[Characteristics of Crohn's disease under 
double balloon enteroscopy].

PubMed

Jia, Jia; Liu, Rui; Liu, Xiangjie; Shen, Shourong; Guo, Qin

2018-05-28

To observe ulcer characteristics of Crohn's disease under double balloon enteroscopy, and to evaluate the correlation between endoscopic severity and clinical manifestations.
 Methods: A prospective, observational study from July 2015 to December 2016 in the Third Xiangya Hospital, Central South University, we selected 45 patients with positive double-balloon enteroscopy (DBE) and confirmed Crohn's disease. Two digestive internal physician observed the ulcer characteristics of Crohn's disease under double balloon enteroscopy, and gave a simple endoscopic score for CD (SES-CD). We analyzed the correlation between SES-CD and Crohn's disease activity index (CDAI).
 Results: DBE indicated 24 patient ulcers (53.33%) locating at the end of the ileum, 5 (11.11%) locating at ileocolon, 16 (35.56%) locating at upper gatrointestinal tract and they did not affect the end of the ileum. Among them, 8 cases (17.78%) affected only jejunum. Thirty-two patients with longitudinal ulcers in Crohn's disease, accounting for 71.11%. There was no correlation between SES-CD score and CDAI score (r=0.237, P=0.136).
 Conclusion: The ulcerative appearance in Crohn's disease were diverse under double balloon enteroscopy. Crohn's disease could only affect the upper gastrointestinal tract or jejunum. The unwounded ileum and ileocecal valve couldn't be a sign to exclude Crohn's disease. CDAI score couldn't fully assess the prognosis of Crohn's disease.

Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup

PubMed Central

Gomes, Guilherme Francisco; Bonin, Eduardo Aimore; Noda, Rafael William; Cavazzola, Leandro Totti; Bartholomei, Thiago Ferreira

2016-01-01

Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause symptoms, such as overt occult lower gastrointestinal bleeding. The diagnostic imaging workup includes computed tomography scan, magnetic resonance imaging enterography, technetium 99m scintigraphy (99mTc) using either labeled red blood cells or pertechnetate (known as the Meckel’s scan) and angiography. The preoperative detection rate of MD in adults is low, and many patients ultimately undergo exploratory laparoscopy. More recently, however, endoscopic identification of MD has been possible with the use of balloon-assisted enteroscopy via direct luminal access, which also provides visualization of the diverticular ostium. The aim of this study was to review the diagnosis by double-balloon enteroscopy of 4 adults with symptomatic MD but who had negative diagnostic imaging workups. These cases indicate that balloon-assisted enteroscopy is a valuable diagnostic method and should be considered in adult patients who have suspected MD and indefinite findings on diagnostic imaging workup, including negative Meckel’s scan. PMID:27803776

Small-bowel capsule endoscopy in patients with suspected Crohn's disease-diagnostic value and complications.

PubMed

Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

2010-01-01

The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.

Small bowel endoluminal imaging (capsule and enteroscopy).

PubMed

Murino, Alberto; Despott, Edward J

2017-04-01

Over the last 16 years, the disruptive technologies of small bowel capsule endoscopy and device-assisted enteroscopy have revolutionised endoluminal imaging and minimally invasive therapy of the small bowel. Further technological developments continue to expand their indications and use. This brief review highlights the state-of-the-art in this arena and aims to summarise the current and potential future role of these technologies in clinical practice.

Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance.

PubMed

Lenz, Philipp; Roggel, Moritz; Domagk, Dirk

2013-09-01

This study aims to compare double- (DBE) and single-balloon enteroscopy (SBE) in small bowel disorders with respect to procedural performance and clinical impact. This retrospective analysis at a tertial referral center included 1,052 DBEs and 515 SBEs performed in 904 patients over 7 years. Procedural and patients' characteristics were precisely analyzed. Significantly more patients with anemia and gastrointestinal bleeding were investigated by DBE (P < 0.01). Oral insertion depth and length of investigated small bowel in the combined approach were significantly higher in the DBE compared to the SBE group (245 ± 65.3 vs. 218 ± 62.6 and 355 ± 101.9 vs. 319 ± 91.2, respectively; P < 0.001, each). By analyzing only recent years of enteroscopy (2008-2011), no difference in small bowel visualization could be observed. The anal insertion depths and complete enteroscopy rates (CER) were comparable. Procedure times were significantly shorter within the SBE procedure (oral: 50 vs. 40 min; anal: 55 vs. 46 min, P < 0.001) and the usage of sedation was significantly less (propofol: P < 0.001; pethidine: P < 0.05). Diagnostic yield was significantly higher in the SBE, compared to the DBE group (61.7 vs. 48.2 %; P < 0.001). The rate of severe adverse events was close to zero. Both enteroscopy techniques are safe diagnostic tools and proved to be indispensable in the daily gastroenterological practice. The lower insertion depths, but higher diagnostic yield, of SBE may reflect the more focused selection of patients scheduled for small bowel diagnostics in recent years.

Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy.

PubMed

Tsutsumi, Koichiro; Kato, Hironari; Tomoda, Takeshi; Matsumoto, Kazuyuki; Sakakihara, Ichiro; Yamamoto, Naoki; Noma, Yasuhiro; Sonoyama, Takayuki; Okada, Hiroyuki; Yamamoto, Kazuhide

2012-12-07

Endoscopic intervention is less invasive than percutaneous or surgical approaches and should be considered the primary drainage procedure in most cases with obstructive jaundice. Recently, therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using double-balloon enteroscopy (DBE) has been shown to be feasible and effective, even in patients with surgically altered anatomies. On the other hand, endoscopic partial stent-in-stent (PSIS) placement of self-expandable metallic stents (SEMSs) for malignant hilar biliary obstruction in conventional ERCP has also been shown to be feasible, safe and effective. We performed PSIS placement of SEMSs for malignant hilar biliary obstruction due to liver metastasis using a short DBE in a patient with Roux-en-Y anastomosis and achieved technical and clinical success. This procedure can result in quick relief from obstructive jaundice in a single session and with short-term hospitalization, even in patients with surgically altered anatomies.

Small bowel endoluminal imaging (capsule and enteroscopy)

PubMed Central

Murino, Alberto

2017-01-01

Over the last 16 years, the disruptive technologies of small bowel capsule endoscopy and device-assisted enteroscopy have revolutionised endoluminal imaging and minimally invasive therapy of the small bowel. Further technological developments continue to expand their indications and use. This brief review highlights the state-of-the-art in this arena and aims to summarise the current and potential future role of these technologies in clinical practice. PMID:28839900

Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

PubMed Central

Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

2010-01-01

Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy. PMID:20811612

Single-photon emission computed tomography enhanced Tc-99m-pertechnetate disodium-labelled red blood cell scintigraphy in the localization of small intestine bleeding: a single-centre twelve-year study.

PubMed

Dolezal, Jiri; Vizda, Jaroslav; Kopacova, Marcela

2011-01-01

To present our experience with the detection of bleeding in the small intestine by means of scintigraphy with in vivo-labelled red blood cells (RBCs) in the period of 1998-2009. A 12-year prospective study was accomplished with 40 patients (23 men, 17 women, aged 12-91, mean 56 years) who had lower gastrointestinal bleeding (obscure-overt bleeding) and underwent scintigraphy with in vivo-labelled RBCs by means of technetium 99m. The scintigraphy was usually performed after other diagnostic tests had failed to locate the bleeding. A total of 26 patients had a positive scintigraphy with in vivo-labelled RBCs and 14 patients had negative scintigraphy. The final diagnosis was confirmed in 20 of 26 patients with a positive scintigraphy by push enteroscopy (6/20), intraoperative enteroscopy (7/20), surgery (4/20), duodenoscopy (1/20), double-balloon enteroscopy (1/20) and X-ray angiography (1/20). The correct location of the bleeding site was identified by RBC scintigraphy in 15 of 20 (75%) patients with the confirmed source. The locations of the bleeding site identified by scintigraphy and enteroscopy (push, intraoperative) and surgical investigations were highly correlated in patients with a positive scintigraphy within the first 3 h. Eleven of the 20 correctly localized studies and none of the incorrectly localized studies were positive in the dynamic phase of imaging. In 5 patients (all erroneously localized), scintigraphy was positive only at a period longer than 18 h. RBC scintigraphy is an effective imaging modality in localizing lower gastrointestinal bleeding in patients for whom other diagnostic tests have failed to locate the bleeding. RBC scintigraphy can be successful in the detection of bleeding sites in the small intestine. Copyright © 2011 S. Karger AG, Basel.

Primary intestinal lymphangiectasia diagnosed by double-balloon enteroscopy and treated by medium-chain triglycerides: a case report.

PubMed

Lai, Yu; Yu, Tao; Qiao, Xiao-Yu; Zhao, Li-Na; Chen, Qi-Kui

2013-01-14

Primary intestinal lymphangiectasia is a disorder characterized by exudative enteropathy resulting from morphologic abnormalities of the intestinal lymphatics. Intestinal lymphangiectasia can be primary or secondary, so the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A double-balloon enteroscopy and biopsy, as well as the pathology can be used to confirm the diagnosis of intestinal lymphangiectasia. A polymeric diet containing medium-chain triglycerides and total parenteral nutrition may be a useful therapy. A 17-year-old girl of Mongoloid ethnicity was admitted to our hospital with a history of diarrhea and edema. She was diagnosed with protein-losing enteropathy caused by intestinal lymphangiectasia. This was confirmed by a double-balloon enteroscopy and multi-dot biopsy. After treatment with total parenteral nutrition in hospital, which was followed by a low-fat and medium-chain triglyceride diet at home, she was totally relieved of her symptoms. Intestinal lymphangiectasia can be diagnosed with a double-balloon enteroscopy and multi-dot biopsy, as well as the pathology of small intestinal tissue showing edema of the submucosa and lymphangiectasia. Because intestinal lymphangiectasia can be primary or secondary, the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A positive clinical response to the special diet therapy, namely a low-fat and medium-chain triglyceride diet, can further confirm the diagnosis of primary intestinal lymphangiectasia.

Linitis plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass: a case report.

PubMed

Haenen, Filip Wn; Gys, Ben; Moreels, Tom; Michielsen, Maartje; Gys, Tobie; Lafullarde, Thierry

2017-12-01

Laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the preferred surgical procedure to treat morbid obesity. It has proven its effects on excess weight loss and its positive effect on comorbidities. One of the main issues, however, is the post-operative evaluation of the bypassed gastric remnant. In literature, cancer of the excluded stomach after RYGB is rare. We describe the case of a 52-year-old woman with gastric linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass, diagnosed by means of laparoscopy and Single-Balloon enteroscopy, and it is clinical importance. Linitis plastica of the excluded stomach after RYGB is a very rare entity. This case report shows the importance of long-term post-operative follow-up, and the importance of single-balloon enteroscopy for visualization of the bypassed stomach remnant, when other investigations remain without results. This case report is only the second report of a linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass.

Pancreatic and Gastric Heterotopia with Associated Submucosal Lipoma Presenting as a 7-cm Obstructive Tumor of the Ileum: Resection with Double Balloon Enteroscopy.

PubMed

Jiang, Kun; Stephen, F Otis; Jeong, Daniel; Pimiento, Jose M

2015-01-01

Pancreatic and gastric heterotopias are rare clinical entities which have been identified throughout the entire length of the gastrointestinal tract. Combined gastric and pancreatic heterotopias, although unusual, have been described in the duodenum and jejunum, and in other structures, including Meckel's diverticulum and the ampulla of Vater. We report a novel case of pancreatic and gastric heterotopia with an associated submucosal lipoma in a 38-year-old female with a recent history of rectal cancer and chronic crampy abdominal pain. On computed tomography, a 7-cm luminal polypoid mass extending into the distal ileum was discovered. The mass was successfully resected using retrograde double balloon enteroscopy. We believe this is the first report of all three histological entities co-existing in an obstructive ileal lesion in an adult. It highlights endoscopic resection trough double enteroscopy as a safe alternative to more invasive surgical approaches for this type of lesion.

Enteroscopic Tattooing for Better Intraoperative Localization of a Bleeding Jejunal GIST Facilitates Minimally Invasive Laparoscopically-assisted Surgery.

PubMed

Iacob, Razvan; Dimitriu, Anca; Stanciulea, Oana; Herlea, Vlad; Popescu, Irinel; Gheorghe, Cristian

2016-03-01

We present the case of a 63-year-old man that was admitted for melena and severe anemia. Upper GI endoscopy and colonoscopy failed to identify the lesion responsible for bleeding, and enteroCT scan was also non-contributive to the diagnosis. Capsule endoscopy indicated possible jejunal bleeding but could not indicate the source of bleeding, recommending anterograde enteroscopy. Single balloon enteroscopy identified a 2 cm submucosal tumour in the distal part of the jejunum, with a macroscopic appearance suggesting a gastrointestinal stromal tumour (GIST). The tumor location was marked using SPOT tattoo and subsequently easily identified by the surgeon and resected via minimally invasive laparoscopic-assisted approach. Histological and immunohistochemical analysis indicated a low risk GIST. The unusual small size of the GIST as a modality of presentation, with digestive bleeding and anemia and the ability to use VCE/enteroscopy to identify and mark the lesion prior to minimally invasive surgery, represent the particularities of the presented case.

Single Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients Who Underwent a Gastrectomy with Roux-en-Y Anastomosis: Six Cases from a Single Center.

PubMed

Soh, Jae Seung; Yang, Dong-Hoon; Lee, Sang Soo; Lee, Seohyun; Bae, Jungho; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun

2015-09-01

Patients with altered anatomy such as a Roux-en-Y anastomosis often present with various pancreaticobiliary problems requiring therapeutic intervention. However, a conventional endoscopic approach to the papilla is very difficult owing to the long afferent limb and acute angle of a Roux-en-Y anastomosis. Balloon-assisted enteroscopy can be used for endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered anatomy. We experienced six cases of Roux-en-Y anastomosis with biliary problems, and attempted ERCP using single balloon enteroscopy (SBE). SBE insertion followed by replacement with a conventional endoscope was attempted in five of six patients. The papilla was successfully approached using SBE in all cases. However, therapeutic intervention was completed in only three cases because of poor maneuverability caused by postoperative adhesion. We conclude that in patients with Roux-en-Y anastomosis, the ampulla can be readily accessed with SBE, but longer dedicated accessories are necessary to improve this therapeutic intervention.

Primary intestinal lymphangiectasia diagnosed by double-balloon enteroscopy and treated by medium-chain triglycerides: a case report

PubMed Central

2013-01-01

Introduction Primary intestinal lymphangiectasia is a disorder characterized by exudative enteropathy resulting from morphologic abnormalities of the intestinal lymphatics. Intestinal lymphangiectasia can be primary or secondary, so the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A double-balloon enteroscopy and biopsy, as well as the pathology can be used to confirm the diagnosis of intestinal lymphangiectasia. A polymeric diet containing medium-chain triglycerides and total parenteral nutrition may be a useful therapy. Case presentation A 17-year-old girl of Mongoloid ethnicity was admitted to our hospital with a history of diarrhea and edema. She was diagnosed with protein-losing enteropathy caused by intestinal lymphangiectasia. This was confirmed by a double-balloon enteroscopy and multi-dot biopsy. After treatment with total parenteral nutrition in hospital, which was followed by a low-fat and medium-chain triglyceride diet at home, she was totally relieved of her symptoms. Conclusion Intestinal lymphangiectasia can be diagnosed with a double-balloon enteroscopy and multi-dot biopsy, as well as the pathology of small intestinal tissue showing edema of the submucosa and lymphangiectasia. Because intestinal lymphangiectasia can be primary or secondary, the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A positive clinical response to the special diet therapy, namely a low-fat and medium-chain triglyceride diet, can further confirm the diagnosis of primary intestinal lymphangiectasia. PMID:23316917

Enteroscopy in the diagnosis and management of celiac disease.

PubMed

Rondonotti, Emanuele; Villa, Federica; Saladino, Valeria; de Franchis, Roberto

2009-07-01

Esophagogastroduodenoscopy (EGD) with 3 to 6 biopsies in the descending duodenum is the gold standard for the diagnosis of celiac disease. At the time of the first diagnosis of celiac disease, an extensive evaluation of the small bowel is not recommended. However, video capsule endoscopy, because of its good sensitivity and specificity in recognizing the Endoscopic features of celiac disease, can be considered a valid alternative to EGD in patients unable or unwilling to undergo EGD with biopsies. Capsule endoscopy is also a possible option in selected cases with strong suspicion of celiac disease but negative first-line tests. In evaluating patients with refractory or complicated celiac disease, in whom a complete evaluation of the small bowel is mandatory (at least in refractory celiac disease type II patients) because of the possible presence of complications beyond the reach of conventional endoscopes, both capsule endoscopy and balloon-assisted enteroscopy have been found to be helpful. In these patients, capsule endoscopy offers several advantages: it is well tolerated, it allows inspection of the entire small bowel, and it is able to recognize subtle mucosal changes. However, in this setting, capsule endoscopy should ideally be coupled with imaging techniques that provide important information about the thickness of the wall of the intestine and about extraluminal abnormalities. Although deep enteroscopy (such as balloon enteroscopy) is expensive, time-consuming, and potentially risky in these frail patients, they may have a key role, because they make it possible to take tissue samples from deep in the small intestine.

Secondary lymphangiectasia of the small bowel: utility of double balloon enteroscopy for diagnosis and management.

PubMed

Safatle-Ribeiro, Adriana Vaz; Iriya, Kiyoshi; Couto, Décio Sampaio; Kawaguti, Fábio Shiguehiss; Retes, Felipe; Ribeiro, Ulysses; Sakai, Paulo

2008-01-01

Sporadic lymphangiectasias are commonly found throughout the small bowel and are considered to be normal. Not uncommonly, lymphangiectasias are pathologic and can lead to mid-gastrointestinal bleeding, abdominal pain and protein-losing enteropathy. Pathologic lymphangiectasias of the small bowel include primary lymphangiectasia, secondary lymphangiectasia and lymphaticovenous malformations. In this report we present three different cases of small bowel lymphangiectasia detected by double balloon enteroscopy. The patients were diagnosed with South American blastomycosis, tuberculosis and primary small bowel lymphangioma. 2009 S. Karger AG, Basel

Small bowel enteroscopy and intraoperative enteroscopy for obscure gastrointestinal bleeding.

PubMed

Lewis, B S; Wenger, J S; Waye, J D

1991-02-01

Intraoperative endoscopy (IOE) is accepted as the ultimate diagnostic procedure for completely evaluating the small bowel in patients with obscure gastrointestinal (GI) bleeding. Small bowel enteroscopy (SBE) has been reported useful in the nonsurgical evaluation of the small intestine in these patients, but findings may be limited because of incomplete small bowel intubation and a lack of tip deflection. Twenty-three patients underwent 25 SBE exams and subsequently had 25 IOE exams during surgical exploration for continued bleeding. Patients' bleeding histories averaged 2 yr, with an average transfusion requirement of 27 units. Findings on IOE were the same as with SBE in 17/22 (77%) of examinations. We conclude that SBE and IOE are comparable in depth of insertion and ability to detect small vascular ectasias. Both procedures missed pathology due to limited visibility and the evanescent nature of ectasias. Long-term success in abolishing bleeding with these combined techniques can be expected in 55% of these patients. SBE should precede surgery, since the finding of diffuse ectasias precludes any benefit from operative intervention.

Laparotomy and intraoperative enteroscopy for obscure gastrointestinal bleeding before and after the era of video capsule endoscopy and deep enteroscopy: a tertiary center experience

PubMed Central

Manatsathit, Wuttiporn; Khrucharoen, Usah; Jensen, Dennis M.; Hines, O. Joe; Kovacs, Thomas; Ohning, Gordon; Jutabha, Rome; Ghassemi, Kevin; Dulai, Gareth S.; Machicado, Gustavo

2017-01-01

Background To evaluate roles of intraoperative endoscopy (IOE) in management of severe obscure GI bleeding (OGIB) before vs. after introduction of video capsule endoscopy (VCE) and deep enteroscopy (DE). Methods We retrospectively reviewed prospectively collected data of patients undergoing IOE for severe OGIB in a tertiary referral center. Results 52 patients had laparotomy/IOE for OGIB, 11 pre and 41 post VCE/DE eras. In the pre VCE/DE era, 36.4% (4/11) had preoperative presumptive diagnoses while in the post VCE/DE era presumptive diagnoses were made in 48.8% (20/41) (p= 0.18). Preoperative evaluation led to correct diagnoses in 18.2% (2/11) in the pre and 51.2% (21/41) in the post VCE/DE era (p=0.09). Vascular lesions and ulcers were the most common diagnoses, but rebleeding was common. No rebleeding was found among patients with tumors, Meckel's diverticulum, and aortoenteric fistula. Conclusions Presumptive diagnoses in the post VCE/DE era were usually accurate. If VCE or DE are negative, the probability of negative IOE is high. Patients with tumors and Meckel's diverticulum were the best candidates for IOE. PMID:28629608

Idiopathic small bowel diaphragm disease identified by laparoscopic-assisted double-balloon enteroscopy in a child: an integrated successful definitive therapeutic method.

PubMed

Soccorso, Giampiero; Sarkhy, Ahmed; Lindley, Richard M; Marven, Sean S; Thomson, Mike

2012-08-01

In adults, small bowel diaphragm disease is a rare complication of small bowel enteropathy secondary to the use of nonsteroidal antiinflammatory drugs. The main clinical manifestations are gastrointestinal bleeding and subacute obstruction, and management can be challenging. We present a case of a 5-year-old girl with small bowel diaphragm disease. To our knowledge, this is the first idiopathic case (no history of nonsteroidal antiinflammatory drug use) in the pediatric age group. This report describes an integrated successful definitive therapeutic method of double-balloon enteroscopy and minimal invasive bowel surgery for small bowel pathology. Copyright © 2012 Elsevier Inc. All rights reserved.

Detection Rate and Clinical Relevance of Ink Tattooing during Balloon-Assisted Enteroscopy

PubMed Central

Ebigbo, A.; Schrempf, M.; Messmann, H.; Gölder, S. K.

2017-01-01

Background and Aims Balloon-assisted enteroscopy (BAE) is a well-established tool in the diagnosis and therapy of small bowel diseases. Ink tattooing of the small bowel is used to mark pathologic lesions or the depth of small bowel insertion. The purpose of this study was to determine the safety, the detection rate, and the clinical relevance of ink tattooing during BAE. Methods We performed a retrospective analysis of all 81 patients who received an ink tattooing during BAE between 2010 and 2015. Results In all patients, ink tattooing was performed with no complications. 26 patients received a capsule endoscopy after BAE. The tattoo could be detected via capsule endoscopy in 19 of these 26 patients. The tattoo of the previous BAE could be detected via opposite BAE in 2 of 11 patients. In 9 patients, ink tattooing influenced the choice of approach for reenteroscopy. In 7 patients, the tattoo was used for intraoperative localization and in 3 patients for intraoperative localization as well as for reenteroscopy. The intraoperative detection rate of the tattoo was 100%. Conclusion Ink tattooing of the small intestine is a safe endoscopic procedure to mark the depth of scope insertion or a pathologic lesion during balloon-assisted enteroscopy. PMID:29230241

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding.

PubMed

Gerson, Lauren B; Fidler, Jeff L; Cave, David R; Leighton, Jonathan A

2015-09-01

Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended for patients with initial negative small bowel evaluations and ongoing overt or occult bleeding.

Capsule endoscopy

MedlinePlus

Capsule enteroscopy; Wireless capsule endoscopy; Video capsule endoscopy (VCE); Small bowel capsule endoscopy (SBCE) ... a computer and software turns them into a video. Your provider watches the video to look for ...

[Effects of electroacupuncture on bispectral index and plasma beta-endorphin in patients undergoing colonoscopy].

PubMed

Ni, Yu-Fei; Li, Jun; Wang, Ben-Fu; Jiang, Song-He; Chen, Yi; Zhang, Wei-Feng; Lian, Qing-Quan

2009-10-01

To observe the effect of electroacupuncture (EA) on bispectral index (BIS) and plasma beta-endorphin (beta-EP) level in patients undergoing colonoscopy. Sixty patients were equally randomized into EA group and control group with 30 cases in each. EA (2 Hz/100 Hz, 4-6 V) was applied to the right Zusanli (ST 36) and Shangjuxu (ST 37), and the left Yinlingquan (SP 9), Sanyinjiao (SP 6) and bilateral Hegu (LI 4) respectively 30 min before colonoscopy. The mean arterial pressure (MAP), heart rate (HR) and BIS in two groups were continuously monitored during the study. Plasma beta-EP concentration was detected by radioimmunoassay. The patient's adverse reactions (including pain, satisfaction degree, etc.) were evaluated by visual analog scale (VAS) and verbal stress scale (VSS). Self-comparison showed that MAP and HR in control group increased significantly during colonoscope's splenic flexure passing (P<0.05). Whereas the 2 indexes in EA group had no significant changes during colonoscope insertion, and its splenic flexure passing, hepatic flexure passing and post-enteroscopy (P>0.05). Comparison between two groups showed that MAP at the time-point of colonoscope insertion, and HR at the time-point of colonoscope's splenic flexure passing in EA group were significantly lower than those in control group (P<0.05). BIS values of EA group were significantly lower than those of control group at different time-points after colonoscope insertion (P<0.01). Plasma beta-EP concentrations at the time-points of colonoscope's hepatic flexure passing and post-enteroscopy were evidently increased in both groups in comparison with pre-enteroscopy (P<0.01), and beta-EP was significantly lower in EA group than that in control group at the time-point of colonoscope's hepatic flexure passing (P<0.05). The dosage of Midazolam used for conscious-sedation and the scores of VAS and VSS were also considerably lower in EA group than those in control group (P<0.05, P<0.01). No significant differences were found between two groups in the adverse reactions as dizziness, nausea, vomiting and abdominal pain, but the patients' satisfaction degree in EA group was evidently higher than that in control group (P<0.05). Acupuncture analgesia can effectively lower the colonoscopy patients' BIS value and plasma beta-EP level, meaning attenuation of the patients' stress responses during colonoscopy after EA.

Enteroscopic biopsies in the management of pancreas transplants: a proof of concept study for a novel monitoring tool.

PubMed

Margreiter, Christian; Aigner, Felix; Resch, Thomas; Berenji, Anna-Katharina; Oberhuber, Rupert; Sucher, Robert; Profanter, Christoph; Veits, Lothar; Öllinger, Robert; Margreiter, Raimund; Pratschke, Johann; Mark, Walter

2012-01-27

Although percutaneous biopsies are considered to be the gold standard in diagnosing pancreas graft rejection, they are not performed routinely because of their association with severe complications. On the other hand, correct diagnosis of rejection is essential but may be difficult in cases of enteric drainage, particularly in patients with a pancreas transplant alone or a pancreas after kidney transplant. Pancreas recipients who underwent enteroscopy between May 2005 and September 2009 were included in this retrospective analysis. Biopsies were graded 0 to 4 for interstitial and vascular changes. During the study period a total of 65 simultaneous pancreas-kidney transplants, 13 pancreas after kidney transplants and 4 pancreas transplants alone were performed. Sixty-three patients underwent a single enteroscopy, 10 had two, and 6 had three or more. Indications were protocol graft monitoring (n=73), graft dysfunction (n=17), enteric hemorrhage (n=9), or other (n=3). The duodenal segment was accessed in 76 instances (75%) with abnormal findings in 23. A total of 69 biopsies were obtained and revealed normal mucosa in 49 cases (71%). Histology showed signs of acute rejection in 11 cases. The upper gastrointestinal tract was also assessed, and, in 13 cases, additional pathologies were identified including gastroduodenitis (n=10), gastric/duodenal ulcer (n=2), and hemorrhagic esophagitis (n=1). No procedure-related complication occurred. This series of enteroscopies demonstrates that the duodenal segment of a pancreatic graft is accessible using our implant technique, and thus permitting biopsies to be obtained and endoscopic interventions to be performed.

Clinical radiology of the small intestine

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

Herlinger, H.; Maglinte, D.

1989-01-01

This book discussed embryology, anatomy, physiology, and immunology of the small intestine. Radiographic procedures in the small intestine especially enterolysis are presented. Focus is on the role of other types of imaging techniques including sonography, computed tomography, radionuclide imaging, angiography, biopsy, and enteroscopy.

Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy

PubMed Central

Park, Min Seon; Lee, Beom Jae; Gu, Dae Hoe; Pyo, Jeung-Hui; Kim, Kyeong Jin; Lee, Yun Ho; Joo, Moon Kyung; Park, Jong-Jae; Kim, Jae Seon; Bak, Young-Tae

2013-01-01

Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage. It causes protein-losing enteropathy and may lead to gastrointestinal bleeding. Commonly, lymphangiectasia presents as whitish spots or specks. To our knowledge, small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported. Here, we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature. An 80-year-old woman was hospitalized for melena. Esophagogastroduodenoscopy could not identify the source of bleeding. Subsequent colonoscopy showed fresh bloody material gushing from the small bowel. An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings. Video capsule endoscopy showed evidence of active and recent bleeding in the ileum. To localize the bleeding site, we performed double balloon enteroscopy by the anal approach. A small, bleeding, polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery. PMID:24363538

Primary intestinal lymphangiectasia diagnosed by capsule endoscopy and double balloon enteroscopy

PubMed Central

Oh, Tak Geun; Chung, Joo Won; Kim, Hee Man; Han, Seok-Joo; Lee, Jin Sung; Park, Jung Yeob; Song, Si Young

2011-01-01

Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lymphatics and the development of protein-losing enteropathy. Patients with PIL develop hypoalbuminemia, hypocalcemia, lymphopenia and hypogammaglobulinemia, and present with bilateral lower limb edema, fatigue, abdominal pain and diarrhea. Endoscopy reveals diffusely elongated, circumferential and polypoid mucosae covered with whitish enlarged villi, all of which indicate intestinal lymphangiectasia. Diagnosis is confirmed by characteristic tissue pathology, which includes dilated intestinal lymphatics with diffusely swollen mucosa and enlarged villi. The prevalence of PIL has increased since the introduction of capsule endoscopy. The etiology and prevalence of PIL remain unknown. Some studies have reported that several genes and regulatory molecules for lymphangiogenesis are related to PIL. We report the case of a patient with PIL involving the entire small bowel that was confirmed by capsule endoscopy and double-balloon enteroscopy-guided tissue pathology who carried a deletion on chromosome 4q25. The relationship between this deletion on chromosome 4 and PIL remains to be investigated. PMID:22110841

Bleeding from duodenal ulcer in a patient with bilio-pancreatic diversion.

PubMed

Garancini, Mattia; Luperto, Margherita; Delitala, Alberto; Maternini, Matteo; Uggeri, Franco

2011-12-01

Scopinaro's bilio-pancreatic diversion is considered as an acceptable malabsorptive surgical approach for the treatment of morbid obesity. We describe a case of acute recurrent gastro-intestinal bleeding in a patient with a previous Scopinaro's bilio-pancreatic diversion. At the first admission in our department, gastroscopy, colonoscopy, contrast-enhanced computerized tomography and angiography resulted negative for active bleeding. Hypovolemic shock indicated laparotomy and an intraoperative enteroscopy performed through a small enterotomy showed an ulcerative perforation sourced in an ischemic portion of a distended duodenal stump, with a bleeding branch of gastro-duodenal artery at the bottom. Hemorrhage was stopped with stitches. Two years later a new episode of duodenal bleeding associated with severe malnutrition occurred. A covered chronic ischemic perforation sustained by duodenal distension due to biliopancreatic limb sub-obstruction appeared to be the most probable etiology of the recurrent duodenal bleeding. The patient underwent again to laparotomy and adhesiolysis; hemorrhage was stopped by means of ligation of gastroduodenal artery and bilio-pancreatic diversion was converted into a standard Roux-en-Y gastroenterostomy with an entero-entero anastomosis 40 cm from the Treitz ligament in order to restore an anatomo-functional condition guaranteeing normal absorption and intestinal transit. After Scopinaro's bilio-pancreatic diversion duodenal bleeding can represent a rare serious presentation of biliopancreatic limb obstruction; because of the complex anatomical reconstruction performed during this intervention, the duodenum results unavailable during upper gastro-intestinal endoscopy, and if a duodenal bleeding is suspected laparotomy followed by enteroscopy represents an effective diagnostic approach.

Effect of Roux-en-Y gastric bypass on the distribution and hormone expression of small-intestinal enteroendocrine cells in obese patients with type 2 diabetes.

PubMed

Rhee, Nicolai A; Wahlgren, Camilla D; Pedersen, Jens; Mortensen, Brynjulf; Langholz, Ebbe; Wandall, Erik P; Friis, Steffen U; Vilmann, Peter; Paulsen, Sarah J; Kristiansen, Viggo B; Jelsing, Jacob; Dalbøge, Louise S; Poulsen, Steen S; Holst, Jens J; Vilsbøll, Tina; Knop, Filip K

2015-10-01

We studied the impact of Roux-en-Y gastric bypass (RYGB) on the density and hormonal gene expression of small-intestinal enteroendocrine cells in obese patients with type 2 diabetes. Twelve patients with diabetes and 11 age- and BMI-matched controls underwent RYGB followed by enteroscopy ~10 months later. Mucosal biopsies taken during surgery and enteroscopy were immunohistochemically stained for glucagon-like peptide-1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), glucose-dependent insulinotropic polypeptide (GIP) and prohormone convertase 2 (PC2) and the expression of GCG (encoding preproglucagon), PYY, CCK, GIP, GHRL (encoding ghrelin), SCT (encoding secretin), NTS (encoding neurotensin) and NR1H4 (encoding farnesoid X receptor) was evaluated. The density of cells immunoreactive for GLP-1, CCK and GIP increased in patients after RYGB and the density of those immunoreactive for GLP-1, PYY, CCK and PC2 increased in controls. In both groups, GHRL, SCT and GIP mRNA was reduced after RYGB while PYY, CCK, NTS and NR1H4 gene expression was unaltered. GCG mRNA was upregulated in both groups. Numerous alterations in the distribution of enteroendocrine cells and their expression of hormonal genes are seen after RYGB and include increased density of GLP-1-, PYY-, CCK-, GIP- and PC2-positive cells, reduced gene expression of GHRL, SCT and GIP and increased expression of GCG.

Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy.

PubMed

Park, Min Seon; Lee, Beom Jae; Gu, Dae Hoe; Pyo, Jeung-Hui; Kim, Kyeong Jin; Lee, Yun Ho; Joo, Moon Kyung; Park, Jong-Jae; Kim, Jae Seon; Bak, Young-Tae

2013-12-07

Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage. It causes protein-losing enteropathy and may lead to gastrointestinal bleeding. Commonly, lymphangiectasia presents as whitish spots or specks. To our knowledge, small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported. Here, we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature. An 80-year-old woman was hospitalized for melena. Esophagogastroduodenoscopy could not identify the source of bleeding. Subsequent colonoscopy showed fresh bloody material gushing from the small bowel. An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings. Video capsule endoscopy showed evidence of active and recent bleeding in the ileum. To localize the bleeding site, we performed double balloon enteroscopy by the anal approach. A small, bleeding, polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery. © 2013 Baishideng Publishing Group Co., Limited. All rights reserved.

Endoscopic features of gastro-intestinal lymphomas: From diagnosis to follow-up

PubMed Central

Vetro, Calogero; Romano, Alessandra; Amico, Irene; Conticello, Concetta; Motta, Giovanna; Figuera, Amalia; Chiarenza, Annalisa; Di Raimondo, Cosimo; Giulietti, Giorgio; Bonanno, Giacomo; Palumbo, Giuseppe Alberto; Di Raimondo, Francesco

2014-01-01

Many progresses have been done in the management of gastrointestinal (GI) lymphomas during last decades, especially after the discovery of Helicobacter pylori-dependent lymphoma development. The stepwise implementation of new endoscopic techniques, by means of echoendoscopy or double-balloon enteroscopy, enabled us to more precisely describe the endoscopic features of GI lymphomas with substantial contribution in patient management and in tailoring the treatment strategy with organ preserving approaches. In this review, we describe the recent progresses in GI lymphoma management from disease diagnosis to follow-up with a specific focus on the endoscopic presentation according to the involved site and the lymphoma subtype. Additionally, new or emerging endoscopic technologies that have an impact on the management of gastrointestinal lymphomas are reported. We here discuss the two most common subtypes of GI lymphomas: the mucosa-associated lymphoid tissue and the diffuse large B cell lymphoma. A general outline on the state-of-the-art of the disease and on the role of endoscopy in both diagnosis and follow-up will be performed. PMID:25278693

Update on imaging of Peutz-Jeghers syndrome

PubMed Central

Tomas, Catherine; Soyer, Philippe; Dohan, Anthony; Dray, Xavier; Boudiaf, Mourad; Hoeffel, Christine

2014-01-01

Peutz-Jeghers syndrome (PJS) is a rare, autosomal dominant disease linked to a mutation of the STK 11 gene and is characterized by the development of benign hamartomatous polyps in the gastrointestinal tract in association with a hyperpigmentation on the lips and oral mucosa. Patients affected by PJS have an increased risk of developing gastrointestinal and extra-digestive cancer. Malignancy most commonly occurs in the small-bowel. Extra-intestinal malignancies are mostly breast cancer and gynecological tumors or, to a lesser extent, pancreatic cancer. These polyps are also at risk of acute gastrointestinal bleeding, intussusception and bowel obstruction. Recent guidelines recommend regular small-bowel surveillance to reduce these risks associated with PJS. Small-bowel surveillance allows for the detection of large polyps and the further referral of selected PJS patients for endoscopic enteroscopy or surgery. Video capsule endoscopy, double balloon pushed enteroscopy, multidetector computed tomography and magnetic resonance enteroclysis or enterography, all of which are relatively new techniques, have an important role in the management of patients suffering from PJS. This review illustrates the pathological, clinical and imaging features of small-bowel abnormalities as well as the role and performance of the most recent imaging modalities for the detection and follow-up of PJS patients. PMID:25152588

Case report of primary intestinal lymphangiectasia diagnosed in an octogenarian by ileal intubation and by push enteroscopy after missed diagnosis by standard colonoscopy and EGD.

PubMed

Cappell, Mitchell S; Edhi, Ahmed; Amin, Mitual

2018-01-01

Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients < 3 years old, is rarely first diagnosed in adulthood, and when first diagnosed in adulthood typically presents with symptoms for many years. Although PIL is often identified by endoscopic abnormalities, it must be emphasized that the jejunoileum/distal duodenum must be intubated for diagnosis because the lesions are present in these regions. This work demonstrates that 1)-PIL can occur in an octogenarian; 2)-shows that the characteristic endoscopic findings are not found at colonoscopy without terminal ileal intubation; and 3)-may be missed at standard EGD without distal duodenal intubation. A patient initially presented at age 83 with symptoms of watery diarrhea, abdominal distention, 5-Kg-weight-gain, and weakness for one month, and had typical clinical findings of PIL including chylous ascites, pleural effusions, bilateral pitting leg edema, hypoalbuminemia, borderline lymphopenia, hypovitaminosis-D, and hypocalcemia. Protein-losing-enteropathy was demonstrated by positive stool tests for alpha-1-antitrypsin. Standard colonoscopy revealed no significant lesions, but terminal ileal intubation during colonoscopy demonstrated creamy-white, punctate, mucosal lesions in terminal ileum, characteristic of lymphangiectasia. EGD with intubation to mid-descending duodenum revealed no significant lesions, but subsequent enteroscopy demonstrated lesions in distal duodenum/proximal jejunum similar to those in terminal ileum characteristic of lymphangiectasia. Histopathologic analysis of lesions of terminal ileum/distal duodenum demonstrated dilated mucosal vessels, confirmed as lymphatic vessels by immunohistochemistry. PIL was diagnosed after excluding secondary causes of intestinal lymphangiectasia. Patient placed on standard PIL diet: oral supplements of medium-chain triglycerides, a high protein diet, supplements of fat-soluble vitamins, and avoiding long-chain fatty acids, with marked clinical improvement. This work shows that: 1)-standard EGD and colonoscopy may miss characteristic lesions of PIL, 2)-enteroscopy or terminal ileal intubation at colonoscopy may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum; and 3)-PIL can first present in the very elderly even with symptoms of short duration. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Case report of primary intestinal lymphangiectasia diagnosed in an octogenarian by ileal intubation and by push enteroscopy after missed diagnosis by standard colonoscopy and EGD

PubMed Central

Cappell, Mitchell S.; Edhi, Ahmed; Amin, Mitual

2018-01-01

Abstract Rationale: Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients < 3 years old, is rarely first diagnosed in adulthood, and when first diagnosed in adulthood typically presents with symptoms for many years. Although PIL is often identified by endoscopic abnormalities, it must be emphasized that the jejunoileum/distal duodenum must be intubated for diagnosis because the lesions are present in these regions. This work demonstrates that 1)-PIL can occur in an octogenarian; 2)-shows that the characteristic endoscopic findings are not found at colonoscopy without terminal ileal intubation; and 3)-may be missed at standard EGD without distal duodenal intubation. Diagnoses: A patient initially presented at age 83 with symptoms of watery diarrhea, abdominal distention, 5-Kg-weight-gain, and weakness for one month, and had typical clinical findings of PIL including chylous ascites, pleural effusions, bilateral pitting leg edema, hypoalbuminemia, borderline lymphopenia, hypovitaminosis-D, and hypocalcemia. Protein-losing-enteropathy was demonstrated by positive stool tests for alpha-1-antitrypsin. Standard colonoscopy revealed no significant lesions, but terminal ileal intubation during colonoscopy demonstrated creamy-white, punctate, mucosal lesions in terminal ileum, characteristic of lymphangiectasia. EGD with intubation to mid-descending duodenum revealed no significant lesions, but subsequent enteroscopy demonstrated lesions in distal duodenum/proximal jejunum similar to those in terminal ileum characteristic of lymphangiectasia. Histopathologic analysis of lesions of terminal ileum/distal duodenum demonstrated dilated mucosal vessels, confirmed as lymphatic vessels by immunohistochemistry. PIL was diagnosed after excluding secondary causes of intestinal lymphangiectasia. Interventions/Outcomes: Patient placed on standard PIL diet: oral supplements of medium-chain triglycerides, a high protein diet, supplements of fat-soluble vitamins, and avoiding long-chain fatty acids, with marked clinical improvement. Lessons: This work shows that: 1)-standard EGD and colonoscopy may miss characteristic lesions of PIL, 2)-enteroscopy or terminal ileal intubation at colonoscopy may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum; and 3)-PIL can first present in the very elderly even with symptoms of short duration. PMID:29505002

Success of single-balloon enteroscopy in patients with surgically altered anatomy.

PubMed

Kurzynske, Frank C; Romagnuolo, Joseph; Brock, Andrew S

2015-08-01

Single-balloon enteroscopy (SBE) was introduced in 2007 to diagnose and treat small-bowel disorders. No study to date has evaluated SBE in patients with surgically altered anatomy outside of ERCP. To evaluate the efficacy, yield, and safety of SBE in patients with surgically altered anatomy. Retrospective study. Tertiary-care academic medical center. All patients with altered surgical anatomy who underwent SBE at the Medical University of South Carolina from July 2007 to September 2013. SBE. Diagnostic yield, therapeutic yield, technical success, and adverse events. A total of 48 patients met inclusion criteria. Mean age was 56 years (77% female). Eleven patients underwent single-balloon PEG placement, 8 single-balloon ERCP, 22 non-PEG/non-ERCP anterograde SBE, and 7 retrograde SBE. Previous surgeries included Roux-en-Y gastric bypass (n=26), small-intestine resection (n=6), colon resection (n=5), Whipple procedure (n=4), choledochojejunostomy (n=3), hepaticojejunostomy (n=1), Billroth I (n=1), Billroth II (n=1), and Puestow procedure (n=1). Procedural indications were PEG tube placement (n=11), choledocholithiasis (n=2), biliary stricture (n=2), obstructive jaundice (n=1), cholangitis (n=1), ampullary mass (n=1), sphincter of Oddi dysfunction (n=1), anemia and/or bleeding (n=15), abdominal pain (n=9), radiologic evidence of obstruction (n=3), and Peutz-Jeghers syndrome (n=2). The technical success rate was 73% in single-balloon PEG placement, 88% in single-balloon ERCP, 82% in other anterograde SBEs, and 86% in retrograde SBEs. No intraprocedural or postprocedural adverse events were observed. Single center, retrospective study. SBE is safe and effective in patients with surgically altered anatomy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Functional Correlation Between the Pancreas and the Small Intestine in Humans: The First Evaluation Using a Newly Developed Enteroscopy.

PubMed

Hayashi, Daijuro; Hirooka, Yoshiki; Kawashima, Hiroki; Ohno, Eizaburo; Ishikawa, Takuya; Kuwahara, Takamichi; Kawai, Manabu; Yamamura, Takeshi; Furukawa, Kazuhiro; Funasaka, Kohei; Nakamura, Masanao; Miyahara, Ryoji; Watanabe, Osamu; Ishigami, Masatoshi; Hashimoto, Senju; Goto, Hidemi

The aim of this study is to evaluate a functional correlation between the pancreas and the small intestine and the association of this relationship with nutritional status, using magnifying enteroscopy. The subjects were adults aged 20 years or older who underwent upper gastrointestinal endoscopy. An endoscope was inserted into the jejunum, and 10% glucose was sprayed under magnifying observation to evaluate changes in blood flow in the villous capillary network. Mucosal biopsy was performed before and after spraying to evaluate the incretin response in the jejunal mucosa. A total of 124 patients participated in the study. There was a positive correlation between villous blood flow change and exocrine pancreas function (R = 0.4337, P < 0.0001). Changes of gastric inhibitory polypeptide and glucagon-like peptide messenger RNAs in biopsy samples were positively correlated with endocrine pancreas function in 88 patients without treatment for diabetes (R = 0.4314, P = 0.0012; R = 0.4112, P = 0.0081). In patients with lower villous blood flow change and decreased pancreatic exocrine function, the prognostic nutritional index were significantly lower (P = 0.0098), compared with other patients. This study provides the first evidence of a close functional correlation between the pancreas and the small intestine.

Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy.

PubMed

Kopáčová, Marcela; Bureš, Jan; Rejchrt, Stanislav; Vávrová, Jaroslava; Bártová, Jolana; Soukup, Tomáš; Tomš, Jan; Tachecí, Ilja

Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis after DBE. We investigated several laboratory markers before and after DBE (serum cathepsin B, lactoferrin, E-selectin, SPINK 1, procalcitonin, S100 proteins, alfa-1-antitrypsin, hs-CRP, malondialdehyde, serum and urine amylase and serum lipase). Serum amylase and lipase rose significantly with the maximum 4 hours after DBE. Serum cathepsin and procalcitonin decreased significantly 4 hours after DBE compared to healthy controls and patients values before DBE. Either serum amylase or lipase 4 hours after DBE did not correlate with any markers before DBE. There was a trend for an association between the number of push-and-pull cycles and procalcitonin and urine amylase 4 hours after DBE; between procalcitonin and alfa-1-antitrypsin, cathepsin and hs-CRP; and between E-selectin and malondialdehyde 4 hours after DBE. We found no laboratory markers determinative in advance those patients in a higher risk of acute pancreatitis after DBE.

A case of gastrojejunocolic fistula with steatohepatitis.

PubMed

Omori, Teppei; Tokushige, Katsutoshi; Kinoshita, Fukiko; Ito, Ayumi; Taniai, Makiko; Taneichi, Mikiko; Iizuka, Bunei; Itabashi, Michio; Nagashima, Yoji; Yamamoto, Masakazu; Nakamura, Shinichi; Hashimoto, Etsuko

2017-02-01

A man in his 30s, who had undergone retrocolic Billroth II reconstruction for perforated duodenal ulcer, presented with watery diarrhea for 2 years and suspected fatty liver. He was referred to our hospital for management of chronic diarrhea, weight loss, hepatopathy and hypoalbuminemia. Initial upper and lower gastrointestinal endoscopies were negative. Since a small bowel lesion was suspected, peroral single-balloon enteroscopy was performed, which identified feces-like residue near the Billroth II anastomotic site and a connection to the colon separate from the afferent and efferent loops. Transanal single-balloon enteroscopy identified a fistula between the gastrojejunal anastomosis and transverse colon, with the scope reaching the stomach transanally. Barium enema confirmed flow of contrast medium from the transverse colon through the fistula to the anastomotic site, allowing the diagnosis of gastrojejunocolic fistula. Liver biopsy showed relatively severe steatohepatitis (Brunt's classification: stage 2-3, grade 3). Resection of the anastomotic site and partial transverse colectomy were performed to remove the fistula, followed by Roux-en-Y reconstruction. Postoperatively, watery diarrhea resolved and the stools became normal. Hepatopathy and hypoproteinemia improved. One year later, liver biopsy showed marked improvement of steatosis. This case demonstrated marked improvement of both diarrhea/nutritional status and steatohepatitis after treatment of gastrojejunocolic fistula, suggesting that the fistula caused non-alcoholic steatohepatitis.

Is non‐steroidal anti‐inflammaory drug (NSAID) enteropathy clinically more important than NSAID gastropathy?

PubMed Central

Adebayo, D; Bjarnason, I

2006-01-01

The side effects of conventional non‐steroidal anti‐inflammatory drugs (NSAIDs) on the stomach is undoubtedly a serious public health problem contributing significantly to the morbidity and mortality of patients receiving these drugs. However, the damage of NSAIDs is not confined to the stomach. Indeed the short term and long term damage of NSAIDs on the small bowel (NSAID enteropathy) is more frequent than NSAID gastropathy. Furthermore, NSAID enteropathy is associated with complications (bleeding and protein loss). While many of these are mild, the serious events (significant bleeding, perforation, obstruction, and sudden death) are frequent as that reported for NSAID gastropathy. The diagnosis of NSAID enteropathy has been greatly aided by the introduction of wireless capsule enteroscopy. PMID:16517800

Is non-steroidal anti-inflammaory drug (NSAID) enteropathy clinically more important than NSAID gastropathy?

PubMed

Adebayo, D; Bjarnason, I

2006-03-01

The side effects of conventional non-steroidal anti-inflammatory drugs (NSAIDs) on the stomach is undoubtedly a serious public health problem contributing significantly to the morbidity and mortality of patients receiving these drugs. However, the damage of NSAIDs is not confined to the stomach. Indeed the short term and long term damage of NSAIDs on the small bowel (NSAID enteropathy) is more frequent than NSAID gastropathy. Furthermore, NSAID enteropathy is associated with complications (bleeding and protein loss). While many of these are mild, the serious events (significant bleeding, perforation, obstruction, and sudden death) are frequent as that reported for NSAID gastropathy. The diagnosis of NSAID enteropathy has been greatly aided by the introduction of wireless capsule enteroscopy.

Hookworm Infection: A Neglected Cause of Overt Obscure Gastrointestinal Bleeding.

PubMed

Wei, Kun-Yan; Yan, Qiong; Tang, Bo; Yang, Shi-Ming; Zhang, Peng-Bing; Deng, Ming-Ming; Lü, Mu-Han

2017-08-01

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

Peritoneal Lipomatosis: A Case Report of a 12-Year-Old Boy

PubMed Central

Fotis, L.; Koglmeier, J.; Shah, N.

2013-01-01

Peritoneal lipomatosis is a rare disease in childhood with only two cases previously described in children. We report a further case of a 12-year-old boy diagnosed with peritoneal lipomatosis. His main symptoms were abdominal pain, alternating bowel habit, abdominal distension, and melaena. His diagnostic work up included an abdominal MRI, wireless capsule endoscopy and single-balloon enteroscopy. Peritoneal lipomatosis although rare can be diagnosed in childhood. It is a benign clinical entity with variable manifestations. PMID:23762668

Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography

PubMed Central

Osoegawa, Takashi; Motomura, Yasuaki; Akahoshi, Kazuya; Higuchi, Naomi; Tanaka, Yoshimasa; Hisano, Terumasa; Itaba, Souichi; Gibo, Junya; Yamada, Mariko; Kubokawa, Masaru; Sumida, Yorinobu; Akiho, Hirotada; Ihara, Eikichi; Nakamura, Kazuhiko

2012-01-01

AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth II gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing, selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth II reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88 %), Billroth II reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire. The mean total duration of the procedure was 93.6 ± 6.8 min and the mean time required to reach the papilla was 30.5 ± 3.7 min. The mean time required to reach the papilla tended to be shorter in Billroth II reconstruction (20.9 ± 5.8 min) than that in Roux-en-Y total gastrectomy (37.1 ± 4.9 min) but there was no significant difference (P = 0.09). A major complication occurred in one patient (3.5%); perforation of the long limb in a patient with Billroth II anastomosis. CONCLUSION: Short-type DBE combined with several technical innovations enabled us to perform ERCP in most patients with altered gastrointestinal anatomy. PMID:23239923

Peutz-Jeghers syndrome: Diagnostic and therapeutic approach

PubMed Central

Kopacova, Marcela; Tacheci, Ilja; Rejchrt, Stanislav; Bures, Jan

2009-01-01

Peutz-Jeghers syndrome (PJS) is an inherited, autosomal dominant disorder distinguished by hamartomatous polyps in the gastrointestinal tract and pigmented mucocutaneous lesions. Prevalence of PJS is estimated from 1 in 8300 to 1 in 280 000 individuals. PJS predisposes sufferers to various malignancies (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular tumors). Bleeding, obstruction and intussusception are common complications in patients with PJS. Double balloon enteroscopy (DBE) allows examination and treatment of the small bowel. Polypectomy using DBE may obviate the need for repeated urgent operations and small bowel resection that leads to short bowel syndrome. Prophylaxis and polypectomy of the entire small bowel is the gold standard in PJS patients. Intraoperative enteroscopy (IOE) was the only possibility for endoscopic treatment of patients with PJS before the DBE era. Both DBE and IOE facilitate exploration and treatment of the small intestine. DBE is less invasive and more convenient for the patient. Both procedures are generally safe and useful. An overall recommendation for PJS patients includes not only gastrointestinal multiple polyp resolution, but also regular lifelong cancer screening (colonoscopy, upper endoscopy, computed tomography, magnetic resonance imaging or ultrasound of the pancreas, chest X-ray, mammography and pelvic examination with ultrasound in women, and testicular examination in men). Although the incidence of PJS is low, it is important for clinicians to recognize these disorders to prevent morbidity and mortality in these patients, and to perform presymptomatic testing in the first-degree relatives of PJS patients. PMID:19916169

Blood detection in wireless capsule endoscopy using expectation maximization clustering

NASA Astrophysics Data System (ADS)

Hwang, Sae; Oh, JungHwan; Cox, Jay; Tang, Shou Jiang; Tibbals, Harry F.

2006-03-01

Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. Other endoscopies such as colonoscopy, upper gastrointestinal endoscopy, push enteroscopy, and intraoperative enteroscopy could be used to visualize up to the stomach, duodenum, colon, and terminal ileum, but there existed no method to view most of the small intestine without surgery. With the miniaturization of wireless and camera technologies came the ability to view the entire gestational track with little effort. A tiny disposable video capsule is swallowed, transmitting two images per second to a small data receiver worn by the patient on a belt. During an approximately 8-hour course, over 55,000 images are recorded to a worn device and then downloaded to a computer for later examination. Typically, a medical clinician spends more than two hours to analyze a WCE video. Research has been attempted to automatically find abnormal regions (especially bleeding) to reduce the time needed to analyze the videos. The manufacturers also provide the software tool to detect the bleeding called Suspected Blood Indicator (SBI), but its accuracy is not high enough to replace human examination. It was reported that the sensitivity and the specificity of SBI were about 72% and 85%, respectively. To address this problem, we propose a technique to detect the bleeding regions automatically utilizing the Expectation Maximization (EM) clustering algorithm. Our experimental results indicate that the proposed bleeding detection method achieves 92% and 98% of sensitivity and specificity, respectively.

The management of lower gastrointestinal bleeding.

PubMed

Marion, Y; Lebreton, G; Le Pennec, V; Hourna, E; Viennot, S; Alves, A

2014-06-01

Lower gastrointestinal (LGI) bleeding is generally less severe than upper gastrointestinal (UGI) bleeding with spontaneous cessation of bleeding in 80% of cases and a mortality of 2-4%. However, unlike UGI bleeding, there is no consensual agreement about management. Once the patient has been stabilized, the main objective and greatest difficulty is to identify the location of bleeding in order to provide specific appropriate treatment. While upper endoscopy and colonoscopy remain the essential first-line examinations, the development and availability of angiography have made this an important imaging modality for cases of active bleeding; they allow diagnostic localization of bleeding and guide subsequent therapy, whether therapeutic embolization, interventional colonoscopy or, if other techniques fail or are unavailable, surgery directed at the precise site of bleeding. Furthermore, newly developed endoscopic techniques, particularly video capsule enteroscopy, now allow minimally invasive exploration of the small intestine; if this is positive, it will guide subsequent assisted enteroscopy or surgery. Other small bowel imaging techniques include enteroclysis by CT or magnetic resonance imaging. At the present time, exploratory surgery is no longer a first-line approach. In view of the lesser gravity of LGI bleeding, it is most reasonable to simply stabilize the patient initially for subsequent transfer to a specialized center, if minimally invasive techniques are not available at the local hospital. In all cases, the complexity and diversity of LGI bleeding require a multidisciplinary collaboration involving the gastroenterologist, radiologist, intensivist and surgeon to optimize diagnosis and treatment of the patient. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Ad hoc cost analysis of the new gastrointestinal bleeding algorithm in patients with ventricular assist device.

