND ELECTRICAL PLAN FOR THE TIROS AND NOAA THEODOLITE STATION, SLC-3E, SHEET 4 OF 4 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Children's Human Figure Drawings Do Not Measure Intellectual Ability

ERIC Educational Resources Information Center

Willcock, Emma; Imuta, Kana; Hayne, Harlene

2011-01-01

Children typically follow a well-defined series of stages as they learn to draw, but the rate at which they progress through these stages varies from child to child. Some experts have argued that these individual differences in drawing development reflect individual differences in intelligence. Here we assessed the validity of a drawing test that…

Photocopy of original drawing showing Wing A (drawing located at ...

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

Photocopy of original drawing showing Wing A (drawing located at NAWS China Lake, Division of Public Works). J.T. STAFFORD-J.H. DAVIES-H.L. GOGERTY: DISPENSARY, SICK CALL AND ADMINISTRATION, ROOF FRAMING PLAN AND DETAILS - Naval Ordnance Test Station Inyokern, Dispensary, Main Site, Lauritsen Road at McIntyre Street, Ridgecrest, Kern County, CA

7. "LAUNCH SILOS; SECTIONS, DETAILS." Specifications No. ENG043535973; Drawing No. ...

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

7. "LAUNCH SILOS; SECTIONS, DETAILS." Specifications No. ENG-04-353-59-73; Drawing No. 5841-S-4; D.O. SERIES AW1525/26 Rev. A.; Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract No. 6601, Rev. A., Date 11 Sep 59. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Missile Silo Type, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

6. "LAUNCH SILOS, PLAN AND DETAILS." Specifications No. OC15973; Drawing ...

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

6. "LAUNCH SILOS, PLAN AND DETAILS." Specifications No. OC1-59-73; Drawing No. 5841 S-3; D.O. SERIES AW-1525/25 Rev. A.; Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract No. 6601, Rev. A., Date 11 Sep 59. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Missile Silo Type, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

14. Historic elevation drawing of Building 206A, September 8, 1982. ...

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

14. Historic elevation drawing of Building 206A, September 8, 1982. NASA GRC drawing number CF-100863. On file at NASA Glenn Research Center. - Rocket Engine Testing Facility, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

49 CFR 572.135 - Upper and lower torso assemblies and torso flexion test procedure.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Upper and lower torso assemblies and torso flexion... torso assemblies and torso flexion test procedure. (a) Upper/lower torso assembly. The test objective is... (drawing 880105-434), on resistance to articulation between the upper torso assembly (drawing 880105-300...

49 CFR 572.135 - Upper and lower torso assemblies and torso flexion test procedure.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Upper and lower torso assemblies and torso flexion... torso assemblies and torso flexion test procedure. (a) Upper/lower torso assembly. The test objective is... (drawing 880105-434), on resistance to articulation between the upper torso assembly (drawing 880105-300...

49 CFR 572.135 - Upper and lower torso assemblies and torso flexion test procedure.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Upper and lower torso assemblies and torso flexion... torso assemblies and torso flexion test procedure. (a) Upper/lower torso assembly. The test objective is... (drawing 880105-434), on resistance to articulation between the upper torso assembly (drawing 880105-300...

49 CFR 572.135 - Upper and lower torso assemblies and torso flexion test procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Upper and lower torso assemblies and torso flexion... torso assemblies and torso flexion test procedure. (a) Upper/lower torso assembly. The test objective is... (drawing 880105-434), on resistance to articulation between the upper torso assembly (drawing 880105-300...

Mean dynamic topography over Peninsular Malaysian seas using multimission satellite altimetry

NASA Astrophysics Data System (ADS)

Abazu, Isaac Chidi; Din, Ami Hassan Md; Omar, Kamaludin Mohd

2017-04-01

The development of satellite altimeters (SALTs) has brought huge benefits, among which is the ability to more adequately sense ocean-surface topography. The radar altimeter database system was used to capture and process ENVISAT, CRYOSAT-2, SARAL, JASON-1, and JASON-2 SALT data of 5 years between 2011 and 2015. The time series of monthly multimission SALT data showed an estimated sea level trend of 1.0, 2.4, 2.4, 3.6, and 12.0 mm/year at Gelang, Port Kelang, Kukup, Cendering, and Keling. The correlation analysis for the selected tide gauge stations produced satisfying results of R-squared with 0.86, 0.89, 0.91, and 0.97 for Cendering, Sedili, Gelang, and Geting, respectively. The ITG-Grace2010s geoid model was used to compute the mean dynamic topography (MDT) and plot to a grid of 0.25 deg for the Malacca Strait and South China Sea of Peninsular Malaysia, with Keling, Port Kelang, Geting, Sedili, and Johor Bahru tide gauge stations having values determined by interpolation to be 1.14, 1.19, 1.26, 1.88, and 2.91 m, respectively. MDT is computed from the SALT with respect to Port Kelang, the north-south sea slope ranges between -0.64 and 0.29 m/50 km and -0.01 and 0.52 m/50 km along the east and west coasts of Peninsular Malaysia, respectively.

The nematode homologue of Mediator complex subunit 28, F28F8.5, is a critical regulator of C. elegans development

PubMed Central

Kostrouchová, Markéta; Kostrouch, David; Kaššák, Filip; Kostrouchová, Veronika; Benda, Aleš; Krause, Michael W.; Saudek, Vladimír; Kostrouchová, Marta

2017-01-01

The evolutionarily conserved Mediator complex is a critical player in regulating transcription. Comprised of approximately two dozen proteins, the Mediator integrates diverse regulatory signals through direct protein-protein interactions that, in turn, modulate the influence of Mediator on RNA Polymerase II activity. One Mediator subunit, MED28, is known to interact with cytoplasmic structural proteins, providing a potential direct link between cytoplasmic dynamics and the control of gene transcription. Although identified in many animals and plants, MED28 is not present in yeast; no bona fide MED28 has been described previously in Caenorhabditis elegans. Here, we identify bioinformatically F28F8.5, an uncharacterized predicted protein, as the nematode homologue of MED28. As in other Metazoa, F28F8.5 has dual nuclear and cytoplasmic localization and plays critical roles in the regulation of development. F28F8.5 is a vital gene and its null mutants have severely malformed gonads and do not reproduce. F28F8.5 interacts on the protein level with the Mediator subunits MDT-6 and MDT-30. Our results indicate that F28F8.5 is an orthologue of MED28 and suggest that the potential to link cytoplasmic and nuclear events is conserved between MED28 vertebrate and nematode orthologues. PMID:28603670

Magnetic field-enhanced cellular uptake of doxorubicin loaded magnetic nanoparticles for tumor treatment

NASA Astrophysics Data System (ADS)

Venugopal, Indu; Pernal, Sebastian; Duproz, Alexandra; Bentley, Jeromy; Engelhard, Herbert; Linninger, Andreas

2016-09-01

Cancer remains the second most common cause of death in the US, accounting for nearly 1 out of every 4 deaths. In recent years, several varieties of nanoparticles (NPs) have been synthesized with the intent of being utilized as tumor drug delivery vehicles. We have produced superparamagnetic, gold-coated magnetite (Fe3O4@Au) NPs and loaded them with the chemotherapeutic drug doxorubicin (DOX) for magnetic drug targeting (MDT) of tumors. The synthetic strategy uses the food thickening agent gellan gum (Phytagel) as a negatively charged shell around the Fe3O4@Au NP onto which the positively charged DOX molecules are loaded via electrostatic attraction. The resulting DOX-loaded magnetic nanoparticles (DOX-MNPs) were characterized using transmission electron microscopy, energy dispersive x-ray spectroscopy, superconducting quantum interference device magnetometry, surface area electron diffraction, zeta potential measurements, fourier transform infrared spectroscopy as well as UV/Vis and fluorescence spectroscopy. Cytotoxicity of the DOX-MNPs was demonstrated using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay on C6 glioma cells. Cellular uptake of DOX-MNPs was enhanced with magnetic fields, which was quantitatively determined using flow cytometry. This improved uptake also led to greater tumor cell death, which was measured using MTT assay. These MDT results are promising for a new therapy for cancer.

The nematode homologue of Mediator complex subunit 28, F28F8.5, is a critical regulator of C. elegans development.

PubMed

Kostrouchová, Markéta; Kostrouch, David; Chughtai, Ahmed A; Kaššák, Filip; Novotný, Jan P; Kostrouchová, Veronika; Benda, Aleš; Krause, Michael W; Saudek, Vladimír; Kostrouchová, Marta; Kostrouch, Zdeněk

2017-01-01

The evolutionarily conserved Mediator complex is a critical player in regulating transcription. Comprised of approximately two dozen proteins, the Mediator integrates diverse regulatory signals through direct protein-protein interactions that, in turn, modulate the influence of Mediator on RNA Polymerase II activity. One Mediator subunit, MED28, is known to interact with cytoplasmic structural proteins, providing a potential direct link between cytoplasmic dynamics and the control of gene transcription. Although identified in many animals and plants, MED28 is not present in yeast; no bona fide MED28 has been described previously in Caenorhabditis elegans. Here, we identify bioinformatically F28F8.5, an uncharacterized predicted protein, as the nematode homologue of MED28. As in other Metazoa, F28F8.5 has dual nuclear and cytoplasmic localization and plays critical roles in the regulation of development. F28F8.5 is a vital gene and its null mutants have severely malformed gonads and do not reproduce. F28F8.5 interacts on the protein level with the Mediator subunits MDT-6 and MDT-30. Our results indicate that F28F8.5 is an orthologue of MED28 and suggest that the potential to link cytoplasmic and nuclear events is conserved between MED28 vertebrate and nematode orthologues.

