Validation of Veterans Affairs Electronic Medical Record Smoking Data Among Iraq- and Afghanistan-Era Veterans.

PubMed

Calhoun, Patrick S; Wilson, Sarah M; Hertzberg, Jeffrey S; Kirby, Angela C; McDonald, Scott D; Dennis, Paul A; Bastian, Lori A; Dedert, Eric A; Beckham, Jean C

2017-11-01

Research using the Veterans Health Administration (VA) electronic medical records (EMR) has been limited by a lack of reliable smoking data. To evaluate the validity of using VA EMR "Health Factors" data to determine smoking status among veterans with recent military service. Sensitivity, specificity, area under the receiver-operating curve (AUC), and kappa statistics were used to evaluate concordance between VA EMR smoking status and criterion smoking status. Veterans (N = 2025) with service during the wars in Iraq/Afghanistan who participated in the VA Mid-Atlantic Post-Deployment Mental Health (PDMH) Study. Criterion smoking status was based on self-report during a confidential study visit. VA EMR smoking status was measured by coding health factors data entries (populated during automated clinical reminders) in three ways: based on the most common health factor, the most recent health factor, and the health factor within 12 months of the criterion smoking status data collection date. Concordance with PDMH smoking status (current, former, never) was highest when determined by the most commonly observed VA EMR health factor (κ = 0.69) and was not significantly impacted by psychiatric status. Agreement was higher when smoking status was dichotomized: current vs. not current (κ = 0.73; sensitivity = 0.84; specificity = 0.91; AUC = 0.87); ever vs. never (κ = 0.75; sensitivity = 0.85; specificity = 0.90; AUC = 0.87). There were substantial missing Health Factors data when restricting analyses to a 12-month period from the criterion smoking status date. Current smokers had significantly more Health Factors entries compared to never or former smokers. The use of computerized tobacco screening data to determine smoking status is valid and feasible. Results indicating that smokers have significantly more health factors entries than non-smokers suggest that caution is warranted when using the EMR to select cases for cohort studies as the risk for selection bias appears high.

Rice Molecular Breeding Laboratories in the Genomics Era: Current Status and Future Considerations

PubMed Central

Collard, Bert C. Y.; Vera Cruz, Casiana M.; McNally, Kenneth L.; Virk, Parminder S.; Mackill, David J.

2008-01-01

Using DNA markers in plant breeding with marker-assisted selection (MAS) could greatly improve the precision and efficiency of selection, leading to the accelerated development of new crop varieties. The numerous examples of MAS in rice have prompted many breeding institutes to establish molecular breeding labs. The last decade has produced an enormous amount of genomics research in rice, including the identification of thousands of QTLs for agronomically important traits, the generation of large amounts of gene expression data, and cloning and characterization of new genes, including the detection of single nucleotide polymorphisms. The pinnacle of genomics research has been the completion and annotation of genome sequences for indica and japonica rice. This information—coupled with the development of new genotyping methodologies and platforms, and the development of bioinformatics databases and software tools—provides even more exciting opportunities for rice molecular breeding in the 21st century. However, the great challenge for molecular breeders is to apply genomics data in actual breeding programs. Here, we review the current status of MAS in rice, current genomics projects and promising new genotyping methodologies, and evaluate the probable impact of genomics research. We also identify critical research areas to “bridge the application gap” between QTL identification and applied breeding that need to be addressed to realize the full potential of MAS, and propose ideas and guidelines for establishing rice molecular breeding labs in the postgenome sequence era to integrate molecular breeding within the context of overall rice breeding and research programs. PMID:18528527

Measurement and Characterization of the Acceleration Environment on Board the Space Station

NASA Technical Reports Server (NTRS)

Baugher, Charles R. (Editor)

1990-01-01

This workshop provides a comprehensive overview of the work and status of each of these areas to provide a basis for establishing a systematic approach to the challenge of avoiding these difficulties during the Space Station era of materials experimentation. The discussions were arranged in the order of: the scientific understanding of the requirements for a micro-gravity environment, a history of acceleration measurements on spacecraft, the state of accelerometer technology, and the current understanding of the predicted Space Station environment.

[Precision nutrition in the era of precision medicine].

PubMed

Chen, P Z; Wang, H

2016-12-06

Precision medicine has been increasingly incorporated into clinical practice and is enabling a new era for disease prevention and treatment. As an important constituent of precision medicine, precision nutrition has also been drawing more attention during physical examinations. The main aim of precision nutrition is to provide safe and efficient intervention methods for disease treatment and management, through fully considering the genetics, lifestyle (dietary, exercise and lifestyle choices), metabolic status, gut microbiota and physiological status (nutrient level and disease status) of individuals. Three major components should be considered in precision nutrition, including individual criteria for sufficient nutritional status, biomarker monitoring or techniques for nutrient detection and the applicable therapeutic or intervention methods. It was suggested that, in clinical practice, many inherited and chronic metabolic diseases might be prevented or managed through precision nutritional intervention. For generally healthy populations, because lifestyles, dietary factors, genetic factors and environmental exposures vary among individuals, precision nutrition is warranted to improve their physical activity and reduce disease risks. In summary, research and practice is leading toward precision nutrition becoming an integral constituent of clinical nutrition and disease prevention in the era of precision medicine.

Dancing partners at the ball: Rational selection of next generation anti-CD20 antibodies for combination therapy of chronic lymphocytic leukemia in the novel agents era.

PubMed

Butler, L A; Tam, C S; Seymour, J F

2017-09-01

The anti-CD20 antibodies represent a major advancement in the therapeutic options available for chronic lymphocytic leukemia. The addition of rituximab, ofatumumab and obinutuzumab to various chemotherapy regimens has led to considerable improvements in both response and survival. Ocaratuzumab, veltuzumab and ublituximab are currently being explored within the trial setting. We review the current status of these antibodies, and discuss how their mechanisms of action may impact on the choice of combinations with novel small molecule agents. Copyright © 2017 Elsevier Ltd. All rights reserved.

Financing of emergency medicine graduate medical education programs in an era of declining Medicare reimbursement and support.

PubMed

Baumann, Michael R; Vadeboncoeur, Tyler F; Schafermeyer, Robert W

2004-07-01

In May 2004, the Society for Academic Emergency Medicine (SAEM) National Affairs Committee was tasked with evaluation of graduate medical education (GME) funding in the face of declining Medicare reimbursement and support, and its implications for emergency medicine. This article was developed to educate the SAEM membership on the current status and climate of funding for GME and to serve as the basis of a position statement from SAEM on this topic. The paper presents the history and background on GME financing followed by currently known changes from the recently signed Medicare Act of 2003.

Measuring Dark Energy with CHIME

NASA Astrophysics Data System (ADS)

Newburgh, Laura; Chime Collaboration

2015-04-01

The Canadian Hydrogen Intensity Mapping Experiment (CHIME) is a new radio transit interferometer currently being built at the Dominion Radio Astrophysical Observatory (DRAO) in Penticton, BC, Canada. We will use the 21 cm emission line of neutral hydrogen to map baryon acoustic oscillations between 400-800 MHz across 3/4 of the sky. These measurements will yield sensitive constraints on the dark energy equation of state between redshifts 0.8 - 2.5, a fascinating but poorly probed era corresponding to when dark energy began to impact the expansion history of the Universe. I will describe theCHIME instrument, the analysis challenges, the calibration requirements, and current status.

Brain metastasis from squamous cell carcinoma of the head and neck: a review of the literature in the genomic era.

PubMed

Barrett, Thomas F; Gill, Corey M; Miles, Brett A; Iloreta, Alfred M C; Bakst, Richard L; Fowkes, Mary; Brastianos, Priscilla K; Bederson, Joshua B; Shrivastava, Raj K

2018-06-01

Squamous cell carcinoma of the head and neck (HNSCC) affects nearly 500,000 individuals globally each year. With the rise of human papillomavirus (HPV) in the general population, clinicians are seeing a concomitant rise in HPV-related HNSCC. Notably, a hallmark of HPV-related HNSCC is a predilection for unique biological and clinical features, which portend a tendency for hematogenous metastasis to distant locations, such as the brain. Despite the classic belief that HNSCC is restricted to local spread via passive lymphatic drainage, brain metastases (BMs) are a rare complication that occurs in less than 1% of all HNSCC cases. Time between initial diagnosis of HNSCC and BM development can vary considerably. Some patients experience more than a decade of disease-free survival, whereas others present with definitive neurological symptoms that precede primary tumor detection. The authors systematically review the current literature on HNSCC BMs and discuss the current understanding of the effect of HPV status on the risk of developing BMs in the modern genomic era.

The second wave of digital-era governance: a quasi-paradigm for government on the Web.

PubMed

Margetts, Helen; Dunleavy, Patrick

2013-03-28

Widespread use of the Internet and the Web has transformed the public management 'quasi-paradigm' in advanced industrial countries. The toolkit for public management reform has shifted away from a 'new public management' (NPM) approach stressing fragmentation, competition and incentivization and towards a 'digital-era governance' (DEG) one, focusing on reintegrating services, providing holistic services for citizens and implementing thoroughgoing digital changes in administration. We review the current status of NPM and DEG approaches, showing how the development of the social Web has already helped trigger a 'second wave' of DEG(2) changes. Web science and organizational studies are converging swiftly in public management and public services, opening up an extensive agenda for future redesign of state organization and interventions. So far, DEG changes have survived austerity pressures well, whereas key NPM elements have been rolled back.

New Era Expansion Act

THOMAS, 111th Congress

Rep. Braley, Bruce L. [D-IA-1

2010-02-03

House - 02/23/2010 Referred to the Subcommittee on Higher Education, Lifelong Learning, and Competitiveness. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Biodiversity, ecosystem functions and services in environmental risk assessment: introduction to the special issue.

PubMed

Schäfer, Ralf B

2012-01-15

This Special Issue focuses on the questions if and how biodiversity, ecosystem functions and resulting services could be incorporated into the Ecological Risk Assessment (ERA). Therefore, three articles provide a framework for the integration of ecosystem services into ERA of soils, sediments and pesticides. Further articles demonstrate ways how stakeholders can be integrated into an ecosystem service-based ERA for soils and describe how the current monitoring could be adapted to new assessment endpoints that are directly linked to ecosystem services. Case studies show that the current ERA may not be protective for biodiversity, ecosystem functions and resulting services and that both pesticides and salinity currently adversely affect ecosystem functions in the field. Moreover, ecological models can be used for prediction of new protection goals and could finally support their implementation into the ERA. Overall, the Special Issue stresses the urgent need to enhance current procedures of ERA if biodiversity, ecosystem functions and resulting services are to be protected. Copyright © 2011 Elsevier B.V. All rights reserved.

Selection of patients for heart transplantation in the current era of heart failure therapy.

PubMed

Butler, Javed; Khadim, Ghazanfar; Paul, Kimberly M; Davis, Stacy F; Kronenberg, Marvin W; Chomsky, Don B; Pierson, Richard N; Wilson, John R

2004-03-03

We sought to assess the relationship between survival, peak exercise oxygen consumption (VO(2)), and heart failure survival score (HFSS) in the current era of heart failure (HF) therapy. Based on predicted survival, HF patients with peak VO(2) <14 ml/min/kg or medium- to high-risk HFSS are currently considered eligible for heart transplantation. However, these criteria were developed before the widespread use of beta-blockers, spironolactone, and defibrillators-interventions known to improve the survival of HF patients. Peak VO(2) and HFSS were assessed in 320 patients followed from 1994 to 1997 (past era) and in 187 patients followed from 1999 to 2001 (current era). Outcomes were compared between these two groups of patients and those who underwent heart transplantation from 1993 to 2000. Survival in the past era was 78% at one year and 67% at two years, as compared with 88% and 79%, respectively, in the current era (both p < 0.01). One-year event-free survival (without urgent transplantation or left ventricular assist device) was improved in the current era, regardless of initial peak VO(2): 64% vs. 48% for peak VO(2) <10 ml/min/kg (p = 0.09), 81% vs. 70% for 10 to 14 ml/min/kg (p = 0.05), and 93% vs. 82% for >14 ml/min/kg (p = 0.04). Of the patients with peak VO(2) of 10 to 14 ml/min/kg, 55% had low-risk HFSS and exhibited 88% one-year event-free survival. One-year survival after transplantation was 88%, which is similar to the 85% rate reported by the United Network for Organ Sharing for 1999 to 2000. Survival for HF patients in the current era has improved significantly, necessitating re-evaluation of the listing criteria for heart transplantation.

Radiogenomics and radiotherapy response modeling

NASA Astrophysics Data System (ADS)

El Naqa, Issam; Kerns, Sarah L.; Coates, James; Luo, Yi; Speers, Corey; West, Catharine M. L.; Rosenstein, Barry S.; Ten Haken, Randall K.

2017-08-01

Advances in patient-specific information and biotechnology have contributed to a new era of computational medicine. Radiogenomics has emerged as a new field that investigates the role of genetics in treatment response to radiation therapy. Radiation oncology is currently attempting to embrace these recent advances and add to its rich history by maintaining its prominent role as a quantitative leader in oncologic response modeling. Here, we provide an overview of radiogenomics starting with genotyping, data aggregation, and application of different modeling approaches based on modifying traditional radiobiological methods or application of advanced machine learning techniques. We highlight the current status and potential for this new field to reshape the landscape of outcome modeling in radiotherapy and drive future advances in computational oncology.

Anti-inflammatory Agents: Present and Future

PubMed Central

Dinarello, Charles A.

2012-01-01

Inflammation involving the innate and adaptive immune systems is a normal response to infection. However, when allowed to continue unchecked, inflammation may result in autoimmune or autoinflammatory disorders, neurodegenerative disease, or cancer. A variety of safe and effective anti-inflammatory agents are available, including aspirin and other nonsteroidal anti-inflammatories, with many more drugs under development. In particular, the new era of anti-inflammatory agents includes “biologicals” such as anticytokine therapies and small molecules that block the activity of kinases. Other anti-inflammatories currently in use or under development include statins, histone deacetylase inhibitors, PPAR agonists, and small RNAs. This Review discusses the current status of anti-inflammatory drug research and the development of new anti-inflammatory therapeutics. PMID:20303881

Current status and future options for trauma and emergency surgery in Turkey.

PubMed

Taviloğlu, Korhan; Ertekin, Cemalettin

2008-01-01

The number of trauma victims in Turkey is expected to increase as a consequence of the increasing vehicular traffic, potential for earthquakes, and risk of terrorist attacks. The Turkish Association for Trauma and Emergency Surgery monitors trauma cases, publishes a quarterly journal, organizes trauma courses and seminars for various health personnel nationwide. It is also extending efforts to improve in-hospital care by establishing trauma and emergency surgery fellowships and trauma and emergency surgery centers nationwide, which is run by General Surgeons currently. Turkey faces the same dilemma as the rest of the developed world regarding the future of trauma surgeons in the current era of nonoperative trauma management. We suggest that the field of trauma and emergency surgery be redefined to include emergency general surgery and cavitary trauma.

Status of ERA Vehicle System Integration Technology Demonstrators

NASA Technical Reports Server (NTRS)

Flamm, Jeffrey D.; Fernandez, Hamilton; Khorrami, Mehdi; James, Kevin D.; Thomas, Russell

2015-01-01

The Environmentally Responsible Aviation (ERA) Project within the Integrated Systems Research Program (ISRP) of the NASA Aeronautics Research Mission Directorate (ARMD) has the responsibility to explore and document the feasibility, benefits, and technical risk of air vehicle concepts and enabling technologies that will reduce the impact of aviation on the environment. The primary goal of the ERA Project is to select air vehicle concepts and technologies that can simultaneously reduce fuel burn, noise, and emissions. In addition, the ERA Project will identify and mitigate technical risk and transfer knowledge to the aeronautics community at large so that new technologies and vehicle concepts can be incorporated into the future design of aircraft.

Conductivity and structure of ErAs nanoparticles embedded in GaAs pn junctions analyzed via conductive atomic force microscopy

NASA Astrophysics Data System (ADS)

Park, K. W.; Dasika, V. D.; Nair, H. P.; Crook, A. M.; Bank, S. R.; Yu, E. T.

2012-06-01

We have used conductive atomic force microscopy to investigate the influence of growth temperature on local current flow in GaAs pn junctions with embedded ErAs nanoparticles grown by molecular beam epitaxy. Three sets of samples, one with 1 ML ErAs deposited at different growth temperatures and two grown at 530 °C and 575 °C with varying ErAs depositions, were characterized. Statistical analysis of local current images suggests that the structures grown at 575 °C have about 3 times thicker ErAs nanoparticles than structures grown at 530 °C, resulting in degradation of conductivity due to reduced ErAs coverage. These findings explain previous studies of macroscopic tunnel junctions.

The Widening Gap between Education and Schooling in the Post 9/11 Era.

ERIC Educational Resources Information Center

Shujaa, Mwalimu J.

2003-01-01

Likens the educational tensions of the post 9-11 era to those of the Vietnam war period, asserting that education is a process of culture and identity transmission, while schooling is intended to ensure that status quo power relationships are maintained. Argues that for persons of African descent, education means developing knowledge bases…

Restoration of Legal Rights for Claimants under Holocaust-Era Insurance Policies Act of 2011

THOMAS, 112th Congress

Sen. Nelson, Bill [D-FL

2011-03-02

Senate - 06/20/2012 Committee on the Judiciary. Hearings held. Hearings printed: S.Hrg. 112-551. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

The district nursing service: a national treasure.

PubMed

Oldman, Crystal

2014-08-01

District nurses are a national treasure. They are the key professionals who will enable the agenda of patients being cared for at home to be realised. They are highly trusted and valued by communities who lead and manage teams of nurses and nursing assistants expertly to deliver high-quality care in the patient's own home. In an era where the focus is now turning to the community for more care, more actions are required to increase our district nursing workforce. This article discusses the above issues in relation to recent reports on the current status of community nursing.

Molecular Pathology and Personalized Medicine: The Dawn of a New Era in Companion Diagnostics-Practical Considerations about Companion Diagnostics for Non-Small-Cell-Lung-Cancer.

PubMed

Plönes, Till; Engel-Riedel, Walburga; Stoelben, Erich; Limmroth, Christina; Schildgen, Oliver; Schildgen, Verena

2016-01-15

Companion diagnostics (CDx) have become a major tool in molecular pathology and assist in therapy decisions in an increasing number of various cancers. Particularly, the developments in lung cancer have been most impressing in the last decade and consequently lung cancer mutation testing and molecular profiling has become a major business of diagnostic laboratories. However, it has become difficult to decide which biomarkers are currently relevant for therapy decisions, as many of the new biomarkers are not yet approved as therapy targets, remain in the status of clinical studies, or still have not left the experimental phase. The current review is focussed on those markers that do have current therapy implications, practical implications arising from the respective companion diagnostics, and thus is focused on daily practice.

Experiments with an EVA Assistant Robot

NASA Technical Reports Server (NTRS)

Burridge, Robert R.; Graham, Jeffrey; Shillcutt, Kim; Hirsh, Robert; Kortenkamp, David

2003-01-01

Human missions to the Moon or Mars will likely be accompanied by many useful robots that will assist in all aspects of the mission, from construction to maintenance to surface exploration. Such robots might scout terrain, carry tools, take pictures, curate samples, or provide status information during a traverse. At NASA/JSC, the EVA Robotic Assistant (ERA) project has developed a robot testbed for exploring the issues of astronaut-robot interaction. Together with JSC's Advanced Spacesuit Lab, the ERA team has been developing robot capabilities and testing them with space-suited test subjects at planetary surface analog sites. In this paper, we describe the current state of the ERA testbed and two weeks of remote field tests in Arizona in September 2002. A number of teams with a broad range of interests participated in these experiments to explore different aspects of what must be done to develop a program for robotic assistance to surface EVA. Technologies explored in the field experiments included a fuel cell, new mobility platform and manipulator, novel software and communications infrastructure for multi-agent modeling and planning, a mobile science lab, an "InfoPak" for monitoring the spacesuit, and delayed satellite communication to a remote operations team. In this paper, we will describe this latest round of field tests in detail.

Toward the definition of specific protection goals for the environmental risk assessment of chemicals: A perspective on environmental regulation in Europe.

PubMed

Brown, A Ross; Whale, Graham; Jackson, Mathew; Marshall, Stuart; Hamer, Mick; Solga, Andreas; Kabouw, Patrick; Galay-Burgos, Malyka; Woods, Richard; Nadzialek, Stephanie; Maltby, Lorraine

2017-01-01

This critical review examines the definition and implementation of environmental protection goals for chemicals in current European Union (EU) legislation, guidelines, and international agreements to which EU countries are party. The European chemical industry is highly regulated, and prospective environmental risk assessments (ERAs) are tailored for different classes of chemical, according to their specific hazards, uses, and environmental exposure profiles. However, environmental protection goals are often highly generic, requiring the prevention of "unacceptable" or "adverse" impacts on "biodiversity" and "ecosystems" or the "environment as a whole." This review aims to highlight working examples, challenges, solutions, and best practices for defining specific protection goals (SPGs), which are seen to be essential for refining and improving ERA. Specific protection goals hinge on discerning acceptable versus unacceptable adverse effects on the key attributes of relevant, sensitive ecological entities (ranging from organisms to ecosystems). Some isolated examples of SPGs for terrestrial and aquatic biota can be found in prospective ERA guidance for plant protection products (PPPs). However, SPGs are generally limited to environmental or nature legislation that requires environmental monitoring and retrospective ERA. This limitation is due mainly to the availability of baselines, which define acceptable versus unacceptable environmental effects on the key attributes of sentinel species, populations and/or communities, such as reproductive status, abundance, or diversity. Nevertheless, very few regulatory case examples exist in which SPGs incorporate effect magnitude, spatial extent, and temporal duration. We conclude that more holistic approaches are needed for defining SPGs, particularly with respect to protecting population sustainability, ecosystem function, and integrity, which are implicit in generic protection goals and explicit in the International Programme for Chemical Safety (IPCS) definition of "adverse effect." A possible solution, which the chemical industry is currently assessing, is wider application of the ecosystem services approach proposed by the European Food Safety Authority (EFSA) for the risk assessment of PPPs. Integr Environ Assess Manag 2017;13:17-37. © 2016 SETAC. © 2016 SETAC.

Supporting the goals and objectives of the Prague Conference on Holocaust Era Assets.

THOMAS, 111th Congress

Rep. Wexler, Robert [D-FL-19

2009-03-30

Senate - 07/06/2009 Received in the Senate and referred to the Committee on Foreign Relations. (All Actions) Tracker: This bill has the status Agreed to in HouseHere are the steps for Status of Legislation:

Wealth, health and frailty in industrial-era London.

PubMed

DeWitte, Sharon N; Hughes-Morey, Gail; Bekvalac, Jelena; Karsten, Jordan

2016-05-01

Socioeconomic status is a powerful predictor of mortality in living populations, as status affects exposure or access to a variety of factors that impact health and survival, such as diet, healthcare, infectious disease and pollution. This study examines the effect of socioeconomic status on mortality and survival in London during a period spanning the early 18th through mid-19th centuries. During this period, London experienced rapid industrialization and heightened class distinctions. This study examines whether low-socioeconomic status was associated with reduced survival at a time when the distinctions between social strata were peaking. The samples for this study are drawn from three skeletal assemblages in London that represent lower and higher social strata. The upper socioeconomic status sample (n = 394) is from Chelsea Old Church and St Bride's Fleet Street (crypt assemblage). The low socioeconomic status sample (n = 474) is from St. Bride's Lower Churchyard (also known as St Bride's Farringdon Street). The effect of status on mortality and survival is assessed using hazard analysis and Kaplan-Meier analysis. The results reveal elevated mortality and reduced survival for lower socioeconomic status children, but no strong effect of status on adult mortality or survival. These results might indicate strong selective mortality operating during childhood or the effects of migration in the industrial-era population of London.

Reductions in Radiographic Progression in Early Rheumatoid Arthritis Over Twenty-Five Years: Changing Contribution From Rheumatoid Factor in Two Multicenter UK Inception Cohorts.

PubMed

Carpenter, Lewis; Norton, Sam; Nikiphorou, Elena; Jayakumar, Keeranur; McWilliams, Daniel F; Rennie, Kirsten L; Dixey, Josh; Kiely, Patrick; Walsh, David Andrew; Young, Adam

2017-12-01

To assess the 5-year progression of erosions and joint space narrowing (JSN) and their associations with rheumatoid factor (RF) status in 2 large, multicenter, early rheumatoid arthritis cohorts, spanning 25 years. Radiographic joint damage was recorded using the Sharp/van der Heijde (SHS) method in the Early Rheumatoid Arthritis Study (ERAS), 1986-2001, and the Early Rheumatoid Arthritis Network (ERAN), 2002-2013. Mixed-effects negative binomial regression estimated changes in radiographic damage over 5 years, including erosions and JSN, separately. RF, along with age, sex, and baseline markers of disease activity were controlled for. A total of 1,216 patients from ERAS and 446 from ERAN had radiographic data. Compared to ERAS, ERAN patients had a lower mean total SHS score at baseline (ERAN 6.2 versus ERAS 10.5; P < 0.001) and mean annual rate of change (ERAN 2.5 per year versus ERAS 6.9 per year; P < 0.001). Seventy-four percent of ERAS and 27% of ERAN patients progressed ≥5 units. Lower scores at baseline in ERAN were largely driven by reductions in JSN (ERAS 3.9 versus ERAN 1.2; P < 0.001), along with erosions (ERAS 1.9 versus ERAN 0.8; P < 0.001). RF was associated with greater progression in each cohort, but the absolute difference in mean annual rate of change for RF-positive patients was substantially higher for ERAS (RF positive 8.6 versus RF negative 5.1; P < 0.001), relative to ERAN (RF positive 2.0 versus RF negative 1.9; P = 0.855). Radiographic progression was shown to be significantly reduced between the 2 cohorts, and was associated with lower baseline damage and other factors, including changes in early disease-modifying antirheumatic drug use. The impact of RF status as a prognostic marker of clinically meaningful change in radiographic progression has markedly diminished in the context of more modern treatment. © 2017, American College of Rheumatology.

Physical and Mental Health Status of Gulf War and Gulf Era Veterans: Results From a Large Population-Based Epidemiological Study.

PubMed

Dursa, Erin K; Barth, Shannon K; Schneiderman, Aaron I; Bossarte, Robert M

2016-01-01

The aim of the study was to report the mental and physical health of a population-based cohort of Gulf War and Gulf Era veterans 20 years after the war. A multimode (mail, Web, or computer-assisted telephone interviewing) heath survey of 14,252 Gulf War and Gulf Era veterans. The survey consisted of questions about general, physical, mental, reproductive, and functional health. Gulf War veterans report a higher prevalence of almost all queried physical and mental health conditions. The population as a whole, however, has a significant burden of disease including high body mass index and multiple comorbid conditions. Gulf War veterans continue to report poorer heath than Gulf Era veterans, 20 years after the war. Chronic disease management and interventions to improve health and wellness among both Gulf War and Gulf Era veterans are necessary.

A History of Sex Education in the United States since 1900

ERIC Educational Resources Information Center

Huber, Valerie J.; Firmin, Michael W.

2014-01-01

We provide a historical perspective toward the current public school practices of American sex education. The primary time frames include the progressive era (1880-1920), intermediate era (1920-1960), the sexual revolution era (1960s and 1970s), and the modern sex education era (1980s to the present). In each period, we highlight key developments…

Twenty-Five Years of Continuing Professional Development of Teachers in the Post-Communist Era in Slovakia: The Story of Paths Not Taken

ERIC Educational Resources Information Center

Kubalíková, Andrea; Kacian, Adrian

2016-01-01

This article analyzes the present status of continuing professional development of teachers (CPD) in Slovakia in the post-communist era. During 25 years of democracy in Slovak society, the system of education has undergone several formal reforms, mainly in the area of legislation. As the analysis demonstrates, CPD in Slovakia still follows the…

Organic bioelectronics: a new era for organic electronics.

PubMed

Malliaras, George G

2013-09-01

This issue of "Biochimica et Biophysica Acta - General Subjects" is dedicated to organic bioelectronics, an interdisciplinary field that has been growing at a fast pace. Bioelectronics creates tremendous promise, excitement, and hype. The application of organic electronic materials in bioelectronics offers many opportunities and is fuelled by some unique features of these materials, such as the ability to transport ions. This is a perspective on the history and current status of the field. Organic bioelectronics currently encompasses many different applications, including neural interfaces, tissue engineering, drug delivery, and biosensors. The interdisciplinary nature of the field necessitates collaborations across traditional scientific boundaries. Organic bioelectronics is a young and exciting interdisciplinary field. This article is part of a Special Issue entitled Organic Bioelectronics - Novel Applications in Biomedicine. Copyright © 2012 Elsevier B.V. All rights reserved.

A resolution expressing the sense of the Senate on the restitution of or compensation for property seized during the Nazi and Communist eras.

THOMAS, 112th Congress

Sen. Nelson, Bill [D-FL

2012-06-29

Senate - 09/19/2012 Placed on Senate Legislative Calendar under General Orders. Calendar No. 527. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

NASDA's view of ground control in mission operations

NASA Technical Reports Server (NTRS)

Tateno, Satoshi

1993-01-01

This paper presents an overview of the present status and future plans of the National Space Development Agency of Japan 's (NASDA's) ground segment and related space missions. The described ground segment consists of the tracking and data acquisition (T&DA) system and the Earth Observation Center (EOC) system. In addition to these systems, the current plan of the Engineering Support Center (ESC) for the Japanese Experiment Module (JEM) attached to Space Station Freedom is introduced. Then, NASDA's fundamental point of view on the future trend of operations and technologies in the coming new space era is discussed. Within the discussion, the increasing importance of international cooperation is also mentioned.

Practical Semantic Astronomy

NASA Astrophysics Data System (ADS)

Graham, Matthew; Gray, N.; Burke, D.

2010-01-01

Many activities in the era of data-intensive astronomy are predicated upon some transference of domain knowledge and expertise from human to machine. The semantic infrastructure required to support this is no longer a pipe dream of computer science but a set of practical engineering challenges, more concerned with deployment and performance details than AI abstractions. The application of such ideas promises to help in such areas as contextual data access, exploiting distributed annotation and heterogeneous sources, and intelligent data dissemination and discovery. In this talk, we will review the status and use of semantic technologies in astronomy, particularly to address current problems in astroinformatics, with such projects as SKUA and AstroCollation.

Are Rich People Perceived as More Trustworthy? Perceived Socioeconomic Status Modulates Judgments of Trustworthiness and Trust Behavior Based on Facial Appearance.

PubMed

Qi, Yue; Li, Qi; Du, Feng

2018-01-01

In the era of globalization, people meet strangers from different countries more often than ever. Previous research indicates that impressions of trustworthiness based on facial appearance play an important role in interpersonal cooperation behaviors. The current study examined whether additional information about socioeconomic status (SES), including national prosperity and individual monthly income, affects facial judgments and appearance-based trust decisions. Besides reproducing previous conclusions that trustworthy faces receive more money than untrustworthy faces, the present study showed that high-income individuals were judged as more trustworthy than low-income individuals, and also were given more money in a trust game. However, trust behaviors were not modulated by the nationality of the faces. The present research suggests that people are more likely to trust strangers with a high income, compared with individuals with a low income.

[Embracing medical innovation in the era of big data].

PubMed

You, Suning

2015-01-01

Along with the advent of big data era worldwide, medical field has to place itself in it inevitably. The current article thoroughly introduces the basic knowledge of big data, and points out the coexistence of its advantages and disadvantages. Although the innovations in medical field are struggling, the current medical pattern will be changed fundamentally by big data. The article also shows quick change of relevant analysis in big data era, depicts a good intention of digital medical, and proposes some wise advices to surgeons.

Recommended Capacities for Educational Leadership: Pre-Reform Era Scholars versus Reform-Era Scholars versus National Standards

ERIC Educational Resources Information Center

Gordon, Stephen P.; Taylor-Backor, Karen; Croteau, Susan

2017-01-01

We reviewed the scholarship on capacities for educational leadership for the past decade of the pre-reform era (1976-1985), as well as a recent decade of the reform era (2005-2015), and compared scholarship from both decades with the current Professional Standards for Educational Leaders. We found that scholars in the past decade of the pre-reform…

Demographic, medical, and psychiatric factors in work and marital status after mild head injury.

PubMed

Vanderploeg, Rodney D; Curtiss, Glenn; Duchnick, Jennifer J; Luis, Cheryl A

2003-01-01

To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not. Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status. Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not. Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status. Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury-13.3% and 9.4% for work and marital status, respectively. These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.

Overview of galactic cosmic ray solar modulation in the AMS-02 era

NASA Astrophysics Data System (ADS)

Bindi, V.; Corti, C.; Consolandi, C.; Hoffman, J.; Whitman, K.

2017-08-01

A new era in cosmic rays physics has started thanks to the precise and continuous observations from space experiments such as PAMELA and AMS-02. Invaluable results are coming out from these new data that are rewriting the theory of acceleration and propagation of cosmic rays. Both at high energies, where several new behaviors have been measured, challenging the accuracy of theoretical models, and also at low energies, in the region affected by the solar modulation. Precise measurements are increasing our knowledge of the effects of solar modulation on low energy cosmic rays, allowing a detailed study of propagation and composition as it has never been done before. These measurements will serve as a high-precision baseline for continued studies of GCR composition, GCR modulation over the solar cycle, space radiation hazards, and other topics. In this review paper, the status of the latest measurements of the cosmic rays in the context of solar modulation are presented together with the current open questions and the future prospects. How new measurements from the AMS-02 experiment will address these questions is also discussed.

Toward Current Standards of Donor Right Hepatectomy for Adult-to-Adult Live Donor Liver Transplantation Through the Experience of 200 Cases

PubMed Central

Chan, See Ching; Fan, Sheung Tat; Lo, Chung Mau; Liu, Chi Leung; Wong, John

2007-01-01

Objective: To define the current standards of donor right hepatectomy, including the middle hepatic vein for adult-to-adult live donor liver transplantation. Summary Background Data: Donor morbidity and mortality are inevitable given the ultra-major nature of the donor operation. Results from a matured center could define the true impact of this donor procedure most accurately. Patients and Methods: From May 9, 1996 to April 13, 2005, 200 consecutive donors underwent donor right hepatectomy at the University of Hong Kong Medical Center. All right liver grafts except one included the middle hepatic vein. Donor characteristics, operation time, blood loss, hospital stay, laboratory results, and complications graded by Clavien's classification divided into four eras (each consecutive 50 cases) were compared. Results: Donor characteristics of the four eras were generally comparable. Operative outcomes improved progressively through the four eras. From era 1 to era 4, operation time decreased from 598 minutes (range, 378–932 minutes) to 391 minutes (range, 304–635 minutes). Blood loss also decreased from 500 mL (200–1600 mL) of era 1 to 251 mL (range, 95–595 mL) of era 4. Overall complication rate was 20.5% (41 of 200). Complications rates from eras 1 to 4 were 34%, 16%, 16%, and 16%, respectively. The most common complications were of grade I (24 of 41, 58.5%). A late donor death occurred in era 4 from the development of a duodenocaval fistula 10 weeks postoperation, giving a donor mortality of 0.5% (1 of 200). Conclusions: This study validated the estimated morbidity and mortality of donor right hepatectomy of 20% and 0.5%, respectively. The data provide reference for counseling potential donors and setting the standards of donor right hepatectomy in the current era. PMID:17197973

Changing outcomes after heart transplantation in patients with amyloid cardiomyopathy.

PubMed

Davis, Margot K; Lee, Peter H U; Witteles, Ronald M

2015-05-01

Amyloid cardiomyopathy (ACM) is associated with a poor prognosis. Previous reports have suggested unfavorable post-heart transplant (HT) survival in this population compared with other HT recipients. Data from the United Network for Organ Sharing (UNOS) registry were used to study outcomes among ACM patients undergoing HT in the modern era (Era 2, 2008 to 2013) as compared with the historical era (Era 1, 1987 to 2007). One hundred eighty-eight ACM patients underwent primary single-organ HT. Ninety-seven patients (51.6%) were transplanted in Era 1 and 91 (48.4%) in Era 2. ACM patients undergoing HT in Era 2 were older (p < 0.0001), had higher body mass index (p = 0.008) and longer ischemic times (p = 0.02), and were more likely to be African-American (p < 0.0001), UNOS Status 1A (p < 0.0001), male (p = 0.01) and highly sensitized (p < 0.0001) compared with those in Era 1. Compared with patients with other etiologies of restrictive cardiomyopathy (RCM; n = 339 in Era 1, n = 164 in Era 2), adjusted hazard ratios (HRs) for post-HT mortality of ACM were 2.08 (p < 0.0001) in Era 1 and 1.22 (p = not statistically significant) in Era 2. Adjusted HRs for mortality of ACM vs all other diagnoses (n = 36,334 in Era 1, n = 9,225 in Era 2) were 1.84 (p < 0.0001) in Era 1 and 1.38 (p = NS) in Era 2. Although post-HT survival did not change with time among non-ACM RCM patients, post-HT mortality was lower in Era 2 compared with Era 1 among ACM patients (HR 0.49, p = 0.03). Although historically associated with inferior survival, post-HT outcomes in ACM patients in the modern era are now approaching those of non-ACM patients. Changes in patients' demographics suggest that this may be related to improved patient selection, including an increased proportion of patients with transthyretin ACM. HT should be considered for appropriate candidates with ACM. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Robots are not just tools

NASA Astrophysics Data System (ADS)

Prescott, Tony J.

2017-04-01

The EPSRC principles of robotics make a number of commitments about the ontological status of robots such as that robots are "just tools" or can give only "an impression or real intelligence". This commentary proposes that this assumes, all too easily, that we know the boundary conditions of future robotics development, and argues that progress towards a more useful set of principles could begin by thinking carefully about the ontological status of robots. Whilst most robots are currently little more than tools, we are entering an era where there will be new kinds of entities that combine some of the properties of tools with psychological capacities that we had previously thought were reserved for complex biological organisms such as humans. The ontological status of robots might be best described as liminal - neither living nor simply mechanical. There is also evidence that people will treat robots as more than just tools regardless of the extent to which their machine nature is transparent. Ethical principles need to be developed that recognise these ontological and psychological issues around the nature of robots and how they are perceived.

Health Status of Gulf War and Era Veterans Serving in the US Military in 2000.

PubMed

Porter, Ben; Long, Kyna; Rull, Rudolph P; Dursa, Erin K

2018-05-01

This research describes Gulf War and era veterans enrolled in the Millennium Cohort Study, who were sampled from US military personnel serving in 2000, and compares health characteristics of this sample to a Department of Veterans Affairs study sampled from the complete population. Demographics characteristics of this sample were described. Self-reported health characteristics were compared between the two studies. Gulf War and era veterans in the Millennium Cohort were generally healthier than in the VA study; they had fewer medical conditions and mental health disorders and better self-reported health. In both studies, Gulf War veterans had poorer health outcomes than era veterans. The Millennium Cohort Study is a unique resource for examining the long-term health effects of Gulf War deployment, particularly comparing deployed and nondeployed personnel and examining illnesses with long latencies.

A resolution expressing the sense of the Senate on the restitution of or compensation for property seized during the Nazi and Communist eras.

THOMAS, 111th Congress

Sen. Nelson, Bill [D-FL

2009-05-19

Senate - 06/18/2009 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Postcolonial Identity Politics, Language and the Schools in St. Lucia

ERIC Educational Resources Information Center

St. Hilaire, Aonghas

2009-01-01

In the postcolonial era, a cultural nationalist movement has sought to elevate the status of St. Lucia's creole vernacular, Kweyol, and with some success--it is now the most visible symbol of St. Lucian national identity. This relatively new development has altered somewhat the historic linguistic status quo between the official, high status…

[Cognitive complaints in people with human immunodeficiency virus in Spain: prevalence and related variables].

PubMed

Muñoz-Moreno, José A; Fuster-Ruiz de Apodaca, Maria J; Fumaz, Carmina R; Ferrer, Maria J; Molero, Fernando; Jaen, Àngels; Clotet, Bonaventura; Dalmau, David

2014-05-20

Cognitive complaints have been scarcely studied in people with HIV in Spain. The aim of this research was to know the prevalence of cognitive complaints in HIV-infected people, as well as its potential relationships with demographic, clinical and psychological variables, in the era of combination antiretroviral therapies. Observational multicenter study developed in 4 hospitals and 10 NGOs, in which 791 people with HIV in Spain participated. A self-reported questionnaire was used to evaluate demographic and clinical variables, and an assessment of cognitive complaints, emotional status and quality of life variables was also included. Descriptive and inferential tests were used for statistical analyses. Almost half of the sample (49.8%) referred cognitive complaints, in 72.1% of them an association with interference on daily living activities was found. Memory and attention were the areas most prevalently perceived as affected. The existence of cognitive complaints correlated with a longer HIV infection, lower CD4+ cell count, undetectable viral load and worse quality of life. A discriminant analysis determined that depression, anxiety, older age, living with no partner and low education level allowed to classify optimally HIV-infected people with cognitive complaints. Self-reported cognitive complaints are frequent in people infected with HIV in the current era of combination antiretroviral therapies. This fact is related to emotional disturbances and poor quality of life, but also to impaired immunological and virological status. Copyright © 2012 Elsevier España, S.L. All rights reserved.

The importance of assessing self-reported HIV status in bio-behavioural surveys.

PubMed

Johnston, Lisa G; Sabin, Miriam Lewis; Prybylski, Dimitri; Sabin, Keith; McFarland, Willi; Baral, Stefan; Kim, Andrea A; Raymond, H Fisher

2016-08-01

In bio-behavioural surveys measuring prevalence of infection with human immunodeficiency virus (HIV), respondents should be asked the results of their last HIV test. However, many government authorities, nongovernmental organizations, researchers and other civil society stakeholders have stated that respondents involved in such surveys should not be asked to self-report their HIV status. The reasons offered for not asking respondents to report their status are that responses may be inaccurate and that asking about HIV status may violate the respondents' human rights and exacerbate stigma and discrimination. Nevertheless, we contend that, in the antiretroviral therapy era, asking respondents in bio-behavioural surveys to self-report their HIV status is essential for measuring and improving access to - and coverage of - services for the care, treatment and prevention of HIV infection. It is also important for estimating the true size of the unmet needs in addressing the HIV epidemic and for interpreting the behaviours associated with the acquisition and transmission of HIV infection correctly. The data available indicate that most participants in health-related surveys are willing to respond to a question about HIV status - as one of possibly several sensitive questions about sexual and drug use behaviours. Ultimately, normalizing the self-reporting of HIV status could help the global community move from an era of so-called exceptionalism to one of destigmatization - and so improve the epidemic response worldwide.

Risk factors and impact of non-Aspergillus mold infections following allogeneic HCT: a CIBMTR infection and immune reconstitution analysis.

PubMed

Riches, M L; Trifilio, S; Chen, M; Ahn, K W; Langston, A; Lazarus, H M; Marks, D I; Martino, R; Maziarz, R T; Papanicolou, G A; Wingard, J R; Young, J-A H; Bennett, C L

2016-02-01

Risk factors for non-Aspergillus mold infection (NAMI) and the impact on transplant outcome are poorly assessed in the current era of antifungal agents. Outcomes of 124 patients receiving allogeneic hematopoietic cell transplantation (HCT) diagnosed with either mucormycosis (n=72) or fusariosis (n=52) between days 0 and 365 after HCT are described and compared with a control cohort (n=11 856). Patients with NAMI had more advanced disease (mucormycois: 25%, fusariosis: 23% and controls: 18%; P=0.004) and were more likely to have a Karnofsky performance status (KPS) <90% at HCT (mucormycosis: 42%, fusariosis: 38% and controls: 28%; P=0.048). The 1-year survival after HCT was 22% (15-29%) for cases and was significantly inferior compared with controls (65% (64-65%); P<0.001). Survival from infection was similarly dismal regardless of mucormycosis: 15% (8-25%) and fusariosis: 21% (11-33%). In multivariable analysis, NAMI was associated with a sixfold higher risk of death (P<0.0001) regardless of the site or timing of infection. Risk factors for mucormycosis include preceding acute GvHD, prior Aspergillus infection and older age. For fusariosis, increased risks including receipt of cord blood, prior CMV infection and transplant before May 2002. In conclusion, NAMI occurs infrequently, is associated with high mortality and appears with similar frequency in the current antifungal era.

High-z Universe with Gamma Ray Bursts

NASA Technical Reports Server (NTRS)

Kouveliotou, C.

2011-01-01

Gamma-Ray Bursts (GRBs) are the most luminous explosions in space and trace the cosmic star formation history back to the first generations of stars. Their bright afterglows allow us to trace the abundances of heavy elements to large distances, thereby measuring cosmic chemical evolution. To date GRBs have been detected up to distances of z=8.23 and possibly even beyond z9. This makes GRBs a unique and powerful tool to probe the high-z Universe up to the re-ionization era. We discuss the current status of the field, place it in context with other probes, and also discuss new mission concepts that have been planned to utilize GRBs as probes.

The current status of bracing for patients with adolescent idiopathic scoliosis.

PubMed

Stokes, O M; Luk, K D K

2013-10-01

Adolescent idiopathic scoliosis affects about 3% of children. Non-operative measures are aimed at altering the natural history to maintain the size of the curve below 40° at skeletal maturity. The application of braces to treat spinal deformity pre-dates the era of evidence-based medicine, and there is a paucity of irrefutable prospective evidence in the literature to support their use and their effectiveness has been questioned. This review considers this evidence. The weight of the evidence is in favour of bracing over observation. The most recent literature has moved away from addressing this question, and instead focuses on developments in the design of braces and ways to improve compliance.

Changing trends in prognostic factors for patients with multiple myeloma after autologous stem cell transplantation during the immunomodulator drug/proteasome inhibitor era

PubMed Central

Takamatsu, Hiroyuki; Honda, Sumihisa; Miyamoto, Toshihiro; Yokoyama, Kenji; Hagiwara, Shotaro; Ito, Toshiro; Tomita, Naoto; Iida, Shinsuke; Iwasaki, Toshihiro; Sakamaki, Hisashi; Suzuki, Ritsuro; Sunami, Kazutaka

2015-01-01

We evaluated the clinical significance of prognostic factors including the International Staging System (ISS) and modified European Group for Blood and Marrow Transplantation response criteria in 1650 Japanese patients with multiple myeloma (MM) who underwent upfront single autologous stem cell transplantation (ASCT). We categorized patients into two treatment cohorts: pre-novel agent era (1995–2006) and novel agent era (2008–2011). The combined percentage of pre-ASCT complete response and very good partial response cases (463 of 988, 47%) significantly increased during the novel agent era compared with the pre-novel agent era (164 of 527, 31%; P < 0.0001). The 2-year overall survival (OS) rate of 87% during the novel agent era was a significant improvement relative to that of 82% during the pre-novel agent era (P = 0.019). Although significant differences in OS were found among ISS stages during the pre-novel agent era, no significant difference was observed between ISS I and II (P = 0.107) during the novel agent era. The factors independently associated with a superior OS were female gender (P = 0.002), a good performance status (P = 0.024), lower ISS (P < 0.001), pre-ASCT response at least partial response (P < 0.001) and ASCT during the novel agent era (P = 0.017). These results indicate that the response rate and OS were significantly improved, and the ISS could not clearly stratify the prognoses of Japanese patients with MM who underwent upfront single ASCT during the novel agent era. PMID:25530023

Academic drug discovery: current status and prospects.

PubMed

Everett, Jeremy R

2015-01-01

The contraction in pharmaceutical drug discovery operations in the past decade has been counter-balanced by a significant rise in the number of academic drug discovery groups. In addition, pharmaceutical companies that used to operate in completely independent, vertically integrated operations for drug discovery, are now collaborating more with each other, and with academic groups. We are in a new era of drug discovery. This review provides an overview of the current status of academic drug discovery groups, their achievements and the challenges they face, together with perspectives on ways to achieve improved outcomes. Academic groups have made important contributions to drug discovery, from its earliest days and continue to do so today. However, modern drug discovery and development is exceedingly complex, and has high failure rates, principally because human biology is complex and poorly understood. Academic drug discovery groups need to play to their strengths and not just copy what has gone before. However, there are lessons to be learnt from the experiences of the industrial drug discoverers and four areas are highlighted for attention: i) increased validation of targets; ii) elimination of false hits from high throughput screening (HTS); iii) increasing the quality of molecular probes; and iv) investing in a high-quality informatics infrastructure.

The current status of beta blockers’ use in the management of hypertension

PubMed Central

Akbar, Shahid; Alorainy, Mohammad S.

2014-01-01

The invention of beta (β)-blockers culminated in a new era in the treatment of cardiovascular diseases (CD), and changed the course of pharmacology research for years to come. Since the introduction of propranolol into clinical practice in 1964, β-blockers enjoyed a special place in the clinicians’ armamentarium against CDs, especially for patients with ischemic heart diseases, and are still one of the most extensively used therapeutic drugs in both cardiac and non-cardiac ailments. Current uses of β-blockers in CDs include ischemic heart diseases, hypertension, cardiac arrhythmias, and heart failure. Other substantial non-cardiac uses include glaucoma, migraine, situational anxiety, benign essential tremors, and cardiac symptoms of thyrotoxicosis. This review covers some of the evolutionary changes of clinical uses of β-blockers, the rationale for their use, some recent controversies surrounding their use for treatment of hypertension, and advantages of newer additions to the group. PMID:25399206

[A consideration on the import of Chinese crude drugs of general use in the 2nd half of Taisho era (7): especially on the change of import volume and price of rhubarb].

PubMed

Harima, S; Tanaka, Y

1991-01-01

Since most of the crude drug rhubarb was imported in the Taisho era, similarly to the Meiji era, it was possible to refer to the government statistic data by investigating and elucidating the import volume of the same in the treaty ports at that time. Upon examining the import status in the period from the late part of the Taisho era to the early part of Showa era (around 1920 to 1930), the following transitions were observed. 1) In 1923 (Taisho 12), the Kantoh earthquake happened and it attacked Yokohama where the function as main trade port was almost totally destroyed. ... 2) The earthquake happened just at the time when the tariff protectionism was increasingly promoted in every country. ... 3) Since the port of Yokohama, as trade port, was damaged by the earthquake at that time and the government import statistic data were limited to a partial summing-up, our investigation was referred to the statistic data at the ports of Osaka and Kobe. ...

Application of enhanced recovery after gastric cancer surgery: An updated meta-analysis

PubMed Central

Wang, Liu-Hua; Zhu, Ren-Fei; Gao, Cheng; Wang, Shou-Lin; Shen, Li-Zong

2018-01-01

AIM To provide an updated assessment of the safety and efficacy of enhanced recovery after surgery (ERAS) protocols in elective gastric cancer (GC) surgery. METHODS PubMed, Medline, EMBASE, World Health Organization International Trial Register, and Cochrane Library were searched up to June 2017 for all available randomized controlled trials (RCTs) comparing ERAS protocols and standard care (SC) in GC surgery. Thirteen RCTs, with a total of 1092 participants, were analyzed in this study, of whom 545 underwent ERAS protocols and 547 received SC treatment. RESULTS No significant difference was observed between ERAS and control groups regarding total complications (P = 0.88), mortality (P = 0.50) and reoperation (P = 0.49). The incidence of pulmonary infection was significantly reduced (P = 0.03) following gastrectomy. However, the readmission rate after GC surgery nearly tripled under ERAS (P = 0.009). ERAS protocols significantly decreased the length of postoperative hospital stay (P < 0.00001) and medical costs (P < 0.00001), and accelerated bowel function recovery, as measured by earlier time to the first flatus (P = 0.0004) and the first defecation (P < 0.0001). Moreover, ERAS protocols were associated with a lower level of serum inflammatory response, higher serum albumin, and superior short-term quality of life (QOL). CONCLUSION Collectively, ERAS results in accelerated convalescence, reduction of surgical stress and medical costs, improved nutritional status, and better QOL for GC patients. However, high-quality multicenter RCTs with large samples and long-term follow-up are needed to more precisely evaluate ERAS in radical gastrectomy. PMID:29662294

Tasks and Status: Newspaper Copy Editing and the Division of Newsroom Labor.

ERIC Educational Resources Information Center

Solomon, William S.

Colonial printers were more or less forced to take sides during the Revolutionary era. As they did so, their social status changed from that akin to mechanics to that of spokespersons of a social movement. From this time on, the gradual separation of editor from printer formed a social basis for defining a journalist's tasks as editorial, not…

The Nativistic Legacy of the Americanization Era in the Education of Mexican Immigrant Students

ERIC Educational Resources Information Center

Galindo, Rene

2011-01-01

Nativism is a forgotten ideology which nevertheless operates in the current era as illustrated by the resurgence of anti-immigrant sentiment and restrictionistic policies in response to growing Latino/a immigration. This response to Latino/a immigration recalls a historic era from the early 1900s known as the Americanization period which was also…

Childhood chronic inflammatory demyelinating polyneuropathy: an overview of 10 cases in the modern era.

PubMed

Ware, Tyson L; Kornberg, Andrew J; Rodriguez-Casero, M Victoria; Ryan, Monique M

2014-01-01

Chronic inflammatory demyelinating polyneuropathy is a rare condition in children. In this article, we report our experience in the management of 10 cases of childhood chronic inflammatory demyelinating polyneuropathy in a single center, in the era of contrast-enhanced magnetic resonance imaging (MRI), genetic microarray, and chronic inflammatory demyelinating polyneuropathy disease activity status. Robust neurophysiologic abnormalities were present in all cases and both MRI and lumbar puncture were useful adjuncts in diagnosis. Genetic microarray is a simple technique useful in excluding the most common hereditary demyelinating neuropathy. Intravenous immunoglobulin was an effective first-line therapy in most cases, with refractory cases responding to corticosteroids and rituximab. We found the chronic inflammatory demyelinating polyneuropathy disease activity status useful for assessing outcome at final follow-up, whereas the modified Rankin score was better for assessing peak motor disability.

Solar Spicules: Prospects for Breakthroughs in Understanding with Solar-B

NASA Astrophysics Data System (ADS)

Sterling, A.

Spicules densely populate the lower solar atmosphere; any image or movie of the chromosphere shows a plethora of them or their "cousins," such as mottles or fibrils. Yet despite several decades of effort we still do not know the mechanism that generates them, or how important their contribution is to the material and energy balance of the overall solar atmosphere. Solar-B will provide exciting new chromospheric observations at high time- and spatial-resolution, along with associated quality magnetic field data, that promise to open doors to revolutionary breakthroughs in spicule research. In this presentation we will review the current observational and theoretical status of spicule studies, and discuss prospects for advances in spicule understanding during the Solar-B era.

Solar Spicules: Prospects for Breakthroughs in Understanding with Solar-B

NASA Technical Reports Server (NTRS)

Sterling, A. C.

2004-01-01

Spicules densely populate the lower solar atmosphere; any image or movie of the chromosphere shows a plethora of them or their "cousins," such as mottles or fibrils. Yet despite several decades of effort we still do not know the mechanism that generates them, or how important their contribution is to the material and energy balance of the overall solar atmosphere. Solar-B will provide exciting new chromospheric observations at high time- and spatial-resolution, along with associated quality magnetic field data, that promise to open doors to revolutionary breakthroughs in spicule research. In this presentation we will review the current observational and theoretical status of spicule studies, and discuss prospects for advances in spicule understanding during the Solar-B era.

Traditional health practitioners’ management of HIV/AIDS in rural South Africa in the era of widespread antiretroviral therapy

PubMed Central

Zuma, Thembelihle; Wight, Daniel; Rochat, Tamsen; Moshabela, Mosa

2017-01-01

ABSTRACT Background: Traditional health practitioners (THPs) have been identified as a key local resource in the fight against human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in South Africa. However, their approaches to the treatment of people living with HIV (PLHIV) have been met with scepticism by some biomedical practitioners amid increasing access to antiretroviral therapy (ART). Objective: In light of this ambivalence, this study aims to document and identify treatment approaches of THPs to the management of illness among PLHIV in the current era of widespread access to ART. Methods: The study was conducted as part of a larger trial of Treatment as Prevention (TasP) in rural northern Kwa-Zulu Natal, intended to treat PLHIV regardless of CD4 count. Nine THPs were enrolled using purposive and snowballing techniques. Repeat group discussions, triangulated with community walks and photovoice techniques, were conducted. A thematic analysis approach was used to analyse the data. Results: Eight of the nine THPs had received training in biomedical aspects of HIV. THPs showed a multilayered decision-making process in managing illness among PLHIV, influenced by the attributes and choices of the THPs. THPs assessed and managed illness among PLHIV based on THP training in HIV/AIDS, THP type, as well as knowledge and experience in the traditional healing practice. Management of illness depended on the patients’ report of their HIV status or willingness to test for HIV. Conclusions: THPs’ approaches to illness in PLHIV appear to be shifting in light of increasing exposure to HIV/AIDS-related information. Importantly, disclosure of HIV status plays a major role in THPs’ management of illness among PLHIV, as well as linkage to HIV testing and care for their patients. Therefore, THPs can potentially enhance the success of ART for PLHIV when HIV status is known. PMID:28771116

Transversus Abdominis Plane Blockade as Part of a Multimodal Postoperative Analgesia Plan in Patients Undergoing Radical Cystectomy.