PubMed

Hirose, Hitoshi; Sarosiek, Konrad; Cavarocchi, Nicholas C

2014-01-01

Gastrointestinal bleed (GIB) is a known complication in patients receiving nonpulsatile ventricular assist devices (VAD). Previously, we reported a new algorithm for the workup of GIB in VAD patients using deep bowel enteroscopy. In this new algorithm, patients underwent fewer procedures, received less transfusions, and took less time to make the diagnosis than the traditional GIB algorithm group. Concurrently, we reviewed the cost-effectiveness of this new algorithm compared with the traditional workup. The procedure charges for the diagnosis and treatment of each episode of GIB was ~ $2,902 in the new algorithm group versus ~ $9,013 in the traditional algorithm group (p < 0.0001). Following the new algorithm in VAD patients with GIB resulted in fewer transfusions and diagnostic tests while attaining a substantial cost savings per episode of bleeding.

Prevention and management of non-steroidal anti-inflammatory drugs-induced small intestinal injury

PubMed Central

Park, Sung Chul; Chun, Hoon Jai; Kang, Chang Don; Sul, Donggeun

2011-01-01

Non-steroidal anti-inflammatory drug (NSAID)-induced small bowel injury is a topic that deserves attention since the advent of capsule endoscopy and balloon enteroscopy. NSAID enteropathy is common and is mostly asymptomatic. However, massive bleeding, stricture, or perforation may occur. The pathogenesis of small intestine injury by NSAIDs is complex and different from that of the upper gastrointestinal tract. No drug has yet been developed that can completely prevent or treat NSAID enteropathy. Therefore, a long-term randomized study in chronic NSAID users is needed. PMID:22180706

Consent, common adverse events, and post-adverse event actions in endoscopy.

PubMed

Adler, Douglas G

2015-01-01

Endoscopy constitutes a wide range of procedures with many indications. Esophagogastroduodenoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography, and enteroscopy comprise the most commonly performed procedures. These examinations all carry risk to the patient, and incumbent in this is some legal risk with regard to how the procedure is conducted, decisions made based on the intraprocedure findings, and the postprocedure results, in addition to events that occur following the procedure. This article provides an overview of consent and complications of endoscopy. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of magnetic resonance imaging and video capsule enteroscopy in diagnosing small-bowel pathology: localization-dependent diagnostic yield.

PubMed

Böcker, Ulrich; Dinter, Dietmar; Litterer, Caroline; Hummel, Frank; Knebel, Phillip; Franke, Andreas; Weiss, Christel; Singer, Manfred V; Löhr, J-Matthias

2010-04-01

New technology has considerably advanced the diagnosis of small-bowel pathology. However, its significance in clinical algorithms has not yet been fully assessed. The aim of the present analysis was to compare the diagnostic utility and yield of video-capsule enteroscopy (VCE) to that of magnetic resonance imaging (MRI) in patients with suspected or established Crohn's disease (Group I), obscure gastrointestinal blood loss (Group II), or suspected tumors (Group III). Forty-six out of 182 patients who underwent both modalities were included: 21 in Group I, 20 in Group II, and five in Group III. Pathology was assessed in three predetermined sections of the small bowel (upper, middle, and lower). The McNemar and Wilcoxon tests were used for statistical analysis. In Group I, lesions were found by VCE in nine of the 21 patients and by MRI in six. In five patients, both modalities showed pathology. In Group II, pathological changes were detected in 11 of the 20 patients by VCE and in eight patients by MRI. In five cases, pathology was found with both modalities. In Group III, neither modality showed small-bowel pathology. For the patient groups combined, diagnostic yield was 43% with VCE and 30% with MRI. The diagnostic yield of VCE was superior to that of MRI in the upper small bowel in both Groups I and II. VCE is superior to MRI for the detection of lesions related to Crohn's disease or obscure gastrointestinal bleeding in the upper small bowel.

Digital clubbing in primary intestinal lymphangiectasia: a case report.

PubMed

Wiedermann, Christian J; Kob, Michael; Benvenuti, Stefano; Carella, Rodolfo; Lucchin, Lucio; Piazzi, Lucia; Chilovi, Fausto; Mazzoleni, Guido

2010-08-01

Primary intestinal lymphangiectasia (PIL), also known as Waldmann's disease, is a rare disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. The symptoms usually start in early infancy. We report a case of secondary hyperparathyroidism, osteopenia, monoclonal gammopathy and digital clubbing in a 57-year-old patient with a 12-year history of discontinuous diarrhea. Malabsorption with inability to gain weight, and finally weight loss and formation of leg edema were associated with protein-losing enteropathy. A low-fat diet associated with medium-chain triglyceride supplementation was clinically effective as medical management in reducing diarrhea and leg edema, and promoting weight gain. Double-balloon enteroscopy and small bowel biopsy histopathology confirmed dilated intestinal lacteals. Digital clubbing associated with primary intestinal lymphangiectasia which may causally be related to chronic platelet excess has not been reported before.

Urticaria due to polyethylene glycol-3350 and electrolytes for oral solution in a patient with jejunal nodular lymphoid hyperplasia.

PubMed

Zhang, Hongfeng; Henry, Winoah A; Chen, Lea Ann; Khashab, Mouen A

2015-01-01

Both jejunal nodular lymphoid hyperplasia (NLH) and polyethylene glycol (PEG)-3350 hypersensitivity are extremely rare. We describe a 30-year-old female who had previously taken a PEG-3350 bowel preparation without adverse effects, and presented for evaluation of chronic diarrhea. An upper and lower gastrointestinal endoscopy, and small bowel series were scheduled. PEG-3350 and electrolytes for oral solution was prescribed for bowel cleansing. During consumption of the bowel preparation she developed urticarial hypersensitivity. An alternative bowel preparation was used. Colonoscopy and upper endoscopy were normal, but small bowel series revealed innumerable sand-like lucencies in the jejunum. NLH was confirmed on biopsy from antegrade enteroscopy. This is the first case report on the pathological jejunal NLH in association with the PEG-3350 urticarial hypersensitivity. The potential pathophysiological etiology of this association is discussed.

Urticaria due to polyethylene glycol-3350 and electrolytes for oral solution in a patient with jejunal nodular lymphoid hyperplasia

PubMed Central

Zhang, Hongfeng; Henry, Winoah A.; Chen, Lea Ann; Khashab, Mouen A.

2015-01-01

Both jejunal nodular lymphoid hyperplasia (NLH) and polyethylene glycol (PEG)-3350 hypersensitivity are extremely rare. We describe a 30-year-old female who had previously taken a PEG-3350 bowel preparation without adverse effects, and presented for evaluation of chronic diarrhea. An upper and lower gastrointestinal endoscopy, and small bowel series were scheduled. PEG-3350 and electrolytes for oral solution was prescribed for bowel cleansing. During consumption of the bowel preparation she developed urticarial hypersensitivity. An alternative bowel preparation was used. Colonoscopy and upper endoscopy were normal, but small bowel series revealed innumerable sand-like lucencies in the jejunum. NLH was confirmed on biopsy from antegrade enteroscopy. This is the first case report on the pathological jejunal NLH in association with the PEG-3350 urticarial hypersensitivity. The potential pathophysiological etiology of this association is discussed. PMID:25608714

Initial design of a novel suction enteroscope for endoscopic locomotion in the small bowel (with video).

PubMed

Wagh, Mihir S; Montane, Roberto

2012-02-01

The upper GI tract and the colon are readily accessible endoscopically, but the small intestine is relatively difficult to evaluate. To demonstrate the feasibility of using suction as a means of locomotion and to assess the initial design of a suction enteroscope. Feasibility study. Animal laboratory. Various prototype suction devices designed in our laboratory were tested in swine small intestine in a force test station. For in vivo experiments in live anesthetized animals, two suction devices (1 fixed tip and 1 movable tip) were attached to the outside of the endoscope. By creating suction in the fixed tip, the endoscope was anchored while the movable tip was advanced. Suction was then applied to the extended tip to attach it to the distal bowel. Suction on the fixed tip was then released and the movable tip with suction pulled back, resulting in advancement of the endoscope. These steps were sequentially repeated. Intestinal segments were sent for pathologic assessment after testing. Force generated ranged from 0.278 to 4.74 N with 64.3 to 88 kPa vacuum pressure. A linear relationship was seen between the pull force and vacuum pressures and tip surface area. During in vivo experiments, the endoscope was advanced in 25-cm segmental increments with sequential suction-and-release maneuvers. No significant bowel trauma was seen on pathology and necropsy. The enteroscopy system requires further refinement. A novel suction enteroscope was designed and tested. Suction tip characteristics played a critical role impacting the functionality of this enteroscopy system. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Primary intestinal lymphangiectasia: Minireview

PubMed Central

Ingle, Sachin B; Hinge (Ingle), Chitra R

2014-01-01

Primary idiopathic intestinal lymphangiectasia is an unusual disease featured by the presence of dilated lymphatic channels which are located in the mucosa, submucosa or subserosa leading to protein loosing enteropathy.Most often affected were children and generally diagnosed before third year of life but may be rarely seen in adults too. Bilateral pitting oedema of lower limb is the main clinical manifestation mimicking the systemic disease and posing a real diagnostic dilemma to the clinicians to differentiate it from other common systemic diseases like Congestive cardiac failure, Nephrotic Syndrome, Protein Energy Malnutrition, etc. Diagnosis can be made on capsule endoscopy which can localise the lesion but unable to take biopsy samples. Thus, recently double-balloon enteroscopy and biopsy in combination can be used as an effective diagnostic tool to hit the correct diagnosis. Patients respond dramatically to diet constituting low long chain triglycerides and high protein content with supplements of medium chain triglyceride. So early diagnosis is important to prevent untoward complications related to disease or treatment for the sake of accurate pathological diagnosis. PMID:25325063

Endoscopy in inflammatory bowel disease when and why

PubMed Central

Rameshshanker, Rajaratnam; Arebi, Naila

2012-01-01

Endoscopy plays an important role in the diagnosis and management of inflammatory bowel disease (IBD). It is useful to exclude other aetiologies, differentiate between ulcerative colitis (UC) and Crohn’s disease (CD), and define the extent and activity of inflammation. Ileocolonoscopy is used for monitoring of the disease, which in turn helps to optimize the management. It plays a key role in the surveillance of UC for dysplasia or neoplasia and assessment of post operative CD. Capsule endoscopy and double balloon enteroscopy are increasingly used in patients with CD. Therapeutic applications relate to stricture dilatation and dysplasia resection. The endoscopist’s role is vital in the overall management of IBD. PMID:22720120

An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery.

PubMed

Chen, Yen-I; Levy, Michael J; Moreels, Tom G; Hajijeva, Gulara; Will, Uwe; Artifon, Everson L; Hara, Kazuo; Kitano, Masayuki; Topazian, Mark; Abu Dayyeh, Barham; Reichel, Andreas; Vilela, Tiago; Ngamruengphong, Saowanee; Haito-Chavez, Yamile; Bukhari, Majidah; Okolo, Patrick; Kumbhari, Vivek; Ismail, Amr; Khashab, Mouen A

2017-01-01

Endoscopic management of post-Whipple pancreatic adverse events (AEs) with enteroscopy-assisted endoscopic retrograde pancreatography (e-ERP) is associated with high failure rates. EUS-guided pancreatic duct drainage (EUS-PDD) has shown promising results; however, no comparative data have been done for these 2 modalities. The goal of this study is to compare EUS-PDD with e-ERP in terms of technical success (PDD through dilation/stent), clinical success (improvement/resolution of pancreatic-type symptoms), and AE rates in patients with post-Whipple anatomy. This is an international multicenter comparative retrospective study at 7 tertiary centers (2 United States, 2 European, 2 Asian, and 1 South American). All consecutive patients who underwent EUS-PDD or e-ERP between January 2010 and August 2015 were included. In total, 66 patients (mean age, 57 years; 48% women) and 75 procedures were identified with 40 in EUS-PDD and 35 in e-ERP. Technical success was achieved in 92.5% of procedures in the EUS-PDD group compared with 20% of procedures in the e-ERP group (OR, 49.3; P < .001). Clinical success (per patient) was attained in 87.5% of procedures in the EUS-PDD group compared with 23.1% in the e-ERP group (OR, 23.3; P < .001). AEs occurred more commonly in the EUS-PDD group (35% vs 2.9%, P < .001). However, all AEs were rated as mild or moderate. Procedure time and length of stay were not significantly different between the 2 groups. EUS-PDD is superior to e-ERP in post-Whipple anatomy in terms of efficacy with acceptable safety. As such, EUS-PDD should be considered as a potential first-line treatment in post-pancreaticoduodenectomy anatomy when necessary expertise is available. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery.

PubMed

De Koning, Michael; Moreels, Tom G

2016-08-22

Roux-en-Y reconstructive surgery excludes the biliopancreatic system from conventional endoscopic access. Balloon-assisted enteroscopy allows therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in these patients, avoiding rescue surgery. The objective of the current study is to compare success and complication rate of double-balloon (DBE) and single-balloon enteroscope (SBE) to perform ERCP in Roux-en-Y patients. Seventy three Roux-en-Y patients with suspected biliary tract pathology underwent balloon-assisted enteroscopy in a tertiary-care center. Retrospective analysis of 95 consecutive therapeutic ERCP procedures was performed to define and compare success and complication rate of DBE and SBE. Male-female ratio was 28/45 with a mean age of 58 ± 2 years. 30 (32 %) procedures were performed with DBE and 65 (68 %) with SBE. Overall ERCP success rate was 73 % for DBE and 75 % for SBE (P = 0.831). Failure was due to inability to reach or cannulate the intact papilla or bilioenteric anastomosis. Success rate was significantly higher when performed at the bilioenteric anastomosis (80 % success in 56 procedures) or at the intact papilla in short-limb Roux-en-Y (80 % in 15 procedures) as compared to the intact papilla in long-limb (58 % in 24 procedures; P = 0.040). Adverse event rates were 10 % (DBE) and 8 % (SBE) (P = 0.707) and mostly dealt with conservatively. ERCP after Roux-en-Y altered small bowel anatomy is feasible and safe using both DBE and SBE. Both techniques are equally competent with high success rates and acceptable adverse events rates. ERCP at the level of the intact papilla in long limb Roux-en-Y is less successful as compared to short-limb or bilioenteric anastomosis.

Current diagnosis and treatment of benign biliary strictures after living donor liver transplantation

PubMed Central

Chang, Jae Hyuck; Lee, Inseok; Choi, Myung-Gyu; Han, Sok Won

2016-01-01

Despite advances in surgical techniques, benign biliary strictures after living donor liver transplantation (LDLT) remain a significant biliary complication and play an important role in graft and patient survival. Benign biliary strictures after transplantation are classified into anastomotic or non-anastomotic strictures. These two types differ in presentation, outcome, and response to therapy. The leading causes of biliary strictures include impaired blood supply, technical errors during surgery, and biliary anomalies. Because patients usually have non-specific symptoms, a high index of suspicion should be maintained. Magnetic resonance cholangiography has gained widespread acceptance as a reliable noninvasive tool for detecting biliary complications. Endoscopy has played an increasingly prominent role in the diagnosis and treatment of biliary strictures after LDLT. Endoscopic management in LDLT recipients may be more challenging than in deceased donor liver transplantation patients because of the complex nature of the duct-to-duct reconstruction. Repeated aggressive endoscopic treatment with dilation and the placement of multiple plastic stents is considered the first-line treatment for biliary strictures. Percutaneous and surgical treatments are now reserved for patients for whom endoscopic management fails and for those with multiple, inaccessible intrahepatic strictures or Roux-en-Y anastomoses. Recent advances in enteroscopy enable treatment, even in these latter cases. Direct cholangioscopy, another advanced form of endoscopy, allows direct visualization of the inner wall of the biliary tree and is expected to facilitate stenting or stone extraction. Rendezvous techniques can be a good option when the endoscopic approach to the biliary stricture is unfeasible. These developments have resulted in almost all patients being managed by the endoscopic approach. PMID:26819525

Capsule endoscopy in neoplastic diseases

PubMed Central

Pennazio, Marco; Rondonotti, Emanuele; de Franchis, Roberto

2008-01-01

Until recently, diagnosis and management of small-bowel tumors were delayed by the difficulty of access to the small bowel and the poor diagnostic capabilities of the available diagnostic techniques. An array of new methods has recently been developed, increasing the possibility of detecting these tumors at an earlier stage. Capsule endoscopy (CE) appears to be an ideal tool to recognize the presence of neoplastic lesions along this organ, since it is non-invasive and enables the entire small bowel to be visualized. High-quality images of the small-bowel mucosa may be captured and small and flat lesions recognized, without exposure to radiation. Recent studies on a large population of patients undergoing CE have reported small-bowel tumor frequency only slightly above that reported in previous surgical series (range, 1.6%-2.4%) and have also confirmed that the main clinical indication to CE in patients with small-bowel tumors is obscure gastrointestinal (GI) bleeding. The majority of tumors identified by CE are malignant; many were unsuspected and not found by other methods. However, it remains difficult to identify pathology and tumor type based on the lesion’s endoscopic appearance. Despite its limitations, CE provides crucial information leading in most cases to changes in subsequent patient management. Whether the use of CE in combination with other new diagnostic (MRI or multidetector CT enterography) and therapeutic (Push-and-pull enteroscopy) techniques will lead to earlier diagnosis and treatment of these neoplasms, ultimately resulting in a survival advantage and in cost savings, remains to be determined through carefully-designed studies. PMID:18785274

[Premalignant conditions of the small bowel].

PubMed

Drastich, P

2013-01-01

Small intestinal dysplastic lesions are rare and difficult to detect before they progress to cancer. New investigative modalities, such as capsule endoscopy and doubleballoon enteroscopy, are very promising in search for premalignant lesions. Screening patients at high-risk for small bowel neoplasia is the only sensible approach. Duodenal adenoma represents the most easily accessible tumors with the possibility of curative endoscopic resection. Due to the strong association of the small bowel and colonic adenomas, it is always necessary to perform colonoscopy. In young patients, the exclusion of familial polyposis by genetic testing is always mandatory. Patients with celiac disease are especially at risk of developing nonHodgkins lymphomas and adenocarcinomas. There is a high-risk of ampuloma and other adenomas in patients with familial adenomatous polyposis. Patients with prolonged and complicated course of Crohns disease, Peutz Jeghers syndrome and patients with ileoanal pouch have higher risk of adenocarcinoma of the small intestine.

Ileal Varices Treated with Balloon-Occluded Retrograde Transvenous Obliteration

PubMed Central

Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

2009-01-01

A 55-year-old man with hepatitis B virus antigen-positive liver cirrhosis was admitted to our hospital with anal bleeding. Colonoscopy revealed blood retention in the entire colon, but no bleeding lesion was found. Computed tomography images showed that vessels in the ileum were connected to the right testicular vein, and we suspected ileal varices to be the most probable cause of bleeding. We immediately performed double balloon enteroscopy, but failed to find any site of bleeding owing to the difficulty of fiberscope insertion with sever adhesion. Using a balloon catheter during retrograde transvenous venography, we found ileal varices communicating with the right testicular vein (efferent vein) with the superior mesenteric vein branch as the afferent vein of these varices. We performed balloon occluded retrograde transvenous obliteration by way of the efferent vein of the varices and have detected no further bleeding in this patient one year after treatment. PMID:27956966

Ileal Varices Treated with Balloon-Occluded Retrograde Transvenous Obliteration.

PubMed

Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

2009-04-01

A 55-year-old man with hepatitis B virus antigen-positive liver cirrhosis was admitted to our hospital with anal bleeding. Colonoscopy revealed blood retention in the entire colon, but no bleeding lesion was found. Computed tomography images showed that vessels in the ileum were connected to the right testicular vein, and we suspected ileal varices to be the most probable cause of bleeding. We immediately performed double balloon enteroscopy, but failed to find any site of bleeding owing to the difficulty of fiberscope insertion with sever adhesion. Using a balloon catheter during retrograde transvenous venography, we found ileal varices communicating with the right testicular vein (efferent vein) with the superior mesenteric vein branch as the afferent vein of these varices. We performed balloon occluded retrograde transvenous obliteration by way of the efferent vein of the varices and have detected no further bleeding in this patient one year after treatment.

[Congenital intestinal lymphangiectasia].

PubMed

Popović, Dugan D j; Spuran, Milan; Alempijević, Tamara; Krstić, Miodrag; Djuranović, Srdjan; Kovacević, Nada; Damnjanović, Svetozar; Micev, Marjan

2011-03-01

Congenital intestinal lymphangiectasia is a disease which leads to protein losing enteropathy. Tortuous, dilated lymphatic vessels in the intestinal wall and mesenterium are typical features of the disease. Clinical manifestations include malabsorption, diarrhea, steatorrhea, edema and effusions. Specific diet and medication are required for disease control. A 19-year old male patient was hospitalized due to diarrhea, abdominal swelling, weariness and fatigue. Physical examination revealed growth impairment, ascites, and lymphedema of the right hand and forearm. Laboratory assessment indicated iron deficiency anaemia, lymphopenia, malabsorption, inflammatory syndrome, and urinary infection. Enteroscopy and video capsule endoscopy demonstrated dilated lymphatic vessels in the small intestine. The diagnosis was confirmed by intestinal biopsy. The patient was put on high-protein diet containing medium-chain fatty acids, somatotropin and supportive therapy. Congenital intestinal lymphangiectasia is a rare disease, usually diagnosed in childhood. Early recognition of the disease and adequate treatment can prevent development of various complications.

Blurry-frame detection and shot segmentation in colonoscopy videos

NASA Astrophysics Data System (ADS)

Oh, JungHwan; Hwang, Sae; Tavanapong, Wallapak; de Groen, Piet C.; Wong, Johnny

2003-12-01

Colonoscopy is an important screening procedure for colorectal cancer. During this procedure, the endoscopist visually inspects the colon. Human inspection, however, is not without error. We hypothesize that colonoscopy videos may contain additional valuable information missed by the endoscopist. Video segmentation is the first necessary step for the content-based video analysis and retrieval to provide efficient access to the important images and video segments from a large colonoscopy video database. Based on the unique characteristics of colonoscopy videos, we introduce a new scheme to detect and remove blurry frames, and segment the videos into shots based on the contents. Our experimental results show that the average precision and recall of the proposed scheme are over 90% for the detection of non-blurry images. The proposed method of blurry frame detection and shot segmentation is extensible to the videos captured from other endoscopic procedures such as upper gastrointestinal endoscopy, enteroscopy, cystoscopy, and laparoscopy.

Capsule Endoscopy in the Assessment of Obscure Gastrointestinal Bleeding: An Evidence-Based Analysis

PubMed Central

2015-01-01

Background Obscure gastrointestinal bleeding (OGIB) is defined as persistent or recurrent bleeding associated with negative findings on upper and lower gastrointestinal (GI) endoscopic evaluations. The diagnosis and management of patients with OGIB is particularly challenging because of the length and complex loops of the small intestine. Capsule endoscopy (CE) is 1 diagnostic modality that is used to determine the etiology of bleeding. Objectives The objective of this analysis was to review the diagnostic accuracy, safety, and impact on health outcomes of CE in patients with OGIB in comparison with other diagnostic modalities. Data Sources A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published between 2007 and 2013. Review Methods Data on diagnostic accuracy, safety, and impact on health outcomes were abstracted from included studies. Quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results The search yielded 1,189 citations, and 24 studies were included. Eight studies reported diagnostic accuracy comparing CE with other diagnostic modalities. Capsule endoscopy has a higher sensitivity and lower specificity than magnetic resonance enteroclysis, computed tomography, and push enteroscopy. Capsule endoscopy has a good safety profile with few adverse events, although comparative safety data with other diagnostic modalities are limited. Capsule endoscopy is associated with no difference in patient health-related outcomes such as rebleeding or follow-up treatment compared with push enteroscopy, small-bowel follow-through, and angiography. Limitations There was significant heterogeneity in estimates of diagnostic accuracy, which prohibited a statistical summary of findings. The analysis was also limited by the fact that there is no established reference standard to which the diagnostic accuracy of CE can be compared. Conclusions There is very-low-quality evidence that CE has a higher sensitivity but a lower specificity than other diagnostic modalities. Capsule endoscopy has few adverse events, with capsule retention being the most serious complication. Capsule endoscopy is perceived by patients as less painful and less burdensome compared with other modalities. There is low-quality evidence that patients who undergo CE have similar rates of rebleeding, further therapeutic interventions, and hospitalization compared with other diagnostic modalities. PMID:26357529

Usefulness of positron emission tomography in primary intestinal follicular lymphoma

PubMed Central

Tari, Akira; Asaoku, Hideki; Kunihiro, Masaki; Tanaka, Shinji; Yoshino, Tadashi

2013-01-01

Double-balloon enteroscopy (DBE) and video capsule endoscopy are useful for the diagnosis of lymphoma in the small intestine. However, DBE cannot be safely performed in cases with passage disturbance due to wall thickening and stenosis. Additionally, video capsule endoscopy cannot be performed in such cases because of the risk of retention. Here, we report 4 cases of primary follicular lymphoma of the gastrointestinal tract that could be detected using 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (PET-CT). The endoscopic findings of these 4 cases included lesions with wall thickening, which comprised macroscopically clusters of nodules, dense clusters of whitish granules or small nodules, fold thickening and ulcers with irregular margins that occupied the whole lumen with edematous mucosa. All patients fulfilled the World Health Organization grade 1 criteria. 18F-fluorodeoxyglucose PET-CT can help predict the risks that may result from certain endoscopic examinations, such as DBE and video capsule endoscopy. PMID:23569346

Steroid-refractory extensive enteritis complicated by ulcerative colitis successfully treated with adalimumab

PubMed Central

Okabayashi, Shinji; Sujino, Tomohisa; Ozaki, Ryo; Umeda, Satoko; Toyonaga, Takahiko; Saito, Eiko; Nakano, Masaru; Tablante, Maria Carla; Morinaga, Shojiroh; Hibi, Toshifumi

2017-01-01

Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down. Computed tomography revealed marked thickening of the ileal wall, and capsule endoscopy and balloon-assisted enteroscopy found diffuse mucosal inflammation with ulcers in the ileum. On the contrary, the inflammation in the colon and rectum was improving. Since the response to the second steroid course was inadequate, treatment with adalimumab and 6-mercaptopurine was initiated and finally achieved clinical and endoscopic remission. The investigation of small intestinal lesions is necessary in patients with UC whose clinical deterioration cannot be explained by colonic lesions. PMID:29142523

Inter and intra-observer concordance for the diagnosis of portal hypertension gastropathy.

PubMed

Casas, Meritxell; Vergara, Mercedes; Brullet, Enric; Junquera, Félix; Martínez-Bauer, Eva; Miquel, Mireia; Sánchez-Delgado, Jordi; Dalmau, Blai; Campo, Rafael; Calvet, Xavier

2018-03-01

At present there is no fully accepted endoscopic classification for the assessment of the severity of portal hypertensive gastropathy (PHG). Few studies have evaluated inter and intra-observer concordance or the degree of concordance between different endoscopic classifications. To evaluate inter and intra-observer agreement for the presence of portal hypertensive gastropathy and enteropathy using different endoscopic classifications. Patients with liver cirrhosis were included into the study. Enteroscopy was performed under sedation. The location of lesions and their severity was recorded. Images were videotaped and subsequently evaluated independently by three different endoscopists, one of whom was the initial endoscopist. The agreement between observations was assessed using the kappa index. Seventy-four patients (mean age 63.2 years, 53 males and 21 females) were included. The agreement between the three endoscopists regarding the presence or absence of PHG using the Tanoue and McCormack classifications was very low (kappa scores = 0.16 and 0.27, respectively). The current classifications of portal hypertensive gastropathy have a very low degree of intra and inter-observer agreement for the diagnosis and assessment of gastropathy severity.

Utility of the balloon-overtube-assisted modified over-the-wire stenting technique to treat post-sleeve gastrectomy complications.

PubMed

Ponte, Ana; Pinho, Rolando; Proença, Luísa; Silva, Joana; Rodrigues, Jaime; Sousa, Mafalda; Silva, João Carlos; Carvalho, João

2017-06-16

To describe a modified technique of deployment of stents using the overtube developed for balloon-assisted enteroscopy in post-sleeve gastrectomy (SG) complications. Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire (OTW) stenting technique were described. The technical success, corresponding to proper placement of the stent in the stomach resulting in exclusion of the SG leak or the stenosis, was evaluated. Complications related to stenting were also reported. Five procedures were included to treat 2 staple line leaks and 3 stenoses. Two types of stents were used, including a fully covered self-expandable metal stent designed for the SG anatomy (Hanarostent, ECBB-30-240-090; M.I. Tech, Co., Ltd, Seoul, South Korea) in 4 procedures and a biodegradable stent (BD stent 019-10A-25/20/25-080, SX-ELLA, Hradec Kralove, Czech Republic) in the remaining procedure. In all cases, an overtube was advanced with the endoscope through the SG to the duodenum. After placement of the guidewire and removal of the endoscope, the stent was easily advanced through the overtube. The overtube was pulled back and the stent was successfully deployed under fluoroscopic guidance. Technical success was achieved in all patients. The adoption of a modified technique of deployment of OTW stents using an overtube may represent an effective option in the approach of SG complications.

Utility of the balloon-overtube-assisted modified over-the-wire stenting technique to treat post-sleeve gastrectomy complications

PubMed Central

Ponte, Ana; Pinho, Rolando; Proença, Luísa; Silva, Joana; Rodrigues, Jaime; Sousa, Mafalda; Silva, João Carlos; Carvalho, João

2017-01-01

AIM To describe a modified technique of deployment of stents using the overtube developed for balloon-assisted enteroscopy in post-sleeve gastrectomy (SG) complications. METHODS Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire (OTW) stenting technique were described. The technical success, corresponding to proper placement of the stent in the stomach resulting in exclusion of the SG leak or the stenosis, was evaluated. Complications related to stenting were also reported. RESULTS Five procedures were included to treat 2 staple line leaks and 3 stenoses. Two types of stents were used, including a fully covered self-expandable metal stent designed for the SG anatomy (Hanarostent, ECBB-30-240-090; M.I. Tech, Co., Ltd, Seoul, South Korea) in 4 procedures and a biodegradable stent (BD stent 019-10A-25/20/25-080, SX-ELLA, Hradec Kralove, Czech Republic) in the remaining procedure. In all cases, an overtube was advanced with the endoscope through the SG to the duodenum. After placement of the guidewire and removal of the endoscope, the stent was easily advanced through the overtube. The overtube was pulled back and the stent was successfully deployed under fluoroscopic guidance. Technical success was achieved in all patients. CONCLUSION The adoption of a modified technique of deployment of OTW stents using an overtube may represent an effective option in the approach of SG complications. PMID:28690770

Distinct management issues with Crohn's disease of the small intestine.

PubMed

Fong, Steven C M; Irving, Peter M

2015-03-01

Small bowel Crohn's disease can present with clinical challenges that are specific to its location. In this review, we address some of the areas that present particular problems in small bowel Crohn's disease. A key issue specific to small bowel Crohn's disease relates to its diagnosis given that access to the small bowel is limited. Radiological advances, particularly in small bowel ultrasonography and MRI, as well as the introduction of capsule endoscopy and balloon enteroscopy are helping to address this. In addition, our ability to differentiate small bowel Crohn's disease from other causes of inflammation, such as tuberculosis, is improving on the basis of better understanding of the features that differentiate these conditions. It is also becoming apparent that jejunal Crohn's disease represents a distinct disease phenotype with potentially worse clinical outcomes. Finally, because it is a rare complication, our understanding of small bowel cancer associated with Crohn's disease remains limited. Recent publications are, however, starting to improve our knowledge of this condition. Although small bowel Crohn's disease presents specific management issues not seen in patients with Crohn's disease elsewhere in the gastrointestinal tract, our knowledge of how to manage these is improving.

Gastrointestinal endoscopy in pregnancy

PubMed Central

Savas, Nurten

2014-01-01

Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. PMID:25386072

Primary Jejunal Adenocarcinoma Presenting as Bilateral Ovarian Metastasis

PubMed Central

Ofori, Emmanuel; Ramai, Daryl; Papafragkakis, Charilaos; Changela, Kinesh; Krishnaiah, Mahesh

2017-01-01

Small intestinal tumors are rare with adenocarcinoma of the small intestine accounting for less than 2% of all gastrointestinal cancers. Primary jejunal adenocarcinoma constitutes a minute portion of small intestine adenocarcinomas. Clinically, this cancer presents at latter stages of its progression, mainly due to vague and non-specific symptoms, and the difficulty encountered in accessing the jejunum on upper endoscopy. Diagnosis of jejunal adenocarcinoma is usually inconclusive with the use of computed tomography (CT) scan, small bowel series, or upper endoscopy. Laparoscopy followed by frozen section biopsy provides a definitive diagnosis. In the past decade, balloon-assisted enteroscopy (BAE) and capsule endoscopy have become popular as useful modalities for diagnosing small bowel diseases. Wide excisional jejunectomy is the only treatment option with an estimated 5-year survival of 40-65%. Physicians are advised to suspect jejunal adenocarcinoma as a differential diagnosis in patients who present with non-specific symptoms of abdominal pain, nausea, vomiting, weight loss, anemia, gastrointestinal bleeding or signs of small bowel obstruction. We present a rare case of a 37-year-old woman with suspected bilateral ovarian masses, which was immunohistochemically confirmed as primary jejunal adenocarcinoma with bilateral ovarian metastasis. PMID:29317945

Primary Jejunal Adenocarcinoma Presenting as Bilateral Ovarian Metastasis.

PubMed

Ofori, Emmanuel; Ramai, Daryl; Papafragkakis, Charilaos; Changela, Kinesh; Krishnaiah, Mahesh

2017-12-01

Small intestinal tumors are rare with adenocarcinoma of the small intestine accounting for less than 2% of all gastrointestinal cancers. Primary jejunal adenocarcinoma constitutes a minute portion of small intestine adenocarcinomas. Clinically, this cancer presents at latter stages of its progression, mainly due to vague and non-specific symptoms, and the difficulty encountered in accessing the jejunum on upper endoscopy. Diagnosis of jejunal adenocarcinoma is usually inconclusive with the use of computed tomography (CT) scan, small bowel series, or upper endoscopy. Laparoscopy followed by frozen section biopsy provides a definitive diagnosis. In the past decade, balloon-assisted enteroscopy (BAE) and capsule endoscopy have become popular as useful modalities for diagnosing small bowel diseases. Wide excisional jejunectomy is the only treatment option with an estimated 5-year survival of 40-65%. Physicians are advised to suspect jejunal adenocarcinoma as a differential diagnosis in patients who present with non-specific symptoms of abdominal pain, nausea, vomiting, weight loss, anemia, gastrointestinal bleeding or signs of small bowel obstruction. We present a rare case of a 37-year-old woman with suspected bilateral ovarian masses, which was immunohistochemically confirmed as primary jejunal adenocarcinoma with bilateral ovarian metastasis.

Enteroscopy and radiology for the management of celiac disease complications: Time for a pragmatic roadmap.

PubMed

Branchi, Federica; Locatelli, Martina; Tomba, Carolina; Conte, Dario; Ferretti, Francesca; Elli, Luca

2016-06-01

Celiac disease is the most common autoimmune enteropathy in Western countries, and is usually associated with a good response to the gluten free diet and an excellent prognosis. However, a minority of patients develop complications of the disease, such as refractory celiac disease, ulcerative jejunoileitis and neoplastic complications such as adenocarcinoma of the small bowel and enteropathy associated T cell lymphoma. Neoplastic complications described in association with celiac disease have a high mortality rate, due to their aggressive behavior and to the usual advanced stage at the time of diagnosis. In recent years, the detection of small bowel lesions has dramatically improved thank to the availability of highly performing radiologic and endoscopic techniques. The diagnostic delay of malignant complications in patients with celiac disease may be improved by establishing a pragmatic flowchart for the identification and follow up of "at risk" patients. We performed a comprehensive review of the articles published on this issue in order to promote a roadmap to be applied when facing with celiac patients with suspected small bowel complications. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Factors Influencing Cecal Intubation Time during Retrograde Approach Single-Balloon Enteroscopy

PubMed Central

Chen, Peng-Jen; Shih, Yu-Lueng; Huang, Hsin-Hung; Hsieh, Tsai-Yuan

2014-01-01

Background and Aim. The predisposing factors for prolonged cecal intubation time (CIT) during colonoscopy have been well identified. However, the factors influencing CIT during retrograde SBE have not been addressed. The aim of this study was to determine the factors influencing CIT during retrograde SBE. Methods. We investigated patients who underwent retrograde SBE at a medical center from January 2011 to March 2014. The medical charts and SBE reports were reviewed. The patients' characteristics and procedure-associated data were recorded. These data were analyzed with univariate analysis as well as multivariate logistic regression analysis to identify the possible predisposing factors. Results. We enrolled 66 patients into this study. The median CIT was 17.4 minutes. With univariate analysis, there was no statistical difference in age, sex, BMI, or history of abdominal surgery, except for bowel preparation (P = 0.021). Multivariate logistic regression analysis showed that inadequate bowel preparation (odds ratio 30.2, 95% confidence interval 4.63–196.54; P < 0.001) was the independent predisposing factors for prolonged CIT during retrograde SBE. Conclusions. For experienced endoscopist, inadequate bowel preparation was the independent predisposing factor for prolonged CIT during retrograde SBE. PMID:25505904

Current Status and Research into Overcoming Limitations of Capsule Endoscopy

PubMed Central

Kwack, Won Gun; Lim, Yun Jeong

2016-01-01

Endoscopic investigation has a critical role in the diagnosis and treatment of gastrointestinal (GI) diseases. Since 2001, capsule endoscopy (CE) has been available for small-bowel exploration and is under continuous development. During the past decade, CE has achieved impressive improvements in areas such as miniaturization, resolution, and battery life. As a result, CE is currently a first-line tool for the investigation of the small bowel in obscure gastrointestinal bleeding and is a useful alternative to wired enteroscopy. Nevertheless, CE still has several limitations, such as incomplete examination and limited diagnostic and therapeutic capabilities. To resolve these problems, many groups have suggested several models (e.g., controlled CO2 insufflation system, magnetic navigation system, mobile robotic platform, tagging and biopsy equipment, and targeted drug-delivery system), which are in development. In the near future, new technological advances will improve the capabilities of CE and broaden its spectrum of applications not only for the small bowel but also for the colon, stomach, and esophagus. The purpose of this review is to introduce the current status of CE and to review the ongoing development of solutions to address its limitations. PMID:26855917

Emerging role of fecal microbiota therapy in the treatment of gastrointestinal and extra-gastrointestinal diseases.

PubMed

Konturek, P C; Haziri, D; Brzozowski, T; Hess, T; Heyman, S; Kwiecien, S; Konturek, S J; Koziel, J

2015-08-01

In the recent decade our understanding of the role of the human gut microbiome has been revolutionized by advances in development of molecular methods. Approximately, up to 100 trillion (10(14)) microorganisms per human body colonize the intestinal tract making an additional acquired organ that provides many vital functions to the host. A healthy gut microbiome can be defined by the presence of the various classes of microbes that enhance metabolism, resistance to infection and inflammation, prevention against cancer and autoimmunity and that positively influence so called braingut axis. Diet represents one of the most important driving forces that besides environmental and genetic factors, can define and influence the microbial composition of the gut. Aging process due to different changes in gut physiology (i.e. gastric hypochlorhydria, motility disorders, use of drugs, degenerative changes in enteric nervous system) has a profound effect on the composition, diversity and functional features of gut microbiota. A perturbed aged gut microbiome has been associated with the increasing number of gastrointestinal (e.g. Clostridium difficile infection - CDI) and non-gastrointestinal diseases (metabolic syndrome, diabetes mellitus, fatty liver disease, atherosclerosis etc.). Fecal microbiota transplantation (FMT) is a highly effective method in the treatment of refractory CDI. FMT is the term used when stool is taken from a healthy individual and instilled during endoscopy (colonoscopy or enteroscopy) into a gut of the sick person to cure certain disease. FMT represents an effective therapy in patient with recurrent CDI and the effectiveness of FMT in the prevention of CDI recurrence had reached approx. 90%. There is also an increasing evidence that the manipulation of gut microbiota by FMT represents a promising therapeutic method in patients with inflammatory bowel disease and irritable bowel syndrome. There is also an increased interest in the role of FMT for the treatment of metabolic syndrome and obesity which collectively present the greatest health challenge in the developed world nowadays. Targeting of gut microbiota by FMT represents an exciting new frontier in the prevention and management of gastrointestinal and non-gastrointestinal diseases that awaits further studies in preclinical and clinical settings.

Classification of intestinal lymphangiectasia with protein-losing enteropathy: white villi type and non-white villi type.

PubMed

Ohmiya, Naoki; Nakamura, Masanao; Yamamura, Takeshi; Yamada, Koji; Nagura, Asuka; Yoshimura, Toru; Hirooka, Yoshiki; Hirata, Ichiro; Goto, Hidemi

2014-01-01

We classified intestinal lymphangiectasia (IL) into two categories, the white and non-white villi types, and evaluated their clinical characteristics and therapeutic responses. Of the 988 patients who underwent double-balloon enteroscopy, 14 consecutive patients (7 men and 7 women, median age at onset 34 years) were enrolled with immunohistochemically confirmed IL with protein-losing enteropathy. Enteroscopically the white villi type (n = 8) showed white plaques and white-tipped villi were scattered in the small bowel, while non-white villi type (n = 6) showed that apparently normal but under more detailed observation, low and round villi with a normal color were diffused. The serum albumin levels and fecal α1-antitrypsin clearance before treatment were significantly worse in the non-white villi type (p = 0.017 and 0.039, respectively), whereas the serum immunoglobulin A and M levels were significantly lower in the white villi type (p = 0.010 and 0.046, respectively). At gastroscopy, a non-cirrhotic snakeskin appearance was significantly observed in the non-white villi type (p = 0.015). The corticosteroid response was better in the non-white villi type (p = 0.015). Two distinct subgroups were found in IL. This classification was useful in pathophysiological clustering and in predicting the therapeutic response. © 2014 S. Karger AG, Basel.

A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies.

PubMed

Kulaksiz, Hasan; Strnad, Pavel; Römpp, Achim; von Figura, Guido; Barth, Thomas; Esposito, Irene; Schirmacher, Peter; Henne-Bruns, Doris; Adler, Guido; Stiehl, Adolf

2011-02-01

Tissue specimen collection represents a cornerstone in diagnosis of proximal biliary tract malignancies offering great specificity, but only limited sensitivity. To improve the tumor detection rate, we developed a new method of forceps biopsy and compared it prospectively with endoscopic transpapillary brush cytology. 43 patients with proximal biliary stenoses, which were suspect for malignancy, undergoing endoscopic retrograde cholangiography were prospectively recruited and subjected to both biopsy [using a double-balloon enteroscopy (DBE) forceps under a guidance of a pusher and guiding catheter with guidewire] and transpapillary brush cytology. The cytological/histological findings were compared with the final clinical diagnosis. 35 out of 43 patients had a malignant disease (33 cholangiocarcinomas, 1 hepatocellular carcinoma, 1 gallbladder carcinoma). The sensitivity of cytology and biopsy in these patients was 49 and 69%, respectively. The method with DBE forceps allowed a pinpoint biopsy of the biliary stenoses. Both methods had 100% specificity, and, when combined, 80% of malignant processes were detected. All patients with non-malignant conditions were correctly assigned by both methods. No clinically relevant complications were observed. The combination of forceps biopsy and transpapillary brush cytology is safe and offers superior detection rates compared to both methods alone, and therefore represents a promising approach in evaluation of proximal biliary tract processes.

Advances in endoscopic management of biliary complications after living donor liver transplantation: Comprehensive review of the literature

PubMed Central

Shin, Milljae; Joh, Jae-Won

2016-01-01

Apart from noticeable improvements in surgical techniques and immunosuppressive agents, biliary complications remain the major causes of morbidity and mortality after living donor liver transplantation (LDLT). Bile leakage and stricture are the predominant complications. The reported incidence of biliary complications is 15%-40%, and these are known to occur more frequently in living donors than in deceased donors. Despite the absence of a confirmed therapeutic algorithm, many approaches have been used for treatment, including surgical, endoscopic, and percutaneous transhepatic techniques. In recent years, nonsurgical approaches have largely replaced reoperation. Among these, the endoscopic approach is currently the preferred initial treatment for patients who undergo duct-to-duct biliary reconstruction. Previously, endoscopic management was achieved most optimally through balloon dilatation and single or multiple stents placement. Recently, there have been significant developments in endoscopic devices, such as novel biliary stents, as well as advances in endoscopic technologies, including deep enteroscopy, the rendezvous technique, magnetic compression anastomosis, and direct cholangioscopy. These developments have resulted in almost all patients being managed by the endoscopic approach. Multiple recent publications suggest superior long-term results, with overall success rates ranging from 58% to 75%. This article summarizes the advances in endoscopic management of patients with biliary complications after LDLT. PMID:27468208

Investigation of Morphological and Functional Changes in the Small Intestine With Pancreatic Disease.

PubMed

Nakamura, Yosuke; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Itoh, Yuya; Hiramatsu, Takeshi; Sugimoto, Hiroyuki; Sumi, Hajime; Hayashi, Daijuro; Kuwahara, Takamichi; Funasaka, Kohei; Nakamura, Masanao; Miyahara, Ryoji; Ohmiya, Naoki; Katano, Yoshiaki; Ishigami, Masatoshi; Shimoyama, Yoshie; Nakamura, Shigeo; Goto, Hidemi; Hirooka, Yoshiki

2015-11-01

The aim of this study was to investigate the relationship between pancreas and small intestine evaluating the endoscopic and histopathologic findings of the proximal small intestine in pancreatic diseases. Fifty patients (18 patients with chronic pancreatitis, 17 patients with pancreatic cancer, 15 control subjects) underwent enteroscopy using a prototype enteroscope. The villous height of the jejunum on bioptic specimens was measured, and the mean values of the villi were compared among the 3 groups. Exocrine function was calculated by the pancreatic function diagnostic test, and the correlation between the recovery rate of p-aminobenzoic acid and the villous height was assessed. Finally, the distribution of the K cells secreting glucose-dependent insulinotropic polypeptide and the L cells secreting glucagon-like peptide 1 in the duodenum and jejunum was investigated using immunohistochemistry for glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1. The mean villous height in chronic pancreatitis (328 ± 67 μm) was significantly lower than that in pancreatic cancer (413 ± 57 μm) and control subjects (461 ± 97 μm) (P = 0.004 and P < 0.0001, respectively). A positive correlation was found between the recovery rate of p-aminobenzoic acid and the villous height (r = 0.52, P = 0.0001). The presence of K and L cells was verified in the duodenum and the jejunum. Close relationship between pancreas and small intestine was demonstrated.

Primary small-bowel malignancy: update in tumor biology, markers, and management strategies.

PubMed

Shenoy, Santosh

2014-12-01

Primary small-bowel malignancies (SBM) are rare tumors but their incidence is rising. An estimated 9160 new cases and 1210 deaths due to SBM may occur in the USA in 2014. We review advances made in tumor biology, immunohistochemistry, and discuss treatment strategies for these malignancies. Relevant articles from PubMed/Medline and Embase searches were collected using the phrases "small-bowel adenocarcinoma, gastrointestinal carcinoids, gastrointestinal stromal tumors, small-bowel leiomyosarcoma, and small-bowel lymphoma". Advances in imaging techniques such as wireless capsule endoscopy, CT and MRI enterography, and endoscopy (balloon enteroscopy) along with discovery of molecular markers such as c-kit and PDGFRA for GIST tumors have improved our ability to diagnose, localize, and treat these patients. Early detection and surgical resection offers the best chance for long-term survival in all tumors except bowel lymphoma where chemotherapy plays the main role. Adjuvant therapy with imatinib has improved overall survival for GIST tumors, somatostatin analogs have improved symptoms and also inhibited tumor growth and stabilized metastatic disease in carcinoid disease, but chemotherapy has not improved survival for adenocarcinoma. Recent advances in molecular characterization holds promise in novel targeted therapies. Currently ongoing trials are exploring efficacy of targeted therapies and role of adjuvant therapy for adenocarcinoma and results are awaited. Early detection and aggressive surgical therapy for all localized tumors and lymph node sampling particularly for adenocarcinoma remains the main treatment modality.

Small bowel adenocarcinoma of the jejunum: a case report and literature review.

PubMed

Li, Jie; Wang, Zhiliang; Liu, Na; Hao, Junfeng; Xu, Xin

2016-07-04

In practice, small bowel cancer is a rare entity. The most common histologic subtype is adenocarcinoma. Adenocarcinoma of the small bowel (SBA) is challenging to diagnose, often presents at a late stage and has a poor prognosis. The treatment of early-stage SBA is surgical resection. No standard protocol has been established for unresectable or metastatic disease. We report here on a 26-year-old man with SBA in the jejunum, lacking specific symptoms and with a delay of 6 months in diagnosis. The diagnosis was finally achieved with a combination of balloon-assisted enteroscopy, computed tomography scans, positron emission computed tomography scans and the values of carcino-embryonic antigen and carbohydrate antigen 19-9. The patient underwent segmental intestine with lymph node resection, followed by eight cycles of FOLFOX palliative chemotherapy with good tolerance. As of the 11-month postoperative follow-up, there has been no evidence of recurrent disease. This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause. We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

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

Liu, Xing; Xu, Yanli; Meng, Qian

Colorectal cancer (CRC) is one of the most common types of malignant tumor worldwide. Currently, although many researchers have been devoting themselves in CRC studies, the process of locating biomarkers for CRC early diagnosis and prognostic is still very slow. Using a centrifugal proteomic reactor-based proteomic analysis of minute amount of colonic biopsies by enteroscopy sampling, 2620 protein groups were quantified between cancer mucosa and adjacent normal colorectal mucosa. Of which, 403 protein groups were differentially expressed with statistic significance between cancer and normal tissues, including 195 up-regulated and 208 down-regulated proteins in cancer tissues. Three proteins (SOD3, PRELP andmore » NGAL) were selected for further Western blot validation. And the resulting Western blot experimental results were consistent with the quantitative proteomic data. SOD3 and PRELP are down-regulated in CRC mucosa comparing to adjacent normal tissue, while NGAL is up-regulated in CRC mucosa. In conclusion, the centrifugal proteomic reactor-based label-free quantitative proteomic approach provides a highly sensitive and powerful tool for analyzing minute protein sample from tiny colorectal biopsies, which may facilitate CRC biomarkers discovery for diagnoses and prognoses. -- Highlights: •Minute amount of colonic biopsies by endoscopy is suitable for proteomic analysis. •Centrifugal proteomic reactor can be used for processing tiny clinic biopsy sample. •SOD3 and PRELP are down-regulated in CRC, while NGAL is up-regulated in CRC.« less

Endoscopy and sedation: an inseparable binomial for the gastroenterologist.

PubMed

Crespo, Javier; Terán, Álvaro

2018-04-01

The development of endoscopy and its increasing demand among the population have led to a growing need for propofol-based sedation techniques. Benefit is indisputable for both patients and endoscopists, but some aspects require considering the "who" and "how" of sedation as related to safety and health care costs. Propofol is first-choice in endoscopy for the European Society of Gastrointestinal Endoscopy because of its fast onset of action and short half-life, and many reports exist on its safety when used by gastroenterologists rather than anesthesiologists. In this issue of REED several originals support the efficiency and safety of propofol even for complex, high-risk, or protracted procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and enteroscopy. Propofol may be safely and effectively administered by a team with specific skills acquired through education and using a specific procedure. However, difficulties arise in real-world clinical practice that preclude such training, which in Spain should be included in the MIR (médico interno residente) specialization program curriculum. The Comisión Nacional de Digestivo (Spanish National Commission on Digestive Diseases), sensitive to this training gap, has included in their latest version of the MIR program (under assessment) four additional competences, with number 145 (training in deep sedation) being most relevant here. In addition, the Spanish Society of Gastrointestinal Endoscopy (SEED) has invested significant efforts in sedation training, with over 50 courses on sedation for endoscopists and nurses. Continuing education and training in this field (for instance, refresher courses on advanced cardiopulmonary resuscitation) should be a goal for all endoscopy units. Because of the diversity found among hospitals, with single or multiple endoscopy rooms, efforts should be made to persuade those in charge of gastroenterology and anesthesiology departments to establish the necessary care circuits in order to guarantee patient safety by developing accurate protocols and promoting consensus among the scientific societies involved (Spanish Society for Digestive Diseases [SEPD], SEED and Spanish Society of Anaesthesiology, Resuscitation and Pain Management [SEDAR]) and their respective national commissions.

Informative-frame filtering in endoscopy videos

NASA Astrophysics Data System (ADS)

An, Yong Hwan; Hwang, Sae; Oh, JungHwan; Lee, JeongKyu; Tavanapong, Wallapak; de Groen, Piet C.; Wong, Johnny

2005-04-01

Advances in video technology are being incorporated into today"s healthcare practice. For example, colonoscopy is an important screening tool for colorectal cancer. Colonoscopy allows for the inspection of the entire colon and provides the ability to perform a number of therapeutic operations during a single procedure. During a colonoscopic procedure, a tiny video camera at the tip of the endoscope generates a video signal of the internal mucosa of the colon. The video data are displayed on a monitor for real-time analysis by the endoscopist. Other endoscopic procedures include upper gastrointestinal endoscopy, enteroscopy, bronchoscopy, cystoscopy, and laparoscopy. However, a significant number of out-of-focus frames are included in this type of videos since current endoscopes are equipped with a single, wide-angle lens that cannot be focused. The out-of-focus frames do not hold any useful information. To reduce the burdens of the further processes such as computer-aided image processing or human expert"s examinations, these frames need to be removed. We call an out-of-focus frame as non-informative frame and an in-focus frame as informative frame. We propose a new technique to classify the video frames into two classes, informative and non-informative frames using a combination of Discrete Fourier Transform (DFT), Texture Analysis, and K-Means Clustering. The proposed technique can evaluate the frames without any reference image, and does not need any predefined threshold value. Our experimental studies indicate that it achieves over 96% of four different performance metrics (i.e. precision, sensitivity, specificity, and accuracy).

Double-balloon endoscopy for retrograde cholangiography in patients with choledochojejunostomy and Roux-en-Y reconstruction.

PubMed

Pohl, J; May, A; Aschmoneit, I; Ell, C

2009-02-01

Choledochojejunal anastomoses with Roux-en-Y reconstruction excludes the biliary tract from conventional endoscopic retrograde cholangiography (ERC) with standard endoscopes due to the length of the interposed small bowel segment. Double-balloon enteroscopy (DBE) facilitates deep insertion into the small bowel and may be used to perform ERC in these patients. In the present case series we report our experience with diagnostic and therapeutic double-balloon ERC in patients with choledochojejunostomy to a long Roux-en-Y loop previously unavailable for standard length endoscopes. Between December 2004 and May 2008 15 patients (mean age: 60.2 years) with choledochojejunal anastomosis underwent a total of 25 DBE-ERC procedures. Cannulation of the bile ducts was achieved in 22 / 25 procedures (84 %). Twenty-one therapeutic interventions, including stone removal, biliary duct dilation, stent placement and removal of previously placed stents were performed during 16 procedures in 8 patients. The mean total duration time of the procedures was 74.6 +/- 25.0 minutes. Postinterventional self-limiting fever occurred after 4 procedures in 3 patients with cholangitis. After therapeutic interventions all patients had a significant drop of bilirubin levels and all except one patient were free of complaints (follow-up 10.4 +/- 8.6 months). The DBE system permits diagnostic and therapeutic ERC in surgically modified anatomy, previously unavailable for endoluminal access. In our experience this procedure is safe and has a high success rate with a favourable patient outcome.

Small bowel capsule endoscopy in 2007: Indications, risks and limitations

PubMed Central

Rondonotti, Emanuele; Villa, Federica; Mulder, Chris JJ; Jacobs, Maarten AJM; de Franchis, Roberto

2007-01-01

Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn’s disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions).The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy). PMID:18069752

Capsule endoscopy in the evaluation and management of inflammatory bowel disease: a future perspective.

