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content DGGS RDF 2015-14 Publication Details Title: Jumbo Dome, interior Alaska: Whole-rock, major- and , 2015, Jumbo Dome, interior Alaska: Whole-rock, major- and trace-element analyses: Alaska Division of

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: Colville Delta State #1; Plaghm Beechey Point #1; Ugnu #1; Simpson Lagoon #32-14; Placid State #1 (3-10-13 Slope Alaska wells: Colville Delta State #1; Plaghm Beechey Point #1; Ugnu #1; Simpson Lagoon #32-14

DefenseLink.mil - Special Report: Remembering Dr. Martin Luther King, Jr

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civil rights leader, is seen with a portrait of her late husband on January 14, 1972, at a time when she civil rights leader, is seen with a portrait of her late husband on January 14, 1972, at a time when she lunch counter when they came home. But he still insisted on the rightness of desegregating the Armed

Climate Prediction Center - 6-10 and 8-14 Day Prognostic Discussions

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About Us Our Mission Who We Are Contact Us CPC Information CPC Web Team 6-10 Day outlooks are issued DISCUSSIONS FOR 6 TO 10 AND 8 TO 14 DAY OUTLOOKS NWS CLIMATE PREDICTION CENTER COLLEGE PARK MD 300 PM EDT SAT CONSISTENCY ISSUES. IN THESE CASES, FORECASTS ARE MANUALLY DRAWN BUT A FULL DISCUSSION IS NOT ISSUED. THE

Science Adventures Calendar

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:00 AM - 2:30 PM for Students, Gr.4-6 July, 2018 9-13 Best Games Ever! Your Own!, 9:00 AM - 12:00 PM for Students, Gr.5-8 9-13 The Forces are with You!, 9:00 AM - 12:00 PM for Students, Gr.1-4 14 Games

Publications - PDF 98-37C | Alaska Division of Geological & Geophysical

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Bison Fossils; C14; Fossils; Geologic Map; Geology; Gold; Holocene; Mammoth Fossils; Measured Sections Geology; Vertebrate Fossils Top of Page Department of Natural Resources, Division of Geological &

NREL: News - New Energy Systems Enhance National Security

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resources, bioenergy and bio-based products, zero energy buildings, wind energy, geothermal energy, solar Energy Systems Enhance National Security Washington D.C., March 14, 2002 Experts from the U.S . Department of Energy's National Renewable Energy Laboratory (NREL) have identified key renewable energy

Biotechnology Process Engineering Center at MIT Home

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is speaking at the 2004 Congressional Biomedical Research Caucus Briefings on July 14th. Her briefing | Education & Outreach | Research | Industrial Programs | Student Leadership Council Facilities | Umbrella

First International Workshop on Grid Simulator Testing of Wind Turbine

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of Wind Turbine Drivetrains First International Workshop on Grid Simulator Testing of Wind Turbine Wind Turbine Drivetrains June 13-14, 2013, at the National Wind Technology Center near Boulder apparatuses involved in grid compliance testing of utility-scale wind turbine generators. This includes both

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Recent Funding Recent Funding The following table lists NREL's annual funding in millions of dollars per fiscal year. Fiscal Year Funding (in millions) FY17 458.0 FY16 427.4 FY15 357.0 FY14 360.3

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index

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) Control panel layout and wiring diagram. (Rev. 6, 12/14/06). 2. SUMMARY AND TEST INFORMATION Barrel Movement Test (*.pdf) Summary of data collected during barrel movement test in June, 2005 (DRAFT, 6/27/05

Publications - RI 97-14B | Alaska Division of Geological & Geophysical

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Tidal Datum Portal Climate and Cryosphere Hazards Coastal Hazards Program Guide to Geologic Hazards in , State of; Alluvial Deposits; Avalanche; Cambrian; Carboniferous; Cenozoic; Coastal and River; Coastal

BUFR TABLE A

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Surface data - sea 2 Vertical soundings (other than satellite) 3 Vertical soundings (satellite) 4 Single level upper-air data (other than satellite) 5 Single level upper-air data (satellite) 6 Radar data 7 tables, complete replacement or update 12 Surface data (satellite) 13 Forecasts 14 Warnings 15-19

Presentations - Smith, J.R. and others, 2013 | Alaska Division of

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Engineering Geology Alaska Tidal Datum Portal Climate and Cryosphere Hazards Coastal Hazards Program Guide to (1.4 M) Keywords Coastal; Coastal and River; Engineering Geology Posters and Presentations; Seward

Ocean Drilling Program: Completed Legs

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. Austin Leg summary Repository Wolfgang Schlager 102 14-Mar-85 25-Apr-85 Miami, Florida 418 Bermuda Rise Lisbon, Portugal 902-906 New Jersey Sea-Level Transect Peter Blum Gregory Mountain Leg summary Repository , Nova Scotia 1071-1073 Continuing the New Jersey Sea-Level Transect Mitchell J. Malone James A. Austin

Intern Programs | Undergraduate Lecture Series

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Tuesday June 12 One West Harrison Prosper Florida State University Particle physics Thursday June 14 One Facilities Ops Mechanical Engineering of accelerators Thursday June 21 One West Anne Schukraft Fermilab Neutrino Division / SBN Introduction to neutrino physics Tuesday June 26 One West Leo Aliaga Fermilab SCD

Louisiana Resource Trustees Early Restoration Public Meeting | NOAA Gulf

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Publications Press Releases Story Archive Home Louisiana Resource Trustees Early Restoration Public Meeting Louisiana Resource Trustees Early Restoration Public Meeting share Posted on June 14, 2011 | Assessment and Early Restoration Restoration Area Title: Louisiana Resource Trustees Early Restoration Public

2014 Southern Nevada Household Travel Survey | Transportation Secure Data

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Center | NREL 14 Southern Nevada Household Travel Survey 2014 Southern Nevada Household Travel Survey The 2014 Southern Nevada Household Travel Survey collected information from residents in the Las conduct the survey. Methodology The survey was conducted in two phases-from March to May 2014 and from

NOVA - Official Website | The Pluto Files

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December 14, 2011 on PBS Program Description (Program not available for streaming.) When the American : So that's when most people first learn about the planets. So his name comes up, and you learn he's a DEGRASSE TYSON (American Museum of Natural History, Hayden Planetarium): In 1930, a farm boy, with a

Publications - PIR 2001-3D | Alaska Division of Geological & Geophysical

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Tidal Datum Portal Climate and Cryosphere Hazards Coastal Hazards Program Guide to Geologic Hazards in Shapefile 1.4 M Metadata - Read me Keywords Coastal and River; Coastal and River Hazards; Construction

Department of the Navy Transformation Plan: FY 2014-2016

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alignment don business priorities (fy14-16) strategic opportunities for transformation don institutional Closing... summary don transformation model Download PDF Submit an Idea Department of the Navy Transformation Plan FY 2014-2016

NCEP Air Quality Forecast(AQF). Web designed by Binbin Zhou,

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NOAA/NWS/NCEP/EMC 2D Fields 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 Select speed: normal 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Cycle: 12Z

Fermilab Today

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Search GO Special Result of the Week Toward a high-intensity muon source Impact of a single pulse of 12 x moment of impact (T=0); b) 9ms after impact; c) 15ms after impact. To solve the mysteries of nature 1012 protons at 14 GeV on a 1cm-wide jet of mercury flowing at 15m/s in a 10T solenoid field: a) at the

IRIS Toxicological Review of 1,4-Dioxane (with Inhalation Update) (Final Report)

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The final IRIS Toxicological Review of 1,4-dioxane (with inhalation update) provides scientific support and rationale for the hazard and dose-response assessment pertaining to chronic exposure to 1,4-dioxane. Human health risk concerns for 1,4-dioxane are primarily relat...

Public Access Policy and Communications | DOE PAGES

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Close Clear All Find DOE PAGES Public Access Policy and Communications Public Access Policy and Communications 7/24/14 Department of Energy Public Access Plan DOE Public Access Plan 2/22/13 White House Office Information (ICSTI) Insights article Public Access at the United States Department of Energy (1,011 KB), by

NREL's National Wind Technology Center Director Named ASME Fellow

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Division before becoming founding director of the NWTC. He joined NREL in 1984 following a 14-year stint as members with at least 10 years of engineering practice who have made "significant contributions" Monrad, (303) 275-4096 Golden, Colo., January 25, 1996 -- Dr. Robert W. Thresher, director of the

ACHP | News | Join Us in Nashville at the National Preservation Conference

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Preserve America Preserve America Communities and Partners Forum Wednesday, October 14, 2009, 1:30-3:30 pm (ACHP) invites all representatives of Preserve America Communities, Neighborhoods, Stewards, Grant Recipients, past Award winners, and public and private partners to attend a Preserve America Communities and

ARC Events

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chair IEEE Technical Committee on Automotive Controls (Feb 2018, IEEE) Dr. Anna Stefanopoulou on research of sustainable vehicle technologies (Jan 24, 2018, WEMU) Stefanopoulou plenary at IEEE 56th CDC (Jan 17, 2018, ME) ARC Researchers at IEEE 56th Conf. Decision and Control (Dec 12-14, 2017, CDC) ARC

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Research Institute will offer a special renewable energy award May 14 at the International Science and Offers Renewable Energy Award at International Competition For more information contact: e:mail of science fairs. As the only international science project competition for 9th - 12th graders, ISEF

Defense.gov - Special Report: Haiti Earthquake Relief

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. Top Stories Medical Group Provides Assistance MANDRIN, Haiti, July 14, 2010 - Airmen with the 56th Medical Group provided optometry, dental and general services at the New Horizons medical site. Story assigned to Joint Task Force New Horizons have made major progress on their engineering and medical

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Welcome to the Next Linear Collider NLC Home Page If you would like to learn about linear colliders in general and about this next-generation linear collider project's mission, design ideas, and Linear Collider. line | NLC Home | NLC Technical | SLAC | mcdunn Tuesday, February 14, 2006 01:32:11 PM

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-2018 21:04 - nam.20180521/ 21-May-2018 21:03 - nam.20180522/ 22-May-2018 21:02 - nam.20180523/ 23-May -2018 21:04 - nam.20180524/ 24-May-2018 21:02 - nam.20180525/ 25-May-2018 21:04 - nam.20180526/ 26-May -2018 21:03 - nam.20180527/ 27-May-2018 11:51 - nam_mos.20180526/ 26-May-2018 14:55 - nam_mos.20180527

Concentrating Solar Power Projects - KaXu Solar One | Concentrating Solar

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Power | NREL KaXu Solar One This page provides information on KaXu Solar One, a concentrating . Status Date: April 14, 2015 Project Overview Project Name: KaXu Solar One Country: South Africa Location

| Earthscope

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Array Funded Projects Geochronology Synthesis Workshops Scientific Publications Science Nuggets ES Synthesis Workshop 06-12 | 06-14 IRIS Workshop: Foundations, Frontiers, and Future Facilities for Seismology 06-15 | Call for Science Nuggets this spring! 07-26 | 07-28 Midcontinent Rift Synthesis Workshop See

First Light for BOSS - A New Kind of Search for Dark Energy | Berkeley

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in the clumping of invisible dark matter. Comparing these scales at different eras makes it possible Web People Close About the Lab Leadership/Organization Calendar News Center Today At Berkeley Lab News Preuss, (510) 486-6249 On the night of September 14 the largest program in the Sloan Digital Sky Survey

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Ethanol and Methanol Tax Ethyl alcohol and methyl alcohol motor fuels are taxed at a rate of $0.14 per gallon when used as a motor fuel. Ethyl alcohol is defined as a motor fuel that is typically derived from agricultural products that have been denatured. Methyl alcohol is a motor fuel that is most

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spotlights BaBar time-reversal measurement. December 14, 2012 PhysicsWorld.com has selected the BaBar time . BaBar Makes First Direct Observation of Time-Reversal Violation August 30, 2012 Fundamental interactions among particles are oblivious to the direction of time (a movie of a rock thrown up and falling back

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multiple data management projects from digital field data collection to data compilation projects to Surveys Digital Data Series 14, http://doi.org/10.14509/photodb. http://doi.org/10.14509/29735 Athey, J.E increasing communication about digital geologic field mapping, in Soller, D.R., ed. Digital Mapping

Climate Forecast System

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number of Reforecast datasets are available at NCDC: 9 Month Means 45Day/Seasonal Timeseries (14 select 9 Month Means Calibration Climatologies of CFSR Monthly Calibration Climatologies of CFSR Timeseries

NEWS ARTICLES

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CENTCOM: Search CENTCOM CENTCOM Home ABOUT US COMMAND NARRATIVE LEADERSHIP COMPONENT COMMANDS HISTORY , security forces May 14, 2018 Syrian Democratic Forces fire in self-defense May 11, 2018 Military Strikes against Daesh terrorists in Iraq and Syria May 04, 2018 Syrian Democratic Forces announce drive to reclaim

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Documents docdb at Drexel - and the directory Jan 2008 US meeting August 2005 US meeting Full December 2007) TBC Full Collaboration Meeting (12-14 March 2006) US Collaboration Meeting (August 2005) The at ANL This page maintained by J. Reichenbacher, last updated 4 August 2008.

NOAA Photo Library

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- spac0117 TIROS I satellite on test stand during preliminary test stage. In: "Weather Analysis from Satellite Observations, " U.S. Navy Research Facility, December 1960. Figure 1.4. Image ID: spac0117 , NOAA In Space Collection Photo Date: 1960 Circa Category: Space/Satellite/Vehicle/ * High Resolution

News | News | Page 12

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of Communication Fermilab news Search Useful links Symmetry magazine Interactions Interact News Fermilab's new chief strategic partnerships officer September 11, 2017 Alison Markovitz will lead externally « 1 ... 10 11 12 13 14 ... 74 » Go Fermilab news Search Useful links Symmetry magazine Interactions

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; means (a) copies of the computer program commonly known as SUNREL, and all of the contents of files accordance with the Documentation. 1.2 "Computer" means an electronic device that accepts computer." 1.4 "Licensee" means the Individual Licensee. 1.5 "Licensed Single Site"

Publications - RI 97-14A | Alaska Division of Geological & Geophysical

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Complex; Mystic Terrane; Ordovician; Ores; Paleocurrent; Paleoenvironment; Paleontology; Paleozoic; Peat ; Tertiary; Triassic; Turbidites; Veleska Lake Volcanic Complex; Volcanic; Yukon-Tanana Terrane Top of Page

Alternative Fuels Data Center: Sacramento Powers up with Electric Vehicles

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Photo of a car Electric Vehicles Charge up at State Parks in West Virginia Dec. 9, 2017 Photo of a car Hydrogen Powers Fuel Cell Vehicles in California Nov. 18, 2017 Photo of a car Smart Car Shopping Nov. 4 , 2017 Image of an ambulance. Emergency Alternatives Oct. 14, 2017 Photo of a car North Carolina Commits

Alternative Fuels Data Center: Smoky Mountains Leads the Way in

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Related Videos Photo of a car Electric Vehicles Charge up at State Parks in West Virginia Dec. 9, 2017 Photo of a car Hydrogen Powers Fuel Cell Vehicles in California Nov. 18, 2017 Photo of a car Smart Car Image of an ambulance. Emergency Alternatives Oct. 14, 2017 Photo of a car North Carolina Commits to

FAQ-HDSC/OWP

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improve transition, they will be different from the ones published on the PFDS around volumes' boundaries . 2.7 Why do I see inconsistencies in some NOAA Atlas 14 estimates at boundaries of different NOAA Atlas different times in volumes based on state boundaries, some differences in estimates between volumes at

Publications - GMC 122 | Alaska Division of Geological & Geophysical

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DGGS GMC 122 Publication Details Title: Total organic carbon, rock-eval pyrolysis, vitrinite for more information. Bibliographic Reference Exxon, and Geo-Strat, Inc., 1989, Total organic carbon Information gmc122.pdf (1.4 M) Keywords Kerogen; Pyrolysis; Rock-Eval Pyrolysis; Total Organic Carbon

Concentrating Solar Power Projects - Saguaro Power Plant | Concentrating

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Solar Power | NREL Saguaro Power Plant This page provides information on Saguaro, a concentrating solar power (CSP) project, with data organized by background, participants, and power plant configuration. Status Date: April 14, 2017 Project Overview Project Name: Saguaro Power Plant Country: United

Travels with Gates - August 2010

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combat floods that are affecting 14 million people. Story Biography Speeches Travels Photo Essays Gates Visits Navy Special Warefare Training More Photo Essays Gates Attends Graduation in San Diego Gates Photo Essays News Photos Week In Photos Videos DIMOC DOD/Military Seals DoD Flickr Secretary of Defense

Power Electronics and Electric Machines Publications | Transportation

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electric machines. For more information about the following publications, contact Sreekant Narumanchi. A , NREL Software Spray System Evaluation (Software 1.1 MB) Papers 2017 Electric Motor Thermal Management Source: Douglas DeVoto. 2017. 14 pp. NREL/MP-5400-67117. Power Electronics Thermal Management Research

Coming Soon: More Cyber Careers?

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exploring the possibility of creating a cyber career field for Army civilians," Lt. Gen. Edward C Programs and Posture," April 14. Establishing a cyber career management field for civilians may be working to implement a cyber career management field for enlisted personnel that will encompass accessions

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Details Title: Geologic map of the South-central Sagavanirktok Quadrangle, North Slope, Alaska (poster , Geologic map of the South-central Sagavanirktok Quadrangle, North Slope, Alaska (poster): Alaska Geological quadrangle, North Slope, Alaska (14.0 M) Keywords Energy Resources Posters and Presentations; Geologic Map

ACHP | News | Nationwide Programmatic Agreement Streamlines 106 Process for

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Publications Search skip specific nav links Home arrow News arrow Nationwide Programmatic Agreement Streamlines 106 Process for NPS Nationwide Programmatic Agreement Streamlines 106 Process for NPS Pursuant to Service (NPS) on November 14, 2008, executed a nationwide Programmatic Agreement (PA) with the Advisory

Defense.gov Special Report: Afghanistan

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Support Soldiers FORWARD OPERATING BASE SHARANA, Afghanistan, May 24, 2011 - Army Lt. Col. Dave Preston BASE TILLMAN, Afghanistan, May 23, 2011 - Where and how you live as a soldier deployed to Afghanistan 14-hour firefight with insurgents. Story Chaplains Prepare for Redeployment FORWARD OPERATING BASE

Department of Revenue > Home

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Revenue Forecast - 3/16/18 Fall 2017 Revenue Sources Book - 12/14/17 Revenue Forecast: Oil Prices Down Revenue Sources Book Find a Job Find a State Employee Commissioner's Office Commissioner's Corner Book Tax Annual Report Tax Division Online Services Education Tax Credit Documents Treasury Division

Fermilab Today

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. Fermilab Colloquium - One West Speaker: Bruce Winstein, University of Chicago Title: CMB Polarization, the FileMaker Pro 8.0 - Dec. 10 NALWO - Christkindlmarket Chicago, Dec. 13 Barn Dance Dec. 14 Fermilab Blood Drive Dec. 16, 17 The University of Chicago Tuition Remission Program deadline Dec. 17 Find carpool

Hermann Muller and Mutations in Drosophila

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&D Nuggets Database dropdown arrow Search Tag Cloud Browse Reports Database Help Finding Aids Studies on Drosophila; DOE Technical Report; 1958 The Influence of Radiation in Altering the Incidence of September 15, 1960 to September 14, 1961; DOE Technical Report; 1960 The Influence of Radiation in Altering

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Carolina, Tennessee, Virginia, West Virginia) 2004 (2006) 3 Precipitation-Frequency Atlas of the United Western United States, California 1973 superseded by NA14 Vol6 back to top 3. Hydrometeorological Reports Precipitation over the Ohio River Basin above Pittsburgh, Pennsylvania 1943 superseded (see PMP documents) 3

CIDRAP

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outbreak total has reached 36 cases, 14 confirmed and 22 suspected. Thermometer in the sun Study finds Ebola cases in DRC, 27 deaths Stephanie Soucheray | May 23, 2018 With worries about the disease newly pledged for an outbreak that has grown to 51 total cases, 28 confirmed. More news Inside CIDRAP

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Home Site Map News Organization Search: Go www.nws.noaa.gov Search the CPC Go Download KML Day 3-7 . See static maps below this for the most up to date graphics. Categorical Outlooks Day 3-7 Day 8-14 EDT May 25 2018 Synopsis: The summer season is expected to move in quickly for much of the contiguous

Alternative Fuels Data Center: Maps and Data

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-26157-12dimne Comparison of gasoline and diesel taxes in Organization for Economic Co-operation and Indiana 12 North Dakota 11 North Carolina 10 South Carolina 8 Alaska 1 New Mexico 8 Washington 10 Tennessee 6 Texas 5 Illinois 11 Virginia 14 Wyoming 3 Delaware 2 Colorado 10 Vermont 3 Montana 6 Oklahoma 8

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Alternative Fuels Data Center: Washington Transportation Data for

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Partnerships Spark Biodiesel Success for Essential Baking Company Partnerships Spark Biodiesel Success for Essential Baking Company Sept. 14, 2012 Video thumbnail for Seattle's Waste Haulers are Going Green

Publications - GMC 87 | Alaska Division of Geological & Geophysical Surveys

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: Unknown Publication Date: 1988 Publisher: Alaska Division of Geological & Geophysical Surveys Total . Bibliographic Reference Unknown, 1988, Capillary pressure test data for 14 North Slope wells: Alaska Division of

AtomicNuclearProperties

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) Polytrifluorochloroethylene [C2F3Cl]n Polyvinylacetate [CH2CHOCOCH3]n Polyvinyl alcohol (C2H3-O-H)n Polyvinyl butyral [C8H1302 other materal for properties of interest in high-energy physics: stopping power (<-dE/dx>) tables (C10H16O) Aniline (C6H5NH2) Anthracene (C14H10) Benzene C6H6 Butane (C4H10) n-Butyl alcohol (C4H9OH) Carbon

Climate Prediction Center - 6 to 10 Day Outlook

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/PNA/AAO About Us Our Mission Who We Are Contact Us CPC Information CPC Web Team Product Feedback 6-10 . Government's official Web portal to all Federal, state and local government Web resources and services. HOME> Used, 8 to 14 Day Outlooks, Heat Index, Our Mission, Who We Are, CPC Information, CPC Web Team NOAA

Climate Prediction Center - 6-10 Day Wind Chill Outlook

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8-14 Day Obsrv'd About Us Our Mission Who We Are Contact Us CPC Information CPC Web Team 6-10 & official Web portal to all federal, state, and local government Web resources and services. 6-10 Day Lowest Park, Maryland 20740 Climate Prediction Center Web Team Page last modified: August 30, 2012 Disclaimer

Stationary Fuel Cell System Composite Data Products | Hydrogen and Fuel

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Capacity by Equipment Type CDP STAT 14, 10/21/15 Average Eligible Cost by Equipment Type, including Other Distributed Generation CDP STAT 15, 10/21/15 Average Eligible Cost for Biogas Sources CDP STAT 16, 10/21/15 Capacity and Eligible Cost (CHP Fuel Cells) CDP STAT 22, 10/21/15 Distribution of Eligible Cost with and

Alternative Fuels Data Center: Florida Schools First in State to Power up

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Indian River County School District became the first in the state to adopt propane-powered school buses Oil Powers Biodiesel Vehicles in Vermont March 4, 2017 Photo of a truck Natural Gas Fuels School Buses Natural Gas Jan. 14, 2017 Photo of buses Baton Rouge School District Adds Propane Buses to Its Fleet Dec

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Fermilab Education Office Registration

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Games Ever! Your Own!, Science Adventure Students July 9-13, 2018 The Forces are with You!, Science Adventure Students July 14, 2018 Games, Magic and the Brain, Science Adventure Students July 15, 2018 Get to

Travels with Lynn: June 2010

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Cybersecurity Cooperation OTTAWA, June 14, 2010 - The cyber threat to the United States and Canada is real and Operation Atlantic Resolve Sexual Assault Prevention Asia-Pacific Rebalance Cyber Strategy News Today in DOD

Defense.gov Special Report: Travels with Panetta - September 2011

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: Regional Defense, Cyber Highlight AUSMIN Talks SAN FRANCISCO, Sept. 14, 2011 - Asia-Pacific defense Sexual Assault Prevention Asia-Pacific Rebalance Cyber Strategy News Today in DOD Press Advisories News

Publications - GMC 181 | Alaska Division of Geological & Geophysical

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DGGS GMC 181 Publication Details Title: Geologic logs and core assays of 14 nickel, copper, and cobalt information. Bibliographic Reference Inspiration Development Company, 1991, Geologic logs and core assays of

Concentrating Solar Power Projects - Dadri ISCC Plant | Concentrating Solar

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Fresnel reflector Turbine Capacity: Gross: 14.0 MW Status: Under construction Start Year: 2017 Do you have , 2016 Start Production: September 2017 Participants Developer(s): Frenell Owner(s) (%): NTCP EPC

Defense.gov Special Report: Invictus Games 2014

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Department of Defense Submit Search DEPARTMENT OF DEFENSE: 2014 Invictus Games U.S. Service Members Compete in Invictus Games UK Flag London | Sept. 10-14, 2014 More than 400 competitors from 13 nations will participate in the inaugural Invictus Games in London, an international sporting event for wounded warriors to

Fermilab Today

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swinging for a home run," said Run Coordinator Jim Morgan. "We knew we had a pretty good shot at . Every four to six stores we add them into the shot, that way we get more luminosity," Morgan said July 14 - July 16 - During this 48 hour period Operations established one store that combined with an

Energy Systems Integration News | Energy Systems Integration Facility |

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, consider the tangible benefits it can bring to utilities and the developer community, and discuss the Energy Systems Integration Facility on July 13 and 14, 2016, to discuss current and future R&D to researching this topic from a technology, business process, and policy perspective. This workshop is an

Alternative Fuels Data Center: Workplace Charging Success: MetLife

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people to use PEVs. " MetLife's Senior Vice President, Global Corporate Services, Joseph Sprouls vehicle (PEV) charging stations at 14 of its U.S. corporate offices as a partner in the Department of benefits of using alternative energy sources. MetLife's Senior Vice President, Global Corporate Services

ACHP | News | Mrs. Laura Bush Presents "Preserve America History Teacher

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. Laura Bush Presents "Preserve America History Teacher of the Year" Award to New Jersey Teacher Mrs. Laura Bush Presents "Preserve America History Teacher of the Year" Award to New Jersey Teacher October 14, 2005 Mrs. Laura Bush Presents "Preserve America History Teacher of the Year"

Specifications of the High-Flux Solar Furnace | Concentrating Solar Power |

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Non-imaging compound parabolic Acceptance angle: 14 degrees Entrance diameter: 6 cm Exit diameter secondary concentrator configurations are possible depending on the experimental needs. Back to top XYZ controllers ranging from 2,000 to 30,000 sccm Exhaust hood above experimental area Drill press and hand tools

Program Alternatives - 36 CFR § 800.14

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implementation of a particular agency program or the resolution of adverse effects from complex projects or and the potential effects from the undertakings must be foreseeable and likely to be minimal or not undertakings, effects, historic properties, or treatment options. Standard treatments carry the ACHP's explicit

Welcome to NNIN | National Nanotechnology Infrastructure Network

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ALD system located at the Stanford Nanofabrication Facility, one of the 14 NNIN nodes. NNIN facilities facilities such as this CVD furnace at the Cornell facility. Student using one of the scanning electron microscopes at the Howard University NNIN facility. This is one of over 1100 major instruments available

NREL's Energy Storage and REopt Teams Awarded $525k from TCF to Study

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Commercial Viability of Optimal, Reliable Building-Integrated Energy Storage | News | NREL NREL's Energy Storage and REopt Teams Awarded $525k from TCF to Study Commercial Viability of Optimal Study Commercial Viability of Optimal, Reliable Building-Integrated Energy Storage November 14, 2017

Publications - PIR 2002-2 | Alaska Division of Geological & Geophysical

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for more information. Quadrangle(s): Philip Smith Mountains Bibliographic Reference Harris, E.E., Mull , scale 1:63,360 (14.0 M) Digital Geospatial Data Digital Geospatial Data Philip Smith Mountains: Geologic Smith Mountains: Topo Data Download psm-topo Shapefile 11.5 M Metadata - Read me Keywords Alaska, State

Home Page, Alaska Department of Labor and Workforce Development

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Analysis Return on Investment 0.jpg 1 1 1 1 1 Play 0.jpg Alaska Gasline Workforce Plan 1.jpg Alaska Hire 2 Protection Program May 14, 2018 Alaska Workforce Investment Board Endorses Gasline Workforce Plan Subscribe Administrative Services Alaska Workforce Investment Board Workers' Compensation Appeals Commission AVTEC

Grid Integration Webinars | Energy Systems Integration Facility | NREL

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Vision Future. The study used detailed nodal simulations of the Western Interconnection system with greater than 35% wind energy, based on scenarios from the DOE Wind Vision study to assess the operability Renewable Energy Integration in California April 14, 2016 Greg Brinkman discussed the Low Carbon Grid Study

Alternative Fuels Data Center: Connecticut Transportation Data for

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Laboratory Case Studies Video thumbnail for Easter Seals: Supporting the Mission and Saving Money with Natural Gas Easter Seals: Supporting the Mission and Saving Money with Natural Gas May 14, 2018 Video

DefenseLink Feature:

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1958, when I was 14, nonviolent protest came to my home town of Wichita, Kansas. There was a drug-store helped end segregation at drug stores throughout Kansas, pre-dating by two years the more famous sit-ins

SSRL Light Source Status

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) 1 Open OK - 48.0 1.249 - 52 1367.22 2 Open OK - 48.0 1.249 - 52 1367.30 4 Open - 10 18.0 1.892 40.65 17288 1362.18 5 Open - 14 38.2 0.255 3.34 268 1363.43 6 Open OK 27 16.1 0.845 5.52 2832 1365.94 7 Open - 10 17.4 1.931 41.48 17996 1367.42 8 Open OK - 48.0 1.249 - 52 1366.41 9 Open - 8 24.6 1.928 49.59

FAQ HURRICANES, TYPHOONS, AND TROPICAL CYCLONES

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Time ? How do I tell at what time a satellite picture was taken ? A14) How do I convert from mph to largest number of hurricanes in the Atlantic Ocean at the same time? E19) How many direct hits by hurricane and how does this feedback to the storm itself? I : REAL TIME INFORMATION I1) Where can I get real

SMARTINIT DOWNSCALING GRAPHICS

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Month: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 first prev next last SMARTINIT Verification NAM VS NEST Graphics MMB web site Model Type: PROD vs PARA DNG Plot Type: Comparison maps Difference plots Region: CONUS Nest 2.5 km South West U.S. New York, NY

National Centers for Environmental Prediction

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OPERATIONAL 00Z, .... 12Z ... EXPERIMENTAL Daily Comparisons between GFS/GEFS control & ECMWF/ECMWF control 00Z T382/38km GFS, 00Z T190/70km GEFS control 12Z T1279/16km ECMWF, 12Z T639/30km ECMWF ensemble control Daily Values of 500 hPa Height AC, RMS, Talagrand & Outliers Mean of 14 GFS, 10 ECMWF and 16

DefenseLink.mil - Special Report - Flag Day - June 14, 2008

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You have reached a collection of archived material. The content available is no longer being . If you wish to see the latest content, please visit the current version of the site. For persons with disabilities experiencing difficulties accessing content on archive.defense.gov, please use the DoD Section 508

DefenseLink Special: Iraqi Freedom Day, April 9, 2006

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Us Iraqi Freedom Day Web Special, April 9, 2006 Operation Cowpens Concludes in Iraq JABOURI PENINSULA , Iraq, April 16, 2006 - Operation Cowpens concluded maneuvers here April 14 after nearly a month of Persian Gulf War would later put that experience to use during Operation Iraqi Freedom, an F-16 pilot who

DIY Solar Market Analysis Webinar Series: Top Solar Tools | State, Local,

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and Tribal Governments | NREL DIY Solar Market Analysis Webinar Series: Top Solar Tools DIY Solar Market Analysis Webinar Series: Top Solar Tools Wednesday, May 14, 2014 As part of a Do-It -Yourself Solar Market Analysis summer series, NREL's Solar Technical Assistance Team (STAT) presented a

Instruments by Telescope | CTIO

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Visitor's Computer Guidelines Network Connection Request Instruments Instruments by Telescope IR Instruments Single-object IR spectrograph 1.1"x28" ~3500 Hawaii2RG 0.80-2.40 Available SOAR Instruments See gratings 1,800-14,000 with 0.45 arcsec slit Fairchild CCD 4096x4096 0.32-0.98 Available Spartan IR imager

Pedestrian Safer Journey

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Pedestrian Safer Journey Skills for Safe Walking for Ages 5 to 18 Use in the classroom or one-on -one. To start, click on an age group below: Ages 5-9 Ages 10-14 Ages 15-18 What is Pedestrian Safer get the conversation started with children and youth. Three videos - one for each of three age groups

TABLE D - WMO AND LOCAL (NCEP) DESCRIPTORS AS WELL AS THOSE AWAITING

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sequences common to satellite observations None 3 05 Meteorological or hydrological sequences common to Vertical sounding sequences (conventional data) None 3 10 Vertical sounding sequences (satellite data) None (satellite data) None 3 13 Sequences common to image data None 3 14 Reserved None 3 15 Oceanographic report

Webinar May 17: Fuel Cell Electric Bus Progress Toward Meeting Technical

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Targets | News | NREL Webinar May 17: Fuel Cell Electric Bus Progress toward Meeting Technical Targets Webinar May 17: Fuel Cell Electric Bus Progress toward Meeting Technical Targets May 14, 2018 The U.S. Department of Energy's (DOE's) Fuel Cell Technologies Office will present a live webinar titled

NREL Research Fellow Howard Branz Named Fellow of American Physical Society

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| News | NREL 3 » NREL Research Fellow Howard Branz Named Fellow of American Physical Society News Release: NREL Research Fellow Howard Branz Named Fellow of American Physical Society January 14 fellow of the American Physical Society (APS). NREL Research Fellow Howard Branz was elected an APS

Concentrating Solar Power Projects - Puerto Errado 1 Thermosolar Power

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linear Fresnel reflector system. Status Date: September 7, 2011 Photo showing an aerial view at an angle ): Novatec Solar España S.L. (100%) Technology: Linear Fresnel reflector Turbine Capacity: Gross: 1.4 MW Technology: Linear Fresnel reflector Status: Operational Country: Spain City: Calasparra Region: Murcia Lat

DefenseLink Special: Stryker Brigade Returns to Fort Wainwright, Alaska

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Fort Wainwright, Alaska, Dec. 13, 2006. Defense Dept. photo by William D. Moss More Photos Leaders command ceremony in Fairbanks, Alaska, Dec. 14, 2006. Defense Dept. photo by William D. Moss More Photos

Concentrating Solar Power Projects - Agua Prieta II | Concentrating Solar

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Turbine Capacity: Net: 12.0 MW Gross: 14.0 MW Status: Under construction Start Year: 2014 Do you have more ): SolarPACES Break Ground: November 2011 Start Production: 2014 Project Type: Commercial Incentives: Global

Current Status of NCEP Model Production

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the page. 00 UTC CYCLE 00 UTC NAM EVENT Average Start Time Average End Time STATUS COMMENTS DATA DUMP AND PREP 01:15:05 01:21:00 COMPLETE-01:21:06 ON-TIME ANALYSIS 01:21:09 01:33:21 COMPLETE-01:33:41 ON -TIME FORECAST F00-F84 01:34:39 02:43:55 COMPLETE-02:44:25 ON-TIME 12hr PRODUCTS 01:40:14 01:52:55

Characterization and Plasma Measurement of the WE-14 Peptide in Patients with Pheochromocytoma

PubMed Central

Guillemot, Johann; Guérin, Marlène; Thouënnon, Erwan; Montéro-Hadjadje, Maité; Leprince, Jérôme; Lefebvre, Hervé; Klein, Marc; Muresan, Mihaela; Anouar, Youssef; Yon, Laurent

2014-01-01

Granins and their derived peptides are valuable circulating biological markers of neuroendocrine tumors. The aim of the present study was to investigate the tumoral chromogranin A (CgA)-derived peptide WE-14 and the potential advantage to combine plasma WE-14 detection with the EM66 assay and the existing current CgA assay for the diagnosis of pheochromocytoma. Compared to healthy volunteers, plasma WE-14 levels were 5.4-fold higher in patients with pheochromocytoma, but returned to normal values after surgical resection of the tumor. Determination of plasma CgA and EM66 concentrations in the same group of patients revealed that the test assays for these markers had an overall 84% diagnostic sensitivity, which is identical to that determined for WE-14. However, we found that WE-14 measurement improved the diagnostic sensitivity when combined with the results of CgA or EM66 assays. By combining the results of the three assays, the sensitivity for the diagnosis of pheochromocytoma was increased to 95%. In fact, the combination of WE-14 with either CgA or EM66 test assays achieved 100% sensitivity for the diagnosis of paragangliomas and sporadic or malignant pheochromocytomas if taken separately to account for the heterogeneity of the tumor. These data indicate that WE-14 is produced in pheochromocytoma and secreted into the general circulation, and that elevated plasma WE-14 levels are correlated with the occurrence of this chromaffin cell tumor. In addition, in association with other biological markers, such as CgA and/or EM66, WE-14 measurement systematically improves the diagnostic sensitivity for pheochromocytoma. These findings support the notion that granin-processing products may represent complementary tools for the diagnosis of neuroendocrine tumors. PMID:24523932

Fermilab Education Office Calendar

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Event 3 DZero & Tevatron Tour, 1:30 PM - 3:30 PM, Special Event 9-13 Best Games Ever! Your Own!, 9 Adventure 14 Games, Magic and the Brain, 9:30 AM - 12:30 PM, Science Adventure 15 Get to Know Fermilab

Concentrating Solar Power Projects - Solar Electric Generating Station I |

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fire in 1999 damaged the storage system and it was not replaced. Status Date: April 14, 2017 Photo with : 3 hour(s) Thermal Storage Description: Storage system was damaged by fire in 1999 and was not

Publications - RI 94-25 | Alaska Division of Geological & Geophysical

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-materials map of the Anchorage C-7 NW Quadrangle, Alaska, scale 1:25,000 (1.4 M) Digital Geospatial Data Digital Geospatial Data Anchorage C-7 NW Derivative materials Data File Format File Size Info Download

Concentrating Solar Power Projects - Atacama-1 | Concentrating Solar Power

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Capacity: Net: 110.0 MW Gross: 110.0 MW Status: Under construction Start Year: 2018 Do you have more Contact(s): Luis Rejano Company: Abengoa Solar Break Ground: May 14, 2014 Start Production: June 2018

LBNL DSD Whole Frog Project

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500 x 1Byte x 136 images. So each 500 bytes from this dataset represents one scan line of the slice image. For example, using PBM: Get frame one: rawtopgm 256 256 < tomato.data > frame1 Get frames one to four into a single image: rawtopgm 256 1024 < tomato.data >frame1-4 Get frame two (skip

Workshop Targets Graduate Students to Advance Careers in PV | News | NREL

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for a select group of U.S. graduate students to spend an immersive week at NREL in a hands-on, small -group research setting. NREL will select 12-14 students to participate in HOPE, held on the NREL campus . Past participants have found this interactive, one-week experience to be packed with information that

Combustion Research Facility | A Department of Energy Office of Science

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Off on EERE Officials Visit CRF CRF Topics About Us(14) About Us(6) Advanced Light Source(7) August September 2017 July 2017 June 2017 May 2017 March 2017 January 2017 August 2016 June 2016 May 2016 March 2016 February 2016 January 2016 December 2015 November 2015 August 2015 June 2015 May 2015 April 2015

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Alternative Fuels Data Center

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Liquefied Natural Gas (LNG) Tax LNG is taxed at a rate of $0.14 per gallon when used as a motor 1.5536 gallons of LNG to equal one volumetric gross gallon of gasoline. LNG is defined as natural gas for use as a motor fuel, which has been cooled to approximately -260 degrees Fahrenheit and is in a liquid

FAQ's - Public Affairs - NOAA's National Weather Service

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Internet? Q3. How do meteorologists calculate wind chill? Q4. What are "degree days?" Q5. What office? Q11. What is Skywarn and is there an internet site where I can get information about Skywarn and accomplishments? Q13. Are there any sites on the internet that provide information on natural disasters? Q14. Is

Defense.gov - Special Report - Yudh Abhyas - The Largest U.S.-India

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, ate Indian food and participated in other cultural events. Fowler is assigned to the 2nd Squadron , 14th Cavalry Regiment. DoD photo by Fred W. Baker III Top Stories Training Exercises Bridges Cultural

Defense.gov - Special Report - Disaster Strikes Philippines, American Samoa

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medical mission in American Samoa wrapped up over the weekend, but 14 Guardsmen with the state’s civil Relief Efforts Continue WASHINGTON, Oct. 2, 2009 – The medical support situation in American Samoa has

tech-rev_2004.htm

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November December January 2004 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 Happy New Year! 2 Tuesday Wednesday Thursday Friday Saturday 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Presidents' Day 17 18 19 20 21 22 23 24 25 26 27 28 29 March 2004 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 2

Defense.gov - Special Report - 2009 Employer Support Freedom Awards

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updated and may no longer be applicable as a result of changes in law, regulation and/or administration Jackson Parish (La.) Sheriff’s Office WASHINGTON, Sept. 14, 2009 – Law enforcement and military service . Story Marks, O’Neil, O’Brien and Courtney Law Firm WASHINGTON, Aug. 28, 2009 – The past five years

Alternative Fuels Data Center: Austin Lays Plans for Carbon-Neutral City

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Biodiesel Aug. 26, 2017 Photo of a car Idaho Surges Ahead with Electric Vehicle Charging Aug. 4, 2017 Photo of a truck Cooking Oil Powers Biodiesel Vehicles in Rhode Island July 14, 2017 Photo of a truck Idaho Largest Home Runs on Biodiesel in North Carolina June 9, 2017 Photo of a bus New Hampshire Cleans up with

ACHP | News | ACHP Issues Program Comment for Disposal of Navy vessels

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Search skip specific nav links Home arrow News arrow ACHP Issues Program Comment for Disposal of Navy vessels ACHP Issues Program Comment for Disposal of Navy vessels March 8, 2010 – The Advisory Council on Historic Preservation (ACHP) has issued a Program Comment, pursuant to 36 CFR 800.14(e), to the U.S. Navy

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ARC Researchers at IEEE 2015 Vehicle Power and Propulsion Conference

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Sustainability of the Energy Storage Systems Thursday, October 22, 2015 14:00 PM - 16:00 PM Des Pins Room SS5-1 Influence of Battery Downsizing and SOC Operating Window on Battery Pack Performance in a Hybrid Electric

Alternative Fuels Data Center

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Federal 28 24 27 26 22 25 11 25 3 6 12 7 0 6 Alabama 2 2 4 4 1 2 1 2 0 2 1 4 0 0 Alaska 1 2 1 1 1 1 0 1 1 1 1 1 0 0 Arizona 4 4 15 14 12 18 2 16 1 0 0 2 1 1 Arkansas 4 3 6 5 2 3 0 3 0 2 0 1 0 1 California 17 15 30 19 32 65 16 60 3 6 7 5 4 11 Colorado 10 9 18 13 8 19 6 18 1 2 2 3 1 2 Connecticut 3 4 4 3 6

Alternative Fuels Data Center: Maps and Data

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2014 2015 2016 Acura 1 2 1 Audi 6 6 7 7 Bentley Motors 3 3 4 4 3 BMW 1 3 1 3 6 6 5 Buick 1 1 1 3 4 5 1 3 2 Cadillac 2 2 4 4 6 4 2 1 Chevrolet 1 2 3 1 4 4 6 5 7 7 8 7 8 9 11 10 11 14 20 26 24 30 27 Chrysler 2 2 3 2 4 1 1 1 3 3 4 2 3 3 3 3 5 5 Coda Automotive 1 1 0 Dodge 2 2 3 7 5 1 4 4 6 6 6 2 4 5 5 5 6

Concentrating Solar Power Projects - Helios I | Concentrating Solar Power |

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Real) Owner(s): Caja Castilla La Mancha Corporación, S.A. (5%) Fundo de Capital de Risco Energias Country: Spain City: Puerto Lápice Region: Ciudad Real Lat/Long Location: 39°14' 24.0" North, 3°28 Start Production: June 2012 Construction Job-Years: 600 Annual O&M Jobs: 40 PPA/Tariff Type: Real

NOAA Climate Test Bed: CFSv.3 Planning Meeting (August 25-26, 2011)

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: Experience of porting CFSv2 NASA Ames SGI ICE platform (Marx) 12:30-14:00 Breakout discussion (1) Group 1A :00 NASA (Suarez) 09:00-09:20 GFDL (Rosati) 09:20-09:40 ECMWF (Molteni) 09:40-10:00 CMCC (Navarra) 10 modeling efforts at other modeling centers (e.g., GFDL, NCAR, NASA, COLA, DOE, ECMWF). Meeting Format: The

Structural Composites With Tuned EM Chirality

DTIC Science & Technology

2014-12-23

photonic   crystals .   Tammuz  Dubnov  (7/14  –  9/14)  –  Laboratory  Assistant  -­‐  assisted in the testing...AFRL-OSR-VA-TR-2015-0018 STRUCTURAL COMPOSITES WITH TUNED EM CHIRALITY Siavouche Nemat Nasser UNIVERSITY OF CALIFORNIA SAN DIEGO Final Report 12/23...REPORT Grant/Contract  Title:        STRUCTURAL  COMPOSITES  WITH  TUNED  EM   CHIRALITY     Grant  No.:

Publications - GMC 375 | Alaska Division of Geological & Geophysical

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: Rotary Drill Hole No. 3, 6, 8, 9, 10, 11, 11A, 13, 14, 15, 16, 17, 18, 19, 20, 26, 27, 28, 29, 30A, 31 ., 2010, AMEX Drill Logs and Assays for the Orange Hill Property, 1970: Rotary Drill Hole No. 3, 6, 8, 9

NCEP Air Quality Forecast(AQF) Graphics

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Forecasts CMAQ PM Bias Corr. Forecasts Change Plot Type: Comparison plots Difference plots Year: 2018 2017 2016 2015 Month: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Cycle: 06Z 12Z Select Region

NCEP Air Quality Forecast(AQF) for Alaska/Hawaii. NOAA/NWS/NCEP/EMC

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: Daily sfc max or avg 2D fields Quick verification O3/PM2.5 Meteor Year: 2012 2013 2014 2015 Month: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18

Aquisição de Estreptococos Mutans e Desenvolvimento de Cárie Dental em Primogênitos

PubMed Central

NOCE, Erica; RUBIRA, Cassia Maria Fischer; da Silva ROSA, Odila Pereira; da SILVA, Salete Moura Bonifácio; BRETZ, Walter Antonio

2011-01-01

Objetivo Avaliar o momento de aquisição de estreptococos mutans (EM), desenvolvimento de cárie dental e as variáveis a eles associadas no decorrer de 23 meses, em primogênitos de famílias de baixo nível socioeconômico, desde os sete meses de idade. Método A amostra foi selecionada com base em mães densamente colonizadas por EM, incluindo todos os membros de 14 famílias que conviviam na mesma casa. Foram envolvidos no estudo 14 mães, pais e primogênitos e 8 parentes, na maioria avós. Exames clínicos e radiográficos iniciais determinaram os índices de cárie e condição periodontal dos adultos. Contagens de EM foram feitas em todos os adultos nas duas primeiras visitas. Nas crianças foram avaliados os níveis de EM, o número de dentes e de cáries, em quatro visitas. Resultados A prevalência de EM nos adultos foi alta, estando ausente em apenas um dos pais. EM foram detectados em 1, 2, 3 e 10 crianças, respectivamente nas visitas #1, 2, 3 e 4. A cárie dental foi detectada em apenas três crianças na última visita (aos 30 meses de idade), as quais apresentaram escores de EM significantemente maiores que as crianças sem cárie, na mesma visita. Conclusão Exclusivamente a condição social de baixa renda e mães densamente colonizadas por EM não são sinônimo de colonização precoce e alta atividade de cárie em crianças cuidadas em casa. O desenvolvimento de cárie está significantemente associado a escores elevados de EM nas crianças. PMID:22022218

Psychological impact on house staff of an initial versus subsequent emergency medicine rotation.

PubMed

Alagappan, K; Grlic, N; Steinberg, M; Pollack, S

2001-01-01

The objective of this study was to assess the psychological impact of a 4-week emergency medicine (EM) rotation on residents undergoing their first EM experience. These findings were compared to the psychological impact the rotation had on residents with prior EM experience. Data were obtained from a post hoc analysis of a previous study. Prerotation and postrotation psychological distress levels were assessed over a 4-week EM rotation. Anxiety and depressive symptoms were evaluated by the Brief Symptom Inventory and the Dissociative Experience Scale that together comprise a total of 14 psychometric scales. All scales were given at the beginning and end of the initial EM rotation for the academic year of 1994-1995. All information was coded and confidential. Eighteen junior residents (9/18 EM [50%]) were analyzed as a group and compared to 53 residents (34/51 EM [66%]) with prior exposure to the authors' emergency department. Residents doing their first EM rotation (N = 18) showed improvement in 13 of 14 scales (P = .002). Of the 13 scales that improved, 3 improved significantly: Brief Symptom Inventory = anxiety (P = .002) and Dissociative Experience Scale = absorption (P = .001) and other (P = .001). Residents with prior EM experience (N = 53) displayed worsening in 9 of 13 scales (P = not significant) and no change in 1. Residents undergoing their first EM rotation showed a significant decrease in psychological distress over the 4-week period. Residents with prior EM experience did not show a similar change.

Advanced control for photoautotrophic growth and CO2-utilization efficiency using a membrane carbonation photobioreactor (MCPBR).

PubMed

Kim, Hyun Woo; Marcus, Andrew K; Shin, Jeong Hoon; Rittmann, Bruce E

2011-06-01

A membrane carbonation (MC) module uses bubbleless gas-transfer membranes to supply inorganic carbon (C(i)) for photoautotrophic cyanobacterial growth in a photobioreactor (PBR); this creates the novel MCPBR system, which allows precise control of the CO(2)-delivery rate and minimal loss of CO(2) to the atmosphere. Experiments controlled the supply rate of C(i) to the main PBR by regulating the recirculation rate (Q(R)) between the module of MC chamber and the main PBR. The experiments evaluated how Q(R) controls the CO(2) mass transport in MC chamber and how it connects with the biomass production rate, C(i) concentration, pH in the PBR, and CO(2)-utilization efficiency. The biomass production rate and C(i) concentration increased in response to the C(i) supply rate (controlled by Q(R)), but not in linear proportion. The biomass production rate increased less than C(i) due to increased light limitation. Except for the highest Q(R), when the higher C(i) concentration caused the pH to decrease, CO(2) loss to gas ventilation was negligible. The results demonstrate that this MCPBR offers independent control over the growth of photoautotrophic biomass, pH control, and minimal loss of CO(2) to the atmosphere.

Hollow fiber membrane based H₂ diffusion for efficient in situ biogas upgrading in an anaerobic reactor.

PubMed

Luo, Gang; Angelidaki, Irini

2013-04-01

Bubbleless gas transfer through a hollow fiber membrane (HFM) module was used to supply H2 to an anaerobic reactor for in situ biogas upgrading, and it creates a novel system that could achieve a CH4 content higher than 90 % in the biogas. The increase of CH4 content and pH, and the decrease of bicarbonate concentration were related with the increase of the H2 flow rate. The CH4 content increased from 78.4 % to 90.2 % with the increase of the H2 flow rate from 930 to 1,440 ml/(l  day), while the pH in the reactor remained below 8.0. An even higher CH4 content (96.1 %) was achieved when the H2 flow rate was increased to 1,760 ml/(l  day); however, the pH increased to around 8.3 due to bicarbonate consumption which hampered the anaerobic process. The biofilm formed on the HFM was found not to be beneficial for the process since it increased the resistance of H2 diffusion to the liquid. The study also demonstrated that the biofilm formed on the membrane only contributed 22-36 % to the H2 consumption, while most of the H2 was consumed by the microorganisms in the liquid phase.

The role of extracellular matrix metalloproteinase inducer (EMMPRIN) in the regulation of bovine endometrial cell functions.

PubMed

Mishra, Birendra; Kizaki, Keiichiro; Sato, Takashi; Ito, Akira; Hashizume, Kazuyoshi

2012-06-01

Extracellular matrix metalloproteinase inducer (EMMPRIN) is a cell surface glycoprotein that stimulates the production of several matrix metalloproteinases (MMPs) for tissue remodeling. Previously, we detected EMMPRIN in the bovine endometrium, and it is mainly expressed in the luminal and glandular epithelium whereas MMPs are expressed in the underlying stroma. From this expression pattern, we hypothesized that EMMPRIN may regulate stromal MMPs in endometrial cell functions. To test this hypothesis, a coculture of epithelial and stromal cells was performed using a transwell system. In the coculture, epithelial cells were cultured on the insert membrane and stromal cell on the surface of well plates. Expression of stromal MMP-2 and MMP-14 was significantly higher in coculture with epithelial cell. Further, with the addition of anti-EMMPRIN antibody into the epithelial cell compartment, the expression of stromal EMMPRIN and MMP-2 and MMP-14 was decreased. To identify the active site of EMMPRIN for the augmentation of MMPs, EMMPRIN synthetic peptides that correspond to the extracellular loop domain-I (EM1, EM2, EM3, and EM4) were added into the epithelial cell compartment, and only EM2 at a higher dose interfered with EMMPRIN-mediated expression of MMP-14. Next, we examined the effects of progesterone and/or estrogen on the expression of EMMPRIN, MMP-2, and MMP-14. Progesterone (300 nM) significantly stimulated the expression of EMMPRIN but had no effects on any of the MMPs. These results suggest that EMMPRIN derived from epithelial cells regulates MMPs in the endometrium under progesterone-rich conditions and may thereby modulate bovine endometrial cell functions during gestation.

Phase Diversity and Polarization Augmented Techniques for Active Imaging

DTIC Science & Technology

2007-03-01

build up a system model for use in algorithm development. 32 IV. Conventional Imaging and Atmospheric Turbulence With an understanding of scalar...28, 59, 115 Cholesky Factorization, 14, 42 C2n, see Turbulence Coherent Image Model, 36 Complete Data, see EM Algorithm Complex Coherence...Data, see EM Algorithm Homotopic, 62 Impulse Response, 34, 44 Incoherent Image Model, 36 Incomplete Data, see EM Algorithm Lo- Turbulence Outer Scale

Taurine supplementation improves economy of movement in the cycle test independently of the detrimental effects of ethanol.

PubMed

Paulucio, Dailson; Costa, Bruno M; Santos, Caleb G M; Nogueira, Fernando; Koch, Alexander; Machado, Marco; Velasques, Bruna; Ribeiro, Pedro; Pompeu, Fernando Ams

2017-12-01

Taurine (TA) ingestion has been touted as blunting the deleterious effects of ethanol (ET) ingestion on motor performance. This study investigated the effects of ingestion of 0.6 mL·kg -1 of ET, 6 grams of TA, and ethanol in combination with taurine (ET+TA) on economy of movement (EM) and heart rate (HR). Nine volunteers, five female (22 ± 3 years) and four male (26 ± 5 years), participated in a study that used a counterbalanced experimental design. EM and HR were measured for 6 min while the subjects were pedalling at a fixed load 10% below the anaerobic threshold. The blood alcohol concentration (BAC) was similar between ET and ET+TA treatments at 30 min after ingestion and after exercise (12.3 mmol·L -1 vs. 13.7 mmol·L -1 , and 9.7 mmol • L -1 vs 10.9 mmol·L -1 , respectively). EM was significantly different among treatments, with lower mL·W -1 following ingestion of TA (-7.1%, p<0.001) than placebo and ET+TA (-2.45%, p=0.001) compared to ET. HR (bpm) was significantly (p<0.05) higher for ET (137 ± 14 bpm) than the other three treatments (placebo = 129 ± 14 bpm; TA = 127 ± 11 bpm; TA+ET = 133 ± 12 and ET = 137 ± 14 bpm). Taurine improved EM when compared to placebo or ET, and reduced HR when compared to ET. The combination of ET+TA also enhanced EM compared to placebo, and reduced HR in comparison to ET alone. Therefore, these findings indicate that taurine improves EM and counteracts ethanol-induced increases in HR during submaximal exercise.

The EmX Franklin Corridor BRT project evaluation : final report, April 2009.

DOT National Transportation Integrated Search

2009-04-01

Lane Transit District began BRT service on its Franklin Corridor EmX in January 14, 2007. The four mile long route connects downtown Eugene and downtown Springfield, the two main hubs for LTDs system. The corridor, which has the greatest ridership...

Administration and leadership competencies: establishment of a national consensus for emergency medicine.