PubMed

Matulewicz, Richard S; Patel, Mehul; Jordan, Brian J; Morano, Jacqueline; Frainey, Brendan; Bhanji, Yasin; Bux, Mahreen; Nader, Antoun; Kundu, Shilajit D; Meeks, Joshua J

2018-04-26

Radical cystectomy (RC) is a morbid procedure with frequent complications that may benefit from implementation of an enhanced recovery after surgery (ERAS) protocol. To examine the benefits of a multimodal analgesic plan that uses continuous transversus abdominis plane (TAP) blockade as part of an ERAS protocol after RC. A retrospective comparison of consecutive patients undergoing RC over a 4-year period was conducted. Patients were designated as having surgery either before or after implementation of an ERAS protocol. A major component of the ERAS protocol was a multi-modal analgesia plan with TAP blockade. Patient demographics, comorbidities, operative details, and outcomes, including days to flatus, bowel movement (BM), narcotic usage, and length of stay (LOS) were compared. In total, 171 patients were included: 100 pre-ERAS and 71 ERAS. There were no differences in age, smoking status, operative approach, or diversion type. The patients in the ERAS cohort were less likely to be male, had a higher median BMI, and more likely to have received neoadjuvant chemotherapy. Total and early postoperative narcotic use were lower in the ERAS cohort: 89 vs. 336 mg ( p  < 0.001) and 62 vs 203 mg ( p  = 0.001), respectively. The ERAS cohort had fewer days to flatus (3 vs. 4, p  < 0.001) and fewer days to bowel movement (4 vs. 5, p  < 0.001). Median LOS was shorter in the ERAS cohort (7 vs. 8.5d, p  = 0.001). There were no differences in complications or readmission rates between the two cohorts. TAP blockade as part of an ERAS multi-modal pain plan is associated with low narcotic usage, and significant improvement in time to flatus, BM, and LOS compared to traditional post-RC pain management.

Environmental risk assessment of chemicals and nanomaterials--The best foundation for regulatory decision-making?

PubMed

Syberg, Kristian; Hansen, Steffen Foss

2016-01-15

Environmental risk assessment (ERA) is often considered as the most transparent, objective and reliable decision-making tool for informing the risk management of chemicals and nanomaterials. ERAs are based on the assumption that it is possible to provide accurate estimates of hazard and exposure and, subsequently, to quantify risk. In this paper we argue that since the quantification of risk is dominated by uncertainties, ERAs do not provide a transparent or an objective foundation for decision-making and they should therefore not be considered as a "holy grail" for informing risk management. We build this thesis on the analysis of two case studies (of nonylphenol and nanomaterials) as well as a historical analysis in which we address the scientific foundation for ERAs. The analyses show that ERAs do not properly address all aspects of actual risk, such as the mixture effect and the environmentally realistic risk from nanomaterials. Uncertainties have been recognised for decades, and assessment factors are used to compensate for the lack of realism in ERAs. The assessment factors' values were pragmatically determined, thus lowering the scientific accuracy of the ERAs. Furthermore, the default choice of standard assay for assessing a hazard might not always be the most biologically relevant, so we therefore argue that an ERA should be viewed as a pragmatic decision-making tool among several, and it should not have a special status for informing risk management. In relation to other relevant decision-making tools we discuss the use of chemical alternative assessments (CAAs) and the precautionary principle. Copyright © 2015 Elsevier B.V. All rights reserved.

A Lower Degree of PBMC L1 Methylation in Women with Lower Folate Status May Explain the MTHFR C677T Polymorphism Associated Higher Risk of CIN in the US Post Folic Acid Fortification Era

PubMed Central

Badiga, Suguna; Johanning, Gary L.; Macaluso, Maurizio; Azuero, Andres; Chambers, Michelle M.; Siddiqui, Nuzhat R.; Piyathilake, Chandrika J.

2014-01-01

Background Studies in populations unexposed to folic acid (FA) fortification have demonstrated that MTHFR C677T polymorphism is associated with increased risk of higher grades of cervical intraepithelial neoplasia (CIN 2+). However, it is unknown whether exposure to higher folate as a result of the FA fortification program has altered the association between MTHFR C677T and risk of CIN, or the mechanisms involved with such alterations. The current study investigated the following in a FA fortified population: 1) The association between MTHFR C677T polymorphism and risk of CIN 2+; 2) The modifying effects of plasma folate concentrations on this association; and 3) The modifying effects of plasma folate on the association between the polymorphism and degree of methylation of long interspersed nucleotide elements (L1s), in peripheral blood mononuclear cell (PBMC) DNA, a documented biomarker of CIN risk. Methods The study included 457 US women diagnosed with either CIN 2+ (cases) or ≤ CIN 1 (non-cases). Unconditional logistic regression models were used to test the associations after adjusting for relevant risk factors for CIN. Results The 677CT/TT MTHFR genotypes were not associated with the risk of CIN 2+. Women with CT/TT genotype with lower folate, however, were more likely to be diagnosed with CIN 2+ compared to women with CT/TT genotype with higher folate (OR = 2.41, P = 0.030). Women with CT/TT genotype with lower folate were less likely to have a higher degree of PBMC L1 methylation compared to women with CT/TT genotype with higher folate (OR = 0.28, P = 0.017). Conclusions This study provides the first evidence that the MTHFR 677CT/TT genotype-associated lower degree of PBMC L1 methylation increases the risk of CIN 2+ in women in the US post-FA fortification era. Thus, even in the post-FA fortification era, not all women have adequate folate status to overcome MTHFR 677CT/TT genotype-associated lower degree of L1 methylation. PMID:25302494

Marine current energy conversion: the dawn of a new era in electricity production.

PubMed

Bahaj, AbuBakr S

2013-02-28

Marine currents can carry large amounts of energy, largely driven by the tides, which are a consequence of the gravitational effects of the planetary motion of the Earth, the Moon and the Sun. Augmented flow velocities can be found where the underwater topography (bathymetry) in straits between islands and the mainland or in shallows around headlands plays a major role in enhancing the flow velocities, resulting in appreciable kinetic energy. At some of these sites where practical flows are more than 1 m s(-1), marine current energy conversion is considered to be economically viable. This study describes the salient issues related to the exploitation of marine currents for electricity production, resource assessment, the conversion technologies and the status of leading projects in the field. This study also summarizes important issues related to site development and some of the approaches currently being undertaken to inform device and array development. This study concludes that, given the highlighted commitments to establish favourable regulatory and incentive regimes as well as the aspiration for energy independence and combating climate change, the progress to multi-megawatt arrays will be much faster than that achieved for wind energy development.

Uncertainty factors in screening ecological risk assessments

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

Duke, L.D.; Taggart, M.

2000-06-01

The hazard quotient (HQ) method is commonly used in screening ecological risk assessments (ERAs) to estimate risk to wildlife at contaminated sites. Many ERAs use uncertainty factors (UFs) in the HQ calculation to incorporate uncertainty associated with predicting wildlife responses to contaminant exposure using laboratory toxicity data. The overall objective was to evaluate the current UF methodology as applied to screening ERAs in California, USA. Specific objectives included characterizing current UF methodology, evaluating the degree of conservatism in UFs as applied, and identifying limitations to the current approach. Twenty-four of 29 evaluated ERAs used the HQ approach: 23 of thesemore » used UFs in the HQ calculation. All 24 made interspecies extrapolations, and 21 compensated for its uncertainty, most using allometric adjustments and some using RFs. Most also incorporated uncertainty for same-species extrapolations. Twenty-one ERAs used UFs extrapolating from lowest observed adverse effect level (LOAEL) to no observed adverse effect level (NOAEL), and 18 used UFs extrapolating from subchronic to chronic exposure. Values and application of all UF types were inconsistent. Maximum cumulative UFs ranged from 10 to 3,000. Results suggest UF methodology is widely used but inconsistently applied and is not uniformly conservative relative to UFs recommended in regulatory guidelines and academic literature. The method is limited by lack of consensus among scientists, regulators, and practitioners about magnitudes, types, and conceptual underpinnings of the UF methodology.« less

Marital age homogamy in China: A reversal of trend in the reform era?*

PubMed Central

Mu, Zheng; Xie, Yu

2014-01-01

This paper reports on a study of trends in marital age homogamy in China from 1960 to 2005 that uses data from the China 2005 1% Population Inter-census Survey. Instead of a consistent increase in age homogamy, as expected, results show an inverted U-shaped trend. One plausible explanation is that intensified economic pressure, rising consumerism, and a shrinking gender gap in education during the post-1990s reform era have acted to increase women's desire to marry men who are more economically established, and thus usually older, than less financially secure men. We argue that age hypergamy maintains status hypergamy, a deeply rooted norm for couples in China. An auxiliary analysis based on the human capital model for earnings supports this interpretation. A continued trend in age hypergamy implies a future “marriage squeeze” for men of low socioeconomic status. PMID:24468440

Status of High Latitude Precipitation Estimates from Observations and Reanalyses

NASA Technical Reports Server (NTRS)

Behrangi, Ali; Christensen, Matthew; Richardson, Mark; Lebsock, Matthew; Stephens, Graeme; Huffman, George J.; Bolvin, David T.; Adler, Robert F.; Gardner, Alex; Lambrigtsen, Bjorn H.;

Trends in the Inactive Kidney Transplant Waitlist and Implications for Candidate Survival

PubMed Central

Grams, Morgan E.; Massie, Allan B.; Schold, Jesse D.; Chen, B. Po-Han; Segev, Dorry L.

2014-01-01

In November 2003, OPTN policy was amended to allow kidney transplant (KT) candidates to accrue waiting time while registered as status 7, or inactive. We evaluated trends in inactive listings and the association of inactive status with transplantation and survival, studying 262,824 adult first-time KT candidates listed between 2000–2011. The proportion of waitlist candidates initially listed as inactive increased from 2.3% pre-policy change to 31.4% in 2011. Candidates initially listed as inactive were older, more often female, African-American, and with higher body mass index. Post-policy change, conversion from initially inactive to active status generally occurred early if at all: at one year after listing, 52.7% of initially inactive candidates had been activated; at 3 years, only 66.3% had been activated. Inactive status was associated with a substantially higher waitlist mortality (aHR 2.21, 95%CI:2.15–2.28, p<0.001) and lower rates of eventual transplantation (aRR 0.68, 95%CI:0.67–0.70, p<0.001). In summary, waitlist practice has changed significantly since November 2003, with a sharp increase in the number of inactive candidates. Using the full waitlist to estimate organ shortage or as a comparison group in transplant outcome studies is less appropriate in the current era. PMID:23399028

Homogenization patterns of the world's freshwater fish faunas.

PubMed

Villéger, Sébastien; Blanchet, Simon; Beauchard, Olivier; Oberdorff, Thierry; Brosse, Sébastien

2011-11-01

The world is currently undergoing an unprecedented decline in biodiversity, which is mainly attributable to human activities. For instance, nonnative species introduction, combined with the extirpation of native species, affects biodiversity patterns, notably by increasing the similarity among species assemblages. This biodiversity change, called taxonomic homogenization, has rarely been assessed at the world scale. Here, we fill this gap by assessing the current homogenization status of one of the most diverse vertebrate groups (i.e., freshwater fishes) at global and regional scales. We demonstrate that current homogenization of the freshwater fish faunas is still low at the world scale (0.5%) but reaches substantial levels (up to 10%) in some highly invaded river basins from the Nearctic and Palearctic realms. In these realms experiencing high changes, nonnative species introductions rather than native species extirpations drive taxonomic homogenization. Our results suggest that the "Homogocene era" is not yet the case for freshwater fish fauna at the worldwide scale. However, the distressingly high level of homogenization noted for some biogeographical realms stresses the need for further understanding of the ecological consequences of homogenization processes.

Environmental control and life support system analysis tools for the Space Station era

NASA Technical Reports Server (NTRS)

Blakely, R. L.; Rowell, L. F.

1984-01-01

This paper describes the concept of a developing emulation, simulation, sizing, and technology assessment program (ESSTAP) which can be used effectively for the various functional disciplines (structures, power, ECLSS, etc.) beginning with the initial system selection and conceptual design processes and continuing on through the mission operation and growth phases of the Space Station for the purpose of minimizing overall program costs. It will discuss the basic requirements for these tools, as currently envisioned for the Environmental Control and Life Support System (ECLSS), identifying their intended and potential uses and applications, and present examples and status of several representative tools. The development and applications of a Space Station Atmospheric Revitalization Subsystem (ARS) demonstration model to be used for concent verification will also be discussed.

On the way to commercializing plant cell culture platform for biopharmaceuticals: present status and prospect.

PubMed

Xu, Jianfeng; Zhang, Ningning

2014-12-01

Plant cell culture is emerging as an alternative bioproduction system for recombinant pharmaceuticals. Growing plant cells in vitro under controlled environmental conditions allows for precise control over cell growth and protein production, batch-to-batch product consistency and a production process aligned with current good manufacturing practices. With the recent US FDA approval and commercialization of the world's first plant cell-based recombinant pharmaceutical for human use, β-glucocerebrosidase for treatment of Gaucher's disease, a new era has come in which plant cell culture shows high potential to displace some established platform technologies in niche markets. This review updates the progress in plant cell culture processing technology, highlights recent commercial successes and discusses the challenges that must be overcome to make this platform commercially viable.

Status of barium studies in the present era of oncology: Are they a history?

PubMed

Mahajan, Abhishek; Desai, Subash; Sable, Nilesh Pandurang; Thakur, Meenakshi Haresh

2016-01-01

With the advent of the modern imaging technologies, the present era of oncology is seeing steady decline in requests for barium studies due to the many reasons. It is prudent to mention here, that, barium examinations cannot be made obsolete! Our aim to preserve the age old technique of barium studies not only to keep it going on but also for the betterment and appropriate management of the patient. Our goal is not to "save" barium studies simply to keep this technology alive, per se, but rather to preserve barium radiology for the quality in patient care.

Molecular Diagnostics for Precision Medicine in Colorectal Cancer: Current Status and Future Perspective.

PubMed

Chen, Guoli; Yang, Zhaohai; Eshleman, James R; Netto, George J; Lin, Ming-Tseh

2016-01-01

Precision medicine, a concept that has recently emerged and has been widely discussed, emphasizes tailoring medical care to individuals largely based on information acquired from molecular diagnostic testing. As a vital aspect of precision cancer medicine, targeted therapy has been proven to be efficacious and less toxic for cancer treatment. Colorectal cancer (CRC) is one of the most common cancers and among the leading causes for cancer related deaths in the United States and worldwide. By far, CRC has been one of the most successful examples in the field of precision cancer medicine, applying molecular tests to guide targeted therapy. In this review, we summarize the current guidelines for anti-EGFR therapy, revisit the roles of pathologists in an era of precision cancer medicine, demonstrate the transition from traditional "one test-one drug" assays to multiplex assays, especially by using next-generation sequencing platforms in the clinical diagnostic laboratories, and discuss the future perspectives of tumor heterogeneity associated with anti-EGFR resistance and immune checkpoint blockage therapy in CRC.

High early cardiovascular mortality following liver transplantation

PubMed Central

VanWagner, Lisa B.; Lapin, Brittany; Levitsky, Josh; Wilkins, John T.; Abecassis, Michael M.; Skaro, Anton I.; Lloyd-Jones, Donald M.

2014-01-01

Cardiovascular disease (CVD) contributes to excess long-term mortality after liver transplantation (LT), however little is known about early post-operative CVD mortality in the current era. In addition, there is no model to predict early post-operative CVD mortality across centers. We analyzed adult recipients of primary LT in the Organ Procurement and Transplantation Network (OPTN) database between February 2002 and December 2012 to assess prevalence and predictors of early (30-day) CVD mortality, defined as death from arrhythmia, heart failure, myocardial infarction, cardiac arrest, thromboembolism, and/or stroke. We performed logistic regression with stepwise selection to develop a predictive model of early CVD mortality. Sex and center volume were forced into the final model, which was validated using bootstrapping techniques. Among 54,697 LT recipients, there were 1576 (2.9%) deaths within 30 days. CVD death was the leading cause of 30-day mortality (42.1%), followed by infection (27.9%) and graft failure (12.2%). In multivariate analysis, 9 (6 recipient, 2 donor, 1 operative) significant covariates were identified: age, pre-operative hospitalization, ICU and ventilator status, calculated MELD score, portal vein thrombosis, national organ sharing, donor BMI and cold ischemia time. The model showed moderate discrimination (c-statistic 0.66, 95% CI: 0.63–0.68). We provide the first multicenter prognostic model for the prediction of early post-LT CVD death, the most common cause of early post-LT mortality in the current transplant era. However, evaluation of additional CVD-related variables not collected by the OPTN are needed in order to improve model accuracy and potential clinical utility. PMID:25044256

Comorbidities and medications of patients with chronic hepatitis C under specialist care in the UK

PubMed Central

Hudson, Benjamin; Walker, Alex J.

2017-01-01

Designing services with the capacity and expertise to meet the needs of the chronic hepatitis C (CHC) population in the era of direct acting antivirals (DAAs), and widening access to such treatments, requires detailed understanding of the characteristics and healthcare needs of the existing patient population. In this retrospective analysis of data from the National HCV Research UK Biobank between March 2012 and October 2014, the characteristics of the CHC population currently under specialist care in the UK were evaluated—with specific focus upon use of medications, adverse lifestyle choices, and comorbidities. Demographic data, risk factors for CHC acquisition, HCV genotype, liver disease status, lifestyle factors, comorbidities, and medication classes were collected. Data were analyzed by history of injecting drug use (IDU), age, and severity of liver disease. A total of 6278 patients (70.5% white; median age, 52 years) from 59 UK specialist centres were included; 59.1% of patients had acquired HCV through IDU. The prevalence of adverse lifestyle factors was significantly lower in non‐IDU compared with previous IDU or recent IDU patients. Depression was common in the previous (50.8%) and recent IDU (68.1%) groups, compared with 27.6% in non‐IDU patients. Cirrhosis was common (23.6%), and prevalence increased with age. We describe a heterogeneous, polymorbid, and aging population of CHC patients in secondary care, and demonstrate underrepresentation of injecting drug users within the current system. The implications of this present significant challenges to physicians and healthcare commissioners in designing services which are fit for purpose inthe DAA era. PMID:28480974

Prevalence and correlates of cigarette smoking among operation Iraqi freedom-era and operation enduring freedom-era women from the Active Component military and Reserve/National Guard.

PubMed

Vander Weg, Mark W; Mengeling, Michelle A; Booth, Brenda M; Torner, James C; Sadler, Anne G

2015-04-01

Tobacco use adversely affects the health and readiness of military personnel. Although rates of cigarette smoking have historically been elevated among men serving in the military, less is known about tobacco use in servicewomen. To examine the prevalence and correlates of tobacco use among women serving in the Active Component (AC) and Reserve/National Guard (RNG) as well as factors associated with starting to smoke during military service. Cross-sectional surveys of 1320 women serving in the AC or RNG were used to examine cigarette use in servicewomen. Associations between self-reported tobacco use history, sociodemographics, military service, and psychosocial factors were investigated using logistic regression analyses. Thirty-six percent of servicewomen had a lifetime history of cigarette use, with 18% reporting current smoking. Thirty-one percent of lifetime smokers initiated smoking during military service. Factors associated with current smoking included pay grade, marital status, use of psychotropic medications, past-year alcohol use, and lifetime illicit drug or illegal prescription medication use. An enlisted pay grade, being white, and a history of deployment were all associated with starting to smoke during military service. Although progress has been made in reducing the gap in tobacco use between military and civilian populations, nearly 1 in 5 servicewomen in our sample smoked cigarettes. Further efforts are needed to address tobacco use in this population. In addition to providing resources to assist smokers with quitting, additional attention should be given to preventing smoking initiation, particularly among deployed female personnel.

Nutritional assessment of elderly patients on dialysis: pitfalls and potentials for practice.

PubMed

Rodrigues, Juliana; Cuppari, Lilian; Campbell, Katrina L; Avesani, Carla Maria

2017-11-01

The chronic kidney disease (CKD) population is aging. Currently a high percentage of patients treated on dialysis are older than 65 years. As patients get older, several conditions contribute to the development of malnutrition, namely protein energy wasting (PEW), which may be compounded by nutritional disturbances associated with CKD and from the dialysis procedure. Therefore, elderly patients on dialysis are vulnerable to the development of PEW and awareness of the identification and subsequent management of nutritional status is of importance. In clinical practice, the nutritional assessment of patients on dialysis usually includes methods to assess PEW, such as the subjective global assessment, the malnutrition inflammation score, and anthropometric and laboratory parameters. Studies investigating measures of nutritional status specifically tailored to the elderly on dialysis are scarce. Therefore, the same methods and cutoffs used for the general adult population on dialysis are applied to the elderly. Considering this scenario, the aim of this review is to discuss specific considerations for nutritional assessment of elderly patients on dialysis addressing specific shortcomings on the interpretation of markers, in addition to providing clinical practice guidance to assess the nutritional status of elderly patients on dialysis. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Virtual University: A Peer to Peer Open Education Network

ERIC Educational Resources Information Center

Razavi, Amir R.; Strommen-Bakhtiar, Abbas; Krause, Paul

2011-01-01

The world is currently going through a transitional period, moving from the Service era to the Information era. Rapid societal and technological innovations are changing the way we live, communicate, and work. As the rate of the technological/societal change increases, pressure on educational institutions also increases. This pressure is…

The influence of preoperative nutritional status on the outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery.

PubMed

Lohsiriwat, V

2014-11-01

The aim of the present study was to evaluate the effects of preoperative nutritional status on the short-term outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery. This prospective observational study included 149 patients who underwent elective resection of colorectal cancer with ERAS from January 2011 to January 2014 in a university hospital. Subjective global assessment (SGA) was used to determine preoperative nutritional status. Primary outcomes included the length of postoperative stay, postoperative morbidity, gastrointestinal recovery, and 30-day readmission. The patients were divided into 3 groups according to the SGA classification. There were 96 patients (64.4 %) in SGA-A (well-nourished), 48 (32.2 %) in SGA-B (mild to moderately malnourished), and 5 (3.4 %) in SGA-C (severely malnourished). Patients in SGA-A had the median length of postoperative stay of 4 days (range 2-23), which was significantly shorter compared to SGA-B (5 days; range 2-16; p < 0.01) and SGA-C (7 days; range 4-17; p < 0.01). The overall complication rates of SGA-A, SGA-B, and SGA-C patients were 11, 31 % (adjusted OR 3.76; 95 % CI 1.36-10.36; p < 0.01) and 40 % (adjusted OR 2.15; 95 % CI 0.07-63.64; p = 0.66). Mean time to resumption of normal diet and time to first defecation were 1.6 ± 1.3 and 2.2 ± 0.9 days in SGA-A, 2.6 ± 1.7 and 3.1 ± 1.6 days in SGA-B (p < 0.01 compared to SGA-A) and 3.2 ± 2.4 days and 2.6 ± 1.5 days in SGA-C (p = 0.07 and p = 0.1 compared to SGA-A, respectively). No 30-day mortality occurred in any group. One patient in SGA-A (1 %), and 3 patients in SGA-B (6 %) had unplanned 30-day re-admission; p = 0.11. Within an ERAS programme for colorectal cancer surgery, malnourished patients were at risk for increased postoperative morbidity, delayed recovery of gastrointestinal function, and prolonged length of hospital stay.

Military Service, Childhood Socio-Economic Status, and Late-Life Lung Function: Korean War Era Military Service Associated with Smaller Disparities.

PubMed

Vable, Anusha M; Kiang, Mathew V; Basu, Sanjay; Rudolph, Kara E; Kawachi, Ichiro; Subramanian, S V; Glymour, M Maria

2018-03-02

Military service is associated with smoking initiation, but U.S. veterans are also eligible for special social, financial, and healthcare benefits, which are associated with smoking cessation. A key public health question is how these offsetting pathways affect health disparities; we assessed the net effects of military service on later life pulmonary function among Korean War era veterans by childhood socio-economic status (cSES). Data came from U.S.-born male Korean War era veteran (service: 1950-1954) and non-veteran participants in the observational U.S. Health and Retirement Study who were alive in 2010 (average age = 78). Veterans (N = 203) and non-veterans (N = 195) were exactly matched using coarsened exact matching on birth year, race, coarsened height, birthplace, childhood health, and parental and childhood smoking. Results were evaluated by cSES (defined as maternal education <8 yr/unknown or ≥8 yr), in predicting lung function, as assessed by peak expiratory flow (PEF), measured in 2008 or 2010. While there was little overall association between veterans and PEF [β = 12.8 L/min; 95% confidence interval (CI): (-12.1, 37.7); p = 0.314; average non-veteran PEF = 379 L/min], low-cSES veterans had higher PEF than similar non-veterans [β = 81.9 L/min; 95% CI: (25.2, 138.5); p = 0.005], resulting in smaller socio-economic disparities among veterans compared to non-veterans [difference in disparities: β = -85.0 L/min; 95% CI: (-147.9, -22.2); p = 0.008]. Korean War era military service appears to disproportionately benefit low-cSES veteran lung functioning, resulting in smaller socio-economic disparities among veterans compared with non-veterans.

Margin Status Remains an Important Determinant of Survival after Surgical Resection of Colorectal Liver Metastases in the Era of Modern Chemotherapy

PubMed Central

Andreou, Andreas; Aloia, Thomas A.; Brouquet, Antoine; Dickson, Paxton V.; Zimmitti, Giuseppe; Maru, Dipen M.; Kopetz, Scott; Loyer, Evelyne M.; Curley, Steven A.; Abdalla, Eddie K.; Vauthey, Jean-Nicolas

2013-01-01

Objective To determine the impact of surgical margin status on overall survival (OS) of patients undergoing hepatectomy for colorectal liver metastases (CLM) after modern preoperative chemotherapy. Summary Background Data In the era of effective chemotherapy for CLM, the association between surgical margin status and survival has become controversial. Methods Clinicopathologic data and outcomes for 378 patients treated with modern preoperative chemotherapy and hepatectomy were analyzed. The effect of positive margins on OS was analyzed in relation to pathologic and computed tomography-based morphologic response to chemotherapy. Results Fifty-two of 378 resections (14%) were R1 resections (tumor-free margin < 1 mm). The 5-year OS rates for patients with R0 resection (margin ≥ 1 mm) and R1 resection were 55% and 26%, respectively (P=0.017). Multivariate analysis identified R1 resection (P=0.03) and minor pathologic response to chemotherapy (P=0.002) as the 2 factors independently associated with worse survival. The survival benefit associated with negative margins (R0 vs. R1 resection) was greater in patients with suboptimal morphologic response (5-year OS rate: 62% vs. 11%, P=0.007) than in patients with optimal response (3-year OS rate: 92% vs. 88%, P=0.917) and greater in patients with minor pathologic response (5-year OS rate: 46% vs. 0%, P=0.002) than in patients with major response (5-year OS rate: 63% vs. 67%, P=0.587). Conclusions In the era of modern chemotherapy, negative margins remain an important determinant of survival and should be the primary goal of surgical therapy. The impact of positive margins is most pronounced in patients with suboptimal response to systemic therapy. PMID:23426338

Margin status remains an important determinant of survival after surgical resection of colorectal liver metastases in the era of modern chemotherapy.

PubMed

Andreou, Andreas; Aloia, Thomas A; Brouquet, Antoine; Dickson, Paxton V; Zimmitti, Giuseppe; Maru, Dipen M; Kopetz, Scott; Loyer, Evelyne M; Curley, Steven A; Abdalla, Eddie K; Vauthey, Jean-Nicolas

2013-06-01

To determine the impact of surgical margin status on overall survival (OS) of patients undergoing hepatectomy for colorectal liver metastases after modern preoperative chemotherapy. In the era of effective chemotherapy for colorectal liver metastases, the association between surgical margin status and survival has become controversial. Clinicopathologic data and outcomes for 378 patients treated with modern preoperative chemotherapy and hepatectomy were analyzed. The effect of positive margins on OS was analyzed in relation to pathologic and computed tomography-based morphologic response to chemotherapy. Fifty-two of 378 resections (14%) were R1 resections (tumor-free margin <1 mm). The 5-year OS rates for patients with R0 resection (margin ≥1 mm) and R1 resection were 55% and 26%, respectively (P = 0.017). Multivariate analysis identified R1 resection (P = 0.03) and a minor pathologic response to chemotherapy (P = 0.002) as the 2 factors independently associated with worse survival. The survival benefit associated with negative margins (R0 vs R1 resection) was greater in patients with suboptimal morphologic response (5-year OS rate: 62% vs 11%; P = 0.007) than in patients with optimal response (3-year OS rate: 92% vs 88%; P = 0.917) and greater in patients with a minor pathologic response (5-year OS rate: 46% vs 0%; P = 0.002) than in patients with a major response (5-year OS rate: 63% vs 67%; P = 0.587). In the era of modern chemotherapy, negative margins remain an important determinant of survival and should be the primary goal of surgical therapy. The impact of positive margins is most pronounced in patients with suboptimal response to systemic therapy.

Overview of the NASA Environmentally Responsible Aviation Project's Propulsion Technology Portfolio

NASA Technical Reports Server (NTRS)

Suder, Kenneth L.

2012-01-01

The NASA Environmentally Responsible Aviation (ERA) Project is focused on developing and demonstrating integrated systems technologies to TRL 4-6 by 2020 that enable reduced fuel burn, emissions, and noise for futuristic air vehicles. The specific goals aim to simultaneously reduce fuel burn by 50%, reduce Landing and Take-off Nitrous Oxides emissions by 75% relative to the CAEP 6 guidelines, and reduce cumulative noise by 42 Decibels relative to the Stage 4 guidelines. These goals apply to the integrated vehicle and propulsion system and are based on a reference mission of 3000nm flight of a Boeing 777-200 with GE90 engines. This paper will focus primarily on the ERA propulsion technology portfolio, which consists of advanced combustion, propulsor, and core technologies to enable these integrated air vehicle systems goals. An overview of the ERA propulsion technologies will be described and the status and results to date will be presented.

Getting folic acid nutrition right

USDA-ARS?s Scientific Manuscript database

The two articles in this issue of the journal provide some definitive answers to questions relating to folic acid exposure and folate nutritional status of the US population in the post-fortification era, and, by implication, pose other questions. Most convincingly, these reports, which are based la...

The Globalization of College and University Rankings

ERIC Educational Resources Information Center

Altbach, Philip G.

2012-01-01

In the era of globalization, accountability, and benchmarking, university rankings have achieved a kind of iconic status. The major ones--the Academic Ranking of World Universities (ARWU, or the "Shanghai rankings"), the QS (Quacquarelli Symonds Limited) World University Rankings, and the "Times Higher Education" World…

Status of barium studies in the present era of oncology: Are they a history?

PubMed Central

Mahajan, Abhishek; Desai, Subash; Sable, Nilesh Pandurang; Thakur, Meenakshi Haresh

2016-01-01

With the advent of the modern imaging technologies, the present era of oncology is seeing steady decline in requests for barium studies due to the many reasons. It is prudent to mention here, that, barium examinations cannot be made obsolete! Our aim to preserve the age old technique of barium studies not only to keep it going on but also for the betterment and appropriate management of the patient. Our goal is not to “save” barium studies simply to keep this technology alive, per se, but rather to preserve barium radiology for the quality in patient care. PMID:28144086

The Italian Middle School in a Deregulation Era: Modernity through Path-Dependency and Global Models

ERIC Educational Resources Information Center

Mincu, Monica E.

2015-01-01

In the current context of intensified moves towards educational deregulation, the configuration of the Italian middle school and its relationship to education governance is an interesting case. Historically, it represents a unique example of the successful "decision-making" model of the welfarist era. Despite some internal constraints,…

Millennial Teachers and Multiculturalism: Considerations for Teaching in Uncertain Times

ERIC Educational Resources Information Center

Hallman, Heidi L.

2017-01-01

Purpose: This paper aims to explore the intersection of generational traits of millennial teachers, multiculturalism and teaching in an era of Uncertain Times. Uncertain Times, as a framework for the paper, characterizes changing aspects of the current era in which we live, such as the rise of the internet and interconnectivity, globalization and…

Detector Developments for the High Luminosity LHC Era (4/4)

ScienceCinema

Bortoletto, Daniela

2018-02-09

Tracking Detectors - Part II. Calorimetry, muon detection, vertexing, and tracking will play a central role in determining the physics reach for the High Luminosity LHC Era. In these lectures we will cover the requirements, options, and the R&D; efforts necessary to upgrade the current LHC detectors and enabling discoveries.

Detector Developments for the High Luminosity LHC Era (3/4)

ScienceCinema

Bortoletto, Daniela

2018-01-23

Tracking Detectors - Part I. Calorimetry, muon detection, vertexing, and tracking will play a central role in determining the physics reach for the High Luminosity LHC Era. In these lectures we will cover the requirements, options, and the R&D; efforts necessary to upgrade the current LHC detectors and enabling discoveries.

Recent Reanalysis Activities at ECMWF: Results from ERA-20C and Plans for ERA5

NASA Astrophysics Data System (ADS)

Dragani, R.; Hersbach, H.; Poli, P.; Pebeuy, C.; Hirahara, S.; Simmons, A.; Dee, D.

2015-12-01

This presentation will provide an overview of the most recent reanalysis activities performed at the European Centre for Medium-Range Weather Forecasts (ECMWF). A pilot reanalysis of the 20th-century (ERA-20C) has recently been completed. Funded through the European FP7 collaborative project ERA-CLIM, ERA-20C is part of a suite of experiments that also includes a model-only integration (ERA-20CM) and a land-surface reanalysis (ERA-20CL). Its data assimilation system is constrained by only surface observations obtained from ISPD (3.2.6) and ICOADS (2.5.1). Surface boundary conditions are provided by the Hadley Centre (HadISST2.1.0.0) and radiative forcing follows CMIP5 recommended data sets. First-guess uncertainty estimates are based on a 10-member ensemble of Data Assimilations, ERA-20C ensemble, run prior to ERA-20C using ten SST and sea-ice realizations from the Hadley Centre. In November 2014, the European Commission entrusted ECMWF to run on its behalf the Copernicus Climate Change Service (C3S) aiming at producing quality-assured information about the past, current and future states of the climate at both European and global scales. Reanalysis will be one of the main components of the C3S portfolio and the first one to be produced is a global modern era reanalysis (ERA5) covering the period from 1979 onwards. Based on a recent version of the ECMWF data assimilation system, ERA5 will replace the widely used ERA-Interim dataset. This new production will benefit from a much improved model, and better characterized and exploited observations compared to its predecessor. The first part of the presentation will focus on the ERA-20C production, provide an overview of its main characteristics and discuss some of the key results from its assessment. The second part of the talk will give an overview of ERA5, and briefly discuss some of its challenges.

76 FR 62790 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

... Energy Montezuma II Wind, LLC. Description: Notice of Self-Certification of Exempt Wholesale Generator Status of NextEra Energy Montezuma II Wind, LLC. Filed Date: 09/27/2011. Accession Numbers: 20110927-5046... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 Take notice...

Comparative Metabolic Physiology in the 'omics' Era: A Call to Arms, Paws, Flippers, and Claws

USDA-ARS?s Scientific Manuscript database

In nutrition, medicine, and animal science, metabolism research is often focused on solving questions using a single organism. Outcomes are most often linked to translational outcomes--understanding or treating a disease, optimizing nutritional status, improving select qualities of production anima...

Review of the temporal and geographical distribution of measles virus genotypes in the prevaccine and postvaccine eras

PubMed Central

Riddell, Michaela A; Rota, Jennifer S; Rota, Paul A

2005-01-01

Molecular epidemiological investigation of measles outbreaks can document the interruption of endemic measles transmission and is useful for establishing and clarifying epidemiological links between cases in geographically distinct clusters. To determine the distribution of measles virus genotypes in the prevaccine and postvaccine eras, a literature search of biomedical databases, measles surveillance websites and other electronic sources was conducted for English language reports of measles outbreaks or genetic characterization of measles virus isolates. Genotype assignments based on classification systems other than the currently accepted WHO nomenclature were reassigned using the current criteria. This review gives a comprehensive overview of the distribution of MV genotypes in the prevaccine and postvaccine eras and describes the geographically diverse distribution of some measles virus genotypes and the localized distributions of other genotypes. PMID:16303052

Intellectual property rights: An overview and implications in pharmaceutical industry.

PubMed

Saha, Chandra Nath; Bhattacharya, Sanjib

2011-04-01

Intellectual property rights (IPR) have been defined as ideas, inventions, and creative expressions based on which there is a public willingness to bestow the status of property. IPR provide certain exclusive rights to the inventors or creators of that property, in order to enable them to reap commercial benefits from their creative efforts or reputation. There are several types of intellectual property protection like patent, copyright, trademark, etc. Patent is a recognition for an invention, which satisfies the criteria of global novelty, non-obviousness, and industrial application. IPR is prerequisite for better identification, planning, commercialization, rendering, and thereby protection of invention or creativity. Each industry should evolve its own IPR policies, management style, strategies, and so on depending on its area of specialty. Pharmaceutical industry currently has an evolving IPR strategy requiring a better focus and approach in the coming era.

Disparity Implications of the Medicare MTM Eligibility Criteria: A Literature Review

PubMed Central

Munshi, Kiraat D.; Shih, Ya-Chen Tina; Brown, Lawrence M.; Dagogo-Jack, Samuel; Wan, Jim Y.; Wang, Junling

2013-01-01

Summary The emphasis on eliminating racial and ethnic disparities in health care has received national attention, with various policy initiatives addressing this problem and proposing solutions. However, in the current economic era requiring tight monetary constraints, emphasis is increasingly being placed on economic efficiency, which often conflicts with the equality doctrine upon which many policies have been framed. Our review aims to highlight the disparity implications of one such policy provision—the predominantly utilization-based eligibility criteria for medication therapy management (MTM) services under Medicare Part D—by identifying studies that have documented racial and ethnic disparities in health status and the use of and spending on prescription medications. Future design and evaluation of various regulations and legislations employing utilization-based eligibility criteria must use caution in order to strike an equity-efficiency balance. PMID:23570431

On the way to commercializing plant cell culture platform for biopharmaceuticals: present status and prospect

PubMed Central

Xu, Jianfeng; Zhang, Ningning

2014-01-01

Plant cell culture is emerging as an alternative bioproduction system for recombinant pharmaceuticals. Growing plant cells in vitro under controlled environmental conditions allows for precise control over cell growth and protein production, batch-to-batch product consistency and a production process aligned with current good manufacturing practices. With the recent US FDA approval and commercialization of the world’s first plant cell-based recombinant pharmaceutical for human use, β-glucocerebrosidase for treatment of Gaucher’s disease, a new era has come in which plant cell culture shows high potential to displace some established platform technologies in niche markets. This review updates the progress in plant cell culture processing technology, highlights recent commercial successes and discusses the challenges that must be overcome to make this platform commercially viable. PMID:25621170

Explosive Transient Camera (ETC) Program

DTIC Science & Technology

1991-10-01

VOLTAGES 4.- VIDEO OUT CCD CLOCKING UNIT UUPSTAIRS" ELECTRONICS AND ANALOG TO DIGITAL IPR OCECSSER I COMMANDS TO DATA AND STATUS INSTRUMENT INFORMATION I...and transmits digital video and status information to the "downstairs" system. The clocking unit and regulator/driver board are the only CCD dependent...A. 1001, " Video Cam-era’CC’" tandari Piells" (1(P’ll m-norartlum, unpublished). Condon,, J.J., Puckpan, M.A., and Vachalski, J. 1970, A. J., 9U, 1149

Nutritional status in the era of target therapy: poor nutrition is a prognostic factor in non-small cell lung cancer with activating epidermal growth factor receptor mutations.

PubMed

Park, Sehhoon; Park, Seongyeol; Lee, Se-Hoon; Suh, Beomseok; Keam, Bhumsuk; Kim, Tae Min; Kim, Dong-Wan; Kim, Young Whan; Heo, Dae Seog

2016-11-01

Pretreatment nutritional status is an important prognostic factor in patients treated with conventional cytotoxic chemotherapy. In the era of target therapies, its value is overlooked and has not been investigated. The aim of our study is to evaluate the value of nutritional status in targeted therapy. A total of 2012 patients with non-small cell lung cancer (NSCLC) were reviewed and 630 patients with activating epidermal growth factor receptor (EGFR) mutation treated with EGFR tyrosine kinase inhibitor (TKI) were enrolled for the final analysis. Anemia, body mass index (BMI), and prognostic nutritional index (PNI) were considered as nutritional factors. Hazard ratio (HR), progression-free survival (PFS) and overall survival (OS) for each group were calculated by Cox proportional analysis. In addition, scores were applied for each category and the sum of scores was used for survival analysis. In univariable analysis, anemia (HR, 1.29; p = 0.015), BMI lower than 18.5 (HR, 1.98; p = 0.002), and PNI lower than 45 (HR, 1.57; p < 0.001) were poor prognostic factors for PFS. Among them, BMI and PNI were independent in multi-variable analysis. All of these were also significant prognostic values for OS. The higher the sum of scores, the poorer PFS and OS were observed. Pretreatment nutritional status is a prognostic marker in NSCLC patients treated with EGFR TKI. Hence, baseline nutritional status should be more carefully evaluated and adequate nutrition should be supplied to these patients.

Enhanced Recovery after Emergency Surgery: A Systematic Review.

PubMed

Paduraru, Mihai; Ponchietti, Luca; Casas, Isidro Martinez; Svenningsen, Peter; Zago, Mauro

2017-04-01

To evaluate the current scientific evidence for the applicability, safety and effectiveness of pathways of enhanced recovery after emergency surgery (ERAS). We undertook a search using PubMed and Cochrane databases for ERAS protocols in emergency cases. The search generated 65 titles; after eliminating the papers not meeting search criteria, we selected 4 cohort studies and 1 randomized clinical trial (RCT). Data extracted for analysis consisted of: patient age, type of surgery performed, ERAS elements implemented, surgical outcomes in terms of postoperative complications, mortality, length of stay (LOS) and readmission rate. The number of ERAS items applied was good, ranging from 11 to 18 of the 20 recommended by the ERAS Society. The implementation resulted in fewer postoperative complications. LOS for ES patients was shorter when compared to conventional care. Mortality, specifically reported in three studies, was equal or lower with ERAS. Readmission rates varied widely and were generally higher for the intervention group but without statistical significance. The studies reviewed agreed that ERAS in emergency surgery (ES) was feasible and safe with generally better outcomes. Lower compliance with some of the ERAS items shows the need for the protocol to be adapted to ES patients. More evidence is clearly required as to what can improve outcomes and how this can be formulated into an effective care pathway for the heterogeneous ES patient.

Modern Era Retrospective-analysis for Research and Applications (MERRA) Global Water and Energy Budgets

NASA Technical Reports Server (NTRS)

Bosilovich, Michael G.; Robertson, Franklin R.; Chen, Junye

2008-01-01

The Modern. Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has produced several years of data, on the way to a completing. the 1979-present modern satellite era. Here, we present a preliminary evaluation of those years currently available, includin g comparisons with the existing long reanalyses (ERA40, JRA25 and NCE P I and II) as well as with global data sets for the water and energy cycle Time series shows that the MERRA budgets can change with some of the variations in observing systems. We will present all terms of the budgets in MERRA including the time rates of change and analysis increments (tendency due to the analysis of observations)

Meta-analysis of self-reported health symptoms in 1990–1991 Gulf War and Gulf War-era veterans

PubMed Central

Maule, Alexis L; Janulewicz, Patricia A; Sullivan, Kimberly A; Krengel, Maxine H; Yee, Megan K; McClean, Michael; White, Roberta F

2018-01-01

Objectives Across diverse groups of Gulf War (GW) veterans, reports of musculoskeletal pain, cognitive dysfunction, unexplained fatigue, chronic diarrhoea, rashes and respiratory problems are common. GW illness is a condition resulting from GW service in veterans who report a combination of these symptoms. This study integrated the GW literature using meta-analytical methods to characterise the most frequently reported symptoms occurring among veterans who deployed to the 1990–1991 GW and to better understand the magnitude of ill health among GW-deployed veterans compared with non-deployed GW-era veterans. Design Meta-analysis. Methods Literature databases were searched for peer-reviewed studies published from January 1990 to May 2017 reporting health symptom frequencies in GW-deployed veterans and GW-era control veterans. Self-reported health symptom data were extracted from 21 published studies. A binomial-normal meta-analytical model was used to determine pooled prevalence of individual symptoms in GW-deployed veterans and GW-era control veterans and to calculate combined ORs of health symptoms comparing GW-deployed veterans and GW-era control veterans. Results GW-deployed veterans had higher odds of reporting all 56 analysed symptoms compared with GW-era controls. Odds of reporting irritability (OR 3.21, 95% CI 2.28 to 4.52), feeling detached (OR 3.59, 95% CI 1.83 to 7.03), muscle weakness (OR 3.19, 95% CI 2.73 to 3.74), diarrhoea (OR 3.24, 95% CI 2.51 to 4.17) and rash (OR 3.18, 95% CI 2.47 to 4.09) were more than three times higher among GW-deployed veterans compared with GW-era controls. Conclusions The higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal and dermatological symptoms among GW-deployed veterans compared with GW-era controls indicates these symptoms are important when assessing GW veteran health status. PMID:29440208

Survival of Asian Females With Advanced Lung Cancer in the Era of Tyrosine Kinase Inhibitor Therapy.

PubMed

Becker, Daniel J; Wisnivesky, Juan P; Grossbard, Michael L; Chachoua, Abraham; Camidge, D Ross; Levy, Benjamin P

2017-01-01

We examined the effect of access to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) therapy on survival for Asian female (AF) EGFR mutation-enriched patients with advanced lung adenocarcinoma. We used the Surveillance Epidemiology and End Results database to study patients with stage IV lung adenocarcinoma diagnosed from 1998 to 2012. We compared survival (lung cancer-specific survival [LCSS] and overall survival) between AFs and non-Asian males (NAMs), an EGFR mutation-enriched and EGFR mutation-unenriched population, respectively, with a diagnosis in the pre-EGFR TKI (1998-2004) and EGFR TKI (2005-2012) eras. We used Cox proportional hazards models to examine the interaction of access to TKI treatment and EGFR enrichment status. Among 3029 AF and 35,352 NAM patients, we found that LCSS was best for AFs with a diagnosis in the TKI era (median, 14 months), followed by AFs with a diagnosis in the pre-TKI era (median, 8 months), NAMs with a diagnosis in the TKI era (median, 5 months), and NAMs with a diagnosis in the pre-TKI era (median, 4 months; log-rank P < .0001). In a multivariable model, the effect of a diagnosis in the TKI era on survival was greater for AFs than for NAMs (LCSS, P = .0020; overall survival, P = .0007). A lung cancer diagnosis in the TKI era was associated with an overall mortality decrease of 26% for AFs (hazard ratio, 0.740; 95% confidence interval, 0.682-0.80) and 15.9% for NAMs (hazard ratio, 0.841; 95% confidence interval, 0.822-0.860). We found increased survival for lung adenocarcinoma diagnoses made after widespread access to EGFR TKIs, with the greatest increase among AF patients enriched for EGFR mutations. The present analysis eliminated the effect of crossover, which has complicated assessments of the survival advantage in EGFR TKI randomized trials. Published by Elsevier Inc.

The Social Basis of Antifeminism.

ERIC Educational Resources Information Center

Himmelstein, Jerome L.

Among the various attempts to identify the social roots of antifeminism, two theories in particular are prominent. The first argues that for both men and women, anti-abortion and anti-Equal Rights Amendment (ERA) sentiments have disproportionate appeal among lower socio-economic status, rural, and older constituencies. The second asserts that for…

Travel modeling in an era of connected and automated transportation systems: an investigation in the Dallas-Fort Worth area.

DOT National Transportation Integrated Search

2017-02-01

The North Central Texas Council of Governments (NCTCOG) engaged D-STOP to conduct a planned four-year study to analyze the status and progress of connected/autonomous vehicle (CAV) development, determine what the wide-ranging effects of the technolog...

Creativity, Scientific Practice, and Knowledge Production

ERIC Educational Resources Information Center

Fryer, Marilyn

2010-01-01

In this interesting article, Hisham Ghassib (2010) describes the transformation of science from its craft status in a pre-modern era to the major knowledge industry it is today. He then compares the production of scientific knowledge with industrial production, but makes the important distinction between the process of developing scientific…

Institutional Roles in Higher Education for Business and Management in Hungary.

ERIC Educational Resources Information Center

Voros, Jozsef; Schermerhorn, John R., Jr.

1993-01-01

Hungarian business education in a restructuring era faces such challenges as underemphasis on corporate finance/accounting and overemphasis on bookkeeping, lack of status for marketing in the curriculum, and isolation of subjects with little practical application. The goal of sustainable development is a possible focus for business administration…

The Promissory Future(s) of Education: Rethinking Scientific Literacy in the Era of Biocapitalism

ERIC Educational Resources Information Center

Pierce, Clayton

2012-01-01

This article investigates the biopolitical dimensions that have grown out of the union between biocapitalism and current science education reform in the US. Drawing on science and technology study theorists, I utilize the analytics of promissory valuation and salvationary discourses to understand how scientific literacy in the neo-Sputnik era has…

A Pos-Graduacao Nas Ciencias Humanas e o Paradigma da Medicina: A Era da Especializacao. (Post-Graduation in the Human Sciences and the Paradigm of Medicine: The Era of Specialization.)

ERIC Educational Resources Information Center

Costa, Celio Juvenal

2000-01-01

Reflects on the current tendency in Brazilian higher education for greater and greater specialization, particularly in human sciences and in medicine. Calls for less specialization and a more historic and general preparation, especially in teacher education. (BT)

Teaching Foreign Policy in the Post-Cold War Era. ERIC Digest.

ERIC Educational Resources Information Center

Graseck, Susan

This ERIC Digest discusses issues relating to teaching about U.S. foreign policy in the changing international environment following the end of the Cold War era and the disintegration of the Soviet Union. The document treats: (1) the need and rationale for teaching and learning about current foreign policy issues; (2) main themes in foreign policy…

Implementation of Enhanced Recovery After Surgery: a strategy to transform surgical care across a health system.

PubMed

Gramlich, Leah M; Sheppard, Caroline E; Wasylak, Tracy; Gilmour, Loreen E; Ljungqvist, Olle; Basualdo-Hammond, Carlota; Nelson, Gregg

2017-05-19

Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system. The ultimate intent of this work is to allow for the development of a model for spread, scale, and sustainability of ERAS in Alberta Health Services (AHS). ERAS for colorectal surgery was implemented at two sites and then spread to four additional sites. The ERAS Interactive Audit System (EIAS) was used to assess compliance with the guidelines, length of stay, readmissions, and complications. Data sources informing knowledge translation included surveys, focus groups, interviews, and other qualitative data sources such as minutes and status updates. The QUERI model and TDF were used to thematically analyze 189 documents with 2188 quotes meeting the inclusion criteria. Data sources were analyzed for barriers or enablers, organized into a framework that included individual to organization impact, and areas of focus for guideline implementation. Compliance with the evidence-based guidelines for ERAS in colorectal surgery at baseline was 40%. Post implementation compliance, consistent with adoption of best practice, improved to 65%. Barriers and enablers were categorized as clinical practice (22%), individual provider (26%), organization (19%), external environment (7%), and patients (25%). In the Alberta context, 26% of barriers and enablers to ERAS implementation occurred at the site and unit levels, with a provider focus 26% of the time, a patient focus 26% of the time, and a system focus 22% of the time. Using the ERAS care system and applying the QUERI model and TDF allow for identification of strategies that can support diffusion and sustainment of innovation of Enhanced Recovery After Surgery across multiple sites within a health care system.

Differing manifestations of hepatitis C and tacrolimus on hospitalized diabetes mellitus occurring after kidney transplantation.

PubMed

Abbott, Kevin C; Bernet, Victor J; Agodoa, Lawrence Y; Yuan, Christina M

2005-09-01

Previous studies suggest the association of recipient hepatitis C seropositivity (HCV+) and use of tacrolimus (TAC) with post-transplant diabetes mellitus (PTDM) may differ by manifestations of type I or type II diabetes, but this has not been assessed in the era of current immunosuppression. We performed a retrospective cohort study of 10,342 Medicare primary renal transplantation recipients without evidence of diabetes at the time of listing in the United States Renal Data System between January 1, 1998 and July 31, 2000, followed until December 31, 2000. Outcomes were hospitalizations for a primary diagnosis of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS). Cox regression analysis was used to calculate adjusted hazard ratios (AHR) for time to DKA or HHS, stratified by diabetes status at the time of transplant. In Cox regression analysis, use of TAC at discharge was independently associated with shorter time to DKA (AHR, 1.88; 95% CI, 1.05-3.37, p=0.034) but not HHS. In contrast, recipient HCV+ was independently associated with shorter time to HHS (AHR, 3.90; 1.59-9.60, p=.003), but not DKA. There was no interaction between TAC and HCV+ for either outcome. These results confirm earlier findings that TAC and HCV+ may mediate the risk of PTDM through different mechanisms, even in the modern era.

Enhanced Recovery after Emergency Surgery: A Systematic Review

PubMed Central

Paduraru, Mihai; Ponchietti, Luca; Casas, Isidro Martinez; Svenningsen, Peter; Zago, Mauro

2017-01-01

Objective: To evaluate the current scientific evidence for the applicability, safety and effectiveness of pathways of enhanced recovery after emergency surgery (ERAS). Methods: We undertook a search using PubMed and Cochrane databases for ERAS protocols in emergency cases. The search generated 65 titles; after eliminating the papers not meeting search criteria, we selected 4 cohort studies and 1 randomized clinical trial (RCT). Data extracted for analysis consisted of: patient age, type of surgery performed, ERAS elements implemented, surgical outcomes in terms of postoperative complications, mortality, length of stay (LOS) and readmission rate. Results: The number of ERAS items applied was good, ranging from 11 to 18 of the 20 recommended by the ERAS Society. The implementation resulted in fewer postoperative complications. LOS for ES patients was shorter when compared to conventional care. Mortality, specifically reported in three studies, was equal or lower with ERAS. Readmission rates varied widely and were generally higher for the intervention group but without statistical significance. Conclusions: The studies reviewed agreed that ERAS in emergency surgery (ES) was feasible and safe with generally better outcomes. Lower compliance with some of the ERAS items shows the need for the protocol to be adapted to ES patients. More evidence is clearly required as to what can improve outcomes and how this can be formulated into an effective care pathway for the heterogeneous ES patient. PMID:28507993

Trends in Wait-list Mortality in Children Listed for Heart Transplantation in the United States

PubMed Central

Singh, Tajinder P.; Almond, Christopher S.; Piercey, Gary; Gauvreau, Kimberlee

2014-01-01

We sought to evaluate trends in overall and race-specific pediatric heart transplant (HT) wait-list mortality in the United States (US) during the last 20 years. We identified all children <18 years old listed for primary HT in the US during 1989–2009 (N=8096, 62% white, 19% black, 13% Hispanic, 6% other) using the Organ Procurement and Transplant Network database. Wait-list mortality was assessed in 4 successive eras (1989–1994, 1995–1999, 2000–2004, and 2005–2009). Overall wait-list mortality declined in successive eras (26%, 23%, 18% and 13%, respectively). The decline across eras remained significant in adjusted analysis (hazard ratio [HR] 0.70 in successive eras, 95% confidence interval [CI] 0.67, 0.74) and was 67% lower for children listed during 2005–2009 vs. those listed during 1989–1994 (HR 0.33, CI 0.28, 0.39). In models stratified by race, wait-list mortality decreased in all racial groups in successive eras. In models stratified by era, minority children were not at higher risk of wait-list mortality in the most recent era. We conclude that the risk of wait-list mortality among US children listed for HT has decreased by two-thirds during the last 20 years. Racial gaps in wait-list mortality present variably in the past are not present in the current era. PMID:21883920

Democratic Teacher Education: Preserving Public Education as a Public Good in an Era of Neoliberalism

ERIC Educational Resources Information Center

Zimmerman, Aaron S.

2018-01-01

We currently live in an era of neoliberalism where privatization and profit are held up as political ideals. The ascendency of this ideology threatens the notion that public schools can serve not only as institutions that supply credentials but also as institutions that lay the building blocks for American democracy. This essay argues that teacher…

Enduring pictures in our heads: the continuance of authoritarianism and racial stereotyping.

