Adherence to Biobehavioral Recommendations in Pediatric Migraine as Measured by Electronic Monitoring: The Adherence in Migraine (AIM) Study.

PubMed

Kroon Van Diest, Ashley M; Ramsey, Rachelle; Aylward, Brandon; Kroner, John W; Sullivan, Stephanie M; Nause, Katie; Allen, Janelle R; Chamberlin, Leigh A; Slater, Shalonda; Hommel, Kevin; LeCates, Susan L; Kabbouche, Marielle A; O'Brien, Hope L; Kacperski, Joanne; Hershey, Andrew D; Powers, Scott W

2016-07-01

The purpose of this investigation was to examine treatment adherence to medication and lifestyle recommendations among pediatric migraine patients using electronic monitoring systems. Nonadherence to medical treatment is a significant public health concern, and can result in poorer treatment outcomes, decreased cost-effectiveness of medical care, and increased morbidity. No studies have systematically examined adherence to medication and lifestyle recommendations in adolescents with migraine outside of a clinical trial. Participants included 56 adolescents ages 11-17 who were presenting for clinical care. All were diagnosed with migraine with or without aura or chronic migraine and had at least 4 headache days per month. Medication adherence was objectively measured using electronic monitoring systems (Medication Event Monitoring Systems technology) and daily, prospective self-report via personal electronic devices. Adherence to lifestyle recommendations of regular exercise, eating, and fluid intake were also assessed using daily self-report on personal electronic devices. Electronic monitoring indicates that adolescents adhere to their medication 75% of the time, which was significantly higher than self-reported rates of medication adherence (64%). Use of electronic monitoring of medication detected rates of adherence that were significantly higher for participants taking once daily medication (85%) versus participants taking twice daily medication (59%). Average reported adherence to lifestyle recommendations of consistent noncaffeinated fluid intake (M = 5 cups per day) was below recommended levels of a minimum of 8 cups per day. Participants on average also reported skipping 1 meal per week despite recommendations of consistently eating three meals per day. Results suggest that intervention focused on adherence to preventive treatments (such as medication) and lifestyle recommendations may provide more optimal outcomes for children and adolescents with

Unveiling the signals from extremely noisy microseismic data for high-resolution hydraulic fracturing monitoring.

PubMed

Huang, Weilin; Wang, Runqiu; Li, Huijian; Chen, Yangkang

2017-09-20

Microseismic method is an essential technique for monitoring the dynamic status of hydraulic fracturing during the development of unconventional reservoirs. However, one of the challenges in microseismic monitoring is that those seismic signals generated from micro seismicity have extremely low amplitude. We develop a methodology to unveil the signals that are smeared in the strong ambient noise and thus facilitate a more accurate arrival-time picking that will ultimately improve the localization accuracy. In the proposed technique, we decompose the recorded data into several morphological multi-scale components. In order to unveil weak signal, we propose an orthogonalization operator which acts as a time-varying weighting in the morphological reconstruction. The orthogonalization operator is obtained using an inversion process. This orthogonalized morphological reconstruction can be interpreted as a projection of the higher-dimensional vector. We first test the proposed technique using a synthetic dataset. Then the proposed technique is applied to a field dataset recorded in a project in China, in which the signals induced from hydraulic fracturing are recorded by twelve three-component (3-C) geophones in a monitoring well. The result demonstrates that the orthogonalized morphological reconstruction can make the extremely weak microseismic signals detectable.

Improving the Statistical Modeling of the TRMM Extreme Precipitation Monitoring System

NASA Astrophysics Data System (ADS)

Demirdjian, L.; Zhou, Y.; Huffman, G. J.

2016-12-01

This project improves upon an existing extreme precipitation monitoring system based on the Tropical Rainfall Measuring Mission (TRMM) daily product (3B42) using new statistical models. The proposed system utilizes a regional modeling approach, where data from similar grid locations are pooled to increase the quality and stability of the resulting model parameter estimates to compensate for the short data record. The regional frequency analysis is divided into two stages. In the first stage, the region defined by the TRMM measurements is partitioned into approximately 27,000 non-overlapping clusters using a recursive k-means clustering scheme. In the second stage, a statistical model is used to characterize the extreme precipitation events occurring in each cluster. Instead of utilizing the block-maxima approach used in the existing system, where annual maxima are fit to the Generalized Extreme Value (GEV) probability distribution at each cluster separately, the present work adopts the peak-over-threshold (POT) method of classifying points as extreme if they exceed a pre-specified threshold. Theoretical considerations motivate the use of the Generalized-Pareto (GP) distribution for fitting threshold exceedances. The fitted parameters can be used to construct simple and intuitive average recurrence interval (ARI) maps which reveal how rare a particular precipitation event is given its spatial location. The new methodology eliminates much of the random noise that was produced by the existing models due to a short data record, producing more reasonable ARI maps when compared with NOAA's long-term Climate Prediction Center (CPC) ground based observations. The resulting ARI maps can be useful for disaster preparation, warning, and management, as well as increased public awareness of the severity of precipitation events. Furthermore, the proposed methodology can be applied to various other extreme climate records.

Recommended methods for range-wide monitoring of prairie dogs in the United States

USGS Publications Warehouse

McDonald, Lyman L.; Stanley, Thomas R.; Otis, David L.; Biggins, Dean E.; Stevens, Patricia D.; Koprowski, John L.; Ballard, Warren

2011-01-01

One of the greatest challenges for conserving grassland, prairie scrub, and shrub-steppe ecosystems is maintaining prairie dog populations across the landscape. Of the four species of prairie dogs found in the United States, the Utah prairie dog (Cynomys parvidens) is listed under the Endangered Species Act (ESA) as threatened, the Gunnison's prairie dog (C. gunnisoni) is a candidate for listing in a portion of its range, and the black-tailed prairie dog (C. ludovicianus) and white-tailed prairie dog (C. leucurus) have each been petitioned for listing at least once in recent history. Although the U.S. Fish and Wildlife Service (USFWS) determined listing is not warranted for either the black-tailed prairie dog or white-tailed prairie dog, the petitions and associated reviews demonstrated the need for the States to monitor and manage for self-sustaining populations. In response to these findings, a multi-State conservation effort was initiated for the nonlisted species which included the following proposed actions: (1) completing an assessment of each prairie dog species in each State, (2) developing a range-wide monitoring protocol for each species using a statistically valid sampling procedure that would allow comparable analyses across States, and (3) monitoring prairie dog status every 3-5 years depending upon the species. To date, each State has completed an assessment and currently is monitoring prairie dog status; however, for some species, the inconsistency in survey methodology has made it difficult to compare data year-to-year or State-to-State. At the Prairie Dog Conservation Team meeting held in November 2008, there was discussion regarding the use of different methods to survey prairie dogs. A recommendation from this meeting was to convene a panel in a workshop-type forum and have the panel review the different methods being used and provide recommendations for range-wide monitoring protocols for each species of prairie dog. Consequently, the Western

Recommendation system for immunization coverage and monitoring.

PubMed

Bhatti, Uzair Aslam; Huang, Mengxing; Wang, Hao; Zhang, Yu; Mehmood, Anum; Di, Wu

2018-01-02

Immunization averts an expected 2 to 3 million deaths every year from diphtheria, tetanus, pertussis (whooping cough), and measles; however, an additional 1.5 million deaths could be avoided if vaccination coverage was improved worldwide. 1 1 Data source for immunization records of 1.5 M: http://www.who.int/mediacentre/factsheets/fs378/en/ New vaccination technologies provide earlier diagnoses, personalized treatments and a wide range of other benefits for both patients and health care professionals. Childhood diseases that were commonplace less than a generation ago have become rare because of vaccines. However, 100% vaccination coverage is still the target to avoid further mortality. Governments have launched special campaigns to create an awareness of vaccination. In this paper, we have focused on data mining algorithms for big data using a collaborative approach for vaccination datasets to resolve problems with planning vaccinations in children, stocking vaccines, and tracking and monitoring non-vaccinated children appropriately. Geographical mapping of vaccination records helps to tackle red zone areas, where vaccination rates are poor, while green zone areas, where vaccination rates are good, can be monitored to enable health care staff to plan the administration of vaccines. Our recommendation algorithm assists in these processes by using deep data mining and by accessing records of other hospitals to highlight locations with lower rates of vaccination. The overall performance of the model is good. The model has been implemented in hospitals to control vaccination across the coverage area.

Recommended features of protocols for long-term ecological monitoring

USGS Publications Warehouse

Oakley, Karen L.; Boudreau, Susan L.; Humphrey, Sioux-Z

2001-01-01

In 1991, the National Park Service (NPS) selected seven parks to serve as prototypes for development of a long-term ecological monitoring program. Denali National Park and Preserve was one of the prototype parks selected. The principal focus of this national program was to detect and document resource changes and to understand the forces driving those changes. One of the major tasks of each prototype park was to develop monitoring protocols. In this paper, we discuss some lessons learned and what we believe to be the most important features of protocols.One of the many lessons we have learned is that monitoring protocols vary greatly in content and format. This variation leads to confusion about what information protocols should contain and how they should be formatted. Problems we have observed in existing protocols include (1) not providing enough detail, (2) omitting critical topics (such as data management), and (3) mixing explanation with instructions. Once written, protocols often sit on the shelf to collect dust, allowing methods changes to occur without being adequately considered, tested, or documented. Because a lengthy and costly research effort is often needed to develop protocols, a vision of what the final product should look like is helpful. Based on our involvement with the prototype monitoring program for Denali (Oakley and Boudreau 2000), we recommend key features of protocols, including a scheme for linking protocols to data in the data management system and for tracking protocol revisions. A protocol system is crucial for producing long-term data sets of known quality that meet program objectives.

Public Health Monitoring of Privilege and Deprivation With the Index of Concentration at the Extremes

PubMed Central

Waterman, Pamela D.; Spasojevic, Jasmina; Li, Wenhui; Maduro, Gil; Van Wye, Gretchen

2016-01-01

Objectives. We evaluated use of the Index of Concentration at the Extremes (ICE) for public health monitoring. Methods. We used New York City data centered around 2010 to assess cross-sectional associations at the census tract and community district levels, for (1) diverse ICE measures plus the US poverty rate, with (2) infant mortality, premature mortality (before age 65 years), and diabetes mortality. Results. Point estimates for rate ratios were consistently greatest for the novel ICE that jointly measured extreme concentrations of income and race/ethnicity. For example, the census tract–level rate ratio for infant mortality comparing the bottom versus top quintile for an ICE contrasting low-income Black versus high-income White equaled 2.93 (95% confidence interval [CI] = 2.11, 4.09), but was 2.19 (95% CI = 1.59, 3.02) for low versus high income, 2.77 (95% CI = 2.02, 3.81) for Black versus White, and 1.56 (95% CI = 1.19, 2.04) for census tracts with greater than or equal to 30% versus less than 10% below poverty. Conclusions. The ICE may be a useful metric for public health monitoring, as it simultaneously captures extremes of privilege and deprivation and can jointly measure economic and racial/ethnic segregation. PMID:26691119

Radiological/Nuclear Human Monitoring Tabletop Exercise: Recommendations and Lessons Identified.

PubMed

Chauhan, Vinita; Duncan, Devin; Wilkins, Ruth C

2017-06-01

Health Canada is the lead department for coordinating the federal response to a Canadian nuclear emergency event. The framework to manage a radiological consequence is outlined in the Federal Nuclear Emergency Plan (FNEP). In 2014, a full scale exercise (FSX) was held to test the capacity of the federal government to handle a nuclear facility emergency disaster in Canada. The FSX provided a means to demonstrate the integration of various departments and agencies in response to such an event, and although a number of task teams within FNEP were tested, the capacity to monitor humans for exposure post-event was not played out fully. To address this, a table top exercise (TTX) was held in 2015 that brought together experts from human monitoring groups (HMGs) in partnership with Provincial and Municipal emergency response organizations. The TTX took the form of a facilitated discussion centered around two types of radiological/nuclear (RN) emergency scenarios that commenced post-release. The purpose of the exercise was to integrate these communities and identify knowledge gaps in policies and concepts of operations pertaining to the human monitoring aspects of RN events including biodosimetry, bioassay, portal monitors, whole body counting, and the provision of personal dosimetry. It also tested the interoperability between first responders/receivers and Federal, Provincial, and Municipal emergency response organizations. The end outcome was the identification of clear knowledge gaps in existing and newly developed concepts of operation in the human population monitoring response to an RN emergency in Canada; these and possible recommendations are captured in this report.

Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

NASA Technical Reports Server (NTRS)

Scheuring, Richard A.; Hamilton, Doug; Jones, Jeffrey A.; Alexander, David

2009-01-01

There are currently several physiological monitoring requirements for EVA in the Human-Systems Interface Requirements (HSIR) document. There are questions as to whether the capability to monitor heart rhythm in the lunar surface space suit is a necessary capability for lunar surface operations. Similarly, there are questions as to whether the capability to monitor heart rhythm during a cabin depressurization scenario in the launch/landing space suit is necessary. This presentation seeks to inform space medicine personnel of recommendations made by an expert panel of cardiovascular medicine specialists regarding in-suit ECG heart rhythm monitoring requirements during lunar surface operations. After a review of demographic information and clinical cases and panel discussion, the panel recommended that ECG monitoring capability as a clinical tool was not essential in the lunar space suit; ECG monitoring was not essential in the launch/landing space suit for contingency scenarios; the current hear rate monitoring capability requirement for both launch/landing and lunar space suits should be maintained; lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG for IVA medical assessments; and, exercise stress testing for astronaut selection and retention should be changed from the current 85% maximum heart rate limit to maximal, exhaustive 'symptom-limited' testing to maximize diagnostic utility as a screening tool for evaluating the functional capacity of astronauts and their cardiovascular health.

Extreme Geohazards: Reducing Disaster Risk and Increasing Resilience

NASA Astrophysics Data System (ADS)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Campus, Paola

2014-05-01

damage on a global scale for a globally connected and stressed society. In particular, large volcanic eruptions could impact climate, damage anthropogenic infrastructure and interrupt resource supplies on a global scale. The occurrence of one or more of the largest volcanic eruptions that took place during the last 2,000 years under today's conditions would likely cause global disasters or catastrophes challenging civilization. Integration of these low-probability, high-impact events in DRR requires an approach focused on resilience and antifragility, as well as the ability to cope with, and recover from failure of infrastructures and social systems. Resilience results from social capital even more than from the robustness of infrastructure. While it is important to understand the hazards through the contribution of geosciences, it is equally important to understand through the contribution of social sciences and engineering the societal processes involved with coping with hazards or leading to failure. For comprehensive development of resilience to natural hazards and, in particular, extreme geohazards, synergy between geosciences, engineering and social sciences, jointed to an improved science-policy relationship is key to success. For example, a simple cost-benefit analysis shows that a comprehensive monitoring system that could identify the onset of an extreme volcanic eruption with sufficient lead time to allow for a globally coordinated preparation makes economic sense. The WP recommends implementation of such a monitoring system with global coverage, assesses the existing assets in current monitoring systems, and illustrates many benefits, besides providing early warning for extreme volcanic eruptions. However, such a monitoring system can provide resilience only via the capability of the global community to react to early warnings. The WP recommends achieving this through the establishment of a global coordination platform comparable to IPCC's role in addressing

Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism in men - a suggested update.

PubMed

Lunenfeld, Bruno; Mskhalaya, George; Kalinchenko, Svetlana; Tishova, Yulia

2013-12-01

Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men were first published by ISSAM in 2002 In 2005, and, in 2008, updated recommendations were published in the International Journal of Andrology, the Journal of Andrology, the Aging Male and European Urology. Towards discussions at the next ISSAM/ESSAM meeting in Moscow, 29 November 2013, we suggest the following update.

A daily wetness index from satellite gravity for near-real time global monitoring of hydrological extremes

NASA Astrophysics Data System (ADS)

Gouweleeuw, Ben; Kvas, Andreas; Gruber, Christian; Mayer-Gürr, Torsten; Flechtner, Frank; Hasan, Mehedi; Güntner, Andreas

2017-04-01

Since April 2002, the Gravity Recovery and Climate Experiment (GRACE) satellite mission has been churning out water storage anomaly data, which has been shown to be a unique descriptor of large-scale hydrological extreme events. Nonetheless, efforts to assess the comprehensive information from GRACE on total water storage variations for near-real time flood or drought monitoring have been limited so far, primarily due to its coarse temporal (weekly to monthly) and spatial (> 150.000 km2) resolution and the latency of standard products of about 2 months,. Pending the status of the aging GRACE satellite mission, the Horizon 2020 funded EGSIEM (European Gravity Service for Improved Emergency Management) project is scheduled to launch a 6 month duration near-real time test run of GRACE gravity field data from April 2017 onward, which will provide daily gridded data with a latency of 5 days. This fast availability allows the monitoring of total water storage variations related to hydrological extreme events, as they occur, as opposed to a 'confirmation after occurrence', which is the current situation. This contribution proposes a global GRACE-derived gridded wetness indicator, expressed as a gravity anomaly in dimensionless units of standard deviation. Results of a retrospective evaluation (April 2002-December 2015) of the proposed index against databases of hydrological extremes will be presented. It is shown that signals for large extreme floods related to heavy/monsoonal rainfall are picked up really well in the Southern Hemisphere and lower Northern Hemisphere (Africa, S-America, Australia, S-Asia), while extreme floods in the Northern Hemisphere (Russia) related to snow melt are often not. The latter is possibly related to a lack of mass movement over longer distances, e.g. when melt water is not drained due to river ice blocking.

Recommendations for strengthening the infrared technology component of any condition monitoring program

NASA Astrophysics Data System (ADS)

Nicholas, Jack R., Jr.; Young, R. K.

1999-03-01

This presentation provides insights of a long term 'champion' of many condition monitoring technologies and a Level III infra red thermographer. The co-authors present recommendations based on their observations of infra red and other components of predictive, condition monitoring programs in manufacturing, utility and government defense and energy activities. As predictive maintenance service providers, trainers, informal observers and formal auditors of such programs, the co-authors provide a unique perspective that can be useful to practitioners, managers and customers of advanced programs. Each has over 30 years experience in the field of machinery operation, maintenance, and support the origins of which can be traced to and through the demanding requirements of the U.S. Navy nuclear submarine forces. They have over 10 years each of experience with programs in many different countries on 3 continents. Recommendations are provided on the following: (1) Leadership and Management Support (For survival); (2) Life Cycle View (For establishment of a firm and stable foundation for a program); (3) Training and Orientation (For thermographers as well as operators, managers and others); (4) Analyst Flexibility (To innovate, explore and develop their understanding of machinery condition); (5) Reports and Program Justification (For program visibility and continued expansion); (6) Commitment to Continuous Improvement of Capability and Productivity (Through application of updated hardware and software); (7) Mutual Support by Analysts (By those inside and outside of the immediate organization); (8) Use of Multiple Technologies and System Experts to Help Define Problems (Through the use of correlation analysis of data from up to 15 technologies. An example correlation analysis table for AC and DC motors is provided.); (9) Root Cause Analysis (Allows a shift from reactive to proactive stance for a program); (10) Master Equipment Identification and Technology Application (To

Monitoring of Recommended Metabolic Laboratory Parameters Among Medicaid Recipients on Second-Generation Antipsychotics in Federally Qualified Health Centers.

PubMed

Uzal, Natalia E; Chavez, Benjamin; Kosirog, Emily R; Billups, Sarah J; Saseen, Joseph J

2018-02-01

In 2004, a consensus statement outlining recommended metabolic monitoring for patients prescribed second-generation antipsychotics (SGAs) was published. More than a decade later, suboptimal adherence rates to these recommendations continue to be reported, which could lead to long-term and costly complications. To define the prevalence of appropriately monitored Medicaid patients receiving care at federally qualified health centers (FQHCs) prescribed SGAs. This was a retrospective study examining electronic health record and Medicaid claims data to assess the rates of glucose and lipid monitoring for patients prescribed SGAs from January 2014 to August 2016 in a FQHC. Prescription and laboratory claims for patients receiving care at 4 FQHCs were reviewed. Descriptive statistics were used to evaluate the primary outcome. A total of 235 patients were included in the analysis. Patients initiated on SGA therapy (n = 92) had baseline glucose and lipid monitoring rates of 50% and 23%, respectively. The 3-month monitoring rates were 37% for glucose and 26% for lipids, whereas annual rates were 71% and 40%, respectively. Patients continuing SGA therapy (n = 143) had annual glucose and lipid monitoring rates of 67% and 44%. Medicaid patients at FQHCs initially prescribed SGAs have low baseline and 3-month metabolic monitoring, whereas annual monitoring was comparable to previously published studies. Adults receiving chronic care at a FQHC were more likely to receive glucose monitoring. Those with type 2 diabetes mellitus and/or hyperlipidemia were more likely to receive glucose and lipid monitoring.

Feedback from physical activity monitors is not compatible with current recommendations: A recalibration study.

PubMed

Thompson, Dylan; Batterham, Alan M; Peacock, Oliver J; Western, Max J; Booso, Rahuman

2016-10-01

Wearable devices to self-monitor physical activity have become popular with individuals and healthcare practitioners as a route to the prevention of chronic disease. It is not currently possible to reconcile feedback from these devices with activity recommendations because the guidelines refer to the amount of activity required on top of normal lifestyle activities (e.g., 150 minutes of moderate-to-vigorous intensity activity per week over-and-above normal moderate-to-vigorous lifestyle activities). The aim of this study was to recalibrate the feedback from self-monitoring. We pooled data from four studies conducted between 2006 and 2014 in patients and volunteers from the community that included both sophisticated measures of physical activity and 10-year risk for cardiovascular disease and type 2 diabetes (n=305). We determined the amount of moderate-to-vigorous intensity activity that corresponded to FAO/WHO/UNU guidance for a required PAL of 1.75 (Total Energy Expenditure/Basal Metabolic Rate). Our results show that, at the UK median PAL, total moderate-to-vigorous intensity physical activity will be around 735 minutes per week (~11% of waking time). We estimate that a 4% increase in moderate-to-vigorous intensity activity will achieve standardised guidance from FAO/WHO/UNU and will require ~1000 minutes of moderate-to-vigorous intensity activity per week. This study demonstrates that feedback from sophisticated wearable devices is incompatible with current physical activity recommendations. Without adjustment, people will erroneously form the view that they are exceeding recommendations by several fold. A more appropriate target from self-monitoring that accounts for normal moderate-to-vigorous lifestyle activities is ~1000 minutes per week, which represents ~15% of waking time. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Digital Divide in Sub-Saharan African Universities: Recommendations and Monitoring

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

Barry, Boubakar; /Assoc. Afr. Univ.; Chukwuma, Victor

The Digital Divide prevents Africa from taking advantages of new information technologies. One of the most urgent priorities is to bring the Internet in African Universities, Research, and Learning Centers to the level of other regions of the world. eGY-Africa, and the Sharing Knowledge Foundation are two bottom-up initiatives by scientists to secure better cyber-infrastructure and Internet facilities in Africa. Recommendations by the present scientific communities are being formulated at national, regional and international levels. The Internet capabilities are well documented at country level overall, but this is not the case at the University level. The snapshot of the Internetmore » status in universities in 17 African countries, obtained by a questionnaire survey, is consistent with measures of Internet penetration in the corresponding country. The monitoring of Internet performance has been proposed to those African universities to provide an information base for arguing the need to improve the coverage for Africa. A pilot program is recommended that will start scientific collaboration with Europe in western Africa using ICT. The program will lay the foundations for the arrival of new technologies like Grids.« less

Improving the development, monitoring and reporting of stroke rehabilitation research: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable.

PubMed

Walker, Marion F; Hoffmann, Tammy C; Brady, Marian C; Dean, Catherine M; Eng, Janice J; Farrin, Amanda J; Felix, Cynthia; Forster, Anne; Langhorne, Peter; Lynch, Elizabeth A; Radford, Kathryn A; Sunnerhagen, Katharina S; Watkins, Caroline L

2017-07-01

Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress, there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016. A total of 15 recommendations were made. To validate the need for the recommendations, the group reviewed all stroke rehabilitation trials published in 2015 (n = 182 papers). Our review highlighted that the majority of publications did not clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention call into question many interventions that have been evaluated for efficacy. More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless, the majority of reporting recommendations were still not adequately described. To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence-based clinical care, we urge the research community to endorse and adopt our recommendations.

Recommendations for the use of mist nets for inventory and monitoring of bird populations

Treesearch

C. John Ralph; Erica H. Dunn; Will J. Peach; Colleen M. Handel

2004-01-01

We provide recommendations on the best practices for mist netting for the purposes of monitoring population parameters such as abundance and demography. Studies should be carefully thought out before nets are set up, to ensure that sampling design and estimated sample size will allow study objectives to be met. Station location, number of nets, type of nets, net...

Evolution of extreme body size disparity in monitor lizards (Varanus).

PubMed

Collar, David C; Schulte, James A; Losos, Jonathan B

2011-09-01

Many features of species' biology, including life history, physiology, morphology, and ecology are tightly linked to body size. Investigation into the causes of size divergence is therefore critical to understanding the factors shaping phenotypic diversity within clades. In this study, we examined size evolution in monitor lizards (Varanus), a clade that includes the largest extant lizard species, the Komodo dragon (V. komodoensis), as well as diminutive species that are nearly four orders of magnitude smaller in adult body mass. We demonstrate that the remarkable body size disparity of this clade is a consequence of different selective demands imposed by three major habitat use patterns-arboreality, terrestriality, and rock-dwelling. We reconstructed phylogenetic relationships and ancestral habitat use and applied model selection to determine that the best-fitting evolutionary models for species' adult size are those that infer oppositely directed adaptive evolution associated with terrestriality and rock-dwelling, with terrestrial lineages evolving extremely large size and rock-dwellers becoming very small. We also show that habitat use affects the evolution of several ecologically important morphological traits independently of body size divergence. These results suggest that habitat use exerts a strong, multidimensional influence on the evolution of morphological size and shape disparity in monitor lizards. © 2011 The Author(s).

Non-invasive hypoglycemia monitoring system using extreme learning machine for Type 1 diabetes.

PubMed

Ling, Sai Ho; San, Phyo Phyo; Nguyen, Hung T

2016-09-01

Hypoglycemia is a very common in type 1 diabetic persons and can occur at any age. It is always threatening to the well-being of patients with Type 1 diabetes mellitus (T1DM) since hypoglycemia leads to seizures or loss of consciousness and the possible development of permanent brain dysfunction under certain circumstances. Because of that, an accurate continuing hypoglycemia monitoring system is a very important medical device for diabetic patients. In this paper, we proposed a non-invasive hypoglycemia monitoring system using the physiological parameters of electrocardiography (ECG) signal. To enhance the detection accuracy, extreme learning machine (ELM) is developed to recognize the presence of hypoglycemia. A clinical study of 16 children with T1DM is given to illustrate the good performance of ELM. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

From the Children’s Oncology Group: Evidence-based recommendations for PEG-asparaginase nurse monitoring, hypersensitivity reaction management, and patient/family education

PubMed Central

Woods, Deborah; Winchester, Kari; Towerman, Alison; Gettinger, Katie; Carey, Christina; Timmermann, Karen; Langley, Rachel; Browne, Emily

2017-01-01

PEG-aspariginase is a backbone chemotherapy agent in pediatric acute lymphoblastic leukemia and in some non-Hodgkin lymphoma therapies. Nurses lack standardized guidelines for monitoring patients receiving PEG-asparaginase and for educating patients/families about hypersensitivity reaction risks. An electronic search of six databases using publication years 2000–2015 and multiple professional organizations and clinical resources was conducted. Evidence sources were reviewed for topic applicability. Each of the final 23 sources was appraised by two team members. The GRADE system was used to assign a quality and strength rating for each recommendation. Multiple recommendations were developed: four relating to nurse monitoring of patients during and after drug administration, eight guiding hypersensitivity reaction management, and four concerning patient/family educational content. These strong recommendations were based on moderate, low, or very-low quality evidence. Several recommendations relied upon generalized drug hypersensitivity guidelines. Additional research is needed to safely guide PEG-asparaginase monitoring, hypersensitivity reaction management and patient/family education. Nurses administering PEG-asparaginase play a critical role in the early identification and management of hypersensitivity reactions. PMID:28602129

Monitoring black-footed ferrets during reestablishment of free-ranging populations: Discussion of alternative methods and recommended minimum standards

USGS Publications Warehouse

Biggins, Dean E.; Godbey, Jerry L.; Matchett, Marc R.; Hanebury, Louis R.; Livieri, Travis M.; Marinari, Paul E.

2006-01-01

Although the monitoring of black-footed ferret (Mustela nigripes) populations following reintroductions has not been haphazard, several ferret recovery groups since 1994 have recommended development of uniform standards prescribing minimum methods, intensities, and frequencies of monitoring that would provide data on population size, mortality rates, and recruitment. Such standards would promote comparability of data among sites, document expectations for those who will attempt to establish new populations, and allow the U.S. Fish and Wildlife Service and other responsible groups to better assess progress made toward achieving recovery objectives. Our recommendations are based on methods that have been successfully used to monitor natural and reintroduced populations of ferrets and are an attempt to balance needs and costs. We suggest a combination of marking ferrets with passive integrated transponder (PIT) tags and annual spotlight searches coupled with automated transponder readers to individually identify survivors. Unmarked ferrets should be captured and implanted with PIT tags whenever possible. These and other methods are detailed. Circumstances that may dictate other methods or more intensive monitoring (e.g., high rates of loss or low recruitment) also are discussed.

Recommendations for standardizing validation procedures assessing physical activity of older persons by monitoring body postures and movements.

PubMed

Lindemann, Ulrich; Zijlstra, Wiebren; Aminian, Kamiar; Chastin, Sebastien F M; de Bruin, Eling D; Helbostad, Jorunn L; Bussmann, Johannes B J

2014-01-10

Physical activity is an important determinant of health and well-being in older persons and contributes to their social participation and quality of life. Hence, assessment tools are needed to study this physical activity in free-living conditions. Wearable motion sensing technology is used to assess physical activity. However, there is a lack of harmonisation of validation protocols and applied statistics, which make it hard to compare available and future studies. Therefore, the aim of this paper is to formulate recommendations for assessing the validity of sensor-based activity monitoring in older persons with focus on the measurement of body postures and movements. Validation studies of body-worn devices providing parameters on body postures and movements were identified and summarized and an extensive inter-active process between authors resulted in recommendations about: information on the assessed persons, the technical system, and the analysis of relevant parameters of physical activity, based on a standardized and semi-structured protocol. The recommended protocols can be regarded as a first attempt to standardize validity studies in the area of monitoring physical activity.

Use of continuous electronic fetal monitoring in a preterm fetus: clinical dilemmas and recommendations for practice.

PubMed

Afors, Karolina; Chandraharan, Edwin

2011-01-01

The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults during labour. Although, National Guidelines on electronic fetal monitoring exist for term fetuses, there is paucity of recommendations based on scientific evidence for monitoring preterm fetuses during labour. Lack of evidence-based recommendations may pose a clinical dilemma as preterm births account for nearly 8% (1 in 13) live births in England and Wales. 93% of these preterm births occur after 28 weeks, 6% between 22-27 weeks, and 1% before 22 weeks. Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult. This review describes the features of normal fetal heart rate patterns at different gestations and the physiological responses of a preterm fetus compared to a fetus at term. We have proposed an algorithm "ACUTE" to aid management.

USACE Extreme Sea levels

DTIC Science & Technology

2014-03-14

with expected changes due to climate change. (tropicals and extra-tropicals) Ivan provided some good information on work being done on tropical...Pattiaratchi, C., Jensen, J., 2013. Estimating extreme water level probabilities: a comparison of the direct methods and recommendations for best practise ...sites: site-by-site analyses. Proudman Oceanographic Laboratory , Internal Document, No. 65, 229pp. Dixon, M.J., Tawn, J.A. (1995) Extreme sea-levels

Use of Continuous Electronic Fetal Monitoring in a Preterm Fetus: Clinical Dilemmas and Recommendations for Practice

PubMed Central

Afors, Karolina; Chandraharan, Edwin

2011-01-01

The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults during labour. Although, National Guidelines on electronic fetal monitoring exist for term fetuses, there is paucity of recommendations based on scientific evidence for monitoring preterm fetuses during labour. Lack of evidence-based recommendations may pose a clinical dilemma as preterm births account for nearly 8% (1 in 13) live births in England and Wales. 93% of these preterm births occur after 28 weeks, 6% between 22–27 weeks, and 1% before 22 weeks. Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult. This review describes the features of normal fetal heart rate patterns at different gestations and the physiological responses of a preterm fetus compared to a fetus at term. We have proposed an algorithm “ACUTE” to aid management. PMID:21922045

Extreme dissolved oxygen variability in urbanised tropical wetlands: The need for detailed monitoring to protect nursery ground values

NASA Astrophysics Data System (ADS)

Dubuc, Alexia; Waltham, Nathan; Malerba, Martino; Sheaves, Marcus

2017-11-01

Little is known about levels of dissolved oxygen fish are exposed to daily in typical urbanised tropical wetlands found along the Great Barrier Reef coastline. This study investigates diel dissolved oxygen (DO) dynamics in one of these typical urbanised wetlands, in tropical North Queensland, Australia. High frequency data loggers (DO, temperature, depth) were deployed for several days over the summer months in different tidal pools and channels that fish use as temporal or permanent refuges. DO was extremely variable over a 24 h cycle, and across the small-scale wetland. The high spatial and temporal DO variability measured was affected by time of day and tidal factors, namely water depth, tidal range and tidal direction (flood vs ebb). For the duration of the logging time, DO was mainly above the adopted threshold for hypoxia (50% saturation), however, for around 11% of the time, and on almost every logging day, DO values fell below the threshold, including a severe hypoxic event (<5% saturation) that continued for several hours. Fish still use this wetland intensively, so must be able to cope with low DO periods. Despite the ability of fish to tolerate extreme conditions, continuing urban expansion is likely to lead to further water quality degradation and so potential loss of nursery ground value. There is a substantial discontinuity between the recommended DO values in the Australian and New Zealand Guidelines for Fresh and Marine Water Quality and the values observed in this wetland, highlighting the limited value of these guidelines for management purposes. Local and regional high frequency data monitoring programs, in conjunction with local exposure risk studies are needed to underpin the development of the management that will ensure the sustainability of coastal wetlands.

Recommendations for standards of monitoring during anaesthesia and recovery 2015: Association of Anaesthetists of Great Britain and Ireland.

PubMed

Checketts, M R; Alladi, R; Ferguson, K; Gemmell, L; Handy, J M; Klein, A A; Love, N J; Misra, U; Morris, C; Nathanson, M H; Rodney, G E; Verma, R; Pandit, J J

2016-01-01

This guideline updates and replaces the 4th edition of the AAGBI Standards of Monitoring published in 2007. The aim of this document is to provide guidance on the minimum standards for physiological monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the United Kingdom and Ireland. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included. There is also guidance on monitoring patients undergoing sedation and also during transfer of anaesthetised or sedated patients. There are new sections discussing the role of monitoring depth of anaesthesia, neuromuscular blockade and cardiac output. The indications for end-tidal carbon dioxide monitoring have been updated. © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.

Dynamic extreme values modeling and monitoring by means of sea shores water quality biomarkers and valvometry.

PubMed

Durrieu, Gilles; Pham, Quang-Khoai; Foltête, Anne-Sophie; Maxime, Valérie; Grama, Ion; Tilly, Véronique Le; Duval, Hélène; Tricot, Jean-Marie; Naceur, Chiraz Ben; Sire, Olivier

2016-07-01

Water quality can be evaluated using biomarkers such as tissular enzymatic activities of endemic species. Measurement of molluscs bivalves activity at high frequency (e.g., valvometry) during a long time period is another way to record the animal behavior and to evaluate perturbations of the water quality in real time. As the pollution affects the activity of oysters, we consider the valves opening and closing velocities to monitor the water quality assessment. We propose to model the huge volume of velocity data collected in the framework of valvometry using a new nonparametric extreme values statistical model. The objective is to estimate the tail probabilities and the extreme quantiles of the distribution of valve closing velocity. The tail of the distribution function of valve closing velocity is modeled by a Pareto distribution with parameter t,τ , beyond a threshold τ according to the time t of the experiment. Our modeling approach reveals the dependence between the specific activity of two enzymatic biomarkers (Glutathione-S-transferase and acetylcholinesterase) and the continuous recording of oyster valve velocity, proving the suitability of this tool for water quality assessment. Thus, valvometry allows in real-time in situ analysis of the bivalves behavior and appears as an effective early warning tool in ecological risk assessment and marine environment monitoring.

Accolades and Recommendations: A Longitudinal Analysis of Monitoring Reports for Two Charter Schools Serving Native American Students

ERIC Educational Resources Information Center

Anderson, Derek L.; Holder, K. C.

2012-01-01

This longitudinal case study examines 10 years' worth of annual monitoring reports for two rural Native American Charter Schools. Using data from multiple sources including interviews, site visits, and document analyses, the authors used provisional coding and constant comparison analysis to categorize the accolades and recommendations embedded in…

Groundwater monitoring of hydraulic fracturing in California: Recommendations for permit-required monitoring

NASA Astrophysics Data System (ADS)

Esser, B. K.; Beller, H. R.; Carroll, S.; Cherry, J. A.; Jackson, R. B.; Jordan, P. D.; Madrid, V.; Morris, J.; Parker, B. L.; Stringfellow, W. T.; Varadharajan, C.; Vengosh, A.

2015-12-01

California recently passed legislation mandating dedicated groundwater quality monitoring for new well stimulation operations. The authors provided the State with expert advice on the design of such monitoring networks. Factors that must be considered in designing a new and unique groundwater monitoring program include: Program design: The design of a monitoring program is contingent on its purpose, which can range from detection of individual well leakage to demonstration of regional impact. The regulatory goals for permit-required monitoring conducted by operators on a well-by-well basis will differ from the scientific goals of a regional monitoring program conducted by the State. Vulnerability assessment: Identifying factors that increase the probability of transport of fluids from the hydrocarbon target zone to a protected groundwater zone enables the intensity of permit-required monitoring to be tiered by risk and also enables prioritization of regional monitoring of groundwater basins based on vulnerability. Risk factors include well integrity; proximity to existing wellbores and geologic features; wastewater disposal; vertical separation between the hydrocarbon and groundwater zones; and site-specific hydrogeology. Analyte choice: The choice of chemical analytes in a regulatory monitoring program is guided by the goals of detecting impact, assuring public safety, preventing resource degradation, and minimizing cost. Balancing these goals may be best served by tiered approach in which targeted analysis of specific chemical additives is triggered by significant changes in relevant but more easily analyzed constituents. Such an approach requires characterization of baseline conditions, especially in areas with long histories of oil and gas development. Monitoring technology: Monitoring a deep subsurface process or a long wellbore is more challenging than monitoring a surface industrial source. The requirement for monitoring multiple groundwater aquifers across

Monitoring Cellular Events in Living Mast Cells Stimulated with an Extremely Small Amount of Fluid on a Microchip

NASA Astrophysics Data System (ADS)

Munaka, Tatsuya; Abe, Hirohisa; Kanai, Masaki; Sakamoto, Takashi; Nakanishi, Hiroaki; Yamaoka, Tetsuji; Shoji, Shuichi; Murakami, Akira

2006-07-01

We successfully developed a measurement system for real-time analysis of cellular function using a newly designed microchip. This microchip was equipped with a micro cell incubation chamber (240 nl) and was stimulated by a very small amount of stimuli (as small as 24 nl). Using the microchip system, cultivation of mast cells was successfully carried out. Monitoring of the cellular events after stimulation with an extremely small amount of fluid on a microchip was performed. This system could be applicable for various types of cellular analysis including real-time monitoring of cellular response by stimulation.

Can Sequential Coagulation Monitoring Predict Major Haemorrhage in Extremely Low Birth Weight Infants?

PubMed

Thanhaeuser, Margarita; Binder, Christoph; Derhaschnig, Ulla; Jilma, Bernd; Kornsteiner-Krenn, Margit; Huber-Dangl, Mercedes; Repa, Andreas; Kreissl, Alexandra; Berger, Angelika; Haiden, Nadja

2018-06-04

 Bleeds such as intra-ventricular (IVH) and pulmonary haemorrhage (PH) are life-threatening events in extremely low birth weight (ELBW) infants. Serial coagulation monitoring by measuring the international normalized ratio (INR) with small volume samples might facilitate early diagnosis and possibly prevent major bleeds.  This was a prospective longitudinal study performed in ELBW infants, who received serial INR monitoring by point of care testing during their first 30 days of life. The primary objective was to explore whether INR monitoring could predict major bleeding events (IVH, PH). Secondary objectives were mortality and feasibility in this patient population.  A total of 127 ELBW infants were stratified into a bleeding and a non-bleeding group. Bleeding events occurred in 31% (39/127) of the infants, whereupon 24% developed IVH and 9% PH. Infants in the bleeding group were 4 days younger at birth ( p  = 0.05) and had a substantially higher mortality rate of 26% versus 5% in controls ( p  = 0.005). Median INR during the first 3 days before a bleeding event was 1.55 (95% confidence interval [CI]: 1.39-1.74) compared with the control group with 1.45 (95% CI: 1.44-1.58; p  = 0.81). Platelet counts were significantly lower in the bleeding group on the 3rd day and during the 2nd to 4th week of life.  Serial coagulation monitoring by an INR point of care testing is feasible in ELBW infants but could not predict bleeding events. Further studies with daily monitoring of INR and platelet counts during the first days of life might be able to more precisely detect a risk of major haemorrhage in ELBW infants. Schattauer GmbH Stuttgart.

Ambulatory reflux monitoring for diagnosis of gastro-esophageal reflux disease: Update of the Porto consensus and recommendations from an international consensus group.

PubMed

Roman, S; Gyawali, C P; Savarino, E; Yadlapati, R; Zerbib, F; Wu, J; Vela, M; Tutuian, R; Tatum, R; Sifrim, D; Keller, J; Fox, M; Pandolfino, J E; Bredenoord, A J

2017-10-01

An international group of experts evaluated and revised recommendations for ambulatory reflux monitoring for the diagnosis of gastro-esophageal reflux disease (GERD). Literature search was focused on indications and technical recommendations for GERD testing and phenotypes definitions. Statements were proposed and discussed during several structured meetings. Reflux testing should be performed after cessation of acid suppressive medication in patients with a low likelihood of GERD. In this setting, testing can be either catheter-based or wireless pH-monitoring or pH-impedance monitoring. In patients with a high probability of GERD (esophagitis grade C and D, histology proven Barrett's mucosa >1 cm, peptic stricture, previous positive pH monitoring) and persistent symptoms, pH-impedance monitoring should be performed on treatment. Recommendations are provided for data acquisition and analysis. Esophageal acid exposure is considered as pathological if acid exposure time (AET) is greater than 6% on pH testing. Number of reflux episodes and baseline impedance are exploratory metrics that may complement AET. Positive symptom reflux association is defined as symptom index (SI) >50% or symptom association probability (SAP) >95%. A positive symptom-reflux association in the absence of pathological AET defines hypersensitivity to reflux. The consensus group determined that grade C or D esophagitis, peptic stricture, histology proven Barrett's mucosa >1 cm, and esophageal acid exposure greater >6% are sufficient to define pathological GERD. Further testing should be considered when none of these criteria are fulfilled. © 2017 John Wiley & Sons Ltd.

FELASA recommendations for the health monitoring of mouse, rat, hamster, guinea pig and rabbit colonies in breeding and experimental units.

PubMed

Mähler Convenor, M; Berard, M; Feinstein, R; Gallagher, A; Illgen-Wilcke, B; Pritchett-Corning, K; Raspa, M

2014-07-01

The microbiological quality of experimental animals can critically influence animal welfare and the validity and reproducibility of research data. It is therefore important for breeding and experimental facilities to establish a laboratory animal health monitoring (HM) programme as an integrated part of any quality assurance system. FELASA has published recommendations for the HM of rodent and rabbit colonies in breeding and experimental units (Nicklas et al. Laboratory Animals, 2002), with the intention of harmonizing HM programmes. As stated in the preamble, these recommendations need to be adapted periodically to meet current developments in laboratory animal medicine. Accordingly, previous recommendations have been revised and shall be replaced by the present recommendations. These recommendations are aimed at all breeders and users of laboratory mice, rats, Syrian hamsters, guinea pigs and rabbits as well as diagnostic laboratories. They describe essential aspects of HM, such as the choice of agents, selection of animals and tissues for testing, frequency of sampling, commonly used test methods, interpretation of results and HM reporting. Compared with previous recommendations, more emphasis is put on the role of a person with sufficient understanding of the principles of HM, opportunistic agents, the use of sentinel animals (particularly under conditions of cage-level containment) and the interpretation and reporting of HM results. Relevant agents, testing frequencies and literature references are updated. Supplementary information on specific agents and the number of animals to be monitored and an example of a HM programme description is provided in the appendices. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Recommendations for the use of mist nets for inventory and monitoring of bird populations

USGS Publications Warehouse

Ralph, C. John; Dunn, Erica H.; Peach, Will J.; Handel, Colleen M.; Ralph, C. John; Dunn, Erica H.

2004-01-01

We provide recommendations on the best practices for mist netting for the purposes of monitoring population parameters such as abundance and demography. Studies should be carefully thought out before nets are set up, to ensure that sampling design and estimated sample size will allow study objectives to be met. Station location, number of nets, type of nets, net placement, and schedule of operation should be determined by the goals of the particular project, and we provide guidelines for typical mist-net studies. In the absence of study-specific requirements for novel protocols, commonly used protocols should be used to enable comparison of results among studies. Regardless of the equipment, net layout, or netting schedule selected, it is important for all studies that operations be strictly standardized, and a well-written operation protocol will help in attaining this goal. We provide recommendations for data to be collected on captured birds, and emphasize the need for good training of project personnel

Effects of Juvenile Idiopathic Arthritis on Kinematics and Kinetics of the Lower Extremities Call for Consequences in Physical Activities Recommendations

PubMed Central

Hartmann, M.; Kreuzpointner, F.; Haefner, R.; Michels, H.; Schwirtz, A.; Haas, J. P.

2010-01-01

Juvenile idiopathic arthritis (JIA) patients (n = 36) with symmetrical polyarticular joint involvement of the lower extremities and healthy controls (n = 20) were compared concerning differences in kinematic, kinetic, and spatio-temporal parameters with 3D gait analysis. The aims of this study were to quantify the differences in gait between JIA patients and healthy controls and to provide data for more detailed sport activities recommendations. JIA-patients showed reduced walking speed and step length, strongly anterior tilted pelvis, reduced maximum hip extension, reduced knee extension during single support phase and reduced plantar flexion in push off. Additionally the roll-off procedure of the foot was slightly decelerated. The reduced push off motion in the ankle was confirmed by lower peaks in ankle moment and power. The gait of JIA-patients can be explained as a crouch-like gait with hyperflexion in hip and knee joints and less plantar flexion in the ankle. A preventive mobility workout would be recommendable to reduce these restrictions in the future. Advisable are sports with emphasis on extension in hip, knee, and ankle plantar flexion. PMID:20862334

Evaluation of TRMM 3B42V7 product on extreme precipitation measurements over peninsular Malaysia

NASA Astrophysics Data System (ADS)

Paska, Jacquoelyne; Lau, Alvin M. S.; Tan, Mou Leong; Tan, Kok Chooi

2017-10-01

Climate variability has become a matter worth our attention as this issue has unveiled to the extreme water-related disasters such as flood and drought. Increments in heavy precipitation have happened over the past century and future climate scenarios show that it may alter the recurrence, timing, force, and length of these occasions. Satellite precipitation products (SPPs) could be used as representation of precipitation over a large region. This could be useful for the monitoring of the precipitation pattern as well as extreme events. Nevertheless, application of these products in monitoring extreme precipitation is still limited because insufficiency of quality assessment. This study aims to evaluate the performance of the Tropical Rainfall Measuring Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA) 3B42V7 product in capturing the behavior of extreme precipitation events over Peninsular Malaysia from 2000 to 2015. Four extreme precipitation indices, in two general categories of absolute threshold (R10mm, R20mm and R50mm) and maximum (Rx1d) indices that recommended by the Expert Team on Climate Change Detection and Indices (ETCCDI) were used. General evaluation has shown that the TRMM 3B42V7 product performed good on the measurements of monthly and annual precipitation. In the respect of extreme precipitation measurements, weak to moderate positive correlations were found between the TRMM 3B42 product and rain gauges over Peninsular Malaysia. The TRMM 3B42V7 product overestimated the R10mm and R20mm indices, while an underestimation was found for the R50mm and Rx1d indices.

Pushing precipitation to the extremes in distributed experiments: Recommendations for simulating wet and dry years

USGS Publications Warehouse

Knapp, Alan K.; Avolio, Meghan L.; Beier, Claus; Carroll, Charles J.W.; Collins, Scott L.; Dukes, Jeffrey S.; Fraser, Lauchlan H.; Griffin-Nolan, Robert J.; Hoover, David L.; Jentsch, Anke; Loik, Michael E.; Phillips, Richard P.; Post, Alison K.; Sala, Osvaldo E.; Slette, Ingrid J.; Yahdjian, Laura; Smith, Melinda D.

2017-01-01

Intensification of the global hydrological cycle, ranging from larger individual precipitation events to more extreme multiyear droughts, has the potential to cause widespread alterations in ecosystem structure and function. With evidence that the incidence of extreme precipitation years (defined statistically from historical precipitation records) is increasing, there is a clear need to identify ecosystems that are most vulnerable to these changes and understand why some ecosystems are more sensitive to extremes than others. To date, opportunistic studies of naturally occurring extreme precipitation years, combined with results from a relatively small number of experiments, have provided limited mechanistic understanding of differences in ecosystem sensitivity, suggesting that new approaches are needed. Coordinated distributed experiments (CDEs) arrayed across multiple ecosystem types and focused on water can enhance our understanding of differential ecosystem sensitivity to precipitation extremes, but there are many design challenges to overcome (e.g., cost, comparability, standardization). Here, we evaluate contemporary experimental approaches for manipulating precipitation under field conditions to inform the design of ‘Drought-Net’, a relatively low-cost CDE that simulates extreme precipitation years. A common method for imposing both dry and wet years is to alter each ambient precipitation event. We endorse this approach for imposing extreme precipitation years because it simultaneously alters other precipitation characteristics (i.e., event size) consistent with natural precipitation patterns. However, we do not advocate applying identical treatment levels at all sites – a common approach to standardization in CDEs. This is because precipitation variability varies >fivefold globally resulting in a wide range of ecosystem-specific thresholds for defining extreme precipitation years. For CDEs focused on precipitation extremes, treatments should be based

Pushing precipitation to the extremes in distributed experiments: recommendations for simulating wet and dry years.

PubMed

Knapp, Alan K; Avolio, Meghan L; Beier, Claus; Carroll, Charles J W; Collins, Scott L; Dukes, Jeffrey S; Fraser, Lauchlan H; Griffin-Nolan, Robert J; Hoover, David L; Jentsch, Anke; Loik, Michael E; Phillips, Richard P; Post, Alison K; Sala, Osvaldo E; Slette, Ingrid J; Yahdjian, Laura; Smith, Melinda D

2017-05-01

Intensification of the global hydrological cycle, ranging from larger individual precipitation events to more extreme multiyear droughts, has the potential to cause widespread alterations in ecosystem structure and function. With evidence that the incidence of extreme precipitation years (defined statistically from historical precipitation records) is increasing, there is a clear need to identify ecosystems that are most vulnerable to these changes and understand why some ecosystems are more sensitive to extremes than others. To date, opportunistic studies of naturally occurring extreme precipitation years, combined with results from a relatively small number of experiments, have provided limited mechanistic understanding of differences in ecosystem sensitivity, suggesting that new approaches are needed. Coordinated distributed experiments (CDEs) arrayed across multiple ecosystem types and focused on water can enhance our understanding of differential ecosystem sensitivity to precipitation extremes, but there are many design challenges to overcome (e.g., cost, comparability, standardization). Here, we evaluate contemporary experimental approaches for manipulating precipitation under field conditions to inform the design of 'Drought-Net', a relatively low-cost CDE that simulates extreme precipitation years. A common method for imposing both dry and wet years is to alter each ambient precipitation event. We endorse this approach for imposing extreme precipitation years because it simultaneously alters other precipitation characteristics (i.e., event size) consistent with natural precipitation patterns. However, we do not advocate applying identical treatment levels at all sites - a common approach to standardization in CDEs. This is because precipitation variability varies >fivefold globally resulting in a wide range of ecosystem-specific thresholds for defining extreme precipitation years. For CDEs focused on precipitation extremes, treatments should be based on

Short-term techniques for monitoring coral reefs: Review, results, and recommendations

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

Mann, G.S.; Hunte, W.

1994-12-31

The health of coral reefs is in question on a global scale. The degradation of reefs has been attributed to both natural (e.g., el nino, crown-of-thorns, and hurricanes) and anthropogenic (e.g., sedimentation, nutrient overloading, oil spills, and thermal pollution) factors. Demonstrating the deleterious effects of lethal factors has not been difficult. However, it has been more difficult to quantitatively link those factors which do not cause rapid coral mortality to reef degradation. Classic techniques, such as cross-transplantation and x-ray analysis of growth bands, have proven to be successful bioassessments of chronic exposure to stressful conditions. The resolution of these techniquesmore » generally limits their usefulness as only long-term exposure (months to years) can provide quantitative differences between impacted and controlled conditions. Short-term monitoring techniques using corals have received relatively little attention from researchers. Two short-term methods have been successfully used to discriminated polluted from less-polluted sites in Barbados. The first is based on adult growth in several coral species. The second focuses on growth and survival of newly-settled juvenile corals. Both methods allowed discrimination in less than two weeks. These methods and others need to be evaluated and standardized in order to permit better, more efficient monitoring of the worlds reefs. Recommendations will be made on what life-history characteristics should be considered when choosing a coral species for use in bioassessment studies.« less

Compilation of 1986 annual reports of the Navy ELF (Extremely Low Frequency) communications system ecological monitoring program, volume 2

NASA Astrophysics Data System (ADS)

1987-07-01

The U.S. Navy is conducting a long-term program to monitor for possible effects from the operation of its Extremely Low Frequency (ELF) Communications System to resident biota and their ecological relationships. This report documents progress of the following studies: soil amoeba; soil and litter arthropoda and earthworm studies; biological studies on pollinating insects: megachilid bees; and small vertebrates: small mammals and nesting birds.

Monitoring strategies and scale-appropriate hydrologic and biogeochemical modelling for natural resource management: Conclusions and recommendations from a session held at the iEMSs 2008

USDA-ARS?s Scientific Manuscript database

This short communication paper presents recommendations for developing scale-appropriate monitoring and modelling strategies to assist decision making in natural resource management. These ideas presented here were discussed in the session (S5) ‘Monitoring strategies and scale-appropriate hydrologic...

A comparative assessment of statistical methods for extreme weather analysis

NASA Astrophysics Data System (ADS)

Schlögl, Matthias; Laaha, Gregor

2017-04-01

Extreme weather exposure assessment is of major importance for scientists and practitioners alike. We compare different extreme value approaches and fitting methods with respect to their value for assessing extreme precipitation and temperature impacts. Based on an Austrian data set from 25 meteorological stations representing diverse meteorological conditions, we assess the added value of partial duration series over the standardly used annual maxima series in order to give recommendations for performing extreme value statistics of meteorological hazards. Results show the merits of the robust L-moment estimation, which yielded better results than maximum likelihood estimation in 62 % of all cases. At the same time, results question the general assumption of the threshold excess approach (employing partial duration series, PDS) being superior to the block maxima approach (employing annual maxima series, AMS) due to information gain. For low return periods (non-extreme events) the PDS approach tends to overestimate return levels as compared to the AMS approach, whereas an opposite behavior was found for high return levels (extreme events). In extreme cases, an inappropriate threshold was shown to lead to considerable biases that may outperform the possible gain of information from including additional extreme events by far. This effect was neither visible from the square-root criterion, nor from standardly used graphical diagnosis (mean residual life plot), but from a direct comparison of AMS and PDS in synoptic quantile plots. We therefore recommend performing AMS and PDS approaches simultaneously in order to select the best suited approach. This will make the analyses more robust, in cases where threshold selection and dependency introduces biases to the PDS approach, but also in cases where the AMS contains non-extreme events that may introduce similar biases. For assessing the performance of extreme events we recommend conditional performance measures that focus

Monitoring Changes of Tropical Extreme Rainfall Events Using Differential Absorption Barometric Radar (DiBAR)

NASA Technical Reports Server (NTRS)

Lin, Bing; Harrah, Steven; Lawrence, R. Wes; Hu, Yongxiang; Min, Qilong

2015-01-01

This work studies the potential of monitoring changes in tropical extreme rainfall events such as tropical storms from space using a Differential-absorption BArometric Radar (DiBAR) operating at 50-55 gigahertz O2 absorption band to remotely measure sea surface air pressure. Air pressure is among the most important variables that affect atmospheric dynamics, and currently can only be measured by limited in-situ observations over oceans. Analyses show that with the proposed radar the errors in instantaneous (averaged) pressure estimates can be as low as approximately 5 millibars (approximately 1 millibar) under all weather conditions. With these sea level pressure measurements, the forecasts, analyses and understanding of these extreme events in both short and long time scales can be improved. Severe weathers, especially hurricanes, are listed as one of core areas that need improved observations and predictions in WCRP (World Climate Research Program) and NASA Decadal Survey (DS) and have major impacts on public safety and national security through disaster mitigation. Since the development of the DiBAR concept about a decade ago, our team has made substantial progress in advancing the concept. Our feasibility assessment clearly shows the potential of sea surface barometry using existing radar technologies. We have developed a DiBAR system design, fabricated a Prototype-DiBAR (P-DiBAR) for proof-of-concept, conducted lab, ground and airborne P-DiBAR tests. The flight test results are consistent with our instrumentation goals. Observational system simulation experiments for space DiBAR performance show substantial improvements in tropical storm predictions, not only for the hurricane track and position but also for the hurricane intensity. DiBAR measurements will lead us to an unprecedented level of the prediction and knowledge on tropical extreme rainfall weather and climate conditions.

Monitoring the impacts of Ocean Acidification on coral reef bioerosion: challenges, methods, recommendations

NASA Astrophysics Data System (ADS)

Enochs, I.; Manzello, D.; Carlton, R.

2013-05-01

Coral reef habitats exist as a dynamic balance between the additive process of calcification and the destructive effects of erosion. A disruption to either the positive or negative side of the coral reef carbonate budget can push a reef system towards rapid collapse. It is well understood that Ocean Acidification (OA) may impair calcification and emerging experimental evidence suggests that it will likely increase the erosive potential of a diverse suite of bioeroding taxa. This may lead to previously unforeseen scenarios where reef framework degradation occurs at a faster pace than that predicted by more simplistic models, resulting from the multifaceted impacts of both slower coral growth and enhanced rates of habitat erosion. As such, it is of paramount importance that monitoring plans tasked with assessing reef resilience to climate change and OA incorporate methods for quantifying bioerosion. This is a complex undertaking as reef ecosystem bioerosion is the result of numerous behaviors, employed by diverse flora and fauna, operating at vastly different scales. Furthermore, these erosive processes are highly variable, dependent on seasonal fluctuations and differing between reef regions, species, individuals, and even the physical characteristics of the substrates acted upon. The strengths and weaknesses of existing bioerosion monitoring methodologies are discussed, ranging from quantification of single species erosion rates to multi-phyletic census-based approaches. Traditional techniques involving the weight change of carbonate blocks are compared alongside more modern methodologies such as micro computed tomography. Finally, recommendations are made for a comprehensive monitoring strategy, incorporating multiple methodologies in a time and cost-effective manner.

Improved Personalized Recommendation Based on Causal Association Rule and Collaborative Filtering

ERIC Educational Resources Information Center

Lei, Wu; Qing, Fang; Zhou, Jin

2016-01-01

There are usually limited user evaluation of resources on a recommender system, which caused an extremely sparse user rating matrix, and this greatly reduce the accuracy of personalized recommendation, especially for new users or new items. This paper presents a recommendation method based on rating prediction using causal association rules.…

Heat Shield for Extreme Entry Environment Technology (HEEET)

NASA Technical Reports Server (NTRS)

Venkatapathy, Ethiraj

2017-01-01

The Heat Shield for Extreme Entry Environment Technology (HEEET) project seeks to mature a game changing Woven Thermal Protection System (TPS) technology to enable in situ robotic science missions recommended by the NASA Research Council Planetary Science Decadal Survey committee. Recommended science missions include Venus probes and landers; Saturn and Uranus probes; and high-speed sample return missions.

Climate change and the effects of temperature extremes on Australian flying-foxes.

PubMed

Welbergen, Justin A; Klose, Stefan M; Markus, Nicola; Eby, Peggy

2008-02-22

Little is known about the effects of temperature extremes on natural systems. This is of increasing concern now that climate models predict dramatic increases in the intensity, duration and frequency of such extremes. Here we examine the effects of temperature extremes on behaviour and demography of vulnerable wild flying-foxes (Pteropus spp.). On 12 January 2002 in New South Wales, Australia, temperatures exceeding 42 degrees C killed over 3500 individuals in nine mixed-species colonies. In one colony, we recorded a predictable sequence of thermoregulatory behaviours (wing-fanning, shade-seeking, panting and saliva-spreading, respectively) and witnessed how 5-6% of bats died from hyperthermia. Mortality was greater among the tropical black flying-fox, Pteropus alecto (10-13%) than the temperate grey-headed flying-fox, Pteropus poliocephalus (less than 1%), and young and adult females were more affected than adult males (young, 23-49%; females, 10-15%; males, less than 3%). Since 1994, over 30000 flying-foxes (including at least 24500 P. poliocephalus) were killed during 19 similar events. Although P. alecto was relatively less affected, it is currently expanding its range into the more variable temperature envelope of P. poliocephalus, which increases the likelihood of die-offs occurring in this species. Temperature extremes are important additional threats to Australian flying-foxes and the ecosystem services they provide, and we recommend close monitoring of colonies where temperatures exceeding 42.0 degrees C are predicted. The effects of temperature extremes on flying-foxes highlight the complex implications of climate change for behaviour, demography and species survival.

