Sample records for effect sizes ess

  1. Confidence intervals for effect sizes: compliance and clinical significance in the Journal of Consulting and clinical Psychology.

    PubMed

    Odgaard, Eric C; Fowler, Robert L

    2010-06-01

    In 2005, the Journal of Consulting and Clinical Psychology (JCCP) became the first American Psychological Association (APA) journal to require statistical measures of clinical significance, plus effect sizes (ESs) and associated confidence intervals (CIs), for primary outcomes (La Greca, 2005). As this represents the single largest editorial effort to improve statistical reporting practices in any APA journal in at least a decade, in this article we investigate the efficacy of that change. All intervention studies published in JCCP in 2003, 2004, 2007, and 2008 were reviewed. Each article was coded for method of clinical significance, type of ES, and type of associated CI, broken down by statistical test (F, t, chi-square, r/R(2), and multivariate modeling). By 2008, clinical significance compliance was 75% (up from 31%), with 94% of studies reporting some measure of ES (reporting improved for individual statistical tests ranging from eta(2) = .05 to .17, with reasonable CIs). Reporting of CIs for ESs also improved, although only to 40%. Also, the vast majority of reported CIs used approximations, which become progressively less accurate for smaller sample sizes and larger ESs (cf. Algina & Kessleman, 2003). Changes are near asymptote for ESs and clinical significance, but CIs lag behind. As CIs for ESs are required for primary outcomes, we show how to compute CIs for the vast majority of ESs reported in JCCP, with an example of how to use CIs for ESs as a method to assess clinical significance.

  2. Violations of Assumptions in School-Based Single-Case Data: Implications for the Selection and Interpretation of Effect Sizes.

    PubMed

    Solomon, Benjamin George

    2014-07-01

    A wide variety of effect sizes (ESs) has been used in the single-case design literature. Several researchers have "stress tested" these ESs by subjecting them to various degrees of problem data (e.g., autocorrelation, slope), resulting in the conditions by which different ESs can be considered valid. However, on the back end, few researchers have considered how prevalent and severe these problems are in extant data and as a result, how concerned applied researchers should be. The current study extracted and aggregated indicators of violations of normality and independence across four domains of educational study. Significant violations were found in total and across fields, including low levels of autocorrelation and moderate levels of absolute trend. These violations affect the selection and interpretation of ESs at the individual study level and for meta-analysis. Implications and recommendations are discussed. © The Author(s) 2013.

  3. Bandwidth based methodology for designing a hybrid energy storage system for a series hybrid electric vehicle with limited all electric mode

    NASA Astrophysics Data System (ADS)

    Shahverdi, Masood

    The cost and fuel economy of hybrid electrical vehicles (HEVs) are significantly dependent on the power-train energy storage system (ESS). A series HEV with a minimal all-electric mode (AEM) permits minimizing the size and cost of the ESS. This manuscript, pursuing the minimal size tactic, introduces a bandwidth based methodology for designing an efficient ESS. First, for a mid-size reference vehicle, a parametric study is carried out over various minimal-size ESSs, both hybrid (HESS) and non-hybrid (ESS), for finding the highest fuel economy. The results show that a specific type of high power battery with 4.5 kWh capacity can be selected as the winning candidate to study for further minimization. In a second study, following the twin goals of maximizing Fuel Economy (FE) and improving consumer acceptance, a sports car class Series-HEV (SHEV) was considered as a potential application which requires even more ESS minimization. The challenge with this vehicle is to reduce the ESS size compared to 4.5 kWh, because the available space allocation is only one fourth of the allowed battery size in the mid-size study by volume. Therefore, an advanced bandwidth-based controller is developed that allows a hybridized Subaru BRZ model to be realized with a light ESS. The result allows a SHEV to be realized with 1.13 kWh ESS capacity. In a third study, the objective is to find optimum SHEV designs with minimal AEM assumption which cover the design space between the fuel economies in the mid-size car study and the sports car study. Maximizing FE while minimizing ESS cost is more aligned with customer acceptance in the current state of market. The techniques applied to manage the power flow between energy sources of the power-train significantly affect the results of this optimization. A Pareto Frontier, including ESS cost and FE, for a SHEV with limited AEM, is introduced using an advanced bandwidth-based control strategy teamed up with duty ratio control. This controller allows the series hybrid's advantage of tightly managing engine efficiency to be extended to lighter ESS, as compared to the size of the ESS in available products in the market.

  4. The intriguing evolution of effect sizes in biomedical research over time: smaller but more often statistically significant.

    PubMed

    Monsarrat, Paul; Vergnes, Jean-Noel

    2018-01-01

    In medicine, effect sizes (ESs) allow the effects of independent variables (including risk/protective factors or treatment interventions) on dependent variables (e.g., health outcomes) to be quantified. Given that many public health decisions and health care policies are based on ES estimates, it is important to assess how ESs are used in the biomedical literature and to investigate potential trends in their reporting over time. Through a big data approach, the text mining process automatically extracted 814 120 ESs from 13 322 754 PubMed abstracts. Eligible ESs were risk ratio, odds ratio, and hazard ratio, along with their confidence intervals. Here we show a remarkable decrease of ES values in PubMed abstracts between 1990 and 2015 while, concomitantly, results become more often statistically significant. Medians of ES values have decreased over time for both "risk" and "protective" values. This trend was found in nearly all fields of biomedical research, with the most marked downward tendency in genetics. Over the same period, the proportion of statistically significant ESs increased regularly: among the abstracts with at least 1 ES, 74% were statistically significant in 1990-1995, vs 85% in 2010-2015. whereas decreasing ESs could be an intrinsic evolution in biomedical research, the concomitant increase of statistically significant results is more intriguing. Although it is likely that growing sample sizes in biomedical research could explain these results, another explanation may lie in the "publish or perish" context of scientific research, with the probability of a growing orientation toward sensationalism in research reports. Important provisions must be made to improve the credibility of biomedical research and limit waste of resources. © The Authors 2017. Published by Oxford University Press.

  5. Child-Parent Attachment and Children's Peer Relations: A Quantitative Review.

    ERIC Educational Resources Information Center

    Schneider, Barry H.; Atkinson, Leslie; Tardif, Christine

    2001-01-01

    Used meta-analysis to examine premise that the early child-parent bond is reflected in interpersonal relationships across the life span. Found that overall effect size (ES) for child-mother attachment was small to moderate. ESs were similar in studies using Strange Situation and Q-sort methods. ESs were larger for middle childhood and adolescent…

  6. Estimating the Effective Sample Size of Tree Topologies from Bayesian Phylogenetic Analyses

    PubMed Central

    Lanfear, Robert; Hua, Xia; Warren, Dan L.

    2016-01-01

    Bayesian phylogenetic analyses estimate posterior distributions of phylogenetic tree topologies and other parameters using Markov chain Monte Carlo (MCMC) methods. Before making inferences from these distributions, it is important to assess their adequacy. To this end, the effective sample size (ESS) estimates how many truly independent samples of a given parameter the output of the MCMC represents. The ESS of a parameter is frequently much lower than the number of samples taken from the MCMC because sequential samples from the chain can be non-independent due to autocorrelation. Typically, phylogeneticists use a rule of thumb that the ESS of all parameters should be greater than 200. However, we have no method to calculate an ESS of tree topology samples, despite the fact that the tree topology is often the parameter of primary interest and is almost always central to the estimation of other parameters. That is, we lack a method to determine whether we have adequately sampled one of the most important parameters in our analyses. In this study, we address this problem by developing methods to estimate the ESS for tree topologies. We combine these methods with two new diagnostic plots for assessing posterior samples of tree topologies, and compare their performance on simulated and empirical data sets. Combined, the methods we present provide new ways to assess the mixing and convergence of phylogenetic tree topologies in Bayesian MCMC analyses. PMID:27435794

  7. Efficacy of memory rehabilitation therapy: a meta-analysis of TBI and stroke cognitive rehabilitation literature.

    PubMed

    Elliott, Madison; Parente, Frederick

    2014-01-01

    To examine the efficacy of cognitive rehabilitation strategies specifically designed to improve memory after traumatic brain injury (TBI) and stroke vs. memory improvement with the passage of time. A meta-analysis was performed on 26 studies of memory retraining and recovery that were published between the years of 1985 and 2013. Effect sizes (ESs) from each study were calculated and converted to Pearson's r and then analysed to assess the overall effect size and the relationship among the ESs, patient demographics and treatment interventions. RESULTS indicated a significant average ES (r = 0.51) in the treatment intervention conditions, as well as a significant average ES (r = 0.31) in the control conditions, in which participants did not receive any treatment. The largest ESs occurred in studies of stroke patients and studies concerning working memory rehabilitation. RESULTS showed that memory rehabilitation was an effective therapeutic intervention, especially for stroke patients and for working memory as a treatment domain. However, the results also indicated that significant memory improvement occurred spontaneously over time.

  8. Sperm competition games: sperm size (mass) and number under raffle and displacement, and the evolution of P2.

    PubMed

    Parker, G A; Immler, S; Pitnick, S; Birkhead, T R

    2010-06-07

    We examine models for evolution of sperm size (i.e. mass m) and number (s) under three mechanisms of sperm competition at low 'risk' levels: (i) raffle with no constraint on space available for competing sperm, (ii) direct displacement mainly by seminal fluid, and (iii) direct displacement mainly by sperm mass. Increasing sperm mass increases a sperm's 'competitive weight' against rival sperm through a diminishing returns function, r(m). ESS total ejaculate expenditure (the product m(*)s(*)) increases in all three models with sperm competition risk, q. If r(m), or ratio r'(m)/r(m), is independent of ESS sperm numbers, ESS sperm mass remains constant, and the sperm mass/number ratio (m(*)/s(*)) therefore decreases with risk. Dependency of sperm mass on risk can arise if r(m) depends on competing sperm density (sperm number / space available for sperm competition). Such dependencies generate complex relationships between sperm mass and number with risk, depending both on the mechanism and how sperm density affects r(m). While numbers always increase with risk, mass can either increase or decrease, but m(*)/s(*) typically decreases with risk unless sperm density strongly influences r(m). Where there is no extrinsic loading due to mating order, ESS paternity of the second (i.e. last) male to mate (P(2)) under displacement always exceeds 0.5, and increases with risk (in the raffle P(2)=0.5). Caution is needed when seeking evidence for a sperm size-number trade off. Although size and number trade-off independently against effort spent on acquiring matings, their product, m(*)s(*), is invariant or fixed at a given risk level, effectively generating a size-number trade off. However, unless controlled for the effects of risk, the relation between m(*) and s(*) can be either positive or negative (a positive relation is usually taken as evidence against a size-number trade off). Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  9. Automated sampling assessment for molecular simulations using the effective sample size

    PubMed Central

    Zhang, Xin; Bhatt, Divesh; Zuckerman, Daniel M.

    2010-01-01

    To quantify the progress in the development of algorithms and forcefields used in molecular simulations, a general method for the assessment of the sampling quality is needed. Statistical mechanics principles suggest the populations of physical states characterize equilibrium sampling in a fundamental way. We therefore develop an approach for analyzing the variances in state populations, which quantifies the degree of sampling in terms of the effective sample size (ESS). The ESS estimates the number of statistically independent configurations contained in a simulated ensemble. The method is applicable to both traditional dynamics simulations as well as more modern (e.g., multi–canonical) approaches. Our procedure is tested in a variety of systems from toy models to atomistic protein simulations. We also introduce a simple automated procedure to obtain approximate physical states from dynamic trajectories: this allows sample–size estimation in systems for which physical states are not known in advance. PMID:21221418

  10. "Are cognitive interventions effective in Alzheimer's disease? A controlled meta- analysis of the effects of bias": Correction to Oltra-Cucarella et al. (2016).

    PubMed

    2016-07-01

    Reports an error in "Are Cognitive Interventions Effective in Alzheimer's Disease? A Controlled Meta-Analysis of the Effects of Bias" by Javier Oltra-Cucarella, Rubén Pérez-Elvira, Raul Espert and Anita Sohn McCormick (Neuropsychology, Advanced Online Publication, Apr 7, 2016, np). In the article the first sentence of the third paragraph of the Source of bias subsection in the Statistical Analysis subsection of the Correlational Meta-Analysis section should read "For the control condition bias, three comparison groups were differentiated: (a) a structured cognitive intervention, (b) a placebo control condition, and (c) a pharma control condition without cognitive intervention or no treatment at all." (The following abstract of the original article appeared in record 2016-16656-001.) There is limited evidence about the efficacy of cognitive interventions for Alzheimer's disease (AD). However, aside from the methodological quality of the studies analyzed, the methodology used in previous meta-analyses is itself a risk of bias as different types of effect sizes (ESs) were calculated and combined. This study aimed at examining the results of nonpharmacological interventions for AD with an adequate control of statistical methods and to demonstrate a different approach to meta-analysis. ESs were calculated with the independent groups pre/post design. Average ESs for separate outcomes were calculated and moderator analyses were performed so as to offer an overview of the effects of bias. Eighty-seven outcomes from 19 studies (n = 812) were meta-analyzed. ESs were small on average for cognitive and functional outcomes after intervention. Moderator analyses showed no effect of control of bias, although ESs were different from zero only in some circumstances (e.g., memory outcomes in randomized studies). Cognitive interventions showed no more efficacy than placebo interventions, and functional ESs were consistently low across conditions. cognitive interventions delivered may not be effective in AD probably due to the fact that the assumptions behind the cognitive interventions might be inadequate. Future directions include a change in the type of intervention as well as the use of outcomes other than standardized tests. Additional studies with larger sample sizes and different designs are needed to increase the power of both primary studies and meta-analyses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  11. Confidence Intervals for Effect Sizes: Compliance and Clinical Significance in the "Journal of Consulting and Clinical Psychology"

    ERIC Educational Resources Information Center

    Odgaard, Eric C.; Fowler, Robert L.

    2010-01-01

    Objective: In 2005, the "Journal of Consulting and Clinical Psychology" ("JCCP") became the first American Psychological Association (APA) journal to require statistical measures of clinical significance, plus effect sizes (ESs) and associated confidence intervals (CIs), for primary outcomes (La Greca, 2005). As this represents the single largest…

  12. Psychosocial effects of competitive Boccia program in persons with severe chronic disability.

    PubMed

    Barak, Sharon; Mendoza-Laiz, Nuria; Fuentes, Maria Teresa Gutierrez; Rubiera, Maria; Huyzler, Yeshayahu

    2016-01-01

    People with severe physical disabilities may experience psychosocial problems. Boccia is one sport that athletes with severe disability can engage in, but no information on the effects of Boccia on psychosocial outcomes for participants with severe disability is available. Therefore, we analyzed the effects of Boccia on psychosocial outcomes in persons with severe disabilities. The study included two competitive Boccia groups: independent competitive (IC) (n = 9) and nonindependent competitive (NIC) (n = 7), as well as a recreational Boccia group (n = 14) and control subjects (n = 13) (mean age = 46.46 +/- 10.75). All participants underwent a rehabilitation program. Between-group differences in change scores were assessed using analysis of variance/multivariate analysis of variance. Within-group differences were compared using t-tests and effect sizes (ESs). Change in psychosocial parameters was not significantly influenced by study group (p > 0.05). All groups presented moderate-to-large ESs in physical and psychological quality of life (ES > 0.51). In comparison to the control group, who presented small-to-trivial ESs in General Health Questionnaire-28 (GHQ-28), State-Trait Anxiety Inventory, and Profile of Mood States-Tension, the IC and recreational group presented moderate ESs in GHQ-28, whereas the NIC group presented moderate ESs in anxiety and tension. In conclusion, the rehabilitation program had a general positive effect on the psychosocial status of individuals with severe physical disabilities. However, the competitive Boccia groups demonstrated a greater number of favorable changes, suggesting an added value of participation in Boccia.

  13. Integrating fragmented evidence by network meta-analysis: relative effectiveness of psychological interventions for adults with post-traumatic stress disorder.

    PubMed

    Gerger, H; Munder, T; Gemperli, A; Nüesch, E; Trelle, S; Jüni, P; Barth, J

    2014-11-01

    To summarize the available evidence on the effectiveness of psychological interventions for patients with post-traumatic stress disorder (PTSD). We searched bibliographic databases and reference lists of relevant systematic reviews and meta-analyses for randomized controlled trials that compared specific psychological interventions for adults with PTSD symptoms either head-to-head or against control interventions using non-specific intervention components, or against wait-list control. Two investigators independently extracted the data and assessed trial characteristics. The analyses included 4190 patients in 66 trials. An initial network meta-analysis showed large effect sizes (ESs) for all specific psychological interventions (ESs between -1.10 and -1.37) and moderate effects of psychological interventions that were used to control for non-specific intervention effects (ESs -0.58 and -0.62). ES differences between various types of specific psychological interventions were absent to small (ES differences between 0.00 and 0.27). Considerable between-trial heterogeneity occurred (τ²= 0.30). Stratified analyses revealed that trials that adhered to DSM-III/IV criteria for PTSD were associated with larger ESs. However, considerable heterogeneity remained. Heterogeneity was reduced in trials with adequate concealment of allocation and in large-sized trials. We found evidence for small-study bias. Our findings show that patients with a formal diagnosis of PTSD and those with subclinical PTSD symptoms benefit from different psychological interventions. We did not identify any intervention that was consistently superior to other specific psychological interventions. However, the robustness of evidence varies considerably between different psychological interventions for PTSD, with most robust evidence for cognitive behavioral and exposure therapies.

  14. Does "Enhanced Support" for Offenders Effectively Reduce Custodial Violence and Disruption? An Evaluation of the Enhanced Support Service Pilot.

    PubMed

    Camp, Jake; Joy, Kerry; Freestone, Mark

    2018-01-01

    This study aimed to examine the effectiveness of The Enhanced Support Service (ESS) pilot in reducing custodial violence and disruption, and the associated costs, by observing the behavioural change of the 35 service users who participated in ESS intervention within its first 22 months of operation. Frequencies of recorded incidents of aggressive behaviours, self-harming behaviours, noncompliance, and positive behaviours were counted from routine administrative systems using a coding structure developed in previous studies. The count data were analysed using nonparametric tests and Poisson regression models to derive an Incident Rate Ratio (IRR). Findings suggest the ESS is associated with a reduction in aggressive behaviours and noncompliance, with medium to large effect sizes ( r = .31-.53); however, it was not associated with a reduction in deliberate self-harm or increased positive behaviours. The Poisson models revealed that levels of pre-intervention behaviour, intervention length, intervention completion, and service location had varying effects on postintervention behaviour, with those who completed intervention demonstrating more favourable outcomes. The ESS service model was associated with a reduction in behaviour that challenges, which has implications for the reduction in associated social, economic, and political costs-as well as the commissioning of interventions and future research in this area.

  15. Short-term adaptations following Complex Training in team-sports: A meta-analysis

    PubMed Central

    Martinez-Rodriguez, Alejandro; Calleja-González, Julio; Alcaraz, Pedro E.

    2017-01-01

    Objective The purpose of this meta-analysis was to study the short-term adaptations on sprint and vertical jump (VJ) performance following Complex Training (CT) in team-sports. CT is a resistance training method aimed at developing both strength and power, which has a direct effect on sprint and VJ. It consists on alternating heavy resistance training exercises with plyometric/power ones, set for set, on the same workout. Methods A search of electronic databases up to July 2016 (PubMed-MEDLINE, SPORTDiscus, Web of Knowledge) was conducted. Inclusion criteria: 1) at least one CT intervention group; 2) training protocols ≥4-wks; 3) sample of team-sport players; 4) sprint or VJ as an outcome variable. Effect sizes (ES) of each intervention were calculated and subgroup analyses were performed. Results A total of 9 studies (13 CT groups) met the inclusion criteria. Medium effect sizes (ES) (ES = 0.73) were obtained for pre-post improvements in sprint, and small (ES = 0.41) in VJ, following CT. Experimental-groups presented better post-intervention sprint (ES = 1.01) and VJ (ES = 0.63) performance than control-groups. Sprint large ESs were exhibited in younger athletes (<20 years old; ES = 1.13); longer CT interventions (≥6 weeks; ES = 0.95); conditioning activities with intensities ≤85% 1RM (ES = 0.96) and protocols with frequencies of <3 sessions/week (ES = 0.84). Medium ESs were obtained in Division I players (ES = 0.76); training programs >12 total sessions (ES = 0.74). VJ Large ESs in programs with >12 total sessions (ES = 0.81). Medium ESs obtained for under-Division I individuals (ES = 0.56); protocols with intracomplex rest intervals ≥2 min (ES = 0.55); conditioning activities with intensities ≤85% 1RM (ES = 0.64); basketball/volleyball players (ES = 0.55). Small ESs were found for younger athletes (ES = 0.42); interventions ≥6 weeks (ES = 0.45). Conclusions CT interventions have positive medium effects on sprint performance and small effects on VJ in team-sport athletes. This training method is a suitable option to include in the season planning. PMID:28662108

  16. Hippotherapy effects on trunk, pelvic, and hip motion during ambulation in children with neurological impairments.

    PubMed

    Encheff, Jenna L; Armstrong, Charles; Masterson, Michelle; Fox, Christine; Gribble, Phillip

    2012-01-01

    This study investigated the effects of a 10-week hippotherapy program on trunk, pelvis, and hip joint positioning during the stance phase of gait. Eleven children (6 boys and 5 girls; 7.9 ± 2.7 years) with neurological disorders and impaired ambulation participated. Joint range of motion data were collected via 3-dimensional computerized gait analysis before and after the program. Paired t tests were performed on kinematic data for each joint. Significant improvements (P ≤ .008) and large effect sizes (ESs) for sagittal plane hip positions at initial contact and toe-off were found. No differences in pelvic or trunk positioning were determined, although sagittal plane pelvic positioning displayed a trend toward improvement with large ESs. Several trunk variables displayed moderate ESs with a trend toward more upright positioning. Improvements in pelvic and hip joint positioning and more normalized vertical trunk position may indicate increased postural control during gait after 10 sessions of hippotherapy.

  17. A Meta-Analysis of Treatments for Panic Disorder.

    ERIC Educational Resources Information Center

    Clum, George A.; And Others

    1993-01-01

    Used metanalysis to compare effectiveness of psychological and pharmacological treatments for panic disorder. Percentage of agoraphobic subjects in sample and duration of illness were unrelated to effect size (ES). Psychological coping strategies involving relaxation training, cognitive restructuring, and exposure yielded most consistent ESs;…

  18. Working memory, short-term memory, and reading disabilities: a selective meta-analysis of the literature.

    PubMed

    Swanson, H Lee; Xinhua Zheng; Jerman, Olga

    2009-01-01

    The purpose of the present study was to synthesize research that compares children with and without reading disabilities (RD) on measures of short-term memory (STM) and working memory (WM). Across a broad age, reading, and IQ range, 578 effect sizes (ESs) were computed, yielding a mean ES across studies of -.89 (SD = 1.03). A total of 257 ESs were in the moderate range for STM measures (M = -.61, 95% confidence range of -.65 to -.58), and 320 ESs were in the moderate range for WM measures (M = -.67, 95% confidence range of -.68 to -.64). The results indicated that children with RD were distinctively disadvantaged compared with average readers on (a) STM measures requiring the recall of phonemes and digit sequences and (b) WM measures requiring the simultaneous processing and storage of digits within sentence sequences and final words from unrelated sentences. No significant moderating effects emerged for age, IQ, or reading level on memory ESs. The findings indicated that domain-specific STM and WM differences between ability groups persisted across age, suggesting that a verbal deficit model that fails to efficiently draw resources from both a phonological and executive system underlies RD.

  19. Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies.

    PubMed

    Kurtz, Matthew M; Gagen, Emily; Rocha, Nuno B F; Machado, Sergio; Penn, David L

    2016-02-01

    Recent advances in psychosocial treatments for schizophrenia have targeted social cognitive deficits. A critical literature review and effect-size (ES) analysis was conducted to investigate the efficacy of comprehensive programs of social cognitive training in schizophrenia. Results revealed 16 controlled studies consisting of seven models of comprehensive treatment with only three of these treatment models investigated in more than one study. The effects of social cognitive training were reported in 11/15 studies that included facial affect recognition skills (ES=.84) and 10/13 studies that included theory-of-mind (ES=.70) as outcomes. Less than half (4/9) of studies that measured attributional style as an outcome reported effects of treatment, but effect sizes across studies were significant (ESs=.30-.52). The effect sizes for symptoms were modest, but, with the exception of positive symptoms, significant (ESs=.32-.40). The majority of trials were randomized (13/16), selected active control conditions (11/16) and included at least 30 participants (12/16). Concerns for this area of research include the absence of blinded outcome raters in more than 50% of trials and low rates of utilization of procedures for maintaining treatment fidelity. These findings provide preliminary support for the broader use of comprehensive social cognitive training procedures as a psychosocial intervention for schizophrenia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Interventions to Improve Medication Adherence among Older Adults: Meta-Analysis of Adherence Outcomes among Randomized Controlled Trials

    ERIC Educational Resources Information Center

    Conn, Vicki S.; Hafdahl, Adam R.; Cooper, Pamela S.; Ruppar, Todd M.; Mehr, David R.; Russell, Cynthia L.

    2009-01-01

    Purpose: This study investigated the effectiveness of interventions to improve medication adherence (MA) in older adults. Design and Methods: Meta-analysis was used to synthesize results of 33 published and unpublished randomized controlled trials. Random-effects models were used to estimate overall mean effect sizes (ESs) for MA, knowledge,…

  1. Effects of Computer Programming on Students' Cognitive Performance: A Quantitative Synthesis.

    ERIC Educational Resources Information Center

    Liao, Yuen-Kuang Cliff

    A meta-analysis was performed to synthesize existing data concerning the effects of computer programing on cognitive outcomes of students. Sixty-five studies were located from three sources, and their quantitative data were transformed into a common scale--Effect Size (ES). The analysis showed that 58 (89%) of the study-weighted ESs were positive…

  2. Splicing of designer exons informs a biophysical model for exon definition

    PubMed Central

    Arias, Mauricio A.; Chasin, Lawrence A.

    2015-01-01

    Pre-mRNA molecules in humans contain mostly short internal exons flanked by longer introns. To explain the removal of such introns, exon recognition instead of intron recognition has been proposed. We studied this exon definition using designer exons (DEs) made up of three prototype modules of our own design: an exonic splicing enhancer (ESE), an exonic splicing silencer (ESS), and a Reference Sequence (R) predicted to be neither. Each DE was examined as the central exon in a three-exon minigene. DEs made of R modules showed a sharp size dependence, with exons shorter than 14 nt and longer than 174 nt splicing poorly. Changing the strengths of the splice sites improved longer exon splicing but worsened shorter exon splicing, effectively displacing the curve to the right. For the ESE we found, unexpectedly, that its enhancement efficiency was independent of its position within the exon. For the ESS we found a step-wise positional increase in its effects; it was most effective at the 3′ end of the exon. To apply these results quantitatively, we developed a biophysical model for exon definition of internal exons undergoing cotranscriptional splicing. This model features commitment to inclusion before the downstream exon is synthesized and competition between skipping and inclusion fates afterward. Collision of both exon ends to form an exon definition complex was incorporated to account for the effect of size; ESE/ESS effects were modeled on the basis of stabilization/destabilization. This model accurately predicted the outcome of independent experiments on more complex DEs that combined ESEs and ESSs. PMID:25492963

  3. Electrosteric stealth Rivastigmine loaded liposomes for brain targeting: preparation, characterization, ex vivo, bio-distribution and in vivo pharmacokinetic studies.

    PubMed

    Nageeb El-Helaly, Sara; Abd Elbary, Ahmed; Kassem, Mohamed A; El-Nabarawi, Mohamed A

    2017-11-01

    Being one of the highly effective drugs in treatment of Alzheimer's disease, Rivastigmine brain targeting is highly demandable, therefore liposomal dispersion of Rivastigmine was prepared containing 2 mol% PEG-DSPE added to Lecithin, Didecyldimethyl ammonium bromide (DDAB), Tween 80 in 1:0.02:0.25 molar ratio. A major challenge during the preparation of liposomes is maintaining a stable formulation, therefore the aim of our study was to increase liposomal stability by addition of DDAB to give an electrostatic stability and PEG-DSPE to increase stability by steric hindrance, yielding what we called an electrosteric stealth (ESS) liposomes. A medium nano-sized liposome (478 ± 4.94 nm) with a nearly neutral zeta potential (ZP, -8 ± 0.2 mV) and an entrapment efficiency percentage of 48 ± 6.22 was prepared. Stability studies showed no major alteration after three months storage period concerning particle size, polydispersity index, ZP, entrapment efficiency and in vitro release study confirming the successful formation of a stable liposomes. No histopathological alteration was recorded for ESS liposomes of the sheep nasal mucosa. While ESS liposomes showed higher % of drug permeating through the sheep nasal mucosa (48.6%) than the drug solution (28.7%). On completing the in vivo pharmacokinetic studies of 36 rabbits showed 424.2% relative bioavailability of the mean plasma levels of the formula ESS compared to that of RHT intranasal solution and 486% relative bioavailability of the mean brain levels.

  4. Success and failure in narrowing the disability employment gap: comparing levels and trends across Europe 2002-2014.

    PubMed

    Geiger, Ben Baumberg; van der Wel, Kjetil A; Tøge, Anne Grete

    2017-12-02

    International comparisons of the disability employment gap are an important driver of policy change. However, previous comparisons have used the European Union Statistics on Income and Living Conditions (EU-SILC), despite known comparability issues. We present new results from the higher-quality European Social Survey (ESS), compare these to EU-SILC and the EU Labour Force Survey (EU-LFS), and also examine trends in the disability employment gap in Europe over the financial crisis for the first time. For cross-sectional comparisons of 25 countries, we use micro-data for ESS and EU-SILC for 2012 and compare these to published EU-LFS 2011 estimates. For trend analyses, we use seven biannual waves of ESS (2002-2014) with a total sample size of 182,195, and annual waves of EU-SILC (2004-2014) with a total sample size of 2,412,791. (i) Cross-sectional: countries that have smaller disability employment gaps in one survey tend to have smaller gaps in the other surveys. Nevertheless, there are some countries that perform badly on the lower-quality surveys but better in the higher-quality ESS. (ii) Trends: the disability employment gap appears to have declined in ESS by 4.9%, while no trend is observed in EU-SILC - but this has come alongside a rise in disability in ESS. There is a need for investment in disability measures that are more comparable over time/space. Nevertheless, it is clear to policymakers there are some countries that do consistently well across surveys and measures (Switzerland), and others that do badly (Hungary).

  5. Reading disabilities in children: A selective meta-analysis of the cognitive literature.

    PubMed

    Kudo, Milagros F; Lussier, Cathy M; Swanson, H Lee

    2015-05-01

    This article synthesizes literature that compares the academic, cognitive, and behavioral performance of children with and without reading disabilities (RD). Forty-eight studies met the criteria for the meta-analysis, yielding 735 effect sizes (ESs) with an overall weighted ES of 0.98. Small to high ESs in favor of children without RD emerged on measures of cognition (rapid naming [ES = 0.89], phonological awareness [ES = 1.00], verbal working memory [ES = 0.79], short-term memory [ES = 0.56], visual-spatial memory [ES = 0.48], and executive processing [ES = 0.67]), academic achievement (pseudoword reading [ES = 1.85], math [ES = 1.20], vocabulary [ES = 0.83], spelling [ES = 1.25], and writing [ES = 1.20]), and behavior skills (ES = 0.80). Hierarchical linear modeling indicated that specific cognitive process measures (verbal working memory, visual-spatial memory, executive processing, and short-term memory) and intelligence measures (general and verbal intelligence) significantly moderated overall group effect size differences. Overall, the results supported the assumption that cognitive deficits in children with RD are persistent. Copyright © 2015. Published by Elsevier Ltd.

  6. Effect size measures in a two-independent-samples case with nonnormal and nonhomogeneous data.

    PubMed

    Li, Johnson Ching-Hong

    2016-12-01

    In psychological science, the "new statistics" refer to the new statistical practices that focus on effect size (ES) evaluation instead of conventional null-hypothesis significance testing (Cumming, Psychological Science, 25, 7-29, 2014). In a two-independent-samples scenario, Cohen's (1988) standardized mean difference (d) is the most popular ES, but its accuracy relies on two assumptions: normality and homogeneity of variances. Five other ESs-the unscaled robust d (d r * ; Hogarty & Kromrey, 2001), scaled robust d (d r ; Algina, Keselman, & Penfield, Psychological Methods, 10, 317-328, 2005), point-biserial correlation (r pb ; McGrath & Meyer, Psychological Methods, 11, 386-401, 2006), common-language ES (CL; Cliff, Psychological Bulletin, 114, 494-509, 1993), and nonparametric estimator for CL (A w ; Ruscio, Psychological Methods, 13, 19-30, 2008)-may be robust to violations of these assumptions, but no study has systematically evaluated their performance. Thus, in this simulation study the performance of these six ESs was examined across five factors: data distribution, sample, base rate, variance ratio, and sample size. The results showed that A w and d r were generally robust to these violations, and A w slightly outperformed d r . Implications for the use of A w and d r in real-world research are discussed.

  7. Effect of primary empty sella syndrome on pituitary surgery for Cushing's disease.

    PubMed

    Mehta, Gautam U; Bakhtian, Kamran D; Oldfield, Edward H

    2014-09-01

    Primary empty sella syndrome (ESS) results from herniation of arachnoid mater into the pituitary fossa. It has been suggested to have a negative effect on pituitary surgery; however, outcomes in this cohort have not been defined. This study was performed to determine the effect of ESS on immediate and long-term biochemical outcome after pituitary surgery for Cushing's disease (CD). Using a matched cohort study design, the authors followed patients treated with pituitary surgery for CD with and without ESS. Complete ESS was defined as pituitary gland height ≤ 2 mm, whereas partial ESS was defined as pituitary gland height > 2 mm but less than three-quarters of the total sellar depth. The primary end points were immediate and long-term biochemical outcome. Cerebrospinal fluid leaks were recorded as a secondary end point. Seventy-eight patients with CD and primary ESS were identified and matched with 78 patients with CD without ESS. After surgical management, immediate biochemical remission was achieved in 69 patients (88%) with ESS and 75 controls (96%, p = 0.10). Long-term remission was achieved in most patients in both groups (5-year cure: 85% vs 92%, p = 0.10). Among patients with ESS, the presence of complete ESS predicted a worse long-term outcome (p = 0.04). Intraoperative CSF leaks were significantly more frequent with ESS (54% vs 24%, p < 0.001), and despite sellar floor repair, the rate of postoperative CSF leaks was also increased (6% vs 3%, p = 0.27). Biochemical outcome after pituitary surgery for CD was worse in patients with complete ESS, and the risk of a CSF leak was increased with both partial and complete ESS. However, as outcome remains superior to those following alternative therapies and the biology of these tumors is unchanged in the setting of ESS, pituitary surgery should remain the initial treatment of choice.

  8. Evolutionary dynamics of fearfulness and boldness.

    PubMed

    Ji, Ting; Zhang, Boyu; Sun, Yuehua; Tao, Yi

    2009-02-21

    A negative relationship between reproductive effort and survival is consistent with life-history. Evolutionary dynamics and evolutionarily stable strategy (ESS) for the trade-off between survival and reproduction are investigated using a simple model with two phenotypes, fearfulness and boldness. The dynamical stability of the pure strategy model and analysis of ESS conditions reveal that: (i) the simple coexistence of fearfulness and boldness is impossible; (ii) a small population size is favorable to fearfulness, but a large population size is favorable to boldness, i.e., neither fearfulness, nor boldness is always favored by natural selection; and (iii) the dynamics of population density is crucial for a proper understanding of the strategy dynamics.

  9. Nuclear Hybrid Energy System: Molten Salt Energy Storage (Summer Report 2013)

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

    Sabharwall, Piyush; mckellar, Michael George; Yoon, Su-Jong

    2013-11-01

    Effective energy use is a main focus and concern in the world today because of the growing demand for energy. The nuclear hybrid energy system (NHES) is a valuable technical concept that can potentially diversify and leverage existing energy technologies. This report considers a particular NHES design that combines multiple energy systems including a nuclear reactor, energy storage system (ESS), variable renewable generator (VRG), and additional process heat applications. Energy storage is an essential component of this particular NHES because its design allows the system to produce peak power while the nuclear reactor operates at constant power output. Many energymore » storage options are available, but this study mainly focuses on a molten salt ESS. The primary purpose of the molten salt ESS is to enable the nuclear reactor to be a purely constant heat source by acting as a heat storage component for the reactor during times of low demand, and providing additional capacity for thermo-electric power generation during times of peak electricity demand. This report will describe the rationale behind using a molten salt ESS and identify an efficient molten salt ESS configuration that may be used in load following power applications. Several criteria are considered for effective energy storage and are used to identify the most effective ESS within the NHES. Different types of energy storage are briefly described with their advantages and disadvantages. The general analysis to determine the most efficient molten salt ESS involves two parts: thermodynamic, in which energetic and exergetic efficiencies are considered; and economic. Within the molten salt ESS, the two-part analysis covers three major system elements: molten salt ESS designs (two tank direct and thermocline), the molten salt choice, and the different power cycles coupled with the molten salt ESS. Analysis models are formulated and analyzed to determine the most effective ESS. The results show that the most efficient idealized energy storage system is the two tank direct molten salt ESS with an Air Brayton combined cycle using LiF-NaF-KF as the molten salt, and the most economical is the same design with KCl MgCl2 as the molten salt. With energy production being a major worldwide industry, understanding the most efficient molten salt ESS boosts development of an effective NHES with cheap, clean, and steady power.« less

  10. Epidemiological Comparisons of Problems and Positive Qualities Reported by Adolescents in 24 Countries

    ERIC Educational Resources Information Center

    Rescorla, Leslie; Achenbach, Thomas M.; Ivanova, Masha Y.; Dumenci, Levent; Almqvist, Fredrik; Bilenberg, Niels; Bird, Hector; Broberg, Anders; Dobrean, Anca; Dopfner, Manfred; Erol, Nese; Forns, Maria; Hannesdottir, Helga; Kanbayashi, Yasuko; Lambert, Michael C.; Leung, Patrick; Minaei, Asghar; Mulatu, Mesfin S.; Novik, Torunn S.; Oh, Kyung-Ja; Roussos, Alexandra; Sawyer, Michael; Simsek, Zeynep; Steinhausen, Hans-Christoph; Weintraub, Sheila; Metzke, Christa Winkler; Wolanczyk, Tomasz; Zilber, Nelly; Zukauskiene, Rita; Verhulst, Frank

    2007-01-01

    In this study, the authors compared ratings of behavioral and emotional problems and positive qualities on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) by adolescents in general population samples from 24 countries (N = 27,206). For problem scales, country effect sizes (ESs) ranged from 3% to 9%, whereas those for gender and age…

  11. Experimental Intervention Studies on Word Problem Solving and Math Disabilities: A Selective Analysis of the Literature

    ERIC Educational Resources Information Center

    Zheng, Xinhua; Flynn, Lindsay J.; Swanson, H. Lee

    2013-01-01

    This article provides a quantitative synthesis of the published literature on word problem solving intervention studies for children with math disabilities (MD). Seven group and eight single-subject design studies met inclusion criteria. Mean effect sizes ("ES"s) for solution accuracy for group design studies were 0.95 (SE = 0.19) for…

  12. Prediction of Indications for Valve Replacement Among Asymptomatic or Minimally Symptomatic Patients With Chronic Aortic Regurgitation and Normal Left Ventricular Performance

    PubMed Central

    Borer, Jeffrey S.; Hochreiter, Clare; Herrold, Edmond McM; Supino, Phyllis; Aschermann, Michael; Wencker, Detlef; Devereux, Richard B.; Roman, Mary J.; Szulc, Massimiliano; Kligfield, Paul; Isom, O. Wayne

    2013-01-01

    Background Optimal criteria for valve replacement are unclear in asymptomatic/minimally symptomatic patients with aortic regurgitation (AR) and normal left ventricular (LV) performance at rest. Moreover, previous studies have not assessed the prognostic capacity of load-adjusted LV performance (“contractility”) variables, which may be fundamentally related to clinical state. Therefore, 18 years ago, we set out to test prospectively the hypothesis that objective noninvasive measures of LV size and performance and, specifically, of load-adjusted variables, assessed at rest and during exercise (ex), could predict the development of currently accepted indications for operation for AR. Methods and Results Clinical variables and measures of LV size, performance, and end-systolic wall stress (ESS) were assessed annually in 104 patients by radionuclide cineangiography at rest and maximal ex and by echocardiography at rest; ESS was derived during ex. During an average 7.3-year follow-up among patients who had not been operated on, 39 of 104 patients either died suddenly (n = 4) or developed operable symptoms only (n = 22) or subnormal LV performance with or without symptoms (n= 13) (progression rate = 6.2%/y). By multivariate Cox model analysis, change (Δ) in LV ejection fraction (EF) from rest to ex, normalized for ΔESS from rest to ex (ΔLVEF-ΔESS index), was the strongest predictor of progression to any end point or to sudden cardiac death alone. Unadjusted ΔLVEF was almost as efficient. Symptom status modified prediction on the basis of the ΔLVEF-ΔESS index. The population tercile at highest risk by ΔLVEF-ΔESS progressed to end points at a rate of 13.3%/y, and the lowest-risk tercile progressed at 1.8%/y. Conclusions Currently accepted symptom and LV performance indications for valve replacement, as well as sudden cardiac death, can be predicted in asymptomatic/minimally symptomatic patients with AR by load-adjusted ΔLVEF-ΔESS index, which includes data obtained during exercise. PMID:9494022

  13. Correlating Subjective and Objective Sleepiness: Revisiting the Association Using Survival Analysis

    PubMed Central

    Aurora, R. Nisha; Caffo, Brian; Crainiceanu, Ciprian; Punjabi, Naresh M.

    2011-01-01

    Study Objectives: The Epworth Sleepiness Scale (ESS) and multiple sleep latency test (MSLT) are the most commonly used measures of subjective and objective sleepiness, respectively. The strength of the association between these measures as well as the optimal ESS threshold that indicates objective sleepiness remains a topic of significant interest in the clinical and research arenas. The current investigation sought to: (a) examine the association between the ESS and the average sleep latency from the MSLT using the techniques of survival analysis; (b) determine whether specific patient factors influence the association; (c) examine the utility of each ESS question; and (d) identify the optimal ESS threshold that indicates objective sleepiness. Design: Cross-sectional study. Patients and Settings: Patients (N = 675) referred for polysomnography and MSLT. Measurements and Results: Using techniques of survival analysis, a significant association was noted between the ESS score and the average sleep latency. The adjusted hazard ratios for sleep onset during the MSLT for the ESS quartiles were 1.00 (ESS < 9), 1.32 (ESS: 10–13), 1.85 (ESS: 14-17), and 2.53 (ESS ≥ 18), respectively. The association was independent of several patient factors and was distinct for the 4 naps. Furthermore, most of the ESS questions were individually predictive of the average sleep latency except the tendency to doze off when lying down to rest in the afternoon, which was only predictive in patients with less than a college education. Finally, an ESS score ≥ 13 optimally predicted an average sleep latency < 8 minutes. Conclusions: In contrast to previous reports, the association between the ESS and the average sleep latency is clearly apparent when the data are analyzed by survival analysis, and most of the ESS questions are predictive of objective sleepiness. An ESS score ≥ 13 most effectively predicts objective sleepiness, which is higher than what has typically been used in clinical practice. Given the ease of administering the ESS, it represents a relatively simple and cost-effective method for identifying individuals at risk for daytime sleepiness. Citation: Aurora RN; Caffo B; Crainiceanu C; Punjabi NM. Correlating subjective and objective sleepiness: revisiting the association using survival analysis. SLEEP 2011;34(12):1707-1714. PMID:22131609

  14. Suitability of representative electrochemical energy storage technologies for ramp-rate control of photovoltaic power

    NASA Astrophysics Data System (ADS)

    Jiang, Yu; Fletcher, John; Burr, Patrick; Hall, Charles; Zheng, Bowen; Wang, Da-Wei; Ouyang, Zi; Lennon, Alison

    2018-04-01

    Photovoltaic (PV) systems can exhibit rapid variances in their power output due to irradiance changes which can destabilise an electricity grid. This paper presents a quantitative comparison of the suitability of different electrochemical energy storage system (ESS) technologies to provide ramp-rate control of power in PV systems. Our investigations show that, for PV systems ranging from residential rooftop systems to megawatt power systems, lithium-ion batteries with high energy densities (up to 600 Wh L-1) require the smallest power-normalised volumes to achieve the ramp rate limit of 10% min-1 with 100% compliance. As the system size increases, the ESS power-normalised volume requirements are significantly reduced due to aggregated power smoothing, with high power lithium-ion batteries becoming increasingly more favourable with increased PV system size. The possibility of module-level ramp-rate control is also introduced, and results show that achievement of a ramp rate of 10% min-1 with 100% compliance with typical junction box sizes will require ESS energy and power densities of 400 Wh L-1 and 2300 W L-1, respectively. While module-level ramp-rate control can reduce the impact of solar intermittence, the requirement is challenging, especially given the need for low cost and long cycle life.

  15. Use of demand for and spatial flow of ecosystem services to identify priority areas.

    PubMed

    Verhagen, Willem; Kukkala, Aija S; Moilanen, Atte; van Teeffelen, Astrid J A; Verburg, Peter H

    2017-08-01

    Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas of unique demand-supply connections (flow zones). We tested ways to account for ES demand and flow zones to identify priority areas in the European Union. We mapped the capacity and demand of a global (carbon sequestration), a regional (flood regulation), and 3 local ESs (air quality, pollination, and urban leisure). We used Zonation software to identify priority areas for ESs based on 6 tests: with and without accounting for ES demand and 4 tests that accounted for the effect of ES flow zone. There was only 37.1% overlap between the 25% of priority areas that encompassed the most ESs with and without accounting for ES demand. The level of ESs maintained in the priority areas increased from 23.2% to 57.9% after accounting for ES demand, especially for ESs with a small flow zone. Accounting for flow zone had a small effect on the location of priority areas and level of ESs maintained but resulted in fewer flow zones without ES maintained relative to ignoring flow zones. Accounting for demand and flow zones enhanced representation and distribution of ESs with local to regional flow zones without large trade-offs relative to the global ES. We found that ignoring ES demand led to the identification of priority areas in remote regions where benefits from ES capacity to society were small. Incorporating ESs in conservation planning should therefore always account for ES demand to identify an effective priority network for ESs. © 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  16. Productivity costs decrease after endoscopic sinus surgery for refractory chronic rhinosinusitis.

    PubMed

    Rudmik, Luke; Smith, Timothy L; Mace, Jess C; Schlosser, Rodney J; Hwang, Peter H; Soler, Zachary M

    2016-03-01

    The primary objective of this pilot study was to define the change in productivity costs following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Secondary objectives were to identify CRS-related characteristics that may influence the degree of productivity improvement after ESS. Prospective, multi-institutional, observational cohort study. The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time were quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US Census and the 2013 US Department of Labor statistics. Twenty-seven patients with refractory CRS who underwent ESS were followed for a mean of 15 months (range, 8-25 months). Following ESS, there were improvements in annual absenteeism (22 days reduced to 3 days), annual presenteeism (41 days reduced to 19 days), and annual household days lost (12 days reduced to 6 days). Overall, the preoperative productivity costs were reduced after ESS ($9,190 vs. $3,373, respectively; P < .001). Daily productivity is negatively impacted by the presence of CRS. The outcomes from this study provide the first insights into the reduced productivity costs associated with receiving ESS for refractory CRS. Future studies with larger sample sizes will need to validate the results from this pilot study. 2c Laryngoscope, 126:570-574, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Productivity Costs Decrease After Endoscopic Sinus Surgery for Refractory Chronic Rhinosinusitis

    PubMed Central

    Rudmik, Luke; Smith, Timothy L.; Mace, Jess C.; Schlosser, Rodney J.; Hwang, Peter H.; Soler, Zachary M.

    2015-01-01

    Objective The primary objective of this pilot study was to define the change in productivity costs following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Secondary objectives were to identify CRS-related characteristics that may influence the degree of productivity improvement after ESS. Study Design Prospective, multi-institutional, observational cohort study. Methods The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US National Census and the 2013 US Department of Labor statistics. Results 27 patients with refractory CRS who underwent ESS were followed for a mean of 15 [SD 4.0] months (range: 8 – 25 months). Following ESS, there were improvements in annual absenteeism (22 days reduced to 3 days), annual presenteeism (41 days reduced to 19 days), and annual household days lost (12 days reduced to 6 days). Overall, the preoperative productivity costs were reduced after ESS, $9,097 vs. $3,301, respectively (p<0.001). Conclusion Daily productivity is negatively impacted by the presence of CRS. The outcomes from this study provide the first insights into the reduced productivity costs associated with receiving ESS for refractory CRS. Future studies with larger sample sizes will need to validate the results from this pilot study. PMID:26371457

  18. Working Memory, Short-Term Memory, and Reading Disabilities: A Selective Meta-Analysis of the Literature

    ERIC Educational Resources Information Center

    Swanson, H. Lee; Zheng, Xinhua; Jerman, Olga

    2009-01-01

    The purpose of the present study was to synthesize research that compares children with and without reading disabilities (RD) on measures of short-term memory (STM) and working memory (WM). Across a broad age, reading, and IQ range, 578 effect sizes (ESs) were computed, yielding a mean ES across studies of -0.89 (SD = 1.03). A total of 257 ESs…

  19. Optimism and Physical Health: A Meta-analytic Review

    PubMed Central

    Rasmussen, Heather N.; Greenhouse, Joel B.

    2010-01-01

    Background Prior research links optimism to physical health, but the strength of the association has not been systematically evaluated. Purpose The purpose of this study is to conduct a meta-analytic review to determine the strength of the association between optimism and physical health. Methods The findings from 83 studies, with 108 effect sizes (ESs), were included in the analyses, using random-effects models. Results Overall, the mean ES characterizing the relationship between optimism and physical health outcomes was 0.17, p<.001. ESs were larger for studies using subjective (versus objective) measures of physical health. Subsidiary analyses were also conducted grouping studies into those that focused solely on mortality, survival, cardiovascular outcomes, physiological markers (including immune function), immune function only, cancer outcomes, outcomes related to pregnancy, physical symptoms, or pain. In each case, optimism was a significant predictor of health outcomes or markers, all p<.001. Conclusions Optimism is a significant predictor of positive physical health outcomes. PMID:19711142

  20. Economic Evaluation of Endoscopic Sinus Surgery versus Continued Medical Therapy for Refractory Chronic Rhinosinusitis

    PubMed Central

    Rudmik, Luke; Soler, Zachary M.; Mace, Jess C.; Schlosser, Rodney J.; Smith, Timothy L.

    2014-01-01

    Objective To evaluate the long-term cost-effectiveness of endoscopic sinus surgery (ESS) compared to continued medical therapy for patients with refractory chronic rhinosinusitis (CRS). Study Design Cohort-style Markov decision tree economic evaluation Methods The economic perspective was the US third party payer with a 30 year time horizon. The two comparative treatment strategies were: 1) ESS followed by appropriate postoperative medical therapy and 2) continued medical therapy alone. Primary outcome was the incremental cost per quality adjusted life year (QALY). Costs were discounted at a rate of 3.5% in the reference case. Multiple sensitivity analyses were performed including differing time-horizons, discounting scenarios, and a probabilistic sensitivity analysis (PSA). Results The reference case demonstrated that the ESS strategy cost a total of $48,838.38 and produced a total of 20.50 QALYs. The medical therapy alone strategy cost a total of $28,948.98 and produced a total of 17.13 QALYs. The incremental cost effectiveness ratio (ICER) for ESS versus medical therapy alone is $5,901.90 per QALY. The cost-effectiveness acceptability curve from the PSA demonstrated that there is 74% certainty that the ESS strategy is the most cost-effective decision for any willingness to pay threshold greater then $25,000. The time horizon analysis suggests that ESS becomes the cost-effective intervention within the 3rd year after surgery. Conclusion Results from this study suggest that employing an ESS treatment strategy is the most cost-effective intervention compared to continued medical therapy alone for the long-term management of patients with refractory CRS. PMID:25186499

  1. A meta-analysis of the RTI literature for children at risk for reading disabilities.

    PubMed

    Tran, Loan; Sanchez, Tori; Arellano, Brenda; Lee Swanson, H

    2011-01-01

    This article synthesizes the literature comparing at-risk children designated as responders and low responders to interventions in reading. The central question addressed in this review is whether individual differences in reading-related skills at pretest predict responders at posttest across a variety of interventions and sets of criteria for determining responding and low responding. A total of 13 studies met criteria for the meta-analysis, yielding 107 weighted effect sizes (ESs) at posttest (M = .76, SE = .03, 95% confidence interval [CI] =.71, .81) and 108 weighted ESs at pretest (M = 1.02, SE = .03, CI = 1.02, 1.13). The results showed that the magnitude of ES between responders and low responders increased from pretest to posttest on measures of reading (e.g., real word identification = 1.06 vs. 1.53, word attack = 1.10 vs. 1.28, and passage comprehension, 0.45 vs. 1.43). Hierarchical linear modeling indicated that overall posttest ESs were significantly moderated by pretest scores as well as the type of measure administered, whereas no significant moderating effects were found for number of weeks of intervention, length of sessions, number of sessions, type of intervention (one-to-one vs. small group instruction), and criteria for defining responders (cutoff, scores, discrepancy, benchmark). Overall, the synthesis suggested that regardless of type of treatment and identification criteria, response-to-intervention (RTI) conditions were not effective in mitigating learner characteristics related to pretest conditions.

  2. Technology-enhanced simulation and pediatric education: a meta-analysis.

    PubMed

    Cheng, Adam; Lang, Tara R; Starr, Stephanie R; Pusic, Martin; Cook, David A

    2014-05-01

    Pediatrics has embraced technology-enhanced simulation (TES) as an educational modality, but its effectiveness for pediatric education remains unclear. The objective of this study was to describe the characteristics and evaluate the effectiveness of TES for pediatric education. This review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards. A systematic search of Medline, Embase, CINAHL, ERIC, Web of Science, Scopus, key journals, and previous review bibliographies through May 2011 and an updated Medline search through October 2013 were conducted. Original research articles in any language evaluating the use of TES for educating health care providers at any stage, where the content solely focuses on patients 18 years or younger, were selected. Reviewers working in duplicate abstracted information on learners, clinical topic, instructional design, study quality, and outcomes. We coded skills (simulated setting) separately for time and nontime measures and similarly classified patient care behaviors and patient effects. We identified 57 studies (3666 learners) using TES to teach pediatrics. Effect sizes (ESs) were pooled by using a random-effects model. Among studies comparing TES with no intervention, pooled ESs were large for outcomes of knowledge, nontime skills (eg, performance in simulated setting), behaviors with patients, and time to task completion (ES = 0.80-1.91). Studies comparing the use of high versus low physical realism simulators showed small to moderate effects favoring high physical realism (ES = 0.31-0.70). TES for pediatric education is associated with large ESs in comparison with no intervention. Future research should include comparative studies that identify optimal instructional methods and incorporate pediatric-specific issues into educational interventions. Copyright © 2014 by the American Academy of Pediatrics.

  3. NCMS ESS 2000 Project

    NASA Technical Reports Server (NTRS)

    Gibbel, Mark; Bellamy, Marvin; DeSantis, Charlie; Hess, John; Pattok, Tracy; Quintero, Andrew; Silver, R.

    1996-01-01

    ESS 2000 has the vision of enhancing the knowledge necessary to implement cost-effective, leading-edge ESS technologies and procedures in order to increase U.S. electronics industry competitiveness. This paper defines EES and discusses the factors driving the project, the objectives of the project, its participants, the three phases of the project, the technologies involved, and project deliverables.

  4. The effect of endoscopic sinus surgery on symptoms of eustachian tube dysfunction.

    PubMed

    Stoikes, Nathaniel F N; Dutton, Jay M

    2005-01-01

    The symptom of eustachian tube dysfunction has been categorized as a "minor" symptom in chronic rhinosinusitis. The aim of this pilot study was to determine the frequency of otologic symptoms in patients with confirmed rhinosinusitis and the likelihood of its resolution in those patients undergoing endoscopic sinus surgery (ESS). Questionnaires were obtained from 168 patients who had undergone prior ESS over a 5-year period. Patients were asked to evaluate if they suffered from several different potential symptoms of eustachian tube dysfunction before ESS and whether that symptom changed postoperatively. Using the binomial test, 95% confidence intervals were determined for the following otologic symptoms of tubal dysfunction: "earfullness and congestion," "ear cracking and popping," "dizziness," and "ear pain. "ESS was found to have a significant treatment effect for the indicated otologic symptoms of tubal dysfunction. Tubal dysfunction, as manifested by otologic symptoms, is common in patients with chronic rhinosinusitis undergoing ESS. The classification of this as a "minor" symptom of rhinosinusitis needs to be reevaluated. These symptoms improve or resolve in the majority of patients undergoing ESS.

  5. Early Retirement: A Meta-Analysis of Its Antecedent and Subsequent Correlates

    PubMed Central

    Topa, Gabriela; Depolo, Marco; Alcover, Carlos-Maria

    2018-01-01

    Early or voluntary retirement (ER) can be defined as the full exit from an organizational job or career path of long duration, decided by individuals of a certain age at the mid or late career before mandatory retirement age, with the aim of reducing their attachment to work and closing a process of gradual psychological disengagement from working life. Given the swinging movements that characterize employment policies, the potential effects of ER—both for individuals and society—are still controversial. This meta-analysis examined the relationships between ER and its antecedent and subsequent correlates. Our review of the literature was generated with 151 empirical studies, containing a total number of 706,937 participants, with a wide range of sample sizes (from N = 27 to N = 127,384 participants) and 380 independent effect sizes (ESs), which included 171 independent samples. A negligible ES value for antecedent correlates of early retirement (family pull, job stress, job satisfaction, and income) was obtained (which ranged from r = −0.13 to 0.19), while a fair ES was obtained for workplace timing for retirement, organizational pressures, financial security, and poor physical and mental health, (ranging from r = 0.28 to 0.25). Regarding ER subsequent correlates, poor ESs were obtained, ranging from r = 0.08 to 0.18 for the relationships with subsequent correlates, and fair ESs only for social engagement (r = −0.25). Examination of the potential moderator variables has been conducted. Only a reduced percentage of variability of primary studies has been explained by moderators. Although potential moderator factors were examined, there are several unknown or not measurable factors which contribute to ER and about which there are very little data available. The discussion is aimed to offer theoretical and empirical implications suggestion in order to improve employee's well-being. PMID:29354075

  6. Assessing Regional-Scale Impacts of Short Rotation Coppices on Ecosystem Services by Modeling Land-Use Decisions.

    PubMed

    Schulze, Jule; Frank, Karin; Priess, Joerg A; Meyer, Markus A

    2016-01-01

    Meeting the world's growing energy demand through bioenergy production involves extensive land-use change which could have severe environmental and social impacts. Second generation bioenergy feedstocks offer a possible solution to this problem. They have the potential to reduce land-use conflicts between food and bioenergy production as they can be grown on low quality land not suitable for food production. However, a comprehensive impact assessment that considers multiple ecosystem services (ESS) and biodiversity is needed to identify the environmentally best feedstock option, as trade-offs are inherent. In this study, we simulate the spatial distribution of short rotation coppices (SRCs) in the landscape of the Mulde watershed in Central Germany by modeling profit-maximizing farmers under different economic and policy-driven scenarios using a spatially explicit economic simulation model. This allows to derive general insights and a mechanistic understanding of regional-scale impacts on multiple ESS in the absence of large-scale implementation. The modeled distribution of SRCs, required to meet the regional demand of combined heat and power (CHP) plants for solid biomass, had little or no effect on the provided ESS. In the policy-driven scenario, placing SRCs on low or high quality soils to provide ecological focus areas, as required within the Common Agricultural Policy in the EU, had little effect on ESS. Only a substantial increase in the SRC production area, beyond the regional demand of CHP plants, had a relevant effect, namely a negative impact on food production as well as a positive impact on biodiversity and regulating ESS. Beneficial impacts occurred for single ESS. However, the number of sites with balanced ESS supply hardly increased due to larger shares of SRCs in the landscape. Regression analyses showed that the occurrence of sites with balanced ESS supply was more strongly driven by biophysical factors than by the SRC share in the landscape. This indicates that SRCs negligibly affect trade-offs between individual ESS. Coupling spatially explicit economic simulation models with environmental and ESS assessment models can contribute to a comprehensive impact assessment of bioenergy feedstocks that have not yet been planted.

  7. Assessing Regional-Scale Impacts of Short Rotation Coppices on Ecosystem Services by Modeling Land-Use Decisions

    PubMed Central

    Schulze, Jule; Frank, Karin; Priess, Joerg A.; Meyer, Markus A.

    2016-01-01

    Meeting the world’s growing energy demand through bioenergy production involves extensive land-use change which could have severe environmental and social impacts. Second generation bioenergy feedstocks offer a possible solution to this problem. They have the potential to reduce land-use conflicts between food and bioenergy production as they can be grown on low quality land not suitable for food production. However, a comprehensive impact assessment that considers multiple ecosystem services (ESS) and biodiversity is needed to identify the environmentally best feedstock option, as trade-offs are inherent. In this study, we simulate the spatial distribution of short rotation coppices (SRCs) in the landscape of the Mulde watershed in Central Germany by modeling profit-maximizing farmers under different economic and policy-driven scenarios using a spatially explicit economic simulation model. This allows to derive general insights and a mechanistic understanding of regional-scale impacts on multiple ESS in the absence of large-scale implementation. The modeled distribution of SRCs, required to meet the regional demand of combined heat and power (CHP) plants for solid biomass, had little or no effect on the provided ESS. In the policy-driven scenario, placing SRCs on low or high quality soils to provide ecological focus areas, as required within the Common Agricultural Policy in the EU, had little effect on ESS. Only a substantial increase in the SRC production area, beyond the regional demand of CHP plants, had a relevant effect, namely a negative impact on food production as well as a positive impact on biodiversity and regulating ESS. Beneficial impacts occurred for single ESS. However, the number of sites with balanced ESS supply hardly increased due to larger shares of SRCs in the landscape. Regression analyses showed that the occurrence of sites with balanced ESS supply was more strongly driven by biophysical factors than by the SRC share in the landscape. This indicates that SRCs negligibly affect trade-offs between individual ESS. Coupling spatially explicit economic simulation models with environmental and ESS assessment models can contribute to a comprehensive impact assessment of bioenergy feedstocks that have not yet been planted. PMID:27082742

  8. Evolution of flowering strategies in Oenothera glazioviana: an integral projection model approach.

    PubMed Central

    Rees, Mark; Rose, Karen E

    2002-01-01

    The timing of reproduction is a key determinant of fitness. Here, we develop parameterized integral projection models of size-related flowering for the monocarpic perennial Oenothera glazioviana and use these to predict the evolutionarily stable strategy (ESS) for flowering. For the most part there is excellent agreement between the model predictions and the results of quantitative field studies. However, the model predicts a much steeper relationship between plant size and the probability of flowering than observed in the field, indicating selection for a 'threshold size' flowering function. Elasticity and sensitivity analysis of population growth rate lambda and net reproductive rate R(0) are used to identify the critical traits that determine fitness and control the ESS for flowering. Using the fitted model we calculate the fitness landscape for invading genotypes and show that this is characterized by a ridge of approximately equal fitness. The implications of these results for the maintenance of genetic variation are discussed. PMID:12137582

  9. Evolution of flowering strategies in Oenothera glazioviana: an integral projection model approach.

    PubMed

    Rees, Mark; Rose, Karen E

    2002-07-22

    The timing of reproduction is a key determinant of fitness. Here, we develop parameterized integral projection models of size-related flowering for the monocarpic perennial Oenothera glazioviana and use these to predict the evolutionarily stable strategy (ESS) for flowering. For the most part there is excellent agreement between the model predictions and the results of quantitative field studies. However, the model predicts a much steeper relationship between plant size and the probability of flowering than observed in the field, indicating selection for a 'threshold size' flowering function. Elasticity and sensitivity analysis of population growth rate lambda and net reproductive rate R(0) are used to identify the critical traits that determine fitness and control the ESS for flowering. Using the fitted model we calculate the fitness landscape for invading genotypes and show that this is characterized by a ridge of approximately equal fitness. The implications of these results for the maintenance of genetic variation are discussed.

  10. Coordinated Control of Wind Turbine and Energy Storage System for Reducing Wind Power Fluctuation

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

    Muljadi, Eduard; Kim, Chunghun; Chung, Chung Choo

    This paper proposes a coordinated control of wind turbine and energy storage system (ESS). Because wind power (WP) is highly dependent on variable wind speed and could induce a severe stability problem to power system especially when the WP has high penetration level. To solve this problem, many power generation corporations or grid operators recently use the ESS. It has very quick response and good performance for reducing the impact of WP fluctuation but has high cost for its installation. Therefore, it is very important to design the control algorithm considering both ESS capacity and grid reliability. Thus, we proposemore » the control algorithm to mitigate the WP fluctuation by using the coordinated control between wind turbine and ESS considering ESS state of charge (SoC) and the WP fluctuation. From deloaded control according to WP fluctuation and ESS SoC management, we can expect the ESS lifespan expansion and improved grid reliability. The effectiveness of the proposed method is validated in MATLAB/Simulink considering power system including both wind turbine generator and conventional generators which react to system frequency deviation.« less

  11. Quantifying the effect of side branches in endothelial shear stress estimates

    PubMed Central

    Giannopoulos, Andreas A.; Chatzizisis, Yiannis S.; Maurovich-Horvat, Pal; Antoniadis, Antonios P.; Hoffmann, Udo; Steigner, Michael L.; Rybicki, Frank J.; Mitsouras, Dimitrios

    2016-01-01

    Background and aims Low and high endothelial shear stress (ESS) is associated with coronary atherosclerosis progression and high-risk plaque features. Coronary ESS is currently assessed via computational fluid dynamic (CFD) simulation in the lumen geometry determined from invasive imaging such as intravascular ultrasound and optical coherence tomography. This process typically omits side branches of the target vessel in the CFD model as invasive imaging of those vessels is not clinically-indicated. The purpose of this study was to determine the extent to which this simplification affects the determination of those regions of the coronary endothelium subjected to pathologic ESS. Methods We determined the diagnostic accuracy of ESS profiling without side branches to detect pathologic ESS in the major coronary arteries of 5 hearts imaged ex vivo with CT angiography. ESS of the three major coronary arteries was calculated both without (test model), and with (reference model) inclusion of all side branches >1.5 mm in diameter, using previously-validated CFD approaches. Diagnostic test characteristics (accuracy, sensitivity, specificity and negative and positive predictive value [NPV/PPV]) with respect to the reference model were assessed for both the entire length as well as only the proximal portion of each major coronary artery, where the majority of high-risk plaques occur. Results Using the model without side branches overall accuracy, sensitivity, specificity, NPV and PPV were 83.4%, 54.0%, 96%, 95.9% and 55.1%, respectively to detect low ESS, and 87.0%, 67.7%, 90.7%, 93.7% and 57.5%, respectively to detect high ESS. When considering only the proximal arteries, test characteristics differed for low and high ESS, with low sensitivity (67.7%) and high specificity (90.7%) to detect low ESS, and low sensitivity (44.7%) and high specificity (95.5%) to detect high ESS. Conclusions The exclusion of side branches in ESS vascular profiling studies greatly reduces the ability to detect regions of the major coronary arteries subjected to pathologic ESS. Single-conduit models can in general only be used to rule out pathologic ESS. PMID:27372207

  12. Quantifying the effect of side branches in endothelial shear stress estimates.

    PubMed

    Giannopoulos, Andreas A; Chatzizisis, Yiannis S; Maurovich-Horvat, Pal; Antoniadis, Antonios P; Hoffmann, Udo; Steigner, Michael L; Rybicki, Frank J; Mitsouras, Dimitrios

    2016-08-01

    Low and high endothelial shear stress (ESS) is associated with coronary atherosclerosis progression and high-risk plaque features. Coronary ESS is currently assessed via computational fluid dynamic (CFD) simulation of coronary blood flow in the lumen geometry determined from invasive imaging such as intravascular ultrasound and optical coherence tomography. This process typically omits side branches of the target vessel in the CFD model as invasive imaging of those vessels is not usually clinically-indicated. The purpose of this study was to determine the extent to which this simplification affects the determination of those regions of the coronary endothelium subjected to pathologic ESS. We determined the diagnostic accuracy of ESS profiling without side branches to detect pathologic ESS in the major coronary arteries of 5 hearts imaged ex vivo with computed tomography angiography (CTA). ESS of the three major coronary arteries was calculated both without (test model), and with (reference model) inclusion of all side branches >1.5 mm in diameter, using previously-validated CFD approaches. Diagnostic test characteristics (accuracy, sensitivity, specificity and negative and positive predictive value [NPV/PPV]) with respect to the reference model were assessed for both the entire length as well as only the proximal portion of each major coronary artery, where the majority of high-risk plaques occur. Using the model without side branches overall accuracy, sensitivity, specificity, NPV and PPV were 83.4%, 54.0%, 96%, 95.9% and 55.1%, respectively to detect low ESS, and 87.0%, 67.7%, 90.7%, 93.7% and 57.5%, respectively to detect high ESS. When considering only the proximal arteries, test characteristics differed for low and high ESS, with low sensitivity (67.7%) and high specificity (90.7%) to detect low ESS, and low sensitivity (44.7%) and high specificity (95.5%) to detect high ESS. The exclusion of side branches in ESS vascular profiling studies greatly reduces the ability to detect regions of the major coronary arteries subjected to pathologic ESS. Single-conduit models can in general only be used to rule out pathologic ESS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Meta-Analyses of Predictors of Hope in Adolescents.

    PubMed

    Yarcheski, Adela; Mahon, Noreen E

    2016-03-01

    The purposes of this study were to identify predictors of hope in the literature reviewed, to use meta-analysis to determine the mean effect size (ES) across studies between each predictor and hope, and to examine four moderators on each predictor-hope relationship. Using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for the literature reviewed, 77 published studies or doctoral dissertations completed between 1990 and 2012 met the inclusion criteria. Eleven predictors of hope were identified and each predictor in relation to hope was subjected to meta-analysis. Five predictors (positive affect, life satisfaction, optimism, self-esteem, and social support) of hope had large mean ESs, 1 predictor (depression) had a medium ES, 4 predictors (negative affect, stress, academic achievement, and violence) had small ESs, and 1 predictor (gender) had a trivial ES. Findings are interpreted for the 11 predictors in relation to hope. Limitations and conclusions are addressed; future studies are recommended. © The Author(s) 2014.

  14. Single vs. multiple sets of resistance exercise for muscle hypertrophy: a meta-analysis.

    PubMed

    Krieger, James W

    2010-04-01

    Previous meta-analyses have compared the effects of single to multiple sets on strength, but analyses on muscle hypertrophy are lacking. The purpose of this study was to use multilevel meta-regression to compare the effects of single and multiple sets per exercise on muscle hypertrophy. The analysis comprised 55 effect sizes (ESs), nested within 19 treatment groups and 8 studies. Multiple sets were associated with a larger ES than a single set (difference = 0.10 +/- 0.04; confidence interval [CI]: 0.02, 0.19; p = 0.016). In a dose-response model, there was a trend for 2-3 sets per exercise to be associated with a greater ES than 1 set (difference = 0.09 +/- 0.05; CI: -0.02, 0.20; p = 0.09), and a trend for 4-6 sets per exercise to be associated with a greater ES than 1 set (difference = 0.20 +/- 0.11; CI: -0.04, 0.43; p = 0.096). Both of these trends were significant when considering permutation test p values (p < 0.01). There was no significant difference between 2-3 sets per exercise and 4-6 sets per exercise (difference = 0.10 +/- 0.10; CI: -0.09, 0.30; p = 0.29). There was a tendency for increasing ESs for an increasing number of sets (0.24 for 1 set, 0.34 for 2-3 sets, and 0.44 for 4-6 sets). Sensitivity analysis revealed no highly influential studies that affected the magnitude of the observed differences, but one study did slightly influence the level of significance and CI width. No evidence of publication bias was observed. In conclusion, multiple sets are associated with 40% greater hypertrophy-related ESs than 1 set, in both trained and untrained subjects.

  15. Effect of food intake on left ventricular wall stress.

    PubMed

    Gårdinger, Ylva; Hlebowicz, Joanna; Björgell, Ola; Dencker, Magnus

    2014-01-28

    Left ventricular wall stress has been investigated in a variety of populations, but the effect of food intake has not been evaluated. We assessed whether left ventricular wall stress is affected by food intake in healthy subjects. Twenty-three healthy subjects aged 25.6 ± 4.5 years were investigated. Meridional end-systolic wall stress (ESS) and circumferential end-systolic wall stress (cESS) were measured before, 30 minutes after, and 110 minutes after a standardised meal. Both ESS and cESS decreased significantly (P < 0.001) from fasting values 30 minutes after the meal, and had not returned to baseline after 110 minutes. ESS decreased from 65 ± 16 kdynes/cm2 (fasting) to 44 ± 12 kdynes/cm2 30 minutes after, and to 58 ± 13 kdynes/cm2 110 minutes after eating. cESS decreased from 98 ± 24 kdynes/cm2 to 67 ± 18 kdynes/cm2 30 minutes after, and to 87 ± 19 kdynes/cm2 110 minutes after the meal. This study shows that left ventricular wall stress is affected by food intake in healthy subjects.

  16. Soil management shapes ecosystem service provision and trade-offs in agricultural landscapes.

    PubMed

    Tamburini, Giovanni; De Simone, Serena; Sigura, Maurizia; Boscutti, Francesco; Marini, Lorenzo

    2016-08-31

    Agroecosystems are principally managed to maximize food provisioning even if they receive a large array of supporting and regulating ecosystem services (ESs). Hence, comprehensive studies investigating the effects of local management and landscape composition on the provision of and trade-offs between multiple ESs are urgently needed. We explored the effects of conservation tillage, nitrogen fertilization and landscape composition on six ESs (crop production, disease control, soil fertility, water quality regulation, weed and pest control) in winter cereals. Conservation tillage enhanced soil fertility and pest control, decreased water quality regulation and weed control, without affecting crop production and disease control. Fertilization only influenced crop production by increasing grain yield. Landscape intensification reduced the provision of disease and pest control. We also found tillage and landscape composition to interactively affect water quality regulation and weed control. Under N fertilization, conventional tillage resulted in more trade-offs between ESs than conservation tillage. Our results demonstrate that soil management and landscape composition affect the provision of several ESs and that soil management potentially shapes the trade-offs between them. © 2016 The Author(s).

  17. Two methods for damping torsional vibrations in DFIG-based wind generators using power converters

    NASA Astrophysics Data System (ADS)

    Zhao, Zuyi; Lu, Yupu; Xie, Da; Yu, Songtao; Wu, Wangping

    2017-01-01

    This paper proposes novel damping control algorithms by using static synchronous compensator (STATCOM) and energy storage system (ESS) to damp torsional vibrations in doubly fed induction generator (DFIG) based wind turbine systems. It first analyses the operating characteristics of STATCOM and ESS for regulating power variations to increase grid voltage stability. Then, new control strategies for STATCOM and ESS are introduced to damp the vibrations. It is followed by illustration of their effectiveness to damp the drive train torsional vibrations of wind turbines, which can be caused by grid disturbances, such as voltage sags and frequency fluctuations. Results suggest that STATCOM is a promising technology to mitigate the torsional vibrations caused by grid voltage sags. By contrast, the ESS connected to the point of common coupling (PCC) of wind turbine systems shows even obvious advantages because of its capability of absorbing/releasing both active and reactive power. It can thus be concluded that STATCOM is useful for stabilizing power system voltage fluctuations, and ESS is more effective both in regulating PCC voltage fluctuations and damping torsional vibrations caused by grid voltage frequency fluctuations.

  18. Protocol for Uniformly Measuring and Expressing the Performance of Energy Storage Systems

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

    Conover, David R.; Crawford, Alasdair J.; Fuller, Jason

    This Protocol provides a set of “best practices” for characterizing energy storage systems (ESSs) and measuring and reporting their performance. It serves as a basis for assessing how an ESS will perform with respect to key performance attributes relevant to different applications. It is intended to provide a valid and accurate basis for the comparison of different ESSs. By achieving the stated purpose, the Protocol will enable more informed decision-making in the selection of ESSs for various stationary applications. The Protocol identifies general information and technical specifications relevant in describing an ESS and also defines a set of test, measurement,more » and evaluation criteria with which to express the performance of ESSs that are intended for energy-intensive and/or power-intensive stationary applications. An ESS includes a storage device, battery management system, and any power conversion systems installed with the storage device. The Protocol is agnostic with respect to the storage technology and the size and rating of the ESS. The Protocol does not apply to single-use storage devices and storage devices that are not coupled with power conversion systems, nor does it address safety, security, or operations and maintenance of ESSs, or provide any pass/fail criteria.« less

  19. Elastic scattering spectroscopy of coagulated brain tissues

    NASA Astrophysics Data System (ADS)

    Ateş, Filiz; Tabakoğlu, Haşim Özgür; Bozkulak, Özgüncem; Canpolat, Murat; Gülsoy, Murat

    2006-02-01

    The goal of this study was to differentiate the parts of lamb brain according to elastic scattering spectroscopy and detect the optical alterations due to coagulation. Cells and tissues are not uniform and have complex structures and shapes. They can be referred to as scattering particles. The process of scattering depends on the light wavelength and on the scattering medium properties; especially on the size and the density of the medium. When elastic scattering spectroscopy (ESS) is employed, the morphological alterations of tissues can be detected using spectral measurements of the elastic scattered light over a wide range of wavelengths. In this study firstly, the slopes of ESS spectra were used to differentiate the parts of lamb brains (brainstem, cerebellum, gray matter, white matter) in vitro in the range of 450 - 750 nm. Secondly, tissues were coagulated at different temperatures (45, 60, and 80 °C) and ESS spectra were taken from native and coagulated tissues. It was observed that as the coagulation temperature increased, the slope of the elastic scattering spectra decreased. Thus, optical properties of tissues were changed with respect to the change in nuclear to cytoplasmic ratio due to the water loss. Results showed that the slopes of ESS spectra in the visible range revealed valuable information about the morphological changes caused by coagulation.

  20. Plant trait-based models identify direct and indirect effects of climate change on bundles of grassland ecosystem services

    PubMed Central

    Lamarque, Pénélope; Lavorel, Sandra; Mouchet, Maud; Quétier, Fabien

    2014-01-01

    Land use and climate change are primary causes of changes in the supply of ecosystem services (ESs). Although the consequences of climate change on ecosystem properties and associated services are well documented, the cascading impacts of climate change on ESs through changes in land use are largely overlooked. We present a trait-based framework based on an empirical model to elucidate how climate change affects tradeoffs among ESs. Using alternative scenarios for mountain grasslands, we predicted how direct effects of climate change on ecosystems and indirect effects through farmers’ adaptations are likely to affect ES bundles through changes in plant functional properties. ES supply was overall more sensitive to climate than to induced management change, and ES bundles remained stable across scenarios. These responses largely reflected the restricted extent of management change in this constrained system, which was incorporated when scaling up plot level climate and management effects on ecosystem properties to the entire landscape. The trait-based approach revealed how the combination of common driving traits and common responses to changed fertility determined interactions and tradeoffs among ESs. PMID:25225382

  1. Plant trait-based models identify direct and indirect effects of climate change on bundles of grassland ecosystem services.

    PubMed

    Lamarque, Pénélope; Lavorel, Sandra; Mouchet, Maud; Quétier, Fabien

    2014-09-23

    Land use and climate change are primary causes of changes in the supply of ecosystem services (ESs). Although the consequences of climate change on ecosystem properties and associated services are well documented, the cascading impacts of climate change on ESs through changes in land use are largely overlooked. We present a trait-based framework based on an empirical model to elucidate how climate change affects tradeoffs among ESs. Using alternative scenarios for mountain grasslands, we predicted how direct effects of climate change on ecosystems and indirect effects through farmers' adaptations are likely to affect ES bundles through changes in plant functional properties. ES supply was overall more sensitive to climate than to induced management change, and ES bundles remained stable across scenarios. These responses largely reflected the restricted extent of management change in this constrained system, which was incorporated when scaling up plot level climate and management effects on ecosystem properties to the entire landscape. The trait-based approach revealed how the combination of common driving traits and common responses to changed fertility determined interactions and tradeoffs among ESs.

  2. Influence of a New "Call-Out Algorithm" for Management of Postoperative Pain and Its Side Effects on Length of Stay in Hospital: A Two-Centre Prospective Randomized Trial.

    PubMed

    Dybvik, Lisa; Skraastad, Erlend; Yeltayeva, Aigerim; Konkayev, Aidos; Musaeva, Tatiana; Zabolotskikh, Igor; Bjertnaes, Lars; Dahl, Vegard; Raeder, Johan; Kuklin, Vladimir

    2017-01-01

    We recently introduced the efficacy safety score (ESS) as a new "call-out algorithm" for management of postoperative pain and side effects. In this study, we report the influence of ESS recorded hourly during the first 8 hours after surgery on the mobility degree, postoperative nonsurgical complications, and length of hospital stay (LOS). We randomized 1152 surgical patients into three groups for postoperative observation: (1) ESS group ( n = 409), (2) Verbal Numeric Rate Scale (VNRS) for pain group ( n = 417), and (3) an ordinary qualitative observation (Control) group ( n = 326). An ESS > 10 or VNRS > 4 at rest or a nurse's observation of pain or adverse reaction to analgesic treatment in the Control group served as a "call-out alarm" for an anaesthesiologist. We found no significant differences in the mobility degree and number of postoperative nonsurgical complications between the groups. LOS was significantly shorter with 12.7 ± 6.3 days (mean ± SD) in the ESS group versus 14.2 ± 6.2 days in the Control group ( P < 0.001). Postoperative ESS recording in combination with the possibility to call upon an anaesthesiologist when exceeding the threshold score might have contributed to the reductions of LOS in this two-centre study. This trial is registered with NCT02143128.

  3. Electronic surveillance systems in infection prevention: Organizational support, program characteristics, and user satisfaction

    PubMed Central

    Grota, Patti G.; Stone, Patricia W.; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

    2012-01-01

    Background The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. Methods A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Results Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Conclusion Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs. PMID:20176411

  4. Electronic surveillance systems in infection prevention: organizational support, program characteristics, and user satisfaction.

    PubMed

    Grota, Patti G; Stone, Patricia W; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

    2010-09-01

    The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs.

  5. Effect of CPAP Therapy in Improving Daytime Sleepiness in Indian Patients with Moderate and Severe OSA.

    PubMed

    Battan, Gulshan; Kumar, Sanjeev; Panwar, Ajay; Atam, Virendra; Kumar, Pradeep; Gangwar, Anil; Roy, Ujjawal

    2016-11-01

    Obstructive Sleep Apnoea (OSA) is a highly prevalent disease and a major public health issue in India. Excessive daytime sleepiness is an almost ubiquitous symptom of OSA. Epworth Sleepiness Scale (ESS) score is a validated objective score to measure the degree of daytime sleepiness. Continuous Positive Airway Pressure (CPAP) therapy has been established as the gold standard treatment modality for OSA patients. A few Indian studies have reported the effectiveness of CPAP therapy in improving ESS scores after 1 st month of CPAP use. To observe both, short-term (one month) and long-term (three month) effects of CPAP therapy on ESS scores in moderate to severe OSA patients. The patients complaining of excessive day-time sleepiness, snoring and choking episodes during sleep, consecutively presenting to medicine OPD over a period of 2 years, were subjected to Polysomnography (PSG). Seventy-three patients with apnoea-hypopnea index (AHI) ≥15 were categorised as having moderate to severe forms of OSA (moderate OSA with AHI=15-30 and severe OSA with AHI >30), and were scheduled for an initial trial of CPAP therapy. Forty-seven patients reported good tolerance to CPAP therapy after a trial period of 2 weeks and comprised the final study group. ESS scores in these patients were recorded at the baseline, and after 1 st and 3 rd month of CPAP therapy, and statistically analysed for significance. Mean ESS score at the baseline among moderate and severe OSA patients were 13.67±2.29 and 16.56 ±1.87, respectively. ESS score in both these subgroups improved significantly to 11.63±3.79, p=0.022, CI (0.3293-4.0106)} and 14.13 ±3.74, p < 0.001, CI (1.2991-4.5408), respectively after one month of CPAP therapy. Likewise, mean ESS scores among moderate and severe OSA patients improved significantly to 9.84 ±2.97, p = 0.022, CI (0.3293-4.0106) and 12.29 ±3.97, p <0.001, CI (2.9414-6.1385), respectively after three months of CPAP therapy. The result of the present study shows that CPAP therapy is significantly effective in improving ESS scores in Indian patients having moderate to severe OSA. Benefits in daytime sleepiness were observed after short-term as well as long-term use of CPAP therapy.

  6. Effect of the Mediterranean diet on cognition and brain morphology and function: a systematic review of randomized controlled trials.

    PubMed

    Radd-Vagenas, Sue; Duffy, Shantel L; Naismith, Sharon L; Brew, Bruce J; Flood, Victoria M; Fiatarone Singh, Maria A

    2018-03-01

    Observational studies of the Mediterranean diet suggest cognitive benefits, potentially reducing dementia risk. We performed the first published review to our knowledge of randomized controlled trials (RCTs) investigating Mediterranean diet effects on cognition or brain morphology and function, with an additional focus on intervention diet quality and its relation to "traditional" Mediterranean dietary patterns. We searched 9 databases from inception (final update December 2017) for RCTs testing a Mediterranean compared with alternate diet for cognitive or brain morphology and function outcomes. Analyses were based on 66 cognitive tests and 1 brain function outcome from 5 included studies (n = 1888 participants). The prescribed Mediterranean diets varied considerably between studies, particularly with regards to quantitative food advice. Only 8/66 (12.1%) of individual cognitive outcomes at trial level significantly favored a Mediterranean diet for cognitive performance, with effect sizes (ESs) ranging from small (0.32) to large (1.66), whereas 2 outcomes favored controls. Data limitations precluded a meta-analysis. Of 8 domain composite cognitive scores from 2 studies, the 3 (Memory, Frontal, and Global function) from PREDIMED (PREvención con DIeta MEDiterránea) were significant, with ESs ranging from 0.39 to 1.29. A posttest comparison at a second PREDIMED site found that the Mediterranean diet modulates the effect of several genotypes associated with dementia risk for some cognitive outcomes, with mixed results. Finally, the risk of low-plasma brain-derived neurotrophic factor was reduced by 78% (OR = 0.22; 95% CI: 0.05, 0.90) in those who consumed a Mediterranean diet compared to control diet at 3 y in this trial. There was no benefit of the Mediterranean diet for incident cognitive impairment or dementia. Five RCTs of the Mediterranean diet and cognition have been published to date. The data are mostly nonsignificant, with small ESs. However, the significant improvements in cognitive domain composites in the most robustly designed study warrant additional research.

  7. Influence of a New “Call-Out Algorithm” for Management of Postoperative Pain and Its Side Effects on Length of Stay in Hospital: A Two-Centre Prospective Randomized Trial

    PubMed Central

    Dybvik, Lisa; Skraastad, Erlend; Yeltayeva, Aigerim; Konkayev, Aidos; Musaeva, Tatiana; Zabolotskikh, Igor; Dahl, Vegard; Raeder, Johan

    2017-01-01

    Background We recently introduced the efficacy safety score (ESS) as a new “call-out algorithm” for management of postoperative pain and side effects. In this study, we report the influence of ESS recorded hourly during the first 8 hours after surgery on the mobility degree, postoperative nonsurgical complications, and length of hospital stay (LOS). Methods We randomized 1152 surgical patients into three groups for postoperative observation: (1) ESS group (n = 409), (2) Verbal Numeric Rate Scale (VNRS) for pain group (n = 417), and (3) an ordinary qualitative observation (Control) group (n = 326). An ESS > 10 or VNRS > 4 at rest or a nurse's observation of pain or adverse reaction to analgesic treatment in the Control group served as a “call-out alarm” for an anaesthesiologist. Results We found no significant differences in the mobility degree and number of postoperative nonsurgical complications between the groups. LOS was significantly shorter with 12.7 ± 6.3 days (mean ± SD) in the ESS group versus 14.2 ± 6.2 days in the Control group (P < 0.001). Conclusion Postoperative ESS recording in combination with the possibility to call upon an anaesthesiologist when exceeding the threshold score might have contributed to the reductions of LOS in this two-centre study. This trial is registered with NCT02143128. PMID:28855800

  8. The Effects of Plyometric Training on Change-of-Direction Ability: A Meta-Analysis.

    PubMed

    Asadi, Abbas; Arazi, Hamid; Young, Warren B; Sáez de Villarreal, Eduardo

    2016-07-01

    To show a clear picture about the possible variables of enhancements of change-of-direction (COD) ability using longitudinal plyometric-training (PT) studies and determine specific factors that influence the training effects. A computerized search was performed, and 24 articles with a total of 46 effect sizes (ESs) in an experimental group and 25 ESs in a control group were reviewed to analyze the role of various factors on the impact of PT on COD performance. The results showed that participants with good fitness levels obtained greater improvements in COD performance (P < .05), and basketball players gained more benefits of PT than other athletes. Also, men obtained COD results similar to those of women after PT. In relation to the variables of PT design, it appears that 7 wk (with 2 sessions/wk) using moderate intensity and 100 jumps per training session with a 72-h rest interval tends to improve COD ability. Performing PT with a combination of different types of plyometric exercises such as drop jumps + vertical jumps + standing long jumps is better than 1 form of exercise. It is apparent that PT can be effective at improving COD ability. The loading parameters are essential for exercise professionals, coaches, and strength and conditioning professionals with regard to the most appropriate dose-response trends to optimize plyometric-induced COD-ability gains.