Lumbar lateral shift in a patient with interspinous device implantation: a case report.

PubMed

Peterson, Seth; Hodges, Cheri

2016-09-01

Lumbar lateral shift (LLS) is a common clinical observation but has rarely been described in a patient with a history of lumbar surgery. The purpose of the current case report was to describe the use of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) in the multi-modal treatment of a patient with an LLS and a history of multiple surgical procedures in the lumbar spine, including interspinous process device (IPD) implantation. A 72-year-old female with chronic low back pain (LBP) and a surgical history in the lumbar spine was referred to physical therapy for radiating leg pain and presented with a right LLS. Her chief complaints included sitting for long periods, vacuuming and ascending stairs into her home. The patient was treated during eight visits over 30 days. Treatment interventions included manual shift correction, self-correction and management, joint mobilisation below the level of IPD implantation ,neurophysiology education, and development of a home exercise programme. At discharge, her leg pain was resolved and all goals had been met. The patient reported maintenance of gains at 6-month follow-up. Utilisation of the MDT approach, including LLS correction, produced positive outcomes in a complex patient with previous IPD implantation. Future research should investigate treatment and outcomes after invasive spinal procedures in similar patient populations to better inform clinical management. 4.

Using the ICF to clarify team roles and demonstrate clinical reasoning in stroke rehabilitation.

PubMed

Tempest, Stephanie; McIntyre, Anne

2006-05-30

The International Classification of Functioning, Disability and Health (ICF) is advocated as a tool to structure rehabilitation and a universal language to aid communication, within the multi-disciplinary team (MDT). The ICF may also facilitate clarification of team roles and clinical reasoning for intervention. This article aims to explore both factors in stroke rehabilitation. Following a review of the literature, a summary was presented and discussed with clinicians working within stroke rehabilitation, to gather expert opinions. The discussions were informal, being part of service development and on-going education. The clinicians summarised key themes for the potential use of the ICF within clinical practice. Two key themes emerged from the literature and expert opinion for the potential use of the ICF in stroke rehabilitation: (i) to aid communication and structure service provision, (ii) to clarify team roles and aid clinical reasoning. Expert opinion was that clarification of team roles needs to occur at a local level due to the skill mix, particular interests, setting and staffing levels within individual teams. The ICF has the potential to demonstrate/facilitate clinical reasoning, especially when different MDT members are working on the same intervention. There is potential for the ICF to be used to clarify team roles and demonstrate clinical reasoning within stroke rehabilitation. Further experiential research is required to substantiate this view.

Retention of ferrofluid aggregates at the target site during magnetic drug targeting

NASA Astrophysics Data System (ADS)

Asfer, Mohammed; Saroj, Sunil Kumar; Panigrahi, Pradipta Kumar

2017-08-01

The present study reports the retention dynamics of a ferrofluid aggregate localized at the target site inside a glass capillary (500 × 500 μm2 square cross section) against a bulk flow of DI water (Re = 0.16 and 0.016) during the process of magnetic drug targeting (MDT). The dispersion dynamics of iron oxide nanoparticles (IONPs) into bulk flow for different initial size of aggregate at the target site is reported using the brightfield visualization technique. The flow field around the aggregate during the retention is evaluated using the μPIV technique. IONPs at the outer boundary experience a higher shear force as compared to the magnetic force, resulting in dispersion of IONPs into the bulk flow downstream to the aggregate. The blockage effect and the roughness of the outer boundary of the aggregate resulting from chain like clustering of IONPs contribute to the flow recirculation at the downstream region of the aggregate. The entrapment of seeding particles inside the chain like clusters of IONPs at the outer boundary of the aggregate reduces the degree of roughness resulting in a streamlined aggregate at the target site at later time. The effect of blockage, structure of the aggregate, and disturbed flow such as recirculation around the aggregate are the primary factors, which must be investigated for the effectiveness of the MDT process for in vivo applications.

Drawing skill is related to the efficiency of encoding object structure.

PubMed

Perdreau, Florian; Cavanagh, Patrick

2014-01-01

Accurate drawing calls on many skills beyond simple motor coordination. A good internal representation of the target object's structure is necessary to capture its proportion and shape in the drawing. Here, we assess two aspects of the perception of object structure and relate them to participants' drawing accuracy. First, we assessed drawing accuracy by computing the geometrical dissimilarity of their drawing to the target object. We then used two tasks to evaluate the efficiency of encoding object structure. First, to examine the rate of temporal encoding, we varied presentation duration of a possible versus impossible test object in the fovea using two different test sizes (8° and 28°). More skilled participants were faster at encoding an object's structure, but this difference was not affected by image size. A control experiment showed that participants skilled in drawing did not have a general advantage that might have explained their faster processing for object structure. Second, to measure the critical image size for accurate classification in the periphery, we varied image size with possible versus impossible object tests centered at two different eccentricities (3° and 8°). More skilled participants were able to categorise object structure at smaller sizes, and this advantage did not change with eccentricity. A control experiment showed that the result could not be attributed to differences in visual acuity, leaving attentional resolution as a possible explanation. Overall, we conclude that drawing accuracy is related to faster encoding of object structure and better access to crowded details.

Drawing skill is related to the efficiency of encoding object structure

PubMed Central

Perdreau, Florian; Cavanagh, Patrick

2014-01-01

Accurate drawing calls on many skills beyond simple motor coordination. A good internal representation of the target object's structure is necessary to capture its proportion and shape in the drawing. Here, we assess two aspects of the perception of object structure and relate them to participants' drawing accuracy. First, we assessed drawing accuracy by computing the geometrical dissimilarity of their drawing to the target object. We then used two tasks to evaluate the efficiency of encoding object structure. First, to examine the rate of temporal encoding, we varied presentation duration of a possible versus impossible test object in the fovea using two different test sizes (8° and 28°). More skilled participants were faster at encoding an object's structure, but this difference was not affected by image size. A control experiment showed that participants skilled in drawing did not have a general advantage that might have explained their faster processing for object structure. Second, to measure the critical image size for accurate classification in the periphery, we varied image size with possible versus impossible object tests centered at two different eccentricities (3° and 8°). More skilled participants were able to categorise object structure at smaller sizes, and this advantage did not change with eccentricity. A control experiment showed that the result could not be attributed to differences in visual acuity, leaving attentional resolution as a possible explanation. Overall, we conclude that drawing accuracy is related to faster encoding of object structure and better access to crowded details. PMID:25469216

21. Historic section drawing of Building 100. June 29, 1955. ...

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

21. Historic section drawing of Building 100. June 29, 1955. NASA GRC drawing number CE-101444. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

9. Historic plan drawing of Building 205, July 1978. NASA ...

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

9. Historic plan drawing of Building 205, July 1978. NASA GRC Drawing no. CC-18263. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 205, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

ThOMAs: the other means of assessment.

PubMed

Williams, Andrew N; Debelle, Geoffrey D; Davies, Paul; Barrett, Tim G

2005-02-01

We describe a pilot study to investigate whether drawing "Thomas the Tank Engine" could be as effective a measure of developmental progress as the Goodenough-Harris Draw A Man test against the ThOMAs test (The Other Means of Assessment), with internal validation. The study included 95 children aged between 3 and 11 years of age, including a subgroup of 13 children with registered special needs from community and general pediatric clinics within Birmingham, UK, as a means of validation. There was no significant evidence that ThOMAS was either culturally or sex biased. Using regression analysis, nine items were found to correlate highly with actual age, and their total score gave a correlation of 0.563 with age. Adding further items did not increase this. After being converted into age-standardized scores, ThOMAS was as sensitive and specific as the Draw A Man test, and more so above a defined age-standardized threshold. This pilot study suggests that drawing Thomas the Tank Engine would appear to be as sensitive and specific a means of identifying children with special needs as the Goodenough-Harris Draw A Man test. The relatively small sample size means that further research is necessary to further define the age standardizations and to refine the ThOMAs test.

Judging Drawing Abilities of Hong Kong Chinese Gifted Students: Could Nonexperts Make Expert-Like Judgments?