PubMed

Thoma, Brent; Poitras, Julien; Penciner, Rick; Sherbino, Jonathan; Holroyd, Brian R; Woods, Robert A

2015-03-01

The Royal College of Physicians and Surgeons of Canada requires emergency medicine (EM) residency programs to meet training objectives relating to administration and leadership. The purpose of this study was to establish a national consensus on the competencies for inclusion in an EM administration and leadership curriculum. A modified Delphi process involving two iterative rounds of an electronic survey was used to achieve consensus on competencies for inclusion in an EM administration and leadership curriculum. An initial list of competencies was compiled using peer-reviewed and grey literature. The participants included 14 EM residency program directors and 43 leadership and administration experts from across Canada who were recruited using a snowball technique. The proposed competencies were organized using the CanMEDS Physician Competency Framework and presented in English or French. Consensus was defined a priori as >70% agreement. Nearly all (13 of 14) of the institutions with an FRCPC EM program had at least one participant complete both surveys. Thirty-five of 57 (61%) participants completed round 1, and 30 (53%) participants completed both rounds. Participants suggested an additional 16 competencies in round 1. The results of round 1 informed the decisions in round 2. Fifty-nine of 109 (54.1%) competencies achieved consensus for inclusion. Based on a national modified Delphi process, we describe 59 competencies for inclusion in an EM administration and leadership curriculum that was arranged by CanMEDS Role. EM educators may consider these competencies when designing local curricula.

Mucin gene mRNA levels in broilers challenged with eimeria and/or Clostridium perfringens.

PubMed

Kitessa, Soressa M; Nattrass, Gregory S; Forder, Rebecca E A; McGrice, Hayley A; Wu, Shu-Biao; Hughes, Robert J

2014-09-01

The effects of Eimeria (EM) and Clostridium perfringens (CP) challenges on the mRNA levels of genes involved in mucin (Muc) synthesis (Muc2, Muc5ac, Muc13, and trefoil family factor-2 [TFF2]), inflammation (tumor necrosis factor alpha [TNF-alpha] and interleukin-18 [IL-18]), and metabolic processes (cluster of differentiation [CD]36) in the jejunum of broilers were investigated. Two parallel experiments involving 1) EM challenge and 2) EM and CP challenges were conducted. The first experiment was a 2 X 2 study with 12 birds per treatment (N = 48) involving fishmeal substitution (25%) in the diet (FM) and EM challenge. The treatments were: Control (FM-, EM-), Fishmeal (FM+, EM-), EM challenge (FM-, EM+), and fishmeal substitution and EM challenge (FM+, EM+). The second experiment was a 2 X 2 X 2 experiment with six birds per treatment (N = 48) involving fishmeal (FM-, FM+), Eimeria (EM-, EM+), and C perfringens (CP-, CP+). In both arms of the study, male broilers were given a starter diet for the whole period of 16 days, except those assigned to FM+, where 25% of the starter ration was replaced with fishmeal from days 8 to 14. EM inoculation was performed on day 9 and CP inoculation on days 14 and 15. The EM challenge birds were euthanatized for sampling on day 13; postmortem examination and sampling for the Eimeria plus C perfringens challenge arm of the study were on day 16. In the Eimeria challenge arm of the study, fishmeal supplementation significantly suppressed the mRNA levels of TNF-alpha, TFF2, and IL-18 pre-CP inoculation but simultaneously increased the levels of Muc13 and CD36 mRNAs. Birds challenged with Eimeria exhibited increased mRNA levels of Muc13, Muc5ac, TNF-alpha, and IL-18. In the Eimeria and C. perfringens challenge arm, birds exposed to EM challenge exhibited significantly lower mRNA levels of Muc2 and CD36. The mRNA levels of CD36 were also significantly suppressed by CP challenge. Our results showed that the transcription of mucin synthesis genes in the jejunum of broilers is modulated by fishmeal inclusion in the diet. Furthermore, we show for the first time suppression of CD36 mRNA levels in the intestine of broilers challenged with Eimeria or C. perfringens.

Enhancing biodegradation of C16-alkyl quaternary ammonium compounds using an oxygen-based membrane biofilm reactor.

PubMed

Lai, YenJung Sean; Ontiveros-Valencia, Aura; Ilhan, Zehra Esra; Zhou, Yun; Miranda, Evelyn; Maldonado, Juan; Krajmalnik-Brown, Rosa; Rittmann, Bruce E

2017-10-15

Quaternary ammonium compounds (QACs) (e.g., hexadecyltrimethyl-ammonium bromide, CTAB) are emerging contaminants with widespread use as surfactants and disinfectants. Because the initial step of QAC biodegradation is mono-oxygenation, QAC degraders require O 2 , but normal aeration leads to serious foaming. Here, we developed and tested an oxygen-based membrane biofilm reactor (O 2 -MBfR) that delivers O 2 by diffusion through the walls of hollow-membranes to a biofilm accumulating on the outer surface of membranes. The O 2 -MBfR sustained QAC biodegradation even with high and toxic QAC input concentrations, up to 400 mg/L CTAB. Bubbleless O 2 transfer completely eliminated foaming, and biofilm accumulation helped the QAC biodegraders resist toxicity. Pseudomonas, Achromobacter, Stenotrophomonas, and members of the Xanthomonadaceae family were dominant in the biofilm communities degrading CTAB, and their proportions depended on the O 2 -delivery capacity of the membranes. Bacteria capable of biodegrading QACs often harbor antibiotic resistance genes (ARGs) that help them avoid QAC toxicity. Gene copies of ARGs were detected in biofilms and liquid, but the levels of ARGs were 5- to 35-fold lower in the liquid than in the biofilm. In summary, the O 2 -MBfR achieved aerobic biodegradation of CTAB with neither foaming nor toxicity, and it also minimized the spread of ARGs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measuring Turbulence Mixing in Indonesian Seas Using Microstructure EM-APEX Floats

DTIC Science & Technology

2016-04-18

14 . ABSTRACT With the help of my graduate student at Columbia Univers ity (Asmi Napitu who is from Indonesia ) I have arranged a plan for the...and Fisheries of Republic of Indonesia (KKP), Bali BPPL lab on their Baruna Jaya 8 cruise in August 2016. Arrangement to sh ip the EM APEX float to... Indonesia in the spring 2016 are being arranged. 15. SUBJECT TERMS mixing within the Banda; EM APEX fl oats; upper ocean processes; mixed layer

What do emergency medicine learners want from their teachers? A multicenter focus group analysis.

PubMed

Thurgur, Lisa; Bandiera, Glen; Lee, Shirley; Tiberius, Richard

2005-09-01

To the best of the authors' knowledge, there are no reports describing what learners believe are good emergency medicine (EM) teaching practices. EM faculty developers are compromised by this lack of knowledge about what EM learners appreciate in their teachers. To determine what Canadian EM learners consider to be good prerequisites and strategies for effective teaching in the emergency department (ED). Clinical clerks and residents from the Canadian College of Family Physicians, Emergency Medicine certification [CCFP(EM)] fellowship program, the Royal College of Physicians and Surgeons of Canada, Emergency Medicine certification [FRCP(EM)] fellowship program, and off-service programs from all five Ontario medical schools participated in monitored focus-group sessions. Conversations were recorded, transcribed by a third party, and coded by two independent assessors using standard grounded theory methods. The text was categorized based on the final code into basic themes and specific qualifiers, which were then sorted by frequency of mention in the focus groups. Results are presented in descriptive fashion. Twenty-eight learners participated. They identified 14 major principles for good EM teaching, and a further 30 specific qualifiers. The top five principles were: "has a positive teacher attitude," "takes time to teach," "uses teachable moments well," "tailors teaching to the learner," and "gives appropriate feedback." Agreement on classification of ideas was 86%. Learners are sensitive to the constraints of the ED teaching environment, and have consistent views about good ED teaching practices. Among 14 general principles identified, "takes time to teach," "gives feedback," "tailors teaching to the learner," "uses teachable moments," and "has a good teacher attitude" were the most commonly reported.

Signs of temporomandibular disorders in migraine patients: a prospective, controlled study.

PubMed

Stuginski-Barbosa, Juliana; Macedo, Henrique R; Bigal, Marcelo Eduardo; Speciali, José Geraldo

2010-06-01

To identify signs of temporomandibular disorders and cervical pain in individuals with episodic and chronic (transformed) migraine (CM), relative to controls without headaches. In this prospective, controlled, double-blind study, we examined 93 individuals divided in 3 groups: episodic migraine EM, (n=31), CM chronic migraine (n=34), and controls without migraine (n=28). We recorded signs of temporomandibular disorders, and of pain in the neck, after the protocol of Helkimo (1974). We calculated the odds ratio (OR) and confidence intervals (CI) of symptoms as a function of headache status. Data from all groups were paired and compared using the chi test. The level of significance was 5% in 2-tailed tests. Relative to controls, participants with EM and CM were significantly more likely to have tenderness in the masticatory muscles [controls=28%, migraine=54%, (OR=3.0, 95% CI=1.1-8.9), CM=73% (OR=6.9, 95% CI=2.3-21.2)], and in the temporomandibular joint [controls=25%, migraine=61%, (OR=4.7, 95% CI=1.5-14.5), CM=61% (OR=4.8, 95% CI=1.6-14.5)]. They were numerically (but nonsignificantly) more likely to have limited lateral jaw movements (CM=34%; EM=26%; NP=18%), joint sounds (CM=44%; EM=29%; NP=28%), and tenderness in neck muscles (CM=64%; EM=51%; NP=35%). In a tertiary care population, individuals with EM and CM are more likely to have tenderness at the temporomandibular joint and on the masticatory muscles, relative to controls. Studies are needed to investigate whether treatment of 1 disorder will improve the other.

Ectomycorrhizal fungal communities of Coccoloba uvifera (L.) L. mature trees and seedlings in the neotropical coastal forests of Guadeloupe (Lesser Antilles).

PubMed

Séne, Seynabou; Avril, Raymond; Chaintreuil, Clémence; Geoffroy, Alexandre; Ndiaye, Cheikh; Diédhiou, Abdala Gamby; Sadio, Oumar; Courtecuisse, Régis; Sylla, Samba Ndao; Selosse, Marc-André; Bâ, Amadou

2015-10-01

We studied belowground and aboveground diversity and distribution of ectomycorrhizal (EM) fungal species colonizing Coccoloba uvifera (L.) L. (seagrape) mature trees and seedlings naturally regenerating in four littoral forests of the Guadeloupe island (Lesser Antilles). We collected 546 sporocarps, 49 sclerotia, and morphotyped 26,722 root tips from mature trees and seedlings. Seven EM fungal species only were recovered among sporocarps (Cantharellus cinnabarinus, Amanita arenicola, Russula cremeolilacina, Inocybe littoralis, Inocybe xerophytica, Melanogaster sp., and Scleroderma bermudense) and one EM fungal species from sclerotia (Cenococcum geophilum). After internal transcribed spacer (ITS) sequencing, the EM root tips fell into 15 EM fungal taxa including 14 basidiomycetes and 1 ascomycete identified. Sporocarp survey only weakly reflected belowground assessment of the EM fungal community, although 5 fruiting species were found on roots. Seagrape seedlings and mature trees had very similar communities of EM fungi, dominated by S. bermudense, R. cremeolilacina, and two Thelephoraceae: shared species represented 93 % of the taxonomic EM fungal diversity and 74 % of the sampled EM root tips. Furthermore, some significant differences were observed between the frequencies of EM fungal taxa on mature trees and seedlings. The EM fungal community composition also varied between the four investigated sites. We discuss the reasons for such a species-poor community and the possible role of common mycorrhizal networks linking seagrape seedlings and mature trees in regeneration of coastal forests.

Vasorelaxant and Hypotensive Effects of an Ethanolic Extract of Eulophia macrobulbon and Its Main Compound 1-(4′-Hydroxybenzyl)-4,8-Dimethoxyphenanthrene-2,7-Diol

PubMed Central

Wisutthathum, Sutthinee; Chootip, Krongkarn; Martin, Hélène; Ingkaninan, Kornkanok; Temkitthawon, Prapapan; Totoson, Perle; Demougeot, Céline

2018-01-01

Background: Ethnopharmacological studies demonstrated the potential for Eulophia species to treat inflammation, cancer, and cardio-metabolic diseases. The aim of the study was to investigate the vasorelaxant effect of ethanolic Eulophia macrobulbon (EM) extract and its main phenanthrene on rat isolated mesenteric artery and to investigate the hypotensive effect of EM. Methods: The vasorelaxant effects of EM extract or phenanthrene and the underlying mechanisms were evaluated on second-order mesenteric arteries from Sprague Dawley rats. In addition, the acute hypotensive effect was evaluated in anesthetized rats infused with cumulative concentrations of the EM extract. Results: Both EM extract (10-4–1 mg/ml) and phenanthrene (10-7–10-4 M) relaxed endothelium-intact arteries, an effect that was partly reduced by endothelium removal (p < 0.001). A significant decrease in the relaxant effect of the extract and the phenanthrene was observed with L-NAME and apamin/charybdotoxin in endothelium-intact vessels, and with iberiotoxin in denuded vessels. SNP (sodium nitroprusside)-induced relaxation was significantly enhanced by EM extract and phenanthrene. By contrast, ODQ (1H-[1,2,4]oxadiazolo[4,3-a]quinoxaline-1-one), 4-aminopyridine and glibenclamide (endothelium-denuded vessels) and indomethacin (endothelium-intact vessels) had no effect. In calcium-free solution, both the EM extract and phenanthrene inhibited extracellular Ca2+-induced contraction in high KCl and phenylephrine (PE) pre-contracted rings. They also inhibited the intracellular Ca2+ release sensitive to PE. The acute infusion of EM extract (20 and 70 mg/kg) induced an immediate and transient dose-dependent hypotensive effect. Conclusion: The ethanolic extract of EM tubers and its main active compound, 1-(4′-hydroxybenzyl)-4,8-dimethoxyphenanthrene-2,7-diol (phenanthrene) induced vasorelaxant effects on rat resistance vessels, through pleiotropic effects including endothelium-dependent effects (NOS activation, enhanced EDH production) and endothelium-independent effects (opening of KCa channels, inhibition of Ca2+ channels, inhibition of intracellular Ca2+ release and PDE inhibition). PMID:29872393

Utility of RAPD marker for genetic diversity analysis in gamma rays and ethyl methane sulphonate (EMS)-treated Jatropha curcas plants.

PubMed

Dhakshanamoorthy, Dharman; Selvaraj, Radhakrishnan; Chidambaram, Alagappan

2015-02-01

The presence of important chemical and physical properties in Jatropha curcas makes it a valuable raw material for numerous industrial applications, including the production of biofuel. Hence, the researcher's interest is diversified to develop more and better varieties with outstanding agronomic characteristics using conventional breeding. Among these, mutation breeding is one of the best approaches to bring genetic changes in plant species. The aim of this study is to evaluate the diversity and genetic relationship among J. curcas mutants, which were obtained from different doses of gamma rays (control, 5 Kr, 10 Kr, 15 Kr, 20 Kr and 25 Kr) and EMS (1%, 2%, 3% and 4%), using RAPD marker. Among the 21 random primers, 20 produced polymorphic bands. The primers, OPM-14 and OPAW-13, produced a minimum number of bands (3) each across the ten mutants, while the primer OPF-13 produced the maximum number of bands (10), followed by the primers OPU-13, OPAM-06, OPAW-09 and OPD-05, which produced 9 bands each. The number of amplicons varied from 3 to 10, with an average of 7 bands, out of which 4.57 were polymorphic. The percentage of polymorphism ranged from 0.00 to 100 with an average of 57%. In the present study, RAPD markers were found most polymorphic, with an average polymorphism information content (PIC) value of 0.347, effective multiplex ratio (EMR) of 35.14, marker index (MI) of 14.19, resolution power (Rp) of 11.19, effective marker index (EMI) of 8.21 and genotype index (GI) of 0.36, indicating that random primers are useful in studies of genetic characterization in J. curcas mutant plants. In a dendrogram constructed based on Jaccard's similarity coefficients, the mutants were grouped into three main clusters viz., (a) control, 10 Kr, 15 Kr, 20 Kr, 2% EMS, and 3% EMS, (b) 5 Kr and 1% EMS, and (c) 25 Kr and 4% EMS mutants. Based on the attributes of the random primers and polymorphism studied, it is concluded that RAPD analysis offers a useful molecular marker for the identification of the mutants in gamma rays and EMS treated plants. Copyright © 2014 Académie des sciences. Published by Elsevier SAS. All rights reserved.

The influence of nicotine in healing of small bowel anastomoses in rats: angiogenesis and miofibroblasts.

PubMed

Skinovsky, James; Malafaia, Osvaldo; Chibata, Mauricio; Tsumanuma, Fernanda; Panegalli, Flávio; Martins, Marcus Vinícius Dantas de Campos

2016-01-01

to know the effect of nicotine on angiogenesis and myofibroblast formation in anastomoses of the small bowel of rats. we randomly divided 60 Wistar rats into the groups Nicotine (N) and control (C), according to the proposed treatment. Each group was subdivided into three subgroups according to the time interval used for the evaluation (7, 14 or 28 days). The N group with 30 animals received nicotine subcutaneously at a dose of 2mg/kg body weight, diluted in 0.3ml of 0.9% saline, twice daily for 28 days prior to the operation, and for more 7, 14 or 28 days, depending on the subgroup. The C group (also 30 animals) received only saline on the same conditions and time intervals. After 28 days we carried out an end-to-end anastomosis 10cm distal to the duodenojejunal flexure in each rat. After 7, 14 or 28 days after surgery, we euthanized ten animals of each group, sent specimens of the anastomosis areas, 1cm proximal to 1cm distal, to counting of blood vessels and myofibroblasts through immunohistochemical staining by the application of monoclonal anti-factor VIII antibodies and anti-smooth muscle alpha-actin. the administration of nicotine led to the decrease in the number of blood vessels measured on the 28th postoperative day and the number of myofibroblasts measured on the seventh day following completion of the anastomoses. administration of nicotine was deleterious on angiogenesis and myofibroblast formation in rats' small intestine anastomoses. conhecer o efeito da nicotina sobre a angiogênese e formação de miofibroblastos em anastomoses do intestino delgado de ratos. sessenta ratos Wistar foram divididos de maneira aleatória em grupos Nicotina(N) e Controle (C), conforme o tratamento proposto. Cada grupo foi subdividido em três subgrupos, de acordo com o intervalo de tempo utilizado para a avaliação (7, 14 ou 28 dias). O grupo N, com 30 animais, recebeu nicotina por via subcutânea, na dose de 2mg/Kg de peso, diluída em 0,3ml de solução salina a 0,9%, em duas aplicações diárias, durante 28 dias prévios à operação e por mais 7, 14 ou 28 dias, conforme o subgrupo. O grupo C (igualmente com 30 animais) recebeu somente a solução salina nas mesmas condições e intervalos de tempo. Após 28 dias efetuou-se, em cada rato, anastomose término-terminal a 10cm da flexura duodenojejunal. Após 7, 14 ou 28 dias da cirurgia, os dez animais de cada subgrupo foram eutanasiados, sendo que as áreas anastomosadas, 1cm proximal a 1cm distal, foram encaminhadas para contagem de vasos sanguíneos e miofibroblastos, através de coloração imuno-histoquímica por aplicação dos anticorpos monoclonais antifator VIII e anti-alfa-actina muscular lisa. a administração de nicotina levou à diminuição do número de vasos sanguíneos aferidos no 28o dia pós-operatório e do número de miofibroblastos aferidos no sétimo dia após a realização das anastomoses. a administração de nicotina foi deletéria sobre a angiogênese e formação de miofibroblastos em anastomoses do intestino delgado de ratos.

Human Asymptomatic Epitopes Identified from the Herpes Simplex Virus Tegument Protein VP13/14 (UL47) Preferentially Recall Polyfunctional Effector Memory CD44high CD62Llow CD8+ TEM Cells and Protect Humanized HLA-A*02:01 Transgenic Mice against Ocular Herpesvirus Infection.

PubMed

Srivastava, Ruchi; Khan, Arif A; Garg, Sumit; Syed, Sabrina A; Furness, Julie N; Vahed, Hawa; Pham, Tiffany; Yu, Howard T; Nesburn, Anthony B; BenMohamed, Lbachir

2017-01-15

Herpes simplex virus 1 (HSV-1) infection is widespread among humans. The HSV-1 virion protein 13/14 (VP13/14), also known as UL47, is a tegument antigen targeted by CD8 + T cells from HSV-seropositive individuals. However, whether VP13/14-specific CD8 + T cells play a role in the natural protection seen in asymptomatic (ASYMP) individuals (individuals who have never had a clinical herpetic disease) has not been elucidated. Using predictive computer-assisted algorithms, we identified 10 potential HLA-A*02:01-restricted CD8 + T-cell epitopes from the 693-amino-acid sequence of the VP13/14 protein. Three out of 10 epitopes exhibited a high to moderate affinity of binding to soluble HLA-A*02:01 molecules. The phenotype and function of CD8 + T cells specific for each epitope were compared in HLA-A*02:01-positive ASYMP individuals and symptomatic (SYMP) individuals (individuals who have frequent clinical herpetic diseases) using determination of a combination of tetramer frequency and the levels of granzyme B, granzyme K, perforin, gamma interferon, tumor necrosis factor alpha, and interleukin-2 production and CD107 a/b cytotoxic degranulation. High frequencies of multifunctional CD8 + T cells directed against three epitopes, VP13/14 from amino acids 286 to 294 (VP13/14 286-294 ), VP13/14 from amino acids 504 to 512 (VP13/14 504-512 ), and VP13/14 from amino acids 544 to 552 (VP13/14 544-552 ), were detected in ASYMP individuals, while only low frequencies were detected in SYMP individuals. The three epitopes also predominantly recalled more CD45RA low CD44 high CCR7 low CD62L low CD8 + effector memory T cells (T EM cells) in ASYMP individuals than SYMP individuals. Moreover, immunization of HLA-A*02:01 transgenic mice with the three CD8 + T EM -cell epitopes from ASYMP individuals induced robust and polyfunctional HSV-specific CD8 + T EM cells associated with strong protective immunity against ocular herpesvirus infection and disease. Our findings outline the phenotypic and functional features of protective HSV-specific CD8 + T cells that should guide the development of a safe and effective T-cell-based herpes simplex vaccine. Although most herpes simplex virus 1 (HSV-1)-infected individuals shed the virus in their body fluids following reactivation from latently infected sensory ganglia, the majority never develop a recurrent herpetic disease and remain asymptomatic (ASYMP). In contrast, small proportions of individuals are symptomatic (SYMP) and develop frequent bouts of recurrent disease. The present study demonstrates that naturally protected ASYMP individuals have a higher frequency of effector memory CD8 + T cells (CD8 + T EM cells) specific to three epitopes derived from the HSV-1 tegument protein VP13/14 (VP13/14 286-294 ,VP13/14 504-512 , and VP13/14 544-552 ) than SYMP patients. Moreover, immunization of humanized HLA-A*02:01 transgenic mice with the three CD8 + T EM -cell epitopes from ASYMP individuals induced robust and polyfunctional HSV-specific CD8 + T cells associated with strong protective immunity against ocular herpesvirus infection and disease. The findings support the emerging concept of the development of a safe and effective asymptomatic herpes simplex vaccine that is selectively based on CD8 + T-cell epitopes from ASYMP individuals. Copyright © 2017 American Society for Microbiology.

Immunization of rhesus macaques with Echinococcus multilocularis recombinant 14-3-3 antigen leads to specific antibody response.

PubMed

Lampe, Karen; Gottstein, B; Becker, T; Stahl-Hennig, C; Kaup, F-J; Mätz-Rensing, K

2017-01-01

E. multilocularis (Em) is the etiologic agent of alveolar echinococcosis (AE), a severe and potentially fatal disease, primarily affecting the liver of and occurring in aberrant intermediate hosts, e.g., humans and non-human primates. Due to increasing numbers of spontaneous cases of AE in the Old World monkey colonies of the German Primate Center, the question arose as to whether vaccination of non-human primates may represent a useful prophylactic approach. In this pilot study, the recombinant antigen Em14-3-3, which has provided a 97 % protection against E. multilocularis challenge infection in rodent models, was used for the first time to immunize rhesus macaques. In order to increase immunogenicity, the antigen was formulated with different adjuvants including Quil A®, aluminum hydroxide (alum), and muramyl dipeptide (MDP). Also, different vaccination regimens were tested. All vaccinated animals developed antigen-specific antibodies. While Quil A® induced a local adverse reaction, alum proved to be the most potent adjuvant in terms of induced antibody levels, longevity as well as tolerability. In conclusion, our pilot study demonstrated that recombinant Em14-3-3 is safe and immunogenic in rhesus monkeys. As a next step, efficacy of the vaccination remains to be explored.

Rehabilitation of face-processing skills in an adolescent with prosopagnosia: Evaluation of an online perceptual training programme.

PubMed

Bate, Sarah; Bennetts, Rachel; Mole, Joseph A; Ainge, James A; Gregory, Nicola J; Bobak, Anna K; Bussunt, Amanda

2015-01-01

In this paper we describe the case of EM, a female adolescent who acquired prosopagnosia following encephalitis at the age of eight. Initial neuropsychological and eye-movement investigations indicated that EM had profound difficulties in face perception as well as face recognition. EM underwent 14 weeks of perceptual training in an online programme that attempted to improve her ability to make fine-grained discriminations between faces. Following training, EM's face perception skills had improved, and the effect generalised to untrained faces. Eye-movement analyses also indicated that EM spent more time viewing the inner facial features post-training. Examination of EM's face recognition skills revealed an improvement in her recognition of personally-known faces when presented in a laboratory-based test, although the same gains were not noted in her everyday experiences with these faces. In addition, EM did not improve on a test assessing the recognition of newly encoded faces. One month after training, EM had maintained the improvement on the eye-tracking test, and to a lesser extent, her performance on the familiar faces test. This pattern of findings is interpreted as promising evidence that the programme can improve face perception skills, and with some adjustments, may at least partially improve face recognition skills.

Determinants of Emergency Medical Services Utilization Among Acute Ischemic Stroke Patients in Hubei Province in China.

PubMed

Yin, Xiaoxv; Yang, Tingting; Gong, Yanhong; Zhou, Yanfeng; Li, Wenzhen; Song, Xingyue; Wang, Mengdie; Hu, Bo; Lu, Zuxun

2016-03-01

Emergency medical services (EMS) can effectively shorten the prehospital delay for patients with acute ischemic stroke. This study aimed to investigate EMS utilization and its associated factors in patients with acute ischemic stroke in China. A cross-sectional study was conducted from October 1, 2014, to January 31, 2015, which included 2096 patients admitted for acute ischemic stroke from 66 hospitals in Hubei province in China. A multivariable stepwise logistic regression model was undertaken to identify the factors associated with EMS utilization. Of the 2096 participants, only 323 cases (15.4%) used EMS. Those acute ischemic stroke patients who previously used EMS (odds ratio [OR] =9.8), whose National Institutes of Health Stroke Scale score was ≥10 (OR=3.7), who lived in urban communities (OR=2.5), who had sudden onset of symptoms (OR=2.4), who experienced their first stroke (OR=1.8), and who recognized initial symptom as stroke (OR=1.4) were more likely to use EMS. Additionally, when acute ischemic stroke patients' stroke symptom were noticed first by others (OR=2.1), rather than by the patients, EMS was more likely to be used. A very low proportion of patients with acute ischemic stroke used the EMS in Hubei province in China. Considerable education programs are required regarding knowledge of potential symptoms and the importance of EMS for stroke. © 2016 American Heart Association, Inc.

Physics based Prediction of Unexploded Ordnance Penetration in Granular Materials

DTIC Science & Technology

2017-05-01

0.08 0.10 0.12 0.14 0.16 0.18 D is pl ac em en t ( m m ) Time (s) Simulation Centrifuge test 91 cylindrical DSE assembly, and the shape of the stress...0.18 D is pl ac em en t ( m m ) Time (s) Simulation Centrifuge test 96 a) b) c) d) Figure 5.21 Projectile penetration simulation vertical...penetration (Fig. 5.25c and Fig. 5.26c). -4000 -3500 -3000 -2500 -2000 -1500 -1000 -500 0 0.00 0.02 0.04 0.06 0.08 0.10 D is pl ac em en t ( m m

Cognitive performance of neuromyelitis optica patients: comparison with multiple sclerosis.

PubMed

Vanotti, Sandra; Cores, Evangelina Valeria; Eizaguirre, Barbara; Melamud, Luciana; Rey, Raúl; Villa, Andrés

2013-06-01

The aim of the present research was to investigate cognitive pattern of patients with neuromyelitis optica (NMO) and to compare it with multiple sclerosis (MS) patients' performance. Fourteen NMO, 14 relapsing remitting multiple sclerosis (RRMS), and 14 healthy control patients participated in the investigation. Neuropsychological functions were evaluated with the Brief Repeatable Neuropsychological Battery for MS; Symbol Digit Modalities Test; Digit Span; and Semantic Fluency. Fifty-seven percent of NMO patients and 42.85% of the MS ones had abnormal performance in at least two cognitive tests. The NMO Group showed abnormal performance in verbal fluency, verbal and visual memories, with greater attention deficits. NMO patients outperformed healthy control in the paced auditory serial addition test (PASAT). However, no difference was found between NMO and RRMS patients. The NMO Group showed more dysfunction in attention and verbal fluencies than in verbal and visual memories. When compared with the MS patients, a similar dysfunction pattern was found. O objetivo da presente pesquisa foi investigar o padrão cognitivo de pacientes com neuromielite óptica (NMO) e compará-lo com o desempenho de pacientes com esclerose múltipla (EM). Métodos: Quatorze pacientes com NMO, 14 com esclerose múltipla recorrente remitente (EMRR) e 14 participantes do Controle saudáveis participaram da presente investigação. As funções neuropsicológicas foram avaliadas com a Bateria Breve de Testes Neuropsicológicos de Rao, Teste Símbolo Digit e a Fluência Semântica. Resultados: Cinquenta e sete por cento dos pacientes com NMO e 42,85% daqueles com EM apresentaram desempenho anormal em pelo menos dois testes cognitivos. O Grupo NMO apresentarou desempenho anormal na fluência verbal e nas memórias visual e verbal, com maiores déficits de atenção. Pacientes com NMO superaram os controles saudáveis em PASAT. No entanto, não foi encontrada diferença entre os pacientes com NMO e aqueles com EMRR. Conclusões: O Grupo NMO mostrou mais disfunção nas fluências de atenção e verbais do que nas memórias verbal e visual. Quando comparados com os pacientes com EM, um padrão de disfunção semelhante foi encontrado.

Avaliação dos efeitos do subgalato de bismuto na proliferação de miofibroblastos

PubMed Central

de Lima, Rubianne Ligório; Sampaio, Cláudia Paraguaçu; Seidel, Karin Caroline; Branco, Melina; Sobreiro, Rafaela Mabile

2016-01-01

Resumo Contexto O subgalato de bismuto é um metal pesado e insolúvel, utilizado por suas propriedades adstringentes e hemostáticas. Objetivo Avaliar os efeitos do subgalato de bismuto na cicatrização mediante observação de miofibroblastos em pele de ratos. Métodos Foram utilizados 60 ratos da linhagem Wistar, que receberam uma ferida no dorso da pele. Os animais foram divididos em dois grupos: controle (aplicação diária de cloreto de sódio a 0,9%) e experimental (aplicação diária de 0,5 mg de subgalato de bismuto). Cada grupo foi subdividido em três subgrupos, que foram reoperados para retirada da ferida em 3, 7 e 14 dias. Foi realizada coloração de hematoxilina eosina, picrosirius e imuno-histoquímica para avaliar contagem de miofibroblastos, resposta inflamatória e síntese de colágeno. Resultados Não foi encontrada diferença entre os grupos controle e experimento com relação ao processo inflamatório – subgrupos 3 dias (p = 1), 7 dias (p = 0,474) e 14 dias (p = 303). A avaliação dos colágenos tipo I e III no grupo-controle não demonstrou benefícios de cicatrização – 3 dias (p = 0,436), 7 dias (p = 0,853) e 14 dias (p = 0,436); já no grupo experimental, houve aumento dos colágenos tipos I e III nos subgrupos 3 e 14 dias (p = 0,005). A imuno-histoquímica confirmou os resultados encontrados na coloração hematoxilina eosina, na qual a área de miofibroblastos entre os subgrupos, nos grupos experimental (p = 0,4) e controle (p = 0,336), foi indiferente. Conclusão A utilização do subgalato de bismuto em ferida de pele de ratos não evidenciou benefícios na cicatrização, ou seja, não houve diferença na fibroplasia quando comparados os grupos experimental e controle. PMID:29930592

Availability and use of emergency obstetric care services in public hospitals in Laos PDR: a systems analysis.

PubMed

Douangphachanh, Xaysomphou; Ali, Moazzam; Outavong, Phathammavong; Alongkon, Phengsavanh; Sing, Menorath; Chushi, Kuroiwa

2010-12-01

The maternal mortality ratio in Laos in 2005 was 660 per 100,000 lives birth which was the third highest in Asia-Pacific Region. The objective was to determine the availability and use of emergency obstetric care (EmOC) in provincial and district hospitals in Borikhamxay, Khammouane, and Savannakhet provinces using UN guidelines. A hospital-based cross sectional survey was conducted from January to March 2008. All district (30) and provincial hospitals (3) from three provinces were included. Analysis was based on hospital records reflecting 12 months of facility data. Data indicates that only 14 hospitals (42.4%) were providing EmOC services, i.e., 9 basic, 5 comprehensive services. The proportion of births in EmOC facilities was only 11.2%, the met need was a very low 14.5%, and the cesarean section rate was only 0.9%. The case fatality rate in Borikhanxay province was 2.8%; in Khammouane and in Savannakhet provinces it was less than 1%. Record keeping at hospitals was poor. Signal functions provided in the last three months showed only 48.5% of the facilities performed assisted vaginal delivery. This is the first study in Lao PDR to assess EmOC services. Almost all the indicators were below the UN recommendations. Health planners must take evidence-based decisions to rectify and improve the situation in the hospitals regarding EmOC services. These data can therefore help government to assign and allocate budgets appropriately, and help policymakers and planners to identify systemic bottlenecks and prioritize solutions and will help in improving maternal health.

Structure of Ribosomal Silencing Factor Bound to Mycobacterium tuberculosis Ribosome.

PubMed

Li, Xiaojun; Sun, Qingan; Jiang, Cai; Yang, Kailu; Hung, Li-Wei; Zhang, Junjie; Sacchettini, James C

2015-10-06

The ribosomal silencing factor RsfS slows cell growth by inhibiting protein synthesis during periods of diminished nutrient availability. The crystal structure of Mycobacterium tuberculosis (Mtb) RsfS, together with the cryo-electron microscopy (EM) structure of the large subunit 50S of Mtb ribosome, reveals how inhibition of protein synthesis by RsfS occurs. RsfS binds to the 50S at L14, which, when occupied, blocks the association of the small subunit 30S. Although Mtb RsfS is a dimer in solution, only a single subunit binds to 50S. The overlap between the dimer interface and the L14 binding interface confirms that the RsfS dimer must first dissociate to a monomer in order to bind to L14. RsfS interacts primarily through electrostatic and hydrogen bonding to L14. The EM structure shows extended rRNA density that it is not found in the Escherichia coli ribosome, the most striking of these being the extended RNA helix of H54a. Copyright © 2015 Elsevier Ltd. All rights reserved.

PREVALENCE OF HELICOBACTER PYLORI TEN YEARS AGO COMPARED TO THE CURRENT PREVALENCE IN PATIENTS UNDERGOING UPPER ENDOSCOPY.

PubMed

Frugis, Sandra; Czeczko, Nicolau Gregori; Malafaia, Osvaldo; Parada, Artur Adolfo; Poletti, Paula Bechara; Secchi, Thiago Festa; Degiovani, Matheus; Rampanazzo-Neto, Alécio; D Agostino, Mariza D

2016-01-01

Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples. Helicobacter pylori vem sendo amplamente estudado desde 1982 estimando-se que 50% da população mundial esteja afetada. A literatura carece de estudos que mostrem a mudança de sua prevalência em uma mesma população ao longo do tempo. Comparar a prevalência do H.pylori no intervalo de 10 anos em população que realizou endoscopia digestiva alta no mesmo serviço de endoscopia. Estudo observacional, retrospectivo e transversal, comparando a prevalência de H. pylori em duas amostras com intervalo de 10 anos (2004 e 2014) que realizaram endoscopia digestiva alta com biópsias e teste da urease para a pesquisa de H. pylori. Foram estudados pacientes em três meses consecutivos de 2004, comparados aos de três meses consecutivos de 2014. O número total de pacientes avaliados foi 2536, sendo 1406 em 2004 e 1130 em 2014. Constatou-se resultado positivo para H.pylori em 17% da amostra como um todo. Houve queda significativa da prevalência de H.pylori de 19,3% em 2004 para 14,1% em 2014 (p<0.005). Houve redução de 5,2% da prevalência de H. pylori comparando-se dois períodos de três meses consecutivos com intervalo de 10 anos em duas amostras populacionais equivalentes.

Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district.

PubMed

Thwala, Siphiwe Bridget Pearl; Blaauw, Duane; Ssengooba, Freddie

2018-01-01

Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio. Data collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared. All 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (p<0.001). The analysis indicated a shortfall of EmNOC facilities in the district. Full EmNOC services were centralised to hospitals to assure patient safety even though national policy guidelines sanction more decentralisation to CHCs. Studies measuring EmNOC availability need to consider facility opening hours, capacity and staffing in addition to the demonstrated performance of signal functions.

Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district

PubMed Central

Blaauw, Duane; Ssengooba, Freddie

2018-01-01

Background Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio. Methods Data collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared. Results All 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (p<0.001). Conclusions The analysis indicated a shortfall of EmNOC facilities in the district. Full EmNOC services were centralised to hospitals to assure patient safety even though national policy guidelines sanction more decentralisation to CHCs. Studies measuring EmNOC availability need to consider facility opening hours, capacity and staffing in addition to the demonstrated performance of signal functions. PMID:29596431

National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

PubMed

Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

2018-01-01

Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

Effects of the August 2003 blackout on the New York City healthcare delivery system: a lesson for disaster preparedness.

PubMed

Prezant, David J; Clair, John; Belyaev, Stanislav; Alleyne, Dawn; Banauch, Gisela I; Davitt, Michelle; Vandervoorts, Kathy; Kelly, Kerry J; Currie, Brian; Kalkut, Gary

2005-01-01

On August 14, 2003, the United States and Canada suffered the largest power failure in history. We report the effects of this blackout on New York City's healthcare system by examining the following: 1) citywide 911 emergency medical service (EMS) calls and ambulance responses; and 2) emergency department (ED) visits and hospital admissions to one of New York City's largest hospitals. Citywide EMS calls and ambulance responses were categorized by 911 call type. Montefiore Medical Center (MMC) ED visits and hospital admissions were categorized by diagnosis and physician-reviewed for relationship to the blackout. Comparisons were made to the week pre- and postblackout. Citywide EMS calls numbered 5,299 on August 14, 2003, and 5,021 on August 15, 2003, a 58% increase (p < .001). During the blackout, there were increases in "respiratory" (189%; p < .001), "cardiac" (68%; p = .016), and "other" (40%; p < .001) EMS call categories, but when expressed as a percent of daily totals, "cardiac" was no longer significant. The MMC-ED reflected this surge with only "respiratory" visits significantly increased (expressed as percent of daily total visits; p < .001). Respiratory device failure (mechanical ventilators, positive pressure breathing assist devices, nebulizers, and oxygen compressors) was responsible for the greatest burden (65 MMC-ED visits, with 37 admissions) as compared with 0 pre- and postblackout. The blackout dramatically increased EMS and hospital activity, with unexpected increases resulting from respiratory device failures in community-based patients. Our findings suggest that current capacity to respond to public health emergencies could be easily overwhelmed by widespread/prolonged power failure(s). Disaster preparedness planning would be greatly enhanced if fully operational, backup power systems were mandated, not only for acute care facilities, but also for community-based patients dependent on electrically powered lifesaving devices.

HVP contributions to the muon (g-2) including QED corrections with twisted-mass fermions

NASA Astrophysics Data System (ADS)

Giusti, Davide; Lubicz, Vittorio; Martinelli, Guido; Sanfilippo, Francesco; Simula, Silvano

2018-03-01

We present a lattice calculation of the Hadronic Vacuum Polarization (HVP) contribution of the strange and charm quarks to the anomalous magnetic moment of the muon including leading-order electromagnetic (e.m.) corrections. We employ the gauge configurations generated by the European Twisted Mass Collaboration (ETMC) with Nf = 2+1 + 1 dynamical quarks at three values of the lattice spacing (a ≃ 0.062,0.082,0.089 fm) with pion masses in the range Mπ ≃ 210 - 450 MeV. The strange and charm quark masses are tuned at their physical values. Neglecting discon-nected diagrams and after the extrapolations to the physical pion mass and to the continuum limit we obtain: aμs(αem2) = (53.1 ± 2.5 )×10-10, aμs(αem2) = (-0.018 ± 0.011)×10-10 and aμs(αem2) = (14.75±0.56)×10-10,aμs(αem2) = (-0.030±0.013)×10-10 for the strange and charm contributions, respectively.!

Electrostimulation improves muscle perfusion but does not affect either muscle deoxygenation or pulmonary oxygen consumption kinetics during a heavy constant-load exercise.

PubMed

Layec, Gwenael; Millet, Grégoire P; Jougla, Aurélie; Micallef, Jean-Paul; Bendahan, David

2008-02-01

Electromyostimulation (EMS) is commonly used as part of training programs. However, the exact effects at the muscle level are largely unknown and it has been recently hypothesized that the beneficial effect of EMS could be mediated by an improved muscle perfusion. In the present study, we investigated rates of changes in pulmonary oxygen consumption (VO(2p)) and muscle deoxygenation during a standardized exercise performed after an EMS warm-up session. We aimed at determining whether EMS could modify pulmonary O(2) uptake and muscle deoxygenation as a result of improved oxygen delivery. Nine subjects performed a 6-min heavy constant load cycling exercise bout preceded either by an EMS session (EMS) or under control conditions (CONT). VO(2p) and heart rate (HR) were measured while deoxy-(HHb), oxy-(HbO(2)) and total haemoglobin/myoglobin (Hb(tot)) relative contents were measured using near infrared spectroscopy. EMS significantly increased (P < 0.05) the Hb(tot) resting level illustrating a residual hyperaemia. The EMS priming exercise did not affect either the HHb time constant (17.7 +/- 14.2 s vs. 13.1 +/- 2.3 s under control conditions) or the VO(2p) kinetics (time-constant = 18.2 +/- 5.2 s vs. 15.4 +/- 4.6 s under control conditions). Likewise, the other VO(2p) parameters were unchanged. Our results further indicated that EMS warm-up improved muscle perfusion through a residual hyperaemia. However, neither VO(2p) nor [HHb] kinetics were modified accordingly. These results suggest that improved O(2) delivery by residual hyperaemia induced by EMS does not accelerate the rate of aerobic metabolism during heavy exercise at least in trained subjects.

Prevalence of emergency medical service utilisation in patients with out-of-hospital cardiac arrest in Thailand.

PubMed

Monsomboon, Apichaya; Chantawatsharakorn, Prasit; Suksuriyayothin, Saovanee; Keorochana, Kris; Mukda, Achara; Prapruetkit, Nattakarn; Surabenjawong, Usapan; Nakornchai, Tanyaporn; Chakorn, Tipa

2016-03-01

Most patients with out-of-hospital cardiac arrest (OHCA) have grave outcomes. The efficacy of emergency medical services (EMS) may affect outcomes. However, no data exists in Thailand. To ascertain the prevalence of EMS utilisation in patients with OHCA transferred to Siriraj Hospital and also to elucidate the rates of return of spontaneous circulation (ROSC), hospital admission and survival to hospital discharge. This prospective cohort study was conducted in patients with OHCA at a university hospital in Bangkok, Thailand from May 2011 to February 2013. The data was gathered by interviewing bystanders. Data about the mode of transportation, reasons for EMS usage, response time, ROSC and 30-day mortality were collected. Patients with rigour mortis or livor mortis were excluded. The factors affecting ROSC and survival rate were determined by univariate analysis. One hundred and fifty-two patients were included. The prevalence of EMS usage was 14.5% (95% CI 9.3 to 21.0). The most common cause of non-usage of EMS was not knowing or forgetting an EMS number (49.2%). The proportion of bystanders having known an EMS number and using EMS was 34%. The ROSC and 30-day survival rates were 53.3% and 10.5%, respectively. Non-cardiac causes and witnessed arrests were associated with ROSC (p<0.05). The prevalence of EMS utilisation in OHCA at Siriraj Hospital was very low. This may affect the outcomes of patients with OHCA. Improving the EMS system by publicity to increase public awareness and providing life-support education nationwide may improve outcomes of patients with OHCA in Thailand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Variation in ectomycorrhizal fungal communities associated with Oreomunnea mexicana (Juglandaceae) in a Neotropical montane forest.

PubMed

Corrales, Adriana; Arnold, A Elizabeth; Ferrer, Astrid; Turner, Benjamin L; Dalling, James W

2016-01-01

Neotropical montane forests are often dominated by ectomycorrhizal (EM) tree species, yet the diversity of their EM fungal communities remains poorly explored. In lower montane forests in western Panama, the EM tree species Oreomunnea mexicana (Juglandaceae) forms locally dense populations in forest otherwise characterized by trees that form arbuscular mycorrhizal (AM) associations. The objective of this study was to compare the composition of EM fungal communities associated with Oreomunnea adults, saplings, and seedlings across sites differing in soil fertility and the amount and seasonality of rainfall. Analysis of fungal nrITS DNA (nuclear ribosomal internal transcribed spacers) revealed 115 EM fungi taxa from 234 EM root tips collected from adults, saplings, and seedlings in four sites. EM fungal communities were equally species-rich and diverse across Oreomunnea developmental stages and sites, regardless of soil conditions or rainfall patterns. However, ordination analysis revealed high compositional turnover between low and high fertility/rainfall sites located ca. 6 km apart. The EM fungal community was dominated by Russula (ca. 36 taxa). Cortinarius, represented by 14 species and previously reported to extract nitrogen from organic sources under low nitrogen availability, was found only in low fertility/high rainfall sites. Phylogenetic diversity analyses of Russula revealed greater evolutionary distance among taxa found on sites with contrasting fertility and rainfall than was expected by chance, suggesting that environmental differences among sites may be important in structuring EM fungal communities. More research is needed to evaluate whether EM fungal taxa associated with Oreomunnea form mycorrhizal networks that might account for local dominance of this tree species in otherwise diverse forest communities.

Peat soils stabilization using Effective Microorganisms (EM)

NASA Astrophysics Data System (ADS)

Yusof, N. Z.; Samsuddin, N. S.; Hanif, M. F.; Syed Osman, S. B.

2018-04-01

Peat soil is known as geotechnical problematic soil since it is the softest soil having highly organic and moisture content which led to high compressibility, low shear strength and long-term settlement. The aim of this study was to obtain the stabilized peat soils using the Effective Microorganisms (EM). The volume of EM added and mixed with peat soils varied with 2%, 4%, 6%, 8% and 10% and then were cured for 7, 14 and 21 days. The experiment was done for uncontrolled and controlled moisture content. Prior conducting the main experiments, the physical properties such as moisture content, liquid limit, specific gravity, and plastic limit etc. were measure for raw peat samples. The Unconfined Compressive Strength (UCS) test was performed followed by regression analysis to check the effect of EM on the soil strength. Obtained results have shown that the mix design for controlled moisture contents showed the promising improvement in their compressive strength. The peat soil samples with 10% of EM shows the highest increment in UCS value and the percentage of increments are in the range of 44% to 65% after curing for 21 days. The regression analysis of the EM with the soil compressive strength showed that in controlled moisture conditions, EM significantly improved the soil stability as the value of R2 ranged between 0.97 – 0.78. The results have indicated that the addition of EM in peat soils provides significant improving in the strength of the soil as well as the other engineering properties.

High school allied health students and their exposure to the profession of EMS.

PubMed

Holloman, Joshua B; Hubble, Michael W

2012-06-01

Ensuring a stable Emergency Medical Services (EMS) workforce is a growing concern, and effective recruiting strategies are needed to expose young adults to the EMS profession. The objective of this study was to assess the exposure of high school allied health students to EMS as a career option, as well as measure their attitudes and beliefs about the EMS profession. Hypothesis Few high school allied health students are exposed to EMS educational and career opportunities. A convenience sample of allied health students in a rural high school system was surveyed about exposure to EMS, career intentions, factors impacting career decisions, and attitudes and beliefs about EMS. Descriptive statistics were calculated, and intention to pursue an EMS career was modeled using logistic regression. Of 171 students enrolled in allied health courses across six high schools, 135 (78.9%) agreed to participate; 85.2% were female. Almost all (92.6%) respondents intended to pursue a health career, but only 43.0% reported that their allied health course exposed them to EMS as a profession. Few participants (37.7%) were knowledgeable about EMS associate degree or baccalaureate degree (27.4%) programs. Only 20.7% of the respondents intended to pursue EMS as a career, although 46.0% wanted to learn more about the profession. Most (68.2%) students expressed interest in an emergency medical technician (EMT) course if one were offered, and 80.0% were interested in a ride-along program. Independent predictors of pursuing an EMS career included exposure to EMS outside of high school (OR = 7.4, 95% CI = 1.7-30.4); media influence on career choice (OR = 9.6, 95% CI = 1.8-50.1); and the belief that EMS was mentally challenging (OR = 15.9, 95% CI = 1.1-216.6). Negative predictors included the beliefs that an EMS career was stimulating (OR = 0.05, 95% CI = 0.00-0.53) and physically challenging (OR = 0.06, 95% CI = 0.00-0.63); as well as prior exposure to an EMS job advertisement (OR = 0.14, 0.03-0.53). Overall, there was a lack of exposure to career and educational options in EMS among allied health students in the school system studied, and few students intended to pursue an EMS career after graduation. However, the majority of students indicated they would like to learn more about EMS, and would enroll in an EMT course and ride-along program if available. These findings suggest that, with exposure to the profession, more allied health students could choose EMS as a career.

Cryo-EM structure and biochemical analysis reveal the basis of the functional difference between human PI3KC3-C1 and -C2.

PubMed

Ma, Meisheng; Liu, Jun-Jie; Li, Yan; Huang, Yuwei; Ta, Na; Chen, Yang; Fu, Hua; Ye, Ming-Da; Ding, Yuehe; Huang, Weijiao; Wang, Jia; Dong, Meng-Qiu; Yu, Li; Wang, Hong-Wei

2017-08-01

Phosphatidylinositol 3-phosphate (PI3P) plays essential roles in vesicular trafficking, organelle biogenesis and autophagy. Two class III phosphatidylinositol 3-kinase (PI3KC3) complexes have been identified in mammals, the ATG14L complex (PI3KC3-C1) and the UVRAG complex (PI3KC3-C2). PI3KC3-C1 is crucial for autophagosome biogenesis, and PI3KC3-C2 is involved in various membrane trafficking events. Here we report the cryo-EM structures of human PI3KC3-C1 and PI3KC3-C2 at sub-nanometer resolution. The two structures share a common L-shaped overall architecture with distinct features. EM examination revealed that PI3KC3-C1 "stands up" on lipid monolayers, with the ATG14L BATs domain and the VPS34 C-terminal domain (CTD) directly contacting the membrane. Biochemical dissection indicated that the ATG14L BATs domain is responsible for membrane anchoring, whereas the CTD of VPS34 determines the orientation. Furthermore, PI3KC3-C2 binds much more weakly than PI3KC3-C1 to both PI-containing liposomes and purified endoplasmic reticulum (ER) vesicles, a property that is specifically determined by the ATG14L BATs domain. The in vivo ER localization analysis indicated that the BATs domain was required for ER localization of PI3KC3. We propose that the different lipid binding capacity is the key factor that differentiates the functions of PI3KC3-C1 and PI3KC3-C2 in autophagy.

Nursing diagnoses in patients with immune-bullous dermatosis.

PubMed

Brandão, Euzeli da Silva; Santos, Iraci Dos; Lanzillotti, Regina Serrão; Ferreira, Adriano Menis; Gamba, Mônica Antar; Azulay-Abulafia, Luna

2016-08-15

identify nursing diagnoses in patients with immune-bullous dermatosis. a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11). 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology. identificar diagnósticos de enfermagem em clientes com dermatoses imunobolhosas. pesquisa quantitativa e descritiva, realizada em três instituições localizadas no Rio de Janeiro e no Mato Grosso do Sul-Brasil, aplicando o Protocolo de Avaliação do Cliente em Dermatologia, durante consulta de enfermagem. Utilizou-se a estatística descritiva simples para análise dos dados. participaram do estudo 14 sujeitos, nove com diagnóstico médico de pênfigo vulgar, dois de foliáceo e três de penfigoide bolhoso. A idade variou entre 27 e 82 anos, predominando 11 pessoas do sexo feminino. Foram discutidos 14 diagnósticos de enfermagem identificados a partir do raciocínio clínico, em todos os participantes do estudo, representando as respostas humanas mais frequentes nesta amostra. A aplicação do Protocolo de Avaliação do Cliente em Dermatologia facilitou a avaliação integral, além de propiciar a identificação dos diagnósticos de acordo com a North American Nursing Diagnosis Association International. os diagnósticos de enfermagem apresentados ratificam a necessidade do trabalho interdisciplinar durante atendimento a esta clientela. Para melhor descrição dos fenômenos relacionados à clientela em questão, sugere-se a inclusão de dois fatores de risco/relacionados em três diagnósticos desta taxonomia. Cabe ressaltar a contribuição dos achados para o cuidar/educar/pesquisar em enfermagem em dermatologia. identificar los diagnósticos de enfermería en pacientes con inmuno dermatosis ampollosa. investigación cuantitativa y descriptiva, realizada en tres instituciones ubicadas en Río de Janeiro y Mato Grosso do Sul, Brasil, utilizando el Protocolo de Evaluación del Cliente en Dermatología en la consulta de enfermería. Se utilizó estadística descriptiva simples para el análisis de datos. 14 sujetos participaron en el estudio, nueve con diagnóstico de pénfigo vulgar, dos de pénfigo foliáceo y tres de penfigoide ampolloso. La edad osciló entre 27 y 82 años, predominio femenino con 11 mujeres. Se discutieron 14 diagnósticos de enfermería identificados desde el razonamiento clínico, en todos los participantes en el estudio, que representa las respuestas humanas más comunes en esta muestra. La aplicación del Protocolo de Evaluación de Dermatología facilitó la evaluación global, además de proporcionar la identificación de los diagnósticos de acuerdo con la North American Nursing Diagnosis Association International. los diagnósticos de enfermería presentados confirman la necesidad del trabajo interdisciplinario en el servicio a estos clientes. Para una mejor descripción de los fenómenos relacionados con los clientes en cuestión, se sugiere la inclusión de dos factores de riesgo/relacionados en tres diagnósticos de esta taxonomía. Vale la pena señalar la contribución de los hallazgos para el cuidado/educación/investigación en enfermería en dermatología.

Emergency Medical Services Utilization in EMS Priority Conditions in Beirut, Lebanon.

PubMed

El Sayed, Mazen; Tamim, Hani; Chehadeh, Ahel Al-Hajj; Kazzi, Amin A

2016-12-01

Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon METHODS: This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction. Patient/proxy survey (20 questions) and chart review were completed. The responses to survey questions were "disagree," "neutral," or "agree" and were scored as one, two, or three with three corresponding to higher likelihood of EMS use. A total scale score ranging from 20 to 60 was created and transformed from 0% to 100%. Data were analyzed based on mode of presentation (EMS vs other). Among the 481 patients enrolled, only 112 (23.3%) used EMS. Mean age for study population was 63.7 years (SD=18.8 years) with 56.5% males. Mean clinical severity score (Emergency Severity Index [ESI]) was 2.5 (SD=0.7) and mean pain score was 3.1 (SD=3.5) at ED presentation. Over one-half (58.8%) needed admission to hospital with 21.8% to an intensive care unit care level and with a mortality rate of 7.3%. Significant associations were found between EMS use and the following variables: severity of illness, degree of pain, familiarity with EMS activation, previous EMS use, perceived EMS benefit, availability of EMS services, trust in EMS response times and treatment, advice from family, and unavailability of immediate private mode of transport (P≤.05). Functional screening, or requiring full assistance (OR=4.77; 95% CI, 1.85-12.29); acute symptoms onset ≤ one hour (OR=2.14; 95% CI, 1.08-4.26); and higher scale scores (OR=2.99; 95% CI, 2.20-4.07) were significant predictors of EMS use. Patients with lower clinical severity (OR=0.53; 95% CI, 0.35-0.81) and those with chest pain (OR=0.05; 95% CI, 0.02-0.12) or respiratory distress (OR=0.15; 95% CI, 0.07-0.31) using cardiac arrest as a reference were less likely to use EMS. Emergency Medical Services use in EMS priority conditions in Lebanon is low. Several predictors of EMS use were identified. Emergency Medical Services initiatives addressing underutilization should result from this proposed assessment of the perspective of the EMS system's end user. El Sayed M , Tamim H , Al-Hajj Chehadeh A , Kazzi AA . Emergency Medical Services utilization in EMS priority conditions in Beirut, Lebanon. Prehosp Disaster Med. 2016;31(6):621-627.

Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

PubMed

Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

2018-03-22

To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Community surveillance of falls among the elderly using computerized EMS transport data.