  9. [Long-term outcome of budesonide middle meatus treatment for chronic rhinosinusitis patients following endoscopic sinus surgery].

    PubMed

    Chen, Xiaodong; Wang, Haiting; Shi, Zhaohui; Li, Xiaoyuan; Shan, Boyi; Xue, Tao; Qiao, Li; Chen, Fuquan

    2016-02-01

    To investigate the long term clinical effect of budesonide treatment in middle meatus for chronic rhinosinusitis(CRS) following endoscopic sinus surgery (ESS). A total number of 53 patients with CRS received ESS were divided into two groups according to budesonide treatment: budesonide-treated group with 21 cases (39.6%) and control group with 32 cases (60.4%). Gelatin sponges soaked with 1 ml budesonide suspension were put in middle meatus in budesonide-treated group, while only gelatin sponges were put in middle meatus in control group. Visual analogy score (VAS), sino-nasal outcome test-22 (SNOT-22) and Lund-Kennedy endoscopic scale were carried out before ESS and two years after ESS. In budesonide-treated group, there were a statistical difference before and after ESS in the VAS, SNOT-20 and Lund-Kennedy score (P<. 05). In control group, difference was also significant in VAS, SNOT-20 and Lund-Kennedy score before and after ESS (P < 0.05). The VAS gap of post-operative and pre-operative in two groups are significantly different (P<. 05). However, there was no significant difference in the SNOT-20 and Lund-Kennedy endoscopic scale gap before or after the operation between two groups. It is safe, convenient and practicable to perform budesonide treatment in middle meatus following ESS, which can significantly ease the post-operative discomfort of nose.

  10. Sinus surgery can improve quality of life, lung infections, and lung function in patients with primary ciliary dyskinesia.

    PubMed

    Alanin, Mikkel Christian; Aanaes, Kasper; Høiby, Niels; Pressler, Tania; Skov, Marianne; Nielsen, Kim Gjerum; Johansen, Helle Krogh; von Buchwald, Christian

    2017-03-01

    Chronic rhinosinusitis (CRS) and bacterial sinusitis are ubiquitous in patients with primary ciliary dyskinesia (PCD). From the sinuses, Pseudomonas aeruginosa can infect the lungs. We studied the effect of endoscopic sinus surgery (ESS) on symptoms of CRS and lower airway infections in PCD patients in a prospective single-arm intervention study of ESS with adjuvant therapy using nasal irrigation with saline, topical nasal steroids, and 2 weeks of systemic antibiotics. Additional treatment with local colistin for 6 months was instigated when P. aeruginosa was cultured at ESS. Twenty-four PCD patients underwent ESS to search for an infectious focus (n = 10), due to severe symptoms of CRS (n = 8), or both (n = 6). Bacteria were cultured from sinus samples in 21 patients (88%), and simultaneous sinus and lung colonization with identical pathogens were observed in 13 patients (62%). Four patients with preoperative P. aeruginosa lung colonization (25%) had no regrowth during follow-up; 2 of these had P. aeruginosa sinusitis. Sinonasal symptoms were improved 12 months after ESS and we observed a trend toward better lung function after ESS. We demonstrated an improvement in CRS-related symptoms after ESS and adjuvant therapy. In selected PCD patients, the suggested regimen may postpone chronic lung infection with P. aeruginosa and stabilize lung function. © 2016 ARS-AAOA, LLC.

  11. Analysis of embolic signals with directional dual tree rational dilation wavelet transform.

    PubMed

    Serbes, Gorkem; Aydin, Nizamettin

    2016-08-01

    The dyadic discrete wavelet transform (dyadic-DWT), which is based on fixed integer sampling factor, has been used before for processing piecewise smooth biomedical signals. However, the dyadic-DWT has poor frequency resolution due to the low-oscillatory nature of its wavelet bases and therefore, it is less effective in processing embolic signals (ESs). To process ESs more effectively, a wavelet transform having better frequency resolution than the dyadic-DWT is needed. Therefore, in this study two ESs, containing micro-emboli and artifact waveforms, are analyzed with the Directional Dual Tree Rational-Dilation Wavelet Transform (DDT-RADWT). The DDT-RADWT, which can be directly applied to quadrature signals, is based on rational dilation factors and has adjustable frequency resolution. The analyses are done for both low and high Q-factors. It is proved that, when high Q-factor filters are employed in the DDT-RADWT, clearer representations of ESs can be attained in decomposed sub-bands and artifacts can be successfully separated.

  12. Outcome assessment of patients undergoing maxillofacial procedures for the treatment of sleep apnea: comparison of subjective and objective results.

    PubMed

    Dattilo, David J; Drooger, Scott A

    2004-02-01

    The purpose of this study was to compare the subjective findings of the Epworth Sleepiness Scale (ESS) to the objective findings of the overnight sleep study (OSS) in 57 patients who underwent phase I and phase II surgery for the correction of obstructive sleep apnea (OSA). Forty-two patients in phase I category (hyoid suspension, palatal surgery, and/or genioglossus advancement) and 15 patients in phase II category (maxillomandibular advancement) were examined. All patients had an OSS and completion of an ESS preoperatively and at a minimum of 8 weeks postoperatively. The results of each test were evaluated to examine any relationship between the improvements of the findings of the OSS to the changes in the ESS. Using accepted criteria, phase I surgery produced an 80% success rate and phase II surgery produced a greater than 95% success rate in both the respiratory disturbance index and the ESS. 1) Both phase I and phase II procedures are effective in treating OSA. 2) Phase II appears to be more effective in treating OSA using both objective and subjective evaluations. 3) Improvement in ESS scores and excessive daytime sleepiness seems to parallel the improvement in OSS scores in patients undergoing surgical correction of OSA.

  13. Comparing Treatment Effect Measurements in Narcolepsy: The Sustained Attention to Response Task, Epworth Sleepiness Scale and Maintenance of Wakefulness Test.

    PubMed

    van der Heide, Astrid; van Schie, Mojca K M; Lammers, Gert Jan; Dauvilliers, Yves; Arnulf, Isabelle; Mayer, Geert; Bassetti, Claudio L; Ding, Claire-Li; Lehert, Philippe; van Dijk, J Gert

    2015-07-01

    To validate the Sustained Attention to Response Task (SART) as a treatment effect measure in narcolepsy, and to compare the SART with the Maintenance of Wakefulness Test (MWT) and the Epworth Sleepiness Scale (ESS). Validation of treatment effect measurements within a randomized controlled trial (RCT). Ninety-five patients with narcolepsy with or without cataplexy. The RCT comprised a double-blind, parallel-group, multicenter trial comparing the effects of 8-w treatments with pitolisant (BF2.649), modafinil, or placebo (NCT01067222). MWT, ESS, and SART were administered at baseline and after an 8-w treatment period. The severity of excessive daytime sleepiness and cataplexy was also assessed using the Clinical Global Impression scale (CGI-C). The SART, MWT, and ESS all had good reliability, obtained for the SART and MWT using two to three sessions in 1 day. The ability to distinguish responders from nonresponders, classified using the CGI-C score, was high for all measures, with a high performance for the SART (r = 0.61) and the ESS (r = 0.54). The Sustained Attention to Response Task is a valid and easy-to-administer measure to assess treatment effects in narcolepsy, enhanced by combining it with the Epworth Sleepiness Scale. © 2015 Associated Professional Sleep Societies, LLC.

  14. Urban expansion simulation and the spatio-temporal changes of ecosystem services, a case study in Atlanta Metropolitan area, USA.

    PubMed

    Sun, Xiao; Crittenden, John C; Li, Feng; Lu, Zhongming; Dou, Xiaolin

    2018-05-01

    Urban expansion can lead to land use changes and, hence, threatens the ecosystems. Understanding the effects of urbanization on ecosystem services (ESs) can provide scientific guidance for land use planning and the protection of ESs. We established a framework to assess the spatial distributions of ESs based on land use changes in the Atlanta Metropolitan area (AMA) from 1985 to 2012. A new comprehensive ecosystem service (CES) index was developed to reflect the comprehensive level of ESs. Associated with the influential factors, we simulated the business as usual scenario in 2030. Four alternative scenarios, including more compact growth (MCG), riparian vegetation buffer (RVB), soil conservation (SC), and combined development (CD) scenarios were developed to explore the optimal land use strategies which can enhance the ESs. The results showed that forest and wetland had the greatest decreases, while low and high intensity built-up lands had the greatest increases. The values of CES and most of ESs decreased significantly due to the sprawling expansion of built-up land. The scenario analysis revealed that the CD scenario performs best in CES value, while it performs the worst in food supply. Compared with the RVB and SC scenarios, MCG scenario is a more optimal land use strategy to enhance the ESs without at the expense of food supply. To integrate multiple ESs into land use planning and decision making, corresponding land management policies and ecological engineering measures should be implemented to enhance: (1) the water yield and water purification in urban core counties, (2) the carbon storage, habitat quality, and recreational opportunity in counties around the core area, and (3) the soil conservation and food supply in surrounding suburban counties. The land use strategies and ecological engineering measures in this study can provide references for enhancing the ESs in the AMA and other metropolitan areas. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Coordinated Control of Wind Turbine and Energy Storage System for Reducing Wind Power Fluctuation

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

    Kim, Chunghun; Muljadi, Eduard; Chung, Chung Choo

    This paper proposes a method for the coordinated control of a wind turbine and an energy storage system (ESS). Because wind power (WP) is highly dependent on wind speed, which is variable, severe stability problems can be caused in power systems, especially when the WP has a high penetration level. To solve this problem, many power generation corporations or grid operators have begun using ESSs. An ESS has very quick response and good performance for reducing the impact of WP fluctuation; however, its installation cost is high. Therefore, it is important to design the control algorithm by considering both themore » ESS capacity and WP fluctuation. Thus, we propose a control algorithm to mitigate the WP fluctuation by using the coordinated control between the wind turbine and the ESS by considering the ESS capacity and the WP fluctuation. Using de-loaded control, according to the WP fluctuation and ESS capacity, we can expand the ESS lifespan and improve grid reliability by avoiding the extreme value of state of charge (SoC) (i.e., 0 or 1 pu). The effectiveness of the proposed method was validated via MATLAB/Simulink by considering a small power system that includes both a wind turbine generator and conventional generators that react to system frequency deviation. We found that the proposed method has better performance in SoC management, thereby improving the frequency regulation by mitigating the impact of the WP fluctuation on the small power system.« less

  16. Coordinated Control of Wind Turbine and Energy Storage System for Reducing Wind Power Fluctuation

    DOE PAGES

    Kim, Chunghun; Muljadi, Eduard; Chung, Chung Choo

    2017-12-27

    This paper proposes a method for the coordinated control of a wind turbine and an energy storage system (ESS). Because wind power (WP) is highly dependent on wind speed, which is variable, severe stability problems can be caused in power systems, especially when the WP has a high penetration level. To solve this problem, many power generation corporations or grid operators have begun using ESSs. An ESS has very quick response and good performance for reducing the impact of WP fluctuation; however, its installation cost is high. Therefore, it is important to design the control algorithm by considering both themore » ESS capacity and WP fluctuation. Thus, we propose a control algorithm to mitigate the WP fluctuation by using the coordinated control between the wind turbine and the ESS by considering the ESS capacity and the WP fluctuation. Using de-loaded control, according to the WP fluctuation and ESS capacity, we can expand the ESS lifespan and improve grid reliability by avoiding the extreme value of state of charge (SoC) (i.e., 0 or 1 pu). The effectiveness of the proposed method was validated via MATLAB/Simulink by considering a small power system that includes both a wind turbine generator and conventional generators that react to system frequency deviation. We found that the proposed method has better performance in SoC management, thereby improving the frequency regulation by mitigating the impact of the WP fluctuation on the small power system.« less

  17. Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: implications for the clinical management of insomnia disorder.

    PubMed

    Kyle, Simon D; Miller, Christopher B; Rogers, Zoe; Siriwardena, A Niroshan; Macmahon, Kenneth M; Espie, Colin A

    2014-02-01

    To investigate whether sleep restriction therapy (SRT) is associated with reduced objective total sleep time (TST), increased daytime somnolence, and impaired vigilance. Within-subject, noncontrolled treatment investigation. Sleep research laboratory. Sixteen patients [10 female, mean age = 47.1 (10.8) y] with well-defined psychophysiological insomnia (PI), reporting TST ≤ 6 h. Patients were treated with single-component SRT over a 4-w protocol, sleeping in the laboratory for 2 nights prior to treatment initiation and for 3 nights (SRT night 1, 8, 22) during the acute interventional phase. The psychomotor vigilance task (PVT) was completed at seven defined time points [day 0 (baseline), day 1,7,8,21,22 (acute treatment) and day 84 (3 mo)]. The Epworth Sleepiness Scale (ESS) was completed at baseline, w 1-4, and 3 mo. Subjective sleep outcomes and global insomnia severity significantly improved before and after SRT. There was, however, a robust decrease in PSG-defined TST during acute implementation of SRT, by an average of 91 min on night 1, 78 min on night 8, and 69 min on night 22, relative to baseline (P < 0.001; effect size range = 1.60-1.80). During SRT, PVT lapses were significantly increased from baseline (at three of five assessment points, all P < 0.05; effect size range = 0.69-0.78), returning to baseline levels by 3 mo (P = 0.43). A similar pattern was observed for RT, with RTs slowing during acute treatment (at four of five assessment points, all P < 0.05; effect size range = 0.57-0.89) and returning to pretreatment levels at 3 mo (P = 0.78). ESS scores were increased at w 1, 2, and 3 (relative to baseline; all P < 0.05); by 3 mo, sleepiness had returned to baseline (normative) levels (P = 0.65). For the first time we show that acute sleep restriction therapy is associated with reduced objective total sleep time, increased daytime sleepiness, and objective performance impairment. Our data have important implications for implementation guidelines around the safe and effective delivery of cognitive behavioral therapy for insomnia.

  18. Design Guide for Earth System Science Education: Common Student Learning Objectives and Special Pedagogical Approaches

    NASA Astrophysics Data System (ADS)

    Baker, D.

    2006-12-01

    As part of the NASA-supported undergraduate Earth System Science Education (ESSE) program, fifty-seven institutions have developed and implemented a wide range of Earth system science (ESS) courses, pedagogies, and evaluation tools. The Teaching, Learning, and Evaluation section of USRA's online ESSE Design Guide showcases these ESS learning environments. This Design Guide section also provides resources for faculty who wish to develop ESS courses. It addresses important course design issues including prior student knowledge and interests, student learning objectives, learning resources, pedagogical approaches, and assessments tied to student learning objectives. The ESSE Design Guide provides links to over 130 ESS course syllabi at introductory, senior, and graduate levels. ESS courses over the past 15 years exhibit common student learning objectives and unique pedagogical approaches. From analysis of ESS course syllabi, seven common student learning objectives emerged: 1) demonstrate systems thinking, 2) develop an ESS knowledge base, 3) apply ESS to the human dimension, 4) expand and apply analytical skills, 5) improve critical thinking skills, 6) build professional/career skills, and 7) acquire an enjoyment and appreciation for science. To meet these objectives, ESSE often requires different ways of teaching than in traditional scientific disciplines. This presentation will highlight some especially successful pedagogical approaches for creating positive and engaging ESS learning environments.

  19. Energy Storage Sizing Taking Into Account Forecast Uncertainties and Receding Horizon Operation

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

    Baker, Kyri; Hug, Gabriela; Li, Xin

    Energy storage systems (ESS) have the potential to be very beneficial for applications such as reducing the ramping of generators, peak shaving, and balancing not only the variability introduced by renewable energy sources, but also the uncertainty introduced by errors in their forecasts. Optimal usage of storage may result in reduced generation costs and an increased use of renewable energy. However, optimally sizing these devices is a challenging problem. This paper aims to provide the tools to optimally size an ESS under the assumption that it will be operated under a model predictive control scheme and that the forecast ofmore » the renewable energy resources include prediction errors. A two-stage stochastic model predictive control is formulated and solved, where the optimal usage of the storage is simultaneously determined along with the optimal generation outputs and size of the storage. Wind forecast errors are taken into account in the optimization problem via probabilistic constraints for which an analytical form is derived. This allows for the stochastic optimization problem to be solved directly, without using sampling-based approaches, and sizing the storage to account not only for a wide range of potential scenarios, but also for a wide range of potential forecast errors. In the proposed formulation, we account for the fact that errors in the forecast affect how the device is operated later in the horizon and that a receding horizon scheme is used in operation to optimally use the available storage.« less

  20. Adaptive Annealed Importance Sampling for Multimodal Posterior Exploration and Model Selection with Application to Extrasolar Planet Detection

    NASA Astrophysics Data System (ADS)

    Liu, Bin

    2014-07-01

    We describe an algorithm that can adaptively provide mixture summaries of multimodal posterior distributions. The parameter space of the involved posteriors ranges in size from a few dimensions to dozens of dimensions. This work was motivated by an astrophysical problem called extrasolar planet (exoplanet) detection, wherein the computation of stochastic integrals that are required for Bayesian model comparison is challenging. The difficulty comes from the highly nonlinear models that lead to multimodal posterior distributions. We resort to importance sampling (IS) to estimate the integrals, and thus translate the problem to be how to find a parametric approximation of the posterior. To capture the multimodal structure in the posterior, we initialize a mixture proposal distribution and then tailor its parameters elaborately to make it resemble the posterior to the greatest extent possible. We use the effective sample size (ESS) calculated based on the IS draws to measure the degree of approximation. The bigger the ESS is, the better the proposal resembles the posterior. A difficulty within this tailoring operation lies in the adjustment of the number of mixing components in the mixture proposal. Brute force methods just preset it as a large constant, which leads to an increase in the required computational resources. We provide an iterative delete/merge/add process, which works in tandem with an expectation-maximization step to tailor such a number online. The efficiency of our proposed method is tested via both simulation studies and real exoplanet data analysis.

  1. Optical biopsy for the diagnosis of dysplasia in Barrett's oesophagus

    NASA Astrophysics Data System (ADS)

    Pickard, David C. O.; Bigio, Irving J.; Bown, Stephen G.; Lovat, Laurence B.; Ripley, Paul M.; Novelli, Marco

    2002-05-01

    Several research groups have been developing optical-spectroscopy methods, often mediated by fibre-optic probes, to noninvasively identify dysplasia and cancer in situ and in real time: often called 'optical biopsy'. Researchers at Los Alamos National Laboratory (Los Alamos, New Mexico) have developed the method of elastic-scattering spectroscopy (ESS). ESS is a point measurement that is sensitive to the morphological changes at the cellular and sub-cellular level, including changes in the size and/or density of the nuclei, mitochondria or other organelles. It is therefore sensitive to morphology features that a pathologist looks for during histological examination. We report on the first stages of a clinical study currently under way at the Middlesex Hospital an University College London, designed to test the ESS method for identification of dysplasia in Barrett's oesophagus. Preliminary results using elastic-scattering spectroscopy during endoscopic examination show that this technique has potential as a real-time test for in vivo detection of dysplasia or early cancer within Barrett's mucosa, or at least as a guide to assist in locating optimum sites for biopsy. Initial data sets are encouraging and the randomly chosen testing and training sets give specificities and sensitivities comparable to the accuracy of histology. It is evident that the ESS technique is proving to be convenient for the physicians given its speed and compatibility with endoscopic equipment. It is intended to begin prospective trials in the next few months to assess the systems suitability for general clinical practice.

  2. Combined effects of climate and land-use change on the provision of ecosystem services in rice agro-ecosystems

    NASA Astrophysics Data System (ADS)

    Langerwisch, Fanny; Václavík, Tomáš; von Bloh, Werner; Vetter, Tobias; Thonicke, Kirsten

    2018-01-01

    Irrigated rice croplands are among the world’s most important agro-ecosystems. They provide food for more than 3.5 billion people and a range of other ecosystem services (ESS). However, the sustainability of rice agro-ecosystems is threatened by continuing climate and land-use changes. To estimate their combined effects on a bundle of ESS, we applied the vegetation and hydrology model LPJmL to seven study areas in the Philippines and Vietnam. We quantified future changes in the provision of four essential ESS (carbon storage, carbon sequestration, provision of irrigation water and rice production) under two climate scenarios (until 2100) and three site-specific land-use scenarios (until 2030), and examined the synergies and trade-offs in ESS responses to these drivers. Our results show that not all services can be provided in the same amounts in the future. In the Philippines and Vietnam the projections estimated a decrease in rice yields (by approximately 30%) and in carbon storage (by 15%) and sequestration (by 12%) towards the end of the century under the current land-use pattern. In contrast, the amount of available irrigation water was projected to increase in all scenarios by 10%-20%. However, the results also indicate that land-use change may partially offset the negative climate impacts in regions where cropland expansion is possible, although only at the expense of natural vegetation. When analysing the interactions between ESS, we found consistent synergies between rice production and carbon storage and trade-offs between carbon storage and provision of irrigation water under most scenarios. Our results show that not only the effects of climate and land-use change alone but also the interaction between ESS have to be considered to allow sustainable management of rice agro-ecosystems under global change.

  3. Ecosystem service trade-offs and their influencing factors: A case study in the Loess Plateau of China.

    PubMed

    Feng, Qiang; Zhao, Wenwu; Fu, Bojie; Ding, Jingyi; Wang, Shuai

    2017-12-31

    Soil erosion control (SEC), carbon sequestration (CAS), and soil moisture (SMO) strongly interact in the semi-arid Loess Plateau. Since SMO has supportive effects on SEC and CAS, it can be considered as ecosystem service (ES), and there is an immediate need to coordinate the relationships among these ecosystem services (ESs) to promote the sustainability of vegetation recovery. In this study, we quantified the ESs, ES trade-offs, and the environmental factors in 151 sample plots in the Ansai watershed, and we used a redundancy analysis (RDA) to clarify the effects of environmental factors on these ESs and their trade-offs. The results were as follows: (1) the general trend in the SEC of vegetation types was Robinia pseudoacacia (CH)>native grass (NG)>small arbor (ST)>Hippophae rhamnoides (SJ)>artificial grass (AG)>Caragana korshinskii (NT)>apple orchard (GY)>crop (CP); the CAS trend was CH>SJ>NT>AG>CP>ST>GY>NG; and the SMO trend was CP>NG>GY>AG>SJ>ST>CH>NT. (2) For SEC-SMO trade-offs, the influence of vegetation type, altitude, silt and sand composition was dominant. The arrangement of NG, AG, and SJ could decrease the extent of the trade-offs. (3) For CAS-SMO trade-offs, vegetation coverage and types were the dominant factors, but the effects were not complex. The extent of these trade-offs was lowest for NT, and that for SJ was the second lowest. (4) Considering the relationships among the three ESs, SJ was the most appropriate afforestation plant. Combing the vegetation types, slope position, slope gradient, and soil properties could regulate these ES relationships. The dominant factors influencing ES trade-offs varied among the different soil layers, so we must consider the corresponding influencing factors to regulate ESs. Moreover, manual management measures were also important for coordinating the ES relationships. Our research provides a better understanding of the mechanisms influencing the relationships among ESs. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Wavelength-dependent backscattering measurements for quantitative real-time monitoring of apoptosis in living cells

    NASA Astrophysics Data System (ADS)

    Mulvey, Christine S.; Sherwood, Carly A.; Bigio, Irving J.

    2009-11-01

    Apoptosis-programmed cell death-is a cellular process exhibiting distinct biochemical and morphological changes. An understanding of the early morphological changes that a cell undergoes during apoptosis can provide the opportunity to monitor apoptosis in tissue, yielding diagnostic and prognostic information. There is avid interest regarding the involvement of apoptosis in cancer. The initial response of a tumor to successful cancer treatment is often massive apoptosis. Current apoptosis detection methods require cell culture disruption. Our aim is to develop a nondisruptive optical method to monitor apoptosis in living cells and tissues. This would allow for real-time evaluation of apoptotic progression of the same cell culture over time without alteration. Elastic scattering spectroscopy (ESS) is used to monitor changes in light-scattering properties of cells in vitro due to apoptotic morphology changes. We develop a simple instrument capable of wavelength-resolved ESS measurements from cell cultures in the backward direction. Using Mie theory, we also develop an algorithm that extracts the size distribution of scatterers in the sample. The instrument and algorithm are validated with microsphere suspensions. For cell studies, Chinese hamster ovary (CHO) cells are cultured to confluence on plates and are rendered apoptotic with staurosporine. Backscattering measurements are performed on pairs of treated and control samples at a sequence of times up to 6-h post-treatment. Initial results indicate that ESS is capable of discriminating between treated and control samples as early as 10- to 15-min post-treatment, much earlier than is sensed by standard assays for apoptosis. Extracted size distributions from treated and control samples show a decrease in Rayleigh and 150-nm scatterers, relative to control samples, with a corresponding increase in 200-nm particles. Work continues to correlate these size distributions with underlying morphology. To our knowledge, this is the first report of the use of backscattering spectral measurements to quantitatively monitor apoptosis in viable cell cultures in vitro.

  5. An ecosystem service approach to support integrated pond management: a case study using Bayesian belief networks--highlighting opportunities and risks.

    PubMed

    Landuyt, Dries; Lemmens, Pieter; D'hondt, Rob; Broekx, Steven; Liekens, Inge; De Bie, Tom; Declerck, Steven A J; De Meester, Luc; Goethals, Peter L M

    2014-12-01

    Freshwater ponds deliver a broad range of ecosystem services (ESS). Taking into account this broad range of services to attain cost-effective ESS delivery is an important challenge facing integrated pond management. To assess the strengths and weaknesses of an ESS approach to support decisions in integrated pond management, we applied it on a small case study in Flanders, Belgium. A Bayesian belief network model was developed to assess ESS delivery under three alternative pond management scenarios: intensive fish farming (IFF), extensive fish farming (EFF) and nature conservation management (NCM). A probabilistic cost-benefit analysis was performed that includes both costs associated with pond management practices and benefits associated with ESS delivery. Whether or not a particular ESS is included in the analysis affects the identification of the most preferable management scenario by the model. Assessing the delivery of a more complete set of ecosystem services tends to shift the results away from intensive management to more biodiversity-oriented management scenarios. The proposed methodology illustrates the potential of Bayesian belief networks. BBNs facilitate knowledge integration and their modular nature encourages future model expansion to more encompassing sets of services. Yet, we also illustrate the key weaknesses of such exercises, being that the choice whether or not to include a particular ecosystem service may determine the suggested optimal management practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis

    PubMed Central

    Bhandarkar, Naveen D.; Mace, Jess C.; Smith, Timothy L.

    2011-01-01

    Background Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been previously studied, the change in antibiotic utilization following ESS is less well known. Objective We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS. Methods A multi-institutional, prospective cohort of patients with CRS and RARS was enrolled between January, 2001 and January, 2009. Patients completed the medication subscale of the Chronic Sinusitis Survey, and the Wilcoxon signed-rank test was used to compare differences in the overall reported time of antibiotic between preoperative and postoperative time points. Results 503 patients were followed for an average 17.3 months. Overall, patients reported a 57.2% reduction in time on antibiotics following ESS. The majority of patients (60.4%) reported significantly less antibiotic utilization after ESS (p<0.001) consisting of an 83.7% reduction in the time on antibiotics. Subgroup analysis also revealed a significant reduction in antibiotic utilization for patients with and without nasal polyposis (59.0% and 58.2%; both p<0.001) as well as RARS (61.2%; p=0.001). Conclusion ESS significantly reduces antibiotic utilization for CRS and RARS. This finding demonstrates potential for lower health care expenditures related to antibiotics, as well as reduced risk of both antibiotic related morbidity and development of bacterial resistance. PMID:21666846

  7. Modification of the Epworth Sleepiness Scale in Central China.

    PubMed

    Zhang, Jin Nong; Peng, Bo; Zhao, Ting Ting; Xiang, Min; Fu, Wei; Peng, Yi

    2011-12-01

    The well-known excessive daytime sleepiness (EDS) assessment, Epworth Sleepiness Scale (ESS), is not consistently qualified for patients with diverse living habits. This study is aimed to build a modified ESS (mESS) and then to verify its feasibility in the assessment of EDS for patients with suspected sleep-disordered breathing (SDB) in central China. A Ten-item Sleepiness Questionnaire (10-ISQ) was built by adding two backup items to the original ESS. Then the 10-ISQ was administered to 122 patients in central China with suspected SDB [among them, 119 cases met the minimal diagnostic criteria for obstructive sleep apnea by sleep study, e.g., apnea and hypopnea index (AHI) ≥ 5 h(-1)] and 117 healthy central Chinese volunteers without SDB. Multivariate exploratory techniques were used for item validation. The unreliable item in the original ESS was replaced by the eligible backup item, thus a modified ESS (mESS) was built, and then verified. Item 8 proved to be the only unreliable item in central Chinese patients, with the least factor loading on the main factor and the lowest item-total correlation both in the 10-ISQ and in the original ESS, deletion of it would increase the Cronbach's alpha (from 0.86 to 0.87 in the 10-ISQ; from 0.83 to 0.85 in the original ESS). The mESS was subsequently built by replacing item 8 in the original ESS with item 10 in the 10-ISQ. Verification with patients' responses revealed that the mESS was a single-factor questionnaire with good internal consistency (Cronbach's alpha = 0.86). The sum score of the mESS not only correlated with AHI (P < 0.01) but was also able to discriminate the severity of obstructive apnea (P < 0.01). Nasal CPAP treatment for severe OSA reduced the score significantly (P < 0.001). The performance of the mESS was poor in evaluating normal subjects. The mESS improves the validity of ESS for our patients. Therefore, it is justified to use it instead of the original one in assessment of EDS for patients with SDB in central China.

  8. A Meta-Analytic Review of the Penn Resiliency Program’s Effect on Depressive Symptoms

    PubMed Central

    Brunwasser, Steven M.; Gillham, Jane E.; Kim, Eric S.

    2015-01-01

    Objectives The purpose of this review was to evaluate whether the Penn Resiliency Program (PRP), a group cognitive-behavioral intervention, is effective in targeting depressive symptoms in youth. Data sources We identified 17 controlled evaluations of PRP (N = 2498) measuring depressive symptoms via an online search of PsycInfo, Medline, ERIC, and ProQuest Dissertations and Theses, and by requesting data from PRP researchers. Review methods We combined effect sizes (ESs; Glass’s d), using random effects models at post-intervention and two follow-up assessments. Results PRP participants reported fewer depressive symptoms at post-intervention and both follow-up assessments compared to youth receiving no intervention, with ESs ranging from 0.11 to 0.21. Limited data show no evidence that PRP is superior to active control conditions. Subgroup analyses showed that PRP’s effects were significant at 1 or more follow-up assessments among studies using both targeted and universal approaches, when group leaders were research team members and community providers, among participants with both low and elevated baseline symptoms, and among boys and girls. Preliminary analyses suggest that PRP’s effects on depressive disorders may be smaller than those reported in a larger meta-analysis of depression prevention programs for older adolescents and adults. Conclusion We found evidence that PRP significantly reduces depressive symptoms through at least 1 year post-intervention. Future PRP research should examine whether PRP’s effects on depressive symptoms lead to clinically meaningful benefits for its participants, whether the program is cost-effective, whether CBT skills mediate program effects, and whether PRP is effective when delivered under real-world conditions. PMID:19968381

  9. Gibberellic Acid, Synthetic Auxins, and Ethylene Differentially Modulate α-l-Arabinofuranosidase Activities in Antisense 1-Aminocyclopropane-1-Carboxylic Acid Synthase Tomato Pericarp Discs1

    PubMed Central

    Sozzi, Gabriel O.; Greve, L. Carl; Prody, Gerry A.; Labavitch, John M.

    2002-01-01

    α-l-Arabinofuranosidases (α-Afs) are plant enzymes capable of releasing terminal arabinofuranosyl residues from cell wall matrix polymers, as well as from different glycoconjugates. Three different α-Af isoforms were distinguished by size exclusion chromatography of protein extracts from control tomatoes (Lycopersicon esculentum) and an ethylene synthesis-suppressed (ESS) line expressing an antisense 1-aminocyclopropane-1-carboxylic synthase transgene. α-Af I and II are active throughout fruit ontogeny. α-Af I is the first Zn-dependent cell wall enzyme isolated from tomato pericarp tissues, thus suggesting the involvement of zinc in fruit cell wall metabolism. This isoform is inhibited by 1,10-phenanthroline, but remains stable in the presence of NaCl and sucrose. α-Af II activity accounts for over 80% of the total α-Af activity in 10-d-old fruit, but activity drops during ripening. In contrast, α-Af III is ethylene dependent and specifically active during ripening. α-Af I released monosaccharide arabinose from KOH-soluble polysaccharides from tomato cell walls, whereas α-Af II and III acted on Na2CO3-soluble pectins. Different α-Af isoform responses to gibberellic acid, synthetic auxins, and ethylene were followed by using a novel ESS mature-green tomato pericarp disc system. α-Af I and II activity increased when gibberellic acid or 2,4-dichlorophenoxyacetic acid was applied, whereas ethylene treatment enhanced only α-Af III activity. Results suggest that tomato α-Afs are encoded by a gene family under differential hormonal controls, and probably have different in vivo functions. The ESS pericarp explant system allows comprehensive studies involving effects of physiological levels of different growth regulators on gene expression and enzyme activity with negligible wound-induced ethylene production. PMID:12114586

  10. Tyrosine kinase receptor status in endometrial stromal sarcoma: an immunohistochemical and genetic-molecular analysis.

    PubMed

    Cossu-Rocca, Paolo; Contini, Marcella; Uras, Maria Gabriela; Muroni, Maria Rosaria; Pili, Francesca; Carru, Ciriaco; Bosincu, Luisanna; Massarelli, Giovannino; Nogales, Francisco F; De Miglio, Maria Rosaria

    2012-11-01

    Endometrial stromal sarcomas (ESS) are rare uterine malignant mesenchymal neoplasms, which are currently treated by surgery, as effective adjuvant therapies have not yet been established. Tyrosine kinase inhibitors have rarely been applied in ESS therapy, with few reports describing imatinib responsivity. The aim of this study was to analyze the status of different tyrosine kinase receptors in an ESS series, in order to evaluate their potential role as molecular targets. Immunohistochemistry was performed for EGFR, c-KIT, PDGFR-α, PDGFR-β, and ABL on 28 ESS. EGFR, PDGFR-α, and PDGFR-β gene expression was investigated by real-time polymerase chain reaction (qRT-PCR) on selected cases. "Hot-spot" mutations were screened for on EGFR, c-KIT, PDGFR-α, and PDGFR-β genes, by sequencing. All analysis was executed from formalin-fixed, paraffin-embedded specimens. Immunohistochemical overexpression of 2 or more tyrosine kinase receptors was observed in 18 of 28 tumors (64%), whereas only 5 tumors were consistently negative. Gene expression profiles were concordant with immunohistochemical overexpression in only 1 tumor, which displayed both high mRNA levels and specific immunoreactivity for PDGFR-α, and PDGFR-β. No activating mutations were found on the tumors included in the study. This study confirms that TKRs expression is frequently observed in ESS. Considering that the responsiveness to tyrosine kinase inhibitors is known to be related to the presence of specific activating mutations or gene over-expression, which are not detectable in ESS, TKRs immunohistochemical over-expression alone should not be considered as a reliable marker for targeted therapies in ESS. Specific post-translational abnormalities, responsible for activation of TKRs, should be further investigated.

  11. The Potential of Energy Storage Systems with Respect to Generation Adequacy and Economic Viability

    NASA Astrophysics Data System (ADS)

    Bradbury, Kyle Joseph

    Intermittent energy resources, including wind and solar power, continue to be rapidly added to the generation fleet domestically and abroad. The variable power of these resources introduces new levels of stochasticity into electric interconnections that must be continuously balanced in order to maintain system reliability. Energy storage systems (ESSs) offer one potential option to compensate for the intermittency of renewables. ESSs for long-term storage (1-hour or greater), aside from a few pumped hydroelectric installations, are not presently in widespread use in the U.S. The deployment of ESSs would be most likely driven by either the potential for a strong internal rate of return (IRR) on investment and through significant benefits to system reliability that independent system operators (ISOs) could incentivize. To assess the potential of ESSs three objectives are addressed. (1) Evaluate the economic viability of energy storage for price arbitrage in real-time energy markets and determine system cost improvements for ESSs to become attractive investments. (2) Estimate the reliability impact of energy storage systems on the large-scale integration of intermittent generation. (3) Analyze the economic, environmental, and reliability tradeoffs associated with using energy storage in conjunction with stochastic generation. First, using real-time energy market price data from seven markets across the U.S. and the physical parameters of fourteen ESS technologies, the maximum potential IRR of each technology from price arbitrage was evaluated in each market, along with the optimal ESS system size. Additionally, the reductions in capital cost needed to achieve a 10% IRR were estimated for each ESS. The results indicate that the profit-maximizing size of an ESS is primarily determined by its technological characteristics (round-trip charge/discharge efficiency and self-discharge) and not market price volatility, which instead increases IRR. This analysis demonstrates that few ESS technologies are likely to be implemented by investors alone. Next, the effects of ESSs on system reliability are quantified. Using historic data for wind, solar, and conventional generation, a correlation-preserving, copula-transform model was implemented in conjunction with Markov chain Monte Carlo framework for estimating system reliability indices. Systems with significant wind and solar penetration (25% or greater), even with added energy storage capacity, resulted in considerable decreases in generation adequacy. Lastly, rather than analyzing the reliability and costs in isolation of one another, system reliability, cost, and emissions were analyzed in 3-space to quantify and visualize the system tradeoffs. The modeling results implied that ESSs perform similarly to natural gas combined cycle (NGCC) systems with respect to generation adequacy and system cost, with the primary difference being that the generation adequacy improvements are less for ESSs than that of NGCC systems and the increase in LCOE is greater for ESSs than NGCC systems. Although ESSs do not appear to offer greater benefits than NGCC systems for managing energy on time intervals of 1-hour or more, we conclude that future research into short-term power balancing applications of ESSs, in particular for frequency regulation, is necessary to understand the full potential of ESSs in modern electric interconnections.

  12. A systematic review of validated sinus surgery simulators.

    PubMed

    Stew, B; Kao, S S-T; Dharmawardana, N; Ooi, E H

    2018-06-01

    Simulation provides a safe and effective opportunity to develop surgical skills. A variety of endoscopic sinus surgery (ESS) simulators has been described in the literature. Validation of these simulators allows for effective utilisation in training. To conduct a systematic review of the published literature to analyse the evidence for validated ESS simulation. Pubmed, Embase, Cochrane and Cinahl were searched from inception of the databases to 11 January 2017. Twelve thousand five hundred and sixteen articles were retrieved of which 10 112 were screened following the removal of duplicates. Thirty-eight full-text articles were reviewed after meeting search criteria. Evidence of face, content, construct, discriminant and predictive validity was extracted. Twenty articles were included in the analysis describing 12 ESS simulators. Eleven of these simulators had undergone validation: 3 virtual reality, 7 physical bench models and 1 cadaveric simulator. Seven of the simulators were shown to have face validity, 7 had construct validity and 1 had predictive validity. None of the simulators demonstrated discriminate validity. This systematic review demonstrates that a number of ESS simulators have been comprehensively validated. Many of the validation processes, however, lack standardisation in outcome reporting, thus limiting a meta-analysis comparison between simulators. © 2017 John Wiley & Sons Ltd.

  13. Earth System Science Education for the 21st Century: Progress and Plans

    NASA Astrophysics Data System (ADS)

    Ruzek, M.; Johnson, D. R.; Wake, C.; Aron, J.

    2005-12-01

    Earth System Science Education for the 21st Century (ESSE 21) is a collaborative undergraduate/graduate Earth system science education program sponsored by NASA offering small grants to colleges and universities with special emphasis on including minority institutions to engage faculty and scientists in the development of Earth system science courses, curricula, degree programs and shared learning resources. The annual ESSE 21 meeting in Fairbanks in August, 2005 provided an opportunity for 70 undergraduate educators and scientists to share their best classroom learning resources through a series of short presentations, posters and skills workshops. This poster will highlight meeting results, advances in the development of ESS learning modules, and describe a community-led proposal to develop in the coming year a Design Guide for Undergraduate Earth system Science Education to be based upon the experience of the 63 NASA-supported ESSE teams over the past 15 years. As a living document on the Web, the Design Guide would utilize and share ESSE experiences that: - Advance understanding of the Earth as a system - Apply ESS to the Vision for Space Exploration - Create environments appropriate for teaching and learning ESS - Improve STEM literacy and broaden career paths - Transform institutional priorities and approaches to ESS - Embrace ESS within Minority Serving Institutions - Build collaborative interdisciplinary partnerships - Develop ESS learning resources and modules The Design Guide aims to be a synthesis of just how ESS has been and is being implemented in the college and university environment, listing items essential for undergraduate Earth system education that reflect the collective wisdom of the ESS education community. The Design Guide will focus the vision for ESS in the coming decades, define the challenges, and explore collaborative processes that utilize the next generation of information and communication technology.

  14. Implementing panic-focused psychodynamic psychotherapy into clinical practice.

    PubMed

    Beutel, Manfred E; Scheurich, Vera; Knebel, Achim; Michal, Matthias; Wiltink, Jörg; Graf-Morgenstern, Mechthild; Tschan, Regine; Milrod, Barbara; Wellek, Stefan; Subic-Wrana, Claudia

    2013-06-01

    To determine the effectiveness of manualized panic-focused psychodynamic psychotherapy (PFPP) in routine care in Germany. German psychoanalysts were trained according to the PFPP manual. Fifty-four consecutive outpatients with panic disorder (with or without agoraphobia) were randomly assigned in a 2:1 ratio to PFPP or cognitive-behavioural therapy (CBT) plus exposure therapy. Subjects (female 57.4%; mean age 36.2 years) had high rates of psychiatric (68.5%) and somatic (64.8%) comorbidity, and previous psychiatric treatments (57.4%). Assessments were performed pre- and posttreatment and at 6-month follow-up. The primary outcome measure was the Panic Disorder Severity Scale. Both treatments were highly effective. In patients randomized to PFPP, remission was achieved in 44.4% at termination and by 50% at follow-up (CBT 61.1% and 55.6%, respectively). No significant differences were found. Emotional awareness, a posited moderator of good outcome in psychotherapies, was significantly higher in the CBT group at baseline. It was found to be a strong moderator of treatment effectiveness in both treatments. After adjusting for initial Levels of Emotional Awareness Scale (LEAS) scores, effect sizes (ESs) for the primary outcome were Cohen d = 1.28, from pre- to posttreatment, and d = 1.03, from pretreatment to follow-up, for PFPP, and d = 1.81 and 1.28 for CBT, respectively. PFPP was implemented effectively into clinical practice by psychoanalysts in the community in a sample with severe mental illness with large ESs. Assessment of LEAS may facilitate the identification of patients suitable for short-term psychotherapy. ( German Clinical Trials Register, DRKS00000245; Universal Trial Number, U1111-1112-4245).

  15. Model-based Impact Assessment of an Integrated Water Management Strategy on Ecosystem Services relevant to Food Security in Namibia

    NASA Astrophysics Data System (ADS)

    Luetkemeier, R.; Liehr, S.

    2012-04-01

    North-central Namibia is characterized by seasonal alterations of drought and heavy rainfall, mostly saline groundwater resources and a lack of perennial rivers. Water scarcity poses a great challenge for freshwater supply, harvest and food security against the background of high population growth and climate change. CuveWaters project aims at poverty reduction and livelihood improvement on a long term basis by introducing a multi-resource-mix as part of an integrated water resources management (IWRM) approach. Herein, creating water buffers by rainwater harvesting (RWH) and subsurface water storage as well as reuse of treated wastewater facilitates micro-scale gardening activities. This link constitutes a major component of a sustainable adaptation strategy by contributing to the conservation and improvement of basic food and freshwater resources in order to reduce drought vulnerability. This paper presents main findings of an impact assessment carried out on the effect of integrated water resources management on ecosystem services (ESS) relevant to food security within the framework of CuveWaters project. North-central Namibia is perceived as a social-ecological system characterized by a strong mutual dependence between natural environment and anthropogenic system. This fundamental reliance on natural resources highlights the key role of ESS in semi-arid environments to sustain human livelihoods. Among other services, food provision was chosen for quantification as one of the most fundamental ESS in north-central Namibia. Different nutritional values were utilized as indicators to adopt a demand-supply approach (Ecosystem Service Profile) to illustrate the ability of the ecosystem to meet people's nutritional requirements. Calculations have been conducted using both Bayesian networks to incorporate uncertainty introduced by the variability of monthly precipitation and the application of plant specific water production functions. Results show that improving the water buffer and water use efficiency by facilities of the multi-resource-mix increases the amount of water available for irrigation and thus enhances intermediate and finale ESS relevant to food supply on the household scale. Furthermore, surplus water can be purified and used as an additional drinking water resource. The case study at hand shows that specific components of an IWRM approach can significantly increase the availability of supporting and provisioning ESS and thus reduce people's vulnerability to climate change and associated impacts. The model itself and the analytical framework as a whole can be utilized as a decision-support-tool in order to determine the optimal size of technological variables to maximize yields especially as a function of hydro-meteorological and socio-economic framework conditions.

  16. Effects of armodafinil and cognitive behavior therapy for insomnia on sleep continuity and daytime sleepiness in cancer survivors.

    PubMed

    Garland, Sheila N; Roscoe, Joseph A; Heckler, Charles E; Barilla, Holly; Gehrman, Philip; Findley, James C; Peoples, Anita R; Morrow, Gary R; Kamen, Charles; Perlis, Michael L

    2016-04-01

    This study involves the analysis of a secondary outcome of a trial examining whether cognitive behavior therapy for insomnia (CBT-I), a wake-promoting medication (armodafinil), or both results in greater improvement in prospectively assessed sleep continuity and daytime sleepiness than a placebo-alone group among a heterogeneous group of cancer survivors. Whether or not armodafinil alone, and/or when combined with CBT-I, affected adherence with CBT-I was evaluated. This study is a randomized, placebo-controlled, clinical trial. This study was conducted at two northeastern academic medical centers. Eighty-eight cancer survivors with chronic insomnia were recruited between October 2008 and November 2012. Participants were assigned to one of four conditions: 1) CBT-I and placebo (CBT-I+P); 2) CBT-I and armodafinil (CBT-I + A); 2) armodafinil alone (ARM); or 4) placebo alone (PLA). CBT-I was delivered in seven weekly individual therapy sessions (three in person, four via telephone). The armodafinil dosage was 50 mg BID. Sleep continuity was measured with daily sleep diaries assessing sleep latency (SL), wake after sleep onset (WASO), and total sleep time (TST). The Epworth Sleepiness Scale (ESS) measured daytime sleepiness. Compared to the PLA group, the CBT-I+P and CBT-I+A groups reported a significant reduction in SL with effect sizes of 0.67 and 0.58, respectively. A significant reduction was observed in WASO in the CBT-I+A group with an effect size of 0.64. An increasing trend of TST was observed in the CBT-I+P, CBT-I+A, and PLA groups, but not in the ARM group. No statistically significant reductions in daytime sleepiness (ESS) were observed for any of the groups. CBT-I alone and in combination with armodafinil caused significant improvement in sleep continuity. The addition of armodafinil did not appear to improve daytime sleepiness or enhance adherence to CBT-I. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Effects of Armodafinil and Cognitive Behavior Therapy for Insomnia on Sleep Continuity and Daytime Sleepiness in Cancer Survivors

    PubMed Central

    Garland, Sheila N.; Roscoe, Joseph A.; Heckler, Charles E.; Barilla, Holly; Gehrman, Philip; Findley, James C.; Peoples, Anita R.; Morrow, Gary R.; Kamen, Charles; Perlis, Michael L.

    2016-01-01

    Study Objectives This study involves the analysis of a secondary outcome of a trial examining whether cognitive behavior therapy for insomnia (CBT-I), a wake-promoting medication (armodafinil), or both results in greater improvement in prospectively assessed sleep continuity and daytime sleepiness than a placebo-alone group among a heterogeneous group of cancer survivors. Whether or not armodafinil alone, and/or when combined with CBT-I, affected adherence with CBT-I was evaluated. Design This study is a randomized, placebo-controlled, clinical trial. Setting This study was conducted at two northeastern academic medical centers. Participants Eighty-eight cancer survivors with chronic insomnia were recruited between October 2008 and November 2012. Participants were assigned to one of four conditions: 1) CBT-I and placebo (CBTI+P); 2) CBT-I and armodafinil (CBT-I+A); 2) armodafinil alone (ARM); or 4) placebo alone (PLA). Interventions CBT-I was delivered in seven weekly individual therapy sessions (three in person, four via telephone). The armodafinil dosage was 50 mg BID. Measurements and Results Sleep continuity was measured with daily sleep diaries assessing sleep latency (SL), wake after sleep onset (WASO), and total sleep time (TST). The Epworth Sleepiness Scale (ESS) measured daytime sleepiness. Compared to the PLA group, the CBT+P and CBT+A groups reported a significant reduction in SL with effect sizes of 0.67 and 0.58, respectively. A significant reduction was observed in WASO in the CBT+A group with an effect size of 0.64. An increasing trend of TST was observed in the CBT+P, CBT+A, and PLA groups, but not in the ARM group. No statistically significant reductions in daytime sleepiness (ESS) were observed for any of the groups. Conclusion CBT-I alone and in combination with armodafinil caused significant improvement in sleep continuity. The addition of armodafinil did not appear to improve daytime sleepiness or enhance adherence to CBT-I. PMID:27318221

  18. ADAPTIVE ANNEALED IMPORTANCE SAMPLING FOR MULTIMODAL POSTERIOR EXPLORATION AND MODEL SELECTION WITH APPLICATION TO EXTRASOLAR PLANET DETECTION

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

    Liu, Bin, E-mail: bins@ieee.org

    2014-07-01

    We describe an algorithm that can adaptively provide mixture summaries of multimodal posterior distributions. The parameter space of the involved posteriors ranges in size from a few dimensions to dozens of dimensions. This work was motivated by an astrophysical problem called extrasolar planet (exoplanet) detection, wherein the computation of stochastic integrals that are required for Bayesian model comparison is challenging. The difficulty comes from the highly nonlinear models that lead to multimodal posterior distributions. We resort to importance sampling (IS) to estimate the integrals, and thus translate the problem to be how to find a parametric approximation of the posterior.more » To capture the multimodal structure in the posterior, we initialize a mixture proposal distribution and then tailor its parameters elaborately to make it resemble the posterior to the greatest extent possible. We use the effective sample size (ESS) calculated based on the IS draws to measure the degree of approximation. The bigger the ESS is, the better the proposal resembles the posterior. A difficulty within this tailoring operation lies in the adjustment of the number of mixing components in the mixture proposal. Brute force methods just preset it as a large constant, which leads to an increase in the required computational resources. We provide an iterative delete/merge/add process, which works in tandem with an expectation-maximization step to tailor such a number online. The efficiency of our proposed method is tested via both simulation studies and real exoplanet data analysis.« less

  19. "Cut-and-Paste" Manufacture of Multiparametric Epidermal Sensor Systems.

    PubMed

    Yang, Shixuan; Chen, Ying-Chen; Nicolini, Luke; Pasupathy, Praveenkumar; Sacks, Jacob; Su, Becky; Yang, Russell; Sanchez, Daniel; Chang, Yao-Feng; Wang, Pulin; Schnyer, David; Neikirk, Dean; Lu, Nanshu

    2015-11-04

    Multifunctional epidermal sensor systems (ESS) are manufactured with a highly cost and time effective, benchtop, and large-area "cut-and-paste" method. The ESS made out of thin and stretchable metal and conductive polymer ribbons can be noninvasively laminated onto the skin surface to sense electrophysiological signals, skin temperature, skin hydration, and respiratory rate. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. 77 FR 37795 - Airworthiness Directives; Dassault Aviation Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... display of ELEC:LH ESS PWR LO or ELEC:LH ESS NO PWR (Abnormal procedure 3-190-40), land at nearest suitable airport Upon display of ELEC:RH ESS PWR LO and ELEC:RH ESS NO PWR (Abnormal procedure 3-190-45...

  1. A software tool for ecosystem services assessments

    NASA Astrophysics Data System (ADS)

    Riegels, Niels; Klinting, Anders; Butts, Michael; Middelboe, Anne Lise; Mark, Ole

    2017-04-01

    The EU FP7 DESSIN project is developing methods and tools for assessment of ecosystem services (ESS) and associated economic values, with a focus on freshwater ESS in urban settings. Although the ESS approach has gained considerable visibility over the past ten years, operationalizing the approach remains a challenge. Therefore, DESSSIN is also supporting development of a free software tool to support users implementing the DESSIN ESS evaluation framework. The DESSIN ESS evaluation framework is a structured approach to measuring changes in ecosystem services. The main purpose of the framework is to facilitate the application of the ESS approach in the appraisal of projects that have impacts on freshwater ecosystems and their services. The DESSIN framework helps users evaluate changes in ESS by linking biophysical, economic, and sustainability assessments sequentially. It was developed using the Common International Classification of Ecosystem Services (CICES) and the DPSIR (Drivers, Pressures, States, Impacts, Responses) adaptive management cycle. The former is a standardized system for the classification of ESS developed by the European Union to enhance the consistency and comparability of ESS assessments. The latter is a well-known concept to disentangle the biophysical and social aspects of a system under study. As part of its analytical component, the DESSIN framework also integrates elements of the Final Ecosystem Goods and Services-Classification System (FEGS-CS) of the US Environmental Protection Agency (USEPA). As implemented in the software tool, the DESSIN framework consists of five parts: • In part I of the evaluation, the ecosystem is defined and described and the local stakeholders are identified. In addition, administrative details and objectives of the assessment are defined. • In part II, drivers and pressures are identified. Once these first two elements of the DPSIR scheme have been characterized, the claimed/expected capabilities of a proposed project can be estimated to determine whether the project affects drivers, pressures, states or a combination of these. • In part III, information about impacts on drivers, pressures, and states is used to identify ESS impacted by a proposed project. Potential beneficiaries of impacted ESS are also identified. • In part IV, changes in ESS are estimated. These estimates include changes in the provision of ESS, the use of ESS, and the value of ESS. • A sustainability assessment in Part V estimates the broader impact of a proposed project according to social, environmental, governance and other criteria. The ESS evaluation software tool is designed to assist an evaluation or study leader carrying out an ESS assessment. The tool helps users move through the logic of the ESS evaluation and make sense of relationships between elements of the DPSIR framework, the CICES classification scheme, and the FEGS approach. The tool also provides links to useful indicators and assessment methods in order to help users quantify changes in ESS and ESS values. The software tool is developed in collaboration with the DESSIN user group, who will use the software to estimate changes in ESS resulting from the implementation of green technologies addressing water quality and water scarcity issues. Although the software is targeted to this user group, it will be made available for free to the public after the conclusion of the project.

  2. Language/Culture Modulates Brain and Gaze Processes in Audiovisual Speech Perception.

    PubMed

    Hisanaga, Satoko; Sekiyama, Kaoru; Igasaki, Tomohiko; Murayama, Nobuki

    2016-10-13

    Several behavioural studies have shown that the interplay between voice and face information in audiovisual speech perception is not universal. Native English speakers (ESs) are influenced by visual mouth movement to a greater degree than native Japanese speakers (JSs) when listening to speech. However, the biological basis of these group differences is unknown. Here, we demonstrate the time-varying processes of group differences in terms of event-related brain potentials (ERP) and eye gaze for audiovisual and audio-only speech perception. On a behavioural level, while congruent mouth movement shortened the ESs' response time for speech perception, the opposite effect was observed in JSs. Eye-tracking data revealed a gaze bias to the mouth for the ESs but not the JSs, especially before the audio onset. Additionally, the ERP P2 amplitude indicated that ESs processed multisensory speech more efficiently than auditory-only speech; however, the JSs exhibited the opposite pattern. Taken together, the ESs' early visual attention to the mouth was likely to promote phonetic anticipation, which was not the case for the JSs. These results clearly indicate the impact of language and/or culture on multisensory speech processing, suggesting that linguistic/cultural experiences lead to the development of unique neural systems for audiovisual speech perception.

  3. EVALUATION OF EFFICACY AND SAFETY POSTOPERATIVE PAIN MANAGEMENT BY INTRAMUSCULAR ANALGESIA AFTER DIFFERENT TYPES OF ANAESTHESIA: PILOT CLINICAL PROSPECTIVE STUDY.

    PubMed

    Konkaev, A K; Eltaeva, A A; Zabolotskikh, I B; Musaeva, T S; Dibvik, L Z; Kuklin, V N

    2016-11-01

    Efficacy Safety Score (ESS) with "call-out algorithm" developed in Kongsberg hospital, Norway was used for the validation. ESS consists of the mathematical sum ofscorefrom: 2 subjective (Visual Analog Scale: VAS at rest and during mobilization) and 4 vital (conscious levels, PONV circulation and respiration status) parameters and ESS > 10 is a "call-out alarm "for visit ofpatient by anaesthesiologist. Hourly registration of ESS, mobility degree and amounts of analgetics during the first 8 hours after surgery was recorded in the specially designed IPad program. According to the type ofanaesthesia all patients were allocated in 4 groups: I spinal anaesthesia (SA), II general anesthesia (GA), III peripheral blockade (PB) and IV Total intravenous anaesthesia (TIVA). A total of 223 patients were included in the study. Statistically low levels of both VAS and ESS in the first 2-4 postoperative hours were found in SA and PB groups compared to GA and TIVA groups. During 8 post-operative hours, VAS> 3 was recorded in 10.5% of SA, 13.9% in GA, 12.8% in PG and 23.5% in TIVA patients. Intramuscular postoperative analgesia was effective in SA, GA and PG groups. More attention of anaesthesiologist must be paid to patients ofter TIVA.

  4. College and University Earth System Science Education for the 21st Century (ESSE 21)

    NASA Astrophysics Data System (ADS)

    Johnson, D. R.; Ruzek, M.; Schweizer, D.

    2002-12-01

    The NASA/USRA Cooperative University-based Program in Earth System Science Education (ESSE), initiated over a decade ago through NASA support, has led in the creation of a nationwide collaborative effort to bring Earth system science into the undergraduate classroom. Forty-five ESSE institutions now offer over 120 Earth system courses each year, reaching thousands of students annually with interdisciplinary content. Through the course offerings by faculty from different disciplines and the organizational infrastructure of colleges and universities emphasizing cross disciplinary curricula, programs, degrees and departments, the ESSE Program has led in systemic change in the offering of a holistic view of Earth system science in the classroom. Building on this successful experience and collaborative infrastructure within and among colleges, universities and NASA partners, an expanded program called ESSE 21 is being supported by NASA to extend the legacy established during the last decade. Through its expanded focus including partnerships with under represented colleges and universities, the Program seeks to further develop broadly based educational resources, including shared courses, electronic learning materials and degree programs that will extend Earth system science concepts in both undergraduate and graduate classrooms and laboratories. These resources emphasizing fundamentals of Earth system science advance the nation's broader agenda for improving science, technology, engineering and mathematics competency. Overall the thrust within the classrooms of colleges and universities is critical to extending and solidifying courses of study in Earth system and global change science. ESSE 21 solicits proposals from undergraduate institutions to create or adopt undergraduate and graduate level Earth system science content in courses, curricula and degree programs. The goal for all is to effect systemic change through developing Earth system science learning materials, courses, curricula, minors or degree tracks, and programs or departments that are self-sustaining in the coming decades. Interdisciplinary college and university teams are competitively selected through a peer-reviewed Call for Participation. ESSE 21 offers an infrastructure for an interactive community of educators and researchers including under represented participants that develops interdisciplinary Earth system science content utilizing NASA resources involving global change data, models, visualizations and electronic media and networks. The Program provides for evaluation and assessment guides to help assure the pedagogical effectiveness of materials developed. The ultimate aim of ESSE 21 is to expand and accelerate the nation's realization of sound, scientific interdisciplinary educational resources for informed learning and decision-making by all from the perspective of sustainability of the Earth as a system.

  5. Effect of levothyroxine on prolonged nocturnal sleep time and excessive daytime somnolence in patients with idiopathic hypersomnia.

    PubMed

    Shinno, Hideto; Ishikawa, Ichiro; Yamanaka, Mami; Usui, Ai; Danjo, Sonoko; Inami, Yasushi; Horiguchi, Jun; Nakamura, Yu

    2011-06-01

    This study aims to examine the effect of levothyroxine, a thyroid hormone, on a prolonged nocturnal sleep and excessive daytime somnolence (EDS) in patients with idiopathic hypersomnia. In a prospective, open-label study, nine patients were enrolled. All subjects met criteria for idiopathic hypersomnia with long sleep time defined by the International Classification of Sleep Disorders, 2nd edition (ICSD-2). Subjects with sleep apnea syndrome, obesity or hypothyroidism were excluded. Sleep architecture and subjective daytime somnolence were estimated by polysomnography (PSG) and Epworth Sleepiness Scale (ESS), respectively. After baseline examinations, levothyroxine (25μg/day) was orally administered every day. Mean total sleep time, ESS score at baseline were compared with those after treatment (2, 4 and 8 weeks). Mean age of participants was 23.8±13.7 years old. At baseline, mean total sleep time (hours) and ESS score were 12.9±0.3 and 17.8±1.4, respectively. Mean total sleep times after treatment were 9.1±0.7 and 8.5±1.0h at 4 and 8 treatment weeks, respectively. Mean ESS scores were 8.8±2.3 and 7.4±2.8 at 4 and 8 treatment weeks, respectively. One patient dropped out at the 2nd week due to poor effect. No adverse effects were noted. After treatment with levothyroxine for over 4 weeks, prolonged sleep time and EDS were improved. Levothyroxine was effective for hypersomnia and well tolerated. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. `Teaching What I Learned': Exploring students' Earth and Space Science learning experiences in secondary school with a particular focus on their comprehension of the concept of `geologic time'

    NASA Astrophysics Data System (ADS)

    Yoon, Sae Yeol; Peate, David W.

    2015-06-01

    According to the national survey of science education, science educators in the USA currently face many challenges such as lack of qualified secondary Earth and Space Science (ESS) teachers. Less qualified teachers may have difficulty teaching ESS because of a lack of conceptual understanding, which leads to diminished confidence in content knowledge. More importantly, teachers' limited conceptual understanding of the core ideas automatically leads to a lack of pedagogical content knowledge. This mixed methods study aims to explore the ways in which current secondary schooling, especially the small numbers of highly qualified ESS teachers in the USA, might influence students' learning of the discipline. To gain a better understanding of the current conditions of ESS education in secondary schools, in the first phase, we qualitatively examined a sample middle and high school ESS textbook to explore how the big ideas of ESS, particularly geological time, are represented. In the second phase, we quantitatively analyzed the participating college students' conceptual understanding of geological time by comparing those who had said they had had secondary school ESS learning experience with those who did not. Additionally, college students' perceptions on learning and teaching ESS are discussed. Findings from both the qualitative and quantitative phases indicate participating students' ESS learning experience in their secondary schools seemed to have limited or little influence on their conceptual understandings of the discipline. We believe that these results reflect the current ESS education status, connected with the declining numbers of highly qualified ESS teachers in secondary schools.

  7. Evolutionary Dynamics of Fearfulness and Boldness: A Stochastic Simulation Model

    PubMed Central

    Lu, Nan; Ji, Ting; Zhang, Jia-Hua; Sun, Yue-Hua; Tao, Yi

    2012-01-01

    A stochastic simulation model is investigated for the evolution of anti-predator behavior in birds. The main goal is to reveal the effects of population size, predation threats, and energy lost per escape on the evolutionary dynamics of fearfulness and boldness. Two pure strategies, fearfulness and boldness, are assumed to have different responses for the predator attacks and nonlethal disturbance. On the other hand, the co-existence mechanism of fearfulness and boldness is also considered. For the effects of total population size, predation threats, and energy lost per escape, our main results show that: (i) the fearful (bold) individuals will be favored in a small (large) population, i.e. in a small (large) population, the fearfulness (boldness) can be considered to be an ESS; (ii) in a population with moderate size, fearfulness would be favored under moderate predator attacks; and (iii) although the total population size is the most important factor for the evolutionary dynamics of both fearful and bold individuals, the small energy lost per escape enables the fearful individuals to have the ability to win the advantage even in a relatively large population. Finally, we show also that the co-existence of fearful and bold individuals is possible when the competitive interactions between individuals are introduced. PMID:22412859

  8. Evolutionary dynamics of fearfulness and boldness: a stochastic simulation model.

    PubMed

    Lu, Nan; Ji, Ting; Zhang, Jia-Hua; Sun, Yue-Hua; Tao, Yi

    2012-01-01

    A stochastic simulation model is investigated for the evolution of anti-predator behavior in birds. The main goal is to reveal the effects of population size, predation threats, and energy lost per escape on the evolutionary dynamics of fearfulness and boldness. Two pure strategies, fearfulness and boldness, are assumed to have different responses for the predator attacks and nonlethal disturbance. On the other hand, the co-existence mechanism of fearfulness and boldness is also considered. For the effects of total population size, predation threats, and energy lost per escape, our main results show that: (i) the fearful (bold) individuals will be favored in a small (large) population, i.e. in a small (large) population, the fearfulness (boldness) can be considered to be an ESS; (ii) in a population with moderate size, fearfulness would be favored under moderate predator attacks; and (iii) although the total population size is the most important factor for the evolutionary dynamics of both fearful and bold individuals, the small energy lost per escape enables the fearful individuals to have the ability to win the advantage even in a relatively large population. Finally, we show also that the co-existence of fearful and bold individuals is possible when the competitive interactions between individuals are introduced.

  9. Sleep apnea, daytime somnolence, and idiopathic dizziness--a novel association.

    PubMed

    Sowerby, Leigh J; Rotenberg, Brian; Brine, Meggan; George, Charles F P; Parnes, Lorne S

    2010-06-01

    To determine if an association exists between sleep apnea, daytime somnolence, and chronic idiopathic dizziness. Case-control study of new patients presenting to a tertiary neuro-otologic practice. A total of 46 subjects with idiopathic dizziness (ID), 20 positive controls with dizziness (benign paroxysmal positional vertigo [BPV]), and 69 negative controls with hearing loss (HL) but no dizziness were enrolled. Participants who were patients diagnosed with the above conditions and who met all other inclusion criteria completed a sleep questionnaire and had a complete physical exam and investigations to establish or exclude a neuro-otologic diagnosis. They were subsequently evaluated for risk of symptomatic sleep disturbance based on the Epworth Sleepiness Scale (ESS), the Berlin Questionnaire, and the Multivariable Apnea Risk Index (MAP). Statistical analysis was carried out using SPSS (SPSS Inc., Chicago, IL). There was no significant demographic difference among the groups in terms of age, sex, body mass index, neck size, alcohol consumption, or smoking. Using a cutoff of both 10 and 12 on the ESS, the ID were more likely to have significant daytime somnolence than the HL group, with a likelihood ratio (LR) of 7.8 for the ESS 12 score (P = .021) and 7.1 for the ESS 10 score (P = .029). Using the MAP score, a statistically significant difference between the ID group and both the BPV group (LR 3.99, P = .046) and the HL group (LR 5.46, P = .019) was found. This study suggests that a previously undescribed link between idiopathic dizziness, daytime somnolence, and sleep apnea might exist. Prospective investigation is warranted to determine whether treatment of any sleep issues resolves symptoms of idiopathic dizziness.

  10. Role of Low Endothelial Shear Stress and Plaque Characteristics in the Prediction of Nonculprit Major Adverse Cardiac Events: The PROSPECT Study.

    PubMed

    Stone, Peter H; Maehara, Akiko; Coskun, Ahmet Umit; Maynard, Charles C; Zaromytidou, Marina; Siasos, Gerasimos; Andreou, Ioannis; Fotiadis, Dimitris; Stefanou, Kostas; Papafaklis, Michail; Michalis, Lampros; Lansky, Alexandra J; Mintz, Gary S; Serruys, Patrick W; Feldman, Charles L; Stone, Gregg W

    2018-03-01

    This study sought to determine whether low endothelial shear stress (ESS) adds independent prognostication for future major adverse cardiac events (MACE) in coronary lesions in patients with high-risk acute coronary syndrome (ACS) from the United States and Europe. Low ESS is a proinflammatory, proatherogenic stimulus associated with coronary plaque development, progression, and destabilization in human-like animal models and in humans. Previous natural history studies including baseline ESS characterization investigated low-risk patients. In the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study, 697 patients with ACS underwent 3-vessel intracoronary imaging. Independent predictors of MACE attributable to untreated nonculprit (nc) coronary lesions during 3.4-year follow-up were large plaque burden (PB), small minimum lumen area (MLA), and thin-cap fibroatheroma (TCFA) morphology. In this analysis, baseline ESS of nc lesions leading to new MACE (nc-MACE lesions) and randomly selected control nc lesions without MACE (nc-non-MACE lesions) were calculated. A propensity score for ESS was constructed for each lesion, and the relationship between ESS and subsequent nc-MACE was examined. A total of 145 lesions were analyzed in 97 patients: 23 nc-MACE lesions (13 TCFAs, 10 thick-cap fibroatheromas [ThCFAs]), and 122 nc-non-MACE lesions (63 TCFAs, 59 ThCFAs). Low local ESS (<1.3 Pa) was strongly associated with subsequent nc-MACE compared with physiological/high ESS (≥1.3 Pa) (23 of 101 [22.8%]) versus (0 of 44 [0%]). In propensity-adjusted Cox regression, low ESS was strongly associated with MACE (hazard ratio: 4.34; 95% confidence interval: 1.89 to 10.00; p < 0.001). Categorizing plaques by anatomic risk (high risk: ≥2 high-risk characteristics PB ≥70%, MLA ≤4 mm 2 , or TCFA), high anatomic risk, and low ESS were prognostically synergistic: 3-year nc-MACE rates were 52.1% versus 14.4% versus 0.0% in high-anatomic risk/low-ESS, low-anatomic risk/low-ESS, and physiological/high-ESS lesions, respectively (p < 0.0001). No lesion without low ESS led to nc-MACE during follow-up, regardless of PB, MLA, or lesion phenotype at baseline. Local low ESS provides incremental risk stratification of untreated coronary lesions in high-risk patients, beyond measures of PB, MLA, and morphology. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  11. Excessive daytime sleepiness in patients on intrathecal analgesia for chronic pain.

    PubMed

    Demartini, Laura; Fanfulla, Francesco; Bonezzi, Cesare; Armiento, Luciana; Buonocore, Michelangelo

    2015-01-01

    Intrathecal (IT) drug administration is an advanced technique in pain treatment algorithm for patients poorly responsive to systemic pharmacological treatment or less invasive techniques. The aim is to improve analgesia lowering side effects; despite this premise, many side effects of long-term IT therapy have been described, mainly related to opioid administration. We observed, in some of the patients regularly followed for pump refills in our Pain Unit, the appearance of excessive daytime sleepiness (EDS) interfering with daily life and work activity; this study aims to investigate the incidence of EDS in patients on IT analgesia with opioid or non-opioid drugs and its possible relationship with respiratory problems during sleep. 21 patients on IT therapy for chronic pain answered the Epworth Sleepiness Scale (ESS). The incidence of EDS in patients receiving IT opioids was compared to a control group not receiving opioids. In 10 patients, who performed polysomnography (PSG) and maintenance of wakefulness test (MWT) for sleep complaints, we studied the relationship between PSG data and ESS scores and we verified the concordance of ESS and MWT results. 38% of the patients reported EDS, according to ESS data; all the patients with EDS were receiving an IT opioid. Even if some patients presented sleep apneas, we failed to correlate this data with daytime sleepiness. Subjective sleepiness is confirmed by the results of MWT. Our data demonstrate that EDS is a frequent and important side effect of IT analgesia and it seems related to opioids administration.

  12. Diet and ADHD, Reviewing the Evidence: A Systematic Review of Meta-Analyses of Double-Blind Placebo-Controlled Trials Evaluating the Efficacy of Diet Interventions on the Behavior of Children with ADHD.

    PubMed

    Pelsser, Lidy M; Frankena, Klaas; Toorman, Jan; Rodrigues Pereira, Rob

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a debilitating mental health problem hampering the child's development. The underlying causes include both genetic and environmental factors and may differ between individuals. The efficacy of diet treatments in ADHD was recently evaluated in three reviews, reporting divergent and confusing conclusions based on heterogeneous studies and subjects. To address this inconsistency we conducted a systematic review of meta-analyses of double-blind placebo-controlled trials evaluating the effect of diet interventions (elimination and supplementation) on ADHD. Our literature search resulted in 14 meta-analyses, six of which confined to double-blind placebo-controlled trials applying homogeneous diet interventions, i.e. artificial food color (AFC) elimination, a few-foods diet (FFD) and poly-unsaturated fatty acid (PUFA) supplementation. Effect sizes (ES) and Confidence intervals (CI) of study outcomes were depicted in a forest plot. I2 was calculated to assess heterogeneity if necessary and additional random effects subgroup meta-regression was conducted if substantial heterogeneity was present. The AFC ESs were 0.44 (95% CI: 0.16-0.72, I2 = 11%) and 0.21 (95% CI: -0.02-0.43, I2 = 68%) [parent ratings], 0.08 (95% CI: -0.07-0.24, I2 = 0%) [teacher ratings] and 0.11 (95% CI: -0.13-0.34, I2 = 12%) [observer ratings]. The FFD ESs were 0.80 (95% CI: 0.41-1.19, I2 = 61%) [parent ratings] and 0.51 (95% CI: -0.02-1.04, I2 = 72%) [other ratings], while the PUFA ESs were 0.17 (95% CI: -0.03-0.38, I2 = 38%) [parent ratings], -0.05 (95% CI: -0.27-0.18, I2 = 0%) [teacher ratings] and 0.16 (95% CI: 0.01-0.31, I2 = 0%) [parent and teacher ratings]. Three meta-analyses (two FFD and one AFC) resulted in high I2 without presenting subgroup results. The FFD meta-analyses provided sufficient data to perform subgroup analyses on intervention type, resulting in a decrease of heterogeneity to 0% (diet design) and 37.8% (challenge design). Considering the small average ESs PUFA supplementation is unlikely to provide a tangible contribution to ADHD treatment, while further research is required for AFC elimination before advising this intervention as ADHD treatment. The average FFD ES is substantial, offering treatment opportunities in subgroups of children with ADHD not responding to or too young for medication. Further FFD research should focus on establishing the underlying mechanisms of food (e.g. incrimination of gut microbiota) to simplify the FFD approach in children with ADHD.

  13. Impact of shift work on sleep and daytime performance among health care professionals.

    PubMed

    Alshahrani, Sultan M; Baqays, Abdulsalam A; Alenazi, Abdelelah A; AlAngari, Abdulaziz M; AlHadi, Ahmad N

    2017-08-01

    To evaluate sleep quality and daytime sleepiness in health care professionals who are performing shift work. Methods: This cross-sectional study was conducted on 510 health care professionals at Prince Sultan Military Medical City and King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia between December 2015 and April 2016. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Participants were divided into 2 groups: shift workers and non-shift workers. Results: We compared both groups regarding the effect of shift work on the total score of PSQI and ESS. We found that the PSQI global score (p less than 0.001) and the total ESS score (p=0.003) were significantly higher in shift work health care professionals.  Conclusion: Shift work among health care professionals is associated with poor sleep quality but not excessive daytime sleepiness. Health care professionals performing shift work have PSQI and ESS scores slightly higher than non-shift work health professionals.

  14. Systematic Review and Meta-analysis of SNOT-22 Outcomes after Surgery for Chronic Rhinosinusitis with Nasal Polyposis.

    PubMed

    Le, Phong T; Soler, Zachary M; Jones, Rabun; Mattos, Jose L; Nguyen, Shaun A; Schlosser, Rodney J

    2018-04-01

    Objective Wide variation exists regarding reported outcomes after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP). This study seeks to combine data across studies to generate a summary measure and explore factors that might lead to variation. Data Sources OVID Medline, Scopus, EbscoHost, Database of Abstracts and Reviews of Effects, Health Technology Assessment, and National Health Service Economic Evaluation Database. Review Methods A search was performed following the PRISMA guidelines. Two independent researchers conducted a search using the mentioned data sources. Studies published before August 29, 2016, that involved ESS to treat CRSwNP were included. Mean changes in Sinonasal Outcome Test-22 (SNOT-22) scores were determined through metaregression of the following independent variables: publication year, sex, age, allergy status, asthma, tobacco use, prior surgery, follow-up length, and preoperative SNOT-22. Results Fifteen articles with 3048 patients treated with ESS met inclusion criteria. Pooled analyses of SNOT-22 scores revealed a mean change of 23.0 points (95% CI, 20.2-25.8; P < .001). A metaregression of patient factor effects on the mean change of SNOT-22 scores demonstrated that age ( r = 0.71, P = .01), asthma ( r = 0.21, P = .01), prior ESS ( r = 0.29, P = .01), and preoperative SNOT-22 score ( r = 0.4, P < .01) correlated with greater improvement in SNOT-22 scores. Tobacco use ( r = -0.91, P = .01) and longer lengths of follow-up ( r = -0.45, P < .01) were associated with less improvement in SNOT-22 scores. Conclusions Quality-of-life outcomes are significantly improved after ESS among patients with CRSwNP. Patient-specific factors may affect the degree of SNOT-22 change after surgery.

  15. The Media as an Invaluable Tool for Informal Earth System Science Education

    NASA Astrophysics Data System (ADS)

    James, E.; Gautier, C.

    2001-12-01

    One of the most widely utilized avenues for educating the general public about the Earth's environment is the media, be it print, radio or broadcast. Accurate and effective communication of issues in Earth System Science (ESS), however, is significantly hindered by the public's relative scientific illiteracy. Discussion of ESS concepts requires the laying down of a foundation of complex scientific information, which must first be conveyed to an incognizant audience before any strata of sophisticated social context can be appropriately considered. Despite such a substantial obstacle to be negotiated, the environmental journalist is afforded the unique opportunity of providing a broad-reaching informal scientific education to a largely scientifically uninformed population base. This paper will review the tools used by various environmental journalists to address ESS issues and consider how successful each of these approaches has been at conveying complex scientific messages to a general audience lacking sufficient scientific sophistication. Different kinds of media materials used to this effect will be analyzed for their ideas and concepts conveyed, as well as their effectiveness in reaching the public at large.

  16. Directional dual-tree rational-dilation complex wavelet transform.

    PubMed

    Serbes, Gorkem; Gulcur, Halil Ozcan; Aydin, Nizamettin

    2014-01-01

    Dyadic discrete wavelet transform (DWT) has been used successfully in processing signals having non-oscillatory transient behaviour. However, due to the low Q-factor property of their wavelet atoms, the dyadic DWT is less effective in processing oscillatory signals such as embolic signals (ESs). ESs are extracted from quadrature Doppler signals, which are the output of Doppler ultrasound systems. In order to process ESs, firstly, a pre-processing operation known as phase filtering for obtaining directional signals from quadrature Doppler signals must be employed. Only then, wavelet based methods can be applied to these directional signals for further analysis. In this study, a directional dual-tree rational-dilation complex wavelet transform, which can be applied directly to quadrature signals and has the ability of extracting directional information during analysis, is introduced.

  17. Ensete superbum ameliorates renal dysfunction in experimental diabetes mellitus.

    PubMed

    Sreekutty, M S; Mini, S

    2016-01-01

    Hyperglycemia mediated oxidative stress plays a key role in the pathogenesis of diabetic complications like nephropathy. In the present study, we evaluated the effect of ethanolic extract of Ensete superbum seeds (ESSE) on renal dysfunction and oxidative stress in streptozotocin-induced diabetic rats. Glucose, HbA1c, total protein, albumin, renal function markers (urea, uric acid and creatinine), and lipid peroxidation levels were evaluated. Renal enzymatic and non-enzymatic antioxidants were examined along with renal histopathological study. ESSE (400 mg/kg BW t) administration reduced glucose and HbA1c, and improved serum total protein and albumin in diabetic rats. ESSE in diabetic rats recorded decrement in renal function markers and renal lipid peroxidation products along with significant increment in enzymatic and non-enzymatic antioxidants. Renal morphological abnormalities of diabetic rats were markedly ameliorated by E. superbum. These results suggest that the antioxidant effect of E. superbum could ameliorate oxidative stress and delay/prevent the progress of diabetic nephropathy in diabetes mellitus.

  18. Electro shield system applications on set gill net as efforts to preserve shark resources

    NASA Astrophysics Data System (ADS)

    Fitri Aristi, DP; Boesono, H.; Prihantoko, K. E.; Gautama, D. Y.

    2018-05-01

    Sharks are kind of ETP biota (Endangered, Threatened, and Protected), and are generally caught as by catch during fishing operations. In addition, sharks are one of the biota that plays a role in the life cycle in coastal waters. The Electro Shield System (ESS) was a device with an electromagnetic wave source that the shark can detect and make it afraid. ESS can be applied to set gill net operation to prevent the shark from getting caught. The objective of the study was to analyze the ESS on shark catches during set gill net operations. The research method was experimental fishing, conducted in March-May 2017 in Bangka Belitung Islands, Indonesia. Design the study by comparing shark catches during set gill net operation between those without using ESS (control) and using ESS with frequency 55 Hz. The shark catch by using Electro Shield System was 5.26% lower than control (7.80%). T-student analysis (sign 0.05) indicates that there was a significant difference between the set gill net without ESS and using the ESS against shark biota as bycatch. This indicates that the application of ESS in set gill net can reduce the capture of shark as by catch.

  19. The ESS and replicator equation in matrix games under time constraints.

    PubMed

    Garay, József; Cressman, Ross; Móri, Tamás F; Varga, Tamás

    2018-06-01

    Recently, we introduced the class of matrix games under time constraints and characterized the concept of (monomorphic) evolutionarily stable strategy (ESS) in them. We are now interested in how the ESS is related to the existence and stability of equilibria for polymorphic populations. We point out that, although the ESS may no longer be a polymorphic equilibrium, there is a connection between them. Specifically, the polymorphic state at which the average strategy of the active individuals in the population is equal to the ESS is an equilibrium of the polymorphic model. Moreover, in the case when there are only two pure strategies, a polymorphic equilibrium is locally asymptotically stable under the replicator equation for the pure-strategy polymorphic model if and only if it corresponds to an ESS. Finally, we prove that a strict Nash equilibrium is a pure-strategy ESS that is a locally asymptotically stable equilibrium of the replicator equation in n-strategy time-constrained matrix games.

  20. ESS++: a C++ objected-oriented algorithm for Bayesian stochastic search model exploration

    PubMed Central

    Bottolo, Leonardo; Langley, Sarah R.; Petretto, Enrico; Tiret, Laurence; Tregouet, David; Richardson, Sylvia

    2011-01-01

    Summary: ESS++ is a C++ implementation of a fully Bayesian variable selection approach for single and multiple response linear regression. ESS++ works well both when the number of observations is larger than the number of predictors and in the ‘large p, small n’ case. In the current version, ESS++ can handle several hundred observations, thousands of predictors and a few responses simultaneously. The core engine of ESS++ for the selection of relevant predictors is based on Evolutionary Monte Carlo. Our implementation is open source, allowing community-based alterations and improvements. Availability: C++ source code and documentation including compilation instructions are available under GNU licence at http://bgx.org.uk/software/ESS.html. Contact: l.bottolo@imperial.ac.uk Supplementary information: Supplementary data are available at Bioinformatics online. PMID:21233165

  1. What's Up in the Atmosphere? Exploring How Aerosols Impact Sky Color Through Hands-on Activities with Elementary GLOBE

    NASA Astrophysics Data System (ADS)

    Damadeo, K.; Taylor, J.

    2015-12-01

    What color is the sky today? The GLOBE Kids - Anita, Simon, and Dennis want to know why the sky isn't always the same shade of blue and sometimes isn't even blue. Through the new Elementary GLOBE Aerosols Storybook and Learning Activities, the GLOBE Kids learn that there's a lot more than air in the atmosphere, which can affect the colors we see in the sky. There are four hands-on activities in this unit: 1) Sky Observers - Students make observations of the sky, record their findings and share their observation reports with their peers. The activity promotes active observation and recording skills to help students observe sky color, and recognize that sky color changes; 2) Why (Not) So Blue? - Students make predictions about how drops of milk will affect color and visibility in cups of water representing the atmosphere to help them understand that aerosols in the atmosphere have an effect on sky conditions, including sky color and visibility. The activity also introduces the classification categories for daytime sky color and visibility; 3) See the Light - Students use prisms and glue sticks to explore the properties of light. The activity demonstrates that white light is made up of seven colors that represent different wavelengths, and illustrates why the sky is blue during the day and red at sunset; 4) Up in the Air - Students work in groups to make an aerosol sampler, a simple adhesive tool that allows students to collect data and estimate the extent of aerosols present at their school, understanding that, in fact, there are particles in the air we breathe. NGSS Alignment includes: Disciplinary Core Ideas- ESS2.D: Weather and Climate, ESS3.C: Human Impacts on Earth Systems, PS4.B: Electromagnetic Radiation, ESS3.A: Natural Resources; Science and Engineering Practices- Asking Questions and Defining Problems, Planning and Carrying Out an Investigation, Analyzing and Interpreting Data, Engaging in Argument from Evidence, Obtaining, Evaluating, and Communicating Information; Crosscutting Concepts- Patterns and Cause and Effect; and Performance Expectations- K-ESS2-1, K-ESS2-2, 4-ESS3-1.

  2. Characterization and Compensation of Network-Level Anomalies in Mixed-Signal Neuromorphic Modeling Platforms

    PubMed Central

    Petrovici, Mihai A.; Vogginger, Bernhard; Müller, Paul; Breitwieser, Oliver; Lundqvist, Mikael; Muller, Lyle; Ehrlich, Matthias; Destexhe, Alain; Lansner, Anders; Schüffny, René; Schemmel, Johannes; Meier, Karlheinz

    2014-01-01

    Advancing the size and complexity of neural network models leads to an ever increasing demand for computational resources for their simulation. Neuromorphic devices offer a number of advantages over conventional computing architectures, such as high emulation speed or low power consumption, but this usually comes at the price of reduced configurability and precision. In this article, we investigate the consequences of several such factors that are common to neuromorphic devices, more specifically limited hardware resources, limited parameter configurability and parameter variations due to fixed-pattern noise and trial-to-trial variability. Our final aim is to provide an array of methods for coping with such inevitable distortion mechanisms. As a platform for testing our proposed strategies, we use an executable system specification (ESS) of the BrainScaleS neuromorphic system, which has been designed as a universal emulation back-end for neuroscientific modeling. We address the most essential limitations of this device in detail and study their effects on three prototypical benchmark network models within a well-defined, systematic workflow. For each network model, we start by defining quantifiable functionality measures by which we then assess the effects of typical hardware-specific distortion mechanisms, both in idealized software simulations and on the ESS. For those effects that cause unacceptable deviations from the original network dynamics, we suggest generic compensation mechanisms and demonstrate their effectiveness. Both the suggested workflow and the investigated compensation mechanisms are largely back-end independent and do not require additional hardware configurability beyond the one required to emulate the benchmark networks in the first place. We hereby provide a generic methodological environment for configurable neuromorphic devices that are targeted at emulating large-scale, functional neural networks. PMID:25303102

  3. Characterization and compensation of network-level anomalies in mixed-signal neuromorphic modeling platforms.

    PubMed

    Petrovici, Mihai A; Vogginger, Bernhard; Müller, Paul; Breitwieser, Oliver; Lundqvist, Mikael; Muller, Lyle; Ehrlich, Matthias; Destexhe, Alain; Lansner, Anders; Schüffny, René; Schemmel, Johannes; Meier, Karlheinz

    2014-01-01

    Advancing the size and complexity of neural network models leads to an ever increasing demand for computational resources for their simulation. Neuromorphic devices offer a number of advantages over conventional computing architectures, such as high emulation speed or low power consumption, but this usually comes at the price of reduced configurability and precision. In this article, we investigate the consequences of several such factors that are common to neuromorphic devices, more specifically limited hardware resources, limited parameter configurability and parameter variations due to fixed-pattern noise and trial-to-trial variability. Our final aim is to provide an array of methods for coping with such inevitable distortion mechanisms. As a platform for testing our proposed strategies, we use an executable system specification (ESS) of the BrainScaleS neuromorphic system, which has been designed as a universal emulation back-end for neuroscientific modeling. We address the most essential limitations of this device in detail and study their effects on three prototypical benchmark network models within a well-defined, systematic workflow. For each network model, we start by defining quantifiable functionality measures by which we then assess the effects of typical hardware-specific distortion mechanisms, both in idealized software simulations and on the ESS. For those effects that cause unacceptable deviations from the original network dynamics, we suggest generic compensation mechanisms and demonstrate their effectiveness. Both the suggested workflow and the investigated compensation mechanisms are largely back-end independent and do not require additional hardware configurability beyond the one required to emulate the benchmark networks in the first place. We hereby provide a generic methodological environment for configurable neuromorphic devices that are targeted at emulating large-scale, functional neural networks.

