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  1. ENG — EDRN Public Portal

    Cancer.gov

    ENG, or endoglin, is a cell surface adhesion protein involved the regulation of angiogenesis. ENG is a major glycoprotein of the vascular endothelium and is also a component of the transforming growth factor beta receptor complex. ENG binds to the beta1 and beta3 peptides with high affinity. ENG may also be involved in preeclampsia and several types of cancer. There are several isoforms encoded by transcript variants.

  2. MHD Stability Study of Oblate FRCs

    NASA Astrophysics Data System (ADS)

    Cone, G. A.; Milroy, R. D.; Kim, C. C.

    2009-11-01

    The n=1 tilt, interchange, and shift modes of oblate FRC plasmas are simulated using the NIMROD code. The grid geometry approximates the shaped, close-fitting flux conserver used in the Swarthmore Spheromak eXperiment (SSX) oblate FRC studyfootnotetextM. J. Schaffer, M. Brown, C. Cothran, N. Murphy, An oblate FRC concept for SSX, ICC Workshop, College Park, MD, Feb 2007. The results validate the work by Belova et alfootnotetextE. V. Belova, S. C. Jardin, H. Ji, M. Yamada, R. Kulsrud, Numerical study of global stability of oblate field-reversed configurations, Phys. Plasmas, 8(4), 1267 (2001) which characterized important thresholds for these instabilities. The tilt mode changes from an internal mode to an external mode with decreasing FRC elongation, and in the oblate case it can be stabilized with a close-fitting conducting wall. By increasing the edge separatrix pressure for wall-supported FRCs, the growth rate of interchange mode decreases, and complete stabilization is achieved when the separatrix beta exceeds 30%. Simulations of the dynamics of FRC formation from two counter-helicity spheromaks are beginning, and preliminary results will be presented.

  3. Users guide for FRCS: fuel reduction cost simulator software.

    Treesearch

    Roger D. Fight; Bruce R. Hartsough; Peter. Noordijk

    2006-01-01

    The Fuel Reduction Cost Simulator (FRCS) spreadsheet application is public domain software used to estimate costs for fuel reduction treatments involving removal of trees of mixed sizes in the form of whole trees, logs, or chips from a forest. Equipment production rates were developed from existing studies. Equipment operating cost rates are from December 2002 prices...

  4. Development of Compact Toroid Injector for C-2 FRCs

    NASA Astrophysics Data System (ADS)

    Matsumoto, Tadafumi; Sekiguchi, Junichi; Asai, Tomohiko; Gota, Hiroshi; Garate, Eusebio; Allfrey, Ian; Valentine, Travis; Smith, Brett; Morehouse, Mark; TAE Team

    2014-10-01

    Collaborative research project with Tri Alpha Energy has been started and we have developed a new compact toroid (CT) injector for the C-2 device, mainly for fueling field-reversed configurations (FRCs). The CT is formed by a magnetized coaxial plasma-gun (MCPG), which consists of coaxial cylinder electrodes; a spheromak-like plasma is generated by discharge and pushed out from the gun by Lorentz force. The inner diameter of outer electrode is 83.1 mm and the outer diameter of inner electrode is 54.0 mm. The surface of the inner electrode is coated with tungsten in order to reduce impurities coming out from the electrode. The bias coil is mounted inside of the inner electrode. We have recently conducted test experiments and achieved a supersonic CT translation speed of up to ~100 km/s. Other typical plasma parameters are as follows: electron density ~ 5 × 1021 m-3, electron temperature ~ 40 eV, and the number of particles ~0.5-1.0 × 1019. The CT injector is now planned to be installed on C-2 and the first CT injection experiment will be conducted in the near future. The detailed MCPG design as well as the test experimental results will be presented.

  5. HIFLUX: OBLATE FRCS, DOUBLE HELICES,SPHEROMAKS AND RFPS IN ONE SYSTEM

    SciTech Connect

    SCHAFFER,MJ; BOEDO,JA

    2003-07-01

    OAK-B135 High magnetic flux is required for thermonuclear FRC reactors and, more immediately, to advance the FRC experimental program in general. Oblate FRCs are of special interest because they are predicted to have certain improved MHD stability over elongated FRCs, and oblate FRCs may yield the most compact, magnetically confined fusion reactors. Neither oblate nor high-flux FRCs have been investigated experimentally to date. Our presently proposed technique is to make two high-flux, oppositely-handed plasmas by a pair of large, external, reversed-field pinch (RFP) sources. The plasmas would propagate as two Taylor-relaxed double-helix plasmas, to an oblate main plasma chamber, where they would relax further to a counter-helicity pair of spheromaks, which would finally merge into a single high-flux FRC. A concept for a new experimental facility, HIFLUX, to make and study high-magnetic-flux oblate Field-Reversed Configuration (FRC) plasmas, is described. Similar principles might also enable high flux non-inductive startup of other plasma devices.

  6. Inductive Sustainment of Oblate FRCs with the Assistance of Magnetic Diffusion, Shaping and Finite-Lamor Radius Stabilization

    SciTech Connect

    Gerhardt, S.; Belova, E. V.; Yamada, M.; Ji, H.; Inomoto, M.; Jacobson, C. M.; Maqueda, R.; McGeehan, B.; Y., Ren

    2008-07-31

    Oblate field-reversed configurations FRCs have been sustained for >300 µs, or >15 magnetic diffusion times, through the use of an inductive solenoid. These argon FRCs can have their poloidal flux sustained or increased, depending on the timing and strength of the induction. An inward pinch is observed during sustainment, leading to a peaking of the pressure profile and maintenance of the FRC equilibrium. The good stability observed in argon (and krypton) does not transfer to lighter gases, which develop terminal co-interchange instabilities. The stability in argon and krypton is attributed to a combination of external field shaping, magnetic diffusion, and finite-Larmor radius effects.

  7. 5'UTR mutations of ENG cause hereditary hemorrhagic telangiectasia.

    PubMed

    Damjanovich, Kristy; Langa, Carmen; Blanco, Francisco J; McDonald, Jamie; Botella, Luisa M; Bernabeu, Carmelo; Wooderchak-Donahue, Whitney; Stevenson, David A; Bayrak-Toydemir, Pinar

    2011-12-22

    Hereditary hemorrhagic telangiectasia (HHT) is a vascular disorder characterized by epistaxis, arteriovenous malformations, and telangiectases. The majority of the patients have a mutation in the coding region of the activin A receptor type II-like 1 (ACVRL1) or Endoglin (ENG) gene. However, in approximately 15% of cases, sequencing analysis and deletion/duplication testing fail to identify mutations in the coding regions of these genes. Knowing its vital role in transcription and translation control, we were prompted to investigate the 5'untranslated region (UTR) of ENG. We sequenced the 5'UTR of ENG for 154 HHT patients without mutations in ENG or ACVRL1 coding regions. We found a mutation (c.-127C > T), which is predicted to affect translation initiation and alter the reading frame of endoglin. This mutation was found in a family with linkage to the ENG, as well as in three other patients, one of which had an affected sibling with the same mutation. In vitro expression studies showed that a construct with the c.-127C > T mutation alters the translation and decreases the level of the endoglin protein. In addition, a c.-9G > A mutation was found in three patients, one of whom was homozygous for this mutation. Expression studies showed decreased protein levels suggesting that the c.-9G > A is a hypomorphic mutation. Our results emphasize the need for the inclusion of the 5'UTR region of ENG in clinical testing for HHT.

  8. Menstrual bleeding patterns in adolescents using etonogestrel (ENG) implant.

    PubMed

    Deokar, Amit M; Jackson, Wendy; Omar, Hatim A

    2011-01-01

    Etonogestrel (ENG) implant is an effective method of contraception. The implant is designed to provide contraceptive efficacy for 3 years with a relatively quick return of fertility upon its removal. Menstrual irregularities are not uncommon on long-acting progestins and can often be the factor for discontinuation or removal. A retrospective chart analysis was done on 58 patients who chose to be on the ENG implant. Age ranged from 12 to 24 years. The cycle ranged from 1 to 17 months. The mean length of use of the implant was 10.9 months. Over the 20-month period, 13 ENG implants were removed because of menstrual bleeding problems. We conducted a chart review of the adolescent patients who received the ENG implant in our adolescent clinic. An analysis was done based on symptoms experienced by patients who were on the ENG implant and their management, which in some cases resulted in its removal. The data is presented on adolescent and young adult patients who receive their reproductive care in the Adolescent Medicine Clinic at the University of Kentucky, Lexington, KY, USA. ENG implant when used correctly and as indicated is extremely effective in providing contraception for up to 3 years. However, menstrual irregularities can be very troublesome and often a reason for its removal. In our experience, 22.4% (13 out of the 58 subjects) had menstrual problems post-insertion that led to its removal. It is crucial for a clinician to inform and be informed about such side effects.

  9. FPIC: A Key Next Step for Stability Studies of Advanced Beam Driven FRCs

    NASA Astrophysics Data System (ADS)

    Dettrick, Sean; Barnes, Dan; Ceccherini, Francesco; Galeotti, Laura; Guerrero, Victor; Hendrix, Doug; Hubbard, Kevin; Milroy, Richard; Necas, Ales; TAE Team

    2015-11-01

    The goal of the C-2U experiment is to use neutral beam heating and edge biasing to sustain an advanced beam-driven FRC for many milliseconds, longer than the growth times of known instabilities and the resistive wall time. To guide the experiment further into unexplored parameter regimes, it is desirable to have a stability code suitable for beam-driven FRC plasmas, in which the bulk of ion orbits are not Larmor-like and hence gyrokinetic approximations are inapplicable. Fully kinetic ions are required for stability simulations of beam driven FRCs, as are multiple ion species, end boundary conditions, and a resistive boundary. To meet these challenges a new 3D quasineutral hybrid code, FPIC, is being developed. FPIC has a choice of zero electron mass and finite electron mass Ohm's law solvers. Uniform staggered grids, finite differencing, and cut cell boundaries are used to simplify and optimize the PIC while allowing arbitrary boundary shapes. Finite resistivity of the boundary is implemented by coupling free-space exterior solutions to the cut-cell edges. The code is MPI parallelized and the particle push is GPU accelerated. Code benchmarks will be presented including the stability of the FRC tilt mode.

  10. Exhibiting monstrosity: Chang and Eng, the 'original' Siamese twins.

    PubMed

    Mitchell, Sarah

    2003-12-01

    Chang and Eng, the two young men who would eventually be known around the world as the 'original' Siamese twins, arrived in the West in 1829. They were brought to the West to be examined by medical men and to be exhibited to the general public. Throughout the 19th century in Britain and the US, 'monstrosities' such as Chang and Eng, as well as a host of other people with unusual anatomies, were considered both spectacles worthy of public display and edifying medical subjects with the potential to build on medical knowledge. The unique case of Chang and Eng illustrates that the boundary between what is of legitimate medical interest and what is considered merely spectacle is often blurred.

  11. Hereditary hemorrhagic telangiectasia: two distinct ENG deletions in one family.

    PubMed

    Wooderchak, W; Gedge, F; McDonald, M; Krautscheid, P; Wang, X; Malkiewicz, J; Bukjiok, C J; Lewis, T; Bayrak-Toydemir, P

    2010-11-01

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by aberrant vascular development. Mutations in endoglin (ENG) or activin A receptor type II-like 1 (ACVRL1) account for around 90% of HHT patients, 10% of those are large deletions or duplications. We report here the first observation of two distinct, large ENG deletions segregating in one pedigree. An ENG exon 4-7 deletion was observed in a patient with HHT. This deletion was identified in several affected family members. However, some affected family members had an ENG exon 3 deletion instead. These deletions were detected by multiplex ligation-dependent probe amplification and confirmed by mRNA sequencing and an oligo-CGH array. Linkage analysis revealed that one individual with the exon 3 deletion inherited the same chromosome from his mother who has the exon 4-7 deletion. This finding has important clinical implications because it shows that targeted family-specific mutation analysis for exon deletions could have led to the misdiagnosis of some affected family members. © 2010 John Wiley & Sons A/S.

  12. Incorporating multi-source feedback into a new clinically based revision course for the FRCS(Plast) exam.

    PubMed

    Chipp, Elizabeth; Srinivasan, Karthik; Khan, Muhammad Adil Abbas; Rayatt, Sukh

    2011-01-01

    Exit exams for completion of surgical training are demanding and have relatively low pass rates with many candidates requiring multiple attempts. To establish a new, clinically based exam preparation course, utilising multi-source feedback, to identify candidates at risk of failure and improve pass rates. We describe the process of establishing a new, unique, clinically based exam preparation course incorporating multi-source feedback from examiners, patients, nurses and other trainees. We present the course results as well as the exam results for each candidate and analyse the results of the multi-source feedback. Nine candidates have so far successfully completed both the preparation course and the FRCS(Plast) exam. Success in the exam preparation course accurately predicts success in the FRCS(Plast) exam. Nursing staff and patients tend to give higher scores than examiners and trainees. The majority of marginal failures from the course went on to pass the exam, indicating that the course allows candidates to successfully address weaknesses identified on the course. A clinically based exam preparation course utilising multi-source feedback allows identification of candidates at risk of failing a surgical training exit exam and allows targeted training in order to maximise pass rates.

  13. The influence of FRCs reinforcement on marginal adaptation of CAD/CAM composite resin endocrowns after simulated fatigue loading.

    PubMed

    Rocca, Giovanni Tommaso; Saratti, Carlo Massimo; Poncet, Antoine; Feilzer, Albert J; Krejci, Ivo

    2016-05-01

    To evaluate the marginal adaptation of endodontically treated molars restored with CAD/CAM composite resin endocrowns either with or without reinforcement by fibre reinforced composites (FRCs), used in different configurations. 32 human endodontically treated molars were cut 2 mm over the CEJ. Two interproximal boxes were created with the margins located 1 mm below the CEJ (distal box) and 1 mm over the CEJ (mesial box). All specimens were divided in four groups (n = 8). The pulp chamber was filled with: group 1 (control), hybrid resin composite (G-aenial Posterior, GC); group 2, as group 1 but covered by 3 meshes of E-glass fibres (EverStick NET, Stick Tech); group 3, FRC resin (EverX Posterior, GC); group 4, as group 3 but covered by 3 meshes of E-glass fibres. The crowns of all teeth were restored with CAD/CAM composite resin endocrowns (LAVA Ultimate, 3M). All specimens were thermo-mechanically loaded in a computer-controlled chewing machine (600,000 cycles, 1.6 Hz, 49 N and simultaneously 1500 thermo-cycles, 60 s, 5-55 °C). Marginal analysis before and after the loading was carried out on epoxy replicas by SEM at 200× magnification. For all the groups, the percentage values of perfect marginal adaptation after loading were always significantly lower than before loading (p < 0.05). The marginal adaptation before and after loading was not significantly different between the experimental groups (p > 0.05). Within the limitations of this in vitro study, the use of FRCs to reinforce the pulp chamber of devitalized molars restored with CAD/CAM composite resin restorations did not significantly influenced their marginal quality.

  14. Closed-loop, non-linear feedback control simulations of beam-driven field-reversed configurations (FRCs)

    NASA Astrophysics Data System (ADS)

    Rath, N.; Onofri, M.; Barnes, D.; Romero, J.; the TAE Team

    2015-11-01

    The C-2U device has recently demonstrated sustainment of an advanced, beam-driven FRC over time scales longer than the characteristic times for confinement, fast ion slow-down, and wall current decay. In anticipation of further advances in plasma lifetime, we are developing feedback control techniques for major FRC parameters and resistive instabilities. The LamyRidge code solves the time-dependent extended MHD equations in axisymmetric geometry. In the Q2D code, LamyRidge is combined with a 3-D kinetic code that tracks fast ions and runs in parallel with LamyRidge. Periodically, the background fields in the kinetic code are updated from the MHD simulation and the averaged fast particle distribution is integrated into the fluid equations. Recently, we have added the capability to run Q2D simulations as subordinate processes in Simulink, giving us the ability to run non-linear, closed-loop simulations using control algorithms developed in Simulink. The same Simulink models can be exported to real-time targets (CPU or FPGA) to perform feedback control in experiments. We present closed-loop simulations of beam-driven FRCs under magnetically-actuated feedback control. Results for positionally unstable FRCs are compared with the predictions of a linearized rigid-plasma model. Plasmas predicted to be passively stabilized by the linear model are found to exhibit Alfvenic growth in several cases. Feedback gains predicted to be stabilizing in the linear model are generally found to be insufficient in non-linear simulations, and vice versa. Control of separatrix geometry is demonstrated.

  15. An Early Look at the Effects of ENG on Local Newscasts.

    ERIC Educational Resources Information Center

    Stone, Gerald C.; And Others

    This study sought evidence that the switch to electronic news gathering (ENG) by local television stations has changed news selection or news presentation. A content analysis was performed during five days of newscasts at three network-operated Los Angeles television stations that were in various stages of converting to total ENG. Although the…

  16. Characterization of engF, a gene for a non-cellulosomal Clostridium cellulovorans endoglucanase.

    PubMed

    Sheweita, S A; Ichi-ishi, A; Park, J S; Liu, C; Malburg, L M; Doi, R H

    1996-12-05

    A new Clostridium cellulovorans (strain ATCC 35296) endoglucanase gene engF has been isolated and sequenced. The gene contains 1671 bp and codes for a protein containing 557 amino acids and a mass of 60.1 kDa. A putative signal peptide of 29 amino acids is present and the mature protein has a mass of 57.1 kDa. EngF does not have amino acid sequence homology to previously isolated EngB and EngD, but does show sequence homology to family 5 glycosyl hydrolases from Bacillus, Erwinia carotovora, and C. acetobutylicum species. EngF is not a component of the cellulosome and does not contain a duplicated sequence (DS) at its C-terminal region. EngF is capable of binding to cellulose and hydrolyzing carboxymethylcellulose but not xylan. The cellulose binding domain (CBD) differs from types I, II and III CBDs and no obvious homology has been found to other CBD types. The maximum activity of EngF occurs at pH 5.5 and at 47 degrees C. Its properties suggest that EngF plays an ancillary role in the degradation of cellulosic materials.

  17. The Eng1 β-Glucanase Enhances Histoplasma Virulence by Reducing β-Glucan Exposure

    PubMed Central

    Garfoot, Andrew L.; Shen, Qian; Wüthrich, Marcel; Klein, Bruce S.

    2016-01-01

    ABSTRACT The fungal pathogen Histoplasma capsulatum parasitizes host phagocytes. To avoid antimicrobial immune responses, Histoplasma yeasts must minimize their detection by host receptors while simultaneously interacting with the phagocyte. Pathogenic Histoplasma yeast cells, but not avirulent mycelial cells, secrete the Eng1 protein, which is a member of the glycosylhydrolase 81 (GH81) family. We show that Histoplasma Eng1 is a glucanase that hydrolyzes β-(1,3)-glycosyl linkages but is not required for Histoplasma growth in vitro or for cell separation. However, Histoplasma yeasts lacking Eng1 function have attenuated virulence in vivo, particularly during the cell-mediated immunity stage. Histoplasma yeasts deficient for Eng1 show increased exposure of cell wall β-glucans, which results in enhanced binding to the Dectin-1 β-glucan receptor. Consistent with this, Eng1-deficient yeasts trigger increased tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) cytokine production from macrophages and dendritic cells. While not responsible for large-scale cell wall structure and function, the secreted Eng1 reduces levels of exposed β-glucans at the yeast cell wall, thereby diminishing potential recognition by Dectin-1 and proinflammatory cytokine production by phagocytes. In α-glucan-producing Histoplasma strains, Eng1 acts in concert with α-glucan to minimize β-glucan exposure: α-glucan provides a masking function by covering the β-glucan-rich cell wall, while Eng1 removes any remaining exposed β-glucans. Thus, Histoplasma Eng1 has evolved a specialized pathogenesis function to remove exposed β-glucans, thereby enhancing the ability of yeasts to escape detection by host phagocytes. PMID:27094334

  18. The Eng1 β-Glucanase Enhances Histoplasma Virulence by Reducing β-Glucan Exposure.

    PubMed

    Garfoot, Andrew L; Shen, Qian; Wüthrich, Marcel; Klein, Bruce S; Rappleye, Chad A

    2016-04-19

    The fungal pathogen Histoplasma capsulatum parasitizes host phagocytes. To avoid antimicrobial immune responses, Histoplasma yeasts must minimize their detection by host receptors while simultaneously interacting with the phagocyte. Pathogenic Histoplasma yeast cells, but not avirulent mycelial cells, secrete the Eng1 protein, which is a member of the glycosylhydrolase 81 (GH81) family. We show that Histoplasma Eng1 is a glucanase that hydrolyzes β-(1,3)-glycosyl linkages but is not required for Histoplasma growth in vitro or for cell separation. However, Histoplasma yeasts lacking Eng1 function have attenuated virulence in vivo, particularly during the cell-mediated immunity stage. Histoplasma yeasts deficient for Eng1 show increased exposure of cell wall β-glucans, which results in enhanced binding to the Dectin-1 β-glucan receptor. Consistent with this, Eng1-deficient yeasts trigger increased tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) cytokine production from macrophages and dendritic cells. While not responsible for large-scale cell wall structure and function, the secreted Eng1 reduces levels of exposed β-glucans at the yeast cell wall, thereby diminishing potential recognition by Dectin-1 and proinflammatory cytokine production by phagocytes. In α-glucan-producing Histoplasma strains, Eng1 acts in concert with α-glucan to minimize β-glucan exposure: α-glucan provides a masking function by covering the β-glucan-rich cell wall, while Eng1 removes any remaining exposed β-glucans. Thus, Histoplasma Eng1 has evolved a specialized pathogenesis function to remove exposed β-glucans, thereby enhancing the ability of yeasts to escape detection by host phagocytes. The success of Histoplasma capsulatum as an intracellular pathogen results, in part, from an ability to minimize its detection by receptors on phagocytic cells of the immune system. In this study, we showed that Histoplasma pathogenic yeast cells, but not avirulent mycelia

  19. Synergy between EngE, XynA and ManA from Clostridium cellulovorans on corn stalk, grass and pineapple pulp substrates.

    PubMed

    Olver, B; Van Dyk, J S; Beukes, N; Pletschke, B I

    2011-12-01

    The synergistic interaction between various hemi/cellulolytic enzymes has become more important in order to achieve effective and optimal degradation of complex lignocellulose substrates for biofuel production. This study investigated the synergistic effect of three enzymes endoglucanase (EngE), mannanase (ManA) and xylanase (XynA) on the degradation of corn stalk, grass, and pineapple fruit pulp and determined the optimal degree of synergy between combinations of these enzymes. It was established that EngE was essential for degradation of all of the substrates, while the hemicellulases were able to contribute in a synergistic fashion to increase the activity on these substrates. Maximum specific activity and degree of synergy on the corn stalk and grass was found with EngE:XynA in a ratio of 75:25%, with a specific activity of 41.1 U/mg protein and a degree of synergy of 6.3 for corn stalk, and 44.1 U/mg protein and 3.4 for grass, respectively. The pineapple fruit pulp was optimally digested using a ManA:EngE combination in a 50:50% ratio; the specific activity and degree of synergy achieved were 52.4 U/mg protein and 2.7, respectively. This study highlights the importance of hemicellulases for the synergistic degradation of complex lignocellulose. The inclusion of a mannanase in an enzyme consortium for biomass degradation should be examined further as this study suggests that it may play an important, although mostly overlooked, role in the synergistic saccharification of lignocellulose.

  20. Abnormal computerized dynamic posturography findings in dizzy patients with normal ENG results.

    PubMed

    Sataloff, Robert T; Hawkshaw, Mary J; Mandel, Heidi; Zwislewski, Amy B; Armour, Jonathan; Mandel, Steven

    2005-04-01

    The complexities of the balance system create difficulties for professionals interested in testing equilibrium function objectively. Traditionally, electronystagmography (ENG) has been used for this purpose, but it provides information on only a limited portion of the equilibrium system. Computerized dynamic posturography (CDP) is less specific than ENG, but it provides more global insight into a patient's ability to maintain equilibrium under more challenging environmental circumstances. CD Palso appears to be valuable in obtaining objective confirmation of an abnormality in some dizzy patients whose ENG findings are normal. Our review of 33 patients with normal ENG results and abnormal CDP findings suggests that posturography is useful for confirming or quantifying a balance abnormality in some patients whose complaints cannot be confirmed by other tests frequently used by otologists.

  1. An implantable ENG detector with in-system velocity selective recording (VSR) capability.

    PubMed

    Clarke, Chris; Rieger, Robert; Schuettler, Martin; Donaldson, Nick; Taylor, John

    2017-06-01

    Detection and classification of electroneurogram (ENG) signals in the peripheral nervous system can be achieved by velocity selective recording (VSR) using multi-electrode arrays. This paper describes an implantable VSR-based ENG recording system representing a significant development in the field since it is the first system of its type that can record naturally evoked ENG and be interfaced wirelessly using a low data rate transcutaneous link. The system consists of two CMOS ASICs one of which is placed close to the multi-electrode cuff array (MEC), whilst the other is mounted close to the wireless link. The digital ASIC provides the signal processing required to detect selectively ENG signals based on velocity. The design makes use of an original architecture that is suitable for implantation and reduces the required data rate for transmission to units placed outside the body. Complete measured electrical data from samples of the ASICs are presented that show that the system has the capability to record signals of amplitude as low as 0.5 μV, which is adequate for the recording of naturally evoked ENG. In addition, measurements of electrically evoked ENG from the explanted sciatic nerves of Xenopus Laevis frogs are presented.

  2. Identification and molecular characterization of a β-1,4-endoglucanase gene (Rr-eng-1) from Rotylenchulus reniformis.

    PubMed

    Wubben, Martin J; Ganji, Satish; Callahan, Franklin E

    2010-12-01

    β-1,4-endoglucanses, a.k.a. cellulases, are parasitism genes that facilitate root penetration and migration by plant-parasitic nematodes. Rotylenchulus reniformis is a sedentary semi-endoparasite for which little molecular data has been collected. In this report, we describe the isolation and characterization of a predicted glycosyl hydrolase family 5 cellulase from R. reniformis that we have named Rr-eng-1. The Rr-eng-1 cDNA was 1,341 bp long and was comprised of a 19 bp 5'-untranslated region (UTR), a 1,245 bp open reading frame (ORF), and an 80 bp 3'-UTR. The Rr-eng-1 genomic sequence was 2,325 bp. Alignment of the cDNA and genomic sequences revealed seven introns and eight exons for Rr-eng-1. BLASTN analysis showed the Rr-eng-1 cDNA was most homologous to the Hg-eng-6 mRNA from Heterodera glycines. Southern blot analysis indicated that at least three Rr-eng-1-like sequences were present in the R. reniformis genome. Translation of the Rr-eng-1 ORF yielded a 414 amino acid peptide (Rr-ENG-1) having an N-terminal signal sequence for secretion. No cellulose binding module (CBM) was detected in Rr-ENG-1; however, a putative CBM linker sequence N-terminal to the catalytic domain was present. Rr-ENG-1 was most homologous to Hg-ENG-6 but also shared a number of intron splice positions with Mi-ENG-2. Quantitative RT-PCR indicated that Rr-eng-1 was highly expressed in the J2 and adult vermiform life-stages with a sharp decline in expression detected in sedentary females.

  3. Efficacy of CDP and ENG in Detecting Balance Impairment Associated With Cerebral White Matter Changes.

    PubMed

    Urban, Matthew J; Sataloff, Robert T

    2016-10-01

    To examine the relationship between white matter changes (WMCs) and abnormal balance test results on computerized dynamic posturography (CDP) and electronystagmography (ENG). Also, to compare the utility of CDP with ENG for this purpose. Retrospective case review. Tertiary care referral center. A retrospective review of 137 subjects was conducted. The CDP and ENG results were compared between patients with (80) and without (57) WMCs as detected byT2/fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). CDP analysis consisted of both sensory organization test (SOT) and motor control test (MCT) results, and ENG analysis included positional, oculomotor, and bithermal caloric testing. Multivariate logistic regression was performed to control for age and hearing loss discrepancies between the two groups. Ninety three percent of patients with WMCs had an abnormal CDP result, as compared with 44% of patients lacking WMCs (p < 0.001). Eighty six percent of patients with WMCs had an abnormal ENG, as did 81% of patients without WMCs (p = 0.435). Multivariate regression analysis maintained that an abnormal CDP result was significantly associated with WMCs when controlling for age and hearing loss (p < 0.001). These findings suggest that patients with cerebral small-vessel ischemic changes are significantly more likely to have an abnormal balance result as detected by CDP, than by ENG. Hence, CDP may be a better study to identify and document patients who have balance dysfunction associated with this central finding. Such identification will permit additional evaluation and treatment based on objective confirmation of balance dysfunction, in this group of balance-impaired subjects who may have normal ENG's.

  4. [Significance of ENG and DPG in the vestibular function examination in patients suffering BPPV].

    PubMed

    Liu, Jianguo; Guo, Suying; Wang, Kun; Li, Zhen; Du, Zhaowen; Xie, Wen; Liu, Yuehui

    2012-04-01

    To detect the significance of the electronystagmography (ENG) and the dynamic posturography (DPG) in the vestibular function examination in patients suffering BPPV. Forty, 34 to 79 old vertigo patients were examined with DPG and ENG. DPG evaluation parameters includes sense organization test from vestibular sensory score, proprioception score, visual score, Romber's score and composite score. ENG examination include caloric test. Twenty-six out of 40 BPPV patients got abnormal caloric test results; 33 patients got DPG abnormality which led to a low vestibular perception scores. Twenty-four out of these patients got abnormal results in both caloric test and DPG, while in 9 patients that got normal caloric results came up with low vestibular perception scores, except for which there was no significant abnormality in SOT. Besides, the BPPV patients, compared with normal, got abnormal scores in caloric test of ENG and vestibular perception test of DPG (P < 0.05), if course of BPPV was over 12 months, higher abnormal degrees appeared (P < 0.05). ENG and DPG are important methods in vestibular function tests, a comprehensive analysis of both is applied to value the severity of vestibular function in patients with BPPV and the duration of BPPV directly affects the vestibular function.

  5. Restructuring Graduate Engineering Education: The M.Eng. Program at Cornell.

    ERIC Educational Resources Information Center

    Cady, K. Bingham; And Others

    1988-01-01

    Discusses the restructuring of the graduate program to accommodate emerging fields in engineering. Notes half of the graduate degrees Cornell grants each year are M.Eng. degrees. Offers 12 specialties: aerospace, agriculture, chemical, civil, electrical, mechanical and nuclear engineering; computer science, engineering physics; geological…

  6. Restructuring Graduate Engineering Education: The M.Eng. Program at Cornell.

    ERIC Educational Resources Information Center

    Cady, K. Bingham; And Others

    1988-01-01

    Discusses the restructuring of the graduate program to accommodate emerging fields in engineering. Notes half of the graduate degrees Cornell grants each year are M.Eng. degrees. Offers 12 specialties: aerospace, agriculture, chemical, civil, electrical, mechanical and nuclear engineering; computer science, engineering physics; geological…

  7. A&M. Jet enging test pad (TAN609) was used in 1968 ...

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

    A&M. Jet enging test pad (TAN-609) was used in 1968 for semiscale test apparatus. View of blowdown test with rollup door open. When break in pressurized coolant loop is simulated, steam is released suddenly. INEEL negative no. 68-3179 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  8. PREFACE: EDS2010 Preface

    NASA Astrophysics Data System (ADS)

    Heggie, Malcolm I.

    2011-03-01

    The biennial international conference on Extended Defects in Semiconductors started in 1978 with a meeting in Hünfeld, Germany. Subsequent meetings rotated between Poland, France, Great Britain, Germany, Russia and Italy, culminating in EDS2004 in Chernogolovka, EDS2006 in Halle and EDS2008 in Poitiers. EDS2010 was held at the University of Sussex at Brighton, UK from September 19th to 24th. An extension of the tabulation of this history, which first appeared on the EDS2006 website, is given in the attached PDF. It is with sadness that we note one of the founders of the series, Prof. Dr Helmut Alexander, passed away on 3 December 2009 and we were proud to dedicate EDS2010 to his memory. It has become a tradition to make an award in his name, and this year it was made to Ivan Isacov for his poster "Electrical levels of dislocation networks in p- and n-type silicon". A short and warm celebration of Prof. Dr Alexander's life by his friends and colleagues, Prof. Drs Helmut Gottschalk, Eicke Weber and Wolfgang Schröter, is included in this volume. The conference was a forum for the state-of-the-art of investigation and modelling of extended defects in semiconductors. Scientists from universities, research institutes and industry made contributions to a deeper understanding of extended defects, their interaction with point defects and their role in the development of semiconductor technology. The remit of the conference included extended defects, nanostructures, nanoparticles, quantum dots and interfaces within semiconducting materials ranging from narrow to wide band gaps, including graphene-derived materials and diamond. Scientific interests range from defect geometry, electronic structure, dynamics, spectroscopy, microscopy, reactions and chemistry to introduction mechanisms, such as implantation and strained layers and the operation of devices such as integrated circuits, heterostructures, and solar cells. The organisers were confronted with a long period between

  9. Mosaic ACVRL1 and ENG mutations in hereditary haemorrhagic telangiectasia patients.

    PubMed

    Best, D Hunter; Vaughn, Cecily; McDonald, Jamie; Damjanovich, Kristy; Runo, James R; Chibuk, Jason M; Bayrak-Toydemir, Pinar

    2011-05-01

    Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder caused by mutations in the ACVRL1, ENG, and SMAD4 genes. HHT is commonly characterised by small arteriovenous malformations (AVMs) known as telangiectasias of the skin, oral or gastrointestinal mucosa, as well as larger AVMs of solid organs (lungs, liver, brain). However, the manifestations of HHT are extremely variable. Two patients with no family history of HHT and strikingly different clinical presentations, who are mosaic for mutations in the ACVRL1 or ENG gene, are reported here. These cases represent the first report of mosaicism in patients clinically affected with classical HHT and pulmonary arterial hypertension, and suggest the need for awareness of mosaicism when performing clinical testing for this disorder.

  10. 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

  11. 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

  12. 30. "CONSTRUCTION PHASING, STATION '50' AREA." Specifications No. ENG043535775, Drawing ...

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

    30. "CONSTRUCTION PHASING, STATION '50' AREA." Specifications No. ENG-04-353-57-75, Drawing No. AF-4502-19, sheet 4 of 5, D.O. Series No. AF 1439/26. Stamped: RECORD DRAWING - AS CONSTRUCTED. Below stamp: Contract no. 5296, Date: 10 NOV. 59. - 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

  13. 4. "ARCHITECTURAL, FLOOR PLANELEVATIONSSECTIONS, OBSERVATION BUNKERS." Specifications No. ENG (NASA)04353631; ...

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

    4. "ARCHITECTURAL, FLOOR PLAN-ELEVATIONS-SECTIONS, OBSERVATION BUNKERS." Specifications No. ENG (NASA)04-353-63-1; Drawing No. 60-09-34; sheet 325. Ref. No. A-13. D.O. SERIES 1597/87. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Observation Bunker 1-D-3, Test Area 1-125, northwest end of Altair Boulevard, Boron, Kern County, CA

  14. Instrumentation and control building, architectural, floor plans. Specifications no. Eng043535572; ...

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

    Instrumentation and control building, architectural, floor plans. Specifications no. Eng-04-353-55-72; Drawing No. 60-09-12' sheet 64 of 148; file no. 1321/15. Stamped: record drawing - as constructed. Below stamp: Contract no. 4338, no change. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Control Center, Test Area 1-115, near Altair & Saturn Boulevards, Boron, Kern County, CA

  15. 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

  16. Eng1 and Exg8 Are the Major β-Glucanases Secreted by the Fungal Pathogen Histoplasma capsulatum.

    PubMed

    Garfoot, Andrew L; Dearing, Kacey L; VanSchoiack, Andrew D; Wysocki, Vicki H; Rappleye, Chad A

    2017-03-24

    Fungal cell walls contain β-glucan polysaccharides that stimulate immune responses when recognized by host immune cells. The fungal pathogen Histoplasma capsulatum minimizes detection of β-glucan by host cells through at least two mechanisms: concealment of β-glucans beneath α-glucans and enzymatic removal of any exposed β-glucan polysaccharides by the secreted glucanase Eng1. Histoplasma yeasts also secrete the putative glucanase Exg8, which may serve a similar role as Eng1 in removing exposed β-glucans from the yeast cell surface. Here, we characterize the enzymatic specificity of the Eng1 and Exg8 proteins and show that Exg8 is an exo-β1,3-glucanase and Eng1 is an endo-β1,3-glucanase. Together, Eng1 and Exg8 account for nearly all of the total secreted glucanase activity of Histoplasma yeasts. Both Eng1 and Exg8 proteins are secreted through a conventional secretion signal and are modified post-translationally by O-linked glycosylation. Both glucanases have near maximal activity at temperature and pH conditions experienced during infection of host cells, supporting roles in Histoplasma pathogenesis. Exg8 has a higher specific activity than Eng1 for β1,3-glucans; yet despite this, Exg8 does not reduce detection of yeasts by the host β-glucan receptor Dectin-1. Exg8 is largely dispensable for virulence in vivo, in contrast to Eng1. These results show that Histoplasma yeasts secrete two β1,3-glucanases and that Eng1 endoglucanase activity is the predominant factor responsible for removal of exposed cell wall β-glucans to minimize host detection of Histoplasma yeasts.

  17. On the unusual characteristics of the diamonds from Letšeng-la-Terae kimberlites, Lesotho

    NASA Astrophysics Data System (ADS)

    Bowen, Debbie C.; Ferraris, Ray D.; Palmer, Claire E.; Ward, John D.

    2009-11-01

    The Letšeng-la-Terae kimberlites are situated 3100 m above sea level in the Maloti Mountains of Lesotho, southern Africa. The principal economic bodies are two Late Cretaceous, low grade, 1-3.5 carats/hundred ton (cpht), kimberlite pipes that host high-value diamonds realising US 2000-2500/carat (/ct) in 2008 terms. Locally, the larger kimberlite body is referred to as the Main Pipe (17.2 ha) and the smaller one is called the Satellite Pipe (5.2 ha). These pipes, and their associated eluvial and proximal alluvial deposits, are renowned for yielding large, "D" colour, gem quality diamonds, including + 100 carat (ct) stones. Earlier artisanal effort (1959-1977) and formal mining (1977-1982) produced 335,000 carats (cts), including the 601 ct Lesotho Brown in 1968. In 2003, Letšeng Diamonds Limited re-commenced mining operations and had produced 265,000 cts by the end of July 2008, including 24 + 100 ct diamonds, the largest of which was the 603 ct Lesotho Promise. We report here on the unusual characteristics of the Letšeng diamond population that include: 75% gem quality that is more commonly associated with alluvial diamond deposits, large average stone size of ca. 1 carat/stone (ct/stn) that is also more typical of certain alluvial diamond placers, high-yielding, rounded to flattened irregular, resorbed dodecahedral shapes (Main Pipe 67% and Satellite Pipe 87%) with subordinate dodecahedral macle (Main Pipe 32% and Satellite Pipe 12%) and broken (ca. 1%) forms. In both pipes the octahedral component is virtually absent (< 0.1%), economically favourable colour mix (ca. 33% white colour diamonds in both pipes), abundance of nitrogen-free, "D" colour, Type IIa diamonds that dominate the internationally recognised "special" stone size fraction which covers all diamonds larger than + 10.8 cts (Main Pipe 32% and Satellite Pipe 51%). During 2008, these larger, "special" diamonds commanded prices in excess of US 15,000/ct, contributing ca. 75% of the revenue generated

  18. Structural insights into the function of a unique tandem GTPase EngA in bacterial ribosome assembly.

    PubMed

    Zhang, Xiaoxiao; Yan, Kaige; Zhang, Yixiao; Li, Ningning; Ma, Chengying; Li, Zhifei; Zhang, Yanqing; Feng, Boya; Liu, Jing; Sun, Yadong; Xu, Yanji; Lei, Jianlin; Gao, Ning

    2014-12-01

    Many ribosome-interacting GTPases, with proposed functions in ribosome biogenesis, are also implicated in the cellular regulatory coupling between ribosome assembly process and various growth control pathways. EngA is an essential GTPase in bacteria, and intriguingly, it contains two consecutive GTPase domains (GD), being one-of-a-kind among all known GTPases. EngA is required for the 50S subunit maturation. However, its molecular role remains elusive. Here, we present the structure of EngA bound to the 50S subunit. Our data show that EngA binds to the peptidyl transferase center (PTC) and induces dramatic conformational changes on the 50S subunit, which virtually returns the 50S subunit to a state similar to that of the late-stage 50S assembly intermediates. Very interestingly, our data show that the two GDs exhibit a pseudo-two-fold symmetry in the 50S-bound conformation. Our results indicate that EngA recognizes certain forms of the 50S assembly intermediates, and likely facilitates the conformational maturation of the PTC of the 23S rRNA in a direct manner. Furthermore, in a broad context, our data also suggest that EngA might be a sensor of the cellular GTP/GDP ratio, endowed with multiple conformational states, in response to fluctuations in cellular nucleotide pool, to facilitate and regulate ribosome assembly. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

  19. Mutational and clinical analysis of the ENG gene in patients with pulmonary arterial hypertension.

    PubMed

    Pousada, Guillermo; Baloira, Adolfo; Fontán, Diego; Núñez, Marta; Valverde, Diana

    2016-06-04

    Pulmonary arterial hypertension (PAH) is a rare vascular disorder characterized by a capillary wedge pressure ≤ 15 mmHg and a mean pulmonary arterial pressure ≥ 25 mmHg at rest. PAH can be idiopathic, heritable or associated with other conditions. The aim of this study was to analyze the Endoglin (ENG) gene and assess the influence of the c.572G > A (p.G191D) mutation in patients with idiopathic or associated PAH. The correlation between the pathogenic mutations and clinical and functional parameters was further analyzed. Sixteen different changes in the ENG gene were found in 44 out of 57 patients. After in silico analysis, we classified eight mutations as pathogenic in 16 of patients. The c.572G>A (p.G191D) variation was observed in ten patients, and the analysis for the splicing process using hybrid minigenes, with pSPL3 vector to assess splicing alterations, do not generate a new transcript. Age at diagnosis (p = 0.049) and the 6-min walking test (p = 0.041) exhibited statistically significant differences between carriers and non-carriers of pathogenic mutations. Patients with pathogenic mutations exhibited disease symptoms 8 years before non-carriers. Five patients with pathogenic mutations were carriers of another mutation in the BMPR2 or ACVRL1 genes. We present a series of PAH patients with mutations in the ENG gene, some of them not previously described, exhibiting clinical and hemodynamic alterations suggesting that the presence of these mutations may be associated with the severity of the disease. Moreover, genetic analysis in patients with PAH may be of clinical relevance and indicates the complexity of the genetic background.

  20. Minimal homozygous endothelial deletion of Eng with VEGF stimulation is sufficient to cause cerebrovascular dysplasia in the adult mouse.

    PubMed

    Choi, Eun-Jung; Walker, Espen J; Shen, Fanxia; Oh, S Paul; Arthur, Helen M; Young, William L; Su, Hua

    2012-01-01

    Brain arteriovenous malformations (bAVMs) represent a high risk for hemorrhagic stroke, leading to significant neurological morbidity and mortality in young adults. The etiopathogenesis of bAVM remains unclear. Research progress has been hampered by the lack of animal models. Hereditary Hemorrhagic Telangiectasia (HHT) patients with haploinsufficiency of endoglin (ENG, HHT1) or activin receptor-like kinase 1 (ALK1, HHT2) have a higher incidence of bAVM than the general population. We previously induced cerebrovascular dysplasia in the adult mouse that resembles human bAVM through Alk1 deletion plus vascular endothelial growth factor (VEGF) stimulation. We hypothesized that Eng deletion plus VEGF stimulation would induce a similar degree of cerebrovascular dysplasia as the Alk1-deleted brain. Ad-Cre (an adenoviral vector expressing Cre recombinase) and AAV-VEGF (an adeno-associated viral vector expressing VEGF) were co-injected into the basal ganglia of 8- to 10-week-old Eng(2f/2f) (exons 5 and 6 flanked by loxP sequences), Alk1(2f/2f) (exons 4-6 flanked by loxP sequences) and wild-type (WT) mice. Vascular density, dysplasia index, and gene deletion efficiency were analyzed 8 weeks later. AAV-VEGF induced a similar degree of angiogenesis in the brain with or without Alk1- or Eng-deletion. Abnormally patterned and dilated dysplastic vessels were found in the viral vector-injected region of Alk1(2f/2f) and Eng(2f/2f) brain sections, but not in WT. Alk1(2f/2f) mice had about 1.8-fold higher dysplasia index than Eng(2f/2f) mice (4.6 ± 1.9 vs. 2.5 ± 1.1, p < 0.05). However, after normalization of the dysplasia index with the gene deletion efficiency (Alk1(2f/2f): 16% and Eng(2f/2f): 1%), we found that about 8-fold higher dysplasia was induced per copy of Eng deletion (2.5) than that of Alk1 deletion (0.3). ENG-negative endothelial cells were detected in the Ad-Cre-treated brain of Eng(2f/2f) mice, suggesting homozygous deletion of Eng in the cells. VEGF induced more

  1. GenEng: A dialogue-based natural language interface to the GenBank

    SciTech Connect

    Karimi, E.

    1993-12-31

    To sequence all the genes in human DNA and analyze their functions, the Human Genome Project has been collecting a large body of data in data banks such as GenBank{copyright}. One of the important issues concerning computational biologists is the availability of the tools which can provide easy and efficient access to these data banks. In this paper, the author will give a brief overview of different approaches to the design of a relational database interface. The paper concentrates on the design of GenEng, a dialogue based natural language interface for information retrieval from the GenBank relational database.

  2. The TUNL Enge Split-Pole Spectrograph: a Facility Entirely Dedicated to Nuclear Astrophysics

    NASA Astrophysics Data System (ADS)

    Setoodehnia, Kiana; Longland, Richard; Marshall, Caleb; Portillo Chaves, Federico; Kowal, Katie; Seed, Caitlin

    The Enge split-pole spectrograph at the Triangle Universities Nuclear Laboratory (TUNL) is the only spectrometer of this kind currently operational in North America for conducting charged-particle spectroscopy experiments using stable beams. This spectrograph was out of service for a relatively long period of time. However, it is now being re-commissioned and upgraded to perform high resolution charged-particle spectroscopy measurements, as well as particle-γ coincidence measurements to study various astrophysically significant reactions. This review discusses the current upgrades to the beamline, the detector system, and outlines near future experimental perspectives.

  3. Edward (Ed) T. Schneider

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Research Pilot Edward T. Schneider is shown sitting in the cockpit of a McDonnell Douglas F/A-18 Hornet that was used in the High Angle-of-Attack Research Vehicle (HARV) program at the National Aeronautics and Space Administration's Ames - Dryden Flight Research Facility. When the aircraft arrived at the Dryden Facility in 1987, from the US Naval Air Test Center, Patuxent River, Maryland, it consisted of parts in crates. The aircraft crew made an airplane from those parts, and in doing so they took a 'sow's ear' and created a 'silk purse', thus the name on the side of the aircraft. Ed's helmet is from his time in the Navy. The design was taken from the Flag that is flown on the bow of a Navy ship, referred to as the Jack, and is navy blue with the 50 States being represented by the white stars. Ed arrived at the NASA Ames-Dryden Flight Research Facility (later renamed the Dryden Flight Research Center) on July 5, 1982, as a Navy Liaison Officer, becoming a NASA research pilot one year later. Ed was the project pilot for the F-18 High Angle-of-Attack program and later served as a project pilot for the F-15 aeronautical research aircraft, the NASA B-52 launch aircraft, and the SR-71 'Blackbird' aircraft. He served on active duty with the U.S. Navy from 1968 to 1983. Following squadron service he graduated from the U.S. Naval Test Pilot School, Patuxent River, Maryland, in 1973, and then served as an engineering test pilot, and test pilot school instructor at the Naval Air Test Center. Ed has been an active member of the Society of Experimental Test Pilots since 1974. He was made a Fellow of the Society in 1993 and served as its President in 1993/94. In 1996 he was awarded the NASA Exceptional Service Medal and the American Institute of Aeronautics and Astronautics' Chanute Flight Award. He retired as a NASA research pilot in September 2000.

  4. Edward (Ed) T. Schneider

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Research Pilot Edward T. Schneider is shown sitting in the cockpit of a McDonnell Douglas F/A-18 Hornet that was used in the High Angle-of-Attack Research Vehicle (HARV) program at the National Aeronautics and Space Administration's Ames - Dryden Flight Research Facility. When the aircraft arrived at the Dryden Facility in 1987, from the US Naval Air Test Center, Patuxent River, Maryland, it consisted of parts in crates. The aircraft crew made an airplane from those parts, and in doing so they took a 'sow's ear' and created a 'silk purse', thus the name on the side of the aircraft. Ed's helmet is from his time in the Navy. The design was taken from the Flag that is flown on the bow of a Navy ship, referred to as the Jack, and is navy blue with the 50 States being represented by the white stars. Ed arrived at the NASA Ames-Dryden Flight Research Facility (later renamed the Dryden Flight Research Center) on July 5, 1982, as a Navy Liaison Officer, becoming a NASA research pilot one year later. Ed was the project pilot for the F-18 High Angle-of-Attack program and later served as a project pilot for the F-15 aeronautical research aircraft, the NASA B-52 launch aircraft, and the SR-71 'Blackbird' aircraft. He served on active duty with the U.S. Navy from 1968 to 1983. Following squadron service he graduated from the U.S. Naval Test Pilot School, Patuxent River, Maryland, in 1973, and then served as an engineering test pilot, and test pilot school instructor at the Naval Air Test Center. Ed has been an active member of the Society of Experimental Test Pilots since 1974. He was made a Fellow of the Society in 1993 and served as its President in 1993/94. In 1996 he was awarded the NASA Exceptional Service Medal and the American Institute of Aeronautics and Astronautics' Chanute Flight Award. He retired as a NASA research pilot in September 2000.

  5. Exome sequencing identifies a novel intronic mutation in ENG that causes recurrence of pulmonary arteriovenous malformations.

    PubMed

    Saji, Naoki; Kawarai, Toshitaka; Miyamoto, Ryosuke; Sato, Takahiro; Morino, Hiroyuki; Orlacchio, Antonio; Oki, Ryosuke; Kimura, Kazumi; Kaji, Ryuji

    2015-05-15

    Hereditary hemorrhagic telangiectasia (HHT) occasionally can be discovered in patients with cerebrovascular disease. Pulmonary arteriovenous malformation (PAVM) is one of the complications in HHT and occasionally is causative for life-threatening embolic stroke. Several genetic defects have been reported in patients with HHT. The broad spectrum of phenotype and intrafamilial phenotype variations, including age-at-onset of vascular events, often make an early diagnosis difficult. We present here a Japanese family with a novel intronic heterozygous mutation of ENG, which was identified using whole exome sequencing (WES). The intronic mutation, IVS3+4delAGTG, results in in-frame deletion of exon 3 and would produce a shorter ENG protein lacking the extracellular forty-seven amino acid sequences, which is located within the orphan domain. Our findings highlight the importance of the domain for the downstream signaling pathway of transforming growth factor-beta and bone morphogenesis protein superfamily receptors. Considering the phenotype variations and the available treatment for vascular complications, an early diagnosis using genetic testing, including WES, should be considered for individuals at risk of HHT. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. A new method for spike extraction using velocity selective recording demonstrated with physiological ENG in Rat.

    PubMed

    Metcalfe, B W; Chew, D J; Clarke, C T; Donaldson, N de N; Taylor, J T

    2015-08-15

    This paper describes a series of experiments designed to verify a new method of electroneurogram (ENG) recording that enables the rate of neural firing within prescribed bands of propagation velocity to be determined in real time. Velocity selective recording (VSR) has been proposed as a solution to the problem of increasing the information available from an implantable neural interface (typically with electrodes in circumferential nerve cuffs) and has been successful in transforming compound action potentials into the velocity domain. The new method extends VSR to naturally-evoked (physiological) ENG in which the rate of neural firing at particular velocities is required in addition to a knowledge of the velocities present in the recording. The experiments, carried out in rats required individual spikes to be distinct and non-overlapping, which could be achieved by a microchannel or small-bore cuff. In these experiments, strands of rat nerve were laid on ten hook electrodes in oil to demonstrate the principle. The new method generates a detailed overview of the firing rates of neurons based on their conduction velocity and direction of propagation. In addition it allows real time working in contrast to existing spike sorting methods using statistical pattern processing techniques. Results show that by isolating neural activity based purely on conduction velocity it was possible to determine the onset of direct cutaneous stimulation of the L5 dermatome. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Allelic dropout in the ENG gene, affecting the results of genetic testing in hereditary hemorrhagic telangiectasia.

    PubMed

    Tørring, Pernille M; Kjeldsen, Anette D; Ousager, Lilian Bomme; Brasch-Andersen, Charlotte; Brusgaard, Klaus

    2012-12-01

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal-dominant vascular disorder with three disease-causing genes identified to date: ENG, ACVRL1, and SMAD4. We report an HHT patient with allelic dropout that on routine sequence analysis for a known mutation in the family (c.817-3T>G in ENG) initially seemed to be homozygous for the mutation. To explore the possibility of allelic dropout causing a false result in this patient. Mutation analysis of additional family members was performed and haplotype analysis carried out. New primers were designed to reveal the presence of a possible sequence variant, which could explain the presumed allelic dropout. Allelic dropout caused by a six-nucleotide duplication close to the standard reverse primer was the assumed cause of a false homozygous diagnosis. Sequence variants outside of the primer regions can be the cause of allelic dropout, creating unforeseen errors in genotyping. Our finding emphasizes the need for careful quality control in all molecular genetic studies.

  8. Clinical features and mutations in the ENG, ACVRL1, and SMAD4 genes in Korean patients with hereditary hemorrhagic telangiectasia.

    PubMed

    Lee, Seung-Tae; Kim, Jee-Ah; Jang, Shin-Yi; Kim, Duk-Kyung; Do, Young Soo; Suh, Gee Young; Kim, Jong-Won; Ki, Chang-Seok

    2009-02-01

    Hereditary hemorrhagic telangiectasia (HHT) is an inherited disorder that is characterized by abnormal communication between the arteries and veins in the skin, mucosa, and various organs. HHT has been reported to show significant phenotypic variability and genetic heterogeneity with wide ethnic and geographic variations. Although mutations in the endoglin (ENG) and activin A receptor type II-like 1 (ACVRL1) genes have been known to cause HHT for more than 10 yr, little is known about the clinical features or genetic background of Korean patients with HHT. In addition, mutations in mothers against decapentaplegic homolog 4 (SMAD4) are also seen in patients with the combined syndrome of juvenile polyposis and HHT. This study examined five Korean patients with the typical manifestations of HHT such as frequent epistaxis and pulmonary arteriovenous malformations. Direct sequencing of the ENG and ACVRL1 genes revealed one known mutation, ENG c.277C>T, in one patient and two novel mutations, ENG c.992-1G>C and ACVRL1 c.81dupT in two patients, respectively. The remaining two patients with negative results were screened for SMAD4 mutations as well as gross deletions of ENG and ACVRL1 using multiple ligation-dependent probe amplification, but none was detected. Despite the small number of patients investigated, we firstly report Korean patients with genetically confirmed HHT, and show the genetic and allelic heterogeneity underlying HHT.

  9. Molecular and biochemical characterization of the β-1,4-endoglucanase gene Mj-eng-3 in the root-knot nematode Meloidogyne javanica.

    PubMed

    Hu, Lili; Cui, Ruqiang; Sun, Longhua; Lin, Borong; Zhuo, Kan; Liao, Jinling

    2013-09-01

    This study describes the molecular and biochemical characterization of the β-1,4-endoglucanase gene (Mj-eng-3) from the root knot nematode Meloidogyne javanica. A 2156-bp genomic DNA sequence of Mj-eng-3 containing six introns was obtained. Mj-eng-3 was localized in the subventral esophageal glands of M. javanica juveniles by in situ hybridization. Real-time RT-PCR assay showed that the highest transcriptional level of Mj-eng-3 occurred in pre-parasitic second-stage juveniles, and this high expression persisted in parasitic second-stage juveniles. Recombinant MJ-ENG-3 degraded carboxymethylcellulose and optimum enzyme activity at 40°C and pH 8.0. EDTA, Mg(2+), Mn(2+), Ca(2+), Co(2+), and Cu(2+) did not affect the activity of MJ-ENG-3; however, Zn(2+) and Fe(2+) inhibited MJ-ENG-3 enzyme activity. In planta Mj-eng-3 RNAi assay displayed a reduction in the number of nematodes and galls in transgenic tobacco roots. These results suggested that MJ-ENG-3 could be secreted by M. javanica to degrade the cellulose of plant cell walls to facilitate its entry and migration during the early stages of parasitism. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. What Is Ag-Ed?

    ERIC Educational Resources Information Center

    Lindley, Judy

    Ag-Ed is an agricultural education project aimed at upper primary students, held in conjunction with the Toowoomba Show (similar to a county fair) in Queensland, Australia. The program achieves its purpose of helping children understand the impact and relevance that agriculture has on their everyday lives through two components, an Ag-Ed day and a…

  11. Rebooting the EdD

    ERIC Educational Resources Information Center

    Wergin, Jon F.

    2011-01-01

    In this essay, Jon Wergin reminds readers of the philosophical and historical foundations of the doctor of education (EdD) degree. He argues that the EdD should be based, in large part, on John Dewey's progressive ideals of democratization and Paulo Freire's concepts of emancipatory education. Drawing on theories of reflective practice,…

  12. Rebooting the EdD

    ERIC Educational Resources Information Center

    Wergin, Jon F.

    2011-01-01

    In this essay, Jon Wergin reminds readers of the philosophical and historical foundations of the doctor of education (EdD) degree. He argues that the EdD should be based, in large part, on John Dewey's progressive ideals of democratization and Paulo Freire's concepts of emancipatory education. Drawing on theories of reflective practice,…

  13. Masculinities in Organizational Cultures in Engineering Education in Europe: Results of the European Union Project WomEng

    ERIC Educational Resources Information Center

    Sagebiel, F.; Dahmen, J.

    2006-01-01

    The paper describes elements of engineering organizational cultures and structures in higher engineering education from the European project WomEng. Hypotheses, based on state of the art, refer to: women friendly presentation, attractiveness of interdisciplinary teaching methods, single sex education, perceptions of minority status, feelings of…

  14. Masculinities in Organizational Cultures in Engineering Education in Europe: Results of the European Union Project WomEng

    ERIC Educational Resources Information Center

    Sagebiel, F.; Dahmen, J.

    2006-01-01

    The paper describes elements of engineering organizational cultures and structures in higher engineering education from the European project WomEng. Hypotheses, based on state of the art, refer to: women friendly presentation, attractiveness of interdisciplinary teaching methods, single sex education, perceptions of minority status, feelings of…

  15. Identification of an invasion and tumor-suppressing gene, Endoglin (ENG), silenced by both epigenetic inactivation and allelic loss in esophageal squamous cell carcinoma.