PubMed

Wofford, J L; Heuser, M D; Moran, W P; Schwartz, E; Mittelmark, M B

1994-07-01

Because falls are common among the elderly and are associated with high morbidity and mortality, community surveillance has been recommended. The purpose of this study was to characterize the impact of falls among the elderly on emergency medical transport services (EMS) and to explore the potential for community surveillance of falls through the use of computerized EMS data. Computerized EMS data and United States census data for 1990 for persons aged > or = 65 in Forsyth County, NC, were used to produce EMS transport rates for falls and to make comparisons by age, gender, race, and residence (nursing home vs community). A fall was reported as the cause for EMS summons in 15.1% (613 of 4,058) of cases. Transport rates in 1990 for falls were 7.8 per 1,000, 25.4 per 1,000, and 58.5 per 1,000 for the age groups of 65 to 74 years, 75 to 84 years, and 85 years and older. Rates were higher for females than for males (17.1 per 1,000 v 8.1 per 1,000) and higher for whites than for African-Americans (14.3 per 1,000 v 10.3 per 1,000). Rates for nursing home residents were four times that of community residents (70.6 per 1,000 v 16.0 per 1,000). Over 50% of nursing home fallers were transported between midnight and 0400 compared with 25% of community dwellers. EMS summons for older adults reporting a fall accounts for a significant portion (15%) of all transports in this county. Computerized EMS data demonstrated patterns of falls among the elderly that are consistent with known demographic factors. The potential for using computerized EMS data as a practical means of community surveillance should be further explored.

Association between poor sleep, fatigue, and safety outcomes in Emergency Medical Services providers

PubMed Central

Patterson, P. Daniel; Weaver, Matthew D.; Frank, Rachel C.; Warner, Charles W.; Martin-Gill, Christian; Guyette, Francis X.; Fairbanks, Rollin J.; Hubble, Michael W.; Songer, Thomas J.; Callaway, Clifton W.; Kelsey, Sheryl F.; Hostler, David

2011-01-01

Objective To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among Emergency Medical Services (EMS) workers. Methods We used convenience sampling of EMS agencies and a cross-sectional survey design. We administered the 19-item Pittsburgh Sleep Quality Index (PSQI), 11-item Chalder Fatigue Questionnaire (CFQ), and 44-item EMS Safety Inventory (EMS-SI) to measure sleep quality, fatigue, and safety outcomes, respectively. We used a consensus process to develop the EMS-SI, which was designed to capture three composite measurements of EMS worker injury, medical errors and adverse events (AE), and safety compromising behaviors. We used hierarchical logistic regression to test the association between poor sleep quality, fatigue, and three composite measures of EMS worker safety outcomes. Results We received 547 surveys from 30 EMS agencies (a 35.6% mean agency response rate). The mean PSQI score exceeded the benchmark for poor sleep (6.9, 95%CI 6.6, 7.2). Greater than half of respondents were classified as fatigued (55%, 95%CI 50.7, 59.3). Eighteen percent of respondents reported an injury (17.8%, 95%CI 13.5, 22.1), forty-one percent a medical error or AE (41.1%, 95%CI 36.8, 45.4), and 89% (95%CI 87, 92) safety compromising behaviors. After controlling for confounding, we identified 1.9 greater odds of injury (95%CI 1.1, 3.3), 2.2 greater odds of medical error or AE (95%CI 1.4, 3.3), and 3.6 greater odds of safety compromising behavior (95%CI 1.5, 8.3) among fatigued respondents versus non-fatigued respondents. Conclusions In this sample of EMS workers, poor sleep quality and fatigue is common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes. PMID:22023164

The Savannah River Site`s groundwater monitoring program. Third quarter 1990

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

Not Available

1991-05-06

The Environmental Protection Department/Environmental Monitoring Section (EPD/EMS) administers the Savannah River Site`s (SRS) Groundwater Monitoring Program. During third quarter 1990 (July through September) EPD/EMS conducted routine sampling of monitoring wells and drinking water locations. EPD/EMS established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria do not define contamination levels; instead they aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, background levels in SRS groundwater, and drinking water standards. All analytical results from third quarter 1990 are listed in thismore » report, which is distributed to all site custodians. One or more analytes exceeded Flag 2 in 87 monitoring well series. Analytes exceeded Flat 2 for the first since 1984 in 14 monitoring well series. In addition to groundwater monitoring, EPD/EMS collected drinking water samples from SRS drinking water systems supplied by wells. The drinking water samples were analyzed for radioactive constituents.« less

The Savannah River Site's groundwater monitoring program

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

Not Available

1991-05-06

The Environmental Protection Department/Environmental Monitoring Section (EPD/EMS) administers the Savannah River Site's (SRS) Groundwater Monitoring Program. During third quarter 1990 (July through September) EPD/EMS conducted routine sampling of monitoring wells and drinking water locations. EPD/EMS established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria do not define contamination levels; instead they aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, background levels in SRS groundwater, and drinking water standards. All analytical results from third quarter 1990 are listed in thismore » report, which is distributed to all site custodians. One or more analytes exceeded Flag 2 in 87 monitoring well series. Analytes exceeded Flat 2 for the first since 1984 in 14 monitoring well series. In addition to groundwater monitoring, EPD/EMS collected drinking water samples from SRS drinking water systems supplied by wells. The drinking water samples were analyzed for radioactive constituents.« less

Height Growth and Percentage of Body Fat in Relation to Early Menarche in Girls from Merida, Yucatan, Mexico.

PubMed

Datta Banik, Sudip; Mendez, Nina; Dickinson, Federico

2015-01-01

Early menarche (EM) (i.e., age at menarche [AAM] <12 years of age) is related to short height and higher body fatness. In a mixed-longitudinal study done in Merida, Yucatan, height, body mass index (BMI), and percentage of body fat (BF%) were recorded at a one-year interval among 258 postmenarcheal (EM = 94) girls. Anthropometric measurements were recorded of the age cohorts in 2008-09 when participants were 13-17 years of age (baseline), and in the one-year follow-up study (± 6 days) the girls were 14-18 years of age. The BF% was estimated through bioelectrical impedance analysis. Mean AAM was 10.59 years in EM girls and 12.54 years in not early menarche (NEM) girls. Height growth (cm/year) was greater in NEM girls. Mean values of BMI, BF%, and frequencies of stunting (low height-for-age) and excess weight (overweight + obesity) were higher in EM girls than in their NEM age peers.

Fitting Multimeric Protein Complexes into Electron Microscopy Maps Using 3D Zernike Descriptors

PubMed Central

Esquivel-Rodríguez, Juan; Kihara, Daisuke

2012-01-01

A novel computational method for fitting high-resolution structures of multiple proteins into a cryoelectron microscopy map is presented. The method named EMLZerD generates a pool of candidate multiple protein docking conformations of component proteins, which are later compared with a provided electron microscopy (EM) density map to select the ones that fit well into the EM map. The comparison of docking conformations and the EM map is performed using the 3D Zernike descriptor (3DZD), a mathematical series expansion of three-dimensional functions. The 3DZD provides a unified representation of the surface shape of multimeric protein complex models and EM maps, which allows a convenient, fast quantitative comparison of the three dimensional structural data. Out of 19 multimeric complexes tested, near native complex structures with a root mean square deviation of less than 2.5 Å were obtained for 14 cases while medium range resolution structures with correct topology were computed for the additional 5 cases. PMID:22417139

Fitting multimeric protein complexes into electron microscopy maps using 3D Zernike descriptors.

PubMed

Esquivel-Rodríguez, Juan; Kihara, Daisuke

2012-06-14

A novel computational method for fitting high-resolution structures of multiple proteins into a cryoelectron microscopy map is presented. The method named EMLZerD generates a pool of candidate multiple protein docking conformations of component proteins, which are later compared with a provided electron microscopy (EM) density map to select the ones that fit well into the EM map. The comparison of docking conformations and the EM map is performed using the 3D Zernike descriptor (3DZD), a mathematical series expansion of three-dimensional functions. The 3DZD provides a unified representation of the surface shape of multimeric protein complex models and EM maps, which allows a convenient, fast quantitative comparison of the three-dimensional structural data. Out of 19 multimeric complexes tested, near native complex structures with a root-mean-square deviation of less than 2.5 Å were obtained for 14 cases while medium range resolution structures with correct topology were computed for the additional 5 cases.

7 CFR 764.51 - Loan application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... plan; and (14) For EM loans, a statement of loss or damage on the appropriate Agency form. (c) For a Lo... require a Lo-Doc applicant to submit any other information listed in paragraph (b) of this section as...

Blade-order-dependent radiocarbon variability in brown seaweed (Undaria pinnatifida) reflected a cold Oyashio water intrusion event in an embayment of the Sanriku coast, northeastern Japan

NASA Astrophysics Data System (ADS)

Satoh, N.; Fukuda, H.; Miyairi, Y.; Yokoyama, Y.; Nagata, T.

2015-12-01

Radiocarbon in dissolved inorganic carbon (DIC) in seawater varies greatly, both geographically and with depth. This "reservoir effect" is thought to be reflected in the radiocarbon content (Δ14C) of marine organisms, via DIC fixation by primary producers and subsequent trophic transfer. The Δ14C of marine organismal soft tissues might thus provide unique information about their habitats, diets, migration and other environmental histories. However, the effectiveness of this approach has yet to be extensively explored, with data on Δ14C variability in soft tissues of marine organisms being markedly limited. Here we examined whether Δ14C values of individual pinnate blades (leaf-like structures) of brown seaweed (Undaria pinnatifida) reflect the Δ14C of DIC in the water current prevailing at the time of blade formation. The study was conducted in Otsuchi Bay located in the Sanriku coastal region, northeastern Japan, where 14C-depleted cold Oyashio current and warm Tsugaru current (high Δ14C) converge, affecting the physiology and growth of marine organisms growing there. U. pinnatifida individuals cultured in the bay (length of saprophytes, 140-215 cm) were harvested in April 2014 and Δ14C of blades were determined by accelerator mass spectrometry. Younger blades formed after the Oyashio water intrusion had significantly lower Δ14C values compared to older blades formed before the event. The Δ14C values of younger and older blades were generally consistent with the Δ14C of DIC in Oyashio (-60.5 ‰) and Tsugaru (24.9 ‰) waters, respectively. Thus, despite possible turnover of organic carbon in seaweed soft tissues, blade-order-dependent Δ14C variability appeared to strongly reflect the Oyashio intrusion event (radiocarbon shift) in the bay.

Pediatric vascular trauma in Manaus, Amazon - Brazil.

PubMed

Costa, Cleinaldo DE Almeida; Souza, José Emerson Dos Santos; Araújo, Antônio Oliveira DE; Melo, Flávio Augusto Oliva; Costa, Isabelle Nascimento; Klein, Paulo Henrique

2016-01-01

to assess the incidence of pediatric vascular injuries in patients treated at the Emergency Room of the Eastern Children's Hospital, in Manaus. we conducted a retrospective study of pediatric patients who suffered vascular injuries treated between February 2001 to February 2012. we studied 71 patients, predominantly male (78.87%), with a mean age of 7.63 years. The predominant mechanism of injury was stab wound in 27 patients (38.03%). The average hospital stay was 10.18 days; 16 patients required care in intensive care unit, with average stay of 8.81 days. The main injuries occurred in the extremities, the upper limb being the most affected, with lesions of the ulnar artery in 13 (15.66%) and radial in 10 (12.04%). The mostly applied procedure was vascular exploration 35 (32.4%). Complications occurred in nine patients (12.68%). Mortality was 1.4%, in one patient with a lesion of the common iliac vein and the inferior vena cava due fall from height. pediatric vascular injury occurred predominantly in the extremities. The dimensions of the injured vessels made surgical correction more complex and increased complication rates, particularly amputations. avaliar a incidência de traumatismos vasculares pediátricos em doentes atendidos no Hospital Pronto Socorro da Criança Zona Leste, na cidade de Manaus. estudo retrospectivo de doentes pediátricos vítimas de traumatismos vasculares atendidos no período de fevereiro de 2001 a fevereiro de 2012. foram estudados 71 doentes com predominância do sexo masculino (78,87%) com média de idade de 7,63 anos. O mecanismo de trauma predominante foi o ferimento por arma branca em 27 pacientes (38,03%). A média de internação foi 10,18 dias, com 16 doentes necessitando de cuidados em unidade de tratamento intensivo com permanência média de 8,81 dias. As principais lesões ocorreram em extremidades, com predomínio do membro superior, com lesões das artérias ulnar em 13 (15,66%) e radial em dez (12,04%). O procedimento mais utilizado foi a exploração vascular 35 (32,4%). Em nove doentes (12,68%) ocorreram complicações. A mortalidade foi 1,4%, em um paciente com lesão da veia ilíaca comum e da veia cava inferior, devido à queda de altura. o traumatismo vascular pediátrico ocorreu predominantemente em extremidades. As dimensões dos vasos lesionados tornaram a correção cirúrgica mais complexa e aumentaram os índices de complicações, particularmente, de amputações.

Emergency ultrasound usage among recent emergency medicine residency graduates of a convenience sample of 14 residencies.

PubMed

Dean, Anthony J; Breyer, Michael J; Ku, Bon S; Mills, Angela M; Pines, Jesse M

2010-02-01

Emergency Medicine (EM) residency graduates are trained to perform Emergency Medicine bedside ultrasound (EMBU). However, the degree to which they use this skill in their practice after graduation is unknown. We sought to test the amount and type of usage of EMBU among recent residency graduates, and how usage and barriers vary among various types of EM practice settings. Graduates from 14 EM residency programs in 2003-2005 were surveyed on their current practice setting and use of EMBU. There were 252 (73%) graduates who completed the survey. Of the 73% of respondents reporting access to EMBU, 98% had used it within the past 3 months. Access to EMBU was higher in academic (97%) vs. community teaching (79%) vs. community non-teaching settings (62%) (p < 0.001), and in Emergency Departments (EDs) where yearly census exceeded 60,000 visits (87% vs. 65%, p < 0.001). Physicians in academic settings reported "high use" of EMBU more frequently than those in community settings for most modalities. FAST (focused assessment by sonography in trauma) was the most common high-use application and the most useful in practice. The greatest impediment to EMBU use was "not enough time" (61%). Ultrasound usage among recent EM residency graduates is significantly higher in teaching than in community settings and in high-volume EDs. Its use is more widespread than in previous reports in all types of practice. There is a wide range of utilization of ultrasound in the various applications in emergency practice, with the evaluation of trauma being the most common. Copyright (c) 2010 Elsevier Inc. All rights reserved.

The clinical spectrum of early Lyme borreliosis in patients with culture-confirmed erythema migrans.

PubMed

Nadelman, R B; Nowakowski, J; Forseter, G; Goldberg, N S; Bittker, S; Cooper, D; Aguero-Rosenfeld, M; Wormser, G P

1996-05-01

The diagnosis of erythema migrans (EM), the characteristic rash of early Lyme borreliosis, is based primarily on its clinical appearance since it often occurs prior to the development of a specific antibody response. Other skin disorders, however, may be confused with EM. Between June 1991 and September 1993, a prospective study was conducted at the Lyme Disease Diagnostic Center of the Westchester County Medical Center to isolate Borrelia burgdorferi systematically from patients with Em, and to characterize the clinical manifestations of patients with culture-documented infection. Skin biopsies and/or needle aspirates of the advancing margin of primary lesions, and blood specimens from adult patients were cultured for B burgdorferi in modified Barbour-Stoenner-Kelly medium at 33 degrees C. B burgdorferi was recovered from 79 patients (49 [62%] males) ranging in age from 16 to 76 years old (mean, 43 +/- 14 years old). Maximum EM diameter (mean, 16 +/- 10 cm; range, 6-73 cm) was a function of EM duration (mean 6.7 +/- 6.4 days; range, 1-39 days) (correlation coefficient = 0.7; P < 0.001). Twenty (25%) patients had noted a tick bite at the site of the primary lesion a mean of 10 days (range, 1-27 days) before onset. Multiple EM lesions (range, 2-70) were present in 14 (18%) patients. Systemic symptoms were present at the time of culture in 54 patients (68%) including fatigue (54%), arthralgia (44%), myalgia (44%), headache, (42%), fever and/or chills (39%), stiff neck (35%), and anorexia (26%). Thirty-three patients (42%) had at least one objective finding on physical examination in addition to EM, including 18 (23%) with localized lymphadenopathy, 13 (16%) with fever (t > or = 37.8 degrees C), seven (9%) with tender neck flexion, six (8%) with joint tenderness, and 1 each with joint swelling, nuchal rigidity, and facial nerve palsy. No patient had new electrocardiogram evidence of atrioventricular block. Liver function assays were abnormally elevated in 37% of patients. Thirty-four percent of patients were seropositive by enzyme-linked immunosorbent assay at presentation. Most others rapidly seroconverted so that 69 of 78 evaluable patients (88%) were seropositive at some point during the first month after diagnosis. We describe the largest group of culture-positive patients with EM from the United States to date. Although systemic symptoms were present in most patients, objective evidence of advanced disease was uncommon. Our patients with culture-confirmed EM were less sick than those described in the days before culture confirmation was possible. The ability to isolate B burgdorferi from lesional skin of large numbers of patients with EM should make culture-positive patients the standard by which to define manifestations of early Lyme borreliosis associated with this rash. Microbiologic documentation of Lyme borreliosis will help delineate the manifestations of this illness, and should form the framework for research directed at pathophysiology, diagnosis, treatment, and prevention.

Quantifying Aerial Concentrations of Maize Pollen in the Atmospheric Surface Layer Using Remote-Piloted Airplanes and Lagrangian Stochastic Modeling

NASA Astrophysics Data System (ADS)

Aylor, Donald E.; Boehm, Matthew T.; Shields, Elson J.

2006-07-01

The extensive adoption of genetically modified crops has led to a need to understand better the dispersal of pollen in the atmosphere because of the potential for unwanted movement of genetic traits via pollen flow in the environment. The aerial dispersal of maize pollen was studied by comparing the results of a Lagrangian stochastic (LS) model with pollen concentration measurements made over cornfields using a combination of tower-based rotorod samplers and airborne radio-controlled remote-piloted vehicles (RPVs) outfitted with remotely operated pollen samplers. The comparison between model and measurements was conducted in two steps. In the first step, the LS model was used in combination with the rotorod samplers to estimate the pollen release rate Q for each sampling period. In the second step, a modeled value for the concentration Cmodel, corresponding to each RPV measured value Cmeasure, was calculated by simulating the RPV flight path through the LS model pollen plume corresponding to the atmospheric conditions, field geometry, wind direction, and source strength. The geometric mean and geometric standard deviation of the ratio Cmodel/Cmeasure over all of the sampling periods, except those determined to be upwind of the field, were 1.42 and 4.53, respectively, and the lognormal distribution corresponding to these values was found to fit closely the PDF of Cmodel/Cmeasure. Model output was sensitive to the turbulence parameters, with a factor-of-100 difference in the average value of Cmodel over the range of values encountered during the experiment. In comparison with this large potential variability, it is concluded that the average factor of 1.4 between Cmodel and Cmeasure found here indicates that the LS model is capable of accurately predicting, on average, concentrations over a range of atmospheric conditions.

Immunogenetic Risk and Protective Factors for Development of L-tryptophan-associated Eosinophilia-Myalgia Syndrome and Associated Symptoms

PubMed Central

Okada, Satoshi; Kamb, Mary L.; Pandey, Janardan P.; Philen, Rossanne M.; Love, Lori A.; Miller, Frederick W.

2009-01-01

Objective To assess L-tryptophan (LT) dose, age, gender and immunogenetic markers as possible risk or protective factors for development of LT-associated eosinophilia myalgia syndrome (EMS) and related clinical findings. Methods HLA DRB1 and DQA1 allele typing and GM/KM phenotyping were performed on a cohort of 94 Caucasian subjects with documented LT ingestion and standardized evaluations. Multivariate analyses compared LT dose, age, gender and alleles among groups of subjects who ingested LT and subsequently developed surveillance criteria for EMS (EMS), or developed EMS or characteristic features of EMS (EMS spectrum disorder), or developed no features of EMS (unaffected). Results Considering all sources of LT, higher LT dose (odds ratio (OR) 1.4, 95% confidence interval (CI) 1.1-1.8), age >45 years (OR 3.0, CI 1.03-8.8) and HLA DRB1*03 (OR 3.9, CI 1.2-15.2), DRB1*04 (OR 3.9, CI 1.1-16.4) and DQA1*0601 (OR 13.7, CI 1.3-1874) were risk factors for the development of EMS, while DRB1*07 (OR 0.12, CI 0.02-0.48) and DQA1*0501 (OR 0.23, CI 0.05-0.85) were protective. Similar risk and protective factors were seen for developing EMS following ingestion of implicated LT, except DRB1*03 was not a risk factor and DQA1*0201 was an additional protective factor. EMS spectrum disorder also showed similar findings, but with DRB1*04 being a risk factor and DRB1*07 and DQA1*0201 being protective. There were no differences in gender distribution, GM/KM allotypes or GM/KM phenotypes among any groups. Conclusion In addition to the xenobiotic dose and subject age, polymorphisms in immune response genes may underlie the development of certain xenobiotic-induced immune-mediated disorders and these findings may have implications for future related epidemics. PMID:19790128

Experimental measurement and theoretical modeling of microwave scattering and the structure of the sea surface influencing radar observations from space

NASA Technical Reports Server (NTRS)

Arnold, David; Kong, J. A.

1992-01-01

The electromagnetic (EM) bias 'epsilon' is an error present in radar altimetry of the ocean due to the nonuniform reflection from wave troughs and crests. The EM bias is defined as the difference between the mean reflecting surface and the mean sea surface. A knowledge of the EM bias is necessary to permit error reduction in mean sea level measurements by satellite radar altimeters. Direct measurements of the EM bias were made from a Shell Offshore oil production platform in the Gulf of Mexico for a six month period during 1989 and 1990. Measurements of the EM bias were made at 5 and 14 Ghz. During the EM bias experiments by Melville et al., a wire wave gauge was used to obtain the modulation of the high frequency waves by the low frequency waves. It became apparent that the EM bias was primarily caused by the modulation of the short waves. This was reported by Arnold et al. The EM bias is explained using physical optics scattering and an empirical model for the short wave modulation. Measurements of the short wave modulation using a wire wave gauge demonstrated a linear dependence of the normalized bias on the short wave modulation strength, M. The theory accurately predicts this dependence by the relation epsilon = -alphaMH sub 1/3. The wind speed dependence of the normalized bias is explained by the dependence of the short wave modulation strength on the wind speed. While other effects such as long wave tilt and curvature will have an effect on the bias, the primary cause of the bias is shown to be due to the short wave modulation. This report will present a theory using physical optics scattering and an empirical model of the short wave modulation to estimate the EM bias. The estimated EM bias will be compared to measurements at C and Ku bands.

Enantioselective disposition of rabeprazole in relation to CYP2C19 genotypes

PubMed Central

Miura, Masatomo; Kagaya, Hideaki; Tada, Hitoshi; Uno, Tsukasa; Yasui-Furukori, Norio; Tateishi, Tomonori; Suzuki, Toshio

2006-01-01

Aim Rabeprazole is metabolized to some extent by CYP2C19. The purpose of this study was to elucidate the pharmacokinetics of each rabeprazole enantiomer in three different CYP2C19 genotype groups. Methods Twenty-four healthy subjects, of whom each each were homozygous extensive metabolizers (homEMs), heterozygous extensive metabolizers (hetEMs) and poor metabolizers (PMs) for CYP2C19, participated in our study. After a single oral dose of 20 mg of racemic rabeprazole, the plasma concentrations of the rabeprazole enantiomers were measured over the course of 24 h. Results The area under the plasma concentration–time curves (AUC) of (R)-rabeprazole in homEMs, hetEMs and PMs were 1.8-, 2.2- and 2.4-fold, respectively, greater than those of (S)-rabeprazole; the relative AUC ratios of (R)- and (S)-rabeprazole in homEMs, hetEMs and PMs were 1 : 1.1 : 2.1 and 1 : 0.9 : 1.5, respectively. The mean maximum plasma concentrations (Cmax) of (R)-rabeprazole in homEMs, hetEMs and PMs were 1.7-, 1.9- and 1.8-fold higher, respectively, than those of the corresponding (S)-enantiomer (P < 0.05). There was no difference between homEMs and PMs in the elimination half-life of (S)-rabeprazole, whereas the elimination half-life of (R)-rabeprazole was significantly longer in PMs than in homEMs [1.7 h (1.4, 2.0) (mean (95% confidence interval)]vs. 0.8 h (0.6, 1.0), respectively, P < 0.0001). Conclusions (R)-Rabeprazole disposition was influenced to a greater degree by CYP2C19 genetic polymorphisms than was that of (S)-rabeprazole. The effect of CYP2C19 polymorphisms on the stereoselective disposition of rabeprazole was less than those of lansoprazole and omeprazole. PMID:16487225

Treatment of Spacecraft Wastewater Using a Hollow Fiber Membrane Biofilm Redox Control Reactor

NASA Technical Reports Server (NTRS)

Smith, Daniel P.

2003-01-01

The purpose of this project was to develop and evaluate design concepts for biological treatment reactors for the purification of spacecraft wastewater prior to reverse osmosis treatment. The motivating factor is that wastewater recovery represents the greatest single potential reduction in the resupply requirements for crewed space missions. Spacecraft wastewater composition was estimated from the characteristics of the three major component streams: urine/flush water, hygiene water, and atmospheric condensate. The key characteristics of composite spacecraft wastewater are a theoretical oxygen demand of 4519 mg/L, of which 65% is nitrogenous oxygen demand, in a volume of 11.5 liter/crew-day. The organic carbon to nitrogen ratio of composite wastewater is 0.86. Urine represents 93% of nitrogen and 49% of the organic carbon in the composite wastestream. Various bioreaction scenarios were evaluated to project stoichiometric oxygen demands and the ability of wastewater carbon to support denitrification. Ammonia nitrification to the nitrite oxidation state reduced the oxygen requirement and enabled wastewater carbon to provide nearly complete denitrification. A conceptual bioreactor design was established using hollow fiber membranes for bubbleless oxygen transfer in a gravity-free environment, in close spatial juxtaposition to a second interspaced hollow fiber array for supplying molecular hydrogen. Highly versatile redox control and an enhanced ability to engineer syntrophic associations are stated advantages. A prototype reactor was constructed using a microporous hollow fiber membrane module for aeration. Maintaining inlet gas pressure within 0.25 psi of the external water pressure resulted in bubble free operation with no water ingress into hollow fiber lumens. Recommendations include the design and operational testing of hollow fiber bioreactors using: 1) Partial nitrification/nitrite predenitrification; 2) Limited aeration for simultaneous nitrification/denitrification or for nitrite reduction/ammonia oxidation; 3) Hydrogenotrophic denitrification.

EMS Provider assessment of vehicle damage compared with assessment by a professional crash reconstructionist.

PubMed

Lerner, E Brooke; Cushman, Jeremy T; Blatt, Alan; Lawrence, Richard D; Shah, Manish N; Swor, Robert A; Brasel, Karen; Jurkovich, Gregory J

2011-01-01

To determine the accuracy of emergency medical services (EMS) provider assessments of motor vehicle damage when compared with measurements made by a professional crash reconstructionist. EMS providers caring for adult patients injured during a motor vehicle crash and transported to the regional trauma center in a midsized community were interviewed upon emergency department arrival. The interview collected provider estimates of crash mechanism of injury. For crashes that met a preset severity threshold, the vehicle's owner was asked to consent to having a crash reconstructionist assess the vehicle. The assessment included measuring intrusion and external automobile deformity. Vehicle damage was used to calculate change in velocity. Paired t-test, correlation, and kappa were used to compare EMS estimates and investigator-derived values. Ninety-one vehicles were enrolled; of these, 58 were inspected and 33 were excluded because the vehicle was not accessible. Six vehicles had multiple patients. Therefore, a total of 68 EMS estimates were compared with the inspection findings. Patients were 46% male, 28% were admitted to hospital, and 1% died. The mean EMS-estimated deformity was 18 inches and the mean measured deformity was 14 inches. The mean EMS-estimated intrusion was 5 inches and the mean measured intrusion was 4 inches. The EMS providers and the reconstructionist had 68% agreement for determination of external automobile deformity (kappa 0.26) and 88% agreement for determination of intrusion (kappa 0.27) when the 1999 American College of Surgeons Field Triage Decision Scheme criteria were applied. The mean (± standard deviation) EMS-estimated speed prior to the crash was 48 ± 13 mph and the mean reconstructionist-estimated change in velocity was 18 ± 12 mph (correlation -0.45). The EMS providers determined that 19 vehicles had rolled over, whereas the investigator identified 18 (kappa 0.96). In 55 cases, EMS and the investigator agreed on seat belt use; for the remaining 13 cases, there was disagreement (five) or the investigator was unable to make a determination (eight) (kappa 0.40). This study found that EMS providers are good at estimating rollover. Vehicle intrusion, deformity, and seat belt use appear to be more difficult for EMS to estimate, with only fair agreement with the crash reconstructionist. As expected, the EMS provider -estimated speed prior to the crash does not appear to be a reasonable proxy for change in velocity.

Structured inspection of medications carried and stored by emergency medical services agencies identifies practices that may lead to medication errors.

PubMed

Kupas, Douglas F; Shayhorn, Meghan A; Green, Paul; Payton, Thomas F

2012-01-01

Medications are essential to emergency medical services (EMS) agencies when providing lifesaving care, but the EMS environment has challenges related to safe medication storage when compared with a hospital setting. We developed a structured process, based on common pharmacy practices, to review medications carried by EMS agencies to identify situations that may lead to medication error and to determine some best practices that may reduce potential errors and the risk of patient harm. To provide a descriptive account of EMS practices related to carrying and storing medications that have the potential for causing a medication administration error or patient harm. Using a structured process for inspection, an emergency medicine pharmacist and emergency physician(s) reviewed the medication carrying and storage practices of all nine advanced life support ambulance agencies within a five-county EMS region. Each medication carried and stored by the EMS agency was inspected for predetermined and spontaneously observed issues that could lead to medication error. These issues were documented and photographed. Two EMS medical directors reviewed each potential error for the risk of producing patient harm and assigned each to a category of high, moderate, or low risk. Because issues of temperature on EMS medications have been addressed elsewhere, this study concentrated on potential for EMS medication administration errors exclusive of storage temperatures. When reviewing medications carried by the nine EMS agencies, 38 medication safety issues were identified (range 1 to 8 per EMS agency). Of these, 16 were considered to be high risk, 14 moderate risk, and eight low risk for patient harm. Examples of potential issues included carrying expired medications, container-labeling issues, different medications stored in look-alike vials or prefilled syringes in the same compartment, and carrying crystalloid solutions next to solutions premixed with a medication. When reviewing medications stored at the EMS agency stations, eight safety issues were identified (range from 0 to 4 per station), including five moderate-risk and three low-risk issues. No agency had any high-risk medication issues related to storage of medication stock in the station. We observed potential medication safety issues related to how medications are carried and stored at all nine EMS agencies in a five-county region. Understanding these issues may assist EMS agencies in reducing the potential for a medication error and risk of patient harm. More research is needed to determine whether following these suggested best practices for carrying medications on EMS vehicles actually reduces errors in medication administration by EMS providers or decreases patient harm.

Pediatric pre-hospital emergencies in Belgium: a 2-year national descriptive study.

PubMed

Demaret, Pierre; Lebrun, Frédéric; Devos, Philippe; Champagne, Caroline; Lemaire, Roland; Loeckx, Isabelle; Messens, Marie; Mulder, André

2016-07-01

This study aims to describe the pediatric physician-staffed EMS missions at a national level and to compare the pediatric and the adult EMS missions. Using a national database, we analyzed 254,812 interventions including 15,294 (6 %) pediatric emergencies. Less children than adults received an intravenous infusion (52.7 versus 77.1 %, p < 0.001), but the intra-osseous access was used more frequently in children (1.3 versus 0.8 %, p < 0.001). More children than adults benefited from a therapeutic immobilization (16.3 versus 13.2 %, p < 0.001). Endotracheal intubation was rare in children (2.1 %) as well as cardiopulmonary resuscitation (1.2 %). Children were more likely than adults to suffer from a neurological problem (32.4 versus 21.3 %, p < 0.001) or from a trauma (27.1 versus 16.8 %, p < 0.001). The prevalence of the pediatric diagnoses showed an age dependency: the respiratory problems were more prevalent in infants (40.3 % of the 0-12-months old), 52.1 % of the 1-4-year-old children suffered from a neurological problem, and the prevalence of trauma raised from 14.8 % of the infants to 47.1 % of the 11-15 year olds. Pre-hospital pediatric EMS missions are not frequent and differ from the adult interventions. The pediatric characteristics highlighted in this study should help EMS teams to be better prepared to deal with sick children in the pre-hospital setting. • Pediatric and adult emergencies differ. • Pediatric life-threatening emergencies are not frequent. What is New: • This study is the first to describe a European national cohort of pediatric physician-staffed EMS missions and to compare the pediatric and the adult missions at a national level. • This large cohort study confirms scarce regional data indicating that pediatric pre-hospital emergencies are not frequent and mostly non-life-threatening.

Cometabolic degradation of ethyl mercaptan by phenol-utilizing Ralstonia eutropha in suspended growth and gas-recycling trickle-bed reactor.

PubMed

Sedighi, Mahsa; Zamir, Seyed Morteza; Vahabzadeh, Farzaneh

2016-01-01

The degradability of ethyl mercaptan (EM), by phenol-utilizing cells of Ralstonia eutropha, in both suspended and immobilized culture systems, was investigated in the present study. Free-cells experiments conducted at EM concentrations ranging from 1.25 to 14.42 mg/l, showed almost complete removal of EM at concentrations below 10.08 mg/l, which is much higher than the maximum biodegradable EM concentration obtained in experiments that did not utilize phenol as the primary substrate, i.e. 2.5 mg/l. The first-order kinetic rate constant (kSKS) for EM biodegradation by the phenol-utilizing cells (1.7 l/g biomass/h) was about 10 times higher than by cells without phenol utilization. Immobilized-cells experiments performed in a gas recycling trickle-bed reactor packed with kissiris particles at EM concentrations ranging from 1.6 to 36.9 mg/l, showed complete removal at all tested concentrations in a much shorter time, compared with free cells. The first-order kinetic rate constant (rmaxKs) for EM utilization was 0.04 l/h for the immobilized system compared to 0.06 for the suspended-growth culture, due to external mass transfer diffusion. Diffusion limitation was decreased by increasing the recycling-liquid flow rate from 25 to 65 ml/min. The removed EM was almost completely mineralized according to TOC and sulfate measurements. Shut down and starvation experiments revealed that the reactor could effectively handle the starving conditions and was reliable for full-scale application. Copyright © 2015 Elsevier Ltd. All rights reserved.

Connections between EM2-containing terminals and GABA/μ-opioid receptor co-expressing neurons in the rat spinal trigeminal caudal nucleus

PubMed Central

Li, Meng-Ying; Wu, Zhen-Yu; Lu, Ya-Cheng; Yin, Jun-Bin; Wang, Jian; Zhang, Ting; Dong, Yu-Lin; Wang, Feng

2014-01-01

Endomorphin-2 (EM2) demonstrates a potent antinociceptive effect via the μ-opioid receptor (MOR). To provide morphological evidence for the pain control effect of EM2, the synaptic connections between EM2-immunoreactive (IR) axonal terminals and γ-amino butyric acid (GABA)/MOR co-expressing neurons in lamina II of the spinal trigeminal caudal nucleus (Vc) were investigated in the rat. Dense EM2-, MOR- and GABA-IR fibers and terminals were mainly observed in lamina II of the Vc. Within lamina II, GABA- and MOR-neuronal cell bodies were also encountered. The results of immunofluorescent histochemical triple-staining showed that approximately 14.2 or 18.9% of GABA-IR or MOR-IR neurons also showed MOR- or GABA-immunopositive staining in lamina II; approximately 45.2 and 36.1% of the GABA-IR and MOR-IR neurons, respectively, expressed FOS protein in their nuclei induced by injecting formalin into the left lower lip of the mouth. Most of the GABA/MOR, GABA/FOS, and MOR/FOS double-labeled neurons made close contacts with EM2-IR fibers and terminals. Immuno-electron microscopy confirmed that the EM2-IR terminals formed synapses with GABA-IR or MOR-IR dendritic processes and neuronal cell bodies in lamina II of the Vc. These results suggest that EM2 might participate in pain transmission and modulation by binding to MOR-IR and GABAergic inhibitory interneuron in lamina II of the Vc to exert inhibitory effect on the excitatory interneuron in lamina II and projection neurons in laminae I and III. PMID:25386121

Evaluation of Effective Microorganisms on home scale organic waste composting.

PubMed

Fan, Yee Van; Lee, Chew Tin; Klemeš, Jiří Jaromír; Chua, Lee Suan; Sarmidi, Mohamad Roji; Leow, Chee Woh

2018-06-15

Home composting can be an effective way to reduce the volume of municipal solid waste. The aim of this study is to evaluate the effect of Effective Microorganism™ (EM) for the home scale co-composting of food waste, rice bran and dried leaves. A general consensus is lacking regarding the efficiency of inoculation composting. Home scale composting was carried out with and without EM (control) to identify the roles of EM. The composting parameters for both trials showed a similar trend of changes during the decomposition. As assayed by Fourier Transform Infrared Spectroscopy (FTIR), the functional group of humic acid was initially dominated by aliphatic structure but was dominated by the aromatic in the final compost. The EM compost has a sharper peak of aromatic CC bond presenting a better degree of humification. Compost with EM achieved a slightly higher temperature at the early stage, with foul odour suppressed, enhanced humification process and a greater fat reduction (73%). No significant difference was found for the final composts inoculated with and without EM. The properties included pH (∼7), electric conductivity (∼2), carbon-to-nitrogen ratio (C: N < 14), colour (dark brown), odour (earthy smell), germination index (>100%), humic acid content (4.5-4.8%) and pathogen content (no Salmonella, <1000 Most Probable Number/g E. coli). All samples were well matured within 2 months. The potassium and phosphate contents in both cases were similar however the EM compost has a higher nitrogen content (+1.5%). The overall results suggested the positive effect provided by EM notably in odour control and humification. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of plasmalemmal V-ATPase activity on plasma membrane potential of resident alveolar macrophages.

PubMed

Heming, T A; Bidani, A

2003-01-01

The acid-base status and functional responses of alveolar macrophages (mphi) are influenced by the activity of plasmalemmal V-type H+-pump (V-ATPase), an electrogenic H+ extruder that provides a possible link between intracellular pH (pHi) and plasma membrane potential (Em). This study examined the relationships among Em, pHi, and plasmalemmal V-ATPase activity in resident alveolar mphi from rabbits. Em and pHi were measured using fluorescent probes. Em was -46 mV and pHi was 7.14 at an extracellular pH (pHo) of 7.4. The pHi declined progressively at lower pHo values. Decrements in pHo, also caused depolarization of the plasma membrane, independent of V-ATPase activity. The pH effects on Em were sensitive to external K+, and hence, probably involved pH-sensitive K+ conductance. H+ were not distributed at equilibrium across the plasma membrane. V-ATPase activity was a major determinant of the transmembrane H+ disequilibrium. Pump inhibition with bafilomycin A1 caused cytosolic acidification, due most likely to the retention of metabolically generated H+. V-ATPase inhibition also caused depolarization of the plasma membrane, but the effects were mediated indirectly via the accompanying pHi changes. V-ATPase activity was sensitive to Em. Em hyperpolarization (valinomycin-clamp) reduced V-ATPase activity, causing an acidic shift in baseline pHi under steady-state conditions and slowing pHi recovery from NH4Cl prepulse acid-loads. The findings indicate that a complex relationship exists among Em, pHi, and pHo that was partially mediated by plasmalemmal V-ATPase activity. This relationship could have important consequences for the expression of pH- and/or voltage-sensitive functions in alveolar mphi.

Policy Options Analysis and the National Fire Operations Reporting System

DTIC Science & Technology

2015-06-01

Personnel Module: NFIRS-10 13. Unit 11 - Arson & Juvenile Firesetting Module: NFIRS-11 14. Summary Leonard Krueger. Determining NFIRS... Jane Brice, Jason D. Averill, and Kathy Notarianni. Report on EMS Field Experiments. September 2010. http://www.iafc.org/files

EMS Provider Assessment of Vehicle Damage Compared to a Professional Crash Reconstructionist

PubMed Central

Lerner, E. Brooke; Cushman, Jeremy T.; Blatt, Alan; Lawrence, Richard; Shah, Manish N.; Swor, Robert; Brasel, Karen; Jurkovich, Gregory J.

2011-01-01

Objective To determine the accuracy of EMS provider assessments of motor vehicle damage, when compared to measurements made by a professional crash reconstructionist. Methods EMS providers caring for adult patients injured during a motor vehicle crash and transported to the regional trauma center in a midsized community were interviewed upon ED arrival. The interview collected provider estimates of crash mechanism of injury. For crashes that met a preset severity threshold, the vehicle’s owner was asked to consent to having a crash reconstructionist assess their vehicle. The assessment included measuring intrusion and external auto deformity. Vehicle damage was used to calculate change in velocity. Paired t-test and correlation were used to compare EMS estimates and investigator derived values. Results 91 vehicles were enrolled; of these 58 were inspected and 33 were excluded because the vehicle was not accessible. 6 vehicles had multiple patients. Therefore, a total of 68 EMS estimates were compared to the inspection findings. Patients were 46% male, 28% admitted to hospital, and 1% died. Mean EMS estimated deformity was 18” and mean measured was 14”. Mean EMS estimated intrusion was 5” and mean measured was 4”. EMS providers and the reconstructionist had 67% agreement for determination of external auto deformity (kappa 0.26), and 88% agreement for determination of intrusion (kappa 0.27) when the 1999 Field Triage Decision Scheme Criteria were applied. Mean EMS estimated speed prior to the crash was 48 mph±13 and mean reconstructionist estimated change in velocity was 18 mph±12 (correlation -0.45). EMS determined that 19 vehicles had rolled over while the investigator identified 18 (kappa 0.96). In 55 cases EMS and the investigator agreed on seatbelt use, for the remaining 13 cases there was disagreement (5) or the investigator was unable to make a determination (8) (kappa 0.40). Conclusions This study found that EMS providers are good at estimating rollover. Vehicle intrusion, deformity, and seatbelt use appear to be more difficult to estimate with only fair agreement with the crash reconstructionist. As expected, the EMS provider estimated speed prior to the crash does not appear to be a reasonable proxy for change in velocity. PMID:21815732

Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh.

PubMed

Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Keith P; Christian, Parul

2015-01-31

Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access to healthcare and key constraints to EmOC provision. Using data from a large population-based community trial, we identified and surveyed the 14 health facilities (7 public, 7 private) most frequently visited for obstetric complications and near misses as reported by women. Availability of EmOC was based on provision of medical services, assessed through clinician interviews and record review. Levels of EmOC availability were defined as basic or comprehensive. Readiness for EmOC provision was based on scores in four categories: staffing, equipment, laboratory capacity, and medicines. Readiness scores were calculated using unweighted averages. Costs of C-section procedures and geographic locations of facilities were described. Textual analysis was used to identify key constraints. The seven surveyed private facilities offered comprehensive EmOC compared to four of the seven public facilities. With 100% representing full readiness, mean EmOC readiness was 81% (range: 63%-91%) among surveyed private facilities compared to 67% (range: 48%-91%) in public facilities (p = 0.040). Surveyed public clinics had low scores on staffing and laboratory capacity (69%; 50%). The mean cost of the C-section procedure in private clinics was $77 (standard deviation: $16) and free in public facilities. The public sub-district facilities were the only facilities located in rural areas, with none providing comprehensive EmOC. Shortages in specialized staff were listed as the main barrier to EmOC provision in public facilities. Although EmOC availability and readiness was higher among the surveyed seven most commonly visited private clinics, public facilities appeared to be more affordable for C-section and more geographically accessible. Strategies to retain anesthesiologists and surgeons, such as non-financial incentives, are needed to improve EmOC provision in the public sector. Centralized blood banks are recommended to streamline safe blood acquisition for obstetric surgeries.

Supporting Warfighters and U.S. Defense Sustainability with Strategic and Critical Materials

DTIC Science & Technology

2010-06-01

S155, ZFNL 9207 300M (Round bar – BAE added testing) 18 - weeks Torsion Bars M50 (2.76 ‐ 8” Diameter) 14 - weeks Bearings AMS 6491, CFR 5200, CPW 378...D1198, DMD 119‐20, EMS 52491, GE C50TF56, KBM250, MSRR 6083, PWA 725, PWA 793 and othersM50 (0.5 ‐2.75” Diameter) 14 - weeks Bearings • Latrobe Steel

Oral Mucoceles in Children--Analysis of 56 New Cases.

PubMed

Bodner, Lipa; Manor, Esther; Joshua, Ben-Zion; Shaco-Levy, Ruthy

2015-01-01

Mucoceles are common cystic lesions of the oral mucosa. Extravasation mucoceles (EMs) are mainly found in the lower lip of young patients, whereas retention mucoceles (RMs) are usually located in the cheek or palate of older patients. This study was undertaken to more fully characterize the clinicopathologic features of mucoceles in pediatric patients. The records of 56 pediatric patients with mucoceles were included in the study. Age, sex, history of trauma, intraoral site, size, and method of treatment were evaluated. Histopathologically the lesions were classified as being EMs or RMs. The age range was 1.5 to 16 years (mean age 11.2 yrs). Of the 56 patients, 24 (43%) were males and 32 (57%) were females, with a male:female ratio of 1:1.33. A history of trauma was recorded in 32 (57%) patients of the lower lip. The intraoral sites were the lower lip (38 [68%]), tongue (10 [18%]), and floor of the mouth (8 [14%]). Of the 56 patients, 44 (79%) were EM and 12 (21%) were ranulas. No RMs were found. Mucoceles ranged from 0.3 to 3.8 cm in diameter (mean 0.9 cm). The treatment of EMs was surgical excision. Cryosurgey, electrosurgery, and carbon dioxide laser were also used. In contrast to adults, where EM and RM types can be found, among children all cases are of the EM type. The disparate site and age incidences of EMs and RMs of the oral mucosa suggest that these two types are not related and possibly have a different etiopathogenesis. © 2015 Wiley Periodicals, Inc.

A Descriptive Analysis of US Prehospital Care Response to Law Enforcement Tactical Incidents.

PubMed

Aberle, Sara J; Lohse, Christine M; Sztajnkrycer, Matthew D

2015-01-01

Law enforcement tactical incidents involve high-risk operations that exceed the capabilities of regular, uniformed police. Despite the existence of tactical teams for 50 years, little is known about the frequency or nature of emergency medical services (EMS) response to tactical events in the United States. The purpose of this study was to perform a descriptive analysis of tactical events reported to a national EMS database. Descriptive analysis of the 2012 National Emergency Medical Services Information System (NEMSIS) Public Release research data set, containing EMS emergency response data from 41 states. A total of 17,479,328 EMS events were reported, of which 3,953 events were coded as "Activation-Tactical or SWAT Specialty Service/Response Team." The most common level of prehospital care present on scene was basic life support (55.2%). The majority (72.3%) of tactical incident activations involved a single patient; mass casualty incidents occurred in 0.5% of events. The most common EMS response locations were homes (48.4%), streets or highways (37.0%), and public buildings (6.3%). The mean age of treated patients was 44.1 years ± 22.0 years; 3.5% of tactical incident activation patients were aged 8 years or less. Injuries were coded as firearm assault in 14.8% and as chemical exposure in 8.9% of events. Cardiac arrest occurred in 5.1% of patients, with the majority (92.2%) occurring prior to EMS arrival. The primary symptoms reported by EMS personnel were pain (37.4%), change in responsiveness (13.1%), and bleeding (8.1%). Advanced airway procedures occurred in 30 patients. No patients were documented as receiving tourniquets or needle thoracostomy. Approximately 11 EMS responses in support of law enforcement tactical operations occur daily in the United States. The majority occur in homes and involve a single patient. Advanced airway procedures are required in a minority of patients. Cardiac arrest is rare and occurs prior to EMS response in the majority of cases. Better understanding of the nature and location of EMS responses to tactical incidents is required to develop consistent EMS policies in support of law enforcement tactical operations. 2015.

Effect of varying concentrations of dietary crude protein and metabolizable energy on laying performance of Pearl Grey guinea fowl hens.

PubMed

Nahashon, S N; Adefope, N A; Amenyenu, A; Wright, D

2007-08-01

This study was conducted to evaluate optimum dietary concentrations of ME and CP for egg production performance of the Pearl Gray guinea fowl laying hens. In a 2 x 3 factorial arrangement, 360 Pearl Gray guinea fowl replacement pullets (22 wk of age) were randomly assigned to experimental diets with 2,800 and 2,900 kcal of ME/kg of diet, each containing 14, 16, and 18% CP, respectively. Each dietary treatment was replicated 4 times, and feed and water were provided ad libitum. Experimental birds were raised in laying cages and received 16 h of light throughout the study period. The birds were observed for feed consumption, hen-day egg production (HDEP), egg weight (EW), egg mass (EM), feed conversion ratio, internal egg quality, shell thickness (ST), and BW at the end of each 28-d lay period at 26 to 50 wk of age and at 62 to 86 wk of age. Mortality was recorded as it occurred. Mean HDEP, EW, EM, and ST were higher (P < 0.05) in hens receiving diets with 2,800 kcal of ME/kg of feed than those fed diets containing 2,900 kcal of ME/kg of diet. Hens on 14% CP diets also exhibited higher (P < 0.05) HDEP, EM, and ST than those fed diets containing 16 and 18% CP diets. Mean feed conversion ratio of birds on 2,800 kcal of ME/kg of diet and 14% CP diets were significantly lower than those of hens on other dietary treatments. Differences in feed consumption, EW, internal egg quality, BW, and mortality among dietary ME and CP concentrations were not significant (P > 0.05). Overall, diets composed of 2,800 kcal of ME/kg of diet and 14% CP were utilized more efficiently by the Pearl Gray guinea fowl laying hens at 26 to 50 and 62 to 86 wk of age.

Bilateral comparison of 10 pF and 100 pF standards (ongoing BIPM key comparisons BIPM.EM-K14.a and 14.b) between the NIS (Egypt) and the BIPM

NASA Astrophysics Data System (ADS)

Gournay, Pierre; Helmy, M.; Raouf, A.; Hamed, Heba A. M.; Eliwa Gad, A.

2017-01-01

This report presents the results of a bilateral comparison of 10 pF and 100 pF capacitance standards between the NIS (Egypt) and the BIPM carried out in 2016. The comparison at 10 pF forms part of the ongoing BIPM key comparison BIPM.EM-K14.a and that at 100 pF of the ongoing BIPM key comparison BIPM.EM-K14.b. The BIPM is the pilot laboratory for both of these comparisons. Two 10 pF and 100 pF travelling standards belonging to the BIPM were used in this comparison carried out with an 'A-B-A' pattern of measurements. The standards were measured first at the BIPM for a period of about one month, then for a similar period at the NIS, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of either 1000 Hz or 1592 Hz, for a measuring rms voltage of 15 V at 10 pF and 10 V at 100 pF. One of the 10 pF travelling standards had to be eliminated from the comparison due to a bistable behaviour, possibly due to transportation. The results from the NIS and the BIPM at both 1000 Hz and 1592 Hz were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of about 0.72 × 10-6 at 10 pF and about 0.65 × 10-6 at 100 pF. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Strange and charm HVP contributions to the muon ( g - 2) including QED corrections with twisted-mass fermions

NASA Astrophysics Data System (ADS)

Giusti, D.; Lubicz, V.; Martinelli, G.; Sanfilippo, F.; Simula, S.

2017-10-01

We present a lattice calculation of the Hadronic Vacuum Polarization (HVP) contribution of the strange and charm quarks to the anomalous magnetic moment of the muon including leading-order electromagnetic corrections. We employ the gauge configurations generated by the European Twisted Mass Collaboration (ETMC) with N f = 2 + 1 + 1 dynamical quarks at three values of the lattice spacing ( a ≃ 0 .062 , 0 .082 , 0 .089 fm) with pion masses in the range M π ≃ 210-450 MeV. The strange and charm quark masses are tuned at their physical values. Neglecting disconnected diagrams and after the extrapolations to the physical pion mass and to the continuum limit we obtain: a μ s ( α em 2 ) = (53.1 ± 2.5) · 10- 10, a μ s ( α em 3 ) = (-0.018 ± 0.011) · 10- 10 and a μ c ( α em 2 ) = (14.75 ± 0.56) · 10- 10, a μ c ( α em 3 ) = (-0.030 ± 0.013) · 10- 10 for the strange and charm contributions, respectively.

Expecting the unexpected: A mixed methods study of violence to EMS responders in an urban fire department.

PubMed

Taylor, Jennifer A; Barnes, Brittany; Davis, Andrea L; Wright, Jasmine; Widman, Shannon; LeVasseur, Michael

2016-02-01

Struck by injuries experienced by females were observed to be higher compared to males in an urban fire department. The disparity was investigated while gaining a grounded understanding of EMS responder experiences from patient-initiated violence. A convergent parallel mixed methods design was employed. Using a linked injury dataset, patient-initiated violence estimates were calculated comparing genders. Semi-structured interviews and a focus group were conducted with injured EMS responders. Paramedics had significantly higher odds for patient-initiated violence injuries than firefighters (OR 14.4, 95%CI: 9.2-22.2, P < 0.001). Females reported increased odds of patient-initiated violence injuries compared to males (OR = 6.25, 95%CI 3.8-10.2), but this relationship was entirely mediated through occupation (AOR = 1.64, 95%CI 0.94-2.85). Qualitative data illuminated the impact of patient-initiated violence and highlighted important organizational opportunities for intervention. Mixed methods greatly enhanced the assessment of EMS responder patient-initiated violence prevention. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Effects of coccidiosis vaccination administered by in ovo injection on Ross 708 broiler performance through 14 days of post-hatch age.

PubMed

Sokale, A O; Zhai, W; Pote, L M; Williams, C J; Peebles, E D

2017-08-01

Effects of the in ovo injection of a commercial coccidiosis vaccine on various hatching chick quality variables and 14 d post-hatch (dph) oocyst shedding have been previously examined. The current study was designed to examine the performance of Ross 708 broilers during the 14 dph period of oocyst shedding following the application of the coccidiosis vaccine. On each of 7 replicate tray levels of a single-stage incubator, a total of 4 treatment groups was randomly represented, with each treatment group containing 63 eggs. Treatments were administered using a commercial multi-egg injector on d 18.5 of incubation. The treatments included 3 control groups (non-injected, dry-punch, and diluent-injected) and one treatment group (injected with diluent containing Inovocox EM1 vaccine). On d 21 of incubation, 20 chicks from each of the 28 treatment-replicate groups were placed in corresponding wire-floored battery cages. Mortality, feed intake (FI), BW gain (BWG), and feed conversion ratio (FCR) were determined for the zero to 7, 7 to 14, and cumulative zero to 14 dph intervals. There were no significant treatment effects on mortality in any interval or on BW at zero dph. There were significant treatment effects on BW at 7 and 14 dph, on BWG and FI in the zero to 7, 7 to 14, and zero to 14 dph intervals, and on FCR in the 7 to 14 and zero to 14 dph intervals. Although the performance variables of birds belonging to the diluent-injected and vaccine-injected groups were not significantly different, the 14 dph BW, 7 to 14 dph FI, and zero to 14 dph BWG and FI of birds belonging to the vaccine treatment group were significantly higher than those in birds belonging to the non-injected control group. It was concluded that use of the Inovocox EM1 vaccine in commercial diluent has no detrimental effect on the overall post-hatch performance of broilers through 14 dph. © 2017 Poultry Science Association Inc.

Minimization of CYP2D6 Polymorphic Differences and Improved Bioavailability via Transdermal Administration: Latrepirdine Example.

PubMed

Chew, Marci L; Mordenti, Joyce; Yeoh, Thean; Ranade, Gautam; Qiu, Ruolun; Fang, Juanzhi; Liang, Yali; Corrigan, Brian

2016-08-01

Transdermal delivery has the potential to offer improved bioavailability by circumventing first-pass gut and hepatic metabolism. This study evaluated the pharmacokinetics of oral immediate release and transdermal latrepirdine in extensive and poor CYP2D6 metabolizers (EM/PM). Latrepirdine transdermal solution was prepared extemporaneously. The solution was applied with occlusive dressing to upper or middle back for 24 h. Each subject received a single dose of 8.14 mg oral, 5 mg transdermal, and 10 mg transdermal (EMs only) latrepirdine free base in a fixed sequence. Twelve EMs and 7 PMs (50-79 years) enrolled and completed the study. Latrepirdine was well tolerated following both routes of administration. Dose-normalized latrepirdine total exposures were approximately 11-fold and 1.5-fold higher in EMs and PMs, respectively following administration of transdermal relative to oral. Differences between EM and PM latrepirdine exposures were decreased, with PMs having 1.9- and 2.7-fold higher peak and total exposures, respectively, following transdermal administration compared to 11- and 20-fold higher exposures, respectively, following oral administration. Transdermal delivery can potentially mitigate the large intersubject differences observed with compounds metabolized primarily by CYP2D6. Transdermal delivery was readily accomplished in the clinic using an extemporaneously prepared solution [NCT00990613].