  4. Internet-provided cognitive behaviour therapy of posttraumatic stress symptoms following childbirth-a randomized controlled trial.

    PubMed

    Nieminen, Katri; Berg, Ida; Frankenstein, Katri; Viita, Lina; Larsson, Kamilla; Persson, Ulrika; Spånberger, Loviisa; Wretman, Anna; Silfvernagel, Kristin; Andersson, Gerhard; Wijma, Klaas

    2016-06-01

    The aim of this study was to analyse the effects of trauma-focused guided Internet-based cognitive behaviour therapy for relieving posttraumatic stress disorder (PTSD) symptoms following childbirth, a problem that about 3% women encounter postpartum. Following inclusion, 56 traumatized women were randomized to either treatment or to a waiting list control group. Primary outcome measures were the Traumatic Event Scale (TES) and Impact of Event Scale-Reversed (IES-R). Secondary measures were Beck depression inventory II, Patient Health Questionnaire (PHQ-9), Beck Anxiety Inventory, Quality Of Life Inventory and the EuroQol 5 Dimensions. The treatment was guided by a clinician and lasted eight weeks and comprised eight modules of written text. The between-group effect size (ES) was d = .82 (p < .0001) for the IES-R. The ES for the TES was small (d = .36) and not statistically significant (p = .09). A small between-group ES (d = .20; p = .02) was found for the PHQ-9. The results from pre- to post-treatment showed large within-group ESs for PTSD symptoms in the treatment group both on the TES (d = 1.42) and the IES-R (d = 1.30), but smaller ESs in the control group from inclusion to after deferred treatment (TES, d = .80; IES-R d = .45). In both groups, the treatment had positive effects on comorbid depression and anxiety, and in the treatment group also on quality of life. The results need to be verified in larger trials. Further studies are also needed to examine long-term effects.

  5. Anticancer activity of biostabilized selenium nanorods synthesized by Streptomyces bikiniensis strain Ess_amA-1

    PubMed Central

    Ahmad, Maged Sayed; Yasser, Manal Mohamed; Sholkamy, Essam Nageh; Ali, Ali Mohamed; Mehanni, Magda Mohamed

    2015-01-01

    Selenium is an important component of human diet and a number of studies have declared its chemopreventive and therapeutic properties against cancer. However, very limited studies have been conducted about the properties of selenium nanostructured materials in comparison to other well-studied selenospecies. Here, we have shown that the anticancer property of biostabilized selenium nanorods (SeNrs) synthesized by applying a novel strain Ess_amA-1 of Streptomyces bikiniensis. The strain was grown aerobically with selenium dioxide and produced stable SeNrs with average particle size of 17 nm. The optical, structural, morphological, elemental, and functional characterizations of the SeNrs were carried out using techniques such as UV-vis spectrophotometry, transmission electron microscopy, energy dispersive X-ray spectrometry, and Fourier transform infrared spectrophotometry, respectively. The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay revealed that the biosynthesized SeNrs induces cell death of Hep-G2 and MCF-7 human cancer cells. The lethal dose (LD50%) of SeNrs on Hep-G2 and MCF-7 cells was recorded at 75.96 μg/mL and 61.86 μg/mL, respectively. It can be concluded that S. bikiniensis strain Ess_amA-1 could be used as renewable bioresources of biosynthesis of anticancer SeNrs. A hypothetical mechanism for anticancer activity of SeNrs is also proposed. PMID:26005349

  6. Anticancer activity of biostabilized selenium nanorods synthesized by Streptomyces bikiniensis strain Ess_amA-1.

    PubMed

    Ahmad, Maged Sayed; Yasser, Manal Mohamed; Sholkamy, Essam Nageh; Ali, Ali Mohamed; Mehanni, Magda Mohamed

    2015-01-01

    Selenium is an important component of human diet and a number of studies have declared its chemopreventive and therapeutic properties against cancer. However, very limited studies have been conducted about the properties of selenium nanostructured materials in comparison to other well-studied selenospecies. Here, we have shown that the anticancer property of biostabilized selenium nanorods (SeNrs) synthesized by applying a novel strain Ess_amA-1 of Streptomyces bikiniensis. The strain was grown aerobically with selenium dioxide and produced stable SeNrs with average particle size of 17 nm. The optical, structural, morphological, elemental, and functional characterizations of the SeNrs were carried out using techniques such as UV-vis spectrophotometry, transmission electron microscopy, energy dispersive X-ray spectrometry, and Fourier transform infrared spectrophotometry, respectively. The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay revealed that the biosynthesized SeNrs induces cell death of Hep-G2 and MCF-7 human cancer cells. The lethal dose (LD50%) of SeNrs on Hep-G2 and MCF-7 cells was recorded at 75.96 μg/mL and 61.86 μg/mL, respectively. It can be concluded that S. bikiniensis strain Ess_amA-1 could be used as renewable bioresources of biosynthesis of anticancer SeNrs. A hypothetical mechanism for anticancer activity of SeNrs is also proposed.

  7. Long chain polyunsaturated fatty acids (LCPUFAs) and nordihydroguaiaretic acid (NDGA) modulate metabolic and inflammatory markers in a spontaneous type 2 diabetes mellitus model (Stillman Salgado rats).

    PubMed

    Dain, Alejandro; Repossi, Gaston; Diaz-Gerevini, Gustavo T; Vanamala, Jairam; Das, Undurti N; Eynard, Aldo R

    2016-11-25

    Diabetes mellitus (DM) is a complex disease with alterations in metabolic and inflammatory markers. Stillman Salgado rats (eSS) spontaneously develop type 2 DM by middle age showing progressive impairment of glucose tolerance with hyperglycemia, hypertriglyceridemia and hyperinsulinemia. We analyzed the effects of supplementation of ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) with or without nordihydroguaiaretic acid (NDGA) added, an antioxidant and lipoxygenase inhibitor, on metabolic and inflammatory parameters in eSS rats to evaluate whether they can delay development and/or prevent progression of DM. After weaning, eSS rats received, intraperitoneally, once a month ω-3 (EPA 35% and DHA 40%-6.25 mg/Kg) or ω-6 (90% arachidonic acid- 6. 25 mg/Kg) for twelve months. Two additional groups of rats received 1.9 mg/kg NDGA added to ω-3 and ω-6 fatty acids. Blood samples were collected at day 40, and at the end of the 6th month and 12th month of age to determine plasma triglycerides (TGs), total plasma fatty acids (FA), A1C hemoglobin (HbA1C), C-reactive protein (CRP), gamma glutamyl transpeptidase (GGT), lipo and hydro peroxides, nitrites and IL-6 (in plasma and liver, kidney, and pancreas) and underwent oral glucose tolerance test (OGTT) as well. Wistar and eSS rats that received saline solution were used as controls. Plasma lipids profile, TG, fasting and post-prandial blood glucose levels, and glycosylated HbA1C showed significant improvements in ω-3 and ω-3 + NDGA treated animals compared to eSS control group. ω-3 and ω-3 + NDGA groups showed an inverse correlation with fasting blood glucose and showed lower plasma levels of GGT, TG, and CRP. eSS rats treated with ω-3 LCPUFAs showed reduced level of inflammatory and oxidative indices in plasma and liver, kidney and pancreas tissues in comparison with eSS control (non-treated) and ω-6 treated groups. eSS rats are a useful model to study type 2 DM pathophysiology and related inflammatory indices. ω-3 + NDGA supplementation, at the doses tested, ameliorated inflammatory, metabolic and oxidative stress markers studied.

  8. Evaluation of the dose calculation accuracy for small fields defined by jaw or MLC for AAA and Acuros XB algorithms.

    PubMed

    Fogliata, Antonella; Lobefalo, Francesca; Reggiori, Giacomo; Stravato, Antonella; Tomatis, Stefano; Scorsetti, Marta; Cozzi, Luca

    2016-10-01

    Small field measurements are challenging, due to the physical characteristics coming from the lack of charged particle equilibrium, the partial occlusion of the finite radiation source, and to the detector response. These characteristics can be modeled in the dose calculations in the treatment planning systems. Aim of the present work is to evaluate the MU calculation accuracy for small fields, defined by jaw or MLC, for anisotropic analytical algorithm (AAA) and Acuros XB algorithms, relative to output measurements on the beam central axis. Single point output factor measurement was acquired with a PTW microDiamond detector for 6 MV, 6 and 10 MV unflattened beams generated by a Varian TrueBeam STx equipped with high definition-MLC. Fields defined by jaw or MLC apertures were set; jaw-defined: 0.6 × 0.6, 0.8 × 0.8, 1 × 1, 2 × 2, 3 × 3, 4 × 4, 5 × 5, and 10 × 10 cm 2 ; MLC-defined: 0.5 × 0.5 cm 2 to the maximum field defined by the jaw, with 0.5 cm stepping, and jaws set to: 2 × 2, 3 × 3, 4 × 4, 5 × 5, and 10 × 10 cm 2 . MU calculation was obtained with 1 mm grid in a virtual water phantom for the same fields, for AAA and Acuros algorithms implemented in the Varian eclipse treatment planning system (version 13.6). Configuration parameters as the effective spot size (ESS) and the dosimetric leaf gap (DLG) were varied to find the best parameter setting. Differences between calculated and measured doses were analyzed. Agreement better than 0.5% was found for field sizes equal to or larger than 2 × 2 cm 2 for both algorithms. A dose overestimation was present for smaller jaw-defined fields, with the best agreement, averaged over all the energies, of 1.6% and 4.6% for a 1 × 1 cm 2 field calculated by AAA and Acuros, respectively, for a configuration with ESS = 1 mm for both X and Y directions for AAA, and ESS = 1.5 and 0 mm for X and Y directions for Acuros. Conversely, a calculated dose underestimation was found for small MLC-defined fields, with the best agreement averaged over all the energies, of -3.9% and 0.2% for a 1 × 1 cm 2 field calculated by AAA and Acuros, respectively, for a configuration with ESS = 0 mm for both directions and both algorithms. For optimal setting applied in the algorithm configuration phase, the agreement of Acuros calculations with measurements could achieve the 3% for MLC-defined fields as small as 0.5 × 0.5 cm 2 . Similar agreement was found for AAA for fields as small as 1 × 1 cm 2 .

  9. Early results of an in vivo trial of ESS in thyroid cancer

    NASA Astrophysics Data System (ADS)

    Rosen, Jennifer E.; Goukassian, Ilona D.; A'Amar, Ousama M.; Bigio, Irving J.; Lee, Stephanie L.

    2012-02-01

    Introduction: Thyroid cancer is the most common endocrine malignancy. The current gold standard for diagnosis, fine-needle aspiration (FNA) biopsy, yields 10-25% of indeterminate cytology results, leading to patients undergoing thyroidectomy for diagnosis. We assessed the technical potential of a miniaturized in vivo ESS (elastic light scattering spectroscopy) probe, built into an FNA needle assembly, to differentiate benign from malignant thyroid nodules. Methods: Under IRB approval, 15 patients in the endocrine clinic undergoing FNAB of a thyroid nodule had collection of ESS data using our novel miniaturized FNA probe. Using final surgical pathology as our gold standard, data post processing and visual inspection was completed. Results: 225 spectra were grouped and analyzed (120 benign, 30 malignant and 75 from indeterminate cytology). ESS probes demonstrated excellent reproducibility in use. Initial analysis of these preliminary data is promising, indicating distinction of spectral ESS features between malignant and benign conditions. Conclusion(s): An in vivo trial of an invasive miniaturized integrated ESS biopsy probe is acceptable to patients, and collection of ESS data is feasible and reliable. With development of a disease-specific algorithm, ESS could potentially be used as an in-situ real time intra-operative diagnostic tool or as a minimally invasive adjunct to conventional FNA cytology.

  10. Simulation of Trolleybus Traction Induction Drive With Supercapacitor Energy Storage System

    NASA Astrophysics Data System (ADS)

    Brazis, V.; Latkovskis, L.; Grigans, L.

    2010-01-01

    The article considers the possibilities of saving the regenerative braking energy in Škoda 24Tr type trolleybuses by installing the onboard supercapacitor energy storage system (ESS) and improving its performance with automated switching to the autonomous traction mode. Proposed is an ESS control system with constant DC bus voltage in the supercapacitor charging mode and supercapacitor current proportional to the AC drive current in the discharging mode. The authors investigate stability of the trolleybus ESS control system operating together with AC traction drive in various overhead voltage failure modes. The co-simulation of ESS operation was done by Matlab/Simulink AC drive and PSIM ESS continuous models.

  11. Electrical signals as mechanism of photosynthesis regulation in plants.

    PubMed

    Sukhov, Vladimir

    2016-12-01

    This review summarizes current works concerning the effects of electrical signals (ESs) on photosynthesis, the mechanisms of the effects, and its physiological role in plants. Local irritations of plants induce various photosynthetic responses in intact leaves, including fast and long-term inactivation of photosynthesis, and its activation. Irritation-induced ESs, including action potential, variation potential, and system potential, probably causes the photosynthetic responses in intact leaves. Probable mechanisms of induction of fast inactivation of photosynthesis are associated with Ca 2+ - and (or) H + -influxes during ESs generation; long-term inactivation of photosynthesis might be caused by Ca 2+ - and (or) H + -influxes, production of abscisic and jasmonic acids, and inactivation of phloem H + -sucrose symporters. It is probable that subsequent development of inactivation of photosynthesis is mainly associated with decreased CO 2 influx and inactivation of the photosynthetic dark reactions, which induces decreased photochemical quantum yields of photosystems I and II and increased non-photochemical quenching of photosystem II fluorescence and cyclic electron flow around photosystem I. However, other pathways of the ESs influence on the photosynthetic light reactions are also possible. One of them might be associated with ES-connected acidification of chloroplast stroma inducing ferredoxin-NADP + reductase accumulation at the thylakoids in Tic62 and TROL complexes. Mechanisms of ES-induced activation of photosynthesis require further investigation. The probable ultimate effect of ES-induced photosynthetic responses in plant life is the increased photosynthetic machinery resistance to stressors, including high and low temperatures, and enhanced whole-plant resistance to environmental factors at least during 1 h after irritation.

  12. The evolution of parental care in the context of sexual selection: a critical reassessment of parental investment theory.

    PubMed

    Wade, Michael J; Shuster, Stephen M

    2002-09-01

    Males and females are often defined by differences in their energetic investment in gametes. In most sexual species, females produce few large ova, whereas males produce many tiny sperm. This difference in initial parental investment is presumed to exert a fundamental influence on sex differences in mating and parental behavior, resulting in a taxonomic bias toward parental care in females and away from parental care in males. In this article, we reexamine the logic of this argument as well as the evolutionarily stable strategy (ESS) theory often used to substantiate it. We show that the classic ESS model, which contrasts parental care with offspring desertion, violates the necessary relationship between mean male and female fitness. When the constraint of equal male and female mean fitness is correctly incorporated into the ESS model, its results are congruent with those of evolutionary genetic theory for the evolution of genes with direct and indirect effects. Male parental care evolves whenever half the magnitude of the indirect effect of paternal care on offspring viability exceeds the direct effect of additional mating success gained by desertion. When the converse is true, desertion invades and spreads. In the absence of a genetic correlation between the sexes, the evolution of paternal care is independent of maternal care. Theories based on sex differences in gametic investment make no such specific predictions. We discuss whether inferences about the evolution of sex differences in parental care can hold if the ESS theory on which they are based contains internal contradictions.

  13. The Effects of High-Altitude Electromagnetic Pulse (HEMP) on Telecommunications Assets

    DTIC Science & Technology

    1988-06-01

    common to a whole class of switches. 5ESS switch software controls the operating system, call processing, and system administration andgmaintenance...LEVEL (ky/rn)3 (a). Mean Fraction of Preset Calls Dropped Due to Induced Transients3 1.0 W -o35kVhM (36 EVENTS) 5-40 kV/M (13 EVENTS) IAUTOMATIC ...eel PERIPHRAL UNIT BUS,IMNA The entire 4ESS system is controlled by the 1A processor. The processor monitors and controls the operation of the

  14. [Research of the Epworth sleepiness scale based on ruzzy comprehensive evaluation].

    PubMed

    Li, P; Lv, Y H; Ma, L; Yang, S H; Xiang, Y; Lei, Q; Du, G D; Huang, D J

    2017-03-05

    Objective: This research explores the effect of Epworth sleepiness scale (ESS) items on domestic patients. Method: Four thousand six hundred and thirty-three suspected OSAHS patients with snoring were selected from respiratory sleep center in the first people's hospital, Yunnan province, between January 2006 and December 2012. These patients filled in the ESS before PSG test. Firstly, these questionnaires were preprocessed, and the null and incorrect ones were deleted. Then, the fuzzy comprehensive evaluation was applied for the value of each item in ESS. Finally, the reliability was compared between before and after the removal of the lowest values. Result: Fuzzy comprehensive evaluation results show that the total value is 1.016, the item value of Sitting and talking to someone and In a car, while stopped for a few minutes in traffic is the lowest, which is 0.131. The result of reliability analysis shows that the value increases 0.2% after the two items being deleted. Conclusion: Some items of ESS are not suitable for Chinese patients, and they need to be deleted or modified to improve the screening efficiency. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  15. Diagnostic Performance of Electronic Syndromic Surveillance Systems in Acute Care

    PubMed Central

    Kashiouris, M.; O’Horo, J.C.; Pickering, B.W.; Herasevich, V.

    2013-01-01

    Context Healthcare Electronic Syndromic Surveillance (ESS) is the systematic collection, analysis and interpretation of ongoing clinical data with subsequent dissemination of results, which aid clinical decision-making. Objective To evaluate, classify and analyze the diagnostic performance, strengths and limitations of existing acute care ESS systems. Data Sources All available to us studies in Ovid MEDLINE, Ovid EMBASE, CINAHL and Scopus databases, from as early as January 1972 through the first week of September 2012. Study Selection: Prospective and retrospective trials, examining the diagnostic performance of inpatient ESS and providing objective diagnostic data including sensitivity, specificity, positive and negative predictive values. Data Extraction Two independent reviewers extracted diagnostic performance data on ESS systems, including clinical area, number of decision points, sensitivity and specificity. Positive and negative likelihood ratios were calculated for each healthcare ESS system. A likelihood matrix summarizing the various ESS systems performance was created. Results The described search strategy yielded 1639 articles. Of these, 1497 were excluded on abstract information. After full text review, abstraction and arbitration with a third reviewer, 33 studies met inclusion criteria, reporting 102,611 ESS decision points. The yielded I2 was high (98.8%), precluding meta-analysis. Performance was variable, with sensitivities ranging from 21% –100% and specificities ranging from 5%-100%. Conclusions There is significant heterogeneity in the diagnostic performance of the available ESS implements in acute care, stemming from the wide spectrum of different clinical entities and ESS systems. Based on the results, we introduce a conceptual framework using a likelihood ratio matrix for evaluation and meaningful application of future, frontline clinical decision support systems. PMID:23874359

  16. Validation of the Epworth Sleepiness Scale for Children and Adolescents using Rasch analysis.

    PubMed

    Janssen, Kitty C; Phillipson, Sivanes; O'Connor, Justen; Johns, Murray W

    2017-05-01

    A validated measure of daytime sleepiness for adolescents is needed to better explore emerging relationships between sleepiness and the mental and physical health of adolescents. The Epworth Sleepiness Scale (ESS) is a widely used scale for daytime sleepiness in adults but contains references to alcohol and driving. The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) has been proposed as the official modified version of the ESS for children and adolescents. This study describes the psychometric analysis of the ESS-CHAD as a measure of daytime sleepiness for adolescents. The ESS-CHAD was completed by 297 adolescents, 12-18 years old, from two independent schools in Victoria, Australia. Exploratory factor analysis and Rasch analysis was conducted to determine the validity of the scale. Exploratory factor analysis and Rasch analysis indicated that ESS-CHAD has internal validity and a unidimensional structure with good model fit. Rasch analysis of four subgroups based on gender and year-level were consistent with the overall results. The results were consistent with published ESS results, which strongly indicates that the changes to the scale do not affect the scale's capacity to measure daytime sleepiness. It is concluded that the ESS-CHAD is a reliable and internally valid measure of daytime sleepiness in adolescents 12-18 years old. Further studies are needed to establish the internal validity of the ESS-CHAD for children under 12 years, and to establish external validity and accurate cut-off points for children and adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Under multilevel selection: "when shall you be neither spiteful nor envious?".

    PubMed

    Garay, József; Csiszár, Villő; Móri, Tamás F

    2014-01-07

    In this paper, we study the egalitarianism-game in multilevel selection situation. The individuals form reproductive groups. In each group, an egalitarianism-game determines the number of juveniles of different phenotypes (spiteful, envious, neutral and donator). Before the juveniles form the next reproductive group, they have to survive either predators' attacks or a fight between two groups. We adopt the ESS definition of Maynard Smith to multilevel selection. Based on the "group size advantage" assumption (which claims that each juvenile's survival rate depends on the size of his own group, supposing that either the survival rate under predators' attacks is higher in larger groups, or in inter-group aggression usually the larger group wins) we found that when the survival probability has a massive effect on the average fitness, then "group fitness maximizing behavior" (in our case, either neutral or donator) has evolutionary advantage over "competitive behavior" (in our case, either spiteful or envious). © 2013 Elsevier Ltd. All rights reserved.

  18. Sleep Restriction Therapy for Insomnia is Associated with Reduced Objective Total Sleep Time, Increased Daytime Somnolence, and Objectively Impaired Vigilance: Implications for the Clinical Management of Insomnia Disorder

    PubMed Central

    Kyle, Simon D.; Miller, Christopher B.; Rogers, Zoe; Siriwardena, A. Niroshan; MacMahon, Kenneth M.; Espie, Colin A.

    2014-01-01

    Study Objectives: To investigate whether sleep restriction therapy (SRT) is associated with reduced objective total sleep time (TST), increased daytime somnolence, and impaired vigilance. Design: Within-subject, noncontrolled treatment investigation. Setting: Sleep research laboratory. Participants: Sixteen patients [10 female, mean age = 47.1 (10.8) y] with well-defined psychophysiological insomnia (PI), reporting TST ≤ 6 h. Interventions: Patients were treated with single-component SRT over a 4-w protocol, sleeping in the laboratory for 2 nights prior to treatment initiation and for 3 nights (SRT night 1, 8, 22) during the acute interventional phase. The psychomotor vigilance task (PVT) was completed at seven defined time points [day 0 (baseline), day 1,7,8,21,22 (acute treatment) and day 84 (3 mo)]. The Epworth Sleepiness Scale (ESS) was completed at baseline, w 1-4, and 3 mo. Measurement and results: Subjective sleep outcomes and global insomnia severity significantly improved before and after SRT. There was, however, a robust decrease in PSG-defined TST during acute implementation of SRT, by an average of 91 min on night 1, 78 min on night 8, and 69 min on night 22, relative to baseline (P < 0.001; effect size range = 1.60-1.80). During SRT, PVT lapses were significantly increased from baseline (at three of five assessment points, all P < 0.05; effect size range = 0.69-0.78), returning to baseline levels by 3 mo (P = 0.43). A similar pattern was observed for RT, with RTs slowing during acute treatment (at four of five assessment points, all P < 0.05; effect size range = 0.57-0.89) and returning to pretreatment levels at 3 mo (P = 0.78). ESS scores were increased at w 1, 2, and 3 (relative to baseline; all P < 0.05); by 3 mo, sleepiness had returned to baseline (normative) levels (P = 0.65). Conclusion: For the first time we show that acute sleep restriction therapy is associated with reduced objective total sleep time, increased daytime sleepiness, and objective performance impairment. Our data have important implications for implementation guidelines around the safe and effective delivery of cognitive behavioral therapy for insomnia. Citation: Kyle SD; Miller CB; Rogers Z; Siriwardena AN; MacMahon KM; Espie CA. Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: implications for the clinical management of insomnia disorder. SLEEP 2014;37(2):229-237. PMID:24497651

  19. 77 FR 15293 - Airworthiness Directives; Dassault Aviation Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-15

    ...-190-20), land at nearest suitable airport Upon display of ELEC:LH ESS PWR LO or ELEC:LH ESS NO PWR (Abnormal procedure 3-190-40), land at nearest suitable airport Upon display of ELEC:RH ESS PWR LO and ELEC...

  20. Psychometric properties of the Epworth Sleepiness Scale: A factor analysis and item-response theory approach.

    PubMed

    Pilcher, June J; Switzer, Fred S; Munc, Alec; Donnelly, Janet; Jellen, Julia C; Lamm, Claus

    2018-04-01

    The purpose of this study is to examine the psychometric properties of the Epworth Sleepiness Scale (ESS) in two languages, German and English. Students from a university in Austria (N = 292; 55 males; mean age = 18.71 ± 1.71 years; 237 females; mean age = 18.24 ± 0.88 years) and a university in the US (N = 329; 128 males; mean age = 18.71 ± 0.88 years; 201 females; mean age = 21.59 ± 2.27 years) completed the ESS. An exploratory-factor analysis was completed to examine dimensionality of the ESS. Item response theory (IRT) analyses were used to provide information about the response rates on the items on the ESS and provide differential item functioning (DIF) analyses to examine whether the items were interpreted differently between the two languages. The factor analyses suggest that the ESS measures two distinct sleepiness constructs. These constructs indicate that the ESS is probing sleepiness in settings requiring active versus passive responding. The IRT analyses found that overall, the items on the ESS perform well as a measure of sleepiness. However, Item 8 and to a lesser extent Item 6 were being interpreted differently by respondents in comparison to the other items. In addition, the DIF analyses showed that the responses between German and English were very similar indicating that there are only minor measurement differences between the two language versions of the ESS. These findings suggest that the ESS provides a reliable measure of propensity to sleepiness; however, it does convey a two-factor approach to sleepiness. Researchers and clinicians can use the German and English versions of the ESS but may wish to exclude Item 8 when calculating a total sleepiness score.

  1. Impacts of climate change on prioritizing conservation areas of hydrological ecosystem services

    NASA Astrophysics Data System (ADS)

    Lien, Wan Yu; Lin, Yu Pin

    2015-04-01

    Ecosystem services (ESs) including hydrological services play important roles in our daily life and provide a lot of benefits for human beings from ecological systems. The systems and their services may be threatened by climate change from global to local scales. We herein developed a systematic approach to assess the impacts of climate change on the hydrological ecosystem services, such as water yield, nutrient (nitrogen and phosphorous) retention, and soil retention in a watershed in Northern Taiwan. We first used an ecosystem service evaluation model, InVEST, to estimate the amount and spatial patterns of annual and monthly hydrological ecosystem services under historical weather data, and different climate change scenarios based on five GMSs. The monthly and annual spatiotemporal variations of the ESs were analyzed in this study. Finally, the multiple estimated ESs were considered as the protection conservation targets and regarded as the input data of the systematic conservation planning software, Zonation, to systematically prioritize reserve areas of the ESs under the climate change scenarios. The ES estimation results indicated that the increasing rainfall in wet season leads to the higher water yield and results in the higher sediment and nutrient export indirectly. The Zonation successfully fielded conservation priorities of the ESs. The conservation priorities of the ESs significantly varied spatially and monthly under the climate change scenarios. The ESs results also indicated that the areas where ESs values and conservation priorities with low resilience under climate change should be considered as high priority protected area to ensure the hydrological services in future. Our proposed approach is a novel systematic approach which can be applied to assess impacts of climate change on spatiotemporal variations of ESs as well as prioritize protected area of the ESs under various climate change scenarios. Keyword: climate change, ecosystem service, conservation planning, spatial analysis.

  2. Randomized, Paired-site Comparison of Autologous Engineered Skin Substitutes and Split-thickness Skin Graft for Closure of Extensive, Full-thickness Burns

    PubMed Central

    Boyce, Steven T.; Simpson, Peggy S.; Rieman, Mary T.; Warner, Petra M.; Yakuboff, Kevin P.; Bailey, J. Kevin; Nelson, Judith K.; Fowler, Laura A.; Kagan, Richard J.

    2016-01-01

    Objectives Stable closure of full-thickness burn wounds remains a limitation to recovery from burns of greater than 50% of the total body surface area (TBSA). Hypothetically, engineered skin substitutes (ESS) consisting of autologous keratinocytes and fibroblasts attached to collagen-based scaffolds may reduce requirements for donor skin, and decrease mortality. Methods ESS were prepared from split-thickness skin biopsies collected after enrollment of 16 pediatric burn patients into an approved study protocol. ESS and split-thickness autograft (AG) were applied to 15 subjects with full-thickness burns involving a mean of 76.9% TBSA. Data consisted of photographs, tracings of donor skin and healed wounds, comparison of mortality with the National Burn Repository (NBR), correlation of TBSA closed wounds with TBSA full-thickness burn, frequencies of regrafting, and immunoreactivity to the biopolymer scaffold. Results One subject expired before ESS application, and 15 subjects received 2056 ESS grafts. The ratio of closed wound to donor areas was 108.7±9.7 for ESS compared with a maximum of 4.0±0.0 for AG. Mortality for enrolled subjects was 6.25%, and 30.3% for a comparable population from the NBR (p<0.05). Engraftment was 83.5±2.0% for ESS and 96.5±0.9 for AG. Percentage TBSA closed was 29.9±3.3% for ESS, and 47.0±2.0 for AG. These values were significantly different between the graft types. Correlation of % TBSA closed with ESS with % TBSA full-thickness burn generated an R2 value of 0.65 (p<0.001). Conclusions These results indicate that autologous ESS reduce mortality and requirements for donor skin harvesting, for grafting of full-thickness burns of greater than 50% TBSA. PMID:27404165

  3. Randomized, Paired-Site Comparison of Autologous Engineered Skin Substitutes and Split-Thickness Skin Graft for Closure of Extensive, Full-Thickness Burns.

    PubMed

    Boyce, Steven T; Simpson, Peggy S; Rieman, Mary T; Warner, Petra M; Yakuboff, Kevin P; Bailey, J Kevin; Nelson, Judith K; Fowler, Laura A; Kagan, Richard J

    Stable closure of full-thickness burn wounds remains a limitation to recovery from burns of greater than 50% of the total body surface area (TBSA). Hypothetically, engineered skin substitutes (ESS) consisting of autologous keratinocytes and fibroblasts attached to collagen-based scaffolds may reduce requirements for donor skin, and decrease mortality. ESS were prepared from split-thickness skin biopsies collected after enrollment of 16 pediatric burn patients into an approved study protocol. ESS and split-thickness autograft (AG) were applied to 15 subjects with full-thickness burns involving a mean of 76.9% TBSA. Data consisted of photographs, tracings of donor skin and healed wounds, comparison of mortality with the National Burn Repository, correlation of TBSA closed wounds with TBSA full-thickness burn, frequencies of regrafting, and immunoreactivity to the biopolymer scaffold. One subject expired before ESS application, and 15 subjects received 2056 ESS grafts. The ratio of closed wound to donor areas was 108.7 ± 9.7 for ESS compared with a maximum of 4.0 ± 0.0 for AG. Mortality for enrolled subjects was 6.25%, and 30.3% for a comparable population from the National Burn Repository (P < .05). Engraftment was 83.5 ± 2.0% for ESS and 96.5 ± 0.9% for AG. Percentage TBSA closed was 29.9 ± 3.3% for ESS, and 47.0 ± 2.0% for AG. These values were significantly different between the graft types. Correlation of % TBSA closed with ESS with % TBSA full-thickness burn generated an R value of 0.65 (P < .001). These results indicate that autologous ESS reduce mortality and requirements for donor skin harvesting, for grafting of full-thickness burns of greater than 50% TBSA.

  4. Systematic neutron guide misalignment for an accelerator-driven spallation neutron source

    NASA Astrophysics Data System (ADS)

    Zendler, C.; Bentley, P. M.

    2016-08-01

    The European Spallation Source (ESS) is a long pulse spallation neutron source that is currently under construction in Lund, Sweden. A considerable fraction of the 22 planned instruments extend as far as 75-150 m from the source. In such long beam lines, misalignment between neutron guide segments can decrease the neutron transmission significantly. In addition to a random misalignment from installation tolerances, the ground on which ESS is built can be expected to sink with time, and thus shift the neutron guide segments further away from the ideal alignment axis in a systematic way. These systematic errors are correlated to the ground structure, position of buildings and shielding installation. Since the largest deformation is expected close to the target, even short instruments might be noticeably affected. In this study, the effect of this systematic misalignment on short and long ESS beam lines is analyzed, and a possible mitigation by overillumination of subsequent guide sections investigated.

  5. Levothyroxine Improves Subjective Sleepiness in a Euthyroid Patient with Narcolepsy without Cataplexy

    PubMed Central

    Sobol, Danielle L.; Spector, Andrew R.

    2014-01-01

    Objective: We discuss the use of levothyroxine for excessive daytime sleepiness (EDS) and prolonged nocturnal sleep time in a euthyroid patient with narcolepsy. Methods: After failure of first-line narcolepsy treatments, a 48-year-old female began levothyroxine (25 mcg/day). After 12 weeks of treatment, the patient was evaluated for improvement in total sleep time and subjective daytime sleepiness assessed by Epworth Sleepiness Scale (ESS). Results: At baseline, ESS score was 16 and total sleep time averaged 16 h/day. After 12 weeks, ESS was 13 and reported total sleep time was 13 h/day. Conclusions: Levothyroxine improved EDS and total sleep time in a euthyroid patient with narcolepsy without cataplexy after 12 weeks without side effects. Citation: Sobol DL, Spector AR. Levothyroxine improves subjective sleepiness in a euthyroid patient with narcolepsy without cataplexy. J Clin Sleep Med 2014;10(11):1231-1232. PMID:25325591

  6. Development of the mechanical properties of engineered skin substitutes after grafting to full-thickness wounds.

    PubMed

    Sander, Edward A; Lynch, Kaari A; Boyce, Steven T

    2014-05-01

    Engineered skin substitutes (ESSs) have been reported to close full-thickness burn wounds but are subject to loss from mechanical shear due to their deficiencies in tensile strength and elasticity. Hypothetically, if the mechanical properties of ESS matched those of native skin, losses due to shear or fracture could be reduced. To consider modifications of the composition of ESS to improve homology with native skin, biomechanical analyses of the current composition of ESS were performed. ESSs consist of a degradable biopolymer scaffold of type I collagen and chondroitin-sulfate (CGS) that is populated sequentially with cultured human dermal fibroblasts (hF) and epidermal keratinocytes (hK). In the current study, the hydrated biopolymer scaffold (CGS), the scaffold populated with hF dermal skin substitute (DSS), or the complete ESS were evaluated mechanically for linear stiffness (N/mm), ultimate tensile load at failure (N), maximum extension at failure (mm), and energy absorbed up to the point of failure (N-mm). These biomechanical end points were also used to evaluate ESS at six weeks after grafting to full-thickness skin wounds in athymic mice and compared to murine autograft or excised murine skin. The data showed statistically significant differences (p <0.05) between ESS in vitro and after grafting for all four structural properties. Grafted ESS differed statistically from murine autograft with respect to maximum extension at failure, and from intact murine skin with respect to linear stiffness and maximum extension. These results demonstrate rapid changes in mechanical properties of ESS after grafting that are comparable to murine autograft. These values provide instruction for improvement of the biomechanical properties of ESS in vitro that may reduce clinical morbidity from graft loss.

  7. Validation of a Hindi version of the Epworth Sleepiness Scale (ESS) at AIIMS, New Delhi in sleep-disordered breathing.

    PubMed

    Kanabar, K; Sharma, S K; Sreenivas, V; Biswas, A; Soneja, M

    2016-12-01

    The Epworth Sleepiness Scale (ESS) is one of the most widely used questionnaire for the assessment of excessive daytime sleepiness (EDS) in sleep-disordered breathing (SDB). This study was conducted to assess the validity of ESS in the Hindi language. The Hindi version was developed by translation and back translation by independent translators. The English and Hindi versions were administered to 115 bilingual subjects who presented with symptoms of SDB, of whom 98 underwent a polysomnography at a tertiary care hospital in North India. The questionnaire had a high level of internal consistency as measured by Cronbach's alpha (α = 0.84). There was no significant difference between the mean ESS scores of Hindi and English versions (11.65 ± 5.47 vs 11.70 ± 5.49, respectively; p = 0.80). The Hindi version of ESS showed a strong correlation with the English version (Spearman's correlation ρ = 0.98 and weighted kappa = 0.94). Each of the 8 individual questions of Hindi ESS demonstrated a good agreement with the corresponding English version. The Hindi ESS score was significantly higher in subjects with OSA compared to those without OSA (12.67 ± 5.29 vs 7.76 ± 5.44, respectively; p = 0.002). However, there was no difference in ESS score between mild and moderate OSA or between moderate and severe OSA. The Hindi version of the ESS showed a good internal consistency and a strong correlation with the English version and can be used in the Hindi-speaking population.

  8. Endometrial stromal sarcomas and related high-grade sarcomas: immunohistochemical and molecular genetic study of 31 cases.

    PubMed

    Kurihara, Shuichi; Oda, Yoshinao; Ohishi, Yoshihiro; Iwasa, Atsuko; Takahira, Tomonari; Kaneki, Eisuke; Kobayashi, Hiroaki; Wake, Norio; Tsuneyoshi, Masazumi

    2008-08-01

    Classification and terminology of non-low-grade endometrial sarcomas, which show significant nuclear atypia, have been controversial. Currently, these tumors seem to be classified all together into "undifferentiated endometrial sarcoma (UES)." However, it remains unclear whether these non-low-grade sarcomas are universally "undifferentiated." We divided these sarcomas morphologically into undifferentiated endometrial sarcoma with nuclear uniformity (UES-U) and undifferentiated endometrial sarcoma with nuclear pleomorphism (UES-P), and compared their molecular genetic and immunohistochemical profiles. Eighteen low-grade endometrial stromal sarcomas (ESS-LG), 7 UES-U, and 6 UES-P were examined. All the patients with ESS-LG were still alive, either with or without disease, whereas 4 of the 5 patients with advanced stage UES-U and all 3 of the patients with advanced stage UES-P had died of the disease. JAZF1-JJAZ1 fusion transcript was detected in 6 (50%) out of 12 ESS-LG and in 1 (33%) of 3 UES-U, whereas it was not detected in any of the cases of UES-P. ESS-LG and UES-U frequently showed positive immunoreaction for estrogen receptor (ESS-LG: 94%, UES-U: 57%) and progesterone receptor (ESS-LG: 94%, UES-U: 57%), whereas all the UES-P were negative for these receptors. Nuclear beta-catenin expression was more frequently recognized in ESS-LG (47%) and UES-U (85%), compared with UES-P (33%). Moreover, nuclear accumulation of p53 and TP53 gene missense mutations were limited to 3 UES-P cases. Our data suggest that UES-U shares some molecular genetic and immunohistochemical characteristics with ESS-LG, but UES-P considerably differs from ESS-LG.

  9. Community-based Monitoring of Water Resources in Remote Mountain Regions

    NASA Astrophysics Data System (ADS)

    Buytaert, W.; Hannah, D. M.; Dewulf, A.; Clark, J.; Zulkafli, Z. D.; Karpouzoglou, T.; Mao, F.; Ochoa-Tocachi, B. F.

    2016-12-01

    Remote mountain regions are often represented by pockets of poverty combined with accelerated environmental change. The combination of harsh climatic and topographical conditions with limited infrastructure puts severe pressures on local livelihoods, many of which rely strongly on local ecosystem services (ESS) such as agricultural production and water supply. It is therefore paramount to optimise the management of ESS for the benefit of local people. This is hindered by a scarcity of quantitative data about physical processes such as precipitation and river flow as well as qualitative data concerning the management of water and land. National and conventional scientific monitoring networks tend to be insufficient to cover adequately the spatial and temporal gradients. Additionally, the data that are being collected often fail to be converted into locally relevant and actionable knowledge for ESS management. In such conditions, community-based monitoring of natural resources may be an effective way to reduce this knowledge gap. The participatory nature of such monitoring also enhances knowledge co-production and integration in locally-based decision-making processes. Here, we present the results of a 4-year consortium project on the use of citizen science technologies for ecosystem services management (Mountain-EVO). The project analyzed ecosystem service dynamics and decision-making processes and implemented a comparative analysis of experiments with community-based monitoring of water resources in 4 remote mountain regions, i.e. Peru, Nepal, Kyrgyzstan, and Ethiopia. We find that community-based monitoring can have a transformative impact on local ESS management, because of its potential to be more inclusive, polycentric, and context-driven as compared to conventional monitoring. However, the results and effectiveness of community-based approaches depend strongly on the natural and socio-economic boundary conditions. As such, this requires a tailored and bottom-up approach to implementation, which ideally isrooted in locally-based set of actors that can act as catalysts for knowledge co-production between the scientific community and local ESS users.

  10. Azithromycin add-on therapy in high-risk postendoscopic sinus surgery patients failing corticosteroid irrigations: A clinical practice audit.

    PubMed

    Maniakas, Anastasios; Desrosiers, Martin

    2014-01-01

    Chronic rhinosinusitis (CRS) has a high potential for recurrence after endoscopic sinus surgery (ESS), despite a postoperative therapy of topical corticosteroid irrigations. Azithromycin (AZI) is a macrolide antibiotic with anti-inflammatory properties that may be of benefit in such steroid-unresponsive patients. Follow-up study was performed to (1) review the effectiveness of the management strategy of adding AZI in high-risk post-ESS patients failing standard management and (2) identify predictive factors for steroid nonresponsiveness. A retrospective audit of the postoperative evolution of all patients undergoing ESS for CRS in 2010 by a single surgeon was undertaken. Patients deemed at high risk of recurrence based on preoperative history and/or perioperative findings received nasal irrigation with 0.5 mg of budesonide (BUD) in 240 mL of saline twice daily after ESS. Patients showing signs of endoscopic recurrence at 4 months, despite BUD, had AZI at 250 mg three times a week added to their treatment regimen. A total of 57 high-risk patients underwent ESS during this period. At 4 months, 63.2% (36/57) had a favorable outcome solely with BUD. Twelve of the 21 nonresponders received AZI, with an additional 66.7% (8/12) subsequently showing a favorable response. Failure of BUD was associated with female gender (p = 0.048), having elevated alpha-1-antitrypsin levels (p = 0.037) and lower recovery rates of Staphylococcus aureus (p = 0.063). Although the AZI subgroup was too small for statistical analysis, female gender was more frequently associated with failure of both BUD and AZI, while IgE was not useful. A significant subgroup of high-risk patients showing disease recurrence after ESS despite topical corticosteroid therapy may respond to the addition of AZI as part of their therapy. These findings suggest that topical steroid-unresponsive CRS may represent a distinct entity and that alternate anti-inflammatory agents may be required for optimal management.

  11. ESS/Special Education Teacher's Guide.

    ERIC Educational Resources Information Center

    Ball, Daniel W.

    This teacher's guide provides Elementary Science Study (ESS) units that can be used with students in grades 1-12 in special education programs. The ESS units represent an interdisciplinary approach to learning and emphasize "hands-on" activities. Activities include Mirror Cards, Pattern Blocks, Clay Boats, Mapping, Earthworms, and…

  12. Effects of pitolisant, a histamine H3 inverse agonist, in drug-resistant idiopathic and symptomatic hypersomnia: a chart review.

    PubMed

    Leu-Semenescu, Smaranda; Nittur, Nandy; Golmard, Jean-Louis; Arnulf, Isabelle

    2014-06-01

    To evaluate the benefits and risks of pitolisant (a wake-enhancing drug that increases the histamine release in the brain by blocking presynaptic H3 histamine reuptake) in patients with idiopathic (IH) and symptomatic (SH) hypersomnia plus sleepiness refractory to available stimulants (modafinil, methylphenidate, mazindol, sodium oxybate, and d-amphetamine). Through retrospective analyses of patient files, the benefit (the score from the Epworth Sleepiness Scale [ESS], authorization renewal) and tolerance (side-effects) of pitolisant were assessed. A total of 78 patients with IH (n=65%, 78% women) and SH (n=13%, 54% women) received pitolisant 5-50 mg once per day over the course of five days to 37 months. The median (interquartile range) ESS scores of patients with IH decreased from 17 (15.5-18.5) to 14 (12-17). There were 36% responders (ESS fall of > or =3). The improvement in ESS score (-1.9±2.6) was different from 0 in IH without long sleep time (P<0.002) and in IH with a long sleep time (P<0.0001), but not in SH. Forty-four (63%) patients with IH and 12 (77%) patients with SH stopped pitolisant, mostly due to a lack of efficacy. Side-effects included gastrointestinal pain (15.4%), increased appetite and weight gain (14.1%), headache (12.8%), insomnia (11.5%), and anxiety (9%), as well as exceptional reports of depression and persistent genital arousal. Pitolisant had a long-term favorable benefit/risk ratio in 23-38% of drug-resistant patients with IH and SH, suggesting that histamine neurons can be stimulated in severe idiopathic and symptomatic hypersomnia. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Aggressive behavior and poor prognosis of endometrial stromal sarcomas with YWHAE-FAM22 rearrangement indicate the clinical importance to recognize this subset.

    PubMed

    Kruse, Arnold-Jan; Croce, Sabrina; Kruitwagen, Roy F P M; Riedl, Robert G; Slangen, Brigitte F M; Van Gorp, Toon; Van de Vijver, Koen K

    2014-11-01

    Although the World Health Organization (WHO) in 2003 defined endometrial stromal sarcomas (ESSs) in general have a good prognosis, considerable differences in clinical behavior and prognosis may exist between different patients with ESS. The ESSs of the type associated with YWHAE-NUTM2 (previously named YWHAE-FAM22) fusion have a more aggressive clinical behavior and poorer prognosis than conventional ESS. Recently, the WHO 2014 classification recognizes this subset of ESS as a separate entity and classifies these as high-grade ESSs. Recognition of this subset has therefore an important clinical impact. We performed a review of the literature to delineate the clinicopathologic features of ESS patients with an YWHAE-NUTM2 rearrangement, with the goal to recognize this subset of ESS. We report a case of a woman with WHO 2014-defined high-grade ESS. Furthermore, published English literature was reviewed for YWHAE-FAM22 ESS and uterus. Twenty patients were identified, with a median age of 50 (range, 28-67) years. There were no clinical features able to recognize YWHAE-NUTM2 ESS. However, they characteristically contain specific histopathological features. Furthermore, YWHAE-NUTM2 ESSs are strongly cyclin D1 positive in contrast to conventional low-grade ESSs. YWHAE-NUTM2 ESSs represent a subset of ESSs with an aggressive clinical behavior and poor prognosis. Specific histopathological features may indicate the presence of YWHAE-NUTM2 rearrangement, which subsequently can be confirmed by cyclin D1 immunostaining.

  14. Impact of electronic healthcare-associated infection surveillance software on infection prevention resources: a systematic review of the literature.

    PubMed

    Russo, P L; Shaban, R Z; Macbeth, D; Carter, A; Mitchell, B G

    2018-05-01

    Surveillance of healthcare-associated infections is fundamental for infection prevention. The methods and practices for surveillance have evolved as technology becomes more advanced. The availability of electronic surveillance software (ESS) has increased, and yet adoption of ESS is slow. It is argued that ESS delivers savings through automation, particularly in terms of human resourcing and infection prevention (IP) staff time. To describe the findings of a systematic review on the impact of ESS on IP resources. A systematic search was conducted of electronic databases Medline and the Cumulative Index to Nursing and Allied Health Literature published between January 1 st , 2006 and December 31 st , 2016 with analysis using the Newcastle-Ottawa Scale. In all, 2832 articles were reviewed, of which 16 studies met the inclusion criteria. IP resources were identified as time undertaken on surveillance. A reduction in IP staff time to undertake surveillance was demonstrated in 13 studies. The reduction proportion ranged from 12.5% to 98.4% (mean: 73.9%). The remaining three did not allow for any estimation of the effect in terms of IP staff time. None of the studies demonstrated an increase in IP staff time. The results of this review demonstrate that adopting ESS yields considerable dividends in IP staff time relating to data collection and case ascertainment while maintaining high levels of sensitivity and specificity. This has the potential to enable reinvestment into other components of IP to maximize efficient use of scarce IP resources. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  15. Determination of Duty Cycle for Energy Storage Systems in a Renewables (Solar) Firming Application

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

    Schoenwald, David A.; Ellison, James

    2016-04-01

    This report supplements the document, “Protocol for Uniformly Measuring and Expressing the Performance of Energy Storage Systems,” issued in a revised version in April 2016, which will include the renewables (solar) firming application for an energy storage system (ESS). This report provides the background and documentation associated with the determination of a duty cycle for an ESS operated in a renewables (solar) firming application for the purpose of measuring and expressing ESS performance in accordance with the ESS performance protocol.

  16. Inventory of Safety-related Codes and Standards for Energy Storage Systems with some Experiences related to Approval and Acceptance

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

    Conover, David R.

    The purpose of this document is to identify laws, rules, model codes, codes, standards, regulations, specifications (CSR) related to safety that could apply to stationary energy storage systems (ESS) and experiences to date securing approval of ESS in relation to CSR. This information is intended to assist in securing approval of ESS under current CSR and to identification of new CRS or revisions to existing CRS and necessary supporting research and documentation that can foster the deployment of safe ESS.

  17. A proposed framework to operationalize ESS for the mitigation of soil threats

    NASA Astrophysics Data System (ADS)

    Schwilch, Gudrun; Bernet, Lea; Fleskens, Luuk; Mills, Jane; Stolte, Jannes; van Delden, Hedwig; Verzandvoort, Simone

    2015-04-01

    Despite various research activities in the last decades across the world, many challenges remain to integrate the concept of ecosystem services (ESS) in decision-making, and a coherent approach to assess and value ESS is still lacking. There are a lot of different - often context-specific - ESS frameworks with their own definitions and understanding of terms. Based on a thorough review, the EU FP7 project RECARE (www.recare-project.eu) suggests an adapted framework for ecosystem services related to soils that can be used for practical application in preventing and remediating degradation of soils in Europe. This lays the foundation for the development and selection of appropriate methods to measure, evaluate, communicate and negotiate the services we obtain from soils with stakeholders in order to improve land management. Similar to many ESS frameworks, the RECARE framework distinguishes between an ecosystem and human well-being part. As the RECARE project is focused on soil threats, this is the starting point on the ecosystem part of the framework. Soil threats affect natural capital, such as soil, water, vegetation, air and animals, and are in turn influenced by those. Within the natural capital, the RECARE framework focuses especially on soil and its properties, classified in inherent and manageable properties. The natural capital then enables and underpins soil processes, while at the same time being affected by those. Soil processes, finally, are the ecosystem's capacity to provide services, thus they support the provision of soil functions and ESS. ESS may be utilized to produce benefits for individuals and human society. Those benefits are explicitly or implicitly valued by individuals and human society. The values placed on those benefits influence policy and decision-making and thus lead to a societal response. Individual (e.g. farmers') and societal decision making and policy determine land management and other (human) driving forces, which in turn affect soil threats and natural capital. In order to improve ESS with Sustainable Land Management (SLM) - i.e. measures aimed to prevent or remediate soil threats, the services identified in the framework need to be "manageable" (modifiable) for the stakeholders. To this end, effects of soil threats and prevention / remediation measures are captured by key soil properties as well as through bio-physical (e.g. reduced soil loss), socio-economic (e.g. reduced workload) and socio-cultural (e.g. aesthetics) impact indicators. In order to use such indicators in RECARE, it should be possible to associate the changes in soil processes to impacts of prevention / remediation measures (SLM). This requires the indicators to be sensitive enough to small changes, but still sufficiently robust to provide evidence of the change and attribute it to SLM. The RECARE ESS framework will be presented and discussed in order to further develop its operationalization. Inputs from the conference participants are highly welcome.

  18. An ultrasensitive and selective electrochemical sensor for determination of estrone 3-sulfate sodium salt based on molecularly imprinted polymer modified carbon paste electrode.

    PubMed

    Song, Han; Wang, Yuli; Zhang, Lu; Tian, Liping; Luo, Jun; Zhao, Na; Han, Yajie; Zhao, Feilang; Ying, Xue; Li, Yingchun

    2017-11-01

    A highly sensitive and selective electrochemical sensor based on carbon paste electrode (CPE) modified with molecularly imprinted polymers (MIPs) has been developed for the determination of estrone 3-sulfate sodium salt (ESS). MIPs were prepared in polar medium via bulk polymerization and characterized by scanning electron microscopy and infrared spectroscopy. Cyclic voltammetry was performed to the study preparation process and binding behavior of the MIP-modified CPE (MIP/CPE) toward ESS. The conditions for preparing MIPs and MIP/CPE as well as ESS detection were optimized. Under the optimal experimental conditions, the detection linear range for ESS is 4 × 10 -12 to 6 × 10 -9  M with a limit of detection of 1.18 × 10 -12  M (S/N = 3). In addition, the sensor exhibits high binding affinity toward ESS over its structural analogues with excellent repeatability and stability. The fabricated MIP/CPE was then successfully employed to detect ESS in pregnant mare urine (PMU) without any pretreatment, and the average recoveries were from 99.6 to 104.9% with relative standard deviation less than 3.0%. High-performance liquid chromatography was adopted as a reference to validate the established approach in detecting ESS and their results showed good agreement. The as-prepared sensor has high potential to be a decent tool for on-site determination of ESS in PMU in a fast and convenient manner. Graphical Abstract ᅟ.

  19. Effect of lidocaine-soaked nasal packing on pain relief after endoscopic sinus surgery.

    PubMed

    Mo, Ji-Hun; Park, Young-Min; Chung, Young-Jun

    2013-01-01

    Nasal packing is usually performed to control bleeding after endoscopic sinus surgery (ESS). Although new packing materials have been developed, they still cause pain. This study was designed to evaluate the effect of lidocaine-soaked packs on pain after ESS. A prospective, randomized, double-blind controlled trial was conducted in 63 patients with CRS undergoing ESS. At the conclusion of the operation, 2% lidocaine-soaked biodegradable synthetic polyurethane foam and saline-soaked polyurethane foam were inserted in both nasal cavities of 31 patients and 32 control patients, respectively. The same lidocaine or saline was reapplied into the nasal packs at postoperative 8 hours. Pain was evaluated using a visual analog scale at postoperative 1, 4, 8, 16, 20, and 24 hour(s). The number of gauze that cleaned the blood around the nose was counted. Heart rate, rhythm, and blood pressures were checked preoperatively and postoperatively to evaluate the influence of lidocaine on vital signs. Postoperative pain decreased in lidocaine group at all of the postoperative time periods (p < 0.05). Lidocaine reduced postoperative bleeding at postoperative 8 and 24 hours. Changes of blood pressure from preoperative values in the lidocaine group were not different from those in the control group (p > 0.05). Heart rate in the lidocaine group was more stable than that in the control group (p < 0.05). Lidocaine-soaked packs significantly reduced postoperative pain without serious changes on vital sign. These findings suggest that topical lidocaine application to nasal packs could be a useful method to reduce pain during the early postoperative period after ESS.

  20. Self-evaluated and Close Relative-Evaluated Epworth Sleepiness Scale vs. Multiple Sleep Latency Test in Patients with Obstructive Sleep Apnea

    PubMed Central

    Li, Yun; Zhang, Jihui; Lei, Fei; Liu, Hong; Li, Zhe; Tang, Xiangdong

    2014-01-01

    Objectives: The aims of this study were to determine (1) the agreement in Epworth Sleepiness Scale (ESS) evaluated by patients and their close relatives (CRs), and (2) the correlation of objective sleepiness as measured by multiple sleep latency test (MSLT) with self-evaluated and close relative-evaluated ESS. Methods: A total of 85 consecutive patients with obstructive sleep apnea (OSA) (70 males, age 46.7 ± 12.9 years old) with an apnea-hypopnea index (AHI) > 5 events per hour (mean 38.9 ± 26.8/h) were recruited into this study. All participants underwent an overnight polysomnographic assessment (PSG), MSLT, and ESS rated by both patients and their CRs. Mean sleep latency < 8 min on MSLT was considered objective daytime sleepiness. Results: Self-evaluated global ESS score (ESSG) was closely correlated with evaluation by CRs (r = 0.79, p < 0.001); the mean ESSG score evaluated by patients did not significantly differ from that evaluated by CRs (p > 0.05). However, Bland- Altman plot showed individual differences between self-evaluated and CR-evaluated ESS scores, with a 95%CI of -9.3 to 7.0. The mean sleep latency on MSLT was significantly associated with CR-evaluated ESSG (r = -0.23, p < 0.05); significance of association with self-evaluated ESSG was marginal (r = -0.21, p = 0.05). Conclusions: CR-evaluated ESS has a good correlation but also significant individual disagreement with self-evaluated ESS in Chinese patients with OSA. CR-evaluated ESS performs as well as, if not better than, self-evaluated ESS in this population when referring to MSLT. Citation: Li Y; Zhang J; Lei F; Liu H; Li Z; Tang X. Self-evaluated and close relative-evaluated Epworth Sleepiness Scale vs. multiple sleep latency test in patients with obstructive sleep apnea. J Clin Sleep Med 2014;10(2):171-176. PMID:24533000

  1. EssC: domain structures inform on the elusive translocation channel in the Type VII secretion system

    PubMed Central

    Zoltner, Martin; Ng, Wui M.A.V.; Money, Jillian J.; Fyfe, Paul K.; Kneuper, Holger; Palmer, Tracy; Hunter, William N.

    2016-01-01

    The membrane-bound protein EssC is an integral component of the bacterial Type VII secretion system (T7SS), which is a determinant of virulence in important Gram-positive pathogens. The protein is predicted to consist of an intracellular repeat of forkhead-associated (FHA) domains at the N-terminus, two transmembrane helices and three P-loop-containing ATPase-type domains, D1–D3, forming the C-terminal intracellular segment. We present crystal structures of the N-terminal FHA domains (EssC-N) and a C-terminal fragment EssC-C from Geobacillus thermodenitrificans, encompassing two of the ATPase-type modules, D2 and D3. Module D2 binds ATP with high affinity whereas D3 does not. The EssC-N and EssC-C constructs are monomeric in solution, but the full-length recombinant protein, with a molecular mass of approximately 169 kDa, forms a multimer of approximately 1 MDa. The observation of protomer contacts in the crystal structure of EssC-C together with similarity to the DNA translocase FtsK, suggests a model for a hexameric EssC assembly. Such an observation potentially identifies the key, and to date elusive, component of pore formation required for secretion by this recently discovered secretion system. The juxtaposition of the FHA domains suggests potential for interacting with other components of the secretion system. The structural data were used to guide an analysis of which domains are required for the T7SS machine to function in pathogenic Staphylococcus aureus. The extreme C-terminal ATPase domain appears to be essential for EssC activity as a key part of the T7SS, whereas D2 and FHA domains are required for the production of a stable and functional protein. PMID:27130157

  2. Comparison of intranasal fluticasone spray, budesonide atomizer, and budesonide respules in patients with chronic rhinosinusitis with polyposis after endoscopic sinus surgery.

    PubMed

    Neubauer, Paul D; Schwam, Zachary G; Manes, R Peter

    2016-03-01

    Nasal steroids are a critical part of the management of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) after endoscopic sinus surgery (ESS). Increasingly, practitioners are using budesonide respules delivered to the sinonasal cavities, which is an off-label use, in lieu of traditional nasal steroids. There has been little research comparing budesonide with traditional nasal steroids and the most effective delivery method of budesonide. A randomized controlled trial was performed on patients after ESS for CRSwNP in a tertiary care center. Patients were randomized into 1 of 3 groups: group A received fluticasone nasal spray twice daily; group B received budesonide respules via a mucosal atomization device (MAD) twice daily; and group C received budesonide respules instilled via the vertex-to-floor (VF) position twice daily. Primary endpoints were 22-item Sino-Nasal Outcome Test (SNOT-22) and Lund-Kennedy scores at 6 months. Thirty-two patients were enrolled in the study, 23 of whom completed the 6-month trial. There were no significant differences among groups A, B, and C with respect to age, gender, asthma, aspirin sensitivity, or previous ESS. Group B had a statistically significant greater reduction in SNOT-22 and Lund-Kennedy scores at the primary endpoint of 6 months compared to groups A and C. Group C had the next greatest reduction, which was statistically significant, followed by group A. Patients treated with budesonide after ESS for CRSwNP had greater improvement in SNOT-22 and Lund-Kennedy scores compared to fluticasone at 6 months. The data supports the use of budesonide respules, particularly with a MAD, over fluticasone for CRSwNP patients after ESS. © 2015 ARS-AAOA, LLC.

  3. The puzzle of partial migration: Adaptive dynamics and evolutionary game theory perspectives.

    PubMed

    De Leenheer, Patrick; Mohapatra, Anushaya; Ohms, Haley A; Lytle, David A; Cushing, J M

    2017-01-07

    We consider the phenomenon of partial migration which is exhibited by populations in which some individuals migrate between habitats during their lifetime, but others do not. First, using an adaptive dynamics approach, we show that partial migration can be explained on the basis of negative density dependence in the per capita fertilities alone, provided that this density dependence is attenuated for increasing abundances of the subtypes that make up the population. We present an exact formula for the optimal proportion of migrants which is expressed in terms of the vital rates of migrant and non-migrant subtypes only. We show that this allocation strategy is both an evolutionary stable strategy (ESS) as well as a convergence stable strategy (CSS). To establish the former, we generalize the classical notion of an ESS because it is based on invasion exponents obtained from linearization arguments, which fail to capture the stabilizing effects of the nonlinear density dependence. These results clarify precisely when the notion of a "weak ESS", as proposed in Lundberg (2013) for a related model, is a genuine ESS. Secondly, we use an evolutionary game theory approach, and confirm, once again, that partial migration can be attributed to negative density dependence alone. In this context, the result holds even when density dependence is not attenuated. In this case, the optimal allocation strategy towards migrants is the same as the ESS stemming from the analysis based on the adaptive dynamics. The key feature of the population models considered here is that they are monotone dynamical systems, which enables a rather comprehensive mathematical analysis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. A randomized controlled trial of a middle meatal silastic stent for reducing adhesions and middle turbinate lateralization following endoscopic sinus surgery.

    PubMed

    Chan, Chun L; Elmiyeh, Behrad; Woods, Charmaine; Ullah, Shahid; Gunawardena, Indunil; Carney, A Simon; Ooi, Eng H

    2015-06-01

    Endoscopic sinus surgery (ESS) is indicated for patients with recalcitrant chronic rhinosinusitis symptoms. However, surgical revision can be required because of adhesion formation and middle turbinate lateralization. We investigate the efficacy of a middle meatal silastic stent in reducing these complications after ESS. Thirty-six patients were randomized to receive a silastic stent in the middle meatus unilaterally after ESS. The surgeon was blinded to the side receiving the stent until completion of the ESS. The contralateral side, with no stent, was the control side. Patients completed a 7-day, postoperative, visual analog scale symptom diary and were blinded to the stent side until its removal at the first postoperative visit. Patients were followed up after 2, 8, and 24 weeks. Endoscopic video of the sinus cavities were recorded at all visits and 2 blinded, independent ear/nose/throat (ENT) surgeons assessed the videos using a modified Lund-Kennedy scoring system. Thirty-five of 36 patients completed 6-months' follow-up. Middle turbinate lateralization was observed in 13 sides without a stent vs 1 side with a stent. There was a significant reduction in adhesions at weeks 2 and 8 (p < 0.001) and crusting (p < 0.01) in the stent side compared to control. Video scores at 6 months after surgery for stent and control sides remained unchanged from the 8-week visit. There was no difference between sides for symptom scores, edema, or nasal discharge. Middle meatal silastic stents are well tolerated by patients and effective in reducing middle turbinate lateralization, adhesions, and crusting postoperatively in ESS. © 2015 ARS-AAOA, LLC.

  5. Appropriateness criteria predict outcomes for sinus surgery and may aid in future patient selection.

    PubMed

    Beswick, Daniel M; Mace, Jess C; Soler, Zachary M; Ayoub, Noel F; Rudmik, Luke; DeConde, Adam S; Smith, Timothy L

    2018-05-14

    Appropriateness criteria to determine surgical candidacy for chronic rhinosinusitis (CRS) have recently been described. This study stratified patients who underwent endoscopic sinus surgery (ESS) according to these new appropriateness criteria and evaluated postoperative improvements among appropriateness categories. Adult patients with uncomplicated CRS electing ESS were prospectively enrolled in a multi-institutional cohort study between March 2011 and June 2015 to assess outcomes. Subsequently, appropriateness criteria that consider preoperative medical therapy, 22-item SinoNasal Outcome Test (SNOT-22) scores, and Lund-Mackay computed tomography scores were retrospectively applied. A total of 92.6% (436 of 471) were categorized as "appropriate" ESS candidates, 3.8% (18 of 471) as "uncertain," and 3.6% (17 of 471) as "inappropriate." Among uncertain patients, two-thirds (12 of 18) had identifiable reasons for undergoing ESS, most commonly oral corticosteroid intolerance (n = 6). Postoperative follow-up was available for 79% (n = 372). Clinically significant SNOT-22 improvements occurred in both appropriate and uncertain groups (all P < 0.050) but not among the inappropriate group. The inappropriate group reported less mean improvement in SNOT-22 total score compared to appropriate (P = 0.008) and uncertain (P = 0.006) groups. The vast majority of patients (∼93%) who underwent ESS in a multi-institutional research program were identified as appropriate candidates for surgical intervention, as defined by current appropriateness criteria. Valid considerations frequently exist for offering ESS to patients categorized as uncertain. Appropriate and uncertain candidates report similar, clinically significant SNOT-22 improvements following surgery. Patients classified as inappropriate reported significantly less improvement following ESS. Surgical appropriateness criteria may assist in predicting outcomes of ESS. 2b. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  6. A high-resolution near-infrared extraterrestrial solar spectrum derived from ground-based Fourier transform spectrometer measurements

    NASA Astrophysics Data System (ADS)

    Menang, Kaah P.; Coleman, Marc D.; Gardiner, Tom D.; Ptashnik, Igor V.; Shine, Keith P.

    2013-06-01

    A detailed spectrally resolved extraterrestrial solar spectrum (ESS) is important for line-by-line radiative transfer modeling in the near-IR. Very few observationally based high-resolution ESS are available in this spectral region. Consequently, the theoretically calculated ESS by Kurucz has been widely adopted. We present the CAVIAR (Continuum Absorption at Visible and Infrared Wavelengths and its Atmospheric Relevance) ESS, which is derived using the Langley technique applied to calibrated observations using a ground-based high-resolution Fourier transform spectrometer (FTS) in atmospheric windows from 2000 to 10,000 cm-1 (1-5 µm). There is good agreement between the strengths and positions of solar lines between the CAVIAR and the satellite-based Atmospheric Chemistry Experiment-FTS ESS, in the spectral region where they overlap, and good agreement with other ground-based FTS measurements in two near-IR windows. However, there are significant differences in the structure between the CAVIAR ESS and spectra from semiempirical models. In addition, we found a difference of up to 8% in the absolute (and hence the wavelength-integrated) irradiance between the CAVIAR ESS and that of Thuillier et al., which was based on measurements from the Atmospheric Laboratory for Applications and Science satellite and other sources. In many spectral regions, this difference is significant, because the coverage factor k = 2 (or 95% confidence limit) uncertainties in the two sets of observations do not overlap. Because the total solar irradiance is relatively well constrained, if the CAVIAR ESS is correct, then this would indicate an integrated "loss" of solar irradiance of about 30 W m-2 in the near-IR that would have to be compensated by an increase at other wavelengths.

  7. Identifying clinically important difference on the Epworth Sleepiness Scale: results from a narcolepsy clinical trial of JZP-110.

    PubMed

    Scrima, Lawrence; Emsellem, Helene A; Becker, Philip M; Ruoff, Chad; Lankford, Alan; Bream, Gary; Khayrallah, Moise; Lu, Yuan; Black, Jed

    2017-10-01

    While scores ≤10 on the Epworth Sleepiness Scale (ESS) are within the normal range, the reduction in elevated ESS score that is clinically meaningful in patients with narcolepsy has not been established. This post hoc analysis of a clinical trial of patients with narcolepsy evaluated correlations between Patient Global Impression of Change (PGI-C) and ESS. Data of adult patients with narcolepsy from a double-blind, 12-week placebo-controlled study of JZP-110, a wake-promoting agent, were used in this analysis. Descriptive statistics and receiver operating characteristic (ROC) analysis compared PGI-C (anchor measure) to percent change from baseline in ESS to establish the responder criterion from patients taking either placebo or JZP-110 (treatments). At week 12, patients (n = 10) who reported being "very much improved" on the PGI-C had a mean 76.7% reduction in ESS score, and patients (n = 33) who reported being "much improved" on the PGI-C had a mean 49.1% reduction in ESS score. ROC analysis showed that patients who improved were almost exclusively from JZP-110 treatment group, with an area-under-the-curve of 0.9, and revealed that a 25% reduction in ESS (sensitivity, 81.4%; specificity, 80.9%) may be an appropriate threshold for defining a meaningful patient response to JZP-110 and placebo. A ≥25% reduction in patients' subjective ESS score may be useful as a threshold to identify patients with narcolepsy who respond to JZP-110 treatment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  8. Muscular adaptations in low- versus high-load resistance training: A meta-analysis.

    PubMed

    Schoenfeld, Brad J; Wilson, Jacob M; Lowery, Ryan P; Krieger, James W

    2016-01-01

    There has been much debate as to optimal loading strategies for maximising the adaptive response to resistance exercise. The purpose of this paper therefore was to conduct a meta-analysis of randomised controlled trials to compare the effects of low-load (≤60% 1 repetition maximum [RM]) versus high-load (≥65% 1 RM) training in enhancing post-exercise muscular adaptations. The strength analysis comprised 251 subjects and 32 effect sizes (ESs), nested within 20 treatment groups and 9 studies. The hypertrophy analysis comprised 191 subjects and 34 ESs, nested with 17 treatment groups and 8 studies. There was a trend for strength outcomes to be greater with high loads compared to low loads (difference = 1.07 ± 0.60; CI: -0.18, 2.32; p = 0.09). The mean ES for low loads was 1.23 ± 0.43 (CI: 0.32, 2.13). The mean ES for high loads was 2.30 ± 0.43 (CI: 1.41, 3.19). There was a trend for hypertrophy outcomes to be greater with high loads compared to low loads (difference = 0.43 ± 0.24; CI: -0.05, 0.92; p = 0.076). The mean ES for low loads was 0.39 ± 0.17 (CI: 0.05, 0.73). The mean ES for high loads was 0.82 ± 0.17 (CI: 0.49, 1.16). In conclusion, training with loads ≤50% 1 RM was found to promote substantial increases in muscle strength and hypertrophy in untrained individuals, but a trend was noted for superiority of heavy loading with respect to these outcome measures with null findings likely attributed to a relatively small number of studies on the topic.

  9. Six Questions about The World Bank's 2020 Education Sector Strategy

    ERIC Educational Resources Information Center

    Shafiq, M. Najeeb

    2011-01-01

    Based on interviews with World Bank staff in April 2011, this article answers six questions about the World Bank's Education Sector Strategy 2020 (ESS 2020): (1) What is the ESS 2020? (2) What is it not? (3) How was the development process of the ESS 2020 different from that of past Strategies? (4) How are the policy recommendations of the ESS…

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

    Anderson, David E.

    The JEMA modulator was originally developed for the European Spallation Source (ESS) when Spain was under consideration as a location for the ESS facility. Discussions ensued and the Spallation Neutron Source Research Accelerator Division agreed to form a collaboration with ESS-Bilbao (ESS-B) consortium to provide services for specifying the requirements for a version of the modulator capable of operating twelve 550 kW klystrons, monitoring the technical progress on the contract with JEMA, installing and commissioning the modulator at SNS, and performing a 30 day full power test. This work was recently completed, and this report discusses those activities with primarymore » emphasis on the installation and testing activities.« less

  11. Environmental Test Screening Procedure

    NASA Technical Reports Server (NTRS)

    Zeidler, Janet

    2000-01-01

    This procedure describes the methods to be used for environmental stress screening (ESS) of the Lightning Mapper Sensor (LMS) lens assembly. Unless otherwise specified, the procedures shall be completed in the order listed, prior to performance of the Acceptance Test Procedure (ATP). The first unit, S/N 001, will be subjected to the Qualification Vibration Levels, while the remainder will be tested at the Operational Level. Prior to ESS, all units will undergo Pre-ESS Functional Testing that includes measuring the on-axis and plus or minus 0.95 full field Modulation Transfer Function and Back Focal Length. Next, all units will undergo ESS testing, and then Acceptance testing per PR 460.

  12. Heritability of lenticular myopia in English Springer spaniels.

    PubMed

    Kubai, Melissa A; Labelle, Amber L; Hamor, Ralph E; Mutti, Donald O; Famula, Thomas R; Murphy, Christopher J

    2013-11-08

    We determined whether naturally-occurring lenticular myopia in English Springer spaniels (ESS) has a genetic component. Streak retinoscopy was performed on 226 related ESS 30 minutes after the onset of pharmacologic mydriasis and cycloplegia. A pedigree was constructed to determine relationships between affected offspring and parents. Estimation of heritability was done in a Bayesian analysis (facilitated by the MCMCglmm package of R) of refractive error in a model, including terms for sex and coat color. Myopia was defined as ≤-0.5 diopters (D) spherical equivalent. The median refractive error for ESS was 0.25 D (range, -3.5 to +4.5 D). Median age was 0.2 years (range, 0.1-15 years). The prevalence of myopia in related ESS was 19% (42/226). The ESS had a strong correlation (r = 0.95) for refractive error between the two eyes. Moderate heritability was present for refractive error with a mean value of 0.29 (95% highest probability density, 0.07-0.50). The distribution of refractive error, and subsequently lenticular myopia, has a moderate genetic component in ESS. Further investigation of genes responsible for regulation of the development of refractive ocular components in canines is warranted.

  13. A scalable and flexible hybrid energy storage system design and implementation

    NASA Astrophysics Data System (ADS)

    Kim, Younghyun; Koh, Jason; Xie, Qing; Wang, Yanzhi; Chang, Naehyuck; Pedram, Massoud

    2014-06-01

    Energy storage systems (ESS) are becoming one of the most important components that noticeably change overall system performance in various applications, ranging from the power grid infrastructure to electric vehicles (EV) and portable electronics. However, a homogeneous ESS is subject to limited characteristics in terms of cost, efficiency, lifetime, etc., by the energy storage technology that comprises the ESS. On the other hand, hybrid ESS (HESS) are a viable solution for a practical ESS with currently available technologies as they have potential to overcome such limitations by exploiting only advantages of heterogeneous energy storage technologies while hiding their drawbacks. However, the HESS concept basically mandates sophisticated design and control to actually make the benefits happen. The HESS architecture should be able to provide controllability of many parts, which are often fixed in homogeneous ESS, and novel management policies should be able to utilize the control features. This paper introduces a complete design practice of a HESS prototype to demonstrate scalability, flexibility, and energy efficiency. It is composed of three heterogenous energy storage elements: lead-acid batteries, lithium-ion batteries, and supercapacitors. We demonstrate a novel system control methodology and enhanced energy efficiency through this design practice.

  14. Sleep quality and disturbances in patients with different-sized rotator cuff tear.

    PubMed

    Gumina, S; Candela, V; Passaretti, D; Venditto, T; Mariani, L; Giannicola, G

    2016-12-01

    The literature is unanimous in saying that shoulder pain, due to rotator cuff tear (RCT), may be mostly at night; to our knowledge, this statement is not supported by scientific evidence. Our aim was to investigate sleep quality and disturbances in patient with RCT and in a control group. A case-control design study was used. We enrolled 324 consecutive patients (Group A) (156M-168F, mean age ± SD: 64.94 ± 6.97; range 47-74) who underwent arthroscopic rotator cuff repair. Tear size was determined intraoperatively. The control group (Group B) included 184 subjects (80M-104F, mean age ± SD = 63.34 ± 6.26; range 44-75) with no RCT. All participants were submitted to two standardized self-reported questionnaires evaluating sleep quality and disturbances: the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Data were submitted to statistics. We found no significant differences between the two groups according to both PSQI (Group A: 5.22 ± 2.59; Group B: 5.21 ± 2.39) and ESS (Group A: 2.59 ± 2.54; Group B: 5.76 ± 2.63), p > 0.05. Patients with small tears had average PSQI and ESS higher than patients with large and massive lesions (p < 0.005). Pearson's test showed that tear severity was negatively correlated with both sleep latency (r 2  = -0.35, β = 0.069, p < 0.005) and sleep disturbances (r 2  = -0.65, β = 0.053, p < 0.001). RCT is only one of the responsible causes for sleep disturbance in middle-aged and elderly subjects. Patients with small tears have a poorer sleep quality with respect to those with a more severe tear; particularly, they not only take more time to fall asleep, but also have a more disturbed sleep compared to patients with large and massive tears. III.

  15. Novel joint selection methods can reduce sample size for rheumatoid arthritis clinical trials with ultrasound endpoints.

    PubMed

    Allen, John C; Thumboo, Julian; Lye, Weng Kit; Conaghan, Philip G; Chew, Li-Ching; Tan, York Kiat

    2018-03-01

    To determine whether novel methods of selecting joints through (i) ultrasonography (individualized-ultrasound [IUS] method), or (ii) ultrasonography and clinical examination (individualized-composite-ultrasound [ICUS] method) translate into smaller rheumatoid arthritis (RA) clinical trial sample sizes when compared to existing methods utilizing predetermined joint sites for ultrasonography. Cohen's effect size (ES) was estimated (ES^) and a 95% CI (ES^L, ES^U) calculated on a mean change in 3-month total inflammatory score for each method. Corresponding 95% CIs [nL(ES^U), nU(ES^L)] were obtained on a post hoc sample size reflecting the uncertainty in ES^. Sample size calculations were based on a one-sample t-test as the patient numbers needed to provide 80% power at α = 0.05 to reject a null hypothesis H 0 : ES = 0 versus alternative hypotheses H 1 : ES = ES^, ES = ES^L and ES = ES^U. We aimed to provide point and interval estimates on projected sample sizes for future studies reflecting the uncertainty in our study ES^S. Twenty-four treated RA patients were followed up for 3 months. Utilizing the 12-joint approach and existing methods, the post hoc sample size (95% CI) was 22 (10-245). Corresponding sample sizes using ICUS and IUS were 11 (7-40) and 11 (6-38), respectively. Utilizing a seven-joint approach, the corresponding sample sizes using ICUS and IUS methods were nine (6-24) and 11 (6-35), respectively. Our pilot study suggests that sample size for RA clinical trials with ultrasound endpoints may be reduced using the novel methods, providing justification for larger studies to confirm these observations. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  16. Investigation of change in cardinal symptoms of chronic rhinosinusitis after surgical or ongoing medical management.

    PubMed

    DeConde, Adam S; Mace, Jess C; Alt, Jeremiah A; Soler, Zachary M; Orlandi, Richard R; Smith, Timothy L

    2015-01-01

    Chronic rhinosinusitis (CRS) has been defined as inflammation of the paranasal sinuses lasting at least 12 weeks with corresponding 2 or more "cardinal symptoms" that include: (1) nasal obstruction; (2) thick nasal discharge; (3) facial pain/pressure; and (4) reduction or loss of sense of smell. Although prior studies have investigated symptoms of CRS after sinus surgery, none have compared the outcomes of these specific symptoms to ongoing medical therapy. Patients with CRS were prospectively enrolled into a multi-institutional, comparative effectiveness, cohort study. Subjects elected either continued medical management or endoscopic sinus surgery (ESS). Baseline characteristics and objective clinical findings were collected. Cardinal symptoms of CRS were operationalized by 4 questions on the 22-item Sino-Nasal Outcome Test (SNOT-22). Symptom improvement was evaluated in subjects with at least 6-month follow-up. A total of 342 subjects were enrolled, with 69 (20.2%) electing continued medical management, whereas 273 (79.8%) elected ESS. Subjects electing surgical therapy were more likely to have a higher baseline aggregate SNOT-22 score (44.3 (18.9) vs 53.6 (18.8); p < 0.001). All subjects improved across all cardinal symptoms; however, subjects undergoing ESS were significantly more likely (p ≤ 0.013) to experience improvement in thick nasal discharge (odds ratio [OR] = 4.36), facial pain/pressure (OR = 3.56), and blockage/congestion of nose (OR = 2.76). Subjects with nasal polyposis were significantly more likely to report complete resolution of smell/taste following ESS compare to medical management (23.8% vs 4.0%; p = 0.026). Across a large population, surgical management is more effective at resolving the cardinal symptoms of CRS than ongoing medical management with the exception of sense of smell/taste. © 2014 ARS-AAOA, LLC.

  17. New light for old eyes: comparing melanopsin-mediated non-visual benefits of blue-light and UV-blocking intraocular lenses.

    PubMed

    Schmoll, Conrad; Khan, Ashraf; Aspinall, Peter; Goudie, Colin; Koay, Peter; Tendo, Christelle; Cameron, James; Roe, Jenny; Deary, Ian; Dhillon, Bal

    2014-01-01

    Melanopsin-expressing photosensitive retinal ganglion cells form a blue-light-sensitive non-visual system mediating diverse physiological effects including circadian entrainment and cognitive alertness. Reduced blue wavelength retinal illumination through cataract formation is thought to blunt these responses while cataract surgery and intraocular lens (IOL) implantation have been shown to have beneficial effects on sleep and cognition. We aimed to use the reaction time (RT) task and the Epworth Sleepiness Score (ESS) as a validated objective platform to compare non-visual benefits of UV- and blue-blocking IOLs. Patients were prospectively randomised to receive either a UV- or blue-blocking IOL, performing an RT test and ESS questionnaire before and after surgery. Optical blurring at the second test controlled for visual improvement. Non-operative age-matched controls were recruited for comparison. 80 participants completed the study. Those undergoing first-eye phacoemulsification demonstrated significant improvements in RT over control (p=0.001) and second-eye surgery patients (p=0.03). Moreover, reduced daytime sleepiness was measured by ESS for the first-eye surgery group (p=0.008) but not for the second-eye group (p=0.09). Choice of UV- or blue-blocking IOL made no significant difference to magnitude of cognitive improvement (p=0.272). Phacoemulsification, particularly first-eye surgery, has a strong positive effect on cognition and daytime alertness, regardless of IOL type.

  18. Benefit and risk of modafinil in idiopathic hypersomnia vs. narcolepsy with cataplexy.

    PubMed

    Lavault, Sophie; Dauvilliers, Yves; Drouot, Xavier; Leu-Semenescu, Smaranda; Golmard, Jean-Louis; Lecendreux, Michel; Franco, Patricia; Arnulf, Isabelle

    2011-06-01

    The benefit/risk ratio of modafinil was recently re-evaluated by the European Medicines Agency and was shown to be negative for idiopathic hypersomnia (IH) because of insufficient data. To evaluate the benefit/risk ratio of modafinil in idiopathic hypersomnia (with and without long sleep time) vs. narcolepsy/cataplexy. The benefit (Epworth sleepiness score, ESS; visual analog scale, patient and clinician opinions) and risks (habituation, adverse effects) of modafinil were studied in a consecutive clinical cohort of 104 IH patients (59 with long sleep time) and 126 patients with narcolepsy/cataplexy. Modafinil was the first line treatment in 96-99% of patients. It produced a similar ESS change in IH patients and in narcolepsy patients (-2.6±5.1 vs. -3±5.1) and a similar benefit as estimated by the patients (6.9±2.7 vs. 6.5±2.5 on a visual analog scale) and clinicians. The ESS change was lower in IH patients with long sleep time than in those without. Sudden loss of efficacy and habituation were rare in both groups. Patients with IH reported similar but more frequent adverse effects with modafinil than narcolepsy patients: nervousness (14%), palpitations (13%), and headache (11%). Modafinil has an excellent benefit/risk ratio in idiopathic hypersomnia, with or without long sleep time, similar to its effect on narcolepsy/cataplexy. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Electron shuttles in biotechnology.

    PubMed

    Watanabe, Kazuya; Manefield, Mike; Lee, Matthew; Kouzuma, Atsushi

    2009-12-01

    Electron-shuttling compounds (electron shuttles [ESs], or redox mediators) are essential components in intracellular electron transfer, while microbes also utilize self-produced and naturally present ESs for extracellular electron transfer. These compounds assist in microbial energy metabolism by facilitating electron transfer between microbes, from electron-donating substances to microbes, and/or from microbes to electron-accepting substances. Artificially supplemented ESs can create new routes of electron flow in the microbial energy metabolism, thereby opening up new possibilities for the application of microbes to biotechnology processes. Typical examples of such processes include halogenated-organics bioremediation, azo-dye decolorization, and microbial fuel cells. Herein we suggest that ESs can be applied widely to create new microbial biotechnology processes.

  20. Comparison of qubit and qutrit like entangled squeezed and coherent states of light

    NASA Astrophysics Data System (ADS)

    Najarbashi, G.; Mirzaei, S.

    2016-10-01

    Squeezed state of light is one of the important subjects in quantum optics which is generated by optical nonlinear interactions. In this paper, we especially focus on qubit like entangled squeezed states (ESS's) generated by beam splitters, phase-shifter and cross Kerr nonlinearity. Moreover the Wigner function of two-mode qubit and qutrit like ESS are investigated. We will show that the distances of peaks of Wigner functions for two-mode ESS are entanglement sensitive and can be a witness for entanglement. Like the qubit cases, monogamy inequality is fulfilled for qutrit like ESS. These trends are compared with those obtained for qubit and qutrit like entangled coherent states (ECS).

  1. PubMed Central

    Voultsos, P.; Casini, M.; Ricci, G.; Tambone, V.; Spagnolo, A.G.

    2017-01-01

    SUMMARY The aim of the present study is to propose legal reform limiting surgeons' criminal liability in high-accuracy and high-risk surgery such as endoscopic sinus surgery (ESS). The study includes a review of the medical literature, focusing on identifying and examining reasons why ESS carries a very high risk of serious complications related to inaccurate surgical manoeuvers and reviewing British and Italian legal theory and case-law on medical negligence, especially with regard to Italian Law 189/2012 (so called "Balduzzi" Law). It was found that serious complications due to inaccurate surgical manoeuvers may occur in ESS regardless of the skill, experience and prudence/diligence of the surgeon. Subjectivity should be essential to medical negligence, especially regarding high-accuracy surgery. Italian Law 189/2012 represents a good basis for the limitation of criminal liability resulting from inaccurate manoeuvres in high-accuracy surgery such as ESS. It is concluded that ESS surgeons should be relieved of criminal liability in cases of simple/ordinary negligence where guidelines have been observed. PMID:28374874

  2. Epistaxis grading in Osler's disease: comparison of comprehensive scores with detailed bleeding diaries.

    PubMed

    Parzefall, Thomas; Wolf, Axel; Frei, Klemens; Kaider, Alexandra; Riss, Dominik

    2017-03-01

    Use of reliable grading scores to measure epistaxis severity in hereditary hemorrhagic telangiectasia (HHT) is essential in clinical routine and for scientific purposes. For practical reasons, visual analog scale (VAS) scoring and the Epistaxis Severity Score (ESS) are widely used. VAS scores are purely subjective, and a potential shortcoming of the ESS is that it is based on self-reported anamnestic bleeding data. The aim of this study was to validate the level of correlation between VAS scores, the ESS, and actual bleeding events, based on detailed epistaxis diaries of patients. Records from daily epistaxis diaries maintained by 16 HHT patients over 112 consecutive days were compared with the monthly ESS and daily VAS scores in the corresponding time period. The Spearman rank correlation coefficient, analysis of variance models, and multiple R 2 measures were used for statistical analysis. Although the ESS and VAS scores generally showed a high degree of correlation with actual bleeding events, mild events were underrepresented in both scores. Our results highlight the usefulness of the ESS as a standard epistaxis score in cohorts with moderate to severe degrees of epistaxis. The use of detailed epistaxis diaries should be considered when monitoring patients and cohorts with mild forms of HHT. © 2016 ARS-AAOA, LLC.

  3. Ethmoidectomy combined with superior meatus enlargement increases olfactory airflow

    PubMed Central

    Kondo, Kenji; Nomura, Tsutomu; Yamasoba, Tatsuya

    2017-01-01

    Objectives The relationship between a particular surgical technique in endoscopic sinus surgery (ESS) and airflow changes in the post‐operative olfactory region has not been assessed. The present study aimed to compare olfactory airflow after ESS between conventional ethmoidectomy and ethmoidectomy with superior meatus enlargement, using virtual ESS and computational fluid dynamics (CFD) analysis. Study Design Prospective computational study. Materials and Methods Nasal computed tomography images of four adult subjects were used to generate models of the nasal airway. The original preoperative model was digitally edited as virtual ESS by performing uncinectomy, ethmoidectomy, antrostomy, and frontal sinusotomy. The following two post‐operative models were prepared: conventional ethmoidectomy with normal superior meatus (ESS model) and ethmoidectomy with superior meatus enlargement (ESS‐SM model). The calculated three‐dimensional nasal geometries were confirmed using virtual endoscopy to ensure that they corresponded to the post‐operative anatomy observed in the clinical setting. Steady‐state, laminar, inspiratory airflow was simulated, and the velocity, streamline, and mass flow rate in the olfactory region were compared among the preoperative and two postoperative models. Results The mean velocity in the olfactory region, number of streamlines bound to the olfactory region, and mass flow rate were higher in the ESS‐SM model than in the other models. Conclusion We successfully used an innovative approach involving virtual ESS, virtual endoscopy, and CFD to assess postoperative outcomes after ESS. It is hypothesized that the increased airflow to the olfactory fossa achieved with ESS‐SM may lead to improved olfactory function; however, further studies are required. Level of Evidence NA. PMID:28894833

  4. Enhanced syndromic surveillance for mass gatherings in the Pacific: a case study of the 11th Festival of Pacific Arts in Solomon Islands, 2012.