ERIC Educational Resources Information Center

Chan, David W.; Chan, Lai-kwan; Chau, Amethyst

2009-01-01

Two drawings based on tasks originally used in Clark's Drawing Abilities Test from each of 297 Chinese students were first evaluated independently by two Chinese visual artists as below average, average, and above average in drawing abilities. Based on these judges' verbalization to make explicit their implicit criteria for judgments, a set of…

Evaluating the Impact of a Canadian National Anatomy and Radiology Contouring Boot Camp for Radiation Oncology Residents

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

Jaswal, Jasbir; D'Souza, Leah; Johnson, Marjorie

Background: Radiation therapy treatment planning has advanced over the past 2 decades, with increased emphasis on 3-dimensional imaging for target and organ-at-risk (OAR) delineation. Recent studies suggest a need for improved resident instruction in this area. We developed and evaluated an intensive national educational course (“boot camp”) designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary (MDT) approach. Methods: The anatomy and radiology contouring (ARC) boot camp was modeled after prior single-institution pilot studies and a needs-assessment survey. The boot camp incorporated joint lectures from radiation oncologists, anatomists, radiologists, and surgeons, with hands-on contouring instructionmore » and small group interactive seminars using cadaveric prosections and correlative axial radiographs. Outcomes were evaluated using pretesting and posttesting, including anatomy/radiology multiple-choice questions (MCQ), timed contouring sessions (evaluated relative to a gold standard using Dice similarity metrics), and qualitative questions on satisfaction and perceived effectiveness. Analyses of pretest versus posttest scores were performed using nonparametric paired testing. Results: Twenty-nine radiation oncology residents from 10 Canadian universities participated. As part of their current training, 29%, 75%, and 21% receive anatomy, radiology, and contouring instruction, respectively. On posttest scores, the MCQ knowledge scores improved significantly (pretest mean 60% vs posttest mean 80%, P<.001). Across all contoured structures, there was a 0.20 median improvement in students' average Dice score (P<.001). For individual structures, significant Dice improvements occurred in 10 structures. Residents self-reported an improved ability to contour OARs and interpret radiographs in all anatomic sites, 92% of students found the MDT format effective for their learning, and 93% found the boot camp more effective than educational sessions at their own institutions. All of the residents (100%) would recommend this course to others. Conclusions: The ARC boot camp is an effective intervention for improving radiation oncology residents' knowledge and understanding of anatomy and radiology in addition to enhancing their confidence and accuracy in contouring.« less

Evaluating the impact of a Canadian national anatomy and radiology contouring boot camp for radiation oncology residents.

PubMed

Jaswal, Jasbir; D'Souza, Leah; Johnson, Marjorie; Tay, KengYeow; Fung, Kevin; Nichols, Anthony; Landis, Mark; Leung, Eric; Kassam, Zahra; Willmore, Katherine; D'Souza, David; Sexton, Tracy; Palma, David A

2015-03-15

Radiation therapy treatment planning has advanced over the past 2 decades, with increased emphasis on 3-dimensional imaging for target and organ-at-risk (OAR) delineation. Recent studies suggest a need for improved resident instruction in this area. We developed and evaluated an intensive national educational course ("boot camp") designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary (MDT) approach. The anatomy and radiology contouring (ARC) boot camp was modeled after prior single-institution pilot studies and a needs-assessment survey. The boot camp incorporated joint lectures from radiation oncologists, anatomists, radiologists, and surgeons, with hands-on contouring instruction and small group interactive seminars using cadaveric prosections and correlative axial radiographs. Outcomes were evaluated using pretesting and posttesting, including anatomy/radiology multiple-choice questions (MCQ), timed contouring sessions (evaluated relative to a gold standard using Dice similarity metrics), and qualitative questions on satisfaction and perceived effectiveness. Analyses of pretest versus posttest scores were performed using nonparametric paired testing. Twenty-nine radiation oncology residents from 10 Canadian universities participated. As part of their current training, 29%, 75%, and 21% receive anatomy, radiology, and contouring instruction, respectively. On posttest scores, the MCQ knowledge scores improved significantly (pretest mean 60% vs posttest mean 80%, P<.001). Across all contoured structures, there was a 0.20 median improvement in students' average Dice score (P<.001). For individual structures, significant Dice improvements occurred in 10 structures. Residents self-reported an improved ability to contour OARs and interpret radiographs in all anatomic sites, 92% of students found the MDT format effective for their learning, and 93% found the boot camp more effective than educational sessions at their own institutions. All of the residents (100%) would recommend this course to others. The ARC boot camp is an effective intervention for improving radiation oncology residents' knowledge and understanding of anatomy and radiology in addition to enhancing their confidence and accuracy in contouring. Copyright © 2015 Elsevier Inc. All rights reserved.

Students' memorization of anatomy, influence of drawing.

PubMed

Alsaid, B; Bertrand, M

2016-03-01

Anatomy is the cornerstone of medical education. Different teaching methods can be combined. This study was designed to evaluate the influence of students' drawing of the anatomical region before and after the dissection session on their memorization of the studied anatomical region. Four hundred and sixteen second-year medical students in the faculty of medicine of Damascus were included in this study during the 2013-2014 academic year. Students were randomly divided into three blinded groups. Two groups had to draw the anatomical region respectively before and after the dissection session, while the third group did not have to draw. The memorization of the region was evaluated twice, one and seven weeks after the course. Means were compared using a t-test. Scores were significantly higher at 1 and 7 weeks tests in groups who were asked to draw either before or after the dissection compared to those who were not asked to draw. No statistical difference was found between the two groups who drew. The authors recommend the use of drawing in teaching anatomy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

8. Historic plan, section, and detail drawing of observation blockhouse. ...

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

8. Historic plan, section, and detail drawing of observation blockhouse. NASA GRC drawing no. CE-101540, June29, 1955 (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, Observation Blockhouse, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

School Readiness and the Draw-a-Man Test: An Empiricaly Derived Alternative to Harris' Scoring System.

ERIC Educational Resources Information Center

Simner, Marvin L.

1985-01-01

An abbreviated scoring system for the Goodenough-Harris Draw-A-Man Test found that three items had the same overall potential for correctly identifying at-risk kindergarteners as more time-consuming scoring methods. (CL)

Draw forming of scale shuttle external tank dome gores

NASA Technical Reports Server (NTRS)

Garfield, G.

1974-01-01

The process for manufacturing external tank dome gores is discussed. The test fixture and test procedure are described. The characteristics of the draw forming die are analyzed. The specific subjects included are: (1) forming, (2) trimming, (3) cleaning, and (4) heat treatment.

1. Photographic copy of engineering drawing showing elevations and sections ...

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

1. Photographic copy of engineering drawing showing elevations and sections of Test Stand 'E' (Building 4259/E-60). California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering 'Solid Propellant Test Stand E-60 - Elevations & Sections,' sheet E60/10, no date. - Jet Propulsion Laboratory Edwards Facility, Test Stand E, Edwards Air Force Base, Boron, Kern County, CA

Silver Drawing Test of Cognition and Emotion. Third Edition, Revised.

ERIC Educational Resources Information Center

Silver, Rawley

This test, the Silver Drawing Test (SDT), evolved from a belief that the intelligence of children and adults who have poor language skills tends to be underestimated. The aim of the SDT is to provide an instrument for assessing the cognitive skills of individuals who have difficulty understanding others and making themselves understood. There are…

SDT: The Brazilian Standardization of the Silver Drawing Test of Cognition and Emotion.

ERIC Educational Resources Information Center

Allessandrini, Cristina Dias; Duarte, Jose Luclano Miranda; Bianco, Marisa Fernandes; Dupas, Margarida Azevedo

1998-01-01

The Silver Drawing Test of Cognition and Emotion was standardized for Brazilian children (N=2,000). ANOVA results are presented for age and education groups from early grades on, including distinguishing adult education levels; results are compared for U.S. and Brazilian populations. Growth in test scores, emotional content responses, and…

Test-retest reliability of quantitative sensory testing for mechanical somatosensory and pain modulation assessment of masticatory structures.

PubMed

Costa, Y M; Morita-Neto, O; de Araújo-Júnior, E N S; Sampaio, F A; Conti, P C R; Bonjardim, L R

2017-03-01

Assessing the reliability of medical measurements is a crucial step towards the elaboration of an applicable clinical instrument. There are few studies that evaluate the reliability of somatosensory assessment and pain modulation of masticatory structures. This study estimated the test-retest reliability, that is over time, of the mechanical somatosensory assessment of anterior temporalis, masseter and temporomandibular joint (TMJ) and the conditioned pain modulation (CPM) using the anterior temporalis as the test site. Twenty healthy women were evaluated in two sessions (1 week apart) by the same examiner. Mechanical detection threshold (MDT), mechanical pain threshold (MPT), wind-up ratio (WUR) and pressure pain threshold (PPT) were assessed on the skin overlying the anterior temporalis, masseter and TMJ of the dominant side. CPM was tested by comparing PPT before and during the hand immersion in a hot water bath. anova and intra-class correlation coefficients (ICCs) were applied to the data (α = 5%). The overall ICCs showed acceptable values for the test-retest reliability of mechanical somatosensory assessment of masticatory structures. The ICC values of 75% of all quantitative sensory measurements were considered fair to excellent (fair = 8·4%, good = 33·3% and excellent = 33·3%). However, the CPM paradigm presented poor reliability (ICC = 0·25). The mechanical somatosensory assessment of the masticatory structures, but not the proposed CPM protocol, can be considered sufficiently reliable over time to evaluate the trigeminal sensory function. © 2016 John Wiley & Sons Ltd.

29. "TEST TRACK, STATION '0' THROUGH '200' AREA." Specifications No. ...