Maximum likelihood estimates, from censored data, for mixed-Weibull distributions

NASA Astrophysics Data System (ADS)

Jiang, Siyuan; Kececioglu, Dimitri

1992-06-01

A new algorithm for estimating the parameters of mixed-Weibull distributions from censored data is presented. The algorithm follows the principle of maximum likelihood estimate (MLE) through the expectation and maximization (EM) algorithm, and it is derived for both postmortem and nonpostmortem time-to-failure data. It is concluded that the concept of the EM algorithm is easy to understand and apply (only elementary statistics and calculus are required). The log-likelihood function cannot decrease after an EM sequence; this important feature was observed in all of the numerical calculations. The MLEs of the nonpostmortem data were obtained successfully for mixed-Weibull distributions with up to 14 parameters in a 5-subpopulation, mixed-Weibull distribution. Numerical examples indicate that some of the log-likelihood functions of the mixed-Weibull distributions have multiple local maxima; therefore, the algorithm should start at several initial guesses of the parameter set.

Capture of sandhill cranes using alpha-chloralose.

PubMed

Hayes, Matthew A; Hartup, Barry K; Pittman, Jeanne M; Barzen, Jeb A

2003-10-01

From 1990-2001, we made 188 successful captures of 166 different greater sandhill cranes (Grus canadensis tabida) through experimental use of alpha-chloralose (AC). Most captures took place during September (72.3%; n = 136), followed by August (14.9%; n = 28), and October (12.8%; n = 24). Territorial pairs were captured more successfully than family groups. Overall morbidity (6.4%) and mortality (4.3%) were lower than most other capture techniques for sandhill cranes. Exertional myopathy (EM) was the most common complication observed using AC (3.7%). Sedation level (chi5(2) = 25.9, P < 0.01) and month of capture (chi2(2) = 12.3, P < 0.01) were both associated with the presence of EM in cranes captured with AC. A logistic regression model suggests lighter sedation and the months of August and October are potential risk factors for EM in sandhill cranes captured with AC in Wisconsin (USA).

The writer's guide to education scholarship in emergency medicine: Education innovations (part 3).

PubMed

Hall, Andrew K; Hagel, Carly; Chan, Teresa M; Thoma, Brent; Murnaghan, Aleisha; Bhanji, Farhan

2018-05-01

The scholarly dissemination of innovative medical education practices helps broaden the reach of this type of work, allowing scholarship to have an impact beyond a single institution. There is little guidance in the literature for those seeking to publish program evaluation studies and innovation papers. This study aims to derive a set of evidence-based features of high-quality reports on innovations in emergency medicine (EM) education. We conducted a scoping review and thematic analysis to determine quality markers for medical education innovation reports, with a focus on EM. A search of MEDLINE, EMBASE, ERIC, and Google Scholar was augmented by a hand search of relevant publication guidelines, guidelines for authors, and website submission portals from medical education and EM journals. Study investigators reviewed the selected articles, and a thematic analysis was conducted. Our search strategy identified 14 relevant articles from which 34 quality markers were extracted. These markers were grouped into seven important themes: goals and need for innovation, preparation, innovation development, innovation implementation, evaluation of innovation, evidence of reflective practice, and reporting and dissemination. In addition, multiple outlets for the publication of EM education innovations were identified and compiled. The publication and dissemination of innovations are critical for the EM education community and the training of health professionals. We anticipate that our list of innovation report quality markers will be used by EM education innovators to support the dissemination of novel educational practices.

EMS Provider Perceptions on Termination of Resuscitation in a Large, Urban EMS System.

PubMed

Tataris, Katie L; Richards, Christopher T; Stein-Spencer, Leslee; Ryan, Stephanie; Lazzara, Pete; Weber, Joseph M

2017-01-01

Despite the value of out-of-hospital Termination of Resuscitation (TOR) and the scientific evidence in favor of this practice, TOR has not been uniformly adopted or consistently practiced in EMS systems. Previous focus group studies have identified multiple barriers to implementation of out of hospital TOR but existing literature on EMS provider perceptions is limited. We sought to identify EMS providers' perceived barriers to performing out-of-hospital TOR in a large urban EMS system. The Chicago EMS System is a regional collaborative of EMS physicians, nurses and provider agencies, including the Chicago Fire Department (CFD), which provides exclusive emergency response for 9-1-1 calls in Chicago. CFD is an urban, fire-based EMS agency with a tiered response, with fire-fighter EMTs and paramedics providing initial care, and single role paramedics providing supplemental care and transport. A 2-page written survey was distributed to understand providers' experiences with managing OHCA and perceived barriers to TOR to inform subsequent improvements in protocol development and education. Of 3500 EMS providers that received the survey, 2309 were completed (66%). Survey respondent demographics were fire-fighter/EMTB (69%), fire-fighter/paramedic (14%), and single role paramedic (17%). The most frequent barrier to field TOR was scene safety (86%). The most common safety issue identified was family reaction to TOR (68%) and many providers felt threatened by family when trying to perform TOR (38%). Providers with a higher career numbers of OHCA were more likely to have felt threatened by the family (OR 6.70, 95% CI 2.99-15.00) and single role paramedics were more likely than FF/EMTBs to have felt threatened (OR 3.34, 95% CI 2.65-4.22). Barriers to delivering a death notification after TOR, include being uncomfortable or threatened with possible family reaction (52%) and family asking to continue the resuscitation (45%). There was lack of formal prior death notification training, the majority learned from colleagues through on the job training. Our study identifies scene safety, death notification delivery, and lack of formal training in death notification as barriers that EMS providers face while performing TOR in a large urban EMS system. These findings informed educational and operational initiatives to overcome the identified provider level issues and improve compliance with TOR policies.

An Open Label Clinical Trial of a Peptide Treatment Serum and Supporting Regimen Designed to Improve the Appearance of Aging Facial Skin.

PubMed

Draelos, Zoe Diana; Kononov, Tatiana; Fox, Theresa

2016-09-01

A 14-week single-center clinical usage study was conducted to test the efficacy of a peptide treatment serum and supporting skincare regimen in 29 women with mild to moderately photodamaged facial skin. The peptide treatment serum contained gamma-aminobutyric acid (GABA) and various peptides with neurotransmitter inhibiting and cell signaling properties. It was hypothesized that the peptide treatment serum would ameliorate eye and facial expression lines including crow's feet and forehead lines. The efficacy of the supporting skincare regimen was also evaluated. An expert investigator examined the subjects at rest and at maximum smile. Additionally, the subjects completed self-assessment questionnaires. At week 14, the expert investigator found a statistically significant improvement in facial lines, facial wrinkles, eye lines, and eye wrinkles at rest when compared to baseline results. The expert investigator also found statistically significant improvement at week 14 in facial lines, eye lines, and eye wrinkles when compared to baseline results at maximum smile. In addition, there was continued highly statistically significant improvement in smoothness, softness, firmness, radiance, luminosity, and overall appearance at rest when compared to baseline results at the 14-week time point. The test regimen was well perceived by the subjects for efficacy and product attributes. The products were well tolerated with no adverse events.

J Drugs Dermatol. 2016;15(9):1100-1106.

Evaluation of amino-acid racemization/epimerization dating using radiocarbon-dated fossil land snails

NASA Astrophysics Data System (ADS)

Goodfriend, Glenn A.

1987-08-01

The relation between age and amino-acid epimer ratios (alloisoleucine/isoleucine, A/I) of Holocene land snails was quantitatively evaluated through 14C and amino-acid analysis of 33 samples from fluvial and colluvial sediments and rodent middens in the Northern Negev Desert of Israel. A/I is strongly correlated with 14C ages in fluvial and rodent midden deposits (r = 0.95 and 0.94, respectively), permitting age estimates from A/I ratios with precisions of ±700 and ±660 yr. The correlation is weaker in colluvial deposits (r = 0.74), and age estimates from A/I ratios are correspondingly less precise (±1580 yr). This probably results from delayed burial, which exposes the shells to intense radiation on the desert surface. Because of the generally strong relation between age and A/I, amino-acid epimerization analysis of individual shells can be used to identify mixed-age deposits and to reconstruct species chronologies from mixed-age deposits.

Correction

NASA Astrophysics Data System (ADS)

1996-04-01

Fallout of volcanic ash to the deep South China Sea induced by the 1991 eruption of Mount Pinatubo (Philippines): Correction Geology, v. 23, p. 885 888 (October 1995) On p. 885, the last sentence of the Introduction should be: Here we report the first in situ record of a submarine fallout of volcanic ash following one of the largest magnitude subaerial eruptions of this century, the June 15, 1991, paroxysmal explosion of Mount Pinatubo (lat 15.148, long 120.358) in the Philippines. The first sentence under the head SUBMARINE FALLOUT MONITORING AND COMPOSITION should be: Fallout of Pinatubo tephra was recorded by fully automated collection devices (sediment traps) moored in 1190 and 3730 m water depth at 14.608N, 115.108E (Fig. 1). On p. 886, center column, the second sentence under the head LINKS TO SUBAERIAL ASH-PLUME MOVEMENT should be: Ash was ejected to a maximum altitude of 35 40 km, and at about14:20 the cloud spread out laterally into a giant umbrella region between 25 and 30 km altitude.

EMS Activations for School-Aged Children From Public Buildings, Places of Recreation or Sport, and Health Care Facilities in Pennsylvania.

PubMed

Catherine, Andrew T; Olympia, Robert P

2016-06-01

To determine the etiology of emergency medical services (EMS) activations in 2011 to public buildings, places of recreation or sport, and health care facilities involving children aged 5 to 18 years in Pennsylvania. Electronic records documenting 2011 EMS activations as provided by the Pennsylvania Department of Health's Bureau of EMS were reviewed. Data elements (demographics, dispatch complaint, mechanism of injury, primary assessment) from patients aged 5 to 18 years involved in an EMS response call originating from either a public building, a place of recreation and sport, or health care facility were analyzed. A total of 12,289 records were available for analysis. The most common primary assessments from public buildings were traumatic injury, behavioral/psychiatric disorder, syncope/fainting, seizure, and poisoning. The most common primary assessments from places of recreation or sport were traumatic injury, syncope/fainting, altered level of consciousness, respiratory distress, and abdominal pain. The most common primary assessments from health care facilities were behavioral/psychiatric disorder, traumatic injury, abdominal pain, respiratory distress, and syncope/fainting. When examining the mechanism of injury for trauma-related primary assessments, falls were the most common mechanism at all 3 locations, followed by being struck by an object. Of the 1335 serious-incident calls (11% of the total EMS activations meeting inclusion criteria), 61.2% were from public buildings, 14.1% from places of recreation or sport, and 24.7% from health care facilities. Our identification of common EMS dispatch complaints, mechanisms of injury, and primary assessments can be used in the education of staff and preparation of facilities for medical emergencies and injuries where children spend time.

Effects of combined electromyostimulation and gymnastics training in prepubertal girls.

PubMed

Deley, Gaëlle; Cometti, Carole; Fatnassi, Anaïs; Paizis, Christos; Babault, Nicolas

2011-02-01

This study investigated the effects of a 6-week combined electromyostimulation (EMS) and gymnastic training program on muscle strength and vertical jump performance of prepubertal gymnasts. Sixteen young women gymnasts (age 12.4 ± 1.2 yrs) participated in this study, with 8 in the EMS group and the remaining 8 as controls. EMS was conducted on knee extensor muscles for 20 minutes 3 times a week during the first 3 weeks and once a week during the last 3 weeks. Gymnasts from both groups underwent similar gymnastics training 5-6 times a week. Isokinetic torque of the knee extensors was determined at different eccentric and concentric angular velocities ranging from -60 to +240° per second. Jumping ability was evaluated using squat jump (SJ), counter movement jump (CMJ), reactivity test, and 3 gymnastic-specific jumps. After the first 3 weeks of EMS, maximal voluntary torque was increased (+40.0 ± 10.0%, +35.3 ± 11.8%, and +50.6 ± 7.7% for -60, +60, and +240°s⁻¹, respectively; p < 0.05), as well as SJ, reactivity test and specific jump performances (+20.9 ± 8.3%, +20.4 ± 26.2% and +14.9 ± 17.2% respectively; p < 0.05). Six weeks of EMS were necessary to improve the CMJ (+10.1 ± 10.0%, p < 0.05). Improvements in jump ability were still maintained 1 month after the end of the EMS training program. To conclude, these results first demonstrate that in prepubertal gymnasts, a 6-week EMS program, combined with the daily gymnastic training, induced significant increases both in knee extensor muscle strength and nonspecific and some specific jump performances.

Calling 911! What role does the pediatrician play?

PubMed

Grossman, Devin; Kunkov, Sergey; Kaplan, Carl; Crain, Ellen F

2013-06-01

The objective of this study was to compare admission rates and medical interventions among children whose caregivers called their child's primary care provider (PCP) before taking an ambulance to the pediatric emergency department (PED) versus those who did not. This was a prospective cohort study of patients brought to an urban, public hospital PED via emergency medical system (EMS). Children were included if the caregiver called 911 to have them transported via EMS and was present in the PED. The main variable was whether the child's PCP was called before EMS utilization. Study outcomes were medical interventions, such as intravenous line insertion or laboratory tests, and hospital admission. χ Test and logistic regression were used to evaluate the relationship of the main variable to the study outcomes. Six hundred fourteen patients met inclusion criteria and were enrolled. Five hundred eighty-five patients (95.3%) were reported to have a PCP. Seventy-four caregivers (12.1%) called their child's PCP before calling EMS. Two hundred seventy-seven patients (45.1%) had medical interventions performed; of these, 42 (15.2%) called their PCP (P = 0.03). Forty-two patients (6.8%) were admitted; among these, 14 (33.3%) called their PCP (P < 0.01). Adjusting for triage level, patients whose caregiver called the PCP before calling EMS were 3.2 times (95% confidence interval, 1.9-5.2 times) more likely to be admitted and 1.7 times (95% confidence interval, 1.1-2.9 times) more likely to have a medical intervention compared with patients whose caregivers did not call their child's PCP. Children were more likely to be admitted or require a medical intervention if their caregiver called their PCP before calling EMS. The availability of a PCP for telephone triage may help to optimize EMS utilization.

The Growth Performance, Carcass Characteristics, and Meat Quality of Egg-Type Male Growing Chicken and White-Mini Broiler in Comparison with Commercial Broiler (Ross 308)

PubMed Central

Kim, Hyun-Wook; Kim, Cheon-Jei; Kim, Eun-Jib; Kim, Hee-Sung

2014-01-01

The present study was conducted to compare the growth performance, carcass characteristics, and meat quality of the egg-type male growing chicken (EM), white-mini broiler (WB), and commercial broiler (Ross 308, CB). A total of 360 1-d-old chicks were reared together using a completely randomized design with 4 replicates for each group under the identical feeding and rearing conditions. The ADG and gain:feed were the highest in CB, intermediate in WB, and the lowest in EM (p<0.05), and the live and carcass weights of CB and EM were significantly higher than those of WB (p<0.05). The pH of breast meat from WB and CB was significantly higher (p<0.05) than that from EM with a similar body weight. The EM had the lowest moisture (p<0.05) and the highest protein content (p<0.05), whereas the fat and ash contents were not different among groups. The mystiric acid (C14:0), palmitoleic acid (C16:1 ω7), and oleic acid (C18:1 ω9) levels were significantly higher in breast meat from CB (p<0.05). The monounsaturated fatty acid (MUFA) content showed the highest (p<0.05) levels in CB. In contrast, the polyunsaturated fatty acid (PUFA) contents of breast meat, including linoleic acid (C18:2 ω6) and arachidonic acid (C20:4 ω6), were higher (p<0.05) in EM and WB than in CB. In conclusion, the EM and WB had less growth performances in comparison with CB, but they each had some unique features (taste, flavor, and physiological characteristics) when raised under the identical rearing and feeding conditions. PMID:26761496

HIFiRE-1 Turbulent Shock Boundary Layer Interaction - Flight Data and Computations (Postprint)

DTIC Science & Technology

2015-06-01

tte rs on o n Se pt em be r 1, 2 01 5 | h ttp :// ar c. ai aa .o rg | D O I: 1 0. 25 14 /6 .2 01 5- 26 39...characteristics of a transitional interaction at about this time. D ow nl oa de d by A FR L D ’A zz o W ri gh t- Pa tte rs on o n Se pt em be r 1, 2 01 5...endoatmospheric. The remainder of the trajectory was exoatmospheric. D ow nl oa de d by A FR L D ’A zz o W

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 14. Appendix I: Communicating with Deaf and Hearing Impaired Patients. Appendix II: Medical Terminology. Appendix III: EMS Organizations. Appendix IV: Legislation (Ohio). Glossary of Terms. Index. Revised.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, contains appendixes, a glossary, and an index. The first appendix is an article on communicating with deaf and hearing-impaired patients. Appendix 2, the largest section in this manual, is an introduction to medical…

The study of the use of a latex biomembrane and conjunctival autograft in rabbit conjunctiva wound healing.

PubMed

Pinho, Erika Christina Canarim Martha de; Chahud, Fernando; Lachat, João-José; Coutinho-Netto, Joaquim José; Sousa, Sidney Julio Faria E

2018-04-01

RESUMO Objetivo: Estudar o uso da biomembrana de látex e o transplante conjuntival autólogo na cicatrização conjuntival em coelhos. Métodos: Em nove coelhos albinos, neo-zelandeses, machos foram removidas áreas retangulares idênticas, do quadrante supero nasal, adjacente ao limbo, de ambos os olhos. As áreas desnudas da camada esclerótica nos olhos direitos foram recobertas com biomembrana de látex e a dos olhos esquerdos com enxerto conjuntival autólogo. Os animais foram sacrificados em grupos de três, aos 7, 14 e 21 dias após a cirurgia. Os tecidos do local cirúrgico, incluindo a córnea, foram fixados em formaldeído, antes de serem processados em parafina e corados com hematoxilina e eosina. A natureza e a intensidade da resposta inflamatória e o padrão de epitelização da superfície conjuntival foram avaliados sob microscopia óptica, em seções histológicas longitudinais, passando pelo centro dos espécimes anatômicos. Resultados: Até o décimo quarto dia pós-operatório, o grupo que recebeu a biomembrana apresentou reação inflamatória mais intensa do que o grupo com auto enxerto conjuntival. Aos 14 dias, os olhos com biomembrana apresentavam-se menos inflamados e com estroma mais espesso do que aos 7 dias. Aos 21 dias, a reparação conjuntival de ambos os grupos apresentavam características semelhantes. Conclusão: Apesar de apresentar uma cicatrização mais lenta, a biomembrana de látex se mostrou tão eficaz quanto o auto enxerto conjuntival na reconstrução da superfície ocular após três semanas de cicatrização pós-operatória. Devido as suas baixas toxicidade e alergenicidade, este material parece ser uma opção terapêutica promissora na reconstrução da conjuntiva.ABSTRACT Purpose: To study a latex biomembrane and conjunctival autograft with regard to the promotion of conjunctival healing in rabbits. The study included nine male albino rabbits. In these rabbits, a rectangular area of the conjunctiva was surgically removed from the superonasal quadrant adjacent to the limbus in both eyes. The bare area of the sclerotic coat of the right eye was reconstructed with a latex biomembrane, and the corresponding site of the left eye was reconstructed with a conjunctival autograft. The animals were killed in groups of three at 7, 14, and 21 days after surgery. The tissues from the surgical site, including the cornea, were fixed in formaldehyde, and were then processed in paraffin and stained with hematoxylin and eosin. The nature and intensity of the inflammatory response and the epithelial pattern at the conjunctival surface were evaluated under optical microscopy with longitudinal histological sections through the center of the anatomical specimens. Until the 14th postoperative day, the inflammatory reaction was greater in the biomembrane group than in the conjunctival autograft group. In the latex biomembrane group, inflammation was less intense and the stroma was thicker on the 14th postoperative day than on the 7th postoperative day. After three weeks, conjunctival healing in both groups showed similar characteristics. Although healing was slower with a latex biomembrane, tissue reconstitution was almost the same as that with a conjunctival autograft by three weeks. A latex biomembrane is as effective as a conjunctival autograft for the reconstruction of the ocular surface. Owing to the lack of toxicity and allergenicity, a latex biomembrane appears to be a promising therapeutic option for conjunctival reconstruction.

Degradation of ethyl mercaptan and its major intermediate diethyl disulfide by Pseudomonas sp. strain WL2.

PubMed

Wang, Xiangqian; Wu, Chao; Liu, Nan; Li, Sujing; Li, Wei; Chen, Jianmeng; Chen, Dongzhi

2015-04-01

A Pseudomonas sp. strain WL2 that is able to efficiently metabolize ethyl mercaptan (EM) into diethyl disulfide (DEDS) through enzymatic oxidation was isolated from the activated sludge of a pharmaceutical wastewater plant. One hundred percent removal of 113.5 mg L(-1) EM and 110.3 mg L(-1) DEDS were obtained within 14 and 32 h, respectively. A putative EM degradation pathway that involved the catabolism via DEDS was proposed, which indicated DEDS were further mineralized into carbon dioxide (CO2), bacterial cells, and sulfate (SO4 (2-)) through the transformation of element sulfur and ethyl aldehyde. Degradation kinetics for EM and DEDS with different initial concentrations by strain WL2 were evaluated using Haldane-Andrews model with maximum specific degradation rates of 3.13 and 1.33 g g(-1) h(-1), respectively, and maximum degradation rate constants of 0.522 and 0.175 h(-1) using pseudo-first-order kinetic model were obtained. Results obtained that aerobic degradation of EM by strain WL2 was more efficient than those from previous studies. Substrate range studies of strain WL2 demonstrated its ability to degrade several mercaptans, disulfides, aldehydes, and methanol. All the results obtained highlight the potential of strain WL2 for the use in the biodegradation of volatile organic sulfur compounds (VOSCs).

Randomised controlled trial of whether erotic material is required for semen collection: impact of informed consent on outcome.

PubMed

Handelsman, D J; Sivananathan, T; Andres, L; Bathur, F; Jayadev, V; Conway, A J

2013-11-01

Semen is collected to evaluate male fertility or cryostore sperm preferentially in laboratories but such collection facilities have no standard fit-out. It is widely believed but untested whether providing erotic material (EM) is required to collect semen by masturbation in the unfamiliar environment. To test this assumption, 1520 men (1046 undergoing fertility evaluation, 474 sperm cryostorage, providing 1932 semen collection episodes) consecutively attending the semen laboratory of a major metropolitan teaching hospital for semen analysis were eligible for randomization to be provided or not with printed erotic material EM (X-rated, soft-core magazines) during semen collection. Randomization was performed by providing magazines in the collection rooms (as a variation on non-standard fit-out) on alternate weeks using a schedule concealed from participants. In the pilot study, men were randomized without seeking consent. In the second part of the study, which continued on from the first without interruption, an approved informed consent procedure was added. The primary outcome, the time to collect semen defined as the time from receiving to returning the sample receptacle, was significantly longer (by ~6%, 14.9 ± 0.3 [mean ± standard error of mean] vs. 14.0 ± 0.2 minutes, p = 0.02) among men provided with EM than those randomized to not being provided. There was no significant increase in the failure to collect semen samples (2.6% overall) nor any difference in age, semen volume or sperm concentration, output or motility according to whether EM was provided or not. The significantly longer time to collect was evident in the pilot study and the study overall, but not in the main study where the informed consent procedure was used. This study provides evidence that refutes the assumption that EM needs to be provided for semen collection in a laboratory. It also provides an example of a usually unobservable participation bias influencing study outcome of a randomized controlled trials. © 2013 American Society of Andrology and European Academy of Andrology.

Assessing Empathy across Childhood and Adolescence: Validation of the Empathy Questionnaire for Children and Adolescents (EmQue-CA)

PubMed Central

Overgaauw, Sandy; Rieffe, Carolien; Broekhof, Evelien; Crone, Eveline A.; Güroğlu, Berna

2017-01-01

Empathy plays a crucial role in healthy social functioning and in maintaining positive social relationships. In this study, 1250 children and adolescents (10–15 year olds) completed the newly developed Empathy Questionnaire for Children and Adolescents (EmQue-CA) that was tested on reliability, construct validity, convergent validity, and concurrent validity. The EmQue-CA aims to assess empathy using the following scales: affective empathy, cognitive empathy, and intention to comfort. A Principal Components Analysis, which was directly tested with a Confirmatory Factor Analysis, confirmed the proposed three-factor model resulting in 14 final items. Reliability analyses demonstrated high internal consistency of the scales. Furthermore, the scales showed high convergent validity, as they were positively correlated with related scales of the Interpersonal Reactivity Index (Davis, 1983). With regard to concurrent validity, higher empathy was related to more attention to others’ emotions, higher friendship quality, less focus on own affective state, and lower levels of bullying behavior. Taken together, we show that the EmQue-CA is a reliable and valid instrument to measure empathy in typically developing children and adolescents aged 10 and older. PMID:28611713

Functional imaging of semantic memory predicts postoperative episodic memory functions in chronic temporal lobe epilepsy.

PubMed

Köylü, Bülent; Walser, Gerald; Ischebeck, Anja; Ortler, Martin; Benke, Thomas

2008-08-05

Medial temporal (MTL) structures have crucial functions in episodic (EM), but also in semantic memory (SM) processing. Preoperative functional magnetic resonance imaging (fMRI) activity within the MTL is increasingly used to predict post-surgical memory capacities. Based on the hypothesis that EM and SM memory functions are both hosted by the MTL the present study wanted to explore the relationship between SM related activations in the MTL as assessed before and the capacity of EM functions after surgery. Patients with chronic unilateral left (n=14) and right (n=12) temporal lobe epilepsy (TLE) performed a standard word list learning test pre- and postoperatively, and a fMRI procedure before the operation using a semantic decision task. SM processing caused significant bilateral MTL activations in both patient groups. While right TLE patients showed asymmetry of fMRI activation with more activation in the left MTL, left TLE patients had almost equal activation in both MTL regions. Contrasting left TLE versus right TLE patients revealed greater activity within the right MTL, whereas no significant difference was observed for the reverse contrast. Greater effect size in the MTL region ipsilateral to the seizure focus was significantly and positively correlated with preoperative EM abilities. Greater effect size in the contralateral MTL was correlated with better postoperative verbal EM, especially in left TLE patients. These results suggest that functional imaging of SM tasks may be useful to predict postoperative verbal memory in TLE. They also advocate a common neuroanatomical basis for SM and EM processes in the MTL.

Relationship between category size and journals' impact factor: implications for emergency medicine journals and researchers.

PubMed

Miró, Òscar; Brown, Anthony F T; Graham, Colin A; Ducharme, James; Martin-Sanchez, Francisco J; Cone, David C

2015-10-01

We assessed the relationship between the size of the 39 Journal Citation Reports (JCR) medical categories and impact factor (IF) of journals in these categories, and the implications that it might have for emergency medicine (EM) journals. Using the 2010 JCR database, we calculated the mean IF, 5-year IF (5y-IF), Eigenfactor (EF), and Article Influence (AI) scores including all journals for each category. We also calculated a 'weighted IF' for all journals by dividing each journal IF by the mean IF of its category. We ranked EM journals according to IF and 'weighted IF' into all the journals included in the 39 categories. We assessed the relationship between category size and bibliometric scores by linear regression. Category size varied from 252 journals (Pharmacology and Pharmacy) to 14 (Primary Healthcare), EM category occupying the 36th position (23 journals). The mean IF of EM category ranked in 34th position, 5-yIF in 32nd, EF in 34th, and AI in 34th position. Category size had a direct and significant association with mean IF, 5y-IF, and AI but not with mean EF. When the EM journals were ranked among all the journals according to their IF, only two (9%) were placed into the first quartile and raised up to eight (35%) when 'weighted IF' was considered. There is a negative relationship between JCR size category and IF achieved by the journals. This places EM journals at a clear disadvantage because they represent one of the smallest clinical medical research disciplines.

Evaluation of a Method Using Three Genomic Guided Escherichia coli Markers for Phylogenetic Typing of E. coli Isolates of Various Genetic Backgrounds

PubMed Central

Hamamoto, Kouta; Ueda, Shuhei; Yamamoto, Yoshimasa

2015-01-01

Genotyping and characterization of bacterial isolates are essential steps in the identification and control of antibiotic-resistant bacterial infections. Recently, one novel genotyping method using three genomic guided Escherichia coli markers (GIG-EM), dinG, tonB, and dipeptide permease (DPP), was reported. Because GIG-EM has not been fully evaluated using clinical isolates, we assessed this typing method with 72 E. coli collection of reference (ECOR) environmental E. coli reference strains and 63 E. coli isolates of various genetic backgrounds. In this study, we designated 768 bp of dinG, 745 bp of tonB, and 655 bp of DPP target sequences for use in the typing method. Concatenations of the processed marker sequences were used to draw GIG-EM phylogenetic trees. E. coli isolates with identical sequence types as identified by the conventional multilocus sequence typing (MLST) method were localized to the same branch of the GIG-EM phylogenetic tree. Sixteen clinical E. coli isolates were utilized as test isolates without prior characterization by conventional MLST and phylogenetic grouping before GIG-EM typing. Of these, 14 clinical isolates were assigned to a branch including only isolates of a pandemic clone, E. coli B2-ST131-O25b, and these results were confirmed by conventional typing methods. Our results suggested that the GIG-EM typing method and its application to phylogenetic trees might be useful tools for the molecular characterization and determination of the genetic relationships among E. coli isolates. PMID:25809972

Evaluation of a Method Using Three Genomic Guided Escherichia coli Markers for Phylogenetic Typing of E. coli Isolates of Various Genetic Backgrounds.

PubMed

Hamamoto, Kouta; Ueda, Shuhei; Yamamoto, Yoshimasa; Hirai, Itaru

2015-06-01

Genotyping and characterization of bacterial isolates are essential steps in the identification and control of antibiotic-resistant bacterial infections. Recently, one novel genotyping method using three genomic guided Escherichia coli markers (GIG-EM), dinG, tonB, and dipeptide permease (DPP), was reported. Because GIG-EM has not been fully evaluated using clinical isolates, we assessed this typing method with 72 E. coli collection of reference (ECOR) environmental E. coli reference strains and 63 E. coli isolates of various genetic backgrounds. In this study, we designated 768 bp of dinG, 745 bp of tonB, and 655 bp of DPP target sequences for use in the typing method. Concatenations of the processed marker sequences were used to draw GIG-EM phylogenetic trees. E. coli isolates with identical sequence types as identified by the conventional multilocus sequence typing (MLST) method were localized to the same branch of the GIG-EM phylogenetic tree. Sixteen clinical E. coli isolates were utilized as test isolates without prior characterization by conventional MLST and phylogenetic grouping before GIG-EM typing. Of these, 14 clinical isolates were assigned to a branch including only isolates of a pandemic clone, E. coli B2-ST131-O25b, and these results were confirmed by conventional typing methods. Our results suggested that the GIG-EM typing method and its application to phylogenetic trees might be useful tools for the molecular characterization and determination of the genetic relationships among E. coli isolates. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Investigation of Electromagnetic Signatures of a FPGA Using an APREL EM-ISIGHT System

DTIC Science & Technology

2015-12-01

unprofessional workmanship in the bonding process. Focused ion beam (FIB) images often consist of some type of etch and/or deposition of material from/to...characteristics of conducted emissions." Electromagnetic Compatibility, 2008. EMC 2008. IEEE International Symposium (2008): 1-4. Montanari, Ivan

A emissão em 8mm e as bandas de Merrill-Sanford em estrelas carbonadas

NASA Astrophysics Data System (ADS)

de Mello, A. B.; Lorenz-Martins, S.

2003-08-01

Estrelas carbonadas possuem bandas moleculares em absorção no visível e, no infravermelho (IR) as principais características espectrais se devem a emissão de grãos. Recentemente foi detectada a presença de bandas de SiC2 (Merrill-Sanford, MS) em emissão sendo atribuída à presença de um disco rico em poeira. Neste trabalho analisamos uma amostra de 14 estrelas carbonadas, observadas no telescópio de 1.52 m do ESO em 4 regiões espectrais diferentes, a fim de detectar as bandas de MS em emissão. Nossa amostra é composta de estrelas que apresentam além da emissão em 11.3 mm, outra em 8 mm. Esta última emissão, não usual nestes objetos, tem sido atribuída ou a moléculas de C2H2, ou a um composto sólido ainda indefinido. A detecção de emissões de MS e aquelas no IR, simultaneamente, revelaria um cenário mais complexo que o habitualmente esperado para os ventos destes objetos. No entanto como primeiro resultado, verificamos que as bandas de Merrill-Sanford encontram-se em absorção, não revelando nenhuma conexão com a emissão a 8 mm. Assim, temos duas hipóteses: (a) a emissão a 8 mm se deve à molécula C2H2 ou (b) essa emissão é resultado da emissão térmica de grãos. Testamos a segunda hipótese modelando a amostra com grãos não-homogêneos de SiC e quartzo, o qual emite em aproximadamente 8mm. Este grão seria produzido em uma fase evolutiva anterior a das carbonadas (estrelas S) e por terem uma estrutura cristalina são destruídos apenas na presença de campos de radiação ultravioleta muito intensos. Os modelos para os envoltórios utilizam o método de Monte Carlo para descrever o problema do transporte da radiação. As conclusões deste trabalho são: (1) as bandas de Merrill-Sanford se encontram em absorção, sugerindo um cenário usual para os ventos das estrelas da amostra; (2) neste cenário, a emissão em 8 mm seria resultado de grãos de quartzo com mantos de SiC, indicando que o quartzo poderia sobreviver a fase evolutiva S.

Alcohol as a Factor in 911 Calls in Denver.

PubMed

Joseph, Daniel; Vogel, Jody A; Smith, C Sam; Barrett, Whitney; Bryskiewicz, Gary; Eberhardt, Aaron; Edwards, David; Rappaport, Lara; Colwell, Christopher B; McVaney, Kevin E

2018-02-08

Excessive alcohol consumption is associated with a substantial number of emergency department visits annually and is responsible for a significant number of lives lost each year in the United States. However, a minimal amount is known about the impact of alcohol on the EMS system. The primary objective was to determine the proportion of 9-1-1 calls in Denver, Colorado in which (1) alcohol was a contributing factor or (2) the individual receiving EMS services had recently ingested alcohol. The secondary objectives were to compare the characteristics of EMS calls and to estimate the associated costs. This was a prospective observational cohort study of EMS calls for adults from July 1, 2012, to June 30, 2014. Primary outcomes for the study were alcohol as a contributing factor to the EMS call and recent alcohol consumption by the patient receiving EMS services. Logistic regression was utilized to determine the associations between EMS call characteristics and the outcomes. Cost was estimated using historic data. During the study period, 169,642 EMS calls were completed by the Denver Health Paramedic Division. Of these 71% were medical and 29% were trauma-related. The median age was 45 (interquartile range [IQR] 29-59) years, and 55% were male. 50,383 calls (30%) had alcohol consumption, and 49,165 (29%) had alcohol as a contributing factor. Alcohol related calls were associated with male sex, traumatic injuries including head trauma, emergent response, use of airway adjuncts, cardiac monitoring, glucose measurement, use of restraints, use of spinal precautions, and administration of medications for sedation. Estimated costs to the EMS system due to alcohol intoxication exceeded $14 million dollars over the study period and required in excess of 37 thousand hours of paramedic time. Compared to 9-1-1 calls that do not involve alcohol, alcohol-related calls are more likely to involve male patients, emergent response, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation. This represents a significant burden on the emergency system and society. Further studies are needed to evaluate whether additional interventions such as social services could be used to lessen this burden.

Four New Species of Eimeria (Apicomplexa: Eimeriidae) from Emoia spp. Skinks (Sauria: Scincidae), from Papua New Guinea and the Insular Pacific.

PubMed

McAllister, Chris T; Duszynski, Donald W; Austin, Christopher C; Fisher, Robert N

2017-02-01

Between September and November 1991, 54 adult skinks from 15 species were collected by hand or blowpipe from several localities on Rarotonga, Cook Islands, Ovalau Island, Fiji, and Papua New Guinea (PNG), and their feces were examined for coccidians. Species included 5 seaside skinks (Emoia atrocostata), 1 Pacific blue-tailed skink (Emoia caeroleocauda), 2 Fiji slender treeskinks (Emoia concolor), 15 white-bellied copper-striped skinks (Emoia cyanura), 1 Bulolo River forest skink (Emoia guttata), 6 dark-bellied copper-striped skinks (Emoia impar), 5 Papua five-striped skinks (Emoia jakati), 2 Papua slender treeskinks (Emoia kordoana), 3 Papua robust treeskinks (Emoia longicauda), 1 brown-backed forest skink (Emoia loveridgei), 3 Papua black-sided skinks (Emoia pallidiceps), 2 Papua white-spotted skinks (Emoia physicae), 2 Papua yellow-head skinks (Emoia popei), 1 Papua brown forest skink (Emoia submetallica), and 5 Fiji barred treeskinks (Emoia trossula) Species of Eimeria (Ei.) were detected from these Emoia (Em.) spp. and are described here as new. Oocysts of Eimeria iovai n. sp. from Em. pallidiceps from PNG were ellipsoidal with a bilayered wall (L × W) 26.5 × 18.1 μm, with a length/width ratio (L/W) of 1.1. Both micropyle and oocyst residuum were absent, but a fragmented polar granule was present. This eimerian also was found in Em. atrocostata from PNG. Oocysts of Eimeria kirkpatricki n. sp. from Em. atrocostata from PNG were ellipsoidal with a bilayered wall, 18.6 × 13.5 μm, L/W 1.4. A micropyle and oocyst residuum were absent, but a fragmented polar granule was present. This eimerian was also shared by Em. cyanura from the Cook Islands and Fiji, Em. impar from the Cook Islands, Em. loveridgei from PNG, Em. pallidiceps from PNG, Em. popei from PNG, and Em. submetallica from PNG. Oocysts of Eimeria stevejayuptoni n. sp. from Em. longicauda were subspheroidal to ellipsoidal with a bilayered wall, 18.7 × 16.6 μm, L/W 1.1. A micropyle and oocyst residuum were absent, but a fragmented polar granule was present. Oocysts of Eimeria emoia n. sp. from Em. longicauda from PNG were cylindroidal with a bilayered wall, 29.2 × 15.7 μm, L/W 1.9. A micropyle and oocyst residuum were absent, but a polar granule was present. These are the first eimerians reported from Emoia spp. and they add to our growing knowledge of the coccidian fauna of scincid lizards of the South Pacific.

Bilateral comparison of 10 pF and 100 pF standards (ongoing BIPM key comparisons BIPM.EM-K14.a and 14.b) between the NMISA (South Africa) and the BIPM

NASA Astrophysics Data System (ADS)

Gournay, Pierre; Khoza, Michael

2017-01-01

This report presents the results of a bilateral comparison of 10 pF and 100 pF capacitance standards between the NMISA (South Africa) and the BIPM carried out in 2016. The comparison at 10 pF forms part of the ongoing BIPM key comparison BIPM.EM-K14.a and that at 100 pF of the ongoing BIPM key comparison BIPM.EM-K14.b. The BIPM is the pilot laboratory for both of these comparisons. Two 10 pF and 100 pF travelling standards belonging to the BIPM were used in this comparison carried out with an 'A-B-A' pattern of measurements. The standards were measured first at the BIPM for a period of about one month, then for a similar period at the NMISA, and finally again at the BIPM. The measurand was the two terminal-pair capacitance at a frequency of either 1000 Hz or 1592 Hz, for a measuring rms voltage of 15 V at 10 pF and 10 V at 100 pF. One of the 10 pF travelling standards had to be eliminated from the comparison due to a bistable behaviour, possibly due to transportation. The results from the NMISA and the BIPM at both 1000 Hz and 1592 Hz were found to be in good agreement, with a difference smaller than the relative expanded uncertainty (95 % confidence, k = 2) of maximum value 0.33 × 10-6 at 10 pF and 0.24 × 10-6 at 100 pF (and 1000 Hz in both cases). Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Highly Emissive Whole Rainbow Fluorophores Consisting of 1,4-Bis(2-phenylethynyl)benzene Core Skeleton: Design, Synthesis, and Light-Emitting Characteristics.

PubMed

Yamaguchi, Yoshihiro; Ochi, Takanori; Matsubara, Yoshio; Yoshida, Zen-ichi

2015-08-13

To create the whole-rainbow-fluorophores (WRF) having the small Δλem (the difference of λem between a given fluorophore and nearest neighboring fluorophore having the same core skeleton) values (<20 nm) in full visible region (λem: 400-650 nm), the high log ε (>4.5), and the high Φf (>0.6), we investigated molecular design, synthesis, and light-emitting characteristics of the π-conjugated molecules (D/A-BPBs) consisting of 1,4-bis(phenylethynyl)benzene (BPB) modified by donor groups (OMe, SMe, NMe2, and NPh2) and an acceptor group (CN). As a result, synthesized 20 D/A-BPBs (1a-5d) were found to be the desired WRF. To get the intense red fluorophore (Φf > 0.7, λem > 610 nm), we synthesized new compounds (5e-5i) and elucidated their photophysical properties in CHCl3 solution. As a result, 5h, in which a 4-cyanophenyl group is introduced to the para-position of two benzene rings in the terminal NPh2 group of 5d, was found to be the desired intense red fluorophore (log ε = 4.56, Φf = 0.76, λem = 611 nm). The intramolecular charge-transfer nature of the S1 state of WRF (1a-5d) was elucidated by the positive linear relationship between optical transition energy (νem) from the S1 state to the S0 state and HOMO(D)-LUMO(A) difference, and the molecular orbitals calculated with the DFT method. It is demonstrated that our concept (Φf = 1/(exp(-Aπ) + 1)) connected with the relationship between Φf and magnitude (Aπ) of π conjugation length in the S1 state can be applied to WRF (1a-5d). It is suggested that the prediction of Φf from a structural model can be achieved by the equation Φf = 1/(exp(-((ν̃a - ν̃f)(1/2) × a(3/2)) + 1), where ν̃a and ν̃f are the wavenumber (cm(-1)) of absorption and fluorescence peaks, respectively, and a is the calculated molecular radius. From the viewpoint of application of WRF to various functional materials, the light-emitting characteristics of 1a-5i in doped polymer films were examined. It was demonstrated that 1a-5i dispersed in two kinds of polymer film (PST and PMMA) emit light at the whole visible region and have the small Δλem values (<20 nm) and the high Φf values (>0.6). Therefore, the present D/A-BPBs can be said to be the desired WRF even in the doped polymer film.

Evaluating pharmaceutical waste disposal in pediatric units.

PubMed

Almeida, Maria Angélica Randoli de; Wilson, Ana Maria Miranda Martins; Peterlini, Maria Angélica Sorgini

2016-01-01

To verify the disposal of pharmaceutical waste performed in pediatric units. A descriptive and observational study conducted in a university hospital. The convenience sample consisted of pharmaceuticals discarded during the study period. Handling and disposal during preparation and administration were observed. Data collection took place at pre-established times and was performed using a pre-validated instrument. 356 drugs disposals were identified (35.1% in the clinic, 31.8% in the intensive care unit, 23.8% in the surgical unit and 9.3% in the infectious diseases unit). The most discarded pharmacological classes were: 22.7% antimicrobials, 14.8% electrolytes, 14.6% analgesics/pain killers, 9.5% diuretics and 6.7% antiulcer agents. The most used means for disposal were: sharps' disposable box with a yellow bag (30.8%), sink drain (28.9%), sharps' box with orange bag (14.3%), and infectious waste/bin with a white bag (10.1%). No disposal was identified after drug administration. A discussion of measures that can contribute to reducing (healthcare) waste volume with the intention of engaging reflective team performance and proper disposal is necessary. Verificar o descarte dos resíduos de medicamentos realizado em unidades pediátricas. Estudo descritivo e observacional, realizado em um hospital universitário. A amostra de conveniência foi constituída pelos medicamentos descartados durante o período de estudo. Observaram-se a manipulação e o descarte durante o preparo e a administração. A coleta dos dados ocorreu em horários preestabelecidos e realizada por meio de instrumento pré-validado. Identificaram-se 356 descartes de medicamentos (35,1% na clínica, 31,8% na unidade de cuidados intensivos, 23,8% na cirúrgica e 9,3% na infectologia). As classes farmacológicas mais descartadas foram: 22,7% antimicrobianos, 14,8% eletrólitos, 14,6% analgésicos, 9,5% diuréticos e 6,7% antiulcerosos. Vias mais utilizadas: caixa descartável para perfurocortante com saco amarelo (30,8%), ralo da pia (28,9%), caixa de perfurocortante com saco laranja (14,3%) e lixeira infectante com saco branco (10,1%). Não foi identificado descarte após a administração dos fármacos. Faz-se necessária a discussão de medidas que contribuam para a redução do volume de resíduos, com o intuito de engajar a atuação reflexiva da equipe e o descarte adequado.

The association between weekly work hours, crew familiarity, and occupational injury and illness in emergency medical services workers.

PubMed

Weaver, Matthew D; Patterson, P Daniel; Fabio, Anthony; Moore, Charity G; Freiberg, Matthew S; Songer, Thomas J

2015-12-01

Emergency Medical Services (EMS) workers are shift workers in a high-risk, uncontrolled occupational environment. EMS-worker fatigue has been associated with self-reported injury, but the influence of extended weekly work hours is unknown. A retrospective cohort study was designed using historical shift schedules and occupational injury and illness reports. Using multilevel models, we examined the association between weekly work hours, crew familiarity, and injury or illness. In total, 966,082 shifts and 950 reports across 14 EMS agencies were obtained over a 1-3 year period. Weekly work hours were not associated with occupational injury or illness. Schedule characteristics that yield decreased exposure to occupational hazards, such as part-time work and night work, conferred reduced risk of injury or illness. Extended weekly work hours were not associated with occupational injury or illness. Future work should focus on transient exposures and agency-level characteristics that may contribute to adverse work events. © 2015 Wiley Periodicals, Inc.

Competencia Comunicativa em Portuges (Communicative Competence in Portuguese).

ERIC Educational Resources Information Center

Paiva, Ricardo

A textbook designed to give speech and writing practice to intermediate and advanced students of Portuguese as a second language includes 14 units intended to cover two semesters' work with approximately five hours per week of instruction. The units typically include: a text forming the basis for free conversation and practice of language…

Personal Equipment and Clothing Correction Factors for the Australian Army: A Pilot Survey

DTIC Science & Technology

2014-11-01

Sitting M24 Fit Thigh Clearance M12 Clearance and Fit, DHM Knee Height, Sitting M13 Fit, DHM Popliteal Height M14 Fit, DHM Buttock-Knee Length...Measure Semi-Nude Definition Encumbered Definition EM28 Knee Height, Sitting Footrest surface to Suprapatella ( M13 ). Footrest surface to

A FISTful of Emotion: Individual Differences in Trait Anxiety and Cognitive-Affective Flexibility During Preadolescence.

PubMed

Mărcuş, Oana; Stanciu, Oana; MacLeod, Colin; Liebregts, Heather; Visu-Petra, Laura

2016-10-01

Cognitive-affective flexibility represents the ability to switch between alternative ways of processing emotional stimuli according to situational demands and individual goals. Although reduced flexibility has been implicated as a mechanism for the development of anxiety, there is very limited data on this relationship in children and adolescents. The aim of the current study was to investigate cognitive-affective flexibility in preadolescents (N = 112, 50 girls, 11-12 and 13-14 years old) and to examine if this ability is related to individual differences in trait anxiety. Their interplay was assessed using the modified version of the Flexible Item Selection Task (FIST; Jacques and Zelazo 2001) with non-emotional stimuli (geometrical shapes) and the Emotional FIST (EM-FIST) with emotional stimuli (emotional facial expressions). Performance on the EM-FIST indicated that across the whole age range, trials requiring greater cognitive flexibility were more demanding than nonflexible ones, as revealed by both response time and accuracy performance. Moreover, flexibility demands were higher for younger children than for older ones but only in terms of response speed. Individual differences in trait anxiety moderated the impact of flexibility only on the EM-FIST. Being flexible on the EM-FIST was more demanding for high trait anxious children than for their low trait anxious peers. Lastly, overall girls responded faster than boys, but only in the EM-FIST. These findings extend the presently limited literature concerning variability in cognitive-affective flexibility during this sensitive developmental window.

The effect of electrical muscle stimulation on the prevention of disuse muscle atrophy in patients with consciousness disturbance in the intensive care unit.

PubMed

Hirose, Tomoya; Shiozaki, Tadahiko; Shimizu, Kentaro; Mouri, Tomoyoshi; Noguchi, Kazuo; Ohnishi, Mitsuo; Shimazu, Takeshi

2013-08-01

Disuse atrophy of the lower limbs of patients with consciousness disturbance has often been recognized as "an unavoidable consequence," such that the mechanism was not investigated diligently. In this study, we examined the preventive effects of electrical muscle stimulation (EMS) against disuse atrophy of the lower limbs in patients in coma after stroke or traumatic brain injury in the intensive care unit. We evaluated changes in cross-sectional area of lower limb muscles weekly with computed tomography in 6 control group patients and 9 EMS group patients. Electrical muscle stimulation was performed daily from day 7 after admission. We evaluated the anterior thigh muscle compartment, posterior thigh muscle compartment, anterior leg muscle compartment, and posterior leg muscle compartment. In the control group, the decrease in cross-sectional area progressed in all compartments every week (P < .0001). Cross-sectional areas of all compartments at day 14 were significantly decreased in the control group compared with those in the EMS group at day 7 (P < .001). We were able to limit the rate of muscle atrophy as measured in the cross-sectional areas to within 4% during the period of EMS (days 7-42) in 5 patients. The difference between the control and the EMS groups was statistically significant (P < .001). Electrical muscle stimulation is effective in the prevention of disuse muscle atrophy in patients with consciousness disorder. Copyright © 2013 Elsevier Inc. All rights reserved.

Teammate Familiarity, Teamwork, and Risk of Workplace Injury in Emergency Medical Services Teams.

PubMed

Hughes, Ashley M; Patterson, P Daniel; Weaver, Matthew D; Gregory, Megan E; Sonesh, Shirley C; Landsittel, Douglas P; Krackhardt, David; Hostler, David; Lazzara, Elizabeth H; Wang, Xiao; Vena, John E; Salas, Eduardo; Yealy, Donald M

2017-07-01

Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury. Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro. We received 2566 completed surveys from 333 clinicians, of which 297 were retained. Mean participation was 40.5% (standard deviation [SD] = 20.5%) across EMS agencies. Survey respondents were primarily white (93.8%), male (67.3%), and ranged between 21-62 years of age (M = 37.4, SD = 9.7). Seventeen percent were prehospital nurses. Respondents worked a mean of 3 shifts with recent teammates in the 8 weeks preceding the survey (M = 3.06, SD = 4.4). We examined data at the team level, which suggest positive views of teamwork (M = 5.92, SD = 0.69). Our hypothesis that increased teammate familiarity protects against adverse safety outcomes through development of positive teamwork was not supported. Teamwork factor Partner Adaptability and Backup Behavior is a likely mediator (odds ratio = 1.03, P = .05). When dyad familiarity is high and there are high levels of backup behavior, the likelihood of injury is increased. The relationship between teammate familiarity and outcomes is complex. Teammate adaptation and backup behavior is a likely mediator of this relationship in EMS teams with greater familiarity. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

The use of free online educational resources by Canadian emergency medicine residents and program directors.

PubMed

Purdy, Eve; Thoma, Brent; Bednarczyk, Joseph; Migneault, David; Sherbino, Jonathan

2015-03-01

Introduction Online educational resources (OERs) are increasingly available for emergency medicine (EM) education. This study describes and compares the use of free OERs by the Royal College of Physicians and Surgeons of Canada (RCPSC) EM residents and program directors (PDs) and investigates the relationship between the use of OERs and peer-reviewed literature. A bilingual, online survey was distributed to RCPSC-EM residents and PDs using a modified Dillman method. The chi-square test and Fisher's exact test were used to compare the responses of residents and PDs. The survey was completed by 214/350 (61%) residents and 11/14 (79%) PDs. Free OERs were used by residents most frequently for general EM education (99.5%), procedural skills training (96%), and learning to interpret diagnostic tests (92%). OER modalities used most frequently included wikis (95%), file-sharing websites (95%), e-textbooks (94%), and podcasts (91%). Residents used wikis, podcasts, vodcasts, and file-sharing websites significantly more frequently than PDs. Relative to PDs, residents found entertainment value to be more important for choosing OERs (p<0.01). Some residents (23%) did not feel that literature references were important, whereas all PDs did. Both groups reported that OERs increased the amount of peer-reviewed literature (75% and 60%, respectively) that they read. EM residents make extensive use of OERs and differ from their PDs in the importance that they place on their entertainment value and incorporation of peer-reviewed references. OERs may increase the use of peer-reviewed literature in both groups. Given the prevalence of OER use for core educational goals among RCPSC-EM trainees, future efforts to facilitate critical appraisal and appropriate resource selection are warranted.

Genomic landscape of ovarian clear cell carcinoma via whole exome sequencing.

PubMed

Kim, Se Ik; Lee, Ji Won; Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh Hyun; Song, Yong-Sang; Seo, Jeong-Sun

2018-02-01

To analyze whole exome sequencing (WES) data on ovarian clear cell carcinoma (OCCC) in Korean patients via the technique of next generation sequencing (NGS). Genomic profiles were compared between endometriosis-associated OCCC (EMS-OCCC) and Non-EMS-OCCC. We used serum samples and cancer tissues, stored at the Seoul National University Hospital Human Biobank, that were initially collected from women diagnosed with OCCC between 2012 and 2016. In total, 15 patients were enrolled: 5 with pathologically confirmed EMS-OCCC and 10 with Non-EMS-OCCC. We performed NGS WES on 15 fresh frozen OCCC tissues and matched serum samples, enabling comprehensive genomic characterization of OCCC. OCCC was characterized by complex genomic alterations, with a median of 178 exonic mutations (range, 111-25,798) and a median of 343 somatic copy number variations (range, 43-1,820) per tumor sample. In all, 54 somatic mutations were discovered across 14 genes, including PIK3CA (40%), ARID1A (40%), and KRAS (20%) in the 15 Korean OCCCs. Copy number gains in NTRK1 (33%), MYC (40%), and GNAS (47%) and copy number losses in TET2 (73%), TSC1 (67%), BRCA2 (60%), and SMAD4 (47%) were frequent. The significantly altered pathways were associated with proliferation and survival (including the PI3K/AKT, TP53, and ERBB2 pathways) in 87% of OCCCs and with chromatin remodeling in 47% of OCCCs. No significant differences in frequencies of genetic alterations were detected between EMS-OCCC and Non-EMS-OCCC groups. We successfully characterized the genomic landscape of 15 Korean patients with OCCC. We identified potential therapeutic targets for the treatment of this malignancy. Copyright © 2017. Published by Elsevier Inc.

Observações espectroscópicas da candidata a pós-AGB IRAS 19386+0155

NASA Astrophysics Data System (ADS)

Lorenz-Martins, S.; Pereira, C. B.

2003-08-01

Nesse trabalho apresentamos a análise fotosférica da estrela candidata a pós-AGB IRAS 19386+0155. Com os dados obtidos no espectrógrafo FEROS foram determinados os parâmetros atmosféricos e abundâncias fotosféricas utilizando o código MOOG. A análise do espectro mostrou que IRAS 19386+0155 possui os seguintes parâmetros atmosféricos : Teff = 6800K, log g = 1.4, [M/H] = -1.5 e Vt = 8.4 km/s. O padrão de abundância obtido para os elementos mais leves (Carbono, Nitrogênio e Oxigênio) e elementos a (Magnésio, Silício e Cálcio) foi inferior ao solar (log C = 7.74, log N = 7.28, Log O = 8.43, log Mg = 7.14, log Si = 7.54 e log Ca = 5.91). Uma inspeção visual do espectro ISO deste objeto revela a presença de poeira fria na forma de silicatos cristalinos. Embora as bandas mais marcantes de silicatos amorfos (em 10 mm e 18mm) não sejam observadas, a emissão em 21 mm, presente em algumas pós-AGBs também não está presente. O espectro ISO parece revelar um meio rico em oxigênio, mas a forma da distribuição de energia no infravermelho não obedece ao padrão apresentado por outras pós-AGBs. Nossos resultados nos levam a sugerir que IRAS 19386+0155 talvez faça parte de um sistema binário, uma vez que outras pós-AGBs que são membros de sistemas binários apresentam padrão de abundância semelhante.

Does increased emergency medical services prehospital time affect patient mortality in rural motor vehicle crashes? A statewide analysis.