PubMed

Cribbs, Sarah E; Austin, D Mark

2011-01-01

This study highlights the importance of examining the influence of personality measures, specifically authoritarianism, on negative racial stereotyping, even in an era of alleged color blindness. The authors examine the relationship of various demographic variables and authoritarianism with negative racial stereotyping in a sample of White urban respondents. Current literature suggests that age, sex, marital status, religious identification, religious service attendance, education level, income, political affiliation, level of authoritarianism, and the demographic composition in an individual's local population all affect racial stereotyping. The evidence presented, using path analysis, suggests that some demographic characteristics influence the level of negative racial stereotyping. While the effects of most included demographic characteristics were statistically significant, others, which continually resurface in the literature, remained insignificant (such as the demographic composition of the respondent's area). The results of this study challenge the loss of traditional prejudice with color blindness and point to the importance of authoritarianism as a mediating factor in negative racial stereotyping. The authors conclude the greatest indicators of negative racial stereotyping included in this study are authoritarianism, education, and income, while many other demographics - such as marital status, religious identification and attendance, and political affiliation - have indirect influences through authoritarianism.

Calibration of Star Formation Rates Across the Electromagnetic Spectrum

NASA Technical Reports Server (NTRS)

Cardiff, Ann H.

2011-01-01

Measuring and mapping star-forming activity in galaxies is a key element for our understanding of their broad- band spectra, and their structure and evolution in our local, as well as the high-redshift Universe. The main tool we use for these measurements is the observed luminosity in various spectral lines and/or continuum bands. However, the available star-formation rate (SFR) indicators are often discrepant and subject to physical biases and calibration uncertainties. We are organizing a special session at the 2012 IAU General Assembly in Beijing, China (August 20-31, 2012) in order to bring together theoreticians and observers working in different contexts of star-formation to discuss the status of current SFR indicators, to identify open issues and to define a strategic framework for their resolution. The is an ideal time to synthesize information from the current golden era of space astrophysics and still have influence on the upcoming missions that will broaden our view of star-formation. We will be including high-energy constraints on SFR in the program and encourage participation from the high energy astrophysics community.

Molecular Diagnostics for Precision Medicine in Colorectal Cancer: Current Status and Future Perspective

PubMed Central

Chen, Guoli; Yang, Zhaohai; Eshleman, James R.; Netto, George J.

2016-01-01

Precision medicine, a concept that has recently emerged and has been widely discussed, emphasizes tailoring medical care to individuals largely based on information acquired from molecular diagnostic testing. As a vital aspect of precision cancer medicine, targeted therapy has been proven to be efficacious and less toxic for cancer treatment. Colorectal cancer (CRC) is one of the most common cancers and among the leading causes for cancer related deaths in the United States and worldwide. By far, CRC has been one of the most successful examples in the field of precision cancer medicine, applying molecular tests to guide targeted therapy. In this review, we summarize the current guidelines for anti-EGFR therapy, revisit the roles of pathologists in an era of precision cancer medicine, demonstrate the transition from traditional “one test-one drug” assays to multiplex assays, especially by using next-generation sequencing platforms in the clinical diagnostic laboratories, and discuss the future perspectives of tumor heterogeneity associated with anti-EGFR resistance and immune checkpoint blockage therapy in CRC. PMID:27699178

Compositional grading of InxGa1-xAs/GaAs tunnel junctions enhanced by ErAs nanoparticles

NASA Astrophysics Data System (ADS)

Salas, R.; Krivoy, E. M.; Crook, A. M.; Nair, H. P.; Bank, S. R.

2011-10-01

We investigate the electrical conductivity of GaAs-based tunnel junctions enhanced with semimetallic ErAs nanoparticles. In particular, we examine the effects of digitally-graded InGaAs alloys on the n-type side of the tunnel junction, along with different p-type doping levels. Device characteristics of the graded structures indicate that the n-type Schottky barrier may not be the limiting factor in the tunneling current as initially hypothesized. Moreover, significantly improved forward and reverse bias tunneling currents were observed with increased p-type doping, suggesting p-side limitation.

Hungarian Marfan family with large FBN1 deletion calls attention to copy number variation detection in the current NGS era

PubMed Central

Ágg, Bence; Meienberg, Janine; Kopps, Anna M.; Fattorini, Nathalie; Stengl, Roland; Daradics, Noémi; Pólos, Miklós; Bors, András; Radovits, Tamás; Merkely, Béla; De Backer, Julie; Szabolcs, Zoltán; Mátyás, Gábor

2018-01-01

Copy number variations (CNVs) comprise about 10% of reported disease-causing mutations in Mendelian disorders. Nevertheless, pathogenic CNVs may have been under-detected due to the lack or insufficient use of appropriate detection methods. In this report, on the example of the diagnostic odyssey of a patient with Marfan syndrome (MFS) harboring a hitherto unreported 32-kb FBN1 deletion, we highlight the need for and the feasibility of testing for CNVs (>1 kb) in Mendelian disorders in the current next-generation sequencing (NGS) era. PMID:29850152

A New Discourse on the Kitchen: Feminism and Environmental Education

ERIC Educational Resources Information Center

Stovall, Holly A.; Baker-Sperry, Lori; Dallinger, Judith M.

2015-01-01

Popularised feminist discourse has devalued daily cooking and implicitly defined it as work that reinforces women's second-class status. In an era of climate change linked to industrialised foods and disease epidemics caused by the modern Western diet, kitchen work has acquired political importance. Daily cooking must be understood as public, as…

ERA: Psychological, Social and Ethical Implications for Psychology.

ERIC Educational Resources Information Center

Russo, Nancy Felipe; Hilberman, Elaine

The mental health implications of sex discrimination as considered by the Subpanel on the Mental Health of Women of the President's Commission of Mental Health are discussed. The status of women's mental health and the problems of women in the mental health delivery system are considered in relation to the larger societal context. Prevention of…

The Link between Educational Expectations and Effort in the College-for-All Era

ERIC Educational Resources Information Center

Domina, Thurston; Conley, AnneMarie; Farkas, George

2011-01-01

From the Wisconsin status attainment model to rational choice, classical sociological, social-psychological, and economic theories of student educational transitions have assumed that students' expectations are positively related to their ultimate attainment. However, the growth of the college-for-all ethos raises questions about that assumption.…

The Development of Education in Nepal. Studies in Comparative Education. Bulletin 1965, No. 5.

ERIC Educational Resources Information Center

Wood, Hugh B.

The historical, administrative, and structural status of education in Nepal is examined in this report. The introduction describes the country's geographic, historic, demographic, and economic background. Section II traces the development of education from religious training in the pre-Christian era through the post-1950 period of rapid…

Response to Section III: What's Needed Now

ERIC Educational Resources Information Center

Catelli, Linda A.

2011-01-01

Those people involved in the professional development school (PDS) effort have arrived at a time in their brief history when PDS partnerships can break the status quo and become contemporary laboratories of innovation for ushering in change and a new era of PK-12 education integrated with teacher education. In this chapter, the author appreciates…

Achieving Quality and Equity through Inclusive Education in an Era of High-Stakes Testing

ERIC Educational Resources Information Center

Peters, Susan; Oliver, Laura Ann

2009-01-01

While great progress has been made by the international community to promote inclusive education for all children, regardless of race, ethnicity, socio-economic status, gender or disability, many countries still continue to marginalize and exclude students in educational systems across the globe. High-stakes assessments in market-driven economies…

Resisting the Status Quo: The Narratives of Black Homeschoolers in Metro-Atlanta and Metro-DC

ERIC Educational Resources Information Center

Fields-Smith, Cheryl; Kisura, Monica Wells

2013-01-01

Trends suggest that homeschooling continues to increase among black families. Yet, research on contemporary Black homeschooling remains scarce. Given black educational history, the phenomena of Black families choosing homeschooling over public and private schools in the post-Desegregation era is worthy of investigation. Further, documenting the…

Teachers' Learning Communities: Catalyst for Change or a New Infrastructure for the Status Quo?

ERIC Educational Resources Information Center

Wood, Diane

2007-01-01

Background/Context: In an era of high stakes accountability, public school districts struggle to improve teaching and learning for all students. As a result, effective professional development approaches for teachers are a high priority. Recently, teachers' learning communities (LCs) have been recommended because successful LCs foster teacher…

The misalignment of institutional "pillars": consequences for the U.S. health care field.

PubMed

Caronna, Carol A

2004-01-01

This paper uses an institutional perspective (Scott, 1994; 2001; DiMaggio and Powell, 1991) to analyze the history and current state of the American health care field in terms of the alignment of its normative, cognitive, and regulatory elements. I depict the relation between institutional elements in each of three historical eras of the health care field (Scott et al. 2000): the era of professional dominance (1945--1965), the era of federal involvement (1966--1982), and the era of managerial control and market mechanisms (after 1983 to the present). I argue that a weakening of alignment between these elements, beginning in the 1970s and increasing in the 1980s, led to consumer and provider dissatisfaction with managed care, and that the state of the field in the beginning of the 21st century suggests that a new era is emerging with renewed alignment between normative beliefs and values, cognitive models, and regulation. Implications for the future of health care and institutional theory are discussed.

Intellectual property rights: An overview and implications in pharmaceutical industry

PubMed Central

Saha, Chandra Nath; Bhattacharya, Sanjib

2011-01-01

Intellectual property rights (IPR) have been defined as ideas, inventions, and creative expressions based on which there is a public willingness to bestow the status of property. IPR provide certain exclusive rights to the inventors or creators of that property, in order to enable them to reap commercial benefits from their creative efforts or reputation. There are several types of intellectual property protection like patent, copyright, trademark, etc. Patent is a recognition for an invention, which satisfies the criteria of global novelty, non-obviousness, and industrial application. IPR is prerequisite for better identification, planning, commercialization, rendering, and thereby protection of invention or creativity. Each industry should evolve its own IPR policies, management style, strategies, and so on depending on its area of specialty. Pharmaceutical industry currently has an evolving IPR strategy requiring a better focus and approach in the coming era. PMID:22171299

Magnetar Observations in the Swift-Fermi/GBM Era

NASA Technical Reports Server (NTRS)

Kouveliotou, Chryssa

2010-01-01

NASA's Fermi Observatory was launched June 11, 2008; the Fermi Gamma Ray Burst Monitor (GBM) began normal operations on July 14, about a month after launch, when the trigger algorithms were enabled. Since then, and against all odds, GBM recorded over 600 bursts from 4 SGRs. Of these four sources, only one was an old magnetar: SGR J1806+20. SGR J0501+4516, was discovered with Swift and extensively monitored with GBM. A source originally classified as AXP 1E1547.0-5408 exhibited SGR-like bursting behavior and we reclassified it as SGR J1550-5418. Finally, GBM discovered SGR J0418+5729 on 2009 June. Finally, on March 2010, a third new magnetar was discovered with Swift, SGR J1833-0832. I report below on the current status of the field and on several results combining multi-satellite and ground-based data

Doing your homework

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

Burr, M.T.

1990-04-01

Building a successful resource recovery plant requires the best technology, management and administration. But even when all the right homework is done and the best planning and design is carried out, the idea of a waste burning facility is difficult to sell to a community - especially during an era marked by not-in-my-backyard sentiment. In addition to negotiating the hurdles involved with site procurement, contractor selection, financing, and compliance with applicable laws, developers of resource recovery facilities must overcome negative popular sentiment. In Florida, all these tasks fall within the jurisdiction of the Solid Waste Authority (SWA) of Palm Beachmore » County, which facilitated the construction of the North County Regional Resource Recovery Facility. SWA built the facility as a showpiece, in hopes that other Florida counties also adopt resource recovery as an answer to their waste management problems. The history of the project and its current status are described.« less

Inter-Module Ventilation Changes to the International Space Station Vehicle to Support Integration of the International Docking Adapter and Commercial Crew Vehicles

NASA Technical Reports Server (NTRS)

Link, Dwight E., Jr.; Balistreri, Steven F., Jr.

2015-01-01

The International Space Station (ISS) Environmental Control and Life Support System (ECLSS) is continuing to evolve in the post-Space Shuttle era. The ISS vehicle configuration that is in operation was designed for docking of a Space Shuttle vehicle, and designs currently under development for commercial crew vehicles require different interfaces. The ECLSS Temperature and Humidity Control Subsystem (THC) Inter-Module Ventilation (IMV) must be modified in order to support two docking interfaces at the forward end of ISS, to provide the required air exchange. Development of a new higher-speed IMV fan and extensive ducting modifications are underway to support the new Commercial Crew Vehicle interfaces. This paper will review the new ECLSS IMV development requirements, component design and hardware status, subsystem analysis and testing performed to date, and implementation plan to support Commercial Crew Vehicle docking.

Perspectives in numerical astrophysics:

NASA Astrophysics Data System (ADS)

Reverdy, V.

2016-12-01

In this discussion paper, we investigate the current and future status of numerical astrophysics and highlight key questions concerning the transition to the exascale era. We first discuss the fact that one of the main motivation behind high performance simulations should not be the reproduction of observational or experimental data, but the understanding of the emergence of complexity from fundamental laws. This motivation is put into perspective regarding the quest for more computational power and we argue that extra computational resources can be used to gain in abstraction. Then, the readiness level of present-day simulation codes in regard to upcoming exascale architecture is examined and two major challenges are raised concerning both the central role of data movement for performances and the growing complexity of codes. Software architecture is finally presented as a key component to make the most of upcoming architectures while solving original physics problems.

Cardiac Biomarkers: a Focus on Cardiac Regeneration

PubMed Central

Forough, Reza; Scarcello, Catherine; Perkins, Matthew

2011-01-01

Historically, biomarkers have been used in two major ways to maintain and improve better health status: first, for diagnostic purposes, and second, as specific targets to treat various diseases. A new era in treatment and even cure for the some diseases using reprograming of somatic cells is about to be born. In this approach, scientists are successfully taking human skin cells (previously considered terminally-differentiated cells) and re-programming them into functional cardiac myocytes and other cell types in vitro. A cell reprograming approach for treatment of cardiovascular diseases will revolutionize the field of medicine and significantly expand the human lifetime. Availability of a comprehensive catalogue for cardiac biomarkers is necessary for developing cell reprograming modalities to treat cardiac diseases, as well as for determining the progress of reprogrammed cells as they become cardiac cells. In this review, we present a comprehensive survey of the cardiac biomarkers currently known. PMID:23074366

Treatment of renal cell carcinoma: Current status and future directions.

PubMed

Barata, Pedro C; Rini, Brian I

2017-11-01

Answer questions and earn CME/CNE Over the past 12 years, medical treatment for renal cell carcinoma (RCC) has transitioned from a nonspecific immune approach (in the cytokine era), to targeted therapy against vascular endothelial growth factor (VEGF), and now to novel immunotherapy agents. Multiple agents-including molecules against vascular endothelial growth factor, platelet-derived growth factor, and related receptors; inhibitors of other targets, such as the mammalian target of rapamycin and the MET and AXL tyrosine-protein kinase receptors; and an immune-checkpoint inhibitor-have been approved based on significant activity in patients with advanced RCC. Despite these advances, important questions remain regarding biomarkers of efficacy, patient selection, and the optimal combination and sequencing of agents. The purpose of this review is to summarize present management and future directions in the treatment of metastatic RCC. CA Cancer J Clin 2017;67:507-524. © 2017 American Cancer Society. © 2017 American Cancer Society.

Bordetella pertussis evolution in the (functional) genomics era

PubMed Central

Belcher, Thomas; Preston, Andrew

2015-01-01

The incidence of whooping cough caused by Bordetella pertussis in many developed countries has risen dramatically in recent years. This has been linked to the use of an acellular pertussis vaccine. In addition, it is thought that B. pertussis is adapting under acellular vaccine mediated immune selection pressure, towards vaccine escape. Genomics-based approaches have revolutionized the ability to resolve the fine structure of the global B. pertussis population and its evolution during the era of vaccination. Here, we discuss the current picture of B. pertussis evolution and diversity in the light of the current resurgence, highlight import questions raised by recent studies in this area and discuss the role that functional genomics can play in addressing current knowledge gaps. PMID:26297914

A qualitative study of U.S. veterans' reasons for seeking Department of Veterans Affairs disability benefits for posttraumatic stress disorder.

PubMed

Sayer, Nina A; Spoont, Michele; Murdoch, Maureen; Parker, Louise E; Hintz, Samuel; Rosenheck, Robert

2011-12-01

Posttraumatic stress disorder (PTSD) is the most prevalent compensable mental disorder within the U.S. Department of Veterans Affairs disability system and the number of veterans with PTSD service-connected disability has increased steadily over the past decade. An understanding of the reasons veterans apply for PTSD disability status may inform interpretation of this increase and policies and interventions to assist veterans with military-related PTSD. The authors conducted an exploratory qualitative study to describe the reasons veterans seek PTSD disability benefits and explored differences between those who served in different military service eras. They gathered data through in-depth interviews with 44 purposefully selected U.S. veterans, and conducted content analysis of transcribed interviews using inductive and deductive analysis with constant comparison. Participants described 5 interrelated categories of reasons for seeking PTSD disability benefits, including 3 internal factors (tangible need, need for problem identification or clarification, beliefs that justify/legitimize PTSD disability status) and 2 external factors (encouragement from trusted others and professional assistance). There were no major differences by service era. Findings may help policy makers, providers, and researchers understand what veterans hope to achieve through PTSD disability and the instrumental role of social networks and government systems in promoting the pursuit of PTSD disability status. Published 2011. This article is a US Government work and is in the public domain in the USA.

Education as an Ethical Concern in the Global Era

ERIC Educational Resources Information Center

Arnove, Robert; Bull, Barry L.

2015-01-01

This article examines the issue of the ethical status of education, particularly as related to individual dignity and freedom. We select cases that have been described in fine detail by social science--the education of girls and the education of all children within counter-hegemonic movements. These cases involve issues of access to equitable and…

Study on the Competency of Bilingual Art Teachers Based on the Psychology Capital Intervention Model

ERIC Educational Resources Information Center

Li, Donglan

2013-01-01

In this globalization era, it is an important strategy to focus on the core status of bilingual art teachers in the internationalization of higher education. And it is necessary to prepare a thorough, detailed, well-designed assessment criterion for teachers, especially for teachers specialized in art, as their competency relates directly to…

"Culture" as a Skill in Undergraduate EFL Classrooms: The Bangladeshi Realities

ERIC Educational Resources Information Center

Shahed, Faheem Hasan

2013-01-01

As regards the status of English in today's globalization era, "culture" has turned out to be an essential component in the teaching and learning of English. Some Applied Linguists have even described it as the fifth skill--after listening, speaking, reading and writing--which must be handled adequately in EFL classrooms. By appreciating…

Language Shift or Increased Bilingualism in South Africa: Evidence from Census Data

ERIC Educational Resources Information Center

Posel, Dorrit; Zeller, Jochen

2016-01-01

In the post-apartheid era, South Africa has adopted a language policy that gives official status to 11 languages (English, Afrikaans, and nine Bantu languages). However, English has remained the dominant language of business, public office, and education, and some research suggests that English is increasingly being spoken in domestic settings.…

Principal Leadership in the Accountability Era: Influence of Expanding Job Responsibilities on Functional Work Performance, Stress Management, and Overall Job Satisfaction

ERIC Educational Resources Information Center

Andreyko, Tammy A.

2010-01-01

This study examined the relationship of stress, burnout, and coping strategies among middle school principals in Western Pennsylvania. This study assessed coping skill preferences among middle school principals, especially regarding their age, gender, marital status, experience, and school enrollment. A review of the literature included studies…

The Afro-American Work/Family Nexus: An Exploratory Analysis.

ERIC Educational Resources Information Center

Collins, Patricia Hill

1986-01-01

Sketches out a framework linking black labor market trends in the post World War II era to actual and potential changes in black family patterns. Summarizes selected scholarship and then provides a gender-specific analysis of the changing employment status of black Americans. Urgres that links be made between black family life and the political…

Trapped in a Local History: Why Did Extramural Fail to Engage in the Era of Engagement?

ERIC Educational Resources Information Center

Duke, Chris

2008-01-01

Extramural liberal adult education (LAE), as conceived in the particular UK tradition, was doomed by its high-minded origins and its privileged status, and contributed little to the new concepts of "éducation permanente," lifelong learning, the knowledge society, the learning society and region, or to the new understandings of university…

Developmental Health and the Wealth of Nations: Social, Biological, and Educational Dynamics.

ERIC Educational Resources Information Center

Keating, Daniel P., Ed.; Hertzman, Clyde, Ed.

Asking how we can best support the health and well-being of infants and children in an era of rapid economic and technological change, this book presents findings on human development as both an individual and a population phenomenon. Topics discussed include links between socioeconomic status, achievement, and health; the impact of early…

Research on Technology Innovation Management in Big Data Environment

NASA Astrophysics Data System (ADS)

Ma, Yanhong

2018-02-01

With the continuous development and progress of the information age, the demand for information is getting larger. The processing and analysis of information data is also moving toward the direction of scale. The increasing number of information data makes people have higher demands on processing technology. The explosive growth of information data onto the current society have prompted the advent of the era of big data. At present, people have more value and significance in producing and processing various kinds of information and data in their lives. How to use big data technology to process and analyze information data quickly to improve the level of big data management is an important stage to promote the current development of information and data processing technology in our country. To some extent, innovative research on the management methods of information technology in the era of big data can enhance our overall strength and make China be an invincible position in the development of the big data era.

Cannabis Use Disorder and Suicide Attempts in Iraq/Afghanistan-Era Veterans

PubMed Central

Kimbrel, Nathan A.; Newins, Amie R.; Dedert, Eric A.; Van Voorhees, Elizabeth E.; Elbogen, Eric B.; Naylor, Jennifer C.; Wagner, H. Ryan; Brancu, Mira; Beckham, Jean C.; Calhoun, Patrick S.

2017-01-01

The objective of the present research was to examine the association between lifetime cannabis use disorder (CUD), current suicidal ideation, and lifetime history of suicide attempts in a large and diverse sample of Iraq/Afghanistan-era veterans (N = 3,233) using a battery of well-validated instruments. As expected, CUD was associated with both current suicidal ideation (OR = 1.683, p = 0.008) and lifetime suicide attempts (OR = 2.306, p < 0.0001), even after accounting for the effects of sex, posttraumatic stress disorder, depression, alcohol use disorder, non-cannabis drug use disorder, history of childhood sexual abuse, and combat exposure. Thus, the findings from the present study suggest that CUD may be a unique predictor of suicide attempts among Iraq/Afghanistan-era veterans; however, a significant limitation of the present study was its cross-sectional design. Prospective research aimed at understanding the complex relationship between CUD, mental health problems, and suicidal behavior among veterans is clearly needed at the present time. PMID:28129565

Spin-powered Pulsars in the CTA Era

NASA Astrophysics Data System (ADS)

Romani, Roger W.

2016-04-01

What can CTA do for the study of isolated and binary neutron stars? Are the recent Crab observations the vanguard of numerous strong pulsed detections in the CTA era? Will the typical pulsar show only the tail of the Fermi spectrum? Or will we be tantalized by a handful of new unusual sources? I review our current HE picture and suggest that pulsar binaries represent a new TeV frontier.

A new standard of sexual behavior? Are claims associated with the "hookup culture" supported by general social survey data?

PubMed

Monto, Martin A; Carey, Anna G

2014-01-01

Popular media have described intimate relationships among contemporary college students as dominated by a pervasive sexual "hookup culture," implying that students are involved in frequent sexual encounters pursued by both participants without the expectation of a continuing relationship. The hookup culture has been described as "a nationwide phenomenon that has largely replaced traditional dating on college campuses" (Bogle, 2008 , p. 5). We tested whether these claims are supported among young adults (18-25) who had completed at least one year of college. Contrasting 1988-1996 waves of the General Social Survey with 2004-2012 waves, we found respondents from the current era did not report more sexual partners since age 18, more frequent sex, or more partners during the past year than respondents from the earlier era. Sexually active respondents from the current era were more likely than those from the earlier era to report sex with a casual date/pickup or friend, and less likely to report sex with a spouse/regular partner. These modest changes are consistent with cultural shifts in the "scripts" and terminology surrounding sexuality. We find no evidence of substantial changes in sexual behavior that would indicate a new or pervasive pattern of non-relational sex among contemporary college students.

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic.

PubMed

Fairbairn, Nadia; Coffin, Phillip O; Walley, Alexander Y

2017-08-01

Community-based overdose prevention programs first emerged in the 1990's and are now the leading public health intervention for overdose. Key elements of these programs are overdose education and naloxone distribution to people who use opioids and their social networks. We review the evolution of naloxone programming through the heroin overdose era of the 1990's, the prescription opioid era of the 2000's, and the current overdose crisis stemming from the synthetic opioid era of illicitly manufactured fentanyl and its analogues in the 2010's. We present current challenges arising in this new era of synthetic opioids, including variable potency of illicit drugs due to erratic adulteration of the drug supply with synthetic opioids, potentially changing efficacy of standard naloxone formulations for overdose rescue, potentially shorter overdose response time, and reports of fentanyl exposure among people who use drugs but are opioid naïve. Future directions for adapting naloxone programming to the dynamic opioid epidemic are proposed, including scale-up to new venues and social networks, new standards for post-overdose care, expansion of supervised drug consumption services, and integration of novel technologies to detect overdose and deliver naloxone. Copyright © 2017 Elsevier B.V. All rights reserved.

Human dignity in the Nazi era: implications for contemporary bioethics.

PubMed

O'Mathúna, Dónal P

2006-03-14

The justification for Nazi programs involving involuntary euthanasia, forced sterilisation, eugenics and human experimentation were strongly influenced by views about human dignity. The historical development of these views should be examined today because discussions of human worth and value are integral to medical ethics and bioethics. We should learn lessons from how human dignity came to be so distorted to avoid repetition of similar distortions. Social Darwinism was foremost amongst the philosophies impacting views of human dignity in the decades leading up to Nazi power in Germany. Charles Darwin's evolutionary theory was quickly applied to human beings and social structure. The term 'survival of the fittest' was coined and seen to be applicable to humans. Belief in the inherent dignity of all humans was rejected by social Darwinists. Influential authors of the day proclaimed that an individual's worth and value were to be determined functionally and materialistically. The popularity of such views ideologically prepared German doctors and nurses to accept Nazi social policies promoting survival of only the fittest humans.A historical survey reveals five general presuppositions that strongly impacted medical ethics in the Nazi era. These same five beliefs are being promoted in different ways in contemporary bioethical discourse. Ethical controversies surrounding human embryos revolve around determinations of their moral status. Economic pressures force individuals and societies to examine whether some people's lives are no longer worth living. Human dignity is again being seen as a relative trait found in certain humans, not something inherent. These views strongly impact what is taken to be acceptable within medical ethics. Five beliefs central to social Darwinism will be examined in light of their influence on current discussions in medical ethics and bioethics. Acceptance of these during the Nazi era proved destructive to many humans. Their widespread acceptance today would similarly lead to much human death and suffering. A different ethic is needed which views human dignity as inherent to all human individuals.

Human dignity in the Nazi era: implications for contemporary bioethics

PubMed Central

O'Mathúna, Dónal P

2006-01-01

Background The justification for Nazi programs involving involuntary euthanasia, forced sterilisation, eugenics and human experimentation were strongly influenced by views about human dignity. The historical development of these views should be examined today because discussions of human worth and value are integral to medical ethics and bioethics. We should learn lessons from how human dignity came to be so distorted to avoid repetition of similar distortions. Discussion Social Darwinism was foremost amongst the philosophies impacting views of human dignity in the decades leading up to Nazi power in Germany. Charles Darwin's evolutionary theory was quickly applied to human beings and social structure. The term 'survival of the fittest' was coined and seen to be applicable to humans. Belief in the inherent dignity of all humans was rejected by social Darwinists. Influential authors of the day proclaimed that an individual's worth and value were to be determined functionally and materialistically. The popularity of such views ideologically prepared German doctors and nurses to accept Nazi social policies promoting survival of only the fittest humans. A historical survey reveals five general presuppositions that strongly impacted medical ethics in the Nazi era. These same five beliefs are being promoted in different ways in contemporary bioethical discourse. Ethical controversies surrounding human embryos revolve around determinations of their moral status. Economic pressures force individuals and societies to examine whether some people's lives are no longer worth living. Human dignity is again being seen as a relative trait found in certain humans, not something inherent. These views strongly impact what is taken to be acceptable within medical ethics. Summary Five beliefs central to social Darwinism will be examined in light of their influence on current discussions in medical ethics and bioethics. Acceptance of these during the Nazi era proved destructive to many humans. Their widespread acceptance today would similarly lead to much human death and suffering. A different ethic in needed which views human dignity as inherent to all human individuals. PMID:16536874

Bordetella pertussis evolution in the (functional) genomics era.

PubMed

Belcher, Thomas; Preston, Andrew

2015-11-01

The incidence of whooping cough caused by Bordetella pertussis in many developed countries has risen dramatically in recent years. This has been linked to the use of an acellular pertussis vaccine. In addition, it is thought that B. pertussis is adapting under acellular vaccine mediated immune selection pressure, towards vaccine escape. Genomics-based approaches have revolutionized the ability to resolve the fine structure of the global B. pertussis population and its evolution during the era of vaccination. Here, we discuss the current picture of B. pertussis evolution and diversity in the light of the current resurgence, highlight import questions raised by recent studies in this area and discuss the role that functional genomics can play in addressing current knowledge gaps. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Critical review on the Environmental Risk Assessment of medicinal products for human use in the centralised procedure.

PubMed

Caneva, Laura; Bonelli, Milton; Papaluca-Amati, Marisa; Vidal, Jean-Marc

2014-04-01

In this article we analyse the Environmental Risk Assessment (ERA) of 59 medicinal products for human use authorised in the EU through the centralised procedure between 2011 and 2012, to establish whether company submissions are compliant with the European Medicines Agency (EMA) guideline and complete in terms of data and study reports provided. The most frequent questions raised by EU regulatory authorities are described, together with an evaluation of the presence and quality of ERA-related information in published regulatory assessment documents. The results of this review show recent improvement in ERA-related data presented in regulatory assessment documents available to the public while also highlighting a need to develop further guidance on environmental issues in order to assist applicants improve their ERA dossiers and overcome current shortcomings. Copyright © 2014 Elsevier Inc. All rights reserved.

Jean-Louis Petit (1674-1750): a pioneer anatomist and surgeon and his contribution to orthopaedic surgery and trauma surgery.

PubMed

Markatos, Konstantinos; Androutsos, Georgios; Karamanou, Marianna; Tzagkarakis, Georgios; Kaseta, Maria; Mavrogenis, Andreas

2018-05-11

The purpose of this review is to summarize the life and work of Jean-Louis Petit, his inventions, his discoveries, and his impact on the evolution of surgery of his era. A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on Petit. Jean-Louis Petit (1674-1750) was an eminent anatomist and surgeon of his era with an invaluable contribution to clinical knowledge, surgical technique, and instrumentation as well as innovative therapeutic modalities and basic scientific discoveries. Jean-Louis Petit was an innovative anatomist and surgeon as well as an excellent clinician of his era. He revolutionized the surgical technique of his era with a significant contribution to what would later become orthopaedic surgery.

Towards a landscape scale management of pesticides: ERA using changes in modelled occupancy and abundance to assess long-term population impacts of pesticides.

PubMed

Topping, Chris J; Craig, Peter S; de Jong, Frank; Klein, Michael; Laskowski, Ryszard; Manachini, Barbara; Pieper, Silvia; Smith, Rob; Sousa, José Paulo; Streissl, Franz; Swarowsky, Klaus; Tiktak, Aaldrik; van der Linden, Ton

2015-12-15

Pesticides are regulated in Europe and this process includes an environmental risk assessment (ERA) for non-target arthropods (NTA). Traditionally a non-spatial or field trial assessment is used. In this study we exemplify the introduction of a spatial context to the ERA as well as suggest a way in which the results of complex models, necessary for proper inclusion of spatial aspects in the ERA, can be presented and evaluated easily using abundance and occupancy ratios (AOR). We used an agent-based simulation system and an existing model for a widespread carabid beetle (Bembidion lampros), to evaluate the impact of a fictitious highly-toxic pesticide on population density and the distribution of beetles in time and space. Landscape structure and field margin management were evaluated by comparing scenario-based ERAs for the beetle. Source-sink dynamics led to an off-crop impact even when no pesticide was present off-crop. In addition, the impacts increased with multi-year application of the pesticide whereas current ERA considers only maximally one year. These results further indicated a complex interaction between landscape structure and pesticide effect in time, both in-crop and off-crop, indicating the need for NTA ERA to be conducted at landscape- and multi-season temporal-scales. Use of AOR indices to compare ERA outputs facilitated easy comparison of scenarios, allowing simultaneous evaluation of impacts and planning of mitigation measures. The landscape and population ERA approach also demonstrates that there is a potential to change from regulation of a pesticide in isolation, towards the consideration of pesticide management at landscape scales and provision of biodiversity benefits via inclusion and testing of mitigation measures in authorisation procedures. Copyright © 2015 Elsevier B.V. All rights reserved.

Enhanced Recovery After Surgery: A Review.

PubMed

Ljungqvist, Olle; Scott, Michael; Fearon, Kenneth C

2017-03-01

Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient. The care protocol is based on published evidence. The ERAS Society, an international nonprofit professional society that promotes, develops, and implements ERAS programs, publishes updated guidelines for many operations, such as evidence-based modern care changes from overnight fasting to carbohydrate drinks 2 hours before surgery, minimally invasive approaches instead of large incisions, management of fluids to seek balance rather than large volumes of intravenous fluids, avoidance of or early removal of drains and tubes, early mobilization, and serving of drinks and food the day of the operation. Enhanced Recovery After Surgery protocols have resulted in shorter length of hospital stay by 30% to 50% and similar reductions in complications, while readmissions and costs are reduced. The elements of the protocol reduce the stress of the operation to retain anabolic homeostasis. The ERAS Society conducts structured implementation programs that are currently in use in more than 20 countries. Local ERAS teams from hospitals are trained to implement ERAS processes. Audit of process compliance and patient outcomes are important features. Enhanced Recovery After Surgery started mainly with colorectal surgery but has been shown to improve outcomes in almost all major surgical specialties. Enhanced Recovery After Surgery is an evidence-based care improvement process for surgical patients. Implementation of ERAS programs results in major improvements in clinical outcomes and cost, making ERAS an important example of value-based care applied to surgery.

Short-term quality of life in patients undergoing colonic surgery using enhanced recovery after surgery program versus conventional perioperative management.

PubMed

Wang, Hao; Zhu, Dexiang; Liang, Li; Ye, Lechi; Lin, Qi; Zhong, Yunshi; Wei, Ye; Ren, Li; Xu, Jianmin; Qin, Xinyu

2015-11-01

Enhanced recovery after surgery (ERAS) integrates evidence-based interventions to reduce surgical stress and accelerate rehabilitation. Our study was to compare the short-term quality of life (QOL) in patients undergoing open colonic surgery using ERAS program or conventional management. A prospective study of 57 patients using ERAS program and 60 patients using conventional management was conducted. The clinical characteristics of all patients were recorded. QOL was evaluated longitudinally using the questionnaires (EORTC QLQ-C30 and QLQ-CR29) pre- and postoperatively. Generalized estimating equation was used to do the analysis in order to determine the effective impact of correlative factors on the postoperative QOL, including age, sex, BMI, ASA grade, tumor location, tumor size, pTNM stage, recovery program and length of time after surgery. The morbidity in ERAS and control group was 17.5 versus 26.7 % (p = 0.235). The patients in ERAS group had much faster rehabilitation and less hospital stay. In the primary statistical analysis, the scores of global QOL (on POD3, POD6, POD10, POD14, POD21), physical functioning (on POD3, POD6, POD10, POD14, POD21), role functioning (on POD6, POD10, POD14, POD21), emotional functioning (on POD3, POD6, POD10, POD14, POD21), cognitive functioning (on POD3, POD6) and social functioning (on POD3, POD6, POD10, POD14, POD21, POD28) were higher in ERAS group than in control group, which suggested that the patients in ERAS group had a better life status. However, the scores of pain (on POD10, POD14, POD21), appetite loss (on POD3, POD6), constipation (on POD3, POD6, POD10), diarrhea (on POD3, POD10), financial difficulties (on POD10, POD14, POD21), perspective of future health (on POD6, POD10, POD14), gastrointestinal tract problems (on POD3, POD6, POD10) and defecation problems (on POD6, POD10, POD14) were lower in ERAS group than in control group, which revealed that the patients in ERAS group suffered less symptoms. In the further generalized estimating equation analysis, the result showed that recovery program and length of time after surgery had independently positive impact on the patient's postoperative QOL. Short-term QOL in patients undergoing colonic cancer using ERAS program was better than that using conventional management.

R & D on Beam Injection and Bunching Schemes in the Fermilab Booster

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

Bhat, C. M.

2016-01-01

Fermilab is committed to upgrade its accelerator complex to support HEP experiments at the intensity frontier. The ongoing Proton Improvement Plan (PIP) enables us to reach 700 kW beam power on the NuMI neutrino targets. By the end of the next decade, the current 400 MeV normal conducting LINAC will be replaced by an 800 MeV superconducting LINAC (PIP-II) with an increased beam power >50% of the PIP design goal. Both in PIP and PIP-II era, the existing Booster is going to play a very significant role, at least for next two decades. In the meanwhile, we have recently developedmore » an innovative beam injection and bunching scheme for the Booster called "early injection scheme" that continues to use the existing 400 MeV LINAC and implemented into operation. This scheme has the potential to increase the Booster beam intensity by >40% from the PIP design goal. Some benefits from the scheme have already been seen. In this paper, I will describe the basic principle of the scheme, results from recent beam experiments, our experience with the new scheme in operation, current status, issues and future plans. This scheme fits well with the current and future intensity upgrade programs at Fermilab.« less

[Psycho-medical care of transsexuals in Spain in the era of depathologization of transsexualism as a mental disorder. An overall review].

PubMed

Wittich, Regina-Michaela

2013-12-01

To identify the strengths and weaknesses of Spanish healthcare protocols for transsexual persons and to compare them to current international protocols. To review the current status as regards transsexuality etiology and prevalence. To suggest measures to optimize care to achieve a significant improvement, including options for saving financial resources. A comparison of the contents of texts related to transsexualism in the ICD-10, DSM-IV, and guidelines of the Spanish gender units with international standards of care for transgender persons and the last draft version of the DSM-5. Systematic revision of the literature related to the etiology and prevalence of transsexualism. Significant discrepancies have been found as regards the minimum time period for diagnosis, access to hormone replacement therapy and to genital surgery, and the requirement of the so-called real-life experience. Impact of sex hormones on the etiology of transsexualism and underestimation of its prevalence was confirmed. The access to hormonal and surgical treatment requires a profound review, and decentralization of transsexual care is recommended, because all university hospitals haves psychiatrists, clinical psychologists, and endocrinologists available. Although gender reassignment surgery also requires plastic surgery specialists, plastic surgeons currently receive training in this field. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

NASA's Modern Era Retrospective-Analysis for Research and Applications (MERRA): Early Results and Future Directions

NASA Technical Reports Server (NTRS)

Schubert, Siegfried

2008-01-01

This talk will review the status and progress of the NASA/Global Modeling and Assimilation Office (GMAO) atmospheric global reanalysis project called the Modern Era Retrospective-Analysis for Research and Applications (MERRA). An overview of NASA's emerging capabilities for assimilating a variety of other Earth Science observations of the land, ocean, and atmospheric constituents will also be presented. MERRA supports NASA Earth science by synthesizing the current suite of research satellite observations in a climate data context (covering the period 1979-present), and by providing the science and applications communities with of a broad range of weather and climate data with an emphasis on improved estimates of the hydrological cycle. MERRA is based on a major new version of the Goddard Earth Observing System Data Assimilation System (GEOS-5), that includes the Earth System Modeling Framework (ESMF)-based GEOS-5 atmospheric general circulation model and the new NOAA National Centers for Environmental Prediction (NCEP) unified grid-point statistical interpolation (GST) analysis scheme developed as a collaborative effort between NCEP and the GMAO. In addition to MERRA, the GMAO is developing new capabilities in aerosol and constituent assimilation, ocean, ocean biology, and land surface assimilation. This includes the development of an assimilation capability for tropospheric air quality monitoring and prediction, the development of a carbon-cycle modeling and assimilation system, and an ocean data assimilation system for use in coupled short-term climate forecasting.

Changing Neurodevelopment at 8 Years in Children Born Extremely Preterm Since the 1990s.

PubMed

Cheong, Jeanie L Y; Anderson, Peter J; Burnett, Alice C; Roberts, Gehan; Davis, Noni; Hickey, Leah; Carse, Elizabeth; Doyle, Lex W

2017-06-01

Survival of extremely preterm (EP; <28 weeks' gestation) infants has increased over the last 2 decades. Equivalent reductions in developmental morbidity in early childhood have not been consistently reported. The aim of this study was to determine trends in neurodevelopmental outcomes at 8 years of age of children born EP (22-27 completed weeks' gestation) over the past 2 decades. Population-based cohorts of all EP survivors born in the state of Victoria, Australia in 1991-1992, 1997, and 2005 were recruited at birth. At 8 years of age, general intelligence (IQ), academic achievement, and neurosensory status were assessed. Major neurosensory disability was defined as any of moderate or severe cerebral palsy, IQ <-2 SD relative to term controls, blindness, or deafness. Rates of major neurosensory disability were similar in all eras (1991-1992, 18%; 1997, 15%; 2005, 18%), as were rates of IQ <-2 SD, cerebral palsy, blindness, and deafness. Mean z scores for IQ were similar across eras, but there was some evidence that scores for academic achievement were lower in 2005 than in 1997, and the odds of having academic problems were higher in 2005 than in both earlier eras. These outcomes were not explained by differences in known perinatal care or sociodemographic variables between eras. Contrary to expectations, rates of major neurosensory disability have not improved, and academic performance is poorer at early school age in 2005 than in earlier eras for EP children born in the state of Victoria, Australia. Copyright © 2017 by the American Academy of Pediatrics.

From local to global--an overview of the Croatian National Theatre in the era of globalization.

PubMed

Penjak, Ana

2012-09-01

The article offers an overview of the Croatian National Theatre research. It comes in two parts. The first examines the position theatre in the era of globalization, while the second focuses on the Croatian National Theatre, in the era of globalization, in the context of specific social and national interests, as well as within the limits of the national possibilities. What emerges in this overview is a feel for how complex the field of theatre research is in Croatia, given its specific position since there are four National Theatres in a country of approximately 4 million people. Also, local budgets and the lack of strategical plan and programme for culture in general represent a sort of limitation. The article ends with two conclusions: a) the Croatian National Theatres in the effort to go global experience primarily different economic status; b) the article draws attention to the present and future challenges that the Croatian National Theatres are faced with, posed by issues such as correlation between globalization and theatre.

History and challenges of national examination as a quality measurement for high school students in Indonesia

NASA Astrophysics Data System (ADS)

Rozamuri, Arif Murti; Suradi, Nur Riza Mohd

2015-02-01

Education in Indonesia has been established before the Indonesian state. Therefore, the history of Education in Indonesia is quite long. Education that has existed since ancient times, and then forwarded to the days of the Hindu and Buddhist religious influence, then the influence of Islamic religious era, the education in the colonial era until education in independence era. At Indonesia for senior high school students, the quality measured by national exam. The national examination has a long history and full of pros and cons in determining the quality of students. With different level social economic status, and teacher quality in each schools, the student quality would be assessed within a period of three years. The interesting part is whether the national examination, able to measure the quality of students?. Is the quality of students can only be measured through the national exam?. Then various fraud taint the education particularly in the implementation of national examination. This research would explain long history of national examination and various problems that occur in national examination.

Drug Development and Biologics in Asthma. A New Era.

PubMed

Doyle, Ramona

2016-03-01

Considerable progress has been made toward developing targeted biological therapeutics for asthma, due in large part to a deeper understanding of asthma pathophysiology. This explosion of knowledge has revealed asthma to be a much more complex and heterogeneous entity than previously understood. The identification of particular asthma phenotypes with distinct pathophysiologic mechanisms has opened up a new era for patient populations not well served by current therapies, especially patients with severe asthma.

Enhanced recovery after surgery: Current research insights and future direction

PubMed Central

Abeles, Aliza; Kwasnicki, Richard Mark; Darzi, Ara

2017-01-01

Since the concept of enhanced recovery after surgery (ERAS) was introduced in the late 1990s the idea of implementing specific interventions throughout the peri-operative period to improve patient recovery has been proven to be beneficial. Minimally invasive surgery is an integral component to ERAS and has dramatically improved post-operative outcomes. ERAS can be applicable to all surgical specialties with the core generic principles used together with added specialty specific interventions to allow for a comprehensive protocol, leading to improved clinical outcomes. Diffusion of ERAS into mainstream practice has been hindered due to minimal evidence to support individual facets and lack of method for monitoring and encouraging compliance. No single outcome measure fully captures recovery after surgery, rather multiple measures are necessary at each stage. More recently the pre-operative period has been the target of a number of strategies to improve clinical outcomes, described as prehabilitation. Innovation of technology in the surgical setting is also providing opportunities to overcome the challenges within ERAS, e.g., the use of wearable activity monitors to record information and provide feedback and motivation to patients peri-operatively. Both modernising ERAS and providing evidence for key strategies across specialties will ultimately lead to better, more reliable patient outcomes. PMID:28289508

Understanding the HRD Role in MNCs: The Imperatives of Social Capital and Networking

ERIC Educational Resources Information Center

Gubbins, Claire; Garavan, Thomas N.

2009-01-01

In an era of increasing global competition, it is argued that knowledge and skills are the key sources of competitive advantage. This places the human resource development (HRD) function in a situation of increased status and power, if HRD professionals adopt roles in a way that adds "value" and facilitates achievement of competitive advantage.…

A World of Opportunity: Postsecondary Training and Education for All

ERIC Educational Resources Information Center

Carnevale, Anthony

2008-01-01

For most of the 20th century, high school was enough for a shot at middle-class status and wages. Eventually high school was surpassed by postsecondary education as the preferred route to professional and managerial jobs in the post-World War II era. This article describes how today, young workers rarely go anywhere in the American job market…

Educators' Perceptions of Using a Language Acquisition Program to Close English Learners' Achievement Gap

ERIC Educational Resources Information Center

Leake, Alecia Ronneice

2017-01-01

For many years English learners (ELs) have lagged behind native speakers of English in the academic community. In an era of accountability, the pressure to achieve and maintain Adequate Yearly Progress (AYP) status is increasing the burden of success on ELs, especially when trying to learn a second language. The population of English learners is…

Oral Communication and Technical Writing: A Reconsideration of Writing in a Multicultural Era

ERIC Educational Resources Information Center

Cibangu, Sylvain K.

2009-01-01

This article investigates the status of orality in the history of technical communication. The article calls for orality as an integral part and driving force of technical writing. The article brings to light the misconceptions that have led to a diminished role of oral communication in technical writing. The article shows the implications of oral…

Gender & Economic Status Matter in Mental Health of Adolescents?

ERIC Educational Resources Information Center

Sharma, Namita; Dua, Radha

2011-01-01

Mental health is the ability to adjust oneself satisfactorily to the various strains of life. Mental health and Education are closely related to each other. Sound mental is prerequisite for the learner. In this era of severe competition to excel or to be on the top is pressurizing today's adolescents to the utmost. Besides a number of factors like…

From Radical Reconstruction to Jim Crow: Education, Nation-Building, and the Making of a New Racial Order

ERIC Educational Resources Information Center

Smith, Christi Michelle

2012-01-01

Drawing on recent theories of boundary processes, status and ethnicity, I investigate processes of group-making in the post-Civil War era (1865-1905) when Americans were faced with two daunting political projects: rebuilding the nation, and creating a new racial order to replace the abolished system of bond slavery. Although scholars have…

HIV Status Disclosure Among People Living with HIV in the Era of Combination Antiretroviral Therapy (cART).

PubMed

Madi, Deepak; Gupta, Parul; Achappa, Basavaprabhu; Bhaskaran, Unnikrishnan; Ramapuram, John T; Rao, Satish; Mahalingam, Soundarya

2015-08-01

As patients with HIV live longer due to Combination Anti-Retroviral Therapy (cART) serostatus disclosure becomes an important issue. Disclosure can have both positive and negative outcomes. Disclosure of HIV status has been associated with better adherence to medication and reduction in levels of psychological distress. Stigma and disruption of family relationships are barriers for disclosure. Most studies regarding disclosure status have been conducted in West. There are many cultural differences in Indian society when compared to west. There is a dearth of research in the field of disclosure of HIV infection in India. To determine the prevalence of HIV status disclosure among people living with HIV (PLHIV) in South India. This descriptive cross-sectional study was done in the hospital attached to Kasturba Medical College (KMC), Mangalore, India from May-June 2013. PLHIV of age more than 18 years were included. During the study period 111 consecutive patients who consented for the study were enrolled. Data was collected using a pre-tested interviewer administered semi structured questionnaire. Data collected was analysed using SPSS Version 11.5 statistical software. Descriptive statistics were done and the results are presented as proportions and mean. The mean age of the study population was 44.86 ± 10.8 years. Majority of the study subjects were men 76 (68.4%). Out of 111 study subjects, 102 (91.9%) had disclosed their HIV status to at least one person while 9 (8.1%) had not disclosed their HIV status to anyone. Disclosure on doctor's advice was the main reason for 56 (54.9%) participants to disclose their HIV status. The main reason for non-disclosure was fear of shame in family. Disclosure rate was high in our study in the era of cART. Society must stop discriminating against PLHIV so that they can disclose their serostatus and gain access to care and treatment services without any fear of stigma. In our study the main reason for disclosure was doctor's advice which clearly states the importance of the commitment of doctors in creating awareness among PLHIV about the need for voluntary disclosure.

Intergenerational Mobility in the Post-1965 Immigration Era: Estimates By An Immigrant Generation Cohort Method

PubMed Central

PARK, JULIE; MYERS, DOWELL

2010-01-01

The new second generation of the post-1965 immigration era is observed as children with their parents in 1980 and again as adults 25 years later. Intergenerational mobility is assessed for both men and women in four major racial/ethnic groups, both in regard to children’s status attainment relative to parents and with regard to the rising societal standards proxied by native-born non-Hispanic whites. A profile of intergenerational mobility is prepared using multiple indicators of status attainment: high school and college completion, upper white-collar occupation, poverty, and homeownership. The immigrant generation cohort method we introduce accounts for four distinct temporal dimensions of immigrant progress, clarifying inconsistencies in the literature and highlighting differences in mobility between racial/ethnic groups and with respect to different outcome measures. The immigrant generation cohort method consistently finds greater intergenerational mobility than suggested by alternative approaches. Our analysis also shows that the intergenerational progress of women is greater than that of men and provides a more complete record of immigrant mobility overall. Findings for individual racial/ethnic groups accord with some expectations in the literature and contradict others. PMID:20608102

Enhanced recovery after surgery and video-assisted thoracic surgery lobectomy: the Italian VATS Group**List of collaborators of the Italian ERAS Group: Jacopo Vannucci, MD (University of Perugia); Antonio D’Andrilli, MD (S. Andrea Hospital, Roma); Majed Refai, MD (Ospedali Riuniti, Ancona); Guendalina Graffigna, MD (Università Cattolica del Sacro Cuore, Milano); Stefano Lovadina, MD (Ospedali Riuniti, Trieste); Marzia Umari (Ospedali Riuniti, Trieste), Paolo Ferrari, MD (IRCCS ISMETT-UPMC, University of Pittsburgh, Palermo); Michele Zuliani, MD (Ospedali Riuniti, Trieste); Marco Taurchini, MD (Casa Sollievo della Sofferenza, San Giovanni Rotondo); Carlo Del Naja, MD (Casa Sollievo della Sofferenza, San Giovanni Rotondo); Domenico Massullo, MD (S. Andrea Hospital, Roma), Olha Putina, MD (ASST Mantova), Nicoletta Pia Ardò (University of Foggia). surgical protocol

PubMed Central

Viggiano, Domenico; Voltolini, Luca; Bertani, Alessandro; Bertolaccini, Luca; Crisci, Roberto; Droghetti, Andrea

2018-01-01

Enhanced recovery after surgery (ERAS®) is a strategy that seeks to reduce patients’ perioperative stress response, thereby reducing potential complications, decreasing hospital length of stay and enabling patients to return more quickly to their baseline functional status. The concept was introduced in the late 1990s and was first adopted in patients undergoing open colorectal surgery. Since then, the concept of ERAS has been adopted by multiple surgical specialties. The diffusion of video-assisted thoracic surgery lobectomy (VATS-L) sets also the surgical treatment of lung cancer as a new area for ERAS development. In this paper, we present the Italian VATS Group (www.vatsgroup.org) surgical protocol as part of the ERAS clinical pathway belonging to the VATS-L national database. PMID:29629203

Healthcare and the Roles of the Medical Profession in the Big Data Era*1

PubMed Central

YAMAMOTO, Yuji

2016-01-01

The accumulation of large amounts of healthcare information is in progress, and society is about to enter the Health Big Data era by linking such data. Medical professionals’ daily tasks in clinical practice have become more complicated due to information overload, accelerated technological development, and the expansion of conceptual frameworks for medical care. Further, their responsibilities are more challenging and their workload is consistently increasing. As medical professionals enter the Health Big Data era, we need to reevaluate the fundamental significance and role of medicine and investigate ways to utilize this available information and technology. For example, a data analysis on diabetes patients has already shed light on the status of accessibility to physicians and the treatment response rate. In time, large amounts of health data will help find solutions including new effective treatment that could not be discovered by conventional means. Despite the vastness of accumulated data and analyses, their interpretation is necessarily conducted by attending physicians who communicate these findings to patients face to face; this task cannot be replaced by technology. As medical professionals, we must take the initiative to evaluate the framework of medicine in the Health Big Data era, study the ideal approach for clinical practitioners within this framework, and spread awareness to the public about our framework and approach while implementing them. PMID:28299246

A biomimetic approach to the detection and identification of estrogen receptor agonists in surface waters using semipermeable membrane devices (SPMDs) and bioassay-directed chemical analysis.

PubMed

Rastall, Andrew C; Getting, Dominic; Goddard, Jon; Roberts, David R; Erdinger, Lothar

2006-07-01

Some anthropogenic pollutants posses the capacity to disrupt endogenous control of developmental and reproductive processes in aquatic biota by activating estrogen receptors. Many anthropogenic estrogen receptor agonists (ERAs) are hydrophobic and will therefore readily partition into the abiotic organic carbon phases present in natural waters. This partitioning process effectively reduces the proportion of ERAs readily available for bioconcentration by aquatic biota. Results from some studies have suggested that for many aquatic species, bioconcentration of the freely-dissolved fraction may be the principal route of uptake for hydrophobic pollutants with logarithm n-octanol/water partition coefficient (log Kow) values less than approximately 6.0, which includes the majority of known anthropogenic ERAs. The detection and identification of freely-dissolved readily bioconcentratable ERAs is therefore an important aspect of exposure and risk assessment. However, most studies use conventional techniques to sample total ERA concentrations and in doing so frequently fail to account for bioconcentration of the freely-dissolved fraction. The aim of the current study was to couple the biomimetic sampling properties of semipermeable membrane devices (SPMDs) to a bioassay-directed chemical analysis (BDCA) scheme for the detection and identification of readily bioconcentratable ERAs in surface waters. SPMDs were constructed and deployed at a number of sites in Germany and the UK. Following the dialytic recovery of target compounds and size exclusion chromatographic cleanup, SPMD samples were fractionated using a reverse-phase HPLC method calibrated to provide an estimation of target analyte log Kow. A portion of each HPLC fraction was then subjected to the yeast estrogen screen (YES) to determine estrogenic potential. Results were plotted in the form of 'estrograms' which displayed profiles of estrogenic potential as a function of HPLC retention time (i.e. hydrophobicity) for each of the samples. Where significant activity was elicited in the YES, the remaining portion of the respective active fraction was subjected to GC-MS analysis in an attempt to identify the ERAs present. Estrograms from each of the field samples showed that readily bioconcentratable ERAs were present at each of the sampling sites. Estimated log Kow values for the various active fractions ranged from 1.92 to 8.63. For some samples, estrogenic potential was associated with a relatively narrow range of log Kow values whilst in others estrogenic potential was more widely distributed across the respective estrograms. ERAs identified in active fractions included some benzophenones, various nonylphenol isomers, benzyl butyl phthalate, dehydroabietic acid, sitosterol, 3-(4-methylbenzylidine)camphor (4-MBC) and 6-acetyl-1,1,2,4,4,7-hexamethyltetralin (AHTN). Other tentatively identified compounds which may have contributed to the observed YES activity included various polycyclic aromatic hydrocarbons (PAHs) and their alkylated derivatives, methylated benzylphenols, various alkyl-phenols and dialkylphenols. However, potential ERAs present in some active fractions remain unidentified. Our results show that SPMD-YES-based BDCA can be used to detect and identify readily bioconcentratable ERAs in surface waters. As such, this biomimetic approach can be employed as an alternative to conventional methodologies to provide investigators with a more environmentally relevant insight into the distribution and identity of ERAs in surface waters. The use of alternative bioassays also has the potential to expand SPMD-based BDCA to include a wide range of toxicological endpoints. Improvements to the analytical methodology used to identify ERAs or other target compounds in active fractions in the current study could greatly enhance the applicability of the methodology to risk assessment and monitoring programmes.

