Bayesian processing of context-dependent text: reasons for appointments can improve detection of influenza.

PubMed

Alemi, Farrokh; Torii, Manabu; Atherton, Martin J; Pattie, David C; Cox, Kenneth L

2012-01-01

This article aims to examine whether words listed in reasons for appointments could effectively predict laboratory-verified influenza cases in syndromic surveillance systems. Data were collected from the Armed Forces Health Longitudinal Technological Application medical record system. We used 2 algorithms to combine the impact of words within reasons for appointments: Dependent (DBSt) and Independent (IBSt) Bayesian System. We used receiver operating characteristic curves to compare the accuracy of these 2 methods of processing reasons for appointments against current and previous lists of diagnoses used in the Department of Defense's syndromic surveillance system. We examined 13,096 cases, where the results of influenza tests were available. Each reason for an appointment had an average of 3.5 words (standard deviation = 2.2 words). There was no difference in performance of the 2 algorithms. The area under the curve for IBSt was 0.58 and for DBSt was 0.56. The difference was not statistically significant (McNemar statistic = 0.0054; P = 0.07). These data suggest that reasons for appointments can improve the accuracy of lists of diagnoses in predicting laboratory-verified influenza cases. This study recommends further exploration of the DBSt algorithm and reasons for appointments in predicting likely influenza cases.

An Investigation into Patient Non-Attendance and Use of a Short-Message Reminder System at a University Dental Clinic.

PubMed

Storrs, Mark J; Ramov, Helen M; Lalloo, Ratilal

2016-01-01

Non-attended appointments in health care facilities create inefficiencies and loss of clinical productivity: clinical teaching hours are reduced, impacting students' ability to meet the competencies necessary for professional registration. The aim of this study was to assess demographic and time-related factors for patient non-attendance at a dental school clinic in Australia. Appointment data were extracted from the patient management system for the years 2011 and 2012. Data included the status of appointment (attended, cancelled, or failed to attend [FTA]) and an array of demographic and time-related factors. Multinomial logistic regression was conducted to assess relationships between these factors and appointment status. Attendance rates were also compared by year following implementation of a short message service (SMS) reminder at the beginning of 2012. The results showed that, of 58,622 appointments booked with students during 2011 and 2012, 68% of patients attended, 23% cancelled, and 9% were FTA. The percentage of non-attended (cancelled or FTA) appointments differed by demographic and time-related factors. Females were 7% less likely to be FTA, those aged 16-24 years were five times more likely to be FTA, and early morning appointments were 18% less likely to be cancelled and FTA. With the SMS reminder system, the odds of a cancellation were 15% higher, but FTAs were 14% lower (both were statistically significant differences). This study found that failing to attend an appointment was significantly related to a number of factors. Clinical scheduling and reminder systems may need to take these factors into account to decrease the number of teaching hours lost due to patients' missing their appointments.

Do general practice patients with and without appointment differ? Cross-sectional study.

PubMed

Riedl, Bernhard; Kehrer, Simon; Werner, Christoph U; Schneider, Antonius; Linde, Klaus

2018-06-23

Even in practices with a comprehensive appointment system a minority of patients walks in without prior notice, sometimes causing problems for practice service quality. We aimed to explore differences between patients consulting primary care practices with and without appointment. Consecutive patients visiting five primary care practices without an appointment and following patients with an appointment were asked to fill in a four-page questionnaire addressing socio-demographic characteristics, the reason for encounter, urgency of seeing a physician, depressive, somatic and anxiety symptoms, personality traits, and satisfaction with the practice. Physicians also documented the reason for encounter and assessed the urgency. Data were analyzed using univariate and multivariate methods. Two hundred fifty-one patients without and 250 patients with appointment participated. Patients without appointment were significantly younger (mean age 44 vs. 50 years) and reported less often chronic diseases (29% vs. 45%). Also, reasons for encounter differed (e.g., 27% vs. 16% with a respiratory problem). Patients' ratings of urgency did not differ between groups (p = 0.46), but physicians rated urgency higher among patients without appointment (p < 0.001). In logistic regression analyses younger age, male gender, absence of chronic disease, positive screening for at least one mental disorder, low values on the personality trait openness for experience, a high urgency rating by the physician, and a respiratory or musculoskeletal problem as reason for encounter were significantly associated with a higher likelihood of being a patient without appointment. In this study, younger age and a high urgency rating by physicians were the variables most consistently associated with the likelihood of being a patient without appointment. Overall, differences between patients seeking general practices with a comprehensive appointment system without prior notice and patients with appointments were relatively minor.