    PubMed

    Hoy, Damian; Saketa, Salanieta T; Maraka, Roy Roger; Sio, Alison; Wanyeki, Ian; Frison, Pascal; Ogaoga, Divi; Iniakawala, Dennie; Joshua, Cynthia; Duituturaga, Sala; Lepers, Christelle; Roth, Adam; White, Paul; Souares, Yvan

    2016-01-01

    Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere. In July 2012, the 11th Festival of Pacific Arts (FOPA), a mass gathering event involving 22 Pacific island states and territories, was hosted by Solomon Islands. An enhanced syndromic surveillance (ESS) system was implemented for the event. Throughout the capital city, Honiara, 15 sentinel sites were established and successfully took part in the ESS system, which commenced one week before the FOPA (25 June) and concluded eight days after the event (22 July). The ESS involved expanding on the existing syndromic surveillance parameters: from one to 15 sentinel sites, from four to eight syndromes, from aggregated to case-based reporting and from weekly to daily reporting. A web-based system was developed to enable data entry, data storage and data analysis. Towards the end of the ESS period, a focus group discussion and series of key informant interviews were conducted. The ESS was considered a success and played an important role in the early detection of possible outbreaks. For the period of the ESS, 1668 patients with syndrome presentations were received across the 15 sentinel sites. There were no major events of public health significance. Several lessons were learnt that are relevant to ESS in mass gathering scenarios, including the importance of having adequate lead in time for engagement and preparation to ensure appropriate policy and institutional frameworks are put in place.

  5. Comparison of Nutech Functional Score with European Stroke Scale for Patients with Cerebrovascular Accident Treated with Human Embryonic Stem Cells: NFS for CVA Patients Treated with hESCs.

    PubMed

    Shroff, Geeta

    2017-06-01

    Stem cell therapy is a promising modality for treatment of patients with chronic cerebrovascular accident (CVA) in whom treatment other than physiotherapy or occupational therapy does not address the repair or recovery of the lost function. In this study, the author aimed at evaluating CVA patients treated with human embryonic stem cell (hESC) therapy and comparing their study outcomes with globally accepted European Stroke Scale (ESS) to that with novel scoring system, Nutech functional score (NFS), a 21-point positional and directional scoring system for assessing patients with CVA. Patients diagnosed with CVA were assessed with NFS and ESS before and after hESC therapy. NFS assessed the patients in the direction of 1-5 (bad to good), where 5 was considered as the highest possible grade (HPG). The findings were obtained for the patients who scored HPG, and had shown improvement by at least one grade. Overall, 66.7% of patients scored HPG level on the NFS scale and about 62.5% of the patients scored HPG according to the ESS scale. Approximately, 52.2% patients showed an improvement of 100% (by at least one grade) on NFS scale. None of the patients showed 100% improvement in the alteration of the score by at least one grade when scored with ESS. NFS and ESS scores show that a large population of CVA patients was benefitted with hESC therapy. NFS was found to give more convincing results than ESS, and overcomes the shortcomings of ESS.

  6. Enhanced syndromic surveillance for mass gatherings in the Pacific: a case study of the 11th Festival of Pacific Arts in Solomon Islands, 2012

    PubMed Central

    Hoy, Damian; Saketa, Salanieta T; Maraka, Roy Roger; Sio, Alison; Wanyeki, Ian; Frison, Pascal; Ogaoga, Divi; Iniakawala, Dennie; Joshua, Cynthia; Duituturaga, Sala; Lepers, Christelle; Roth, Adam; White, Paul; Souares, Yvan

    2016-01-01

    Mass gatherings pose public health challenges to host countries, as they can cause or exacerbate disease outbreaks within the host location or elsewhere. In July 2012, the 11th Festival of Pacific Arts (FOPA), a mass gathering event involving 22 Pacific island states and territories, was hosted by Solomon Islands. An enhanced syndromic surveillance (ESS) system was implemented for the event. Throughout the capital city, Honiara, 15 sentinel sites were established and successfully took part in the ESS system, which commenced one week before the FOPA (25 June) and concluded eight days after the event (22 July). The ESS involved expanding on the existing syndromic surveillance parameters: from one to 15 sentinel sites, from four to eight syndromes, from aggregated to case-based reporting and from weekly to daily reporting. A web-based system was developed to enable data entry, data storage and data analysis. Towards the end of the ESS period, a focus group discussion and series of key informant interviews were conducted. The ESS was considered a success and played an important role in the early detection of possible outbreaks. For the period of the ESS, 1668 patients with syndrome presentations were received across the 15 sentinel sites. There were no major events of public health significance. Several lessons were learnt that are relevant to ESS in mass gathering scenarios, including the importance of having adequate lead in time for engagement and preparation to ensure appropriate policy and institutional frameworks are put in place. PMID:27766181

  7. A new methodology for accurate 3-dimensional coronary artery reconstruction using routine intravascular ultrasound and angiographic data: implications for widespread assessment of endothelial shear stress in humans.

    PubMed

    Bourantas, Christos V; Papafaklis, Michail I; Athanasiou, Lambros; Kalatzis, Fanis G; Naka, Katerina K; Siogkas, Panagiotis K; Takahashi, Saeko; Saito, Shigeru; Fotiadis, Dimitrios I; Feldman, Charles L; Stone, Peter H; Michalis, Lampros K

    2013-09-01

    To develop and validate a new methodology that allows accurate 3-dimensional (3-D) coronary artery reconstruction using standard, simple angiographic and intravascular ultrasound (IVUS) data acquired during routine catheterisation enabling reliable assessment of the endothelial shear stress (ESS) distribution. Twenty-two patients (22 arteries: 7 LAD; 7 LCx; 8 RCA) who underwent angiography and IVUS examination were included. The acquired data were used for 3-D reconstruction using a conventional method and a new methodology that utilised the luminal 3-D centreline to place the detected IVUS borders and anatomical landmarks to estimate their orientation. The local ESS distribution was assessed by computational fluid dynamics. In corresponding consecutive 3 mm segments, lumen, plaque and ESS measurements in the 3-D models derived by the centreline approach were highly correlated to those derived from the conventional method (r>0.98 for all). The centreline methodology had a 99.5% diagnostic accuracy for identifying segments exposed to low ESS and provided similar estimations to the conventional method for the association between the change in plaque burden and ESS (centreline method: slope= -1.65%/Pa, p=0.078; conventional method: slope= -1.64%/Pa, p=0.084; p =0.69 for difference between the two methodologies). The centreline methodology provides geometrically correct models and permits reliable ESS computation. The ability to utilise data acquired during routine coronary angiography and IVUS examination will facilitate clinical investigation of the role of local ESS patterns in the natural history of coronary atherosclerosis.

  8. Echocardiographic assessments of longitudinal left ventricular function in healthy English Springer spaniels.

    PubMed

    Dickson, D; Shave, R; Rishniw, M; Patteson, M

    2017-08-01

    To establish reference intervals for echocardiographic measures of longitudinal left ventricular function in adult English Springer spaniel (ESS) dogs. This study involved 42 healthy adult ESS. Animals were prospectively recruited from a general practice population in the United Kingdom. Dogs were examined twice, at least 12 months apart, to exclude dogs with progressive cardiac disease. Mitral annular plane systolic excursion, tissue Doppler imaging mitral annular velocities and two-dimensional speckle-tracking echocardiographic left ventricular longitudinal strain and strain rate were measured. Intraoperator and intraobserver variability were examined and reference intervals were calculated. The potential effects of body weight, age and heart rate on these variables were examined. Intraoperator and intraobserver variability was <10% for all parameters except tissue Doppler imaging E' (the peak velocity of early diastolic mitral annular motion as determined by pulsed wave Doppler) and two-dimensional speckle-tracking echocardiographic variables, which were all <20%. Thirty-nine dogs were used to create reference intervals. Significant (but mostly weak) effects of age, heart rate and body weight on were detected. Reference intervals were similar to previously published values in different breeds. Breed specific reference intervals for measures of longitudinal left ventricular function in the ESS are presented. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Character and Implications of a Newly Identified Creeping Strand of the San Andreas fault NE of Salton Sea, Southern California

    NASA Astrophysics Data System (ADS)

    Janecke, S. U.; Markowski, D.

    2015-12-01

    The overdue earthquake on the Coachella section, San Andreas fault (SAF), the model ShakeOut earthquake, and the conflict between cross-fault models involving the Extra fault array and mapped shortening in the Durmid Hill area motivate new analyses at the southern SAF tip. Geologic mapping, LiDAR, seismic reflection, magnetic and gravity datasets, and aerial photography confirm the existence of the East Shoreline strand (ESS) of the SAF southwest of the main trace of the SAF. We mapped the 15 km long ESS, in a band northeast side of the Salton Sea. Other data suggest that the ESS continues N to the latitude of the Mecca Hills, and is >35 km long. The ESS cuts and folds upper Holocene beds and appears to creep, based on discovery of large NW-striking cracks in modern beach deposits. The two traces of the SAF are parallel and ~0.5 to ~2.5 km apart. Groups of east, SE, and ENE-striking strike-slip cross-faults connect the master dextral faults of the SAF. There are few sinistral-normal faults that could be part of the Extra fault array. The 1-km wide ESS contains short, discontinuous traces of NW-striking dextral-oblique faults. These en-echelon faults bound steeply dipping Pleistocene beds, cut out section, parallel tight NW-trending folds, and produced growth folds. Beds commonly dip toward the ESS on both sides, in accord with persistent NE-SW shortening across the ESS. The dispersed fault-fold structural style of the ESS is due to decollements in faulted mud-rich Pliocene to Holocene sediment and ramps and flats along the strike-slip faults. A sheared ladder-like geometric model of the two master dextral strands of the SAF and their intervening cross-faults, best explains the field relationships and geophysical datasets. Contraction across >40 km2 of the southernmost SAF zone in the Durmid Hills suggest that interaction of active structures in the SAF zone may inhibit the nucleation of large earthquakes in this region. The ESS may cross the northern Coachella Valley to join the blind Palm Spring dextral fault- a source of microearthquakes and differential subsidence. The ESS may also continue north parallel to the margin of the Salton Trough or have both a NW and NE branch. The risk of a future large earthquake directly beneath the greater Palm Springs metropolitan area may be larger if the first or last options are correct.

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

    Conover, David R.

    This report acquaints stakeholders and interested parties involved in the development and/or deployment of energy storage systems (ESS) with the subject of safety-related codes, standards and regulations (CSRs). It is hoped that users of this document gain a more in depth and uniform understanding of safety-related CSR development and deployment that can foster improved communications among all ESS stakeholders and the collaboration needed to realize more timely acceptance and approval of safe ESS technology through appropriate CSR.

  11. Extravehicular activity translation arm (EVATA) study

    NASA Technical Reports Server (NTRS)

    Preiswerk, P. R.; Stammreich, J. R.

    1978-01-01

    The preliminary design of a deployable Extravehicular Activity Translation Arm (EVATA) assembly which will allow an EVA crewman to perform tasks in the vicinity of the External TNK (ET) umbilical doors and to inspect most of the underside of the shuttle spacecraft is reported. The concept chosen for the boom structure was the Astro Extendable Support Structure (ESS) which formed the main structure for the Synthetic Aperture Radar (SAR) Antenna System on the SEASAT A spacecraft. This structure is a deployable triangular truss. A comparison of the EVATA and the SEASAT A ESS is shown. The development of status of the ESS is shown. The satellite configuration, the stowed truss load path, and the envelope deployment sequence for the ESS are also shown.

  12. Lack of association between MAOA-uVNTR variants and excessive daytime sleepiness.

    PubMed

    Ozen, Filiz; Yegin, Zeynep; Yavlal, Figen; Saglam, Zuhal Aydan; Koc, Haydar; Berber, Ismet

    2017-05-01

    Sleep disorders are highly prevalent in the population and have dramatic health, social, and economic impacts. However, their treatments may remain symptomatic due to ignorance of molecular factors which may provide fundamental insights into the neurological bases of sleep. Excessive daytime sleepiness (EDS) is a common complaint encountered in neurological practice with significant effects both on individuals and on society. We aimed to investigate the role of monoamine oxidase A (MAOA) as a candidate gene in EDS. Epworth sleepiness scale (ESS) was applied to 221 subjects who were also genotyped for MAOA upstream variable number of tandem repeats (MAOA-uVNTR). Patient group displayed higher ESS values (mean 12.67) when compared with the control group (mean 6.38). However, MAOA-uVNTR genotypes did not show a significant association with ESS scores neither on women nor on men. Finally, these data suggest further replications in different populations. Moreover, the investigation of some other genes together with MAOA and/or some possible regulatory molecular mechanisms may offer a more comprehensive approach in the role of genetic factors contributing to EDS.

  13. Comparison of the effects of continuous positive airway pressure and mandibular advancement devices on sleepiness in patients with obstructive sleep apnoea: a network meta-analysis.

    PubMed

    Bratton, Daniel J; Gaisl, Thomas; Schlatzer, Christian; Kohler, Malcolm

    2015-11-01

    Excessive daytime sleepiness is the most important symptom of obstructive sleep apnoea and can affect work productivity, quality of life, and the risk of road traffic accidents. We aimed to quantify the effects of the two main treatments for obstructive sleep apnoea (continuous positive airway pressure and mandibular advancement devices) on daytime sleepiness and to establish predictors of response to continuous positive airway pressure. We searched MEDLINE and the Cochrane Library from inception to May 31, 2015, to identify randomised controlled trials comparing the effects of continuous positive airway pressure, mandibular advancement devices or an inactive control (eg, placebo or no treatment) on the Epworth Sleepiness Scale (ESS, range 0-24 points) in patients with obstructive sleep apnoea. We did a network meta-analysis using multivariate random-effects meta-regression to assess the effect of each treatment on ESS. We used meta-regression to assess the association of the reported effects of continuous positive airway pressure versus inactive controls with the characteristics of trials and their risk of bias. We included 67 studies comprising 6873 patients in the meta-analysis. Compared with an inactive control, continuous positive airway pressure was associated with a reduction in ESS score of 2·5 points (95% CI 2·0-2·9) and mandibular advancement devices of 1·7 points (1·1-2·3). We estimated that, on average, continuous positive airway pressure reduced the ESS score by a further 0·8 points compared with mandibular advancement devices (95% CI 0·1-1·4; p=0·015). However, there was a possibility of publication bias in favour of continuous positive airway pressure that might have resulted in this difference. We noted no evidence that studies reporting higher continuous positive airway pressure adherence also reported larger treatment effects (p=0·70). Continuous positive airway pressure and mandibular advancement devices are effective treatments for reducing daytime sleepiness in patients with obstructive sleep apnoea. Continuous positive airway pressure seemed to be a more effective treatment than mandibular advancement devices, and had an increasingly larger effect in more severe or sleepier obstructive sleep apnoea patients when compared with inactive controls. However, mandibular advancement devices are an effective alternative treatment should continuous positive airway pressure not be tolerated. Swiss National Science Foundation and the University of Zurich Clinical Research Priority Program Sleep and Health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Evolution of proliferation and the angiogenic switch in tumors with high clonal diversity.

    PubMed

    Bickel, Scott T; Juliano, Joseph D; Nagy, John D

    2014-01-01

    Natural selection among tumor cell clones is thought to produce hallmark properties of malignancy. Efforts to understand evolution of one such hallmark--the angiogenic switch--has suggested that selection for angiogenesis can "run away" and generate a hypertumor, a form of evolutionary suicide by extreme vascular hypo- or hyperplasia. This phenomenon is predicted by models of tumor angiogenesis studied with the techniques of adaptive dynamics. These techniques also predict that selection drives tumor proliferative potential towards an evolutionarily stable strategy (ESS) that is also convergence-stable. However, adaptive dynamics are predicated on two key assumptions: (i) no more than two distinct clones or evolutionary strategies can exist in the tumor at any given time; and (ii) mutations cause small phenotypic changes. Here we show, using a stochastic simulation, that relaxation of these assumptions has no effect on the predictions of adaptive dynamics in this case. In particular, selection drives proliferative potential towards, and angiogenic potential away from, their respective ESSs. However, these simulations also show that tumor behavior is highly contingent on mutational history, particularly for angiogenesis. Individual tumors frequently grow to lethal size before the evolutionary endpoint is approached. In fact, most tumor dynamics are predicted to be in the evolutionarily transient regime throughout their natural history, so that clinically, the ESS is often largely irrelevant. In addition, we show that clonal diversity as measured by the Shannon Information Index correlates with the speed of approach to the evolutionary endpoint. This observation dovetails with results showing that clonal diversity in Barrett's esophagus predicts progression to malignancy.

  15. Developing Earth System Science Courses and Programs at Minority Serving Institutions

    NASA Astrophysics Data System (ADS)

    Johnson, D. R.; Jackson, C.; Ruzek, M.

    2004-12-01

    In the current NASA/USRA ESSE21 Program, emphasis is placed on the development of Earth System Science courses and degree offerings in Minority Serving Institutions (MSIs). Of the 18 colleges/universities being supported by NASA through USRA, 10 colleges/universities are MSIs. While there is recognition of the need for Earth system science courses, minors and degree programs by NASA and other agencies, within MSIs, a central challenge is how to provide a vision of the future opportunities in ESS and STEM disciplines that attracts and motivates students to these studies. Students need career guidance, role models and mentoring to encourage entry into STEM in general, and Earth system science in particular. Then there is the question of how to bring interested faculty together in institutions to form a critical mass that would forego the breadth and depth of disciplinary interests to undertake the development of multi/cross and interdisciplinary courses, minors and degree programs in ESS. Within the ESSE21 Diversity Working Group, the question has been raised as to how will MSIs ever be mainstream participants in ESS without teaching and engaging in research in remote sensing, modeling of the Earth's climate system and other like endeavors. Two other related questions raised within the Working Group are what are the long-term objectives of MSI adoption of ESS and what course corrections are needed to make ESS viable at MSIs. Within these considerations there are unresolved questions concerning the need and availability of resources from NASA, other agencies and local institutions. Apart from these larger considerations, efforts are underway within the ESSE21 Program that provide for sharing of resources among participants, organization of and access to materials that already exist, online resources, course outlines and successful listings for online resources by topics for particular courses and subject areas. The Lesson Learned Working Group, as well as the program office continue with efforts in organization of the resources to foster availability and utilization. Then there is the emphasis on educational assessment, formative, ongoing and summative by the Evaluation Working Group. These challenges, questions and Working Group activities will be briefly reviewed in relation to the collaborative development of Earth System Science and STEM education within ESSE21 and its current focus on MSIs.

  16. Local rhamnosoft, ceramides and L-isoleucine in atopic eczema: a randomized, placebo controlled trial

    PubMed Central

    Marseglia, Alessia; Licari, Amelia; Agostinis, Fabio; Barcella, Antonio; Bonamonte, Domenico; Puviani, Mario; Milani, Massimo; Marseglia, GianLuigi

    2014-01-01

    Background A non-steroidal, anti-inflammatory moisturizing cream containing rhamnosoft, ceramides, and L-isoleucine (ILE) (pro-AMP cream) has been recently developed for the specific treatment of atopic eczema (AE) of the face. In this trial, we evaluated the clinical efficacy and tolerability of pro-AMP cream in the treatment of facial AE in children in comparison with an emollient cream. Methods In a randomized, prospective, assessor-blinded, parallel groups (2:1) controlled trial, 107 children (72 allocated to pro-AMP cream and 35 allocated to control group) with mild-to-moderate chronic AE of the face were enrolled. Treatments were applied twice daily for a 6-week period. Facial Eczema Severity Score (ESS) was evaluated at baseline, week 3, and week 6, by an assessor unaware of treatment allocation. Investigator's Global Assessment (IGA) score was assessed at week 3 and at week 6. Tolerability was evaluated at week 3 and at week 6 using a 4-point score (from 0: low tolerability to 3: very good tolerability). Results At baseline ESS, mean (SD) was 6.1 (2.4) in the pro-AMP cream group and 5.3 (3) in the control group. In the pro-AMP group, in comparison with baseline, ESS was significantly reduced to 2.5 (−59%) after 3 wks and to 1.0 (−84%) at week 6 (p = 0.0001). In the control group, ESS was reduced to 3 (−42%) at week 2 and to 2.6 (−50%) at week 6. At week 6, ESS in pro-AMP cream was significantly lower than the control group (1.0 vs. 2.6; p = 0.001). Both products were well tolerated. Conclusion Pro-AMP cream has shown to be effective in the treatment of mild-to-moderate chronic lesion of AE of the face. Clinical efficacy was greater in comparison with an emollient cream. (Clinical trial Registry: NTR4084). PMID:24750568

  17. Bipolar microdebrider may reduce intraoperative blood loss and operating time during nasal polyp surgery.

    PubMed

    Kumar, Nishant; Sindwani, Raj

    2012-08-01

    Bleeding during endoscopic sinus surgery (ESS) can interrupt the flow of the procedure and increase the risk of complications. Advances in microdebrider design now allow for bleeding to be controlled by bipolar energy during the suctioning and shaving of polyps. We conducted a retrospective study to examine the effects of this technology on blood loss and operating times during ESS for chronic rhinosinusitis with nasal polyps (CRS+P). Our patient population was made up of 80 patients who had undergone ESS for CRS+P by the same surgeon from January 2007 through May 2008. All surgeries were performed with either the PK diego bipolar microdebrider (Gyrus ACMI, ENT Division; Bartlett, Tenn.) or a standard microdebrider. There were 40 patients in each group. The PK group was made up of 23 males and 17 females, aged 14 to 66 years (mean: 43.1), and the control group included 21 males and 19 females, aged 17 to 71 years (mean: 43.1); there were no statistically significant differences between the two groups in terms of sex and age. In addition to demographic data, the charts were reviewed for comorbidities and operative variables; the latter included blood loss, operating room (OR) time, and complications. The preoperative treatment and anesthesia protocols were similar for all patients, and all patients demonstrated a similar disease burden on imaging (mean Harvard CT stage: 3.12 for the PK group and 3.15 for the controls; p > 0.05). We found that during ESS, the PK group experienced significantly less intraoperative blood loss than did the controls (means: 86.0 and 123.0 ml, respectively; p = 0.015). In addition, the PK device was associated with significantly shorter OR times (means: 88.9 and 101.4 min, respectively; p = 0.026). There were no complications in either group. We conclude that using a microdebrider with bipolar capabilities during ESS may offer the advantages of less blood loss and shorter operating times in patients with nasal polyps.

  18. An ESS maximum principle for matrix games.

    PubMed

    Vincent, T L; Cressman, R

    2000-11-01

    Previous work has demonstrated that for games defined by differential or difference equations with a continuum of strategies, there exists a G-function, related to individual fitness, that must take on a maximum with respect to a virtual variable v whenever v is one of the vectors in the coalition of vectors which make up the evolutionarily stable strategy (ESS). This result, called the ESS maximum principle, is quite useful in determining candidates for an ESS. This principle is reformulated here, so that it may be conveniently applied to matrix games. In particular, we define a matrix game to be one in which fitness is expressed in terms of strategy frequencies and a matrix of expected payoffs. It is shown that the G-function in the matrix game setting must again take on a maximum value at all the strategies which make up the ESS coalition vector. The reformulated maximum principle is applicable to both bilinear and nonlinear matrix games. One advantage in employing this principle to solve the traditional bilinear matrix game is that the same G-function is used to find both pure and mixed strategy solutions by simply specifying an appropriate strategy space. Furthermore we show how the theory may be used to solve matrix games which are not in the usual bilinear form. We examine in detail two nonlinear matrix games: the game between relatives and the sex ratio game. In both of these games an ESS solution is determined. These examples not only illustrate the usefulness of this approach to finding solutions to an expanded class of matrix games, but aids in understanding the nature of the ESS as well.

  19. Bacteria, phages, and pigs: the effects of in-feed antibiotics on the microbiome at different gut locations

    USDA-ARS?s Scientific Manuscript database

    Disturbance of the beneficial gut microbial community is one collateral effect of antibiotics, which have many uses in animal agriculture (disease treatment or prevention and feed efficiency improvement). Antibiotic effects on bacterial communities at different intestinal locations are perhaps esse...

  20. Quantitative Digital Autoradiography for Environmental Swipe Sample Prioritization: System design, Characterization, and Initial Measurements

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

    McDonald, Benjamin S.; Zalavadia, Mital A.; Miller, Brian W.

    Environmental sampling and sample analyses by the International Atomic Energy Agency’s (IAEA) Network of Analytical Laboratories (NWAL) is a critical technical tool used to detect facility misuse under a Comprehensive Safeguards Agreement and to verify the absence of undeclared nuclear material activities under an Additional Protocol. Currently all environmental swipe samples (ESS) are screened using gamma spectrometry and x-ray fluorescence to estimate the amount of U and/or Pu in the ESS, to guide further analysis, and to assist in the shipment of ESS to the NWAL. Quantitative Digital Autoradiography for Environmental Samples (QDARES) is being developed to complement existing techniquesmore » through the use of a portable, real-time, high-spatial-resolution camera called the Ionizing-radiation Quantum Imaging Detector (iQID). The iQID constructs a spatial map of radionuclides within a sample or surface in real-time as charged particles (betas) and photons (gamma/x-rays) are detected and localized on an event-by-event basis. Knowledge of the location and nature of radioactive hot spots on the ESS could provide information for subsequent laboratory analysis. As a nondestructive technique, QDARES does not compromise the ESS chain of custody or subsequent laboratory analysis. In this paper we will present the system design and construction, characterization measurements with calibration sources, and initial measurements of ESS.« less

  1. A proposal for limited criminal liability in high-accuracy endoscopic sinus surgery.

    PubMed

    Voultsos, P; Casini, M; Ricci, G; Tambone, V; Midolo, E; Spagnolo, A G

    2017-02-01

    The aim of the present study is to propose legal reform limiting surgeons' criminal liability in high-accuracy and high-risk surgery such as endoscopic sinus surgery (ESS). The study includes a review of the medical literature, focusing on identifying and examining reasons why ESS carries a very high risk of serious complications related to inaccurate surgical manoeuvers and reviewing British and Italian legal theory and case-law on medical negligence, especially with regard to Italian Law 189/2012 (so called "Balduzzi" Law). It was found that serious complications due to inaccurate surgical manoeuvers may occur in ESS regardless of the skill, experience and prudence/diligence of the surgeon. Subjectivity should be essential to medical negligence, especially regarding high-accuracy surgery. Italian Law 189/2012 represents a good basis for the limitation of criminal liability resulting from inaccurate manoeuvres in high-accuracy surgery such as ESS. It is concluded that ESS surgeons should be relieved of criminal liability in cases of simple/ordinary negligence where guidelines have been observed. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  2. Improved design of proton source and low energy beam transport line for European Spallation Source

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

    Neri, L., E-mail: neri@lns.infn.it; Celona, L.; Gammino, S.

    2014-02-15

    The design update of the European Spallation Source (ESS) accelerator is almost complete and the construction of the prototype of the microwave discharge ion source able to provide a proton beam current larger than 70 mA to the 3.6 MeV Radio Frequency Quadrupole (RFQ) started. The source named PS-ESS (Proton Source for ESS) was designed with a flexible magnetic system and an extraction system able to merge conservative solutions with significant advances. The ESS injector has taken advantage of recent theoretical updates and new plasma diagnostics tools developed at INFN-LNS (Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare). Themore » design strategy considers the PS-ESS and the low energy beam transport line as a whole, where the proton beam behaves like an almost neutralized non-thermalized plasma. Innovative solutions have been used as hereinafter described. Thermo-mechanical optimization has been performed to withstand the chopped beam and the misaligned focused beam over the RFQ input collimator; the results are reported here.« less

  3. Opportunity to Participate in ESSE 21: The 2003 Call for Participation

    NASA Astrophysics Data System (ADS)

    Ruzek, M.; Johnson, D. R.

    2003-12-01

    Earth System Science Education for the 21st Century (ESSE 21), sponsored by NASA through the Universities Space Research Association (USRA), is a collaborative undergraduate/graduate education program offering small grants to colleges and universities to engage a diverse interdisciplinary community of faculty and scientists in the development of courses, curricula and degree programs and sharing of learning resources focused on the fundamental understanding and application of Earth system principles for the classroom and laboratory. Through an expanded focus including partnerships with minority institutions, ESSE 21 is further developing broadly based courses, educational resources, electronic learning materials and degree programs that extend Earth system science concepts in both undergraduate and graduate classrooms and laboratories. These resources emphasizing the fundamentals of Earth system science advance the nation's broader agenda for improving science, technology, engineering and mathematics competency. The thrust to establish Earth system and global change science within the classrooms of colleges and universities is critical to laying and extending the foundation for knowledge-based decision making in the 21st century by both scientists and society in an effort to achieve sustainability. ESSE 21 released a Call for Participation (CFP) in the Fall of 2002 soliciting proposals from undergraduate institutions to create and adopt undergraduate and graduate level Earth system science content in courses, curricula and degree programs. In February 2003, twelve college and university teams were competitively selected through the CFP as the Year 1 and Year 2 Program participants. Eight of the participating teams are from minority institutions. The goal for all is to effect systemic change through developing Earth system science learning materials, courses, curricula, degree tracks or programs, and departments that are self-sustaining in the coming decades. ESSE 21 offers an expanded infrastructure for an interactive community of educators and researchers including minority participants that develops interdisciplinary Earth system science content. Emphasis is on the utilization of NASA resources involving global change data, models, visualizations and electronic media and networks. The ultimate aim of ESSE 21 is to expand and accelerate the nation's realization of sound, scientific interdisciplinary educational resources for informed learning and decision-making by all from the perspective of sustainability of the Earth as a system. The next Call for Participation will be released in late 2003.

  4. Regenerative fuel cell systems for mid- to high-orbit satellites

    NASA Technical Reports Server (NTRS)

    Taenaka, R. K.; Adler, E.; Stofel, E. J.; Clark, K. B.

    1987-01-01

    An assessment of the present and projected capabilities of selected hydrogen-oxygen and hydrogen-halogen fuel cell and electrolyzer combinations for energy storage systems (ESS) in configurations useful for spacecraft missions operating in the 10- to 50-kW range for many years in midaltitude to geosynchronous orbits has recently been completed. Results of the study indicate that regenerative fuel cell ESS are feasible for the intended application. A computer model was used to provide tradeoff analyses for optimizing the various ESS fuel cell concepts. When appropriately configured to be compatible with the mission needs of the selected model spacecraft, the specific energy for these ESS are intermediate between that presently available for nickel-hydrogen batteries and that expected for the newly emerging sodium-sulfur technology.

  5. Beam commission of the high intensity proton source developed at INFN-LNS for the European Spallation Source

    NASA Astrophysics Data System (ADS)

    Neri, L.; Celona, L.; Gammino, S.; Miraglia, A.; Leonardi, O.; Castro, G.; Torrisi, G.; Mascali, D.; Mazzaglia, M.; Allegra, L.; Amato, A.; Calabrese, G.; Caruso, A.; Chines, F.; Gallo, G.; Longhitano, A.; Manno, G.; Marletta, S.; Maugeri, A.; Passarello, S.; Pastore, G.; Seminara, A.; Spartà, A.; Vinciguerra, S.

    2017-07-01

    At the Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali del Sud (INFN-LNS) the beam commissioning of the high intensity Proton Source for the European Spallation Source (PS-ESS) started in November 2016. Beam stability at high current intensity is one of the most important parameter for the first steps of the ongoing commissioning. Promising results were obtained since the first source start with a 6 mm diameter extraction hole. The increase of the extraction hole to 8 mm allowed improving PS-ESS performances and obtaining the values required by the ESS accelerator. In this work, extracted beam current characteristics together with Doppler shift and emittance measurements are presented, as well as the description of the next phases before the installation at ESS in Lund.

  6. Parent and Friend Social Support and Adolescent Hope.

    PubMed

    Mahon, Noreen E; Yarcheski, Adela

    2017-04-01

    The purpose of this study was to conduct two meta-analyses. The first examined social support from parents in relation to adolescent hope, and the second examined social support from friends in relation to adolescent hope. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the literature reviewed, nine published studies or doctoral dissertations completed between 1990 and 2014 met the inclusion criteria. Using meta-analytic techniques and the mean weighted r statistic, the results indicated that social support from friends had a stronger mean effect size (ES = .31) than social support from parents (ES = .21); there was a statistically significant difference between the two ESs. Two of the four moderators for the parent social support-adolescent hope relationship were statistically significant. They were quality score and health status. Implications for school nurses and nurses in all settings are addressed, and conclusions are drawn based on the findings.

  7. Efficacy of chitosan dressing on endoscopic sinus surgery: a systematic review and meta-analysis.

    PubMed

    Zhou, Jing-Chun; Zhang, Jing-Jing; Zhang, Wei; Ke, Zhao-Yang; Zhang, Bo

    2017-09-01

    Chitosan dressing might be promising to promote the recovery following endoscopic sinus surgery (ESS). However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the influence of chitosan dressing on ESS. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of chitosan dressing on endoscopic sinus surgery were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were synechia and hemostasis. Meta-analysis was performed using random-effect model. Four RCTs involving 268 patients were included in the meta-analysis. Overall following ESS, compared with control intervention, chitosan dressing significantly reduced synechia (RR = 0.25; 95% CI 0.13-0.49; P < 0.0001) and promoted hemostasis (RR = 1.70; 95% CI 1.37-2.11; P < 0.00001), but showed no impact on granulations (RR = 1.18; 95% CI 0.72-1.95; P = 0.52), mucosal edema (RR = 0.88; 95% CI 0.60-1.29; P = 0.51), crusting (RR = 0.85; 95% CI 0.48-1.53; P = 0.60), and infection (RR = 0.88; 95% CI 0.51-1.52; P = 0.64). Compared to control intervention, chitosan dressing could significantly decrease edema and improve hemostasis, but had no effect on granulations, mucosal edema, crusting and infection.

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

    Lindroos M.; Calaga R.; Bousson S.

    In 2003 the joint European effort to design a European Spallation Source (ESS) resulted in a set of reports, and in May 2009 Lund was agreed to be the ESS site. The ESS Scandinavia office has since then worked on setting all the necessary legal and organizational matters in place so that the Design Update and construction can be started in January 2011, in collaboration with European partners. The Design Update phase is expected to end in 2012, to be followed by a construction phase, with first neutrons expected in 2018-2019.

  9. Construct validity and factor structure of the pittsburgh sleep quality index and epworth sleepiness scale in a multi-national study of African, South East Asian and South American college students.

    PubMed

    Gelaye, Bizu; Lohsoonthorn, Vitool; Lertmeharit, Somrat; Pensuksan, Wipawan C; Sanchez, Sixto E; Lemma, Seblewengel; Berhane, Yemane; Zhu, Xiaotong; Vélez, Juan Carlos; Barbosa, Clarita; Anderade, Asterio; Tadesse, Mahlet G; Williams, Michelle A

    2014-01-01

    The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand). A cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA). The largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71) while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28). The largest component-total correlation coefficient for excessive daytime sleepiness as assessed using ESS was found for item 1 (sitting/reading) in Chile (r = 0.65) while the lowest item-total correlation was observed for item 6 (sitting and talking to someone) in Thailand (r = 0.35). Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countries. Overall, we documented cross-cultural comparability of sleep quality and excessive daytime sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the scales suggesting limited usefulness of the global PSQI and ESS scores to assess sleep quality and excessive daytime sleepiness.

  10. Charting a Course to Earth System Science Literacy

    NASA Astrophysics Data System (ADS)

    Karsten, J. L.; Koch, L.; Ridky, R.; Wei, M.; Ladue, N.

    2008-12-01

    Public literacy of fundamental ideas in Earth System Science (ESS) is immensely important, both because of its relevance to the daily lives of individual citizens and the role played by informed policy decisions related to water, energy, climate change, and hazards in securing our Nation's well-being and prosperity. The National Science Education Standards (NRC, 1996) argued that topics which comprise ESS also have tremendous value in providing context and meaning for the teaching of Biology, Chemistry, and Physics concepts and their applications, thereby serving the goals of the America COMPETES Act. Yet, as documented in the 2006 Program for International Student Assessment (PISA) results, the U.S. continues to lag significantly behind other developed nations in science literacy. A major obstacle to improving public ESS literacy, specifically, and strengthening science literacy, in general, is the fact that fewer than 30% of students in U.S. high schools take any courses related to ESS. Often, these courses are taught by teachers with limited preparation in this content area. A new grass-roots movement within the geoscience research and education communities, fueled by interagency collaboration, is seeking to overcome these obstacles and steer a new course for ESS education in the Nation. The Earth System Science Literacy Initiative (ESSLI) builds on recent efforts within portions of the geosciences community to reach consensus on what defines scientific literacy within their fields. Individual literacy frameworks now exist for the ocean, atmospheric science, Earth science, and climate topic areas, and others are under development. The essential principles and fundamental concepts articulated in these frameworks provide consistent core messages that can be delivered and reinforced not only through formal education channels, but also through informal education activities and the media, thereby avoiding the inherent obstacles of the formal education setting. Efforts underway to (1) integrate the individual literacy documents into a coherent, scientifically accurate ESS literacy framework that reflects the interactive complexity of Earth systems and (2) establish a new strategic plan for reforming ESS education in the U.S., in order to achieve such ESS literacy, will be described.

  11. The effect of augmented real-time image guidance on task workload during endoscopic sinus surgery.

    PubMed

    Dixon, Benjamin J; Chan, Harley; Daly, Michael J; Vescan, Allan D; Witterick, Ian J; Irish, Jonathan C

    2012-01-01

    Due to proximity to critical structures, the need for spatial awareness during endoscopic sinus surgery (ESS) is essential. We have developed an augmented, real-time image-guided surgery (ART-IGS) system that provides live navigational data and proximity alerts to the operating surgeon during ablation. We wished to test the hypothesis that task workload would be reduced when using this technology. A trial involved 8 otolaryngology residents and fellows performing ESS on cadaveric specimens; 1 side in a conventional method (control) and 1 side with ART-IGS. After computed tomography scanning, anatomical contouring, and registration of the head, a three-dimensional (3D) virtual endoscopic view, ablative tool tracking, and proximity alerts were enabled. Each subject completed ESS tasks and rated their workload during and after the exercise using the National Aeronautics and Space Administration (NASA) Task Load Index (TLX). A questionnaire and open feedback interview were completed after the procedure. There was a significant reduction in mental demand, temporal demand, effort, and frustration when using the ART-IGS system in comparison to the control (p < 0.02). Perceived performance was increased (p = 0.02). Most subjects agreed that the system was sufficiently accurate, caused minimal interruption, and increased confidence. Optical tracking line-of-sight issues were frequently cited as the main limitation early in the study; however, this was largely resolved. ART-IGS reduces task workload for trainees performing ESS. Live navigation and alert zones may be a valuable intraoperative teaching aid. Copyright © 2012 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.

  12. The ESS spoke cavity cryomodules

    NASA Astrophysics Data System (ADS)

    Bousson, Sebastien; Darve, Christine; Duthil, Patxi; Elias, Nuno; Molloy, Steve; Reynet, Denis; Thermeau, Jean-Pierre

    2014-01-01

    The European Spallation Source (ESS) is a multi-disciplinary research centre under design and construction in Lund, Sweden. This new facility is funded by a collaboration of 17 European countries and is expected to be up to 30 times brighter than today's leading facilities and neutron sources. The ESS will enable new opportunities for researchers in the fields of life sciences, energy, environmental technology, cultural heritage and fundamental physics. A 5 MW long pulse proton accelerator is used to reach this goal. The pulsed length is 2.86 ms, the repetition frequency is 14 Hz (4 % duty cycle), and the beam current is 62.5 mA. It is composed of one string of spoke cavity cryomodule and two strings of elliptical cavity cryomodules. This paper introduces the thermo-mechanical design and expected operation of the ESS spoke cavity cryomodules. These cryomodules contain two double spoke bulk Niobium cavities operating at 2 K and at a frequency of 352.21 MHz. The superconducting section of the Spoke Linac accelerates the beam from 90 MeV to 220 MeV. A Spoke Cavity Cryomodule Technology Demonstrator will be built and tested in order to validate the ESS series production.

  13. The ESS elliptical cavity cryomodules

    NASA Astrophysics Data System (ADS)

    Darve, Christine; Bosland, Pierre; Devanz, Guillaume; Olivier, Gilles; Renard, Bertrand; Thermeau, Jean-Pierre

    2014-01-01

    The European Spallation Source (ESS) is a multi-disciplinary research centre under design and construction in Lund, Sweden. This new facility is funded by a collaboration of 17 European countries and is expected to be up to 30 times brighter than today's leading facilities and neutron sources. The ESS will enable new opportunities for researchers in the fields of life sciences, energy, environmental technology, cultural heritage and fundamental physics. A 5 MW long pulse proton accelerator is used to reach this goal. The pulsed length is 2.86 ms, the repetition frequency is 14 Hz (4 % duty cycle), and the beam current is 62.5 mA. The superconducting section of the Linac accelerates the beam from 80 MeV to 2.0 GeV. It is composed of one string of spoke cavity cryomodule and two strings of elliptical cavity cryomodules. These cryomodules contain four elliptical Niobium cavities operating at 2 K and at a frequency of 704.42 MHz. This paper introduces the thermo-mechanical design, the prototyping and the expected operation of the ESS elliptical cavity cryomodules. An Elliptical Cavity Cryomodule Technology Demonstrator (ECCTD) will be built and tested in order to validate the ESS series production.

  14. Charge scheduling of an energy storage system under time-of-use pricing and a demand charge.

    PubMed

    Yoon, Yourim; Kim, Yong-Hyuk

    2014-01-01

    A real-coded genetic algorithm is used to schedule the charging of an energy storage system (ESS), operated in tandem with renewable power by an electricity consumer who is subject to time-of-use pricing and a demand charge. Simulations based on load and generation profiles of typical residential customers show that an ESS scheduled by our algorithm can reduce electricity costs by approximately 17%, compared to a system without an ESS and by 8% compared to a scheduling algorithm based on net power.

  15. Charge Scheduling of an Energy Storage System under Time-of-Use Pricing and a Demand Charge

    PubMed Central

    Yoon, Yourim

    2014-01-01

    A real-coded genetic algorithm is used to schedule the charging of an energy storage system (ESS), operated in tandem with renewable power by an electricity consumer who is subject to time-of-use pricing and a demand charge. Simulations based on load and generation profiles of typical residential customers show that an ESS scheduled by our algorithm can reduce electricity costs by approximately 17%, compared to a system without an ESS and by 8% compared to a scheduling algorithm based on net power. PMID:25197720

  16. Spatiotemporal assessment and trade-offs of multiple ecosystem services based on land use changes in Zengcheng, China.

    PubMed

    Sun, Xiao; Li, Feng

    2017-12-31

    Driven by rapid urbanization, land use change has become a significant factor influencing ecosystem services (ESs). To support the decision-making process of city planners and policy makers, assessing the spatiotemporal changes associated with multiple ESs is vital. In this study, we developed a general structure to assess the changes of multiple ESs in Zengcheng, China. A new index also was developed to measure the comprehensive ecosystem service (CES). Trade-offs of various ESs were analyzed by using correlation analysis. We then designed four alternate scenarios to explore the optimal land use strategies to increase the CES value and minimize trade-offs among various ESs. Results demonstrated that rapid expansion of built-up land and traffic land resulted in a decrease of CES in Zengcheng from 2003 to 2013. Although the water supply, water purification, and vegetable and fruit production services increased, the climate regulation, soil conservation, biodiversity protection, recreation opportunity and grain production services decreased during the ten-year period. Government should implement land use policies and ecological engineering measures to improve soil conservation in the northern region; recreation opportunity in the central region; and carbon storage, water purification, biodiversity protection and recreation opportunity in the southern region. Among all alternative scenarios, woodland buffer and soil conservation scenarios exhibit the highest CES values, indicating that policies such as the "Ecological corridor construction" project and the "Grain for Green" project should be implemented. However, a caveat is that these policies improve the ESs at the expense of food production due to significant trade-off relationships. To minimize the trade-offs, a more sustainable intensification of agriculture should be adopted to increase food production without decreasing other ESs or occupying additional land. The land use strategies and ecological engineering measures in this study can provide a reliable reference for sustainable development of other urbanized regions in China. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Investigation of the Oxidative Stress and DIO1 Expression in CRF Patients Accompanied With and Without Euthyroid Sick Syndrome.

    PubMed

    Shu-Lan, Qin; Chun-Yan, He; Qi, He; Juan, Chen; Cheng-Fang, Jiang; Aimee, Young Charlotte; Xia, Sheng; Zhi-Hong, Li; Long-Xin, Xiong

    2018-01-01

    Chronic renal failure (CRF) is often accompanied by increased oxidative stress and euthyroid sick syndrome (ESS). The cause of ESS is unknown, and it is unknown whether there exists a link between oxidant stress and ESS in CRF patients. Therefore, we aim to investigate oxidative stress and type 1 deiodinase (DIO1) expression, which plays the key role in the ESS in CRF patients. In-patients with CRF were divided into the two group: Group 1 is ESS patients consisting of 60 patients with low free triiodothyronine (FT3) and Group 2 consisting of 60 patients with normal FT3. Group 3 consisted of 60 healthy volunteers recruited as controls. The baseline clinical parameters of patients were evaluated with standard routine methods in a clinical laboratory. Serum levels of 8-isoprostane and DIO1 were measured by enzyme-linked immunosorbent assay (ELISA). Multiple regression analysis was used to analyze the relationship between oxidative stress, DIO1 and FT3. The concentrations of serum 8-Isoprostane in Group 1 and Group 2 were substantially higher than that of Group 3 (p< 0.05), however there was no significant difference between Group 1 and Group 2 (p=0.516). The serum DIO1 level was higher in Group 2 than in Group 1 and Group 3 (p< 0.001). Multivariate linear regression analysis revealed that the DIO1 concentration and FT3 level were not associated with the concentration of serum 8-Isoprostane. CRF patients showed elevated oxidative stress. The CRF patients without ESS showed higher expression of DIO1 than patients with ESS and the control group. The concentration of serum 8-Isoprostane was not correlated with FT3 and DIO1 levels. © 2018 The Author(s). Published by S. Karger AG, Basel.

  18. Environmental System Science Data Infrastructure for a Virtual Ecosystem (ESS-DIVE) - A New U.S. DOE Data Archive

    NASA Astrophysics Data System (ADS)

    Agarwal, D.; Varadharajan, C.; Cholia, S.; Snavely, C.; Hendrix, V.; Gunter, D.; Riley, W. J.; Jones, M.; Budden, A. E.; Vieglais, D.

    2017-12-01

    The ESS-DIVE archive is a new U.S. Department of Energy (DOE) data archive designed to provide long-term stewardship and use of data from observational, experimental, and modeling activities in the earth and environmental sciences. The ESS-DIVE infrastructure is constructed with the long-term vision of enabling broad access to and usage of the DOE sponsored data stored in the archive. It is designed as a scalable framework that incentivizes data providers to contribute well-structured, high-quality data to the archive and that enables the user community to easily build data processing, synthesis, and analysis capabilities using those data. The key innovations in our design include: (1) application of user-experience research methods to understand the needs of users and data contributors; (2) support for early data archiving during project data QA/QC and before public release; (3) focus on implementation of data standards in collaboration with the community; (4) support for community built tools for data search, interpretation, analysis, and visualization tools; (5) data fusion database to support search of the data extracted from packages submitted and data available in partner data systems such as the Earth System Grid Federation (ESGF) and DataONE; and (6) support for archiving of data packages that are not to be released to the public. ESS-DIVE data contributors will be able to archive and version their data and metadata, obtain data DOIs, search for and access ESS data and metadata via web and programmatic portals, and provide data and metadata in standardized forms. The ESS-DIVE archive and catalog will be federated with other existing catalogs, allowing cross-catalog metadata search and data exchange with existing systems, including DataONE's Metacat search. ESS-DIVE is operated by a multidisciplinary team from Berkeley Lab, the National Center for Ecological Analysis and Synthesis (NCEAS), and DataONE. The primarily data copies are hosted at DOE's NERSC supercomputing facility with replicas at DataONE nodes.

  19. Comparing Bioenergy Production Sites in the Southeastern US Regarding Ecosystem Service Supply and Demand

    PubMed Central

    Meyer, Markus A.; Chand, Tanzila; Priess, Joerg A.

    2015-01-01

    Biomass for bioenergy is debated for its potential synergies or tradeoffs with other provisioning and regulating ecosystem services (ESS). This biomass may originate from different production systems and may be purposefully grown or obtained from residues. Increased concerns globally about the sustainable production of biomass for bioenergy has resulted in numerous certification schemes focusing on best management practices, mostly operating at the plot/field scale. In this study, we compare the ESS of two watersheds in the southeastern US. We show the ESS tradeoffs and synergies of plantation forestry, i.e., pine poles, and agricultural production, i.e., wheat straw and corn stover, with the counterfactual natural or semi-natural forest in both watersheds. The plantation forestry showed less distinct tradeoffs than did corn and wheat production, i.e., for carbon storage, P and sediment retention, groundwater recharge, and biodiversity. Using indicators of landscape composition and configuration, we showed that landscape planning can affect the overall ESS supply and can partly determine if locally set environmental thresholds are being met. Indicators on landscape composition, configuration and naturalness explained more than 30% of the variation in ESS supply. Landscape elements such as largely connected forest patches or more complex agricultural patches, e.g., mosaics with shrub and grassland patches, may enhance ESS supply in both of the bioenergy production systems. If tradeoffs between biomass production and other ESS are not addressed by landscape planning, it may be reasonable to include rules in certification schemes that require, e.g., the connectivity of natural or semi-natural forest patches in plantation forestry or semi-natural landscape elements in agricultural production systems. Integrating indicators on landscape configuration and composition into certification schemes is particularly relevant considering that certification schemes are governance tools used to ensure comparable sustainability standards for biomass produced in countries with variable or absent legal frameworks for landscape planning. PMID:25768660

  20. Epworth Sleepiness Scale may be an indicator for blood pressure profile and prevalence of coronary artery disease and cerebrovascular disease in patients with obstructive sleep apnea.

    PubMed

    Feng, Jing; He, Quan-ying; Zhang, Xi-long; Chen, Bao-yuan

    2012-03-01

    This study seeks to determine whether scores of a short questionnaire assessing subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]) are associated with blood pressure (BP) level, BP profile, and prevalence of related coronary artery disease (CAD) and cerebrovascular disease (CVD) in obstructive sleep apnea (OSA) patients diagnosed by polysomnography (PSG). Twenty university hospital sleep centers in China mainland were organized by the Chinese Medical Association to participate in this study. Between January 2004 and April 2006, 2,297 consecutive patients (aged 18-85 years; 1,981 males and 316 females) referred to these centers were recruited. BP assessments were evaluated at four time points (daytime, evening, nighttime, and morning) under standardized conditions. Anthropometric measurements, medical history of hypertension, CAD, and CVD were collected. ESS score was calculated for each participant and at the night of BP assessment, nocturnal PSG was performed and subjects were classified into four groups based on the apnea-hypopnea index (AHI) from PSG as follows: control group (control, n = 213) with AHI < 5; mild sleep apnea (mild, n = 420) with AHI ≥ 5 and <15; moderate sleep apnea (moderate, n = 460) with AHI ≥ 15 and <30; and severe sleep apnea (severe, n = 1,204) with AHI ≥ 30. SPSS 11.5 software package was used for the relationships between ESS and BP profile and prevalence of CAD and CVD. ESS is correlated positively with average daytime, nighttime, evening, and morning BP before and even after controlling for confounding effects of age, sex, BMI, AHI, and nadir nocturnal oxygen saturation (before--r = 0.182, 0.326, 0.245, and 0.329, respectively, all P values < 0.001; after--r = 0.069, 0.212, 0.137, and 0.208, respectively, all P values < 0.001). In the severe group, nighttime, evening, morning average BPs (ABPs), the ratio of nighttime/daytime average BP (ratio of nighttime average BP to daytime average BP), and prevalence of hypertension, drug-resistant hypertension (R-HTN), isolated nighttime hypertension (IN-HTN), CAD, and CVD in excessive daytime sleepiness (EDS, ESS ≥ 11) subjects are higher than those in non-EDS (ESS 0-10; t/χ(2) = -8.388, -6.207, -8.607, -5.901, 12.742, 38.980, 16.343, 59.113, and 67.113, respectively; all P values < 0.05). For EDS subjects in the moderate group but not in the control and mild group, nighttime ABP and the ratio of nighttime/daytime average BP are higher (t = -2.086 and -3.815, respectively, all P values < 0.05). Linear fitting with ESS and the ratio of nighttime/daytime average BP shows a positive correlation (r(2) = 0.049, P < 0.001). In severe OSA patients with comparable AHI, EDS may identify a subset of individuals with OSA at higher risk of hypertension, R-HTN, IN-HTN, CAD, and CVD. Overall, nighttime ABP seems to be more sensitive to be influenced by EDS than other ABP parameters. Future studies should investigate the potential dose-effect relationship between EDS and hypertension and the possibility that diagnosis and treatment of EDS could aid in BP reduction and ultimately in decreased morbidity and mortality from cardiovascular and cerebrovascular complications (TMUIRB20010002 at www.clinicaltrials.gov ).

  1. Are health care professionals able to judge cancer patients' health care preferences correctly? A cross-sectional study

    PubMed Central

    2010-01-01

    Background Health care for cancer patients is primarily shaped by health care professionals. This raises the question to what extent health care professionals are aware of patients' preferences, needs and values. The aim of this study was to explore to what extent there is concordance between patients' preferences in cancer care and patients' preferences as estimated by health care professionals. We also examined whether there were gender differences between health care professionals with regard to the degree in which they can estimate patients' preferences correctly. Methods To obtain unbiased insight into the specific preferences of cancer patients, we developed the 'Cancer patients' health care preferences' questionnaire'. With this questionnaire we assessed a large sample of cancer patients (n = 386). Next, we asked health care professionals (medical oncologists, nurses and policymakers, n = 60) to fill out this questionnaire and to indicate preferences they thought cancer patients would have. Mean scores between groups were compared using Mann-Whitney tests. Effect sizes (ESs) were calculated for statistically significant differences. Results We found significant differences (ESs 0.31 to 0.90) between patients and professionals for eight out of twenty-one scales and two out of eight single items. Patients valued care aspects related to expertise and attitude of health care providers and accessibility of services as more important than the professionals thought they would do. Health care professionals overestimated the value that patients set on particularly organisational and environmental aspects. We found significant gender-related differences between the professionals (ESs 0.69 to 1.39 ) for eight out of twenty-one scales and two out of eight single items. When there were significant differences between male and female healthcare professionals in their estimation of patients health care preferences, female health care professionals invariably had higher scores. Generally, female health care professionals did not estimate patients' preferences and needs better than their male colleagues. Conclusions Health care professionals are reasonably well able to make a correct estimation of patients preferences, but they should be aware of their own bias and use additional resources to gain a better understanding of patients' specific preferences for each patient is different and ultimately the care needs and preferences will also be unique to the person. PMID:20615226

  2. Efficiency in evolutionary games: Darwin, Nash and the secret handshake.

    PubMed

    Robson, A J

    1990-06-07

    This paper considers any evolutionary game possessing several evolutionarily stable strategies, or ESSs, with differing payoffs. A mutant is introduced which will "destroy" any ESS which yields a lower payoff than another. This mutant possesses a costless signal and also conditions on the presence of this signal in each opponent. The mutant then can protect itself against a population playing an inefficient ESS by matching this against these non-signalers. At the same time, the mutants can achieve the more efficient ESS against the signaling mutant population itself. This construction is illustrated by means of the simplest possible example, a co-ordination game. The one-shot prisoner's dilemma is used to illustrate how a superior outcome which is not induced by an ESS may be temporarily but not permanently attained. In the case of the repeated prisoner's dilemma, the present argument seems to render the "evolution of co-operation" ultimately inevitable.

  3. Hawks, doves, and mixed-symmetry games.

    PubMed

    Crowley, P H

    2000-06-21

    The hawk-dove game has proved to be an important tool for understanding the role of aggression in social interactions. Here, the game is presented in a more general form (GHD) to facilitate analyses of interactions between individuals that may differ in "size", where size is interpreted as a surrogate for resource holding power. Three different situations are considered, based on the availability and use of information that interacting individuals have about their sizes: the classical symmetric case, in which no information about sizes is used, the asymmetric case, in which the individuals know their relative sizes and thus their chances of prevailing in combat, and a mixed-symmetry case, in which each individual only knows its own size (or only knows its opponent's size). I describe and use some recently developed methods for multitype games-evolutionary games involving two or more categories of players. With these methods and others, the evolutionarily stable strategies (ESSs) that emerge for the three different cases are identified and compared. A proof of the form and uniqueness of the ESS for the mixed-symmetry case is presented. In this situation, one size category at most can play a mixed strategy; larger individuals are aggressive and smaller individuals are not. As the number of size categories approaches infinity and the size distribution becomes continuous, there is a threshold size, above which all individuals are aggressive, and below which they are not. Copyright 2000 Academic Press.

  4. Noninvasive ventilation in amyotrophic lateral sclerosis: effects on sleep quality and quality of life.

    PubMed

    Vandoorne, Eva; Vrijsen, Bart; Belge, Catharina; Testelmans, Dries; Buyse, Bertien

    2016-12-01

    Little is known about the effects of noninvasive ventilation (NIV) on sleep quality in amyotrophic lateral sclerosis (ALS). We aim to evaluate the long-term effects of NIV on sleep quality and quality of life in patients with ALS. In this prospective observational study, 13 ALS patients were followed for one year after initiating NIV. We evaluated sleep quality, quality of life and functional status with several questionnaires: Epworth sleepiness Scale (ESS), Pittsburg sleep quality index (PSQI), Short Form 36 Health Questionnaire (SF-36), McGill Quality of Life questionnaire (McGillQoL) and revised Amyotrophic Lateral Sclerosis Functional Rating Scale scores (ALSFRS-R). Median and interquartile range (IQR) at the start of NIV was 59 (53-65) years. The ALSFRS-R at start was 30 (24-37) (median, IQR), with three patients having severe bulbar impairment (ALSFRS-R-bulbar ≤ 9). The P a CO 2 at start of NIV treatment was 48 (43-52) mmHg (median, IQR). During the one-year follow-up period, a significant decrease in the ALSFRS-R was observed. The impact of NIV in a short term (1 month) revealed a statistically significant decrease in ESS, decrease in total PSQI and of four PSQI subscales and improvement of almost all subscales of the McGill questionnaire. Long-term analyses (9 months to 1 year) revealed that amelioration in ESS and total PSQI was sustained. We conclude that accurately titrated NIV in ALS patients can stabilize sleep quality and quality of life for at least one year, despite significant disease progression.

  5. Image-guidance in endoscopic sinus surgery: is it associated with decreased medicolegal liability?

    PubMed

    Eloy, Jean Anderson; Svider, Peter F; D'Aguillo, Christine M; Baredes, Soly; Setzen, Michael; Folbe, Adam J

    2013-12-01

    The use of image-guidance (IG) in endoscopic sinus surgery (ESS) has escalated over the last decade despite a lack of consensus that its use improves outcomes or decreases complications. One theoretical reason for using IG in ESS is its potential to minimize legal liability should an adverse outcome occur. In this study, we aimed to characterize the role of IG in ESS litigation, and further detail other factors in pertinent cases. A secondary objective was to characterize recent malpractice litigation for other relevant factors. Relevant cases from Westlaw were examined to determine whether the use of IG played a role in initiating litigation in ESS malpractice suits. Factors such as patient demographics and alleged cause(s) of malpractice litigation were examined. Out of 30 malpractice cases from 2004 to April 2013, 4 (13.3%) mentioned the use of IG during ESS, although this did not appear to be a factor affecting the plaintiff's decision to initiate litigation, nor the case outcomes. In the 26 cases (86.7%) in which IG was not used, its non-use was not specified as an alleged cause of negligence. Eleven (36.7%) cases were resolved in the defendant's favor. Frequently-cited factors included iatrogenic injury (83.3%), permanent deficits (66.7%), needing additional surgery (63.3%), orbital and intracranial injury, and perceived deficits in informed consent (40.0%). The use of IG was not found to be a factor in ESS litigation. This suggests that not using IG does not necessarily make one more vulnerable to malpractice litigation. © 2013 ARS-AAOA, LLC.

  6. [Circadian rhythm : Influence on Epworth Sleepiness Scale score].

    PubMed

    Herzog, M; Bedorf, A; Rohrmeier, C; Kühnel, T; Herzog, B; Bremert, T; Plontke, S; Plößl, S

    2017-02-01

    The Epworth Sleepiness Scale (ESS) is frequently used to determine daytime sleepiness in patients with sleep-disordered breathing. It is still unclear whether different levels of alertness induced by the circadian rhythm influence ESS score. The aim of this study is to investigate the influence of circadian rhythm-dependent alertness on ESS performance. In a monocentric prospective noninterventional observation study, 97 patients with suspected sleep-disordered breathing were investigated with respect to daytime sleepiness in temporal relationship to polysomnographic examination and treatment. The Karolinska Sleepiness Scale (KSS) and the Stanford Sleepiness Scale (SSS) served as references for the detection of present sleepiness at three different measurement times (morning, noon, evening), prior to and following a diagnostic polysomnography night as well as after a continuous positive airway pressure (CPAP) titration night (9 measurements in total). The KSS, SSS, and ESS were performed at these times in a randomized order. The KSS and SSS scores revealed a circadian rhythm-dependent curve with increased sleepiness at noon and in the evening. Following a diagnostic polysomnography night, the scores were increased compared to the measurements prior to the night. After the CPAP titration night, sleepiness in the morning was reduced. KSS and SSS reflect the changes in alertness induced by the circadian rhythm. The ESS score war neither altered by the intra-daily nor by the inter-daily changes in the level of alertness. According to the present data, the ESS serves as a reliable instrument to detect the level of daytime sleepiness independently of the circadian rhythm-dependent level of alertness.

  7. A Novel ESAT-6 Secretion System-Secreted Protein EsxX of Community-Associated Staphylococcus aureus Lineage ST398 Contributes to Immune Evasion and Virulence.

    PubMed

    Dai, Yingxin; Wang, Yanan; Liu, Qian; Gao, Qianqian; Lu, Huiying; Meng, Hongwei; Qin, Juanxiu; Hu, Mo; Li, Min

    2017-01-01

    The ESAT-6 secretion system (ESS) has been reported to contribute to the virulence and pathogenicity of several Staphylococcus aureus strains such as USA300 and Newman. However, the role of the ESS in community-associated S. aureus (CA-SA) lineage ST398 in China is not well understood. By comparing the ess locus of ST398 with the published S. aureus sequence in the NCBI database, we found one gene in the ess locus encoding a novel WXG superfamily protein that is highly conserved only in ST398. LC-MS/MS and Western blot analysis revealed that this protein is a novel secreted protein controlled by the ST398 ESS, and we named the protein EsxX. Although EsxX was not under the control of the accessory gene regulator like many other virulence factors and had no influence on several phenotypes of ST398, such as growth, hemolysis, and biofilm formation, it showed important impacts on immune evasion and virulence in ST398. An esxX deletion mutant led to significantly reduced resistance to neutrophil killing and decreased virulence in murine skin and blood infection models, indicating its essential contribution to the evasion of innate host defense and virulence to support the pathogenesis of ST398 infections. The function of this novel secreted protein EsxX might help us better understand the role of the ESS in the virulence and epidemic success of the CA-SA lineage ST398.

  8. Project report : road weather information system phase I

    DOT National Transportation Integrated Search

    2004-11-01

    The Alaska Department of Transportation & Public Facilities (ADOT&PF) initiated the first eight environmental sensor stations (ESS) in the Anchorage area, called the Road Weather Information System (RWIS) Phase I. The ESS are used to detect road weat...

  9. Creation of an emergency surgery service concentrates resident training in general surgical procedures.

    PubMed

    Ahmed, Hesham M; Gale, Stephen C; Tinti, Meredith S; Shiroff, Adam M; Macias, Aitor C; Rhodes, Stancie C; Defreese, Marissa A; Gracias, Vicente H

    2012-09-01

    Emergency general surgery (EGS) is increasingly being provided by academic trauma surgeons in an acute care surgery model. Our tertiary care hospital recently changed from a model where all staff surgeons (private, subspecialty academic, and trauma academic) were assigned EGS call to one in which an emergency surgery service (ESS), staffed by academic trauma faculty, cares for all EGS patients. In the previous model, many surgeries were "not covered" by residents because of work-hour restrictions, conflicting needs, or private surgeon preference. The ESS was separate from the trauma service. We hypothesize that by creating a separate ESS, residents can accumulate needed and concentrated operative experience in a well-supervised academic environment. A prospectively accrued EGS database was retrospectively queried for the 18-month period: July 2010 to June 2011. The Accreditation Council for Graduate Medical Education (ACGME) databases were queried for operative numbers for our residency program and for national resident data for 2 years before and after creating the ESS. The ACGME operative requirements were tabulated from online sources. ACGME requirements were compared with surgical cases performed. During the 18-month period, 816 ESS operations were performed. Of these, 307 (38%) were laparoscopy. Laparoscopic cholecystectomy and appendectomy were most common (138 and 145, respectively) plus 24 additional laparoscopic surgeries. Each resident performed, on average, 34 basic laparoscopic cases during their 2-month rotation, which is 56% of their ACGME basic laparoscopic requirement. A diverse mixture of 70 other general surgical operations was recorded for the remaining 509 surgical cases, including reoperative surgery, complex laparoscopy, multispecialty procedures, and seldom-performed operations such as surgery for perforated ulcer disease. Before the ESS, the classes of 2008 and 2009 reported that only 48% and 50% of cases were performed at the main academic institution, respectively. This improved for the classes of 2010 and 2011 to 63% and 68%, respectively, after ESS creation. An ESS rotation is becoming essential in large teaching hospitals by helping to fulfill ACGME requirements and by providing emergent general surgical skills an efficient and well-supervised academic environment. Movement toward concentrating EGS on a single service can enhance resident education and may decrease the need to supplement certain aspects of general surgery education with away rotations.

  10. Are farm-to-school programs more common in states with farm-to-school-related laws?

    PubMed

    Schneider, Linda; Chriqui, Jamie; Nicholson, Lisa; Turner, Lindsey; Gourdet, Camille; Chaloupka, Frank

    2012-05-01

    Farm-to-School programs (FTSPs) connect schools with locally grown food. This article examines whether FTSPs are more common in public elementary schools (ESs) in states with a formal, FTSP law or with a related, locally grown procurement law. A pooled, cross-sectional analysis linked nationally representative samples of 1872 public ESs (across 47 states) for the 2006-2007, 2007-2008, and 2008-2009 school years with state laws effective as of the beginning of September of each year that were collected and analyzed for all states. Multivariate logistic regression models examined the impact of state law on school FTSP participation, controlling for year and school-level race/ethnicity, region, locale, free-reduced lunch participation, and school size. The percentage of schools located in a state with a FTSP-specific law increased from 7.3% to 20.4% over the 3-year period, while the percentage of schools located in a state with a locally grown procurement law was approximately 30% across all years. The percentage of schools with FTSPs has more than tripled over the last 3 years (from 4.9% to 17.7%). After adjusting for all covariates except year, FTSPs were significantly more likely in states with a FTSP-specific law (OR = 2.45, 95% CI = 1.28-4.67); once adjusting for year, the results were marginally significant (OR = 1.72, 95% CI = .91-3.25). School-level FTSPs were not related to state locally grown procurement laws. Although the percentage of schools with FTSPs is relatively small, these programs are becoming more common, particularly in states with FTSP-specific laws. © 2012, American School Health Association.

  11. Influence of Maturation Stage on Agility Performance Gains After Plyometric Training: A Systematic Review and Meta-analysis.

    PubMed

    Asadi, Abbas; Arazi, Hamid; Ramirez-Campillo, Rodrigo; Moran, Jason; Izquierdo, Mikel

    2017-09-01

    Asadi, A, Arazi, H, Ramirez-Campillo, R, Moran, J, and Izquierdo, M. Influence of maturation stage on agility performance gains after plyometric training: a systematic review and meta-analysis. J Strength Cond Res 31(9): 2609-2617, 2017-Although plyometric training (PT) improves change of direction (COD) ability, the influence of age on COD gains after PT is unclear. Therefore, the aim of this systematic review was to identify the age-related pattern of improvement in COD ability after PT in youths. A computerized search within 6 databases was performed, selecting studies based on specific inclusion criteria: experimental trials published in English-language journals, PT focused on the lower-body, COD ability measurements reported before and after training, and male participants aged 10 to 18 years. Sixteen articles with a total of 30 effect sizes (ESs) in the experimental groups and 13 ESs in the control groups were included. For the analyses, subjects were categorized into 3 age groups: 10-12.9 years of age (PRE), 13-15.9 years of age (MID), and 16-18 years of age (POST). Independent of age, PT improved COD ability in youths (ES = 0.86, time gains [TG = -0.61]). However, a tendency toward greater COD ability gains was observed in older subjects (MID, ES = 0.95; POST, ES = 0.99) compared with younger subjects (PRE, ES = 0.68). Pearson product-moment correlation (r) indicated that 2-weekly sessions of PT-induced meaningful COD ability gains (for ES, r = 0.436; for TG, r = -0.624). A positive relationship was found between training intensity and ES (r = 0.493). In conclusion, PT improves COD ability in youths, with meaningfully greater effects in older youths. Two PT sessions per week, with 1,400 moderate-intensity jumps for 7 weeks, seems to be an adequate dose.

  12. Empty Sella Syndrome

    MedlinePlus

    ... hormone prolactin, which can interfere with the normal function of the testicles and ovaries. Primary ESS is most common in adults and women, ... hormone prolactin, which can interfere with the normal function of the testicles and ovaries. Primary ESS is most common in adults and women, ...

  13. An adaptive sharing elitist evolution strategy for multiobjective optimization.

    PubMed

    Costa, Lino; Oliveira, Pedro

    2003-01-01

    Almost all approaches to multiobjective optimization are based on Genetic Algorithms (GAs), and implementations based on Evolution Strategies (ESs) are very rare. Thus, it is crucial to investigate how ESs can be extended to multiobjective optimization, since they have, in the past, proven to be powerful single objective optimizers. In this paper, we present a new approach to multiobjective optimization, based on ESs. We call this approach the Multiobjective Elitist Evolution Strategy (MEES) as it incorporates several mechanisms, like elitism, that improve its performance. When compared with other algorithms, MEES shows very promising results in terms of performance.

  14. Sleep disorder among medical students: relationship to their academic performance.

    PubMed

    Abdulghani, Hamza M; Alrowais, Norah A; Bin-Saad, Norah S; Al-Subaie, Nourah M; Haji, Alhan M A; Alhaqwi, Ali I

    2012-01-01

    Medical students are exposed to a significant level of pressure due to academic demands. Their sleep pattern is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. To examine the prevalence of sleep disorder among medical students and investigate any relationship between sleep disorder and academic performance. This is a cross-sectional self-administered questionnaire-based study. The participants were medical students of the first, second, and third academic years. The Epworth Sleepiness Scale (ESS) was also included to identify sleep disorder and grade point average was recorded for academic performance. There were 491 responses with a response rate of 55%. The ESS score demonstrated that 36.6% of participants were considered to have abnormal sleep habits, with a statistically significant increase in female students (p = 0.000). Sleeping between 6-10 h per day was associated with normal ESS scores (p = 0.019) as well as the academic grades ≥ 3.75. Abnormal ESS scores were associated with lower academic achievement (p = 0.002). A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.

  15. Numerical Investigation on Head and Brain Injuries Caused by Windshield Impact on Riders Using Electric Self-Balancing Scooters

    PubMed Central

    Zheng, Yanting; Shen, Ming; Yang, Xianfeng

    2018-01-01

    To investigate head-brain injuries caused by windshield impact on riders using electric self-balancing scooters (ESS). Numerical vehicle ESS crash scenarios are constructed by combining the finite element (FE) vehicle model and multibody scooter/rider models. Impact kinematic postures of the head-windshield contact under various impact conditions are captured. Then, the processes during head-windshield contact are reconstructed using validated FE head/laminated windshield models to assess the severity of brain injury caused by the head-windshield contact. Governing factors, such as vehicle speed, ESS speed, and the initial orientation of ESS rider, have nontrivial influences over the severity of a rider's brain injuries. Results also show positive correlations between vehicle speed and head-windshield impact speeds (linear and angular). Meanwhile, the time of head-windshield contact happens earlier when the vehicle speed is faster. According to the intensive study, windshield-head contact speed (linear and angular), impact location on the windshield, and head collision area are found to be direct factors on ESS riders' brain injuries during an impact. The von Mises stress and shear stress rise when relative contact speed of head-windshield increases. Brain injury indices vary widely when the head impacting the windshield from center to the edge or impacting with different areas. PMID:29770161

  16. Tested Tools You Can Use: Evaluating Earth System Science Courses

    NASA Astrophysics Data System (ADS)

    Lee, S. P.; Prakash, A.; Reider, D.; Baker, D.

    2006-12-01

    Earth System Science Education for the 21st Century (ESSE 21) has created a public access on-line evaluation resource available at http://esse21.usra.edu/evaltoolkit in collaboration with the ESSE 21 institutions, PIs, and evaluators. The purpose of the ESSE toolkit is to offer examples of how evaluation and assessment are/have been used in Earth System Science courses and programs. Our goal is to help instructors recognize different types of assessment and evaluation tools and uses that have proved useful in these courses and provide models for designing assessments in new courses. We have included actual examples of evaluations used by ESSE institution faculty in their own courses. This is not a comprehensive toolkit on educational evaluation and assessment, but it does provide several examples of evaluations that have been used successfully in Earth System Science courses and links to many good web resources on course evaluation. We have provided examples of assessments that are designed to collect information from students before, during and after courses. Some, presented in different formats, are designed to assess what students learn, others are designed to provide course instructors with information they can use to revise their courses. These assessments range from content tests to portfolios, from feedback forms to interviews, and from concept maps to attitude surveys.

  17. Aging reduces the association between sleepiness and sleep-disordered breathing

    PubMed Central

    Morrell, Mary; Finn, Laurel; McMillian, Alison; Peppard, Paul E.

    2013-01-01

    Aim To investigate age-related changes in sleepiness symptoms associated with sleep disordered breathing (SDB). Methods Wisconsin Sleep Cohort participants were assessed with polysomnography, Epworth Sleepiness Scale (ESS) and Multiple Sleep Latency Test (MSLT). SDB was defined as an apnea/hypopnea index≥15 events/hour, sleepiness as ESS≥10 and MSLT≤5 minutes. Odds ratios were calculated using generalized estimating equations associating sleepiness with SDB, and conditional logistic regression examining changes in longitudinal sleepiness status (ESS only). Models were, a priori, stratified by gender. Results ESS was measured in 1281 participants and MSLT in 998, at multiple time points (ESS n=3695; MSLT n=1846). Significant interactions were found between SDB and age in men, but not women. The odds ratios (OR) modeled for sleepiness in a 40 year old male with SDB were significant, compared to a male without SDB (OR: ESS 2.1; MSLT 2.9); however, these associations were not significant at 60 years. The within-subject odds ratio for sleepiness was also significant at 40 years (OR: 3.4), but not at 60 years. Conclusion The age-related reductions in the association between sleepiness and SDB may have clinical implications for the diagnosis and treatment of SDB in older people since sleepiness is often used as a therapeutic marker. PMID:22241742

  18. Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study.

    PubMed

    Inoue, Yuichi; Takasaki, Yuji; Yamashiro, Yoshihiro

    2013-08-15

    This double-blind study evaluated the efficacy and safety of modafinil for treating excessive daytime sleepiness in Japanese patients with obstructive sleep apnea syndrome (OSAS). Patients with residual excessive sleepiness (Epworth Sleepiness Scale [ESS] ≥ 11) on optimal nasal continuous positive airway pressure (nCPAP) therapy (apnea-hypopnea index ≤ 10) were randomized to either 200 mg modafinil (n = 52) or placebo (n = 62) once daily for 4 weeks. Outcomes included baseline-week 4 changes in ESS total score, sleep latency on maintenance of wakefulness test (SL-MWT), nocturnal polysomnography, Pittsburgh Sleep Quality Index (PSQI), and safety. All 114 randomized patients completed the study. Mean change in ESS total score (-6.6 vs -2.4, p < 0.001) and SL-MWT (+2.8 vs -0.4 minutes, p = 0.009) were significantly greater with modafinil than with placebo. ESS total score decreased from > 11 to < 11 at the final assessment in 69.2% of modafinil-treated patients and 30.6% of placebo-treated patients (p < 0.001). Corresponding rates at week 1 were 57.7% and 33.9% (p = 0.014). Changes in nocturnal polysomnography, PSQI, and apnea-hypopnea index from baseline to the final assessment were similar in both groups. Adverse drug reactions occurred in 36.5% and 22.6% of patients in the modafinil and placebo groups, respectively (p = 0.146). Once-daily modafinil was effective and well tolerated for managing residual daytime sleepiness in Japanese OSAS patients with residual excessive daytime sleepiness on optimal nCPAP therapy.

  19. Missense mutations of MLH1 and MSH2 genes detected in patients with gastrointestinal cancer are associated with exonic splicing enhancers and silencers

    PubMed Central

    ZHU, MING; CHEN, HUI-MEI; WANG, YA-PING

    2013-01-01

    The MLH1 and MSH2 genes in DNA mismatch repair are important in the pathogenesis of gastrointestinal cancer. Recent studies of normal and alternative splicing suggest that the deleterious effects of missense mutations may in fact be splicing-related when they are located in exonic splicing enhancers (ESEs) or exonic splicing silencers (ESSs). In this study, we used ESE-finder and FAS-ESS software to analyze the potential ESE/ESS motifs of the 114 missense mutations detected in the two genes in East Asian gastrointestinal cancer patients. In addition, we used the SIFT tool to functionally analyze these mutations. The amount of the ESE losses (68) was 51.1% higher than the ESE gains (45) of all the mutations. However, the amount of the ESS gains (27) was 107.7% higher than the ESS losses (13). In total, 56 (49.1%) mutations possessed a potential exonic splicing regulator (ESR) error. Eighty-one mutations (71.1%) were predicted to be deleterious with a lower tolerance index as detected by the Sorting Intolerant from Tolerant (SIFT) tool. Among these, 38 (33.3%) mutations were predicted to be functionally deleterious and possess one potential ESR error, while 18 (15.8%) mutations were predicted to be functionally deleterious and exhibit two potential ESR errors. These may be more likely to affect exon splicing. Our results indicated that there is a strong correlation between missense mutations in MLH1 and MSH2 genes detected in East Asian gastrointestinal cancer patients and ESR motifs. In order to correctly understand the molecular nature of mutations, splicing patterns should be compared between wild-type and mutant samples. PMID:23760103

  20. Safety, feasibility, and efficacy of placement of steroid-eluting bioabsorbable sinus implants in the office setting: a prospective case series.

    PubMed

    Matheny, Keith E; Carter, Kenny B; Tseng, Ewen Y; Fong, Karen J

    2014-10-01

    The outcomes of endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) can be compromised by postoperative inflammation, recurrent polyposis, middle turbinate lateralization, and synechiae, often requiring subsequent interventions. A bioabsorbable steroid-eluting sinus implant placed in the operating room following ESS has been proven safe and effective in 2 randomized controlled trials and a subsequent meta-analysis, for its ability to preserve sinus patency, and reduce medical and surgical interventions. This trial sought to evaluate the safety, feasibility, and outcomes of implants placed in the office after achieving hemostasis. Twenty patients with CRS underwent ESS including bilateral ethmoidectomy. A steroid-eluting bioabsorbable implant was deployed into each ethmoid cavity in the office within 7 days after ESS. Endoscopic appearance of the ethmoid cavities was evaluated at 1 week, 2 weeks, and 4 weeks postoperatively by the operating surgeon and an independent blinded evaluator. Procedural tolerance was assessed at week 2 using a patient preference questionnaire. The 20-item Sino-Nasal Outcome Test (SNOT-20) questionnaire was completed at baseline, week 2, and week 4. In-office placement of steroid-eluting bioabsorbable implants was well tolerated, with 90% of patients very satisfied with the overall experience, and 80% very satisfied with the recovery process. At 1 month, there were no significant adhesions or frank polyposis, and middle turbinate lateralization was only 5%. Compared to baseline, ethmoid sinus inflammation was significantly reduced (p = 0.03), and the mean SNOT-20 score was significantly improved (p < 0.001). In-office placement of steroid-eluting bioabsorbable implants after achieving hemostasis was well tolerated and might improve local drug diffusion and surgical outcomes. © 2014 ARS-AAOA, LLC.

  1. Structural properties of a bone-ceramic composite as a promising material in spinal surgery

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

    Kirilova, I. A., E-mail: IKirilova@mail.ru; Sadovoy, M. A.; Podorozhnaya, V. T., E-mail: VPodorognaya@niito.ru

    The paper describes the results of in vitro tests of composite bone-ceramic implants and procedures for modifying implant surfaces to enhance osteogenesis. Analysis of CBCI ESs demonstrated that they have a porous structure with the mean longitudinal pore size of 70 µm and the mean transverse pore size of 46 µm; surface pores are open, while inner pores are closed. Elemental analysis of the CBCI surface demonstrates that CBCIs are composed of aluminum and zirconium oxides and contain HA inclusions. Profilometry of the CBCI ES surface revealed the following deviations: the maximum deviation of the profile in the sample center is 15 µmmore » and 16 µm on the periphery, while the arithmetical mean and mean square deviations of the profile are 2.65 and 3.4 µm, respectively. In addition, CBCI biodegradation products were pre-examined; a 0.9% NaCl solution was used as a comparison group. Potentially toxic and tissue accumulated elements, such as cadmium, cobalt, mercury, and lead, are present only in trace amounts and have no statistically significant differences with the comparison group, which precludes their potential toxic effects on the macroorganism. Ceramic-based CBCI may be effective and useful in medicine for restoration of the anatomic integrity and functions of the bone tissue.« less

  2. A randomized prospective study of oral levofloxacin vs intravenous flomoxef prophylaxis in postoperative infection after endoscopic sinus surgery.

    PubMed

    Inoshita, Ayako; Yokoi, Hidenori; Matsumoto, Fumihiko; Yao, Toru; Kawano, Kenji; Furukawa, Masayuki; Ikeda, Katsuhisa

    2010-01-01

    The clinical efficacy and cost effectiveness of oral antimicrobial prophylaxis with levofloxacin (LVFX) on endoscopic sinus surgery (ESS) was evaluated. Ninety-three patients undergoing ESS were prospectively enrolled in the present study. The patients were randomly divided into 2 groups, LVFX and flomoxef (FMOX). Two hundred milligrams of LVFX was orally given 2 hours before the start of surgery and 6 hours after the end of surgery, which was followed by the administration of 200 mg every 12 hours for 2 days. One gram of FMOX was dissolved in 100 ml of physiological saline and given intravenously at the induction of anesthesia and 6 hours after the end of surgery, followed by infusion twice daily for 2 days. There were no statistically significant differences between 2 groups in terms of age, sex, systemic complications, surgical procedures, the duration of the operation, the length of hospitalization, the amount of blood loss, body temperature, or the number of white blood cells or C-reactive protein. Although no statistical significance was observed in the bacterial resistance between the two antibiotics, LVFX seems to show a low rate of resistance pattern change as compared to FMOX. The present study demonstrated that no patients treated with LVFX or FMOX were afflicted with postsurgical infection. Oral administration of LVFX is a simple, cost-effective and safe alternative to intravenous prophylaxis in ESS based on clinical efficacy and bacteriological study. Copyright 2010 Elsevier Inc. All rights reserved.

  3. Characterizing and Mapping of Ecosystem Services (CMESs) Literature Database Version 1.0

    EPA Science Inventory

    Ecosystem services (ESs) represent an ecosystem’s capacity for satisfying essential human needs, directly or indirectly, above that required to maintain ecosystem integrity (structure, function and processes). The spatial characterization and mapping of ESs is an essential first ...

  4. Replication Unreliability in Psychology: Elusive Phenomena or “Elusive” Statistical Power?

    PubMed Central

    Tressoldi, Patrizio E.

    2012-01-01

    The focus of this paper is to analyze whether the unreliability of results related to certain controversial psychological phenomena may be a consequence of their low statistical power. Applying the Null Hypothesis Statistical Testing (NHST), still the widest used statistical approach, unreliability derives from the failure to refute the null hypothesis, in particular when exact or quasi-exact replications of experiments are carried out. Taking as example the results of meta-analyses related to four different controversial phenomena, subliminal semantic priming, incubation effect for problem solving, unconscious thought theory, and non-local perception, it was found that, except for semantic priming on categorization, the statistical power to detect the expected effect size (ES) of the typical study, is low or very low. The low power in most studies undermines the use of NHST to study phenomena with moderate or low ESs. We conclude by providing some suggestions on how to increase the statistical power or use different statistical approaches to help discriminate whether the results obtained may or may not be used to support or to refute the reality of a phenomenon with small ES. PMID:22783215

  5. A spiritual sleepiness scale: the Friday prayer.

    PubMed

    Abouda, Maher; Turki, Senda; Hachicha, Amani; Yangui, Ferdaous; Triki, Miriam; Charfi, Med Ridha

    2016-03-01

    Excessive daytime sleepiness (EDS) affects 5% to 20% of the population and is involved in a large number of traffic accidents. EDS is a major symptom in sleep disorders, especially obstructive sleep apnea syndrome (OSA). The daytime sleepiness is evaluated subjectively using scales and questionnaires based on perception. This study is aimed to build a new questionnaire more suited to our lifestyle and then to compare it to the Epworth sleepiness scales (ESS). We administered to 91 adult's patients (76 men and 15 women) consulting for sleep disturbance the ESS and a single subjective question tendency to drowsiness during the Friday prayer. Patients were listed in four groups according to their response to the question «During the past month, have you ever doze or fall asleep during the sermon of the Friday prayer? » By G1 never dozes, G2 low chance of falling asleep, G3 average chance of dozing, G4 high chance of falling asleep. Only 63 patients (58 men and 5 women) responded to both questionnaires. Group 1 included 14 patients with a ESS of 5.5 +/- 1.8, Group 2 included 18 patients with a ESS of 7.3 +/- 1.9, Group 3 included 18 patients with a ESS of 11.05 +/- 2 and Group 4 included 13 patients with a ESS of 14.69 +/- 2.3. The Rho correlation coefficient was high (0.86) and shows a strong correlation between the Results of the two questionnaires. the answer to the question " During the past month, have you ever doze or fall asleep during the sermon of the Friday prayer? » seems to be an appropriate Sleepiness Scale among Muslim patients.

  6. Endometrial Stromal Sarcoma of the Uterus: Magnetic Resonance Imaging Findings Including Apparent Diffusion Coefficient Value and Its Correlation With Ki-67 Expression.

    PubMed

    Li, Hai Ming; Liu, Jia; Qiang, Jin Wei; Gu, Wei Yong; Zhang, Guo Fu; Ma, Feng Hua

    2017-11-01

    This study aimed to investigate the conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) features of endometrial stromal sarcoma (ESS) including a preliminary investigation of the correlation between the apparent diffusion coefficient (ADC) value and Ki-67 expression. The clinical and MRI data of 15 patients with ESS confirmed by surgery and pathology were analyzed retrospectively. The conventional MR morphological features, signal intensity on DWI, ADC value (n = 14), and clinicopathological marker Ki-67 (n = 13) were evaluated. Of 15 patients with ESS, 13 tumors were low-grade ESS (LGESS), and the remaining 2 were high-grade ESS (HGESS); 9 tumors were located in the myometrium, 5 were located in the endometrium and/or cervical canal, and 1 was located in extrauterine. Thirteen (87%) of 15 tumors showed a homo- or heterogeneous isointensity on T1-weighted imaging and a heterogeneous hyperintensity on T2-weighted imaging. The hypointense bands were observed in 11 tumors (73%) on T2-weighted imaging. The degenerations (cystic/necrosis/hemorrhage) were observed in 7 LGESS tumors and 2 HGESS tumors. The DWI hyperintensity was observed in 13 tumors (93%) and isointensity in remaining 1. The mean ADC value of the solid components in 14 ESSs was (1.05 ± 0.20) × 10mm/s. The contrast-enhanced MRI showed an obvious enhancement in 14 tumors (93%) (heterogeneous in 7 LGESSs and 2 HGESSs; homogeneous in 5 LGESSs). The ADC value was inversely correlated with the Ki-67 expression (r = -0.613, P = 0.026). Patients with ESS showed some characteristics on conventional MRI and DWI, and there was an inverse correlation between the ADC value and Ki-67 expression.