PRSEUS Structural Concept Development

NASA Technical Reports Server (NTRS)

Velicki, Alex; Jegley, Dawn

2014-01-01

A lighter, more robust airframe is one of the key technological advancements necessary for the successful launch of any large next-generation transport aircraft. Such a premise dictates that considerable improvements beyond current state-of-the-art aluminum structures is needed, and that improvements of this magnitude will require an extensive use of composite materials that are not only lightweight, but also economical to produce. To address this challenge, researchers at NASA and The Boeing Company are developing a novel structural concept called the Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS) under the Environmentally Responsible Aviation (ERA) Project. It is an integrally stiffened panel concept that is stitched together and designed to maintain residual load-carrying capabilities under a variety of damage scenarios. In addition to improved structural performance, an important facet of this unique arrangement of stitched carbon fibers is its innovative manufacturing method that has the potential to lower fabrication costs by eliminating fasteners and autoclave cures. The rationale and development status for this new approach forms the basis of the work described in this paper. The test specimens described herein were fabricated, or are currently being fabricated, by The Boeing Company, while the structural analyses and testing tasks are being performed by NASA and Boeing personnel.

Do non-nucleoside reverse transcriptase inhibitors contribute to lipodystrophy?

PubMed

Nolan, David

2005-01-01

Lipodystrophy complications, including lipoatrophy (pathological fat loss) and metabolic complications, have emerged as important long-term toxicities associated with antiretroviral therapy in the current era. The wealth of data that has accumulated over the past 6 years has now clarified the contribution of specific antiretroviral drugs to the risk of these clinical endpoints, with evidence that lipoatrophy is strongly associated with the choice of nucleoside reverse transcriptase inhibitor therapy (specifically, stavudine and to a lesser extent zidovudine). The aetiological basis of metabolic complications of antiretroviral therapy has proven to be complex, in that the risk appears to be modulated by a number of lifestyle factors that have made the metabolic syndrome highly prevalent in the general population, with additional contributions from HIV disease status itself, as well as from individual drugs within the HIV protease inhibitor class. The currently licensed non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs, efavirenz and nevirapine, have been proven to have a favourable safety profile in terms of lipodystrophy complications. However, it must be noted that NNRTI drugs also have individual toxicity profiles that must be accounted for when considering and/or monitoring their use in the treatment of HIV infection.

GCF Mark IV development

NASA Technical Reports Server (NTRS)

Mortensen, L. O.

1982-01-01

The Mark IV ground communication facility (GCF) as it is implemented to support the network consolidation program is reviewed. Changes in the GCF are made in the area of increased capacity. Common carrier circuits are the medium for data transfer. The message multiplexing in the Mark IV era differs from the Mark III era, in that all multiplexing is done in a GCF computer under GCF software control, which is similar to the multiplexing currently done in the high speed data subsystem.

Slaves, embryos, and nonhuman animals: moral status and the limitations of common morality theory.

PubMed

Lindsay, Ronald A

2005-12-01

Common morality theory must confront apparent counterexamples from the history of morality, such as the widespread acceptance of slavery in prior eras, that suggest core norms have changed over time. A recent defense of common morality theory addresses this problem by drawing a distinction between the content of the norms of the common morality and the range of individuals to whom these norms apply. This distinction is successful in reconciling common morality theory with practices such as slavery, but only at the cost of underscoring the limits of common morality theory, in particular its inability to resolve disputes about the moral status of entities. Given that many controversies in bioethics center on the disputed status of various entities, such as embryos and nonhuman animals, this is an important limitation. Nonetheless, common morality theory still can be a useful resource in diminishing moral conflict on issues that do not involve disputes over moral status.

[Enhanced Recovery after Surgery from Theory to Practice
What do We Need to Do?

PubMed

Che, Guowei; Liu, Lunxu; Zhou, Qinghua

2017-04-20

Enhanced recovery after surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes, shorter length of hospital stay and cost savings. But the current ERAS either by application of breadth or depth is not enough, why? The main reason is the lack of "operability, evaluation, repetition" ERAS protocol and suitable for clinical extensive application protocol. How to form the clinical available protocol? Operational mainly refers to the clinical scheme is simple and feasible, and protocol compliance is good; Evaluate refers to the methods used before, during and after are the objective evaluation criteria and plan; Repeatable is clinical scheme repeatability in the process of single or multiple center.

Quality and cost improvement of healthcare via complementary measurement and diagnosis of patient general health outcome using electronic health record data: research rationale and design.

PubMed

Stusser, Rodolfo J; Dickey, Richard A

2013-12-01

In this evolving 'third era of health', one of the US Health Care Reform Act's goals is to effectively facilitate the primary care physician's ability to better diagnose and manage the health outcome of the outpatient. That goal must include research on the complementary quantitative-qualitative assessment and rating of the patient's health status. This paper proposes an overview of the rationale and design of a research program for a balanced measurement and diagnostic clinical decision support system (CDSS) of the changing general health status of the patient -including disease- using electronic health record (EHR) data. The rationale, objectives, health metric-diagnostic tools architecture, simulation-optimization, and clinical trials are outlined. Resources, time frames, costs, feasibility, healthcare benefits and data-integration of the project are delineated. The basis and components of the research program to achieve an automated-CDSS to complement physician's clinical judgment, calculating a mathematical 'health equation' from each patient's EHR database, assisting physician-patient collaboration to diagnose, and improve general health outcomes is described. Use of multiple dimensional index, ways of classification, and causal factors' assessments, to arrive at the EHR-based CDSS algorithm-software providing a general health level and state rating of the patient are proposed. Its application could provide a compass for the general practitioner's best choice and use of the myriad of healthcare educational and technological options available with lower costs for everyday clinical practice and research. It could advance the approaches and focus of the 'eras of diseases', to the promising 'era of health', in an integrated, general approach to 'health.'

Significance of R1 Resection for Advanced Colorectal Liver Metastases in the Era of Modern Effective Chemotherapy.

PubMed

Laurent, Christophe; Adam, Jean-Philippe; Denost, Quentin; Smith, Denis; Saric, Jean; Chiche, Laurence

2016-05-01

The prognosis impact of positive margins after resection of colorectal liver metastases (CLM) in patients treated with modern effective chemotherapy has not been elucidated. The objective was to compare oncologic outcomes after R0 and R1 resections in the era of modern effective chemotherapy. Between 1999 and 2010, all consecutive patients undergoing liver resection for CLM were analyzed retrospectively. Patients with extrahepatic metastases, macroscopic residual tumor, treated with combined radiofrequency, or not treated with chemotherapy were excluded. Survival and recurrence after R0 (tumor-free margin >0 mm) and R1 resections were analyzed. Among 466 patients undergoing hepatectomy for CLM, 191 were eligible. Of them, 164 (86 %) received preoperative chemotherapy and 105 (55 %) received postoperative chemotherapy. R1 resection (10 %) was comparable in patients treated or not by preoperative chemotherapy. R1 status was associated with more intrahepatic recurrences. Overall survival (OS) (44 vs. 61 %; p = 0.047) and disease-free survival (DFS) (8 vs. 26 %; p = 0.082) were lower in patients after R1 compared to R0 resection (32 months of median follow-up). Preoperative chemotherapy and major hepatectomy were prognostic factors of survival, whereas postoperative chemotherapy was a protective factor from recurrences. In patients treated with preoperative chemotherapy, OS and DFS were similar between R1 and R0 resections (40 vs. 55 %, p = 0.104 and 9 vs. 22 %, p = 0.174, respectively). In the era of modern effective chemotherapy, R1 resection leads to more intrahepatic recurrences but did not affect OS in selected patient responders to neoadjuvant chemotherapy. Postoperative chemotherapy protects from recurrences whatever the margin resection status.

Long-term outcomes of open radical retropubic prostatectomy for clinically localized prostate cancer in the prostate-specific antigen era.

PubMed

Dorin, Ryan P; Daneshmand, Siamak; Lassoff, Mark A; Cai, Jie; Skinner, Donald G; Lieskovsky, Gary

2012-03-01

To determine long-term oncological outcomes and complication rates for patients with clinically organ confined prostate adenocarcinoma (PCa) treated with open radical retropubic prostatectomy and pelvic lymph node dissection (RRP/PLND) in the prostate-specific antigen (PSA) era. Outcomes data were obtained from a prospectively maintained prostate cancer database. Patients with cT1/cT2 PCa undergoing RRP/PLND without neoadjuvant therapy between July 1988 and June 2008 were included. Kaplan-Meier and Cox proportional regression models were used to evaluate factors influencing biochemical recurrence, clinical recurrence, and overall survival (OS). A total of 2487 patients met inclusion criteria, and median follow-up was 7.2 years (range 1-21 years). Of the patients, 49.7% were low risk, 33.2% intermediate risk, and 16.1% high risk by D'Amico criteria, and 6% were LN+. The 10-year biochemical recurrence-free survival (BCRFS) for low-, intermediate-, and high-risk patients was 92%, 83%, and 76%, respectively (P < .001), and 10 year OS was 91%, 83%, and 74%, respectively (P < .001). BCRFS at 10 years was 76% and 88% for patients with positive and negative margins, respectively (P < .001). Of the 2487 patients, 11% developed BCR, and 3.7% experienced CR, with 9 local recurrences. The overall complication rate was 2.3%, and the cancer specific mortality rate was 2%. D'Amico risk group, margin status, and LN status are significantly correlated with outcomes in patients undergoing RRP/PLND for clinically localized PCa. Local recurrence and death from prostate cancer are rare in patients undergoing open RRP/PLND for clinically organ confined disease in the PSA era. Copyright © 2012 Elsevier Inc. All rights reserved.

The association of PTSD with physical and mental health functioning and disability (VA Cooperative Study #569: the course and consequences of posttraumatic stress disorder in Vietnam-era Veteran twins)

PubMed Central

Magruder, Kathryn M.; Forsberg, Christopher W.; Kazis, Lewis E.; Üstün, T. Bedirhan; Friedman, Matthew J.; Litz, Brett T.; Vaccarino, Viola; Heagerty, Patrick J.; Gleason, Theresa C.; Huang, Grant D.; Smith, Nicholas L.

2018-01-01

Purpose To assess the relationship of posttraumatic stress disorder (PTSD) with health functioning and disability in Vietnamera Veterans. Methods A cross-sectional study of functioning and disability in male Vietnam-era Veteran twins. PTSD was measured by the Composite International Diagnostic Interview; health functioning and disability were assessed using the Veterans RAND 36-Item Health Survey (VR-36) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). All data collection took place between 2010 and 2012. Results Average age of the 5,574 participating Veterans (2,102 Vietnam theater and 3,472 non-theater) was 61.0 years. Veterans with PTSD had poorer health functioning across all domains of VR-36 and increased disability for all subscales of WHODAS 2.0 (all p < .001) compared with Veterans without PTSD. Veterans with PTSD were in poorer overall health on the VR-36 physical composite summary (PCS) (effect size = 0.31 in theater and 0.47 in non-theater Veterans; p < .001 for both) and mental composite summary (MCS) (effect size = 0.99 in theater and 0.78 in non-theater Veterans; p < .001 for both) and had increased disability on the WHODAS 2.0 summary score (effect size = 1.02 in theater and 0.96 in non-theater Veterans; p < .001 for both). Combat exposure, independent of PTSD status, was associated with lower PCS and MCS scores and increased disability (all p < .05, for trend). Within-pair analyses in twins discordant for PTSD produced consistent findings. Conclusions Vietnam-era Veterans with PTSD have diminished functioning and increased disability. The poor functional status of aging combat-exposed Veterans is of particular concern. PMID:24318083

Transformation in pretreatment manifestations of Gaucher disease type 1 during two decades of alglucerase/imiglucerase enzyme replacement therapy in the International Collaborative Gaucher Group (ICGG) Gaucher Registry

PubMed Central

Batista, Julie L.; Andersson, Hans C.; Balwani, Manisha; Burrow, Thomas Andrew; Charrow, Joel; Kaplan, Paige; Khan, Aneal; Kishnani, Priya S.; Kolodny, Edwin H.; Rosenbloom, Barry; Scott, C. Ronald; Weinreb, Neal

2017-01-01

Abstract This study tests the hypothesis that the prevalence of severe clinical manifestations in Gaucher disease type 1 (GD1) patients at the time of treatment initiation has changed since alglucerase/imiglucerase enzyme replacement therapy (ERT) was approved in the United States (US) in 1991. US alglucerase/imiglucerase‐treated GD1 patients from the International Collaborative Gaucher Group Gaucher Registry clinicaltrials.gov NCT00358943 were stratified by age at ERT initiation (<18, 18 to <50, ≥50 years), era of ERT initiation (1991‐1995, 1996‐2000, 2001‐2005, 2006‐2009), and splenectomy status pre‐ERT. Prevalence of splenectomy decreased dramatically across the eras among all age groups. Bone manifestations were more prevalent in splenectomized patients than non‐splenectomized patients in all age groups. Prevalence of bone manifestations differed across eras in certain age groups: non‐splenectomized patients had a lower prevalence of ischemic bone events (pediatric patients) and bone crisis (pediatric patients and adults 18 to <50 years) in later eras; splenectomized adult (18 to <50 years) patients had a lower prevalence of ischemic bone events and bone crisis in later eras. Over two decades after the introduction of ERT, the prevalence of splenectomy and associated skeletal complications has declined dramatically. Concomitantly, the interval between diagnosis and initiation of ERT has decreased, most strikingly in pediatric patients who have the most severe disease. Together, these findings suggest that since the introduction of alglucerase/imiglucerase ERT, optimal standard of care has become established in the US to prevent destructive complications of GD1. PMID:28569047

An Examination of Latent Threads and Themes in "The Catalyst" (1969-1971)

ERIC Educational Resources Information Center

Blasingame, Christina; Brown, Dee; Duemer, Lee S.; Green, Birgit; Richardson, Belinda

2009-01-01

America has an over 200 year tradition of underground publications spanning a wide range of social and political expression. One notable period in this tradition was the era of the 1960s and early 1970s, and students' efforts to express themselves and challenge the status quo. Student attention was drawn to issues such as the Vietnam War, women's…

Factors affecting the retirement of commercial transport jet aircraft

NASA Technical Reports Server (NTRS)

Spencer, F. A.

1979-01-01

The historical background of the technology and economics of aircraft replacement and retirement in the prejet era is reviewed in order to determine whether useful insights can be obtained applicable to the jet era. Significant differences between the two periods are noted. New factors are identified and examined. Topics discussed include concern over current policies regarding deregulation, regulatory reform, and retroactive noise regulations; financing and compliance legislation; aging; economic environment and inflation; technological progress; fuel efficiency and cost; and a financial perspective of replacement decisions.

Health care – an everlasting challenge in temporal and spatial domains

PubMed Central

Chen, Wenxi

2010-01-01

Health care is an everlasting challenge that requires effort at all levels, from national and organizational to individual domains, over a long-term period. This article reviews the historical development of health care-related issues worldwide and accentuates the necessity of health care in the current era. Through investigating the historical background in both the occidental and the oriental worlds and the latest achievements from academic and industrial endeavors, many lessons can be learnt, and as a result, an integrative strategy is proposed to meet today’s pressing needs. A government-funded project, “Challenge to 100 years of age”, which involved more than 600 residents in west Aizu village, lasted over 15 years. After reviewing its outcomes, a metrology of health based upon the three-dimensional phase space, which integrates with social well-being, mental status, and physical condition for a lifelong span, is advocated as a measure of the holistic view of health state. PMID:21197368

CuInSe2-Based Thin-Film Photovoltaic Technology in the Gigawatt Production Era

NASA Astrophysics Data System (ADS)

Kushiya, Katsumi

2012-10-01

The objective of this paper is to review current status and future prospect on CuInSe2 (CIS)-based thin-film photovoltaic (PV) technology. In CIS-based thin-film PV technology, total-area cell efficiency in a small-area (i.e., smaller than 1 cm2) solar cell with top grids has been over 20%, while aperture-area efficiency in a large-area (i.e., larger than 800 cm2 as definition) monolithic module is approaching to an 18% milestone. However, most of the companies with CIS-based thin-film PV technology still stay at a production research stage, except Solar Frontier K.K. In July, 2011, Solar Frontier has joined the gigawatt (GW) group by starting up their third facility with a 0.9-GW/year production capacity. They are keeping the closest position to pass a 16% module-efficiency border by transferring the developed technologies in the R&D and accelerating the preparation for the future based on the concept of a product life-cycle management.

Robust Modeling of Stellar Triples in PHOEBE

NASA Astrophysics Data System (ADS)

Conroy, Kyle E.; Prsa, Andrej; Horvat, Martin; Stassun, Keivan G.

2017-01-01

The number of known mutually-eclipsing stellar triple and multiple systems has increased greatly during the Kepler era. These systems provide significant opportunities to both determine fundamental stellar parameters of benchmark systems to unprecedented precision as well as to study the dynamical interaction and formation mechanisms of stellar and planetary systems. Modeling these systems to their full potential, however, has not been feasible until recently. Most existing available codes are restricted to the two-body binary case and those that do provide N-body support for more components make sacrifices in precision by assuming no stellar surface distortion. We have completely redesigned and rewritten the PHOEBE binary modeling code to incorporate support for triple and higher-order systems while also robustly modeling data with Kepler precision. Here we present our approach, demonstrate several test cases based on real data, and discuss the current status of PHOEBE's support for modeling these types of systems. PHOEBE is funded in part by NSF grant #1517474.

The "SWOT" of BRAF inhibition in melanoma: RAF inhibitors, MEK inhibitors or both?

PubMed

Nissan, Moriah H; Solit, David B

2011-12-01

Activating mutations in the BRAF gene are among the most prevalent kinase mutations in human cancer. BRAF mutations are most frequent in patients with melanoma where they occur in approximately 50% of patients with advanced disease. Remarkable clinical activity has recently been reported with highly selective RAF inhibitors in melanoma patients whose tumors harbor V600E BRAF mutations. The response rates of RAF inhibitors in patients with BRAF-mutant melanomas far exceed the activity level of any prior therapy studied in this disease. The results suggest that we have entered an era of personalized therapy for patients with metastatic melanoma in which treatment selection will be guided by BRAF mutational status. This review will discuss the strengths, weaknesses, opportunities and threats ("SWOT") of developing RAF and MEK selective inhibitors as anti-cancer therapies, recent insights into the mechanisms of intrinsic and acquired resistance to these agents, and current efforts to develop mechanism-based combination therapies.

Nuclear threat in the post cold-war era. Monograph

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

Kurey, W.S.

1995-05-14

This monograph discusses the nuclear threat that the United States faces following the downfall of the Soviet Union. The Russian and Chinese nuclear arsenals represent a formidable threat that must be countered and a new threat is emerging in the third world despite efforts to counter the proliferation of weapons of mass destruction. The monograph reviews the current status of both the Russian and Chinese arsenals and lists the programs that are being undertaken to modernize and improve their respective nuclear capabilities. Both nations are taking significant steps to preserve and improve their nuclear strike capability. The proliferation of nuclearmore » weapons technology, fissile material, and ballistic missiles in the third world is an emerging threat to national security interests. The lack of appropriate security measures during the on-going dismantling of the former Soviet nuclear arsenal presents an opportunity for rogue states and terrorist organizations to readily obtain the materials to produce their own nuclear weapons.« less

Capabilities and prospects of the East Asia Very Long Baseline Interferometry Network

NASA Astrophysics Data System (ADS)

An, T.; Sohn, B. W.; Imai, H.

2018-02-01

The very long baseline interferometry (VLBI) technique offers angular resolutions superior to any other instruments at other wavelengths, enabling unique science applications of high-resolution imaging of radio sources and high-precision astrometry. The East Asia VLBI Network (EAVN) is a collaborative effort in the East Asian region. The EAVN currently consists of 21 telescopes with diverse equipment configurations and frequency setups, allowing flexible subarrays for specific science projects. The EAVN provides the highest resolution of 0.5 mas at 22 GHz, allowing the fine imaging of jets in active galactic nuclei, high-accuracy astrometry of masers and pulsars, and precise spacecraft positioning. The soon-to-be-operational Five-hundred-meter Aperture Spherical radio Telescope (FAST) will open a new era for the EAVN. This state-of-the-art VLBI array also provides easy access to and crucial training for the burgeoning Asian astronomical community. This Perspective summarizes the status, capabilities and prospects of the EAVN.

Recent Advances in Photonic Devices for Optical Computing and the Role of Nonlinear Optics-Part II

NASA Technical Reports Server (NTRS)

Abdeldayem, Hossin; Frazier, Donald O.; Witherow, William K.; Banks, Curtis E.; Paley, Mark S.

2007-01-01

The twentieth century has been the era of semiconductor materials and electronic technology while this millennium is expected to be the age of photonic materials and all-optical technology. Optical technology has led to countless optical devices that have become indispensable in our daily lives in storage area networks, parallel processing, optical switches, all-optical data networks, holographic storage devices, and biometric devices at airports. This chapters intends to bring some awareness to the state-of-the-art of optical technologies, which have potential for optical computing and demonstrate the role of nonlinear optics in many of these components. Our intent, in this Chapter, is to present an overview of the current status of optical computing, and a brief evaluation of the recent advances and performance of the following key components necessary to build an optical computing system: all-optical logic gates, adders, optical processors, optical storage, holographic storage, optical interconnects, spatial light modulators and optical materials.

Artificial Blood Substitutes: First Steps on the Long Route to Clinical Utility

PubMed Central

Moradi, Samira; Jahanian-Najafabadi, Ali; Roudkenar, Mehryar Habibi

2016-01-01

The 21st century is challenging for human beings. Increased population growth, population aging, generation of new infectious agents, and natural disasters are some threatening factors for the current state of blood transfusion. However, it seems that science and technology not only could overcome these challenges but also would turn many human dreams to reality in this regard. Scientists believe that one of the future evolutionary innovations could be artificial blood substitutes that might pave the way to a new era in transfusion medicine. In this review, recent status and progresses in artificial blood substitutes, focusing on red blood cells substitutes, are summarized. In addition, steps taken toward the development of artificial blood technology and some of their promises and hurdles will be highlighted. However, it must be noted that artificial blood is still at the preliminary stages of development, and to fulfill this dream, ie, to routinely transfuse artificial blood into human vessels, we still have to strengthen our knowledge and be patient. PMID:27812292

Metabolic engineering approaches for production of biochemicals in food and medicinal plants.

PubMed

Wilson, Sarah A; Roberts, Susan C

2014-04-01

Historically, plants are a vital source of nutrients and pharmaceuticals. Recent advances in metabolic engineering have made it possible to not only increase the concentration of desired compounds, but also introduce novel biosynthetic pathways to a variety of species, allowing for enhanced nutritional or commercial value. To improve metabolic engineering capabilities, new transformation techniques have been developed to allow for gene specific silencing strategies or stacking of multiple genes within the same region of the chromosome. The 'omics' era has provided a new resource for elucidation of uncharacterized biosynthetic pathways, enabling novel metabolic engineering approaches. These resources are now allowing for advanced metabolic engineering of plant production systems, as well as the synthesis of increasingly complex products in engineered microbial hosts. The status of current metabolic engineering efforts is highlighted for the in vitro production of paclitaxel and the in vivo production of β-carotene in Golden Rice and other food crops. Copyright © 2014 Elsevier Ltd. All rights reserved.

Achieving Transformational Materials Performance in a New Era of Science

ScienceCinema

Sarrao, John

2017-12-22

The inability of current materials to meet performance requirements is a key stumbling block for addressing grand challenges in energy and national security. Fortunately, materials research is on the brink of a new era - a transition from observation and validation of materials properties to prediction and control of materials performance. In this talk, I describe the nature of the current challenge, the prospects for success, and a specific facility concept, MaRIE, that will provide the needed capabilities to meet these challenges, especially for materials in extreme environments. MaRIE, for Matter-Radiation Interactions in Extremes, is Los Alamos' concept to realize this vision of 21st century materials research. This vision will be realized through enhancements to the current LANSCE accelerator, development of a fourth-generation x-ray light source co-located with the proton accelerator, and a comprehensive synthesis and characterization facility focused on controlling complex materials and the defect/structure link to materials performance.

The Fragile State of the National Institutes of Health Pediatric Research Portfolio, 1992-2015: Doing More With Less?

PubMed

Gitterman, Daniel P; Langford, W Scott; Hay, William W

2018-03-01

In this article, we examine the status of the National Institutes of Health (NIH) pediatric research portfolio between start of federal fiscal year (FY) 1992 and end of FY 2015. The NIH experienced the greatest mean annual growth rate during the "doubling era" (FY 1998-2003): both the NIH budget (13.5%) and pediatric research portfolios (11.5%) increased annually by double digits. However, in the "postdoubling" era (FY 2004-2009), both the NIH (2.0%) and pediatric (-0.2%) mean annual growth rates decreased dramatically. In the most recent era (FY 2010-2015), the NIH mean annual growth rate has been flat (-0.1%) and pediatric research funding has posted very modest gains (3.5%) without accounting for 1-time increases under the 2009 American Recovery and Reinvestment Act. We offer recommendations to protect against further erosion of the pediatric research portfolio because continuation of these trends will have a negative effect on the health of children during their childhood and as adults. As capacity to conduct basic and applied research is further constrained, it will be a challenge for pediatric researchers to do more with less and less.

Technological Literacy: A Multiliteracies Approach for Democracy

ERIC Educational Resources Information Center

Williams, P. John

2009-01-01

Throughout history various grand narratives have impacted on technology education. In the current post modern era of globalization, technology education continues to struggle for relevance and definition, and takes various forms in different countries, but none seem resoundingly successful. The current development of what some have termed a…

Generation of a novel live rabies vaccine strain with a high level of safety by introducing attenuating mutations in the nucleoprotein and glycoprotein.

PubMed

Nakagawa, Keisuke; Nakagawa, Kento; Omatsu, Tsutomu; Katayama, Yukie; Oba, Mami; Mitake, Hiromichi; Okada, Kazuma; Yamaoka, Satoko; Takashima, Yasuhiro; Masatani, Tatsunori; Okadera, Kota; Ito, Naoto; Mizutani, Tetsuya; Sugiyama, Makoto

2017-10-09

The current live rabies vaccine SAG2 is attenuated by only one mutation (Arg-to-Glu) at position 333 in the glycoprotein (G333). This fact generates a potential risk of the emergence of a pathogenic revertant by a back mutation at this position during viral propagation in the body. To circumvent this risk, it is desirable to generate a live vaccine strain highly and stably attenuated by multiple mutations. However, the information on attenuating mutations other than that at G333 is very limited. We previously reported that amino acids at positions 273 and 394 in the nucleoprotein (N273/394) (Leu and His, respectively) of fixed rabies virus Ni-CE are responsible for the attenuated phenotype by enhancing interferon (IFN)/chemokine gene expressions in infected neural cells. In this study, we found that amino acid substitutions at N273/394 (Phe-to-Leu and Tyr-to-His, respectively) attenuated the pathogenicity of the oral live vaccine ERA, which has a virulent-type Arg at G333. Then we generated ERA-N273/394-G333 attenuated by the combination of the above attenuating mutations at G333 and N273/394, and checked its safety. Similar to the ERA-G333, which is attenuated by only the mutation at G333, ERA-N273/394-G333 did not cause any symptoms in adult mice after intracerebral inoculation, indicating a low level of residual pathogenicity of ERA-N273/394-G333. Further examination revealed that infection with ERA-N273/394-G333 induces IFN-β and CXCL10 mRNA expressions more strongly than ERA-G333 infection in a neuroblastoma cell line. Importantly, we found that the ERA-N273/394-G333 stain has a lower risk for emergence of a pathogenic revertant than does the ERA-G333. These results indicate that ERA-N273/394-G333 has a potential to be a promising candidate for a live rabies vaccine strain with a high level of safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of the Modern Era Retrospective-Analysis for Research and Applications (MERRA) Global Water and Energy Budgets

NASA Technical Reports Server (NTRS)

Bosilovich, Michael G.; Robertson, F. R.; Chen, J.

2010-01-01

The Modern Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has completed 27 years of data) soon to be caught up to present. Here) we present an evaluation of those years currently available) including comparisons with the existing long reanalyses (ERA40) JRA25 and NCEP I and II) as well as with global data sets for the water and energy cycle. Time series shows that the MERRA budgets can change with some of the variations in observing systems, but that the magnitude of energy imbalance in the system is improved with more observations. We will present all terms of the budgets in MERRA including the time rates of change and analysis increments (tendency due to the analysis of observations).

From R&D to the mouth--a viable roadmap for the technology era.

PubMed

Simon, M

1996-09-01

This article serves as an overview of the status of dental technology as the profession approaches a new century. Its purpose is to define various ways in which dental manufacturers and marketers can better understand the thinking of the dental professional, those factors that influence their thought processes and how to use this information to develop more effective and predictive marketing strategies. With the advent of more complex and expensive dental technologies, e.g., video imaging, digitized radiology, electronic data transmission, etc., the dentist is faced with a variety of decisions relating to purchasing, implementation and costs/benefits analysis that go beyond the normal daily concerns of delivering competent dental care. It is no longer enough for a manufacturer to make a good product; successful marketing strategies must also include a means for guiding the dentist in the successful integration of these technologies into their offices. In order for dental marketers to meet the competitive demands of this advanced technology era, there must be a commitment to the development of strategic information through the use of third party, customized marketing research. Too much of the input currently used to develop marketing strategies is anecdotal, inherently biased and often not representative of the target market as a whole. It is hoped that this article will effectively challenge the reader to look at the development of dental products and services from a somewhat different, less traditional perspective and that it will provide the impetus and direction for creating better targeted and more rewarding marketing strategies.

Military Factors Associated with Smoking in Veterans.

PubMed

Golden, Sara E; Thakurta, Sujata; Slatore, Christopher G; Woo, Hyeyoung; Sullivan, Donald R

2018-05-18

Given the high prevalence of smoking among Veterans and the economic, social, and clinical implications, it is important to understand the factors that contribute to smoking in order to focus efforts to mitigate these factors and improve smoking cessation efforts among Veterans. The availability of research on smoking in Veterans compared with civilians is limited given the military-specific differences in their life course. We aimed to identify military-specific factors combined with sociodemographic factors for ever smoking and current smoking among Veterans to inform future interventions. We used data from the 2010 National Survey of Veterans, the most current, to analyze the association of sociodemographic and military-specific factors with ever versus never smoking, and current versus past smoking using multiple variable logistic regression models (IRB#4125). Among 8,618 respondents, the proportions of current, past, and never smokers were 17%, 48%, and 34%, respectively. Sociodemographic factors associated with ever smoking were female gender, educational attainment of less than a bachelor's degree, and being divorced/separated/widowed. Military-specific factors associated with ever smoking were exposure to dead/dying/wounded soldiers during service, and past, current, and unsure enrollment in Veterans Affairs healthcare. Never smoking was associated with Hispanic ethnicity, income over $75,000, and reporting fair or poor health. Military factors associated with never smoking were presence of a service-connected disability and military service July 1964 or earlier (i.e., pre-Vietnam). Among 5,652 ever smokers, sociodemographic factors associated with current smoking were age less than 65, being non-Hispanic black, educational attainment of less than a bachelor's degree, being divorced/separated/widowed, never married, and having no insurance. Factors associated with reduced likelihood of current smoking compared with past smoking included income >$41,000 and reporting fair or poor health. Military-specific variables associated with reduced likelihood of current smoking were service era of May 1975 or later (i.e., post-Vietnam) and 5 or more years of service. Military-specific variables are associated with smoking behaviors among Veterans. Findings from this study that exposure to dead/dying/wounded soldiers, service era, duration of service, service-connected disability status, and enrollment in VA care all influence smoking in Veterans, can inform prevention and cessation efforts in part by encouraging alternative healthy habits or cessation techniques in subgroups of Veterans with particular military backgrounds. By assessing risk factors in this unique population future research can leverage these findings to determine mechanisms that help explain these associations. Identifying factors associated with smoking offers insights for smoking cessation and prevention interventions given the military experiences and increased smoking incidence among Veterans.

Evaluation of the willingness-to-pay for cancer treatment in Korean metastatic breast cancer patients: a multicenter, cross-sectional study.

PubMed

Oh, Do-Youn; Crawford, Bruce; Kim, Sung-Bae; Chung, Hyun-Cheol; McDonald, Jeffrey; Lee, Sang Yoon; Ko, Su-Kyoung; Ro, Jungsil

2012-09-01

To evaluate the inherent value of breast cancer therapy a willingness-to-pay (WTP) study was conducted in Korean patients with metastatic breast cancer. Patients were prospectively enrolled from four study centers and completed quality of life questionnaires to reflect their status pre-cancer and their current health status. Clinical and socioeconomic data were collected to characterize the population and utilize during modeling. Patients' WTP for breast cancer treatment was assessed using an open-ended question following three rounds of bidding to better hone in on their maximal WTP, starting with one of three randomly assigned start bids. Predictors of patient WTP was evaluated using linear regression models. Associations between WTP and other parameters were evaluated with correlations. Korean metastatic breast cancer patients were WTP an average of KRW 8 696 329 (US$7555) per month to return to their pre-cancer health state, with those who were recently diagnosed as WTP the most (KRW 12 955 000 [$11 254]). WTP was closely associated with the patient's education level, income, personal financial difficulties, Eastern Cooperative Oncology Group performance status, and their experience of arm symptoms. The results suggest that patients are WTP significant amounts per month for treatment. Breast cancer patients are heavily burdened physically, mentally and financially, and the present study indicated this significant financial burden by disclosing its relationship with WTP. Providing a better understanding of the inherent value of treatment will allow Koreans to better evaluate treatment in the coming era of personalized medicine. © 2012 Wiley Publishing Asia Pty Ltd.

Cognitive architectures: choreographing the dance of mental operations with the task environment.

PubMed

Gray, Wayne D

2008-06-01

In this article, I present the ideas and trends that have given rise to the use of cognitive architectures in human factors and provide a cognitive engineering-oriented taxonomy of these architectures and a snapshot of their use for cognitive engineering. Architectures of cognition have had a long history in human factors but a brief past. The long history entails a 50-year preamble, whereas the explosion of work in the current decade reflects the brief past. Understanding this history is key to understanding the current and future prospects for applying cognitive science theory to human factors practice. The review defines three formative eras in cognitive engineering research: the 1950s, 1980s, and now. In the first era, the fledging fields of cognitive science and human factors emphasized characteristics of the dancer the limited capacity or bounded rationality view of the mind, and the ballroom, the task environment. The second era emphasized the dance (i.e., the dynamic interaction between mental operations and task environment). The third era has seen the rise of cognitive architectures as tools for choreographing the dance of mental operations within the complex environments posed by human factors practice. Hybrid architectures present the best vector for introducing cognitive science theories into a renewed engineering-based human factors. The taxonomy provided in this article may provide guidance on when and whether to apply a cognitive science or a hybrid architecture to a human factors issue.

Endemism hotspots are linked to stable climatic refugia

PubMed Central

Noss, Reed

2017-01-01

Background Centres of endemism have received much attention from evolutionists, biogeographers, ecologists and conservationists. Climatic stability is often cited as a major reason for the occurrences of these geographic concentrations of species which are not found anywhere else. The proposed linkage between endemism and climatic stability raises unanswered questions about the persistence of biodiversity during the present era of rapidly changing climate. Key Questions The current status of evidence linking geographic centres of endemism to climatic stability over evolutionary time was examined. The following questions were asked. Do macroecological analyses support such an endemism–stability linkage? Do comparative studies find that endemic species display traits reflecting evolution in stable climates? Will centres of endemism in microrefugia or macrorefugia remain relatively stable and capable of supporting high biological diversity into the future? What are the implications of the endemism–stability linkage for conservation? Conclusions Recent work using the concept of climate change velocity supports the classic idea that centres of endemism occur where past climatic fluctuations have been mild and where mountainous topography or favourable ocean currents contribute to creating refugia. Our knowledge of trait differences between narrow endemics and more widely distributed species remains highly incomplete. Current knowledge suggests that centres of endemism will remain relatively climatically buffered in the future, with the important caveat that absolute levels of climatic change and species losses in these regions may still be large. PMID:28064195

Economic Status of Women in the Labor Market and Prospects for Pay Equity Over the Life Cycle.

ERIC Educational Resources Information Center

Figart, Deborah M.

Social and economic forces in the post-war era have lead to an increased commitment by women of all ages to the labor force. In contrast, the labor force participation rate for men has declined. With women's continued predominance in the service sector and jobs lost in the traditionally male manufacturing sector of the U.S. economy, men and women…

76 FR 81926 - Notice of Effectiveness of Exempt Wholesale Generator Status

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... Renewables, LLC EG11-126-000 Invenergy Illinois Solar I LLC EG11-127-000 Record Hill Wind LLC EG11-128-000 Vasco Winds, LLC EG11-129-000 NexEra Energy Montezuma II Wind, LLC EG11-130-000 Richard-Stryker Generation LLC EG11-131-000 Pioneer Trail Wind Farm, LLC EG11-132-000 GSG 6, LLC EG11-133-000 Take notice...

Is Deliberation a Laudable Goal When Policy Is a "Done Deal"? The Habermasian Public Sphere and Legitimacy in a Market Era of Education Policymaking

ERIC Educational Resources Information Center

Pappas, Liza N.

2016-01-01

The state mandated public hearings concerning school closing proposals in New York City provide a window into a diverse set of policy actors and their deliberations. Opposition to school closures is often cast as entrenched interests, emotional attachment, support for the status quo or at worst negligence. However, content analysis reveals that…

Veterans Employment Assistance Program

DTIC Science & Technology

1985-03-28

Department of-Defense ’)IRECTIVE AD-A270 588 March 28, 1985 NUMBER 1341.6 ASD(MI sUBJECT: Veterans Employment Assistance Program Reference: (a) DoD...Instruction 1404.9, "Vietnam Era Veterans Employment Assistance Program ," August 28, 1974 (hereby canceled) (b) Title 38, United States Code, Section...assessment of local needs. b. As considered necessary, each DoD Component shall assess the status of the Veterans Employment Assistance Program and determine

Technology and Rights

ERIC Educational Resources Information Center

Petrina, Stephen; Volk, Kenneth; Kim, Soowook

2004-01-01

What do we know about technology and rights? This article provides a fairly comprehensive overview of current issues regarding this topic. We explore and analyse a wide spectrum of rights that are challenged in this current era of technological convergence. We use the United States Bill of Rights as an example of the vulnerability of legal…

Inpatient mortality rates during an era of increased access to HIV testing and ART: A prospective observational study in Lilongwe, Malawi.

PubMed

Matoga, Mitch M; Rosenberg, Nora E; Stanley, Christopher C; LaCourse, Sylvia; Munthali, Charles K; Nsona, Dominic P; Haac, Bryce; Hoffman, Irving; Hosseinipour, Mina C

2018-01-01

In the era of increased access to HIV testing and antiretroviral treatment (ART), the impact of HIV and ART status on inpatient mortality in Malawi is unknown. We prospectively followed adult inpatients at Kamuzu Central Hospital medical wards in Lilongwe, Malawi, between 2011 and 2012, to evaluate causes of mortality, and the impact of HIV and ART status on mortality. We divided the study population into five categories: HIV-negative, new HIV-positive, ART-naïve patients, new ART-initiators, and ART-experienced. We used multivariate binomial regression models to compare risk of death between categories. Among 2911 admitted patients the mean age was 38.5 years, and 50% were women. Eighty-one percent (81%) of patients had a known HIV status at the time of discharge or death. Mortality was 19.4% and varied between 13.9% (HIV-negative patients) and 32.9% (HIV-positive patients on ART ≤1 year). In multivariable analyses adjusted for age, sex and leading causes of mortality, being new HIV-positive (RR = 1.64 95% CI: 1.16-2.32), ART-naive (RR = 2.28 95% CI: 1.66-2.32) or being a new ART-initiator (RR = 2.41 95% CI: 1.85-3.14) were associated with elevated risk of mortality compared to HIV-negative patients. ART-experienced patients had comparable mortality (RR = 1.33 95% CI: 0.94-1.88) to HIV-negative patients. HIV related mortality remains high among medical inpatients, especially among HIV-positive patients who recently initiated ART or have not started ART yet.

Implementation of Enhanced Recovery After Surgery (ERAS) Pathways in Gynecologic Oncology. A NOGGO-AGO* survey of 144 Gynecological Departments in Germany.

PubMed

Muallem, Mustafa Zelal; Dimitrova, Desislava; Pietzner, Klaus; Richter, Rolf; Feldheiser, Aarne; Scharfe, Irina; Schmeil, Iryna; Hösl, Teresa Maria; Mustea, Alexander; Wimberger, Pauline; Burges, Alexander; Kimmig, Rainer; Sehouli, Jalid

2016-08-01

To gather standardized information of current perioperative management of gynecological oncology patients and to evaluate up to what extent the Enhanced Recovery after Surgery (ERAS) elements are established in the clinical routine of gynecologic oncology units in Germany. We performed a multi-centric nationwide survey among 654 primary, secondary and maximal health care gynecological departments in Germany. A multiple-choice questionnaire based on the principles of ERAS was developed to gather information about perioperative management of two fictional cases in gynecological oncology. One hundred four units (22%) have been taken the survey. Only 49.5% of surveyed hospitals claimed to be adherent to more than 70% of ERAS elements in managing perioperative period of primary cytoreductive surgery in ovarian cancer patients. 21% of these hospitals implemented more than 80% and only 8.4% implemented more than 90%. The results in border-line tumors operations did not differ from those of ovarian cancer operations. The implementation of ERAS elements in gynecologic oncology in Germany is still not satisfying as only half of the departments will now be able to apply 70% of these principles. Therefore, we plan the second step of this survey in order to be able to build a consistent structured reporting platform between gynecological oncology units in Germany to facilitate the wide implementation and standardization of ERAS protocol. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Cytoreductive Surgery in the Management of Renal Tumours: Rationale, Current Evidence and Future Perspectives.

PubMed

Khochikar, Makarand V

2017-03-01

Renal cell carcinoma accounts for 3% of adult solid malignant tumours. Approximately 25% of the patients present with metastatic disease at presentation. In the era of immunotherapy (interferon alpha-2b and interleukin-2), studies showed significant survival benefit with cytoreductive nephrectomy (CRN) followed by interferon alpha-2b than interferon alpha 2-b alone. Introduction of targeted therapies (vascular endothelial growth factor receptor-tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors) in 2005 generated a great interest in the management of metastatic renal cell carcinoma (mRCC) as these drugs exhibited tumour shrinkage in the primary tumour as well as in the metastatic site/s. Though there is no level 1 evidence, many studies have shown the usefulness of cytoreductive nephrectomy along with targeted therapy as against to targeted therapy alone. This review is aimed at the rationale behind the cytoreductive nephrectomy in mRCC, the current evidence and what is in store for the future. A detailed search on the management of mRCC was carried out on MEDLINE, Embase, CANCERLIT and Cochrane Library databases using the key words "cytoreductive nephrectomy", "immunotherapy" and "targeted therapy" since 1980 till 2015. Original articles, review articles, monograms, book chapters on metastatic renal cancer and textbooks on urologic oncology, oncology and urology were reviewed. Various international guidelines on this issue were also studied. An identical search was performed using the American Society of Clinical Oncology Abstract database. Trials in the progress or recently completed that were relevant to this paper were identified through clinicaltrials.gov. The latest information for new articles ahead of publication was last accessed in November 2015. CRN has remained an integral part to the management of metastatic renal cell carcinoma mainly for the patients with good performance status, life expectancy of more than 12 months and in the absence of adverse prognostic factors. It had shown measurable survival benefit in the era of immunotherapy (CRN + immunotherapy vs. immunotherapy alone). In the era of targeted therapy, many studies have shown significant survival benefit with CRN + targeted therapy. However, there is no clear level 1 evidence to support this. The ongoing trials (CARMENA and European Organisation for Research and Treatment of Cancer SURTIME) would perhaps guide us in the way in which we should manage mRCC disease in the future. Maybe we may find some answers on the issues of the effectiveness of targeted therapy, the timing of CRN and sequencing these treatment arms once the results of these ongoing and future trials are through.

The evolution of the high-speed civil transport

NASA Technical Reports Server (NTRS)

Spearman, M. Leroy

1994-01-01

Current research directed toward the technology requirements for a high-speed civil transport (HSCT) airplane is an outgrowth of many years of activity related to air transportation. The purpose was to review some of the events that provided the background upon which current research programs are built. The review will include the subsonic era of transport aircraft and some events of the supersonic era that are related to the development of commercial supersonic transport aircraft. These events include the early NASA in-house studies and industry evaluations, the U.S. Supersonic Transport (SST) Program, the follow-on NASA supersonic cruise research programs, and the issuance of the National Aeronautical Research and Development (R&D) goals. Observations are made concerning some of the factors, both technical and nontechnical, that have had an impact on HSCT studies.

History and development of evidence-based medicine.

PubMed

Claridge, Jeffrey A; Fabian, Timothy C

2005-05-01

This article illustrates the timeline of the development of evidence-based medicine (EBM). The term "evidence-based medicine" is relatively new. In fact, as far as we can tell, investigators from McMaster's University began using the term during the 1990s. EBM was defined as "a systemic approach to analyze published research as the basis of clinical decision making." Then in 1996, the term was more formally defined by Sacket et al., who stated that EBM was "the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients." Ancient era EBM consists of ancient historical or anecdotal accounts of what may be loosely termed EBM. This was followed by the development of the renaissance era of EBM, which began roughly during the seventeenth century. During this era personal journals were kept and textbooks began to become more prominent. This was followed by the 1900s, during an era we term the transitional era of EBM (1900-1970s). Knowledge during this era could be shared more easily in textbooks and eventually peer-reviewed journals. Finally, during the 1970s we enter the modern era of EBM. Technology has had a large role in the advancement of EBM. Computers and database software have allowed compilation of large amounts of data. The Index Medicus has become a medical dinosaur of the past that students of today likely do not recognize. The Internet has also allowed incredible access to masses of data and information. However, we must be careful with an overabundance of "unfiltered" data. As history, as clearly shown us, evidence and data do not immediately translate into evidence based practice.

Extragalactic radio surveys in the pre-Square Kilometre Array era

PubMed Central

2017-01-01

The era of the Square Kilometre Array is almost upon us, and pathfinder telescopes are already in operation. This brief review summarizes our current knowledge of extragalactic radio sources, accumulated through six decades of continuum surveys at the low-frequency end of the electromagnetic spectrum and the extensive complementary observations at other wavelengths necessary to gain this understanding. The relationships between radio survey data and surveys at other wavelengths are discussed. Some of the outstanding questions are identified and prospects over the next few years are outlined. PMID:28791175

Status and Plans for Reanalysis at NASA/GMAO

NASA Technical Reports Server (NTRS)

Gelaro, Ron

2017-01-01

Reanalysis plays a critical role in GMAOs goal to enhance NASA's program of Earth observations, providing vital data sets for climate research and the development of future missions. As the breadth of NASAs observations expands to include multiple components of the Earth system, so does the need to assimilate observations from currently uncoupled components of the system in a more physically consistent manner. GMAOs most recent reanalysis of the satellite era, MERRA-2, has completed the period 1980-present, and is now running as a continuing global climate analysis with two- to three-week latency. MERRA-2 assimilates meteorological and aerosol observations as a weakly coupled assimilation system as a first step toward GMAOs longer term goal of developing an integrated Earth system analysis (IESA) capability that will couple assimilation systems for the atmosphere, ocean, land and chemistry. The GMAO strategy is to progress incrementally toward an IESA through an evolving combination of coupled systems and offline component reanalyses driven by, for example, MERRA-2 atmospheric forcing. Most recently, the GMAO has implemented a weakly coupled assimilation scheme for analyzing ocean skin temperature within the existing atmospheric analysis. The scheme uses background fields from a near-surface ocean diurnal layer model to assimilate surface-sensitive radiances plus in-situ observations along with all other observations in the atmospheric assimilation system. In addition, MERRA-2-driven simulations of the ocean (plus sea ice) and atmospheric chemistry (for the EOS period) are currently underway, as is the development of a coupled atmosphere-ocean assimilation system. This talk will describe the status of these ongoing efforts and the planned steps toward an IESA capability for climate research.

ERA-MIN: The European network (ERA-NET) on non-energy raw materials

NASA Astrophysics Data System (ADS)

vidal, o.; christmann, p.; Bol, d.; Goffé, b.; Groth, m.; Kohler, e.; Persson Nelson, k.; Schumacher, k.

2012-04-01

Non-energy raw materials are vital for the EU's economy, and for the development of environmentally friendly technologies. The EU is the world's largest consumers of non-energy minerals, but it remains dependent on the importation of many metals, as its domestic production is limited to about 3% of world production. We will present the project ERA-MIN, which is an ERA-NET on the Industrial Handling of Raw Materials for European industries, financially supported by the European Commission. The main objectives of ERA-MIN are: 1) Mapping and Networking: interconnecting the members of the currently fragmented European mineral resources research area, to the aim of fostering convergence of public research programs, industry, research institutes, academia and the European Commission, 2) Coordinating: establishing a permanent mechanism for planning and coordination of the European non-energy mineral raw materials research community (ENERC). 3) Roadmapping: defining the most important scientific and technological challenges that should be supported by the EU and its state members, 4) Programming: designing a Joint European Research Programme model and implementating it into a call for proposals open to academic and industrial research. The topics of interest in ERA-MIN are the primary continental and marine resources, the secondary resources and their related technologies, substitution and material efficiency, along with transversal topics such as environmental impact, public policy support, mineral intelligence, and public education and teaching. Public scientific research is very central in the scope of the ERA-MIN activity, whose consortium is indeed lead by a public organisation of fundamental research. Thus, universities and public research organisations are warmly invited to play an active role in defining the scientific questions and challenges that shall determine the European Raw Materials Roadmap and should be addressed by joint programming at the European scale. The various levels of possible involvement in ERA-MIN for the interested stakeholders will be presented.

The third era of human rights: global accountability.

PubMed

Suter, Keith

2007-01-01

This article argues that the trend in the current protection of human rights may be seen as a revival of an old idea: governments are accountable for their actions. The protection of human rights has gone through three eras. In the first era, the Catholic Church in the Middle Ages claimed to rule from a divine mandate. This principle of natural law was a unifying factor in western Europe because it created a standard system of morality. The second era, beginning in the seventeenth century with the doctrine of state sovereignty, rejected that natural law. Rulers wanted to run their own territories and not be subject to foreign influence. Laws were created by the 'national sovereign' (king, queen, president, parliament, congress and so on). This legal doctrine survived for about three centuries, but the excesses of leaders such as Hitler in the middle of last century forced a re-think. Although the term 'natural law' is not used, there has been a revival of its essential meaning: that governments have to be answerable to a higher authority for their behaviour.

[Simejigahara, a place noted for moxa].

PubMed

Oda, R

1996-01-01

Shimejigahara is a place-name often used in old Waka (Japanese poems). It was reputed in the past to be a site rich in the plants moxa and mugwort. A study of this placed carried out. Shimejigahara, as mentioned in the literature of the Heian to Kamakura eras, seems to have been located at the site of the current Tochigi City. During the Edo era, however, Senjogahara in Nikko came to be referred to as Shimejigahara. In addition, some other places in what is now called Utsunomiya City, on Ibuki Mountain in Shiga Prefecture, and in Chiba City were referred to as Shimejigahara during the Edo era. When the types of wild mugwort seen in these various sites called "Shimejigahara" were searched for, Artemisia princeps P. was found in the cities of Tochigi, Utsunomiya and Chiba, while A. montana P. was seen in Senjogahara and on Ibuki Mountain. Papers published during the Edo era suggest that moxa, gathered in the Shimejigahara, was on the market during that period. It is, however, doubtful that the moxa produced from Shimejigahara was really commercialized, like the well-known "Ibuki moxa."

Is having a job a protective factor? Employment status and state of medical care as subjectively perceived by adults with CHD in Germany.

PubMed

Helm, Paul C; Sticker, Elisabeth J; Keuchen, Roland; Koerten, Marc-André; Diller, Gerhard-Paul; Tutarel, Oktay; Bauer, Ulrike M M

2017-08-01

Most patients born with CHD nowadays reach adulthood, and thus quality of life, life situation, and state of medical care aspects are gaining importance in the current era. The present study aimed to investigate whether patients' assessment depends on their means of occupation. The findings are expected to be helpful in optimising care and for developing individual treatment plans. The present study was based on an online survey conducted in cooperation with patient organisations. Participants were recruited from the database of the German National Register for Congenital Heart Defects. In total, 1828 individuals (777 males, 1051 females) took part. Participants were asked to rate aspects such their state of health on a six-tier scale (1=worst specification). Response behaviour was measured against the background of occupational details. Training for or pursuing a profession was found to be significantly associated with participants' rating of five of the six examined aspects (p<0.05). Sex seemed to play an important part in four of the six aspects. An optimal treatment plan for adults with CHD should always consider aspects such as sex and employment status. To work out such an optimal and individual treatment plan for each adult CHD patient, an objective tool to measure patients' actual CHD-specific knowledge precluding socially accepted response bias would be very useful.

Status of Advanced Stitched Unitized Composite Aircraft Structures

NASA Technical Reports Server (NTRS)

Jegley, Dawn C.; Velicki, Alex

2013-01-01

NASA has created the Environmentally Responsible Aviation (ERA) Project to explore and document the feasibility, benefits and technical risk of advanced vehicle configurations and enabling technologies that will reduce the impact of aviation on the environment. A critical aspect of this pursuit is the development of a lighter, more robust airframe that will enable the introduction of unconventional aircraft configurations that have higher lift-to-drag ratios, reduced drag, and lower community noise levels. The primary structural concept being developed under the ERA project in the Airframe Technology element is the Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS) concept. This paper describes how researchers at NASA and The Boeing Company are working together to develop fundamental PRSEUS technologies that could someday be implemented on a transport size aircraft with high aspect ratio wings or unconventional shapes such as a hybrid wing body airplane design.

Scandinavian neuroscience during the Nazi era.

PubMed

Kondziella, Daniel; Hansen, Klaus; Zeidman, Lawrence A

2013-07-01

Although Scandinavian neuroscience has a proud history, its status during the Nazi era has been overlooked. In fact, prominent neuroscientists in German-occupied Denmark and Norway, as well as in neutral Sweden, were directly affected. Mogens Fog, Poul Thygesen (Denmark) and Haakon Sæthre (Norway) were resistance fighters, tortured by the Gestapo: Thygesen was imprisoned in concentration camps and Sæthre executed. Jan Jansen (Norway), another neuroscientist resistor, escaped to Sweden, returning under disguise to continue fighting. Fritz Buchthal (Denmark) was one of almost 8000 Jews escaping deportation by fleeing from Copenhagen to Sweden. In contrast, Carl Værnet (Denmark) became a collaborator, conducting inhuman experiments in Buchenwald concentration camp, and Herman Lundborg (Sweden) and Thorleif Østrem (Norway) advanced racial hygiene in order to maintain the "superior genetic pool of the Nordic race." Compared to other Nazi-occupied countries, there was a high ratio of resistance fighters to collaborators and victims among the neuroscientists in Scandinavia.

Status of ERA Airframe Technology Demonstrators

NASA Technical Reports Server (NTRS)

Davis, Pamela; Jegley, Dawn; Rigney, Tom

2015-01-01

NASA has created the Environmentally Responsible Aviation (ERA) Project to explore and document the feasibility, benefits and technical risk of advanced vehicle configurations and enabling technologies that will reduce the impact of aviation on the environment. A critical aspect of this pursuit is the development of a lighter, more robust airframe that will enable the introduction of unconventional aircraft configurations that have higher lift-to-drag ratios, reduced drag, and lower community noise. The Airframe Technology subproject contains two elements. Under the Damage Arresting Composite Demonstration an advanced material system is being explored which will lead to lighter airframes that are more structural efficient than the composites used in aircraft today. Under the Adaptive Compliant Trailing Edge Flight Experiment a new concept of a flexible wing trailing edge is being evaluated which will reduce weight and improve aerodynamic performance. This presentation will describe the development these two airframe technologies.