    PubMed

    Wong, Victor Chun Lam; Chan, Pui Ling; Bernabeu, Carmelo; Law, Simon; Wang, Li Dong; Li, Ji-Lin; Tsao, Sai Wah; Srivastava, Gopesh; Lung, Maria Li

    2008-12-15

    Endoglin (ENG) has been identified as a candidate tumor-suppressor gene in esophageal squamous cell carcinoma (ESCC). Earlier microcell-mediated chromosome transfer (MMCT) studies of chromosome 9 in ESCC narrowed down a tumor-suppressive critical region to 9q33-34. ENG maps to 9q34-qter and encodes a transformation growth factor beta (TGFbeta) superfamily auxiliary receptor. This study aims to identify the potential role for ENG in ESCC development. Significant downregulation of ENG was detected at frequencies of 87.5% in 16 ESCC cell lines, 39.1% directly in 23 ESCC tumor specimens from Hong Kong, and 33.4% in 18 ESCC tumor specimens from the high-risk ESCC region of Henan, China. By methylation-specific PCR, methylated sequences were detected in an ESCC cell line panel and in clinical specimens. Following demethylation treatment in 9 ESCC cell lines, ENG expression was obviously restored. Loss of heterozygosity (LOH) in a 4.7 Mb region on 9q32-q34, where ENG maps, was observed directly in ESCC tumor tissues. Both epigenetic methylation and allelic loss appear to contribute to ENG downregulation in tumor cells. In vitro and in vivo functional studies such as colony formation, Matrigel culture, invasion and tumorigenicity assays were performed. Colony formation efficiency was significantly reduced by overexpression of ENG. In addition, significantly smaller colonies of ENG stable transfectants were formed in Matrigel culture. Significant suppression of invasion efficiency and tumorigenicity were also observed, when comparing the ENG stable transfectants with the vector-alone transfectants. This study provides evidence supporting ENG, as a cell invasion and tumor-suppressing gene in ESCC. (c) 2008 Wiley-Liss, Inc.

  16. EDS operator and control software

    SciTech Connect

    Ott, L.L.

    1985-04-01

    The Enrichment Diagnostic System (EDS) was developed at Lawrence Livermore National Laboratory (LLNL) to acquire, display and analyze large quantities of transient data for a real-time Advanced Vapor Laser Isotope Separation (AVLIS) experiment. Major topics discussed in this paper are the EDS operator interface (SHELL) program, the data acquisition and analysis scheduling software, and the graphics software. The workstation concept used in EDS, the software used to configure a user's workstation, and the ownership and management of a diagnostic are described. An EDS diagnostic is a combination of hardware and software designed to study specific aspects of the process. Overall system performance is discussed from the standpoint of scheduling techniques, evaluation tools, optimization techniques, and program-to-program communication methods. EDS is based on a data driven design which keeps the need to modify software to a minimum. This design requires a fast and reliable data base management system. A third party data base management product, Berkeley Software System Database, written explicitly for HP1000's, is used for all EDS data bases. All graphics is done with an in-house graphics product, Device Independent Graphics Library (DIGLIB). Examples of devices supported by DIGLIB are: Versatec printer/plotters, Raster Technologies Graphic Display Controllers, and HP terminals (HP264x and HP262x). The benefits derived by using HP hardware and software as well as obstacles imposed by the HP environment are presented in relation to EDS development and implementation.

  17. MicroRNA-370 suppresses proliferation and promotes endometrioid ovarian cancer chemosensitivity to cDDP by negatively regulating ENG.

    PubMed

    Chen, Xiao-Ping; Chen, You-Guo; Lan, Jian-Yun; Shen, Zong-Ji

    2014-10-28

    MicroRNAs (miRNAs) are a class of non-coding RNAs that post-transcriptionally inhibit gene expression. In this study, we discovered that microRNA-370 (miR-370) was down-regulated in endometrioid ovarian cancer cells. In IGROV1 and TOV112D endometrioid ovarian cancer cells, miR-370 suppressed cellular viability and colony formation. miR-370 also enhanced endometrioid ovarian cancer cell chemosensitivity to cDDP. Endoglin (ENG) was directly and negatively regulated by miR-370. In addition, hypermethylation was a potential mechanism of miR-370 epigenetic silencing. We conclude that miR-370 acts as a tumor suppressor in endometrioid ovarian cancer via ENG regulation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Effects of Using a Neuroeducational Intervention to Enhance Perseverance for Online EdD and EdS Students

    ERIC Educational Resources Information Center

    Cadle, Charles R.

    2013-01-01

    Developing and maintaining a "completion mindset" is a necessary mental condition for online educational doctorate (EdD) and educational specialist (EdS) students to obtain their advanced degrees. The purpose of this research study was to examine the effect of a neuroeducational intervention on a volunteer convenience sample of EdD and…

  19. Effects of Using a Neuroeducational Intervention to Enhance Perseverance for Online EdD and EdS Students

    ERIC Educational Resources Information Center

    Cadle, Charles R.

    2013-01-01

    Developing and maintaining a "completion mindset" is a necessary mental condition for online educational doctorate (EdD) and educational specialist (EdS) students to obtain their advanced degrees. The purpose of this research study was to examine the effect of a neuroeducational intervention on a volunteer convenience sample of EdD and…

  20. Intravenous Bevacizumab Therapy in a Patient with Hereditary Hemorrhagic Telangiectasia, ENG E137K, Alcoholic Cirrhosis, and Portal Hypertension.

    PubMed

    Bertoli, Luigi F; Lee, Pauline L; Lallone, Lauren; Barton, James C

    2017-01-01

    Intravenous bevacizumab decreased mucosal bleeding in some patients with hereditary hemorrhagic telangiectasia (HHT). We treated a 47-year-old male who had HHT, severe epistaxis, and gastrointestinal bleeding, alcoholic cirrhosis, and portal hypertension with intravenous bevacizumab 2.5 mg/kg every 2 weeks. We tabulated these measures weekly during weeks 1-33 (no bevacizumab); 34-57 (bevacizumab); and 58-97 (no bevacizumab): hemoglobin (Hb) levels; platelet counts; units of transfused packed erythrocytes (PRBC units); and quantities of iron infused as iron dextran to support erythropoiesis. We performed univariate and multivariable analyses. We sequenced his ENG and ACVRL1 genes. Epistaxis and melena decreased markedly during bevacizumab treatment. He reported no adverse effects due to bevacizumab. Mean weekly Hb levels were significantly higher and mean weekly PRBC units and quantities of intravenous iron were significantly lower during bevacizumab treatment. We performed a multiple regression on weekly Hb levels using these independent variables: bevacizumab treatment (dichotomous); weekly platelet counts; weekly PRBC units; and weekly quantities of intravenous iron. There was 1 positive association: (bevacizumab treatment; p = 0.0046) and 1 negative association (PRBC units; p = 0.0004). This patient had the novel ENG mutation E137K (exon 4; c.409G→A). Intravenous bevacizumab treatment 2.5 mg/kg every 2 weeks for 24 weeks was well-tolerated by a patient with HHT due to ENG E137K and was associated with higher weekly Hb levels and fewer weekly PRBC units.

  1. Potassium Acts as a GTPase-Activating Element on Each Nucleotide-Binding Domain of the Essential Bacillus subtilis EngA

    PubMed Central

    Foucher, Anne-Emmanuelle; Reiser, Jean-Baptiste; Ebel, Christine; Housset, Dominique; Jault, Jean-Michel

    2012-01-01

    EngA proteins form a unique family of bacterial GTPases with two GTP-binding domains in tandem, namely GD1 and GD2, followed by a KH (K-homology) domain. They have been shown to interact with the bacterial ribosome and to be involved in its biogenesis. Most prokaryotic EngA possess a high GTPase activity in contrast to eukaryotic GTPases that act mainly as molecular switches. Here, we have purified and characterized the GTPase activity of the Bacillus subtilis EngA and two shortened EngA variants that only contain GD1 or GD2-KH. Interestingly, the GTPase activity of GD1 alone is similar to that of the whole EngA, whereas GD2-KH has a 150-fold lower GTPase activity. At physiological concentration, potassium strongly stimulates the GTPase activity of each protein construct. Interestingly, it affects neither the affinities for nucleotides nor the monomeric status of EngA or the GD1 domain. Thus, potassium likely acts as a chemical GTPase-activating element as proposed for another bacterial GTPase like MnmE. However, unlike MnmE, potassium does not promote dimerization of EngA. In addition, we solved two crystal structures of full-length EngA. One of them contained for the first time a GTP-like analogue bound to GD2 while GD1 was free. Surprisingly, its overall fold was similar to a previously solved structure with GDP bound to both sites. Our data indicate that a significant structural change must occur upon K+ binding to GD2, and a comparison with T. maritima EngA and MnmE structures allowed us to propose a model explaining the chemical basis for the different GTPase activities of GD1 and GD2. PMID:23056455

  2. Mitigating Higher Ed Cyber Attacks

    ERIC Educational Resources Information Center

    Rogers, Gary; Ashford, Tina

    2015-01-01

    In this presentation we will discuss the many and varied cyber attacks that have recently occurred in the higher ed community. We will discuss the perpetrators, the victims, the impact and how these institutions have evolved to meet this threat. Mitigation techniques and defense strategies will be covered as will a discussion of effective security…

  3. Overview of Deployed EDS Technologies

    SciTech Connect

    Martz, H E; Crawford, C

    2009-09-24

    The term explosive detection system (EDS) is used by the TSA to describe equipment that is certified to detect explosives in checked bags. The EDS, as certified, by the TSL must consist of device for interrogating a bag and an automated detection algorithm (ATD) for evaluating the results of the interrogation. We only consider CT as the interrogation device in this report. A schematic drawing of a CT-based EDS is shown in Figure 2. The output of the ATD is the binary decision of alarm or non-alarm. Alarms may true- or false-positives. Non-alarms may be true- or false-negatives. False positives are also denoted false alarms. The true detection means that the ATD reports an alarm when a threat is present in the scanned bag. The probability of detecting a threat given that a threat is present is denoted the probability of detection (PD). The probability of false alarm (PFA) is the case when an alarm is reported when a threat is not present in a bag. Certification in this context means passing tests for PD and PFA at the TSL. The results of the EDS include CT cross-sectional images of the bag and specifics about the alarmed objects generated by ATD. These results are presented on a display so that a person may override the decision of ATD and declare the alarm to be a non-alarm. This process is denoted clearing. Bags that are not cleared by the person are sent to a secondary inspection process. Here the bags may be opened or assessed with explosive trace detection (ETD) in order to clear the bags. Bags that are not cleared at this point are evaluated by an ordinance disposal team. The CT scanner along with ATD is denoted Level 1 screening. The process of clearing on a display is denoted Level 2 screening. Secondary inspection is denoted Level 3 screening. Vendors of the deployed EDSs supply the TSA with equipment for all three levels. Therefore, the term EDS may include the equipment provided for Levels 1, 2 and 3. A schematic diagram of an EDS and the levels of

  4. A novel ENG mutation causing impaired co-translational processing of endoglin associated with hereditary hemorrhagic telangiectasia.

    PubMed

    Suzuki, Atsuo; Nakashima, Daisuke; Miyawaki, Yuhri; Fujita, Junko; Maki, Asuka; Fujimori, Yuta; Takagi, Akira; Murate, Takashi; Teranishi, Masaaki; Matsushita, Tadashi; Saito, Hidehiko; Kojima, Tetsuhito

    2012-05-01

    Hereditary hemorrhagic telangiectasia (HHT) is an inherited autosomal dominant vascular dysplasia caused by mutations in mainly the endoglin gene (ENG) or activin-like kinase receptor 1 (ALK1) gene (ACVRL1). We investigated the molecular basis of HHT in a Japanese patient, and identified a novel missense mutation in ENG (c.38T>A, p.Leu13Gln) located in the signal peptide's hydrophobic core, but not in ACVRL1. In experiments in COS-1 cells, the Leu13Gln (L13Q) mutant endoglin appeared to be expressed as a precursor form, probably due to impaired protein processing. Flow cytometry analyses of the COS-1 cells transiently expressing recombinant endoglins revealed that the wild-type endoglin was detected on the cell surface, but the L13Q mutant was not. We also analyzed expression patterns of the recombinant endoglins by immunofluorescent staining, and found that the wild-type co-localized with the endoplasmic reticulum (ER), but the L13Q mutant did not. These results implied that the L13Q mutant endoglin fails to insert into the ER, probably due to destruction of the hydrophobic core structure in the signal peptide to be recognized by signal recognition particles. Thus, the Leu13 in the signal peptide of endoglin might be essential for correct protein processing through the ER and cell-surface expression. Taken together, the novel c.38T>A mutation in ENG would impair co-translational processing of the endoglin, and could be responsible for HHT in this patient. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Characterization of the GPI-anchored endo β-1,3-glucanase Eng2 of Aspergillus fumigatus.

    PubMed

    Hartl, Lukas; Gastebois, Amandine; Aimanianda, Vishukumar; Latgé, Jean-Paul

    2011-02-01

    A GPI-anchored endo β-1,3-glucanase of Aspergillus fumigatus was characterized. The enzyme encoded by ENG2 (AFUA_2g14360) belongs to the glycoside hydrolase family 16 (GH16). The activity was characterized using a recombinant protein produced by Pichiapastoris. The recombinant enzyme preferentially acts on soluble β-1,3-glucans. Enzymatic analysis of the endoglucanase activity using Carboxymethyl-Curdlan-Remazol Brilliant Blue (CM-Curdlan-RBB) as a substrate revealed a wide temperature optimum of 24-40°C, a pH optimum of 5.0-6.5 and a K(m) of 0.8 mg ml(-1). HPAEC analysis of the products formed by Eng2 when acting on different oligo-β-1,3-glucans confirmed the predicted endoglucanase activity and also revealed a transferase activity for oligosaccharides of a low degree of polymerization. The growth phenotype of the Afeng2 mutant was identical to that of the wt strain. Copyright © 2010 Elsevier Inc. All rights reserved.

  6. Real time analysis under EDS

    NASA Astrophysics Data System (ADS)

    Schneberk, D.

    1985-07-01

    The analysis component of the Enrichment Diagnostic System (EDS) developed for the Atomic Vapor Laser Isotope Separation Program (AVLIS) at Lawrence Livermore National Laboratory (LLNL) is described. Four different types of analysis are performed on data acquired through EDS: (1) absorption spectroscopy on laser-generated spectral lines, (2) mass spectrometer analysis, (3) general purpose waveform analysis, and (4) separation performance calculations. The information produced from this data includes: measures of particle density and velocity, partial pressures of residual gases, and overall measures of isotope enrichment. The analysis component supports a variety of real-time modeling tasks, a means for broadcasting data to other nodes, and a great degree of flexibility for tailoring computations to the exact needs of the process. A particular data base structure and program flow is common to all types of analysis. Key elements of the analysis component are: (1) a fast access data base which can configure all types of analysis, (2) a selected set of analysis routines, (3) a general purpose data manipulation and graphics package for the results of real time analysis.

  7. Real time analysis under EDS

    SciTech Connect

    Schneberk, D.

    1985-07-01

    This paper describes the analysis component of the Enrichment Diagnostic System (EDS) developed for the Atomic Vapor Laser Isotope Separation Program (AVLIS) at Lawrence Livermore National Laboratory (LLNL). Four different types of analysis are performed on data acquired through EDS: (1) absorption spectroscopy on laser-generated spectral lines, (2) mass spectrometer analysis, (3) general purpose waveform analysis, and (4) separation performance calculations. The information produced from this data includes: measures of particle density and velocity, partial pressures of residual gases, and overall measures of isotope enrichment. The analysis component supports a variety of real-time modeling tasks, a means for broadcasting data to other nodes, and a great degree of flexibility for tailoring computations to the exact needs of the process. A particular data base structure and program flow is common to all types of analysis. Key elements of the analysis component are: (1) a fast access data base which can configure all types of analysis, (2) a selected set of analysis routines, (3) a general purpose data manipulation and graphics package for the results of real time analysis. Each of these components are described with an emphasis upon how each contributes to overall system capability. 3 figs.

  8. Instability of EDS maglev systems

    SciTech Connect

    Cai, Y.; Chen, S.S.

    1993-09-01

    Instabilities of an EDS maglev suspension system with 3 D.O.F. and 5 D.O.F. vehicles traveling on a double L-shaped set of guideway conductors have been investigated with various experimentally measured magnetical force data incorporated into the theoretical models. Divergence and flutter are obtained from both analytical and numerical solutions for coupled vibration of the 3 D.O.F. maglev vehicle model. Instabilities of five direction motions (heave, slip, rill, pitch and yaw) are observed for the 4 D.O.F. vehicle model. It demonstrates that system parameters, such as, system damping, vehicle geometry and coupling effects among five different motions play very important roles in the occurrence of dynamic instabilities of maglev vehicles.

  9. Extended C-terminus and length of the linker connecting the G-domains are species-specific variations in the EngA family of GTPases.

    PubMed

    Tomar, Sushil Kumar; Kumar, Prashant; Majumdar, Soneya; Bhaskar, Varun; Dutta, Prasun; Prakash, Balaji

    2012-01-01

    EngA is an essential protein involved in ribosome biogenesis. It is an unique GTPase, possessing two consecutive G-domains. Using sequence and phylogenetic analysis, we found two intriguing variants among EngA homologues - one with a shorter linker joining the G-domains and another with a longer linker, which additionally possesses an extended C-terminus. Interestingly, while the former variant is mainly restricted to firmicutes, the latter is found in nonfirmicutes. Chimeric proteins with interchanged linkers and extensions were generated to gauge the importance of these elements. Ribosome interaction experiments employing the chimeric proteins suggest that a precise combination of the linker and C-terminal extension are important features regulating EngA ribosome interactions in a variant-specific manner.

  10. Building a Community on the Fast Track: ENG. 09/111 at Central Virginia Community College (CVCC) as a Tier C Model

    ERIC Educational Resources Information Center

    Velez, Lana

    2012-01-01

    This author organized and taught the new ENG 09/111 classes at her college, as well as authoring the course text and workbook. English 09/111 offers a unique opportunity for students who are not quite ready for freshmen composition, but more than likely do not need an entire semester of developmental English. In this article, she details the…

  11. The Impact of "ED" on Educational Research.

    ERIC Educational Resources Information Center

    Florio, David H.

    1980-01-01

    The purposes, structure, and component parts of the newly formed Department of Education (ED) organizations from which educational research programs will be administered are discussed. As the climate surrounding ED changes, opportunities to take advantage of the elevated status of research will be presented. (Author/RL)

  12. Mechanical Ventilation and ARDS in the ED

    PubMed Central

    Mohr, Nicholas M.; Miller, Christopher N.; Deitchman, Andrew R.; Castagno, Nicole; Hassebroek, Elizabeth C.; Dhedhi, Adam; Scott-Wittenborn, Nicholas; Grace, Edward; Lehew, Courtney; Kollef, Marin H.

    2015-01-01

    BACKGROUND: There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment. METHODS: This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED. The primary outcome was the incidence of ARDS after admission. Multivariable logistic regression was used to determine the predictors of ARDS. RESULTS: We analyzed 219 patients receiving mechanical ventilation to assess ED ventilation practices. Median tidal volume was 7.6 mL/kg predicted body weight (PBW) (interquartile range, 6.9-8.9), with a range of 4.3 to 12.2 mL/kg PBW. Lung-protective ventilation was used in 122 patients (55.7%). The incidence of ARDS after admission from the ED was 14.7%, with a mean onset of 2.3 days. Progression to ARDS was associated with higher illness severity and intubation in the prehospital environment or transferring facility. Of the 15 patients with ARDS in the ED (6.8%), lung-protective ventilation was used in seven (46.7%). Patients who progressed to ARDS experienced greater duration in organ failure and ICU length of stay and higher mortality. CONCLUSIONS: Lung-protective ventilation is infrequent in patients receiving mechanical ventilation in the ED, regardless of ARDS status. Progression to ARDS is common after admission, occurs early, and worsens outcome. Patient- and treatment-related factors present in the ED are associated with ARDS. Given the limited treatment options for ARDS, and the early onset after admission from the ED, measures to prevent onset and to mitigate severity should be instituted in the ED. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01628523; URL: www.clinicaltrials.gov PMID:25742126

  13. English II: ENG 152.

    ERIC Educational Resources Information Center

    Hudson, James

    A course guide for students in English 152 of Oakland Community College, a composition course in argumentative writing, this document gives the class schedule, the course outline, examples of writing, worksheets, ways of preparing bibliography and note cards, checklists, and a research bibliography, as well as presenting other cogent materials.…

  14. MicroED data collection and processing

    SciTech Connect

    Hattne, Johan; Reyes, Francis E.; Nannenga, Brent L.; Shi, Dan; Cruz, M. Jason de la; Leslie, Andrew G. W.; Gonen, Tamir

    2015-07-01

    The collection and processing of MicroED data are presented. MicroED, a method at the intersection of X-ray crystallography and electron cryo-microscopy, has rapidly progressed by exploiting advances in both fields and has already been successfully employed to determine the atomic structures of several proteins from sub-micron-sized, three-dimensional crystals. A major limiting factor in X-ray crystallography is the requirement for large and well ordered crystals. By permitting electron diffraction patterns to be collected from much smaller crystals, or even single well ordered domains of large crystals composed of several small mosaic blocks, MicroED has the potential to overcome the limiting size requirement and enable structural studies on difficult-to-crystallize samples. This communication details the steps for sample preparation, data collection and reduction necessary to obtain refined, high-resolution, three-dimensional models by MicroED, and presents some of its unique challenges.

  15. Expedition 7 Crew Interview: Ed Lu

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Ed Lu of Expedition Seven is seen during a pre-launch interview. He explains why he became interested in space flight. He states that this is a different type of mission and gives his reaction to the Columbia Space Shuttle tragedy. The handover of Expedition six is explained by Ed Lu. The challenges of this mission are also described by Lu. These challenges include working with a crew member reduction from three to two, and the conservation of clothing and consumables. Ed Lu talks about what it is like to work with commander Yuri Malenchenko in space. Finally, Ed Lu states that he will continue scientific experiments in space on calcium loss in bones.

  16. Expedition 7 Crew Interview: Ed Lu

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Ed Lu of Expedition Seven is seen during a pre-launch interview. He explains why he became interested in space flight. He states that this is a different type of mission and gives his reaction to the Columbia Space Shuttle tragedy. The handover of Expedition six is explained by Ed Lu. The challenges of this mission are also described by Lu. These challenges include working with a crew member reduction from three to two, and the conservation of clothing and consumables. Ed Lu talks about what it is like to work with commander Yuri Malenchenko in space. Finally, Ed Lu states that he will continue scientific experiments in space on calcium loss in bones.

  17. 78 FR 55684 - ConnectED Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... ConnectED Workshop will discuss the growing bandwidth needs of K-12 schools as more schools use mobile devices to enrich the learning experience; as teachers increasingly integrate Web video and other digital...

  18. ED visits by males with hemophilia.

    PubMed

    Nuss, Rachelle; Hoffman, Richard; Hammond, Lucinda

    2002-03-01

    Hemophilia is a rare disorder affecting 1 in 5,000 males. Because hemophilia-associated hemorrhage may occur at anytime, affected males frequently seek care in the ED. We studied the epidemiology of ED visits by males with hemophilia. The medical records of all identified Coloradan males with hemophilia who sought care in Colorado EDs in 1998 were reviewed. Fifty-one males with hemophilia had a total of 125 ED visits; hemorrhage accounted for 64.8% of visits (95% CI=55.6, 73.1). On 13.0% (95% CI=6.4, 22.6) of visits for hemorrhage, treatment was warranted, but not given. On 12.3% (95% CI=5.5, 22.8) of visits when treatment was given, there were errors in product choice or dose. Documentation of factor concentrate brand and lot number was present for just 13.9% (95% CI=6.5, 24.7) and 24.6% (95% CI=14.8, 36.9) of visits, respectively. There is substantial room for improvement in the prescribing practices and documentation related to hemophilia care in the ED. Available resources should be utilized by ED physicians. Copyright 2002, Elsevier Science (USA). All rights reserved.)

  19. Disparities in potentially avoidable emergency department (ED) care: ED visits for ambulatory care sensitive conditions.

    PubMed

    Johnson, Pamela Jo; Ghildayal, Neha; Ward, Andrew C; Westgard, Bjorn C; Boland, Lori L; Hokanson, Jon S

    2012-12-01

    Hospital care for ambulatory care sensitive conditions (ACSC) is potentially avoidable and often viewed as an indicator of suboptimal primary care. However, potentially preventable encounters with the health care system also occur in emergency department (ED) settings. We examined ED visits to identify subpopulations with disproportionate use of EDs for ACSC care. We analyzed data from the 2007-2009 National Hospital Ambulatory Medical Care Survey for 78,114 ED visits by adults aged 18 and older. Outcomes were ACSC visits determined from the primary ED diagnosis. We constructed analytic groups aligned with Agency for Healthcare Research and Quality's priority populations. Multivariate logistic regression was used to estimate the odds of all-cause, acute, and chronic ACSC visits. We used Stata SE survey techniques to account for the complex survey design. Overall, 8.4% of ED visits were for ACSC, representing over 8 million potentially avoidable ED visits annually. ACSC visits were more likely to result in hospitalization than non-ACSC visits (34.4% vs. 14.0%, P<0.001). Multivariate models revealed significant disparities in ACSC visits to the ED by race/ethnicity, insurance status, age group, and socioeconomic status, although patterns differed for acute and chronic ACSC. Disproportionately higher use of EDs for ACSC care exists for many priority populations and across a broader range of priority populations than previously documented. These differences constitute disparities in potentially avoidable ED visits for ACSC. To avoid exacerbating disparities, health policy efforts to minimize economic inefficiencies in health care delivery by limiting ED visits for ACSC should first address their determinants.

  20. MicroED data collection and processing

    PubMed Central

    Hattne, Johan; Reyes, Francis E.; Nannenga, Brent L.; Shi, Dan; de la Cruz, M. Jason; Leslie, Andrew G. W.; Gonen, Tamir

    2015-01-01

    MicroED, a method at the intersection of X-ray crystallography and electron cryo-microscopy, has rapidly progressed by exploiting advances in both fields and has already been successfully employed to determine the atomic structures of several proteins from sub-micron-sized, three-dimensional crystals. A major limiting factor in X-ray crystallography is the requirement for large and well ordered crystals. By permitting electron diffraction patterns to be collected from much smaller crystals, or even single well ordered domains of large crystals composed of several small mosaic blocks, MicroED has the potential to overcome the limiting size requirement and enable structural studies on difficult-to-crystallize samples. This communication details the steps for sample preparation, data collection and reduction necessary to obtain refined, high-resolution, three-dimensional models by MicroED, and presents some of its unique challenges. PMID:26131894

  1. A Quantitative Content Analysis of Mercer University MEd, EdS, and Doctoral Theses

    ERIC Educational Resources Information Center

    Randolph, Justus J.; Gaiek, Lura S.; White, Torian A.; Slappey, Lisa A.; Chastain, Andrea; Harris, Rose Prejean

    2010-01-01

    Quantitative content analysis of a body of research not only helps budding researchers understand the culture, language, and expectations of scholarship, it helps identify deficiencies and inform policy and practice. Because of these benefits, an analysis of a census of 980 Mercer University MEd, EdS, and doctoral theses was conducted. Each thesis…

  2. TED-Ed lessons & TED-Ed clubs: Educational activities to amplify students' voices

    NASA Astrophysics Data System (ADS)

    Villias, Georgios

    2017-04-01

    TED-Ed lessons and TED-Ed clubs are two powerful educational tools that can be used in today's school classrooms in order to create an educational environment that is engaging for the students and favors their active participation, created and fostered by TED-Ed. TED-Ed is TED's educational initiative, committed to create lessons worth sharing and amplify the voices and ideas of teachers and students around the world. TED-Ed animated lessons are fully organized lessons structured around an animated video that introduces new topics to learners in an exciting, thought-provoking way. These lessons have been created as a result of the cooperation between expert educators and animators and have been uploaded at the TED-Ed platform (http://ed.ted.com). On the other hand, TED-Ed Clubs are also an interesting way to offer students the chance, the voice and the opportunity to express their thoughts, engage actively on these matters and connect with each other, both at a local, as well as at an international level (http://ed.ted.com/clubs). By developing new TED-Ed lessons or by customizing appropriately existing animated TED-Ed lessons (translating, modifying the questions asked, introducing new discussion topics), I have created and implemented in my student-centered, didactic approach, a series of TED-ED animated lessons directly connected with the Greek national science syllabus that were used to spark students curiosity and initiate a further analytical discussion or introduce other relevant educational activities (http://gvillias.wixsite.com/education). Furthermore, at my school, we established Varvakeio TED-Ed Club, an environment that supports and empowers our students to research, develop and disseminate their own personal ideas that worth spreading. During the year, our members were inspired by watching TED talks presented by experts on their field on various different areas, including social, economical, environmental and technological-scientific issues. Our aim

  3. One Year Medical Outcomes and ED Recidivism Following ED Observation for Cocaine-Associated Chest Pain

    PubMed Central

    Cunningham, Rebecca; Walton, Maureen A.; Weber, Jim Edward; O'Broin, Samantha; Tripathi, Shanti P; Maio, Ronald F.; Booth, Brenda M.

    2010-01-01

    Chest pain is the most common complaint among cocaine users who present to the ED seeking care and many hospital resources are applied to stratify cocaine users in regard to future cardiac morbidity and mortality. Little is known about the longitudinal cardiac and non cardiac medical outcomes of cocaine users who have been stratified to an ED observation period following their ED visit. Objectives to examine one-year cardiac outcomes in a low-intermediate risk sample of patients with cocaine- associated chest pain in an urban ED, as well as to examine ED recidivism one year for cardiac and non-cardiac complaints. Methods Prospective consecutive cohort study of patients (18–60 years) who presented to an urban Level 1 ED with cocaine-associated chest pain and were risk stratified to low-intermediate cardiac risk. Exclusion criteria: EKG suggestive of AMI, elevated serum cardiac markers, history of AMI or CABG, hemodynamic instability, unstable angina. Baseline interviews using validated measures of health functioning, and substance use were conducted during CPOU stay, and 3, 6, and 12 months. ED utilization during the study year was abstracted from medical chart. Zero-Inflated Poisson regression analyses were conducted to predict recurrent ED visits. Results 219 participants (73% participation) were enrolled, 65% returned to the ED post index visit; 23% returned for chest pain, of these 66% had a positive cocaine urine screen. No patient had an AMI within the one year follow up period. Patients with continued cocaine use were more likely to have a recurrent ED visit (p<0.001) but these repeat visits were most often related to musculoskeletal pain (21%), and injury (30%) rather than potential cardiac complaints. Conclusions Patients with cocaine-associated chest pain who are low to intermediate cardiac risk and complete a CPOU protocol have less then 1% rate of MI in the subsequent 12-months. PMID:18824277

  4. Canadian EdGEO National Workshop Program

    NASA Astrophysics Data System (ADS)

    Clinton, L. A.; Haidl, F. M.; Hymers, L. A.; van der Flier-Keller, E.

    2009-05-01

    Established in the early 1970s, EdGEO supports locally driven geosciences workshops for Canadian teachers. Workshops are organized by geoscientists and teachers, and typically have field, laboratory and classroom components. Grants of up to $3000 per workshop are available from the National EdGEO Program. By providing educational opportunities for today's teachers and, through them, their students, EdGEO seeks to cultivate a heightened awareness of our planet. EdGEO workshops provide teachers with potential fieldtrip sites for their students and the knowledge, enthusiasm and materials to inspire their students to engage in geoscience. Networking opportunities with local experts promote the importance of the geoscience profession. The expected result is an improved capacity on the part of Canadians to understand the Earth and to make informed decisions, especially with regard to the use of mineral and energy resources, the maintenance and remediation of the environment, and response to geological hazards. There exists a critical need to provide teachers with training and resources to tackle their Earth science curricula. In 2008, EdGEO supported fourteen workshops, with an unprecedented 521 teachers attending. These teachers then used our resources to reach an estimated 14,000 students during that single academic year. EdGEO workshops are locally driven and are therefore very diverse. Workshops are strongly tied to the provincial curriculum, focus on a specific geoscience topic, or may be largely field-based to demonstrate and practice how field activities could be incorporated into Earth science teaching. Many strive to include all of these important components. Geoscientists and teachers work collaboratively to develop and deliver EdGEO workshops to ensure that the activities can be effectively used in the classroom. The length of these professional development opportunities range from two-hour sessions to several days, and can generally accommodate up to twenty

  5. 34 CFR 85.942 - ED Deciding Official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false ED Deciding Official. 85.942 Section 85.942 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 85.942 ED Deciding Official. The ED Deciding Official is an ED officer who has...

  6. ED's Oasis: Teacher Support for Internet Use.

    ERIC Educational Resources Information Center

    Gray, Terrie

    1998-01-01

    Describes ED's Oasis, a multifunction Web site funded by the AT&T Foundation, through the AT&T Learning Network program, and developed by a team of educators to help teachers use the Internet with their students. Examples are given of various possible uses, including designing interdisciplinary units. (LRW)

  7. What Should I Know about ED Grants?

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    The Department of Education's ability to create a high-performance education system is directly linked to the public's understanding of how to apply for and make proper use of federal grant funds. This booklet is intended for individuals who are interested in applying to the U.S. Department of Education (ED) for discretionary grants and…

  8. The Consequences of edTPA

    ERIC Educational Resources Information Center

    Greenblatt, Deborah

    2016-01-01

    States and teacher preparation programs across the country are increasingly using a teacher candidate assessment called edTPA. The purpose? To make sure that teacher candidates are ready and able to teach before they begin their careers. The teacher performance assessment requires candidates to compile a portfolio that consists of lesson plans,…

  9. Manufacturing techniques help turn ED around.

    PubMed

    2005-05-01

    Borrowing quality tools from other industries can help give you a new perspective on the operations of your ED. Computer simulations can help you visualize impact of patient arrivals at peak hours. A flexible approach opens up new options for using existing space more efficiently. 'Manufacturing' approach enables you to break down large processes into more manageable subsets.

  10. The Consequences of edTPA

    ERIC Educational Resources Information Center

    Greenblatt, Deborah

    2016-01-01

    States and teacher preparation programs across the country are increasingly using a teacher candidate assessment called edTPA. The purpose? To make sure that teacher candidates are ready and able to teach before they begin their careers. The teacher performance assessment requires candidates to compile a portfolio that consists of lesson plans,…

  11. Measuring the Impact of Re-ED

    ERIC Educational Resources Information Center

    Freado, Mark D.

    2010-01-01

    From its origins nearly a half century ago, the Re-ED model has generated a series of research studies evaluating its efficacy. This article provides a historical perspective on the evidence base for this early strength-based model for working with troubled youth.

  12. Risk factors for ED use among homeless veterans.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2013-05-01

    Despite national concern about homeless veterans, there has been little examination of their use of emergency department (ED) services. This study examines factors related to the use of ED services in the Veterans Affairs (VA) healthcare system, where insurance is not a barrier to ambulatory healthcare. National VA administrative data from fiscal year 2010 are used to describe the proportions of ED users among homeless and domiciled VA patients. A case-control design is then used to compare homeless ED and non-ED users on sociodemographic and clinical correlates, as well as use of ambulatory care and psychotropic medications. Sixteen percent of domiciled VA patients used EDs at least once during the year and 1% were frequent ED users (>4 ED visits) compared to 45% of homeless VA patients, 10% who were frequent ED users. Among homeless VA patients, those who used EDs were more likely to have a range of psychiatric and medical conditions, and had more service visits and psychotropic medication prescriptions than non-ED users. Multivariate analyses suggest their risk for psychiatric and medical conditions increase their likelihood of using ED services. The high rate of ED use among homeless veterans is associated with significant morbidity, but also greater use of ambulatory care and psychotropics suggesting their ED use may reflect unmet psychosocial needs.

  13. [Propofol: ED50 and ED90 induction doses in pediatric anesthesia].

    PubMed

    Blanco, D; Montes, A; Moreno, V; Costa, J; Alloza, P; Vidal, F

    1994-01-01

    To study ED50 and ED90 induction doses of propofol in children. Seventy-two children from 1 to 110 months of age and premedicated with pentobarbital 4 mg/kg participated in the study. Seven different doses of propofol (1.5, 2, 2.5, 3, 3.5, 4 and 4.5 mg/kg) were injected into the dorsal hand or foot vein in 30 seconds. We measured the response to application of the mask, corneal reflex and response to trapezius muscle compression 30 and 60 s after administration. A log-probit statistical analysis was used and complications were noted. The doses that produced 50% elimination of reflexes (ED50) or 90% elimination (ED90) in our patients were 1.74 and 3.95 mg/kg for response to mask; 2.47 and 4.26 mg/kg for elimination of corneal reflex; and 3.27 and 4.79 mg/kg for compression of trapezius. Frequency of pain upon injection was 74% and that of spontaneous movement was 12%. Apnea (breathing halted for longer than 20 s) occurred in 7% of our patients. We recorded no cases of broncho or laryngeal spasm, or skin rash. Induction with propofol is appropriate given the rarity of stimulant effects, but there is a high frequency of pain upon injection, limiting the usefulness of this drug for anesthetic induction in pediatrics. ED50 and ED90 varies depending on the stimulus assessed.

  14. Cytoplasmic Streaming - Skylab Student Experiment ED-63

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment (ED-63), Cytoplasmic Streaming, proposed by Cheryl A. Peitz of Arapahoe High School, Littleton, Colorado. Experiment ED-63 was to observe the effect of zero-gravity on cytoplasmic streaming in the aquatic plant named Elodea, commonly called water weed or water thyme. The phenomenon of cytoplasmic streaming is not well understood, but it is recognized as the circulation mechanism of the internal materials or cytoplasm of a cell. Cytoplasm is a gelatinous substance that has the ability to change its viscosity and flow, carrying various cell materials with it. The activity can be stimulated by sunlight or heat. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  15. Cytoplasmic Streaming - Skylab Student Experiment ED-63

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment (ED-63), Cytoplasmic Streaming, proposed by Cheryl A. Peitz of Arapahoe High School, Littleton, Colorado. Experiment ED-63 was to observe the effect of zero-gravity on cytoplasmic streaming in the aquatic plant named Elodea, commonly called water weed or water thyme. The phenomenon of cytoplasmic streaming is not well understood, but it is recognized as the circulation mechanism of the internal materials or cytoplasm of a cell. Cytoplasm is a gelatinous substance that has the ability to change its viscosity and flow, carrying various cell materials with it. The activity can be stimulated by sunlight or heat. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  16. EDs pool resources to weather flood.

    PubMed

    2006-10-01

    When disaster strikes your community, creativity can go a long way toward keeping your ED up and running, but cooperating with neighboring facilities can double your available resources in a hurry. Contact all unscheduled staff members and request that they accept additional shifts during the crisis. If nearby facilities are shut down, contact their manager to ascertain availability of their staff and supplies. Seek additional staffing help from local residency programs.

  17. Ethanol elimination rates in an ED population.

    PubMed

    Brennan, D F; Betzelos, S; Reed, R; Falk, J L

    1995-05-01

    Knowledge of the rate of ethanol elimination is essential in the assessment of the intoxicated patient. Surprisingly little literature is available regarding ethanol elimination rates in emergency department (ED) patients; prior studies almost exclusively examined populations of alcoholics or normal controls. Consequently, this prospective observational study was undertaken to assess the rate of ethanol elimination in an ED population. Twenty-four consecutive adult ED patients clinically suspected of intoxication who had serum ethanol determinations drawn were enrolled. Patients underwent serial ethanol determinations via breathalyzer (Intoxilyzer 1400, CMI Inc., Owensboro, KY). Linear regression analysis of the plot of decrease in ethanol level over time was performed to determine the rate of ethanol elimination. Initial ethanol levels in the 24 patients ranged from 58 to 447 mg/dL (mean, 249 +/- 109 [SD] mg/dL). Patients were observed for a minimum of 2 and a maximum of 9 observations (mean, 3.9 +/- 1.7), over a period of 0.5 to 12.1 hours (mean, 4.4 +/-3.5 h). Clinical features of intoxication were poorly correlated with ethanol level (r < .5). The rate of ethanol elimination in the ED population was 19.6 mg/dL/h (r = .83; 95% confidence interval [CI], 16.9 to 22.3 mg/dL/h). Subgroup analysis found differences that were statistically significant but small. Multiple regression analysis showed that time was the major variable useful in predicting changes in ethanol level (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Prospective study of violence against ED workers.

    PubMed

    Kowalenko, Terry; Gates, Donna; Gillespie, Gordon Lee; Succop, Paul; Mentzel, Tammy K

    2013-01-01

    Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events. The objective was to describe the incidence of violence in ED health care workers (HCWs) over 9 months. Specific aims were to (1) identify demographic, occupational, and perpetrator factors related to violent events (VEs) and (2) identify predictors of acute stress in victims and predictors of loss of productivity. A longitudinal, repeated-methods design was used to collect monthly survey data from ED HCWs at 6 hospitals. Surveys assessed number and type of VEs, and feelings of safety and confidence. Victims also completed specific VE surveys. Descriptive statistics and a repeated-measure linear regression model were used. Two hundred thirteen ED HCWs completed 1795 monthly surveys and 827 VEs were reported. Average VE rate per person per 9 months was 4.15. Six hundred one events were physical threats (PTs) (3.01 per person). Two hundred twenty six events were assaults (1.13 per person). Five hundred one VE surveys were completed, describing 341 PTs and 160 assaults. Men perpetrated 63% of PTs and 52% of assaults. Significant differences in VEs were reported between registered nurses (RNs) and medical doctors (MDs) (P = .0017) and patient care assistants (P < .05). The RNs felt less safe than the MDs (P = .0041). The MDs felt more confident than the RNs in dealing with violent patients (P = .013). The RNs were more likely to experience acute stress than the MDs (P < .001). Acute stress reduced productivity (P < .001). Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Regional Energy Deployment System (ReEDS)

    SciTech Connect

    Short, W.; Sullivan, P.; Mai, T.; Mowers, M.; Uriarte, C.; Blair, N.; Heimiller, D.; Martinez, A.

    2011-12-01

    The Regional Energy Deployment System (ReEDS) is a deterministic optimization model of the deployment of electric power generation technologies and transmission infrastructure throughout the contiguous United States into the future. The model, developed by the National Renewable Energy Laboratory's Strategic Energy Analysis Center, is designed to analyze the critical energy issues in the electric sector, especially with respect to potential energy policies, such as clean energy and renewable energy standards or carbon restrictions. ReEDS provides a detailed treatment of electricity-generating and electrical storage technologies and specifically addresses a variety of issues related to renewable energy technologies, including accessibility and cost of transmission, regional quality of renewable resources, seasonal and diurnal generation profiles, variability of wind and solar power, and the influence of variability on the reliability of the electrical grid. ReEDS addresses these issues through a highly discretized regional structure, explicit statistical treatment of the variability in wind and solar output over time, and consideration of ancillary services' requirements and costs.

  20. 9q33.3q34.11 microdeletion: new contiguous gene syndrome encompassing STXBP1, LMX1B and ENG genes assessed using reverse phenotyping.

    PubMed

    Nambot, Sophie; Masurel, Alice; El Chehadeh, Salima; Mosca-Boidron, Anne-Laure; Thauvin-Robinet, Christel; Lefebvre, Mathilde; Marle, Nathalie; Thevenon, Julien; Perez-Martin, Stéphanie; Dulieu, Véronique; Huet, Frédéric; Plessis, Ghislaine; Andrieux, Joris; Jouk, Pierre-Simon; Billy-Lopez, Gipsy; Coutton, Charles; Morice-Picard, Fanny; Delrue, Marie-Ange; Heron, Delphine; Rooryck, Caroline; Goldenberg, Alice; Saugier-Veber, Pascale; Joly-Hélas, Géraldine; Calenda, Patricia; Kuentz, Paul; Manouvrier-Hanu, Sylvie; Dupuis-Girod, Sophie; Callier, Patrick; Faivre, Laurence

    2016-06-01

    The increasing use of array-CGH in malformation syndromes with intellectual disability could lead to the description of new contiguous gene syndrome by the analysis of the gene content of the microdeletion and reverse phenotyping. Thanks to a national and international call for collaboration by Achropuce and Decipher, we recruited four patients carrying de novo overlapping deletions of chromosome 9q33.3q34.11, including the STXBP1, the LMX1B and the ENG genes. We restrained the selection to these three genes because the effects of their haploinsufficency are well described in the literature and easily recognizable clinically. All deletions were detected by array-CGH and confirmed by FISH. The patients display common clinical features, including intellectual disability with epilepsy, owing to the presence of STXBP1 within the deletion, nail dysplasia and bone malformations, in particular patellar abnormalities attributed to LMX1B deletion, epistaxis and cutaneous-mucous telangiectasias explained by ENG haploinsufficiency and common facial dysmorphism. This systematic analysis of the genes comprised in the deletion allowed us to identify genes whose haploinsufficiency is expected to lead to disease manifestations and complications that require personalized follow-up, in particular for renal, eye, ear, vascular and neurological manifestations.

  1. Genetic variation in the functional ENG allele inherited from the non-affected parent associates with presence of pulmonary arteriovenous malformation in hereditary hemorrhagic telangiectasia 1 (HHT1) and may influence expression of PTPN14.

    PubMed

    Letteboer, Tom G W; Benzinou, Michael; Merrick, Christopher B; Quigley, David A; Zhau, Kechen; Kim, Il-Jin; To, Minh D; Jablons, David M; van Amstel, Johannes K P; Westermann, Cornelius J J; Giraud, Sophie; Dupuis-Girod, Sophie; Lesca, Gaetan; Berg, Jonathan H; Balmain, Allan; Akhurst, Rosemary J

    2015-01-01

    HHT shows clinical variability within and between families. Organ site and prevalence of arteriovenous malformations (AVMs) depend on the HHT causative gene and on environmental and genetic modifiers. We tested whether variation in the functional ENG allele, inherited from the unaffected parent, alters risk for pulmonary AVM in HHT1 mutation carriers who are ENG haploinsufficient. Genetic association was found between rs10987746 of the wild type ENG allele and presence of pulmonary AVM [relative risk = 1.3 (1.0018-1.7424)]. The rs10987746-C at-risk allele associated with lower expression of ENG RNA in a panel of human lymphoblastoid cell lines (P = 0.004). Moreover, in angiogenically active human lung adenocarcinoma tissue, but not in uninvolved quiescent lung, rs10987746-C was correlated with expression of PTPN14 (P = 0.004), another modifier of HHT. Quantitative TAQMAN expression analysis in a panel of normal lung tissues from 69 genetically heterogeneous inter-specific backcross mice, demonstrated strong correlation between expression levels of Eng, Acvrl1, and Ptpn14 (r2 = 0.75-0.9, P < 1 × 10(-12)), further suggesting a direct or indirect interaction between these three genes in lung in vivo. Our data indicate that genetic variation within the single functional ENG gene influences quantitative and/or qualitative differences in ENG expression that contribute to risk of pulmonary AVM in HHT1, and provide correlative support for PTPN14 involvement in endoglin/ALK1 lung biology in vivo. PTPN14 has been shown to be a negative regulator of Yap/Taz signaling, which is implicated in mechanotransduction, providing a possible molecular link between endoglin/ALK1 signaling and mechanical stress. EMILIN2, which showed suggestive genetic association with pulmonary AVM, is also reported to interact with Taz in angiogenesis. Elucidation of the molecular mechanisms regulating these interactions in endothelial cells may ultimately provide more rational choices for HHT therapy.

  2. 34 CFR 85.942 - ED Deciding Official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Definitions § 85.942 ED Deciding Official. The ED Deciding Official is an ED officer who has delegated authority under the procedures of the Department of Education to decide whether to affirm a suspension or enter a debarment. Authority: E.O. 12549 (3 CFR, 1986 Comp., p. 189), E.O. 12689 ( 3 CFR, 1989 Comp., p...

  3. 2 CFR 3485.937 - ED Deciding Official.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false ED Deciding Official. 3485.937 Section 3485.937 Grants and Agreements Federal Agency Regulations for Grants and Agreements DEPARTMENT OF EDUCATION NONPROCUREMENT DEBARMENT AND SUSPENSION Definitions § 3485.937 ED Deciding Official. The ED Deciding Official...

  4. 2 CFR 3485.937 - ED Deciding Official.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2 Grants and Agreements 1 2013-01-01 2013-01-01 false ED Deciding Official. 3485.937 Section 3485.937 Grants and Agreements Federal Agency Regulations for Grants and Agreements DEPARTMENT OF EDUCATION NONPROCUREMENT DEBARMENT AND SUSPENSION Definitions § 3485.937 ED Deciding Official. The ED Deciding Official...

  5. Prevalence of Germline PTEN, BMPR1A, SMAD4, STK11, and ENG Mutations in Patients with Moderate-Load Colorectal Polyps

    PubMed Central

    Ngeow, Joanne; Heald, Brandie; Rybicki, Lisa A.; Orloff, Mohammed S.; Chen, Jin Lian; Liu, Xiuli; Yerian, Lisa; Willis, Joseph; Lehtonen, Heli; Lehtonen, Rainer; Mester, Jessica L.; Moline, Jessica; Burke, Carol A.; Church, James; Aaltonen, Lauri A.; Eng, Charis

    2014-01-01

    BACKGROUND & AIMS Gastrointestinal polyposis is a common clinical problem, yet there is no consensus on how to best manage patients with moderate-load polyposis. Identifying genetic features of this disorder could improve management, and especially surveillance, of these patients. We sought to determine the prevalence of hamartomatous polyposis associated mutations in the susceptibility genes PTEN, BMPR1A, SMAD4, ENG, and STK11 in individuals with 5 or more gastrointestinal polyps, including at least 1 hamartomatous or hyperplastic/serrated polyp. METHODS We performed a prospective, referral-based study of 603 patients (median age 51 y; range, 2–89 y), enrolled from June 2006 through January 2012. Genomic DNA was extracted from peripheral lymphocytes and analyzed for specific mutations and large rearrangements in PTEN, BMPR1A, SMAD4, and STK11, as well as mutations in ENG. Recursive partitioning analysis was used to determine cutoffs for continuous variables. The prevalence of mutations was compared using Fischer’s exact test. Logistic regression analyses were used to determine univariate and multivariate risk factors. RESULTS Of 603 patients, 119 (20%) had a personal history of colorectal cancer and most (461; 76%) had fewer than 30 polyps. Seventy-seven patients (13%) were found to have polyposis-associated mutations, comprising 11 in ENG (1.8%), 13 in PTEN (2.2%), 13 in STK11 (2.2%), 20 in BMPR1A (3.3%), and 21 in SMAD4 (3.5%). Univariate clinical predictors for risk of having these mutations included age at presentation less than 40 years (19% vs 10%; P=.008), a polyp burden of 30 or more (19% vs 11%; P=0.014), and male sex (16% vs 10%; P=.03). Patients who had 1 or more ganglioneuromas (29% vs 2%; P<.001) or presented with polyps of 3 or more histologic types (20% vs 2%; P=.003) were more likely to have germline mutations in PTEN. CONCLUSIONS Age less than 40 years, male sex, and specific polyp histologies are significantly associated with risk of germline

  6. Prevalence of germline PTEN, BMPR1A, SMAD4, STK11, and ENG mutations in patients with moderate-load colorectal polyps.

    PubMed

    Ngeow, Joanne; Heald, Brandie; Rybicki, Lisa A; Orloff, Mohammed S; Chen, Jin Lian; Liu, Xiuli; Yerian, Lisa; Willis, Joseph; Lehtonen, Heli J; Lehtonen, Rainer; Mester, Jessica L; Moline, Jessica; Burke, Carol A; Church, James; Aaltonen, Lauri A; Eng, Charis

    2013-06-01

    Gastrointestinal polyposis is a common clinical problem, yet there is no consensus on how to best manage patients with moderate-load polyposis. Identifying genetic features of this disorder could improve management and especially surveillance of these patients. We sought to determine the prevalence of hamartomatous polyposis-associated mutations in the susceptibility genes PTEN, BMPR1A, SMAD4, ENG, and STK11 in individuals with ≥5 gastrointestinal polyps, including at least 1 hamartomatous or hyperplastic/serrated polyp. We performed a prospective, referral-based study of 603 patients (median age: 51 years; range, 2-89 years) enrolled from June 2006 through January 2012. Genomic DNA was extracted from peripheral lymphocytes and analyzed for specific mutations and large rearrangements in PTEN, BMPR1A, SMAD4, and STK11, as well as mutations in ENG. Recursive partitioning analysis was used to determine cutoffs for continuous variables. The prevalence of mutations was compared using Fisher's exact test. Logistic regression analyses were used to determine univariate and multivariate risk factors. Of 603 patients, 119 (20%) had a personal history of colorectal cancer and most (n = 461 [76%]) had <30 polyps. Seventy-seven patients (13%) were found to have polyposis-associated mutations, including 11 in ENG (1.8%), 13 in PTEN (2.2%), 13 in STK11 (2.2%), 20 in BMPR1A (3.3%), and 21 in SMAD4 (3.5%). Univariate clinical predictors for risk of having these mutations included age at presentation younger than 40 years (19% vs 10%; P = .008), a polyp burden of ≥30 (19% vs 11%; P = .014), and male sex (16% vs 10%; P = .03). Patients who had ≥1 ganglioneuroma (29% vs 2%; P < .001) or presented with polyps of ≥3 histologic types (20% vs 2%; P = .003) were more likely to have germline mutations in PTEN. Age younger than 40 years, male sex, and specific polyp histologies are significantly associated with risk of germline mutations in hamartomatous-polyposis associated genes

  7. EDS Coal Liquefaction Process Development. Phase V. Laboratory evaluation of the characteristics of EDS Illinois bottoms

    SciTech Connect

    Lao, T C; Levasseur, A A

    1984-02-01

    This interim report documents work carried out by Combustion Engineering, Inc. under a contract to Exxon Research and Engineering Company to develop a conceptual Hybrid Boiler design fueled by the vacuum distillation residue (vacuum bottoms) derived from Illinois No. 6 coal in the EDS Coal Liquefaction Process. This report was prepared by Combustion Engineering, Inc., and is the first of two reports on the predevelopment phase of the Hybrid Boiler program. This report covers the results of a laboratory investigation to assess the fuel and ash properties of EDS vacuum bottoms. The results of the laboratory testing reported here were used in conjunction with Combustion Engineering's design experience to predict fuel performance and to develop appropriate boiler design parameters. These boiler design parameters were used to prepare the engineering design study reported in EDS Interim Report FE-2893-113, the second of the two reports on the predevelopment phase of the Hybrid Boiler Program. 46 figures, 29 tables.

  8. The tRNAarg gene and engA are essential genes on the 1.7-Mb pSymB megaplasmid of Sinorhizobium meliloti and were translocated together from the chromosome in an ancestral strain.

    PubMed

    diCenzo, George; Milunovic, Branislava; Cheng, Jiujun; Finan, Turlough M

    2013-01-01

    Bacterial genomes with two (or more) chromosome-like replicons are known, and these appear to be particularly frequent in alphaproteobacteria. The genome of the N(2)-fixing alfalfa symbiont Sinorhizobium meliloti 1021 contains a 3.7-Mb chromosome and 1.4-Mb (pSymA) and 1.7-Mb (pSymB) megaplasmids. In this study, the tRNA(arg) and engA genes, located on the pSymB megaplasmid, are shown to be essential for growth. These genes could be deleted from pSymB when copies were previously integrated into the chromosome. However, in the closely related strain Sinorhizobium fredii NGR234, the tRNA(arg) and engA genes are located on the chromosome, in a 69-kb region designated the engA-tRNA(arg)-rmlC region. This region includes bacA, a gene that is important for intracellular survival during host-bacterium interactions for S. meliloti and the related alphaproteobacterium Brucella abortus. The engA-tRNA(arg)-rmlC region lies between the kdgK and dppF2 (NGR_c24410) genes on the S. fredii chromosome. Synteny analysis showed that kdgK and dppF2 orthologues are adjacent to each other on the chromosomes of 15 sequenced strains of S. meliloti and Sinorhizobium medicae, whereas the 69-kb engA-tRNA(arg)-rmlC region is present on the pSymB-equivalent megaplasmids. This and other evidence strongly suggests that the engA-tRNA(arg)-rmlC region translocated from the chromosome to the progenitor of pSymB in an ancestor common to S. meliloti and S. medicae. To our knowledge, this work represents one of the first experimental demonstrations that essential genes are present on a megaplasmid.

  9. The ACVRL1 c.314-35A>G Polymorphism is Associated with Organ Vascular Malformations in Hereditary Hemorrhagic Telangiectasia Patients with ENG Mutations, but not in Patients with ACVRL1 Mutations

    PubMed Central

    Pawlikowska, Ludmila; Nelson, Jeffrey; Guo, Diana E.; McCulloch, Charles E.; Lawton, Michael T.; Young, William L.; Kim, Helen; Faughnan, Marie E.

    2015-01-01

    Hereditary hemorrhagic telangiectasia (HHT) is characterized by the presence of vascular malformations (VMs) and caused by mutations in TGFβ/BMP9 pathway genes, most commonly ENG or ACVRL1. Patients with HHT have diverse phenotypes related to skin and mucosal telangiectases and organ VMs, including arteriovenous malformations (AVM). The clinical heterogeneity of HHT suggests a potential role for genetic modifier effects. We hypothesized that the common polymorphisms ACVRL1 c.314-35A>G and ENG c.207G>A, previously associated with sporadic brain AVM, are also associated with organ VM in HHT. We genotyped ACVRL1 c.314-35A>G and ENG c.207G>A in 716 patients with HHT recruited by the Brain Vascular Malformation Consortium and evaluated association of genotype with presence of any organ VM, and specifically with brain VM, liver VM and pulmonary AVM, by multivariate logistic regression analyses stratified by HHT mutation. Among all patients with HHT, neither polymorphism was significantly associated with presence of any organ VM; ACVRL1 c.314-35A>G showed a trend toward association with pulmonary AVM (OR=1.48, p=0.062). ACVRL1 c.314-35A>G was significantly associated with any VM among patients with HHT with ENG (OR=2.66, p=0.022), but not ACVRL1 (OR=0.79, p=0.52) mutations. ACVRL1 c.314-35A>G was also significantly associated with pulmonary AVM and liver VM among ENG mutation carriers. There were no significant associations between ENG c.207G>A and any VM phenotype. These results suggest that common polymorphisms in HHT genes other than the mutated gene modulate phenotype severity of HHT disease, specifically presence of organ VM. PMID:25847705

  10. The use of mechanical ventilation in the ED.

    PubMed

    Easter, Benjamin D; Fischer, Christopher; Fisher, Jonathan

    2012-09-01

    Although EDs are responsible for the initial care of critically ill patients and the amount of critical care provided in the ED is increasing, there are few data examining mechanical ventilation (MV) in the ED. In addition, characteristics of ED-based ventilation may affect planning for ventilator shortages during pandemic influenza or bioterrorist events. The study examined the epidemiology of MV in US EDs, including demographic, clinical, and hospital characteristics; indications for MV; ED length of stay (LOS); and in-hospital mortality. This study was a retrospective review of the 1993 to 2007 National Hospital Ambulatory Medical Care Survey ED data sets. Ventilated patients were compared with ED patients admitted to the intensive care unit (ICU) and to all other ED visits. There were 3.6 million ED MV visits (95% confidence interval [CI], 3.2-4.0 million) over the study period. Sex, age, race, and payment source were similar for mechanically ventilated and ICU patients (P > .05 for all). Approximately 12.5% of ventilated patients underwent cardiopulmonary resuscitation compared with 1.7% of ICU admissions and 0.2% of all other ED visits (P < .0001). Accordingly, in-hospital mortality was significantly higher for ventilated patients (24%; 95% CI, 13.1%-34.9%) than both comparison groups (9.3% and 2.5%, respectively). Median LOS for ventilated patients was 197 minutes (interquartile range, 112-313 minutes) compared with 224 minutes for ICU admissions and 140 minutes for all other ED visits. Patients undergoing ED MV have particularly high in-hospital mortality rates, but their ED LOS is sufficient for implementation of evidence-based ventilator interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Appropriateness of epinephrine use in ED patients with anaphylaxis.