Recommendations for Assessment of the Reliability, Sensitivity, and Validity of Data Provided by Wearable Sensors Designed for Monitoring Physical Activity

PubMed Central

2018-01-01

Although it is becoming increasingly popular to monitor parameters related to training, recovery, and health with wearable sensor technology (wearables), scientific evaluation of the reliability, sensitivity, and validity of such data is limited and, where available, has involved a wide variety of approaches. To improve the trustworthiness of data collected by wearables and facilitate comparisons, we have outlined recommendations for standardized evaluation. We discuss the wearable devices themselves, as well as experimental and statistical considerations. Adherence to these recommendations should be beneficial not only for the individual, but also for regulatory organizations and insurance companies. PMID:29712629

The Efficacy of Intraoperative Neurophysiological Monitoring Using Transcranial Electrically Stimulated Muscle-evoked Potentials (TcE-MsEPs) for Predicting Postoperative Segmental Upper Extremity Motor Paresis After Cervical Laminoplasty.

PubMed

Fujiwara, Yasushi; Manabe, Hideki; Izumi, Bunichiro; Tanaka, Hiroyuki; Kawai, Kazumi; Tanaka, Nobuhiro

2016-05-01

Prospective study. To investigate the efficacy of transcranial electrically stimulated muscle-evoked potentials (TcE-MsEPs) for predicting postoperative segmental upper extremity palsy following cervical laminoplasty. Postoperative segmental upper extremity palsy, especially in the deltoid and biceps (so-called C5 palsy), is the most common complication following cervical laminoplasty. Some papers have reported that postoperative C5 palsy cannot be predicted by TcE-MsEPs, although others have reported that it can be predicted. This study included 160 consecutive cases that underwent open-door laminoplasty, and TcE-MsEP monitoring was performed in the biceps brachii, triceps brachii, abductor digiti minimi, tibialis anterior, and abductor hallucis. A >50% decrease in the wave amplitude was defined as an alarm point. According to the monitoring alarm, interventions were performed, which include steroid administration, foraminotomies, etc. Postoperative deltoid and biceps palsy occurred in 5 cases. Among the 155 cases without segmental upper extremity palsy, there were no monitoring alarms. Among the 5 deltoid and biceps palsy cases, 3 had significant wave amplitude decreases in the biceps during surgery, and palsy occurred when the patients awoke from anesthesia (acute type). In the other 2 cases in which the palsy occurred 2 days after the operation (delayed type), there were no significant wave decreases. In all of the cases, the palsy was completely resolved within 6 months. The majority of C5 palsies have been reported to occur several days after surgery, but some of them have been reported to occur immediately after surgery. Our results demonstrated that TcE-MsEPs can predict the acute type, whereas the delayed type cannot be predicted. A >50% wave amplitude decrease in the biceps is useful to predict acute-type segmental upper extremity palsy. Further examination about the interventions for monitoring alarm will be essential for preventing palsy.

Modeling extreme PM10 concentration in Malaysia using generalized extreme value distribution

NASA Astrophysics Data System (ADS)

Hasan, Husna; Mansor, Nadiah; Salleh, Nur Hanim Mohd

2015-05-01

Extreme PM10 concentration from the Air Pollutant Index (API) at thirteen monitoring stations in Malaysia is modeled using the Generalized Extreme Value (GEV) distribution. The data is blocked into monthly selection period. The Mann-Kendall (MK) test suggests a non-stationary model so two models are considered for the stations with trend. The likelihood ratio test is used to determine the best fitted model and the result shows that only two stations favor the non-stationary model (Model 2) while the other eleven stations favor stationary model (Model 1). The return level of PM10 concentration that is expected to exceed the maximum once within a selected period is obtained.

Monitoring the tobacco use epidemic IV. The vector: Tobacco industry data sources and recommendations for research and evaluation.

PubMed

Cruz, Tess Boley

2009-01-01

This Vector paper (IV of V on monitoring the tobacco use epidemic) presents the data sources and methods that can be used to monitor tobacco marketing and makes recommendations for creating a national surveillance system. In 2002, the Vector Work Group of the National Tobacco Monitoring, Research and Evaluation Workshop identified priority indicators of tobacco marketing: tobacco brand pricing strategies, retail environment advertising and promotional allowances, gray market or smuggling activities, lobbying, direct mail marketing, tobacco brand placements in films, Internet promotions, and sponsorship at bars and events. This paper reviews and identifies data sources and gaps for these priority indicators and for 12 other indicators of interest. There are 38 commercial data sites and Internet sources, as well as individual research efforts that address the priority indicators. These sources are not integrated, often costly, and limited in standardization. Tobacco marketing could be more effectively monitored with the development of a national research network. Surveillance of the tobacco industry's methods to push tobacco and pull consumers can help the public health community identify new markets and campaigns, justify and tailor effective tobacco control strategies, and evaluate existing counter-marketing efforts.

Familial correlates of extreme weight control behaviors among adolescents.

PubMed

Fonseca, Helena; Ireland, Marjorie; Resnick, Michael D

2002-12-01

To identify familial factors associated with extreme weight control among adolescents. Analysis of a comprehensive 1996 health survey of Connecticut students. Familial factors among extreme dieters who deliberately vomited, took diet pills, laxatives, or diuretics were compared with youth reporting none of these behaviors, using logistic regression controlling for age and body mass index. Nearly 7% of adolescents reported engaging in extreme weight control behaviors. Boys' risk factors included high parental supervision/monitoring and sexual abuse history. Protective factors included high parental expectations, maternal presence, and connectedness with friends and other adults. The only significant risk factor for girls was sexual abuse history. Protective factors included family connectedness, positive family communication, parental supervision/monitoring, and maternal presence. Extreme dieting appears to be less an expression of body composition than of psychosocial issues. That connectedness to family, other adults, and friends is protective further demonstrates interrelationships of extreme weight control behaviors with family/social issues. Copyright 2002 by Wiley Periodicals, Inc. Int J Eat Disord 32: 441-448, 2002.

Asymmetry of projected increases in extreme temperature distributions

PubMed Central

Kodra, Evan; Ganguly, Auroop R.

2014-01-01

A statistical analysis reveals projections of consistently larger increases in the highest percentiles of summer and winter temperature maxima and minima versus the respective lowest percentiles, resulting in a wider range of temperature extremes in the future. These asymmetric changes in tail distributions of temperature appear robust when explored through 14 CMIP5 climate models and three reanalysis datasets. Asymmetry of projected increases in temperature extremes generalizes widely. Magnitude of the projected asymmetry depends significantly on region, season, land-ocean contrast, and climate model variability as well as whether the extremes of consideration are seasonal minima or maxima events. An assessment of potential physical mechanisms provides support for asymmetric tail increases and hence wider temperature extremes ranges, especially for northern winter extremes. These results offer statistically grounded perspectives on projected changes in the IPCC-recommended extremes indices relevant for impacts and adaptation studies. PMID:25073751

Diagnosis, monitoring, and treatment of primary ciliary dyskinesia: PCD foundation consensus recommendations based on state of the art review.

PubMed

Shapiro, Adam J; Zariwala, Maimoona A; Ferkol, Thomas; Davis, Stephanie D; Sagel, Scott D; Dell, Sharon D; Rosenfeld, Margaret; Olivier, Kenneth N; Milla, Carlos; Daniel, Sam J; Kimple, Adam J; Manion, Michele; Knowles, Michael R; Leigh, Margaret W

2016-02-01

Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, rare lung disease resulting in chronic oto-sino-pulmonary disease in both children and adults. Many physicians incorrectly diagnose PCD or eliminate PCD from their differential diagnosis due to inexperience with diagnostic testing methods. Thus far, all therapies used for PCD are unproven through large clinical trials. This review article outlines consensus recommendations from PCD physicians in North America who have been engaged in a PCD centered research consortium for the last 10 years. These recommendations have been adopted by the governing board of the PCD Foundation to provide guidance for PCD clinical centers for diagnostic testing, monitoring, and appropriate short and long-term therapeutics in PCD patients. © 2015 The Authors. Pediatric Pulmonology Published by Wiley Periodicals, Inc.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista.

PubMed

Stake, Seth; du Breuil, Anne L; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

PubMed Central

du Breuil, Anne L.; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses. PMID:27800207

Monitoring a local extreme weather event with the scope of hyperspectral sounding

NASA Astrophysics Data System (ADS)

Satapathy, Jyotirmayee; Jangid, Buddhi Prakash

2018-06-01

Operational space-based hyperspectral Infrared sounders retrieve atmospheric temperature and humidity profiles from the measured radiances. These sounders like Atmospheric InfraRed Sounder, Infrared Atmospheric Sounding Interferometer as well as INSAT-3D sounders on geostationary orbit have proved to be very successful in providing these retrievals on global and regional scales, respectively, with good enough spatio-temporal resolutions and are well competent with that of traditional profiles from radiosondes and models fields. The aim of this work is to show how these new generation hyperspectral Infrared sounders can benefit in real-time weather monitoring. We have considered a regional extreme weather event to demonstrate how the profiles retrieved from these operational sounders are consistent with the environmental conditions which have led to this severe weather event. This work has also made use of data products of Moderate Resolution Imaging Spectroradiometer as well as by radiative transfer simulation of clear and cloudy atmospheric conditions using Numerical Weather Prediction profiles in conjunction with INSAT-3D sounder. Our results indicate the potential use of high-quality hyperspectral atmospheric profiles to aid in delineation of real-time weather prediction.

A Top Pilot Tunnel Preconditioning Method for the Prevention of Extremely Intense Rockbursts in Deep Tunnels Excavated by TBMs

NASA Astrophysics Data System (ADS)

Zhang, Chuanqing; Feng, Xiating; Zhou, Hui; Qiu, Shili; Wu, Wenping

2012-05-01

The headrace tunnels at the Jinping II Hydropower Station cross the Jinping Mountain with a maximum overburden depth of 2,525 m, where 80% of the strata along the tunnels consist of marble. A number of extremely intense rockbursts occurred during the excavation of the auxiliary tunnels and the drainage tunnel. In particular, a tunnel boring machine (TBM) was destroyed by an extremely intense rockburst in a 7.2-m-diameter drainage tunnel. Two of the four subsequent 12.4-m-diameter headrace tunnels will be excavated with larger size TBMs, where a high risk of extremely intense rockbursts exists. Herein, a top pilot tunnel preconditioning method is proposed to minimize this risk, in which a drilling and blasting method is first recommended for the top pilot tunnel excavation and support, and then the TBM excavation of the main tunnel is conducted. In order to evaluate the mechanical effectiveness of this method, numerical simulation analyses using the failure approaching index, energy release rate, and excess shear stress indices are carried out. Its construction feasibility is discussed as well. Moreover, a microseismic monitoring technique is used in the experimental tunnel section for the real-time monitoring of the microseismic activities of the rock mass in TBM excavation and for assessing the effect of the top pilot tunnel excavation in reducing the risk of rockbursts. This method is applied to two tunnel sections prone to extremely intense rockbursts and leads to a reduction in the risk of rockbursts in TBM excavation.

Modeling mutual feedback between users and recommender systems

NASA Astrophysics Data System (ADS)

Zeng, An; Yeung, Chi Ho; Medo, Matúš; Zhang, Yi-Cheng

2015-07-01

Recommender systems daily influence our decisions on the Internet. While considerable attention has been given to issues such as recommendation accuracy and user privacy, the long-term mutual feedback between a recommender system and the decisions of its users has been neglected so far. We propose here a model of network evolution which allows us to study the complex dynamics induced by this feedback, including the hysteresis effect which is typical for systems with non-linear dynamics. Despite the popular belief that recommendation helps users to discover new things, we find that the long-term use of recommendation can contribute to the rise of extremely popular items and thus ultimately narrow the user choice. These results are supported by measurements of the time evolution of item popularity inequality in real systems. We show that this adverse effect of recommendation can be tamed by sacrificing part of short-term recommendation accuracy.

A Recommender System in the Cyber Defense Domain

DTIC Science & Technology

2014-03-27

monitoring software is a java based program sending updates to the database on the sensor machine. The host monitoring program gathers information about...3.2.2 Database. A MySQL database located on the sensor machine acts as the storage for the sensors on the network. Snort, Nmap, vulnerability scores, and...machine with the IDS and the recommender is labeled “sensor”. The recommender system code is written in java and compiled using java version 1.6.024

Imaging of neuro-cognitive performance in extreme Environments—A (p)review

NASA Astrophysics Data System (ADS)

Schneider, Stefan; Bubeev, Juri A.; Choukèr, Alexander; Morukov, Boris; Johannes, Bernd; Strüder, Heiko K.

2012-12-01

Living in extreme environments is accompanied by a number of stressors, which can be classified either as physiological stressors (e.g. microgravity, missing sunlight) or psychological stressors (e.g. confinement). From earth bound studies a negative impact of stress on mental health and cognitive performance is well known and both factors might impair mission success and mission safety during longer inhabitation of space. Accordingly there is the need to identify adequate countermeasures. Nevertheless causal research of neuro-cognitive impairments in space remains speculative due to missing possibilities of brain imaging. Furthermore the reliability of current psychological tests used to assess and monitor cognitive performance in extreme environments seems to be vulnerable due to a lack of compliance. With on-going plans of international space agencies to send people to moon and/or mars, this manuscript aims to summarize and review research attempts of the past two decades and to identify methodological shortcomings. Finally, following the guideline that research has no legacy for its own but must serve the self-concept and well-being of man, this manuscript presents a number of recommendations to enhance future neuro-cognitive research in extreme environments. A deeper insight into neuro-cognitive coherence is not only desirable to understand the effects of stress on mental health, which seems to be a major issue for our current society, and to develop adequate countermeasures but will also help to maintain and improve mission success and mission safety in manned space flight.

Prevention and management of infections associated with combat-related extremity injuries.

PubMed

Murray, Clinton K; Hsu, Joseph R; Solomkin, Joseph S; Keeling, John J; Andersen, Romney C; Ficke, James R; Calhoun, Jason H

2008-03-01

Orthopedic injuries suffered by casualties during combat constitute approximately 65% of the total percentage of injuries and are evenly distributed between upper and lower extremities. The high-energy explosive injuries, environmental contamination, varying evacuation procedures, and progressive levels of medical care make managing combat-related injuries challenging. The goals of orthopedic injury management are to prevent infection, promote fracture healing, and restore function. It appears that 2% to 15% of combat-related extremity injuries develop osteomyelitis, although lower extremity injuries are at higher risk of infections than upper extremity. Management strategies of combat-related injuries primarily focus on early surgical debridement and stabilization, antibiotic administration, and delayed primary closure. Herein, we provide evidence-based recommendations from military and civilian data to the management of combat-related injuries of the extremity. Areas of emphasis include the utility of bacterial cultures, antimicrobial therapy, irrigation fluids and techniques, timing of surgical care, fixation, antibiotic impregnated beads, wound closure, and wound coverage with negative pressure wound therapy. Most of the recommendations are not supported by randomized controlled trials or adequate cohorts studies in a military population and further efforts are needed to answer best treatment strategies.

Promoting Cold-Start Items in Recommender Systems

PubMed Central

Liu, Jin-Hu; Zhou, Tao; Zhang, Zi-Ke; Yang, Zimo; Liu, Chuang; Li, Wei-Min

2014-01-01

As one of the major challenges, cold-start problem plagues nearly all recommender systems. In particular, new items will be overlooked, impeding the development of new products online. Given limited resources, how to utilize the knowledge of recommender systems and design efficient marketing strategy for new items is extremely important. In this paper, we convert this ticklish issue into a clear mathematical problem based on a bipartite network representation. Under the most widely used algorithm in real e-commerce recommender systems, the so-called item-based collaborative filtering, we show that to simply push new items to active users is not a good strategy. Interestingly, experiments on real recommender systems indicate that to connect new items with some less active users will statistically yield better performance, namely, these new items will have more chance to appear in other users' recommendation lists. Further analysis suggests that the disassortative nature of recommender systems contributes to such observation. In a word, getting in-depth understanding on recommender systems could pave the way for the owners to popularize their cold-start products with low costs. PMID:25479013

Promoting cold-start items in recommender systems.

PubMed

Liu, Jin-Hu; Zhou, Tao; Zhang, Zi-Ke; Yang, Zimo; Liu, Chuang; Li, Wei-Min

2014-01-01

As one of the major challenges, cold-start problem plagues nearly all recommender systems. In particular, new items will be overlooked, impeding the development of new products online. Given limited resources, how to utilize the knowledge of recommender systems and design efficient marketing strategy for new items is extremely important. In this paper, we convert this ticklish issue into a clear mathematical problem based on a bipartite network representation. Under the most widely used algorithm in real e-commerce recommender systems, the so-called item-based collaborative filtering, we show that to simply push new items to active users is not a good strategy. Interestingly, experiments on real recommender systems indicate that to connect new items with some less active users will statistically yield better performance, namely, these new items will have more chance to appear in other users' recommendation lists. Further analysis suggests that the disassortative nature of recommender systems contributes to such observation. In a word, getting in-depth understanding on recommender systems could pave the way for the owners to popularize their cold-start products with low costs.

Controversial cytogenetic observations in mammalian somatic cells exposed to extremely low frequency electromagnetic radiation: a review and future research recommendations.

PubMed

Vijayalaxmi; Obe, Guenter

2005-07-01

During the years 1990-2003, a large number of investigations were conducted using animals, cultured rodent and human cells as well as freshly collected human blood lymphocytes to determine the genotoxic potential of exposure to nonionizing radiation emitted from extremely low frequency electromagnetic fields (EMF). Among the 63 peer reviewed scientific reports, the conclusions from 29 studies (46%) did not indicate increased damage to the genetic material, as assessed from DNA strand breaks, incidence of chromosomal aberrations (CA), micronuclei (MN), and sister chromatid exchanges (SCE), in EMF exposed cells as compared with sham exposed and/or unexposed cells, while those from 14 investigations (22%) have suggested an increase in such damage in EMF exposed cells. The observations from 20 other studies (32%) were inconclusive. This study reviews the investigations published in peer reviewed scientific journals during 1990-2003 and attempts to identify probable reason(s) for the conflicting results. Recommendations are made for future research to address some of the controversial observations. Copyright 2005 Wiley-Liss, Inc.

Developing Effective Communications about Extreme Weather Risks.

NASA Astrophysics Data System (ADS)

Bruine de Bruin, W.

2014-12-01

Members of the general public often face complex decisions about the risks that they face, including those associated with extreme weather and climate change adaptation. Scientific experts may be asked to develop communications with the goal of improving people's understanding of weather and climate risks, and informing people's decisions about how to protect against these risks. Unfortunately, scientific experts' communication efforts may fail if they lack information about what people need or want to know to make more informed decisions or what wording people prefer use to describe relevant concepts. This presentation provides general principles for developing effective risk communication materials that aim for widespread dissemination, such as brochures and websites. After a brief review of the social science evidence on how to design effective risk communication materials, examples will focus on communications about extreme weather events and climate change. Specifically, data will be presented from ongoing projects on flood risk perception, public preparedness for heat waves, and public perceptions of climate change. The presentation will end with specific recommendations about how to improve recipients' understanding about risks and inform decisions. These recommendations should be useful to scientific experts who aim to communicate about extreme weather, climate change, or other risks.

Recommendations for Assessment of the Reliability, Sensitivity, and Validity of Data Provided by Wearable Sensors Designed for Monitoring Physical Activity.

PubMed

Düking, Peter; Fuss, Franz Konstantin; Holmberg, Hans-Christer; Sperlich, Billy

2018-04-30

Although it is becoming increasingly popular to monitor parameters related to training, recovery, and health with wearable sensor technology (wearables), scientific evaluation of the reliability, sensitivity, and validity of such data is limited and, where available, has involved a wide variety of approaches. To improve the trustworthiness of data collected by wearables and facilitate comparisons, we have outlined recommendations for standardized evaluation. We discuss the wearable devices themselves, as well as experimental and statistical considerations. Adherence to these recommendations should be beneficial not only for the individual, but also for regulatory organizations and insurance companies. ©Peter Düking, Franz Konstantin Fuss, Hans-Christer Holmberg, Billy Sperlich. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 30.04.2018.

A single pH fluorescent probe for biosensing and imaging of extreme acidity and extreme alkalinity.

PubMed

Chao, Jian-Bin; Wang, Hui-Juan; Zhang, Yong-Bin; Li, Zhi-Qing; Liu, Yu-Hong; Huo, Fang-Jun; Yin, Cai-Xia; Shi, Ya-Wei; Wang, Juan-Juan

2017-07-04

A simple tailor-made pH fluorescent probe 2-benzothiazole (N-ethylcarbazole-3-yl) hydrazone (Probe) is facilely synthesized by the condensation reaction of 2-hydrazinobenzothiazole with N-ethylcarbazole-3-formaldehyde, which is a useful fluorescent probe for monitoring extremely acidic and alkaline pH, quantitatively. The pH titrations indicate that Probe displays a remarkable emission enhancement with a pK a of 2.73 and responds linearly to minor pH fluctuations within the extremely acidic range of 2.21-3.30. Interestingly, Probe also exhibits strong pH-dependent characteristics with pK a 11.28 and linear response to extreme-alkalinity range of 10.41-12.43. In addition, Probe shows a large Stokes shift of 84 nm under extremely acidic and alkaline conditions, high selectivity, excellent sensitivity, good water-solubility and fine stability, all of which are favorable for intracellular pH imaging. The probe is further successfully applied to image extremely acidic and alkaline pH values fluctuations in E. coli cells. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of staff training and electronic event monitoring on long-term adherence to lung-protective ventilation recommendations.

PubMed

Castellanos, Ixchel; Martin, Marcus; Kraus, Stefan; Bürkle, Thomas; Prokosch, Hans-Ulrich; Schüttler, Jürgen; Toddenroth, Dennis

2018-02-01

To investigate long-term effects of staff training and electronic clinical decision support (CDS) on adherence to lung-protective ventilation recommendations. In 2012, group instructions and workshops at two surgical intensive care units (ICUs) started, focusing on standardized protocols for mechanical ventilation and volutrauma prevention. Subsequently implemented CDS functions continuously monitor ventilation parameters, and from 2015 triggered graphical notifications when tidal volume (V T ) violated individual thresholds. To estimate the effects of these educational and technical interventions, we retrospectively analyzed nine years of V T records from routine care. As outcome measures, we calculated relative frequencies of settings that conform to recommendations, case-specific mean excess V T , and total ICU survival. Assessing 571,478 V T records from 10,241 ICU cases indicated that adherence during pressure-controlled ventilation improved significantly after both interventions; the share of conforming V T records increased from 61.6% to 83.0% and then 86.0%. Despite increasing case severity, ICU survival remained nearly constant over time. Staff training effectively improves adherence to lung-protective ventilation strategies. The observed CDS effect seemed less pronounced, although it can easily be adapted to new recommendations. Both interventions, which futures studies could deploy in combination, promise to improve the precision of mechanical ventilation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Diagnosis, monitoring, and treatment of primary ciliary dyskinesia: PCD foundation consensus recommendations based on state of the art review

PubMed Central

Zariwala, Maimoona A.; Ferkol, Thomas; Davis, Stephanie D.; Sagel, Scott D.; Dell, Sharon D.; Rosenfeld, Margaret; Olivier, Kenneth N.; Milla, Carlos; Daniel, Sam J.; Kimple, Adam J.; Manion, Michele; Knowles, Michael R.; Leigh, Margaret W.

2015-01-01

Summary Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, rare lung disease resulting in chronic oto‐sino‐pulmonary disease in both children and adults. Many physicians incorrectly diagnose PCD or eliminate PCD from their differential diagnosis due to inexperience with diagnostic testing methods. Thus far, all therapies used for PCD are unproven through large clinical trials. This review article outlines consensus recommendations from PCD physicians in North America who have been engaged in a PCD centered research consortium for the last 10 years. These recommendations have been adopted by the governing board of the PCD Foundation to provide guidance for PCD clinical centers for diagnostic testing, monitoring, and appropriate short and long‐term therapeutics in PCD patients. Pediatr Pulmonol. 2016;51:115–132. © 2015 The Authors. Pediatric Pulmonology Published by Wiley Periodicals, Inc. PMID:26418604

Space Station Induced Monitoring

NASA Technical Reports Server (NTRS)

Spann, James F. (Editor); Torr, Marsha R. (Editor)

1988-01-01

This report contains the results of a conference convened May 10-11, 1988, to review plans for monitoring the Space Station induced environment, to recommend primary components of an induced environment monitoring package, and to make recommendations pertaining to suggested modifications of the Space Station External Contamination Control Requirements Document JSC 30426. The contents of this report are divided as Follows: Monitoring Induced Environment - Space Station Work Packages Requirements, Neutral Environment, Photon Emission Environment, Particulate Environment, Surface Deposition/Contamination; and Contamination Control Requirements.

USGEO DMWG Cloud Computing Recommendations

NASA Astrophysics Data System (ADS)

de la Beaujardiere, J.; McInerney, M.; Frame, M. T.; Summers, C.

2017-12-01

The US Group on Earth Observations (USGEO) Data Management Working Group (DMWG) has been developing Cloud Computing Recommendations for Earth Observations. This inter-agency report is currently in draft form; DMWG hopes to have released the report as a public Request for Information (RFI) by the time of AGU. The recommendations are geared toward organizations that have already decided to use the Cloud for some of their activities (i.e., the focus is not on "why you should use the Cloud," but rather "If you plan to use the Cloud, consider these suggestions.") The report comprises Introductory Material, including Definitions, Potential Cloud Benefits, and Potential Cloud Disadvantages, followed by Recommendations in several areas: Assessing When to Use the Cloud, Transferring Data to the Cloud, Data and Metadata Contents, Developing Applications in the Cloud, Cost Minimization, Security Considerations, Monitoring and Metrics, Agency Support, and Earth Observations-specific recommendations. This talk will summarize the recommendations and invite comment on the RFI.

Updated recommendations on the use of hydroxychloroquine in dermatologic practice.

PubMed

Fernandez, Anthony P

2017-06-01

Hydroxychloroquine has unique immunomodulatory properties and an attractive adverse effect profile. Over the past 10 years, research has led to significant updates in clinical recommendations concerning the optimal use of hydroxychloroquine and monitoring of patients taking it. We discuss updated recommendations concerning hydroxychloroquine daily dosing, retinopathy screening, serologic monitoring, use in smokers, use in pregnant women, and adverse effect risk and monitoring. This review can hopefully serve as an aid to dermatologists and help ensure they continue using hydroxychloroquine safely and effectively. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Model methodology for estimating pesticide concentration extremes based on sparse monitoring data

USGS Publications Warehouse

Vecchia, Aldo V.

2018-03-22

This report describes a new methodology for using sparse (weekly or less frequent observations) and potentially highly censored pesticide monitoring data to simulate daily pesticide concentrations and associated quantities used for acute and chronic exposure assessments, such as the annual maximum daily concentration. The new methodology is based on a statistical model that expresses log-transformed daily pesticide concentration in terms of a seasonal wave, flow-related variability, long-term trend, and serially correlated errors. Methods are described for estimating the model parameters, generating conditional simulations of daily pesticide concentration given sparse (weekly or less frequent) and potentially highly censored observations, and estimating concentration extremes based on the conditional simulations. The model can be applied to datasets with as few as 3 years of record, as few as 30 total observations, and as few as 10 uncensored observations. The model was applied to atrazine, carbaryl, chlorpyrifos, and fipronil data for U.S. Geological Survey pesticide sampling sites with sufficient data for applying the model. A total of 112 sites were analyzed for atrazine, 38 for carbaryl, 34 for chlorpyrifos, and 33 for fipronil. The results are summarized in this report; and, R functions, described in this report and provided in an accompanying model archive, can be used to fit the model parameters and generate conditional simulations of daily concentrations for use in investigations involving pesticide exposure risk and uncertainty.

Extreme weather exposure identification for road networks - a comparative assessment of statistical methods

NASA Astrophysics Data System (ADS)

Schlögl, Matthias; Laaha, Gregor

2017-04-01

The assessment of road infrastructure exposure to extreme weather events is of major importance for scientists and practitioners alike. In this study, we compare the different extreme value approaches and fitting methods with respect to their value for assessing the exposure of transport networks to extreme precipitation and temperature impacts. Based on an Austrian data set from 25 meteorological stations representing diverse meteorological conditions, we assess the added value of partial duration series (PDS) over the standardly used annual maxima series (AMS) in order to give recommendations for performing extreme value statistics of meteorological hazards. Results show the merits of the robust L-moment estimation, which yielded better results than maximum likelihood estimation in 62 % of all cases. At the same time, results question the general assumption of the threshold excess approach (employing PDS) being superior to the block maxima approach (employing AMS) due to information gain. For low return periods (non-extreme events) the PDS approach tends to overestimate return levels as compared to the AMS approach, whereas an opposite behavior was found for high return levels (extreme events). In extreme cases, an inappropriate threshold was shown to lead to considerable biases that may outperform the possible gain of information from including additional extreme events by far. This effect was visible from neither the square-root criterion nor standardly used graphical diagnosis (mean residual life plot) but rather from a direct comparison of AMS and PDS in combined quantile plots. We therefore recommend performing AMS and PDS approaches simultaneously in order to select the best-suited approach. This will make the analyses more robust, not only in cases where threshold selection and dependency introduces biases to the PDS approach but also in cases where the AMS contains non-extreme events that may introduce similar biases. For assessing the performance of

Impact of an extreme climatic event on community assembly.

PubMed

Thibault, Katherine M; Brown, James H

2008-03-04

Extreme climatic events are predicted to increase in frequency and magnitude, but their ecological impacts are poorly understood. Such events are large, infrequent, stochastic perturbations that can change the outcome of entrained ecological processes. Here we show how an extreme flood event affected a desert rodent community that has been monitored for 30 years. The flood (i) caused catastrophic, species-specific mortality; (ii) eliminated the incumbency advantage of previously dominant species; (iii) reset long-term population and community trends; (iv) interacted with competitive and metapopulation dynamics; and (v) resulted in rapid, wholesale reorganization of the community. This and a previous extreme rainfall event were punctuational perturbations-they caused large, rapid population- and community-level changes that were superimposed on a background of more gradual trends driven by climate and vegetation change. Captured by chance through long-term monitoring, the impacts of such large, infrequent events provide unique insights into the processes that structure ecological communities.

Recommendations Service for Chronic Disease Patient in Multimodel Sensors Home Environment

PubMed Central

Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Latif, Khalid

2015-01-01

Abstract With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC3). SC3 services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC3 platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms. PMID:25559934

Recommendations service for chronic disease patient in multimodel sensors home environment.

PubMed

Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Lee, Sungyoung; Latif, Khalid

2015-03-01

With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC(3)). SC(3) services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC(3) platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms.

Thermal Evaluation of Fiber Bragg Gratings at Extreme Temperatures

NASA Technical Reports Server (NTRS)

Juergens, Jeffrey; Adamovsky, Grigory; Bhatt, Ramakrishna; Morscher, Gregory; Floyd, Bertram

2005-01-01

The development of integrated fiber optic sensors for use in aerospace health monitoring systems demands that the sensors be able to perform in extreme environments. In order to use fiber optic sensors effectively in an extreme environment one must have a thorough understanding of the sensor's capabilities, limitations, and performance under extreme environmental conditions. This paper reports on our current sensor evaluation examining the performance of freestanding fiber Bragg gratings (FBG) at extreme temperatures. While the ability of FBGs to survive at extreme temperatures has been established, their performance and long term survivability is not well documented. At extreme temperatures the grating structure would be expected to dissipate, degrading the sensors performance and eventually ceasing to return a detectable signal. The fiber jacket will dissipate leaving a brittle, unprotected fiber. For FBGs to be used in aerospace systems their performance and limitations need to be thoroughly understood at extreme temperatures. As the limits of the FBGs performance are pushed the long term survivability and performance of the sensor comes into question. We will not only examine the ability of FBGs to survive extreme temperatures but also look at their performance during many thermal cycles. This paper reports on test results of the performance of thermal cycling commercially available FBGs, at temperatures up to 1000 C, seen in aerospace applications. Additionally this paper will report on the performance of commercially available FBGs held at 1000 C for hundreds of hours. Throughout the evaluation process, various parameters of the FBGs performance were monitored and recorded. Several test samples were subjected to identical test conditions to allow for statistical analysis of the data. Test procedures, calibrations, referencing techniques, performance data, and interpretations and explanations of results are presented in the paper along with directions for

Assessing the features of extreme smog in China and the differentiated treatment strategy

NASA Astrophysics Data System (ADS)

Deng, Lu; Zhang, Zhengjun

2018-01-01

Extreme smog can have potentially harmful effects on human health, the economy and daily life. However, the average (mean) values do not provide strategically useful information on the hazard analysis and control of extreme smog. This article investigates China's smog extremes by applying extreme value analysis to hourly PM2.5 data from 2014 to 2016 obtained from monitoring stations across China. By fitting a generalized extreme value (GEV) distribution to exceedances over a station-specific extreme smog level at each monitoring location, all study stations are grouped into eight different categories based on the estimated mean and shape parameter values of fitted GEV distributions. The extreme features characterized by the mean of the fitted extreme value distribution, the maximum frequency and the tail index of extreme smog at each location are analysed. These features can provide useful information for central/local government to conduct differentiated treatments in cities within different categories and conduct similar prevention goals and control strategies among those cities belonging to the same category in a range of areas. Furthermore, hazardous hours, breaking probability and the 1-year return level of each station are demonstrated by category, based on which the future control and reduction targets of extreme smog are proposed for the cities of Beijing, Tianjin and Hebei as an example.

Design and Manufacturing of Extremely Low Mass Flight Systems

NASA Technical Reports Server (NTRS)

Johnson, Michael R.

2002-01-01

Extremely small flight systems pose some unusual design and manufacturing challenges. The small size of the components that make up the system generally must be built with extremely tight tolerances to maintain the functionality of the assembled item. Additionally, the total mass of the system is extremely sensitive to what would be considered small perturbations in a larger flight system. The MUSES C mission, designed, built, and operated by Japan, has a small rover provided by NASA that falls into this small flight system category. This NASA-provided rover is used as a case study of an extremely small flight system design. The issues that were encountered with the rover portion of the MUSES C program are discussed and conclusions about the recommended mass margins at different stages of a small flight system project are presented.

Personalized professional content recommendation

DOEpatents

Xu, Songhua

2015-10-27

A personalized content recommendation system includes a client interface configured to automatically monitor a user's information data stream transmitted on the Internet. A hybrid contextual behavioral and collaborative personal interest inference engine resident to a non-transient media generates automatic predictions about the interests of individual users of the system. A database server retains the user's personal interest profile based on a plurality of monitored information. The system also includes a server programmed to filter items in an incoming information stream with the personal interest profile and is further programmed to identify only those items of the incoming information stream that substantially match the personal interest profile.

Extreme seismicity and disaster risks: Hazard versus vulnerability (Invited)

NASA Astrophysics Data System (ADS)

Ismail-Zadeh, A.

2013-12-01

Although the extreme nature of earthquakes has been known for millennia due to the resultant devastation from many of them, the vulnerability of our civilization to extreme seismic events is still growing. It is partly because of the increase in the number of high-risk objects and clustering of populations and infrastructure in the areas prone to seismic hazards. Today an earthquake may affect several hundreds thousand lives and cause significant damage up to hundred billion dollars; it can trigger an ecological catastrophe if occurs in close vicinity to a nuclear power plant. Two types of extreme natural events can be distinguished: (i) large magnitude low probability events, and (ii) the events leading to disasters. Although the first-type events may affect earthquake-prone countries directly or indirectly (as tsunamis, landslides etc.), the second-type events occur mainly in economically less-developed countries where the vulnerability is high and the resilience is low. Although earthquake hazards cannot be reduced, vulnerability to extreme events can be diminished by monitoring human systems and by relevant laws preventing an increase in vulnerability. Significant new knowledge should be gained on extreme seismicity through observations, monitoring, analysis, modeling, comprehensive hazard assessment, prediction, and interpretations to assist in disaster risk analysis. The advanced disaster risk communication skill should be developed to link scientists, emergency management authorities, and the public. Natural, social, economic, and political reasons leading to disasters due to earthquakes will be discussed.

Recent and future extreme precipitation over Ukraine

NASA Astrophysics Data System (ADS)

Vyshkvarkova, Olena; Voskresenskaya, Elena

2014-05-01

The aim of study is to analyze the parameters of precipitation extremes and inequality over Ukraine in recent climate epoch and their possible changes in the future. Data of observations from 28 hydrometeorological stations over Ukraine and output of GFDL-CM3 model (CMIP5) for XXI century were used in the study. The methods of concentration index (J. Martin-Vide, 2004) for the study of precipitation inequality while the extreme precipitation indices recommended by the ETCCDI - for the frequency of events. Results. Precipitation inequality on the annual and seasonal scales was studied using estimated CI series for 1951-2005. It was found that annual CI ranges vary from 0.58 to 0.64. They increase southward from the north-west (forest zone) and the north-east (forest steppe zone) of Ukraine. CI maxima are located in the coastal regions of the Black Sea and the Sea of Azov. Annual CI spatial distribution indicates that the contribution of extreme precipitation into annual totals is most significant at the boundary zone between steppe and marine regions. At the same time precipitation pattern at the foothill of Carpathian Mountains is more homogenous. The CI minima (0.54) are typical for the winter season in foothill of Ukrainian Carpathians. The CI maxima reach 0.71 in spring at the steppe zone closed to the Black Sea coast. It should be noted that the greatest ranges of CI maximum and CI minimum deviation are typical for spring. It is associated with patterns of cyclone trajectories in that season. The most territory is characterized by tendency to decrease the contribution of extreme precipitation into the total amount (CI linear trends are predominantly negative in all seasons). Decadal and interdecadal variability of precipitation inequality associated with global processes in ocean-atmosphere system are also studied. It was shown that precipitation inequality over Ukraine on 10 - 15 % stronger in negative phase of Pacific Decadal Oscillation and in positive phase

SiC Sensors in Extreme Environments: Real-time Hydrogen Monitoring for Energy Plant Applications

NASA Astrophysics Data System (ADS)

Ghosh, Ruby

2008-03-01

Clean, efficient energy production, such as the gasification of coal (syngas), requires physical and chemical sensors for exhaust gas monitoring as well as real-time control of the combustion process. Wide-bandgap semiconducting materials systems can meet the sensing demands in these extreme environments consisting of chemically corrosive gases at high temperature and pressure. We have developed a SiC based micro-sensor for detection of hydrogen containing species with millisecond response at 600 C. The sensor is a Pt-SiO2-SiC device with a dense Pt catalytic sensing film, capable of withstanding months of continuous high temperature operation. The device was characterized in robust sensing module that is compatible with an industrial reactor. We report on the performance of the SiC sensor in a simulated syngas ambient at 370 C containing the common interferants CO2, CH4 and CO [1]. In addition we demonstrate that hours of exposure to >=1000 ppm H2S and 15% water vapor does not degrade the sensor performance. To elucidate the mechanisms responsible for the hydrogen response of the sensor we have modeled the hydrogen adsorptions kinetics at the internal Pt-SiO2 interface, using both the Tempkin and Langmuir isotherms. Under the conditions appropriate for energy plant applications, the response of our sensor is significantly larger than that obtained from ultra-high vacuum electrochemical sensor measurements at high temperatures. We will discuss the role of morphology, at the nano to micro scale, on the enhanced catalytic activity observed for our Pt sensing films in response to a heated hydrogen gas stream at atmospheric pressure. [1] R. Loloee, B. Chorpening, S. Beers & R. Ghosh, Hydrogen monitoring for power plant applications using SiC sensors, Sens. Actuators B:Chem. (2007), doi:10.1016/j.snb.2007.07.118

Urban development under extreme hydrologic and weather conditions for El Paso-Juarez: Recommendations resulting from hydrologic modeling, GIS, and remote sensing analyses

NASA Astrophysics Data System (ADS)

Barud-Zubillaga, Alberto

During the 2006 El Paso-Juarez flood there were many concerns regarding the capability of the existing stormwater system to handle 50- and 100-year flood events in El Paso, Texas and Juarez, Mexico area. Moreover in 2008, a considerable wet year from the normal 223 mm of annual precipitation for El Paso demonstrated that the area could very well received large amounts of precipitation at localized areas in short periods of time, representing a great flood threat to residents living in areas prone to flood. Some climate change projections for the area are exactly what had occurred over the last two decades; an increased number of torrential rainstorms over smaller concentrated pieces of land separated by longer years of drought between rainstorms. This study consisted in three projects focused on three critical regions within the El Paso-Juarez area that were greatly affected by the 2006 Flood. The goal was to identify if natural arroyos or the existent built stormwater system, could properly managed the projected precipitation patterns. The three projects described in this dissertation touch on the following points: (a) the importance of a reliable precipitation model that could accurately describes precipitation patterns in the region under extreme drought and wet climates conditions; (b) differences in land use/land cover characteristics as factors promoting or disrupting the possibility for flooding, and (c) limitations and capabilities of existent stormwater systems and natural arroyos as means to control flooding. Conclusions and recommendations are shown below, which apply not only to each particular project, but also to all study areas and similar areas in the El Paso-Juarez region. Urbanization can improve or worsen a pre-existing natural stormwater system if built under its required capacity. Such capacity should be calculated considering extreme weather conditions, based on a denser network of precipitation stations to capture the various microclimates

Bone Health Monitoring in Astronauts: Recommended Use of Quantitative Computed Tomography [QCT] for Clinical and Operational Decisions

NASA Technical Reports Server (NTRS)

Sibonga, J. D.; Truskowski, P.

2010-01-01

This slide presentation reviews the concerns that astronauts in long duration flights might have a greater risk of bone fracture as they age than the general population. A panel of experts was convened to review the information and recommend mechanisms to monitor the health of bones in astronauts. The use of Quantitative Computed Tomography (QCT) scans for risk surveillance to detect the clinical trigger and to inform countermeasure evaluation is reviewed. An added benefit of QCT is that it facilitates an individualized estimation of bone strength by Finite Element Modeling (FEM), that can inform approaches for bone rehabilitation. The use of FEM is reviewed as a process that arrives at a composite number to estimate bone strength, because it integrates multiple factors.

Adherence to recommended electronic health record safety practices across eight health care organizations.

PubMed

Sittig, Dean F; Salimi, Mandana; Aiyagari, Ranjit; Banas, Colin; Clay, Brian; Gibson, Kathryn A; Goel, Ashutosh; Hines, Robert; Longhurst, Christopher A; Mishra, Vimal; Sirajuddin, Anwar M; Satterly, Tyler; Singh, Hardeep

2018-04-26

The Safety Assurance Factors for EHR Resilience (SAFER) guides were released in 2014 to help health systems conduct proactive risk assessment of electronic health record (EHR)- safety related policies, processes, procedures, and configurations. The extent to which SAFER recommendations are followed is unknown. We conducted risk assessments of 8 organizations of varying size, complexity, EHR, and EHR adoption maturity. Each organization self-assessed adherence to all 140 unique SAFER recommendations contained within 9 guides (range 10-29 recommendations per guide). In each guide, recommendations were organized into 3 broad domains: "safe health IT" (total 45 recommendations); "using health IT safely" (total 80 recommendations); and "monitoring health IT" (total 15 recommendations). The 8 sites fully implemented 25 of 140 (18%) SAFER recommendations. Mean number of "fully implemented" recommendations per guide ranged from 94% (System Interfaces-18 recommendations) to 63% (Clinical Communication-12 recommendations). Adherence was higher for "safe health IT" domain (82.1%) vs "using health IT safely" (72.5%) and "monitoring health IT" (67.3%). Despite availability of recommendations on how to improve use of EHRs, most recommendations were not fully implemented. New national policy initiatives are needed to stimulate implementation of these best practices.

How extreme are extremes?

NASA Astrophysics Data System (ADS)

Cucchi, Marco; Petitta, Marcello; Calmanti, Sandro

2016-04-01

High temperatures have an impact on the energy balance of any living organism and on the operational capabilities of critical infrastructures. Heat-wave indicators have been mainly developed with the aim of capturing the potential impacts on specific sectors (agriculture, health, wildfires, transport, power generation and distribution). However, the ability to capture the occurrence of extreme temperature events is an essential property of a multi-hazard extreme climate indicator. Aim of this study is to develop a standardized heat-wave indicator, that can be combined with other indices in order to describe multiple hazards in a single indicator. The proposed approach can be used in order to have a quantified indicator of the strenght of a certain extreme. As a matter of fact, extremes are usually distributed in exponential or exponential-exponential functions and it is difficult to quickly asses how strong was an extreme events considering only its magnitude. The proposed approach simplify the quantitative and qualitative communication of extreme magnitude

Congenital hypothyroidism - Polish recommendations for therapy, treatment monitoring, and screening tests in special categories of neonates with increased risk of hypothyroidism.

PubMed

Kucharska, Anna Małgorzata; Beń-Skowronek, Iwona; Walczak, Mieczysław; Ołtarzewski, Mariusz; Szalecki, Mieczysław; Jackowska, Teresa; Lewiński, Andrzej; Bossowski, Artur

2016-01-01

Proper treatment of congenital hypothyroidism warrants normal intellectual and physical development. This paper introduces the principles of treatment of congenital hypothyroidism, the recommended levothyroxine dosage, and the aims of therapy with its justification. The principles of treatment, specialist care of the patient, and methods used to evaluate therapeutic effects are described. Based on these data, recommendations concerning treatment and its monitoring in patients with congenital hypothyroidism are formulated. The paper also highlights the importance of educating the patients and/or their caretakers as one of the basic components of an effective therapy. The interpretation of screening tests in preterm neonates is provided as well. In the current screening program in preterm children TSH was determined between days three and five of life and then after three weeks. During this time TSH values are frequently low because of the immaturity of the hypothalamic-pituitary axis. Due to the increased risk of primary and secondary hypothyroidism in preterm and low birth weight babies the determination of TSH and fT4 between days three and five of life is recommended, irrespective of the screening test. (Endokrynol Pol 2016; 67 (5): 536-547).

Spatiotemporal trends in extreme rainfall and temperature indices over Upper Tapi Basin, India

NASA Astrophysics Data System (ADS)

Sharma, Priyank J.; Loliyana, V. D.; S. R., Resmi; Timbadiya, P. V.; Patel, P. L.

2017-12-01

The flood risk across the globe is intensified due to global warming and subsequent increase in extreme temperature and precipitation. The long-term trends in extreme rainfall (1944-2013) and temperature (1969-2012) indices have been investigated at annual, seasonal, and monthly time scales using nonparametric Mann-Kendall (MK), modified Mann-Kendall (MMK), and Sen's slope estimator tests. The extreme rainfall and temperature indices, recommended by the Expert Team on Climate Change Detection Monitoring Indices (ETCCDMI), have been analyzed at finer spatial scales for trend detection. The results of trend analyses indicate decreasing trend in annual total rainfall, significant decreasing trend in rainy days, and increasing trend in rainfall intensity over the basin. The seasonal rainfall has been found to decrease for all the seasons except postmonsoon, which could affect the rain-fed agriculture in the basin. The 1- and 5-day annual maximum rainfalls exhibit mixed trends, wherein part of the basin experiences increasing trend, while other parts experience a decreasing trend. The increase in dry spells and concurrent decrease in wet spells are also observed over the basin. The extreme temperature indices revealed increasing trends in hottest and coldest days, while decreasing trends in coldest night are found over most parts of the basin. Further, the diurnal temperature range is also found to increase due to warming tendency in maximum temperature (T max) at a faster rate compared to the minimum temperature (T min). The increase in frequency and magnitude of extreme rainfall in the basin has been attributed to the increasing trend in maximum and minimum temperatures, reducing forest cover, rapid pace of urbanization, increase in human population, and thereby increase in the aerosol content in the atmosphere. The findings of the present study would significantly help in sustainable water resource planning, better decision-making for policy framework, and setting up

Early Ambulation After Microsurgical Reconstruction of the Lower Extremity.

PubMed

Orseck, Michael J; Smith, Christopher Robert; Kirby, Sean; Trujillo, Manuel

2018-06-01

Successful outcomes after microsurgical reconstruction of the lower extremity include timely return to ambulation. Some combination of physical examination, ViOptix tissue oxygen saturation monitoring, and the implantable venous Doppler have shown promise in increasing sensitivity of current flap monitoring. We have incorporated this system into our postoperative monitoring protocol in an effort to initiate earlier dependency protocols. A prospective analysis of 36 anterolateral thigh free flap and radial forearm flaps for lower extremity reconstruction was performed. Indications for reconstruction were acute and chronic wounds, as well as oncologic resection. Twenty-three patients were able to ambulate and 3 were able to dangle their leg on the first postoperative day. One flap showed early mottling that improved immediately after elevation. After reelevation and return to baseline, the dependency protocol was successfully implemented on postoperative day 3. All flaps went on to successful healing. Physical examination, implantable venous Doppler, and ViOptix can be used reliably as an adjunct to increase the sensitivity of detecting poorly performing flaps during the postoperative progression of dependency.

76 FR 38360 - Workshop-Monitoring Changes in Extreme Storm Statistics: State of Knowledge; Notice of Open...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... Changes in Extreme Storm Statistics: State of Knowledge; Notice of Open Public Workshop AGENCY: National... .) SUPPLEMENTARY INFORMATION: This workshop will provide an update to the climate science surrounding extreme... storms. Specific topics include: Severe Thunderstorms (and associated hail and winds), tornadoes, extreme...

Impact of climate change on European weather extremes

NASA Astrophysics Data System (ADS)

Duchez, Aurelie; Forryan, Alex; Hirschi, Joel; Sinha, Bablu; New, Adrian; Freychet, Nicolas; Scaife, Adam; Graham, Tim

2015-04-01

An emerging science consensus is that global climate change will result in more extreme weather events with concomitant increasing financial losses. Key questions that arise are: Can an upward trend in natural extreme events be recognised and predicted at the European scale? What are the key drivers within the climate system that are changing and making extreme weather events more frequent, more intense, or both? Using state-of-the-art coupled climate simulations from the UK Met Office (HadGEM3-GC2, historical and future scenario runs) as well as reanalysis data, we highlight the potential of the currently most advanced forecasting systems to progress understanding of the causative drivers of European weather extremes, and assess future frequency and intensity of extreme weather under various climate change scenarios. We characterize European extremes in these simulations using a subset of the 27 core indices for temperature and precipitation from The Expert Team on Climate Change Detection and Indices (Tank et al., 2009). We focus on temperature and precipitation extremes (e.g. extremes in daily and monthly precipitation and temperatures) and relate them to the atmospheric modes of variability over Europe in order to establish the large-scale atmospheric circulation patterns that are conducive to the occurrence of extreme precipitation and temperature events. Klein Tank, Albert M.G., and Francis W. Zwiers. Guidelines on Analysis of Extremes in a Changing Climate in Support of Informed Decisions for Adaptation. WMO-TD No. 1500. Climate Data and Monitoring. World Meteorological Organization, 2009.

Computer-assisted upper extremity training using interactive biking exercise (iBikE) platform.

PubMed

Jeong, In Cheol; Finkelstein, Joseph

2012-01-01

Upper extremity exercise training has been shown to improve clinical outcomes in different chronic health conditions. Arm-operated bicycles are frequently used to facilitate upper extremity training however effective use of these devices at patient homes is hampered by lack of remote connectivity with clinical rehabilitation team, inability to monitor exercise progress in real time using simple graphical representation, and absence of an alert system which would prevent exertion levels exceeding those approved by the clinical rehabilitation team. We developed an interactive biking exercise (iBikE) platform aimed at addressing these limitations. The platform uses a miniature wireless 3-axis accelerometer mounted on a patient wrist that transmits the cycling acceleration data to a laptop. The laptop screen presents an exercise dashboard to the patient in real time allowing easy graphical visualization of exercise progress and presentation of exercise parameters in relation to prescribed targets. The iBikE platform is programmed to alert the patient when exercise intensity exceeds the levels recommended by the patient care provider. The iBikE platform has been tested in 7 healthy volunteers (age range: 26-50 years) and shown to reliably reflect exercise progress and to generate alerts at pre-setup levels. Implementation of remote connectivity with patient rehabilitation team is warranted for future extension and evaluation efforts.

Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit.

PubMed

Lasky, Robert E; Williams, Amber L

2009-02-01

The objectives of this study were to characterize noise and light levels for extremely low birth weight newborns throughout their stay in the NICU, evaluate factors influencing noise and light levels, and determine whether exposures meet recommendations from the American Academy of Pediatrics. Sound and light were measured inside the beds of extremely low birth weight newborns (n = 22) from birth to discharge. Measurements were recorded for 20 consecutive hours weekly from birth until 36 weeks' postmenstrual age, biweekly until 40 weeks, and every 4 weeks thereafter. Clinical variables including bed type and method of respiratory support were recorded at each session. Age-related changes in respiratory support and bed type explained the weekly increase of 0.22 dB in sound level and 3.67 lux in light level. Old incubators were the noisiest bed types, and new incubators were the quietest. Light levels were significantly higher in open beds than in incubators. The variations in noise and light levels over time were greatest for open beds. Noise and light levels were much less affected by respiratory support in incubators compared with open beds. A typical extremely low birth weight neonate was exposed to noise levels averaging 56.44 dB(A) and light levels averaging 70.56 lux during their stay from 26 to 42 weeks' postmenstrual age in the NICU. Noise levels were rarely within American Academy of Pediatrics recommendations (5.51% of the time), whereas light levels almost always met recommendations (99.37% of the time). Bed type and respiratory support explained differences in noise and light levels that extremely low birth weight newborns experience during their hospital stay. Noise levels exceeded recommendations, although evidence supporting those recommendations is lacking. Well-designed intervention studies are needed to determine the effects of noise reduction on the development of extremely low birth weight newborns.

Environmental monitoring plan

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

Holland, R.C.

This Environmental Monitoring Plan was written to fulfill the requirements of Department of Energy (DOE) Order 5400.1 and DOE Environmental Regulatory Guide DOE/EH 0173T. This Plan documents the background, organizational structure, and methods used for effluent monitoring and environmental surveillance at Sandia National Laboratories/California. The design, rationale, and historical results of the environmental monitoring system are discussed in detail. Throughout the Plan, recommendations for improvements to the monitoring system are made. 52 refs., 10 figs., 12 tabs.

Recommending personally interested contents by text mining, filtering, and interfaces

DOEpatents

Xu, Songhua

2015-10-27

A personalized content recommendation system includes a client interface device configured to monitor a user's information data stream. A collaborative filter remote from the client interface device generates automated predictions about the interests of the user. A database server stores personal behavioral profiles and user's preferences based on a plurality of monitored past behaviors and an output of the collaborative user personal interest inference engine. A programmed personal content recommendation server filters items in an incoming information stream with the personal behavioral profile and identifies only those items of the incoming information stream that substantially matches the personal behavioral profile. The identified personally relevant content is then recommended to the user following some priority that may consider the similarity between the personal interest matches, the context of the user information consumption behaviors that may be shown by the user's content consumption mode.

An equity dashboard to monitor vaccination coverage.

PubMed

Arsenault, Catherine; Harper, Sam; Nandi, Arijit; Rodríguez, José M Mendoza; Hansen, Peter M; Johri, Mira

2017-02-01

Equity monitoring is a priority for Gavi, the Vaccine Alliance, and for those implementing The 2030 agenda for sustainable development . For its new phase of operations, Gavi reassessed its approach to monitoring equity in vaccination coverage. To help inform this effort, we made a systematic analysis of inequalities in vaccination coverage across 45 Gavi-supported countries and compared results from different measurement approaches. Based on our findings, we formulated recommendations for Gavi's equity monitoring approach. The approach involved defining the vulnerable populations, choosing appropriate measures to quantify inequalities, and defining equity benchmarks that reflect the ambitions of the sustainable development agenda. In this article, we explain the rationale for the recommendations and for the development of an improved equity monitoring tool. Gavi's previous approach to measuring equity was the difference in vaccination coverage between a country's richest and poorest wealth quintiles. In addition to the wealth index, we recommend monitoring other dimensions of vulnerability (maternal education, place of residence, child sex and the multidimensional poverty index). For dimensions with multiple subgroups, measures of inequality that consider information on all subgroups should be used. We also recommend that both absolute and relative measures of inequality be tracked over time. Finally, we propose that equity benchmarks target complete elimination of inequalities. To facilitate equity monitoring, we recommend the use of a data display tool - the equity dashboard - to support decision-making in the sustainable development period. We highlight its key advantages using data from Côte d'Ivoire and Haiti.

An equity dashboard to monitor vaccination coverage

PubMed Central

Harper, Sam; Nandi, Arijit; Rodríguez, José M Mendoza; Hansen, Peter M; Johri, Mira

2017-01-01

Abstract Equity monitoring is a priority for Gavi, the Vaccine Alliance, and for those implementing The 2030 agenda for sustainable development. For its new phase of operations, Gavi reassessed its approach to monitoring equity in vaccination coverage. To help inform this effort, we made a systematic analysis of inequalities in vaccination coverage across 45 Gavi-supported countries and compared results from different measurement approaches. Based on our findings, we formulated recommendations for Gavi’s equity monitoring approach. The approach involved defining the vulnerable populations, choosing appropriate measures to quantify inequalities, and defining equity benchmarks that reflect the ambitions of the sustainable development agenda. In this article, we explain the rationale for the recommendations and for the development of an improved equity monitoring tool. Gavi’s previous approach to measuring equity was the difference in vaccination coverage between a country’s richest and poorest wealth quintiles. In addition to the wealth index, we recommend monitoring other dimensions of vulnerability (maternal education, place of residence, child sex and the multidimensional poverty index). For dimensions with multiple subgroups, measures of inequality that consider information on all subgroups should be used. We also recommend that both absolute and relative measures of inequality be tracked over time. Finally, we propose that equity benchmarks target complete elimination of inequalities. To facilitate equity monitoring, we recommend the use of a data display tool – the equity dashboard – to support decision-making in the sustainable development period. We highlight its key advantages using data from Côte d’Ivoire and Haiti. PMID:28250513

Validation of a global satellite rainfall product for real time monitoring of meteorological extremes

NASA Astrophysics Data System (ADS)

Cánovas-García, Fulgencio; García-Galiano, Sandra; Karbalaee, Negar

2017-10-01

for the study area if PERSIANN-CCS is to be used as an operational tool for the monitoring of extreme meteorological phenomena.

Implementing AORN recommended practices for hand hygiene.

PubMed

Patrick, Marcia; Van Wicklin, Sharon A

2012-04-01

This article focuses on implementing the revised AORN "Recommended practices for hand hygiene in the perioperative setting." The content of the document has been expanded and reorganized from the previous iteration and now includes specific activity statements about water temperature, water and soap dispensing controls, the type of dispensers to use, paper towel dispenser requirements, placement of soap and rub dispensers, and regulatory requirements for products and recommendations for hand hygiene practices. A successful hand hygiene program allows end users to have input into the selection and evaluation of products and should include educating personnel about proper hand hygiene, product composition and safety, and how and when to use specific products. Measures for competency evaluation and compliance monitoring include observations, quizzes, skills labs, electronic monitoring systems, handheld device applications, and data collection forms. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Lifestyle change recommendations in major depression: Do they work?

PubMed

Serrano Ripoll, M J; Oliván-Blázquez, B; Vicens-Pons, E; Roca, M; Gili, M; Leiva, A; García-Campayo, J; Demarzo, M P; García-Toro, M

2015-09-01

Modifying some lifestyle factors can be useful in depression, at least as an adjuvant treatment. Combining different lifestyle interventions seems to be an adequate strategy to increase their antidepressant efficacy according with preliminary studies, but this issue has not been enough investigated. The present study is a randomized, double-blinded, multicentre, two arm-parallel clinical trials, with a 12 month follow-up. The sample consisted of 273 Primary Care patients. Four combined hygienic-dietary written recommendations were given to the patients about diet, exercise, light exposure and sleep hygiene. Both active and control interventions were associated with improvement on BDI (Beck Depression Inventory) scores. However, there were not statistically significant differences (7.0 vs. 7.6; p=0.594). We were unable to monitor whether patients carry out recommendations. Intervention could be too difficult to accomplish for depressed patients without enough support and supervision. Just giving written lifestyle recommendations are not enough for depressive patients to benefit from them, so perhaps lifestyle change recommendations work or do not work on Depression depending on how they are presented to patients and on monitoring systems of their implementation. Copyright © 2015 Elsevier B.V. All rights reserved.