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

29. "TEST TRACK, STATION '0' THROUGH '200' AREA." Specifications No. ENG-OC-1-57-75, Drawing No. AF-6009-15, sheet 53 of 96, D.O. Series No. AF 1394/73, Rev. C. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 5296 Rev. C, Date: 19 NOV 59. Drawing includes plan, section, and details of track. - Edwards Air Force Base, South Base Sled Track, Edwards Air Force Base, North of Avenue B, between 100th & 140th Streets East, Lancaster, Los Angeles County, CA

10. Photographic copy of engineering drawing showing the plumbing layout ...

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

10. Photographic copy of engineering drawing showing the plumbing layout of Test Stand 'C' Cv Cell, vacuum line, and scrubber-condenser as erected in 1977-78. JPL drawing by VTN Consolidated, Inc. Engineers, Architects, Planners, 2301 Campus Drive, Irvine, California 92664: 'JPL-ETS E-18 (C-Stand Modifications) Flow Diagram,' sheet M-2 (JPL sheet number E18/41-0), September 1, 1977. - Jet Propulsion Laboratory Edwards Facility, Test Stand C, Edwards Air Force Base, Boron, Kern County, CA

9. Photographic copy of engineering drawing showing the mechanical layout ...

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

9. Photographic copy of engineering drawing showing the mechanical layout of Test Stand 'C' Cv Cell, vacuum line, and scrubber-condenser as erected in 1977-78. JPL drawing by VTN Consolidated, Inc. Engineers, Architects, Planners, 2301 Campus Drive, Irvine, California 92664: 'JPL-ETS E-18 (C-Stand Modifications) Control Elevations & Schematics,' sheet M-5 (JPL sheet number E18/44-0), 1 September 1977. - Jet Propulsion Laboratory Edwards Facility, Test Stand C, Edwards Air Force Base, Boron, Kern County, CA

8. Historic plan, section, elevation, and detail drawing of Building ...

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

8. Historic plan, section, elevation, and detail drawing of Building 206, August 26, 1968. NASA GRC drawing number CE-101188 (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 206, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

20. Historic south and west elevation drawing of Building 100. ...

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

20. Historic south and west elevation drawing of Building 100. June 29, 1955. NASA GRC drawing number CE-101443. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

19. Historic north and east elevation drawing of Building 100. ...

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

19. Historic north and east elevation drawing of Building 100. June 29, 1955. NASA GRC drawing number CE-101442. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

61. Historic elevation and section drawing of Building 202 exhaust ...

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

61. Historic elevation and section drawing of Building 202 exhaust scrubber, July 18, 1955. NASA GRC drawing no. CD-101263. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 202, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Culture, perception, and artistic visualization: a comparative study of children's drawings in three Siberian cultural groups.

PubMed

Istomin, Kirill V; Panáková, Jaroslava; Heady, Patrick

2014-01-01

In a study of three indigenous and non-indigenous cultural groups in northwestern and northeastern Siberia, framed line tests and a landscape drawing task were used to examine the hypotheses that test-based assessments of context sensitivity and independence are correlated with the amount of contextual information contained in drawings, and with the order in which the focal and background objects are drawn. The results supported these hypotheses, and inspection of the regression relationships suggested that the intergroup variations in test performance were likely to result from differences in the attention accorded to contextual information, as revealed by the drawings. Social and environmental explanations for the group differences in context sensitivity are also discussed. The conclusions support the argument that cultural differences in artistic styles and perceptual tests reflect the same underlying perceptual tendencies, and they are consistent with the argument that these tendencies reflect corresponding differences in patterns of social and environmental interaction. Copyright © 2013 Cognitive Science Society, Inc.

Symbolic use of size and color in freehand drawing of the tree: myth or reality?

PubMed

Picard, Delphine; Lebaz, Samuel

2010-03-01

In this study, we tested whether children and young adults varied the size and color of their tree drawings based on hypotheses related to the emotional characterization of the drawn topic. We asked a sample of 80 5- to 11-year-old children and adults to draw a tree (baseline drawing) and then a happy versus sad tree from their imagination. Results indicate that size, but not color, is used to express emotion under free drawing conditions. We discuss implications for clinical psychologists and practitioners interpreting drawings of the tree.

8. "TEST STAND, ARCHITECTURAL, FLOOR PLANS AND SCHEDULES." Specifications No. ...

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

8. "TEST STAND, ARCHITECTURAL, FLOOR PLANS AND SCHEDULES." Specifications No. ENG-04-353-55-72; Drawing No. 60-0912; sheet 22 of 148; file no. 1320/73. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A Terminal Room, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

The BaeSR Two-Component Regulatory System Mediates Resistance to Condensed Tannins in Escherichia coli▿ †

PubMed Central

Zoetendal, Erwin G.; Smith, Alexandra H.; Sundset, Monica A.; Mackie, Roderick I.

2008-01-01

The gene expression profiles of Escherichia coli strains grown anaerobically with or without Acacia mearnsii (black wattle) extract were compared to identify tannin resistance strategies. The cell envelope stress protein gene spy and the multidrug transporter-encoding operon mdtABCD, both under the control of the BaeSR two-component regulatory system, were significantly up-regulated in the presence of tannins. BaeSR mutants were more tannin sensitive than their wild-type counterparts. PMID:18039828

[Determine and Implement Updates to Be Made to MODEAR (Mission Operations Data Enterprise Architecture Repository)

NASA Technical Reports Server (NTRS)

Fanourakis, Sofia

2015-01-01

My main project was to determine and implement updates to be made to MODEAR (Mission Operations Data Enterprise Architecture Repository) process definitions to be used for CST-100 (Crew Space Transportation-100) related missions. Emphasis was placed on the scheduling aspect of the processes. In addition, I was to complete other tasks as given. Some of the additional tasks were: to create pass-through command look-up tables for the flight controllers, finish one of the MDT (Mission Operations Directorate Display Tool) displays, gather data on what is included in the CST-100 public data, develop a VBA (Visual Basic for Applications) script to create a csv (Comma-Separated Values) file with specific information from spreadsheets containing command data, create a command script for the November MCC-ASIL (Mission Control Center-Avionics System Integration Laboratory) testing, and take notes for one of the TCVB (Terminal Configured Vehicle B-737) meetings. In order to make progress in my main project I scheduled meetings with the appropriate subject matter experts, prepared material for the meetings, and assisted in the discussions in order to understand the process or processes at hand. After such discussions I made updates to various MODEAR processes and process graphics. These meetings have resulted in significant updates to the processes that were discussed. In addition, the discussions have helped the departments responsible for these processes better understand the work ahead and provided material to help document how their products are created. I completed my other tasks utilizing resources available to me and, when necessary, consulting with the subject matter experts. Outputs resulting from my other tasks were: two completed and one partially completed pass through command look-up tables for the fight controllers, significant updates to one of the MDT displays, a spreadsheet containing data on what is included in the CST-100 public data, a tool to create a csv file with specific information from spreadsheets containing command data, a command script for the November MCC-ASIL testing which resulted in a successful test day identifying several potential issues, and notes from one of the TCVB meetings that was used to keep the teams up to date on what was discussed and decided. I have learned a great deal working at NASA these last four months. I was able to meet and work with amazing individuals, further develop my technical knowledge, expand my knowledge base regarding human spaceflight, and contribute to the CST-100 missions. My work at NASA has strengthened my desire to continue my education in order to make further contributions to the field, and has given me the opportunity to see the advantages of a career at NASA.

Effects of Using Graphics and Animation Online Problem-Based Learning on Visualization Skills among Students

NASA Astrophysics Data System (ADS)

Ariffin, A.; Samsudin, M. A.; Zain, A. N. Md.; Hamzah, N.; Ismail, M. E.

2017-05-01

The Engineering Drawing subject develops skills in geometry drawing becoming more professional. For the concept in Engineering Drawing, students need to have good visualization skills. Visualization is needed to help students get a start before translating into a drawing. So that, Problem Based Learning (PBL) using animation mode (PBL-A) and graphics mode (PBL-G) will be implemented in class. Problem-solving process is repeatedly able to help students interpret engineering drawings step work correctly and accurately. This study examined the effects of PBL-A online and PBL-G online on visualization skills of students in polytechnics. Sixty eight mechanical engineering students have been involved in this study. The visualization test adapted from Bennett, Seashore and Wesman was used in this study. Results showed significant differences in mean scores post-test of visualization skills among the students enrolled in PBL-G with the group of students who attended PBL-A online after effects of pre-test mean score is controlled. Therefore, the effects of animation modes have a positive impact on increasing students’ visualization skills.

Mechanical Drawing: Grades 7-12.

ERIC Educational Resources Information Center

Instructional Objectives Exchange, Los Angeles, CA.

Eighty-five behavioral objectives and related evaluation items for mechanical drawing in grades 7 through 12 are presented. Each sample contains the objective, test items, and means for judging the adequacy of the response. The following categories are included: (1) basic drafting skills; (2) beginning lettering; (3) drawing; (4) orthographic…

34. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING NORTH ...

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

34. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING NORTH AND SOUTH ELEVATIONS. RALPH M. PARSONS DRAWING NUMBER: 1229-2 ANP/GE 5-629-A-3. DATED MARCH 15, 1957. - Idaho National Engineering Laboratory, Test Area North, Hangar No. 629, Scoville, Butte County, ID

JaxoDraw: A graphical user interface for drawing Feynman diagrams

NASA Astrophysics Data System (ADS)

Binosi, D.; Theußl, L.

2004-08-01

JaxoDraw is a Feynman graph plotting tool written in Java. It has a complete graphical user interface that allows all actions to be carried out via mouse click-and-drag operations in a WYSIWYG fashion. Graphs may be exported to postscript/EPS format and can be saved in XML files to be used for later sessions. One of JaxoDraw's main features is the possibility to create ? code that may be used to generate graphics output, thus combining the powers of ? with those of a modern day drawing program. With JaxoDraw it becomes possible to draw even complicated Feynman diagrams with just a few mouse clicks, without the knowledge of any programming language. Program summaryTitle of program: JaxoDraw Catalogue identifier: ADUA Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADUA Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Distribution format: tar gzip file Operating system: Any Java-enabled platform, tested on Linux, Windows ME, XP, Mac OS X Programming language used: Java License: GPL Nature of problem: Existing methods for drawing Feynman diagrams usually require some 'hard-coding' in one or the other programming or scripting language. It is not very convenient and often time consuming, to generate relatively simple diagrams. Method of solution: A program is provided that allows for the interactive drawing of Feynman diagrams with a graphical user interface. The program is easy to learn and use, produces high quality output in several formats and runs on any operating system where a Java Runtime Environment is available. Number of bytes in distributed program, including test data: 2 117 863 Number of lines in distributed program, including test data: 60 000 Restrictions: Certain operations (like internal latex compilation, Postscript preview) require the execution of external commands that might not work on untested operating systems. Typical running time: As an interactive program, the running time depends on the complexity of the diagram to be drawn.