    PubMed

    Baalmann, Damian V; Hagan, John B; Li, James T C; Hess, Erik P; Campbell, Ronna L

    2016-02-01

    Studies have demonstrated low rates of emergency department (ED) epinephrine administration for anaphylaxis patients, suggestive of ED undertreatment of anaphylaxis. Our study assessed the appropriateness of ED epinephrine administration in anaphylaxis management. A prospective observational study was conducted involving ED patients presenting with possible allergic reactions. Patients and ED providers completed questionnaires regarding the suspected trigger, signs and symptoms, and prehospital treatment. Two board-certified allergists-immunologists independently reviewed the questionnaires, as well as electronic health records, to determine whether the cases represented anaphylaxis and whether ED epinephrine administration was appropriate. Among 174 patients enrolled in the study, 61 (35%) were confirmed to have anaphylaxis. Overall, 47 anaphylaxis patients (77%) received epinephrine either before ED arrival or in the ED. In the latter situation, 24 anaphylaxis patients (39%) received epinephrine and 37 (61%) did not. Of the patients who received ED epinephrine, the allergists-immunologists determined that its administration was appropriate in all cases (95% confidence interval [CI], 83%-100%). Among the 37 patients who did not receive ED epinephrine, the allergists-immunologists determined that nonadministration of epinephrine was appropriate in 36 patients (97%; 95% CI, 84%-100%). The allergists-immunologists determined that overall, ED management was appropriate for 60 (98%) of 61 patients with anaphylaxis (95% CI, 90%-100%). Although more than 60% of anaphylaxis patients did not receive epinephrine in the ED, the allergists-immunologists deemed ED management appropriate in 98% of total cases. Previous retrospective studies may underestimate the appropriateness of ED anaphylaxis management, particularly when prehospital epinephrine administration is not reported. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Text message program improves outcomes, decreases ED utilization among ED patients with poorly controlled diabetes.

    PubMed

    2014-02-01

    Diabetic patients who lack access to primary care tend to frequent the ED, often with complications from their disease that could have been prevented with proper management and education. To get around the problem of access, researchers tested an automated program that continuously delivered educational messaging via text to a group of patients who presented to the ED with poorly controlled diabetes. After six months, researchers noted improvements in Hb A1c levels, self-reported medication adherence, and ED utilization when compared with a control group. And the impact was particularly noteworthy among Latinos, according to the researchers. The text messaging program, dubbed TExT-Med, was developed by four physicians and two diabetes educators. The messages were delivered daily, and contained educational as well motivational content derived from the National Diabetes Education Program.There were also medication reminders, healthy living challenges, and trivia questions about diabetes. At six months, Hb A1c levels decreased by 1.05% in the intervention group, compared to 0.60% in the control group, and self-reported medication adherence improved from 4.5 to 5.4 (as measured on an 8 point scale) in the intervention group versus a decrease of 0.1 in the control group. During the six-month study period, 35.9% of patients in the intervention group presented to the ED for care, as compared to 51.6% of patients in the control group.

  13. Capillary Study - Skylab Student Experiment ED-72

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment ED-72, Capillary Study, proposed by Roger G. Johnson of St. Paul, Mirnesota. Johnson theorized that capillary rise might continue to infinity in Skylab's zero-gravity environment. The behavior of fluids, particularly their flow properties in a low-gravity environment, had been important from the time that Robert H. Goddard launched his liquid-fueled rockets in the 1920's to the more sophisticated space systems of the day. It was necessary to design fluid-flow systems that would not only overcome the lack of gravity but also overcome, or take advantage of, the effect of surface tension. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  14. Characteristics of Medicaid enrollees with frequent ED use.

    PubMed

    Capp, Roberta; Rosenthal, Marjorie S; Desai, Mayur M; Kelley, Lauren; Borgstrom, Christopher; Cobbs-Lomax, Darcey L; Simonette, Peggy; Spatz, Erica S

    2013-09-01

    Medicaid enrollees are disproportionately represented among patients with frequent Emergency Department (ED) visits, yet prior studies investigating frequent ED users have focused on patients with all insurance types. This was a single center, retrospective study of Medicaid-insured frequent ED users (defined as ≥4 ED visits/year not resulting in hospital admission) to assess patients' sociodemographic and clinical characteristics and evaluate differences in these characteristics by frequency of use (4-6, 7-17, and ≥18 ED visits). Twelve percent (n = 1619) of Medicaid enrollees who visited the ED during the 1-year study period were frequent ED users, accounting for 38% of all ED visits (n = 10,337). Most frequent ED users (n = 1165, 72%) had 4-6 visits; 416 (26%) had 7-17 visits, and 38 (2%) had ≥18 visits. Overall, 67% had a primary care provider and 56% had at least one chronic medical condition. The most common ED diagnosis among patients with 4-6 visits was abdominal pain (7%); among patients with 7-17 and ≥18 ED visits, the most common diagnosis was alcohol-related disorders (11% and 36%, respectively). Compared with those who had 4-6 visits, patients with ≥18 visits were more likely to be homeless (7% vs 42%, P < .05) and suffer from alcohol abuse (15% vs 42%, P < .05). One out of 8 Medicaid enrollees who visited the ED had ≥4 visits in a year. Efforts to reduce frequent ED use should focus on reducing barriers to accessing primary care. More tailored interventions are needed to meet the complex needs of adults with ≥18 visits per year. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Take steps to curb violence, improve safety for ED personnel.

    PubMed

    2011-10-01

    While violent eruptions are well documented in the ED, there is a not a lot of research into what strategies are most effective at both curbing violence and managing incidents when they do occur. Experts suggest that ED managers should consider staff training and visible security measures when developing procedures for dealing with violence. In one survey of ED physicians, more than three-quarters reported at least one incident of workplace violence in the previous 12 months. Researchers report that many EDs post security at the point of entry, but lack security coverage in patient care areas. Experts suggest that verbal de-escalation techniques can be helpful in lowering anxiety levels.They also urge ED managers to bring in assistance when the ED is crowded or waiting times are long.

  16. Contribution of ED admissions to inpatient hospital revenue.

    PubMed

    Sacchetti, Alfred; Harris, Russell H; Warden, Todd; Roth, Sandra

    2002-01-01

    Emergency department (ED) practices are traditionally profiled in terms of their patient encounters. Such evaluations reflect a preponderance of outpatient visits while crediting income from admitted patients to traditional hospital-based services. This study evaluates the contribution of ED admissions to inpatient hospital revenue. The study was set at an urban tertiary care community hospital with university affiliation. Information referable to ED patients was collected from the hospital's Universal Billing Code (UB-92)-based patient information warehouse. Data fields referable to hospital charges, insurance type, and disposition were used for analysis of a 1-year period from September 1, 1998 to August 31, 1999. Statistical analysis was through chi square and ANOVA. During the study period 33,174 patients were treated in the ED with 6,671 (20%) admitted to inpatient services. Total hospital charges for all ED patients during this time were $107 million dollars with $9.1 million (8.5%) generated from discharged patients and $98.0 million (91.5%) from admitted ED patients (P <.001). Mean charges for individual discharged patients were $344.10 whereas for individual admitted patients mean charges were $14,692.28. (P <.001) Medicaid and self pay represented 55.4% of the insurance coverage for discharged ED patients whereas these same insurance classes accounted for only 16.3% of admitted patients. (P <.001) Medicare visits accounted for 12.7% of discharged ED patients but 60.7% of admitted patients (P <.001). Total hospital gross revenue for inpatient services for the study period was $288 million of which 34% was contributed from admitted ED patients. ED services represent a major source of inpatient hospital revenue. The recognition of the ED's potential in this area may be lost if income from patients admitted through the ED is credited to traditional hospital-based services.

  17. Rural ED transfers due to lack of radiology services.

    PubMed

    Lyon, Matthew; Sturgis, LaShon; Lendermon, Darren; Kuchinski, Ann Marie; Mueller, Taylor; Loeffler, Patrick; Xu, Hongyan; Gibson, Robert

    2015-11-01

    Our objectives were to determine the frequency of patient transfers to a tertiary care emergency department (Tertiary ED) due to a lack of radiology services in rural hospital EDs (Rural EDs), and examine the community and patient attributes that are associated with these transfers. This was a retrospective chart review of patients transferred to a Tertiary ED from Rural EDs. Transfers excluded from the study included pediatric patients (age <18 years old) and patients transferred for trauma surgeon evaluation. Only those patients who were transferred for radiology services were included in the final analysis. Over a 12-month period, 1445 patients were transferred to the Tertiary ED with 73.8% (n = 1066) of this population being transferred from a Rural ED. Excluding 381 trauma and pediatric patients, 64.3% (n = 685) of patients were transferred from a Rural ED and were included in the study. Of these 685 transfers, 24.5% (n = 168) were determined to be due primarily to a lack of a radiology service. Lack of radiology services in Rural EDs leads to numerous patient transfers to the Tertiary ED each year. A disproportionate number of these transfer patients are African American. These transfers place additional financial and social burdens on patients and their families. This study discusses these findings and alternative diagnostic options (ie, telemedicine and ultrasound video transfer) to address the lack of radiology services available in Rural EDs. The use of these alternate diagnostic options will likely reduce the number of patient transfers to Tertiary EDs. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Completing EdTPA: TSOL Candidate Performance and Reflection

    ERIC Educational Resources Information Center

    Micek, Timothy A.

    2017-01-01

    edTPA is a pre-service assessment process designed to determine if a new teacher is ready for the job. edTPA is part of a national movement towards the use of performance assessments in teacher education. As of 2014, 41 states (a) require a state-approved performance assessment like edTPA for program completion or for state licensure and/or state…

  19. ED crowding and the use of nontraditional beds.

    PubMed

    McNaughton, Candace; Self, Wesley H; Jones, Ian D; Arbogast, Patrick G; Chen, Ning; Dittus, Robert S; Russ, Stephan

    2012-10-01

    In an effort to compensate for crowding, many emergency departments (EDs) evaluate and treat patients in nontraditional settings such as gurneys in hallways and conference rooms. The impact of this practice on ED evaluation time is unknown. A historical cohort of adult ED visits to an academic hospital between August 1, 2009 and August 1, 2010, was used to evaluate the relationship between ED bed assignment (traditional, hallway, or conference room bed) and mean ED evaluation time, defined as the time spent in an ED bed before admission or discharge. Chief complaints were categorized into the 5 most frequent categories: abdominal/genitourinary, joint/muscle, general (fever, malaise), head/neck, and other. Multiple linear regression and marginal prediction were used to calculate the mean ED evaluation times for each bed type, overall, and by chief complaint category. During the study period, 15 073 patient visits met the inclusion criteria. After adjustment for patient and ED factors, assignments to hallway and conference room beds were associated with increases in a mean ED evaluation time of 13.3 minutes (95% confidence interval, 13.2-13.3) and 10.9 minutes (95% confidence interval, 10.8-10.9), respectively, compared with the traditional bed ED evaluation time. This varied by chief complaint category. Use of nontraditional beds is associated with increases in mean ED evaluation time; however, these increases are small and may be further minimized by restricting the use of nontraditional beds to patients with specific chief complaints. Nontraditional beds may have a role in improving ED throughput during times of crowding. Published by Elsevier Inc.

  20. EDs trying not to let the bed bugs bite.

    PubMed

    2010-09-01

    As bed bugs have emerged as a growing problem for EDs, managers have developed strategies for prevention and decontamination. Here are some of the approaches they have shared with ED Management: Educate your staff on what they should look for on patients and in rooms that would indicate the presence of bed bugs. Be proactive. Have an exterminator examine your ED on a regular basis. A decontamination room on the outside of the building will prevent the spread of these bugs in your ED.

  1. Mobile unit helps ED cut LWBS in half.

    PubMed

    2008-03-01

    One viable option for reducing the stress on an overburdened ED is the leasing of a mobile unit. For a relatively modest cost, it can be used as a fast-track department, as the ED at Jefferson Memorial Hospital in Ranson, WV, is doing. The unit at Jefferson is staffed by a registered nurse, a nurse practitioner, and a technician who floats between the mobile unit and the main ED. The mobile care unit has four beds and also is equipped with computers, a medication dispensing system, and monitors to view digital X-rays. The triage nurse determines whether a patient goes to the mobile unit or the main ED.

  2. The ACVRL1 c.314-35A>G polymorphism is associated with organ vascular malformations in hereditary hemorrhagic telangiectasia patients with ENG mutations, but not in patients with ACVRL1 mutations.

    PubMed

    Pawlikowska, Ludmila; Nelson, Jeffrey; Guo, Diana E; McCulloch, Charles E; Lawton, Michael T; Young, William L; Kim, Helen; Faughnan, Marie E

    2015-06-01

    Hereditary hemorrhagic telangiectasia (HHT) is characterized by vascular malformations (VMs) and caused by mutations in TGFβ/BMP9 pathway genes, most commonly ENG or ACVRL1. Patients with HHT have diverse manifestations related to skin and mucosal telangiectases and organ VMs, including arteriovenous malformations (AVM). The clinical heterogeneity of HHT suggests a role for genetic modifiers. We hypothesized that the ACVRL1 c.314-35A>G and ENG c.207G>A polymorphisms, previously associated with sporadic brain AVM, are associated with organ VM in HHT. We genotyped these variants in 716 patients with HHT and evaluated association of genotype with presence of any organ VM, and specifically with brain VM, liver VM and pulmonary AVM, by multivariate logistic regression analyses stratified by HHT mutation. Among all patients with HHT, neither polymorphism was significantly associated with presence of any organ VM; ACVRL1 c.314-35A>G showed a trend toward association with pulmonary AVM (OR = 1.48, P = 0.062). ACVRL1 c.314-35A>G was significantly associated with any VM among patients with HHT with ENG (OR = 2.66, P = 0.022), but not ACVRL1 (OR = 0.79, P = 0.52) mutations. ACVRL1 c.314-35A>G was also associated with pulmonary AVM and liver VM among ENG mutation heterozygotes. There were no significant associations between ENG c.207G>A and any VM phenotype. These results suggest that common polymorphisms in HHT genes other than the mutated gene modulate phenotype severity of HHT disease, specifically presence of organ VM. © 2015 Wiley Periodicals, Inc.

  3. Web Formation - Skylab Student Experiment ED-52

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Judith S. Miles of Lexington High School, Lexington, Massachusetts, proposed skylab student experiment ED-52, Web Formation. This experiment was a study of a spider's behavior in a weightless environment. The geometrical structure of the web of the orb-weaving spider provides a good measure of the condition of its central nervous system. Since the spider senses its own weight to determine the required thickness of web material and uses both the wind and gravity to initiate construction of its web, the lack of gravitational force in Skylab provided a new and different stimulus to the spider's behavioral response. Two common cross spiders, Arabella and Anita, were used for the experiment aboard the Skylab-3 mission. After initial disoriented attempts, both spiders produced almost Earth-like webs once they had adapted to weightlessness. This photograph is of Arabella, a cross spider, in her initial attempt at spirning a web. This picture was taken by the crew of the Skylab 3 mission before Arabella adapted to her new environment.

  4. Web Formation - Skylab Student Experiment ED-52

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Judith S. Miles of Lexington High School, Lexington, Massachusetts, proposed skylab student experiment ED-52, Web Formation. This experiment was a study of a spider's behavior in a weightless environment. The geometrical structure of the web of the orb-weaving spider provides a good measure of the condition of its central nervous system. Since the spider senses its own weight to determine the required thickness of web material and uses both the wind and gravity to initiate construction of its web, the lack of gravitational force in Skylab provided a new and different stimulus to the spider's behavioral response. Two common cross spiders, Arabella and Anita, were used for the experiment aboard the Skylab-3 mission. After initial disoriented attempts, both spiders produced almost Earth-like webs once they had adapted to weightlessness. This photograph is of Arabella, a cross spider, in her initial attempt at spirning a web. This picture was taken by the crew of the Skylab 3 mission before Arabella adapted to her new environment.

  5. Neutron Analysis - Skylab Student Experiment ED-76

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The rate of neutron flow is commonly referred to as a flux. The measurement of neutron fluxes in Skylab was the subject of a proposal by Terry Quist of San Antonio, Texas. This chart describes Quist's experiment, Neutron Analysis, Skylab student experiment ED-76. These measurements were considered important not only by NASA but also by the scientific community for four reasons. High energy neutrons can be harmful to human tissue if they are present in significant quantities. Fluxes of neutrons can damage film and other sensitive experimental equipment in a marner similar to those produced by x-rays or other radiation. Furthermore, neutron fluxes can be used as a calibration source for other space-oriented particle physics experiments. Finally, neutron fluxes can affect sensitive x-ray and gamma-ray astronomy observations. Quist's objectives were to measure the neutron fluxes present in Skylab and, with the assistance of NASA and other physicists, to attempt determination of their origin as well as their energy range or spectrum. This experiment had stimulated interest in further studies of neutron phenomena in space. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  6. On E.D. Jones' MICROCOSMOLOGY

    SciTech Connect

    Noyes, H. Pierre

    2003-01-08

    By taking seriously the limits on observability which come from combining relativistic quantum mechanics with general relativity, Ed Jones has shown that the current measurements of the cosmological constant density {Omega}{sub {Lambda}} {approx} 0.7 imply that the temperature scale at which it becomes possible to discuss cosmological models is {approx} 5 Tev (5.8 x 10{sup 16} K). This is self-consistent with the assumption that the number of Planck masses which make some sort of ''phase transition'' to this state is N{sub Pk} {approx} 4 x 10{sup 61}. We review Jones' argument and the bit-string physics calculation which gives the baryon-photon ratio at nucleosynthesis as {approx} 2/256{sup 4}, the dark matter-baryon ratio as {approx} 12.7, and hence {Omega}{sub m} {approx} 0.3, in agreement with current observations. Accepting these values for the two energy densities {Omega}{sub {Lambda}} + {Omega}{sub m} {approx} 1 in accord with recent analyses of fluctuations in the CMB showing that space is flat to about 6%. We conclude that experiments with particle accelerators in the 5-10 Tev range must either show that current theory can adequately describe the currently observed structure of our universe or force us to revise our ideas about physics at a very fundamental level.

  7. The relationship between the thermoelectric generator efficiency and the device engineering figure of merit Zd,eng. The maximum efficiency 𝜼max

    NASA Astrophysics Data System (ADS)

    Hapenciuc, C. L.; Borca-Tasciuc, T.; Mihailescu, I. N.

    2017-04-01

    Thermoelectric materials are used today in thermoelectric devices for heat to electricity(thermoelectric generators-TEG) or electricity to heat(heat pumps) conversion in a large range of applications. In the case of TEGs the final measure of their performance is given by a quantity named the maximum efficiency which shows how much from the heat input is converted into electrical power. Therefore it is of great interest to know correctly how much is the efficiency of a device to can make commercial assessments. The concept of engineering figure of merit, Zeng, and engineering power factor, Peng, were already introduced in the field to quantify the efficiency of a single material under temperature dependent thermoelectric properties, with the mention that the formulas derivation was limited to one leg of the thermoelectric generator. In this paper we propose to extend the concept of engineering figure of merit to a thermoelectric generator by introducing a more general concept of device engineering thermoelectric figure of merit, Zd,eng, which depends on the both TEG materials properties and which shall be the right quantity to be used when we are interested in the evaluation of the efficiency. Also, this work takes into account the electrical contact resistance between the electrodes and thermoelement legs in an attempt to quantify its influence upon the performance of a TEG. Finally, a new formula is proposed for the maximum efficiency of a TEG.

  8. MedEdPORTAL: Educational Scholarship for Teaching

    ERIC Educational Resources Information Center

    Reynolds, Robby J.; Candler, Christopher S.

    2008-01-01

    MedEdPORTAL is an online publication service provided at no charge by the Association of American Medical Colleges (AAMC). The intent is to promote collaboration and educational scholarship by helping educators publish and share educational resources. With MedEdPORTAL, users can quickly locate high-quality, peer-reviewed teaching materials in both…

  9. ExpandED Options: Learning beyond High School Walls

    ERIC Educational Resources Information Center

    ExpandED Schools, 2014

    2014-01-01

    Through ExpandED Options by TASC, New York City high school students get academic credit for learning career-related skills that lead to paid summer jobs. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. ExpandED Options students live the connection between mastering new…

  10. Teaching Elementary School Social Studies Methods under edTPA

    ERIC Educational Resources Information Center

    An, Sohyun

    2016-01-01

    This article reports a self-study that analyzes my experience as a teacher educator navigating a turbulent educational landscape with the advent of edTPA. The data consist of my journal entries, the syllabi, handouts, work submitted by my students, and course evaluations. Data were analyzed by using an inductive process to describe how the edTPA…

  11. Threats to Validity in the edTPA Video Component

    ERIC Educational Resources Information Center

    Choppin, Jeffrey; Meuwissen, Kevin

    2017-01-01

    The edTPA, a performance assessment designed to generate reliable and valid measures of teaching practice, increasingly is used as a gatekeeping mechanism for beginning teacher licensure in various states, including New York, Washington State, Wisconsin, and Georgia. One of the edTPA's key components is the demonstration of instructional practice…

  12. Measuring the Fidelity of Re-ED Programs.

    ERIC Educational Resources Information Center

    Meadowcroft, Pamela; Cantrell, Mary Lynn; Cantrell, Robert P.

    2002-01-01

    The effectiveness of a comprehensive intervention like Re-ED (Reeducation of Emotional Disturbed Children) requires a clear definition of the essential components of the model. This article describes an ongoing process to create a program assessment tool for Re-ED. Program fidelity requires being able to specify precisely what is meant by certain…

  13. Teaching Elementary School Social Studies Methods under edTPA

    ERIC Educational Resources Information Center

    An, Sohyun

    2016-01-01

    This article reports a self-study that analyzes my experience as a teacher educator navigating a turbulent educational landscape with the advent of edTPA. The data consist of my journal entries, the syllabi, handouts, work submitted by my students, and course evaluations. Data were analyzed by using an inductive process to describe how the edTPA…

  14. MedEdPORTAL: Educational Scholarship for Teaching

    ERIC Educational Resources Information Center

    Reynolds, Robby J.; Candler, Christopher S.

    2008-01-01

    MedEdPORTAL is an online publication service provided at no charge by the Association of American Medical Colleges (AAMC). The intent is to promote collaboration and educational scholarship by helping educators publish and share educational resources. With MedEdPORTAL, users can quickly locate high-quality, peer-reviewed teaching materials in both…

  15. Measuring the Fidelity of Re-ED Programs.

    ERIC Educational Resources Information Center

    Meadowcroft, Pamela; Cantrell, Mary Lynn; Cantrell, Robert P.

    2002-01-01

    The effectiveness of a comprehensive intervention like Re-ED (Reeducation of Emotional Disturbed Children) requires a clear definition of the essential components of the model. This article describes an ongoing process to create a program assessment tool for Re-ED. Program fidelity requires being able to specify precisely what is meant by certain…

  16. TechEdSat Nano-Satellite Series Fact Sheet

    NASA Technical Reports Server (NTRS)

    Murbach, Marcus; Martinez, Andres; Guarneros Luna, Ali

    2014-01-01

    TechEdSat-3p is the second generation in the TechEdSat-X series. The TechEdSat Series uses the CubeSat standards established by the California Polytechnic State University Cal Poly), San Luis Obispo. With typical blocks being constructed from 1-unit (1U 10x10x10 cm) increments, the TechEdSat-3p has a 3U volume with a 30 cm length. The project uniquely pairs advanced university students with NASA researchers in a rapid design-to-flight experience lasting 1-2 semesters.The TechEdSat Nano-Satellite Series provides a rapid platform for testing technologies for future NASA Earth and planetary missions, as well as providing students with an early exposure to flight hardware development and management.

  17. The full moon and ED patient volumes: unearthing a myth.

    PubMed

    Thompson, D A; Adams, S L

    1996-03-01

    To determine if there is any effect of the full moon on emergency department (ED) patient volume, ambulance runs, admissions, or admissions to a monitored unit, a retrospective analysis of the hospital electronic records of all patients seen in an ED during a 4-year period was conducted in an ED of a suburban community hospital. A full moon occurred 49 times during the study period. There were 150,999 patient visits to the ED during the study period, of which 34,649 patients arrived by ambulance. A total of 35,087 patients was admitted to the hospital and 11,278 patients were admitted to a monitored unit. No significant differences were found in total patient visits, ambulance runs, admissions to the hospital, or admissions to a monitored unit on days of the full moon. The occurrence of a full moon has no effect on ED patient volume, ambulance runs, admissions, or admissions to a monitored unit.

  18. ED leadership competency matrix: an administrative management tool.

    PubMed

    Propp, Douglas A; Glickman, Seth; Uehara, Dennis T

    2003-10-01

    A successful ED relies on its leaders to master and demonstrate core competencies to be effective in the many arenas in which they interact and are responsible. A unique matrix model for the assessment of an ED leadership's key administrative skill sets is presented. The model incorporates capabilities related to the individual's cognitive aptitude, experience, acquired technical skills, behavioral characteristics, as well as the ability to manage relationships effectively. Based on the personnel inventory using the matrix, focused evaluation, development, and recruitment of ED key leaders occurs. This dynamic tool has provided a unique perspective for the evaluation and enhancement of overall ED leadership performance. It is hoped that incorporation of such a model will similarly improve the accomplishments of EDs at other institutions.

  19. [Correlation between E.N.G. changes and the evolution of the hematic constants in patients under prolonged hemodialysis and renal transplantation].

    PubMed

    Teijeira Alvarez, J M

    1974-01-01

    An evolutive study of the E.N.G. on 25 patients affected of chronic renal failure (c.r.f.) in their previous periods and during the dialysis programme was developed. At the same time a large study on various serum changes was carried on. It is observed that the motor conduction velocity (M.C.V.) shows a decreasing evolution during dialysis, which mathematical patters is a branch of an equilateral hyperbola, of equation: (see article) The Na and K evolutive curves are also significatively fitted to the same mathematical pattern. It is observed a direct and inverse lineal correlation between M.C.V. values and those ones of the Na and K respectively, with p less than 0,05 and p less than 0,01. It is not observed any correlation of significatively value with the other serum parameters studied (R.A., Cl, Urea, Total proteins, Hematocrit, Ca, P, Creatinine, fluids and acid-base equilibrium). After a renal transplantation the M.C.V. presents a growing trayectory of the same mathematical pattern described before, reaching normal values about a year post-transplantion. The levels of Sodium serum follow a parallel trayectory than that one of the M.C.V. The recovery of the remainders serum parameters after renal transplantion occour during the first week, except for the hematocrit. It only remains a parallelism between the evolutive changes of M.C.V./Natremia during dialysis stage and after renal transplantion. These results seem to show a close dependence between variation of M.C.V. and Natremia. The hipoxia role over the sodium pump and the consequent variations of Natremia are discussed.

  20. ED cuts LWBS from 5% to 0.5%.

    PubMed

    2010-04-01

    The leaders at King's Daughters Medical Center in Ashland, KY, firmly believe that solving ED throughput problems must be the responsibility of the entire hospital. They must be on the right track. A recent initiative has slashed the rate of patients who left without being seen from 5% to 0.5%. When beds are available in the ED, presenting patients are moved there immediately and then triaged by the bed nurse. Throughput assessments are conducted hourly so that problems can be addressed immediately. When the ED is in danger of becoming overwhelmed, all department leaders are paged and direct their units to take appropriate action.

  1. Population-based burden of COPD-related visits in the ED: return ED visits, hospital admissions, and comorbidity risks.

    PubMed

    Yeatts, Karin B; Lippmann, Steven J; Waller, Anna E; Hassmiller Lich, Kristen; Travers, Debbie; Weinberger, Morris; Donohue, James F

    2013-09-01

    Little is known about the population-based burden of ED care for COPD. We analyzed statewide ED surveillance system data to quantify the frequency of COPD-related ED visits, hospital admissions, and comorbidities. In 2008 to 2009 in North Carolina, 97,511 COPD-related ED visits were made by adults ≥ 45 years of age, at an annual rate of 13.8 ED visits/1,000 person-years. Among patients with COPD (n = 33,799), 7% and 28% had a COPD-related return ED visit within a 30- and 365-day period of their index visit, respectively. Compared with patients on private insurance, Medicare, Medicaid, and noninsured patients were more likely to have a COPD-related return visit within 30 and 365 days and have three or more COPD-related visits within 365 days. There were no differences in return visits by sex. Fifty-one percent of patients with COPD were admitted to the hospital from the index ED visit. Subsequent hospital admission risk in the cohort increased with age, peaking at 65 to 69 years (risk ratio [RR], 1.41; 95% CI, 1.26-1.57); there was no difference by sex. Patients with congestive heart failure (RR, 1.29; 95% CI, 1.22-1.37), substance-related disorders (RR, 1.35; 95% CI, 1.13-1.60), or respiratory failure/supplemental oxygen (RR, 1.25; 95% CI, 1.19-1.31) were more likely to have a subsequent hospital admission compared with patients without these comorbidities. The population-based burden of COPD-related care in the ED is significant. Further research is needed to understand variations in COPD-related ED visits and hospital admissions.

  2. Structure of catalase determined by MicroED.

    PubMed

    Nannenga, Brent L; Shi, Dan; Hattne, Johan; Reyes, Francis E; Gonen, Tamir

    2014-10-10

    MicroED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2.9 Å resolution with MicroED (Shi et al., 2013). Here we present the structure of bovine liver catalase determined from a single crystal at 3.2 Å resolution by MicroED. The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of MicroED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination.

  3. 1. Photocopy of photograph (from Stuart, I. L., ed. History ...

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

    1. Photocopy of photograph (from Stuart, I. L., ed. History of Franklin County, Iowa. Chicago: S. J. Clarke, 1914. Date unknown, sometime in period 1866-1890 GENERAL VIEW - Franklin County Courthouse II, Courthouse Square, Hampton, Franklin County, IA

  4. Structure of catalase determined by MicroED

    PubMed Central

    Nannenga, Brent L; Shi, Dan; Hattne, Johan; Reyes, Francis E; Gonen, Tamir

    2014-01-01

    MicroED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2.9 Å resolution with MicroED (Shi et al., 2013). Here we present the structure of bovine liver catalase determined from a single crystal at 3.2 Å resolution by MicroED. The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of MicroED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination. DOI: http://dx.doi.org/10.7554/eLife.03600.001 PMID:25303172

  5. Nuclear Medicine Physics: The Basics. 7th ed.

    PubMed

    Mihailidis, Dimitris

    2012-10-01

    Nuclear Medicine Physics: The Basics. 7th ed. Ramesh Chandra, Lippincott Williams and Wilkins, a Wolters Kluwer Business. Philadelphia, 2012. Softbound, 224 pp. Price: $69.99. ISBN: 9781451109412. © 2012 American Association of Physicists in Medicine.

  6. Re-ED: Forty Years Young, Alive and Lively!

    ERIC Educational Resources Information Center

    Cantrell, Mary Lynn; Cantrell Robert P.

    2002-01-01

    Introduces this special journal issue that addresses Re-Education with troubling youth. Highlights the Re-ED (Reeducation of Emotional Disturbed Children) model and its use over the past 40 years. (GCP)

  7. What Men Need to Know about ED Drugs and Anesthesia

    MedlinePlus

    ... medlineplus.gov/news/fullstory_166880.html What Men Need to Know About ED Drugs and Anesthesia Having ... HealthDay News) -- Men who take erectile dysfunction drugs need to alert the anesthetist before having surgery or ...

  8. Elephants or Dinosaurs? A Call to Action for Ed Schools

    ERIC Educational Resources Information Center

    Murphy, Jerome T.

    2006-01-01

    To conclude this special section, guest editor Murphy examines why Ed Schools should redesign their leadership education programs, explores what it will take to foster change, and presents a model program to stimulate debate and action. (Contains 21 endnotes.)

  9. Redefining the EdD: Seeking a Separate Identity

    ERIC Educational Resources Information Center

    Boyce, Barbara Ann

    2012-01-01

    The purpose of this manuscript was to discuss the recommendations and guidelines of the Carnegie Group's 2007 effort to "Reclaim the EdD" as well as to outline the work completed at the University of Virginia related to their re-design of the Doctor of Education (EdD) degree. In order to address the re-envision and re-formulation of the…

  10. Redefining the EdD: Seeking a Separate Identity

    ERIC Educational Resources Information Center

    Boyce, Barbara Ann

    2012-01-01

    The purpose of this manuscript was to discuss the recommendations and guidelines of the Carnegie Group's 2007 effort to "Reclaim the EdD" as well as to outline the work completed at the University of Virginia related to their re-design of the Doctor of Education (EdD) degree. In order to address the re-envision and re-formulation of the…

  11. Ambienti Circumstellari ed Interstellari di Supernovae di vario Tipo ed Applicazioni Astrofisiche

    NASA Astrophysics Data System (ADS)

    Boffi, Francesca R.

    Nella presente tesi vengono studiati gli ambienti circumstellari ed interstellari di supernovae (anche SNe; singolare SN) di vario tipo. In particolare si descrivono alcune applicazioni astrofisiche, relative a questi ambienti, che permettono di desumere informazioni sui sistemi stellari progenitori delle supernovae o di determinare le distanze a tali oggetti. L' emissione radio da supernovae, prodotta nell' ambiente circumstellare ad opera dell'interazione idrodinamica del gas di SN con l' ambiente circostante, puo' essere impiegata come mezzo di indagine del sistema di pre-supernova. In particolare si e' introdotta l'idea che tale emissione possa essere impiegata nel caso delle SNe di tipo Ia come test dei sistemi progenitori di tipo simbiotico. Il test e' stato effettuato sulla SN 1986G, per la quale avevamo ottenuto limiti superiori a lunghezze d'onda radio. Nel caso che un sistema simbiotico sia responsabile di una SN Ia, l'interazione tra l' ejecta e una shell circumstellare origina, in un'epoca molto prossima al massimo di luce, un'emissione radio rivelabile con strumenti tipo Very Large Array. Inoltre l'emissione radio fornisce informazioni circa gli stadi di pre-supernova nel caso di altri tipi di supernova. In questo lavoro di tesi vengono presentati i risultati ottenuti nel caso delle SNe di tipo II 1984E e 1986E. Queste due SNe non mostrano emissione radio: la prima, in prossimita del massimo ottico, stava interagendo con una shell circumstellare prodotta da un episodio di perdita di massa di breve durata in fase di pre-supernova; la seconda, invece e' la prima SN ``vecchia'' ad essere rivelata nell' ottico ma non nel radio (l' oggetto non ha ancora iniziato la fase di supernova remnant ed emette radiazione ottica prodotta ancora per interazione circumstellare). In ambiente circum-interstellare, gli echi di luce, prodotti dallo scattering della luce della supernova ad opera della polvere presente, possono essere utilizzati per determinare le distanze

  12. Epidemiology of elevated blood pressure in the ED.

    PubMed

    Adhikari, Srikar; Mathiasen, Ross

    2014-11-01

    To determine the prevalence and demographics of elevated blood pressure (BP) in emergency department (ED) patients. Retrospective study at an academic ED. ED patients with any systolic blood pressure (SBP) ≥140mm Hg or diastolic blood pressure (DBP) ≥90mm Hg over a 1-year period were included. Data pertaining to frequency of elevated BP across different ethnic categories, age groups, days of the week, shifts, and gender were collected. A total of 44435 patient records were accessed. Overall 47.6% (95% CI, 47.2%-48.1%) of patients had elevated BP (SBP ≥140mm Hg or DBP ≥90mm Hg). Fifty three percent (95% CI, 52%-54%) were women. Among patients with elevated BP, 18% (95% CI, 17.8%-18.9%) had severe BP elevation (SBP ≥180 or DBP ≥110). Overall, patients >45years old were more likely to have elevated BP in ED. Across all ethnic groups, BP increased with age. Significant differences were noted in the prevalence of elevated BP between whites (52%), and other ethnic groups (African Americans [45%] and Hispanics [31%]) (P < .01). Overall, 64% (95% CI, 63.3%-64.6%) of patients with elevated BP were discharged from the ED. Forty four percent (95% CI, 42.4%-45.5%) of patients with severe BP elevation were also discharged from the ED. This study provides knowledge of distribution of elevated BP among different age, gender and ethnic groups in the ED which can be used to develop specific interventions to improve recognition, prevention, detection, and treatment of hypertension. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. HIV postexposure prophylaxis practices by US ED practitioners.

    PubMed

    Merchant, Roland C; Keshavarz, Reza

    2003-07-01

    To determine how often US ED practitioners have prescribed HIV post-exposure prophylaxis (HIV PEP) and to discern how willing they are to offer it to patients, the authors surveyed 600 ED practitioners attending a national conference. According to their self-report, 11% had taken HIV PEP themselves. Sixty-eight percent had prescribed HIV PEP at some time. Of these, 92% had treated needlestick-injured health care workers, 48% sexual assault survivors, and 49% nonhealth care needlestick-injured persons. ED practitioners were more willing to offer HIV PEP after exposures to HIV-infected or high-risk sources than unknown or low- risk sources, as well as after sexual assault than consensual sex. Female practitioners, those who had themselves taken HIV PEP, resident physicians, and ED practitioners with fewer than 6 years of clinical practice were generally more apt to offer HIV PEP. Educational campaigns appear to be necessary to help ED practitioners determine when HIV PEP is appropriate.

  14. Chick embryo proliferation studies using EdU labeling.

    PubMed

    Warren, Michelle; Puskarczyk, Karolina; Chapman, Susan C

    2009-04-01

    Cell proliferation studies are an important experimental tool. The most commonly used thymidine analogues, tritiated thymidine and bromodeoxyuridine (BrdU) label cells during S-phase. Both methods have significant drawbacks: low sensitivity in the case of tritiated thymidine and a denaturation step during BrdU detection that destroys most cellular epitopes, requiring careful optimization. The antibody against BrdU is also large and tissue penetration can be difficult. EdU (5'-ethynyl-2'-deoxyuridine) is closely chemically related to BrdU, with detection achieved by a copper catalyzed reaction requiring a small fluorescently conjugated azide. Cell cultures, flow cytometry and high throughput studies using EdU-labeled cells is exceptionally fast and does not require denaturation or antibodies. We have developed a tissue-labeling technique in chick embryos using EdU. Following EdU chemistry to detect proliferating cells, the tissue can undergo immunolabeling. We demonstrate fluorescent EdU chemistry followed by Tuj1 antibody staining resulting in multiplex fluorescent tissues.

  15. Reduction of electron channeling in EDS using precession.

    PubMed

    Liao, Yifeng; Marks, Laurence D

    2013-03-01

    We demonstrated that EDS measurement can be significantly improved by precessing the electron beam, thereby reducing electron channeling effects. For a SrTiO3 specimen orientated along the [001] zone axis, the measured strontium to titanium atomic ratio was 0.74-0.80 using conventional EDS methods, and the ratio was improved to ~0.99 by precessing the electron beam for angles greater than 22.54 mRad. In ALCHEMI-like experiments in which the specimen was tilted to near two-beam condition, the strontium to titanium ratio was insensitive to the deviation from the Bragg condition using a precessed electron beam. Similar reduction of electron channeling effects was also observed in precession-assisted EDS measurements for an L21-ordered Fe2MnAl intermetallic alloy tilted to the [011] zone axis as well as near two-beam conditions.

  16. Motivations for seeking treatment for ED: the woman's perspective.

    PubMed

    McCabe, M P; Conaglen, H; Conaglen, J; O'Connor, E

    2010-01-01

    There is increasing evidence that partners have a major role in treatment-seeking behavior for men with ED. This study investigated the motivations of 100 females for seeking medical treatment for their partner's ED. Semi-structured interviews focused on reasons for seeking treatment from the female's perspective. The themes that emerged from the data centered on the importance of sex in the relationship, with closeness and intimacy frequently being seen as more important than sex. The second major theme related to hopes that females had in relation to the medication, particularly in relation to increasing their partner's confidence and reducing his sexual frustration. Enhancement of the relationship as well as improving the female's own feelings of self-doubt and sexual frustration were also mentioned. The results of this study show the multi-faceted nature of the motivations that females express in terms of seeking help for their partner's ED.

  17. Automated SEM-EDS GSR Analysis for Turkish Ammunitions

    NASA Astrophysics Data System (ADS)

    Cakir, Ismail; Uner, H. Bulent

    2007-04-01

    In this work, Automated Scanning Electron Microscopy with Energy Dispersive X-ray Spectrometry (SEM-EDS) was used to characterize 7.65 and 9mm cartridges Turkish ammunition. All samples were analyzed in a SEM Jeol JSM-5600LV equipped BSE detector and a Link ISIS 300 (EDS). A working distance of 20mm, an accelerating voltage of 20 keV and gunshot residue software was used in all analysis. Automated search resulted in a high number of particles analyzed containing gunshot residues (GSR) unique elements (PbBaSb). The obtained data about the definition of characteristic GSR particles was concordant with other studies on this topic.

  18. Automated SEM-EDS GSR Analysis for Turkish Ammunitions

    SciTech Connect

    Cakir, Ismail; Uner, H. Bulent

    2007-04-23

    In this work, Automated Scanning Electron Microscopy with Energy Dispersive X-ray Spectrometry (SEM-EDS) was used to characterize 7.65 and 9mm cartridges Turkish ammunition. All samples were analyzed in a SEM Jeol JSM-5600LV equipped BSE detector and a Link ISIS 300 (EDS). A working distance of 20mm, an accelerating voltage of 20 keV and gunshot residue software was used in all analysis. Automated search resulted in a high number of particles analyzed containing gunshot residues (GSR) unique elements (PbBaSb). The obtained data about the definition of characteristic GSR particles was concordant with other studies on this topic.

  19. Microbiologic Methods Utilized in the MAL-ED Cohort Study

    PubMed Central

    Houpt, Eric; Gratz, Jean; Kosek, Margaret; Zaidi, Anita K. M.; Qureshi, Shahida; Kang, Gagandeep; Babji, Sudhir; Mason, Carl; Bodhidatta, Ladaporn; Samie, Amidou; Bessong, Pascal; Barrett, Leah; Lima, Aldo; Havt, Alexandre; Haque, Rashidul; Mondal, Dinesh; Taniuchi, Mami; Stroup, Suzanne; McGrath, Monica; Lang, Dennis

    2014-01-01

    A central hypothesis of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is that enteropathogens contribute to growth faltering. To examine this question, the MAL-ED network of investigators set out to achieve 3 goals: (1) develop harmonized protocols to test for a diverse range of enteropathogens, (2) provide quality-assured and comparable results from 8 global sites, and (3) achieve maximum laboratory throughput and minimum cost. This paper describes the rationale for the microbiologic assays chosen and methodologies used to accomplish the 3 goals. PMID:25305291

  20. Multivariate statistical analysis of low-voltage EDS spectrum images

    SciTech Connect

    Anderson, I.M.

    1998-03-01

    Whereas energy-dispersive X-ray spectrometry (EDS) has been used for compositional analysis in the scanning electron microscope for 30 years, the benefits of using low operating voltages for such analyses have been explored only during the last few years. This paper couples low-voltage EDS with two other emerging areas of characterization: spectrum imaging and multivariate statistical analysis. The specimen analyzed for this study was a finished Intel Pentium processor, with the polyimide protective coating stripped off to expose the final active layers.

  1. New psych unit eases patient burden in ED.

    PubMed

    2008-06-01

    Creating a special unit for psychiatric patients frees up beds in your ED, ensures better care for that patient population, and improves the atmosphere in the main department for the rest of your patients. Consider these suggestions: The creation of a psych unit can be extremely costly. Be prepared to demonstrate projected savings when pitching the idea to administration. Make sure an ED physician has overall responsibility for each patient at all times. Keep a regular group of nurses in rotation. This setup will help ensure smooth handoffs.

  2. ED becomes 'lean' and cuts LBTC, LOS times.

    PubMed

    2008-04-01

    Lean manufacturing techniques, first developed by Toyota, can be successfully adapted to help improve processes in your ED. St. Luke's Episcopal Hospital in Houston, has used Lean to reduce median length of stay, frequency of diversions, and the percentage of patients who left before treatment was complete (LBTC). Here's why "Lean" can help improve the performance of your ED: It enables you and your staff to see things from the patient's point of view. Lean tools enable you to view the status of your department in real-time and to compare that status with your performance goals. Exercises help identify areas where your processes break down and determine the most likely solutions.

  3. Discussion of "The Case for the Median Fragment Size as a Better Fragment Size Descriptor than the Mean" by Finn Ouchterlony, Rock Mech Rock Eng, 2015. doi:10.1007/s00603-015-0722-1

    NASA Astrophysics Data System (ADS)

    Spathis, A. T.

    2016-01-01

    Ouchterlony (The Case for the Median Fragment Size as a Better Fragment Size Descriptor than the Mean, Rock Mech Rock Eng, 2015. doi: 10.1007/s00603-015-0722-1) argues that the median is preferred over the mean as a measure of central tendency of the rock fragmentation size distribution produced by blasting. This discussion suggests that neither is favoured over the other. Indeed, for distributions where both exist, they may be found in terms of each other, either by an analytical expression or by numerical calculation.

  4. Biographical sketch: Charles Hewitt Moore, FRCS (1821-1870).

    PubMed

    Brand, Richard A

    2012-08-01

    This biographical sketch on Charles Moore corresponds to the historic text, The Classic: An account of a Case of Fracture and Distortion of the Pelvis, combined with an unusual form of Dislocation of the Femur (1851), available at DOI 10.1007/s11999-012-2425-1 .

  5. Biographical sketch: Thomas Callaway, FRCS (1822-1869).

    PubMed

    Brand, Richard A

    2011-12-01

    This biographical sketch on Thomas Callaway corresponds to the historic text, The Classic: A Dissertation Upon Dislocations and Fractures of the Clavicle and Shoulder-Joint (1849) available at DOI 10.1007/s11999-011-2098-1 .

  6. Biographical sketch: William John Little, FRCS (1810-1894).

    PubMed

    Brand, Richard A

    2012-05-01

    This biographical sketch on William Little corresponds to the historic text, The Classic: Hospital for the Cure of Deformities: Course of Lectures on the Deformities of the Human Frame (1843), available at DOI 10.1007/s11999-012-2302-y .

  7. 34 CFR 84.400 - What are my responsibilities as a(n) ED awarding official?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false What are my responsibilities as a(n) ED awarding... REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of ED Awarding Officials § 84.400 What are my responsibilities as a(n) ED awarding official? As a(n) ED awarding official, you...

  8. 34 CFR 84.400 - What are my responsibilities as a(n) ED awarding official?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false What are my responsibilities as a(n) ED awarding... REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of ED Awarding Officials § 84.400 What are my responsibilities as a(n) ED awarding official? As a(n) ED awarding official, you...

  9. 34 CFR 84.400 - What are my responsibilities as a(n) ED awarding official?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false What are my responsibilities as a(n) ED awarding... REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of ED Awarding Officials § 84.400 What are my responsibilities as a(n) ED awarding official? As a(n) ED awarding official, you...

  10. 34 CFR 84.400 - What are my responsibilities as a(n) ED awarding official?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false What are my responsibilities as a(n) ED awarding... REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of ED Awarding Officials § 84.400 What are my responsibilities as a(n) ED awarding official? As a(n) ED awarding official, you...

  11. 34 CFR 84.400 - What are my responsibilities as a(n) ED awarding official?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What are my responsibilities as a(n) ED awarding... REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of ED Awarding Officials § 84.400 What are my responsibilities as a(n) ED awarding official? As a(n) ED awarding official, you...

  12. Authentic Field-Based Learning Experiences for EdD Students

    ERIC Educational Resources Information Center

    Hershberger, Jane Boag

    2009-01-01

    This EPP examines the problem of EdD coursework not having sufficient connection to the work that EdD students will eventually assume as leaders of school districts or other educational systems. It reviews literature critical of EdD programs and websites of educational administration professional organizations with recommended curriculum for EdD…

  13. Violence prevention in the ED: linkage of the ED to a social service agency.

    PubMed

    Zun, Leslie S; Downey, La Vonne; Rosen, Jodi

    2003-10-01

    was a strong positive correlation of using services and case management (Pearson coefficient = 0.728, significance =.00). The referral of young victims of violence from the ED to psychosocial services could be successful using a case management model and an alliance between a healthcare system and a social service agency.

  14. Perceived Influence of Cooperating Teachers on edTPA Performance

    ERIC Educational Resources Information Center

    Behney, Jennifer

    2016-01-01

    The Education Teaching Performance Assessment (edTPA) is a performance assessment of teacher effectiveness that is increasingly used to make decisions about licensure for teacher candidates, including candidates seeking certification in world languages. Because of the high-stakes nature of this assessment, it is important to isolate and better…

  15. SSF1deg-Month Terra Ed4

    Atmospheric Science Data Center

    2017-03-08

    ... Search and Order:  ASDC Order Tool Order Data:  Earthdata Search:  Earthdata Search Guide ... Detailed CERES SSF1deg-lite Product Information Data Products Catalog: DPC_SSF1deg-Month_Ed4_R6V1 Readme Files:  ...

  16. SSF1deg-Day Terra Ed4

    Atmospheric Science Data Center

    2017-03-08

    ... Search and Order:  ASDC Order Tool Order Data:  Earthdata Search:  Earthdata Search Guide ... Detailed CERES SSF1deg-lite Product Information Data Products Catalog: DPC_SSF1deg-Day_Ed4_R5V1 Readme Files:  ...

  17. SSF1deg-Day Aqua Ed4

    Atmospheric Science Data Center

    2017-03-08

    ... Search and Order:  ASDC Order Tool Order Data:  Earthdata Search:  Earthdata Search Guide ... Detailed CERES SSF1deg-lite Product Information Data Products Catalog: DPC_SSF1deg-Day_Ed4_R6V1 Readme Files:  ...

  18. Skylab-4 Mission Onboard Photograph - Astronaut Ed Gibson at Work

    NASA Technical Reports Server (NTRS)

    1974-01-01

    This Skylab-4 mission onboard photograph shows Astronaut Ed Gibson at the complex control and display console for the Apollo Telescope Mount solar telescopes located in the Skylab Multiple Docking Adapter. Astronauts watched the Sun, and photographed and recorded the solar activities, such as the birth of a solar flare.

  19. Embracing the Common Cause Advocating for Ed Tech

    ERIC Educational Resources Information Center

    Roland, Jennifer

    2006-01-01

    This is a common response from educators confronted with the notion of advocating for educational technology funding. But, in a time when U.S. funding for Ed Tech is in danger of being cut from the budget, ISTE believes that all of its members, and in fact, all U.S. educators, must become advocates for our common cause. "Effective advocacy from…

  20. 5 Ways That edX Could Change Education

    ERIC Educational Resources Information Center

    Parry, Marc

    2012-01-01

    Since MIT and Harvard started edX, their joint experiment with free online courses, the venture has attracted enormous attention for opening the ivory tower to the world. But in the process, the world will become part of an expensive and ambitious experiment testing some of the most interesting--and difficult--questions in digital education. Can…

  1. Three Ways edTPA Prepared Me for the Classroom

    ERIC Educational Resources Information Center

    Butler, Matthew

    2015-01-01

    edTPA, a capstone assessment designed to assess whether new teachers are ready for the job by evaluating their teaching and their analysis of their teaching, helped prepare the author for the classroom in three ways. First, he became accountable to his students. Second, he learned to analyze his teaching. Third, he discovered how to relate…

  2. Creating a Minnesota Statewide SNAP-Ed Program Evaluation

    ERIC Educational Resources Information Center

    Gold, Abby; Barno, Trina Adler; Sherman, Shelley; Lovett, Kathleen; Hurtado, G. Ali

    2013-01-01

    Systematic evaluation is an essential tool for understanding program effectiveness. This article describes the pilot test of a statewide evaluation tool for the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). A computer algorithm helped Community Nutrition Educators (CNEs) build surveys specific to their varied educational settings…

  3. Creating a Minnesota Statewide SNAP-Ed Program Evaluation

    ERIC Educational Resources Information Center

    Gold, Abby; Barno, Trina Adler; Sherman, Shelley; Lovett, Kathleen; Hurtado, G. Ali

    2013-01-01

    Systematic evaluation is an essential tool for understanding program effectiveness. This article describes the pilot test of a statewide evaluation tool for the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). A computer algorithm helped Community Nutrition Educators (CNEs) build surveys specific to their varied educational settings…

  4. HAZ-ED Classroom Activities for Understanding Hazardous Waste.

    ERIC Educational Resources Information Center

    Environmental Protection Agency, Washington, DC.

    The Federal Superfund Program investigates and cleans up hazardous waste sites throughout the United States. Part of this program is devoted to informing the public and involving people in the process of cleaning up hazardous waste sites from beginning to end. The Haz-Ed program was developed to assist the Environmental Protection Agency's (EPA)…

  5. EdMOO: One Approach to a Multimedia Collaborative Environment.

    ERIC Educational Resources Information Center

    Holkner, Bernard

    The nature of the multiuser object oriented (MOO) environment lends itself to flexible and rich interactive collaboration space providing interactive discussion, mail, mailing list, and news features to its virtual denizens. EdMOO (HREF1) was created in mid-1995 as an environment for teachers to experience the text based virtual reality…

  6. Perceived Influence of Cooperating Teachers on edTPA Performance

    ERIC Educational Resources Information Center

    Behney, Jennifer

    2016-01-01

    The Education Teaching Performance Assessment (edTPA) is a performance assessment of teacher effectiveness that is increasingly used to make decisions about licensure for teacher candidates, including candidates seeking certification in world languages. Because of the high-stakes nature of this assessment, it is important to isolate and better…

  7. Candidate Success and edTPA: Looking at the Data

    ERIC Educational Resources Information Center

    Evans, Lesley A.; Kelly, Mary K.; Baldwin, Joni L.; Arnold, Jackie M.

    2016-01-01

    This descriptive study looks at the correlations between Teacher Performance Assessment (edTPA) data and numerous program data points, including GPA, major GPA, and benchmark assignment scores, gathered in an Early Childhood Education (ECE) program. Previous studies have looked to correlate grade point average (GPA) with pre-service teacher…

  8. The Theater of Confrontation: Ed Bullins, Up Against the Wall

    ERIC Educational Resources Information Center

    Evans, Don

    1974-01-01

    Discusses ed Bullins' role in bringing together in the summer of 1968 a representative collection of works from the Black Arts Movement; the controversy surrounding his 1971 Lincoln Center production of his play, "The Duplex"; and his play, "House Party," a collage of voices and images from Blacktown mounted at The American…

  9. 5 Ways That edX Could Change Education

    ERIC Educational Resources Information Center

    Parry, Marc

    2012-01-01

    Since MIT and Harvard started edX, their joint experiment with free online courses, the venture has attracted enormous attention for opening the ivory tower to the world. But in the process, the world will become part of an expensive and ambitious experiment testing some of the most interesting--and difficult--questions in digital education. Can…

  10. Skylab-4 Mission Onboard Photograph - Astronaut Ed Gibson at Work

    NASA Technical Reports Server (NTRS)

    1974-01-01

    This Skylab-4 mission onboard photograph shows Astronaut Ed Gibson at the complex control and display console for the Apollo Telescope Mount solar telescopes located in the Skylab Multiple Docking Adapter. Astronauts watched the Sun, and photographed and recorded the solar activities, such as the birth of a solar flare.

  11. Inside the Sex Ed Studio: An Interview with Peggy Brick

    ERIC Educational Resources Information Center

    Taverner, William J.

    2008-01-01

    "Inside the Sex Ed Studio" profiles leaders in the field of sexuality education. Peggy Brick, former director of Planned Parenthood of Greater Northern New Jersey's Center for Family Life Education (CFLE) and author of numerous sexuality education resources used worldwide, is the subject of this interview. Ms. Brick was interviewed by…

  12. Three Ways edTPA Prepared Me for the Classroom

    ERIC Educational Resources Information Center

    Butler, Matthew

    2015-01-01

    edTPA, a capstone assessment designed to assess whether new teachers are ready for the job by evaluating their teaching and their analysis of their teaching, helped prepare the author for the classroom in three ways. First, he became accountable to his students. Second, he learned to analyze his teaching. Third, he discovered how to relate…

  13. Candidate Success and edTPA: Looking at the Data

    ERIC Educational Resources Information Center

    Evans, Lesley A.; Kelly, Mary K.; Baldwin, Joni L.; Arnold, Jackie M.

    2016-01-01

    This descriptive study looks at the correlations between Teacher Performance Assessment (edTPA) data and numerous program data points, including GPA, major GPA, and benchmark assignment scores, gathered in an Early Childhood Education (ECE) program. Previous studies have looked to correlate grade point average (GPA) with pre-service teacher…

  14. Weck Ed. Weck Educational Development Program. Final Performance Report.

    ERIC Educational Resources Information Center

    Coplin, Jennifer; And Others

    This document includes a final performance report and evaluation report from the Weck Ed program, through which job-linked adult basic education and General Educational Development (GED) test preparation courses that were jointly developed by the company Pilling Weck and Durham Technical Community College were offered to Pilling Weck employees on…

  15. FETC, TCEA Commemorate 25 Years of Serving Ed Tech Industry

    ERIC Educational Resources Information Center

    T.H.E. Journal, 2005

    2005-01-01

    There's only one way to prepare for all of the exciting things that the ed tech market has in store for 2005-- by attending a conference. That's why T.H.E. Journal hopes readers will join them at this year's FETC (Booth 1505) and TCEA (Booth 1934) conferences to help celebrate their 25th anniversaries. Overviews are provided for both conferences…

  16. Lifeworld and Textualism: Reassembling the Researcher/ed and "Others"

    ERIC Educational Resources Information Center

    Payne, Phillip G.

    2005-01-01

    This response to McKenzie's "post-post" concerns about environmental education research draws upon empirical, conceptual, anecdotal, metaphorical, imaged and poetic means to help the researcher "reassemble" the researcher/ed by attending to her/his relational body and embodiment of various, often hegemonic, socially constructed environmental…

  17. SYN1deg-1Hour Ed1A

    Atmospheric Science Data Center

    2017-10-04

    ... Tool: CERES Order Tool Order Data:  Earthdata Search:  Order Data Guide Documents:  SYN1deg Description/Abstract ... Detailed CERES SYN1deg Product Information Data Products Catalog: DPC_SYN1deg-Hour_Ed4_R6V1 (PDF) Readme ...

  18. SSF1deg-Month Aqua Ed4

    Atmospheric Science Data Center

    2017-08-21

    ... Guide Documents:  Detailed CERES SSF1deg-lite Product Information Data Products Catalog: DPC_SSF1deg-Month_Ed4_R6V1 Readme Files:  Readme ... Spatial Coverage: Relevant to each product Full Product Page ...

  19. Engaging the public through writing an op-ed

    NASA Astrophysics Data System (ADS)

    Labosier, Chris; Zhu, Laiyin; Quiring, Steven

    2012-10-01

    In May, prior to the start of the 2012 hurricane season, AGU asked us to write an op-ed for the Houston Chronicle on the importance of funding hurricane research. We were excited to be asked and pleased that AGU facilitated the process by providing us with some guidance on writing the op-ed. Given the impact that Hurricane Ike had in Texas just a few years ago, we felt it was important to remind the citizens of the greater Houston metropolitan area of the societal benefits of funding hurricane research. Thanks to the assistance of AGU staff, writing the article required only a few hours of time. Our op-ed was published in the print edition of the Houston Chronicle on 1 June 2012, the official start of the hurricane season (http://www.chron.com/default/article/Tight-budgets-posing-threat-to-Texas-hurricane-3600363.php). It was picked up by the media relations office in the College of Geosciences at Texas A&M University and featured on the college's Web site in the dean's biweekly briefing and on its Facebook page. As a result, the op-ed reached a large and diverse audience.

  20. Preparing Ed.D. Students to Conduct Group Dissertations

    ERIC Educational Resources Information Center

    Browne-Ferrigno, Tricia; Jensen, Jane McEldowney

    2012-01-01

    In this article we present an overview of a recently launched cohort-based Ed.D. program that prepares participants to conduct group dissertations. The program, a hybrid model of online learning activities and monthly face-to-face class sessions, is delivered through a partnership between a university's college of education and the administrative…

  1. Something Happened on the Way to Completing the edTPA: A Case Study of Teacher Candidates' Perceptions of the edTPA

    ERIC Educational Resources Information Center

    Heil, Leila; Berg, Margaret H.