PubMed

Saruta, Masayuki; Papadakis, Konstantinos A

2009-01-01

Wireless capsule endoscopy (WCE) has emerged as an important diagnostic tool for the evaluation of patients with suspected small intestinal (SI) disease, including obscure gastrointestinal bleeding, Crohn's disease (CD), malabsorptive disorders and SI tumors. Since a great number of patients with CD have small-bowel (SB) involvement, it is important for newly diagnosed patients to undergo an evaluation of the SB, which has traditionally been performed using a radiographic study such as a SB follow-through. The greatest utility of WCE in the evaluation of SB CD has been observed in cases of suspected CD, where the initial evaluation with upper and lower endoscopy as well as traditional radiographic techniques have failed to establish the diagnosis. WCE can detect SB involvement in CD, particularly early lesions that can be overlooked by traditional radiological studies. The sensitivity of diagnosing SB CD by WCE is superior to other endoscopic or radiological methods such as push enteroscopy, computed tomography or magnetic resonance enteroclysis. The utility of WCE in patients with known CD, indeterminate colitis and a select group of patients with ulcerative colitis can help to better define the diagnosis and extent of the disease, and assist in the management of patients with persistent symptoms. A disadvantage of WCE is that the device may be retained in a strictured area of the SB, which may often be present in patients with CD, in addition to a lower specificity. WCE may replace classical studies and become the gold standard for diagnosing SB involvement in patients with suspected, or known CD, in the absence of strictures and fistulae.

Asian Perspectives on Diagnostic and Therapeutic Strategies in Inflammatory Bowel Disease: Report and Analysis of a Survey with Questionnaires.

PubMed

Yoshida, Atsushi; Ueno, Fumiaki; Morizane, Toshio; Joh, Takashi; Kamiya, Takeshi; Takahashi, Shin''ichi; Tokunaga, Kengo; Iwakiri, Ryuichi; Kinoshita, Yoshikazu; Suzuki, Hidekazu; Naito, Yuji; Uchiyama, Kazuhiko; Fukodo, Shin; Chan, Francis K L; Halm, Ki-Baik; Kachintorn, Udom; Fock, Kwong Ming; Rani, Abdul Aziz; Syam, Ari Fahrial; Sollano, Jose D; Zhu, Qi

2017-01-01

Diagnostic and therapeutic strategies in inflammatory bowel disease (IBD) vary among countries in terms of availability of modalities, affordability of health care resource, health care policy and cultural background. This may be the case in different countries in Eastern Asia. The aim of this study was to determine and understand the differences in diagnostic and therapeutic strategies of IBD between Japan and the rest of Asian countries (ROA). Questionnaires with regard to clinical practice in IBD were distributed to members of the International Gastroenterology Consensus Symposium Study Group. The responders were allowed to select multiple items for each question, as multiple modalities are frequently utilized in the diagnosis and the management of IBD. Dependency and independency of selected items for each question were evaluated by the Bayesian network analysis. The selected diagnostic modalities were not very different between Japan and ROA, except for those related to small bowel investigations. Balloon-assisted enteroscopy and small bowel follow through are frequently used in Japan, while CT/MR enterography is popular in ROA. Therapeutic modalities for IBD depend on availability of such modalities in clinical practice. As far as modalities commonly available in both regions are concerned, there seemed to be similarity in the selection of each therapeutic modality. However, evaluation of dependency of separate therapeutic modalities by Bayesian network analysis disclosed some difference in therapeutic strategies between Japan and ROA. Although selected modalities showed some similarity, Bayesian network analysis elicited certain differences in the clinical approaches combining multiple modalities in various aspects of IBD between Japan and ROA. © 2016 S. Karger AG, Basel.

Diagnostic yield of capsule endoscopy in refractory celiac disease.

PubMed

Barret, Maximilien; Malamut, Georgia; Rahmi, Gabriel; Samaha, Elia; Edery, Joël; Verkarre, Virginie; Macintyre, Elizabeth; Lenain, Emilie; Chatellier, Gilles; Cerf-Bensussan, Nadine; Cellier, Christophe

2012-10-01

Capsule endoscopy (CE) allows for the assessment of the small bowel in numerous intestinal diseases, including celiac disease (CD). The main advantage of CE is the complete visualization of the intestinal mucosal surface. The objective of this study was to investigate whether CE can predict the severity of CD and detect complications. We retrospectively studied the medical files of 9 patients with symptomatic CD, 11 patients with refractory celiac disease type I (RCDI) and 18 patients with refractory celiac disease type II (RCDII), and 45 patients without CD who were investigated both CE and upper endoscopy or enteroscopy. The type of CD was diagnosed on the basis of a centralized histological review, flow cytometry analysis of intraepithelial lymphocytes, and the analysis of T-cell receptor rearrangement by multiplex polymerase chain reaction. A total of 47 CEs (10, 11, and 26 CEs in the symptomatic CD, RCDI, and RCDII groups, respectively) from the 38 celiac patients and 47 CEs from the 45 nonceliac patients were retrospectively reviewed. Villous atrophy, numerous, or distally located ulcers were more frequent in celiac patients than in controls. Among celiac patients, CE was of acceptable quality in 96% of cases and was complete in 62% of cases. The concordance of CE with histology for villous atrophy was better than that of optic endoscopy (κ coefficient =0.45 vs. 0.24, P<0.001). Extensive mucosal damage on CE was associated with low serum albumin (P=0.003) and the RCDII form (P=0.02). Three cases of overt lymphoma were detected by CE during the follow-up. CE findings have a satisfactory concordance with histology and nutritional status in patients with symptomatic or refractory CD. Moreover, CE may predict the type of RCD and allows for the early detection of overt lymphoma.

Spiral assisted ERCP is equivalent to single balloon assisted ERCP in patients with Roux-en-Y anatomy.

PubMed

Lennon, Anne Marie; Kapoor, Sumit; Khashab, Mouen; Corless, Erin; Amateau, Stuart; Dunbar, Kerry; Chandrasekhara, Vinay; Singh, Vikesh; Okolo, Patrick I

2012-05-01

Endoscopic retrograde cholangiopancreatography (ERCP) is often unsuccessful in patients with Roux-en-Y anatomy. Augmented enteroscopy allows deep insertion into the small bowel and can be useful in patients with Roux-en-Y anatomy. The aim of this study was to compare single balloon assisted ERCP (SBE-ERCP) and spiral assisted ERCP (SE-ERCP) in patients with Roux-en-Y anatomy in terms of diagnostic and therapeutic yield, procedure time, and complications. This is a retrospective cohort study of consecutive patients with Roux-en-Y anatomy who underwent SBE-ERCP or SE-ERCP between October 2007 and March 2011. Diagnostic yield was defined as successful duct cannulation. Therapeutic yield was defined as the ability to successfully carry out endoscopic therapy in those cannulated. Procedure time and complications were assessed. Thirty-four consecutive patients with Roux-en-Y anatomy underwent 54 ERCP procedures. The overall diagnostic yield was 44.4% with no significant difference between the diagnostic yield of SBE-ERCP (48.3%) and SE-ERCP (40%). The diagnostic yield was lower in patients with gastric by-pass (38.9%) compared with other types of Roux-en-Y anatomy (47.2%) but this was not statistically significant (P = 0.772). The overall therapeutic yield was 93.8%, with a therapeutic yield of 100% for SBE-ERCP and 87.5% for SE-ERCP (P = 1.0). There was one perforation during SBE-ERCP, giving a complication rate of 3.5%. The mean procedure time did not differ between the two techniques. Diagnostic and therapeutic yields are similar with SBE-ERCP and SE-ERCP in patients with Roux-en-Y anatomy with no significant difference in procedure time or complication rates.

Endoscopic intestinal bypass creation by using self-assembling magnets in a porcine model.

PubMed

Ryou, Marvin; Agoston, A Tony; Thompson, Christopher C

2016-04-01

A purely endoluminal method of GI bypass would be desirable for the treatment of obstruction, obesity, or metabolic syndrome. We have developed a technology based on miniature self-assembling magnets that create large-caliber anastomoses (Incisionless Anastomosis System [IAS]). The aim of this study was to evaluate procedural characteristics of IAS deployment and long-term anastomotic integrity and patency. We performed a 3-month survival study of Yorkshire pigs (5 interventions, 3 controls). Intervention pigs underwent simultaneous enteroscopy/colonoscopy performed with the animals under intravenous sedation. The IAS magnets were deployed and coupled with reciprocal magnets under fluoroscopy. Every 3 to 6 days pigs underwent endoscopy until jejunocolonic anastomosis (dual-path bypass) creation and magnet expulsion. Necropsies and histological evaluation were performed. The primary endpoints were technical success; secondary endpoints of anastomosis integrity, patency, and histological characteristics were weight trends. Under intravenous sedation, endoscopic bypass creation by using IAS magnets was successfully performed in 5 of 5 pigs (100%). Given porcine anatomy, the easiest dual-path bypass to create was between the proximal jejunum and colon. The mean procedure time was 14.7 minutes. Patent, leak-free anastomoses formed by day 4. All IAS magnets were expelled by day 12. All anastomoses were fully patent at 3 months with a mean diameter of 3.5 cm. The mean 3-month weight was 45 kg in bypass pigs and 78 kg in controls (P = .01). At necropsy, adhesions were absent. Histology showed full re-epithelialization across the anastomosis without fibrosis or inflammation. Large-caliber, leak-free, foreign body-free endoscopic intestinal bypass by using IAS magnets can be safely and rapidly performed in the porcine by model using only intravenous sedation. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Exploring the Engagement Effects of Visual Programming Language for Data Structure Courses

ERIC Educational Resources Information Center

Chang, Chih-Kai; Yang, Ya-Fei; Tsai, Yu-Tzu

2017-01-01

Previous research indicates that understanding the state of learning motivation enables researchers to deeply understand students' learning processes. Studies have shown that visual programming languages use graphical code, enabling learners to learn effectively, improve learning effectiveness, increase learning fun, and offering various other…

Investigating the Role of Collective Trust, Collective Efficacy, and Enabling School Structures on Overall School Effectiveness

ERIC Educational Resources Information Center

Gray, Julie

2016-01-01

This study investigated the role of collective trust, collective efficacy, and enabling school structures on overall school effectiveness. While the concept of organizational effectiveness can be complex and difficult to measure, the results of this research demonstrated a connection of these variables to school effectiveness. Collective trust had…

A Cross-Disciplinary Literature Review: Examining Trust on Virtual Teams

ERIC Educational Resources Information Center

Berry, Gregory R.

2011-01-01

Effective and efficient teams communicate, collaborate, and perform, even if these teams are not co-located. Although much is known about enabling effectiveness on face-to-face teams, considerably less is known about similarly enabling effectiveness on virtual teams. Yet the use of virtual teams is common and will likely become more commonplace as…

Effectiveness and Impact of Technology-Enabled Project-Based Learning with the Use of Process Prompts in Teacher Education

ERIC Educational Resources Information Center

Chen, Ching-Huei; Chan, Lim-Ha

2011-01-01

This study investigated the effectiveness and impacts of process prompts on students' learning and computer self-efficacy within the technology-enabled project-based learning (PBL) context in an undergraduate educational technology course. If the aim is to prepare prospective teachers to effectively, efficiently, and engagingly use technologies in…

The Effect of the Developed Differentiation Approach on the Achievements of the Students

ERIC Educational Resources Information Center

Altintas, Esra; Özdemir, Ahmet S.

2015-01-01

Problem Statement: The present study is of importance for designing a differentiation approach, which enables gifted students to use their present potential in mathematics effectively and enables them to develop their achievement, while looking at the effect of the approach on both gifted and non-gifted students. Within the scope of the developed…

Detroit regional transit study : a study of factors that enable and inhibit effective regional transit.

DOT National Transportation Integrated Search

2014-03-01

An interdisciplinary team of six faculty members and six students at the University of Detroit Mercy (UDM) conducted a : comprehensive study of the factors enabling or inhibiting development of effective regional transit. Focusing on Metro Detroit an...

Enabling a Comprehensive Teaching Strategy: Video Lectures

ERIC Educational Resources Information Center

Brecht, H. David; Ogilby, Suzanne M.

2008-01-01

This study empirically tests the feasibility and effectiveness of video lectures as a form of video instruction that enables a comprehensive teaching strategy used throughout a traditional classroom course. It examines student use patterns and the videos' effects on student learning, using qualitative and nonparametric statistical analyses of…

Enablers and challenges to occupational therapists’ research engagement: A qualitative study

PubMed Central

Di Bona, Laura; Wenborn, Jennifer; Field, Becky; Hynes, Sinéad M; Ledgerd, Ritchard; Mountain, Gail; Swinson, Tom

2017-01-01

Introduction To develop occupational therapy’s evidence base and improve its clinical outcomes, occupational therapists must increase their research involvement. Barriers to research consumption and leadership are well documented, but those relating to delivering research interventions, less so. Yet, interventions need to be researched within practice to demonstrate their clinical effectiveness. This study aims to improve understanding of challenges and enablers experienced by occupational therapists who deliver interventions within research programmes. Method Twenty-eight occupational therapists who participated in the Valuing Active Life in Dementia (VALID) research programme reported their experiences in five focus groups. Data were analysed thematically to identify key and subthemes. Results Occupational therapists reported that overwhelming paperwork, use of videos, recruitment and introducing a new intervention challenged their research involvement, whereas support, protected time and a positive attitude enabled it. The impact of these challenges and enablers varied between therapists and organisations. Conclusion Challenges and enablers to research involvement can be identified but must be addressed within individual and organisational contexts. Multifaceted collective action to minimise challenges and maximise enablers can facilitate clinicians’ involvement in research. Using this approach should enable occupational therapists to increase their research involvement, thus demonstrating the clinical effectiveness of their interventions. PMID:29170592

Received social support and exercising: An intervention study to test the enabling hypothesis.

PubMed

Rackow, Pamela; Scholz, Urte; Hornung, Rainer

2015-11-01

Received social support is considered important for health-enhancing exercise participation. The enabling hypothesis of social support suggests an indirect association of social support and exercising via constructs of self-regulation, such as self-efficacy. This study aimed at examining an expanded enabling hypothesis by examining effects of different kinds of social support (i.e., emotional and instrumental) on exercising not only via self-efficacy but also via self-monitoring and action planning. An 8-week online study was conducted. Participants were randomly assigned to an intervention or a control group. The intervention comprised finding and then exercising regularly with a new exercise companion. Intervention and control group effects were compared by a manifest multigroup model. Received emotional social support predicted self-efficacy, self-monitoring, and action planning in the intervention group. Moreover, received emotional social support was indirectly connected with exercise via the examined mediators. The indirect effect from received emotional social support via self-efficacy mainly contributed to the total effect. No direct or indirect effect of received instrumental social support on exercise emerged. In the control group, neither emotional nor instrumental social support was associated with any of the self-regulation constructs nor with exercise. Actively looking for a new exercise companion and exercising together seems to be beneficial for the promotion of received emotional and instrumental social support. Emotional support in turn promotes exercise by enabling better self-regulation, in particular self-efficacy. Statement of contribution What is already known on this subject? With the 'enabling hypothesis', Benight and Bandura (2004, Behav. Res. Ther., 42, 1129) claimed that social support indirectly affects behaviour via self-efficacy. Research in the domain of physical exercise has provided evidence for this enabling hypothesis on a correlational basis only preventing causal inferences. What does this study add? We found evidence for the enabling hypothesis of received social support via self-efficacy on physical exercise in an intervention study. Moreover, this study demonstrated the distinct contribution of received emotional and instrumental social support in the context of the enabling hypothesis. © 2015 The British Psychological Society.

The human jejunum has an endogenous microbiota that differs from those in the oral cavity and colon.

PubMed

Sundin, Olof H; Mendoza-Ladd, Antonio; Zeng, Mingtao; Diaz-Arévalo, Diana; Morales, Elisa; Fagan, B Matthew; Ordoñez, Javier; Velez, Philip; Antony, Nishaal; McCallum, Richard W

2017-07-17

The upper half of the human small intestine, known as the jejunum, is the primary site for absorption of nutrient-derived carbohydrates, amino acids, small peptides, and vitamins. In contrast to the colon, which contains 10 11 -10 12 colony forming units of bacteria per ml (CFU/ml), the normal jejunum generally ranges from 10 3 to 10 5  CFU per ml. Because invasive procedures are required to access the jejunum, much less is known about its bacterial microbiota. Bacteria inhabiting the jejunal lumen have been investigated by classical culture techniques, but not by culture-independent metagenomics. The lumen of the upper jejunum was sampled during enteroscopy of 20 research subjects. Culture on aerobic and anaerobic media gave live bacterial counts ranging from 5.8 × 10 3 CFU/ml to 8.0 × 10 6 CFU/ml. DNA from the same samples was analyzed by 16S rRNA gene-specific quantitative PCR, yielding values from 1.5 × 10 5 to 3.1 × 10 7 bacterial genomes per ml. When calculated for each sample, estimated bacterial viability ranged from effectively 100% to a low of 0.3%. 16S rRNA metagenomic analysis of uncultured bacteria by Illumina MiSeq sequencing gave detailed microbial composition by phylum, genus and species. The genera Streptococcus, Prevotella, Veillonella and Fusobacterium, were especially abundant, as well as non-oral genera including Escherichia, Klebsiella, and Citrobacter. The jejunum was devoid of the genera Alistipes, Ruminococcus, Faecalibacterium, and other extreme anaerobes abundant in the colon. In patients with higher bacterial loads, there was no significant change in microbial species composition. The jejunal lumen contains a distinctive bacterial population consisting primarily of facultative anaerobes and oxygen-tolerant obligate anaerobes similar to those found in the oral cavity. However, the frequent abundance of Enterobacteriaceae represents a major difference from oral microbiota. Although a few genera are shared with the colon, we found no evidence for retrograde movement of the most abundant colonic microbes to the jejunum. Some individuals had much higher bacterial loads, but this was not correlated with decreases in bacterial species diversity or other evidence of dysbiosis.

Acquisition of Modular Low Earth Orbit Satellites for Improved Intelligence Collection

DTIC Science & Technology

2012-09-01

26 4. Space Enabled Effects for Military Engagements ( SeeMe ) Architecture...27 Figure 7. A Depiction of the SeeMe Notional Concept of Operations (From Barnhart, 2012...Evaluation SATCOM Satellite Communications SBIRS Space Based Infrared Systems SeeMe Space Enabled Effects for Military Engagements SMAD Space

"OnTrack" to University: Understanding Mechanisms of Student Retention in an Australian Pre-University Enabling Program

ERIC Educational Resources Information Center

Lisciandro, Joanne G.; Gibbs, Gael

2016-01-01

University-based enabling programs have become an important pathway to university for non-traditional students. There is increasing interest in understanding the mechanisms that facilitate retention and success of enabling pathway students, with the aim of developing effective strategies for maximising opportunities for university access and…

Effects of Energy Chirp on Echo-Enabled Harmonic Generation Free-Electron Lasers

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

Huang, Z.; Ratner, D.; Stupakov, G.

2009-02-23

We study effects of energy chirp on echo-enabled harmonic generation (EEHG). Analytical expressions are compared with numerical simulations for both harmonic and bunching factors. We also discuss the EEHG free-electron laser bandwidth increase due to an energy-modulated beam and its pulse length dependence on the electron energy chirp.

Evaluating the Cost-Effectiveness of Instructional Programs.

ERIC Educational Resources Information Center

Alkin, Marvin C.

A model of cost-effectiveness is outlined which enables consideration of some non-financial, as well as financial, elements of educational systems at school or district levels. The model enables the decision-maker to compare educational outcomes of different units, to assess the impact of alternative levels of financial input, and to select…

Enablement, Constraint, and "The 7 Habits of Highly Effective People."

ERIC Educational Resources Information Center

Carlone, David

2001-01-01

Uses interviews to examine how the self-help book "The 7 Habits of Highly Effective People" shapes the identity of organization members who read and use the book. Suggests that such people are simultaneously enabled and constrained as they confront tensions between individualism and community, competition and cooperation, and domination and…

RIC-3 phosphorylation enables dual regulation of excitation and inhibition of Caenorhabditis elegans muscle

PubMed Central

Safdie, Gracia; Liewald, Jana F.; Kagan, Sarah; Battat, Emil; Gottschalk, Alexander; Treinin, Millet

2016-01-01

Brain function depends on a delicate balance between excitation and inhibition. Similarly, Caenorhabditis elegans motor system function depends on a precise balance between excitation and inhibition, as C. elegans muscles receive both inhibitory, GABAergic and excitatory, cholinergic inputs from motor neurons. Here we show that phosphorylation of the ER-resident chaperone of nicotinic acetylcholine receptors, RIC-3, leads to increased muscle excitability. RIC-3 phosphorylation at Ser-164 depends on opposing functions of the phosphatase calcineurin (TAX-6), and of the casein kinase II homologue KIN-10. Effects of calcineurin down-regulation and of phosphorylated RIC-3 on muscle excitability are mediated by GABAA receptor inhibition. Thus RIC-3 phosphorylation enables effects of this chaperone on GABAA receptors in addition to nAChRs. This dual effect provides coordinated regulation of excitation and inhibition and enables fine-tuning of the excitation–inhibition balance. Moreover, regulation of inhibitory GABAA signaling by calcineurin, a calcium- and calmodulin-dependent phosphatase, enables homeostatic balancing of excitation and inhibition. PMID:27489343

Microrandomized trials: An experimental design for developing just-in-time adaptive interventions.

PubMed

Klasnja, Predrag; Hekler, Eric B; Shiffman, Saul; Boruvka, Audrey; Almirall, Daniel; Tewari, Ambuj; Murphy, Susan A

2015-12-01

This article presents an experimental design, the microrandomized trial, developed to support optimization of just-in-time adaptive interventions (JITAIs). JITAIs are mHealth technologies that aim to deliver the right intervention components at the right times and locations to optimally support individuals' health behaviors. Microrandomized trials offer a way to optimize such interventions by enabling modeling of causal effects and time-varying effect moderation for individual intervention components within a JITAI. The article describes the microrandomized trial design, enumerates research questions that this experimental design can help answer, and provides an overview of the data analyses that can be used to assess the causal effects of studied intervention components and investigate time-varying moderation of those effects. Microrandomized trials enable causal modeling of proximal effects of the randomized intervention components and assessment of time-varying moderation of those effects. Microrandomized trials can help researchers understand whether their interventions are having intended effects, when and for whom they are effective, and what factors moderate the interventions' effects, enabling creation of more effective JITAIs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Micro-Randomized Trials: An Experimental Design for Developing Just-in-Time Adaptive Interventions

PubMed Central

Klasnja, Predrag; Hekler, Eric B.; Shiffman, Saul; Boruvka, Audrey; Almirall, Daniel; Tewari, Ambuj; Murphy, Susan A.

2015-01-01

Objective This paper presents an experimental design, the micro-randomized trial, developed to support optimization of just-in-time adaptive interventions (JITAIs). JITAIs are mHealth technologies that aim to deliver the right intervention components at the right times and locations to optimally support individuals’ health behaviors. Micro-randomized trials offer a way to optimize such interventions by enabling modeling of causal effects and time-varying effect moderation for individual intervention components within a JITAI. Methods The paper describes the micro-randomized trial design, enumerates research questions that this experimental design can help answer, and provides an overview of the data analyses that can be used to assess the causal effects of studied intervention components and investigate time-varying moderation of those effects. Results Micro-randomized trials enable causal modeling of proximal effects of the randomized intervention components and assessment of time-varying moderation of those effects. Conclusions Micro-randomized trials can help researchers understand whether their interventions are having intended effects, when and for whom they are effective, and what factors moderate the interventions’ effects, enabling creation of more effective JITAIs. PMID:26651463

Using Email to Enable E[superscript 3] (Effective, Efficient, and Engaging) Learning

ERIC Educational Resources Information Center

Kim, ChanMin

2008-01-01

This article argues that technology that supports both noncognitive and cognitive aspects can make learning more effective, efficient, and engaging (e[superscript 3]-learning). The technology of interest in this article is email. The investigation focuses on characteristics of email that are likely to enable e[superscript 3]-learning. In addition,…

Incentives and enablers to improve adherence in tuberculosis

PubMed Central

Lutge, Elizabeth E; Wiysonge, Charles Shey; Knight, Stephen E; Sinclair, David; Volmink, Jimmy

2015-01-01

Background Patient adherence to medications, particularly for conditions requiring prolonged treatment such as tuberculosis (TB), is frequently less than ideal and can result in poor treatment outcomes. Material incentives to reward good behaviour and enablers to remove economic barriers to accessing care are sometimes given in the form of cash, vouchers, or food to improve adherence. Objectives To evaluate the effects of material incentives and enablers in patients undergoing diagnostic testing, or receiving prophylactic or curative therapy, for TB. Search methods We undertook a comprehensive search of the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; LILACS; Science Citation Index; and reference lists of relevant publications up to 5 June 2015. Selection criteria Randomized controlled trials of material incentives in patients being investigated for TB, or on treatment for latent or active TB. Data collection and analysis At least two review authors independently screened and selected studies, extracted data, and assessed the risk of bias in the included trials. We compared the effects of interventions using risk ratios (RR), and presented RRs with 95% confidence intervals (CI). The quality of the evidence was assessed using GRADE. Main results We identified 12 eligible trials. Ten were conducted in the USA: in adolescents (one trial), in injection drug or cocaine users (four trials), in homeless adults (three trials), and in prisoners (two trials). The remaining two trials, in general adult populations, were conducted in Timor-Leste and South Africa. Sustained incentive programmes Only two trials have assessed whether material incentives and enablers can improve long-term adherence and completion of treatment for active TB, and neither demonstrated a clear benefit (RR 1.04, 95% CI 0.97 to 1.14; two trials, 4356 participants; low quality evidence). In one trial, the incentive, given as a daily hot meal, was not well received by the population due to the inconvenience of attending the clinic at midday, whilst in the other trial, nurses distributing the vouchers chose to "ration" their distribution among eligible patients, giving only to those whom they felt were most deprived. Three trials assessed the effects of material incentives and enablers on completion of TB prophylaxis with mixed results (low quality evidence). A large effect was seen with regular cash incentives given to drug users at each clinic visit in a setting with extremely low treatment completion in the control group (treatment completion 52.8% intervention versus 3.6% control; RR 14.53, 95% CI 3.64 to 57.98; one trial, 108 participants), but no effects were seen in one trial assessing a cash incentive for recently released prisoners (373 participants), or another trial assessing material incentives offered by parents to teenagers (388 participants). Single once-only incentives However in specific populations, such as recently released prisoners, drug users, and the homeless, trials show that material incentives probably do improve one-off clinic re-attendance for initiation or continuation of anti-TB prophylaxis (RR 1.58, 95% CI 1.27 to 1.96; three trials, 595 participants; moderate quality evidence), and may increase the return rate for reading of tuberculin skin test results (RR 2.16, 95% CI 1.41 to 3.29; two trials, 1371 participants; low quality evidence). Comparison of different types of incentives Single trials in specific sub-populations suggest that an immediate cash incentive may be more effective than delaying the incentive until completion of treatment (RR 1.11, 95% CI 0.98 to 1.24; one trial, 300 participants; low quality evidence), cash incentives may be more effective than non-cash incentives (completion of TB prophylaxis: RR 1.26, 95% CI 1.02 to 1.56; one trial, 141 participants; low quality evidence; return for skin test reading: RR 1.13, 95% CI 1.07 to 1.19; one trial, 652 participants; low quality evidence); and higher cash incentives may be more effective than lower cash incentives (RR 1.08, 95% CI 1.01 to 1.16; one trial, 404 participants; low quality evidence). Authors' conclusions Material incentives and enablers may have some positive short term effects on clinic attendance, particularly for marginal populations such as drug users, recently released prisoners, and the homeless, but there is currently insufficient evidence to know if they can improve long term adherence to TB treatment. PLAIN LANGUAGE SUMMARY Incentives and enablers for improving patient adherence to tuberculosis diagnosis, prophylaxis, and treatment Cochrane researchers conducted a review of the effects of material (economic) incentives or enablers on the adherence and outcomes of patients being tested or treated for latent or active tuberculosis (TB). After searching up to 5 June 2015 for relevant trials, they included 12 randomized controlled trials in this Cochrane review. What are material incentives and enablers and how might they improve patient care? Material incentives and enablers are economic interventions which may be given to patients to reward healthy behaviour (incentives) or remove economic barriers to accessing healthcare (enablers). Incentives and enablers may be given directly as cash or vouchers, or indirectly in the provision of a service for which the patient might otherwise have to pay (like transport to a health facility). What the research says Material incentives and enablers may have little or no effect in improving the outcomes of patients on treatment for active TB (low quality evidence), but further trials of alternative incentives and enablers are needed. Material incentives and enablers may have some effects on completion of prophylaxis for latent TB in some circumstances but trial results were mixed, with one trial showing a large effect, and two trials showing no effect (low quality evidence). One-off material incentives and enablers probably improve rates of return to a single clinic appointment for patients starting or continuing prophylaxis for TB (moderate quality evidence) and may improve the rate of return to the clinic for the reading of diagnostic tests for TB (low quality evidence). Thus although material incentives and enablers may improve some patients' attendance at the clinic in the short term, more research is needed to determine if they have an important positive effect in patients on long term treatment for TB. PMID:26333525

Barriers affecting successful technology enablement of supply chain: An Indian perspective

NASA Astrophysics Data System (ADS)

Arora, R.; Haleem, A.; Farooquie, J. A.

2018-03-01

In order to compete, organizations need to focus on improving supply chain and technology acts as a major enabler. Technology enablement of supply chain has not always been successful and has been examined by many researchers. The purpose of this paper is to do a systematic literature review of technology enabled supply chain from a strategic viewpoint. The literature is examined from two perspectives. Firstly, it studies the growing interest in technology-enabled supply chain in India. Secondly, it studies barriers affecting technology enablement of supply chain. The literature review identifies that technology enabled supply chain helps in improving performance via effective decision making, monitoring entire supply chain, faster reaction to customer service problems, etc. The research has emphasized the importance of 12 barriers affecting technology enablement. This research will help as a guide for practitioners in order to successfully implement technology and fills the gap in existing literature by highlighting and consolidating the significant research work done in past.

Enteroendocrine K and L cells in healthy and type 2 diabetic individuals.

PubMed

Jorsal, Tina; Rhee, Nicolai A; Pedersen, Jens; Wahlgren, Camilla D; Mortensen, Brynjulf; Jepsen, Sara L; Jelsing, Jacob; Dalbøge, Louise S; Vilmann, Peter; Hassan, Hazem; Hendel, Jakob W; Poulsen, Steen S; Holst, Jens J; Vilsbøll, Tina; Knop, Filip K

2018-02-01

Enteroendocrine K and L cells are pivotal in regulating appetite and glucose homeostasis. Knowledge of their distribution in humans is sparse and it is unknown whether alterations occur in type 2 diabetes. We aimed to evaluate the distribution of enteroendocrine K and L cells and relevant prohormone-processing enzymes (using immunohistochemical staining), and to evaluate the mRNA expression of the corresponding genes along the entire intestinal tract in individuals with type 2 diabetes and healthy participants. In this cross-sectional study, 12 individuals with type 2 diabetes and 12 age- and BMI-matched healthy individuals underwent upper and lower double-balloon enteroscopy with mucosal biopsy retrieval from approximately every 30 cm of the small intestine and from seven specific anatomical locations in the large intestine. Significantly different densities for cells positive for chromogranin A (CgA), glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide, peptide YY, prohormone convertase (PC) 1/3 and PC2 were observed along the intestinal tract. The expression of CHGA did not vary along the intestinal tract, but the mRNA expression of GCG, GIP, PYY, PCSK1 and PCSK2 differed along the intestinal tract. Lower counts of CgA-positive and PC1/3-positive cells, respectively, were observed in the small intestine of individuals with type 2 diabetes compared with healthy participants. In individuals with type 2 diabetes compared with healthy participants, the expression of GCG and PYY was greater in the colon, while the expression of GIP and PCSK1 was greater in the small intestine and colon, and the expression of PCSK2 was greater in the small intestine. Our findings provide a detailed description of the distribution of enteroendocrine K and L cells and the expression of their products in the human intestinal tract and demonstrate significant differences between individuals with type 2 diabetes and healthy participants. NCT03044860.

A novel germline mutation (c.A527G) in STK11 gene causes Peutz-Jeghers syndrome in a Chinese girl: A case report.

PubMed

Zhao, Zi-Ye; Jiang, Yu-Liang; Li, Bai-Rong; Yang, Fu; Li, Jing; Jin, Xiao-Wei; Sun, Shu-Han; Ning, Shou-Bin

2017-12-01

Peutz-Jeghers syndrome (PJS) is a Mendelian autosomal dominant disease caused by mutations in the tumor suppressor gene, serine/threonine kinase 11 (STK11). The features of this syndrome include gastrointestinal (GI) hamartomas, melanin spots on the lips and the extremities, and an increased risk of developing cancer. Early onset of disease is often characterized by mucocutaneous pigmentation and intussusception due to GI polyps in childhood. A girl with a positive family history grew oral pigmentation at 1 and got intussusception by small bowel hamartomas at 5. She was diagnosed with PJS based on oral pigmentation and a positive family history of PJS. Enteroscopy was employed to treat the GI polyps. Sanger sequencing was used to investigate STK11 mutation in this family. A large jejunal polyp together with other smaller ones was resected, and the girl recovered uneventfully. We discovered a heterozygous substitution in STK11, c.A527G in exon 4, in the girl and her father who was also a PJS patient, and the amine acid change was an aspartic acid-glycine substitution in codon 176. This mutation was not found in other healthy family members and 50 unrelated non-PJS controls, and it is not recorded in databases, which prove it a novel mutation. Evolutionary conservation analysis of amino acid residues showed this aspartic acid is a conserved one between species, and protein structure prediction by SWISS-MODEL indicated an obvious change in local structure. In addition, PolyPhen-2 score for this mutation is 1, which indicates it probably damaging. PJS can cause severe complication like intussusception in young children, and early screening for small bowel may be beneficial for these patients. The mutation of STK11 found in this girl is a novel one, which enlarges the spectrum of STK11. Our analysis supported it a causative one in PJS.

A novel germline mutation (c.A527G) in STK11 gene causes Peutz–Jeghers syndrome in a Chinese girl

PubMed Central

Zhao, Zi-Ye; Jiang, Yu-Liang; Li, Bai-Rong; Yang, Fu; Li, Jing; Jin, Xiao-Wei; Sun, Shu-Han; Ning, Shou-Bin

2017-01-01

Abstract Rationale: Peutz–Jeghers syndrome (PJS) is a Mendelian autosomal dominant disease caused by mutations in the tumor suppressor gene, serine/threonine kinase 11 (STK11). The features of this syndrome include gastrointestinal (GI) hamartomas, melanin spots on the lips and the extremities, and an increased risk of developing cancer. Early onset of disease is often characterized by mucocutaneous pigmentation and intussusception due to GI polyps in childhood. Patient concerns: A girl with a positive family history grew oral pigmentation at 1 and got intussusception by small bowel hamartomas at 5. Diagnoses: She was diagnosed with PJS based on oral pigmentation and a positive family history of PJS. Interventions: Enteroscopy was employed to treat the GI polyps. Sanger sequencing was used to investigate STK11 mutation in this family. Outcomes: A large jejunal polyp together with other smaller ones was resected, and the girl recovered uneventfully. We discovered a heterozygous substitution in STK11, c.A527G in exon 4, in the girl and her father who was also a PJS patient, and the amine acid change was an aspartic acid-glycine substitution in codon 176. This mutation was not found in other healthy family members and 50 unrelated non-PJS controls, and it is not recorded in databases, which prove it a novel mutation. Evolutionary conservation analysis of amino acid residues showed this aspartic acid is a conserved one between species, and protein structure prediction by SWISS-MODEL indicated an obvious change in local structure. In addition, PolyPhen-2 score for this mutation is 1, which indicates it probably damaging. Lessons: PJS can cause severe complication like intussusception in young children, and early screening for small bowel may be beneficial for these patients. The mutation of STK11 found in this girl is a novel one, which enlarges the spectrum of STK11. Our analysis supported it a causative one in PJS. PMID:29245219

Paediatric intestinal cancer and polyposis due to bi-allelic PMS2 mutations: case series, review and follow-up guidelines.

PubMed

Herkert, Johanna C; Niessen, Renée C; Olderode-Berends, Maria J W; Veenstra-Knol, Hermine E; Vos, Yvonne J; van der Klift, Heleen M; Scheenstra, Rene; Tops, Carli M J; Karrenbeld, Arend; Peters, Frans T M; Hofstra, Robert M W; Kleibeuker, Jan H; Sijmons, Rolf H

2011-05-01

Bi-allelic germline mutations of one of the DNA mismatch repair genes, so far predominantly found in PMS2, cause constitutional MMR-deficiency syndrome. This rare disorder is characterised by paediatric intestinal cancer and other malignancies. We report the clinical, immunohistochemical and genetic characterisation of four families with bi-allelic germline PMS2 mutations. We present an overview of the published gastrointestinal manifestations of CMMR-D syndrome and propose recommendations for gastro-intestinal screening. The first proband developed a cerebral angiosarcoma at age 2 and two colorectal adenomas at age 7. Genetic testing identified a complete PMS2 gene deletion and a frameshift c.736_741delinsTGTGTGTGAAG (p.Pro246CysfsX3) mutation. In the second family, both the proband and her brother had multiple intestinal adenomas, initially wrongly diagnosed as familial adenomatous polyposis. A splice site c.2174+1G>A, and a missense c.137G>T (p.Ser46Ile) mutation in PMS2 were identified. The third patient was diagnosed with multiple colorectal adenomas at age 11; he developed a high-grade dysplastic colorectal adenocarcinoma at age 21. Two intragenic PMS2 deletions were found. The fourth proband developed a cerebral anaplastic ganglioma at age 9 and a high-grade colerectal dysplastic adenoma at age 10 and carries a homozygous c.2174+1G>A mutation. Tumours of all patients showed microsatellite instability and/or loss of PMS2 expression. Our findings show the association between bi-allelic germline PMS2 mutations and severe childhood-onset gastrointestinal manifestations, and support the notion that patients with early-onset gastrointestinal adenomas and cancer should be investigated for CMMR-D syndrome. We recommend yearly follow-up with colonoscopy from age 6 and simultaneous video-capsule small bowel enteroscopy from age 8. Copyright © 2011 Elsevier Ltd. All rights reserved.

Thermal Analysis for Monitoring Effects of Shock-Induced Physical, Mechanical, and Chemical Changes in Materials

DTIC Science & Technology

2015-01-19

MS WINDOWS platform, which enables multitasking with simultaneous evaluation and operation 1. REPORT DATE (DD-MM-YYYY) 4. TITLE AND SUBTITLE 13...measurement and analysis software for data acquisition, storage and evaluation with MS WINDOWS platform, which enables multitasking with simultaneous...Proteus measurement and analysis software for data acquisition, storage and evaluation with MS WINDOWS platform, which enables multitasking with

Developing and implementing a service charter for an integrated regional stroke service: an exploratory case study

PubMed Central

2014-01-01

Background Based on practices in commercial organizations and public services, healthcare organizations are using service charters to inform patients about the quality of service they can expect and to increase patient-centeredness. In the Netherlands, an integrated regional stroke service involving five organizations has developed and implemented a single service charter. The purpose of this study is to determine the organizational enablers for the effective development and implementation of this service charter. Methods We have conducted an exploratory qualitative study using Grounded Theory to determine the organizational enablers of charter development and implementation. Individual semi-structured interviews were held with all members of the steering committee and the taskforce responsible for the service charter. In these twelve interviews, participants were retrospectively asked for their opinions of the enablers. Interview transcripts have been analysed using Glaser’s approach of substantive coding consisting of open and selective coding in order to develop a framework of these enablers. A tabula rasa approach was used without any preconceived frameworks used in the coding process. Results We have determined seven categories of enablers formed of a total of 27 properties. The categories address a broad spectrum of enablers dealing with the basic foundations for cooperation, the way to manage the project’s organization and the way to implement the service charter. In addition to the enablers within each individual organization, enablers that reflect the whole chain seem to be important for the effective development and implementation of this service charter. Strategic alignment of goals within the chain, trust between organizations, willingness to cooperate and the extent of process integration are all important properties. Conclusions This first exploratory study into the enablers of the effective development and implementation was based on a single case study in the Netherlands. This is the only integrated care chain using a single service charter that we could find. Nevertheless, the results of our explorative study provide an initial framework for the development and implementation of service charters in integrated care settings. This research contributes to the literature on service charters, on patient-centeredness in integrated care and on the implementation of innovations. PMID:24678839

A Service Oriented Architecture to Enable Sensor Webs

NASA Technical Reports Server (NTRS)

Sohlberg, Rob; Frye, Stu; Cappelaere, Pat; Ungar, Steve; Ames, Troy; Chien, Steve

2006-01-01

This viewgraph presentation reviews the development of a Service Oriented Architecture to assist in lowering the cost of new Earth Science products. This architecture will enable rapid and cost effective reconfiguration of new sensors.

Connected commercial vehicles-integrated truck project : final report.

DOT National Transportation Integrated Search

2014-01-01

Connected vehicle wireless data communications can enable safety applications that may reduce crashes, injuries, and fatalities suffered on our roads and highways, as well as enabling reductions in traffic congestion and effects on the environment. A...

CrossTalk: The Journal of Defense Software Engineering. Volume 21, Number 3

DTIC Science & Technology

2008-03-01

describes essentials for requirements development and management. In addi- tion to providing training, eLearning and consulting services, she speaks at and...information, support sense- making, enable collaborative decision making, and effect changes in the physical environment. For example, the Global ...across layers, which enables effective use of resources and helps enforce security and confiden- tiality policies. Global Data Space DDS provides a

Microfluidic multiplexed partitioning enables flexible and effective utilization of magnetic sensor arrays.

PubMed

Bechstein, Daniel J B; Ng, Elaine; Lee, Jung-Rok; Cone, Stephanie G; Gaster, Richard S; Osterfeld, Sebastian J; Hall, Drew A; Weaver, James A; Wilson, Robert J; Wang, Shan X

2015-11-21

We demonstrate microfluidic partitioning of a giant magnetoresistive sensor array into individually addressable compartments that enhances its effective use. Using different samples and reagents in each compartment enables measuring of cross-reactive species and wide dynamic ranges on a single chip. This compartmentalization technique motivates the employment of high density sensor arrays for highly parallelized measurements in lab-on-a-chip devices.

High-Resolution Structural Monitoring of Ionospheric Absorption Events

DTIC Science & Technology

2013-07-01

ionospheric plasma conductivity 5 . This results in enhanced absorption of the cosmic high frequency (HF; typically 10 – 60 MHz) radio background ...7 riometry. Incorporation of an outrigger site, to enable treatment of the unknown structure of the celestial background and the effects of...riometry. Incorporation of an outrigger site, to enable treatment of the unknown structure of the celestial background and the effects of confusion

Commercial driver rest & parking requirements : making space for safety

DOT National Transportation Integrated Search

2014-01-01

Connected vehicle wireless data communications can enable safety applications that may reduce injuries and fatalities suffered on our roads and highways, as well as enabling reductions in traffic congestion and effects on the environment. As a critic...

Nanofiller Presence Enhances Polycyclic Aromatic Hydrocarbon (PAH) Profile on Nanoparticles Released during Thermal Decomposition of Nano-enabled Thermoplastics: Potential Environmental Health Implications.

PubMed

Singh, Dilpreet; Schifman, Laura Arabella; Watson-Wright, Christa; Sotiriou, Georgios A; Oyanedel-Craver, Vinka; Wohlleben, Wendel; Demokritou, Philip

2017-05-02

Nano-enabled products are ultimately destined to reach end-of-life with an important fraction undergoing thermal degradation through waste incineration or accidental fires. Although previous studies have investigated the physicochemical properties of released lifecycle particulate matter (called LCPM) from thermal decomposition of nano-enabled thermoplastics, critical questions about the effect of nanofiller on the chemical composition of LCPM still persist. Here, we investigate the potential nanofiller effects on the profiles of 16 Environmental Protection Agency (EPA)-priority polycyclic aromatic hydrocarbons (PAHs) adsorbed on LCPM from thermal decomposition of nano-enabled thermoplastics. We found that nanofiller presence in thermoplastics significantly enhances not only the total PAH concentration in LCPM but most importantly also the high molecular weight (HMW, 4-6 ring) PAHs that are considerably more toxic than the low molecular weight (LMW, 2-3 ring) PAHs. This nano-specific effect was also confirmed during in vitro cellular toxicological evaluation of LCPM for the case of polyurethane thermoplastic enabled with carbon nanotubes (PU-CNT). LCPM from PU-CNT shows significantly higher cytotoxicity compared to PU which could be attributed to its higher HMW PAH concentration. These findings are crucial and make the case that nanofiller presence in thermoplastics can significantly affect the physicochemical and toxicological properties of LCPM released during thermal decomposition.

Paper Capillary Enables Effective Sampling for Microfluidic Paper Analytical Devices.

PubMed

Shangguan, Jin-Wen; Liu, Yu; Wang, Sha; Hou, Yun-Xuan; Xu, Bi-Yi; Xu, Jing-Juan; Chen, Hong-Yuan

2018-06-06

Paper capillary is introduced to enable effective sampling on microfluidic paper analytical devices. By coupling mac-roscale capillary force of paper capillary and microscale capillary forces of native paper, fluid transport can be flexibly tailored with proper design. Subsequently, a hybrid-fluid-mode paper capillary device was proposed, which enables fast and reliable sampling in an arrayed form, with less surface adsorption and bias for different components. The resulting device thus well supports high throughput, quantitative, and repeatable assays all by hands operation. With all these merits, multiplex analysis of ions, proteins, and microbe have all been realized on this platform, which has paved the way to level-up analysis on μPADs.

The Usage and Impact of Internet Enabled Phones on Academic Concentration among Students of Tertiary Institutions: A Study at the University of Ibadan, Nigeria

ERIC Educational Resources Information Center

Ezemenaka, Emeka

2013-01-01

The usage of Internet enabled phones has been a 21st century phenomenon that spreads for different purposes and functions. This study looks into the usage and perceived effect implications internet enabled phones have on the academic performance of the tertiary students using University of Ibadan students in Nigeria as a case study. The study was…

Statistical Relational Learning (SRL) as an Enabling Technology for Data Acquisition and Data Fusion in Video

DTIC Science & Technology

2013-05-02

REPORT Statistical Relational Learning ( SRL ) as an Enabling Technology for Data Acquisition and Data Fusion in Video 14. ABSTRACT 16. SECURITY...particular, it is important to reason about which portions of video require expensive analysis and storage. This project aims to make these...inferences using new and existing tools from Statistical Relational Learning ( SRL ). SRL is a recently emerging technology that enables the effective 1

75 FR 13235 - IP-Enabled Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 63 [WC Docket No. 04-36; FCC 09-40] IP-Enabled Services AGENCY: Federal Communications Commission ACTION: Final rule; announcement of effective date... Internet Protocol (VoIP) service the discontinuance obligations that apply to domestic non-dominant...

Measuring the Strategic Value of the Armed Forces Health Longitudinal Technology Application (AHLTA)

DTIC Science & Technology

2008-01-01

Mission Centered Care IP2 Beneficiaries partner with us to improve health outcomes IP1 Evidence - based medicine is used to improve quality, safety, and...Battlefield” IP6 Comprehensive globally accessible health and business information enable medical surveillance, evidence - based medicine and effective...information enables medical surveillance, evidence - based medicine , and effective healthcare operations. 4 OASD (2007a). Measures for the MHS Strategic

Web-Enabled Systems for Student Access.

ERIC Educational Resources Information Center

Harris, Chad S.; Herring, Tom

1999-01-01

California State University, Fullerton is developing a suite of server-based, Web-enabled applications that distribute the functionality of its student information system software to external customers without modifying the mainframe applications or databases. The cost-effective, secure, and rapidly deployable business solution involves using the…

Enable: Developing Instructional Language Skills.

ERIC Educational Resources Information Center

Witt, Beth

The program presented in this manual provides a structure and activities for systematic development of effective listening comprehension in typical and atypical children. The complete ENABLE kit comes with pictures, cut-outs, and puppets to illustrate the directives, questions, and narrative activities. The manual includes an organizational and…

Effect of Annealing on the Passive Film Stability and Corrosion Resistance of New Families of Iron-Based Amorphous Metals

DTIC Science & Technology

2011-06-01

metallic glass easier to create and more stable once formed, thus improving the corrosion resistance. Adding titanium will enable the formation of...glass easier to create and more stable once formed, thus improving the corrosion resistance. Adding titanium will enable the formation of an extremely...research, it was hypothesized that additions of titanium could enable the formation of a protective titanium oxide film on the surface of the alloy

A Study of Asynchronous Mobile-Enabled SMS Text Psychotherapy.

PubMed

Hull, Thomas D; Mahan, Kush

2017-03-01

Many obstacles to obtaining psychotherapy continue to diminish its reach despite its documented positive effects. Using short message service (SMS) texting and Web platforms to enable licensed psychotherapists to deliver therapy directly to the lived context of the client is one possible solution. Employing a feasibility study design, this pilot trial further evaluated the external validity for treatment outcomes of text therapy and extended findings to include mobile-enabled text platforms. Adults seeking text therapy treatment for a variety of disorders were recruited from a text therapy service (N = 57). Clinical outcomes were measured using the General Health Questionnaire-12 (GHQ-12) through 15 weeks of treatment. A process variable, the therapeutic alliance, was measured with the Working Alliance Inventory. Treatment acceptability was assessed with ratings of satisfaction for several aspects of the treatment, including affordability, effectiveness, convenience, wait times to receiving treatment, and cost-effectiveness. Results indicate evidence for the effectiveness of the intervention (GHQ-12, Cohen's d = 1.3). Twenty-five (46%) participants experienced clinically significant symptom remission. Therapeutic alliance scores were lower than those found in traditional treatment settings, but still predicted symptom improvement (R 2  = 0.299). High levels of satisfaction with text therapy were reported on dimensions of affordability, convenience, and effectiveness. Cost-effectiveness analyses suggest that text therapy is 42.2% the cost of traditional services and offers much reduced wait times. Mobile-enabled asynchronous text therapy with a licensed therapist is an acceptable and clinically beneficial medium for individuals with various diagnoses and histories of psychological distress.

A Test Bed for Detection of Botnet Infections in Low Data Rate Tactical Networks

DTIC Science & Technology

2009-09-01

perimeter, their effectiveness in preventing further proliferation within a LAN is almost non-existent. Conficker disables antivirus and firewall software...enable: Yes Disable “strict” capture filtering: no Fencelist location: /etc/fencelist.txt (IP addresses and CIDR blocks Enable Fencelist filtering

Teaching Mathematics in Primary Schools with Challenging Tasks: The Big (Not So) Friendly Giant

ERIC Educational Resources Information Center

Russo, James

2016-01-01

The use of enabling and extending prompts allows tasks to be both accessible and challenging within a classroom. This article provides an example of how to use enabling and extending prompts effectively when employing a challenging task in Year 2.

Human Factors Engineering: An Enabler for Military Transformation Through Effective Integration of Technology and Personnel

DTIC Science & Technology

2003-06-01

2. Wilber Shramm and William Porter, Men, Women, Messages and Media: Understanding Human Communication (New York, Harper and Rowe, 1982). 3...about the problem” Men, Women, Messages and Media: Understanding Human Communication Rev 14 5 Military Transformation Enabler for Warfighting

RF-MEMS capacitive switches with high reliability

DOEpatents

Goldsmith, Charles L.; Auciello, Orlando H.; Carlisle, John A.; Sampath, Suresh; Sumant, Anirudha V.; Carpick, Robert W.; Hwang, James; Mancini, Derrick C.; Gudeman, Chris

2013-09-03

A reliable long life RF-MEMS capacitive switch is provided with a dielectric layer comprising a "fast discharge diamond dielectric layer" and enabling rapid switch recovery, dielectric layer charging and discharging that is efficient and effective to enable RF-MEMS switch operation to greater than or equal to 100 billion cycles.

Training a Joint and Expeditionary Mindset

DTIC Science & Technology

2006-12-01

associated with the JEM constructs and for using them to create effective computer-mediated training scenarios. The pedagogic model enables development of...ensure the instructional rigor of scenarios and provide a sound basis for determining performance indicators. The pedagogical model enables development...and Subordinate Constructs ........................................................................... 3 Pedagogical Fram ew ork

Cross-jurisdictional signal coordination in Phoenix & Seattle : lessons learned from the metropolitan model deployment initiative : removing barriers to seamless arterial travel

DOT National Transportation Integrated Search

2014-01-01

Connected vehicle wireless data communications can enable safety applications that may reduce crashes, injuries, and fatalities suffered on our roads and highways, as well as enabling reductions in traffic congestion and effects on the environment. A...

Vertical Isolation for Photodiodes in CMOS Imagers

NASA Technical Reports Server (NTRS)

Pain, Bedabrata

2008-01-01

In a proposed improvement in complementary metal oxide/semi conduct - or (CMOS) image detectors, two additional implants in each pixel would effect vertical isolation between the metal oxide/semiconductor field-effect transistors (MOSFETs) and the photodiode of the pixel. This improvement is expected to enable separate optimization of the designs of the photodiode and the MOSFETs so as to optimize their performances independently of each other. The purpose to be served by enabling this separate optimization is to eliminate or vastly reduce diffusion cross-talk, thereby increasing sensitivity, effective spatial resolution, and color fidelity while reducing noise.

Contributions of treatment theory and enablement theory to rehabilitation research and practice.

PubMed

Whyte, John

2014-01-01

Scientific theory is crucial to the advancement of clinical research. The breadth of rehabilitation treatment requires that many different theoretical perspectives be incorporated into the design and testing of treatment interventions. In this article, the 2 broad classes of theory relevant to rehabilitation research and practice are defined, and their distinct but complementary contributions to research and clinical practice are explored. These theory classes are referred to as treatment theories (theories about how to effect change in clinical targets) and enablement theories (theories about how changes in a proximal clinical target will influence distal clinical aims). Treatment theories provide the tools for inducing clinical change but do not specify how far reaching the ultimate impact of the change will be. Enablement theories model the impact of changes on other areas of function but provide no insight as to how treatment can create functional change. Treatment theories are more critical in the early stages of treatment development, whereas enablement theories become increasingly relevant in specifying the clinical significance and practical effectiveness of more mature treatments. Understanding the differences in the questions these theory classes address and how to combine their insights is crucial for effective research development and clinical practice. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Memory Reactivation Enables Long-Term Prevention of Interference.

PubMed

Herszage, Jasmine; Censor, Nitzan

2017-05-22

The ability of the human brain to successively learn or perform two competing tasks constitutes a major challenge in daily function. Indeed, exposing the brain to two different competing memories within a short temporal offset can induce interference, resulting in deteriorated performance in at least one of the learned memories [1-4]. Although previous studies have investigated online interference and its effects on performance [5-13], whether the human brain can enable long-term prevention of future interference is unknown. To address this question, we utilized the memory reactivation-reconsolidation framework [2, 12] stemming from studies at the synaptic level [14-17], according to which reactivation of a memory enables its update. In a set of experiments, using the motor sequence learning task [18] we report that a unique pairing of reactivating the original memory (right hand) in synchrony with novel memory trials (left hand) prevented future interference between the two memories. Strikingly, these effects were long-term and observed a month following reactivation. Further experiments showed that preventing future interference was not due to practice per se, but rather specifically depended on a limited time window induced by reactivation of the original memory. These results suggest a mechanism according to which memory reactivation enables long-term prevention of interference, possibly by creating an updated memory trace integrating original and novel memories during the reconsolidation time window. The opportunity to induce a long-term preventive effect on memories may enable the utilization of strategies optimizing normal human learning, as well as recovery following neurological insults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review.

PubMed

Miller, Kimberly J; Adair, Brooke S; Pearce, Alan J; Said, Catherine M; Ozanne, Elizabeth; Morris, Meg M

2014-03-01

use of virtual reality and commercial gaming systems (VR/gaming) at home by older adults is receiving attention as a means of enabling physical activity. to summarise evidence for the effectiveness and feasibility of VR/gaming system utilisation by older adults at home for enabling physical activity to improve impairments, activity limitations or participation. a systematic review searching 12 electronic databases from 1 January 2000-10 July 2012 using key search terms. Two independent reviewers screened yield articles using pre-determined selection criteria, extracted data using customised forms and applied the Cochrane Collaboration Risk of Bias Tool and the Downs and Black Checklist to rate study quality. fourteen studies investigating the effects of VR/gaming system use by healthy older adults and people with neurological conditions on activity limitations, body functions and physical impairments and cognitive and emotional well-being met the selection criteria. Study quality ratings were low and, therefore, evidence was not strong enough to conclude that interventions were effective. Feasibility was inconsistently reported in studies. Where feasibility was discussed, strong retention (≥70%) and adherence (≥64%) was reported. Initial assistance to use the technologies, and the need for monitoring exertion, aggravation of musculoskeletal symptoms and falls risk were reported. existing evidence to support the feasibility and effectiveness VR/gaming systems use by older adults at home to enable physical activity to address impairments, activity limitations and participation is weak with a high risk of bias. The findings of this review may inform future, more rigorous research.