The Privileges of Rank

PubMed Central

MacLean, Alair

2010-01-01

This article examines the effects of peacetime cold war military service on the life course according to four potentially overlapping theories that state that military service (1) was a disruption, (2) was a positive turning point, (3) allowed veterans to accumulate advantage, and (4) was an agent of social reproduction. The article argues that the extent to which the effect of military service on veterans' lives corresponds with one or another of the preceding theories depends on historical shifts in three dimensions: conscription, conflict, and benefits. Military service during the peacetime draft era of the late 1950s had a neutral effect on the socioeconomic attainment of enlisted veterans. However, it had a positive effect on veterans who served as officers, which partly stemmed from status reproduction and selection. Yet net of pre-service and educational differences by rank, officers in this peacetime draft era were still able to accumulate advantage. PMID:20842210

Prevalence of Posttraumatic Stress Disorder in Vietnam-Era Women Veterans: The Health of Vietnam-Era Women's Study (HealthVIEWS).

PubMed

Magruder, Kathryn; Serpi, Tracey; Kimerling, Rachel; Kilbourne, Amy M; Collins, Joseph F; Cypel, Yasmin; Frayne, Susan M; Furey, Joan; Huang, Grant D; Gleason, Theresa; Reinhard, Matthew J; Spiro, Avron; Kang, Han

2015-11-01

Many Vietnam-era women veterans served in or near war zones and may have experienced stressful or traumatic events during their service. Although posttraumatic stress disorder (PTSD) is well studied among men who served in Vietnam, no major epidemiologic investigation of PTSD among women has been performed. To assess (1) the onset and prevalence of lifetime and current PTSD for women who served during the Vietnam era, stratified by wartime location (Vietnam, near Vietnam, or the United States), and (2) the extent to which wartime location was associated with PTSD, with adjustment for demographics, service characteristics, and wartime exposures. Survey of 8742 women who were active-duty military personnel in the US Armed Forces at any time from July 4, 1965, through March 28, 1973, and alive as of survey receipt as part of Department of Veterans Affairs Cooperative Study 579, HealthVIEWS. Data were obtained from mailed and telephone surveys from May 16, 2011, through August 5, 2012, and analyzed from June 26, 2013, through July 30, 2015. Lifetime and current PTSD as measured by the PTSD module of the Composite International Diagnostic Interview, version 3.0; onset of PTSD; and wartime experiences as measured by the Women's Wartime Exposure Scale-Revised. Among the 4219 women (48.3%) who completed the survey and a telephone interview, the weighted prevalence (95% CI) of lifetime PTSD was 20.1% (18.3%-21.8%), 11.5% (9.1%-13.9%), and 14.1% (12.4%-15.8%) for the Vietnam, near-Vietnam, and US cohorts, respectively. The weighted prevalence (95% CI) of current PTSD was 15.9% (14.3%-17.5%), 8.1% (6.0%-10.2%), and 9.1% (7.7%-10.5%) for the 3 cohorts, respectively. Few cases of PTSD among the Vietnam or near-Vietnam cohorts were attributable to premilitary onset (weighted prevalence, 2.9% [95% CI, 2.2%-3.7%] and 2.9% [95% CI, 1.7%-4.2%], respectively). Unadjusted models for lifetime and current PTSD indicated that women who served in Vietnam were more likely to meet PTSD criteria than women who mainly served in the United States (odds ratio [OR] for lifetime PTSD, 1.53 [95% CI, 1.28-1.83]; OR for current PTSD, 1.89 [95% CI, 1.53-2.33]). When we adjusted for wartime exposures, serving in Vietnam or near Vietnam did not increase the odds of having current PTSD (adjusted ORs, 1.05 [95% CI, 0.75-1.46] and 0.77 [95% CI, 0.52-1.14], respectively). The prevalence of PTSD for the Vietnam cohort was higher than previously documented. Vietnam service significantly increased the odds of PTSD relative to US service; this effect appears to be associated with wartime exposures, especially sexual discrimination or harassment and job performance pressures. Results suggest long-lasting mental health effects of Vietnam-era service among women veterans.

The use of enhanced recovery after surgery (ERAS) principles in Scottish orthopaedic units--an implementation and follow-up at 1 year, 2010-2011: a report from the Musculoskeletal Audit, Scotland.

PubMed

Scott, Nicholas B; McDonald, David; Campbell, Jane; Smith, Richard D; Carey, A Kate; Johnston, Ian G; James, Kate R; Breusch, Steffen J

2013-01-01

To establish whether a nationally guided programme can lead to more widespread implementation of enhanced recovery after surgery (ERAS), a well-established optimised care pathway for lower limb arthroplasty. In 2010, National Services Scotland's Musculoskeletal Audit was asked to perform a 'snapshot' audit of the current peri-operative management of patients undergoing total hip and knee arthroplasty in all 22 Scottish orthopaedic units with an identical follow-up audit in 2011 after input and support from the national steering group. Audit 1 and audit 2 involved 1,345 and 1,278 patients, respectively. The number of Scottish units that developed an ERAS programme increased from 8 (36 %) to 15 (68 %). Units that included more ERAS patients had earlier mobilisation rates (146/474, 36 % ERAS patients mobilised same day vs. 34/873, 4 % non-ERAS; n = 22 units, r = 0.55, p = 0.008) and shorter post-operative length of stay (median 4 days vs. ERAS, 5 days non-ERAS, n = 22 units, r = -0.64, p = 0.001). ERAS knee arthroplasty patients had lower blood transfusion rates (5/205, 2 % vs. 51/399, 13 %, n = 22 units, r = -0.62, p = 0.002). Units that restricted the use of IV fluids post-operatively had higher early mobilisation rates (n = 22 units, r = 0.48, p = 0.03) and shorter post-operative length of stay (n = 22 units, r = -0.56, p = 0.007). Reduced use of patient-controlled analgesia was also associated with earlier mobilisation (n = 22 units, r = 0.49, p = 0.02) and shorter length of stay (n = 22 units, r = -0.39, p = 0.07). Urinary catheterisation rates also dropped from 468/1,345 (35 %) in 2010 to 337/1,278 (26 %) in 2011 (n = 22 units, z = 2.19, p = 0.03). A clinically guided and nationally supported process has proven highly successful in achieving a further uptake of enhanced recovery principles after lower limb arthroplasty in Scotland, which has resulted in clinical benefits to patients and reduced length of hospital stay.

Determining Effective Teaching Behaviors through the Hiring Process

ERIC Educational Resources Information Center

Schumacher, Gary; Grigsby, Bettye; Vesey, Winona

2015-01-01

Purpose: One bad hiring decision can lead to low student achievement. Research supports that teachers are the most influential factor in student success. As a result, principals' current practice of hiring teachers based on intuition and likeability must change. Given the current high stakes era, principals need reassurance that the teachers they…

Anti-Black Latino Racism in an Era of Trumpismo

ERIC Educational Resources Information Center

Haywood, Jasmine M.

2017-01-01

This article describes the Latino population that voted for the current president and overview reasons as to why they voted for the current president. I purposefully center the anti-Black racism within the Latino community and focus specifically on recent political and nationwide events that are connected to anti-Black Latino racism. Additionally,…

The Opportunity Gap Achievement and Inequality in Education. Harvard Educational Review Reprint Series

ERIC Educational Resources Information Center

da Silva, Carol DeShano, Ed.; Huguley, James Philip, Ed.; Kakli, Zenub, Ed.; Rao, Radhika, Ed.

2007-01-01

"The Opportunity Gap" aims to shift attention from the current overwhelming emphasis on schools in discussions of the achievement gap to more fundamental questions about social and educational opportunity. The achievement gap looms large in the current era of high-stakes testing and accountability. Yet questions persist: Has the…

Teacher Identity and Agency in an Era of Accountability

ERIC Educational Resources Information Center

Buchanan, Rebecca

2015-01-01

The current zeitgeist in education in the USA emphasizes accountability for schools, students, and teachers, based on performance that can be easily quantified. Within this, current debates involving who should be teaching, what a good teacher looks like, and how best to evaluate and reward teachers are actually debates about the teaching…

[The Application of Information and Communication Technology (ICT) in Nursing Education].

PubMed

Chiou, Shwu-Fen; Su, Hsiu-Chuan; Huang, Ean-Wen

2017-12-01

With the rapid development of information and communication technologies (ICT) in the 21st century, all walks of life have experienced disruptive changes, including the healthcare profession. Although nurses represent the largest number of professionals in medical institutions, it is doubtful whether nurses possess sufficient capabilities to face challenges in this era of rapid medical informatization. Currently, the courses necessary to cultivate information literacy in nursing students are insufficient in Taiwan, and traditional instruction methods are largely adopted as nursing teaching strategies. Additionally, most teachers hold a passive attitude towards the application of ICT in teaching. On the contrary, ICT have been integrated into nursing education in many countries around the world for nearly 20 years, achieving good levels of teaching efficacy. Reflecting the Taiwan government's promotion of digital learning projects, academic circles in various fields have also started to gradually integrate ICT into teaching. Nursing educators in Taiwan have much to reference and to learn from these disparate integration experiences. Therefore, this article introduces the concepts of integration of ICT into teaching, the current status of the application of ICT in international nursing education, and the issues faced during this application as a reference for nursing education in Taiwan in order to promote the integration of ICT into nursing education.

Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

PubMed Central

Fung, Foon Yin; Linn, Yeh Ching

2015-01-01

Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM. PMID:25949261

Observations of synaptic structures: origins of the neuron doctrine and its current status

PubMed Central

Guillery, R.W

2004-01-01

The neuron doctrine represents nerve cells as polarized structures that contact each other at specialized (synaptic) junctions and form the developmental, functional, structural and trophic units of nervous systems. The doctrine provided a powerful analytical tool in the past, but is now seldom used in educating neuroscientists. Early observations of, and speculations about, sites of neuronal communication, which were made in the early 1860s, almost 30 years before the neuron doctrine was developed, are presented in relation to later accounts, particularly those made in support of, or opposition to, the neuron doctrine. These markedly differing accounts are considered in relation to limitations imposed by preparative and microscopical methods, and are discussed briefly as representing a post-Darwinian, reductionist view, on the one hand, opposed to a holistic view of mankind as a special part of creation, on the other. The widely misunderstood relationship of the neuron doctrine to the cell theory is discussed, as is the degree to which the neuron doctrine is still strictly applicable to an analysis of nervous systems. Current research represents a ‘post-neuronist’ era. The neuron doctrine provided a strong analytical approach in the past, but can no longer be seen as central to contemporary advances in neuroscience. PMID:16147523

Early Beam Injection Scheme for the Fermilab Booster: A Path for Intensity Upgrade

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

Bhat, C. M.

Over the past decade, Fermilab has focused efforts on the intensity frontier physics and is committed to increase the average beam power delivered to the neutrino and muon programs substantially. Many upgrades to the existing injector accelerators, namely, the current 400 MeV LINAC and the Booster, are in progress under the Proton Improvement Plan (PIP). Proton Improvement Plan-II (PIP-II) proposes to replace the existing 400 MeV LINAC by a new 800 MeV LINAC, as an injector to the Booster which will increase Booster output power by nearly a factor of two from the PIP design value by the end ofmore » its completion. In any case, the Fermilab Booster is going to play a very significant role for nearly next two decades. In this context, I have developed and investigated a new beam injection scheme called "early injection scheme" (EIS) for the Booster with the goal to significantly increase the beam intensity output from the Booster thereby increasing the beam power to the HEP experiments even before PIP-II era. The scheme, if implemented, will also help improve the slip-stacking efficiency in the MI/RR. Here I present results from recent simulations, beam studies, current status and future plans for the new scheme.« less

Ophthalmic Vascular Events after Primary Unilateral Intra-arterial Chemotherapy for Retinoblastoma in Early and Recent Eras.

PubMed

Dalvin, Lauren A; Ancona-Lezama, David; Lucio-Alvarez, J Antonio; Masoomian, Babak; Jabbour, Pascal; Shields, Carol L

2018-06-16

To assess risk factors for ophthalmic vascular events after intra-arterial chemotherapy (IAC) for retinoblastoma. Retrospective cohort study. Patients who received unilateral IAC as primary treatment for retinoblastoma from January 1, 2009, to November 30, 2017, at a single center. Records were reviewed for patient demographics, tumor features, IAC parameters, and treatment-related vascular events in the early IAC era (2009-2011) compared with the recent era (2012-2017) using the t test and Fisher exact test. Change in event rates over time was assessed using Poisson regression analysis, with Spearman's rho used to test correlation. Rate of IAC-induced ophthalmic vascular events. There were 243 chemotherapy infusions in 76 eyes of 76 patients, divided into early (22 eyes, 57 infusions) and recent (54 eyes, 186 infusions) eras. Intra-arterial chemotherapy consisted of melphalan (243 infusions), topotecan (124 infusions), and carboplatin (9 infusions). A comparison (early vs. recent era) revealed fewer mean number of infusions (2.6 vs. 3.4, P = 0.02) with similar mean patient age and presenting tumor features. Event rates decreased over time (P < 0.01), with fewer ophthalmic vascular events (early era vs. recent era) in the recent era (59% vs. 9% per eye, 23% vs. 3% per infusion, P < 0.01), including peripheral retinal nonperfusion (5% vs. 2% per eye, P = 0.50), vitreous hemorrhage (9% vs. 2%, P = 0.20), subretinal hemorrhage (0% vs. 2%, P = 0.99), branch retinal vein occlusion (5% vs. 0%, P = 0.29), choroidal ischemia (14% vs. 4%, P = 0.14), and ophthalmic artery spasm/occlusion (27% vs. 0%, P < 0.01). Events did not correlate to patient age (P = 0.75), tumor diameter (P = 0.32), tumor thickness (P = 0.59), or cumulative dosage of melphalan (P = 0.13) or topotecan (P = 0.59). There were no IAC-induced vascular events in 72 infusions of 21 consecutively treated eyes in 2016 to 2017. Ophthalmic vascular events after IAC have decreased from the early era (2009-2011) through the current era (2012-2017) at this center. Experience performing this highly specialized procedure could be an important factor predicting IAC-related vascular events. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Advancing a New Era of Energy Delivery in the West (Fact Sheet)

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

Not Available

2014-11-01

This 2-page fact sheet provides a high-level overview of the Western Area Power Administration's Transmission Infrastructure Program, including background, purpose, goals, eligibility criteria, and current projects.

The Strengths and Limitations of South Africa's Search for Apartheid-Era Missing Persons.

PubMed

Aronson, Jay D

2011-07-01

This article examines efforts to account for missing persons from the apartheid era in South Africa by family members, civil society organizations and the current government's Missing Persons Task Team, which emerged out of the Truth and Reconciliation Commission process. It focuses on how missing persons have been officially defined in the South African context and the extent to which the South African government is able to address the current needs and desires of relatives of the missing. I make two main arguments: that family members ought to have an active role in shaping the initiatives and institutions that seek to resolve the fate of missing people, and that the South African government ought to take a more holistic 'grave-to-grave' approach to the process of identifying, returning and reburying the remains of the missing.

Revisiting global mean sea level budget closure : Preliminary results from an integrative study within ESA's Climate Change Initiative -Sea level Budget Closure-Climate Change Initiative

NASA Astrophysics Data System (ADS)

Palanisamy, H.; Cazenave, A. A.

2017-12-01

The global mean sea level budget is revisited over two time periods: the entire altimetry era, 1993-2015 and the Argo/GRACE era, 2003-2015 using the version '0' of sea level components estimated by the SLBC-CCI teams. The SLBC-CCI is an European Space Agency's project on sea level budget closure using CCI products. Over the entire altimetry era, the sea level budget was performed as the sum of steric and mass components that include contributions from total land water storage, glaciers, ice sheets (Greenland and Antarctica) and total water vapor content. Over the Argo/GRACE era, it was performed as the sum of steric and GRACE based ocean mass. Preliminary budget analysis performed over the altimetry era (1993-2015) results in a trend value of 2.83 mm/yr. On comparison with the observed altimetry-based global mean sea level trend over the same period (3.03 ± 0.5 mm/yr), we obtain a residual of 0.2 mm/yr. In spite of a residual of 0.2 mm/yr, the sea level budget result obtained over the altimetry era is very promising as this has been performed using the version '0' of the sea level components. Furthermore, uncertainties are not yet included in this study as uncertainty estimation for each sea level component is currently underway. Over the Argo/GRACE era (2003-2015), the trend estimated from the sum of steric and GRACE ocean mass amounts to 2.63 mm/yr while that observed by satellite altimetry is 3.37 mm/yr, thereby leaving a residual of 0.7 mm/yr. Here an ensemble GRACE ocean mass data (mean of various available GRACE ocean mass data) was used for the estimation. Using individual GRACE data results in a residual range of 0.5 mm/yr -1.1 mm/yr. Investigations are under way to determine the cause of the vast difference between the observed sea level and the sea level obtained from steric and GRACE ocean mass. One main suspect is the impact of GRACE data gaps on sea level budget analysis due to lack of GRACE data over several months since 2011. The current action plan of the project is to work on an accurate closure of the sea level budget using both the above performed methodologies. We also intend to provide a standardized uncertainty estimation and to correctly identify the causes leading to sea level budget non-closure if that is the case.

Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: a Japanese multicenter study.

PubMed

Egawa, H; Teramukai, S; Haga, H; Tanabe, M; Mori, A; Ikegami, T; Kawagishi, N; Ohdan, H; Kasahara, M; Umeshita, K

2014-01-01

We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

Role of Imaging in the Era of Precision Medicine.

PubMed

Giardino, Angela; Gupta, Supriya; Olson, Emmi; Sepulveda, Karla; Lenchik, Leon; Ivanidze, Jana; Rakow-Penner, Rebecca; Patel, Midhir J; Subramaniam, Rathan M; Ganeshan, Dhakshinamoorthy

2017-05-01

Precision medicine is an emerging approach for treating medical disorders, which takes into account individual variability in genetic and environmental factors. Preventive or therapeutic interventions can then be directed to those who will benefit most from targeted interventions, thereby maximizing benefits and minimizing costs and complications. Precision medicine is gaining increasing recognition by clinicians, healthcare systems, pharmaceutical companies, patients, and the government. Imaging plays a critical role in precision medicine including screening, early diagnosis, guiding treatment, evaluating response to therapy, and assessing likelihood of disease recurrence. The Association of University Radiologists Radiology Research Alliance Precision Imaging Task Force convened to explore the current and future role of imaging in the era of precision medicine and summarized its finding in this article. We review the increasingly important role of imaging in various oncological and non-oncological disorders. We also highlight the challenges for radiology in the era of precision medicine. Published by Elsevier Inc.

The Rhodes Scholarship in the Current Era of Student Activism: What Do We Consider "Prestigious" and Who Benefits?

ERIC Educational Resources Information Center

Adam, LeAnn

2016-01-01

Contemporary student activism has revealed deep feelings of alienation on college campuses, prompting strong reactions to current and historical racial injustice, including the history of Cecil Rhodes. Can advisors promote restorative justice by encouraging reflection upon privileges afforded to Rhodes scholars and their responsibility to address…

Real Teaching in an Era of Fake News

ERIC Educational Resources Information Center

Colglazier, Will

2017-01-01

Against the backdrop of our country's current political climate, the author sometimes wonder if he is doing his job as a high school history teacher to the best of his ability. He doesn't see his role as simply covering what's in the textbook or helping students analyze current events. Rather, he believes it's his professional responsibility--his…

HIV-Exposed Uninfected Infants in Zimbabwe: Insights into Health Outcomes in the Pre-Antiretroviral Therapy Era

PubMed Central

Evans, Ceri; Humphrey, Jean H.; Ntozini, Robert; Prendergast, Andrew J.

2016-01-01

The ZVITAMBO trial recruited 14,110 mother–infant pairs to a randomized controlled trial of vitamin A between 1997 and 2000, before the availability of antiretroviral therapy for HIV prophylaxis or treatment in Zimbabwe. The HIV status of mothers and infants was well characterized through 1–2 years of follow-up, leading to the largest cohort to date of HIV-exposed uninfected (HEU) infants (n = 3135), with a suitable comparison group of HIV-unexposed infants (n = 9510). Here, we draw on 10 years of published findings from the ZVITAMBO trial. HEU infants had increased morbidity compared to HIV-unexposed infants, with 50% more hospitalizations in the neonatal period and 30% more sick clinic visits during infancy, particularly for skin infections, lower respiratory tract infections, and oral thrush. HEU children had 3.9-fold and 2.0-fold higher mortality than HIV-unexposed children during the first and second years of life, respectively, most commonly due to acute respiratory infections, diarrhea/dysentery, malnutrition, sepsis, and meningitis. Infant morbidity and mortality were strongly related to maternal HIV disease severity, and increased morbidity remained until maternal CD4 counts were >800 cells/μL. HEU infants were more likely to be premature and small-for-gestational age than HIV-unexposed infants, and had more postnatal growth failure. Here, we propose a conceptual framework to explain the increased risk of infectious morbidity, mortality, and growth failure among HEU infants, hypothesizing that immune activation and inflammation are key drivers of both infection susceptibility and growth failure. Future studies should further dissect the causes of infection susceptibility and growth failure and determine the impact of ART and cotrimoxazole on outcomes of this vulnerable group of infants in the current era. PMID:27375613

Head circumferences of children born to HIV-infected and HIV-uninfected mothers in Zimbabwe during the preantiretroviral therapy era

PubMed Central

Evans, Ceri; Chasekwa, Bernard; Ntozini, Robert; Humphrey, Jean H.; Prendergast, Andrew J.

2016-01-01

Objectives: To describe the head growth of children according to maternal and child HIV infection status. Design: Longitudinal analysis of head circumference data from 13 647 children followed from birth in the ZVITAMBO trial, undertaken in Harare, Zimbabwe, between 1997 and 2001, prior to availability of antiretroviral therapy (ART) or cotrimoxazole prophylaxis. Methods: Head circumference was measured at birth, then at regular intervals through 24 months of age. Mean head circumference-for-age Z-scores (HCZ) and prevalence of microcephaly (HCZ < −2) were compared between HIV-unexposed children, HIV-exposed uninfected (HEU) children and children infected with HIV in utero (IU), intrapartum (IP) and postnatally (PN). Results: Children infected with HIV in utero had head growth restriction at birth. Head circumference Z-scores remained low throughout follow-up in IP children, whereas they progressively declined in IU children. During the second year of life, HCZ in the PN group declined, reaching a similar mean as IP-infected children by 21 months of age. Microcephaly was more common among IU and IP children than HIV-uninfected children through 24 months. HEU children had significantly lower head circumferences than HIV-unexposed children through 12 months. Conclusion: HIV-infected children had lower head circumferences and more microcephaly than HIV-uninfected children. Timing of HIV acquisition; influenced HCZ, with those infected before birth having particularly poor head growth. HEU children had poorer head growth until 12 months of age. Correlations between head growth and neurodevelopment in the context of maternal/infant HIV infection, and further studies from the current ART era, will help determine the predictive value of routine head circumference measurement. PMID:27428746

Determining the status of non-transferred embryos in Ireland: a conspectus of case law and implications for clinical IVF practice

PubMed Central

Sills, Eric Scott; Murphy, Sarah Ellen

2009-01-01

The development of in vitro fertilisation (IVF) as a treatment for human infertilty was among the most controversial medical achievements of the modern era. In Ireland, the fate and status of supranumary (non-transferred) embryos derived from IVF brings challenges both for clinical practice and public health policy because there is no judicial or legislative framework in place to address the medical, scientific, or ethical uncertainties. Complex legal issues exist regarding informed consent and ownership of embryos, particularly the use of non-transferred embryos if a couple separates or divorces. But since case law is only beginning to emerge from outside Ireland and because legislation on IVF and human embryo status is entirely absent here, this matter is poised to raise contractual, constitutional and property law issues at the highest level. Our analysis examines this medico-legal challenge in an Irish context, and summarises key decisions on this issue rendered from other jurisdictions. The contractual issues raised by the Roche case regarding informed consent and the implications the initial judgment may have for future disputes over embryos are also discussed. Our research also considers a putative Constitutional 'right to procreate' and the implications EU law may have for an Irish case concerning the fate of frozen embryos. Since current Medical Council guidelines are insufficient to ensure appropriate regulation of the advanced reproductive technologies in Ireland, the report of the Commission on Assisted Human Reproduction is most likely to influence embryo custody disputes. Public policy requires the establishment and implementation of a more comprehensive legislative framework within which assisted reproductive medical services are offered. PMID:19589140

The Association Between Suicide and OIF/OEF Deployment History

DTIC Science & Technology

2015-03-01

members who were younger, male, not married , and identified as non-Hispanic White, Native American, or unspecified racial/ethnic category. Crude...Marital status Never married 3,789 17,525,813 21.62 20.73, 22.54 Married 1,511 12,120,351 12.47 11.67, 13.32 Separated, divorced, widowed 203 1,229,255...be married with children. Women make up a greater percentage of service members than their Vietnam-era counterparts as well. While many post

The medical care system of Hungary.

PubMed

Raffel, N K; Raffel, M W

1988-01-01

Medical care in Hungary has made significant progress since World War II in spite of other social priorities which have limited financial support of the health system. A shortage of hard currency in a high technological era is now having a particularly severe adverse impact on further development. Decentralized administration and local finance have, however, provided some room for progress. Preventive efforts are hampered by a deeply entrenched life style which is not conducive to improving the population's health status.

Raising the bar: the importance of hospital library standards in the continuing medical education accreditation process*

PubMed Central

Cyr Gluck, Jeannine; Hassig, Robin Ackley

2001-01-01

The Connecticut State Medical Society (CSMS) reviews and accredits the continuing medical education (CME) programs offered by Connecticut's hospitals. As part of the survey process, the CSMS assesses the quality of the hospitals' libraries. In 1987, the CSMS adopted the Medical Library Association's (MLA's) “Minimum Standards for Health Sciences Libraries in Hospitals.” In 1990, professional librarians were added to the survey team and, later, to the CSMS CME Committee. Librarians participating in this effort are recruited from the membership of the Connecticut Association of Health Sciences Librarians (CAHSL). The positive results of having a qualified librarian on the survey team and the invaluable impact of adherence to the MLA standards are outlined. As a direct result of this process, hospitals throughout the state have added staffing, increased space, and added funding for resources during an era of cutbacks. Some hospital libraries have been able to maintain a healthy status quo, while others have had proposed cuts reconsidered by administrators for fear of losing valuable CME accreditation status. Creating a relationship with an accrediting agency is one method by which hospital librarians elsewhere may strengthen their efforts to ensure adequate library resources in an era of downsizing. In addition, this collaboration has provided a new and important role for librarians to play on an accreditation team. PMID:11465686

HIV-Related Medical Admissions to a South African District Hospital Remain Frequent Despite Effective Antiretroviral Therapy Scale-Up

PubMed Central

Meintjes, Graeme; Kerkhoff, Andrew D.; Burton, Rosie; Schutz, Charlotte; Boulle, Andrew; Van Wyk, Gavin; Blumenthal, Liz; Nicol, Mark P.; Lawn, Stephen D.

2015-01-01

Abstract The public sector scale-up of antiretroviral therapy (ART) in South Africa commenced in 2004. We aimed to describe the hospital-level disease burden and factors contributing to morbidity and mortality among hospitalized HIV-positive patients in the era of widespread ART availability. Between June 2012 and October 2013, unselected patients admitted to medical wards at a public sector district hospital in Cape Town were enrolled in this cross-sectional study with prospective follow-up. HIV testing was systematically offered and HIV-infected patients were systematically screened for TB. The spectrum of admission diagnoses among HIV-positive patients was documented, vital status at 90 and 180 days ascertained and factors independently associated with death determined. Among 1018 medical admissions, HIV status was ascertained in 99.5%: 60.1% (n = 609) were HIV-positive and 96.1% (n = 585) were enrolled. Of these, 84.4% were aware of their HIV-positive status before admission. ART status was naive in 35.7%, current in 45.0%, and interrupted in 19.3%. The most frequent primary clinical diagnoses were newly diagnosed TB (n = 196, 33.5%), other bacterial infection (n = 100, 17.1%), and acquired immunodeficiency syndrome (AIDS)-defining illnesses other than TB (n = 64, 10.9%). By 90 days follow-up, 175 (29.9%) required readmission and 78 (13.3%) died. Commonest causes of death were TB (37.2%) and other AIDS-defining illnesses (24.4%). Independent predictors of mortality were AIDS-defining illnesses other than TB, low hemoglobin, and impaired renal function. HIV still accounts for nearly two-thirds of medical admissions in this South African hospital and is associated with high mortality. Strategies to improve linkage to care, ART adherence/retention and TB prevention are key to reducing HIV-related hospitalizations in this setting. PMID:26683950

A review of UK housing policy: ideology and public health.

PubMed

Stewart, J

2005-06-01

The aim of this paper is to review UK public health policy, with a specific reference to housing as a key health determinant, since its inception in the Victorian era to contemporary times. This paper reviews the role of social and private housing policy in the development of the UK public health movement, tracing its initial medical routes through to the current socio-economic model of public health. The paper establishes five distinct ideologically and philosophically driven eras, placing public health and housing within liberal (Victorian era), state interventionist (post World War 1; post World War 2), neoliberal (post 1979) and "Third Way" (post 1997) models, showing the political perspective of policy interventions and overviewing their impact on public health. The paper particularly focuses on the contemporary model of public health since the Acheson Report, and how its recommendations have found their way into policy, also the impact on housing practice. Public health is closely related to political ideology, whether driven by the State, individual or partnership arrangements. The current political system, the Third Way, seeks to promote a sustainable "social contract" between citizens and the State, public, private and voluntary organizations in delivering community-based change in areas where health inequalities can be most progressively and successfully addressed.

Endemism hotspots are linked to stable climatic refugia.

PubMed

Harrison, Susan; Noss, Reed

2017-01-01

Centres of endemism have received much attention from evolutionists, biogeographers, ecologists and conservationists. Climatic stability is often cited as a major reason for the occurrences of these geographic concentrations of species which are not found anywhere else. The proposed linkage between endemism and climatic stability raises unanswered questions about the persistence of biodiversity during the present era of rapidly changing climate. The current status of evidence linking geographic centres of endemism to climatic stability over evolutionary time was examined. The following questions were asked. Do macroecological analyses support such an endemism-stability linkage? Do comparative studies find that endemic species display traits reflecting evolution in stable climates? Will centres of endemism in microrefugia or macrorefugia remain relatively stable and capable of supporting high biological diversity into the future? What are the implications of the endemism-stability linkage for conservation? Recent work using the concept of climate change velocity supports the classic idea that centres of endemism occur where past climatic fluctuations have been mild and where mountainous topography or favourable ocean currents contribute to creating refugia. Our knowledge of trait differences between narrow endemics and more widely distributed species remains highly incomplete. Current knowledge suggests that centres of endemism will remain relatively climatically buffered in the future, with the important caveat that absolute levels of climatic change and species losses in these regions may still be large. © The Author 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Role of nondestructive evaluation in civil aviation: historical development, current status, future challenges

NASA Astrophysics Data System (ADS)

Weber, Hans J.

1995-07-01

Nondestructive evaluation has been used in civil aviation for 50 years. Until the arrival of the jet era it was mostly applied to component inspection. Since the damage-tolerant design philosophy was introduced by mandate for large transport aircraft, it has become an integral part of their design and maintenance. In the near future its role in the maintenance of aging small transport aircraft is expected to grow significantly. The most important factor contributing to the growing importance of NDE is the fact that the industry has been operating its aircraft much longer than originally envisioned, making it necessary to carefully monitor their structural condition to assure their airworthiness. NDE is helping making it economically feasible to operate aircraft for extended life times. Another major factor is the increased use of advanced materials, such as composites. Again, monitoring has to assure integrity. More recently, in an industry which has become highly competitive, NDE is becoming an important tool in the quest for reducing maintenance costs. The importance of NDE is expected to grow further.

The future of biotic indices in the ecogenomic era: Integrating (e)DNA metabarcoding in biological assessment of aquatic ecosystems.

PubMed

Pawlowski, Jan; Kelly-Quinn, Mary; Altermatt, Florian; Apothéloz-Perret-Gentil, Laure; Beja, Pedro; Boggero, Angela; Borja, Angel; Bouchez, Agnès; Cordier, Tristan; Domaizon, Isabelle; Feio, Maria Joao; Filipe, Ana Filipa; Fornaroli, Riccardo; Graf, Wolfram; Herder, Jelger; van der Hoorn, Berry; Iwan Jones, J; Sagova-Mareckova, Marketa; Moritz, Christian; Barquín, Jose; Piggott, Jeremy J; Pinna, Maurizio; Rimet, Frederic; Rinkevich, Buki; Sousa-Santos, Carla; Specchia, Valeria; Trobajo, Rosa; Vasselon, Valentin; Vitecek, Simon; Zimmerman, Jonas; Weigand, Alexander; Leese, Florian; Kahlert, Maria

2018-05-15

The bioassessment of aquatic ecosystems is currently based on various biotic indices that use the occurrence and/or abundance of selected taxonomic groups to define ecological status. These conventional indices have some limitations, often related to difficulties in morphological identification of bioindicator taxa. Recent development of DNA barcoding and metabarcoding could potentially alleviate some of these limitations, by using DNA sequences instead of morphology to identify organisms and to characterize a given ecosystem. In this paper, we review the structure of conventional biotic indices, and we present the results of pilot metabarcoding studies using environmental DNA to infer biotic indices. We discuss the main advantages and pitfalls of metabarcoding approaches to assess parameters such as richness, abundance, taxonomic composition and species ecological values, to be used for calculation of biotic indices. We present some future developments to fully exploit the potential of metabarcoding data and improve the accuracy and precision of their analysis. We also propose some recommendations for the future integration of DNA metabarcoding to routine biomonitoring programs. Copyright © 2018 Elsevier B.V. All rights reserved.

Obstructive Lung Diseases in HIV: A Clinical Review and Identification of Key Future Research Needs

PubMed Central

Drummond, M. Bradley; Kunisaki, Ken M.; Huang, Laurence

2016-01-01

HIV infection has shifted from what was once a disease directly impacting short-term mortality to what is now a chronic illness controllable in the era of effective combination antiretroviral therapy (ART). In this setting, life expectancy for HIV-infected individual is nearly comparable to that of individuals without HIV. Subsequent to this increase in life expectancy, there has been recognition of increased multimorbidity among HIV-infected persons, with prevalence of comorbid chronic illnesses now approaching 65%. Obstructive lung diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are prevalent conditions associated with substantial morbidity and mortality in the United States. There is overlap in risk factors for HIV acquisition and chronic lung diseases, including lower socioeconomic status and the use of tobacco and illicit drugs. Objectives of this review are to (1) summarize the current state of knowledge regarding COPD and asthma among HIV-infected persons, (2) highlight implications for clinicians caring for patients with these combined comorbidities, and (3) identify key research initiatives to reduce the burden of obstructive lung diseases among HIV-infected persons. PMID:26974304

Liverpool Telescope and Liverpool Telescope 2

NASA Astrophysics Data System (ADS)

Copperwheat, C. M.; Steele, I. A.; Barnsley, R. M.; Bates, S. D.; Clay, N. R.; Jermak, H.; Marchant, J. M.; Mottram, C. J.; Piascik, A.; Smith, R. J.

2016-12-01

The Liverpool Telescope is a fully robotic optical/near-infrared telescope with a 2-metre clear aperture, located at the Observatorio del Roque de los Muchachos on the Canary Island of La Palma. The telescope is owned and operated by Liverpool John Moores University, with financial support from the UK's Science and Technology Facilities Council. The telescope began routine science operations in 2004 and is a common-user facility with time available through a variety of committees via an open, peer reviewed process. Seven simultaneously mounted instruments support a broad science programme, with a focus on transient follow-up and other time domain topics well suited to the characteristics of robotic observing. Development has also begun on a successor facility, with the working title `Liverpool Telescope 2', to capitalise on the new era of time domain astronomy which will be brought about by the next generation of survey facilities such as LSST. The fully robotic Liverpool Telescope 2 will have a 4-metre aperture and an improved response time. In this paper we provide an overview of the current status of both facilities.

The maternal womb: a novel target for cancer prevention in the era of the obesity pandemic?

PubMed Central

Simmen, Frank A.; Simmen, Rosalia C.M.

2011-01-01

The dramatic rise in worldwide prevalence of obesity has necessitated the search for more efficacious anti-obesity strategies to counter the increased cancer risks in overweight and obese individuals. The mechanistic pathways linking obesity status with adult chronic diseases such as cancer remain incompletely understood. A growing body of evidence suggests that novel approaches and interventional agents to disrupt the feed-forward cycle of maternal to offspring obesity transfer that is initiated in utero, will be important for stemming both the obesity pandemic and the associated increase in cancer incidence. The convergence of multiple research areas including those encompassing the insulin and insulin-like growth factor (IGF) systems, epigenetics, and stem cell biology is providing insights into the potential for cancer prevention in adult offspring previously exposed to the intrauterine environment of overweight/obese mothers. Here, we review the current state of this nascent research field, with a focus on three major cancers namely breast, colorectal and liver, and suggest some possible future directions to optimize its impact for the health of future generations. PMID:21701386

Rejection with hemodynamic compromise in the current era of pediatric heart transplantation: a multi-institutional study.

PubMed

Everitt, Melanie D; Pahl, Elfriede; Schechtman, Kenneth B; Zheng, Jie; Ringewald, Jeremy M; L'ecuyer, Thomas; Naftel, David C; Kirklin, James K; Blume, Elizabeth D; Bullock, Emily A; Canter, Charles E

2011-03-01

Survival after pediatric heart transplant has improved over time, as has the incidence of overall rejection. We studied the effect of era on the occurrence and outcome of rejection with hemodynamic compromise (HC). Data from 2227 patients who received allografts between 1993 and 2006 at 36 centers in the Pediatric Heart Transplant Study were analyzed to determine incidence, outcome, and risk factors for rejection with HC in early (1993-1999) and recent (2000-2006) eras. Rejection with HC was classified as severe (RSHC) when inotropes were used for circulatory support and mild (RMHC) when inotropes were not used. Of 1217 patients with any episode of rejection, 541 had rejection with HC. Freedom from RMHC improved at 1 year (81% vs 90%, p < 0.001) and at 5 years (74% vs 85%, p < 0.001) in the early vs recent eras, but freedom from RSHC was similar between eras (93% vs 95% at 1 year and 85% vs 87% at 5 years, p = 0.24). Survival after RSHC (63% at 1 year and 49% at 5 years) was worse than after RMHC (87% at 1 year and 72% at 5 years, p < 0.001) and did not change over time. Risk factors for RSHC were non-white race (hazard ratio [HR], 1.73; 95% confidence interval [CI], 1.29-2.32, p < 0.01), older age (HR, 2.85; 95% CI, 1.24-6.53; p = 0.01), and non-A blood type (HR, 1.51;, 95% CI, 1.11-2.04,; p = 0.01), but the only risk factor for RMHC was earlier era of transplant (HR, 1.94; 95% CI, 1.56-2.41; p < 0.001). The incidence of RMHC has declined over time but the same era effect has not occurred with RSHC. Close follow-up after RSHC is crucial because mortality is so high. Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Successful implementation of an enhanced recovery after surgery programme for elective colorectal surgery: a process evaluation of champions' experiences.

PubMed

Gotlib Conn, Lesley; McKenzie, Marg; Pearsall, Emily A; McLeod, Robin S

2015-07-17

Enhanced recovery after surgery (ERAS) is a multimodal evidence-based approach to patient care that has become the standard in elective colorectal surgery. Implemented globally, ERAS programmes represent a considerable change in practice for many surgical care providers. Our current understanding of specific implementation and sustainability challenges is limited. In January 2013, we began a 2-year ERAS implementation for elective colorectal surgery in 15 academic hospitals in Ontario. The purpose of this study was to understand the process enablers and barriers that influenced the success of ERAS implementation in these centres with a view towards supporting sustainable change. A qualitative process evaluation was conducted from June to September 2014. Semi-structured interviews with implementation champions were completed, and an iterative inductive thematic analysis was conducted. Following a data-driven analysis, the Normalization Process Theory (NPT) was used as an analytic framework to understand the impact of various implementation processes. The NPT constructs were used as sensitizing concepts, reviewed against existing data categories for alignment and fit. Fifty-eight participants were included: 15 surgeons, 14 anaesthesiologists, 15 nurses, and 14 project coordinators. A number of process-related implementation enablers were identified: champions' belief in the value of the programme, the fit and cohesion of champions and their teams locally and provincially, a bottom-up approach to stakeholder engagement targeting organizational relationship-building, receptivity and support of division leaders, and the normalization of ERAS as everyday practice. Technical enablers identified included effective integration with existing clinical systems and using audit and feedback to report to hospital stakeholders. There was an overall optimism that ERAS implementation would be sustained, accompanied by concern about long-term organizational support. Successful ERAS implementation is achieved by a complex series of cognitive and social processes which previously have not been well described. Using the Normalization Process Theory as a framework, this analysis demonstrates the importance of champion coherence, external and internal relationship building, and the strategic management of a project's organization-level visibility as important to ERAS uptake and sustainability.

When teens don't wait: encouraging contraception.

PubMed

1990-01-01

Sexually active teenagers must be diligently encouraged to use contraceptives to reduce early unintended pregnancy. Public awareness of this problem has grown and the debate about how to stop has also grown. Delaying the initiation of sexual activity is seen as the only acceptable method by some, but abstinence will not help reduce early unintended pregnancy in already sexually active teenagers. Strategies must be developed to reach these teenagers with contraception, parenting, adoption, or abortion for when contraception fails. Wide spread sexual activity is the reality of the current era. Parents and teenagers must be provided a variety of strategies that reflect the diverse value system of the current era. Efforts to encourage contraception among adolescents that are successful presuppose that strong, effective family planning services are widely available. In order to create a positive climate for adolescents to fully adopt and use a regimen of contraceptive care automatically implies that such services are acceptable and accessible to the teenagers.

The Strengths and Limitations of South Africa’s Search for Apartheid-Era Missing Persons

PubMed Central

Aronson, Jay D.

2011-01-01

This article examines efforts to account for missing persons from the apartheid era in South Africa by family members, civil society organizations and the current government’s Missing Persons Task Team, which emerged out of the Truth and Reconciliation Commission process. It focuses on how missing persons have been officially defined in the South African context and the extent to which the South African government is able to address the current needs and desires of relatives of the missing. I make two main arguments: that family members ought to have an active role in shaping the initiatives and institutions that seek to resolve the fate of missing people, and that the South African government ought to take a more holistic ‘grave-to-grave’ approach to the process of identifying, returning and reburying the remains of the missing. PMID:21984885

Environmentally Responsible Aviation - Real Solutions for Environmental Challenges Facing Aviation

NASA Technical Reports Server (NTRS)

Collier, Fayette; Thomas, Russell; Burley, Casey; Nickol, Craig; Lee, Chi-Ming; Tong, Michael

2010-01-01

The combined reality of persistently strong growth in air traffic and the vital economic role of the air transport system result in continued demand for the progress of technology for the reduction of aircraft noise, emissions of oxides of nitrogen, and fuel burn. NASA s Environmentally Responsible Aviation (ERA) project has set aggressive goals in these three areas including a noise goal of 42 dB cumulative below the Stage 4 certification level. The goal for the reduction of oxides of nitrogen is 75% below the current standard. The fuel burn reduction goal is 50% below that of a current state-of-the-art aircraft. Furthermore, the overall goal of ERA is to mature technologies that will meet these goals simultaneously and with a timeframe of 2020 for technical readiness. This paper outlines the key technologies and the progress achieved to date toward the goals.

Assessing Progress in Retinopathy Outcomes in Type 1 Diabetes

PubMed Central

LeCaire, Tamara J.; Palta, Mari; Klein, Ronald; Klein, Barbara E.K.; Cruickshanks, Karen J.

2013-01-01

OBJECTIVE The Wisconsin Diabetes Registry Study (WDRS) cohort consisted of patients diagnosed with type 1 diabetes in the same geographic region as, but 8–34 years later than the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) cohort, providing a unique opportunity to assess changes in complications. We estimated the current prevalence and severity of diabetic retinopathy at 20 years of diabetes duration, compared these between eras, and evaluated the influence of diabetes management. RESEARCH DESIGN AND METHODS Twenty-year examinations, including fundus photographs, were completed on 305 WDRS subjects during 2007–2011. A subgroup of the WESDR cohort participated in one of four study visits during 1980–1996, at similar diabetes duration (n = 583). Adjusted ordinal logistic regression with three retinopathy severity categories was used to estimate odds ratios (ORs) of more severe retinopathy with diagnosis during an earlier era. RESULTS Mean hemoglobin A1c (HbA1c) was lower in WDRS than in WESDR (8.0% vs. 9.3% [P < 0.001], and 93.4% vs. 21.3% [P < 0.001]) used ≥3 daily insulin injections or an insulin pump. In WDRS, 18% had vision-threatening levels of retinopathy vs. 43% in WESDR. The adjusted OR of more severe retinopathy in the earlier era (OR 3.0 [95% CI 2.2–4.0]) was reduced by including 20-year HbA1c in the model (OR 2.2 [1.6–3.0]). CONCLUSIONS Retinopathy severity at a diabetes duration of 20 years is lower in the more recent era of type 1 diabetes. Updated projections should be used when informing newly diagnosed individuals of prognosis and for health care cost assessments. Current glycemic control explained a limited amount of the difference. PMID:23193204

Small Aerostationary Telecommunications Orbiter Concept for Mars in the 2020s

NASA Technical Reports Server (NTRS)

Lock, Robert E.; Edwards, Charles D., Jr.; Nicholas, Austin; Woolley, Ryan; Bell, David J.

2016-01-01

Current Mars science orbiters carry UHF proximity payloads to provide limited access and data services to landers and rovers on Mars surface. In the era of human spaceflight to Mars, very high rate and reliable relay services will be needed to serve a large number of supporting vehicles, habitats, and orbiters, as well as astronaut EVAs. These will likely be provided by a robust network of orbiting assets in very high orbits, such as areostationary orbits. In the decade leading to that era, telecommunications orbits can be operated at areostationary orbit that can support a significant population of robotic precursor missions and build the network capabilities needed for the human spaceflight era. Telecommunications orbiters of modest size and cost, delivered by Solar Electric Propulsion to areostationary orbit, can provide continuous access at very high data rates to users on the surface and in Mars orbit.In the era of human spaceflight to Mars very high rate andreliable relay services will be needed to serve a largenumber of supporting vehicles, habitats, and orbiters, aswell as astronaut EVAs. These could be provided by arobust network of orbiting assets in very high orbits. In thedecade leading to that era, telecommunications orbiterscould be operated at areostationary orbit that could support asignificant population of robotic precursor missions andbuild the network capabilities needed for the humanspaceflight era. These orbiters could demonstrate thecapabilities and services needed for the future but withoutthe high bandwidth and high reliability requirements neededfor human spaceflight.Telecommunications orbiters of modest size and cost,delivered by Solar Electric Propulsion to areostationaryorbit, could provide continuous access at very high datarates to users on the surface and in Mars orbit. Twoexamples highlighting the wide variety of orbiter deliveryand configuration options were shown that could providehigh-performance service to users.

A Current Analysis of the Treatment of Japanese Americans and Internment in United States History Textbooks

ERIC Educational Resources Information Center

Hawkins, Jeffrey M.; Buckendorf, Michael

2010-01-01

A content analysis of ten United States history textbooks (2005-2008) was conducted by the researchers to determine the current depiction of Japanese Americans and internment during the World War II era. This study updates and expands upon the textbooks used in prior research by Romanowski (1995), Harada (2000), and Ogawa (2004) that had numerous…

Top Down Implementation Plan for system performance test software

NASA Technical Reports Server (NTRS)

Jacobson, G. N.; Spinak, A.

1982-01-01

The top down implementation plan used for the development of system performance test software during the Mark IV-A era is described. The plan is based upon the identification of the hierarchical relationship of the individual elements of the software design, the development of a sequence of functionally oriented demonstrable steps, the allocation of subroutines to the specific step where they are first required, and objective status reporting. The results are: determination of milestones, improved managerial visibility, better project control, and a successful software development.

For First Time in Modern Era, Living with Parents Edges out Other Living Arrangements for 18- to 34-Year-Olds: Share Living with Spouse or Partner Continues to Fall

ERIC Educational Resources Information Center

Fry, Richard

2016-01-01

Broad demographic shifts in marital status, educational attainment and employment have transformed the way young adults in the U.S. are living. This Pew Research Center analysis of census data highlights the implications of these changes for the most basic element of their lives -- where they call home. In 2014, for the first time in more than 130…

Relevance of the immunoglobulin VH somatic mutation status in patients with chronic lymphocytic leukemia treated with fludarabine, cyclophosphamide, and rituximab (FCR) or related chemoimmunotherapy regimens.

PubMed

Lin, Katherine I; Tam, Constantine S; Keating, Michael J; Wierda, William G; O'Brien, Susan; Lerner, Susan; Coombes, Kevin R; Schlette, Ellen; Ferrajoli, Alessandra; Barron, Lynn L; Kipps, Thomas J; Rassenti, Laura; Faderl, Stefan; Kantarjian, Hagop; Abruzzo, Lynne V

2009-04-02

Although immunoglobulin V(H) mutation status (IgV(H) MS) is prognostic in patients with chronic lymphocytic leukemia (CLL) who are treated with alkylating agents or single-agent fludarabine, its significance in the era of chemoimmunotherapy is not known. We determined the IgV(H) somatic mutation status (MS) in 177 patients enrolled in a phase 2 study of fludarabine, cyclophosphamide, and rituximab (FCR) and in 127 patients treated with subsequent chemoimmunotherapy protocols. IgV(H) MS did not impact significantly on the complete remission (CR) rate of patients receiving FCR or related regimens. However, CR duration was significantly shorter in patients with CLL that used unmutated IgV(H) than those whose CLL used mutated IgV(H) (TTP 47% vs 82% at 6 years, P < .001). In a multivariate model considering all baseline characteristics, IgV(H) MS emerged as the only determinant of remission duration (hazard ratio 3.8, P < .001). Our results suggest that postremission interventions should be targeted toward patients with unmutated IgV(H) status.

Inter-device differences in monitoring for goal-directed fluid therapy.

PubMed

Thiele, Robert H; Bartels, Karsten; Gan, Tong-Joo

2015-02-01

Goal-directed fluid therapy is an integral component of many Enhanced Recovery After Surgery (ERAS) protocols currently in use. The perioperative clinician is faced with a myriad of devices promising to deliver relevant physiologic data to better guide fluid therapy. The goal of this review is to provide concise information to enable the clinician to make an informed decision when choosing a device to guide goal-directed fluid therapy. The focus of many devices used for advanced hemodynamic monitoring is on providing measurements of cardiac output, while other, more recent, devices include estimates of fluid responsiveness based on dynamic indices that better predict an individual's response to a fluid bolus. Currently available technologies include the pulmonary artery catheter, esophageal Doppler, arterial waveform analysis, photoplethysmography, venous oxygen saturation, as well as bioimpedance and bioreactance. The underlying mechanistic principles for each device are presented as well as their performance in clinical trials relevant for goal-directed therapy in ERAS. The ERAS protocols typically involve a multipronged regimen to facilitate early recovery after surgery. Optimizing perioperative fluid therapy is a key component of these efforts. While no technology is without limitations, the majority of the currently available literature suggests esophageal Doppler and arterial waveform analysis to be the most desirable choices to guide fluid administration. Their performance is dependent, in part, on the interpretation of dynamic changes resulting from intrathoracic pressure fluctuations encountered during mechanical ventilation. Evolving practice patterns, such as low tidal volume ventilation as well as the necessity to guide fluid therapy in spontaneously breathing patients, will require further investigation.

Making the transition to the third era of natural resources management

USGS Publications Warehouse

Stephenson, Nathan L.

2015-01-01

We are entering the third era of National Park Service (NPS) natural resources management— an era defined by rapid and unprecedented global changes. This third era promises to overturn not only some of our most fundamental assumptions about parks and protected areas, but also many of the ideals we currently hold dear. A common initial reaction to the diverse challenges of this transition is to feel overwhelmed and adrift; I have certainly had such feelings myself. But these feelings carry the risk of reducing our effectiveness as resource stewards right when we can least afford to be less effective: during a transition that is demanding us to be particularly clear-headed and far-seeing. Here I briefly examine some of the challenges of this new era, focusing on those that can most often elicit feelings of discouragement. When we examine the challenges individually, they begin to lose some of their ability to cast gloom—especially when we consider them in the light of lessons from an earlier fundamental transition in NPS natural resources management, beginning a half-century ago. My perspective is shaped by my 35 years as a place-based scientist stationed in a large national park (Sequoia and Kings Canyon), and by my passion for national parks in general. While the discussion that follows is most relevant to large national parks set aside primarily for their natural features, several of the ideas are also relevant to other park units.

Conceptual Design and Structural Optimization of NASA Environmentally Responsible Aviation (ERA) Hybrid Wing Body Aircraft

NASA Technical Reports Server (NTRS)

Quinlan, Jesse R.; Gern, Frank H.

2016-01-01

Simultaneously achieving the fuel consumption and noise reduction goals set forth by NASA's Environmentally Responsible Aviation (ERA) project requires innovative and unconventional aircraft concepts. In response, advanced hybrid wing body (HWB) aircraft concepts have been proposed and analyzed as a means of meeting these objectives. For the current study, several HWB concepts were analyzed using the Hybrid wing body Conceptual Design and structural optimization (HCDstruct) analysis code. HCDstruct is a medium-fidelity finite element based conceptual design and structural optimization tool developed to fill the critical analysis gap existing between lower order structural sizing approaches and detailed, often finite element based sizing methods for HWB aircraft concepts. Whereas prior versions of the tool used a half-model approach in building the representative finite element model, a full wing-tip-to-wing-tip modeling capability was recently added to HCDstruct, which alleviated the symmetry constraints at the model centerline in place of a free-flying model and allowed for more realistic center body, aft body, and wing loading and trim response. The latest version of HCDstruct was applied to two ERA reference cases, including the Boeing Open Rotor Engine Integration On an HWB (OREIO) concept and the Boeing ERA-0009H1 concept, and results agreed favorably with detailed Boeing design data and related Flight Optimization System (FLOPS) analyses. Following these benchmark cases, HCDstruct was used to size NASA's ERA HWB concepts and to perform a related scaling study.

Efforts to standardize wildlife toxicity values remain unrealized.

PubMed

Mayfield, David B; Fairbrother, Anne

2013-01-01

Wildlife toxicity reference values (TRVs) are routinely used during screening level and baseline ecological risk assessments (ERAs). Risk assessment professionals often adopt TRVs from published sources to expedite risk analyses. The US Environmental Protection Agency (USEPA) developed ecological soil screening levels (Eco-SSLs) to provide a source of TRVs that would improve consistency among risk assessments. We conducted a survey and evaluated more than 50 publicly available, large-scale ERAs published in the last decade to evaluate if USEPA's goal of uniformity in the use of wildlife TRVs has been met. In addition, these ERAs were reviewed to understand current practices for wildlife TRV use and development within the risk assessment community. The use of no observed and lowest observed adverse effect levels culled from published compendia was common practice among the majority of ERAs reviewed. We found increasing use over time of TRVs established in the Eco-SSL documents; however, Eco-SSL TRV values were not used in the majority of recent ERAs and there continues to be wide variation in TRVs for commonly studied contaminants (e.g., metals, pesticides, PAHs, and PCBs). Variability in the toxicity values was driven by differences in the key studies selected, dose estimation methods, and use of uncertainty factors. These differences result in TRVs that span multiple orders of magnitude for many of the chemicals examined. This lack of consistency in TRV development leads to highly variable results in ecological risk assessments conducted throughout the United States. Copyright © 2012 SETAC.

Biotechnology Computing: Information Science for the Era of Molecular Medicine.

ERIC Educational Resources Information Center

Masys, Daniel R.

1989-01-01

The evolution from classical genetics to biotechnology, an area of research involving key macromolecules in living cells, is chronicled and the current state of biotechnology is described, noting related advances in computing and clinical medicine. (MSE)

An Empirical Model of Titan's Magnetic Environment During the Cassini Era: Evidence for Seasonal Variability

NASA Astrophysics Data System (ADS)

Simon, S.; Kabanovic, S.; Meeks, Z. C.; Neubauer, F. M.

2017-12-01

Based on the magnetic field data collected during the Cassini era, we construct an empirical model of the ambient magnetospheric field conditions along the orbit of Saturn's largest moon Titan. Observations from Cassini's close Titan flybys as well as 191 non-targeted crossings of Titan's orbit are taken into account. For each of these events we apply the classification technique of Simon et al. (2010) to categorize the ambient magnetospheric field as current sheet, lobe-like, magnetosheath, or an admixture of these regimes. Independent of Saturnian season, Titan's magnetic environment around noon local time is dominated by the perturbed fields of Saturn's broad magnetodisk current sheet. Only observations from the nightside magnetosphere reveal a slow, but steady change of the background field from southern lobe-type to northern lobe-type on a time scale of several years. This behavior is consistent with a continuous change in the curvature of the bowl-shaped magnetodisk current sheet over the course of the Saturnian year. We determine the occurrence rate of each magnetic environment category along Titan's orbit as a function of Saturnian season and local time.