PubMed

Gonzalez, Richard P; Cummings, Glenn R; Phelan, Herbert A; Mulekar, Madhuri S; Rodning, Charles B

2009-01-01

Fatality rates from rural vehicular trauma are almost double those found in urban settings. It has been suggested that increased prehospital time is a factor that adversely affects fatality rates in rural vehicular trauma. By linking and analyzing Alabama's statewide prehospital data, emergency medical services (EMS) prehospital time was assessed for rural and urban vehicular crashes. An imputational methodology permitted linkage of data from police motor vehicle crash (MVC) and EMS records. MVCs were defined as rural or urban by crash location using the United States Census Bureau criteria. Areas within Alabama that fell outside the Census Bureau definition of urban were defined as rural. Prehospital data were analyzed to determine EMS response time, scene time, and transport time in rural and urban settings. Over a 2-year period from January 2001 through December 2002, data were collected from EMS Patient Care Reports and police crash reports for the entire state of Alabama. By using an imputational methodology and join specifications, 45,763 police crash reports were linked to EMS Patient Care Reports. Of these, 34,341 (75%) were injured in rural settings and 11,422 (25%) were injured in urban settings. A total of 714 mortalities were identified, of which 611 (1.78%) occurred in rural settings and 103 (.90%) occurred in urban settings (P < .0001). When mortalities occurred, the mean EMS response time in rural settings was 10.67 minutes and 6.50 minutes in urban settings (P < .0001). When mortalities occurred, the mean EMS scene time in rural settings was 18.87 minutes and 10.83 minutes in urban settings (patients who were dead on scene and extrication patients were excluded from both settings) (P < .0001). When mortalities occurred, the mean EMS transport time in rural settings was 12.45 minutes and 7.43 minutes in urban settings (P < .0001). When mortalities occurred, the overall mean prehospital time in rural settings was 42.0 minutes and 24.8 minutes in urban settings (P < .0001). The mean EMS response time for rural MVCs with survivors was 8.54 minutes versus a mean of 10.67 minutes with mortalities (P < .0001). The mean EMS scene time for rural MVCs with survivors was 14.81 minutes versus 18.87 minutes with mortalities (patients who were dead on scene and extrication patients were excluded) (P = .0014). Based on this statewide analysis of MVCs, increased EMS prehospital time appears to be associated with higher mortality rates in rural settings.

Intensive Care Unit Structure Variation and Implications for Early Mobilization Practices. An International Survey.

PubMed

Bakhru, Rita N; McWilliams, David J; Wiebe, Douglas J; Spuhler, Vicki J; Schweickert, William D

2016-09-01

Early mobilization (EM) improves outcomes for mechanically ventilated patients. Variation in structure and organizational characteristics may affect implementation of EM practices. We queried intensive care unit (ICU) environment and standardized ICU practices to evaluate organizational characteristics that enable EM practice. We recruited 151 ICUs in France, 150 in Germany, 150 in the United Kingdom, and 500 in the United States by telephone. Survey domains included respondent characteristics, hospital and ICU characteristics, and ICU practices and protocols. We surveyed 1,484 ICU leaders and received a 64% response rate (951 ICUs). Eighty-eight percent of respondents were in nursing leadership roles; the remainder were physiotherapists. Surveyed ICUs were predominantly mixed medical-surgical units (67%), and 27% were medical ICUs. ICU staffing models differed significantly (P < 0.001 each) by country for high-intensity staffing, nurse/patient ratios, and dedicated physiotherapists. ICU practices differed by country, with EM practices present in 40% of French ICUs, 59% of German ICUs, 52% of U.K. ICUs, and 45% of U.S. ICUs. Formal written EM protocols were present in 24%, 30%, 20%, and 30%, respectively, of those countries' ICUs. In multivariate analysis, EM practice was associated with multidisciplinary rounds (odds ratio [OR], 1.77; P = 0.001), setting daily goals for patients (OR, 1.62; P = 0.02), presence of a dedicated physiotherapist (OR, 2.48; P < 0.001), and the ICU's being located in Germany (reference, United States; OR, 2.84; P < 0.001). EM practice was also associated with higher nurse staffing levels (1:1 nurse/patient ratio as a reference; 1:2 nurse/patient ratio OR, 0.59; P = 0.05; 1:3 nurse/patient ratio OR, 0.33; P = 0.005; 1:4 or less nurse/patient ratio OR, 0.37; P = 0.005). Those responding rarely cited ambulation of mechanically ventilated patients, use of a bedside cycle, or neuromuscular electrical stimulation as part of their EM practice. Physical therapy initiation, barriers to EM practice, and EM equipment were highly variable among respondents. International ICU structure and practice is quite heterogeneous, and several factors (multidisciplinary rounds, setting daily goals for patients, presence of a dedicated physiotherapist, country, and nurse/patient staffing ratio) are significantly associated with the practice of EM. Practice and barriers may be far different based upon staffing structure. To achieve successful implementation, whether through trials or quality improvement, ICU staffing and practice patterns must be taken into account.

Observações das explosões cósmicas de raios gama GRB021004 e GRB021211 com o satélite HETE

NASA Astrophysics Data System (ADS)

Braga, J.; Ricker, G.; Hurley, K.; Lamb, D.; Grew, G.; et al.

2003-08-01

O High Energy Transient Explorer (HETE) é o primeiro satélite inteiramente dedicado ao estudo das explosões cósmicas de raios gama (ECRGs). Lançado em 9 de outubro de 2000, o HETE possui instrumentação capaz de observar as ECRGs desde o UV até raios gama e localizá-las com precisão de ~ 1-10 minutos de arco. As localizações das ECRGs detectadas são disseminadas rapidamente (em alguns segundos) pela Internet através de uma rede de estações de recepção ao longo do equador. A participação brasileira nesse projeto se dá através da montagem e operação de uma estação de recepção em Natal, RN, e da participação na equipe científica da missão. Neste trabalho são apresentados resultados da observação pelo HETE de duas ECRGs: GRB 021004 e GRB 021211. A GRB021004 foi detectada em raios gama pelo HETE em 4 de outubro de 2002 e localizada em raios-X em apenas 48 s, quando a emissão de raios gama ainda estava se processando. A explosão, relativamente brilhante e longa, durou aproximadamente 100 s. Um transiente óptico de magnitude 15 foi detectado no local da explosão nove minutos após o evento, e observações realizadas após 7 horas determinaram um desvio para o vermelho de absorção de 1,6. O GRB021004 foi o burst mais bem observado até o momento e suas observações em vários comprimentos de onda têm sido fundamentais para o aprimoramento dos modelos de ECRGs. O GRB21211, um burst brilhante e rico em raios-X, foi detectado em 11 de dezembro de 2002 e localizado em raios-X em 22 s após o início do evento. A duração do burst foi de 2,3 s em altas energias (85 a 400 keV) e de 8,5 s em baixas energias (2 a 10 keV). Caso essa explosão não tivesse sido rapidamente localizada pelo HETE, ela teria sido classificada como "opticamente escura", já que o transiente óptico decaiu rapidamente de R < 14 a R»19 dentro dos primeiros 20 minutos e já estava mais fraco do que R»23 depois de 24 horas da ocorrência do burst. Serão discutidas as implicações desse resultado nos modelos de afterglows de ECRGs.

Liquid chromatography/fluorescence method for emamectin B1a and desmethylamino-emamectin B1a residues in lobster tissue.

PubMed

Tauber, Ronald; Gillan, Niall; Crouch, Louis; Greenhalgh, Roy

2006-01-01

A liquid chromatography (LC)/fluorescence procedure was validated for emamectin (EM B1a) and desmethylamino-emamectin (DMAEM B1a) residues in lobster tissue. They were extracted by shaking and sonicating with 1% ammonium acetate-methanol in the presence of sand. The extract was concentrated, partitioned with ethyl acetate, and cleaned up on a propylsulfonic cation exchange cartridge. The analytes were eluted from the cartridge with 5% ammonium hydroxide-methyl acetate, the eluate was concentrated, and the solvent was changed to dry 20% ethyl acetate-acetonitrile before derivatization with trifluoroacetic anhydride-N-methylimidizole. The products were analyzed by LC-fluorescence, and no interference [>limit of detection (LOD)] was detected in the control samples. Lobster tissues fortified with EM B1a and DMAEM B1a at 0.5, 5, 10, 25, and 50 ng/g gave overall mean recoveries of 96.7 +/- 12.4%, relative standard deviation (RSD) = 12.8% for EM B1 and 83.6 +/- 12.1%, RSD = 14.5% for DMAEM B1a. Regression analysis of the calibration data gave slopes of 0.90 (EM B1a) and 0.71 (DMAEM B1a) with an r2 = 0.99 for both compounds. The calculated LOD and limit of quantification (LOQ) for EM B1a were 1.10 and 3.32 ng/g, respectively, and for DMAEM B1a were 0.762 and 2.31 ng/g, respectively. Residues of EM B1a and DMAEM B1a in fortified lobster tissues stored at -20 degrees C showed that residues were stable for 10-12 months. No loss of EM B1a and DMAEM B1a residues was observed after 3 freeze/thaw cycles of fortified tissue in a 5-day period.

Improved Outcome of Enteric Peritonitis in Peritoneal Dialysis Patients Aged 50 Years and Older with Temporary Discontinuation of Peritoneal Dialysis and Intravenous Meropenem.

PubMed

Abrahams, Alferso C; Rüger, Wim; Ter Wee, Pieter M; van Ittersum, Frans J; Boer, Walther H

2017-01-01

♦ BACKGROUND: Peritonitis is a major cause of morbidity, mortality, and technique failure in peritoneal dialysis (PD) patients, especially when caused by enteric microorganisms (EM). We have implemented a treatment protocol specifically aimed at improving the outcome in EM peritonitis. The adapted protocol was applied in all PD patients 50 years and older presenting with peritonitis who were considered to be at risk of EM peritonitis and involves 3 interventions: 1) temporary discontinuation of PD without removing the catheter (peritoneal rest), 2) intravenous meropenem, and 3) meropenem intracatheter as lock (Mero-PerRest protocol). ♦ METHODS: In this observational study, we compared the outcome of 203 peritonitis episodes in 71 patients treated with the Mero-PerRest protocol, with 217 episodes in 104 patients treated with a more traditional intraperitoneal gentamicin-rifampicin-based regimen. ♦ RESULTS: In EM peritonitis episodes, the Mero-PerRest protocol resulted in a higher primary cure rate (90.0% vs 65.3%, adjusted odds ratio [OR] 4.54 [95% confidence interval (CI) 1.46 - 14.15]) and better technique survival (90.0% vs 69.4%, adjusted OR 3.41 [95% CI 1.07 - 10.87]). This effect was most distinct in patients with polymicrobial EM peritonitis (cure rate 87.5% vs 34.8%, p = 0.0003). Interestingly, primary cure rate (95.6% vs 84.7%, adjusted OR 3.92 [95% CI 1.37 - 11.19]) and technique survival (95.6% vs 85.6%, adjusted OR 3.60 [95% CI 1.25 - 10.32]) were also excellent in non-EM peritonitis episodes. Patient survival did not differ significantly. ♦ CONCLUSION: The poor outcome of peritonitis caused by EM in PD patients aged 50 years and older could be improved by applying a treatment protocol involving temporary discontinuation of PD without catheter removal and intravenous and intracatheter meropenem. Copyright © 2017 International Society for Peritoneal Dialysis.

Relationship between Resting Heart Rate, Blood Pressure and Pulse Pressure in Adolescents.

PubMed

Christofaro, Diego Giulliano Destro; Casonatto, Juliano; Vanderlei, Luiz Carlos Marques; Cucato, Gabriel Grizzo; Dias, Raphael Mendes Ritti

2017-05-01

High resting heart rate is considered an important factor for increasing mortality chance in adults. However, it remains unclear whether the observed associations would remain after adjustment for confounders in adolescents. To analyze the relationship between resting heart rate, blood pressure and pulse pressure in adolescents of both sexes. A cross-sectional study with 1231 adolescents (716 girls and 515 boys) aged 14-17 years. Heart rate, blood pressure and pulse pressure were evaluated using an oscillometric blood pressure device, validated for this population. Weight and height were measured with an electronic scale and a stadiometer, respectively, and waist circumference with a non-elastic tape. Multivariate analysis using linear regression investigated the relationship between resting heart rate and blood pressure and pulse pressure in boys and girls, controlling for general and abdominal obesity. Higher resting heart rate values were observed in girls (80.1 ± 11.0 beats/min) compared to boys (75.9 ± 12.7 beats/min) (p ≤ 0.001). Resting heart rate was associated with systolic blood pressure in boys (Beta = 0.15 [0.04; 0.26]) and girls (Beta = 0.24 [0.16; 0.33]), with diastolic blood pressure in boys (Beta = 0.50 [0.37; 0.64]) and girls (Beta = 0.41 [0.30; 0.53]), and with pulse pressure in boys (Beta = -0.16 [-0.27; -0.04]). This study demonstrated a relationship between elevated resting heart rate and increased systolic and diastolic blood pressure in both sexes and pulse pressure in boys even after controlling for potential confounders, such as general and abdominal obesity. A frequência cardíaca de repouso é considerada um importante fator de aumento de mortalidade em adultos. Entretanto, ainda é incerto se as associações observadas permanecem após ajuste para fatores de confusão em adolescentes. Analisar a relação entre frequência cardíaca de repouso, pressão arterial e pressão de pulso em adolescentes dos dois sexos. Estudo transversal com 1231 adolescentes (716 meninas e 515 meninos, idade de 14-17 anos). Frequência cardíaca, pressão arterial e pressão de pulso foram avaliadas com esfigmomanômetro oscilométrico validado para essa população. Peso e altura foram medidos com balança eletrônica e estadiômetro, respectivamente, e a circunferência abdominal, com uma fita inextensível. Análise multivariada com regressão linear investigou a relação entre frequência cardíaca de repouso, pressão arterial e pressão de pulso em meninos e meninas, controlando para obesidade geral e abdominal. Valores maiores de frequência cardíaca de repouso foram observados em meninas (80,1 ± 11,0 bpm) em comparação a meninos (75,9 ± 12,7 bpm) (p ≤ 0,001). Frequência cardíaca de repouso associou-se com pressão arterial sistólica em meninos [Beta = 0,15 (0,04; 0,26)] e meninas [Beta = 0,24 (0,16; 0,33)], com pressão arterial diastólica em meninos [Beta = 0,50 (0,37; 0,64)] e meninas [Beta = 0,41 (0,30; 0,53)], e com pressão de pulso apenas em meninos [Beta = -0,16 (-0,27; -0,04)]. Este estudo demonstrou a relação da frequência cardíaca de repouso elevada com aumento das pressões arteriais sistólica e diastólica em ambos os sexos e com pressão de pulso em meninos, mesmo após controle para potenciais fatores de confusão, como obesidade geral e abdominal.

Isolation of midgut escape mutants of two American genotype dengue 2 viruses from Aedes aegypti

PubMed Central

2013-01-01

Background Several studies have shown that American genotype dengue 2 viruses (DENV2) have reduced viral fitness in the mosquito vector, Aedes aegypti, compared to other DENV2 genotypes. Diminished replication efficiency or inability to efficiently traverse membrane barriers encompassing organs such as the midgut or salivary glands are considered major factors negatively impacting viral fitness in the mosquito. Results We analyzed the vector competence of Ae. aegypti for two American DENV2 strains, QR94 and PR159 originating from Mexico and Puerto-Rico, respectively. Both strains infected mosquito midguts following acquisition of infectious bloodmeals. However, DENV2-QR94 and DENV2-PR159 poorly disseminated from the midgut at 7 or 14 days post-bloodmeal (pbm). We detected one virus isolate, EM33, among 31 DENV2-QR94 infected mosquitoes, and one isolate, EM41, among 121 DENV2-PR159 infected mosquitoes, generating high virus titers in mosquito carcasses at 7 days pbm. In oral challenge experiments, EM33 and EM41 showed midgut dissemination rates of 40-50%. Replication efficiency of EM41 in secondary mosquito tissue was similar to that of a dissemination-competent control strain, whereas the replication efficiency of EM33 was significantly lower than that of the control virus. The genome sequence of DENV2-QR94 encoded seven unique amino acids (aa), which were not found in 100 of the most closely related DENV2 strains. EM33 had one additional aa change, E202K, in the E protein. DENV2-PR159 encoded four unique aa residues, one of them E202K, whereas EM41 had two additional aa substitutions, Q77E in the E protein and E93D in NS3. Conclusions Our results indicate that the midgut of Ae. aegypti acts as a selective sieve for DENV2 in which genetically distinct, dissemination-competent virus variants are rapidly selected from the viral quasispecies to be transmitted to vertebrates. PMID:23937713

Characteristics of the pediatric patients treated by the Pediatric Emergency Care Applied Research Network's affiliated EMS agencies.

PubMed

Lerner, E Brooke; Dayan, Peter S; Brown, Kathleen; Fuchs, Susan; Leonard, Julie; Borgialli, Dominic; Babcock, Lynn; Hoyle, John D; Kwok, Maria; Lillis, Kathleen; Nigrovic, Lise E; Mahajan, Prashant; Rogers, Alexander; Schwartz, Hamilton; Soprano, Joyce; Tsarouhas, Nicholas; Turnipseed, Samuel; Funai, Tomohiko; Foltin, George

2014-01-01

To describe pediatric patients transported by the Pediatric Emergency Care Applied Research Network's (PECARN's) affiliated emergency medical service (EMS) agencies and the process of submitting and aggregating data from diverse agencies. We conducted a retrospective analysis of electronic patient care data from PECARN's partner EMS agencies. Data were collected on all EMS runs for patients less than 19 years old treated between 2004 and 2006. We conducted analyses only for variables with usable data submitted by a majority of participating agencies. The investigators aggregated data between study sites by recoding it into categories and then summarized it using descriptive statistics. Sixteen EMS agencies agreed to participate. Fourteen agencies (88%) across 11 states were able to submit patient data. Two of these agencies were helicopter agencies (HEMS). Mean time to data submission was 378 days (SD 175). For the 12 ground EMS agencies that submitted data, there were 514,880 transports, with a mean patient age of 9.6 years (SD 6.4); 53% were male, and 48% were treated by advanced life support (ALS) providers. Twenty-two variables were aggregated and analyzed, but not all agencies were able to submit all analyzed variables and for most variables there were missing data. Based on the available data, median response time was 6 minutes (IQR: 4-9), scene time 15 minutes (IQR: 11-21), and transport time 9 minutes (IQR: 6-13). The most common chief complaints were traumatic injury (28%), general illness (10%), and respiratory distress (9%). Vascular access was obtained for 14% of patients, 3% received asthma medication, <1% pain medication, <1% assisted ventilation, <1% seizure medication, <1% an advanced airway, and <1% CPR. Respiratory rate, pulse, systolic blood pressure, and GCS were categorized by age and the majority of children were in the normal range except for systolic blood pressure in those under one year old. Despite advances in data definitions and increased use of electronic databases nationally, data aggregation across EMS agencies was challenging, in part due to variable data collection methods and missing data. In our sample, only a small proportion of pediatric EMS patients required prehospital medications or interventions.

Estudo em microondas do aprisionamento e precipitação de elétrons em explosões solares

NASA Astrophysics Data System (ADS)

Rosal, A. C.; Costa, J. E. R.

2003-08-01

Uma explosão solar é uma variação rápida e intensa do brilho que ocorre nas chamadas regiões ativas da atmosfera, constituídas por um plasma magnetizado com intensa indução magnética. Os modelos de explosões solares atuais, discutidos na literatura, apresentam características de aprisionamento e precipitação de elétrons em ambientes magnéticos simplificados. Neste trabalho, nos propusemos a separar a emissão dos elétrons aprisionados da emissão dos elétrons em precipitação apenas a partir da emissão em microondas, melhorando portanto o controle sobre o conjunto de parâmetros inferidos. A emissão em microondas da população em precipitação é bastante fraca e portanto da nossa base de dados de 130 explosões observadas pelo Rádio Polarímetro de Nobeyama, em sete freqüências, apenas para 32 foi possível separar as duas componentes de emissão com uma boa razão sinal/ruído. A partir de estudos das escalas de tempo das emissões devidas à variação gradual da emissão no aprisionamento e da variação rápida da emissão dos elétrons em precipitação foi possível obter a separação utilizando um filtro temporal nas emissões resultantes. Em nossa análise destas explosões estudamos os espectros girossincrotrônicos da emissão gradual, a qual associamos provir do topo dos arcos magnéticos e da emissão de variação rápida associada aos elétrons em precipitação. Estes espectros foram calculados e dos quais inferimos que a indução magnética efetiva do topo e dos pés foi em média, Btopo = 236 G e Bpés = 577 G, inferidas das freqüências de pico dos espectros em ntopo = 11,8 GHz e npés = 14,6 GHz com leve anisotropia (pequeno alargamento espectral). O índice espectral da distribuição não-térmica de elétrons d, inferido do índice espectral de fótons da emissão em regime opticamente fino, foi de dtopo = 3,3 e dpés = 3,9. Estes parâmetros são típicos da maioria das análises realizadas em ambiente único de emissão e a relação dos índices espectrais, dpés > dtopo prioriza as interpretações com difusão em ângulo de passo devida a colisões Coulombianas. Nesta difusão o déficit de elétrons energéticos na precipitação seria uma conseqüência natural da dependência em e-3/2 das colisões elétron-próton (onde e é a energia dos elétrons).

Four new species of Eimeria (Apicomplexa: Eimeriidae) from Emoia spp. Skinks (Sauria: Scincidae), from Papua New Guinea and the Insular Pacific

USGS Publications Warehouse

McAllister, Chris T.; Duszynski, Donald W.; Austin, Christopher C.; Fisher, Robert N.

2017-01-01

Between September and November 1991, 54 adult skinks from 15 species were collected by hand or blowpipe from several localities on Rarotonga, Cook Islands, Ovalau Island, Fiji, and Papua New Guinea (PNG), and their feces were examined for coccidians. Species included 5 seaside skinks (Emoia atrocostata), 1 Pacific blue-tailed skink (Emoia caeroleocauda), 2 Fiji slender treeskinks (Emoia concolor), 15 white-bellied copper-striped skinks (Emoia cyanura), 1 Bulolo River forest skink (Emoia guttata), 6 dark-bellied copper-striped skinks (Emoia impar), 5 Papua five-striped skinks (Emoia jakati), 2 Papua slender treeskinks (Emoia kordoana), 3 Papua robust treeskinks (Emoia longicauda), 1 brown-backed forest skink (Emoia loveridgei), 3 Papua black-sided skinks (Emoia pallidiceps), 2 Papua white-spotted skinks (Emoia physicae), 2 Papua yellow-head skinks (Emoia popei), 1 Papua brown forest skink (Emoia submetallica), and 5 Fiji barred treeskinks (Emoia trossula) Species of Eimeria (Ei.) were detected from these Emoia (Em.) spp. and are described here as new. Oocysts of Eimeria iovai n. sp. from Em. pallidiceps from PNG were ellipsoidal with a bilayered wall (L × W) 26.5 × 18.1 μm, with a length/width ratio (L/W) of 1.1. Both micropyle and oocyst residuum were absent, but a fragmented polar granule was present. This eimerian also was found in Em. atrocostata from PNG. Oocysts of Eimeria kirkpatricki n. sp. from Em. atrocostata from PNG were ellipsoidal with a bilayered wall, 18.6 × 13.5 μm, L/W 1.4. A micropyle and oocyst residuum were absent, but a fragmented polar granule was present. This eimerian was also shared by Em. cyanura from the Cook Islands and Fiji, Em. imparfrom the Cook Islands, Em. loveridgei from PNG, Em. pallidicepsfrom PNG, Em. popei from PNG, and Em. submetallica from PNG. Oocysts of Eimeria stevejayuptoni n. sp. from Em. longicaudawere subspheroidal to ellipsoidal with a bilayered wall, 18.7 × 16.6 μm, L/W 1.1. A micropyle and oocyst residuum were absent, but a fragmented polar granule was present. Oocysts of Eimeria emoia n. sp. from Em. longicauda from PNG were cylindroidal with a bilayered wall, 29.2 × 15.7 μm, L/W 1.9. A micropyle and oocyst residuum were absent, but a polar granule was present. These are the first eimerians reported from Emoia spp. and they add to our growing knowledge of the coccidian fauna of scincid lizards of the South Pacific.

Orbital parameters of the multiple system EM Boo

NASA Astrophysics Data System (ADS)

Özkardeş, B.; Bakış, H.; Bakış, V.

2018-02-01

EM Boo is a relatively bright (V = 8.98 mag.) and short orbital period (P⁓2.45 days) binary star member of the multiple system WDS J14485+2445AB. There is neither photometric nor spectroscopic study of the system in the literature. In this work, we obtained spectroscopic orbital parameters of the system from new high resolution spectroscopic observations made with échelle spectrograph attached to UBT60 telescope of Akdeniz University. The spectroscopic solution yielded the values K1 = 100.7±2.6 km/s, K2 = 120.1±2.6 km/s and Vγ = -14.6±3.1 km/s, and thus the mass ratio of the system q = 0.838±0.064.

Air and Space Power Journal-Spring 2016

DTIC Science & Technology

2016-01-01

control the human domain. Hypothetically, if an opponent attacks or manipulates the use of radio frequencies within the EMS, through cyber or other means...to US home- land systems via a radio frequency signal almost instantaneously. Furthermore, these information packets can be pre-positioned and lay...Remarkable Life of Apollo 14 Astronaut Stuart Roosa . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Willie G

Associations Between the Differential Definitions of Elder Mistreatment and Suicidal Ideation Outcomes in U.S. Chinese Older Adults: Do the Definitions Matter?

PubMed

Dong, XinQi

2017-07-01

Elder mistreatment (EM) prevalence varies greatly according to definitional criteria. However, little is known regarding the significance of different EM definitions with respect to health outcome. This paper explores the association between different definitions of EM and their subtypes and suicidal ideation (SI) in an U.S. Chinese aging population. The Population Study of ChINese Elderly in Chicago Study was conducted from 2011 to 2013 of 3157 community-dwelling Chinese older adults aged 60 years. Psychological, physical mistreatment (PM), caregiver neglect (CN), financial exploitation (FE), and overall EM were measured by different definitional approaches varying in the strictness. SI in the past 2 weeks and 12 months were assessed. After adjusting for confounders, the least restrictive EM definition (odds ratio [OR], 2.10 [1.34-3.28]; OR, 2.43 [1.66-3.55]), moderately restrictive EM definition (OR, 2.87 [1.80-4.56]; OR, 2.71 [1.82-4.04]), and most restrictive EM definition (OR, 2.24 [1.36-3.66]; OR, 2.34 [1.54-3.56]) were associated with increased risk for 2-week and 12-month SI. For subtypes of EM, psychological mistreatment (the least and most restrictive definitions, 2-week SI: OR, 2.83 [1.71-4.68]; OR, 3.13 [1.10-8.91]; 12-month SI: OR, 2.43 [1.56-3.78]; OR, 2.88 [1.10-7.54]), PM (2-week SI: OR, 5.12 [1.83-14.29]; 12-month SI: OR, 3.45 [1.30-9.13]), and FE was not associated with 2-week SI, only the broadly defined FE (OR, 1.73 [1.01-2.96]) was associated with higher odds of reporting 12-month SI. CN was only associated with higher odds of reporting 12-month SI (OR, 2.17 [1.19-3.96]; OR, 1.94 [1.24-3.04]) but not 2-week SI. EM and its subtypes were significantly associated with SI; some associations varied by definitions and subtypes. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparison of team-focused CPR vs standard CPR in resuscitation from out-of-hospital cardiac arrest: Results from a statewide quality improvement initiative.

PubMed

Pearson, David A; Darrell Nelson, R; Monk, Lisa; Tyson, Clark; Jollis, James G; Granger, Christopher B; Corbett, Claire; Garvey, Lee; Runyon, Michael S

2016-08-01

Team-focused CPR (TFCPR) is a choreographed approach to cardiopulmonary resuscitation (CPR) with emphasis on minimally interrupted high-quality chest compressions, early defibrillation, discourages endotracheal intubation and encourages use of the bag-valve-mask (BVM) and/or blind-insertion airway device (BIAD) with a ventilation rate of 8-10 breaths/min to minimize hyperventilation. Widespread incorporation of TFCPR in North Carolina (NC) EMS agencies began in 2011, yet its impact on outcomes is unknown. To determine whether TFCPR improves survival with good neurological outcome in out-of-hospital cardiac arrest (OHCA) patients compared to standard CPR. This retrospective cohort analysis of NC EMS agencies reporting data to the Cardiac Arrest Registry for Enhanced Survival (CARES) database from January 2010 to June 2014 included adult, non-traumatic OHCA with presumed cardiac etiology where EMS performed CPR or patient received defibrillation. Exclusions were arrest terminated per EMS policy or DNR. EMS agencies self-reported the TFCPR implementation dates. Patients were categorized as receiving either TFCPR or standard CPR. The primary outcome was good neurologic outcome at time of hospital discharge defined as Pittsburgh Cerebral Performance Category (CPC) 1-2. Of 14,994 OHCAs, 14,129 patients were included for analysis with a mean age 65 (IQR 50-81) years, 61% male, 7.3% with good neurologic outcome, 24.3% with shockable initial rhythm, and 71.5% receiving TFCPR. Of the 3427 (24.3%) with an initial shockable rhythm, 739 (71.9%) had a good neurological outcome. Good neurologic outcome was higher with TFCPR [836 (8.3%, 95%CI 7.7-8.8%)] vs. standard CPR [193 (4.8%, 95%CI 4.2-5.5%)]. Logistic regression controlling for demographic and arrest characteristics revealed TFCPR (OR 1.5), witnessed arrest (OR 4.3), initial shockable rhythm (OR 7.1), and in-hospital hypothermia (OR 3.3) were associated with good neurologic outcome. Mechanical CPR device (OR 0.68), CPR feedback device (OR 0.47), and endotracheal intubation (OR 0.44) were associated with less likelihood for a good neurologic outcome. In our statewide OHCA cohort, TFCPR was associated with improved survival with good neurological outcome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Global Emergency Medicine Journal Club: A Social Media Discussion About the Lack of Association Between Press Ganey Scores and Emergency Department Analgesia.

PubMed

Westafer, Lauren; Hensley, Justin; Shaikh, Sameed; Lin, Michelle

2016-01-01

Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host a public discussion featuring the 2014 Annals article on the association between Press Ganey scores and emergency department (ED) analgesia by Schwartz et al. The objective was to curate a 14-day (December 1 through 14, 2014) worldwide academic dialogue among clinicians in regard to preselected questions about the article. Five online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by the 4 preselected questions. Engagement was tracked through Web analytic tools and analysis of tweets. Blog comments, tweets, and video expert commentary involving the featured article are summarized and reported. The dialogue resulted in 978 page views from 342 cities in 33 countries on the ALiEM Web site, 464,345 Twitter impressions, and 83 views of the video interview with experts. Of the unique 169 identified tweets, discussion (53.3%) and learning points (32.5%) were the most common category of tweets identified. Common themes that arose in the open-access multimedia discussions included Press Ganey data validity and the utility of patient satisfaction in determining pain treatment efficacy. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide scholarly discourse. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Asynchronous learning: student utilization out of sync with their preference.

PubMed

Lew, Edward K; Nordquist, Erik K

2016-01-01

Asynchronous learning is gaining popularity. Data are limited regarding this learning method in medical students rotating in emergency medicine (EM). In EM, faculty time is limited to give in-person lectures. The authors sought to create an online curriculum that students could utilize as an additional learning modality. The goal was to evaluate effectiveness, participation, and preference for this mode of learning. We developed five online, narrated PowerPoint presentations. After orientation, access to the online curriculum was provided to the students, which they could review at their leisure. One hundred and seven fourth-year medical students participated. They reported the curriculum to be of high quality. Pretest scores were similar for those that viewed all lectures - compliant group (CG) (9.5 [CI 4.8-14.1]) and those that did not view any - non-compliant group (NCG) (9.6 [CI 5.9-13.4]). There was no statistical significant difference in posttest scores between the groups although there was improvement overall: CG 14.6 (CI 6.9-22.1); NCG 11.4 (CI 5.7-17.1). A majority (69.2%) favored inclusion of asynchronous learning, but less than a quarter (22.4%) reported viewing all five modules and more than a third (36.4%) viewed none. Despite student-expressed preference for an online curriculum, they used the online resource less than expected. This should give pause to educators looking to convert core EM topics to an online format. However, when high-quality online lectures are utilized as a learning tool, this study demonstrates that they had neither a positive nor a negative impact on test scores.

Association between cytochrome P450 2D6 polymorphisms and body fluid methamphetamine concentrations in Japanese forensic autopsy cases.

PubMed

Matsusue, Aya; Ikeda, Tomoya; Tani, Naoto; Waters, Brian; Hara, Kenji; Kashiwagi, Masayuki; Takayama, Mio; Ikematsu, Natsuki; Kubo, Shin-Ichi; Ishikawa, Takaki

2018-05-18

Methamphetamine (MA) is an illicit stimulant that affects the central nervous system. Cytochrome P450 2D6 (CYP2D6) plays an important role in MA metabolism. Numerous allelic variants confer substantial variation in CYP2D6 activity among individuals. In the present study, we examined the frequencies of CYP2D6 alleles, including CYP2D6*1, *2, *4, *5, *10, *14A, *14B, *18, and *36, and multiplication, in 82 forensic autopsy cases of MA abusers and 567 autopsy cases in which MA was not detected (controls). Ultrarapid metabolizer (UM), extensive metabolizer (EM), intermediate metabolizer (IM), and poor metabolizer (PM) phenotypes were predicted from CYP2D6 genotypes. Of MA abusers, 64 subjects were predicted to be EM, 17 were IM, and 1 was UM. No MA abuser had the predicted PM phenotype. No significant differences in CYP2D6 phenotype frequencies were found between MA abusers and controls. MA and amphetamine (AMP) concentrations were measured in the right heart blood, left heart blood, peripheral external iliac blood, urine, pericardial fluid, and bone marrow of MA abusers. MA concentrations in urine and bone marrow were significantly higher in IM than in EM. AMP concentration was not associated with CYP2D6 phenotype in any body fluid. These results suggest that the MA concentration in body fluids is influenced by CYP2D6 phenotypes in the Japanese population. Copyright © 2018 Elsevier B.V. All rights reserved.

Association of Burnout with Workforce-Reducing Factors among EMS Professionals.

PubMed

Crowe, Remle P; Bower, Julie K; Cash, Rebecca E; Panchal, Ashish R; Rodriguez, Severo A; Olivo-Marston, Susan E

2018-01-01

Emergency medical services (EMS) professionals often work long hours at multiple jobs and endure frequent exposure to traumatic events. The stressors inherent to the prehospital setting may increase the likelihood of experiencing burnout and lead providers to exit the profession, representing a serious workforce and public health concern. Our objectives were to estimate the prevalence of burnout, identify characteristics associated with experiencing burnout, and quantify its relationship with factors that negatively impact EMS workforce stability, namely sickness absence and turnover intentions. A random sample of 10,620 emergency medical technicians (EMTs) and 10,540 paramedics was selected from the National EMS Certification database to receive an electronic questionnaire between October, 2015 and November, 2015. Using the validated Copenhagen Burnout Inventory (CBI), we assessed burnout across three dimensions: personal, work-related, and patient-related. We used multivariable logistic regression modeling to identify burnout predictors and quantify the association between burnout and our workforce-related outcomes: reporting ten or more days of work absence due to personal illness in the past 12 months, and intending to leave an EMS job or the profession within the next 12 months. Burnout was more prevalent among paramedics than EMTs (personal: 38.3% vs. 24.9%, work-related: 30.1% vs. 19.1%, and patient-related: 14.4% vs. 5.5%). Variables associated with increased burnout in all dimensions included certification at the paramedic level, having between five and 15 years of EMS experience, and increased weekly call volume. After adjustment, burnout was associated with over a two-fold increase in odds of reporting ten or more days of sickness absence in the past year. Burnout was associated with greater odds of intending to leave an EMS job (personal OR:2.45, 95% CI:1.95-3.06, work-related OR:3.37, 95% CI:2.67-4.26, patient-related OR: 2.38, 95% CI:1.74-3.26) or the EMS profession (personal OR:2.70, 95% CI:1.94-3.74, work-related OR:3.43, 95% CI:2.47-4.75, patient-related OR:3.69, 95% CI:2.42-5.63). The high estimated prevalence of burnout among EMS professionals represents a significant concern for the physical and mental well-being of this critical healthcare workforce. Further, the strong association between burnout and variables that negatively impact the number of available EMS professionals signals an important workforce concern that warrants further prospective investigation.

Ondas de choque em jatos de quasares e objetos BL Lacertae

NASA Astrophysics Data System (ADS)

Melo, F. E.; Botti, L. C. L.

2003-08-01

Este trabalho é parte de um projeto que vem sendo realizado há dois anos no CRAAM, cujos objetivos principais são analisar e aplicar um modelo generalizado de ondas de choque em jatos relativísticos de plasma, presentes em quasares e objetos BL Lacertae, para explicar a variabilidade observada nestes objetos. O método consiste em uma decomposição de curvas de luz em séries de explosões similares, em várias freqüências, baseando-se em uma evolução espectro-temporal média das explosões. A partir da evolução média, um ajuste de cada explosão é feito com base em equações empíricas, modificando-se apenas parâmetros específicos de cada explosão. Inicialmente o modelo foi aplicado ajustando-se as curvas de luz a explosões delineadas por uma evolução do choque em três estágios, segundo a predominância do processo de emissão: síncrotron, Compton e adiabático. Entretanto, nesta nova fase de projeto, visando uma parametrização mais concisa, uma otimização do algoritmo de ajuste e uma convergência mais rápida, a formulação para cada evento foi assumida com uma evolução em apenas dois estágios: subida e descida. Isto possibilitou uma ótima delineação das curvas de luz das fontes OV236, OJ287, 3C273 e BL Lac, entre 1980 e 2000, nas freqüências 4.8, 8.0, 14.5 e 22 GHz, utilizando-se dados do Observatório da Universidade de Michigan, do Observatório do Itapetinga (Atibaia SP) e do Observatório Metsähovi. Como conclusões importantes, verificou-se que: os parâmetros ajustados descrevem o comportamento do jato; os valores do índice que descreve a expansão do jato sugerem que o mesmo se expande de uma forma não-cônica; o campo magnético é turbulento atrás da frente de choque; e as peculiaridades das explosões são devidas à influência de grandezas tais como o coeficiente da distribuição espectral de energia dos elétrons, a intensidade de campo magnético e o fator de feixe Doppler, no início do choque.

The influence of effective microorganisms (EM) and yeast on the degradation of strobilurins and carboxamides in leafy vegetables monitored by LC-MS/MS and health risk assessment.

PubMed

Wołejko, Elżbieta; Łozowicka, Bożena; Kaczyński, Piotr; Jankowska, Magdalena; Piekut, Jolanta

2016-01-01

The aim of this study was to determine the behaviour of strobilurin and carbocyamides commonly used in chemical protection of lettuce depending on carefully selected effective microorganisms (EM) and yeast (Y). Additionally, the assessment of the chronic health risk during a 2-week experiment was performed. The statistical method for correlation of physico-chemical parameters and time of degradation for pesticides was applied. In this study, the concentration of azoxystrobin, boscalid, pyraclostrobin and iprodione using liquid chromatography-mass spectrometry (LC-MS/MS) in the matrix of lettuce plants was performed, and there was no case of concentration above maximum residues levels. Before harvest, four fungicides and their mixture with EM (1 % and 10 %) and/or yeast 5 % were applied. In our work, the mixtures of 1%EM + Y and 10%EM + Y both stimulated and inhibited the degradation of the tested active substances. Adding 10%EM to the test substances strongly inhibited the degradation of iprodione, and its concentration decreased by 30 %, and in the case of other test substances, the degradation was approximately 60 %. Moreover, the addition of yeast stimulated the distribution of pyraclostrobin and boscalid in lettuce leaves. The risk assessment for the pesticides ranged from 0.4 to 64.8 % on day 1, but after 14 days, it ranged from 0.0 to 20.9 % for children and adults, respectively. It indicated no risk of adverse effects following exposure to individual pesticides and their mixtures with EM and yeast.

Education in Neurology Resident Documentation Using Payroll Simulation.

PubMed

Liang, John W; Shanker, Vicki L

2017-04-01

Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. To improve the quality of neurology resident documentation through payroll simulation. A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback "paystubs" every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits ( P < .001), with a reduction in the financial loss to 6% ($1,880). Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.

The U.S. Department of Energy - Office of Environmental Management Cooperation Program with the Russian Federal Atomic Energy Agency (ROSATOM)

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

Gerdes, K.D.; Holtzscheiter, E.W.

2006-07-01

The U.S. Department of Energy's (DOE) Office of Environmental Management (EM) has collaborated with the Russian Federal Atomic Energy Agency - Rosatom (formerly Minatom) for 14 years on waste management challenges of mutual concern. Currently, EM is cooperating with Rosatom to explore issues related to high-level waste and investigate Russian experience and technologies that could support EM site cleanup needs. EM and Rosatom are currently implementing six collaborative projects on high-level waste issues: 1) Advanced Melter Technology Application to the U.S. DOE Defense Waste Processing Facility (DWPF) - Cold Crucible Induction Heated Melter (CCIM); 2) - Design Improvements to themore » Cold Crucible Induction Heated Melter; 3) Long-term Performance of Hanford Low-Activity Glasses in Burial Environments; 4) Low-Activity-Waste (LAW) Glass Sulfur Tolerance; 5) Improved Retention of Key Contaminants of Concern in Low Temperature Immobilized Waste Forms; and, 6) Documentation of Mixing and Retrieval Experience at Zheleznogorsk. Preliminary results and the path forward for these projects will be discussed. An overview of two new projects 7) Entombment technology performance and methodology for the Future 8) Radiation Migration Studies at Key Russian Nuclear Disposal Sites is also provided. The purpose of this paper is to provide an overview of EM's objectives for participating in cooperative activities with the Russian Federal Atomic Energy Agency, present programmatic and technical information on these activities, and outline specific technical collaborations currently underway and planned to support DOE's cleanup and closure mission. (authors)« less

Pregnancy persistently affects memory T cell populations.

PubMed

Kieffer, Tom E C; Faas, Marijke M; Scherjon, Sicco A; Prins, Jelmer R

2017-02-01

Pregnancy is an immune challenge to the maternal immune system. The effects of pregnancy on maternal immunity and particularly on memory T cells during and after pregnancy are not fully known. This observational study aims to show the short term and the long term effects of pregnancy on the constitution, size and activation status of peripheral human memory T-lymphocyte populations. Effector memory (EM) and central memory (CM) T-lymphocytes were analyzed using flow cytometry of peripheral blood from 14 nulligravid, 12 primigravid and 15 parous women that were on average 18 months postpartum. The short term effects were shown by the significantly higher CD4+ EM cell and activated CD4+ memory cell proportions in primigravid women compared to nulligravid women. The persistent effects found in this study were the significantly higher proportions of CD4+ EM, CD4+ CM and activated memory T cells in parous women compared to nulligravid women. In contrast to CD4+ cells, activation status of CD8+ memory cells did not differ between the groups. This study shows that pregnancy persistently affects the pre-pregnancy CD4+ memory cell pool in human peripheral blood. During pregnancy, CD4+ T-lymphocytes might differentiate into EM cells followed by persistent higher proportions of CD4+ CM and EM cells postpartum. The persistent effects of pregnancy on memory T cells found in this study support the hypothesis that memory T cells are generated during pregnancy and that these cells could be involved in the lower complication risks in multiparous pregnancies in humans. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

TRANEXAMIC ACID ACTION ON LIVER REGENERATION AFTER PARTIAL HEPATECTOMY: EXPERIMENTAL MODEL IN RATS.

PubMed

Sobral, Felipe Antonio; Daga, Henrique; Rasera, Henrique Nogueira; Pinheiro, Matheus da Rocha; Cella, Igor Furlan; Morais, Igor Henrique; Marques, Luciana de Oliveira; Collaço, Luiz Martins

2016-01-01

Different lesions may affect the liver resulting in harmful stimuli. Some therapeutic procedures to treat those injuries depend on liver regeneration to increase functional capacity of this organ. Evaluate the effects of tranexamic acid on liver regeneration after partial hepatectomy in rats. 40 rats (Rattus norvegicus albinus, Rodentia mammalia) of Wistar-UP lineage were randomly divided into two groups named control (CT) and tranexamic acid (ATX), with 20 rats in each. Both groups were subdivided, according to liver regeneration time of 32 h or seven days after the rats had been operated. The organ regeneration was evaluated through weight and histology, stained with HE and PCNA. The average animal weight of ATX and CT 7 days groups before surgery were 411.2 g and 432.7 g, and 371.3 g and 392.9 g after the regeneration time, respectively. The average number of mitotic cells stained with HE for the ATX and CT 7 days groups were 33.7 and 32.6 mitosis, and 14.5 and 14.9 for the ATX and CT 32 h groups, respectively. When stained with proliferating cell nuclear antigen, the numbers of mitotic cells counted were 849.7 for the ATX 7 days, 301.8 for the CT 7 days groups, 814.2 for the ATX 32 hand 848.1 for the CT 32 h groups. Tranexamic acid was effective in liver regeneration, but in longer period after partial hepatectomy. Muitas são as injúrias que acometem o fígado e levam a estímulo lesivo. Alguns procedimentos terapêuticos para tratamento dessas lesões dependem da regeneração hepática para aumentar a sua capacidade funcional. Avaliar o efeito do ácido tranexâmico na regeneração hepática após hepatectomia parcial em ratos. Foram utilizados 40 ratos (Rattus norvegicus albinus, Rodentia mammalia) convencionais da linhagem Wistar-UP. Foram divididos aleatoriamente em dois grupos de 20: grupo controle (CT) e grupo ácido tranexâmico (ATX). Cada um deles foi divido em dois subgrupos para avaliar a regeneração hepática no tempo de 32 h e 7 dias do pós-operatório. A regeneração do órgão foi avaliada quanto ao peso e histologia, sendo esta última por hematoxilina-eosina e antígeno nuclear de proliferação celular. A média dos pesos dos animais dos grupos ATX 7 dias e CT 7 dias no pré-operatório foram de 411,2 g e 432,7 g, respectivamente, e após a regeneração foram de 371,3 g e 392,9 g. As médias das taxas de mitose coradas por HE dos dois grupos em 7 dias foram de 33,7 e 32,6 mitoses, respectivamente, e de 14,5 e 14,9 mitoses para os grupos ATX e CT 32 h. A contagem de células por antígeno nuclear de proliferação celular mostrou valores de 849,7 para o grupo ATX 7 dias e 301,8 para o CT 7 dias; 814,2 para o grupo ATX 32 h e 848,1 para o CT 32 h. O ácido tranexâmico mostrou-se efetivo na regeneração hepática somente em período mais longo de observação após hepatectomia parcial.

Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women.

PubMed

Feitosa, Alina Coutinho Rodrigues; Barreto, Luciana Tedgue; Silva, Isabela Matos da; Silva, Felipe Freire da; Feitosa, Gilson Soares

2017-07-01

There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA). To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities. Durante a gestação ocorrem, fisiologicamente, elevações do colesterol total (CT) e triglicerídios (TG). Alguns autores definem dislipidemia (DLP) gestacional quando as concentrações de CT, LDL e TG são superiores ao percentil 95 (P95%) e de HDL, inferiores ao percentil 5 (P5%) para a idade gestacional. Comparar a prevalência da DLP em gestantes conforme critério por percentis com o da V Diretriz Brasileira de Dislipidemia e avaliar a associação com desfechos materno-fetais. Gestantes com patologias de alto risco, idade entre 18 a 50 anos, e, pelo menos um perfil lipídico durante a gestação foram classificadas quanto à presença de DLP por dois critérios. Dados clínicos e laboratoriais das mães e neonatos foram avaliados. Estudou-se 433 gestantes com idade de 32,9 ± 6,5 anos. A maioria (54,6%) teve o perfil lipídico coletado no terceiro trimestre. A prevalência de quaisquer das alterações lipídicas, conforme os critérios da Diretriz Nacional, foi de 83,8%: CT ≥ 200 mg/dL foi encontrado em 49,9%; LDL ≥ 160 mg/dL, em 14,3%, HDL ≤ 50 mg/dL em 44,4% e TG ≥ 150 mg/dL, em 65,3%. Quaisquer das alterações lipídicas pelo critério dos percentis foi encontrada em 19,6%: sendo que elevação superior ao P95% para CT foi encontrada em 0,7%; para LDL, em 1,7%; para TG, em 6,4% e inferiores ao P5% para o HDL em 13%. A frequência das comorbidades: hipertensão, diabetes, tabagismo, obesidade e pré-eclâmpsia foi semelhante entre as gestantes quando se comparou DLP pelos dois critérios. A prevalência de DLP na gestação variou significativamente conforme o critério utilizado, entretanto nenhum demonstrou superioridade na associação com comorbidades.

Demonstration of Electro-Osmotic Pulse Technology in Earth-Covered Magazines at Fort A.P. Hill, VA

DTIC Science & Technology

2009-08-01

Electromagnetic Radiation to Ordnance ( HERO ) Evaluation Tests were conducted on magazines to detect any radio frequency (RF) emissions produced and to...measure electromagnetic (EM) radiation from the anodes installed in the magazines. The detailed results of a HERO ( Hazards of Electromagnetic ...reinforcement steel ........................................................... 14 3.3.6 Testing for electromagnetic radiation hazards

Chapter 15 - Composition and structure of whitebark and limber pine stands in the Interior West and the silvicultural implications (Project INT-EM-B-14-01)

Treesearch

James N. Long; John Shaw; Marcella Windmuller-Campione

2018-01-01

As forest communities continue to experience interactions between climate change and shifting disturbance regimes, there is anincreased need to link ecological understanding to applied management. Whitebark pine (Pinus albicaulis) and limber pine (P. flexilis) are important high-elevation five-needle pines in the...

Transcriptome Assessment of Erythema Migrans Skin Lesions in Patients With Early Lyme Disease Reveals Predominant Interferon Signaling.

PubMed

Marques, Adriana; Schwartz, Ira; Wormser, Gary P; Wang, Yanmei; Hornung, Ronald L; Demirkale, Cumhur Y; Munson, Peter J; Turk, Siu-Ping; Williams, Carla; Lee, Chyi-Chia Richard; Yang, Jun; Petzke, Mary M

2017-12-27

The most common clinical manifestation of early Lyme disease is the erythema migrans (EM) skin lesion that develops at the tick bite site typically between 7 and 14 days after infection with Borreliella burgdorferi. The host-pathogen interactions that occur in the skin may have a critical role in determining outcome of infection. Gene arrays were used to characterize the global transcriptional alterations in skin biopsy samples of EM lesions from untreated adult patients with Lyme disease in comparison to controls. The transcriptional pattern in EM biopsies consisted of 254 differentially regulated genes (180 induced and 74 repressed) characterized by the induction of chemokines, cytokines, Toll-like receptors, antimicrobial peptides, monocytoid cell activation markers, and numerous genes annotated as interferon (IFN)-inducible. The IFN-inducible genes included 3 transcripts involved in tryptophan catabolism (IDO1, KMO, KYNU) that play a pivotal role in immune evasion by certain other microbial pathogens by driving the differentiation of regulatory T cells. This is the first study to globally assess the human skin transcriptional response during early Lyme disease. Borreliella burgdorferi elicits a predominant IFN signature in the EM lesion, suggesting a potential mechanism for spirochetal dissemination via IDO1-mediated localized immunosuppression. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Comparison of Metallic Foreign-Body Removal between Dynamic Ultrasound and Static Radiography in a Pigs' Feet Model

PubMed Central

Manson, William C; Ryan, James G; Ladner, Heidi; Gupta, Sanjey

2011-01-01

Introduction We compared the immediate cosmetic outcome of metallic foreign-body removal by emergency medicine (EM) residents with ultrasound guidance and conventional radiography. Methods This single-blinded, randomized, crossover study evaluated the ability of EM residents to remove metallic pins embedded in pigs' feet. Before the experiment, we embedded 1.5-cm metallic pins into numbered pigs' feet. We randomly assigned 14 EM residents to use either ultrasound or radiography to help remove the foreign body. Residents had minimal ultrasound experience. After a brief lecture, we provided residents with a scalpel, laceration kit, a bedside portable ultrasound machine, nipple markers, paper clips, a dedicated radiograph technician, and radiograph machine 20 feet away. After removal, 3 board-certified emergency physicians, who were blinded to the study group, evaluated the soft-tissue model by using a standardized form. They recorded incision length and cosmetic appearance on the Visual Analog Scale. Results In total, 28 foreign bodies were removed. No significant difference in the time of removal (P = 0.12), cosmetic appearance (P = 0.96), or incision length (P = 0.76) was found. Conclusion This study showed no difference between bedside ultrasound and radiography in assisting EM residents with metallic foreign-body removal from soft tissue. No significant difference was found in removal time or cosmetic outcome when comparing ultrasound with radiography. PMID:22224139

A priority dispatch system for emergency medical services.

PubMed

Slovis, C M; Carruth, T B; Seitz, W J; Thomas, C M; Elsea, W R

1985-11-01

A decision tree priority dispatch system for emergency medical services (EMS) was developed and implemented in Atlanta and Fulton County, Georgia. The dispatch system shortened the average response time from 14.2 minutes to 10.4 minutes for the 30% of patients deemed most urgent (P less than or equal to .05); resulted in a significant increase in the use of advanced life support units for this group (P less than or equal to .02); decreased the number of calls that required a backup ambulance service; and significantly increased conformity to national EMS response time standards for critically ill and injured patients (P less than or equal to .0009). Due to dispatch error, 0.3% of calls were dispatched as least severe but subsequently were found to be most urgent.

Sustainable Design Policy and Leadership in Energy and Environmental Design Certification

DTIC Science & Technology

2008-03-01

pl ex  B lo ck  2 25 Sa cr am en to CA 47 9, 00 0. 00 30 .0 % 45 .0 % PV 14 6. 65...0 .4 0  43 17 , 1 8 18 Ca lP ER S  H ea dq ua rt er s  Co m pl ex Sa cr em en to CA 55 0, 00 0. 00 0. 0% 0. 00 38 .0 % PV 32 8. 89...75 8. 00 30 .0 % 45 .0 % N o 15 2. 53 $                 38 32 31 D ep ar tm en t o f L ab or  a nd   Em pl oy m en t D en ve

Study on EM-parameters and EM-wave absorption properties of materials with bio-flaky particles added

NASA Astrophysics Data System (ADS)

Zhang, Wenqiang; Zhang, Deyuan; Xu, Yonggang; McNaughton, Ryan

2016-01-01

Bio-flaky particles, fabricated through deposition of carbonyl iron on the surface of disk shaped diatomite, demonstrated beneficial performance on electromagnetic parameters. This paper will detail the improvements to the electromagnetic parameters and absorbing properties of traditional absorbing material generated by the addition of bio-flaky particles. Composites' electromagnetic parameters were measured using the transmission method. Calculated test results confirmed with bio-flaky particles were added, composites' permittivity increased due to the high permeability of bio-flaky particles. Secondly, the permeability of composites increased as a result of the increased volume content of iron particles. Composites with bio-flaky particles added exhibited superlative absorption properties at 0.5 mm thickness, with a maximum reflection loss of approximately -5.1 dB at 14.4 GHz.

Productivity and career paths of previous recipients of Society for Academic Emergency Medicine research grant awards.

PubMed

Young, Kelly D

2008-06-01

The objective was to assess productivity of previous recipients of Society for Academic Emergency Medicine (SAEM) grant awards. All previous recipients of SAEM Research Training Grants, Neuroscience Research Awards, Scholarly Sabbatical Awards, and Emergency Medical Services (EMS) Research Fellowship awards funded through 2004 were identified through SAEM's records and surveyed. Award categories assessed were those still offered by SAEM at the time of the survey and therefore excluded the Geriatric Research Award. The 2005-2006 SAEM Grants Committee developed a survey using previous publications assessing productivity of training grants and fellowship awards and refined it through consensus review and limited pilot testing. We assessed measures of academic productivity (numbers of publications and additional grants awarded), commitment to an academic career, satisfaction with the SAEM award, and basic demographic information. Overall response rate was 70%; usable data were returned by all seven Research Training Grant awardees, both Neuroscience awardees, four of five Scholarly Sabbatical awardees, and six of 14 EMS Research Fellowship awardees. Of those who gave demographic information, 78% (14/18) were male and 94% (16/17) were non-Hispanic white. All the respondents remained in academics, and 14 of 19 felt that they will definitely be in academics 5 years from the time of the survey. They have a median of 1.8 original research publications per year since the end of their grant period, and 74% (14/19) have received subsequent federal funding. All found the SAEM award to be helpful or very helpful to their careers. Previous recipients of the SAEM grant awards show evidence of academic productivity in the form of subsequent grant funding and research publications, and the majority remain committed to and satisfied with their academic research careers.

Post-operative day two versus day seven mobilization after burr-hole drainage of subacute and chronic subdural haematoma in Nigerians.