Inverse spin Hall and spin rectification effects in NiFe/FeMn exchange-biased thin films

NASA Astrophysics Data System (ADS)

Garcia, W. J. S.; Seeger, R. L.; da Silva, R. B.; Harres, A.

2017-11-01

Materials presenting high spin-orbit coupling are able to convert spin currents in charge currents. The phenomenon, known as inverse spin Hall effect, promises to revolutionize spintronic technology enabling the electrical detection of spin currents. It has been observed in a variety of systems, usually non-magnetic metals. We study the voltage emerging in exchange biased Ta/NiFe/FeMn/Ta thin films near the ferromagnetic resonance. Measured signals are related to both inverse spin Hall and spin rectification effects, and two distinct protocols were employed to separate their contributions.The curve shift due to the exchange bias effect may enable high frequency applications without an external applied magnetic field.

Managing Risk on the Final Frontier

NASA Technical Reports Server (NTRS)

Lengyel, David M.; Newman, J. S.

2009-01-01

The National Aeronautics and Space Administration (NASA). Exploration Systems Mission Directorate (ESMD) has combined the Continuous Risk Management (CRM) discipline with innovative knowledge management (KM) practices to more effectively enable the accomplishment of work. CRM enables proactive problem identification and problem solving in the complex world of rocket science. while KM is used to improve this process.

Using Mathematics to Solve Real World Problems: The Role of Enablers

ERIC Educational Resources Information Center

Geiger, Vincent; Stillman, Gloria; Brown, Jill; Galbriath, Peter; Niss, Mogens

2018-01-01

The purpose of this article is to report on a newly funded research project in which we will investigate how secondary students apply mathematical modelling to effectively address real world situations. Through this study, we will identify factors, mathematical, cognitive, social and environmental that "enable" year 10/11 students to…

Biotechniques Laboratory: An Enabling Course in the Biological Sciences

ERIC Educational Resources Information Center

Di Trapani, Giovanna; Clarke, Frank

2012-01-01

Practical skills and competencies are critical to student engagement and effective learning in laboratory courses. This article describes the design of a yearlong, stand-alone laboratory course--the Biotechniques Laboratory--a common core course in the second year of all our degree programs in the biological sciences. It is an enabling,…

Supporting Pre-Service Teachers' Technology-Enabled Learning Design Thinking through Whole of Programme Transformation

ERIC Educational Resources Information Center

Bower, Matt; Highfield, Kate; Furney, Pam; Mowbray, Lee

2013-01-01

This paper explains a development and evaluation project aimed at transforming two pre-service teacher education programmes at Macquarie University to more effectively cultivate students' technology-enabled learning design thinking. The process of transformation was based upon an explicit and sustained focus on developing university academics'…

Implementing Self-Management within a Group Counseling Context: Effects on Academic Enabling Behaviors

ERIC Educational Resources Information Center

Briesch DuBois, Jacquelyn M.; Briesch, Amy M.; Hoffman, Jessica A.; Struzziero, Joan; Toback, Robin

2017-01-01

Self-management interventions have been adapted to serve as targeted interventions to increase academic enabling behaviors in groups of students. However, a trade-off exists between adapting these interventions to feasibly fit group contexts and maintaining theoretical intervention components. This study examines the use of self-management within…

29 CFR 785.16 - Off duty.

Code of Federal Regulations, 2010 CFR

2010-07-01

... long enough to enable him to use the time effectively for his own purposes are not hours worked. He is... until a definitely specified hour has arrived. Whether the time is long enough to enable him to use the... to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL POLICY OR...

Integrated radiologist's workstation enabling the radiologist as an effective clinical consultant

NASA Astrophysics Data System (ADS)

McEnery, Kevin W.; Suitor, Charles T.; Hildebrand, Stan; Downs, Rebecca; Thompson, Stephen K.; Shepard, S. Jeff

2002-05-01

Since February 2000, radiologists at the M. D. Anderson Cancer Center have accessed clinical information through an internally developed radiologist's clinical interpretation workstation called RadStation. This project provides a fully integrated digital dictation workstation with clinical data review. RadStation enables the radiologist as an effective clinical consultant with access to pertinent sources of clinical information at the time of dictation. Data sources not only include prior radiology reports from the radiology information system (RIS) but access to pathology data, laboratory data, history and physicals, clinic notes, and operative reports. With integrated clinical information access, a radiologists's interpretation not only comments on morphologic findings but also can enable evaluation of study findings in the context of pertinent clinical presentation and history. Image access is enabled through the integration of an enterprise image archive (Stentor, San Francisco). Database integration is achieved by a combination of real time HL7 messaging and queries to SQL-based legacy databases. A three-tier system architecture accommodates expanding access to additional databases including real-time patient schedule as well as patient medications and allergies.

Health IT-enabled Care for Underserved Rural Populations: The Role of Nursing

PubMed Central

Effken, Judith A.; Abbott, Patricia

2009-01-01

This white paper explains the strong roles that nursing can play in using information technology (IT) to improve healthcare delivery in rural areas. The authors describe current challenges to providing care in rural areas, and how technology innovations can help rural communities to improve their health and health care. To maximize benefits, rural stakeholders (as individuals and groups) must collaborate to effect change. Because nonphysician providers deliver much of the health care in rural communities, this paper focuses on the critical roles of nurses on IT-enabled caremanagement teams. The authors propose changes in nursing practice, policy, and education to better prepare, encourage, and enable nurses to assume leadership roles in IT-enabled health care management in rural communities. PMID:19261937

Hormonal effects in newborns

MedlinePlus

... page: //medlineplus.gov/ency/article/001911.htm Hormonal effects in newborns To use the sharing features on this page, please enable JavaScript. Hormonal effects in newborns occur because in the womb, babies ...

Demand Response Advanced Controls Framework and Assessment of Enabling Technology Costs

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

Potter, Jennifer; Cappers, Peter

The Demand Response Advanced Controls Framework and Assessment of Enabling Technology Costs research describe a variety of DR opportunities and the various bulk power system services they can provide. The bulk power system services are mapped to a generalized taxonomy of DR “service types”, which allows us to discuss DR opportunities and bulk power system services in fewer yet broader categories that share similar technological requirements which mainly drive DR enablement costs. The research presents a framework for the costs to automate DR and provides descriptions of the various elements that drive enablement costs. The report introduces the various DRmore » enabling technologies and end-uses, identifies the various services that each can provide to the grid and provides the cost assessment for each enabling technology. In addition to a report, this research includes a Demand Response Advanced Controls Database and User Manual. They are intended to provide users with the data that underlies this research and instructions for how to use that database more effectively and efficiently.« less

Barriers and enablers that influence sustainable interprofessional education: a literature review.

PubMed

Lawlis, Tanya Rechael; Anson, Judith; Greenfield, David

2014-07-01

The effective incorporation of interprofessional education (IPE) within health professional curricula requires the synchronised and systematic collaboration between and within the various stakeholders. Higher education institutions, as primary health education providers, have the capacity to advocate and facilitate this collaboration. However, due to the diversity of stakeholders, facilitating the pedagogical change can be challenging and complex, and brings a degree of uncertainty and resistance. This review, through an analysis of the barriers and enablers investigates the involvement of stakeholders in higher education IPE through three primary stakeholder levels: Government and Professional, Institutional and Individual. A review of eight primary databases using 21 search terms resulted in 40 papers for review. While the barriers to IPE are widely reported within the higher education IPE literature, little is documented about the enablers of IPE. Similarly, the specific identification and importance of enablers for IPE sustainability and the dual nature of some barriers and enablers have not been previously reported. An analysis of the barriers and enablers of IPE across the different stakeholder levels reveals five key "fundamental elements" critical to achieving sustainable IPE in higher education curricula.

Ranking and clustering of nodes in networks with smart teleportation

NASA Astrophysics Data System (ADS)

Lambiotte, R.; Rosvall, M.

2012-05-01

Random teleportation is a necessary evil for ranking and clustering directed networks based on random walks. Teleportation enables ergodic solutions, but the solutions must necessarily depend on the exact implementation and parametrization of the teleportation. For example, in the commonly used PageRank algorithm, the teleportation rate must trade off a heavily biased solution with a uniform solution. Here we show that teleportation to links rather than nodes enables a much smoother trade-off and effectively more robust results. We also show that, by not recording the teleportation steps of the random walker, we can further reduce the effect of teleportation with dramatic effects on clustering.

Exploring the Classroom Practices That May Enable a Compassionate Approach to Financial Literacy Education

ERIC Educational Resources Information Center

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2018-01-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The…

Viral Vectors for Use in the Development of Biodefense Vaccines

DTIC Science & Technology

2005-06-17

vaccinia virus, and Venezuelan equine encephalitis virus, as vaccine vectors has enabled researchers to develop effective means for countering the...biowarfare. The use of viruses, for example adenovirus, vaccinia virus, and Venezuelan equine encephalitis virus, as vaccine -vectors has enabled researchers to... vaccines . . . . . . . . . . . . . . . . . . . 1298 2.1.3. Vaccinia virus-vectored Venezuelan equine encephalitis vaccines

Enabling Self-Directed Computer Use for Individuals with Cerebral Palsy: A Systematic Review of Assistive Devices and Technologies

ERIC Educational Resources Information Center

Davies, T. Claire; Mudge, Suzie; Ameratunga, Shanthi; Stott, N. Susan

2010-01-01

Aim: The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP). Methods: Nine electronic databases were searched using keywords "computer", "software", "spastic",…

The Computing And Interdisciplinary Systems Office: Annual Review and Planning Meeting

NASA Technical Reports Server (NTRS)

Lytle, John K.

2003-01-01

The goal of this research is to develop an advanced engineering analysis system that enables high-fidelity, multi-disciplinary, full propulsion system simulations to be performed early in the design process (a virtual test cell that integrates propulsion and information technologies). This will enable rapid, high-confidence, cost-effective design of revolutionary systems.

New Technologies: Real-time Telepathology Systems-Novel Cost-effective Tools for Real-time Consultation and Data Sharing.

PubMed

Siegel, Gabriel; Regelman, Dan; Maronpot, Robert; Rosenstock, Moti; Nyska, Abraham

2017-12-01

Real-time telepathology for use in investigative and regulated preclinical toxicology studies is now feasible. Newly developed microscope-integrated telepathology systems enable geographically remote stakeholders to view the live histopathology slide as seen by the study pathologist within the microscope. Simultaneous online viewing and dialog between study pathologist and remote colleagues is an efficient and cost-effective means for consultation, pathology working groups, and peer review, facilitating good science and economic benefits by enabling more timely and informed clinical decisions.

The effectiveness of using the calculated braking current for longitudinal differential protection of 110 - 750 kV shunt reactors

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

Vdovin, S. A.; Shalimov, A. S.

2013-05-15

The use of the function of effective current braking of the longitudinal differential protection of shunt reactors to offset current surges, which enables the sensitivity of differential protection to be increased when there are short circuits with low damage currents, is considered. It is shown that the use of the calculated braking characteristic enables the reliability of offset protection from transients to be increased when the reactor is connected, which is accompanied by the flow of asymmetric currents containing an aperiodic component.

On the use of fractional order PK-PD models

NASA Astrophysics Data System (ADS)

Ionescu, Clara; Copot, Dana

2017-01-01

Quantifying and controlling depth of anesthesia is a challenging process due to lack of measurement technology for direct effects of drug supply into the body. Efforts are being made to develop new sensor techniques and new horizons are explored for modeling this intricate process. This paper introduces emerging tools available on the ‘engineering market’ imported from the area of fractional calculus. A novel interpretation of the classical drug-effect curve is given, enabling linear control. This enables broadening the horizon of signal processing and control techniques and suggests future research lines.

Linking Automated Data Analysis and Visualization with Applications in Developmental Biology and High-Energy Physics

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

Ruebel, Oliver

2009-11-20

Knowledge discovery from large and complex collections of today's scientific datasets is a challenging task. With the ability to measure and simulate more processes at increasingly finer spatial and temporal scales, the increasing number of data dimensions and data objects is presenting tremendous challenges for data analysis and effective data exploration methods and tools. Researchers are overwhelmed with data and standard tools are often insufficient to enable effective data analysis and knowledge discovery. The main objective of this thesis is to provide important new capabilities to accelerate scientific knowledge discovery form large, complex, and multivariate scientific data. The research coveredmore » in this thesis addresses these scientific challenges using a combination of scientific visualization, information visualization, automated data analysis, and other enabling technologies, such as efficient data management. The effectiveness of the proposed analysis methods is demonstrated via applications in two distinct scientific research fields, namely developmental biology and high-energy physics.Advances in microscopy, image analysis, and embryo registration enable for the first time measurement of gene expression at cellular resolution for entire organisms. Analysis of high-dimensional spatial gene expression datasets is a challenging task. By integrating data clustering and visualization, analysis of complex, time-varying, spatial gene expression patterns and their formation becomes possible. The analysis framework MATLAB and the visualization have been integrated, making advanced analysis tools accessible to biologist and enabling bioinformatic researchers to directly integrate their analysis with the visualization. Laser wakefield particle accelerators (LWFAs) promise to be a new compact source of high-energy particles and radiation, with wide applications ranging from medicine to physics. To gain insight into the complex physical processes of particle acceleration, physicists model LWFAs computationally. The datasets produced by LWFA simulations are (i) extremely large, (ii) of varying spatial and temporal resolution, (iii) heterogeneous, and (iv) high-dimensional, making analysis and knowledge discovery from complex LWFA simulation data a challenging task. To address these challenges this thesis describes the integration of the visualization system VisIt and the state-of-the-art index/query system FastBit, enabling interactive visual exploration of extremely large three-dimensional particle datasets. Researchers are especially interested in beams of high-energy particles formed during the course of a simulation. This thesis describes novel methods for automatic detection and analysis of particle beams enabling a more accurate and efficient data analysis process. By integrating these automated analysis methods with visualization, this research enables more accurate, efficient, and effective analysis of LWFA simulation data than previously possible.« less

Vulnerabilities in First-Generation RFID-enabled Credit Cards

NASA Astrophysics Data System (ADS)

Heydt-Benjamin, Thomas S.; Bailey, Daniel V.; Fu, Kevin; Juels, Ari; O'Hare, Tom

RFID-enabled credit cards are widely deployed in the United States and other countries, but no public study has thoroughly analyzed the mechanisms that provide both security and privacy. Using samples from a variety of RFID-enabled credit cards, our study observes that (1) the cardholder's name and often credit card number and expiration are leaked in plaintext to unauthenticated readers, (2) our homemade device costing around 150 effectively clones one type of skimmed cards thus providing a proof-of-concept implementation for the RF replay attack, (3) information revealed by the RFID transmission cross contaminates the security of RFID and non-RFID payment contexts, and (4) RFID-enabled credit cards are susceptible in various degrees to a range of other traditional RFID attacks such as skimming and relaying.

Cognitive, sensory and physical factors enabling driving safety in older adults.

PubMed

Anstey, Kaarin J; Wood, Joanne; Lord, Stephen; Walker, Janine G

2005-01-01

We reviewed literature on cognitive, sensory, motor and physical factors associated with safe driving and crash risk in older adults with the goal of developing a model of factors enabling safe driving behaviour. Thirteen empirical studies reporting associations between cognitive, sensory, motor and physical factors and either self-reported crashes, state crash records or on-road driving measures were identified. Measures of attention, reaction time, memory, executive function, mental status, visual function, and physical function variables were associated with driving outcome measures. Self-monitoring was also identified as a factor that may moderate observed effects by influencing driving behavior. We propose that three enabling factors (cognition, sensory function and physical function/medical conditions) predict driving ability, but that accurate self-monitoring of these enabling factors is required for safe driving behaviour.

Utilizing Fission Technology to Enable Rapid and Affordable Access to any Point in the Solar System

NASA Technical Reports Server (NTRS)

Houts, Mike; Bonometti, Joe; Morton, Jeff; Hrbud, Ivana; Bitteker, Leo; VanDyke, Melissa; Godfroy, T.; Pedersen, K.; Dobson, C.; Patton, B.;

Microfluidic interconnects

DOEpatents

Benett, William J.; Krulevitch, Peter A.

2001-01-01

A miniature connector for introducing microliter quantities of solutions into microfabricated fluidic devices. The fluidic connector, for example, joins standard high pressure liquid chromatography (HPLC) tubing to 1 mm diameter holes in silicon or glass, enabling ml-sized volumes of sample solutions to be merged with .mu.l-sized devices. The connector has many features, including ease of connect and disconnect; a small footprint which enables numerous connectors to be located in a small area; low dead volume; helium leak-tight; and tubing does not twist during connection. Thus the connector enables easy and effective change of microfluidic devices and introduction of different solutions in the devices.

Intestinal lymphangiectasia in adults.

PubMed

Freeman, Hugh James; Nimmo, Michael

2011-02-15

Intestinal lymphangiectasia in the adult may be characterized as a disorder with dilated intestinal lacteals causing loss of lymph into the lumen of the small intestine and resultant hypoproteinemia, hypogammaglobulinemia, hypoalbuminemia and reduced number of circulating lymphocytes or lymphopenia. Most often, intestinal lymphangiectasia has been recorded in children, often in neonates, usually with other congenital abnormalities but initial definition in adults including the elderly has become increasingly more common. Shared clinical features with the pediatric population such as bilateral lower limb edema, sometimes with lymphedema, pleural effusion and chylous ascites may occur but these reflect the severe end of the clinical spectrum. In some, diarrhea occurs with steatorrhea along with increased fecal loss of protein, reflected in increased fecal alpha-1-antitrypsin levels, while others may present with iron deficiency anemia, sometimes associated with occult small intestinal bleeding. Most lymphangiectasia in adults detected in recent years, however, appears to have few or no clinical features of malabsorption. Diagnosis remains dependent on endoscopic changes confirmed by small bowel biopsy showing histological evidence of intestinal lymphangiectasia. In some, video capsule endoscopy and enteroscopy have revealed more extensive changes along the length of the small intestine. A critical diagnostic element in adults with lymphangiectasia is the exclusion of entities (e.g. malignancies including lymphoma) that might lead to obstruction of the lymphatic system and "secondary" changes in the small bowel biopsy. In addition, occult infectious (e.g. Whipple's disease from Tropheryma whipplei) or inflammatory disorders (e.g. Crohn's disease) may also present with profound changes in intestinal permeability and protein-losing enteropathy that also require exclusion. Conversely, rare B-cell type lymphomas have also been described even decades following initial diagnosis of intestinal lymphangiectasia. Treatment has been historically defined to include a low fat diet with medium-chain triglyceride supplementation that leads to portal venous rather than lacteal uptake. A number of other pharmacological measures have been reported or proposed but these are largely anecdotal. Finally, rare reports of localized surgical resection of involved areas of small intestine have been described but follow-up in these cases is often limited.

Intestinal lymphangiectasia in adults

PubMed Central

Freeman, Hugh James; Nimmo, Michael

2011-01-01

Intestinal lymphangiectasia in the adult may be characterized as a disorder with dilated intestinal lacteals causing loss of lymph into the lumen of the small intestine and resultant hypoproteinemia, hypogammaglobulinemia, hypoalbuminemia and reduced number of circulating lymphocytes or lymphopenia. Most often, intestinal lymphangiectasia has been recorded in children, often in neonates, usually with other congenital abnormalities but initial definition in adults including the elderly has become increasingly more common. Shared clinical features with the pediatric population such as bilateral lower limb edema, sometimes with lymphedema, pleural effusion and chylous ascites may occur but these reflect the severe end of the clinical spectrum. In some, diarrhea occurs with steatorrhea along with increased fecal loss of protein, reflected in increased fecal alpha-1-antitrypsin levels, while others may present with iron deficiency anemia, sometimes associated with occult small intestinal bleeding. Most lymphangiectasia in adults detected in recent years, however, appears to have few or no clinical features of malabsorption. Diagnosis remains dependent on endoscopic changes confirmed by small bowel biopsy showing histological evidence of intestinal lymphangiectasia. In some, video capsule endoscopy and enteroscopy have revealed more extensive changes along the length of the small intestine. A critical diagnostic element in adults with lymphangiectasia is the exclusion of entities (e.g. malignancies including lymphoma) that might lead to obstruction of the lymphatic system and “secondary” changes in the small bowel biopsy. In addition, occult infectious (e.g. Whipple’s disease from Tropheryma whipplei) or inflammatory disorders (e.g. Crohn’s disease) may also present with profound changes in intestinal permeability and protein-losing enteropathy that also require exclusion. Conversely, rare B-cell type lymphomas have also been described even decades following initial diagnosis of intestinal lymphangiectasia. Treatment has been historically defined to include a low fat diet with medium-chain triglyceride supplementation that leads to portal venous rather than lacteal uptake. A number of other pharmacological measures have been reported or proposed but these are largely anecdotal. Finally, rare reports of localized surgical resection of involved areas of small intestine have been described but follow-up in these cases is often limited. PMID:21364842

Dimethyl amiloride improves glucose homeostasis in mouse models of type 2 diabetes.

PubMed

Gunawardana, Subhadra C; Head, W Steven; Piston, David W

2008-06-01

Dimethyl amiloride (DMA) enhances insulin secretion in the pancreatic beta-cell. DMA also enhances time-dependent potentiation (TDP) and enables TDP to occur in situations where it is normally absent. As we have demonstrated before, these effects are mediated in part through inhibition of neuronal nitric oxide synthase (nNOS), resulting in increased availability of arginine. Thus both DMA and arginine have the potential to correct the secretory defect in diabetes by enabling or enhancing TDP. In the current study we have demonstrated the ability of these agents to improve blood glucose homeostasis in three mouse models of type 2 diabetes. The pattern of TDP under different conditions indicates that inhibition of NOS is not the only mechanism through which DMA exerts its positive effects. Thus we also have explored another possible mechanism through which DMA enables/enhances TDP, via the activation of mitochondrial alpha-ketoglutarate dehydrogenase.

Enhanced Droplet Control by Transition Boiling

PubMed Central

Grounds, Alex; Still, Richard; Takashina, Kei

2012-01-01

A droplet of water on a heated surface can levitate over a film of gas produced by its own evaporation in the Leidenfrost effect. When the surface is prepared with ratchet-like saw-teeth topography, these droplets can self-propel and can even climb uphill. However, the extent to which the droplets can be controlled is limited by the physics of the Leidenfrost effect. Here, we show that transition boiling can be induced even at very high surface temperatures and provide additional control over the droplets. Ratchets with acute protrusions enable droplets to climb steeper inclines while ratchets with sub-structures enable their direction of motion to be controlled by varying the temperature of the surface. The droplets' departure from the Leidenfrost regime is assessed by analysing the sound produced by their boiling. We anticipate these techniques will enable the development of more sophisticated methods for controlling small droplets and heat transfer. PMID:23056912

Self-management support interventions that are clinically linked and technology enabled: can they successfully prevent and treat diabetes?

PubMed

Kaufman, Neal D; Woodley, Paula D Patnoe

2011-05-01

Patients with diabetes need a complex set of services and supports. The challenge of integrating these services into the diabetes regimen can be successfully overcome through self-management support interventions that are clinically linked and technology enabled: self-management support because patients need help mastering the knowledge, attitudes, skills, and behaviors so necessary for good outcomes; interventions because comprehensive theory-based, evidence-proven, long-term, longitudinal interventions work better than direct-to-consumer or nonplanned health promotion approaches; clinically linked because patients are more likely to adopt new behaviors when the approach is in the context of a trusted therapeutic relationship and within an effective medical care system; and technology enabled because capitalizing on the amazing power of information technology leads to the delivery of cost-effective, scalable, engaging solutions that prevent and manage diabetes. © 2011 Diabetes Technology Society.

Single-expose patterning development for EUV lithography

NASA Astrophysics Data System (ADS)

De Silva, Anuja; Petrillo, Karen; Meli, Luciana; Shearer, Jeffrey C.; Beique, Genevieve; Sun, Lei; Seshadri, Indira; Oh, Taehwan; Han, Seulgi; Saulnier, Nicole; Lee, Joe; Arnold, John C.; Hamieh, Bassem; Felix, Nelson M.; Furukawa, Tsuyoshi; Singh, Lovejeet; Ayothi, Ramakrishnan

2017-03-01

Initial readiness of EUV (extreme ultraviolet) patterning was demonstrated in 2016 with IBM Alliance's 7nm device technology. The focus has now shifted to driving the 'effective' k1 factor and enabling the second generation of EUV patterning. With the substantial cost of EUV exposure there is significant interest in extending the capability to do single exposure patterning with EUV. To enable this, emphasis must be placed on the aspect ratios, adhesion, defectivity reduction, etch selectivity, and imaging control of the whole patterning process. Innovations in resist materials and processes must be included to realize the full entitlement of EUV lithography at 0.33NA. In addition, enhancements in the patterning process to enable good defectivity, lithographic process window, and post etch pattern fidelity are also required. Through this work, the fundamental material challenges in driving down the effective k1 factor will be highlighted.

Enhanced Droplet Control by Transition Boiling

NASA Astrophysics Data System (ADS)

Grounds, Alex; Still, Richard; Takashina, Kei

2012-10-01

A droplet of water on a heated surface can levitate over a film of gas produced by its own evaporation in the Leidenfrost effect. When the surface is prepared with ratchet-like saw-teeth topography, these droplets can self-propel and can even climb uphill. However, the extent to which the droplets can be controlled is limited by the physics of the Leidenfrost effect. Here, we show that transition boiling can be induced even at very high surface temperatures and provide additional control over the droplets. Ratchets with acute protrusions enable droplets to climb steeper inclines while ratchets with sub-structures enable their direction of motion to be controlled by varying the temperature of the surface. The droplets' departure from the Leidenfrost regime is assessed by analysing the sound produced by their boiling. We anticipate these techniques will enable the development of more sophisticated methods for controlling small droplets and heat transfer.

What results when firms implement practices: the differential relationship between specific practices, firm financial performance, customer service, and quality.

PubMed

Gibson, Cristina B; Porath, Christine L; Benson, George S; Lawler, Edward E

2007-11-01

Previous research on organizational practices is replete with contradictory evidence regarding their effects. Here, the authors argue that these contradictory findings may have occurred because researchers have often examined complex practice combinations and have failed to investigate a broad variety of firm-level outcomes. Thus, past research may obscure important differential effects of specific practices on specific firm-level outcomes. Extending this research, the authors develop hypotheses about the effects of practices that (a) enable information sharing, (b) set boundaries, and (c) enable teams on 3 different firm-level outcomes: financial performance, customer service, and quality. Relationships are tested in a sample of observations from over 200 Fortune 1000 firms. Results indicate that information-sharing practices were positively related to financial performance 1 year following implementation of the practices, boundary-setting practices were positively related to firm-level customer service, and team-enabling practices were related to firm-level quality. No single set of practices predicted all 3 firm-level outcomes, indicating practice-specific effects. These findings help resolve the theoretical tension in the literature regarding the effects of organizational practices and offer guidance as to how to best target practices to increase specific work-related outcomes. Implications for theory, research, and practice are discussed. (c) 2007 APA

Wild jujube polysaccharides protect against experimental inflammatory bowel disease by enabling enhanced intestinal barrier function.

PubMed

Yue, Yuan; Wu, Shuangchan; Li, Zhike; Li, Jian; Li, Xiaofei; Xiang, Jin; Ding, Hong

2015-08-01

Dietary polysaccharides provide various beneficial effects for our health. We investigated the protective effects of wild jujube (Ziziphus jujuba Mill. var. spinosa (Bunge) Hu ex H. F. Chou) sarcocarp polysaccharides (WJPs) against experimental inflammatory bowel disease (IBD) by enabling enhanced intestinal barrier function. Colitis was induced in rats by the intrarectal administration of TNBS. We found that WJPs markedly ameliorated the colitis severity, including less weight loss, decreased disease activity index scores, and improved mucosal damage in colitis rats. Moreover, WJPs suppressed the inflammatory response via attenuation of TNF-α, IL-1β, IL-6 and MPO activity in colitis rats. And then, to determine the effect of WJPs on the intestinal barrier, we measured the effect of WJPs on the transepithelial electrical resistance (TER) and FITC-conjugated dextran permeability in Caco-2 cell stimulation with TNF-α. We further demonstrated that the alleviation of WJPs to colon injury was associated with barrier function by assembly of tight junction proteins. Moreover, the effect of WJPs on TER was eliminated by the specific inhibitor of AMPK. AMPK activity was also up-regulated by WJPs in Caco-2 cell stimulation with TNF-α and in colitis rats. This study demonstrates that WJPs protect against IBD by enabling enhanced intestinal barrier function involving the activation of AMPK.

Interventions to improve antibiotic prescribing practices for hospital inpatients.

PubMed

Davey, Peter; Marwick, Charis A; Scott, Claire L; Charani, Esmita; McNeil, Kirsty; Brown, Erwin; Gould, Ian M; Ramsay, Craig R; Michie, Susan

2017-02-09

Antibiotic resistance is a major public health problem. Infections caused by multidrug-resistant bacteria are associated with prolonged hospital stay and death compared with infections caused by susceptible bacteria. Appropriate antibiotic use in hospitals should ensure effective treatment of patients with infection and reduce unnecessary prescriptions. We updated this systematic review to evaluate the impact of interventions to improve antibiotic prescribing to hospital inpatients. To estimate the effectiveness and safety of interventions to improve antibiotic prescribing to hospital inpatients and to investigate the effect of two intervention functions: restriction and enablement. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library), MEDLINE, and Embase. We searched for additional studies using the bibliographies of included articles and personal files. The last search from which records were evaluated and any studies identified incorporated into the review was January 2015. We included randomised controlled trials (RCTs) and non-randomised studies (NRS). We included three non-randomised study designs to measure behavioural and clinical outcomes and analyse variation in the effects: non- randomised trials (NRT), controlled before-after (CBA) studies and interrupted time series (ITS) studies. For this update we also included three additional NRS designs (case control, cohort, and qualitative studies) to identify unintended consequences. Interventions included any professional or structural interventions as defined by the Cochrane Effective Practice and Organisation of Care Group. We defined restriction as 'using rules to reduce the opportunity to engage in the target behaviour (or increase the target behaviour by reducing the opportunity to engage in competing behaviours)'. We defined enablement as 'increasing means/reducing barriers to increase capability or opportunity'. The main comparison was between intervention and no intervention. Two review authors extracted data and assessed study risk of bias. We performed meta-analysis and meta-regression of RCTs and meta-regression of ITS studies. We classified behaviour change functions for all interventions in the review, including those studies in the previously published versions. We analysed dichotomous data with a risk difference (RD). We assessed certainty of evidence with GRADE criteria. This review includes 221 studies (58 RCTs, and 163 NRS). Most studies were from North America (96) or Europe (87). The remaining studies were from Asia (19), South America (8), Australia (8), and the East Asia (3). Although 62% of RCTs were at a high risk of bias, the results for the main review outcomes were similar when we restricted the analysis to studies at low risk of bias.More hospital inpatients were treated according to antibiotic prescribing policy with the intervention compared with no intervention based on 29 RCTs of predominantly enablement interventions (RD 15%, 95% confidence interval (CI) 14% to 16%; 23,394 participants; high-certainty evidence). This represents an increase from 43% to 58% .There were high levels of heterogeneity of effect size but the direction consistently favoured intervention.The duration of antibiotic treatment decreased by 1.95 days (95% CI 2.22 to 1.67; 14 RCTs; 3318 participants; high-certainty evidence) from 11.0 days. Information from non-randomised studies showed interventions to be associated with improvement in prescribing according to antibiotic policy in routine clinical practice, with 70% of interventions being hospital-wide compared with 31% for RCTs. The risk of death was similar between intervention and control groups (11% in both arms), indicating that antibiotic use can likely be reduced without adversely affecting mortality (RD 0%, 95% CI -1% to 0%; 28 RCTs; 15,827 participants; moderate-certainty evidence). Antibiotic stewardship interventions probably reduce length of stay by 1.12 days (95% CI 0.7 to 1.54 days; 15 RCTs; 3834 participants; moderate-certainty evidence). One RCT and six NRS raised concerns that restrictive interventions may lead to delay in treatment and negative professional culture because of breakdown in communication and trust between infection specialists and clinical teams (low-certainty evidence).Both enablement and restriction were independently associated with increased compliance with antibiotic policies, and enablement enhanced the effect of restrictive interventions (high-certainty evidence). Enabling interventions that included feedback were probably more effective than those that did not (moderate-certainty evidence).There was very low-certainty evidence about the effect of the interventions on reducing Clostridium difficile infections (median -48.6%, interquartile range -80.7% to -19.2%; 7 studies). This was also the case for resistant gram-negative bacteria (median -12.9%, interquartile range -35.3% to 25.2%; 11 studies) and resistant gram-positive bacteria (median -19.3%, interquartile range -50.1% to +23.1%; 9 studies). There was too much variance in microbial outcomes to reliably assess the effect of change in antibiotic use. Heterogeneity of intervention effect on prescribing outcomesWe analysed effect modifiers in 29 RCTs and 91 ITS studies. Enablement and restriction were independently associated with a larger effect size (high-certainty evidence). Feedback was included in 4 (17%) of 23 RCTs and 20 (47%) of 43 ITS studies of enabling interventions and was associated with greater intervention effect. Enablement was included in 13 (45%) of 29 ITS studies with restrictive interventions and enhanced intervention effect. We found high-certainty evidence that interventions are effective in increasing compliance with antibiotic policy and reducing duration of antibiotic treatment. Lower use of antibiotics probably does not increase mortality and likely reduces length of stay. Additional trials comparing antibiotic stewardship with no intervention are unlikely to change our conclusions. Enablement consistently increased the effect of interventions, including those with a restrictive component. Although feedback further increased intervention effect, it was used in only a minority of enabling interventions. Interventions were successful in safely reducing unnecessary antibiotic use in hospitals, despite the fact that the majority did not use the most effective behaviour change techniques. Consequently, effective dissemination of our findings could have considerable health service and policy impact. Future research should instead focus on targeting treatment and assessing other measures of patient safety, assess different stewardship interventions, and explore the barriers and facilitators to implementation. More research is required on unintended consequences of restrictive interventions.

Using a Wiki to Enhance Cooperative Learning in a Real Analysis Course

ERIC Educational Resources Information Center

Peterson, Elisha

2009-01-01

This article describes how the author used a wiki-based website in a real analysis course, and assesses its effectiveness. The wiki was used to post course materials, maintain a forum, enable students to write collaborative projects, and enable students to develop a glossary of important terms. The wiki proved to be very successful; it facilitated…

College English Writing Instruction for Non-English Majors in Mainland China: The "Output-Driven, Input-Enabled" Hypothesis Perspective

ERIC Educational Resources Information Center

Ren, Junhong

2017-01-01

College English writing instruction has been a prominent research area in EFL field in mainland China. This paper has continued the focus by exploring a seemingly effective way for college English writing instruction in China--teaching writing based on reading on the basis of the "output-driven, input-enabled" hypothesis. This hypothesis…

Visual Annual Reviews: How to Include Pupils with Learning Difficulties in their Educational Reviews

ERIC Educational Resources Information Center

Hayes, Julia

2004-01-01

The challenge for schools, following the Green Paper Every Child Matters (HM Treasury, 2003) and the Special Educational Needs Code of Practice (DfES, 2001), is to enable young people to give their views about matters affecting their lives. Whilst these recommendations are a welcome step to enable the effective inclusion of all young people,…

Tap Testing Hammer using Unmanned Aerial Systems (UASs)

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

Mason, JaMein DeShon; Ayorinde, Emmanuel Temiloluwa; Mascarenas, David Dennis

This is the final poster for a Student Symposium at Los Alamos National Laboratory. This research describes the development, validation, and testing of a remote concrete tapping mechanism enabled by UAS. The conclusion is the following: The results quantify for the first time concrete tapping data collected remotely with UAS, enabling cost-effective, safer and sustainable upgrade prioritization of railroad bridges inventories.

Developing Long-Term Computing Skills among Low-Achieving Students via Web-Enabled Problem-Based Learning and Self-Regulated Learning

ERIC Educational Resources Information Center

Tsai, Chia-Wen; Lee, Tsang-Hsiung; Shen, Pei-Di

2013-01-01

Many private vocational schools in Taiwan have taken to enrolling students with lower levels of academic achievement. The authors re-designed a course and conducted a series of quasi-experiments to develop students' long-term computing skills, and examined the longitudinal effects of web-enabled, problem-based learning (PBL) and self-regulated…

Enabling technologies built on a sonochemical platform: challenges and opportunities.

PubMed

Cintas, Pedro; Tagliapietra, Silvia; Caporaso, Marina; Tabasso, Silvia; Cravotto, Giancarlo

2015-07-01

Scientific and technological progress now occurs at the interface between two or more scientific and technical disciplines while chemistry is intertwined with almost all scientific domains. Complementary and synergistic effects have been found in the overlay between sonochemistry and other enabling technologies such as mechanochemistry, microwave chemistry and flow-chemistry. Although their nature and effects are intrinsically different, these techniques share the ability to significantly activate most chemical processes and peculiar phenomena. These studies offer a comprehensive overview of sonochemistry, provide a better understanding of correlated phenomena (mechanochemical effects, hot spots, etc.), and pave the way for emerging applications which unite hybrid reactors. Copyright © 2014 Elsevier B.V. All rights reserved.

Ames Culture Chamber System: Enabling Model Organism Research Aboard the international Space Station

NASA Technical Reports Server (NTRS)

Steele, Marianne

2014-01-01

Understanding the genetic, physiological, and behavioral effects of spaceflight on living organisms and elucidating the molecular mechanisms that underlie these effects are high priorities for NASA. Certain organisms, known as model organisms, are widely studied to help researchers better understand how all biological systems function. Small model organisms such as nem-atodes, slime mold, bacteria, green algae, yeast, and moss can be used to study the effects of micro- and reduced gravity at both the cellular and systems level over multiple generations. Many model organisms have sequenced genomes and published data sets on their transcriptomes and proteomes that enable scientific investigations of the molecular mechanisms underlying the adaptations of these organisms to space flight.

Shape and Color Features for Object Recognition Search

NASA Technical Reports Server (NTRS)

Duong, Tuan A.; Duong, Vu A.; Stubberud, Allen R.

2012-01-01

A bio-inspired shape feature of an object of interest emulates the integration of the saccadic eye movement and horizontal layer in vertebrate retina for object recognition search where a single object can be used one at a time. The optimal computational model for shape-extraction-based principal component analysis (PCA) was also developed to reduce processing time and enable the real-time adaptive system capability. A color feature of the object is employed as color segmentation to empower the shape feature recognition to solve the object recognition in the heterogeneous environment where a single technique - shape or color - may expose its difficulties. To enable the effective system, an adaptive architecture and autonomous mechanism were developed to recognize and adapt the shape and color feature of the moving object. The bio-inspired object recognition based on bio-inspired shape and color can be effective to recognize a person of interest in the heterogeneous environment where the single technique exposed its difficulties to perform effective recognition. Moreover, this work also demonstrates the mechanism and architecture of the autonomous adaptive system to enable the realistic system for the practical use in the future.

Passive Cooling Enabled by Polymer Composite Coating: Dependence on Filler, Filler Size and Coating Thickness

NASA Astrophysics Data System (ADS)

Shao, Yue; Shi, Frank G.

2017-07-01

The effective passive radiation cooling that is enabled by silicone-based composites is investigated for its dependence on coating thickness and filler size in the range of nanometers to micrometers. It is established, contrary to prior reports, that the effective passive radiation cooling does not exhibit a filler size dependence, i.e., there is no optimal size at which a maximum cooling would be reached. However, the apparent cooling effect is filler type dependent and among the fillers investigated, Al2O3 exhibits the best apparent cooling effect. In addition, the apparent cooling effect is dependent on coating thickness: the thickness dependence is non-monotonic, and the maximum cooling occurs at an optimal thickness of 70 μm, regardless of filler type. Potential significant implications of the findings are also discussed.

Principal-Staff Relations: Situational Mediator of Effectiveness

ERIC Educational Resources Information Center

Williams, Leonard B.; Hoy, Wayne K.

1971-01-01

Explores the usefulness of the "Contingency Model" of leadership effectiveness -- effectiveness of a group is contingent upon the relationship between leadership style and the degree to which the situation enables the leader to exert his influence. (Author)

Effect of hyperfine-induced spin mixing on the defect-enabled spin blockade and spin filtering in GaNAs

NASA Astrophysics Data System (ADS)

Puttisong, Y.; Wang, X. J.; Buyanova, I. A.; Chen, W. M.

2013-03-01

The effect of hyperfine interaction (HFI) on the recently discovered room-temperature defect-enabled spin-filtering effect in GaNAs alloys is investigated both experimentally and theoretically based on a spin Hamiltonian analysis. We provide direct experimental evidence that the HFI between the electron and nuclear spin of the central Ga atom of the spin-filtering defect, namely, the Gai interstitials, causes strong mixing of the electron spin states of the defect, thereby degrading the efficiency of the spin-filtering effect. We also show that the HFI-induced spin mixing can be suppressed by an application of a longitudinal magnetic field such that the electronic Zeeman interaction overcomes the HFI, leading to well-defined electron spin states beneficial to the spin-filtering effect. The results provide a guideline for further optimization of the defect-engineered spin-filtering effect.

Exploring the classroom practices that may enable a compassionate approach to financial literacy education

NASA Astrophysics Data System (ADS)

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2017-08-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The financial maths task asked students to decide on the best fundraising option for the school. We used the theory of practice architectures to analyse the interactions in the classroom in order to understand what may have enabled and constrained classroom practices. We found that classroom practices such as engaging with peers through positive and collaborative learning opportunities, making ethical, social and mathematical connections of the task, and considering the impact of financial decisions on others may enable a compassionate approach to financial literacy education.

Exploring the classroom practices that may enable a compassionate approach to financial literacy education

NASA Astrophysics Data System (ADS)

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2018-06-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The financial maths task asked students to decide on the best fundraising option for the school. We used the theory of practice architectures to analyse the interactions in the classroom in order to understand what may have enabled and constrained classroom practices. We found that classroom practices such as engaging with peers through positive and collaborative learning opportunities, making ethical, social and mathematical connections of the task, and considering the impact of financial decisions on others may enable a compassionate approach to financial literacy education.

Enabling comparative effectiveness research with informatics: show me the data!

PubMed

Safdar, Nabile M; Siegel, Eliot; Erickson, Bradley J; Nagy, Paul

2011-09-01

Both outcomes researchers and informaticians are concerned with information and data. As such, some of the central challenges to conducting successful comparative effectiveness research can be addressed with informatics solutions. Specific informatics solutions which address how data in comparative effectiveness research are enriched, stored, shared, and analyzed are reviewed. Imaging data can be made more quantitative, uniform, and structured for researchers through the use of lexicons and structured reporting. Secure and scalable storage of research data is enabled through data warehouses and cloud services. There are a number of national efforts to help researchers share research data and analysis tools. There is a diverse arsenal of informatics tools designed to meet the needs of comparative effective researchers. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Thermally Generated Spin Signals in a Nondegenerate Silicon Spin Valve

NASA Astrophysics Data System (ADS)

Yamashita, Naoto; Ando, Yuichiro; Koike, Hayato; Miwa, Shinji; Suzuki, Yoshishige; Shiraishi, Masashi

2018-05-01

Thermally generated spin signals are observed in a nondegenerate Si spin valve. The spin-dependent Seebeck effect is used for thermal spin-signal generation. A thermal gradient of about 200 mK at the interface of Fe and Si enables the generation of a spin voltage of 8 μ V at room temperature. A simple expansion of the conventional spin-drift-diffusion model that takes into account the spin-dependent Seebeck effect shows that semiconductor materials are more promising for thermal spin-signal generation comparing than metallic materials, and thus enable efficient heat recycling in semiconductor spin devices.

NASP - Enabling new space launch options

NASA Astrophysics Data System (ADS)

Froning, David; Gaubatz, William; Mathews, George

1990-10-01

Successful NASP developments in the United States are bringing about the possibility of effective, fully reusable vehicles for transport of people and cargo between earth and space. These developments include: extension of airbreathing propulsion to a much higher speed; densification of propellants for greater energy per unit volume of mass; structures with much greater strength-to-weight at high temperatures; computational advancements that enable more optimal design and integration of airframes, engines and controls; and advances in avionics, robotics, artificial intelligence and automation that enable accomplishment of earth-to-orbit (ETO) operations with much less manpower support and cost. This paper describes the relative magnitude of improvement that these developments may provide.

NASP - Enabling new space launch options

NASA Technical Reports Server (NTRS)

Froning, David; Gaubatz, William; Mathews, George

1990-01-01

Successful NASP developments in the United States are bringing about the possibility of effective, fully reusable vehicles for transport of people and cargo between earth and space. These developments include: extension of airbreathing propulsion to a much higher speed; densification of propellants for greater energy per unit volume of mass; structures with much greater strength-to-weight at high temperatures; computational advancements that enable more optimal design and integration of airframes, engines and controls; and advances in avionics, robotics, artificial intelligence and automation that enable accomplishment of earth-to-orbit (ETO) operations with much less manpower support and cost. This paper describes the relative magnitude of improvement that these developments may provide.

Echo-Enabled X-Ray Vortex Generation

NASA Astrophysics Data System (ADS)

Hemsing, E.; Marinelli, A.

2012-11-01

A technique to generate high-brightness electromagnetic vortices with tunable topological charge at extreme ultraviolet and x-ray wavelengths is described. Based on a modified version of echo-enabled harmonic generation for free-electron lasers, the technique uses two lasers and two chicanes to produce high-harmonic microbunching of a relativistic electron beam with a corkscrew distribution that matches the instantaneous helical phase structure of the x-ray vortex. The strongly correlated electron distribution emerges from an efficient three-dimensional recoherence effect in the echo-enabled harmonic generation transport line and can emit fully coherent vortices in a downstream radiator for access to new research in x-ray science.

Sensor Technology Baseline Study for Enabling Condition Based Maintenance Plus in Army Ground Vehicles

DTIC Science & Technology

2012-03-01

for enabling condition based maintenance plus in Army ground vehicles. The sensor study was driven from Failure Mode Effects Analysis ( FMEA ...of Tables Table 1. Sensor technology baseline study based on engine FMEA report. ...................................5 Table 2. Sensor technology...baseline study based on transmission FMEA report. .........................8 Table 3. Sensor technology baseline study based on alternator FMEA report

Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence.

PubMed

Reilly, Rachel; Evans, Katharine; Gomersall, Judith; Gorham, Gillian; Peters, Micah D J; Warren, Steven; O'Shea, Rebekah; Cass, Alan; Brown, Alex

2016-04-06

Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Given the human cost of dialysis and the growing population of people living with CKD, there is an urgent need to draw lessons from the available evidence from this and other sources, including studies in the broader population, to better serve this population with programs that address the barriers to receiving high-quality care and improve quality of life.

Effective Biot theory and its generalization to poroviscoelastic models

NASA Astrophysics Data System (ADS)

Liu, Xu; Greenhalgh, Stewart; Zhou, Bing; Greenhalgh, Mark

2018-02-01

A method is suggested to express the effective bulk modulus of the solid frame of a poroelastic material as a function of the saturated bulk modulus. This method enables effective Biot theory to be described through the use of seismic dispersion measurements or other models developed for the effective saturated bulk modulus. The effective Biot theory is generalized to a poroviscoelastic model of which the moduli are represented by the relaxation functions of the generalized fractional Zener model. The latter covers the general Zener and the Cole-Cole models as special cases. A global search method is described to determine the parameters of the relaxation functions, and a simple deterministic method is also developed to find the defining parameters of the single Cole-Cole model. These methods enable poroviscoelastic models to be constructed, which are based on measured seismic attenuation functions, and ensure that the model dispersion characteristics match the observations.

Non-airborne conflicts: The causes and effects of runway transgressions

NASA Technical Reports Server (NTRS)

Tarrel, Richard J.

1985-01-01

The 1210 ASRS runway transgression reports are studied and expanded to yield descriptive statistics. Additionally, a one of three subset was studied in detail for purposes of evaluating the causes, risks, and consequences behind trangression events. Occurrences are subdivided by enabling factor and flight phase designations. It is concluded that a larger risk of collision is associated with controller enabled departure transgressions over all other categories. The influence of this type is especially evident during the period following the air traffic controllers' strike of 1981. Causal analysis indicates that, coincidentally, controller enabled departure transgressions also, show the strongest correlations between causal factors. It shows that departure errors occur more often when visibility is reduced, and when multiple takeoff runways or intersection takeoffs are employed. In general, runway transgressions attributable to both pilot and controller errors arise from three problem areas: information transfer, awareness, and spatial judgement. Enhanced awareness by controllers will probably reduce controller enabled incidents.

The Combat Cloud: Enabling Multi-Domain Command and Control Across the Range of Military Operations

DTIC Science & Technology

2017-03-01

and joint by their very nature.3 The Combat Cloud architecture will enable MDC2 by increasing the interoperability of existing networks...order to provide operating platforms with a robust architecture that communicates with relevant players, operates at reduced levels of connectivity...responsibility or aircraft platform, and a Combat Cloud architecture helps focus thought toward achieving efficient MDC2 and effects rather than

Pellet to Part Manufacturing System for CNCs

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

Roschli, Alex C.; Love, Lonnie J.; Post, Brian K.

Oak Ridge National Laboratory’s Manufacturing Demonstration Facility worked with Hybrid Manufacturing Technologies to develop a compact prototype composite additive manufacturing head that can effectively extrude injection molding pellets. The head interfaces with conventional CNC machine tools enabling rapid conversion of conventional machine tools to additive manufacturing tools. The intent was to enable wider adoption of Big Area Additive Manufacturing (BAAM) technology and combine BAAM technology with conventional machining systems.

Leadership Training Module on Enable Others to Act (Kouzes & Posner)

ERIC Educational Resources Information Center

Sharma, Ananya

2013-01-01

Everyone has either come in contact with a leader or played the role of a leader. Everyone has also worked with effective leaders and ineffective leaders. And all of us want to work with leaders who can share a vision with us and empower and enable us to meet our goals. One can say that leaders play a crucial role in the success or failure of a…

A high performance biometric signal and image processing method to reveal blood perfusion towards 3D oxygen saturation mapping

NASA Astrophysics Data System (ADS)

Imms, Ryan; Hu, Sijung; Azorin-Peris, Vicente; Trico, Michaël.; Summers, Ron

2014-03-01

Non-contact imaging photoplethysmography (PPG) is a recent development in the field of physiological data acquisition, currently undergoing a large amount of research to characterize and define the range of its capabilities. Contact-based PPG techniques have been broadly used in clinical scenarios for a number of years to obtain direct information about the degree of oxygen saturation for patients. With the advent of imaging techniques, there is strong potential to enable access to additional information such as multi-dimensional blood perfusion and saturation mapping. The further development of effective opto-physiological monitoring techniques is dependent upon novel modelling techniques coupled with improved sensor design and effective signal processing methodologies. The biometric signal and imaging processing platform (bSIPP) provides a comprehensive set of features for extraction and analysis of recorded iPPG data, enabling direct comparison with other biomedical diagnostic tools such as ECG and EEG. Additionally, utilizing information about the nature of tissue structure has enabled the generation of an engineering model describing the behaviour of light during its travel through the biological tissue. This enables the estimation of the relative oxygen saturation and blood perfusion in different layers of the tissue to be calculated, which has the potential to be a useful diagnostic tool.

Time Together: A nursing intervention in psychiatric inpatient care: Feasibility and effects.

PubMed

Molin, Jenny; Lindgren, Britt-Marie; Graneheim, Ulla Hällgren; Ringnér, Anders

2018-04-25

The facilitation of quality time between patients and staff in psychiatric inpatient care is useful to promote recovery and reduce stress experienced by staff. However, interventions are reported to be complex to implement and are poorly described in the literature. This multisite study aimed to evaluate the feasibility and effects of the nursing intervention Time Together, using mixed methods. Data consisted of notes from participant observations and logs to evaluate feasibility, and questionnaires to evaluate effects. The primary outcome for patients was quality of interactions, and for staff, it was perceived stress. The secondary outcome for patients was anxiety and depression symptom levels, and for staff, it was stress of conscience. Data were analysed using visual analysis, percentage of nonoverlapping data, and qualitative content analysis. The results showed that Time Together was a feasible intervention, but measurements showed no effects on the two patient outcomes: quality of interactions and anxiety and depressive symptoms and, questionable effects on perceived stress and stress of conscience among staff. Shared responsibility, a friendly approach, and a predictable structure enabled Time Together, while a distant approach and an unpredictable structure hindered the intervention. In conclusion, the intervention proved to be feasible with potential to enable quality interactions between patients and staff using the enabling factors as supportive components. It also had some effects on perceived stress and stress of conscience among staff. Further evaluation is needed to build on the evidence for the intervention. © 2018 Australian College of Mental Health Nurses Inc.

SketchBio: a scientist's 3D interface for molecular modeling and animation.

PubMed

Waldon, Shawn M; Thompson, Peter M; Hahn, Patrick J; Taylor, Russell M

2014-10-30

Because of the difficulties involved in learning and using 3D modeling and rendering software, many scientists hire programmers or animators to create models and animations. This both slows the discovery process and provides opportunities for miscommunication. Working with multiple collaborators, a tool was developed (based on a set of design goals) to enable them to directly construct models and animations. SketchBio is presented, a tool that incorporates state-of-the-art bimanual interaction and drop shadows to enable rapid construction of molecular structures and animations. It includes three novel features: crystal-by-example, pose-mode physics, and spring-based layout that accelerate operations common in the formation of molecular models. Design decisions and their consequences are presented, including cases where iterative design was required to produce effective approaches. The design decisions, novel features, and inclusion of state-of-the-art techniques enabled SketchBio to meet all of its design goals. These features and decisions can be incorporated into existing and new tools to improve their effectiveness.

The role of goal-focused leadership in enabling the expression of conscientiousness.

PubMed

Colbert, Amy E; Witt, L A

2009-05-01

The authors tested the hypothesis that goal-focused leadership enables conscientious workers to perform effectively by helping them to accurately understand organizational goal priorities. Data collected from 162 workers in a private sector document processing organization supported the hypotheses that goal-focused leadership moderates the relationship between conscientiousness and job performance and that person-organization goal congruence mediates this moderated relationship. Specifically, conscientiousness was more strongly positively related to performance among workers who perceived that their supervisors effectively set goals and defined roles, responsibilities, and priorities than among workers who did not perceive this type of goal-focused leadership. (c) 2009 APA, all rights reserved.

Thermodynamic theory of dislocation-enabled plasticity

NASA Astrophysics Data System (ADS)

Langer, J. S.

2017-11-01

The thermodynamic theory of dislocation-enabled plasticity is based on two unconventional hypotheses. The first of these is that a system of dislocations, driven by external forces and irreversibly exchanging heat with its environment, must be characterized by a thermodynamically defined effective temperature that is not the same as the ordinary temperature. The second hypothesis is that the overwhelmingly dominant mechanism controlling plastic deformation is thermally activated depinning of entangled pairs of dislocations. This paper consists of a systematic reformulation of this theory followed by examples of its use in analyses of experimentally observed phenomena including strain hardening, grain-size (Hall-Petch) effects, yielding transitions, and adiabatic shear banding.

Enabling access to new WHO essential medicines: the case for nicotine replacement therapies

PubMed Central

2010-01-01

Nicotine replacement therapies (NRT) are powerful tools for the successful treatment of nicotine addiction and tobacco use. The medicines are clinically effective, supported by the Framework Convention on Tobacco Control, and are now World Health Organization-approved essential medicines. Enabling global access to NRT remains a challenge given ongoing confusion and misperceptions about their efficacy, cost-effectiveness, and availability with respect to other tobacco control and public health opportunities. In this commentary, we review existing evidence and guidelines to make the case for global access to NRT highlighting the smoker's right to access treatment to sensibly address nicotine addiction. PMID:21092092

Phototheranostic Porphyrin Nanoparticles Enable Visualization and Targeted Treatment of Head and Neck Cancer in Clinically Relevant Models

PubMed Central

Muhanna, Nidal; Jin, Cheng S; Huynh, Elizabeth; Chan, Harley; Qiu, Yi; Jiang, Wenlei; Cui, Liyang; Burgess, Laura; Akens, Margarete K; Chen, Juan; Irish, Jonathan C; Zheng, Gang

2015-01-01

Head and neck cancer is the fifth most common type of cancer worldwide and remains challenging for effective treatment due to the proximity to critical anatomical structures in the head and neck region, which increases the probability of toxicity from surgery and radiotherapy, and therefore emphasizes the importance of maximizing the targeted ablation. We have assessed the effectiveness of porphysome nanoparticles to enhance fluorescence and photoacoustic imaging of head and neck tumors in rabbit and hamster models. In addition, we evaluated the effectiveness of this agent for localized photothermal ablative therapy of head and neck tumors. We have demonstrated that porphysomes not only enabled fluorescence and photoacoustic imaging of buccal and tongue carcinomas, but also allowed for complete targeted ablation of these tumors. The supremacy of porphysome-enabled photothermal therapy over surgery to completely eradicate primary tumors and metastatic regional lymph node while sparing the adjacent critical structures' function has been demonstrated for the first time. This study represents a novel breakthrough that has the potential to revolutionize our approach to tumor diagnosis and treatment in head and neck cancer and beyond. PMID:26681987

Modeling and Simulating Multiple Failure Masking enabled by Local Recovery for Stencil-based Applications at Extreme Scales

DOE PAGES

Gamell, Marc; Teranishi, Keita; Mayo, Jackson; ...