  7. Impact of synechiae after endoscopic sinus surgery on long-term outcomes in chronic rhinosinusitis

    PubMed Central

    Henriquez, Oswaldo A.; Schlosser, Rodney J.; Mace, Jess. C; Smith, Timothy L.; Soler, Zachary M.

    2013-01-01

    Introduction Synechiae are one of the most common unwanted outcomes after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). However, there has been scant investigation into the true significance of synechiae formation after ESS. The aim of this study was to evaluate the impact of synechiae formation on quality-of-life (QOL) outcomes after ESS in patients with CRS. Study Design Prospective, multi-institutional cohort. Methods Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey (CSS) scores were measured in adult patients before and after undergoing ESS for CRS. Differences in QOL were evaluated between those who developed sinonasal synechiae and those who did not, controlling for demographic factors, medical comorbidities, and measures of disease severity at baseline. Results A total of 286 patients underwent ESS, with 55 (19.2%) developing synechiae in the follow-up period. Patients developing synechiae reported significantly less improvement on the RSDI total scores (13.5 vs. 21.4, p=0.008), RSDI physical subscores (5.3 vs. 8.3, p=0.007), RSDI emotional subscores (2.9 vs. 5.8, p=0.008), CSS total scores (14.5 vs. 21.2, p=0.093) and CSS symptom subscores (19.9 vs 30.3, p=0.069) compared to those who did not develop synechiae postoperatively. These differences persisted even after controlling for baseline differences in disease severity. Conclusions Synechiae of the sinonasal cavity commonly occurs following ESS, particularly in those undergoing revision surgeries. Although both groups improve, the degree of QOL improvement appears to be less in those who form postoperative synechaie after surgery compared to those who do not. PMID:23670876

  8. Outcome and Prognostic Factors in Endometrial Stromal Tumors: A Rare Cancer Network Study

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

    Schick, Ulrike, E-mail: Ulrike.schick@icr.ac.uk; Bolukbasi, Yasmin; Thariat, Juliette

    2012-04-01

    Purpose: To provide further understanding regarding outcome and prognostic factors of endometrial stromal tumors (EST). Methods and Materials: A retrospective analysis was performed on the records of 59 women diagnosed with EST and treated with curative intent between 1983 and 2007 in the framework of the Rare Cancer Network. Results: Endometrial stromal sarcomas (ESS) were found in 44% and undifferentiated ESS (UES) in 49% of the cases. In 7% the grading was unclear. Of the total number of patients, 33 had Stage I, 4 Stage II, 20 Stage III, and 1 presented with Stage IVB disease. Adjuvant chemotherapy was administeredmore » to 12 patients, all with UES. External-beam radiotherapy (RT) was administered postoperatively to 48 women. The median follow-up was 41.4 months. The 5-year overall survival (OS) rate was 96.2% and 64.8% for ESS and UES, respectively, with a corresponding 5-year disease-free survival (DFS) rate of 49.4% and 43.4%, respectively. On multivariate analysis, adjuvant RT was an independent prognostic factor for OS (p = 0.007) and DFS (p = 0.013). Locoregional control, DFS, and OS were significantly associated with age ({<=}60 vs. >60 years), grade (ESS vs. UES), and International Federation of Gynecology and Obstetrics stage (I-II vs. III-IV). Positive lymph node staging had an impact on OS (p < 0.001). Conclusion: The prognosis of ESS differed from that of UES. Endometrial stromal sarcomas had an excellent 5-year OS, whereas the OS in UES was rather low. However, half of ESS patients had a relapse. For this reason, adjuvant treatment such as RT should be considered even in low-grade tumors. Multicenter randomized studies are still warranted to establish clear guidelines.« less

  9. The alignment of enzymatic steps reveals similar metabolic pathways and probable recruitment events in Gammaproteobacteria.

    PubMed

    Poot-Hernandez, Augusto Cesar; Rodriguez-Vazquez, Katya; Perez-Rueda, Ernesto

    2015-11-17

    It is generally accepted that gene duplication followed by functional divergence is one of the main sources of metabolic diversity. In this regard, there is an increasing interest in the development of methods that allow the systematic identification of these evolutionary events in metabolism. Here, we used a method not based on biomolecular sequence analysis to compare and identify common and variable routes in the metabolism of 40 Gammaproteobacteria species. The metabolic maps deposited in the KEGG database were transformed into linear Enzymatic Step Sequences (ESS) by using the breadth-first search algorithm. These ESS represent subsequent enzymes linked to each other, where their catalytic activities are encoded in the Enzyme Commission numbers. The ESS were compared in an all-against-all (pairwise comparisons) approach by using a dynamic programming algorithm, leaving only a set of significant pairs. From these comparisons, we identified a set of functionally conserved enzymatic steps in different metabolic maps, in which cell wall components and fatty acid and lysine biosynthesis were included. In addition, we found that pathways associated with biosynthesis share a higher proportion of similar ESS than degradation pathways and secondary metabolism pathways. Also, maps associated with the metabolism of similar compounds contain a high proportion of similar ESS, such as those maps from nucleotide metabolism pathways, in particular the inosine monophosphate pathway. Furthermore, diverse ESS associated with the low part of the glycolysis pathway were identified as functionally similar to multiple metabolic pathways. In summary, our comparisons may help to identify similar reactions in different metabolic pathways and could reinforce the patchwork model in the evolution of metabolism in Gammaproteobacteria.

  10. Evolutionarily stable size of a megagametophyte: evolution of tiny megagametophytes of angiosperms from large ones of gymnosperms.

    PubMed

    Sakai, Satoki

    2013-02-01

    To examine the factors favoring large megagametophytes of gymnosperms and tiny ones of angiosperms, a game model for seed production was developed in which megagametophytes growing in the same female parent compete for resources provided by the parent. In the model, megagametophytes may continue to grow until seed completion or may cease to grow at a certain time and regrow at pollination or fertilization. Autonomous abortion of unpollinated or unfertilized megagametophytes may occur either at pollination or fertilization. Those megagametophytes absorb a certain amount of resources before abortion, due to constraints in the signal process, in addition to the resources absorbed before pollination or fertilization. It was found that both growth habits can be the ESS: megagametophytes continue to grow without cessation and monopolize resources, such as gymnosperms, or cease to grow until fertilization to reduce the loss of resources due to autonomous abortion, such as angiosperms. The former and the latter are the ESS if the time interval between pollination and fertilization is long and short, respectively. Thus, the fertilization interval may be a critical factor selecting for large megagametophytes of gymnosperms or tiny ones of angiosperms. © 2012 The Author(s). Evolution© 2012 The Society for the Study of Evolution.

  11. KSC-2009-1996

    NASA Image and Video Library

    2009-03-09

    CAPE CANAVERAL, Fla. – Media were invited to a showing of the Ares I-X simulator rocket segments at NASA's Kennedy Space Center in Florida. Here, Bob Ess and Jon Cowart discuss the flight test objectives of the Ares I-X targeted for launch in July 2009. Ess is manager of the Ares I-X project. Cowart is Ares I-X deputy mission manager. The I-X flight will provide NASA an early opportunity to test and prove hardware, facilities and ground operations associated with Ares I, part of the Constellation Program to return men to the moon and beyond. Ares I is the essential core of a safe, reliable, cost-effective space transportation system that eventually will carry crewed missions back to the moon, on to Mars and out into the solar system. Photo credit: NASA/Jack Pfaller

  12. Road weather information system environmental sensor station siting guide, version 2.0

    DOT National Transportation Integrated Search

    2008-11-01

    FHWA initiated an effort in 2007 to evaluate and update, as necessary the ESS Guidelines first published in 2004 (FHWA-HOP-05-026). This effort is summarized in a companion report Implementation and Evaluation of RWIS ESS Siting Guidelines. The...

  13. Computational fluid dynamics tools can be used to predict the progression of coronary artery disease

    NASA Astrophysics Data System (ADS)

    Coşkun, A. Ümit; Chen, Caixia; Stone, Peter H.; Feldman, Charles L.

    2006-03-01

    Atherosclerosis is focal and individual plaques evolve in an independent manner. The endothelium regulates arterial behavior by responding to its local shear stress. In vitro studies indicate that low endothelial shear stress (ESS) upregulates the genetic and molecular responses leading to the initiation and progression of atherosclerosis and promotes inflammation and formation of other features characteristic of vulnerable plaque. Physiologic ESS is vasculoprotective and fosters quiescence of the endothelium and vascular wall. High ESS promotes platelet aggregation. ESS and vascular wall morphology along the course of human coronary arteries can now be characterized in vivo, and may predict the focal areas in which atherosclerosis progression occurs. Rapidly evolving methodologies are able to characterize the arterial wall and the local hemodynamic factors likely responsible for progression of coronary disease in man. These new diagnostic modalities allow for identification of plaque progression. Accurate identification of arterial segments at high-risk for progression may permit pre-emptive intervention strategies to avoid adverse coronary events.

  14. Exploring optimal supplement strategy of medicinal herbs and tea extracts for bioelectricity generation in microbial fuel cells.

    PubMed

    Chen, Bor-Yann; Liao, Jia-Hui; Hsu, An-Wei; Tsai, Po-Wei; Hsueh, Chung-Chuan

    2018-05-01

    This first-attempt study used extracts of appropriate antioxidant abundant Camellia and non-Camellia tea and medicinal herbs as model ESs to stably intensify bioelectricity generation performance in microbial fuel cells (MFCs). As electron shuttles (ESs) could stimulate electron transport phenomena by significant reduction of electron transfer resistance, the efficiency of power generation for energy extraction in microbial fuel cells (MFCs) could be appreciably augmented. Using environmentally friendly natural bioresource as green bioresource of ESs is the most promising to sustainable practicability. As comparison of power-density profiles indicated, supplement of Camellia tea extracts would be the most appropriate, then followed non-Camellia Chrysanthemum tea and medicinal herbs. Antioxidant activities, total phenolic contents and power stimulating activities were all electrochemically associated. In particular, the extract of unfermented Camellia tea (i.e., green tea) was the most promising ESs to augment bioenergy extraction compared to other refreshing medicinal herb extracts. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Fatigue as Presenting Symptom and a High Burden of Premature Ventricular Contractions Are Independently Associated With Increased Ventricular Wall Stress in Patients With Normal Left Ventricular Function.

    PubMed

    van Huls van Taxis, Carine F B; Piers, Sebastiaan R D; de Riva Silva, Marta; Dekkers, Olaf M; Pijnappels, Daniël A; Schalij, Martin J; Wijnmaalen, Adrianus P; Zeppenfeld, Katja

    2015-12-01

    High idiopathic premature ventricular contractions (PVC) burden has been associated with PVC-induced cardiomyopathy. Patients may be symptomatic before left ventricular (LV) dysfunction develops. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and circumferential end-systolic wall stress (cESS) on echocardiography are markers for increased ventricular wall stress. This study aimed to evaluate the relation between presenting symptoms, PVC burden, and increased ventricular wall stress in patients with frequent PVCs and preserved LV function. Eighty-three patients (41 men; 49±15 years) with idiopathic PVCs and normal LV function referred for PVC ablation were included. Type of symptoms (palpitations, fatigue, and [near-]syncope), PVC burden on 24-hour Holter, NT-proBNP levels, and cESS on echocardiography were assessed before and 3 months after ablation. Sustained successful ablation was defined as ≥80% PVC burden reduction during follow-up. Patients were symptomatic for 24 months (Q1-Q3, 16-60); 73% reported palpitations, 47% fatigue, and 30% (near-)syncope. Baseline PVC burden was 23±13%, median NT-proBNP 92 pg/mL (Q1-Q3 50-156), and cESS 143±35 kdyne/cm(2). Fatigue was associated with higher baseline NT-proBNP and cESS (P<0.001, P=0.011, respectively). After sustained successful ablation, achieved in 81%, NT-proBNP and cESS decreased significantly (P<0.001 and P=0.036, respectively). Fatigue was independently associated with a significantly larger reduction in NT-proBNP. In patients with nonsuccessful ablation, NT-proBNP and cESS remained unchanged. In patients with frequent PVCs and preserved LV function, fatigue was associated with higher baseline NT-proBNP and cESS, and with a significantly larger reduction in NT-proBNP after sustained successful ablation. These findings support a link between fatigue and PVC-induced increased ventricular wall stress, despite preserved LV function. © 2015 American Heart Association, Inc.

  16. Broadband Seismometers with Electrochemical Motion Sensors: Past, Present, Future.

    NASA Astrophysics Data System (ADS)

    Abramovich, I. A.; Kharlamov, A. V.

    2004-05-01

    First conceived in the fifties, electrochemical seismic sensors (ESS), despite their many attractive features, until relatively recently could not compete successfully with traditional electromechanical instruments. ESS are characterized by ruggedness, low to extremely low power consumption, no need in any maintenance (mass locking and centering), ability to operate normally at large installation tilts. The main shortcoming was ESS insuffi-cient parameter stability and limited dynamic range. The only way to overcome these deficiencies was to introduce a force-balancing feedback. A seemingly more suitable (both physics- and design-wise ) magnetohydrodynamic feedback was thorough investigated and while provided for adequate stability, proved highly ineffective in expanding the dy-namic range on higher frequencies. Finally, after many unsuccessful attempts, we man-aged to incorporate an electrodynamic feedback which solved both problems. In order to enable using such a feedback it was necessary to completely re-evaluate the hydrodynamic and electrochemical properties of the motion sensor and work around numerous parasitic effects which required re-evaluation of the sensor's mathematical model and exhaustive experimentation. This work resulted in the development of a family of high-performance seismometers. Further R&D effort is two-fold: improvement of the present sensors and development of a broadband seismometer with noise below the NLNM across the whole passband.

  17. Effects of the new Accreditation Council for Graduate Medical Education work hour rules on surgical interns: a prospective study in a community teaching hospital.

    PubMed

    Kamine, Tovy Haber; Barron, Rebecca J; Lesicka, Agnieszka; Galbraith, John D; Millham, Frederick H; Larson, Janet

    2013-02-01

    On July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) eliminated 30-hour call in an attempt to improve resident wakefulness. We surveyed interns on the Newton Wellesley Hospital (NWH) surgery service before and after the transition from Q4 overnight call to a night float schedule. For 15 weeks, interns completed weekly surveys including the Epworth Sleepiness Scale (ESS). The service changed to a night float schedule after 3 weeks (ie, first to 3-4 and then to 6 nights in a row). The average ESS score rose from 9.8 ± 5.2 to 14.9 ± 3.1 and 14.4 ± 4.5 (P = .042) on the 3/4 and 6/1 schedules, respectively. Interns were more likely to be abnormally tired on either night float schedule (relative risk = 2.86; 95% confidence interval, 1.17-6.97, P = .029). The new ACGME work hours increased the ESS scores among interns at NWH and caused interns to be more tired than interns on the Q4 schedule. This is likely caused by the multiple nights of poor sleep without a post-call day to make up sleep. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Physicochemical characterization of atorvastatin calcium/ezetimibe amorphous nano-solid dispersions prepared by electrospraying method.

    PubMed

    Jahangiri, Azin; Barzegar-Jalali, Mohammad; Javadzadeh, Yousef; Hamishehkar, Hamed; Adibkia, Khosro

    2017-09-01

    In the present study, electrospraying was applied as a novel method for the fabrication of amorphous nano-solid dispersions (N-SDs) of atorvastatin calcium (ATV), ezetimibe (EZT), and ATV/EZT combination as poorly water-soluble drugs. N-SDs were prepared using polyvinylpyrrolidone K30 as an amorphous carrier in 1:1 and 1:5 drug to polymer ratios and the total solid (including drug and polymer) concentrations of 10 and 20% (w/v). The prepared formulations were further investigated for their morphological, physicochemical, and dissolution properties. Scanning electron microscopy studies indicated that the morphology and diameter of the electrosprayed samples (ESs) were influenced by the solution concentration and drug:polymer ratio, so that an increase in the solution concentration resulted in fiber formation while an increase in the polymer ratio led to enhancement of the particle diameter. Differential scanning calorimetry and X-ray powder diffraction studies together with in vitro dissolution test revealed that the ESs were present in an amorphous form with improved dissolution properties. Infrared spectroscopic studies showed hydrogen-bonding interaction between the drug and polymer in ESs. Since the electrospraying method benefits from the both amorphization and nanosizing effect, this novel approach seems to be an efficient method for the fabrication of N-SDs of poorly water-soluble drugs.

  19. Effect of APAP and heated humidification with a heated breathing tube on adherence, quality of life, and nasopharyngeal complaints.

    PubMed

    Nilius, Georg; Franke, Karl J; Domanski, Ulrike; Schroeder, Maik; Ruhle, Karl H

    2016-03-01

    Positive airway pressure (PAP) therapy adherence can be affected by rhinitis sicca and xerostomia complaints. Additional heated humidification (HH) is the appropriate method when such complaints arise. The aim of this study was to determine if HH with a supplementary heated breathing tube can increase adherence, reduce subjective nasopharyngeal complaints (NPC), and improve sleepiness (ESS: Epworth Sleepiness Scale) and quality of life (FOSQ: Functional Outcome of Sleep Questionnaire). We subdivided 72 obstructive sleep apnea (OSA) patients into two groups before therapy initiation. The NPC risk group consists of subjects with NPC and the low-risk group without. The risk group was identified by a score of >9 in a 5-item 25-point NPC questionnaire and pathological ESS. All patients were eligible for automatic CPAP devices (APAP), which were randomly configured with or without HH during 6 weeks. The adherence differences with and without HH were not significant in the NPC risk group (330 ± 103 vs. 281 ± 118 min/night) and in the low-risk group (330 ± 116 vs. 321 ± 89). NPC and ESS scores in the risk group were both significantly reduced with HH. Daily function (FOSQ) in the risk group was significantly improved with HH (90.0 ± 11.9 vs. 82.0 ± 12.0 (p < 0.05)). HH showed a tendency to improve APAP adherence. The adherence in both groups was quite high, and for that reason, it is difficult to show a statistically significant effect. A differentiation into NPC risk groups before starting PAP treatment is useful. HH reduces side effects and sleepiness and improves quality of life in an NPC risk group.

  20. Report from enhanced safety surveillance of two influenza vaccines (Vaxigrip and Intanza 15 μg) in two European countries during influenza season 2016/17 and comparison with 2015/16 season

    PubMed Central

    Chabanon, Anne Laure; Bricout, Hélène; Ballandras, Céline; Souverain, Audrey; Caroe, Timothy David; Butler, Karina M.

    2018-01-01

    ABSTRACT Passive enhanced safety surveillance (ESS) was implemented in the United Kingdom and in the Republic of Ireland for Vaxigrip and Intanza 15 µg influenza vaccines during the 2016/17 influenza season. Lessons learned during 2015/16 ESS implementation were integrated and applied towards the current ESS. The primary objective was to estimate the reporting rates of suspected adverse reactions (ARs) occurring within 7 days of vaccination with Vaxigrip or Intanza 15 µg. For Vaxigrip (N = 962), 17 vaccinees (1.8%) reported 59 suspected ARs (6.1%) within 7 days of vaccination. For Intanza 15 µg (N = 1000), 21 vaccinees (2.1%) reported 101 (10.1%) suspected ARs within 7 days of vaccination. No obvious pattern in the type of suspected ARs or their frequency was observed for either vaccine. None of the frequencies of suspected ARs were above the 2015/16 ESS frequencies for Vaxigrip, whereas for Intanza 15 µg only one AR (oropharyngeal pain) crossed the historical threshold. There was no change in reactogenicity and data was consistent with the safety profiles of the two vaccines. The passive ESS experience gained from season to season will help to contribute to a sustainable safety surveillance system of seasonal influenza vaccines early in the season. PMID:29148911

  1. Inositol phosphate pathway controls transcription of telomeric expression sites in trypanosomes

    PubMed Central

    Cestari, Igor; Stuart, Ken

    2015-01-01

    African trypanosomes evade clearance by host antibodies by periodically changing their variant surface glycoprotein (VSG) coat. They transcribe only one VSG gene at a time from 1 of about 20 telomeric expression sites (ESs). They undergo antigenic variation by switching transcription between telomeric ESs or by recombination of the VSG gene expressed. We show that the inositol phosphate (IP) pathway controls transcription of telomeric ESs and VSG antigenic switching in Trypanosoma brucei. Conditional knockdown of phosphatidylinositol 5-kinase (TbPIP5K) or phosphatidylinositol 5-phosphatase (TbPIP5Pase) or overexpression of phospholipase C (TbPLC) derepresses numerous silent ESs in T. brucei bloodstream forms. The derepression is specific to telomeric ESs, and it coincides with an increase in the number of colocalizing telomeric and RNA polymerase I foci in the nucleus. Monoallelic VSG transcription resumes after reexpression of TbPIP5K; however, most of the resultant cells switched the VSG gene expressed. TbPIP5K, TbPLC, their substrates, and products localize to the plasma membrane, whereas TbPIP5Pase localizes to the nucleus proximal to telomeres. TbPIP5Pase associates with repressor/activator protein 1 (TbRAP1), and their telomeric silencing function is altered by TbPIP5K knockdown. These results show that specific steps in the IP pathway control ES transcription and antigenic switching in T. brucei by epigenetic regulation of telomere silencing. PMID:25964327

  2. Assessment of Dry Epidermal Electrodes for Long-Term Electromyography Measurements

    PubMed Central

    Peters, Keshia M.; Milovanovic, Ivana; Kuang, Irene; Yang, Zeyu; Lu, Nanshu; Steele, Katherine M.

    2018-01-01

    Commercially available electrodes can only provide quality surface electromyography (sEMG) measurements for a limited duration due to user discomfort and signal degradation, but in many applications, collecting sEMG data for a full day or longer is desirable to enhance clinical care. Few studies for long-term sEMG have assessed signal quality of electrodes using clinically relevant tests. The goal of this research was to evaluate flexible, gold-based epidermal sensor system (ESS) electrodes for long-term sEMG recordings. We collected sEMG and impedance data from eight subjects from ESS and standard clinical electrodes on upper extremity muscles during maximum voluntary isometric contraction tests, dynamic range of motion tests, the Jebsen Taylor Hand Function Test, and the Box & Block Test. Four additional subjects were recruited to test the stability of ESS signals over four days. Signals from the ESS and traditional electrodes were strongly correlated across tasks. Measures of signal quality, such as signal-to-noise ratio and signal-to-motion ratio, were also similar for both electrodes. Over the four-day trial, no significant decrease in signal quality was observed in the ESS electrodes, suggesting that thin, flexible electrodes may provide a robust tool that does not inhibit movement or irritate the skin for long-term measurements of muscle activity in rehabilitation and other applications. PMID:29677129

  3. Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis.

    PubMed

    Vest, Joshua R; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B

    2015-12-01

    Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004-2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = -0.17; 95% confidence interval [CI] = [-0.25, -0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis

    PubMed Central

    Vest, Joshua R.; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B.

    2016-01-01

    Introduction Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Methods Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004–2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. Results A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = −0.17; 95% confidence interval [CI] = [−0.25, −0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Conclusions Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. PMID:26614882

  5. Supporting NEESPI with Data Services - The SIB-ESS-C e-Infrastructure

    NASA Astrophysics Data System (ADS)

    Gerlach, R.; Schmullius, C.; Frotscher, K.

    2009-04-01

    Data discovery and retrieval is commonly among the first steps performed for any Earth science study. The way scientific data is searched and accessed has changed significantly over the past two decades. Especially the development of the World Wide Web and the technologies that evolved along shortened the data discovery and data exchange process. On the other hand the amount of data collected and distributed by earth scientists has increased exponentially requiring new concepts for data management and sharing. One such concept to meet the demand is to build up Spatial Data Infrastructures (SDI) or e-Infrastructures. These infrastructures usually contain components for data discovery allowing users (or other systems) to query a catalogue or registry and retrieve metadata information on available data holdings and services. Data access is typically granted using FTP/HTTP protocols or, more advanced, through Web Services. A Service Oriented Architecture (SOA) approach based on standardized services enables users to benefit from interoperability among different systems and to integrate distributed services into their application. The Siberian Earth System Science Cluster (SIB-ESS-C) being established at the University of Jena (Germany) is such a spatial data infrastructure following these principles and implementing standards published by the Open Geospatial Consortium (OGC) and the International Organization for Standardization (ISO). The prime objective is to provide researchers with focus on Siberia with the technical means for data discovery, data access, data publication and data analysis. The region of interest covers the entire Asian part of the Russian Federation from the Ural to the Pacific Ocean including the Ob-, Lena- and Yenissey river catchments. The aim of SIB-ESS-C is to provide a comprehensive set of data products for Earth system science in this region. Although SIB-ESS-C will be equipped with processing capabilities for in-house data generation (mainly from Earth Observation), current data holdings of SIB-ESS-C have been created in collaboration with a number of partners in previous and ongoing research projects (e.g. SIBERIA-II, SibFORD, IRIS). At the current development stage the SIB-ESS-C system comprises a federated metadata catalogue accessible through the SIB-ESS-C Web Portal or from any OGC-CSW compliant client. Due to full interoperability with other metadata catalogues users of the SIB-ESS-C Web Portal are able to search external metadata repositories. The Web Portal contains also a simple visualization component which will be extended to a comprehensive visualization and analysis tool in the near future. All data products are already accessible as a Web Mapping Service and will be made available as Web Feature and Web Coverage Services soon allowing users to directly incorporate the data into their application. The SIB-ESS-C infrastructure will be further developed as one node in a network of similar systems (e.g. NASA GIOVANNI) in the NEESPI region.

  6. PVD thermal barrier coating applications and process development for aircraft engines

    NASA Astrophysics Data System (ADS)

    Rigney, D. V.; Viguie, R.; Wortman, D. J.; Skelly, D. W.

    1997-06-01

    Thermal barrier coatings (TBCs) have been developed for application to aircraft engine components to improve service life in an increasingly hostile thermal environment. The choice of TBC type is related to the component, intended use, and economics. Selection of electron beam physical vapor deposition proc-essing for turbine blade is due in part to part size, surface finish requirements, thickness control needs, and hole closure issues. Process development of PVD TBCs has been carried out at several different sites, including GE Aircraft Engines (GEAE). The influence of processing variables on microstructure is dis-cussed, along with the GEAE development coater and initial experiences of pilot line operation.

  7. Effect of Adenotonsillectomy on Parent-Reported Sleepiness in Children with Obstructive Sleep Apnea

    PubMed Central

    Paruthi, Shalini; Buchanan, Paula; Weng, Jia; Chervin, Ronald D.; Mitchell, Ronald B.; Dore-Stites, Dawn; Sadhwani, Anjali; Katz, Eliot S.; Bent, John; Rosen, Carol L.; Redline, Susan; Marcus, Carole L.

    2016-01-01

    Study Objectives: To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC. Methods: Parents of children aged 5.0–9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire-Sleepiness Subscale (PSQ-SS). PSG was performed at baseline and at 7-mo endpoint. Children underwent early adenotonsillectomy or WWSC. Results: The mESS and PSQ-SS classified 24% and 53% of the sample as excessively sleepy, respectively. At baseline, mean mESS score was 7.4 ± 5.0 (SD) and mean PSQ-SS score was 0.44 ± 0.30. Sleepiness scores were higher in African American children; children with shorter sleep duration; older children; and overweight children. At endpoint, mean mESS score decreased by 2.0 ± 4.2 in the eAT group versus 0.3 ± 4.0 in the WWSC group (P < 0.0001); mean PSQ-SS score decreased 0.29 ± 0.40 in eAT versus 0.08 ± 0.40 in the WWSC group (P < 0.0001). Despite higher baseline sleepiness, African American children experienced similar improvement with adenotonsillectomy than other children. Improvement in sleepiness was weakly associated with improved apnea-hypopnea index or oxygen desaturation indices, but not with change in other polysomnographic measures. Conclusions: Sleepiness assessed by parent report was prevalent; improved more after eAT than after WWSC; and was not strongly predicted by sleep disturbances identified by PSG. Clinical Trial Registration: Childhood Adenotonsillectomy Study for Children with OSA (CHAT). ClinicalTrials.gov Identifier #NCT00560859. Citation: Paruthi S, Buchanan P, Weng J, Chervin RD, Mitchell RB, Dore-Stites D, Sadhwani A, Katz ES, Bent J, Rosen CL, Redline S, Marcus CL. Effect of adenotonsillectomy on parent-reported sleepiness in children with obstructive sleep apnea. SLEEP 2016;39(11):2005–2012. PMID:27568804

  8. On the Berry-Esséen bound of frequency polygons for ϕ-mixing samples.

    PubMed

    Huang, Gan-Ji; Xing, Guodong

    2017-01-01

    Under some mild assumptions, the Berry-Esséen bound of frequency polygons for ϕ -mixing samples is presented. By the bound derived, we obtain the corresponding convergence rate of uniformly asymptotic normality, which is nearly [Formula: see text] under the given conditions.

  9. The Landscape Framework for the Spatial Characterization and Mapping of Ecosystem Services: What is the State of the Science?

    EPA Science Inventory

    Ecosystem services (ESS) represent an ecosystems capacity for satisfying essential human needs, directly or indirectly, above that required to maintain ecosystem integrity (structure, function and processes). The spatial characterization and mapping of ESS is an essential first s...

  10. Assessing the Accuracy of Soil Carbon Inventories in a Forested Watershed Using Conventional and Advanced Approaches

    EPA Science Inventory

    Soils provide a number of vital Ecosystem Services (ESs) that society depends upon. Carbon held in soils contributes to a number of ESs including the production of food and fiber; water recharge, storage and purification; nutrient cycling, reducing soil erosion and climate regul...

  11. Digital Interventions for Problematic Cannabis Users in Non-Clinical Settings: Findings from a Systematic Review and Meta-Analysis.

    PubMed

    Hoch, Eva; Preuss, Ulrich W; Ferri, Marica; Simon, Roland

    2016-01-01

    Existing cannabis treatment programs reach only a very limited proportion of people with cannabis-related problems. The aim of this systematic review and meta-analysis was to assess the effectiveness of digital interventions applied outside the health care system in reducing problematic cannabis use. We systematically searched the Cochrane Central Register of Controlled Trials (2015), PubMed (2009-2015), Medline (2009-2015), Google Scholar (2015) and article reference lists for potentially eligible studies. Randomized controlled trials examining the effects of internet- or computer-based interventions were assessed. Study effects were estimated by calculating effect sizes (ESs) using Cohen's d and Hedges' g bias-corrected ES. The primary outcome assessed was self-reported cannabis use, measured by a questionnaire. Fifty-two studies were identified. Four studies (including 1,928 participants) met inclusion criteria. They combined brief motivational interventions and cognitive behavioral therapy delivered online. All studies were of good quality. The pooled mean difference (x0394; = 4.07) and overall ES (0.11) give evidence of small effects at 3-month follow-up in favor of digital interventions. Digital interventions can help to successfully reduce problematic cannabis use outside clinical settings. They have some potential to overcome treatment barriers and increase accessibility for at-risk cannabis users. © 2016 S. Karger AG, Basel.

  12. Long-term sinonasal outcomes of aspirin desensitization in aspirin exacerbated respiratory disease.

    PubMed

    Cho, Kyu-Sup; Soudry, Ethan; Psaltis, Alkis J; Nadeau, Kari C; McGhee, Sean A; Nayak, Jayakar V; Hwang, Peter H

    2014-10-01

    This study aimed to assess sinonasal outcomes in patients with aspirin exacerbated respiratory disease (AERD) undergoing aspirin desensitization following endoscopic sinus surgery (ESS). Case series with chart review. University hospital. A retrospective review of sinonasal outcomes was conducted for 30 AERD patients undergoing aspirin desensitization and maintenance therapy following ESS. Sinonasal outcomes were prospectively assessed by the Sinonasal Outcomes Test-22 (SNOT-22) and endoscopic polyp grading system. Data were collected preoperatively, 1 and 4 weeks postsurgery (before desensitization), and 1, 6, 12, 18, 24, and 30 months after aspirin desensitization. Twenty-eight of 30 patients (93.3%) successfully completed aspirin desensitization, whereas 2 of 30 (6.7%) were unable to complete desensitization due to respiratory intolerance. Of the 21 patients who successfully completed a minimum of 24 weeks of follow-up, 20 (95.2%) patients demonstrated sustained endoscopic and symptomatic improvement for a median follow-up period of 33 months. After surgical treatment but before desensitization, patients experienced significant reductions in SNOT-22 and polyp grade scores. In the first 6 months after aspirin desensitization, patients experienced further significant reductions in SNOT-22 scores, whereas polyp grade remained stable. The improvements in symptom endoscopic scores were preserved throughout the follow-up period after desensitization. No patients required additional sinus surgery. One patient had to discontinue aspirin therapy due to gastrointestinal side effects. No other adverse reactions to aspirin were noted. Aspirin desensitization following ESS appears to be a well-tolerated and effective adjunctive therapy for long-term control of nasal polyposis in patients with AERD. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  13. Contemporary considerations in concurrent endoscopic sinus surgery and rhinoplasty.

    PubMed

    Steele, Toby O; Gill, Amarbir; Tollefson, Travis T

    2018-06-11

    Characterize indications, perioperative considerations, clinical outcomes and complications for concurrent endoscopic sinus surgery (ESS) and rhinoplasty. Chronic rhinosinusitis and septal deviation with or without inferior turbinate hypertrophy independently impair patient-reported quality of life. Guidelines implore surgeons to include endoscopy to accurately evaluate patient symptoms. Complication rates parallel those of either surgery (ESS and rhinoplasty) alone and are not increased when performed concurrently. Operative time is generally longer for joint surgeries. Patient satisfaction rates are high. Concurrent functional and/or cosmetic rhinoplasty and ESS is a safe endeavor to perform in a single operative setting and most outcomes data suggest excellent patient outcomes. Additional studies that include patient-reported outcome measures are needed.

  14. The ESS Superconducting RF Cavity and Cryomodule Cryogenic Processes

    NASA Astrophysics Data System (ADS)

    Darve, C.; Elias, N.; Molloy, S.; Bosland, P.; Renard, B.; Bousson, S.; Olivier, G.; Reynet, D.; Thermeau, J. P.

    The European Spallation Source (ESS) is one of Europe's largest research infrastructures, tobring new insights to the grand challenges of science and innovation in fields as diverse as material and life sciences, energy, environmental technology, cultural heritage,solid-state and fundamental physics by the end of the decade. The collaborative project is funded by a collaboration of 17 European countries and is under design and construction in Lund, Sweden. A 5 MW, long pulse proton accelerator is used to reach this goal. The pulsed length is 2.86 ms and the repetition frequency is 14 Hz (4% duty cycle). The choice of SRF technology is a key element in the development of the ESS linear accelerator (linac). The superconducting linacis composed of one section of spoke cavity cryomodules(352.21 MHz) and two sections of elliptical cavity cryomodules (704.42 MHz). These cryomodules contain niobium SRF cavities operating at 2 K, cooled by the accelerator cryoplantthrough the cryogenic distribution system. This paper presents the superconducting RF cavity and cryomodule cryogenic processes, which are developed for the technology demonstrators and to be ultimately integrated for the ESS tunnel operation.

  15. Use of an Electrostatic Spraying System or the Sprayed Lethality in Container Method To Deliver Antimicrobial Agents onto the Surface of Beef Subprimals To Control Shiga Toxin-Producing Escherichia coli.

    PubMed

    Stella, J Max; Luchansky, John B; Miller, Kelsey; Shoyer, Bradley A; Shane, Laura E; McGeary, Lianna; Osoria, Manuela; Stahler, Laura J; Sevart, Nicholas J; Phebus, Randall K; Thippareddi, Harshavardhan; Porto-Fett, Anna C S

    2017-08-01

    The efficacy of an electrostatic spraying system (ESS) and/or the sprayed lethality in container (SLIC) method to deliver antimicrobial agents onto the surface of beef subprimals to reduce levels of Shiga toxin-producing Escherichia coli (STEC) was evaluated. Beef subprimals were surface inoculated (lean side; ca. 5.8 log CFU per subprimal) with 2 mL of an eight-strain cocktail comprising single strains of rifampin-resistant (100 μg/mL) STEC (O26:H11, O45:H2, O103:H2, O104:H4, O111:H - , O121:H19, O145:NM, and O157:H7). Next, inoculated subprimals were surface treated with lauric arginate (LAE; 1%), peroxyacetic acid (PAA; 0.025%), or cetylpyridinium chloride (CPC; 0.4%) by passing each subprimal, with the inoculated lean side facing upward, through an ESS cabinet or via SLIC. Subprimals were then vacuum packaged and stored at 4°C. One set of subprimals was sampled after an additional 2 h, 3 days, or 7 days of refrigerated storage, whereas another set was retreated via SLIC after 3 days of storage with a different one of the three antimicrobial agents (e.g., a subprimal treated with LAE on day 0 was then treated with PAA or CPE on day 3). Retreated subprimals were sampled after 2 h or 4 days of additional storage at 4°C. A single initial application of LAE, PAA, or CPC via ESS or SLIC resulted in STEC reductions of ca. 0.3 to 1.3 log CFU per subprimal after 7 days of storage. However, when subprimals were initially treated with LAE, PAA, or CPC via ESS or SLIC and then separately retreated with a different one of these antimicrobial agents via SLIC on day 3, additional STEC reductions of 0.4 to 1.0 log CFU per subprimal were observed after an additional 4 days of storage. Application of LAE, PAA, or CPC, either alone or in combination, via ESS or SLIC is effective for reducing low levels (ca. 0.3 to 1.6 log CFU) of STEC that may be naturally present on the surface of beef subprimals.

  16. The Effects of Activity-Based Elementary Science Programs on Student Outcomes and Classroom Practices: A Meta Analysis of Controlled Studies.

    ERIC Educational Resources Information Center

    Bredderman, Ted

    A quantitative synthesis of research findings on the effects of three major activity-based elementary science programs developed with National Science Foundation support was conducted. Controlled evaluation studies of the Elementary Science Study (ESS), Science-A Process Approach (SAPA), or The Science Curriculum Improvement Study (SCIS) were used…

  17. Construct validity of the ovine model in endoscopic sinus surgery training.

    PubMed

    Awad, Zaid; Taghi, Ali; Sethukumar, Priya; Tolley, Neil S

    2015-03-01

    To demonstrate construct validity of the ovine model as a tool for training in endoscopic sinus surgery (ESS). Prospective, cross-sectional evaluation study. Over 18 consecutive months, trainees and experts were evaluated in their ability to perform a range of tasks (based on previous face validation and descriptive studies conducted by the same group) relating to ESS on the sheep-head model. Anonymized randomized video recordings of the above were assessed by two independent and blinded assessors. A validated assessment tool utilizing a five-point Likert scale was employed. Construct validity was calculated by comparing scores across training levels and experts using mean and interquartile range of global and task-specific scores. Subgroup analysis of the intermediate group ascertained previous experience. Nonparametric descriptive statistics were used, and analysis was carried out using SPSS version 21 (IBM, Armonk, NY). Reliability of the assessment tool was confirmed. The model discriminated well between different levels of expertise in global and task-specific scores. A positive correlation was noted between year in training and both global and task-specific scores (P < .001). Experience of the intermediate group was variable, and the number of ESS procedures performed under supervision had the highest impact on performance. This study describes an alternative model for ESS training and assessment. It is also the first to demonstrate construct validity of the sheep-head model for ESS training. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Mobile Visualization and Analysis Tools for Spatial Time-Series Data

    NASA Astrophysics Data System (ADS)

    Eberle, J.; Hüttich, C.; Schmullius, C.

    2013-12-01

    The Siberian Earth System Science Cluster (SIB-ESS-C) provides access and analysis services for spatial time-series data build on products from the Moderate Resolution Imaging Spectroradiometer (MODIS) and climate data from meteorological stations. Until now a webportal for data access, visualization and analysis with standard-compliant web services was developed for SIB-ESS-C. As a further enhancement a mobile app was developed to provide an easy access to these time-series data for field campaigns. The app sends the current position from the GPS receiver and a specific dataset (like land surface temperature or vegetation indices) - selected by the user - to our SIB-ESS-C web service and gets the requested time-series data for the identified pixel back in real-time. The data is then being plotted directly in the app. Furthermore the user has possibilities to analyze the time-series data for breaking points and other phenological values. These processings are executed on demand of the user on our SIB-ESS-C web server and results are transfered to the app. Any processing can also be done at the SIB-ESS-C webportal. The aim of this work is to make spatial time-series data and analysis functions available for end users without the need of data processing. In this presentation the author gives an overview on this new mobile app, the functionalities, the technical infrastructure as well as technological issues (how the app was developed, our made experiences).

  19. PROTECTED POLYMORPHISMS AND EVOLUTIONARY STABILITY OF PATCH-SELECTION STRATEGIES IN STOCHASTIC ENVIRONMENTS

    PubMed Central

    EVANS, STEVEN N.; HENING, ALEXANDRU; SCHREIBER, SEBASTIAN J.

    2015-01-01

    We consider a population living in a patchy environment that varies stochastically in space and time. The population is composed of two morphs (that is, individuals of the same species with different genotypes). In terms of survival and reproductive success, the associated phenotypes differ only in their habitat selection strategies. We compute invasion rates corresponding to the rates at which the abundance of an initially rare morph increases in the presence of the other morph established at equilibrium. If both morphs have positive invasion rates when rare, then there is an equilibrium distribution such that the two morphs coexist; that is, there is a protected polymorphism for habitat selection. Alternatively, if one morph has a negative invasion rate when rare, then it is asymptotically displaced by the other morph under all initial conditions where both morphs are present. We refine the characterization of an evolutionary stable strategy for habitat selection from [Schreiber, 2012] in a mathematically rigorous manner. We provide a necessary and sufficient condition for the existence of an ESS that uses all patches and determine when using a single patch is an ESS. We also provide an explicit formula for the ESS when there are two habitat types. We show that adding environmental stochasticity results in an ESS that, when compared to the ESS for the corresponding model without stochasticity, spends less time in patches with larger carrying capacities and possibly makes use of sink patches, thereby practicing a spatial form of bet hedging. PMID:25151369

  20. Preparing Laboratory and Real-World EEG Data for Large-Scale Analysis: A Containerized Approach

    PubMed Central

    Bigdely-Shamlo, Nima; Makeig, Scott; Robbins, Kay A.

    2016-01-01

    Large-scale analysis of EEG and other physiological measures promises new insights into brain processes and more accurate and robust brain–computer interface models. However, the absence of standardized vocabularies for annotating events in a machine understandable manner, the welter of collection-specific data organizations, the difficulty in moving data across processing platforms, and the unavailability of agreed-upon standards for preprocessing have prevented large-scale analyses of EEG. Here we describe a “containerized” approach and freely available tools we have developed to facilitate the process of annotating, packaging, and preprocessing EEG data collections to enable data sharing, archiving, large-scale machine learning/data mining and (meta-)analysis. The EEG Study Schema (ESS) comprises three data “Levels,” each with its own XML-document schema and file/folder convention, plus a standardized (PREP) pipeline to move raw (Data Level 1) data to a basic preprocessed state (Data Level 2) suitable for application of a large class of EEG analysis methods. Researchers can ship a study as a single unit and operate on its data using a standardized interface. ESS does not require a central database and provides all the metadata data necessary to execute a wide variety of EEG processing pipelines. The primary focus of ESS is automated in-depth analysis and meta-analysis EEG studies. However, ESS can also encapsulate meta-information for the other modalities such as eye tracking, that are increasingly used in both laboratory and real-world neuroimaging. ESS schema and tools are freely available at www.eegstudy.org and a central catalog of over 850 GB of existing data in ESS format is available at studycatalog.org. These tools and resources are part of a larger effort to enable data sharing at sufficient scale for researchers to engage in truly large-scale EEG analysis and data mining (BigEEG.org). PMID:27014048

  1. Performance of Optimization Heuristics for the Operational Planning of Multi-energy Storage Systems

    NASA Astrophysics Data System (ADS)

    Haas, J.; Schradi, J.; Nowak, W.

    2016-12-01

    In the transition to low-carbon energy sources, energy storage systems (ESS) will play an increasingly important role. Particularly in the context of solar power challenges (variability, uncertainty), ESS can provide valuable services: energy shifting, ramping, robustness against forecast errors, frequency support, etc. However, these qualities are rarely modelled in the operational planning of power systems because of the involved computational burden, especially when multiple ESS technologies are involved. This work assesses two optimization heuristics for speeding up the optimal operation problem. It compares their accuracy (in terms of costs) and speed against a reference solution. The first heuristic (H1) is based on a merit order. Here, the ESS are sorted from lower to higher operational costs (including cycling costs). For each time step, the cheapest available ESS is used first, followed by the second one and so on, until matching the net load (demand minus available renewable generation). The second heuristic (H2) uses the Fourier transform to detect the main frequencies that compose the net load. A specific ESS is assigned to each frequency range, aiming to smoothen the net load. Finally, the reference solution is obtained with a mixed integer linear program (MILP). H1, H2 and MILP are subject to technical constraints (energy/power balance, ramping rates, on/off states...). Costs due to operation, replacement (cycling) and unserved energy are considered. Four typical days of a system with a high share of solar energy were used in several test cases, varying the resolution from one second to fifteen minutes. H1 and H2 achieve accuracies of about 90% and 95% in average, and speed-up times of two to three and one to two orders of magnitude, respectively. The use of the heuristics looks promising in the context of planning the expansion of power systems, especially when their loss of accuracy is outweighed by solar or wind forecast errors.

  2. EssOilDB: a database of essential oils reflecting terpene composition and variability in the plant kingdom

    PubMed Central

    Kumari, Sangita; Pundhir, Sachin; Priya, Piyush; Jeena, Ganga; Punetha, Ankita; Chawla, Konika; Firdos Jafaree, Zohra; Mondal, Subhasish; Yadav, Gitanjali

    2014-01-01

    Plant essential oils are complex mixtures of volatile organic compounds, which play indispensable roles in the environment, for the plant itself, as well as for humans. The potential biological information stored in essential oil composition data can provide an insight into the silent language of plants, and the roles of these chemical emissions in defense, communication and pollinator attraction. In order to decipher volatile profile patterns from a global perspective, we have developed the ESSential OIL DataBase (EssOilDB), a continually updated, freely available electronic database designed to provide knowledge resource for plant essential oils, that enables one to address a multitude of queries on volatile profiles of native, invasive, normal or stressed plants, across taxonomic clades, geographical locations and several other biotic and abiotic influences. To our knowledge, EssOilDB is the only database in the public domain providing an opportunity for context based scientific research on volatile patterns in plants. EssOilDB presently contains 123 041 essential oil records spanning a century of published reports on volatile profiles, with data from 92 plant taxonomic families, spread across diverse geographical locations all over the globe. We hope that this huge repository of VOCs will facilitate unraveling of the true significance of volatiles in plants, along with creating potential avenues for industrial applications of essential oils. We also illustrate the use of this database in terpene biology and show how EssOilDB can be used to complement data from computational genomics to gain insights into the diversity and variability of terpenoids in the plant kingdom. EssOilDB would serve as a valuable information resource, for students and researchers in plant biology, in the design and discovery of new odor profiles, as well as for entrepreneurs—the potential for generating consumer specific scents being one of the most attractive and interesting topics in the cosmetic industry. Database URL: http://nipgr.res.in/Essoildb/ PMID:25534749

  3. Spatial clusters of daytime sleepiness and association with nighttime noise levels in a Swiss general population (GeoHypnoLaus).

    PubMed

    Joost, Stéphane; Haba-Rubio, José; Himsl, Rebecca; Vollenweider, Peter; Preisig, Martin; Waeber, Gérard; Marques-Vidal, Pedro; Heinzer, Raphaël; Guessous, Idris

    2018-05-31

    Daytime sleepiness is highly prevalent in the general adult population and has been linked to an increased risk of workplace and vehicle accidents, lower professional performance and poorer health. Despite the established relationship between noise and daytime sleepiness, little research has explored the individual-level spatial distribution of noise-related sleep disturbances. We assessed the spatial dependence of daytime sleepiness and tested whether clusters of individuals exhibiting higher daytime sleepiness were characterized by higher nocturnal noise levels than other clusters. Population-based cross-sectional study, in the city of Lausanne, Switzerland. Sleepiness was measured using the Epworth Sleepiness Scale (ESS) for 3697 georeferenced individuals from the CoLaus|PsyCoLaus cohort (period = 2009-2012). We used the sonBASE georeferenced database produced by the Swiss Federal Office for the Environment to characterize nighttime road traffic noise exposure throughout the city. We used the GeoDa software program to calculate the Getis-Ord G i * statistics for unadjusted and adjusted ESS in order to detect spatial clusters of high and low ESS values. Modeled nighttime noise exposure from road and rail traffic was compared across ESS clusters. Daytime sleepiness was not randomly distributed and showed a significant spatial dependence. The median nighttime traffic noise exposure was significantly different across the three ESS Getis cluster classes (p < 0.001). The mean nighttime noise exposure in the high ESS cluster class was 47.6, dB(A) 5.2 dB(A) higher than in low clusters (p < 0.001) and 2.1 dB(A) higher than in the neutral class (p < 0.001). These associations were independent of major potential confounders including body mass index and neighborhood income level. Clusters of higher daytime sleepiness in adults are associated with higher median nighttime noise levels. The identification of these clusters can guide tailored public health interventions. Copyright © 2018 The Authors. Published by Elsevier GmbH.. All rights reserved.

  4. Challenges of the NGSS for Future Geoscience Education

    NASA Astrophysics Data System (ADS)

    Wysession, M. E.; Colson, M.; Duschl, R. A.; Lopez, R. E.; Messina, P.; Speranza, P.

    2013-12-01

    The new Next Generation Science Standards (NGSS), which spell out a set of K-12 performance expectations for life science, physical science, and Earth and space science (ESS), pose a variety of opportunities and challenges for geoscience education. Among the changes recommended by the NGSS include establishing ESS on an equal footing with both life science and physical sciences, at the full K-12 level. This represents a departure from the traditional high school curriculum in most states. In addition, ESS is presented as a complex, integrated, interdisciplinary, quantitative Earth Systems-oriented set of sciences that includes complex and politically controversial topics such as climate change and human impacts. The geoscience communities will need to mobilize in order to assist and aid in the full implementation of ESS aspects of the NGSS in as many states as possible. In this context, the NGSS highlight Earth and space science to an unprecedented degree. If the NGSS are implemented in an optimal manner, a year of ESS will be taught in both middle and high school. In addition, because of the complexity and interconnectedness of the ESS content (with material such as climate change and human sustainability), it is recommended (Appendix K of the NGSS release) that much of it be taught following physics, chemistry, and biology. However, there are considerable challenges to a full adoption of the NGSS. A sufficient work force of high school geoscientists qualified in modern Earth Systems Science does not exist and will need to be trained. Many colleges do not credit high school geoscience as a lab science with respect to college admission. The NGSS demand curricular practices that include analyzing and interpreting real geoscience data, and these curricular modules do not yet exist. However, a concerted effort on the part of geoscience research and education organizations can help resolve these challenges.

  5. Refractory Inclusion Size Distribution and Fabric Measured in a Large Slab of the Allende CV3 Chondrite

    NASA Technical Reports Server (NTRS)

    Srinivasan, P.; Simon, Justin I.; Cuzzi, J. N.

    2013-01-01

    Aggregate textures of chondrites reflect accretion of early-formed particles in the solar nebula. Explanations for the size and density variations of particle populations found among chondrites are debated. Differences could have risen out of formation in different locations in the nebula, and/or they could have been caused by a sorting process [1]. Many ideas on the cause of chondrule sorting have been proposed; some including sorting by mass [2,3], by X-winds [4], turbulent concentration [5], and by photophoresis [6]. However, few similar studies have been conducted for Ca-, Al-rich inclusions (CAIs). These particles are known to have formed early, and their distribution could attest to the early stages of Solar System (ESS) history. Unfortunately, CAIs are not as common in chondrites as chondrules are, reducing the usefulness of studies restricted to a few thin sections. Furthermore, the largest sizes of CAIs are generally much larger than chondrules, and therefore rarely present in most studied chondrite thin sections. This study attempts to perform a more representative sampling of the CAI population in the Allende chondrite by investigating a two decimeter-sized slab.

  6. Endometrial stromal sarcoma involving the urinary bladder: a study of 6 cases.

    PubMed

    Tian, Wei; Latour, Mathieu; Epstein, Jonathan I

    2014-07-01

    Endometrial stromal sarcoma (ESS) involving the urinary bladder is very rare, with no prior series reported. We identified 6 cases of low-grade ESS involving the bladder at our institution (1998 to 2013), 5 of them consults. The median age at bladder involvement was 60 years (range, 44 to 77 y). One patient presented with bladder involvement at initial diagnosis of ESS. The remaining 5 cases with bladder involvement presented 7 to 30 years (mean 18 y) after a known diagnosis of ESS (n=2) or after a remote history of hysterectomy with an uncertain diagnosis (n=3). The location of bladder involvement included dome (n=1), trigone (n=2), diffuse (n=1), and unknown (n=2). Two cases demonstrated worm-like infiltrating tumor nests classic of low-grade ESS with little stromal reaction with retraction artifact mimicking vascular invasion. One case originating from the ovary showed focal glandular differentiation in the bladder, resembling endometriosis. Two cases had abundant keloidal collagen formation, arranged haphazardly or in a sunburst pattern. One case showed primitive cells infiltrating entirely hyalinized stroma, after chemotherapy given for a misdiagnosis of urothelial carcinoma. CD31 was negative in all cases, except for 1 case with obvious large vessel invasion. The differential diagnosis included a large nested variant of urothelial carcinoma, carcinoid tumor, synovial sarcoma, solitary fibrous tumor, Ewing sarcoma/primitive neuroectodermal tumors, and endometriosis. CD10 was strongly positive in 5 cases, and 1 case had very focal, moderate staining. Estrogen receptor showed strong and diffuse staining in all 6 cases. Progesterone receptor showed moderate to strong staining in 5 cases and focal staining in 1 case. One case showed PAX8 expression, and 2 cases showed p16 nuclear and cytoplasmic expression. CD56 showed weak to strong staining in 4 cases. Two cases had diffuse synaptophysin, and 1 case had focal p63 positivity. GATA-3, CD34, and CD99 were negative in all cases. The Ki-67 index was 1% to 10% (mean 4%). The mitotic count was 0 to 3/10 HPF (mean <1/10 HPF). Two patients had metastases to pelvic lymph nodes, and 1 had possible lung metastasis. Three patients were treated with Megace and 1 with Arimidex after surgery. Follow-up averaged 19 years (0 to 33 y) after the initial diagnosis of ESS or hysterectomy and 3.5 years (0 to 11 y) after bladder surgery. ESS involving the bladder is extremely rare with a very long interval from onset to bladder involvement. In female patients, low-grade spindle cell lesions involving the bladder should include ESS in the differential diagnosis.

  7. EFFECT OF STRUCTURED PHYSICAL ACTIVITY ON SLEEP-WAKE BEHAVIORS IN SEDENTARY ELDERS WITH MOBILITY LIMITATIONS

    PubMed Central

    Vaz Fragoso, Carlos A.; Miller, Michael E.; King, Abby C.; Kritchevsky, Stephen B.; Liu, Christine K.; Myers, Valerie H.; Nadkarni, Neelesh K.; Pahor, Marco; Spring, Bonnie J.; Gill, Thomas M.

    2016-01-01

    OBJECTIVE To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elders with mobility limitations. DESIGN Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors pre-specified as a tertiary outcome over a planned intervention period ranging between 24 and 30 months. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling persons, aged 70–89 years, who were initially sedentary with a Short Physical Performance Battery score <10. MEASUREMENTS Sleep-wake behaviors were evaluated by the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (> 5 defined poor sleep quality) — administered at baseline and subsequently at 6, 18, and 30 months. RESULTS The randomized groups were similar on baseline demographic variables, including mean age (79 years) and sex (67% female). Relative to health education, structured physical activity significantly reduced the likelihood of having poor sleep quality (adjusted odds ratios [adjOR] for PSQI >5 of 0.80 [0.68, 0.94]), including a reduction in new cases (adjOR for PSQI >5 of 0.70 [0.54, 0.89]) but not in resolution of prevalent cases (adjOR for PSQI ≤5 of 1.13 [0.90, 1.43]). No significant intervention effects were observed for ISI or ESS. CONCLUSION Structured physical activity reduced the likelihood of developing poor sleep quality (PSQI >5) over the intervention period, when compared with health education, but had no effect on prevalent cases of poor sleep quality, or on sleep-wake behaviors evaluated by the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated by the PSQI. PMID:26115386

  8. Effect of Structured Physical Activity on Sleep-Wake Behaviors in Sedentary Elderly Adults with Mobility Limitations.

    PubMed

    Vaz Fragoso, Carlos A; Miller, Michael E; King, Abby C; Kritchevsky, Stephen B; Liu, Christine K; Myers, Valerie H; Nadkarni, Neelesh K; Pahor, Marco; Spring, Bonnie J; Gill, Thomas M

    2015-07-01

    To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elderly adults with mobility limitations. Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors prespecified as a tertiary outcome over a planned intervention period ranging from 24 to 30 months. Lifestyle Interventions and Independence for Elders Study. Community-dwelling persons aged 70 to 89 who were initially sedentary and had a Short Physical Performance Battery score less than 10 (N = 1,635). Sleep-wake behaviors were evaluated using the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (>5 defined poor sleep quality) administered at baseline and 6, 18, and 30 months. The randomized groups were similar in terms of baseline demographic variables, including mean age (79) and sex (67% female). Structured physical activity resulted in a significantly lower likelihood of having poor sleep quality (adjusted odds ratios (aOR) for PSQI >5 = 0.80, 95% confidence interval (CI) = 0.68-0.94), including fewer new cases (aOR for PSQI >5 = 0.70, 95% CI = 0.54-0.89), than health education but not in resolution of prevalent cases (aOR for PSQI ≤5 = 1.13, 95% CI = 0.90-1.43). No significant intervention effects were observed for the ISI or ESS. Structured physical activity resulted in a lower likelihood of developing poor sleep quality (PSQI >5) over the intervention period than health education but had no effect on prevalent cases of poor sleep quality or on sleep-wake behaviors evaluated using the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated using the PSQI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  9. Scaling Characteristics of Mesoscale Wind Fields in the Lower Atmospheric Boundary Layer: Implications for Wind Energy

    NASA Astrophysics Data System (ADS)

    Kiliyanpilakkil, Velayudhan Praju

    Atmospheric motions take place in spatial scales of sub-millimeters to few thousands of kilometers with temporal changes in the atmospheric variables occur in fractions of seconds to several years. Consequently, the variations in atmospheric kinetic energy associated with these atmospheric motions span over a broad spectrum of space and time. The mesoscale region acts as an energy transferring regime between the energy generating synoptic scale and the energy dissipating microscale. Therefore, the scaling characterizations of mesoscale wind fields are significant in the accurate estimation of the atmospheric energy budget. Moreover, the precise knowledge of the scaling characteristics of atmospheric mesoscale wind fields is important for the validation of the numerical models those focus on wind forecasting, dispersion, diffusion, horizontal transport, and optical turbulence. For these reasons, extensive studies have been conducted in the past to characterize the mesoscale wind fields. Nevertheless, the majority of these studies focused on near-surface and upper atmosphere mesoscale regimes. The present study attempt to identify the existence and to quantify the scaling of mesoscale wind fields in the lower atmospheric boundary layer (ABL; in the wind turbine layer) using wind observations from various research-grade instruments (e.g., sodars, anemometers). The scaling characteristics of the mesoscale wind speeds over diverse homogeneous flat terrains, conducted using structure function based analysis, revealed an altitudinal dependence of the scaling exponents. This altitudinal dependence of the wind speed scaling may be attributed to the buoyancy forcing. Subsequently, we use the framework of extended self-similarity (ESS) to characterize the observed scaling behavior. In the ESS framework, the relative scaling exponents of the mesoscale atmospheric boundary layer wind speed exhibit quasi-universal behavior; even far beyond the inertial range of turbulence (Delta t within 10 minutes to 6 hours range). The ESS framework based study is extended further to enquire its validity over complex terrain. This study, based on multiyear wind observations, demonstrate that the ESS holds for the lower ABL wind speed over the complex terrain as well. Another important inference from this study is that the ESS relative scaling exponents corresponding to the mesoscale wind speed closely matches the scaling characteristics of the inertial range turbulence, albeit not exactly identical. The current study proposes benchmark using ESS-based quasi-universal wind speed scaling characteristics in the ABL for the mesoscale modeling community. Using a state-of-the-art atmospheric mesoscale model in conjunction with different planetary boundary layer (PBL) parameterization schemes, multiple wind speed simulations have been conducted. This study reveals that the ESS scaling characteristics of the model simulated wind speed time series in the lower ABL vary significantly from their observational counterparts. The study demonstrate that the model simulated wind speed time series for the time intervals Delta t < 2 hours do not capture the ESS-based scaling characteristics. The detailed analysis of model simulations using different PBL schemes lead to the conclusion that there is a need for significant improvements in the turbulent closure parameterizations adapted in the new-generation atmospheric models. This study is unique as the ESS framework has never been reported or examined for the validation of PBL parameterizations.

  10. Home Versus Away Competition: Effect on Psychophysiological Variables in Elite Rugby Union.

    PubMed

    Cunniffe, Brian; Morgan, Kevin A; Baker, Julien S; Cardinale, Marco; Davies, Bruce

    2015-09-01

    This study evaluated the effect of game venue and starting status on precompetitive psychophysiological measures in elite rugby union. Saliva samples were taken from players (starting XV, n = 15, and nonstarters, n = 9) on a control day and 90 min before 4 games played consecutively at home and away venues against local rivals and league leaders. Precompetition psychological states were assessed using the Competitive State Anxiety Inventory-2. The squad recorded 2 wins (home) and 2 losses (away) over the study period. Calculated effect sizes (ESs) showed higher pregame cortisol- (C) and testosterone- (T) difference values before all games than on a baseline control day (ES 0.7-1.5). Similar findings were observed for cognitive and somatic anxiety. Small between-venues C differences were observed in starting XV players (ES 0.2-0.25). Conversely, lower home T- (ES 0.95) and higher away C- (ES 0.6) difference values were observed in nonstarters. Lower T-difference values were apparent in nonstarters (vs starting XV) before home games, providing evidence of a between-groups effect (ES 0.92). Findings show an anticipatory rise in psychophysiological variables before competition. Knowledge of starting status appears a moderating factor in the magnitude of player endocrine response between home and away games.

  11. Sleep Architecture in Night Shift Workers Police Officers with Obstructive Sleep Apnea-hypopnea Syndrome.

    PubMed

    Verde-Tinoco, Selene; Santana-Miranda, Rafael; Gutiérrez-Escobar, Romel; Haro, Reyes; Miranda-Ortiz, Joana; Berruga-Fernandez, Talia; Jimenez-Correa, Ulises; Poblano, Adrián

    2017-01-01

    Reduced sleep to increase work hours is common among police officers, when this situation is combined with Obstructive sleep apnea/hypopnea syndrome (OSAHS), health consequences are greater, therefore we believe there is a need of research for these alterations. The aim of this study was to measure the changes in sleep architecture (SA) in police officers who currently have Night shift work (NSW) and OSAHS. We compared SA in 107 subjects divided in three groups: the first group included police officers with NSW and severe OSAHS (n = 48); the second group were non-police officers with diurnal work time and severe OSAHS (n = 48) and the third group was formed by healthy controls (n = 11). Polysomnography (PSG) variables and Epworth sleepiness scale (ESS) scores were compared. SA was more disrupted in the group of police officers with NSW and OSAHS than in patients with OSAHS only and in the control group. Police officers with NSW and OSAHS presented an increased number of electroencephalographic activations, apnea/hypopnea index, and sleep latency, and showed lower scores of oxygen saturation, and in the ESS. Multivariate analysis revealed significant influence of age and Body mass index (BMI). Data suggested with caution an additive detrimental effect of NSW and OSAHS in SA and ESS of police officers. However age and BMI must be also taken into account in future studies.

  12. 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.

  13. Earth Systems Science: An Analytic Framework

    ERIC Educational Resources Information Center

    Finley, Fred N.; Nam, Younkeyong; Oughton, John

    2011-01-01

    Earth Systems Science (ESS) is emerging rapidly as a discipline and is being used to replace the older earth science education that has been taught as unrelated disciplines--geology, meteorology, astronomy, and oceanography. ESS is complex and is based on the idea that the earth can be understood as a set of interacting natural and social systems.…

  14. The Impact of Work-Integrated Learning Experiences on Attaining Graduate Attributes for Exercise and Sports Science Students

    ERIC Educational Resources Information Center

    Hall, Melinda; Pascoe, Deborah; Charity, Megan

    2017-01-01

    Exercise and Sports Science (E&SS) programs at Federation University Australia provide work-integrated learning (WIL) opportunities for students to develop, apply and consolidate theoretical knowledge in the workplace. This study aimed to determine the influence of WIL experiences on achieving common graduate attributes for E&SS students.…

  15. Social Inequality in Education and the Use of Extramural Support Services: Access and Parental Experiences in Disadvantaged Families

    ERIC Educational Resources Information Center

    Bodvin, Kathleen; Verschueren, Karine; De Haene, Lucia; Struyf, Elke

    2018-01-01

    As low socioeconomic status (SES) and ethnic minority students often experience barriers during their school career, increased levels of referral of these students to extramural support services in education (ESS) can be expected. Yet, research indicates that disadvantaged students are often underrepresented in different types of ESS. The purpose…

  16. A Comparison of Biologic Content in Three Elementary-School Science Curriculum Projects: ESS, S-APA, SCIS

    ERIC Educational Resources Information Center

    Simpson, Ronald D.

    1974-01-01

    Three elementary school science curriculum projects, Elementary Science Study (ESS), Science - A Process Approach (S-APA), and Science Curriculum Improvement Study (SCIS), are compared concerning the biologic content each project contains. The reviewer found a lack of activities designed to represent functions at the cellular level. Two projects…

  17. Effect of Adenotonsillectomy on Parent-Reported Sleepiness in Children with Obstructive Sleep Apnea.

    PubMed

    Paruthi, Shalini; Buchanan, Paula; Weng, Jia; Chervin, Ronald D; Mitchell, Ronald B; Dore-Stites, Dawn; Sadhwani, Anjali; Katz, Eliot S; Bent, John; Rosen, Carol L; Redline, Susan; Marcus, Carole L

    2016-11-01

    To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC. Parents of children aged 5.0-9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire-Sleepiness Subscale (PSQ-SS). PSG was performed at baseline and at 7-mo endpoint. Children underwent early adenotonsillectomy or WWSC. The mESS and PSQ-SS classified 24% and 53% of the sample as excessively sleepy, respectively. At baseline, mean mESS score was 7.4 ± 5.0 (SD) and mean PSQ-SS score was 0.44 ± 0.30. Sleepiness scores were higher in African American children; children with shorter sleep duration; older children; and overweight children. At endpoint, mean mESS score decreased by 2.0 ± 4.2 in the eAT group versus 0.3 ± 4.0 in the WWSC group (P < 0.0001); mean PSQ-SS score decreased 0.29 ± 0.40 in eAT versus 0.08 ± 0.40 in the WWSC group (P < 0.0001). Despite higher baseline sleepiness, African American children experienced similar improvement with adenotonsillectomy than other children. Improvement in sleepiness was weakly associated with improved apnea-hypopnea index or oxygen desaturation indices, but not with change in other polysomnographic measures. Sleepiness assessed by parent report was prevalent; improved more after eAT than after WWSC; and was not strongly predicted by sleep disturbances identified by PSG. Childhood Adenotonsillectomy Study for Children with OSA (CHAT). ClinicalTrials.gov Identifier #NCT00560859. © 2016 Associated Professional Sleep Societies, LLC.

  18. Exact exchange potential evaluated from occupied Kohn-Sham and Hartree-Fock solutions

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

    Cinal, M.; Holas, A.

    2011-06-15

    The reported algorithm determines the exact exchange potential v{sub x} in an iterative way using energy shifts (ESs) and orbital shifts (OSs) obtained with finite-difference formulas from the solutions (occupied orbitals and their energies) of the Hartree-Fock-like equation and the Kohn-Sham-like equation, the former used for the initial approximation to v{sub x} and the latter for increments of ES and OS due to subsequent changes of v{sub x}. Thus, the need for solution of the differential equations for OSs, used by Kuemmel and Perdew [Phys. Rev. Lett. 90, 043004 (2003)], is bypassed. The iterated exchange potential, expressed in terms ofmore » ESs and OSs, is improved by modifying ESs at odd iteration steps and OSs at even steps. The modification formulas are related to the optimized-effective-potential equation (satisfied at convergence) written as the condition of vanishing density shift (DS). They are obtained, respectively, by enforcing its satisfaction through corrections to approximate OSs and by determining the optimal ESs that minimize the DS norm. The proposed method, successfully tested for several closed-(sub)shell atoms, from Be to Kr, within the density functional theory exchange-only approximation, proves highly efficient. The calculations using the pseudospectral method for representing orbitals give iterative sequences of approximate exchange potentials (starting with the Krieger-Li-Iafrate approximation) that rapidly approach the exact v{sub x} so that, for Ne, Ar, and Zn, the corresponding DS norm becomes less than 10{sup -6} after 13, 13, and 9 iteration steps for a given electron density. In self-consistent density calculations, orbital energies of 10{sup -4} hartree accuracy are obtained for these atoms after, respectively, 9, 12, and 12 density iteration steps, each involving just two steps of v{sub x} iteration, while the accuracy limit of 10{sup -6} to 10{sup -7} hartree is reached after 20 density iterations.« less

  19. Exact exchange potential evaluated from occupied Kohn-Sham and Hartree-Fock solutions

    NASA Astrophysics Data System (ADS)

    Cinal, M.; Holas, A.

    2011-06-01

    The reported algorithm determines the exact exchange potential vx in an iterative way using energy shifts (ESs) and orbital shifts (OSs) obtained with finite-difference formulas from the solutions (occupied orbitals and their energies) of the Hartree-Fock-like equation and the Kohn-Sham-like equation, the former used for the initial approximation to vx and the latter for increments of ES and OS due to subsequent changes of vx. Thus, the need for solution of the differential equations for OSs, used by Kümmel and Perdew [Phys. Rev. Lett.PRLTAO0031-900710.1103/PhysRevLett.90.043004 90, 043004 (2003)], is bypassed. The iterated exchange potential, expressed in terms of ESs and OSs, is improved by modifying ESs at odd iteration steps and OSs at even steps. The modification formulas are related to the optimized-effective-potential equation (satisfied at convergence) written as the condition of vanishing density shift (DS). They are obtained, respectively, by enforcing its satisfaction through corrections to approximate OSs and by determining the optimal ESs that minimize the DS norm. The proposed method, successfully tested for several closed-(sub)shell atoms, from Be to Kr, within the density functional theory exchange-only approximation, proves highly efficient. The calculations using the pseudospectral method for representing orbitals give iterative sequences of approximate exchange potentials (starting with the Krieger-Li-Iafrate approximation) that rapidly approach the exact vx so that, for Ne, Ar, and Zn, the corresponding DS norm becomes less than 10-6 after 13, 13, and 9 iteration steps for a given electron density. In self-consistent density calculations, orbital energies of 10-4 hartree accuracy are obtained for these atoms after, respectively, 9, 12, and 12 density iteration steps, each involving just two steps of vx iteration, while the accuracy limit of 10-6 to 10-7 hartree is reached after 20 density iterations.

  20. How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

    PubMed Central

    Boccabella, Allegra; Malouf, John

    2017-01-01

    Study Objectives: To measure differences in functional status between men and women presenting with sleep-related health problems. Methods: A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. Results: On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores (P < .001). Secondary outcome measures showed that females were more likely to feel excessively tired and depressed, have difficulties with memory and concentration, and have trouble sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Conclusions: Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. Citation: Boccabella A, Malouf J. How do sleep-related health problems affect functional status according to sex? J Clin Sleep Med. 2017;13(5):685–692. PMID:28260591

  1. How Do Sleep-Related Health Problems Affect Functional Status According to Sex?

    PubMed

    Boccabella, Allegra; Malouf, John

    2017-05-15

    To measure differences in functional status between men and women presenting with sleep-related health problems. A retrospective clinical audit of 744 Australian patients across 7 private general practices between April 2013 and January 2015 was conducted. Patients completed an electronic survey as part of their routine consultation, which included the Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10), and other questions relating to the effect of their sleep problem. The proportion of males and females with ESS and FOSQ-10 scores associated with disorders of daytime sleepiness and burden of symptoms due to sleepiness, respectively, were compared, as well as reported differences between the sexes in memory, concentration, issues with relationships, feeling depressed, and trouble sleeping. On presentation, females were more likely to have sleeping disorders associated with daytime sleepiness (median ESS score of 9 for females versus 8 for males, P = .038; proportion ESS > 9 was 49.0% for females versus 36.9% for males, P = .003). Women were also more likely to report an increased burden of symptoms due to sleepiness compared to men, as shown by lower FOSQ-10 scores ( P < .001). Secondary outcome measures showed that females were more likely to feel excessively tired and depressed, have difficulties with memory and concentration, and have trouble sleeping at night. Snoring kept partners awake in roughly the same proportion of males and females, and a larger proportion of the partners of males were forced out of the room. Sleep-related health issues both manifest in and affect the lives of males and females differently. Sleep health professionals should recognize these differences on all levels of disease prevention and health promotion from patient education, to diagnosis and management to improve quality of life for those with sleep-related health problems. © 2017 American Academy of Sleep Medicine

  2. "Cut-and-paste" manufacture of multiparametric epidermal electronic systems

    NASA Astrophysics Data System (ADS)

    Lu, Nanshu; Yang, Shixuan; Wang, Pulin

    2016-05-01

    Epidermal electronics is a class of noninvasive and unobstructive skin-mounted, tattoo-like sensors and electronics capable of vital sign monitoring and establishing human-machine interface. The high cost of manpower, materials, vacuum equipment, and photolithographic facilities associated with its manufacture greatly hinders the widespread use of disposable epidermal electronics. Here we report a cost and time effective, completely dry, benchtop "cut-and-paste" method for the freeform and portable manufacture of multiparametric epidermal sensor systems (ESS) within minutes. This versatile method works for all types of thin metal and polymeric sheets and is compatible with any tattoo adhesives or medical tapes. The resulting ESS are multimaterial and multifunctional and have been demonstrated to noninvasively but accurately measure electrophysiological signals, skin temperature, skin hydration, as well as respiratory rate. In addition, planar stretchable coils exploiting double-stranded serpentine design have been successfully applied as wireless, passive epidermal strain sensors.

  3. Breast Density and Risk of Breast Cancer in Asian Women: A Meta-analysis of Observational Studies.

    PubMed

    Bae, Jong-Myon; Kim, Eun Hee

    2016-11-01

    The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women. PubMed and Scopus were searched, and the final date of publication was set as December 31, 2015. The effect size in each article was calculated using the interval-collapse method. Summary effect sizes (sESs) and 95% confidence intervals (CIs) were calculated by conducting a meta-analysis applying a random effect model. To investigate the dose-response relationship, random effect dose-response meta-regression (RE-DRMR) was conducted. Six analytical epidemiology studies in total were selected, including one cohort study and five case-control studies. A total of 17 datasets were constructed by type of breast density index and menopausal status. In analyzing the subgroups of premenopausal vs. postmenopausal women, the percent density (PD) index was confirmed to be associated with a significantly elevated risk for breast cancer (sES, 2.21; 95% CI, 1.52 to 3.21; I 2 =50.0%). The RE-DRMR results showed that the risk of breast cancer increased 1.73 times for each 25% increase in PD in postmenopausal women (95% CI, 1.20 to 2.47). In Asian women, breast cancer risk increased with breast density measured using the PD index, regardless of menopausal status. We propose the further development of a breast cancer risk prediction model based on the application of PD in Asian women.

  4. Introduction: Why Link Indigenous Ways of Knowing with the Teaching of Environmental Studies and Sciences?

    ERIC Educational Resources Information Center

    Rich, Nancy

    2012-01-01

    This paper introduces a mini-symposium on bringing Indigenous ways of knowing together with the teaching of environmental studies and sciences (ESS). Both knowledges share a fundamental interest in the relationship of humans with the Earth, yet until recently, Indigenous ways of knowing have rarely been visible in the teaching of ESS. Teaching…

  5. 75 FR 27414 - Airworthiness Directives; Airbus A318, A319, A320, A321 Series Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... occurrences of loss of the AC [alternating current] BUS 1 have been reported which led in some instances to the loss of the AC ESS [essential] BUS and DC [direct current] ESS BUS and connected systems. The... condition for the specified products. The MCAI states: Several occurrences of loss of the AC [alternating...

  6. Hazardous Waste Minimization Assessment: Fort Meade, MD

    DTIC Science & Technology

    1991-01-01

    Manual TSCA Toxic Substances Control Act TSDF T.xatment. Storage, and Disposal Facility USACERL U.S. Army Construction Engineering Research Laboratory...generation; and current methods of treatment, storage, and disposal, researchers conducted feasibility and economicanalyses of milnimizaion options...Bernard A. Donahue 7. PERFORMING ORGANIZATION NAME(S) ANO ADO ESS(ES) S. PERFORMING ORGANIZATION REPORT NUMBER U.S. Army Construction Engineering Research

  7. A Study of the Cognitive and Affective Performance of Children in the Elementary Science Study Program.

    ERIC Educational Resources Information Center

    Henson, Stanley

    Three studies are reported for children participating in the Elementary Science Study (ESS) program. They are the cognitive and affective performances and the classroom learning environment. Three groups of ESS children were evaluated: nine-year-olds, ten-year-olds, and eleven-year-olds. Each age group contained 30 randomly selected subjects. The…

  8. Comparing the Preparedness, Content Knowledge, and Instructional Quality of Elementary Science Specialists and Self-Contained Teachers

    ERIC Educational Resources Information Center

    Brobst, Joseph; Markworth, Kimberly; Tasker, Tammy; Ohana, Chris

    2017-01-01

    In this article, we report on the results of a study comparing the preparedness, content knowledge, and instructional practices of elementary science specialist (ESS) teachers with those of a matched sample of self-contained elementary teachers. Analysis of survey data collected for the two groups indicated that ESS teachers were more likely than…

  9. Improving the critical thinking skills of junior high school students on Earth and Space Science (ESS) materials

    NASA Astrophysics Data System (ADS)

    Marlina, L.; Liliasari; Tjasyono, B.; Hendayana, S.

    2018-05-01

    Critical thinking skills need to be developed in students. With critical thinking skills, students will be able to understand the concept with more depth easily, be sensitive with problems that occur, understand and solve problems that occur in their surroundings, and apply the concepts in different situations. Earth and Space Science (ESS) material is part of the science subjects given from elementary school to college. This research is a test of research program with quantitative method. This study aims to investigate the improvement of critical thinking skills of students through training of science teachers in junior high school in designing learning media for teaching ESS. With samples of 24 science teachers and 32 students of grade 7th in junior high school which are chosen by purposive sampling in a school in Ogan Ilir District, South Sumatra, obtained average pre-test and post-test scores of students’ critical thinking skills are 52.26 and 67.06 with an average N-gain of 0.31. A survey and critical thinking skills based-test were conducted to get the data. The results show positive impact and an increase in students’ critical thinking skills on the ESS material.

  10. Sleep Respiratory Disorders and Clinical Profile in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Fontela, Paula Caitano; Winkelmann, Eliane Roseli; Pretto, Luciana Meggiolaro; Berlezi, Evelise Moraes

    2014-01-01

    Introduction Sleep respiratory disorders (SRDs) are often found in patients with type 2 diabetes mellitus (T2DM). Objective The aim was to establish the prevalence of risk to develop an SRD using the Clinical Berlin Questionnaire (CBQ) and Epworth Sleepiness Scale (ESS) in patients with T2DM and verifying the correlation of anthropometric measurements and life quality (LQ) with ESS. Methods A descriptive and analytical study of a case series evaluating 208 patients with T2DM, submitted to clinical and biochemical evaluation and implementation of CBQ, ESS, and WHOQOL-bref to evaluate LQ. Results Mean age was 60.8 ± 8.8 years, and 65.4% were women. Most diabetics were overweight (36.1%), and 29.8% were class I obese. One-third had positive risk signals for a SRD, with 87.0 and 34.1% having high risk in CBQ and sleep disorders in ESS, respectively. There was a significant difference in the general LQ between the low- and high-risk groups in the CBQ. Conclusion In this scenario, it is noteworthy that the active search for sleep disorders must start from simple methods, such as application of protocols. PMID:25992154

  11. Revenue sources for essential services in Florida: findings and implications for organizing and funding public health.

    PubMed

    Livingood, William C; Morris, Michael; Sorensen, Bonita; Chapman, Karen; Rivera, Lillian; Beitsch, Les; Street, Phil; Coughlin, Susan; Smotherman, Carmen; Wood, David

    2013-01-01

    The Florida Public Health Practice-Based Research Network conducted the study of Florida county health departments (CHDs) to assess relationships between self-assessed performance on essential services (ESs) and sources of funding. Primary data were collected using an online survey based on Public Health Accreditation Board standards for ES. Bivariate and multivariate analyses were conducted to assess the relationship of sources and amounts of revenue obtained from the Florida Department of Health financial system to responses to the survey of CHD capacity for ESs. Self-assessed CHD performance for each ES varied extensively among the CHDs and across the 10 ESs, ranging from a high of 98% CHDs completely or almost completely meeting the standards for ES 2 (Investigating Problems and Hazards) to a low of 32% completely or almost completely meeting standards for ES 10 (Research/Evidence). Medicaid revenue and fees were positively correlated with some ESs. Per capita revenue support varied extensively among the CHDs. Revenue for ES is decreasing and is heavily reliant on noncategorical (discretionary) revenue. This study has important implications for continued reliance on ES as an organizing construct for public health.

  12. Effectiveness of Integrative Restoration (iRest) Yoga Nidra on Mindfulness, Sleep, and Pain in Health Care Workers.

    PubMed

    Livingston, Eva; Collette-Merrill, Katreena

    This article examines the effectiveness of Integrative Restoration (iRest) Yoga Nidra meditation on mindfulness, sleep, and pain in health care workers. As health care workers provide emotional support to patients, it is not uncommon for workers to experience both physical and mental exhaustion. One holistic approach to support employees is mindfulness training. iRest Yoga Nidra is a complementary and integrative health therapy that increases mindfulness. A pre-/postinterveniton descriptive survey design was used. Before and after experiencing iRest meditation, participants completed a 51-item questionnaire consisting of demographics plus 3 validated instruments: the Five-Facet Mindfulness Questionnaire (FFMQ), the Epworth Sleepiness Scale (ESS), and Department of Defense/Veterans Administration (DoD/VA) Pain Supplemental Questions (PSQ). A total of 15 participants completed both questionnaires. Postintervention FFMQ scores were significantly higher than preintervention (z = -3.294, P = .001). The highest subscale scores were "acting with awareness" and "nonjudging of inner experience." There was a not a significant difference in the mean ESS scores at baseline and follow-up. However, there was a strong negative correlation between the mean ESS improvement score and the number of weeks attended (rs = -0.705, P = .003). There was a not a significant difference in the mean pain baseline and follow-up scores. This study showed significant improvement in mindfulness of health care workers following a guided 8-week iRest Yoga Nidra program. The results of this study may provide some insight into helping health care workers deal with the demands of their profession in a positive manner, thus leading to an improved workplace environment.

  13. Fertilization capacity of cryopreserved Iberian ibex epididymal sperm in a heterologous in vitro fertilization assay.

    PubMed

    López-Saucedo, J; Santiago-Moreno, J; Fierro, R; Izquierdo, D; Coloma, M A; Catalá, M G; Jiménez, I; Paramio, M T

    2015-02-01

    In vitro fertilization (IVF) can be used to assess the fertilization capacity of sperm. Heterologous IVF may be useful when assessing that of wild animals as it is often difficult to obtain adequate numbers of naturally corresponding oocytes. The aim of the present study was to assess the fertilization capacity of frozen-thawed ibex epididymal spermatozoa via heterologous IVF involving the oocytes of prepubertal domestic goats. The effect on fertilization and embryo development of adding oestrous sheep serum (ESS) to the fertilization medium was also examined. Cumulus-oocyte complexes (COCs) were matured in TCM-199 for 24-27 h at 38.5°C in a 5% CO2 in air atmosphere. Frozen-thawed epididymal spermatozoa were selected by density gradient centrifugation. After maturation, the oocytes were co-incubated with spermatozoa in synthetic oviductal fluid (SOF) with different concentrations of ESS: SOF-C (0%), SOF-2 (2%) and SOF-20 (20%). At 17 h post-insemination (hpi), zygotes with one female and one male pronucleus (2PN) were categorised as normal; zygotes with 3PN were recorded as polyspermic, and oocytes with 1PN as asynchronous. Cleavage and blastocyst development were assessed at 48 and 168 hpi respectively. The percentage of zygotes with 2PN was higher in the SOF-2 than in the SOF-20 treatment group (27.7% versus 2.9% P < 0.05). The percentage of blastocysts formed with the SOF-C, SOF-2 and SOF-20 treatments were 1.1%, 7.5% and 0% respectively. These results show that the presence of 2% ESS achieves better results than the use of no serum or the standard 20% concentration. Heterologous IVF may be an effective method for predicting the fertilization capacity of ibex spermatozoa, and therefore perhaps that of other wild mountain ungulates.

  14. The effect of nocturia on sleep quality and daytime function in patients with lower urinary tract symptoms: a cross-sectional study.

    PubMed

    Shao, I-Hung; Wu, Chia-Chen; Hsu, Hueih-Shing; Chang, Shyh-Chyi; Wang, Hsu-Hsiang; Chuang, Heng-Chang; Tam, Yuan-Yun

    2016-01-01

    Nocturia has been proven to have a negative impact on the quality of life and sleep quality in general elderly population. However, there are limited studies on the quantitative effect of nocturia on sleep quality and daytime dysfunction, specifically in patients with lower urinary tract symptoms. During March 1, 2015 to December 31, 2015, a total of 728 patients who visited our urology department due to voiding dysfunction and experienced nocturia at least once per night were enrolled. Three questionnaires were administered to them after obtaining their written consents. Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS) questionnaire, and International Prostate Symptom Score (IPSS) questionnaire were applied to evaluate their sleep quality, daytime dysfunction, and voiding problems, respectively. Statistical analysis of the impact of nocturia on sleep quality and daytime dysfunction was performed. The mean age of patients was 61 years, with a male-to-female ratio of 2.7. The mean nocturia number was 3.03. The IPSS, PSQI, and ESS scores were 17.56, 8.35, and 8.22, respectively. The nocturia number increased with age and was significantly correlated to ESS score (daytime dysfunction) and PSQI total score (sleep quality) in overall group. Among subgroups divided by age and sex, there was a significant correlation between nocturia number and daytime dysfunction in male patients or patients younger than 65 years. In patients with lower urinary tract symptoms, nocturia number increased with age and was significantly correlated with poor sleep quality. Nocturia plays an important role in patients younger than 65 years in daytime dysfunction.

  15. Selection of energy source and evolutionary stable strategies for power plants under financial intervention of government

    NASA Astrophysics Data System (ADS)

    Hafezalkotob, Ashkan; Mahmoudi, Reza

    2017-09-01

    Currently, many socially responsible governments adopt economic incentives and deterrents to manage environmental impacts of electricity suppliers. Considering the Stackelberg leadership of the government, the government's role in the competition of power plants in an electricity market is investigated. A one-population evolutionary game model of power plants is developed to study how their production strategy depends on tariffs levied by the government. We establish that a unique evolutionary stable strategy (ESS) for the population exists. Numerical examples demonstrate that revenue maximization and environment protection policies of the government significantly affect the production ESS of competitive power plants. The results reveal that the government can introduce a green energy source as an ESS of the competitive power plants by imposing appropriate tariffs.

  16. Darwinism in quantum systems?

    NASA Astrophysics Data System (ADS)

    Iqbal, A.; Toor, A. H.

    2002-03-01

    We investigate the role of quantum mechanical effects in the central stability concept of evolutionary game theory, i.e., an evolutionarily stable strategy (ESS). Using two and three-player symmetric quantum games we show how the presence of quantum phenomenon of entanglement can be crucial to decide the course of evolutionary dynamics in a population of interacting individuals.

  17. Plans of Implementation and Methods for Increasing Student Enrollment in the Earth Systems Science Course at Elizabeth City State University

    NASA Astrophysics Data System (ADS)

    Porter, W.

    2001-12-01

    This presentation reviews the experience of Elizabeth City State University (ECSU) in offering the Earth Systems Science (ESS) online course sponsored the Earth System Science Education Alliance (ESSEA) and how it relates to our plans to offer the course in the Spring Semester of 2002. The course was offered for the first time at ECSU during the Fall semester 2000. Eight students were enrolled in the course, which may not be considered a large number; however, we felt the administration of the course was successful because of the staff's learning experience. The small number is also a reflection of the nature of ECSU's primary recruitment region of northeastern North Carolina; this area is extremely rural with a smaller population, lower economic development, and fewer cultural amenities than most regions of the state. Our approach to this project is for a long-term effective offering of a course that is much needed, especially in this area of the state. The ultimate goal is to develop ESS as our online offering of courses in the Geoscience Department curriculum as to recruit students who might not have the opportunity to take college-level courses because of daytime work commitments and/or inaccessibility to a local college or university. A major component of ESS is its focus on problem-based learning built upon the life experiences of participating students. Having learned from the previous offering of the course, the following are objectives related to the Spring Semester 2002: 1. To get ESS to become a part of the Geoscience curriculum so that it will be listed on the schedule of classes for the Spring Semester 2002 and each succeeding semester; 2. To aggressively reach out to the public school teachers, especially in the recruitment region of ECSU in northeastern North Carolina, by using effective recruitment strategies; 3. To have an active and continuous communication with prospective students prior to and immediately after the enrollment, as well as being accessible to them during the entire period of the course; and 4. To have students focus on the problem-based aspect of the course as it relates to their life experiences. These objectives are designed to increase enrollment in the course as well as to enhance the retention of participating students.