    2017-01-01

    This case study addresses a need for evidence of teacher candidates' perceptions of the edTPA. Data were collected via a focus group interview, a survey, and miscellaneous documents. Perceptions of the edTPA were informed by external influences including alumni experiences and internet resources. Perceived positive features of the edTPA included…

  2. The arrival of the ED-based POISINDEX: perceived impact on poison control center use.

    PubMed

    Wax, P M; Rodewald, L; Lawrence, R

    1994-09-01

    The purpose of this study was to determine the prevalence of emergency department-based POISINDEX (Micromedex Inc, Denver, CO) and assess its perceived impact on use of poison control centers. Survey methodology was used. A written questionnaire was distributed to all emergency departments (EDs) in the state of New York. ED directors or their designee (n = 239) were surveyed regarding the presence of POISINDEX in their ED and their perceptions of its impact on ED use of poison control centers. Completed questionnaires were returned from 180 of 239 (75%) EDs. Of the returned questionnaires, 42 of 180 (23%) have their own POISINDEX. In 32 of 42 (76%) of these EDs that have their own POISINDEX, it was perceived that ED-based POISINDEX decreased poison control center use. Use of ED-based POISINDEX may decrease ED use of poison control centers.

  3. Patient's jewelry stolen as she rests in the ED.

    PubMed

    2007-12-01

    In a hospital ED in Rhode Island, a 96-year-old patient was robbed of her jewelry while she rested in her room. The thief was dressed in scrubs. Identification badges are only one way of keeping unwanted intruders out and your patients' belongings safe. Other suggestions: Have different groups of staff members, i.e., ED doctors and nurses, wear color-coded scrubs that distinguish them from other hospital personnel. If your staff see a strangely dressed person or someone who looks lost or like they don't fit in, they should question them about their identity. Create protocols for the removal and safekeeping of patients' jewelry that cover several different scenarios.

  4. Fuel management and reloading optimization at EdF

    SciTech Connect

    Rosset, F.D.; Barral, J.C. )

    1993-01-01

    Technical and economical pressurized water reactor (PWR) performances are strongly influenced by fuel management, e.g., fuel utilization and core design. Because of the large number of standardized French PWR units, this question is of considerable importance for Electricite de France (EdF). At present, EdF operates two standardized types of PWR: thirty-four 900-MW and twenty 1300-MW PWRS. Economic optimization will lead to global management of the nuclear power plants in the coming years through three main types of fuel management: four-batch 3.7% UO[sub 2] management and plutonium recycling management for the 900-MW PWRs and extended cycle management for the 1300-MW PWRS. The best optimization is made on each reactor by computing a loading pattern that flattens the power map to ensure a certain flexibility of operation (early shutdown, stretch-out).

  5. Safe Handling of Snakes in an ED Setting.

    PubMed

    Cockrell, Melanie; Swanson, Kristofer; Sanders, April; Prater, Samuel; von Wenckstern, Toni; Mick, JoAnn

    2017-01-01

    Efforts to improve consistency in management of snakes and venomous snake bites in the emergency department (ED) can improve patient and staff safety and outcomes, as well as improve surveillance data accuracy. The emergency department at a large academic medical center identified an opportunity to implement a standardized process for snake disposal and identification to reduce staff risk exposure to snake venom from snakes patients brought with them to the ED. A local snake consultation vendor and zoo Herpetologist assisted with development of a process for snake identification and disposal. All snakes have been identified and securely disposed of using the newly implemented process and no safety incidents have been reported. Other emergency department settings may consider developing a standardized process for snake disposal using listed specialized consultants combined with local resources and suppliers to promote employee and patient safety. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  6. Microbiologic methods utilized in the MAL-ED cohort study.

    PubMed

    Houpt, Eric; Gratz, Jean; Kosek, Margaret; Zaidi, Anita K M; Qureshi, Shahida; Kang, Gagandeep; Babji, Sudhir; Mason, Carl; Bodhidatta, Ladaporn; Samie, Amidou; Bessong, Pascal; Barrett, Leah; Lima, Aldo; Havt, Alexandre; Haque, Rashidul; Mondal, Dinesh; Taniuchi, Mami; Stroup, Suzanne; McGrath, Monica; Lang, Dennis

    2014-11-01

    A central hypothesis of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is that enteropathogens contribute to growth faltering. To examine this question, the MAL-ED network of investigators set out to achieve 3 goals: (1) develop harmonized protocols to test for a diverse range of enteropathogens, (2) provide quality-assured and comparable results from 8 global sites, and (3) achieve maximum laboratory throughput and minimum cost. This paper describes the rationale for the microbiologic assays chosen and methodologies used to accomplish the 3 goals. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. Remotely operated welding systems for EdF plant maintenance

    SciTech Connect

    Thapon, G. ); Blight, J.; Durand, B. )

    1992-01-01

    With the objective of improving weld quality, reducing outage times, and minimizing integrated dose, Electricite de France (EdF) and Comex Nucleaire (CxN) have developed a number of advanced remotely controlled welding systems. Three such developments are described, two having been used operationally and the third being qualified for use in the coming months. The three developments involve replacing pressurizes heaters, replacing fuel charge head sleeves, and real-time interactive welding.

  8. ED Utilization Trends in Sports-Related Traumatic Brain Injury

    PubMed Central

    Pomerantz, Wendy J.; Gittelman, Mike

    2013-01-01

    BACKGROUND: Emergency department (ED) visits for sports-related traumatic brain injuries (TBIs) have risen. This study evaluated how the number and severity of admissions have changed as ED visits for sports-related TBIs have increased. METHODS: A retrospective study of children aged 0 to 19 years at a level 1 trauma center was performed. Patients from 2002 to 2011 with a primary or secondary diagnosis of TBI were identified from the hospital’s inpatient and outpatient trauma registries. Frequencies were used to characterize the population, χ2 analysis was performed to determine differences between groups, and regression analysis looked at relationship between year and injury severity score or length of stay. RESULTS: Sport was responsible for injury in 3878 (15.4%) cases during the study period; 3506 (90.4%) were discharged from the hospital, and 372 (9.6%) were admitted. Seventy-three percent were male patients and 78% Caucasian; mean age was 13 ± 3.5 years. ED visits for sports-related TBIs increased 92% over the study period, yet there was no significant change (χ2 = 9.8, df = 9, P = .37) in the percentage of children admitted. Mean injury severity score for those admitted decreased from 7.8 to 4.8 (β = –0.46; P = .006); length of stay trended downward (β = –0.05; P = .05). CONCLUSIONS: The percentage of children being admitted from the ED with sports-related TBI has not changed over the past 10 years. The severity of admitted sports-related TBI is decreasing. Additional research is needed to correlate these trends with other TBI mechanisms. PMID:24081999

  9. Lean-driven solutions slash ED wait times, LOS.

    PubMed

    2012-12-01

    The ED at The Aroostook Medical Center (TAMC) in Presque Isle, ME, is a level II trauma center. It is the largest in the region, with only 89 beds. It has undergone a transformation in recent months, with average wait times to see a provider going from four to five hours down to less than five minutes, and the left-without-being-seen (LWBS) rate has been slashed from a high of 7% down to less than 1%. The hospital says the improvements are the result of lean-driven, staff-designed solutions, coupled with administrative engagement and oversight. And administrators say more improvements are on the way in 2013 when a hospital-wide workgroup will try to clear away obstacles and inefficiencies from the hospital admissions process. To tackle long wait times among patients with lower triage levels, the ED instituted a fast-track system, manned by mid-level providers and a tech or LPN. Responsibilities for charge nurses have been redesigned so that they have the power to monitor and facilitate patient flow. The ED has initiated more point-of-care testing so that nurses and techs can conduct many routine tests on their own. While the lean model relies on staff-driven solutions, administrators make the difference when it comes to sustaining changes and minimizing employee resistance.

  10. Edward (Ed) T. Schneider preparing for an F-104 flight

    NASA Technical Reports Server (NTRS)

    1989-01-01

    NASA research pilot Edward T. Scheider is shown standing in the cockpit of a two-seat F-104. He is wearing a full pressure suit, which is required on all flights above 50,000 feet. Ed served in the U.S. Navy from 1968 to 1983. He attended the U.S. Naval Test Pilot School and graduated in 1973. He was then assigned as an engineering test pilot, and as an instructor at the Naval Test Pilot School. He first arrived at what was then called the Ames-Dryden Flight Research Facility (now the Dryden Flight Research Center) as a Navy Liaison Officer on July 5, 1982. He joined NASA as a research pilot a year later. Ed was a project pilot on the F-18 High Angle-of-Attack program, the F-15 aeronautical research aircraft, the B-52 launch aircraft, and the NASA-operated SR-71 Blackbirds. Ed retired as a NASA research pilot in September 2000.

  11. States leverage telepsychiatry solutions to ease ED crowding, accelerate care.

    PubMed

    2015-02-01

    Many states are having success turning to telepsychiatry-based solutions to connect mental health patients with needed care while also decompressing crowded EDs. Just one year into a statewide telepsychiatry initiative in North Carolina (NC-STeP), administrators say the approach has saved as much as $7 million, and hospital demand for the service is higher than anticipated. In Texas, mental health emergency centers (MHEC) that use telepsychiatry to connect patients in rural areas with needed psychiatric care are freeing up EDs to focus on medical care. In just 11 months, 91 North Carolina hospitals have at least started the process to engage in NC-STeP. Much of the savings from NC-STeP come from involuntary commitment orders being overturned as a result of the telepsychiatry consults, reducing the need for expensive inpatient care. Implementing NC-STeP has involved multiple hurdles including credentialing difficulties and technical/firewall challenges. The Texas model provides 24/7 availability of psychiatrists via telemedicine through a network of MHECs. In-person staff at the MHECs perform basic screening tests and blood draws so that medical clearance can be achieved without the need for an ED visit in most cases. Funding for the MHECs comes from the state, hospitals in the region, and local governmental authorities that reap savings or benefits from the initiative.

  12. Impact of prospective verification of intravenous antibiotics in an ED.

    PubMed

    Hunt, Allyson; Nakajima, Steven; Hall Zimmerman, Lisa; Patel, Manav

    2016-12-01

    Delay in appropriate antibiotic therapy is associated with an increase in mortality and prolonged length of stay. Automatic dispensing machines decrease the delivery time of intravenous (IV) antibiotics to patients in the emergency department (ED). However, when IV antibiotics are not reviewed by pharmacists before being administered, patients are at risk for receiving inappropriate antibiotic therapy. The objective of this study was to determine if a difference exists in the time to administration of appropriate antibiotic therapy before and after implementation of prospective verification of antibiotics in the ED. This retrospective, institutional review board-approved preimplementation vs postimplementation study evaluated patients 18years or older who were started on IV antibiotics in the ED. Patients were excluded if pregnant, if the patient is a prisoner, if no cultures were drawn, or if the patient was transferred from an outside facility. Appropriate antibiotic therapy was based on empiric source-specific evidence-based guidelines, appropriate pharmacokinetic and pharmacodynamic properties, and microbiologic data. The primary end point was the time from ED arrival to administration of appropriate antibiotic therapy. Of the 1628 evaluated, 128 patients met the inclusion criteria (64 pre vs 64 post). Patients were aged 65.2±17.0years, with most of infections being pneumonia (44%) and urinary tract infections (18%) and most patients being noncritically ill. Time to appropriate antibiotic therapy was reduced in the postgroup vs pregroup (8.1±8.6 vs 15.2±22.8hours, respectively, P=.03). In addition, appropriate empiric antibiotics were initiated more frequently after the implementation (92% post vs 66% pre; P=.0001). There was no difference in mortality or length of stay between the 2 groups. Prompt administration of the appropriate antibiotics is imperative in patients with infections presenting to the ED. The impact of prospective verification of

  13. Health care utilization before and after an outpatient ED visit in older people.

    PubMed

    Horney, Carolyn; Schmader, Kenneth; Sanders, Linda L; Heflin, Mitchell; Ragsdale, Luna; McConnell, Eleanor; Hocker, Michael; Hastings, S Nicole

    2012-01-01

    Older adults in the United States receive a significant amount of care in the emergency department (ED), yet the associations between ED and other types of health care utilization have not been adequately studied in this population. The goals of this study were to examine the relationships between health care use before and after an ED visit among older adults. This retrospective cohort study examined health care use among 308 patients 65 years or older discharged from a university-affiliated ED. Proportional-hazards models were used to assess the relationship between pre-ED health care use (primary care physician [PCP], specialist, ED, and hospital) and risk of return ED visits. Older ED patients in this study had visited other types of providers frequently in the previous year (median number of PCP and specialist visits, 4). Patients who used the ED on 2 or more occasions in the previous year were found to have visited their PCP more often than those without frequent ED use (median number of visits, 7.0 vs 4.0; P < .001). Despite more PCP use in this population, frequent ED use was associated with increased risk of a repeat ED visit (hazard ratio, 2.20; 95% confidence interval, 1.15-4.21), in models adjusted for demographics and health status. Older adults who use the ED are also receiving significant amounts of care from other sources; simply providing additional access to care may not improve outcomes for these vulnerable individuals. Published by Elsevier Inc.

  14. Imaging utilization from the ED: no difference between observation and admitted patients.

    PubMed

    Prabhakar, Anand M; Misono, Alexander S; Harvey, H Benjamin; Yun, Brian J; Saini, Sanjay; Oklu, Rahmi

    2015-08-01

    This study aims to determine the use of diagnostic imaging in emergency department (ED) observation units, particularly relative to inpatients admitted from the ED. Retrospective, descriptive analysis. Our database of ED patients was retrospectively reviewed to identify patients managed in the observation unit or admitted to inpatient services. In February 2014, we randomly selected 105 ED observation patients and 108 patients admitted to inpatient services from the ED. Electronic medical records were reviewed to assess diagnosis as well as type and quantity of imaging tests obtained. Eighty (76%) ED observation patients underwent imaging tests (radiographs, 39%; computed tomography, 25%; magnetic resonance imaging (MRI), 24%; ultrasound, 8%; other, 4%); 85 inpatients (79%) underwent imaging tests while in the ED (radiographs, 52%; computed tomography, 30%; MRI, 8%; ultrasound, 9%; other, 1%). There was no significant difference in overall imaging use between ED observation patients and inpatients, but ED observation patients were more likely to undergo MRI (P=.0243). The most common presenting diagnoses to the ED observation unit were neurologic complaints (25%), abdominal pain (17%), and cardiac symptoms (16%). There is no difference in the overall use of imaging in patients transferred to the ED observation unit vs those directly admitted from the ED. However, because ED observation unit patients tend to be accountable for a higher proportion of their health care bill, the impact of imaging in these patients is likely substantive. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. EDS coal liquefaction process development. Phase V. EDS commercial plant study design update. Illinois coal. Volume 1. Main report

    SciTech Connect

    Epperly, W. R.

    1981-03-01

    The objectives of the Study Design Update (SDU) were to identify the technical issues facing a potential commercial-size EDS plant design; to provide a reliable basis for estimating the cost of EDS products; and to furnish research guidance to the EDS Project. The SDU consists of two distinct studies in which different processing schemes are used to produce the hydrogen and fuel gas required by the plant. These studies are referred to as the Base Case and the Market Flexibility Sensitivity Case. In the Base Case, hydrogen is generated by steam reforming of the light hydrocarbon gases produced in the plant. Fuel gas is generated by feeding the bottoms stream from the liquefaction section vacuum pipestill to a FLEXICOKING unit. In the FLEXICOKING unit reactor, the bottoms stream is converted to coke; additional liquid product is also recovered. The coke is converted to low-Btu fuel gas in the FLEXICOKING unit gasifier. In the Market Flexibility Sensitivity (MFS) Case, the bottoms stream from the vacuum pipestill is split, and about half is sent to the FLEXICOKING unit for recovery of additional liquid product and production of fuel gas. The remainder of the bottoms stream is converted to hydrogen in a Partial Oxidation Unit. Hence the MFS Case does not consume light hydrocarbon gases produced and they are available for sale. The study of these two cases has demonstrated the importance of bottoms process selection to the economics and thermal efficiency of an EDS plant. Volume 1 - Main Report has been developed to be a stand-alone document. Both the Base Case and Market Flexibility Sensitivity (MFS) Case are covered. This volume includes an overview and detailed case summaries. It also covers economics, product recovery factors, material and energy balances, cost estimates and enviromental considerations.

  16. EDS coal liquefaction process development, Phase V. Engineering design study of an EDS Illinois bottoms fired hybrid boiler

    SciTech Connect

    1984-04-01

    This interim report documents work carried out by Combustion Engineering, Inc. under a contract to Exxon Research and Engineering Company and was prepared by Combustion Engineering, Inc. This report is the second of two reports by Combustion Engineering, Inc. on the predevelopment phase of the Hybrid Boiler program and covers the results of an engineering design study of a Hybrid Boiler firing the vacuum distillation residue (vacuum bottoms) derived from processing Illinois No. 6 coal in the EDS Coal Liquefaction Process. The function of the Hybrid Boiler is to heat the coal slurry feed for an EDS coal liquefaction plant by a process coil in the convection section and to generate high pressure steam in the radiant section. The Hybrid Boiler design developed in this phase of the program is based on the results of a laboratory characterization program (reported in EDS Interim Report FE-2893-112), on Combustion Engineering, Inc.'s extensive experience as a designer and supplier of steam generating equipment, and on Exxon Research and Engineering Co.'s experience with the design and operation of process heaters.

  17. A Successful ED Fall Risk Program Using the KINDER 1 Fall RiskAssessment Tool.

    PubMed

    Townsend, Ann B; Valle-Ortiz, Marisol; Sansweet, Tracy

    2016-11-01

    Emergency nurses did not perform falls risk assessments routinely on our ED patients; the instrument used was aimed at inpatients. We identified a need to revise fall assessment practices specific to our emergency department. The purpose of the performance improvement project was to reduce ED falls and evaluate the use of an ED-specific fall risk tool, the KINDER 1 Fall Risk Assessment. The plan was to establish fall risk assessment practices at point of ED entry and to decrease total falls.

  18. Molecular cloning and characterization of enhanced disease susceptibility 1 (EDS1) from Gossypium barbadense.

    PubMed

    Su, Xiaofeng; Qi, Xiliang; Cheng, Hongmei

    2014-06-01

    Arabidopsis enhanced disease susceptibility 1 (EDS1) plays an important role in plant defense against biotrophic and necrotrophic pathogens. The necrotrophic pathogen Verticillium dahliae infection of Gossypium barbadense could lead to Verticillium wilt which seriously reduces the cotton production. Here, we cloned and characterized a G. barbadense homolog of EDS1, designated as GbEDS1. The full-length cDNA of the GbEDS1 gene was obtained by the technique of rapid-amplification of cDNA ends. The open reading frame of the GbEDS1 gene was 1,647 bp long and encoded a protein of 548 amino acids residues. Comparison of the cDNA and genomic DNA sequence of GbEDS1 indicated that this gene contained a single intron and two exons. Like other EDS1s, GbEDS1 contained a conserved N-terminal lipase domain and an EDS1-specific KNEDT motif. Subcellular localization assay revealed that GbEDS1-green fluorescence protein fusion protein was localized in both cytosol and nucleus. Interestingly, the transcript levels of GbEDS1 were dramatically increased in response to pathogen V. dahliae infection. To investigate the role of GbEDS1 in plant resistance against V. dahliae, a conserved fragment derived from GbEDS1 was used to knockdown the endogenous EDS1 in Nicotiana benthamiana by heterologous virus-induced gene silencing. Our data showed that silencing of NbEDS1 resulted in increased susceptibility to V. dahliae infection in N. benthamiana, suggesting a possible involvement of the novelly isolated GbEDS1 in the regulation of plant defense against V. dahliae.

  19. Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

    PubMed Central

    Sharp, Brian R.; Sharp, Kristen M.; Patterson, Brian; Dooley-Hash, Suzanne

    2016-01-01

    Introduction Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06–1.61]), high parity (OR 1.50 95% CI [1.12–2.00]), and early gestational age (OR 0.74 95% CI [0.60–0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59–0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002). Conclusion NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition. PMID:27625723

  20. EDS1 mediates pathogen resistance and virulence function of a bacterial effector in soybean

    USDA-ARS?s Scientific Manuscript database

    Enhanced disease susceptibility 1 (EDS1) and phytoalexin deficient 4 (PAD4) are well known regulators of both basal and resistance (R) protein-mediated plant defense. We identified two EDS1- (GmEDS1a/b) and one PAD4-like (GmPAD4) protein that are required for resistance signaling in soybean. Consist...

  1. Self-Esteem and Emotional Intelligence among B.Ed Trainees of Tsunami Affected Coastal Belt

    ERIC Educational Resources Information Center

    Babu M, Sameer

    2008-01-01

    Through this study the author investigates the relationship between self-esteem and emotional intelligence among B.Ed trainees of Tsunami affected coastal belt of Alappey district of Kerala, India. Stream of study, marital status and age based comparisons were made among the B.Ed trainees. 92 B.Ed trainees were the participants in the study. It…

  2. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Age distinctions contained in ED's regulations. 110.17... FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in ED's regulations. Any age distinction contained in regulations issued by ED is presumed to be...

  3. Uncovering the Identities of Students and Graduates in a CPED-Influenced EdD Program

    ERIC Educational Resources Information Center

    Zambo, Debby; Buss, Ray R.; Zambo, Ron

    2015-01-01

    The educational doctorate (EdD) is being re-envisioned as a distinct professional degree. Today's EdD graduates are envisioned as scholarly practitioners. Given this it may be reasoned these individuals have unique identities comprised of several layers. In this study, we examined how 18 entering students and 17 graduating students from an EdD…

  4. 34 CFR 110.1 - What is the purpose of ED's age discrimination regulations?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false What is the purpose of ED's age discrimination... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General § 110.1 What is the purpose of ED's age discrimination regulations? The purpose of these regulations is to set out ED's rules for implementing the...

  5. 34 CFR 110.1 - What is the purpose of ED's age discrimination regulations?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false What is the purpose of ED's age discrimination... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General § 110.1 What is the purpose of ED's age discrimination regulations? The purpose of these regulations is to set out ED's rules for implementing the...

  6. 34 CFR 110.1 - What is the purpose of ED's age discrimination regulations?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false What is the purpose of ED's age discrimination... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General § 110.1 What is the purpose of ED's age discrimination regulations? The purpose of these regulations is to set out ED's rules for implementing the...

  7. 34 CFR 110.1 - What is the purpose of ED's age discrimination regulations?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false What is the purpose of ED's age discrimination... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General § 110.1 What is the purpose of ED's age discrimination regulations? The purpose of these regulations is to set out ED's rules for implementing the...

  8. 34 CFR 110.1 - What is the purpose of ED's age discrimination regulations?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What is the purpose of ED's age discrimination... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General § 110.1 What is the purpose of ED's age discrimination regulations? The purpose of these regulations is to set out ED's rules for implementing the...

  9. EDS V26 Containment Vessel Explosive Qualification Test Report

    SciTech Connect

    Crocker, Robert W.; Haroldsen, Brent L.; Stofleth, Jerome H.

    2013-11-01

    The objective of the test was to qualify the vessel for its intended use by subjecting it to a 1.25 times overtest. The criteria for success are that the measured strains do not exceed the calculated strains from the vessel analysis, there is no significant additional plastic strain on subsequent tests at the rated design load (shakedown), and there is no significant damage to the vessel and attached hardware that affect form, fit, or function. Testing of the V25 Vessel in 2011 established a precedent for testing V26 [2]. As with V25, two tests were performed to satisfy this objective. The first test used 9 pounds of Composition C-4 (11.25 lbs. TNT-equivalent), which is 125 percent of the design basis load. The second test used 7.2 pounds of Composition C-4 (9 lbs. TNT-equivalent) which is 100 percent of the design basis load. The first test provided the required overtest while the second test served to demonstrate shakedown and the absence of additional plastic deformation. Unlike the V25 vessel, which was mounted in a shipping cradle during testing, the V26 vessel was mounted on the EDS P2U3 trailer prior to testing. Visual inspections of the EDS vessel, surroundings, and diagnostics were completed before and after each test event. This visual inspection included analyzing the seals, fittings, and interior surfaces of the EDS vessel and documenting any abnormalities or damages. Photographs were used to visually document vessel conditions and findings before and after each test event.

  10. ED case managers are crucial to help maximize reimbursement.

    PubMed

    2011-08-01

    As payers tighten their belts and recoup payments for inappropriate care and regulators increase penalties for fraud and abuse, hospitals need to ensure all admissions are appropriate and patient are placed in the right level of care. Hospitals are likely to have to return reimbursement for patients who don't meet inpatient criteria. Improper admissions can exacerbate capacity problems and result in hospital-acquired conditions. Correcting inappropriate admissions retrospectively can be a red flag to auditors. ED case managers can impact length of stay by ensuring that care starts in the emergency department.

  11. Pilot Ed Lewis with T-34C aircraft on ramp

    NASA Image and Video Library

    1998-03-04

    NASA pilot Ed Lewis with the T-34C aircraft on the Dryden Flight Research Center Ramp. The aircraft was previously used at the Lewis Research Center in propulsion experiments involving turboprop engines, and was used as a chase aircraft at Dryden for smaller and slower research projects. Chase aircraft accompany research flights for photography and video purposes, and also as support for safety and research. At Dryden, the T-34 is used mainly for smaller remotely piloted vehicles which fly slower than NASA's F-18's, used for larger scale projects. This aircraft was returned to the U.S. Navy in May of 2002.

  12. SEM/EDS Characterization of Ambient PM during Agricultural Burns

    NASA Astrophysics Data System (ADS)

    Wagner, J.; Wall, S.

    2010-12-01

    Ambient particulate matter (PM) samples were collected with UNC passive samplers during agricultural burns in Imperial Valley, California. Four Bermuda grass field burn events were sampled at 3-8 locations surrounding each burn. Sampling began at the start of each burn (30-60 min) and continued for 24-120 hours. During 3 of the 4 burn events, winds were calm and plumes were observed to travel straight up to the inversion layer. In one event, winds created a ground-level plume that enveloped two UNC samplers mounted on telephone poles very close to the field (0.2-0.3 miles away). Computer-controlled scanning electron microscopy / energy-dispersive x-ray spectroscopy (CCSEM/EDS) was used to measure particle sizes and elemental composition, from which mass concentrations and size distributions were calculated. The median PM2.5 and PM10 levels measured in this study were 3.4 and 20 ug/m3, respectively. To determine quantitative accuracy, UNC sampler PM2.5 results (PM< 2.5 um) were compared to PM2.5 results from four co-located, continuous-reading beta-attenuation monitors (EBAMs). The median agreement (EBAM - UNC) was 3.8 ug/m3. Manual SEM/EDS detected various distinctive species in these samples, including sea salt, spores, plant fragments, and large soot agglomerates. During the ‘plume event’, 24-hour PM2.5 exposures downwind were up to 17 times higher than that measured upwind. Numerous submicron combustion particles with carbon and oxygen only were directly observed by manual SEM/EDS in the two plume-impacted samples, along with larger ash particles enriched in potassium, sulfur, chlorine, calcium, sodium, and phosphorus. CCSEM/EDS data from this event was grouped into 5 particle classes to generate size-fraction-specific pie charts. Burn-related particle types contributed 95% of the PM2.5 in the location directly impacted by the ground-level plume, compared to only 12% in the upwind location. A sample of Imperial County Bermuda grass analyzed in bulk and

  13. Pilot explores organ donation in the ED--challenges raised.

    PubMed

    2010-06-01

    A pilot program for ED organ donation at University of Pittsburgh Medical Center (UPMC)--Presbyterian Hospital is seeking much-needed organs, while maintaining optimal medical care for the living and avoiding potential conflicts of interest. Separate teams are involved with organ donation and with patient care, creating a "firewall" to prevent conflicts of interest. After failed CPR, a minimum of two minutes of no-CPR time is allowed to pass after death is pronounced to be certain there is no occult cardiac activity. Infusions of cold fluids are used to give enough time for the transplant surgeon to arrive and determine if any organs can be procured.

  14. The relative contribution of provider and ED-level factors to variation among the top 15 reasons for ED admission.

    PubMed

    Khojah, Imad; Li, Suhui; Luo, Qian; Davis, Griffin; Galarraga, Jessica E; Granovsky, Michael; Litvak, Ori; Davis, Samuel; Shesser, Robert; Pines, Jesse M

    2017-09-01

    We examine adult emergency department (ED) admission rates for the top 15 most frequently admitted conditions, and assess the relative contribution in admission rate variation attributable to the provider and hospital. This was a retrospective, cross-sectional study of ED encounters (≥18years) from 19 EDs and 603 providers (January 2012-December 2013), linked to the Area Health Resources File for county-level information on healthcare resources. "Hospital admission" was the outcome, a composite of inpatient, observation, or intra-hospital transfer. We studied the 15 most commonly admitted conditions, and calculated condition-specific risk-standardized hospital admission rates (RSARs) using multi-level hierarchical generalized linear models. We then decomposed the relative contribution of provider-level and hospital-level variation for each condition. The top 15 conditions made up 34% of encounters and 49% of admissions. After adjustment, the eight conditions with the highest hospital-level variation were: 1) injuries, 2) extremity fracture (except hip fracture), 3) skin infection, 4) lower respiratory disease, 5) asthma/chronic obstructive pulmonary disease (A&C), 6) abdominal pain, 7) fluid/electrolyte disorders, and 8) chest pain. Hospital-level intra-class correlation coefficients (ICC) ranged from 0.042 for A&C to 0.167 for extremity fractures. Provider-level ICCs ranged from 0.026 for abdominal pain to 0.104 for chest pain. Several patient, hospital, and community factors were associated with admission rates, but these varied across conditions. For different conditions, there were different contributions to variation at the hospital- and provider-level. These findings deserve consideration when designing interventions to optimize admission decisions and in value-based payment programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. The collection of MicroED data for macromolecular crystallography

    PubMed Central

    Shi, Dan; Nannenga, Brent L; de la Cruz, M Jason; Liu, Jinyang; Sawtelle, Steven; Calero, Guillermo; Reyes, Francis E; Hattne, Johan; Gonen, Tamir

    2017-01-01

    The formation of large, well-ordered crystals for crystallographic experiments remains a crucial bottleneck to the structural understanding of many important biological systems. To help alleviate this problem in crystallography, we have developed the MicroED method for the collection of electron diffraction data from 3D microcrystals and nanocrystals of radiation-sensitive biological material. In this approach, liquid solutions containing protein microcrystals are deposited on carbon-coated electron microscopy grids and are vitrified by plunging them into liquid ethane. MicroED data are collected for each selected crystal using cryo-electron microscopy, in which the crystal is diffracted using very few electrons as the stage is continuously rotated. This protocol gives advice on how to identify microcrystals by light microscopy or by negative-stain electron microscopy in samples obtained from standard protein crystallization experiments. The protocol also includes information about custom-designed equipment for controlling crystal rotation and software for recording experimental parameters in diffraction image metadata. Identifying microcrystals, preparing samples and setting up the microscope for diffraction data collection take approximately half an hour for each step. Screening microcrystals for quality diffraction takes roughly an hour, and the collection of a single data set is ~10 min in duration. Complete data sets and resulting high-resolution structures can be obtained from a single crystal or by merging data from multiple crystals. PMID:27077331

  16. Domestic violence in an inner-city ED.

    PubMed

    Ernst, A A; Nick, T G; Weiss, S J; Houry, D; Mills, T

    1997-08-01

    A confidential written survey was conducted at the emergency department (ED) of Charity Hospital in New Orleans to determine the prevalence of domestic violence (DV) for male and female ED patients and to determine the demographics of DV. Four violence parameters were calculated for patients who had a partner at the time of presentation: 1) present physical; 2) present nonphysical; 3) past physical; and 4) past nonphysical. Out of the 516 patients enrolled, 283 were women and 233 were men. On the basis of Index of Spouse Abuse scoring, 14% of men and 22% of women had experienced past nonphysical violence, and 28% of men and 33% of women had experienced past physical violence. Of the 157 men and 207 women with partners at the time of presentation, 11% men and 15% women reported present nonphysical violence, and 20% men and 19% of the women reported present physical violence. Logistic-regression models demonstrated that women experienced significantly more past and present nonphysical violence but not physical violence than men. Alcohol, drug use, and suicidal ideation were found to be significant predictors associated with DV. In conclusion, DV rates were high in the New Orleans population, with nearly equal rates of past and present physical violence for men and women.

  17. The collection of MicroED data for macromolecular crystallography.

    PubMed

    Shi, Dan; Nannenga, Brent L; de la Cruz, M Jason; Liu, Jinyang; Sawtelle, Steven; Calero, Guillermo; Reyes, Francis E; Hattne, Johan; Gonen, Tamir

    2016-05-01

    The formation of large, well-ordered crystals for crystallographic experiments remains a crucial bottleneck to the structural understanding of many important biological systems. To help alleviate this problem in crystallography, we have developed the MicroED method for the collection of electron diffraction data from 3D microcrystals and nanocrystals of radiation-sensitive biological material. In this approach, liquid solutions containing protein microcrystals are deposited on carbon-coated electron microscopy grids and are vitrified by plunging them into liquid ethane. MicroED data are collected for each selected crystal using cryo-electron microscopy, in which the crystal is diffracted using very few electrons as the stage is continuously rotated. This protocol gives advice on how to identify microcrystals by light microscopy or by negative-stain electron microscopy in samples obtained from standard protein crystallization experiments. The protocol also includes information about custom-designed equipment for controlling crystal rotation and software for recording experimental parameters in diffraction image metadata. Identifying microcrystals, preparing samples and setting up the microscope for diffraction data collection take approximately half an hour for each step. Screening microcrystals for quality diffraction takes roughly an hour, and the collection of a single data set is ∼10 min in duration. Complete data sets and resulting high-resolution structures can be obtained from a single crystal or by merging data from multiple crystals.

  18. Progress and opportunities in EELS and EDS tomography.

    PubMed

    Collins, Sean M; Midgley, Paul A

    2017-09-01

    Electron tomography using energy loss and X-ray spectroscopy in the electron microscope continues to develop in rapidly evolving and diverse directions, enabling new insight into the three-dimensional chemistry and physics of nanoscale volumes. Progress has been made recently in improving reconstructions from EELS and EDS signals in electron tomography by applying compressed sensing methods, characterizing new detector technologies in detail, deriving improved models of signal generation, and exploring machine learning approaches to signal processing. These disparate threads can be brought together in a cohesive framework in terms of a model-based approach to analytical electron tomography. Models incorporate information on signal generation and detection as well as prior knowledge of structures in the spectrum image data. Many recent examples illustrate the flexibility of this approach and its feasibility for addressing challenges in non-linear or limited signals in EELS and EDS tomography. Further work in combining multiple imaging and spectroscopy modalities, developing synergistic data acquisition, processing, and reconstruction approaches, and improving the precision of quantitative spectroscopic tomography will expand the frontiers of spatial resolution, dose limits, and maximal information recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Micro Slot Generation by μ-ED Milling

    NASA Astrophysics Data System (ADS)

    Dave, H. K.; Mayanak, M. K.; Rajpurohit, S. R.; Mathai, V. J.

    2016-08-01

    Micro electro discharge machining is one of the most widely used advanced micro machining technique owing to its capability to fabricate micro features on any electrically conductive materials irrespective of its material properties. Despite its wide acceptability, the process is always adversely affected by issues like wear that occurred on the tool electrode, which results into generation of inaccurate features. Micro ED milling, a process variant in which the tool electrode simultaneously rotated and scanned during machining, is reported to have high process efficiency for generation of 3D complicated shapes and features with relatively less electrode wear intensity. In the present study an attempt has been made to study the effect of two process parameters viz. capacitance and scanning speed of tool electrode on end wear that occurs on the tool electrode and overcut of micro slots generated by micro ED milling. The experiment has been conducted on Al 1100 alloy with tungsten electrode having diameter of 300 μm. Results suggest that wear on the tool electrode and overcut of the micro features generated are highly influenced by the level of the capacitance employed during machining. For the parameter usage employed for present study however, no significant effect of variation of scanning speed has been observed on both responses.

  20. Effect of a Bolus Dose of Fentanyl on the ED50 and ED95 of Sevoflurane in Neonates

    PubMed Central

    She, Ying-Jun; Wang, Huai-Zhen; Huang, Jun-Xiang; Tan, Yong-Hong; Wang, Zi-Xing; Tian, Hang; Song, Xing-Rong

    2014-01-01

    Background The minimum alveolar concentration (MAC) of sevoflurane in neonates is 3.3%, but this value has not been verified in Chinese neonates and the effect of different doses of fentanyl on MAC in neonates has not been investigated. This study was designed to determine the ED50 and ED95 values of sevoflurane in Chinese neonates with and without fentanyl. Material/Methods Ninety-three neonates were randomly assigned to receive sevoflurane alone (control group, n=30), 1 μg/kg sevoflurane (group fent1, n=29), or 2 μg/kg fentanyl (group fent2, n=32). Following inhalational induction and tracheal intubation, the end-tidal concentration of sevoflurane was adjusted to achieve the designated concentration, which was determined using the modified Dixon’s up-and-down method starting with 3.0% in each group, with a 0.25% step size. Success was defined as no motor response within 60 s of skin incision. Results The MAC (standard deviation) values of sevoflurane were 2.91% (0.27) in the control group, 2.53% (0.31) in the fent1 group, and 2.34% (0.33) in the fent2 group according to Dixon’s up-and-down method. Logistic probit regression analysis revealed that the ED50 and ED95 (95% CI) of sevoflurane in neonates were 2.82% (2.66–2.98) and 3.39% (2.89–3.89), respectively, in the control group; 2.44% (2.19–2.68) and 3.30% (2.51–4.09), respectively, in the fent1 group; and 2.21% (1.97–2.45) and 3.11% (2.35–3.88), respectively, in the fent2 group. Conclusions The MAC value of sevoflurane in Chinese neonates was lower than previously reported and was reduced by the addition of fentanyl. PMID:25503557

  1. Improving ED specimen TAT using Lean Six Sigma.

    PubMed

    Sanders, Janet H; Karr, Tedd

    2015-01-01

    Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve

  2. In review of ED utilization reduction strategies, data regarding impact on safety, outcomes in short supply.

    PubMed

    2014-01-01

    To gather insight on an array strategies used to curb ED utilization, investigators conducted a systematic review of five types of interventions that are based outside of the ED: patient education, patient financial incentives, the creation of additional non-ED capacity, pre-hospital diversion, and managed care. While the available evidence showed that all of the interventions had some impact on reducing ED utilization, researchers caution that there was scant data showing what impact these interventions had on outcomes or safety. Investigators found that patient education interventions were associated with the greatest magnitude of reductions in ED use, but they stress that the interventions reviewed were very heterogeneous. Interventions involving patient financial incentives primarily focused on putting financial barriers in place between patients and the ED. They were effective at reducing ED utilization, but investigators caution that policy makers need to consider the potential impact on outcomes. There was some evidence that creating additional non-ED capacity fueled demand for care, but had a small impact on ED utilization. Going forward, emergency providers need to fully engage in any discussions about ED utilization and demonstrate the value that EDs bring to the health care system, say experts.

  3. Registered Nurses and Discharge Planning in a Taiwanese ED: A Neglected Issue?

    PubMed

    Chang, Wen; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Liu, Hsueh-Erh; Han, Chin-Yen

    2016-10-01

    Published research on discharge planning is written from the perspective of hospital wards and community services. Limited research focuses on discharge planning in the emergency department (ED). The objective of this study was to identify ED nurses' perceptions of factors influencing the implementation of discharge planning. This qualitative study collected data from 25 ED nurses through in-depth interviews and a drawing task in which participants were asked to depict on paper the implementation of discharge planning in their practice. Factors influencing discharge planning were grouped into three categories: discharge planning as a neglected issue in the ED, heavy workload, and the negative attitudes of ED patients and their families. The study highlighted a need for effective discharge planning to be counted as an essential clinical competency for ED nurses and factored into their everyday workload. Nurses perceived that organizational culture, and parents' and relatives' attitudes were barriers to implementing discharge teaching in the ED.

  4. Has the rescheduling of hydrocodone changed ED prescribing practices?

    PubMed

    Oehler, Elizabeth C; Day, Rachel L; Robinson, David B; Brown, Lawrence H

    2016-12-01

    The objective was to examine the effect of hydrocodone-containing product (HCP) rescheduling on the proportion of prescriptions for HCPs given to patients discharged from the emergency department (ED). Electronic queries of ED records were used to identify patients aged 15 years and older discharged with a pain-related prescription in the 12 months before and after HCP rescheduling. Prescriptions were classified as HCPs; other Schedule II medications (eg, oxycodone products); other Schedule III medications (eg, codeine products); and non-Schedule II/III products (eg, nonsteroidal anti-inflammatory drugs). We compared the proportions of patients receiving each type of prescription before and after rescheduling using χ(2) analysis and used logistic regression to explore the relationship between prescription type and time period while controlling for age, sex, race, and ethnicity. Before rescheduling, 58.1% (95% confidence interval [CI], 57.4-58.7) of patients receiving a pain-related prescription received an HCP; after rescheduling, 13.2% (95% CI, 12.7-13.7) received an HCP (P < .001). Concurrently, other Schedule III prescriptions increased (pre: 11.7% [CI, 11.3-12.2] vs post: 44.9% [CI, 44.2-45.6], P < .001)), as did non-Schedule II/III prescriptions (pre: 51.8% [CI, 51.2-52.5] vs post: 59.3% [CI, 58.6-60.0], P < .001). When controlling for demographic characteristics, patients remained less likely to receive an HCP after rescheduling (adjusted odds ratio [AOR], 0.11; CI, 0.10-0.11) and more likely to receive other Schedule III (AOR, 6.1; CI, 5.8-6.5) and non-Schedule II/III (AOR, 1.4; CI, 1.3-1.4) products. Rescheduling HCPs from Schedule III to Schedule II led to a substantial decrease in HCP prescriptions in our ED and an increase in prescriptions for other Schedule III and non-Schedule II/III products. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. ED services: the impact of caring behaviors on patient loyalty.

    PubMed

    Liu, Sandra S; Franz, David; Allen, Monette; Chang, En-Chung; Janowiak, Dana; Mayne, Patricia; White, Ruth

    2010-09-01

    This article describes an observational study of caring behaviors in the emergency departments of 4 Ascension Health hospitals and the impact of these behaviors on patient loyalty to the associated hospital. These hospitals were diverse in size and geography, representing 3 large urban community hospitals in metropolitan areas and 1 in a midsized city. Research assistants from Purdue University (West Lafayette, IN) conducted observations at the first study site and validated survey instruments. The Purdue research assistants trained contracted observers at the subsequent study sites. The research assistants conducted observational studies of caregivers in the emergency departments at 4 study sites using convenience sampling of patients. Caring behaviors were rated from 0 (did not occur) to 5 (high intensity). The observation included additional information, for example, caregiver roles, timing, and type of visit. Observed and unobserved patients completed exit surveys that recorded patient responses to the likelihood-to-recommend (loyalty) questions, patient perceptions of care, and demographic information. Common themes across all study sites emerged, including (1) the area that patients considered most important to an ED experience (prompt attention to their needs upon arrival to the emergency department); (2) the area that patients rated as least positive in their actual ED experience (prompt attention to their needs upon arrival to the emergency department); (3) caring behaviors that significantly affected patient loyalty (eg, making sure that the patient is aware of care-related details, working with a caring touch, and making the treatment procedure clearly understood by the patient); and (4) the impact of wait time to see a caregiver on patient loyalty. A number of correlations between caring behaviors and patient loyalty were statistically significant (P < .05) at all sites. The study results raised considerations for ED caregivers, particularly with regard

  6. EDS V25 containment vessel explosive qualification test report.

    SciTech Connect

    Rudolphi, John Joseph

    2012-04-01

    The V25 containment vessel was procured by the Project Manager, Non-Stockpile Chemical Materiel (PMNSCM) as a replacement vessel for use on the P2 Explosive Destruction Systems. It is the first EDS vessel to be fabricated under Code Case 2564 of the ASME Boiler and Pressure Vessel Code, which provides rules for the design of impulsively loaded vessels. The explosive rating for the vessel based on the Code Case is nine (9) pounds TNT-equivalent for up to 637 detonations. This limit is an increase from the 4.8 pounds TNT-equivalency rating for previous vessels. This report describes the explosive qualification tests that were performed in the vessel as part of the process for qualifying the vessel for explosive use. The tests consisted of a 11.25 pound TNT equivalent bare charge detonation followed by a 9 pound TNT equivalent detonation.

  7. Accuracy in ED Triage for Symptoms of Acute Myocardial Infarction.

    PubMed

    Sanders, Susan F; DeVon, Holli A

    2016-07-01

    More than 6 million people present to emergency departments across the United States annually with symptoms of acute myocardial infarction (AMI). Of the 1 million patients with AMI, 350,000 die during the acute phase. Accurate ED triage can reduce mortality and morbidity, yet accuracy rates are low. In this study we explored the relationship between patient and nurse characteristics and accuracy of triage in patients with symptoms of AMI. This retrospective, descriptive study used patient data from electronic medical records. The sample of 286 patients was primarily white, with a mean age of 61.44 years (standard deviation [SD], ±13.02), and no history of heart disease. The sample of triage nurses was primarily white and female, with a mean age of 45.46 years (SD, ±11.72) and 18 years of nursing experience. Nineteen percent of the nurses reported having earned a bachelor's degree. Emergency nurse triage accuracy was 54%. Patient race and presence of chest pain were significant predictors of accuracy. Emergency nurse age was a significant predictor of accuracy in triage, but years of experience in nursing was not a significant predictor. Of the 9 variables investigated, only patient race, symptom presentation, and emergency nurse age were significant predictors of triage accuracy. Inconsistency in triage decisions may be due to other conditions not yet explored, such as critical thinking skills and executive functions. This study adds to the body of evidence regarding ED triage of patients with symptoms of AMI. However, further exploration into decisions at triage is warranted to improve accuracy, expedite care, and improve outcomes. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  8. Pivot Nursing: An Alternative to Traditional ED Triage.

    PubMed

    Christensen, Maria; Rosenberg, Mark; Mahon, Eileen; Pineda, Sharon; Rojas, Eva; Soque, Victoria; Johansen, Mary L

    2016-09-01

    A 7.2% increase in patient volume from 130,700 to 140,800 in 2012 prompted St Joseph's Regional Medical Center Emergency Department to review existing triage processes to decrease turnaround time. "Pivot triage" is a new, efficient intake process that entails use of 4 rather than 8 determinants to identify acuity levels. The purpose of this performance improvement project was to create alternatives to traditional triage to decrease ED length of stay and door-to-physician time. After education, the pivot process was implemented using 4 determinants established by a multidisciplinary team. The pivot process was slowly implemented for 6 hours over a 1-week period to work out processing issues. Arrival time, door-to-physician time, and departure time from the emergency department were elements used to calculate the patient's turnaround time. Length of ED stay was collected monthly beginning in the fourth quarter of 2011. Comparisons were made after Pivot implementation in the fourth quarter of 2012. Despite the increasing volume, the mean door-to-physician time decreased from 71 to 40 minutes, a 43.7% reduction. The overall turnaround time decreased from 220 to 181 minutes, representing approximately a 17.7% reduction. The percentage of patients who left without being seen decreased from 2.5% to 1.0%. The pivot process improved patient flow in the emergency department, reducing time spent by the patient in the department. The pivot process is a viable alternative to traditional triage. Nurses are able to accurately pivot patients with a reduced amount of information. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  9. Applying Lean methodologies reduces ED laboratory turnaround times.

    PubMed

    White, Benjamin A; Baron, Jason M; Dighe, Anand S; Camargo, Carlos A; Brown, David F M

    2015-11-01

    Increasing the value of health care delivery is a national priority, and providers face growing pressure to reduce cost while improving quality. Ample opportunity exists to increase efficiency and quality simultaneously through the application of systems engineering science. We examined the hypothesis that Lean-based reorganization of laboratory process flow would improve laboratory turnaround times (TAT) and reduce waste in the system. This study was a prospective, before-after analysis of laboratory process improvement in a teaching hospital emergency department (ED). The intervention included a reorganization of laboratory sample flow based in systems engineering science and Lean methodologies, with no additional resources. The primary outcome was the median TAT from sample collection to result for 6 tests previously performed in an ED kiosk. After the intervention, median laboratory TAT decreased across most tests. The greatest decreases were found in "reflex tests" performed after an initial screening test: troponin T TAT was reduced by 33 minutes (86 to 53 minutes; 99% confidence interval, 30-35 minutes) and urine sedimentation TAT by 88 minutes (117 to 29 minutes; 99% confidence interval, 87-90 minutes). In addition, troponin I TAT was reduced by 12 minutes, urinalysis by 9 minutes, and urine human chorionic gonadotropin by 10 minutes. Microbiology rapid testing TAT, a "control," did not change. In this study, Lean-based reorganization of laboratory process flow significantly increased process efficiency. Broader application of systems engineering science might further improve health care quality and capacity while reducing waste and cost. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Softball injuries treated in US EDs, 1994 to 2010.

    PubMed

    Birchak, John C; Rochette, Lynne M; Smith, Gary A

    2013-06-01

    Softball is a popular participant sport in the United States. This study investigated the epidemiology of softball injuries with comparisons between children and adults. Data from the National Electronic Injury Surveillance System for patients 7 years and older treated in an emergency department (ED) for a softball injury from 1994 through 2010 were analyzed. An estimated 2107823 (95% confidence interval [CI], 1736417-2479229) patients were treated in US EDs for a softball injury during the 17-year study period. The annual number of injuries decreased by 23.0% from 1994 to 2010 (P < .001); however, during the last 6 years of the study, injuries increased by 11.7% (P = .008). The annual rate of softball injuries increased significantly during the study period (P = .035). The most commonly injured body regions were the hand/wrist (22.2%) and face (19.3%). Being hit by a ball was the most common mechanism of injury (52.4%) and accounted for most of face (89.6%) and head (75.7%) injuries. Injuries associated with running (relative risk, 2.36; 95% CI, 1.97-2.82) and diving for a ball (relative risk, 4.61; 95% CI, 3.50-6.09) were more likely to occur among adult than pediatric patients. To our knowledge, this is the first study to investigate softball injuries using a nationally representative sample. Softball is a common source of injury among children and adults. Increased efforts are needed to promote safety measures, such as face guards, mouth guards, safety softballs, and break-away bases, to decrease these injuries. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Prevalence and correlates of erectile dysfunction (ED) and treatment seeking for ED in Asian Men: the Asian Men's Attitudes to Life Events and Sexuality (MALES) study.

    PubMed

    Tan, Hui-Meng; Low, Wah Yun; Ng, Chirk Jenn; Chen, Kuang-Kuo; Sugita, Minoru; Ishii, Nobuhisa; Marumo, Ken; Lee, Sung Won; Fisher, William; Sand, Michael

    2007-11-01

    There have been limited multiregional studies in Asia examining the parameters of men's general and sexual health and quality of life in the general population vs. those in clinical cohorts of patients with erectile dysfunction (ED). The aims of the Asian Men's Attitudes to Life Events and Sexuality (Asian MALES) study were to investigate the prevalence of ED, associated health conditions, and ED treatment-seeking patterns in the general male population in five regions of Asia (China, Japan, Korea, Malaysia, and Taiwan). Standardized questionnaire previously used in a similar multiregional study and modified to ensure culturally appropriate content for Asia. Phase I of the study involved 10,934 adult men, aged 20-75 years, who were interviewed using the standardized questionnaire. Phase II of the study involved men with self-reported ED recruited from Phase I and via physician referral, invitations in general practitioner offices, and street interception (total Phase II sample, N = 1,209). The overall prevalence of self-reported ED in the Phase I study population was 6.4%. ED prevalence varied by region and significantly increased with age (P < 0.01). Men with ED reported significantly greater rates of comorbid illness (P < 0.0001) and a reduced quality of life (P = 0.0001), compared with men without ED. Phase II of the study revealed that fewer than half of men with self-reported ED had sought treatment for their problem. Men were more likely to seek help for erection difficulties from Western doctors than from traditional medicine practitioners (P = 0.0001). A man's partner/spouse was the most common influencer of treatment seeking in all regions except Malaysia. The findings confirm those of existing research on ED in both Asian and non-Asian males: ED is a prevalent condition; the prevalence of ED increases with age and is strongly associated with comorbid conditions; and the majority of men have never sought treatment for their condition. This study highlights

  12. SED-ED, a workflow editor for computational biology experiments written in SED-ML.

    PubMed

    Adams, Richard R

    2012-04-15

    The simulation experiment description markup language (SED-ML) is a new community data standard to encode computational biology experiments in a computer-readable XML format. Its widespread adoption will require the development of software support to work with SED-ML files. Here, we describe a software tool, SED-ED, to view, edit, validate and annotate SED-ML documents while shielding end-users from the underlying XML representation. SED-ED supports modellers who wish to create, understand and further develop a simulation description provided in SED-ML format. SED-ED is available as a standalone Java application, as an Eclipse plug-in and as an SBSI (www.sbsi.ed.ac.uk) plug-in, all under an MIT open-source license. Source code is at https://sed-ed-sedmleditor.googlecode.com/svn. The application itself is available from https://sourceforge.net/projects/jlibsedml/files/SED-ED/.

  13. Are family physicians the answer to ED doctor shortage, or 'blasphemy'?

    PubMed

    2011-01-01

    Some organizations maintain that family physicians have the skills and training necessary to practice in the ED and help combat the current physician shortage, while others maintain their training is inadequate. Here are some issues to take into consideration with such candidates: Have they obtained thorough experience the necessary skills to practice in the ED? Have they received a significant amount of clinical training in an ED? Has their training progress been monitored by a teaching attending?

  14. EdF`s Mercier on the biggest maintenance program in the world

    SciTech Connect

    Mercier, E.F.

    1993-08-01

    This article presents an interview with Jean-Pierre Mercier, present vice president of operations and maintenance engineering at Electricite de France (EdF). The maintenance budget for EdF is in the range of 1.5 to 1.7 billion US dollars per year. Mercier discusses the changing direction of the EdF maintenance program, with increasing emphasis on human performance, safety culture, and professionalism at the power station sites and among the many outside contractors.

  15. The ED use and non-urgent visits of elderly patients.

    PubMed

    Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

    2016-12-01

    To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p < 0.001). While the rate of elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p < 0.001). For both genders, the rates of ED visits for patients between 65 and 74 years old was higher than for other elderly age groups (p < 0.001). The prevalence of upper respiratory tract infection (URTI) was the highest within the elderly population (17.5%, CI: 17.1-17.9). The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%), and they were highest in the winter season (25.9%) and in January (10.2%). The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries.

  16. SEM-EDS analysis and discrimination of forensic soil.

    PubMed

    Cengiz, Salih; Cengiz Karaca, Ali; Cakir, Ismail; Bülent Uner, H; Sevindik, Aytekin

    2004-04-20

    Soils vary among different areas, and have some characteristics because of the natural effects and transfers made by human and other living beings in time. So that forensic examination of soil is not only concerned with the analysis of naturally occurring rocks, minerals, vegetation, and animal matter. It also includes the detection of such manufactured materials such as ions from synthetic fertilizers and from different environments (e.g., nitrate, phosphate, and sulfate) as environmental artifacts (e.g., lead or objects as glass, paint chips, asphalt, brick fragments, and cinders) whose presence may impart soil with characteristics that will make it unique to a particular location. Many screening and analytical methods have been applied for determining the characteristics which differentiate and discriminate the forensic soil samples but none of them easily standardized. Some of the methods that applied in forensic laboratories in forensic soil discrimination are the color comparison of the normal air-dried (dehumidified) and overheated soil samples, macroscopic observation, and low-power stereo-microscopic observation, determination of anionic composition by capillary electrophoresis (CE), and the elemental composition by scanning electron microscope (SEM)-energy dispersive X-ray spectrometer (EDS) and other high sensitivity techniques. The objective of this study was to show the effect of the application of 9 tonnes/cm2 pressure on the elemental compositions obtained by SEM-EDS technique and comparing the discrimination power of the pressed-homogenized and not homogenized forensic soil samples. For this purpose soil samples from 17 different locations of Istanbul were collected. Aliquots of the well mixed samples were dried in an oven at 110-120 degrees C and sieved by using 0.5 mm sieve and then the undersieve fraction(<0.5 mm) of these samples put on an adhesive tape placed on a stub. About 100-150 mg aliquots of dried, sieved samples were pressed under 9

  17. FormEd: An X Window System application for managing first-order formulas

    SciTech Connect

    Henry, T.L.; McCune, W.W.

    1990-11-01

    FormEd is a window-based program for constructing, displaying, and managing first-order logic formulas. The main motivation for constructing FormEd was the desire to have formulas displayed in a readable, two-dimensional format. Users of FormEd can make two kinds of transformation on formulas: logic transformations, such as negation normal form translation, which preserve the meaning of a formula, and edit transformations, which can be used to make arbitrary changes, such as adding a hypothesis to a subformula. FormEd was written by using the X Window System, Version 11, and code from the theorem prover OTTER. 4 refs.

  18. Curvature sensing MARCKS-ED peptides bind to membranes in a stereo-independent manner.

    PubMed

    Yan, Lei; de Jesus, Armando Jerome; Tamura, Ryo; Li, Victoria; Cheng, Kui; Yin, Hang

    2015-07-01

    Membrane curvature and lipid composition plays a critical role in interchanging of matter and energy in cells. Peptide curvature sensors are known to activate signaling pathways and promote molecular transport across cell membranes. Recently, the 25-mer MARCKS-ED peptide, which is derived from the effector domain of the myristoylated alanine-rich C kinase substrate protein, has been reported to selectively recognize highly curved membrane surfaces. Our previous studies indicated that the naturally occurring L-MARCKS-ED peptide could simultaneously detect both phosphatidylserine and curvature. Here, we demonstrate that D-MARCKS-ED, composed by unnatural D-amino acids, has the same activities as its enantiomer, L-MARCKS-ED, as a curvature and lipid sensor. An atomistic molecular dynamics simulation suggests that D-MARCKS-ED may change from linear to a boat conformation upon binding to the membrane. Comparable enhancement of fluorescence intensity was observed between D- and L-MARCKS-ED peptides, indicating similar binding affinities. Meanwhile, circular dichroism spectra of D- and L-MARCKS-ED are almost symmetrical both in the presence and absence of liposomes. These results suggest similar behavior of artificial D- and natural L-MARCKS-ED peptides when binding to curved membranes. Our studies may contribute to further understanding of how MARCKS-ED senses membrane curvature as well as provide a new direction to develop novel membrane curvature probes.

  19. ED plaster-of-Paris jacket for infantile scoliosis.

    PubMed

    Morin, Christian; Kulkarni, Shrirang

    2014-07-01

    There are various articles published in last few years which consider surgical methods like growing rod instrumentation and modulation of the growth as a "gold standard" for the treatment of early onset severe scoliosis. We emphasize orthopaedic correction with serial casting as another option for such progressive deformity. The key to the success of this treatment is to understand the strategy and the technique involved in the effective casting. The conventional technique of elongation, derotation, flexion cast (named EDF by Cotrel) is described with some modifications like wedging the cast (gypsotomy) in order to produce the flexion component. Serial casting with ED casts for the treatment of progressive idiopathic infantile scoliosis is an effective tool for the benign types of curves (Mehta) and spinal fusion was not necessary in two-third of our cases. Surgical option for treatment of early onset scoliosis is not a "gold standard". Orthopaedic treatment with serial elongation, derotation casts remain the centerpiece of this treatment. Each detail to understand the technique must be known in order to obtain the best result.