2017-04-24

By obtaining multi-process hard failure resilience at the application level is a key challenge that must be overcome before the promise of exascale can be fully realized. Some previous work has shown that online global recovery can dramatically reduce the overhead of failures when compared to the more traditional approach of terminating the job and restarting it from the last stored checkpoint. If online recovery is performed in a local manner further scalability is enabled, not only due to the intrinsic lower costs of recovering locally, but also due to derived effects when using some application types. In this papermore » we model one such effect, namely multiple failure masking, that manifests when running Stencil parallel computations on an environment when failures are recovered locally. First, the delay propagation shape of one or multiple failures recovered locally is modeled to enable several analyses of the probability of different levels of failure masking under certain Stencil application behaviors. These results indicate that failure masking is an extremely desirable effect at scale which manifestation is more evident and beneficial as the machine size or the failure rate increase.« less

Salicylate enables cochlear arachidonic-acid-sensitive NMDA receptor responses.

PubMed

Ruel, Jérôme; Chabbert, Christian; Nouvian, Régis; Bendris, Rim; Eybalin, Michel; Leger, Claude Louis; Bourien, Jérôme; Mersel, Marcel; Puel, Jean-Luc

2008-07-16

Currently, many millions of people treated for various ailments receive high doses of salicylate. Consequently, understanding the mechanisms by which salicylate induces tinnitus is an important issue for the research community. Behavioral testing in rats have shown that tinnitus induced by salicylate or mefenamate (both cyclooxygenase blockers) are mediated by cochlear NMDA receptors. Here we report that the synapses between the sensory inner hair cells and the dendrites of the cochlear spiral ganglion neurons express NMDA receptors. Patch-clamp recordings and two-photon calcium imaging demonstrated that salicylate and arachidonate (a substrate of cyclooxygenase) enabled the calcium flux and the neural excitatory effects of NMDA on cochlear spiral ganglion neurons. Salicylate also increased the arachidonate content of the whole cochlea in vivo. Single-unit recordings of auditory nerve fibers in adult guinea pig confirmed the neural excitatory effect of salicylate and the blockade of this effect by NMDA antagonist. These results suggest that salicylate inhibits cochlear cyclooxygenase, which increased levels of arachidonate. The increased levels of arachidonate then act on NMDA receptors to enable NMDA responses to glutamate that inner hair cells spontaneously release. This new pharmacological profile of salicylate provides a molecular mechanism for the generation of tinnitus at the periphery of the auditory system.

Student reflections following exposure to a case-based interprofessional learning experience: Preliminary findings.

PubMed

Goldberg, Lynette R; Brown, Gina R; Mosack, Victoria A; Fletcher, Phyllis A

2015-01-01

This study analyzed students' written reflections following their initial exposure to interprofessional teamwork in case-based problem-solving. A three-hour seminar featuring three sequenced scenarios was developed and offered 12-times over two semesters. A total of 305 students from a variety of healthcare programs worked together with standardized patients in an on-campus laboratory simulating hospital ward and rehabilitation settings. A thematic analysis of students' reflections showed that they valued the shared learning and realistic case study. However, they felt the experience would be strengthened by working in smaller, more representative teams that included students from medicine, psychology, and social work to enable more effective communication and comprehensive case discussion. While useful for future planning, the identified themes did not enable a comparative statistical analysis of what students found helpful and difficult and a re-coding of students' responses now is underway. Implications for measuring the effectiveness of future interprofessional case-based learning center on addressing the identified weaknesses, and establishing a research design that enables a comparison of pre- and post-seminar data, and the effectiveness of the IPE experience compared to profession-specific experiences.

Modeling and Simulating Multiple Failure Masking enabled by Local Recovery for Stencil-based Applications at Extreme Scales

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

Gamell, Marc; Teranishi, Keita; Mayo, Jackson

By obtaining multi-process hard failure resilience at the application level is a key challenge that must be overcome before the promise of exascale can be fully realized. Some previous work has shown that online global recovery can dramatically reduce the overhead of failures when compared to the more traditional approach of terminating the job and restarting it from the last stored checkpoint. If online recovery is performed in a local manner further scalability is enabled, not only due to the intrinsic lower costs of recovering locally, but also due to derived effects when using some application types. In this papermore » we model one such effect, namely multiple failure masking, that manifests when running Stencil parallel computations on an environment when failures are recovered locally. First, the delay propagation shape of one or multiple failures recovered locally is modeled to enable several analyses of the probability of different levels of failure masking under certain Stencil application behaviors. These results indicate that failure masking is an extremely desirable effect at scale which manifestation is more evident and beneficial as the machine size or the failure rate increase.« less

A geodata warehouse: Using denormalisation techniques as a tool for delivering spatially enabled integrated geological information to geologists

NASA Astrophysics Data System (ADS)

Kingdon, Andrew; Nayembil, Martin L.; Richardson, Anne E.; Smith, A. Graham

2016-11-01

New requirements to understand geological properties in three dimensions have led to the development of PropBase, a data structure and delivery tools to deliver this. At the BGS, relational database management systems (RDBMS) has facilitated effective data management using normalised subject-based database designs with business rules in a centralised, vocabulary controlled, architecture. These have delivered effective data storage in a secure environment. However, isolated subject-oriented designs prevented efficient cross-domain querying of datasets. Additionally, the tools provided often did not enable effective data discovery as they struggled to resolve the complex underlying normalised structures providing poor data access speeds. Users developed bespoke access tools to structures they did not fully understand sometimes delivering them incorrect results. Therefore, BGS has developed PropBase, a generic denormalised data structure within an RDBMS to store property data, to facilitate rapid and standardised data discovery and access, incorporating 2D and 3D physical and chemical property data, with associated metadata. This includes scripts to populate and synchronise the layer with its data sources through structured input and transcription standards. A core component of the architecture includes, an optimised query object, to deliver geoscience information from a structure equivalent to a data warehouse. This enables optimised query performance to deliver data in multiple standardised formats using a web discovery tool. Semantic interoperability is enforced through vocabularies combined from all data sources facilitating searching of related terms. PropBase holds 28.1 million spatially enabled property data points from 10 source databases incorporating over 50 property data types with a vocabulary set that includes 557 property terms. By enabling property data searches across multiple databases PropBase has facilitated new scientific research, previously considered impractical. PropBase is easily extended to incorporate 4D data (time series) and is providing a baseline for new "big data" monitoring projects.

Toward responsible development and effective risk management of nano-enabled products in the U.S. construction industry

NASA Astrophysics Data System (ADS)

West, Gavin H.; Lippy, Bruce E.; Cooper, Michael R.; Marsick, Daniel; Burrelli, Leonard G.; Griffin, Kelsey N.; Segrave, Alan M.

2016-02-01

The global construction sector is experiencing major improvements to building materials used in large quantities through commercial applications of nanotechnology. Nano-enabled construction products hold great promise for energy efficiency and resource conservation, but risk assessments lag as new products emerge. This paper presents results from an inventory, survey, and exposure assessment conducted by the authors and explores these findings in the broader context of evolving research trends and responsible development of nanotechnology. An inventory of 458 reportedly nano-enabled construction products provided insight into product availability, potential exposures, and deficiencies in risk communication that are barriers to adoption of proactive safety measures. Seasoned construction trainers surveyed were largely unaware of the availability of nano-enabled construction products. Exposure assessment demonstrated the effectiveness of ventilation to reduce exposures during mechanical abrasion of photocatalytic tiles containing titanium dioxide (TiO2). Dissociated particles of TiO2 just above the nanoscale (138 nm) were detected in the debris collected during cutting of the tiles, but measurements were below recommended exposure limits for TiO2. Exposure assessments remain scarce, and toxicological understanding primarily pertains to unincorporated nanomaterials; less is known about the occupational risks of nano-enabled construction products across their life cycle. Further research is needed to characterize and quantify exposure to debris released from nanocomposite materials for realistic risk assessment, and to ascertain how nanocomposite matrices, fillers, and degradation forces interact to affect release dynamics. Improving risk communication strategies and implementing safe work practices will cultivate responsible development of nanotechnology in construction, as will multidisciplinary research efforts.

Improving the efficacy of healthcare services for Aboriginal Australians.

PubMed

Gwynne, Kylie; Jeffries, Thomas; Lincoln, Michelle

2018-01-16

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for practitioners? Aboriginal people fare worse in both experience and outcomes when they access usual care services. Health services intended for Aboriginal people should be tailored using the five enablers to provide timely, culturally safe and high-quality care.

NREL Senior Research Fellow Honored by The Journal of Physical Chemistry |

Science.gov Websites

and quantum size effects in semiconductors and carrier dynamics in semiconductor quantum dots and using hot carrier effects, size quantization, and superlattice concepts that could, in principle, enable

Sport Management Graduate Programs: Characteristics of Effectiveness.

ERIC Educational Resources Information Center

Li, Ming; And Others

1994-01-01

Reports a study that examined the characteristics that enable graduate sport management programs to achieve their objectives. Surveys of sport management educators found they agreed on 11 characteristics that indicated a sport management program's effectiveness. Respondents believed an effective program should produce sport managers, not…

Landpower 2020: Enabling Regionally Aligned US Army Forces with Threat-Based Planning

DTIC Science & Technology

2013-03-01

situation, EUCOM has prioritized BPC as a tenet of its theater strategy, and it is the only command to have submitted the requirement for additional...Army forces to enable BPC as part of the annual GCC’s submission of integrated priorities to the joint staff.27 In fact, EUCOM has requested...perform BPC tasks in the AOR. However, United States Central Command (CENTCOM) indicated a vulnerability to effectively respond to emerging

Strategic Research to Enable NASA's Exploration Missions Conference and Workshop: Poster Session. Volume 2

NASA Technical Reports Server (NTRS)

Nahra, Henry (Compiler)

2004-01-01

Reports are presented from volume 2 of the conference titled Strategic Research to Enable NASA's Exploration Missions, poster session. Topics included spacecraft fire suppression and fire extinguishing agents,materials flammability, various topics on the effects of microgravity including crystal growth, fluid mechanics, electric particulate suspension, melting and solidification, bubble formation, the sloshing of liquid fuels, biological studies, separation of carbon dioxide and carbon monoxide for Mars ISRU.

The Role of Virtual Learning Environment in Improving Information and Communication Technology Adoption in Teaching Exploring How Virtual Learning Environments Improve University Teacher's Attitudes about the Use of Information and Communication Technology

ERIC Educational Resources Information Center

Ageel, Mohammed

2012-01-01

The adoption of ICT-enabled teaching in contemporary schools has largely lagged behind despite its obvious and many benefits, mainly because teachers still hold ignorant, misinformed and highly negative attitudes towards ICT-enabled teaching. This article aimed at investigating the effect of Virtual Learning Environments (VLE) on university…

[Determination of cost-effective strategies in colorectal cancer screening].

PubMed

Dervaux, B; Eeckhoudt, L; Lebrun, T; Sailly, J C

1992-01-01

The object of the article is to implement particular methodologies in order to determine which strategies are cost-effective in the mass screening of colorectal cancer after a positive Hemoccult test. The first approach to be presented consists in proposing a method which enables all the admissible diagnostic strategies to be determined. The second approach enables a minimal cost function to be estimated using an adaptation of "Data Envelopment Analysis". This method proves to be particularly successful in cost-efficiency analysis, when the performance indicators are numerous and hard to aggregate. The results show that there are two cost-effective strategies after a positive Hemoccult test: coloscopy and sigmoidoscopy; they put into question the relevance of double contrast barium enema in the diagnosis of colo-rectal lesions.

Toxicological Implications of Released Particulate Matter during Thermal Decomposition of Nano-Enabled Thermoplastics

PubMed Central

Watson-Wright, Christa; Singh, Dilpreet; Demokritou, Philip

2017-01-01

Nano-enabled thermoplastics are part of the growing market of nano-enabled products (NEPs) that have vast utility in several industries and consumer goods. The use and disposal of NEPs at their end of life has raised concerns about the potential release of constituent engineered nanomaterials (ENMs) during thermal decomposition and their impact on environmental health and safety. To investigate this issue, industrially relevant nano-enabled thermoplastics including polyurethane, polycarbonate, and polypropylene containing carbon nanotubes (0.1 and 3% w/v, respectively), polyethylene containing nanoscale iron oxide (5% w/v), and ethylene vinyl acetate containing nanoscale titania (2 and 5% w/v) along with their pure thermoplastic matrices were thermally decomposed using the recently developed lab based Integrated Exposure Generation System (INEXS). The life cycle released particulate matter (called LCPM) was monitored using real time instrumentation, size fractionated, sampled, extracted and prepared for toxicological analysis using primary small airway epithelial cells to assess potential toxicological effects. Various cellular assays were used to assess reactive oxygen species and total glutathione as measurements of oxidative stress along with mitochondrial function, cellular viability, and DNA damage. By comparing toxicological profiles of LCPM released from polymer only (control) with nano-enabled LCPM, potential nanofiller effects due to the use of ENMs were determined. We observed associations between NEP properties such as the percent nanofiller loading, host matrix, and nanofiller chemical composition and the physico-chemical properties of released LCPM, which were linked to biological outcomes. More specifically, an increase in percent nanofiller loading promoted a toxicological response independent of increasing LCPM dose. Importantly, differences in host matrix and nanofiller composition were shown to enhance biological activity and toxicity of LCPM. This work highlights the importance of assessing the toxicological properties of LCPM and raises environmental health and safety concerns of nano-enabled products at their end of life during thermal decomposition/incineration. PMID:29333505

Toxicological Implications of Released Particulate Matter during Thermal Decomposition of Nano-Enabled Thermoplastics.

PubMed

Watson-Wright, Christa; Singh, Dilpreet; Demokritou, Philip

2017-01-01

Nano-enabled thermoplastics are part of the growing market of nano-enabled products (NEPs) that have vast utility in several industries and consumer goods. The use and disposal of NEPs at their end of life has raised concerns about the potential release of constituent engineered nanomaterials (ENMs) during thermal decomposition and their impact on environmental health and safety. To investigate this issue, industrially relevant nano-enabled thermoplastics including polyurethane, polycarbonate, and polypropylene containing carbon nanotubes (0.1 and 3% w/v, respectively), polyethylene containing nanoscale iron oxide (5% w/v), and ethylene vinyl acetate containing nanoscale titania (2 and 5% w/v) along with their pure thermoplastic matrices were thermally decomposed using the recently developed lab based Integrated Exposure Generation System (INEXS). The life cycle released particulate matter (called LCPM) was monitored using real time instrumentation, size fractionated, sampled, extracted and prepared for toxicological analysis using primary small airway epithelial cells to assess potential toxicological effects. Various cellular assays were used to assess reactive oxygen species and total glutathione as measurements of oxidative stress along with mitochondrial function, cellular viability, and DNA damage. By comparing toxicological profiles of LCPM released from polymer only (control) with nano-enabled LCPM, potential nanofiller effects due to the use of ENMs were determined. We observed associations between NEP properties such as the percent nanofiller loading, host matrix, and nanofiller chemical composition and the physico-chemical properties of released LCPM, which were linked to biological outcomes. More specifically, an increase in percent nanofiller loading promoted a toxicological response independent of increasing LCPM dose. Importantly, differences in host matrix and nanofiller composition were shown to enhance biological activity and toxicity of LCPM. This work highlights the importance of assessing the toxicological properties of LCPM and raises environmental health and safety concerns of nano-enabled products at their end of life during thermal decomposition/incineration.

Procedure Enabling Simulation and In-Depth Analysis of Optical Effects in Camera-Based Time-Of Sensors

NASA Astrophysics Data System (ADS)

Baumgart, M.; Druml, N.; Consani, M.

2018-05-01

This paper presents a simulation approach for Time-of-Flight cameras to estimate sensor performance and accuracy, as well as to help understanding experimentally discovered effects. The main scope is the detailed simulation of the optical signals. We use a raytracing-based approach and use the optical path length as the master parameter for depth calculations. The procedure is described in detail with references to our implementation in Zemax OpticStudio and Python. Our simulation approach supports multiple and extended light sources and allows accounting for all effects within the geometrical optics model. Especially multi-object reflection/scattering ray-paths, translucent objects, and aberration effects (e.g. distortion caused by the ToF lens) are supported. The optical path length approach also enables the implementation of different ToF senor types and transient imaging evaluations. The main features are demonstrated on a simple 3D test scene.

The New South Wales Allied Health Workplace Learning Study: barriers and enablers to learning in the workplace.

PubMed

Lloyd, Bradley; Pfeiffer, Daniella; Dominish, Jacqueline; Heading, Gaynor; Schmidt, David; McCluskey, Annie

2014-03-25

Workplace learning refers to continuing professional development that is stimulated by and occurs through participation in workplace activities. Workplace learning is essential for staff development and high quality clinical care. The purpose of this study was to explore the barriers to and enablers of workplace learning for allied health professionals within NSW Health. A qualitative study was conducted with a purposively selected maximum variation sample (n =46) including 19 managers, 19 clinicians and eight educators from 10 allied health professions. Seven semi-structured interviews and nine focus groups were audio-recorded and transcribed. The 'framework approach' was used to guide the interviews and analysis. Textual data were coded and charted using an evolving thematic framework. Key enablers of workplace learning included having access to peers, expertise and 'learning networks', protected learning time, supportive management and positive staff attitudes. The absence of these key enablers including heavy workload and insufficient staffing were important barriers to workplace learning. Attention to these barriers and enablers may help organisations to more effectively optimise allied health workplace learning. Ultimately better workplace learning may lead to improved patient, staff and organisational outcomes.

Robotics to enable older adults to remain living at home.

PubMed

Pearce, Alan J; Adair, Brooke; Miller, Kimberly; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E

2012-01-01

Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving.

The New South Wales Allied Health Workplace Learning Study: barriers and enablers to learning in the workplace

PubMed Central

2014-01-01

Background Workplace learning refers to continuing professional development that is stimulated by and occurs through participation in workplace activities. Workplace learning is essential for staff development and high quality clinical care. The purpose of this study was to explore the barriers to and enablers of workplace learning for allied health professionals within NSW Health. Methods A qualitative study was conducted with a purposively selected maximum variation sample (n = 46) including 19 managers, 19 clinicians and eight educators from 10 allied health professions. Seven semi-structured interviews and nine focus groups were audio-recorded and transcribed. The ‘framework approach’ was used to guide the interviews and analysis. Textual data were coded and charted using an evolving thematic framework. Results Key enablers of workplace learning included having access to peers, expertise and ‘learning networks’, protected learning time, supportive management and positive staff attitudes. The absence of these key enablers including heavy workload and insufficient staffing were important barriers to workplace learning. Conclusion Attention to these barriers and enablers may help organisations to more effectively optimise allied health workplace learning. Ultimately better workplace learning may lead to improved patient, staff and organisational outcomes. PMID:24661614

Coater/developer based techniques to improve high-resolution EUV patterning defectivity

NASA Astrophysics Data System (ADS)

Hontake, Koichi; Huli, Lior; Lemley, Corey; Hetzer, Dave; Liu, Eric; Ko, Akiteru; Kawakami, Shinichiro; Shimoaoki, Takeshi; Hashimoto, Yusaku; Tanaka, Koichiro; Petrillo, Karen; Meli, Luciana; De Silva, Anuja; Xu, Yongan; Felix, Nelson; Johnson, Richard; Murray, Cody; Hubbard, Alex

2017-10-01

Extreme ultraviolet lithography (EUVL) technology is one of the leading candidates under consideration for enabling the next generation of devices, for 7nm node and beyond. As the focus shifts to driving down the 'effective' k1 factor and enabling the full scaling entitlement of EUV patterning, new techniques and methods must be developed to reduce the overall defectivity, mitigate pattern collapse, and eliminate film-related defects. In addition, CD uniformity and LWR/LER must be improved in terms of patterning performance. Tokyo Electron Limited (TEL™) and IBM Corporation are continuously developing manufacturing quality processes for EUV. In this paper, we review the ongoing progress in coater/developer based processes (coating, developing, baking) that are required to enable EUV patterning.

Microfluidic interconnects

DOEpatents

Benett, William J.; Krulevitch, Peter A.

2001-01-01

A miniature connector for introducing microliter quantities of solutions into microfabricated fluidic devices, and which incorporates a molded ring or seal set into a ferrule cartridge, with or without a compression screw. The fluidic connector, for example, joins standard high pressure liquid chromatography (HPLC) tubing to 1 mm diameter holes in silicon or glass, enabling ml-sized volumes of sample solutions to be merged with .mu.l-sized devices. The connector has many features, including ease of connect and disconnect; a small footprint which enables numerous connectors to be located in a small area; low dead volume; helium leak-tight; and tubing does not twist during connection. Thus the connector enables easy and effective change of microfluidic devices and introduction of different solutions in the devices.

Cavitation Enhancing Nanodroplets Mediate Efficient DNA Fragmentation in a Bench Top Ultrasonic Water Bath

PubMed Central

Malc, Ewa P.; Jayakody, Chatura N.; Tsuruta, James K.; Mieczkowski, Piotr A.; Janzen, William P.; Dayton, Paul A.

2015-01-01

A perfluorocarbon nanodroplet formulation is shown to be an effective cavitation enhancement agent, enabling rapid and consistent fragmentation of genomic DNA in a standard ultrasonic water bath. This nanodroplet-enhanced method produces genomic DNA libraries and next-generation sequencing results indistinguishable from DNA samples fragmented in dedicated commercial acoustic sonication equipment, and with higher throughput. This technique thus enables widespread access to fast bench-top genomic DNA fragmentation. PMID:26186461

The effect of automated monitoring and real-time prompting on nurses' hand hygiene performance.

PubMed

Levchenko, Alexander I; Boscart, Veronique M; Fernie, Geoff R

2013-10-01

Adequate hand hygiene compliance by healthcare staff is considered an effective method to reduce hospital-acquired infections. The electronic system developed at Toronto Rehabilitation Institute automatically detects hand hygiene opportunities and records hand hygiene actions. It includes an optional visual hand hygiene status indication, generates real-time hand hygiene prompting signals, and enables automated monitoring of individual and aggregated hand hygiene performance. The system was installed on a complex continuous care unit at the entrance to 17 patient rooms and a utility room. A total of 93 alcohol gel and soap dispensers were instrumented and 14 nurses were provided with the personal wearable electronic monitors. The study included three phases with the system operating in three different modes: (1) an inactive mode during the first phase when hand hygiene opportunities and hand hygiene actions were recorded but prompting and visual indication functions were disabled, (2) only hand hygiene status indicators were enabled during the second phase, and (3) both hand hygiene status and real-time hand hygiene prompting signals were enabled during the third phase. Data collection was performed automatically during all of the three phases. The system indicated significantly higher hand hygiene activity rates and compliance during the third phase, with both hand hygiene indication and real-time prompting functions enabled. To increase the efficacy of the technology, its use was supplemented with individual performance reviews of the automatically collected data.

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

Boucher, Laurel A.

Successful collaboration requires effective communication and collective problem solving. Regardless of the subject area --- environmental remediation, waste management, program planning and budgeting --- those involved must focus their efforts in an orderly and cooperative manner. A thinking tool is a technique used to get individuals to focus on specific components of the task at the same time and to eliminate the 'noise' that accompanies communications among individuals with different objectives and different styles of communicating. For example, one of these thinking tools is a technique which enables a working group to delineate its roles, responsibilities and communication protocols somore » that it can deliver the right information to the right people at the right time. Another enables a group to objectively and collectively evaluate and improve a policy, plan, or program. A third technique enables a group to clarify its purpose and direction while generating interest and buy-in. A fourth technique makes it possible for a group with polarized opinions to acknowledge their differences as well as what they have in common. A fifth technique enables a group to consider a subject of importance from all perspectives so as to produce a more comprehensive and sustainable solution. These thinking tools make effective communication and collective problem solving possible in radioactive waste management and remediation. They can be used by a wide spectrum of professionals including policy specialists, program administrators, program and project managers, and technical specialists. (author)« less

Semi-quantitative analysis of solid waste flows from nano-enabled consumer products in Europe, Denmark and the United Kingdom - Abundance, distribution and management.

PubMed

Heggelund, Laura; Hansen, Steffen Foss; Astrup, Thomas Fruergaard; Boldrin, Alessio

2016-10-01

Many nano-enabled consumer products are known to be in the global market. At the same, little is known about the quantity, type, location etc. of the engineered nanomaterials (ENMs) inside the products. This limits the scientific investigations of potential environmental effects of these materials, and especially the knowledge of ENM behaviour and potential effects at the end-of-life stage of the products is scarce. To gain a better understanding of the end-of-life waste treatment of nano-enabled consumer product, we provide an overview of the ENMs flowing into and throughout waste systems in Europe, Denmark and the United Kingdom. Using a nanoproduct inventory (nanodb.dk), we performed a four-step analysis to estimate the most abundant ENMs and in which waste fractions they are present. We found that in terms of number of products: (i) nano silver is the most used ENM in consumer products, and (ii) plastic from used product containers is the largest waste fraction also comprising a large variety of ENMs, though possibly in very small masses. Also, we showed that the local waste management system can influence the distribution of ENMs. It is recommended that future research focus on recycling and landfilling of nano-enabled products since these compartments represent hot spots for end-of-life nanoproducts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effective Administrative Support for Able Teachers.

ERIC Educational Resources Information Center

Willing, Delight C.

1979-01-01

The continuing education administrator should provide support that will enable teachers to perform effectively. By using Herzberg's motivation-hygiene theory as a framework, the administrator can develop a positive working environment and seek ways of providing motivation to the teacher. (SK)

Thermodynamic theory of dislocation-enabled plasticity

DOE PAGES

Langer, J. S.

2017-11-30

The thermodynamic theory of dislocation-enabled plasticity is based on two unconventional hypotheses. The first of these is that a system of dislocations, driven by external forces and irreversibly exchanging heat with its environment, must be characterized by a thermodynamically defined effective temperature that is not the same as the ordinary temperature. The second hypothesis is that the overwhelmingly dominant mechanism controlling plastic deformation is thermally activated depinning of entangled pairs of dislocations. This paper consists of a systematic reformulation of this theory followed by examples of its use in analyses of experimentally observed phenomena including strain hardening, grain-size (Hall-Petch) effects,more » yielding transitions, and adiabatic shear banding.« less

Health Informatics and Technology for Integrated Elderly Care in the Context of Hong Kong: A Case Study.

PubMed

Chau, Cheuk Wing; Leung, Eman

2017-01-01

The aging population creates tremendous pressure to healthcare. To resolve, scholars recognized the solution to this challenge is integrated care. To facilitate integrated care, health information technologies (HIT) is a critical enabler. This paper will first review how technology enhanced integrated care, and review on the existing literatures in system effective use and the three key external factors that enable HIT implementation. Applying Burton-Jones and Volkoff's contextualized theories of effective use of HIT to understand the role of health informatics and technology in the unique context of Hong Kong, we have conducted a case study research to identify the levers for improving HK integration of care through HIT.

Effect of Knowledge Management on Organizational Performance: Enabling Thought Leadership and Social Capital through Technology Management

NASA Astrophysics Data System (ADS)

Chalhoub, Michel S.

The present paper studies the relationship between social networks enabled by technological advances in social software, and overall business performance. With the booming popularity of online communication and the rise of knowledge communities, businesses are faced with a challenge as well as an opportunity - should they monitor the use of social software or encourage it and learn from it? We introduce the concept of user-autonomy and user-fun, which go beyond the traditional user-friendly requirement of existing information technologies. We identified 120 entities out of a sample of 164 from Mediterranean countries and the Gulf region, to focus on the effect of social exchange information systems in thought leadership.

Axial flow plasma shutter

DOEpatents

Krausse, George J.

1988-01-01

A shutter (36) is provided for controlling a beam, or current, of charged particles in a device such as a thyratron (10). The substrate (38) defines an aperture (60) with a gap (32) which is placeable within the current. Coils (48) are formed on the substrate (38) adjacent the aperture (60) to produce a magnetic field for trapping the charged particles in or about aperture (60). The proximity of the coils (48) to the aperture (60) enables an effective magnetic field to be generated by coils (48) having a low inductance suitable for high frequency control. The substantially monolithic structure including the substrate (38) and coils (48) enables the entire shutter assembly (36) to be effectively located with respect to the particle beam.

Australia's TERN: Advancing Ecosystem Data Management in Australia

NASA Astrophysics Data System (ADS)

Phinn, S. R.; Christensen, R.; Guru, S.

2013-12-01

Globally, there is a consistent movement towards more open, collaborative and transparent science, where the publication and citation of data is considered standard practice. Australia's Terrestrial Ecosystem Research Network (TERN) is a national research infrastructure investment designed to support the ecosystem science community through all stages of the data lifecycle. TERN has developed and implemented a comprehensive network of ';hard' and ';soft' infrastructure that enables Australia's ecosystem scientists to collect, publish, store, share, discover and re-use data in ways not previously possible. The aim of this poster is to demonstrate how TERN has successfully delivered infrastructure that is enabling a significant cultural and practical shift in Australia's ecosystem science community towards consistent approaches for data collection, meta-data, data licensing, and data publishing. TERN enables multiple disciplines, within the ecosystem sciences to more effectively and efficiently collect, store and publish their data. A critical part of TERN's approach has been to build on existing data collection activities, networks and skilled people to enable further coordination and collaboration to build each data collection facility and coordinate data publishing. Data collection in TERN is through discipline based facilities, covering long term collection of: (1) systematic plot based measurements of vegetation structure, composition and faunal biodiversity; (2) instrumented towers making systematic measurements of solar, water and gas fluxes; and (3) satellite and airborne maps of biophysical properties of vegetation, soils and the atmosphere. Several other facilities collect and integrate environmental data to produce national products for fauna and vegetation surveys, soils and coastal data, as well as integrated or synthesised products for modelling applications. Data management, publishing and sharing in TERN are implemented through a tailored data licensing framework suitable for ecosystem data, national standards for metadata, a DOI-minting service, and context-appropriate data repositories and portals. The TERN Data infrastructure is based on loosely coupled 'network of networks.' Overall, the data formats used across the TERN facilities vary from NetCDF, comma-separated values and descriptive documents. Metadata standards include ISO19115, Ecological Metadata Language and rich semantic enabled contextual information. Data services vary from Web Mapping Service, Web Feature Service, OpeNDAP, file servers and KNB Metacat. These approaches enable each data collection facility to maintain their discipline based data collection and storage protocols. TERN facility meta-data are harvested regularly for the central TERN Data Discovery Portal and converted to a national standard format. This approach enables centralised discovery, access, and re-use of data simply and effectively, while maintaining disciplinary diversity. Effort is still required to support the cultural shift towards acceptance of effective data management, publication, sharing and re-use as standard practice. To this end TERN's future activities will be directed to supporting this transformation and undertaking ';education' to enable ecosystem scientists to take full advantage of TERN's infrastructure, and providing training and guidance for best practice data management.

Enhancing Transfer Effectiveness: A Model for the 1990s.

ERIC Educational Resources Information Center

Berman, Paul; And Others

In an effort to identify effective transfer practices appropriate to different community college circumstances, and to establish a quantitative database that would enable valid comparisons of transfer between their 28 member institutions, the National Effective Transfer Consortium (NETC) sponsored a survey of more than 30,000 students attending…

The Effect of Professor's Attractiveness on Distance Learning Students

ERIC Educational Resources Information Center

Liu, Jeanny; Tomasi, Stella D.

2015-01-01

Technology enabled learning is becoming more popular and pervasive in education. While the effectiveness of distance learning versus traditional classroom education is strongly debated, human factors such as students' perception of their professors can influence their desire to learn. This research examines the perceptual effect of attractive…

Ten Principles of Effective School Design

ERIC Educational Resources Information Center

New Visions for Public Schools, 2006

2006-01-01

This brief document offers ten principles of effective school design. They are: (1) Clear Focus and High Expectations for staff and students are defining features of an effective school; (2) A Rigorous Instructional Program provides equitable opportunities to learn and enables every student to master challenging content, skills, and learning…

Neuroscience imaging enabled by new highly tunable and high peak power femtosecond lasers

NASA Astrophysics Data System (ADS)

Hakulinen, T.; Klein, J.

2017-02-01

Neuroscience applications benefit from recent developments in industrial femtosecond laser technology. New laser sources provide several megawatts of peak power at wavelength of 1040 nm, which enables simultaneous optogenetics photoactivation of tens or even hundreds of neurons using red shifted opsins. Another recent imaging trend is to move towards longer wavelengths, which would enable access to deeper layers of tissue due to lower scattering and lower absorption in the tissue. Femtosecond lasers pumping a non-collinear optical parametric amplifier (NOPA) enable the access to longer wavelengths with high peak powers. High peak powers of >10 MW at 1300 nm and 1700 nm allow effective 3-photon excitation of green and red shifted calcium indicators respectively and access to deeper, sub-cortex layers of the brain. Early results include in vivo detection of spontaneous activity in hippocampus within an intact mouse brain, where neurons express GCaMP6 activated in a 3-photon process at 1320 nm.

Public participation and marginalized groups: the community development model.

PubMed

O'Keefe, Eileen; Hogg, Christine

1999-12-01

OBJECTIVES: To develop ways of reaching house-bound people and enabling them to give their views in planning and monitoring health and social care. STRATEGY: HealthLINK - a project based in a community health council - explored ways of involving older house-bound people in the London Borough of Camden, in planning and monitoring health and social care using community development techniques. RESULTS: HealthLINK set up an infrastructure to enable house-bound people to have access to information and to enable them to give their views. This resulted in access for health and local authorities to the views of house-bound older people and increased the self esteem and quality of life of those who became involved. CONCLUSIONS: Community development approaches that enable an infrastructure to be established may be an effective way of reaching marginalized communities. However, there are tensions in this approach between the different requirements for public involvement of statutory bodies and of users, and between representation of groups and listening to individual voices.

Effects of Selected Socio-Demographic Characteristics of Community Health Workers on Performance of Home Visits during Pregnancy: A Cross-Sectional Study in Busia District, Kenya

PubMed Central

Crispin, Ndedda; Wamae, Annah; Ndirangu, Meshack; Wamalwa, David; Wangalwa, Gilbert; Watako, Patrick; Mbiti, Elijah

2012-01-01

Objective: Appropriate performance of home visits facilitates adoption of best practices at home and increased demand for facility based services. Methods: It was a cross-sectional study in which community health workers were observed conducting home visits during pregnancy. Data was collected using a structured questionnaire and the Consultant Quality Index (CQI-2 tool) on record keeping, use of job aids, counselling, client satisfaction and client enablement. Descriptive and inferential statistics were used. Relationships were determined using chi square and odds ratios. Results: The study showed significant relationships of age with good record keeping (p = 0.0001), appropriate use of job aids (p=0.0001), client satisfaction (p = 0.018) and client enablement (p = 0.001). Male CHWs were 1.6 times more likely to keep better records than females (OR 1.64 CI (1.02-2.63), while females were more likely to counsel and enable their clients OR 0.42 CI (0.25-0.71) and OR 0.29 CI (012-070) respectively when compared to men. Moreover, higher levels of education were associated with good record keeping OR 0.30 CI (0.19-0.49), p=0.0001; appropriate use of job aids OR 0.30 CI (0.15-0.61) and to appropriately counsel their clients OR 0.34 CI (0.20-0.58) than their lower literacy level counterparts. Experience of CHWs was associated with appropriate use of job aids (p = 0.049); client satisfaction (p = 0.0001) and client enablement (p = 0.032). Conclusions: Socio-demographic characteristics of community health workers affect the performance of home visits in various ways. The study also confirmed that CHWs with lower literacy levels satisfy and enable their clients effectively. PMID:22980380

Enablers and barriers of men with Duchenne muscular dystrophy transitioning from an adult clinic within a pediatric hospital.

PubMed

Lindsay, Sally; McAdam, Laura; Mahendiran, Tania

2017-01-01

Young men with Duchenne muscular dystrophy (DMD) live into adulthood and need specialized care. However, services for adults are fragmented. We know little about young men's experiences, their parents, and clinicians who support them as they transition to adult care. To explore the enablers and barriers of clinicians, young men, and parents as they transition from an adult DMD clinic within a pediatric hospital to an adult health facility. We conducted semi-structured, in-depth interviews with 16 participants (7 clinicians, 5 parents, 4 youth). We used an open-coding, thematic approach to analyze the data. Clinicians, youth and their parents experienced several enablers and barriers in transitioning to an adult health care center. Clinicians reported that structural factors including leadership and advocacy supported the transition. Clinicians and parents found that the availability and continuity of care both enabled and hindered the transition. Parents and youth conveyed the difficulties of adjusting to the different model of adult care and also accessing resources. All participants described how relational factors (i.e., effective communication and family involvement) enabled the transition. On an individual level, clinicians, parents and youth viewed transition readiness and other life skill supports as an enabler and a barrier to transitioning. All participants reported the difficulties of maintaining mental health for youth with DMD transitioning to adult health care. Clinicians, youth, and parents experienced several enablers and barriers in transitioning to adult health care. Further work is needed to understand the complex transition needs of youth with DMD. Copyright © 2016 Elsevier Inc. All rights reserved.

Predator Dispersal Determines the Effect of Connectivity on Prey Diversity

PubMed Central

Limberger, Romana; Wickham, Stephen A.

2011-01-01

Linking local communities to a metacommunity can positively affect diversity by enabling immigration of dispersal-limited species and maintenance of sink populations. However, connectivity can also negatively affect diversity by allowing the spread of strong competitors or predators. In a microcosm experiment with five ciliate species as prey and a copepod as an efficient generalist predator, we analysed the effect of connectivity on prey species richness in metacommunities that were either unconnected, connected for the prey, or connected for both prey and predator. Presence and absence of predator dispersal was cross-classified with low and high connectivity. The effect of connectivity on local and regional richness strongly depended on whether corridors were open for the predator. Local richness was initially positively affected by connectivity through rescue of species from stochastic extinctions. With predator dispersal, however, this positive effect soon turned negative as the predator spread over the metacommunity. Regional richness was unaffected by connectivity when local communities were connected only for the prey, while predator dispersal resulted in a pronounced decrease of regional richness. The level of connectivity influenced the speed of richness decline, with regional species extinctions being delayed for one week in weakly connected metacommunities. While connectivity enabled rescue of prey species from stochastic extinctions, deterministic extinctions due to predation were not overcome through reimmigration from predator-free refuges. Prey reimmigrating into these sink habitats appeared to be directly converted into increased predator abundance. Connectivity thus had a positive effect on the predator, even when the predator was not dispersing itself. Our study illustrates that dispersal of a species with strong negative effects on other community members shapes the dispersal-diversity relationship. When connections enable the spread of a generalist predator, positive effects of connectivity on prey species richness are outweighed by regional extinctions through predation. PMID:22194992

Teaching and Evaluating Instructor Effectiveness Using the Instructor Effectiveness Questionnaire and the Instructor Effectiveness Check Sheet Combination

ERIC Educational Resources Information Center

Phipps, Maurice L.; Hayashi, Aya; Lewandowski, April; Padgett, Allison H.

2005-01-01

This article describes the use of two linked instruments, the Instructor Effectiveness Check Sheet (IEC) and Instructor Effectiveness Questionnaire (IEQ). The use of an evaluation instrument during a course can enable improvements to be made--even with experienced instructors. Detail can be taken from the IEC and IEQ to find obvious and not so…

Evaluation of touch-sensitive screen tablet terminal button size and spacing accounting for effect of fingertip contact angle.

PubMed

Nishimura, T; Doi, K; Fujimoto, H

2015-08-01

Touch-sensitive screen terminals enabling intuitive operation are used as input interfaces in a wide range of fields. Tablet terminals are one of the most common devices with a touch-sensitive screen. They have a feature of good portability, enabling use under various conditions. On the other hand, they require a GUI designed to prevent decrease of usability under various conditions. For example, the angle of fingertip contact with the display changes according to finger posture during operation and how the case is held. When a human fingertip makes contact with an object, the contact area between the fingertip and contact object increases or decreases as the contact angle changes. A touch-sensitive screen detects positions using the change in capacitance of the area touched by the fingertip; hence, differences in contact area between the touch-sensitive screen and fingertip resulting from different forefinger angles during operation could possibly affect operability. However, this effect has never been studied. We therefore conducted an experiment to investigate the relationship between size/spacing and operability, while taking the effect of fingertip contact angle into account. As a result, we have been able to specify the button size and spacing conditions that enable accurate and fast operation regardless of the forefinger contact angle.

Emulation Platform for Cyber Analysis of Wireless Communication Network Protocols

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

Van Leeuwen, Brian P.; Eldridge, John M.

Wireless networking and mobile communications is increasing around the world and in all sectors of our lives. With increasing use, the density and complexity of the systems increase with more base stations and advanced protocols to enable higher data throughputs. The security of data transported over wireless networks must also evolve with the advances in technologies enabling more capable wireless networks. However, means for analysis of the effectiveness of security approaches and implementations used on wireless networks are lacking. More specifically a capability to analyze the lower-layer protocols (i.e., Link and Physical layers) is a major challenge. An analysis approachmore » that incorporates protocol implementations without the need for RF emissions is necessary. In this research paper several emulation tools and custom extensions that enable an analysis platform to perform cyber security analysis of lower layer wireless networks is presented. A use case of a published exploit in the 802.11 (i.e., WiFi) protocol family is provided to demonstrate the effectiveness of the described emulation platform.« less

Novel graphene-based biosensor for early detection of Zika virus infection.

PubMed

Afsahi, Savannah; Lerner, Mitchell B; Goldstein, Jason M; Lee, Joo; Tang, Xiaoling; Bagarozzi, Dennis A; Pan, Deng; Locascio, Lauren; Walker, Amy; Barron, Francie; Goldsmith, Brett R

2018-02-15

We have developed a cost-effective and portable graphene-enabled biosensor to detect Zika virus with a highly specific immobilized monoclonal antibody. Field Effect Biosensing (FEB) with monoclonal antibodies covalently linked to graphene enables real-time, quantitative detection of native Zika viral (ZIKV) antigens. The percent change in capacitance in response to doses of antigen (ZIKV NS1) coincides with levels of clinical significance with detection of antigen in buffer at concentrations as low as 450pM. Potential diagnostic applications were demonstrated by measuring Zika antigen in a simulated human serum. Selectivity was validated using Japanese Encephalitis NS1, a homologous and potentially cross-reactive viral antigen. Further, the graphene platform can simultaneously provide the advanced quantitative data of nonclinical biophysical kinetics tools, making it adaptable to both clinical research and possible diagnostic applications. The speed, sensitivity, and selectivity of this first-of-its-kind graphene-enabled Zika biosensor make it an ideal candidate for development as a medical diagnostic test. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Investigating Experimental Effects within the Framework of Structural Equation Modeling: An Example with Effects on Both Error Scores and Reaction Times

ERIC Educational Resources Information Center

Schweizer, Karl

2008-01-01

Structural equation modeling provides the framework for investigating experimental effects on the basis of variances and covariances in repeated measurements. A special type of confirmatory factor analysis as part of this framework enables the appropriate representation of the experimental effect and the separation of experimental and…

Tuning the carrier scattering mechanism to effectively improve the thermoelectric properties

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

Shuai, Jing; Mao, Jun; Song, Shaowei

2017-01-01

A high thermoelectric power factor not only enables a potentially high figure of meritZTbut also leads to a large output power density, and hence it is pivotal to find an effective route to improve the power factor.

Cost of Achieving Squad Overmatch by Training Resilience and Situational Awareness Skills that Optimize Human Performance and Discourage PTS and Suicide

DTIC Science & Technology

2015-12-01

actors. The study team canvassed commercial, academic, and research institutions for a possible surrogate solution and introduced wall based avatars ...barrel, tent, or market stand); other technologies such as wall-projected avatars are not used (instead role players are used). CACTF/MOUT must be...sites at each home station are fitted with mounts or docks to enable enhanced site technology (MILES-enabled wall- projected avatars , non-pyro effects

Microfluidic volumetric flow determination using optical coherence tomography speckle: An autocorrelation approach

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

De Pretto, Lucas R., E-mail: lucas.de.pretto@usp.br; Nogueira, Gesse E. C.; Freitas, Anderson Z.

2016-04-28

Functional modalities of Optical Coherence Tomography (OCT) based on speckle analysis are emerging in the literature. We propose a simple approach to the autocorrelation of OCT signal to enable volumetric flow rate differentiation, based on decorrelation time. Our results show that this technique could distinguish flows separated by 3 μl/min, limited by the acquisition speed of the system. We further perform a B-scan of gradient flow inside a microchannel, enabling the visualization of the drag effect on the walls.

Relativistic klystron driven compact high gradient accelerator as an injector to an X-ray synchrotron radiation ring

DOEpatents

Yu, David U. L.

1990-01-01

A compact high gradient accelerator driven by a relativistic klystron is utilized to inject high energy electrons into an X-ray synchrotron radiation ring. The high gradients provided by the relativistic klystron enables accelerator structure to be much shorter (typically 3 meters) than conventional injectors. This in turn enables manufacturers which utilize high energy, high intensity X-rays to produce various devices, such as computer chips, to do so on a cost effective basis.

A Voice Enabled Procedure Browser for the International Space Station

NASA Technical Reports Server (NTRS)

Rayner, Manny; Chatzichrisafis, Nikos; Hockey, Beth Ann; Farrell, Kim; Renders, Jean-Michel

2005-01-01

Clarissa, an experimental voice enabled procedure browser that has recently been deployed on the International Space Station (ISS), is to the best of our knowledge the first spoken dialog system in space. This paper gives background on the system and the ISS procedures, then discusses the research developed to address three key problems: grammar-based speech recognition using the Regulus toolkit; SVM based methods for open microphone speech recognition; and robust side-effect free dialogue management for handling undos, corrections and confirmations.

Sonic Boom Modeling Technical Challenge

NASA Technical Reports Server (NTRS)

Sullivan, Brenda M.

2007-01-01

This viewgraph presentation reviews the technical challenges in modeling sonic booms. The goal of this program is to develop knowledge, capabilities and technologies to enable overland supersonic flight. The specific objectives of the modeling are: (1) Develop and validate sonic boom propagation model through realistic atmospheres, including effects of turbulence (2) Develop methods enabling prediction of response of and acoustic transmission into structures impacted by sonic booms (3) Develop and validate psychoacoustic model of human response to sonic booms under both indoor and outdoor listening conditions, using simulators.

Antiepileptic Drug Behavioral Side Effects in Individuals with Mental Retardation and the Use of Behavioral Measurement Techniques.

ERIC Educational Resources Information Center

Kalachnik, John E.; And Others

1995-01-01

Behavioral psychology measurement methods helped assess antiepileptic drug behavioral side effects in five individuals with mental retardation who could not verbally communicate presence of side effects. When the suspected antiepileptic drug was altered, an 81% reduction of maladaptive behaviors occurred. The measurement methods enabled systematic…

Student Perceptions and Effectiveness of an Innovative Learning Tool: Anatomy Glove Learning System

ERIC Educational Resources Information Center

Lisk, Kristina; McKee, Pat; Baskwill, Amanda; Agur, Anne M. R.

2015-01-01

A trend in anatomical education is the development of alternative pedagogical approaches to replace or complement experiences in a cadaver laboratory; however, empirical evidence on their effectiveness is often not reported. This study aimed to evaluate the effectiveness of Anatomy Glove Learning System (AGLS), which enables students to learn the…

A THEORY OF LEADERSHIP EFFECTIVENESS. MCGRAW-HILL SERIES IN MANAGEMENT.

ERIC Educational Resources Information Center

FIEDLER, FRED E.

CENTRAL TO THE THEORY OF LEADERSHIP EFFECTIVENESS OUTLINED HERE IS A CONTINGENCY MODEL, ACCORDING TO WHICH GROUP EFFECTIVENESS DEPENDS ON INTERACTION BETWEEN LEADERSHIP STYLES AND THE DEGREE TO WHICH SITUATIONS ENABLE LEADERS TO EXERT INFLUENCE. THE THEORY PREDICTS THAT A TASK-ORIENTED STYLE WILL BE THE BEST STYLE IN FAVORABLE LEADERSHIP…

Differentiating high priority pathway-based toxicity from non-specific effects in high throughput toxicity data: A foundation for prioritizing AOP development.

EPA Science Inventory

The ToxCast chemical screening approach enables the rapid assessment of large numbers of chemicals for biological effects, primarily at the molecular level. Adverse outcome pathways (AOPs) offer a means to link biomolecular effects with potential adverse outcomes at the level of...

The Effects of Virtual Communities on Group Identity in Classroom Management

ERIC Educational Resources Information Center

Ho, Tu-Kuang; Lin, Yu-Tzeng

2016-01-01

Group identity is a critical component in developing effective classroom management. While there have been numerous studies on group identity, they have primarily focused on its effects on the physical classroom entity. Advances in information technology, however, have enabled the creation of virtual communities, which have become a vital channel…

Parsonian Influence and the Effect of School Climate and Bureaucracy on the Perceived Effectiveness in Schools

ERIC Educational Resources Information Center

McVey, Deidre

2009-01-01

School climate is a significant way to predict school achievement as a positive correlation to students' standardized test scores and also teachers' perceptions of bureaucratic effectiveness and empowerment (Hoy, Tarter & Kottkamp, 1991; Sweetland & Hoy, 2000). Enabling bureaucracies are positively related to teacher empowering; however,…

An Organic Vertical Field-Effect Transistor with Underside-Doped Graphene Electrodes.

PubMed

Kim, Jong Su; Kim, Beom Joon; Choi, Young Jin; Lee, Moo Hyung; Kang, Moon Sung; Cho, Jeong Ho

2016-06-01

High-performance vertical field-effect transistors are developed, which are based on graphene electrodes doped using the underside doping method. The underside doping method enables effective tuning of the graphene work function while maintaining the surface properties of the pristine graphene. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Impact of Faculty Perceived Reconfigurability of Learning Management Systems on Effective Teaching Practices

ERIC Educational Resources Information Center

Wang, Jianfeng; Doll, William J.; Deng, Xiaodong; Park, Kihyun; Yang, Ma Ga

2013-01-01

This study explores whether learning management systems (LMSs) enable faculty course developers to use the reconfigurable characteristics of the software to implement the seven principles of effective teaching (Chickering & Gamson, 1987). If LMSs are to be considered pedagogically effective, these systems must help engage faculty in effective…

Managing Sustainable Data Infrastructures: The Gestalt of EOSDIS

NASA Technical Reports Server (NTRS)

Behnke, Jeanne; Lowe, Dawn; Lindsay, Francis; Lynnes, Chris; Mitchell, Andrew

2016-01-01

EOSDIS epitomizes a System of Systems, whose many varied and distributed parts are integrated into a single, highly functional organized science data system. A distributed architecture was adopted to ensure discipline-specific support for the science data, while also leveraging standards and establishing policies and tools to enable interdisciplinary research, and analysis across multiple scientific instruments. The EOSDIS is composed of system elements such as geographically distributed archive centers used to manage the stewardship of data. The infrastructure consists of underlying capabilities connections that enable the primary system elements to function together. For example, one key infrastructure component is the common metadata repository, which enables discovery of all data within the EOSDIS system. EOSDIS employs processes and standards to ensure partners can work together effectively, and provide coherent services to users.

Space Nuclear Power Systems

NASA Technical Reports Server (NTRS)

Houts, Michael G.

2012-01-01

Fission power and propulsion systems can enable exciting space exploration missions. These include bases on the moon and Mars; and the exploration, development, and utilization of the solar system. In the near-term, fission surface power systems could provide abundant, constant, cost-effective power anywhere on the surface of the Moon or Mars, independent of available sunlight. Affordable access to Mars, the asteroid belt, or other destinations could be provided by nuclear thermal rockets. In the further term, high performance fission power supplies could enable both extremely high power levels on planetary surfaces and fission electric propulsion vehicles for rapid, efficient cargo and crew transfer. Advanced fission propulsion systems could eventually allow routine access to the entire solar system. Fission systems could also enable the utilization of resources within the solar system.

Using mathematics to solve real world problems: the role of enablers

NASA Astrophysics Data System (ADS)

Geiger, Vincent; Stillman, Gloria; Brown, Jill; Galbriath, Peter; Niss, Mogens

2018-03-01

The purpose of this article is to report on a newly funded research project in which we will investigate how secondary students apply mathematical modelling to effectively address real world situations. Through this study, we will identify factors, mathematical, cognitive, social and environmental that "enable" year 10/11 students to successfully begin the modelling process, that is, formulate and mathematise a real world problem. The 3-year study will take a design research approach in working intensively with six schools across two educational jurisdictions. It is anticipated that this research will generate new theoretical and practical insights into the role of "enablers" within the process of mathematisation, leading to the development of principles for the design and implementation for tasks that support students' development as modellers.

Exogenous Attention Enables Perceptual Learning

PubMed Central

Szpiro, Sarit F. A.; Carrasco, Marisa

2015-01-01

Practice can improve visual perception, and these improvements are considered to be a form of brain plasticity. Training-induced learning is time-consuming and requires hundreds of trials across multiple days. The process of learning acquisition is understudied. Can learning acquisition be potentiated by manipulating visual attentional cues? We developed a protocol in which we used task-irrelevant cues for between-groups manipulation of attention during training. We found that training with exogenous attention can enable the acquisition of learning. Remarkably, this learning was maintained even when observers were subsequently tested under neutral conditions, which indicates that a change in perception was involved. Our study is the first to isolate the effects of exogenous attention and to demonstrate its efficacy to enable learning. We propose that exogenous attention boosts perceptual learning by enhancing stimulus encoding. PMID:26502745

The Multigroup Multilevel Categorical Latent Growth Curve Models

ERIC Educational Resources Information Center

Hung, Lai-Fa

2010-01-01

Longitudinal data describe developmental patterns and enable predictions of individual changes beyond sampled time points. Major methodological issues in longitudinal data include modeling random effects, subject effects, growth curve parameters, and autoregressive residuals. This study embedded the longitudinal model within a multigroup…

Effectiveness of a multidisciplinary risk assessment and management programme-diabetes mellitus (RAMP-DM) on patient-reported outcomes.

PubMed

Wan, Eric Yuk Fai; Fung, Colman Siu Cheung; Wong, Carlos King Ho; Choi, Edmond Pui Hang; Jiao, Fang Fang; Chan, Anca Ka Chun; Chan, Karina Hiu Yen; Lam, Cindy Lo Kuen

2017-02-01

Little is known about how the patient-reported outcomes is influenced by multidisciplinary-risk-assessment-and-management-programme for patients with diabetes mellitus (RAMP-DM). This paper aims to evaluate the effectiveness of RAMP-DM on patient-reported outcomes. This was a prospective longitudinal study on 1039 diabetes mellitus patients (714/325 RAMP-DM/non-RAMP-DM) managed in primary care setting. 536 and 402 RAMP-DM participants, and 237 and 187 non-RAMP-DM participants were followed up at 12 and 24 months with completed survey, respectively. Patient-reported outcomes included health-related quality of life, change in global health condition and patient enablement measured by Short Form-12 Health Survey version-2 (SF-12v2), Global Rating Scale, Patient Enablement Instrument respectively. The effects of RAMP-DM on patient-reported outcomes were evaluated by mixed effect models. Subgroup analysis was performed by stratifying haemoglobin A1c (HbA1c) (optimal HbA1c < 7 % and suboptimal HbA1c ≥ 7 %). RAMP-DM with suboptimal HbA1c was associated with greater improvement in SF-12v2 physical component summary score at 12-month (coefficient:3.80; P-value < 0.05) and 24-month (coefficient:3.82;P-value < 0.05), more likely to feel more enabled at 12-month (odds ratio: 2.57; P-value < 0.05), and have improved in GRS at 24-month (odds ratio:4.05; P-value < 0.05) compared to non-RAMP-DM participants. However, there was no significant difference in patient-reported outcomes between RAMP-DM and non-RAMP-DM participants with optimal HbA1c. Participation in RAMP-DM is effective in improving physical component of HRQOL, Global Rating Scale and patient enablement among diabetes mellitus patients with suboptimal HbA1c, but not in those with optimal HbA1c. Patients with sub-optimal diabetes mellitus control should be the priority target population for RAMP-DM. This observational study design may have potential bias in the characteristics between groups, and randomized clinical trial is needed to confirm the results.

A federated semantic metadata registry framework for enabling interoperability across clinical research and care domains.