A web-based appointment system to reduce waiting for outpatients: a retrospective study.

PubMed

Cao, Wenjun; Wan, Yi; Tu, Haibo; Shang, Fujun; Liu, Danhong; Tan, Zhijun; Sun, Caihong; Ye, Qing; Xu, Yongyong

2011-11-22

Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8%) completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time (P<0.001). However, gender, urban residence, and valid waiting time showed no significant differences (P>0.05). Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day (P<0.001). Compared to the usual queuing method, the web-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However, further improvements are needed for broad use of the system.

Characteristics of HIV patients who missed their scheduled appointments

PubMed Central

Nagata, Delsa; Gutierrez, Eliana Battaggia

2016-01-01

ABSTRACT OBJECTIVE To analyze whether sociodemographic characteristics, consultations and care in special services are associated with scheduled infectious diseases appointments missed by people living with HIV. METHODS This cross-sectional and analytical study included 3,075 people living with HIV who had at least one scheduled appointment with an infectologist at a specialized health unit in 2007. A secondary data base from the Hospital Management & Information System was used. The outcome variable was missing a scheduled medical appointment. The independent variables were sex, age, appointments in specialized and available disciplines, hospitalizations at the Central Institute of the Clinical Hospital at the Faculdade de Medicina of the Universidade de São Paulo, antiretroviral treatment and change of infectologist. Crude and multiple association analysis were performed among the variables, with a statistical significance of p ≤ 0.05. RESULTS More than a third (38.9%) of the patients missed at least one of their scheduled infectious diseases appointments; 70.0% of the patients were male. The rate of missed appointments was 13.9%, albeit with no observed association between sex and absences. Age was inversely associated to missed appointment. Not undertaking anti-retroviral treatment, having unscheduled infectious diseases consultations or social services care and being hospitalized at the Central Institute were directly associated to missed appointments. CONCLUSIONS The Hospital Management & Information System proved to be a useful tool for developing indicators related to the quality of health care of people living with HIV. Other informational systems, which are often developed for administrative purposes, can also be useful for local and regional management and for evaluating the quality of care provided for patients living with HIV. PMID:26786472

Comparison of Traditional and Open-Access Appointment Scheduling for Exponentially Distributed Service Time.

PubMed

Yan, Chongjun; Tang, Jiafu; Jiang, Bowen; Fung, Richard Y K

2015-01-01

This paper compares the performance measures of traditional appointment scheduling (AS) with those of an open-access appointment scheduling (OA-AS) system with exponentially distributed service time. A queueing model is formulated for the traditional AS system with no-show probability. The OA-AS models assume that all patients who call before the session begins will show up for the appointment on time. Two types of OA-AS systems are considered: with a same-session policy and with a same-or-next-session policy. Numerical results indicate that the superiority of OA-AS systems is not as obvious as those under deterministic scenarios. The same-session system has a threshold of relative waiting cost, after which the traditional system always has higher total costs, and the same-or-next-session system is always preferable, except when the no-show probability or the weight of patients' waiting is low. It is concluded that open-access policies can be viewed as alternative approaches to mitigate the negative effects of no-show patients.

Reminder systems to improve patient adherence to tuberculosis clinic appointments for diagnosis and treatment

PubMed Central

Liu, Qin; Abba, Katharine; Alejandria, Marissa M; Sinclair, David; Balanag, Vincent M; Lansang, Mary Ann D