  20. The utility of transvaginal ultrasound in the ED evaluation of complications of first trimester pregnancy.

    PubMed

    Panebianco, Nova L; Shofer, Frances; Fields, J Matthew; Anderson, Kenton; Mangili, Alessandro; Matsuura, Asako C; Dean, Anthony J

    2015-06-01

    For patients with early intrauterine pregnancy (IUP), the sonographic signs of the gestation may be below the resolution of transabdominal ultrasound (TAU); however, it may be identified by transvaginal ultrasound (TVU). We sought to determine how often TVU performed in the emergency department (ED) reveals a viable IUP after a nondiagnostic ED TAU and the impact of ED TVU on patient length of stay (LOS). This was a retrospective cohort study of women presenting to our ED with complications of early pregnancy from January 1, 2007 to February 28, 2009 in a single urban adult ED. Abstractors recorded clinical and imaging data in a database. Patient imaging modality and results were recorded and compared with respect to ultrasound (US) findings and LOS. Of 2429 subjects identified, 795 required TVU as part of their care. Emergency department TVU was performed in 528 patients, and 267 went to radiology (RAD). Emergency department TVU identified a viable IUP in 261 patients (49.6%). Patients having initial ED US had shorter LOS than patients with initial RAD US (median 4.0 vs 6.0 hours; P < .001). Emergency department LOS was shorter for women who had ED TVU performed compared with those sent for RAD TVU regardless of the findings of the US (median 4.9 vs 6.7 hours; P < .001). There was no increased LOS for patients who needed further RAD US after an indeterminate ED TVU (7.0 vs 7.1 hours; P = .43). There was no difference in LOS for those who had a viable IUP confirmed on ED TAU vs ED (median 3.1 vs 3.2 hours, respectively; P < .32). When an ED TVU was performed, a viable IUP was detected 49.6% of the time. Emergency department LOS was significantly shorter for women who received ED TVU after indeterminate ED TAU compared with those sent to RAD for TVU, with more marked time savings among those with live IUP diagnosed on ED TVU. For patients who do not receive a definitive diagnosis of IUP on ED TVU, this approach does not result in increased LOS. Copyright © 2015

  1. A Preliminary Examination of Loss of Control Eating Disorder (LOC-ED) in Middle Childhood

    PubMed Central

    Matherne, Camden E.; Tanofsky-Kraff, Marian; Altschul, Anne M.; Shank, Lisa M.; Schvey, Natasha A.; Brady, Sheila M.; Galescu, Ovidiu; Demidowich, Andrew P.; Yanovski, Susan Z.; Yanovski, Jack A.

    2015-01-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6–12y with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29y ± 1.54, 53.8% female, 57.8 % White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n = 19), LOC in the absence of the full disorder (subLOC, n = 33), and youth not reporting LOC (noLOC, n = 199). LOC-ED youth had higher BMIz (p = 0.001) and adiposity (p = 0.003) and reported greater disordered eating concerns (p < 0.001) compared to noLOC youth. Compared to subLOC youth, LOC-ED youth had non-significantly higher BMIz (p = 0.11), and significantly higher adiposity (p = 0.04) and disordered eating attitudes (p = 0.02). SubLOC youth had greater disordered eating concerns (p < 0.001) and BMIz (p = 0.03) but did not differ in adiposity (p = 0.33) compared to noLOC youth. These preliminary data suggest that LOC-ED youth are elevated on disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. PMID:25913008

  2. Chronic hypothyroidism only marginally affects adult-type Leydig cell regeneration after EDS administration.

    PubMed

    Rijntjes, Eddy; van Kesteren-Buiting, Anita; Keijer, Jaap; Teerds, Katja J

    2010-02-01

    Chronic prenatally induced dietary hypothyroidism delays adult-type Leydig cell development, but does not block this process. Using a chemical model to induce hypothyroidism, it was suggested that development of a new population of Leydig cells was completely inhibited following the addition of the cytotoxic compound ethane-1,2-dimethyl sulphonate (EDS). In this study, we used a dietary approach to induce hypothyroidism and reinvestigated the regeneration of the Leydig cell population following EDS administration. Eighty-four day old euthyroid and chronically hypothyroid rats received an injection of EDS and were killed directly before or at regular intervals up to 77 days after EDS. In some control and hypothyroid animals, the first progenitor-type Leydig cells were observed at day 12 after EDS. At day 16, Leydig cell progenitors were present in all rats. The percentage of proliferating Leydig cells peaked in the euthyroid animals at day 21 after EDS. In the hypothyroid testis such a peak was not observed, although the percentage of proliferating regenerating Leydig cells was significantly higher from days 35 to 56 compared with the controls. This suggested that the wave of Leydig cell proliferation was delayed in the hypothyroid animals as compared with the euthyroid controls. On the day of EDS injection, the Leydig/Sertoli cell ratio was 37% lower in the hypothyroid rats compared with the controls. The Leydig/Sertoli cell ratio remained lower in the EDS-treated hypothyroid animals compared with the controls at all time points investigated. At day 77 after EDS, the Leydig cell population had returned to its pre-treatment size in both groups. Plasma testosterone production was reduced to below detectable levels immediately after EDS injection, and started to increase again on day 16, reaching pre-treatment values on day 21 in both groups. Taken together, severely reduced thyroid hormone levels did not block the regeneration of the adult-type Leydig cell population

  3. An ED pilot intervention to facilitate outpatient acute care for cancer patients.

    PubMed

    Brooks, Gabriel A; Chen, Eddy J; Murakami, Mark A; Giannakis, Marios; Baugh, Christopher W; Schrag, Deb

    2016-10-01

    Unplanned hospitalizations are common in patients with cancer, and most hospitalizations originate in the emergency department (ED). We implemented an ED-based pilot intervention designed to reduce hospitalizations among patients with solid tumors. The intervention, piloted at a single academic medical center, involved a medical oncologist embedded in the ED during evening hours. We used a quasiexperimental preimplementation/postimplementation study design to evaluate the proportion of ED visits that resulted in inpatient hospital admission, before and after pilot implementation. General estimating equations were used to evaluate the association between the intervention and hospital admission. There were 390 ED visits by eligible cancer patients in the preintervention period and 418 visits in the intervention period. During the intervention period, 158 (38%) of 418 ED visits were identified by the embedded oncologist during the evening intervention shift. The proportion of ED visits leading to hospitalization was 70% vs 69% in the preintervention and intervention periods (odds ratio, 0.93 [95% confidence interval, 0.69-1.24]; P= .62). There were no differences between periods in ED length of stay or subsequent use of acute care. Among patients with initial ED presentation during the operating hours of the intervention, the proportion of ED visits leading to hospitalization was 77% vs 67% in the preintervention and intervention periods (odds ratio, 0.62 [0.36-1.08]; P= .08). Embedding an oncologist in the ED of an academic medical center did not significantly reduce hospital admissions. Novel approaches are needed to strengthen outpatient acute care for patients with cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. A preliminary examination of Loss of Control Eating Disorder (LOC-ED) in middle childhood.

    PubMed

    Matherne, Camden E; Tanofsky-Kraff, Marian; Altschul, Anne M; Shank, Lisa M; Schvey, Natasha A; Brady, Sheila M; Galescu, Ovidiu; Demidowich, Andrew P; Yanovski, Susan Z; Yanovski, Jack A

    2015-08-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6-12years with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29years±1.54, 53.8% female, 57.8% White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n=19), LOC in the absence of the full disorder (subLOC, n=33), and youth not reporting LOC (noLOC, n=199). LOC-ED youth had higher BMIz (p=0.001) and adiposity (p=0.003) and reported greater disordered eating concerns (p<0.001) compared to noLOC youth. Compared to subLOC youth, LOC-ED youth had non-significantly higher BMIz (p=0.11), and significantly higher adiposity (p=0.04) and disordered eating attitudes (p=0.02). SubLOC youth had greater disordered eating concerns (p<0.001) and BMIz (p=0.03) but did not differ in adiposity (p=0.33) compared to noLOC youth. These preliminary data suggest that LOC-ED youth are elevated on disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain.

  5. Using edTPA to Compare Online and Face to Face Teacher Preparation Programs

    ERIC Educational Resources Information Center

    Heafner, Tina; Petty, Teresa

    2016-01-01

    Central to determining the effectiveness of technology to support learning and the value of technology-mediated instruction is the quality of programs. edTPA is a widely accepted, national measure of teacher readiness and preparation. Using edTPA score reports for teacher candidates completing a teacher education program, this study provides data…

  6. Evaluation of the Demonstration Sites in the ConnectEd Network

    ERIC Educational Resources Information Center

    Farr, Beverly; Bradby, Denise; Hartry, Ardice; Sipes, Laurel; Hall, Leslie; Tasoff, Shayna

    2009-01-01

    In California, the James Irvine Foundation created ConnectEd: The California Center for College and Career to promote multiple pathways that link to the state's 15 major industry sectors. The ConnectEd Network of Schools, a demonstration project supported by Irvine, plays a critical role in expanding student options through multiple pathways and…

  7. Multiple Intelligence and Digital Learning Awareness of Prospective B.Ed Teachers

    ERIC Educational Resources Information Center

    Gracious, F. L. Antony; Shyla, F. L. Jasmine Anne

    2012-01-01

    The present study Multiple Intelligence and Digital Learning Awareness of prospective B.Ed teachers was probed to find the relationship between Multiple Intelligence and Digital Learning Awareness of Prospective B.Ed Teachers. Data for the study were collected using self made Multiple Intelligence Inventory and Digital Learning Awareness Scale.…

  8. Connecting Teachers and Ed-Tech Developers: Lessons from NYC's "Gap App" Program. Report

    ERIC Educational Resources Information Center

    Villavicencio, Adriana; Siman, Nina; Lafayette, Camille; Kang, David

    2016-01-01

    In 2011, with support from a federal Investing in Innovation grant, the NYC Department of Education launched Innovate NYC Schools. The initiative was designed to address two, related challenges to effectively integrating education technology (ed-tech) into classrooms: First, procurement of ed-tech tools is often hampered by a disconnect between…

  9. G. ED. Paper-Book 1974-1984. The Process of Growth of an Innovation.

    ERIC Educational Resources Information Center

    Verduin-Muller, Henriette, Ed.

    Fifteen papers presented at conferences throughout Europe and in the USSR, Nigeria, Japan, Jamaica, and Tunesia provide an introduction to the research work being done by the graduate level Department of Geography for Education (G.ED.) at the University of Utrecht in the Netherlands. An introductory chapter describes the three G.ED. modules, which…

  10. Economic Development Network (ED>Net): 1995-96 Report to the Governor and the Legislature.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Office of the Chancellor.

    The Economic Development Network (ED>Net) of the California Community Colleges was designed to advance the state's economic growth and competitiveness by coordinating and facilitating workforce improvement, technology deployment, and business development initiatives. This report reviews outcomes for ED>Net for 1995-96 based on reports…

  11. Is There a Future for Teacher Ed Curriculum? An Answer from History and Moral Philosophy

    ERIC Educational Resources Information Center

    Null, J. Wesley

    2008-01-01

    Is there a future for teacher ed "curriculum"? The author contends that he is not sure if there is a future for teacher ed curriculum, but if such a future is to exist, the answer will come only from history and moral philosophy. In this article, the author opines that individuals cannot make good decisions about the future of teacher ed…

  12. 75 FR 11937 - EDS, HP Company, Fairfield Township, OH; Notice of Termination of Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration EDS, HP Company, Fairfield Township, OH; Notice of Termination of... response to a petition filed on October 29, 2009 by the State on behalf of workers of EDS, HP Company...

  13. A Review of "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only"

    ERIC Educational Resources Information Center

    Garrity, Joan Mogul

    2010-01-01

    While virtually all sex ed curricula are designed to be used with children, teens and young adults, "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only" ([C] 2009, Planned Parenthood of Greater Northern New Jersey) offers lessons to help participants fully embrace the possibility of sexual pleasure and intimacy from mid-life through…

  14. A Review of "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only"

    ERIC Educational Resources Information Center

    Garrity, Joan Mogul

    2010-01-01

    While virtually all sex ed curricula are designed to be used with children, teens and young adults, "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only" ([C] 2009, Planned Parenthood of Greater Northern New Jersey) offers lessons to help participants fully embrace the possibility of sexual pleasure and intimacy from mid-life through…

  15. Connecting Teachers and Ed-Tech Developers: Lessons from NYC's "Gap App" Program. Technical Appendices

    ERIC Educational Resources Information Center

    Villavicencio, Adriana; Siman, Nina; Lafayette, Camille; Kang, David

    2016-01-01

    In 2011, with support from a federal Investing in Innovation grant, the NYC Department of Education launched Innovate NYC Schools. The initiative was designed to address two, related challenges to effectively integrating education technology (ed-tech) into classrooms: First, procurement of ed-tech tools is often hampered by a disconnect between…

  16. Emotional Disturbance and School Personnel's Interactions: Perspectives of Families of Youth with ED

    ERIC Educational Resources Information Center

    Smith-Quinn, Renee

    2012-01-01

    Nearly eight percent of the six million students, ages 6 to 21 years, who are receiving special education or related services are identified as having Emotional Disturbance (ED). Students with ED have been identified among all students with disabilities as having the worst student outcomes such as lower grades, high failing rates, higher…

  17. ED-B fibronectin expression is a marker of epithelial-mesenchymal transition in translational oncology.

    PubMed

    Petrini, Iacopo; Barachini, Serena; Carnicelli, Vittoria; Galimberti, Sara; Modeo, Letizia; Boni, Roberto; Sollini, Martina; Erba, Paola Anna

    2017-01-17

    Fibronectin is a component of the extracellular matrix that links collagen fibers to integrins on the cell's surface. The splicing isoforms, containing the ED-B domain, are not expressed in adult tissues but only in tumor stroma or during embryonic development. Fibroblasts and endothelial cells express ED-B fibronectin during angiogenesis. Also cancer cells can synthetize ED-B fibronectin, but its function in tumor growth needs to be further elucidated.We evaluated the expression of ED-B fibronectin in prostate cancer cell lines: PC3 and DU145. Using TGF-β, we induced epithelial to mesenchymal transition in culture and observed an increase of ED-B fibronectin expression. Thereafter, we evaluated the expression of ED-B fibronectin in multipotent mesangiogenic progenitor cells, and in mesenchymal stromal cells. The expression of ED-B fibronectin was much higher in mesenchymal than prostate cancer cells even after the epithelial to mesenchymal transition.Epithelial to mesenchymal transition is a key step for tumor progression contributing to the metastatic spread. Therefore, circulating cancer cells could seed into the metastatic niche taking advantage from the ED-B fibronectin that secrete their own.

  18. Unstandardized Responses to a "Standardized" Test: The edTPA as Gatekeeper and Curriculum Change Agent

    ERIC Educational Resources Information Center

    Ledwell, Katherine; Oyler, Celia

    2016-01-01

    We examine edTPA (a teacher performance assessment) implementation at one private university during the first year that our state required this exam for initial teaching certification. Using data from semi-structured interviews with 19 teacher educators from 12 programs as well as public information on edTPA pass rates, we explore whether the…

  19. Characteristics of Reading Disability Types in Middle School Students Classified ED

    ERIC Educational Resources Information Center

    Mattison, Richard E.

    2008-01-01

    Types of reading disabilities (RD) have not yet been investigated in students classified with emotional disturbance (ED). The prevalence of RD and differentiating characteristics were examined in 118 middle school students attending a self-contained school for ED students by defining RDs with reading standard scores less than 85 on the two…

  20. Evaluating Prospective Teachers: Testing the Predictive Validity of the edTPA. Working Paper 157

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Cowan, James; Theobald, Roddy

    2016-01-01

    We use longitudinal data from Washington State to provide estimates of the extent to which performance on the edTPA, a performance-based, subject-specific assessment of teacher candidates, is predictive of the likelihood of employment in the teacher workforce and value-added measures of teacher effectiveness. While edTPA scores are highly…

  1. Race to the Top District Competition: The Data Quality Campaign's Comments on ED's Proposed Criteria

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2012

    2012-01-01

    The Data Quality Campaign (DQC) submits these comments in response to the US Department of Education's (ED) draft requirements, priorities, selection criteria, and definitions for the Race to the Top District (RTT-D) competition. DQC applauds ED for including the following components of the proposal: (1) Data is acknowledged throughout the…

  2. Standalone engine simulator (SAES), Engine Dynamics simulator (EDS) Xerox Sigma 5 interface hardware manual

    NASA Technical Reports Server (NTRS)

    Kirshten, P. M.; Black, S.; Pearson, R.

    1979-01-01

    The ESS-EDS and EDS-Sigma interfaces within the standalone engine simulator are described. The operation of these interfaces, including the definition and use of special function signals and data flow paths within them during data transfers, is presented along with detailed schematics and circuit layouts of the described equipment.

  3. Unstandardized Responses to a "Standardized" Test: The edTPA as Gatekeeper and Curriculum Change Agent

    ERIC Educational Resources Information Center

    Ledwell, Katherine; Oyler, Celia

    2016-01-01

    We examine edTPA (a teacher performance assessment) implementation at one private university during the first year that our state required this exam for initial teaching certification. Using data from semi-structured interviews with 19 teacher educators from 12 programs as well as public information on edTPA pass rates, we explore whether the…

  4. Project LOGgED ON: Advanced Science Online for Gifted Learners

    ERIC Educational Resources Information Center

    Reed, Christine; Urquhart, Jill

    2007-01-01

    Gifted students are often underserved because they do not have access to highly challenging curriculum. In October, 2002, Project LOGgED ON (www.scrolldown.com/loggedon/) at University of Virginia received federal funding from the Jacob Javits Act to tackle this issue. Those who were part of the LOGgED ON project developed advanced science…

  5. Minimizing ED Waiting Times and Improving Patient Flow and Experience of Care.

    PubMed

    Sayah, Assaad; Rogers, Loni; Devarajan, Karthik; Kingsley-Rocker, Lisa; Lobon, Luis F

    2014-01-01

    We conducted a pre- and postintervention analysis to assess the impact of a process improvement project at the Cambridge Hospital ED. Through a comprehensive and collaborative process, we reengineered the emergency patient experience from arrival to departure. The ED operational changes have had a significant positive impact on all measured metrics. Ambulance diversion decreased from a mean of 148 hours per quarter before changes in July 2006 to 0 hours since April 2007. ED total length of stay decreased from a mean of 204 minutes before the changes to 132 minutes. Press Ganey patient satisfaction scores rose from the 12th percentile to the 59th percentile. ED patient volume grew by 11%, from a mean of 7,221 patients per quarter to 8,044 patients per quarter. Compliance with ED specific quality core measures improved from a mean of 71% to 97%. The mean rate of ED patients that left without being seen (LWBS) dropped from 4.1% to 0.9%. Improving ED operational efficiency allowed us to accommodate increasing volume while improving the quality of care and satisfaction of the ED patients with minimal additional resources, space, or staffing.

  6. Minimizing ED Waiting Times and Improving Patient Flow and Experience of Care

    PubMed Central

    Rogers, Loni; Devarajan, Karthik; Lobon, Luis F.

    2014-01-01

    We conducted a pre- and postintervention analysis to assess the impact of a process improvement project at the Cambridge Hospital ED. Through a comprehensive and collaborative process, we reengineered the emergency patient experience from arrival to departure. The ED operational changes have had a significant positive impact on all measured metrics. Ambulance diversion decreased from a mean of 148 hours per quarter before changes in July 2006 to 0 hours since April 2007. ED total length of stay decreased from a mean of 204 minutes before the changes to 132 minutes. Press Ganey patient satisfaction scores rose from the 12th percentile to the 59th percentile. ED patient volume grew by 11%, from a mean of 7,221 patients per quarter to 8,044 patients per quarter. Compliance with ED specific quality core measures improved from a mean of 71% to 97%. The mean rate of ED patients that left without being seen (LWBS) dropped from 4.1% to 0.9%. Improving ED operational efficiency allowed us to accommodate increasing volume while improving the quality of care and satisfaction of the ED patients with minimal additional resources, space, or staffing. PMID:24829802

  7. "What about Bilingualism?" A Critical Reflection on the edTPA with Teachers of Emergent Bilinguals

    ERIC Educational Resources Information Center

    Kleyn, Tatyana; López, Dina; Makar, Carmina

    2015-01-01

    Amidst the debates surrounding teacher quality and preparation programs, the edTPA (education Teaching Performance Assessment) has emerged to assess future teachers through a portfolio-based certification process. This study offers the perspective of three faculty members who participated in an experimental configuration of edTPA implementation…

  8. How do clinicians with different training backgrounds manage walk-in patients in the ED setting?

    PubMed

    Harris, Tim; McDonald, Keith

    2014-12-01

    To compare the initial assessment and management of walk-in emergency department (ED) patients between different types of healthcare providers. A large teaching hospital with an annual ED census of 140 000 adult patients. A random sample of 384 patients who self-presented to the ED was obtained. A detailed analysis of each patient record was performed by two clinicians. Data were obtained on the presenting condition, and disposition of each patient, either into the ED for further assessment, or discharge. GPs were significantly more likely to discharge patients home as compared to emergency nurses. ED senior nurses were more likely than GPs to stream patients into the ED for further assessment. Of the patients referred into the ED for further assessment by senior ED nurses, the majority were discharged home. There were insufficient numbers of emergency physician assessments for meaningful statistical analysis. The clinician groups studied here demonstrated different patterns of discharge and referral, reflecting their training and experience. When planning operational procedures, the training and background of the staff allocated to each area should be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Using edTPA to Compare Online and Face to Face Teacher Preparation Programs

    ERIC Educational Resources Information Center

    Heafner, Tina; Petty, Teresa

    2016-01-01

    Central to determining the effectiveness of technology to support learning and the value of technology-mediated instruction is the quality of programs. edTPA is a widely accepted, national measure of teacher readiness and preparation. Using edTPA score reports for teacher candidates completing a teacher education program, this study provides data…

  10. Envisioning the EdD and PhD as a Partnership for Change

    ERIC Educational Resources Information Center

    Aiken, Judith A.; Gerstl-Pepin, Cynthia

    2013-01-01

    The Carnegie Project on the Education Doctorate (CPED)--which the College of Education and Social Services (CESS) at the University of Vermont has actively been involved in since 2007--has invited us to think carefully about our EdD doctoral program and its role in the improvement of schools and society. Although the EdD program in Educational…

  11. Project LOGgED ON: Advanced Science Online for Gifted Learners

    ERIC Educational Resources Information Center

    Reed, Christine; Urquhart, Jill

    2007-01-01

    Gifted students are often underserved because they do not have access to highly challenging curriculum. In October, 2002, Project LOGgED ON (www.scrolldown.com/loggedon/) at University of Virginia received federal funding from the Jacob Javits Act to tackle this issue. Those who were part of the LOGgED ON project developed advanced science…

  12. G. ED. Paper-Book 1974-1984. The Process of Growth of an Innovation.

    ERIC Educational Resources Information Center

    Verduin-Muller, Henriette, Ed.

    Fifteen papers presented at conferences throughout Europe and in the USSR, Nigeria, Japan, Jamaica, and Tunesia provide an introduction to the research work being done by the graduate level Department of Geography for Education (G.ED.) at the University of Utrecht in the Netherlands. An introductory chapter describes the three G.ED. modules, which…

  13. Trouble with the edTPA: Lessons Learned from a Narrative Self-Study

    ERIC Educational Resources Information Center

    Cronenberg, Stephanie; Harrison, Dorian; Korson, Stacey; Jones, Alexis; Murray-Everett, Natasha C.; Parrish, Michael; Johnston-Parsons, Marilyn

    2016-01-01

    This paper is written by faculty, staff, and graduate students responsible for preparing a group of 100 elementary/middle school licensure students for the edTPA portfolio assessment. It is a narrative self-study analysis of our experiences doing so during the pilot year. The edTPA is a performance assessment that requires future teachers to plan,…

  14. Content Analysis of the Ph.D vs. Ed.D. Dissertation.

    ERIC Educational Resources Information Center

    Coorough, Calleen; Nelson, Jack

    Typically, the Ph.D. degree is said to be more research-oriented, whereas the Ed.D. degree is aimed more at the educational practitioner. The two degrees were compared with regard to research design, statistics, target populations for inference of findings, and other characteristics. A sample of 1,007 Ph.D. and 960 Ed.D dissertations was selected…

  15. EdTrAc Teacher Education Program: First-Year Implementation Evaluation (2005-2006)

    ERIC Educational Resources Information Center

    Pittman, Brian; Shelton, Ellen

    2006-01-01

    The Educational Training Academy (EdTrAc) is an NSF-funded project of Normandale Community College to increase the number, diversity, and skills of students preparing to be elementary and middle school teachers with a specialty in math and science. Overall, this evaluation indicates that the EdTrAc implementation is on track after its first year…

  16. "What about Bilingualism?" A Critical Reflection on the edTPA with Teachers of Emergent Bilinguals

    ERIC Educational Resources Information Center

    Kleyn, Tatyana; López, Dina; Makar, Carmina

    2015-01-01

    Amidst the debates surrounding teacher quality and preparation programs, the edTPA (education Teaching Performance Assessment) has emerged to assess future teachers through a portfolio-based certification process. This study offers the perspective of three faculty members who participated in an experimental configuration of edTPA implementation…

  17. The Prevalence of Eating Disorders in Co-Ed versus Single-Sex Residence Halls.

    ERIC Educational Resources Information Center

    Berg, Kathleen M.

    1988-01-01

    Investigated incidence of eating disorders among 584 women living in university residence halls and differences in prevalence rates between single-sex and co-ed floors. Results revealed a significantly higher incidence of bulimic symptomatology on co-ed floors than on single-sex floors. (Author/NB)

  18. Variation in opioid prescribing patterns between ED providers.

    PubMed

    Smulowitz, Peter B; Cary, Chris; Boyle, Katherine L; Novack, Victor; Jagminas, Liudvikas

    2016-12-01

    Abuse of opioid prescription drugs has become an epidemic across the developed world. Despite the fact that emergency physicians overall account for a small proportion of total opioids prescribed, the number of prescriptions has risen dramatically in the past decade and, to some degree, contributes to the available supply of opioids in the community, some of which are diverted for non-medical use. Since successfully reducing opioid prescribing on the individual level first requires knowledge of current prescribing patterns, we sought to determine to what extent variation exists in opioid prescribing patterns at our institution. This was a single-institution observational study at a community hospital with an annual ED volume of 47,000 visits. We determined the number of prescriptions written by each provider, both total number and accounting for the number of patients seen. Our primary outcome measure was the level of variation at the physician level for number of prescriptions written per patient. We also identified the mean number of pills written per prescription. We analyzed data from November 13, 2014 through July 31, 2015 for 21 full-time providers. There were a total of 2211 prescriptions for opioids written over this time period for a total of 17,382 patients seen. On a per-patient basis, the rate of opioid prescriptions written per patient during this period was 127 per 1000 visits (95 % CI 122-132). There was a variation on the individual provider level, with rates ranging from 33 per to 332 per 1000 visits. There was also substantial variation by provider in the number of pills written per prescription with coefficient of variation (standard deviation divided by mean) averaged over different opioids ranging from 16 to 40 %. There was significant variation in opioid prescribing patterns at the individual physician level, even when accounting for the number of patients seen.

  19. ED patients: how nonurgent are they? Systematic review of the emergency medicine literature.

    PubMed

    Durand, Anne-Claire; Gentile, Stéphanie; Devictor, Bénédicte; Palazzolo, Sylvie; Vignally, Pascal; Gerbeaux, Patrick; Sambuc, Roland

    2011-03-01

    Nonurgent visits to emergency departments (ED) are a controversial issue; they have been negatively associated with crowding and costs. We have conducted a critical review of the literature regarding methods for categorizing ED visits into urgent or nonurgent and analyzed the proportions of nonurgent ED visits. We found 51 methods of categorization. Seventeen categorizations conducted prospectively in triage areas were based on somatic complaint and/or vital sign collection. Categorizations conducted retrospectively (n = 34) were based on the diagnosis, the results of tests obtained during the ED visit, and hospital admission. The proportions of nonurgent ED visits varied considerably: 4.8% to 90%, with a median of 32%. Comparisons of methods of categorization in the same population showed variability in levels of agreement. Our review has highlighted the lack of reliability and reproducibility. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Arsenic and Old Mustard: Chemical Problems of Old Arsenical and 'Mustard' Munitions (Joseph F. Bunnett and Marian Mikotajczyk, Eds.)

    NASA Astrophysics Data System (ADS)

    Garrett, Benjamin

    1999-10-01

    technologies; and international obligations attendant to the Chemical Weapons Convention, which entered into force in 1997. Hermann Martens's presentation of German arsenical and mustard munitions and of technical approaches to their destruction is similarly detailed, thorough, and engaging. W. R. Cullen's chapter "Arsenic in the Environment" and Shigeru Maeda's chapter "Biotransformation of Arsenic in Freshwater Organisms" help place the problems associated with the arsenicals in their environmental context and, hence, should appeal to a large audiencenot merely those specialists dealing with chemical weapon destruction. The reports of the three discussion groupsYperite,3 Arsenicals, and Recovered Munitionsprovide useful summaries of current knowledge and needs for additional research. The Arsenicals report observes that "destruction of arsenical agents appears to have received little attention." This situation may change if searches in Washington, DC, should uncover caches of old arsenicals at CUA and, especially, when the governments of the People's Republic of China and Japan agree on funding for destruction of the chemical munitions Japan caused to be abandoned on what is now the territory of the PRC. A conservative estimate is that there are 2,000,000 of these abandoned munitions, most of them being arsenicals and mustards.4 Notes and References 1. Nieuwland (1878-1936) hired Rockne in 1914 as a chemistry instructor. According to Father Nieuwland, Rockne owed much of his prowess as one of the greatest coaches of all time to his training in chemistry, which taught him the method of reasoning (Ind. Eng. Chem. New Ed., April 20, 1931). W. Lee Lewis, Lewisite's eponym, credits Nieuwland's unpublished dissertation as the source for his 1918 synthesis (Lewis, W. L.; Perkins, G. A. The beta-Chlorovinyl Chloroarsines; Ind. Eng. Chem. 1923, 15, 290-295). Lewisite itself is actually the group of mono-, di-, and tri-substituted 2-chloroethenyl derivatives of arsenic(III) chloride

  1. Predicting frequent ED use by people with epilepsy with health information exchange data.

    PubMed

    Grinspan, Zachary M; Shapiro, Jason S; Abramson, Erika L; Hooker, Giles; Kaushal, Rainu; Kern, Lisa M

    2015-09-22

    To describe (1) the predictability of frequent emergency department (ED) use (a marker of inadequate disease control and/or poor access to care), and (2) the demographics, comorbidities, and use of health services of frequent ED users, among people with epilepsy. We obtained demographics, comorbidities, and 2 years of encounter data for 8,041 people with epilepsy from a health information exchange in New York City. Using a retrospective cohort design, we explored bivariate relationships between baseline characteristics (year 1) and subsequent frequent ED use (year 2). We then built, evaluated, and compared predictive models to identify frequent ED users (≥4 visits year 2), using multiple techniques (logistic regression, lasso, elastic net, CART [classification and regression trees], Random Forests, AdaBoost, support vector machines). We selected a final model based on performance and simplicity. People with epilepsy who, in year 1, were adults (rather than children or seniors), male, Manhattan residents, frequent users of health services, users of multiple health systems, or had medical, neurologic, or psychiatric comorbidities, were more likely to frequently use the ED in year 2. Predictive techniques identified frequent ED visitors with good positive predictive value (approximately 70%) but poor sensitivity (approximately 20%). A simple strategy, selecting individuals with 11+ ED visits in year 1, performed as well as more sophisticated models. People with epilepsy with 11+ ED visits in a year are at highest risk of continued frequent ED use and may benefit from targeted intervention to avoid preventable ED visits. Future work should focus on improving the sensitivity of predictions. © 2015 American Academy of Neurology.

  2. Evaluation of Exxon Donor Solvent (EDS) coal-derived liquid as utility diesel fuel. Final report

    SciTech Connect

    Heater, W.R.; Froh, T.W.; Ariga, S.; Baker, Q.A.; Piispanen, W.; Webb, P.; Trayser, D.; Keane, W.J.

    1983-10-01

    The program consisted of three phases: (I) characterization of the physical and chemical properties of EDS, (II) evaluation of EDS in a laboratory medium-speed diesel engine, and (III) evaluation of EDS in a low-speed diesel engine operating at a utility. The characteristics of high aromatic content and low cetane number that were found during Phase I made it unlikely that EDS could be used as a direct substitute for diesel fuel without engine modification to provide ignition assistance. Phase II was conducted on a 12-cylinder General Electric Company 7FDL diesel engine. Blends of up to 30% EDS and 70% 0.2 diesel fuel (DF-2) were successfully consumed. Dual fuel tests were also conducted on a single cylinder by injecting EDS through the existing engine fuel oil system and injecting DF-2 through an auxiliary nozzle as an ignition source. Acceptable operation was achieved using 5 to 10% pilot oil heat input. Phase III was conducted on a 16-cylinder Cooper-Bessemer LSV-16-GDT diesel engine at an EUC plant in Easton, Maryland. Blends of up to 66.7% EDS and 33.3% DF-2 were successfully consumed. Dual fuel tests were also conducted on a single cylinder by injecting EDS through the existing fuel oil system and using a natural-gas-fueled precombustion chamber as an ignition source. Acceptable operation was achieved using 3 to 6% pilot gas heat input. The program confirmed that it is feasible to consume significant proportions of EDS in a diesel engine, but more development is needed before EDS can be considered a viable alternative liquid fuel for diesel engines, and an industrial hygiene program is needed to assure safe handling of the fuel.

  3. Urinary oncofetal ED-A fibronectin correlates with poor prognosis in patients with bladder cancer.

    PubMed

    Arnold, Shanna A; Loomans, Holli A; Ketova, Tatiana; Andl, Claudia D; Clark, Peter E; Zijlstra, Andries

    2016-01-01

    The extracellular matrix protein fibronectin (FN) contributes to the structural integrity of tissues as well as the adhesive and migratory functions of cells. While FN is abundantly expressed in adult tissues, the expression of several alternatively spliced FN isoforms is restricted to embryonic development, tissue remodeling and cancer. These FN isoforms, designated ED-A and ED-B, are frequently expressed by cancer cells, tumor-associated fibroblasts and newly forming blood vessels. Using a highly sensitive collagen-based indirect ELISA, we evaluated the correlation of urinary ED-A and ED-B at time of cystectomy with overall survival in patients with high-grade bladder cancer (BCa). Detectable levels of total FN as well as ED-A and ED-B were found in urine from 85, 73 and 51 % of BCa patients, respectively. The presence of urinary ED-A was a significant independent predictor of 2-year overall survival (OS) after adjusting for age, tumor stage, lymph node stage, and urinary creatinine by multivariable Logistic Regression (p = 0.029, OR = 4.26, 95 % CI 1.16-15.71) and improved accuracy by 3.6 %. Furthermore, detection of ED-A in the urine was a significant discriminator of survival specifically in BCa patients with negative lymph node status (Log-Rank, p = 0.006; HR = 5.78, 95 % CI 1.39-24.13). Lastly, multivariable Cox proportional hazards analysis revealed that urinary ED-A was an independent prognostic indicator of 5-year OS rate for patients with BCa (p = 0.04, HR = 2.20, 95 % CI 1.04-4.69). Together, these data suggest that cancer-derived, alternatively spliced FN isoforms can act as prognostic indicators and that additional studies are warranted to assess the clinical utility of ED-A in BCa.

  4. Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions

    PubMed Central

    Flanigan, Moira; Heilman, James A.; Johnson, Tom; Yarris, Lalena M.

    2015-01-01

    Introduction The Accreditation Council for Graduate Medical Education requires that residency programs ensure resident competency in performing safe, effective handoffs. Understanding resident, attending, and nurse perceptions of the key elements of a safe and effective emergency department (ED) handoff is a crucial step to developing feasible, acceptable educational interventions to teach and assess this fundamental competency. The aim of our study was to identify the essential themes of ED-based handoffs and to explore the key cultural and interprofessional themes that may be barriers to developing and implementing successful ED-based educational handoff interventions. Methods Using a grounded theory approach and constructivist/interpretivist research paradigm, we analyzed data from three primary and one confirmatory focus groups (FGs) at an urban, academic ED. FG protocols were developed using open-ended questions that sought to understand what participants felt were the crucial elements of ED handoffs. ED residents, attendings, a physician assistant, and nurses participated in the FGs. FGs were observed, hand-transcribed, audio-recorded and subsequently transcribed. We analyzed data using an iterative process of theme and subtheme identification. Saturation was reached during the third FG, and the fourth confirmatory group reinforced the identified themes. Two team members analyzed the transcripts separately and identified the same major themes. Results ED providers identified that crucial elements of ED handoff include the following: 1) Culture (provider buy-in, openness to change, shared expectations of sign-out goals); 2) Time (brevity, interruptions, waiting); 3) Environment (physical location, ED factors); 4) Process (standardization, information order, tools). Conclusion Key participants in the ED handoff process perceive that the crucial elements of intershift handoffs involve the themes of culture, time, environment, and process. Attention to these

  5. EdU induces DNA damage response and cell death in mESC in culture.

    PubMed

    Kohlmeier, Fanni; Maya-Mendoza, Apolinar; Jackson, Dean A

    2013-03-01

    Recently, a novel DNA replication precursor analogue called 5-ethynyl-2'-deoxyuridine (EdU) has been widely used to monitor DNA synthesis as an alternative to bromodeoxyuridine. Use of EdU benefits from simplicity and reproducibility and the simple chemical detection systems allows excellent preservation of nuclear structure. However, the alkyne moiety is highly reactive, raising the possibility that incorporation might compromise genome stability. To assess the extent of possible DNA damage, we have analysed the effect of EdU incorporation into DNA during short- and long-term cell culture using a variety of cell lines. We show that EdU incorporation has no measurable impact on the rate of elongation of replication forks during synthesis. However, using different cell lines we find that during long-term cell culture variable responses to EdU incorporation are seen, which range from delayed cell cycle progression to complete cell cycle arrest. The most profound phenotypes were seen in mouse embryonic stem cells, which following incorporation of EdU accumulated in the G2/M-phase of the cell cycle before undergoing apoptosis. In long-term cell culture, EdU incorporation also triggered a DNA damage response in all cell types analysed. Our study shows that while EdU is extremely useful to tag sites of on-going replication, for long-term studies (i.e. beyond the cell cycle in which labelling is performed), a careful analysis of cell cycle perturbations must be performed in order to ensure that any conclusions made after EdU treatment are not a direct consequence of EdU-dependent activation of cell stress responses.

  6. Sex differences in frequent ED use among those with multimorbid chronic diseases.

    PubMed

    Milani, Sadaf A; Crooke, Hannah; Cottler, Linda B; Striley, Catherine W

    2016-11-01

    The objectives were to examine the association between multimorbid chronic disease and frequency of past 6 months emergency department (ED) visits, by sex, in a community sample of adults from North Florida (N=7143). Data came from HealthStreet, a community engagement program at the University of Florida which uses the Community Health Worker Model to assess community member health conditions and concerns, and willingness to participate in health research. Using logistic regression, we estimated associations between multimorbid chronic disease and frequent ED use using sex as an effect modifier. Multimorbid chronic disease was associated with frequent ED use overall, with a stronger association among men. Of the 7143 respondents, 14.4% were frequent ED users, 58.0% were female, and 61.5% were black non-Hispanic. Major findings included that women with 3+ chronic diseases were 2.49 (95% confidence interval, 1.7-3.6) times as likely as women without chronic diseases to report frequent ED use, compared with men with 3+ chronic diseases, who were 4.98 (95% confidence interval, 2.9-8.6) times as likely as men without chronic disease to report frequent ED use. Multimorbid chronic disease is very strongly associated with frequent ED use among all, but the association is especially strong among men. Future research is needed to further understand this association and its implication for health care. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma☆,☆☆,★

    PubMed Central

    Vogel, Jody A.; Seleno, Nicole; Hopkins, Emily; Colwell, Christopher B.; Gravitz, Craig; Haukoos, Jason S.

    2016-01-01

    Background Early identification of trauma patients at risk for inhospital mortality may facilitate goal-directed resuscitation and secondary triage to improve outcomes. The objective of this study was to compare prognostic accuracies of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, ED Sequential Organ Failure Assessment (SOFA) score, and ED base deficit and ED lactate for inhospital mortality in adult trauma patients. Methods Consecutive adult trauma patients from 2005 to 2008 from the Denver Health Trauma Registry were included. Prognostic accuracies of the Denver ED TOF Score, ED SOFA score, ED base deficit, and ED lactate for inhospital mortality were evaluated with receiver operating characteristic curves. Results Of the 4355 patients, the median age was 37 years (interquartile range [IQR], 26-51 years), median Injury Severity Score was 9 (IQR, 4-16), and 81% had blunt mechanisms. In addition, 38% (1670 patients) were admitted to the intensive care unit with a median intensive care unit length of stay of 2.5 days (IQR, 1-8 days), and 3% (138 patients) died. The areas under the receiver operating characteristic curves for the Denver ED TOF, ED lactate, ED base deficit, and ED SOFA were 0.94 (95% confidence interval [CI], 0.94-0.96), 0.88 (95% CI, 0.85-0.91), 0.82 (95% CI, 0.78-0.86), and 0.78 (95% CI, 0.73-0.82), respectively. Conclusions The Denver ED TOF Score more accurately predicts inhospital mortality in adult trauma patients compared to the ED SOFA score, ED base deficit, or ED lactate. The Denver ED TOF Score may help identify patients early who are at risk for mortality, allowing for targeted resuscitation and secondary triage to improve outcomes PMID:26254505

  8. Does primary stroke center certification change ED diagnosis, utilization, and disposition of patients with acute stroke?

    PubMed

    Ballard, Dustin W; Reed, Mary E; Huang, Jie; Kramer, Barbara J; Hsu, John; Chettipally, Uli

    2012-09-01

    We examined the impact of primary stroke center (PSC) certification on emergency department (ED) use and outcomes within an integrated delivery system in which EDs underwent staggered certification. A retrospective cohort study of 30,461 patients seen in 17 integrated delivery system EDs with a primary diagnosis of transient ischemic attack (TIA), intracranial hemorrhage, or ischemic stroke between 2005 and 2008 was conducted. We compared ED stroke patient visits across hospitals for (1) temporal trends and (2) pre- and post-PSC certification-using logistic and linear regression models to adjust for comorbidities, patient characteristics, and calendar time, to examine major outcomes (ED throughput time, hospital admission, radiographic imaging utilization and throughput, and mortality) across certification stages. There were 15,687 precertification ED visits and 11,040 postcertification visits. Primary stroke center certification was associated with significant changes in care processes associated with PSC certification process, including (1) ED throughput for patients with intracranial hemorrhage (55 minutes faster), (2) increased utilization of cranial magnetic resonance imaging for patients with ischemic stroke (odds ratio, 1.88; 95% confidence interval, 1.36-2.60), and (3) decrease in time to radiographic imaging for most modalities, including cranial computed tomography done within 6 hours of ED arrival (TIA: 12 minutes faster, ischemic stroke: 11 minutes faster), magnetic resonance imaging for patients with ischemic stroke (197 minutes faster), and carotid Doppler sonography for TIA patients (138 minutes faster). There were no significant changes in survival. Stroke center certification was associated with significant changes in ED admission and radiographic utilization patterns, without measurable improvements in survival. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Perceptions of participating emergency nurses regarding an ED seasonal influenza vaccination program.

    PubMed

    Venkat, Arvind; Hunter, Roger; Hegde, Gajanan G; Chan-Tompkins, Noreen H; Chuirazzi, David M; Szczesiul, Jillian M

    2012-01-01

    Numerous professional organizations have recommended that emergency departments provide influenza vaccine to patients. However, no study has reported on the perceptions of participating emergency nurses regarding ED influenza vaccination programs. We conducted an anonymous Web-based survey to assess the post-participation perceptions of emergency nurses regarding an ED influenza vaccination protocol. The vaccination protocol occurred at an urban, academic emergency department and was designed to be performed by emergency nurses without added staffing resources by using ED Electronic Medical Record technology. Data from the Web-based survey were analyzed using descriptive statistics and χ(2) analysis to assess significant associations of where emergency nurses believed the protocol was time inefficient. The ED influenza vaccination protocol was in effect from October 1-25, 2009, with 3091 eligible ED visits and 613 patients receiving ED seasonal influenza vaccination. Fifty-eight of 59 participating emergency nurses (98%) responded to the survey. Significant findings were that 59% of responding emergency nurses found the protocol too time consuming and believed it was inappropriate in the ED setting. Responding emergency nurses reported that protocol efficiency could be improved by adding staff, simplifying screening and vaccination documentation requirements, and improving vaccine supply and stocking procedures in the emergency department. A majority of surveyed emergency nurses who had participated in an ED influenza vaccination program reported that the protocol was too time consuming and inappropriate for the ED setting. Surveyed emergency nurses expressed the opinion that such protocols required added staff, simplified patient consent/vaccination documentation requirements, and improved vaccine supply and stocking processes. Copyright © 2012 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  10. Resource utilization and health care charges associated with the most frequent ED users.

    PubMed

    Ondler, Cory; Hegde, G G; Carlson, Jestin N

    2014-10-01

    Emergency department (ED) visits have continued to rise, and frequent ED users account for up to 8% of all ED visits. Reducing visits by frequent ED users may be one way to help reduce health care costs. We hypothesize that frequent users have unique ED utilization patterns resulting in differences in health care charges. We conducted a retrospective review of electronic medical records from an urban community teaching hospital for the year 2012 comparing the top 108 frequent ED users (>12 visits/year) to a randomly selected group of 108 nonfrequent users (<4 visits/year). We compared demographic characteristics, distance lived from the hospital, medical and psychiatric history, substance abuse history, diagnostic testing, disposition, and amount charged to the patient for each visit. We compared data using χ(2) for proportions and t test or Wilcoxon rank sum based on normality of the data. The top 108 frequent ED users accounted for 1922 visits (2.9%), whereas the 108 nonfrequent users accounted for 150 visits (0.2%), in 2012 (all ED visits n = 65,398). Frequent users were more often unemployed, have public insurance, have mental health conditions, use tobacco, have a greater number of allergies to medications, and live closer to the hospital (P < .01). Disposition and median charge per visit did not differ between frequent and nonfrequent users ($1220 vs $1280). The total charges of the frequent ED users' visits were $10,465,216.07 versus $1,012,610.21 for nonfrequent users. Frequent users have unique medical and social characteristics; however, disposition and visit charges did not differ from nonfrequent users. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Increased door to admission time is associated with prolonged throughput for ED patients discharged home.

    PubMed

    Krall, Scott P; Guardiola, Jose; Richman, Peter B

    2016-09-01

    Emergency Department (ED) service evaluations are typically based on surveys of discharged patients. Physicians/administrators benefit from data that quantifies system-based factors that adversely impact the experience of those who represent the survey cohort. While investigators have established that admitted patient boarding impacts overall ED throughput times, we sought to specifically quantify the relationship between throughput times for patients admitted (EDLOS) versus discharged home from the ED (DCLOS). We performed a prospective analysis of consecutive patient encounters at an inner-city ED. Variables collected: median daily DCLOS for ED patients, ED daily census, left without being seen (LWBS), median door to doctor, median room to doctor, and daily number admitted. Admitted patients divided into 2 groups based on daily median EDLOS for admits (<6 hours, ≥6 hours). Continuous variables analyzed by t-tests. Multivariate regression utilized to identify independent effects of the co-variants on median daily DCLOS. We analyzed 24,127 patient visits. ED patient DCLOS was longer for patients seen on days with prolonged EDLOS (193.7 minutes, 95%CI 186.7-200.7 vs. 152.8, 144.9-160.5, P< .0001). Variables that were associated with increased daily median EDLOS for admits included: daily admits (P= 0.01), room to doctor time (P< .01), number of patients that left without being seen (P< .01). When controlling for the covariate daily census, differences in DCLOS remained significant for the ≥6 hours group (189.4 minutes, 95%CI 184.1-194.7 vs. 164.8, 155.7-173.9 (P< .0001). Prolonged ED stays for admitted patients were associated with prolonged throughput times for patients discharged home from the ED. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Impact of a national time target for ED length of stay on patient outcomes.

    PubMed

    Jones, Peter; Wells, Susan; Harper, Alana; Le Fevre, James; Stewart, Joanna; Curtis, Elana; Reid, Papaarangi; Ameratunga, Shanthi

    2017-05-12

    The impact of national targets for emergency department (ED) length of stay (LOS) on patient care is unclear. This study aimed to determine the effect of New Zealand's six-hour time target (95% of ED patients discharged or admitted to hospital within six hours) on a range of quality indicators. A nationwide observational study from 2006 to 2012 modelled differences in changes over time before and after target introduction in 2009. The observed model estimates in 2012 were compared to those predicted if pre-target trends had continued. Differences are absolute values except for morality, which is presented as a relative change. There were 5,793,767 ED presentations and 2,082,374 elective admissions from 18 out of a possible 20 district health boards included in the study. There were clinically important reductions in hospital LOS (-0.29 days), EDLOS (-1.1 hours), admitted patients EDLOS (-2.9 hours), ED crowding (-26.8%), ED mortality (-57.8%), elective inpatient mortality (-42.2%) and the proportion not waiting for assessment (-2.8%). Small changes were seen in time to assessment in the ED (-3.4 minutes), re-presentation to ED within 48 hours of the index ED discharge (-0.7%), re-presentation to ED within 48 hours from ward discharge (+0.4%) and acute admissions (+3.9%). An increase was observed in re-admission to a ward within 30 days of discharge (1.0%). These changes were all statistically significant (p<0.001). Most outcomes we investigated either improved or were unchanged after the introduction of the time target policy in New Zealand. However, attention is required to ensure that reductions in hospital length of stay are not at the expense of subsequent re-admissions.

  13. Making Improvements in the ED: Does ED Busyness Affect Time to Antibiotics in Febrile Pediatric Oncology Patients Presenting to the Emergency Department?

    PubMed

    Benner, Christopher A; Mora, Erika; Mueller, Emily; Seagull, F Jacob; Walkovich, Kelly; Johnson, Kaleena; Halverson, Schuyler; Rothman, Ed; Hucks, George; Younger, John G; Nypaver, Michele M

    2016-10-04

    Febrile neutropenic pediatric patients are at heightened risk for serious bacterial infections, and rapid antibiotic administration (in <60 minutes) improves survival. Our objectives were to reduce the time-to-antibiotic (TTA) administration and to evaluate the effect of overall emergency department (ED) busyness on TTA. This study was a quality improvement initiative with retrospective chart review to reduce TTA in febrile children with underlying diagnosis of cancer or hematologic immunodeficiency who visited the pediatric ED. A multidisciplinary clinical practice guideline (CPG) was implemented to improve TTA. The CPG's main focus was delivery of antibiotics before availability of laboratory data. We collected data on TTA during baseline and intervention periods. Concurrent patient arrivals to the ED per hour served as a proxy of busyness. Time to antibiotic was compared with the number of concurrent arrivals per hour. Analyses included scatter plot and regression analysis. There were 253 visits from October 1, 2010 to March 30, 2012. Median TTA administration dropped from 207 to 89 minutes (P < 0.001). Eight months after completing all intervention periods, the median had dropped again to 44 minutes with 70% of patients receiving antibiotics within 60 minutes of ED arrival. There was no correlation between concurrent patient arrivals and TTA administration during the historical or intervention periods. Implementation of a CPG and process improvements significantly reduced median TTA administration. Total patient arrivals per hour as a proxy of ED crowding did not affect TTA administration. Our data suggest that positive improvements in clinical care can be successful despite fluctuations in ED patient volume.

  14. New levitation scheme with AC superconducting magnet for EDS MAGLEV system

    SciTech Connect

    Kim, D.H.; Lee, J.K.; Hahn, S.Y.; Cha, G.

    1996-09-01

    This paper proposes a new magnetic levitation scheme which is able to generate levitation force for all speeds including a standstill. Auxiliary wheels which are needed in EDS MAGLEV vehicle can be eliminated. This scheme uses AC superconducting magnets to generate levitation force. In this paper, magnetic fields, forces and power dissipations generated by AC magnets moving above a conducting slab are calculated analytically. Results of calculation show characteristics of EDS system with AC magnet, such as levitation force and loss, are superior to those of EDS system with DC magnets for all speeds.

  15. Rapid Primary Care Follow-up from the ED to Reduce Avoidable Hospital Admissions.

    PubMed

    Carmel, Amanda S; Steel, Peter; Tanouye, Robert; Novikov, Aleksey; Clark, Sunday; Sinha, Sanjai; Tung, Judy

    2017-08-01

    Hospital admissions from the emergency department (ED) now account for approximately 50% of all admissions. Some patients admitted from the ED may not require inpatient care if outpatient care could be optimized. However, access to primary care especially immediately after ED discharge is challenging. Studies have not addressed the extent to which hospital admissions from the ED may be averted with access to rapid (next business day) primary care follow-up. We evaluated the impact of an ED-to-rapid-primary-care protocol on avoidance of hospitalizations in a large, urban medical center. We conducted a retrospective review of patients referred from the ED to primary care (Weill Cornell Internal Medicine Associates - WCIMA) through a rapid-access-to-primary-care program developed at New York-Presbyterian / Weill Cornell Medical Center. Referrals were classified as either an avoided admission or not, and classifications were performed by both emergency physician (EP) and internal medicine physician reviewers. We also collected outcome data on rapid visit completion, ED revisits, hospitalizations and primary care engagement. EPs classified 26 (16%) of referrals for rapid primary care follow-up as avoided admissions. Of the 162 patients referred for rapid follow-up, 118 (73%) arrived for their rapid appointment. There were no differences in rates of ED revisits or subsequent hospitalizations between those who attended the rapid follow-up and those who did not attend. Patients who attended the rapid appointment were significantly more likely to attend at least one subsequent appointment at WCIMA during the six months after the index ED visit [N=55 (47%) vs. N=8 (18%), P=0.001]. A rapid-ED-to-primary-care-access program may allow EPs to avoid admitting patients to the hospital without risking ED revisits or subsequent hospitalizations. This protocol has the potential to save costs over time. A program such as this can also provide a safe and reliable ED discharge option

  16. Study: wait times continue to lengthen--visits increase as EDS disappear.

    PubMed

    2008-03-01

    Despite seemingly insurmountable odds, several ED managers have been able to reduce wait times--in many cases, quite dramatically. Here are some of the strategies they say will help you decrease those waiting times: Create a chest pain policy that focuses not only on getting patients back as quickly as possible, but also frontloads your work force. Encourage staff to bring EKG results to the ED doc as soon as they are obtained. When seeking important hospitalwide changes, remind your board of the political consequences of a poor ED image.

  17. All-Natural Tips to Improve Your Sex Life: Exercise, Diet Changes May Help Reverse ED (Erectile Dysfunction)

    MedlinePlus

    ... your inbox ! All-natural tips to improve your sex life Exercise, diet changes may help reverse ED ... problem , may reverse your ED and improve your sex life. They are easy to adopt and enrich ...

  18. Plant Growth/Plant Phototropism - Skylab Student Experiment ED-61/62

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment ED-61, Plant Growth, and experiment ED-62, Plant Phototropism. Two similar proposals were submitted by Joel G. Wordekemper of West Point, Nebraska, and Donald W. Schlack of Downey, California. Wordekemper's experiment (ED-61) was to see how the lack of gravity would affect the growth of roots and stems of plants. Schlack's experiment (ED-62) was to study the effect of light on a seed developing in zero gravity. The growth container of the rice seeds for their experiment consisted of eight compartments arranged in two parallel rows of four. Each had two windowed surfaces to allow periodic photography of the developing seedlings. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  19. A Win-Win Relationship: Re-ED and Child Psychiatry.

    ERIC Educational Resources Information Center

    Jewell, Steven W.

    2002-01-01

    There has been a tension between the traditional deficit and disease models of child psychiatry and the strength-based Re-ED (Reeducation of Emotional Disturbed Children) model. This child psychiatrist shares his struggle to blend these perspectives. (Author)

  20. Biological effects of a maternal ED on pregnancy and foetal development: a review.

    PubMed

    Micali, Nadia; Treasure, Janet

    2009-11-01

    The aim of this paper was to review the literature on the biological effects of a maternal eating disorder (ED) (and relevant comorbidities) in pregnancy on mothers and in particular on the foetus. We also aimed to highlight possible mechanisms of risk for long-term consequences in the offspring. Relevant literature was searched for using PubMed, PsychInfo and Google Scholar and manually through relevant research papers. The consequences of maternal EDs in pregnancy on EDs symptoms, psychopathology and perinatal outcomes are discussed. A developmental model of possible risk mechanisms for adverse long-term nutritional and psychopathological outcomes in the offspring is proposed. Maternal EDs during pregnancy are likely to have important long-term biological effects on the foetus. Further research needs to clarify potential biological risk mechanisms highlighted in this review.

  1. Activities during the "Bob Hope Special" for the Ed White Memorial Benefit.

    NASA Image and Video Library

    2009-10-08

    Activities during the "Bob Hope Special" for the Ed White Memorial Benefit. Left to right : Mayor of Houston Louie Welch, Bob Hope, Astronaut Jack Swigert , Astronaut Deke Slayton, Sig Sjoberg, Astronaut Fred Haise.

  2. Plant Growth/Plant Phototropism - Skylab Student Experiment ED-61/62

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment ED-61, Plant Growth, and experiment ED-62, Plant Phototropism. Two similar proposals were submitted by Joel G. Wordekemper of West Point, Nebraska, and Donald W. Schlack of Downey, California. Wordekemper's experiment (ED-61) was to see how the lack of gravity would affect the growth of roots and stems of plants. Schlack's experiment (ED-62) was to study the effect of light on a seed developing in zero gravity. The growth container of the rice seeds for their experiment consisted of eight compartments arranged in two parallel rows of four. Each had two windowed surfaces to allow periodic photography of the developing seedlings. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  3. 48 CFR 3452.232-70 - Prohibition against the use of ED funds to influence legislation or appropriations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... use of ED funds to influence legislation or appropriations. 3452.232-70 Section 3452.232-70 Federal... PROVISIONS AND CONTRACT CLAUSES Texts of Provisions and Clauses 3452.232-70 Prohibition against the use of ED... 3432.770: Prohibition Against the Use of ED Funds To Influence Legislation or Appropriations (APR...

  4. 48 CFR 3432.770 - Prohibition against the use of ED funds to influence legislation or appropriations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... use of ED funds to influence legislation or appropriations. 3432.770 Section 3432.770 Federal... CONTRACT FINANCING Contract Funding 3432.770 Prohibition against the use of ED funds to influence... Against the Use of ED Funds to Influence Legislation or Appropriations, in contracts with...

  5. 20 CFR 641.360 - How does the State Plan relate to the equitable distribution (ED) report?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... equitable distribution (ED) report? 641.360 Section 641.360 Employees' Benefits EMPLOYMENT AND TRAINING... equitable distribution (ED) report? The two documents address some of the same areas, and are prepared at different points in time. The ED report is prepared by State agencies at the beginning of each fiscal...

  6. Using PAs in prehospital environments to reduce ED and EMS overuse.

    PubMed

    Thompson, Katherine M; Tozier, William L

    2017-04-01

    Emergency medical services (EMS) and EDs in large cities are burdened with a significant number of patients with chronic disease who have limited options for receiving proper care. Despite their relatively small numbers, these "superusers" can have a significant effect on EMS, particularly in large cities. Additionally, EDs are not designed to provide chronic and continuous healthcare. This article describes how several organizations use physician assistants to manage these patients.