Intra-seasonal risk of agriculturally-relevant weather extremes in West African Sudan Savanna

NASA Astrophysics Data System (ADS)

Boansi, David; Tambo, Justice A.; Müller, Marc

2018-01-01

Using household survey data and historical daily climate data for 29 communities across Upper East Ghana and Southwest Burkina Faso, we document climatic conditions deemed major threat to farming in the West African Sudan Savanna and assess risks posed by such conditions over the period 1997-2014. Based on farmers' perception, it is found that drought, low rainfall, intense precipitation, flooding, erratic rainfall pattern, extremely high temperatures, delayed rains, and early cessation of rains are the major threats farmers face. Using first-order Markov chain model and relevant indices for monitoring weather extremes, it is discovered that climatic risk is a general inherent attribute of the rainy season in the study area. Due to recent changes in onset of rains and length of the rainy season, some farmers have either resorted to early planting of drought-hardy crops, late planting of drought-sensitive crops, or spreading of planting across the first 3 months of the season to moderate harm. Each of these planting decisions however has some risk implications. The months of May, June, and October are found to be more susceptible to relatively longer duration of dry and hot spells, while July, August, and September are found to be more susceptible to intense precipitation and flooding. To moderate harm from anticipated weather extremes, farmers need to adjust their cropping calendar, adopt appropriate crop varieties, and implement soil and water management practices. For policy makers and other stakeholders, we recommend the supply of timely and accurate weather forecasts to guide farmers in their seasonal cropping decisions and investment in/installation of low cost irrigation facilities to enhance the practice of supplemental irrigation.

Recommendations for screening, monitoring, prevention, prophylaxis and therapy of hepatitis B virus reactivation in patients with haematologic malignancies and patients who underwent haematologic stem cell transplantation-a position paper.

PubMed

Sarmati, L; Andreoni, M; Antonelli, G; Arcese, W; Bruno, R; Coppola, N; Gaeta, G B; Galli, M; Girmenia, C; Mikulska, M; Pane, F; Perno, C F; Picardi, M; Puoti, M; Rambaldi, A; Svicher, V; Taliani, G; Gentile, G

2017-12-01

Hepatitis B virus (HBV) infection reactivation is associated with high morbidity and mortality in patients with haematologic malignancy and/or haematopoietic stem cell transplantation (HSCT). However, information on this issue is limited. The scope of this position paper is to provide recommendations on HBV screening, monitoring, prophylaxis, treatment and vaccination in the patients described above. These recommendations were developed from one meeting of experts attended by different Italian scientific societies as well as from a systematic literature review (of articles published through December 31, 2016) on HBV infection in haematologic patients and in patients who underwent haematopoietic stem cell transplantation published in the same issue of the journal. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess each recommendation's quality. These recommendations provide the answers to the following questions: (a) HBV screening and monitoring: Who should be screened before chemotherapy? Which screening tests should be used? Should HBV-DNA detection be used to monitor HBV reactivation before starting antivirals? What is the best timeline to monitor HBV reactivation? (b) Prophylaxis in HBsAg-positive patients: Which antiviral drugs should be used to treat HBsAg-positive patients? How long should antiviral prophylaxis be provided to HBsAg-positive patients? (c) Prophylaxis in patients with resolved HBV infection: Which patients with resolved HBV infection should receive antiviral prophylaxis? Which antiviral drug should be used? How long should antiviral prophylaxis be provided? (d) HBV infection management strategy in autologous (auto-HSCT) and allogeneic HSCT (allo-HSCT): Which HSCT recipients should receive antiviral prophylaxis? Which antiviral drug should be used? How long should antiviral prophylaxis be provided? (e) Choice of antiviral drugs in the treatment of HBV reactivation: Should third

Definition of air quality measurements for monitoring space shuttle launches

NASA Technical Reports Server (NTRS)

Thorpe, R. D.

1978-01-01

A description of a recommended air quality monitoring network to characterize the impact on ambient air quality in the Kennedy Space Center (KSC) (area) of space shuttle launch operations is given. Analysis of ground cloud processes and prevalent meteorological conditions indicates that transient HCl depositions can be a cause for concern. The system designed to monitor HCl employs an extensive network of inexpensive detectors combined with a central analysis device. An acid rain network is also recommended. A quantitative measure of projected minimal long-term impact involves the limited monitoring of NOx and particulates. All recommended monitoring is confined ti KSC property.

Environment Monitor

NASA Technical Reports Server (NTRS)

1988-01-01

Viking landers touched down on Mars equipped with a variety of systems to conduct automated research, each carrying a compact but highly sophisticated instrument for analyzing Martian soil and atmosphere. Instrument called a Gas Chromatography/Mass Spectrometer (GC/MS) had to be small, lightweight, shock resistant, highly automated and extremely sensitive, yet require minimal electrical power. Viking Instruments Corporation commercialized this technology and targeted their primary market as environmental monitoring, especially toxic and hazardous waste site monitoring. Waste sites often contain chemicals in complex mixtures, and the conventional method of site characterization, taking samples on-site and sending them to a laboratory for analysis is time consuming and expensive. Other terrestrial applications are explosive detection in airports, drug detection, industrial air monitoring, medical metabolic monitoring and for military, chemical warfare agents.

Evaluation of impairment of the upper extremity.

PubMed

Blair, S J; McCormick, E; Bear-Lehman, J; Fess, E E; Rader, E

1987-08-01

Evaluation of impairment of the upper extremity is the product of a team effort by the physician, occupational therapist, physical therapist, and rehabilitation counselor. A careful recording of the anatomic impairment should be made because this is critical in determining the subsequent functional activities of the extremity. The measurement criteria for clinical and functional evaluation includes condition assessment instruments. Some assess the neurovascular system, others assess movements including the monitoring of articular motion and musculotendinous function. Sensibility assessment instruments measure sympathetic response and detect single joint stimulus, discrimination, quantification, and recognition abilities. A detailed description of each assessment is recorded and physical capacity evaluation is only one component of the entire vocational evaluation. This evaluation answers questions regarding the injured worker's ability to return to his previous job. The work simulator is a useful instrument that allows rehabilitation and testing of the injured upper extremity. Job site evaluation includes assessment criteria for work performance, work behavior, and work environment.

SU-G-JeP4-14: Assessment of Inter- and Intra-Fractional Motion for Extremity Soft Tissue Sarcoma Patients by Using In-House Real-Time Optical Image-Based Monitoring System

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

Kim, H; Kim, I; Ye, S

Purpose: This study aimed to assess inter- and intra-fractional motion for extremity Soft Tissue Sarcoma (STS) patients, by using in-house real-time optical image-based monitoring system (ROIMS) with infra-red (IR) external markers. Methods: Inter- and intra-fractional motions for five extremity (1 upper, 4 lower) STS patients received postoperative 3D conformal radiotherapy (3D-CRT) were measured by registering the image acquired by ROIMS with the planning CT image (REG-ROIMS). To compare with the X-ray image-based monitoring, pre- and post-treatment cone beam computed tomography (CBCT) scans were performed once per week and registered with planning CT image as well (REG-CBCT). If the CBCT scanmore » is not feasible due to the large couch shift, AP and LR on-board imager (OBI) images were acquired. The comparison was done by calculating mutual information (MI) of those registered images. Results: The standard deviation (SD) of the inter-fractional motion was 2.6 mm LR, 2.8 mm SI, and 2.0 mm AP, and the SD of the intra-fractional motion was 1.4 mm, 2.1 mm, and 1.3 mm in each axis, respectively. The SD of rotational inter-fractional motion was 0.6° pitch, 0.9° yaw, and 0.8° roll and the SD of rotational intra-fractional motion was 0.4° pitch, 0.9° yaw, and 0.7° roll. The derived averaged MI values were 0.83, 0.92 for REG-CBCT without rotation and REG-ROIMS with rotation, respectively. Conclusion: The in-house real-time optical image-based monitoring system was implemented clinically and confirmed the feasibility to assess inter- and intra-fractional motion for extremity STS patients while the daily basis and real-time CBCT scan is not feasible in clinic.« less

Compilation of 1986 annual reports of the Navy ELF (extremely low frequency) communications system ecological-monitoring program. Volume 2. Tabs D-G. Annual progress report, January-December 1986

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

Not Available

1987-07-01

The U.S. Navy is conducting a long-term program to monitor for possible effects from the operation of its Extremely Low Frequency (ELF) Communications System to resident biota and their ecological relationships. This report documents progress of the following studies: Soil Amoeba; Soil and Litter Arthropoda and Earthworm Studies; Biological Studies on Pollinating insects: Megachilid Bees; and Small Vertebrates: Small Mammals and Nesting Birds.

Recommendations for the prescription of physical exercise for patients with spondyloarthritis.

PubMed

Flórez García, Mariano Tomás; Carmona, Loreto; Almodóvar, Raquel; Fernández de Las Peñas, César; García Pérez, Fernando; Pérez Manzanero, M Ángeles; García García, José Manuel; Soriano Segarra, Lidón; Jiménez Díaz, José Fernando; Mendoza Laiz, Nuria; de Miguel Mendieta, Eugenio; Torre Alonso, Juan Carlos; Linares Ferrando, Luis Francisco; Collantes Estévez, Eduardo; Sanz Sanz, Jesús; Zarco Montejo, Pedro

2017-08-11

To develop expert-based recommendations on physical activity and exercise for patients with spondyloarthritis (SpA). Two discussion groups, one of physical therapists, rehabilitation physicians, and professionals of physical activity and sports, and another of rheumatologists interested in SpA, were held to discuss the results of a survey of rheumatologists on exercise and two focus groups with patients on barriers to exercise. Preliminary recommendations were drafted. These were submitted to the opinion of the experts in both groups according to a two round Delphi methodology. Twenty one recommendations covering general aspects of exercise, adaptation to patient, how to deliver messages, pain management, and type of exercise and monitoring were issued. The level of agreement varied slightly between expert groups but it was high overall. Items with poor agreement were removed from the consensus. We present recommendations on when and how to prescribe and monitor exercise in patients with SpA based on the opinion of experts in exercise and in SpA. We must now test whether these recommendations are useful for clinical practice and have an effect on patients with SpA seen by rheumatologists. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Overview of human health in the Arctic: conclusions and recommendations.

PubMed

Donaldson, Shawn; Adlard, Bryan; Odland, Jon Øyvind

2016-01-01

This article is intended to provide an overview of the key conclusions, knowledge gaps and key recommendations based on the recent 2015 Arctic human health assessment under the Arctic Monitoring and Assessment Program. This assessment was based primarily on data from human health monitoring and research studies and peer-reviewed literature published since the last assessment in 2009.

Development and validation of an exercise performance support system for people with lower extremity impairment.

PubMed

Minor, M A; Reid, J C; Griffin, J Z; Pittman, C B; Patrick, T B; Cutts, J H

1998-02-01

To identify innovative strategies to support appropriate, self-directed exercise that increase physical activity levels of people with arthritis. This article reports on one interactive, multimedia exercise performance support system (PSS) for people with lower extremity impairments in strength or flexibility. An interdisciplinary team developed the PSS using self-report of lower extremity musculoskeletal impairments (flexibility and strength) to produce an individualized exercise program with video and print educational materials. Initial evaluation has investigated the validity and reliability of program assessments and recommendations. PSS self-report and professional assessments were similar, with more impairments indicated by self-report. PSS exercise recommendations were similar to those made by 3 expert physical therapists using the same exercise data base. Results of PSS impairment assessments were stable over a 1-week period. PSS exercise recommendations appear to be reliable and a valid reflection of current exercise knowledge in rheumatology. Furthermore, users were able to complete the computer-based program with minimal assistance and reported it to be enjoyable and informative.

Biological Contamination of Mars: Issues and Recommendations

NASA Technical Reports Server (NTRS)

1992-01-01

The ad hoc Task Group on Planetary Protection formed by the Space Studies Board (SSB) of the National Research Council focused on making recommendations concerning the protection of Mars from forward contamination (i.e., Earth to Mars) during upcoming missions by both the United States and the former Soviet Union. In so doing, it distinguished between missions whose goals include reconnaissance and measurement and those that specifically include experiments to detect life. The task group also discussed what additional knowledge will be needed in order to assure that future recommendations regarding contamination of Earth from Mars might be made with a higher degree of certainty than is now possible. Following a short introduction to the rationale underlying planetary exploration (Chapter 1) is a brief summary of approved and contemplated missions to Mars (Chapter 2). Chapter 3 briefly reviews the state of knowledge in several areas pertinent to the problem of planetary protection, in the limits of life on Earth and the abilities of known terrestrial organisms to withstand extreme environment conditions, as well as new approaches to detecting life forms. Chapter 5 includes a review and comments (made in light of current knowledge)- on the recommendations made in 'Recommendations on Quarantine Policy for Mars, Jupiter, Saturn, Uranus, Neptune, and Titan'. Updates to the recommendations made in 1978 are also given in Chapter 5. Chapter 6 gives additional recommendations concerning collection of essential data, spacecraft sterilization and bioburden assessment, and future research, as well as legal and social issues and NASA's overall planetary protection program.

Dynamics of molecules in extreme rotational states

PubMed Central

Yuan, Liwei; Teitelbaum, Samuel W.; Robinson, Allison; Mullin, Amy S.

2011-01-01

We have constructed an optical centrifuge with a pulse energy that is more than 2 orders of magnitude larger than previously reported instruments. This high pulse energy enables us to create large enough number densities of molecules in extreme rotational states to perform high-resolution state-resolved transient IR absorption measurements. Here we report the first studies of energy transfer dynamics involving molecules in extreme rotational states. In these studies, the optical centrifuge drives CO2 molecules into states with J ∼ 220 and we use transient IR probing to monitor the subsequent rotational, translational, and vibrational energy flow dynamics. The results reported here provide the first molecular insights into the relaxation of molecules with rotational energy that is comparable to that of a chemical bond.

Secondary prevention of work-related upper extremity disorders: recommendations from the Annapolis conference.

PubMed

Feuerstein, Michael; Harrington, Cherise B

2006-09-01

Efforts to improve the secondary prevention of work-related upper extremity (WRUE) symptoms continue to present a challenge. As with many occupational musculoskeletal pain disorders no single, direct cause-effect relationship exists among specific exposures, pathologic processes, and symptoms. The field has yet to create truly effective and efficient interventions for these problems that are based on current epidemiological and clinical knowledge. A working conference was held in Annapolis, Maryland on September 23rd and 24th, 2005 with leaders in research and application related to upper extremity disorders to address this challenge. The intent of the meeting was to review "state of the art" evidence in epidemiology and intervention research in order to develop suggestions regarding next steps in intervention research and application. On day 2 a number of stakeholders were present to discuss what they perceived as the missing pieces in both epidemiological research and applied intervention research in order to generate more effective workplace interventions. The papers in this series of the Journal of Occupational Rehabilitation indicate that scientifically sound progress has been made over the past decade in identifying ergonomic, workplace psychosocial, and individual factors in both the etiology and exacerbation of these symptoms/disorders. However, there is a gap between this knowledge and the development and practical implementation of comprehensive interventions for these problems. The conference also highlighted the paucity of economic analyses of the impact of these disorders as well as the economic study of the impact of intervention. Approaches for such evaluations were presented and are included in this special section of the journal. This series of papers and the summary of the invited group's discussions provided in this paper clearly emphasize the need for innovative ways to think about these problems and specific research topics that can help

Operational early warning platform for extreme meteorological events

NASA Astrophysics Data System (ADS)

Mühr, Bernhard; Kunz, Michael

2015-04-01

Operational early warning platform for extreme meteorological events Most natural disasters are related to extreme weather events (e.g. typhoons); weather conditions, however, are also highly relevant for humanitarian and disaster relief operations during and after other natural disaster like earthquakes. The internet service "Wettergefahren-Frühwarnung" (WF) provides various information on extreme weather events, especially when these events are associated with a high potential for large damage. The main focus of the platform is on Central Europe, but major events are also monitored worldwide on a daily routine. WF provides high-resolution forecast maps for many weather parameters which allow detailed and reliable predictions about weather conditions during the next days in the affected areas. The WF service became operational in February 2004 and is part of the Center for Disaster Management and Risk Reduction Technology (CEDIM) since 2007. At the end of 2011, CEDIM embarked a new type of interdisciplinary disaster research termed as forensic disaster analysis (FDA) in near real time. In case of an imminent extreme weather event WF plays an important role in CEDIM's FDA group. It provides early and precise information which are always available and updated several times during a day and gives advice and assists with articles and reports on extreme events.

Extreme Ultraviolet Explorer Science Operation Center

NASA Technical Reports Server (NTRS)

Wong, G. S.; Kronberg, F. A.; Meriwether, H. D.; Wong, L. S.; Grassi, C. L.

1993-01-01

The EUVE Science Operations Center (ESOC) is a satellite payload operations center for the Extreme Ultraviolet Explorer project, located on the Berkeley campus of the University of California. The ESOC has the primary responsibility for commanding the EUVE telescopes and monitoring their telemetry. The ESOC is one of a very few university-based satellite operations facilities operating with NASA. This article describes the history, operation, and advantages of the ESOC as an on-campus operations center.

Kidney function monitoring and nonvitamin K oral anticoagulant dosage in atrial fibrillation.

PubMed

Andreu Cayuelas, Jose Manuel; Caro Martínez, Cesar; Flores Blanco, Pedro Jose; Elvira Ruiz, Gines; Albendin Iglesias, Helena; Cerezo Manchado, Juan Jose; Bailen Lorenzo, Jose Luis; Januzzi, James L; García Alberola, Arcadio; Manzano-Fernández, Sergio

2018-06-01

Clinical practice guidelines recommend regular kidney function monitoring in atrial fibrillation patients on nonvitamin K oral anticoagulants (NOAC); however, information regarding compliance with these recommendations in daily life conditions is scarce. We sought to determine the compliance with kidney function monitoring recommendations in nonvalvular atrial fibrillation (NVAF) patients starting NOAC and its implication on the appropriateness of NOAC dosage. This study involves the retrospective analysis of a multicentre registry including consecutive NVAF patients who started NOAC (n = 692). Drug dosage changes and serum creatinine determinations were recorded during 1-year follow-up. European Heart Rhythm Association criteria were used to define the appropriateness of kidney function monitoring as well as adequate NOAC dosage. During the follow-up (334 ± 89 days), the compliance with kidney function monitoring recommendations was 61% (n = 425). After multivariate adjustment, age (OR × year: 0.92 (CI 95%: 0.89-0.95) P < .001), creatinine clearance (OR × mL/min: 1.02 (CI 95%: 1.01-1.03) P < .001) and adequate NOAC dosage at baseline (OR: 1.54 (CI 95%: 1.06-2.23), P = .024) were independent predictors of appropriate kidney function monitoring. Compliance with kidney function monitoring recommendations was independently associated with change to appropriate NOAC dose after 1 year (OR: 2.80 (CI 95%: 1.01-7.80), P = .049). Noncompliance with kidney function monitoring recommendations is common in NVAF patients starting NOAC, especially in elderly patients with kidney dysfunction. Compliance with kidney function monitoring recommendations was associated with adequate NOAC dosage at 1-year follow-up. Further studies are warranted to evaluate the implication of kidney function monitoring on prognosis. © 2018 Stichting European Society for Clinical Investigation Journal Foundation.

Quality assurance in nuclear medicine facilities; availability of final recommendations--FDA. Notice.

PubMed

1985-05-13

The Food and Drug Administration (FDA) is announcing the availability of final recommendations prepared by its Center for Devices and Radiological Health (CDRH) on quality assurance programs in nuclear medicine facilities. The final recommendations include the agency's rationale for the recommendations as well as references that can be used as well as references that can be used as guides in conducting quality control monitoring. These final recommendations are available as a technical report in CDRH's radiation recommendations series. They are intended to encourage and promote the development of voluntary quality assurance programs in nuclear medicine facilities.

Stress fractures of the ribs and upper extremities: causation, evaluation, and management.

PubMed

Miller, Timothy L; Harris, Joshua D; Kaeding, Christopher C

2013-08-01

Stress fractures are common troublesome injuries in athletes and non-athletes. Historically, stress fractures have been thought to predominate in the lower extremities secondary to the repetitive stresses of impact loading. Stress injuries of the ribs and upper extremities are much less common and often unrecognized. Consequently, these injuries are often omitted from the differential diagnosis of rib or upper extremity pain. Given the infrequency of this diagnosis, few case reports or case series have reported on their precipitating activities and common locations. Appropriate evaluation for these injuries requires a thorough history and physical examination. Radiographs may be negative early, requiring bone scintigraphy or MRI to confirm the diagnosis. Nonoperative and operative treatment recommendations are made based on location, injury classification, and causative activity. An understanding of the most common locations of upper extremity stress fractures and their associated causative activities is essential for prompt diagnosis and optimal treatment.

Interindividual and intraindividual variations in postprandial glycemia peak time complicate precise recommendations for self-monitoring of glucose in persons with type 1 diabetes mellitus.

PubMed

Johansen, Mette Dencker; Gjerløv, Irene; Christiansen, Jens Sandahl; Hejlesen, Ole K

2012-03-01

In glycemic control, postprandial glycemia may be important to monitor and optimize as it reveals glycemic control quality, and postprandial hyperglycemia partly predicts late diabetic complications. Self-monitoring of blood glucose (SMBG) may be an appropriate technology to use, but recommendations on measurement time are crucial. We retrospectively analyzed interindividual and intraindividual variations in postprandial glycemic peak time. Continuous glucose monitoring (CGM) and carbohydrate intake were collected in 22 patients with type 1 diabetes mellitus. Meals were identified from carbohydrate intake data. For each meal, peak time was identified as time from meal to CGM zenith within 40-150 min after meal start. Interindividual (one-way Anova) and intraindividual (intraclass correlation coefficient) variation was calculated. Nineteen patients were included with sufficient meal data quality. Mean peak time was 87 ± 29 min. Mean peak time differed significantly between patients (p = 0.02). Intraclass correlation coefficient was 0.29. Significant interindividual and intraindividual variations exist in postprandial glycemia peak time, thus hindering simple and general advice regarding postprandial SMBG for detection of maximum values. © 2012 Diabetes Technology Society.

Challenges of physiological monitoring in a Navy operational setting

NASA Technical Reports Server (NTRS)

Banta, Guy R.

1988-01-01

Challenges to physiological monitoring in the Navy include environmental extremes, acceptance of use by test subjects, data transfer, data interpretation, and capability of relating collected data to valid operational relevant criterion measures. These problems are discussed with respect to diving, electrophysiological monitoring, in-flight monitoring, aircrew fatigue, in-flight cardiac stress, and in-flight monitoring devices.

ELF (Extremely Low Frequency) Communications Systems Ecological Monitoring Program: Wetland Studies

DTIC Science & Technology

1989-11-01

energized, or a fully operational, transmitting facility had no measurable effect on peatland plant species. I I I I UNCLASSIFIED SECURITY...field studies (1983-1987) designed to examine potential extremely low frequency (ELF) I electromagnetic field effects on peatland ecosystems in... peatlands within 0.05 km of the antenna system. The INTERMEDIATE sites (Bog’s 3 2,7,11) are located between the antenna arms and had lower

Berkeley extreme-ultraviolet airglow rocket spectrometer: BEARS.

PubMed

Cotton, D M; Chakrabarti, S

1992-09-20

We describe the Berkeley extreme-UV airglow rocket spectrometer, which is a payload designed to test several thermospheric remote-sensing concepts by measuring the terrestrial O I far-UV and extreme-UV dayglow and the solar extreme-UV spectrum simultaneously. The instrument consisted of two near-normal Rowland mount spectrometers and a Lyman-alpha photometer. The dayglow spectrometer covered two spectral regions from 980 to 1040 A and from 1300 to 1360 A with 1.5-A resolution. The solar spectrometer had a bandpass of 250-1150 A with an ~ 10-A resolution. All three spectra were accumulated by using a icrochannel-plate-intensified, two-dimensional imaging detector with three separate wedge-and strip anode readouts. The hydrogen Lyman-alpha photometer was included to monitor the solar Lyman-alpha irradiance and geocoronal Lyman-alpha emissions. The instrument was designed, fabricated, and calibrated at the University of California, Berkeley and was successfully launched on 30 September 1988 aboard the first test flight of a four-stage sounding rocket, Black Brant XII.

Thermal Analysis of the NASA Integrated Vehicle Health Monitoring Experiment Technology for X-Vehicles (NITEX)

NASA Technical Reports Server (NTRS)

Hegab, Hisham E.

2002-01-01

The purpose of this project was to perform a thermal analysis for the NASA Integrated Vehicle Health Monitoring (IVHM) Technology Experiment for X-vehicles (NITEX). This electronics package monitors vehicle sensor information in flight and downlinks vehicle health summary information via telemetry. The experiment will be tested on the X-34 in an unpressurized compartment, in the vicinity of one of the vehicle's liquid oxygen tanks. The transient temperature profile for the electronics package has been determined using finite element analysis for possible mission profiles that will most likely expose the package to the most extreme hot and cold environmental conditions. From the analyses, it was determined that temperature limits for the electronics would be exceeded for the worst case cold environment mission profile. The finite element model used for the analyses was modified to examine the use of insulation to address this problem. Recommendations for insulating the experiment for the cold environment are presented, and were analyzed to determine their effect on a nominal mission profile.

Thermal Analysis Of The NASA Integrated Vehicle Health Monitoring Experiment Technology For X-Vehicles (NITEX)

NASA Technical Reports Server (NTRS)

Hegab, Hisham E.

2001-01-01

The purpose of this project was to perform a thermal analysis for the NASA Integrated Vehicle Health Monitoring (IVHM) Technology Experiment for X-vehicles (NITEX). This electronics package monitors vehicle sensor information in flight and downlinks vehicle health summary information via telemetry. The experiment will be tested on the X-34 in an unpressurized compartment, in the vicinity of one of the vehicle's liquid oxygen tanks. The transient temperature profile for the electronics package has been determined using finite element analysis for possible mission profiles that will most likely expose the package to the most extreme hot and cold environmental conditions. From the analyses, it was determined that temperature limits for the electronics would be exceeded for the worst case cold environment mission profile. The finite element model used for the analyses was modified to examine the use of insulation to address this problem. Recommendations for insulating the experiment for the cold environment are presented, and were analyzed to determine their effect on a nominal mission profile.

Warfarin monitoring in nursing homes assessed by case histories. Do recommendations and electronic alerts affect judgements?

PubMed

Teruel, Reyes Serrano; Thue, Geir; Fylkesnes, Svein Ivar; Sandberg, Sverre; Kristoffersen, Ann Helen

2017-09-01

Older adults treated with warfarin are prone to complications, and high-quality monitoring is essential. The aim of this case history based study was to assess the quality of warfarin monitoring in a routine situation, and in a situation with an antibiotic-warfarin interaction, before and after receiving an electronic alert. In April 2014, a national web-based survey with two case histories was distributed among Norwegian nursing home physicians and general practitioners working part-time in nursing homes. Case A represented a patient on stable warfarin treatment, but with a substantial INR increase within the therapeutic interval. Case B represented a more challenging patient with trimethoprim sulfamethoxazole (TMS) treatment due to pyelonephritis. In both cases, the physicians were asked to state the next warfarin dose and the INR recall interval. In case B, the physicians could change their suggestions after receiving an electronic alert on the TMS-warfarin interaction. Three hundred and ninety eight physicians in 292 nursing homes responded. Suggested INR recall intervals and warfarin doses varied substantially in both cases. In case A, 61% gave acceptable answers according to published recommendations, while only 9% did so for case B. Regarding the TMS-warfarin interaction in case history B, the electronic alert increased the percentage of respondents correctly suggesting a dose reduction from 29% to 53%. Having an INR instrument in the nursing home was associated with shortened INR recall times. Practical advice on handling of warfarin treatment and drug interactions is needed. Electronic alerts as presented in electronic medical records seem insufficient to change practice. Availability of INR instruments may be important regarding recall time.

Optical characteristics of waste stabilization ponds: recommendations for monitoring.

PubMed

Davies-Colley, R J; Craggs, R J; Park, J; Nagels, J W

2005-01-01

The optical character of waste stabilization ponds (WSPs) is of concern for several reasons. Algal photosynthesis, which produces oxygen for waste oxidation in WSPs, is influenced by attenuation of sunlight in ponds. Disinfection in WSPs is influenced by optical characteristics because solar UV exposure usually dominates inactivation. The optical nature of WSPs effluent also affects assimilation by receiving waters. Despite the importance of light behaviour in WSPs, few studies have been made of their optical characteristics. We discuss simple optical measures suitable for routine monitoring of WSPs (including at sites remote from laboratories): optical density of filtrates - an index of dissolved coloured organic (humic) matter, visual clarity - to provide an estimate of the beam attenuation coefficient (a fundamental quantity needed for optical modelling) colour (hue) - as an indicator of general WSP 'condition' and irradiance attenuation quantifying depth of light penetration. The value of optical characterisation of WSPs is illustrated with reference to optical data for WSPs in NZ (including high-rate algal ponds) treating dairy cattle wastewater versus domestic sewage. We encourage increased research on optical characteristics of WSPs and the incorporation of optical measures in monitoring and modelling of WSP performance.

Extreme Geohazards: Reducing the Disaster Risk and Increasing Resilience

NASA Astrophysics Data System (ADS)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Marsh, Stuart; Campus, Paola

2013-04-01

Extreme geohazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Exposure of human assets to geohazards has increased dramatically in recent decades, and the sensitivity of the built environment and the embedded socio-economic fabric have changed. We are putting the urban environment, including megacities, in harm's way. Paradoxically, innovation during recent decades, in particular, urban innovation, has increased the disaster risk and coupled this risk to the sustainability crisis. Only more innovation can reduce disaster risk and lead us out of the sustainability crisis. Extreme geohazards (volcanic eruptions, earthquakes, tsunamis) that occurred regularly throughout the last few millennia mostly did not cause major disasters because population density was low and the built environment was not sprawling into hazardous areas to the same extent as today. Similar extreme events today would cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. The Geohazards Community of Practice of the Group on Earth Observations (GEO) with support from the European Science Foundation is preparing a white paper assessing the contemporary disaster risks associated with extreme geohazards and developing a vision for science and society to engage in deliberations addressing this risk (see http://www.geohazcop.org/projects/extgeowp). Risk awareness and monitoring is highly uneven across the world, and this creates two kinds of problems. Firstly, potential hazards are much more closely monitored in wealthy countries than in the developing world. But the largest hazards are global in nature, and it is critical to get as much forewarning as possible to develop an effective response. The disasters and near-misses of the past show that adherence to scientific

The Influence of Wheelchair Propulsion Hand Pattern on Upper Extremity Muscle Power and Stress

PubMed Central

Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground. PMID:27062591

Monitoring for conservation

USGS Publications Warehouse

Nichols, J.D.; Williams, B.K.

2006-01-01

Human-mediated environmental changes have resulted in appropriate concern for the conservation of ecological systems and have led to the development of many ecological monitoring programs worldwide. Many programs that are identified with the purpose of `surveillance? represent an inefficient use of conservation funds and effort. Here, we revisit the 1964 paper by Platt and argue that his recommendations about the conduct of science are equally relevant to the conduct of ecological monitoring programs. In particular, we argue that monitoring should not be viewed as a stand-alone activity, but instead as a component of a larger process of either conservation-oriented science or management. Corresponding changes in monitoring focus and design would lead to substantial increases in the efficiency and usefulness of monitoring results in conservation.

Exploration of the aftermath of a large collision in an extreme debris disk

NASA Astrophysics Data System (ADS)

Moor, Attila; Abraham, Peter; Cataldi, Gianni; Kospal, Agnes; Pal, Andras; Vida, Krisztian

2018-05-01

Warm debris disks with extremely high fractional luminosities are exceptional, rare systems. Not explainable by steady-state evolutionary models, these extreme debris disks are believed to stem from a recent large collision of planetary embryos in the terrestrial zone. Our team recently discovered a new extreme debris disk around TYC 4209-1322-1, whose WISE W1/W2 band photometry showed a significant brightening probably related to a giant collision in the inner disk. In Cycle 13 we monitor the system by Spitzer, revealing a fading trend with an e-folding time of 1500 days with hints for a quasi-periodic modulation and a possible second smaller amplitude collision event. Here we propose to continue the monitoring campaign until the end of Cycle 14 to explore the evolution of the current long fading trend and of the second collision, and characterize the hinted modulation. Thanks to a better sampled Spitzer light curve and the unique opportunity that NASA's TESS satellite will obtain high-precision optical photometry in the same period, a new dimension will be opened in Cycle 14 in the study of one of the most spectacular extreme debris disk, scrutinizing for the first time the possible influence of stellar activity on a debris disk.

Life in extreme environments: how will humans perform on Mars?

NASA Technical Reports Server (NTRS)

Newman, D. J.

2000-01-01

This review of astronaut extravehicular activity (EVA) and the details of American and Soviet/Russian spacesuit design focuses on design recommendations to enhance astronaut safety and effectiveness. Innovative spacesuit design is essential, given the challenges of future exploration-class missions in which astronauts will be called upon to perform increasingly complex and physically demanding tasks in the extreme environments of microgravity and partial gravity.

Equity-Oriented Monitoring in the Context of Universal Health Coverage

PubMed Central

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

2014-01-01

Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC

[Equity-oriented monitoring in the context of universal health coverage].

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

2015-07-01

Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC.

Impact of Extreme Climatic Events on the Temperature Regimes in Urban Streams

NASA Astrophysics Data System (ADS)

Parchem, C.; Stewart, I. T.

2016-12-01

Urban streams provide important aquatic and riparian habitat close to population centers, as well as other ecosystem services such as flood protection, storm water drainage and recreational functions. Yet, they are already greatly impacted by human action through water management, channel modifications, destruction of riparian habitat, and pollution. This has potentially rendered them more vulnerable to the climatic extremes projected from climatic changes. From 2012 - 2016, California has experienced to date the most severe drought since the beginning of weather recordings. The combination of the resulting extremely low stream flows exacerbated by low precipitation, high evaporation rates, and greater human demand on water, with high temperature have increased the temperature regime in urban streams. However, the extent to which urban stream temperatures are impacted by extreme climatic conditions and what role stream morphology, stream flow characteristics, and riparian vegetation play, are not sufficiently understood. For this project, we monitored stream temperature, dissolved oxygen, and flow depth along a network of 18 sites in the Los Gatos Creek, Guadalupe River, and Coyote Creek, located in the urban regions of the southern San Francisco Bay Area. Monitoring sites were distributed from stream headwaters to flood plains and represented a variety of stream environments. We examined the variation in stream temperature and dissolved oxygen with extreme air temperature, extremely low flow conditions, riparian shading, and channel morphology. Our results show that during the recent drought, hourly stream temperatures rose up to 34°C during summer heat waves for sites in the lower stream reaches without riparian shading. By contrast, shaded sites with deeper flows, and minimally affected by water management were able to maintain lower temperatures by several degrees. Understanding the conditions driving the response of urban streams to climatic extremes can aid

Deciphering the Sensitivity and Specificity of the Implantable Doppler Probe in Free Flap Monitoring.

PubMed

Chang, Edward I; Ibrahim, Amir; Zhang, Hong; Liu, Jun; Nguyen, Alexander T; Reece, Gregory P; Yu, Peirong

2016-03-01

The efficacy of implantable Doppler probes remains an area of considerable debate. This study aims to decipher its sensitivity and specificity for free flap monitoring. A retrospective review of all free flaps with an implantable Doppler probe was performed between 2000 and 2012. A Cook-Swartz implantable Doppler probe was used in 439 patients (head and neck, n = 364; breast, n = 53; extremity, n = 22), and demonstrated equivalent sensitivity and specificity between flap types. The overall sensitivity and specificity were 77.8 percent and 88.4 percent, respectively. The artery was monitored in 267 patients, compared to venous monitoring in 101 patients, and in 71 patients both the artery and vein were monitored. Arterial monitoring had significantly greater specificity than venous monitoring, (94.2 percent versus 74.0 percent; p < 0.001), but no benefit was found in monitoring both the artery and the vein. Venous monitoring was significantly associated with reoperation (OR, 3.17; 95 percent CI, 1.70 to 5.91; p = 0.0003). There were 284 flaps that had a monitoring segment in addition to the implantable Doppler probe that significantly increased overall specificity for microvascular complications (OR, 17.71; 95 percent CI, 3.39 to 92.23; p = 0.0006). The specificity (90.5 percent versus 84.8 percent) and sensitivity (80.0 percent versus 66.7 percent) were significantly higher for clinically monitored flaps. The take-back rate was 13.0 percent, with positive findings in 59.6 percent, and 5.2 percent total flap loss. The use of implantable Doppler probes has high sensitivity and specificity for buried free flaps despite positive findings in less than 60 percent of take-backs. Monitoring the artery is recommended, but clinical examination remains the gold standard for flap monitoring. Diagnostic, IV.

Environmental monitoring in interventional radiology

NASA Astrophysics Data System (ADS)

Del Sol, S.; Garcia, R.; Sánchez-Guzmán, D.; Ramirez, G.; Chavarin, E. U.; Rivera, T.

2017-01-01

The procedures in Interventional Radiology involve long times of exposure and high number of radiographic images that bring higher radiation doses to patients, staff and environmental than those received in conventional Radiology. Currently for monitoring the dose, the thermoluminescent dosimetry use is recommended. The aim of this work was to carry out the monitoring of the environmental scattered radiation inside the IR room using two types of thermoluminescent dosimeters, TLD-100 (reference dosimeter), CaSO4:Dy (synthesized in our laboratory). The results indicate that the TLD-100 is not effective for the environmental monitoring of low-energy Rx rooms. The CaSO4:Dy presented good behaviour over the 6 months of study. The results will be specific to each room so it is recommended such studies as part of the program of quality control of each Rx room.

Extreme Temperature Performance of Automotive-Grade Small Signal Bipolar Junction Transistors

NASA Technical Reports Server (NTRS)

Boomer, Kristen; Damron, Benny; Gray, Josh; Hammoud, Ahmad

2018-01-01

Electronics designed for space exploration missions must display efficient and reliable operation under extreme temperature conditions. For example, lunar outposts, Mars rovers and landers, James Webb Space Telescope, Europa orbiter, and deep space probes represent examples of missions where extreme temperatures and thermal cycling are encountered. Switching transistors, small signal as well as power level devices, are widely used in electronic controllers, data instrumentation, and power management and distribution systems. Little is known, however, about their performance in extreme temperature environments beyond their specified operating range; in particular under cryogenic conditions. This report summarizes preliminary results obtained on the evaluation of commercial-off-the-shelf (COTS) automotive-grade NPN small signal transistors over a wide temperature range and thermal cycling. The investigations were carried out to establish a baseline on functionality of these transistors and to determine suitability for use outside their recommended temperature limits.

Wearable Beat-to-Beat Blood Pressure Monitor

NASA Technical Reports Server (NTRS)

Lee, Yong Jin

2015-01-01

Linea Research Corporation has developed a wearable noninvasive monitor that provides continuous blood pressure and heart rate measurements in extreme environments. Designed to monitor the physiological effects of astronauts' prolonged exposure to reduced-gravity environments as well as the effectiveness of various countermeasures, the device offers wireless connectivity to allow transfer of both real-time and historical data. It can be modified to monitor the health status of astronaut crew members during extravehicular missions.

NOAA Environmental Satellite Measurements of Extreme Space Weather Events

NASA Astrophysics Data System (ADS)

Denig, W. F.; Wilkinson, D. C.; Redmon, R. J.

2015-12-01

For over 40 years the National Oceanic and Atmospheric Administration (NOAA) has continuously monitored the near-earth space environment in support of space weather operations. Data from this period have covered a wide range of geophysical conditions including periods of extreme space weather such as the great geomagnetic March 1989, the 2003 Halloween storm and the more recent St Patrick's Day storm of 2015. While not specifically addressed here, these storms have stressed our technology infrastructure in unexpected and surprising ways. Space weather data from NOAA geostationary (GOES) and polar (POES) satellites along with supporting data from the Air Force are presented to compare and contrast the space environmental conditions measured during extreme events.

Recommendations for the design, optimization, and qualification of cell-based assays used for the detection of neutralizing antibody responses elicited to biological therapeutics.

PubMed

Gupta, Shalini; Indelicato, Stephen R; Jethwa, Vijay; Kawabata, Thomas; Kelley, Marian; Mire-Sluis, Anthony R; Richards, Susan M; Rup, Bonita; Shores, Elizabeth; Swanson, Steven J; Wakshull, Eric

2007-04-10

The administration of biological therapeutics can evoke some level of immune response to the drug product in the receiving subjects. An immune response comprised of neutralizing antibodies can lead to loss of efficacy or potentially more serious clinical sequelae. Therefore, it is important to monitor the immunogenicity of biological therapeutics throughout the drug product development cycle. Immunoassays are typically used to screen for the presence and development of anti-drug product antibodies. However, in-vitro cell-based assays prove extremely useful for the characterization of immunoassay-positive samples to determine if the detected antibodies have neutralizing properties. This document provides scientific recommendations based on the experience of the authors for the development of cell-based assays for the detection of neutralizing antibodies in non-clinical and clinical studies.

Monitoring as a Means to Focus Research and Conservation - The Grassland Bird Monitoring Example

Treesearch

Brenda Dale; Michael Norton; Constance Downes; Brian Collins

2005-01-01

One recommendation of the Canadian Landbird Monitoring Strategy of Partners in Flight-Canada is to improve monitoring capability for rapidly declining grassland birds. In Canada, we lack statistical power for many grassland species because they are detected in small numbers, on a low number of routes, or show high year-to-year variability. In developing a Grassland...

A Psychophysical Protocol to Develop Ergonomic Recommendations for Sitting and Standing Workstations.

PubMed

Lin, Michael Y; Catalano, Paul; Dennerlein, Jack T

2016-06-01

The aim of this study was to determine user self-selected setup for both sitting and standing computer workstations and identify major differences. No current ergonomic setup guideline for standing computer workstations is available. Twenty adult participants completed four 45-min sessions of simulated office computer work with an adjustable sit-stand computer workstation. Placement and relative position of all workstation components, including a cordless mouse, a cordless keyboard, a height-adjustable desk, and a 22-inch monitor mounted on a mechanical-assisted arm were recorded during the four sessions, which alternated between sitting and standing for each session. Participants were interrupted four times within each session, and the workstation was "reset" to extreme locations. Participants were instructed to adjust the location to achieve the most comfortable arrangement and to make as many adjustments during the session to achieve this goal. Overall, users placed the keyboard closer to their body (sternum), set desk height lower than their elbow, and set the monitor lower relative to their eyes with a greater upward tilt while standing compared to sitting. During the 45-min sessions, the number of adjustments participants made became smaller and over the four sessions was consistent, suggesting the psychophysical protocol was effective and consistent. Users preferred different workstation setups for sitting and standing computer workstations. Therefore, future setup guidelines and principles for standing computer workstations may not be simply translated from those for sitting. These results can serve as the first step toward making recommendations to establish ergonomic guidelines for standing computer workstation arrangement. © 2016, Human Factors and Ergonomics Society.

Matthew Jones House: Recommendations for Treatment

DTIC Science & Technology

2016-04-01

strongly recommend that a structural engineer be contracted to provide in depth analysis and monitoring. The decay of the historic timber top plates...of the structure . This report summarizes the research and findings by the NCPTT. It also includes an engineer’s report and other supplemental in...NEEDED. DO NOT RETURN IT TO THE ORIGINATOR. ERDC/CERL CR-16-1 iii Foreword After identifying a variety of structural issues with the Matthew Jones

Extreme temperature robust optical sensor designs and fault-tolerant signal processing

DOEpatents

Riza, Nabeel Agha [Oviedo, FL; Perez, Frank [Tujunga, CA

2012-01-17

Silicon Carbide (SiC) probe designs for extreme temperature and pressure sensing uses a single crystal SiC optical chip encased in a sintered SiC material probe. The SiC chip may be protected for high temperature only use or exposed for both temperature and pressure sensing. Hybrid signal processing techniques allow fault-tolerant extreme temperature sensing. Wavelength peak-to-peak (or null-to-null) collective spectrum spread measurement to detect wavelength peak/null shift measurement forms a coarse-fine temperature measurement using broadband spectrum monitoring. The SiC probe frontend acts as a stable emissivity Black-body radiator and monitoring the shift in radiation spectrum enables a pyrometer. This application combines all-SiC pyrometry with thick SiC etalon laser interferometry within a free-spectral range to form a coarse-fine temperature measurement sensor. RF notch filtering techniques improve the sensitivity of the temperature measurement where fine spectral shift or spectrum measurements are needed to deduce temperature.

TrustRank: a Cold-Start tolerant recommender system

NASA Astrophysics Data System (ADS)

Zou, Haitao; Gong, Zhiguo; Zhang, Nan; Zhao, Wei; Guo, Jingzhi

2015-02-01

The explosive growth of the World Wide Web leads to the fast advancing development of e-commerce techniques. Recommender systems, which use personalised information filtering techniques to generate a set of items suitable to a given user, have received considerable attention. User- and item-based algorithms are two popular techniques for the design of recommender systems. These two algorithms are known to have Cold-Start problems, i.e., they are unable to effectively handle Cold-Start users who have an extremely limited number of purchase records. In this paper, we develop TrustRank, a novel recommender system which handles the Cold-Start problem by leveraging the user-trust networks which are commonly available for e-commerce applications. A user-trust network is formed by friendships or trust relationships that users specify among them. While it is straightforward to conjecture that a user-trust network is helpful for improving the accuracy of recommendations, a key challenge for using user-trust network to facilitate Cold-Start users is that these users also tend to have a very limited number of trust relationships. To address this challenge, we propose a pre-processing propagation of the Cold-Start users' trust network. In particular, by applying the personalised PageRank algorithm, we expand the friends of a given user to include others with similar purchase records to his/her original friends. To make this propagation algorithm scalable to a large amount of users, as required by real-world recommender systems, we devise an iterative computation algorithm of the original personalised TrustRank which can incrementally compute trust vectors for Cold-Start users. We conduct extensive experiments to demonstrate the consistently improvement provided by our proposed algorithm over the existing recommender algorithms on the accuracy of recommendations for Cold-Start users.

Influence of weather extremes on the water levels of glaciated prairie wetlands

USGS Publications Warehouse

Johnson, W.C.; Boettcher, S.E.; Poiani, K.A.; Guntenspergen, G.

2004-01-01

Orchid Meadows is a long-term wetland research and monitoring site on the Coteau des Prairie in extreme east-central South Dakota, USA. It is a 65-ha Waterfowl Production Area with numerous temporary, seasonal, and semi-permanent wetlands. Ground water and surface water have been monitored at the site from 1987 to 1989 and from 1993 to the present. Vegetation has been monitored since 1993. The monitoring record includes two nearly back-to-back weather extremes: a drought in the late 1980s and a deluge in the early- to mid-1990s. Wetlands differed sharply in water levels between 3-yr dry and wet periods. For example, the time of inundation ranged among semi-permanent wetlands from 13 to 71 percent during the dry years to 100 percent during the wet years, while for seasonal wetlands, it was 0-29 percent and 46-100 percent, respectively, during dry and wet periods. Temporary wetlands had no surface water during the dry period but had standing water 0-67 percent of the time during the deluge years. The highest ground-water levels during the dry period were lower than most levels during the wet period. The difference in the water-table elevations of temporary wetlands between the periods was as much as 4 m. Ground-water levels near semi-permanent wetlands were considerably more stable (annual range of 0.3-1.6 m) than those near temporary wetlands (1.3-2.5 m). The results support the concept that weather extremes drive the wetland cover cycle and other key ecological processes in prairie wetlands. The new data from Orchid Meadows, together with other long-term data sets from North Dakota and Saskatchewan, Canada, are useful for many research purposes, including the parameterization and testing of models that simulate the effects of climate variability and climate change on prairie wetland ecosystems.

Regional estimation of extreme suspended sediment concentrations using watershed characteristics

NASA Astrophysics Data System (ADS)

Tramblay, Yves; Ouarda, Taha B. M. J.; St-Hilaire, André; Poulin, Jimmy

2010-01-01

SummaryThe number of stations monitoring daily suspended sediment concentration (SSC) has been decreasing since the 1980s in North America while suspended sediment is considered as a key variable for water quality. The objective of this study is to test the feasibility of regionalising extreme SSC, i.e. estimating SSC extremes values for ungauged basins. Annual maximum SSC for 72 rivers in Canada and USA were modelled with probability distributions in order to estimate quantiles corresponding to different return periods. Regionalisation techniques, originally developed for flood prediction in ungauged basins, were tested using the climatic, topographic, land cover and soils attributes of the watersheds. Two approaches were compared, using either physiographic characteristics or seasonality of extreme SSC to delineate the regions. Multiple regression models to estimate SSC quantiles as a function of watershed characteristics were built in each region, and compared to a global model including all sites. Regional estimates of SSC quantiles were compared with the local values. Results show that regional estimation of extreme SSC is more efficient than a global regression model including all sites. Groups/regions of stations have been identified, using either the watershed characteristics or the seasonality of occurrence for extreme SSC values providing a method to better describe the extreme events of SSC. The most important variables for predicting extreme SSC are the percentage of clay in the soils, precipitation intensity and forest cover.

Recommendations for Third Molar Removal: A Practice-Based Cohort Study

PubMed Central

Rothen, Marilynn; Spiekerman, Charles; Drangsholt, Mark; McClellan, Lyle; Huang, Greg J.

2014-01-01

Objectives. We investigated general dentists’ reasons for recommending removal or retention of third molars and whether patients adhered to dentists’ recommendations. Methods. In a 2-year prospective cohort study (2009–2011) in the Pacific Northwest, we followed 801 patients aged 16 to 22 years from 50 general dental practices. Generalized estimating equations logistic regressions related patient and dentist characteristics to dentists' recommendations to remove third molars and to patient adherence. Results. General dentists recommended removal of 1683 third molars from 469 (59%) participants, mainly to prevent future problems (79%) or because a third molar had an unfavorable orientation or was unlikely to erupt (57%). Dentists recommended retention and monitoring of 1244 third molars from 366 (46%) participants, because it was too early to decide (73%), eruption path was favorable (39%), or space for eruption was sufficient (26%). When dentists recommended removal, 55% of participants adhered to this recommendation during follow-up, and the main reason was availability of insurance (88%). Conclusions. General dentists frequently recommended removal of third molars for reasons not related to symptoms or pathology, but rather to prevent future problems. PMID:24524519

Classroom-tested Recommendations for Teaching Problem Solving within a Traditional College Course: Genetics.

ERIC Educational Resources Information Center

Smith, Mike U.

Both teachers and students alike acknowledge that genetics and genetics problem-solving are extremely difficult to learn and to teach. Therefore, a number of recommendations for teaching college genetics are offered. Although few of these ideas have as yet been tested in controlled experiments, they are supported by research and experience and may…

Extreme Environments Development of Decision Processes and Training Programs for Medical Policy Formulation

NASA Technical Reports Server (NTRS)

Stough, Roger

2004-01-01

The purpose of this workshop was to survey existing health and safety policies as well as processes and practices for various extreme environments; to identify strengths and shortcomings of these processes; and to recommend parameters for inclusion in a generic approach to policy formulation, applicable to the broadest categories of extreme environments. It was anticipated that two additional workshops would follow. The November 7, 2003 workshop would be devoted to the evaluation of different model(s) and a concluding expert evaluation of the usefulness of the model using a policy formulation example. The final workshop was planned for March 2004.

Design of a real-time and continua-based framework for care guideline recommendations.

PubMed

Lin, Yu-Feng; Shie, Hsin-Han; Yang, Yi-Ching; Tseng, Vincent S

2014-04-16

Telehealth is an important issue in the medical and healthcare domains. Although a number of systems have been developed to meet the demands of emerging telehealth services, the following problems still remain to be addressed: (1) most systems do not monitor/predict the vital signs states so that they are able to send alarms to caregivers in real-time; (2) most systems do not focus on reducing the amount of work that caregivers need to do, and provide patients with remote care; and (3) most systems do not recommend guidelines for caregivers. This study thus proposes a framework for a real-time and Continua-based Care Guideline Recommendation System (Cagurs) which utilizes mobile device platforms to provide caregivers of chronic patients with real-time care guideline recommendations, and that enables vital signs data to be transmitted between different devices automatically, using the Continua standard. Moreover, the proposed system adopts the episode mining approach to monitor/predict anomalous conditions of patients, and then offers related recommended care guidelines to caregivers so that they can offer preventive care in a timely manner.

Design of a Real-Time and Continua-Based Framework for Care Guideline Recommendations

PubMed Central

Lin, Yu-Feng; Shie, Hsin-Han; Yang, Yi-Ching; Tseng, Vincent S.

2014-01-01

Telehealth is an important issue in the medical and healthcare domains. Although a number of systems have been developed to meet the demands of emerging telehealth services, the following problems still remain to be addressed: (1) most systems do not monitor/predict the vital signs states so that they are able to send alarms to caregivers in real-time; (2) most systems do not focus on reducing the amount of work that caregivers need to do, and provide patients with remote care; and (3) most systems do not recommend guidelines for caregivers. This study thus proposes a framework for a real-time and Continua-based Care Guideline Recommendation System (Cagurs) which utilizes mobile device platforms to provide caregivers of chronic patients with real-time care guideline recommendations, and that enables vital signs data to be transmitted between different devices automatically, using the Continua standard. Moreover, the proposed system adopts the episode mining approach to monitor/predict anomalous conditions of patients, and then offers related recommended care guidelines to caregivers so that they can offer preventive care in a timely manner. PMID:24743843

Survey of hydrogen monitoring devices

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

Lai, W.

Presented are results of a survey of commercially available monitoring devices suitable for hydrogen detection in the secondary containment vessel of a nuclear power plant during the post postulated accident period. Available detectors were grouped into the following five classes: combustion, solid state, electrochemical, thermal conductivity, and absorption. The performance of most available sensors is likely to deteriorate when exposed to the postulated conditions which include moisture, which could be at high temperature, and radioactive noncondensibles. Of the commercial devices, those using metallic filament thermal conductivity detectors seem least susceptible to performance change. Absorption detectors are best suited for thismore » monitoring task but the only available device is designed for pipeline corrosion assessment. Initiation of experimental study to assess apparent deficiencies of commercial detectors is recommended. Also recommended is an analytical/experimental effort to determine the optimum detector array for monitoring in the secondary containment vessels.« less

Evaluation of extreme temperature events in northern Spain based on process control charts

NASA Astrophysics Data System (ADS)

Villeta, M.; Valencia, J. L.; Saá, A.; Tarquis, A. M.

2018-02-01

Extreme climate events have recently attracted the attention of a growing number of researchers because these events impose a large cost on agriculture and associated insurance planning. This study focuses on extreme temperature events and proposes a new method for their evaluation based on statistical process control tools, which are unusual in climate studies. A series of minimum and maximum daily temperatures for 12 geographical areas of a Spanish region between 1931 and 2009 were evaluated by applying statistical process control charts to statistically test whether evidence existed for an increase or a decrease of extreme temperature events. Specification limits were determined for each geographical area and used to define four types of extreme anomalies: lower and upper extremes for the minimum and maximum anomalies. A new binomial Markov extended process that considers the autocorrelation between extreme temperature events was generated for each geographical area and extreme anomaly type to establish the attribute control charts for the annual fraction of extreme days and to monitor the occurrence of annual extreme days. This method was used to assess the significance of changes and trends of extreme temperature events in the analysed region. The results demonstrate the effectiveness of an attribute control chart for evaluating extreme temperature events. For example, the evaluation of extreme maximum temperature events using the proposed statistical process control charts was consistent with the evidence of an increase in maximum temperatures during the last decades of the last century.

Investigating NARCCAP Precipitation Extremes via Bivariate Extreme Value Theory (Invited)

NASA Astrophysics Data System (ADS)

Weller, G. B.; Cooley, D. S.; Sain, S. R.; Bukovsky, M. S.; Mearns, L. O.

2013-12-01

We introduce methodology from statistical extreme value theory to examine the ability of reanalysis-drive regional climate models to simulate past daily precipitation extremes. Going beyond a comparison of summary statistics such as 20-year return values, we study whether the most extreme precipitation events produced by climate model simulations exhibit correspondence to the most extreme events seen in observational records. The extent of this correspondence is formulated via the statistical concept of tail dependence. We examine several case studies of extreme precipitation events simulated by the six models of the North American Regional Climate Change Assessment Program (NARCCAP) driven by NCEP reanalysis. It is found that the NARCCAP models generally reproduce daily winter precipitation extremes along the Pacific coast quite well; in contrast, simulation of past daily summer precipitation extremes in a central US region is poor. Some differences in the strength of extremal correspondence are seen in the central region between models which employ spectral nudging and those which do not. We demonstrate how these techniques may be used to draw a link between extreme precipitation events and large-scale atmospheric drivers, as well as to downscale extreme precipitation simulated by a future run of a regional climate model. Specifically, we examine potential future changes in the nature of extreme precipitation along the Pacific coast produced by the pineapple express (PE) phenomenon. A link between extreme precipitation events and a "PE Index" derived from North Pacific sea-surface pressure fields is found. This link is used to study PE-influenced extreme precipitation produced by a future-scenario climate model run.

Lower limb joint kinetics in walking: the role of industry recommended footwear.

PubMed

Keenan, Geoffrey S; Franz, Jason R; Dicharry, Jay; Della Croce, Ugo; Kerrigan, D Casey

2011-03-01

The effects of current athletic footwear on lower extremity biomechanics are unknown. The aim of this study was to examine the changes, if any, that occur in peak lower extremity net joint moments while walking in industry recommended athletic footwear. Sixty-eight healthy young adults underwent kinetic evaluation of lower extremity extrinsic joint moments while walking barefoot and while walking in current standard athletic footwear matched to the foot mechanics of each subject while controlling for speed. A secondary analysis was performed comparing peak knee joint extrinsic moments during barefoot walking to those while walking in three different standard footwear types: stability, motion control, and cushion. 3-D motion capture data were collected in synchrony with ground reaction force data collected from an instrumented treadmill. The shod condition was associated with a 9.7% increase in the first peak knee varus moment, and increases in the hip flexion and extension moments. These increases may be largely related to a 6.5% increase in stride length with shoes associated with increases in the ground reaction forces in all three axes. The changes from barefoot walking observed in the peak knee joint moments were similar when subjects walked in all three footwear types. It is unclear to what extent these increased joint moments may be clinically relevant, or potentially adverse. Nonetheless, these differences should be considered in the recommendation as well as the design of footwear in the future. Copyright © 2010 Elsevier B.V. All rights reserved.

Occupational Exposure to Asbestos; Criteria for a Recommended Standard.

ERIC Educational Resources Information Center

National Inst. for Occupational Safety and Health (DHEW/PHS), Rockville, MD.

Recommended standards for control of exposure to asbestos dust in the workplace are set out from the following standpoints: environmental, medical, labeling, personal protective equipment and clothing, apprisal of employees, work practices, and monitoring and recordkeeping requirements. The goal is maintenance of a low level of concentration to…

Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society.

PubMed

Vågberg, M; Axelsson, M; Birgander, R; Burman, J; Cananau, C; Forslin, Y; Granberg, T; Gunnarsson, M; von Heijne, A; Jönsson, L; Karrenbauer, V D; Larsson, E-M; Lindqvist, T; Lycke, J; Lönn, L; Mentesidou, E; Müller, S; Nilsson, P; Piehl, F; Svenningsson, A; Vrethem, M; Wikström, J

2017-01-01

Multiple sclerosis (MS) is associated with inflammatory lesions in the brain and spinal cord. The detection of such inflammatory lesions using magnetic resonance imaging (MRI) is important in the consideration of the diagnosis and differential diagnoses of MS, as well as in the monitoring of disease activity and predicting treatment efficacy. Although there is strong evidence supporting the use of MRI for both the diagnosis and monitoring of disease activity, there is a lack of evidence regarding which MRI protocols to use, the frequency of examinations, and in what clinical situations to consider MRI examination. A national workshop to discuss these issues was held in Stockholm, Sweden, in August 2015, which resulted in a Swedish consensus statement regarding the use of MRI in the care of individuals with MS. The aim of this consensus statement is to provide practical advice for the use of MRI in this setting. The recommendations are based on a review of relevant literature and the clinical experience of workshop attendees. It is our hope that these recommendations will benefit individuals with MS and guide healthcare professionals responsible for their care. © 2016 The Authors. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.

Amma - Monitoring and Management Application

NASA Astrophysics Data System (ADS)

Rakesh Adapa, Swamy

Agriculture has been the part and parcel of the human life. It has been the major occupation around the world prior to the industrial revolution. Today many of the developing countries had their strong economical fundamentals from it. UN has been doing a great job in uplifting the rural population in terms of health and education. There is a need for uplifting the agricultural sector which has been lagging in the present economies. More than 70% of the rural employment comes from agricultural activities. So, there is a need for utilization of cutting edge technologies to make it more profitable. The problems that are being mainly faced by the farmers are illiteracy, climatic changes, improper data transfer, low technical skills, migration, natural disasters etc; AMMA helps the farmers to utilize the fruits of Geoinformatics ,tele-education, mobile technology etc; The farmer gets registered at our website through the Village Resource Centre (VRC), or AMMA Centre. The coordinator collects the data from the farmer about the past status of the crop; his economic status etc; now the process goes like this..,1.The coordinator sends the crop status through images and text data.2. The expert group sends the advice on viewing the crop status, satellite images on weekly basis.3.The coordinator on receiving the report explains it to the farmer about how to execute the recommendations that are made by the expert group.4.The farmer follows the recommendations that were said by his coordinator and takes appropriate steps. He gives back the feedback after the recommendations made by the agricultural supervisor are implemented.5.The feedback sent back by the farmer is verified by the agricultural geographer, whether the recommendations made by the experts are implemented or not.So, through the above process the crop is strictly monitored and extreme care is taken in the management of the crop. This cycle is repeated every week through internet. Here at AMMA a quantitative and

Extreme temperature indices analyses: A case study of five meteorological stations in Peninsular Malaysia

NASA Astrophysics Data System (ADS)

Hasan, Husna; Salleh, Nur Hanim Mohd

2015-10-01

Extreme temperature events affect many human and natural systems. Changes in extreme temperature events can be detected and monitored by developing the indices based on the extreme temperature data. As an effort to provide the understanding of these changes to the public, a study of extreme temperature indices is conducted at five meteorological stations in Peninsular Malaysia. In this study, changes in the means and extreme events of temperature are assessed and compared using the daily maximum and minimum temperature data for the period of 2004 to 2013. The absolute extreme temperature indices; TXx, TXn, TXn and TNn provided by Expert Team on Climate Change Detection and Indices (ETCCDI) are utilized and linear trends of each index are extracted using least square likelihood method. The results indicate that there exist significant decreasing trend in the TXx index for Kota Bharu station and increasing trend in TNn index for Chuping and Kota Kinabalu stations. The comparison between the trend in mean and extreme temperatures show the same significant tendency for Kota Bharu and Kuala Terengganu stations.