2014-01-01

Background People with active tuberculosis (TB) require six months of treatment. Some people find it difficult to complete treatment, and there are several approaches to help ensure completion. One such system relies on reminders, where the health system prompts patients to attend for appointments on time, or re-engages people who have missed or defaulted on a scheduled appointment. Objectives To assess the effects of reminder systems on improving attendance at TB diagnosis, prophylaxis, and treatment clinic appointments, and their effects on TB treatment outcomes. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, Cochrane Effective Practice andOrganization of Care Group Specialized Register, CENTRAL,MEDLINE, EMBASE, LILACS, CINAHL, SCI-EXPANDED, SSCI, m RCT, and the Indian Journal of Tuberculosis without language restriction up to 29 August 2014. We also checked reference lists and contacted researchers working in the field. Selection criteria Randomized controlled trials (RCTs), including cluster RCTs and quasi-RCTs, and controlled before-and-after studies comparing reminder systems with no reminders or an alternative reminder system for people with scheduled appointments for TB diagnosis, prophylaxis, or treatment. Data collection and analysis Two review authors independently extracted data and assessed the risk of bias in the included trials. We compared the effects of interventions by using risk ratios (RR) and presented RRs with 95% confidence intervals (CIs). Also we assessed the quality of evidence using the GRADE approach. Main results Nine trials, including 4654 participants, met our inclusion criteria. Five trials evaluated appointment reminders for people on treatment for active TB, two for people on prophylaxis for latent TB, and four for people undergoing TB screening using skin tests.We classified the interventions into 'pre-appointment' reminders (telephone calls or letters prior to a scheduled appointment) or'default' reminders (telephone calls, letters, or home visits to people who had missed an appointment). For people being treated for active TB, clinic attendance and TB treatment completion were higher in people receiving pre-appointment reminder phone-calls (clinic attendance: 66% versus 50%; RR 1.32, 95% CI 1.10 to 1.59, one trial (USA), 615 participants, low quality evidence; TB treatment completion: 100% versus 88%; RR 1.14, 95% CI 1.02 to 1.27, one trial (Thailand), 92 participants, low quality evidence). Clinic attendance and TB treatment completion were also higher with default reminders (letters or home visits) (clinic attendance: 52% versus 10%; RR 5.04, 95% CI 1.61 to 15.78, one trial (India), 52 participants, low quality evidence; treatment completion: RR 1.17, 95% CI 1.11 to 1.24, two trials (Iraq and India), 680 participants, moderate quality evidence). For people on TB prophylaxis, clinic attendance was higher with a policy of pre-appointment phone-calls (63% versus 48%; RR 1.30, 95% CI 1.07 to 1.59, one trial (USA), 536 participants); and attendance at the final clinic was higher with regular three-monthly phone-calls or nurse visits (93% versus 65%, one trial (Spain), 318 participants). For people undergoing screening for TB, three trials of pre-appointment phone-calls found little or no effect on the proportion of people returning to clinic for the result of their skin test (three trials, 1189 participants, low quality evidence), and two trials found little or no effect with take home reminder cards (two trials, 711 participants). All four trials were conducted among healthy volunteers in the USA. Authors' conclusions Policies of sending reminders to people pre-appointment, and contacting people who miss appointments, seem sensible additions to any TB programme, and the limited evidence available suggests they have small but potentially important benefits. Future studies of modern technologies such as short message service (SMS) reminders would be useful, particularly in low-resource settings. Plain Language Summary Reminder systems to improve patient attendance at tuberculosis clinics This Cochrane Review summarizes trials evaluating the effects of reminder systems on attendance at tuberculosis (TB) clinics and completion of TB treatment. After searching for relevant trials up to 29 August 2014, we included nine trials, including 4654 people. What are reminder systems and how might they help? Effective treatment for TB requires people to take multiple drugs daily for at least six months. Consequently, once they start to feel well again, some patients stop attending clinics and stop taking theirmedication which can lead to the illness returning and the development of drug resistance. One strategy theWorldHealthOrganization recommends is that an appointed person (a health worker or volunteer) watches the person take their medication everyday (called direct observation). Other strategies include reminder systems to prompt patients to attend for appointments on time, or to re-engage people who have missed or defaulted on a scheduled appointment. These prompts may be in the form of telephone calls or letters before the next scheduled appointment (“pre-appointment reminders”), or phone calls, letters, or home visits after a missed appointment (“default reminders”). What the research says: For people being treated for active TB: - More people attended the clinic and completed TB treatment with pre-appointment reminder phone-calls (low quality evidence). - More people attended the clinic and completed TB treatment with a policy of default reminders (low and moderate quality evidence respectively). For people on TB prophylaxis: - More people attended the clinic with pre-appointment phone-calls, and the number attending the final clinic was higher with threemonthly phone-calls or nurse home visits. For people being treated for active TB: - Similar numbers of people attended clinic for skin test reading with and without pre-appointment phone-calls (low quality evidence). - Similar numbers of people attended clinic for skin test reading with and without take home reminder cards. PMID:25403701

5 CFR 532.403 - New appointments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false New appointments. 532.403 Section 532.403 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PREVAILING RATE SYSTEMS Pay Administration § 532.403 New appointments. (a) Except as provided in paragraphs (b) and (c) of this section, a...