2. Photographic copy of engineering drawing showing mechanical systems in ...

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

2. Photographic copy of engineering drawing showing mechanical systems in plan and sections of Test Stand 'E,' including tunnel entrance. California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering 'Bldg. E-60 Mechanical, Solid Propellant Test Stand,' sheet E60/13-4, June 20, 1961. - Jet Propulsion Laboratory Edwards Facility, Test Stand E, Edwards Air Force Base, Boron, Kern County, CA

What Is the Teacher Doing? What Are the Students Doing? An Application of the Draw-a-Science-Teacher-Test

ERIC Educational Resources Information Center

Minogue, James

2010-01-01

This study documents the use of the Draw-a-Science-Teacher-Test as diagnostic tool for both preservice teacher beliefs about science teaching and science methods course effectiveness. Direct comparison of pre-course to post-course images from 50 preservice elementary teachers was undertaken using McNemar's test. Results indicated statistically…

Results on the Slosson Drawing Coordination Test with Appalachian Sheltered Workshop Clients.

ERIC Educational Resources Information Center

Rogers, George W., Jr.; Richmond, Bert O.

Fifty-four clients (13- to 52-years-old) in an Appalachian sheltered workshop were administered the Slosson Drawing Coordination Test (SDCT) and the Bender Visual Motor Gestalt Test. Twenty-nine Ss were labeled possibly brain damaged by the SDCT, and 17 Ss by the M. Hutt scoring system for the Bender-Gestalt. Two psychologists using all available…

12. "SITE PLAN." Test Area 1100. Specifications No. OC35973; Drawing ...

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

12. "SITE PLAN." Test Area 1-100. Specifications No. OC359-73; Drawing No. 5841-C-1; D.O. SERIES AW1525/7 Rev. A. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Leuhman Ridge near Highways 58 & 395, Boron, Kern County, CA

Comparison of changes in oxygenated hemoglobin during the tree-drawing task between patients with schizophrenia and healthy controls.

PubMed

Nakano, Shinya; Shoji, Yoshihisa; Morita, Kiichiro; Igimi, Hiroyasu; Sato, Mamoru; Ishii, Youhei; Kondo, Akihiko; Uchimura, Naohisa

2018-01-01

Tree-drawing test is used as a projective psychological test that expresses the abnormal internal experience in patients with schizophrenia (SZ). Despite the widely accepted view that the cognitive function is involved in characteristic tree-drawing in patients with SZ, no study has psychophysiologically examined it. The present study aimed to investigate the involvement of cognitive function during tree-drawing in patients with SZ. For that purpose, we evaluated the brain function in patients with SZ during a tree-drawing task by using near-infrared spectroscopy (NIRS) and compared them with those in healthy controls. The subjects were 28 healthy controls and 28 patients with SZ. Changes in the oxygenated hemoglobin ([oxy-Hb]) concentration in both the groups during the task of drawing a tree imagined freely (free-drawing task) and the task of copying an illustration of a tree (copying task) were measured by using NIRS. Because of the difference between the task conditions, [oxy-Hb] levels in controls during the free-drawing task were higher than that during the copying task at the bilateral frontal pole regions and left inferior frontal region. Because of the difference between the groups, [oxy-Hb] levels at the left middle frontal region, bilateral inferior frontal regions, bilateral inferior parietal regions, and left superior temporal region during the free-drawing task in patients were lower than that in controls. [oxy-Hb] during the tree-drawing task in patients with SZ was lower than that in healthy controls. Our results suggest that brain dysfunction in patients with SZ might be associated with their tree-drawing.

The human figure drawing as related to attention-deficit hyperactivity disorder (ADHD).

PubMed

Perets-Dubrovsky, Sharon; Kaveh, Michelle; Deutsh-Castel, Tsofia; Cohen, Ayala; Tirosh, Emanuel

2010-06-01

To assess the reliability and validity of the human figure drawing test among children with attention-deficit hyperactivity disorder (ADHD) and/or learning disability, boys (n = 136) between the ages of 8 and 10 years, with either or both ADHD and learning disability, were included. Two drawings were used: person and house, tree and person. The drawings were analyzed using the Koppitz emotional and developmental scales. Conners teacher and parent rating scales and the Matching Familiar Figure Test were administered. High intertest reliability for the emotional scale and a significant negative correlation between the 2 scales were found. The reported anxiety and learning were significantly correlated with the cognitive score. A combination of cognitive and emotional items resulted in 67% correct classification of ADHD and learning disability. This test can be used as part of the assessment of ADHD/learning disability.

Stimulating Scientific Reasoning with Drawing-Based Modeling

ERIC Educational Resources Information Center

Heijnes, Dewi; van Joolingen, Wouter; Leenaars, Frank

2018-01-01

We investigate the way students' reasoning about evolution can be supported by drawing-based modeling. We modified the drawing-based modeling tool SimSketch to allow for modeling evolutionary processes. In three iterations of development and testing, students in lower secondary education worked on creating an evolutionary model. After each…

63. Historic detail drawing of inlet duct cone on exhaust ...

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

63. Historic detail drawing of inlet duct cone on exhaust scrubber at building 202, June 18, 1955. NASA GRC drawing no. CD-101266. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 202, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

35. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING EAST ...

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

35. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING EAST AND WEST ELEVATIONS AND OTHER DETAILS. RALPH M. PARSONS DRAWING NUMBER: 1229-2 ANP/GE 5-629-A-4. DATED MARCH 15, 1957. - Idaho National Engineering Laboratory, Test Area North, Hangar No. 629, Scoville, Butte County, ID

Data compression/error correction digital test system. Appendix 3: Maintenance. Book 2: Receiver assembly drawings

NASA Technical Reports Server (NTRS)

1972-01-01

The assembly drawings of the receiver unit are presented for the data compression/error correction digital test system. Equipment specifications are given for the various receiver parts, including the TV input buffer register, delta demodulator, TV sync generator, memory devices, and data storage devices.

49 CFR 572.120 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Child Test Dummy, Beta Version § 572.120 Incorporation by reference. (a) The following materials are... List and Drawings, Hybrid III Six-year-old Child Test Dummy (H-III6C, Beta Version) (June 2002... (vii) The Hybrid III Six-year-old Child Parts/Drawing List. (2) A procedures manual entitled...

12. "TEST STAND; STRUCTURAL; DEFLECTOR PIT DETAILS, SHEET NO. 1." ...

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

12. "TEST STAND; STRUCTURAL; DEFLECTOR PIT DETAILS, SHEET NO. 1." Specifications No. ENG-04-353-55-72; Drawing No. 60-09-12; sheet 41 of 148; file no. 1320/92, Rev. A. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A Terminal Room, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

11. "INSTRUMENTATION AND CONTROL SYSTEMS, EQUIPMENT LOCATION, TEST STAND TERMINAL ...

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

11. "INSTRUMENTATION AND CONTROL SYSTEMS, EQUIPMENT LOCATION, TEST STAND TERMINAL ROOM, PLANS AND SECTION." Specifications No. ENG-04-353-55-72; Drawing No. 60-0912; sheet 106 of 148; file no. 1321/57. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A Terminal Room, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

27. "TEST STAND; STRUCTURAL; SIDEWALL, NORTH WALL AND SOUTH WALL ...

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

27. "TEST STAND; STRUCTURAL; SIDEWALL, NORTH WALL AND SOUTH WALL FRAMING ELEVATIONS." Specifications No. ENG-04353-55-72; Drawing No. 60-09-12; sheet 27 of 148; file no. 1320/78. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, Rev. B; date: 15 April 1957. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

9. "TEST STAND; STRUCTURAL; CABLE TUNNEL, PLAN, SECTIONS, DETAILS." Specifications ...

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

9. "TEST STAND; STRUCTURAL; CABLE TUNNEL, PLAN, SECTIONS, DETAILS." Specifications No. OC1-55-72-(Rev.); Drawing No. 60-09-12; sheet 43 of 148; file no. AF 1320/94, Rev. A. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A Terminal Room, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

Child molesters vs. rapists as reflected in their self-figure drawings: a pilot study.

PubMed

Lev-Wiesel, Rachel; Witztum, Eliezer

2006-01-01

This study explored whether child molesters can be differentiated from rapists in their self-figure drawings. To achieve this aim, the Machover Draw-A-Person test (Machover, 1949) was used. A sample of 41 male adult perpetrators of sexual assault, 19 rapists and 22 child molesters (all incarcerated in jail) participated in the study. Participants were given paper and pencil and were asked to draw themselves. Results indicated that self-figure drawings of rapists had more indicators of a violent aggressive behavior trait than drawings of child molesters, whereas exaggeration and emphasis of penis were more obvious in the self-figure drawings of child molesters. However, indicators of anxiety were not found to significantly differ between the groups.