Using a Recommender System and Hyperwave Attributes To Augment an Electronic Resource Library.

ERIC Educational Resources Information Center

Fenn, B.; Lennon, J.

There has been increasing interest over the past few years in systems that help users exchange recommendations about World Wide Web documents. Programs have ranged from those that rely totally on user pre-selection, to others that are based on artificial intelligence. This paper proposes a system that falls between these two extremes, providing…

Behaviours of overweight and obese women during pregnancy who achieve and exceed recommended gestational weight gain

PubMed Central

Chuang, Cynthia H.; Stengel, Michael R.; Hwang, Sandra W.; Velott, Diana; Kjerulff, Kristen H.; Kraschnewski, Jennifer L.

2014-01-01

Summary Background Excessive gestational weight gain (GWG) is associated with increased risk of pregnancy-related complications, postpartum weight retention, and long-term obesity. Little is known about the behavioural habits of pregnant women who achieve and exceed recommended GWG. Method In 2011, qualitative interviews were conducted in Pennsylvania with post-partum women who were overweight or obese prior to pregnancy to ascertain their behaviours and attitudes regarding dietary habits, physical activity, and self-monitoring during pregnancy. Thematic analysis identified the habits of women who achieved and exceeded recommended GWG guidelines. Results Of the 29 women interviewed, 11 had appropriate GWG and 18 had excessive GWG. Women achieving appropriate GWG reported modest increases in caloric intake if at all, with deliberate meal and snack planning, while women with excessive GWG described “eating-for-two.” Nearly all women with excessive GWG reported exercising less during pregnancy (or remaining sedentary), while women with appropriate GWG largely increased or maintained pre-pregnancy physical activity levels. About half of the sample reported self-monitoring weight gain during pregnancy, but women achieving recommended GWG tied their weight monitoring with GWG goals consistent with recommended guidelines. Conclusions Women who achieved appropriate GWG reported deliberate dietary habits and physical activity planning, with appropriate GWG goals during pregnancy. Women exceeding recommended GWG described “eating-for-two,” were sedentary, and either had no goals for GWG or intended to gain more weight than recommended. PMID:25434913

Climate extremes in the Pacific: improving seasonal prediction of tropical cyclones and extreme ocean temperatures to improve resilience

NASA Astrophysics Data System (ADS)

Kuleshov, Y.; Jones, D.; Spillman, C. M.

2012-04-01

Climate change and climate extremes have a major impact on Australia and Pacific Island countries. Of particular concern are tropical cyclones and extreme ocean temperatures, the first being the most destructive events for terrestrial systems, while the latter has the potential to devastate ocean ecosystems through coral bleaching. As a practical response to climate change, under the Pacific-Australia Climate Change Science and Adaptation Planning program (PACCSAP), we are developing enhanced web-based information tools for providing seasonal forecasts for climatic extremes in the Western Pacific. Tropical cyclones are the most destructive weather systems that impact on coastal areas. Interannual variability in the intensity and distribution of tropical cyclones is large, and presently greater than any trends that are ascribable to climate change. In the warming environment, predicting tropical cyclone occurrence based on historical relationships, with predictors such as sea surface temperatures (SSTs) now frequently lying outside of the range of past variability meaning that it is not possible to find historical analogues for the seasonal conditions often faced by Pacific countries. Elevated SSTs are the primary trigger for mass coral bleaching events, which can lead to widespread damage and mortality on reef systems. Degraded coral reefs present many problems, including long-term loss of tourism and potential loss or degradation of fisheries. The monitoring and prediction of thermal stress events enables the support of a range of adaptive and management activities that could improve reef resilience to extreme conditions. Using the climate model POAMA (Predictive Ocean-Atmosphere Model for Australia), we aim to improve accuracy of seasonal forecasts of tropical cyclone activity and extreme SSTs for the regions of Western Pacific. Improved knowledge of extreme climatic events, with the assistance of tailored forecast tools, will help enhance the resilience and

Eye lens monitoring for interventional radiology personnel: dosemeters, calibration and practical aspects of H p (3) monitoring. A 2015 review.

PubMed

Carinou, Eleftheria; Ferrari, Paolo; Bjelac, Olivera Ciraj; Gingaume, Merce; Merce, Marta Sans; O'Connor, Una

2015-09-01

A thorough literature review about the current situation on the implementation of eye lens monitoring has been performed in order to provide recommendations regarding dosemeter types, calibration procedures and practical aspects of eye lens monitoring for interventional radiology personnel. Most relevant data and recommendations from about 100 papers have been analysed and classified in the following topics: challenges of today in eye lens monitoring; conversion coefficients, phantoms and calibration procedures for eye lens dose evaluation; correction factors and dosemeters for eye lens dose measurements; dosemeter position and influence of protective devices. The major findings of the review can be summarised as follows: the recommended operational quantity for the eye lens monitoring is H p (3). At present, several dosemeters are available for eye lens monitoring and calibration procedures are being developed. However, in practice, very often, alternative methods are used to assess the dose to the eye lens. A summary of correction factors found in the literature for the assessment of the eye lens dose is provided. These factors can give an estimation of the eye lens dose when alternative methods, such as the use of a whole body dosemeter, are used. A wide range of values is found, thus indicating the large uncertainty associated with these simplified methods. Reduction factors from most common protective devices obtained experimentally and using Monte Carlo calculations are presented. The paper concludes that the use of a dosemeter placed at collar level outside the lead apron can provide a useful first estimate of the eye lens exposure. However, for workplaces with estimated annual equivalent dose to the eye lens close to the dose limit, specific eye lens monitoring should be performed. Finally, training of the involved medical staff on the risks of ionising radiation for the eye lens and on the correct use of protective systems is strongly recommended.

Performance evaluation of recommendation algorithms on Internet of Things services

NASA Astrophysics Data System (ADS)

Mashal, Ibrahim; Alsaryrah, Osama; Chung, Tein-Yaw

2016-06-01

Internet of Things (IoT) is the next wave of industry revolution that will initiate many services, such as personal health care and green energy monitoring, which people may subscribe for their convenience. Recommending IoT services to the users based on objects they own will become very crucial for the success of IoT. In this work, we introduce the concept of service recommender systems in IoT by a formal model. As a first attempt in this direction, we have proposed a hyper-graph model for IoT recommender system in which each hyper-edge connects users, objects, and services. Next, we studied the usefulness of traditional recommendation schemes and their hybrid approaches on IoT service recommendation (IoTSRS) based on existing well known metrics. The preliminary results show that existing approaches perform reasonably well but further extension is required for IoTSRS. Several challenges were discussed to point out the direction of future development in IoTSR.

Sunshine Skyway Bridge monitoring phase I : system assessment and integration recommendations.

DOT National Transportation Integrated Search

2016-10-01

The Sunshine Skyway Bridge has several different types of monitoring instruments in place maintained by Florida : Department of Transportation (FDOT) offices, divisions, and partners. The current decentralized approach to data collection : and monito...

Thin film filter lifetesting results in the extreme ultraviolet

NASA Technical Reports Server (NTRS)

Vedder, P. W.; Vallerga, J. V.; Gibson, J. L.; Stock, J.; Siegmund, O. H. W.

1993-01-01

We present the results of the thin film filter lifetesting program conducted as part of the NASA Extreme Ultraviolet Explorer (EUVE) satellite mission. This lifetesting program is designed to monitor changes in the transmission and mechanical properties of the EUVE filters over the lifetime of the mission (fabrication, assembly, launch and operation). Witness test filters were fabricated from thin film foils identical to those used in the flight filters. The witness filters have been examined and calibrated periodically over the past seven years. The filters have been examined for evidence of pinholing, mechanical degradation, and oxidation. Absolute transmissions of the flight and witness filters have been measured in the extreme ultraviolet (EUV) over six orders of magnitude at numerous wavelengths using the Berkeley EUV Calibration Facility.

The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health

PubMed Central

Valle, Adolfo Martinez

2016-01-01

Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH. PMID:26928215

The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health.

PubMed

Valle, Adolfo Martinez

2016-01-01

Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH.

Effects of Extreme Events on Arsenic Cycling in Salt Marshes

NASA Astrophysics Data System (ADS)

Northrup, Kristy; Capooci, Margaret; Seyfferth, Angelia L.

2018-03-01

Extreme events such as storm surges, intense precipitation, and supermoons cause anomalous and large fluctuations in water level in tidal salt marshes, which impacts the sediment biogeochemistry that dictates arsenic (As) cycling. In addition to changes in water level, which impacts soil redox potential, these extreme events may also change salinity due to freshwater inputs from precipitation or saltwater inputs due to surge. It is currently unknown how As mobility in tidal salt marshes will be impacted by extreme events, as fluctuations in salinity and redox potential may act synergistically to mobilize As. To investigate impacts of extreme events on As cycling in tidal salt marshes, we conducted a combined laboratory and field investigation. We monitored pore water and soil samples before, during, and after two extreme events: a supermoon lunar eclipse followed by a storm surge and precipitation induced by Hurricane Joaquin in fall 2015 at the St. Jones Reserve in Dover, Delaware, a representative tidal salt marsh in the Mid-Atlantic United States. We also conducted soil incubations of marsh sediments in batch and in flow-through experiments in which redox potential and/or salinity were manipulated. Field investigations showed that pore water As was inversely proportional to redox potential. During the extreme events, a distinct pulse of As was observed in the pore water with maximum salinity. Combined field and laboratory investigations revealed that this As pulse is likely due to rapid changes in salinity. These results have implications for As mobility in the face of extreme weather variability.

The dichotomous response of flood and storm extremes to rising global temperatures

NASA Astrophysics Data System (ADS)

Sharma, A.; Wasko, C.

2017-12-01

Rising temperature have resulted in increases in short-duration rainfall extremes across the world. Additionally it has been shown (doi:10.1038/ngeo2456) that storms will intensify, causing derived flood peaks to rise even more. This leads us to speculate that flood peaks will increase as a result, complying with the storyline presented in past IPCC reports. This talk, however, shows that changes in flood extremes are much more complex. Using global data on extreme flow events, the study conclusively shows that while the very extreme floods may be rising as a result of storm intensification, the more frequent flood events are decreasing in magnitude. The study argues that changes in the magnitude of floods are a function of changes in storm patterns and as well as pre-storm or antecedent conditions. It goes on to show that while changes in storms dominate for the most extreme events and over smaller, more urbanised catchments, changes in pre-storm conditions are the driving factor in modulating flood peaks in large rural catchments. The study concludes by providing recommendations on how future flood design should proceed, arguing that current practices (or using a design storm to estimate floods) are flawed and need changing.

Prevention through policy: Urban macroplastic leakages to the marine environment during extreme rainfall events.

PubMed

Axelsson, Charles; van Sebille, Erik

2017-11-15

The leakage of large plastic litter (macroplastics) into the ocean is a major environmental problem. A significant fraction of this leakage originates from coastal cities, particularly during extreme rainfall events. As coastal cities continue to grow, finding ways to reduce this macroplastic leakage is extremely pertinent. Here, we explore why and how coastal cities can reduce macroplastic leakages during extreme rainfall events. Using nine global cities as a basis, we establish that while cities actively create policies that reduce plastic leakages, more needs to be done. Nonetheless, these policies are economically, socially and environmentally cobeneficial to the city environment. While the lack of political engagement and economic concerns limit these policies, lacking social motivation and engagement is the largest limitation towards implementing policy. We recommend cities to incentivize citizen and municipal engagement with responsible usage of plastics, cleaning the environment and preparing for future extreme rainfall events. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Global intensification in observed short-duration rainfall extremes

NASA Astrophysics Data System (ADS)

Fowler, H. J.; Lewis, E.; Guerreiro, S.; Blenkinsop, S.; Barbero, R.; Westra, S.; Lenderink, G.; Li, X.

2017-12-01

Extreme rainfall events are expected to intensify with a warming climate and this is currently driving extensive research. While daily rainfall extremes are widely thought to have increased globally in recent decades, changes in rainfall extremes on shorter timescales, often associated with flash flooding, have not been documented at global scale due to surface observational limitations and the lack of a global sub-daily rainfall database. The access to and use of such data remains a challenge. For the first time, we have synthesized across multiple data sources providing gauge-based sub-daily rainfall observations across the globe over the last 6 decades. This forms part of the INTENSE project (part of the World Climate Research Programme (WCRP)'s Grand Challenge on 'Understanding and Predicting Weather and Climate Extremes' and the Global Water and Energy Exchanges (GEWEX) Hydroclimate Project cross-cut on sub-daily rainfall). A set of global hydroclimatic indices have been produced based upon stakeholder recommendations including indices that describe maximum rainfall totals and timing, the intensity, duration and frequency of storms, frequency of storms above specific thresholds and information about the diurnal cycle. This will provide a unique global data resource on sub-daily precipitation whose derived indices will be freely available to the wider scientific community. Because of the physical connection between global warming and the moisture budget, we also sought to infer long-term changes in sub-daily rainfall extremes contingent on global mean temperature. Whereas the potential influence of global warming is uncertain at regional scales, where natural variability dominates, aggregating surface stations across parts of the world may increase the global warming-induced signal. Changes in terms of annual maximum rainfall across various resolutions ranging from 1-h to 24-h are presented and discussed.

Outcomes for extremely premature infants.

PubMed

Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

2015-06-01

Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (<1000 g) remain at high risk for death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address

Extremely preterm infants who are small for gestational age have a high risk of early hypophosphatemia and hypokalemia.

PubMed

Boubred, F; Herlenius, E; Bartocci, M; Jonsson, B; Vanpée, M

2015-11-01

Electrolyte balances have not been sufficiently evaluated in extremely preterm infants after early parenteral nutrition. We investigated the risk of early hypophosphatemia and hypokalemia in extremely preterm infants born small for gestational age (SGA) who received nutrition as currently recommended. This prospective, observational cohort study included all consecutive extremely preterm infants born at 24-27 weeks who received high amino acids and lipid perfusion from birth. We evaluated the electrolyte levels of SGA infants and infants born appropriate for gestational age (AGA) during the first five days of life. The 12 SGA infants had lower plasma potassium levels from Day One compared to the 36 AGA infants and were more likely to have hypokalemia (58% vs 17%, p = 0.001) and hypophosphatemia (40% vs 9%, p < 0.01) during the five-day observation period. After adjusting for perinatal factors, SGA remained significantly associated with hypophosphatemia (odds ratio 1.39, confidence intervals 1.07-1.81, p = 0.01). Extremely preterm infants born SGA who were managed with currently recommended early parenteral nutrition had a high risk of early hypokalemia and hypophosphatemia. Potassium and phosphorus intakes should be set at sufficient levels from birth onwards, especially in SGA infants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Extreme winds and tornadoes: design and evaluation of buildings and structures

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

McDonald, J.R.

1985-01-01

The general provisions of ANSI A58.1-1982 are explained in detail. As mentioned above, these procedures may be used to determine design wind loads on structures from extreme winds, hurricane and tornado winds. Treatment of atmospheric pressure change loads are discussed, including recommendations for venting a building, if necessary, and the effects of rate of pressure change on HVAC systems. Finally, techniques for evaluating existing facilities are described.

The NASA Energy and Water Cycle Extreme (NEWSE) Integration Project

NASA Technical Reports Server (NTRS)

House, P. R.; Lapenta, W.; Schiffer, R.

2008-01-01

Skillful predictions of water and energy cycle extremes (flood and drought) are elusive. To better understand the mechanisms responsible for water and energy extremes, and to make decisive progress in predicting these extremes, the collaborative NASA Energy and Water cycle Extremes (NEWSE) Integration Project, is studying these extremes in the U.S. Southern Great Plains (SGP) during 2006-2007, including their relationships with continental and global scale processes, and assessment of their predictability on multiple space and time scales. It is our hypothesis that an integrative analysis of observed extremes which reflects the current understanding of the role of SST and soil moisture variability influences on atmospheric heating and forcing of planetary waves, incorporating recently available global and regional hydro- meteorological datasets (i.e., precipitation, water vapor, clouds, etc.) in conjunction with advances in data assimilation, can lead to new insights into the factors that lead to persistent drought and flooding. We will show initial results of this project, whose goals are to provide an improved definition, attribution and prediction on sub-seasonal to interannual time scales, improved understanding of the mechanisms of decadal drought and its predictability, including the impacts of SST variability and deep soil moisture variability, and improved monitoring/attributions, with transition to applications; a bridging of the gap between hydrological forecasts and stakeholders (utilization of probabilistic forecasts, education, forecast interpretation for different sectors, assessment of uncertainties for different sectors, etc.).

The FOBIMO (FOraminiferal BIo-MOnitoring) initiative—Towards a standardised protocol for soft-bottom benthic foraminiferal monitoring studies

USGS Publications Warehouse

Schoenfeld, Joachim; Alve, Elisabeth; Geslin, Emmanuelle; Jorissen, Frans; Korsun, Sergei; Spezzaferri, Silva; Abramovich, Sigal; Almogi-Labin, Ahuva; Armynot du Chatelet, Eric; Barras, Christine; Bergamin, Luisa; Bicchi, Erica; Bouchet, Vincent; Cearreta, Alejandro; Di Bella, Letizia; Dijkstra, Noortje; Trevisan Disaro, Sibelle; Ferraro, Luciana; Frontalini, Fabrizio; Gennari, Giordana; Golikova, Elena; Haynert, Kristin; Hess, Silvia; Husum, Katrine; Martins, Virginia; McGann, Mary; Oron, Shai; Romano, Elena; Mello Sousa, Silvia; Tsujimoto, Akira

2012-01-01

The European Community Marine Strategy Framework Directive (MSFD) was established to provide guidelines for monitoring the quality of marine ecosystems. Monitoring the status of marine environments is traditionally based on macrofauna surveys, for which standardised methods have been established. Benthic foraminifera are also good indicators of environmental status because of their fast turnover rates, high degree of specialisation, and the preservation of dead assemblages in the fossil record. In spite of the growing interest in foraminiferal bio-monitoring during the last decades, no standardised methodology has been proposed until today. The aim of the FOraminiferal BIo-MOnitoring (FOBIMO) expert workshop, held in June 2011 at Fribourg, Switzerland, which assembled 37 scientists from 24 research groups and 13 countries, was to develop a suite of standard methods. This paper presents the main outcome of the workshop, a list of motivated recommendations with respect to sampling devices, sample storage, treatment, faunal analysis and documentation. Our recommendations fulfil the criteria imposed both by scientific rigour and by the practical limitations of routine studies. Hence, our aim is to standardise methodologies used in bio-monitoring only and not to limit the use of different methods in pure scientific studies. Unless otherwise stated, all recommendations concern living (stained) benthic foraminiferal assemblages. We have chosen to propose two types of recommendations. Mandatory recommendations have to be followed if a study wants to qualify as sound and compatible to the norms. The most important of these recommendations are the interval from 0 to 1 cm below the sediment surface has to be sampled, and an interface corer or box corer that keeps the sediment surface intact is to be used for offshore surveys. A grab sampler must not be deployed in soft sediments. Three replicate samples are to be taken and analysed separately. Samples are to be washed on a

Monitoring guidance for patients with hypophosphatasia treated with asfotase alfa.

PubMed

Kishnani, Priya S; Rush, Eric T; Arundel, Paul; Bishop, Nick; Dahir, Kathryn; Fraser, William; Harmatz, Paul; Linglart, Agnès; Munns, Craig F; Nunes, Mark E; Saal, Howard M; Seefried, Lothar; Ozono, Keiichi

2017-09-01

Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures. Asfotase alfa is a human, recombinant enzyme replacement therapy that is approved in many countries for the treatment of patients with HPP. To address the unmet need for guidance in the monitoring of patients receiving asfotase alfa, an international panel of physicians with experience in diagnosing and managing HPP convened in May 2016 to discuss treatment monitoring parameters. The panel discussions focused on recommendations for assessing and monitoring patients after the decision to treat with asfotase alfa had been made and did not include recommendations for whom to treat. Based on the consensus of panel members, this review provides guidance on the monitoring of patients with HPP during treatment with asfotase alfa, including recommendations for laboratory, efficacy, and safety assessments and the frequency with which these should be performed during the course of treatment. Recommended assessments are based on patient age and include regular monitoring of biochemistry, skeletal radiographs, respiratory function, growth, pain, mobility and motor function, and quality of life. Because of the systemic presentation of HPP, a coordinated, multidisciplinary, team-based, patient-focused approach is recommended in the management of patients receiving asfotase alfa. Monitoring of efficacy and safety outcomes must be tailored to the individual patient, depending on medical history, clinical manifestations, availability of resources in the clinical

Gastroduodenal neuroendocrine neoplasms, including gastrinoma - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours).

PubMed

Lipiński, Michał; Rydzewska, Grażyna; Foltyn, Wanda; Andrysiak-Mamos, Elżbieta; Bałdys-Waligórska, Agata; Bednarczuk, Tomasz; Blicharz-Dorniak, Jolanta; Bolanowski, Marek; Boratyn-Nowicka, Agnieszka; Borowska, Małgorzata; Cichocki, Andrzej; Ćwikła, Jarosław B; Falconi, Massimo; Handkiewicz-Junak, Daria; Hubalewska-Dydejczyk, Alicja; Jarząb, Barbara; Junik, Roman; Kajdaniuk, Dariusz; Kamiński, Grzegorz; Kolasińska-Ćwikła, Agnieszka; Kowalska, Aldona; Król, Robert; Królicki, Leszek; Kunikowska, Jolanta; Kuśnierz, Katarzyna; Lampe, Paweł; Lange, Dariusz; Lewczuk-Myślicka, Anna; Lewiński, Andrzej; Londzin-Olesik, Magdalena; Marek, Bogdan; Nasierowska-Guttmejer, Anna; Nowakowska-Duława, Ewa; Pilch-Kowalczyk, Joanna; Poczkaj, Karolina; Rosiek, Violetta; Ruchała, Marek; Siemińska, Lucyna; Sowa-Staszczak, Anna; Starzyńska, Teresa; Steinhof-Radwańska, Katarzyna; Strzelczyk, Janusz; Sworczak, Krzysztof; Syrenicz, Anhelli; Szawłowski, Andrzej; Szczepkowski, Marek; Wachuła, Ewa; Zajęcki, Wojciech; Zemczak, Anna; Zgliczyński, Wojciech; Kos-Kudła, Beata

2017-01-01

This paper presents the updated Polish Neuroendocrine Tumour Network expert panel recommendations on the management of neuroendocrine neoplasms (NENs) of the stomach and duodenum, including gastrinoma. The recommendations discuss the epidemiology, pathogenesis, and clinical presentation of these tumours as well as their diagnosis, including biochemical, histopathological, and localisation diagnoses. The principles of treatment are discussed, including endoscopic, surgical, pharmacological, and radionuclide treatments. Finally, there are also recommendations on patient monitoring.

Beneficial effects of restoration practices can be thwarted by climate extremes.

PubMed

Maccherini, Simona; Bacaro, Giovanni; Marignani, Michela

2018-06-01

The impacts of climate extremes on species, communities and ecosystems have become critical concerns to science and society. Under a changing climate, how restoration outcomes are affected by extreme climate variables is a largely unknown topic. We analyzed the effects of experimental factors (grazing and sowing of native species), extreme climate events (intense precipitation and extreme temperatures indexes) and their combination on the restoration progress of a dry, calcareous grassland in Tuscany (Italy) with a 1 year before/15 years continuous annual monitoring after, control/impact (BACI) experiment. Grazing had a beneficial effect on the diversity of the grassland, while sowing had a limited impact. The climatic index that most affected the entire plant community composition was the number of very heavy precipitation days. The interaction of grazing and extreme climatic indexes had a significant detrimental effect on restoration outcomes, increasing the cover of synanthropic and Cosmopolitan-Subcosmopolitan generalist species and decreasing the cover of more valuable species such endemic species. In the richest grazed plots, species richness showed a lower sensitivity to the average precipitation per wet day but in grazed site, restoration outcomes can be negatively influenced by the intensification of precipitation and temperature extremes. In a context of progressive tropicalization of the Mediterranean area, to assist managers setting achievable restoration goals, restoration practitioners should consider that climate extremes might interfere with the beneficial effects of restoration practices. Copyright © 2018 Elsevier B.V. All rights reserved.

Influence of upper extremity positioning on pain, paresthesia, and tolerance: advancing current practice.

PubMed

Lester, Mark E; Hazelton, Jill; Dewey, William S; Casey, James C; Richard, Reginald

2013-01-01

Loss of upper extremity motion caused by axillary burn scar contracture is a major complication of burn injury. Positioning acutely injured patients with axillary burns in positions above 90° of shoulder abduction may improve shoulder motion and minimize scar contracture. However, these positions may increase injury risk to the nerves of the brachial plexus. This study evaluated the occurrence of paresthesias, pain, and positional intolerance in four shoulder abduction positions in healthy adults. Sixty men and women were placed in four randomly assigned shoulder abduction positions for up to 2 hours: 1) 90° with elbow extension (90 ABD); 2) 130° with elbow flexion at 110° (130 ABD); 3) 150° with elbow extension (150 ABD); and 4) 170° with elbow extension (170 ABD). Outcome measures were assessed at baseline and every 30 minutes and included the occurrence of upper extremity paresthesias, position comfort/tolerance, and pain. Transient paresthesias, lasting less than 3 minutes, occurred in all test positions in 10 to 37% of the cases. Significantly fewer subjects reported paresthesias in the 90 ABD position compared with the other positions (P < .01). Pain was reported more frequently in the 170° position (68%) compared with the other positions (P < .01). Positioning with the elbow flexed or in terminal extension is not recommended, regardless of the degree of shoulder abduction. Positioning patients in a position of 150° of shoulder abduction was shown to be safe and well tolerated. Consideration of positions above this range should be undertaken cautiously and only with strict monitoring in alert and oriented patients for short time periods.

Physical activity recommendations: an alternative approach using energy expenditure.

PubMed

Mudd, Lanay M; Rafferty, Ann P; Reeves, Mathew J; Pivarnik, James M

2008-10-01

Most adults do not meet the American College of Sports Medicine and Centers for Disease Control and Prevention (ACSM/CDC) physical activity recommendations. Even fewer meet the more extreme Institute of Medicine (IOM) physical activity recommendations. Compliance with either recommendation has been conventionally assessed by combining frequencies and durations of self-reported activities. Leisure-time energy expenditure is a cumulative measure of activity that offers an alternative method of defining compliance. To calculate the leisure-time energy expenditure of adults complying with the ACSM/CDC or the IOM physical activity recommendations determined by conventional measures and to reexamine compliance with the IOM recommendation using energy expenditure criteria. National, cross-sectional data from the 2000 Behavioral Risk Factor Surveillance System determined the mode, frequency, and duration of up to two leisure-time activities performed by adults. Four mutually exclusive activity groups (Non-, Low-, ACSM/CDC-, and IOM-Active) were defined on the basis of frequencies and durations of reported activities. Leisure-time energy expenditure (kcal x kg(-1) x wk(-1)) was calculated per respondent. The energy expenditure threshold for meeting the IOM recommendation was calculated as 21 kcal x kg(-1) x wk(-1). Of the 162,669 respondents included in the analyses, 29.9% were Nonactive, whereas 42.3%, 23.3%, and 4.5% were Low-, ACSM/CDC-, and IOM-Active, respectively. Median leisure-time energy expenditure values were 9.0, 27.4, and 63.0 kcal x kg(-1) x wk(-1) for Low-, ACSM/CDC-, and IOM-Active groups, respectively. When using energy expenditure criteria, compliance with the IOM recommendation rose to 27.7% of respondents. Compliance with the IOM physical activity recommendation dramatically increased when assessed by energy expenditure compared with conventional criteria, thereby highlighting the potential bias of conventional methods. A significant proportion of adults

Pollution monitoring system. [photographic laboratory by-products

NASA Technical Reports Server (NTRS)

Goodding, R. A.

1973-01-01

An investigation was undertaken to identify those photographic laboratory by-products which can produce harmful reactions if released untreated. After identification of these by-products, specific monitoring systems for each of the offending ions were investigated and recommendations for implementation are presented. Appropriate monitoring systems are discussed.

Seasonal and Non-Seasonal Generalized Pareto Distribution to Estimate Extreme Significant Wave Height in The Banda Sea

NASA Astrophysics Data System (ADS)

Nursamsiah; Nugroho Sugianto, Denny; Suprijanto, Jusup; Munasik; Yulianto, Bambang

2018-02-01

The information of extreme wave height return level was required for maritime planning and management. The recommendation methods in analyzing extreme wave were better distributed by Generalized Pareto Distribution (GPD). Seasonal variation was often considered in the extreme wave model. This research aims to identify the best model of GPD by considering a seasonal variation of the extreme wave. By using percentile 95 % as the threshold of extreme significant wave height, the seasonal GPD and non-seasonal GPD fitted. The Kolmogorov-Smirnov test was applied to identify the goodness of fit of the GPD model. The return value from seasonal and non-seasonal GPD was compared with the definition of return value as criteria. The Kolmogorov-Smirnov test result shows that GPD fits data very well both seasonal and non-seasonal model. The seasonal return value gives better information about the wave height characteristics.

A consensus approach to planetary protection requirements: recommendations for Mars lander missions

NASA Technical Reports Server (NTRS)

Rummel, J. D.; Meyer, M. A.

1996-01-01

Over the last several years, the nature of the surface conditions on the planet Mars, our knowledge of the growth capabilities of Earth organisms under extreme conditions, and future opportunities for Mars exploration have been under extensive review in the United States and elsewhere. As part of these examinations, in 1992 the US Space Studies Board made a series of recommendations to NASA on the requirements that should be implemented on future missions that will explore Mars. In particular, significant changes were recommended in the requirements for Mars landers, changes that significantly alleviated the burden of planetary protection implementation for these missions. In this paper we propose a resolution implementing this new set of recommendations, for adoption by COSPAR at its 30th meeting in Hamburg. We also discuss future directions and study areas for planetary protection, in light of changing plans for Mars exploration.

Black breast cancer survivors experience greater upper extremity disability.

PubMed

Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

2015-11-01

Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p < 0.001). After adjusting for BMI, age, education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95 % confidence interval 0.18-8.01) higher QuickDASH score (p = 0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

CT contrast extravasation in the upper extremity: strategies for management.

PubMed

Sbitany, Hani; Koltz, Peter F; Mays, Chester; Girotto, John A; Langstein, Howard N

2010-01-01

Extravasation of CT scan contrast media into upper extremity subcutaneous tissue is a relatively frequent complication of injection. Potential sequelae of extravasation include compartment syndrome, skin sloughing, and necrosis. Many institutions institute protocols requiring inpatient plastic surgery consultations immediately following extravasation injury to the upper extremity. We hypothesize that conversion to non-ionic contrast media for contrast CT studies has greatly reduced the incidence of severe extravasation injuries, and may alleviate the need for routine hand surgery consultations. Records from 102 consecutive CT contrast media extravasation injuries were identified. Data acquired from a single institution included type and amount of contrast extravasated, anatomic location, post-procedural clinical symptoms, whether consult was obtained, and final recommendations and outcome. In 102 consecutive cases, immediate surgical therapy was necessary in 0. Non-ionic medium was used in 94% of these cases, and ionic dye was used in 6%. Extravasation of less than 100 cc occurred in 90%, and only 10% were greater. Plastic surgery consultation was immediately obtained in 42% of cases. Factors prompting consultation included extravasation >30 cc, and the presence of erythema or induration. Trends for consultation remained without discernable pattern when patients were stratified by age, amount of extravasate, or anatomic location. Conservative management was recommended in all cases. This included elevation of the extremity, frequent pulse and sensation exams, local message, and temporary splinting. There were no secondary complications requiring surgical intervention. Extravasation of non-ionic CT contrast media appears to be innocuous and can be treated with conservative therapy. Plastic surgery consultation should be obtained when there are obvious signs of skin and soft tissue compromise or symptoms of compartment syndrome. Copyright 2010 Surgical Associates Ltd

How extreme is extreme hourly precipitation?

NASA Astrophysics Data System (ADS)

Papalexiou, Simon Michael; Dialynas, Yannis G.; Pappas, Christoforos

2016-04-01

The importance of accurate representation of precipitation at fine time scales (e.g., hourly), directly associated with flash flood events, is crucial in hydrological design and prediction. The upper part of a probability distribution, known as the distribution tail, determines the behavior of extreme events. In general, and loosely speaking, tails can be categorized in two families: the subexponential and the hyperexponential family, with the first generating more intense and more frequent extremes compared to the latter. In past studies, the focus has been mainly on daily precipitation, with the Gamma distribution being the most popular model. Here, we investigate the behaviour of tails of hourly precipitation by comparing the upper part of empirical distributions of thousands of records with three general types of tails corresponding to the Pareto, Lognormal, and Weibull distributions. Specifically, we use thousands of hourly rainfall records from all over the USA. The analysis indicates that heavier-tailed distributions describe better the observed hourly rainfall extremes in comparison to lighter tails. Traditional representations of the marginal distribution of hourly rainfall may significantly deviate from observed behaviours of extremes, with direct implications on hydroclimatic variables modelling and engineering design.

Capabilities of a Global 3D MHD Model for Monitoring Extremely Fast CMEs

NASA Astrophysics Data System (ADS)

Wu, C. C.; Plunkett, S. P.; Liou, K.; Socker, D. G.; Wu, S. T.; Wang, Y. M.

2015-12-01

Since the start of the space era, spacecraft have recorded many extremely fast coronal mass ejections (CMEs) which have resulted in severe geomagnetic storms. Accurate and timely forecasting of the space weather effects of these events is important for protecting expensive space assets and astronauts and avoiding communications interruptions. Here, we will introduce a newly developed global, three-dimensional (3D) magnetohydrodynamic (MHD) model (G3DMHD). The model takes the solar magnetic field maps at 2.5 solar radii (Rs) and intepolates the solar wind plasma and field out to 18 Rs using the algorithm of Wang and Sheeley (1990, JGR). The output is used as the inner boundary condition for a 3D MHD model. The G3DMHD model is capable of simulating (i) extremely fast CME events with propagation speeds faster than 2500 km/s; and (ii) multiple CME events in sequence or simultaneously. We will demonstrate the simulation results (and comparison with in-situ observation) for the fastest CME in record on 23 July 2012, the shortest transit time in March 1976, and the well-known historic Carrington 1859 event.

Office Visits to Monitor Stimulant Medication Safety and Efficacy: Recommended Care.

PubMed

Zima, Bonnie T; Norquist, Grayson S; Altchuler, Steven I; Behrens, Jacob; Iles-Shih, Matthew D; Ng, Yiu Kee Warren; Schaepper, Mary Ann

2018-06-01

The clinical guidance based on the research article, "Specific Components of Pediatricians' Medication-Related Care Predict Attention-Deficit/Hyperactivity Disorder Improvement," published in the June 2017 issue, 1 might be premature. The authors, Epstein et al., suggest that "Physicians do not need to necessarily rely on office visits to monitor medication response and side effects in the week(s) after initially prescribing medication, but instead could use phone calls or email correspondence to check in with the family" (p. 489). However, this advice has the potential to be misinterpreted that phone or email contact is acceptable clinical practice to monitor stimulant medication safety and efficacy, especially during the maintenance phase. It also could be erroneously interpreted that phone or email contact is sufficient for follow-up care for children receiving medication treatment for attention-deficit/hyperactivity disorder (ADHD) for national quality measures. Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Management of venomous snakebite injury to the extremities.

PubMed

Anz, Adam W; Schweppe, Mark; Halvorson, Jason; Bushnell, Brandon; Sternberg, Michael; Andrew Koman, L

2010-12-01

Pit vipers (subfamily Crotalinae) are responsible for most venomous snakebites in the United States. The mixture of proteins with cytotoxic, proteolytic, and/or neurotoxic enzymes in snake venom varies by species. Treatment in the field consists of safe identification of the species of snake and rapid transport of the patient to the nearest health care facility. Swelling, bruising, and systemic symptoms are seen following snakebite. Most patients respond to elevation of the affected extremity and observation. Some require the administration of antivenin. Crotalidae Polyvalent Immune Fab (Ovine) (CroFab, BTG International, West Conshohocken, PA) antivenin is safe and effective for the management of local and systemic effects of envenomation. Rarely, compartment syndrome may develop in the affected limb because of edema and tissue necrosis. Close monitoring of the extremity via serial physical examination and measurement of compartment pressure is a reliable method of determining whether surgical intervention is required.

The potential power of robotics for upper extremity stroke rehabilitation.

PubMed

Dukelow, Sean P

2017-01-01

Two decades of research on robots and upper extremity rehabilitation has resulted in recommendations from systematic reviews and guidelines on their use in stroke. Robotics are often cited for their ability to encourage mass practice as a means to enhance recovery of movement. Yet, stroke recovery is a complex process occurring across many aspects of neurologic function beyond movement. As newer devices are developed and enhanced assessments are integrated into treatment protocols, the potential of robotics to advance rehabilitation will continue to grow.

Thermodynamics of extremal rotating thin shells in an extremal BTZ spacetime and the extremal black hole entropy

NASA Astrophysics Data System (ADS)

Lemos, José P. S.; Minamitsuji, Masato; Zaslavskii, Oleg B.

2017-02-01

In a (2 +1 )-dimensional spacetime with a negative cosmological constant, the thermodynamics and the entropy of an extremal rotating thin shell, i.e., an extremal rotating ring, are investigated. The outer and inner regions with respect to the shell are taken to be the Bañados-Teitelbom-Zanelli (BTZ) spacetime and the vacuum ground state anti-de Sitter spacetime, respectively. By applying the first law of thermodynamics to the extremal thin shell, one shows that the entropy of the shell is an arbitrary well-behaved function of the gravitational area A+ alone, S =S (A+). When the thin shell approaches its own gravitational radius r+ and turns into an extremal rotating BTZ black hole, it is found that the entropy of the spacetime remains such a function of A+, both when the local temperature of the shell at the gravitational radius is zero and nonzero. It is thus vindicated by this analysis that extremal black holes, here extremal BTZ black holes, have different properties from the corresponding nonextremal black holes, which have a definite entropy, the Bekenstein-Hawking entropy S (A+)=A/+4G , where G is the gravitational constant. It is argued that for extremal black holes, in particular for extremal BTZ black holes, one should set 0 ≤S (A+)≤A/+4G;i.e., the extremal black hole entropy has values in between zero and the maximum Bekenstein-Hawking entropy A/+4 G . Thus, rather than having just two entropies for extremal black holes, as previous results have debated, namely, 0 and A/+4 G , it is shown here that extremal black holes, in particular extremal BTZ black holes, may have a continuous range of entropies, limited by precisely those two entropies. Surely, the entropy that a particular extremal black hole picks must depend on past processes, notably on how it was formed. A remarkable relation between the third law of thermodynamics and the impossibility for a massive body to reach the velocity of light is also found. In addition, in the procedure, it

Monitoring and evaluating civil structures using measured vibration

NASA Astrophysics Data System (ADS)

Straser, Erik G.; Kiremidjian, Anne S.

1996-04-01

The need for a rapid assessment of the state of critical and conventional civil structures, such as bridges, control centers, airports, and hospitals, among many, has been amply demonstrated during recent natural disasters. Research is underway at Stanford University to develop a state-of-the-art automated damage monitoring system for long term and extreme event monitoring based on both ambient and forced response measurements. Such research requires a multi-disciplinary approach harnessing the talents and expertise of civil, electrical, and mechanical engineering to arrive at a novel hardware and software solution. Recent advances in silicon micro-machining and microprocessor design allow for the economical integration of sensing, processing, and communication components. Coupling these technological advances with parameter identification algorithms allows for the realization of extreme event damage monitoring systems for civil structures. This paper addresses the first steps toward the development of a near real-time damage diagnostic and monitoring system based on structural response to extreme events. Specifically, micro-electro-mechanical- structures (MEMS) and microcontroller embedded systems (MES) are demonstrated to be an effective platform for the measurement and analysis of civil structures. Experimental laboratory tests with small scale model specimens and a preliminary sensor module are used to evaluate hardware and obtain structural response data from input accelerograms. A multi-step analysis procedure employing ordinary least squares (OLS), extended Kalman filtering (EKF), and a substructuring approach is conducted to extract system characteristics of the model. Results from experimental tests and system identification (SI) procedures as well as fundamental system design issues are presented.

Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level

PubMed Central

DE HERT, MARC; COHEN, DAN; BOBES, JULIO; CETKOVICH-BAKMAS, MARCELO; LEUCHT, STEFAN; M. NDETEI, DAVID; W. NEWCOMER, JOHN; UWAKWE, RICHARD; ASAI, ITSUO; MÖLLER, HANS-JURGEN; GAUTAM, SHIV; DETRAUX, JOHAN; U. CORRELL, CHRISTOPH

2011-01-01

Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in developed countries. Moreover, specific patient, provider, treatment and system factors act as barriers to the recognition and to the management of physical diseases in people with SMI. Psychiatrists can play a pivotal role in the improvement of the physical health of these patients by expanding their task from clinical psychiatric care to the monitoring and treatment of crucial physical parameters. At a system level, actions are not easy to realize, especially for developing countries. However, at an individual level, even simple and very basic monitoring and treatment actions, undertaken by the treating clinician, can already improve the problem of suboptimal medical care in this population. Adhering to monitoring and treatment guidelines will result in a substantial enhancement of physical health outcomes. Furthermore, psychiatrists can help educate and motivate people with SMI to address their suboptimal lifestyle, including smoking, unhealthy diet and lack of exercise. The adoption of the recommendations presented in this paper across health care systems throughout the world will contribute to a significant improvement in the medical and related psychiatric health outcomes of patients with SMI. PMID:21633691

The National Integrated Heat Health Information System (NIHHIS) as a Learning System for Extreme Heat: Evolving Future Resilience from Present Climate Extremes

NASA Astrophysics Data System (ADS)

Jones, H.; Trtanj, J.; Pulwarty, R. S.; Higgins, W.

2016-12-01

There is presently no consensus indicator for the effect of extreme heat on human health. At the early warning timescale, a variety of approaches to setting temperature thresholds (minimum, maximum, time-lagged) or more complex approaches (Heat Index, Thermal Comfort, etc...) for issuing alerts and warnings have been recommended by literature and implemented, leading to much heterogeneity. At longer timescales, efforts have been made to quantify potential future health outcomes using climate projections, but nonstationarity of the climate system, economy, and demography may invalidate many of the assumptions which were necessarily made in these studies. Furthermore, in our pursuit of developing the best models and indicators to represent the impacts of climate extremes, perhaps we have not paid enough attention to what makes them policy-relevant, responsive to changing assumptions, and targeted at elements that can actually be predicted. In response to this concern, a comprehensive approach to improving the impactfulness of these indicators is underway as part of the National Integrated Heat Health Information System (NIHHIS), which was initiated by NOAA and CDC, but has grown to include many other federal agency and non-governmental partners. NIHHIS is a framework that integrates what we know about extreme heat and health outcomes within a learning system - simultaneously informing early warning and long-term risk reduction prior to, during, and while recovering from extreme heat events. NIHHIS develops impactful evolutionary responses to climate extremes. Through ongoing regional engagements, we are applying the lessons of impact modeling studies to create learning systems in the Southwest, Northeast, Midwest, and soon other regions of the U.S. This session will provide a view of this process as it has been carried out in the Southwest region - focused on the transboundary (US-Mexico) region around El Paso, Texas, and the NIHHIS approach to indicators overall.

Gunshot-induced fractures of the extremities: a review of antibiotic and debridement practices.

PubMed

Sathiyakumar, Vasanth; Thakore, Rachel V; Stinner, Daniel J; Obremskey, William T; Ficke, James R; Sethi, Manish K

2015-09-01

The use of antibiotic prophylaxis and debridement is controversial when treating low- and high-velocity gunshot-induced fractures, and established treatment guidelines are currently unavailable. The purpose of this review was to evaluate the literature for the prophylactic antibiotic and debridement policies for (1) low-velocity gunshot fractures of the extremities, joints, and pelvis and (2) high-velocity gunshot fractures of the extremities. Low-velocity gunshot fractures of the extremities were subcategorized into operative and non-operative cases, whereas low-velocity gunshot fractures of the joints and pelvis were evaluated based on the presence or absence of concomitant bowel injury. In the absence of surgical necessity for fracture care such as concomitant absence of gross wound contamination, vascular injury, large soft-tissue defect, or associated compartment syndrome, the literature suggests that superficial debridement for low-velocity ballistic fractures with administration of antibiotics is a satisfactory alternative to extensive operative irrigation and debridement. In operative cases or those involving bowel injuries secondary to pelvic fractures, the literature provides support for and against extensive debridement but does suggest the use of intravenous antibiotics. For high-velocity ballistic injuries, the literature points towards the practice of extensive immediate debridement with prophylactic intravenous antibiotics. Our systematic review demonstrates weak evidence for superficial debridement of low-velocity ballistic fractures, extensive debridement for high-velocity ballistic injuries, and antibiotic use for both types of injury. Intra-articular fractures seem to warrant debridement, while pelvic fractures with bowel injury have conflicting evidence for debridement but stronger evidence for antibiotic use. Given a relatively low number of studies on this subject, we recommend that further high-quality research on the debridement and

24 CFR 1000.530 - What corrective and remedial actions will HUD request or recommend to address performance...

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... for completing activities or complying with the requirements of this part; (3) Recommend that the recipient suspend, discontinue, or not incur costs for the affected activity; (4) Recommend that the...

24 CFR 1000.530 - What corrective and remedial actions will HUD request or recommend to address performance...

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... for completing activities or complying with the requirements of this part; (3) Recommend that the recipient suspend, discontinue, or not incur costs for the affected activity; (4) Recommend that the...

24 CFR 1000.530 - What corrective and remedial actions will HUD request or recommend to address performance...

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... for completing activities or complying with the requirements of this part; (3) Recommend that the recipient suspend, discontinue, or not incur costs for the affected activity; (4) Recommend that the...

The strategy for improving water-quality monitoring in the United States; final report of the Intergovernmental Task Force on Monitoring Water Quality; technical appendices

USGS Publications Warehouse

,

1995-01-01

The Intergovernmental Task Force on Monitoring Water Quality (ITFM) prepared this report in collaboration with representatives of all levels of government and the private sector. The report recommends a strategy for nationwide water-quality monitoring and technical monitoring improvements to support sound water-quality decisionmaking. The strategy is intended to achieve a better return on public and private investments in monitoring, environmental protection, and natural resources management. It is also designed to expand the base of information useful to a variety of users at multiple geographic scales. Institutional and technical changes are needed to improve water-quality monitoring and to meet the full range of monitoring requirements. Monitoring must be incorporated as a critical element of program planning, implementation, and evaluation. The strategy includes recommendations in many key elements, such as the development of goal-oriented monitoring and indicators, institutional collaboration, and methods comparability. Initial actions have been taken to implement the strategy. Several Federal agencies have jointly purchased and shared remotely sensed land-cover information needed for water assessment. Major agency data systems are using common data-element names and reference tables that will ensure easy sharing of data. A number of States have held meetings with collectors of water information to initiate statewide monitoring strategies. New monitoring guidance has been developed for Federal water-quality grants to States. Many State offices have changed monitoring programs to place emphasis on priority watersheds and to improve assessment of water quality. As the competition increases for adequate supplies of clean water, concerns about public health and the environment escalate, and more demands are placed on the water information infrastructure. To meet these demands, the collaborative approach has already produced benefits, which will continue to grow as

Geoscientific process monitoring with positron emission tomography (GeoPET)

NASA Astrophysics Data System (ADS)

Kulenkampff, Johannes; Gründig, Marion; Zakhnini, Abdelhamid; Lippmann-Pipke, Johanna

2016-08-01

Transport processes in geomaterials can be observed with input-output experiments, which yield no direct information on the impact of heterogeneities, or they can be assessed by model simulations based on structural imaging using µ-CT. Positron emission tomography (PET) provides an alternative experimental observation method which directly and quantitatively yields the spatio-temporal distribution of tracer concentration. Process observation with PET benefits from its extremely high sensitivity together with a resolution that is acceptable in relation to standard drill core sizes. We strongly recommend applying high-resolution PET scanners in order to achieve a resolution on the order of 1 mm. We discuss the particularities of PET applications in geoscientific experiments (GeoPET), which essentially are due to high material density. Although PET is rather insensitive to matrix effects, mass attenuation and Compton scattering have to be corrected thoroughly in order to derive quantitative values. Examples of process monitoring of advection and diffusion processes with GeoPET illustrate the procedure and the experimental conditions, as well as the benefits and limits of the method.

Demonstration of subsidence monitoring system

NASA Astrophysics Data System (ADS)

Conroy, P. J.; Gyarmaty, J. H.; Pearson, M. L.

1981-06-01

Data on coal mine subsidence were studied as a basis for the development of subsidence control technology. Installation, monitoring, and evaluation of three subsidence monitoring instrument systems were examined: structure performance, performance of supported systems, and performance of caving systems. Objectives of the instrument program were: (1) to select, test, assemble, install, monitor, and maintain all instrumentation required for implementing the three subsidence monitoring systems; and (2) to evaluate performance of each instrument individually and as part of the appropriate monitoring system or systems. The use of an automatic level and a rod extensometer for measuring structure performance, and the automatic level, steel tape extensometer, FPBX, FPBI, USBM borehole deformation gauge, and vibrating wire stressmeters for measuring the performance of caving systems are recommended.

Recommendations for assessing water quality and safety on board merchant ships.

PubMed

Grappasonni, Iolanda; Cocchioni, Mario; Degli Angioli, Rolando; Saturnino, Andrea; Sibilio, Fabio; Scuri, Stefania; Amenta, Francesco

2013-01-01

Health and diseases on board ships may depend on water. Interventions to improve the quality of water may bring to significant benefits to health and water stores/supply and should be controlledto protect health. This paper has reviewed the main regulations for the control of water safety and qualityon board ships and presents some practical recommendations for keeping water healthy and safe in passenger and cargo merchant ships. The main international regulations and guidelines on the topic were analysed. Guidelines forWater Quality on Board Merchant Ships Including Passenger Vessels of Health Protection Agency, World Health Organisation (WHO) Guide to Ship Sanitation, WHO Guidelines for Drinking Water Quality, WHO Water Safety Plan and the United States Center for Disease Control and Prevention Vessel Sanitation Program were examined. Recommendations for passenger and, if available, for cargo ships were collected and compared. Recommended questionnaire: A questionnaire summarising the main information to collect for assessingthe enough quality of water for the purposes it should be used on board is proposed. The need of havinga crew member with water assessment duties on board, trained for performing these activities properlyis discussed. Water quality on board ships should be monitored routinely. Monitoring should be directedto chemical and microbiological parameters for identifying possible contamination sources, using specifickits by a designed crew member. More detailed periodic assessments should be under the responsibility ofspecialised personnel/laboratories and should be based on sample collection from all tanks and sites of waterdistribution. It is important to select a properly trained crew member on board for monitoring water quality.

A review of the outcomes of the recommendations made during paediatric telepsychiatry consultations.

PubMed

Boydell, Katherine M; Volpe, Tiziana; Kertes, Angela; Greenberg, Natasha

2007-01-01

Little is known about whether the recommendations made during telepsychiatry are actually implemented. We reviewed 100 telepsychiatry consultations, chosen randomly from a paediatric telepsychiatry programme serving rural communities in Ontario. Treatment recommendations had been made for each case reviewed and up to nine recommendations had been made for a single case. Twenty-seven percent of recommendations revolved around monitoring (10%), changing (9%), starting (4%), continuing (3%) and stopping (1%) medication. Case managers associated with 54 of the cases were interviewed to determine whether the recommendations had been implemented and to examine the barriers and facilitators to implementation. The results indicated that cooperation of both child and parent, clear communication of recommendations, involvement of the school and local health providers, stability of the agencies and availability of services were key components in the successful implementation of recommendations. The matter of technology or technological difficulties acting as a barrier to telepsychiatric consultations was not mentioned by case managers, suggesting that it was not a problem.

Real-time video quality monitoring

NASA Astrophysics Data System (ADS)

Liu, Tao; Narvekar, Niranjan; Wang, Beibei; Ding, Ran; Zou, Dekun; Cash, Glenn; Bhagavathy, Sitaram; Bloom, Jeffrey

2011-12-01

The ITU-T Recommendation G.1070 is a standardized opinion model for video telephony applications that uses video bitrate, frame rate, and packet-loss rate to measure the video quality. However, this model was original designed as an offline quality planning tool. It cannot be directly used for quality monitoring since the above three input parameters are not readily available within a network or at the decoder. And there is a great room for the performance improvement of this quality metric. In this article, we present a real-time video quality monitoring solution based on this Recommendation. We first propose a scheme to efficiently estimate the three parameters from video bitstreams, so that it can be used as a real-time video quality monitoring tool. Furthermore, an enhanced algorithm based on the G.1070 model that provides more accurate quality prediction is proposed. Finally, to use this metric in real-world applications, we present an example emerging application of real-time quality measurement to the management of transmitted videos, especially those delivered to mobile devices.

Assessing, Modeling, and Monitoring the Impacts of Extreme Climate Events

NASA Astrophysics Data System (ADS)

Murnane, Richard J.; Diaz, Henry F.

2006-01-01

Extreme weather and climate events provide dramatic content for the news media, and the past few years have supplied plenty of material. The 2004 and 2005 Atlantic hurricane seasons were very active; the United States was struck repeatedly by landfalling major hurricanes. A five-year drought in the southwestern United States was punctuated in 2003 by wildfires in southern California that caused billions of dollars in losses. Ten cyclones of at least tropical storm strength struck Japan in 2004, easily breaking the 1990 and 1993 records of six cyclones each year. Hurricane Catarina was the first recorded hurricane in the South Atlantic. Europe's summer of 2003 saw record-breaking heat that caused tens of thousands of deaths. These events have all been widely publicized, and they naturally raise several questions: Is climate changing, and if so, why? What can we expect in the future? How can we better respond to climate variability regardless of its source?

Expert Panel Recommendations for Hanford Double-Shell Tank Life Extension

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

Stewart, Charles W; Bush, Spencer H; Berman, Herbert Stanton

2001-06-29

Expert workshops were held in Richland in May 2001 to review the Hanford Double-Shell Tank Integrity Project and make recommendations to extend the life of Hanford's double-shell waste tanks. The workshop scope was limited to corrosion of the primary tank liner, and the main areas for review were waste chemistry control, tank inspection, and corrosion monitoring. Participants were corrosion experts from Hanford, Savannah River Site, Brookhaven National Lab., Pacific Northwest National Lab., and several consultants. This report describes the current state of the three areas of the program, the final recommendations of the workshop, and the rationale for their selection.

Learning Problems in Kindergarten Students with Extremely Preterm Birth

PubMed Central

Taylor, H. Gerry; Klein, Nancy; Anselmo, Marcia G.; Minich, Nori; Espy, Kimberly A.; Hack, Maureen

2012-01-01

Objective To assess learning problems in extremely preterm children in kindergarten and identify risk factors. Design Cohort study. Setting Children’s hospital. Participants A cohort of extremely preterm children born January 2001 – December 2003 (n=148), defined as <28 weeks gestation and/or <1000 g birth weight, and term-born normal birth weight classmate controls (n=111). Main Interventions The children were enrolled during their first year in kindergarten and assessed on measures of learning progress. Main Outcome Measures Achievement testing, teacher ratings of learning progress, and individual educational assistance. Results The extremely preterm children had lower mean standard scores than controls on tests of spelling (8.52 points, 95% CI: 4.58, 12.46) and applied mathematics (11.02 points, 95% CI: 6.76, 15.28). They also had higher rates of substandard learning progress by teacher report in written language (OR = 4.23, 95% CI: 2.32, 7.73) and mathematics (OR = 7.08, 95% CI: 2.79, 17.95). Group differences on mathematics achievement and in teacher ratings of learning progress were significant even in children without neurosensory deficits or low global cognitive ability. Neonatal risk factors, early childhood neurodevelopmental impairment, and socioeconomic status predicted learning problems in extremely preterm children, yet many of the children with problems were not in a special education program. Conclusion Learning problems in extremely preterm children are evident in kindergarten and are associated with neonatal and early childhood risk factors. The findings support efforts to provide more extensive monitoring and interventions both prior to and during the first year in school. PMID:21893648

Leveraging tagging and rating for recommendation: RMF meets weighted diffusion on tripartite graphs

NASA Astrophysics Data System (ADS)

Li, Jianguo; Tang, Yong; Chen, Jiemin

2017-10-01

Recommender systems (RSs) have been a widely exploited approach to solving the information overload problem. However, the performance is still limited due to the extreme sparsity of the rating data. With the popularity of Web 2.0, the social tagging system provides more external information to improve recommendation accuracy. Although some existing approaches combine the matrix factorization models with the tag co-occurrence and context of tags, they neglect the issue of tag sparsity that would also result in inaccurate recommendations. Consequently, in this paper, we propose a novel hybrid collaborative filtering model named WUDiff_RMF, which improves regularized matrix factorization (RMF) model by integrating Weighted User-Diffusion-based CF algorithm(WUDiff) that obtains the information of similar users from the weighted tripartite user-item-tag graph. This model aims to capture the degree correlation of the user-item-tag tripartite network to enhance the performance of recommendation. Experiments conducted on four real-world datasets demonstrate that our approach significantly performs better than already widely used methods in the accuracy of recommendation. Moreover, results show that WUDiff_RMF can alleviate the data sparsity, especially in the circumstance that users have made few ratings and few tags.

Social and content aware One-Class recommendation of papers in scientific social networks.

PubMed

Wang, Gang; He, XiRan; Ishuga, Carolyne Isigi

2017-01-01

With the rapid development of information technology, scientific social networks (SSNs) have become the fastest and most convenient way for researchers to communicate with each other. Many published papers are shared via SSNs every day, resulting in the problem of information overload. How to appropriately recommend personalized and highly valuable papers for researchers is becoming more urgent. However, when recommending papers in SSNs, only a small amount of positive instances are available, leaving a vast amount of unlabelled data, in which negative instances and potential unseen positive instances are mixed together, which naturally belongs to One-Class Collaborative Filtering (OCCF) problem. Therefore, considering the extreme data imbalance and data sparsity of this OCCF problem, a hybrid approach of Social and Content aware One-class Recommendation of Papers in SSNs, termed SCORP, is proposed in this study. Unlike previous approaches recommended to address the OCCF problem, social information, which has been proved playing a significant role in performing recommendations in many domains, is applied in both the profiling of content-based filtering and the collaborative filtering to achieve superior recommendations. To verify the effectiveness of the proposed SCORP approach, a real-life dataset from CiteULike was employed. The experimental results demonstrate that the proposed approach is superior to all of the compared approaches, thus providing a more effective method for recommending papers in SSNs.

Social and content aware One-Class recommendation of papers in scientific social networks

PubMed Central

Wang, Gang; He, XiRan

2017-01-01

With the rapid development of information technology, scientific social networks (SSNs) have become the fastest and most convenient way for researchers to communicate with each other. Many published papers are shared via SSNs every day, resulting in the problem of information overload. How to appropriately recommend personalized and highly valuable papers for researchers is becoming more urgent. However, when recommending papers in SSNs, only a small amount of positive instances are available, leaving a vast amount of unlabelled data, in which negative instances and potential unseen positive instances are mixed together, which naturally belongs to One-Class Collaborative Filtering (OCCF) problem. Therefore, considering the extreme data imbalance and data sparsity of this OCCF problem, a hybrid approach of Social and Content aware One-class Recommendation of Papers in SSNs, termed SCORP, is proposed in this study. Unlike previous approaches recommended to address the OCCF problem, social information, which has been proved playing a significant role in performing recommendations in many domains, is applied in both the profiling of content-based filtering and the collaborative filtering to achieve superior recommendations. To verify the effectiveness of the proposed SCORP approach, a real-life dataset from CiteULike was employed. The experimental results demonstrate that the proposed approach is superior to all of the compared approaches, thus providing a more effective method for recommending papers in SSNs. PMID:28771495

Geophysical Hazards and Preventive Disaster Management of Extreme Natural Events

NASA Astrophysics Data System (ADS)

Ismail-Zadeh, A.; Takeuchi, K.

2007-12-01

Geophysical hazard is potentially damaging natural event and/or phenomenon, which may cause the loss of life or injury, property damage, social and economic disruption, or environmental degradation. Extreme natural hazards are a key manifestation of the complex hierarchical nonlinear Earth system. An understanding, accurate modeling and forecasting of the extreme hazards are most important scientific challenges. Several recent extreme natural events (e.g., 2004 Great Indian Ocean Earthquake and Tsunami and the 2005 violent Katrina hurricane) demonstrated strong coupling between solid Earth and ocean, and ocean and atmosphere. These events resulted in great humanitarian tragedies because of a weak preventive disaster management. The less often natural events occur (and the extreme events are rare by definition), the more often the disaster managers postpone the preparedness to the events. The tendency to reduce the funding for preventive disaster management of natural catastrophes is seldom follows the rules of responsible stewardship for future generations neither in developing countries nor in highly developed economies where it must be considered next to malfeasance. Protecting human life and property against earthquake disasters requires an uninterrupted chain of tasks: from (i) understanding of physics of the events, analysis and monitoring, through (ii) interpretation, modeling, hazard assessment, and prediction, to (iii) public awareness, preparedness, and preventive disaster management.