PubMed

Sinaci, A Anil; Laleci Erturkmen, Gokce B

2013-10-01

In order to enable secondary use of Electronic Health Records (EHRs) by bridging the interoperability gap between clinical care and research domains, in this paper, a unified methodology and the supporting framework is introduced which brings together the power of metadata registries (MDR) and semantic web technologies. We introduce a federated semantic metadata registry framework by extending the ISO/IEC 11179 standard, and enable integration of data element registries through Linked Open Data (LOD) principles where each Common Data Element (CDE) can be uniquely referenced, queried and processed to enable the syntactic and semantic interoperability. Each CDE and their components are maintained as LOD resources enabling semantic links with other CDEs, terminology systems and with implementation dependent content models; hence facilitating semantic search, much effective reuse and semantic interoperability across different application domains. There are several important efforts addressing the semantic interoperability in healthcare domain such as IHE DEX profile proposal, CDISC SHARE and CDISC2RDF. Our architecture complements these by providing a framework to interlink existing data element registries and repositories for multiplying their potential for semantic interoperability to a greater extent. Open source implementation of the federated semantic MDR framework presented in this paper is the core of the semantic interoperability layer of the SALUS project which enables the execution of the post marketing safety analysis studies on top of existing EHR systems. Copyright © 2013 Elsevier Inc. All rights reserved.

Translating a US Early Palliative Care Model for Turkey and Singapore.

PubMed

Akyar, Imatullah; Dionne-Odom, James N; Yang, Grace Meijuan; Bakitas, Marie A

2018-01-01

The field of palliative care is growing in acceptance and sophistication globally. No longer considered just for patients at end-of-life, palliative care is now being incorporated early in the disease trajectory. Despite professional guidelines supporting early palliative care, there are few models that have been created that can be translated into practice cross-culturally. In the United States, the Educate, Nurture, Advise, Before, Life Ends (ENABLE) early palliative care telehealth model has demonstrated effectiveness in improving quality of life, mood, symptom relief, and survival for patients with cancer and is now being tested in patients with heart failure. Family caregivers of patients who have received ENABLE concurrent with their care recipients have also demonstrated positive outcomes in quality of life and caregiver burden. Internationally, a number of investigators are culturally adapting ENABLE for patients and family caregivers. While some elements of ENABLE, such as symptom management and self-care, and the caregiving role are relevant cross-culturally, others have been built on Western principles of self-determination or represent concepts such as advance care planning which will require more cultural adaptation. In addition, ENABLE was initially an in-person approach that was converted to telehealth to accommodate a rural population-it will be important to understand cultural norms related to receiving care by phone or if an in-person approach will be more culturally acceptable. This paper describes efforts in Turkey and Singapore to culturally adapt the ENABLE early palliative care principles for their countries.

Translating a US Early Palliative Care Model for Turkey and Singapore

PubMed Central

Akyar, Imatullah; Dionne-Odom, James N.; Yang, Grace Meijuan; Bakitas, Marie A.

2018-01-01

The field of palliative care is growing in acceptance and sophistication globally. No longer considered just for patients at end-of-life, palliative care is now being incorporated early in the disease trajectory. Despite professional guidelines supporting early palliative care, there are few models that have been created that can be translated into practice cross-culturally. In the United States, the Educate, Nurture, Advise, Before, Life Ends (ENABLE) early palliative care telehealth model has demonstrated effectiveness in improving quality of life, mood, symptom relief, and survival for patients with cancer and is now being tested in patients with heart failure. Family caregivers of patients who have received ENABLE concurrent with their care recipients have also demonstrated positive outcomes in quality of life and caregiver burden. Internationally, a number of investigators are culturally adapting ENABLE for patients and family caregivers. While some elements of ENABLE, such as symptom management and self-care, and the caregiving role are relevant cross-culturally, others have been built on Western principles of self-determination or represent concepts such as advance care planning which will require more cultural adaptation. In addition, ENABLE was initially an in-person approach that was converted to telehealth to accommodate a rural population-it will be important to understand cultural norms related to receiving care by phone or if an in-person approach will be more culturally acceptable. This paper describes efforts in Turkey and Singapore to culturally adapt the ENABLE early palliative care principles for their countries. PMID:29379831

Optimizing health information technology's role in enabling comparative effectiveness research.

PubMed

Navathe, Amol S; Conway, Patrick H

2010-12-01

Health information technology (IT) is a key enabler of comparative effectiveness research (CER). Health IT standards for data sharing are essential to advancing the research data infrastructure, and health IT is critical to the next step of incorporating clinical data into data sources. Four key principles for advancement of CER are (1) utilization of data as a strategic asset, (2) leveraging public-private partnerships, (3) building robust, scalable technology platforms, and (4) coordination of activities across government agencies. To maximize the value of the resources, payers and providers must contribute data to initiatives, engage with government agencies on lessons learned, continue to develop new technologies that address key challenges, and utilize the data to improve patient outcomes and conduct research.

Nuclear magnetic resonance (NMR) study of the effect of cisplatin on the metabolic profile of MG-63 osteosarcoma cells.

PubMed

Duarte, Iola F; Lamego, Ines; Marques, Joana; Marques, M Paula M; Blaise, Benjamin J; Gil, Ana M

2010-11-05

In the present study, (1)H HRMAS NMR spectroscopy was used to assess the changes in the intracellular metabolic profile of MG-63 human osteosarcoma (OS) cells induced by the chemotherapy agent cisplatin (CDDP) at different times of exposure. Multivariate analysis was applied to the cells spectra, enabling consistent variation patterns to be detected and drug-specific metabolic effects to be identified. Statistical recoupling of variables (SRV) analysis and spectral integration enabled the most relevant spectral changes to be evaluated, revealing significant time-dependent alterations in lipids, choline-containing compounds, some amino acids, polyalcohols, and nitrogenated bases. The metabolic relevance of these compounds in the response of MG-63 cells to CDDP treatment is discussed.

Modulation-doped β-(Al0.2Ga0.8)2O3/Ga2O3 field-effect transistor

NASA Astrophysics Data System (ADS)

Krishnamoorthy, Sriram; Xia, Zhanbo; Joishi, Chandan; Zhang, Yuewei; McGlone, Joe; Johnson, Jared; Brenner, Mark; Arehart, Aaron R.; Hwang, Jinwoo; Lodha, Saurabh; Rajan, Siddharth

2017-07-01

Modulation-doped heterostructures are a key enabler for realizing high mobility and better scaling properties for high performance transistors. We report the realization of a modulation-doped two-dimensional electron gas (2DEG) at the β-(Al0.2Ga0.8)2O3/Ga2O3 heterojunction by silicon delta doping. The formation of a 2DEG was confirmed using capacitance voltage measurements. A modulation-doped 2DEG channel was used to realize a modulation-doped field-effect transistor. The demonstration of modulation doping in the β-(Al0.2Ga0.8)2O3/Ga2O3 material system could enable heterojunction devices for high performance electronics.

Signal-processing analysis of the MC2823 radar fuze: an addendum concerning clutter effects

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

Jelinek, D.A.

1978-07-01

A detailed analysis of the signal processing of the MC2823 radar fuze was published by Thompson in 1976 which enabled the computation of dud probability versus signal-to-noise ratio where the noise was receiver noise. An addendum to Thompson's work was published by Williams in 1978 that modified the weighting function used by Thompson. The analysis presented herein extends the work of Thompson to include the effects of clutter (the non-signal portion of the echo from a terrain) using the new weighting function. This extension enables computation of dud probability versus signal-to-total-noise ratio where total noise is the sum of themore » receiver-noise power and the clutter power.« less

Governing for the Common Good.

PubMed

Ruger, Jennifer Prah

2015-12-01

The proper object of global health governance (GHG) should be the common good, ensuring that all people have the opportunity to flourish. A well-organized global society that promotes the common good is to everyone's advantage. Enabling people to flourish includes enabling their ability to be healthy. Thus, we must assess health governance by its effectiveness in enhancing health capabilities. Current GHG fails to support human flourishing, diminishes health capabilities and thus does not serve the common good. The provincial globalism theory of health governance proposes a Global Health Constitution and an accompanying Global Institute of Health and Medicine that together propose to transform health governance. Multiple lines of empirical research suggest that these institutions would be effective, offering the most promising path to a healthier, more just world.

Three-Dimensional Printing of Nanomaterial Scaffolds for Complex Tissue Regeneration

PubMed Central

O'Brien, Christopher M.; Holmes, Benjamin; Faucett, Scott

2015-01-01

Three-dimensional (3D) printing has recently expanded in popularity, and become the cutting edge of tissue engineering research. A growing emphasis from clinicians on patient-specific care, coupled with an increasing knowledge of cellular and biomaterial interaction, has led researchers to explore new methods that enable the greatest possible control over the arrangement of cells and bioactive nanomaterials in defined scaffold geometries. In this light, the cutting edge technology of 3D printing also enables researchers to more effectively compose multi-material and cell-laden scaffolds with less effort. In this review, we explore the current state of 3D printing with a focus on printing of nanomaterials and their effect on various complex tissue regeneration applications. PMID:25084122

Interface-Located Photothermoelectric Effect of Organic Thermoelectric Materials in Enabling NIR Detection.

PubMed

Huang, Dazhen; Zou, Ye; Jiao, Fei; Zhang, Fengjiao; Zang, Yaping; Di, Chong-an; Xu, Wei; Zhu, Daoben

2015-05-06

Organic photothermoelectric (PTE) materials are promising candidates for various photodetection applications. Herein, we report on poly[Cux(Cu-ett)]:PVDF, which is an excellent polymeric thermoelectric composite, possesses unprecedented PTE properties. The NIR light irradiation on the poly[Cu(x)(Cu-ett)]:PVDF film could induce obvious enhancement in Seebeck coefficient from 52 ± 1.5 to 79 ± 5.0 μV/K. By taking advantage of prominent photothermoelectric effect of poly[Cu(x)(Cu-ett)]:PVDF, an unprecedented voltage of 12 mV was obtained. This excellent performance enables its promising applications in electricity generation from solar energy and NIR detection to a wide range of light intensities ranging from 1.7 mW/cm(2) to 17 W/cm(2).

Wernicke-Korsakoff syndrome: recognition and treatment.

PubMed

Donnelly, Alexander

2017-03-29

Wernicke-Korsakoff syndrome is a potentially debilitating and fatal condition that is caused by thiamine (vitamin B1) deficiency in the brain. It can be treated effectively or prevented completely; however, the condition is often undiagnosed and inadequately managed. Wernicke-Korsakoff syndrome is commonly considered to be specific to individuals who misuse alcohol; however, there are many other predisposing factors and causes associated with the condition. This article aims to raise awareness of Wernicke-Korsakoff syndrome, to enable nurses in all practice settings to recognise the signs, symptoms and risk factors associated with the condition and be informed about available treatments. Increased awareness aims to improve early diagnosis of the condition, enabling effective treatment and improving patients' symptoms, such as cognitive impairment.

Plasmon resonance enhanced multicolour photodetection by graphene

PubMed Central

Liu, Yuan; Cheng, Rui; Liao, Lei; Zhou, Hailong; Bai, Jingwei; Liu, Gang; Liu, Lixin; Huang, Yu; Duan, Xiangfeng

2012-01-01

Graphene has the potential for high-speed, wide-band photodetection, but only with very low external quantum efficiency and no spectral selectivity. Here we report a dramatic enhancement of the overall quantum efficiency and spectral selectivity that enables multicolour photodetection, by coupling graphene with plasmonic nanostructures. We show that metallic plasmonic nanostructures can be integrated with graphene photodetectors to greatly enhance the photocurrent and external quantum efficiency by up to 1,500%. Plasmonic nanostructures of variable resonance frequencies selectively amplify the photoresponse of graphene to light of different wavelengths, enabling highly specific detection of multicolours. Being atomically thin, graphene photodetectors effectively exploit the local plasmonic enhancement effect to achieve a significant enhancement factor not normally possible with traditional planar semiconductor materials. PMID:22146398

Enhancing Transfer Effectiveness: A Model for the 1990's. First Year Report to the National Effective Transfer Consortium. Executive Summary.

ERIC Educational Resources Information Center

Berman, Paul; And Others

This first-year report of the National Effective Transfer Consortium (NETC) summarizes the progress made by the member colleges in creating standardized measures of actual and expected transfer rates and of transfer effectiveness, and establishing a database that would enable valid comparisons among NETC colleges. Following background information…

Robotics to Enable Older Adults to Remain Living at Home

PubMed Central

Pearce, Alan J.; Adair, Brooke; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E.

2012-01-01

Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving. PMID:23304507

Small-bowel capsule endoscopy: A ten-point contemporary review

PubMed Central

Koulaouzidis, Anastasios; Rondonotti, Emanuele; Karargyris, Alexandros

2013-01-01

The introduction of capsule endoscopy (CE) in clinical practice increased the interest for the study of the small-bowel. Consequently, in about 10 years, an impressive quantity of literature on indications, diagnostic yield (DY), safety profile and technical evolution of CE has been published as well as several reviews. At present time, there are 5 small-bowel capsule enteroscopy (SBCE) models in the worldwide market. Head-to-head trials have showed in the great majority of studies comparable results in terms of DY, image quality and completion rate. CE meta-analyses formed the basis of national/international guidelines; these guidelines place CE in a prime position for the diagnostic work-up of patients with obscure gastrointestinal bleeding, known and/or suspected Crohn’s disease and possible small-bowel neoplasia. A 2-L polyethylene glycol-based purge, administered the day before the procedure, is the most widely practiced preparation regimen. Whether this regimen can be further improved (i.e., by further decreasing its volume, changing the timing of administration, coupling it with prokinetics and/or other factors) or if it can really affect the DY, is still under discussion. Faecal calprotectin has been used in SBCE studies in two settings: in patients taking non-steroidal anti-inflammatory drugs, to evaluate the type and extent of mucosal damage and, more importantly from a clinical point of view, in patients with known or suspected Crohn’s disease for assessment of inflammation activity. Although there is still a lot of debate around the exact reasons of SBCE poor performance in various small-bowel segments, it is worth to remember that the capsule progress is non-steerable, hence more rapid in the proximal than in lower segments of the small-bowel. Capsule aspiration, a relatively unexpected complication, has been reported with increasing frequency. This is probably related with the increase in the mean age of patients undergoing CE. CE video review is a time-consuming procedure. Therefore, several attempts have been made to develop technical software features, in order to make CE video analysis easier and shorter (without jeopardizing its accuracy). Suspected Blood Indicator, QuickView and Fujinon Intelligent Chromo Endoscopy are some of the software tools that have been checked in various clinical studies to date. PMID:23840112

Dissociation of Down syndrome and Alzheimer's disease effects with imaging.

PubMed

Matthews, Dawn C; Lukic, Ana S; Andrews, Randolph D; Marendic, Boris; Brewer, James; Rissman, Robert A; Mosconi, Lisa; Strother, Stephen C; Wernick, Miles N; Mobley, William C; Ness, Seth; Schmidt, Mark E; Rafii, Michael S

2016-06-01

Down Syndrome (DS) adults experience accumulation of Alzheimer's disease (AD)-like amyloid plaques and tangles and a high incidence of dementia and could provide an enriched population to study AD-targeted treatments. However, to evaluate effects of therapeutic intervention, it is necessary to dissociate the contributions of DS and AD from overall phenotype. Imaging biomarkers offer the potential to characterize and stratify patients who will worsen clinically but have yielded mixed findings in DS subjects. We evaluated 18F fluorodeoxyglucose positron emission tomography (PET), florbetapir PET, and structural magnetic resonance (sMR) image data from 12 nondemented DS adults using advanced multivariate machine learning methods. Our results showed distinctive patterns of glucose metabolism and brain volume enabling dissociation of DS and AD effects. AD-like pattern expression corresponded to amyloid burden and clinical measures. These findings lay groundwork to enable AD clinical trials with characterization and disease-specific tracking of DS adults.

Effect of threshold disorder on the quorum percolation model

NASA Astrophysics Data System (ADS)

Monceau, Pascal; Renault, Renaud; Métens, Stéphane; Bottani, Samuel

2016-07-01

We study the modifications induced in the behavior of the quorum percolation model on neural networks with Gaussian in-degree by taking into account an uncorrelated Gaussian thresholds variability. We derive a mean-field approach and show its relevance by carrying out explicit Monte Carlo simulations. It turns out that such a disorder shifts the position of the percolation transition, impacts the size of the giant cluster, and can even destroy the transition. Moreover, we highlight the occurrence of disorder independent fixed points above the quorum critical value. The mean-field approach enables us to interpret these effects in terms of activation probability. A finite-size analysis enables us to show that the order parameter is weakly self-averaging with an exponent independent on the thresholds disorder. Last, we show that the effects of the thresholds and connectivity disorders cannot be easily discriminated from the measured averaged physical quantities.

A Surgical Device to Study the Efficacy of Bioengineered Skin Substitutes in Mice Wound Healing Models.

PubMed

Jeschke, Marc G; Sadri, Ali-Reza; Belo, Cassandra; Amini-Nik, Saeid

2017-04-01

Due to the poor regenerative capacity of adult mammalian skin, there is a need to develop effective skin substitutes for promoting skin regeneration after a severe wound. However, the complexity of skin biology has made it difficult to enable perfect regeneration of skin. Thus, animal models are being used to test potential skin substitutes. Murine models are valuable but their healing process involves dermal contraction. We have developed a device called a dome that is able to eliminate the contraction effect of rodent skin while simultaneously housing a bioengineered skin graft. The dome comes in two models, which enables researchers to evaluate the cells that contribute in wound healing from neighboring intact tissue during skin healing/regeneration. This protocol simplifies grafting of skin substitutes, eliminates the contraction effect of surrounding skin, and summarizes a simple method for animal surgery for wound healing and skin regeneration studies.

The AMERE project: Enabling real-time detection of radiation effects in individual cells in deep space

NASA Astrophysics Data System (ADS)

De Vos, Winnok H.; Meesen, Geert; Szpirer, Cedric; Scohy, Sophie; Cherukuri, Chaitanya; Evrard, Olivier; Hutsebaut, Xavier; Beghuin, Didier

2012-12-01

A major concern for long-term deep space missions is the detrimental impact of cosmic radiation on human health. Especially the presence of high-energy particles of high atomic mass (HZE) represents a serious threat. To contribute to a fundamental understanding of space radiation effects and to help improving risk assessment for humans on the Moon, the ESA Lunar Lander mission model payload includes a package dedicated to cell-based radiobiology experiments in the form of an Autonomous Microscope for Examination of Radiation Effects (AMERE). The purpose of this setup is to enable real-time visualization of DNA damage repair in living cells after traversal of HZE particles on the Moon. To assess the feasibility of this challenging experiment, we have analysed the biological and technological demands. In this article, we discuss the experimental concept, the biological considerations and describe the implications for system design.

Active intestinal drug absorption and the solubility-permeability interplay.

PubMed

Porat, Daniel; Dahan, Arik

2018-02-15

The solubility-permeability interplay deals with the question: what is the concomitant effect on the drug's apparent permeability when increasing the apparent solubility with a solubility-enabling formulation? The solubility and the permeability are closely related, exhibit certain interplay between them, and ongoing research throughout the past decade shows that treating the one irrespectively of the other may be insufficient. The aim of this article is to provide an overview of the current knowledge on the solubility-permeability interplay when using solubility-enabling formulations for oral lipophilic drugs, highlighting active permeability aspects. A solubility-enabling formulation may affect the permeability in opposite directions; the passive permeability may decrease as a result of the apparent solubility increase, according to the solubility-permeability tradeoff, but at the same time, certain components of the formulation may inhibit/saturate efflux transporters (when relevant), resulting in significant apparent permeability increase. In these cases, excipients with both solubilizing and e.g. P-gp inhibitory properties may lead to concomitant increase of both the solubility and the permeability. Intelligent development of such formulation will account for the simultaneous effects of the excipients' nature/concentrations on the two arms composing the overall permeability: the passive and the active arms. Overall, thorough mechanistic understanding of the various factors involved in the solubility-permeability interplay may allow developing better solubility-enabling formulations, thereby exploiting the advantages analyzed in this article, offering oral delivery solution even for BCS class IV drugs. Copyright © 2017 Elsevier B.V. All rights reserved.

Free and open source enabling technologies for patient-centric, guideline-based clinical decision support: a survey.

PubMed

Leong, T Y; Kaiser, K; Miksch, S

2007-01-01

Guideline-based clinical decision support is an emerging paradigm to help reduce error, lower cost, and improve quality in evidence-based medicine. The free and open source (FOS) approach is a promising alternative for delivering cost-effective information technology (IT) solutions in health care. In this paper, we survey the current FOS enabling technologies for patient-centric, guideline-based care, and discuss the current trends and future directions of their role in clinical decision support. We searched PubMed, major biomedical informatics websites, and the web in general for papers and links related to FOS health care IT systems. We also relied on our background and knowledge for specific subtopics. We focused on the functionalities of guideline modeling tools, and briefly examined the supporting technologies for terminology, data exchange and electronic health record (EHR) standards. To effectively support patient-centric, guideline-based care, the computerized guidelines and protocols need to be integrated with existing clinical information systems or EHRs. Technologies that enable such integration should be accessible, interoperable, and scalable. A plethora of FOS tools and techniques for supporting different knowledge management and quality assurance tasks involved are available. Many challenges, however, remain in their implementation. There are active and growing trends of deploying FOS enabling technologies for integrating clinical guidelines, protocols, and pathways into the main care processes. The continuing development and maturation of such technologies are likely to make increasingly significant contributions to patient-centric, guideline-based clinical decision support.

Fusion Teaching: Utilizing Course Management Technology to Deliver an Effective Multimodal Pedagogy

ERIC Educational Resources Information Center

Childs, Bradley D.; Cochran, Howard H.; Velikova, Marieta

2013-01-01

Fusion teaching merges several pedagogies into a coherent whole. Course management technology allows for the digitization and delivery of pedagogies in an effective and exciting manner. Online course management options more easily enable outcome assessment and monitoring for continuous improvement.

Vocabulary Levels and Size of Malaysian Undergraduates

ERIC Educational Resources Information Center

Harji, Madhubala Bava; Balakrishnan, Kavitha; Bhar, Sareen Kaur; Letchumanan, Krishnaveni

2015-01-01

Vocabulary is a fundamental requirement of language acquisition, and its competence enables independent reading and effective language acquisition. Effective language use requires adequate level of vocabulary knowledge; therefore, efforts must be made to identify students' vocabulary base for greater efficiency and competency in the language.…

75 FR 373 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... Request; Experimental Study: Presentation of Quantitative Effectiveness Information to Consumers in Direct... clearance. Experimental Study: Presentation of Quantitative Effectiveness Information to Consumers in Direct... research has proposed that providing quantitative information about product efficacy enables consumers to...

Migraine Management During Menstruation and Menopause.

PubMed

MacGregor, E Anne

2015-08-01

Migraine is most prevalent in women during their reproductive years. An understanding of the effects of menstruation and menopause on migraine can enable neurologists to provide targeted and appropriate medical and hormonal strategies, enabling their patients to achieve better control of migraine and reduced disability. This article reviews the effects of hormonal events on migraine and summarizes the evidence-based options available for management. Estrogen "withdrawal" during the late luteal phase of the natural menstrual cycle and the hormone-free interval of combined hormonal contraceptives has long been implicated in the pathophysiology of menstrual migraine. However, more recent research suggests that other independent mechanisms may be relevant. Prostaglandin inhibitors used for management of dysmenorrhea are effective for associated menstrual migraine, suggesting a common pathophysiology. The interplay between serotonin and estrogen also deserves further research. Menstrual and perimenopausal migraine can be managed effectively using a variety of strategies, the choice of which depends on the efficacy of acute treatment, predictability and regularity of menstruation, use of contraception, and presence of menstrual disorders or perimenopausal vasomotor symptoms.

Next Generation X-Ray Optics: High-Resolution, Light-Weight, and Low-Cost

NASA Technical Reports Server (NTRS)

Zhang, William W.

2012-01-01

X-ray telescopes are essential to the future of x-ray astronomy. In this talk I will describe a comprehensive program to advance the technology for x-ray telescopes well beyond the state of the art represented by the three currently operating missions: Chandra, XMM-Newton, and Suzaku. This program will address the three key issues in making an x-ray telescope: (1) angular resolution, (2) effective area per unit mass, and (3) cost per unit effective area. The objectives of this technology program are (1) in the near term, to enable Explorer-class x-ray missions and an IXO-type mission, and (2) in the long term, to enable a flagship x-ray mission with sub-arcsecond angular resolution and multi-square-meter effective area, at an affordable cost. We pursue two approaches concurrently, emphasizing the first approach in the near term (2-5 years) and the second in the long term (4-10 years). The first approach is precision slumping of borosilicate glass sheets. By design and choice at the outset, this technique makes lightweight and low-cost mirrors. The development program will continue to improve angular resolution, to enable the production of 5-arcsecond x-ray telescopes, to support Explorer-class missions and one or more missions to supersede the original IXO mission. The second approach is precision polishing and light-weighting of single-crystal silicon mirrors. This approach benefits from two recent commercial developments: (1) the inexpensive and abundant availability of large blocks of monocrystalline silicon, and (2) revolutionary advances in deterministic, precision polishing of mirrors. By design and choice at the outset, this technique is capable of producing lightweight mirrors with sub-arcsecond angular resolution. The development program will increase the efficiency and reduce the cost of the polishing and the light-weighting processes, to enable the production of lightweight sub-arcsecond x-ray telescopes. Concurrent with the fabrication of lightweight mirror segments is the continued development and perfection of alignment and integration techniques, for incorporating individual mirror segments into a precision mirror assembly. Recently, we have been developing a technique called edge-bonding, which has achieved an accuracy to enable 10-arcsecond x-ray telescopes. Currently, we are investigating and improving the long-term alignment stability of so-bonded mirrors. Next, we shall refine this process to enable 5-arsecond x-ray telescopes. This technology development program includes all elements to demonstrate progress toward TRL-6: metrology; x-ray performance tests; coupled structural, thermal, and optical performance analysis, and environmental testing.

Next Generation X-Ray Optics: High-Resolution, Light-Weight, and Low-Cost

NASA Technical Reports Server (NTRS)

Zhang, William W.

2011-01-01

X-ray telescopes are essential to the future of x-ray astronomy. This paper describes a comprehensive program to advance the technology for x-ray telescopes well beyond the state of the art represented by the three currently operating missions: Chandra, XMM-Newton , and Suzaku . This program will address the three key issues in making an x-ray telescope: (I) angular resolution, (2) effective area per unit mass, and (3) cost per unit effective area. The objectives of this technology program are (1) in the near term, to enable Explorer-class x-ray missions and an IXO type mission, and (2) in the long term, to enable a flagship x-ray mission with sub-arcsecond angular resolution and multi-square-meter effective area, at an affordable cost. We pursue two approaches concurrently, emphasizing the first approach in the near term (2-5 years) and the second in the long term (4-10 years). The first approach is precision slumping of borosilicate glass sheets. By design and choice at the outset, this technique makes lightweight and low-cost mirrors. The development program will continue to improve angular resolution, to enable the production of 5-arcsecond x-ray telescopes, to support Explorer-class missions and one or more missions to supersede the original IXO mission. The second approach is precision polishing and light-weighting of single-crystal silicon mirrors. This approach benefits from two recent commercial developments: (1) the inexpensive and abundant availability of large blocks of mono crystalline silicon, and (2) revolutionary advances in deterministic, precision polishing of mirrors. By design and choice at the outset, this technique is capable of producing lightweight mirrors with sub-arcsecond angular resolution. The development program will increase the efficiency and reduce the cost of the polishing and the lightweighting processes, to enable the production of lightweight sub-arcsecond x-ray telescopes. Concurrent with the fabrication of lightweight mirror segments is the continued development and perfection of alignment and integration techniques, for incorporating individual mirror segments into a precision mirror assembly. Recently, we have been developing a technique called edge-bonding, which has achieved an accuracy to enable 10- arcsecond x-ray telescopes. Currently, we are investigating and improving the long-term alignment stability of so-bonded mirrors. Next, we shall refine this process to enable 5-arsecond x-ray telescopes. This technology development program includes all elements to demonstrate progress toward TRL-6: metrology; x-ray performance tests; coupled structural, thermal, and optical performance analysis, and environmental testing.

High Angular Resolution and Lightweight X-Ray Optics for Astronomical Missions

NASA Technical Reports Server (NTRS)

Zhang, W. W.; Biskach, M. P.; Blake, P. N.; Chan, K. W.; Evans, T. C.; Hong, M.; Jones, W. D.; Jones, W. D.; Kolos, L. D.; Mazzarella, J. M.;

A Measure of Systems Engineering Effectiveness in Government Acquisition of Complex Information Systems: A Bayesian Belief Network-Based Approach

ERIC Educational Resources Information Center

Doskey, Steven Craig

2014-01-01

This research presents an innovative means of gauging Systems Engineering effectiveness through a Systems Engineering Relative Effectiveness Index (SE REI) model. The SE REI model uses a Bayesian Belief Network to map causal relationships in government acquisitions of Complex Information Systems (CIS), enabling practitioners to identify and…

Building a Collaborative Governance System: A Comparative Case Analysis

DTIC Science & Technology

2015-06-01

additional resources. Bandwagon effects occur. As the process emerges and appears to be achieving success, more resources are attracted. Consensus...97 C. WHAT ARE THE ENABLERS AND BARRIERS TO EFFECTIVE COLLABORATION IN THIS CASE...seems as though the challenges are getting bigger as well as more frequent, across many disciplines.”1 Effective incident response requires command

Why and when hierarchy impacts team effectiveness: A meta-analytic integration.

PubMed

Greer, Lindred L; de Jong, Bart A; Schouten, Maartje E; Dannals, Jennifer E

2018-06-01

Hierarchy has the potential to both benefit and harm team effectiveness. In this article, we meta-analytically investigate different explanations for why and when hierarchy helps or hurts team effectiveness, drawing on results from 54 prior studies (N = 13,914 teams). Our findings show that, on net, hierarchy negatively impacts team effectiveness (performance: ρ = -.08; viability: ρ = -.11), and that this effect is mediated by increased conflict-enabling states. Additionally, we show that the negative relationship between hierarchy and team performance is exacerbated by aspects of the team structure (i.e., membership instability, skill differentiation) and the hierarchy itself (i.e., mutability), which make hierarchical teams prone to conflict. The predictions regarding the positive effect of hierarchy on team performance as mediated by coordination-enabling processes, and the moderating roles of several aspects of team tasks (i.e., interdependence, complexity) and the hierarchy (i.e., form) were not supported, with the exception that task ambiguity enhanced the positive effects of hierarchy. Given that our findings largely support dysfunctional views on hierarchy, future research is needed to understand when and why hierarchy may be more likely to live up to its purported functional benefits. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Evaluating the Flipped Classroom: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Wozny, Nathan; Balser, Cary; Ives, Drew

2018-01-01

Despite recent interest in flipped classrooms, rigorous research evaluating their effectiveness is sparse. In this study, the authors implement a randomized controlled trial to evaluate the effect of a flipped classroom technique relative to a traditional lecture in an introductory undergraduate econometrics course. Random assignment enables the…

Web-Based Project Portfolio Management Portal Success: A Quantitative Investigation

ERIC Educational Resources Information Center

Excellent, Frendy

2013-01-01

Due to its centralized content-sharing features, a project portfolio management (PPM) portal enables vertical, as well as horizontal, electronic exchanges between project professionals. Such exchanges, if effective, may deliver an individual impact through improved project performance. Effectiveness engenders use and satisfaction, reflecting the…

An Embedded Wireless Sensor Network with Wireless Power Transmission Capability for the Structural Health Monitoring of Reinforced Concrete Structures.

PubMed

Gallucci, Luca; Menna, Costantino; Angrisani, Leopoldo; Asprone, Domenico; Moriello, Rosario Schiano Lo; Bonavolontà, Francesco; Fabbrocino, Francesco

2017-11-07

Maintenance strategies based on structural health monitoring can provide effective support in the optimization of scheduled repair of existing structures, thus enabling their lifetime to be extended. With specific regard to reinforced concrete (RC) structures, the state of the art seems to still be lacking an efficient and cost-effective technique capable of monitoring material properties continuously over the lifetime of a structure. Current solutions can typically only measure the required mechanical variables in an indirect, but economic, manner, or directly, but expensively. Moreover, most of the proposed solutions can only be implemented by means of manual activation, making the monitoring very inefficient and then poorly supported. This paper proposes a structural health monitoring system based on a wireless sensor network (WSN) that enables the automatic monitoring of a complete structure. The network includes wireless distributed sensors embedded in the structure itself, and follows the monitoring-based maintenance (MBM) approach, with its ABCDE paradigm, namely: accuracy, benefit, compactness, durability, and easiness of operations. The system is structured in a node level and has a network architecture that enables all the node data to converge in a central unit. Human control is completely unnecessary until the periodic evaluation of the collected data. Several tests are conducted in order to characterize the system from a metrological point of view and assess its performance and effectiveness in real RC conditions.

Calcium Binding-Mediated Sustained Release of Minocycline from Hydrophilic Multilayer Coatings Targeting Infection and Inflammation

PubMed Central

Zhang, Zhiling; Nix, Camilla A.; Ercan, Utku K.; Gerstenhaber, Jonathan A.; Joshi, Suresh G.; Zhong, Yinghui

2014-01-01

Infection and inflammation are common complications that seriously affect the functionality and longevity of implanted medical implants. Systemic administration of antibiotics and anti-inflammatory drugs often cannot achieve sufficient local concentration to be effective, and elicits serious side effects. Local delivery of therapeutics from drug-eluting coatings presents a promising solution. However, hydrophobic and thick coatings are commonly used to ensure sufficient drug loading and sustained release, which may limit tissue integration and tissue device communications. A calcium-mediated drug delivery mechanism was developed and characterized in this study. This novel mechanism allows controlled, sustained release of minocycline, an effective antibiotic and anti-inflammatory drug, from nanoscale thin hydrophilic polyelectrolyte multilayers for over 35 days at physiologically relevant concentrations. pH-responsive minocycline release was observed as the chelation between minocycline and Ca2+ is less stable at acidic pH, enabling ‘smart’ drug delivery in response to infection and/or inflammation-induced tissue acidosis. The release kinetics of minocycline can be controlled by varying initial loading, Ca2+ concentration, and Ca2+ incorporation into different layers, enabling facile development of implant coatings with versatile release kinetics. This drug delivery platform can potentially be used for releasing any drug that has high Ca2+ binding affinity, enabling its use in a variety of biomedical applications. PMID:24409292

Vision Forward for NASA's Astrophysics Education Program

NASA Astrophysics Data System (ADS)

Hasan, Hashima; Sheth, Kartik J.

2016-01-01

NASA has recently re-structured its Science Education program with the competitive selection of twenty-seven programs. Of these, ~60% are relevant to Astrophysics, and three have primarily Astrophysics content. A brief overview of the rationale for re-structuring will be presented. We have taken a strategic approach, building on our science-discipline based legacy and looking at new approaches given Stakeholder priorities. We plan to achieve our education goals with the selection of organizations that utilize NASA data, products, or processes to meet NASA's education objectives; and by enabling our scientists and engineers with education professionals, tools, and processes to better meet user needs. Highlights of the selected programs will be presented, and how they enable the vision going forward of achieving the goal of enabling NASA scientists and engineers to engage more effectively with learners of all ages.

Exogenous Attention Enables Perceptual Learning.

PubMed

Szpiro, Sarit F A; Carrasco, Marisa

2015-12-01

Practice can improve visual perception, and these improvements are considered to be a form of brain plasticity. Training-induced learning is time-consuming and requires hundreds of trials across multiple days. The process of learning acquisition is understudied. Can learning acquisition be potentiated by manipulating visual attentional cues? We developed a protocol in which we used task-irrelevant cues for between-groups manipulation of attention during training. We found that training with exogenous attention can enable the acquisition of learning. Remarkably, this learning was maintained even when observers were subsequently tested under neutral conditions, which indicates that a change in perception was involved. Our study is the first to isolate the effects of exogenous attention and to demonstrate its efficacy to enable learning. We propose that exogenous attention boosts perceptual learning by enhancing stimulus encoding. © The Author(s) 2015.

Towards a comprehensive framework for reuse: A reuse-enabling software evolution environment

NASA Technical Reports Server (NTRS)

Basili, V. R.; Rombach, H. D.

1988-01-01

Reuse of products, processes and knowledge will be the key to enable the software industry to achieve the dramatic improvement in productivity and quality required to satisfy the anticipated growing demand. Although experience shows that certain kinds of reuse can be successful, general success has been elusive. A software life-cycle technology which allows broad and extensive reuse could provide the means to achieving the desired order-of-magnitude improvements. The scope of a comprehensive framework for understanding, planning, evaluating and motivating reuse practices and the necessary research activities is outlined. As a first step towards such a framework, a reuse-enabling software evolution environment model is introduced which provides a basis for the effective recording of experience, the generalization and tailoring of experience, the formalization of experience, and the (re-)use of experience.

Nuclear Energy for Space Exploration

NASA Technical Reports Server (NTRS)

Houts, Michael G.

2010-01-01

Nuclear power and propulsion systems can enable exciting space exploration missions. These include bases on the moon and Mars; and the exploration, development, and utilization of the solar system. In the near-term, fission surface power systems could provide abundant, constant, cost-effective power anywhere on the surface of the Moon or Mars, independent of available sunlight. Affordable access to Mars, the asteroid belt, or other destinations could be provided by nuclear thermal rockets. In the further term, high performance fission power supplies could enable both extremely high power levels on planetary surfaces and fission electric propulsion vehicles for rapid, efficient cargo and crew transfer. Advanced fission propulsion systems could eventually allow routine access to the entire solar system. Fission systems could also enable the utilization of resources within the solar system. Fusion and antimatter systems may also be viable in the future

Increasing the Capacity of Primary Care Through Enabling Technology.

PubMed

Young, Heather M; Nesbitt, Thomas S

2017-04-01

Primary care is the foundation of effective and high-quality health care. The role of primary care clinicians has expanded to encompass coordination of care across multiple providers and management of more patients with complex conditions. Enabling technology has the potential to expand the capacity for primary care clinicians to provide integrated, accessible care that channels expertise to the patient and brings specialty consultations into the primary care clinic. Furthermore, technology offers opportunities to engage patients in advancing their health through improved communication and enhanced self-management of chronic conditions. This paper describes enabling technologies in four domains (the body, the home, the community, and the primary care clinic) that can support the critical role primary care clinicians play in the health care system. It also identifies challenges to incorporating these technologies into primary care clinics, care processes, and workflow.

Color doppler in clinical cardiology

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

Duncan, W.J.

1987-01-01

A presentation of color doppler, which enables physicians to pinpoint problems and develop effective treatment. State-of-the-art illustrations and layout, with color images and explanatory text are included.

Rippled graphene in an in-plane magnetic field: effects of a random vector potential.

PubMed

Lundeberg, Mark B; Folk, Joshua A

2010-10-01

We report measurements of the effects of a random vector potential generated by applying an in-plane magnetic field to a graphene flake. Magnetic flux through the ripples cause orbital effects: Phase-coherent weak localization is suppressed, while quasirandom Lorentz forces lead to anisotropic magnetoresistance. Distinct signatures of these two effects enable the ripple size to be characterized.

Solar Electric Propulsion Technology Development for Electric Propulsion

NASA Technical Reports Server (NTRS)

Mercer, Carolyn R.; Kerslake, Thomas W.; Scheidegger, Robert J.; Woodworth, Andrew A.; Lauenstein, Jean-Marie

2015-01-01

NASA is developing technologies to prepare for human exploration missions to Mars. Solar electric propulsion (SEP) systems are expected to enable a new cost effective means to deliver cargo to the Mars surface. Nearer term missions to Mars moons or near-Earth asteroids can be used to both develop and demonstrate the needed technology for these future Mars missions while demonstrating new capabilities in their own right. This presentation discusses recent technology development accomplishments for high power, high voltage solar arrays and power management that enable a new class of SEP missions.

Prelithiation of silicon-carbon nanotube anodes for lithium ion batteries by stabilized lithium metal powder (SLMP).

PubMed

Forney, Michael W; Ganter, Matthew J; Staub, Jason W; Ridgley, Richard D; Landi, Brian J

2013-09-11

Stabilized lithium metal powder (SLMP) has been applied during battery assembly to effectively prelithiate high capacity (1500-2500 mAh/g) silicon-carbon nanotube (Si-CNT) anodes, eliminating the 20-40% first cycle irreversible capacity loss. Pressure-activation of SLMP is shown to enhance prelithiation and enable capacity matching between Si-CNT anodes and lithium nickel cobalt aluminum oxide (NCA) cathodes in full batteries with minimal added mass. The prelithiation approach enables high energy density NCA/Si-CNT batteries achieving >1000 cycles at 20% depth-of-discharge.

Nursing home quality of life: study of an enabling garden.

PubMed

Raske, Martha

2010-05-01

The purpose of this study was to conduct an in-depth evaluation of the impact of the construction and use of an enabling garden on resident quality of life in a rural nursing home. This qualitative study used interviews with residents, family members, staff members, and community volunteers who built the garden. Findings suggest the garden had positive effects on resident quality of life, particularly in terms of meaningful daily activities, enjoyment of daily life, resident relationships, and functional competency. Implications for research and practice are discussed.

Fission Technology for Exploring and Utilizing the Solar System

NASA Technical Reports Server (NTRS)

Houts, Mike; VanDyke, Melissa; Godfroy, Tom; Pedersen, Kevin; Martin, James; Dickens, Ricky; Salvail, Pat; Hrbub, Ivana; Schmidt, George R. (Technical Monitor)

2000-01-01

Fission technology can enable rapid, affordable access to any point in the solar system. Potential fission-based transportation options include bimodal nuclear thermal rockets, high specific energy propulsion systems, and pulsed fission propulsion systems. In-space propellant re-supply enhances the effective performance of all systems, but requires significant infrastructure development. Safe, timely, affordable utilization of first-generation space fission propulsion systems will enable the development of more advanced systems. First generation space systems will build on over 45 years of US and international space fission system technology development to minimize cost,

HMDs as enablers of situation awareness: the OODA loop and sense-making

NASA Astrophysics Data System (ADS)

Melzer, James E.

2012-06-01

Helmet-Mounted Displays have been shown to be powerful tools that can unlock the pilot from the interior of the cockpit or the forward line of sight of the Head-Up Display. Imagery that is presented in one of three reference frames can enable the pilots to do their job more effectively while simultaneously decreasing workload. This paper will review key attributes of Situation Awareness, the Observe/Orient/Decide/Act (OODA) Loop and Sensemaking and how HMDs can aid the pilot in achieving these ideal cognitive states.

System and method to allow a synchronous motor to successfully synchronize with loads that have high inertia and/or high torque

DOEpatents

Melfi, Michael J.

2015-10-20

A mechanical soft-start type coupling is used as an interface between a line start, synchronous motor and a heavy load to enable the synchronous motor to bring the heavy load up to or near synchronous speed. The soft-start coupling effectively isolates the synchronous motor from the load for enough time to enable the synchronous motor to come up to full speed. The soft-start coupling then brings the load up to or near synchronous speed.

Injection-controlled laser resonator

DOEpatents

Chang, J.J.

1995-07-18

A new injection-controlled laser resonator incorporates self-filtering and self-imaging characteristics with an efficient injection scheme. A low-divergence laser signal is injected into the resonator, which enables the injection signal to be converted to the desired resonator modes before the main laser pulse starts. This injection technique and resonator design enable the laser cavity to improve the quality of the injection signal through self-filtering before the main laser pulse starts. The self-imaging property of the present resonator reduces the cavity induced diffraction effects and, in turn, improves the laser beam quality. 5 figs.

Injection-controlled laser resonator

DOEpatents

Chang, Jim J.

1995-07-18

A new injection-controlled laser resonator incorporates self-filtering and self-imaging characteristics with an efficient injection scheme. A low-divergence laser signal is injected into the resonator, which enables the injection signal to be converted to the desired resonator modes before the main laser pulse starts. This injection technique and resonator design enable the laser cavity to improve the quality of the injection signal through self-filtering before the main laser pulse starts. The self-imaging property of the present resonator reduces the cavity induced diffraction effects and, in turn, improves the laser beam quality.

Managing Stigma: Disclosure-Response Communication Patterns in Pro-Anorexic Websites.

PubMed

Chang, Pamara F; Bazarova, Natalya N

2016-01-01

Pro-anorexic websites are a popular online venue for individuals with anorexia, but recent research suggests that they play a role of "online negative enabling support groups" because they can undermine recovery and encourage negative behaviors by validating pro-anorexic views. By analyzing 22,811 messages from 5,590 conversations from the Pro-Ana Nation online discussion board forum, this study examines communicative mechanisms of online negative enabling support through language analysis of disclosure-response sequences, changes in the language of the initial discloser within an interaction exchange, and the role of responses in eliciting those changes. The findings show that initiating disclosures containing stigma-related emotion words, anorexia-specific content, and sociorelational content are typically met with negatively valenced responses from other members of the pro-anorexic community. Moreover, although the act of revealing stigmatized information has some cathartic effects, disclosers use more, not fewer, stigma-related emotion words when they receive negatively valenced responses. These results provide insight into communicative dynamics and effects of online negative enabling support through validation of the pro-anorexic identity and the dangerous cycle of stigma escalation in disclosure-response exchanges on pro-anorexic online communities.

Towards G2G: Systems of Technology Database Systems

NASA Technical Reports Server (NTRS)

Maluf, David A.; Bell, David

2005-01-01

We present an approach and methodology for developing Government-to-Government (G2G) Systems of Technology Database Systems. G2G will deliver technologies for distributed and remote integration of technology data for internal use in analysis and planning as well as for external communications. G2G enables NASA managers, engineers, operational teams and information systems to "compose" technology roadmaps and plans by selecting, combining, extending, specializing and modifying components of technology database systems. G2G will interoperate information and knowledge that is distributed across organizational entities involved that is ideal for NASA future Exploration Enterprise. Key contributions of the G2G system will include the creation of an integrated approach to sustain effective management of technology investments that supports the ability of various technology database systems to be independently managed. The integration technology will comply with emerging open standards. Applications can thus be customized for local needs while enabling an integrated management of technology approach that serves the global needs of NASA. The G2G capabilities will use NASA s breakthrough in database "composition" and integration technology, will use and advance emerging open standards, and will use commercial information technologies to enable effective System of Technology Database systems.

The IBD interactome: an integrated view of aetiology, pathogenesis and therapy.

PubMed

de Souza, Heitor S P; Fiocchi, Claudio; Iliopoulos, Dimitrios

2017-12-01

Crohn's disease and ulcerative colitis are prototypical complex diseases characterized by chronic and heterogeneous manifestations, induced by interacting environmental, genomic, microbial and immunological factors. These interactions result in an overwhelming complexity that cannot be tackled by studying the totality of each pathological component (an '-ome') in isolation without consideration of the interaction among all relevant -omes that yield an overall 'network effect'. The outcome of this effect is the 'IBD interactome', defined as a disease network in which dysregulation of individual -omes causes intestinal inflammation mediated by dysfunctional molecular modules. To define the IBD interactome, new concepts and tools are needed to implement a systems approach; an unbiased data-driven integration strategy that reveals key players of the system, pinpoints the central drivers of inflammation and enables development of targeted therapies. Powerful bioinformatics tools able to query and integrate multiple -omes are available, enabling the integration of genomic, epigenomic, transcriptomic, proteomic, metabolomic and microbiome information to build a comprehensive molecular map of IBD. This approach will enable identification of IBD molecular subtypes, correlations with clinical phenotypes and elucidation of the central hubs of the IBD interactome that will aid discovery of compounds that can specifically target the hubs that control the disease.

BBB disruption with unfocused ultrasound alone-A paradigm shift

NASA Astrophysics Data System (ADS)

Kyle, Al

2012-10-01

One paradigm for ultrasound-enabled blood brain barrier disruption uses image guided focused ultrasound and preformed microbubble agents to enable drug delivery to the brain. We propose an alternative approach: unguided, unfocused ultrasound with no adjunctive agent. Compared with the focused approach, the proposed method affects a larger region of the brain, and is aimed at treatment of regional neurological disease including glioblastoma multiforme (GBM). Avoidance of image guidance and focusing reduces cost for equipment and staff training. Avoidance of adjunctive agents also lowers cost and is enabled by a longer exposure time. Since 2004, our group has worked with two animal models, three investigators in four laboratories to safely deliver five compounds, increasing the concentration of large molecule markers in brain tissue two fold or more. Safety and effectiveness data for four studies have been presented at the Ultrasound Industry Association meetings in 2007 and 2010. This paper describes new safety and effectiveness results for a fifth study. We present evidence of delivery of large molecules - including Avastin-to the brains of a large animal model correlated with acoustic pressure, and summarize the advantages and disadvantages of this novel approach.

A simple cage-autonomous method for the maintenance of the barrier status of germ-free mice during experimentation.

PubMed

Hecht, G; Bar-Nathan, C; Milite, G; Alon, I; Moshe, Y; Greenfeld, L; Dotsenko, N; Suez, J; Levy, M; Thaiss, C A; Dafni, H; Elinav, E; Harmelin, A

2014-10-01

The use of germ-free (GF) isolators for microbiome-related research is exponentially increasing, yet limited by its cost, isolator size and potential for trans-contamination. As such, current isolator technology is highly limiting to researchers engaged in short period experiments involving multiple mouse strains and employing a variety of mono-inoculated microorganisms. In this study, we evaluate the use of positive pressure Isocages as a solution for short period studies (days to 2-3 weeks) of experimentation with GF mice at multiple simultaneous conditions. We demonstrate that this new Isocage technology is cost-effective and room-sparing, and enables maintenance of multiple simultaneous groups of GF mice. Using this technology, transferring GF mice from isolators to Isocage racks for experimentation, where they are kept under fully germ-free conditions, enables parallel inoculation with different bacterial strains and simultaneous experimentation with multiple research conditions. Altogether, the new GF Isocage technology enables the expansion of GF capabilities in a safe and cost-effective manner that can facilitate the growth, elaboration and flexibility of microbiome research. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Quantum sensing of weak radio-frequency signals by pulsed Mollow absorption spectroscopy.

PubMed

Joas, T; Waeber, A M; Braunbeck, G; Reinhard, F

2017-10-17

Quantum sensors-qubits sensitive to external fields-have become powerful detectors for various small acoustic and electromagnetic fields. A major key to their success have been dynamical decoupling protocols which enhance sensitivity to weak oscillating (AC) signals. Currently, those methods are limited to signal frequencies below a few MHz. Here we harness a quantum-optical effect, the Mollow triplet splitting of a strongly driven two-level system, to overcome this limitation. We microscopically understand this effect as a pulsed dynamical decoupling protocol and find that it enables sensitive detection of fields close to the driven transition. Employing a nitrogen-vacancy center, we detect GHz microwave fields with a signal strength (Rabi frequency) below the current detection limit, which is set by the center's spectral linewidth [Formula: see text]. Pushing detection sensitivity to the much lower 1/T 2 limit, this scheme could enable various applications, most prominently coherent coupling to single phonons and microwave photons.Dynamical decoupling protocols can enhance the sensitivity of quantum sensors but this is limited to signal frequencies below a few MHz. Here, Joas et al. use the Mollow triplet splitting in a nitrogen-vacancy centre to overcome this limitation, enabling sensitive detection of signals in the GHz range.

Clinical Data Warehouse: An Effective Tool to Create Intelligence in Disease Management.

PubMed

Karami, Mahtab; Rahimi, Azin; Shahmirzadi, Ali Hosseini

Clinical business intelligence tools such as clinical data warehouse enable health care organizations to objectively assess the disease management programs that affect the quality of patients' life and well-being in public. The purpose of these programs is to reduce disease occurrence, improve patient care, and decrease health care costs. Therefore, applying clinical data warehouse can be effective in generating useful information about aspects of patient care to facilitate budgeting, planning, research, process improvement, external reporting, benchmarking, and trend analysis, as well as to enable the decisions needed to prevent the progression or appearance of the illness aligning with maintaining the health of the population. The aim of this review article is to describe the benefits of clinical data warehouse applications in creating intelligence for disease management programs.

Feasibility study of generating ultra-high harmonic radiation with a single stage echo-enabled harmonic generation scheme

NASA Astrophysics Data System (ADS)

Zhou, Kaishang; Feng, Chao; Wang, Dong

2016-10-01

The echo enabled harmonic generation (EEHG) scheme holds the ability for the generation of fully coherent soft x-ray free-electron laser (FEL) pulses directly from external UV seeding sources. In this paper, we study the feasibility of using a single stage EEHG to generate coherent radiation in the "water window" and beyond. Using the high-order operating modes of the EEHG scheme, intensive numerical simulations have been performed considering various three-dimensional effects. The simulation results demonstrated that coherent soft x-ray radiation at 150th harmonic (1.77 nm) of the seed can be produced by a single stage EEHG. The decreasing of the final bunching factor at the desired harmonic caused by intra beam scattering (IBS) effect has also been analyzed.

Tunable optical frequency comb enabled scalable and cost-effective multiuser orthogonal frequency-division multiple access passive optical network with source-free optical network units.

PubMed

Chen, Chen; Zhang, Chongfu; Liu, Deming; Qiu, Kun; Liu, Shuang

2012-10-01

We propose and experimentally demonstrate a multiuser orthogonal frequency-division multiple access passive optical network (OFDMA-PON) with source-free optical network units (ONUs), enabled by tunable optical frequency comb generation technology. By cascading a phase modulator (PM) and an intensity modulator and dynamically controlling the peak-to-peak voltage of a PM driven signal, a tunable optical frequency comb source can be generated. It is utilized to assist the configuration of a multiple source-free ONUs enhanced OFDMA-PON where simultaneous and interference-free multiuser upstream transmission over a single wavelength can be efficiently supported. The proposed multiuser OFDMA-PON is scalable and cost effective, and its feasibility is successfully verified by experiment.

Decision support for patient care: implementing cybernetics.

PubMed

Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A

2004-01-01

The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.

A small business approach to nanomaterial environment, health, and safety.

PubMed

Gause, Charles B; Layman, Rachel M; Small, Aaron C

2011-06-01

Integral to the commercialization process for nanotechnology enabled products is the methodology for protecting workers potentially exposed to nanomaterials during product development. Occupational health surveillance is a key aspect of protecting employees and involves both hazard identification and surveillance of known medical data. However, when the health effects and exposure pathways of both new and existing "nano-scale" chemical substances are not yet well understood, conservative hazard controls and baseline data collection can facilitate both immediate and long-term worker protection. Luna Innovations uses a conservative approach based on risk assessment and the OSHA General Duty Clause. To date, Luna's approach has been effective for our business model. Understanding and managing potential hazards to our nanotechnology workers is key to the success and acceptance of nanotechnology enabled products.

Experimental Methods for Investigation of Shape Memory Based Elastocaloric Cooling Processes and Model Validation

PubMed Central

Schmidt, Marvin; Ullrich, Johannes; Wieczorek, André; Frenzel, Jan; Eggeler, Gunther; Schütze, Andreas; Seelecke, Stefan

2016-01-01

Shape Memory Alloys (SMA) using elastocaloric cooling processes have the potential to be an environmentally friendly alternative to the conventional vapor compression based cooling process. Nickel-Titanium (Ni-Ti) based alloy systems, especially, show large elastocaloric effects. Furthermore, exhibit large latent heats which is a necessary material property for the development of an efficient solid-state based cooling process. A scientific test rig has been designed to investigate these processes and the elastocaloric effects in SMAs. The realized test rig enables independent control of an SMA's mechanical loading and unloading cycles, as well as conductive heat transfer between SMA cooling elements and a heat source/sink. The test rig is equipped with a comprehensive monitoring system capable of synchronized measurements of mechanical and thermal parameters. In addition to determining the process-dependent mechanical work, the system also enables measurement of thermal caloric aspects of the elastocaloric cooling effect through use of a high-performance infrared camera. This combination is of particular interest, because it allows illustrations of localization and rate effects — both important for efficient heat transfer from the medium to be cooled. The work presented describes an experimental method to identify elastocaloric material properties in different materials and sample geometries. Furthermore, the test rig is used to investigate different cooling process variations. The introduced analysis methods enable a differentiated consideration of material, process and related boundary condition influences on the process efficiency. The comparison of the experimental data with the simulation results (of a thermomechanically coupled finite element model) allows for better understanding of the underlying physics of the elastocaloric effect. In addition, the experimental results, as well as the findings based on the simulation results, are used to improve the material properties. PMID:27168093

Experimental Methods for Investigation of Shape Memory Based Elastocaloric Cooling Processes and Model Validation.