  7. Timeliness of interfacility transfer for ED patients with ST-elevation myocardial infarction.

    PubMed

    Ward, Michael J; Kripalani, Sunil; Storrow, Alan B; Liu, Dandan; Speroff, Theodore; Matheny, Michael; Thomassee, Eric J; Vogus, Timothy J; Munoz, Daniel; Scott, Carol; Fredi, Joseph L; Dittus, Robert S

    2015-03-01

    Most US hospitals lack primary percutaneous coronary intervention (PCI) capabilities to treat patients with ST-elevation myocardial infarction (STEMI) necessitating transfer to PCI-capable centers. Transferred patients rarely meet the 120-minute benchmark for timely reperfusion, and referring emergency departments (EDs) are a major source of preventable delays. We sought to use more granular data at transferring EDs to describe the variability in length of stay at referring EDs. We retrospectively analyzed a secondary data set used for quality improvement for patients with STEMI transferred to a single PCI center between 2008 and 2012. We conducted a descriptive analysis of the total time spent at each referring ED (door-in-door-out [DIDO] interval), periods that comprised DIDO (door to electrocardiogram [EKG], EKG-to-PCI activation, and PCI activation to exit), and the relationship of each period with overall time to reperfusion (medical contact-to-balloon [MCTB] interval). We identified 41 EDs that transferred 620 patients between 2008 and 2012. Median MCTB was 135 minutes (interquartile range [IQR] 114,172). Median overall ED DIDO was 74 minutes (IQR 56,103) and was composed of door to EKG, 5 minutes (IQR 2,11); EKG-to-PCI activation, 18 minutes (IQR 7,37); and PCI activation to exit, 44 minutes (IQR 34,56). Door-in door-out accounted for the largest proportion (60%) of overall MCTB and had the largest variability (coefficient of variability, 1.37) of these intervals. In this cohort of transferring EDs, we found high variability and substantial delays after EKG performance for patients with STEMI. Factors influencing ED decision making and transportation coordination after PCI activation are a potential target for intervention to improve the timeliness of reperfusion in patients with STEMI. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. National differences between ED and ambulatory visits for suicidal ideation and attempts and depression.

    PubMed

    Chakravarthy, Bharath; Toohey, Shannon; Rezaimehr, Yalda; Anderson, Craig L; Hoonpongsimanont, Wirachin; Menchine, Michael; Lotfipour, Shahram

    2014-05-01

    Many suicidal and depressed patients are seen in emergency departments (EDs), whereas outpatient visits for depression remain high. The primary objective of the study is to determine a relationship between the incidence of suicidal and depressed patients presenting to EDs and the incidence of depressed patients presenting to outpatient clinics. The secondary objective is to analyze trends among suicidal patients. The National Hospital Ambulatory Medical Care Survey and the National Ambulatory Medical Care Survey were screened to provide a sampling of ED and outpatient visits, respectively. Suicidal and depressed patients presenting to EDs were compared with depressed patients presenting to outpatient clinics. Subgroup analyses included age, sex, race/ethnicity, method of payment, regional variation, and urban verses rural distribution. Emergency department visits for depression (1.16% of visits in 2002) and suicide attempts (0.51% of visits in 2002) remained stable over the years. Office visits for depression decreased from 3.14% of visits in 2002 to 2.65% of visits in 2008. Non-Latino whites had a higher percentage of ED visits for depression and suicide attempt and office visits for depression than other groups. The percentage of ED visits for suicide attempt resulting in hospital admission decreased by 2.06% per year. From 2002 to 2008, the percentage of outpatient visits for depression decreased, whereas ED visits for depression and suicide remained stable. When examined in the context of a decreasing prevalence of depression among adults, we conclude that an increasing percentage of the total patients with depression are being evaluated in the ED, vs outpatient clinics. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Characteristics of patients who accept and decline ED rapid HIV testing.

    PubMed

    Schechter-Perkins, Elissa M; Koppelman, Elisa; Mitchell, Patricia M; Morgan, Jake R; Kutzen, Randie; Drainoni, Mari-Lynn

    2014-09-01

    Understanding differences between patients who accept and decline HIV testing is important for developing methods to reduce decliner rates among patients at risk for undiagnosed HIV. The objectives of this study were to determine the rates of acceptance and reasons for declining, and to determine if differences exist in patient or visit characteristics between those who accept and decline testing. This was a retrospective medical record review of all patients offered an emergency department (ED) HIV test from 11/1/11 to 10/31/12. Patient demographic characteristics, health characteristics, and ED visit characteristics were compared to assess differences between those who accept and those who decline testing. Of 4510 ED patients offered an HIV test, 3470 accepted for an acceptance rate of 77%. The most common reasons for declining were "no perceived risk" and "tested in the last 3 months." Those who accepted testing were more likely to be unmarried, less than age 35, Hispanic or African American, Spanish speaking, foreign born, have no primary care provider, report no pain at triage, have a daytime ED visit, and be discharged from the ED compared to admitted. Sex, employment status, and ED length of stay did not affect whether patients accepted testing. Acceptance of ED-based rapid HIV testing is not universal, and there are both patient and visit characteristics consistently associated with declining testing. This detracts from the goal of using the ED to screen a large number of at-risk patients who do not have access to testing elsewhere. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Magnitude of national ED visits and resource utilization by the uninsured.

    PubMed

    Carlson, Jestin N; Menegazzi, James J; Callaway, Clifton W

    2013-04-01

    For nearly 51 million persons in the United States who lack health care insurance, the emergency department (ED) functions as a safety net where no patient is denied care based on ability to pay, and much public rhetoric has characterized ED utilization by uninsured patients. We estimated national ED utilization by uninsured patients and compared uninsured and insured ED patients in terms of demographics, diagnostic testing, disposition and final diagnoses. We analyzed data from the National Hospital Ambulatory Medical Care Survey (2006-2009) stratified by insurance status. Demographic data, diagnoses, testing, and procedures performed in the ED were tabulated for each visit. Weighted percentages provided by National Hospital Ambulatory Medical Care Survey were used to estimate national rates for each variable, and multivariate models were constructed for predicting testing, procedures, and admission. The 135085 ED visits represent 475 million patients visits, of which 78.9 million (16.6%) were uninsured. Compared with insured patients, uninsured patients were more often male (51.1% vs 44.3%) and younger (age 18-44 years, 66.2% vs 35.4%). Uninsured patients had lower rates of circulatory/cardiovascular (7.5% vs 4.1%) and respiratory diagnoses (14.6% vs 11.8%). Uninsured patients had fewer diagnostic tests and procedures and fewer hospital admissions than those with insurance. In our multivariate models, insurance status was predictive of testing and procedures but not hospital admission. Uninsured patients account for approximately 20 million or 1 in 6 ED visits annually in the United States and have differences in demographics, diagnoses, and ED utilization patterns from those with insurance. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED.

    PubMed

    Zanobetti, Maurizio; Scorpiniti, Margherita; Gigli, Chiara; Nazerian, Peiman; Vanni, Simone; Innocenti, Francesca; Stefanone, Valerio T; Savinelli, Caterina; Coppa, Alessandro; Bigiarini, Sofia; Caldi, Francesca; Tassinari, Irene; Conti, Alberto; Grifoni, Stefano; Pini, Riccardo

    2017-06-01

    Acute dyspnea is a common symptom in the ED. The standard approach to dyspnea often relies on radiologic and laboratory results, causing excessive delay before adequate therapy is started. Use of an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis, while maintaining an acceptable safety profile. Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled. The gold standard was the final diagnosis assessed by two expert reviewers. Two physicians independently evaluated the patient; a sonographer performed an ultrasound evaluation of the lung, heart, and inferior vena cava, while the treating physician requested traditional tests as needed. Time needed to formulate the ultrasound and the ED diagnoses was recorded and compared. Accuracy and concordance of the ultrasound and the ED diagnoses were calculated. A total of 2,683 patients were enrolled. The average time needed to formulate the ultrasound diagnosis was significantly lower than that required for ED diagnosis (24 ± 10 min vs 186 ± 72 min; P = .025). The ultrasound and the ED diagnoses showed good overall concordance (κ = 0.71). There were no statistically significant differences in the accuracy of PoCUS and the standard ED evaluation for the diagnosis of acute coronary syndrome, pneumonia, pleural effusion, pericardial effusion, pneumothorax, and dyspnea from other causes. PoCUS was significantly more sensitive for the diagnosis of heart failure, whereas a standard ED evaluation performed better in the diagnosis of COPD/asthma and pulmonary embolism. PoCUS represents a feasible and reliable diagnostic approach to the patient with dyspnea, allowing a reduction in time to diagnosis. This protocol could help to stratify patients who should undergo a more detailed evaluation. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  12. The attitudes and awareness of emergency department (ED) physicians towards the management of common dentofacial emergencies.

    PubMed

    Trivedy, Chetan; Kodate, Naonori; Ross, Alastair; Al-Rawi, Harrith; Jaiganesh, Thiagarajan; Harris, Tim; Anderson, Janet E

    2012-04-01

    Dentofacial emergencies are a common presentation to the emergency department (ED) but there is little recent data on physicians' knowledge, confidence and attitudes in handling these cases. A questionnaire was administered to 103 ED physicians. The sample was primarily drawn from London hospitals as well a smaller contribution from around the UK and included physicians with a range of experience and at different grades. The majority of the 102 participants (76.5%) did not receive any formal training in managing dentofacial emergencies. The percentage of participants who were happy to manage common dentofacial emergencies is as follows: dental trauma (20.4%); major facial trauma (39.8%); interpreting facial X-rays (68.0%); and facial suturing (85.4%). When questioned 12.1% of the participants felt that ED physicians should be responsible for managing dental emergencies compared to 22.4% who felt that ED physicians should manage maxillofacial emergencies. Only 3.9% of the participants would opt to be treated by an ED doctor in the event of them presenting to the ED with a dental injury. The remaining 72.5% would prefer to be seen by a maxillofacial surgeon, 23.5% by a dentist and none of the participants opted to be seen by the emergency nurse practitioner. ED physicians do not feel confident in managing some dentofacial emergencies. This may be attributed to a lack of training in this area as well as exposure to these types of emergencies. There is a need for greater awareness, validated guidelines and training resources for ED physicians to treat dentofacial emergencies as well more research in this field of emergency medicine. © 2011 John Wiley & Sons A/S.

  13. Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial.

    PubMed

    Cunningham, Rebecca M; Chermack, Stephen T; Ehrlich, Peter F; Carter, Patrick M; Booth, Brenda M; Blow, Frederic C; Barry, Kristen L; Walton, Maureen A

    2015-10-01

    This study examined the efficacy of emergency department (ED)-based brief interventions (BIs), delivered by a computer or therapist, with and without a post-ED session, on alcohol consumption and consequences over 12 months. Patients (ages 14-20 years) screening positive for risky drinking were randomized to: BI (n = 277), therapist BI (n = 278), or control (n = 281). After the 3-month follow-up, participants were randomized to receive a post-ED BI session or control. Incorporating motivational interviewing, the BIs addressed alcohol consumption and consequences, including driving under the influence (DUI), and alcohol-related injury, as well as other concomitant drug use. The computer BI was an offline, Facebook-styled program. Among 4389 patients screened, 1054 patients reported risky drinking and 836 were enrolled in the randomized controlled trial. Regression models examined the main effects of the intervention conditions (versus control) and the interaction effects (ED condition × post-ED condition) on primary outcomes. The therapist and computer BIs significantly reduced consumption at 3 months, consequences at 3 and 12 months, and prescription drug use at 12 months; the computer BI reduced the frequency of DUI at 12 months; and the therapist BI reduced the frequency of alcohol-related injury at 12 months. The post-ED session reduced alcohol consequences at 6 months, benefiting those who had not received a BI in the ED. A single-session BI, delivered by a computer or therapist in the ED, shows promise for underage drinkers. Findings for the fully automated stand-alone computer BI are particularly appealing given the ease of future implementation. Copyright © 2015 by the American Academy of Pediatrics.

  14. ED-HOME: Improving educator confidence and patient education in the Emergency Department.

    PubMed

    Coombs, Nicole M; Porter, Joanne E; Beauchamp, Alison

    2016-08-01

    Barriers to effective patient communication in the emergency department (ED) are well recognised; time, resources and staff and consumer expectations. This project aimed to improve the quality of health education provided in the ED by increasing nurses' confidence as educators. By providing a staff information package including the introduction of a new structured education tool; ED-HOME, and by assessing the confidence and self-efficacy of the nurses in the process, we hoped to determine if an improvement in practice and confidence was achieved. A quantitative, pre and post-test questionnaire comparison study was undertaken before and after a four week implementation period. The project examined the attitudes and practices of registered emergency nurses and was conducted in one metropolitan emergency department. Results indicated that nurse confidence and self-efficacy improved by using the new structured ED-HOME format and both staff satisfaction and education competence increased. Participants positively responded to the new tool and recommended future use in the ED. This project demonstrates that if emergency nurses feel more confident with their educating practices and by using a structured format, patients will benefit from better quality patient education provided in the ED. Copyright © 2016 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  15. Using demand analysis and system status management for predicting ED attendances and rostering.

    PubMed

    Ong, Marcus Eng Hock; Ho, Khoy Kheng; Tan, Tiong Peng; Koh, Seoh Kwee; Almuthar, Zain; Overton, Jerry; Lim, Swee Han

    2009-01-01

    It has been observed that emergency department (ED) attendances are not random events but rather have definite time patterns and trends that can be observed historically. To describe the time demand patterns at the ED and apply systems status management to tailor ED manpower demand. Observational study of all patients presenting to the ED at the Singapore General Hospital during a 3-year period was conducted. We also conducted a time series analysis to determine time norms regarding physician activity for various severities of patients. The yearly ED attendances increased from 113387 (2004) to 120764 (2005) and to 125773 (2006). There was a progressive increase in severity of cases, with priority 1 (most severe) increasing from 6.7% (2004) to 9.1% (2006) and priority 2 from 33.7% (2004) to 35.1% (2006). We noticed a definite time demand pattern, with seasonal peaks in June, weekly peaks on Mondays, and daily peaks at 11 to 12 am. These patterns were consistent during the period of the study. We designed a demand-based rostering tool that matched doctor-unit-hours to patient arrivals and severity. We also noted seasonal peaks corresponding to public holidays. We found definite and consistent patterns of patient demand and designed a rostering tool to match ED manpower demand.

  16. Insulin Resistance Is an Independent Determinate of ED in Young Adult Men

    PubMed Central

    Zheng, Fufu; Ou, Yangbin; Tu, Xiangan; Zhang, Yadong; Gao, Yong; Chen, Xin; Zheng, Tao; Yang, Qiyun; Wan, Zi; Zhang, Yuanyuan; Sun, Xiangzhou; Liu, Guihua; Deng, Chunhua

    2013-01-01

    Background Insulin resistance (IR) triggers endothelial dysfunction, which contributes to erectile dysfunction (ED) and cardiovascular disease. Aim To evaluate whether IR was related to ED in young adult patients. Methods A total of 283 consecutive men complaining of ED at least six months were enrolled, with a full medical history, physical examination, and laboratory tests collected. Quantitative Insulin Sensitivity Check Index (QUICKI) was used to determine IR. The severity of ED was assessed by IIEF-5 questionnaire. Endothelial function was assessed by ultrasonographic examination of brachial artery flow mediated dilation (FMD). Results IR was detected in 52% patients. Subjects with IR had significant higher total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-c), glycated haemoglobin (HBA1c), high sensitivity C-reactive protein (hs-CRP) and body mass index (BMI), but showed significant lower IIEF-5 score, FMD%, high density lipoprotein -cholesterol (HDL-c), testosterone, sex hormone binding globulin (SHBG) levels than patients without IR. Multiple regression analysis showed QUICKI and testosterone were independent predictors of IIEF-5 score. Furthermore, the incidence of IR was correlated with the severity of ED. Conclusions Compared with other CVFs, IR was found as the most prevalent in our subjects. Besides, IR was independently associated with ED and its severity, suggesting an adverse effect of insulin resistance on erectile function. PMID:24391852

  17. Chemical analysis and biological testing of materials from the EDS coal liquefaction process: a status report

    SciTech Connect

    Later, D.W.; Pelroy, R.A.; Wilson, B.W.

    1984-05-01

    Representative process materials were obtained from the EDS pilot plant for chemical and biological analyses. These materials were characterized for biological activity and chemical composition using a microbial mutagenicity assay and chromatographic and mass spectrometric analytical techniques. The two highest boiling distillation cuts, as well as process solvent (PS) obtained from the bottoms recycle mode operation, were tested for initiation of mouse skin tumorigenicity. All three materials were active; the crude 800/sup 0 +/F cut was substantially more potent than the crude bottoms recycle PS or 750 to 800/sup 0/F distillate cut. Results from chemical analyses showed the EDS materials, in general, to be more highly alkylated and have higher hydroaromatic content than analogous SRC II process materials (no in-line process hydrogenation) used for comparison. In the microbial mutagenicity assays the N-PAC fractions showed greater activity than did the aliphatic hydrocarbon, hydroxy-PAH, or PAH fractions, although mutagenicity was detected in certain PAH fractions by a modified version of the standard microbial mutagenicity assay. Mutagenic activities for the EDS materials were lower, overall, than those for the corresponding materials from the SRC II process. The EDS materials produced under different operational modes had distinguishable differences in both their chemical constituency and biological activity. The primary differences between the EDS materials studied here and their SRC II counterparts used for comparison are most likely attributable to the incorporation of catalytic hydrogenation in the EDS process. 27 references, 28 figures, 27 tables.

  18. The influence of physician seniority on disparities of admit/discharge decision making for ED patients.

    PubMed

    Wu, Kuan-Han; Chen, I-Chuan; Li, Chao-Jui; Li, Wen-Cheng; Lee, Wen-Huei

    2012-10-01

    Differences in disposition between emergency physicians (EPs) have been studied in select patient populations but not in general emergency department (ED) patients. After determining whether a difference existed in admit/discharge decision making of EPs for general ED patients, we focus our study in examining the influence of EP seniority on the decision to discharge ED patients. In a 1-year retrospective study, we included a convenience sample of all 18 953 adult nontraumatic ED patients. We reviewed the admit/discharge dispositions at each shift made by 16 EPs. EPs were categorized by seniority to determine whether seniority influenced disposition. Three groups had 5, 4, and 7 EPs each, with >10 years, 5 to 9 years, and <5 years of working experience, respectively. Patient demographics, triage level, and number of patients per shift did not differ statistically between EPs and each group. The number of discharged patients per shift differed statistically between EPs (P < .001) and each group. The most senior EPs had the lowest discharge rates compared with EPs in intermediate and junior groups. They had lower discharge rates for patients at triage levels 1, 2, and 3 as well as for all patients. However, no difference in unscheduled ED revisit rates was found. EPs vary in their admit/discharge decision making for general ED patients. More importantly, the most senior EPs were found to have the lowest discharge rates compared with their junior colleagues. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Solving the worldwide emergency department crowding problem - what can we learn from an Israeli ED?

    PubMed

    Pines, Jesse M; Bernstein, Steven L

    2015-01-01

    ED crowding is a prevalent and important issue facing hospitals in Israel and around the world, including North and South America, Europe, Australia, Asia and Africa. ED crowding is associated with poorer quality of care and poorer health outcomes, along with extended waits for care. Crowding is caused by a periodic mismatch between the supply of ED and hospital resources and the demand for patient care. In a recent article in the Israel Journal of Health Policy Research, Bashkin et al. present an Ishikawa diagram describing several factors related to longer length of stay (LOS), and higher levels of ED crowding, including management, process, environmental, human factors, and resource issues. Several solutions exist to reduce ED crowding, which involve addressing several of the issues identified by Bashkin et al. This includes reducing the demand for and variation in care, and better matching the supply of resources to demands in care in real time. However, what is needed to reduce crowding is an institutional imperative from senior leadership, implemented by engaged ED and hospital leadership with multi-disciplinary cross-unit collaboration, sufficient resources to implement effective interventions, access to data, and a sustained commitment over time. This may move the culture of a hospital to facilitate improved flow within and across units and ultimately improve quality and safety over the long-term.

  20. Bio-EdIP: An automatic approach for in vitro cell confluence images quantification.

    PubMed

    Cardona, Andrés; Ariza-Jiménez, Leandro; Uribe, Diego; Arroyave, Johanna C; Galeano, July; Cortés-Mancera, Fabian M

    2017-07-01

    Cell imaging is a widely-employed technique to analyze multiple biological processes. Therefore, simple, accurate and quantitative tools are needed to understand cellular events. For this purpose, Bio-EdIP was developed as a user-friendly tool to quantify confluence levels using cell culture images. The proposed algorithm combines a pre-processing step with subsequent stages that involve local processing techniques and a morphological reconstruction-based segmentation algorithm. Segmentation performance was assessed in three constructed image sets, comparing F-measure scores and AUC values (ROC analysis) for Bio-EdIP, its previous version and TScratch. Furthermore, segmentation results were compared with published algorithms using eight public benchmarks. Bio-EdIP automatically segmented cell-free regions from images of in vitro cell culture. Based on mean F-measure scores and ROC analysis, Bio-EdIP conserved a high performance regardless of image characteristics of the constructed dataset, when compared with its previous version and TScratch. Although acquisition quality of the public dataset affected Bio-EdIP segmentation, performance was better in two out of eight public sets. Bio-EdIP is a user-friendly interface, which is useful for the automatic analysis of confluence levels and cell growth processes using in vitro cell culture images. Here, we also presented new manually annotated data for algorithms evaluation. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Edward (Ed) T. Schneider in Front of SR-71 Blackbird

    NASA Technical Reports Server (NTRS)

    1995-01-01

    SR-71 research pilot Ed Schneider is pictured here in front of an SR-71 Blackbird on the ramp at the Dryden Flight Research Center, Edwards, California. Schneider became a NASA research pilot at Dryden in 1983. Data from the SR-71 program will be used to aid designers of future supersonic aircraft and propulsion systems. He retired as a NASA research pilot in September 2000. Two SR-71 aircraft have been used by NASA as testbeds for high-speed and high-altitude aeronautical research. The aircraft, an SR-71A and an SR-71B pilot trainer aircraft, have been based here at NASA's Dryden Flight Research Center, Edwards, California. They were transferred to NASA after the U.S. Air Force program was cancelled. As research platforms, the aircraft can cruise at Mach 3 for more than one hour. For thermal experiments, this can produce heat soak temperatures of over 600 degrees Fahrenheit (F). This operating environment makes these aircraft excellent platforms to carry out research and experiments in a variety of areas -- aerodynamics, propulsion, structures, thermal protection materials, high-speed and high-temperature instrumentation, atmospheric studies, and sonic boom characterization. The SR-71 was used in a program to study ways of reducing sonic booms or over pressures that are heard on the ground, much like sharp thunderclaps, when an aircraft exceeds the speed of sound. Data from this Sonic Boom Mitigation Study could eventually lead to aircraft designs that would reduce the 'peak' overpressures of sonic booms and minimize the startling affect they produce on the ground. One of the first major experiments to be flown in the NASA SR-71 program was a laser air data collection system. It used laser light instead of air pressure to produce airspeed and attitude reference data, such as angle of attack and sideslip, which are normally obtained with small tubes and vanes extending into the airstream. One of Dryden's SR-71s was used for the Linear Aerospike Rocket Engine, or

  2. Extensive FE-SEM/EDS, HR-TEM/EDS and ToF-SIMS studies of micron- to nano-particles in anthracite fly ash.

    PubMed

    Ribeiro, Joana; DaBoit, Kátia; Flores, Deolinda; Kronbauer, Marcio A; Silva, Luis F O

    2013-05-01

    The generation of anthropogenic carbonaceous matter and mixed crystalline/amorphous mineral ultrafine/nano-particles in the 1 to 100 nm size range by worldwide coal power plants represents serious environmental problems due to their potential hazards. Coal fly ash (CFA) that resulted from anthracite combustion in a Portuguese thermal power plant was studied in this work. The physico-chemical characterization of ultrafine/nano-particles present in the CFA samples and their interaction with environment are the aim of this study. The methodologies applied for this work were field emission scanning electron microscopy (FE-SEM) with energy dispersive X-ray spectroscopy (EDS), high-resolution transmission electron microscopy with energy dispersive X-ray spectroscopy (HR-TEM/EDS) and time of flight secondary ion mass spectrometry (ToF-SIMS). Some hazardous volatile elements, C, N, S and Hg contents were also determined in the studied samples. Generally, the CFA samples comprise carbonaceous, glassy and metallic solid spheres with some containing mixed amorphous/crystalline phases. The EDS analysis coupled with the FE-SEM and HR-TEM observations of the fly ash particles with 100 to 0.1 nm demonstrates that these materials contain a small but significant proportion of encapsulated HVEs. In addition, the presence of abundant multi-walled carbon nanotubes (MWCNTs) and amorphous carbon particles, both containing hazardous volatile elements (HVEs), was also evidenced by the FE-SEM/EDS and HR-TEM/EDS analysis. A wide range of organic and inorganic compounds was determined by chemical maps obtained in ToF-SIMS analysis.

  3. Comparison of UTI antibiograms stratified by ED patient  disposition.

    PubMed

    Grodin, Lee; Conigliaro, Alyssa; Lee, Song-Yi; Rose, Michael; Sinert, Richard

    2017-09-01

    Institutional antibiograms guide Emergency Department (ED) clinicians' empiric antibiotic selection. For this study, we created and compared antibiograms of ED patients stratified by disposition (admitted or discharged). We conducted a cross-sectional study at two hospitals for 2014, comparing antibiograms limited to Escherichia coli urinary tract infections. Study-Specific Antibiograms, created for the study, excluded polymicrobial samples and multiple cultures from the same patient. Study-Specific Antibiograms were arranged by patient disposition: admitted (IP-Only) vs discharged from the ED (ED-Only). Antibiogram data were presented as average antibiotic sensitivities with 95% confidence intervals and demographic data as medians with interquartile ranges. Sensitivities between Study-Specific Antibiograms were compared by Fisher's Exact Test, alpha=0.05, 2 tails. For Hospital A, 13 antibiotics were compared between Study-Specific ED-Only (n=313) vs IP-Only (n=244). We found that sensitivities to all four antibiotics appropriate for empiric outpatient therapy by Infectious Disease Society of America guidelines were significantly (p<0.0001) higher in the ED-Only compared to IP-Only groups: ciprofloxacin 80% (76-90%) vs 60% (53-69%), levofloxacin 81% (77-91%) vs 63% (57-72%), nitrofurantoin 75% (70-84%) vs 51% (44-58%), and trimethoprim/sulfamethoxazole 73% (68-82%) vs 58% (52-67%). For Hospital B, 14 antibiotics were compared between Study-Specific ED-Only (n=256) and IP-Only (n=168). Two out of the five appropriate empiric outpatient antibiotics had significantly (p<0.0001) higher sensitivities for ED-Only compared to IP-Only: ciprofloxacin 87% (83-91%) vs 71% (64-78%) and levofloxacin 86% (82-91%) vs 71% (65-78%). We found higher antibiotic sensitivities in ED-Only than the IP-Only Study-Specific Antibiograms. Our Study-Specific Antibiograms offer an alternative guide for antibiotic selection in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Cell type specific applicability of 5-ethynyl-2'-deoxyuridine (EdU) for dynamic proliferation assessment in flow cytometry.

    PubMed

    Diermeier-Daucher, Simone; Clarke, Scott T; Hill, Dani; Vollmann-Zwerenz, Arabel; Bradford, Jolene A; Brockhoff, Gero

    2009-06-01

    Using the nucleoside analogue EdU (5-ethynyl-2'-deoxyuridine) for thymidine substitution instead of BrdU (5-bromo-2'-deoxyuridine) in cell proliferation assays has recently been proposed. However, the effect of EdU on cell viability, DNA synthesis, and cell cycle progression and consequently its usability for dynamic cell proliferation analysis in vitro has not been explored. We compared the effect of EdU and BrdU incorporation into SK-BR-3 and BT474 breast cancer cells and the impact on cell cycle kinetics, cell viability, and DNA damage. We found that EdU can be used not only for pulse but also for continuous cell labeling and henceforth in high resolution EdU/Hoechst quenching assays. BrdU and EdU proliferation assays based on click chemistry revealed comparable results. However, cell viability of SK-BR-3 breast cancer cells was highly affected by long term exposure to EdU. Both SK-BR-3 as well as BT474 cells show cell cycle arrests upon long term EdU treatment whereas only SK-BR-3 cells were driven into necrotic cell death by long term exposure to EdU. In contrast BT474 cells appeared essentially unharmed by EdU treatment in terms of viability. Consequently using EdU enables highly sensitive and quantitative detection of proliferating cells and facilitates even continuous cell cycle assessment. Nevertheless, potential cellular susceptibility needs to be individually evaluated.

  5. Why Do Cancer Patients Die in the Emergency Department? An Analysis of 283 Deaths in NC EDs

    PubMed Central

    Leak, Ashley; Mayer, Deborah K.; Wyss, Annah; Travers, Debbie; Waller, Anna

    2013-01-01

    Emergency department (ED) visits are made by cancer patients for symptom management, treatment effects, oncologic emergencies, or end of life care. While most patients prefer to die at home, many die in health care institutions. The purpose of this study is to describe visit characteristics of cancer patients who died in the ED and their most common chief complaints using 2008 ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). Of the 37,760 cancer-related ED visits, 283 resulted in death. For lung cancer patients, 104 died in the ED with 70.9% dying on their first ED visit. Research on factors precipitating ED visits by cancer patients is needed to address end of life care needs. PMID:22556288

  6. Why do cancer patients die in the emergency department?: an analysis of 283 deaths in NC EDs.

    PubMed

    Leak, Ashley; Mayer, Deborah K; Wyss, Annah; Travers, Debbie; Waller, Anna

    2013-03-01

    Emergency department (ED) visits are made by cancer patients for symptom management, treatment effects, oncologic emergencies, or end of life care. While most patients prefer to die at home, many die in health care institutions. The purpose of this study is to describe visit characteristics of cancer patients who died in the ED and their most common chief complaints using 2008 ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). Of the 37,760 cancer-related ED visits, 283 resulted in death. For lung cancer patients, 104 died in the ED with 70.9% dying on their first ED visit. Research on factors precipitating ED visits by cancer patients is needed to address end of life care needs.

  7. Understanding non-emergency patients admitted to hospitals through the emergency department for efficient ED functions.

    PubMed

    Hwang, Jee-In; Chang, Hyejung

    2010-05-01

    ED overcrowding and inefficient flow are closely related to the presence of non-emergency patients. This study aims to examine the characteristics of the non-emergency patients admitted to hospitals through the emergency department by comparison with emergency ED patients and inpatients admitted through outpatient departments, in terms of patient demographics and health care utilization and outcomes. This study used an exploratory descriptive design. The retrospective data of 280,104 patients from 38 hospitals were analyzed. chi(2) Tests and logistic regression analyses were performed to determine significant differences among the 3 patient groups. Among the patients admitted through the emergency department, 13.1% were non-emergency patients. These non-emergency ED patients showed different health care utilization characteristics: 42.8% had 4 or more diagnoses, 90.3% had 5 or more laboratory tests, and 89.4% had radiology tests. After we controlled for patient characteristics and health care utilization variables, mortality risk of emergency ED patients was 2-fold higher than that of non-emergency ED patients and standard inpatients (odds ratio, 2.1), but the referral rate to other facilities on discharge was the highest in non-emergency ED patients compared with standard inpatients (odds ratio, 3.3). Non-emergency patients admitted to hospitals through the emergency department showed special needs for health care services: care continuity, improved access, and fast tracking for acute care hospital-level treatment. Health care policies and strategies are suggested for efficient ED functions. Copyright 2010. Published by Mosby, Inc.

  8. Effect of a redesigned fracture management pathway and 'virtual' fracture clinic on ED performance.

    PubMed

    Vardy, J; Jenkins, P J; Clark, K; Chekroud, M; Begbie, K; Anthony, I; Rymaszewski, L A; Ireland, A J

    2014-06-13

    Collaboration between the orthopaedic and emergency medicine (ED) services has resulted in standardised treatment pathways, leaflet supported discharge and a virtual fracture clinic review. Patients with minor, stable fractures are discharged with no further follow-up arranged. We aimed to examine the time taken to assess and treat these patients in the ED along with the rate of unplanned reattendance. A retrospective study was undertaken that covered 1 year before the change and 1 year after. Prospectively collected administrative data from the electronic patient record system were analysed and compared before and after the change. An ED and orthopaedic unit, serving a population of 300 000, in a publicly funded health system. 2840 patients treated with referral to a traditional fracture clinic and 3374 patients managed according to the newly redesigned protocol. Time for assessment and treatment of patients with orthopaedic injuries not requiring immediate operative management, and 7-day unplanned reattendance. Where plaster backslabs were replaced with removable splints, the consultation time was reduced. There was no change in treatment time for other injuries treated by the new discharge protocol. There was no increase in unplanned ED attendance, related to the injury, within 7 days (p=0.149). There was a decrease in patients reattending the ED due to a missed fracture clinic appointment. This process did not require any new time resources from the ED staff. This process brought significant benefits to the ED as treatment pathways were agreed. The pathway reduced unnecessary reattendance of patients at face-to-face fracture clinics for a review of stable, self-limiting injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Hospitalizations and return visits after chronic obstructive pulmonary disease ED visits.

    PubMed

    Lippmann, Steven J; Yeatts, Karin B; Waller, Anna E; Hassmiller Lich, Kristen; Travers, Debbie; Weinberger, Morris; Donohue, James F

    2013-09-01

    The aim of this study was to describe population-based patterns of chronic obstructive pulmonary disease (COPD)-related emergency department (ED) visits. We analyzed all COPD-related ED visits made by North Carolina residents 45 years or older in 2008 to 2009 using statewide surveillance system data. Return visits were identified when patients returned to the same ED within 3 or 14 days of a prior COPD-related visit. We quantify the prevalence of hospitalization and return visits by age, sex, and payment method and describe ED disposition patterns. Nearly half (46.3%) of the 97 511 COPD-related ED visits resulted in hospital admission. The percent of visits preceded by another COPD-related visit within 3 and 14 days was 1.6% and 6.2%, respectively. Emergency department-related hospitalizations increased with age; there were no differences by sex. Hospitalizations were less likely for uninsured, Medicare, and Medicaid visits than for privately insured visits. In contrast, 3- and 14-day return visits were more likely to be uninsured, Medicare, and Medicaid visits than privately insured visits. Fourteen-day returns were more likely to be made by men. Return visits initially increased with age compared with the 45- to 49-year age group, then decreased steadily after age 65 years. When return visits were made, discharge at both visits was the most common disposition pattern. However, 33.7% of 3-day returns and 22.7% of 14-day returns were discharged at the first visit and hospitalized upon returning to the ED. Chronic obstructive pulmonary disease-related hospital admissions and short-term return ED visits were common and varied by age and insurance status. Chronic obstructive pulmonary disease management remains a critical area for intervention and quality improvement. © 2013.

  10. Frequent ED users: are most visits for mental health, alcohol, and drug-related complaints?

    PubMed

    Liu, Shan W; Nagurney, John T; Chang, Yuchiao; Parry, Blair A; Smulowitz, Peter; Atlas, Steven J

    2013-10-01

    To determine whether frequent emergency department (ED) users are more likely to make at least one and a majority of visits for mental health, alcohol, or drug-related complaints compared to non-frequent users. We performed a retrospective cohort study exploring frequent ED use and ED diagnosis at a single, academic hospital and included all ED patients between January 1 and December 31, 2010. We compared differences in ED visits with a primary International Classification of Diseases, 9th Revision visit diagnosis of mental health, alcohol or drug-related diagnoses between non-frequent users (<4 visits during previous 12-months) and frequent (repeat [4-7 visits], highly frequent [8-18 visits] and super frequent [≥19 visits]) users in univariate and multivariable analyses. Frequent users (2496/65201 [3.8%] patients) were more likely to make at least one visit associated with mental health, alcohol, or drug-related diagnoses. The proportion of patients with a majority of visits related to any of the three diagnoses increased from 5.8% among non-frequent users (3616/62705) to 9.4% among repeat users (181/1926), 13.1% among highly frequent users (62/473), and 25.8% (25/97 patients) in super frequent users. An increasing proportion of visits with alcohol-related diagnoses was observed among repeat, highly frequent, and super frequent users but was not found for mental health or drug-related complaints. Frequent ED users were more likely to make a mental health, alcohol or drug-related visit, but a majority of visits were only noted for those with alcohol-related diagnoses. To address frequent ED use, interventions focusing on managing patients with frequent alcohol-related visits may be necessary. © 2013.

  11. The prehospital and hospital costs of emergency care for frequent ED patients.

    PubMed

    Solberg, Robert G; Edwards, Brandy L; Chidester, Jeffrey P; Perina, Debra G; Brady, William J; Williams, Michael D

    2016-03-01

    Frequent emergency department (ED) use has been identified as a cause of ED overcrowding and increasing health care costs. Studies have examined the expense of frequent patients (FPs) to hospitals but have not added the cost Emergency Medical Services (EMS) to estimate the total cost of this pattern of care. Data on 2012 ED visits to a rural Level I Trauma Center and public safety net hospital were collected through a deidentified patient database. Transport data and 2012 Medicare Reimbursement Schedules were used to estimate the cost of EMS transport. Health information, outcomes, and costs were compared to find differences between the FP and non-FP group. This study identified 1242 FPs who visited the ED 5 or more times in 2012. Frequent patients comprised 3.25% of ED patients but accounted for 17% of ED visits and 13.7% of hospital costs. Frequent patients had higher rates of chronic disease, severity scores, and mortality. Frequent patients arrived more often via ambulance and accounted for 32% of total transports at an estimated cost of $2.5-$3.2 million. Hospital costs attributable to FPs were $29.1 million, bringing the total cost of emergency care to $31.6-$32.3 million, approximately $25,000 per patient. This study demonstrates that the inclusion of a prehospital cost estimate adds approximately 10% to the cost of care for the FP population. In addition to improving care for a sick population of patients, programs that reduce frequent EMS and ED use have the potential to produce a favorable cost benefit to communities and health systems. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Modelling the growth of Populus species using Ecosystem Demography (ED) model

    NASA Astrophysics Data System (ADS)

    Wang, D.; Lebauer, D. S.; Feng, X.; Dietze, M. C.

    2010-12-01

    Hybrid poplar plantations are an important source being evaluated for biomass production. Effective management of such plantations requires adequate growth and yield models. The Ecosystem Demography model (ED) makes predictions about the large scales of interest in above- and belowground ecosystem structure and the fluxes of carbon and water from a description of the fine-scale physiological processes. In this study, we used a workflow management tool, the Predictive Ecophysiological Carbon flux Analyzer (PECAn), to integrate literature data, field measurement and the ED model to provide predictions of ecosystem functioning. Parameters for the ED ensemble runs were sampled from the posterior distribution of ecophysiological traits of Populus species compiled from the literature using a Bayesian meta-analysis approach. Sensitivity analysis was performed to identify the parameters which contribute the most to the uncertainties of the ED model output. Model emulation techniques were used to update parameter posterior distributions using field-observed data in northern Wisconsin hybrid poplar plantations. Model results were evaluated with 5-year field-observed data in a hybrid poplar plantation at New Franklin, MO. ED was then used to predict the spatial variability of poplar yield in the coterminous United States (United States minus Alaska and Hawaii). Sensitivity analysis showed that root respiration, dark respiration, growth respiration, stomatal slope and specific leaf area contribute the most to the uncertainty, which suggests that our field measurements and data collection should focus on these parameters. The ED model successfully captured the inter-annual and spatial variability of the yield of poplar. Analyses in progress with the ED model focus on evaluating the ecosystem services of short-rotation woody plantations, such as impacts on soil carbon storage, water use, and nutrient retention.

  13. The acute asthmatic patient in the ED: to admit or discharge.

    PubMed

    Brenner, B; Kohn, M S

    1998-01-01

    Treating asthma in the emergency department (ED) always involves the potentially difficult decision as to whether to discharge the patient, to continue treatment, or to admit to the hospital. The following are useful guidelines. (1) The duration of the bronchospasm, frequency of visits, history of previous endotracheal intubation, pulse rate, and accessory muscle use are findings affecting successful discharge from the ED. (2) Patients with peak expiratory flow rate (PEFR) of < 20% and who do not respond to inhalant therapy, with PEFR values persisting at < 40% of predicted, will require 4 or more days to resolve and should be admitted to the hospital. (3) Patients with a PEFR between 40% and 70% of predicted after initial inhalant therapy may well be responsive to steroids in the ED, but an ED will adequately need to care for the patient for 5 to 12 hours while waiting for the onset of action of glucocorticoids. Discharged with glucocorticoids, this group has a 6% relapse rate within 10 days of the ED visit. (4) Patients with a PEFR of > or = 70% have a 14% relapse rate after discharge without glucocorticoids. Other reasons to consider admission are pneumonia, barotrauma, lability, prominent psychiatric difficulties, poor access to medications, poor educability, fear of steroids, patients on glucocorticoids or those who have recently stopped glucocorticoids, and evening discharges of patients from the ED, which all predispose to relapses of acute asthma. To decrease the relapse rate, provocative factors should be reviewed with the patient, as well as access to medication and use of spacers, inhaler techniques, PEFR meters, self-management plans, and referral to a defined appointment at 24 to 48 hours of the ED visit.

  14. Flow cytometric analysis of T lymphocyte proliferation in vivo by EdU incorporation.

    PubMed

    Sun, Xiaojing; Zhang, Chunpan; Jin, Hua; Sun, Guangyong; Tian, Yue; Shi, Wen; Zhang, Dong

    2016-12-01

    Monitoring T lymphocyte proliferation, especially in vivo, is essential for the evaluation of adaptive immune reactions. Flow cytometry-based proliferation assays have advantages in measuring cell division of different T lymphocyte subsets at the same time by multicolor labelling. In this study, we aimed to establish the use of 5-Ethynyl-2'-deoxyuridine (EdU) incorporation in vivo to monitor T lymphocyte proliferation by flow cytometry with an adoptive transfer model. We found that fixation followed by permeabilization preserved T cell surface antigens and had no obvious effects on the fluorescence intensity of APC, PE, PE-Cy7, FITC and PerCP-Cy5.5 when the concentration of the permeabilization reagents was optimized. However, the click reaction resulted in a significant decrease in the fluorescence intensity of PE and PE-Cy7, and surface staining after the click reaction improved the fluorescence intensity. Thus, an extra step of blocking with PBS with 3% FBS between the click reaction and cell surface staining is needed. Furthermore, the percentage of EdU-positive cells increased in a dose-dependent manner, and the saturated dose of EdU was 20mg/kg. Intraperitoneal and intravenous injection had no differences in lymphocyte proliferation detection with EdU in vivo. In addition, T cell proliferation measured by EdU incorporation was comparable to BrdU but was lower than CFSE labelling. In conclusion, we optimized the protocols for EdU administration in vivo and staining in vitro, providing a feasible method for the measurement of T lymphocyte proliferation with EdU incorporation by flow cytometry in vivo.

  15. Suicide Prevention in an Emergency Department Population: The ED-SAFE Study.

    PubMed

    Miller, Ivan W; Camargo, Carlos A; Arias, Sarah A; Sullivan, Ashley F; Allen, Michael H; Goldstein, Amy B; Manton, Anne P; Espinola, Janice A; Jones, Richard; Hasegawa, Kohei; Boudreaux, Edwin D

    2017-06-01

    Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped. To determine whether an ED-initiated intervention reduces subsequent suicidal behavior. This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013. Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk. The primary outcome was suicide attempts (nonfatal and fatal) over the 52-week follow-up period. The proportion and total number of attempts were analyzed. A total of 1376 participants were recruited, including 769 females (55.9%) with a median (interquartile range) age of 37 (26-47) years. A total of 288 participants (20.9%) made at least 1 suicide attempt, and there were 548 total suicide attempts among participants. There were no significant differences in risk reduction between the TAU and screening phases (23% vs 22%, respectively). However, compared with the TAU phase, patients in the intervention phase showed a 5% absolute reduction in suicide attempt risk (23% vs 18%), with a relative risk reduction of 20%. Participants in the intervention phase had 30% fewer total suicide attempts than participants in the TAU phase. Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts

  16. Rat macrophage lysosomal membrane antigen recognized by monoclonal antibody ED1.

    PubMed Central

    Damoiseaux, J G; Döpp, E A; Calame, W; Chao, D; MacPherson, G G; Dijkstra, C D

    1994-01-01

    The monoclonal antibody (mAb) ED1 is being used widely as a marker for rat macrophages. The distribution of the recognized antigen in tissues and isolated cells strongly supports this use as a macrophage marker, since the majority of macrophages are recognized and only seldomly are other cell types stained by mAb ED1. In the present study we further characterized the recognized antigen by a detailed description of the localization of the antigen and by determining biochemical and functional properties. We show that the antigen is expressed on the membranes of cytoplasmic granules, like phagolysosomes, as well as on the cell surface. The amount of ED1 expression in a single cell can be correlated to phagocytic activity of the respective cell type, but the mAb ED1 is not able to block latex phagocytosis or bacterial killing. The mAb ED1 appears to recognize a heavily glycosylated protein of 90,000-110,000 MW, depending on the cell type used as antigen source. A possible relation with other known lysosomal glycoproteins with a similar molecular weight is discussed. Images Figure 1 Figure 3 Figure 4 Figure 5 PMID:7821959

  17. Take advantage of opportunities to reduce ED violence, recidivism among children and young adults.

    PubMed

    2013-05-01

    There is evidence that ED-based interventions can make a difference in short-circuiting the cycle of violence that often impacts children and young adults. Since the Violence Intervention Advocacy Program was launched at Boston Medical Center in 2006, recidivism to the ED among gunshot victims is down by 30% and recidivism among stabbing victims is down by about one-half. At Denver Health Medical Center, the At Risk Intervention and Monitoring (AIM) project just launched in June, but thus far, none of the patients being followed in the program have reappeared in the ED with a violent injury. The U.S. Centers for Disease Control and Prevention reports that 700,000 people between the ages of 10 and 24 were treated in EDs for injuries caused by violence in 2009. To effectively intervene with victims of violence, experts recommend that EDs partner with community groups that have deep ties to the neighborhoods most impacted by violence. To avoid re-traumatizing victims of violence, health care personnel need to be trained in how to provide"trauma-informed care," a method of speaking to patients so that they feel empowered and safe. With young victims of violence, the biggest issues requiring attention are mental health, safety, and housing.

  18. The prognostic factors of adult patients with hepatic portal venous gas in the ED.

    PubMed

    Seak, Chen-June; Hsu, Kuang-Hung; Wong, Yon-Cheong; Ng, Chip-Jin; Yen, David Hung-Tsang; Seak, Joanna Chen-Yeen; Seak, Chen-Ken

    2014-09-01

    This study aimed to investigate the prognostic factors of adult patients with hepatic portal venous gas (HPVG) in the emergency department (ED) to facilitate clinical decision making by emergency physicians. Data from adult patients with HPVG who visited our ED between December 2009 and December 2013 were analyzed. The computed tomographic scan images were reviewed, and the presence of HPVG with or without pneumatosis intestinalis (PI) was confirmed by a certified radiologist. The study end point was mortality or survival upon discharge. The factors associated with mortality were specifically analyzed with multiple logistic regression models. Among the total of 50 HPVG patients, the overall mortality rate was 56%. No deaths were observed among the patients with neither shock nor PI in the ED. Shock (odds ratio, 17.02; 95% confidence interval, 3.36-86.22) and PI (odds ratio, 5.14; 95% confidence interval, 1.03-25.67) were determined to be significant predictors of patient mortality after adjusting for age and sex. The mortality of the patients with both shock and PI was very high (84%). Early resuscitation should be initiated for the prevention of shock in adult patients with HPVG in the ED. To enhance the chance for survival, the prompt consultation of surgeons for emergency operations should be considered for adult ED patients exhibiting both shock and PI, which may indicate true ischemic bowel disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Partial Deletion of the Bovine ED1 Gene Causes Anhidrotic Ectodermal Dysplasia in Cattle

    PubMed Central

    Drögemüller, Cord; Distl, Ottmar; Leeb, Tosso

    2001-01-01

    Anhidrotic ectodermal dysplasia (ED1) is characterized by hypotrichosis, reduced number of sweat glands, and incisior anodontia in human, mouse, and cattle. In affected humans and mice, mutations in the ED1 gene coding for ectodysplasin 1 are found. Ectodysplasin 1 is a novel trimeric transmembrane protein with an extracellular TNF-like signaling domain that is believed to be involved in the formation of hair follicles and tooth buds during fetal development. We report the construction of a 480-kb BAC contig harboring the complete bovine ED1 gene on BTA Xq22–Xq24. Physical mapping and sequence analysis of the coding parts of the ED1 gene revealed that a large genomic region including exon 3 of the ED1 gene is deleted in cattle with anhidrotic ectodermal dysplasia in a family of German Holstein cattle with three affected maternal half sibs. [The sequence data described in this paper have been submitted to the EMBL nucleotide database under accession nos. AJ300468, AJ300469, and AJ278907.] PMID:11591646

  20. Enriched Medical Home Intervention Using Community Health Worker Home Visitation and ED Use.

    PubMed

    Anugu, Meghana; Braksmajer, Amy; Huang, Jiayu; Yang, Jie; Ladowski, Kristi L; Pati, Susmita

    2017-05-01

    Community health workers (CHWs) have great potential to extend medical home services and reduce emergent health care use, but evidence in pediatrics is scarce. We evaluated the impact of an existing enriched medical home intervention (EMHI) that directly integrates CHWs into emergency department (ED) visits and hospitalizations for pediatric ambulatory care-sensitive conditions (ACSCs). The EMHI group in this prospective cohort study received home visits from trained CHWs to support adherence to recommended care; the comparison group received usual care (UC). Sociodemographic characteristics were compiled from the EMHI database, and ED and hospitalization information was extracted for study participants from a statewide database. The Wilcoxon signed rank test was used to compare ED data and the Wald test was used to compare hospitalization use for ACSCs between the intervention and UC groups after adjusting for different characteristics between groups by using propensity score matching method. The study sample included 922 children (225 intervention, 697 UC). After propensity score matching, the analytic sample included 450 children (225 intervention, 225 UC). After propensity score matching, the intervention group was significantly less likely than the UC group to visit the ED for an ACSC (18.2% vs 35.1%; P = .004). We found no differences in ACSC hospitalizations between the 2 groups. Our findings suggest that EMHIs using trained CHWs may be a cost-effective model to reduce preventable ED utilization, especially among vulnerable children. Copyright © 2017 by the American Academy of Pediatrics.

  1. Triage quality control is missing tools-a new observation technique for ED quality improvement.

    PubMed

    Malmström, Tomi; Harjola, Veli-Pekka; Torkki, Paulus; Kumpulainen, Salla; Malmström, Raija

    2017-04-01

    Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods. The study developed an observation technique for identifying patients with possible erroneous assessments in triage. Data sample for the observation technique is carried out with survey form filled in by nurse. Hospital ED with ~74 000 patient visits annually. Consecutive adult patients in an ED for baseline study period of 14 days (1774 patients) in 2010 and control study period of 4 days (541 patients) in 2012. Triage observation technique for continuous improvement of triage performance. Primary measures of triage improvement were triage accuracy and nurses' ability to predict patient admissions. With the observation technique the ED staff was able to identify patient groups at risk for erroneous triage. Under-triage related mostly to patients with chest pain, shortness of breath, collapse, stomach pain and infections. Instead injures and muscular skeletal symptoms were seldom undertriaged even though they are common. EDs can control triage quality with simple observation technique. The usability of observation technique and triage quality improvement process were good.

  2. Association between tree pollen counts and asthma ED visits in a high-density urban center.

    PubMed

    Jariwala, Sunit P; Kurada, Satya; Moday, Heather; Thanjan, Andy; Bastone, Laurel; Khananashvili, Moisey; Fodeman, Jason; Hudes, Golda; Rosenstreich, David

    2011-06-01

    Asthma exacerbation patterns are cyclic in nature and often correlate with air particle concentrations. To examine the relationship between asthma-related emergency department (ED) visits and outdoor air quality for pediatric and adult patients in a high asthma prevalence area, the New York City borough of the Bronx. Numbers of daily asthma-related adult and pediatric ED visits during one complete year (1999) were obtained from the seven major Bronx hospitals. Daily values of nitrogen oxides (NO(x)), ozone (O(3)), sulfur dioxide (SO(2)), and pollen counts were acquired. Asthma-related ED visit numbers were highest in December-January and lowest in July. There were three distinct peaks of increased asthma ED visits: winter (December-January), spring (late April-May), and fall (October). The spring peak was the most striking and coincided with high tree pollen counts (tree pollen: r = 0.90, p = .03). We observed a positive correlation between asthma ED visits in the winter and SO(2) and NO(x) levels. Winter peaks of SO(2) and NO(x) in early December appeared to precede the winter asthma peak. The spring asthma peak is closely associated with increased tree pollen counts, and the asthma increase at this time is likely due to allergic reactions to pollen. No significant associations could be established with the fall peak. The winter peak correlates with elevated SO(2) and NO(x) levels.

  3. ED-110, a novel indolocarbazole, prevents the growth of experimental tumors in mice.

    PubMed

    Arakawa, H; Iguchi, T; Yoshinari, T; Kojiri, K; Suda, H; Okura, A

    1993-05-01

    A new indolocarbazole compound, ED-110, which was obtained by glucosylating a microbial product (BE-13793C) and is a potent topoisomerase I inhibitor, showed characteristic inhibitory effects on the growth of 12 human tumor cell lines tested. The IC50 values of ED-110 against 9 of the 12 lines ranged from 11.5 micrograms/ml to 0.07 microgram/ml, while the remaining 3 lines were quite resistant (IC50, > 100 micrograms/ml). In in vivo experiments, i.p. treatment with ED-110 increased the survival period by more than two-fold in mice implanted i.p. with P388, L1210, L5178Y or EL4 murine leukemic cells. The minimum effective dose increasing the life-span of mice bearing P388 leukemia by 25% was < 2.5 mg/kg/day x 10 and the maximum tolerated dose was > 160 mg/kg/day x 10. ED-110 was also effective against the spontaneous metastasis of mouse Meth A fibrosarcoma cells and the growth of xenografted MKN-45 human stomach cancer cells as well as s.c. implanted mouse colon 26 and IMC carcinoma cells. These results indicated that ED-110 may have potential as a new antineoplastic agent with a large chemotherapeutic index and a wide range of effective doses.

  4. Cardiac cell proliferation assessed by EdU, a novel analysis of cardiac regeneration.

    PubMed

    Zeng, Bin; Tong, Suiyang; Ren, Xiaofeng; Xia, Hao

    2016-08-01

    Emerging evidence suggests that mammalian hearts maintain the capacity for cardiac regeneration. Rapid and sensitive identification of cardiac cellular proliferation is prerequisite for understanding the underlying mechanisms and strategies of cardiac regeneration. The following immunologically related markers of cardiac cells were analyzed: cardiac transcription factors Nkx2.5 and Gata 4; specific marker of cardiomyocytes TnT; endothelial cell marker CD31; vascular smooth muscle marker smooth muscle myosin IgG; cardiac resident stem cells markers IsL1, Tbx18, and Wt1. Markers were co-localized in cardiac tissues of embryonic, neonatal, adult, and pathological samples by 5-ethynyl-2'-deoxyuridine (EdU) staining. EdU was also used to label isolated neonatal cardiomyocytes in vitro. EdU robustly labeled proliferating cells in vitro and in vivo, co-immunostaining with different cardiac cells markers. EdU can rapidly and sensitively label proliferating cardiac cells in developmental and pathological states. Cardiac cell proliferation assessed by EdU is a novel analytical tool for investigating the mechanism and strategies of cardiac regeneration in response to injury.

  5. Efficacy of ketorolac tromethamine versus meperidine in the ED treatment of acute renal colic.

    PubMed

    Larkin, G L; Peacock, W F; Pearl, S M; Blair, G A; D'Amico, F

    1999-01-01

    To compare the efficacy of intramuscular ketorolac and meperidine in the emergency department (ED) treatment of renal colic, a prospective, controlled, randomized, double-blind trial was conducted in an academic ED with 76,000 annual visits. Participants were volunteer ED patients with a diagnosis of ureterolithiasis confirmed by intravenous pyelogram. Subjects were randomized 1:1 to receive a single intramuscular injection of either 60 mg ketorolac or 100 to 150 mg meperidine, based on weight. Of the 70 patients completing the trial, 33 received ketorolac and 37 received meperidine. Demographic characteristics and baseline pain scores of both groups were comparable (P = NS, Mann Whitney U). Ketorolac was significantly (P < .05) more effective than meperidine in reducing renal colic at 40, 60, and 90 minutes as measured on a 10-cm visual analogue scale. Similar proportions of patients in each group were given rescue analgesia and admitted. Of patients who were discharged home without rescue, those treated with ketorolac left the ED significantly earlier than those treated with meperidine (3.46 v 4.33 h, P < .05). These results show that intramuscular ketorolac as a single agent for renal colic is more effective than meperidine and promotes earlier discharge of renal colic patients from the ED.

  6. Pharmacist impact on time to antibiotic administration in patients with sepsis in an ED.

    PubMed

    Moussavi, Kayvan; Nikitenko, Vitaliy

    2016-11-01

    The purpose was to determine if the physical presence of a clinical pharmacist in the emergency department (ED) would decrease antibiotic order to administration time in adult patients with sepsis, severe sepsis, or septic shock. We conducted a retrospective review of adult patients presenting to the ED between January and December 2014 with a diagnosis of sepsis, severe sepsis, or septic shock who required intravenous antibiotics. A total of 186 patients (92 patients when an ED pharmacist was present and 94 when no ED pharmacist was present) were included in the analysis. Baseline characteristics were similar between groups. When a pharmacist was present, patients received antibiotics sooner (median 0.61 vs 0.88 hour, P=.001), Surviving Sepsis Campaign goals for antibiotic administration time were more likely to be met (88% vs 72%, P=.0097), and initial antibiotics were appropriate more often (97% vs 81%, P=.0008). No significant differences were noted in intensive care unit length of stay, hospital length of stay, ventilator days, or in-hospital mortality. Physical presence of a clinical pharmacist in the ED decreased time to administration and increased appropriateness of intravenous antibiotics for adult patients with sepsis, severe sepsis, or septic shock. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Treatment motivation of men with ED: what motivates men with ED to seek professional help and how can women support their partners?

    PubMed

    Gerster, S; Günzler, C; Roesler, C; Leiber, C; Berner, M M

    2013-01-01

    Although ED can impair sexual satisfaction as well as the quality of partnership and life, men affected often avoid seeking treatment. There is growing evidence that women have an influence on their partner's help-seeking behavior. This qualitative study examined men with ED and their female partners in order to detect motivational factors for men to seek treatment and motivational actions of the women to support their partners. Twelve couples took part in a semi-structured telephone interview, which was performed separately in men and women. Analysis was on the basis of the Grounded Theory. The identified motivational factors could be divided into extrinsic (for example, media, female partner) and intrinsic (for example, desire to clarify the cause of the ED, hope for improvement) factors. Women can support their partners in treatment-seeking through various motivational actions such as talking with each other, showing interest and dealing actively with the problem, appealing to the male self-esteem, supporting the doctor's visit, forcing the treatment, active cooperation and participation in the treatment or initiating sexual intercourse. On the basis of these findings, recommendations for women were developed to support their partners and increase the probability of help-seeking behavior.

  8. Representation of the Solar Capacity Value in the ReEDS Capacity Expansion Model: Preprint

    SciTech Connect

    Sigrin, B.; Sullivan, P.; Ibanez, E.; Margolis, R.

    2014-08-01

    An important emerging issue is the estimation of renewables' contributions to reliably meeting system demand, or their capacity value. While the capacity value of thermal generation can be estimated easily, assessment of wind and solar requires a more nuanced approach due to resource variability. Reliability-based methods, particularly, effective load-carrying capacity (ELCC), are considered to be the most robust techniques for addressing this resource variability. The Regional Energy Deployment System (ReEDS) capacity expansion model and other long-term electricity capacity planning models require an approach to estimating CV for generalized PV and system configurations with low computational and data requirements. In this paper we validate treatment of solar photovoltaic (PV) capacity value by ReEDS capacity expansion model by comparing model results to literature for a range of energy penetration levels. Results from the ReEDS model are found to compare well with both comparisons--despite not being resolved at an hourly scale.