Reference Cross Sections for Charged-particle Monitor Reactions

NASA Astrophysics Data System (ADS)

Hermanne, A.; Ignatyuk, A. V.; Capote, R.; Carlson, B. V.; Engle, J. W.; Kellett, M. A.; Kibédi, T.; Kim, G.; Kondev, F. G.; Hussain, M.; Lebeda, O.; Luca, A.; Nagai, Y.; Naik, H.; Nichols, A. L.; Nortier, F. M.; Suryanarayana, S. V.; Takács, S.; Tárkányi, F. T.; Verpelli, M.

2018-02-01

Evaluated cross sections of beam-monitor reactions are expected to become the de-facto standard for cross-section measurements that are performed over a very broad energy range in accelerators in order to produce particular radionuclides for industrial and medical applications. The requirements for such data need to be addressed in a timely manner, and therefore an IAEA coordinated research project was launched in December 2012 to establish or improve the nuclear data required to characterise charged-particle monitor reactions. An international team was assembled to recommend more accurate cross-section data over a wide range of targets and projectiles, undertaken in conjunction with a limited number of measurements and more extensive evaluations of the decay data of specific radionuclides. Least-square evaluations of monitor-reaction cross sections including uncertainty quantification have been undertaken for charged-particle beams of protons, deuterons, 3He- and 4He-particles. Recommended beam monitor reaction data with their uncertainties are available at the IAEA-NDS medical portal http://www-nds.iaea.org/medical/monitor_reactions.html.

Knowledge, Attitudes, and Beliefs of Youth Sports Coaches Regarding Sport Volume Recommendations and Sport Specialization.

PubMed

Post, Eric G; Trigsted, Stephanie M; Schaefer, Daniel A; Cadmus-Bertram, Lisa A; Watson, Andrew M; McGuine, Timothy A; Brooks, M Alison; Bell, David R

2018-02-22

Overuse injuries in youth athletes are becoming increasingly common which may be a result of the prevalence of year-round specialized sport participation. Previous research has identified sport volume recommendations related to months per year, hours per week, and simultaneous participation in multiple sports leagues. Coaches are a primary influence on a youth athlete's decision to specialize in a single sport. Therefore, identifying coaches' baseline beliefs and perceptions is important for developing strategies to educate coaches about safe sport participation. A total of 253 youth sport coaches (207 males) completed an anonymous online questionnaire regarding knowledge of sport volume recommendations and attitudes and beliefs regarding sport specialization. Eligible participants were required to serve as a head or assistant coach of a youth sport team in the past 12 months whose members were between the ages of 12 and 18. Most coaches were unaware of recommendations regarding the maximum number of months per year (79.4%), hours per week in one sport (79.3%), or number of simultaneous leagues for an athlete to participate in to reduce injury (77.6%). Fewer than half (43.2%) of all coaches were "very" or "extremely" concerned about the risk of injury in youth sports. A majority (60.1%) believed that sport specialization was either "quite a bit" or "a great deal" of a problem. Two-thirds (67.2%) responded that year-round participation in a single sport was either "very" or "extremely" likely to increase an athlete's risk of injury. Although the responses to this survey were predominantly from coaches from one state, our results suggest that coaches are unaware of sport volume recommendations but are concerned about specialization. Future efforts are needed to communicate these recommendations to coaches in order to reduce the risk of overuse injury in youth sports.

75 FR 51269 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... resistant isolates. GISP provides critical surveillance for antimicrobial resistance, allowing for informed treatment recommendations. Monitoring antibiotic susceptibility is critical since Neisseria gonorrhoeae has demonstrated the consistent ability to gain antibiotic resistance. GISP was established in 1986 as a voluntary...

Estimating the impact of extreme climatic events on riverine sediment transport: new tools and methods

NASA Astrophysics Data System (ADS)

Lajeunesse, E.; Delacourt, C.; Allemand, P.; Limare, A.; Dessert, C.; Ammann, J.; Grandjean, P.

2010-12-01

A series of recent works have underlined that the flux of material exported outside of a watershed is dramatically increased during extreme climatic events, such as storms, tropical cyclones and hurricanes [Dadson et al., 2003 and 2004; Hilton et al., 2008]. Indeed the exceptionally high rainfall rates reached during these events trigger runoff and landsliding which destabilize slopes and accumulate a significant amount of sediments in flooded rivers. This observation raises the question of the control that extreme climatic events might exert on the denudation rate and the morphology of watersheds. Addressing this questions requires to measure sediment transport in flooded rivers. However most conventional sediment monitoring technics rely on manned operated measurements which cannot be performed during extreme climatic events. Monitoring riverine sediment transport during extreme climatic events remains therefore a challenging issue because of the lack of instruments and methodologies adapted to such extreme conditions. In this paper, we present a new methodology aimed at estimating the impact of extreme events on sediment transport in rivers. Our approach relies on the development of two instruments. The first one is an in-situ optical instrument, based on a LISST-25X sensor, capable of measuring both the water level and the concentration of suspended matter in rivers with a time step going from one measurement every hour at low flow to one measurement every 2 minutes during a flood. The second instrument is a remote controlled drone helicopter used to acquire high resolution stereophotogrammetric images of river beds used to compute DEMs and to estimate how flash floods impact the granulometry and the morphology of the river. These two instruments were developed and tested during a 1.5 years field survey performed from june 2007 to january 2009 on the Capesterre river located on Basse-Terre island (Guadeloupe archipelago, Lesser Antilles Arc).

Novice Interpretations of Progress Monitoring Graphs: Extreme Values and Graphical Aids

ERIC Educational Resources Information Center

Newell, Kirsten W.; Christ, Theodore J.

2017-01-01

Curriculum-Based Measurement of Reading (CBM-R) is frequently used to monitor instructional effects and evaluate response to instruction. Educators often view the data graphically on a time-series graph that might include a variety of statistical and visual aids, which are intended to facilitate the interpretation. This study evaluated the effects…

ENVIRONMENTAL MONITORING FOR PUBLIC ACCESS AND COMMUNITY TRACKING (EMPACT) PROGRAM MICROBIOLOGICAL MONITORING OF RECREATIONAL WATER

EPA Science Inventory

Current Environmental Protection Agency (EPA) recommended microbiological monitoring practices for bathing beach water quality were suggested in 1968, as a part of the fecal coliform guideline developed by the Federal Water Pollution Control Administration. The guideline stated ...

Developing the Tools for Geologic Repository Monitoring - Andra's Monitoring R and D Program - 12045

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

Buschaert, S.; Lesoille, S.; Bertrand, J.

2012-07-01

The French Safety Guide recommends that Andra develop a monitoring program to be implemented during repository construction and conducted until (and possibly after) closure, in order to confirm expected behavior and enhance knowledge of relevant processes. To achieve this, Andra has developed an overall monitoring strategy and identified specific technical objectives to inform disposal process management on evolutions relevant to both the long term safety and reversible, pre-closure management of the repository. Andra has launched an ambitious R and D program to ensure that reliable, durable, metrologically qualified and tested monitoring systems will be available at the time of repositorymore » construction in order to respond to monitoring objectives. After four years of a specific R and D program, first observations are described and recommendations are proposed. The results derived from 4 years of Andra's R and D program allow three main observations to be shared. First, while other industries also invest in monitoring equipment, their obvious emphasis will always be on their specific requirements and needs, thus often only providing a partial match with repository requirements. Examples can be found for all available sensors, which are generally not resistant to radiation. Second, the very close scrutiny anticipated for the geologic disposal process is likely to place an unprecedented emphasis on the quality of monitoring results. It therefore seems important to emphasize specific developments with an aim at providing metrologically qualified systems. Third, adapting existing technology to specific repository needs, and providing adequate proof of their worth, is a lengthy process. In conclusion, it therefore seems prudent to plan ahead and to invest wisely in the adequate development of those monitoring tools that will likely be needed in the repository to respond to the implementers' and regulators' requirements, including those agreed and developed to

Footwear traction and lower extremity noncontact injury.

PubMed

Wannop, John W; Luo, Geng; Stefanyshyn, Darren J

2013-11-01

Football is the most popular high school sport; however, it has the highest rate of injury. Speculation has been prevalent that foot fixation due to high footwear traction contributes to injury risk. Therefore, the purpose of the study was to determine whether a relationship exists between the athlete's specific footwear traction (measured with their own shoes on the field of play) and lower extremity noncontact injury in high school football. For 3 yr, 555 high school football athletes had their footwear traction measured on the actual field of play at the start of the season, and any injury the athletes suffered during a game was recorded. Lower extremity noncontact injury rates, grouped based on the athlete's specific footwear traction (both translational and rotational), were compared. For translational traction, injury rate reached a peak of 23.3 injuries/1000 game exposures within the midrange of translational traction, before decreasing to 5.0 injuries/1000 game exposures in the high range of traction. For rotational traction, there was a steady increase in injury rate as footwear traction increased, starting at 4.2 injuries/1000 game exposures at low traction and reaching 19.2 injuries/1000 game exposures at high traction. A relationship exists between footwear traction and noncontact lower extremity injury, with increases in rotational traction leading to a greater injury rate and increases in translational traction leading to a decrease in injury. It is recommended that athletes consider selecting footwear with the lowest rotational traction values for which no detriment in performance results.

Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

PubMed

Sacks, David B; Arnold, Mark; Bakris, George L; Bruns, David E; Horvath, Andrea Rita; Kirkman, M Sue; Lernmark, Ake; Metzger, Boyd E; Nathan, David M

2011-06-01

Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A(1c) (HbA(1c)) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA(1c). The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

PubMed

Sacks, David B; Arnold, Mark; Bakris, George L; Bruns, David E; Horvath, Andrea Rita; Kirkman, M Sue; Lernmark, Ake; Metzger, Boyd E; Nathan, David M

2011-06-01

Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A(1c) (Hb A(1c)) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A(1c). The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

Less or more hemodynamic monitoring in critically ill patients.

PubMed

Jozwiak, Mathieu; Monnet, Xavier; Teboul, Jean-Louis

2018-06-07

Hemodynamic investigations are required in patients with shock to identify the type of shock, to select the most appropriate treatments and to assess the patient's response to the selected therapy. We discuss how to select the most appropriate hemodynamic monitoring techniques in patients with shock as well as the future of hemodynamic monitoring. Over the last decades, the hemodynamic monitoring techniques have evolved from intermittent toward continuous and real-time measurements and from invasive toward less-invasive approaches. In patients with shock, current guidelines recommend the echocardiography as the preferred modality for the initial hemodynamic evaluation. In patients with shock nonresponsive to initial therapy and/or in the most complex patients, it is recommended to monitor the cardiac output and to use advanced hemodynamic monitoring techniques. They also provide other useful variables that are useful for managing the most complex cases. Uncalibrated and noninvasive cardiac output monitors are not reliable enough in the intensive care setting. The use of echocardiography should be initially encouraged in patients with shock to identify the type of shock and to select the most appropriate therapy. The use of more invasive hemodynamic monitoring techniques should be discussed on an individualized basis.

Recommendations for management of diabetes during Ramadan: update 2015

PubMed Central

Ibrahim, Mahmoud; Abu Al Magd, Megahed; Annabi, Firas A; Assaad-Khalil, Samir; Ba-Essa, Ebtesam M; Fahdil, Ibtihal; Karadeniz, Sehnaz; Meriden, Terry; Misha'l, Aly A; Pozzilli, Paolo; Shera, Samad; Thomas, Abraham; Bahijri, Suhad; Tuomilehto, Jaakko; Yilmaz, Temel; Umpierrez, Guillermo E

2015-01-01

Since the first ADA working group report on the recommendations for management of diabetes during Ramadan in 2005 and our update in 2010, we received many inquiries asking for regular updates on information regarding education, nutritional habits and new oral and injectable agents that may be useful for the management of patients with diabetes during Ramadan. Patients can be stratified into their risk of hypoglycemia and/or complications prior to the start of the fasting period of Ramadan. Those at high risk of hypoglycemia and with multiple diabetic complications should be advised against prolonged fasting. Even in the lower hypoglycemia risk group, adverse effects may still occur. In order to minimize adverse side effects during fasting in patients with diabetes and improve or maintain glucose control, education and discussion of glucose monitoring and treatment regimens should occur several weeks prior to Ramadan. Agents such as metformin, thiazolidinediones and dipeptidyl peptidase-4 inhibitors appear to be safe and do not need dose adjustment. Most sulfonylureas may not be used safely during Ramadan except with extreme caution; besides, older agents, such as chlorpropamide or glyburide, should not be used. Reduction of the dosage of sulfonylurea is needed depending on the degree of control prior to fasting. Misconceptions and local habits should be addressed and dealt with in any educational intervention and therapeutic planning with patients with diabetes. In this regard, efforts are still needed for controlled prospective studies in the field of efficacy and safety of the different interventions during the Ramadan Fast. PMID:26113983

Microhabitats reduce animal's exposure to climate extremes.

PubMed

Scheffers, Brett R; Edwards, David P; Diesmos, Arvin; Williams, Stephen E; Evans, Theodore A

2014-02-01

Extreme weather events, such as unusually hot or dry conditions, can cause death by exceeding physiological limits, and so cause loss of population. Survival will depend on whether or not susceptible organisms can find refuges that buffer extreme conditions. Microhabitats offer different microclimates to those found within the wider ecosystem, but do these microhabitats effectively buffer extreme climate events relative to the physiological requirements of the animals that frequent them? We collected temperature data from four common microhabitats (soil, tree holes, epiphytes, and vegetation) located from the ground to canopy in primary rainforests in the Philippines. Ambient temperatures were monitored from outside of each microhabitat and from the upper forest canopy, which represent our macrohabitat controls. We measured the critical thermal maxima (CTmax ) of frog and lizard species, which are thermally sensitive and inhabit our microhabitats. Microhabitats reduced mean temperature by 1-2 °C and reduced the duration of extreme temperature exposure by 14-31 times. Microhabitat temperatures were below the CTmax of inhabitant frogs and lizards, whereas macrohabitats consistently contained lethal temperatures. Microhabitat temperatures increased by 0.11-0.66 °C for every 1 °C increase in macrohabitat temperature, and this nonuniformity in temperature change influenced our forecasts of vulnerability for animal communities under climate change. Assuming uniform increases of 6 °C, microhabitats decreased the vulnerability of communities by up to 32-fold, whereas under nonuniform increases of 0.66 to 3.96 °C, microhabitats decreased the vulnerability of communities by up to 108-fold. Microhabitats have extraordinary potential to buffer climate and likely reduce mortality during extreme climate events. These results suggest that predicted changes in distribution due to mortality and habitat shifts that are derived from macroclimatic samples and that assume

An Independent Assessment of Anthropogenic Attribution Statements for Recent Extreme Temperature and Rainfall Events

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

Angélil, Oliver; Stone, Dáithí; Wehner, Michael

The annual "State of the Climate" report, published in the Bulletin of the American Meteorological Society (BAMS), has included a supplement since 2011 composed of brief analyses of the human influence on recent major extreme weather events. There are now several dozen extreme weather events examined in these supplements, but these studies have all differed in their data sources as well as their approaches to defining the events, analyzing the events, and the consideration of the role of anthropogenic emissions. This study reexamines most of these events using a single analytical approach and a single set of climate model andmore » observational data sources. In response to recent studies recommending the importance of using multiple methods for extreme weather event attribution, results are compared from these analyses to those reported in the BAMS supplements collectively, with the aim of characterizing the degree to which the lack of a common methodological framework may or may not influence overall conclusions. Results are broadly similar to those reported earlier for extreme temperature events but disagree for a number of extreme precipitation events. Based on this, it is advised that the lack of comprehensive uncertainty analysis in recent extreme weather attribution studies is important and should be considered when interpreting results, but as yet it has not introduced a systematic bias across these studies.« less

An Independent Assessment of Anthropogenic Attribution Statements for Recent Extreme Temperature and Rainfall Events

DOE PAGES

Angélil, Oliver; Stone, Dáithí; Wehner, Michael; ...

2016-12-16

The annual "State of the Climate" report, published in the Bulletin of the American Meteorological Society (BAMS), has included a supplement since 2011 composed of brief analyses of the human influence on recent major extreme weather events. There are now several dozen extreme weather events examined in these supplements, but these studies have all differed in their data sources as well as their approaches to defining the events, analyzing the events, and the consideration of the role of anthropogenic emissions. This study reexamines most of these events using a single analytical approach and a single set of climate model andmore » observational data sources. In response to recent studies recommending the importance of using multiple methods for extreme weather event attribution, results are compared from these analyses to those reported in the BAMS supplements collectively, with the aim of characterizing the degree to which the lack of a common methodological framework may or may not influence overall conclusions. Results are broadly similar to those reported earlier for extreme temperature events but disagree for a number of extreme precipitation events. Based on this, it is advised that the lack of comprehensive uncertainty analysis in recent extreme weather attribution studies is important and should be considered when interpreting results, but as yet it has not introduced a systematic bias across these studies.« less

Unpredictable interference of new transcranial motor-evoked potential monitor against the implanted pacemaker.

PubMed

Hayashi, Kazuko

2016-12-01

Recently, NuVasive NV-M5 nerve monitoring system, a new transcranial motor-evoked potential (TcMEP) monitor, has been introduced with the spread of flank-approach spinal operations such as extreme lateral interbody fusion, to prevent nerve damage. Conventional TcMEP monitors use changes in MEP wave patterns, such as amplitude and/or latency, whereas the NV-M5 nerve monitor system first measures the MEP baseline waveform from the transcranial-evoked potential then measures the electric current necessary to obtain the standard of the previous baseline wave pattern at subsequent monitoring times. The NV-M5 monitor determines nerve damage according to the increase in necessary electric current threshold. The NV-M5 monitor also uses a local electrical stimulation mode to monitor the safety of setting screws into the lumbar vertebrae. In this way, various electrical stimulations with various durations and frequencies are used, and electrical noise may result in unpredictable interference with cardiac pacemakers. We performed anesthetic management of extreme lateral interbody fusion surgery using the NV-M5 in a patient with an implanted pacemaker, during which TcMEP stimulation caused interference with the implanted pacemaker. Copyright © 2016 Elsevier Inc. All rights reserved.

Climate change and health in Israel: adaptation policies for extreme weather events.

PubMed

Green, Manfred S; Pri-Or, Noemie Groag; Capeluto, Guedi; Epstein, Yoram; Paz, Shlomit

2013-06-27

Climatic changes have increased the world-wide frequency of extreme weather events such as heat waves, cold spells, floods, storms and droughts. These extreme events potentially affect the health status of millions of people, increasing disease and death. Since mitigation of climate change is a long and complex process, emphasis has recently been placed on the measures required for adaptation. Although the principles underlying these measures are universal, preparedness plans and policies need to be tailored to local conditions. In this paper, we conducted a review of the literature on the possible health consequences of extreme weather events in Israel, where the conditions are characteristic of the Mediterranean region. Strong evidence indicates that the frequency and duration of several types of extreme weather events are increasing in the Mediterranean Basin, including Israel. We examined the public health policy implications for adaptation to climate change in the region, and proposed public health adaptation policy options. Preparedness for the public health impact of increased extreme weather events is still relatively limited and clear public health policies are urgently needed. These include improved early warning and monitoring systems, preparedness of the health system, educational programs and the living environment. Regional collaboration should be a priority.

Climate change and health in Israel: adaptation policies for extreme weather events

PubMed Central

2013-01-01

Climatic changes have increased the world-wide frequency of extreme weather events such as heat waves, cold spells, floods, storms and droughts. These extreme events potentially affect the health status of millions of people, increasing disease and death. Since mitigation of climate change is a long and complex process, emphasis has recently been placed on the measures required for adaptation. Although the principles underlying these measures are universal, preparedness plans and policies need to be tailored to local conditions. In this paper, we conducted a review of the literature on the possible health consequences of extreme weather events in Israel, where the conditions are characteristic of the Mediterranean region. Strong evidence indicates that the frequency and duration of several types of extreme weather events are increasing in the Mediterranean Basin, including Israel. We examined the public health policy implications for adaptation to climate change in the region, and proposed public health adaptation policy options. Preparedness for the public health impact of increased extreme weather events is still relatively limited and clear public health policies are urgently needed. These include improved early warning and monitoring systems, preparedness of the health system, educational programs and the living environment. Regional collaboration should be a priority. PMID:23805950

Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men.

PubMed

Lunenfeld, Bruno; Mskhalaya, George; Zitzmann, Michael; Arver, Stefan; Kalinchenko, Svetlana; Tishova, Yuliya; Morgentaler, Abraham

2015-03-01

Hypogonadism or Testosterone Deficiency (TD) in adult men as defined by low levels of serum testosterone accompanied by characteristic symptoms and/or signs as detailed further on can be found in long-recognized clinical entities such as Klinefelter syndrome, Kallmann syndrome, pituitary or testicular disorders, as well as in men with idiopathic, metabolic or iatrogenic conditions that result in testosterone deficiency. These recommendations do not encompass the full range of pathologies leading to hypogonadism (testosterone deficiency), but instead focus on the clinical spectrum of hypogonadism related to metabolic and idiopathic disorders that contribute to the majority of cases that occur in adult men.

Water monitor system: Phase 1 test report

NASA Technical Reports Server (NTRS)

Taylor, R. E.; Jeffers, E. L.

1976-01-01

Automatic water monitor system was tested with the objectives of assuring high-quality effluent standards and accelerating the practice of reclamation and reuse of water. The NASA water monitor system is described. Various components of the system, including the necessary sensors, the sample collection system, and the data acquisition and display system, are discussed. The test facility and the analysis methods are described. Test results are reviewed, and recommendations for water monitor system design improvement are presented.

Characterizing differences in precipitation regimes of extreme wet and dry years: implications for climate change experiments.

PubMed

Knapp, Alan K; Hoover, David L; Wilcox, Kevin R; Avolio, Meghan L; Koerner, Sally E; La Pierre, Kimberly J; Loik, Michael E; Luo, Yiqi; Sala, Osvaldo E; Smith, Melinda D

2015-02-03

Climate change is intensifying the hydrologic cycle and is expected to increase the frequency of extreme wet and dry years. Beyond precipitation amount, extreme wet and dry years may differ in other ways, such as the number of precipitation events, event size, and the time between events. We assessed 1614 long-term (100 year) precipitation records from around the world to identify key attributes of precipitation regimes, besides amount, that distinguish statistically extreme wet from extreme dry years. In general, in regions where mean annual precipitation (MAP) exceeded 1000 mm, precipitation amounts in extreme wet and dry years differed from average years by ~40% and 30%, respectively. The magnitude of these deviations increased to >60% for dry years and to >150% for wet years in arid regions (MAP<500 mm). Extreme wet years were primarily distinguished from average and extreme dry years by the presence of multiple extreme (large) daily precipitation events (events >99th percentile of all events); these occurred twice as often in extreme wet years compared to average years. In contrast, these large precipitation events were rare in extreme dry years. Less important for distinguishing extreme wet from dry years were mean event size and frequency, or the number of dry days between events. However, extreme dry years were distinguished from average years by an increase in the number of dry days between events. These precipitation regime attributes consistently differed between extreme wet and dry years across 12 major terrestrial ecoregions from around the world, from deserts to the tropics. Thus, we recommend that climate change experiments and model simulations incorporate these differences in key precipitation regime attributes, as well as amount into treatments. This will allow experiments to more realistically simulate extreme precipitation years and more accurately assess the ecological consequences. © 2015 John Wiley & Sons Ltd.

High Energy Ion Acceleration by Extreme Laser Radiation Pressure

DTIC Science & Technology

2017-03-14

and was published in Nuclear Instruments and Methods A [11]. For similar targets, it was found that by monitoring the divergence of a low- energy ...AFRL-AFOSR-UK-TR-2017-0015 High energy ion acceleration by extreme laser radiation pressure Paul McKenna UNIVERSITY OF STRATHCLYDE VIZ ROYAL COLLEGE...MM-YYYY)   14-03-2017 2. REPORT TYPE  Final 3. DATES COVERED (From - To)  01 May 2013 to 31 Dec 2016 4. TITLE AND SUBTITLE High energy ion acceleration

Youth injury prevention in Canada: use of the Delphi method to develop recommendations.

PubMed

Pike, Ian; Piedt, Shannon; Davison, Colleen M; Russell, Kelly; Macpherson, Alison K; Pickett, William

2015-12-22

The Health Behaviour in School-aged Children Survey is one of very few cross-national health surveys that includes information on injury occurrence and prevention within adolescent populations. A collaboration to develop a Canadian youth injury report using these data resulted in, Injury among Young Canadians: A national study of contextual determinants. The objective of this study was to develop specific evidence-based, policy-oriented recommendations arising from the national report, using a modified-Delphi process with a panel of expert stakeholders. Eight injury prevention experts and a 3-person youth advisory team associated with a Canadian injury prevention organization (Parachute Canada) reviewed, edited and commented on report recommendations through a three-stage iterative modified-Delphi process. From an initial list of 27 draft recommendations, the modified-Delphi process resulted in a final list of 19 specific recommendations, worded to resonate with the group(s) responsible to lead or take the recommended action. Two recommendations were rated as "extremely important" or "very important" by 100 % of the expert panel, two were deleted, a further two recommendations were deleted but the content included as text in the report, and four were merged with other existing recommendations. The modified-Delphi process was an appropriate method to achieve agreement on 19 specific evidence-based, policy-oriented recommendations to complement the national youth injury report. In providing their input, it is noted that the injury stakeholders each acted as individual experts, unattached to any organizational position or policy. These recommendations will require multidisciplinary collaborations in order to support the proposed policy development, additional research, programming and clear decision-making for youth injury prevention.

Observed changes in extremes of daily rainfall and temperature in Jemma Sub-Basin, Upper Blue Nile Basin, Ethiopia

NASA Astrophysics Data System (ADS)

Worku, Gebrekidan; Teferi, Ermias; Bantider, Amare; Dile, Yihun T.

2018-02-01

Climate variability has been a threat to the socio-economic development of Ethiopia. This paper examined the changes in rainfall, minimum, and maximum temperature extremes of Jemma Sub-Basin of the Upper Blue Nile Basin for the period of 1981 to 2014. The nonparametric Mann-Kendall, seasonal Mann-Kendall, and Sen's slope estimator were used to estimate annual trends. Ten rainfall and 12 temperature indices were used to study changes in rainfall and temperature extremes. The results showed an increasing trend of annual and summer rainfall in more than 78% of the stations and a decreasing trend of spring rainfall in most of the stations. An increase in rainfall extreme events was detected in the majority of the stations. Several rainfall extreme indices showed wetting trends in the sub-basin, whereas limited indices indicated dryness in most of the stations. Annual maximum and minimum temperature and extreme temperature indices showed warming trend in the sub-basin. Presence of extreme rainfall and a warming trend of extreme temperature indices may suggest signs of climate change in the Jemma Sub-Basin. This study, therefore, recommended the need for exploring climate induced risks and implementing appropriate climate change adaptation and mitigation strategies.

Negative First-Term Outcomes Associated with Lower Extremity Injury During Recruit Training Among Female Marine Corps Graduates

DTIC Science & Technology

2007-01-01

regarding stress fractures and retention, and no sex -specific practices. Current medical practice at MCRD Parris Island is to recommend separation for...2.5 Lower Extremity Injury Stress Fracture IU Reference B Failed to completed H No promotlon# • No reenllst# | Fig. 1. AORs for first- tenn outcome

Superiority of automatic remote monitoring compared with in-person evaluation for scheduled ICD follow-up in the TRUST trial - testing execution of the recommendations.

PubMed

Varma, Niraj; Michalski, Justin; Stambler, Bruce; Pavri, Behzad B

2014-05-21

To test recommended implantable cardioverter defibrillator (ICD) follow-up methods by 'in-person evaluations' (IPE) vs. 'remote Home Monitoring' (HM). ICD patients were randomized 2:1 to automatic HM or to Conventional monitoring, with follow-up checks scheduled at 3, 6, 9, 12, and 15 months post-implant. Conventional patients were evaluated with IPE only. Home Monitoring patients were assessed remotely only for 1 year between 3 and 15 month evaluations. Adherence to follow-up was measured. HM and Conventional patients were similar (age 63 years, 72% male, left ventricular ejection fraction 29%, primary prevention 73%, DDD 57%). Conventional management suffered greater patient attrition during the trial (20.1 vs. 14.2% in HM, P = 0.007). Three month follow-up occurred in 84% in both groups. There was 100% adherence (5 of 5 checks) in 47.3% Conventional vs. 59.7% HM (P < 0.001). Between 3 and 15 months, HM exhibited superior (2.2×) adherence to scheduled follow-up [incidence of failed follow up was 146 of 2421 (6.0%) in HM vs. 145 of 1098 (13.2%) in Conventional, P < 0.001] and punctuality. In HM (daily transmission success rate median 91%), transmission loss caused only 22 of 2275 (0.97%) failed HM evaluations between 3 and 15 months; others resulted from clinic oversight. Overall IPE failure rate in Conventional [193 of 1841 (10.5%) exceeded that in HM [97 of 1484 (6.5%), P < 0.001] by 62%, i.e. HM patients remained more loyal to IPE when this was mandated. Automatic remote monitoring better preserves patient retention and adherence to scheduled follow-up compared with IPE. NCT00336284. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

Outcomes for Extremely Premature Infants

PubMed Central

Glass, Hannah C.; Costarino, Andrew T.; Stayer, Stephen A.; Brett, Claire; Cladis, Franklyn; Davis, Peter J.

2015-01-01

Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (< 1000 grams) remain at high risk for death and disability with 30–50% mortality and, in survivors, at least 20–50% risk of morbidity. The introduction of CPAP, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for

Nutrition recommendations and the Children's Food and Beverage Advertising Initiative's 2014 approved food and beverage product list.

PubMed

Schermbeck, Rebecca M; Powell, Lisa M

2015-04-23

We compare the Children's Food and Beverage Advertising Initiative's (CFBAI's) April 2014 list of food and beverage products approved to be advertised on children's television programs with the federal Interagency Working Group's nutrition recommendations for such advertised products. Products were assessed by using the nutrients to limit (saturated fat, trans fat, sugar, and sodium) component of the Interagency Working Group's recommendations. Fifty-three percent of the listed products did not meet the nutrition recommendations and, therefore, were ineligible to be advertised. We recommend continued monitoring of food and beverage products marketed to children.

Quarterly report on Defense Nuclear Facilities Safety Board Recommendation 90-7 for the period ending December 31, 1992

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

Cash, R.J.; Dukelow, G.T.; Forbes, C.J.

1993-03-01

This is the seventh quarterly report on the progress of activities addressing safety issues associated with Hanford Site high-level radioactive waste tanks that contain ferrocyanide compounds. In the presence of oxidizing materials, such as nitrates or nitrites, ferrocyanide can be made to explode in the laboratory by heating it to high temperatures [above 285{degrees}C (545{degrees}F)]. In the mid 1950s approximately 140 metric tons of ferrocyanide were added to 24 underground high-level radioactive waste tanks. An implementation plan (Cash 1991) responding to the Defense Nuclear Facilities Safety Board Recommendation 90-7 (FR 1990) was issued in March 1991 describing the activities thatmore » were planned and underway to address each of the six parts of Recommendation 90-7. A revision to the original plan was transmitted to US Department of Energy by Westinghouse Hanford Company in December 1992. Milestones completed this quarter are described in this report. Contents of this report include: Introduction; Defense Nuclear Facilities Safety Board Implementation Plan Task Activities (Defense Nuclear Facilities Safety Board Recommendation for enhanced temperature measurement, Recommendation for continuous temperature monitoring, Recommendation for cover gas monitoring, Recommendation for ferrocyanide waste characterization, Recommendation for chemical reaction studies, and Recommendation for emergency response planning); Schedules; and References. All actions recommended by the Defense Nuclear Facilities Safety Board for emergency planning by Hanford Site emergency preparedness organizations have been completed.« less

Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men

PubMed Central

Lunenfeld, Bruno; Zitzmann, Michael; Arver, Stefan; Kalinchenko, Svetlana; Tishova, Yuliya; Morgentaler, Abraham

2015-01-01

Hypogonadism or Testosterone Deficiency (TD) in adult men as defined by low levels of serum testosterone accompanied by characteristic symptoms and/or signs as detailed further on can be found in long-recognized clinical entities such as Klinefelter syndrome, Kallmann syndrome, pituitary or testicular disorders, as well as in men with idiopathic, metabolic or iatrogenic conditions that result in testosterone deficiency. These recommendations do not encompass the full range of pathologies leading to hypogonadism (testosterone deficiency), but instead focus on the clinical spectrum of hypogonadism related to metabolic and idiopathic disorders that contribute to the majority of cases that occur in adult men. PMID:25657080

Exploring Occupational Therapists’ Perceptions of the Usefulness of Musculoskeletal Sonography in Upper-Extremity Rehabilitation

PubMed Central

McLaughlin Gray, Julie; Frank, Gelya; Wolkoff, Monique

2015-01-01

OBJECTIVE. To identify the potential utility of musculoskeletal sonographic imaging in upper-extremity rehabilitation. METHOD. Two occupational therapists in an outpatient hand rehabilitation clinic were recruited by convenience, were trained in the use of sonography, and implemented sonographic imaging in their clinical practice. Qualitative data were obtained during and after the implementation period by means of questionnaires and interviews. Data collection, analysis, and interpretation were completed in an iterative process that culminated in a thematic analysis of the therapists’ perceptions. RESULTS. The data indicate four potential areas of utility for musculoskeletal sonography in upper-extremity rehabilitation: (1) mastering anatomy and pathology, (2) augmenting clinical reasoning, (3) supplementing intervention, and (4) building evidence. CONCLUSION. Numerous potential uses were identified that would benefit both therapist and client. Further exploration of complexities and efficacy for increasing patient outcomes is recommended to determine best practices for the use of musculoskeletal sonography in upper-extremity rehabilitation. PMID:26114469

Wireless Sensor Applications in Extreme Aeronautical Environments

NASA Technical Reports Server (NTRS)

Wilson, William C.; Atkinson, Gary M.

2013-01-01

NASA aeronautical programs require rigorous ground and flight testing. Many of the testing environments can be extremely harsh. These environments include cryogenic temperatures and high temperatures (greater than 1500 C). Temperature, pressure, vibration, ionizing radiation, and chemical exposure may all be part of the harsh environment found in testing. This paper presents a survey of research opportunities for universities and industry to develop new wireless sensors that address anticipated structural health monitoring (SHM) and testing needs for aeronautical vehicles. Potential applications of passive wireless sensors for ground testing and high altitude aircraft operations are presented. Some of the challenges and issues of the technology are also presented.

[Biomechanical air-vibration stimulation in the medical rehabilitation of patients with chronic venous insufficiency of the lower extremities].

PubMed

Zhukov, B N; Katorkin, S E

1993-01-01

Biomechanical pneumo-vibration stimulation of lower extremities was used in 146 patients with different forms and stages of chronic venous insufficiency of lower extremities during conservative treatment in preoperative preparation and the following early rehabilitation, in 106 patients with consequences of the trauma and diseases of the spinal cord as well as in 35 healthy people. The biomechanical pneumo-vibration stimulation is thought by the authors to be a promising noninvasive conservative method of medical rehabilitation. It can be recommended for clinical use with due regard for contraindications.

The Extreme Case of Magnetars

NASA Technical Reports Server (NTRS)

Kouveliotou, Chryssa

2011-01-01

Magnetars are magnetically powered rotating neutron stars with extreme magnetic fields (over 10(exp 14) Gauss). They were discovered in the X- and gamma-rays where they predominantly emit their radiation. Very few sources (roughly 18) have been found since their discovery in 1987. NASA's Fermi Gamma-ray Space Telescope was launched June 11, 2009; since then the Fermi Gamma-ray Burst Monitor (GBM) recorded emission from four magnetar sources. Two of these were brand new sources, SGR J0501+4516, discovered with Swift and extensively monitored with Swift and GBM, SGR J0418+5729, discovered with GBM and the Interplanetary Network (IPN). A third was SGR J1550-5418, a source originally classified as an Anomalous X-ray Pulsar (AXP 1E1547.0-5408), but exhibiting a very prolific outburst with over 400 events recorded in January 2009. In my talk I will give a short history of magnetars and describe how this, once relatively esoteric field, has emerged as a link between several astrophysical areas including Gamma-Ray Bursts. Finally, I will describe the exciting new results of Fermi in this field and the current status of our knowledge of the magnetar population properties and magnetic fields.

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

PubMed Central

Arnold, Mark; Bakris, George L.; Bruns, David E.; Horvath, Andrea Rita; Kirkman, M. Sue; Lernmark, Ake; Metzger, Boyd E.; Nathan, David M.

2011-01-01

BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (HbA1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended. PMID:21617108

A variational approach to probing extreme events in turbulent dynamical systems

PubMed Central

Farazmand, Mohammad; Sapsis, Themistoklis P.

2017-01-01

Extreme events are ubiquitous in a wide range of dynamical systems, including turbulent fluid flows, nonlinear waves, large-scale networks, and biological systems. We propose a variational framework for probing conditions that trigger intermittent extreme events in high-dimensional nonlinear dynamical systems. We seek the triggers as the probabilistically feasible solutions of an appropriately constrained optimization problem, where the function to be maximized is a system observable exhibiting intermittent extreme bursts. The constraints are imposed to ensure the physical admissibility of the optimal solutions, that is, significant probability for their occurrence under the natural flow of the dynamical system. We apply the method to a body-forced incompressible Navier-Stokes equation, known as the Kolmogorov flow. We find that the intermittent bursts of the energy dissipation are independent of the external forcing and are instead caused by the spontaneous transfer of energy from large scales to the mean flow via nonlinear triad interactions. The global maximizer of the corresponding variational problem identifies the responsible triad, hence providing a precursor for the occurrence of extreme dissipation events. Specifically, monitoring the energy transfers within this triad allows us to develop a data-driven short-term predictor for the intermittent bursts of energy dissipation. We assess the performance of this predictor through direct numerical simulations. PMID:28948226

Cocoa agroforestry is less resilient to sub-optimal and extreme climate than cocoa in full sun.

PubMed

Abdulai, Issaka; Vaast, Philippe; Hoffmann, Munir P; Asare, Richard; Jassogne, Laurence; Van Asten, Piet; Rötter, Reimund P; Graefe, Sophie

2018-01-01

Cocoa agroforestry is perceived as potential adaptation strategy to sub-optimal or adverse environmental conditions such as drought. We tested this strategy over wet, dry and extremely dry periods comparing cocoa in full sun with agroforestry systems: shaded by (i) a leguminous tree species, Albizia ferruginea and (ii) Antiaris toxicaria, the most common shade tree species in the region. We monitored micro-climate, sap flux density, throughfall, and soil water content from November 2014 to March 2016 at the forest-savannah transition zone of Ghana with climate and drought events during the study period serving as proxy for projected future climatic conditions in marginal cocoa cultivation areas of West Africa. Combined transpiration of cocoa and shade trees was significantly higher than cocoa in full sun during wet and dry periods. During wet period, transpiration rate of cocoa plants shaded by A. ferruginea was significantly lower than cocoa under A. toxicaria and full sun. During the extreme drought of 2015/16, all cocoa plants under A. ferruginea died. Cocoa plants under A. toxicaria suffered 77% mortality and massive stress with significantly reduced sap flux density of 115 g cm -2  day -1 , whereas cocoa in full sun maintained higher sap flux density of 170 g cm -2  day -1 . Moreover, cocoa sap flux recovery after the extreme drought was significantly higher in full sun (163 g cm -2  day -1 ) than under A. toxicaria (37 g cm -2  day -1 ). Soil water content in full sun was higher than in shaded systems suggesting that cocoa mortality in the shaded systems was linked to strong competition for soil water. The present results have major implications for cocoa cultivation under climate change. Promoting shade cocoa agroforestry as drought resilient system especially under climate change needs to be carefully reconsidered as shade tree species such as the recommended leguminous A. ferruginea constitute major risk to cocoa functioning under

Trunk restraint to promote upper extremity recovery in stroke patients: a systematic review and meta-analysis.

PubMed

Wee, Seng Kwee; Hughes, Ann-Marie; Warner, Martin; Burridge, Jane H

2014-09-01

Many stroke patients exhibit excessive compensatory trunk movements during reaching. Compensatory movement behaviors may improve upper extremity function in the short-term but be detrimental to long-term recovery. To evaluate the evidence that trunk restraint limits compensatory trunk movement and/or promotes better upper extremity recovery in stroke patients. A search was conducted through electronic databases from January 1980 to June 2013. Only randomized controlled trials (RCTs) comparing upper extremity training with and without trunk restraint were selected for review. Three review authors independently assessed the methodological quality and extracted data from the studies. Meta-analysis was conducted when there was sufficient homogenous data. Six RCTs involving 187 chronic stroke patients were identified. Meta-analysis of key outcome measures showed that trunk restraint has a moderate statistically significant effect on improving Fugl-Meyer Upper Extremity (FMA-UE) score, active shoulder flexion, and reduction in trunk displacement during reaching. There was a small, nonsignificant effect of trunk restraint on upper extremity function. Trunk restraint has a moderate effect on reduction of upper extremity impairment in chronic stroke patients, in terms of FMA-UE score, increased shoulder flexion, and reduction in excessive trunk movement during reaching. There is insufficient evidence to demonstrate that trunk restraint improves upper extremity function and reaching trajectory smoothness and straightness in chronic stroke patients. Future research on stroke patients at different phases of recovery and with different levels of upper extremity impairment is recommended. © The Author(s) 2014.

Applications of tethers in space: A review of workshop recommendations

NASA Technical Reports Server (NTRS)

Vontiesenhausen, G. (Editor)

1986-01-01

Well-organized and structured efforts of considerable magnitude involving NASA, industry, and academia have explored and defined the engineering and technological requirements of the use of tethers in space and have discovered their broad range of operational and economic benefits. The results of these efforts have produced a family of extremely promising candidate applications. The extensive efforts now in progress are gaining momentum and a series of flight demonstrations are being planned and can be expected to take place in a few years. This report provides an analysis and a review of NASA's second major workshop on Applications of Tethers in Space held in October 15 to 17, 1985, in Venice, Italy. It provides a summary of an up-to-date assessment and recommendations by the NASA Tether Applications in Space Program Planning Group, consisting of representatives of seven NASA Centers and responsible for tether applications program planning implementation as recommended by the workshop panels.

Monitoring challenges and innovative ideas

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

O'Neill, R.V.; Hunsaker, C.T.; Levine, D.A.

1990-01-01

Monitoring programs are difficult to design even when they focus on specific problems. Ecosystems are complex, and it is often impossible to predetermine what aspects of system structure or dynamics will respond to a specific insult. It is equally difficult to interpret whether a response is a stabilizing compensatory mechanism or a real loss of capacity to maintain the ecosystem. The problems are compounded in a broad monitoring program designed to assess ecosystem health'' at regional and continental scales. It is challenging in the extreme to monitor ecosystem response, at any scale, to past insults as well as an unknownmore » future array of impacts. The present paper will examine some of the fundamental issues and challenges raised by large-scale monitoring efforts. The challenges will serve as a framework and as an excuse to discuss several important topics in more detail. Following the discussion of challenges, we suggest some basic innovations that could be important across a range of monitoring programs. The innovations include integrative measures, innovative methodology, and creative interpretation. 59 refs., 1 tab.« less

Probabilistic forecasting of extreme weather events based on extreme value theory

NASA Astrophysics Data System (ADS)

Van De Vyver, Hans; Van Schaeybroeck, Bert

2016-04-01

Extreme events in weather and climate such as high wind gusts, heavy precipitation or extreme temperatures are commonly associated with high impacts on both environment and society. Forecasting extreme weather events is difficult, and very high-resolution models are needed to describe explicitly extreme weather phenomena. A prediction system for such events should therefore preferably be probabilistic in nature. Probabilistic forecasts and state estimations are nowadays common in the numerical weather prediction community. In this work, we develop a new probabilistic framework based on extreme value theory that aims to provide early warnings up to several days in advance. We consider the combined events when an observation variable Y (for instance wind speed) exceeds a high threshold y and its corresponding deterministic forecasts X also exceeds a high forecast threshold y. More specifically two problems are addressed:} We consider pairs (X,Y) of extreme events where X represents a deterministic forecast, and Y the observation variable (for instance wind speed). More specifically two problems are addressed: Given a high forecast X=x_0, what is the probability that Y>y? In other words: provide inference on the conditional probability: [ Pr{Y>y|X=x_0}. ] Given a probabilistic model for Problem 1, what is the impact on the verification analysis of extreme events. These problems can be solved with bivariate extremes (Coles, 2001), and the verification analysis in (Ferro, 2007). We apply the Ramos and Ledford (2009) parametric model for bivariate tail estimation of the pair (X,Y). The model accommodates different types of extremal dependence and asymmetry within a parsimonious representation. Results are presented using the ensemble reforecast system of the European Centre of Weather Forecasts (Hagedorn, 2008). Coles, S. (2001) An Introduction to Statistical modelling of Extreme Values. Springer-Verlag.Ferro, C.A.T. (2007) A probability model for verifying deterministic

Quantifying the relationship between extreme air pollution events and extreme weather events

NASA Astrophysics Data System (ADS)

Zhang, Henian; Wang, Yuhang; Park, Tae-Won; Deng, Yi

2017-05-01

Extreme weather events can strongly affect surface air quality, which has become a major environmental factor to affect human health. Here, we examined the relationship between extreme ozone and PM2.5 (particular matter with an aerodynamic diameter less than 2.5 μm) events and the representative meteorological parameters such as daily maximum temperature (Tmax), minimum relative humidity (RHmin), and minimum wind speed (Vmin), using the location-specific 95th or 5th percentile threshold derived from historical reanalysis data (30 years for ozone and 10 years for PM2.5). We found that ozone and PM2.5 extremes were decreasing over the years, reflecting EPA's tightened standards and effort on reducing the corresponding precursor's emissions. Annual ozone and PM2.5 extreme days were highly correlated with Tmax and RHmin, especially in the eastern U.S. They were positively (negatively) correlated with Vmin in urban (rural and suburban) stations. The overlapping ratios of ozone extreme days with Tmax were fairly constant, about 32%, and tended to be high in fall and low in winter. Ozone extreme days were most sensitive to Tmax, then RHmin, and least sensitive to Vmin. The majority of ozone extremes occurred when Tmax was between 300 K and 320 K, RHmin was less than 40%, and Vmin was less than 3 m/s. The number of annual extreme PM2.5 days was highly positively correlated with the extreme RHmin/Tmax days, with correlation coefficient between PM2.5/RHmin highest in urban and suburban regions and the correlation coefficient between PM2.5/Tmax highest in rural area. Tmax has more impact on PM2.5 extreme over the eastern U.S. Extreme PM2.5 days were more likely to occur at low RH conditions in the central and southeastern U.S., especially during spring time, and at high RH conditions in the northern U.S. and the Great Plains. Most extreme PM2.5 events occurred when Tmax was between 300 K and 320 K and RHmin was between 10% and 50%. Extreme PM2.5 days usually occurred when

Calibration of ITER Instant Power Neutron Monitors: Recommended Scenario of Experiments at the Reactor

NASA Astrophysics Data System (ADS)

Borisov, A. A.; Deryabina, N. A.; Markovskij, D. V.

2017-12-01

Instant power is a key parameter of the ITER. Its monitoring with an accuracy of a few percent is an urgent and challenging aspect of neutron diagnostics. In a series of works published in Problems of Atomic Science and Technology, Series: Thermonuclear Fusion under a common title, the step-by-step neutronics analysis was given to substantiate a calibration technique for the DT and DD modes of the ITER. A Gauss quadrature scheme, optimal for processing "expensive" experiments, is used for numerical integration of 235U and 238U detector responses to the point sources of 14-MeV neutrons. This approach allows controlling the integration accuracy in relation to the number of coordinate mesh points and thus minimizing the number of irradiations at the given uncertainty of the full monitor response. In the previous works, responses of the divertor and blanket monitors to the isotropic point sources of DT and DD neutrons in the plasma profile and to the models of real sources were calculated within the ITER model using the MCNP code. The neutronics analyses have allowed formulating the basic principles of calibration that are optimal for having the maximum accuracy at the minimum duration of in situ experiments at the reactor. In this work, scenarios of the preliminary and basic experimental ITER runs are suggested on the basis of those principles. It is proposed to calibrate the monitors only with DT neutrons and use correction factors to the DT mode calibration for the DD mode. It is reasonable to perform full calibration only with 235U chambers and calibrate 238U chambers by responses of the 235U chambers during reactor operation (cross-calibration). The divertor monitor can be calibrated using both direct measurement of responses at the Gauss positions of a point source and simplified techniques based on the concepts of equivalent ring sources and inverse response distributions, which will considerably reduce the amount of measurements. It is shown that the monitor

Distributed Motor Controller (DMC) for Operation in Extreme Environments

NASA Technical Reports Server (NTRS)

McKinney, Colin M.; Yager, Jeremy A.; Mojarradi, Mohammad M.; Some, Rafi; Sirota, Allen; Kopf, Ted; Stern, Ryan; Hunter, Don

2012-01-01

This paper presents an extreme environment capable Distributed Motor Controller (DMC) module suitable for operation with a distributed architecture of future spacecraft systems. This motor controller is designed to be a bus-based electronics module capable of operating a single Brushless DC motor in extreme space environments: temperature (-120 C to +85 C required, -180 C to +100 C stretch goal); radiation (>;20K required, >;100KRad stretch goal); >;360 cycles of operation. Achieving this objective will result in a scalable modular configuration for motor control with enhanced reliability that will greatly lower cost during the design, fabrication and ATLO phases of future missions. Within the heart of the DMC lies a pair of cold-capable Application Specific Integrated Circuits (ASICs) and a Field Programmable Gate Array (FPGA) that enable its miniaturization and operation in extreme environments. The ASICs are fabricated in the IBM 0.5 micron Silicon Germanium (SiGe) BiCMOS process and are comprised of Analog circuitry to provide telemetry information, sensor interface, and health and status of DMC. The FPGA contains logic to provide motor control, status monitoring and spacecraft interface. The testing and characterization of these ASICs have yielded excellent functionality in cold temperatures (-135 C). The DMC module has demonstrated successful operation of a motor at temperature.

Rainfall extremes from TRMM data and the Metastatistical Extreme Value Distribution

NASA Astrophysics Data System (ADS)

Zorzetto, Enrico; Marani, Marco

2017-04-01

A reliable quantification of the probability of weather extremes occurrence is essential for designing resilient water infrastructures and hazard mitigation measures. However, it is increasingly clear that the presence of inter-annual climatic fluctuations determines a substantial long-term variability in the frequency of occurrence of extreme events. This circumstance questions the foundation of the traditional extreme value theory, hinged on stationary Poisson processes or on asymptotic assumptions to derive the Generalized Extreme Value (GEV) distribution. We illustrate here, with application to daily rainfall, a new approach to extreme value analysis, the Metastatistical Extreme Value Distribution (MEVD). The MEVD relaxes the above assumptions and is based on the whole distribution of daily rainfall events, thus allowing optimal use of all available observations. Using a global dataset of rain gauge observations, we show that the MEVD significantly outperforms the Generalized Extreme Value distribution, particularly for long average recurrence intervals and when small samples are available. The latter property suggests MEVD to be particularly suited for applications to satellite rainfall estimates, which only cover two decades, thus making extreme value estimation extremely challenging. Here we apply MEVD to the TRMM TMPA 3B42 product, an 18-year dataset of remotely-sensed daily rainfall providing a quasi-global coverage. Our analyses yield a global scale mapping of daily rainfall extremes and of their distributional tail properties, bridging the existing large gaps in ground-based networks. Finally, we illustrate how our global-scale analysis can provide insight into how properties of local rainfall regimes affect tail estimation uncertainty when using the GEV or MEVD approach. We find a dependence of the estimation uncertainty, for both the GEV- and MEV-based approaches, on the average annual number and on the inter-annual variability of rainy days. In

Advancing the adaptive capacity of social-ecological systems to absorb climate extremes

NASA Astrophysics Data System (ADS)

Thonicke, Kirsten; Bahn, Michael; Bardgett, Richard; Bloemen, Jasper; Chabay, Ilan; Erb, Karlheinz; Giamberini, Mariasilvia; Gingrich, Simone; Lavorel, Sandra; Liehr, Stefan; Rammig, Anja

2017-04-01

The recent and projected increases in climate variability and the frequency of climate extremes are posing a profound challenge to society and the biosphere (IPCC 2012, IPCC 2013). Climate extremes can affect natural and managed ecosystems more severely than gradual warming. The ability of ecosystems to resist and recover from climate extremes is therefore of fundamental importance for society, which strongly relies on their ability to supply provisioning, regulating, supporting and cultural services. Society in turn triggers land-use and management decisions that affect ecosystem properties. Thus, ecological and socio-economic conditions are tightly coupled in what has been referred to as the social-ecological system. For ensuring human well-being in the light of climate extremes it is crucial to enhance the resilience of the social-ecological system (SES) across spatial, temporal and institutional scales. Stakeholders, such as resource managers, urban, landscape and conservation planners, decision-makers in agriculture and forestry, as well as natural hazards managers, require an improved knowledge base for better-informed decision making. To date the vulnerability and adaptive capacity of SESs to climate extremes is not well understood and large uncertainties exist as to the legacies of climate extremes on ecosystems and on related societal structures and processes. Moreover, we lack empirical evidence and incorporation of simulated future ecosystem and societal responses to support pro-active management and enhance social-ecological resilience. In our presentation, we outline the major research gaps and challenges to be addressed for understanding and enhancing the adaptive capacity of SES to absorb and adapt to climate extremes, including acquisition and elaboration of long-term monitoring data and improvement of ecological models to better project climate extreme effects and provide model uncertainties. We highlight scientific challenges and discuss

Flood frequency estimates and documented and potential extreme peak discharges in Oklahoma

USGS Publications Warehouse

Tortorelli, Robert L.; McCabe, Lan P.

2001-01-01

Knowledge of the magnitude and frequency of floods is required for the safe and economical design of highway bridges, culverts, dams, levees, and other structures on or near streams; and for flood plain management programs. Flood frequency estimates for gaged streamflow sites were updated, documented extreme peak discharges for gaged and miscellaneous measurement sites were tabulated, and potential extreme peak discharges for Oklahoma streamflow sites were estimated. Potential extreme peak discharges, derived from the relation between documented extreme peak discharges and contributing drainage areas, can provide valuable information concerning the maximum peak discharge that could be expected at a stream site. Potential extreme peak discharge is useful in conjunction with flood frequency analysis to give the best evaluation of flood risk at a site. Peak discharge and flood frequency for selected recurrence intervals from 2 to 500 years were estimated for 352 gaged streamflow sites. Data through 1999 water year were used from streamflow-gaging stations with at least 8 years of record within Oklahoma or about 25 kilometers into the bordering states of Arkansas, Kansas, Missouri, New Mexico, and Texas. These sites were in unregulated basins, and basins affected by regulation, urbanization, and irrigation. Documented extreme peak discharges and associated data were compiled for 514 sites in and near Oklahoma, 352 with streamflow-gaging stations and 162 at miscellaneous measurements sites or streamflow-gaging stations with short record, with a total of 671 measurements.The sites are fairly well distributed statewide, however many streams, large and small, have never been monitored. Potential extreme peak-discharge curves were developed for streamflow sites in hydrologic regions of the state based on documented extreme peak discharges and the contributing drainage areas. Two hydrologic regions, east and west, were defined using 98 degrees 15 minutes longitude as the

Extreme Conservation Leads to Recovery of the Virunga Mountain Gorillas

PubMed Central

Robbins, Martha M.; Gray, Markye; Fawcett, Katie A.; Nutter, Felicia B.; Uwingeli, Prosper; Mburanumwe, Innocent; Kagoda, Edwin; Basabose, Augustin; Stoinski, Tara S.; Cranfield, Mike R.; Byamukama, James; Spelman, Lucy H.; Robbins, Andrew M.

2011-01-01

As wildlife populations are declining, conservationists are under increasing pressure to measure the effectiveness of different management strategies. Conventional conservation measures such as law enforcement and community development projects are typically designed to minimize negative human influences upon a species and its ecosystem. In contrast, we define “extreme” conservation as efforts targeted to deliberately increase positive human influences, including veterinary care and close monitoring of individual animals. Here we compare the impact of both conservation approaches upon the population growth rate of the critically endangered Virunga mountain gorillas (Gorilla beringei beringei), which increased by 50% since their nadir in 1981, from approximately 250 to nearly 400 gorillas. Using demographic data from 1967–2008, we show an annual decline of 0.7%±0.059% for unhabituated gorillas that received intensive levels of conventional conservation approaches, versus an increase 4.1%±0.088% for habituated gorillas that also received extreme conservation measures. Each group of habituated gorillas is now continuously guarded by a separate team of field staff during daylight hours and receives veterinary treatment for snares, respiratory disease, and other life-threatening conditions. These results suggest that conventional conservation efforts prevented a severe decline of the overall population, but additional extreme measures were needed to achieve positive growth. Demographic stochasticity and socioecological factors had minimal impact on variability in the growth rates. Veterinary interventions could account for up to 40% of the difference in growth rates between habituated versus unhabituated gorillas, with the remaining difference likely arising from greater protection against poachers. Thus, by increasing protection and facilitating veterinary treatment, the daily monitoring of each habituated group contributed to most of the difference in growth

Blood pressure monitoring: theory and practice. European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability Teaching Course Proceedings.

PubMed

Stergiou, George S; Palatini, Paolo; Asmar, Roland; Bilo, Grzegorz; de la Sierra, Alejandro; Head, Geoff; Kario, Kazuomi; Mihailidou, Anastasia; Wang, Jiguang; Mancia, Giuseppe; O'Brien, Eoin; Parati, Gianfranco

2018-02-01

The European Society of Hypertension (ESH) Working Group on Blood Pressure (BP) Monitoring and Cardiovascular Variability organized a Teaching Course on 'Blood Pressure Monitoring: Theory and Practice' during the 2017 ESH Meeting in Milan, Italy. This course performed by 11 international BP monitoring experts covered key topics of BP monitoring, including office BP measurement, ambulatory BP monitoring, home BP monitoring, ambulatory versus home BP, white-coat and masked hypertension, cuff use, and BP variability. This article presents a summary of the proceedings of the ESH BP Monitoring Teaching Course, including essential information, practical issues, and recommendations on the clinical application of BP monitoring methods, aiming to the optimal management of patients with suspected or diagnosed hypertension.

Melorheostosis in the upper extremity.

PubMed

Yildirim, Cengiz; Ozyürek, Selahattin; Ciçek, Engin Ilker; Kuskucu, Mesih

2009-04-01

Melorheostosis is a rare mesodermal disease affecting the skeleton and adjacent soft tissues. Often it is incidentally detected on radiographs. In the standard radiology and orthopedics literature, melorheostosis is described as a "flowing hyperostosis, resembling dripping candle wax as an incidental radiographic finding." A 22-year-old man presented with a 2-year history of right-hand pain. Radiologic evaluation of the hand showed massive sclerotic changes in the first and second metacarpal and phalangeal bones on the right side. Further radiographic evaluation of the right upper extremity revealed the same sclerotic changes in the right scapula, humerus, radius, and scaphoid. Computed tomography (CT) scans showed a high attenuation undulating cortical hyperostosis with a "dripping candle wax appearance" involving the radial and/or dorsal aspects of humerus, radius, scaphoid, and first and second ray bones of the hand. Radionuclide triphasic bone scintigraphy showed diffuse homogenous radiotracer uptake within the entire right upper extremity involving the scapula, humerus, radius, scaphoid, and first and second metacarpals and phalangeal bones of the hand. The patient was followed conservatively, and 1-year follow-up revealed no change in the clinical, laboratory, or radiological findings. The diagnosis of melorheostosis was made on the basis of the characteristic distribution, location, and combined radiographic, CT, and radionuclide imaging features of the abnormalities. Conservative treatment was recommended for the patient. After 26 months of follow-up, despite the persistence of the radiologic findings, the patient is currently well, with no painful symptoms unless he performs forceful exercise.

Hydrologic extremes - an intercomparison of multiple gridded statistical downscaling methods

NASA Astrophysics Data System (ADS)

Werner, A. T.; Cannon, A. J.

2015-06-01

-scale spatial gradients, passed the greatest number of tests for hydrologic extremes. Non-stationarity in the observational/reanalysis datasets complicated the evaluation of downscaling performance. Comparing temporal homogeneity and trends in climate indices and hydrological model outputs calculated from downscaled reanalyses and gridded observations was useful for diagnosing the reliability of the various historical datasets. We recommend that such analyses be conducted before such data are used to construct future hydro-climatic change scenarios.

Hydrologic extremes - an intercomparison of multiple gridded statistical downscaling methods

NASA Astrophysics Data System (ADS)

Werner, Arelia T.; Cannon, Alex J.

2016-04-01

-scale spatial gradients, passed the greatest number of tests for hydrologic extremes. Non-stationarity in the observational/reanalysis data sets complicated the evaluation of downscaling performance. Comparing temporal homogeneity and trends in climate indices and hydrological model outputs calculated from downscaled reanalyses and gridded observations was useful for diagnosing the reliability of the various historical data sets. We recommend that such analyses be conducted before such data are used to construct future hydro-climatic change scenarios.

Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea - STD Surveillance Network, United States, 2016.