The evolution of personalized cancer genetic counseling in the era of personalized medicine.

PubMed

Vig, Hetal S; Wang, Catharine

2012-09-01

Practice changes in cancer genetic counseling have occurred to meet the demand for cancer genetic services. As cancer genetics continues to impact not only prevention strategies but also treatment decisions, current cancer genetic counseling models will need to be tailored to accommodate emerging clinical indications. These clinical indications include: surgical prophylactic bilateral mastectomy candidates, PARP-inhibitor candidates, patients with abnormal tumor screening results for Lynch syndrome, and post-test counseling patients (after genetic testing is ordered by another healthcare provider). A more personalized, multidisciplinary approach to selecting the best framework, for a given clinical indication, may become increasingly necessary in this era of personalized medicine.

Lessons learned from modern military surgery.

PubMed

Beekley, Alec C; Starnes, Benjamin W; Sebesta, James A

2007-02-01

The era of global terrorism and asymmetric warfare heralded by the September 11, 2001 attacks on the United States have blurred the traditional lines between civilian and military trauma. The lessons learned by physicians in the theaters of war, particularly regarding the response to mass casualties, blast and fragmentation injuries, and resuscitation of casualties in austere environments, likely resonate strongly with civilian trauma surgeons in the current era. The evolution of a streamlined trauma system in the theaters of operations, the introduction of an in-theater institution review board process, and dedicated personnel to collect combat casualty data have resulted in improved data capture and realtime, on-the-scene research.

Spanning the genomics era: the vital role of a single institution biorepository for childhood cancer research over a decade

PubMed Central

Zhou, Li

2015-01-01

The ‘genomics era’ is considered to have begun with the commencement of the Human Genome Project. As translational genomic studies can only be established when human tissue samples are available for analysis, biospecimens are now proven to be an essential element for their success. During the genomics era the necessity for more extensive biobanking infrastructure has been highlighted. With the increased number of genomic studies into cancer, it is considered that the availability of biospecimens will become the rate limiting step. Despite the efforts in international biobanking, translational genomics is hampered when there low numbers of biospecimens for a particular rare diseases and is most apparent for paediatric cancer. As there is a call for biobanking practice to be responsive to the current experimental needs of the time and for more expansive systems of tissue procurement to be established we have asked the question what role does a single institution biorepository play in the current highly networked world of translational genomics. Here we describe such a case. The Tumour Bank at The Children’s Hospital at Westmead (TB-CHW) in the western suburbs of Sydney was formally established in 1998 as a key resource for translational paediatric cancer research. During the genomics era, we show that the TB-CHW has developed into a key biospecimen repository for the cancer research community, during which time it has increasingly found itself having a vital role in the establishment of translational genomics for paediatric cancer. Here we detail metrics that demonstrate how as a single institution biorepository, the TB-CHW has been a strong participant in the advancement of translational genomics throughout the genomics era. This paper describes the significant contribution of a single institutional hospital embedded tumour biobank to the genomic research community. Despite the increased stringencies placed on biobanking practice, the TB-CHW has shown that a single institution biorespository can have a consistent and effective contribution to translational research into rare paediatric malignancy demonstrating its long term benefit throughout the genomics era. PMID:26835365

Anticipation of the Impact of Human Papillomavirus on Clinical Decision Making for the Head and Neck Cancer Patient.

PubMed

Gillison, Maura L; Restighini, Carlo

2015-12-01

Human papillomavirus (HPV) is the cause of a distinct subset of oropharyngeal cancer rising in incidence in the United States and other developed countries. This increased incidence, combined with the strong effect of tumor HPV status on survival, has had a profound effect on the head and neck cancer discipline. The multidisciplinary field of head and neck cancer is in the midst of re-evaluating evidence-based algorithms for clinical decision making, developed from clinical trials conducted in an era when HPV-negative cancer predominated. This article reviews relationships between tumor HPV status and gender, cancer incidence trends, overall survival, treatment response, racial disparities, tumor staging, risk stratification, survival post disease progression, and clinical trial design. Copyright © 2015 Elsevier Inc. All rights reserved.

Developing protocols for recombinant adeno-associated virus-mediated gene therapy in space.

PubMed

Ohi, S

2000-07-01

With the advent of the era of International Space Station (ISS) and Mars exploration, it is important more than ever to develop means to cure genetic and acquired diseases, which include cancer and AIDS, for these diseases hamper human activities. Thus, our ultimate goal is to develop protocols for gene therapy, which are suitable to humans on the earth as well as in space. Specifically, we are trying to cure the hemoglobinopathies, beta-thalassemia (Cooley's anemia) and sickle cell anemia, by gene therapy. These well-characterized molecular diseases serve as models for developing ex vivo gene therapy, which would apply to other disorders as well. For example, the procedure may become directly relevant to treating astronauts for space-anemia, immune suppression and bone marrow derived tumors, e.g. leukemia. The adeno-associated virus serotype 2 (AAV2) is a non-pathogenic human parvovirus with broad host-range and tissue specificity. Exploiting these characteristics we have been developing protocols for recombinant AAV2 (rAAV)-based gene therapy. With the rAAV constructs and hematopoietic stem cell (HSC) culture systems in hand, we are currently attempting to cure the mouse model of beta-thalassemia [C57BL/6- Hbbth/Hbbth, Hb(d-minor)] by HSC transplantation (HST) as well as by gene therapy. This paper describes the current status of our rAAV-gene therapy research.

Eigensystem realization algorithm modal identification experiences with mini-mast

NASA Technical Reports Server (NTRS)

Pappa, Richard S.; Schenk, Axel; Noll, Christopher

1992-01-01

This paper summarizes work performed under a collaborative research effort between the National Aeronautics and Space Administration (NASA) and the German Aerospace Research Establishment (DLR, Deutsche Forschungsanstalt fur Luft- und Raumfahrt). The objective is to develop and demonstrate system identification technology for future large space structures. Recent experiences using the Eigensystem Realization Algorithm (ERA), for modal identification of Mini-Mast, are reported. Mini-Mast is a 20 m long deployable space truss used for structural dynamics and active vibration-control research at the Langley Research Center. A comprehensive analysis of 306 frequency response functions (3 excitation forces and 102 displacement responses) was performed. Emphasis is placed on two topics of current research: (1) gaining an improved understanding of ERA performance characteristics (theory vs. practice); and (2) developing reliable techniques to improve identification results for complex experimental data. Because of nonlinearities and numerous local modes, modal identification of Mini-Mast proved to be surprisingly difficult. Methods were available, ERA, for obtaining detailed, high-confidence results.

A review on the Avicenna's contribution to the field of cardiology.

PubMed

Zarshenas, Mohammad M; Zargaran, Arman

2015-03-01

The cardiology and field of cardiovascular approaches are often mentioned as of the earliest concerns throughout the history of mankind civilization. During the golden ages of Islamic era, 9th to 12th centuries A.D., medical knowledge from various fields including cardiology was flourished by prominent Persian physicians and scholars. Among those outstanding physicians and scientists of the Islamic golden era, Avicenna is known as a famous and pioneer character. To outline the cardiovascular knowledge and contribution of Avicenna, current review compiled all his evidence-based concepts of cardiovascular findings from current medical literatures as well as those mentioned in his important medical encyclopedia, the Canon of Medicine. In this review, Avicenna's findings on cardiovascular anatomy such as his description of Willis circle, capillary circulation and arterial and ventricular contractions in the cardiovascular system have been mentioned. Also, his books and manuscripts on cardiology as well as findings and theories on cardiovascular and allied diseases were discussed. These findings are included in his descriptions on cardiac tamponade, stroke, palpitation, atherosclerosis, hypertension, association of the cardiovascular complications with erection and ejaculation, interaction between the heart and emotions as well as some of his mentioned drugs for cardiological disorders and the early concepts of drug targeting. These results can show Avicenna's great contribution to improve the sciences of cardiology in early medieval era. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Influence of reanalysis datasets on dynamically downscaling the recent past

NASA Astrophysics Data System (ADS)

Moalafhi, Ditiro B.; Evans, Jason P.; Sharma, Ashish

2017-08-01

Multiple reanalysis datasets currently exist that can provide boundary conditions for dynamic downscaling and simulating local hydro-climatic processes at finer spatial and temporal resolutions. Previous work has suggested that there are two reanalyses alternatives that provide the best lateral boundary conditions for downscaling over southern Africa. This study dynamically downscales these reanalyses (ERA-I and MERRA) over southern Africa to a high resolution (10 km) grid using the WRF model. Simulations cover the period 1981-2010. Multiple observation datasets were used for both surface temperature and precipitation to account for observational uncertainty when assessing results. Generally, temperature is simulated quite well, except over the Namibian coastal plain where the simulations show anomalous warm temperature related to the failure to propagate the influence of the cold Benguela current inland. Precipitation tends to be overestimated in high altitude areas, and most of southern Mozambique. This could be attributed to challenges in handling complex topography and capturing large-scale circulation patterns. While MERRA driven WRF exhibits slightly less bias in temperature especially for La Nina years, ERA-I driven simulations are on average superior in terms of RMSE. When considering multiple variables and metrics, ERA-I is found to produce the best simulation of the climate over the domain. The influence of the regional model appears to be large enough to overcome the small difference in relative errors present in the lateral boundary conditions derived from these two reanalyses.

Pyridostigmine bromide and the long-term subjective health status of a sample of over 700 male Reserve Component Gulf War era veterans.

PubMed

Schumm, Walter R; Reppert, Earl J; Jurich, Anthony P; Bollman, Stephan R; Webb, Farrell J; Castelo, Carlos S; Stever, James C; Kaufman, Mark; Deng, Liang-Yu; Krehbiel, Michelle; Owens, Barbara L; Hall, Carolyn A; Brown, Beverlyn F Cay; Lash, Jeanne F; Fink, Carol J; Crow, Janet R; Bonjour, Gabriele N

2002-06-01

Data from a 1996-1997 survey of approximately 700 Reserve Component male veterans indicate that the consumption of pyridostigmine bromide pills, used as a pretreatment for potential exposure to the nerve agent Soman, was a significant predictor of declines in reported subjective health status after the war, even after controlling for a number of other possible factors. Reported reactions to vaccines and other medications also predicted declines in subjective health. While higher military rank generally predicted better health during and after the war, educational attainment, minority status, number of days in theater, and age generally did not predict changes in subjective health. Although servicemembers were directed to take three pills a day, veterans reported a range of compliance--less than a fourth (24%) followed the medical instructions compared to 61% who took fewer than three pills daily and 6% who took six or more pills a day. Implications for use of pyridostigmine bromide are discussed.

Morbidity, mortality, and health care costs for patients undergoing spine surgery following the ACGME resident duty-hour reform: Clinical article.

PubMed

Babu, Ranjith; Thomas, Steven; Hazzard, Matthew A; Lokhnygina, Yuliya V; Friedman, Allan H; Gottfried, Oren N; Isaacs, Robert E; Boakye, Maxwell; Patil, Chirag G; Bagley, Carlos A; Haglund, Michael M; Lad, Shivanand P

2014-10-01

The Accreditation Council for Graduate Medical Education (ACGME) implemented resident duty-hour restrictions on July 1, 2003, in concern for patient and resident safety. Whereas studies have shown that duty-hour restrictions have increased resident quality of life, there have been mixed results with respect to patient outcomes. In this study, the authors have evaluated the effect of duty-hour restrictions on morbidity, mortality, length of stay (LOS), and charges in patients who underwent spine surgery. The Nationwide Inpatient Sample was used to evaluate the effect of duty-hour restrictions on complications, mortality, LOS, and charges by comparing the prereform (2000-2002) and postreform (2005-2008) periods. Outcomes were compared between nonteaching and teaching hospitals using a difference-in-differences (DID) method. Results A total of 693,058 patients were included in the study. The overall complication rate was 8.6%, with patients in the postreform era having a significantly higher rate than those in the pre-duty-hour restriction era (8.7% vs. 8.4%, p < 0.0001). Examination of hospital teaching status revealed complication rates to decrease in nonteaching hospitals (8.2% vs. 7.6%, p < 0.0001) while increasing in teaching institutions (8.6% vs. 9.6%, p < 0.0001) in the duty-hour reform era. The DID analysis to compare the magnitude in change between teaching and nonteaching institutions revealed that teaching institutions to had a significantly greater increase in complications during the postreform era (p = 0.0002). The overall mortality rate was 0.37%, with no significant difference between the pre- and post-duty-hour eras (0.39% vs. 0.36%, p = 0.12). However, the mortality rate significantly decreased in nonteaching hospitals in the postreform era (0.30% vs. 0.23%, p = 0.0008), while remaining the same in teaching institutions (0.46% vs. 0.46%, p = 0.75). The DID analysis to compare the changes in mortality between groups revealed that the difference between the effects approached significance (p = 0.069). The mean LOS for all patients was 4.2 days, with hospital stay decreasing in nonteaching hospitals (3.7 vs. 3.5 days, p < 0.0001) while significantly increasing in teaching institutions (4.7 vs. 4.8 days, p < 0.0001). The DID analysis did not demonstrate the magnitude of change for each group to differ significantly (p = 0.26). Total patient charges were seen to rise significantly in the post-duty-hour reform era, increasing from $40,000 in the prereform era to $69,000 in the postreform era. The DID analysis did not reveal a significant difference between the changes in charges between teaching and nonteaching hospitals (p = 0.55). The implementation of duty-hour restrictions was associated with an increased risk of postoperative complications for patients undergoing spine surgery. Therefore, contrary to its intended purpose, duty-hour reform may have resulted in worse patient outcomes. Additional studies are needed to evaluate strategies to mitigate these effects and assist in the development of future health care policy.

Review of the scientific evidence to support environmental risk assessment of shale gas development in the UK.

PubMed

Prpich, George; Coulon, Frédéric; Anthony, Edward J

2016-09-01

Interest in the development of shale gas resources using hydraulic fracturing techniques is increasing worldwide despite concerns about the environmental risks associated with this activity. In the United Kingdom (UK), early attempts to hydraulically fracture a shale gas well resulted in a seismic event that led to the suspension of all hydraulic fracturing operations. In response to this occurrence, UK regulators have requested that future shale gas operations that use hydraulic fracturing should be accompanied by a high-level environmental risk assessment (ERA). Completion of an ERA can demonstrate competency, communicate understanding, and ultimately build trust that environmental risks are being managed properly, however, this assessment requires a scientific evidence base. In this paper we discuss how the ERA became a preferred assessment technique to understand the risks related to shale gas development in the UK, and how it can be used to communicate information between stakeholders. We also provide a review of the evidence base that describes the environmental risks related to shale gas operations, which could be used to support an ERA. Finally, we conclude with an update of the current environmental risks associated with shale gas development in the UK and present recommendations for further research. Copyright © 2015 Elsevier B.V. All rights reserved.

Organizational climate and culture: Reflections on the history of the constructs in the Journal of Applied Psychology.

PubMed

Schneider, Benjamin; González-Romá, Vicente; Ostroff, Cheri; West, Michael A

2017-03-01

We review the literature on organizational climate and culture paying specific attention to articles published in the Journal of Applied Psychology (JAP) since its first volume in 1917. The article traces the history of the 2 constructs though JAP has been far more important for climate than culture research. We distinguish 4 main periods: the pre-1971 era, with pioneering work on exploring conceptualization and operationalizations of the climate construct; the 1971-1985 era, with foundational work on aggregation issues, outcome-focused climates (on safety and service) and early writings on culture; the 1986-1999 era, characterized by solidification of a focused climate approach to understanding organizational processes (justice, discrimination) and outcomes (safety, service) and the beginnings of survey approaches to culture; and the 2000-2014 era, characterized by multilevel work on climate, climate strength, demonstrated validity for a climate approach to outcomes and processes, and the relationship between leadership and climate and culture. We summarize and comment on the major theory and research achievements in each period, showing trends observed in the literature and how JAP has contributed greatly to moving research on these constructs, especially climate, forward. We also recommend directions for future research given the current state of knowledge. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population

PubMed Central

Äyräväinen, Leena; Leirisalo-Repo, Marjatta; Kuuliala, Antti; Ahola, Kirsi; Koivuniemi, Riitta; Meurman, Jukka H; Heikkinen, Anna Maria

2017-01-01

Objectives To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Design Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. Settings and participants The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Outcome measures Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Results Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem to affect the results. Conclusions Moderate periodontitis was more frequent in patients with RA than in controls. Patients with ERA and CRA exhibited poorer periodontal health parameters when compared with controls. There was no association between antirheumatic treatment and periodontal parameters. PMID:28143836

Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population.

PubMed

Äyräväinen, Leena; Leirisalo-Repo, Marjatta; Kuuliala, Antti; Ahola, Kirsi; Koivuniemi, Riitta; Meurman, Jukka H; Heikkinen, Anna Maria

2017-01-31

To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem to affect the results. Moderate periodontitis was more frequent in patients with RA than in controls. Patients with ERA and CRA exhibited poorer periodontal health parameters when compared with controls. There was no association between antirheumatic treatment and periodontal parameters. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

College Preparatory Mathematics: Change from Within.

ERIC Educational Resources Information Center

Kysh, Judith M.

1995-01-01

The College Preparatory Mathematics: Change from Within Project (CPM) was created to develop a rich, integrated mathematics curriculum, based on the best current wisdom of how people learn and the mathematics needed in an era of computers, and involving teachers in materials development. (MKR)

Branding in children: a barbaric practice still exists in India.

PubMed

Patra, Pratap Kumar

2016-01-01

Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era.

High Prevalence of Echocardiographic Abnormalities among HIV-infected Persons in the Era of Highly Active Antiretroviral Therapy.

PubMed

Mondy, Kristin E; Gottdiener, John; Overton, E Turner; Henry, Keith; Bush, Tim; Conley, Lois; Hammer, John; Carpenter, Charles C; Kojic, Erna; Patel, Pragna; Brooks, John T

2011-02-01

in the era of highly active antiretroviral therapy (HAART), human immunodeficiency virus (HIV)-infected persons have higher cardiovascular disease risk. Little is known about asymptomatic abnormalities in cardiac structure and function in this population. the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN Study) is a prospective, observational, multi-site cohort of 656 HIV-infected participants who underwent baseline echocardiography during 2004-2006. We examined prevalence of and factors associated with left ventricular systolic dysfunction (LVSD), diastolic dysfunction (DD), pulmonary hypertension (PHTN), left ventricular hypertrophy (LVH), and left atrial enlargement (LAE). participant characteristics were as follows: median age, 41 years; 24% women; 29% non-Hispanic black; 73% receiving HAART; and median CD4+ cell count, 462 cells/μL. Among evaluable participants, 18% had LVSD, 26% had DD, 57% had PHTN (right ventricular pressure >30 mm Hg), 6.5% had LVH, and 40% had LAE. In multivariate analyses, significant factors (P < .05) associated with LVSD were history of MI, elevated highly sensitive C-reactive protein (hsCRP) level, and current tobacco smoking; for DD, elevated hsCRP level and hypertension; for PHTN, current use of ritonavir; for LVH, hypertension, diabetes, non-white race, female sex with elevated body mass index, calculated as the weight in kilograms divided by the square of height in meters, of ≥ 25, elevated hsCRP level, and current use of abacavir; for LAE, hypertension and recent marijuana use. in this large contemporary HIV cohort, the prevalence of subclinical functional and structural cardiac abnormalities was greater than expected for age. Abnormalities were mostly associated with expected and often modifiable risks. Lifestyle modification should become a greater priority in the management of chronic HIV disease.

Robotics and the spine: a review of current and ongoing applications.

PubMed

Shweikeh, Faris; Amadio, Jordan P; Arnell, Monica; Barnard, Zachary R; Kim, Terrence T; Johnson, J Patrick; Drazin, Doniel

2014-03-01

Robotics in the operating room has shown great use and versatility in multiple surgical fields. Robot-assisted spine surgery has gained significant favor over its relatively short existence, due to its intuitive promise of higher surgical accuracy and better outcomes with fewer complications. Here, the authors analyze the existing literature on this growing technology in the era of minimally invasive spine surgery. In an attempt to provide the most recent, up-to-date review of the current literature on robotic spine surgery, a search of the existing literature was conducted to obtain all relevant studies on robotics as it relates to its application in spine surgery and other interventions. In all, 45 articles were included in the analysis. The authors discuss the current status of this technology and its potential in multiple arenas of spinal interventions, mainly spine surgery and spine biomechanics testing. There are numerous potential advantages and limitations to robotic spine surgery, as suggested in published case reports and in retrospective and prospective studies. Randomized controlled trials are few in number and show conflicting results regarding accuracy. The present limitations may be surmountable with future technological improvements, greater surgeon experience, reduced cost, improved operating room dynamics, and more training of surgical team members. Given the promise of robotics for improvements in spine surgery and spine biomechanics testing, more studies are needed to further explore the applicability of this technology in the spinal operating room. Due to the significant cost of the robotic equipment, studies are needed to substantiate that the increased equipment costs will result in significant benefits that will justify the expense.

Review article: the gut microbiome in inflammatory bowel disease-avenues for microbial management.

PubMed

McIlroy, J; Ianiro, G; Mukhopadhya, I; Hansen, R; Hold, G L

2018-01-01

The concept of an altered collective gut microbiota rather than identification of a single culprit is possibly the most significant development in inflammatory bowel disease research. We have entered the "omics" era, which now allows us to undertake large-scale/high-throughput microbiota analysis which may well define how we approach diagnosis and treatment of inflammatory bowel disease (IBD) in the future, with a strong steer towards personalised therapeutics. To assess current epidemiological, experimental and clinical evidence of the current status of knowledge relating to the gut microbiome, and its role in IBD, with emphasis on reviewing the evidence relating to microbial therapeutics and future microbiome modulating therapeutics. A Medline search including items 'intestinal microbiota/microbiome', 'inflammatory bowel disease', 'ulcerative colitis', 'Crohn's disease', 'faecal microbial transplantation', 'dietary manipulation' was performed. Disease remission and relapse are associated with microbial changes in both mucosal and luminal samples. In particular, a loss of species richness in Crohn's disease has been widely observed. Existing therapeutic approaches broadly fall into 3 categories, namely: accession, reduction or indirect modulation of the microbiome. In terms of microbial therapeutics, faecal microbial transplantation appears to hold the most promise; however, differences in study design/methodology mean it is currently challenging to elegantly translate results into clinical practice. Existing approaches to modulate the gut microbiome are relatively unrefined. Looking forward, the future of microbiome-modulating therapeutics looks bright with several novel strategies/technologies on the horizon. Taken collectively, it is clear that ignoring the microbiome in IBD is not an option. © 2017 John Wiley & Sons Ltd.

Milestones in chloroplast genetic engineering: an environmentally friendly era in biotechnology.

PubMed

Daniell, Henry; Khan, Muhammad S; Allison, Lori

2002-02-01

Chloroplast genomes defied the laws of Mendelian inheritance at the dawn of plant genetics, and continue to defy the mainstream approach to biotechnology, leading the field in an environmentally friendly direction. Recent success in engineering the chloroplast genome for resistance to herbicides, insects, disease and drought, and for production of biopharmaceuticals, has opened the door to a new era in biotechnology. The successful engineering of tomato chromoplasts for high-level transgene expression in fruits, coupled to hyper-expression of vaccine antigens, and the use of plant-derived antibiotic-free selectable markers, augur well for oral delivery of edible vaccines and biopharmaceuticals that are currently beyond the reach of those who need them most.

[Centennial retrospective on the evolution and development of the nursing profession in Taiwan].

PubMed

Wang, Kwua-Yun; Chang, Shu-Rong

2014-08-01

This article explores the evolution and development of the Taiwanese nursing profession. After introducing the origins of nursing, this article proceeds to introduce nursing during various periods in Taiwan, including the early-Qing Dynasty, foreign missionary nursing, the Japanese Colonial Era, and the Nationalist Chinese Era following World War Two up to the present. The authors then present the current situation in the Taiwanese nursing profession in terms of gender issues, high-technology developments, educational issues, the nursing licensing examination, hiring and training, multiple role functions, and the skill-mix care model. Finally, the authors make recommendations for the further development and improvement of the nursing profession in Taiwan.

Prognostic Factors in Patients With Stemi Undergoing Primary PCI in the Clopidogrel Era: Role of Dual Antiplatelet Therapy at Admission and the Smoking Paradox on Long-Term Outcome.

PubMed

Ciccarelli, Giovanni; Barbato, Emanuele; Golino, Marco; Cimmino, Giovanni; Bartunek, Jozef; Di Serafino, Luigi; Di Girolamo, Domenico; De Bruyne, Bernard; Wijns, William; Golino, Paolo

2017-02-01

Several clinical and laboratory variables have an impact on the prognosis of STEMI patients undergoing PPCI; however, little is known about the role of ongoing DAPT at the time of the event and the smoking status as prognostic factors affecting the outcome of these patients. Seven-hundred and thirteen consecutive STEMI patients undergoing PPCI, admitted to the S. Anna and S. Sebastiano Hospital (Caserta, Italy) and to the OLV Clinic (Aalst, Belgium), between March 2009 and December 2011, were retrospectively enrolled. Rescue PCI was the only exclusion criterion. Primary end-point was the combination of death for all causes, re-infarction, stroke, and target lesion revascularization (TLR). Patients already on DAPT at admission (26.4%) showed a significant increase in the event rate at univariate analysis (HR 2.34, CI 1.62-3.75, P < 0.05), while current smokers (56.5%) had a lower event rate, as compared to non-smokers (HR 0.67, CI 0.46-0.96, P < 0.05). In smoking patients already on DAPT at admission, a lower event rate was observed than in non-smoking patients on DAPT. Although, patients already on DAPT had a higher-risk profile (renal impairment, ongoing statin treatment, ST resolution <50%, and Killip class >1 were more frequently present than in patients not on DAPT), Cox regression analysis confirmed that both DAPT (HR 1.74, 95%CI 1.20-2.53, P < 0.01) and smoking status (HR 0.69, 95%CI 0.48-1.00, P < 0.05) retained their statistical significance, as they and were significantly associated with a worse and a better outcome, respectively, underlying their role as independent prognostic factors. Not being a current smoker and ongoing DAPT at admission, in patients with STEMI undergoing PPCI, represent independent negative prognostic value. © 2016, Wiley Periodicals, Inc.

Branding in children: a barbaric practice still exists in India

PubMed Central

Patra, Pratap Kumar

2016-01-01

Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era. PMID:27217887

Improving Aerosol and Visibility Forecasting Capabilities Using Current and Future Generations of Satellite Observations

DTIC Science & Technology

2015-08-27

and 2) preparing for the post-MODIS/MISR era using the Geostationary Operational Environmental Satellite (GOES). 3. Improve model representations of...meteorological property retrievals. In this study, using collocated data from Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) and Geostationary

Observing Inflationary Reheating

NASA Astrophysics Data System (ADS)

Martin, Jérôme; Ringeval, Christophe; Vennin, Vincent

2015-02-01

Reheating is the epoch which connects inflation to the subsequent hot big-bang phase. Conceptually very important, this era is, however, observationally poorly known. We show that the current Planck satellite measurements of the cosmic microwave background (CMB) anisotropies constrain the kinematic properties of the reheating era for most of the inflationary models. This result is obtained by deriving the marginalized posterior distributions of the reheating parameter for about 200 models of slow-roll inflation. Weighted by the statistical evidence of each model to explain the data, we show that the Planck 2013 measurements induce an average reduction of the posterior-to-prior volume by 40%. Making some additional assumptions on reheating, such as specifying a mean equation of state parameter, or focusing the analysis on peculiar scenarios, can enhance or reduce this constraint. Our study also indicates that the Bayesian evidence of a model can substantially be affected by the reheating properties. The precision of the current CMB data is therefore such that estimating the observational performance of a model now requires incorporating information about its reheating history.

Anthrax Vaccination and Self-reported Symptoms, Functional Status, and Medical Conditions in the National Health Survey of Gulf War Era Veterans and Their Families

DTIC Science & Technology

2003-04-01

botulism, immune globulin , plague, and meningncocu.s). Among the 11,441 Culf War veterans, a total of 4601 Gulf veterans (40.2%)) self-reported (S-R...administered (typhoid, borulinum toxoid, immune globulin , plague, and meningococus). This variable was coded as the sum of the number of vaccines...parametric Wilcoxon signecl- ranks test was used to assess whether the prc\\lalencc in S-R yes group was the same as the prevalcncc in the S-R n o

New developments in reaction theory: preparing for the FRIB era

NASA Astrophysics Data System (ADS)

Nunes, F. M.; Capel, P. C.; Elster, Ch.; Hlophe, L.; Lei, Jin; Li, Weichuan; Lovell, A. E.; Potel, G.; Rotureau, J.; Poxon-Pearson, T.

2018-05-01

This is a brief report on the progress made towards an exact theory for (d,p) on heavy nuclei, which is important to determine neutron capture rates for r-process nuclei. We first discuss the role of core excitation in the framework of Faddeev equations. Following that, we provide the status of the Faddeev theory being developed in the Coulomb basis with separable interactions. We then present some recent developments on nonlocal nucleon optical potentials. Finally, the progress on the theory transfer to the continuum is summarized.

Upper stage alternatives for the shuttle era

NASA Technical Reports Server (NTRS)

1981-01-01

The status and general characteristics of Space Shuttle upper stages now in use or in development, as well as new vehicle possibilities are examined. Upper stage requirements for both civil and Department of Defense missions, categorized generally into near-term (early and mid-1980's), mid-term (late 1980's to mid-1990's), and far-term (late 1990's and beyond) are discussed. Finally, the technical, schedule and cost impact of alternative ways in which these requirements could be met are examined, and a number of conclusions and recommendations are reached.

NASA support for commerce in space - Broadening opportunities

NASA Technical Reports Server (NTRS)

Stone, Barbara A.; Livingston, Candace D.

1989-01-01

The status of the NASA Office of Commercial Program's initiatives to implement the 1988 commercial space policy and expand industrial interest in the commercial development of space in the post-Challenger era is presented. Specific objectives have been developed to capture the drive and creativity of the private sector, for increasing NASA's effectiveness in conducting business with industrial firms, and impacting the commercial space market. An aggressive, comprehensive, and forward-looking program has been defined which provides the type of infrastructure and organization required to bring industry into the mainstream of space activities.

Public sector employment, relative deprivation and happiness in adult urban Chinese employees.

PubMed

Hu, Anning

2013-09-01

The decline in perceived happiness within economic prosperity in Chinese society calls for further examination. In this research, we investigate the effect of employment in public sector work units on perceived happiness through the mediation of economic and social status relative deprivations. In the reform era of China, work unit is still an important mechanism maintaining social inequality, and those working in government/Communist Party agencies and public institutions have advantages of getting access to high wage, comprehensive welfare and the manipulation of administrative public power. Such economic and social status advantages are expected to reduce their relative deprivation and further promote their perceived happiness. Using a nationwide survey data conducted in 2006, we find working in public sector can significantly reduce the odds of experiencing economic relative deprivation, which is further contributive to the improvement of subjective wellbeing.

Review of power requirements for satellite remote sensing systems

NASA Technical Reports Server (NTRS)

Morain, Stanley A.

1988-01-01

The space environment offers a multitude of attributes and opportunities to be used to enhance human life styles and qualities of life for all future generations, worldwide. Among the prospects having immense social as well as economic benefits are earth-observing systems capable of providing near real-time data in such areas as food and fiber production, marine fisheries, ecosystem monitoring, disaster assessment, and global environmental exchanges. The era of Space Station, the Shuttle program, the planned unmanned satellites in both high and low Earth orbit will transfer to operational status what, until now, has been largely research and development proof of concept for remotely sensing Earth's natural and cultural resources. An important aspect of this operational status focuses on the orbital designs and power requirements needed to optimally sense any of these important areas.

Facilitators and barriers of implementing enhanced recovery in colorectal surgery at a safety net hospital: A provider and patient perspective.

PubMed

Alawadi, Zeinab M; Leal, Isabel; Phatak, Uma R; Flores-Gonzalez, Juan R; Holihan, Julie L; Karanjawala, Burzeen E; Millas, Stefanos G; Kao, Lillian S

2016-03-01

Enhanced Recovery After Surgery (ERAS) pathways are known to decrease complications and duration of stay in colorectal surgery patients. However, it is unclear whether an ERAS pathway would be feasible and effective at a safety-net hospital. The aim of this study was to identify local barriers and facilitators before the adoption of an ERAS pathway for patients undergoing colorectal operations at a safety-net hospital. Semistructured interviews were conducted to assess the perceived barriers and facilitators before ERAS adoption. Stratified purposive sampling was used. Interviews were audiotaped, transcribed verbatim, and analyzed using content analysis. Analytic and investigator triangulation were used to establish credibility. Interviewees included 8 anesthesiologists, 5 surgeons, 6 nurses, and 18 patients. Facilitators identified across the different medical professions were (1) feasibility and alignment with current practice, (2) standardization of care, (3) smallness of community, (4) good teamwork and communication, and (5) caring for patients. The barriers were (1) difficulty in adapting to change, (2) lack of coordination between different departments, (3) special needs of a highly comorbid and socioeconomically disadvantaged patient population, (4) limited resources, and (5) rotating residents. Facilitators identified by the patients were (1) welcoming a speedy recovery, (2) being well-cared for and satisfied with treatment, (3) adequate social support, (4) welcoming early mobilization, and (5) effective pain management. The barriers were (1) lack of quiet and private space, (2) need for more patient education and counseling, and (3) unforeseen complications. Although limited hospital resources are perceived as a barrier to ERAS implementation at a safety-net hospital, there is strong support for such pathways and multiple factors were identified that may facilitate change. Inclusion of patient perspectives is critical to identifying challenges and facilitators to implementing ERAS changes focused on optimizing patient perioperative health and outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of Transcatheter Technology on Surgical Aortic Valve Replacement Volume, Outcomes, and Cost.

PubMed

Hawkins, Robert B; Downs, Emily A; Johnston, Lily E; Mehaffey, J Hunter; Fonner, Clifford E; Ghanta, Ravi K; Speir, Alan M; Rich, Jeffrey B; Quader, Mohammed A; Yarboro, Leora T; Ailawadi, Gorav

2017-06-01

Transcatheter aortic valve replacement (TAVR) represents a disruptive technology that is rapidly expanding in use. We evaluated the effect on surgical aortic valve replacement (SAVR) patient selection, outcomes, volume, and cost. A total of 11,565 patients who underwent SAVR, with or without coronary artery bypass grafting (2002 to 2015), were evaluated from the Virginia Cardiac Services Quality Initiative database. Patients were stratified by surgical era: pre-TAVR era (2002 to 2008, n = 5,113), early-TAVR era (2009 to 2011, n = 2,709), and commercial-TAVR era (2012 to 2015, n = 3,743). Patient characteristics, outcomes, and resource utilization were analyzed by univariate analyses. Throughout the study period, statewide SAVR volumes increased with median volumes of pre-TAVR: 722 cases/year, early-TAVR: 892 cases/year, and commercial-TAVR: 940 cases/year (p = 0.005). Implementation of TAVR was associated with declining Society of Thoracic Surgeons predicted risk of mortality among SAVR patients (3.7%, 2.6%, and 2.4%; p < 0.0001), despite increasing rates of comorbid disease. The mortality rate was lowest in the current commercial-TAVR era (3.9%, 4.3%, and 3.2%; p = 0.05), and major morbidity decreased throughout the time period (21.2%, 20.5%, and 15.2%; p < 0.0001). The lowest observed-to-expected ratios for both occurred in the commercial-TAVR era (0.9 and 0.9, respectively). Resource utilization increased generally, including total cost increases from $42,835 to $51,923 to $54,710 (p < 0.0001). At present, SAVR volumes have not been affected by the introduction of TAVR. The outcomes for SAVR continue to improve, potentially due to availability of transcatheter options for high-risk patients. Despite rising costs for SAVR, open approaches still provide a significant cost advantage over TAVR. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Data Analysis of GPM Constellation Satellites-IMERG and ERA-Interim precipitation products over West of Iran

NASA Astrophysics Data System (ADS)

Sharifi, Ehsan; Steinacker, Reinhold; Saghafian, Bahram

2016-04-01

Precipitation is a critical component of the Earth's hydrological cycle. The primary requirement in precipitation measurement is to know where and how much precipitation is falling at any given time. Especially in data sparse regions with insufficient radar coverage, satellite information can provide a spatial and temporal context. Nonetheless, evaluation of satellite precipitation is essential prior to operational use. This is why many previous studies are devoted to the validation of satellite estimation. Accurate quantitative precipitation estimation over mountainous basins is of great importance because of their susceptibility to hazards. In situ observations over mountainous areas are mostly limited, but currently available satellite precipitation products can potentially provide the precipitation estimation needed for meteorological and hydrological applications. One of the newest and blended methods that use multi-satellites and multi-sensors has been developed for estimating global precipitation. The considered data set known as Integrated Multi-satellitE Retrievals (IMERG) for GPM (Global Precipitation Measurement) is routinely produced by the GPM constellation satellites. Moreover, recent efforts have been put into the improvement of the precipitation products derived from reanalysis systems, which has led to significant progress. One of the best and a worldwide used model is developed by the European Centre for Medium Range Weather Forecasts (ECMWF). They have produced global reanalysis daily precipitation, known as ERA-Interim. This study has evaluated one year of precipitation data from the GPM-IMERG and ERA-Interim reanalysis daily time series over West of Iran. IMERG and ERA-Interim yield underestimate the observed values while IMERG underestimated slightly and performed better when precipitation is greater than 10mm. Furthermore, with respect to evaluation of probability of detection (POD), threat score (TS), false alarm ratio (FAR) and probability of false detection (POFD) IMERG yields a better value of POD, TS, FAR and POFD in comparison to era-Interim. Overall, ERA-Interim product produced fewer robust results when compared to IMERG.

Oral Candida colonization and its relation with predisposing factors in HIV-infected children and their uninfected siblings in Brazil: the era of highly active antiretroviral therapy.

PubMed

Cerqueira, Daniella Ferraz; Portela, Maristela Barbosa; Pomarico, Luciana; de Araújo Soares, Rosangela Maria; de Souza, Ivete Pomarico Ribeiro; Castro, Glória Fernanda

2010-02-01

To evaluate predisposing factors such as orofacial manifestations, immunosuppression status and antiretroviral therapy in relation to oral colonization by Candida spp. in Brazilian HIV-infected children and their uninfected siblings in the era of highly active antiretroviral therapy (HAART). Whole stimulated saliva was collected from 65 HIV-infected children (HIV+) and 40 uninfected siblings (HIV-), followed by assessment of orofacial manifestation, caries indexes and the number of cavitated dentinal carious teeth (CDT). The salivary samples were cultured and the colonies were counted. After which they were identified by sugar assimilation and fermentation (API 20C). Data was analyzed using chi-square, Mann-Whitney, Spearman tests and logistic regression. Regarding positive growth, HIV+ presented 80% (52/65) and HIV- 57.5% (23/40) (P = 0.013). Absence of antiretroviral therapy and HAART increased the probability of Candida isolation (P < 0.05). Mean CD4%, immune-status and history of recurrent oral candidiasis (OC) had no influence on Candida isolation. Mixed Candida spp. cultures were observed in HIV+ (40%) and HIV- (52%): C. albicans was more frequently found in both groups, with a higher prevalence in HIV+ (P = 0.05); other non-albicans species were isolated in HIV+ and HIV-. Low prevalence of orofacial manifestations was observed in HIV+ (10.7% of OC). There was an association between means of CDT and Candida growth (P < 0.05) and a positive correlation between number of CDT and Candida cfu-counts in HIV+ and HIV-. Mean CD4% and immune-status had no influence on Candida isolation. Absence of antiretroviral therapy and HAART increased the probability of Candida isolation (P < 0.05). The HIV infected children had a significantly higher prevalence of oral Candida spp. compared to their uninfected siblings. Absence of HAART and presence of dentinal carious teeth increased significantly Candida spp. colonization in these children.

Distribution of Cervical Lymph Node Metastases From Squamous Cell Carcinoma of the Oropharynx in the Era of Risk Stratification Using Human Papillomavirus and Smoking Status.

PubMed

Amsbaugh, Mark J; Yusuf, Mehran; Cash, Elizabeth; Silverman, Craig; Wilson, Elizabeth; Bumpous, Jeffrey; Potts, Kevin; Perez, Cesar; Bert, Robert; Redman, Rebecca; Dunlap, Neal

2016-10-01

To investigate the factors contributing to the clinical presentation of oropharyngeal squamous cell carcinoma (OPSCC) in the era of risk stratification using human papilloma virus (HPV) and smoking status. All patients with OPSCC presenting to our institutional multidisciplinary clinic from January 2009 to June 2015 were reviewed from a prospective database. The patients were grouped as being at low risk, intermediate risk, and high risk in the manner described by Ang et al. Variance in clinical presentation was examined using χ(2), Kruskal-Wallis, Mann-Whitney, and logistic regression analyses. The rates of HPV/p16 positivity (P<.001), never-smoking (P=.016), and cervical lymph node metastases (P=.023) were significantly higher for patients with OPSCC of the tonsil, base of tongue (BOT), or vallecula subsites when compared with pharyngeal wall or palate subsites. Low-risk patients with tonsil, base of tongue, or vallecula primary tumors presented with nodal stage N2a at a much higher than expected frequency (P=.007), and high-risk patients presented with tumor stage T4 at a much higher than expected frequency (P=.003). Patients with BOT primary tumors who were never-smokers were less likely to have clinically involved ipsilateral neck disease than were former smokers (odds ratio 1.8; P=.038). The distribution of cervical lymph node metastases was not associated with HPV/p16 positivity, risk group, or subsite. When these data were compared with those in historical series, no significant differences were seen in the patterns of cervical lymph node metastases for patients with OPSCC. For patients with OPSCC differences in HPV status, smoking history and anatomic subsite were associated with differences in clinical presentation but not with distribution of cervical lymph node metastases. Historical series describing the patterns of cervical lymph node metastases in patients with OPSCC remain clinically relevant. Copyright © 2016 Elsevier Inc. All rights reserved.

Observational status of Tachyon Natural Inflation and reheating

NASA Astrophysics Data System (ADS)

Rashidi, Narges; Nozari, Kourosh; Grøn, Øyvind

2018-05-01

We study observational viability of Natural Inflation with a tachyon field as inflaton. By obtaining the main perturbation parameters in this model, we perform a numerical analysis on the parameter space of the model and in confrontation with 68% and 95% CL regions of Planck2015 data. By adopting a warped background geometry, we find some new constraints on the width of the potential in terms of its height and the warp factor. We show that the Tachyon Natural Inflation in the large width limit recovers the tachyon model with a phi2 potential which is consistent with Planck2015 observational data. Then we focus on the reheating era after inflation by treating the number of e-folds, temperature and the effective equation of state parameter in this era. Since it is likely that the value of the effective equation of state parameter during the reheating era to be in the range 0<= ωeff<= 1/3, we obtain some new constraints on the tensor to scalar ratio, r, as well as the e-folds number and reheating temperature in this Tachyon Natural Inflation model. In particular, we show that a prediction of this model is r<=8/3 δns, where δns is the scalar spectral tilt, δns=1‑ns. In this regard, given that from the Planck2015 data we have δns=0.032 (corresponding to ns=0.968), we get r<= 0.085.

Applied Linguistics in Its Disciplinary Context

ERIC Educational Resources Information Center

Liddicoat, Anthony J.

2010-01-01

Australia's current attempt to develop a process to evaluate the quality of research (Excellence in Research for Australia--ERA) places a central emphasis on the disciplinary organisation of academic work. This disciplinary focus poses particular problems for Applied Linguistics in Australia. This paper will examine Applied Linguistics in relation…

Agricultural diseases on the move early in the third millennium

USDA-ARS?s Scientific Manuscript database

With few exceptions, the diseases that present the greatest risk to food animal production have been largely similar throughout the modern era of veterinary medicine. The current trend of ever - increasing globalization of trade of animals and animal products ensures that agricultural diseases will ...

A General Survey of Qualitative Research Methodology.

ERIC Educational Resources Information Center

Cary, Rick

Current definitions and philosophical foundations of qualitative research are presented; and designs, evaluation methods, and issues in application of qualitative research to education are discussed. The effects of positivism and the post-positivist era on qualitative research are outlined, and naturalist and positivist approaches are contrasted.…

Automated conflict resolution issues

NASA Technical Reports Server (NTRS)

Wike, Jeffrey S.

1991-01-01

A discussion is presented of how conflicts for Space Network resources should be resolved in the ATDRSS era. The following topics are presented: a description of how resource conflicts are currently resolved; a description of issues associated with automated conflict resolution; present conflict resolution strategies; and topics for further discussion.

Teaching Multimedia Data Protection through an International Online Competition

ERIC Educational Resources Information Center

Battisti, F.; Boato, G.; Carli, M.; Neri, A.

2011-01-01

Low-cost personal computers, wireless access technologies, the Internet, and computer-equipped classrooms allow the design of novel and complementary methodologies for teaching digital information security in electrical engineering curricula. The challenges of the current digital information era require experts who are effectively able to…

Today's Higher Education IT Workforce

ERIC Educational Resources Information Center

Bichsel, Jacqueline

2014-01-01

The professionals making up the current higher education IT workforce have been asked to adjust to a culture of increased IT consumerization, more sourcing options, broader interest in IT's transformative potential, and decreased resources. Disruptions that include the bring-your-own-everything era, cloud computing, new management practices,…

The Department of Defense Chemical and Biological Defense Program: An Enabler of the Third Offset Strategy.

PubMed

Roos, Jason; Chue, Calvin; DiEuliis, Diane; Emanuel, Peter

The US Department of Defense (DOD) established programs to defend against chemical and biological weapons 100 years ago because military leaders understood that the operational capability of the US military is diminished when service member health is compromised. These threats to operational readiness can be from an overt attack using chemical and biological threats but may also arise from natural exposures. In the current era of rapidly emerging technologies, adversaries are not only rediscovering chemical and biological weapons; they are also displaying an increased propensity to employ them to cause strategic instability among deployed forces or nations undergoing conflict. The United States's investments in its Chemical and Biological Defense Program (CBDP) can be a critical enabler of the third offset strategy, which is a DOD initiative that seeks to maximize force capability to offset emerging threats. To realize this vision, the CBDP must make fundamental changes in acquiring and employing effective technologies so that enemy use of chemical and biological agents against US assets is no longer a viable option. Maximization of US force health status will provide a strategic advantage over theater opponents more vulnerable to operational degradation from chemical and biological threats.

60 Years of Studying the Earth-Sun System from Space: Explorer 1

NASA Astrophysics Data System (ADS)

Zurbuchen, T.

2017-12-01

The era of space-based observation of the Earth-Sun system initiated with the Explorer-1 satellite has revolutionized our knowledge of the Earth, Sun, and the processes that connect them. The space-based perspective has not only enabled us to achieve a fundamentally new understanding of our home planet and the star that sustains us, but it has allowed for significant improvements in predictive capability that serves to protect life, health, and property. NASA has played a leadership role in the United States in creating both the technology and science that has enabled and benefited from these new capabilities, and works closely with partner agencies and around the world to synergistically address these global challenges which are of sufficient magnitude that no one nation or organization can address on their own. Three areas are at the heart of NASA's comprehensive science program: Discovering the secrets of the universe, searching for life elsewhere, and safeguarding and improving life on Earth. Together, these tenets will help NASA lead on a civilization scale. In this talk, a review of these 60 years of advances, a status of current activities, and thoughts about their evolution into the future will be presented.

Electronic Diaries: Appraisal and Current Status

PubMed Central

Broderick, Joan E.

2009-01-01

The recent explosion of technology has moved the field of patient reported outcomes (PROs) into a new era. Use of paper-and-pencil questionnaires administered before and after treatment has been eclipsed by highly sophisticated random prompts for symptom ratings at multiple points throughout the day, a method known as ecological momentary assessment (EMA). During the last 25 years, research has demonstrated that retrospective ratings are subject to a variety of cognitive heuristics that can distort the report. Initially, this was addressed by adopting paper diary protocols involving multiple ratings in a day or across a week. Technology was also advancing, and some researchers began to utilize electronic platforms for EMA assessment. A good deal of research has been conducted comparing paper and electronic formats. Issues of compliance have been particularly problematic for paper diaries. Electronic technologies can be expensive and require expertise in programming and data management. Not all research questions will require intensive momentary assessment, and end-of-day ratings may be adequate for many applications. What is required of the investigator is familiarity with the strengths and weaknesses of the methods and platforms available as well as a reasoned decision to elect a particular methodology for the study question at hand. PMID:20037672

The MPO system for automatic workflow documentation

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

Abla, G.; Coviello, E. N.; Flanagan, S. M.

Data from large-scale experiments and extreme-scale computing is expensive to produce and may be used for critical applications. However, it is not the mere existence of data that is important, but our ability to make use of it. Experience has shown that when metadata is better organized and more complete, the underlying data becomes more useful. Traditionally, capturing the steps of scientific workflows and metadata was the role of the lab notebook, but the digital era has resulted instead in the fragmentation of data, processing, and annotation. Here, this article presents the Metadata, Provenance, and Ontology (MPO) System, the softwaremore » that can automate the documentation of scientific workflows and associated information. Based on recorded metadata, it provides explicit information about the relationships among the elements of workflows in notebook form augmented with directed acyclic graphs. A set of web-based graphical navigation tools and Application Programming Interface (API) have been created for searching and browsing, as well as programmatically accessing the workflows and data. We describe the MPO concepts and its software architecture. We also report the current status of the software as well as the initial deployment experience.« less

The MPO system for automatic workflow documentation

DOE PAGES

Abla, G.; Coviello, E. N.; Flanagan, S. M.; ...

2016-04-18

Data from large-scale experiments and extreme-scale computing is expensive to produce and may be used for critical applications. However, it is not the mere existence of data that is important, but our ability to make use of it. Experience has shown that when metadata is better organized and more complete, the underlying data becomes more useful. Traditionally, capturing the steps of scientific workflows and metadata was the role of the lab notebook, but the digital era has resulted instead in the fragmentation of data, processing, and annotation. Here, this article presents the Metadata, Provenance, and Ontology (MPO) System, the softwaremore » that can automate the documentation of scientific workflows and associated information. Based on recorded metadata, it provides explicit information about the relationships among the elements of workflows in notebook form augmented with directed acyclic graphs. A set of web-based graphical navigation tools and Application Programming Interface (API) have been created for searching and browsing, as well as programmatically accessing the workflows and data. We describe the MPO concepts and its software architecture. We also report the current status of the software as well as the initial deployment experience.« less

Are the Origins of Precision Medicine Found in the Corpus Hippocraticum?

PubMed

Konstantinidou, Meropi K; Karaglani, Makrina; Panagopoulou, Maria; Fiska, Aliki; Chatzaki, Ekaterini

2017-12-01

Precision medicine (PM) is currently placed at the center of global attention following decades of research towards the improvement of medical practice. The subject of this study was to examine whether this trend had emerged earlier, in fact if the fundamentals of PM can be traced back to the ancient Greek era. For this reason, we studied the collection of all the Hippocratic texts, called the Corpus Hippocraticum, using original translations, and attempted an interpretation of the ancient authors in the context of the modern concept of PM. The most important points located in the ancient passages were: (1) medicine in not 'absolute', thus its directions cannot be generalized to everybody, (2) each human body/organism is different and responds differently to therapy; therefore, the same treatment cannot be suitable for everybody and (3) the physician should choose the appropriate treatment, depending on the patients' individual characteristics, such as different health status and life style (activities, diet, etc.). Although the ancient 'precision medicine' is different from its modern description, the latter derived from well-established experimental conclusions, it becomes apparent that there is a common conception, aiming to achieve more effective healing by focusing on the individual.

No wisdom in the crowd: genome annotation in the era of big data - current status and future prospects.

PubMed

Danchin, Antoine; Ouzounis, Christos; Tokuyasu, Taku; Zucker, Jean-Daniel

2018-07-01

Science and engineering rely on the accumulation and dissemination of knowledge to make discoveries and create new designs. Discovery-driven genome research rests on knowledge passed on via gene annotations. In response to the deluge of sequencing big data, standard annotation practice employs automated procedures that rely on majority rules. We argue this hinders progress through the generation and propagation of errors, leading investigators into blind alleys. More subtly, this inductive process discourages the discovery of novelty, which remains essential in biological research and reflects the nature of biology itself. Annotation systems, rather than being repositories of facts, should be tools that support multiple modes of inference. By combining deduction, induction and abduction, investigators can generate hypotheses when accurate knowledge is extracted from model databases. A key stance is to depart from 'the sequence tells the structure tells the function' fallacy, placing function first. We illustrate our approach with examples of critical or unexpected pathways, using MicroScope to demonstrate how tools can be implemented following the principles we advocate. We end with a challenge to the reader. © 2018 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

Suicidal Ideation and Mental Distress Among Adults With Military Service History: Results From 5 US States, 2010

PubMed Central

Gordon, Adam J.; Bossarte, Robert M.

2014-01-01

Objectives. We examined the association of military service history with past-year suicidal ideation and past-30-days mental distress in a probability-based sample of adults. Methods. We gathered 2010 Behavioral Risk Factor Surveillance System data from 5 states that asked about past-year suicidal ideation. Military service was defined as current or former active-duty service or National Guard or Reserves service. We stratified analyses into 18 to 39 years, 40 to 64 years, and 65 years and older age groups and used multiple logistic regression analyses, adjusted for demographic confounders, to discern the association of military service history with past-year suicidal ideation and past-30-days mental distress. Results. Among the 26 736 respondents, 13.1% indicated military service history. After adjusting for several confounders, we found military history status among those aged 40 to 64 years was associated with both past-year suicidal ideation and past-30-days mental distress. We found no significant associations among the younger or older age groups. Conclusions. Differences in suicidal ideation between military and nonmilitary individuals may occur in midlife. Future research should examine the possibility of cohort effects, service era effects, or both. PMID:25100426

Speciation genetics: current status and evolving approaches

PubMed Central

Wolf, Jochen B. W.; Lindell, Johan; Backström, Niclas

2010-01-01

The view of species as entities subjected to natural selection and amenable to change put forth by Charles Darwin and Alfred Wallace laid the conceptual foundation for understanding speciation. Initially marred by a rudimental understanding of hereditary principles, evolutionists gained appreciation of the mechanistic underpinnings of speciation following the merger of Mendelian genetic principles with Darwinian evolution. Only recently have we entered an era where deciphering the molecular basis of speciation is within reach. Much focus has been devoted to the genetic basis of intrinsic postzygotic isolation in model organisms and several hybrid incompatibility genes have been successfully identified. However, concomitant with the recent technological advancements in genome analysis and a newfound interest in the role of ecology in the differentiation process, speciation genetic research is becoming increasingly open to non-model organisms. This development will expand speciation research beyond the traditional boundaries and unveil the genetic basis of speciation from manifold perspectives and at various stages of the splitting process. This review aims at providing an extensive overview of speciation genetics. Starting from key historical developments and core concepts of speciation genetics, we focus much of our attention on evolving approaches and introduce promising methodological approaches for future research venues. PMID:20439277

Pharmacogenetics and breast cancer management: current status and perspectives.

PubMed

Ciccolini, Joseph; Fanciullino, Raphaelle; Serdjebi, Cindy; Milano, Gérard

2015-05-01

Breast cancer has benefited from a number of innovative therapeutics over the last decade. Cytotoxics, hormone therapy, targeted therapies and biologics can now be given to ensure optimal management of patients. As life expectancy of breast cancer patients has been significantly stretched and that several lines of treatment are now made available, determining the best drug or drug combinations to be primarily given and the best dosing and scheduling for each patient is critical for ensuring an optimal toxicity/efficacy balance. Defining patient's characteristics at the tumor level (pharmacogenomics) and the constitutional level (pharmacogenetics) is a rising trend in oncology. This review covers the latest strategies based upon the search of relevant biomarkers for efficacy, resistance and toxicity to be undertaken at the bedside to shift towards precision medicine in breast cancer patients. In the expanding era of bioguided medicine, identifying relevant and clinically validated biomarkers from the plethora of published material remains an uneasy task. Sorting the variety of genetic and molecular markers that have been investigated over the last decade on their level of evidence and addressing the issue of drug exposure should help to improve the management of breast cancer therapy.