Improvements in dental care using a new mobile app with cloud services.

PubMed

Lin, Chia-Yung; Peng, Kang-Lin; Chen, Ji; Tsai, Jui-Yuan; Tseng, Yu-Chee; Yang, Jhih-Ren; Chen, Min-Huey

2014-10-01

Traditional dental care, which includes long-term oral hygiene maintenance and scheduled dental appointments, requires effective communication between dentists and patients. In this study, a new system was designed to provide a platform for direct communication between dentists and patients. A new mobile app, Dental Calendar, combined with cloud services specific for dental care was created by a team constituted by dentists, computer scientists, and service scientists. This new system would remind patients about every scheduled appointment, and help them take pictures of their own oral cavity parts that require dental treatment and send them to dentists along with a symptom description. Dentists, by contrast, could confirm or change appointments easily and provide professional advice to their patients immediately. In this study, 26 dentists and 32 patients were evaluated by a questionnaire containing eight dental-service items before and after using this system. Paired sample t test was used for statistical analysis. After using the Dental Calendar combined with cloud services, dentists were able to improve appointment arrangements significantly, taking care of the patients with sudden worse prosthesis (p < 0.05). Patients also achieved significant improvement in appointment reminder systems, rearrangement of appointments in case of sudden worse prosthesis, and establishment of a direct relationship with dentists (p < 0.05). Our new mobile app, Dental Calendar, in combination with cloud services, provides efficient service to both dentists and patients, and helps establish a better relationship between them. It also helps dentists to arrange appointments for patients with sudden worsening of prosthesis function. Copyright © 2014. Published by Elsevier B.V.

Appointment length, psychiatrists' communication behaviors, and medication management appointment adherence.

PubMed

Cruz, Mario; Roter, Debra L; Cruz, Robyn F; Wieland, Melissa; Larson, Susan; Cooper, Lisa A; Pincus, Harold Alan

2013-09-01

The authors explored the relationship between critical elements of medication management appointments (appointment length, patient-centered talk, and positive nonverbal affect among providers) and patient appointment adherence. The authors used an exploratory, cross-sectional design employing quantitative analysis of 83 unique audio recordings of split treatment medication management appointments for 46 African-American and 37 white patients with 24 psychiatrists at four ambulatory mental health clinics. All patients had a diagnosis of depression. Data collected included demographic information; Patient Health Questionnaire-9 scores for depression severity; psychiatrist verbal and nonverbal communication behaviors during medication management appointments, identified by the Roter Interaction Analysis System during analysis of audio recordings; and appointment adherence. Bivariate analyses were employed to identify covariates that might influence appointment adherence. Generalized estimating equations (GEEs) were employed to assess the relationship between appointment length, psychiatrist patient-centered talk, and positive voice tone ratings and patient appointment adherence, while adjusting for covariates and the clustering of observations within psychiatrists. Wald chi square analyses were used to test whether all or some variables significantly influenced appointment adherence. GEE revealed a significant relationship between positive voice tone ratings and appointment adherence (p=.03). Chi square analyses confirmed the hypothesis of a positive and significant relationship between appointment adherence and positive voice tone ratings (p=.03) but not longer visit length and more patient-centered communication. The nonverbal conveyance of positive affect was associated with greater adherence to medication management appointments by depressed patients. These findings potentially have important implications for communication skills training and adherence research.

Randomized trial of a novel game-based appointment system for a university hospital venereology unit: study protocol.