PubMed

Schmidt, Marvin; Ullrich, Johannes; Wieczorek, André; Frenzel, Jan; Eggeler, Gunther; Schütze, Andreas; Seelecke, Stefan

2016-05-02

Shape Memory Alloys (SMA) using elastocaloric cooling processes have the potential to be an environmentally friendly alternative to the conventional vapor compression based cooling process. Nickel-Titanium (Ni-Ti) based alloy systems, especially, show large elastocaloric effects. Furthermore, exhibit large latent heats which is a necessary material property for the development of an efficient solid-state based cooling process. A scientific test rig has been designed to investigate these processes and the elastocaloric effects in SMAs. The realized test rig enables independent control of an SMA's mechanical loading and unloading cycles, as well as conductive heat transfer between SMA cooling elements and a heat source/sink. The test rig is equipped with a comprehensive monitoring system capable of synchronized measurements of mechanical and thermal parameters. In addition to determining the process-dependent mechanical work, the system also enables measurement of thermal caloric aspects of the elastocaloric cooling effect through use of a high-performance infrared camera. This combination is of particular interest, because it allows illustrations of localization and rate effects - both important for efficient heat transfer from the medium to be cooled. The work presented describes an experimental method to identify elastocaloric material properties in different materials and sample geometries. Furthermore, the test rig is used to investigate different cooling process variations. The introduced analysis methods enable a differentiated consideration of material, process and related boundary condition influences on the process efficiency. The comparison of the experimental data with the simulation results (of a thermomechanically coupled finite element model) allows for better understanding of the underlying physics of the elastocaloric effect. In addition, the experimental results, as well as the findings based on the simulation results, are used to improve the material properties.

Enabling chip-scale trace gas sensing systems with silicon photonics

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

Green, William

Tunable laser trace-gas spectroscopy has been effectively used in both environmental and medical applications, for its sensitivity and specificity. We’ll describe how contemporary silicon photonics manufacturing and assembly are leveraged for a cost-effective miniaturized spectroscopic sensor platform, and outline uses in fugitive methane emissions monitoring.

The College Dean, or, It's Difficult to Save Your Sanity When You're the Peanut Butter in a Peanut Butter Sandwich

ERIC Educational Resources Information Center

Meyers, Richard S.

1975-01-01

Changing conditions dictate an active rather than passive role for college deans. Instructional technology can be an effective tool in the dean's active search for information to enable him to effect change in curriculum and instruction. (NHM)

Effects of Different Student Response Modes on Science Learning

ERIC Educational Resources Information Center

Kho, Lee Sze; Chen, Chwen Jen

2017-01-01

Student response systems (SRSs) are wireless answering devices that enable students to provide simple real-time feedback to instructors. This study aims to evaluate the effects of different SRS interaction modes on elementary school students' science learning. Three interaction modes which include SRS Individual, SRS Collaborative, and Classroom…

32 CFR Appendix E to Part 247 - DoD Command Newspaper and Magazine Review System

Code of Federal Regulations, 2010 CFR

2010-07-01

... commanders in establishing and maintaining cost-effective internal communications essential to mission accomplishment. The system also enables internal information managers to assess the cost and effective use of...-day quality assurance procedures or established critique programs. C. Review criteria. Each newspaper...

Cost-Effects Analysis of Year-Round Education Programs.

ERIC Educational Resources Information Center

Hough, David; And Others

This feasibility study was designed to gather and analyze data to determine the potential cost-effectiveness of year-round education (YRE) compared to traditional-schedule education in California. An expanded version of the Stanford Research Institute's cost model was used to fit a broad conceptualization that enabled school districts with…

Managing Distance Education Institutions through Value Chain Analysis: the Nigerian Experience.

ERIC Educational Resources Information Center

Aderinto, J. A.; Akintayo, M. O.

Value chain analysis can gauge, analyze, and predict organization effects to control cost in light of achieving strategic organization objectives of distance education. Value chain analysis enables organizations to accomplish their goal or mission through cost effectiveness or differentiation. The value chain activity structure in a distance…

Compliance-Effect Correlation Bias in Instrumental Variables Estimators

ERIC Educational Resources Information Center

Reardon, Sean F.

2010-01-01

Instrumental variable estimators hold the promise of enabling researchers to estimate the effects of educational treatments that are not (or cannot be) randomly assigned but that may be affected by randomly assigned interventions. Examples of the use of instrumental variables in such cases are increasingly common in educational and social science…

75 FR 51867 - Self-Regulatory Organizations; National Securities Clearing Corporation; Order Approving Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... Enhance the Process for Transfers Through the Automated Customer Account Transfer Service August 16, 2010... Transfer Service (``ACATS'') system enables Members to effect automated transfers of customer accounts... transfer services and to effect customer account transfers within specified time frames. \\4\\ CNS is an...

Effects of Multimedia Instructional Strategy for Enhancing Students' Learning and Retention in Mathematics

ERIC Educational Resources Information Center

Kumar, R. Raj; Hema, G.

2017-01-01

Information and Communication Technology (ICT) has infused in every walk of life effecting the technology fields, such as launching satellites, managing businesses across the globe, and also enabling social networking. The technological tools provide students in discovering, classifying, and enhancing the knowledge towards mathematical concepts…

Effects of DDL Technology on Genre Learning

ERIC Educational Resources Information Center

Cotos, Elena; Link, Stephanie; Huffman, Sarah

2017-01-01

To better understand the promising effects of data-driven learning (DDL) on language learning processes and outcomes, this study explored DDL learning events enabled by the Research Writing Tutor (RWT), a web-based platform containing an English language corpus annotated to enhance rhetorical input, a concordancer that was searchable for…

The Ripple Tank: Management and Observation

ERIC Educational Resources Information Center

Auty, Geoff

2017-01-01

This overview is intended to help colleagues achieve successful and satisfying observations using a ripple tank. There are many observations to consider that can effectively illustrate reflection, refraction, interference and diffraction, but the most important consideration is to make every effort to enable students to see the effects we want…

Significant Differences in Pediatric Psychotropic Side Effects: Implications for School Performance

ERIC Educational Resources Information Center

Kubiszyn, Thomas; Mire, Sarah; Dutt, Sonia; Papathopoulos, Katina; Burridge, Andrea Backsheider

2012-01-01

Some side effects (SEs) of increasingly prescribed psychotropic medications can impact student performance in school. SE risk varies, even among drugs from the same class (e.g., antidepressants). Knowing which SEs occur significantly more often than others may enable school psychologists to enhance collaborative risk-benefit analysis, medication…

Protocol for a cluster randomised controlled trial on information technology-enabled nutrition intervention among urban adults in Chandigarh (India): SMART eating trial

PubMed Central

Kaur, Jasvir; Kaur, Manmeet; Webster, Jacqui; Kumar, Rajesh

2018-01-01

ABSTRACT Nutrition is an important determinant of health. At present, nutrition programs in India mainly emphasize improving maternal and child nutrition. Adult nutrition has not received due attention, though diseases like hypertension and diabetes are largely preventable through changes in dietary and physical activity behaviour. Little is known about the best approaches to improve dietary behaviours, especially the role of modern information technology (IT) in health education. We describe the protocol of the SMART Eating (Small, Measurable and Achievable dietary changes by Reducing fat, sugar and salt consumption and Trying different fruits and vegetables) health promotion intervention. A Cluster Randomised Controlled Trial will evaluate the effect of an IT-enabled intervention on nutrition behaviour among urban adults of Chandigarh, India. Formative research using a qualitative exploratory approach was undertaken to inform the intervention. The IT-enabled intervention programme includes website development, Short Message Service (SMS), e-mail reminders and interactive help by mobile and landline phones. The IT-enabled intervention will be compared to the traditional nutrition education program of distributing pamphlets in the control group. The primary outcome will be the percentage of study participants meeting the dietary intake guidelines of the National Institute of Nutrition, Hyderabad, India and the change in intake of fat, sugar, salt, fruit and vegetables after the intervention. The difference in differences method will be used to determine the net change in dietary intakes resulting from the interventions. Measurements will be made at baseline and at 6 months post-intervention, using a food frequency questionnaire. The formative research led to the development of a comprehensive intervention, focusing on five dietary components and using multi-channel communication approach including the use of IT to target urban North Indians from diverse socio-economic backgrounds. The Cluster Randomised Controlled Trial design is suitable for evaluating the effectiveness of this IT-enabled intervention for dietary behaviour change. PMID:29370744

A novel approach: high resolution inspection with wafer plane defect detection

NASA Astrophysics Data System (ADS)

Hess, Carl; Wihl, Mark; Shi, Rui-fang; Xiong, Yalin; Pang, Song

2008-05-01

High Resolution reticle inspection is well-established as a proven, effective, and efficient means of detecting yield-limiting mask defects as well as defects which are not immediately yield-limiting yet can enable manufacturing process improvements. Historically, RAPID products have enabled detection of both classes of these defects. The newly-developed Wafer Plane Inspection (WPI) detector technology meets the needs of some advanced mask manufacturers to identify the lithographically-significant defects while ignoring the other non-lithographically-significant defects. Wafer Plane Inspection accomplishes this goal by performing defect detection based on a modeled image of how the mask features would actually print in the photoresist. This has the effect of reducing sensitivity to non-printing defects while enabling higher sensitivity focused in high MEEF areas where small reticle defects still yield significant printing defects on wafers. WPI is a new inspection mode that has been developed by KLA-Tencor and is currently under test with multiple customers. It employs the same transmitted and reflected-light high-resolution images as the industry-standard high-resolution inspections, but with much more sophisticated processing involved. A rigorous mask pattern recovery algorithm is used to convert the transmitted and reflected light images into a modeled representation of the reticle. Lithographic modeling of the scanner is then used to generate an aerial image of the mask. This is followed by resist modeling to determine the exposure of the photoresist. The defect detectors are then applied on this photoresist plane so that only printing defects are detected. Note that no hardware modifications to the inspection system are required to enable this detector. The same tool will be able to perform both our standard High Resolution inspections and the Wafer Plane Inspection detector. This approach has several important features. The ability to ignore non-printing defects and to apply additional effective sensitivity in high MEEF areas enables advanced node development. In addition, the modeling allows the inclusion of important polarization effects that occur in the resist for high NA operation. This allows for the results to better match wafer print results compared to alternate approaches. Finally, the simulation easily allows for the application of arbitrary illumination profiles. With this approach, users of WPI can make use of unique or custom scanner illumination profiles. This allows the more precise modeling of profiles without inspection system hardware modification or loss of company intellectual property. This paper examines WPI in Die:Die mode. Future work includes a review of Die:Database WPI capability.

Traffic Detector Handbook. Second Edition

DOT National Transportation Integrated Search

2013-11-01

Analysis Modeling and Simulation (AMS) Testbeds can make significant contributions in identifying the benefits of more effective, more active systems management, resulting from integrating transformative applications enabled by new data from wireless...

Implementing Innovations in Global Women's, Children's, and Adolescents' Health: Realizing the Potential for Implementation Science.

PubMed

Peterson, Herbert B; Haidar, Joumana; Fixsen, Dean; Ramaswamy, Rohit; Weiner, Bryan J; Leatherman, Sheila

2018-03-01

The launch of the United Nations Sustainable Development Goals and the new Secretary General's Global Strategy for Women's, Children's, and Adolescents' Health are a window of opportunity for improving the health and well-being of women, children, and adolescents in the United States and around the world. Realizing the full potential of this historic moment will require that we improve our ability to successfully implement life-saving and life-enhancing innovations, particularly in low-resource settings. Implementation science, a new and rapidly evolving field that addresses the "how-to" component of providing sustainable quality services at scale, can make an important contribution on this front. A synthesis of the implementation science evidence indicates that three interrelated factors are required for successful, sustainable outcomes at scale: 1) effective innovations, 2) effective implementation, and 3) enabling contexts. Implementation science addresses the interaction among these factors to help make innovations more usable, to build ongoing capacity to assure the effective implementation of these innovations, and to ensure enabling contexts to sustain their full and effective use in practice. Improving access to quality services will require transforming health care systems and, therefore, much of the focus of implementation science in global health is on improving the ability of health systems to serve as enabling contexts. The field of implementation science is inherently interdisciplinary and academe will need to respond by facilitating collaboration among scientists from relevant disciplines, including evaluation, improvement, and systems sciences. Platforms and programs to facilitate collaborations among researchers, practitioners, policymakers, and funders are likewise essential.

Effect Coding as a Mechanism for Improving the Accuracy of Measuring Students Who Self-Identify with More than One Race

ERIC Educational Resources Information Center

Mayhew, Matthew J.; Simonoff, Jeffrey S.

2015-01-01

The purpose of this paper is to describe effect coding as an alternative quantitative practice for analyzing and interpreting categorical, multi-raced independent variables in higher education research. Not only may effect coding enable researchers to get closer to respondents' original intentions, it allows for more accurate analyses of all race…

Teacher-Child Interactions in Voluntary Pre-Kindergarten Programs in Child Care Settings: A Critical Analysis of Barriers and Facilitators

ERIC Educational Resources Information Center

Kim, Seunghee

2008-01-01

We investigated barriers to and facilitators of effective teacher-child interactions in voluntary pre-kindergarten programs in child care settings. An effective teacher-child interaction enables both teachers and children to actively engage in solving the problems they confront in their daily lives. The effective teacher-child interaction relies…

CLEAR: Cross-Layer Exploration for Architecting Resilience

DTIC Science & Technology

2017-03-01

benchmark analysis, also provides cost-effective solutions (~1% additional energy cost for the same 50× improvement). This paper addresses the...core (OoO-core) [Wang 04], across 18 benchmarks . Such extensive exploration enables us to conclusively answer the above cross-layer resilience...analysis of the effects of soft errors on application benchmarks , provides a highly effective soft error resilience approach. 3. The above

DoD Autonomy Roadmap: Autonomy Community of Interest

DTIC Science & Technology

2015-03-24

Initiative 27  Exploiting Priming Effects Team (Navy)  Develop machine perception relatable to the manner in which a human perceives the ...and trust among the team members; understanding of each member’s tasks, intentions, capabilities, and progress; and ensuring effective and timely...learning capabilities to greatly reduce the need for human interventions, while enabling effective teaming with the warfighter Machine Perception

Enabling Joint Interdependence through Capability Portfolio Management

DTIC Science & Technology

2008-06-13

7 Habits of Highly Effective People , author Stephen Covey notes that “you...incentives to implement the strategy, they 5 Stephen R. Covey, The 7 Habits of Highly Effective People (New York: Simon and Schuster, 1989), 229...and Implement the Best Strategy for Your Business. Boston, MA: Harvard Business School Press, 2005. Covey, Stephen R. The 7 Habits of Highly Effective People .

Manual on Cost-Effectiveness of Training Modalities in Population Education. Population Education Programme Service Series.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

This manual is the result of a regional training workshop on the cost-effectiveness of different training strategies in population education by Unesco in Kathmandu, Nepal, June 1-8, 1987. The purpose of the manual is to enable project staff to initiate studies to determine cost-effective training strategies in population growth control education.…

Nondestructive cryomicro-CT imaging enables structural and molecular analysis of human lung tissue.

PubMed

Vasilescu, Dragoş M; Phillion, André B; Tanabe, Naoya; Kinose, Daisuke; Paige, David F; Kantrowitz, Jacob J; Liu, Gang; Liu, Hanqiao; Fishbane, Nick; Verleden, Stijn E; Vanaudenaerde, Bart M; Lenburg, Marc; Stevenson, Christopher S; Spira, Avrum; Cooper, Joel D; Hackett, Tillie-Louise; Hogg, James C

2017-01-01

Micro-computed tomography (CT) enables three-dimensional (3D) imaging of complex soft tissue structures, but current protocols used to achieve this goal preclude cellular and molecular phenotyping of the tissue. Here we describe a radiolucent cryostage that permits micro-CT imaging of unfixed frozen human lung samples at an isotropic voxel size of (11 µm) 3 under conditions where the sample is maintained frozen at -30°C during imaging. The cryostage was tested for thermal stability to maintain samples frozen up to 8 h. This report describes the methods used to choose the materials required for cryostage construction and demonstrates that whole genome mRNA integrity and expression are not compromised by exposure to micro-CT radiation and that the tissue can be used for immunohistochemistry. The new cryostage provides a novel method enabling integration of 3D tissue structure with cellular and molecular analysis to facilitate the identification of molecular determinants of disease. The described micro-CT cryostage provides a novel way to study the three-dimensional lung structure preserved without the effects of fixatives while enabling subsequent studies of the cellular matrix composition and gene expression. This approach will, for the first time, enable researchers to study structural changes of lung tissues that occur with disease and correlate them with changes in gene or protein signatures. Copyright © 2017 the American Physiological Society.

Caring at home until death: enabled determination.

PubMed

Robinson, Carole A; Bottorff, Joan L; McFee, Erin; Bissell, Laura J; Fyles, Gillian

2017-04-01

The importance of family caregivers in providing palliative care at home and in supporting a home death is well supported. Gaining a better understanding of what enables palliative family caregivers to continue caring at home for their family members until death is critical to providing direction for more effective support. The purpose of the study was to describe the experiences of bereaved family caregivers whose terminally ill family members with advanced cancer were successful in achieving a desired home death. A qualitative interpretive descriptive approach was used. Data were collected using semi-structured, audio-recorded interviews conducted in-person or via telephone in addition to field notes and reflective journaling. The study took place in British Columbia, Canada, and included 29 bereaved adult family caregivers who had provided care for a family member with advanced cancer and experienced a home death. Four themes captured the experience of caring at home until death: context of providing care, supportive antecedents to providing care, determination to provide care at home, and enabled determination. Factors that enabled determination to achieve a home death included initiation of formal palliative care, asking for and receiving help, augmented care, relief or respite, and making the healthcare system work for the ill person. Clarifying caregiving goals and supporting the factors that enable caregiver determination appear to be critical in enhancing the likelihood of a desired home death.

Barriers to and Enablers of Contraceptive Use among Adolescent Females and their Interest in an Emergency Department-based Intervention

PubMed Central

Chernick, Lauren S; Schnall, Rebecca; Higgins, Tracy; Stockwell, Melissa; Castaño, Paula; Santelli, John; Dayan, Peter S

2015-01-01

Objective Over 15 million adolescents, many at high risk for pregnancy, use emergency departments (ED) in the United States annually, but little is known regarding reasons for failure to use contraceptives in this population. The purpose of this study was to identify the barriers to and enablers of contraceptive use among adolescent females using the ED and determine their interest in an ED-based pregnancy prevention intervention. Study Design We conducted semi-structured, open-ended interviews with females in an urban ED. Eligible females were 14-19 years old, sexually active, presenting for reproductive health complaints, and at risk for pregnancy, defined as non-use of effective (per the World Health Organization) contraception. Interviews were recorded, transcribed, and coded based on thematic analysis. Enrollment continued until no new themes emerged. A modified Health Belief Model guided the organization of the data. Results Participants (n=14) were predominantly Hispanic (93%), insured (93%), and in a sexual relationship (86%). The primary barrier to contraceptive use was perceived health risk, including effects on menstruation, weight, and future fertility. Other barriers consisted of mistrust in contraceptives, ambivalent pregnancy intentions, uncertainty about the future, partner's desire for pregnancy, and limited access to contraceptives. Enablers of past contraceptive use included the presence of a school-based health clinic and clear plans for the future. All participants were receptive to ED-based pregnancy prevention interventions. Conclusions The identified barriers and enablers influencing hormonal contraceptive use can be used to inform the design of future ED-based adolescent pregnancy prevention interventions. PMID:25499588

Enabling factors for specialist outreach in western KwaZulu-Natal

PubMed Central

2018-01-01

Background There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa. Aim This study attempts to uncover some of the factors that enable good multifaceted specialist outreach. Setting The study was conducted in hospitals in western KwaZulu-Natal province. This health area is served by a tertiary hospital and 20 peripheral hospitals; three of these are regional level and the majority are district level hospitals. Specialist outreach emanates from the tertiary hospital. Methods Specialists providing outreach services from the tertiary hospital and medical officers at seven receiving hospitals were interviewed to explore perceptions regarding factors that might enable successful specialist outreach. Framework analysis on the transcribed interviews was carried out using NVivo version 11. Results A major positive finding concerns the relationships formed between outreach specialists and doctors at the recipient hospitals. The management of the programme with respect to structure, dependability, data management, transport provision, communication technology and public health systems was also seen as beneficial in specialist outreach. Conclusion Specialist outreach plays an essential role in providing equality in health care. To enable effectiveness, it is important to make full use of the multifaceted nature of this intervention. PMID:29781691

Falling short: how state laws can address health information exchange barriers and enablers.

PubMed

Schmit, Cason D; Wetter, Sarah A; Kash, Bita A

2018-06-01

Research on the implementation of health information exchange (HIE) organizations has identified both positive and negative effects of laws relating to governance, incentives, mandates, sustainability, stakeholder participation, patient engagement, privacy, confidentiality, and security. We fill a substantial research gap by describing whether comprehensive state and territorial HIE legal frameworks address identified legal facilitators and barriers. We used the Westlaw database to identify state and territorial laws relating to HIEs in effect on June 7, 2016 (53 jurisdictions). We blind-coded all laws and addressed coding discrepancies in peer-review meetings. We recorded a consensus code for each law in a master database. We compared 20 HIE legal attributes with identified barriers to and enablers of HIE activity in the literature. Forty-two states, the District of Columbia, and 2 territories have laws relating to HIEs. On average, jurisdictions address 8.32 of the 20 criteria selected in statutes and regulations. Twenty jurisdictions unambiguously address ≤5 criteria in statutes and regulations. None of the significant legal criteria are unambiguously addressed in >60% of the 53 jurisdictions. Laws can be barriers to or enablers of HIEs. However, jurisdictions are not addressing many significant issues identified by researchers. Consequently, there is a substantial risk that existing legal frameworks are not adequately supporting HIEs. The current evidence base is insufficient for comparative assessments or impact rankings of the various factors. However, the detailed Centers for Disease Control and Prevention dataset of HIE laws could enable investigations into the types of laws that promote or impede HIEs.

TK3 eBook software to author, distribute, and use electronic course content for medical education.

PubMed

Morton, David A; Foreman, K Bo; Goede, Patricia A; Bezzant, John L; Albertine, Kurt H

2007-03-01

The methods for authoring and distributing course content are undergoing substantial changes due to advancement in computer technology. Paper has been the traditional method to author and distribute course content. Paper enables students to personalize content through highlighting and note taking but does not enable the incorporation of multimedia elements. Computers enable multimedia content but lack the capability of the user to personalize the content. Therefore, we investigated TK3 eBooks as a potential solution to incorporate the benefits of both paper and computer technology. The objective of our study was to assess the utility of TK3 eBooks in the context of authoring and distributing dermatology course content for use by second-year medical students at the University of Utah School of Medicine during the spring of 2004. We incorporated all dermatology course content into TK3 eBook format. TK3 eBooks enable students to personalize information through tools such as "notebook," "hiliter," "stickies," mark pages, and keyword search. Students were given the course content in both paper and eBook formats. At the conclusion of the dermatology course, students completed a questionnaire designed to evaluate the effectiveness of the eBooks compared with paper. Students perceived eBooks as an effective way to distribute course content and as a study tool. However, students preferred paper over eBooks to take notes during lecture. In conclusion, the present study demonstrated that eBooks provide a convenient method for authoring, distributing, and using course content but that students preferred paper to take notes during lecture.

Connected Vehicle-Enabled Weather Responsive Traffic Management

DOT National Transportation Integrated Search

2018-04-01

Weather Responsive Traffic Management (WRTM) is an initiative under the Federal Highway Administration's (FHWA) Road Weather Management Program that supports traffic management agencies and professionals in implementing effective advisory, control, a...

A Buzzing Bee.

ERIC Educational Resources Information Center

Donovan, Edward P.; Barnes, Eb

1996-01-01

Presents an activity enabling students of grades four to nine to construct a "Buzzing Bee" model using simple materials. Provides students with the opportunity to explore the concepts of sound and the Doppler effect. (MKR)

Intravital hybrid optical-optoacoustic microscopy based on fiber-Bragg interferometry

NASA Astrophysics Data System (ADS)

Shnaiderman, Rami; Wissmeyer, Georg; Seeger, Markus; Estrada, Hector; Ntziachristos, Vasilis

2018-02-01

Optoacoustic microscopy (OAM) has enabled high-resolution, label-free imaging of tissues at depths not achievable with purely optical microscopy. However, widespread implementation of OAM into existing epi-illumination microscopy setups is often constrained by the performance and size of the commonly used piezoelectric ultrasound detectors. In this work, we introduce a novel acoustic detector based on a π-phase-shifted fiber Bragg grating (π-FBG) interferometer embedded inside an ellipsoidal acoustic cavity. The cavity enables seamless integration of epi-illumination OAM into existing microscopy setups by decoupling the acoustic and optical paths between the microscope objective and the sample. The cavity also acts as an acoustic condenser, boosting the sensitivity of the π-FBG and enabling cost effective CW-laser interrogation technique. We characterize the sensor's sensitivity and bandwidth and demonstrate hybrid OAM and second-harmonic imaging of phantoms and mouse tissue in vivo.

In-Orbit Servicing: The Master Enabler

NASA Technical Reports Server (NTRS)

Reed, Benjamin B.; Kienlen, Michael; Naasz, Bo; Roberts, Brian; Deweese, Keith

2015-01-01

Some of the most noteworthy missions in space exploration have occurred in the last two decades and owe their success to on-orbit servicing. The tremendously successful Hubble Space Telescope repair and upgrade missions, as well as the completed assembly of the International Space Station (ISS) and its full utilization, lead us to the next chapter and set of challenges. These include fully exploiting the many space systems already launched, assembling large structures in situ thereby enabling new scientific discoveries, and providing systems that reliably and cost-effectively support the next steps in space exploration. In-orbit servicing is a tool--a tool that can serve as the master enabler to create space architectures that would otherwise be unattainable. This paper will survey how NASA's satellite-servicing technology development efforts are being applied to the planning and execution of two such ambitious missions, specifically asteroid capture and the in-space assembly of a very large life-finding telescope.

The Master Enabler: In Orbit Servicing

NASA Technical Reports Server (NTRS)

Reed, Benjamin B.; Kienlen, Michael; Naasz, Bo; Roberts, Brian; Deweese, Keith; Cassidy, Justin

2015-01-01

Some of the most noteworthy missions in space exploration have occurred in the last two decades and owe their success to on-orbit servicing. The tremendously successful Hubble Space Telescope repair and upgrade missions, as well as the completed assembly of the International Space Station (ISS) and its full utilization, lead us to the next chapter and set of challenges. These include fully exploiting the many space systems already launched, assembling large structures in situ thereby enabling new scientific discoveries, and providing systems that reliably and cost-effectively support the next steps in space exploration. In-orbit servicing is a tool--a tool that can serve as the master enabler to create space architectures that would otherwise be unattainable. This paper will survey how NASA's satellite-servicing technology development efforts are being applied to the planning and execution of two such ambitious missions, specifically asteroid capture and the in-space assembly of a very large life-finding telescope.

Liquid metal enabled pump

PubMed Central

Tang, Shi-Yang; Khoshmanesh, Khashayar; Sivan, Vijay; Petersen, Phred; O’Mullane, Anthony P.; Abbott, Derek; Mitchell, Arnan; Kalantar-zadeh, Kourosh

2014-01-01

Small-scale pumps will be the heartbeat of many future micro/nanoscale platforms. However, the integration of small-scale pumps is presently hampered by limited flow rate with respect to the input power, and their rather complicated fabrication processes. These issues arise as many conventional pumping effects require intricate moving elements. Here, we demonstrate a system that we call the liquid metal enabled pump, for driving a range of liquids without mechanical moving parts, upon the application of modest electric field. This pump incorporates a droplet of liquid metal, which induces liquid flow at high flow rates, yet with exceptionally low power consumption by electrowetting/deelectrowetting at the metal surface. We present theory explaining this pumping mechanism and show that the operation is fundamentally different from other existing pumps. The presented liquid metal enabled pump is both efficient and simple, and thus has the potential to fundamentally advance the field of microfluidics. PMID:24550485

Photophoretic levitation of engineered aerosols for geoengineering

PubMed Central

Keith, David W.

2010-01-01

Aerosols could be injected into the upper atmosphere to engineer the climate by scattering incident sunlight so as to produce a cooling tendency that may mitigate the risks posed by the accumulation of greenhouse gases. Analysis of climate engineering has focused on sulfate aerosols. Here I examine the possibility that engineered nanoparticles could exploit photophoretic forces, enabling more control over particle distribution and lifetime than is possible with sulfates, perhaps allowing climate engineering to be accomplished with fewer side effects. The use of electrostatic or magnetic materials enables a class of photophoretic forces not found in nature. Photophoretic levitation could loft particles above the stratosphere, reducing their capacity to interfere with ozone chemistry; and, by increasing particle lifetimes, it would reduce the need for continual replenishment of the aerosol. Moreover, particles might be engineered to drift poleward enabling albedo modification to be tailored to counter polar warming while minimizing the impact on equatorial climates. PMID:20823254

Photophoretic levitation of engineered aerosols for geoengineering.

PubMed

Keith, David W

2010-09-21

Aerosols could be injected into the upper atmosphere to engineer the climate by scattering incident sunlight so as to produce a cooling tendency that may mitigate the risks posed by the accumulation of greenhouse gases. Analysis of climate engineering has focused on sulfate aerosols. Here I examine the possibility that engineered nanoparticles could exploit photophoretic forces, enabling more control over particle distribution and lifetime than is possible with sulfates, perhaps allowing climate engineering to be accomplished with fewer side effects. The use of electrostatic or magnetic materials enables a class of photophoretic forces not found in nature. Photophoretic levitation could loft particles above the stratosphere, reducing their capacity to interfere with ozone chemistry; and, by increasing particle lifetimes, it would reduce the need for continual replenishment of the aerosol. Moreover, particles might be engineered to drift poleward enabling albedo modification to be tailored to counter polar warming while minimizing the impact on equatorial climates.

A Biomimetic-Computational Approach to Optimizing the Quantum Efficiency of Photovoltaics

NASA Astrophysics Data System (ADS)

Perez, Lisa M.; Holzenburg, Andreas

The most advanced low-cost organic photovoltaic cells have a quantum efficiency of 10%. This is in stark contrast to plant/bacterial light-harvesting systems which offer quantum efficiencies close to unity. Of particular interest is the highly effective quantum coherence-enabled energy transfer (Fig. 1). Noting that quantum coherence is promoted by charged residues and local dielectrics, classical atomistic simulations and time-dependent density functional theory (DFT) are used to identify charge/dielectric patterns and electronic coupling at exactly defined energy transfer interfaces. The calculations make use of structural information obtained on photosynthetic protein-pigment complexes while still in the native membrane making it possible to establish a link between supramolecular organization and quantum coherence in terms of what length scales enable fast energy transport and prevent quenching. Calculating energy transfer efficiencies between components based on different proximities will permit the search for patterns that enable defining material properties suitable for advanced photovoltaics.

A Single-use Strategy to Enable Manufacturing of Affordable Biologics.

PubMed

Jacquemart, Renaud; Vandersluis, Melissa; Zhao, Mochao; Sukhija, Karan; Sidhu, Navneet; Stout, Jim

2016-01-01

The current processing paradigm of large manufacturing facilities dedicated to single product production is no longer an effective approach for best manufacturing practices. Increasing competition for new indications and the launch of biosimilars for the monoclonal antibody market have put pressure on manufacturers to produce at lower cost. Single-use technologies and continuous upstream processes have proven to be cost-efficient options to increase biomass production but as of today the adoption has been only minimal for the purification operations, partly due to concerns related to cost and scale-up. This review summarizes how a single-use holistic process and facility strategy can overcome scale limitations and enable cost-efficient manufacturing to support the growing demand for affordable biologics. Technologies enabling high productivity, right-sized, small footprint, continuous, and automated upstream and downstream operations are evaluated in order to propose a concept for the flexible facility of the future.

Technology Assessment for Large Vertical-Lift Transport Tiltrotors

NASA Technical Reports Server (NTRS)

Germanowski, Peter J.; Stille, Brandon L.; Strauss, Michael P.

2010-01-01

The technical community has identified rotor efficiency as a critical enabling technology for large vertical-lift transport (LVLT) rotorcraft. The size and performance of LVLT aircraft will be far beyond current aircraft capabilities, enabling a transformational change in cargo transport effectiveness. Two candidate approaches for achieving high efficiency were considered for LVLT applications: a variable-diameter tiltrotor (VDTR) and a variable-speed tiltrotor (VSTR); the former utilizes variable-rotor geometry and the latter utilizes variable-rotor speed. Conceptual aircraft designs were synthesized for the VDTR and VSTR and compared to a conventional tiltrotor (CTR). The aircraft were optimized to a common objective function and bounded by a set of physical- and requirements-driven constraints. The resulting aircraft were compared for weight, size, performance, handling qualities, and other attributes. These comparisons established a measure of the relative merits of the variable-diameter and -speed rotor systems as enabling technologies for LVLT capability.

Assessing Inter-Sectoral Climate Change Risks: The Role of ISIMIP

NASA Technical Reports Server (NTRS)

Rosenzweig, Cynthia; Arnell, Nigel W.; Ebi, Kristie L.; Lotze-Campen, Hermann; Raes, Frank; Rapley, Chris; Smith, Mark Stafford; Cramer, Wolfgang; Frieler, Katja; Reyer, Christopher P. O.;

The "Master Enabler" - In-Orbit Servicing

NASA Technical Reports Server (NTRS)

Reed, Benjamin; Kienlen, Michael; Naasz, Bo; Roberts, Brian; Deweese, Keith; Cassidy, Justin

2015-01-01

Some of the most noteworthy missions in space exploration have occurred in the last two decades and owe their success to on-orbit servicing. The tremendously successful Hubble Space Telescope repair and upgrade missions, as well as the completed assembly of the International Space Station (ISS) and its full utilization, lead us to the next chapter and set of challenges. These include fully exploiting the many space systems already launched, assembling large structures in situ thereby enabling new scientific discoveries, and providing systems that reliably and cost-effectively support the next steps in space exploration. In-orbit servicing is a tool-a tool that can serve as the master enabler to create space architectures that would otherwise be unattainable. This paper will survey how NASA's satellite-servicing technology development efforts are being applied to the planning and execution of two such ambitious missions, specifically asteroid capture and the in-space assembly of a very large life-finding telescope.

Framework for Building Collaborative Research Environment

DOE PAGES

Devarakonda, Ranjeet; Palanisamy, Giriprakash; San Gil, Inigo

2014-10-25

Wide range of expertise and technologies are the key to solving some global problems. Semantic web technology can revolutionize the nature of how scientific knowledge is produced and shared. The semantic web is all about enabling machine-machine readability instead of a routine human-human interaction. Carefully structured data, as in machine readable data is the key to enabling these interactions. Drupal is an example of one such toolset that can render all the functionalities of Semantic Web technology right out of the box. Drupal’s content management system automatically stores the data in a structured format enabling it to be machine. Withinmore » this paper, we will discuss how Drupal promotes collaboration in a research setting such as Oak Ridge National Laboratory (ORNL) and Long Term Ecological Research Center (LTER) and how it is effectively using the Semantic Web in achieving this.« less

Strain-engineered inverse charge-funnelling in layered semiconductors.

PubMed

De Sanctis, Adolfo; Amit, Iddo; Hepplestone, Steven P; Craciun, Monica F; Russo, Saverio

2018-04-25

The control of charges in a circuit due to an external electric field is ubiquitous to the exchange, storage and manipulation of information in a wide range of applications. Conversely, the ability to grow clean interfaces between materials has been a stepping stone for engineering built-in electric fields largely exploited in modern photovoltaics and opto-electronics. The emergence of atomically thin semiconductors is now enabling new ways to attain electric fields and unveil novel charge transport mechanisms. Here, we report the first direct electrical observation of the inverse charge-funnel effect enabled by deterministic and spatially resolved strain-induced electric fields in a thin sheet of HfS 2 . We demonstrate that charges driven by these spatially varying electric fields in the channel of a phototransistor lead to a 350% enhancement in the responsivity. These findings could enable the informed design of highly efficient photovoltaic cells.

A delicate web: household changes in health behaviour enabled by microcredit in Burkina Faso.

PubMed

Hennink, Monique; McFarland, Deborah A

2013-01-01

Providing microcredit to women in developing countries has long been highlighted as a simple and effective strategy for poverty reduction and health improvement. However, little is known about how microcredit enables changes in health behaviour. This knowledge is critical to further strengthen microcredit initiatives. This qualitative study, conducted in Burkina Faso, shows how microcredit can not only facilitate savings and investment strategies, but also lead to changes in household decision-making, enabling women to initiate health prevention, seek health treatment and manage health emergencies. Some changes led to increased household burdens for women that impeded health gains, such as administrative loan delays by the microcredit institution and reduced household contributions by the husband. Furthermore, the study highlighted the fragile nature of health gains, which may be eroded due to economic shocks on a household, such as crop failure, drought or illness.

Reconfigurable photonic crystals enabled by pressure-responsive shape-memory polymers

PubMed Central

Fang, Yin; Ni, Yongliang; Leo, Sin-Yen; Taylor, Curtis; Basile, Vito; Jiang, Peng

2015-01-01

Smart shape-memory polymers can memorize and recover their permanent shape in response to an external stimulus (for example, heat). They have been extensively exploited for a wide spectrum of applications ranging from biomedical devices to aerospace morphing structures. However, most of the existing shape-memory polymers are thermoresponsive and their performance is hindered by heat-demanding programming and recovery steps. Although pressure is an easily adjustable process variable such as temperature, pressure-responsive shape-memory polymers are largely unexplored. Here we report a series of shape-memory polymers that enable unusual ‘cold' programming and instantaneous shape recovery triggered by applying a contact pressure at ambient conditions. Moreover, the interdisciplinary integration of scientific principles drawn from two disparate fields—the fast-growing photonic crystal and shape-memory polymer technologies—enables fabrication of reconfigurable photonic crystals and simultaneously provides a simple and sensitive optical technique for investigating the intriguing shape-memory effects at nanoscale. PMID:26074349

Adolescents' knowledge and beliefs about pregnancy: the impact of "ENABL".

PubMed

Arnold, E M; Smith, T E; Harrison, D F; Springer, D W

2000-01-01

Finding effective ways to prevent adolescent pregnancy is a concern of public health officials, educators, social workers, parents, and legislators. Numerous programs exist, but there is debate as to whether it is the specific program itself or other factors that are responsible for participants' successful outcomes. Using a quasi-experimental design, this study sought to determine which factors predicted changes in knowledge and beliefs among middle school students (N = 1,450) after exposure to Postponing Sexual Involvement (PSI), the curricular component of Education Now and Babies Later (ENABL), a pregnancy prevention program. It was found that the single most important predictor of improvement in knowledge and beliefs about pregnancy prevention was PSI itself, not background variables. The findings contradict some of the previous studies on factors impacting teenage pregnancy and lend support for the continued examination of ENABL as a promising component of pregnancy prevention efforts.

Vitreous carbon mask substrate for X-ray lithography

DOEpatents

Aigeldinger, Georg [Livermore, CA; Skala, Dawn M [Fremont, CA; Griffiths, Stewart K [Livermore, CA; Talin, Albert Alec [Livermore, CA; Losey, Matthew W [Livermore, CA; Yang, Chu-Yeu Peter [Dublin, CA

2009-10-27

The present invention is directed to the use of vitreous carbon as a substrate material for providing masks for X-ray lithography. The new substrate also enables a small thickness of the mask absorber used to pattern the resist, and this enables improved mask accuracy. An alternative embodiment comprised the use of vitreous carbon as a LIGA substrate wherein the VC wafer blank is etched in a reactive ion plasma after which an X-ray resist is bonded. This surface treatment provides a surface enabling good adhesion of the X-ray photoresist and subsequent nucleation and adhesion of the electrodeposited metal for LIGA mold-making while the VC substrate practically eliminates secondary radiation effects that lead to delamination of the X-ray resist form the substrate, the loss of isolated resist features, and the formation of a resist layer adjacent to the substrate that is insoluble in the developer.

Stoichiometry of Calcium Medicines

ERIC Educational Resources Information Center

Pinto, Gabriel

2005-01-01

The topic of calcium supplement and its effects on human lives is presented in the way of questions to the students. It enables the students to realize the relevance of chemistry outside the classroom surrounding.

14 CFR 1216.204 - General implementation requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Unified National Program for Flood Plain Management (U.S. Water Resources Council, 1978). (1) Descriptive... permits and grants to enable them to similarly evaluate, in accordance with the Orders, the effects of...

14 CFR 1216.204 - General implementation requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Unified National Program for Flood Plain Management (U.S. Water Resources Council, 1978). (1) Descriptive... permits and grants to enable them to similarly evaluate, in accordance with the Orders, the effects of...

14 CFR 1216.204 - General implementation requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Unified National Program for Flood Plain Management (U.S. Water Resources Council, 1978). (1) Descriptive... permits and grants to enable them to similarly evaluate, in accordance with the Orders, the effects of...

14 CFR 1216.204 - General implementation requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Unified National Program for Flood Plain Management (U.S. Water Resources Council, 1978). (1) Descriptive... permits and grants to enable them to similarly evaluate, in accordance with the Orders, the effects of...

Phoenix metropolitan model deployment initiative : evaluation report

DOT National Transportation Integrated Search

2013-11-01

Analysis Modeling and Simulation (AMS)Testbeds can make significant contributions in identifying the benefits of more effective, more active systems management, resulting from integrating transformative applications enabled by new data from wirelessl...

Change, Training and Farm Profitability. A National Farmers Federation Discussion Paper.

ERIC Educational Resources Information Center

Kilpatrick, Sue

1996-01-01

A project collected empirical data on the effectiveness of training in agriculture in Australia. Emphasis was on types of training and delivery modes most effective in enabling profitable changes to farm management or agricultural practice and on other catalysts that result in farmers making changes to increase profitability. Data were obtained…

Utilization and Effectiveness of Florida's Multidisciplinary Family Service Planning Teams.

ERIC Educational Resources Information Center

Lazear, Katherine; Everett, Judith; Eggers, Terri

This conference paper discusses the results of a study on the effectiveness of Florida's multidisciplinary Family Service Planning Teams (FSPT). The FSPTs were developed to create holistic service plans to enable children with emotional disabilities to live in the community and be successful in school. The FSPTs have become the focus of service…

The Provision of Critical Incident Stress Debriefing Services by EAPs: A Case Study.

ERIC Educational Resources Information Center

McWhirter, Ellen Hawley; Linzer, Marc

1994-01-01

Provides a description of critical incident stress debriefing (CISD) strategies used after a bank robbery-hostage incident. Intervention intended to reduce the effects of the incident on the employees' morale, health, and productivity. Knowledge of CISD procedures will enable counselors to respond effectively to traumatic incidents in the…

School Effectiveness Research Findings in the Portuguese Speaking Countries: Brazil and Portugal

ERIC Educational Resources Information Center

Ferrão, Maria Eugénia

2014-01-01

This paper provides findings of research on school effectiveness and discusses implications for evaluation in Brazil and Portugal. Most findings reported over the last decade have been published in Brazilian or Portuguese refereed journals. Thus, a brief literature review of such studies enables that knowledge to reach international scholars and…

Excuse Me, Is This Thing On? Audiotape Commentary in Dialogic Classrooms.

ERIC Educational Resources Information Center

Vandenberg, Peter

1992-01-01

Asserts that audiotape commentary on student papers should not be considered a panacea for composition teachers. Argues that, although its effectiveness always depends on a greater dialogic context, it can be a collaborative, enabling method for reader and writer to exchange information about intention and effect that exceeds the limitations of…

The Science of Prescribed Fire: to Enable a Different Kind of Control

Treesearch

Timothy E. Paysen; Marcia G. Narog; Jack D. Cohen

1998-01-01

A paradigm shift from fire suppression to fire suppression and prescription requires a shift in emphasis from simply controlling wildfire occurrence and spread to one that includes controlling characteristics of prescribed fire. Suppression focuses on preventing unwanted effects that might result from wildfire occurrence. Prescription promotes desired effects by...

Effective Teaching Strategies for Gifted/Learning-Disabled Students with Spatial Strengths

ERIC Educational Resources Information Center

Mann, Rebecca L.

2006-01-01

This study sought to determine effective teaching strategies for use with high-ability students who have spatial strengths and sequential weaknesses. Gifted students with spatial strengths and weak verbal skills often struggle in the traditional classroom. Their learning style enables them to grasp complex systems and excel at higher levels of…

Television and Its Social Effects in China.

ERIC Educational Resources Information Center

Chaozeng, Ma

Changes and development in Chinese television (CCTV) over the past 28 years have had profound effects on Chinese society. National News, which has the biggest television audience, has enabled the populace to know what is happening in China. Educational programming is given high priority through special telecourses presented for society in general,…

Postscript: Through TCM, STM Shines Bright

ERIC Educational Resources Information Center

Davelaar, Eddy J.; Usher, Marius; Haarmann, Henk J.; Goshen-Gottstein, Yonatan

2008-01-01

We find the reply by Kahana, Sederberg, and Howard helpful in clarifying the temporal-context model (TCM) function, in particular with regard to the elimination of the recency effect by a difficult distractor under parameters that still enable long-term contiguity effects to emerge. We agree with Kahana et al. that what matters most to the…

Tacit Knowledge Flows and Institutional Theory: Accelerating Acculturation

DTIC Science & Technology

2010-01-01

sustainable competitive advantage , but different kinds of knowledge affect competitive advantage differently. This applies especially to the...such qualitative fieldwork and informs theory and practice alike. 1. Introduction Knowledge is key to sustainable competitive advantage ...4,8,19]. Knowledge enables effective action; effective action drives superior performance; and superior performance supports competitive advantage

Use of Technology for Development and Alumni/Constituent Relations among CASE Members

ERIC Educational Resources Information Center

Council for Advancement and Support of Education, 2012

2012-01-01

This research explores the role of "advancement-enabling" technologies in helping institutions meet the challenges of engaging constituents and attracting private support. It includes data on the use of technology, the barriers to effective use of technology, and strategies for effective deployment of technology. First conducted in 2010,…

Am I Extravert or Introvert? Considering the Personality Effect toward e-Learning System

ERIC Educational Resources Information Center

Al-Dujaily, Amal; Kim, Jieun; Ryu, Hokyoung

2013-01-01

A concern of computer-based learning system design is how to accommodate learners' individual differences during learning activities. Previous research suggests that adaptive e-learning systems can effectively address such individual differences and, consequently, they enable more directed tutoring via computer-assisted instruction. In this paper,…

Assessing Teachers' Skills in Detecting and Identifying Effective Interactions in the Classroom: Theory and Measurement

ERIC Educational Resources Information Center

Jamil, Faiza M.; Sabol, Terri J.; Hamre, Bridget K.; Pianta, Robert C.

2015-01-01

Contemporary education reforms focus on assessing teachers' performance and developing selection mechanisms for hiring effective teachers. Tools that enable the prediction of teachers' classroom performance promote schools' ability to hire teachers more likely to be successful in the classroom. In addition, these assessment tools can be used for…

The Promise of Virtual Teams: Identifying Key Factors in Effectiveness and Failure

ERIC Educational Resources Information Center

Horwitz, Frank M.; Bravington, Desmond; Silvis, Ulrik

2006-01-01

Purpose: The aim of the investigation is to identify enabling and disenabling factors in the development and operation of virtual teams; to evaluate the importance of factors such as team development, cross-cultural variables, leadership, communication and social cohesion as contributors to virtual team effectiveness. Design/methodology/approach:…

Effecting Change in a Resistant Organization.

ERIC Educational Resources Information Center

Caldwell, Patricia F.; Gould, Edward

In an effort to overcome organizational resistance to change, Victor Valley College, in Victorville, California, has utilized a seven-part strategy to enable leaders to empower others and effect change. Step 1 requires the development of a visionary plan, so that changes have a meaningful context. Step 2 calls for an assessment of the campus…

Electron/Ion Transport Enhancer in High Capacity Li-Ion Battery Anodes

DOE PAGES

Kwon, Yo Han; Minnici, Krysten; Huie, Matthew M.; ...

2016-08-30

In this paper, magnetite (Fe 3O 4) was used as a model high capacity metal oxide active material to demonstrate advantages derived from consideration of both electron and ion transport in the design of composite battery electrodes. The conjugated polymer, poly[3-(potassium-4-butanoate) thiophene] (PPBT), was introduced as a binder component, while polyethylene glycol (PEG) was coated onto the surface of Fe 3O 4 nanoparticles. The introduction of PEG reduced aggregate size, enabled effective dispersion of the active materials and facilitated ionic conduction. As a binder for the composite electrode, PPBT underwent electrochemical doping which enabled the formation of effective electrical bridgesmore » between the carbon and Fe 3O 4 components, allowing for more efficient electron transport. Additionally, the PPBT carboxylic moieties effect a porous structure, and stable electrode performance. Finally, the methodical consideration of both enhanced electron and ion transport by introducing a carboxylated PPBT binder and PEG surface treatment leads to effectively reduced electrode resistance, which improved cycle life performance and rate capabilities.« less

A steep-slope transistor based on abrupt electronic phase transition

NASA Astrophysics Data System (ADS)

Shukla, Nikhil; Thathachary, Arun V.; Agrawal, Ashish; Paik, Hanjong; Aziz, Ahmedullah; Schlom, Darrell G.; Gupta, Sumeet Kumar; Engel-Herbert, Roman; Datta, Suman

2015-08-01

Collective interactions in functional materials can enable novel macroscopic properties like insulator-to-metal transitions. While implementing such materials into field-effect-transistor technology can potentially augment current state-of-the-art devices by providing unique routes to overcome their conventional limits, attempts to harness the insulator-to-metal transition for high-performance transistors have experienced little success. Here, we demonstrate a pathway for harnessing the abrupt resistivity transformation across the insulator-to-metal transition in vanadium dioxide (VO2), to design a hybrid-phase-transition field-effect transistor that exhibits gate controlled steep (`sub-kT/q') and reversible switching at room temperature. The transistor design, wherein VO2 is implemented in series with the field-effect transistor's source rather than into the channel, exploits negative differential resistance induced across the VO2 to create an internal amplifier that facilitates enhanced performance over a conventional field-effect transistor. Our approach enables low-voltage complementary n-type and p-type transistor operation as demonstrated here, and is applicable to other insulator-to-metal transition materials, offering tantalizing possibilities for energy-efficient logic and memory applications.

A steep-slope transistor based on abrupt electronic phase transition.

PubMed

Shukla, Nikhil; Thathachary, Arun V; Agrawal, Ashish; Paik, Hanjong; Aziz, Ahmedullah; Schlom, Darrell G; Gupta, Sumeet Kumar; Engel-Herbert, Roman; Datta, Suman

2015-08-07

Collective interactions in functional materials can enable novel macroscopic properties like insulator-to-metal transitions. While implementing such materials into field-effect-transistor technology can potentially augment current state-of-the-art devices by providing unique routes to overcome their conventional limits, attempts to harness the insulator-to-metal transition for high-performance transistors have experienced little success. Here, we demonstrate a pathway for harnessing the abrupt resistivity transformation across the insulator-to-metal transition in vanadium dioxide (VO2), to design a hybrid-phase-transition field-effect transistor that exhibits gate controlled steep ('sub-kT/q') and reversible switching at room temperature. The transistor design, wherein VO2 is implemented in series with the field-effect transistor's source rather than into the channel, exploits negative differential resistance induced across the VO2 to create an internal amplifier that facilitates enhanced performance over a conventional field-effect transistor. Our approach enables low-voltage complementary n-type and p-type transistor operation as demonstrated here, and is applicable to other insulator-to-metal transition materials, offering tantalizing possibilities for energy-efficient logic and memory applications.

Single molecule tracking

DOEpatents

Shera, E. Brooks

1988-01-01

A detection system is provided for identifying individual particles or molecules having characteristic emission in a flow train of the particles in a flow cell. A position sensitive sensor is located adjacent the flow cell in a position effective to detect the emissions from the particles within the flow cell and to assign spatial and temporal coordinates for the detected emissions. A computer is then enabled to predict spatial and temporal coordinates for the particle in the flow train as a function of a first detected emission. Comparison hardware or software then compares subsequent detected spatial and temporal coordinates with the predicted spatial and temporal coordinates to determine whether subsequently detected emissions originate from a particle in the train of particles. In one embodiment, the particles include fluorescent dyes which are excited to fluoresce a spectrum characteristic of the particular particle. Photones are emitted adjacent at least one microchannel plate sensor to enable spatial and temporal coordinates to be assigned. The effect of comparing detected coordinates with predicted coordinates is to define a moving sample volume which effectively precludes the effects of background emissions.

Single molecule tracking

DOEpatents

Shera, E.B.

1987-10-07

A detection system is provided for identifying individual particles or molecules having characteristic emission in a flow train of the particles in a flow cell. A position sensitive sensor is located adjacent the flow cell in a position effective to detect the emissions from the particles within the flow cell and to assign spatial and temporal coordinates for the detected emissions. A computer is then enabled to predict spatial and temporal coordinates for the particle in the flow train as a function of a first detected emission. Comparison hardware or software then compares subsequent detected spatial and temporal coordinates with the predicted spatial and temporal coordinates to determine whether subsequently detected emissions originate from a particle in the train of particles. In one embodiment, the particles include fluorescent dyes which are excited to fluoresce a spectrum characteristic of the particular particle. Photons are emitted adjacent at least one microchannel plate sensor to enable spatial and temporal coordinates to be assigned. The effect of comparing detected coordinates with predicted coordinates is to define a moving sample volume which effectively precludes the effects of background emissions. 3 figs.

Investigating the Direct Meltwater Effect in Terrestrial Oxygen-Isotope Paleoclimate Records Using an Isotope-Enabled Earth System Model

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

Zhu, Jiang; Liu, Zhengyu; Brady, Esther C.

Variations in terrestrial oxygen-isotope reconstructions from ice cores and speleothems have been primarily attributed to climatic changes of surface air temperature, precipitation amount, or atmospheric circulation. In this work, we demonstrate with the fully coupled isotope-enabled Community Earth System Model an additional process contributing to the oxygen-isotope variations during glacial meltwater events. This process, termed “the direct meltwater effect,” involves propagating large amounts of isotopically depleted meltwater throughout the hydrological cycle and is independent of climatic changes. We find that the direct meltwater effect can make up 15–35% of the δ 18O signals in precipitation over Greenland and eastern Brazilmore » for large freshwater forcings (0.25–0.50 sverdrup (10 6 m 3/s)). Model simulations further demonstrate that the direct meltwater effect increases with the magnitude and duration of the freshwater forcing and is sensitive to both the location and shape of the meltwater. These new modeling results have important implications for past climate interpretations of δ 18O.« less

Investigating the Direct Meltwater Effect in Terrestrial Oxygen-Isotope Paleoclimate Records Using an Isotope-Enabled Earth System Model

DOE PAGES

Zhu, Jiang; Liu, Zhengyu; Brady, Esther C.; ...

2017-12-28

Variations in terrestrial oxygen-isotope reconstructions from ice cores and speleothems have been primarily attributed to climatic changes of surface air temperature, precipitation amount, or atmospheric circulation. In this work, we demonstrate with the fully coupled isotope-enabled Community Earth System Model an additional process contributing to the oxygen-isotope variations during glacial meltwater events. This process, termed “the direct meltwater effect,” involves propagating large amounts of isotopically depleted meltwater throughout the hydrological cycle and is independent of climatic changes. We find that the direct meltwater effect can make up 15–35% of the δ 18O signals in precipitation over Greenland and eastern Brazilmore » for large freshwater forcings (0.25–0.50 sverdrup (10 6 m 3/s)). Model simulations further demonstrate that the direct meltwater effect increases with the magnitude and duration of the freshwater forcing and is sensitive to both the location and shape of the meltwater. These new modeling results have important implications for past climate interpretations of δ 18O.« less

NASA Space Technology Can Improve Soldier Health, Performance and Safety

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.

2000-01-01

One of the primary goals of NASA Life Sciences research is '... to enable a permanent human presence in space.' To meet this goal, NASA is creating alternative protocols designed to evaluate and test countermeasures that will account for and correct the environmental effects of space flight on crewmembers health, safety, and operational performance. NASA investigators have previously evaluated the effects of long-duration space flight on physiology and performance of cosmonauts aboard the MIR space station. They also initiated tests of a countermeasure, Autogenic-Feedback Training Exercise (AFTE) designed to prevent and/or correct adverse effects, i.e., facilitate adaptation to space and re-adaptation to Earth. AFTE is a six-hour physiological training program that has proven to be a highly efficient and effective method for enabling people to monitor and voluntarily control a range of their own physiological responses, thereby minimizing adverse reactions to environmental stress. However, because of limited opportunities to test this technology with space flight crews, it is essential to find operational or 'real world' environments in which to validate the efficacy of this approach.

Towards inclusive occupational therapy: Introducing the CORE approach for inclusive and occupation-focused practice.

PubMed

Pereira, Robert B

2017-12-01

Occupation is a human right and a social determinant of health. It is also taken for granted. Having access to, and participating in, occupation, is intricately linked to positive health and wellbeing. Despite theory and evidence to support the link between occupation, health and wellbeing, occupational therapists can struggle with applying an occupation focus in practice and knowing how to use occupational frameworks to enable occupation. The purpose of this paper is to introduce the Capabilities, Opportunities, Resources and Environments (CORE) approach for inclusive and occupation-focused practice. It provides occupational therapists with a means of operationalising occupational enablement and facilitating social inclusion. The CORE approach is introduced by linking its main ideas to Economist and Nobel Prize Laureate Amartya Sen's capabilities approach, as well as findings from the author's doctoral research into entrenched disadvantage and social inclusion. Practical questions guided by the CORE approach's acronym are given to explore how the approach can be utilised alongside other occupational models and frameworks to encourage strategies for effective enablement through occupation for social inclusion. As experts in enabling occupation, occupational therapists can use the CORE approach to design occupation-focused interventions and promote inclusive occupational therapy. © 2017 Occupational Therapy Australia.