Design and development of synthetic microbial platform cells for bioenergy

PubMed Central

Lee, Sang Jun; Lee, Sang-Jae; Lee, Dong-Woo

2013-01-01

The finite reservation of fossil fuels accelerates the necessity of development of renewable energy sources. Recent advances in synthetic biology encompassing systems biology and metabolic engineering enable us to engineer and/or create tailor made microorganisms to produce alternative biofuels for the future bio-era. For the efficient transformation of biomass to bioenergy, microbial cells need to be designed and engineered to maximize the performance of cellular metabolisms for the production of biofuels during energy flow. Toward this end, two different conceptual approaches have been applied for the development of platform cell factories: forward minimization and reverse engineering. From the context of naturally minimized genomes,non-essential energy-consuming pathways and/or related gene clusters could be progressively deleted to optimize cellular energy status for bioenergy production. Alternatively, incorporation of non-indigenous parts and/or modules including biomass-degrading enzymes, carbon uptake transporters, photosynthesis, CO2 fixation, and etc. into chassis microorganisms allows the platform cells to gain novel metabolic functions for bioenergy. This review focuses on the current progress in synthetic biology-aided pathway engineering in microbial cells and discusses its impact on the production of sustainable bioenergy. PMID:23626588

Metabolomics for Plant Improvement: Status and Prospects

PubMed Central

Kumar, Rakesh; Bohra, Abhishek; Pandey, Arun K.; Pandey, Manish K.; Kumar, Anirudh

2017-01-01

Post-genomics era has witnessed the development of cutting-edge technologies that have offered cost-efficient and high-throughput ways for molecular characterization of the function of a cell or organism. Large-scale metabolite profiling assays have allowed researchers to access the global data sets of metabolites and the corresponding metabolic pathways in an unprecedented way. Recent efforts in metabolomics have been directed to improve the quality along with a major focus on yield related traits. Importantly, an integration of metabolomics with other approaches such as quantitative genetics, transcriptomics and genetic modification has established its immense relevance to plant improvement. An effective combination of these modern approaches guides researchers to pinpoint the functional gene(s) and the characterization of massive metabolites, in order to prioritize the candidate genes for downstream analyses and ultimately, offering trait specific markers to improve commercially important traits. This in turn will improve the ability of a plant breeder by allowing him to make more informed decisions. Given this, the present review captures the significant leads gained in the past decade in the field of plant metabolomics accompanied by a brief discussion on the current contribution and the future scope of metabolomics to accelerate plant improvement. PMID:28824660

Genetic transformation of fruit trees: current status and remaining challenges.

PubMed

Gambino, Giorgio; Gribaudo, Ivana

2012-12-01

Genetic transformation has emerged as a powerful tool for genetic improvement of fruit trees hindered by their reproductive biology and their high levels of heterozygosity. For years, genetic engineering of fruit trees has focussed principally on enhancing disease resistance (against viruses, fungi, and bacteria), although there are few examples of field cultivation and commercial application of these transgenic plants. In addition, over the years much work has been performed to enhance abiotic stress tolerance, to induce modifications of plant growth and habit, to produce marker-free transgenic plants and to improve fruit quality by modification of genes that are crucially important in the production of specific plant components. Recently, with the release of several genome sequences, studies of functional genomics are becoming increasingly important: by modification (overexpression or silencing) of genes involved in the production of specific plant components is possible to uncover regulatory mechanisms associated with the biosynthesis and catabolism of metabolites in plants. This review focuses on the main advances, in recent years, in genetic transformation of the most important species of fruit trees, devoting particular attention to functional genomics approaches and possible future challenges of genetic engineering for these species in the post-genomic era.

Challenges, coping strategies, and recommendations related to the HIV services field in the HAART era: a systematic literature review of qualitative studies from the United States and Canada.

PubMed

Kerr, Zachary Y; Miller, Katye R; Galos, Dylan; Love, Randi; Poole, Charles

2013-02-01

Qualitative research methods have been utilized to study the nature of work in the HIV services field. Yet current literature lacks a Highly Active Anti-Retroviral Treatment (HAART) era compendium of qualitative research studying challenges and coping strategies in the field. This study systematically reviewed challenges and coping strategies that qualitative researchers observed in the HIV services field during the HAART era, and their recommendations to organizations. Four online databases were searched for peer-reviewed research that utilized qualitative methods, were published from January 1998 to February 2012, utilized samples of individuals in the HIV services field; occurred in the U.S. or Canada, and contained information related to challenges and/or coping strategies. Abstracts were identified (n=846) and independently read and coded for inclusion by at least two of the four first authors. Identified articles (n=26) were independently read by at least two of the four first authors who recorded the study methodology, participant demographics, challenges and coping strategies, and recommendations. A number of challenges affecting those in the HIV services field were noted, particularly interpersonal and organizational issues. Coping strategies were problem- and emotion-focused. Summarized research recommendations called for increased support, capacity-building, and structural changes. Future research on challenges and coping strategies must provide up-to-date information to the HIV services field while creating, implementing, and evaluating interventions to manage current challenges and reduce the risk of burnout.

Verbal Memory Declines More Rapidly with Age in HIV Infected versus Uninfected Adults

PubMed Central

Seider, Talia R.; Luo, Xi; Gongvatana, Assawin; Devlin, Kathryn N.; de la Monte, Suzanne M.; Chasman, Jesse D.; Yan, Peisi; Tashima, Karen T.; Navia, Bradford; Cohen, Ronald A.

2015-01-01

Objectives In the current era of effective antiretroviral treatment, the number of older adults living with HIV is rapidly increasing. This study investigated the combined influence of age and HIV infection on longitudinal changes in verbal and visuospatial learning and memory. Methods In this longitudinal, case-control design, 54 HIV seropositive and 30 seronegative individuals aged 40–74 received neurocognitive assessments at baseline visits and again one year later. Assessment included tests of verbal and visuospatial learning and memory. Linear regression was used to predict baseline performance and longitudinal change on each test using HIV serostatus, age, and their interaction as predictors. MANOVA was used to assess the effects of these predictors on overall baseline performance and overall longitudinal change. Results The interaction of HIV and age significantly predicted longitudinal change in verbal memory performance, as did HIV status, indicating that although the seropositive group declined more than the seronegative group overall, the rate of decline depended on age such that greater age was associated with a greater decline in this group. The regression models for visuospatial learning and memory were significant at baseline, but did not predict change over time. HIV status significantly predicted overall baseline performance and overall longitudinal change. Conclusions This is the first longitudinal study focused on the effects of age and HIV on memory. Findings suggest that age and HIV interact to produce larger declines in verbal memory over time. Further research is needed to gain a greater understanding of the effects of HIV on the aging brain. PMID:24645772

Effect of obesity and lifestyle on the oral health of pre adolescent children.

PubMed

Anand, Nithya; Suresh, M; Chandrasekaran, S C

2014-02-01

Worldwide estimates of childhood obesity are as high as 43 million, and rates continue to increase each year. Childhood obesity is a growing problem in the present era and it causes serious consequences in the later years. In today's society, electronic media have been thoroughly integrated into the fabric of life, with television, video games, and computers being central to both work and play. While these media outlets can provide education and entertainment to children, many researches are concerned with the negative impact of electronic media on children. The current study aimed to evaluate the correlation, as to how oral hygiene and periodontal health were influenced by obesity and lifestyle factors, among pre-adolescents of ages of 9-12 years. This study was conducted in schools located around Velachery, Chennai, India. A total of 426 children of age group of 9-12 years were selected. Information on their socio-economic, dietary, oral health statuses and time spent in leisure activities were assessed by using a questionnaire, followed by BMI estimation and these variables were correlated with their oral hygiene statuses. The prevalence of poor oral hygiene and poor dietary habits was observed in children who spent more time in watching television, playing videogames and using computer. Good oral hygiene was observed in children who had visited dentists in the past. There is a strong association of lifestyle factors with oral hygiene in pre-adolescent children. Sedentary lifestyle, with more leisure activities, has a negative impact on the oral health of children.

Exerciser for rehabilitation of the Arm (ERA): Development and unique features of a 3D end-effector robot.

PubMed

Milot, Marie-Helene; Hamel, Mathieu; Provost, Philippe-Olivier; Bernier-Ouellet, Julien; Dupuis, Maxime; Letourneau, Dominic; Briere, Simon; Michaud, Francois

2016-08-01

Stroke is one of the leading causes of disability worldwide. Consequently, many stroke survivors exhibit difficulties undergoing voluntary movement in their affected upper limb, compromising their functional performance and level of independence. To minimize the negative impact of stroke disabilities, exercises are recognized as a key element in post-stroke rehabilitation. In order to provide the practice of exercises in a uniform and controlled manner as well as increasing the efficiency of therapists' interventions, robotic training has been found, and continues to prove itself, as an innovative intervention for post-stroke rehabilitation. However, the complexity as well as the limited degrees of freedom and workspace of currently commercially available robots can limit their use in clinical settings. Up to now, user-friendly robots covering a sufficiently large workspace for training of the upper limb in its full range of motion are lacking. This paper presents the design and implementation of ERA, an upper-limb 3-DOF force-controlled exerciser robot, which presents a workspace covering the entire range of motion of the upper limb. The ERA robot provides 3D reaching movements in a haptic virtual environment. A description of the hardware and software components of the ERA robot is also presented along with a demonstration of its capabilities in one of the three operational modes that were developed.

Differences in Rhodococcus equi Infections Based on Immune Status and Antibiotic Susceptibility of Clinical Isolates in a Case Series of 12 Patients and Cases in the Literature

PubMed Central

Suzuki, Yasuhiro; Ribes, Julie A.; Thornton, Alice

2016-01-01

Rhodococcus equi is an unusual zoonotic pathogen that can cause life-threatening diseases in susceptible hosts. Twelve patients with R. equi infection in Kentucky were compared to 137 cases reported in the literature. Although lungs were the primary sites of infection in immunocompromised patients, extrapulmonary involvement only was more common in immunocompetent patients (P < 0.0001). Mortality in R. equi-infected HIV patients was lower in the HAART era (8%) than in pre-HAART era (56%) (P < 0.0001), suggesting that HAART improves prognosis in these patients. Most (85–100%) of clinical isolates were susceptible to vancomycin, clarithromycin, rifampin, aminoglycosides, ciprofloxacin, and imipenem. Interestingly, there was a marked difference in susceptibility of the isolates to cotrimoxazole between Europe (35/76) and the US (15/15) (P < 0.0001). Empiric treatment of R. equi infection should include a combination of two antibiotics, preferably selected from vancomycin, imipenem, clarithromycin/azithromycin, ciprofloxacin, rifampin, or cotrimoxazole. Local antibiograms should be checked prior to using cotrimoxazole due to developing resistance. PMID:27631004

Testing the limits of Rodent Sperm Analysis: azoospermia in an otherwise healthy wild rodent population.

PubMed

Tannenbaum, Lawrence V; Thran, Brandolyn H; Willams, Keith J

2009-01-01

By comparing the sperm parameters of small rodents trapped at contaminated terrestrial sites and nearby habitat-matched noncontaminated locations, the patent-pending Rodent Sperm Analysis (RSA) method provides a direct health status appraisal for the maximally chemical-exposed mammalian ecological receptor in the wild. RSA outcomes have consistently allowed for as definitive determinations of receptor health as are possible at the present time, thereby streamlining the ecological risk assessment (ERA) process. Here, we describe the unanticipated discovery, at a contaminated US EPA Superfund National Priorities List site, of a population of Hispid cotton rats (Sigmodon hispidus), with a high percentage of adult males lacking sperm entirely (azoospermia). In light of the RSA method's role in streamlining ERAs and in bringing contaminated Superfund-type site investigations to closure, we consider the consequences of the discovery. The two matters specifically discussed are (1) the computation of a population's average sperm count where azoospermia is present and (2) the merits of the RSA method and its sperm parameter thresholds-for-effect when azoospermia is masked in an otherwise apparently healthy rodent population.

Prolonged Exposure Therapy for Combat-Related Posttraumatic Stress Disorder: Comparing Outcomes for Veterans of Different Wars

PubMed Central

Yoder, Matthew; Tuerk, Peter W.; Price, Matthew; Grubaugh, Anouk L.; Strachan, Martha; Myrick, Hugh; Acierno, Ron

2012-01-01

There is significant support for exposure therapy as an effective treatment for posttraumatic stress disorder (PTSD) across a variety of populations, including veterans; however, there is little empirical information regarding how veterans of different war theaters respond to exposure therapy. Accordingly, questions remain regarding therapy effectiveness for treatment of PTSD for veterans of different eras. Such questions have important implications for the dissemination of evidence based treatments, treatment development, and policy. The current study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in Prolonged Exposure (PE) treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Persian Gulf veterans did not respond to treatment at the same rate or to the same degree as veterans from the other two eras. Questions and issues regarding the effectiveness of evidence based treatment for veterans from different eras are discussed. PMID:22449084

Prolonged exposure therapy for combat-related posttraumatic stress disorder: comparing outcomes for veterans of different wars.

PubMed

Yoder, Matthew; Tuerk, Peter W; Price, Matthew; Grubaugh, Anouk L; Strachan, Martha; Myrick, Hugh; Acierno, Ron

2012-02-01

There is significant support for exposure therapy as an effective treatment for posttraumatic stress disorder (PTSD) across a variety of populations, including veterans; however, there is little empirical information regarding how veterans of different war theaters respond to exposure therapy. Accordingly, questions remain regarding therapy effectiveness for treatment of PTSD for veterans of different eras. Such questions have important implications for the dissemination of evidence based treatments, treatment development, and policy. The current study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in prolonged exposure (PE) treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Persian Gulf veterans did not respond to treatment at the same rate or to the same degree as veterans from the other two eras. Questions and issues regarding the effectiveness of evidence based treatment for veterans from different eras are discussed.

Excess mortality among 10-year survivors of classical Hodgkin lymphoma in adolescents and young adults.

PubMed

Xavier, Ana C; Epperla, Narendranath; Taub, Jeffrey W; Costa, Luciano J

2018-02-01

Adolescents and young adults (AYA) surviving classical Hodgkin lymphoma (cHL) risk long term fatal treatment-related toxicities. We utilized the Surveillance, Epidemiology and End Results (SEER) program to compare excess mortality rate (EMR-observed minus expected mortality) for 10-year survivors of AYA cHL diagnosed in 1973-1992 and 1993-2003 eras. The 15-year EMR reduced from 4.88% to 2.19% while the 20-year EMR reduced from 9.46% to 4.07% between eras. Survivors of stages 1-2 had lower EMR than survivors of stages 3-4 cHL in the 1993-2003 but not in the 1973-1992 era. There was an overall decline in risk of death between 10 and 15 years from diagnosis, driven mostly by second neoplasms and cardiovascular mortality. Despite reduction in fatal second neoplasms and cardiovascular disease with more current therapy, long term survivors of AYA cHL still have a higher risk of death than the general population highlighting the need for safer therapies. © 2017 Wiley Periodicals, Inc.

Integrated presentation of ecological risk from multiple stressors

NASA Astrophysics Data System (ADS)

Goussen, Benoit; Price, Oliver R.; Rendal, Cecilie; Ashauer, Roman

2016-10-01

Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk. Key components include environmental scenarios that integrate exposure and ecology, and ecological modelling of relevant endpoints to assess the effect of a combination of stressors. Our illustrative results demonstrate the importance of regional differences in environmental conditions and the confounding interactions of stressors. Using this framework and prevalence plots provides a risk-based approach that combines risk assessment and risk management in a meaningful way and presents a truly mechanistic alternative to the threshold approach. Even whilst research continues to improve the underlying models and data, regulators and decision makers can already use the framework and prevalence plots. The integration of multiple stressors, environmental conditions and variability makes ERA more relevant and realistic.

Radionuclide Myocardial Perfusion Imaging for the Evaluation of Patients With Known or Suspected Coronary Artery Disease in the Era of Multimodality Cardiovascular Imaging

PubMed Central

Taqueti, Viviany R.; Di Carli, Marcelo F.

2018-01-01

Over the last several decades, radionuclide myocardial perfusion imaging (MPI) with single photon emission tomography and positron emission tomography has been a mainstay for the evaluation of patients with known or suspected coronary artery disease (CAD). More recently, technical advances in separate and complementary imaging modalities including coronary computed tomography angiography, computed tomography perfusion, cardiac magnetic resonance imaging, and contrast stress echocardiography have expanded the toolbox of diagnostic testing for cardiac patients. While the growth of available technologies has heralded an exciting era of multimodality cardiovascular imaging, coordinated and dispassionate utilization of these techniques is needed to implement the right test for the right patient at the right time, a promise of “precision medicine.” In this article, we review the maturing role of MPI in the current era of multimodality cardiovascular imaging, particularly in the context of recent advances in myocardial blood flow quantitation, and as applied to the evaluation of patients with known or suspected CAD. PMID:25770849

Integrated presentation of ecological risk from multiple stressors.

PubMed

Goussen, Benoit; Price, Oliver R; Rendal, Cecilie; Ashauer, Roman

2016-10-26

Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk. Key components include environmental scenarios that integrate exposure and ecology, and ecological modelling of relevant endpoints to assess the effect of a combination of stressors. Our illustrative results demonstrate the importance of regional differences in environmental conditions and the confounding interactions of stressors. Using this framework and prevalence plots provides a risk-based approach that combines risk assessment and risk management in a meaningful way and presents a truly mechanistic alternative to the threshold approach. Even whilst research continues to improve the underlying models and data, regulators and decision makers can already use the framework and prevalence plots. The integration of multiple stressors, environmental conditions and variability makes ERA more relevant and realistic.

Personalized Medicine in a New Genomic Era: Ethical and Legal Aspects.

PubMed

Shoaib, Maria; Rameez, Mansoor Ali Merchant; Hussain, Syed Ather; Madadin, Mohammed; Menezes, Ritesh G

2017-08-01

The genome of two completely unrelated individuals is quite similar apart from minor variations called single nucleotide polymorphisms which contribute to the uniqueness of each and every person. These single nucleotide polymorphisms are of great interest clinically as they are useful in figuring out the susceptibility of certain individuals to particular diseases and for recognizing varied responses to pharmacological interventions. This gives rise to the idea of 'personalized medicine' as an exciting new therapeutic science in this genomic era. Personalized medicine suggests a unique treatment strategy based on an individual's genetic make-up. Its key principles revolve around applied pharmaco-genomics, pharmaco-kinetics and pharmaco-proteomics. Herein, the ethical and legal aspects of personalized medicine in a new genomic era are briefly addressed. The ultimate goal is to comprehensively recognize all relevant forms of genetic variation in each individual and be able to interpret this information in a clinically meaningful manner within the ambit of ethical and legal considerations. The authors of this article firmly believe that personalized medicine has the potential to revolutionize the current landscape of medicine as it makes its way into clinical practice.

21 CFR 210.1 - Status of current good manufacturing practice regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice regulations...

The Business of Education

ERIC Educational Resources Information Center

Barron, Michael

2012-01-01

This article is a response to John Silber's article, "Marketing Higher Education: The Survival Value of Integrity." Silber speaks to the very heart of the academy about its integrity and ethics, and does so in timeless fashion through the decades to the current era. In his introduction, he characterizes the "business of education" as inevitable…

The Sun in Time

NASA Technical Reports Server (NTRS)

Adams, Mitzi L.

1998-01-01

The presentation will include slides and documentation concerning archaeological sites where observations of the Sun may have taken place, as well as a discussion of the role the Sun played in the lives of the ancients. We will complete our discussion by contrasting ancient ideas of the Sun with those of the current era.

Disabled Student Access in an Era of Technology.

ERIC Educational Resources Information Center

Wall, Patricia S.; Sarver, Lee

2003-01-01

Advocates for disabled students now assert that the Americans with Disabilities Act of 1990 (ADA) and the Rehabilitation Act of 1973, which prohibit discrimination against students with disabilities at public and private universities, also require accommodation for Web-based instruction. This article reviews some of the laws and current issues…

Sticky IT Workers: Discovering Why Information Technology Professionals Retain Their Employers

ERIC Educational Resources Information Center

Lewis, Phillip Mike

2013-01-01

In the current business climate and social technologies expansion era, Information Technology (IT) workers are important organization contributors that connect organizations into today's data-driven, highly social, and always-on global economy. Thus, organizations need IT workers. Unfortunately, as a class, IT workers have developed a reputation…

A New Era in Admissions. Focus 7, 1980.

ERIC Educational Resources Information Center

Westoff, Leslie Aldridge

1980-01-01

In this issue on admissions in colleges and universities, the history of the admissions process and trends are outlined, and the current situation of declining enrollments reviewed. The place of testing is discussed briefly, and other factors in selection listed: student background (educational, extracurricular, and ethnic), and student…

o'Peer: open peer review

NASA Astrophysics Data System (ADS)

Brewer, J. H.

2014-12-01

I have built a "demonstration" website at http://oPeer.org to illustrate how peer review and publication might be improved relative to the current model, which was designed and implemented in an era when scientific communication was either face-to-face or relied upon human delivery of ink marks on dead trees.

A Vertical Approach to Math Instruction

ERIC Educational Resources Information Center

Gojak, Linda

2012-01-01

In the current era of mathematics standards, whether they are Common Core State Standards or other state standards, effective vertical mathematics teams offer an opportunity for teachers to grow professionally through shared experiences, for leadership to grow among the faculty, and for the school to change its perspective on the teaching and…

Towards a New Era of Character Education in Theory and in Practice

ERIC Educational Resources Information Center

Walker, David I.; Roberts, Michael P.; Kristjánsson, Kristján

2015-01-01

The authors use a Bourdieuean framework of "legitimating principles" and the "symbolic capital" of dominant "discursive themes" to explore (a) the genealogy and (b) the current state of the discourse on "character education" (understood broadly as any approach to moral education that foregrounds the…

The Challenge of Computer Furniture.

ERIC Educational Resources Information Center

Dolan, Thomas G.

2003-01-01

Explains that classrooms and school furniture were built for a different era and often do not have sufficient power for technology, discussing what is needed to support modern technology in education. One solution involves modular cabling and furniture that is capable of being rearranged. Currently, there are no comprehensive standards from which…

Career Transitions and Career Success in the "New" Career Era

ERIC Educational Resources Information Center

Chudzikowski, Katharina

2012-01-01

The "new" career, most notably the boundaryless career, is associated with high career mobility, which is in turn associated with employability and career success of individuals. The current study examined how frequency, form (organisational, horizontal or vertical) and impact (objective career success) of career transitions have changed…

Developing ecosystem services-based assessment endpoints for determining ecological risks to estuarine environments

EPA Science Inventory

Current U.S. EPA ecological risk assessment (ERA) guidance defines an assessment endpoint (AE) as an explicit expression of the environmental value that is to be protected, and recommends that AEs are selected based on ecological relevance, susceptibility to known or potential st...

Planning and Implementing Institutional Image and Promoting Academic Programs in Higher Education

ERIC Educational Resources Information Center

Cetin, Rubeena

2003-01-01

Universities face a multitude of issues and challenges in the current era of higher educational endeavors. Universities are being urged to provide high quality education, exist as a well-reputed university, achieve enrollment success, improve competitive positioning, provide contemporary and well-designed academic programs, and maintain financial…

The Leadership Behaviors of Effective Elementary School Principals

ERIC Educational Resources Information Center

Hawthorne, Mary Jane Golding

2009-01-01

The mandates of the federal law "No Child Left Behind," enacted in 2002, have placed tremendous pressure on school principals in this current era of unprecedented accountability. Because of the increasing number of targeted schools, the rigid standards of federal legislation, and the punitive consequences imposed by accountability…

Automating the conflict resolution process

NASA Technical Reports Server (NTRS)

Wike, Jeffrey S.

1991-01-01

The purpose is to initiate a discussion of how the conflict resolution process at the Network Control Center can be made more efficient. Described here are how resource conflicts are currently resolved as well as the impacts of automating conflict resolution in the ATDRSS era. A variety of conflict resolution strategies are presented.

Transmodalities and Transnational Encounters: Fostering Critical Cosmopolitan Relations

ERIC Educational Resources Information Center

Hawkins, Margaret R.

2018-01-01

The "trans-" turn in language studies illuminates human communication as the coordination and interpretation of a vast array of semiotic resources that are entangled with language in fluid and unpredictable ways. It also highlights the current era of globalization in which communication occurs with ever-increasing rapidity among…

The Big Picture and Specifics of College General Education

ERIC Educational Resources Information Center

Gan, Yang

2018-01-01

In recent years, general education has developed considerably in Chinese universities, but it still faces many challenges and problems. Among the various negative factors, four problems may be the greatest challenges currently faced by Chinese university general education and ordinary undergraduate education: (1) In the era of massified higher…

Thinking with Theory in an Era of Trump

ERIC Educational Resources Information Center

Strom, Kathryn J.; Martin, Adrian D.

2017-01-01

This introduction to this special issue on "Thinking with Theory in Teacher Education" dedicates considerable space to broadly discussing the current U.S. political context to emphasize why, at this precise moment in history, educators, teacher educators, and educational researchers are in dire need of different ways to understand the…

Running on Empty? Finding the Time and Capacity to Lead Learning

ERIC Educational Resources Information Center

Hallinger, Philip; Murphy, Joseph F.

2013-01-01

In recent years, policy changes in American education have refocused a spotlight on principal instructional leadership. Although in previous eras the professional literature exhorted principals to "be instructional leaders," there were few sanctions if they failed to do so. In the current policy context, however, instructional leadership has…

HLA-B27 predicts a more chronic disease course in an 8-year followup cohort of patients with juvenile idiopathic arthritis.

PubMed

Berntson, Lillemor; Nordal, Ellen; Aalto, Kristiina; Peltoniemi, Suvi; Herlin, Troels; Zak, Marek; Nielsen, Susan; Rygg, Marite

2013-05-01

We investigated associations of HLA-B27 with clinical manifestations and longterm outcome in a near population-based setting among patients with juvenile idiopathic arthritis (JIA). We studied clinical and serological data from 410 patients with HLA-B27 results among 440 prospectively collected patients with JIA with 8-year followup data in a Nordic database. The study was structured to be as close to a population-based study as possible. HLA-B27 was analyzed in 93% of patients, and was positive in 21% of the cohort, in 18.4% of the girls and in 25.9% of the boys. Boys who were HLA-B27-positive had significantly higher age at onset compared to HLA-B27-negative boys and compared to both HLA-B27-negative and positive girls. This difference in onset age in relation to HLA-B27 was not found in girls. HLA-B27 was associated with clinical signs of sacroiliitis, enthesitis, and tenosynovitis in boys, but not in girls. After 8 years of disease, 46 children (11.2%) were classified as having enthesitis-related arthritis (ERA). Boys with ERA had clinical signs of sacroiliitis more often than girls with ERA. HLA-B27-positive children, as well as children with clinical signs of sacroiliitis, enthesitis, and hip arthritis, had higher odds of not being in remission off medication after 8 years of disease. In this near population-based Nordic JIA cohort we found significant differences between HLA-B27-positive boys and girls in age at disease onset, clinical signs of sacroiliitis, and ERA classification. HLA-B27 was negatively associated with longterm remission status, possibly because of its association with clinical disease characteristics, such as sacroiliitis, rather than being a general marker of persistent disease.

Cultivating the Role of Nurse Practitioners in Providing Primary Care to Vulnerable Populations in an Era of Health-Care Reform.

PubMed

Xue, Ying; Intrator, Orna

2016-02-01

The evolving role of nurse practitioners (NPs) as primary care providers, especially for vulnerable populations, is central to the debate regarding strategies to address the growing need for primary care services. The current article provides policy recommendations for leveraging and expanding the historic role of NPs in caring for vulnerable populations, by focusing on three key policy levers: NP scope-of-practice regulation, distribution of the NP workforce, and NP education. These policy levers must go hand in hand to build a sufficient and equitably distributed NP workforce, to help meet the escalating need for primary care in an era of health-care reform. © The Author(s) 2016.

Nelson syndrome: historical perspectives and current concepts.

PubMed

Hornyak, Mark; Weiss, Martin H; Nelson, Don H; Couldwell, William T

2007-01-01

The appearance of an adrenocorticotropic hormone (ACTH)-producing tumor after bilateral adrenalectomy for Cushing disease was first described by Nelson in 1958. The syndrome that now bears his name was characterized by hyperpigmentation, a sellar mass, and increased plasma ACTH levels. The treatment of Cushing disease has changed drastically since the 1950s, when the choice was adrenalectomy. Thus, the occurrence, diagnosis, and treatment of Nelson syndrome have changed as well. In the modern era of high-resolution neuroimaging, transsphenoidal microneurosurgery, and stereotactic radiosurgery, Nelson syndrome has become a rare entity. The authors describe the history of the diagnosis and treatment of Nelson syndrome. In light of the changes described, the authors believe this disease must be reevaluated in the contemporary era and a modern paradigm adopted.

Rubella Seromarkers and Determinants of Infection among Tanzanian Children and Adolescents in Prevaccination Era: Are We in the Right Track?

PubMed

Mirambo, Mariam M; Aboud, Said; Groß, Uwe; Majigo, Mtebe; Mushi, Martha F; Mshana, Stephen E

2017-01-01

The World health organization advocates assessment of the burden of rubella and congenital rubella syndrome (CRS) by seroepidemiological surveys and surveillance programs in all countries without vaccination programs. Due to scarcity of data in developing countries, this study was conducted to assess the seromakers for natural rubella infection in Tanzania during prevaccination era so as to ascertain the gaps for future research and prevention strategies. A cross-sectional study was conducted between September and October 2014. Indirect enzyme-linked immunosorbent assay was used to detect rubella IgG and IgM antibodies. STATA version 11 was used to perform data analysis. Of 723 enrolled participants, 368 (50.8%) and 94 (13%) were positive for specific IgG and IgM rubella antibodies, respectively. On multivariable logistic regression analysis, significant determinants of rubella IgG seropositivity were increase in age (odds ratios [OR]: 1.24, 95% confidence interval [CI]: 1.18-1.29, P < 0.001), low socioeconomic status (SES) (OR: 2.38, 95% CI: 1.1.23-4.50, P = 0.010), and absence of rash (OR: 4.34, 95% CI: 1.1.17-15.3, P = 0.027), while only the presence of rashes was significant determinant of rubella IgM seropositivity (OR: 2.5, 95%; 1.07-5.98, P = 0.034). Significantly higher mean IgG titers were observed in population ≥10 years ( P < 0.001), those residing in urban and peri-urban areas ( P < 0.001), those from employed mothers ( P = 0.018), and those with no current history of fever ( P = 0.018). The prevalence of specific rubella IgG antibodies in Tanzania is high and is associated with increase in age, absence of rash, and low SES. Results suggest a need to reconsider upper age limit for vaccination campaigns in developing countries. Screening and vaccinating women may be cost-effective campaign to prevent CRS in developing countries.

The evolution of alcohol use in India.

PubMed

Sharma, H K; Tripathi, B M; Pelto, Pertti J

2010-08-01

This paper traces the role of alcohol production and use in the daily lives of people in India, from ancient times to the present day. Alcohol use has been an issue of great ambivalence throughout the rich and long history of the Indian subcontinent. The behaviors and attitudes about alcohol use in India are very complex, contradictory and convoluted because of the many different influences in that history. The evolution of alcohol use patterns in India can be divided into four broad historical periods (time of written records), beginning with the Vedic era (ca. 1500-700 BCE). From 700 BCE to 1100 CE, ("Reinterpretation and Synthesis") is the time of emergence of Buddhism and Jainism, with some new anti-alcohol doctrines, as well as post-Vedic developments in the Hindu traditions and scholarly writing. The writings of the renowned medical practitioners, Charaka and Susruta, added new lines of thought, including arguments for "moderate alcohol use." The Period of Islamic Influence (1100-1800 CE), including the Mughal era from the 1520s to 1800, exhibited a complex interplay of widespread alcohol use, competing with the clear Quranic opposition to alcohol consumption. The fourth period (1800 to the present) includes the deep influence of British colonial rule and the recent half century of Indian independence, beginning in 1947. The contradictions and ambiguities-with widespread alcohol use in some sectors of society, including the high status caste of warriors/rulers (Kshatriyas), versus prohibitions and condemnation of alcohol use, especially for the Brahmin (scholar-priest) caste, have produced alcohol use patterns that include frequent high-risk, heavy and hazardous drinking. The recent increases in alcohol consumption in many sectors of the general Indian population, coupled with the strong evidence of the role of alcohol in the spread of HIV/STI infections and other health risks, point to the need for detailed understanding of the complex cross-currents emerging from the past history of alcohol use and abuse in India.

Cost-Benefit Analysis of the Implementation of an Enhanced Recovery Program in Liver Surgery.

PubMed

Joliat, Gaëtan-Romain; Labgaa, Ismaïl; Hübner, Martin; Blanc, Catherine; Griesser, Anne-Claude; Schäfer, Markus; Demartines, Nicolas

2016-10-01

Enhanced recovery after surgery (ERAS) programs have been shown to ease the postoperative recovery and improve clinical outcomes for various surgery types. ERAS cost-effectiveness was demonstrated for colorectal surgery but not for liver surgery. The present study aim was to analyze the implementation costs and benefits of a specific ERAS program in liver surgery. A dedicated ERAS protocol for liver surgery was implemented in our department in July 2013. The subsequent year all consecutive patients undergoing liver surgery were treated according to this protocol (ERAS group). They were compared in terms of real in-hospital costs with a patient series before ERAS implementation (pre-ERAS group). Mean costs per patient were compared with a bootstrap T test. A cost-minimization analysis was performed. Seventy-four ERAS patients were compared with 100 pre-ERAS patients. There were no significant pre- and intraoperative differences between the two groups, except for the laparoscopy number (n = 18 ERAS, n = 9 pre-ERAS, p = 0.010). Overall postoperative complications were observed in 36 (49 %) and 64 patients (64 %) in the ERAS and pre-ERAS groups, respectively (p = 0.046). The median length of stay was significantly shorter for the ERAS group (8 vs. 10 days, p = 0.006). The total mean costs per patient were €38,726 and €42,356 for ERAS and pre-ERAS (p = 0.467). The cost-minimization analysis showed a total mean cost reduction of €3080 per patient after ERAS implementation. ERAS implementation for liver surgery induced a non-significant decrease in cost compared to standard care. Significant decreased complication rate and hospital stay were observed in the ERAS group.

Outcomes Associated with Steroid Avoidance and Alemtuzumab among Kidney Transplant Recipients.

PubMed

Serrano, Oscar K; Friedmann, Patricia; Ahsanuddin, Sayeeda; Millan, Carlos; Ben-Yaacov, Almog; Kayler, Liise K

2015-11-06

Alemtuzumab is a humanized anti-CD52 monoclonal antibody used as induction in kidney transplantation (KTX) since 2003. Few studies have evaluated long-term outcomes of this agent or changes in outcomes over time. A retrospective cohort study was performed examining United States registry data from 2003 to 2014 of primary KTX recipients receiving induction with alemtuzumab (AZ; n=5521) or antithymocyte globulin (ATG; n=8504) and maintenance immunosuppression with tacrolimus and mycophenolate mofetil and early withdrawal of steroids. The primary outcome was overall death-censored graft survival (DCGS), and secondary outcomes were overall patient survival and 1-year acute rejection. Multivariate models were fit with donor, recipient, and transplant covariates. Because poorer outcomes with AZ may occur from a learning curve impact with the use of a new medication, transplant year was categorized into three time periods to evaluate outcomes over time (2003-2005, 2006-2008, ≥2009), and an interaction term of induction type with transplant year category was included in all models to test for era impacts. On multivariate analysis of DCGS there was a significant interaction between AZ and era (P<0.001). AZ was significantly associated with inferior DCGS in the earliest 2003-2005 era (adjusted hazard ratio [aHR], 2.21; 95% confidence interval [95% CI], 1.72 to 2.84) but not in the middle 2006-2008 era (aHR, 1.14; 95% CI, 0.96 to 1.36) or the most recent 2009-2014 era (aHR, 1.08; 95% CI, 0.90 to 1.29) compared with ATG. Risk-adjusted patient survival (aHR, 1.32; 95% CI, 1.08 to 1.61; aHR, 1.26; 95% CI, 1.09 to 1.46; and aHR, 1.10; 95% CI, 0.93 to 1.29 by era, respectively) and acute rejection (adjusted odds ratio [aOR], 1.17; 95% CI, 0.96 to 1.42; aOR, 0.94; 95% CI, 0.82 to 1.07; aOR, 0.89; 95% CI, 0.81 to 0.98 by era, respectively) with AZ was comparable with ATG in the most recent era; however, there was no significant interaction with time (P=0.13 and P=0.06, respectively). Current alemtuzumab utilization is associated with comparable graft and patient survival and acute rejection compared with ATG. Graft survival with alemtuzumab has improved over time. Copyright © 2015 by the American Society of Nephrology.

Outcomes Associated with Steroid Avoidance and Alemtuzumab among Kidney Transplant Recipients

PubMed Central

Serrano, Oscar K.; Friedmann, Patricia; Ahsanuddin, Sayeeda; Millan, Carlos; Ben-Yaacov, Almog

2015-01-01

Background and objectives Alemtuzumab is a humanized anti-CD52 monoclonal antibody used as induction in kidney transplantation (KTX) since 2003. Few studies have evaluated long-term outcomes of this agent or changes in outcomes over time. Design, setting, participants, & measurements A retrospective cohort study was performed examining United States registry data from 2003 to 2014 of primary KTX recipients receiving induction with alemtuzumab (AZ; n=5521) or antithymocyte globulin (ATG; n=8504) and maintenance immunosuppression with tacrolimus and mycophenolate mofetil and early withdrawal of steroids. The primary outcome was overall death-censored graft survival (DCGS), and secondary outcomes were overall patient survival and 1-year acute rejection. Multivariate models were fit with donor, recipient, and transplant covariates. Because poorer outcomes with AZ may occur from a learning curve impact with the use of a new medication, transplant year was categorized into three time periods to evaluate outcomes over time (2003–2005, 2006–2008, ≥2009), and an interaction term of induction type with transplant year category was included in all models to test for era impacts. Results On multivariate analysis of DCGS there was a significant interaction between AZ and era (P<0.001). AZ was significantly associated with inferior DCGS in the earliest 2003–2005 era (adjusted hazard ratio [aHR], 2.21; 95% confidence interval [95% CI], 1.72 to 2.84) but not in the middle 2006–2008 era (aHR, 1.14; 95% CI, 0.96 to 1.36) or the most recent 2009–2014 era (aHR, 1.08; 95% CI, 0.90 to 1.29) compared with ATG. Risk-adjusted patient survival (aHR, 1.32; 95% CI, 1.08 to 1.61; aHR, 1.26; 95% CI, 1.09 to 1.46; and aHR, 1.10; 95% CI, 0.93 to 1.29 by era, respectively) and acute rejection (adjusted odds ratio [aOR], 1.17; 95% CI, 0.96 to 1.42; aOR, 0.94; 95% CI, 0.82 to 1.07; aOR, 0.89; 95% CI, 0.81 to 0.98 by era, respectively) with AZ was comparable with ATG in the most recent era; however, there was no significant interaction with time (P=0.13 and P=0.06, respectively). Conclusions Current alemtuzumab utilization is associated with comparable graft and patient survival and acute rejection compared with ATG. Graft survival with alemtuzumab has improved over time. PMID:26342042

Impact of DAAs on liver transplantation: major effects on the evolution of indications and results. An ELITA study based on the ELTR registry.

PubMed

Belli, Luca Saverio; Perricone, Giovanni; Adam, Rene; Cortesi, Paolo A; Strazzabosco, Mario; Facchetti, Rita; Karam, Vincent; Salizzoni, Mauro; Andujar, Rafael Lopez; Fondevila, Costantino; De Simone, Paolo; Morelli, Cristina; Fabregat-Prous, Joan; Samuel, Didier; Agarwaal, Kosh; Gonzales, Enrique Moreno; Charco, Ramon; Zieniewicz, Krzysztof; De Carlis, Luciano; Duvoux, Christophe

2018-06-22

Direct-acting antiviral drugs (DAAs) have dramatically improved the outcome of patients with hepatitis C virus (HCV) infection including those with decompensated cirrhosis (DC). We analysed the evolution of indications and results of liver transplantation (LT) in the past 10 years in Europe, focusing on the changes induced by the advent of the DAA. This is a cohort study based on data from the European Liver Transplant Registry (ELTR). Data of adult LTs performed between January 2007 to June 2017 for HCV, hepatitis B virus (HBV), alcohol (ETOH) and non-alcoholic steatohepatitis (NASH) was analysed. The period was divided into different eras: interferon (IFN/RBV; 2007-2010), protease inhibitor (PI; 2011-2013) and second generation DAA (DAA; 2014-June 2017). Out of a total number of 60,527 LTs, 36,382 were performed in patients with HCV, HBV, ETOH and NASH. The percentage of LTs due to HCV-related liver disease varied significantly over time (p<0.0001), decreasing from 22.8% in IFN/RBV era to 17.4% in the DAA era, while those performed for NASH increased significantly (p<0.0001). In the DAA era, the percentage of LTs for HCV decreased significantly (p<0.0001) from 21.1% (first semester 2014) to 10.6% (first semester 2017). This decline was more evident in patients with DC (HCV-DC, -58.0%) than in those with HCC associated to HCV (HCV-HCC, -41.2%). Conversely, three-year survival of LT recipients with HCV related liver disease improved from 65.1% in the IFN/RBV era to 76.9% in the DAA era, being currently comparable to the survival of recipients with HBV infection (p=0.3807). In Europe, the number of LTs due to HCV infection is rapidly declining for both HCV-DC and HCV-HCC indications and post-LT survival has dramatically improved over the last three years. This is the first comprehensive study of the overall impact of DAA treatment for HCV on liver transplantation in Europe. After the advent of DAAs in 2014, a dramatic decline in the number of LT performed both in patients with decompensated cirrhosis due to HCV, minus 60%, and in those with HCC associated to HCV, minus 41%, was observed. Furthermore, this is the first large scale study demonstrating that the survival of LT recipients with HCV related liver disease has dramatically improved over the last three years, being currently comparable to the survival of recipients with HBV infection. A positive result from decreased need of LT for HCV related indications is greater availability of livers, at least 6oo every year, which may be allocated to indications other than HCV. Copyright © 2018. Published by Elsevier B.V.

HIV disclosure as practice and public policy

PubMed Central

Adam, Barry D.; Corriveau, Patrice; Elliott, Richard; Globerman, Jason; English, Ken; Rourke, Sean

2015-01-01

Responses to the largest surveys of HIV-positive people in Ontario show that most either disclose to or do not have partners who are HIV-negative or of unknown status. Non-disclosure strategies and assumptions are reported by relatively small sets of people with some variation according to employment status, sexual orientation, gender, ethnicity, and having had a casual partner. Interviews with 122 people living with HIV show that disclosure is an undertaking fraught with emotional pitfalls complicated by personal histories of having misread cues or having felt deceived leading up to their own sero-conversion, then having to negotiate a stigmatized status with new people. In gay communities, constructions of the self as individual actors in a marketplace of risk co-exist with the sexual etiquette developed throughout the AIDS era of care of the self and other through safer sex. Among heterosexual populations, notions of responsibility show some divergence by gender. The findings of this study suggest that the heightened pressure of criminal sanction on decision-making about disclosure in personal interactions does not address difficulties in HIV transmission and is unlikely to result in enhanced prevention. PMID:26339127

Highlights of Astronomy, Vol. 16

NASA Astrophysics Data System (ADS)

Montmerle, Thierry

2015-04-01

Part I. Invited Discourses: 1. The Herschel view of star formation; 2. Past, present and future of Chinese astronomy; 3. The zoo of galaxies; 4. Supernovae, the accelerating cosmos, and dark energy; Part II. Joint Discussion: 5. Very massive stars in the local universe; 6. 3-D views of the cycling Sun in stellar context; 7. Ultraviolet emission in early-type galaxies; 8. From meteors and meteorites to their parent bodies: current status and future developments; 9. The connection between radio properties and high-energy emission in AGNs; 10. Space-time reference systems for future research; Part III. Special Sessions: 11. Origin and complexity of massive star clusters; 12. Cosmic evolution of groups and clusters of galaxies; 13. Galaxy evolution through secular processes; 14. New era for studying interstellar and intergalactic magnetic fields; 15. The IR view of massive stars: the main sequence and beyond; 16. Science with large solar telescopes; 17. The impact hazard: current activities and future plans; 18. Calibration of star-formation rate measurements across the electromagnetic spectrum; 19. Future large scale facilities; 20. Dynamics of the star-planet relations strategic plan and the Global Office of Astronomy for Development; 21. Strategic plan and the Global Office of Astronomy for Development; 22. Modern views of the interstellar medium; 23. High-precision tests of stellar physics from high-precision photometry; 24. Communicating astronomy with the public for scientists; 25. Data intensive astronomy; 26. Unexplained spectral phenomena in the interstellar medium; 27. Light pollution: protecting astronomical sites and increasing global awareness through education.

Resurgence of Mumps in Korea

PubMed Central

2015-01-01

Routine vaccination against mumps has markedly reduced its incidence. However, the incidence of mumps continuously has increased since 2007. In 2013, a large mumps epidemic occurred in Korea, and this epidemic is still an ongoing problem. This epidemic occurred primarily in school settings and affected vaccinated adolescents, predominantly male students. The recent resurgence of mumps is caused by multiple factors: suboptimal effectiveness of the current mumps vaccines, use of the Rubini strain vaccine, waning immunity in the absence of natural boosting due to the marked reduction in the mumps incidence, genotype mismatch between the vaccine and circulating mumps virus strains, and environmental conditions that foster intense exposures. Containment of mumps outbreaks is challenging because the sensitivity of diagnostic tests is low among vaccinees and control measures are less efficient because of the inherent nature of the mumps virus. Despite the suboptimal vaccine effectiveness in outbreak settings, maintaining the high vaccine coverage is an important strategy to prevent mumps outbreaks, given that the routine use of mumps vaccines has substantially reduced the incidence of mumps and its complications as compared with that in the pre-vaccine era. In order to control the current mumps epidemic and prevent further outbreaks, we need to better understand the dynamics of mumps among vaccinated populations and the changing epidemiology in Korea. Concerted efforts should be made to systematically monitor the immunization status of the Korean population and to improve diagnosis efficiency. Furthermore, more effective mumps vaccines need to be developed in the future. PMID:25844258

Marginal regression approach for additive hazards models with clustered current status data.

PubMed

Su, Pei-Fang; Chi, Yunchan

2014-01-15

Current status data arise naturally from tumorigenicity experiments, epidemiology studies, biomedicine, econometrics and demographic and sociology studies. Moreover, clustered current status data may occur with animals from the same litter in tumorigenicity experiments or with subjects from the same family in epidemiology studies. Because the only information extracted from current status data is whether the survival times are before or after the monitoring or censoring times, the nonparametric maximum likelihood estimator of survival function converges at a rate of n(1/3) to a complicated limiting distribution. Hence, semiparametric regression models such as the additive hazards model have been extended for independent current status data to derive the test statistics, whose distributions converge at a rate of n(1/2) , for testing the regression parameters. However, a straightforward application of these statistical methods to clustered current status data is not appropriate because intracluster correlation needs to be taken into account. Therefore, this paper proposes two estimating functions for estimating the parameters in the additive hazards model for clustered current status data. The comparative results from simulation studies are presented, and the application of the proposed estimating functions to one real data set is illustrated. Copyright © 2013 John Wiley & Sons, Ltd.

Adaptive Significance of ERα Splice Variants in Killifish ...

EPA Pesticide Factsheets

The possibility that chronic, multigenerational exposure to environmental estrogens selects for adaptive hormone response phenotypes is a critical unanswered question. Embryos/larvae of killifish from an estrogenic polluted environment (New Bedford Harbor, NBH), as compared to those from a reference site, overexpress estrogen receptor a (ERa) mRNA but are hypo-responsive to estradiol (E2). Analysis of ERa mRNAs in the two populations revealed differences in splicing of the gene encoding ERa (esr1). Here we tested the transactivation functions of four differentially expressed ERa mRNAs and tracked their association with the hypo-responsive phenotype for three generations after transfer of NBH parents to a clean environment. Deletion variants ERaΔ6 and ERaΔ6 – 8 were specific to NBH killifish; had dominant negative functions in an in vitro reporter assay; and were heritable. Morpholino-mediated induction of ERaΔ6 mRNA in zebrafish embryos verified its role as a dominant negative ER on natural estrogen-responsive promoters. Alternate long (ERaL) and short (ERaS) 5'-variants were similar transcriptionally but differed in estrogen responsiveness (ERaS >> ERaL). ERaS accounted for high total ERa expression in F1 NBH embryos/ larvae but this trait was abolished by transfer to clean water. By contrast, the hypo-responsive phenotype of F1 NBH embryos/larvae persisted after long term lab holding but reverted to a normal or hyper-responsive phenotype after two or thre

[The physical and health status of runaway slaves announced in Jornal do Commercio (RJ) in 1850].

PubMed

Amantino, Márcia

2007-01-01

The article examines the state of health of a population of runaway slaves, based on announcements published in Rio de Janeiro's Jornal do Commercio in 1850. Two strategies were used. The first entailed analysis of the slaves' physical characteristics, as described by their masters. Taking into account the slave's health, the second step was to describe his or her physical problems as viewed by the era's medical or folk knowledge. This evidence can be traced to procedures found in the slave system, which sought to maximize use of captives.

Proceedings of the symposium on assessing the industrial hygiene monitoring needs for the coal conversion and oil shale industries

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

White, O. Jr.

1979-03-01

This work was supported by the United States Department of Energy, Division of Biomedical and Environmental Research, Analysis and Assessment Program, through the Safety and Environmental Protection Division at Brookhaven National Laboratory. The symposium program included presentations centering around the themes: Recognition of Occupational Health Monitoring Requirements for the Coal Conversion and Oil Shale Industries and Status of Dosimetry Technology for Occupational Health Monitoring for the Coal Conversion and Oil Shale Industries. Sixteen papers have been entered individually into EDB and ERA; six had been entered previously from other sources. (LTN)

Sustained UK marine observations. Where have we been? Where are we now? Where are we going?

PubMed Central

Owens, Nicholas J. P.

2014-01-01

This introduction traces the earliest interaction of ancient humans with their marine environment, through marine explorations in the Middle Ages and Renaissance, to the development of early marine science in the Enlightenment. This sets the scene for how marine observations developed in the modern era and explains the status of today's marine observation networks. The paper concludes with an assessment of the future needs and constraints of sustained marine observation networks and suggests the lessons from a long history might be the key to the future. PMID:25157193

Testing antecedents to sales performance in postapartheid era: a field study.

PubMed

Barbuto, John E; Barbuto, Liezel; De La Rey, Piet; Boshoff, Adre B; Xu, Ye

2006-10-01

The predictors of objectively measured sales performance were assessed with 245 sales representatives from a large South African life insurance company. Sales representatives completed measures of their locus of control, entrepreneurial attitudes, biographical history, and performance was assessed from company records of sales, net commissions earned, and lapse ratios. The nature of employment contract, job status, and race explained significant differences in performance outcomes. The predictive nature of locus of control and entrepreneurial attitudes for performance outcomes was tested using structural equation modeling procedures, with limited validity. The implications for research and practice are also discussed.

Clinical epidemiology of HIV-associated end-stage renal failure in the UK.

PubMed

Bansi, Loveleen; Hughes, Amelia; Bhagani, Sanjay; Mackie, Nicola E; Leen, Clifford; Levy, Jeremy; Edwards, Simon; Connolly, John; Holt, Steve G; Hendry, Bruce M; Sabin, Caroline; Post, Frank A

2009-11-27

To describe the clinical epidemiology of HIV-associated end-stage renal failure (HIV/ESRF) from 1998 to 2007 in the United Kingdom. Observational cohort study. Seven leading HIV centres and affiliated renal clinics in the United Kingdom. A total of 21 951 patients in whom renal function was measured. Development of end-stage renal failure (ESRF) as defined by initiation of permanent renal replacement therapy (pRRT). Sixty-eight (0.31%) patients had HIV/ESRF, 44 (64.7%) of whom were black. The prevalence of ESRF in black patients increased over time from 0.26% in 1998-1999 to 0.92% in 2006-2007 (P for trend = 0.001). Overall 5-year survival from starting pRRT was 70.3%, and significantly better for black patients compared to those of other ethnicities (85.2 vs. 43.4%, P = 0.001). In multivariable analysis, black ethnicity was associated with a higher risk of ESRF [HR 6.93, 95% confidence interval (CI) 3.56, 13.48], whereas a higher current CD4 cell count was associated with reduced risk (HR: 0.83, 95% CI 0.76, 0.95) per 50 cells higher). No association was seen between current viral load or current highly active antiretroviral therapy (HAART) status and ESRF. On the basis of these observations, we estimate that 231 HIV-infected patients required pRRT in the United Kingdom in 2007, and an HIV prevalence of 0.51% among the United Kingdom pRRT recipients in that year. The prevalence of HIV/ESRF increased during the HAART era to reach nearly 1% in black patients, in whom favourable survival rates were observed. Earlier HIV diagnosis will be an important strategy to stem the rising trend of HIV/ESRF.

A CEFR-Based Computerized Adaptive Testing System for Chinese Proficiency

ERIC Educational Resources Information Center

Wang, Hsuan-Po; Kuo, Bor-Chen; Tsai, Ya-Hsun; Liao, Chen-Huei

2012-01-01

In the era of globalization, the trend towards learning Chinese as a foreign language (CFL) has become increasingly popular worldwide. The increasing demand in learning CFL has raised the profile of the Chinese proficiency test (CPT). This study will analyze in depth the inadequacy of current CPT's utilizing the common European framework of…

Making Progress: Education and Culture in New Times.

ERIC Educational Resources Information Center

Carlson, Dennis

The essays in this collection, although written at different times, are all part of a process of forming a democratic progressive educational policy and practice for the United States in the new historical era. Each chapter groups essays that critique some aspect of existing public school practice, explores the limitations of current reform…

Emerging Trends in Parent-School Communication.

ERIC Educational Resources Information Center

Seibert, Jane B.; And Others

School and home communication is of increasing interest in an era of concern for educational accountability. A review of research shows that landmark studies of the 1960s concentrated on the educational needs of the disadvantaged child and the influence of the home on school achievement. The current trend is toward attempting to unite the…

Variation in Maltese English: The Interplay of the Local and the Global in an Emerging Postcolonial Variety

ERIC Educational Resources Information Center

Bonnici, Lisa Marie

2010-01-01

In our current era of increased globalization, constraints on language variation in postcolonial English varieties are multifaceted. Local and global language ideologies collide and multiple sources of influence converge in present-day patterns of linguistic variation in emerging English varieties. While research into the structure and…

A Brave New World: Imagining Faculty Development in the Global Era

ERIC Educational Resources Information Center

VanZanten, Susan

2015-01-01

What might globalization and the demographic shift in Christianity mean for faculty development programs? What faculty members need most is the ability to imagine globalization as Christians. This article surveys and critiques the most powerful and persistent accounts in the current contest of narratives within the field of global education. These…

Transforming Individuals, Families, and Communities through Travel

ERIC Educational Resources Information Center

Austin, Tanya

2006-01-01

It was predicted that the 21st century would be an era of family stress and transformation (McCubbin, McCubbin, Thompson, Han, & Allen, 1997). When evaluating what families face today and what FCS professionals are addressing in current research, curriculum, and programming, it seems that this is indeed the case. Today's FCS professionals need to…

Ghanaian Students in TIMSS 2011: Relationship between Contextual Factors and Mathematics Performance

ERIC Educational Resources Information Center

Butakor, Paul Kwame; Ampadu, Ernest; Cole, Yaa

2017-01-01

Educational effectiveness research has witnessed some growth in the last three decades because the current era of global competitiveness compels each country to train and equip its citizens with knowledge and skills that would make them successful. Researchers from different countries are investigating factors across various levels within the…

Sustainability and Higher Education: From Arborescent to Rhizomatic Thinking

ERIC Educational Resources Information Center

Le Grange, Lesley Lionel Leonard

2011-01-01

Currently, global society is delicately poised on a civilisational threshold similar to that of the feudal era. This is a time when outmoded institutions, values, and systems of thought and their associated dogmas are ripe for transcendence by more relevant systems of organization and knowledge (Davidson, 2000). The foundations of the modern era…

Interpreting the Right to an Education as a Norm Referenced Adequacy Standard

ERIC Educational Resources Information Center

Pijanowski, John

2016-01-01

Our current conceptions of educational adequacy emerged out of an era dominated by equity-based school resource litigation. During that time of transitioning between successful litigation strategies, legal opinions provided clues as to how future courts might view a norm-referenced approach to establishing an adequacy standard--an approach that…

Neoliberalism: A Useful Tool for Teaching Critical Topics in Political Science

ERIC Educational Resources Information Center

Hartmann-Mahmud, Lori

2009-01-01

Neoliberalism is one of the most pervasive and contested concepts of our contemporary era. Thus, it is essential for students to gain an understanding of its history, meaning, assumptions, and policy prescriptions. In addition to recognizing the importance of neoliberalism in the current political discourse, I argue that the polarized responses to…

The Case for Participatory Evaluation in an Era of Accountability

ERIC Educational Resources Information Center

Chouinard, Jill Anne

2013-01-01

Evaluation occurs within a specific context and is influenced by the economic, political, historical, and social forces that shape that context. The culture of evaluation is thus very much embedded in the culture of accountability that currently prevails in public sector institutions, policies, and program. As such, our understanding of the…

Financial and technical feasibility of dynamic congestion pricing as a revenue generation source in Indiana : exploiting the availability of real-time information and dynamic pricing technologies.