PubMed

Adeolu, Augustine Abiodun; Rabiu, Taopheeq Bamidele; Adeleye, Amos Olufemi

2012-10-01

The traditional care of patients with subacute/chronic subdural haematoma (S/CSDH) often involves delayed mobilization after burr-hole drainage. It is thought that delayed mobilization aids brain re-expansion thereby reducing the risk of recurrence. However, there is paucity of information regarding its efficacy and safety over early mobilization. We evaluated the efficacy and complications of each type of mobilization following burr-hole drainage of S/CSDH. This was a prospective study from October 2004 and September 2010. A total of 50 patients who had burr-hole drainage of S/CSDH were sequentially allocated to either early (day 2) or late (day 7) mobilization (EM or LM) groups (25 patients in each group). Wound related complications, recurrence of haematoma, complications of prolonged bed rest and Glasgow Outcome Score (GOS) at discharge were studied in the two groups. Patients who could not obey commands to mobilize in the early post-operative period were excluded. There were 43 (86%) males and 7 (14%) females. The mean age was 57 years (range: 27-90 years). Fourteen (28%) of the patients were elderly (age > 65 years). Two complications, wound infection in a 76-year old man in the LM group and tension pneumocephalus requiring re-opening burr-hole drainage in a 55-year old man in the EM group were recorded. There was no recurrence or problem associated with prolonged bed rest in the two groups. Five (10%) patients had moderate disability (GOS 4) at discharge (1 EM, 4 LM) while the others (90%) had good recovery (GOS 5) (24 EM, 21 LM). These differences were not statistically significant (p-value: 0.349). It appears that both EM and LM are equally beneficial in the post-operative care of patients following burr-hole drainage of S/CSDH. There is no significant complication referable to the specific type of mobilization. The authors, therefore, advocate EM of patients to reduce the length of hospital stay.

Emergency medicine resident education in palliative care: a needs assessment.

PubMed

Lamba, Sangeeta; Pound, Amy; Rella, Joseph G; Compton, Scott

2012-05-01

Hospice and Palliative Medicine is a newly designated subspecialty of Emergency Medicine (EM). As yet, no well defined palliative care (PC) models for education or training exist. A needs assessment is the first step towards developing a curriculum. To characterize emergency physicians' (EP) perceived educational and formal training needs for PC related skills. All EM residents and faculty of one academic facility were asked to complete an anonymous needs-assessment survey. Participants were asked to rank statements related to attitudes about PC and rate their formal training and knowledge in 10 aspects of PC using a 5-point Likert-scale. EPs also ranked 4 learning modalities in order of preference and 12 PC educational topics in order of perceived importance in an EM curriculum. Ninety-three percent (42/45) of eligible participants completed the survey (28 residents, 14 faculty). Respondents agreed/strongly agreed that PC skills are an important competence for EM (88%, 37/42) and that they would "like to have more training/education in PC" (79%, 33/42). Respondents also disagreed/strongly disagreed with the statement that "PC consult is called when no more can be done for the patient" (90%, 38/42). Important PC topics identified were pain management, discussing code status, and management of dyspnea and other symptoms in terminal illness. Bedside teaching was listed as the preferred learning modality. EM residents reported minimal training in pain management (46%, 13/28), managing hospice patients (54%, 15/28), withdrawal/withholding life support (54%, 15/28), and managing the imminently dying (43%, 12/28). There was no consistent, significant improvement reported in any domain as training and experience progressed from PGY (postgraduate year) 1 to PGY 4 to attending physician. EPs view PC skills as important for EM practice and report that they are not yet adequately educated and trained in providing PC. Domains of particular interest and targeted areas for PC skills training for EPs may include managing hospice patients, withdrawal of life support, prognostication, and pain management.

The survival benefit of dual dispatch of EMS and fire-fighters in out-of-hospital cardiac arrest may differ depending on population density--a prospective cohort study.

PubMed

Nordberg, Per; Jonsson, Martin; Forsberg, Sune; Ringh, Mattias; Fredman, David; Riva, Gabriel; Hasselqvist-Ax, Ingela; Hollenberg, Jacob

2015-05-01

Outcome after out-of-hospital cardiac arrest (OHCA) varies between contexts. Dual dispatching of fire-fighters or police in addition to emergency medical services (EMS) has the potential to increase survival, but the effect in urban vs. rural areas is unknown. The aim of this study was to determine the effects of dual dispatching on response times and outcome in regions with different population density. The study design was a prospective cohort study of EMS-treated OHCAs from 2004 (historical controls, only EMS dispatch) and 2006-2009 (intervention, dual dispatch of EMS and fire-fighters), with data on exact geographical coordinates. Patients were divided into four subgroups depending on population density: rural (<250 persons/km2), suburban (250-2999/km2), urban (3000-5999/km2) and downtown (≥6000/km2). Totally, 2513 OHCAs were included (historical controls, n=571 and intervention, n=1942). Median time to arrival of first unit shortened significantly in all subgroups, ranging from 0.8 to 3.2 min, with the main time gain in the rural area. There were significant differences in 30-day survival between the historical controls vs. the intervention group in the suburban population (3.1% vs. 7.0%, p=0.02) and in downtown (4.1 vs. 14.6, p=0.04). In the urban population the difference was 2.7 vs. 6.9% (p=0.06) and in the rural population (4.7 vs. 5.3, p=0.82). Dual dispatch of fire-fighters and EMS in OHCA significantly reduced response times in all studied regions. The 30-day survival increased significantly in the downtown and suburban populations, while a limited impact was seen in the rural areas. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Ethnic and regional differences in STI clinic use: a Dutch epidemiological study using aggregated STI clinic data combined with population numbers.

PubMed

van Oeffelen, A A M; van den Broek, I V F; Doesburg, M; Boogmans, B; Götz, H M; van Leeuwen-Voerman, F A M; van Veen, M G; Woestenberg, P J; van Benthem, B H B; van Steenbergen, J E

2017-02-01

Ethnic minorities (EM) from STI-endemic countries are at increased risk to acquire an STI. The objectives of this study were to investigate the difference in STI clinic consultation and positivity rates between ethnic groups, and compare findings between Dutch cities. Aggregated population numbers from 2011 to 2013 of 15-44 year-old citizens of Amsterdam, Rotterdam, The Hague and Utrecht extracted from the population register (N=3 129 941 person-years) were combined with aggregated STI clinic consultation data in these cities from the national STI surveillance database (N=113 536). Using negative binomial regression analyses (adjusted for age and gender), we compared STI consultation and positivity rates between ethnic groups and cities. Compared with ethnic Dutch (consultation rate: 40.3/1000 person-years), EM from Eastern Europe, Sub-Sahara Africa, Suriname, the Netherlands Antilles/Aruba and Latin America had higher consultation rates (range relative risk (RR): 1.27-2.26), whereas EM from Turkey, North Africa, Asia and Western countries had lower consultation rates (range RR: 0.29-0.82). Of the consultations among ethnic Dutch, 12.2% was STI positive. Positivity rates were higher among all EM groups (range RR: 1.14-1.81). Consultation rates were highest in Amsterdam and lowest in Utrecht independent of ethnic background (range RR Amsterdam vs Utrecht: 4.30-10.30). Positivity rates differed less between cities. There were substantial differences in STI clinic use between ethnic groups and cities in the Netherlands. Although higher positivity rates among EM suggest that these high-risk individuals reach STI clinics, it remains unknown whether their reach is optimal. Special attention should be given to EM with comparatively low consultation rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

On-Demand Calibration and Evaluation for Electromagnetically Tracked Laparoscope in Augmented Reality Visualization

PubMed Central

Liu, Xinyang; Plishker, William; Zaki, George; Kang, Sukryool; Kane, Timothy D.; Shekhar, Raj

2017-01-01

Purpose Common camera calibration methods employed in current laparoscopic augmented reality systems require the acquisition of multiple images of an entire checkerboard pattern from various poses. This lengthy procedure prevents performing laparoscope calibration in the operating room (OR). The purpose of this work was to develop a fast calibration method for electromagnetically (EM) tracked laparoscopes, such that calibration can be performed in the OR on demand. Methods We designed a mechanical tracking mount to uniquely and snugly position an EM sensor to an appropriate location on a conventional laparoscope. A tool named fCalib was developed to calibrate intrinsic camera parameters, distortion coefficients, and extrinsic parameters (transformation between the scope lens coordinate system and the EM sensor coordinate system) using a single image that shows an arbitrary portion of a special target pattern. For quick evaluation of calibration result in the OR, we integrated a tube phantom with fCalib and overlaid a virtual representation of the tube on the live video scene. Results We compared spatial target registration error between the common OpenCV method and the fCalib method in a laboratory setting. In addition, we compared the calibration re-projection error between the EM tracking-based fCalib and the optical tracking-based fCalib in a clinical setting. Our results suggested that the proposed method is comparable to the OpenCV method. However, changing the environment, e.g., inserting or removing surgical tools, would affect re-projection accuracy for the EM tracking-based approach. Computational time of the fCalib method averaged 14.0 s (range 3.5 s – 22.7 s). Conclusions We developed and validated a prototype for fast calibration and evaluation of EM tracked conventional (forward viewing) laparoscopes. The calibration method achieved acceptable accuracy and was relatively fast and easy to be performed in the OR on demand. PMID:27250853

On-demand calibration and evaluation for electromagnetically tracked laparoscope in augmented reality visualization.

PubMed

Liu, Xinyang; Plishker, William; Zaki, George; Kang, Sukryool; Kane, Timothy D; Shekhar, Raj

2016-06-01

Common camera calibration methods employed in current laparoscopic augmented reality systems require the acquisition of multiple images of an entire checkerboard pattern from various poses. This lengthy procedure prevents performing laparoscope calibration in the operating room (OR). The purpose of this work was to develop a fast calibration method for electromagnetically (EM) tracked laparoscopes, such that the calibration can be performed in the OR on demand. We designed a mechanical tracking mount to uniquely and snugly position an EM sensor to an appropriate location on a conventional laparoscope. A tool named fCalib was developed to calibrate intrinsic camera parameters, distortion coefficients, and extrinsic parameters (transformation between the scope lens coordinate system and the EM sensor coordinate system) using a single image that shows an arbitrary portion of a special target pattern. For quick evaluation of calibration results in the OR, we integrated a tube phantom with fCalib prototype and overlaid a virtual representation of the tube on the live video scene. We compared spatial target registration error between the common OpenCV method and the fCalib method in a laboratory setting. In addition, we compared the calibration re-projection error between the EM tracking-based fCalib and the optical tracking-based fCalib in a clinical setting. Our results suggest that the proposed method is comparable to the OpenCV method. However, changing the environment, e.g., inserting or removing surgical tools, might affect re-projection accuracy for the EM tracking-based approach. Computational time of the fCalib method averaged 14.0 s (range 3.5 s-22.7 s). We developed and validated a prototype for fast calibration and evaluation of EM tracked conventional (forward viewing) laparoscopes. The calibration method achieved acceptable accuracy and was relatively fast and easy to be performed in the OR on demand.

SU-F-BRA-03: Integrating Novel Electromagnetic Tracking Hollow Needle Assistance in Permanent Implant Brachytherapy Procedures

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

Racine, E; Hautvast, G; Binnekamp, D

Purpose: To report on the results of a complete permanent implant brachytherapy procedure assisted by an electromagnetic (EM) hollow needle possessing both 3D tracking and seed drop detection abilities. Methods: End-to-end in-phantom EM-assisted LDR procedures were conducted. The novel system consisted of an EM tracking apparatus (NDI Aurora V2, Planar Field Generator), a 3D US scanner (Philips CX50), a hollow needle prototype allowing 3D tracking and seed drop detection and a specially designed treatment planning software (Philips Healthcare). A tungsten-doped 30 cc spherical agarose prostate immersed in gelatin was used for the treatment. A cylindrical shape of 0.8 cc wasmore » carved along its diameter to mimic the urethra. An initial plan of 26 needles and 47 seeds was established with the system. The plan was delivered with the EM-tracked hollow needle, and individual seed drop locations were recorded on the fly. The phantom was subsequently imaged with a CT scanner from which seed positions and contour definitions were obtained. The DVHs were then independently recomputed and compared with those produced by the planning system, both before and after the treatment. Results: Of the 47 seeds, 45 (96%) were detected by the EM technology embedded in the hollow needle design. The executed plan (from CT analysis) differed from the initial plan by 2%, 14% and 8% respectively in terms of V100, D90 and V150 for the prostate, and by 8%, 7% and 10% respectively in terms of D5, V100 and V120 for the urethra. Conclusion: The average DVH deviations between initial and executed plans were within a 5% tolerance imposed for this proof-of-concept assessment. This relatively good concordance demonstrates the feasibility and potential benefits of combining EM tracking and seed drop detection for real-time dosimetry validation and assistance in permanent implant brachytherapy procedures. This project has been entirely funded by Philips Healthcare.« less

Impact of ergonomic intervention in manual orange harvester among the workers of hilly region in India.

PubMed

Pranav, P K; Patel, Thaneswer

2016-04-07

Manual orange harvesting is very laborious, time consuming and unsafe operation whereas neither mechanical harvesting nor mechanized hand harvesting is possible in north-east India due to its hilly terrains. The awkward postures and repetitive nature of work in orange harvesting, demands a comfortable and appropriate hand harvester for hilly region. The purpose of this study was to develop a manual orange harvester for hilly regions considering the ergonomic parameters, and compare the performance with the existing models of the manual harvester. In this study twenty healthy experienced orchard workers (10 male and 10 female) participated who did not have any previous functional musculoskeletal disorders. We developed a manual orange harvester by eliminating the problems associated with the existing harvesters. The developed model along with existing models was evaluated extensively in the field. During evaluations, heart rate of the subjects was measured and oxygen consumption was predicted to calculate the energy expenditure rate (EER) from the established relationship in the laboratory before the field experiments. Further, performance parameters of orange harvester i.e. plucking rate (PR), damaged quantity (DQ), plucking energy requirement (PER) and discomfort rating were also observed. The PR was 425, 300 and 287 pieces per hour for the developed model (DM), first existing model (EM1) and second existing model (EM2), respectively. The DM showed lower PER (2.14 kJ/piece) followed by EM2 (2.95 kJ/piece) and EM1 (4.02 kJ/piece) which is considered as overall performance as it includes energy per unit of plucking. Further, the body part discomfort score revealed that DM was more comfortable in use followed by EM2 and EM1. The performance of the DM was found better in terms of plucking rate, energy requirement and body part discomfort than the other existing models. Shoulders and neck are the most affected body parts where all subjects felt severe discomfort.

Effect of the CYP2C19 genotype on the pharmacokinetics of icotinib in healthy male volunteers.

PubMed

Ruan, Can-Jun; Liu, Dong-Yang; Jiang, Ji; Hu, Pei

2012-12-01

Icotinib hydrochloride {4-[(3-ethynylphenyl)amino]-6,7-benzo-12-crown-4-quinazoline hydrochloride}, a novel epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI), was designed for the treatment of non-small cell lung cancer (NSCLC). In the present study, we investigated the influence of the CYP2C19*2 and CYP2C19*3 alleles on the pharmacokinetics of icotinib in healthy Chinese volunteers. In a single-dose pharmacokinetic study, 12 healthy Chinese volunteers received an oral dose of 600 mg of icotinib. Plasma was sampled for up to 72 h post-dose, followed by quantification of icotinib by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS-MS). Five subjects genotyped as homozygous extensive metabolizers (CYP2C19*1/*1), 6 subjects genotyped as heterozygous extensive metabolizers (CYP2C19*1/*2 or CYP2C19*1/*3), and 1 subject genotyped as a poor metabolizer (CYP2C19*2/*3) and was withdrawn from the research because of urticaria. The mean icotinib AUC(0-∞) and C(max) (14.56 ±5.31 h mg/L and 2.32 ± 0.49 μg/mL) in homozygous EMs was 1.56 and 1.41-fold lower than that in heterozygous EMs (22.7 ± 6.11 and 3.28 ± 0.48, P = 0.046 and 0.047). The mean CL/F (44.18 ± 12.17 L/h) in homozygous EMs was 1.55-fold higher than that in heterozygous EMs (28.42 ± 9.23 L/h, P = 0.013). The data showed that the pharmacokinetics of icotinib differ significantly between homozygous EMs and heterozygous EMs in CYP2C19.

Design and evaluation of a computed tomography (CT)-compatible needle insertion device using an electromagnetic tracking system and CT images.

PubMed

Shahriari, Navid; Hekman, Edsko; Oudkerk, Matthijs; Misra, Sarthak

2015-11-01

Percutaneous needle insertion procedures are commonly used for diagnostic and therapeutic purposes. Although current technology allows accurate localization of lesions, they cannot yet be precisely targeted. Lung cancer is the most common cause of cancer-related death, and early detection reduces the mortality rate. Therefore, suspicious lesions are tested for diagnosis by performing needle biopsy. In this paper, we have presented a novel computed tomography (CT)-compatible needle insertion device (NID). The NID is used to steer a flexible needle (φ0.55 mm) with a bevel at the tip in biological tissue. CT images and an electromagnetic (EM) tracking system are used in two separate scenarios to track the needle tip in three-dimensional space during the procedure. Our system uses a control algorithm to steer the needle through a combination of insertion and minimal number of rotations. Noise analysis of CT images has demonstrated the compatibility of the device. The results for three experimental cases (case 1: open-loop control, case 2: closed-loop control using EM tracking system and case 3: closed-loop control using CT images) are presented. Each experimental case is performed five times, and average targeting errors are 2.86 ± 1.14, 1.11 ± 0.14 and 1.94 ± 0.63 mm for case 1, case 2 and case 3, respectively. The achieved results show that our device is CT-compatible and it is able to steer a bevel-tipped needle toward a target. We are able to use intermittent CT images and EM tracking data to control the needle path in a closed-loop manner. These results are promising and suggest that it is possible to accurately target the lesions in real clinical procedures in the future.

Structural and mechanistic insights into human splicing factor SF3b complex derived using an integrated approach guided by the cryo-EM density maps

PubMed Central

Rakesh, Ramachandran; Joseph, Agnel Praveen; Bhaskara, Ramachandra M.; Srinivasan, Narayanaswamy

2016-01-01

ABSTRACT Pre-mRNA splicing in eukaryotes is performed by the spliceosome, a highly complex macromolecular machine. SF3b is a multi-protein complex which recognizes the branch point adenosine of pre-mRNA as part of a larger U2 snRNP or U11/U12 di-snRNP in the dynamic spliceosome machinery. Although a cryo-EM map is available for human SF3b complex, the structure and relative spatial arrangement of all components in the complex are not yet known. We have recognized folds of domains in various proteins in the assembly and generated comparative models. Using an integrative approach involving structural and other experimental data, guided by the available cryo-EM density map, we deciphered a pseudo-atomic model of the closed form of SF3b which is found to be a “fuzzy complex” with highly flexible components and multiplicity of folds. Further, the model provides structural information for 5 proteins (SF3b10, SF3b155, SF3b145, SF3b130 and SF3b14b) and localization information for 4 proteins (SF3b10, SF3b145, SF3b130 and SF3b14b) in the assembly for the first time. Integration of this model with the available U11/U12 di-snRNP cryo-EM map enabled elucidation of an open form. This now provides new insights on the mechanistic features involved in the transition between closed and open forms pivoted by a hinge region in the SF3b155 protein that also harbors cancer causing mutations. Moreover, the open form guided model of the 5′ end of U12 snRNA, which includes the branch point duplex, shows that the architecture of SF3b acts as a scaffold for U12 snRNA: pre-mRNA branch point duplex formation with potential implications for branch point adenosine recognition fidelity. PMID:27618338

Falls in long-term care institutions for elderly people: protocol validation.

PubMed

Baixinho, Cristina Rosa Soares Lavareda; Dixe, Maria Dos Anjos Coelho Rodrigues; Henriques, Maria Adriana Pereira

2017-01-01

To validate the content of a fall management risk protocol in long-term institutions for elderly people. Methodological, quanti-qualitative study using the Delphi technique. The tool, based on the literature, was sent electronically to obtain consensus among the 14 experts that meet the defined inclusion criteria. The 27 indicators of the protocol are organized in three dimensions: prepare for the institutionalization (IRA=.88); manage the risk of falls throughout the institutionalization (IRA=.9); and lead the communication and formation (IRA=1), with a CVI=.91. Two rounds were performed to get a consensus superior to 80% in every item. The values obtained in the reliability test (>0.8) show that the protocol can be used to meet the intended goal. The next step is the clinic validation of the protocol with residents of long-term care institutions for elderly people. Validar o conteúdo de um protocolo para a gestão do risco de queda em Instituições de Longa Permanência para Idosos. Estudo metodológico, de abordagem quantiqualitativa, utilizando a técnica de Delphi. O instrumento, construído com base na literatura, foi enviado por via electrónica, para obter consenso entre os 14 peritos que respeitam os critérios de inclusão definidos. Os 27 indicadores do protocolo estão organizados em três dimensões: Preparar a Institucionalização (IRA=,88); Gerir o Risco de Queda ao longo da Institucionalização (IRA=,9) e Liderar a comunicação e formação (IRA=1), com um CVI=,91. Foram efetuadas duas rodadas para se obter consenso superior a 80% em todos os itens. Os valores obtidos no teste de fidedignidade (>0,8) atestam que o protocolo pode ser utilizado para atingir o fim que se pretende. A próxima etapa é a validação clínica do protocolo com idosos residentes em Instituições de Longa Permanência para Idosos.

Education in Neurology Resident Documentation Using Payroll Simulation

PubMed Central

Liang, John W.

2017-01-01

Background Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. Objective To improve the quality of neurology resident documentation through payroll simulation. Methods A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback “paystubs” every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Results Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits (P < .001), with a reduction in the financial loss to 6% ($1,880). Conclusions Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided. PMID:28439359

Educational technology improves ECG interpretation of acute myocardial infarction among medical students and emergency medicine residents.

PubMed

Pourmand, Ali; Tanski, Mary; Davis, Steven; Shokoohi, Hamid; Lucas, Raymond; Zaver, Fareen

2015-01-01

Asynchronous online training has become an increasingly popular educational format in the new era of technology-based professional development. We sought to evaluate the impact of an online asynchronous training module on the ability of medical students and emergency medicine (EM) residents to detect electrocardiogram (ECG) abnormalities of an acute myocardial infarction (AMI). We developed an online ECG training and testing module on AMI, with emphasis on recognizing ST elevation myocardial infarction (MI) and early activation of cardiac catheterization resources. Study participants included senior medical students and EM residents at all post-graduate levels rotating in our emergency department (ED). Participants were given a baseline set of ECGs for interpretation. This was followed by a brief interactive online training module on normal ECGs as well as abnormal ECGs representing an acute MI. Participants then underwent a post-test with a set of ECGs in which they had to interpret and decide appropriate intervention including catheterization lab activation. 148 students and 35 EM residents participated in this training in the 2012-2013 academic year. Students and EM residents showed significant improvements in recognizing ECG abnormalities after taking the asynchronous online training module. The mean score on the testing module for students improved from 5.9 (95% CI [5.7-6.1]) to 7.3 (95% CI [7.1-7.5]), with a mean difference of 1.4 (95% CI [1.12-1.68]) (p<0.0001). The mean score for residents improved significantly from 6.5 (95% CI [6.2-6.9]) to 7.8 (95% CI [7.4-8.2]) (p<0.0001). An online interactive module of training improved the ability of medical students and EM residents to correctly recognize the ECG evidence of an acute MI.

Prosthetic hip dislocations: is relocation in the emergency department by emergency medicine staff better?

PubMed

Lawrey, Emma; Jones, Peter; Mitchell, Robin

2012-04-01

Prosthetic hip dislocation is common. This study compares prosthetic hip relocations attempted within the ED by emergency doctors and those under orthopaedic care in the ED or operating theatre (OT). Retrospective cohort study of patients presenting to Auckland City Hospital Adult Emergency Department with prosthetic hip dislocations between 1 January 2003 and 14 April 2008. Primary outcomes were proportion of successful relocation attempts and length of hospital stay. Secondary outcomes were: time to relocation, complications, post-procedural advice, representation rate and long-term outcomes for first-time dislocations. There were 410 eligible presentations during the study period. Emergency medicine (EM) was successful in 254/323 attempts (79%, 95% confidence interval [CI] 74-83). Orthopaedics were successful in 25/35 reductions in the ED (71%, 95% CI 55-84) and 49/51 OT attempts (96%, 95% CI 86-100), P = 0.004 for location OT versus ED. Median times to discharge were 8.8 h for EM, 28.3 h for orthopaedics in the ED and 81 h for orthopaedics in the OT, P < 0.001 for EM versus orthopaedics. Mechanical complications of procedures and early redislocations were infrequent. Complication of sedation were more often seen in OT compared to ED (23/47 [49%, 95% CI 35-63]vs 37/318 [12%, 95% CI 9-16]). There was no difference between EM and orthopaedics in the proportion of hips successfully relocated or complications in the ED; however, EM patients were discharged much sooner, with important resource implications. Procedures carried out in the OT were more successful than in the ED but resulted in prolonged hospital stays and were associated with more complications. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

EMS providers' perceptions of safety climate and adherence to safe work practices.

PubMed

Eliseo, Laura J; Murray, Kate A; White, Laura F; Dyer, Sophia; Mitchell, Patricia A; Fernandez, William G

2012-01-01

Occupational injuries are an important source of morbidity for emergency medical services (EMS) providers. Previous work has shown that employee perceptions of an organization's commitment to safety (i.e., safety climate) correlate with adherence to safe practices. To assess the association between perceived safety climate and compliance with safety procedures in an urban EMS system with >100,000 calls/year. EMS providers were issued a self-administered survey that included questions on demographics, years of experience, perceived safety climate, and adherence to safety procedures. Safety climate was assessed with a 20-item validated instrument. Adherence to safety procedures was assessed with a nine-item list of safety behaviors. Strict adherence to safety procedures was defined as endorsing "agree" or "strongly agree" on 80% of items. The effect of safety climate on compliance with safe practices was estimated using multiple logistic regression. One hundred ninety-six of 221 providers (89%) completed surveys; 74% were male; the median age was 36-40 years; and the median amount of experience was 8 years. One hundred twenty-seven of 196 respondents (65%) reported strict adherence to safe work practice. Factor analysis confirmed the original six-factor grouping of questions; frequent safety-related feedback/training was significantly associated with safe practices (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.01-4.51). EMS workers perceiving a high degree of perceived safety climate was associated with twofold greater odds of self-reported level of strict adherence to safe work practices. Frequent safety-related feedback/training was the one dimension of safety climate that had the strongest association with adherence to safe workplace behaviors.

The incidence of traumatic intracranial hemorrhage in head-injured older adults transported by EMS with and without anticoagulant or antiplatelet use.

PubMed

Nishijima, Daniel Kiden; Gaona, Samuel D; Waechter, Trent; Maloney, Ric; Blitz, Adam; Elms, Andrew R; Farrales, Roel D; Montoya, James; Bair, Troy; Howard, Calvin; Gilbert, Megan; Trajano, Renee; Hatchel, Kaela; Faul, Mark; Bell, Jeneita M; Coronado, Victor; Vinson, David R; Ballard, Dustin W; Tancredi, Daniel J; Garzon, Hernando; Mackey, Kevin E; Shahlaie, Kiarash; Holmes, James F

2017-11-06

Field triage guidelines recommend transport of head-injured patients on anticoagulants or antiplatelets to a higher-level trauma center based on studies suggesting a high incidence of traumatic intracranial hemorrhage (tICH). We compared the incidence of tICH in older adults transported by EMS with and without anticoagulation or antiplatelet use and evaluated the accuracies of different sets of field triage criteria to identify tICH. This was a prospective, observational study at 5 EMS agencies and 11 hospitals. Older adults (≥55 years) with head trauma and transported by EMS from Aug 2015 to Sept 2016 were eligible. EMS providers completed standardized data forms and patients were followed through ED or hospital discharge. We enrolled 1,304 patients; 1147 (88%) received a cranial CT scan and were eligible for analysis. 434 (33%) patients had anticoagulant or antiplatelet use and 112 (10%) had tICH. The incidence of tICH in patients with (11%, 95%CI 8-14%) and without (9%, 95%CI 7-11%) anticoagulant or antiplatelet use was similar. Anticoagulant or antiplatelet use was not predictive of tICH on adjusted analysis. Steps 1-3 criteria alone were not sensitive in identifying tICH (27%) while the addition of anticoagulant or antiplatelet criterion improved sensitivity (63%). Other derived sets of triage criteria were highly sensitive (>98%) but poorly specific (<11%). The incidence of tICH was similar between patients with and without anticoagulant or antiplatelet use. Use of anticoagulant or antiplatelet medications was not a risk factor for tICH. We were unable to identify a set of triage criteria that was accurate for trauma center need.

The Medical Duty Officer: An Attempt to Mitigate the Ambulance At-Hospital Interval

PubMed Central

Halliday, Megan H.; Bouland, Andrew J.; Lawner, Benjamin J.; Comer, Angela C.; Ramos, Daniel C.; Fletcher, Mark

2016-01-01

Introduction A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time. Methods The MDO was implemented on November 11, 2013. A senior EMS paramedic was assigned to the position and was placed in the fire communication bureau from 9 a.m. to 9 p.m., seven days a week. We defined the pre-intervention period as August 2013 – October 2013 and the post-intervention period as December 2013 – February 2014. We also compared the post-intervention period to the “seasonal match control” one year earlier to adjust for seasonal variation in EMS volume. The MDO was tasked with the prospective management of city EMS resources through intensive monitoring of unit availability and hospital ED traffic. The MDO could suggest alternative transport destinations in the event of ED crowding. We collected and analyzed data from BCFD computer-aided dispatch (CAD) system for the following: ambulance response times, ambulance at-hospital interval, hospital diversion and alert status, and “suppression wait time” (defined as the total time suppression units remained on scene until ambulance arrival). The data analysis used a pre/post intervention design to examine the MDO impact on the BCFD EMS system. Results There were a total of 15,567 EMS calls during the pre-intervention period, 13,921 in the post-intervention period and 14,699 in the seasonal match control period one year earlier. The average at-hospital time decreased by 1.35 minutes from pre- to post-intervention periods and 4.53 minutes from the pre- to seasonal match control, representing a statistically significant decrease in this interval. There was also a statistically significant decrease in hospital alert time (approximately 1,700 hour decrease pre- to post-intervention periods) and suppression wait time (less than one minute decrease from pre- to post- and pre- to seasonal match control periods). The decrease in ambulance response time was not statistically significant. Conclusion Proactive deployment of a designated MDO was associated with a small, contemporaneous reduction in at-hospital time within an urban EMS jurisdiction. This project emphasized the importance of better communication between EMS systems and area hospitals as well as uniform reporting of variables for future iterations of this and similar projects. PMID:27625737

New Directions in Resources for Special Needs Hearing Impaired Students: Outreach '88. Proceedings of the Annual Southeast Regional Summer Conference (8th, Cave Spring, Georgia, June 14-17, 1988).

ERIC Educational Resources Information Center

Kemp, Faye, Ed.; And Others

The proceedings include, after the keynote address by E.M. Childers and the conference agenda, the following papers: "An Additional Handicap: Visual Perceptual Learning Disabilities of Deaf Children" (Vivienne Ratner); "Minimum Competency Testing" (Carl Williams); "Transitional Planning for Hearing Impaired Students in the Mainstream" (Helen…

Chapter 10 - Wildfire and fire severity effects on post-fire carbon and nitrogen cycling in forest soil (Project NC-EM-F-14-1)

Treesearch

Jessica R. Miesel; Randy Kolka; Phil Townsend

2018-01-01

Fire is a key ecological driver in determining vegetation composition, biomass, and ecosystem dynamics in coniferous forests of the Laurentian Mixed Forest in the Great Lakes region (Cleland and others 2004, Frelich 1995). Regional projections of future climate conditions indicate warmer temperatures, more variable precipitation patterns, and greater moisture stress (...

Platelet reactivity in the early and late phases of acute coronary syndromes according to cytochrome P450 2C19 phenotypes.

PubMed

Nagashima, Zenko; Tsukahara, Kengo; Morita, Satoshi; Endo, Tsutomu; Sugano, Teruyasu; Hibi, Kiyoshi; Himeno, Hideo; Fukui, Kazuki; Umemura, Satoshi; Kimura, Kazuo

2013-09-01

It remains unknown whether the time course of the antiplatelet effects of clopidogrel differs according to cytochrome P450 (CYP) 2C19 phenotype in Japanese patients with acute coronary syndromes (ACS). Platelet reactivity was serially assessed by VerifyNow-P2Y12 assay (Accumetrics, San Diego, CA, USA). Results were expressed as P2Y12-reaction-units (PRU) in 177 patients with ACS who underwent stent implantation and received aspirin plus a 300-mg loading dose of clopidogrel followed by 75 mg/day. High on-clopidogrel treatment platelet reactivity (HTPR) was defined as PRU>235. On the basis of the CYP2C19*2 and *3 alleles, 46 patients (26.0%) were classified as extensive metabolizers (EM), 103 (58.2%) as intermediate metabolizers (IM), and 28 (15.8%) as poor metabolizers (PM). At <7 days, the PRU level (232±102 vs. 279±70, 308±67, p<0.001) and the incidence of HTPR (49% vs. 74%, 86%, p=0.001) was lower in EM than in IM and PM. At 14-28 days the effects of CYP2C19 polymorphisms on PRU levels increased in a stepwise fashion (168±99 vs. 213±77 vs. 278±69, p<0.001), and EM and IM had lower percentages of HTPR than PM (28%, 37% vs. 73%, p<0.001). There was no significant difference in the cumulative frequency of 12-month adverse cardiovascular events among 3 phenotypes (16.5%, 14.1%, 9.2%; p=0.67). About three quarters of Japanese patients with ACS carried CYP2C19 variant alleles. The majority of IM and PM had increased platelet reactivity during the early phase of ACS. Although HTPR was frequently observed even 14-28 days after standard maintenance doses of clopidogrel in PM, the incidence of adverse outcomes did not differ, irrespective of CYP2C19 genotype. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Farmyard Manure and Fertilizer Effects on Seed Potato (Solanum tuberosum L.) Yield in Green House Production

NASA Astrophysics Data System (ADS)

László, M.

2009-04-01

Nowadays is widely well know that the potato is an important vegetable crop at Brazíl. It is grown on about 173.000 ha, with total yield of 2.6 million tons year-1. The average yield is 15 t ha-1. This level is very low because degeneration of crop is rapid under high temperature and high viruses pressure. Therefore seed potato propagation and production is principal on consumption potato production. This is why we found it necessary to develop it. The latossolo vermelho soil-farmyard manure- burnt rice straw-fertilizer 4N:14P:8K greenhouse pot trial was set up at the National Vegetable Crops Research Center, Brasília-DF, Brazíl in 1990. The methods of the experiments were soil x farmyard manure x burnt rice straw, soil x 4N:14P:8K fertilizer and soil x farmyard manure x burnt rice straw x 4N:14P:8K fertilizer on randomized block design in total 29 combination of treatments in 5, 5 and 3 repetitions with in a total parcel of 116. According to chemical analysis of the a., soil, b., farmyard manure and c., burnt rice straw the agrochemistry parameters were as follows (estimated datas): a., latossolo vermelho soil: CaCO3 0.3-0.7%, humo 0.9-1.0%, pH (H2O) 5.3, pH (KCl) 4.5, AL- P2O5 3.2-3.5 mg kg-1, AL- K2O 180 mg kg-1, Mg (KCl) 70 mg kg-1, EDTA-Zn 0.5-0.8 mg kg-1, EDTA-Cu 0.5-0.6 mg kg-1, b., farmyard manure: N 1.8 g kg-1, P2O5 2.0 g kg-1, K2O 4.0 g kg-1, c., burnt rice straw: N 0.8 g kg-1, P2O5 7.0 g kg-1, K2O 4.5 g kg-1. The experimental datas were estimated by analysis of variance, ANOVA and MANOVA. The main conclusions were as follows: 1. Mixture of 80% latossolo vermelho, 10% burnt rice straw and 10% farmyard manure were shown best performance on seed potato productivity. The piece of tubers with a 0-20 mm (consumption seeds) was increased by 77%. 2. Total seed potato number was reached maximum at 10.8 g pot-1 4N:14P:8K fertilizer regarding to average of treatments with a 33%. 3. Dry biomassa production plant-1 was decreased by high dose of 4N:14P:8K fertilizer (18.0 g pot-1) with a hard effect (57%). Our results are shown that it was possible developing of the seed potato production under tropical greenhouse conditions by optimalised soil-organic matter-fertilizer system. This datas should be as indicators to sustainable field potato advisory systems. Keywords: potato (Solanum tuberosum L.), greenhouse, latossolo vermelho soil, farmyard manure, burnt rice straw, 4N:14P:8K fertilizer, sustainability, yield Introducáo: Importância e situação actual em produção da batata no Brazíl A batata é atualmente uma das hortaliças de maior importância no Brasíl (Márton 2000a., 2000b.) com um cultivo annual médio de 173.000 ha e uma produção de 2600000 t. A produtividade médio nacional é de 15 t ha-1, muito baixa se considerar que é possivel a obtenção de rendimentos acima de 40 t ha-1. Observa- se também, que existe variação no produtividade entre regiões e estados. E importante como fonte de alimento pelo seu alto valor nutricional a quantidade produzida muito superior por unidade de área a tempo, se comparada com diversas outras culturas (László 2000b., 2000c.). Os estados que tradicionalmente produzem batata em maior ou menor escala são indicados em seguente: Pernambuco, Ceará, Sergipe, Goiás, Mato Grosso, Mato Grosso do Sul, Rondonia e Acre. Os plantios predominantes são o das águas e das secas, sendo o de inverno bem menos expressivo, pois poucas áreas permitem o seu cultivo, na maioria dos casos necessitando- se de irrigação. Considerando as três épocas de plantio e diferentes condições climaticas brasileiras, podemos definir de um modo geral o plantio de batata no Brasíl da seguinte maneira: Nordeste e Centro- Oeste- plantio de inverno, Sudeste- plantio das águas, secas e inverno, Sul- plantio das aguas, secas e inverno. Sendo este último em áreas muito limitadas. Dentre as hortaliças a batata é uma das culturas mais estudadas actualmente. Os principais problemas que afetam a cultura da batata podem ser de ordem agronómica, economica e comercial. Como exemplos destes podem ser citados: o uso racional de matérias orgânicos, esterco de curral e inorgânico fertilizantes. Efeito de materias orgnicânicos e N, P, K elementos minerais para produção da batata As necessidades em N, P, e K elementos minerais da batata são superidas pela aplicação apropriada de matérias orgânicos, esterco de currals, fertilizantes ao solo, combinada com a ambiente (Márton 2001a., 2001b.), época adequada e posição ideal de aplicá- lo. Efeito da materias orgânicos O suprimento de N á batateira provém principalmente da matéria orgânica do solo e do fertilizante aplicado (László 2000a., Márton et all. 2000.). Embora não seja muito praticado no Brasíl, a incorporação de esterco ao solo é fator de aumento da produção de tuberculos. Este resultado favorável poderia ser atribuído ao melhoramento da estrutura do solo, á maior retenção de água pelo e mesmo favorecendo o melhor desenvolvimento do sistema radicular da planta. A batata pode ser cultivada em todo tipo de solo desde que tenha boa drenagem e seja bem estruturado. Isto é tem que ser bem aerado e permitir o bom desenvolvimento dos órgãos subterráneos da batateira. Sem de matéria orgânicos e esterco de curral a tendencia de determinados solos formar crosta, oferecendo uma alta resisténcia mecánica á emergéncia das plantas, pode ser um determinante de stands desuniformes. A cause primaria da formação de crostas é a destruição dos agregados do solo pela excessiva manipulação mecánica resultando em aeração reduzida e aumento da densidade e coesão das particulas do solo. O encrostamento do solo pode ser reduzido através com matérias orgânicos. De maneira geral, a produção de tuberculos em solo de baixa potencialidade (aqueles em que a penetração das raizes é dificultada pela compactação, textura argilosa ou com camadas no solo) será menor do que nagueles com alta potencialidade (boa textura e adequada retenção de agua). Efeito do nitrogênio No Brazíl em todas regiões onde se cultiva batata é raro encontrar solos com elevado teor de nitrogênio e que não precisam de quantidades desta elemento. É o elemento que governa o padrão de desenvolvimento da planta, estimulando principalmente o crescimento da parte aérea (Kádár et all. 2000., László 2000.). Para se obter rendimento de tubérculos é necessário um rápido e curto periodo de desenvolvimento da parte aérea e uma fase de acúmulo maior possível. Para tanto, devem ser evitadas doses muito altas de nitrogênio e, principalmente, se aplicadas tardiamente, pois haverá demasiado desenvolvimento de folhas que demorarão mais a finalizar seu crescimento e maturação. Isto implicará na redução do periodo de intenso desenvolvimento dos tubérculos e armazenagem do amido, resultando em menor produção. Há risco para a saúde na ingestão de alimentos com altos teores de nitrato e nitrito, havendo preocupação com o efeito de doses mais altas de nitrogênio sobre os teores dos mesmos nos tuberculos. Embora haja diferenças entre cultivares, localidades e períodos de armazenamento, há estudos mostrando que a fertilização com até 150 kg ha-1 de nitrogênio não foi suficiente para propiciar niveis preocupantes de nitrato nos tuberculos colhidos. Efeito do fósforo A grande maioria dos solos brasileiros cultivados com batata apresentam limitações ao bom desenvolvimento e produção da cultura em função dos baixos níveis de fósforo. Isto significa que aumentos de produção quase sempre ocorrem quando o solo recebe adubação fosfatada (László 2001a.). Estes aumentos são mais marcantes em solos nunca antes adubados ou com baixo teor de fósforo. Nestes, dificilmente alcanca- se a produção máxima com níveis reduzidos de fósforo. Não seria exagerado supor níveis de 600 a 800 kg ha-1 de P2O5, como sendo aqueles que iriam proporcionar produção máximas, principalmente em solos mais ácidos e pobres em matéria orgânico. A adubação fosfatada é muito importante no crescimento inicial da planta e, além de aumentar a produção de tuberculos em peso e números, aumenta também a quantidade e qualidade do amido neles contidos e reduz perdas durante o armazenamento dos mesmos. A quantidade de fósforo a aplicar dependerá da análise do solo considerando- se principalmente o nível de P existente e a textura do solo. Solos de textura média e arenosa necessitam maior conteúdo de fósforo do que os de textura argilosa para serem considerandos solos de baixo, médio ou alto teor de fósfato. Efeito da potássica Embora seja o elemento mais absorbido pela batateira, nem sempre há resposta positiva da aduba potássica sobre o rendimento da cultura. Provavelmente isto esteja relacionado com níveis elevados deste elemento no solo (Kurnik et all. 2001.). Entretanto, em solos com médios e baixos teores de potássio, aumentos significativos são conseguidos. Por isto, as recomendações de adubação com potássio, nas diversas regiões do mundo, variam de 50-300 kg ha-1 de K2O. Resultados de trabalhos em brasiléiros têm demonstrado que a aduba potássica pode ser substituída pela aplicação de 150 m3 ha-1 de vinhaça de cana de açúcar. Ao elevar- se a dose de fertilização potássica deverá haver precaução para que a adubação magnesiana seja suficiente. O K além de aumentar a produção, em solos deficientes, aumenta também o tamanho dos tubérculos produzidos, e a proporção de tubérculos grandes. Deficiência no suprimento de potássio á planta pode acarretar produção de tubérculos com elevada susceptibilidade aos danos mecánicos pós-colheita. Os tubérculos injuriados enegrecem facilmente e este enegrecimento é inversamente proporcional á quantidade de potássio nos tuberculos. Ademais, quando fritos dão origem a um produto escuro, de baixa valor comercial. Manejo de adubação Diversos fatores como potencial de produção do solo, modo de aplicação do fertilizante dentre outro fatores afetam a resposta da batateira á aplicação de fertilizantes (Refschneider 1987.). Depreende- se pois que no estabelecimento de um nivel ideal de fertilização as variáveis planta, solo e condições climaticas devem ser visualizadas como um sistema pouco provável de ser homogeneo mesmo em nivel de fazenda. Como tal, generalizações a respeito de doses ou niveis de fertlização são difíceis de serem feitas, recomendações exigem julgamento hábil por parte do fazendeiro ou do tecnico responsavel pela cultura (Márton 2001a., 2001b.). Este julgamento será mais preciso conhecendo- se pontos que serão rápidamente discutidos a seguir. A taxa de absorção de nutrientes é governada pela concentração externa ou suprimento de nutrientes pelo solo e a demanda do nutriente criada pelo desenvolvimento e funcinamento normal dos diversos órgãos das plantas. O nivel de nutrientes na solução do solo deve ser suficiamente alto para que suas taxas de absorção não sejam limitantes ao crescimento. Por outro lado, não deve ser demasiado para causar excessiva absorção de outros nutrientes. Forte associação existe entre a absorção de nutrientes e o desenvolvimento da planta. De maneira geral, a fase de rapido desenvolvimento da cultura é acompanhada por um grande aumento na absorção de nutrientes com a taxa de absorção declinado quando a taxa de crescimento diminuiu. Normalmente todos os fertilizantes potássicos e fosfatados são adicionados ao solo na época do plantio. O nitrogênio normalmente é parcelado. Cerca de 2 por 3 do nível recomendado é colocado no sulco de plantio e o restante adicionado por ocasião da amontoa. É uma prática tradicinal e com pouco suporte experimental no condiõces brasileiras. Espera -se que a aplicação parcelada do nitrogênio e mesmo do potássio possem ser benéficas quando houver chuva excessiva ou irrigações mal executadas principalmente em solos mais arenosos onde poderá ocorrer a lixiviacão dos mesmos (Márton 2001a., 2001b.). O parcelamento poderá também ser benéfico quando elevados níveis de fertilizantes porém recomendandos e a aplicação por feita nos sulcos de plantio, pois evitar-se ia assim, elevada concentração salina em torno dos tubérculos plantados, embora a aplicação á lanco, em toda área, possa ser opção vantajosa. Quantidades corretas de fertilizantes, posição ideal e época certa de aplicação, combinadas adequadamente, definem o programa de adubação da batata. Esse programa é variável de acordo com o solo, a batata e condisões ambientais (Márton 2001a.). A dose de um elemento a ser aplicada em batata, é função da quantidade desse elemento suprida pelo solo e da percentagem de recuperação do elemento adicionado ao solo como fertilizante. Resultados experimentais comparando a aplicação de fertilizante á lanco ou localizado mostram respostas variadas sobre a produção. E possivel encontrar resultados iguais em ambos os métodos, de supremacia da aplicação á lanco ou da aplicação localizada (Kurnik et all. 2001.). Parece que baixas quantidades de fertilizantes são mais eficiemente utilizadas quando aplicação nos sulcos de plantios. Entretanto o potancial de produção pode ser aumentando com alta ou mesmo moderada quantidade de fertilizantes aplicados á lanço. A recomendação geral de colocar o adubo no sulco de plantio da batata merece ser questionada. É uma recomendação válida ao entender- se que a batata responde bastante á aplicação de fósforo, que os solos brasileiros tem alta capacidade de absorção de fósforo e que haverá maior proliferação de raízes na área fertilizada. Uma indagação aparece: um solo com baxa disponibilidade de fósforo fora da zona fertilizada permitiria o desenvolvimento ótimo da planta. Algumas evidéncias mostram, para outras espécies, que grande parte do sistema radicular, deve estar exposta ao fósforo para suprir as necessidades das plantas. Ademais, há um determinado valor de concentração de fósforo, na solução do solo, acima da qual a taxa de absorção não é aumentada. Essas considerações suscitam a possibilidade de questionar se a aplicação de fósforo em sulcos seria a forma mais eficiente de usá-lo quando se pretende alcancar elevadas produções. Deve-se lembrar entretanto, que solos tropicais, ainda com baixos teores fósforo e alta capacidade de adsorção, seria necessária dose muito elevada de P, quando aplicada á lanço, em todo o terreno. Se a aplicação localizada do fósforo pode, em parte, ser explicada, a do nitrogênio e potássio não são facilmente justificadas sob o aspecto de eficiéncia de utilização. Pelo contrário, ela pode ser questionada, principalmente pelas suas caracteristicas de difusão, pelo efeito que altas concentração de amónio e cloreto podem ter sobre a pressão osmotica da solução do solo junto aos tubérculos plantados, pelo efeito negativo do cloreto sobre a absorção de fósforo e também sobre a capacidade produtiva das plantas. Portanto, existe a possibilidade de ocorrer toxidez de amónio e de cloreto ao se aplicar doses altas dos fertilizantes nos sulcos de plantios. Isto pode determinar uma menor eficiéncia no uso dos fertilizantes. Materiais e Metodos: Nos desenvolverémos os três experimentos (i.e.: 1., 2., 3.) para aumentár-se do produção e produtividade da batata (Solanum tuberosum L.) semente pré- básica no casa de vegetação com diferentes doságens do latossolo vermelho novo, do esterco de curral e do adubo fórmula 4N:14P:8K no Empresa Brasileira de Pesquisa Agropecuaria- Centro Nacional de Pesquisas de Hortaliças, da Brazília-DF no 1990. Caracteristicas agroquímicas do solo em faixa arado (dados estimados), e conteudos N, P2O5, K2O do esterco de curral e palha de arroz queimado (dados estimados): a., caracteristicas agroquímicas do solo latossolo vermelho (solo novo: nunca foi usado para produção da batata semente): CaCO3 0.3-0.7%, humo 0.9-1.0%, pH (H2O) 5.3, pH (KCl) 4.5, AL- P2O5 3.2-3.5 mg kg-1, AL- K2O 180 mg kg-1, Mg (KCl) 70 mg kg-1, EDTA-Zn 0.5-0.8 mg kg-1, EDTA-Cu 0.5-0.6 mg kg-1 com abastecer fraco destes elementos, b., conteudos N, P2O5, K2O do esterco de curral (qualidade médio): N 1.8 g kg-1, P2O5 2.0 g kg-1, K2O 4.0 g kg-1, c., conteudos N, P2O5, K2O do palha de arroz queimado (palha de arroz foi queimado em um especial forno): N 0.8 g kg-1, P2O5 7.0 g kg-1, K2O 4.5 g kg-1. Nestas provas usarémos para controle a *mistura padrão. O este tratamento é a composição usual neste programa i.e.: 150 l de solo novo, 50 l de palha de arroz queimado, 50 l de esterco de curral, 350 gramas de cal e 300 gramas de adubo da fórmula 4N:14P:8K. Experimento 1. Efeito de diferentes misturas para produção da batata semente pré- básica em casa de vegetação O experimento foi instalado considerando-se sete misturas de substrato (latossolo vermelho novo, esterco de curral, palha de arroz queimado) em 3000 cm3 volume de capacidade de vasos preto com cinco repetições, no delineamento experimental de blocos ao acaso, na mésas experimentais em caso de vegetação. A cultivar foi a Achat, com plãntulas provenientes de cultura de tecidos. A data de plantio foi 18.04.1990. Plantarémos em cada vaso 3-3 "in vitro" plantulas com raiz embaixo de 4cm de superficie da mistura no vasos. Irrigarémos com 12 mm quantidade da augua 2 vezes por semana. Para produção aplicarémos sistema de proteção de plantas como usados no Brasíl. Ambiente foi controlado com ventilação automatizado. Temperatura médio foi 22 0C e humidade médio foi 68% durante de experimento. A data de colheta foi 04.07.1990. As pesagens foram feitos como peso fresco. Os resultados foram submetidos a analise de variáncia, ANOVA. As misturas do substrato utilizadas foram como a seguir no Tabela 1. Experimento 2. Efeito de adubo 4N:14P:8K para produção da batata semente pré- básica em casa de vegetação O experimento foi instalado considerando-se 9 dosagens de adubo da fórmula 4N:14P:8K com latossolo vermelho novo em 3000 cm3 volume de capacidade de vasos preto com cinco repetições, no delineamento experimental de blocos ao acaso na mésas experimentais em casa de vegetação. O adubo foi posicionando no solo de 4 cm abaixo de superficie do solo. A cultivar foi a Achat, com plãntulas provenientes de cultura de tecidos. A data de plantio foi 18.04.1990. Plantarémos em cada vaso 3-3 "in vitro" plantulas com raiz embaixo de 4cm de superficie da mistura no vasos. Irrigarémos com 12 mm quantidade da augua 2 vezes por semana. Para produção aplicarémos sistema de proteção de plantas como usados no Brasíl. Ambiente foi controlado com ventilação automatizado. Temperatura médio foi 22 0C e humidade médio foi 68% durante de experimento. A data de colheta foi 04.07.1990. As pesagens foram feitos como peso fresco. Os resultados foram submetidos a analise de variáncia, ANOVA. As doságens de adubo foram como a seguir no Tabela 2. Experimento 3. Efeito de latossolo vermelho novo, palha de arroz queimado e adubo 4N:14P:8K para produção da batata semente pré- básica em casa de vegetação Para pesquisar estes efeitos o experimento tipo de (2 x 6) foi instalado considerando-se as combinações entre duas misturas (i.e.: 1., 2.) e seis doságens de adubo complexo 4N:14P:8K, com três repetições, no delineamento experimental de bloco ao acaso, sendo 1 vaso (3000 cm3 volume de capacidade de vasos preto) por parcela na mésas experimentais em casa de vegetação. O adubo foi posicionando no solo de 4 cm abaixo de superficie do solo. A cultivar utilizada foi Baraka e o tamanho de tuberculos foi com 0-20 mm. A data de plantio foi 25.09.1990. Plantarémos em cada vaso 3-3 tuberculos com embaixo de 4cm de superficie da mistura no vasos. Irrigarémos com 12 mm quantidade da augua 2 vezes por semana. Para produção aplicarémos sistema de proteção de plantas como usados no Brasíl. Ambiente foi controlado ventilação automatizado. Temperatura médio foi 21 0C é humidade médio foi 66% durante de experimento. A data de colheta foi 14.12.1990. As pesagens foram feitos como peso fresco e matéria seca. Os resultados foram submetidos a analise de variáncia, MANOVA. Os manejos foram como a seguir no Tabela 3. Resultados e Discuscáo Experimento 1. Efeito de diferentes misturas para produção da batata semente pré- básica em casa de vegetação O tratamento 3. i.e.: mistura de 80% latossolo vermelho novo, 10% palha de arroz queimado e 10% esterco de curral, apresentou os maiores valores para numero de tuberculos com 0-20 mm (tamanho de comercial), peso de tuberculos com 0-20 mm e peso total de tuberculos por vaso. Porém, não houve diferencas significativas para o numero tuberculos comerciais, i.e.: com 0-20 mm, para os tratamentos 2., 3., 4., e 5. Portanto, a mistura poderá ter uma composição entre 60 a 90% de latossolo vermelho novo, 6 a 24% de palha de arroz queimado e de 4 a 16% de esterco de curral. Não houve diferenca significativa entre a mistura padrão utilizada e as misturas incluidas nos extremos indicados anteriormente. Porém, a mistura padrão recebeu adubação quimica de 4N:14P:8K (3.6 grama vaso-1) e calcário na dosagem de 4.2 grama vaso-1, o que não aconteceu com as parcelas das misturas em analise. Experimento 2. Efeito de adubo 4N:14P:8K para produção da batata semente pré- básica em casa de vegetação Há um efeito crescente das dóses de 4N:14P:8K nos caracteres observados. Porém, a maior dóse não chegou a ultrapassar a mistura padrão. Experimento 3. Efeito de latossolo vermelho novo, palha de arroz queimado e adubo 4N:14P:8K para produção da batata semente pré- básica em casa de vegetação Efeitos de misturas As duas misturas (i.e.: 1 e 2) deram resultados significativos mais alto que a mistura padrão, em média 54 %. Entre as misturas 1 e 2, foi melhor a 2. (80% latossolo vermelho novo, 10% palha de arroz queimado, 10% esterco de curral). Examinando-se 15 fatores, entre 11 casos afirmou-se a mistura como para melhor que a mistura 1. (70% latossolo vermelho novo, 20% palha de arroz queimado, 10% esterco de curral). Em caso de número de tuberculos 0-20 mm com a mistura 2. foi possivel aumentar geralmente os números de tuberculos em 77% que a mistura padrão. Efeitos de adubação 1. Área da folhas por planta entre manejo foi melhor de modo significativo a doságem de 3.6 grama vaso-1 adubo complexo (3103 cm2 plantas-1). 2. Peso fresco da folhas e de hastes por plantas as tendencias foram parecidos com o da área de folhas. 3. Peso fresco de raizis por planta até 7.2 grama vaso-1 diminuiu depois aumentou. 4. Peso fresco total de tuberculos por planta as crescentes doságens de um modo forte diminuiram a produção de tuberculos de 0 e 18.0 grama vaso-1 em 160% em os dois caso da mistura. 5. Peso de fitomassa fresco por planta foi melhor a 3.6 g vaso-1 (239 grama planta-1 em médio da dois mistura), depois os dados diminuirám. 6. Produção de biomassa fresco por planta a maxima produção (188 grama planta-1) foi obtida com 3.6 grama vaso-1. Deste ponto de modo forte caiu a produção. 7. Peso da matéria seca de folhas, hastes e raizis por planta somente em caso de mistura padrão o resultado foi significativo em relação aos outros tratamentos. 8. Péso da matéria seca de tuberculos total por planta modo significativo diminuiu a produção (0 e 18.0 grama vaso-1 = 360%) em médio da duas misturas. 9. Biomassa produção de materia seca por planta modo significativo diminuiu para efeito de alta dosagens de adubo complexo (0 e 18.0 grama vaso-1 = 158%) em médio da duas misturas. 10. Peso fresco de tuberculos com 0-20 mm as crescentes dosagens de 0 e 18.0 grama vaso-1 diminuiram a produção em 213% em médio da duas misturas. 11. Peso fresco de tuberculos com 20 mm-1 as crescentes dosagens de 0 e 18.0 grama vaso-1 diminuiram a produção assima de 250% em médio da duas misturas. 12. Numero de tuberculos 0-20 mm e 20 mm- por planta com os manejos de 0 e 18.0 grama vaso-1 foi possível aumentar em media 200% sobre a mistura padrão. Os manejo de 18.0 grama de adubo vaso-1 já causaram importante diminuição em relação caso a absoluto controle. 13. Numero total de tuberculos por planta entre manejos foi melhor a dosagem de 7.2 grama vaso-1 adubo complexo 4N:14P:8K comparando da mistura padrão. Nos verificamos-se que a mistura padrão sempre deu menor rasultados do que as outras misturas (i.e.: 1 e 2). Entre as misturas 1 e 2 a melhor foi a número 2. (80% latossolo vermelho novo, 10% palha de arroz queimado, 10% esterco de curral). Com esta mistura e com relação a mistura padrão, foi possível aumentar o número de tuberculos 0-20 mm com 77%. No caso do adubação, verificamos que grande quantidades de adubo acima de 7.2 grama vaso-1, de modo rigoroso diminuiu a produção de batata-semente pré- básica. Este fato deve ser considerado para a eleição das dosagens de adubos. Deve-se indicar o caso de número de tuberculos acima 20 mm-, onde em relação mistura padrão foi possivel aumentar em média 73% os resultados. Reconhecimento: Esta pesquisa foi apoio da Empresa Brasileira de Pesquisa Agropecuaria- Centro Nacional de Pesquisas de Hortaliças, Brasília-DF e Centro Pesquisa de Solo e Agroquímica do Academia Húngara de Ciências, Budapest References Kádár I-Márton L.-Horváth S. 2000. Mineral fertilisation of potato (Solanum tuberosum L.) on calcareous chernozem soil. Plant Production. 49: 291-306. Kurnik E.-Németh T.-Márton L.-Radimszki L. 2001. Effects of a new environment friendly deep fertilization system on a limy chernozem soil parameters. Agrochemistry and Soil Science. Budapest. In press László M. 2000. Nutrition of potato (Solanum tuberosum L.) on Hungary on a chernozem soil. Acta Agronomica Óváriensis. 42: 81-93. László M. 2001a. Climate change and N, P, K, Mg fertilization effects on potato (Solanum tuberosum L.) yield and quality. EAPR. Hamburg. In press László M. 2001b. Year and fertilization effect analysis in long field term experiments. XLIII. Georgikon Days. University of Veszprém. Keszthely László M.-Imre K.-Jose E.M. 2000a. Effects of Crotalaria juncea L. and Crotalaria spectabilis ROTH. on soil fertility and soil conservation in Hungary. Acta Agronomica Óváriensis. 42: 99-106. László M.-Silva J.C.-Jose A.B. 2000b. Ecological friendly dragée technics on different crops and vegetables seeds. Acta Agronomica Óváriensis. 42: 107-111. László M.-Silva J.B.C.-Jose A.B. 2000c. Ecological friendly dragée technics to sustainable precision agriculture. Fertilization in the Third Millenium. CASISCF. Beijing Márton L. 2000a. Effects of NPK fertilizers on potato (Solanum tuberosum L.) yield. Doctoral Ph.D Dissertation. University of Veszprém, Keszthely Márton L. 2000b. Effects of NPK fertilizers on potato (Solanum tuberosum L.) yield. Doctoral Ph.D Thesis. University of Veszprém, Keszthely Márton L. 2001a. Climete change effets on rye (Secale cereale L.) yield. Agrochemistry and Soil Science. Budapest. In press Márton L. 2001b. Climate change and fertilization effect analysis at the Tisza- river basin on rye yield. SZINET. University of Szent István. Gödöllő Márton L.-Kádár I.-Estáquio M.J. 2000. Effects of Crotalaria juncea L. and Crotalaria spectabilis ROTH on soil fertility and soil conservation. ESSC. Man and Soil at the Third Millennium. Abstract Book. 195. Valencia Reifschneider F.J.B. 1987. Produção de batata. Linha Gráfica e Editora. Brasília. p. 239. Tabela 1. Tratamentos do experimento 1. (Brasília-DF, 1990) ------------------------------------------------------------------ Numero de Composição em % Tratamento Solo novo Palha de arroz queimado Esterco de curral ------------------------------------------------------------------ 1. 100 0 0 2. 90 6 4 3. 80 10 10 4. 70 18 12 5. 60 24 16 6. 50 30 20 7. 40 36 24 ----------------------------------------------------------------- Tabela 2. Tratamentos do experimento 2. (Brasília-DF, 1990) ------------------------------------------------------- Numero de Adubo 4:14:8 N P2O5 K2O Tratamento Grama vaso-1 ------------------------------------------------------- 1. 0.0 0.000 0.000 0.000 2. 1.8 0.072 0.252 0.144 3. 3.6 0.144 0.504 0.288 4. 5.4 0.216 0.756 0.432 5. 7.2 0.288 1.008 0.576 6. 9.0 0.360 1.260 0.720 7. 10.8 0.432 1.512 0.864 8. 12.6 0.504 1.764 1.008 9. 14.4 0.576 2.016 1.152 ------------------------------------------------------- Tabela 3. Tratamentos do experimento 3. (Brasília-DF, 1990) ------------------------------------------------------------------------ Num. de Mistura % Trat. Solo novo Palea de arr. Q Esterco de curral 4N:14P:8K g vaso-1 ------------------------------------------------------------------------ 1. 70 20 10 0.0 2 70 20 10 3.6 3. 70 20 10 7.2 4. 70 20 10 10.8 5. 70 20 10 14.4 6. 70 20 10 18.0 7. 80 10 10 0.0 8. 80 10 10 3.6 9. 80 10 10 7.2 10. 80 10 10 10.8 11. 80 10 10 14.4 12. 80 10 10 18.0 ------------------------------------------------------------------------

Extraneural metastases of primary central nervous system tumors identified by fine needle aspiration: a retrospective analysis.