  18. The welfare effects of integrating renewable energy into electricity markets

    NASA Astrophysics Data System (ADS)

    Lamadrid, Alberto J.

    The challenges of deploying more renewable energy sources on an electric grid are caused largely by their inherent variability. In this context, energy storage can help make the electric delivery system more reliable by mitigating this variability. This thesis analyzes a series of models for procuring electricity and ancillary services for both individuals and social planners with high penetrations of stochastic wind energy. The results obtained for an individual decision maker using stochastic optimization are ambiguous, with closed form solutions dependent on technological parameters, and no consideration of the system reliability. The social planner models correctly reflect the effect of system reliability, and in the case of a Stochastic, Security Constrained Optimal Power Flow (S-SC-OPF or SuperOPF), determine reserve capacity endogenously so that system reliability is maintained. A single-period SuperOPF shows that including ramping costs in the objective function leads to more wind spilling and increased capacity requirements for reliability. However, this model does not reflect the inter temporal tradeoffs of using Energy Storage Systems (ESS) to improve reliability and mitigate wind variability. The results with the multiperiod SuperOPF determine the optimum use of storage for a typical day, and compare the effects of collocating ESS at wind sites with the same amount of storage (deferrable demand) located at demand centers. The collocated ESS has slightly lower operating costs and spills less wind generation compared to deferrable demand, but the total amount of conventional generating capacity needed for system adequacy is higher. In terms of the total system costs, that include the capital cost of conventional generating capacity, the costs with deferrable demand is substantially lower because the daily demand profile is flattened and less conventional generation capacity is then needed for reliability purposes. The analysis also demonstrates that the optimum daily pattern of dispatch and reserves is seriously distorted if the stochastic characteristics of wind generation are ignored.

  19. A crossover randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnoea-hypopnoea (TOMADO).

    PubMed

    Quinnell, Timothy G; Bennett, Maxine; Jordan, Jake; Clutterbuck-James, Abigail L; Davies, Michael G; Smith, Ian E; Oscroft, Nicholas; Pittman, Marcus A; Cameron, Malcolm; Chadwick, Rebecca; Morrell, Mary J; Glover, Matthew J; Fox-Rushby, Julia A; Sharples, Linda D

    2014-10-01

    Mandibular advancement devices (MADs) are used to treat obstructive sleep apnoea-hypopnoea syndrome (OSAHS) but evidence is lacking regarding their clinical and cost-effectiveness in less severe disease. To compare clinical- and cost-effectiveness of a range of MADs against no treatment in mild to moderate OSAHS. This open-label, randomised, controlled, crossover trial was undertaken at a UK sleep centre. Adults with Apnoea-Hypopnoea Index (AHI) 5-<30/h and Epworth Sleepiness Scale (ESS) score ≥9 underwent 6 weeks of treatment with three non-adjustable MADs: self-moulded (SleepPro 1; SP1); semi-bespoke (SleepPro 2; SP2); fully-bespoke MAD (bMAD); and 4 weeks no treatment. Primary outcome was AHI scored by a polysomnographer blinded to treatment. Secondary outcomes included ESS, quality of life, resource use and cost. 90 patients were randomised and 83 were analysed. All devices reduced AHI compared with no treatment by 26% (95% CI 11% to 38%, p=0.001) for SP1, 33% (95% CI 24% to 41%) for SP2 and 36% (95% CI 24% to 45%, p<0.001) for bMAD. ESS was 1.51 (95% CI 0.73 to 2.29, p<0.001, SP1) to 2.37 (95% CI 1.53 to 3.22, p<0.001, bMAD) lower than no treatment (p<0.001 for all). Compliance was lower for SP1, which was the least preferred treatment at trial exit. All devices were cost-effective compared with no treatment at a £20,000/quality-adjusted life year (QALY) threshold. SP2 was the most cost-effective up to £39,800/QALY. Non-adjustable MADs achieve clinically important improvements in mild to moderate OSAHS and are cost-effective. Of those trialled, the semi-bespoke MAD is an appropriate first choice. ISRCTN02309506. 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.

  20. Tectono-metallogenetic evolution of the Fe-Cu deposit of Dominga, northern Chile

    NASA Astrophysics Data System (ADS)

    Veloso, E.; Cembrano, J.; Arancibia, G.; Heuser, G.; Neira, S.; Siña, A.; Garrido, I.; Vermeesch, P.; Selby, D.

    2017-04-01

    The Dominga district in northern Chile (2082 Mt at 23.3 % Fe, 0.07 % Cu) shows a spatial and genetic affinity among distinctive structural elements and Fe-Cu-rich paragenetic mineral assemblages. Deep seated, NE-to-E striking structural elements form a right-lateral duplex-like structural system (early structural system, ESS) that cuts a regionally extensive alteration (stage I) zone. The EES system served as a locus and as path for the emplacement of biotite-magnetite alteration/mineralization (stage IIa) as veins and Fe-bearing layers following altered volcano sedimentary strata. NW-striking actinolite-magnetite hydrothermal breccias, coeval with and part of the ESS, include apatite (stage IIb) crystallized at 127 ± 15 Ma (U-Pb, 2σ). The ESS was also the locus of subsequent alteration/mineralization represented by K-feldspar, epidote, and albite (stage IIIa) and Fe-Cu-rich (vermiculite-anhydrite-chalcopyrite, stage IIIb) mineral associations. Shallowly developed, NNE-striking, left-lateral structural elements defining the El Tofo Structural System (ETSS)—probably part of the Atacama Fault System—clearly crosscut the ESS. Minerals associated with alteration/mineralization stage IIIb also occur as veins and as part of hydrothermal breccias of the ETSS, marking the transition from the ESS to ETSS. Molybdenite associated with alteration/mineralization stage IIIb yielded a Re-Os age of 127.1 ± 0.7 Ma (2σ). Both the ESS and ETSS were cut by left-lateral, NW- to E-striking shallowly developed structural elements (Intermediate Structural System, ISS) on which a hematite-calcite assemblage (stage IV) occurs mostly as infill material of veins and fault veins. The ISS is cut by N-striking, left-lateral, and shallowly developed structural elements (Late Structural System, LSS) showing no evidence of alteration/mineralization. Estimated strain and stress fields indicate an overall NW-trending shortening/compression and NE-trending stretching/tension strike-slip regime probably due to oblique subduction during the Mesozoic. However, the orientations of the stress and strain fields calculated for each structural system suggest a back-and-forth rotation pattern during transition from one structural system to the other—as they change between transtension and transpression—and between alteration/mineralization stages.

  1. The Next Generation Science Standards: An Historic Opportunity for K-12 Earth and Space Science Education

    NASA Astrophysics Data System (ADS)

    Johnson, R. M.; Passow, M. J.; Holzer, M. A.; Moore, J.

    2014-12-01

    The Next Generation Science Standards (NGSS) provide an historic opportunity to significantly improve Earth and space science (ESS) education nationally at the K-12 level. The increased emphasis on ESS related topics in the NGSS relative to previous standards provides a real opportunity for ensuring all K-12 students in adopting states learn about the ESS - allowing us to reach many more students than are currently are exposed to our discipline. The new standards are also exciting in that they explicitly couple science and engineering practice, cross-cutting concepts, and disciplinary core ideas in such a way that student must actively demonstrate their understanding through actions rather than through mere regurgitation of memorized responses. Achieving mastery of NGSS Performance Expectations will require practice with higher-order learning skills - with students engaging in the practices of scientists and engineers. Preparing students for this mastery will be a challenging task for teachers, since in many states professional development support is limited at best for the current curriculum - let alone the curricula that will be developed to address the NGSS. As adoption of the NGSS expands across the country, states will be at various levels of implementation of the new standards over the next several years - and there is real concern that teachers must have sufficient professional development to be able to be successful in preparing their students - particularly in view of likely coupled assessments and teacher evaluations. NESTA strongly supports implementation of the NGSS, and the rigorous and compelling ESS education it will engender, when coupled with a strong emphasis nationwide on teacher professional development. For the past two years, the National Earth Science Teachers Association (NESTA) has continued our leadership in K-12 ESS education through workshops, web seminars, events and publications that emphasize implementation of the NGSS in ESS-related courses. Our recent survey of K-12 Earth and space science educators confirms widespread enthusiasm about the potential offered by the new standards, as well as concern about the urgent need for professional development to support teacher implementation of the standards.

  2. Standardized error severity score (ESS) ratings to quantify risk associated with child restraint system (CRS) and booster seat misuse.

    PubMed

    Rudin-Brown, Christina M; Kramer, Chelsea; Langerak, Robin; Scipione, Andrea; Kelsey, Shelley

    2017-11-17

    Although numerous research studies have reported high levels of error and misuse of child restraint systems (CRS) and booster seats in experimental and real-world scenarios, conclusions are limited because they provide little information regarding which installation issues pose the highest risk and thus should be targeted for change. Beneficial to legislating bodies and researchers alike would be a standardized, globally relevant assessment of the potential injury risk associated with more common forms of CRS and booster seat misuse, which could be applied with observed error frequency-for example, in car seat clinics or during prototype user testing-to better identify and characterize the installation issues of greatest risk to safety. A group of 8 leading world experts in CRS and injury biomechanics, who were members of an international child safety project, estimated the potential injury severity associated with common forms of CRS and booster seat misuse. These injury risk error severity score (ESS) ratings were compiled and compared to scores from previous research that had used a similar procedure but with fewer respondents. To illustrate their application, and as part of a larger study examining CRS and booster seat labeling requirements, the new standardized ESS ratings were applied to objective installation performance data from 26 adult participants who installed a convertible (rear- vs. forward-facing) CRS and booster seat in a vehicle, and a child test dummy in the CRS and booster seat, using labels that only just met minimal regulatory requirements. The outcome measure, the risk priority number (RPN), represented the composite scores of injury risk and observed installation error frequency. Variability within the sample of ESS ratings in the present study was smaller than that generated in previous studies, indicating better agreement among experts on what constituted injury risk. Application of the new standardized ESS ratings to installation performance data revealed several areas of misuse of the CRS/booster seat associated with high potential injury risk. Collectively, findings indicate that standardized ESS ratings are useful for estimating injury risk potential associated with real-world CRS and booster seat installation errors.

  3. Meeting the Chemical Threat Psychiatric Casualties in a Chemical Environment

    DTIC Science & Technology

    1983-12-01

    str-ess reactions, high or low level exposures to anticholinesterases , and high cr low level exposures to anticholinergic (antidote) compounds...Shervette et al reported on 29 adolescents who abused Jimscn "eloco" weed and found the following: 10 seeds of the plants contained 1 mg of atropine...onset, duration, and temi.iation of the behavioral effects parallel the appearance, persistence, and disappearance of slow EEG activity . These effects

  4. A multicentre randomised controlled trial and economic evaluation of continuous positive airway pressure for the treatment of obstructive sleep apnoea syndrome in older people: PREDICT.

    PubMed

    McMillan, Alison; Bratton, Daniel J; Faria, Rita; Laskawiec-Szkonter, Magda; Griffin, Susan; Davies, Robert J; Nunn, Andrew J; Stradling, John R; Riha, Renata L; Morrell, Mary J

    2015-06-01

    The therapeutic and economic benefits of continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnoea syndrome (OSAS) have been established in middle-aged people. In older people there is a lack of evidence. To determine the clinical efficacy of CPAP in older people with OSAS and to establish its cost-effectiveness. A randomised, parallel, investigator-blinded multicentre trial with within-trial and model-based cost-effectiveness analysis. Two hundred and seventy-eight patients, aged ≥ 65 years with newly diagnosed OSAS [defined as oxygen desaturation index at ≥ 4% desaturation threshold level for > 7.5 events/hour and Epworth Sleepiness Scale (ESS) score of ≥ 9] recruited from 14 hospital-based sleep services across the UK. CPAP with best supportive care (BSC) or BSC alone. Autotitrating CPAP was initiated using standard clinical practice. BSC was structured advice on minimising sleepiness. Subjective sleepiness at 3 months, as measured by the ESS (ESS mean score: months 3 and 4) and cost-effectiveness over 12 months, as measured in quality-adjusted life-years (QALYs) calculated using the European Quality of Life-5 Dimensions (EQ-5D) and health-care resource use, information on which was collected monthly from patient diaries. Subjective sleepiness at 12 months (ESS mean score: months 10, 11 and 12) and objective sleepiness, disease-specific and generic quality of life, mood, functionality, nocturia, mobility, accidents, cognitive function, cardiovascular risk factors and events at 3 and 12 months. Two hundred and seventy-eight patients were randomised to CPAP (n = 140) or BSC (n = 138) over 27 months and 231 (83%) patients completed the trial. Baseline ESS score was similar in both groups [mean (standard deviation; SD) CPAP 11.5 (3.3), BSC 11.4 (4.2)]; groups were well balanced for other characteristics. The mean (SD) in ESS score at 3 months was -3.8 (0.4) in the CPAP group and -1.6 (0.3) in the BSC group. The adjusted treatment effect of CPAP compared with BSC was -2.1 points [95% confidence interval (CI) -3.0 to -1.3 points; p < 0.001]. At 12 months the effect was -2.0 points (95% CI -2.8 to -1.2 points; p < 0.001). The effect was greater in patients with increased CPAP use or higher baseline ESS score. The number of QALYs calculated using the EQ-5D was marginally (0.005) higher with CPAP than with BSC (95% CI -0.034 to 0.044). The average cost per patient was £1363 (95% CI £1121 to £1606) for those allocated to CPAP and £1389 (95% CI £1116 to £1662) for those allocated to BSC. On average, costs were lower in the CPAP group (mean -£35; 95% CI -£390 to £321). The probability that CPAP was cost-effective at thresholds conventionally used by the NHS (£20,000 per QALY gained) was 0.61. QALYs calculated using the Short Form questionnaire-6 Dimensions were 0.018 higher in the CPAP group (95% CI 0.003 to 0.034 QALYs) and the probability that CPAP was cost-effective was 0.96. CPAP decreased objective sleepiness (p = 0.02), increased mobility (p = 0.03) and reduced total and low-density lipoprotein cholesterol (p = 0.05, p = 0.04, respectively) at 3 months but not at 12 months. In the BSC group, there was a fall in systolic blood pressure of 3.7 mmHg at 12 months, which was not seen in the CPAP group (p = 0.04). Mood, functionality, nocturia, accidents, cognitive function and cardiovascular events were unchanged. There were no medically significant harms attributable to CPAP. In older people with OSAS, CPAP reduces sleepiness and is marginally more cost-effective than BSC over 12 months. Further work is required in the identification of potential biomarkers of sleepiness and those patients at increased risk of cognitive impairment. Early detection of which could be used to inform the clinician when in the disease cycle treatment is needed to avert central nervous system sequelae and to assist patients decision-making regarding treatment and compliance. Treatment adherence is also a challenge in clinical trials generally, and adherence to CPAP therapy in particular is a recognised concern in both research studies and clinical practice. Suggested research priorities would include a focus on optimisation of CPAP delivery or support and embracing the technological advances currently available. Finally, the improvements in quality of life in trials do not appear to reflect the dramatic changes noted in clinical practice. There should be a greater focus on patient centred outcomes which would better capture the symptomatic improvement with CPAP treatment and translate these improvements into outcomes which could be used in health economic analysis. Current Controlled Trials ISRCTN90464927. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 40. See the NIHR Journals Library website for further project information.

  5. Dynamic model based novel findings in power systems analysis and frequency measurement verification

    NASA Astrophysics Data System (ADS)

    Kook, Kyung Soo

    This study selects several new advanced topics in power systems, and verifies their usefulness using the simulation. In the study on ratio of the equivalent reactance and resistance of the bulk power systems, the simulation results give us the more correct value of X/R of the bulk power system, which can explain why the active power compensation is also important in voltage flicker mitigation. In the application study of the Energy Storage System(ESS) to the wind power, the new model implementation of the ESS connected to the wind power is proposed, and the control effect of ESS to the intermittency of the wind power is verified. Also this study conducts the intensive simulations for clarifying the behavior of the wide-area power system frequency as well as the possibility of the on-line instability detection. In our POWER IT Laboratory, since 2003, the U.S. national frequency monitoring network (FNET) has been being continuously operated to monitor the wide-area power system frequency in the U.S. Using the measured frequency data, the event of the power system is triggered, and its location and scale are estimated. This study also looks for the possibility of using the simulation technologies to contribute the applications of FNET, finds similarity of the event detection orders between the frequency measurements and the simulations in the U.S. Eastern power grid, and develops the new methodology for estimating the event location based on the simulated N-1 contingencies using the frequency measurement. It has been pointed out that the simulation results can not represent the actual response of the power systems due to the inevitable limit of modeling power systems and different operating conditions of the systems at every second. However, in the circumstances that we need to test such an important infrastructure supplying the electric energy without taking any risk of it, the software based simulation will be the best solution to verify the new technologies in power system engineering and, for doing this, new models and better application of the simulation should be proposed. Conducting extensive simulation studies, this dissertation verified that the actual X/R ratio of the bulk power systems is much lower than what has been known as its typical value, showed the effectiveness of the ESS control to mitigate the intermittence of the wind power from the perspective of the power grid using the newly proposed simulation model of ESS connected to the wind power, and found many characteristics of the wide-area frequency wave propagation. Also the possibility of using the simulated responses of the power system for replacing the measured data could be confirmed and this is very promising to the future application of the simulation to the on-line analysis of the power systems based on the FNET measurements.

  6. Assessing narcolepsy with cataplexy in children and adolescents: development of a cataplexy diary and the ESS-CHAD

    PubMed Central

    Wang, Y Grace; Benmedjahed, Khadra; Lambert, Jérémy; Evans, Christopher J; Hwang, Steve; Black, Jed; Johns, Murray W

    2017-01-01

    Objective The aim of this study was to qualitatively evaluate concepts for incorporation into a daily diary to capture cataplexy frequency and to assess the content validity of the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) in pediatric patients with narcolepsy. Patients and methods Face-to-face concept elicitation and cognitive interviews were conducted with children (7–9 years; n=13) and adolescents (10–17 years; n=16) who have narcolepsy with cataplexy, and their parents/caregivers. Results Similarities and differences were noted between narcolepsy concepts described by children and their parents/caregivers, suggesting some different but complementary perspectives; parents may not recognize cataplexy symptoms/triggers as well as children, but parents have greater recognition of the circumstances of falling asleep. Cataplexy diary modifications included changes in definitions and examples of cataplexy, using child-friendly terminology, adding a quantitative question to determine daily frequency, and standardizing the questionnaire for evening administration with self-completion by the child. Modifications were made to ESS-CHAD for child-friendly wording and to ensure that items reflect activities (eating, watching TV/video) and environments (school, bus/car transport) in which children are likely to participate. Two ESS-CHAD versions were proposed: one with a 1-month recall period, for general use, and the other with a recall period of “since your last study visit,” for research, which could be shorter or longer than 1 month (as short as 1 week). Conclusion The cataplexy diary and ESS-CHAD were modified for the assessment of children and adolescents. Further psychometric validation is recommended. These measures are being used in a Phase III, placebo-controlled clinical trial of sodium oxybate in children and adolescents with narcolepsy. PMID:28860883

  7. Report of the Peer Review Panel on the early site suitability evaluation of the Potential Repository Site at Yucca Mountain, Nevada; Yucca Mountain Site Characterization Project

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

    NONE

    1992-01-01

    The US Department of Energy (DOE) Yucca mountain Site Characterization Project Office (YMPO) assigned Science Applications International Corporation (SAIC), the Technical and Management Support Services (T&MSS) contractor to the YmPo, the task of conducting an Early Site Suitability Evaluation (ESSE) of the Yucca mountain site as a potential site for a high-level radioactive waste repository. First, the assignment called for the development of a method to evaluate a single site against the DOE General Guidelines for Recommendation of Sites for Nuclear Waste Repositories, 10 CFR Part 960. Then, using this method, an evaluation team, the ESSE Core Team, of seniormore » YMP scientists, engineers, and technical experts, evaluated new information obtained about the site since publication of the final Environmental Assessment (DOE, 1986) to determine if new suitability/unsuitability findings could be recommended. Finally, the Core Team identified further information and analyses needed to make final determinations for each of the guidelines. As part of the task, an independent peer review of the ESSE report has been conducted. Expertise was solicited that covered the entire spectrum of siting guidelines in 10 CFR Part 960 in order to provide a complete, in-depth critical review of the data evaluated and cited in the ESSE report, the methods used to evaluate the data, and the conclusions and recommendations offered by the report. Fourteen nationally recognized technical experts (Table 2) served on the Peer Review Panel. The comments from the Panel and the responses prepared by the ESSE Core Team, documented on formal Comment Response Forms, constitute the body of this document.« less

  8. Excessive Daytime Sleepiness is Associated with Longer Culprit Lesion and Adverse Outcomes in Patients with Coronary Artery Disease

    PubMed Central

    Lee, Chi-Hang; Ng, Wai-Yee; Hau, William; Ho, Hee-Hwa; Tai, Bee-Choo; Chan, Mark Y.; Richards, A. Mark; Tan, Huay-Cheem

    2013-01-01

    Study Objectives: We assessed whether excessive daytime sleepiness was associated with coronary plaque phenotype and subsequent adverse cardiovascular events. Methods: Prospective cohort study. Intravascular ultrasound (IVUS) examination of the culprit coronary stenosis was performed. The Epworth Sleepiness Scale (ESS) questionnaire was administered, and the patients were divided into 2 groups—(1) sleepier and (2) less sleepy—based on the ESS score. Adverse cardiovascular outcomes were defined as cardiac death, myocardial infarction, stroke, unplanned revascularization, or heart failure admission. Results: One hundred seventeen patients undergoing urgent or non-urgent coronary angiography were recruited. Compared with the less sleepy group (ESS ≤ 10, n = 87), the sleepier group (ESS > 10, n = 30) had higher serum levels of total cholesterol and of low-density-lipoprotein cholesterols (p < 0.05 for both). The IVUS examinations indicated coronary stenoses were longer in the sleepier group than in the less sleepy group (p = 0.011). The cumulative incidence of adverse cardiovascular events at 16-month follow-up was higher in the sleepier than the less sleepy group (12.5% versus 6.9%, p = 0.03). Cox regression analysis adjusting for age and smoking showed increased hazard of adverse cardiovascular events in sleepier group as compared to less sleepy group (HR = 3.44, 95% CI 1.01-11.72). Conclusion: In patients presenting with coronary artery disease, excessive daytime sleepiness based on ESS > 10 was associated with longer culprit lesions and future adverse cardiovascular events. Citation: Lee CH; Ng WY; Hau W; Ho HH; Tai BC; Chan MY; Richards AM; Tan HC. Excessive daytime sleepiness is associated with longer culprit lesion and adverse outcomes in patients with coronary artery disease. J Clin Sleep Med 2013;9(12):1267-1272. PMID:24340288

  9. Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

    PubMed

    Svider, Peter F; Darlin, Spencer; Bobian, Michael; Sekhsaria, Vibhav; Harvey, Richard J; Gray, Stacey T; Baredes, Soly; Folbe, Adam J; Eloy, Jean Anderson

    2018-06-01

    Balloon dilation (BD) represents a minimally invasive alternative to endoscopic sinus surgery (ESS). Although BD was introduced in 2006, distinct Current Procedural Terminology (CPT) codes were not available until 2011, making prior analysis of population-based trends difficult. Our objectives were to evaluate these trends and compare any changes to the use of traditional ESS techniques. Geographic trends also were evaluated. Medicare Part B national datasets encompassing procedures from 2011 to 2015 were obtained. ESS CPT codes (frontal sinusotomy, maxillary antrostomy with/without tissue removal, sphenoidotomy) and BD codes were searched to determine temporal trends in their use. Additionally, state carriers were individually evaluated for geographic trends. National use of BD increased greater than five-fold (39,193 from 7,496 among Medicare patients), whereas the use of ESS increased by only 5.9%. This increase in BD was observed across all sites, including the sphenoid (7.0x), maxillary (5.1x), and frontal (4.7x) sinuses. In the most recent year for which data was available (2015), a significantly greater portion of sinus procedures in these sites utilized BD in the South (42.1%) compared to the Northeast (30.6%), West (29.5%), and Midwest (25.3%) regions (P < 0.0001). The performance of BD has increased markedly in recent years. Because the use of ESS codes remain stable, observed BD trends are unlikely to be due simply to greater familiarity with newer CPT coding. The reasons for the striking increase in BD popularity are speculative and beyond the scope of this analysis, but further study may be needed. NA. Laryngoscope, 128:1299-1303, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  10. Comparison of least squares and exponential sine sweep methods for Parallel Hammerstein Models estimation

    NASA Astrophysics Data System (ADS)

    Rebillat, Marc; Schoukens, Maarten

    2018-05-01

    Linearity is a common assumption for many real-life systems, but in many cases the nonlinear behavior of systems cannot be ignored and must be modeled and estimated. Among the various existing classes of nonlinear models, Parallel Hammerstein Models (PHM) are interesting as they are at the same time easy to interpret as well as to estimate. One way to estimate PHM relies on the fact that the estimation problem is linear in the parameters and thus that classical least squares (LS) estimation algorithms can be used. In that area, this article introduces a regularized LS estimation algorithm inspired on some of the recently developed regularized impulse response estimation techniques. Another mean to estimate PHM consists in using parametric or non-parametric exponential sine sweeps (ESS) based methods. These methods (LS and ESS) are founded on radically different mathematical backgrounds but are expected to tackle the same issue. A methodology is proposed here to compare them with respect to (i) their accuracy, (ii) their computational cost, and (iii) their robustness to noise. Tests are performed on simulated systems for several values of methods respective parameters and of signal to noise ratio. Results show that, for a given set of data points, the ESS method is less demanding in computational resources than the LS method but that it is also less accurate. Furthermore, the LS method needs parameters to be set in advance whereas the ESS method is not subject to conditioning issues and can be fully non-parametric. In summary, for a given set of data points, ESS method can provide a first, automatic, and quick overview of a nonlinear system than can guide more computationally demanding and precise methods, such as the regularized LS one proposed here.

  11. Antibodies to pituitary surface antigens during various pituitary disease states.

    PubMed

    Keda, Y M; Krjukova, I V; Ilovaiskaia, I A; Morozova, M S; Fofanova, O V; Babarina, M B; Marova, E I; Pankov, Y A; Kandror, V I

    2002-11-01

    Autoantibodies to cell surface antigens of human somatotropinoma (ASAS), human prolactinoma (ASAP) and rat adenohypophysis (ASARA) were assayed in the serum of patients with pituitary diseases associated with GH deficiency (GHD), such as pituitary dwarfism and primary empty sella syndrome (ESS), and in the serum of patients with hyperprolactinaemia of different etiologies: idiopathic hyperprolactinaemia, prolactinoma and ESS. The investigation was carried out with a cellular variant of an ELISA. Among children with GHD, the highest percentage of antibody-positive patients was found in the group with idiopathic isolated GHD (89% of ASAS(+) patients and 30% of ASARA(+) patients vs 33.3% and 0% respectively in the group with idiopathic combined pituitary hormone deficiency, and 33.3% and 9% in patients with pituitary hypoplasia associated with isolated GHD or combined pituitary hormone deficiency). Among hyperprolactinaemic patients, the highest ASAP and ASARA frequency was observed in patients with idiopathic hyperprolactinaemia (67.7% and 41.9% respectively) where it was twice as high as in the group of patients with prolactinoma. The proportion of ASAS(+) and ASARA(+) did not differ significantly between the groups of patients with ess with or without GHD. Similarly, there was no significant difference between the number of ESS ASAP(+) and ASARA(+) patients with or without hyperprolactinaemia. The data obtained suggested that autoimmune disorders may be primary, and responsible, at least in part, for pituitary dysfunction in the cases of idiopathic isolated GHD and idiopathic hyperprolactinaemia. At the same time, the autoimmune disorders in the patients with prolactinoma or ESS are probably secondary to the organic pituitary lesion and their significance in the development of the pituitary dysfunction is obscure.

  12. Cultural competence education for health professionals.

    PubMed

    Horvat, Lidia; Horey, Dell; Romios, Panayiota; Kis-Rigo, John

    2014-05-05

    Cultural competence education for health professionals aims to ensure all people receive equitable, effective health care, particularly those from culturally and linguistically diverse (CALD) backgrounds. It has emerged as a strategy in high-income English-speaking countries in response to evidence of health disparities, structural inequalities, and poorer quality health care and outcomes among people from minority CALD backgrounds. However there is a paucity of evidence to link cultural competence education with patient, professional and organisational outcomes. To assess efficacy, for this review we developed a four-dimensional conceptual framework comprising educational content, pedagogical approach, structure of the intervention, and participant characteristics to provide consistency in describing and assessing interventions. We use the term 'CALD participants' when referring to minority CALD populations as a whole. When referring to participants in included studies we describe them in terms used by study authors. To assess the effects of cultural competence education interventions for health professionals on patient-related outcomes, health professional outcomes, and healthcare organisation outcomes. We searched: MEDLINE (OvidSP) (1946 to June 2012); Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library) (June 2012); EMBASE (OvidSP) (1988 to June 2012); CINAHL (EbscoHOST) (1981 to June 2012); PsycINFO (OvidSP) (1806 to June 2012); Proquest Dissertations and Theses database (1861 to October 2011); ERIC (CSA) (1966 to October 2011); LILACS (1982 to March 2012); and Current Contents (OvidSP) (1993 Week 27 to June 2012).Searches in MEDLINE, CENTRAL, PsycINFO, EMBASE, Proquest Dissertations and Theses, ERIC and Current Contents were updated in February 2014. Searches in CINAHL were updated in March 2014.There were no language restrictions. We included randomised controlled trials (RCTs), cluster RCTs, and controlled clinical trials of educational interventions for health professionals working in health settings that aimed to improve: health outcomes of patients/consumers of minority cultural and linguistic backgrounds; knowledge, skills and attitudes of health professionals in delivering culturally competent care; and healthcare organisation performance in culturally competent care. We used the conceptual framework as the basis for data extraction. Two review authors independently extracted data on interventions, methods, and outcome measures and mapped them against the framework. Additional information was sought from study authors. We present results in narrative and tabular form. We included five RCTs involving 337 healthcare professionals and 8400 patients; at least 3463 (41%) were from CALD backgrounds. Trials compared the effects of cultural competence training for health professionals, with no training. Three studies were from the USA, one from Canada and one from The Netherlands. They involved health professionals of diverse backgrounds, although most were not from CALD minorities. Cultural background was determined using a validated scale (one study), self-report (two studies) or not reported (two studies). The design effect from clustering meant an effective minimum sample size of 3164 CALD participants. No meta-analyses were performed. The quality of evidence for each outcome was judged to be low.Two trials comparing cultural competence training with no training found no evidence of effect for treatment outcomes, including the proportion of patients with diabetes achieving LDL cholesterol control targets (risk difference (RD) -0.02, 95% CI -0.06 to 0.02; 1 study, USA, 2699 "black" patients, moderate quality), or change in weight loss (standardised mean difference (SMD) 0.07, 95% CI -0.41 to 0.55, 1 study, USA, effective sample size (ESS) 68 patients, low quality).Health behaviour (client concordance with attendance) improved significantly among intervention participants compared with controls (relative risk (RR) 1.53, 95% CI 1.03 to 2.27, 1 study, USA, ESS 28 women, low quality). Involvement in care by "non-Western" patients (described as "mainly Turkish, Moroccan, Cape Verdean and Surinamese patients") with largely "Western" doctors improved in terms of mutual understanding (SMD 0.21, 95% CI 0.00 to 0.42, 1 study, The Netherlands, 109 patients, low quality). Evaluations of care were mixed (three studies). Two studies found no evidence of effect in: proportion of patients reporting satisfaction with consultations (RD 0.14, 95% CI -0.03 to 0.31, 1 study, The Netherlands, 109 patients, low quality); patient scores of physician cultural competency (SMD 0.11 95% CI -0.63 to 0.85, 1 study, USA, ESS 68 "Caucasian" and "non-Causcasian" patients (described as Latino, African American, Asian and other, low quality). Client perceptions of health professionals were significantly higher in the intervention group (SMD 1.60 95% CI 1.05 to 2.15, 1 study, USA, ESS 28 "Black" women, low quality).No study assessed adverse outcomes.There was no evidence of effect on clinician awareness of "racial" differences in quality of care among clients at a USA health centre (RR 1.37, 95% CI 0.97 to 1.94. P = 0.07) with no adjustment for clustering. Included studies did not measure other outcomes of interest. Sensitivity analyses using different values for the Intra-cluster coefficient (ICC) did not substantially alter the magnitude or significance of summary effect sizes.All four domains of the conceptual framework were addressed, suggesting agreement on core components of cultural competence education interventions may be possible. Cultural competence continues to be developed as a major strategy to address health inequities. Five studies assessed the effects of cultural competence education for health professionals on patient-related outcomes. There was positive, albeit low-quality evidence, showing improvements in the involvement of CALD patients. Findings either showed support for the educational interventions or no evidence of effect. No studies assessed adverse outcomes. The quality of evidence is insufficient to draw generalisable conclusions, largely due to heterogeneity of the interventions in content, scope, design, duration, implementation and outcomes selected.Further research is required to establish greater methodological rigour and uniformity on core components of education interventions, including how they are described and evaluated. Our conceptual framework provides a basis for establishing consensus to improve reporting and allow assessment across studies and populations. Future studies should measure the patient outcomes used: treatment outcomes; health behaviours; involvement in care and evaluations of care. Studies should also measure the impact of these types of interventions on healthcare organisations, as these are likely to affect uptake and sustainability.

  13. Assessment of environmental consequences of the normal operations of the ESS facility

    NASA Astrophysics Data System (ADS)

    Ene, D.; Avila, R.; Hjerpe, T.; Bugay, D.; Stenberg, K.

    2018-06-01

    As other accelerator based facilities, the European Spallation Source ESS facility will interact with the environment. The Swedish legislation requires a demonstration that the sum of the doses resulting from the exposure of any member of the public to ionizing radiation dose does not exceed the specified limit of 50 μSv/year. A radiological assessment has been produced to provide that demonstration. This evaluation was based upon the actual status of the ESS design. A graded approach was adopted through over the assessment allowing estimating dose for all radionuclides and exposure pathways, but the degree of detail in the assessment depend upon their relative radiological importance. The total dose was obtained making the sum of the contribution of all-important radionuclides treated realistically with that of all screened out radionuclides, derived by means a conservative method.

  14. Extraction, scrub, and strip test results for the salt waste processing facility caustic side solvent extraction solvent example

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

    Peters, T. B.

    An Extraction, Scrub, and Strip (ESS) test was performed on a sample of Salt Waste Processing Facility (SWPF) Caustic-Side Solvent Extraction (CSSX) solvent and salt simulant to determine cesium distribution ratios (D(Cs)), and cesium concentration in the strip effluent (SE) and decontaminated salt solution (DSS) streams; this data will be used by Parsons to help determine if the solvent is qualified for use at the SWPF. The ESS test showed acceptable performance of the solvent for extraction, scrub, and strip operations. The extraction D(Cs) measured 12.9, exceeding the required value of 8. This value is consistent with results from previousmore » ESS tests using similar solvent formulations. Similarly, scrub and strip cesium distribution ratios fell within acceptable ranges.« less

  15. ESS Cryogenic System Process Design

    NASA Astrophysics Data System (ADS)

    Arnold, P.; Hees, W.; Jurns, J.; Su, X. T.; Wang, X. L.; Weisend, J. G., II

    2015-12-01

    The European Spallation Source (ESS) is a neutron-scattering facility funded and supported in collaboration with 17 European countries in Lund, Sweden. Cryogenic cooling at ESS is vital particularly for the linear accelerator, the hydrogen target moderators, a test stand for cryomodules, the neutron instruments and their sample environments. The paper will focus on specific process design criteria, design decisions and their motivations for the helium cryoplants and auxiliary equipment. Key issues for all plants and their process concepts are energy efficiency, reliability, smooth turn-down behaviour and flexibility. The accelerator cryoplant (ACCP) and the target moderator cryoplant (TMCP) in particular need to be prepared for a range of refrigeration capacities due to the intrinsic uncertainties regarding heat load definitions. Furthermore the paper addresses questions regarding process arrangement, 2 K cooling methodology, LN2 precooling, helium storage, helium purification and heat recovery.

  16. Does CPAP Affect Patient-Reported Voice Outcomes?

    PubMed

    Hartke, Vance; Gillespie, Amanda; Smith, Libby J; Soose, Ryan J

    2018-04-01

    Upper aerodigestive tract symptoms are common in patients with obstructive sleep apnea (OSA). It remains unclear whether continuous positive airway pressure (CPAP) improves or worsens these otolaryngology symptoms. As therapy-related side effects limit CPAP adherence, this study aimed to determine if CPAP negatively affects voice, sinonasal, and reflux symptoms of the upper airway. Case series with planned data collection was performed at an academic otolaryngology sleep center. Newly diagnosed patients with OSA were evaluated before and 6 months after initiating CPAP therapy. Data collected included CPAP data download, Reflux Symptom Index (RSI), Epworth Sleepiness Scale (ESS), Voice Handicap Index 10 (VHI-10), Sino-Nasal Questionnaire (SNQ), and oral dryness visual analog scale (VAS). For the 11 CPAP-adherent participants, the RSI significantly improved with CPAP (mean RSI, 22.0-9.5; P = .002); however, the VAS, VHI-10, and SNQ did not change after 6 months of CPAP therapy. In a small sample size, patient-reported voice outcomes (VHI-10) and other upper aerodigestive tract symptoms did not worsen with CPAP; rather, CPAP therapy was associated with a reduction in reflux symptoms.

  17. Which Features of the Environment Impact Community Participation of Older Adults? A Systematic Review and Meta-Analysis.

    PubMed

    Vaughan, Molly; LaValley, Michael P; AlHeresh, Rawan; Keysor, Julie J

    2016-09-01

    The objective of this study is to identify features of the environment associated with community participation of older adults. A systematic review of studies that examined associations between environment and community participation in older adults was conducted. Environmental features were extracted and grouped using the International Classification of Functioning, Disability, and Health's environmental categories. Meta-analysis of environmental categories was conducted by calculating combined effect size (ES) estimates. Significant, small to moderate, random ESs were found for six of seven environmental categories: neighborliness (ES = 0.52, 95% confidence interval [CI] = [0.18, 0.87]), social support (ES = 0.38, 95% CI = [0.13, 0.62]), land-use diversity (ES = 0.29, 95% CI = [0.16, 0.42]), transportation (ES = 0.29, 95% CI = [0.15, 0.43]), civil protection (e.g., safety; ES = 0.27, 95% CI = [0.0, 0.54]), and street connectivity/walkability (ES = 0.20, 95% CI = [0.15, 0.26]). Community initiatives that address specific features of the social environment and street-level environment may increase community participation of older adults. © The Author(s) 2015.

  18. Assigning value to energy storage systems at multiple points in an electrical grid

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

    Balducci, Patrick J.; Alam, M. Jan E.; Hardy, Trevor D.

    This article presents a taxonomy for assigning benefits to the services provided by energy storage systems (ESSs), defines approaches for monetizing the value associated with these services, assigns values to major ESS applications by region based on a review of an extensive set of literature, and summarizes and evaluates the capabilities of several tools currently used to estimate value for specific ESS deployments.

  19. Assigning value to energy storage systems at multiple points in an electrical grid

    DOE PAGES

    Balducci, Patrick J.; Alam, M. Jan E.; Hardy, Trevor D.; ...

    2018-01-01

    This article presents a taxonomy for assigning benefits to the services provided by energy storage systems (ESSs), defines approaches for monetizing the value associated with these services, assigns values to major ESS applications by region based on a review of an extensive set of literature, and summarizes and evaluates the capabilities of several tools currently used to estimate value for specific ESS deployments.

  20. Use of air-assisted electrostatic spraying system (ESS)or the sprayed lethality in container(SLIC) method to deliver anticmicrobials onto the surface of beef subprimals to ... shiga toxin-producing cells of Escherichia coli

    USDA-ARS?s Scientific Manuscript database

    We evaluated the efficacy of an air-assisted electrostatic spraying system (ESS) and/or the Sprayed Lethality in Container (SLIC) method to deliver antimicrobials onto the surface of beef subprimals to reduce levels of Shiga toxin-producing Escherichia coli (STEC). Beef subprimals were surface inocu...

  1. Assessing the Reliability and Use of the Expository Scoring Scheme as a Measure of Developmental Change in Monolingual English and Bilingual French/English Children

    ERIC Educational Resources Information Center

    Bird, Elizabeth Kay-Raining; Joshi, Nila; Cleave, Patricia L.

    2016-01-01

    Purpose: The Expository Scoring Scheme (ESS) is designed to analyze the macrostructure of descriptions of a favorite game or sport. This pilot study examined inter- and intrarater reliability of the ESS and use of the scale to capture developmental change in elementary school children. Method: Twenty-four children in 2 language groups (monolingual…

  2. "Teaching What I Learned": Exploring Students' Earth and Space Science Learning Experiences in Secondary School with a Particular Focus on Their Comprehension of the Concept of "Geologic Time"

    ERIC Educational Resources Information Center

    Yoon, Sae Yeol; Peate, David W.

    2015-01-01

    According to the national survey of science education, science educators in the USA currently face many challenges such as lack of qualified secondary Earth and Space Science (ESS) teachers. Less qualified teachers may have difficulty teaching ESS because of a lack of conceptual understanding, which leads to diminished confidence in content…

  3. A Case of Fragmented High School Earth and Space Science Education in the Great Plains: Tracing Teacher Certification Policy to Students' Access

    ERIC Educational Resources Information Center

    Lewis, Elizabeth; Lu, Jia

    2017-01-01

    Although U.S. high school students' access to Earth and space science (ESS) varies widely from state to state, nationally, ESS content is the most neglected area of science education and scientific literacy. States have been considering whether they will formally adopt, or less formally adapt, the new national science education standards, the Next…

  4. Seeing the Solar System through Two Perspectives. Part 2 of a Series Focusing on Learning Progressions

    ERIC Educational Resources Information Center

    Tretter, Thomas R.; Thornburgh, William R.; Duckwall, Mark

    2016-01-01

    Supporting elementary student understandings of ideas related to Earth's Place in the Universe (ESS1) can be challenging, especially given the large time and distance scales involved with many of the concepts. However, with effective use of crosscutting concepts and science and engineering practices, important concepts within this content domain…

  5. Library History Seminar No. 3, Proceedings, 1968.

    ERIC Educational Resources Information Center

    Zachert, Martha Jane, Ed.

    Included in this book are 12 papers: (1) "The Newberry Library: A Research Opportunity in Library History," by Lawrence W. Towner; (2) "Society's Contradictions and the Library: Notes on Some Negative Effects of Humanism," by Sidney L. Jackson; (3) "The Acquisition of the Van Ess Library by Union Theological Seminary in the City of New York," by…

  6. Shame, trauma, temperament and psychopathology: Construct validity of the Experience of Shame Scale.

    PubMed

    Vizin, Gabriella; Urbán, Róbert; Unoka, Zsolt

    2016-12-30

    Although Experience of Shame Scale (ESS) is used in clinical research and it covers psychiatrically relevant dimensions of chronic shame, characterological (CS), behavioral (BS) and bodily (BoS) respectively, its factor structures were not confirmed on clinical sample. The goals of our research were to examine the factor structure of the Hungarian version of ESS, in addition, to analyze the associations between factors of ESS and different types of predictors, such as clinical status, gender, age, school years, early abuse history, general psychopathology (GSI), and temperament dimensions by using a series of confirmatory factor analyses (CFA) with covariates in a large clinical and matched healthy sample. Psychiatric inpatients (N=148) and healthy control subjects (N=148) participated in this cross-sectional questionnaire study. In both samples, the degree of fit was adequate. The final CFA with covariates model showed significant and positive associations between CS and clinical status and education respectively, between CS, BS, BoS and frequency of verbal abuse, between CS and BoS and GSI and between CS and BS and harm avoidance and in addition we found negative associations between each of the shame factors and age. Our results support the psychiatric validity of the ESS construct. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Scientific Research for Integrated Solutions to Community Challenges: The Thriving Earth Exchange (TEX) Approach

    NASA Astrophysics Data System (ADS)

    Udu-gama, N.; Pandya, R.

    2015-12-01

    There is tremendous unmet and sometimes unrealized need for Earth and space science (ESS) expertise as part of civic decisions and local planning for climate change, natural hazards and natural resources. The Thriving Earth Exchange (TEX) helps AGU contribute that expertise to humanity in respectful, integrated ways. TEX brings ESS scientists together with local communities tackling issues of climate change, natural hazards and natural resources to co-design solutions that equitably integrate both scientific and community knowledge. To achieve this ambitious goal, TEX is partnering with organizations that are respected by and knowledgeable about communities both in the United States and internationally. Such partnerships include Rockefeller's 100 Resilient Cities Initiative, ICLEI USA, MIT's Climate Colab, among others. TEX works with these partners to approach communities who are ready to or already addressing ESS related issues. With partners, we help the communities define their goals, develop specific projects, and connect with relevant and helpful ESS scientists. We will also show how we help scientists and community leaders work productively together, and the tools we bring to support their innovation. It will highlight international examples, such as in the Pamir Mountains of Afghanistan-Tajikistan, Sri Lanka, and Ethiopia, and provide concrete examples of how these initiatives are helping TEX further expand the frontiers of collaborative research.

  8. Beam modulation: A novel ToF-technique for high resolution diffraction at the Beamline for European Materials Engineering Research (BEER)

    NASA Astrophysics Data System (ADS)

    Rouijaa, M.; Kampmann, R.; Šaroun, J.; Fenske, J.; Beran, P.; Müller, M.; Lukáš, P.; Schreyer, A.

    2018-05-01

    The Beamline for European Materials Engineering Research (BEER) is under construction at the European Spallation Source (ESS) in Lund, Sweden. A basic requirement on BEER is to make best use of the long ESS pulse (2.86 ms) for engineering investigations. High-resolution diffraction, however, demands timing resolution up to 0.1% corresponding to a pulse length down to about 70 μs for the case of thermal neutrons (λ ∼ 1.8 Å). Such timing resolution can be achieved by pulse shaping techniques cutting a short section out of the long pulse, and thus paying for resolution by strong loss of intensity. In contrast to this, BEER proposes a novel operation mode called pulse modulation technique based on a new chopper design, which extracts several short pulses out of the long ESS pulse, and hence leads to a remarkable gain of intensity compared to nowadays existing conventional pulse shaping techniques. The potential of the new technique can be used with full advantage for investigating strains and textures of highly symmetric materials. Due to its instrument design and the high brilliance of the ESS pulse, BEER is expected to become the European flagship for engineering research for strain mapping and texture analysis.

  9. NLP is a novel transcription regulator involved in VSG expression site control in Trypanosoma brucei.

    PubMed

    Narayanan, Mani Shankar; Kushwaha, Manish; Ersfeld, Klaus; Fullbrook, Alexander; Stanne, Tara M; Rudenko, Gloria

    2011-03-01

    Trypanosoma brucei mono-allelically expresses one of approximately 1500 variant surface glycoprotein (VSG) genes while multiplying in the mammalian bloodstream. The active VSG is transcribed by RNA polymerase I in one of approximately 15 telomeric VSG expression sites (ESs). T. brucei is unusual in controlling gene expression predominantly post-transcriptionally, and how ESs are mono-allelically controlled remains a mystery. Here we identify a novel transcription regulator, which resembles a nucleoplasmin-like protein (NLP) with an AT-hook motif. NLP is key for ES control in bloodstream form T. brucei, as NLP knockdown results in 45- to 65-fold derepression of the silent VSG221 ES. NLP is also involved in repression of transcription in the inactive VSG Basic Copy arrays, minichromosomes and procyclin loci. NLP is shown to be enriched on the 177- and 50-bp simple sequence repeats, the non-transcribed regions around rDNA and procyclin, and both active and silent ESs. Blocking NLP synthesis leads to downregulation of the active ES, indicating that NLP plays a role in regulating appropriate levels of transcription of ESs in both their active and silent state. Discovery of the unusual transcription regulator NLP provides new insight into the factors that are critical for ES control.

  10. Adjunctive low-dose docosahexaenoic acid (DHA) for major depression: An open-label pilot trial.

    PubMed

    Smith, Deidre J; Sarris, Jerome; Dowling, Nathan; O'Connor, Manjula; Ng, Chee H

    2018-04-01

    Whilst the majority of evidence supports the adjunctive use of eicosapentaenoic acid (EPA) in improving mood, to date no study exists using low-dose docosahexaenoic acid (DHA) alone as an adjunctive treatment in patients with mild to moderate major depressive disorder (MDD). A naturalistic 8-week open-label pilot trial of low-dose DHA, (260 mg or 520 mg/day) in 28 patients with MDD who were non-responsive to medication or psychotherapy, with a Hamilton Depression Rating Scale (HAM-D) score of greater than 17, was conducted. Primary outcomes of depression, clinical severity, and daytime sleepiness were measured. After 8 weeks, 54% of patients had a ≥50% reduction on the HAM-D, and 45% were in remission (HAM-D ≤ 7). The eta-squared statistic (0.59) indicated a large effect size for the reduction of depression (equivalent to Cohen's d of 2.4). However confidence in this effect size is tempered due to the lack of a placebo. The mean score for the Clinical Global Impression Severity Scale was significantly improved by 1.28 points (P < 0.05). Despite a significant reduction in the HAM-D score for middle insomnia (P = 0.02), the reduction in excessive daytime somnolence on the total Epworth Sleepiness Scale (ESS) did not reach significance. No significant adverse reactions to DHA were found. Within the major limits of this open-label pilot study, the results suggest that DHA may provide additional adjunctive benefits in patients with mild- to -moderate depression.

  11. Marketing Program: Tripler Army Medical Center, Hawaii

    DTIC Science & Technology

    1990-12-01

    advertising agency. Good deeds are only effective when accompanied by good words. Thp qrimarv bEnefit of r P-,essful marketing program are improved...professional advertising agency. Good deeds are only effective when accompanied by good words. The primary benefits of a successful marketing program are... market plan itself. MARKET PLAN A market plan is not just advertising and gimmicks. It is only of value if it is a means of assisting people to satisfy

  12. Expert system verification and validation study. Phase 2: Requirements Identification. Delivery 2: Current requirements applicability

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The second phase of a task is described which has the ultimate purpose of ensuring that adequate Expert Systems (ESs) Verification and Validation (V and V) tools and techniques are available for Space Station Freedom Program Knowledge Based Systems development. The purpose of this phase is to recommend modifications to current software V and V requirements which will extend the applicability of the requirements to NASA ESs.

  13. RADC (Rome Air Development Center) Guide to Environmental Stress Screening

    DTIC Science & Technology

    1986-08-01

    and the processes which are used in their manufacture. ESS is the vehicle by which latent defects are accelerated to early failure in the factory. ESS...structured as part of a production 2 reliability assurance program, is the vehicle through which product reliability in manufacture can be maintained...mechanical, electrical and/or thermal stresses to an equipment item for the purpose of precipitating latent part and workmanship defects to early failure

  14. Elastic Scattering Spectroscopy for the Detection of Pre-Cancer and Early Cancer of the Breast

    DTIC Science & Technology

    2006-06-01

    and it is not currently possible even to use biopsy forceps through the sheath alone. However, it is practical to pass an ESS probe through the...to accept our ESS probe, tiny biopsy forceps or brushes for cytological PAGE 53 PAGE 54 examination. We envisage being able to take...ductoscopy (where biopsy is not feasible) and detect aneuploidy, an important prognostic factor. These results justify further prospective studies

  15. Extraction, scrub, and strip test results for the solvent transfer to salt waste processing facility

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

    Peters, T.

    The Savannah River National Laboratory (SRNL) prepared approximately 240 gallons of Caustic-Side Solvent Extraction (CSSX) solvent for use at the Salt Waste Processing Facility (SWPF). An Extraction, Scrub, and Strip (ESS) test was performed on a sample of the prepared solvent using a salt solution prepared by Parsons to determine cesium distribution ratios (D(Cs)), and cesium concentration in the strip effluent (SE) and decontaminated salt solution (DSS) streams. This data will be used by Parsons to help qualify the solvent for use at the SWPF. The ESS test showed acceptable performance of the solvent for extraction, scrub, and strip operations.more » The extraction D(Cs) measured 15.5, exceeding the required value of 8. This value is consistent with results from previous ESS tests using similar solvent formulations. Similarly, scrub and strip cesium distribution ratios fell within acceptable ranges.« less

  16. Protocol for Uniformly Measuring and Expressing the Performance of Energy Storage Systems

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

    Conover, David R.; Crawford, Aladsair J.; Fuller, Jason C.

    The Protocol for Uniformly Measuring and Expressing the Performance of Energy Storage Systems (PNNL-22010) was first issued in November 2012 as a first step toward providing a foundational basis for developing an initial standard for the uniform measurement and expression of energy storage system (ESS) performance. Based on experiences with the application and use of that document, and to include additional ESS applications and associated duty cycles, test procedures and performance metrics, a first revision of the November 2012 Protocol was issued in June 2014 (PNNL 22010 Rev. 1). As an update of the 2014 revision 1 to the Protocol,more » this document (the March 2016 revision 2 to the Protocol) is intended to supersede the June 2014 revision 1 to the Protocol and provide a more user-friendly yet more robust and comprehensive basis for measuring and expressing ESS performance.« less

  17. Efficacy and Safety of Adjunctive Modafinil Treatment on Residual Excessive Daytime Sleepiness among Nasal Continuous Positive Airway Pressure-Treated Japanese Patients with Obstructive Sleep Apnea Syndrome: A Double-Blind Placebo-Controlled Study

    PubMed Central

    Inoue, Yuichi; Takasaki, Yuji; Yamashiro, Yoshihiro

    2013-01-01

    Study Objectives: This double-blind study evaluated the efficacy and safety of modafinil for treating excessive daytime sleepiness in Japanese patients with obstructive sleep apnea syndrome (OSAS). Methods: Patients with residual excessive sleepiness (Epworth Sleepiness Scale [ESS] ≥ 11) on optimal nasal continuous positive airway pressure (nCPAP) therapy (apnea-hypopnea index ≤ 10) were randomized to either 200 mg modafinil (n = 52) or placebo (n = 62) once daily for 4 weeks. Outcomes included baseline-week 4 changes in ESS total score, sleep latency on maintenance of wakefulness test (SL-MWT), nocturnal polysomnography, Pittsburgh Sleep Quality Index (PSQI), and safety. Results: All 114 randomized patients completed the study. Mean change in ESS total score (-6.6 vs -2.4, p < 0.001) and SL-MWT (+2.8 vs -0.4 minutes, p = 0.009) were significantly greater with modafinil than with placebo. ESS total score decreased from > 11 to < 11 at the final assessment in 69.2% of modafinil-treated patients and 30.6% of placebo-treated patients (p < 0.001). Corresponding rates at week 1 were 57.7% and 33.9% (p = 0.014). Changes in nocturnal polysomnography, PSQI, and apnea-hypopnea index from baseline to the final assessment were similar in both groups. Adverse drug reactions occurred in 36.5% and 22.6% of patients in the modafinil and placebo groups, respectively (p = 0.146). Conclusions: Once-daily modafinil was effective and well tolerated for managing residual daytime sleepiness in Japanese OSAS patients with residual excessive daytime sleepiness on optimal nCPAP therapy. Clinical Trial Registration: JapicCTI-No.090777 Citation: Inoue Y; Takasaki Y; Yamashiro Y. Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated Japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study. J Clin Sleep Med 2013;9(8):751-757. PMID:23946704

  18. A review of electrolyte materials and compositions for electrochemical supercapacitors.

    PubMed

    Zhong, Cheng; Deng, Yida; Hu, Wenbin; Qiao, Jinli; Zhang, Lei; Zhang, Jiujun

    2015-11-07

    Electrolytes have been identified as some of the most influential components in the performance of electrochemical supercapacitors (ESs), which include: electrical double-layer capacitors, pseudocapacitors and hybrid supercapacitors. This paper reviews recent progress in the research and development of ES electrolytes. The electrolytes are classified into several categories, including: aqueous, organic, ionic liquids, solid-state or quasi-solid-state, as well as redox-active electrolytes. Effects of electrolyte properties on ES performance are discussed in detail. The principles and methods of designing and optimizing electrolytes for ES performance and application are highlighted through a comprehensive analysis of the literature. Interaction among the electrolytes, electro-active materials and inactive components (current collectors, binders, and separators) is discussed. The challenges in producing high-performing electrolytes are analyzed. Several possible research directions to overcome these challenges are proposed for future efforts, with the main aim of improving ESs' energy density without sacrificing existing advantages (e.g., a high power density and a long cycle-life) (507 references).

  19. Evolutionary stability for matrix games under time constraints.

    PubMed

    Garay, József; Csiszár, Villő; Móri, Tamás F

    2017-02-21

    Game theory focuses on payoffs and typically ignores time constraints that play an important role in evolutionary processes where the repetition of games can depend on the strategies, too. We introduce a matrix game under time constraints, where each pairwise interaction has two consequences: both players receive a payoff and they cannot play the next game for a specified time duration. Thus our model is defined by two matrices: a payoff matrix and an average time duration matrix. Maynard Smith's concept of evolutionary stability is extended to this class of games. We illustrate the effect of time constraints by the well-known prisoner's dilemma game, where additional time constraints can ensure the existence of unique evolutionary stable strategies (ESS), both pure and mixed, or the coexistence of two pure ESS. Our general results may be useful in several fields of biology where evolutionary game theory is applied, principally in ecological games, where time constraints play an inevitable role. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. SLS-PLAN-IT: A knowledge-based blackboard scheduling system for Spacelab life sciences missions

    NASA Technical Reports Server (NTRS)

    Kao, Cheng-Yan; Lee, Seok-Hua

    1992-01-01

    The primary scheduling tool in use during the Spacelab Life Science (SLS-1) planning phase was the operations research (OR) based, tabular form Experiment Scheduling System (ESS) developed by NASA Marshall. PLAN-IT is an artificial intelligence based interactive graphic timeline editor for ESS developed by JPL. The PLAN-IT software was enhanced for use in the scheduling of Spacelab experiments to support the SLS missions. The enhanced software SLS-PLAN-IT System was used to support the real-time reactive scheduling task during the SLS-1 mission. SLS-PLAN-IT is a frame-based blackboard scheduling shell which, from scheduling input, creates resource-requiring event duration objects and resource-usage duration objects. The blackboard structure is to keep track of the effects of event duration objects on the resource usage objects. Various scheduling heuristics are coded in procedural form and can be invoked any time at the user's request. The system architecture is described along with what has been learned with the SLS-PLAN-IT project.

  1. Effect of supplementing fat to pregnant nonlactating cows on colostral fatty acid profile and passive immunity of the newborn calf.

    PubMed

    Garcia, M; Greco, L F; Favoreto, M G; Marsola, R S; Martins, L T; Bisinotto, R S; Shin, J H; Lock, A L; Block, E; Thatcher, W W; Santos, J E P; Staples, C R

    2014-01-01

    The objectives were to evaluate the effect of supplementing saturated or unsaturated long-chain fatty acids (FA) to nulliparous and parous Holstein animals (n=78) during late gestation on FA profile of colostrum and plasma of newborn calves and on production and absorption of IgG. The saturated FA supplement (SAT) was enriched in C18:0 and the unsaturated FA supplement (ESS) was enriched in the essential FA C18:2n-6. Fatty acids were supplemented at 1.7% of dietary dry matter to low-FA diets (1.9% of dietary dry matter) during the last 8 wk of gestation. Calves were fed 4 L of colostrum within 2h of birth from their own dam or from a dam fed the same treatment. Feeding fat did not affect prepartum dry matter intake, body weight change, or gestation length. Parous but not nulliparous dams tended to give birth to heavier calves if fed fat prepartum. Parous dams were less able to synthesize essential FA derivatives, as evidenced by lower desaturase indices, compared with nulliparous dams, suggesting a greater need for essential FA supplementation. The FA profile of colostrum was modified to a greater degree by prepartum fat feeding than was that of neonatal calf plasma. The placental transfer and synthesis of elongated n-3 FA (C20:5, C22:5, and C22:6) were reduced, whereas the n-6 FA (C18:2, C18:3, and C20:3) were increased in plasma of calves born from dams fed ESS rather than SAT. Supplementing unsaturated FA prepartum resulted in elevated concentrations of trans isomers of unsaturated monoene and diene FA, as well as C18:2n-6 in colostrum. Serum concentrations of IgG tended to be increased in calves born from dams fed fat compared with those not fed fat, and prepartum feeding of SAT tended to improve circulating concentrations of IgG in newborn calves above the feeding of ESS. Apparent efficiency of absorption of IgG was improved in calves born from dams fed fat, and SAT supplementation appeared more effective than supplementation with ESS. Feeding SAT prepartum may be of greater benefit based upon greater circulating IgG concentrations of calves after colostrum feeding. Feeding moderate amounts of saturated or unsaturated long-chain FA during the last 8 wk of gestation changed the FA profile of colostrum and plasma of neonates to reflect that of the supplements. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  2. Survival of Burns Involving 90% of the Total Body Surface Area After Treatment With Autologous Engineered Skin Substitutes

    DTIC Science & Technology

    2008-12-01

    during acute hospitalization, and can result in long-term morbidity from scars . In this study, autologous ESS were compared with split-thickness...meshed skin autograft treatment of two pediatric patients with burns of 90% TBSA or greater, and evaluated qualitatively for formation of scar , and...populations ( Armour et al. 2007). Availability of ESS for treatment of extensive, deep burns may reduce time to wound closure, morbidity and

  3. Treatment of low-grade endometrial stromal sarcoma in a nulligravid woman.

    PubMed

    Michael Straughn, J; Boitano, Teresa; Smith, Haller J; Dilley, Sarah E; Liang, Margaret I; Novak, Lea

    2018-06-07

    A 32 year-old nulligravid woman with a uterine mass underwent exploratory laparotomy with myomectomy. Final pathology revealed a low-grade endometrial stromal sarcoma (ESS) with positive margins. She subsequently underwent definitive robotic hysterectomy and bilateral salpingectomy with ovarian preservation. She was diagnosed with a stage IB low-grade ESS. She is currently undergoing observation. Discussion of classification, surgical options, and adjuvant therapy is presented. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. The Crew Earth Observations Experiment: Earth System Science from the ISS

    NASA Technical Reports Server (NTRS)

    Stefanov, William L.; Evans, Cynthia A.; Robinson, Julie A.; Wilkinson, M. Justin

    2007-01-01

    This viewgraph presentation reviews the use of Astronaut Photography (AP) as taken from the International Space Station (ISS) in Earth System Science (ESS). Included are slides showing basic remote sensing theory, data characteristics of astronaut photography, astronaut training and operations, crew Earth observations group, targeting sites and acquisition, cataloging and database, analysis and applications for ESS, image analysis of particular interest urban areas, megafans, deltas, coral reefs. There are examples of the photographs and the analysis.

  5. Comparative study of electrical and switch-skipping mechanical switch for self-powered SSHI in medium coupled piezoelectric vibration energy harvesters

    NASA Astrophysics Data System (ADS)

    Asanuma, H.; Sakamoto, K.; Komatsuzaki, T.; Iwata, Y.

    2018-07-01

    To increase output power for piezoelectric vibration energy harvesters, considerable attention has recently been focused on a self-powered synchronized switch harvesting on inductor (SSHI) technique employing an electrical and mechanical switch. However, there are two technical issues: in a medium or highly coupled harvester, the piezoelectric coupling force, which increases as the SSHI’s voltage increases, will reduce the harvester’s displacement and the resulting output power, and there are few reports comparing the performance of electrical switch SSHI (ESS) and mechanical switch SSHI (MSS) that include consideration of the piezoelectric coupling force. We developed a simulation technique that allows us to evaluate the output power considering the piezoelectric coupling force, and investigated the performance of stopper-based MSS and ESS, both numerically and experimentally. The numerical investigation predicted the following: (1) the output power for the ESS is lower than that for the MSS at acceleration lower than 3.5 m s‑2 and (2) intriguingly, the output power for the MSS continues to increase, whereas the peak–peak displacement remains constant. The experimental results showed behaviour similar to that of the numerical predictions. The results are attributed to the different switching strategies: the MSS turns on only when the harvester’s displacement exceeds the gap distance, while the ESS turns on at every maximum/minimum displacement.

  6. Determination of Duty Cycle for Energy Storage Systems in a PV Smoothing Application

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

    Schoenwald, David A.; Ellison, James

    This report supplements the document, "Protocol for Uniformly Measuring and Expressing the Performance of Energy Storage Systems," issued in a revised version in April 2016 (see [4]), which will include the photovoltaic (PV) smoothing application for an energy storage system (ESS). This report provides the background and documentation associated with the determination of a duty cycle for an ESS operated in a PV smoothing application for the purpose of measuring and expressing ESS performance in accordance with the ESS performance protocol. ACKNOWLEDGEMENTS The authors gratefully acknowledge the support of Dr. Imre Gyuk, program manager for the DOE Energy Storage Systemsmore » Program. The authors would also like to express their appreciation to all the stakeholders who participated as members of the PV Smoothing Subgroup. Without their thoughtful input and recommendations, the definitions, metrics, and duty cycle provided in this report would not have been possible. A complete listing of members of the PV Smoothing Subgroup appears in the first chapter of this report. Special recognition should go to the staffs at Pacific Northwest National Laboratory (PNNL) and Sandia National Laboratories (SNL) in collaborating on this effort. In particular, Mr. David Conover and Dr. Vish Viswanathan of PNNL and Dr. Summer Ferreira of SNL were especially helpful in their suggestions for the determination of a duty cycle for the PV Smoothing application.« less

  7. Ectopic Acromegaly Arising from a Pituitary Adenoma within the Bony Intersphenoid Septum of a Patient with Empty Sella Syndrome

    PubMed Central

    Arzamendi, Audrey E.; Shahlaie, Kiarash; Latchaw, Richard E.; Lechpammer, Mirna; Arzumanyan, Hasmik

    2016-01-01

    Objective  To describe the work-up and treatment of rare ectopic acromegaly caused by a biopsy-proven somatotroph pituitary adenoma located within the bony intersphenoid septum of a patient with empty sella syndrome (ESS). Methods  We report the presentation, clinical course, diagnostic work-up, and lesion localization and treatment challenges encountered in a 55-year-old patient, with a brief review of relevant literature. Results  A 55-year-old African-American man presented with acromegaly and ESS. Attempts to definitively localize the causative tumor were unsuccessful, though petrosal sinus sampling supported central growth hormone production and imaging suggested bone-enclosed subsellar pituitary tissue. Endoscopic endonasal transphenoidal exploration was undertaken with resection of a somatotroph pituitary microadenoma, and subsequent clinical improvement and biochemical remission. Retrospective review revealed the patient's pituitary to have been located ectopically within a unique bony intersphenoid septum. Conclusion  This report describes the first known case of an ectopic pituitary adenoma located within the midline bony intersphenoid septum, which we postulate to have resulted from anomalous embryological pituitary migration. Intra-intersphenoid septal tumors should be considered in cases of apparent central acromegaly with ESS or absence of tumor tissue within the paranasal sinuses or other peripheral locations. Indexing  Acromegaly, ESS, pituitary adenoma, sphenoid sinus septum. PMID:27468406

  8. Cost of outpatient endoscopic sinus surgery from the perspective of the Canadian government: a time-driven activity-based costing approach.

    PubMed

    Au, Jennifer; Rudmik, Luke

    2013-09-01

    The time-driven activity-based costing (TD-ABC) method is a novel approach to quantify the costs of a complex system. The aim of this study was to apply the TD-ABC technique to define the overall cost of a routine outpatient endoscopic sinus surgery (ESS) from the perspective of the Canadian government payer. Costing perspective was the Canadian government payer. All monetary values are in Canadian dollars as of December 2012. Costs were obtained by contacting staff unions, reviewing purchasing databases and provincial physician fee schedules. Practical capacity time values were collected from the College and Association of Registered Nurses of Alberta. Capacity cost rates ($/min) were calculated for all staff, capital equipment, and hospital space. The overall cost for routine outpatient ESS was $3510.31. The cost per ESS case for each clinical pathway encounter was as follows: preoperative holding ($49.19); intraoperative ($3296.60); sterilization ($90.20); postanesthesia care unit ($28.64); and postoperative day ward ($45.68). The 3 major cost drivers were physician fees, disposable equipment, and nursing costs. The intraoperative phase contributed to 94.5% of the overall cost. This study applied the TD-ABC method to evaluate the cost of outpatient ESS from the perspective of the Canadian government payer and defined the overall cost to be $3510.31 per case. © 2013 ARS-AAOA, LLC.

  9. A novel sleep optimisation programme to improve athletes' well-being and performance.

    PubMed

    Van Ryswyk, Emer; Weeks, Richard; Bandick, Laura; O'Keefe, Michaela; Vakulin, Andrew; Catcheside, Peter; Barger, Laura; Potter, Andrew; Poulos, Nick; Wallace, Jarryd; Antic, Nick A

    2017-03-01

    To improve well-being and performance indicators in a group of Australian Football League (AFL) players via a six-week sleep optimisation programme. Prospective intervention study following observations suggestive of reduced sleep and excessive daytime sleepiness in an AFL group. Athletes from the Adelaide Football Club were invited to participate if they had played AFL senior-level football for 1-5 years, or if they had excessive daytime sleepiness (Epworth Sleepiness Scale [ESS] >10), measured via ESS. An initial education session explained normal sleep needs, and how to achieve increased sleep duration and quality. Participants (n = 25) received ongoing feedback on their sleep, and a mid-programme education and feedback session. Sleep duration, quality and related outcomes were measured during week one and at the conclusion of the six-week intervention period using sleep diaries, actigraphy, ESS, Pittsburgh Sleep Quality Index, Profile of Mood States, Training Distress Scale, Perceived Stress Scale and the Psychomotor Vigilance Task. Sleep diaries demonstrated an increase in total sleep time of approximately 20 min (498.8 ± 53.8 to 518.7 ± 34.3; p < .05) and a 2% increase in sleep efficiency (p < 0.05). There was a corresponding increase in vigour (p < 0.001) and decrease in fatigue (p < 0.05). Improvements in measures of sleep efficiency, fatigue and vigour indicate that a sleep optimisation programme may improve athletes' well-being. More research is required into the effects of sleep optimisation on athletic performance.

  10. Effects of Exercise-Based Interventions on Neonatal Outcomes: A Meta-Analysis of Randomized Controlled Trials.

    PubMed

    Sanabria-Martínez, Gema; García-Hermoso, Antonio; Poyatos-León, Raquel; González-García, Alberto; Sánchez-López, Mairena; Martínez-Vizcaíno, Vicente

    2016-03-01

    The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled clinical trials (RCTs) assessing the influence of physical exercise interventions during pregnancy on some neonatal outcomes. Key words were used to conduct a computerized search in six databases: Cochrane Library Plus, Science Direct, EMBASE, PubMed, Web of Science, and ClinicalTrials.gov. RCTs that included an exercise program for healthy pregnant women who were sedentary or had low levels of physical activity were selected. Two independent reviewers extracted data and assessed the quality of the studies included. Of 4296 articles retrieved, 14 RCTs (3044 pregnant women) met the inclusion criteria. Pooled effect sizes (ESs) were calculated using a fixed model. Overall, physical exercise programs during pregnancy produced a small reduction in neonatal birth weight (ES = -.10; p = .04). The Apgar score at 1 minute was also weakly increased with combined exercise (aerobic, strength, and flexibility) (ES = .09; p = .048) and no differences between groups were observed in gestational age at delivery and Apgar score at 5 minutes. Structured physical exercise programs during pregnancy appear to be safe for the neonate, mainly favoring a lower birth weight within normal range. However, more studies are needed to establish recommendations. © The Author(s) 2016.

  11. Psychosocial work characteristics predicting daytime sleepiness in day and shift workers.

    PubMed

    Takahashi, Masaya; Nakata, Akinori; Haratani, Takashi; Otsuka, Yasumasa; Kaida, Kosuke; Fukasawa, Kenji

    2006-01-01

    Characteristics of work organization other than working time arrangements may contribute importantly to daytime sleepiness. The present study was designed to identify the psychosocial factors at work that predict daytime sleepiness in a sample of day and shift workers. Participants working at a pulp and chemical factory completed an annual questionnaire regarding psychosocial factors at work using the U.S. National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (i.e., quantitative workload, variance in workload, job control, support from supervisor, coworkers, or family/friends, job satisfaction, and depressive symptoms), as well as daytime sleepiness (through the Epworth Sleepiness Scale [ESS]) and sleep disturbances for three years starting in 2002 (response rates, 94.6-99.0%). The present analysis included 55 day workers (11 women) and 57 shift workers (all men) who participated in all three years of the study, worked under the same work schedule throughout the study period, and had no missing data on any of the daytime sleep items. A repeated-measures analysis of covariance (ANCOVA) was used to test the effects of work schedule (day vs. shift work) and psychosocial factors at work in 2002 on the ESS scores in subsequent years, with sleep duration, insomnia symptoms, chronic diseases, and sleepiness levels at baseline as covariates. Given significant and near-significant interactions of work schedules with psychosocial factor or study year, the ANCOVA, with the factors of psychosocial work characteristics and study year, was performed by type of work schedule. The results indicated a significant main effect of psychosocial work characteristics (p = 0.010, partial eng2 = 0.14) and an almost significant main effect of study year (p = 0.067, partial eng2 = 0.06) and interaction between psychosocial work characteristics and study year (p = 0.085, partial eng2 = 0.06) for variance in workload among the day work group. The day workers reporting high variance in workload in 2002 exhibited significantly higher ESS scores in 2003 and 2004 than did those reporting low variance in workload. The ANCOVA for the shift work group showed a main effect of psychosocial work characteristics for job satisfaction (p = 0.026, partial eng2 = 0.10) and depressive symptoms (p = 0.094, partial eng2 = 0.06) with the interaction between psychosocial work characteristics and study year for job satisfaction (p = 0.172, partial eng2 = 0.04) and depressive symptoms (p = 0.035, partial eng2 = 0.07). The shift workers with low job satisfaction and high symptoms of depression in 2002 showed significantly greater ESS scores in 2003 and/or 2004 than did those with opposite characteristics. These results may suggest a potential predictive value of variance in workload for day workers as well as job satisfaction and depressive symptoms for shift workers with respect to daytime sleepiness. The present findings may imply that redesigning these aspects of work environment would be of help in managing daytime sleepiness.

  12. Volumetric analysis of chronic maxillary atelectasis.

    PubMed

    Lin, Giant C; Sedaghat, Ahmad R; Bleier, Benjamin S; Holbrook, Eric H; Busaba, Nicolas Y; Yoon, Michael K; Gray, Stacey T

    2015-01-01

    The relationship between orbit and maxillary sinus volumes in patients with chronic maxillary atelectasis (CMA), commonly known as silent sinus syndrome if enophthalmos is present, is poorly understood. A retrospective review of 22 patients who underwent endoscopic sinus surgery (ESS) for CMA from 2005 to 2013 was performed. Computed tomography (CT) images were analyzed using OsiriX 5.8.2 software for volumetric analysis of the orbit and maxillary sinus at presentation and after surgical treatment with ESS. Pretreatment mean orbit volumes on the diseased side (DS) and the contralateral side (CS) were 29.22 and 26.50 mL, respectively (p < 0.001); mean sinus volumes on the DS and CS were 8.51 and 17.20 mL, respectively (p < 0.001); and pretreatment mean midorbit heights (MOHs) on the DS and CS were 3.39 cm and 3.07 cm, respectively (p < 0.001). The percent decrease in sinus volume on the DS compared to that on the CS did not correlate significantly with the percent orbit-volume increase. Enophthalmos was present in nine (41%) patients, and diplopia was present in three (14%) patients. The measured degree of increased orbit volume and decreased sinus volume secondary to CMA did not significantly predict the presence of enophthalmos at presentation. Seven patients underwent sinus CT more than 6 months after ESS. In these patients, orbit volume on the DS decreased from 29.67 to 27.52 mL (p = 0.005), and sinus volume on the DS increased from 9.78 to 11.84 mL (p = 0.08). Volumetric analysis is a powerful and novel method for objectively demonstrating the degree of orbit expansion and maxillary sinus contraction seen with CMA. Spontaneous maxillary sinus expansion and a decrease in orbit volume can occur after ESS, but post-ESS volumes do not return to the normal volume of the CS.

  13. Does the length of uvula affect the palatal implant outcome in the management of habitual snoring?

    PubMed

    Akpinar, Meltem Esen; Yigit, Ozgur; Kocak, Ismail; Altundag, Aytug

    2011-05-01

    To evaluate the impact of the uvular length on the efficacy of palatal implants in primary snoring. Prospective case series, tertiary hospital, snoring and respiratory sleep disorders center. Forty subjects with inserted palatal implants and diagnoses of primary snoring were included. All met the inclusion criteria of age >18 years, body mass index <30, apnea-hypopnea index <5, tonsil grade <3, soft-palate length >25 mm, and Friedman tongue position <3 following clinical, endoscopic, and polysomnographic evaluation. Epworth sleepiness scale (ESS) and the snoring-intensity visual analogue scale (VAS) were recorded before and 9 months after the implant. Four subjects with extruded implants were excluded; the remaining 36 subjects were divided into two groups, Group I and Group II, with uvular lengths of ≤15 mm and >15 mm, respectively. The study assessed and compared subjective outcome measures including the partner's satisfaction (PS), partner's reported improvement (PRI), 50% VAS and ESS reduction, and subjective success (SS) defined as 50% VAS reduction. The Student t test, χ(2) test, and logistic regression models were used for statistical evaluation. SS (50% VAS reduction), PS, PRI, and 50% ESS reduction were significantly higher in Group I (P < .001, P = .0257, P = .027, P < .001). The overall SS, PRI, PS, and 50% ESS reduction were 33%, 78%, 50%, and 50%, respectively. The uvular length was found to be the determinant factor of SS (P = .005; odds ratio = 0.75), PRI (P = .039; odds ratio = 0.83), and 50% ESS reduction (P = .038; odds ratio: 0.84) following implant insertion through stepwise logistic regression analysis. Excess uvular length (>15 mm) is an important anatomic feature decreasing the efficacy of palatal implants in snoring, and additional measures, such as uvulectomy, should be considered simultaneously for better outcomes (level 4). Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  14. SOCS3 inhibits the pathological effects of IL-22 in non-melanoma skin tumor-derived keratinocytes.

    PubMed

    Madonna, Stefania; Scarponi, Claudia; Morelli, Martina; Sestito, Rosanna; Scognamiglio, Pasqualina Liana; Marasco, Daniela; Albanesi, Cristina

    2017-04-11

    Basal cell carcinomas (BCC) and squamous-cell carcinomas (SCC) are common malignancies in humans, caused by neoplastic transformation of keratinocytes of the basal or suprabasal layers of epidermis, respectively. Tumor-infiltrating lymphocytes (TILs) are frequently found in BCC and SCC, and functionally promote epithelial carcinogenesis. TILs secreting IL-22, in particular, participate to BCC and SCC growth by inducing keratinocyte proliferation and migration, as well as the expression of inflammatory, anti-apoptotic and pro-angiogenic genes.In this study, we identified SOCS3 as a valid candidate to be manipulated for suppressing tumorigenic functions in BCC and SCC. We found that SOCS3 and SOCS1 expression was reduced in vivo, in tumor lesions of BCC and SCC, as compared to other skin inflammatory conditions such as psoriasis, despite the high number of IL-22-secreting TILs. Moreover, IL-22 was not able to induce in vitro the transcriptional expression of SOCS3 in BCC-or SCC-derived keratinocytes, contrarily to healthy cells. Aimed at rescuing SOCS3 activity in these tumor contexts, a SOCS3-derived peptide, named KIR-ESS, was synthesized, and its ability in suppressing IL-22-induced responses was evaluated in healthy and transformed keratinocytes. We found that KIR-ESS peptide efficiently suppressed the IL-22 molecular signaling in keratinocytes, by acting on STAT3 and Erk1/2 cascade, as well as on the expression of STAT3-dependent downstream genes. Interestingly, after treatment with peptide, both healthy and transformed keratinocytes could no longer aberrantly proliferate and migrate in response to IL-22. Finally, treatment of athymic nude mice bearing SCC xenografts with KIR-ESS peptide concomitantly reduced tumor growth and activated STAT3 levels. As a whole, these data provides the rationale for the use in BCC and SCC skin tumors of SOCS3 mimetics, being able to inhibit the deleterious effects of IL-22 in these contexts.

  15. SOCS3 inhibits the pathological effects of IL-22 in non-melanoma skin tumor-derived keratinocytes

    PubMed Central

    Madonna, Stefania; Scarponi, Claudia; Morelli, Martina; Sestito, Rosanna; Scognamiglio, Pasqualina Liana; Marasco, Daniela; Albanesi, Cristina

    2017-01-01

    Basal cell carcinomas (BCC) and squamous-cell carcinomas (SCC) are common malignancies in humans, caused by neoplastic transformation of keratinocytes of the basal or suprabasal layers of epidermis, respectively. Tumor-infiltrating lymphocytes (TILs) are frequently found in BCC and SCC, and functionally promote epithelial carcinogenesis. TILs secreting IL-22, in particular, participate to BCC and SCC growth by inducing keratinocyte proliferation and migration, as well as the expression of inflammatory, anti-apoptotic and pro-angiogenic genes. In this study, we identified SOCS3 as a valid candidate to be manipulated for suppressing tumorigenic functions in BCC and SCC. We found that SOCS3 and SOCS1 expression was reduced in vivo, in tumor lesions of BCC and SCC, as compared to other skin inflammatory conditions such as psoriasis, despite the high number of IL-22-secreting TILs. Moreover, IL-22 was not able to induce in vitro the transcriptional expression of SOCS3 in BCC-or SCC-derived keratinocytes, contrarily to healthy cells. Aimed at rescuing SOCS3 activity in these tumor contexts, a SOCS3-derived peptide, named KIR-ESS, was synthesized, and its ability in suppressing IL-22-induced responses was evaluated in healthy and transformed keratinocytes. We found that KIR-ESS peptide efficiently suppressed the IL-22 molecular signaling in keratinocytes, by acting on STAT3 and Erk1/2 cascade, as well as on the expression of STAT3-dependent downstream genes. Interestingly, after treatment with peptide, both healthy and transformed keratinocytes could no longer aberrantly proliferate and migrate in response to IL-22. Finally, treatment of athymic nude mice bearing SCC xenografts with KIR-ESS peptide concomitantly reduced tumor growth and activated STAT3 levels. As a whole, these data provides the rationale for the use in BCC and SCC skin tumors of SOCS3 mimetics, being able to inhibit the deleterious effects of IL-22 in these contexts. PMID:28445952

  16. Development and Field Testing of a Model to Simulate a Demonstration of Le Chatelier's Principle Using the Wheatstone Bridge Circuit.

    ERIC Educational Resources Information Center

    Vickner, Edward Henry, Jr.

    An electronic simulation model was designed, constructed, and then field tested to determine student opinion of its effectiveness as an instructional aid. The model was designated as the Equilibrium System Simulator (ESS). The model was built on the principle of electrical symmetry applied to the Wheatstone bridge and was constructed from readily…

  17. Improved Operational Readiness through Environmental Stress Screening

    DTIC Science & Technology

    1987-11-01

    Rhoades of Gru-,.:an’s Field Marketing Department, and the cooperation of the ni- merous Air Force logistics centers and operational facilities visited...EQUIPMENT AGE * ENVIRONMENTAL MAINTENANCE EFFECT PROFILES DtATA * TAILORING DEFINTION MET HOD1OLOGY I 1GUIDELINE oi FIELD ESS IMPLEMENTATION GUIDELINW...any mixing or mismatching appeared, the data was eliminated completely. Figure 5 provides the annual historical trends of each case history equipment

  18. Effects of electroacupuncture on stress-related symptoms in medical students: a randomised placebo-controlled study.

    PubMed

    Dias, Marcio; Vellarde, Guillermo Coca; Olej, Beni; Teófilo Salgado, Ana Emília; de Barros Rezende, Ighor

    2014-02-01

    To assess the effects of electroacupuncture (EA) on relieving stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students. Eighty-two students were randomised into an EA treatment group (n=30), a sham TENS group (n=18) and an untreated control group (n=34). EA was applied at a continuous frequency of 2 Hz to the limbs, face, ears and scalp for 20 min once a week, over 6-8 weeks. Sham transcutaneous electrical nerve stimulation (TENS) was performed on similar sites for the same number of times in each session and for the same length of time. Outcome measurements included a comparison of the indices obtained by different self-applied questionnaires before and after treatment. The surveys used were the Mini-Sleep Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the Beck Depression and Anxiety Inventories (BDI and BAI) and the Maslach Burnout Inventory-Student Survey (MBI-SS), in addition to the Quality of Life Questionnaire-abbreviated version (WHOQOL-bref). EA significantly improved scores on the MSQ, PSQI, BDI and the cynicism and academic efficacy (AE) dimensions of the MBI-SS in relation to the control. Sleep quality (MSQ) improved from 36.9 (SD 7.6) to 25.0 (5.7) with EA, 37.6 (6.0) to 32.1 (6.9) with sham TENS, and 36.5 (5.9) to 33.6 (6.7) in the controls (p=0.0000). Compared with the sham TENS group, EA significantly reduced scores on the PSQI. Score improvements in the sham TENS group in relation to control group were significant in the MSQ, BDI and AE. In the EA group, the number of students with better scores after intervention was significantly higher for the MSQ, PSQI, ESS and BAI. This only occurred for the MSQ in the sham TENS group and for the MSQ and ESS in the control group. EA significantly reduced stress-related mental symptoms. The improvement obtained by sham TENS compared with the control group confirmed the presence of a placebo effect resulting from the treatment ritual.

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

    Ene, D.; Andersson, K.; Jensen, M.

    The European Spallation Source (ESS) will produce tritium via spallation and activation processes during operational activities. Within the location of ESS facility in Lund, Sweden site it is mandatory to demonstrate that the management strategy of the produced tritium ensures the compliance with the country regulation criteria. The aim of this paper is to give an overview of the different aspects of the tritium management in ESS facility. Besides the design parameter study of the helium coolant purification system of the target the consequences of the tritium releasing into the environment were also analyzed. Calculations show that the annual releasemore » of tritium during the normal operations represents a small fraction from the estimated total dose. However, more refined calculations of migration of activated-groundwater should be performed for higher hydraulic conductivities, with the availability of the results on soil examinations. With the assumption of 100% release of tritium to the atmosphere during the occurring of the extreme accidents, it was found as well that the total dose complies with the constraint. (authors)« less

  20. Birth of the first ESS: George Price, John Maynard Smith, and the discovery of the lost "Antlers" paper.

    PubMed

    Harman, Oren

    2011-01-15

    The application of game theory to evolutionary problems is so commonplace today, that few stop to consider how it all began. John Maynard Smith and George R. Price's 1973 Nature article, "The Logic of Animal Conflict," is often referred to as the first description in the literature of the concept of an evolutionary stable strategy (ESS), but what was the "behind the scenes" of the writing of that seminal paper? This article tracks the little known story of the curious American polymath, George Price. As will be shown, it was an earlier paper, the lost "Antlers, Intraspecific Combat, and Altruism," sent by Price to Nature in August 1968 (Unpublished), and refereed by Maynard Smith, which instigated the birth of the first ESS. Recently, the "Antlers" paper has been re-discovered by the author, shedding new light, together with letters and journals from the personal papers of George Price and John Maynard Smith, on their historical paper. © 2010 Wiley-Liss, Inc.

  1. Extraction-Scrub-Strip test results from the interim Salt Disposition Program Macrobatch 9 Tank 21H qualification samples

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

    Peters, T.