PubMed

Gabarron, Elia; Serrano, J Artur; Fernandez-Luque, Luis; Wynn, Rolf; Schopf, Thomas

2015-04-08

Chlamydia is the most common reportable sexually transmitted disease (STD) in Norway, and its incidence in the two northernmost counties has been disclosed to be nearly the double of the Norwegian average. The latest publicly available rates showed that 85.6% of the new cases were diagnosed in people under 29 years old. The information and communication technologies are among the most powerful influences in the lives of young people. The Internet can potentially represent a way to educate on sexual health and encourage young people, and especially youth, to be tested for STDs. If hospital websites include an easy and anonymous system for scheduling appointments with the clinic, it is possible that this could lead to an increase in the number of people tested for STDs. The purpose of the study is to assess the impact of a game-based appointment system on the frequency of consultations at a venereology unit and on the use of an educational web app. An A/B testing methodology is used. Users from the city of Tromsø, in North Norway, will be randomized to one of the two versions of the game-style web app on sexual health at www.sjekkdeg.no. Group A will have access to educational content only, while group B will have, in addition, access to a game-based appointment system with automatic prioritization. After one year of the trial, it will be analyzed if the game-based appointment system increases the number of consultations at the venereology unit and if health professionals deem the system useful. This study will explore if facilitating the access to health services for youth through the use of a game-based appointment system integrated in a game-style web app on sexual health education can have an impact on appointment rates. The trial is registered at clinicaltrials.org under the identifier ClinicalTrials.gov NCT:02128620.

Quantitative Analysis of the Contributing Factors Affecting Specialty Care No-Show Rates at Brooke Army Medical Center

DTIC Science & Technology

2007-03-30

2002). In the Vein Treatment Surgery Center in Texas, failure to properly cancel cosmetic appointments will result in forfeiture of the patients’ $100...appointments. This problem affects more than just the United States. Missed appointments cost the National Healthcare System ( NHS ) in England a...significant amount of money last year. Official figures from the NHS showed 5.7 million appointments were missed in 2004-2005 (Carvel, 2006). When patients

GCT Bayonne’s Drayage Truck Appointment System

EPA Pesticide Factsheets

Global Container Terminals (GCT) has implemented an advanced truck appointment system at its GCT Bayonne facility at the Port of New York and New Jersey that has realized benefits in terms of cost savings, turn times, the environment, and congestion.

Factors affecting adherence to appointment system in the clinic for non-communicable diseases in UNRWA's Khan Younis Health Centre and the role of mobile phone text messages to improve adherence: a descriptive cross-sectional study.

PubMed

Al Najjar, Sanaa; Al Shaer, Tamer

2018-02-21

To meet the emerging needs of the increasing numbers of patients with non-communicable diseases and to provide optimum care with optimum contact time and minimum waiting time, as stated in UNRWA guidelines, the mobile phone text messaging system was implemented in UNRWA centres to remind patients of upcoming appointments and to thereby improve the quality of care for vulnerable patients and regulate the work load in the clinics for non-communicable diseases. The aim of this study was to assess the causes for lack of adherence to the appointment system at UNRWA centres. This descriptive cross-sectional study was done in the UNRWA's Khan Younis Health Centre (KYHC), which serves the same refugee population as other UNRWA health centres and follows the same guidelines with minimal variation. Data were collected through interviewer-administered questionnaires, with ten medical staff members involved in the appointment process and 50 patients with non-communicable diseases selected randomly from patients attending the KYHC. The text-message reminder intervention targeted 1000 patients with non-communicable diseases and consisted of an electronic message technique that was developed to remind patients about the day and time of upcoming appointments. Administrative approval was obtained from the chief of UNRWA health programme. Verbal consent was obtained from participants. We followed the Modified International Code of Ethics Principles (1975), known as the Declaration of Helsinki. The main barrier to adherence to appointments in the clinic for non-communicable diseases was forgetting the appointment. Other factors were lack of awareness, clinic overcrowding, appointments that do not match the patient's preference, availability of other service providers, and financial issues. In March, 2016, after the completion of the intervention, the proportion of patients that adhered to their appointment by date and time was 76%, compared with about 45% in January and February, 2016 (p=0·013). The text messaging reminder is a successful way of improving patient's adherence to appointments in UNRWA clinics for non-communicable diseases. The intervention should be continued and integrated in daily work. More financial resources are needed to support the text messaging reminder system. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

Nurse telephone triage for same day appointments in general practice: multiple interrupted time series trial of effect on workload and costs