PubMed

Vandenbussche, Christopher J; Ho, Cheng-Ying; Nugent, Summer L; Ali, Syed Z

2014-01-01

Extraneural metastasis (EM) of primary central nervous system (PCNS) neoplasms is rare and signifies a poor clinical outcome. Due to its infrequent occurrence, relatively few reports on the cytomorphology of these neoplasms have been published. We describe a series of 19 cases from 16 patients at a single, large tertiary care center. A retrospective analysis of 19 cases of metastases from PCNS neoplasms identified on fine needle aspiration (FNA) in 8 male and 8 female patients aged 14-72 years (mean age 39.6) from 1989 to 2013 was conducted to further characterize the cytomorphologic features identified at metastatic sites. Six different PCNS neoplasms were identified: meningioma, glioblastoma, hemangiopericytoma (HPC), oligodendroglioma, medulloblastoma, and retinoblastoma. The mean latency period between the diagnoses of the primary and first metastatic tumors was 7.4 years (range 0-15). The most common PCNS malignancy responsible for EM was HPC. The most common metastatic sites were the lung (31%) and soft tissue/bone (31%). EM of PCNS tumors is extremely rare. FNA allows for quick, safe and accurate diagnosis. Cytomorphologic features are characteristic, and in conjunction with the clinical history and immunohistochemistry, an accurate diagnosis was obtained in 100% of the cases.

Appearance of the bona fide spiral tubule of ORF virus is dependent on an intact 10-kilodalton viral protein.

PubMed

Spehner, D; De Carlo, S; Drillien, R; Weiland, F; Mildner, K; Hanau, D; Rziha, H-J

2004-08-01

Parapoxviruses can be morphologically distinguished from other poxviruses in conventional negative staining electron microscopy (EM) by their ovoid appearance and the spiral tubule surrounding the virion's surface. However, this technique may introduce artifacts. We have examined Orf virus (ORFV; the prototype species of the Parapoxvirus genus) by cryoelectron microscopy (cryo-EM) and cryo-negative staining EM. From these studies we suggest that the shape and unique spiral tubule are authentic features of the parapoxviruses. We also constructed an ORFV mutant deleted of a gene encoding a 10-kDa protein, which is an orthologue of the vaccinia virus (VACV) 14-kDa fusion protein, and investigated its ultrastructure. This mutant virus multiplied slowly in permissive cells and produced infectious but morphologically aberrant particles. Mutant virions lacked the spiral tubule but displayed short disorganized tubules similar to those observed on the surface of VACV. In addition, thin extensions or loop-like structures were appended to the ORFV mutant particles. We suggest that these appended structures arise from a failure of the mutant virus particles to properly seal and that the sealing activity is dependent on the 10-kDa protein.

Special Issues Related to Hematopoietic Stem Cell Transplantation in the Eastern Mediterranean Region and the First Regional Activity Report

PubMed Central

Aljurf, Mahmoud; Zaidi, Syed Z; El Solh, Hassan; Hussain, Fazal; Ghavamzadeh, Ardeshir; Mahmoud, Hossam Kamel; Shamsi, Tahir; Othman, Tarek Ben; Sarhan, Mahmoud M.; Dennison, David; Ibrahim, Ahmad; Benchekroun, Said; Chaudhri, Naeem; Labar, Boris; Horowitz, Mary; Niederwieser, Dietger; Gratwohl, Alois

2012-01-01

Although several centers are now performing allogeneic HSCT in the Eastern Mediterranean (EM) region, the availability is still limited. Special issues including compatible donor availability and potential for alternate donor programs are discussed. In comparison to Europe & North America, differences in pattern of diseases and pre-HSCT general status particularly for patients with BM failure are described. Other differences including high seropositivity for CMV, Hepatitis B and C infection and specific observations about GVHD with its relation to genetically homogeneous community are also discussed. We report that a total of 17 HSCT programs (performing 5 or more HSCTs annually) exist in 9 countries of the EM region. Only 6 programs are currently reporting to EBMT or IBMTR. A total of 7617 HSCTs have been performed by these programs including 5701 allogeneic HSCTs. Due to low HSCT team density (1.5583 teams/10 million inhabitants vs. 14.4333 in Europe) and very low HSCT team distribution (0.2729 teams/10,000 sq km area vs. <1 to 6 teams in Europe). GNI/capita had no clear association with low HSCT activity; however improvement in infrastructure & formation of EM regional HSCT registry are needed. PMID:19043456

States of phage T3/T7 capsids: buoyant density centrifugation and cryo-EM.

PubMed

Serwer, Philip; Wright, Elena T; Demeler, Borries; Jiang, Wen

2018-04-01

Mature double-stranded DNA bacteriophages have capsids with symmetrical shells that typically resist disruption, as they must to survive in the wild. However, flexibility and associated dynamism assist function. We describe biochemistry-oriented procedures used to find previously obscure flexibility for capsids of the related phages, T3 and T7. The primary procedures are hydration-based buoyant density ultracentrifugation and purified particle-based cryo-electron microscopy (cryo-EM). We review the buoyant density centrifugation in detail. The mature, stable T3/T7 capsid is a shell flexibility-derived conversion product of an initially assembled procapsid (capsid I). During DNA packaging, capsid I expands and loses a scaffolding protein to form capsid II. The following are observations made with capsid II. (1) The in vivo DNA packaging of wild type T3 generates capsid II that has a slight (1.4%), cryo-EM-detected hyper-expansion relative to the mature phage capsid. (2) DNA packaging in some altered conditions generates more extensive hyper-expansion of capsid II, initially detected by hydration-based preparative buoyant density centrifugation in Nycodenz density gradients. (3) Capsid contraction sometimes occurs, e.g., during quantized leakage of DNA from mature T3 capsids without a tail.

Frequency of indeterminate results from an interferon-gamma release assay among HIV-infected individuals.

PubMed

Oliveira, Sandra Maria do Valle Leone de; Trajman, Anete; Paniago, Anamaria Mello Miranda; Motta-Castro, Ana Rita Coimbra; Ruffino-Netto, Antonio; Maciel, Ethel Leonor Noia; Croda, Julio; Bonecini-Almeida, Maria da Gloria

2017-01-01

To evaluate the frequency of and factors associated with indeterminate interferon-gamma release assay (IGRA) results in people living with HIV/AIDS (PLWHA). We tested 81 PLWHA in the central-west region of Brazil, using the tuberculin skin test and an IGRA. Information on sociodemographic and clinical variables was gathered through the use of questionnaires and from medical records. The association of those variables with indeterminate results was analyzed by calculating the adjusted ORs in a multivariate logistic regression model. Concordance was evaluated by determining the kappa statistic. Among the 81 patients evaluated, the tuberculin skin test results were positive in 18 (22.2%) of the patients, and the IGRA results were positive in 10 (12.3%), with a kappa of 0.62. The IGRA results were indeterminate in 22 (27.1%) of the patients (95% CI: 17.8-38.1%). The odds of obtaining indeterminate results were significantly higher in smokers (adjusted OR = 6.0; 95% CI: 1.4-26.7) and in samples stored for less than 35 days (adjusted OR = 14.0; 95% CI: 3.1-64.2). Patients with advanced immunosuppression (CD4+ T-cell count < 200 cells/mm3) were at a higher risk for indeterminate results (OR adjusted for smoking and inadequate duration of sample storage = 4.7; 95% CI: 0.91-24.0), although the difference was not significant. The high prevalence of indeterminate results can be a major limitation for the routine use of IGRAs in PLWHA. The need to repeat the test increases its costs and should be taken into account in cost-effectiveness studies. The processing of samples can significantly alter the results. Avaliar a frequência de resultados indeterminados de um interferon-gamma release assay (IGRA, ensaio de liberação de interferon-gama) e os fatores relacionados com esses resultados em pessoas vivendo com HIV/AIDS (PVHA). Foram avaliadas 81 PVHA na região Centro-Oeste do Brasil, por meio do teste tuberculínico e de um IGRA. Informações a respeito de variáveis sociodemográficas e clínicas foram obtidas por meio de questionários e prontuários médicos. A relação entre essas variáveis e os resultados indeterminados foi avaliada por meio do cálculo da OR ajustada em um modelo de regressão logística multivariada. A concordância foi avaliada por meio do coeficiente kappa. Os resultados do teste tuberculínico e do IGRA foram positivos em 18 (22,2%) e 10 (12,3%), respectivamente, dos 81 pacientes avaliados (κ = 0,62). O resultado do IGRA foi indeterminado em 22 (27,1%) dos pacientes (IC95%: 17,8-38,1%). A chance de resultados indeterminados foi significativamente maior em fumantes (OR ajustada = 6,0; IC95%: 1,4-26,7) e em amostras armazenadas durante menos de 35 dias (OR ajustada = 14,0; IC95%: 3,1-64,2). Pacientes com imunossupressão avançada (contagem de células T CD4+ < 200 células/mm3) apresentaram maior risco de resultados indeterminados (OR ajustada para tabagismo e tempo inadequado de armazenamento das amostras = 4,7; IC95%: 0,91-24,0), embora a diferença não tenha sido significativa. A alta prevalência de resultados indeterminados pode ser um grande obstáculo ao uso rotineiro de IGRAs em PVHA. A necessidade de repetir o teste aumenta seu custo e deve ser levada em conta em estudos da relação entre custo e eficácia. O processamento das amostras pode alterar significativamente os resultados.

Cellular Transport of Esculin and Its Acylated Derivatives in Caco-2 Cell Monolayers and Their Antioxidant Properties in Vitro.

PubMed

Zhang, Mengmeng; Xin, Xuan; Lai, Furao; Zhang, Xiaoyuan; Li, Xiaofeng; Wu, Hui

2017-08-30

Esculin has many pharmacological effects, but these are difficult to observe after oral administration owing to poor lipid solubility. In our previous study, five acylated derivatives with different acyl chain lengths (EA, EP, EO, EL, and EM) were synthesized to improve the lipophilicity of esculin. In this study, the bioavailability and antioxidant activity of the five derivatives were investigated. The logP of esculin, EA, EP, EO, EL, and EM were -1.1 ± 0.1, -0.3 ± 0.14, 0.1 ± 0.17, 1.6 ± 0.09, 2.4 ± 0.11, and 2.8 ± 0.18, and their P app were 0.71 ± 0.02, 1.24 ± 0.18, 1.74 ± 0.11, 11.6 ± 3.6, 4.11 ± 1.03, and 2.64 ± 0.97 × 10 -6 cm/s, respectively. Besides, the bioavailability of EO, EL, and EM were seriously affected by carboxylesterase. The results of ABTS, ORAC, and DPPH assays indicated that the antiradical ability of the five derivatives did not exceed that of esculin. However, EA, EP, and EO showed more effective inhibition of AAPH-induced oxidative hemolysis than esculin did (p < 0.05), and EL and EM were less effective than esculin (p < 0.05). The mechanism was related to the distribution and localization of the derivatives in "oil-water interface" between the cytomembrane and the aqueous phase.

Background CO2 levels and error analysis from ground-based solar absorption IR measurements in central Mexico

NASA Astrophysics Data System (ADS)

Baylon, Jorge L.; Stremme, Wolfgang; Grutter, Michel; Hase, Frank; Blumenstock, Thomas

2017-07-01

In this investigation we analyze two common optical configurations to retrieve CO2 total column amounts from solar absorption infrared spectra. The noise errors using either a KBr or a CaF2 beam splitter, a main component of a Fourier transform infrared spectrometer (FTIR), are quantified in order to assess the relative precisions of the measurements. The configuration using a CaF2 beam splitter, as deployed by the instruments which contribute to the Total Carbon Column Observing Network (TCCON), shows a slightly better precision. However, we show that the precisions in XCO2 ( = 0.2095 ṡ Total Column CO2Total Column O2) retrieved from > 96 % of the spectra measured with a KBr beam splitter fall well below 0.2 %. A bias in XCO2 (KBr - CaF2) of +0.56 ± 0.25 ppm was found when using an independent data set as reference. This value, which corresponds to +0.14 ± 0.064 %, is slightly larger than the mean precisions obtained. A 3-year XCO2 time series from FTIR measurements at the high-altitude site of Altzomoni in central Mexico presents clear annual and diurnal cycles, and a trend of +2.2 ppm yr-1 could be determined.

Modeling and Simulation Architecture for Studying Doppler-Based Radar with Complex Environments

DTIC Science & Technology

2009-03-26

structures can interfere with a radar’s ability to detect moving aircraft because radar returns from turbines are comparable to those from slow flying...Netherlands Organisation for Applied Scientific Research . 13 EM Electromagnetic . . . . . . . . . . . . . . . . . . . . . . . 14 MTI Moving Target Indicator...ensure the turbine won’t interact with the radar. However, (2.3) doesn’t account for terrain masking or shadowing. If there is a tall object or terrain

Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate: Anabolic, Neuroprotective, and Neuroexcitatory Properties in Military Men

DTIC Science & Technology

2013-01-01

in olfactory bulbectomized mice. J Neurochem 2011; 117(5); 879-91. 14. Gubba EM Fawcett JW, Herbert J; The effects of corticosterone and...Newman AE, MacDougall-Shackleton SA, An YS, Kriengwatana B. Soma KK: Corticosterone and dehydroepiandrosterone have opposing effects on adult...supports nerve cell proliferation), and salivary alpha amylase (sAA; a proxy of sympathetic nervous system function). Separate regression analyses were

Electromagnetic-Optical Coherence Tomography Guidance of Transbronchial Solitary Pulmonary Nodule Biopsy

DTIC Science & Technology

2017-12-01

AD_________________ (Leave blank) Award Number: W81XWH-13-1-0155 TITLE: Electromagnetic -Optical Coherence Tomography Guidance of Transbronchial...2. REPORT TYPE Final 3. DATES COVERED (From - To) 1 July 2013 - 30 Sep 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Electromagnetic -Optical...SUPPLEMENTARY NOTES 14. ABSTRACT We present a novel high-resolution multimodality imaging platform utilizing CT and electromagnetic (EM) navigation for spatial

A Comparison of Antenna Measurements in a Near-Field Range and a Newly Renovated Short-Tapered Chamber

DTIC Science & Technology

2016-09-01

SUPPLEMENTARY NOTES 14. ABSTRACT This study was undertaken to quantify and compare electromagnetic device (i.e., antenna) measurements using the US Army...15. SUBJECT TERMS electromagnetic , chamber, near-field range, anechoic chamber, antenna measurement 16. SECURITY CLASSIFICATION OF: 17...undertaken to quantify and compare electromagnetic (EM) device (i.e., antenna) measurements using the US Army Research Laboratory’s (ARL’s) near-field

Histopathological spectrum of childhood nephrotic syndrome in Pakistan.

PubMed

Mubarak, Muhammed; Lanewala, Ali; Kazi, Javed Iqbal; Akhter, Fazal; Sher, Atika; Fayyaz, Amir; Bhatti, Sajid

2009-12-01

There is no information in international literature on the pattern of glomerulopathies in children with idiopathic nephrotic syndrome (INS) in Pakistan. We undertook this study to determine the pattern of glomerulopathies based on renal biopsies studied by light (LM), immunofluorescence (IF), and electron microscopy (EM). The study was conducted at Sindh Institute of Urology and Transplantation (SIUT), Karachi over 12 years (1996-2008). All children (

Climate Prediction Center - Stratosphere: Stratosphere-Troposphere

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Wave 2 Wave 3 - NH EQ SH NH EQ SH NH EQ SH NH EQ SH NH SH NH SH NH SH NH SH Annual N E S N E S N E S N E S N S N S N S N S JFM N E S N E S N E S N E S N S N S N S N S AMJ N E S N E S N E S N E S N S N S N S N S JAS N E S N E S N E S N E S N S N S N S N S OND N E S N E S N E S N E S N S N S N S N S Past

CFSv2 Seasonal Climate Forecasts

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Nino3.4 Nino4 E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) E1 (data) E2 (data) E3 (data) Sea surface height and

Conacyt

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Organismos de Inspección Organismos de Certificación de personas Calidad Acreditación ¿Que es la : Estructuración de la Evaluación de la Conformidad 1.2: Fortalecimiento y articulación de las instituciones Componente 2: Fortalecimiento del Sistema Nacional de Innovación 6: Incorporación de la Innovación en la

In-hospital airway management training for non-anesthesiologist EMS physicians: a descriptive quality control study.

PubMed

Trimmel, Helmut; Beywinkler, Christoph; Hornung, Sonja; Kreutziger, Janett; Voelckel, Wolfgang G

2017-04-26

Pre-hospital airway management is a major challenge for emergency medical service (EMS) personnel. Despite convincing evidence that the rescuer's qualifications determine efficacy of tracheal intubation, in-hospital airway management training is not mandatory in Austria, and often neglected. Thus we sought to prove that airway management competence of EMS physicians can be established and maintained by a tailored training program. In this descriptive quality control study we retrospectively evaluated all in- and pre-hospital airway cases managed by EMS physicians who underwent a structured in-hospital training program in anesthesia at General Hospital Wiener Neustadt. Data was obtained from electronic anesthesia and EMS documentation systems. From 2006 to 2016, 32 EMS physicians with 3-year post-graduate education, but without any prior experience in anesthesia were trained. Airway management proficiency was imparted in three steps: initial training, followed by an ongoing practice schedule in the operating room (OR). Median and interquartile range of number of in-hospital tracheal intubations (TIs) vs. use of supra-glottic airway devices (SGA) were 33.5 (27.5-42.5) vs. 19.0 (15.0-27.0) during initial training; 62.0 (41.8-86.5) vs. 33.5 (18.0-54.5) during the first, and 64.0 (34.5-93.8) vs. 27 (12.5-56.0) during the second year. Pre-hospitaly, every physician performed 9.0 (5.0-14.8) TIs vs. 0.0 (0.0-0.0) SGA cases during the first, and 9.0 (7.0-13.8) TIs vs. 0.0 (0.0-0.3) SGA during the second year. Use of an SGA was mandatory when TI failed after the second attempt, thus accounting for a total of 33 cases. In 8 cases, both TI and SGA failed, but bag mask ventilation was successfully performed. No critical events related to airway management were noted and overall success rate for TI with a max of 2 attempts was 95.3%. Number of TIs per EMS physician is low in the pre-hospital setting. A training concept that assures an additional 60+ TIs per year appears to minimize failure rates. Thus, a fixed amount of working days in anesthesia seems crucial to maintain proficiency. CONCLUSIONS: In-hospital training programs are mandatory for non-anesthetist EMS physicians to gain competence in airway management and emergency anesthesia.Our results might be helpful when discussing the need for regulation and financing with the authorities.

Berkeley Lab - Materials Sciences Division

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2018 [PDF] October 2017 [PDF] July 2017 [PDF] April 2017 [PDF] January 2017 [PDF] October 2016 [PDF ] July 2016 [PDF] April 2016 [PDF] January 2016 [PDF] October 2015 [PDF] March 2015 [PDF] December 2014 [PDF] April 2014 [PDF] February 2014 [PDF] September 2013 [PDF] March 2013 [PDF] October, 2012 [PDF

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BREAST CANCER METASTASIS IN THE STOMACH: WHEN THE GASTRECTOMY IS INDICATED ?

PubMed

Rodrigues, Marcus Vinicius Rozo; Tercioti-Junior, Valdir; Lopes, Luiz Roberto; Coelho-Neto, João de Souza; Andreollo, Nelson Adami

2016-01-01

Breast cancer is the most common malignant neoplasm in the female population. However, stomach is a rare site for metastasis, and can show up many years after initial diagnosis and treatment of the primary tumor. Analyze a case series of this tumor and propose measures that can diagnose it with more precocity. Were analyzed 12 patients with secondary gastric tumors. Immunohistochemistry has demonstrated that primary tumor was breast cancer. We retrieved information of age, histological type, interval between diagnosis of the primary breast cancer and its metastases, immunohistochemistry results, treatment and survival. The mean age was 71.3 years (ranging 40-86). Ten cases had already been underwent mastectomy in the moment of the diagnosis of gastric metastasis. Two patients had diagnosis of both primary and secondary tumors concomitantly. At average, diagnosis of gastric metastasis was seven years after diagnosis of primary breast cancer (ranging 0-13). Besides, nine cases had also metastases in other organs, being bones the most affected ones. Immunohistochemistry of the metastases has shown positivity for CK7 antibody in 83.34%, estrogen receptor in 91.67%, progesterone receptor in 66.67% and AE1AE3 antibody in 75%, considering all 12 cases. Moreover, CK20 was absent significantly (66.67%). The positivity of BRST2 marker did not present statistical significance (41.67%). Eight cases were treated with chemotherapy associated or not with hormonal blockade. Surgical treatment of gastric metastasis was performed in four cases: three of them with total gastrectomy and one with distal gastrectomy. Follow-up has shown a mean survival of 14.58 months after diagnosis of metastasis, with only two patients still alive. Patients with a history of breast cancer presenting endoscopic diagnosis of gastric cancer it is necessary to consider the possibility of gastric metastasis of breast cancer. The confirmation is by immunohistochemistry and gastrectomy should be oriented in the absence of other secondary involvement and control of the primary lesion. A neoplasia de mama é o tumor maligno mais comum na população feminina tendo o trato gastrointestinal, e mais especificamente o estômago, como local incomum para metástases. Analisar uma série de casos com esse tumor e propor medidas que possam diagnosticá-lo com maior precocidade. Foram analisados retrospectivamente 12 pacientes com diagnóstico de neoplasia gástrica secundária a câncer de mama, confirmado por biópsia e imunoistoquímica. Foram analisados idade do diagnóstico, tipo histológico do tumor primário, intervalo de tempo entre o diagnóstico do tumor e a metástase, tratamento e sobrevida. A idade média foi de 71,3 anos (40-86 anos). Em média, o diagnóstico da metástase gástrica foi de sete anos após o diagnóstico da lesão primaria (0-13 anos). Nove casos tiveram metástases em outros órgãos, sendo os ossos os locais mais acometidos. Evidenciou-se positividade de anticorpo CK7 em 90,9% casos, receptor de estrógeno em 91,67%, receptor de progesterona em 66,67% e BRST2 em 41,67%. A ausência de CK20 foi de 88,89%. Oito casos foram tratados com quimioterapia associada ou não ao bloqueio hormonal e em quatro foi indicada ressecção cirúrgica sendo em três gastrectomia total e em um caso gastrectomia subtotal. A sobrevida média foi de 14,58 meses. Em doentes com história prévia de câncer de mama apresentando diagnóstico endoscópico de neoplasia gástrica, é necessário considerar a possibilidade de metástase. A confirmação é feita por estudo imunoistoquímico e a gastrectomia deve ser orientada diante da ausência de outros locais de acometimento secundário e controle da lesão primária.

ACHP | Case Digest - Protecting Historic Properties: Section 106 in Action

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Digest index. Previous issues: Summer 2012 (PDF) Spring 2012 (PDF) Winter 2012 (PDF) Fall 2011 (PDF ) Summer 2011 (PDF) Spring 2011 (PDF) Winter 2011 (PDF) Fall 2010 (PDF) Summer 2010 (PDF) Winter 2010 (PDF ) Fall 2009 (PDF) Summer 2009 (PDF) Spring 2009 (PDF) Winter 2009 (PDF) Fall 2008 (PDF) Summer 2008 (PDF

Evidence-Based Guidelines for Fatigue Risk Management in EMS: Formulating Research Questions and Selecting Outcomes.

PubMed

Patterson, P Daniel; Higgins, J Stephen; Lang, Eddy S; Runyon, Michael S; Barger, Laura K; Studnek, Jonathan R; Moore, Charity G; Robinson, Kathy; Gainor, Dia; Infinger, Allison; Weiss, Patricia M; Sequeira, Denisse J; Martin-Gill, Christian

2017-01-01

Greater than half of Emergency Medical Services (EMS) personnel report work-related fatigue, yet there are no guidelines for the management of fatigue in EMS. A novel process has been established for evidence-based guideline (EBG) development germane to clinical EMS questions. This process has not yet been applied to operational EMS questions like fatigue risk management. The objective of this study was to develop content valid research questions in the Population, Intervention, Comparison, and Outcome (PICO) framework, and select outcomes to guide systematic reviews and development of EBGs for EMS fatigue risk management. We adopted the National Prehospital EBG Model Process and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for developing, implementing, and evaluating EBGs in the prehospital care setting. In accordance with steps one and two of the Model Process, we searched for existing EBGs, developed a multi-disciplinary expert panel and received external input. Panelists completed an iterative process to formulate research questions. We used the Content Validity Index (CVI) to score relevance and clarity of candidate PICO questions. The panel completed multiple rounds of question editing and used a CVI benchmark of ≥0.78 to indicate acceptable levels of clarity and relevance. Outcomes for each PICO question were rated from 1 = less important to 9 = critical. Panelists formulated 13 candidate PICO questions, of which 6 were eliminated or merged with other questions. Panelists reached consensus on seven PICO questions (n = 1 diagnosis and n = 6 intervention). Final CVI scores of relevance ranged from 0.81 to 1.00. Final CVI scores of clarity ranged from 0.88 to 1.00. The mean number of outcomes rated as critical, important, and less important by PICO question was 0.7 (SD 0.7), 5.4 (SD 1.4), and 3.6 (SD 1.9), respectively. Patient and personnel safety were rated as critical for most PICO questions. PICO questions and outcomes were registered with PROSPERO, an international database of prospectively registered systematic reviews. We describe formulating and refining research questions and selection of outcomes to guide systematic reviews germane to EMS fatigue risk management. We outline a protocol for applying the Model Process and GRADE framework to create evidence-based guidelines.

A National Description of Violence toward Emergency Medical Services Personnel.

PubMed

Gormley, Mirinda A; Crowe, Remle P; Bentley, Melissa A; Levine, Roger

2016-01-01

EMS personnel often work in unpredictable environments and are at high risk for sustaining occupational injuries. One potential source of injury that is of growing concern is violence toward EMS personnel. To describe the prevalence of violence directed at EMS personnel by type and source, and to identify characteristics associated with experiencing violence. The 2013 Longitudinal EMT Attributes and Demographics Study contained 14 items assessing violence experienced in the past 12 months. Violence was categorized by type (physical or verbal) and by source (the patient or a patient's family member or bystander). EMS personnel characteristics included sex, age, race, marital status, certification level, firefighter, volunteerism, agency type, and community size. Descriptive and comparative analyses were performed on personnel whose primary role was providing patient care. Multivariable logistic regression modelling was used to assess associations between provider characteristics and experiencing violence. A total of 2,515/4,238 (59.3%) responses were received and 1,789 met inclusion criteria. Over two-thirds (69.0%) experienced at least one form of violence in the past 12 months. Verbal violence was more prevalent than physical (67.0% vs. 43.6%). Using multivariable logistic regression to control for other demographic and employment characteristics, paramedics had nearly triple the odds of experiencing physical (OR = 2.67, 95% CI = 2.06-3.46) and verbal (OR = 2.63, 95% CI = 1.99-3.46) violence as EMTs. Urban personnel had increased odds of experiencing physical (OR = 1.53, 95% CI = 1.21-1.93) and verbal violence (OR = 1.32, 95% CI = 1.02-1.71). Each additional weekly transport increased the odds of experiencing physical (OR = 1.04, 95% CI = 1.03-1.05) and verbal (OR = 1.04, 95% CI = 1.03-1.06) violence by 4%. Those who were volunteers at their main EMS jobs had decreased odds of experiencing physical (OR = 0.68, 95% CI = 0.50-0.92) and verbal (OR = 0.59, 95% CI = 0.44-0.78) violence. Over two-thirds of EMS personnel experienced at least one form of violence in the last 12 months. Demographic and employment characteristics associated with experiencing violence were identified. Our findings may be used in education initiatives to raise awareness of the high prevalence of violence toward EMS personnel and factors associated with experiencing violence.

Transient formation of nano-crystalline structures during fibrillation of an Aβ-like peptide

PubMed Central

Otzen, Daniel E.; Oliveberg, Mikael

2004-01-01

During the first few minutes of fibrillation of a 14-residue peptide homologous to the hydrophobic C-terminal part of the Aβ-peptide, EM micrographs reveal small crystalline areas (100 to 150 nm, repeating unit 47 Å) scattered in more amorphous material. On a longer time scale, these crystalline areas disappear and are replaced by tangled clusters resembling protofilaments (hours), and eventually by more regular amyloid fibrils of 60 Å to 120 Å diameter (days). The transient population of the crystalline areas indicates the presence of ordered substructures in the early fibrillation process, the diameter of which matches the length of the 14-mer peptide in an extended β-strand conformation. PMID:15096642

Piezoelectric Motors and Transformers

NASA Astrophysics Data System (ADS)

Uchino, K.

Piezoelectric ceramics forms a new field between electronic and structural ceramics [1-4]. Application fields are classified into three categories: positioners, motors, and vibration suppressors. From the market research result for 80 Japanese component industries in 1992, tiny motors in the range of 5-8 mm are required in large numbers for office and portable equipment; the conventional electromagnetic (EM) motors are rather difficult to produce in this size with sufficient energy efficiency, while Silicon MEMS actuators are too small to be used in practice. Piezoelectric ultrasonic motors whose efficiency is insensitive to size are superior in the millimeter motor area. The manufacturing precision of optical instruments such as lasers and cameras, and the positioning accuracy for fabricating semiconductor chips are of the order of 0.1μm which is much smaller than the backlash of the EM motors. Vibration suppression in space structures and military vehicles also require compact but mighty piezoelectric actuators.

Substrateless ultra-thin quarter meta-waveplate based on Babinet’s Principle

NASA Astrophysics Data System (ADS)

Loo, Y. L.; Guo, B. S.; Ong, C. K.

2018-06-01

This work proposes a substrateless ultrathin metamaterial for converting an incident electromagnetic (EM) wave from linear to a circular state of polarization within the frequency range of 10 to 14 GHz. Owing to the absence of a substrate, the polarization converter can realize a remarkable ultra-thin thickness of approximately 400 times smaller than the central working wavelength. In addition, simulated results demonstrate its capability of achieving a 3 dB axial ratio bandwidth of 34.5% at normal incidence and more than 25% for an oblique incidence angle up to 40°. The metamaterial experimental transmission coefficients for horizontal and vertical polarized EM fields show excellent agreement with the simulated results. The metasurface, which comprises of a self-complementary L-shaped structure, is designed based on Babinet’s principle, and fabricated using an advanced method for precise cutting of metal.

Indianapolis emergency medical service and the Indiana Network for Patient Care: evaluating the patient match algorithm.

PubMed

Park, Seong C; Finnell, John T

2012-01-01

In 2009, Indianapolis launched an electronic medical record system within their ambulances1 and started to exchange patient data with the Indiana Network for Patient Care (INPC) This unique system allows EMS personnel to get important information prior to the patient's arrival to the hospital. In this descriptive study, we found EMS personnel requested patient data on 14% of all transports, with a "success" match rate of 46%, and a match "failure" rate of 17%. The three major factors for causing match "failure" were ZIP code 55%, Patient Name 22%, and Birth date 12%. We conclude that the ZIP code matching process needs to be improved by applying a limitation of 5 digits in ZIP code instead of using ZIP+4 code. Non-ZIP code identifiers may be a better choice due to inaccuracies and changes of the ZIP code in a patient's record.

What measurements of proton self emission tell us about hohlraum fields and yield anomalies

NASA Astrophysics Data System (ADS)

Petrasso, R.; Li, C.; Seguin, F.; Frenje, J.; Rosenberg, M.; Rinderknecht, H.; Philippe, F.; Casner, A.; Caillaud, T.; Landoas, O.; Bourgade, J.-L.; Amendt, P.; Izumi, N.; Koch, J.; Landen, O.; Milovich, J.; Park, H.; Robey, H.; Robey, R.; Town, R.; Nikroo, A.; Kilkenny, J.

2009-11-01

Measurements have been made of 14.7-MeV self-emission protons, from reactions of D-3He fuel, for a variety of hohlraums - scale 1 and scale .5ex3 -.1em/ -.15em.25ex3 , gold and cocktail hohlraums, vacuum and gas-filled hohlraums, cylindrical and rugby geometries, drive with and without phase plates, drive with different numbers of beams, and implosions with different capsule parameters. The picture that emerges is quite consistent: large anisotropies in the proton fluence pattern are generally observed out the LEH but little if any variations through the hohlraum equator. In addition, we examine whether the scaling of yields from pure D2 to D-3He mixtures is found to deviate from the expected density scaling (i.e. the Rygg Effect), as reported recently for directly driven capsules (1). (1) H. Herrmann et al., PoP 16, 056312(2009)

NOAA Weather Radio

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recepción confiable en algunas localidades debido a bloqueos de las señales y/o distancia excesiva de la mensajes NOTA: Servicio de NWR para un condado depende de recepción confiable la señal, la cual cobertura de NWR, o cobertura parcial, serán indicados. Algunos condados o partes de condados

Periodic Table of Elements: Los Alamos National Laboratory

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, Communication Specialist talks about the Periodic Table of Elements 7/17/17 Back to Elements List Fermium is process, but the identification of Pu-244 raised the possibility that still more neutrons could have been discovery of the new elements, and the new data on neutron capture, was kept secret on the orders of the U.S

Staff - Trystan M. Herriott | Alaska Division of Geological & Geophysical

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sandstone interval in outcrop of the Tonnie Siltstone Member, Chinitna Formation, lower Cook Inlet, south Paveloff Siltstone Member of the Chinitna Formation: Exploring the potential role of facies variations in member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska, in Wartes, M.A., ed

NOAA Weather Radio

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. -------------------------------------------------------------------------------- La DESCRIPCIÓN DE COLUMNAS EN TABLAS DE ESTADOS Al hacer un clic en un estado o territorio de la la radio. (Todas áreas de ahora en adelante serán llamados condados.) Entonces la radio les mensaje de la emisión, los oyentes oirán un corto estallido estático digital que señala el fin del

United States Nuclear Data Program (USNDP)

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Report FY 2016 Annual Report FY 2015 Annual Report FY 2014 Annual Report FY 2013 Annual Report FY 2012 Annual Report FY 2011 Annual Report FY 2010 Annual Report FY 2009 Annual Report FY 2008 Annual Report FY 2007 Annual Report FY 2006 Annual Report FY 2005 Annual Report FY 2004 Final Report FY 2003 Final

Staff - Nina T. Harun | Alaska Division of Geological & Geophysical Surveys

Science.gov Websites

mapping of the Upper Jurassic Naknek Formation in a footwall syncline associated with the Bruin Bay fault Ivishak Formation in the northeastern Brooks Range, Alaska: University of Alaska Fairbanks, M.S. thesis Triassic Ivishak Formation in the Sadlerochit Mountains, northeastern Alaska: Alaska Division of Geological

A pooled analysis of CYP2D6 genotype in breast cancer prevention trials of low-dose tamoxifen.

PubMed

Johansson, Harriet; Gandini, Sara; Serrano, Davide; Gjerde, Jennifer; Lattanzi, Monia; Macis, Debora; Guerrieri-Gonzaga, Aliana; Aristarco, Valentina; Mellgren, Gunnar; Lien, Ernst; DeCensi, Andrea; Bonanni, Bernardo

2016-08-01

Decreased CYP2D6 activity is associated with lower levels of active tamoxifen metabolites. We examined the impact of CYP2D6 genotype on tamoxifen pharmacokinetics, biomarker activity, and efficacy in a pooled analysis of low-dose tamoxifen. Four randomized breast cancer prevention trials of very-low-dose (1 mg/day, n = 52 or 10 mg/week, n = 152) or low-dose tamoxifen (5 mg/day, n = 171) were pooled. DNA from 367 subjects was genotyped for CYP2D6 alleles associated with absent (PM allele: *3, *4, *5, *6, *7, *8, *12, and *14), reduced (IM allele: *9, *10, *17, *29, *41), normal (EM allele), or increased (UM: *XN) enzyme activity. Associations of tamoxifen, metabolites, activity biomarkers, and event-free survival with rapid (UM/EM, UM/IM, EM/EM, EM/IM, or EM/PM alleles) versus slow metabolizers (PM/IM or PM/PM) were investigated through random effects models, with 'study' as the random factor, and Cox regression models, adjusting for confounders. Rapid metabolizers had higher endoxifen levels than slow metabolizers: 15.3 versus 12.2 ng/mL (P = 0.018) with 5 mg/day, and 3.8 versus 2.8 ng/mL (P = 0.004) with 1 mg/day or 10 mg/week tamoxifen. The IGF-I decrease correlated with endoxifen (P = 0.002) and 4-hydroxytamoxifen levels, demonstrating steeper decreases at higher metabolite levels (P = 0.001). After a median follow-up of 12 years, rapid metabolizers with prior history of breast neoplasms allocated to tamoxifen 5 mg/day had a 60 % reduction of risk of recurrences (HR = 0.40, 95 % CI: 0.16-0.99) compared to slow metabolizers. CYP2D6 genotype may have an impact on tamoxifen efficacy at low doses. Trials investigating tamoxifen dose adjustments based on the woman's hormonal context and CYP2D6 genotype are warranted.

Salivary steroid response and competitive anxiety in elite basketball players: Effect of opponent level.

PubMed

Arruda, Ademir F S; Aoki, Marcelo S; Paludo, Ana Carolina; Moreira, Alexandre

2017-08-01

This study examined the effect of playing matches against different opponent teams (hard match; HM, medium match; MM, and easy match; EM) on pre-match testosterone concentration (T), pre-to-post match cortisol (C) concentration, and pre-competitive anxiety (CSAI-2 questionnaire) in 20 elite male basketball players. One training session (TS) was also assessed (control condition). Saliva steroids were determined by ELISA. The pre-T concentration was significantly lower for the TS (163±54pmolL -1 ), compared to the three official matches (EM: 208±82pmolL -1 , MM: 213±57pmolL -1 , and HM: 218±37pmolL -1 ) (p<0.05). A significant change in C from pre-to-post was observed for all conditions (TS [5.8±3.7 vs 14.4±9.4ƞmolL -1 ], EM [10.1±4.9 vs 17.3±10.2ƞmolL -1 ], MM [13.0±7.4 vs 21.5±8.3ƞmolL -1 ], and HM [18.9±5.8 vs 31.4±5.3ƞmolL -1 ] (p<0.05). A higher PRE-C was observed for the HM, compared to TS and EM (p<0.05) and a higher POST-C concentration for the HM was detected, compared to the TS, EM, and MM (p<0.05). A lower anxiety level was observed for the EM (somatic: 15.0±3.7; cognitive: 15.8±4.5 arbitrary units [AU]) compared, to the MM (somatic: 16.4±3.5; cognitive: 17.7±4.0AU) and HM (somatic: 15.8±3.9; cognitive: 18.3±3.9AU) (p<0.05) and a higher self-confidence was observed for the TS (28.9±5.1AU), compared to the HM (26.7±3.0AU) (p<0.05). These results suggest that playing against a high-level opponent may cause a higher psychobiological stress, likely because opponent level may be perceived as threating to the social status in a given hierarchy. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevendo a atividade solar através de redes neurais nebulosas

NASA Astrophysics Data System (ADS)

Martin, V. A. F.; Poppe, P. C. R.

2003-08-01

Atualmente, a integração de redes neurais com técnicas da Matemática Nebulosa (Fuzzy Sets), tem sido usada robustamente para fazer previsões em vários sistemas físicos. Este trabalho representa uma continuidade da contribuição apresentada anteriormente durante a XXVIIa Reunião Anual da SAB, onde exploramos a aplicação de redes neurais para previsões futuras de séries temporais. Para este, enfatizamos o uso da técnica ANFIS (Adaptative Neuro-Fuzzy Inference System), que consiste em uma rede do tipo back-propagation, onde os dados são processados em uma camada intermediária, tendo numa camada de saída, os dados numéricos. Para que a previsão seja feita com sucesso utilizando-se técnicas matemáticas adequadas, é fundamental a existência de uma série razoavelmente longa de modo que a dinâmica contida nesta possa ser melhor extraída pela rede neural. Nesse sentido, foram utilizados novamente os dados históricos das manchas do Sol (1818-2002) afim de verificar o comportamento futuro da atividade solar (Ciclos de Schawbe) a partir da técnica descrita acima. Previsões realizadas para o ciclo anterior (n.22, máximo de 158,5 em julho de 1989), bem como para o atual (n.23, máximo de 153 em setembro de 2000), apontam valores bastante coerentes com os publicados na literatura, levando em consideração, respectivamente, as barras de erros associadas: 166+/-18 e 160+/-14. Para o próximo ciclo de Schawbe (2006-2017), nossa previsão aponta o valor de 172+/-23 como máximo para o primeiro semestre de 2011 (Abril +/- 3 meses). A ANFIS acompanha de maneira satisfatória o movimento das séries estudadas durante o treinamento e durante a verificação (menor dispersão das funções de pertinência), com erro absoluto inferior a 20 por cento.

NOAA Weather Radio

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televisión afuera o dentro de la casa. Todos éstos pueden mejorar recepción a cualquier radio de FM , incluso NWR. Cualquier pregunta específica sobre la recepción (o falta de ella) en su sitio debe Search For Go NWS All NOAA NWR Recepción El área de la recepción nominal para un receptor de Radio

Fermilab Today - Related Content

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Fermilab Today Related Content Subscribe | Contact Fermilab Today | Archive | Classifieds Search Experiment Profiles Current Archive Current Fermilab Today Archive of 2015 Archive of 2014 Archive of 2013 Archive of 2012 Archive of 2011 Archive of 2010 Archive of 2009 Archive of 2008 Archive of 2007 Archive of

Neutron Scattering Reference

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Conversion Factors Periodic Table of the Elements Chart of the Nuclides Map of the Nuclides Computer Index of (Atominstitut der Österreichischen Universitäten) Neutron Activation Table of Elements Neutron Scattering at neutronsources.org. The information contained here in the Neutron Scattering Web has been

Homepage

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Reading List Chief of Staff of the Air Force Professional Reading List Menu + Leadership Gateway Force Archives Reading List 2016 Reading List 2015 Reading List 2014 Reading List 2013 Reading List 2012 Reading List 2011 Reading List 2010 Reading List 2009 Reading List 2008 Reading List 2007 Resources Site

Defense.gov Special Report: National Disability Employment Awareness Month

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service at the U.S. Army Corps of Engineers, DeLisa L. Kviz currently works as chief ... Profile photo of of service with the Department of the Navy, including over 11 years ... Profile photo of Ivan E is a technical information specialist in the Analysis and ... Profile photo of Chad A. Molenhour

Learning of Unknown Environments in Goal-Directed Guidance and Navigation Tasks: Autonomous Systems and Humans

NASA Astrophysics Data System (ADS)

Vidal, Joao Vasco Silvestres

Este trabalho expoe um estudo teorico e experimental das propriedades anisotropicas magnetoeletricas (ME) em diferentes compositos contendo monocristais piezoeletricos (PE), maioritariamente sem chumbo na sua composicao, com vista a diversas aplicacoes multifuncionais. Uma descricao linear do efeito ME em termos de campos eletricos, magneticos e elasticos e constantes materiais e apresentada. Um modelo fenomenologico quasi-estatico e usado para ilustrar a relacao entre as constantes materiais, sua anisotropia e os coeficientes MEs transversais de tensao e carga. Subsequentemente, este modelo e empregue para estimar o maximo coeficiente ME direto de tensao expectavel numa serie de compositos tri-camadas de Metglas/Piezocristal/Metglas em funcao da orientacao do cristal PE. Demonstra-se assim como os efeitos MEs sao fortemente dependentes da orientacao cristalina, o que suporta a possibilidade de se gerarem coeficientes MEs de tensao elevados em compositos contendo monocristais PEs sem chumbo como o niobato de litio (LiNbO3; LNO), tantalato de litio (LiTaO3), ortofosfato de galio (GaPO4; GPO), quartzo (SiO2), langatato (La3Ga5.5Ta0.5O14) e langasite (La3Ga5SiO14) atraves da otimizacao da orientacao cristalina. Uma tecnica experimental dinâmica de lock-in para a medicao da impedância e efeito ME direto e exposta. O formalismo descritivo desta tecnica, assim como um arranjo experimental desenvolvido para o efeito sao apresentados. O esquema e caracteristicas deste, assim como diferentes formas de reduzir o ruido e a indesejavel inducao mutua sao exploradas. Um estudo comparativo do efeito ME direto em compositos tri-camadas de Metglas e monocristais de LNO e PMN-PT conectados de forma simples e exposto. Embora o PMN-PT possua piezocoeficientes de carga muito superiores aos do LNO, o coeficiente ME direto de tensao demonstrou-se comparavel entre ambos os compositos devido a uma muito menor permitividade dieletrica do LNO. Calculos teoricos indicam ainda que as propriedades MEs poderao ser significativamente melhoradas (ate 500 V/(cm.Oe)) atraves da otimizacao do ângulo de corte do LNO, espessura relativa entre camadas ferroeletrica/ferromagnetica e uma melhor colagem entre o Metglas e o LNO. Vantagens da utilizacao do material ferroeletrico LNO em compositos MEs sao discutidas. Num estudo subsequente, as propriedades dinâmicas anisotropicas de impedância e MEs em compositos tri-camadas de Metglas e monocristais PEs sem chumbo de LNO e GPO sao exploradas. Medicoes foram realizadas em funcao do corte de cristal, magnitude e orientacao do campo magnetico de polarizacao e frequencia do campo de modulacao. Coeficientes MEs altamente intensos em certos modos de ressonância sao explorados, e a sua relacao com as propriedades materiais dos cristais e geometria dos compositos e investigada. Um coeficiente ME de ate 249 V/(cm.Oe) foi aqui observado num composito com um cristal de LNO com corte 41ºY a 323.1 kHz. Mostramos assim que compositos multicamadas contendo cristais sem chumbo de LNO e GPO podem exibir efeitos MEs anisotropicos relativamente elevados. Demonstramos tambem que o controlo da orientacao dos cristais PEs pode em principio ser usado na obtencao de propriedades MEs anisotropicas desejaveis para qualquer aplicacao. Caracteristicas unicas como elevada estabilidade quimica, piezoeletricidade linear e robusteza termica abrem verdadeiras perspetivas para a utilizacao de compositos baseados no LNO e GPO em diversas aplicacoes. Eventualmente, compositos bi-camadas contendo lâminas PEs com bidominios de LNO com corte 127ºY foram estudados tanto teoricamente como experimentalmente. Estas lâminas de LNO possuem uma estrutura de bidominios com vetores de polarizacao espontânea opostos ao longo da direcao da sua espessura (i.e. uma estrutura de macrodominios ferroeletricos "head-to-head" ou "tail-to-tail") Medicoes de impedância, efeito ME e densidade de ruido magnetico equivalente foram realizadas nos compositos operando sob condicoes quasi-estaticas e de ressonância. Coeficientes MEs de ate 578 V/(cm.Oe) foram obtidos a ca. 30 kHz sob ressonâncias de dobramento usando cristais PEs com 0.5 mm de espessura. Medicoes de densidade de ruido magnetico equivalente demosntraram valores de ate 153 pT/Hz1/2 a 1 kHz (modo quasi-estatico) e 524 fT/Hz1/2 sob condicoes de ressonância. E de esperar que uma otimizacao adicional das tecnicas de fabrico, geometria dos compositos e circuitos de detencao possa permitir reduzir estes valores ate pelo menos 10 pT/Hz1/2 e 250 fT/Hz1/2, respetivamente, e a frequencia de ressonância em pelo menos duas ordens de grandeza. Estes sistemas poderao assim no futuro ser usados em sensores vetoriais de campo magnetico simples e sensiveis, passivos e estaveis e operaveis a elevadas temperaturas. None

C2 of Next-Generation Satellites

DTIC Science & Technology

2013-06-01

held 19-21 June, 2013 in Alexandria, VA. 14. ABSTRACT Space systems have come to be used so extensively that it is almost impossible to imagine...Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 1 Abstract for: C2 of Next-Generation Satellites Space systems have come to be used so...satellites and payloads noted above have generated intense demand for EM spectrum bandwidth, which is expected to increase exponentially in the coming

Chapter 14 - Effects of spruce beetle (Dendroctonus rufipennis) outbreaks on fuels, carbon, and stand structure and composition in Utah and Western Wyoming (Project INT-EM-F-13-02)

Treesearch

Daniel S. Ott; Christopher J. Fettig; Darrell W. Ross; A. Steven. Munson

2018-01-01

Spruce beetle (Dendroctonus rufipennis) is the primary mortality agent of mature spruce species in Western North America (Jenkins and others 2014a, Schmid and Frye 1977). The species preferentially colonizes hosts with reduced defenses, including diseased trees or downed material produced by wind events, snow avalanches, and landslides, as well as...

Stationary Digital Tomosynthesis System for Early Detection of Breast Tumors

DTIC Science & Technology

2012-05-01

Vol. 5745. 2005. 14. Y. Zhang, et al., A comparative study of limited-angle cone-beam reconstruction methods 505 for breast tomosynthesis. Med...opening angl em integratio designed line nia Dimension determine the try calibration th the detector ain is sent fro between XC urce not fou here...screening mammography. AJR, 2007. 189: p. 616. 12. P. Baldelli, et al., A prototype of a quasi-monochromatic system for mammography applications . Phys

Spontaneous Energy Concentration in Energetic Molecules, Interfaces and Composites: Response to Ultrasound and THz Radiation

DTIC Science & Technology

2015-12-21

SUPPLEMENTARY NOTES 14. ABSTRACT The effects of weak energies, THz and ultrasound, on energetic materials, was studied experimentally using laser...project involves fundamental research to investigate the detailed effects of THz and ultrasound, so called " weak energies", on energetic materials...EM). The focus is on mechanisms that produce spontaneous energy concentration. The relevant Navy mission is the potential use of weak energies to

Differential MDR in Breast Cancer Stem Cells

DTIC Science & Technology

2006-05-01

Source: Sanofi -Aventis Grant Title: CMDRP Era of Hope Scholar Award BC044784 Breast Cancer Stem Cells: A Novel Therapeutic Target Role in Project Co...E.M. and Whiteside, T.L. “Processing of Tumors for Vaccine and/or Tumor Infiltrating Lymphocytes”, p. 817-819 in Rose, N.R., Conway de Macario, E...Counterparts, Ernst Schering Res Foundation Workshop, In Press. [14] E.M. Elder, T.L. Whiteside, Processing of tumors for vaccine and/or tumor

Owen Barwell - Chief Financial Officer | NREL

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Owen Barwell - Chief Financial Officer Owen Barwell - Chief Financial Officer A photo of Owen , analysis, and management. He previously served as the Acting Chief Financial Officer and Deputy Chief Financial Officer of the U.S. Department of Energy (DOE), where he was directly responsible for DOE's

Smoot Cosmology Group

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. ___________________________________________________________________________________ What do the different colors on the map of the CMB represent? Although the temperature of the CMB is The most conclusive and carefully examined evidence for The Big Bang is the existence of an isotropic radiation bath that permeates the entirety of the universe known as the cosmic microwave

Automotive Research Center

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| photos Web page Web page 2016 PDF | photos Web page Web page 2015 PDF | photos | video Web page Web page 2014 PDF | photos | videos Web page Web page 2013 PDF | photos Web page Web page 2012 PDF | photos Web page Web page 2011 PDF | photos PDF Web page 2010 PDF PDF PDF 2009 PDF PDF PDF 2008 PDF PDF PDF 2007

NOAA Weather Radio - EAS Description

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio - Outage Reporting

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR SAME

NOAA Weather Radio - Reception Problems

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing interés abajo de dentro de la lista entera del archivo nacional Transmisores de NWR en los Estados ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES

AF family shares experience with child's autism > U.S. Air Force >

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Reading List 2017 CSAF Reading List 2016 CSAF Reading List 2015 CSAF Reading List 2014 CSAF Reading List 2013 CSAF Reading List 2012 CSAF Reading List 2011 CSAF Reading List 2010 CSAF Reading List 2009 CSAF Reading List 2008 CSAF Reading List 2007 CSAF Reading List 2006 CSAF Reading List 50 Years of the CMSAF

X-Ray Data Booklet

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X-RAY DATA BOOKLET Center for X-ray Optics and Advanced Light Source Lawrence Berkeley National Laboratory Introduction X-Ray Properties of Elements Electron Binding Energies X-Ray Energy Emission Energies Table of X-Ray Properties Synchrotron Radiation Characteristics of Synchrotron Radiation History of X

Air and Pesticides

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Pesticides and Human Health Pesticide Incidents What Happens to Pesticides Released into the Environment Pesticides and Human Health Pesticide Incidents What Happens to Pesticides Released into the Environment ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife

Smoot Cosmology Group

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all forces show that they are the same basic force, and have frozen out to different forces in the . What do the different colors on the map of the CMB represent? Although the temperature of the CMB is Implications of the COBE DMR Map of the Early Universe What COBE DMR saw: The COBE DMR (Cosmic

What about using pesticides if I am pregnant or have a baby?