PubMed

Weston, Emily J; Workowski, Kimberly; Torrone, Elizabeth; Weinstock, Hillard; Stenger, Mark R

2018-04-27

Gonorrhea, the sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, is the second most common notifiable disease in the United States after chlamydia; 468,514 cases were reported to state and local health departments in 2016, an increase of 18.5% from 2015 (1). N. gonorrhoeae has progressively developed resistance to most antimicrobials used to treat the infection (2). As a result, CDC recommends two antimicrobials (250 mg of ceftriaxone [IM] plus 1 g of azithromycin [PO]) for treating uncomplicated gonorrhea to improve treatment efficacy and, potentially, to slow the emergence and spread of antimicrobial resistance. To monitor adherence to the current CDC-recommended regimen for uncomplicated gonorrhea, CDC reviewed enhanced data collected on a random sample of reported cases of gonorrhea in seven jurisdictions participating in the STD Surveillance Network (SSuN) and estimated the proportion of patients who received the CDC-recommended regimen for uncomplicated gonorrhea, by patient characteristics and diagnosing facility type. In 2016, the majority of reported patients with gonorrhea (81%) received the recommended regimen. There were no differences in the proportion of patients receiving the recommended regimen by age or race/ethnicity; however, patients diagnosed with gonorrhea in STD (91%) or family planning/reproductive health (94%) clinics were more likely to receive this regimen than were patients diagnosed in other provider settings (80%). These data document high provider adherence to CDC gonorrhea treatment recommendations in specialty STD clinics, indicating high quality of care provided in those settings. Local and state health departments should monitor adherence with recommendations in their jurisdictions and consider implementing interventions to improve provider and patient compliance with gonorrhea treatment recommendations where indicated.

The Role of Parental Monitoring in Metabolic Control: Effect on Adherence and Externalizing Behaviors During Adolescence

PubMed Central

Horton, Dwayne; Butner, Jonathan; Wiebe, Deborah J.

2009-01-01

Objective We examined the role of parental monitoring (general and diabetes specific) on metabolic control through better adherence and lower externalizing behaviors for adolescents with type 1 diabetes. Methods Adolescents aged 10–14 (n = 252) completed assessments of general and diabetes-specific mothers’ and fathers’ monitoring, adherence, and the Youth Self Report (YSR). Glycosylated hemoglobin (HbA1c) indexed diabetes control. Results Path analyses revealed that perceived mothers’ general monitoring was indirectly associated with lower HbA1c through lower externalizing behaviors and higher adherence. Perceived fathers’ general monitoring was associated with HbA1c differently at the extremes: low fathers’ monitoring was associated with higher HbA1c through higher externalizing behaviors; high fathers’ monitoring was associated with HbA1c through higher adherence. Diabetes-specific monitoring was not associated with externalizing behaviors. Conclusion Perceived mothers’ and fathers’ general parental monitoring facilitates metabolic control through a similar process, with parental differences largely seen at the extremes. PMID:19420225

Network of movement and proximity sensors for monitoring upper-extremity motor activity after stroke: proof of principle.

PubMed

Sokal, Brad; Uswatte, Gitendra; Barman, Joydip; Brewer, Michael; Byrom, Ezekiel; Latten, Jessica; Joseph, Jeethu; Serafim, Camila; Ghaffari, Touraj; Sarkar, Nilanjan

2014-03-01

To test the convergent validity of an objective method, Sensor-Enabled Radio-frequency Identification System for Monitoring Arm Activity (SERSMAA), that distinguishes between functional and nonfunctional activity. Cross-sectional study. Laboratory. Participants (N=25) were ≥0.2 years poststroke (median, 9) with a wide range of severity of upper-extremity hemiparesis. Not applicable. After stroke, laboratory tests of the motor capacity of the more-affected arm poorly predict spontaneous use of that arm in daily life. However, available subjective methods for measuring everyday arm use are vulnerable to self-report biases, whereas available objective methods only provide information on the amount of activity without regard to its relation with function. The SERSMAA consists of a proximity-sensor receiver on the more-affected arm and multiple units placed on objects. Functional activity is signaled when the more-affected arm is close to an object that is moved. Participants were videotaped during a laboratory simulation of an everyday activity, that is, setting a table with cups, bowls, and plates instrumented with transmitters. Observers independently coded the videos in 2-second blocks with a validated system for classifying more-affected arm activity. There was a strong correlation (r=.87, P<.001) between time that the more-affected arm was used for handling objects according to the SERSMAA and functional activity according to the observers. The convergent validity of SERSMAA for measuring more-affected arm functional activity after stroke was supported in a simulation of everyday activity. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Developing a flood monitoring system from remotely sensed data for the Limpopo basin

USGS Publications Warehouse

Asante, K.O.; Macuacua, R.D.; Artan, G.A.; Lietzow, R.W.; Verdin, J.P.

2007-01-01

This paper describes the application of remotely sensed precipitation to the monitoring of floods in a region that regularly experiences extreme precipitation and flood events, often associated with cyclonic systems. Precipitation data, which are derived from spaceborne radar aboard the National Aeronautics and Space Administration's Tropical Rainfall Measuring Mission and from National Oceanic and Atmospheric Administration's infrared-based products, are used to monitor areas experiencing extreme precipitation events that are defined as exceedance of a daily mean areal average value of 50 mm over a catchment. The remotely sensed precipitation data are also ingested into a hydrologic model that is parameterized using spatially distributed elevation, soil, and land cover data sets that are available globally from remote sensing and in situ sources. The resulting stream-flow is classified as an extreme flood event when flow anomalies exceed 1.5 standard deviations above the short-term mean. In an application in the Limpopo basin, it is demonstrated that the use of satellite-derived precipitation allows for the identification of extreme precipitation and flood events, both in terms of relative intensity and spatial extent. The system is used by water authorities in Mozambique to proactively initiate independent flood hazard verification before generating flood warnings. The system also serves as a supplementary information source when in situ gauging systems are disrupted. This paper concludes that remotely sensed precipitation and derived products greatly enhance the ability of water managers in the Limpopo basin to monitor extreme flood events and provide at-risk communities with early warning information. ?? 2007 IEEE.

Recommendations for the nutrition management of phenylalanine hydroxylase deficiency

PubMed Central

Singh, Rani H.; Rohr, Fran; Frazier, Dianne; Cunningham, Amy; Mofidi, Shideh; Ogata, Beth; Splett, Patricia L.; Moseley, Kathryn; Huntington, Kathleen; Acosta, Phyllis B.; Vockley, Jerry; Van Calcar, Sandra C.

2014-01-01

The effectiveness of a phenylalanine-restricted diet to improve the outcome of individuals with phenylalanine hydroxylase deficiency (OMIM no. 261600) has been recognized since the first patients were treated 60 years ago. However, the treatment regime is complex, costly, and often difficult to maintain for the long term. Improvements and refinements in the diet for phenylalanine hydroxylase deficiency have been made over the years, and adjunctive therapies have proven to be successful for certain patients. Yet evidence-based guidelines for managing phenylalanine hydroxylase deficiency, optimizing outcomes, and addressing all available therapies are lacking. Thus, recommendations for nutrition management were developed using evidence from peer-reviewed publications, gray literature, and consensus surveys. The areas investigated included choice of appropriate medical foods, integration of adjunctive therapies, treatment during pregnancy, monitoring of nutritional and clinical markers, prevention of nutrient deficiencies, providing of access to care, and compliance strategies. This process has not only provided assessment and refinement of current nutrition management and monitoring recommendations but also charted a direction for future studies. This document serves as a companion to the concurrently published American College of Medical Genetics and Genomics guideline for the medical treatment of phenylalanine hydroxylase deficiency. Genet Med 16 2, 121–131. PMID:24385075

Analysis of extreme rainfall events using attributes control charts in temporal rainfall processes

NASA Astrophysics Data System (ADS)

Villeta, María; Valencia, Jose Luis; Saá-Requejo, Antonio; María Tarquis, Ana

2015-04-01

The impacts of most intense rainfall events on agriculture and insurance industry can be very severe. This research focuses in the analysis of extreme rainfall events throughout the use of attributes control charts, which constitutes a usual tool in Statistical Process Control (SPC) but unusual in climate studios. Here, series of daily precipitations for the years 1931-2009 within a Spanish region are analyzed, based on a new type of attributes control chart that takes into account the autocorrelation between the extreme rainfall events. The aim is to conclude if there exist or not evidence of a change in the extreme rainfall model of the considered series. After adjusting seasonally the precipitation series and considering the data of the first 30 years, a frequency-based criterion allowed fixing specification limits in order to discriminate between extreme observed rainfall days and normal observed rainfall days. The autocorrelation amongst maximum precipitation is taken into account by a New Binomial Markov Extended Process obtained for each rainfall series. These modelling of the extreme rainfall processes provide a way to generate the attributes control charts for the annual fraction of rainfall extreme days. The extreme rainfall processes along the rest of the years under study can then be monitored by such attributes control charts. The results of the application of this methodology show evidence of change in the model of extreme rainfall events in some of the analyzed precipitation series. This suggests that the attributes control charts proposed for the analysis of the most intense precipitation events will be of practical interest to agriculture and insurance sectors in next future.

Improving Ecological Response Monitoring of Environmental Flows

NASA Astrophysics Data System (ADS)

King, Alison J.; Gawne, Ben; Beesley, Leah; Koehn, John D.; Nielsen, Daryl L.; Price, Amina

2015-05-01

Environmental flows are now an important restoration technique in flow-degraded rivers, and with the increasing public scrutiny of their effectiveness and value, the importance of undertaking scientifically robust monitoring is now even more critical. Many existing environmental flow monitoring programs have poorly defined objectives, nonjustified indicator choices, weak experimental designs, poor statistical strength, and often focus on outcomes from a single event. These negative attributes make them difficult to learn from. We provide practical recommendations that aim to improve the performance, scientific robustness, and defensibility of environmental flow monitoring programs. We draw on the literature and knowledge gained from working with stakeholders and managers to design, implement, and monitor a range of environmental flow types. We recommend that (1) environmental flow monitoring programs should be implemented within an adaptive management framework; (2) objectives of environmental flow programs should be well defined, attainable, and based on an agreed conceptual understanding of the system; (3) program and intervention targets should be attainable, measurable, and inform program objectives; (4) intervention monitoring programs should improve our understanding of flow-ecological responses and related conceptual models; (5) indicator selection should be based on conceptual models, objectives, and prioritization approaches; (6) appropriate monitoring designs and statistical tools should be used to measure and determine ecological response; (7) responses should be measured within timeframes that are relevant to the indicator(s); (8) watering events should be treated as replicates of a larger experiment; (9) environmental flow outcomes should be reported using a standard suite of metadata. Incorporating these attributes into future monitoring programs should ensure their outcomes are transferable and measured with high scientific credibility.

Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

NASA Technical Reports Server (NTRS)

Scheuring, Richard A.; Hamilton, D.; Jones, J. A.; Alexander, D.

2008-01-01

Currently there are several physiological monitoring requirements for Extravehicular Activity (EVA) in the Human-Systems Interface Requirements (HSIR) document, including continuous heart rhythm monitoring. However, it is not known whether heart rhythm monitoring in the lunar surface space suit is a necessary capability for lunar surface operations or in launch/landing suit the event of a cabin depressurization enroute to or from the moon. Methods: Current US astronaut corps demographic information was provided to an expert panel of cardiovascular medicine experts, including specialists in electrophysiology, exercise physiology, interventional cardiology and arrhythmia. This information included averages for male/female age, body mass index (BMI), blood pressure, cholesterol, inflammatory markers, echocardiogram, ranges for coronary artery calcium (CAC) scores for long duration astronauts, and ranges for heart rate (HR) and metabolic (MET) rates obtained during microgravity and lunar EVA. Results: The panel determined that no uncontrolled hazard was likely to occur in the suit during lunar surface or contingency microgravity ops that would require ECG monitoring in the highly screened US astronaut population. However having the capability for rhythm monitoring inside the vehicle (IVA) was considered critical to manage an astronaut in distress. Discussion: Heart rate (HR) monitoring alone allows effective monitoring of astronaut health and function. Consequently, electrocardiographic (ECG) monitoring capability as a clinical tool is not essential in the lunar or launch/landing space suit. However, the panel considered that rhythm monitoring could be useful in certain clinical situations, it was not considered required for safe operations. Also, lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG (derived 12- lead) for IVA medical assessments.

Monitoring Change in Temperate Coniferous Forest Ecosystems

NASA Technical Reports Server (NTRS)

Williams, Darrel (Technical Monitor); Woodcock, Curtis E.

2004-01-01

The primary goal of this research was to improve monitoring of temperate forest change using remote sensing. In this context, change includes both clearing of forest due to effects such as fire, logging, or land conversion and forest growth and succession. The Landsat 7 ETM+ proved an extremely valuable research tool in this domain. The Landsat 7 program has generated an extremely valuable transformation in the land remote sensing community by making high quality images available for relatively low cost. In addition, the tremendous improvements in the acquisition strategy greatly improved the overall availability of remote sensing images. I believe that from an historical prespective, the Landsat 7 mission will be considered extremely important as the improved image availability will stimulate the use of multitemporal imagery at resolutions useful for local to regional mapping. Also, Landsat 7 has opened the way to global applications of remote sensing at spatial scales where important surface processes and change can be directly monitored. It has been a wonderful experience to have participated on the Landsat 7 Science Team. The research conducted under this project led to contributions in four general domains: I. Improved understanding of the information content of images as a function of spatial resolution; II. Monitoring Forest Change and Succession; III. Development and Integration of Advanced Analysis Methods; and IV. General support of the remote sensing of forests and environmental change. This report is organized according to these topics. This report does not attempt to provide the complete details of the research conducted with support from this grant. That level of detail is provided in the 16 peer reviewed journal articles, 7 book chapters and 5 conference proceedings papers published as part of this grant. This report attempts to explain how the various publications fit together to improve our understanding of how forests are changing and how to

Orion Entry Monitor

NASA Technical Reports Server (NTRS)

Smith, Kelly M.

2016-01-01

NASA is scheduled to launch the Orion spacecraft atop the Space Launch System on Exploration Mission 1 in late 2018. When Orion returns from its lunar sortie, it will encounter Earth's atmosphere with speeds in excess of 11 kilometers per second, and Orion will attempt its first precision-guided skip entry. A suite of flight software algorithms collectively called the Entry Monitor has been developed in order to enhance crew situational awareness and enable high levels of onboard autonomy. The Entry Monitor determines the vehicle capability footprint in real-time, provides manual piloting cues, evaluates landing target feasibility, predicts the ballistic instantaneous impact point, and provides intelligent recommendations for alternative landing sites if the primary landing site is not achievable. The primary engineering challenges of the Entry Monitor is in the algorithmic implementation in making a highly reliable, efficient set of algorithms suitable for onboard applications.

Monitoring the tobacco use epidemic V: The environment: factors that influence tobacco use.

PubMed

Farrelly, Matthew C

2009-01-01

This environment paper (V of V) summarizes important surveillance and evaluation systems that monitor influences on tobacco use such as smoke-free laws and other legislation, excise taxes, mass media, and a broad range of tobacco control activities, discusses their strengths and weaknesses, and makes recommendations for enhancement. We summarize and expand on the recommendations from the Environment Working Group of the National Tobacco Monitoring, Research, and Evaluation Workshop prioritized surveillance needs. This group rank-ordered surveillance needs various environmental influences, considering both the perceived importance of each environmental influence and the adequacy of the current surveillance systems. Based on this ranking and subsequent discussion, the group identified key priorities for enhancement. The group arrived at two key priorities: (1) develop and implement a national system for local tobacco control ordinance surveillance, and (2) develop and implement a comprehensive program monitoring system that is used by all states and supported by all funding agencies. Other environmental influences recommended for priority monitoring include cigarette prices and tobacco countermarketing. Systematic surveillance and monitoring of key program inputs and outputs and environmental influences is central to understand the effectiveness and cost-effectiveness of tobacco control efforts.

Extreme weather and climate events with ecological relevance: a review

PubMed Central

Meehl, Gerald A.

2017-01-01

Robust evidence exists that certain extreme weather and climate events, especially daily temperature and precipitation extremes, have changed in regard to intensity and frequency over recent decades. These changes have been linked to human-induced climate change, while the degree to which climate change impacts an individual extreme climate event (ECE) is more difficult to quantify. Rapid progress in event attribution has recently been made through improved understanding of observed and simulated climate variability, methods for event attribution and advances in numerical modelling. Attribution for extreme temperature events is stronger compared with other event types, notably those related to the hydrological cycle. Recent advances in the understanding of ECEs, both in observations and their representation in state-of-the-art climate models, open new opportunities for assessing their effect on human and natural systems. Improved spatial resolution in global climate models and advances in statistical and dynamical downscaling now provide climatic information at appropriate spatial and temporal scales. Together with the continued development of Earth System Models that simulate biogeochemical cycles and interactions with the biosphere at increasing complexity, these make it possible to develop a mechanistic understanding of how ECEs affect biological processes, ecosystem functioning and adaptation capabilities. Limitations in the observational network, both for physical climate system parameters and even more so for long-term ecological monitoring, have hampered progress in understanding bio-physical interactions across a range of scales. New opportunities for assessing how ECEs modulate ecosystem structure and functioning arise from better scientific understanding of ECEs coupled with technological advances in observing systems and instrumentation. This article is part of the themed issue ‘Behavioural, ecological and evolutionary responses to extreme climatic

Recommendations for toxicological investigation of drug-impaired driving and motor vehicle fatalities.

PubMed

Logan, Barry K; Lowrie, Kayla J; Turri, Jennifer L; Yeakel, Jillian K; Limoges, Jennifer F; Miles, Amy K; Scarneo, Colleen E; Kerrigan, Sarah; Farrell, Laurel J

2013-10-01

This report describes the review and update of a set of minimum recommendations for the toxicological investigation of suspected alcohol and drug-impaired driving cases and motor vehicle fatalities involving drugs or alcohol. The recommendations have the goal of ensuring that a consistent set of data regarding the most frequently encountered drugs linked to driving impairment is collected for practical application in the investigation of these cases and to allow epidemiological monitoring and the development of evidence-based public policy on this important public safety issue. The recommendations are based on a survey of practices in US laboratories performing this kind of analysis, consideration of existing epidemiological crash and arrest data and practical considerations of widely available technology platforms in laboratories performing this work. The final recommendations were derived from a consensus meeting of experts recruited from survey respondents and the membership of the National Safety Council's Alcohol, Drug and Impairment Division (formerly known as the Committee on Alcohol and Other Drugs, CAOD).

Real-time earthquake monitoring: Early warning and rapid response

NASA Technical Reports Server (NTRS)

1991-01-01

A panel was established to investigate the subject of real-time earthquake monitoring (RTEM) and suggest recommendations on the feasibility of using a real-time earthquake warning system to mitigate earthquake damage in regions of the United States. The findings of the investigation and the related recommendations are described in this report. A brief review of existing real-time seismic systems is presented with particular emphasis given to the current California seismic networks. Specific applications of a real-time monitoring system are discussed along with issues related to system deployment and technical feasibility. In addition, several non-technical considerations are addressed including cost-benefit analysis, public perceptions, safety, and liability.

Indicators for Universal Health Coverage: can Kenya comply with the proposed post-2015 monitoring recommendations?

PubMed

Obare, Valerie; Brolan, Claire E; Hill, Peter S

2014-12-20

Universal Health Coverage (UHC), referring to access to healthcare without financial burden, has received renewed attention in global health spheres. UHC is a potential goal in the post-2015 development agenda. Monitoring of progress towards achieving UHC is thus critical at both country and global level, and a monitoring framework for UHC was proposed by a joint WHO/World Bank discussion paper in December 2013. The aim of this study was to determine the feasibility of the framework proposed by WHO/World Bank for global UHC monitoring framework in Kenya. The study utilised three documents--the joint WHO/World Bank UHC monitoring framework and its update, and the Bellagio meeting report sponsored by WHO and the Rockefeller Foundation--to conduct the research. These documents informed the list of potential indicators that were used to determine the feasibility of the framework. A purposive literature search was undertaken to identify key government policy documents and relevant scholarly articles. A desk review of the literature was undertaken to answer the research objectives of this study. Kenya has yet to establish an official policy on UHC that provides a clear mandate on the goals, targets and monitoring and evaluation of performance. However, a significant majority of Kenyans continue to have limited access to health services as well as limited financial risk protection. The country has the capacity to reasonably report on five out of the seven proposed UHC indicators. However, there was very limited capacity to report on the two service coverage indicators for the chronic condition and injuries (CCIs) interventions. Out of the potential tracer indicators (n = 27) for aggregate CCI-related measures, four tracer indicators were available. Moreover the country experiences some wider challenges that may impact on the implementation and feasibility of the WHO/World Bank framework. The proposed global framework for monitoring UHC will only be feasible in Kenya if

Evaluation and prioritization of stream habitat monitoring in the Lower Columbia Salmon and Steelhead Recovery Domain as related to the habitat monitoring needs of ESA recovery plans

USGS Publications Warehouse

Puls, Amy L.; Anlauf Dunn, Kara; Graham Hudson, Bernadette

2014-01-01

The lower Columbia River and its tributaries once supported abundant runs of salmon and steelhead; however, there are five species currently listed under the federal Endangered Species Act (ESA). The National Marine Fisheries Service has completed, and is proposing for adoption, a comprehensive ESA Recovery Plan for the Lower Columbia Evolutionarily Significant Units (ESUs) based on the recovery plans developed by Oregon and Washington. One of the primary factors attributed to the decline of these species is habitat degradation. There are numerous entities conducting status and/or trends monitoring of instream habitat in the lower Columbia River Basin, but because the programs were developed for agency specific reasons, the existing monitoring efforts are not well coordinated, and often lack the spatial coverage, certainty, or species coverage necessary to answer questions related to status and trends of the ESA listed populations. The Pacific Northwest Aquatic Monitoring Partnership’s Integrated Status and Trends Monitoring (ISTM) project was initiated to improve integration of existing and new monitoring efforts by developing recommendations for sampling frames, protocols, and data sharing. In an effort to meet the ISTM project goals, five objectives were identified: (1) identify and prioritize decisions, questions, and monitoring objectives, (2) evaluate how existing programs align with these management decisions, questions, and objectives, (3) identify the most appropriate monitoring design to inform priority management decisions, questions, and objectives, (4) use trade-off analysis to develop specific recommendations for monitoring based on outcomes of Objectives 1-3 and (5) recommend implementation and reporting mechanisms. This report summarizes the effort to address Objectives 1 and 2, detailing the commonalities among the habitat characteristics that all entities measure and monitor, and how the metrics align with the priorities listed in the

Examining personal values in extreme environment contexts: Revisiting the question of generalizability

NASA Astrophysics Data System (ADS)

Smith, N.; Sandal, G. M.; Leon, G. R.; Kjærgaard, A.

2017-08-01

Land-based extreme environments (e.g. polar expeditions, Antarctic research stations, confinement chambers) have often been used as analog settings for spaceflight. These settings share similarities with the conditions experienced during space missions, including confinement, isolation and limited possibilities for evacuation. To determine the utility of analog settings for understanding human spaceflight, researchers have examined the extent to which the individual characteristics (e.g., personality) of people operating in extreme environments can be generalized across contexts (Sandal, 2000) [1]. Building on previous work, and utilising new and pre-existing data, the present study examined the extent to which personal value motives could be generalized across extreme environments. Four populations were assessed; mountaineers (N =59), military personnel (N = 25), Antarctic over-winterers (N = 21) and Mars simulation participants (N = 12). All participants completed the Portrait Values Questionnaire (PVQ; Schwartz; 2) capturing information on 10 personal values. Rank scores suggest that all groups identified Self-direction, Stimulation, Universalism and Benevolence as important values and acknowledged Power and Tradition as being low priorities. Results from difference testing suggest the extreme environment groups were most comparable on Self-direction, Stimulation, Benevolence, Tradition and Security. There were significant between-group differences on five of the ten values. Overall, findings pinpointed specific values that may be important for functioning in challenging environments. However, the differences that emerged on certain values highlight the importance of considering the specific population when comparing results across extreme settings. We recommend that further research examine the impact of personal value motives on indicators of adjustment, group working, and performance. Information from such studies could then be used to aid selection and

Implementing AORN recommended practices for sterile technique.

PubMed

Kennedy, Lynne

2013-07-01

Using sterile technique helps prevent the surgical environment from becoming contaminated and thus can help reduce the incidence of surgical site infection. The AORN "Recommended practices for sterile technique" provides guidance for setting up, maintaining, and monitoring a sterile field. Topics include the use of surgical attire and personal protective equipment; appropriate selection and evaluation of surgical gowns, gloves, and drape products for each procedure; use of sterile technique to don sterile gowns and gloves; appropriate methods for establishing and monitoring a sterile field; and techniques to ensure that items such as surgical instruments that may be contaminated are not used. Breaks in sterile technique should be corrected immediately unless the actions necessary would endanger the patient. If remedial actions must be delayed, they should be undertaken as soon as possible. Adhering to best practices for sterile technique requires remaining up to date with new approaches and incorporating these into quality initiatives. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Enhanced Cumulative Sum Charts for Monitoring Process Dispersion

PubMed Central

Abujiya, Mu’azu Ramat; Riaz, Muhammad; Lee, Muhammad Hisyam

2015-01-01

The cumulative sum (CUSUM) control chart is widely used in industry for the detection of small and moderate shifts in process location and dispersion. For efficient monitoring of process variability, we present several CUSUM control charts for monitoring changes in standard deviation of a normal process. The newly developed control charts based on well-structured sampling techniques - extreme ranked set sampling, extreme double ranked set sampling and double extreme ranked set sampling, have significantly enhanced CUSUM chart ability to detect a wide range of shifts in process variability. The relative performances of the proposed CUSUM scale charts are evaluated in terms of the average run length (ARL) and standard deviation of run length, for point shift in variability. Moreover, for overall performance, we implore the use of the average ratio ARL and average extra quadratic loss. A comparison of the proposed CUSUM control charts with the classical CUSUM R chart, the classical CUSUM S chart, the fast initial response (FIR) CUSUM R chart, the FIR CUSUM S chart, the ranked set sampling (RSS) based CUSUM R chart and the RSS based CUSUM S chart, among others, are presented. An illustrative example using real dataset is given to demonstrate the practicability of the application of the proposed schemes. PMID:25901356

Recommendations for scale-up of community-based misoprostol distribution programs.

PubMed

Robinson, Nuriya; Kapungu, Chisina; Carnahan, Leslie; Geller, Stacie

2014-06-01

Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Research on the remote sensing methods of drought monitoring in Chongqing

NASA Astrophysics Data System (ADS)

Yang, Shiqi; Tang, Yunhui; Gao, Yanghua; Xu, Yongjin

2011-12-01

There are regional and periodic droughts in Chongqing, which impacted seriously on agricultural production and people's lives. This study attempted to monitor the drought in Chongqing with complex terrain using MODIS data. First, we analyzed and compared three remote sensing methods for drought monitoring (time series of vegetation index, temperature vegetation dryness index (TVDI), and vegetation supply water index (VSWI)) for the severe drought in 2006. Then we developed a remote sensing based drought monitoring model for Chongqing by combining soil moisture data and meteorological data. The results showed that the three remote sensing based drought monitoring models performed well in detecting the occurrence of drought in Chongqing on a certain extent. However, Time Series of Vegetation Index has stronger sensitivity in time pattern but weaker in spatial pattern; although TVDI and VSWI can reflect inverse the whole process of severe drought in 2006 summer from drought occurred - increased - relieved - increased again - complete remission in spatial domain, but TVDI requires the situation of extreme drought and extreme moist both exist in study area which it is more difficult in Chongqing; VSWI is simple and practicable, which the correlation coefficient between VSWI and soil moisture data reaches significant levels. In summary, VSWI is the best model for summer drought monitoring in Chongqing.

Evidence-based recommendations for the use of topical oxygen therapy in the treatment of lower extremity wounds.

PubMed

Gordillo, Gayle M; Sen, Chandan K

2009-06-01

Topical oxygen therapy provides another tool in the armamentarium of clinicians treating refractory lower extremity wounds. Devices suitable for providing topical oxygen therapy in a clinical setting have recently become available. This article reviews the evidence to justify the use of this treatment modality, including in vitro, preclinical data, and clinical data. It also provides a protocol for how to administer topical oxygen therapy as well as guidance on patient selection and management to optimize outcomes. Randomized controlled trials are not yet reported and clearly necessary. The current body of evidence suggests that topical oxygen therapy may be considered as a second line of therapy for refractory wounds.

Monitoring iCCM: a feasibility study of the indicator guide for monitoring and evaluating integrated community case management.

PubMed

Roberton, Timothy; Kasungami, Dyness; Guenther, Tanya; Hazel, Elizabeth

2016-07-01

Most countries in sub-Saharan Africa have now adopted integrated community case management (iCCM) of common childhood illnesses as a strategy to improve child health. In March 2014, the iCCM Task Force published an Indicator Guide for Monitoring and Evaluating iCCM: a 'menu' of recommended indicators with globally agreed definitions and methodology, to guide countries in developing robust iCCM monitoring systems. The Indicator Guide was conceived as an evolving document that would incorporate collective experience and learning as iCCM programmes themselves evolve. This article presents findings from two studies that examined the feasibility of collecting the Indicator Guide's 18 routine monitoring indicators with the iCCM monitoring systems that countries currently have in place. We reviewed iCCM monitoring tools, protocols and reports from a purposive sample of 10 countries in sub-Saharan Africa. We developed a scorecard system to assess which of the Indicator Guide's 18 routine monitoring indicators could be calculated with the given monitoring tools, and at which level of the health system the relevant information would be available. We found that the data needed to calculate many of the Indicator Guide's routine monitoring indicators are already being collected through existing monitoring systems, although much of these data are only available at health facility level and not aggregated to district or national levels. Our results highlight challenge of using supervision checklists as a data source, and the need for countries to maintain accurate deployment data for CHWs and CHW supervisors. We suggest that some of the recommended indicators need revising. Routine monitoring will be more feasible, effective and efficient if iCCM programmes focus on a smaller set of high-value indicators that are easy to measure, reliably interpreted and useful both for global and national stakeholders and for frontline health workers themselves. © The Author 2016. Published by

Bridge reliability assessment based on the PDF of long-term monitored extreme strains

NASA Astrophysics Data System (ADS)

Jiao, Meiju; Sun, Limin

2011-04-01

Structural health monitoring (SHM) systems can provide valuable information for the evaluation of bridge performance. As the development and implementation of SHM technology in recent years, the data mining and use has received increasingly attention and interests in civil engineering. Based on the principle of probabilistic and statistics, a reliability approach provides a rational basis for analysis of the randomness in loads and their effects on structures. A novel approach combined SHM systems with reliability method to evaluate the reliability of a cable-stayed bridge instrumented with SHM systems was presented in this paper. In this study, the reliability of the steel girder of the cable-stayed bridge was denoted by failure probability directly instead of reliability index as commonly used. Under the assumption that the probability distributions of the resistance are independent to the responses of structures, a formulation of failure probability was deduced. Then, as a main factor in the formulation, the probability density function (PDF) of the strain at sensor locations based on the monitoring data was evaluated and verified. That Donghai Bridge was taken as an example for the application of the proposed approach followed. In the case study, 4 years' monitoring data since the operation of the SHM systems was processed, and the reliability assessment results were discussed. Finally, the sensitivity and accuracy of the novel approach compared with FORM was discussed.

Measuring Progress Toward Universal Health Coverage: Does the Monitoring Framework of Bangladesh Need Further Improvement?

PubMed

Gupta, Rajat Das; Shahabuddin, Asm

2018-01-08

This review aimed to compare Bangladesh's Universal Health Coverage (UHC) monitoring framework with the global-level recommendations and to find out the existing gaps of Bangladesh's UHC monitoring framework compared to the global recommendations. In order to reach the aims of the review, we systematically searched two electronic databases - PubMed and Google Scholar - by using appropriate keywords to select articles that describe issues related to UHC and the monitoring framework of UHC applied globally and particularly in Bangladesh. Four relevant documents were found and synthesized. The review found that Bangladesh incorporated all of the recommendations suggested by the global monitoring framework regarding mentoring the financial risk protection and equity perspective. However, a significant gap in the monitoring framework related to service coverage was observed. Although Bangladesh has a significant burden of mental illnesses, cataract, and neglected tropical diseases, indicators related to these issues were absent in Bangladesh's UHC framework. Moreover, palliative-care-related indicators were completely missing in the framework. The results of this review suggest that Bangladesh should incorporate these indicators in their UHC monitoring framework in order to track the progress of the country toward UHC more efficiently and in a robust way.

Extreme Ultraviolet Variability Experiment (EVE) Multiple EUV Grating Spectrographs (MEGS): Radiometric Calibrations and Results

NASA Technical Reports Server (NTRS)

Hock, R. A.; Woods, T. N.; Crotser, D.; Eparvier, F. G.; Woodraska, D. L.; Chamberlin, P. C.; Woods, E. C.

2010-01-01

The NASA Solar Dynamics Observatory (SDO), scheduled for launch in early 2010, incorporates a suite of instruments including the Extreme Ultraviolet Variability Experiment (EVE). EVE has multiple instruments including the Multiple Extreme ultraviolet Grating Spectrographs (MEGS) A, B, and P instruments, the Solar Aspect Monitor (SAM), and the Extreme ultraviolet SpectroPhotometer (ESP). The radiometric calibration of EVE, necessary to convert the instrument counts to physical units, was performed at the National Institute of Standards and Technology (NIST) Synchrotron Ultraviolet Radiation Facility (SURF III) located in Gaithersburg, Maryland. This paper presents the results and derived accuracy of this radiometric calibration for the MEGS A, B, P, and SAM instruments, while the calibration of the ESP instrument is addressed by Didkovsky et al. . In addition, solar measurements that were taken on 14 April 2008, during the NASA 36.240 sounding-rocket flight, are shown for the prototype EVE instruments.

Design Exception In-Service Monitoring Program Development

DOT National Transportation Integrated Search

2017-05-01

This study evaluates various possible program designs for in-service monitoring of design exceptions (DEs) for the Georgia Department of Transportation. The study recommends a multitier stepwise approach to the evaluation of DEs. Specifically, the pr...

Recommender systems

NASA Astrophysics Data System (ADS)

Lü, Linyuan; Medo, Matúš; Yeung, Chi Ho; Zhang, Yi-Cheng; Zhang, Zi-Ke; Zhou, Tao

2012-10-01

The ongoing rapid expansion of the Internet greatly increases the necessity of effective recommender systems for filtering the abundant information. Extensive research for recommender systems is conducted by a broad range of communities including social and computer scientists, physicists, and interdisciplinary researchers. Despite substantial theoretical and practical achievements, unification and comparison of different approaches are lacking, which impedes further advances. In this article, we review recent developments in recommender systems and discuss the major challenges. We compare and evaluate available algorithms and examine their roles in the future developments. In addition to algorithms, physical aspects are described to illustrate macroscopic behavior of recommender systems. Potential impacts and future directions are discussed. We emphasize that recommendation has great scientific depth and combines diverse research fields which makes it interesting for physicists as well as interdisciplinary researchers.

Liver enzyme monitoring in patients treated with troglitazone.

PubMed

Graham, D J; Drinkard, C R; Shatin, D; Tsong, Y; Burgess, M J

2001-08-15

Soon after initial marketing in March 1997, troglitazone, the first thiazolidinedione antidiabetic agent, was found to cause life-threatening acute liver failure. The drug was removed from the market in March 2000. To evaluate the effect of US Food and Drug Administration (FDA) risk management efforts, including repeated labeling changes and "Dear Healthcare Professional" letters, on periodic liver enzyme monitoring of patients taking troglitazone. Claims data from a large, multistate managed care organization were used to establish 4 cohorts of patients (N = 7603) with at least 90 days of health plan enrollment before first troglitazone prescription during 4 consecutive periods spanning April 1997 to September 1999 and representing 4 progressively stringent liver monitoring recommendations. Percentage of eligible troglitazone users in each cohort with baseline, monthly (for up to 6 months of continuous use), and complete (baseline and monthly) enzyme monitoring, based on computerized records of laboratory claims. Baseline testing increased from 15% before any FDA monitoring recommendations (cohort 1) to 44.6% following 4 separate FDA interventions (cohort 4; P<.001). In cohort 4, 33.4% of users had follow-up testing after 1 month of therapy, falling to 13% after 5 months of continuous use. In all cohorts, less than 5% received all recommended liver enzyme tests by the third month of continuous use. The FDA risk management efforts did not achieve meaningful or sustained improvement in liver enzyme testing. Evaluation of the impact of regulatory actions is needed before such actions can be regarded as effective or sufficient.

Reliability Assessment of Advanced Flip-clip Interconnect Electronic Package Assemblies under Extreme Cold Temperatures (-190 and -120 C)

NASA Technical Reports Server (NTRS)

Ramesham, Rajeshuni; Ghaffarian, Reza; Shapiro, Andrew; Napala, Phil A.; Martin, Patrick A.

2005-01-01

Flip-chip interconnect electronic package boards have been assembled, underfilled, non-destructively evaluated and subsequently subjected to extreme temperature thermal cycling to assess the reliability of this advanced packaging interconnect technology for future deep space, long-term, extreme temperature missions. In this very preliminary study, the employed temperature range covers military specifications (-55 C to 100 C), extreme cold Martian (-120 C to 115 C) and asteroid Nereus (-180 C to 25 C) environments. The resistance of daisy-chained, flip-chip interconnects were measured at room temperature and at various intervals as a function of extreme temperature thermal cycling. Electrical resistance measurements are reported and the tests to date have not shown significant change in resistance as a function of extreme temperature thermal cycling. However, the change in interconnect resistance becomes more noticeable with increasing number of thermal cycles. Further research work has been carried out to understand the reliability of flip-chip interconnect packages under extreme temperature applications (-190 C to 85 C) via continuously monitoring the daisy chain resistance. Adaptation of suitable diagnostic techniques to identify the failure mechanisms is in progress. This presentation will describe the experimental test results of flip-chip testing under extreme temperatures.

Extreme ultraviolet probing of nonequilibrium dynamics in high energy density germanium

NASA Astrophysics Data System (ADS)

Principi, E.; Giangrisostomi, E.; Mincigrucci, R.; Beye, M.; Kurdi, G.; Cucini, R.; Gessini, A.; Bencivenga, F.; Masciovecchio, C.

2018-05-01

Intense femtosecond infrared laser pulses induce a nonequilibrium between thousands of Kelvin hot valence electrons and room-temperature ions in a germanium sample foil. The evolution of this exotic state of matter is monitored with time-resolved extreme ultraviolet absorption spectroscopy across the Ge M2 ,3 edge (≃30 eV ) using the FERMI free-electron laser. We analyze two distinct regimes in the ultrafast dynamics in laser-excited Ge: First, on a subpicosecond time scale, the electron energy distribution thermalizes to an extreme temperature unreachable in equilibrium solid germanium; then, during the following picoseconds, the lattice reacts strongly altering the electronic structure and resulting in melting to a metallic state alongside a breakdown of the local atomic order. Data analysis, based on a hybrid approach including both numerical and analytical calculations, provides an estimation of the electron and ion temperatures, the electron density of states, the carrier-phonon relaxation time, as well as the carrier density and lattice heat capacity under those extreme nonequilibrium conditions. Related structural anomalies, such as the occurrence of a transient low-density liquid phase and the possible drop in lattice heat capacity are discussed.

Monitoring the Condition of Education.

ERIC Educational Resources Information Center

Buccino, Alphonse

Five categories of data collection are recommended for monitoring the quality of education: (1) outcomes, based on an input-output model, including data from student testing and credentials and degrees; (2) participation--who is served by education; (3) resources available to education; (4) long-term impact of education on work, income,…

A novel framework to alleviate the sparsity problem in context-aware recommender systems

NASA Astrophysics Data System (ADS)

Yu, Penghua; Lin, Lanfen; Wang, Jing

2017-04-01

Recommender systems have become indispensable for services in the era of big data. To improve accuracy and satisfaction, context-aware recommender systems (CARSs) attempt to incorporate contextual information into recommendations. Typically, valid and influential contexts are determined in advance by domain experts or feature selection approaches. Most studies have focused on utilizing the unitary context due to the differences between various contexts. Meanwhile, multi-dimensional contexts will aggravate the sparsity problem, which means that the user preference matrix would become extremely sparse. Consequently, there are not enough or even no preferences in most multi-dimensional conditions. In this paper, we propose a novel framework to alleviate the sparsity issue for CARSs, especially when multi-dimensional contextual variables are adopted. Motivated by the intuition that the overall preferences tend to show similarities among specific groups of users and conditions, we first explore to construct one contextual profile for each contextual condition. In order to further identify those user and context subgroups automatically and simultaneously, we apply a co-clustering algorithm. Furthermore, we expand user preferences in a given contextual condition with the identified user and context clusters. Finally, we perform recommendations based on expanded preferences. Extensive experiments demonstrate the effectiveness of the proposed framework.

Extreme Temperature Operation of a 10 MHz Silicon Oscillator Type STCL1100

NASA Technical Reports Server (NTRS)

Patterson, Richard L.; Hammoud, Ahmad

2008-01-01

The performance of STMicroelectronics 10 MHz silicon oscillator was evaluated under exposure to extreme temperatures. The oscillator was characterized in terms of its output frequency stability, output signal rise and fall times, duty cycle, and supply current. The effects of thermal cycling and re-start capability at extreme low and high temperatures were also investigated. The silicon oscillator chip operated well with good stability in its output frequency over the temperature region of -50 C to +130 C, a range that by far exceeded its recommended specified boundaries of -20 C to +85 C. In addition, this chip, which is a low-cost oscillator designed for use in applications where great accuracy is not required, continued to function at cryogenic temperatures as low as - 195 C but at the expense of drop in its output frequency. The STCL1100 silicon oscillator was also able to re-start at both -195 C and +130 C, and it exhibited no change in performance due to the thermal cycling. In addition, no physical damage was observed in the packaging material due to extreme temperature exposure and thermal cycling. Therefore, it can be concluded that this device could potentially be used in space exploration missions under extreme temperature conditions in microprocessor and other applications where tight clock accuracy is not critical. In addition to the aforementioned screening evaluation, additional testing, however, is required to fully establish the reliability of these devices and to determine their suitability for long-term use.

[Guide for monitoring children's development in pediatric practice].

PubMed

2017-06-01

The pediatrician is the best-informed professional to whom many families look to be the expert, not only on childhood illnesses but also on development. Early identification, diagnosis and monitoring of these patients are a real challenge for physicians who serve children. This guide provides recommendations for development monitoring, evaluation, diagnosis and follow up of patients with developmental delays and disabilities. Sociedad Argentina de Pediatría.

Indications of 24-h esophageal pH monitoring, capsule pH monitoring, combined pH monitoring with multichannel impedance, esophageal manometry, radiology and scintigraphy in gastroesophageal reflux disease?

PubMed

Vardar, Rukiye; Keskin, Muharrem

2017-12-01

Ambulatory esophageal pH monitoring is an essential method in patients exhibiting signs of non-erosive reflux disease (NERD) to make an objective diagnosis. Intra-esophageal pH monitoring is important in patients who are non-responsive to medications and in those with extraesophageal symptoms, particularly in NERD, before surgical interventions. With the help of the wireless capsule pH monitoring, measurements can be made under more physiological conditions as well as longer recordings can be performed because the investigation can be better tolerated by patients. Ambulatory esophageal pH monitoring can be detected within normal limits in 17%-31.4% of the patients with endoscopic esophagitis; therefore, normal pH monitoring cannot exclude the diagnosis of gastroesophageal reflux disease (GERD). Multi-channel intraluminal impedance pH (MII-pH) technology have been developed and currently the most sensitive tool to evaluate patients with both typical and atypical reflux symptoms. The sensitivity of a pH catheter test is 58% for the detection of acid reflux compared with MII-pH monitoring; further, its sensitivity is 28% for the detection of weak acid reflux compared with MII-pH monitoring. By adding impedance to pH catheter in patients with reflux symptoms, particularly in those receiving PPIs, it has been demonstrated that higher rates of diagnoses and symptom analyses can be obtained than those using only pH catheter. Esophageal manometry is used in the evaluation of patients with functional dysphagia and unexplained noncardiac chest pain and prior to antireflux surgery. The use of esophageal manometry is suitable for the detection of esophageal motor patterns and extreme motor abnormalities (e.g., achalasia and extreme hypomotility). Esophageal manometry and ambulatory pH monitoring are often used in assessments prior to laparoscopic antireflux surgery and in patients with reflux symptoms refractory to medical treatment. Although the esophageal motility is

iPhone app adherence to expert-recommended guidelines for pediatric obesity prevention.

PubMed

Wearing, Jessica R; Nollen, Nikki; Befort, Christie; Davis, Ann M; Agemy, Carolina K

2014-04-01

Pediatric obesity is a serious and prevalent problem. Smartphone technology, which is becoming increasingly available to children of diverse backgrounds, presents a unique opportunity to instill healthy behaviors before the onset of obesity. Past studies have examined the use of smartphone applications as tools of health behavior modification for adults. The present study examines the content of children's exercise and nutrition smartphone apps. Sixty-two iPhone apps were identified and coded by two independent raters for adherence to expert-recommended behaviors (e.g., five fruits/vegetables per day) and strategies (e.g., self-monitoring diet/physical activity) for the prevention of pediatric obesity. App behavioral and strategy index scores were uniformly low. Apps were more likely to address expert-recommended behaviors for the prevention of pediatric obesity (93.5%), whereas few apps addressed recommended strategies (20.9%). The most common behaviors addressed included physical activity (53.2%) and fruit/vegetable consumption (48.3%). Other important behaviors (e.g., screen time [1.6%] and family meals together [1.6%]) were rarely addressed. Current children's diet and exercise apps could be improved with increased adherence to expert-recommended guidelines, especially expert-recommended strategies.

iPhone App Adherence to Expert-Recommended Guidelines for Pediatric Obesity Prevention

PubMed Central

Wearing, Jessica R.; Befort, Christie; Davis, Ann M.; Agemy, Carolina K.

2014-01-01

Abstract Background: Pediatric obesity is a serious and prevalent problem. Smartphone technology, which is becoming increasingly available to children of diverse backgrounds, presents a unique opportunity to instill healthy behaviors before the onset of obesity. Past studies have examined the use of smartphone applications as tools of health behavior modification for adults. The present study examines the content of children's exercise and nutrition smartphone apps. Method: Sixty-two iPhone apps were identified and coded by two independent raters for adherence to expert-recommended behaviors (e.g., five fruits/vegetables per day) and strategies (e.g., self-monitoring diet/physical activity) for the prevention of pediatric obesity. Results: App behavioral and strategy index scores were uniformly low. Apps were more likely to address expert-recommended behaviors for the prevention of pediatric obesity (93.5%), whereas few apps addressed recommended strategies (20.9%). The most common behaviors addressed included physical activity (53.2%) and fruit/vegetable consumption (48.3%). Other important behaviors (e.g., screen time [1.6%] and family meals together [1.6%]) were rarely addressed. Conclusions: Current children's diet and exercise apps could be improved with increased adherence to expert-recommended guidelines, especially expert-recommended strategies. PMID:24655230

The Challenges from Extreme Climate Events for Sustainable Development in Amazonia: the Acre State Experience

NASA Astrophysics Data System (ADS)

Araújo, M. D. N. M.

2015-12-01

In the past ten years Acre State, located in Brazil´s southwestern Amazonia, has confronted sequential and severe extreme events in the form of droughts and floods. In particular, the droughts and forest fires of 2005 and 2010, the 2012 flood within Acre, the 2014 flood of the Madeira River which isolated Acre for two months from southern Brazil, and the most severe flooding throughout the state in 2015 shook the resilience of Acrean society. The accumulated costs of these events since 2005 have exceeded 300 million dollars. For the last 17 years, successive state administrations have been implementing a socio-environmental model of development that strives to link sustainable economic production with environmental conservation, particularly for small communities. In this context, extreme climate events have interfered significantly with this model, increasing the risks of failure. The impacts caused by these events on development in the state have been exacerbated by: a) limitations in monitoring; b) extreme events outside of Acre territory (Madeira River Flood) affecting transportation systems; c) absence of reliable information for decision-making; and d) bureaucratic and judicial impediments. Our experience in these events have led to the following needs for scientific input to reduce the risk of disasters: 1) better monitoring and forecasting of deforestation, fires, and hydro-meteorological variables; 2) ways to increase risk perception in communities; 3) approaches to involve more effectively local and regional populations in the response to disasters; 4) more accurate measurements of the economic and social damages caused by these disasters. We must improve adaptation to and mitigation of current and future extreme climate events and implement a robust civil defense, adequate to these new challenges.

Changes of Climate Extremes in Urmia Lake Basin: Observations and Multimodel Ensemble Projections

NASA Astrophysics Data System (ADS)

Ashraf, B.; AghaKouchak, A.

2017-12-01

This study presents an analysis of the changes in temperature and precipitation extremes in Urmia Lake Basin, in Iran in 21th century. The latest observations in the past three decades and multimodel ensemble projections from eleven General Circulation Models (GCMs) under the three Representative Concentration Pathways (RCPs) 2.6, 4.5 and 8.5 scenarios are employed for analysis in this study. The twenty-seven indicative temperature and precipitation indices recommended by the joint World Meteorological Organization CCL/CLIVAR/JCOMM Expert Team on Climate Change Detection and Indices (ETCCDI) were used for assessing changes in extremes. Results indicate that most warm (cold) extreme temperature indices have shown significantly positive (negative) trends in the Urmia Lake Basin in past three decades, while only slight changes in precipitation extremes can be observed. Ensemble projection from Bayesian Model Averaging (BMA) of Phase 5 of the Coupled Model Intercomparison Project (CMIP5) suggests that the increasing consecutive dry days (CDD), together with the decreasing frost day (FD) and increasing warm nights frequency (TN90) contribute to more frequent/severe droughts in Urmia Lake Basin. Meanwhile, the results show slight increase of annual count of days with precipitation of more than 10 mm (R10), maximum 5-day precipitation total (R5D), simple daily intensity index (SDII), and annual total precipitation with precipitation >95th percentile (R95) in projections. Our finding provides information on how extremes might change in the future from a wide range of scenarios that can potentially be sued for water resource and eco-environmental planning and adaptation strategies.

PROTECTING HEALTH WITH SAME DAY WATER QUALITY MONITORING RESULTS FOR BATHING BEACHES

EPA Science Inventory

Current US Environmental Protection Agency guidelines recommend the use of cultural methods for E. coli and enterococci to monitor beach water quality. The guidelines recommend a single sample value or a geometric mean value from at least five samples. The single sample guideli...

Extreme Environments Rig

NASA Image and Video Library

2013-08-13

The Glenn Extreme Environment Chamber (GEER) simulates the extreme conditions found in space and tests many devices that will explore Venus to see if they can withstand the punishing environment and temperatures over 800 degrees F.

Extreme weather and climate events with ecological relevance: a review.

PubMed

Ummenhofer, Caroline C; Meehl, Gerald A

2017-06-19

Robust evidence exists that certain extreme weather and climate events, especially daily temperature and precipitation extremes, have changed in regard to intensity and frequency over recent decades. These changes have been linked to human-induced climate change, while the degree to which climate change impacts an individual extreme climate event (ECE) is more difficult to quantify. Rapid progress in event attribution has recently been made through improved understanding of observed and simulated climate variability, methods for event attribution and advances in numerical modelling. Attribution for extreme temperature events is stronger compared with other event types, notably those related to the hydrological cycle. Recent advances in the understanding of ECEs, both in observations and their representation in state-of-the-art climate models, open new opportunities for assessing their effect on human and natural systems. Improved spatial resolution in global climate models and advances in statistical and dynamical downscaling now provide climatic information at appropriate spatial and temporal scales. Together with the continued development of Earth System Models that simulate biogeochemical cycles and interactions with the biosphere at increasing complexity, these make it possible to develop a mechanistic understanding of how ECEs affect biological processes, ecosystem functioning and adaptation capabilities. Limitations in the observational network, both for physical climate system parameters and even more so for long-term ecological monitoring, have hampered progress in understanding bio-physical interactions across a range of scales. New opportunities for assessing how ECEs modulate ecosystem structure and functioning arise from better scientific understanding of ECEs coupled with technological advances in observing systems and instrumentation.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events

Magnetars: Challenging the Extremes of Nature

NASA Technical Reports Server (NTRS)

Kouveliotou, Chryssa

2011-01-01

Magnetars are magnetically powered rotating neutron stars with extreme magnetic fields (over 10(exp 14) Gauss). They are discovered and emit predominantly in the X- and gamma-rays. Very few sources (roughly 15) have been found since their discovery in 1987. NASA s Fermi Observatory was launched June 11, 2009; 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, we recorded emission from four magnetar sources; of these, only one was an old magnetar: SGR 1806+20. The other three detections were two brand new sources, SGR J0501+4516, discovered with Swift and extensively monitored with both Swift and GBM, SGR J0418+5729, discovered with GBM and the Interplanetary Network (IPN), and SGR J1550-5418, a source originally classified as an Anomalous X-ray Pulsar (AXP 1E1547.0-5408). In my talk I will give a short history of the discovery of magnetars and describe how this, once relatively esoteric field, has emerged as a link between several astrophysical areas including Gamma-Ray Bursts. Finally, I will describe the properties of these sources and the current status of our knowledge of the magnetar population and birth rate.

Bivariate extreme value distributions

NASA Technical Reports Server (NTRS)

Elshamy, M.

1992-01-01

In certain engineering applications, such as those occurring in the analyses of ascent structural loads for the Space Transportation System (STS), some of the load variables have a lower bound of zero. Thus, the need for practical models of bivariate extreme value probability distribution functions with lower limits was identified. We discuss the Gumbel models and present practical forms of bivariate extreme probability distributions of Weibull and Frechet types with two parameters. Bivariate extreme value probability distribution functions can be expressed in terms of the marginal extremel distributions and a 'dependence' function subject to certain analytical conditions. Properties of such bivariate extreme distributions, sums and differences of paired extremals, as well as the corresponding forms of conditional distributions, are discussed. Practical estimation techniques are also given.

Monitoring the tobacco use epidemic II. The Agent: Current and Emerging Tobacco Products

PubMed Central

Stellman, Steven D.; Djordjevic, Mirjana V.

2009-01-01

Objective This Agent paper summarizes the findings and recommendations of the Agent (product) Working Group of the November, 2002, National Tobacco Monitoring, Research and Evaluation Workshop. Methods The Agent Working Group evaluated the need to develop new surveillance systems for quantifying ingredients and emissions of tobacco and tobacco smoke and to improve methods to assess uptake and metabolism of these constituents taking into account variability in human smoking behavior. Results The toxic properties of numerous tobacco and tobacco smoke constituents are well known, yet systematic monitoring of tobacco products has historically been limited to tar, nicotine, and CO in mainstream cigarette smoke using a machine-smoking protocol that does not reflect human smoking behavior. Toxicity of smokeless tobacco products has not been regularly monitored. Tobacco products are constantly changing and untested products are introduced into the marketplace with great frequency, including potential reduced-exposure products (PREPs). The public health impact of new or modified tobacco products is unknown. Conclusions Systematic surveillance is recommended for mainstream smoke constituents such as polycyclic aromatic hydrocarbons (PAH), tobacco-specific nitrosamines (TSNA), total and free-base nicotine, volatile organic compounds, aromatic amines, and metals; and design attributes including tobacco blend, additives, and filter ventilation. Research on smoking topography is recommended to help define machine-smoking protocols for monitoring emissions reflective of human smoking behavior. Recommendations are made for marketplace product sampling and for population monitoring of smoking topography, emissions of toxic constituents, biomarkers of exposure and, eventually, risk of tobacco-related diseases. PMID:18848577

Ionization monitor with improved ultra-high megohm resistor

DOEpatents

Burgess, Edward T.

1988-11-05

An ionization monitor measures extremely small currents using a resistor containing a beta emitter to generate ion-pairs which are collected as current when the device is used as a feedback resistor in an electrometer circuit. By varying the amount of beta emitter, the resistance of the resistor may be varied.

Extreme Droughts In Sydney And Melbourne Since The 1850s

NASA Astrophysics Data System (ADS)

Dogan, Selim

2014-05-01

Sydney and Melbourne are the two highly populated and very well known Australian cities. Population is over 4 million for each. These cities are subject to extreme droughts which affect regional water resources and cause substantial agricultural and economic losses. This study presents a drought analysis of Sydney and Melbourne for the period of 1850s to date by using Effective Drought Index (EDI) and Standardized Precipitation Index (SPI). EDI is a function of precipitation needed for return to normal conditions, the amount of precipitation necessary for recovery from the accumulated deficit since the beginning of a drought. SPI is the most popular and widely used drought index for the last decades. According to the results of EDI analysis; 8 different extreme drought events identified in Sydney, and 5 events in Melbourne since 1850s. The characterization of these extreme drought events were investigated in terms of magnitude, duration, intensity and interarrival time between previous drought event. EDI results were compared with the results of SPI and the similarities and differences were then discussed in more detail. The most severe drought event was identified for the period of July 1979 to February 1981 (lasted 19 months) for Sydney, while the most severe drought took longer in Melbourne for the period of March 2006 to February 2010 (47 months). This study focuses on the benefits of the use of EDI and SPI methods in order to monitor droughts beside presenting the extreme drought case study of Sydney and Melbourne.

Evaluating the extreme precipitation events using a mesoscale atmopshere model

NASA Astrophysics Data System (ADS)

Yucel, I.; Onen, A.

2012-04-01

Evidence is showing that global warming or climate change has a direct influence on changes in precipitation and the hydrological cycle. Extreme weather events such as heavy rainfall and flooding are projected to become much more frequent as climate warms. Mesoscale atmospheric models coupled with land surface models provide efficient forecasts for meteorological events in high lead time and therefore they should be used for flood forecasting and warning issues as they provide more continuous monitoring of precipitation over large areas. This study examines the performance of the Weather Research and Forecasting (WRF) model in producing the temporal and spatial characteristics of the number of extreme precipitation events observed in West Black Sea Region of Turkey. Extreme precipitation events usually resulted in flood conditions as an associated hydrologic response of the basin. The performance of the WRF system is further investigated by using the three dimensional variational (3D-VAR) data assimilation scheme within WRF. WRF performance with and without data assimilation at high spatial resolution (4 km) is evaluated by making comparison with gauge precipitation and satellite-estimated rainfall data from Multi Precipitation Estimates (MPE). WRF-derived precipitation showed capabilities in capturing the timing of the precipitation extremes and in some extent spatial distribution and magnitude of the heavy rainfall events. These precipitation characteristics are enhanced with the use of 3D-VAR scheme in WRF system. Data assimilation improved area-averaged precipitation forecasts by 9 percent and at some points there exists quantitative match in precipitation events, which are critical for hydrologic forecast application.

Recommended methods for monitoring change in bird populations by counting and capture of migrants

Treesearch

David J. T. Hussell; C. John Ralph

2005-01-01

Counts and banding captures of spring or fall migrants can generate useful information on the status and trends of the source populations. To do so, the counts and captures must be taken and recorded in a standardized and consistent manner. We present recommendations for field methods for counting and capturing migrants at intensively operated sites, such as bird...

Lipid needs of preterm infants: updated recommendations.

PubMed

Lapillonne, Alexandre; Groh-Wargo, Sharon; Gonzalez, Carlos H Lozano; Uauy, Ricardo

2013-03-01

Long-chain polyunsaturated fatty acids (LCPUFAs) are of nutritional interest because they are crucial for normal development of the central nervous system and have potential long-lasting effects that extend beyond the period of dietary insufficiency. Here we review the recent literature and current recommendations regarding LCPUFAs as they pertain to preterm infant nutrition. In particular, findings that relate to fetal accretion, LCPUFA absorption and metabolism, effects on development, and current practices and recommendations have been used to update recommendations for health care providers. The amounts of long-chain polyunsaturated fatty acids (LCPUFAs) used in early studies were chosen to produce the same concentrations as in term breast milk. This might not be a wise approach for preterm infants, however, particularly for very and extremely preterm infants, whose requirements for LCPUFAs and other nutrients exceed what is normally provided in the small volumes that they are able to tolerate. Recent studies have reported outcome data in preterm infants fed milk with a docosahexaenoic acid (DHA) content 2-3 times higher than the current concentration in infant formulas. Overall, these studies show that providing larger amounts of DHA supplements, especially to the smallest infants, is associated with better neurologic outcomes in early life. We emphasize that current nutritional management might not provide sufficient amounts of preformed DHA during the parenteral and enteral nutrition periods and in very preterm/very low birth weight infants until their due date, and that greater amounts than used routinely likely will be needed to compensate for intestinal malabsorption, DHA oxidation, and early deficit. Research should continue to address the gaps in knowledge and further refine adequate intake for each group of preterm infants. Copyright © 2013 Mosby, Inc. All rights reserved.