Experimental analysis of the sheet metal forming behavior of newly developed press hardening steels

NASA Astrophysics Data System (ADS)

Meza-García, Enrique; Kräusel, Verena; Landgrebe, Dirk

2018-05-01

The aim of this work was the characterization of the newly developed press hardening sheet alloys 1800 PHS and 2000 PHS developed by SSAB with regard to their hot forming behavior on the basis of the experimental determination of relevant mechanical and technological properties. For this purpose conventional and non-conventional sheet metal testing methods were used. To determine the friction coefficient, the strip drawing test was applied, while the deep drawing cup test was used to determine the maximum draw depth. Finally, a V-bending test was carried out to evaluate the springback behavior of the investigated alloys by varying the blank temperature and quenching media. This work provides a technological guideline for the production of press hardened sheet parts made of these investigated sheet metals.

Enhancing the Arctic Mean Sea Surface and Mean Dynamic Topography with CryoSat-2 Data

NASA Astrophysics Data System (ADS)

Stenseng, Lars; Andersen, Ole B.; Knudsen, Per

2014-05-01

A reliable mean sea surface (MSS) is essential to derive a good mean dynamic topography (MDT) and for the estimation of short and long-term changes in the sea surface. The lack of satellite radar altimetry observations above 82 degrees latitude means that existing mean sea surface models have been unreliable in the Arctic Ocean. We here present the latest DTU mean sea surface and mean dynamic topography models that includes CryoSat-2 data to improve the reliability in the Arctic Ocean. In an attempt to extrapolate across the gap above 82 degrees latitude the previously models included ICESat data, gravimetrical geoids, ocean circulation models and various combinations hereof. Unfortunately cloud cover and the short periods of operation has a negative effect on the number of ICESat sea surface observations. DTU13MSS and DTU13MDT are the new generation of state of the art global high-resolution models that includes CryoSat-2 data to extend the satellite radar altimetry coverage up to 88 degrees latitude. Furthermore the SAR and SARin capability of CryoSat-2 dramatically increases the amount of useable sea surface returns in sea-ice covered areas compared to conventional radar altimeters like ENVISAT and ERS-1/2. With the inclusion of CryoSat-2 data the new mean sea surface is improved by more than 20 cm above 82 degrees latitude compared with the previous generation of mean sea surfaces.

Building a multidisciplinary team for burn treatment - Lessons learned from the Montreal tendon transfer experience.

PubMed

Karam, E; Lévesque, M C; Jacquemin, G; Delure, A; Robidoux, I; Laramée, M T; Odobescu, A; Harris, P G; Danino, A M

2014-03-31

Multidisciplinary teams (MDTs) represent a recognized component of care in the treatment of complex conditions such as burns. However, most institutions do not provide adequate support for the formation of these teams. Furthermore, the majority of specialists lack the managerial skills required to create a team and have difficulties finding the proper tools. Our objective is to provide an insight for health care professionals, who wish to form a MDT for burn treatment, on the challenges that are likely to be faced, and to identify key elements that may facilitate the establishment of such a project. The setting for this was a plastic surgery department and rehabilitation center at a national reference center. A qualitative analysis was performed on all correspondences related to our tetraplegia project, from 2006 to 2008. To guide our thematic analysis, we used a form of systems theory known as the complexity theory. The qualitative analysis was performed using the NVivo software (Version 8.0 QSR International Melbourne, Australia). Lastly, the data was organized in chronologic order. Three main themes emerged from the results: knowledge acquisition, project organizational setup and project steps design. These themes represented respectively 24%, 50% and 26% of all correspondences. Project steps design and knowledge acquisition correspondences increased significantly after the introduction of the mentor team to our network. We conclude that an early association with a mentor team is beneficial for the establishment of a MDT.

Effect of non-Newtonian characteristics of blood on magnetic particle capture in occluded blood vessel

NASA Astrophysics Data System (ADS)

Bose, Sayan; Banerjee, Moloy

2015-01-01

Magnetic nanoparticles drug carriers continue to attract considerable interest for drug targeting in the treatment of cancer and other pathological conditions. Magnetic carrier particles with surface-bound drug molecules are injected into the vascular system upstream from the desired target site, and are captured at the target site via a local applied magnetic field. Herein, a numerical investigation of steady magnetic drug targeting (MDT) using functionalized magnetic micro-spheres in partly occluded blood vessel having a 90° bent is presented considering the effects of non-Newtonian characteristics of blood. An Eulerian-Lagrangian technique is adopted to resolve the hemodynamic flow and the motion of the magnetic particles in the flow using ANSYS FLUENT. An implantable infinitely long cylindrical current carrying conductor is used to create the requisite magnetic field. Targeted transport of the magnetic particles in a partly occluded vessel differs distinctly from the same in a regular unblocked vessel. Parametric investigation is conducted and the influence of the insert configuration and its position from the central plane of the artery (zoffset), particle size (dp) and its magnetic property (χ) and the magnitude of current (I) on the "capture efficiency" (CE) is reported. Analysis shows that there exists an optimum regime of operating parameters for which deposition of the drug carrying magnetic particles in a target zone on the partly occluded vessel wall can be maximized. The results provide useful design bases for in vitro set up for the investigation of MDT in stenosed blood vessels.

Management of achalasia in the UK, do we need new guidelines?

PubMed

El Kafsi, Jihene; Foliaki, Antonio; Dehn, Thomas C B; Maynard, Nicholas D

2016-12-01

It is recommended that management of complex benign upper gastrointestinal pathology is discussed at multi disciplinary team (MDT) meetings. American College of Gastroenterology (ACG) guidelines further recommend that treatment delivery is provided by high volume centres, with objective post-procedural investigations, in order to improve patient outcomes. We aimed to survey the current UK practice in the management of achalasia. 443 Upper gastrointestinal (UGI) specialist surgeons throughout the UK were sent a surveymonkey.com questionnaire about the management of achalasia. 100 responses were received. The majority of patients with achalasia are referred directly to surgeons (80%) and only 15% of units have a MDT meeting for discussing such patients. Diagnosis was mainly with oesophagogastroduodenoscopy (OGD) and contrast swallow, and only 61% of units have access to high resolution manometry (HRM). 89% of younger patients were offered surgery initially, whilst in the elderly surgery was offered as first line treatment in 55%. Partial fundoplication was carried out by 91% of responders as part of the operation, and 58% responders carry out an intraoperative OGD. The average number of operations carried out per annum is 4 per responder. Most responders (66%) did not perform routine post-intervention investigations and follow-up varied from none to lifelong. Diagnosis and management of achalasia within the UK is relatively standardised, although there remains limited access to HRM. Discussion at benign MDTs however is poor and follow-up differs widely. UK guidelines may help to make these more uniform.

Magnetic drug targeting through a realistic model of human tracheobronchial airways using computational fluid and particle dynamics.

PubMed

Pourmehran, Oveis; Gorji, Tahereh B; Gorji-Bandpy, Mofid

2016-10-01

Magnetic drug targeting (MDT) is a local drug delivery system which aims to concentrate a pharmacological agent at its site of action in order to minimize undesired side effects due to systemic distribution in the organism. Using magnetic drug particles under the influence of an external magnetic field, the drug particles are navigated toward the target region. Herein, computational fluid dynamics was used to simulate the air flow and magnetic particle deposition in a realistic human airway geometry obtained by CT scan images. Using discrete phase modeling and one-way coupling of particle-fluid phases, a Lagrangian approach for particle tracking in the presence of an external non-uniform magnetic field was applied. Polystyrene (PMS40) particles were utilized as the magnetic drug carrier. A parametric study was conducted, and the influence of particle diameter, magnetic source position, magnetic field strength and inhalation condition on the particle transport pattern and deposition efficiency (DE) was reported. Overall, the results show considerable promise of MDT in deposition enhancement at the target region (i.e., left lung). However, the positive effect of increasing particle size on DE enhancement was evident at smaller magnetic field strengths (Mn [Formula: see text] 1.5 T), whereas, at higher applied magnetic field strengths, increasing particle size has a inverse effect on DE. This implies that for efficient MTD in the human respiratory system, an optimal combination of magnetic drug career characteristics and magnetic field strength has to be achieved.

Comparison of changes in oxygenated hemoglobin during the tree-drawing task between patients with schizophrenia and healthy controls

PubMed Central

Nakano, Shinya; Shoji, Yoshihisa; Morita, Kiichiro; Igimi, Hiroyasu; Sato, Mamoru; Ishii, Youhei; Kondo, Akihiko; Uchimura, Naohisa

2018-01-01

Background Tree-drawing test is used as a projective psychological test that expresses the abnormal internal experience in patients with schizophrenia (SZ). Despite the widely accepted view that the cognitive function is involved in characteristic tree-drawing in patients with SZ, no study has psychophysiologically examined it. The present study aimed to investigate the involvement of cognitive function during tree-drawing in patients with SZ. For that purpose, we evaluated the brain function in patients with SZ during a tree-drawing task by using near-infrared spectroscopy (NIRS) and compared them with those in healthy controls. Patients and methods The subjects were 28 healthy controls and 28 patients with SZ. Changes in the oxygenated hemoglobin ([oxy-Hb]) concentration in both the groups during the task of drawing a tree imagined freely (free-drawing task) and the task of copying an illustration of a tree (copying task) were measured by using NIRS. Results Because of the difference between the task conditions, [oxy-Hb] levels in controls during the free-drawing task were higher than that during the copying task at the bilateral frontal pole regions and left inferior frontal region. Because of the difference between the groups, [oxy-Hb] levels at the left middle frontal region, bilateral inferior frontal regions, bilateral inferior parietal regions, and left superior temporal region during the free-drawing task in patients were lower than that in controls. Conclusion [oxy-Hb] during the tree-drawing task in patients with SZ was lower than that in healthy controls. Our results suggest that brain dysfunction in patients with SZ might be associated with their tree-drawing. PMID:29719398

36. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING FLOOR ...