Control of robotic assistance using poststroke residual voluntary effort.

PubMed

Makowski, Nathaniel S; Knutson, Jayme S; Chae, John; Crago, Patrick E

2015-03-01

Poststroke hemiparesis limits the ability to reach, in part due to involuntary muscle co-activation (synergies). Robotic approaches are being developed for both therapeutic benefit and continuous assistance during activities of daily living. Robotic assistance may enable participants to exert less effort, thereby reducing expression of the abnormal co-activation patterns, which could allow participants to reach further. This study evaluated how well participants could perform a reaching task with robotic assistance that was either provided independent of effort in the vertical direction or in the sagittal plane in proportion to voluntary effort estimated from electromyograms (EMG) on the affected side. Participants who could not reach targets without assistance were enabled to reach further with assistance. Constant anti-gravity force assistance that was independent of voluntary effort did not reduce the quality of reach and enabled participants to exert less effort while maintaining different target locations. Force assistance that was proportional to voluntary effort on the affected side enabled participants to exert less effort and could be controlled to successfully reach targets, but participants had increased difficulty maintaining a stable position. These results suggest that residual effort on the affected side can produce an effective command signal for poststroke assistive devices.

Economic and societal dimensions of nanotechnology-enabled drug delivery.

PubMed

te Kulve, Haico; Rip, Arie

2013-05-01

There is an increasing interest in nanotechnology-enabled drug delivery systems which are expected to have significant impacts for health care. The economic and societal aspects are uncertain, even ambiguous, at this stage of development, and often not addressed, or only as part of the promises about present options. In our review we will report on assessments of actors regarding economic and societal aspects and, occasionally, of expected impacts. Topics discussed include: present and future markets of nano-enabled drug delivery, industry dynamics, regulation, cost-effectiveness, and broader ethical issues. We also include a brief discussion of anticipatory activities of actors who are concerned about these aspects. Performance of nano-enabled drug delivery, a necessary step to have future impacts at all, needs to be improved further, and in interaction with demands of users along the product value chain and with further stakeholder such as regulatory agencies and health insurers. When supported by analysis of societal embedding of new products and scenarios, this allows relevant societal and economic aspects to be taken into account at an early stage. A key issue in realizing impacts will be liability, and roles and responsibilities of technology developers and stakeholders more generally.

Thermodynamics of Hydrophobic Amino Acids in Solution: A Combined Experimental–Computational Study

DOE PAGES

Song, Lingshuang; Yang, Lin; Meng, Jie; ...

2016-12-29

Here, we present a joint experimental-computational study to quantitatively describe the thermodynamics of hydrophobic leucine amino acids in aqueous solution. X-ray scattering data were acquired at a series of solute and salt concentrations to effectively measure inter-leucine interactions, indicating that a major scattering peak is observed consistently at q = 0.83 Å -1. Atomistic molecular dynamics simulations were then performed and compared with the scattering data, achieving high consistency at both small and wider scattering angles (q = 0$-$1.5 Å -1). This experimental-computational consistence enables a first glimpse of the leucineleucine interacting landscape, where two leucine molecules are aligned mostlymore » in a parallel fashion, as opposed to anti-parallel, but also allows us to derive effective leucine-leucine interactions in solution. Collectively, this combined approach of employing experimental scattering and molecular simulation enables a quantitative characterization on effective inter-molecular interactions of hydrophobic amino acids, critical for protein function and dynamics such as protein folding.« less

Thermodynamics of Hydrophobic Amino Acids in Solution: A Combined Experimental–Computational Study

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

Song, Lingshuang; Yang, Lin; Meng, Jie

Here, we present a joint experimental-computational study to quantitatively describe the thermodynamics of hydrophobic leucine amino acids in aqueous solution. X-ray scattering data were acquired at a series of solute and salt concentrations to effectively measure inter-leucine interactions, indicating that a major scattering peak is observed consistently at q = 0.83 Å -1. Atomistic molecular dynamics simulations were then performed and compared with the scattering data, achieving high consistency at both small and wider scattering angles (q = 0$-$1.5 Å -1). This experimental-computational consistence enables a first glimpse of the leucineleucine interacting landscape, where two leucine molecules are aligned mostlymore » in a parallel fashion, as opposed to anti-parallel, but also allows us to derive effective leucine-leucine interactions in solution. Collectively, this combined approach of employing experimental scattering and molecular simulation enables a quantitative characterization on effective inter-molecular interactions of hydrophobic amino acids, critical for protein function and dynamics such as protein folding.« less

Bioinspired Functionalized Melanin Nanovariants with a Range of Properties Provide Effective Color Matched Photoprotection in Skin.

PubMed

Vij, Manika; Grover, Ritika; Gotherwal, Vishvabandhu; Wani, Naiem Ahmad; Joshi, Prashant; Gautam, Hemlata; Sharma, Kanupriya; Chandna, Sudhir; Gokhale, Rajesh S; Rai, Rajkishor; Ganguli, Munia; Natarajan, Vivek T

2016-09-12

Melanin and related polydopamine hold great promise; however, restricted fine-tunabilility limits their usefulness in biocompatible applications. In the present study, by taking a biomimetic approach, we synthesize peptide-derived melanin with a range of physicochemical properties. Characterization of these melanin polymers indicates that they exist as nanorange materials with distinct size distribution, shapes, and surface charges. These variants demonstrate similar absorption spectra but have different optical properties that correlate with particle size. Our approach enables incorporation of chemical groups to create functionalized polyvalent organic nanomaterials and enables customization of melanin. Further, we establish that these synthetic variants are efficiently taken up by the skin keratinocytes, display appreciable photoprotection with minimal cytotoxicity, and thereby function as effective color matched photoprotective agents. In effect we demonstrate that an array of functionalized melanins with distinct properties could be synthesized using bioinspired green chemistry, and these are of immense utility in generating customized melanin/polydopamine like materials.

The integration of cyanide hydratase and tyrosinase catalysts enables effective degradation of cyanide and phenol in coking wastewaters.

PubMed

Martínková, Ludmila; Chmátal, Martin

2016-10-01

The aim of this study was to design an effective method for the bioremediation of coking wastewaters, specifically for the concurrent elimination of their highly toxic components - cyanide and phenols. Almost full degradation of free cyanide (0.32-20 mM; 8.3-520 mg L(-1)) in the model and the real coking wastewaters was achieved by using a recombinant cyanide hydratase in the first step. The removal of cyanide, a strong inhibitor of tyrosinase, enabled an effective degradation of phenols by this enzyme in the second step. Phenol (16.5 mM, 1,552 mg L(-1)) was completely removed from a real coking wastewater within 20 h and cresols (5.0 mM, 540 mg L(-1)) were removed by 66% under the same conditions. The integration of cyanide hydratase and tyrosinase open up new possibilities for the bioremediation of wastewaters with complex pollution. Copyright © 2016 Elsevier Ltd. All rights reserved.

Real World Data in Adaptive Biomedical Innovation: A Framework for Generating Evidence Fit for Decision-Making.

PubMed

Schneeweiss, S; Eichler, H-G; Garcia-Altes, A; Chinn, C; Eggimann, A-V; Garner, S; Goettsch, W; Lim, R; Löbker, W; Martin, D; Müller, T; Park, B J; Platt, R; Priddy, S; Ruhl, M; Spooner, A; Vannieuwenhuyse, B; Willke, R J

2016-12-01

Analyses of healthcare databases (claims, electronic health records [EHRs]) are useful supplements to clinical trials for generating evidence on the effectiveness, harm, use, and value of medical products in routine care. A constant stream of data from the routine operation of modern healthcare systems, which can be analyzed in rapid cycles, enables incremental evidence development to support accelerated and appropriate access to innovative medicines. Evidentiary needs by regulators, Health Technology Assessment, payers, clinicians, and patients after marketing authorization comprise (1) monitoring of medication performance in routine care, including the materialized effectiveness, harm, and value; (2) identifying new patient strata with added value or unacceptable harms; and (3) monitoring targeted utilization. Adaptive biomedical innovation (ABI) with rapid cycle database analytics is successfully enabled if evidence is meaningful, valid, expedited, and transparent. These principles will bring rigor and credibility to current efforts to increase research efficiency while upholding evidentiary standards required for effective decision-making in healthcare. © 2016 American Society for Clinical Pharmacology and Therapeutics.

Density-matrix based determination of low-energy model Hamiltonians from ab initio wavefunctions

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

Changlani, Hitesh J.; Zheng, Huihuo; Wagner, Lucas K.

2015-09-14

We propose a way of obtaining effective low energy Hubbard-like model Hamiltonians from ab initio quantum Monte Carlo calculations for molecular and extended systems. The Hamiltonian parameters are fit to best match the ab initio two-body density matrices and energies of the ground and excited states, and thus we refer to the method as ab initio density matrix based downfolding. For benzene (a finite system), we find good agreement with experimentally available energy gaps without using any experimental inputs. For graphene, a two dimensional solid (extended system) with periodic boundary conditions, we find the effective on-site Hubbard U{sup ∗}/t tomore » be 1.3 ± 0.2, comparable to a recent estimate based on the constrained random phase approximation. For molecules, such parameterizations enable calculation of excited states that are usually not accessible within ground state approaches. For solids, the effective Hamiltonian enables large-scale calculations using techniques designed for lattice models.« less

Use of multicriteria decision analysis for assessing the benefit and risk of over-the-counter analgesics.

PubMed

Moore, Andrew; Crossley, Anne; Ng, Bernard; Phillips, Lawrence; Sancak, Özgür; Rainsford, K D

2017-10-01

To test the ability of a multicriteria decision analysis (MCDA) model to incorporate disparate data sources of varying quality along with clinical judgement in a benefit-risk assessment of six well-known pain-relief drugs. Six over-the-counter (OTC) analgesics were evaluated against three favourable effects and eight unfavourable effects by seven experts who specialise in the relief of pain, two in a 2-day facilitated workshop whose input data and judgements were later peer-reviewed by five additional experts. Ibuprofen salts and solubilised emerged with the best benefit-risk profile, followed by naproxen, ibuprofen acid, diclofenac, paracetamol and aspirin. Multicriteria decision analysis enabled participants to evaluate the OTC analgesics against a range of favourable and unfavourable effects in a group setting that enabled all issues to be openly aired and debated. The model was easily communicated and understood by the peer reviewers, so the model should be comprehensible to physicians, pharmacists and other health professionals. © 2017 Royal Pharmaceutical Society.

No more summaries for wonks

NASA Astrophysics Data System (ADS)

Black, Richard

2015-04-01

IPCC assessments present an unparalleled opportunity for climate science to speak directly to power. Re-thinking the summaries written for policymakers would enable scientists to communicate far more effectively with political leaders and the public.

76 FR 4870 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-27

... substrate and energy data and gear specific habitat vulnerability parameters. This tool will enable a better... vulnerability to particular fishing gears, and the distribution of adverse effects from fishing activities on...

14 CFR § 1216.204 - General implementation requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Unified National Program for Flood Plain Management (U.S. Water Resources Council, 1978). (1) Descriptive... permits and grants to enable them to similarly evaluate, in accordance with the Orders, the effects of...

Breakthrough: Better Fiber for Better Products

ScienceCinema

Griffith, George; Garnier, John

2018-01-08

Researchers at Idaho National Laboratory have developed a cost-effective method for the continuous production of alpha silicon carbide fiber. The exceptionally strong, lightweight fiber could enable significant performance improvements in many everyday products.

Flow Cells for Scalable Energy Conversion and Storage

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

Mukundan, Rangachary

2017-10-26

This project is a response to current flow systems that are V-aqueous and not cost effective. It will hopefully enable high energy/ power density flow cells through rational materials and system design.

RMP Guidance for Chemical Distributors - Appendix D: OSHA Guidance on PSM

EPA Pesticide Factsheets

Guidance on the Process Safety Management standard says information (including MSDS) about chemicals, including process intermediates, must enable accurate assessment of fire/explosion characteristics, reactivity hazards, and corrosing/erosion effects.

Development of rehabilitation training support system for occupational therapy of upper limb motor function

NASA Astrophysics Data System (ADS)

Morita, Yoshifumi; Hirose, Akinori; Uno, Takashi; Uchid, Masaki; Ukai, Hiroyuki; Matsui, Nobuyuki

2007-12-01

In this paper we propose a new rehabilitation training support system for upper limbs. The proposed system enables therapists to quantitatively evaluate the therapeutic effect of upper limb motor function during training, to easily change the load of resistance of training and to easily develop a new training program suitable for the subjects. For this purpose we develop control algorithms of training programs in the 3D force display robot. The 3D force display robot has parallel link mechanism with three motors. The control algorithm simulating sanding training is developed for the 3D force display robot. Moreover the teaching/training function algorithm is developed. It enables the therapists to easily make training trajectory suitable for subject's condition. The effectiveness of the developed control algorithms is verified by experiments.

Designing Epigenome Editors: Considerations of Biochemical and Locus Specificities.

PubMed

Sen, Dilara; Keung, Albert J

2018-01-01

The advent of locus-specific protein recruitment technologies has enabled a new class of studies in chromatin biology. Epigenome editors enable biochemical modifications of chromatin at almost any specific endogenous locus. Their locus specificity unlocks unique information including the functional roles of distinct modifications at specific genomic loci. Given the growing interest in using these tools for biological and translational studies, there are many specific design considerations depending on the scientific question or clinical need. Here we present and discuss important design considerations and challenges regarding the biochemical and locus specificities of epigenome editors. These include how to account for the complex biochemical diversity of chromatin; control for potential interdependency of epigenome editors and their resultant modifications; avoid sequestration effects; quantify the locus specificity of epigenome editors; and improve locus specificity by considering concentration, affinity, avidity, and sequestration effects.

Real medical benefit assessed by indirect comparison.

PubMed

Falissard, Bruno; Zylberman, Myriam; Cucherat, Michel; Izard, Valérie; Meyer, François

2009-01-01

Frequently, in data packages submitted for Marketing Approval to the CHMP, there is a lack of relevant head-to-head comparisons of medicinal products that could enable national authorities responsible for the approval of reimbursement to assess the Added Therapeutic Value (ASMR) of new clinical entities or line extensions of existing therapies.Indirect or mixed treatment comparisons (MTC) are methods stemming from the field of meta-analysis that have been designed to tackle this problem. Adjusted indirect comparisons, meta-regressions, mixed models, Bayesian network analyses pool results of randomised controlled trials (RCTs), enabling a quantitative synthesis.The REAL procedure, recently developed by the HAS (French National Authority for Health), is a mixture of an MTC and effect model based on expert opinions. It is intended to translate the efficacy observed in the trials into effectiveness expected in day-to-day clinical practice in France.

Enabling cost-effective high-current burst-mode operation in superconducting accelerators

DOE PAGES

Sheffield, Richard L.

2015-06-01

Superconducting (SC) accelerators are very efficient for CW or long-pulse operation, and normal conducting (NC) accelerators are cost effective for short-pulse operation. The addition of a short NC linac section to a SC linac can correct for the energy droop that occurs when pulsed high-current operation is required that exceeds the capability of the klystrons to replenish the cavity RF fields due to the long field fill-times of SC structures, or a requirement to support a broad range of beam currents results in variable beam loading. This paper describes the implementation of this technique to enable microseconds of high beam-current,more » 90 mA or more, in a 12 GeV SC long-pulse accelerator designed for the MaRIE 42-keV XFEL proposed for Los Alamos National Laboratory.« less

Enabling communication in emergency response environments.

PubMed

Aldunate, Roberto G; Schmidt, Klaus Nicholas; Herrera, Oriel

2012-01-01

Effective communication among first responders during response to natural and human-made large-scale catastrophes has increased tremendously during the last decade. However, most efforts to achieve a higher degree of effectiveness in communication lack synergy between the environment and the technology involved to support first responders operations. This article presents a natural and intuitive interface to support Stigmergy; or communication through the environment, based on intuitively marking and retrieving information from the environment with a pointer. A prototype of the system was built and tested in the field, however the pointing activity revealed challenges regarding accuracy due to limitations of the sensors used. The results obtained from these field tests were the basis for this research effort and will have the potential to enable communication through the environment for first responders operating in highly dynamical and inhospitable disaster relief environments.

The Use of Absorptive Capacity in Improving the New Product Development (NPD

NASA Astrophysics Data System (ADS)

Gunawan, W.; Gerardus, P.; Tji, B. J.; Richard, K.

2017-01-01

The term Absorptive Capacity (AC) refers to maximizing the external knowledge transfer into the organization in order to improve its performance. Since its introduction in year 1990, AC has been applied widely in many fields such as: economy, business, KM, HR, intellectual capital, IT, operation management, marketing, etc. Due to its wide application, nevertheless, The AC application in both Indonesian industry and higher education institutions (HEIs) are still rare to find. The Indonesian Directorate General of Higher Education (DGHE) has encouraged creating effective collaboration model that enables to link the HEIs with the industries in order to improve knowledge creation in improving product development that can be used by the firms. For this reason, the article examines the effective AC model that enables to assist in improving new product development (NPD) process in the polytechnic perspectives.

CZT sensors for Computed Tomography: from crystal growth to image quality

NASA Astrophysics Data System (ADS)

Iniewski, K.

2016-12-01

Recent advances in Traveling Heater Method (THM) growth and device fabrication that require additional processing steps have enabled to dramatically improve hole transport properties and reduce polarization effects in Cadmium Zinc Telluride (CZT) material. As a result high flux operation of CZT sensors at rates in excess of 200 Mcps/mm2 is now possible and has enabled multiple medical imaging companies to start building prototype Computed Tomography (CT) scanners. CZT sensors are also finding new commercial applications in non-destructive testing (NDT) and baggage scanning. In order to prepare for high volume commercial production we are moving from individual tile processing to whole wafer processing using silicon methodologies, such as waxless processing, cassette based/touchless wafer handling. We have been developing parametric level screening at the wafer stage to ensure high wafer quality before detector fabrication in order to maximize production yields. These process improvements enable us, and other CZT manufacturers who pursue similar developments, to provide high volume production for photon counting applications in an economically feasible manner. CZT sensors are capable of delivering both high count rates and high-resolution spectroscopic performance, although it is challenging to achieve both of these attributes simultaneously. The paper discusses material challenges, detector design trade-offs and ASIC architectures required to build cost-effective CZT based detection systems. Photon counting ASICs are essential part of the integrated module platforms as charge-sensitive electronics needs to deal with charge-sharing and pile-up effects.

Work-based assessment: qualitative perspectives of novice nutrition and dietetics educators.

PubMed

Palermo, C; Beck, E J; Chung, A; Ash, S; Capra, S; Truby, H; Jolly, B

2014-10-01

The assessment of competence for health professionals including nutrition and dietetics professionals in work-based settings is challenging. The present study aimed to explore the experiences of educators involved in the assessment of nutrition and dietetics students in the practice setting and to identify barriers and enablers to effective assessment. A qualitative research approach using in-depth interviews was employed with a convenience sample of inexperienced dietitian assessors. Interviews explored assessment practices and challenges. Data were analysed using a thematic approach within a phenomenological framework. Twelve relatively inexperienced practice educators were purposefully sampled to take part in the present study. Three themes emerged from these data. (i) Student learning and thus assessment is hindered by a number of barriers, including workload demands and case-mix. Some workplaces are challenged to provide appropriate learning opportunities and environment. Adequate support for placement educators from the university, managers and their peers and planning are enablers to effective assessment. (ii) The role of the assessor and their relationship with students impacts on competence assessment. (iii) There is a lack of clarity in the tasks and responsibilities of competency-based assessment. The present study provides perspectives on barriers and enablers to effective assessment. It highlights the importance of reflective practice and feedback in assessment practices that are synonymous with evidence from other disciplines, which can be used to better support a work-based competency assessment of student performance. © 2013 The British Dietetic Association Ltd.

The future of drug discovery: enabling technologies for enhancing lead characterization and profiling therapeutic potential.

PubMed

Janero, David R

2014-08-01

Technology often serves as a handmaiden and catalyst of invention. The discovery of safe, effective medications depends critically upon experimental approaches capable of providing high-impact information on the biological effects of drug candidates early in the discovery pipeline. This information can enable reliable lead identification, pharmacological compound differentiation and successful translation of research output into clinically useful therapeutics. The shallow preclinical profiling of candidate compounds promulgates a minimalistic understanding of their biological effects and undermines the level of value creation necessary for finding quality leads worth moving forward within the development pipeline with efficiency and prognostic reliability sufficient to help remediate the current pharma-industry productivity drought. Three specific technologies discussed herein, in addition to experimental areas intimately associated with contemporary drug discovery, appear to hold particular promise for strengthening the preclinical valuation of drug candidates by deepening lead characterization. These are: i) hydrogen-deuterium exchange mass spectrometry for characterizing structural and ligand-interaction dynamics of disease-relevant proteins; ii) activity-based chemoproteomics for profiling the functional diversity of mammalian proteomes; and iii) nuclease-mediated precision gene editing for developing more translatable cellular and in vivo models of human diseases. When applied in an informed manner congruent with the clinical understanding of disease processes, technologies such as these that span levels of biological organization can serve as valuable enablers of drug discovery and potentially contribute to reducing the current, unacceptably high rates of compound clinical failure.

An Embedded Wireless Sensor Network with Wireless Power Transmission Capability for the Structural Health Monitoring of Reinforced Concrete Structures

PubMed Central

Gallucci, Luca; Menna, Costantino; Angrisani, Leopoldo; Asprone, Domenico

2017-01-01

Maintenance strategies based on structural health monitoring can provide effective support in the optimization of scheduled repair of existing structures, thus enabling their lifetime to be extended. With specific regard to reinforced concrete (RC) structures, the state of the art seems to still be lacking an efficient and cost-effective technique capable of monitoring material properties continuously over the lifetime of a structure. Current solutions can typically only measure the required mechanical variables in an indirect, but economic, manner, or directly, but expensively. Moreover, most of the proposed solutions can only be implemented by means of manual activation, making the monitoring very inefficient and then poorly supported. This paper proposes a structural health monitoring system based on a wireless sensor network (WSN) that enables the automatic monitoring of a complete structure. The network includes wireless distributed sensors embedded in the structure itself, and follows the monitoring-based maintenance (MBM) approach, with its ABCDE paradigm, namely: accuracy, benefit, compactness, durability, and easiness of operations. The system is structured in a node level and has a network architecture that enables all the node data to converge in a central unit. Human control is completely unnecessary until the periodic evaluation of the collected data. Several tests are conducted in order to characterize the system from a metrological point of view and assess its performance and effectiveness in real RC conditions. PMID:29112128

Does Your Cohort Matter? Measuring Peer Effects in College Achievement. NBER Working Paper No. 14032

ERIC Educational Resources Information Center

Carrell, Scott E.; Fullerton, Richard L.; West, James E.

2008-01-01

To estimate peer effects in college achievement we exploit a unique dataset in which individuals have been exogenously assigned to peer groups of about 30 students with whom they are required to spend the majority of their time interacting. This feature enables us to estimate peer effects that are more comparable to changing the entire cohort of…

Toward cost-effective solar energy use.

PubMed

Lewis, Nathan S

2007-02-09

At present, solar energy conversion technologies face cost and scalability hurdles in the technologies required for a complete energy system. To provide a truly widespread primary energy source, solar energy must be captured, converted, and stored in a cost-effective fashion. New developments in nanotechnology, biotechnology, and the materials and physical sciences may enable step-change approaches to cost-effective, globally scalable systems for solar energy use.

Observation of the Effectiveness of Drama Method in Helping to Acquire the Addition-Subtraction Skills by Children at Preschool Phase

ERIC Educational Resources Information Center

Soydan, Sema; Quadir, Seher Ersoy

2013-01-01

Principal aim of this study is to show the effectiveness of the program prepared by researchers in order to enable 6 year-old children attending pre-school educational institutions to effectively gain addition subtraction skills through a drama-related method. The work group in the research comprised of 80 kids who continued their education in…

New Technologies for Rapid Bacterial Identification and Antibiotic Resistance Profiling.

PubMed

Kelley, Shana O

2017-04-01

Conventional approaches to bacterial identification and drug susceptibility testing typically rely on culture-based approaches that take 2 to 7 days to return results. The long turnaround times contribute to the spread of infectious disease, negative patient outcomes, and the misuse of antibiotics that can contribute to antibiotic resistance. To provide new solutions enabling faster bacterial analysis, a variety of approaches are under development that leverage single-cell analysis, microfluidic concentration and detection strategies, and ultrasensitive readout mechanisms. This review discusses recent advances in this area and the potential of new technologies to enable more effective management of infectious disease.

Risk analysis of computer system designs

NASA Technical Reports Server (NTRS)

Vallone, A.

1981-01-01

Adverse events during implementation can affect final capabilities, schedule and cost of a computer system even though the system was accurately designed and evaluated. Risk analysis enables the manager to forecast the impact of those events and to timely ask for design revisions or contingency plans before making any decision. This paper presents a structured procedure for an effective risk analysis. The procedure identifies the required activities, separates subjective assessments from objective evaluations, and defines a risk measure to determine the analysis results. The procedure is consistent with the system design evaluation and enables a meaningful comparison among alternative designs.

Migration of magnetotactic bacteria in porous media.

PubMed

Rismani Yazi, Saeed; Nosrati, Reza; Stevens, Corey A; Vogel, David; Escobedo, Carlos

2018-01-01

Magnetotactic bacteria (MTB) migrate in complex porous sediments where fluid flow is ubiquitous. Here, we demonstrate that magnetotaxis enables MTB to migrate effectively through porous micromodels. Directed MTB can circumvent curved obstacles by traveling along the boundaries and pass flat obstacles by repeatedly switching between forward and backward runs. Magnetotaxis enables directed motion of MTB through heterogeneous porous media, overcoming tortuous flow fields with local velocities as high as 250  μ m s -1 . Our findings bring new insights into the migration behaviour of MTB in their natural habitats and their potential in vivo applications as microbiorobots.

Optimal cooperative time-fixed impulsive rendezvous

NASA Technical Reports Server (NTRS)

Mirfakhraie, Koorosh; Conway, Bruce A.

1990-01-01

New capabilities have been added to a method that had been developed for determining optimal, i.e., minimum fuel, trajectories for the fixed-time cooperative rendezvous of two spacecraft. The method utilizes the primer vector theory. The new capabilities enable the method to accomodate cases in which there are fuel constraints on the spacecraft and/or enable the addition of a mid-course impulse to one of the vehicle's trajectories. Results are presented for a large number of cases, and the effect of varying parameters, such as vehicle fuel constraints, vehicle initial masses, and time allowed for the rendezvous, is demonstrated.

Songlines and navigation in Wardaman and other Australian Aboriginal cultures

NASA Astrophysics Data System (ADS)

Norris, Ray P.; Harney, Bill Yidumdum

2014-07-01

We discuss the songlines and navigation of the Wardaman people, and place them in context by comparing them with corresponding practices in other Aboriginal Australian language groups, using previously-unpublished information and also information drawn from the literature. Songlines are effectively oral maps of the landscape, enabling the transmission of oral navigational skills in cultures that do not have a written language. In many cases, songlines on the Earth are mirrored by songlines in the sky, enabling the sky to be used as a navigational tool, both by using it as a compass and by using it as a mnemonic.

The UCSC genome browser: what every molecular biologist should know.

PubMed

Mangan, Mary E; Williams, Jennifer M; Kuhn, Robert M; Lathe, Warren C

2009-10-01

Electronic data resources can enable molecular biologists to query and display many useful features that make benchwork more efficient and drive new discoveries. The UCSC Genome Browser provides a wealth of data and tools that advance one's understanding of genomic context for many species, enable detailed understanding of data, and provide the ability to interrogate regions of interest. Researchers can also supplement the standard display with their own data to query and share with others. Effective use of these resources has become crucial to biological research today, and this unit describes some practical applications of the UCSC Genome Browser.

MCCx C3I Control Center Interface Emulator

NASA Technical Reports Server (NTRS)

Mireles, James R.

2010-01-01

This slide presentation reviews the project to develop and demonstrate alternate Information Technologies and systems for new Mission Control Centers that will reduce the cost of facility development, maintenance and operational costs and will enable more efficient cost and effective operations concepts for ground support operations. The development of a emulator for the Control Center capability will enable the facilities to conduct the simulation requiring interactivity with the Control Center when it is off line or unavailable, and it will support testing of C3I interfaces for both command and telemetry data exchange messages (DEMs).

Microdosing: Concept, Application and Relevance

PubMed Central

Tewari, Tushar; Mukherjee, Shoibal

2010-01-01

The use of microdose pharmacokinetic studies as an essential tool in drug development is still to catch on. While this approach promises potential cost savings and a quantum leap in efficiencies of the drug development process, major hurdles still need to be overcome before the technique becomes commonplace and part of routine practice. Clear regulations in Europe and the USA have had an enabling effect. The lack of enabling provisions for microdosing studies in Indian regulation, despite low risk and manifest relevance for the local drug development industry, is inconsistent with the country's aspirations to be among the leaders in pharmaceutical research. PMID:21829784

Microdosing: concept, application and relevance.

PubMed

Tewari, Tushar; Mukherjee, Shoibal

2010-04-01

The use of microdose pharmacokinetic studies as an essential tool in drug development is still to catch on. While this approach promises potential cost savings and a quantum leap in efficiencies of the drug development process, major hurdles still need to be overcome before the technique becomes commonplace and part of routine practice. Clear regulations in Europe and the USA have had an enabling effect. The lack of enabling provisions for microdosing studies in Indian regulation, despite low risk and manifest relevance for the local drug development industry, is inconsistent with the country's aspirations to be among the leaders in pharmaceutical research.

Transaction-Based Building Controls Framework, Volume 1: Reference Guide

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

Somasundaram, Sriram; Pratt, Robert G.; Akyol, Bora A.

This document proposes a framework concept to achieve the objectives of raising buildings’ efficiency and energy savings potential benefitting building owners and operators. We call it a transaction-based framework, wherein mutually-beneficial and cost-effective market-based transactions can be enabled between multiple players across different domains. Transaction-based building controls are one part of the transactional energy framework. While these controls realize benefits by enabling automatic, market-based intra-building efficiency optimizations, the transactional energy framework provides similar benefits using the same market -based structure, yet on a larger scale and beyond just buildings, to the society at large.

Building Science-Relevant Literacy with Technical Writing in High School

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

Girill, T R

2006-06-02

By drawing on the in-class work of an on-going literacy outreach project, this paper explains how well-chosen technical writing activities can earn time in high-school science courses by enabling underperforming students (including ESL students) to learn science more effectively. We adapted basic research-based text-design and usability techniques into age-appropriate exercises and cases using the cognitive apprenticeship approach. This enabled high-school students, aided by explicit guidelines, to build their cognitive maturity, learn how to craft good instructions and descriptions, and apply those skills to better note taking and technical talks in their science classes.

Enablers towards establishing and growing South Africa's waste to electricity industry.

PubMed

Amsterdam, Heinrich; Thopil, George Alex

2017-10-01

In South Africa the electricity generation mix is relatively un-diverse whereas globally the transformation of the sector is advancing rapidly. Coal remains the predominant fuel source and limited success has to date been achieved in the renewable energy sector. The electricity generation sector is therefore hindered from moving towards an electricity generation landscape where alternative fuel sources is utilised. This research is aimed at gaining insight into the enablers that led towards an increasing trend (observed globally) in exploiting waste as a fuel for electricity generation, and to outline the presence of obstacles that hinder separation of waste for electricity use in the South African context. Furthermore it is an attempt at informing what appropriate interventions (operational and policy) may be considered suitable for South Africa to overcome these barriers in order to enable a sustainable South African waste to electricity (WTE) Industry. Findings show that numerous barriers to a WTE exists in the South African context, however overcoming these barriers is not as simple as adopting the European model with the aim to modify the electricity generation mix and waste management landscape. Selected enablers deemed appropriate in the South African context are adapted from the European model, and are greatly influenced by the prevailing socio-economic status of South Africa. Primary enablers identified were, (i) government support is needed especially in the form of subsidisation for green energy, (ii) increase landfill costs through the implementation of a landfill tax, (iii) streamline the process for Independent Private Power Producers (IPPPs) to connect to the national grid with off-take guaranteed and the inclusion of WTE into an electricity roadmap (effectively government's strategy). The proposed enabling interventions would help in overcoming the barriers for a South African WTE industry. Copyright © 2017 Elsevier Ltd. All rights reserved.

Modeling Thermal Effects for Simulation of Post Exposure Baking (PEB) Process in Positive Photoresist

NASA Astrophysics Data System (ADS)

Asai, Satoru; Hanyu, Isamu; Nunokawa, Mitsuji; Abe, Masayuki

1991-03-01

We studied the thermal effects in a positive photoresist during post exposure baking (PEB). Infrared analysis and the reduced dissolution rate in the exposed resist suggest that the carboxylic acid is decreased and/or that ECA solvent evaporates. In order to simulate the effects, we assume that the concentration of the alkali-soluble material (carboxylic acid) decreases equivalently. Our model explains PEB and enables its effects to be simulated.

Unconventional High-Performance Laser Protection System Based on Dichroic Dye-Doped Cholesteric Liquid Crystals

NASA Astrophysics Data System (ADS)

Zhang, Wanshu; Zhang, Lanying; Liang, Xiao; Le Zhou; Xiao, Jiumei; Yu, Li; Li, Fasheng; Cao, Hui; Li, Kexuan; Yang, Zhou; Yang, Huai

2017-02-01

High-performance and cost-effective laser protection system is of crucial importance for the rapid advance of lasers in military and civilian fields leading to severe damages of human eyes and sensitive optical devices. However, it is crucially hindered by the angle-dependent protective effect and the complex preparation process. Here we demonstrate that angle-independence, good processibility, wavelength tunability, high optical density and good visibility can be effectuated simultaneously, by embedding dichroic anthraquinone dyes in a cholesteric liquid crystal matrix. More significantly, unconventional two-dimensional parabolic protection behavior is reported for the first time that in stark contrast to the existing protection systems, the overall parabolic protection behavior enables protective effect to increase with incident angles, hence providing omnibearing high-performance protection. The protective effect is controllable by dye concentration, LC cell thickness and CLC reflection efficiency, and the system can be made flexible enabling applications in flexible and even wearable protection devices. This research creates a promising avenue for the high-performance and cost-effective laser protection, and may foster the development of optical applications such as solar concentrators, car explosion-proof membrane, smart windows and polarizers.

Mechanistic models enable the rational use of in vitro drug-target binding kinetics for better drug effects in patients.

PubMed

de Witte, Wilhelmus E A; Wong, Yin Cheong; Nederpelt, Indira; Heitman, Laura H; Danhof, Meindert; van der Graaf, Piet H; Gilissen, Ron A H J; de Lange, Elizabeth C M

2016-01-01

Drug-target binding kinetics are major determinants of the time course of drug action for several drugs, as clearly described for the irreversible binders omeprazole and aspirin. This supports the increasing interest to incorporate newly developed high-throughput assays for drug-target binding kinetics in drug discovery. A meaningful application of in vitro drug-target binding kinetics in drug discovery requires insight into the relation between in vivo drug effect and in vitro measured drug-target binding kinetics. In this review, the authors discuss both the relation between in vitro and in vivo measured binding kinetics and the relation between in vivo binding kinetics, target occupancy and effect profiles. More scientific evidence is required for the rational selection and development of drug-candidates on the basis of in vitro estimates of drug-target binding kinetics. To elucidate the value of in vitro binding kinetics measurements, it is necessary to obtain information on system-specific properties which influence the kinetics of target occupancy and drug effect. Mathematical integration of this information enables the identification of drug-specific properties which lead to optimal target occupancy and drug effect in patients.

The AOP framework and causality: Meeting chemical risk ...

EPA Pesticide Factsheets

Chemical safety assessments are expanding from a focus on a few chemicals (or chemical mixtures) to the broader “universe” of thousands, if not hundreds of thousands of substances that potentially could impact humans or the environment. This is exemplified in regulatory activities such as the REACH program in Europe, or the recent reauthorization of TSCA in the US, which require consideration of the potential impacts of a much greater number of chemicals than in the past. The data needed to address these types of legislated mandates cannot realistically be obtained solely through using the whole animal testing approaches historically employed for chemical risk assessment. Rather, there needs to be an increased emphasis on cost-effective tools that enable robust prediction of potential chemical impacts when empirical data are lacking. Concurrent with the realization that predictive methods will need to play an increasingly prominent role in regulatory toxicology has been the recent explosion in technology in the biological sciences enabling collection of large amounts of pathway-based molecular and biochemical data. For example, genomic techniques and high-throughput (robotic-based) in vitro testing enable the generation of knowledge concerning the effects of chemical perturbation on biological systems in an increasingly efficient and rapid manner. However, a pressing need stemming from these technological advances is the ability to actually apply th

Aqueous two-phase printing of cell-containing contractile collagen microgels.

PubMed

Moraes, Christopher; Simon, Arlyne B; Putnam, Andrew J; Takayama, Shuichi

2013-12-01

This work describes the use of aqueous two-phase systems to print cell-containing contractile collagen microdroplets. The fully aqueous conditions enable convenient formation of sub-microliter 'microgels' that are much smaller than otherwise possible to fabricate while maintaining high cell viability. The produced microgels contract over several days, mimicking the behavior of macroscale contraction assays, which have been valued as an important biological readout for over three decades. Use of microgels not only reduces reagent consumption and increases throughput of the assay, but also improves transport of molecules into and out of the collagen matrix, thereby enabling efficient and more precise studies of timed stimulation profiles. Utility of the technology is demonstrated by analyzing the effects of TGF-β1 on gel contraction, and we demonstrate that brief 'burst' stimulation profiles in microgels prompt contraction of the matrix, a feature not observed in the conventional macroscale assay. The fully aqueous process also enables the integration of contractile collagen microgels within existing cell culture systems, and we demonstrate proof-of-principle experiments in which a contractile collagen droplet is fabricated in situ on an existing epithelial monolayer. The simplicity, versatility and ability to robustly produce collagen microgels should allow effective translation of this microengineering technology into a variety of research environments. Copyright © 2013 Elsevier Ltd. All rights reserved.

Gentle, fast and effective crystal soaking by acoustic dispensing

PubMed Central

Ng, Jia Tsing; Talon, Romain; Nekrosiute, Karolina; Krojer, Tobias; Douangamath, Alice; Brandao-Neto, Jose; Pearce, Nicholas M.; von Delft, Frank

2017-01-01

The steady expansion in the capacity of modern beamlines for high-throughput data collection, enabled by increasing X-ray brightness, capacity of robotics and detector speeds, has pushed the bottleneck upstream towards sample preparation. Even in ligand-binding studies using crystal soaking, the experiment best able to exploit beamline capacity, a primary limitation is the need for gentle and nontrivial soaking regimens such as stepwise concentration increases, even for robust and well characterized crystals. Here, the use of acoustic droplet ejection for the soaking of protein crystals with small molecules is described, and it is shown that it is both gentle on crystals and allows very high throughput, with 1000 unique soaks easily performed in under 10 min. In addition to having very low compound consumption (tens of nanolitres per sample), the positional precision of acoustic droplet ejection enables the targeted placement of the compound/solvent away from crystals and towards drop edges, allowing gradual diffusion of solvent across the drop. This ensures both an improvement in the reproducibility of X-ray diffraction and increased solvent tolerance of the crystals, thus enabling higher effective compound-soaking concentrations. The technique is detailed here with examples from the protein target JMJD2D, a histone lysine demethylase with roles in cancer and the focus of active structure-based drug-design efforts. PMID:28291760

Effect of Binding Components in Complex Sample Matrices on Recovery in Direct Immersion Solid-Phase Microextraction: Friends or Foe?

PubMed

Alam, Md Nazmul; Pawliszyn, Janusz

2018-02-20

The development of matrix compatible coatings for solid-phase microextraction (SPME) has enabled direct extraction of analytes from complex sample matrices. The direct immersion (DI) mode of SPME when utilized in conjunction with such extraction phases facilitates extraction of a wide range of analytes from complex matrices without the incurrence of fouling or coating saturation. In this work, mathematical models and computational simulations were employed to investigate the effect of binding components present in complex samples on the recovery of small molecules varying in logP for extractions carried out using the direct immersion approach. The presented findings corroborate that the studied approach indeed enables the extraction of both polar and nonpolar analytes from complex matrices, provided a suitable sorbent is employed. Further results indicated that, in certain cases, the kinetics of extraction of a given analyte in its free form might be dependent on the desorption kinetics of their bound form from matrix components, which might lower total recoveries of analytes with high affinity for the matrix. However, the binding of analytes to matrix components also enables SPME to extract a balanced quantity of different logP analytes, facilitated by multiphase equilibria, with a single extraction device.

RFID in the blood supply chain--increasing productivity, quality and patient safety.

PubMed

Briggs, Lynne; Davis, Rodeina; Gutierrez, Alfonso; Kopetsky, Matthew; Young, Kassandra; Veeramani, Raj

2009-01-01

As part of an overall design of a new, standardized RFID-enabled blood transfusion medicine supply chain, an assessment was conducted for two hospitals: the University of Iowa Hospital and Clinics (UIHC) and Mississippi Baptist Health System (MBHS). The main objectives of the study were to assess RFID technological and economic feasibility, along with possible impacts to productivity, quality and patient safety. A step-by-step process analysis focused on the factors contributing to process "pain points" (errors, inefficiency, product losses). A process re-engineering exercise produced blueprints of RFID-enabled processes to alleviate or eliminate those pain-points. In addition, an innovative model quantifying the potential reduction in adverse patient effects as a result of RFID implementation was created, allowing improvement initiatives to focus on process areas with the greatest potential impact to patient safety. The study concluded that it is feasible to implement RFID-enabled processes, with tangible improvements to productivity and safety expected. Based on a comprehensive cost/benefit model, it is estimated for a large hospital (UIHC) to recover investment from implementation within two to three years, while smaller hospitals may need longer to realize ROI. More importantly, the study estimated that RFID technology could reduce morbidity and mortality effects substantially among patients receiving transfusions.

Quality labeled faces in the wild (QLFW): a database for studying face recognition in real-world environments

NASA Astrophysics Data System (ADS)

Karam, Lina J.; Zhu, Tong

2015-03-01

The varying quality of face images is an important challenge that limits the effectiveness of face recognition technology when applied in real-world applications. Existing face image databases do not consider the effect of distortions that commonly occur in real-world environments. This database (QLFW) represents an initial attempt to provide a set of labeled face images spanning the wide range of quality, from no perceived impairment to strong perceived impairment for face detection and face recognition applications. Types of impairment include JPEG2000 compression, JPEG compression, additive white noise, Gaussian blur and contrast change. Subjective experiments are conducted to assess the perceived visual quality of faces under different levels and types of distortions and also to assess the human recognition performance under the considered distortions. One goal of this work is to enable automated performance evaluation of face recognition technologies in the presence of different types and levels of visual distortions. This will consequently enable the development of face recognition systems that can operate reliably on real-world visual content in the presence of real-world visual distortions. Another goal is to enable the development and assessment of visual quality metrics for face images and for face detection and recognition applications.

Perturbed path integrals in imaginary time: Efficiently modeling nuclear quantum effects in molecules and materials

NASA Astrophysics Data System (ADS)

Poltavsky, Igor; DiStasio, Robert A.; Tkatchenko, Alexandre

2018-03-01

Nuclear quantum effects (NQE), which include both zero-point motion and tunneling, exhibit quite an impressive range of influence over the equilibrium and dynamical properties of molecules and materials. In this work, we extend our recently proposed perturbed path-integral (PPI) approach for modeling NQE in molecular systems [I. Poltavsky and A. Tkatchenko, Chem. Sci. 7, 1368 (2016)], which successfully combines the advantages of thermodynamic perturbation theory with path-integral molecular dynamics (PIMD), in a number of important directions. First, we demonstrate the accuracy, performance, and general applicability of the PPI approach to both molecules and extended (condensed-phase) materials. Second, we derive a series of estimators within the PPI approach to enable calculations of structural properties such as radial distribution functions (RDFs) that exhibit rapid convergence with respect to the number of beads in the PIMD simulation. Finally, we introduce an effective nuclear temperature formalism within the framework of the PPI approach and demonstrate that such effective temperatures can be an extremely useful tool in quantitatively estimating the "quantumness" associated with different degrees of freedom in the system as well as providing a reliable quantitative assessment of the convergence of PIMD simulations. Since the PPI approach only requires the use of standard second-order imaginary-time PIMD simulations, these developments enable one to include a treatment of NQE in equilibrium thermodynamic properties (such as energies, heat capacities, and RDFs) with the accuracy of higher-order methods but at a fraction of the computational cost, thereby enabling first-principles modeling that simultaneously accounts for the quantum mechanical nature of both electrons and nuclei in large-scale molecules and materials.

Inherent work suit buoyancy distribution: effects on lifejacket self-righting performance.

PubMed

Barwood, Martin J; Long, Geoffrey M; Lunt, Heather; Tipton, Michael J

2014-09-01

Accidental immersion in cold water is an occupational risk. Work suits and life jackets (LJ) should work effectively in combination to keep the airway clear of the water (freeboard) and enable self-righting. We hypothesized that inherent buoyancy, in the suit or LJ, would be beneficial for enabling freeboard, but its distribution may influence LJ self-righting. Six participants consented to complete nine immersions. Suits and LJ tested were: flotation suit (FLOAT; 85 N inherent buoyancy); oilskins 1 (OS-1) and 2 (OS-2), both with no inherent buoyancy; LJs (inherent buoyancy/buoyancy after inflation/total buoyancy), LJ-1 50/150/200 N, LJ-2 0/290/290 N, LJ-3 80/190/270 N. Once dressed, the subject entered an immersion pool where uninflated freeboard, self-righting performance, and inflated freeboard were measured. Data were compared using Friedman's test to the 0.05 alpha level. All suits and LJs enabled uninflated and inflated freeboard, but differences were seen between the suits and LJs. Self-righting was achieved on 43 of 54 occasions, irrespective of suit or LJ. On all occasions that self-righting was not achieved, this occurred in an LJ that included inherent buoyancy (11/54 occasions). Of these 11 failures, 8 occurred (73% of occasions) when the FLOAT suit was being worn. LJs that included inherent buoyancy, that are certified as effective on their own, worked less effectively from the perspective of self-righting in combination with a work suit that also included inherent buoyancy. Equipment that is approved for use in the workplace should be tested in combination to ensure adequate performance in an emergency scenario.

Networking between community health programs: a case study outlining the effectiveness, barriers and enablers

PubMed Central

2012-01-01

Background In India, since the 1990s, there has been a burgeoning of NGOs involved in providing primary health care. This has resulted in a complex NGO-Government interface which is difficult for lone NGOs to navigate. The Uttarakhand Cluster, India, links such small community health programs together to build NGO capacity, increase visibility and better link to the government schemes and the formal healthcare system. This research, undertaken between 1998 and 2011, aims to examine barriers and facilitators to such linking, or clustering, and the effectiveness of this clustering approach. Methods Interviews, indicator surveys and participant observation were used to document the process and explore the enablers, the barriers and the effectiveness of networks improving community health. Results The analysis revealed that when activating, framing, mobilising and synthesizing the Uttarakhand Cluster, key brokers and network players were important in bridging between organisations. The ties (or relationships) that held the cluster together included homophily around common faith, common friendships and geographical location and common mission. Self interest whereby members sought funds, visibility, credibility, increased capacity and access to trainings was also a commonly identified motivating factor for networking. Barriers to network synthesizing included lack of funding, poor communication, limited time and lack of human resources. Risk aversion and mistrust remained significant barriers to overcome for such a network. Conclusions In conclusion, specific enabling factors allowed the clustering approach to be effective at increasing access to resources, creating collaborative opportunities and increasing visibility, credibility and confidence of the cluster members. These findings add to knowledge regarding social network formation and collaboration, and such knowledge will assist in the conceptualisation, formation and success of potential health networks in India and other developing world countries. PMID:22812627

Networking between community health programs: a case study outlining the effectiveness, barriers and enablers.

PubMed

Grills, Nathan J; Robinson, Priscilla; Phillip, Maneesh

2012-07-19

In India, since the 1990s, there has been a burgeoning of NGOs involved in providing primary health care. This has resulted in a complex NGO-Government interface which is difficult for lone NGOs to navigate. The Uttarakhand Cluster, India, links such small community health programs together to build NGO capacity, increase visibility and better link to the government schemes and the formal healthcare system. This research, undertaken between 1998 and 2011, aims to examine barriers and facilitators to such linking, or clustering, and the effectiveness of this clustering approach. Interviews, indicator surveys and participant observation were used to document the process and explore the enablers, the barriers and the effectiveness of networks improving community health. The analysis revealed that when activating, framing, mobilising and synthesizing the Uttarakhand Cluster, key brokers and network players were important in bridging between organisations. The ties (or relationships) that held the cluster together included homophily around common faith, common friendships and geographical location and common mission. Self interest whereby members sought funds, visibility, credibility, increased capacity and access to trainings was also a commonly identified motivating factor for networking. Barriers to network synthesizing included lack of funding, poor communication, limited time and lack of human resources. Risk aversion and mistrust remained significant barriers to overcome for such a network. In conclusion, specific enabling factors allowed the clustering approach to be effective at increasing access to resources, creating collaborative opportunities and increasing visibility, credibility and confidence of the cluster members. These findings add to knowledge regarding social network formation and collaboration, and such knowledge will assist in the conceptualisation, formation and success of potential health networks in India and other developing world countries.

Short communication: Effect of active food packaging materials on fluid milk quality and shelf life.

PubMed

Wong, Dana E; Goddard, Julie M

2014-01-01

Active packaging, in which active agents are embedded into or on the surface of food packaging materials, can enhance the nutritive value, economics, and stability of food, as well as enable in-package processing. In one embodiment of active food packaging, lactase was covalently immobilized onto packaging films for in-package lactose hydrolysis. In prior work, lactase was covalently bound to low-density polyethylene using polyethyleneimine and glutaraldehyde cross-linkers to form the packaging film. Because of the potential contaminants of proteases, lipases, and spoilage organisms in typical enzyme preparations, the goal of the current work was to determine the effect of immobilized-lactase active packaging technology on unanticipated side effects, such as shortened shelf-life and reduced product quality. Results suggested no evidence of lipase or protease activity on the active packaging films, indicating that such active packaging films could enable in-package lactose hydrolysis without adversely affecting product quality in terms of dairy protein or lipid stability. Storage stability studies indicated that lactase did not migrate from the film over a 49-d period, and that dry storage resulted in 13.41% retained activity, whereas wet storage conditions enabled retention of 62.52% activity. Results of a standard plate count indicated that the film modification reagents introduced minor microbial contamination; however, the microbial population remained under the 20,000 cfu/mL limit through the manufacturer's suggested 14-d storage period for all film samples. This suggests that commercially produced immobilized lactase active packaging should use purified cross-linkers and enzymes. Characterization of unanticipated effects of active packaging on food quality reported here is important in demonstrating the commercial potential of such technologies. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

A Comparative Analysis of Bicycle Lanes Versus Wide Curb Lanes

DOT National Transportation Integrated Search

2013-11-01

Analysis Modeling and Simulation (AMS) Testbeds can make significant contributions in identifying the benefits of more effective, more active systems management, resulting from integrating transformative applications enabled by new data from wireless...

USTRANSCOM 2007 Annual Report

DTIC Science & Technology

2007-01-01

USTRANSCOM recently completed another successful Joint Logistics Over-the-Shore (JLOTS) exercise in Puerto Quetzal , Guatemala. Planning for the exercise...to track requisitions through the system and enable effective decisions exercise in Puerto Quetzal , Guatemala. • Efficiency. Using wise

METHODS MODULE

EPA Science Inventory

The ultimate goal of classification is to reduce variation within classes to enable detection of differences between reference and impacted condition within classes as cost-effectively as possible, while minimizing the number of classes for which reference conditions must be defi...

Multiparametric or practical quantitative liver MRI: towards millisecond, fat fraction, kilopascal and function era.

PubMed

Unal, Emre; Idilman, Ilkay Sedakat; Karçaaltıncaba, Muşturay

2017-02-01

New advances in liver magnetic resonance imaging (MRI) may enable diagnosis of unseen pathologies by conventional techniques. Normal T1 (550-620 ms for 1.5 T and 700-850 ms for 3 T), T2, T2* (>20 ms), T1rho (40-50 ms) mapping, proton density fat fraction (PDFF) (≤5%) and stiffness (2-3kPa) values can enable differentiation of a normal liver from chronic liver and diffuse diseases. Gd-EOB-DTPA can enable assessment of liver function by using postcontrast hepatobiliary phase or T1 reduction rate (normally above 60%). T1 mapping can be important for the assessment of fibrosis, amyloidosis and copper overload. T1rho mapping is promising for the assessment of liver collagen deposition. PDFF can allow objective treatment assessment in NAFLD and NASH patients. T2 and T2* are used for iron overload determination. MR fingerprinting may enable single slice acquisition and easy implementation of multiparametric MRI and follow-up of patients. Areas covered: T1, T2, T2*, PDFF and stiffness, diffusion weighted imaging, intravoxel incoherent motion imaging (ADC, D, D* and f values) and function analysis are reviewed. Expert commentary: Multiparametric MRI can enable biopsyless diagnosis and more objective staging of diffuse liver disease, cirrhosis and predisposing diseases. A comprehensive approach is needed to understand and overcome the effects of iron, fat, fibrosis, edema, inflammation and copper on MR relaxometry values in diffuse liver disease.

Momentum transfer Monte Carlo for the simulation of laser speckle imaging and its application in the skin.

PubMed

Regan, Caitlin; Hayakawa, Carole; Choi, Bernard

2017-12-01

Due to its simplicity and low cost, laser speckle imaging (LSI) has achieved widespread use in biomedical applications. However, interpretation of the blood-flow maps remains ambiguous, as LSI enables only limited visualization of vasculature below scattering layers such as the epidermis and skull. Here, we describe a computational model that enables flexible in-silico study of the impact of these factors on LSI measurements. The model uses Monte Carlo methods to simulate light and momentum transport in a heterogeneous tissue geometry. The virtual detectors of the model track several important characteristics of light. This model enables study of LSI aspects that may be difficult or unwieldy to address in an experimental setting, and enables detailed study of the fundamental origins of speckle contrast modulation in tissue-specific geometries. We applied the model to an in-depth exploration of the spectral dependence of speckle contrast signal in the skin, the effects of epidermal melanin content on LSI, and the depth-dependent origins of our signal. We found that LSI of transmitted light allows for a more homogeneous integration of the signal from the entire bulk of the tissue, whereas epi-illumination measurements of contrast are limited to a fraction of the light penetration depth. We quantified the spectral depth dependence of our contrast signal in the skin, and did not observe a statistically significant effect of epidermal melanin on speckle contrast. Finally, we corroborated these simulated results with experimental LSI measurements of flow beneath a thin absorbing layer. The results of this study suggest the use of LSI in the clinic to monitor perfusion in patients with different skin types, or inhomogeneous epidermal melanin distributions.

Momentum transfer Monte Carlo for the simulation of laser speckle imaging and its application in the skin

PubMed Central

Regan, Caitlin; Hayakawa, Carole; Choi, Bernard

2017-01-01

Due to its simplicity and low cost, laser speckle imaging (LSI) has achieved widespread use in biomedical applications. However, interpretation of the blood-flow maps remains ambiguous, as LSI enables only limited visualization of vasculature below scattering layers such as the epidermis and skull. Here, we describe a computational model that enables flexible in-silico study of the impact of these factors on LSI measurements. The model uses Monte Carlo methods to simulate light and momentum transport in a heterogeneous tissue geometry. The virtual detectors of the model track several important characteristics of light. This model enables study of LSI aspects that may be difficult or unwieldy to address in an experimental setting, and enables detailed study of the fundamental origins of speckle contrast modulation in tissue-specific geometries. We applied the model to an in-depth exploration of the spectral dependence of speckle contrast signal in the skin, the effects of epidermal melanin content on LSI, and the depth-dependent origins of our signal. We found that LSI of transmitted light allows for a more homogeneous integration of the signal from the entire bulk of the tissue, whereas epi-illumination measurements of contrast are limited to a fraction of the light penetration depth. We quantified the spectral depth dependence of our contrast signal in the skin, and did not observe a statistically significant effect of epidermal melanin on speckle contrast. Finally, we corroborated these simulated results with experimental LSI measurements of flow beneath a thin absorbing layer. The results of this study suggest the use of LSI in the clinic to monitor perfusion in patients with different skin types, or inhomogeneous epidermal melanin distributions. PMID:29296499