How to monitor patient safety in primary care? Healthcare professionals' views

PubMed Central

Samra, R; Car, J; Majeed, A; Vincent, C

2016-01-01

Summary Objective To identify patient safety monitoring strategies in primary care. Design Open-ended questionnaire survey. Participants A total of 113 healthcare professionals returned the survey from a group of 500 who were invited to participate achieving a response rate of 22.6%. Setting North-West London, United Kingdom. Method A paper-based and equivalent online survey was developed and subjected to multiple stages of piloting. Respondents were asked to suggest strategies for monitoring patient safety in primary care. These monitoring suggestions were then subjected to a content frequency analysis which was conducted by two researchers. Main Outcome measures Respondent-derived monitoring strategies. Results In total, respondents offered 188 suggestions for monitoring patient safety in primary care. The content analysis revealed that these could be condensed into 24 different future monitoring strategies with varying levels of support. Most commonly, respondents supported the suggestion that patient safety can only be monitored effectively in primary care with greater levels of staffing or with additional resources. Conclusion Approximately one-third of all responses were recommendations for strategies which addressed monitoring of the individual in the clinical practice environment (e.g. GP, practice nurse) to improve safety. There was a clear need for more staff and resource set aside to allow and encourage safety monitoring. Respondents recommended the dissemination of specific information for monitoring patient safety such as distributing the lessons of significant event audits amongst GP practices to enable shared learning. PMID:27540488

Extremal entanglement witnesses

NASA Astrophysics Data System (ADS)

Hansen, Leif Ove; Hauge, Andreas; Myrheim, Jan; Sollid, Per Øyvind

2015-02-01

We present a study of extremal entanglement witnesses on a bipartite composite quantum system. We define the cone of witnesses as the dual of the set of separable density matrices, thus TrΩρ≥0 when Ω is a witness and ρ is a pure product state, ρ=ψψ† with ψ=ϕ⊗χ. The set of witnesses of unit trace is a compact convex set, uniquely defined by its extremal points. The expectation value f(ϕ,χ)=TrΩρ as a function of vectors ϕ and χ is a positive semidefinite biquadratic form. Every zero of f(ϕ,χ) imposes strong real-linear constraints on f and Ω. The real and symmetric Hessian matrix at the zero must be positive semidefinite. Its eigenvectors with zero eigenvalue, if such exist, we call Hessian zeros. A zero of f(ϕ,χ) is quadratic if it has no Hessian zeros, otherwise it is quartic. We call a witness quadratic if it has only quadratic zeros, and quartic if it has at least one quartic zero. A main result we prove is that a witness is extremal if and only if no other witness has the same, or a larger, set of zeros and Hessian zeros. A quadratic extremal witness has a minimum number of isolated zeros depending on dimensions. If a witness is not extremal, then the constraints defined by its zeros and Hessian zeros determine all directions in which we may search for witnesses having more zeros or Hessian zeros. A finite number of iterated searches in random directions, by numerical methods, leads to an extremal witness which is nearly always quadratic and has the minimum number of zeros. We discuss briefly some topics related to extremal witnesses, in particular the relation between the facial structures of the dual sets of witnesses and separable states. We discuss the relation between extremality and optimality of witnesses, and a conjecture of separability of the so-called structural physical approximation (SPA) of an optimal witness. Finally, we discuss how to treat the entanglement witnesses on a complex Hilbert space as a subset of the

A model-based reasoning approach to sensor placement for monitorability

NASA Technical Reports Server (NTRS)

Chien, Steve; Doyle, Richard; Homemdemello, Luiz

1992-01-01

An approach is presented to evaluating sensor placements to maximize monitorability of the target system while minimizing the number of sensors. The approach uses a model of the monitored system to score potential sensor placements on the basis of four monitorability criteria. The scores can then be analyzed to produce a recommended sensor set. An example from our NASA application domain is used to illustrate our model-based approach to sensor placement.

ACR Appropriateness Criteria® Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis.

PubMed

Jacobson, Jon A; Roberts, Catherine C; Bencardino, Jenny T; Appel, Marc; Arnold, Erin; Baccei, Steven J; Cassidy, R Carter; Chang, Eric Y; Fox, Michael G; Greenspan, Bennett S; Gyftopoulos, Soterios; Hochman, Mary G; Mintz, Douglas N; Newman, Joel S; Rosenberg, Zehava S; Shah, Nehal A; Small, Kirstin M; Weissman, Barbara N

2017-05-01

Evaluation for suspected inflammatory arthritis as a cause for chronic extremity joint pain often relies on imaging. This review first discusses the characteristic osseous and soft tissue abnormalities seen with inflammatory arthritis and how they may be imaged. It is essential that imaging results are interpreted in the context of clinical and serologic results to add specificity as there is significant overlap of imaging findings among the various types of arthritis. This review provides recommendations for imaging evaluation of specific types of inflammatory arthritis, including rheumatoid arthritis, seronegative spondyloarthropathy, gout, calcium pyrophosphate dihydrate disease (or pseudogout), and erosive osteoarthritis. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Measuring Progress Toward Universal Health Coverage: Does the Monitoring Framework of Bangladesh Need Further Improvement?

PubMed Central

Shahabuddin, ASM

2018-01-01

This review aimed to compare Bangladesh’s Universal Health Coverage (UHC) monitoring framework with the global-level recommendations and to find out the existing gaps of Bangladesh’s UHC monitoring framework compared to the global recommendations. In order to reach the aims of the review, we systematically searched two electronic databases - PubMed and Google Scholar - by using appropriate keywords to select articles that describe issues related to UHC and the monitoring framework of UHC applied globally and particularly in Bangladesh. Four relevant documents were found and synthesized. The review found that Bangladesh incorporated all of the recommendations suggested by the global monitoring framework regarding mentoring the financial risk protection and equity perspective. However, a significant gap in the monitoring framework related to service coverage was observed. Although Bangladesh has a significant burden of mental illnesses, cataract, and neglected tropical diseases, indicators related to these issues were absent in Bangladesh’s UHC framework. Moreover, palliative-care-related indicators were completely missing in the framework. The results of this review suggest that Bangladesh should incorporate these indicators in their UHC monitoring framework in order to track the progress of the country toward UHC more efficiently and in a robust way. PMID:29541562

A circumpolar monitoring framework for polar bears

USGS Publications Warehouse

Vongraven, Dag; Aars, Jon; Amstrup, Steven C.; Atkinson, Stephen N.; Belikov, Stanislav; Born, Erik W.; DeBruyn, T.D.; Derocher, Andrew E.; Durner, George M.; Gill, Michael J.; Lunn, Nicholas J.; Obbard, Martyn E.; Omelak, Jack; Ovsyanikov, Nikita; Peacock, Elizabeth; Richardson, E.E.; Sahanatien, Vicki; Stirling, Ian; Wiig, Øystein

2012-01-01

Polar bears (Ursus maritimus) occupy remote regions that are characterized by harsh weather and limited access. Polar bear populations can only persist where temporal and spatial availability of sea ice provides adequate access to their marine mammal prey. Observed declines in sea ice availability will continue as long as greenhouse gas concentrations rise. At the same time, human intrusion and pollution levels in the Arctic are expected to increase. A circumpolar understanding of the cumulative impacts of current and future stressors is lacking, long-term trends are known from only a few subpopulations, and there is no globally coordinated effort to monitor effects of stressors. Here, we describe a framework for an integrated circumpolar monitoring plan to detect ongoing patterns, predict future trends, and identify the most vulnerable polar bear subpopulations. We recommend strategies for monitoring subpopulation abundance and trends, reproduction, survival, ecosystem change, human-caused mortality, human–bear conflict, prey availability, health, stature, distribution, behavioral change, and the effects that monitoring itself may have on polar bears. We assign monitoring intensity for each subpopulation through adaptive assessment of the quality of existing baseline data and research accessibility. A global perspective is achieved by recommending high intensity monitoring for at least one subpopulation in each of four major polar bear ecoregions. Collection of data on harvest, where it occurs, and remote sensing of habitat, should occur with the same intensity for all subpopulations. We outline how local traditional knowledge may most effectively be combined with the best scientific methods to provide comparable and complementary lines of evidence. We also outline how previously collected intensive monitoring data may be sub-sampled to guide future sampling frequencies and develop indirect estimates or indices of subpopulation status. Adoption of this framework

Nonparametric functional data estimation applied to ozone data: prediction and extreme value analysis.

PubMed

Quintela-del-Río, Alejandro; Francisco-Fernández, Mario

2011-02-01

The study of extreme values and prediction of ozone data is an important topic of research when dealing with environmental problems. Classical extreme value theory is usually used in air-pollution studies. It consists in fitting a parametric generalised extreme value (GEV) distribution to a data set of extreme values, and using the estimated distribution to compute return levels and other quantities of interest. Here, we propose to estimate these values using nonparametric functional data methods. Functional data analysis is a relatively new statistical methodology that generally deals with data consisting of curves or multi-dimensional variables. In this paper, we use this technique, jointly with nonparametric curve estimation, to provide alternatives to the usual parametric statistical tools. The nonparametric estimators are applied to real samples of maximum ozone values obtained from several monitoring stations belonging to the Automatic Urban and Rural Network (AURN) in the UK. The results show that nonparametric estimators work satisfactorily, outperforming the behaviour of classical parametric estimators. Functional data analysis is also used to predict stratospheric ozone concentrations. We show an application, using the data set of mean monthly ozone concentrations in Arosa, Switzerland, and the results are compared with those obtained by classical time series (ARIMA) analysis. Copyright © 2010 Elsevier Ltd. All rights reserved.

Extreme Water Deficit in Brazil Detected from Space

NASA Technical Reports Server (NTRS)

Vieira Getirana

2016-01-01

Extreme droughts have caused significant socioeconomic and environmental damage worldwide. In Brazil, ineffective energy development and water management policies have magnified the impacts of recent severe droughts, which include massive agricultural losses, water supply restrictions, and energy rationing. Spaceborne remote sensing data advance our understanding of the spatiotemporal variability of large-scale droughts and enhance the detection and monitoring of extreme water-related events. In this study, data derived from the Gravity Recovery and Climate Experiment (GRACE) mission are used to detect and quantify an extended major drought over eastern Brazil and provide estimates of impacted areas and region-specific water deficits. Two structural breakpoint detection methods were applied to time series of GRACE-based terrestrial water storage anomalies (TWSA), determining when two abrupt changes occurred. One, in particular, defines the beginning of the current drought. Using TWSA, a water loss rate of 26.1 cmyr21 over southeastern Brazil was detected from 2012 to 2015. Based on analysis of Global Land Data Assimilation System(GLDAS) outputs, the extreme drought is mostly related to lower-than-usual precipitation rates, resulting in high soil moisture depletion and lower-than-usual rates of evapotranspiration. A reduction of 2023 of precipitation over an extended period of 3 years is enough to raise serious water scarcity conditions in the country. Correlations between monthly time series of both grid-based TWSA and ground-based water storage measurements at 16 reservoirs located within southeastern Brazil varied from 0.42 to 0.82. Differences are mainly explained by reservoir sizes and proximity to the drought nucleus.

Extreme Environment Technologies for Space and Terrestrial Applications

NASA Technical Reports Server (NTRS)

Balint, Tibor S.; Cutts, James A.; Kolawa, Elizabeth A.; Peterson, Craig E.

2008-01-01

Over the next decades, NASA's planned solar system exploration missions are targeting planets, moons and small bodies, where spacecraft would be expected to encounter diverse extreme environmental (EE) conditions throughout their mission phases. These EE conditions are often coupled. For instance, near the surface of Venus and in the deep atmospheres of giant planets, probes would experience high temperatures and pressures. In the Jovian system low temperatures are coupled with high radiation. Other environments include thermal cycling, and corrosion. Mission operations could also introduce extreme conditions, due to atmospheric entry heat flux and deceleration. Some of these EE conditions are not unique to space missions; they can be encountered by terrestrial assets from the fields of defense,oil and gas, aerospace, and automotive industries. In this paper we outline the findings of NASA's Extreme Environments Study Team, including discussions on state of the art and emerging capabilities related to environmental protection, tolerance and operations in EEs. We will also highlight cross cutting EE mitigation technologies, for example, between high g-load tolerant impactors for Europa and instrumented projectiles on Earth; high temperature electronics sensors on Jupiter deep probes and sensors inside jet engines; and pressure vessel technologies for Venus probes and sea bottom monitors. We will argue that synergistic development programs between these fields could be highly beneficial and cost effective for the various agencies and industries. Some of these environments, however, are specific to space and thus the related technology developments should be spear headed by NASA with collaboration from industry and academia.

Nutrition Recommendations and the Children’s Food and Beverage Advertising Initiative’s 2014 Approved Food and Beverage Product List

PubMed Central

Powell, Lisa M.

2015-01-01

We compare the Children’s Food and Beverage Advertising Initiative’s (CFBAI’s) April 2014 list of food and beverage products approved to be advertised on children’s television programs with the federal Interagency Working Group’s nutrition recommendations for such advertised products. Products were assessed by using the nutrients to limit (saturated fat, trans fat, sugar, and sodium) component of the Interagency Working Group’s recommendations. Fifty-three percent of the listed products did not meet the nutrition recommendations and, therefore, were ineligible to be advertised. We recommend continued monitoring of food and beverage products marketed to children. PMID:25906434

Comparing methods suitable for monitoring marine mammals in low visibility conditions during seismic surveys.

PubMed

Verfuss, Ursula K; Gillespie, Douglas; Gordon, Jonathan; Marques, Tiago A; Miller, Brianne; Plunkett, Rachael; Theriault, James A; Tollit, Dominic J; Zitterbart, Daniel P; Hubert, Philippe; Thomas, Len

2018-01-01

Loud sound emitted during offshore industrial activities can impact marine mammals. Regulations typically prescribe marine mammal monitoring before and/or during these activities to implement mitigation measures that minimise potential acoustic impacts. Using seismic surveys under low visibility conditions as a case study, we review which monitoring methods are suitable and compare their relative strengths and weaknesses. Passive acoustic monitoring has been implemented as either a complementary or alternative method to visual monitoring in low visibility conditions. Other methods such as RADAR, active sonar and thermal infrared have also been tested, but are rarely recommended by regulatory bodies. The efficiency of the monitoring method(s) will depend on the animal behaviour and environmental conditions, however, using a combination of complementary systems generally improves the overall detection performance. We recommend that the performance of monitoring systems, over a range of conditions, is explored in a modelling framework for a variety of species. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

EAES recommendations on methodology of innovation management in endoscopic surgery.

PubMed

Neugebauer, Edmund A M; Becker, Monika; Buess, Gerhard F; Cuschieri, Alfred; Dauben, Hans-Peter; Fingerhut, Abe; Fuchs, Karl H; Habermalz, Brigitte; Lantsberg, Leonid; Morino, Mario; Reiter-Theil, Stella; Soskuty, Gabriela; Wayand, Wolfgang; Welsch, Thilo

2010-07-01

Under the mandate of the European Association for Endoscopic Surgery (EAES) a guideline on methodology of innovation management in endoscopic surgery has been developed. The primary focus of this guideline is patient safety, efficacy, and effectiveness. An international expert panel was invited to develop recommendations for the assessment and introduction of surgical innovations. A consensus development conference (CDC) took place in May 2009 using the method of a nominal group process (NGP). The recommendations were presented at the annual EAES congress in Prague, Czech Republic, on June 18th, 2009 for discussion and further input. After further Delphi processes between the experts, the final recommendations were agreed upon. The development and implementation of innovations in surgery are addressed in five sections: (1) definition of an innovation, (2) preclinical and (3) clinical scientific development, (4) scientific approval, and (5) implementation along with monitoring. Within the present guideline each of the sections and several steps are defined, and several recommendations based on available evidence have been agreed within each category. A comprehensive workflow of the different steps is given in an algorithm. In addition, issues of health technology assessment (HTA) serving to estimate efficiency followed by ethical directives are given. Innovations into clinical practice should be introduced with the highest possible grade of safety for the patient (nil nocere: do no harm). The recommendations can contribute to the attainment of this objective without preventing future promising diagnostic and therapeutic innovations in the field of surgery and allied techniques.

Superiority of automatic remote monitoring compared with in-person evaluation for scheduled ICD follow-up in the TRUST trial - testing execution of the recommendations

PubMed Central

Varma, Niraj; Michalski, Justin; Stambler, Bruce; Pavri, Behzad B.

2014-01-01

Aims To test recommended implantable cardioverter defibrillator (ICD) follow-up methods by ‘in-person evaluations’ (IPE) vs. ‘remote Home Monitoring’ (HM). Methods and results ICD patients were randomized 2:1 to automatic HM or to Conventional monitoring, with follow-up checks scheduled at 3, 6, 9, 12, and 15 months post-implant. Conventional patients were evaluated with IPE only. Home Monitoring patients were assessed remotely only for 1 year between 3 and 15 month evaluations. Adherence to follow-up was measured. HM and Conventional patients were similar (age 63 years, 72% male, left ventricular ejection fraction 29%, primary prevention 73%, DDD 57%). Conventional management suffered greater patient attrition during the trial (20.1 vs. 14.2% in HM, P = 0.007). Three month follow-up occurred in 84% in both groups. There was 100% adherence (5 of 5 checks) in 47.3% Conventional vs. 59.7% HM (P < 0.001). Between 3 and 15 months, HM exhibited superior (2.2×) adherence to scheduled follow-up [incidence of failed follow up was 146 of 2421 (6.0%) in HM vs. 145 of 1098 (13.2%) in Conventional, P < 0.001] and punctuality. In HM (daily transmission success rate median 91%), transmission loss caused only 22 of 2275 (0.97%) failed HM evaluations between 3 and 15 months; others resulted from clinic oversight. Overall IPE failure rate in Conventional [193 of 1841 (10.5%) exceeded that in HM [97 of 1484 (6.5%), P < 0.001] by 62%, i.e. HM patients remained more loyal to IPE when this was mandated. Conclusion Automatic remote monitoring better preserves patient retention and adherence to scheduled follow-up compared with IPE. Clinical trial registration NCT00336284. PMID:24595864

A twenty-first century California observing network for monitoring extreme weather events

USGS Publications Warehouse

White, A.B.; Anderson, M.L.; Dettinger, M.D.; Ralph, F.M.; Hinojosa, A.; Cayan, D.R.; Hartman, R.K.; Reynolds, D.W.; Johnson, L.E.; Schneider, T.L.; Cifelli, R.; Toth, Z.; Gutman, S.I.; King, C.W.; Gehrke, F.; Johnston, P.E.; Walls, C.; Mann, Dorte; Gottas, D.J.; Coleman, T.

2013-01-01

During Northern Hemisphere winters, the West Coast of North America is battered by extratropical storms. The impact of these storms is of paramount concern to California, where aging water supply and flood protection infrastructures are challenged by increased standards for urban flood protection, an unusually variable weather regime, and projections of climate change. Additionally, there are inherent conflicts between releasing water to provide flood protection and storing water to meet requirements for water supply, water quality, hydropower generation, water temperature and flow for at-risk species, and recreation. In order to improve reservoir management and meet the increasing demands on water, improved forecasts of precipitation, especially during extreme events, is required. Here we describe how California is addressing their most important and costliest environmental issue – water management – in part, by installing a state-of-the-art observing system to better track the area’s most severe wintertime storms.

Assessment of Observational Uncertainty in Extreme Precipitation Events over the Continental United States

NASA Astrophysics Data System (ADS)

Slinskey, E. A.; Loikith, P. C.; Waliser, D. E.; Goodman, A.

2017-12-01

Extreme precipitation events are associated with numerous societal and environmental impacts. Furthermore, anthropogenic climate change is projected to alter precipitation intensity across portions of the Continental United States (CONUS). Therefore, a spatial understanding and intuitive means of monitoring extreme precipitation over time is critical. Towards this end, we apply an event-based indicator, developed as a part of NASA's support of the ongoing efforts of the US National Climate Assessment, which assigns categories to extreme precipitation events based on 3-day storm totals as a basis for dataset intercomparison. To assess observational uncertainty across a wide range of historical precipitation measurement approaches, we intercompare in situ station data from the Global Historical Climatology Network (GHCN), satellite-derived precipitation data from NASA's Tropical Rainfall Measuring Mission (TRMM), gridded in situ station data from the Parameter-elevation Regressions on Independent Slopes Model (PRISM), global reanalysis from NASA's Modern Era Retrospective-Analysis version 2 (MERRA 2), and regional reanalysis with gauge data assimilation from NCEP's North American Regional Reanalysis (NARR). Results suggest considerable variability across the five-dataset suite in the frequency, spatial extent, and magnitude of extreme precipitation events. Consistent with expectations, higher resolution datasets were found to resemble station data best and capture a greater frequency of high-end extreme events relative to lower spatial resolution datasets. The degree of dataset agreement varies regionally, however all datasets successfully capture the seasonal cycle of precipitation extremes across the CONUS. These intercomparison results provide additional insight about observational uncertainty and the ability of a range of precipitation measurement and analysis products to capture extreme precipitation event climatology. While the event category threshold is fixed

International recommendations for glucose control in adult non diabetic critically ill patients.

PubMed

Ichai, Carole; Preiser, Jean-Charles

2010-01-01

The purpose of this research is to provide recommendations for the management of glycemic control in critically ill patients. Twenty-one experts issued recommendations related to one of the five pre-defined categories (glucose target, hypoglycemia, carbohydrate intake, monitoring of glycemia, algorithms and protocols), that were scored on a scale to obtain a strong or weak agreement. The GRADE (Grade of Recommendation, Assessment, Development and Evaluation) system was used, with a strong recommendation indicating a clear advantage for an intervention and a weak recommendation indicating that the balance between desirable and undesirable effects of an intervention is not clearly defined. A glucose target of less than 10 mmol/L is strongly suggested, using intravenous insulin following a standard protocol, when spontaneous food intake is not possible. Definition of the severe hypoglycemia threshold of 2.2 mmol/L is recommended, regardless of the clinical signs. A general, unique amount of glucose (enteral/parenteral) to administer for any patient cannot be suggested. Glucose measurements should be performed on arterial rather than venous or capillary samples, using central lab or blood gas analysers rather than point-of-care glucose readers. Thirty recommendations were obtained with a strong (21) and a weak (9) agreement. Among them, only 15 were graded with a high level of quality of evidence, underlying the necessity to continue clinical studies in order to improve the risk-to-benefit ratio of glucose control.

Canaries in the coal mine: Interpersonal violence, gang violence, and violent extremism through a public health prevention lens.

PubMed

Eisenman, David P; Flavahan, Louise

2017-08-01

This paper asks what programmes and policies for preventing violent extremism (also called 'countering violent extremism', or CVE) can learn from the public health violence prevention field. The general answer is that addressing violent extremism within the wider domain of public health violence prevention connects the effort to a relevant field of research, evidence-based policy and programming, and a broader population reach. This answer is reached by examining conceptual alignments between the two fields at both the case-level and the theoretical level. To address extremist violence within the wider reach of violence prevention, having a shared model is seen as a first step. The World Health Organization uses the social-ecological framework for assessing the risk and protective factors for violence and developing effective public-health based programmes. This study illustrates how this model has been used for gang violence prevention and explores overlaps between gang violence prevention and preventing violent extremism. Finally, it provides policy and programme recommendations to align CVE with public health violence prevention.

Sampling and monitoring for closure

USGS Publications Warehouse

McLemore, Virginia T.; Smith, Kathleen S.; Russell, Carol C.

2007-01-01

An important aspect of planning a new mine or mine expansion within the modern regulatory framework is to design for ultimate closure. Sampling and monitoring for closure is a form of environmental risk management. By implementing a sampling and monitoring program early in the life of the mining operation, major costs can be avoided or minimized. The costs for treating mine drainage in perpetuity are staggering, especially if they are unanticipated. The Metal Mining Sector of the Acid Drainage Technology Initiative (ADTI-MMS), a cooperative government-industry-academia organization, was established to address drainage-quality technologies of metal mining and metallurgical operations. ADTI-MMS recommends that sampling and monitoring programs consider the entire mine-life cycle and that data needed for closure of an operation be collected from exploration through postclosure.

Overview of systematic reviews of therapeutic ranges: methodologies and recommendations for practice.

PubMed

Cooney, Lewis; Loke, Yoon K; Golder, Su; Kirkham, Jamie; Jorgensen, Andrea; Sinha, Ian; Hawcutt, Daniel

2017-06-02

Many medicines are dosed to achieve a particular therapeutic range, and monitored using therapeutic drug monitoring (TDM). The evidence base for a therapeutic range can be evaluated using systematic reviews, to ensure it continues to reflect current indications, doses, routes and formulations, as well as updated adverse effect data. There is no consensus on the optimal methodology for systematic reviews of therapeutic ranges. An overview of systematic reviews of therapeutic ranges was undertaken. The following databases were used: Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts and Reviews of Effects (DARE) and MEDLINE. The published methodologies used when systematically reviewing the therapeutic range of a drug were analyzed. Step by step recommendations to optimize such systematic reviews are proposed. Ten systematic reviews that investigated the correlation between serum concentrations and clinical outcomes encompassing a variety of medicines and indications were assessed. There were significant variations in the methodologies used (including the search terms used, data extraction methods, assessment of bias, and statistical analyses undertaken). Therapeutic ranges should be population and indication specific and based on clinically relevant outcomes. Recommendations for future systematic reviews based on these findings have been developed. Evidence based therapeutic ranges have the potential to improve TDM practice. Current systematic reviews investigating therapeutic ranges have highly variable methodologies and there is no consensus of best practice when undertaking systematic reviews in this field. These recommendations meet a need not addressed by standard protocols.

Self-monitoring of blood glucose in diabetes mellitus: arguments for an individualized approach.

PubMed

Nauck, Michael A; El-Ouaghlidi, Andrea; Vardarli, Irfan

2009-09-01

The utility of glucose self-monitoring in different types and stages of diabetes is controversial, as there is only sparse relevant evidence from randomized controlled clinical trials. In this analysis, the authors aim to develop individualized recommendations based on clinical needs and the available literature. The PubMed database was searched for articles that appeared up to 30 September 2008 containing the terms "measurement," "control","monitoring," and "hypoglycemia"; the retrieved articles were supplemented by other articles that were cited in them. A directed search was also made for the recommendations of the German, European, American, and international diabetological societies. Conclusions were then drawn about the useful modalities and extent of glucose self-monitoring on the basis of the clinical features of the major types of diabetes and the main treatment strategies for them. With the exception of intensified treatment strategies (which rely on blood-sugar regulation with insulin), only a few evidence-based recommendations can be derived from randomized clinical trials and meta-analyses. Nonetheless, a strategy for self-monitoring according to the patient's individual needs can be derived from the characteristics of therapeutic regimens: depending on the type of diabetes from which the patient suffers, the predicted number of glucometer strips required for self-monitoring will vary from almost none to roughly 400 per month. The decision to use glucose self-monitoring, as well as the type and extent of self-monitoring that will be used, should be based on the individual patient's type of diabetes, treatment regimen, and clinical characteristics. Like any other type of therapeutic intervention, self-monitoring should have a well-documented, rational justification.

In-Flight Decision-Making by General Aviation Pilots Operating in Areas of Extreme Thunderstorms.

PubMed

Boyd, Douglas D

2017-12-01

General aviation (comprised mainly of noncommercial, light aircraft) accounts for 94% of civil aviation fatalities in the United States. Although thunderstorms are hazardous to light aircraft, little research has been undertaken on in-flight pilot decision-making regarding their avoidance. The study objectives were: 1) to determine if the thunderstorm accident rate has declined over the last two decades; and 2) assess in-flight (enroute/landing) airman decision-making regarding adherence to FAA separation minima from thunderstorms. Thunderstorm-related accidents were identified from the NTSB database. To determine en route/arriving aircraft real-time thunderstorm proximity/relative position and airplane location, using a flight-tracking (Flight Aware®) website, were overlaid on a graphical weather image. Statistics employed Poisson and Chi-squared analyses. The thunderstorm-related accident rate was undiminished over the 1996-2014 period. In a prospective analysis the majority (enroute 77%, landing 93%) of flights violated the FAA-recommended separation distance from extreme convection. Of these, 79 and 69% (en route and landing, respectively) selected a route downwind of the thunderstorm rather than a less hazardous upwind flight path. Using a mathematical product of binary (separation distance, relative aircraft-thunderstorm position) and nominal (thunderstorm-free egress area) parameters, airmen were more likely to operate in the thunderstorm hazard zone for landings than en route operations. The thunderstorm-related accident rate, carrying a 70% fatality rate, remains unabated, largely reflecting nonadherence to the FAA-recommended separation minima and selection of a more hazardous route (downwind) for circumnavigation of extreme convective weather. These findings argue for additional emphasis in ab initio pilot training/recurrency on thunderstorm hazards and safe practices (separation distance and flight path).Boyd DD. In-flight decision-making by general

Optical monitor for real time thickness change measurements via lateral-translation induced phase-stepping interferometry

DOEpatents

Rushford, Michael C.

2002-01-01

An optical monitoring instrument monitors etch depth and etch rate for controlling a wet-etching process. The instrument provides means for viewing through the back side of a thick optic onto a nearly index-matched interface. Optical baffling and the application of a photoresist mask minimize spurious reflections to allow for monitoring with extremely weak signals. A Wollaston prism enables linear translation for phase stepping.

Eliminating Inappropriate Telemetry Monitoring: An Evidence-Based Implementation Guide.

PubMed

Yeow, Raymond Y; Strohbehn, Garth W; Kagan, Calvin M; Petrilli, Christopher M; Krishnan, Jamuna K; Edholm, Karli; Sussman, L Scott; Blanck, Jaime F; Popa, Remus I; Pahwa, Amit K

2018-06-04

In-hospital continuous electrocardiographic monitoring, commonly referred to as telemetry, has allowed for rapid recognition of life-threatening conditions, including complex arrhythmias and myocardial ischemia. However, inappropriate use can lead to unnecessary downstream testing from "false alarms," which in turn affects clinician efficiency and increases health care costs without benefiting patients. For these reasons, the Society of Hospital Medicine's Choosing Wisely campaign recommended use of a protocol-driven discontinuation of telemetry. The American Heart Association (AHA) developed a set of Practice Standards for the appropriate use of telemetry monitoring in 2004, which they updated in 2017. Unfortunately, the AHA Practice Standards have not been widely adopted-with as many as 43% of monitored patients lacking a recommended indication for monitoring. Thus, we created an overview discussing the safety and efficacy of incorporating the AHA Practice Standards and a review of studies highlighting their successful incorporation within patient care workflow. We conclude by outlining an "implementation blueprint" for health system professionals and administrators seeking to change their institution's culture of telemetry use. As the health care landscape continues to shift, enacting high-value initiatives that improve patient safety and efficiency of care will be critical.

[Adaptive mechanisms and behavioural recommendations: playing football in heat, cold and high altitude conditions].

PubMed

Born, D-P; Hoppe, M W; Lindner, N; Freiwald, J; Holmberg, H-C; Sperlich, B

2014-03-01

Football is played worldwide and players often have to cope with hot and cold temperatures as well as high altitude conditions. The upcoming and past world championships in Brazil, Qatar and South Africa illustrate the necessity for behavioural strategies and adaptation to extreme environmental conditions. When playing football in the heat or cold, special clothing, hydration and nutritional and acclimatisation strategies are vital for high-level performance. When playing at high altitude, the reduced oxygen partial pressure impairs endurance performance and alters the technical and tactical requirements. Special high-altitude adaptation and preparation strategies are essential for football teams based at sea-level in order to perform well and compete successfully. Therefore, the aim of the underlying review is: 1) to highlight the difficulties and needs of football teams competing in extreme environmental conditions, 2) to summarise the thermoregulatory, physiological, neuronal and psychological mechanism, and 3) to provide recommendations for coping with extreme environmental conditions in order to perform at a high level when playing football in the heat, cold and at high altitude. © Georg Thieme Verlag KG Stuttgart · New York.

Fiberoptic characteristics for extreme operating environments

NASA Technical Reports Server (NTRS)

Delcher, R. C.

1992-01-01

Fiberoptics could offer several major benefits for cryogenic liquid-fueled rocket engines, including lightning immunity, weight reduction, and the possibility of implementing a number of new measurements for engine condition monitoring. The technical feasibility of using fiberoptics in the severe environments posed by cryogenic liquid-fueled rocket engines was determined. The issues of importance and subsequent requirements for this use of fiberoptics were compiled. These included temperature ranges, moisture embrittlement succeptability, and the ability to withstand extreme shock and vibration levels. Different types of optical fibers were evaluated and several types of optical fibers' ability to withstand use in cryogenic liquid-fueled rocket engines was demonstrated through environmental testing of samples. This testing included: cold-bend testing, moisture embrittlement testing, temperature cycling, temperature extremes testing, vibration testing, and shock testing. Three of five fiber samples withstood the tests to a level proving feasibility, and two of these remained intact in all six of the tests. A fiberoptic bundle was also tested, and completed testing without breakage. Preliminary cabling and harnessing for fiber protection was also demonstrated. According to cable manufacturers, the successful -300 F cold bend, vibration, and shock tests are the first instance of any major fiberoptic cable testing below roughly -55 F. This program has demonstrated the basic technical feasibility of implementing optical fibers on cryogenic liquid-fueled rocket engines, and a development plan is included highlighting requirements and issues for such an implementation.

Establishing a Numerical Modeling Framework for Hydrologic Engineering Analyses of Extreme Storm Events

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

Chen, Xiaodong; Hossain, Faisal; Leung, L. Ruby

In this study a numerical modeling framework for simulating extreme storm events was established using the Weather Research and Forecasting (WRF) model. Such a framework is necessary for the derivation of engineering parameters such as probable maximum precipitation that are the cornerstone of large water management infrastructure design. Here this framework was built based on a heavy storm that occurred in Nashville (USA) in 2010, and verified using two other extreme storms. To achieve the optimal setup, several combinations of model resolutions, initial/boundary conditions (IC/BC), cloud microphysics and cumulus parameterization schemes were evaluated using multiple metrics of precipitation characteristics. Themore » evaluation suggests that WRF is most sensitive to IC/BC option. Simulation generally benefits from finer resolutions up to 5 km. At the 15km level, NCEP2 IC/BC produces better results, while NAM IC/BC performs best at the 5km level. Recommended model configuration from this study is: NAM or NCEP2 IC/BC (depending on data availability), 15km or 15km-5km nested grids, Morrison microphysics and Kain-Fritsch cumulus schemes. Validation of the optimal framework suggests that these options are good starting choices for modeling extreme events similar to the test cases. This optimal framework is proposed in response to emerging engineering demands of extreme storm events forecasting and analyses for design, operations and risk assessment of large water infrastructures.« less

Recommendations for the surgical treatment of endometriosis-part 1: ovarian endometrioma.

PubMed

Saridogan, Ertan; Becker, Christian M; Feki, Anis; Grimbizis, Grigoris F; Hummelshoj, Lone; Keckstein, Joerg; Nisolle, Michelle; Tanos, Vasilios; Ulrich, Uwe A; Vermeulen, Nathalie; De Wilde, Rudy Leon

2017-01-01

What does this document on the surgical treatment of endometriosis jointly prepared by the European Society for Gynaecological Endoscopy (ESGE), ESHRE, and the World Endometriosis Society (WES) provide? This document provides recommendations covering technical aspects of different methods of surgery for endometriomas in women of reproductive age. Endometriomas (ovarian endometriotic cysts) are a commonly diagnosed form of endometriosis, owing to the relative ease and accuracy of ultrasound diagnosis. They frequently present a clinical dilemma as to whether and how to treat them when found during imaging or incidentally during surgery. Previously published guidelines have provided recommendations based on the best available evidence, but without technical details on the management of endometriosis. A working group of ESGE, ESHRE and WES collaborated on writing recommendations on the practical aspects of endometrioma surgery. This document focused on endometrioma surgery. Further documents in this series will provide recommendations for surgery of deep and peritoneal endometriosis. The document presents general recommendations for surgery of endometrioma and specific recommendations for cystectomy, ablation by laser or by plasma energy, electrocoagulation and a combination of these techniques applied together or with an interval between them. Owing to the limited evidence available, recommendations are mostly based on clinical expertise. These recommendations complement previous guidelines on the management of endometriosis. The meetings of the working group were funded by ESGE, ESHRE and WES. CB declares to be a member of the independent data monitoring committee for a clinical study by ObsEva and receiving research grants from Bayer, Roche Diagnostics, MDNA Life Sciences and Volition. ES received honoraria for provision of training to healthcare professionals from Ethicon, Olympus and Gedeon Richter. The other authors declare that they have no conflict of interest.

Instrumentation Recommendations for Volcano Monitoring at U.S. Volcanoes Under the National Volcano Early Warning System

USGS Publications Warehouse

Moran, Seth C.; Freymueller, Jeff T.; LaHusen, Richard G.; McGee, Kenneth A.; Poland, Michael P.; Power, John A.; Schmidt, David A.; Schneider, David J.; Stephens, George; Werner, Cynthia A.; White, Randall A.

2008-01-01

As magma moves toward the surface, it interacts with anything in its path: hydrothermal systems, cooling magma bodies from previous eruptions, and (or) the surrounding 'country rock'. Magma also undergoes significant changes in its physical properties as pressure and temperature conditions change along its path. These interactions and changes lead to a range of geophysical and geochemical phenomena. The goal of volcano monitoring is to detect and correctly interpret such phenomena in order to provide early and accurate warnings of impending eruptions. Given the well-documented hazards posed by volcanoes to both ground-based populations (for example, Blong, 1984; Scott, 1989) and aviation (for example, Neal and others, 1997; Miller and Casadevall, 2000), volcano monitoring is critical for public safety and hazard mitigation. Only with adequate monitoring systems in place can volcano observatories provide accurate and timely forecasts and alerts of possible eruptive activity. At most U.S. volcanoes, observatories traditionally have employed a two-component approach to volcano monitoring: (1) install instrumentation sufficient to detect unrest at volcanic systems likely to erupt in the not-too-distant future; and (2) once unrest is detected, install any instrumentation needed for eruption prediction and monitoring. This reactive approach is problematic, however, for two reasons. 1. At many volcanoes, rapid installation of new ground-1. based instruments is difficult or impossible. Factors that complicate rapid response include (a) eruptions that are preceded by short (hours to days) precursory sequences of geophysical and (or) geochemical activity, as occurred at Mount Redoubt (Alaska) in 1989 (24 hours), Anatahan (Mariana Islands) in 2003 (6 hours), and Mount St. Helens (Washington) in 1980 and 2004 (7 and 8 days, respectively); (b) inclement weather conditions, which may prohibit installation of new equipment for days, weeks, or even months, particularly at

Extreme-Dipper Profile, Increased Aortic Stiffness, and Impaired Subendocardial Viability in Hypertension.

PubMed

Amah, Guy; Ouardani, Rahma; Pasteur-Rousseau, Adrien; Voicu, Sebastian; Safar, Michel E; Kubis, Nathalie; Bonnin, Philippe

2017-04-01

In treated hypertensives, extreme-dippers with stable coronary artery disease (CAD) exhibit more severe nighttime cardiac ischemia than dippers. After excluding confounding factors such as diabetes, CAD or chronic kidney disease (CKD), we assessed whether subendocardial viability, determined by the Buckberg index, was more significantly impaired in extreme-dippers than in dippers. Two hundred thirteen consecutive treated hypertensives (156 dippers, 57 extreme-dippers), were included. After 24-hour ambulatory blood pressure (BP) monitoring, patients underwent radial applanation tonometry (with determination of: subendocardial viability ratio [SEVR], central augmentation index [AIx], and pulse pressure amplification [PPamp]), carotid-femoral pulse wave velocity (cfPWV) measurement, and cycle ergometer stress testing. Extreme-dippers showed higher cfPWV (8.99 ± 2.16 vs. 8.29 ± 1.69 m/s, P = 0.014), higher AIx (29.7 ± 9.4 vs. 26.4 ± 10.4%, P = 0.042), lower PPamp (1.22 ± 0.14 vs. 1.30 ± 0.15, P < 0.001), lower SEVR (146 ± 23% vs. 157 ± 26%, P = 0.007), and lower nighttime diastolic BP (DBP) (70 ± 9 vs. 75 ± 9 mm Hg, P < 0.001) than dippers. SEVR and cfPWV were inversely correlated. Among extreme-dippers, women exhibited lower SEVR (138 ± 21% vs. 161 ± 23%, P = 0.004), PPamp (1.16 ± 0.10 vs. 1.31 ± 0.15, P < 0.001), and nighttime DBP (67 ± 8 mm Hg vs. 72 ± 8 mm Hg, P = 0.017) than men. Extreme-dipper treated hypertensives with no history of CAD, diabetes or CKD, present increased aortic stiffness and low PPamp. Furthermore, this is the first demonstration of the greater likelihood of these patients to exhibit impaired subendocardial viability compared to dippers. Extreme-dipper hypertensive patients, women in particular, may have a significantly higher risk of silent myocardial ischemia, thus justifying systematic screening. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Extreme Events in Urban Streams Leading to Extreme Temperatures in Birmingham, UK

NASA Astrophysics Data System (ADS)

Rangecroft, S.; Croghan, D.; Van Loon, A.; Sadler, J. P.; Hannah, D. M.

2016-12-01

Extreme flows and high water temperature events act as critical stressors on the ecological health of rivers. Urban headwater streams are considered particularly vulnerable to the effects of these extreme events. Despite this, such catchments remain poorly characterised and the effect of differences in land use is rarely quantified, especially in relation to water temperature. Thus a key research gap has emerged in understanding the patterns of water temperature during extreme events within contrasting urban, headwater catchments. We studied the headwaters of two bordering urban catchments of contrasting land use within Birmingham, UK. To characterise response to extreme events, precipitation and flow were analysed for the period of 1970-2016. To analyse the effects of extreme events on water temperature, 10 temperature loggers recording at 15 minute intervals were placed within each catchment covering a range of land use for the period May 2016 - present. During peak over threshold flood events higher average peaks were observed in the less urbanised catchment; however highest maximum flow peaks took place in the more densely urbanised catchment. Very similar average drought durations were observed between the two catchments with average flow drought durations of 27 days in the most urbanised catchment, and 29 in the less urbanised catchment. Flashier water temperature regimes were observed within the more urbanised catchment and increases of up to 5 degrees were apparent within 30 minutes during certain storms at the most upstream sites. Only in the most extreme events did the more densely urban stream appear more susceptible to both extreme high flows and extreme water temperature events, possibly resultant from overland flow emerging as the dominant flow pathway during intense precipitation events. Water temperature surges tended to be highly spatially variable indicating the importance of local land use. During smaller events, water temperature was less

Rabi oscillations in extreme ultraviolet ionization of atomic argon

NASA Astrophysics Data System (ADS)

Flögel, Martin; Durá, Judith; Schütte, Bernd; Ivanov, Misha; Rouzée, Arnaud; Vrakking, Marc J. J.

2017-02-01

We demonstrate Rabi oscillations in nonlinear ionization of argon by an intense femtosecond extreme ultraviolet (XUV) laser field produced by high-harmonic generation. We monitor the formation of A r2 + as a function of the time delay between the XUV pulse and an additional near-infrared (NIR) femtosecond laser pulse, and show that the population of an A r+* intermediate resonance exhibits strong modulations both due to an NIR laser-induced Stark shift and XUV-induced Rabi cycling between the ground state of A r+ and the A r+* excited state. Our experiment represents a direct experimental observation of a Rabi-cycling process in the XUV regime.

Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care.

PubMed

Sanello, Ashley; Gausche-Hill, Marianne; Mulkerin, William; Sporer, Karl A; Brown, John F; Koenig, Kristi L; Rudnick, Eric M; Salvucci, Angelo A; Gilbert, Gregory H

2018-05-01

In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the AMS protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were patient assessment, point-of-care tests, supplemental oxygen, use of standardized scoring, evaluating for causes of AMS, blood glucose evaluation, toxicological treatment, and pediatric evaluation and management. Protocols across 33 EMS agencies in California varied widely. All protocols call for a blood glucose check, 21 (64%) suggest treating adults at <60mg/dL, and half allow for the use of dextrose 10%. All the protocols recommend naloxone for signs of opioid overdose, but only 13 (39%) give specific parameters. Half the agencies (52%) recommend considering other toxicological causes of AMS, often by using the mnemonic AEIOU TIPS. Eight (24%) recommend a 12-lead electrocardiogram; others simply suggest cardiac monitoring. Fourteen (42%) advise supplemental oxygen as needed; only seven (21%) give specific parameters. In terms of considering various etiologies of AMS, 25 (76%) give instructions to consider trauma, 20 (61%) to consider stroke, and 18 (55%) to consider seizure. Twenty-three (70%) of the agencies have separate pediatric AMS protocols; others include pediatric considerations within the adult protocol. Protocols for patients with AMS vary widely across the State

Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care

PubMed Central

Sanello, Ashley; Mulkerin, William; Sporer, Karl A.; Brown, John F.; Koenig, Kristi L.; Rudnick, Eric M.; Salvucci, Angelo A.; Gilbert, Gregory H.

2018-01-01

Introduction In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the AMS protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were patient assessment, point-of-care tests, supplemental oxygen, use of standardized scoring, evaluating for causes of AMS, blood glucose evaluation, toxicological treatment, and pediatric evaluation and management. Results Protocols across 33 EMS agencies in California varied widely. All protocols call for a blood glucose check, 21 (64%) suggest treating adults at <60mg/dL, and half allow for the use of dextrose 10%. All the protocols recommend naloxone for signs of opioid overdose, but only 13 (39%) give specific parameters. Half the agencies (52%) recommend considering other toxicological causes of AMS, often by using the mnemonic AEIOU TIPS. Eight (24%) recommend a 12-lead electrocardiogram; others simply suggest cardiac monitoring. Fourteen (42%) advise supplemental oxygen as needed; only seven (21%) give specific parameters. In terms of considering various etiologies of AMS, 25 (76%) give instructions to consider trauma, 20 (61%) to consider stroke, and 18 (55%) to consider seizure. Twenty-three (70%) of the agencies have separate pediatric AMS protocols; others include pediatric considerations within the adult protocol. Conclusion Protocols for

Home blood pressure monitoring. Current knowledge and directions for future research.

PubMed

Reims, H; Fossum, E; Kjeldsen, S E; Julius, S

2001-01-01

Home blood pressure (BP) monitoring has become popular in clinical practice and several automated devices for home BP measurement are now recommendable. Home BP is generally lower than clinic BP, and similar to daytime ambulatory BP. Home BP measurement eliminates the white coat effect and provides a high number of readings, and it is considered more accurate and reproducible than clinic BP. It can improve the sensitivity and statistical power of clinical drug trials and may have a higher prognostic value than clinic BP. Home monitoring may improve compliance and BP control, and reduce costs of hypertension management. Diagnostic thresholds and treatment target values for home BP remain to be established by longitudinal studies. Until then, home BP monitoring is to be considered a supplement. However, high home BP may support or confirm the diagnosis made in the doctor's office, and low home BP may warrant ambulatory BP monitoring. During long-term follow-up, home BP monitoring provides an opportunity for close attention to BP levels and variations. The first international guidelines have established a consensus document with recommendations, including a proposal of preliminary diagnostic thresholds, but further research is needed to define the precise role of home BP monitoring in clinical practice.

Preliminary Development of Online Monitoring Acoustic Emission System for the Integrity of Research Reactor Components

NASA Astrophysics Data System (ADS)

Bakhri, S.; Sumarno, E.; Himawan, R.; Akbar, T. Y.; Subekti, M.; Sunaryo, G. R.

2018-02-01

Three research reactors owned by BATAN have been more than 25 years. Aging of (Structure, System and Component) SSC which is mainly related to mechanical causes become the most important issue for the sustainability and safety operation. Acoustic Emission (AE) is one of the appropriate and recommended methods by the IAEA for inspection as well as at the same time for the monitoring of mechanical SSC related. However, the advantages of AE method in detecting the acoustic emission both for the inspection and the online monitoring require a relatively complex measurement system including hardware software system for the signal detection and analysis purposes. Therefore, aim of this work was to develop an AE system based on an embedded system which capable for doing both the online monitoring and inspection of the research reactor’s integrity structure. An embedded system was selected due to the possibility to install the equipment on the field in extreme environmental condition with capability to store, analyses, and send the required information for further maintenance and operation. The research was done by designing the embedded system based on the Field Programmable Gate Array (FPGA) platform, because of their execution speed and system reconfigurable opportunities. The AE embedded system is then tested to identify the AE source location and AE characteristic under tensile material testing. The developed system successfully acquire the AE elastic waveform and determine the parameter-based analysis such as the amplitude, peak, duration, rise time, counts and the average frequency both for the source location test and the tensile test.

Survival of extreme opinions

NASA Astrophysics Data System (ADS)

Hsu, Jiann-wien; Huang, Ding-wei

2009-12-01

We study the survival of extreme opinions in various processes of consensus formation. All the opinions are treated equally and subjected to the same rules of changing. We investigate three typical models to reach a consensus in each case: (A) personal influence, (B) influence from surroundings, and (C) influence to surroundings. Starting with uniformly distributed random opinions, our calculated results show that the extreme opinions can survive in both models (A) and (B), but not in model (C). We obtain a conclusion that both personal influence and passive adaptation to the environment are not sufficient enough to eradicate all the extreme opinions. Only the active persuasion to change the surroundings eliminates the extreme opinions completely.

An exploratory analysis of the self-reported goals of individuals with chronic upper-extremity paresis following stroke.

PubMed

Waddell, Kimberly J; Birkenmeier, Rebecca L; Bland, Marghuretta D; Lang, Catherine E

2016-01-01

To classify the self-identified goals of individuals post-stroke with chronic upper extremity (UE) paresis, and determine if age, UE functional capacity and pre-stroke hand dominance influence overall goal selection. Sixty-five subjects participated. Using the Canadian Occupational Performance Measure (COPM) to establish treatment goals, the top five goals were categorized using the Occupational Therapy Practice Framework into five categories: activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure, work and general UE movement. A Chi-square analysis determined if age, UE functional capacity (measured by the Action Research Arm Test) and UE hand dominance influenced individual goal selection. The majority of goals were in the ADL (37%) and IADL (40%) categories. A small percentage (12%) was related to general UE movement. Individuals with moderate UE functional capacity identified more ADL goals than those with higher UE functional capacity. There was not a difference between age and UE dominance across all five goal areas. Individuals with chronic UE paresis had specific goals that were not influenced by age or hand dominance, but partially influenced by severity. General UE movement goals were identified less than goals related to specific activities. Considering the specificity of individual goals following stroke, it is recommended that clinicians regularly utilize a goal setting tool to help establish client goals. It is recommended that clinicians further inquire about general goals in order to link upper extremity deficits to functional activity limitations. Age, upper extremity functional capacity and hand dominance have little influence on the rehabilitation goals for individuals with chronic paresis after stroke.

Reliability of the mangled extremity severity score in combat-related upper and lower extremity injuries.

PubMed

Ege, Tolga; Unlu, Aytekin; Tas, Huseyin; Bek, Dogan; Turkan, Selim; Cetinkaya, Aytac

2015-01-01

Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS). However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the environmental circumstance. The purpose of the retrospective study was to evaluate the extent of extremity injuries due to ballistic missiles and to detect the reliability of mangled extremity severity score (MESS) in both upper and lower extremities. Between 2004 and 2014, 139 Gustillo Anderson Type III open fractures of both the upper and lower extremities were enrolled in the study. Data for patient age, fire arm type, transporting time from the field to the hospital (and the method), injury severity scores, MESS scores, fracture types, amputation levels, bone fixation methods and postoperative infections and complications retrieved from the two level-2 trauma center's data base. Sensitivity, specificity, positive and negative predictive values of the MESS were calculated to detect the ability in deciding amputation in the mangled limb. Amputation was performed in 39 extremities and limb salvage attempted in 100 extremities. The mean followup time was 14.6 months (range 6-32 months). In the amputated group, the mean MESS scores for upper and lower extremity were 8.8 (range 6-11) and 9.24 (range 6-11), respectively. In the limb salvage group, the mean MESS scores for upper and lower extremities were 5.29 (range 4-7) and 5.19 (range 3-8), respectively. Sensitivity of MESS in upper and lower extremities were calculated as 80% and 79.4% and positive predictive values detected as 55.55% and 83.3%, respectively. Specificity of MESS score for upper and lower extremities was 84% and 86.6%; negative

Robot-aided assessment of lower extremity functions: a review.

PubMed

Maggioni, Serena; Melendez-Calderon, Alejandro; van Asseldonk, Edwin; Klamroth-Marganska, Verena; Lünenburger, Lars; Riener, Robert; van der Kooij, Herman

2016-08-02

The assessment of sensorimotor functions is extremely important to understand the health status of a patient and its change over time. Assessments are necessary to plan and adjust the therapy in order to maximize the chances of individual recovery. Nowadays, however, assessments are seldom used in clinical practice due to administrative constraints or to inadequate validity, reliability and responsiveness. In clinical trials, more sensitive and reliable measurement scales could unmask changes in physiological variables that would not be visible with existing clinical scores.In the last decades robotic devices have become available for neurorehabilitation training in clinical centers. Besides training, robotic devices can overcome some of the limitations in traditional clinical assessments by providing more objective, sensitive, reliable and time-efficient measurements. However, it is necessary to understand the clinical needs to be able to develop novel robot-aided assessment methods that can be integrated in clinical practice.This paper aims at providing researchers and developers in the field of robotic neurorehabilitation with a comprehensive review of assessment methods for the lower extremities. Among the ICF domains, we included those related to lower extremities sensorimotor functions and walking; for each chapter we present and discuss existing assessments used in routine clinical practice and contrast those to state-of-the-art instrumented and robot-aided technologies. Based on the shortcomings of current assessments, on the identified clinical needs and on the opportunities offered by robotic devices, we propose future directions for research in rehabilitation robotics. The review and recommendations provided in this paper aim to guide the design of the next generation of robot-aided functional assessments, their validation and their translation to clinical practice.

Processing of the WLCG monitoring data using NoSQL

NASA Astrophysics Data System (ADS)

Andreeva, J.; Beche, A.; Belov, S.; Dzhunov, I.; Kadochnikov, I.; Karavakis, E.; Saiz, P.; Schovancova, J.; Tuckett, D.

2014-06-01

The Worldwide LHC Computing Grid (WLCG) today includes more than 150 computing centres where more than 2 million jobs are being executed daily and petabytes of data are transferred between sites. Monitoring the computing activities of the LHC experiments, over such a huge heterogeneous infrastructure, is extremely demanding in terms of computation, performance and reliability. Furthermore, the generated monitoring flow is constantly increasing, which represents another challenge for the monitoring systems. While existing solutions are traditionally based on Oracle for data storage and processing, recent developments evaluate NoSQL for processing large-scale monitoring datasets. NoSQL databases are getting increasingly popular for processing datasets at the terabyte and petabyte scale using commodity hardware. In this contribution, the integration of NoSQL data processing in the Experiment Dashboard framework is described along with first experiences of using this technology for monitoring the LHC computing activities.

Development of an intelligent hydroinformatic system for real-time monitoring and assessment of civil infrastructure

NASA Astrophysics Data System (ADS)

Cahill, Paul; Michalis, Panagiotis; Solman, Hrvoje; Kerin, Igor; Bekic, Damir; Pakrashi, Vikram; McKeogh, Eamon

2017-04-01

With the effects of climate change becoming more apparent, extreme weather events are now occurring with greater frequency throughout the world. Such extreme events have resulted in increased high intensity flood events which are having devastating consequences on hydro-structures, especially on bridge infrastructure. The remote and often inaccessible nature of such bridges makes inspections problematic, a major concern if safety assessments are required during and after extreme flood events. A solution to this is the introduction of smart, low cost sensing solutions at locations susceptible to hydro-hazards. Such solutions can provide real-time information on the health of the bridge and its environments, with such information aiding in the mitigation of the risks associated with extreme weather events. This study presents the development of an intelligent system for remote, real-time monitoring of hydro-hazards to bridge infrastructure. The solution consists of two types of remote monitoring stations which have the capacity to monitor environmental conditions and provide real-time information to a centralized, big data database solution, from which an intelligent decision support system will accommodate the results to control and manage bridge, river and catchment assets. The first device developed as part of the system is the Weather Information Logging Device (WILD), which monitors rainfall, temperature and air and soil moisture content. The ability of the WILD to monitor rainfall in real time enables flood early warning alerts and predictive river flow conditions, thereby enabling decision makers the ability to make timely and effective decisions about critical infrastructures in advance of extreme flood events. The WILD is complemented by a second monitoring device, the Bridge Information Recording Device (BIRD), which monitors water levels at a given location in real-time. The monitoring of water levels of a river allows for, among other applications

Defibrillator/monitor/pacemakers.

PubMed

2002-02-01

Defibrillator/monitors allow operators to assess and monitor a patient's ECG and, when necessary, deliver a defibrillating shock to the heart. When integral noninvasive pacing capability is added, the resulting device is referred to as a defibrillator/monitor/pacemaker. In this Update Evaluation, we present our findings for one newly evaluated model, the Philips Heartstream XL, and we summarize our findings for the seven previously evaluated models that are still on the market. (Our previous Evaluations were published in the May-June 1993, February 1998, and September 2000 issues of Health Devices.) Defibrillator/monitor/pacemakers are used for a variety of applications within the hospital, as well as by emergency medical services (EMS) personnel and others in the prehospital environment. To help both hospital-based and prehospital users select an appropriate model, we rate the models (1) for each of three in-hospital applications--general crash-cart use, in-hospital transport use, and in-hospital use by basic as well as advanced users--and (2) for prehospital (EMS) use. For in-hospital use, we recommend four of the evaluated models. These received either Preferred or Acceptable ratings for all the applications considered. For prehospital use, we found that five of the models will meet most organizations' needs.

Development of laser interferometric high-precision geometry monitor for JASMINE

NASA Astrophysics Data System (ADS)

Niwa, Yoshito; Arai, Koji; Ueda, Akitoshi; Sakagami, Masaaki; Gouda, Naoteru; Kobayashi, Yukiyasu; Yamada, Yoshiyuki; Yano, Taihei

2008-07-01

The telescope geometry of JASMINE should be stabilized and monitored with the accuracy of about 10 to 100 picometer or 10 to 100 picoradian in root-mean-square over about 10 hours. For this purpose, a high-precision interferometric laser metrology system is employed. One of useful techniques for measuring displacements in extremely minute scales is the heterodyne interferometrical method. Experiment for verification of multi degree of freedom measurement was performed and mirror motions were successfully monitored with three degree of freedom.

Remote Monitoring of Cardiac Implantable Electronic Devices.

PubMed

Cheung, Christopher C; Deyell, Marc W

2018-01-08

Over the past decade, technological advancements have transformed the delivery of care for arrhythmia patients. From early transtelephonic monitoring to new devices capable of wireless and cellular transmission, remote monitoring has revolutionized device care. In this article, we review the current evolution and evidence for remote monitoring in patients with cardiac implantable electronic devices. From passive transmission of device diagnostics, to active transmission of patient- and device-triggered alerts, remote monitoring can shorten the time to diagnosis and treatment. Studies have shown that remote monitoring can reduce hospitalization and emergency room visits, and improve survival. Remote monitoring can also reduce the health care costs, while providing increased access to patients living in rural or marginalized communities. Unfortunately, as many as two-thirds of patients with remote monitoring-capable devices do not use, or are not offered, this feature. Current guidelines recommend remote monitoring and interrogation, combined with annual in-person evaluation in all cardiac device patients. Remote monitoring should be considered in all eligible device patients and should be considered standard of care. Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

2016 update of the EULAR recommendations for the management of early arthritis.

PubMed

Combe, Bernard; Landewe, Robert; Daien, Claire I; Hua, Charlotte; Aletaha, Daniel; Álvaro-Gracia, Jose María; Bakkers, Margôt; Brodin, Nina; Burmester, Gerd R; Codreanu, Catalin; Conway, Richard; Dougados, Maxime; Emery, Paul; Ferraccioli, Gianfranco; Fonseca, Joao; Raza, Karim; Silva-Fernández, Lucía; Smolen, Josef S; Skingle, Diana; Szekanecz, Zoltan; Kvien, Tore K; van der Helm-van Mil, Annette; van Vollenhoven, Ronald

2017-06-01

Since the 2007 recommendations for the management of early arthritis have been presented, considerable research has been published in the field of early arthritis, mandating an update of the 2007 European League Against Rheumatism (EULAR) recommendations for management of early arthritis. In accordance with the 2014 EULAR Standardised Operating Procedures, the expert committee pursued an approach that was based on evidence in the literature and on expert opinion. The committee involved 20 rheumatologists, 2 patients and 1 healthcare professional representing 12 European countries. The group defined the focus of the expert committee and target population, formulated a definition of 'management' and selected the research questions. A systematic literature research (SLR) was performed by two fellows with the help of a skilled librarian. A set of draft recommendations was proposed on the basis of the research questions and the results of the SLR. For each recommendation, the categories of evidence were identified, the strength of recommendations was derived and the level of agreement was determined through a voting process. The updated recommendations comprise 3 overarching principles and 12 recommendations for managing early arthritis. The selected statements involve the recognition of arthritis, referral, diagnosis, prognostication, treatment (information, education, pharmacological and non-pharmacological interventions), monitoring and strategy. Eighteen items were identified as relevant for future research. These recommendations provide rheumatologists, general practitioners, healthcare professionals, patients and other stakeholders with an updated EULAR consensus on the entire management of early arthritis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

On the widespread capacity for, and functional significance of, extreme inbreeding in ferns.

PubMed

Sessa, Emily B; Testo, Weston L; Watkins, James E

2016-08-01

Homosporous vascular plants utilize three different mating systems, one of which, gametophytic selfing, is an extreme form of inbreeding only possible in homosporous groups. This mating system results in complete homozygosity in all progeny and has important evolutionary and ecological implications. Ferns are the largest group of homosporous land plants, and the significance of extreme inbreeding for fern evolution has been a subject of debate for decades. We cultured gametophytes in the laboratory and quantified the relative frequencies of sporophyte production from isolated and paired gametophytes, and examined associations between breeding systems and several ecological and evolutionary traits. The majority of fern species studied show a capacity for gametophytic selfing, producing sporophytes from both isolated and paired gametophytes. While we did not follow sporophytes to maturity to investigate potential detrimental effects of homozygosity at later developmental stages, our results suggest that gametophytic selfing may have greater significance for fern evolution and diversification than has previously been realized. We present evidence from the largest study of mating behavior in ferns to date that the capacity for extreme inbreeding is prevalent in this lineage, and we discuss its implications and relevance and make recommendations for future studies of fern mating systems. © 2016 The Authors. New Phytologist © 2016 New Phytologist Trust.