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? Related Topics: Pesticides and Human Health Pesticides and Pregnancy Pesticides and Children Understanding @ace.orst.edu. Last updated January 27, 2016 Related Topics: Pesticides and Human Health Pesticides and ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife

Mineral Resources | Alaska Division of Geological & Geophysical Surveys

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and geophysical framework of Alaska as it pertains to the mineral resources of the state. Summary maps and reports illustrate the geology of the state's prospective mineral terranes and provide data on the location, type, and potential of the state's mineral resources. These data aid in the state's management of

Centro Nacional de Información de Pesticidas - Portada

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a.m. a 12:00 p.m. PT, de lunes a viernes A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Índice acuerdo de cooperación entre la Universidad Estatal de Oregón y la Agencia de Protección Ambiental de los Estados Unidos (acuerdo de cooperación # X8-83560101). La información contenida en esta

NOAA Weather Radio - County Coverage by State

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio - Deaf and Hard of Hearing

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing ±ol Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR

NOAA Weather Radio

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Emergencia (EAS) de la Comisión Federal de Comunicaciones, Radio NOAA es una red para todo tipo de peligros . De este modo, es la fuente más comprensiva de información del tiempo y emergencias que està químicos o derramamientos de petróleo). Conocida como "La Voz del Servicio Nacional de Meteorología

NOAA Weather Radio - Viewing Outages

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR Recepción Explicacion de NWR SAME Programación en Español

Publications - GMC 395 | Alaska Division of Geological & Geophysical

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investigations of the diatom stratigraphy of Borehole TA8, Portage Alaska: Alaska Division of Geological & Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical DGGS GMC 395 Publication Details Title: Preliminary investigations of the diatom stratigraphy of

CXRO - Mi-Young Im, Staff Scientist

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X-Ray Database Zone Plate Education Nanomagnetism X-Ray Microscopy LDJIM EUV Lithography EUV Mask Publications Contact The Center for X-Ray Optics is a multi-disciplined research group within Lawrence Berkeley -Ray Optics X-Ray Database Nanomagnetism X-Ray Microscopy EUV Lithography EUV Mask Imaging

Solar Integration Data Sets | Grid Modernization | NREL

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modeled solar data to study the operational impacts of solar on the electric power grid. Solar Power Data need to estimate power production from hypothetical solar power plants. Solar Integration National Dataset (SIND) Toolkit The next generation of modeled solar data with higher temporal and spatial

CNEA - Centro Atómico Bariloche

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³mica (CNEA), a través de la Sección de... EL RA-6, RENOVADO EN EL AÑO DE SU 35º ANIVERSARIO EL RA-6 DIRIGIDAS A DOCENTES REALIZAN EN EL CAB CAPACITACIONES DIRIGIDAS A... La Comisión Nacional de Energía Atà ... RECONOCIMIENTO PARA LA SECCIÓN DE DIVULGACIÓN CIENTÍFICA Y TECNOLÓGICA DEL CAB RECONOCIMIENTO PARA LA SECCIÃ

NOAA Weather Radio

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para un condado depende de recepción de la seña fiable, que típicamente se extiende en un radio de 40 millas del transmisor, asumiendo terreno plano. Condados sin la cobertura de NWR o cobertura obstáculos de la seña y/o la distancia excesiva del transmisor. Usted puede referirse directamente a

Defense.gov - Special Report - Travels With Gates

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. If you wish to see the latest content, please visit the current version of the site. For persons with look at production of the newest all-terrain vehicles slated for Afghanistan, and praised the modern You have reached a collection of archived material. The content available is no longer being

Publications - PIR 2008-1 | Alaska Division of Geological & Geophysical

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investigations in the Brooks Range Foothills and North Slope, Alaska: Alaska Division of Geological & interpretations of the Nanushuk Formation exposed along the Colville River near the confluences with the Awuna and Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

Periodic Table of Elements: Los Alamos National Laboratory

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, Communication Specialist talks about the Periodic Table of Elements 7/17/17 Back to Elements List Seaborgium is Phone Periodic Table of Elements: LANL Chemistry Division » Periodic Table of Elements Chemistry the Elements Chemical Properties Elements List Periodic Table Download News LANL Biofuels Work

NIST Digital Archives

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Nederlands Français Search Search Advanced Search Find results with: error div Add another field Search by date Search by date: from after before on from: mm/dd/yyyy to to: mm/dd/yyyy Search Clear All Searching physical science laboratories. Instant Search Search PHOTOS Search Photos Search NIST PUBLICATIONS Search

Comparison of Two Central Venous Pressure Control Strategies to Prevent Atrial Fibrillation After Coronary Artery Bypass Grafting.

PubMed

Costa, Mario Augusto Cray da; Lirani, Wesley; Wippich, Ana Caroline; Lopes, Luana; Tolentino, Eduardo de Souza; Zampar, Beatriz; Schafranski, Marcelo Derbli

2017-04-01

Atrial fibrillation (AF) takes place in 10-40% of patients undergoing coronary artery bypass grafting (CABG), and increases cardiovascular mortality. Enlargement of atrial chambers is associated with increased AF incidence, so patients with higher central venous pressure (CVP) are expected to have larger atrial distension, which increases AF incidence. To compare post-CABG AF incidence, following two CVP control strategies. Interventional, randomized, controlled clinical study. The sample comprised 140 patients undergoing CABG between 2011 and 2015. They were randomized into two groups, G15 and G20, with CVP maintained ≤ 15 cmH2O and ≤ 20 cmH2O, respectively. 70 patients were included in each group. The AF incidence in G15 was 8.57%, and in G20, 22.86%, with absolute risk reduction of 14.28%, and number needed to treat (NNT) of 7 (p = 0.03). Mortality (G15 = 5.71%; G20 = 11.42%; p = 0.07), hospital length of stay (G15 = 7.14 days; G20 = 8.21 days; p = 0.36), number of grafts (median: G15 = 3, G2 = 2; p = 0.22) and cardiopulmonary bypass use (G15 = 67.10%; G20 = 55.70%; p = 0.22) were statistically similar. Age (p = 0.04) and hospital length of stay (p = 0.001) were significantly higher in patients who developed AF in both groups. Keeping CVP low in the first 72 post-CABG hours reduces the relative risk of AF, and may be useful to prevent AF after CABG. A fibrilação atrial (FA) ocorre em 10-40% dos pacientes submetidos a cirurgia de revascularização miocárdica (RM), e eleva a mortalidade cardiovascular. Como o aumento dos átrios está associado ao aumento da incidência de FA, espera-se que pacientes com pressão venosa central (PVC) mais alta tenham maior distensão atrial, o que eleva a incidência dessa arritmia. Comparar a incidência de FA em pós-operatório de RM, seguindo duas estratégias de controle de PVC. Estudo clínico randomizado controlado intervencionista. A amostra foi composta por 140 pacientes submetidos a RM entre 2011 e 2015. Os pacientes foram randomizados em dois grupos, G15 e G20, mantidos com PVC máxima de 15 cmH2O e 20 cmH2O, respectivamente. Foram incluídos 70 pacientes em cada grupo. A incidência da arritmia em G15 foi de 8,57% e, no G20, de 22,86%, com redução de risco absoluto de 14,28% e número necessário para tratar (NNT) de 7 (p = 0,03). Mortalidade (G15 = 5,71%; G20 = 11,42%; p = 0,07), tempo de internamento (G15 = 7,14 dias; G20 = 8,21 dias; p = 0,36), número de enxertos (medianas: G15 = 3, G2 = 2; p = 0,22) e uso de circulação extracorpórea (G15 = 67,10%; G20 = 55,70%; p = 0,22) mostraram-se estatisticamente semelhantes. A idade (p = 0,04) e o tempo de internamento (p = 0,001) foram significativamente maiores nos pacientes que desenvolveram FA nos dois grupos. Manter a PVC com valores mais baixos nas primeiras 72h após a cirurgia de RM reduz o risco relativo de FA e pode ser uma ferramenta útil na prevenção da FA após RM.

Department of Navy Chief Information Officer

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(6) Freedom of Information Act (29) IT Investment Management (47) Records Management (37 Management and Knowledge Management programs. DON CIO Information About the DON CIO Website Accessibility this website is to facilitate effective information flow about information management/information

Prevalence of methicillin-resistant Staphylococcus aureus on the stethoscopes of emergency medical services providers.

PubMed

Merlin, Mark A; Wong, Matthew L; Pryor, Peter W; Rynn, Kevin; Marques-Baptista, Andreia; Perritt, Rachael; Stanescu, Catherine G; Fallon, Timothy

2009-01-01

The investigation seeks to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) on the stethoscopes of emergency medical services (EMS) providers. While stethoscopes are known fomites for MRSA, the prevalence of MRSA in the prehospital setting is not well documented in the literature. This was a prospective, observational cohort study of 50 stethoscopes provided by consecutive, consenting EMS providers at our academic emergency department (ED). Stethoscopes were swabbed with saline culture applicators and samples were cultured on a commercial MRSA test kit containing mannitol salt agar with oxacillin. After 72 hours of incubation at 37 degrees C, two emergency physicians and one microbiologist analyzed the plates independently. MRSA colonization was recorded as positive if all three reviewers agreed that colonization had occurred. Of 50 stethoscopes, 16 had MRSA colonization, and 16 (32%) EMS professionals had no recollection of when their stethoscopes had been cleaned last. Reported length of time since last cleaning was grouped into six categories: one to seven days, eight to 14 days, 15 to 30 days, 31 to 180 days, 181 days to 365 days, and unknown. The median time frame reported since the last cleaning was one to seven days. In the model, an increase from one time category to the next increased the odds of MRSA colonization by 1.86 (odds ratio = 1.86, p = 0.038). In this ED setting, MRSA was found on approximately one in three stethoscopes of EMS professionals. A longer length of time since the last stethoscope cleaning increased the odds of MRSA colonization.

On Effective Radiative Forcing of Partial Internally and Externally Mixed Aerosols and Their Effects on Global Climate

NASA Astrophysics Data System (ADS)

Zhou, Chen; Zhang, Hua; Zhao, Shuyun; Li, Jiangnan

2018-01-01

The total effective radiative forcing (ERF) due to partial internally mixed (PIM) and externally mixed (EM) anthropogenic aerosols, as well as their climatic effects since the year of 1850, was evaluated and compared using the aerosol-climate online coupled model of BCC_AGCM2.0_CUACE/Aero. The influences of internal mixing (IM) on aerosol hygroscopicity parameter, optical properties, and concentration were considered. Generally, IM could markedly weaken the negative ERF and cooling effects of anthropogenic aerosols. The global annual mean ERF of EM anthropogenic aerosols from 1850 to 2010 was -1.87 W m-2, of which the aerosol-radiation interactive ERF (ERFari) and aerosol-cloud interactive ERF (ERFaci) were -0.49 and -1.38 W m-2, respectively. The global annual mean ERF due to PIM anthropogenic aerosols from 1850 to 2010 was -1.23 W m-2, with ERFari and ERFaci of -0.23 and -1.01 W m-2, respectively. The global annual mean surface temperature and water evaporation and precipitation were reduced by 1.74 K and 0.14 mm d-1 for EM scheme and 1.28 K and 0.11 mm d-1 for PIM scheme, respectively. However, the relative humidity near the surface was slightly increased for both mixing cases. The Intertropical Convergence Zone was southwardly shifted for both EM and PIM cases but was less southwardly shifted in PIM scheme due to the less reduction in atmospheric temperature in the midlatitude and low latitude of the Northern Hemisphere.

Alternative Fuels Data Center: Recursos en español

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colaboración entre el gobierno y la industria patrocinada por el Programa de Tecnologías de Vehículos del enchufables Recursos en la web Use estas recursos para obtener información sobre: Economía de combustible y huella de carbono de su vehículo Cómo aumentar la economía de combustible Importancia de la economía

NOAA Weather Radio

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¡tico de programación de la Radio del Tiempo de NOAA la capacidad de transmitir en español. Cualquier Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Search For Go NWS All NOAA Las Políticas de Programación en Español Se le añadió al sistema automÃ

Operating the Western Interconnection with 80%-90% Renewables - Text

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different penetration levels. This chart here shows the left column is the actual penetration of the renewables in all of the different scenarios. The higher base load and the higher VG before curtailment are to a lot of results. This next slide shows the generation by the different types of both renewable

Characteristics of evidence-based medicine training in Royal College of Physicians and Surgeons of Canada emergency medicine residencies - a national survey of program directors.

PubMed

Bednarczyk, Joseph; Pauls, Merril; Fridfinnson, Jason; Weldon, Erin

2014-03-21

Recent surveys suggest few emergency medicine (EM) training programs have formal evidence-based medicine (EBM) or journal club curricula. Our primary objective was to describe the methods of EBM training in Royal College of Physicians and Surgeons of Canada (RCPSC) EM residencies. Secondary objectives were to explore attitudes regarding current educational practices including e-learning, investigate barriers to journal club and EBM education, and assess the desire for national collaboration. A 16-question survey containing binary, open-ended, and 5-pt Likert scale questions was distributed to the 14 RCPSC-EM program directors. Proportions of respondents (%), median, and IQR are reported. The response rate was 93% (13/14). Most programs (85%) had established EBM curricula. Curricula content was delivered most frequently via journal club, with 62% of programs having 10 or more sessions annually. Less than half of journal clubs (46%) were led consistently by EBM experts. Four programs did not use a critical appraisal tool in their sessions (31%). Additional teaching formats included didactic and small group sessions, self-directed e-learning, EBM workshops, and library tutorials. 54% of programs operated educational websites with EBM resources. Program directors attributed highest importance to two core goals in EBM training curricula: critical appraisal of medical literature, and application of literature to patient care (85% rating 5 - "most importance", respectively). Podcasts, blogs, and online journal clubs were valued for EBM teaching roles including creating exposure to literature (4, IQR 1.5) and linking literature to clinical practice experience (4, IQR 1.5) (1-no merit, 5-strong merit). Five of thirteen respondents rated lack of expert leadership and trained faculty educators as potential limitations to EBM education. The majority of respondents supported the creation of a national unified EBM educational resource (4, IQR 1) (1-no support, 5- strongly support). RCPSC-EM programs have established EBM teaching curricula and deliver content most frequently via journal club. A lack of EBM expert educators may limit content delivery at certain sites. Program directors supported the nationalization of EBM educational resources. A growing usage of electronic resources may represent an avenue to link national EBM educational expertise, facilitating future collaborative educational efforts.

Association of the protein tyrosine phosphatase non-receptor 22 polymorphism (PTPN22) with endometriosis: a meta-analysis.

PubMed

Pabalan, Noel; Jarjanazi, Hamdi; Christofolini, Denise Maria; Bianco, Bianca; Barbosa, Caio Parente

2017-01-01

To evaluate PTPN22 C1858T polymorphism and the risk of endometriosis. A meta-analysis of 10 published case-control studies (from four articles), with a total sample of 971 cases and 1,181 controls, was performed. We estimated risk (odds ratio and 95% confidence intervals) of endometriosis associations with the C1858T polymorphism. A significant increased risk in all genetic models of the variant T allele with endometriosis (odds ratio: 3.14-5.55; p<0.00001-0.002) was found. The analysis without the study whose controls deviated from the Hardy-Weinberg equilibrium exacerbated these effects in the homozygous and recessive models (odds ratio: 7.19-9.45; p<0.00001-0.0002). In the Italian subgroup, a significant risk association was found in the homozygous and recessive models (odds ratio: 8.72-11.12; p=0.002). The associations observed between PTPN22 (C1858T) and the risk of endometriosis suggest this polymorphism might be a useful susceptibility marker for this disease. Avaliar o polimorfismo PTPN22 C1858T e o risco de endometriose. Foi realizada uma metanálise de 10 estudos caso-controle publicados (a partir de quatro artigos), com uma amostra total de 971 casos e 1.181 controles. O risco da associação da endometriose com o polimorfismo C1858T foi estimado em razão de chance e intervalo de confiança de 95%. Observou-se um aumento de risco significativo em todos os modelos genéticos com o alelo variante T e a endometriose (razão de chance: 3,14-5,55; p<0,00001-0,002). A análise sem incluir o estudo, em que os controles não estavam em equilíbrio de Hardy-Weinberg, mostrou aumento significativo nos modelos homozigotos e recessivos (razão de chance: 7,19-9,45; p<0,00001-0,0002). No subgrupo italiano, uma associação significativa foi encontrada considerando os modelos homozigoto e recessivo (razão de chance: 8,72-11,12; p=0,002). As associações observadas entre PTPN22 (C1858T) e o risco de endometriose sugerem que este polimorfismo pode ser um marcador de suscetibilidade para a endometriose.

Philip A. Parilla | NREL

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atomic layer deposition for applications. He also manages the majority of X-ray characterization equipment at NREL, specifically X-ray diffraction and X-ray fluorescence instrumentation. Additionally, he for EERE's Hydrogen Storage program. He is also an expert in X-ray diffraction and X-ray fluorescence

Energy Analysis Publications | Energy Analysis | NREL

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Systems Impact Analysis We perform impact analysis to evaluate and understand the impact of markets publications. Featured Publications Complex Systems Analysis Complex systems analysis integrates all aspects of , policies, and financing on technology uptake and the impact of new technologies on markets and policy

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NREL's Advanced Atomic Layer Deposition Enables Lithium-Ion Battery

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Battery Technology News Release: NREL's Advanced Atomic Layer Deposition Enables Lithium-Ion Battery increasingly demanding needs of any battery application. These lithium-ion batteries feature a hybrid solid further customized lithium-ion battery materials for high performance devices by utilizing our patented

Chunmei Ban | NREL

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degradation in silicon nanowires for lithium ion battery," ACS Nano, 2015, 9(5), pp 5559-5566, DOI molecular layer deposited coating on silicon nanoparticles for lithium ion battery anodes," ACS Nano lithium-ion batteries, lithium-air batteries, organic radical batteries, and magnesium-ion batteries. The

Transportation Research News | Transportation News | Transportation

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Engineering has yielded new insights for lithium-ion (Li-ion) battery electrodes at the microstructural level -Phase Stochastics in Lithium-Ion Battery Electrodes" detailing the research and resulting revolutionizes the way lithium-ion (Li-ion) batteries are evaluated so designs can be improved before batteries

DoD ESI

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Information Management, Microsoft Platform Management, Identity & Access Management, Endpoint Systems /2016-24054/category-management). OMB released this IT Success Story for "Information Sharing Management of Common Information Technology: Mobile Devices and Services 7/1/2016 Category Management Policy

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para un condado depende de recepción de la seña fiable, que típicamente se extiende en un radio de 40 millas del transmisor, asumiendo terreno plano. Condados sin la cobertura de NWR o cobertura obstáculos de la seña y/o la distancia excesiva del transmisor. Usted puede referirse directamente a

DIY Solar Market Analysis Webinar Series: PVWatts® | State, Local, and

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, and updates the energy prediction algorithms to be in line with the actual performance of modern the latest update." In this webinar, one of the tool's developers explains how the new version of ® Wednesday, July 9, 2014 As part of a Do-It-Yourself Solar Market Analysis summer series, NREL's Solar

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who have a lot of experience in this area may handle the process on their own while others may decide greatest number of respondents and give the agency the greatest number of options. Solar RFP Elements As to the selection criteria. Sources Solar Powering Your Community: Key Elements of Solar Requests for

What's New | Galaxy of Images

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has the ability to view various parts of a frog from many different angles, and with the different here - the Virtual Dissection Kit - has been accessed by 50,000 different sites, in over 50 different form document that is a translation of the user interface into a different language (the Virtual Frog

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: Formation hardness of Hemlock Formation cores after immersion in water and oil based fracturing fluids; and mechanics: Formation hardness of Hemlock Formation cores after immersion in water and oil based fracturing Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

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Turbine Control Systems Wind Turbine Control Systems Advanced wind turbine controls can reduce the loads on wind turbine components while capturing more wind energy and converting it into electricity turbines. A photo of a wind turbine against blue sky with white blades on their sides in the foreground

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Wind Energy Modeling and Simulation Wind Turbine Modeling and Simulation Wind turbines are unique wind turbines. It enables the analysis of a range of wind turbine configurations, including: Two- or (SOWFA) employs computational fluid dynamics to allow users to investigate wind turbine and wind power

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Energy for Wind Systems Today Cost and Value of Wind Power-Implications of Wind Turbine Design, János Aaron Smith, PPI Session II: Uncertainty Impacts on Wind Turbine Design and Performance Mitigation of Wind Turbine Design Load Uncertainties, Anand Natarajan, DTU Wind Energy Uncertainty in the Wind

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DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE NAM CONUS NEST? (04 Nov 2011, updated 13 April 2017 . Back to Table of Contents WHY IS THE QPF DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE NAM different QPF fields between the 12km NAM parent and the NAM nests. 13 April 2017 update: In the 12 August

NOAA Weather Radio - Using NWR SAME

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NOAA Weather Radio - General Information

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Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing - Special Needs ESPAÑOL Español Condado de cobertura Listado de estación Lista de Emisora y Cobertura Acerca de NWR ESTACIONES NACIONAL Información General Información Para el consumidor receptor NWR

The Sky This Week, 2016 April 26 - May 3 - Naval Oceanography Portal

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the week coursing through the summer Milky Way, skirting the southern reaches of the ecliptic in the morning sky. Last Quarter occurs on the 29th at 11:29 pm Eastern Daylight Time. As Luna wanes through her begins on the 29th and lasts through May 8th. This month's target constellation is Leo, the Lion, which

The Evolving Search for the Nature of Dark Energy | Berkeley Lab

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percent of its contents is ordinary matter, 24 percent is dark matter, and all the rest is dark energy ordinary matter, 24 percent is dark matter, and all the rest is dark energy - unless there's a flaw in our Universe, and it's pushing all the rest - ordinary matter and dark matter - farther apart at an ever

[Neuropsychological study of false memory in patients with amnesia mild cognitive impairment].

PubMed

Xie, Dan-dan; Cheng, Huai-dong; Yin, Chang-lin; Lü, Xin-yi; Wang, Kai

2011-01-18

To explore the profile of false memory in aMCI (amnesia mild cognitive impairment) and to elucidate the neuropsychological mechanism of false memory. False memory provoked by pictures and feeling-of-knowing (FOK) test in episodic memory (EM) were conducted in 25 aMCI patients at our hospital from October 2009 to May 2010. And 25 age and education level-matched healthy patients were recruited into the healthy control (HC) group. As compared with HC group, the rate of false memory was higher in the aMCI group. The rate of false memory in recall stage was 26% ± 7% and that of questionnaire stage 28% ± 12%. And the difference between two group was significant (t = 14.437, 7.597, P < 0.05). The FOK-EM of correct judgment and false recognition in the aMCI group (41% ± 10%) was higher than the HC group. And the difference was significant (t = 4.207, P < 0.05). The rates of false memory in recall and questionnaire stages were positively correlated with FOK-EM in aMCI group (r = 0.563, 0.705, P < 0.01). The aMCI patients tend to have more false memory provoked by pictures. The deficit of memory monitoring in aMCI may be the foundation of false memory.

Using Electromagnetic Microwave Field Combined With Laserotherapy in Postoperative Period of Patients With Purulent-Inflammatory Diseases of the Hand in Outpatient Clinic

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

Rabenok, L.; Grimalsky, V.; Juarez R, D.

2008-08-11

The results of a treatment of 51 patients with purulent-inflammatory diseases of the hand in outpatient clinic are analyzed; a new method of treatment using electromagnetic (EM) microwave field combined with laserotherapy was applied. A portable apparatus was used that operates in the millimeter (mm) wave range in 4 regimes of an intensity 2-10 mW/cm{sup 2} and a red laser of 0.65 {mu}m wavelength of a low intensity 10-15 mW/cm{sup 2}. A peculiarity of the method was an absence of any antibacterial medicine. An exposure of an influence was 10 min. The total course included 5-7 applications. An influence ofmore » low intensity EM radiation was started 15-20 min before the operation. The action was to the center of purulent inflammation and to the biological active points of acupuncture (G14, E36). Starting from the first day since the operation, the low intensity EM radiation was applied to the biological active points combined with laserotherapy to the wound in the sedative regime (the repetition rate 9-10 Hz) during 10 min. Clinical symptomatology, radiographic findings, the results of microbiologic, morphologic studies were analyzed as well and were satisfactory (without any complications)« less

Polarization-dependent bi-functional metasurface for directive radiation and diffusion-like scattering

NASA Astrophysics Data System (ADS)

Cui, Li; Wang, Wenjun; Ding, Guowen; Chen, Ke; Zhao, Junming; Jiang, Tian; Zhu, Bo; Feng, Yijun

2017-11-01

In this paper, we design a bi-functional metasurface with different spatial distribution of reflection phase responses depending on the incident polarization. The metasurface with a thickness of only 0.067 λ0 (λ0 is the working wavelength) is constructed by unit cells composing two orthogonal I-shaped metallic structures, and the reflection phase for x- and y-linearly polarized incidence can be independently controlled by the geometric parameters. The metasurface can work as a flat parabolic reflector antenna with a maximum gain reaching about 22 dBi around 9.5 GHz, when it is illuminated by the x-polarized feed source of an offset open-ended waveguide antenna. Meanwhile, designed with randomly distributed reflection phases, the proposed metasurface can behave as an electromagnetic (EM) diffusion-like surface, which is capable of suppressing the backward scattering in a broadband from 8.5 GHz to 14 GHz for y-polarized incidence. By this strategy of EM functionality integration, a metasurface reflector antenna equipped with stealth technique to achieve simultaneously high gain and low backward scattering is obtained. Finally, experiments have been carried out to demonstrate this design principle, which agree with the simulation results. The proposed metasurface could offer a promising route for designing EM devices with polarization-dependent multi-functionalities.

Grouped fuzzy SVM with EM-based partition of sample space for clustered microcalcification detection.

PubMed

Wang, Huiya; Feng, Jun; Wang, Hongyu

2017-07-20

Detection of clustered microcalcification (MC) from mammograms plays essential roles in computer-aided diagnosis for early stage breast cancer. To tackle problems associated with the diversity of data structures of MC lesions and the variability of normal breast tissues, multi-pattern sample space learning is required. In this paper, a novel grouped fuzzy Support Vector Machine (SVM) algorithm with sample space partition based on Expectation-Maximization (EM) (called G-FSVM) is proposed for clustered MC detection. The diversified pattern of training data is partitioned into several groups based on EM algorithm. Then a series of fuzzy SVM are integrated for classification with each group of samples from the MC lesions and normal breast tissues. From DDSM database, a total of 1,064 suspicious regions are selected from 239 mammography, and the measurement of Accuracy, True Positive Rate (TPR), False Positive Rate (FPR) and EVL = TPR* 1-FPR are 0.82, 0.78, 0.14 and 0.72, respectively. The proposed method incorporates the merits of fuzzy SVM and multi-pattern sample space learning, decomposing the MC detection problem into serial simple two-class classification. Experimental results from synthetic data and DDSM database demonstrate that our integrated classification framework reduces the false positive rate significantly while maintaining the true positive rate.

Using Electromagnetic Microwave Field Combined With Laserotherapy in Postoperative Period of Patients With Purulent-Inflammatory Diseases of the Hand in Outpatient Clinic

NASA Astrophysics Data System (ADS)

Rabenok, L.; Grimalsky, V.; Juárez-R., D.

2008-08-01

The results of a treatment of 51 patients with purulent-inflammatory diseases of the hand in outpatient clinic are analyzed; a new method of treatment using electromagnetic (EM) microwave field combined with laserotherapy was applied. A portable apparatus was used that operates in the millimeter (mm) wave range in 4 regimes of an intensity 2-10 mW / cm2 and a red laser of 0.65 μm wavelength of a low intensity 10-15 mW / cm2 . A peculiarity of the method was an absence of any antibacterial medicine. An exposure of an influence was 10 min. The total course included 5-7 applications. An influence of low intensity EM radiation was started 15-20 min before the operation. The action was to the center of purulent inflammation and to the biological active points of acupuncture (G14, E36). Starting from the first day since the operation, the low intensity EM radiation was applied to the biological active points combined with laserotherapy to the wound in the sedative regime (the repetition rate 9-10 Hz) during 10 min. Clinical symptomatology, radiographic findings, the results of microbiologic, morphologic studies were analyzed as well and were satisfactory (without any complications).

Predicting contraceptive vigilance in adolescent females: a projective method for assessing ego development.

PubMed

Speier, P L; Mélèse-D'Hospital, I A; Tschann, J M; Moore, P J; Adler, N E

1997-01-01

To test the hypothesis that ego development would predict contraceptive use. Problems in ego development were defined in terms of three factors: (1) realism, (2) complexity, and (3) discontinuity. Forty-one respondents aged 14-17 years were selected from a group of 233 adolescents who were administered a projective pregnancy scenario and participated in a 12-month follow-up. Twenty of these adolescents were randomly selected from the group determined to be effective contraceptive users, while 21 were randomly selected from the group of poor contraceptors. Chi-square test revealed a significant association (p < .0005) between the composite ego maturity (EM) measure and contraceptive outcome (chi 2 = 13.82, with df-1). Low scores on the ego maturity measure predicted poor contraceptive use. EM was unrelated to age but was associated with race (chi 2 = 7.535, .025 < p < .05). However, EM predicted contraceptive use when controlling for the effects of race. A simple, time-efficient projective pregnancy scenario is an effective way of determining adolescent females at risk for poor contraceptive effectiveness and, therefore, untimely pregnancy. These stories are analyzed using factors related to the ego development of the adolescent. Subjects who scored lower on this measure have poor contraceptive effectiveness while subjects with higher levels demonstrated effective contraception use, at 1-year follow-up.

Chief Information Officer > About DoD CIO > Organization > DCIO CS

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Skip to main content (Press Enter). Toggle navigation Chief Information Officer Search Search Chief Information Officer: Search Search Chief Information Officer: Search Chief Information Officer U.S. Department of Defense Chief Information Officer Home About DoD CIO Bios Organization DCIO C4&IIC DCIO IE

Defense.gov - Special Report - Progress Report: Department of Defense

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the need to re-shape and re-balance the direction of the Department and an increasingly challenging capabilities, requirements, risks and needs for the purpose of shifting the Department toward a different , the Landing Platform Dock ship and Mobile Landing Platform ship; and Completing production of the C-17

Publications - PIR 2015-5 | Alaska Division of Geological & Geophysical

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superposition of strike-slip and reverse-slip faults in the Bruin Bay fault system, Ursus Head, lower Cook Inlet , Preliminary investigation of fracture populations in Mesozoic strata of the Cook Inlet forearc basin: Iniskin observations: Continued facies analysis of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska

Publications - GMC 329 | Alaska Division of Geological & Geophysical

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Bee Creek 1976 holes of Chignik C2 Quadrangle (B-1, 265'; B-2, 500'; B-3, 500'; B-4, 300' and B-5, 300 the Bee Creek 1976 holes of Chignik C2 Quadrangle (B-1, 265'; B-2, 500'; B-3, 500'; B-4, 300' and B-5

NOAA Weather Radio

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Search For Go NWS All NOAA NWR Recepción El área de la recepción nominal para un receptor de Radio cosas afectan la recepción de señas de la radio. Por ejemplo, las extensiones grandes de agua de sal de NWR. Siga leyendo si está dentro del área pero tiene dificultad con recepción. Su seña de la

Developmental stage-associated differences in the transplacental distribution of 13-cis- and all-trans-retinoic acid as well as their glucuronides in rats and mice.

PubMed

Tzimas, G; Collins, M D; Nau, H

1995-07-01

In mice and rats, 13-cis-retinoic acid (13-cis-RA) has a much lower teratogenic potency than all-trans-retinoic acid (all-trans-RA). Previous studies on Gestational Day (GD) 11 or 12 (in mice or rats, respectively) showed a limited transfer of 13-cis-RA to the embryo, in contrast to the efficient transplacental passage of all-trans-RA. In the present study we examined if the distribution between maternal circulation and embryo of 13-cis- and all-trans-RA as well as their metabolites is different at gestational times when the placenta is developing from a choriovitelline to a chorioallantoic type. In the first experiment, 13-cis-RA was administered orally to pregnant rats (75 mg/kg/day) daily, from either GD 7 to 12 or 11 to 16. In the second experiment, 13-cis-RA or all-trans-RA was given orally to pregnant mice once on either GD 11 or 14, at two dose levels (10 and 100 mg/kg). HPLC analysis of plasma and embryo samples collected at various time points post-treatment showed that 13-cis-RA was predominantly metabolized to its beta-glucuronide (13-cis-RAG) while all-trans-RA was primarily biotransformed to all-trans-4-oxo-RA and to a lesser extent to all-trans-RAG. 13-cis-RA showed a more efficient transplacental passage to the rat embryo on GD 16 than on GD 12, as indicated by higher ratios of embryonic to maternal plasma concentrations (E/M concentration ratio) on GD 16 vs. GD 12 and its E/M ratio of area-under-the-concentration-time-curve values (E/M AUC ratio; twofold higher on GD 16 vs. GD 12). In the mouse, the E/M concentration ratio of 13-cis-RA was significantly higher on GD 14 than on GD 11 only at the low dose. On the other hand, all-trans-RA and all-trans-4-oxo-RA showed an efficient transfer to the mouse embryo at both gestational times. In both species, 13-cis- and all-trans-RAG embryonic concentrations on the later gestational days exceeded significantly the corresponding ones on the earlier gestational days which resulted in far higher E/M concentration and AUC ratios for each of these metabolites on the later vs earlier gestational days. This may result from a more efficient placental transfer of the RAGs during later gestational stages and/or higher capacity of the late embryo or other conceptal tissues to biotransform RAs in situ to their glucuronides.(ABSTRACT TRUNCATED AT 400 WORDS)

Research | Photovoltaic Research | NREL

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-V cells Hybrid tandems Polycrystalline Thin-Film PV CdTe solar cells CIGS solar cells Perovskites and Organic PV Perovskite solar cells Organic PV solar cells Advanced Materials, Devices, and Science Interfacial and Surface Science Reliability and Engineering Real-Time PV and Solar Resource

Chioke Harris | NREL

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transfer and materials science to the development of high-performance building components. He is member of the Building Energy Science Group, his research focuses on the application of fundamental heat particularly interested in the development of novel opaque insulation and window frame materials using nano

Water Power Research | Water Power | NREL

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Water Power Research Water Power Research NREL conducts water power research; develops design tools Columbia River, Washington. Hydropower Research Hydropower technologies convert the energy of water moving ; and evaluates, validates, and supports the demonstration of innovative water power technologies. Photo

Mengjin Yang | NREL

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on the formation of higher efficiency formamidinium lead triiodide-based solar cells," Chem -0003-2019-4298 Dr. Mengjin Yang received his Ph.D. in Materials Science from the University of Pittsburgh, where he investigated nanomaterials for solar energy conversion under the supervision of Prof

Geothermal Energy | Climate Neutral Research Campuses | NREL

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Geothermal Energy Geothermal Energy Research campuses can take advantage of geothermal resources sections that describe how examining geothermal energy may fit into your climate action plans. Campus Options Considerations Sample Project Related Links Campus Geothermal Energy Options Campuses can use

Battery Control Algorithms | Transportation Research | NREL

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publications. Accounting for Lithium-Ion Battery Degradation in Electric Vehicle Charging Optimization Advanced Reformulation of Lithium-Ion Battery Models for Enabling Electric Transportation Fail-Safe Design for Large Capacity Lithium-Ion Battery Systems Contact Ying Shi Email | 303-275-4240

A retrospective review of hyperaesthetic leucotrichia in horses in the USA.

PubMed

Goodale, Elizabeth C; White, Stephen D; Outerbridge, Catherine A; Everett, Angela D; Affolter, Verena K

2016-08-01

Hyperaesthetic leucotrichia (HL) rarely affects horses and causes painful lesions on the dorsum that result in leucotrichia. This may be a variant of erythema multiforme (EM), but there are no studies investigating this condition. Describe the clinical and histological features of HL and compare them to the histological features of EM. A retrospective review of medical records from 1985 to 2015 identified 15 horses with HL. Thirteen biopsies of HL and five of EM were evaluated and compared. Arabian horses and their crosses (χ(2) (1)  = 8.56, P < 0.01) and American paint horses (χ(2) (1)  = 6.64, P < 0.05) were over represented. The onset of clinical signs was between April and September (14 of 15). The most common clinical signs were pain (15 of 15), leucotrichia (11 of 15), crusting (10 of 15) and alopecia (8 of 15) limited to darkly pigmented skin. The lesions recurred seasonally in 6 of 12 horses and unpredictably in 1 of 12 horse. The most common histological features were the presence of large stellate cells (13 of 13) and oedema (12 of 13) in the superficial dermis, perivascular to diffuse lymphocytic inflammation (13 of 13), pigmentary incontinence (12 of 13), apoptotic keratinocytes (9 of 13) and vesicle formation (8 of 13). Horses with EM (n = 5) had significantly more acanthosis (z = -2.40, P < 0.02) and lymphocytic exocytosis (z = -3.1, P < 0.004), satellitosis (Fisher's exact P = 0.02) and inflammation (z = -2.91, P < 0.004). Horses with HL had significantly more pigmentary incontinence (z = 2.13, P < 0.04) and superficial dermal oedema (z = 2.56, P < 0.002). HL affects primarily Arabian horses and American paint horses. It occurs mainly in summer and may recur. Histologically HL shares features with EM, but there are significant differences between them. © 2016 ESVD and ACVD.

Quality Improvement Practices in Academic Emergency Medicine: Perspectives from the Chairs

PubMed Central

DelliFraine, Jami; Langabeer, James; King, Brent

2010-01-01

Objective To assess academic emergency medicine (EM) chairs’ perceptions of quality improvement (QI) training programs. Methods A voluntary anonymous 20 item survey was distributed to a sample of academic chairs of EM through the Association of Academic Chairs of Emergency Medicine. Data was collected to assess the percentage of academic emergency physicians who had received QI training, the type of training they received, their perception of the impact of this training on behavior, practice and outcomes, and any perceived barriers to implementing QI programs in the emergency department. Results The response rate to the survey was 69% (N = 59). 59.3% of respondents report that their hospital has a formal QI program for physicians. Chairs received training in a variety of QI programs. The type of QI program used by respondents was perceived as having no impact on goals achieved by QI (χ2 = 12.382; p = 0.260), but there was a statistically significant (χ2 = 14.383; p = 0.006) relationship between whether or not goals were achieved and academic EM chairs’ perceptions about return on investment for QI training. Only 22% of chairs responded that they have already made changes as a result of the QI training. 78.8% of EM chairs responded that quality programs could have a significant positive impact on their practice and the healthcare industry. Chairs perceived that QI programs had the most potential value in the areas of understanding and reducing medical errors and improving patient flow and throughput. Other areas of potential value of QI include improving specific clinical indicators and standardizing physician care. Conclusion Academic EM chairs perceived that QI programs were an effective way to drive needed improvements. The results suggest that there is a high level of interest in QI but a low level of adoption of training and implementation. PMID:21293770

NREL: News - Winner of Solar Decathlon to be Announced

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Winner of Solar Decathlon to be Announced Friday, October 4, 2002 Washington, D.C.- The winner of National Gallery of Art Note: All houses competing in the Solar Decathlon will be open to the public from 9 the U.S. Department of Energy's first Solar Decathlon will be announced noon, Saturday, October 6 in

Site Description | CTIO

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Preserving the Dark Skies La Oficina de Protección de la Calidad del Cielo del Norte de Chile - OPCC Light view Cerro Pachón CTIO/AURA La Serena Facilities The "El Totoral" Reserve, Cerro Tololo and . back to top Sky Brightness over Cerro Pachón and Cerro Tololo Light pollution from nearby cities (La

AF Week in Photos > U.S. Air Force > Article Display

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Professors Senior Mentor Biographies Fact Sheets Commander's Call Topics CCT Archive CSAF Reading List 2017 CSAF Reading List 2016 CSAF Reading List 2015 CSAF Reading List 2014 CSAF Reading List 2013 CSAF Reading List 2012 CSAF Reading List 2011 CSAF Reading List 2010 CSAF Reading List 2009 CSAF Reading List

National Wind Technology Center | NREL

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. Wind Energy Research Wind turbine blade Wind energy research at the NWTC allows for validation and verification of large and small components and wind turbine systems. Photo by Dennis Schroeder / NREL 40935 Wind energy research at the NWTC has pioneered wind turbine components, systems, and modeling methods

Astronomical Information Center - Naval Oceanography Portal

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section Advanced Search... Sections Home Time Earth Orientation Astronomy Meteorology Oceanography Ice You the Moon Illuminated Time Universal Time and Greenwich Mean Time What is Terrestrial Time? Computing Greenwich Apparent Sidereal Time What are the U.S. Time Zones? World Time Zone Map When Does Daylight Time

Alternative Fuels Data Center: Data Downloads

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Data Downloads to someone by E-mail Share Alternative Fuels Data Center: Data Downloads on Facebook Tweet about Alternative Fuels Data Center: Data Downloads on Twitter Bookmark Alternative Fuels Data Center: Data Downloads on Google Bookmark Alternative Fuels Data Center: Data Downloads on Delicious Rank

Home Page, Alaska Department of Fish and Game

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Orders Media/Press Releases Hot Topics & Issues Board of Fisheries and Game: Actions & Activities Habitat Special Areas Fish Habitat Boards Board of Game Board of Fisheries The Joint Board Commissioner Maps & Area Information File Hunt Report Trapping Boards Board of Fisheries Board of Game

CAEBAT Model Featured on American Chemical Society Journal Tenth

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University's School of Mechanical Engineering has yielded new insights for lithium-ion (Li-ion) battery corresponding article, "Secondary-Phase Stochastics in Lithium-Ion Battery Electrodes" detailing the microstructural modifications can greatly improve overall Li-ion battery performance. The value of this work is

Energy Storage News | Transportation | Transportation Research | NREL

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NREL/Purdue team's corresponding article, "Secondary-Phase Stochastics in Lithium-Ion Battery by NREL and NASA, the Battery ISC Device revolutionizes the way lithium-ion (Li-ion) batteries are collaboration with Purdue University's School of Mechanical Engineering has yielded new insights for lithium-ion

News and Feature Stories | NREL

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insights for lithium-ion (Li-ion) battery electrodes at the microstructural level, that can lead to Lithium-Ion Battery Electrodes" detailing the research and resulting discoveries, is showcased inside 19th annual Middle School Electric Car Competition, where students raced solar and lithium-ion powered

Publications - GMC 73 | Alaska Division of Geological & Geophysical Surveys

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following seven NPRA wells: Fish Creek test well #1; Oumalik test well #1; Peard test well #1; Tunalik #1 ; Umiat test well #11; Wolf Creek test well #3; and Walapka test well #1 Authors: Unknown Publication Date wells: Fish Creek test well #1; Oumalik test well #1; Peard test well #1; Tunalik #1; Umiat test well

Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly.

PubMed

Souza, Jonas Gordilho; Apolinario, Daniel; Farfel, José Marcelo; Jaluul, Omar; Magaldi, Regina Miksian; Busse, Alexandre Leopold; Campora, Flávia; Jacob-Filho, Wilson

2016-01-01

To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge. A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control. We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency. This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills. Traduzir, adaptar e avaliar as propriedades de uma versão, em português do Brasil, do Spoken Knowledge in Low Literacy Patients with Diabetes, um questionário que avalia conhecimento em diabetes. Estudo transversal, em diabéticos tipo 2, com idade ≥60 anos de uma instituição pública de saúde, em São Paulo (SP). Após o desenvolvimento da versão na língua portuguesa, foram avaliadas suas propriedades psicométricas e associação com variáveis sociodemográficas e clínicas. Os modelos de regressão foram ajustados para dados sociodemográficos, alfabetismo funcional em saúde, tempo de doença, uso de insulina e controle glicêmico. Foram avaliados 129 diabéticos, com média de idade de 75,9 (±6,2) anos, escolaridade média de 5,2 (±4,4) anos, hemoglobina glicada média de 7,2% (±1,4) e valor médio do Spoken Knowledge in Low Literacy Patients with Diabetes de 42,1% (±25,8). No modelo de regressão, as variáveis associadas de forma independente ao Spoken Knowledge in Low Literacy Patients with Diabetes foram escolaridade (B=0,193; p=0,003), uso de insulina (B=1,326; p=0,004), tempo de doença (B=0,053; p=0,022) e alfabetismo em saúde (B=0,108; p=0,021). O coeficiente de determinação foi de 0,273. O a de Cronbach apresentou valor de 0,75, revelando consistência interna adequada. Esta versão traduzida do Spoken Knowledge in Low LiteraFcy Patients with Diabetes mostrou-se adequada para avaliar conhecimentos em diabetes em idosos de baixa escolaridade, apresentando distribuição normal, consistência interna adequada, sem a presença de efeito teto ou chão. O instrumento teve boa aplicabilidade, já que pôde ser administrado de maneira rápida e não depende da capacidade de leitura.

Geographic Discordance Between Patient Residence and Incident Location in Emergency Medical Services Responses.

PubMed

Hsia, Renee Y; Dai, Mengtao; Wei, Ran; Sabbagh, Sarah; Mann, N Clay

2017-01-01

The location of a patient's residence is often used for emergency medical services (EMS) system planning. Our objective is to evaluate the association between patient residence and emergency incident zip codes for 911 calls. We used data from the 2013 National Emergency Medical Services Information System (NEMSIS) Public-Release Research Dataset. We studied all 911 calls with a valid complaint by dispatch, identifying zip codes for both the residence and incident locations (n=12,376,784). The primary outcomes were geographic and distance discordances between patient residence and incident zip codes. We used a multivariate logistic regression model to determine geographic discordance between residence and incident zip codes by dispatch complaint, age, and sex. We also measured distances between locations with geospatial processing. The overall proportion of geographic discordance for all 911 calls was 27.7% (95% confidence interval [CI] 27.7% to 27.8%) and the median distance discordance was 11.5 miles (95% CI 11.5 to 11.5 miles). Lower geographic discordance rates were found among patients aged 65 to 79 years (20.2%; 95% CI 20.1% to 20.2%) and 80 years and older (14.5%; 95% CI 14.5% to 14.6%). Motor vehicle crashes (63.5%; 95% CI 63.5% to 63.6%), industrial accidents (59.3%; 95% CI 58.0% to 60.6%), and mass casualty incidents (50.6%; 95% CI 49.6% to 51.5%) were more likely to occur outside a patient's residence zip code. Median network distance between home and incident zip centroid codes ranged from 8.6 to 23.5 miles. In NEMSIS, there was geographic discordance between patient residence zip code and call location zip code in slightly more than one quarter of EMS responses records. The geographic discordance rates between residence and incident zip codes were associated with dispatch complaints and age. Although a patient's residence might be a valid proxy for incident location for elderly patients, this relationship holds less true for other age groups and among different complaints. Our findings have important implications for EMS system planning, resource allocation, and injury surveillance. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Nolan Wilson | NREL

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Nolan Wilson Nolan Wilson Postdoctoral Researcher-Chemical Engineering Nolan.Wilson@nrel.gov | 303 Ph.D., Chemical and Biomolecular Engineering, Clemson University, 2014 M.S., Chemical and Biomolecular Engineering, Clemson University, 2012 B.S., Chemical Engineering, Auburn University, 2007 Professional

GISD

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information on the ecology of the species, its impacts and management, a comprehensive bibliography and a list ) General Impact information Management information Distribution The Distribution page presents the global page collates management information from the profile narrative page plus location-specific management

Staff - Trent D. Hubbard | Alaska Division of Geological & Geophysical

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, R.P., Darrow, M.M., and Hubbard, T.D., 2015, Influence of catchment properties on stability of frozen : Evaluating geologic hazards and the distribution and character of geologic materials on Alaska's North Slope Professor, Department of Biology and Earth Sciences, University of Central Missouri, Warrensburg, MO 2003

Standard Terms and Conditions | NREL

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and Technical Services Subcontracts, Cost-Type (1) Cost Sharing (2) Cost Reimbursement (3) Cost Plus Than Foreign) (1) Cost Sharing (2) Cost Reimbursement (2) Cost Plus Fixed Fee. Appendix B-10 (12/15/16 /15/16) Standard Terms and Conditions for Travel Requirements (1) Cost Sharing (2) Cost Reimbursement

Publications - PIR 2015-5-8 | Alaska Division of Geological & Geophysical

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lower sandstone member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska, in Wartes member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska Authors: Wartes, M.A Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

Publications - PIR 2015-5-4 | Alaska Division of Geological & Geophysical

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facies analysis of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska, in Wartes, M.A of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska Authors: Bull, K.F. Publication Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska

Presentations - Herriott, T.M. and others, 2011 | Alaska Division of

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Details Title: Detailed geologic mapping and overview of structural and stratigraphic studies in the east Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of in the east-central North Slope foothills, Alaska (poster): 3P Arctic, The Polar Petroleum Potential

Idaho Water Resources Research Institute

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Students Parents Alumni Faculty & Staff students walk on University of Idaho campus Visit U of I Learn Visit Students on Campus Title IX Helping to ensure U of I is a safe and engaging place for students to Diversity Athletics Events News Directory A - Z Prospective Students Current Students Parents Alumni Faculty

Community Solar | State, Local, and Tribal Governments | NREL

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distributed generation owners for the power that their systems contribute to the grid. Community solar generation from an offsite solar system. Some form of VNM must exist for community solar to work properly so Electric Power Association. Community Solar: NREL's Working Group on Community Solar Gardens meeting

NREL Projects Awarded More Than $3 Million to Advance Novel Solar

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in Grid Operations," evaluating a research solution to better integrate solar power generation funding program, which advances state-of-the-art techniques for predicting solar power generation to Office to advance predictive modeling of solar power as part of its Solar Forecasting 2 funding program

Scanning Defect Mapping | Photovoltaic Research | NREL

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SDMS moves the treated wafer across a stationary laser beam and maps the defects for each location on the wafer. The amount of light reflected from an area is proportional to the dislocation density for that area and provides a direct statistical count of the number of dislocations. PV Research Other

Climate Prediction Center - Seasonal Outlook

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ACCOUNT FOR THE LATEST DYNAMICAL AND STATISTICAL GUIDANCE. LONG TERM TRENDS ACCOUNT FOR THE FAMILIAR U Time. Please consult the schedule of 30 & 90-day outlooks for exact release dates. Text Discussions COLLEGE PARK MD 830 AM EDT THU MAY 17 2018 SUMMARY OF THE OUTLOOK FOR NON-TECHNICAL USERS ENSO NEUTRAL

Project Development Model | Integrated Energy Solutions | NREL

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. The five elements of project fundamentals are: Baseline: Analyze the current situation for the site . The two-phase iterative model includes elements in project fundamentals and project development based State and Local Energy Data (SLED) tool, developed by NREL for the U.S. Department of Energy, to get

Rare Earth Elements | Alaska Division of Geological & Geophysical Surveys

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- Mineral Resources main content Rare Earth Elements Rare earth elements and the supply and demand of these deposits containing rare earth elements to meet the perceived future demand. High prices for rare earth earth element occurrences in the DGGS publications catalog. Department of Natural Resources, Division of

John B. Goodenough, Cathode Materials, and Rechargeable Lithium-ion

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cathode materials for the lithium-ion rechargeable battery that is ubiquitous in today’s portable conductors has enabled realization of the rechargeable lithium-ion battery used in cellular telephones and Goodenough, the rechargeable lithium ion battery, and related research is available in electronic documents

La Aventura de las Partículas

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ciertas formas fundamentales. Explore las siguientes rutas que le explicarán la materia del universo! La grande del logo de la Ruta SM) La ruta de las evidencias experimentales : aprenda como los físicos diseà explicación de los "por qué" de las interacciones físicas hay todavía muchos misterios por

NOAA Weather Radio - Información General

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logo La Radio de Canada NWR receiver logo recepción COVERAGE County Coverage Listings State Coverage Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Search For Go NWS All NOAA Información General NWR receiver logo Información de Fondo (incluyendo

Real-time catheter tracking for high-dose-rate prostate brachytherapy using an electromagnetic 3D-guidance device: A preliminary performance study

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

Zhou Jun; Sebastian, Evelyn; Mangona, Victor

2013-02-15

Purpose: In order to increase the accuracy and speed of catheter reconstruction in a high-dose-rate (HDR) prostate implant procedure, an automatic tracking system has been developed using an electromagnetic (EM) device (trakSTAR, Ascension Technology, VT). The performance of the system, including the accuracy and noise level with various tracking parameters and conditions, were investigated. Methods: A direct current (dc) EM transmitter (midrange model) and a sensor with diameter of 1.3 mm (Model 130) were used in the trakSTAR system for tracking catheter position during HDR prostate brachytherapy. Localization accuracy was assessed under both static and dynamic analyses conditions. For themore » static analysis, a calibration phantom was used to investigate error dependency on operating room (OR) table height (bottom vs midposition vs top), sensor position (distal tip of catheter vs connector end of catheter), direction [left-right (LR) vs anterior-posterior (AP) vs superior-inferior (SI)], sampling frequency (40 vs 80 vs 120 Hz), and interference from OR equipment (present vs absent). The mean and standard deviation of the localization offset in each direction and the corresponding error vectors were calculated. For dynamic analysis, the paths of five straight catheters were tracked to study the effects of directions, sampling frequency, and interference of EM field. Statistical analysis was conducted to compare the results in different configurations. Results: When interference was present in the static analysis, the error vectors were significantly higher at the top table position (3.3 {+-} 1.3 vs 1.8 {+-} 0.9 mm at bottom and 1.7 {+-} 1.0 mm at middle, p < 0.001), at catheter end position (3.1 {+-} 1.1 vs 1.4 {+-} 0.7 mm at the tip position, p < 0.001), and at 40 Hz sampling frequency (2.6 {+-} 1.1 vs 2.4 {+-} 1.5 mm at 80 Hz and 1.8 {+-} 1.1 at 160 Hz, p < 0.001). So did the mean offset errors in the LR direction (-1.7 {+-} 1.4 vs 0.4 {+-} 0.5 mm in AP and 0.8 {+-} 0.8 mm in SI directions, p < 0.001). The error vectors were significantly higher with surrounding interference (2.2 {+-} 1.3 mm) vs without interference (1.0 {+-} 0.7 mm, p < 0.001). An accuracy of 1.6 {+-} 0.2 mm can be reached when using optimum configuration (160 Hz at middle table position). When interference was present in the dynamic tracking, the mean tracking errors in LR direction (1.4 {+-} 0.5 mm) was significantly higher than that in AP direction (0.3 {+-} 0.2 mm, p < 0.001). So did the mean vector errors at 40 Hz (2.1 {+-} 0.2 mm vs 1.3 {+-} 0.2 mm at 80 Hz and 0.9 {+-} 0.2 mm at 160 Hz, p < 0.05). However, when interference was absent, they were comparable in the both directions and at all sampling frequencies. An accuracy of 0.9 {+-} 0.2 mm was obtained for the dynamic tracking when using optimum configuration. Conclusions: The performance of an EM tracking system depends highly on the system configuration and surrounding environment. The accuracy of EM tracking for catheter reconstruction in a prostate HDR brachytherapy procedure can be improved by reducing interference from surrounding equipment, decreasing distance from transmitter to tracking area, and choosing appropriated sampling frequency. A calibration scheme is needed to further reduce the tracking error when the interference is high.« less

Xiaowen Chen | NREL

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Xiaowen Chen Photo of Xiaowen Chen Xiaowen Chen Researcher IV-Chemical Engineering Xiaowen.Chen Education Ph.D., Chemical Engineering, University of Maine, 2009 M.S., Chemical Engineering, University of Maine, 2005 B.S., Chemical Engineering in Polymer Science and Technology, Nanjing University of Science

Sandia National Laboratories: Research: R&D 100 Awards

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high radiation environments such as space. Watch the video. control system for active damping of inter first commercially available, high-voltage, high-frequency, high-current, high-temperature, single-chip Materials Science Nanodevices & Microsystems Radiation Effects & High Energy Density Science