PubMed Central

Richards, David A; Meakins, Joan; Tawfik, Jane; Godfrey, Lesley; Dutton, Evelyn; Richardson, Gerald; Russell, Daphne

2002-01-01

Objective To compare the workloads of general practitioners and nurses and costs of patient care for nurse telephone triage and standard management of requests for same day appointments in routine primary care. Design Multiple interrupted time series using sequential introduction of experimental triage system in different sites with repeated measures taken one week in every month for 12 months. Setting Three primary care sites in York. Participants 4685 patients: 1233 in standard management, 3452 in the triage system. All patients requesting same day appointments during study weeks were included in the trial. Main outcome measures Type of consultation (telephone, appointment, or visit), time taken for consultation, presenting complaints, use of services during the month after same day contact, and costs of drugs and same day, follow up, and emergency care. Results The triage system reduced appointments with general practitioner by 29-44%. Compared with standard management, the triage system had a relative risk (95% confidence interval) of 0.85 (0.72 to 1.00) for home visits, 2.41 (2.08 to 2.80) for telephone care, and 3.79 (3.21 to 4.48) for nurse care. Mean overall time in the triage system was 1.70 minutes longer, but mean general practitioner time was reduced by 2.45 minutes. Routine appointments and nursing time increased, as did out of hours and accident and emergency attendance. Costs did not differ significantly between standard management and triage: mean difference £1.48 more per patient for triage (95% confidence interval –0.19 to 3.15). Conclusions Triage reduced the number of same day appointments with general practitioners but resulted in busier routine surgeries, increased nursing time, and a small but significant increase in out of hours and accident and emergency attendance. Consequently, triage does not reduce overall costs per patient for managing same day appointments. What is already known on this topicNurse telephone triage is used to manage the increasing demand for same day appointments in general practiceEvidence that nurse telephone triage is effective is limitedWhat this study addsTriage resulted in 29-44% fewer same day appointments with general practitioners than standard managementNursing and overall time increased in the triage group as 40% of patients were managed by nursesTriage was not less costly than standard management because of increased costs for nursing, follow up, out of hours, and accident and emergency care PMID:12446539

Reducing Non-Attendance Rates for Assessment at an Eating Disorders Service: A Quality Improvement Initiative.

PubMed

Jenkins, Paul E

2017-10-01

Rates of non-attendance at initial appointments within community eating disorder (ED) services are frequently high, although this has received relatively little research attention and no reports of interventions designed to address this. The current report describes outcomes following a change of procedure introducing a 'partial booking' system. Attendance rates at first appointments (N = 1260) were audited following introduction of a system designed to reduce non-attendance in January 2013 within a UK ED service. Rates were compared following implementation of the new system, using a historical control group for comparison, and showed a decline from 20.4 to 15.1%, a medium-sized effect. Use of a system asking patients to book an appointment reduced non-attendance at initial appointments and may be of use to similar services experiencing high non-attendance rates. Opt-in initiatives can reduce burden resulting from long waiting times and can be easily adapted to individual services.

Why We Don’t Come: Patient Perceptions on No-Shows

PubMed Central

Lacy, Naomi L.; Paulman, Audrey; Reuter, Matthew D.; Lovejoy, Bruce

2004-01-01

PURPOSE Patients who schedule clinic appointments and fail to keep them have a negative impact on the workflow of a clinic in many ways. This study was conducted to identify the reasons patients in an urban family practice setting give for not keeping scheduled appointments. METHODS Semistructured interviews were conducted with 34 adult patients coming to the clinic for outpatient care. Interviews were audiotaped and transcribed verbatim. A multidisciplinary team used an immersion-crystallization organizing style to analyze the content of the qualitative interviews individually and in team meetings. RESULTS Participants identified 3 types of issues related to missing appointments without notifying the clinic staff: emotions, perceived disrespect, and not understanding the scheduling system. Although they discussed logistical issues of appointment keeping, participants did not identify these issues as key reasons for nonattendance. Appointment making among these participants was driven by immediate symptoms and a desire for self-care. At the same time, many of these participants experienced anticipatory fear and anxiety about both procedures and bad news. Participants did not feel obligated to keep a scheduled appointment in part because they felt disrespected by the health care system. The effect of this feeling was compounded by participants’ lack of understanding of the scheduling system. CONCLUSIONS The results of this study suggest that reducing no-show rates among patients who sometimes attend might be addressed by reviewing waiting times and participants’ perspectives of personal respect. PMID:15576538

Understanding the mediating effects of relationship quality on technology acceptance: an empirical study of e-appointment system.