    2016-02-23

    Savannah River National Laboratory (SRNL) analyzed samples from Tank 21H in support of qualification of Macrobatch (Salt Batch) 9 for the Interim Salt Disposition Program (ISDP). The Salt Batch 9 characterization results were previously reported. An Extraction-Scrub-Strip (ESS) test was performed to determine cesium distribution ratios (D (Cs)) and cesium concentration in the strip effluent and decontaminated salt solution (DSS) streams; this data will be used by Tank Farm Engineering to project a cesium decontamination factor (DF). This test used actual Tank 21H material, and a blend solvent prepared by SRNL that mimics the solvent composition currently being used atmore » the Modular Caustic-Side Solvent Extraction Unit (MCU). The ESS test showed acceptable performance with an extraction D (Cs) value of 52.4. This value is consistent with results from previous salt batch ESS tests using similar solvent formulations. This compares well against the predicted value of 56.5 from a recently created D (Cs) model« less

  2. Endometrial stromal tumors: the new WHO classification.

    PubMed

    Conklin, Christopher M J; Longacre, Teri A

    2014-11-01

    Endometrial stromal tumors are rare uterine mesenchymal neoplasms that have intrigued pathologists for years, not only because they commonly pose diagnostic dilemmas, but also because the classification and pathogenesis of these tumors has been widely debated. The current World Health Organization recognizes 4 categories of endometrial stromal tumor: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS). uterine sarcoma. These categories are defined by the presence of distinct translocations as well as tumor morphology and prognosis. Specifically, the JAZF1-SUZ12 (formerly JAZF1-JJAZ1) fusion identifies a large proportion of ESN and LG-ESSs, whereas the YWHAE-FAM22 translocation identifies HG-ESSs. The latter tumors appear to have a prognosis intermediate between LG-ESS and UUS, which exhibits no specific translocation pattern. This review (1) presents the clinicopathologic features of endometrial stromal tumors; (2) discusses their immunophenotype; and (3) highlights the recent advances in molecular genetics which explain their pathogenesis and lend support for a new classification system.

  3. Experimental Evaluation and Workload Characterization for High-Performance Computer Architectures

    NASA Technical Reports Server (NTRS)

    El-Ghazawi, Tarek A.

    1995-01-01

    This research is conducted in the context of the Joint NSF/NASA Initiative on Evaluation (JNNIE). JNNIE is an inter-agency research program that goes beyond typical.bencbking to provide and in-depth evaluations and understanding of the factors that limit the scalability of high-performance computing systems. Many NSF and NASA centers have participated in the effort. Our research effort was an integral part of implementing JNNIE in the NASA ESS grand challenge applications context. Our research work under this program was composed of three distinct, but related activities. They include the evaluation of NASA ESS high- performance computing testbeds using the wavelet decomposition application; evaluation of NASA ESS testbeds using astrophysical simulation applications; and developing an experimental model for workload characterization for understanding workload requirements. In this report, we provide a summary of findings that covers all three parts, a list of the publications that resulted from this effort, and three appendices with the details of each of the studies using a key publication developed under the respective work.

  4. Extraction, Scrub, and Strip Test Results for the Salt Waste Processing Facility Caustic Side Solvent Extraction Solvent Sample

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

    Peters, T. B.

    An Extraction, Scrub, and Strip (ESS) test was performed on a sample of Salt Waste Processing Facility (SWPF) Caustic-Side Solvent Extraction (CSSX) solvent and salt simulant to determine cesium distribution ratios (D( Cs)), and cesium concentration in the strip effluent (SE) and decontaminated salt solution (DSS) streams; this data will be used by Parsons to help determine if the solvent is qualified for use at the SWPF. The ESS test showed acceptable performance of the solvent for extraction, scrub, and strip operations. The extraction D( Cs) measured 12.5, exceeding the required value of 8. This value is consistent with resultsmore » from previous ESS tests using similar solvent formulations. Similarly, scrub and strip cesium distribution ratios fell within acceptable ranges. This revision was created to correct an error. The previous revision used an incorrect set of temperature correction coefficients which resulted in slight deviations from the correct D( Cs) results.« less

  5. Extraction, -scrub, -strip test results from the interim salt disposition program macrobatch 10 tank 21H qualification samples

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

    Peters, T. B.

    Savannah River National Laboratory (SRNL) analyzed samples from Tank 21H in support of qualification of Macrobatch (Salt Batch) 10 for the Interim Salt Disposition Program (ISDP). The Salt Batch 10 characterization results were previously reported.ii,iii An Extraction, -Scrub, -Strip (ESS) test was performed to determine cesium distribution ratios (D(Cs)) and cesium concentration in the strip effluent (SE) and decontaminated salt solution (DSS) streams; this data will be used by Tank Farm Engineering to project a cesium decontamination factor (DF). This test used actual Tank 21H material, and a sample of the NGS Blend solvent currently being used at the Modularmore » Caustic-Side Solvent Extraction Unit (MCU). The ESS test showed acceptable performance with an extraction D(Cs) value of 110. This value is consistent with results from previous salt batch ESS tests using similar solvent formulations. This is better than the predicted value of 39.8 from a recently created D(Cs) model.« less

  6. MS PHD'S: A Synergistic Model for Diversifying the Earth Science Community

    NASA Astrophysics Data System (ADS)

    Ricciardi, L.; Johnson, A.; Williamson Whitney, V.; Ithier-Guzman, W.; Braxton, L.; Johnson, A.

    2013-05-01

    The Minorities Striving and Pursuing Higher Degrees of Success in Earth System Science (MS PHD'S) program focuses on increasing the number of underrepresented minorities (URM) receiving advanced degrees in Earth system sciences (ESS). Subscribing to Aristotle's philosophy that the "whole is greater than the sum of its parts", MS PHD'S uses a synergistic model of tiered mentoring practices, successful minority scientist role models, peer-to-peer community building activities, professional development training techniques, networking opportunities, and state of the art virtual communication tools to facilitate the retention and advancement of underrepresented ESS scientists. Using a three-phase program structure supported by a virtual community, URM students in ESS are afforded opportunities to establish mentoring relationships with successful scientists, build meaningful ties with URM peers and future colleagues, strengthen oral and written communication skills, engage in networking opportunities within premier scientific venues, and maintain continuity of networks formed through program participation. Established in 2003, MS PHD'S is now in its ninth cohort. From the original cohort of 24 participants, the program has grown to support 213 participants. Of these 213 participants, 42 have obtained the doctorate and are employed within the ESS workforce. Another 71 are enrolled in doctoral programs. Looking to the future with the purpose of continually furthering its synergistic philosophy, MS PHD'S has developed a new initiative, Beyond the PhD, designed to support and advance the representation of URM scientists within a global workforce.

  7. Adenotonsillectomy outcomes in children with sleep apnea and narcolepsy.

    PubMed

    Biyani, Sneh; Cunningham, Tina D; Baldassari, Cristina M

    2017-09-01

    To identify improvements in daytime sleepiness following adenotonsillectomy in children with non-severe obstructive sleep apnea and narcolepsy. Case series with chart review over 15 years. Tertiary Children's Hospital. Children between 6 and 17 years of age with narcolepsy that underwent adenotonsillectomy for non-severe obstructive sleep apnea (OSA) were included. Narcolepsy was diagnosed based on clinical assessment and the Multiple Sleep Latency Test (MSLT) results. A standardized instrument, the pediatric Epworth Sleepiness Scale (ESS), was used to assess daytime sleepiness before and after adenotonsillectomy. Nine children with a mean age of 12.1 years were included. The majority of the subjects (78%, n = 7) were African American and six children (66.7%) were obese. Four children (44%) were treated with wake promoting agents during the study. The mean preoperative apnea hypopnea index on polysomnography was 4.89 (SD 1.86), while the mean sleep latency on MSLT was 6.32 min (SD 3.14). The mean preoperative ESS was 16.10 and the postoperative ESS was 10.80 (SD 3.96). There was significant improvement (p = 0.02) in the ESS following adenotonsillectomy with seven children (78%) reporting diminished daytime sleepiness. Children with non-severe OSA and narcolepsy experience significant improvement in daytime sleepiness following adenotonsillectomy. Future studies are needed to determine the incidence and clinical significance of non-severe OSA in children with narcolepsy. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Increases in lower-body strength transfer positively to sprint performance: a systematic review with meta-analysis.

    PubMed

    Seitz, Laurent B; Reyes, Alvaro; Tran, Tai T; Saez de Villarreal, Eduardo; Haff, G Gregory

    2014-12-01

    Although lower-body strength is correlated with sprint performance, whether increases in lower-body strength transfer positively to sprint performance remain unclear. This meta-analysis determined whether increases in lower-body strength (measured with the free-weight back squat exercise) transfer positively to sprint performance, and identified the effects of various subject characteristics and resistance-training variables on the magnitude of sprint improvement. A computerized search was conducted in ADONIS, ERIC, SPORTDiscus, EBSCOhost, Google Scholar, MEDLINE and PubMed databases, and references of original studies and reviews were searched for further relevant studies. The analysis comprised 510 subjects and 85 effect sizes (ESs), nested with 26 experimental and 11 control groups and 15 studies. There is a transfer between increases in lower-body strength and sprint performance as indicated by a very large significant correlation (r = -0.77; p = 0.0001) between squat strength ES and sprint ES. Additionally, the magnitude of sprint improvement is affected by the level of practice (p = 0.03) and body mass (r = 0.35; p = 0.011) of the subject, the frequency of resistance-training sessions per week (r = 0.50; p = 0.001) and the rest interval between sets of resistance-training exercises (r = -0.47; p ≤ 0.001). Conversely, the magnitude of sprint improvement is not affected by the athlete's age (p = 0.86) and height (p = 0.08), the resistance-training methods used through the training intervention, (p = 0.06), average load intensity [% of 1 repetition maximum (RM)] used during the resistance-training sessions (p = 0.34), training program duration (p = 0.16), number of exercises per session (p = 0.16), number of sets per exercise (p = 0.06) and number of repetitions per set (p = 0.48). Increases in lower-body strength transfer positively to sprint performance. The magnitude of sprint improvement is affected by numerous subject characteristics and resistance-training variables, but the large difference in number of ESs available should be taken into consideration. Overall, the reported improvement in sprint performance (sprint ES = -0.87, mean sprint improvement = 3.11 %) resulting from resistance training is of practical relevance for coaches and athletes in sport activities requiring high levels of speed.

  9. A Pilot, Multicentre Pragmatic Randomised Trial to Explore the Impact of Carer Skills Training on Carer and Patient Behaviours: Testing the Cognitive Interpersonal Model in Adolescent Anorexia Nervosa.

    PubMed

    Hodsoll, John; Rhind, Charlotte; Micali, Nadia; Hibbs, Rebecca; Goddard, Elizabeth; Nazar, Bruno Palazzo; Schmidt, Ulrike; Gowers, Simon; Macdonald, Pamela; Todd, Gillian; Landau, Sabine; Treasure, Janet

    2017-11-01

    The aim of the study is to establish the acceptability, feasibility and approximate size of the effect of adding a carer intervention [Experienced Caregivers Helping Others (ECHO)] to treatment as usual (TAU) for adolescents with anorexia nervosa. The study is a pilot randomised trial comparing TAU (n = 50) alone or TAU plus ECHO with (n = 50) or without (n = 49) telephone guidance. Effect sizes (ESs) were regression coefficients standardised by baseline standard deviations of measure. Although engagement with ECHO was poor (only 36% of carers in the ECHO group read over 50% of the book), there were markers of intervention fidelity, in that caregivers in the ECHO group showed a moderate increase in carer skills (ES = 0.4) at 12 months and a reduction in accommodating and enabling behaviour at 6 months (ES = 0.17). In terms of efficacy, in the ECHO group, carers spent less time care giving (ES = 0.40, p = 0.04) at 1 year, and patients had a minor advantage in body mass index (ES = 0.17), fewer admissions, decreased peer problems (ES = -0.36) and more pro-social behaviours (ES = 0.53). The addition of telephone guidance to ECHO produced little additional benefit. The provision of self-management materials for carers to standard treatment for adolescent anorexia nervosa shows benefits for both carers and patients. This could be integrated as a form of early intervention in primary care. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  10. Extensive survey of terrestrial organic carbon in surface sediments of the East Siberian Sea

    NASA Astrophysics Data System (ADS)

    Vonk, Jorien; Gustafsson, Örjan; Alling, Vanja; Sánchez-García, Laura; van Dongen, Bart; Andersson, Per; Dudarev, Oleg; Semiletov, Igor; Eglinton, Tim

    2010-05-01

    The East Siberian Sea (ESS) is the largest and shallowest continental shelf sea of the Arctic Ocean, yet it is the least explored. The perenially frozen tundra and taiga of the circum-Arctic coastal area holds approximately half of the global belowground carbon pool. Significant amounts of terrestrial organic carbon (terrOC) are exported with the Great Siberian Arctic rivers to the shelf seas. In addition, the carbon-rich, ice-bound Yedoma coasts in East Siberia release significant amounts of Pleistocene carbon through thermal degradation and coastal erosion. The fate of these large-scale releases of terrOC in the East Siberian Shelf Sea is still poorly understood. The urgency of this research is accentuated by the fact that the East-Siberian Arctic landmass is experiencing the strongest climate warming on Earth, with a great potential for various carbon-climate feedback links. During the International Siberian Shelf Study 2008 (ISSS-08), a 50-day research expedition onboard the Russian vessel Yakob Smirnitskiy in late summer 2008, we obtained surface sediments from over 60 ESS locations. The data obtained after bulk analyses of these sediments are combined with results obtained from previous ESS campaigns in 2003 and 2004 to facilitate a comprehensive investigation of the ESS surface sediment composition. Sedimentary OC contents were between 0.13 and 3.7% (median 1.02%, interquartile range 0.563) with the highest values near the Indigirka and Kolyma river mouths and in the Long Strait. Stable carbon isotope values were in the range of -27.4 to -21.2 per mill (median -25.3 per mill, interquartile range 2.04), with more depleted values close to the coast. A clear transition was observed east of 170° E with more enriched values, signalling a regime shift with stronger influence of the Pacific Ocean. The terrOC fraction in the surface sediments was estimated from the 13C data to be on average 70% for ESS as a whole, with maximal values of 90-100% (along most of the coastline and in Sannikov and Dmitry Laptev Strait) and minimal values of 10-35% (outer shelf and Long Strait). An extensive set of bulk organic 14C data of the sedimentary OC in the ESS will also be interpreted with respect to relative contributions of coastal Yedoma erosion versus river input. Based on published and calculated (calculated from ISSS08 sediment cores) sedimentation velocities, we estimated terrOC burial sink on the East Siberian Shelf Sea.

  11. CrossFit Overview: Systematic Review and Meta-analysis.

    PubMed

    Claudino, João Gustavo; Gabbett, Tim J; Bourgeois, Frank; Souza, Helton de Sá; Miranda, Rafael Chagas; Mezêncio, Bruno; Soncin, Rafael; Cardoso Filho, Carlos Alberto; Bottaro, Martim; Hernandez, Arnaldo Jose; Amadio, Alberto Carlos; Serrão, Julio Cerca

    2018-02-26

    CrossFit is recognized as one of the fastest growing high-intensity functional training modes in the world. However, scientific data regarding the practice of CrossFit is sparse. Therefore, the objective of this study is to analyze the findings of scientific literature related to CrossFit via systematic review and meta-analysis. Systematic searches of the PubMed, Web of Science, Scopus, Bireme/MedLine, and SciELO online databases were conducted for articles reporting the effects of CrossFit training. The systematic review followed the PRISMA guidelines. The Oxford Levels of Evidence was used for all included articles, and only studies that investigated the effects of CrossFit as a training program were included in the meta-analysis. For the meta-analysis, effect sizes (ESs) with 95% confidence interval (CI) were calculated and heterogeneity was assessed using a random-effects model. Thirty-one articles were included in the systematic review and four were included in the meta-analysis. However, only two studies had a high level of evidence at low risk of bias. Scientific literature related to CrossFit has reported on body composition, psycho-physiological parameters, musculoskeletal injury risk, life and health aspects, and psycho-social behavior. In the meta-analysis, significant results were not found for any variables. The current scientific literature related to CrossFit has few studies with high level of evidence at low risk of bias. However, preliminary data has suggested that CrossFit practice is associated with higher levels of sense of community, satisfaction, and motivation.

  12. Myofunctional therapy improves adherence to continuous positive airway pressure treatment.

    PubMed

    Diaféria, Giovana; Santos-Silva, Rogerio; Truksinas, Eveli; Haddad, Fernanda L M; Santos, Renata; Bommarito, Silvana; Gregório, Luiz C; Tufik, Sergio; Bittencourt, Lia

    2017-05-01

    Few studies have investigated myofunctional therapy in patients with obstructive sleep apnea syndrome (OSAS). The objective of this study was to evaluate the effect of myofunctional therapy on continuous positive airway pressure (CPAP) adherence. The study was registered at ClinicalTrials.gov (NCT01289405). Male patients with OSAS were randomly divided into four treatment groups: placebo, patients undergoing placebo myofunctional therapy (N = 24); myofunctional therapy, undergoing myofunctional therapy (N = 27); CPAP, undergoing treatment with CPAP (N = 27); and combined, undergoing CPAP therapy and myofunctional therapy (N = 22). All patients underwent evaluations before and after 3 months of treatment evaluation and after 3 weeks of washout. Evaluations included Epworth sleepiness scale (ESS), polysomnography, and myofunctional evaluation. The 100 men had a mean age of 48.1 ± 11.2 years, body mass index of 27.4 ± 4.9 kg/m 2 , ESS score of 12.7 ± 3.0, and apnea-hypopnea index (AHI) of 30.9 ± 20.6. All treated groups (myofunctional therapy, CPAP, and combined myofunctional therapy with CPAP) showed decreased ESS and snoring, and the myofunctional therapy group maintained this improvement after the "washout" period. AHI reduction occurred in all treated groups and was more significant in CPAP group. The myofunctional therapy and combined groups showed improvement in tongue and soft palate muscle strength when compared with the placebo group. The association of myofunctional therapy to CPAP (combined group) showed an increased adherence to CPAP compared with the CPAP group. Our results suggest that in patients with OSAS, myofunctional therapy may be considered as an adjuvant treatment and an intervention strategy to support adherence to CPAP.

  13. Cognitive impairment associated with cocaine use: The role of co-existent alcohol abuse/dependence.

    PubMed

    Blanco-Presas, Laura; Moreno-Alcázar, Ana; Alonso-Lana, Silvia; Salvador, Raymond; Pomarol-Clotet, Edith; McKenna, Peter

    2018-05-29

    Cocaine abuse has been reported as leading to impaired cognitive function. However, cocaine abusers commonly also abuse alcohol, which can itself produce cognitive impairment. This study, therefore, aimed to examine the potential confounding effect of alcohol abuse on neuropsychological test performance in cocaine and alcohol abusing individuals, comparing them with individuals who abused alcohol alone and non-abusing controls. Nineteen cocaine abusers who also met DSM-IV criteria for alcohol abuse/dependence (14 m, 5f; mean age 38.65 ± 3.83) and 20 matched individuals who met criteria for alcohol abuse/dependence alone (12 m, 8f; mean age 38.19 ± 4.82) were administered a battery of neuropsychological tests covering executive function, memory, language and visual/visuospatial function after two to four weeks of abstinence. Nineteen matched healthy controls (8 m, 11f; mean age 37.01 ± 5.98) were also tested. Both the cocaine + alcohol group and the alcohol group performed significantly more poorly than the healthy controls on the executive (ESs 2.13 and 2.57) and memory tests (ESs 0.58 and 1.06). The findings were similar for language (ESs 0.92 and 1.69), where the cocaine + alcohol abusers additionally performed significantly better than the alcohol abusers. Both patient groups were impaired on two of the five tests of visual/visuospatial function, with better performance by the cocaine + alcohol group on one of them. Chronic cocaine abuse does not appear from this study to be associated with cognitive impairment over and above that which can be attributed to co-existent alcohol abuse. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Staphylococcus aureus biofilms: Nemesis of endoscopic sinus surgery.

    PubMed

    Singhal, Deepti; Foreman, Andrew; Jervis-Bardy, Joshua; Bardy, Josh-Jervis; Wormald, Peter-John

    2011-07-01

    Chronic rhinosinusitis (CRS) patients with biofilms have persistent postoperative symptoms, ongoing mucosal inflammation, and recurrent infections. Recent evidence suggests that biofilms of differing species confer varying disease profiles in CRS patients. We aimed to prospectively investigate the effects of Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenzae, and fungal biofilms on outcomes following endoscopic sinus surgery (ESS). Prospective blinded study. In this prospective blinded study, 39 patients undergoing ESS for CRS assessed their symptoms preoperatively using internationally accepted standardized symptom scoring systems and quality-of-life measures (10-point visual analog scale, Sino-Nasal Outcome Test-20, global severity of CRS). Their sinonasal mucosa was graded (Lund-Kennedy scale) and extent of radiologic disease on computed tomography scans scored (Lund-McKay scale). Random sinonasal tissue samples were assessed for different bacterial species forming biofilms by using fluorescent in-situ hybridization and confocal laser microscopy. For 12 months after surgery, CRS symptoms, quality of life, and objective evidence of persisting disease were assessed by using the preoperative tools. Different bacterial species combinations were found in 30 of 39 patients; 60% of these 30 biofilms were polymicrobial biofilms and 70% had S aureus biofilms. Preoperative nasendoscopy and radiologic disease severity were significantly worse in patients with multiple biofilms (P = .02 and P = .01, respectively), and they had worse postsurgery mucosal outcomes on endoscopy (P = .01) requiring significantly more postoperative visits (P = .04). Those with S aureus biofilms progressed poorly with their symptom scores and quality-of-life outcomes, with significant differences in nasendoscopy scores (P = .007). S. aureus biofilms play a dominant role in negatively affecting outcomes of ESS with persisting postoperative symptoms, ongoing mucosal inflammation, and infections. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  15. The Influence of Sleep Disorders on Voice Quality.

    PubMed

    Rocha, Bruna Rainho; Behlau, Mara

    2017-09-19

    To verify the influence of sleep quality on the voice. Descriptive and analytical cross-sectional study. Data were collected by an online or printed survey divided in three parts: (1) demographic data and vocal health aspects; (2) self-assessment of sleep and vocal quality, and the influence that sleep has on voice; and (3) sleep and voice self-assessment inventories-the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and the Voice Handicap Index reduced version (VHI-10). A total of 862 people were included (493 women, 369 men), with a mean age of 32 years old (maximum age of 79 and minimum age of 18 years old). The perception of the influence that sleep has on voice showed a difference (P < 0.050) between measures of sleep quality and vocal self-assessment. There were higher scores on the ESS, PSQI, and VHI-10 protocols if sleep and vocal self-assessment were poor. The results indicate that the greater the effect that sleep has on voice, the greater the perceived voice handicap. The aspects that influence a voice handicap are vocal self-assessment, ESS total score, and self-assessment of the influence that sleep has on voice. The absence of daytime sleepiness is a protective factor (odds ratio [OR] > 1) against perceived voice handicap; the presence of daytime sleepiness is a damaging factor (OR < 1). Sleep quality influences voice. Perceived poor sleep quality is related to perceived poor vocal quality. Individuals with a voice handicap observe a greater influence of sleep on voice than those without. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. IPNS upgrade: A feasibility study

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

    NONE

    1995-04-01

    Many of Argonne National Laboratory`s (ANL`s) scientific staff members were very active in R&D work related to accelerator-based spoliation sources in the 1970s and early 1980s. In 1984, the Seitz/Eastman Panel of the National Academy of Sciences reviewed U.S. materials science research facilities. One of the recommendations of this panel was that the United States build a reactor-based steady-state source, the Advanced Neutron Source (ANS), at Oak Ridge National Laboratory. Subsequently, R&D activities related to the design of an accelerator-based source assumed a lower priority. The resumption of pulsed-source studies in this country started simultaneously with design activities in Europemore » aimed at the European Spallation Source (ESS). The European Community funded a workshop in September 1991 to define the parameters of the ESS. Participants in this workshop included both accelerator builders and neutron source users. A consortium of European countries has proposed to build a 5-MW pulsed source, and a feasibility study is currently under way. Soon after the birth of the ESS, a small group at ANL set about bringing themselves up to date on pulsed-source information since 1984 and studied the feasibility of upgrading ANL`s Intense Pulsed Neutron Source (IPNS) to 1 MW by means of a rapidly cycling synchrotron that could be housed, along with its support facilities, in existing buildings. In early 1993, the Kohn panel recommended that (1) design and construction of the ANS should be completed according to the proposed project schedule and (2) development of competitive proposals for cost-effective design and construction of a 1-MW pulsed spallation source should be authorized immediately.« less

  17. Effect of CPAP Therapy on Symptoms of Nocturnal Gastroesophageal Reflux among Patients with Obstructive Sleep Apnea.

    PubMed

    Tamanna, Sadeka; Campbell, Douglas; Warren, Richard; Ullah, Mohammad I

    2016-09-15

    Nocturnal gastroesophageal reflux (nGER) is common among patients with obstructive sleep apnea (OSA). Previous studies demonstrated that continuous positive airway pressure (CPAP) reduces symptoms of nGER. However, improvement in nGER symptoms based on objective CPAP compliance has not been documented. We have examined the polysomnographic characteristics of patients with nGER and OSA and looked for association of OSA severity and CPAP compliance with improvement in nGER symptoms. We interviewed 85 veterans with OSA to assess their daytime sleepiness (Epworth Sleepiness scale [ESS]) and nGER symptom frequency after their polysomnography and polysomnographic data were reviewed. At 6 months' follow-up, ESS score, nGER score, and CPAP machine compliance data were reassessed. Data from 6 subjects were dropped from final analysis due to their initiation of new medication for nGER symptom since the initial evaluation. Sixty-two of 79 (78%) patients complained of nGER symptoms during initial visit. At baseline, nGER score was correlated with sleep efficiency (r = 0.43), and BMI correlated with the severity of OSA (r = 0.41). ESS and nGER improved (p < 0.0001) in all patients after 6 months, but more significantly in CPAP compliant patients. A minimum CPAP compliance of 25% was needed to achieve any benefit in nGER improvement. Nocturnal gastroesophageal reflux is common among patients with OSA which increases sleep disruption and worsens the symptoms of daytime sleepiness. CPAP therapy may help improve the symptoms of both nocturnal acid reflux and daytime sleepiness, but adherence to CPAP is crucial to achieve this benefit. © 2016 American Academy of Sleep Medicine.

  18. The SGI/CRAY T3E: Experiences and Insights

    NASA Technical Reports Server (NTRS)

    Bernard, Lisa Hamet

    1999-01-01

    The focus of the HPCC Earth and Space Sciences (ESS) Project is capability computing - pushing highly scalable computing testbeds to their performance limits. The drivers of this focus are the Grand Challenge problems in Earth and space science: those that could not be addressed in a capacity computing environment where large jobs must continually compete for resources. These Grand Challenge codes require a high degree of communication, large memory, and very large I/O (throughout the duration of the processing, not just in loading initial conditions and saving final results). This set of parameters led to the selection of an SGI/Cray T3E as the current ESS Computing Testbed. The T3E at the Goddard Space Flight Center is a unique computational resource within NASA. As such, it must be managed to effectively support the diverse research efforts across the NASA research community yet still enable the ESS Grand Challenge Investigator teams to achieve their performance milestones, for which the system was intended. To date, all Grand Challenge Investigator teams have achieved the 10 GFLOPS milestone, eight of nine have achieved the 50 GFLOPS milestone, and three have achieved the 100 GFLOPS milestone. In addition, many technical papers have been published highlighting results achieved on the NASA T3E, including some at this Workshop. The successes enabled by the NASA T3E computing environment are best illustrated by the 512 PE upgrade funded by the NASA Earth Science Enterprise earlier this year. Never before has an HPCC computing testbed been so well received by the general NASA science community that it was deemed critical to the success of a core NASA science effort. NASA looks forward to many more success stories before the conclusion of the NASA-SGI/Cray cooperative agreement in June 1999.

  19. The effects of mometasone furoate and desloratadine in obstructive sleep apnea syndrome patients with allergic rhinitis.

    PubMed

    Acar, Mustafa; Cingi, Cemal; Sakallioglu, Oner; San, Turhan; Fatih Yimenicioglu, Mehmet; Bal, Cengiz

    2013-01-01

    Allergic rhinitis (AR) and obstructive sleep apnea syndrome (OSAS) are worldwide prevalent diseases. These diseases impair patient quality of life. The aim of this study was to investigate and compare the efficacy of treatment of AR on OSAS by objective and subjective methods. The study group was composed of 80 OSAS patients with AR between the ages of 30 and 50 years. The patients were admitted with the complaint of snoring, and they were asked about AR-related symptoms (nasal discharge, nasal itching, sneeze, and nasal obstruction). Daytime somnolence was measured by the Epworth sleepiness scale (ESS). Sleep parameters on polysomnography tests before and after treatment were compared, and the effects of different AR treatment protocols on sleep quality were evaluated. When pretreatment and posttreatment apnea-hypopnea index (AHI) values of the groups were compared, the most significant difference was observed in the nasal steroid (Ns) + antihistamine (Ah) group (p < 0.05). The ESS results were significantly decreased in the Ns and Ns + Ah groups after treatment (p < 0.05). AHI oxygen saturation <90% were significantly decreased in the Ns and Ns + Ah groups after treatment (p < 0.05). Nasal obstruction due to nasal congestion causes increases in airway resistance and can lead to development of OSAS. We concluded that treating AR with Ns has both positive effects on OSAS and daily activity. However, adding Ah to this treatment did not show improved effects compared with placebo treatment.

  20. Energy-Efficient Systems Eliminate Icing Danger for UAVs

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Ames Research Center engineer Leonard Haslim invented an anti-icing t echnology called an electroexpulsive separation system, which uses m echanical force to shatter potentially dangerous ice buildup on an ai rcraft surface. Temecula, California-based Ice Management Systems (no w known as IMS-ESS) licensed the technology from Ames and has discov ered a niche market for the lightweight, energy-efficient technology: unmanned aerial vehicles (UAVs). IMS-ESS systems now prevent damagi ng ice accumulation on military UAVs, allowing the vehicles to carry out crucial missions year round.

  1. Crown depth as a result of evolutionary games: decreasing solar angle should lead to shallower, not deeper crowns.

    PubMed

    Vermeulen, Peter Johannes

    2014-06-01

    There is a general notion in the literature that, with increasing latitude, trees have deeper crowns as a result of a lower solar elevation angle. However, these predictions are based on models that did not include the effects of competition for light between individuals. Here, I argue that there should be selection for trees to increase the height of the crown base, as this decreases shading by neighbouring trees, leading to an evolutionarily stable strategy (ESS). Because the level of between-tree shading increases with decreasing solar angle, the predicted ESS will shift to higher crown base height. This argument is supported by a simulation model to check for the effects of crown shape and the change of light intensity that occurs with changing solar angle on model outcomes. So, the lower solar angle at higher latitudes would tend to select for shallower, and not deeper, crowns. This casts doubt on the common belief that a decreasing solar angle increases crown depth. More importantly, it shows that different assumptions about what should be optimized can lead to different predictions, not just for absolute trait values, but for the direction of selection itself. © 2014 The Author. New Phytologist © 2014 New Phytologist Trust.

  2. Earth System Science Education in a General Education Context: Two Case Studies

    NASA Astrophysics Data System (ADS)

    Herring, J. A.

    2004-12-01

    The teaching of Earth System Science (ESS) to non-science majors is examined in a large lecture format class at a state university and in small classes with a significant research component at a liberal arts college. Quantitative and qualitative evaluations of both approaches reveal some of the challenges educators face as they work to advance students' integrated understanding of the Earth system. Student learning on selected concepts in the large lecture format class was poorly or negatively correlated with the amount of class time spent on the topic, even when the time was spent in teacher-student dialogue or in cooperative learning activities. The small class format emphasized student participation in research, which was found to be particularly effective when the class operated as a three-week intensive block and student use of computer models to simulate the dynamics of complex systems, which was found to be more effective when the class was held in a ten-week quarter. This study provides some clarification as to the utility of specific pedagogical frameworks (such as constructivism and experiential education) in the teaching of ESS to a general education audience and emphasizes the importance of carefully defining educational goals (both cognitive and affective) as a part of the curriculum design.

  3. Successful treatment with levothyroxine for idiopathic hypersomnia patients with subclinical hypothyroidism.

    PubMed

    Shinno, Hideto; Inami, Yasushi; Inagaki, Takuji; Kawamukai, Tetsuya; Utani, Etsuko; Nakamura, Yu; Horiguchi, Jun

    2009-01-01

    Our objective was to discuss the effect of levothyroxine on excessive daytime sleepiness (EDS) and a prolonged nocturnal sleep at patients with idiopathic hypersomnia who presented with subclinical hypothyroidism. We present two patients with hypersomnia who complained of EDS and a prolonged nocturnal sleep time. Sleep architecture and subjective daytime sleepiness were estimated by polysomnography (PSG) and Epworth Sleepiness Scale (ESS), respectively. Diagnoses were made using the International Classification of Sleep Disorders, 2nd Edition criteria for idiopathic hypersomnia with long sleep time. PSG demonstrated a short sleep latency, a prolonged total sleep time and normal proportions of all non-rapid eye movement (REM) and REM sleep stages. Nocturnal PSG excluded other causes of EDS. No medical, neurological and mental disorders were present. Their laboratory data indicated mildly elevated thyrotropin, despite free thyroxine (T4) and triiodothyronine (T3) estimates within their reference ranges, which is a characteristic of latent hypothyroidism. Levothyroxine (25 microg/day) was administrated orally. After treatment with levothyroxine for 8 weeks, the mean daily sleep times decreased. EDS was also improved, and a significant decrease in the ESS score was observed. Levothyroxine was effective for their hypersomnia and well tolerated. It should be noted that hypersomnia may be associated with subclinical hypothyroidism, although few abnormalities in physical and neurological examinations are present.

  4. Validation of the Urdu version of the Epworth Sleepiness Scale.

    PubMed

    Surani, Asif Anwar; Ramar, Kannan; Surani, Arif Anwar; Khaliqdina, Jehangir Shehryar; Subramanian, Shyam; Surani, Salim

    2012-09-01

    To translate and validate the Epworth Sleepiness Scale (ESS) for use in Urdu-speaking population. The original Epworth Sleepiness Scale was translated into the Urdu version (ESS-Ur) in three phases - translation and back-translation; committee-based translation; and testing in bilingual individuals. The final was subsequently tested on 89 healthy bilingual subjects between February and April, 2010, to assess the validity of the translation compared to the original version. The subjects were students and employees of Dow University of Health Sciences, Karachi. Both English and Urdu versions of the Epworth Sleepiness Scale were administered to 59 (67%) women and 30 (33%) men. The mean composite Epworth score was 7.53 in English language and 7.7 in the Urdu version (p=0.76). The translated version was found to be highly correlated with the original scale (rho=0.938; p<.01). The study validated the scale's Urdu version as an effective tool for measuring daytime sleepiness in Urdu-speaking population. Future studies assessing the validity of such patients with sleep disorders need to be undertaken.

  5. Demonstration of decomposition and optimization in the design of experimental space systems

    NASA Technical Reports Server (NTRS)

    Padula, Sharon; Sandridge, Chris A.; Haftka, Raphael T.; Walsh, Joanne L.

    1989-01-01

    Effective design strategies for a class of systems which may be termed Experimental Space Systems (ESS) are needed. These systems, which include large space antenna and observatories, space platforms, earth satellites and deep space explorers, have special characteristics which make them particularly difficult to design. It is argued here that these same characteristics encourage the use of advanced computer-aided optimization and planning techniques. The broad goal of this research is to develop optimization strategies for the design of ESS. These strategics would account for the possibly conflicting requirements of mission life, safety, scientific payoffs, initial system cost, launch limitations and maintenance costs. The strategies must also preserve the coupling between disciplines or between subsystems. Here, the specific purpose is to describe a computer-aided planning and scheduling technique. This technique provides the designer with a way to map the flow of data between multidisciplinary analyses. The technique is important because it enables the designer to decompose the system design problem into a number of smaller subproblems. The planning and scheduling technique is demonstrated by its application to a specific preliminary design problem.

  6. P-wave velocity models of continental shelf of East Siberian Sea using the Laplace-domain full waveform inversion

    NASA Astrophysics Data System (ADS)

    Kang, S. G.; Hong, J. K.; Jin, Y. K.; Jang, U.; Niessen, F.; Baranov, B.

    2017-12-01

    2016 IBRV ARAON Arctic Cruise Leg-2, Expedition ARA07C was a multidisciplinary undertaking carried out in the East Siberian Sea (ESS) from August 25 to September 10, 2016. The program was conducted as a collaboration between the Korea Polar Research Institute (KOPRI), P.P. Shirshov Institute of Oceanology (IORAS), and Alfred Wegener Institute (AWI). During this expedition, the multi-channel seismic (MCS) data were acquired on the continental shelf and the upper slope of the ESS, totaling 3 lines with 660 line-kilometers. The continental shelf of ESS is one of the widest shelf seas in the world and it is believed to cover the largest area of sub-sea permafrost in the Arctic. According to the present knowledge of the glacial history of the western Arctic Ocean, it is likely that during the LGM with a sea level approximately 120 m below present, the entire shelf area of the ESS was exposed to very cold air temperatures so that thick permafrost should have formed. Indeed, in water depths shallower than 80 m, sub-bottom profiles in the ESS recorded from the shelf edge to a latitude of 74°30' N in 60 m water depth exhibited acoustic facies, suggesting that at least relicts of submarine permafrost are present. In order to identify the existence and/or non-existence of subsea permafrost in our study area, we analyze the MCS data using the Laplace domain full waveform inversion (FWI). In case of the Canadian continental shelf of the Beaufort Sea, subsea permafrost has high seismic velocity values (over 2.6 km/sec) and strong refraction events were found in the MCS shotgathers. However, in the EES our proposed P-wave velocity models derived from FWI have neither found high velocity structures (over 2.6 km/sec) nor indicate strong refraction events by subsea permafrost. Instead, in 300 m depth below sea floor higher P-wave velocity structures (1.8 2.2 km/s) than normal subsea sediment layers were found, which are interpreted as cemented strata by glaciation activities.

  7. ED20. Crisis or Opportunity? Earth and Space Science Education at the State and National Levels

    NASA Astrophysics Data System (ADS)

    Brett, J. M.

    2011-12-01

    Scientists and researchers, those often in oversight positions and often control of the purse strings, have historically not been kind to the Earth Systems Science (ESS) discipline. This is puzzling to those of us who are ESS educators because we know that to appreciate how our planet works it is necessary to integrate and apply all the disciplines of science. With our amazing technologies and the increasing demands of a growing population we are dramatically changing our home planet. Perhaps a crisis? As the last century ended we found ESS in the same minor league position it was in when the 20th Century started. During the review period of what was to become the National Science Education Standards (NSES) draft after draft, no matter what color the cover was, seemed to ignore, omit, or severely limit ESS topics in meteorology and oceanography. Once published the NSES became the basis for the science standards in many states with what many said were critical gaps. In the years following 1996 different groups have worked to correct the omissions they found by developing guides...Ocean Literacy: Essential Principles of Ocean Science K-12 and Climate Literacy: The Essential Principals of Climate Science. An observer on the side might have considered each effort one of lobbying to get attention, funding and materials. Each effort was clearly interested in making an impact where it mattered...in the classroom. Now our Opportunity! The NAS process for developing "A Framework for K-12 Science Education" presented ESS educators with a real opportunity and we can proudly say we made our voices heard. And while there is great enthusiasm for the framework and the Chapter 7 Earth and Space we face critically important work to bring real Earth Space Science Education into the K-12 classroom. The possibility of the standards to be developed from the Framework becoming Common Core for the majority of states following the course of ELA and mathematics requires that those who previously guarded their territory collaborate.

  8. Assessing Dryland Ecosystem Services in Xinjiang, Northwest China

    NASA Astrophysics Data System (ADS)

    Siew, T. F.; Brauman, K. A.; Zuo, L.; Doll, P. M.

    2014-12-01

    Dryland ecosystems, including grassland, forest, and irrigated cropland, cover about 41% of earth's land area and are inhabited by over two billion people. In drylands, particularly arid and semiarid areas, the production of ecosystem services is primarily constrained by freshwater availability. Often, water allocated to production by one ecosystem or of one ecosystem service negatively impacts other ecosystems or ecosystem services (ESS). The challenge is to determine how much water should be allocated to which ecosystems (natural and manmade) such that multiple ESS are maximized, thus improving overall well-being. This strategic management decision must be supported by knowledge about spatial and temporal availability of water and its relationship to production (location and scale) of ESS that people receive. We assess the spatial and temporal relationships between water availability and ESS production in Xinjiang, Northwest China. We address four questions: (1) What services are produced by which ecosystems with water available? (2) Where are these services produced? (3) Who uses the services produced? (4) How the production of services changes with variability of water available? Using existing global, national, and regional spatial and statistical data, we assess food, fiber, livestock, and wood production as well as unique forest landscapes (as a proxy for aesthetic appreciation and habitats for unique animals and plants) and protection from dust storms. Irrigation is necessary for crop production in Xinjiang. The production of about 4.2 million tons of wheat and 500,000 tons of cotton requires more than 2 km3 of water each year. This is an important source of food and income for local residents, but the diverted water has negative and potentially costly impacts on downstream forests that potentially provide aesthetic services and protection from dust. Our analyses also show that cropland had increased by about 1.6 million ha from 1987 to 2010, while grassland and woodland had decreased by about 1.5 million ha and 33,000 ha, respectively. Cropland expansion had increased water need for irrigation and decreased services produced by other ecosystems. This assessment helps understand connections between water and ESS better and contributes to water and land management in dry regions, particularly China.

  9. Treatment of obstructive sleep apnea syndrome with nasal positive airway pressure improves golf performance.

    PubMed

    Benton, Marc L; Friedman, Neil S

    2013-12-15

    Obstructive sleep apnea syndrome (OSAS) is associated with impairment of cognitive function, and improvement is often noted with treatment. Golf is a sport that requires a range of cognitive skills. We evaluated the impact of nasal positive airway pressure (PAP) therapy on the handicap index (HI) of golfers with OSAS. Golfers underwent a nocturnal polysomnogram (NPSG) to determine whether they had significant OSAS (respiratory disturbance index > 15). Twelve subjects with a positive NPSG were treated with PAP. HI, an Epworth Sleepiness Scale (ESS), and sleep questionnaire (SQ) were submitted upon study entry. After 20 rounds of golf on PAP treatment, the HI was recalculated, and the questionnaires were repeated. A matched control group composed of non-OSAS subjects was studied to assess the impact of the study construct on HI, ESS, and SQ. Statistical comparisons between pre- and post-PAP treatment were calculated. The control subjects demonstrated no significant change in HI, ESS, or SQ during this study, while the OSAS group demonstrated a significant drop in average HI (11.3%, p = 0.01), ESS, (p = 0.01), and SQ (p = 0.003). Among the more skilled golfers (defined as HI ≤ 12), the average HI dropped by an even greater degree (31.5%). Average utilization of PAP was 91.4% based on data card reporting. Treatment of OSAS with PAP enhanced performance in golfers with this condition. Treatment adherence was unusually high in this study. Non-medical performance improvement may be a strong motivator for selected subjects with OSAS to seek treatment and maximize adherence.

  10. The utility of cadaver dissection in endoscopic sinus surgery training courses.

    PubMed

    Zuckerman, Jodi D; Wise, Sarah K; Rogers, G Aaron; Senior, Brent A; Schlosser, Rodney J; DelGaudio, John M

    2009-01-01

    Understanding paranasal sinus anatomy is crucial for successful outcomes in endoscopic sinus surgery (ESS). This study was designed to evaluate subjective and objective differences in ESS cadaver dissections among participants of varying experience levels in association with the use of image guidance and computer-aided technologies in a physician training cadaver dissection laboratory. Participants in a 2-day cadaver dissection course completed daily predissection surveys evaluating subjective comfort with ESS. Pre- and postdissection computer tomography (CT) scans assessed completeness of dissection. Images were analyzed for maxillary antrostomy, frontal and sphenoid sinusotomy, residual ethmoid cells and partitions, and residual frontal recess cells. Fifty-one sides were dissected. Participant comfort increased significantly from day 1 to 2 for overall ESS (p = 0.001) and for individual sinuses (p < 0.001 to p = 0.047). Participants with more years in practice had fewer unopened ethmoid cells (p = 0.015) and frontal recess cells (p = 0.014) on dissection day 1. Participants with increased comfort in ethmoid dissection had fewer retained ethmoid partitions on day 1 (p = 0.017). Observed differences on dissection day 1 for unopened ethmoid and frontal recess cells and retained ethmoid partitions were not present on day 2. No significant differences were found based on use of image guidance for any parameter. Surgeons with increased comfort and more years in practice had more complete endoscopic cadaver dissections initially. Differences among participants diminished on dissection day 2, indicating the ability to review postdissection CT scans may improve surgeon comfort level and completeness of dissection.

  11. The comparability of the universalism value over time and across countries in the European Social Survey: exact vs. approximate measurement invariance

    PubMed Central

    Zercher, Florian; Schmidt, Peter; Cieciuch, Jan; Davidov, Eldad

    2015-01-01

    Over the last decades, large international datasets such as the European Social Survey (ESS), the European Value Study (EVS) and the World Value Survey (WVS) have been collected to compare value means over multiple time points and across many countries. Yet analyzing comparative survey data requires the fulfillment of specific assumptions, i.e., that these values are comparable over time and across countries. Given the large number of groups that can be compared in repeated cross-national datasets, establishing measurement invariance has been, however, considered unrealistic. Indeed, studies which did assess it often failed to establish higher levels of invariance such as scalar invariance. In this paper we first introduce the newly developed approximate approach based on Bayesian structural equation modeling (BSEM) to assess cross-group invariance over countries and time points and contrast the findings with the results from the traditional exact measurement invariance test. BSEM examines whether measurement parameters are approximately (rather than exactly) invariant. We apply BSEM to a subset of items measuring the universalism value from the Portrait Values Questionnaire (PVQ) in the ESS. The invariance of this value is tested simultaneously across 15 ESS countries over six ESS rounds with 173,071 respondents and 90 groups in total. Whereas, the use of the traditional approach only legitimates the comparison of latent means of 37 groups, the Bayesian procedure allows the latent mean comparison of 73 groups. Thus, our empirical application demonstrates for the first time the BSEM test procedure on a particularly large set of groups. PMID:26089811

  12. The role of mitomycin C in preventing synechia and stenosis after endoscopic sinus surgery.

    PubMed

    Anand, Vijay K; Tabaee, Abtin; Kacker, Ashutosh; Newman, Jason G; Huang, Clark

    2004-01-01

    Synechia and stenosis formation after endoscopic sinus surgery (ESS) represents a potential source of surgical failure. Mitomycin C (MMC) has been used successfully in other fields to decrease postoperative scar formation. We hypothesize that the topical application of MMC reduces the incidence of stenosis and synechia formation after ESS. This study is a randomized, controlled, single-blinded study based in a tertiary care teaching hospital. After routine ESS, a pledget soaked in MMC (0.5%) was randomly placed into the middle meatus of one nasal cavity for 5 minutes and a pledget soaked in saline was placed in the contralateral side in each patient. A blinded observer followed the patients for any evidence of stenosis or synechia formation. The medical records of enrolled patients were reviewed for demographics, diagnosis, prior surgery, type of sinus surgery, complications, incidence of stenosis/synechia, and need for further procedures. Twenty-nine patients were included in the final analysis. The mean follow-up period was 15 months (range, 3-32 months). There were no complications in this series. Eight patients experienced 10 episodes of synechia formation and one patient experienced 1 episode of synechia formation and 1 episode of stenosis of the maxillary sinus ostium. Seven of the 12 episodes of synechia/stenosis occurred on the side of the MMC application and the remaining 5 episodes occurred on the side opposite to the MMC application. This difference was not statistically significant. The topical application of MMC did not decrease the incidence of stenosis and synechia formation after ESS.

  13. Analysis of a novel autonomous marine hybrid power generation/energy storage system with a high-voltage direct current link

    NASA Astrophysics Data System (ADS)

    Wang, Li; Lee, Dong-Jing; Lee, Wei-Jen; Chen, Zhe

    This paper presents both time-domain and frequency-domain simulated results of a novel marine hybrid renewable-energy power generation/energy storage system (PG/ESS) feeding isolated loads through an high-voltage direct current (HVDC) link. The studied marine PG subsystems comprise both offshore wind turbines and Wells turbines to respectively capture wind energy and wave energy from marine wind and ocean wave. In addition to wind-turbine generators (WTGs) and wave-energy turbine generators (WETGs) employed in the studied system, diesel-engine generators (DEGs) and an aqua electrolyzer (AE) absorbing a part of generated energy from WTGs and WETGs to generate available hydrogen for fuel cells (FCs) are also included in the PG subsystems. The ES subsystems consist of a flywheel energy storage system (FESS) and a compressed air energy storage (CAES) system to balance the required energy in the hybrid PG/ESS. It can be concluded from the simulation results that the proposed hybrid marine PG/ESS feeding isolated loads can stably operate to achieve system power-frequency balance condition.

  14. Geobiological constraints on Earth system sensitivity to CO₂ during the Cretaceous and Cenozoic.

    PubMed

    Royer, D L; Pagani, M; Beerling, D J

    2012-07-01

    Earth system climate sensitivity (ESS) is the long-term (>10³ year) response of global surface temperature to doubled CO₂ that integrates fast and slow climate feedbacks. ESS has energy policy implications because global temperatures are not expected to decline appreciably for at least 10³ year, even if anthropogenic greenhouse gas emissions drop to zero. We report provisional ESS estimates of 3 °C or higher for some of the Cretaceous and Cenozoic based on paleo-reconstructions of CO₂ and temperature. These estimates are generally higher than climate sensitivities simulated from global climate models for the same ancient periods (approximately 3 °C). Climate models probably do not capture the full suite of positive climate feedbacks that amplify global temperatures during some globally warm periods, as well as other characteristic features of warm climates such as low meridional temperature gradients. These absent feedbacks may be related to clouds, trace greenhouse gases (GHGs), seasonal snow cover, and/or vegetation, especially in polar regions. Better characterization and quantification of these feedbacks is a priority given the current accumulation of atmospheric GHGs. © 2012 Blackwell Publishing Ltd.

  15. Nash Equilibrium of Social-Learning Agents in a Restless Multiarmed Bandit Game.

    PubMed

    Nakayama, Kazuaki; Hisakado, Masato; Mori, Shintaro

    2017-05-16

    We study a simple model for social-learning agents in a restless multiarmed bandit (rMAB). The bandit has one good arm that changes to a bad one with a certain probability. Each agent stochastically selects one of the two methods, random search (individual learning) or copying information from other agents (social learning), using which he/she seeks the good arm. Fitness of an agent is the probability to know the good arm in the steady state of the agent system. In this model, we explicitly construct the unique Nash equilibrium state and show that the corresponding strategy for each agent is an evolutionarily stable strategy (ESS) in the sense of Thomas. It is shown that the fitness of an agent with ESS is superior to that of an asocial learner when the success probability of social learning is greater than a threshold determined from the probability of success of individual learning, the probability of change of state of the rMAB, and the number of agents. The ESS Nash equilibrium is a solution to Rogers' paradox.

  16. Real - time Optimization of Distributed Energy Storage System Operation Strategy Based on Peak Load Shifting

    NASA Astrophysics Data System (ADS)

    Wang, Qian; Lu, Guangqi; Li, Xiaoyu; Zhang, Yichi; Yun, Zejian; Bian, Di

    2018-01-01

    To take advantage of the energy storage system (ESS) sufficiently, the factors that the service life of the distributed energy storage system (DESS) and the load should be considered when establishing optimization model. To reduce the complexity of the load shifting of DESS in the solution procedure, the loss coefficient and the equal capacity ratio distribution principle were adopted in this paper. Firstly, the model was established considering the constraint conditions of the cycles, depth, power of the charge-discharge of the ESS, the typical daily load curves, as well. Then, dynamic programming method was used to real-time solve the model in which the difference of power Δs, the real-time revised energy storage capacity Sk and the permission error of depth of charge-discharge were introduced to optimize the solution process. The simulation results show that the optimized results was achieved when the load shifting in the load variance was not considered which means the charge-discharge of the energy storage system was not executed. In the meantime, the service life of the ESS would increase.

  17. Effects of statins on bone mineral density: a meta-analysis of clinical studies.

    PubMed

    Uzzan, Bernard; Cohen, Régis; Nicolas, Patrick; Cucherat, Michel; Perret, Gérard-Yves

    2007-06-01

    Statins inhibit HMG-CoA reductase, preventing synthesis of mevalonate but also of isoprenoids, which affect osteoclast activity. Amino-bisphosphonates share this effect. In vitro and in vivo, statins show convincing anabolic and anti-resorptive bone effects. However, in a clinical meta-analysis (MA), they did not prevent hip fractures. Our meta-analysis studied the impact of statins on bone mineral density (BMD) at various sites and compared the effects of lipophilic and more hydrophilic statins. Our PubMed and Embase queries using two keywords (statins, BMD) were updated to October 2006. Two readers independently collected BMDs from studies. Twenty-one studies, mostly observational (three randomized controlled trials and one pseudo-randomized study), were assessed. Two studies were excluded (no control groups). Three studies could not be analyzed. The sixteen studies analyzed mainly included postmenopausal osteopenic women (2971 patients under statins). Statins significantly increased BMD at total hip (TH) and femoral neck (FN). Effect sizes (ESs) were modest: 0.21 at TH (95% confidence interval [CI]: 0.16-0.25) and 0.20 at FN (CI: 0.08-0.28). Among women, statins acted similarly (ES: 0.20 for TH and 0.18 for FN; CI: 0.14-0.25 and 0.06-0.31 respectively); lipophilic statins (simvastatin, lovastatin) almost entirely caused this effect, at both TH (ES: 0.20; CI: 0.15-0.26) and FN (ES: 0.22; CI: 0.06-0.37). Our findings of modest but statistically significant beneficial effects of statins on hip BMD should promote large double-blind randomized controlled trials on their bone effects, in view of their major beneficial cardiovascular effects with excellent safety profile.

  18. Sport-based physical activity intervention on body weight in children and adolescents: a meta-analysis.

    PubMed

    Kim, Kyungun; Ok, Gina; Jeon, Soeun; Kang, Minsoo; Lee, Sukho

    2017-02-01

    Controversial results reported in past research pertaining to the effectiveness of sport-based physical activity interventions on weight loss. The purpose of this study was to assess the impact of sport-based physical activity intervention on body weight in children and adolescents using a meta-analysis. Academic Search Complete, Education Source, ERIC, Medline, ProQuest, PsycINFO and SportDiscus databases were searched from January 2000 to April 2015. Eighteen studies met following inclusion criteria: sport-based intervention studies; subjects aged 6-18 years; reported body weight; published in peer-reviewed journals written in English. The mean intervention duration was 17.72 weeks. The overall effect size (ES) was 0.52 (Cohen's d (ES) = 0.52, 95% CI = 0.08, 0.95, P = 0.021), using a random effects model. Moderator analyses results showed that the Q statistic for the sport type (individual sport or team sport, Qbetween (Q b ) = 14.52, df = 1, P = 0.001) and diet control (Qbetween (Q b ) = 8.85, df = 1, P = 0.001), explained the heterogeneity of ESs. Our study showed that there was a moderate overall effect of sport-based physical activity intervention on body weight reduction. The team sport type (ES = 1.05, 95% CI = 0.44, 1.66) and diet control group (ES = 0.84, 95% CI = 0.26, 1.41) appeared to be more effective in reducing body weight.

  19. Viability of using energy storage for frequency regulation on power grid

    NASA Astrophysics Data System (ADS)

    Lim, Y. S.; Hau, L. C.; Loh, K. Y.; Lim, K. Y.; Lyons, P. F.; Taylor, P. C.

    2018-05-01

    This project is about the development and integration of a real-time network simulator in the laboratory using hardware in the loop (HIL) for the purpose of frequency regulation. Frequency regulation is done using the energy storage system (ESS) and a real-time network test bed developed in the smart energy laboratory in Newcastle University. An IEEE Test System was built in the OPAL-RT network simulator to mimic the power grid with renewable energy sources. The study demonstrates the viability of using an ESS to regulate the frequency under an increased penetration of renewable energy sources.

  20. Expert system verification and validation survey, delivery 4

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

  1. Expert system verification and validation survey. Delivery 2: Survey results

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and industry applications. This is the first task of the series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

  2. Expert system verification and validation survey. Delivery 5: Revised

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

  3. Shielding activated return water at the ESS

    NASA Astrophysics Data System (ADS)

    Klinkby, Esben; Muhrer, Günter; Carlsson, H.; Eriksson, Björn

    2018-06-01

    ESS utilises water both for moderating neutrons to thermal energies, as well as to cool beryllium- and steel reflectors, the shielding and plugs. This means that the water, in separate loops, will be subject to a significant proton and neutron irradiation causing the water to activate. After irradiation, the water is led to delay tanks situated inside the target building. Before returned to the target monolith ∼ 10% is led to the ion exchanger. This paper aims at determining the shielding required to ensure that the biological dose-rate requirements in the target building and neighbouring instrument halls are met during operation of facility.

  4. Expert system verification and validation survey. Delivery 3: Recommendations

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

  5. Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome*#

    PubMed Central

    TANG, Shi-xiong; QING, Jing; WANG, Yao-wen; CHAI, Liang; ZHANG, Wei-min; Ye, Xian-wang; Zhang, Jie; Huang, Yi-qin; Cheng, Peng

    2015-01-01

    Objective: To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome (OSAHS). Methods: We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus (exercising group). Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale (ESS), checked patients’ polysomnography, and took 320 detector computed tomography (CT) before treatment. Six and twelve months later, we made records of apnea hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), body mass index (BMI), the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment (control group) at the same time. SPSS 10.0 was used to analyze the data. Results: Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group (P<0.05). However, there was no statistical difference in all the parameters between 6 and 12 months of exercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups (P<0.0001). There was no statistical difference in the effective rate of the exercising group between 6 and 12 months of exercising (P>0.05). At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower (P<0.01) than that before treatment. There was no significant change of BMI in either group. Conclusions: Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure (CPAP) treatment. In addition, exercising pharyngeal musculature and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapies. PMID:26537211

  6. Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome.

    PubMed

    Tang, Shi-xiong; Qing, Jing; Wang, Yao-wen; Chai, Liang; Zhang, Wei-min; Ye, Xian-wang; Zhang, Jie; Huang, Yi-qin; Cheng, Peng

    2015-11-01

    To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome (OSAHS). We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus (exercising group). Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale (ESS), checked patients' polysomnography, and took 320-detector computed tomography (CT) before treatment. Six and twelve months later, we made records of apnea hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), body mass index (BMI), the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment (control group) at the same time. SPSS 10.0 was used to analyze the data. Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group (P<0.05). However, there was no statistical difference in all the parameters between 6 and 12 months of exercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups (P<0.0001). There was no statistical difference in the effective rate of the exercising group between 6 and 12 months of exercising (P>0.05). At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower (P<0.01) than that before treatment. There was no significant change of BMI in either group. Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure (CPAP) treatment. In addition, exercising pharyngeal musculature and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapies.

  7. Self-perceived health in older Europeans: Does the choice of survey matter?

    PubMed Central

    Croezen, Simone; Burdorf, Alex

    2016-01-01

    Abstract Background: Cross-national comparisons of health in European countries provide crucial information to monitor health and disease within and between countries and to inform policy and research priorities. However, variations in estimates might occur when information from cross-national European surveys with different characteristics are used. We compared the prevalence of very good or good self-perceived health across 10 European countries according to three European surveys and investigated which survey characteristics contributed to differences in prevalence estimates. Methods: We used aggregate data from 2004 to 2005 of respondents aged 55–64 years from the European Union Statistics on Income and Living Conditions (EU-SILC), the Survey of Health, Ageing and Retirement in Europe (SHARE) and the European Social Survey (ESS). Across the surveys, self-perceived health was assessed by the same question with response options ranging from very good to very bad. Results: Despite a good correlation between the surveys (intraclass correlation coefficient: 0.77), significant differences were found in prevalence estimates of very good or good self-perceived health. The survey response, sample size and survey mode contributed statistically significantly to the differences between the surveys. Multilevel linear regression analyses, adjusted for survey characteristics, showed a higher prevalence for SHARE (+6.96, 95% CIs: 3.14 to 10.8) and a lower prevalence (−3.12; 95% CIs: −7.11 to 0.86) for ESS, with EU-SILC as the reference survey. Conclusion: Three important health surveys in Europe showed substantial differences for presence of very good or good self-perceived health. These differences limit the usefulness for direct comparisons across studies in health policies for Europe. PMID:26989125

  8. The influence of sleep complaints on the association between chronotype and negative emotionality in young adults.

    PubMed

    Simor, Péter; Zavecz, Zsófia; Pálosi, Vivien; Török, Csenge; Köteles, Ferenc

    2015-02-01

    A great body of research indicates that eveningness is associated with negative psychological outcomes, including depressive and anxiety symptoms, behavioral dyscontrol and different health impairing behaviors. Impaired subjective sleep quality, increased circadian misalignment and daytime sleepiness were also reported in evening-type individuals in comparison with morning-types. Although sleep problems were consistently reported to be associated with poor psychological functioning, the effects of sleep disruption on the relationship between eveningness preference and negative emotionality have scarcely been investigated. Here, based on questionnaire data of 756 individuals (25.5% males, age range = 18-43 years, mean = 25.3 ± 5.8 years), as well as of the evening-type (N = 211) and morning-type (N = 189) subgroups, we examined the relationship among sleep problems, eveningness and negative emotionality. Subjects completed the Hungarian Version of the Horne and Östberg Morningness-Eveningness Questionnaire (MEQ-14), The Athen Insomnia Scale (AIS) and the Epworth Sleepiness Scale (ESS). Moreover, a composite score of Negative Emotionality (NE) was computed based on the scores of the Short Beck Depression Inventory (BDI-9), the Perceived Stress Scale (PSS-4) and the General Health Questionnaire (GHQ-12). Morning and evening circadian misalignment was calculated based on the difference between preferred and real wake- and bedtimes. Two possible models were tested, hypothesizing that sleep problems (circadian misalignment, insomniac symptoms and daytime sleepiness) moderate or mediate the association between eveningness and negative emotionality. Eveningness preference was correlated with increased NE and increased AIS, ESS and circadian misalignment scores. Our results indicate that eveningness-preference is an independent risk factor for higher negative emotionality regardless of the effects of age, gender, circadian misalignment and sleep complaints. Nevertheless, while chronotype explained ∼6%, sleep problems (AIS and ESS) accounted for a much larger proportion (∼28%) of the variance of NE. We did not find a significant effect of interaction (moderation) between chronotype and sleep problems. In contrast, insomniac symptoms (AIS) emerged as a partial mediator between chronotype and NE. These findings argue against the assumption that indicators of mental health problems in evening-type individuals can be explained exclusively on the basis of disturbed sleep. Nevertheless, negative psychological outcomes seem to be partially attributable to increased severity of insomniac complaints in evening-types.

  9. Does the Timing of Middle Turbinate Resection Influence Quality-of-Life Outcomes for Patients with Chronic Rhinosinusitis?

    PubMed

    Scangas, George A; Remenschneider, Aaron K; Bleier, Benjamin S; Holbrook, Eric H; Gray, Stacey T; Metson, Ralph B

    2017-11-01

    Objective To evaluate the impact of bilateral middle turbinate resection (BMTR) on patient-reported quality of life following primary and revision endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Study Design Prospective cohort study. Setting Tertiary care center. Subjects and Methods Patients with CRS who were recruited from 11 otolaryngologic practices completed the Sino-Nasal Outcome Test-22, Chronic Sinusitis Survey, and EuroQol 5-Dimension questionnaires at baseline, as well as 3 and 12 months after ESS. In the primary ESS cohort (n = 406), patients who underwent BMTR (n = 78) at the time of surgery were compared with patients (n = 328) whose middle turbinates were preserved. In the revision ESS cohort (n = 363), a similar comparison was made between patients who did (n = 64) and did not (n = 299) undergo BMTR. Results Sino-Nasal Outcome Test-22, Chronic Sinusitis Survey, and EuroQol 5-Dimension scores showed similar improvements for both the turbinate resection and preservation cohorts at 3 months ( P < .001) and 12 months ( P < .001) after surgery. For patients who underwent revision surgery, the performance of BMTR resulted in greater improvement in Chronic Sinusitis Survey scores at 1 year as compared with the turbinate preservation group (change from baseline: 28.1 vs 20.7, respectively; P = .026). History of tobacco use and the presence of nasal polyps did not affect clinical outcomes at any time point. Conclusion Patients who underwent BMTR during primary and revision sinus surgery reported similar benefits in quality-of-life outcomes 1 year after surgery. In select patients undergoing revision sinus surgery, the performance of BMTR results in improved disease-specific quality of life.

  10. Are all quantitative postmarketing signal detection methods equal? Performance characteristics of logistic regression and Multi-item Gamma Poisson Shrinker.

    PubMed

    Berlin, Conny; Blanch, Carles; Lewis, David J; Maladorno, Dionigi D; Michel, Christiane; Petrin, Michael; Sarp, Severine; Close, Philippe

    2012-06-01

    The detection of safety signals with medicines is an essential activity to protect public health. Despite widespread acceptance, it is unclear whether recently applied statistical algorithms provide enhanced performance characteristics when compared with traditional systems. Novartis has adopted a novel system for automated signal detection on the basis of disproportionality methods within a safety data mining application (Empirica™ Signal System [ESS]). ESS uses two algorithms for routine analyses: empirical Bayes Multi-item Gamma Poisson Shrinker and logistic regression (LR). A model was developed comprising 14 medicines, categorized as "new" or "established." A standard was prepared on the basis of safety findings selected from traditional sources. ESS results were compared with the standard to calculate the positive predictive value (PPV), specificity, and sensitivity. PPVs of the lower one-sided 5% and 0.05% confidence limits of the Bayes geometric mean (EB05) and of the LR odds ratio (LR0005) almost coincided for all the drug-event combinations studied. There was no obvious difference comparing the PPV of the leading Medical Dictionary for Regulatory Activities (MedDRA) terms to the PPV for all terms. The PPV of narrow MedDRA query searches was higher than that for broad searches. The widely used threshold value of EB05 = 2.0 or LR0005 = 2.0 together with more than three spontaneous reports of the drug-event combination produced balanced results for PPV, sensitivity, and specificity. Consequently, performance characteristics were best for leading terms with narrow MedDRA query searches irrespective of applying Multi-item Gamma Poisson Shrinker or LR at a threshold value of 2.0. This research formed the basis for the configuration of ESS for signal detection at Novartis. Copyright © 2011 John Wiley & Sons, Ltd.

  11. Sleep-Disordered Breathing and Excessive Daytime Sleepiness in Patients With Atrial Fibrillation

    PubMed Central

    Albuquerque, Felipe N.; Calvin, Andrew D.; Sert Kuniyoshi, Fatima H.; Konecny, Tomas; Lopez-Jimenez, Francisco; Pressman, Gregg S.; Kara, Thomas; Friedman, Paul; Ammash, Naser; Somers, Virend K.

    2012-01-01

    Background: An important consequence of sleep-disordered breathing (SDB) is excessive daytime sleepiness (EDS). EDS often predicts a favorable response to treatment of SDB, although in the setting of cardiovascular disease, particularly heart failure, SDB and EDS do not reliably correlate. Atrial fibrillation (AF) is another highly prevalent condition strongly associated with SDB. We sought to assess the relationship between EDS and SDB in patients with AF. Methods: We conducted a prospective study of 151 patients referred for direct current cardioversion for AF who also underwent sleep evaluation and nocturnal polysomnography. The Epworth Sleepiness Scale (ESS) was administered prior to polysomnography and considered positive if the score was ≥ 11. The apnea-hypopnea index (AHI) was tested for correlation with the ESS, with a cutoff of ≥ 5 events/h for the diagnosis of SDB. Results: Among the study participants, mean age was 69.1 ± 11.7 years, mean BMI was 34.1 ± 8.4 kg/m2, and 76% were men. The prevalence of SDB in this population was 81.4%, and 35% had EDS. The association between ESS score and AHI was low (R2 = 0.014, P = .64). The sensitivity and specificity of the ESS for the detection of SDB in patients with AF were 32.2% and 54.5%, respectively. Conclusions: Despite a high prevalence of SDB in this population with AF, most patients do not report EDS. Furthermore, EDS does not appear to correlate with severity of SDB or to accurately predict the presence of SDB. Further research is needed to determine whether EDS affects the natural history of AF or modifies the response to SDB treatment. PMID:21903736

  12. Evolution of cooperation with shared costs and benefits

    PubMed Central

    Brown, Joel S; Vincent, Thomas L

    2008-01-01

    The quest to determine how cooperation evolves can be based on evolutionary game theory, in spite of the fact that evolutionarily stable strategies (ESS) for most non-zero-sum games are not cooperative. We analyse the evolution of cooperation for a family of evolutionary games involving shared costs and benefits with a continuum of strategies from non-cooperation to total cooperation. This cost–benefit game allows the cooperator to share in the benefit of a cooperative act, and the recipient to be burdened with a share of the cooperator's cost. The cost–benefit game encompasses the Prisoner's Dilemma, Snowdrift game and Partial Altruism. The models produce ESS solutions of total cooperation, partial cooperation, non-cooperation and coexistence between cooperation and non-cooperation. Cooperation emerges from an interplay between the nonlinearities in the cost and benefit functions. If benefits increase at a decelerating rate and costs increase at an accelerating rate with the degree of cooperation, then the ESS has an intermediate level of cooperation. The game also exhibits non-ESS points such as unstable minima, convergent-stable minima and unstable maxima. The emergence of cooperative behaviour in this game represents enlightened self-interest, whereas non-cooperative solutions illustrate the Tragedy of the Commons. Games having either a stable maximum or a stable minimum have the property that small changes in the incentive structure (model parameter values) or culture (starting frequencies of strategies) result in correspondingly small changes in the degree of cooperation. Conversely, with unstable maxima or unstable minima, small changes in the incentive structure or culture can result in a switch from non-cooperation to total cooperation (and vice versa). These solutions identify when human or animal societies have the potential for cooperation and whether cooperation is robust or fragile. PMID:18495622

  13. Evaluation of resin infiltration using quantitative light-induced fluorescence technology.

    PubMed

    Min, Ji-Hyun; Inaba, Daisuke; Kim, Baek-Il

    2016-09-01

    To determine whether quantitative light-induced fluorescence (QLF) technology can be used to classify the colour of teeth specimens before and after resin infiltration (RI) treatment, and calculate the correlation between the ΔF value and colour difference (ΔE) in fluorescence images of the specimens obtained using a QLF-digital (QLF-D) device. Sixty sound bovine permanent teeth specimens were immersed in demineralized solution. Two exposed windows were formed in each specimen, and RI treatment was applied to one of them. The ΔE values were obtained for the differences between a sound tooth surface (SS), an early dental caries surface (ECS) and an ECS treated with RI (RS) in white-light and fluorescence images obtained using QLF-D, respectively. The ΔF value was obtained from fluorescence images using dedicated software for QLF-D. The mean differences between the ΔE values obtained from the white-light and fluorescence images were analyzed by paired t-test. Pearson correlation analysis and Bland-Altman plots were applied to the differences between the ΔF value for ECS (ΔFSS-ECS) and the ΔE value between SS and ECS (ΔESS-ECS), and between the ΔF value for RS (ΔFSS-RS) and the ΔE value between SS and RS (ΔESS-RS) in fluorescence images. The ΔE values obtained from fluorescence images were three times higher than the ΔE values obtained from white-light images (p<0.001). Significant correlations were confirmed between ΔESS-ECS and ΔFSS-ECS (r=-0.492, p<0.001) and between ΔESS-RS and ΔFSS-RS (r=-0.661, p<0.001). QLF technology can be used to confirm the presence of RI in teeth. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Readability assessment of Internet-based patient education materials related to endoscopic sinus surgery.

    PubMed

    Cherla, Deepa V; Sanghvi, Saurin; Choudhry, Osamah J; Liu, James K; Eloy, Jean Anderson

    2012-08-01

    Numerous professional societies, clinical practices, and hospitals provide Internet-based patient education materials (PEMs) to the general public, but not all of this information is written at a reading level appropriate for the average patient. The National Institutes of Health and the US Department of Health and Human Services recommend that PEMs be written at or below the sixth-grade level. Our purpose was to assess the readability of endoscopic sinus surgery (ESS)-related PEMs available on the Internet and compare readability levels of PEMs provided by three sources: professional societies, clinical practices, and hospitals. A descriptive and correlational design was used for this study. The readability of 31 ESS-related PEMs was assessed with four different readability indices: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG). Averages were evaluated against national recommendations and between each source using analysis of variance and t tests. The majority of PEMs (96.8%) were written above the recommended sixth-grade reading level, based on FKGL (P < .001). Only one article (3.2%) had an FKGL at or below the sixth-grade level. The mean readability values were: FRES 47.1 ± 13.4, FKGL 10.7 ± 2.4, SMOG 13.7 ± 1.6, and Gunning FOG 12.4 ± 2.7. Current Internet-based PEMs related to ESS, regardless of source type, were written well above the recommended sixth-grade level. Materials from the hospitals/university-affiliated websites had lower readability scores, but were still above recommended levels. Web-based PEMs pertaining to ESS should be written with the average patient in mind. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  15. Blood flow patterns during incremental and steady-state aerobic exercise.

    PubMed

    Coovert, Daniel; Evans, LeVisa D; Jarrett, Steven; Lima, Carla; Lima, Natalia; Gurovich, Alvaro N

    2017-05-30

    Endothelial shear stress (ESS) is a physiological stimulus for vascular homeostasis, highly dependent on blood flow patterns. Exercise-induced ESS might be beneficial on vascular health. However, it is unclear what type of ESS aerobic exercise (AX) produces. The aims of this study are to characterize exercise-induced blood flow patterns during incremental and steady-state AX. We expect blood flow pattern during exercise will be intensity-dependent and bidirectional. Six college-aged students (2 males and 4 females) were recruited to perform 2 exercise tests on cycleergometer. First, an 8-12-min incremental test (Test 1) where oxygen uptake (VO2), heart rate (HR), blood pressure (BP), and blood lactate (La) were measured at rest and after each 2-min step. Then, at least 48-hr. after the first test, a 3-step steady state exercise test (Test 2) was performed measuring VO2, HR, BP, and La. The three steps were performed at the following exercise intensities according to La: 0-2 mmol/L, 2-4 mmol/L, and 4-6 mmol/L. During both tests, blood flow patterns were determined by high-definition ultrasound and Doppler on the brachial artery. These measurements allowed to determine blood flow velocities and directions during exercise. On Test 1 VO2, HR, BP, La, and antegrade blood flow velocity significantly increased in an intensity-dependent manner (repeated measures ANOVA, p<0.05). Retrograde blood flow velocity did not significantly change during Test 1. On Test 2 all the previous variables significantly increased in an intensity-dependent manner (repeated measures ANOVA, p<0.05). These results support the hypothesis that exercise induced ESS might be increased in an intensity-dependent way and blood flow patterns during incremental and steady-state exercises include both antegrade and retrograde blood flows.

  16. SOS score: an optimized score to screen acute stroke patients for obstructive sleep apnea.

    PubMed

    Camilo, Millene R; Sander, Heidi H; Eckeli, Alan L; Fernandes, Regina M F; Dos Santos-Pontelli, Taiza E G; Leite, Joao P; Pontes-Neto, Octavio M

    2014-09-01

    Obstructive sleep apnea (OSA) is frequent in acute stroke patients, and has been associated with higher mortality and worse prognosis. Polysomnography (PSG) is the gold standard diagnostic method for OSA, but it is impracticable as a routine for all acute stroke patients. We evaluated the accuracy of two OSA screening tools, the Berlin Questionnaire (BQ), and the Epworth Sleepiness Scale (ESS) when administered to relatives of acute stroke patients; we also compared these tools against a combined screening score (SOS score). Ischemic stroke patients were submitted to a full PSG at the first night after onset of symptoms. OSA severity was measured by apnea-hypopnea index (AHI). BQ and ESS were administered to relatives of stroke patients before the PSG and compared to SOS score for accuracy and C-statistics. We prospectively studied 39 patients. OSA (AHI ≥10/h) was present in 76.9%. The SOS score [area under the curve (AUC): 0.812; P = 0.005] and ESS (AUC: 0.789; P = 0.009) had good predictive value for OSA. The SOS score was the only tool with significant predictive value (AUC: 0.686; P = 0.048) for severe OSA (AHI ≥30/h), when compared to ESS (P = 0.119) and BQ (P = 0.191). The threshold of SOS ≤10 showed high sensitivity (90%) and negative predictive value (96.2%) for OSA; SOS ≥20 showed high specificity (100%) and positive predictive value (92.5%) for severe OSA. The SOS score administered to relatives of stroke patients is a useful tool to screen for OSA and may decrease the need for PSG in acute stroke setting. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. The potential association of later initiation of oral/enteral nutrition on euthyroid sick syndrome in burn patients.

    PubMed

    Pérez-Guisado, Joaquín; de Haro-Padilla, Jesús M; Rioja, Luis F; Derosier, Leo C; de la Torre, Jorge I

    2013-01-01

    Objective. The aim of this study was to determine if early initiation of oral/enteral nutrition in burn patients minimizes the drop in fT3 levels, reduces the potential for euthyroid sick syndrome (ESS), and shortens the length of hospital stay (LHS). Subjects and Methods. We retrospectively evaluated the statistical association of serum fT3, fT4, and TSH at the first (2nd-5th day) and second sample collection (9th-12th day) after the burn injury in 152 burn patients. Three groups were established depending on time of initiation of the oral/enteral nutrition: <24 h before the injury (Group 1), 24-48 h after the injury (Group 2), and >48 h after the injury (Group 3). Results. They were expressed as mean ± standard deviation. We found that LHS and the fT3 levels were statistically different in the 3 groups. The LHS (in days) was, respectively, in each group, 16.77 ± 4.56, 21.98 ± 4.86, and 26.06 ± 5.47. Despite the quantifiable drop in fT3, ESS was present only at the first sample collection (2.61 ± 0.92 days) in Group 3, but there was no group with ESS at the second sample collection (9.89 ± 1.01 days). Our data suggest that early initiation of nutritional supplementation decreases the length of hospitalization and is associated with decreasing fT3 serum concentration depression. Conclusion. Early initiation of oral/enteral nutrition counteracts ESS and improves the LHS in burn patients.

  18. Global Assessment of the Impact of Type 2 Diabetes on Sleep through Specific Questionnaires. A Case-Control Study.

    PubMed

    Lecube, Albert; Sánchez, Enric; Gómez-Peralta, Fernando; Abreu, Cristina; Valls, Joan; Mestre, Olga; Romero, Odile; Martínez, María Dolores; Sampol, Gabriel; Ciudin, Andreea; Hernández, Cristina; Simó, Rafael

    2016-01-01

    Type 2 diabetes (T2D) is an independent risk factor for sleep breathing disorders. However, it is unknown whether T2D affects daily somnolence and quality of sleep independently of the impairment of polysomnographic parameters. A case-control study including 413 patients with T2D and 413 non-diabetic subjects, matched by age, gender, BMI, and waist and neck circumferences. A polysomnography was performed and daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). In addition, 135 subjects with T2D and 45 controls matched by the same previous parameters were also evaluated through the Pittsburgh Sleep Quality Index (PSQI) to calculate sleep quality. Daytime sleepiness was higher in T2D than in control subjects (p = 0.003), with 23.9% of subjects presenting an excessive daytime sleepiness (ESS>10). Patients with fasting plasma glucose (FPG ≥13.1 mmol/l) were identified as the group with a higher risk associated with an ESS>10 (OR 3.9, 95% CI 1.8-7.9, p = 0.0003). A stepwise regression analyses showed that the presence of T2D, baseline glucose levels and gender but not polysomnographic parameters (i.e apnea-hyoapnea index or sleeping time spent with oxigen saturation lower than 90%) independently predicted the ESS score. In addition, subjects with T2D showed higher sleep disturbances [PSQI: 7.0 (1.0-18.0) vs. 4 (0.0-12.0), p<0.001]. The presence of T2D and high levels of FPG are independent risk factors for daytime sleepiness and adversely affect sleep quality. Prospective studies addressed to demonstrate whether glycemia optimization could improve the sleep quality in T2D patients seem warranted.

  19. A Laboratory Evaluation of Liquid Cooled Vests for Non-Combatants

    DTIC Science & Technology

    1986-04-01

    intermediate between these extremes have been or could be used by, for example, firefighters, stokers, furnace workers , surgeons (to inhibit sweating ...M., and Stein, R.W. (1976) An ice-cooling garment for mine rescue workers . Report PB-254487, US Department of Commerce, Washington DC, USA. Edwards...ermoregulatory sdeating of three sabjects. All su:-ects stated that the vests co-vide_ so,-e relief from heat stress, but no effects of eat st-ess on

  20. Effects of industrial wind turbine noise on sleep and health.

    PubMed

    Nissenbaum, Michael A; Aramini, Jeffery J; Hanning, Christopher D

    2012-01-01

    Industrial wind turbines (IWTs) are a new source of noise in previously quiet rural environments. Environmental noise is a public health concern, of which sleep disruption is a major factor. To compare sleep and general health outcomes between participants living close to IWTs and those living further away from them, participants living between 375 and 1400 m (n = 38) and 3.3 and 6.6 km (n = 41) from IWTs were enrolled in a stratified cross-sectional study involving two rural sites. Validated questionnaires were used to collect information on sleep quality (Pittsburgh Sleep Quality Index - PSQI), daytime sleepiness (Epworth Sleepiness Score - ESS), and general health (SF36v2), together with psychiatric disorders, attitude, and demographics. Descriptive and multivariate analyses were performed to investigate the effect of the main exposure variable of interest (distance to the nearest IWT) on various health outcome measures. Participants living within 1.4 km of an IWT had worse sleep, were sleepier during the day, and had worse SF36 Mental Component Scores compared to those living further than 1.4 km away. Significant dose-response relationships between PSQI, ESS, SF36 Mental Component Score, and log-distance to the nearest IWT were identified after controlling for gender, age, and household clustering. The adverse event reports of sleep disturbance and ill health by those living close to IWTs are supported.

  1. Evaluation of a novel approach in the prevention of white spot lesions around orthodontic brackets.

    PubMed

    Yap, J; Walsh, L J; Naser-Ud Din, S; Ngo, H; Manton, D J

    2014-03-01

    The purpose of this study was to evaluate and compare the relative efficacy of a resin fissure sealant, nano-filled self-adhesive protective coating, resin infiltrant, glass ionomer cement (GIC), and GIC containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in preventing the formation of subsurface lesions of enamel (SLE) adjacent to orthodontic brackets by acting as an enamel surface sealant (ESS). Eighty-five enamel specimens with molar tubes bonded at their centre were randomly divided into five groups, each treated with a different material at the bracket's periphery. Specimens were stored in an acetate demineralization solution at pH 4.5 for 7 days at 37 °C then imaged using quantitative light-induced fluorescence (QLF) to determine the difference in fluorescence (∆F) between sound- and acid-exposed enamel. Lesion cross-sections were then examined using backscattered scanning electron microscopy (SEM) to measure lesion depth. The use of GIC alone or incorporating CPP-ACP significantly reduced ∆F compared with other materials. Backscattered SEM images showed no measurable demineralization for enamel treated with either GIC material in contrast with other groups, which showed statistically significant demineralization levels. The fluoride-releasing effects and CPP-ACP benefits of the GIC materials show promise as an effective ESS in inhibiting enamel demineralization adjacent to orthodontic brackets. © 2014 Australian Dental Association.

  2. The effects of resistance training interventions on vertical jump performance in basketball players: a meta-analysis.

    PubMed

    Sperlich, Paula F; Behringer, Michael; Mester, Joachim

    2016-01-01

    Vertical jump performance is one of the key factors in basketball. In order to determine the effectiveness of previously published interventions and their influencing factors we performed a meta-analysis. A computerized search was conducted using the databases PubMed (1966), Web of Science (1900), SPORTDiscus™ (1975),Medline (1966) and SportPilot (2008). Studies involving healthy male or female basketball players at any age and performance level were included. All trials had to investigate the benefits of resistance training programs on jumping performance in basketball players and provide a control group. The effect size (ES) was computed and the relationship between ESs and continuous variables was examined by meta-regressions, whereas subgroup meta-analyses and z-tests were used to assess the impact of categorical moderator variables. The meta-analysis included 14 studies with 20 subgroups and a total of 37 outcomes. A total of 399 participants were examined, N.=157 served as control and N.=242 took part in particular training interventions. The overall weighted ES of 0.78 (95% CI 0.41, 1.15) was significantly greater than zero (P<0.001). None of the categorical moderator variables affected the training effect. However, positive correlations were found for training duration (r=0.68; P=0.02). The present meta-analysis demonstrates that resistance training throughout the year, using bodyweight or external weight, significantly improves vertical jump performance in healthy basketball players. Since vertical jump improvements were independent of intervention period but dependent on the duration of each individual training session the total training amount should be based on longer training sessions.

  3. Molecular evolution and phylodynamics of hepatitis B virus infection circulating in Iran.

    PubMed

    Mozhgani, Sayed-Hamidreza; Malekpour, Seyed Amir; Norouzi, Mehdi; Ramezani, Fatemeh; Rezaee, Seyed Abdolrahim; Poortahmasebi, Vahdat; Sadeghi, Mehdi; Alavian, Seyed Moayed; Zarei-Ghobadi, Mohadeseh; Ghaziasadi, Azam; Karimzadeh, Hadi; Malekzadeh, Reza; Ziaee, Masood; Abedi, Farshid; Ataei, Behrooz; Yaran, Majid; Sayad, Babak; Jahantigh, Hamid Reza; Somi, Mohammad Hossein; Sarizadeh, Gholamreza; Sanei-Moghaddam, Ismail; Mansour-Ghanaei, Fariborz; Keyvani, Hossein; Kalantari, Ebrahim; Fakhari, Zahra; Geravand, Babak; Jazayeri, Seyed Mohammad

    2018-06-01

    Previous local and national Iranian publications indicate that all Iranian hepatitis B virus (HBV) strains belong to HBV genotype D. The aim of this study was to analyze the evolutionary history of HBV infection in Iran for the first time, based on an intensive phylodynamic study. The evolutionary parameters, time to most recent common ancestor (tMRCA), and the population dynamics of infections were investigated using the Bayesian Monte Carlo Markov chain (BMCMC). The effective sample size (ESS) and sampling convergence were then monitored. After sampling from the posterior distribution of the nucleotide substitution rate and other evolutionary parameters, the point estimations (median) of these parameters were obtained. All Iranian HBV isolates were of genotype D, sub-type ayw2. The origin of HBV is regarded as having evolved first on the eastern border, before moving westward, where Isfahan province then hosted the virus. Afterwards, the virus moved to the south and west of the country. The tMRCA of HBV in Iran was estimated to be around 1894, with a 95% credible interval between the years 1701 and 1957. The effective number of infections increased exponentially from around 1925 to 1960. Conversely, from around 1992 onwards, the effective number of HBV infections has decreased at a very high rate. Phylodynamic inference clearly demonstrates a unique homogenous pattern of HBV genotype D compatible with a steady configuration of the decreased effective number of infections in the population in recent years, possibly due to the implementation of blood donation screening and vaccination programs. Adequate molecular epidemiology databases for HBV are crucial for infection prevention and treatment programs.

  4. Caffeine and diuresis during rest and exercise: A meta-analysis

    PubMed Central

    Coca, Aitor; Casa, Douglas J.; Antonio, Jose; Green, James M.; Bishop, Phillip A.

    2016-01-01

    Objectives Although ergogenic, acute caffeine ingestion may increase urine volume, prompting concerns about fluid balance during exercise and sport events. This meta-analysis evaluated caffeine induced diuresis in adults during rest and exercise. Design Meta-analysis. Methods A search of three databases was completed on November 1, 2013. Only studies that involved healthy adults and provided sufficient information concerning the effect size (ES) of caffeine ingestion on urine volume were included. Sixteen studies met the inclusion criteria, providing a total of 28 ESs for the meta-analysis. Heterogeneity was assessed using a random-effects model. Results The median caffeine dosage was 300 mg. The overall ES of 0.29 (95% confidence interval (CI) = 0.11-0.48, p = 0.001) corresponds to an increase in urine volume of 109 ± 195 mL or 16.0 ± 19.2% for caffeine ingestion vs. non-caffeine conditions. Subgroup meta-analysis confirmed exercise as a strong moderator: active ES = 0.10, 95% CI = −0.07 to 0.27, p = 0.248 vs. resting ES = 0.54, 95% CI = 0.22–0.85, p = 0.001 (Cochran's Q, p = 0.019). Females (ES = 0.75,95% CI = 0.38–1.13, p< 0.001) were more susceptible to diuretic effects than males (ES = 0.13,95% CI = −0.05 to 0.31, p = 0.158) (Cochran's Q, p = 0.003). Conclusions Caffeine exerted a minor diuretic effect which was negated by exercise. Concerns regarding unwanted fluid loss associated with caffeine consumption are unwarranted particularly when ingestion precedes exercise. PMID:25154702

  5. The health of European populations: introduction to the special supplement on the 2014 European Social Survey (ESS) rotating module on the social determinants of health.