  9. Antimicrobial effect of camphorated chloroxylenol (ED 84) in the treatment of infected root canals.

    PubMed

    Schäfer, E; Bössmann, K

    1999-08-01

    During and after chemomechanical preparation, particularly before the definitive filling of an infected root canal, a temporary intracanal dressing with an antimicrobial activity is generally indicated. Therefore, the aim of this study was to investigate the antimicrobial effect of ED 84, a liquid root canal disinfectant containing chloroxylenol (10%) and camphor (15%), against selected test organisms (Staphylococcus aureus, Streptococcus faecalis, Escherichia coli, and Candida albicans) both in vitro and under clinical conditions, using extracted teeth. With a contact time of 180 min between undiluted ED 84 and the four bacterial suspensions in the canal, there was a 2 to 3 log reduction in the number of organisms. Under in vitro conditions, the reduction was even greater than 3 logs. When using a liquid medication as a temporary root canal dressing for a duration of approximately 2 days, ED 84 can definitely be used.

  10. Dependence and physical exercise: Spanish validation of the Exercise Dependence Scale-Revised (EDS-R).

    PubMed

    Sicilia, Alvaro; González-Cutre, David

    2011-05-01

    The purpose of this study was to validate the Spanish version of the Exercise Dependence Scale-Revised (EDS-R). To achieve this goal, a sample of 531 sport center users was used and the psychometric properties of the EDS-R were examined through different analyses. The results supported both the first-order seven-factor model and the higher-order model (seven first-order factors and one second-order factor). The structure of both models was invariant across age. Correlations among the subscales indicated a related factor model, supporting construct validity of the scale. Alpha values over .70 (except for Reduction in Other Activities) and suitable levels of temporal stability were obtained. Users practicing more than three days per week had higher scores in all subscales than the group practicing with a frequency of three days or fewer. The findings of this study provided reliability and validity for the EDS-R in a Spanish context.

  11. Bedside point of care toxicology screens in the ED: Utility and pitfalls

    PubMed Central

    Bhalla, Ashish

    2014-01-01

    Exposure to drugs and toxins is a major cause for patients’ visits to the emergency department (ED). For most drugs-of-abuse intoxication, ED physicians are skeptical to rely on results of urine drug testing for emergent management decisions. This is partially because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor intensive. Testing for toxic alcohols is needed, but rapid commercial assays are not available. ED physicians need stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs that could be used as agents of self-harm. In this review, we look at the potential limitations of these screening tests and suggest improvements and innovations needed for better clinical utilization. New drugs of abuse should be sought and assays should be developed to meet changing abuse patterns. PMID:25337490

  12. Patient-centered transfer process for patients admitted through the ED boosts satisfaction, improves safety.

    PubMed

    2013-02-01

    To improve safety and patient flow, administrators at Hallmark Health System, based in Melrose, MA, implemented a new patient-centered transfer process for patients admitted through the ED at the health system's two hospitals. Under the new approach, inpatient nurses come down to the ED to take reports on new patients in a process that includes the ED care team as well as family members. The inpatient nurses then accompany the patients up to their designated floors. Since the new patient-transfer process was implemented in June 2012, patient satisfaction has increased by at least one point on patient satisfaction surveys. Administrators anticipate that medical errors or omissions related to the handoff process will show a drop of at least 50%, when data is tabulated.

  13. Chronic obstructive pulmonary disease (COPD) and erectile dysfunction (ED): Results of the BRED observational study.

    PubMed

    Lauretti, Stefano; Cardaci, Vittorio; Barrese, Francesco; Calzetta, Luigino

    2016-10-05

    Most patients with chronic obstructive pulmonary disease (COPD) share many risk factors and similar aetiological agents with erectile dysfunction (ED). Both conditions also cause serious interference with quality of life and sexual relationships. In general, ageing and chronic illness decrease sexual interest, sexual function, and testosterone levels. This observational study included 66 male patients referred to our centre with different grades of COPD. We studied the different correlations between COPD and ED. The data collected from each patient regarded the following features: demographic and social condition; smoking status; clinical status; spirometric measurements. In this group, COPD was diagnosed in 78.8% and ED was present in 83.3% with increased severity in presence of LUTS and nicotinism.

  14. Enhanced Mental Health Interventions in the Emergency Department: Suicide and Suicide Attempt Prevention in the ED

    PubMed Central

    Hughes, Jennifer L.; Asarnow, Joan R.

    2015-01-01

    Suicide is the third leading cause of death in adolescents, and often youths with suicidal behavior or ideation present to the emergency department (ED) for care. Many suicidal youths do not receive mental health care after discharge from the ED, and interventions are needed to enhance linkage to outpatient intervention. This paper describes the Family Intervention for Suicide Prevention (FISP). Designed for use in emergency settings, the FISP is a family-based cognitive-behavior therapy session designed to increase motivation for follow-up treatment, support, coping, and safety, augmented by care linkage telephone contacts after discharge. In a randomized trial of the intervention, the FISP was shown to significantly increase the likelihood of youths receiving outpatient treatment, including psychotherapy and combined medication and psychotherapy. The FISP is a brief, focused, efficacious treatment that can be delivered in the ED to improve the probability of follow-up treatment for suicidal youths. PMID:25904825

  15. Combined EBSD/EDS tomography in a dual-beam FIB/FEG-SEM.

    PubMed

    West, G D; Thomson, R C

    2009-03-01

    An automated method for collecting combined three-dimensional (3D) electron backscatter diffraction (EBSD)/energy dispersive spectroscopy (EDS) data sets on a dual-beam focused ion beam (FIB)/field emission gun scanning electron microscope (FEG-SEM) microscope is described. The method uses simple scripting files on the dual beam to move between the EBSD collection and the FIB slicing positions, which are linked to a commercial EBSD data collection programme. The EDS data are collected simultaneously with the EBSD patterns analogous to combined two-dimensional (2D) EBSD/EDS. The technique has been successfully applied to study both the interdiffusion zone between a coating and a substrate and a complex multi-phase coating on a nickel-based superalloy sample. This analysis is shown to enable the complex grain shapes, location of precipitates and phase interconnectivity within these samples to be determined without the ambiguities associated with 2D stereographic analysis.

  16. Discordance between patient report and chart review of risk factors for antimicrobial resistance in ED patients.

    PubMed

    Caterino, Jeffrey M; Graham, Lauren; King, Andrew; Hoppes, Tyler

    2013-09-01

    The objective of this study is to identify the level of agreement between patient self-report and chart review for presence of antimicrobial resistance (AR) risk factors in emergency department (ED) patients. This is a cross-sectional analysis of adult ED patients from July 2010 to January 2011. All ED patients 18 years or older were eligible. Exclusion criteria included pregnant women, prisoners, altered mental status, non-English speakers, traumas, and patients unable to provide consent. Data were obtained by ED patient interview and review of the preceding 3 months of the medical record. We report the difference between patient self-report and chart review of identifying 1 or more AR risk factors using McNemar's χ(2). The test statistic was also calculated for individual risk factors and significance adjusted for multiple comparisons (P < .003). Agreement was calculated using κ with 95% confidence intervals (CIs). Risk factor domains assessed included nursing home residence, recent health care utilization, current indwelling devices, and medical history. Among 289 patients, 1 or more risk factors were reported by 68% (95% CI, 63%-74%) of patients and found in 59% (95% CI, 53%-65%) of charts, a difference of 9.7% (95% CI, 5.3%-14%) (P < .001; κ = 0.72). Patients were more likely to report recent antibiotic use (42% vs 29%; P < .001; κ = 0.52) and recent surgery (17% vs 11%; P < .001; κ = 0.64). There is disagreement between ED patient self-report and medical record review for many AR risk factors. This could affect both clinical care and results of ED research studies relying on chart reviews. Patient self-report identifies a greater number of AR risk factors than chart review. © 2013.

  17. Are triage questions sufficient to assign fall risk precautions in the ED?

    PubMed

    Southerland, Lauren T; Slattery, Lauren; Rosenthal, Joseph A; Kegelmeyer, Deborah; Kloos, Anne

    2017-02-01

    The American College of Emergency Physicians Geriatric Emergency Department (ED) Guidelines and the Center for Disease Control recommend that older adults be assessed for risk of falls. The standard ED assessment is a verbal query of fall risk factors, which may be inadequate. We hypothesized that the addition of a functional balance test endorsed by the Center for Disease Control Stop Elderly Accidents, Deaths, and Injuries Falls Prevention Guidelines, the 4-Stage Balance Test (4SBT), would improve the detection of patients at risk for falls. Prospective pilot study of a convenience sample of ambulatory adults 65 years and older in the ED. All participants received the standard nursing triage fall risk assessment. After patients were stabilized in their ED room, the 4SBT was administered. The 58 participants had an average age of 74.1 years (range, 65-94), 40.0% were women, and 98% were community dwelling. Five (8.6%) presented to the ED for a fall-related chief complaint. The nursing triage screen identified 39.7% (n=23) as at risk for falls, whereas the 4SBT identified 43% (n=25). Combining triage questions with the 4SBT identified 60.3% (n=35) as at high risk for falls, as compared with 39.7% (n=23) with triage questions alone (P<.01). Ten (17%) of the patients at high risk by 4SBT and missed by triage questions were inpatients unaware that they were at risk for falls (new diagnoses). Incorporating a quick functional test of balance into the ED assessment for fall risk is feasible and significantly increases the detection of older adults at risk for falls. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Effect of Job Specialization on the Hospital Stay and Job Satisfaction of ED Nurses

    PubMed Central

    Shamsi, Vahid; Mahmoudi, Hosein; Sirati Nir, Masoud; Babatabar Darzi, Hosein

    2016-01-01

    Background: In recent decades, the increasing crowdedness of the emergency departments has posed various problems for patients and healthcare systems worldwide. These problems include prolonged hospital stay, patient dissatisfaction and nurse burnout or job dissatisfaction. Objectives: The aim of this study was to investigate the effect of emergency department (ED) nurses’ job specialization on their job satisfaction and the length of patient stay in the ED. Patients and Methods: This before-after quasi-experimental study was conducted from April to May 2014 at the Baqiyatallah Hospital, Tehran, Iran. Initially, 35 patients were recruited as controls and the length of their stay in the ED was measured in minutes via a chronometer; Moreover, nurses’ job satisfaction was evaluated using the Mohrman-Cooke-Mohrman job satisfaction scale. Then, a job specialization intervention was developed based on the stabilization model. After that, 35 new patients were recruited to the treatment group and received specialized care services. Accordingly, the length of their stay in the ED was measured. Moreover, the same nurses’ job satisfaction was re-evaluated after the study. The study intervention lasted one month. Data were analyzed using the SPSS software version 20 and statistical tests such as the Kolmogrov-Smirnov, the paired and the independent t, and chi-square tests. Results: There was a significant difference between the two groups of patients concerning the length of their stay in the ED (P < 0.001). Moreover, compared with the pretest readings, nurses had greater job satisfaction after the study (P < 0.001). Conclusions: The job specialization intervention can improve nurses’ satisfaction and relieve the crowdedness of the EDs. PMID:27218054

  19. PopED lite: An optimal design software for preclinical pharmacokinetic and pharmacodynamic studies.

    PubMed

    Aoki, Yasunori; Sundqvist, Monika; Hooker, Andrew C; Gennemark, Peter

    2016-04-01

    Optimal experimental design approaches are seldom used in preclinical drug discovery. The objective is to develop an optimal design software tool specifically designed for preclinical applications in order to increase the efficiency of drug discovery in vivo studies. Several realistic experimental design case studies were collected and many preclinical experimental teams were consulted to determine the design goal of the software tool. The tool obtains an optimized experimental design by solving a constrained optimization problem, where each experimental design is evaluated using some function of the Fisher Information Matrix. The software was implemented in C++ using the Qt framework to assure a responsive user-software interaction through a rich graphical user interface, and at the same time, achieving the desired computational speed. In addition, a discrete global optimization algorithm was developed and implemented. The software design goals were simplicity, speed and intuition. Based on these design goals, we have developed the publicly available software PopED lite (http://www.bluetree.me/PopED_lite). Optimization computation was on average, over 14 test problems, 30 times faster in PopED lite compared to an already existing optimal design software tool. PopED lite is now used in real drug discovery projects and a few of these case studies are presented in this paper. PopED lite is designed to be simple, fast and intuitive. Simple, to give many users access to basic optimal design calculations. Fast, to fit a short design-execution cycle and allow interactive experimental design (test one design, discuss proposed design, test another design, etc). Intuitive, so that the input to and output from the software tool can easily be understood by users without knowledge of the theory of optimal design. In this way, PopED lite is highly useful in practice and complements existing tools. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Using process indicators to optimize service completion of an ED drug and alcohol brief intervention program.

    PubMed

    Akin, Joanna; Johnson, J Aaron; Seale, J Paul; Kuperminc, Gabriel P

    2015-01-01

    The strongest evidence for effectiveness of screening, brief intervention, and referral to treatment (SBIRT) programs is in primary care settings. Emergency department (ED) studies have shown mixed results. Implementation of SBIRT into ED settings is complicated by the type of patients seen and the fast-paced, high-throughput nature of the ED environment that makes it difficult to reach patients flagged for SBIRT services. This study uses data from an ED-based SBIRT program to examine the relationship between screen-positive rate, ED patient flow, and SBIRT service delivery. Data for the study (N = 67137) were derived from weekly reports extracted directly from one hospital's electronic health record. Measures included time and day of patient entry, drug/alcohol screen result (positive or negative), and whether the patient was reached by SBIRT specialists. Factorial analysis of variance compared variations in screen-positive rates by day and time and the percentage of patients reached by SBIRT specialists during these periods. Overall, 56% of screen-positive patients received SBIRT services. Only 5% of patients offered SBIRT services refused. Day and time of entry had a significant interaction effect on the reached rate (F12,14166 =3.48, P < .001). Although patient volume was lowest between 11 pm and 7 am, screen-positive rates were highest during this period, particularly on weekends; and patients were least likely to be reached during these periods. When implementing an ED-based SBIRT program, thoughtful consideration should be given to patient flow and staffing to maximize program impact and increase the likelihood of sustainability. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Paid sick leave is associated with fewer ED visits among US private sector working adults.

    PubMed

    Bhuyan, Soumitra S; Wang, Yang; Bhatt, Jay; Dismuke, S Edward; Carlton, Erik L; Gentry, Dan; LaGrange, Chad; Chang, Cyril F

    2016-05-01

    The United States (US) is the only developed country that does not guarantee short-term or longer-term paid sick leave. This study used a multiyear nationally representative database to examine the association between availability of paid sick leave and frequency of emergency department (ED) use among US private sector employees. We used the National Health Interview Survey data (2012-2014). The final study sample consists of 42,460 US adults between 18 and 64years of age and working in nongovernmental private sector. Our results suggest that availability of paid sick leave is significantly associated with lower likelihood of ED use, for both moderate (1-3 times/year) and repeated users (4 or more times/year). After controlling for confounding factors, respondents with paid sick leave are 14% less likely to be moderate ED users (adjusted odds ratio, 0.86; 95% CI, 0.79-0.93) and 32% less likely to be repeated ED users (adjusted odds ratio, 0.68; 95% CI, 0.50-0.91). Although expansion of health insurance coverage under the Affordable Care Act has not been shown to reduce utilization of high cost health care services such as the ED, our study suggests other factors such as the availability of paid sick leave may do so, by allowing patients to seek care through other more cost-effective mechanisms (eg, primary care providers). To reduce ED utilization, health policymakers should consider alternative reforms including paid sick leave. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Tired of seeing your patients in the ED? Let's give parent education another look!

    PubMed

    Yoffe, Stuart J; McClellan, David A; Tolson, Homer; Moore, Robert W; McKay, Rebecca

    2012-02-01

    This study was conducted to determine if a parent-oriented educational intervention reduces the use of emergency department (ED) services for the care of infants. Infants aged 7 days to 1 year and older children aged 2 to 10 years were tracked for 3 years in two separate primary care (PC) practices in Washington County, Texas, with the last year being the interventional study period. Also, infants aged 7 days to 1 year and older children aged 7 days to 5 years were tracked in a third PC practice in Burleson County, Texas. The study group consisted of all parents of patients aged 7 days to 1 year seen by the pediatric group in Washington County during the 1-year interventional period. Only parents of infants in the study group received a specific educational intervention booklet. Five separate control groups were followed in this study. The control groups received usual care with standardized patient information, but they did not receive the educational intervention booklet. Each group was evaluated by calculating its monthly ED utilization rate, which is the quotient derived from dividing the number of children from that particular group seen in the ED per month by the number of children from the same group seen in the PC clinic per month. A difference of proportions test was applied to test for statistical significance regarding ED utilization. Compared with parents in the control group, parents receiving the intervention booklet (the study group) showed significantly (P < .05) lower use of ED services for care of their infants. We found no change in ED utilization for children of parents receiving other standard educational information.

  3. ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults.

    PubMed

    Dermody, Gordana; Sawyer, Patricia; Kennedy, Richard; Williams, Courtney; Brown, Cynthia J

    2017-01-01

    The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purpose of this study was to describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department and to examine the differences in self-reported symptoms among those who did and did not utilize the emergency department. A prospective longitudinal design was used. The sample included 403 community-dwelling older adults aged 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance and fair/poor well-being were significantly associated with ED utilization. Several symptoms were common among this cohort of older adults. However, no significant differences were found in the types of symptoms reported by older adults who utilized the emergency department compared with those who did not utilize the emergency department. Based on these findings, it appears that symptoms among community-dwelling older adults may not be the primary reason for ED utilization. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  4. Stroke Risk After Non-Stroke ED Dizziness Presentations: A Population-Based Cohort Study

    PubMed Central

    Kerber, Kevin A.; Zahuranec, Darin B.; Brown, Devin L.; Meurer, William J.; Burke, James F.; Smith, Melinda A.; Lisabeth, Lynda D.; Fendrick, A. Mark; McLaughlin, Thomas; Morgenstern, Lewis B.

    2014-01-01

    Objective Acute stroke is a serious concern in Emergency Department (ED) dizziness presentations. Prior studies, however, suggest that stroke is actually an unlikely cause of these presentations. Lacking are data on short- and long-term follow-up from population-based studies to establish stroke risk after presumed non-stroke ED dizziness presentations. Methods From 5/8/2011 to 5/7/2012, patients ≥ 45 years of age presenting to EDs in Nueces County, Texas, with dizziness, vertigo, or imbalance were identified, excluding those with stroke as the initial diagnosis. Stroke events after the ED presentation up to 10/2/2012 were determined using the Brain Attack Surveillance in Corpus Christi (BASIC) study, which uses rigorous surveillance and neurologist validation. Cumulative stroke risk was calculated using Kaplan-Meier estimates. Results 1,245 patients were followed for a median of 347 days (IQR 230- 436 days). Median age was 61.9 years (IQR, 53.8-74.0 years). After the ED visit, fifteen patients (1.2%) had a stroke. Stroke risk was 0.48% (95% CI, 0.22%-1.07%) at 2 days; 0.48% (95% CI, 0.22%-1.07%) at 7 days; 0.56% (95% CI, 0.27%-1.18%) at 30 days; 0.56% (95% CI, 0.27%-1.18%) at 90 days; and 1.42% (95% CI, 0.85%-2.36%) at 12 months. Interpretation Using rigorous case ascertainment and outcome assessment in a population-based design, we found that the risk of stroke after presumed non-stroke ED dizziness presentations is very low, supporting a non-stroke etiology to the overwhelming majority of original events. High-risk subgroups likely exist, however, because most of the 90-day stroke risk occurred within 2-days. Vascular risk stratification was insufficient to identify these cases. PMID:24788511

  5. MedEdPORTAL: a report on oral health resources for health professions educators.

    PubMed

    Chickmagalur, Nithya S; Allareddy, Veerasathpurush; Sandmeyer, Sue; Valachovic, Richard W; Candler, Christopher S; Saleh, Michael; Cahill, Emily; Karimbux, Nadeem Y

    2013-09-01

    MedEdPORTAL is a unique web-based peer-reviewed publication venue for clinical health educators sponsored by the Association of American Medical Colleges (AAMC). The open exchange of educational resources promotes professional collaboration across health professions. In 2008, the American Dental Education Association (ADEA) collaborated with AAMC to allow dental educators to use the platform to publish dental curriculum resources. Oral health is integral to general health; hence, collaboration among health care professionals brings enormous value to patient-centered care. The aim of this study was to conduct a current survey of metrics and submission statistics of MedEdPORTAL resources. The data were collected using the MedEdPORTAL search engine and ADEA and AAMC staff. The data collected were categorized and reported in tables and charts. Results showed that at the time of this study there were over 2,000 medical and dental resources available to anyone worldwide. Oral health resources constituted approximately 30 percent of the total resources, which included cross-indexing with information relevant to both medical and dental audiences. There were several types of dental resources available; the most common were the ones focusing on critical thinking. The usage of MedEdPORTAL has been growing, with participation from over 190 countries and 10,000 educational institutions around the world. The findings of this report suggest that MedEdPORTAL is succeeding in its aim to foster global collaborative education, professional education, and educational scholarship. As such, MedEdPORTAL is providing a new forum for collaboration and opens venues for promising future work in professional education.

  6. Intravenous migraine therapy in children with posttraumatic headache in the ED.

    PubMed

    Chan, Steven; Kurowski, Brad; Byczkowski, Terri; Timm, Nathan

    2015-05-01

    More than 3.8 million children sustain traumatic brain injuries annually. Treatment of posttraumatic headache (PTH) in the emergency department (ED) is variable, and benefits are unclear. The objective of the study is to determine if intravenous migraine therapy reduces pain scores in children with PTH and factors associated with improved response. This was a retrospective study of children, 8 to 21 years old, presenting to a tertiary pediatric ED with mild traumatic brain injury (mTBI) and PTH from November 2009 to June 2013. Inclusion criteria were mTBI (defined by diagnosis codes) within 14 days of ED visit, headache, and administration of one or more intravenous medications: ketorolac, prochlorperazine, metoclopramide, chlorpromazine, and ondansetron. Primary outcome was treatment success defined by greater than or equal to 50% pain score reduction during ED visit. Bivariate analysis and logistic regression were used to determine predictors of treatment success: age, sex, migraine or mTBI history, time since injury, ED head computed tomographic (CT) imaging, and pretreatment with oral analgesics. A total of 254 patients were included. Mean age was 13.8 years, 51% were female, 80% were white, mean time since injury was 2 days, and 114 patients had negative head CTs. Eighty-six percent of patients had treatment success with 52% experiencing complete resolution of headache. Bivariate analysis showed that patients who had a head CT were less likely to respond (80% vs 91%; P = .008). Intravenous migraine therapy reduces PTH pain scores for children presenting within 14 days after mTBI. Further prospective work is needed to determine long-term benefits of acute PTH treatment in the ED. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Promoting an obesity education program among minority patients in a single urban pediatric Emergency Department (ED).

    PubMed

    Haber, Jordana J; Atti, Sukshant; Gerber, Linda M; Waseem, Muhammad

    2015-12-01

    The purpose of this study was to assess the feasibility of the Emergency Department (ED) as a place for obesity education and to evaluate its impact on patient's lifestyle modification. In this study, children between 8 and 18 years of age, who presented to the ED for non-urgent reasons in a single urban hospital, were enrolled. Parents' perception of their child's diet and exercise were assessed prior to the intervention. Both parents and children attended a brief audio-visual presentation that provided educational information on age-appropriate diet and exercise. Following the intervention, the participants were asked about their impressions regarding the ED as a place to receive obesity education and whether they plan to make any changes in diet and exercise. One hundred children and their parents participated in this study. Of these, 76 were Latino and 21 were African-Americans. The mean age was 14 years, and the mean body mass index (BMI) was 25.6. Following the intervention, 21 (100 %) of the African-American parents and 73 (98.6 %) of the Latino parents felt that the ED should provide obesity education. Eighteen (85.7 %) of the African-American parents and 72 (97.3 %) of the Latino parents planned to make changes in their child's diet and exercise. Among the children, 21 (100 %) of African-American participants and 76 (100 %) of Latino participants reported that they found the audio-visual useful. Seventeen (81.0 %) of the African-American children and 73 (96.1 %) of Latino children stated learning new information from the intervention program. This study suggests the ED may have a role in primary health promotion and obesity prevention. An ED-based intervention may be used to provide education about obesity prevention and has the potential to impact life style modifications, including diet and exercise.

  8. SEM/EDS analysis for problem solving in the food industry

    NASA Astrophysics Data System (ADS)

    Niemeyer, Wayne D.

    2015-10-01

    For forensic investigation in the food industry, scanning electron microscopy (SEM) in conjunction with energy dispersive X-ray spectrometry (EDS) is a powerful, often non-destructive, instrumental analysis tool to provide information about: • Identification of inorganic (and some organic) materials found as foreign contaminants in food products returned by consumers or detected during quality control inspections in the production facilities • Identification of wear particles found in production lines • Distribution of materials within a matrix • Corrosion and failure analysis of production equipment The identification of materials by SEM/EDS is accomplished through a combination of morphology by SEM imaging and the elemental composition of the material by EDS. Typically, the EDS analysis provides a qualitative spectrum showing the elements present in the sample. Further analysis can be done to quantify the detected elements in order to further refine the material identification. Metal alloys can often be differentiated even within the same family such as 300 Series stainless steels. Glass types can be identified by the elemental composition where the detected elements are quantified as the oxides of each element. In this way, for example, common window glass is distinguishable from insulation glass used in many ovens. Wear particles or fragments from breakage can find their way into food products. SEM/EDS analysis of the materials is an important resource to utilize when trying to determine the original source. Suspected source materials can then be sampled for comparative analysis. EDS X-ray mapping is another tool that is available to provide information about the distribution of materials within a matrix. For example, the distribution of inorganic ingredients in a dried food helps to provide information about the grind and blend of the materials.

  9. New Zealand's emergency department target - did it reduce ED length of stay, and if so, how and when?

    PubMed

    Tenbensel, Tim; Chalmers, Linda; Jones, Peter; Appleton-Dyer, Sarah; Walton, Lisa; Ameratunga, Shanthi

    2017-09-26

    In 2009, the New Zealand government introduced a hospital emergency department (ED) target - 95% of patients seen, treated or discharged within 6 h - in order to alleviate crowding in public hospital EDs. While these targets were largely met by 2012, research suggests that such targets can be met without corresponding overall reductions in ED length-of-stay (LOS). Our research explores whether the NZ ED time target actually reduced ED LOS, and if so, how and when. We adopted a mixed-methods approach with integration of data sources. After selecting four hospitals as case study sites, we collected all ED utilisation data for the period 2006 to 2012. ED LOS data was derived in two forms-reported ED LOS, and total ED LOS - which included time spent in short-stay units. This data was used to identify changes in the length of ED stay, and describe the timing of these changes to these indicators. Sixty-eight semi-structured interviews and two surveys of hospital clinicians and managers were conducted between 2011 and 2013. This data was then explored to identify factors that could account for ED LOS changes and their timing. Reported ED LOS reduced in all sites after the introduction of the target, and continued to reduce in 2011 and 2012. However, total ED LOS only decreased from 2008 to 2010, and did not reduce further in any hospital. Increased use of short-stay units largely accounted for these differences. Interview and survey data showed changes to improve patient flow were introduced in the early implementation period, whereas increased ED resources, better information systems to monitor target performance, and leadership and social marketing strategies mainly took throughout 2011 and 2012 when total ED LOS was not reducing. While the ED target clearly stimulated improvements in patient flow, our analysis also questions the value of ED targets as a long term approach. Increased use of short-stay units suggests that the target became less effective in 'standing

  10. [Eating disorders (ED) and obsessive-compulsive disorders (OCD): common factors].

    PubMed

    Bertrand, Audrey; Bélanger, Claude; O'Connor, Kieron

    2011-01-01

    Several similarities exist in the phenomenology of obsessive-compulsive disorder (OCD) and eating disorders (ED : anorexia nervosa and bulimia). Both disorders include obsessive thoughts and compulsive or ritualized behaviours. Furthermore, these two disorders frequently present with similar comorbid disorders. In this article, the authors examine similarities between ED and OCD, and whether eating disorders can be conceptualized as a variant of obsessive-compulsive disorders. This raises the possibility that treatments proven effective for OCD could be successfully adapted for ED. The authors consequently further examine both treatments utilized for both disorders.

  11. Trends in Hospital Admission and Surgical Procedures Following ED visits for Diverticulitis.

    PubMed

    Greenwood-Ericksen, Margaret B; Havens, Joaquim M; Ma, Jiemin; Weissman, Joel S; Schuur, Jeremiah D

    2016-07-01

    Diverticulitis is a common diagnosis in the emergency department (ED). Outpatient management of diverticulitis is safe in selected patients, yet the rates of admission and surgical procedures following ED visits for diverticulitis are unknown, as are the predictive patient characteristics. Our goal is to describe trends in admission and surgical procedures following ED visits for diverticulitis, and to determine which patient characteristics predict admission. : We performed a cross-sectional descriptive analysis using data on ED visits from 2006-2011 to determine change in admission and surgical patterns over time. The Nationwide Emergency Department Sample database, a nationally representative administrative claims dataset, was used to analyze ED visits for diverticulitis. We included patients with a principal diagnosis of diverticulitis (ICD-9 codes 562.11, 562.13). We analyzed the rate of admission and surgery in all admitted patients and in low-risk patients, defined as age <50 with no comorbidities (Elixhauser). We used hierarchical multivariate logistic regression to identify patient characteristics associated with admission for diverticulitis. Fryom 2006 to 2011 ED visits for diverticulitis increased by 21.3% from 238,248 to 302,612, while the admission rate decreased from 55.7% to 48.5% (-7.2%, 95% CI [-7.78 to -6.62]; p<0.001 for trend). The admission rate among low-risk patients decreased from 35.2% in 2006 to 26.8% in 2011 (-8.4%, 95% CI [-9.6 to -7.2]; p<0.001 for trend). Admission for diverticulitis was independently associated with male gender, comorbid illnesses, higher income and commercial health insurance. The surgical rate decreased from 6.5% in 2006 to 4.7% in 2011 (-1.8%, 95% CI [-2.1 to -1.5]; p<0.001 for trend), and among low-risk patients decreased from 4.0% to 2.2% (-1.8%, 95% CI [-4.5 to -1.7]; p<0.001 for trend). From 2006 to 2011 ED visits for diverticulitis increased, while ED admission rates and surgical rates declined, with

  12. Planning a brand new ED? Study up on acoustics, air quality, and patient wish-lists.

    PubMed

    2012-01-01

    Hospitals planning to construct new EDs have a golden opportunity to integrate designs and materials that can please both patients and providers. Experts say attention to acoustics, privacy, and air quality can lower stress levels and boost satisfaction. Further, designs that prioritize efficient work flows get high marks from providers. Experts advise hospital leaders to get considerable input from patients before designing a new ED facility. Privacy, quiet, and a connection to nature are top priorities for patients. Use design to enhance patient flow.

  13. Hot spot. Planning, design and construction is the right remedy for ED dangers.

    PubMed

    Allison, D J; Matthew, R T

    1998-03-01

    Forget the TV show "ER." The real thing is much more dramatic--and dangerous. In fact, the emergency department poses the greatest security risk in hospitals. Some estimates show that about 60 percent of crime in hospitals occurs in EDs. That's why the department should be designed, constructed and furnished to minimize security risks. Careful, strategic site planning and design measures are especially important for the site areas adjacent to or serving the ED. Here are some special planning and design tactics that can improve your hospital's security.

  14. EdU, a new thymidine analogue for labelling proliferating cells in the nervous system.

    PubMed

    Chehrehasa, Fatemah; Meedeniya, Adrian C B; Dwyer, Patrick; Abrahamsen, Greger; Mackay-Sim, Alan

    2009-02-15

    Labelling and identifying proliferating cells is central to understanding neurogenesis and neural lineages in vivo and in vitro. We present here a novel thymidine analogue, ethynyl deoxyuridine (EdU) for labelling dividing cells, detected with a fluorescent azide which forms a covalent bond via the "click" chemistry reaction (the Huisgen 1,3-dipolar cycloaddition reaction of an organic azide to a terminal acetylene). Unlike the commonly used BrdU, EdU detection requires no heat or acid treatment. It is quick and easy and compatible with multiple probes for fluorescence immunochemistry, facilitating the characterisation of proliferating cells at high resolution.

  15. An introduction to the Emergency Department Adult Clinical Escalation protocol: ED-ACE.

    PubMed

    Coughlan, Eoin; Geary, Una; Wakai, Abel; O'Sullivan, Ronan; Browne, John; McAuliffe, Eilish; Ward, Marie; McDaid, Fiona; Deasy, Conor

    2017-09-01

    This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment. An action research approach was taken to designing a longitudinal patient monitoring system appropriate for the ED. While the first draft protocol for post-triage monitoring and escalation was designed by a core research group, six clinical sites were included in iterative cycles of planning, action, reviewing and further planning. Reasons for refining the system at each site were collated and the protocol was adjusted accordingly before commencing the process at the next site. The ED Adult Clinical Escalation longitudinal patient monitoring system (ED-ACE) evolved through iterative cycles of design and testing to include: (1) a monitoring chart for adult patients; (2) a standardised approach to the monitoring and reassessment of patients after triage until they are assessed by a clinician; (3) the ISBAR (I=Identify, S=Situation, B=Background, A=Assessment, R=Recommendation) tool for interprofessional communication relating to clinical escalation; (4) a template for prescribing a patient-specific monitoring plan to be used by treating clinicians to guide patient monitoring from the time the patient is assessed until when they leave the ED and (5) a protocol for clinical escalation prompted by single physiological triggers and clinical concern. This tool offers a link in the 'Chain of Prevention' between

  16. Linkage disequilibrium mapping of the gene for Margarita Island ectodermal dysplasia (ED4) to 11q23.

    PubMed Central

    Suzuki, K; Bustos, T; Spritz, R A

    1998-01-01

    Margarita Island ectodermal dysplasia (ED4) is an autosomal recessive disorder characterized by unusual facies, dental anomalies, hypotrichosis, palmoplantar hyperkeratosis and onychodysplasia, syndactyly, and cleft lip/cleft palate. We have used an affected-only DNA-pooling strategy to carry out linkage disequilibrium mapping of the ED4 gene to 11q23. Haplotype analysis of four complex Margarita Island ED4 families localized the ED4 gene to an approximately 1-2-Mb interval spanned by just two YACs. PMID:9758630

  17. An Analysis of Professional Practice Ed.D. Dissertations in Educational Technology

    ERIC Educational Resources Information Center

    Dawson, Kara; Kumar, Swapna

    2014-01-01

    The University of Florida offers an online professional practice Ed.D. focused on Educational Technology. Twenty-three students have completed professional practice dissertations and graduated since the program's inception in 2008. The purpose of this article is to share what these dissertations have looked like and to begin a dialogue about…

  18. WORK-ED. (World of Related Knowledge and Educational Development). A Manual for Trainers.

    ERIC Educational Resources Information Center

    Fraleigh, Virginia A.

    This manual is designed to assist personnel responsible for training teachers in the implementation of the World of Related Knowledge and Educational Development (WORK-ED). (The program is a career education course for ninth graders developed to enable students who have not chosen the traditional college-prep high school course to make career…

  19. Trimmed logit method for estimating the ED50 in quantal bioassay.

    PubMed

    Sanathanan, L P; Gade, E T; Shipkowitz, N L

    1987-12-01

    Trimmed nonparametric procedures such as the trimmed Spearman-Karber method have been proposed in the literature for overcoming the deficiencies of the probit and logit models in the analysis of quantal bioassay data. However, there are situations where the median effective dose (ED50) is not calculable with the trimmed Spearman-Karber method, but is estimable with a parametric model. Also, it is helpful to have a parametric model for estimating percentiles of the dose-response curve such as the ED10 and ED25. A trimmed logit method that combines the advantages of a parametric model with that of trimming in dealing with heavy-tailed distributions is presented here. These advantages are substantiated with examples of actual bioassay data. Simulation results are presented to support the validity of the trimmed logit method, which has been found to work well in our experience with over 200 data sets. A computer program for computing the ED50 and associated 95% asymptotic confidence interval, based on the trimmed logit method, can be obtained from the authors.

  20. The Ed.D. in Educational Leadership and Administration: The Students' and Alumni's Experiences

    ERIC Educational Resources Information Center

    Vera, Edith B.

    2012-01-01

    The doctoral experience unfolds many complexities and challenges for students, faculty, and institutions that contribute toward degree completion. The purpose of this study is to investigate the students' and alumni's experiences afforded by the Ed.D. in Educational Leadership and Administration at the University of Texas at El Paso (UTEP). The…

  1. ED QUEST: A Process for Linking Environmental Changes with Strategic Management. [Revised].

    ERIC Educational Resources Information Center

    Morrison, James L.; Mecca, Thomas V.

    Educational Quick Environmental Scanning Technique (ED QUEST) is a process designed to identify emerging issues and events that indicate potential threats and opportunities to educational organizations, to analyze the probable impact of these variables on the organization, and to facilitate the development of appropriate organizational strategies.…

  2. APA Reporting Standards in Quantitative Research Dissertations from an Online EdD Program

    ERIC Educational Resources Information Center

    Salgado, Griselle

    2013-01-01

    This study was an investigation of the reporting practices in dissertations with quantitative research designs produced by students enrolled in an online Doctor of Education (EdD) program, one that follows the American Psychological Association (APA) standards for reporting research. Limited, empirical information exists about the competencies in…

  3. Broad Categories for the Diagnosis of Eating Disorders (BCD-ED): An Alternative System for Classification

    PubMed Central

    Walsh, B. Timothy; Sysko, Robyn

    2009-01-01

    Eating Disorder Not Otherwise Specified (EDNOS), a residual category in DSM-IV, is the most commonly used eating disorder diagnosis in clinical settings. However, the features of individuals with EDNOS are heterogeneous and difficult to characterize. A diagnostic scheme, termed Broad Categories for the Diagnosis of Eating Disorders (BCD-ED), is proposed to diminish use of the EDNOS category markedly while preserving the existing eating disorder categories. The BCD-ED scheme consists of three broad categories, in a hierarchical relationship, consisting of: Anorexia Nervosa and Behaviorally Similar disorders, Bulimia Nervosa and Behaviorally Similar Disorders, Binge Eating Disorder and Behaviorally Similar Disorders, and a residual category of EDNOS. The advantages and disadvantages of adopting this scheme for DSM-V are considered, and issues relevant to BCD-ED are discussed. Specifically, we review the proportion of individuals with DSM-IV EDNOS that would be re-classified under the BCD-ED system, support for the hierarchy of the three categories, and the potential risk of “overdiagnosis.” PMID:19650083

  4. Choice of Instructional Media of B.Ed. Students of Ignou from Two Indian Metropolises

    ERIC Educational Resources Information Center

    Bose, Sutapa; Sharma, Parveen

    2010-01-01

    Indira Gandhi National Open University (IGNOU) of India uses multiple media and modes for reaching out to its distant learners. For most of the programmes offered to these learners, print is the master medium and other media supplement it. Instructions for the Bachelor in Education (B.Ed.), one of the popular programmes of IGNOU, are also…

  5. Learning the Attachment Theory with the CM-ED Concept Map Editor

    ERIC Educational Resources Information Center

    Rueda, U.; Arruarte, A.; Elorriaga, J. A.; Herran, E.

    2009-01-01

    This paper presents a study carried out at the University of the Basque Country UPV/EHU with the aim of evaluating the CM-ED (concept map editor) with social education students. Concept mapping is a widely accepted technique that promotes meaningful learning. Graphically representing concepts of the learning domain and relationships between them…

  6. Crystal structures of the components of the Staphylococcus aureus leukotoxin ED

    DOE PAGES

    Nocadello, S.; Minasov, G.; Shuvalova, L.; ...

    2016-01-01

    Staphylococcal leukotoxins are a family of β-barrel, bicomponent, pore-forming toxins with membrane-damaging functions. These bacterial exotoxins share sequence and structural homology and target several host-cell types. Leukotoxin ED (LukED) is one of these bicomponent pore-forming toxins thatStaphylococcus aureusproduces in order to suppress the ability of the host to contain the infection. The recent delineation of the important role that LukED plays inS. aureuspathogenesis and the identification of its protein receptors, combined with its presence inS. aureusmethicillin-resistant epidemic strains, establish this leukocidin as a possible target for the development of novel therapeutics. Here, the crystal structures of the water-soluble LukE andmore » LukD components of LukED have been determined. Lastly, the two structures illustrate the tertiary-structural variability with respect to the other leukotoxins while retaining the conservation of the residues involved in the interaction of the protomers in the bipartite leukotoxin in the pore complex.« less

  7. Crystal structures of the components of the Staphylococcus aureus leukotoxin ED

    SciTech Connect

    Nocadello, S.; Minasov, G.; Shuvalova, L.; Dubrovska, I.; Sabini, E.; Bagnoli, F.; Grandi, G.; Anderson, W. F.

    2016-01-01

    Staphylococcal leukotoxins are a family of β-barrel, bicomponent, pore-forming toxins with membrane-damaging functions. These bacterial exotoxins share sequence and structural homology and target several host-cell types. Leukotoxin ED (LukED) is one of these bicomponent pore-forming toxins thatStaphylococcus aureusproduces in order to suppress the ability of the host to contain the infection. The recent delineation of the important role that LukED plays inS. aureuspathogenesis and the identification of its protein receptors, combined with its presence inS. aureusmethicillin-resistant epidemic strains, establish this leukocidin as a possible target for the development of novel therapeutics. Here, the crystal structures of the water-soluble LukE and LukD components of LukED have been determined. Lastly, the two structures illustrate the tertiary-structural variability with respect to the other leukotoxins while retaining the conservation of the residues involved in the interaction of the protomers in the bipartite leukotoxin in the pore complex.

  8. EDS coal liquefaction process development: Phase V. Final technical progress report, Volume I

    SciTech Connect

    1984-02-01

    All objectives in the EDS Cooperative Agreement for Phases III-B through V have been achieved for the RCLU pilot plants. EDS operations have been successfully demonstrated in both the once-through and bottoms recycle modes for coals of rank ranging from bituminous to lignitic. An extensive data base detailing the effects of process variable changes on yields, conversions and product qualities for each coal has been established. Continuous bottoms recycle operations demonstrated increased overall conversion and improved product slate flexibility over once-through operations. The hydrodynamics of the liquefaction reactor in RCLU were characterized through tests using radioactive tracers in the gas and slurry phases. RCLU was shown to have longer liquid residence times than ECLP. Support work during ECLP operations contributed to resolving differences between ECLP conversions and product yields and those of the small pilot plants. Solvent hydrogenation studies during Phases IIIB-V of the EDS program focused on long term activity maintenance of the Ni-MO-10 catalyst. Process variable studies for solvents from various coals (bituminous, subbituminous, and lignitic), catalyst screening evaluations, and support of ECLP solvent hydrogenation operations. Product quality studies indicate that highly cyclic EDS naphthas represent unique and outstanding catalytic reforming feedstocks. High volumes of high octane motor gasoline blendstock are produced while liberating a considerable quantity of high purity hydrogen.

  9. Studying Learning in the Worldwide Classroom Research into edX's First MOOC

    ERIC Educational Resources Information Center

    Breslow, Lori; Pritchard, David E.; DeBoer, Jennifer; Stump, Glenda S.; Ho, Andrew D.; Seaton, Daniel T.

    2013-01-01

    "Circuits and Electronics" (6.002x), which began in March 2012, was the first MOOC developed by edX, the consortium led by MIT and Harvard. Over 155,000 students initially registered for 6.002x, which was composed of video lectures, interactive problems, online laboratories, and a discussion forum. As the course ended in June 2012,…

  10. GESTATIONAL EXPOSURE TO ETHANE DIMETHANESULFONATE (EDS) ALTERS DEVELOPMENT OF THE MOUSE TESTIS

    EPA Science Inventory

    GESTATIONAL EXPOSURE TO ETHANE DIMETHANESULFONATE (EDS) ALTERS DEVELOPMENT OF THE MOUSE TESTIS. D.K. Tarka*1,2, J.D. Suarez*2, N.L. Roberts*2, J.M. Rogers*1,2, M.P. Hardy3, and G.R. Klinefelter1,2. 1University of North Carolina, Curriculum in Toxicology, Chapel Hill, NC; 2USEPA,...

  11. Content Analysis of PhD and EdD Dissertations in Special Education

    ERIC Educational Resources Information Center

    Walker, David W.; Haley-Mize, Shannon

    2012-01-01

    Previous research conducted by Nelson and Coorough (1994) found support for the statement that PhD programs were more research oriented, whereas doctorate of education (EdD) programs were more oriented to the educational practitioner. This previous study, however, had grouped all dissertations in education and had not looked at dissertations by…

  12. Where Practicum Meets Test Preparation: Supporting Teacher Candidates through EdTPA

    ERIC Educational Resources Information Center

    Clark-Gareca, Beth

    2015-01-01

    A strong focus on teacher performance is resurfacing in teacher-preparation programs across the US. EdTPA, a teacher-performance assessment designed to determine K-12 teacher candidates' readiness for the classroom, has become central in teacher-preparation programs in several states and promises to be implemented in more states in the coming…

  13. APA Reporting Standards in Quantitative Research Dissertations from an Online EdD Program

    ERIC Educational Resources Information Center

    Salgado, Griselle

    2013-01-01

    This study was an investigation of the reporting practices in dissertations with quantitative research designs produced by students enrolled in an online Doctor of Education (EdD) program, one that follows the American Psychological Association (APA) standards for reporting research. Limited, empirical information exists about the competencies in…

  14. What Is the Underlying Conception of Teaching of the edTPA?

    ERIC Educational Resources Information Center

    Sato, Mistilina

    2014-01-01

    The edTPA, a nationally available performance assessment for teacher candidates, has recently been developed and implemented in teacher education programs across the United States. Advocates make arguments for the need for such an assessment while critics of standardized performance assessments point out the dangers of standardization. This…

  15. Chemical Quantification of Atomic-Scale EDS Maps under Thin Specimen Conditions

    SciTech Connect

    Lu, Ping; Romero, Eric; Lee, Shinbuhm; MacManus-Driscoll, Judith L.; Jia, Quanxi

    2014-10-13

    We report our effort to quantify atomic-scale chemical maps obtained by collecting energy-dispersive X-ray spectra (EDS) using scanning transmission electron microscopy (STEM) (STEM-EDS). Under a thin specimen condition and when the EDS scattering potential is localized, the X-ray counts from atomic columns can be properly counted by fitting Gaussian peaks at the atomic columns, and can then be used for site-by-site chemical quantification. The effects of specimen thickness and X-ray energy on the Gaussian peak-width are investigated by using SrTiO3 (STO) as a model specimen. The relationship between the peak-width and spatial-resolution of an EDS map is also studied. Furthermore, the method developed by this work is applied to study a Sm-doped STO thin film and antiphase boundaries present within the STO film. We find that Sm atoms occupy both Sr and Ti sites but preferably the Sr sites, and Sm atoms are relatively depleted at the antiphase boundaries likely due to the effect of strain.

  16. Next Generation Science Standards and edTPA: Evidence of Science and Engineering Practices

    ERIC Educational Resources Information Center

    Brownstein, Erica M.; Horvath, Larry

    2016-01-01

    Science teacher educators in the United States are currently preparing future science teachers to effectively implement the "Next Generation Science Standards" (NGSS) and, in thirteen states, to successfully pass a content-specific high stakes teacher performance assessment, the edTPA. Science education and teacher performance assessment…

  17. Developing a Culture of Learning around the edTPA: One University's Journey

    ERIC Educational Resources Information Center

    Miller, Matthew; Carroll, David; Jancic, Mitchell; Markworth, Kimberly

    2015-01-01

    In this article, we discuss how an interdisciplinary faculty team at a midsized public university created supports for the Teacher Performance Assessment (edTPA), a high-stakes performance assessment for preservice candidates being adopted by many states. We provide a general description of our work in contending with the challenge of developing a…

  18. ExpandED Schools National Demonstration: Lessons for Scale and Sustainability

    ERIC Educational Resources Information Center

    Russell, Christina A.; Hildreth, Jeanine L.; Stevens, Pamela

    2016-01-01

    The ExpandED Schools model for expanded learning is designed to transform schools by changing the use of time, both as experienced by students in learning and by teachers in instruction. The model is grounded in the belief that strategically adding time to the school day can enhance skills and knowledge and broaden horizons by engaging students in…

  19. Bike Ed '77: A Conference Report (Washington, D.C., May 4-6, 1977).

    ERIC Educational Resources Information Center

    Johnson (Lawrence) and Associates, Inc., Washington, DC.

    As a result of intensified need for sound safety education programs for both young and mature bicyclists due to the dramatic increase in bicycling as a form of transportation and recreation, the first national conference on bicyclist safety education was held--Bike Ed '77. Major purposes of the conference were to stimulate communication among…

  20. ED's Proposed Changes to SFSF Data Collection and Reporting Requirements: DQC's Submitted Comments

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2011

    2011-01-01

    This letter is submitted to comment on the U.S. Department of Education's (ED) proposed revisions to the American Recovery and Reinvestment Act's (ARRA) State Fiscal Stabilization Fund (SFSF), as published in the September 23, 2011, Federal Register. Overall, the Data Quality Campaign believes the proposed changes strike a sensible balance: they…

  1. PROJECT RE-ED, A DEMONSTRATION PROJECT FOR THE REEDUCATION OF EMOTIONALLY DISTURBED CHILDREN.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Mental Health, Raleigh.

    THE PROJECT FOR THE REEDUCATION OF EMOTIONALLY DISTURBED CHILDREN (PROJECT RE-ED), A DEMONSTRATION PROJECT (1961-1968) TO DEVELOP AND EVALUATE THE EFFECTIVENESS OF RESIDENTIAL SCHOOLS (SUNDAY THROUGH FRIDAY) FOR DISTURBED CHILDREN, IS DESCRIBED. THE PROFESSIONAL TRAINING AT GEORGE PEABODY COLLEGE, TENNESSEE, AND USE OF CAREFULLY SELECTED…

  2. Chemical Quantification of Atomic-Scale EDS Maps under Thin Specimen Conditions

    DOE PAGES

    Lu, Ping; Romero, Eric; Lee, Shinbuhm; ...

    2014-10-13

    We report our effort to quantify atomic-scale chemical maps obtained by collecting energy-dispersive X-ray spectra (EDS) using scanning transmission electron microscopy (STEM) (STEM-EDS). Under a thin specimen condition and when the EDS scattering potential is localized, the X-ray counts from atomic columns can be properly counted by fitting Gaussian peaks at the atomic columns, and can then be used for site-by-site chemical quantification. The effects of specimen thickness and X-ray energy on the Gaussian peak-width are investigated by using SrTiO3 (STO) as a model specimen. The relationship between the peak-width and spatial-resolution of an EDS map is also studied. Furthermore,more » the method developed by this work is applied to study a Sm-doped STO thin film and antiphase boundaries present within the STO film. We find that Sm atoms occupy both Sr and Ti sites but preferably the Sr sites, and Sm atoms are relatively depleted at the antiphase boundaries likely due to the effect of strain.« less

  3. Evaluating the Amazon water cycle components using ED model against GRACE

    NASA Astrophysics Data System (ADS)

    Lee, E.; Han, S. C.; Yeo, I. Y.; Longo, M.; Swann, A. L. S.; Knox, R. G.; Briscoe, J.; Moorcroft, P. R.

    2014-12-01

    Changes in the water cycle components of the Amazon and its surrounding regions are a key to assessing regional impacts of climate and land-cover changes, as they may affect rain-fed agriculture and hydroelectric power generation in Brazil. A comprehensive validation of the modeled water budget, therefore, is a necessary part of understanding the region's hydroclimatology. We evaluate the water cycle components from Ecosystem Demography (ED) model both as a stand-alone model and a coupled model to the Brazilian Regional Atmospheric Modeling System (BRAMS). Model results are compared with satellite-driven observations and a flux tower measurement in central Amazon. Our results indicate that the modeled EDBRAMS precipitation over Amazonia replicates the observed patterns of the Tropical Rainfall Measuring Mission (TRMM) from 2001 to 2009. Total Water Storage Change (TWSC) anomalies from the ED model at the Paraná River basin shows a better agreement with the Gravity Recovery And Climate Experiment (GRACE) satellite observation from 2002 to 2008, as compared to the Global Land Data Assimilation System (GLDAS)/NOAH model. The Nash-Sutcliff model efficiency coefficient improved from 0.50 (GLDAS/NOAH vs. GRACE) to 0.65 (ED vs. GRACE). We also evaluate the modeled evapotranspiration (ET) against the flux tower measurement. Our study affirms the capabilities of the ED model in simulating the Amazon hydrological cycle, which helps investigate its sustainable thresholds with various land-cover and climate change scenarios.

  4. Using Ontological Engineering to Overcome AI-ED Problems: Contribution, Impact and Perspectives

    ERIC Educational Resources Information Center

    Mizoguchi, Riichiro; Bourdeau, Jacqueline

    2016-01-01

    This article reflects on the ontology engineering methodology discussed by the paper entitled "Using Ontological Engineering to Overcome AI-ED Problems" published in this journal in 2000. We discuss the achievements obtained in the last 10 years, the impact of our work as well as recent trends and perspectives in ontology engineering for…

  5. GESTATIONAL EXPOSURE TO ETHANE DIMETHANESULFONATE (EDS) ALTERS DEVELOPMENT OF THE MOUSE TESTIS

    EPA Science Inventory

    GESTATIONAL EXPOSURE TO ETHANE DIMETHANESULFONATE (EDS) ALTERS DEVELOPMENT OF THE MOUSE TESTIS. D.K. Tarka*1,2, J.D. Suarez*2, N.L. Roberts*2, J.M. Rogers*1,2, M.P. Hardy3, and G.R. Klinefelter1,2. 1University of North Carolina, Curriculum in Toxicology, Chapel Hill, NC; 2USEPA,...

  6. The NASA Exoplanet Science Institute Archives: KOA and NStED

    NASA Astrophysics Data System (ADS)

    Berriman, G. B.; Ciardi, D.; Abajian, M.; Barlow, T.; Bryden, G.; von Braun, K.; Good, J.; Kane, S.; Kong, M.; Laity, A.; Lynn, M.; Elroy, D. M.; Plavchan, P.; Ramirez, S.; Schmitz, M.; Stauffer, J.; Wyatt, P.; Zhang, A.; Goodrich, R.; Mader, J.; Tran, H.; Tsubota, M.; Beekley, A.; Berukoff, S.; Chan, B.; Lau, C.; Regelson, M.; Saucedo, M.; Swain, M.

    2010-12-01

    The NASA Exoplanet Science Institute (NExScI) maintains a series of archival services in support of NASA’s planet finding and characterization goals. Two of the larger archival services at NExScI are the Keck Observatory Archive (KOA) and the NASA Star and Exoplanet Database (NStED). KOA, a collaboration between the W. M. Keck Observatory and NExScI, serves raw data from the High Resolution Echelle Spectrograph (HIRES) and extracted spectral browse products. As of June 2009, KOA hosts over 28 million files (4.7 TB) from over 2,000 nights. In Spring 2010, it will begin to serve data from the Near-Infrared Echelle Spectrograph (NIRSPEC). NStED is a general purpose archive with the aim of providing support for NASA’s planet finding and characterization goals, and stellar astrophysics. There are two principal components of NStED: a database of (currently) all known exoplanets, and images; and an archive dedicated to high precision photometric surveys for transiting exoplanets. NStED is the US portal to the CNES mission CoRoT, the first space mission dedicated to the discovery and characterization of exoplanets. These archives share a common software and hardware architecture with the NASA/IPAC Infrared Science Archive (IRSA). The software architecture consists of standalone utilities that perform generic query and retrieval functions. They are called through program interfaces and plugged together to form applications through a simple executive library.

  7. A Professional Doctorate in Educational Leadership: Saint Louis University's Ed.D. Program

    ERIC Educational Resources Information Center

    Everson, Susan Toft

    2009-01-01

    This article presents the case of a professional doctorate program in educational leadership at Saint Louis University (SLU). This Ed.D. program was designed to prepare students for executive leadership positions in school districts, distinguishing it from SLU's Ph.D. program that prepares students for research or academic positions. This article…

  8. Inside the Sex Ed Studio: An Interview with Susan N. Wilson

    ERIC Educational Resources Information Center

    Taverner, William J.

    2007-01-01

    "Inside the Sex Ed Studio" profiles leaders in the field of sexuality education. Susan N. Wilson, former Executive Coordinator of the Network for Family Life Education, long-time advocate for sexuality education, and the driving force behind New Jersey's K-12 mandate for comprehensive sexuality education was the first such leader to be…

  9. A Model for Developing Literacy Leadership through an M.A. Ed. Program in Reading

    ERIC Educational Resources Information Center

    Justice-Crickmer, Janet; Thompson, E. H.

    2007-01-01

    Arthur Levine's (2006) study of teacher preparation in the United States and his resulting controversial recommendations have increased the need for teacher educators in independent institutions to share insights into designing and implementing effective degree programs. To that end, this article highlights aspects of an innovative M.A. Ed.…

  10. TechEdSat 5 PhoneSat 5 Team Photo

    NASA Image and Video Library

    2016-07-28

    TechEdSat 5 PhoneSat 5 Team photo on July 26, 2016. Taken in fron of the 1/3 scale Shuttle Orbiter Model, in front of the Parade Ground on Clark Road at NASA Research Park. Mark Murbach Sarosh Hussain Ali Guarneros Luna David Handy Jonathan Hanson Jakqueline Granillo Sarah Chu Alejandro Sales

  11. Time to Grow: Year Two Report on ExpandED Schools. A TASC Report

    ERIC Educational Resources Information Center

    Traill, Saskia; Brohawn, Katie

    2014-01-01

    An analysis of data from the second year of The After-School Corporation's (TASC's) national demonstration of an expanded school day for elementary and middle school students shows that ExpandED Schools improved school culture, decreased rates of students' chronic absenteeism and helped students develop positive learning habits and attitudes.…

  12. Promoting Social Inclusion Counting with Everyone: Learning Communities and INCLUD-ED

    ERIC Educational Resources Information Center

    Gatt, Suzanne; Ojala, Mikko; Soler, Marta

    2011-01-01

    The scientific community has provided a wide range of evidence that family and community involvement in schools benefits not only students' learning but also their surrounding community. The INCLUD-ED project has conducted case studies of successful schools around Europe that have strong community participation. Some of them are engaged in the…

  13. A long range transmission system communication plan for ComEd of Chicago 1995 to 2000

    SciTech Connect

    Casanova, R.; Gerleve, F.J.

    1995-10-01

    The design of a telecommunication fiber optical network serving ComEd`s commercial centers and generation stations is described. A long range communication plan is presented describing a migration of transmission substation protection, monitoring and control from an analog system over power line carrier, microwave, and leased phone lines to a digital system using an optimum mix of communication channels including fiber.