PubMed

Chen, Shih-Chih; Liu, Shih-Chi; Li, Shing-Han; Yen, David C

2013-12-01

This study extends the Technology Acceptance Model (TAM) by incorporating relationship quality as a mediator to construct a comprehensive framework for understanding the influence on continuance intention in the hospital e-appointment system. A survey of 334 Taiwanese citizens who were contacted via phone or the Internet and Structural Equation Modeling (SEM) is used for path analysis and hypothesis tests. The study shows that perceived ease of use (PEOU) and perceived usefulness (PU) have significant influence on continuance intention through the mediation of relationship quality, consisting of satisfaction and trust. The direct impact of relationship quality on continuance intention is also significant. The analytical results reveal that the relationship between the hospital, patients and e-appointment users can be improved via enhancing the continued usage of e-appointment. This paper also proposes a general model to synthesize the essence of PEOU, PU, and relationship quality for explaining users' continuous intention of e-appointment.

Approximate dynamic programming approaches for appointment scheduling with patient preferences.

PubMed

Li, Xin; Wang, Jin; Fung, Richard Y K

2018-04-01

During the appointment booking process in out-patient departments, the level of patient satisfaction can be affected by whether or not their preferences can be met, including the choice of physicians and preferred time slot. In addition, because the appointments are sequential, considering future possible requests is also necessary for a successful appointment system. This paper proposes a Markov decision process model for optimizing the scheduling of sequential appointments with patient preferences. In contrast to existing models, the evaluation of a booking decision in this model focuses on the extent to which preferences are satisfied. Characteristics of the model are analysed to develop a system for formulating booking policies. Based on these characteristics, two types of approximate dynamic programming algorithms are developed to avoid the curse of dimensionality. Experimental results suggest directions for further fine-tuning of the model, as well as improving the efficiency of the two proposed algorithms. Copyright © 2018 Elsevier B.V. All rights reserved.

Patient-Centered Appointment Scheduling Using Agent-Based Simulation

PubMed Central

Turkcan, Ayten; Toscos, Tammy; Doebbeling, Brad N.

2014-01-01

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to better understand clinic workflow and key constraints. We then developed an agent-based simulation model that includes all access modalities (appointments, walk-ins, and after-hours access), incorporate resources and key constraints and determine the best appointment scheduling method that improves access and continuity of care. This paper demonstrates the value of simulation models to test a variety of alternative strategies to improve access to care through scheduling. PMID:25954423

A novel optical gating method for laser gated imaging

NASA Astrophysics Data System (ADS)

Ginat, Ran; Schneider, Ron; Zohar, Eyal; Nesher, Ofer

2013-06-01

For the past 15 years, Elbit Systems is developing time-resolved active laser-gated imaging (LGI) systems for various applications. Traditional LGI systems are based on high sensitive gated sensors, synchronized to pulsed laser sources. Elbit propriety multi-pulse per frame method, which is being implemented in LGI systems, improves significantly the imaging quality. A significant characteristic of the LGI is its ability to penetrate a disturbing media, such as rain, haze and some fog types. Current LGI systems are based on image intensifier (II) sensors, limiting the system in spectral response, image quality, reliability and cost. A novel propriety optical gating module was developed in Elbit, untying the dependency of LGI system on II. The optical gating module is not bounded to the radiance wavelength and positioned between the system optics and the sensor. This optical gating method supports the use of conventional solid state sensors. By selecting the appropriate solid state sensor, the new LGI systems can operate at any desired wavelength. In this paper we present the new gating method characteristics, performance and its advantages over the II gating method. The use of the gated imaging systems is described in a variety of applications, including results from latest field experiments.

48 CFR 301.603-2 - Selection and appointment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Selection and appointment. 301.603-2 Section 301.603-2 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES GENERAL... individual as a Contracting Officer only when a valid organizational need is demonstrated and after...

48 CFR 301.603-2 - Selection and appointment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Selection and appointment. 301.603-2 Section 301.603-2 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES GENERAL... individual as a Contracting Officer only when a valid organizational need is demonstrated and after...