    PubMed

    Beckfield, Jason; Balaj, Mirza; McNamara, Courtney L; Huijts, Tim; Bambra, Clare; Eikemo, Terje A

    2017-02-01

    This introduction summarizes the main findings of the Supplement 'Social inequalities in health and their determinants' to the European Journal of Public Health. The 16 articles that constitute this supplement use the new ESS (2014) health module data to analyze the distribution of health across European populations. Three main themes run across these articles: documentation of cross-national variation in the magnitude and patterning of health inequalities; assessment of health determinants variation across populations and in their contribution to health inequalities; and the examination of the effects of health outcomes across social groups. Social inequalities in health are investigated from an intersectional stance providing ample evidence of inequalities based on socioeconomic status (occupation, education, income), gender, age, geographical location, migrant status and their interactions. Comparison of results across these articles, which employ a wide range of health outcomes, social determinants and social stratification measures, is facilitated by a shared theoretical and analytical approach developed by the authors in this supplement. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  6. An analytical approach to customer requirement information processing

    NASA Astrophysics Data System (ADS)

    Zhou, Zude; Xiao, Zheng; Liu, Quan; Ai, Qingsong

    2013-11-01

    'Customer requirements' (CRs) management is a key component of customer relationship management (CRM). By processing customer-focused information, CRs management plays an important role in enterprise systems (ESs). Although two main CRs analysis methods, quality function deployment (QFD) and Kano model, have been applied to many fields by many enterprises in the past several decades, the limitations such as complex processes and operations make them unsuitable for online businesses among small- and medium-sized enterprises (SMEs). Currently, most SMEs do not have the resources to implement QFD or Kano model. In this article, we propose a method named customer requirement information (CRI), which provides a simpler and easier way for SMEs to run CRs analysis. The proposed method analyses CRs from the perspective of information and applies mathematical methods to the analysis process. A detailed description of CRI's acquisition, classification and processing is provided.

  7. Effects of postexercise ice-water and room-temperature water immersion on the sensory organization of balance control and lower limb proprioception in amateur rugby players: A randomized controlled trial.

    PubMed

    Chow, Gary C C; Yam, Timothy T T; Chung, Joanne W Y; Fong, Shirley S M

    2017-02-01

    This single-blinded, three-armed randomized controlled trial aimed to compare the effects of postexercise ice-water immersion (IWI), room-temperature water immersion (RWI), and no water immersion on the balance performance and knee joint proprioception of amateur rugby players. Fifty-three eligible amateur rugby players (mean age ± standard deviation: 21.6 ± 2.9 years) were randomly assigned to the IWI group (5.3 °C), RWI group (25.0 °C), or the no immersion control group. The participants in each group underwent the same fatigue protocol followed by their allocated recovery intervention, which lasted for 1 minute. Measurements were taken before and after the fatigue-recovery intervention. The primary outcomes were the sensory organization test (SOT) composite equilibrium score (ES) and the condition-specific ES, which were measured using a computerized dynamic posturography machine. The secondary outcome was the knee joint repositioning error. Two-way repeated measures analysis of variance was used to test the effect of water immersion on each outcome variable. There were no significant within- and between-group differences in the SOT composite ESs or the condition-specific ESs. However, there was a group-by-time interaction effect on the knee joint repositioning error. It seems that participants in the RWI group had lower errors over time, but those in the IWI and control groups had increased errors over time. The RWI group had significantly lower error score than the IWI group at postintervention. One minute of postexercise IWI or RWI did not impair rugby players' sensory organization of balance control. RWI had a less detrimental effect on knee joint proprioception to IWI at postintervention.

  8. Effects of postexercise ice-water and room-temperature water immersion on the sensory organization of balance control and lower limb proprioception in amateur rugby players

    PubMed Central

    Chow, Gary C.C.; Yam, Timothy T.T.; Chung, Joanne W.Y.; Fong, Shirley S.M.

    2017-01-01

    Abstract Background: This single-blinded, three-armed randomized controlled trial aimed to compare the effects of postexercise ice-water immersion (IWI), room-temperature water immersion (RWI), and no water immersion on the balance performance and knee joint proprioception of amateur rugby players. Methods: Fifty-three eligible amateur rugby players (mean age ± standard deviation: 21.6 ± 2.9 years) were randomly assigned to the IWI group (5.3 °C), RWI group (25.0 °C), or the no immersion control group. The participants in each group underwent the same fatigue protocol followed by their allocated recovery intervention, which lasted for 1 minute. Measurements were taken before and after the fatigue-recovery intervention. The primary outcomes were the sensory organization test (SOT) composite equilibrium score (ES) and the condition-specific ES, which were measured using a computerized dynamic posturography machine. The secondary outcome was the knee joint repositioning error. Two-way repeated measures analysis of variance was used to test the effect of water immersion on each outcome variable. Results: There were no significant within- and between-group differences in the SOT composite ESs or the condition-specific ESs. However, there was a group-by-time interaction effect on the knee joint repositioning error. It seems that participants in the RWI group had lower errors over time, but those in the IWI and control groups had increased errors over time. The RWI group had significantly lower error score than the IWI group at postintervention. Conclusion: One minute of postexercise IWI or RWI did not impair rugby players’ sensory organization of balance control. RWI had a less detrimental effect on knee joint proprioception to IWI at postintervention. PMID:28207546

  9. Communication analysis for the expendable explorer spacecraft

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This report provides the results of communication analysis for the baseline and enhanced performance spacecraft designs proposed for Expendable Explorer Spacecraft (EES) series of missions. Five classes of orbits (Geosynchronous, Circular-28 degree inclination, Polar-90 degree inclination, Sunsynchronous-97 degree inclination, Molniya orbit) and a set of candidate instrument payloads provided by the ESS Study Manager were used to formulate the basis for the ESS Communications Study. The study was performed to assess the feasibility of using Space Network or ground stations for supporting the communications, tracking and data handling of the candidate instruments that are proposed to be launched into the desired orbit.

  10. Characterization of the Multi-Blade 10B-based detector at the CRISP reflectometer at ISIS for neutron reflectometry at ESS

    NASA Astrophysics Data System (ADS)

    Piscitelli, F.; Mauri, G.; Messi, F.; Anastasopoulos, M.; Arnold, T.; Glavic, A.; Höglund, C.; Ilves, T.; Lopez Higuera, I.; Pazmandi, P.; Raspino, D.; Robinson, L.; Schmidt, S.; Svensson, P.; Varga, D.; Hall-Wilton, R.

    2018-05-01

    The Multi-Blade is a Boron-10-based gaseous thermal neutron detector developed to face the challenge arising in neutron reflectometry at neutron sources. Neutron reflectometers are challenging instruments in terms of instantaneous counting rate and spatial resolution. This detector has been designed according to the requirements given by the reflectometers at the European Spallation Source (ESS) in Sweden. The Multi-Blade has been installed and tested on the CRISP reflectometer at the ISIS neutron and muon source in U.K.. The results on the detailed detector characterization are discussed in this manuscript.

  11. Preparation and evaluation of magnetic carbonaceous materials for pesticide and metal removal.

    PubMed

    Ohno, Masaki; Hayashi, Hiroki; Suzuki, Kazuyuki; Kose, Tomohiro; Asada, Takashi; Kawata, Kuniaki

    2011-07-15

    Magnetic carbonaceous materials were produced by carbonization of a cation exchange resin loaded with ferrous or ferric iron and activation using sieved oyster shell as the activation agent. The magnetic carbonaceous material with the maximum magnetic flux density on every axis (ESS-1) was obtained from the ferric-loaded resin by carbonization at 700°C, followed by activation with the oyster shell at 900°C, and magnetization. A separate step of carbonization and activation appears to cause more of a reduction reaction of Fe to form γ-Fe(2)O(3). The Fe compound in the magnetic carbonaceous material was identified from the XRD pattern as mainly γ-Fe(2)O(3). The magnetic flux density on every axis increased linearly as the amount of the oyster shell increased. Moreover, the adsorption ability of the products was evaluated for pesticides and metal ions. Both ESS-1 and a carbonaceous material obtained from the resin without ferric ion (RC) appear to have the highest adsorption ability for lead. Furthermore, the adsorption ability of ESS-1 might decrease by blockages of the pores with the loaded Fe compounds. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Shift-work disorder and sleep-related environmental factors in the manufacturing industry.

    PubMed

    Taniyama, Yukari; Nakamura, Arisa; Yamauchi, Takenori; Takeuchi, Shouhei; Kuroda, Yoshiki

    2015-03-01

    The aim of this study was to examine the relationship between shift-work disorder (SWD) and environmental and somatic factors related to falling asleep among rapidly rotating shift workers in a manufacturing industry.A total of 556 male workers were recruited to complete a self-administered questionnaire regarding age, shift work experience, lifestyle, and family structure; the Epworth sleepiness scale (ESS); the Pittsburgh sleep quality index (PSQI); and the Horne and Ostberg questionnaire, a questionnaire for environmental and somatic factors related to falling asleep. We classified workers according to having SWD or not, and compared workers with SWD with those without this disorder in terms of all items covered in the aforementioned questionnaires. A total of 208 workers (62.8%) working rapidly rotating shifts were diagnosed with SWD. The ESS and PSQI scores and scores for environmental and somatic factors were significantly higher in workers with SWD than in those without this disorder. The ESS scores and scores for environmental and somatic factors were also associated with SWD in the logistic regression analyses. We suggest that susceptibility to SWD in the manufacturing industry may be associated with environmental and somatic factors related to falling asleep.

  13. Daytime somnolence in adult sleepwalkers.

    PubMed

    Desautels, Alex; Zadra, Antonio; Labelle, Marc-Antoine; Dauvilliers, Yves; Petit, Dominique; Montplaisir, Jacques

    2013-11-01

    Sleepwalkers often complain of excessive daytime somnolence (EDS). Our retrospective study aimed to document the presence of EDS in a substantial sample of sleepwalkers and to explore the contribution of other sleep disorders, nocturnal sleep disruption, and sleep depth to the alteration of their daytime vigilance. Seventy adult sleepwalkers and 70 control subjects completed the Epworth Sleepiness Scale (ESS). Sleepwalkers also were studied for one night in the sleep laboratory. We compared the sleep profiles of 32 somnolent vs 38 nonsomnolent sleepwalkers and investigated the relationship between ESS scores and sleep-related variables. No differences were found in polysomnographic (PSG) parameters. Slow-wave activity (SWA) also was similar in the two subgroups. Sleepwalkers' ESS scores were not correlated with their body mass index (BMI) or periodic limb movements during sleep (PLMS) index, but they tended to be negatively correlated with indices of respiratory events. The EDS reported by adult sleepwalkers does not appear to be explained by the presence of concomitant sleep disorders or PSG signs of nocturnal sleep disruption. These results raise the possibility that EDS is part of the sleepwalking phenotype and that it is linked to its underlying pathophysiology. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Two brothers' alleged paternity for a child: who is the father?

    PubMed

    Dogan, Muhammed; Kara, Umut; Emre, Ramazan; Fung, Wing Kam; Canturk, Kemal Murat

    2015-06-01

    In paternity cases where individuals are close relatives, it may be necessary to evaluate mother's DNA profile (trio test) and to increase the number of polymorphic STR loci that are analyzed. In our case, two alleged fathers who are brothers and the child (duo case) were analyzed based on 20 STR loci; however, no exclusions could be achieved. Then trio test (with mother) was performed using the Identifiler Plus kit (Applied Biosystems) and no exclusions could be achieved again. Analysis performed with the ESS Plex Plus kit (Qiagen), the paternity of one of the two alleged fathers was rejected only on 2 STR loci. We made the calculations of power of exclusion values to interpret our results more properly. The probability of exclusion (PE) is calculated as 0.9776546 in 15 loci of Identifiler Plus kit without mother. The PE is calculated as 0.9942803, if 5 additional loci from ESS Plex Plus kit are typed. The PE becomes 0.9961048 for the Identifiler Plus kit in trio analysis. If both Identifiler Plus and ESS Plex Plus kits are used for testing, the PE is calculated as 0.999431654, which indicates that the combined kits are highly discriminating.

  15. Cyclic Alternating Pattern in Obstructive Sleep Apnea Patients with versus without Excessive Sleepiness.

    PubMed

    Korkmaz, Selda; Bilecenoglu, Nedime Tugce; Aksu, Murat; Yoldas, Tahir Kurtulus

    2018-01-01

    One of the main hypotheses on the development of daytime sleepiness (ES) is increased arousal in obstructive sleep apnea (OSA). Cyclic alternating pattern (CAP) is considered to be the main expression of sleep microstructure rather than arousal. Therefore, we aimed to investigate whether there is any difference between OSA patients with versus without ES in terms of the parameters of sleep macro- and microstructure and which variables are associated with Epworth Sleepiness Scale (ESS) score. Thirty-eight male patients with moderate to severe OSA were divided into two subgroups by having been used to ESS as ES or non-ES. There was no difference between two groups in clinical characteristics and macrostructure parameters of sleep. However, ES group had significantly higher CAP rate, CAP duration, number of CAP cycles, and duration and rate of the subtypes A2 ( p = 0.033, 0.019, 0.013, and 0.019, respectively) and lower mean phase B duration ( p = 0.028) compared with non-ES group. In correlation analysis, ESS score was not correlated with any CAP measure. OSA patients with ES have increased CAP measures rather than those without ES.

  16. Application of the MCNPX-McStas interface for shielding calculations and guide design at ESS

    NASA Astrophysics Data System (ADS)

    Klinkby, E. B.; Knudsen, E. B.; Willendrup, P. K.; Lauritzen, B.; Nonbøl, E.; Bentley, P.; Filges, U.

    2014-07-01

    Recently, an interface between the Monte Carlo code MCNPX and the neutron ray-tracing code MCNPX was developed [1, 2]. Based on the expected neutronic performance and guide geometries relevant for the ESS, the combined MCNPX-McStas code is used to calculate dose rates along neutron beam guides. The generation and moderation of neutrons is simulated using a full scale MCNPX model of the ESS target monolith. Upon entering the neutron beam extraction region, the individual neutron states are handed to McStas via the MCNPX-McStas interface. McStas transports the neutrons through the beam guide, and by using newly developed event logging capability, the neutron state parameters corresponding to un-reflected neutrons are recorded at each scattering. This information is handed back to MCNPX where it serves as neutron source input for a second MCNPX simulation. This simulation enables calculation of dose rates in the vicinity of the guide. In addition the logging mechanism is employed to record the scatterings along the guides which is exploited to simulate the supermirror quality requirements (i.e. m-values) needed at different positions along the beam guide to transport neutrons in the same guide/source setup.

  17. The impact of obstructive sleep apnea and daytime sleepiness on work limitation.

    PubMed

    Mulgrew, A T; Ryan, C F; Fleetham, J A; Cheema, R; Fox, N; Koehoorn, M; Fitzgerald, J M; Marra, C; Ayas, N T

    2007-12-01

    Many patients with obstructive sleep apnea (OSA) participate in the work force. However, the impact of OSA and sleepiness on work performance is unclear. To address this issue, we administered the Epworth Sleepiness Scale (ESS), the Work Limitations Questionnaire (WLQ), and an occupational survey to patients undergoing full-night polysomnography for the investigation of sleep-disordered breathing. Of 498 patients enrolled in the study, 428 (86.0%) completed the questionnaires. Their mean age+/-standard deviation (SD) was 49+/-12 years, mean body mass index (BMI) was 31+/-7 kg/m(2) mean apnea hypopnea index (AHI) was 21+/-22 events/h, and mean ESS score was 10+/-5. Subjects worked a mean of 39+/-18 h per week. The first 100 patients to complete the survey were followed up at two years. In the group as a whole, there was no significant relationship between severity of OSA and the four dimensions of work limitation. However, in blue-collar workers, significant differences were detected between patients with mild OSA (AHI 5-15/h) and those with severe OSA (AHI>30/h) with respect to time management (limited 23.1% of the time vs. 43.8%, p=0.05) and mental/personnel interactions (17.9% vs. 33.0%, p=0.05). In contrast, there were strong associations between subjective sleepiness (as assessed by the ESS) and three of the four scales of work limitation. That is, patients with an ESS of 5 had much less work limitation compared to those with an ESS 18 in terms of time management (19.7% vs. 38.6 %, p<0.001), mental-interpersonal relationships (15.5% vs. 36.0%, p<0.001) and work output (16.8% vs. 36.0%; p<0.001). Of the group followed up, 49 returned surveys and 33 who were using continuous positive airway pressure (CPAP) showed significant improvements between the initial and second follow-up in time management (26% vs. 9%, p=0.0005), mental-interpersonal relationships (16% vs. 11.0%, p=0.014) and work output (18% vs. 10%; p<0.009). We have demonstrated a clear relationship between excessive sleepiness and decreased work productivity in a population referred for suspected sleep-disordered breathing. Screening for sleepiness and sleep-disordered breathing in the workplace has the potential to identify a reversible cause of low work productivity.

  18. Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports.

    PubMed

    Gosteli, Gaël; Yersin, Bertrand; Mabire, Cédric; Pasquier, Mathieu; Albrecht, Roland; Carron, Pierre-Nicolas

    2016-07-01

    Extreme sports (ESs) are increasingly popular, and accidents due to ESs sometimes require helicopter emergency medical services (HEMSs). Little is known about their epidemiology, severity, specific injuries and required rescue operations. Our aims were to perform an epidemiological analysis, to identify specific injuries and to describe the characteristic of prehospital procedures in ES accidents requiring HEMSs. This is a retrospective study, reviewing all rescue missions dedicated to ESs provided by HEMS REGA Lausanne, from 1 January 1998 to 31 December 2008. ES were classified into three categories of practice, according to the type of risk at the time of the fall. Among the 616 cases meeting inclusion criteria, 219 (36%) were clearly high-risk ES accidents; 69 (11%) and 328 (53%) were related to potential ES, but with respectively low or indeterminate risk at the time of the fall. In the high-risk ES group, the median age was 32 years and 80% were male. Mortality at 48h was 11%, almost ten times higher than in the other two groups. The proportion of potentially life-threatening injuries (the National Advisory Committee for Aeronautics (NACA) score≥4) was 39% in the high-risk ES group and 13% in the other two groups. Thirty per cent of the cases in the high-risk ES group presented an Injury Severity Score (ISS) >15, compared with 7% in the other groups. Thoracolumbar vertebral fractures were the most common injuries with 32% of all cases having at least one, involving the T12-L2 junction in 56% of cases. The other most frequent injuries were traumatic brain injuries (16%), rib fractures (9%), pneumothorax (8%) and femoral (7%), cervical (7%), ankle (5%) and pelvic (5%) fractures. Median time on site for rescue teams was higher in the confirmed high-risk ES group, with 50% of prehospital missions including at least one environmental difficulty. High-risk ESs led to high-energy accidents, characterized by a large proportion of severe injuries and axial traumas (spine, thorax, pelvis and proximal femur). We identified a considerable percentage of thoracolumbar vertebral fractures, mainly in the T12-L2 junction. HEMSs dedicated to high-risk ESs implied longer and more complex interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. The Salem Smart Power Center: An Assessment of Battery Performance and Economic Potential

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

    Balducci, Patrick J.; Alam, M. J.E.; Viswanathan, Vilayanur

    This paper presents an assessment of the economic potential of a 5 MW/1.25 MWh Energy Storage System (ESS) installed at the Salem Smart Power Center (SSPC), a smart grid technology demonstration facility owned and operated by Portland General Electric (PGE) in Salem, Oregon. The ESS and the grid conditions in which it operates were modeled using Pacific Northwest National Laboratory’s Battery Storage Evaluation Tool (BSET) to explore tradeoffs between services, and to develop optimal control strategies. This assessment monetized the value derived from nine services the SSPC could provide to PGE and the customers it serves. The ESS and themore » grid conditions in which it operates were modeled using PNNL’s in-house optimization tool BSET to explore tradeoffs between services, and to develop optimal control strategies. The analysis resulted in a number of lessons that provide crucial insights into the practical application of ESS, including; The SSPC, which was originally conceived as a research and test facility and built with the prevailing maturity technology level, was built at a cost ($20.4 million) that exceeds current day prices ($5.4 million) for a similarly designed and built 5 MW/1.25 MWh system; In terms of economic operation, the SSPC is currently underutilized, deployed only for primary frequency response. PNNL modeling indicates that optimal operation of the ESS could generate an additional value of $2.3 million over 20 years. It should also be noted that primary frequency response is the highest benefit application but requires a response from the SSPC only 17 hours each year. While optimally engaged, the ESS would provide arbitrage and ancillary services 78 percent of the time, but those services generate only 27 percent of the total value; Participation in Western EIM represents an interesting opportunity for PGE with a potential to generate $2.1 million value in PV terms over 20 years in the 5-min real-time market; With an energy to power ratio of only 0.25, the SSPC is not well suited to engage in most energy-intensive applications such as arbitrage or ancillary services. By upsizing the storage capacity to 5 MWh and 10MWh, the additional value allows the benefits ($13.3 million and 20.3 million, respectively) to exceed the system’s revenue requirements ($11.5 and $16.4 million, respectively). For the SSPC, ROI ratios exceeded 1.0 when the energy to power ratio fell between 0.5 and 3.5, and peaked at an energy to power ratio of 2.0. This report represents the output of the first of a two-phase effort. Phase II will involve the development of enhanced control strategies to assist PGE in realizing the benefits of energy storage in real-time.« less

  20. Sperm competition games: sperm selection by females.

    PubMed

    Ball, M A; Parker, G A

    2003-09-07

    We analyse a co-evolutionary sexual conflict game, in which males compete for fertilizations (sperm competition) and females operate sperm selection against unfavourable ejaculates (cryptic female choice). For simplicity, each female mates with two males per reproductive event, and the competing ejaculates are of two types, favourable (having high viability or success) or unfavourable (where progeny are less successful). Over evolutionary time, females can increase their level of sperm selection (measured as the proportion of unfavourable sperm eliminated) by paying a fecundity cost. Males can regulate sperm allocations depending on whether they will be favoured or disfavoured, but increasing sperm allocation reduces their mating rate. The resolution of this game depends on whether males are equal, or unequal. Males could be equal: each is favoured with probability, p, reflecting the proportion of females in the population that favour his ejaculate (the 'random-roles' model); different males are favoured by different sets of females. Alternatively, males could be unequal: given males are perceived consistently by all females as two distinct types, favoured and disfavoured, where p is now the frequency of the favoured male type in the population (the 'constant-types' model). In both cases, the evolutionarily stable strategy (ESS) is for females initially to increase sperm selection from zero as the viability of offspring from unfavourable ejaculates falls below that of favourable ejaculates. But in the random-roles model, sperm selection decreases again towards zero as the unfavourable ejaculates become disastrous (i.e. as their progeny viability decreases towards zero). This occurs because males avoid expenditure in unfavourable matings, to conserve sperm for matings in the favoured role where their offspring have high viability, thus allowing females to relax sperm selection. If sperm selection is costly to females, ESS sperm selection is high across a region of intermediate viabilities. If it is uncostly, there is no ESS in this region unless sperm limitation (i.e. some eggs fail to be fertilized because sperm numbers are too low) is included into the model. In the constant-types model, no relaxation of sperm selection occurs at very low viabilities of disfavoured male progeny. If sperm selection is sufficiently costly, ESS sperm selection increases as progeny viability decreases down towards zero; but if it is uncostly, there is no ESS at the lowest viabilities, and unlike the random-roles model, this cannot be stabilized by including sperm limitation. Sperm allocations in the ESS regions differ between the two models. With random roles, males always allocate more sperm in the favoured role. With constant types, the male type that is favoured allocates less sperm than the disfavoured type. These results suggests that empiricists studying cryptic female choice and sperm allocation patterns need to determine whether sperm selection is applied differently, or consistently, on given males by different females in the same population.

  1. Screening for Obstructive Sleep Apnea in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force.

    PubMed

    Jonas, Daniel E; Amick, Halle R; Feltner, Cynthia; Weber, Rachel Palmieri; Arvanitis, Marina; Stine, Alexander; Lux, Linda; Harris, Russell P

    2017-01-24

    Many adverse health outcomes are associated with obstructive sleep apnea (OSA). To review primary care-relevant evidence on screening adults for OSA, test accuracy, and treatment of OSA, to inform the US Preventive Services Task Force. MEDLINE, Cochrane Library, EMBASE, and trial registries through October 2015, references, and experts, with surveillance of the literature through October 5, 2016. English-language randomized clinical trials (RCTs); studies evaluating accuracy of screening questionnaires or prediction tools, diagnostic accuracy of portable monitors, or association between apnea-hypopnea index (AHI) and health outcomes among community-based participants. Two investigators independently reviewed abstracts and full-text articles. When multiple similar studies were available, random-effects meta-analyses were conducted. Sensitivity, specificity, area under the curve (AUC), AHI, Epworth Sleepiness Scale (ESS) scores, blood pressure, mortality, cardiovascular events, motor vehicle crashes, quality of life, and harms. A total of 110 studies were included (N = 46 188). No RCTs compared screening with no screening. In 2 studies (n = 702), the screening accuracy of the multivariable apnea prediction score followed by home portable monitor testing for detecting severe OSA syndrome (AHI ≥30 and ESS score >10) was AUC 0.80 (95% CI, 0.78 to 0.82) and 0.83 (95% CI, 0.77 to 0.90), respectively, but the studies oversampled high-risk participants and those with OSA and OSA syndrome. No studies prospectively evaluated screening tools to report calibration or clinical utility for improving health outcomes. Meta-analysis found that continuous positive airway pressure (CPAP) compared with sham was significantly associated with reduction of AHI (weighted mean difference [WMD], -33.8 [95% CI, -42.0 to -25.6]; 13 trials, 543 participants), excessive sleepiness assessed by ESS score (WMD, -2.0 [95% CI, -2.6 to -1.4]; 22 trials, 2721 participants), diurnal systolic blood pressure (WMD, -2.4 points [95% CI, -3.9 to -0.9]; 15 trials, 1190 participants), and diurnal diastolic blood pressure (WMD, -1.3 points [95% CI, -2.2 to -0.4]; 15 trials, 1190 participants). CPAP was associated with modest improvement in sleep-related quality of life (Cohen d, 0.28 [95% CI, 0.14 to 0.42]; 13 trials, 2325 participants). Mandibular advancement devices (MADs) and weight loss programs were also associated with reduced AHI and excessive sleepiness. Common adverse effects of CPAP and MADs included oral or nasal dryness, irritation, and pain, among others. In cohort studies, there was a consistent association between AHI and all-cause mortality. There is uncertainty about the accuracy or clinical utility of all potential screening tools. Multiple treatments for OSA reduce AHI, ESS scores, and blood pressure. Trials of CPAP and other treatments have not established whether treatment reduces mortality or improves most other health outcomes, except for modest improvement in sleep-related quality of life.

  2. Lessons from a Train-the-Trainer Professional Development Program: The Sustainable Trainer Engagement Program (STEP)

    NASA Astrophysics Data System (ADS)

    Shupla, Christine; Gladney, Alicia; Dalton, Heather; LaConte, Keliann; Truxillo, Jeannette; Shipp, Stephanie

    2015-11-01

    The Sustainable Trainer Engagement Program (STEP) is a modified train-the-trainer professional development program being conducted by the Lunar and Planetary Institute (LPI). STEP has provided two cohorts of 6-8th grade science specialists and lead teachers in the Houston region with in-depth Earth and Space Science (ESS) content, activities, and pedagogy over 15 days each, aligned with Texas science standards. This project has two over-arching goals: to improve middle school ESS instruction, and to create and test an innovative model for Train-the-Trainer.This poster will share details regarding STEP’s activities and resources, program achievements, and its main findings to date. STEP is being evaluated by external evaluators at the Research Institute of Texas, part of the Harris County Department of Education. External evaluation shows an increase after one year in STEP participants’ knowledge (cohort 1 showed a 10% increase; cohort 2 showed a 20% increase), confidence in teaching Earth and Space Science effectively (cohort 1 demonstrated a 10% increase; cohort 2 showed a 20% increase), and confidence in preparing other teachers (cohort 1 demonstrated a 12% increase; cohort 2 showed a 20% increase). By September 2015, STEP participants led (or assisted in leading) approximately 40 workshops for about 1800 science teachers in Texas. Surveys of teachers attending professional development conducted by STEP participants show very positive responses, with averages for conference workshop evaluations ranging from 3.6 on a 4 point scale, and other evaluations averaging from 4.1 to 5.0 on a 5 point scale.Main lessons for the team on the train-the-trainer model include: a lack of confidence by leaders in K-12 science education in presenting ESS professional development, difficulties in arranging for school or district content-specific professional development, the minimal duration of most school and district professional development sessions, and uncertainties in partnerships between scientists and educators.

  3. Plasma radiofrequency preceded by pressure recording enhances success for treating sleep-related breathing disorders.

    PubMed

    Tvinnereim, Magne; Mitic, Svetislav; Hansen, Rolf K

    2007-04-01

    Sleep-related breathing disorders (SRBD) that cannot be treated conservatively are commonly treated using uvulopalatopharyngoplasty, although success rates are generally less than 70%. The purpose of this study was to assess a plasma-mediated radiofrequency (RF)-based coblation assisted upper airway procedure (CAUP) to treat SRBD patients determined to have obstruction localized to the upper (mid)-pharyngeal region. Prospective case series (n = 40). Six patients had socially bothersome snoring, and 34 patients had mild to moderate sleep apnea (apnea/hypopnea index [AHI] <20), with the primary level of obstruction (>50%) within the upper pharyngeal region as determined using whole night recordings, including airway pressure fluctuation monitoring (ApneaGraph, MRA-Medical Ltd, Gloucestershire, UK). CAUP consisted of making a lateral palatal incision, ablating three upward channels on each side of the midline (fan-shaped) into the soft palate using a plasma mediated RF-based device (ArthroCare Corporation, Austin, TX), and performing a partial uvulectomy. Clinical outcomes included the Epworth Sleepiness Scale (ESS), partner rating of snoring using a visual analogue scale (VAS), and night-time apnea and hypopnea events (AHI, hypopnea index [HI], apnea index [AI]). Patients were 28 to 68 (46 +/- 12) years old; 28 (70%) were male. Preoperatively, clinical assessment scores (median +/- interquartile range) were as follows: ESS (11.0 +/- 3.0), VAS (8.15 +/- 1.00), AHI (9.58 +/- 5.58), HI (9.00 +/- 5.29), AI (0.333 +/- 0.625). After CAUP, no postoperative scarring, fibrosis, or any other clinically significant side effects were observed. Postoperatively (9.1 +/- 1.5; 7-15 mo), ESS (4.0 +/- 1.0), VAS (2.70 +/- 1.38), AHI (3.75 +/- 2.92), HI (3.58 +/- 2.50), and AI (0.167 +/- 0.167) were significantly improved (P < .001). CAUP preceded by site-specific obstruction diagnosis using pressure recording is a well-tolerated outpatient treatment that is well suited for treating SRBD.

  4. Handbook of Modeling for Circuit Analysis Including Radiation Effects

    DTIC Science & Technology

    1979-05-01

    appropriate chapter’s. ithis handbook is the Cuhlifnation of several years,’ eftort by many persons and orljan i’- la tions in modeliing of semi conductor...o . t ’ LA 4 - 11-13 ,* ’ C i0 S0 ,i i *e=S...S.. * * - a ’ta (a* * to LA - C 0 𔃺 (a 0. 40 2Z - 𔃾- - 0 * La C 0 40to E Ct, C C V to V * 5- - - 0% * .- * S * * C * a -, * 4 . V - * L

  5. Ramelteon for Insomnia Symptoms in a Community Sample of Adults with Generalized Anxiety Disorder: An Open Label Study

    PubMed Central

    Gross, Paul K.; Nourse, Rosemary; Wasser, Thomas E.

    2009-01-01

    Objective: Prior research confirms the relationship between insomnia and psychiatric disorders, particularly anxiety and depression. The effectiveness and tolerability of ramelteon was examined in adult generalized anxiety disorder (GAD) patients with insomnia symptoms. Methods: Twenty-seven adults with sleep disturbance meeting DSM-IV diagnostic criteria for GAD and partially responsive on an SSRI or SNRI by randomization visit (as signified by a Hamilton Anxiety scale [HAMA] maximum score of 15 and minimum of 8, Clinical Global Impressions Severity of Illness [CGI-S] scale of ≤ 4 and ≥ 2 [measuring anxiety symptoms], CGI-S of ≥ 4 [measuring insomnia symptoms], ≥ 5 on the Pittsburgh Sleep Quality Index [PSQI], and ≥ 10 on the Epworth Sleepiness Scale [ESS]) were treated openly for 10 weeks on ramelteon 8 mg at bedtime. Analysis was conducted using repeated measures methodology. Patient reported sleep diaries were maintained throughout the study. Results: Significant symptom reduction was observed on all scales (HAMA, ESS, CGI-I, CGI-S), with subjects falling asleep faster and sleeping longer. Headache upon stopping ramelteon, daytime tiredness, agitation, and depression were the most commonly reported side effects and were cited as transient. Conclusion: Data from this 12-week open-label study suggests ramelteon is an effective and generally well tolerated treatment for insomnia symptoms in this community sample of adults with GAD. Citation: Gross PK; Nourse R; Wasser TE. Ramelteon for insomnia symptoms in a community sample of adults with generalized anxiety disorder: an open label study. J Clin Sleep Med 2009;5(1):28–33. PMID:19317378

  6. Contribution of Benson's Relaxation Technique and Brief Psycho-Educational Intervention on Quality of Life of Primary Caregivers of Iranian Children with Chronic Diseases.

    PubMed

    Mowla, Forough; Khanjari, Sedigheh; Inanlou, Mehrnoush

    Chronic diseases leave a significant effect on not only the afflicted children but also their parents. Chronic diseases in children may also influence their parents' or primary caregivers' quality of life (QoL). To determine the effectiveness of a Brief Psycho-educational Intervention (BPI) and Benson's Relaxation Technique (BRT) on the QoL of primary caregivers of children with chronic diseases. The present quasi-experimental pre-test post-test design was conducted on 100 parents with children who had one chronic disease (50 in each of the control and intervention groups) and were admitted to two state-run pediatric hospitals in Tehran, Iran in 2014. The primary caregivers' QoL was assessed using the SF-36 questionnaire before (T1) and four weeks after the intervention (T2). The training was done in four 60-70minute sessions over one week with a 4-week follow-up. Paired t-test, independent t-test, chi-square and Fisher's exact tests were used to analyze the data. On average, large effect sizes (ES≥0.80) were observed after interventions in SF-36 subscales that measured the effect of emotional roles. Small (0.20-0.49) to moderate (0.50-0.79) ESs were found in subscales measuring physical functioning, physical-role, bodily pain, vitality, social functioning and mental health. General health scores remained relatively unchanged at T2. These results suggested that BPI and BRT were effective strategies to improve the QoL of primary caregivers. Furthermore, interventions with low cost, and good safety and outcome could improve the QoL of primary caregivers of children with chronic diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. School-based intervention for childhood disruptive behavior in disadvantaged settings: a randomized controlled trial with and without active teacher support.

    PubMed

    Liber, Juliette M; De Boo, Gerly M; Huizenga, Hilde; Prins, Pier J M

    2013-12-01

    In this randomized controlled trial, we investigated the effectiveness of a school-based targeted intervention program for disruptive behavior. A child-focused cognitive behavioral therapy (CBT) program was introduced at schools in disadvantaged settings and with active teacher support (ATS) versus educational teacher support (ETS) (CBT + ATS vs. CBT + ETS). Screening (n = 1,929) and assessment (n = 224) led to the inclusion of 173 children ages 8-12 years from 17 elementary schools. Most of the children were boys (n = 136, 79%) of low or low-to-middle class socioeconomic status (87%); the sample was ethnically diverse (63% of non-Western origin). Children received CBT + ATS (n = 29) or CBT + ETS (n = 41) or were entered into a waitlist control condition (n = 103) to be treated afterward (CBT + ATS, n = 39, and CBT + ETS, n = 64). Effect sizes (ES), clinical significance (reliable change), and the results of multilevel modeling are reported. Ninety-seven percent of children completed treatment. Teachers and parents reported positive posttreatment effects (mean ES = .31) for CBT compared with the waitlist control condition on disruptive behavior. Multilevel modeling showed similar results. Clinical significance was modest. Changes had remained stable or had increased at 3-months follow-up (mean ES = .39). No consistent effect of teacher condition was found at posttreatment; however, at follow-up, children who received ETS fared significantly better. This study shows that a school-based CBT program is beneficial for difficult-to-reach children with disruptive behavior: The completion rate was remarkably high, ESs (mean ES = .31) matched those of previous studies with targeted intervention, and effects were maintained or had increased at follow-up.

  8. Bilateral Endoscopic Medial Maxillectomy for Bilateral Inverted Papilloma

    PubMed Central

    Kodama, Satoru; Kawano, Toshiaki; Suzuki, Masashi

    2012-01-01

    Inverted papilloma (IP) is a benign tumor of the nasal cavity and paranasal sinuses that is unilateral in most cases. Bilateral IP, involving both sides of the nasal cavity and sinuses, is extremely rare. This paper describes a large IP that filled in both sides of the nasal cavity and sinuses, mimicking association with malignancy. The tumor was successfully treated by bilateral endoscopic medial maxillectomy (EMM). The patient is without evidence of the disease 24 months after surgery. If preoperative diagnosis does not confirm the association with malignancy in IP, endoscopic sinus surgery (ESS) should be selected, and ESS, including EMM, is a good first choice of the treatment for IP. PMID:22953103

  9. Crop-phenology and LANDSAT-based irrigated lands inventory in the high plains. [Texas, New Mexico, Oklahma, Kansas, Colorado, Nebraska, Wyoming, and South Dakota

    NASA Technical Reports Server (NTRS)

    Martinko, E. A. (Principal Investigator); Poracsky, J.; Kipp, E. R.; Krieger, H.

    1981-01-01

    Crop calendars for 1979 and 1980 were investigated in support of an effort to develop techniques for mapping the High Plains aquifer region. Optimal LANDSAT image dates for 1980 were preliminarily identified based on ESS weekly crop weather reports and 1979 ESS agricultural statistics were entered into the computer. A questionnaire was compiled and sent to ASCS county agents with the approval of the Extension Directors in each state involved. Data from returning questionnaires were tabulated and development started on a set of computer programs to allow the preparation of computer assisted graphic displays of much of the collected data.

  10. ISHN Ion Source Control System. First Steps Toward an EPICS Based ESS-Bilbao Accelerator Control System

    NASA Astrophysics Data System (ADS)

    Eguiraun, M.; Jugo, J.; Arredondo, I.; del Campo, M.; Feuchtwanger, J.; Etxebarria, V.; Bermejo, F. J.

    2013-04-01

    ISHN (Ion Source Hydrogen Negative) consists of a Penning type ion source in operation at ESS-Bilbao facilities. From the control point of view, this source is representative of the first steps and decisions taken towards the general control architecture of the whole accelerator to be built. The ISHN main control system is based on a PXI architecture, under a real-time controller which is programmed using LabVIEW. This system, with additional elements, is connected to the general control system. The whole system is based on EPICS for the control network, and the modularization of the communication layers of the accelerator plays an important role in the proposed control architecture.

  11. The South Carolina Amazing Coast Program: Using Ocean Sciences to Address Next Generation Science Standards in Grades 3-5

    NASA Astrophysics Data System (ADS)

    Bell, E. V.; Thomas, C.; Weiss, B.; Bliss, A.; Spence, L.

    2013-12-01

    The Next Generation Science Standards (NGSS) are more inclusive of ocean sciences than the National Science Standards and respective state science standards. In response, the Center for Ocean Sciences Education Excellence-SouthEast (COSEE SE) is piloting the South Carolina's Amazing Coast (SCAC) program: a three-year initiative that incorporates ocean science concepts in grades 3-5 with the goals of addressing NGSS, STEM (science-technology-engineering-math) disciplines, and inquiry skills. The SCAC program targeted two Charleston County, South Carolina elementary schools that were demographically similar: Title 1 status (75% free or reduced lunch), > 90% African American student population, grade level size <55, and proximity to tidal salt marsh or barrier islands (< 2 miles). Fourteen teachers and approximately 240 students participated in the SCAC program between 2010 and 2013. The SCAC framework uses a scaffolding and multi-pronged approach for teacher professional development and student engagement. The scaffolding approach to curriculum implementation focuses on one grade level per year (Year 1 = 3rd; Year 2 = 4th, and Year 3 = 5th), thus building student and teacher literacy in ocean sciences. The coach-mentor model of teacher professional development was also used for the implementation of the program which differs from the traditional 'train the trainer' method in allowing for more frequent and consistent interaction by COSEE SE staff with the students and teachers during the school year. The coach mentor model enabled the creation of a community of practice where teachers served as both learners and practitioners of student learning. Methods for student engagement aligned with the NGSS and included hands-on classroom activities, use of 'hook' species such as loggerhead sea turtles (Caretta caretta), diamondback terrapins (Malaclemys terrapin) and smooth cord grass (Spartina alterniflora), field experiences to explore local ecosystems, interactions with marine scientists, and a capstone project incorporating STEM and inquiry skills. Specifically, third grade students learn about coastal habitats, animal and plant adaptations, and human impacts to the environment, and engage in a salt marsh restoration capstone project. This part of the curriculum aligns with the NGSS Core Ideas 3-LS1, 3-LS3, 3-LS4, 3-ESS3. The fourth grade students learn about weather, organism responses to the environment, and engage in a weather buoy construction capstone project. This part of the curriculum aligns with the NGSSS Core Ideas 4-LS1, 4-ESS2, 4-ESS3, 3-5-ETS1. In 5th grade, students focus specifically on the ocean ecosystem, human impacts on the environment and engage in a capstone project of designing and constructing remotely operated vehicles. This part of the curriculum aligns with NGSS Core Ideas 5-PS2, 5-LS1, 5-LS2, 5-ESS2, 3-5-ETS1. Initial evaluation results indicate that the SCAC teachers value the coach mentor approach for teacher professional development as well as the impact of field based experiences, place-based learning, and a culminating capstone project on student learning. Teacher feedback also indicates elements of sustainability that extend beyond the scope of the pilot project.These initial evaluation results poise the SCAC curriculum to be replicated in other southeastern states.

  12. A multicenter evaluation of oral pressure therapy for the treatment of obstructive sleep apnea.

    PubMed

    Colrain, Ian M; Black, Jed; Siegel, Lawrence C; Bogan, Richard K; Becker, Philip M; Farid-Moayer, Mehran; Goldberg, Rochelle; Lankford, D Alan; Goldberg, Andrew N; Malhotra, Atul

    2013-09-01

    We aimed to evaluate the impact of a novel noninvasive oral pressure therapy (OPT) (Winx®, ApniCure) system on polysomnographic measures of sleep-disordered breathing, sleep architecture, and sleep stability in obstructive sleep apnea (OSA). A 4-week, multicenter, prospective, open-label, randomized, crossover, first-night order of control vs treatment, single-arm trial was conducted in five American Academy of Sleep Medicine (AASM) - accredited sleep clinics and one research laboratory. Sixty-three subjects (analysis cohort) were studied from a screening cohort of 367 subjects. The analysis cohort was 69.8% men, ages 53.6±8.9 years (mean±SD), body mass index of 32.3±4.5kg/m(2), with mild to severe OSA. At treatment initiation, subjects received random assignment to one night with and one without (control) treatment, and they were assessed again following 28 nights of treatment. Breathing and sleep architecture were assessed each night based on blind scoring by a single centralized scorer using AASM criteria. Average nightly usage across the take-home period was 6.0±1.4h. There were no severe or serious device-related adverse events (AEs). Median apnea-hypopnea index (AHI) was 27.5 events per hour on the control night, 13.4 events per hour on the first treatment night, and 14.8 events per hour after 28days of treatment. A clinically significant response (treatment AHI ⩽10/h and ⩽50% of control values) was seen in 20 of the 63 subjects evaluated. Rapid eye movement percentage (REM%) was significantly increased, and N1%, stage shifts to N1 sleep, overall stage shifts, total awakenings, and arousals per hour were all significantly reduced at both treatment nights compared to controls. Mean Epworth sleepiness scale (ESS) was significantly reduced from 12.1 to 8.6 (Cohen d effect size, 0.68) in those untreated for two or more weeks prior to OPT study participation and remained unchanged in subjects who directly switched from continuous positive airway pressure (CPAP) therapy to OPT. Clinically significant improvements in sleep quality and continuity, AHI, ODI, ESS, and overall clinical status were achieved in an easily identified subgroup. OPT was safe and well-tolerated and nightly usage was high. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Single versus multiple sets of resistance exercise: a meta-regression.

    PubMed

    Krieger, James W

    2009-09-01

    There has been considerable debate over the optimal number of sets per exercise to improve musculoskeletal strength during a resistance exercise program. The purpose of this study was to use hierarchical, random-effects meta-regression to compare the effects of single and multiple sets per exercise on dynamic strength. English-language studies comparing single with multiple sets per exercise, while controlling for other variables, were considered eligible for inclusion. The analysis comprised 92 effect sizes (ESs) nested within 30 treatment groups and 14 studies. Multiple sets were associated with a larger ES than a single set (difference = 0.26 +/- 0.05; confidence interval [CI]: 0.15, 0.37; p < 0.0001). In a dose-response model, 2 to 3 sets per exercise were associated with a significantly greater ES than 1 set (difference = 0.25 +/- 0.06; CI: 0.14, 0.37; p = 0.0001). There was no significant difference between 1 set per exercise and 4 to 6 sets per exercise (difference = 0.35 +/- 0.25; CI: -0.05, 0.74; p = 0.17) or between 2 to 3 sets per exercise and 4 to 6 sets per exercise (difference = 0.09 +/- 0.20; CI: -0.31, 0.50; p = 0.64). There were no interactions between set volume and training program duration, subject training status, or whether the upper or lower body was trained. Sensitivity analysis revealed no highly influential studies, and no evidence of publication bias was observed. In conclusion, 2 to 3 sets per exercise are associated with 46% greater strength gains than 1 set, in both trained and untrained subjects.

  14. A sled push stimulus potentiates subsequent 20-m sprint performance.

    PubMed

    Seitz, Laurent B; Mina, Minas A; Haff, G Gregory

    2017-08-01

    The objective of this study was to examine the potentiating effects of performing a single sprint-style sled push on subsequent unresisted 20m sprint performance. Randomized crossover design. Following a familiarization session, twenty rugby league players performed maximal unresisted 20m sprints before and 15s, 4, 8 and 12min after a single sled push stimulus loaded with either 75 or 125% body mass. The two sled push conditions were performed in a randomized order over a one-week period. The fastest sprint time recorded before each sled push was compared to that recorded at each time point after to determine the post-activation potentiation (PAP) effect. After the 75% body mass sled push, sprint time was 0.26±1.03% slower at the 15s time point (effect size [ES]=0.07) but faster at the 4 (-0.95±2.00%; ES=-0.22), 8 (-1.80±1.43%; ES=-0.42) and 12 (-1.54±1.54%; ES=-0.36)min time points. Sprint time was slower at all the time points after the 125% body mass sled (1.36±2.36%-2.59±2.90%; ESs=0.34-0.64). Twenty-meter sprint performance is potentiated 4-12min following a sled push loaded with 75% body mass while it is impaired after a 125% body mass sled. These results are of great importance for coaches seeking to potentiate sprint performance with the sled push exercise. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  15. Assortment of encounters and evolution of cooperativeness.

    PubMed

    Eshel, I; Cavalli-Sforza, L L

    1982-02-01

    The method of evolutionary stable strategies (ESS), in its current form, is confronted with a difficulty when it tries to explain how some social behaviors initiate their evolution. We show that this difficulty may be removed by changing the assumption made tacitly in game theory (and in ESS) of randomness of meetings or encounters. In reality, such randomness seems to be rare in nature. Family, population and social structure, customs, and habits impose various types of deviation from randomness. Introducing nonrandomness of meeting in a way formally similar to assortative mating, we show that the bar to initial increase of inherited cooperative or altruistic behaviors can be removed, provided there is sufficient assortment of meetings. Family structure may cause contacts predominantly between certain types of relatives, and one can reconstruct some results of classical kin selection in terms of evolutionary stable strategy with assortative meetings. Neighbor effects and group selection might be similarly treated. Assortment need not be a passive consequence of population and social structure, but it can also be actively pursued. Behaviors favoring the choice of cooperative companions will have the effect of favoring the evolution of cooperativeness. It can be shown that discrimination in the choice of companions, especially if combined with assortment, can favor the development of cooperativeness, making initial increase of cooperative behavior possible even at levels of assortment passively imposed which would not be adequate, per se, to guarantee the increase of cooperativeness. It is possible that, in some cases, cooperativeness and behavior favoring some type of assortment are coselected.

  16. Which Instructional Practices Most Help First Grade Students with and without Mathematics Difficulties?

    PubMed Central

    Morgan, Paul L.; Farkas, George; Maczuga, Steve

    2015-01-01

    We used population-based, longitudinal data to investigate the relation between mathematics instructional practices used by 1st grade teachers in the U.S. and the mathematics achievement of their students. Factor analysis identified four types of instructional activities (i.e., teacher-directed, student-centered, manipulatives/calculators, movement/music) and eight types of specific skills taught (e.g., adding two-digit numbers). First-grade students were then classified into five groups on the basis of their fall and/or spring of kindergarten mathematics achievement—three groups with mathematics difficulties (MD) and two without MD. Regression analysis indicated that a higher percentage of MD students in 1st grade classrooms was associated with greater use by teachers of manipulatives/calculators and movement/music to teach mathematics. Yet follow-up analysis for each of the MD and non-MD groups indicated that only teacher-directed instruction was significantly associated with the achievement of students with MD (covariate-adjusted ESs = .05–.07). The largest predicted effect for a specific instructional practice was for routine practice and drill. In contrast, for both groups of non-MD students, teacher-directed and student-centered instruction had approximately equal, statistically significant positive predicted effects (covariate-adjusted ESs = .03–.04). First-grade teachers in the U.S. may need to increase their use of teacher-directed instruction if they are to raise the mathematics achievement of students with MD. PMID:26180268

  17. Comparison on the efficacy of dexpanthenol in sea water and saline in postoperative endoscopic sinus surgery.

    PubMed

    Fooanant, Supranee; Chaiyasate, Saisawat; Roongrotwattanasiri, Kannika

    2008-10-01

    To compare the efficacy of dexpanthenol spray and saline irrigation in the postoperative care of sinusitis patients following endoscopic sinus surgery (ESS). One hundred twenty eight sinusitis patients undergoing ESS were randomly allocated to receive dexpanthenol spray (Mar plus) or saline irrigation twice a day for 4 weeks after the operation. Total nasal symptom score, crusting, infection, compliance, and patient satisfaction were evaluated at 1, 2-3, 4-6, and 12 weeks. Mucociliary clearance was assessed with the saccharin test before ESS and at the last visit. One hundred ten patients remained at the present study termination. Chi-square test and Mann-Whitney U test were employed. Total nasal symptom score, mucociliary clearance, and infection improved in both groups after the operation. The dexpanthenol group resulted in a better mucociliary clearance than saline irrigation (9.93 +/- 6.04 vs. 12.38 +/- 9.32 min, p = 0.43). Saline irrigation resulted in a greater reduction of post nasal drip than dexpanthenol at the first visit (74% vs. 87%, p = 0.04). Compliance and patient satisfaction were comparable. The efficacy of dexpanthenol was comparable to nasal saline irrigation in the postoperative care of sinusitis patients following endoscopic sinus surgery. Dexpanthenol is an alternative treatment, which may be useful in young children and complicated cases.

  18. Translation, cultural adaptation, and validation of the Sleep Apnea Quality of Life Index (SAQLI) in Persian-speaking patients with obstructive sleep apnea.

    PubMed

    Rahavi-Ezabadi, Sara; Amali, Amin; Sadeghniiat-Haghighi, Khosro; Montazeri, Ali; Nedjat, Saharnaz

    2016-05-01

    The aim of this study was the translation, cross-cultural adaptation, and validation of the Sleep Apnea Quality of Life Index (SAQLI) in Persian-speaking patients with obstructive sleep apnea (OSA). Ninety-six patients with OSA completed a series of questionnaires including SAQLI, Epworth Sleepiness Scale (ESS),10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10), and Medical Outcome Survey Short form 12 (SF-12) for assessment of reliability, validity, and responsiveness of Persian version of SAQLI. The Persian version of SAQLI had a very good internal consistency and also demonstrated good test-retest reliability. Concurrent validity was confirmed by significant correlations with ESS, FOSQ-10 and SF-12 subscale scores. Comparison of SAQLI scores in groups of patients categorized by ESS showed the high discriminative power of this instrument. However, there was no significant difference in the SAQLI scores of patients with mild, moderate, and severe sleep apnea. The results of sensitivity to change verified that the SAQLI was able to detect changes after continuous positive airway pressure (CPAP) treatment. The findings of this study indicate that the Persian version of SAQLI is a reliable, valid, and responsive measure for evaluation of quality of life in patients with OSA.

  19. Spatial assessment of land degradation through key ecosystem services: The role of globally available data.

    PubMed

    Cerretelli, Stefania; Poggio, Laura; Gimona, Alessandro; Yakob, Getahun; Boke, Shiferaw; Habte, Mulugeta; Coull, Malcolm; Peressotti, Alessandro; Black, Helaina

    2018-07-01

    Land degradation is a serious issue especially in dry and developing countries leading to ecosystem services (ESS) degradation due to soil functions' depletion. Reliably mapping land degradation spatial distribution is therefore important for policy decisions. The main objectives of this paper were to infer land degradation through ESS assessment and compare the modelling results obtained using different sets of data. We modelled important physical processes (sediment erosion and nutrient export) and the equivalent ecosystem services (sediment and nutrient retention) to infer land degradation in an area in the Ethiopian Great Rift Valley. To model soil erosion/retention capability, and nitrogen export/retention capability, two datasets were used: a 'global' dataset derived from existing global-coverage data and a hybrid dataset where global data were integrated with data from local surveys. The results showed that ESS assessments can be used to infer land degradation and identify priority areas for interventions. The comparison between the modelling results of the two different input datasets showed that caution is necessary if only global-coverage data are used at a local scale. In remote and data-poor areas, an approach that integrates global data with targeted local sampling campaigns might be a good compromise to use ecosystem services in decision-making. Copyright © 2018. Published by Elsevier B.V.

  20. Comparison of surgical conditions following premedication with oral clonidine versus oral diazepam for endoscopic sinus surgery: A randomized, double-blinded study

    PubMed Central

    Bhat Pai, Rohini V; Badiger, Santhoshi; Sachidananda, Roopa; Basappaji, Santhosh Mysore Chandramouli; Shanbhag, Raghunath; Rao, Raghavendra

    2016-01-01

    Background and Aims: Endoscopic sinus surgery (ESS) provides a challenge and an opportunity to the anesthesiologists to prove their mettle and give the surgeons a surgical field which can make their delicate surgery safer,more precise and faster. The aim of the study was to evaluate the surgical field and the rate of blood loss in patients premedicated with oral clonidine versus oral diazepam for endoscopic sinus surgery. Material and Methods: ASA I or II patients who were scheduled to undergo ESS were randomly allocated to group D (n = 30) or group C (n = 30). The patients' vital parameters, propofol infusion rate, and rate of blood loss were observed and calculated. The surgeon, who was blinded, rated the visibility of the surgical field from grade 0-5. Results: In the clonidine group, the rate of blood loss, the surgical time, propofol infusion rate was found to be statistically lower as compared to the diazepam group. Also a higher number of patients in the clonidine group had a better surgical score (better surgical field) than the diazepam group and vice versa. Conclusions: Premedication with clonidine as compared to diazepam, provides a better surgical field with less blood loss in patients undergoing ESS. PMID:27275059

  1. Building Climate Resilience in the Blue Nile/Abay Highlands: A Role for Earth System Sciences

    PubMed Central

    Zaitchik, Benjamin F.; Simane, Belay; Habib, Shahid; Anderson, Martha C.; Ozdogan, Mutlu; Foltz, Jeremy D.

    2012-01-01

    The Blue Nile (Abay) Highlands of Ethiopia are characterized by significant interannual climate variability, complex topography and associated local climate contrasts, erosive rains and erodible soils, and intense land pressure due to an increasing population and an economy that is almost entirely dependent on smallholder, low-input agriculture. As a result, these highland zones are highly vulnerable to negative impacts of climate variability. As patterns of variability and precipitation intensity alter under anthropogenic climate change, there is concern that this vulnerability will increase, threatening economic development and food security in the region. In order to overcome these challenges and to enhance sustainable development in the context of climate change, it is necessary to establish climate resilient development strategies that are informed by best-available Earth System Science (ESS) information. This requirement is complicated by the fact that climate projections for the Abay Highlands contain significant and perhaps irreducible uncertainties. A critical challenge for ESS, then, is to generate and to communicate meaningful information for climate resilient development in the context of a highly uncertain climate forecast. Here we report on a framework for applying ESS to climate resilient development in the Abay Highlands, with a focus on the challenge of reducing land degradation. PMID:22470302

  2. The Economic Value of the Greater Montreal Blue Network (Quebec, Canada): A Contingent Choice Study Using Real Projects to Estimate Non-Market Aquatic Ecosystem Services Benefits

    PubMed Central

    Dupras, Jérôme; Fetue Ndefo, Franck; He, Jie

    2016-01-01

    This study used a contingent choice method to determine the economic value of improving various ecosystem services (ESs) of the Blue Network of Greater Montreal (Quebec, Canada). Three real projects were used and the evaluation focused on six ESs that are related to freshwater aquatic ecosystems: biodiversity, water quality, carbon sequestration, recreational activities, landscape aesthetics and education services. We also estimated the value associated with the superficies of restored sites. We calculated the monetary value that a household would be willing to pay for each additional qualitative or quantitative unit of different ESs, and these marginal values range from $0.11 to $15.39 per household per unit. Thus, under certain assumptions, we determined the monetary values that all Quebec households would allocate to improve each ES in Greater Montreal by one unit. The most valued ES was water quality ($13.5 million), followed by education services ($10.7 million), recreational activities ($8.9 million), landscape aesthetics ($4.1 million), biodiversity ($1.2 million), and carbon sequestration ($0.1 million). Our results ascribe monetary values to improved (or degraded) aquatic ecosystems in the Blue Network of Greater Montreal, but can also enhance economic analyses of various aquatic ecosystem restoration and management projects. PMID:27513558

  3. Shame and Anxiety Feelings of a Roma Population in Greece.

    PubMed

    Gouva, M; Mentis, M; Kotrotsiou, S; Paralikas, Th; Kotrotsiou, E

    2015-12-01

    Shame is a crucial issue for Roma. The purpose of the present study was to evaluate the severity of shame and anxiety feelings in a Roma population living in Greece and assess the differentiation of these feelings between Roma men and women. A quota sample of 194 Roma adult men and women living in Southern Greece was retrieved. The Experiences of Shame Scale (ESS), the Other As Shamer Scale (OAS) and the Spielberg's State/Trait Anxiety Inventory (STAI) questionnaires were used. Women scored statistically significantly higher than men on ESS, whereas men scored higher on OAS scale (52.27 ± 16.91 vs 45.42 ± 9.98 and 35.93 ± 16.94 vs 30.87 ± 13.72 respectively). Women scored higher than men in both STAI subscales, however significant differences were observed only in State Anxiety scale (48.83 ± 9.26 vs 43.20 ± 9.81). OAS total score was inversely related to state anxiety, whereas ESS total score was positive related to trait anxiety, all correlations being significant at p < 0.05 level. Roma men and women exhibit high levels of shame and anxiety. Cultural, social and minority issues contribute to feelings of inferiority and anxiety experience.

  4. The Economic Value of the Greater Montreal Blue Network (Quebec, Canada): A Contingent Choice Study Using Real Projects to Estimate Non-Market Aquatic Ecosystem Services Benefits.

    PubMed

    Poder, Thomas G; Dupras, Jérôme; Fetue Ndefo, Franck; He, Jie

    2016-01-01

    This study used a contingent choice method to determine the economic value of improving various ecosystem services (ESs) of the Blue Network of Greater Montreal (Quebec, Canada). Three real projects were used and the evaluation focused on six ESs that are related to freshwater aquatic ecosystems: biodiversity, water quality, carbon sequestration, recreational activities, landscape aesthetics and education services. We also estimated the value associated with the superficies of restored sites. We calculated the monetary value that a household would be willing to pay for each additional qualitative or quantitative unit of different ESs, and these marginal values range from $0.11 to $15.39 per household per unit. Thus, under certain assumptions, we determined the monetary values that all Quebec households would allocate to improve each ES in Greater Montreal by one unit. The most valued ES was water quality ($13.5 million), followed by education services ($10.7 million), recreational activities ($8.9 million), landscape aesthetics ($4.1 million), biodiversity ($1.2 million), and carbon sequestration ($0.1 million). Our results ascribe monetary values to improved (or degraded) aquatic ecosystems in the Blue Network of Greater Montreal, but can also enhance economic analyses of various aquatic ecosystem restoration and management projects.

  5. Morphological and immunohistochemical diversity of endometrial stromal sarcoma in rats.

    PubMed

    Kumabe, Shino; Sato, Junko; Tomonari, Yuki; Takahashi, Miwa; Inoue, Kaoru; Yoshida, Midori; Doi, Takuya; Wako, Yumi; Tsuchitani, Minoru

    2018-04-01

    To clarify the histopathological characteristics of rat endometrial stromal sarcoma (ESS), we morphologically reviewed 12 malignant uterine tumors protruding into the lumen in previous rat carcinogenicity studies. The 12 cases were classified into the following 6 types based on their morphological features: spindle cell and collagen rich type, pleomorphic/spindle cell and compact type, decidual alteration type, histiocytic and multinucleated giant cell mixture type, Antoni A-type schwannoma type, and Antoni B-type schwannoma type. Immunohistochemically, tumor cells in all cases exhibited focal or diffuse positive reactions for vimentin, and 11 of the 12 cases were positive for S-100. Interestingly, 9 cases were positive for desmin or αSMA, indicating tumor cells expressing smooth muscle properties. Both Antoni A- and B-type schwannoma types showed low reactions for both muscle markers. Positive results for estrogen receptor α in the 11 cases suggested that they were derived from endometrial stromal cells. On the basis of their immunohistochemical profiles, they were considered to be derived from endometrial stromal cells while they showed morphological variation. The detection of a basement membrane surrounding tumor cells might not be a definitive indicator for differential diagnosis of ESS from malignant schwannoma. In conclusion, ESS could exhibit wide morphological and immunohistochemical variation including features of schwannoma or smooth muscle tumor.

  6. Review-of-systems questionnaire as a predictive tool for psychogenic nonepileptic seizures.

    PubMed

    Robles, Liliana; Chiang, Sharon; Haneef, Zulfi

    2015-04-01

    Patients with refractory epilepsy undergo video-electroencephalography for seizure characterization, among whom approximately 10-30% will be discharged with the diagnosis of psychogenic nonepileptic seizures (PNESs). Clinical PNES predictors have been described but in general are not sensitive or specific. We evaluated whether multiple complaints in a routine review-of-system (ROS) questionnaire could serve as a sensitive and specific marker of PNESs. We performed a retrospective analysis of a standardized ROS questionnaire completed by patients with definite PNESs and epileptic seizures (ESs) diagnosed in our adult epilepsy monitoring unit. A multivariate analysis of covariance (MANCOVA) was used to determine whether groups with PNES and ES differed with respect to the percentage of complaints in the ROS questionnaire. Tenfold cross-validation was used to evaluate the predictive error of a logistic regression classifier for PNES status based on the percentage of positive complaints in the ROS questionnaire. A total of 44 patients were included for analysis. Patients with PNESs had a significantly higher number of complaints in the ROS questionnaire compared to patients with epilepsy. A threshold of 17% positive complaints achieved a 78% specificity and 85% sensitivity for discriminating between PNESs and ESs. We conclude that the routine ROS questionnaire may be a sensitive and specific predictive tool for discriminating between PNESs and ESs. Published by Elsevier Inc.

  7. Evaluation of obstructive sleep apnea in obese patients scheduled for bariactric surgery.

    PubMed

    Lopes Neto, José Maurício; Brandão, Leandro Ortega; Loli, Alessandra; Leite, Celso Vieira de Souza; Weber, Silke Anna Theresa

    2013-04-01

    To evaluate the frequency of obstructive sleep apnea (OSA) in obese patients scheduled for bariatric surgery and their identification for risk of OSA by Berlin Questionnaire (BQ) and excessive daytime sleepiness by Epworth Sleepiness Scale (ESS). Fifty nine patients were evaluated by BQ and ESS. Out of these individuals, 35 performed a full-night sleep study using a type 3 portable monitoring (PM). The questionnaire results were compared for gender and BMI. The presence and severity of OSA was correlated with gender and both questionnaires. 94.75% of the respondents presented high risk for OSA by BQ and 59.65% presented positivity by ESS. Taking into account the AHI> 5 per hour for OSA diagnosis, all of them presented OSA, average AHI of 45.31 ± 26.3 per hour and 68.6% have severe OSA (AHI>30). The male patients had a higher AHI (p<0.05). There was a positive correlation between the positivity in both questionnaires as well as the severity of OSA measured by AHI (p<0.05). The frequency and severe obstructive sleep apnea in the studied group is high. The Berlin Questionnaire and Epworth Sleepiness Scale had a positive correlation with the diagnosis of OSA in the group studied.

  8. Excessive Daytime sleepiness in idiopathic restless legs syndrome: characteristics and evolution under dopaminergic treatment.

    PubMed

    Kallweit, Ulf; Siccoli, Massimiliano M; Poryazova, Rositsa; Werth, Esther; Bassetti, Claudio L

    2009-01-01

    Whereas insomnia is frequent in restless legs syndrome (RLS), little is known about daytime sleepiness. We studied a series of 27 consecutive patients with idiopathic RLS in order to identify the characteristics and evolution of excessive daytime sleepiness (EDS) under dopaminergic treatment. Patients were assessed by clinical examination, questionnaires and video-polysomnography (PSG). Sleepy patients, as defined by Epworth Sleepiness Scale (ESS) >10, were also assessed by the multiple sleep latency test (MSLT). We excluded RLS patients with other sleep-wake disorders, in particular chronic sleep deprivation. Mean age was 56 years, the mean International RLS Study Group Rating Scale score was 24 at baseline. Ten (37%) of the 27 patients reported EDS. RLS patients with sleepiness had a higher amount of total sleep time (p = 0.029) on PSG and a mean sleep latency of 6.4 min on MSLT. No other differences regarding clinical or polysomnographic parameters were found. RLS severity improved in all patients under dopaminergic treatment (p = 0.001); this was also the case for the ESS score in sleepy patients (p = 0.007). In our series of RLS patients, EDS was common, characterized by longer sleep (PSG) and reduced sleep latencies on MSLT. Under dopaminergic treatment, both RLS severity and ESS improved. Copyright 2009 S. Karger AG, Basel.

  9. Large-Scale Features of Pliocene Climate: Results from the Pliocene Model Intercomparison Project

    NASA Technical Reports Server (NTRS)

    Haywood, A. M.; Hill, D.J.; Dolan, A. M.; Otto-Bliesner, B. L.; Bragg, F.; Chan, W.-L.; Chandler, M. A.; Contoux, C.; Dowsett, H. J.; Jost, A.; hide

    2013-01-01

    Climate and environments of the mid-Pliocene warm period (3.264 to 3.025 Ma) have been extensively studied.Whilst numerical models have shed light on the nature of climate at the time, uncertainties in their predictions have not been systematically examined. The Pliocene Model Intercomparison Project quantifies uncertainties in model outputs through a coordinated multi-model and multi-mode data intercomparison. Whilst commonalities in model outputs for the Pliocene are clearly evident, we show substantial variation in the sensitivity of models to the implementation of Pliocene boundary conditions. Models appear able to reproduce many regional changes in temperature reconstructed from geological proxies. However, data model comparison highlights that models potentially underestimate polar amplification. To assert this conclusion with greater confidence, limitations in the time-averaged proxy data currently available must be addressed. Furthermore, sensitivity tests exploring the known unknowns in modelling Pliocene climate specifically relevant to the high latitudes are essential (e.g. palaeogeography, gateways, orbital forcing and trace gasses). Estimates of longer-term sensitivity to CO2 (also known as Earth System Sensitivity; ESS), support previous work suggesting that ESS is greater than Climate Sensitivity (CS), and suggest that the ratio of ESS to CS is between 1 and 2, with a "best" estimate of 1.5.

  10. Fontes binárias supermoles de raios X

    NASA Astrophysics Data System (ADS)

    Pires, A. M.; Janot Pacheco, E.

    2003-08-01

    Estuda-se as características físicas das fontes supermoles (de raios X (SSS), utilizando dados ópticos e em altas energias, no âmbito de um trabalho de IC. Trata-se de binárias que apresentam espectro X muito mole, baixas temperaturas e altas luminosidades bolométricas. Esse sistemas são compostos por uma anã branca realizando fusão em sua superfície, a partir de matéria perdida pela estrela companheira. Os resíduos de fusão se acumulam na superfície da anã branca, e essa pode ultrapassar o limite de Chadrasekhar, produzir um colapso gravitacional, sendo esse um dos cenários propostos para as explosões de SN Ia. Apresentamos nesta comunicação o estado da arte das características físicas das fontes SSS, situando-as no âmbito das VCs. Procuramos também situar esses objetos em relação às variáveis galácticas V Sge, na medida em que os dois grupos apresentam certas caracerísticas bastante semelhantes.A metodologia adotada é aquela pedagógico-cognitiva clássica de um trabalho de IC na área de ciências exatas.

  11. Empiric auto-titrating CPAP in people with suspected obstructive sleep apnea.

    PubMed

    Drummond, Fitzgerald; Doelken, Peter; Ahmed, Qanta A; Gilbert, Gregory E; Strange, Charlie; Herpel, Laura; Frye, Michael D

    2010-04-15

    Efficient diagnosis and treatment of obstructive sleep apnea (OSA) can be difficult because of time delays imposed by clinic visits and serial overnight polysomnography. In some cases, it may be desirable to initiate treatment for suspected OSA prior to polysomnography. Our objective was to compare the improvement of daytime sleepiness and sleep-related quality of life of patients with high clinical likelihood of having OSA who were randomly assigned to receive empiric auto-titrating continuous positive airway pressure (CPAP) while awaiting polysomnogram versus current usual care. Serial patients referred for overnight polysomnography who had high clinical likelihood of having OSA were randomly assigned to usual care or immediate initiation of auto-titrating CPAP. Epworth Sleepiness Scale (ESS) scores and the Functional Outcomes of Sleep Questionnaire (FOSQ) scores were obtained at baseline, 1 month after randomization, and again after initiation of fixed CPAP in control subjects and after the sleep study in auto-CPAP patients. One hundred nine patients were randomized. Baseline demographics, daytime sleepiness, and sleep-related quality of life scores were similar between groups. One-month ESS and FOSQ scores were improved in the group empirically treated with auto-titrating CPAP. ESS scores improved in the first month by a mean of -3.2 (confidence interval -1.6 to -4.8, p < 0.001) and FOSQ scores improved by a mean of 1.5, (confidence interval 0.5 to 2.7, p = 0.02), whereas scores in the usual-care group did not change (p = NS). Following therapy directed by overnight polysomnography in the control group, there were no differences in ESS or FOSQ between the groups. No adverse events were observed. Empiric auto-CPAP resulted in symptomatic improvement of daytime sleepiness and sleep-related quality of life in a cohort of patients awaiting polysomnography who had a high pretest probability of having OSA. Additional studies are needed to evaluate the applicability of empiric treatment to other populations.

  12. The ESS neutrino facility for CP violation discovery

    NASA Astrophysics Data System (ADS)

    Baussan, Eric; Bouquerel, Elian; Dracos, Marcos

    2017-09-01

    The comparatively large value of the neutrino mixing angle θ 13 measured in 2012 by neutrino reactor experiments has opened the possibility to observe for the first time CP violation in the leptonic sector. The measured value of θ 13 also privileges the 2nd oscillation maximum for the discovery of CP violation instead of the usually used 1st oscillation maximum. The sensitivity at the 2nd oscillation maximum is about three times higher than at the 1st oscillation maximum implying a significantly lower sensitivity to systematic errors. Measuring at the 2nd oscillation maximum necessitates a very intense neutrino beam with the appropriate energy. The world’s most intense pulsed spallation neutron source, the European Spallation Source, has a proton linac with 5 MW power and 2 GeV energy. This linac also has the potential to become the proton driver of the world’s most intense neutrino beam with very high potential for the discovery of neutrino CP violation. The physics performance of that neutrino Super Beam in conjunction with a megaton Water Cherenkov neutrino detector installed ca 1000 m down in a mine at a distance of about 500 km from ESS has been evaluated. In addition, the use of such a detector will make it possible to extent the physics program to proton decay, atmospheric neutrinos and astrophysics searches. The ESS proton linac upgrade, the accumulator ring needed for proton pulse compression, the target station optimization and the physics potential are described. In addition to the production of neutrinos, this facility will also be a copious source of muons which could be used to feed a low energy nuSTORM facility, a future neutrino factory or a muon collider. The ESS linac, under construction, will reach full operation at 5 MW by 2023 after which the upgrades for the neutrino facility could start.

  13. Treatment of Obstructive Sleep Apnea Syndrome with Nasal Positive Airway Pressure Improves Golf Performance

    PubMed Central

    Benton, Marc L.; Friedman, Neil S.

    2013-01-01

    Study Objectives: Obstructive sleep apnea syndrome (OSAS) is associated with impairment of cognitive function, and improvement is often noted with treatment. Golf is a sport that requires a range of cognitive skills. We evaluated the impact of nasal positive airway pressure (PAP) therapy on the handicap index (HI) of golfers with OSAS. Methods: Golfers underwent a nocturnal polysomnogram (NPSG) to determine whether they had significant OSAS (respiratory disturbance index > 15). Twelve subjects with a positive NPSG were treated with PAP. HI, an Epworth Sleepiness Scale (ESS), and sleep questionnaire (SQ) were submitted upon study entry. After 20 rounds of golf on PAP treatment, the HI was recalculated, and the questionnaires were repeated. A matched control group composed of non-OSAS subjects was studied to assess the impact of the study construct on HI, ESS, and SQ. Statistical comparisons between pre- and post-PAP treatment were calculated. Results: The control subjects demonstrated no significant change in HI, ESS, or SQ during this study, while the OSAS group demonstrated a significant drop in average HI (11.3%, p = 0.01), ESS, (p = 0.01), and SQ (p = 0.003). Among the more skilled golfers (defined as HI ≤ 12), the average HI dropped by an even greater degree (31.5%). Average utilization of PAP was 91.4% based on data card reporting. Conclusions: Treatment of OSAS with PAP enhanced performance in golfers with this condition. Treatment adherence was unusually high in this study. Non-medical performance improvement may be a strong motivator for selected subjects with OSAS to seek treatment and maximize adherence. Commentary: A commentary on this article appears in this issue on page 1243. Citation: Benton ML; Friedman NS. Treatment of obstructive sleep apnea syndrome with nasal positive airway pressure improves golf performance. J Clin Sleep Med 2013;9(12):1237-1242. PMID:24340283

  14. Genetic Causal Attribution of Epilepsy and its Implications for Felt Stigma

    PubMed Central

    Sabatello, Maya; Phelan, Jo C.; Hesdorffer, Dale C.; Shostak, Sara; Goldsmith, Jeff; Sorge, Shawn T.; Winawer, Melodie R.; Chung, Wendy K.; Ottman, Ruth

    2015-01-01

    Summary Objective Research in other disorders suggests that genetic causal attribution of epilepsy might be associated with increased stigma. We investigated this hypothesis in a unique sample of families containing multiple individuals with epilepsy. Methods 181 people with epilepsy and 178 biological relatives without epilepsy completed a self-administered survey. In people with epilepsy, felt stigma was assessed through the Epilepsy Stigma Scale (ESS), scored 1 to 7 with higher scores indicating more stigma and >4 indicating some felt stigma. Felt stigma related to having epilepsy in the family was assessed through the Family Epilepsy Stigma Scale (FESS), created by replacing “epilepsy” with “epilepsy in my family” in each ESS item. Genetic attribution was assessed through participants’ perceptions of the (1) role of genetics in causing epilepsy in the family, (2) chance they had an epilepsy-related mutation, and (3) (in people with epilepsy) influence of genetics in causing their epilepsy. Results Among people with epilepsy, 22% met criteria for felt stigma (ESS score >4). Scores were increased among individuals who were aged ≥60 years, were unemployed, reported epilepsy-related discrimination, or had seizures within the last year or >100 seizures in their lifetime. Adjusting for other variables, ESS scores in people with epilepsy were significantly higher among those who perceived genetics played a “medium” or “big” role in causing epilepsy in the family than in others (3.4 vs. 2.7, p=0.025). Only 4% of relatives without epilepsy had felt stigma. Scores in relatives were unrelated to genetic attribution. Significance In these unusual families, predictors of felt stigma in individuals with epilepsy are similar to those in other studies, and stigma levels are low in relatives without epilepsy. Felt stigma may be increased in people with epilepsy who believe epilepsy in the family has a genetic cause, emphasizing the need for sensitive communication about genetics. PMID:26290354

  15. Attrition among Women and Minorities in Earth and Space Science (ESS) Graduate Programs

    NASA Astrophysics Data System (ADS)

    Alexander, C. J.; Hawthorne, C.; Allen, W. R.; Alvarez, R.; Geisler, J.

    2001-05-01

    Recent data collected by the American Geological Institute (AGI) indicates that the rate of enrollment of ethnic minorities in the geosciences has steadily declined since the 1980's, and in that time the number of geoscience degrees awarded to ethnic minorities has been fairly steady at less than 1%. Data from the National Science Foundation suggests that only 43 of 186 Universities offering an ESS program have ever graduated an ethnic minority in the history of their program. Factors contributing to these abysmal figures differ for different ethnic-minority groups. We will address institutional obstacles to graduate learning which result in above-normal attrition of ethnic-minorities in ESS graduate programs. The recent studies show an attrition rate of 70% among African American males in ESS graduate programs, while among Hispanic females the attrition rate is only 3%. Studies by sociologists have recently shown that some law schools and medical schools have traits in common with these geoscience departments in the rates at which degrees are awarded to ethnic minorities. Institutional barriers encountered by ethnic minorities in graduate schools may take many forms, but can also be as simple as a lack of community support. In the 1990's the California Institute of Technology (Caltech) made a commitment to the retention of women in their graduate and undergraduate schools. Their program included mentoring, focussed tutoring, self-esteem support groups, and other retention efforts. Under this program, the attrition rate of women has dramatically slowed. In this paper, we will discuss the AGI data, the program instituted by Caltech, possible causes of attrition among populations of Hispanic, and African American males and females, as well as potential programs to address these problems. We will also present, from the nationwide study, data on geoscience departments which have been relatively successful at retaining and graduating ethnic minorities in Earth and Space Sciences. The AGI Report on the Status of [U.S.] Academic Geoscience Departments is available online at the URL listed below.

  16. Sleep hygiene and its association with daytime sleepiness, depressive symptoms, and quality of life in patients with mild obstructive sleep apnea.

    PubMed

    Lee, Sang-Ahm; Paek, Joon-Hyun; Han, Su-Hyun

    2015-12-15

    To investigate the direct and indirect associations of sleep hygiene with daytime sleepiness, depressive symptoms, and quality of life (QoL), in newly diagnosed, untreated patients with mild obstructive sleep apnea (OSA). Data were collected from adults with mild OSA. The Sleep Hygiene Index (SHI), Sleep Problems Index-1 (SPI-1) of the Medical Outcomes Study-Sleep Scale, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Medical Outcomes Study Short-Form Health survey (SF-36) were used to evaluate patients. To determine the indirect and direct associations between SHI and disease outcomes, the Sobel test and multiple linear regression analyses were used, respectively. When we evaluated the direct associations, we excluded 3 items of the original SHI which were more reflective of general health rather than sleep-specific habits and environments. In total, 260 patients with mild OSA participated in this study. The average age, AHI, and SHI scores were 49.1 years (SD 12.5), 9.3/h (SD 2.9), and 24.7 (SD 6.0), respectively. Here, ≥ 10% of participants indicated poor sleep hygiene behaviors on 7 of 13 items. Young age and men were associated with higher SHI scores (both p<0.01). The 13-item SHI scores were indirectly related to ESS, BDI, and SF-36 scores via SPI-1 (all p<0.05). The 10-item SHI scores were related to ESS (p=0.049) and SF-36 (p=0.001), but not to BDI, independently of SPI-1 or other confounding factors in mild OSA patients. Age, sex, AHI, and body mass index were not related to ESS, BDI, or total SF-36 scores. Sleep hygiene is indirectly related to daytime sleepiness, depressive symptoms, QoL via sleep quality and also related to daytime sleepiness and QoL independent of sleep quality in mild OSA patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Pathways to URM Retention: IBP's Professional Development and Mentoring Activities

    NASA Astrophysics Data System (ADS)

    Johnson, A.; Williamson Whitney, V.; Ricciardi, L.; Detrick, L.; Siegfried, D.; Fauver, A.; Ithier-Guzman, W.; Thomas, S. H.; Valaitis, S.

    2013-05-01

    As a not for profit organization, the Institute for Broadening Participation (IBP) hosts a variety of initiatives designed to increase the retention of underrepresented minority (URM) students pursuing pathways in STEM. IBP also assists with formative program evaluation design and implementation to help strengthen URM recruitment and retention elements. Successful initiatives include virtual and face-to-face components that bring together URM students with established URM and other scientists in academia, government and industry. These connections provide URMs with mentoring, networking opportunities, and professional skill development contributing to an improved retention rate of URM students. IBP's initiatives include the NASA One Stop Shopping Initiative (NASA OSSI), Pathways to Ocean Science and Engineering, and the Minorities Striving and Pursuing Higher Degrees of Success (MS PHD'S) in Earth System Science (ESS) Professional Development Program. The NASA OSSI recruits and facilitates student engagement in NASA education and employment opportunities. Pathways to Ocean Science connects and supports URM students with Ocean Science REU programs and serves as a resource for REU program directors. Pathways to Engineering has synthesized mentoring resources into an online mentoring manual for URM students that has been extensively vetted by mentoring experts throughout the country. The mentoring manual, which is organized by roles, provides undergraduates, graduates, postdocs, faculty and project directors with valuable resources. MS PHD'S, one of IBP's longest running and most successful initiatives, focuses on increasing the retention rate of URM students receiving advanced degrees in ESS. The program addresses barriers to retention in ESS including isolation, lack of preparation and professional development, and lack of mentoring. Program activities center on peer-to-peer community building, professional development exercises, networking experiences, one-on-one mentoring, and a facilitated virtual community. MS PHD'S students report a reduced sense of isolation, an increased sense of community, and a higher level of confidence about their ability to succeed in their chosen field. 42 MS PHD'S alumni have completed their PhD and are actively engaged in the ESS workforce.

  18. Global Assessment of the Impact of Type 2 Diabetes on Sleep through Specific Questionnaires. A Case-Control Study

    PubMed Central

    Lecube, Albert; Sánchez, Enric; Gómez-Peralta, Fernando; Abreu, Cristina; Valls, Joan; Mestre, Olga; Romero, Odile; Martínez, María Dolores; Sampol, Gabriel; Ciudin, Andreea; Hernández, Cristina; Simó, Rafael

    2016-01-01

    Abstract Type 2 diabetes (T2D) is an independent risk factor for sleep breathing disorders. However, it is unknown whether T2D affects daily somnolence and quality of sleep independently of the impairment of polysomnographic parameters. Material and Methods A case-control study including 413 patients with T2D and 413 non-diabetic subjects, matched by age, gender, BMI, and waist and neck circumferences. A polysomnography was performed and daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). In addition, 135 subjects with T2D and 45 controls matched by the same previous parameters were also evaluated through the Pittsburgh Sleep Quality Index (PSQI) to calculate sleep quality. Results Daytime sleepiness was higher in T2D than in control subjects (p = 0.003), with 23.9% of subjects presenting an excessive daytime sleepiness (ESS>10). Patients with fasting plasma glucose (FPG ≥13.1 mmol/l) were identified as the group with a higher risk associated with an ESS>10 (OR 3.9, 95% CI 1.8–7.9, p = 0.0003). A stepwise regression analyses showed that the presence of T2D, baseline glucose levels and gender but not polysomnographic parameters (i.e apnea-hyoapnea index or sleeping time spent with oxigen saturation lower than 90%) independently predicted the ESS score. In addition, subjects with T2D showed higher sleep disturbances [PSQI: 7.0 (1.0–18.0) vs. 4 (0.0–12.0), p<0.001]. Conclusion The presence of T2D and high levels of FPG are independent risk factors for daytime sleepiness and adversely affect sleep quality. Prospective studies addressed to demonstrate whether glycemia optimization could improve the sleep quality in T2D patients seem warranted. PMID:27315083

  19. Effect of Oral JZP-110 (ADX-N05) on Wakefulness and Sleepiness in Adults with Narcolepsy: A Phase 2b Study

    PubMed Central

    Ruoff, Chad; Swick, Todd J.; Doekel, Robert; Emsellem, Helene A.; Feldman, Neil T.; Rosenberg, Russell; Bream, Gary; Khayrallah, Moise A.; Lu, Yuan; Black, Jed

    2016-01-01

    Study Objectives: To evaluate the efficacy and safety of oral JZP-110, a second-generation wake-promoting agent with dopaminergic and noradrenergic activity, for treatment of impaired wakefulness and excessive sleepiness in adults with narcolepsy. Methods: This was a phase 2b, randomized, double-blind, placebo-controlled, parallel-group trial conducted at 28 centers in the United States. Patients were adults with narcolepsy who had baseline scores ≥ 10 on the Epworth Sleepiness Scale (ESS) and baseline sleep latency ≤ 10 min on the Maintenance of Wakefulness Test (MWT). Patients received a daily placebo (n = 49) or JZP-110 (n = 44) 150 mg/day weeks 1–4 and 300 mg/day weeks 5–12. Primary efficacy endpoints were change from baseline in average MWT sleep latency, and the Clinical Global Impression-Change (CGI-C); secondary endpoints were change from baseline in ESS score and Patient Global Impression-Change. Results: Improvements were significantly greater with JZP-110 versus placebo on mean MWT sleep latency (4 w, 9.5 versus 1.4 min, P < 0.0001; 12 w, 12.8 versus 2.1 min, P < 0.0001), percentage of patients with CGI-C improvement (4 w, 80% versus 51%, P = 0.0066; 12 w, 86% versus 38%, P < 0.0001), and mean change in ESS (4 w, −5.6 versus −2.4, P = 0.0038; 12 w, −8.5 versus −2.5, P < 0.0001). Three JZP-110-treated patients (6.8%) discontinued due to adverse events (AEs). The most common AEs with JZP-110 versus placebo were insomnia (23% versus 8%), headache (16% versus 10%), nausea (14% versus 6%), diarrhea (11% versus 6%), decreased appetite (14% versus 0%), and anxiety (11% versus 0%). Conclusions: At doses of 150–300 mg/day, JZP-110 was well tolerated and significantly improved the ability to stay awake and subjective symptoms of excessive sleepiness in adults with narcolepsy. Clinical Trials Registration: Clinicaltrials.gov identifier NCT01681121. Citation: Ruoff C, Swick TJ, Doekel R, Emsellem HA, Feldman NT, Rosenberg R, Bream G, Khayrallah MA, Lu Y, Black J. Effect of oral JZP-110 (ADX-N05) on wakefulness and sleepiness in adults with narcolepsy: a phase 2b study. SLEEP 2016;39(7):1379–1387. PMID:27166238

  20. A Spatial Data Infrastructure to Share Earth and Space Science Data

    NASA Astrophysics Data System (ADS)

    Nativi, S.; Mazzetti, P.; Bigagli, L.; Cuomo, V.

    2006-05-01

    Spatial Data Infrastructure:SDI (also known as Geospatial Data Infrastructure) is fundamentally a mechanism to facilitate the sharing and exchange of geospatial data. SDI is a scheme necessary for the effective collection, management, access, delivery and utilization of geospatial data; it is important for: objective decision making and sound land based policy, support economic development and encourage socially and environmentally sustainable development. As far as data model and semantics are concerned, a valuable and effective SDI should be able to cross the boundaries between the Geographic Information System/Science (GIS) and Earth and Space Science (ESS) communities. Hence, SDI should be able to discover, access and share information and data produced and managed by both GIS and ESS communities, in an integrated way. In other terms, SDI must be built on a conceptual and technological framework which abstracts the nature and structure of shared dataset: feature-based data or Imagery, Gridded and Coverage Data (IGCD). ISO TC211 and the Open Geospatial Consortium provided important artifacts to build up this framework. In particular, the OGC Web Services (OWS) initiatives and several Interoperability Experiment (e.g. the GALEON IE) are extremely useful for this purpose. We present a SDI solution which is able to manage both GIS and ESS datasets. It is based on OWS and other well-accepted or promising technologies, such as: UNIDATA netCDF and CDM, ncML and ncML-GML. Moreover, it uses a specific technology to implement a distributed and federated system of catalogues: the GI-Cat. This technology performs data model mediation and protocol adaptation tasks. It is used to work out a metadata clearinghouse service, implementing a common (federal) catalogue model which is based on the ISO 19115 core metadata for geo-dataset. Nevertheless, other well- accepted or standard catalogue data models can be easily implemented as common view (e.g. OGC CS-W, the next coming INSPIRE discovery metadata model, etc.). The proposed solution has been conceived and developed for building up the "Lucan SDI". This is the SDI of the Italian Basilicata Region. It aims to connect the following data providers and users: the National River Basin Authority of Basilicata, the Regional Environmental Agency, the Land Management & Cadastre Regional Authorities, the Prefecture, the Regional Civil Protection Centers, the National Research Council Institutes in Basilicata, the Academia, several SMEs.

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