  14. Racist Ordering, Settler Colonialism, and EdTPA: A Participatory Policy Analysis

    ERIC Educational Resources Information Center

    Tuck, Eve; Gorlewski, Julie

    2016-01-01

    This article tells the story of an intervention by a collective of teacher educators on New York State's adoption of edTPA. Too often in education policy analysis, issues of race are discussed briefly, if at all. This article argues that attending to constructions of race specific to settler colonialism is an important approach to education policy…

  15. The use of model-based iterative reconstruction to decrease ED radiation exposure.

    PubMed

    Gatewood, Medley O; Grubish, Lindsay; Busey, Janet M; Shuman, William P; Strote, Jared

    2015-04-01

    The radiation risk posed by diagnostic computed tomography (CT) is a growing concern. The use of model-based iterative reconstruction (MBIR) technology reduces radiation exposure but requires additional processing time. The goal of this study was to compare MBIR and a standard CT reconstructive protocols in terms of emergency department (ED) visit duration and reduction in radiation exposure. A retrospective, matched, case-control design was used to compare patients who received MBIR and standard protocol abdomen and pelvis CTs. ED length of stay (LOS) and radiation exposure were the 2 primary outcome variables. During the study period, 121 patients met inclusion criteria and were matched to controls for a total of 242 subjects. Although the low-dose group LOS was slightly longer, there was no significant difference in LOS. Mean differences were 18 minutes overall (520 vs 502 minutes; P = .497), 11 minutes for admitted patients (587 vs 576 minutes; P = .839), and 22 minutes for discharged patients (490 vs 468 minutes; P = .482). The mean volume CT dose index for the standard-dose CT was 11.6 ± 8.3 and 7.7 ± 4.6 mGy for the reduced-dose CT, a 34% decrease (P < .001). Use of MBIR in the ED may provide decreased radiation exposure while minimally impacting ED LOS. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Breakers, Benders, and Obeyers: Inquiring into Teacher Educators' Mediation of edTPA

    ERIC Educational Resources Information Center

    Ratner, Andrew R.; Kolman, Joni S.

    2016-01-01

    This article reflects a qualitative exploratory inquiry into the lived experiences of faculty members working within a system of urban schools of education as they supported diverse teacher candidates in completing the Educative Teacher Performance Assessment (edTPA) during its first semesters of high-stakes implementation. Drawing upon…

  17. On-Going Dialogue: Degrees of Difference: The Ph.D. and the Ed.D.

    ERIC Educational Resources Information Center

    Carpenter, D. Stanley

    1987-01-01

    The controversy over Ph.D. vs. Ed.D. programs in higher education is examined, including discussion of differential research requirements and the ways in which traditional disciplines dominate thinking about the study of higher education. It is concluded that each field must define its own standards for each degree. (MSE)

  18. Systematic Review of ED-based Intimate Partner Violence Intervention Research

    PubMed Central

    Choo, Esther K.; Gottlieb, Amy S.; DeLuca, Marie; Tape, Chantal; Colwell, Lauren; Zlotnick, Caron

    2015-01-01

    Introduction Assessment reactivity may be a factor in the modest results of brief interventions for substance use in the emergency department (ED). The presence of assessment reactivity in studies of interventions for intimate partner violence (IPV) has not been studied. Our objectives were to identify ED IPV intervention studies and evaluate the presence of a consistently positive effect on the control groups. Methods We performed a systematic search of electronic databases for English=language intervention studies addressing IPV in the ED published since 1990. Study selection and assessment of methodologic quality were performed by two independent reviewers. Data extraction was performed by one reviewer and then independently checked for completeness and accuracy by a second reviewer. Results Of 3,620 unique manuscripts identified by database search, 667 underwent abstract review and 12 underwent full-text review. Only three met full eligibility criteria; data on the control arm were available for two studies. In these two studies, IPV-related outcomes improved for both the experimental and control condition. Conclusion The paucity of controlled trials of IPV precluded a robust evaluation for assessment reactivity. This study highlighted a critical gap in ED research on IPV. PMID:26759650

  19. Massively Open Online Course for Educators (MOOC-Ed) Network Dataset

    ERIC Educational Resources Information Center

    Kellogg, Shaun; Edelmann, Achim

    2015-01-01

    This paper presents the Massively Open Online Course for Educators (MOOC-Ed) network dataset. It entails information on two online communication networks resulting from two consecutive offerings of the MOOC called "The Digital Learning Transition in K-12 Schools" in spring and fall 2013. The courses were offered to educators from the USA…

  20. Buyer Beware: Lessons Learned from EdTPA Implementation in New York State

    ERIC Educational Resources Information Center

    Greenblatt, Deborah; O'Hara, Kate E.

    2015-01-01

    As states across the country continue their implementation of the Teacher Performance Assessment Portfolio (edTPA), a complex and high-stakes certification requirement for teacher certification, there are important lessons for educators and education advocates to learn from New York State's implementation. As Linda Darling-Hammond, developer and…

  1. Ed Bullins/Stage One: Everybody Wants to Know Why I Sing the Blues

    ERIC Educational Resources Information Center

    Smitherman, Geneva

    1974-01-01

    Both as director/playwright of New York's New Lafayette Theater and as a writer seriously committed to the forging of a black aesthetic, Ed Bullins brings to the community an artistic synthesis of the Folk-Oral and Formal-Literate Traditions. (Author/JM)

  2. Sex Ed for Caring Schools: Creating an Ethics-Based Curriculum

    ERIC Educational Resources Information Center

    Lamb, Sharon

    2013-01-01

    While arguments for and against teaching abstinence, the use of contraceptives, and sexual identity are becoming more and more polarized, most people agree that students must learn to navigate an increasingly sexual world. "Sex Ed for Caring Schools" presents a curriculum that goes beyond the typical health education most students receive today.…

  3. Community-Engaged Faculty: A Must for Preparing Impactful Ed.D. Graduates

    ERIC Educational Resources Information Center

    Peterson, Deborah; Perry, Jill Alexa; Dostilio, Lina; Zambo, Debby

    2016-01-01

    Since its inception nine years ago, CPED members have re-envisioned and implemented a new purpose for the professional practice doctorate in education, or Ed.D. This new purpose is grounded in the goal of preparing doctoral students to serve as scholarly practitioners, those who engage community as stakeholders in the process of improving problems…

  4. Sex Ed for Caring Schools: Creating an Ethics-Based Curriculum

    ERIC Educational Resources Information Center

    Lamb, Sharon

    2013-01-01

    While arguments for and against teaching abstinence, the use of contraceptives, and sexual identity are becoming more and more polarized, most people agree that students must learn to navigate an increasingly sexual world. "Sex Ed for Caring Schools" presents a curriculum that goes beyond the typical health education most students receive today.…

  5. The effect of practitioner characteristics on patient pain and embarrassment during ED internal examinations.

    PubMed

    Patton, Kenneth R; Bartfield, Joel M; McErlean, Mara

    2003-05-01

    The objective was to determine if practitioner characteristics influence patients' pain and embarrassment during an emergency department (ED) internal pelvic examination (IPE). This prospective, comparative study was performed in an urban, university teaching hospital ED with an annual census of 64,000. The study population consisted of a convenience sample of patients who required an IPE as part of her ED evaluation. Information gathered included patient age and final diagnosis, as well as examiner gender and level of training (LOT). Immediately after IPE, the patient was asked to rate both pain and embarrassment of the examination using a previously validated 100-mm visual analog scale (VAS). Finally, each subject was asked to indicate her practitioner gender preference for IPE. The influence of examiner gender and LOT on patient pain and embarrassment was assessed using a t-test or ANOVA with significance defined as P <.05. A total of 278 subjects completed the study (mean age 27.7 +/- 10.5 years, range 13 to 70 years). The mean pain and embarrassment scores were 29.7 and 17.5 respectively. Examiner gender, examiner LOT and patient age did not predict pain and embarrassment scores. Overall, 173 (62%) patients had no practitioner gender preference, whereas 93 (34%) preferred women and 11 (4%) preferred men. Examiner characteristics do not influence either the pain or the embarrassment associated with IPE in the ED.

  6. Developing Scientific Literacy Skills through Interdisciplinary, Technology-Based Global Simulations: GlobalEd 2

    ERIC Educational Resources Information Center

    Lawless, Kimberly A.; Brown, Scott W.

    2015-01-01

    GlobalEd 2 (GE2) is a set of technology-mediated, problem-based learning (PBL) simulations for middle-grade students, that capitalises on the multidisciplinary nature of the social sciences as an expanded curricular space for students to learn and apply scientific literacies and concepts, while simultaneously also enriching their understanding of…

  7. Effect of weather on the number and the nature of visits to a pediatric ED.

    PubMed

    Attia, M W; Edward, R

    1998-07-01

    To determine whether unfavorable weather conditions affect the number and acuity of visits to a pediatric emergency department (ED), a retrospective analysis was conducted of children's hospital ED visits and weather conditions utilizing an ED log book and local climatological data during the year 1993. Visits, intensive care unit (ICU) admissions, non-ICU admissions, time periods with favorable weather (TPF), and time periods with unfavorable weather (TPUF) were measured. Each day of the year was divided into two time periods. The time periods were labeled TPF or TPUF based on certain weather conditions. There were 632 (86%) TPF and 98 (14%) TPUF. The number of visits, non-ICU admissions, and ICU admissions during TPF were 13,008 (88%), 1,031 (87%) and 121 (86%), respectively. The number of visits, non-ICU admissions, and ICU admissions during TPUF were 1,720 (12%), 148 (13%), and 19 (14%), respectively. No significant differences in visits and admissions during TPF and TPUF were identified. Also, there was no difference identified when the distribution of visits and admissions was examined during TPUF due to different weather factors, eg, low temperature, precipitation, etc. The results show that unfavorable weather due to the types of weather factors discussed does not affect the number or the nature of visits to a pediatric ED.

  8. Xu Bing, Ed Pien and Gu Xiong: Lost and Found in Translation

    ERIC Educational Resources Information Center

    Mahon, Patrick

    2008-01-01

    The works of contemporary artists Xu Bing, Ed Pien and Gu Xiong are involved in bringing to light some of the factors inherent in social, cultural and linguistic translation. In doing so, each artist is also engaged in the nuanced activity of moving between historical and contemporary aesthetic strategies in order to interrogate the way meaning is…

  9. Using Ontological Engineering to Overcome AI-ED Problems: Contribution, Impact and Perspectives

    ERIC Educational Resources Information Center

    Mizoguchi, Riichiro; Bourdeau, Jacqueline

    2016-01-01

    This article reflects on the ontology engineering methodology discussed by the paper entitled "Using Ontological Engineering to Overcome AI-ED Problems" published in this journal in 2000. We discuss the achievements obtained in the last 10 years, the impact of our work as well as recent trends and perspectives in ontology engineering for…

  10. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Age distinctions contained in ED's regulations. 110.17..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in...

  11. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Age distinctions contained in ED's regulations. 110.17..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in...

  12. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Age distinctions contained in ED's regulations. 110.17..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in...

  13. WORK-ED. (World of Related Knowledge and Educational Development). A Manual for Trainers.

    ERIC Educational Resources Information Center

    Fraleigh, Virginia A.

    This manual is designed to assist personnel responsible for training teachers in the implementation of the World of Related Knowledge and Educational Development (WORK-ED). (The program is a career education course for ninth graders developed to enable students who have not chosen the traditional college-prep high school course to make career…

  14. Meeting the Needs of Distance Learners of M.Ed Program: Bangladesh Open University Perspective

    ERIC Educational Resources Information Center

    Islam, Amirul; Ferdowsi, Sakiba

    2014-01-01

    This study draws on the experience of a cohort of 22 students from 09 tutorial centers enrolled in a Master of Education (M Ed) distance learning program administered by the Bangladesh Open University (BOU). It's purpose is to locate the aims and philosophies of distance learning within the experiences of actual distance learners in order to see…

  15. Developing Scientific Literacy Skills through Interdisciplinary, Technology-Based Global Simulations: GlobalEd 2

    ERIC Educational Resources Information Center

    Lawless, Kimberly A.; Brown, Scott W.

    2015-01-01

    GlobalEd 2 (GE2) is a set of technology-mediated, problem-based learning (PBL) simulations for middle-grade students, that capitalises on the multidisciplinary nature of the social sciences as an expanded curricular space for students to learn and apply scientific literacies and concepts, while simultaneously also enriching their understanding of…

  16. 34 CFR 110.17 - Age distinctions contained in ED's regulations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Age distinctions contained in ED's regulations. 110.17..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Standards for Determining Age Discrimination § 110.17 Age distinctions contained in...

  17. Visualization of mitochondrial DNA replication in individual cells by EdU signal amplification.

    PubMed

    Haines, Kristine M; Feldman, Eva L; Lentz, Stephen I

    2010-11-15

    Mitochondria are key regulators of cellular energy and mitochondrial biogenesis is an essential component of regulating mitochondria numbers in healthy cells. One approach for monitoring mitochondrial biogenesis is to measure the rate of mitochondrial DNA (mtDNA) replication. We developed a sensitive technique to label newly synthesized mtDNA in individual cells in order to study mtDNA biogenesis. The technique combines the incorporation of 5-ethynyl-2'-deoxyuridine (EdU) with a tyramide signal amplification (TSA) protocol to visualize mtDNA replication within subcellular compartments of neurons. EdU is superior to other thymidine analogs, such as 5-bromo-2-deoxyuridine (BrdU), because the initial click reaction to label EdU does not require the harsh acid treatments or enzyme digests that are required for exposing the BrdU epitope. The milder labeling of EdU allows for direct comparison of its incorporation with other cellular markers. The ability to visualize and quantify mtDNA biogenesis provides an essential tool for investigating the mechanisms used to regulate mitochondrial biogenesis and would provide insight into the pathogenesis associated with drug toxicity, aging, cancer and neurodegenerative diseases. Our technique is applicable to sensory neurons as well as other cell types. The use of this technique to measure mtDNA biogenesis has significant implications in furthering the understanding of both normal cellular physiology as well as impaired disease states.

  18. Unique program aims to connect frequent ED utilizers with medical homes, resources to meet complex needs.

    PubMed

    2014-10-01

    Sinai Hospital of Baltimore in Baltimore, MD, is partnering with HealthCare Access Maryland, a non-profit organization in the state, to link patients who frequent the ED for care with medical homes and other resources that can better meet their medical and social needs. Under the Access Health Program, ED-based care coordinators intervene with patients who meet program criteria, linking them with medical homes and other resources that address their complex needs. The hospital has devised a flag to notify the ED when a frequent-utilizing patient presents in the department for care. Care coordinators then meet with these patients and get their consent to participate in the program. Within a week of the ED visit, care coordinators schedule a home visit with the patient to establish a care plan containing specific goals and a time frame to carry out these goals. Patients remain in the program for 90 days as care coordinators work to hand them off to longer-term resources. Many of the patients enrolled in the program have substance abuse and mental health problems. Patients are also often uninsured and/or homeless. Within two months of launching the program, care coordinators enrolled 74 patients, with the goal of eventually bringing that number to 200.

  19. Racist Ordering, Settler Colonialism, and EdTPA: A Participatory Policy Analysis

    ERIC Educational Resources Information Center

    Tuck, Eve; Gorlewski, Julie

    2016-01-01

    This article tells the story of an intervention by a collective of teacher educators on New York State's adoption of edTPA. Too often in education policy analysis, issues of race are discussed briefly, if at all. This article argues that attending to constructions of race specific to settler colonialism is an important approach to education policy…

  20. An Analysis of Professional Practice Ed.D. Dissertations in Educational Technology

    ERIC Educational Resources Information Center

    Dawson, Kara; Kumar, Swapna

    2014-01-01

    The University of Florida offers an online professional practice Ed.D. focused on Educational Technology. Twenty-three students have completed professional practice dissertations and graduated since the program's inception in 2008. The purpose of this article is to share what these dissertations have looked like and to begin a dialogue about…

  1. Time to Grow: Year Two Report on ExpandED Schools. A TASC Report

    ERIC Educational Resources Information Center

    Traill, Saskia; Brohawn, Katie

    2014-01-01

    An analysis of data from the second year of The After-School Corporation's (TASC's) national demonstration of an expanded school day for elementary and middle school students shows that ExpandED Schools improved school culture, decreased rates of students' chronic absenteeism and helped students develop positive learning habits and attitudes.…

  2. Global Emissions Database (GLoED) version 1.0 (on diskette). Software

    SciTech Connect

    1997-09-01

    The Global Emissions Database (GloED) is a user-friendly, menu-driven tool for storing and retrieving emissions factors and activity data on a country-specific basis. Data can be selected from databases resident within GloED and/or supplied by the user. The data are used to construct emissions scenarios for the countries and sources selected. References are linked to the data to ensure clear data pedigrees. The scenario outputs can be displayed on thematic global maps or other graphic outputs such as pie or bar charts. In addition, data files can be exported to a printer. The majority of the datasets are single gas (i.e., methane emissions datasets). Some of the datasets include emissions from several greenhouse gases. The sources included emission from: motor vehicles, landfills, minor CH{sub 4} sources, rice cultivation, fuelwood burning, global VOC, animal waste methane, animal enteric CH{sub 4}, domestic waste water, underground mines, biomass burning, and CH{sub 4} from oil and gas production. GloED is a software system designed as a tool to generate estimates of global emissions by combining pollutant-specific emission factors with quantitative data on emission-producing activities for that source. GloED also serves as a repository for emissions data, activity data, and emission factors.

  3. Impact of Curricular Reforms on Educational Philosophy Courses in M.Ed Programmes

    ERIC Educational Resources Information Center

    Gafoor, K. Abdul; Remia, K. R.

    2014-01-01

    In the context of Vision of Teacher Education envisaged in National Curriculum Framework for Teacher Education, this study probes "Do M.Ed programmes provide for the prerequisites of educational philosophy for teacher educators?" and "whether the syllabi following credit and non credit pattern vary in their coverage of content of…

  4. The Ed.D. in Educational Leadership and Administration: The Students' and Alumni's Experiences

    ERIC Educational Resources Information Center

    Vera, Edith B.

    2012-01-01

    The doctoral experience unfolds many complexities and challenges for students, faculty, and institutions that contribute toward degree completion. The purpose of this study is to investigate the students' and alumni's experiences afforded by the Ed.D. in Educational Leadership and Administration at the University of Texas at El Paso (UTEP). The…

  5. Massively Open Online Course for Educators (MOOC-Ed) Network Dataset

    ERIC Educational Resources Information Center

    Kellogg, Shaun; Edelmann, Achim

    2015-01-01

    This paper presents the Massively Open Online Course for Educators (MOOC-Ed) network dataset. It entails information on two online communication networks resulting from two consecutive offerings of the MOOC called "The Digital Learning Transition in K-12 Schools" in spring and fall 2013. The courses were offered to educators from the USA…

  6. Measuring relative performance of an EDS detector using a NiO standard.

    SciTech Connect

    Sugar, Joshua Daniel; Kotula, Paul Gabriel

    2013-09-01

    A method for measuring the relative performance of energy dispersive spectrometers (EDS) on a TEM is discussed. A NiO thin-film standard fabricated at Sandia CA is used. A performance parameter,, is measured and compared to values on several TEM systems.

  7. Advancing Coupled Human-Earth System Models: The Integrated Ecosystem Demography Model (iED) Project

    NASA Astrophysics Data System (ADS)

    Hurtt, G. C.; Chini, L. P.; Clarke, L.; Calvin, K. V.; Chambers, J. Q.; Dubayah, R.; Dolan, K.; Edmonds, J. A.; Fisk, J. P.; Flanagan, S.; Frolking, S.; Janetos, A. C.; LePage, Y.; Morton, D. C.; Patel, P.; Rourke, O.; Sahajpal, R.; Thomson, A. M.; Wise, M.; Ying, Q.

    2012-12-01

    Recent studies with integrated assessment models, models linking human and natural systems at a global scale, highlight the importance of terrestrial systems in climate stabilization efforts. Here we introduce a new modeling framework iED, designed to link advanced remote sensing data (active and passive.), height-structured terrestrial ecosystem dynamics (ED), gridded land-use change projections (GLM), and integrated assessment modeling (GCAM) into a single coupled modeling framework with unprecedented spatial resolution and process-level detail. Our research aims to reduce uncertainties associated with forest modeling within integrated assessments, and to quantify the impacts of climate change on forest growth, mortality, and productivity for integrated assessments of terrestrial carbon management. iED is being used to address key science questions including: (1) What are the opportunities for land-use strategies such as afforestation or woody bioenergy crop production to contribute to stabilization of atmospheric CO2 concentrations? (2) How could potentially altered disturbance rates from tropical cyclones and Amazonian fires affect vegetation, carbon stocks and fluxes, and the development of climate change mitigation strategies? (3) What are the linked remote sensing/ecosystem modeling requirements for improving integrated assessments of climate mitigation strategies? With its strong connections to data and conceptual linkages to other models in development, iED is also designed to inform the next generation of remote sensing and integrated Earth system modeling efforts.

  8. Is the EdTPA the Right Choice for Evaluating Teacher Readiness?

    ERIC Educational Resources Information Center

    Parkes, Kelly A.; Powell, Sean R.

    2015-01-01

    The purpose of this article is to describe and analyze the edTPA, a performance assessment created by the Stanford Center for Assessment, Learning, and Equity (SCALE) and administered by Pearson, Inc., to assess the professional readiness of student teachers. We challenge claims made in support of using this assessment, specifically within the…

  9. Xu Bing, Ed Pien and Gu Xiong: Lost and Found in Translation

    ERIC Educational Resources Information Center

    Mahon, Patrick

    2008-01-01

    The works of contemporary artists Xu Bing, Ed Pien and Gu Xiong are involved in bringing to light some of the factors inherent in social, cultural and linguistic translation. In doing so, each artist is also engaged in the nuanced activity of moving between historical and contemporary aesthetic strategies in order to interrogate the way meaning is…

  10. EDS1 contributes to nonhost resistance of Arabidopsis thaliana against Erwinia amylovora.

    PubMed

    Moreau, Manon; Degrave, Alexandre; Vedel, Régine; Bitton, Frédérique; Patrit, Oriane; Renou, Jean-Pierre; Barny, Marie-Anne; Fagard, Mathilde

    2012-03-01

    Erwinia amylovora causes fire blight in rosaceous plants. In nonhost Arabidopsis thaliana, E. amylovora triggers necrotic symptoms associated with transient bacterial multiplication, suggesting either that A. thaliana lacks a susceptibility factor or that it actively restricts E. amylovora growth. Inhibiting plant protein synthesis at the time of infection led to an increase in necrosis and bacterial multiplication and reduced callose deposition, indicating that A. thaliana requires active protein synthesis to restrict E. amylovora growth. Analysis of the callose synthase-deficient pmr4-1 mutant indicated that lack of callose deposition alone did not lead to increased sensitivity to E. amylovora. Transcriptome analysis revealed that approximately 20% of the genes induced following E. amylovora infection are related to defense and signaling. Analysis of mutants affected in NDR1 and EDS1, two main components of the defense-gene activation observed, revealed that E. amylovora multiplied ten times more in the eds1-2 mutant than in the wild type but not in the ndr1-1 mutant. Analysis of mutants affected in three WRKY transcription factors showing EDS1-dependent activation identified WRKY46 and WRKY54 as positive regulators and WRKY70 as a negative regulator of defense against E. amylovora. Altogether, we show that EDS1 is a positive regulator of nonhost resistance against E. amylovora in A. thaliana and hypothesize that it controls the production of several effective defenses against E. amylovora through the action of WRKY46 and WRKY54, while WRKY70 acts as a negative regulator.

  11. An uncommon life-threatening complication after chest tube drainage of pneumothorax in the ED.

    PubMed

    Beng, Sim Tiong; Mahadevan, Malcom

    2004-11-01

    Re-expansion pulmonary oedema (REPO) after chest tube drainage of pneumothorax is uncommon. We contrast one patient with life threatening against another mildly symptomatic REPO occurring in our emergency department (ED). The mechanism and management of REPO differs distinctly from that of cardiogenic pulmonary oedema. We discuss the predictors of REPO, review clinical details of reported fatalities and suggest preventive measures.

  12. Towards Understanding the DO-178C / ED-12C Assurance Case

    NASA Technical Reports Server (NTRS)

    Holloway, C M.

    2012-01-01

    This paper describes initial work towards building an explicit assurance case for DO-178C / ED-12C. Two specific questions are explored: (1) What are some of the assumptions upon which the guidance in the document relies, and (2) What claims are made concerning test coverage analysis?

  13. Brief Intervention for Drug Users Presenting in Emergency Departments (NIDA CTN Protocol 0047: SMART-ED)

    PubMed Central

    Bogenschutz, Michael P.; Donovan, Dennis M.; Mandler, Raul N.; Perl, Harold I.; Forcehimes, Alyssa A.; Crandall, Cameron; Lindblad, Robert; Oden, Neal L.; Sharma, Gaurav; Metsch, Lisa; Lyons, Michael S.; McCormack, Ryan; Konstantopoulos, Wendy Macias; Douaihy, Antoine

    2014-01-01

    IMPORTANCE Medical treatment settings such as Emergency Departments (EDs) present important opportunities to address problematic substance use. Currently, EDs do not typically intervene beyond acute medical stabilization. OBJECTIVE To contrast the effects of a brief intervention with telephone boosters (BI-B) to those of screening, assessment, and referral to treatment (SAR) and minimal screening only (MSO) among drug-using ED patients. DESIGN Between October 2010 and February 2012, 1285 patients were randomized to MSO (n = 431), SAR (n = 427), or BI-B (n = 427). Follow-up assessments were conducted at 3, 6, and 12 months by blinded interviewers. SETTING EDs of six academic hospitals in the U.S. PARTICIPANTS Participants were adult ED patients scoring ≥ 3 on the 10-item Drug Abuse Screening Test (indicating moderate to severe problems related to drug use) and currently using drugs. INTERVENTIONS Following screening, MSO participants received only an informational pamphlet. SAR participants received assessment plus referral to addiction treatment if indicated. BI-B participants received assessment and referral as in SAR, plus a manual-guided counseling session based on motivational interviewing principles and up to 2 “booster” sessions by telephone during the month following the ED visit. MAIN OUTCOMES AND MEASURES Outcomes evaluated at follow-up visits included self-reported days using the patient-defined primary problem drug, days using any drug, days of heavy drinking, and drug use based on analysis of hair samples. RESULTS Follow-up rates were 88%, 86%, and 81% at 3, 6, and 12 months, respectively. There were no significant differences between groups in self-reported days using the primary drug, days using any drug, or heavy drinking days at 3, 6, or 12 months. At the 3-month follow-up, participants in the SAR group had a higher rate of hair samples positive for their primary drug of abuse (265/280, 95%) than did participants in the MSO group (253/287, 88

  14. Missing the boat: odds for the patients who leave ED without being seen

    PubMed Central

    2013-01-01

    Background A patient left without being seen is a well-recognized indicator of Emergency Department overcrowding. The aim of this study was to define the characteristics of LWBS patients, their rates and associated factors from a tertiary care hospital of Pakistan. Methods A retrospective patient record review was undertaken. All patients presenting to the Aga Khan University Hospital, Karachi, between April and December of the year 2010, were included in the study. Information was collected on age, sex, presenting complaints, ED capacity, month, time, shift, day of the week, and waiting times in the ED. A basic descriptive analysis was made and the rates of LWBS patients were determined among the patient subgroups. Logistic regression analysis was used to assess the risk factors associated with a patient not being seen in the ED. Results A total of 38,762 patients visited ED during the study period. Among them 5,086 (13%) patients left without being seen. Percentage of leaving was highest in the night shift (20%). The percentage was twice as high when the ED was on diversion (19.8%) compared to regular periods of operation (9.8%). Mean waiting time before leaving the ED in pediatric patients was 154 minutes while for adults it was 171 minutes. More than 32% of patients had waited for more than 180 minutes before they left without being seen, compared to the patients who were seen in ED. Important predictors for LWBS included; Triage category P4 i.e. walk –in-patients had an OR of 13.62(8.72-21.3), Diversion status, OR 1.49(1.26-1.76), night shift , OR 2.44(1.95-3.05) and Pediatric age, OR 0.57(0.48-0.66). Conclusions Our study elucidates the LWBS population characteristics and identifies the risk factors for this phenomenon. Targeted interventions should be planned and implemented to decrease the waiting time and alternate services should be provided for high-risk patients (for LWBS) to minimize their number. PMID:23324162

  15. Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker.

    PubMed

    Crouser, Elliott D; Parrillo, Joseph E; Seymour, Christopher; Angus, Derek C; Bicking, Keri; Tejidor, Liliana; Magari, Robert; Careaga, Diana; Williams, JoAnna; Closser, Douglas R; Samoszuk, Michael; Herren, Luke; Robart, Emily; Chaves, Fernando

    2017-09-01

    Sepsis most often presents to the ED, and delayed detection is harmful. WBC count is often used to detect sepsis, but changes in WBC count size also correspond to sepsis. We sought to determine if volume increases of circulating immune cells add value to the WBC count for early sepsis detection in the ED. A blinded, prospective cohort study was conducted in two different ED populations within a large academic hospital. Neutrophil and monocyte volume parameters were measured in conjunction with routine CBC testing on a UniCel DxH 800 analyzer at the time of ED admission and were evaluated for the detection of sepsis. There were 1,320 subjects in the ED consecutively enrolled and categorized as control subjects (n = 879) and those with systemic inflammatory response syndrome (SIRS) (n = 203), infection (n = 140), or sepsis (n = 98). Compared with other parameters, monocyte distribution width (MDW) best discriminated sepsis from all other conditions (area under the curve [AUC], 0.79; 95% CI, 0.73-0.84; sensitivity, 0.77; specificity, 0.73; MDW threshold, 20.50), sepsis from SIRS (AUC, 0.74; 95% CI, 0.67-0.84), and severe sepsis from noninfected patients in the ED (AUC, 0.88; 95% CI, 0.75-0.99; negative predictive value, 99%). The added value of MDW to WBC count was statistically significant (AUC, 0.89 for MDW + WBC vs 0.81 for WBC alone; P < .01); a decision curve analysis also showed improved performance compared with WBC count alone. The incorporation of MDW with WBC count is shown in this prospective cohort study to improve detection of sepsis compared with WBC count alone at the time of admission in the ED. ClinicalTrials.gov; No.: NCT02232750; URL: www.clinicaltrials.gov. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  16. Exploring personality clusters among parents of ED subjects. Relationship with parents' psychopathology, attachment, and family dynamics.

    PubMed

    Amianto, Federico; Daga, Giovanni Abbate; Bertorello, Antonella; Fassino, Secondo

    2013-10-01

    Eating disorders are some of the most difficult mental disorders to treat and manage. Family interacts with genetic dispositions and other pathogenic factors, and may influence the outburst, development and outcome of EDs. The present study explores with a cluster analysis the personality traits of parents of ED subjects. One-hundred-eight mothers and 104 fathers were tested with Temperament Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), State-Trait Anger Expression Inventory (STAX), Family Assessment Device (FAD), Attachment Style Questionnaire (ASQ), Symptom Questionnaire (SQ), Psychological Well-Being scales (PWB). The cluster distribution of parents based on personality traits was explored. Parents' clusters TCI scores were compared as regards personality, psychopathology, attachment and family features. Cross distribution of temperament and character clusters in mothers and fathers, among couples and ED diagnoses of the daughters was explored. Two clusters of mothers and fathers were identified with temperament clustering. Character traits led to two mothers and three fathers clusters. Mothers temperament cluster 1 (MTC1) correspond to a explosive/adventurous profile, MTC2 to a cautious/passive-dependent profile. Fathers temperament cluster 1 (FTC1) was explosive/methodic, FTC2 was independent/methodic. Character clustering distinguished very immature mothers (MCC1) and majority (65%) of character mature mothers with low self-transcendence (MCC2). A third of fathers was severely immature (FCC1), a third impaired as regards relationships (poor cooperativeness and self-transcendence; FCC2), and one third character mature fathers with low self-transcendence (FCC3). Each cluster evidences specific psychopathology and attachment characteristics. FTC1 was more frequently associated with character immaturity. No significant clusters' cross correlation was found in parental couples. Parents' clusters analyze in depth the univocal picture of

  17. Tackling causes and costs of ED presentation for American football injuries: a population-level study.

    PubMed

    Smart, Blair J; Haring, R Sterling; Asemota, Anthony O; Scott, John W; Canner, Joseph K; Nejim, Besma J; George, Benjamin P; Alsulaim, Hatim; Kirsch, Thomas D; Schneider, Eric B

    2016-07-01

    American tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually. Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department (ED) treatment of football-related injury across all age groups in a large nationally representative data set. Patients presenting for ED treatment of injuries sustained playing American tackle football (identified using International Classification of Diseases, Ninth Revision, Clinical Modification code E007.0) from 2010 to 2011 were studied in the Nationwide Emergency Department Sample. Patient-specific injuries were identified using the primary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code and categorized by type and anatomical region. Standard descriptive methods examined patient demographics, diagnosis categories, and ED and inpatient outcomes and charges. During the study period 397363 football players presented for ED treatment, 95.8% of whom were male. Sprains/strains (25.6%), limb fractures (20.7%), and head injuries (including traumatic brain injury; 17.5%) represented the most presenting injuries. Overall, 97.9% of patients underwent routine ED discharge with 1.1% admitted directly and fewer than 11 patients in the 2-year study period dying prior to discharge. The proportion of admitted patients who required surgical interventions was 15.7%, of which 89.9% were orthopedic, 4.7% neurologic, and 2.6% abdominal. Among individuals admitted to inpatient care, mean hospital length of stay was 2.4days (95% confidence interval, 2.2-2.6) and 95.6% underwent routine discharge home. The mean total charge for all patients was $1941 (95% confidence interval, $1890-$1992) with substantial

  18. Co-Morbid Erectile Dysfunction (Ed) and Antidepressant Treatment in a Patient - A Management Challenge?

    PubMed

    Zainol, Maszaidi; Sidi, Hatta; Kumar, Jaya; Das, Srijit; Ismail, Shaiful; Hatta, Muhammad Hizri; Baharudin, Najwa; Ravindran, Arun

    2017-03-15

    Across the globe, antidepressants (AD) and phosphodiesterase-5 inhibitors (PDE-5i) are commonly prescribed psychopharmacological agents for patients with co-morbid mental-health problem and sexual dysfunction (SD). The serotonergic and/or noradrenergic ADs, although is an effective agent are not without SD side-effects, especially erectile dysfunction (ED). ED is an inability to achieve, or maintain an erection for satisfactory sexual intercourse during the phases of male's sexual arousal. It is recognized as an important reason why non-adherence to treatment was observed in patients who are on AD. AD intervention caused remission to some of the pre-treatment psychopathology of ED, but to many patients, AD potentially magnified the unwanted sexual side-effects. This made this situation a challenging task for the mental health professional. These challenges are based on the complexity of ED - its etiology, and the associated risk factors, which further compounded with AD side-effect. The neuro-psychopharmacological basis for AD treatment selection used was deliberated. Biopsychosocial interventions are recommended at a two pivotal stage. First, a step should be taken for proper assessment (e.g. detailed history, psychosocial and laboratory investigations); and identifying some modifiable risk factors for ED and associated mental health issue. Secondly, with guidance of an algorithm pathway, a practical intervention should include steps like dose reduction, augmentation or changing to an AD with lesser/ no sexual side-effects like bupropion and mirtazepine. Some achievable suggestions, e.g. revising sexual scripts and improving sexual techniques, life-style modifications, psychotherapy and other non-pharmacological approaches will be beneficial for both patients and his partner.

  19. The Phosphodiesterase 5-Inhibitors (PDE-5i) for ERECTILE DYSFUNCTION (ED): A Therapeutic Challenge For Psychiatrists.

    PubMed

    Koon, Chong Siew; Sidi, Hatta; Kumar, Jaya; Das, Srijit; Xi, Ong Wan; Hatta, Muhammad Hizri; Alfonso, Cesar

    2017-02-15

    Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually leads to orgasm - a biopsychophysiological state of euphoria - leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in the context of treating ED constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial's guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male's self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles beside being cautious with the potential side-effects and drug-drug interactions. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one's sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED.

  20. From Napkin to Orbit in 9 Months; The TechEdSat Spacecraft Mission

    NASA Technical Reports Server (NTRS)

    Cohen, Aaron; Hoppins, Nicholas; Trinh, Greenfield; Schulte, Jan; Bruhn, Fredrik; Loefgren, Henrik; Selin, Per

    2013-01-01

    The TechEdSat spacecraft mission saw one of the fastest turn around times for concept through launch of a CubeSat. On 26 October 2011, John Hines sketched on a brown paper napkin the outline for which components would be in this 1U CubeSat, and how they would be stacked; 269 days later that spacecraft launched from Tanegashima Space Center aboard the HTV-3 ISS resupply mission, with a total development time of only eight months. TechEdSat was among the first of five CubeSats deployed from the ISS. The goals of the TechEdSat mission were to explore the use of the Space Plug-n-Play Architecture (SPA) in a CubeSat, and to evaluate Commercial Off The Shelf (COTS) space-to-space communication solutions. TechEdSat featured an array of processors from ÅAC Microtec including four NanoRTU's and the RTULite main processor, all communicating using the SPA-1 protocol. TechEdSat featured two primary payloads: an Iridium 9602 Modem, and a Quake Global Q1000 OrbComm modem. After a successful deployment on 4 October 2012 from the ISS, over 2000 packets of 122 bytes each (250 kB total) were received in the first four months of the mission. In this paper we discuss the challenges to rapid CubeSat development, the experience of having a CubeSat approved for deployment from the ISS, the ongoing results of the mission and lessons learned.

  1. Magnetic resonance imaging and computed tomography utilization trends in an academic ED.

    PubMed

    Quaday, Karen A; Salzman, Joshua G; Gordon, Bradley D

    2014-06-01

    The objective of this study is to examine the annual utilization trends of emergency department (ED)-ordered magnetic resonance imaging (MRI) and computed tomography (CT) at an urban academic hospital from 2007 to 2011. We hypothesized that MRI and CT use would increase annually over the study period. This was a retrospective observational study of ED encounters between January 1, 2007, and December 31, 2011. All patients seen by a provider were identified, and demographics were abstracted. Type of CT and/or MRI examination, clinical indication, and final disposition were collected. Records of patients with an ED-ordered MRI were also examined for presence of a CT within ±3 days of their encounter date. Unadjusted linear regression was used to assess for differences among years for both CT and MRI. Secondary outcomes were descriptively summarized. A total of 7089 MRI (20 per 1000) and 85,673 CT (243 per 1000) examinations were ordered over a 60-month period. Computed tomography use decreased significantly (P=.021). Magnetic resonance imaging use significantly increased (2.2 per 1000 ED visits each year, P=.005). Magnetic resonance imaging of the head was ordered most frequently (10.7 per 1000). The overwhelming majority of MRI images were completed for acute neurologic/behavioral problem. Of patients with an MRI completed, 89.4% had a CT completed within 3 calendar days with most of the CT examinations (81%) completed during the encounter. There was a steady increase in MRI testing in our academic ED, with most MRIs ordered for acute neurologic or behavioral changes. There was a corresponding decreasing trend for CT scans. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Pediatric overtriage as a consequence of the tachycardia responses of children upon ED admission.

    PubMed

    Chang, Yu-Che; Ng, Chip-Jin; Wu, Chang-Teng; Chen, Li-Chin; Chen, Jih-Chang; Hsu, Kuang-Hung

    2015-01-01

    Overtriage has been observed among pediatric patients in emergency departments (EDs) under 5-level acuity pediatric triage systems. This study aimed to investigate the causes of overtriage and to provide suggestions for future amendments to such systems. This study has a retrospective follow-up design in which 42000 pediatric patients who were admitted to the ED of the largest medical center in Taiwan between January and December of 2010 were recruited. The study variables included patient demographics, chief concerns, individual vital signs (ie, blood pressure, heart rate, body temperature, respiratory rate, and O2 saturation), triage level, ED final disposition, ED expenses, and total medical expenses. A logistic regression model was applied to explore the causes of overtriage and the effectiveness of a modified acuity system. Approximately 13.6% of the pediatric ED visits were upgraded to acuity level 1 based on vital signs that included heart rate (97.3%). The strength of the trend association (odds ratio) between decreasing acuity urgency (from levels 1 to 5) and hospitalization increased from 0.73 (95% confidence interval, 0.72-0.75) with the Pediatric Triage and Acuity System (Ped-TTAS) to 0.57 (95% confidence interval, 0.55-0.59) with the modified Ped-TTAS, which downgraded acuity levels by excluding the weighting of vital signs. Further validation was accomplished by comparing the trend association between decreasing acuity urgency and total medical expenses (Ped-TTAS: β = -0.13; modified Ped-TTAS: β = -0.18). Heart rate is prone to be affected by emotional responses among pediatric patients in certain specific age groups. Appropriate revisions of the pediatric triage system are suggested. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Resistance of Escherichia coli urinary isolates in ED-treated patients from a community hospital.

    PubMed

    Fleming, Virginia H; White, Bryan P; Southwood, Robin

    2014-08-01

    The purpose of this study is to provide resistance data for Escherichia coli isolates causing urinary tract infections in emergency department (ED) patients not requiring admission and explore if differences between this subpopulation and the hospital antibiogram exist. Differences between community-acquired urinary tract infection (CA-UTI) and health care-associated (HA-UTI) subgroups were also investigated. Patients with a positive urine culture treated and discharged from the ED of a 200-bed community hospital were reviewed. Patients with urinary isolates of more than 100000 colony-forming unit/mL and documented intention to treat were included. Patients who required admission, were pregnant, less than the age of 18 years, or who had a positive culture but without any evidence of intention to treat were excluded. Only the initial visit was included for patients who returned to the ED within 7 days. Overall, 308 visits were screened, and 217 were included. Of these, 78.3% were CA-UTI, and 21.7% were HA-UTI. Females comprised 88.5% of all patients. E coli was the most common pathogen overall and in both subgroups. E coli resistance to levofloxacin was 13.5% overall, 9.2% for CA-UTI, and 38.5% for HA-UTI compared with 27% on the hospital antibiogram. E coli resistance to sulfamethoxazole/trimethoprim was 26.9% overall, 25.2% for CA-UTI, and 34.6% for HA-UTI vs 26% on the antibiogram. E coli susceptibility for ED patients not requiring admission may not be accurately represented by hospital antibiograms that contain culture data from various patient types, sites of infection, or patients with varying illness severity. Separation of the ED population into CA-UTI and HA-UTI subgroups may be helpful when selecting empiric antibiotic therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Incorporating Alternative Care Site Characteristics Into Estimates of Substitutable ED Visits.

    PubMed

    Trueger, Nathan Seth; Chua, Kao-Ping; Hussain, Aamir; Liferidge, Aisha T; Pitts, Stephen R; Pines, Jesse M

    2017-07-01

    Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed. To develop methods to incorporate the variability in alternative care site characteristics into estimates of ED visit "substitutability." Our approach uses the range of hours and capabilities among alternative care sites to estimate lower and upper bounds of ED visit substitutability. We constructed "basic" and "extended" criteria that captured the plausible degree of variation in each site's hours and capabilities. To illustrate our approach, we analyzed data from 22,697 ED visits by adults in the 2011 National Hospital Ambulatory Medical Care Survey, defining a visit as substitutable if it was treat-and-release and met both the operating hours and functional capabilities criteria. Use of the combined basic hours/basic capabilities criteria and extended hours/extended capabilities generated lower and upper bounds of estimates. Our criteria classified 5.5%-27.1%, 7.6%-20.4%, and 10.6%-46.0% of visits as substitutable in primary care offices, retail clinics, and urgent care centers, respectively. Alternative care sites vary widely in operating hours and functional capabilities. Methods such as ours may help incorporate this variability into estimates of ED visit substitutability.

  5. ED crowding is associated with an increased time to pneumonia treatment.

    PubMed

    Sikka, Rishi; Mehta, Supriya; Kaucky, Carleen; Kulstad, Erik B

    2010-09-01

    We measured the correlation between emergency department (ED) occupancy rate and time to antibiotic administration for patients with pneumonia treated in a community hospital setting. We reviewed quality improvement data on patients treated for pneumonia in our ED and admitted over a 5-month period. The outcomes were timeliness of antibiotic therapy (within 4 hours of arrival) and overall time to antibiotic administration. Emergency department crowding was measured as the ED occupancy rate. We calculated (1) the Spearman correlation between occupancy rate at time of patient presentation and the time to antibiotic administration, (2) the odds ratio of receiving antibiotics within 4 hours with increasing ED occupancy, and (3) the ability of the occupancy rate to predict failure of achieving the 4-hour goal with the receiver operating characteristic curve. A total of 334 patients were treated over the study period, of which 262 had complete data available. Occupancy rate ranged from 20% to 245%, and median was 137%. Eighty-one percent received antibiotics within 4 hours; the median time was 150 minutes. Time to antibiotics showed a positive correlation with occupancy rate (Spearman ρ = 0.17, P = .008). An increasing ED occupancy rate was associated with decreased odds of receiving antibiotics within 4 hours (odds ratio, 0.31; 95% confidence interval, 0.13-0.75). Receiver operating characteristic curve area was 0.62 (95% confidence interval, 0.54-0.70; P = .009). Emergency department occupancy rate was associated with increased time to antibiotic treatment for patients admitted with pneumonia. Occupancy rate had fair success in predicting failure of treatment within 4 hours. Copyright © 2010 Elsevier Inc. All rights reserved.

  6. Commodity Ed

    ERIC Educational Resources Information Center

    Waters, John K.

    2013-01-01

    With schools and students now able to secure high-quality online courses from beyond the ivy-covered walls, faculty--and institutions themselves--are weighing whether their stock is rising or falling. Increasingly, online courses and their content--previously the jealously guarded domain of professors--are being offered as out-of-the-box solutions…

  7. Commodity Ed

    ERIC Educational Resources Information Center

    Waters, John K.

    2013-01-01

    With schools and students now able to secure high-quality online courses from beyond the ivy-covered walls, faculty--and institutions themselves--are weighing whether their stock is rising or falling. Increasingly, online courses and their content--previously the jealously guarded domain of professors--are being offered as out-of-the-box solutions…

  8. Ed News

    ERIC Educational Resources Information Center

    Journal of Aerospace Education, 1977

    1977-01-01

    Describes the organization and activities of 16 different aviation classes, workshops, and groups about the United States. Projects range from flight training activities to the construction of a small, one-man airplane. (SL)

  9. Documentation of HEART score discordance between emergency physician and cardiologist evaluations of ED patients with chest pain.

    PubMed

    Wu, W Kelly; Yiadom, Maame Yaa A B; Collins, Sean P; Self, Wesley H; Monahan, Ken

    2017-01-01

    A triage cardiology program, in which cardiologists provide consultation to the Emergency Department (ED), may safely reduce admissions. For patients with chest pain, the HEART Pathway may obviate the need for cardiology involvement, unless there is a difference between ED and cardiology assessments. Therefore, in a cohort concurrently evaluated by both specialties, we analyzed discordance between ED and cardiology HEART scores. We performed a single-center, cross-sectional, retrospective study of adults presenting to the ED with chest pain who had a documented bedside evaluation by a triage cardiologist. Separate ED and cardiology HEART scores were computed based on documentation by the respective physicians. Discrepancies in HEART score between ED physicians and cardiologists were quantified using Cohen κ coefficient. Thirty-three patients underwent concurrent ED physician and cardiologist evaluation. Twenty-three patients (70%) had discordant HEART scores (κ = 0.13; 95% confidence interval, -0.02 to 0.32). Discrepancies in the description of patients' chest pain were the most common source of discordance and were present in more than 50% of cases. HEART scores calculated by ED physicians tended to overestimate the scores calculated by cardiologists. When categorized into low-risk or high-risk by the HEART Pathway, more than 25% of patients were classified as high risk by the ED physician, but low risk by the cardiologist. There is substantial discordance in HEART scores between ED physicians and cardiologists. A triage cardiology system may help refine risk stratification of patients presenting to the ED with chest pain, even when the HEART Pathway tool is used. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Use of broad-spectrum antibiotics in French EDs: different trends for third-generation cephalosporins and fluoroquinolones.

    PubMed

    Batard, Eric; Vibet, Marie-Anne; Lemarchand, Cathelle; Navas, Dominique; Lepelletier, Didier; Potel, Gilles; Montassier, Emmanuel

    2017-06-01

    Third-generation cephalosporins and fluoroquinolones are particularly prone to promoting bacterial resistance. Their use in Emergency Departments (EDs) is poorly known. Our objectives were to assess the use of antibacterial agents in French EDs. This study is a retrospective study of antibiotics delivered to the adult units of 11 EDs of French academic centres in 2012, and to six of these EDs between 2009 and 2012. The total antibiotic use was 66.4 defined daily doses (DDD)/1000 ED visits in 2012, and it increased between 2009 and 2012 (yearly estimate, +1.8±0.9 DDD/1000 ED visits, P=0.048). The 3GC-FQ class, which grouped third-generation cephalosporins and fluoroquinolones, accounted for 39.2% of the total antibiotic use, and the use of this class of antibiotics was highly variable among EDs (range, 31.6-49.5% of total antibiotic use). The aminopenicillin and β-lactamase inhibitor/3GC-FQ ratio varied among EDs [median (range), 0.91 (0.52-1.25)]. Between 2009 and 2012, there was a significant decrease in the use of the 3GC-FQ class (yearly estimate, -0.8±0.4% of total antibiotic use), antipneumococcal fluoroquinolones (-0.8±0.3%) and other fluoroquinolones (-0.9%±0.3%), and there was a significant increase in the use of third-generation cephalosporins (+0.7±0.3%), aminoglycosides (+0.4±0.1%), imidazole derivatives (+0.4±0.1%) and lincosamides (+0.1±0.0%). Fluoroquinolones and third-generation cephalosporins are widely used in the ED. Their use is highly variable among EDs. Third-generation cephalosporins were increasingly used between 2009 and 2012, whereas the use of fluoroquinolones decreased. Reduced use of cephalosporins in the ED, without increasing fluoroquinolone use, should be aimed at through antibiotic stewardship programs.

  11. Staphylococcus aureus Leukocidin LukED and HIV-1 gp120 Target Different Sequence Determinants on CCR5.

    PubMed

    Tam, Kayan; Schultz, Megan; Reyes-Robles, Tamara; Vanwalscappel, Bénédicte; Horton, Joshua; Alonzo, Francis; Wu, Beili; Landau, Nathaniel R; Torres, Victor J

    2016-12-13

    Leukocidin ED (LukED) is a bicomponent pore-forming toxin produced by Staphylococcus aureus that lyses host cells by targeting the chemokine receptors CC chemokine receptor type 5 (CCR5), CXCR1, CXCR2, and DARC. In addition to its role as a receptor for LukED, CCR5 is the major coreceptor for primary isolates of human immunodeficiency virus type 1 (HIV-1) and has been extensively studied. To compare how LukED and HIV-1 target CCR5, we analyzed their respective abilities to use CCR5/CCR2b chimeras to mediate cytotoxicity and virus entry. These analyses showed that the second and third extracellular loops (ECL) of CCR5 are necessary and sufficient for LukED to target the receptor and promote cell lysis. In contrast, the second ECL of CCR5 is necessary but not sufficient for HIV-1 infectivity. The analysis of CCR5 point mutations showed that glycine-163 is critical for HIV-1 infectivity, while arginine-274 and aspartic acid-276 are critical for LukED cytotoxicity. Point mutations in ECL2 diminished both HIV-1 infectivity and LukED cytotoxicity. Treatment of cells with LukED did not interfere with CCR5-tropic HIV-1 infectivity, demonstrating that LukED and the viral envelope glycoprotein use nonoverlapping sites on CCR5. Analysis of point mutations in LukE showed that amino acids 64 to 69 in the rim domain are required for CCR5 targeting and cytotoxicity. Taking the results together, this study identified the molecular basis by which LukED targets CCR5, highlighting the divergent molecular interactions evolved by HIV-1 and LukED to interact with CCR5.

  12. Staphylococcus aureus Leukocidin LukED and HIV-1 gp120 Target Different Sequence Determinants on CCR5

    PubMed Central

    Tam, Kayan; Schultz, Megan; Reyes-Robles, Tamara; Vanwalscappel, Bénédicte; Horton, Joshua; Alonzo, Francis; Wu, Beili

    2016-01-01

    ABSTRACT Leukocidin ED (LukED) is a bicomponent pore-forming toxin produced by Staphylococcus aureus that lyses host cells by targeting the chemokine receptors CC chemokine receptor type 5 (CCR5), CXCR1, CXCR2, and DARC. In addition to its role as a receptor for LukED, CCR5 is the major coreceptor for primary isolates of human immunodeficiency virus type 1 (HIV-1) and has been extensively studied. To compare how LukED and HIV-1 target CCR5, we analyzed their respective abilities to use CCR5/CCR2b chimeras to mediate cytotoxicity and virus entry. These analyses showed that the second and third extracellular loops (ECL) of CCR5 are necessary and sufficient for LukED to target the receptor and promote cell lysis. In contrast, the second ECL of CCR5 is necessary but not sufficient for HIV-1 infectivity. The analysis of CCR5 point mutations showed that glycine-163 is critical for HIV-1 infectivity, while arginine-274 and aspartic acid-276 are critical for LukED cytotoxicity. Point mutations in ECL2 diminished both HIV-1 infectivity and LukED cytotoxicity. Treatment of cells with LukED did not interfere with CCR5-tropic HIV-1 infectivity, demonstrating that LukED and the viral envelope glycoprotein use nonoverlapping sites on CCR5. Analysis of point mutations in LukE showed that amino acids 64 to 69 in the rim domain are required for CCR5 targeting and cytotoxicity. Taking the results together, this study identified the molecular basis by which LukED targets CCR5, highlighting the divergent molecular interactions evolved by HIV-1 and LukED to interact with CCR5. PMID:27965453

  13. The Customers' Perspective: The EdNET 98 Survey of Buyers and Managers of Educational Technology. Constructive Input for the Educational Technology Industry from the EdNET 98 Education Executives Advisory Board.

    ERIC Educational Resources Information Center

    Craighead, Donna; Bigham, Vicki Smith; Heller, Nelson B.

    The EdNET 98 Education Executives Advisory Board, also known as Partners in Education Program (PEP), is a featured activity of the EdNET 98 Conference. Its focus is to bring educators and vendors together to share their perspectives about technology in education and discussion technology-related concerns and issues. This report presents results…

  14. The Customers' Perspective: The EdNET 98 Survey of Buyers and Managers of Educational Technology. Constructive Input for the Educational Technology Industry from the EdNET 98 Education Executives Advisory Board.

    ERIC Educational Resources Information Center

    Craighead, Donna; Bigham, Vicki Smith; Heller, Nelson B.

    The EdNET 98 Education Executives Advisory Board, also known as Partners in Education Program (PEP), is a featured activity of the EdNET 98 Conference. Its focus is to bring educators and vendors together to share their perspectives about technology in education and discussion technology-related concerns and issues. This report presents results…

  15. There Are Sex Differences in the Demographics and Risk Profiles of Emergency Department (ED) Patients With Atrial Fibrillation and Flutter, but no Apparent Differences in ED Management or Outcomes.

    PubMed

    Scheuermeyer, Frank Xavier; Mackay, Martha; Christenson, Jim; Grafstein, Eric; Pourvali, Reza; Heslop, Claire; MacPhee, Jan; Ward, John; Heilbron, Brett; McGrath, Lorraine; Humphries, Karin

    2015-09-01

    In non-emergency department (ED) settings, women with atrial fibrillation and flutter (AFF) have different presentations, treatments, and outcomes than men: they are older, less likely to be treated with rhythm control strategies or appropriate anticoagulation, and more likely to have strokes. This has not been investigated in ED patients. Records from consecutive ED patients from January 1 to December 31, 2009, with electrocardiogram-proven AFF at two urban hospitals were collected. Review of administrative and clinical data identified patient demographics, clinical characteristics, comorbidities, and ED treatments. The regional ED database was queried to determine 30-day and 1-year follow-up visits, and the provincial vital statistics database was referenced to obtain 30-day and 1-year mortality; all outcomes were stratified by sex. The primary outcome, which reflected overall appropriateness of ED care, was the proportion of patients who were discharged home at their index ED visits, who then had unscheduled 30-day ED revisits. Secondary outcomes included the proportion of eligible patients who underwent acute rhythm control strategies and the proportion of high-risk patients who had previously inadequately anticoagulation strategies corrected by the emergency physician. Additional outcomes included the ED length of stay (LOS) and 30-day and 1-year rates of stroke and death. A total of 1,112 records were reviewed: 470 women (42.3%) and 642 men. Women were a median 8 years (interquartile range = 3 to 13 years) older than men, had higher rates of cardiovascular comorbidities, and were more likely to present with atypical symptoms such as weakness or dyspnea. On their index ED visits, 50.2% of women and 41.3% of men were admitted. At 30 days, 39 of 234 (16.7%) women and 55 of 377 (14.6%) men who were discharged at their index ED visits had made revisits, for a risk difference of 2.1% (95% confidence interval = -3.9% to 8.5%). There were no apparent sex differences

  16. Competencies for Effective School Leadership: To What Extent Are They Included in Ed.D. Leadership Programs?

    ERIC Educational Resources Information Center

    Dunlap, Jody; Li, Jinyi; Kladifko, Robert

    2015-01-01

    Purpose: With the increasing need for well-­-prepared and leading practitioners in the field of education as well as the renewed efforts to further distinguish the EdD from the PhD in higher education in recent years, the curriculum of EdD programs nationwide has been questioned and criticized for its disconnection from the needs of leading…

  17. Effectiveness of Mutual Learning Approach in the Academic Achievement of B.Ed Students in Learning Optional II English

    ERIC Educational Resources Information Center

    Arulselvi, Evangelin

    2013-01-01

    The present study aims at finding out the effectiveness of Mutual learning approach over the conventional method in learning English optional II among B.Ed students. The randomized pre-test, post test, control group and experimental group design was employed. The B.Ed students of the same college formed the control and experimental groups. Each…

  18. Comparing patients who leave the ED prematurely, before vs after medical evaluation: a National Hospital Ambulatory Medical Care Survey analysis.

    PubMed

    Moe, Jessica; Belsky, Justin Brett

    2016-05-01

    Many patients leave the Emergency Department (ED) before beginning or completing medical evaluation. Some of these patients may be at higher medical risk depending on their timing of leaving the ED. To compare patient, hospital, and visit characteristics of patients who leave before completing medical care to patients who leave before ED evaluation. Retrospective cross-sectional analysis of ED visits using the 2009-2011 National Hospital Ambulatory Medical Care Survey. A total of 100962 ED visits were documented in the 2009-2011 National Hospital Ambulatory Medical Care Survey, representing a weighted count of 402211907 total ED visits. 2646 (2.62%) resulted in a disposition of left without completing medical care. Of these visits, 1792 (67.7%) left before being seen by a medical provider versus 854 (32.3%) who left after medical provider evaluation but before a final disposition. Patients who left after being assessed by a medical provider were older, had higher acuity visits, were more likely to have visited an ED without nursing triage, arrived more often by ambulance, and were more likely to have private insurance than to be self-paying or to have other payment arrangements (e.g. worker's compensation or charity/no charge). When comparing all patients who left the ED before completion of care, those who left after versus before medical provider evaluation differed in their patient, hospital, and visit characteristics and may represent a high risk patient group. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Effectiveness of Mathematics Teaching and Learning Experiences through Wireless Technology as Recent Style to Enhance B.Ed. Trainees

    ERIC Educational Resources Information Center

    Joan, D. R. Robert

    2015-01-01

    The objective of the study was to find out the effect of learning through Wireless technologies and the traditional method in teaching and learning Mathematics. The investigator adopted experimental research to find the effectiveness of implementing Wireless technologies in the population of B.Ed. trainees. The investigator selected 32 B.Ed.…

  20. Mentoring from Different Social Spheres: How Can Multiple Mentors Help in Doctoral Student Success in Ed.D Programs?

    ERIC Educational Resources Information Center

    Terry, Tarae; Ghosh, Rajashi

    2015-01-01

    Doctoral students leave their programs early due to lack of mentoring relationships needed to support degree completion and success. However, how mentoring contributes to Ed.D degree completion is not widely studied. In this qualitative narrative study, we sought to explore how multiple mentoring relationships reduced attrition in an Ed.D program.…