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

36. AS BUILT DRAWING OF TAN 629 HANGAR SHOWING FLOOR PLAN AND VICINITY PLAN RELATIONSHIP TO ADMINISTRATION AND MAINTENANCE AREA. RALPH M. PARSONS DRAWING NUMBER: 1229-2 ANP/GE 5-629-A-2. DATED MARCH 15, 1957. - Idaho National Engineering Laboratory, Test Area North, Hangar No. 629, Scoville, Butte County, ID

Training Compliance Control Yields Improvements in Drawing as a Function of Beery Scores

PubMed Central

Snapp-Childs, Winona; Flatters, Ian; Fath, Aaron; Mon-Williams, Mark; Bingham, Geoffrey P.

2014-01-01

Many children have difficulty producing movements well enough to improve in sensori-motor learning. Previously, we developed a training method that supports active movement generation to allow improvement at a 3D tracing task requiring good compliance control. Here, we tested 7–8 year old children from several 2nd grade classrooms to determine whether 3D tracing performance could be predicted using the Beery VMI. We also examined whether 3D tracing training lead to improvements in drawing. Baseline testing included Beery, a drawing task on a tablet computer, and 3D tracing. We found that baseline performance in 3D tracing and drawing co-varied with the visual perception (VP) component of the Beery. Differences in 3D tracing between children scoring low versus high on the Beery VP replicated differences previously found between children with and without motor impairments, as did post-training performance that eliminated these differences. Drawing improved as a result of training in the 3D tracing task. The training method improved drawing and reduced differences predicted by Beery scores. PMID:24651280

Students' Illustrations of the Human Nervous System as a Formative Assessment Tool

ERIC Educational Resources Information Center

Ranaweera, Sisika Priyani Nelum; Montplaisir, Lisa Marie

2010-01-01

The purpose of this study was to explore students' knowledge and learning of the human nervous system (HNS) in an introductory undergraduate Human Anatomy and Physiology course. Classroom observations, demographic data, a preinstructional unit test with drawings, and a postinstructional unit test with drawings were used to identify students'…

Some Methodological Issues with "Draw a Scientist Tests" among Young Children

ERIC Educational Resources Information Center

Losh, Susan C.; Wilke, Ryan; Pop, Margareta

2008-01-01

Children's stereotypes about scientists have been postulated to affect student science identity and interest in science. Findings from prior studies using "Draw a Scientist Test" methods suggest that students see scientists as largely white, often unattractive, men; one consequence may be that girls and minority students feel a science career is…

Early Detection of Alzheimer's Disease Based on the Patient's Creative Drawing Process: First Results with a Novel Neuropsychological Testing Method.

PubMed

Heymann, Petra; Gienger, Regine; Hett, Andreas; Müller, Stephan; Laske, Christoph; Robens, Sibylle; Ostermann, Thomas; Elbing, Ulrich

2018-01-01

Based on the knowledge of art therapy, we developed a new neuropsychological drawing test in order to identify individuals with mild cognitive impairment (MCI) as well as dementia patients and healthy controls (HC). By observing a variety of drawing characteristics of 92 participants with a mean age of 67.7, art therapy and dementia experts discriminate HC from MCI, early dementia of the Alzheimer-type (eDAT), and moderate dementia of the Alzheimer-type (mDAT) by the process analysis of tree drawings on a digitizing tablet. The art therapist's average categorical rating of healthy and MCI or demented individuals matched the clinical diagnosis by 88%. In a first small study, we analyzed interrater reliability, sensitivity, specificity, negative and positive predicted values of our tree drawing test (TDT) in comparison with the clock drawing test (CDT). Similar values of moderate interrater reliability were found for the TDT (0.56) as well as for the CDT (0.54). A significant high sensitivity of 0.9 within this binary impairment scale (HC versus impaired or demented) can be demonstrated. Substantial values for the specificity (0.67) could be obtained that however remain under a perfect value of the CDT (1.0). Considering 31 individuals that received the clinical diagnosis "impaired or demented" the TDT shows a higher recognition rate for the MCI group than the CDT. Furthermore in 8 of 12 borderline cases of clinical diagnosis, the outcome of the TDT diagnosis was consistent with the final clinical result.

Relationship of Bender Gestalt Developmental Scores and Human Drawing Developmental Scores in a Sample of Turkish Preschool Children

ERIC Educational Resources Information Center

Ozer, Serap

2009-01-01

The Bender Gestalt test and Human Drawings are frequently utilized tests in assessing school readiness in children. This study was a pilot attempt to evaluate these two tests in a Turkish sample as they relate to first grade behaviour as measured by teacher ratings. One hundred and five children were evaluated at the end of kindergarten using the…

Artistic drawing as a mnemonic device

NASA Astrophysics Data System (ADS)

Baker Christensen, Leslie

Despite art-based learning being widely used, existing data are primarily qualitative, and most research has not isolated particular variables such as memory for empirical study. The few experiments that have been conducted demonstrated that drawing improves free recall of unpaired words, and retention improves after lessons integrated with drawing, drama, and narrative exercises. To help fill the gap in the current literature, the present study compared the effectiveness of encoding and the rate of memory decay between a drawing mnemonic and note taking on a paired associates task. Using a within-subjects experimental design, participants were presented with word pairs and asked to complete either a drawing mnemonic (DM) or note taking (NT) to assist memorization. Participants were tested immediately after the word pair presentation and after a 20-minute delay. Results supported the hypothesis that the DM condition would produce superior encoding, as evidenced by greater retention on the immediate test. However, no memory decay was observed in the experiment, and therefore results on the delayed test were inconclusive. In fact, scores for the NT condition improved over time whereas the scores for the DM condition did not, which might imply that note taking results in a different consolidation process than drawing. Findings from this study suggested that arts integration can be an effective method to support memory for learned information. Future studies that examine the effect of rehearsal and the long-term effectiveness of a drawing mnemonic are warranted. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd.

This photocopy of an engineering drawing shows the floor plan ...

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

This photocopy of an engineering drawing shows the floor plan of the Liner Lab, including room functions. Austin, Field & Fry, Architects Engineers, 22311 West Third Street, Los Angeles 57, California: Edwards Test Station Complex Phase II, Jet Propulsion Laboratory, California Institute of Technology, Edwards Air Force Base, Edwards, California: "Liner Laboratory, Floor Plan and Schedules," drawing no. E33/4-2, 26 June 1962. California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering: engineering drawings of structures at JPL Edwards Facility. Drawings on file at JPL Plant Engineering, Pasadena, California. California Institute of Technology, Jet Propulsion Laboratory, Plant Engineering: engineering drawings of structures at JPL Edwards Facility. Drawings on file at JPL Plant Engineering, Pasadena, California - Jet Propulsion Laboratory Edwards Facility, Liner Laboratory, Edwards Air Force Base, Boron, Kern County, CA

Combustion of Hazard Division 1.3 M1 Gun Propellant in a Reinforced Concrete Structure

DTIC Science & Technology

2015-08-01

pretest setup and post - test remains. An overall picture of ground zero and the surrounding location was taken for each test . Photographs were taken...how the door was tied in was made based on post - test pictures following rupture of the structure from Tests 2 and 4. The pressure-time histories from...analysis. The Kasun structure was modeled according to the drawings; deviation from drawing design on how the door was tied in was made based on post

4. "TEST STAND NO. 13, CONCRETE STRUCTURAL PLAN AND ELEVATION." ...

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

4. "TEST STAND NO. 1-3, CONCRETE STRUCTURAL PLAN AND ELEVATION." Specifications No. OC11-50-10; Drawing No. 60-09-06; no sheet number within title block. D.O. SERIES 1109/12 REV. E. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04-353 Eng. 177, Rev. E; Date: 17 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-3, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

6. "TEST STAND NO. 13, RETAINING WALLS & APRON, SECTIONS ...

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

6. "TEST STAND NO. 1-3, RETAINING WALLS & APRON, SECTIONS & ELEVATIONS." Specifications No. OC11-50-10; Drawing No. 60-09-06; no sheet number within title block. D.O. SERIES 1109/20, Rev. B. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04-353 Eng. 177, Rev. B; Date: 26 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-3, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

11. "TEST STANDS NOS. 11, 13, & 15; CONCRETE STRUCTURAL ...

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

11. "TEST STANDS NOS. 1-1, 1-3, & 1-5; CONCRETE STRUCTURAL SECTIONS AND DETAILS." Specifications No. OC12-50-10; Drawing No. 60-09-04; no sheet number within title block. D.O. SERIES 1109/15, Rev. E. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04353 Eng. 177, Rev. E; Date: 21 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

13. "TEST STANDS NOS. 11, 13, & 15; CONCRETE STRUCTURAL ...