DOT National Transportation Integrated Search

2011-10-19

"Highway stakeholders continue to support research studies that address critical issues of the current era, including congestion mitigation and revenue generation. A mechanism that addresses both concerns is congestion pricing which establishes a dir...

An Exploration of At-Risk Students' Journeys through a Continuation High School

ERIC Educational Resources Information Center

Putney, David

2010-01-01

There is a void of current research on continuation schools and the students who attend these unique and historic educational institutions (Kelly, 1993). In an era of increased pressure surrounding student performance, of tight financial constraints, and of a changing landscape of student demographics, this study attempts to explore and understand…

Innovation Efforts in Education and School Administration: Views of Turkish School Administrators

ERIC Educational Resources Information Center

Akin, Ugur

2016-01-01

Problem Statement: In the current information era, nearly all organizations make efforts to make innovations in the fields of information, communication, technology, etc. Educational organizations are no exception to this trend. Moreover, it can be argued that educational institutions make a particular effort to rapidly keep pace with change. In…

Social Justice and Career Guidance in the Age of Talent

ERIC Educational Resources Information Center

Arthur, Nancy

2014-01-01

The practice of career guidance is heavily influenced by changes in the workplace impacted by globalization and fluctuating economies. In the current era, known as the Age of Talent, people are increasingly viewed as commodities to fulfill labor market needs. There are controversies and inequities about who has access to meaningful employment and…

Insurgency and Counterinsurgency in the Current Era of Conflict

DTIC Science & Technology

2017-01-26

one refers to them collectively as the “Global War on Terror ” or as “Overseas Contingency Operations” is largely irrelevant – insurgency and...concept of citizenship. This might seem foreign to an Iraqi, who might have lived under the dictatorship of Saddam Hussein and then under the terror of

Mining the Present: Reconstructing Progressive Education in an Era of Global Change

ERIC Educational Resources Information Center

Edwards, Laura A.; Greenwalt, Kyle A.

2013-01-01

This paper explores what might be seen as a paradox at the heart of the current push to "globalize" education: at a moment when administrators, especially in higher education, are seeking to globalize their programs (often for reasons having to do with increasing international competition and decreasing funding for education), global…

Open Rotor Development

NASA Technical Reports Server (NTRS)

Van Zante, Dale E.; Rizzi, Stephen A.

2016-01-01

The ERA project executed a comprehensive test program for Open Rotor aerodynamic and acoustic performance. System studies used the data to estimate the fuel burn savings and acoustic margin for an aircraft system with open rotor propulsion. The acoustic measurements were used to produce an auralization that compares the legacy blades to the current generation of open rotor designs.

The Crisis in High-School Physics Education: Overview of the Problem.

ERIC Educational Resources Information Center

Layman, John W.

1983-01-01

Discusses the current crisis in science education, focusing on declining physics enrollments and physics teacher shortages. Indicates that the present situation is the culmination of a long trend, interrupted only weakly in the sputnik era, and that the state of the economy may provide a new context for examining the issues. (JN)

"Friending Facebook?" A Minicourse on the Use of Social Media by Health Professionals

ERIC Educational Resources Information Center

George, Daniel R.

2011-01-01

Introduction: Health professionals are working in an era of social technologies that empower users to generate content in real time. This article describes a 3-part continuing education minicourse called "Friending Facebook?" undertaken at Penn State Hershey Medical Center that aimed to model the functionality of current technologies in…

Envisioning the Future of Special Education Personnel Preparation in a Standards-Based Era

ERIC Educational Resources Information Center

Leko, Melinda M.; Brownell, Mary T.; Sindelar, Paul T.; Kiely, Mary Theresa

2015-01-01

The authors consider the future of special education personnel preparation by responding to an overarching question: "What frameworks might teacher educators use as a basis to promote special education teacher effective performance now and in the future?" In answering this question, they summarize current trends in the context of…

Mall Schools: A New Era for Cutting Edge Alternative Education

ERIC Educational Resources Information Center

Chalker, Christopher Scott; Stelsel, Kirk

2008-01-01

Education Resource Centers (ERCs) were established by the Simon Youth Foundation (SYF) as a means of providing economic opportunities and life choices for youth considered at risk through focused programs and initiatives with public school partners. In the current academic year there are 21 ERCs operating primarily in Simon Property Group (SPG)…

Integrating Scaffolding Strategies into Technology-Enhanced Assessments of English Learners: Task Types and Measurement Models

ERIC Educational Resources Information Center

Wolf, Mikyung Kim; Guzman-Orth, Danielle; Lopez, Alexis; Castellano, Katherine; Himelfarb, Igor; Tsutagawa, Fred S.

2016-01-01

This article investigates ways to improve the assessment of English learner students' English language proficiency given the current movement of creating next-generation English language proficiency assessments in the Common Core era. In particular, this article discusses the integration of scaffolding strategies, which are prevalently utilized as…

From Retrospective to Proactive: Creating the Future that Students Need

ERIC Educational Resources Information Center

Shuler, Scott C.

2014-01-01

Changes in education policy--particularly at the federal and state levels--during the current era of ideologically and profit-driven "education reform" threaten balanced education in general and music/arts education in particular. Emerging answers to a number of pivotal questions will determine the future of the arts, arts education, and…

Unalienated Recognition as a Feature of Democratic Schooling

ERIC Educational Resources Information Center

Rheingold, Alison

2012-01-01

The current era of standards and accountability in U.S. public schooling narrows recognition and assessment to an almost exclusive focus on the production of test scores as legitimate markers of student achievement. This climate prevents rather than encourages democratic forms of exchange within and across social worlds. Via a case study of one…

A Theater-as-Education Project Discourages Tobacco and Alcohol Use

ERIC Educational Resources Information Center

Bell-Ellison, Bethany A.; Forthofer, Melinda S.; McDermott, Robert J.; Zapata, Lauren B.; Nearns, Jodi L.; Curran, K. T.; Calkins, Susan A.; Bryant, Carol A.; McCormack Brown, Kelli R.

2009-01-01

Theater has been used as an educational tool since the Great Depression era, and it is currently considered an effective tool for health promotion and reducing risk-taking behaviors among youth. Theater projects are well suited for communicating prevention messages to youth audiences because they can depict real-life settings and characters who…

Non-Formal Education: A Major Educational Force in the Postmodern Era

ERIC Educational Resources Information Center

Romi, Shlomo; Schmida, Mirjam

2009-01-01

This study aims to describe the current position of non-formal education (NFE) as a major educational force in the postmodern world, and to analyze its philosophical and theoretical assumptions. Far from being "supplementary education" or "extracurricular activities", NFE has developed into a worldwide educational industry. However, it has yet to…

"The Dalmatian": First Australian Opera by a Woman

ERIC Educational Resources Information Center

Jenkins, Louise

2014-01-01

Australia is currently responding to an international trend that encourages social inclusion and the provision of equal opportunity for all. In a climate that is encouraging and supporting social inclusion, it can be enriching to look back at Australia's history and consider the benefits that have been gained in a previous era when people were…

In Search of Our Mothers' Gardens: Black Women Teachers and Professional Socialization

ERIC Educational Resources Information Center

Dixson, Adrienne; Dingus, Jeannine E.

2008-01-01

Background/Context: The current era of educational reform targets teacher education and aims to improve the performance of children who have traditionally underperformed and are underserved in public schools. Although educational policy has tried to address the ways in which "good teaching" contributes to improved student educational outcomes,…

Leadership in Transition: The Community College Presidency.

ERIC Educational Resources Information Center

Vaughan, George B.

Stemming from the author's personal experiences, interviews, research, and needs expressed by individuals in the community college field, this book examines issues currently facing community college presidents and argues for a change in leadership to meet the needs of a new era in higher education. Chapter 1 briefly describes the role of the…

Engineering Education in Russia in an Era of Changes

ERIC Educational Resources Information Center

Lukianenko, M. V.; Polezhaev, O. A.; Churliaeva, N. P.

2013-01-01

Engineering education in Russia is undergoing reforms, but the history of this form of higher education does not indicate that it will succeed in bringing it into line with current world standards, or even making it more able to contribute at a high level to Russian economic growth. (Contains 5 notes.)

The Employment Retention and Advancement Project: Paths to Advancement for Single Parents

ERIC Educational Resources Information Center

Miller, Cynthia; Deitch, Victoria; Hill, Aaron

2010-01-01

Between 2000 and 2003, the Employment Retention and Advancement (ERA) project identified and implemented a diverse set of innovative models designed to promote employment stability and wage or earnings progression among low-income individuals, mostly current or former welfare recipients. The project's goal was to determine which strategies could…

The Employment Retention and Advancement Project: Paths to Advancement for Single Parents. Executive Summary

ERIC Educational Resources Information Center

Miller, Cynthia; Deitch, Victoria; Hill, Aaron

2010-01-01

Between 2000 and 2003, the Employment Retention and Advancement (ERA) project identified and implemented a diverse set of innovative models designed to promote employment stability and wage or earnings progression among low-income individuals, mostly current or former welfare recipients. The project's goal was to determine which strategies could…

Each cell counts: Hematopoiesis and immunity research in the era of single cell genomics.

PubMed

Jaitin, Diego Adhemar; Keren-Shaul, Hadas; Elefant, Naama; Amit, Ido

2015-02-01

Hematopoiesis and immunity are mediated through complex interactions between multiple cell types and states. This complexity is currently addressed following a reductionist approach of characterizing cell types by a small number of cell surface molecular features and gross functions. While the introduction of global transcriptional profiling technologies enabled a more comprehensive view, heterogeneity within sampled populations remained unaddressed, obscuring the true picture of hematopoiesis and immune system function. A critical mass of technological advances in molecular biology and genomics has enabled genome-wide measurements of single cells - the fundamental unit of immunity. These new advances are expected to boost detection of less frequent cell types and fuzzy intermediate cell states, greatly expanding the resolution of current available classifications. This new era of single-cell genomics in immunology research holds great promise for further understanding of the mechanisms and circuits regulating hematopoiesis and immunity in both health and disease. In the near future, the accuracy of single-cell genomics will ultimately enable precise diagnostics and treatment of multiple hematopoietic and immune related diseases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Problem formulation and option assessment (PFOA) linking governance and environmental risk assessment for technologies: a methodology for problem analysis of nanotechnologies and genetically engineered organisms.

PubMed

Nelson, Kristen C; Andow, David A; Banker, Michael J

2009-01-01

Societal evaluation of new technologies, specifically nanotechnology and genetically engineered organisms (GEOs), challenges current practices of governance and science. Employing environmental risk assessment (ERA) for governance and oversight assumes we have a reasonable ability to understand consequences and predict adverse effects. However, traditional ERA has come under considerable criticism for its many shortcomings and current governance institutions have demonstrated limitations in transparency, public input, and capacity. Problem Formulation and Options Assessment (PFOA) is a methodology founded on three key concepts in risk assessment (science-based consideration, deliberation, and multi-criteria analysis) and three in governance (participation, transparency, and accountability). Developed through a series of international workshops, the PFOA process emphasizes engagement with stakeholders in iterative stages, from identification of the problem(s) through comparison of multiple technology solutions that could be used in the future with their relative benefits, harms, and risk. It provides "upstream public engagement" in a deliberation informed by science that identifies values for improved decision making.

Climate impacts of deforestation/land-use changes in Central South America in the PRECIS regional climate model: mean precipitation and temperature response to present and future deforestation scenarios.

PubMed

Canziani, Pablo O; Carbajal Benitez, Gerardo

2012-01-01

Deforestation/land-use changes are major drivers of regional climate change in central South America, impacting upon Amazonia and Gran Chaco ecoregions. Most experimental and modeling studies have focused on the resulting perturbations within Amazonia. Using the Regional Climate Model PRECIS, driven by ERA-40 reanalysis and ECHAM4 Baseline model for the period 1961-2000 (40-year runs), potential effects of deforestation/land-use changes in these and other neighboring ecoregions are evaluated. Current 2002 and estimated 2030 land-use scenarios are used to assess PRECIS's response during 1960-2000. ERA-40 and ECHAM4 Baseline driven runs yield similar results. Precipitation changes for 2002 and 2030 land-use scenarios, while significant within deforested areas, do not result in significant regional changes. For temperature significant changes are found within deforested areas and beyond, with major temperature enhancements during winter and spring. Given the current climate, primary effects of deforestation/land-use changes remain mostly confined to the tropical latitudes of Gran Chaco, and Amazonia.

Improvement of research quality in the fields of orthopaedics and trauma: a global perspective.

PubMed

Fayaz, Hangama C; Haas, Norbert; Kellam, James; Bavonratanavech, Suthorn; Parvizi, Javad; Dyer, George; Pohlemann, Tim; Jerosch, Jörg; Prommersberger, Karl-Josef; Pape, Hans Christoph; Smith, Malcolm; Vrahas, Marc; Perka, Carsten; Siebenrock, Klaus; Elhassan, Bassem; Moran, Christopher; Jupiter, Jesse B

2013-07-01

The international orthopaedic community aims to achieve the best possible outcome for patient care by constantly modifying surgical techniques and expanding the surgeon's knowledge. These efforts require proper reflection within a setting that necessitates a higher quality standard for global orthopaedic publication. Furthermore, these techniques demand that surgeons acquire information at a rapid rate while enforcing higher standards in research performance. An international consensus exists on how to perform research and what rules should be considered when publishing a scientific paper. Despite this global agreement, in today's "Cross Check Era", too many authors do not give attention to the current standards of systematic research. Thus, the purpose of this paper is to describe these performance standards, the available choices for orthopaedic surgeons and the current learning curve for seasoned teams of researchers and orthopaedic surgeons with more than three decades of experience. These lead to provide an accessible overview of all important aspects of the topics that will significantly influence the research development as we arrive at an important globalisation era in orthopaedics and trauma-related research.

Gender differences in outcomes in patients with acute coronary syndrome in the current era: A review.

PubMed

Tan, Ying C; Sinclair, Hannah; Ghoorah, Kuldeepa; Teoh, Xuyan; Mehran, Roxana; Kunadian, Vijay

2016-11-01

Coronary heart disease is the most common cause of death worldwide. In the United Kingdom in 2010, over 80,000 deaths were attributed to coronary heart disease, and one in 10 female deaths were due to coronary heart disease. Acute coronary syndrome, a subset of coronary heart disease, was responsible for 175,000 inpatient admissions in the United Kingdom in 2012. While men have traditionally been considered to be at higher risk of acute coronary syndrome, various studies have demonstrated that women often suffer from poorer outcomes following an adverse cardiovascular event. This gap is gradually narrowing with the introduction of advanced interventional strategies and pharmacotherapy. However, a better understanding of these differences is of crucial importance for the improvement of the pharmacological and interventional management of acute coronary syndrome and for the development of possible new gender-specific diagnostic and therapeutic options. The goals of this review are to evaluate gender differences in outcomes in patients with acute coronary syndrome in the current era and identify potential mechanisms behind these differences in outcomes following percutaneous coronary intervention.

Climate Impacts of Deforestation/Land-Use Changes in Central South America in the PRECIS Regional Climate Model: Mean Precipitation and Temperature Response to Present and Future Deforestation Scenarios

PubMed Central

Canziani, Pablo O.; Carbajal Benitez, Gerardo

2012-01-01

Deforestation/land-use changes are major drivers of regional climate change in central South America, impacting upon Amazonia and Gran Chaco ecoregions. Most experimental and modeling studies have focused on the resulting perturbations within Amazonia. Using the Regional Climate Model PRECIS, driven by ERA-40 reanalysis and ECHAM4 Baseline model for the period 1961–2000 (40-year runs), potential effects of deforestation/land-use changes in these and other neighboring ecoregions are evaluated. Current 2002 and estimated 2030 land-use scenarios are used to assess PRECIS's response during 1960–2000. ERA-40 and ECHAM4 Baseline driven runs yield similar results. Precipitation changes for 2002 and 2030 land-use scenarios, while significant within deforested areas, do not result in significant regional changes. For temperature significant changes are found within deforested areas and beyond, with major temperature enhancements during winter and spring. Given the current climate, primary effects of deforestation/land-use changes remain mostly confined to the tropical latitudes of Gran Chaco, and Amazonia. PMID:22645487

Current questions in HIV-associated lung cancer.

PubMed

Shcherba, Marina; Shuter, Jonathan; Haigentz, Missak

2013-09-01

In this review, we explore current questions regarding risk factors contributing to frequent and early onset of lung cancer among populations with HIV infection, treatment, and outcomes of lung cancer in HIV-infected patients as well as challenges in a newly evolving era of lung cancer screening. Lung cancer, seen in three-fold excess in HIV-infected populations, has become the most common non-AIDS defining malignancy in the highly active antiretroviral therapy era. HIV-associated lung cancer appears to be associated with young age at diagnosis, cigarette smoking, advanced stage at presentation, and a more aggressive clinical course. There is no unified explanation for these observations, and aside from traditional risk factors, HIV-related immunosuppression and biological differences might play a role. In addition to smoking cessation interventions, screening and early cancer detection in HIV-infected populations are of high clinical importance, although evidence supporting lung cancer screening in this particularly high-risk subset is currently lacking, as are prospective studies of lung cancer therapy. There is an urgent need for prospective clinical trials in HIV-associated lung cancer to improve understanding of lung cancer pathogenesis and to optimize patient care. Several clinical trials are in progress to address questions in cancer biology, screening, and treatment for this significant cause of mortality in persons with HIV infection.

Practical cryptographic strategies in the post-quantum era

NASA Astrophysics Data System (ADS)

Kabanov, I. S.; Yunusov, R. R.; Kurochkin, Y. V.; Fedorov, A. K.

2018-02-01

Quantum key distribution technologies promise information-theoretic security and are currently being deployed in com-mercial applications. We review new frontiers in information security technologies in communications and distributed storage applications with the use of classical, quantum, hybrid classical-quantum, and post-quantum cryptography. We analyze the cur-rent state-of-the-art, critical characteristics, development trends, and limitations of these techniques for application in enterprise information protection systems. An approach concerning the selection of practical encryption technologies for enterprises with branched communication networks is discussed.

Con: Higher serum bicarbonate in dialysis patients is protective.

PubMed

Chauveau, Philippe; Rigothier, Claire; Combe, Christian

2016-08-01

Metabolic acidosis is often observed in advanced chronic kidney disease, with deleterious consequences on the nutritional status, bone and mineral status, inflammation and mortality. Through clearance of the daily acid load and a net gain in alkaline buffers, dialysis therapy is aimed at correcting metabolic acidosis. A normal bicarbonate serum concentration is the recommended target in dialysis patients. However, several studies have shown that a mild degree of metabolic acidosis in patients treated with dialysis is associated with better nutritional status, higher protein intake and improved survival. Conversely, a high bicarbonate serum concentration is associated with poor nutritional status and lower survival. It is likely that mild acidosis results from a dietary acid load linked to animal protein intake. In contrast, a high bicarbonate concentration in patients treated with dialysis could result mainly from an insufficient dietary acid load, i.e. low protein intake. Therefore, a high pre-dialysis serum bicarbonate concentration should prompt nephrologists to carry out nutritional investigations to detect insufficient dietary protein intake. In any case, a high bicarbonate concentration should be neither a goal of dialysis therapy nor an index of adequate dialysis, whereas mild acidosis could be considered as an indicator of appropriate protein intake. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Filling the gaps in meteorological continuous data measured at FLUXNET sites with ERA-Interim reanalysis

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

Vuichard, N.; Papale, D.

In this study, exchanges of carbon, water and energy between the land surface and the atmosphere are monitored by eddy covariance technique at the ecosystem level. Currently, the FLUXNET database contains more than 500 registered sites, and up to 250 of them share data (free fair-use data set). Many modelling groups use the FLUXNET data set for evaluating ecosystem models' performance, but this requires uninterrupted time series for the meteorological variables used as input. Because original in situ data often contain gaps, from very short (few hours) up to relatively long (some months) ones, we develop a new and robustmore » method for filling the gaps in meteorological data measured at site level. Our approach has the benefit of making use of continuous data available globally (ERA-Interim) and a high temporal resolution spanning from 1989 to today. These data are, however, not measured at site level, and for this reason a method to downscale and correct the ERA-Interim data is needed. We apply this method to the level 4 data (L4) from the La Thuile collection, freely available after registration under a fair-use policy. The performance of the developed method varies across sites and is also function of the meteorological variable. On average over all sites, applying the bias correction method to the ERA-Interim data reduced the mismatch with the in situ data by 10 to 36 %, depending on the meteorological variable considered. In comparison to the internal variability of the in situ data, the root mean square error (RMSE) between the in situ data and the unbiased ERA-I (ERA-Interim) data remains relatively large (on average over all sites, from 27 to 76 % of the standard deviation of in situ data, depending on the meteorological variable considered). The performance of the method remains poor for the wind speed field, in particular regarding its capacity to conserve a standard deviation similar to the one measured at FLUXNET stations.« less

Filling the gaps in meteorological continuous data measured at FLUXNET sites with ERA-Interim reanalysis

DOE PAGES

Vuichard, N.; Papale, D.

2015-07-13

In this study, exchanges of carbon, water and energy between the land surface and the atmosphere are monitored by eddy covariance technique at the ecosystem level. Currently, the FLUXNET database contains more than 500 registered sites, and up to 250 of them share data (free fair-use data set). Many modelling groups use the FLUXNET data set for evaluating ecosystem models' performance, but this requires uninterrupted time series for the meteorological variables used as input. Because original in situ data often contain gaps, from very short (few hours) up to relatively long (some months) ones, we develop a new and robustmore » method for filling the gaps in meteorological data measured at site level. Our approach has the benefit of making use of continuous data available globally (ERA-Interim) and a high temporal resolution spanning from 1989 to today. These data are, however, not measured at site level, and for this reason a method to downscale and correct the ERA-Interim data is needed. We apply this method to the level 4 data (L4) from the La Thuile collection, freely available after registration under a fair-use policy. The performance of the developed method varies across sites and is also function of the meteorological variable. On average over all sites, applying the bias correction method to the ERA-Interim data reduced the mismatch with the in situ data by 10 to 36 %, depending on the meteorological variable considered. In comparison to the internal variability of the in situ data, the root mean square error (RMSE) between the in situ data and the unbiased ERA-I (ERA-Interim) data remains relatively large (on average over all sites, from 27 to 76 % of the standard deviation of in situ data, depending on the meteorological variable considered). The performance of the method remains poor for the wind speed field, in particular regarding its capacity to conserve a standard deviation similar to the one measured at FLUXNET stations.« less

Predictive Toxicology: Current Status and Future Outlook (EBI ...

EPA Pesticide Factsheets

Slide presentation at the EBI-EMBL Industry Programme Workshop on Predictive Toxicology and the currently status of Computational Toxicology activities at the US EPA. Slide presentation at the EBI-EMBL Industry Programme Workshop on Predictive Toxicology and the currently status of Computational Toxicology activities at the US EPA.

Epigenetics in the Vascular Endothelium: Looking From a Different Perspective in the Epigenomics Era.

PubMed

Yan, Matthew S; Marsden, Philip A

2015-11-01

Cardiovascular diseases are commonly thought to be complex, non-Mendelian diseases that are influenced by genetic and environmental factors. A growing body of evidence suggests that epigenetic pathways play a key role in vascular biology and might be involved in defining and transducing cardiovascular disease inheritability. In this review, we argue the importance of epigenetics in vascular biology, especially from the perspective of endothelial cell phenotype. We highlight and discuss the role of epigenetic modifications across the transcriptional unit of protein-coding genes, especially the role of intragenic chromatin modifications, which are underappreciated and not well characterized in the current era of genome-wide studies. Importantly, we describe the practical application of epigenetics in cardiovascular disease therapeutics. © 2015 American Heart Association, Inc.

Steps Toward an EOS-Era Aerosol Air Mass Type Climatology

NASA Technical Reports Server (NTRS)

Kahn, Ralph A.

2012-01-01

We still have a way to go to develop a global climatology of aerosol type from the EOS-era satellite data record that currently spans more than 12 years of observations. We have demonstrated the ability to retrieve aerosol type regionally, providing a classification based on the combined constraints on particle size, shape, and single-scattering albedo (SSA) from the MISR instrument. Under good but not necessarily ideal conditions, the MISR data can distinguish three-to-five size bins, two-to-four bins in SSA, and spherical vs. non-spherical particles. However, retrieval sensitivity varies enormously with scene conditions. So, for example, there is less information about aerosol type when the mid-visible aerosol optical depth (AOD) is less that about 0.15 or 0.2.

Apoplexy, cerebrovascular disease, and stroke: Historical evolution of terms and definitions

PubMed Central

Engelhardt, Eliasz

2017-01-01

ABSTRACT. The long-standing concept of “apoplexy' can be followed from Antiquity, passing through the Middle Ages and Renaissance, and reaching the Modern era and the present day, with the new designation of “stroke”. The definition of “apoplexy” can be divided, by the history of autopsy, into a period predating this practice, which spanned from Antiquity until the Renaissance, with a relatively stable clinically-based umbrella concept, and an autopsy period of the Modern era, when the condition was subdivided into several subtypes. Thus, it took about 2,500 years assembling the numerous pieces of information to achieve a fairly well-defined picture. The “stroke” concept inherited the information developed for “apoplexy”, incorporating all historical acquisitions to form the current state of this knowledge. PMID:29354227

A Conservation Ethic and the Collecting of Animals by Institutions of Natural Heritage in the Twenty-First Century: Case Study of the Australian Museum

PubMed Central

Ikin, Timothy

2011-01-01

Simple Summary It is a core task of collecting institutions like museums to take examples of animals and preserve them as specimens in collections. In the twenty-first century, museums are equally the places where research is conducted and education is promoted in the service of conservation of animals in an era of the decline of biodiversity. In this paper, the balance of co-operation between collecting of animals by museums and the promotion and scientific pursuit of conservation of fauna in those museums is considered. As a “challenge” to museum science, it is considered in the context of Australia's oldest museum, and its policy and practice in the current century. Abstract Collecting of animals from their habitats for preservation by museums and related bodies is a core operation of such institutions. Conservation of biodiversity in the current era is a priority in the scientific agendas of museums of natural heritage in Australia and the world. Intuitively, to take animals from the wild, while engaged in scientific or other practices that are supposed to promote their ongoing survival, may appear be incompatible. The Australian Museum presents an interesting ground to consider zoological collecting by museums in the twenty-first century. Anderson and Reeves in 1994 argued that a milieu existed that undervalued native species, and that the role of natural history museums, up to as late as the mid-twentieth century, was only to make a record the faunal diversity of Australia, which would inevitably be extinct. Despite the latter, conservation of Australia's faunal diversity is a key aspect of research programmes in Australia's institutions of natural heritage in the current era. This paper analyses collecting of animals, a core task for institutions of natural heritage, and how this interacts with a professed “conservation ethic” in a twenty-first century Australian setting. PMID:26486222

Integrated presentation of ecological risk from multiple stressors

PubMed Central

Goussen, Benoit; Price, Oliver R.; Rendal, Cecilie; Ashauer, Roman

2016-01-01

Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk. Key components include environmental scenarios that integrate exposure and ecology, and ecological modelling of relevant endpoints to assess the effect of a combination of stressors. Our illustrative results demonstrate the importance of regional differences in environmental conditions and the confounding interactions of stressors. Using this framework and prevalence plots provides a risk-based approach that combines risk assessment and risk management in a meaningful way and presents a truly mechanistic alternative to the threshold approach. Even whilst research continues to improve the underlying models and data, regulators and decision makers can already use the framework and prevalence plots. The integration of multiple stressors, environmental conditions and variability makes ERA more relevant and realistic. PMID:27782171

Maxwell's Enduring Legacy

NASA Astrophysics Data System (ADS)

Longair, Malcolm

2016-07-01

Preface; Acknowledgements; Figure credits; Part I. To 1874: 1. Physics in the nineteenth century; 2. Mathematics and physics in Cambridge in the nineteenth century; Part II. 1874 to 1879: 3. The Maxwell era; Part III. 1879 to 1884: 4. Rayleigh's Quinquennium; Part IV. 1884 to 1919: 5. The challenges facing J. J. Thomson; 6. The J. J. Thomson era, 1884-1900 - the electron; 7. The Thomson era, 1900-19 - atomic structure; Part V. 1919 to 1937: 8. Rutherford at McGill and Manchester Universities - new challenges in Cambridge; 9. The Rutherford era - the radioactivists; 10. Rutherford era - the seeds of the new physics; Part VI. 1938 to 1953: 11. Bragg and the war years; 12. Bragg and the post-war years; Part VII. 1953 to 1971: 13. The Mott era - an epoch of expansion; 14. The Mott era - radio astronomy and high energy physics; 15. The Mott era - the growth of condensed matter physics; Part VIII. 1971 to 1982: 16. The Pippard era - a new laboratory and a new vision; 17. The Pippard era - radio astronomy, high energy physics and laboratory astrophysics; 18. The Pippard era - condensed matter physics; Part IX. 1984 to 1995: 19. The Edwards era - a new epoch of expansion; 20. The Edwards era - new directions in condensed matter physics; 21. The Edwards era - high energy physics and radio astronomy; Part X. 1995 to present: 22. Towards the new millennium and beyond; 23. The evolution of the New Museums site; Notes; Bibliography; Author index; Index.

Status and Preliminary Evaluation for Chinese Re-Analysis Datasets

NASA Astrophysics Data System (ADS)

bin, zhao; chunxiang, shi; tianbao, zhao; dong, si; jingwei, liu

2016-04-01

Based on operational T639L60 spectral model, combined with Hybird_GSI assimilation system by using meteorological observations including radiosondes, buoyes, satellites el al., a set of Chinese Re-Analysis (CRA) datasets is developing by Chinese National Meteorological Information Center (NMIC) of Chinese Meteorological Administration (CMA). The datasets are run at 30km (0.28°latitude / longitude) resolution which holds higher resolution than most of the existing reanalysis dataset. The reanalysis is done in an effort to enhance the accuracy of historical synoptic analysis and aid to find out detailed investigation of various weather and climate systems. The current status of reanalysis is in a stage of preliminary experimental analysis. One-year forecast data during Jun 2013 and May 2014 has been simulated and used in synoptic and climate evaluation. We first examine the model prediction ability with the new assimilation system, and find out that it represents significant improvement in Northern and Southern hemisphere, due to addition of new satellite data, compared with operational T639L60 model, the effect of upper-level prediction is improved obviously and overall prediction stability is enhanced. In climatological analysis, compared with ERA-40, NCEP/NCAR and NCEP/DOE reanalyses, the results show that surface temperature simulates a bit lower in land and higher over ocean, 850-hPa specific humidity reflects weakened anomaly and the zonal wind value anomaly is focus on equatorial tropics. Meanwhile, the reanalysis dataset shows good ability for various climate index, such as subtropical high index, ESMI (East-Asia subtropical Summer Monsoon Index) et al., especially for the Indian and western North Pacific monsoon index. Latter we will further improve the assimilation system and dynamical simulating performance, and obtain 40-years (1979-2018) reanalysis datasets. It will provide a more comprehensive analysis for synoptic and climate diagnosis.

White matter disease in midlife is heritable, related to hypertension, and shares some genetic influence with systolic blood pressure.

PubMed

Fennema-Notestine, Christine; McEvoy, Linda K; Notestine, Randy; Panizzon, Matthew S; Yau, Wai-Ying Wendy; Franz, Carol E; Lyons, Michael J; Eyler, Lisa T; Neale, Michael C; Xian, Hong; McKenzie, Ruth E; Kremen, William S

2016-01-01

White matter disease in the brain increases with age and cardiovascular disease, emerging in midlife, and these associations may be influenced by both genetic and environmental factors. We examined the frequency, distribution, and heritability of abnormal white matter and its association with hypertension in 395 middle-aged male twins (61.9 ± 2.6 years) from the Vietnam Era Twin Study of Aging, 67% of whom were hypertensive. A multi-channel segmentation approach estimated abnormal regions within the white matter. Using multivariable regression models, we characterized the frequency distribution of abnormal white matter in midlife and investigated associations with hypertension and Apolipoprotein E- ε4 status and the impact of duration and control of hypertension. Then, using the classical twin design, we estimated abnormal white matter heritability and the extent of shared genetic overlap with blood pressure. Abnormal white matter was predominantly located in periventricular and deep parietal and frontal regions; associated with age ( t  = 1.9, p  = 0.05) and hypertension ( t  = 2.9, p  = 0.004), but not Apolipoprotein ε4 status; and was greater in those with uncontrolled hypertension relative to controlled ( t  = 3.0, p  = 0.003) and normotensive ( t  = 4.0, p  = 0.0001) groups, suggesting that abnormal white matter may reflect currently active cerebrovascular effects. Abnormal white matter was highly heritable (a 2  = 0.81) and shared some genetic influences with systolic blood pressure (r A  = 0.26), although there was evidence for distinct genetic contributions and unique environmental influences. Future longitudinal research will shed light on factors impacting white matter disease presentation, progression, and potential recovery.

[Recent crisis of psychiatry in the context of modern and postmodern science].

PubMed

Petho, Bertalan

2008-01-01

We have investigated the recent crisis of psychiatry in perspective of the last two centuries of its history. First and longer part of this period belongs to the Modern era. The second part beginning in the sixties of the last century is the Postmodern era, the one we live in today. We have pointed out that the recent crisis has not come by accident but as one of the several changes characterising our transition into the era labelled "Postmodern". The crisis of psychiatry was analysed in respect of the development of science and in social context. We focused on psychiatry and science and their interconnectedness in their historical articulations. A way out of the crisis of the current era can be found also with the use of historical methods. Science is changing both in respect of its quality and its role in our age. Taking into consideration normal and post-normal science, we differentiated two additional generations of science, pro-normal science and perato-scientia, in the most recent history. On the one hand, psychiatry serves as a paradigm for the conceptualisation of contemporary science. On the other hand, as an up-to-date science re-conceptualised partly according to its own paradigm it may find a way out of its own crisis. The many facets of the current crisis were demonstrated by analysing recent developments of the Hungarian health politics. Concerning this topic we adopted the term "economicity" elaborated by us earlier. We found that psychiatry operated by the hegemony of the rules of economicity might become a relay station for selecting patients to be thrown away as human garbage. This catastrophic outcome may occur if a political system is organized purely by economicity rules without either historical responsibility or local solidarity. However, up-to-date trends of scientificity as shown by pro-normal science and perato-scientia guarantee a radically different course for psychiatry. Following this course, which is consistent with the insight into the common lot of normal and abnormal people, psychiatry should be guided also in the future by the categorical imperative of therapy.

Are flexion extension films necessary for cervical spine clearance in patients with neck pain after negative cervical CT scan?

PubMed

Tran, Baotram; Saxe, Jonathan M; Ekeh, Akpofure Peter

2013-09-01

There are variations in cervical spine (CS) clearance protocols in neurologically intact blunt trauma patients with negative radiological imaging but persistent neck pain. Current guidelines from the current Eastern Association for the Surgery of Trauma include options of maintaining the cervical collar or obtaining either magnetic resonance imaging (MRI) or flexion-extension films (FEF). We evaluated the utility of FEF in the current era of routine computerized tomography (CT) for imaging the CS in trauma. All neurologically intact, awake, nonintoxicated patients who underwent FEF for persistent neck pain after negative CT scan of the CS at our level I trauma center over a 13-mo period were identified. Their charts were reviewed and demographic data obtained. There were 354 patients (58.5% male) with negative cervical CS CT scans who had FEF for residual neck pain. Incidental degenerative changes were seen in 37%--which did not affect their acute management. FEF were positive for possible ligamentous injury in 5 patients (1.4%). Two of these patients had negative magnetic resonance images and the other three had collars removed within 3 wk as the findings were ultimately determined to be degenerative. In the current era, where cervical CT has universally supplanted initial plain films, FEF appear to be of little value in the evaluation of persistent neck pain. Their use should be excluded from cervical spine clearance protocols in neurologically intact, awake patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Digging Postholes Adds Depth and Authenticity to a Shallow Curriculum

ERIC Educational Resources Information Center

Virtue, David C.; Buchanan, Anne; Vogler, Kenneth E.

2012-01-01

In the current era of high-stakes testing and accountability, many social studies teachers struggle to find creative ways to add depth and authenticity to a broad, shallow curriculum. Teachers can use the time after tests are administered for students to reflect back on the social studies curriculum and select topics they want to study more deeply…

The Policy of Universal Secondary Education: Its Influence on Secondary Schooling in Grenada

ERIC Educational Resources Information Center

Knight, Verna

2014-01-01

In an era of increasing access to secondary education in the Caribbean, it becomes critical that we understand the effect that Universal Secondary Education (USE) has had on our education systems in order to inform current educational reform efforts and future educational planning. This study explores the experience of the country of Grenada with…

The Virtual History Museum: Learning U.S. History in Diverse Eighth Grade Classrooms

ERIC Educational Resources Information Center

Okolo, Cynthia M.; Englert, Carol Sue; Bouck, Emily C.; Heutsche, Anne; Wang, Hequn

2011-01-01

History is an important but often overlooked content area for all students in this current era of accountability. Yet instruction in history can help students become problem solvers and learn to make interpretations from multiple perspectives. This article reports the results of a pilot study examining history learning across three groups of…

On the Right Track? Islamic Schools in the Netherlands after an Era of Turmoil

ERIC Educational Resources Information Center

Merry, Michael S.; Driessen, Geert

2016-01-01

The Netherlands currently has 43 Islamic primary schools. Each is fully subsidised by the government. Yet since the first school was established in 1988 Islamic schools have been confronted with obstacles by the Ministry of Education, bad press and increasingly strict state supervision. Under pressure to improve their image, since 2008 Dutch…

Investigation of Physiological Properties of Nerves and Muscles Using Electromyography

ERIC Educational Resources Information Center

Roe, Seán M.; Johnson, Christopher D.; Tansey, Etain A.

2014-01-01

The measurement and representation of the electrical activity of muscles [electromyography (EMG)] have a long history from the Victorian Era until today. Currently, EMG has uses both as a research tool, in noninvasively recording muscle activation, and clinically in the diagnosis and assessment of nerve and muscle disease and injury as well as in…

Digital ureteroscopes: technology update

PubMed Central

Gridley, Chad M; Knudsen, Bodo E

2017-01-01

The field of ureteroscopy has undergone a continual evolution since the first ureteroscopes were introduced. Over the past 10 years, we have entered into the digital era of ureteroscopy with both semirigid and flexible options becoming available. The following review looks at the benefits and drawbacks of digital flexible ureteroscopes as well as the current commercially available options. PMID:28203551

Chapter 9 - Vegetation succession modeling for the LANDFIRE Prototype Project

Treesearch

Donald Long; B. John (Jack) Losensky; Donald Bedunah

2006-01-01

One of the main objectives of the Landscape Fire and Resource Management Planning Tools Prototype Project, or LANDFIRE Prototype Project, was to determine departure of current vegetation conditions from the range and variation of conditions that existed during the historical era identified in the LANDFIRE guidelines as 1600-1900 A.D. (Keane and Rollins, Ch. 3). In...

The Debate Over International Armament Programs: Integrating Current Knowledge and the FSX Case

DTIC Science & Technology

1989-09-01

Japanese technology which the U.S. could obtain under the technology flowback provisions of the MOU. Of particular interest to the U.S. is the composite...hold promise. However, success at technology flowback will depend heavily on the actions of the United States. The FSX has ushered in a new era. No

Skin-Color Prejudice and Within-Group Racial Discrimination: Historical and Current Impact on Latino/a Populations

ERIC Educational Resources Information Center

Chavez-Dueñas, Nayeli Y.; Adames, Hector Y.; Organista, Kurt C.

2014-01-01

The psychological literature on colorism, a form of within-group racial discrimination, is sparse. In an effort to contribute to this understudied area and highlight its significance, a concise and selective review of the history of colorism in Latin America is provided. Specifically, three historical eras (i.e., conquest, colonization, and…

Cost Considerations in the Current ARV Era

PubMed Central

Eaton, Ellen F; Tamhane, Ashutosh; Saag, Michael; Mugavero, Michael J; Kilgore, Meredith L

2018-01-01

Summary Of five commonly prescribed regimens for treatment-naïve HIV patients in one clinic (2007–2012), Emtricitabine and Tenofovir with Efavirenz and Raltegravir were the only consistently cost-effective options; the Rilpivirine-based regimen was valuable in limited scenarios. Further data on the comparative effectiveness of Efavirenz and Rilpivirine are needed before they are abandoned. PMID:27088319

The Impact on Future Guidance Programs of Current Developments in Computer Science, Telecommunications, and Biotechnology.

ERIC Educational Resources Information Center

Mitchell, Lynda K.; Hardy, Philippe L.

The purpose of this chapter is to envision how the era of technological revolution will affect the guidance, counseling, and student support programs of the future. Advances in computer science, telecommunications, and biotechnology are discussed. These advances have the potential to affect dramatically the services of guidance programs of the…

Contested Alliances: International NGOs and Authoritarian Governments in the Era of Globalization

ERIC Educational Resources Information Center

Silova, Iveta

2008-01-01

The NGO boom of the 1990s was matched by mounting literature on the influence of NGOs on world politics. The 1998 inaugural issue of "Current Issues in Comparative Education" ("CICE")--"Are NGOs Overrated?"--brought these debates into the very center of international and comparative education. The journal issue inspired a fascinating conversation…

The Counseling Profession in Russia: Historical Roots, Current Trends, and Future Perspectives

ERIC Educational Resources Information Center

Currie, Christine L.; Kuzmina, Marina V.; Nadyuk, Ruslan I.

2012-01-01

Psychology was established in Russia before the Communist era. The social work profession was created in 1991 for a society in turmoil after the collapse of the Soviet Union. In 2011, the counseling profession officially emerged as a branch of social work called "social psychological help". Professional counseling associations are in the…

Peer Mentoring as an Academic Resource: Or "My Friend Says..."

ERIC Educational Resources Information Center

Maher, JaneMaree; Lindsay, Jo; Peel, Vicki; Twomey, Christina

2006-01-01

On current projections in could take thirty years for women to be equally represented in the academic workplace. Traditional methods of mentoring by senior staff often seem relics of an earlier era, but here a group of more junior academics reflect on the success of a peer-mentoring exercise which helped transform their first experience of…

Building Research Partnerships with Health Care Organizations: The Scholar Award Model in Action

ERIC Educational Resources Information Center

Aroian, Karen J.; Robertson, Patricia; Allred, Kelly; Andrews, Diane; Waldrop, Julee

2012-01-01

In the current era of limited funding, researchers need strategic alliances to launch or sustain programs of research to significantly impact the nation's health. This article presents a collaborative model, the Scholar Award Model, which is based on a strategic alliance between a College of Nursing in a research-intensive university and a…

Educational Travel to Israel in the Era of Globalization

ERIC Educational Resources Information Center

Ezrachi, Elan

2015-01-01

Travel to Israel has been a central feature of Jewish and Zionist education yet it is time for this educational travel to be examined in the context of current cultural trends of travel and transnational experiences. The Jewish educational community has not yet internalized the impact of global trends on the field of travel to Israel from a…

Structuralism's Relevance in a Post-Structural Era: Re-Visiting Research on Multicultural Curricular Studies

ERIC Educational Resources Information Center

Shim, Jenna Min

2011-01-01

At the current historical juncture in which differences and inequalities are surfacing greater than ever in the world, societies, and schools, the main goal of this essay is to revisit the aspects of structuralism that can potentially contribute productively to understanding the invisible structures and forces that everyone carries (mostly…

How We Define Success: Holding Values in an Era of High Stakes Accountability

ERIC Educational Resources Information Center

Gasoi, Emily

2009-01-01

In the current climate of high stakes testing and tough love rhetoric, many educational stakeholders have become increasingly reliant on standardized test scores to determine whether or not individual students, teachers, and schools--and even entire districts and states--are successful. In contrast to the black and white picture that test-driven…

Family and Family Change in Ireland: An Overview

ERIC Educational Resources Information Center

Canavan, John

2012-01-01

In Ireland, historically and in the current era, family has been a central concern for society and the State. This article provides a descriptive overview of family life in Ireland and of major family-related changes over the past 40 years. It presents a general framework of analysis within which these changes can be understood, considers the…

Reducing the Complexity Gap: Expanding the Period of Human Nurturance

ERIC Educational Resources Information Center

Kiel, L. Douglas

2014-01-01

Socio-techno-cultural reality, in the current historical era, evolves at a faster rate than do human brain or human institutions. This reality creates a "complexity gap" that reduces human and institutional capacities to adapt to the challenges of late modernity. New insights from the neurosciences may help to reduce the complexity gap.…

Student Retention in an Era of Globalization: A Case Study of IGNOU Regional Centre, Mumbai

ERIC Educational Resources Information Center

Rajesh, M.

2011-01-01

Student Retention is a function of a number of factors, the most important among them being--the academic response mechanism of an institution, effectiveness in handling administrative queries, counseling at learner support centres, effectiveness in handling practical session and so on. The current paper is an attempt to study the effectiveness of…

Classroom Software for the Information Age. Technical Report No. 23.

ERIC Educational Resources Information Center

Sheingold, Karen; And Others

Consumers and producers of educational software must make decisions about what kind of software to buy and create. Both groups must base these decisions on criteria that consider what it is important to learn in our technological era, what is workable, and what is currently practical and cost-effective. Five criteria that are central to these…

The Current Attack on Women's Rights: A Political-Economic Perspective.

ERIC Educational Resources Information Center

Kress, June

The right-wing attack on women's rights in the United States manifests itself in the regulation of reproductive rights, the family, and the workplace and corresponds to the changing needs of capital in an era of social and economic crises. Against this background, anti-abortion legislation, the Family Protection Act, and discrimination in the…

Motivation Factors in Students Decision to Study at International Branch Campuses in Malaysia

ERIC Educational Resources Information Center

Ahmad, Syed Zamberi; Buchanan, Frederick Robert

2017-01-01

Transnational education is becoming a popular way for students to earn an attractive credential from a foreign university in emerging education hubs in Asia. In an era where students are staying closer to home for their education, this paper offers insights into the motivations or choice criteria used by students currently enrolled at…

Examining a Public Montessori School's Response to the Pressures of High-Stakes Accountability

ERIC Educational Resources Information Center

Block, Corrie Rebecca

2015-01-01

A public Montessori school is expected to demonstrate high student scores on standardized assessments to succeed in the current school accountability era. A problem for a public Montessori elementary school is how to make sense of the school's high-stakes assessment scores in terms of Montessori's unique educational approach. This case study…

Practising the Public? Collaborative Teacher Inquiry in an Era of Standardization and Accountability

ERIC Educational Resources Information Center

Hardy, Ian

2018-01-01

This paper analyses the nature of collaborative teacher learning as a form of 'public sphere', under current policy conditions. The research draws upon Habermas' notions of communicative action and public spheres, and literature on the nature of teachers' learning in the context of standardized curriculum and assessment reform, to analyse how…

’Stinger under Armor:’ An Analysis of Alternatives

DTIC Science & Technology

1990-01-01

This paper examines a concept for employment of the Stinger Air Defense Artillery weapon system known as ’Stinger under Armor .’ It traces the...areas air defense in the pre-FAADS era. This broader deficiency ultimately drove the need for ’Stinger under Armor ’ as a short-term solution to a current battlefield vulnerability.

Science Education and Religion in the Post-Darwin Era: An Historical Perspective

ERIC Educational Resources Information Center

Prince, Tiffany

2009-01-01

This article is part of the author's current research into science teachers' perspectives on the theory of evolution and its teaching in the classroom. Anti-evolutionary views have recently become very prominent in the context of science education, with almost one third of science teachers in the United Kingdom agreeing that creationism should be…

Academic Professionalism in the Era of Change: Role Subidentities and Transformation of Time Budgets

ERIC Educational Resources Information Center

Abramov, Roman Nikolaevich; Gruzdev, Ivan Andreevich; Terentyev, Evgeny Andreevich

2016-01-01

This article is based on a case study conducted within the National Research University Higher School of Economics (NRU HSE) that examined the identity fragmentation of academic professionals in the context of current educational and academic reforms in Russia. Seven hundred and five professors were surveyed for the study, which focused on…

Dance Education in an Era of Racial Backlash: Moving Forward as We Step Backwards

ERIC Educational Resources Information Center

Kerr-Berry, Julie A.

2012-01-01

The field of dance education is not immune to conflicted discourses about race in the United States. This article investigates the subject of race, education, and dance, and problematizes current postracial discourses in postsecondary education. It examines the implications of race and ethnicity in a number of critical areas, such as faculty and…

The Possibilities of Encouraging Student's Metacognitive Strategies through Heuristic-Methodological Instruction

ERIC Educational Resources Information Center

Veselinov, Danica; Nikolic, Radmila

2015-01-01

In the era of contemporary society, which revolves around the fast information science revolution, the pupil is no longer just an observer in the educational process but rather an active constructor of one's own knowledge. Current didactic theories proclaim teaching, in which the teacher is an instructor and a facilitator, and as such should…

Curriculum Policy Reform in an Era of Technical Accountability: "Fixing" Curriculum, Teachers and Students in English Schools

ERIC Educational Resources Information Center

Winter, Christine

2017-01-01

Drawing on a Levinasian ethical perspective, the argument driving this paper is that the technical accountability movement currently dominating the educational system in England is less than adequate because it overlooks educators' responsibility for ethical relations in responding to difference in respect of the other. Curriculum policy makes a…

Understanding College Students' Lived Experiences in a Diverse Blended Model Class

ERIC Educational Resources Information Center

Cook, Sarah Taylor

2016-01-01

The current study was used to explore the lived experiences of students enrolled in a college-level course developed within an interinstitutional partnership that leveraged technology platforms, such as Twitter® and online learning management systems, and included the participation of prominent figures from the 1960s Civil Rights Era. The focus of…

Career Management in Transition: HRD Themes from the Estonian Civil Service

ERIC Educational Resources Information Center

Rees, Christopher J.; Jarvalt, Jane; Metcalfe, Beverley

2005-01-01

Purpose: To explore, through a case study, some of the key career-related HRD issues that senior managers are currently facing in the Estonian civil service. Design/methodology/approach: Presents primary empirical research into career management in the Estonian civil service since 1991, that is, in the post-Soviet era. The research involved…

Theory Meets Practice: HBCU Initiatives that Promote Academic Success among African Americans in STEM

ERIC Educational Resources Information Center

Palmer, Robert T.; Davis, Ryan J.; Thompson, Tiffany

2010-01-01

In the current postindustrial era, increasing the number of minorities in science, technology, engineering, and mathematics (STEM) is critically important for the United States' economic growth and its position in the global marketplace. Given the U.S. Census Bureau's 2008 projection that the population of minorities is expected to increase by…

Data integration in the era of omics: current and future challenges

PubMed Central

2014-01-01

To integrate heterogeneous and large omics data constitutes not only a conceptual challenge but a practical hurdle in the daily analysis of omics data. With the rise of novel omics technologies and through large-scale consortia projects, biological systems are being further investigated at an unprecedented scale generating heterogeneous and often large data sets. These data-sets encourage researchers to develop novel data integration methodologies. In this introduction we review the definition and characterize current efforts on data integration in the life sciences. We have used a web-survey to assess current research projects on data-integration to tap into the views, needs and challenges as currently perceived by parts of the research community. PMID:25032990

Varicella hospitalizations in Los Angeles during the varicella vaccination era, 2003–2011: Are they preventable?

PubMed Central

Agopian, Anya; Lopez, Adriana; Wilson, Dulmini; Peralta, Vi; El Amin, Alvin Nelson; Bialek, Stephanie

2016-01-01

Characteristics of varicella-related hospitalizations in the mature varicella vaccination era, including the proportion vaccinated and the severity of disease, are not well described. We present the vaccination status, severity and reasons for hospitalization of the hospitalized varicella cases reported to the Los Angeles County Health Department from 2003 to 2011, the period which includes the last 4 years of the mature one-dose program and the first 5 years after introduction of the routine two-dose program. A total of 158 hospitalized varicella cases were reported overall, of which 52.5% were potentially preventable and eligible for vaccination, 41.8% were not eligible for vaccination, and 5.7% were vaccinated. Most hospitalizations (72.2%) occurred among healthy persons, 54.4% occurred among persons ≥20 years of age, and 3.8% of hospitalizations resulted in death. Our data suggest that as many as half of the hospitalized varicella cases, including half of the deaths, may have been preventable given that they occurred in persons who were eligible for vaccination. More complete implementation of the routine varicella vaccination program could further reduce the disease burden of severe varicella. PMID:25087675

Viral taxonomy needs a spring clean; its exploration era is over.

PubMed

Gibbs, Adrian J

2013-08-09

The International Committee on Taxonomy of Viruses has recently changed its approved definition of a viral species, and also discontinued work on its database of virus descriptions. These events indicate that the exploration era of viral taxonomy has ended; over the past century the principles of viral taxonomy have been established, the tools for phylogenetic inference invented, and the ultimate discriminatory data required for taxonomy, namely gene sequences, are now readily available. Further changes would make viral taxonomy more informative. First, the status of a 'taxonomic species' with an italicized name should only be given to viruses that are specifically linked with a single 'type genomic sequence' like those in the NCBI Reference Sequence Database. Secondly all approved taxa should be predominately monophyletic, and uninformative higher taxa disendorsed. These are 'quality assurance' measures and would improve the value of viral nomenclature to its users. The ICTV should also promote the use of a public database, such as Wikipedia, to replace the ICTV database as a store of the primary metadata of individual viruses, and should publish abstracts of the ICTV Reports in that database, so that they are 'Open Access'.

Congenital anomalies of the limbs in mythology and antiquity.

PubMed

Mavrogenis, Andreas F; Markatos, Konstantinos; Nikolaou, Vasilios; Gartziou-Tatti, Ariadne; Soucacos, Panayotis N

2018-04-01

Congenital anomalies of the limbs have been observed since ancient human civilizations, capturing the imagination of ancient physicians and people. The knowledge of the era could not possibly theorize on the biologic aspects of these anomalies; however, from the very beginning of civilization the spiritual status of people attempted to find a logical explanation for the existence of such cases. The next logical step of the spiritual and religious system of the ancients was to correlate these anomalies with the Gods and to attribute them to a different level of existence in order to rationalize their existence. In these settings, the mythology and religious beliefs of ancient civilizations comprised several creatures that were related to the observed congenital anomalies in humans. The purpose of this historic review is to summarize the depiction of congenital anomalies of the limbs in mythology and antiquity, to present several mythological creatures with resemblance to humans with congenital anomalies of the limbs, to present the atmosphere of the era concerning the congenital anomalies, and to theorize on the anomaly and medical explanation upon which such creatures were depicted. Our aim is to put historic information in one place, creating a comprehensive review that the curious reader would find interesting and enjoyable.

Selective elimination of breast cancer surgery in exceptional responders: historical perspective and current trials.

PubMed

van la Parra, Raquel F D; Kuerer, Henry M

2016-03-08

With improvements in chemotherapy regimens, targeted therapies, and our fundamental understanding of the relationship of tumor subtype and pathologic complete response (pCR), there has been dramatic improvement in pCR rates in the past decade, especially among triple-negative and human epidermal growth factor receptor 2-positive breast cancers. Rates of pCR in these groups of patients can be in the 60 % range and thus question the paradigm for the necessity of breast and nodal surgery in all cases, particularly when the patient will be receiving adjuvant local therapy with radiotherapy. Current practice for patients who respond well to neoadjuvant chemotherapy (NCT) is often to proceed with the same breast and axillary procedures as would have been offered women who had not received NCT, regardless of the apparent clinical response. Given these high response rates in defined subgroups among exceptional responders it is appropriate to question whether surgery is now a redundant procedure in their overall management. Further, definitive radiation without surgical resection with or without systemic therapy has been proven effective for several other malignant disease sites including some stages of esophageal, anal, laryngeal, prostate, cervical, and lung carcinoma. The main impediments for potential elimination of surgery have been the fact that prior and current standard and functional breast imaging methods are incapable of accurate prediction of residual disease and that integrating percutaneous biopsy of the breast primary and nodes following NCT may circumvent this issue. This article highlights historical attempts at omission of surgery following NCT in an earlier era, the current status of breast and nodal imaging to predict residual carcinoma, and ongoing and planned trials designed to identify appropriate patients who might be selected for clinical trials designed to test the safety of selected elimination of breast cancer surgery in percutaneous image-guided biopsy-proven exceptional responders to NCT.