[Therapeutic drug monitoring of levetiracetam].

PubMed

Dailly, Eric; Bouquié, Régis; Bentué-Ferrer, Danièle

2010-01-01

Levetiracetam is an anticonvulsant drug used to treat partial seizures, myoclonic seizures of juvenile myoclonic epilepsy and primary generalized tonic-clonic seizures. A review of the literature with an evidence-based medicine method highlighted parameters (age, renal failure, pregnancy, combination with other anticonvulsant drugs) which affect levetiracetam pharmacokinetics but no significant relationship between plasma concentration of levetiracetam and efficacy or toxicity. Concentrations usually observed in therapeutics is from 6 to 18 mg/L. However, the determination of an individual therapeutic concentration, associated with an effective and well tolerated therapy, could be recommended particularly before pregnancy. Consequently, therapeutic drug monitoring of levetiracetam which is not currently recommended could be possibly useful in specific clinical situations.

Idaho National Laboratory Cultural Resource Monitoring Report for FY 2009

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

Brenda R. Pace; Julie B. Braun

2009-10-01

This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during fiscal year 2009 (FY 2009). Throughout the year, thirty-eight cultural resource localities were revisited including: two locations with Native American human remains, one of which is a cave, two additional caves, twenty-two prehistoric archaeological sites, six historic homesteads, two historic stage stations, two historic trails, and two nuclear resources, including Experimental Breeder Reactor-I, which is a designated National Historic Landmark. Several INL project areas were also monitored in FY 2009 to assess project compliance with cultural resource recommendations and monitormore » the effects of ongoing project activities. Although impacts were documented at a few locations and trespassing citations were issued in one instance, no significant adverse effects that would threaten the National Register eligibility of any resources were observed. Monitoring also demonstrated that several INL projects generally remain in compliance with recommendations to protect cultural resources.« less

WMO World Record Lightning Extremes: Longest Reported Flash Distance and Longest Reported Flash Duration.

PubMed

Lang, Timothy J; Pédeboy, Stéphane; Rison, William; Cerveny, Randall S; Montanyà, Joan; Chauzy, Serge; MacGorman, Donald R; Holle, Ronald L; Ávila, Eldo E; Zhang, Yijun; Carbin, Gregory; Mansell, Edward R; Kuleshov, Yuriy; Peterson, Thomas C; Brunet, Manola; Driouech, Fatima; Krahenbuhl, Daniel S

2017-06-01

A World Meteorological Organization weather and climate extremes committee has judged that the world's longest reported distance for a single lightning flash occurred with a horizontal distance of 321 km (199.5 mi) over Oklahoma in 2007, while the world's longest reported duration for a single lightning flash is an event that lasted continuously for 7.74 seconds over southern France in 2012. In addition, the committee has unanimously recommended amendment of the AMS Glossary of Meteorology definition of lightning discharge as a "series of electrical processes taking place within 1 second" by removing the phrase "within one second" and replacing with "continuously." Validation of these new world extremes (a) demonstrates the recent and on-going dramatic augmentations and improvements to regional lightning detection and measurement networks, (b) provides reinforcement regarding the dangers of lightning, and (c) provides new information for lightning engineering concerns.

Visual Sensing for Urban Flood Monitoring

PubMed Central

Lo, Shi-Wei; Wu, Jyh-Horng; Lin, Fang-Pang; Hsu, Ching-Han

2015-01-01

With the increasing climatic extremes, the frequency and severity of urban flood events have intensified worldwide. In this study, image-based automated monitoring of flood formation and analyses of water level fluctuation were proposed as value-added intelligent sensing applications to turn a passive monitoring camera into a visual sensor. Combined with the proposed visual sensing method, traditional hydrological monitoring cameras have the ability to sense and analyze the local situation of flood events. This can solve the current problem that image-based flood monitoring heavily relies on continuous manned monitoring. Conventional sensing networks can only offer one-dimensional physical parameters measured by gauge sensors, whereas visual sensors can acquire dynamic image information of monitored sites and provide disaster prevention agencies with actual field information for decision-making to relieve flood hazards. The visual sensing method established in this study provides spatiotemporal information that can be used for automated remote analysis for monitoring urban floods. This paper focuses on the determination of flood formation based on image-processing techniques. The experimental results suggest that the visual sensing approach may be a reliable way for determining the water fluctuation and measuring its elevation and flood intrusion with respect to real-world coordinates. The performance of the proposed method has been confirmed; it has the capability to monitor and analyze the flood status, and therefore, it can serve as an active flood warning system. PMID:26287201

Analysis of extreme rain and flood events using a regional hydrologically enhanced hydrometeorological system

NASA Astrophysics Data System (ADS)

Yucel, Ismail; Onen, Alper

2013-04-01

Evidence is showing that global warming or climate change has a direct influence on changes in precipitation and the hydrological cycle. Extreme weather events such as heavy rainfall and flooding are projected to become much more frequent as climate warms. Regional hydrometeorological system model which couples the atmosphere with physical and gridded based surface hydrology provide efficient predictions for extreme hydrological events. This modeling system can be used for flood forecasting and warning issues as they provide continuous monitoring of precipitation over large areas at high spatial resolution. This study examines the performance of the Weather Research and Forecasting (WRF-Hydro) model that performs the terrain, sub-terrain, and channel routing in producing streamflow from WRF-derived forcing of extreme precipitation events. The capability of the system with different options such as data assimilation is tested for number of flood events observed in basins of western Black Sea Region in Turkey. Rainfall event structures and associated flood responses are evaluated with gauge and satellite-derived precipitation and measured streamflow values. The modeling system shows skills in capturing the spatial and temporal structure of extreme rainfall events and resulted flood hydrographs. High-resolution routing modules activated in the model enhance the simulated discharges.

History of ozone injury monitoring methods and the development of a recommended protocol

Treesearch

Daniel Duriscoe; Kenneth Stolte; John Pronos

1996-01-01

The minimum requirement for long–term monitoring of air pollution effects on forest stands is to develop methods for observers to locate, evaluate, and re–evaluate individual trees at intervals of one or more years. Studies of this nature have used permanent quadrats or "plots" in which individual plants are tagged or mapped. Multiple levels of information...

Bolt Stress Monitor

NASA Technical Reports Server (NTRS)

1978-01-01

In photo, an engineer is using a new Ultrasonic Bolt Stress Monitor developed by NASA's Langley Research Center to determine whether a bolt is properly tightened. A highly accurate device, the monitor is an important tool in construction of such structures as pressure vessels, bridges and power plants, wherein precise measurement of the stress on a tightened bolt is critical. Overtightened or undertightened bolts can fail and cause serious industrial accidents or costly equipment break-downs. There are a number of methods for measuring bolt stress. Most widely used and least costly is the torque wrench, which is inherently inaccurate; it does not take into account the friction between nut and bolt, which has an influence on stress. At the other end of the spectrum, there are accurate stress-measuring systems, but they are expensive and not portable. The battery-powered Langley monitor fills a need; it is inexpensive, lightweight, portable and extremely accurate because it is not subject to friction error. Sound waves are transmitted to the bolt and a return signal is received. As the bolt is tightened, it undergoes changes in resonance due to stress, in the manner that a violin string changes tone when it is tightened. The monitor measures the changes in resonance and provides a reading of real stress on the bolt. The device, patented by NASA, has aroused wide interest and a number of firms have applied for licenses to produce it for the commercial market.

Review of present groundwater monitoring programs at the Nevada Test Site

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

Hershey, R.L.; Gillespie, D.

1993-09-01

Groundwater monitoring at the Nevada Test Site (NTS) is conducted to detect the presence of radionuclides produced by underground nuclear testing and to verify the quality and safety of groundwater supplies as required by the State of Nevada and federal regulations, and by U.S. Department of Energy (DOE) Orders. Groundwater is monitored at water-supply wells and at other boreholes and wells not specifically designed or located for traditional groundwater monitoring objectives. Different groundwater monitoring programs at the NTS are conducted by several DOE Nevada Operations Office (DOE/NV) contractors. Presently, these individual groundwater monitoring programs have not been assessed or administeredmore » under a comprehensive planning approach. Redundancy exists among the programs in both the sampling locations and the constituents analyzed. Also, sampling for certain radionuclides is conducted more frequently than required. The purpose of this report is to review the existing NTS groundwater monitoring programs and make recommendations for modifying the programs so a coordinated, streamlined, and comprehensive monitoring effort may be achieved by DOE/NV. This review will be accomplished in several steps. These include: summarizing the present knowledge of the hydrogeology of the NTS and the potential radionuclide source areas for groundwater contamination; reviewing the existing groundwater monitoring programs at the NTS; examining the rationale for monitoring and the constituents analyzed; reviewing the analytical methods used to quantify tritium activity; discussing monitoring network design criteria; and synthesizing the information presented and making recommendations based on the synthesis. This scope of work was requested by the DOE/NV Hydrologic Resources Management Program (HRMP) and satisfies the 1993 (fiscal year) HRMP Groundwater Monitoring Program Review task.« less

Current practice and recommendations in UK epilepsy monitoring units. Report of a national survey and workshop.

PubMed

Hamandi, Khalid; Beniczky, Sandor; Diehl, Beate; Kandler, Rosalind H; Pressler, Ronit M; Sen, Arjune; Solomon, Juliet; Walker, Matthew C; Bagary, Manny

2017-08-01

Inpatient video-EEG monitoring (VEM) is an important investigation in patients with seizures or blackouts, and in the pre-surgical workup of patients with epilepsy. There has been an expansion in the number of Epilepsy Monitoring Units (EMU) in the UK offering VEM with a necessary increase in attention on quality and safety. Previous surveys have shown variation across centres on issues including consent and patient monitoring. In an effort to bring together healthcare professionals in the UK managing patients on EMU, we conducted an online survey of current VEM practice and held a one-day workshop convened under the auspices of the British Chapter of the ILAE. The survey and workshop aimed to cover all aspects of VEM, including pre-admission, consent procedures, patient safety, drug reduction and reinstatement, seizure management, staffing levels, ictal testing and good data recording practice. This paper reports on the findings of the survey, the workshop presentations and workshop discussions. 32 centres took part in the survey and there were representatives from 22 centres at the workshop. There was variation in protocols, procedures and consent processes between units, and levels of observation of monitored patients. Nevertheless, the workshop discussion found broad areas of agreement on points. A survey and workshop of UK epilepsy monitoring units found that some variability in practice is inevitable due to different local arrangements and patient groups under investigation. However, there were areas of clear consensus particularly in relation to consent and patient safety that can be applied to most units and form a basis for setting minimum standards. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Surface Acoustic Wave Monitor for Deposition and Analysis of Ultra-Thin Films

NASA Technical Reports Server (NTRS)

Hines, Jacqueline H. (Inventor)

2015-01-01

A surface acoustic wave (SAW) based thin film deposition monitor device and system for monitoring the deposition of ultra-thin films and nanomaterials and the analysis thereof is characterized by acoustic wave device embodiments that include differential delay line device designs, and which can optionally have integral reference devices fabricated on the same substrate as the sensing device, or on a separate device in thermal contact with the film monitoring/analysis device, in order to provide inherently temperature compensated measurements. These deposition monitor and analysis devices can include inherent temperature compensation, higher sensitivity to surface interactions than quartz crystal microbalance (QCM) devices, and the ability to operate at extreme temperatures.

Tropical river suspended sediment and solute dynamics in storms during an extreme drought

NASA Astrophysics Data System (ADS)

Clark, Kathryn E.; Shanley, James B.; Scholl, Martha A.; Perdrial, Nicolas; Perdrial, Julia N.; Plante, Alain F.; McDowell, William H.

2017-05-01

Droughts, which can strongly affect both hydrologic and biogeochemical systems, are projected to become more prevalent in the tropics in the future. We assessed the effects of an extreme drought during 2015 on stream water composition in the Luquillo Mountains of Puerto Rico. We demonstrated that drought base flow in the months leading up to the study was sourced from trade-wind orographic rainfall, suggesting a resistance to the effects of an otherwise extreme drought. In two catchments (Mameyes and Icacos), we sampled a series of four rewetting events that partially alleviated the drought. We collected and analyzed dissolved constituents (major cations and anions, organic carbon, and nitrogen) and suspended sediment (inorganic and organic matter (particulate organic carbon and particulate nitrogen)). The rivers appeared to be resistant to extreme drought, recovering quickly upon rewetting, as (1) the concentration-discharge (C-Q) relationships deviated little from the long-term patterns; (2) "new water" dominated streamflow during the latter events; (3) suspended sediment sources had accumulated in the channel during the drought flushed out during the initial events; and (4) the severity of the drought, as measured by the US drought monitor, was reduced dramatically after the rewetting events. Through this interdisciplinary study, we were able to investigate the impact of extreme drought through rewetting events on the river biogeochemistry.

Tropical river suspended sediment and solute dynamics in storms during an extreme drought

USGS Publications Warehouse

Clark, Kathryn E.; Shanley, James B.; Scholl, Martha A.; Perdrial, Nicolas; Perdrial, Julia N.; Plante, Alain F.; McDowell, William H.

2017-01-01

Droughts, which can strongly affect both hydrologic and biogeochemical systems, are projected to become more prevalent in the tropics in the future. We assessed the effects of an extreme drought during 2015 on stream water composition in the Luquillo Mountains of Puerto Rico. We demonstrated that drought base flow in the months leading up to the study was sourced from trade-wind orographic rainfall, suggesting a resistance to the effects of an otherwise extreme drought. In two catchments (Mameyes and Icacos), we sampled a series of four rewetting events that partially alleviated the drought. We collected and analyzed dissolved constituents (major cations and anions, organic carbon, and nitrogen) and suspended sediment (inorganic and organic matter (particulate organic carbon and particulate nitrogen)). The rivers appeared to be resistant to extreme drought, recovering quickly upon rewetting, as (1) the concentration-discharge (C-Q) relationships deviated little from the long-term patterns; (2) “new water” dominated streamflow during the latter events; (3) suspended sediment sources had accumulated in the channel during the drought flushed out during the initial events; and (4) the severity of the drought, as measured by the US drought monitor, was reduced dramatically after the rewetting events. Through this interdisciplinary study, we were able to investigate the impact of extreme drought through rewetting events on the river biogeochemistry.

Current practices in laboratory monitoring of HIV infection

PubMed Central

Vajpayee, Madhu; Mohan, Teena

2011-01-01

After a diagnosis of HIV infection is made, the patient needs to be monitored using both clinical assessment and laboratory markers. HIV/AIDS monitoring is essential in guiding when to recommend initiation of therapy. Clinical monitoring will include staging of the HIV/AIDS disease using either the presence or absence of HIV-related signs and symptoms using the WHO staging system. Various laboratory methods can be used to monitor the disease progression and to guide whether the patient will need antiretroviral therapy or not. Laboratory monitoring for patients who are not on drugs is done to provide information about the stage of illness; to enable the clinician to make decisions on treatment and to give information on prognosis of the patient. Patients on drugs are monitored to assess their response to treatment with antiretroviral drugs and to detect any possible toxicity and improvement associated with the antiretroviral drugs. PMID:22310815

Strategies to assess the validity of recommendations: a study protocol

PubMed Central

2013-01-01

Background Clinical practice guidelines (CPGs) become quickly outdated and require a periodic reassessment of evidence research to maintain their validity. However, there is little research about this topic. Our project will provide evidence for some of the most pressing questions in this field: 1) what is the average time for recommendations to become out of date?; 2) what is the comparative performance of two restricted search strategies to evaluate the need to update recommendations?; and 3) what is the feasibility of a more regular monitoring and updating strategy compared to usual practice?. In this protocol we will focus on questions one and two. Methods The CPG Development Programme of the Spanish Ministry of Health developed 14 CPGs between 2008 and 2009. We will stratify guidelines by topic and by publication year, and include one CPG by strata. We will develop a strategy to assess the validity of CPG recommendations, which includes a baseline survey of clinical experts, an update of the original exhaustive literature searches, the identification of key references (reference that trigger a potential recommendation update), and the assessment of the potential changes in each recommendation. We will run two alternative search strategies to efficiently identify important new evidence: 1) PLUS search based in McMaster Premium LiteratUre Service (PLUS) database; and 2) a Restrictive Search (ReSe) based on the least number of MeSH terms and free text words needed to locate all the references of each original recommendation. We will perform a survival analysis of recommendations using the Kaplan-Meier method and we will use the log-rank test to analyse differences between survival curves according to the topic, the purpose, the strength of recommendations and the turnover. We will retrieve key references from the exhaustive search and evaluate their presence in the PLUS and ReSe search results. Discussion Our project, using a highly structured and transparent

Representing Extremes in Agricultural Models

NASA Technical Reports Server (NTRS)

Ruane, Alex

2015-01-01

AgMIP and related projects are conducting several activities to understand and improve crop model response to extreme events. This involves crop model studies as well as the generation of climate datasets and scenarios more capable of capturing extremes. Models are typically less responsive to extreme events than we observe, and miss several forms of extreme events. Models also can capture interactive effects between climate change and climate extremes. Additional work is needed to understand response of markets and economic systems to food shocks. AgMIP is planning a Coordinated Global and Regional Assessment of Climate Change Impacts on Agricultural Production and Food Security with an aim to inform the IPCC Sixth Assessment Report.

Extreme Mean and Its Applications

NASA Technical Reports Server (NTRS)

Swaroop, R.; Brownlow, J. D.

1979-01-01

Extreme value statistics obtained from normally distributed data are considered. An extreme mean is defined as the mean of p-th probability truncated normal distribution. An unbiased estimate of this extreme mean and its large sample distribution are derived. The distribution of this estimate even for very large samples is found to be nonnormal. Further, as the sample size increases, the variance of the unbiased estimate converges to the Cramer-Rao lower bound. The computer program used to obtain the density and distribution functions of the standardized unbiased estimate, and the confidence intervals of the extreme mean for any data are included for ready application. An example is included to demonstrate the usefulness of extreme mean application.

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association.

PubMed

Sandau, Kristin E; Funk, Marjorie; Auerbach, Andrew; Barsness, Gregory W; Blum, Kay; Cvach, Maria; Lampert, Rachel; May, Jeanine L; McDaniel, George M; Perez, Marco V; Sendelbach, Sue; Sommargren, Claire E; Wang, Paul J

2017-11-07

This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Many of the recommendations are based on limited data, so authors conclude with specific questions for further research. © 2017 American Heart Association, Inc.

Report from the NOAA workshops to standardize protocols for monitoring toxic Pfiesteria species and associated environmental conditions.

PubMed

Luttenberg, D; Turgeon, D; Higgins, J

2001-10-01

Long-term monitoring of water quality, fish health, and plankton communities in susceptible bodies of water is crucial to identify the environmental factors that contribute to outbreaks of toxic Pfiesteria complex (TPC) species. In the aftermath of the 1997 toxic Pfiesteria outbreaks in North Carolina and Maryland, federal and several state agencies agreed that there was a need to standardize monitoring protocols. The National Oceanic & Atmospheric Administration convened two workshops that brought together state, federal, and academic resource managers and scientific experts to a) seek consensus on responding to and monitoring potential toxic Pfiesteria outbreaks; b) recommend standard parameters and protocols to characterize water quality, fish health, and plankton at historical event sites and potentially susceptible sites; and c) discuss options for integrating monitoring data sets from different states into regional and national assessments. Workshop recommendations included the development of a three-tiered TPC monitoring strategy: Tier 1, rapid event response; Tier 2, comprehensive assessment; and Tier 3, routine monitoring. These tiers correspond to varying levels of water quality, fish health, and plankton monitoring frequency and intensity. Under the strategy, sites are prioritized, depending upon their history and susceptibility to TPC events, and assigned an appropriate level of monitoring activity. Participants also agreed upon a suite of water quality parameters that should be monitored. These recommendations provide guidance to state and federal agencies conducting rapid-response and assessment activities at sites of suspected toxic Pfiesteria outbreaks, as well as to states that are developing such monitoring programs for the first time.

Reliability of the mangled extremity severity score in combat-related upper and lower extremity injuries

PubMed Central

Ege, Tolga; Unlu, Aytekin; Tas, Huseyin; Bek, Dogan; Turkan, Selim; Cetinkaya, Aytac

2015-01-01

Background: Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS). However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the environmental circumstance. The purpose of the retrospective study was to evaluate the extent of extremity injuries due to ballistic missiles and to detect the reliability of mangled extremity severity score (MESS) in both upper and lower extremities. Materials and Methods: Between 2004 and 2014, 139 Gustillo Anderson Type III open fractures of both the upper and lower extremities were enrolled in the study. Data for patient age, fire arm type, transporting time from the field to the hospital (and the method), injury severity scores, MESS scores, fracture types, amputation levels, bone fixation methods and postoperative infections and complications retrieved from the two level-2 trauma center's data base. Sensitivity, specificity, positive and negative predictive values of the MESS were calculated to detect the ability in deciding amputation in the mangled limb. Results: Amputation was performed in 39 extremities and limb salvage attempted in 100 extremities. The mean followup time was 14.6 months (range 6–32 months). In the amputated group, the mean MESS scores for upper and lower extremity were 8.8 (range 6–11) and 9.24 (range 6–11), respectively. In the limb salvage group, the mean MESS scores for upper and lower extremities were 5.29 (range 4–7) and 5.19 (range 3–8), respectively. Sensitivity of MESS in upper and lower extremities were calculated as 80% and 79.4% and positive predictive values detected as 55.55% and 83.3%, respectively. Specificity of MESS score for

Amputation: Not a failure for severe lower extremity combat injury.

PubMed

van Dongen, Thijs T C F; Huizinga, Eelco P; de Kruijff, Loes G M; van der Krans, Arie C; Hoogendoorn, Jochem M; Leenen, Luke P H; Hoencamp, Rigo

2017-02-01

The use of improvised explosive devices is a frequent method of insurgents to inflict harm on deployed military personnel. Consequently, lower extremity injuries make up the majority of combat related trauma. The wounding pattern of an explosion is not often encountered in a civilian population and can lead to substantial disability. It is therefore important to study the impact of these lower extremity injuries and their treatment (limb salvage versus amputation) on functional outcome and quality of life. All Dutch repatriated service members receiving treatment for wounds on the lower extremity sustained in the Afghan theater between august 2005 and August 2014, were invited to participate in this observational cohort study. We conducted a survey regarding their physical and mental health using the Short Form health survey 36, EuroQoL 6 dimensions and Lower Extremity Functional Scale questionnaires. Results were collated in a specifically designed electronic database combined with epidemiology and hospital statistics gathered from the archive of the Central Military Hospital. Statistical analyses were performed to identify differences between combat and non-combat related injuries and between limb salvage treatment and amputation. In comparison with non-battle injury patients, battle casualties were significantly younger of age, sustained more severe injuries, needed more frequent operations and clinical rehabilitation. Their long-term outcome scores in areas concerning well-being, social and cognitive functioning, were significantly lower. Regarding treatment, amputees experienced higher physical well-being and less pain compared to those treated with limb salvage surgery. Sustaining a combat injury to the lower extremity can lead to partial or permanent dysfunction. However, wounded service members, amputees included, are able to achieve high levels of activity and participation in society, proving a remarkable resilience. These long-term results demonstrate

HIV Treatment and Prevention: An Overview of Recommendations From the 2016 IAS–USA Antiretroviral Guidelines Panel

PubMed Central

Volberding, Paul A.

2017-01-01

Updated recommendations from the IAS–USA Antiretroviral Guidelines Panel on antiretroviral therapy for the treatment and prevention of HIV infection in adults were published in the Journal of the American Medical Association in 2016. The updated, evidence-based recommendations address when to initiate antiretroviral therapy, recommended initial antiretroviral regimens, including integrase strand transfer inhibitor (InSTI)-based regimens, recommended regimens for persons in whom an InSTI is not an option, and special treatment considerations. The interface between antiretroviral therapy and opportunistic infections, when and how to switch antiretroviral therapy, laboratory monitoring, engagement in care, adherence to antiretroviral therapy, and use of antiretroviral therapy as HIV prevention are also discussed, as well as future directions in HIV treatment. This article summarizes an IAS–USA continuing education webinar presented by Paul A. Volberding, MD, in August 2016. PMID:28402930

The Extreme Climate Index: a novel and multi-hazard index for extreme weather events.

NASA Astrophysics Data System (ADS)

Cucchi, Marco; Petitta, Marcello; Calmanti, Sandro

2017-04-01

In this presentation we introduce the Extreme Climate Index (ECI): an objective, multi-hazard index capable of tracking changes in the frequency or magnitude of extreme weather events in African countries, thus indicating that a shift to a new climate regime is underway in a particular area. This index has been developed in the context of XCF (eXtreme Climate Facilities) project lead by ARC (African Risk Capacity, specialised agency of the African Union), and will be used in the payouts triggering mechanism of an insurance programme against risks related to the increase of frequency and magnitude of extreme weather events due to climate regimes' changes. The main hazards covered by ECI will be extreme dry, wet and heat events, with the possibility of adding region-specific risk events such as tropical cyclones for the most vulnerable areas. It will be based on data coming from consistent, sufficiently long, high quality historical records and will be standardized across broad geographical regions, so that extreme events occurring under different climatic regimes in Africa can be comparable. The first step to construct such an index is to define single hazard indicators. In this first study we focused on extreme dry/wet and heat events, using for their description respectively the well-known SPI (Standardized Precipitation Index) and an index developed by us, called SHI (Standardized Heat-waves Index). The second step consists in the development of a computational strategy to combine these, and possibly other indices, so that the ECI can describe, by means of a single indicator, different types of climatic extremes. According to the methodology proposed in this paper, the ECI is defined by two statistical components: the ECI intensity, which indicates whether an event is extreme or not; the angular component, which represent the contribution of each hazard to the overall intensity of the index. The ECI can thus be used to identify "extremes" after defining a

A review on emerging contaminants in wastewaters and the environment: current knowledge, understudied areas and recommendations for future monitoring.

PubMed

Petrie, Bruce; Barden, Ruth; Kasprzyk-Hordern, Barbara

2015-04-01

This review identifies understudied areas of emerging contaminant (EC) research in wastewaters and the environment, and recommends direction for future monitoring. Non-regulated trace organic ECs including pharmaceuticals, illicit drugs and personal care products are focused on due to ongoing policy initiatives and the expectant broadening of environmental legislation. These ECs are ubiquitous in the aquatic environment, mainly derived from the discharge of municipal wastewater effluents. Their presence is of concern due to the possible ecological impact (e.g., endocrine disruption) to biota within the environment. To better understand their fate in wastewaters and in the environment, a standardised approach to sampling is needed. This ensures representative data is attained and facilitates a better understanding of spatial and temporal trends of EC occurrence. During wastewater treatment, there is a lack of suspended particulate matter analysis due to further preparation requirements and a lack of good analytical approaches. This results in the under-reporting of several ECs entering wastewater treatment works (WwTWs) and the aquatic environment. Also, sludge can act as a concentrating medium for some chemicals during wastewater treatment. The majority of treated sludge is applied directly to agricultural land without analysis for ECs. As a result there is a paucity of information on the fate of ECs in soils and consequently, there has been no driver to investigate the toxicity to exposed terrestrial organisms. Therefore a more holistic approach to environmental monitoring is required, such that the fate and impact of ECs in all exposed environmental compartments are studied. The traditional analytical approach of applying targeted screening with low resolution mass spectrometry (e.g., triple quadrupoles) results in numerous chemicals such as transformation products going undetected. These can exhibit similar toxicity to the parent EC, demonstrating the necessity

Surveillance Recommendations for Children with Overgrowth Syndromes and Predisposition to Wilms Tumors and Hepatoblastoma.

PubMed

Kalish, Jennifer M; Doros, Leslie; Helman, Lee J; Hennekam, Raoul C; Kuiper, Roland P; Maas, Saskia M; Maher, Eamonn R; Nichols, Kim E; Plon, Sharon E; Porter, Christopher C; Rednam, Surya; Schultz, Kris Ann P; States, Lisa J; Tomlinson, Gail E; Zelley, Kristin; Druley, Todd E

2017-07-01

A number of genetic syndromes have been linked to increased risk for Wilms tumor (WT), hepatoblastoma (HB), and other embryonal tumors. Here, we outline these rare syndromes with at least a 1% risk to develop these tumors and recommend uniform tumor screening recommendations for North America. Specifically, for syndromes with increased risk for WT, we recommend renal ultrasounds every 3 months from birth (or the time of diagnosis) through the seventh birthday. For HB, we recommend screening with full abdominal ultrasound and alpha-fetoprotein serum measurements every 3 months from birth (or the time of diagnosis) through the fourth birthday. We recommend that when possible, these patients be evaluated and monitored by cancer predisposition specialists. At this time, these recommendations are not based on the differential risk between different genetic or epigenetic causes for each syndrome, which some European centers have implemented. This differentiated approach largely represents distinct practice environments between the United States and Europe, and these guidelines are designed to be a broad framework within which physicians and families can work together to implement specific screening. Further study is expected to lead to modifications of these recommendations. Clin Cancer Res; 23(13); e115-e22. ©2017 AACR See all articles in the online-only CCR Pediatric Oncology Series . ©2017 American Association for Cancer Research.

Context-aware recommender system based on ontology for recommending tourist destinations at Bandung

NASA Astrophysics Data System (ADS)

Rizaldy Hafid Arigi, L.; Abdurahman Baizal, Z. K.; Herdiani, Anisa

2018-03-01

Recommender System is software that is able to provide personalized recommendation suits users’ needs. Recommender System has been widely implemented in various domains, including tourism. One approach that can be done for more personalized recommendations is the use of contextual information. This paper proposes a context aware recommender based ontology system in the tourism domain. The system is capable of recommending tourist destinations by using user preferences of the categories of tourism and contextual information such as user locations, weather around tourist destinations and close time of destination. Based on the evaluation, the system has accuracy of of 0.94 (item recommendation precision evaluated by expert) and 0.58 (implicitly from system-end user interaction). Based on the evaluation of user satisfaction, the system provides a satisfaction level of more than 0.7 (scale 0 to 1) for speed factors for providing liked recommendations (PE), informative description of recommendations (INF) and user trust (TR).

Treat-to-target (T2T) recommendations for gout.

PubMed

Kiltz, U; Smolen, J; Bardin, T; Cohen Solal, A; Dalbeth, N; Doherty, M; Engel, B; Flader, C; Kay, J; Matsuoka, M; Perez-Ruiz, F; da Rocha Castelar-Pinheiro, G; Saag, K; So, A; Vazquez Mellado, J; Weisman, M; Westhoff, T H; Yamanaka, H; Braun, J

2017-04-01

The treat-to-target (T2T) concept has been applied successfully in several inflammatory rheumatic diseases. Gout is a chronic disease with a high burden of pain and inflammation. Because the pathogenesis of gout is strongly related to serum urate levels, gout may be an ideal disease in which to apply a T2T approach. Our aim was to develop international T2T recommendations for patients with gout. A committee of experts with experience in gout agreed upon potential targets and outcomes, which was the basis for the systematic literature search. Eleven rheumatologists, one cardiologist, one nephrologist, one general practitioner and one patient met in October 2015 to develop T2T recommendations based on the available scientific evidence. Levels of evidence, strength of recommendations and levels of agreement were derived. Although no randomised trial was identified in which a comparison with standard treatment or an evaluation of a T2T approach had been performed in patients with gout, indirect evidence was provided to focus on targets such as normalisation of serum urate levels. The expert group developed four overarching principles and nine T2T recommendations. They considered dissolution of crystals and prevention of flares to be fundamental; patient education, ensuring adherence to medications and monitoring of serum urate levels were also considered to be of major importance. This is the first application of the T2T approach developed for gout. Since no publication reports a trial comparing treatment strategies for gout, highly credible overarching principles and level D expert recommendations were created and agreed upon. 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/.

Moving in extreme environments: what's extreme and who decides?

PubMed

Cotter, James David; Tipton, Michael J

2014-01-01

Humans work, rest and play in immensely varied extreme environments. The term 'extreme' typically refers to insufficiency or excess of one or more stressors, such as thermal energy or gravity. Individuals' behavioural and physiological capacity to endure and enjoy such environments varies immensely. Adverse effects of acute exposure to these environments are readily identifiable (e.g. heat stroke or bone fracture), whereas adverse effects of chronic exposure (e.g. stress fractures or osteoporosis) may be as important but much less discernable. Modern societies have increasingly sought to protect people from such stressors and, in that way, minimise their adverse effects. Regulations are thus established, and advice is provided on what is 'acceptable' exposure. Examples include work/rest cycles in the heat, hydration regimes, rates of ascent to and duration of stay at altitude and diving depth. While usually valuable and well intentioned, it is important to realise the breadth and importance of limitations associated with such guidelines. Regulations and advisories leave less room for self-determination, learning and perhaps adaptation. Regulations based on stress (e.g. work/rest cycles relative to WBGT) are more practical but less direct than those based on strain (e.g. core temperature), but even the latter can be substantively limited (e.g. by lack of criterion validation and allowance for behavioural regulation in the research on which they are based). Extreme Physiology & Medicine is publishing a series of reviews aimed at critically examining the issues involved with self- versus regulation-controlled human movement acutely and chronically in extreme environments. These papers, arising from a research symposium in 2013, are about the impact of people engaging in such environments and the effect of rules and guidelines on their safety, enjoyment, autonomy and productivity. The reviews will cover occupational heat stress, sporting heat stress, hydration, diving

Recommendations for the use of ultrasound and magnetic resonance in patients with rheumatoid arthritis.

PubMed

Möller, Ingrid; Loza, Estibaliz; Uson, Jacqueline; Acebes, Carlos; Andreu, Jose Luis; Batlle, Enrique; Bueno, Ángel; Collado, Paz; Fernández-Gallardo, Juan Manuel; González, Carlos; Jiménez Palop, Mercedes; Lisbona, María Pilar; Macarrón, Pilar; Maymó, Joan; Narváez, Jose Antonio; Navarro-Compán, Victoria; Sanz, Jesús; Rosario, M Piedad; Vicente, Esther; Naredo, Esperanza

To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA). Recommendations were generated following a nominal group technique. A panel of experts, consisting of 15 rheumatologists and 3 radiologists, was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents). A first draft of recommendations and text was generated. Then, an electronic Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% of experts voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. The full text was circulated and reviewed by the panel. The consensus was coordinated by an expert methodologist. A total of 20 recommendations were proposed. They include the validity of US and MRI regarding inflammation and damage detection, diagnosis, prediction (structural damage progression, flare, treatment response, etc.), monitoring and the use of US guided injections/biopsies. These recommendations will help clinicians use US and MRI in RA patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Educational Evaluation and Assessment in the United States. Position Paper and Recommendations for Action.

ERIC Educational Resources Information Center

Council of Chief State School Officers, Washington, DC.

The lack of high quality data to describe and monitor U.S. educational systems hampers reform decisions and will impair reform evaluation. This paper sets forth the Council of Chief State School Officers' (CCSSO) recommendations for the Council and federal, state, and local education agencies to help improve the quality of educational indicators.…

Recommendations for presymptomatic genetic testing and management of individuals at risk for hereditary transthyretin amyloidosis.

PubMed

Obici, Laura; Kuks, Jan B; Buades, Juan; Adams, David; Suhr, Ole B; Coelho, Teresa; Kyriakides, Theodore

2016-02-01

These recommendations highlight recent experience in genetic counselling for the severe autosomal-dominant, late-onset transthyretin familial amyloid polyneuropathy (TTR-FAP) disease, and present a structured approach towards identification and monitoring of asymptomatic carriers of the mutated gene. The effectiveness of current treatment options is still limited in patients with TTR-FAP beyond stage I. Diagnosis in the early stages of TTR-FAP is essential to prevent or delay the progression of disease. Existing legal and cultural issues differ among countries within Europe. Experts of the European Network for TTR-FAP (ATTReuNET) concluded that genetic counselling for diagnosed individuals and at-risk family members is mostly beneficial and should be carried out with care by trained professionals. Systematic and regular monitoring of an asymptomatic carrier is necessary to detect early signs of TTR-FAP and maximize the effectiveness of treatment. This includes five areas of assessment: history/clinical examination, sensorimotor function, autonomic dysfunction, cardiac function, and renal function. At least two related symptoms and positive biopsy findings are required to confirm diagnosis of TTR-FAP. Early detection of TTR-FAP is essential to improve the prognosis of TTR-FAP. ATTReuNET recommends genetic counselling and routine monitoring for asymptomatic carriers of TTR-FAP.

Development of a video decision aid to inform parents on potential outcomes of extreme prematurity.

PubMed

Guillén, Ú; Suh, S; Wang, E; Stickelman, V; Kirpalani, H

2016-11-01

The objective of the study is to develop and validate a video-based parental decision aid about the outcomes of extremely premature infants. Thirty-one clinicians and 30 parents of extremely premature infants (<26 weeks gestation) previously underwent semi-structured interviews to assess perceptions of antenatal counseling. Interviewees recommended a video. A video was iteratively developed, with final validation by three groups: clinicians (n=16), parents with a history of extreme prematurity (n=14) and healthy 'naïve' women without prior knowledge of prematurity (n=13). Two iterations of the video were created. Following a simulated counseling session, an eight-question survey and the State-Trait Anxiety Inventory (STAI) were administered to parents and 'naïve' participants to assess usefulness and stress provocation. The final 10-min video shows six children/parent dyads of former 23 to 25 week premature children with a wide range of outcomes. This video was well accepted by clinicians as well as parent and 'naïve' participants, who perceived it as 'balanced' with a 'neutral' message. The video was felt to provide useful information and insight on prematurity. The final version of the video did not induce anxiety: parents STAI-S 36.1±12.1; 'naïve' 30.2±8.9. A short video showing the range of outcomes of extreme prematurity has been produced. It is well accepted and does not increase levels of anxiety as measured by the STAI. This video may be a useful and non-stress-inducing aid at the time of counseling parents facing extreme prematurity.

Assessment of extreme quantitative precipitation forecasts and development of regional extreme event thresholds using data from HMT-2006 and COOP observers

USGS Publications Warehouse

Ralph, F.M.; Sukovich, E.; Reynolds, D.; Dettinger, M.; Weagle, S.; Clark, W.; Neiman, P.J.

2010-01-01

found that the thresholds for the top 1% and top 0.1%of precipitation events were 7.6 cm (24 h)21 [3.0 in. (24 h)-1] and 14.2 cm (24 h)-1 [5.6 in. (24 h)-1] or greater for the CNRFC and only 5.1 cm (24 h)-1 [2.0 in. (24 h)-1] and 9.4 cm (24 h)-1 [3.7 in. (24 h)-1] for the NWRFC, respectively. Similar analyses for all NWS RFCs showed that the threshold for the top 1% of events varies from;3.8 cm (24 h)-1 [1.5 in. (24 h)-1] in the Colorado Basin River Forecast Center (CBRFC) to~5.1 cm (24 h)-1 [3.0 in. (24 h)-1] in the northern tier of RFCs and;7.6 cm (24 h)-1 [3.0 in. (24 h)-1] in both the southern tier and the CNRFC. It is recommended that NWS QPF performance in the future be assessed for extreme events using these thresholds. ?? 2010 American Meteorological Society.

Are Adults Diagnosed with Diabetes achieving the American Diabetes Association Clinical Practice Recommendations?

PubMed Central

Pérez, Cynthia M.; Febo-Vázquez, Isaedmarie; Guzmán, Manuel; Ortiz, Ana Patricia; Suárez, Erick

2012-01-01

Objective This study assessed the proportion of adults with previously diagnosed diabetes mellitus (DM) who met selected preventive practices and treatment goals according to the American Diabetes Association (ADA) standards of medical care. Methods A secondary analysis of data collected for a previous epidemiologic study that used a probability cluster design to select 859 persons aged 21–79 years in the San Juan metropolitan area was undertaken. This study focused on 136 (15.8%) adults who self-reported DM. The Standards of Medical Care in Diabetes published by the ADA in 2011 were used to determine the proportion of adults achieving selected clinical practice recommendations. Results Less than half of adults achieved recommended treatment goals for LDL-cholesterol (47.8%), HDL-cholesterol (44.1%), blood pressure (41.2%) and HbA1c (28.7%). The percentage of adults achieving recommended levels of HbA1c, blood pressure and LDL-cholesterol simultaneously was 6.6%; the percentage achieving HbA1c, blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides and albumin-to-creatinine ratio target levels was only 2.2%. More than half (60.2%) reported daily self-monitoring of foot ulcers and HbA1c testing at least twice over the past year (52.3%). However, less than half reported annual dilated eye examination (49.2%), annual comprehensive foot examination (43.8%), daily self-monitoring blood glucose (37.5%), moderate or vigorous physical activity (33.8%), and self-management DM education (28.9%). Conclusion This study showed that a substantial proportion of adults with DM did not achieve ADA recommendations on selected preventive practices and treatment goals. Strategies to improve DM medical care and surveillance of preventive-care practices and treatment goals among affected individuals are essential for planning further initiatives that contribute to reduce the burden of DM complications. PMID:22432404

International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process.

PubMed

Howell, Ann-Marie; Burns, Elaine M; Hull, Louise; Mayer, Erik; Sevdalis, Nick; Darzi, Ara

2017-02-01

Patient safety incident reporting systems (PSRS) have been established for over a decade, but uncertainty remains regarding the role that they can and ought to play in quantifying healthcare-related harm and improving care. To establish international, expert consensus on the purpose of PSRS regarding monitoring and learning from incidents and developing recommendations for their future role. After a scoping review of the literature, semi-structured interviews with experts in PSRS were conducted. Based on these findings, a survey-based questionnaire was developed and subsequently completed by a larger expert panel. Using a Delphi approach, consensus was reached regarding the ideal role of PSRSs. Recommendations for best practice were devised. Forty recommendations emerged from the Delphi procedure on the role and use of PSRS. Experts agreed reporting system should not be used as an epidemiological tool to monitor the rate of harm over time or to appraise the relative safety of hospitals. They agreed reporting is a valuable mechanism for identifying organisational safety needs. The benefit of a national system was clear with respect to medication error, device failures, hospital-acquired infections and never events as these problems often require solutions at a national level. Experts recommended training for senior healthcare professionals in incident investigation. Consensus recommendation was for hospitals to take responsibility for creating safety solutions locally that could be shared nationally. We obtained reasonable consensus among experts on aims and specifications of PSRS. This information can be used to reflect on existing and future PSRS, and their role within the wider patient safety landscape. The role of PSRS as instruments for learning needs to be elaborated and developed further internationally. 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/.

Monitoring viability of seeds in gene banks: developing software tools to increase efficiency

USDA-ARS?s Scientific Manuscript database

Monitoring the decline of seed viability is essential for effective long term seed storage in ex situ collections. Recent FAO Genebank Standards recommend monitoring intervals at one-third the time predicted for viability to fall to 85% of initial viability. This poster outlines the development of ...

Extreme Value Analysis of hydro meteorological extremes in the ClimEx Large-Ensemble

NASA Astrophysics Data System (ADS)

Wood, R. R.; Martel, J. L.; Willkofer, F.; von Trentini, F.; Schmid, F. J.; Leduc, M.; Frigon, A.; Ludwig, R.

2017-12-01

Many studies show an increase in the magnitude and frequency of hydrological extreme events in the course of climate change. However the contribution of natural variability to the magnitude and frequency of hydrological extreme events is not yet settled. A reliable estimate of extreme events is from great interest for water management and public safety. In the course of the ClimEx Project (www.climex-project.org) a new single-model large-ensemble was created by dynamically downscaling the CanESM2 large-ensemble with the Canadian Regional Climate Model version 5 (CRCM5) for an European Domain and a Northeastern North-American domain. By utilizing the ClimEx 50-Member Large-Ensemble (CRCM5 driven by CanESM2 Large-Ensemble) a thorough analysis of natural variability in extreme events is possible. Are the current extreme value statistical methods able to account for natural variability? How large is the natural variability for e.g. a 1/100 year return period derived from a 50-Member Large-Ensemble for Europe and Northeastern North-America? These questions should be answered by applying various generalized extreme value distributions (GEV) to the ClimEx Large-Ensemble. Hereby various return levels (5-, 10-, 20-, 30-, 60- and 100-years) based on various lengths of time series (20-, 30-, 50-, 100- and 1500-years) should be analyzed for the maximum one day precipitation (RX1d), the maximum three hourly precipitation (RX3h) and the streamflow for selected catchments in Europe. The long time series of the ClimEx Ensemble (7500 years) allows us to give a first reliable estimate of the magnitude and frequency of certain extreme events.

Generalized extreme gust wind speeds distributions

USGS Publications Warehouse

Cheng, E.; Yeung, C.

2002-01-01

Since summer 1996, the US wind engineers are using the extreme gust (or 3-s gust) as the basic wind speed to quantify the destruction of extreme winds. In order to better understand these destructive wind forces, it is important to know the appropriate representations of these extreme gust wind speeds. Therefore, the purpose of this study is to determine the most suitable extreme value distributions for the annual extreme gust wind speeds recorded in large selected areas. To achieve this objective, we are using the generalized Pareto distribution as the diagnostic tool for determining the types of extreme gust wind speed distributions. The three-parameter generalized extreme value distribution function is, thus, reduced to either Type I Gumbel, Type II Frechet or Type III reverse Weibull distribution function for the annual extreme gust wind speeds recorded at a specific site.With the considerations of the quality and homogeneity of gust wind data collected at more than 750 weather stations throughout the United States, annual extreme gust wind speeds at selected 143 stations in the contiguous United States were used in the study. ?? 2002 Elsevier Science Ltd. All rights reserved.

Management of upper extremity dysfunction in people with Parkinson disease and Huntington disease: facilitating outcomes across the disease lifespan.

PubMed

Quinn, Lori; Busse, Monica; Dal Bello-Haas, Vanina

2013-01-01

Parkinson Disease (PD) and Huntington Disease (HD) are degenerative neurological diseases, which can result in impairments and activity limitations affecting the upper extremities from early in the disease process. The progressive nature of these diseases poses unique challenges for therapists aiming to effectively maximize physical functioning and minimize participation restrictions in these patient groups. Research is underway in both diseases to develop effective disease-modifying agents and pharmacological interventions, as well as mobility-focused rehabilitation protocols. Rehabilitation, and in particular task-specific interventions, has the potential to influence the upper extremity functional abilities of patients with these degenerative conditions. However to date, investigations of interventions specifically addressing upper extremity function have been limited in both PD, and in particular HD. In this paper, we provide an update of the known pathological features of PD and HD as they relate to upper extremity function. We further review the available literature on the use of outcome measures, and the clinical management of upper extremity function in both conditions. Due to the currently limited evidence base in both diseases, we recommend utilization of a clinical management framework specific for degenerative conditions that can serve as a guideline for disease management. Copyright © 2013. Published by Elsevier Inc.

Inflatable Habitat Health Monitoring: Implementation, Lessons Learned, and Application to Lunar or Martian Habitat Health Monitoring

NASA Technical Reports Server (NTRS)

Rojdev, Kristina; Hong, Todd; Hafermalz, Scott; Hunkins, Robert; Valle, Gerald; Toups, Larry

2009-01-01

NASA's exploration mission is to send humans to the Moon and Mars, in which the purpose is to learn how to live and work safely in those harsh environments. A critical aspect of living in an extreme environment is habitation, and within that habitation element there are key systems which monitor the habitation environment to provide a safe and comfortable living and working space for humans. Expandable habitats are one of the options currently being considered due to their potential mass and volume efficiencies. This paper discusses a joint project between the National Science Foundation (NSF), ILC Dover, and NASA in which an expandable habitat was deployed in the extreme environment of Antarctica to better understand the performance and operations over a one-year period. This project was conducted through the Innovative Partnership Program (IPP) where the NSF provided the location at McMurdo Station in Antarctica and support at the location, ILC Dover provided the inflatable habitat, and NASA provided the instrumentation and data system for monitoring the habitat. The outcome of this project provided lessons learned in the implementation of an inflatable habitat and the systems that support that habitat. These lessons learned will be used to improve current habitation capabilities and systems to meet the objectives of exploration missions to the moon and Mars.

Use of Portal Monitors for Detection of Technogenic Radioactive Sources in Scrap Metal

NASA Astrophysics Data System (ADS)

Solovev, D. B.; Merkusheva, A. E.

2017-11-01

The article considers the features of organization of scrap-metal primary radiation control on the specialized enterprises engaging in its deep processing and storage at using by primary technical equipment - radiation portal monitors. The issue of this direction relevance, validity of radiation control implementation with the use of radiation portal monitors, physical and organizational bases of radiation control are considered in detail. The emphasis is put on the considerable increase in the number of technogenic radioactive sources detected in scrap-metal that results in the entering into exploitation of radioactive metallic structures as different building wares. One of reasons of such increase of the number of technogenic radioactive sources getting for processing with scrap-metal is the absence of any recommendations on the radiation portal monitors exploitation. The practical division of the article offers to recommendation on tuning of the modes of work of radiation portal monitors depending on influence the weather factor thus allowing to considerably increase the percent of technogenic radioactive sources detection.

Recommendations for representative ballast water sampling

NASA Astrophysics Data System (ADS)

Gollasch, Stephan; David, Matej

2017-05-01

Until now, the purpose of ballast water sampling studies was predominantly limited to general scientific interest to determine the variety of species arriving in ballast water in a recipient port. Knowing the variety of species arriving in ballast water also contributes to the assessment of relative species introduction vector importance. Further, some sampling campaigns addressed awareness raising or the determination of organism numbers per water volume to evaluate the species introduction risk by analysing the propagule pressure of species. A new aspect of ballast water sampling, which this contribution addresses, is compliance monitoring and enforcement of ballast water management standards as set by, e.g., the IMO Ballast Water Management Convention. To achieve this, sampling methods which result in representative ballast water samples are essential. We recommend such methods based on practical tests conducted on two commercial vessels also considering results from our previous studies. The results show that different sampling approaches influence the results regarding viable organism concentrations in ballast water samples. It was observed that the sampling duration (i.e., length of the sampling process), timing (i.e., in which point in time of the discharge the sample is taken), the number of samples and the sampled water quantity are the main factors influencing the concentrations of viable organisms in a ballast water sample. Based on our findings we provide recommendations for representative ballast water sampling.

Evolution caused by extreme events.

PubMed

Grant, Peter R; Grant, B Rosemary; Huey, Raymond B; Johnson, Marc T J; Knoll, Andrew H; Schmitt, Johanna

2017-06-19

Extreme events can be a major driver of evolutionary change over geological and contemporary timescales. Outstanding examples are evolutionary diversification following mass extinctions caused by extreme volcanism or asteroid impact. The evolution of organisms in contemporary time is typically viewed as a gradual and incremental process that results from genetic change, environmental perturbation or both. However, contemporary environments occasionally experience strong perturbations such as heat waves, floods, hurricanes, droughts and pest outbreaks. These extreme events set up strong selection pressures on organisms, and are small-scale analogues of the dramatic changes documented in the fossil record. Because extreme events are rare, almost by definition, they are difficult to study. So far most attention has been given to their ecological rather than to their evolutionary consequences. We review several case studies of contemporary evolution in response to two types of extreme environmental perturbations, episodic (pulse) or prolonged (press). Evolution is most likely to occur when extreme events alter community composition. We encourage investigators to be prepared for evolutionary change in response to rare events during long-term field studies.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'. © 2017 The Author(s).

Real-time monitoring of particles, PAH, and CO in an occupied townhouse.

PubMed

Wallace, L

2000-01-01

Beginning in October 1996, indoor and sometimes outdoor air at an occupied house in a suburban area of Virginia has been monitored continuously for particles, PAH, and CO. Two Climet monitors have been used to count particles in six size ranges between 0.3 and > 10 microns, with 1-minute averages being collected every 5 minutes. Two Ecochem PAH monitors have been used to sample for particle-bound PAHs once every minute. Also, two Langan CO monitor-data loggers have measured CO once each minute while logging the PAH data. Two Aethalometers measure black carbon. A single Scanning Mobility Particle Sizer (SMPS) measures ultrafine particles. The pairs of monitors are set up either to provide an indoor/outdoor or an upstairs office/downstairs kitchen comparison. Air exchange is occasionally measured using a Bruel & Kjaer 1302 SF6 monitor, as a parameter necessary for estimating deposition rates for particles and PAH. Results from the first 16 months of monitoring (approximately 10 M observations) include: neighborhood woodburning and morning rush hour traffic are the most important sources of PAH and black carbon outdoors; candles, matches, incense, and frying, sauteeing, broiling, deep-frying, and stir-frying are additional important indoor sources of PM. One citronella candle was an extremely powerful PAH source. Neither woodburning nor vehicles appears to be an important source of particles indoors, but frying, grilling, and sauteeing are extremely strong indoor sources, together with combustion events such as use of matches and candles. Physical movement was an important source of coarse but not fine particles. Use of the gas stove for extended periods of time led to increased CO concentrations--vehicles and woodburning were relatively minor sources in comparison. The gas oven, gas burners, and electric toaster oven were important sources of ultrafine particles (< 0.1 micron). A source-proximity effect was noted with the kitchen monitor reading two to five times

Electronics for Extreme Environments

NASA Astrophysics Data System (ADS)

Patel, J. U.; Cressler, J.; Li, Y.; Niu, G.

2001-01-01

Most of the NASA missions involve extreme environments comprising radiation and low or high temperatures. Current practice of providing friendly ambient operating environment to electronics costs considerable power and mass (for shielding). Immediate missions such as the Europa orbiter and lander and Mars landers require the electronics to perform reliably in extreme conditions during the most critical part of the mission. Some other missions planned in the future also involve substantial surface activity in terms of measurements, sample collection, penetration through ice and crust and the analysis of samples. Thus it is extremely critical to develop electronics that could reliably operate under extreme space environments. Silicon On Insulator (SOI) technology is an extremely attractive candidate for NASA's future low power and high speed electronic systems because it offers increased transconductance, decreased sub-threshold slope, reduced short channel effects, elimination of kink effect, enhanced low field mobility, and immunity from radiation induced latch-up. A common belief that semiconductor devices function better at low temperatures is generally true for bulk devices but it does not hold true for deep sub-micron SOI CMOS devices with microscopic device features of 0.25 micrometers and smaller. Various temperature sensitive device parameters and device characteristics have recently been reported in the literature. Behavior of state of the art technology devices under such conditions needs to be evaluated in order to determine possible modifications in the device design for better performance and survivability under extreme environments. Here, we present a unique approach of developing electronics for extreme environments to benefit future NASA missions as described above. This will also benefit other long transit/life time missions such as the solar sail and planetary outposts in which electronics is out open in the unshielded space at the ambient space

Deformation mechanisms in a coal mine roadway in extremely swelling soft rock.

PubMed

Li, Qinghai; Shi, Weiping; Yang, Renshu

2016-01-01

The problem of roadway support in swelling soft rock was one of the challenging problems during mining. For most geological conditions, combinations of two or more supporting approaches could meet the requirements of most roadways; however, in extremely swelling soft rock, combined approaches even could not control large deformations. The purpose of this work was to probe the roadway deformation mechanisms in extremely swelling soft rock. Based on the main return air-way in a coal mine, deformation monitoring and geomechanical analysis were conducted, as well as plastic zone mechanical model was analysed. Results indicated that this soft rock was potentially very swelling. When the ground stress acted alone, the support strength needed in situ was not too large and combined supporting approaches could meet this requirement; however, when this potential released, the roadway would undergo permanent deformation. When the loose zone reached 3 m within surrounding rock, remote stress p ∞ and supporting stress P presented a linear relationship. Namely, the greater the swelling stress, the more difficult it would be in roadway supporting. So in this extremely swelling soft rock, a better way to control roadway deformation was to control the releasing of surrounding rock's swelling potential.

24 CFR 1000.530 - What corrective and remedial actions will HUD request or recommend to address performance...

Code of Federal Regulations, 2013 CFR

2013-04-01

... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability... is repeated; (2) Request the recipient to submit progress schedules for completing activities or... incur costs for the affected activity; (4) Recommend that the recipient redirect funds from affected...

24 CFR 1000.530 - What corrective and remedial actions will HUD request or recommend to address performance...

Code of Federal Regulations, 2014 CFR

2014-04-01

... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability... is repeated; (2) Request the recipient to submit progress schedules for completing activities or... incur costs for the affected activity; (4) Recommend that the recipient redirect funds from affected...

Estuarine monitoring programs in the Albemarle Sound study area, North Carolina

USGS Publications Warehouse

Moorman, Michelle; Kolb, Katharine R.; Supak, Stacy

2014-01-01

The purpose of this report is to identify major natural resource management issues for the region, provide information on current monitoring activities occurring within the Albemarle Sound study area, determine how the current monitoring network fits into the design of the NMN, and determine what additional monitoring data are needed to address these issues. In order to address these questions, a shapefile and data table were created to document monitoring and research programs in the Albemarle Sound study area with an emphasis on current monitoring programs within the region. This database was queried to determine monitoring gaps that existed in the Albemarle Sound by comparing current monitoring programs with the design indicated by the NMN. The report uses this information to provide recommendations on how monitoring could be improved in the Albemarle Sound study area.

Individualized Behavioral Health Monitoring Tool

NASA Technical Reports Server (NTRS)

Mollicone, Daniel

2015-01-01

Behavioral health risks during long-duration space exploration missions are among the most difficult to predict, detect, and mitigate. Given the anticipated extended duration of future missions and their isolated, extreme, and confined environments, there is the possibility that behavior conditions and mental disorders will develop among astronaut crew. Pulsar Informatics, Inc., has developed a health monitoring tool that provides a means to detect and address behavioral disorders and mental conditions at an early stage. The tool integrates all available behavioral measures collected during a mission to identify possible health indicator warning signs within the context of quantitatively tracked mission stressors. It is unobtrusive and requires minimal crew time and effort to train and utilize. The monitoring tool can be deployed in space analog environments for validation testing and ultimate deployment in long-duration space exploration missions.

Technology review: prototyping platforms for monitoring ambient conditions.

PubMed

Afolaranmi, Samuel Olaiya; Ramis Ferrer, Borja; Martinez Lastra, Jose Luis

2018-05-08

The monitoring of ambient conditions in indoor spaces is very essential owing to the amount of time spent indoors. Specifically, the monitoring of air quality is significant because contaminated air affects the health, comfort and productivity of occupants. This research work presents a technology review of prototyping platforms for monitoring ambient conditions in indoor spaces. It involves the research on sensors (for CO 2 , air quality and ambient conditions), IoT platforms, and novel and commercial prototyping platforms. The ultimate objective of this review is to enable the easy identification, selection and utilisation of the technologies best suited for monitoring ambient conditions in indoor spaces. Following the review, it is recommended to use metal oxide sensors, optical sensors and electrochemical sensors for IAQ monitoring (including NDIR sensors for CO 2 monitoring), Raspberry Pi for data processing, ZigBee and Wi-Fi for data communication, and ThingSpeak IoT platform for data storage, analysis and visualisation.

Delivery room management of extremely low birth weight infants in Italy: comparison between academic and non-academic birth centres.

PubMed

Mardegan, Veronica; Satariano, Irene; Doglioni, Nicoletta; Criscoli, Giulio; Cavallin, Francesco; Gizzi, Camilla; Martano, Claudio; Ciralli, Fabrizio; Torielli, Flaminia; Villani, Paolo Ernesto; Di Fabio, Sandra; Quartulli, Lorenzo; Giannini, Luigi; Trevisanuto, Daniele

2016-01-01

International Guidelines provide a standardised approach to newborn resuscitation in the DR and, in their most recent versions, recommendations dedicated to management of ELBWI were progressively increased. It is expected that introduction in clinical practice and dissemination of the most recent evidence should be more consistent in academic than in non-academic hospitals. The aim of the study was to compare adherence to the International Guidelines and consistency of practice in delivery room management of extremely low birth weight infants between academic and non-academic institutions. A questionnaire was sent to the directors of all Italian level III centres between April and August 2012. There was a 92% (n = 98/107) response rate. Apart from polyethylene wrapping to optimise thermal control, perinatal management approach was comparable between academic and non-academic centres. There were minor differences in management of extremely low birth weight infants between Italian academic and non-academic institutions, apart from thermal management. Although there was a good, overall adherence to the International Guidelines for Neonatal Resuscitation, temperature management was not in accordance with official recommendations and every effort has to be done to improve this aspect.

WMO World Record Lightning Extremes: Longest Reported Flash Distance and Longest Reported Flash Duration

PubMed Central

Lang, Timothy J.; Pédeboy, Stéphane; Rison, William; Cerveny, Randall S.; Montanyà, Joan; Chauzy, Serge; MacGorman, Donald R.; Holle, Ronald L.; Ávila, Eldo E.; Zhang, Yijun; Carbin, Gregory; Mansell, Edward R.; Kuleshov, Yuriy; Peterson, Thomas C.; Brunet, Manola; Driouech, Fatima; Krahenbuhl, Daniel S.

2017-01-01

A World Meteorological Organization weather and climate extremes committee has judged that the world’s longest reported distance for a single lightning flash occurred with a horizontal distance of 321 km (199.5 mi) over Oklahoma in 2007, while the world’s longest reported duration for a single lightning flash is an event that lasted continuously for 7.74 seconds over southern France in 2012. In addition, the committee has unanimously recommended amendment of the AMS Glossary of Meteorology definition of lightning discharge as a “series of electrical processes taking place within 1 second” by removing the phrase “within one second” and replacing with “continuously.” Validation of these new world extremes (a) demonstrates the recent and on-going dramatic augmentations and improvements to regional lightning detection and measurement networks, (b) provides reinforcement regarding the dangers of lightning, and (c) provides new information for lightning engineering concerns. PMID:28111477

Experts' recommendations for the management of cardiogenic shock in children.