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

13. "TEST STANDS NOS. 1-1, 1-3, & 1-5; CONCRETE STRUCTURAL SECTIONS AND DETAILS." Specifications No. OC12-50-10; Drawing No. 60-09-04; no sheet number within title block. D.O. SERIES 1109/18, Rev. D. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04353 Eng. 177, Rev. D, no change; Date: 18 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

15. "TEST STANDS NOS. 11, 13, & 15; STRUCTURAL STEEL; ...

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

15. "TEST STANDS NOS. 1-1, 1-3, & 1-5; STRUCTURAL STEEL; PLAN & DETAILS." Specifications No. ENG 04-353-50-10; Drawing No. 60-09-04; no sheet number within title block. D.O. SERIES 1109/34, Rev. A. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04353 Eng. 177, Rev. A, no change; Date: 21 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

9. "TEST STANDS NOS. 11, 13, & 15; CONCRETE STRUCTURAL ...

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

9. "TEST STANDS NOS. 1-1, 1-3, & 1-5; CONCRETE STRUCTURAL SECTIONS AND DETAILS." Specifications No. ENG 04-35350-10; Drawing No. 60-09-04; no sheet number within title block. D.O. SERIES 1109/13. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04353 Eng. 177, no change; Date: 17 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

10. "TEST STANDS NOS. 11, 13, & 15; CONCRETE STRUCTURAL ...

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

10. "TEST STANDS NOS. 1-1, 1-3, & 1-5; CONCRETE STRUCTURAL SECTIONS AND DETAILS." Specifications No. OC12-50-10; Drawing No. 60-09-04; no sheet number within title block. D.O. SERIES 1109/14, Rev. B. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04353 Eng. 177, Rev. B; Date: 21 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

16. "TEST STANDS NOS. 11, 13, & 15; STRUCTURAL STEEL; ...

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

16. "TEST STANDS NOS. 1-1, 1-3, & 1-5; STRUCTURAL STEEL; ELEVATIONS AND SECTIONS." Specifications No. ENG 04353-50-10; Drawing No. 60-09-04; no sheet number within title block. D.O. SERIES 1109/35, Rev. A. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04-353 Eng. 177, Rev. A; Date: 29 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

12. "TEST STANDS NOS. 11, 13, & 15; CONCRETE STRUCTURAL ...

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

12. "TEST STANDS NOS. 1-1, 1-3, & 1-5; CONCRETE STRUCTURAL SECTIONS AND DETAILS." Specifications No. OC12-50-10; Drawing No. 60-09-06; no sheet number within title block. D.O. SERIES 1109/16, Rev. E. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04353 Eng. 177, Rev. E; Date: 26 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

14. "TEST STANDS NOS. 11, 13, & 15; MISCELLANEOUS DETAILS." ...

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

14. "TEST STANDS NOS. 1-1, 1-3, & 1-5; MISCELLANEOUS DETAILS." Specifications No. OC12-50-10; Drawing No. 60-09-04; no sheet number within title block. D.O. SERIES 1109/22, Rev. D. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract DA-04-353 Eng. 177, Rev. D, no change; Date: 17 Dec. 1951. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-5, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

The Role of Canonical Orientations in Children's Drawing of Interpersonal Relationships: Aspects of Graphic Feature Marking.

ERIC Educational Resources Information Center

Ives, William; Houseworth, Marguerite

Aspects of children's early representational drawing ability may provide evidence for feature marking in non-linguistic symbol systems. To test this assumption children in kindergarten, second, and fourth grade were asked to draw a set of referent objects in three conditions: a nominal or standard condition with no implied relationship ("two…

The Relationship between Drawing and Oral Language in Deaf Students Aged Three to Five

ERIC Educational Resources Information Center

Silvestre, Nuria; Cambra, Cristina

2009-01-01

This study examines the relationship between drawing and oral language acquisition in deaf students aged three to five. The sample is made up of one hundred participants: fifty deaf and fifty hearing children. Goodenough's Human Figure Drawing Test and the WPPSI Scale of Intelligence geometric design subtest have been used to evaluate graphic…

Investigating Young Children's Human Figure Drawings Using Rasch Analysis

ERIC Educational Resources Information Center

Campbell, Claire; Bond, Trevor

2017-01-01

The Goodenough-Harris Drawing Test (GHDT) is a non-verbal assessment designed to infer young children's levels of intellectual development and understanding via the collection of three human figure drawings (HFDs)--one each of a man, a woman and a self-portrait. This paper presents findings from a research project that applied the Rasch model for…

Stages in the Development of Children's Drawing.

ERIC Educational Resources Information Center

Dennis, Sonja I.

Case's cognitive developmental theory was used in an investigation of unconstrained drawings by children 4, 6, 8, and 10 years of age. The objectives were: (1) to look for qualitative changes in drawing at these ages, (2) to relate whatever changes were found to qualitative changes in other tasks during the same period, and (3) to test whether a…

49 CFR 572.20 - Limbs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 3-Year-Old Child § 572.20 Limbs. The limbs consist of the assemblies shown on drawing SA 103C 001 as Nos. SA 103C 041, SA 103C 042, SA 103C 051, SA... each of the applicable drawings listed under their respective numbers of the drawing SA 103C 002...

Testing for Controlled Rapid Pressurization

DOE Data Explorer

Steven Knudsen

2014-09-03

Borehole W1 is a NQ core hole drilled at our test site in Socorro. The rock is rhyolite. Borehole W1 which was used to test gas-gas explosive mixtures is 55 feet deep with casing (pinkish in the drawing) set to 35 feet. The model is a representation of the borehole and the holes we cored around the central borehole after the test. The brown colored core holes showed dye when we filled W1 with water and slightly pressurized it. This indicates there was some path between W1 and the colored core hole. The core holes are shown to their TD in the drawing. The green plane is a fracture plane which we believe is the result of the explosions of the gas mixture in W1. Data resource is a 2D .pdf Solid Works Drawing of borehole w-1

The Score Reliability of Draw-a-Person Intellectual Ability Test (DAP: IQ) for Rural Malawi Students

ERIC Educational Resources Information Center

Khasu, Denis S.; Williams, Thomas O., Jr.

2016-01-01

In this brief article, the reliability of scores for the Draw-A-Person Intellectual Ability Test for Children, Adolescents, and Adults (DAP: IQ; Reynolds & Hickman, 2004) was examined through several analyses with a sample of 147 children from rural Malawi, Africa using a Chichewa translation of instructions. Cronbach alpha coefficients for…

The Tree Drawing Test: A Measurement of Cognitive Development. Symposium III B.

ERIC Educational Resources Information Center

Yoshikawa, Kimio; And Others

Reported at this symposium were investigations using the projective "Tree Drawing" test in (1) a case study of the impact of natural and cultural environments on Japanese children attending elementary and junior high schools in Singapore by Kimio Yoshikawa and K. Loganathan Mutharayan; (2) a study comparing cognitive processes of normal,…

33. Drawing R268 (1916), 'Record Of Wash Borings and Test ...

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

33. Drawing R-268 (1916), 'Record Of Wash Borings and Test Piles Taken In Vicinity Of Hunters Point, Cal.'; showing site in 1916 with Dry Docks 1 and 2 and without Dry Dock No. 4. - Hunters Point Naval Shipyard, Drydock No. 4, East terminus of Palou Avenue, San Francisco, San Francisco County, CA

The Draw a Scientist Test: A Different Population and a Somewhat Different Story

ERIC Educational Resources Information Center

Thomas, Mark D.; Henley, Tracy B.; Snell, Catherine M.

2006-01-01

This study examined Draw-a-Scientist-Test (DAST) images solicited from 212 undergraduate students for the presence of traditional gender stereotypes. Participants were 100 males and 112 females enrolled in psychology or computer science courses with a mean age of 21.02 years. A standard multiple regression generated a model that accounts for the…

Drawings reflect a new dimension of the psychological impact of long-term remission of Cushing's syndrome.

PubMed

Tiemensma, Jitske; Daskalakis, Nikolaos P; van der Veen, Else M; Ramondt, Steven; Richardson, Stephanie K; Broadbent, Elizabeth; Romijn, Johannes A; Pereira, Alberto M; Biermasz, Nienke R; Kaptein, Adrian A

2012-09-01

Drawings can be used to assess perceptions of patients about their disease. We aimed to explore the utility of the drawing test and its relation to illness perceptions, quality of life (QoL), and clinical disease severity in patients after long-term remission of Cushing's syndrome. We conducted a cross-sectional study including 47 patients with long-term remission of Cushing's syndrome. Patients completed the drawing test, the Illness Perception Questionnaire-Revised, the Short-Form 36, the EuroQoL-5D, and the Cushing QoL. The Cushing's syndrome severity index was scored based on medical records. Characteristics of the drawings were strongly associated with the Cushing's syndrome severity index and severity ratings of health professionals (all P < 0.02). In addition, patients perceived a dramatic change in body size during the active state of the disease compared to the healthy state before disease. Patients reported that their body does not completely return to the original size (i.e. before disease) after treatment. There were no clear associations between characteristics of the drawings and QoL or illness perceptions. This indicates that drawings and QoL or illness perceptions do not share multiple common properties and measure different aspects/dimensions of the disease process. Drawings reflect a new dimension of the psychological impact of long-term remission of Cushing's syndrome because drawings do not share common properties with parameters of QoL or illness perceptions, but do represent the clinical severity of the disease. The assessment of drawings may enable doctors to appreciate the perceptions of patients with long-term remission of Cushing's syndrome and will lead the way in dispelling idiosyncratic beliefs.