How many surgery appointments should be offered to avoid undesirable numbers of 'extras'?

PubMed

Kendrick, T; Kerry, S

1999-04-01

Patients seen as 'extras' (or 'fit-ins') are usually given less time for their problems than those in pre-booked appointments. Consequently, long queues of 'extras' should be avoided. To determine whether a predictable relationship exists between the number of available appointments at the start of the day and the number of extra patients who must be fitted in. This might be used to help plan a practice appointment system. Numbers of available appointments at the start of the day and numbers of 'extras' seen were recorded prospectively in 1995 and 1997 in one group general practice. Minimum numbers of available appointments at the start of the day, below which undesirably large numbers of extra patients could be predicted, were determined using logistic regression applied to the 1995 data. Predictive values of the minimum numbers calculated for 1995, in terms of predicting undesirable numbers of 'extras', were then determined when applied to the 1997 data. Numbers of extra patients seen correlated negatively with available appointments at the start of the day for all days of the week, with coefficients ranging from -0.66 to -0.80. Minimum numbers of available appointments below which undesirably large numbers of extras could be predicted were 26 for Mondays and four for the other week-days. When applied to 1997 data, these minimum numbers gave positive and negative predictive values of 76% and 82% respectively, similar to their values for 1995, despite increases in patient attendance and changes in the day-to-day pattern of surgery provision between the two years. A predictable relationship exists between the number of available appointments at the start of the day and the number of extras who must be fitted in, which may be used to help plan the appointment system for some years ahead, at least in this relatively stable suburban practice.

Technical Note: High temporal resolution characterization of gating response time.

PubMed

Wiersma, Rodney D; McCabe, Bradley P; Belcher, Andrew H; Jensen, Patrick J; Smith, Brett; Aydogan, Bulent

2016-06-01

Low temporal latency between a gating ON/OFF signal and the LINAC beam ON/OFF during respiratory gating is critical for patient safety. Here the authors describe a novel method to precisely measure gating lag times at high temporal resolutions. A respiratory gating simulator with an oscillating platform was modified to include a linear potentiometer for position measurement. A photon diode was placed at linear accelerator isocenter for beam output measurement. The output signals of the potentiometer and diode were recorded simultaneously at 2500 Hz with an analog to digital converter for four different commercial respiratory gating systems. The ON and OFF of the beam signal were located and compared to the expected gating window for both phase and position based gating and the temporal lag times extracted. For phase based gating, a real-time position management (RPM) infrared marker tracking system with a single camera and a RPM system with a stereoscopic camera were measured to have mean gate ON/OFF lag times of 98/90 and 86/44 ms, respectively. For position based gating, an AlignRT 3D surface system and a Calypso magnetic fiducial tracking system were measured to have mean gate ON/OFF lag times of 356/529 and 209/60 ms, respectively. Temporal resolution of the method was high enough to allow characterization of individual gate cycles and was primary limited by the sampling speed of the data recording device. Significant variation of mean gate ON/OFF lag time was found between different gating systems. For certain gating devices, individual gating cycle lag times can vary significantly.

Technical Note: High temporal resolution characterization of gating response time

PubMed Central

Wiersma, Rodney D.; McCabe, Bradley P.; Belcher, Andrew H.; Jensen, Patrick J.; Smith, Brett; Aydogan, Bulent

2016-01-01

Purpose: Low temporal latency between a gating ON/OFF signal and the LINAC beam ON/OFF during respiratory gating is critical for patient safety. Here the authors describe a novel method to precisely measure gating lag times at high temporal resolutions. Methods: A respiratory gating simulator with an oscillating platform was modified to include a linear potentiometer for position measurement. A photon diode was placed at linear accelerator isocenter for beam output measurement. The output signals of the potentiometer and diode were recorded simultaneously at 2500 Hz with an analog to digital converter for four different commercial respiratory gating systems. The ON and OFF of the beam signal were located and compared to the expected gating window for both phase and position based gating and the temporal lag times extracted. Results: For phase based gating, a real-time position management (RPM) infrared marker tracking system with a single camera and a RPM system with a stereoscopic camera were measured to have mean gate ON/OFF lag times of 98/90 and 86/44 ms, respectively. For position based gating, an AlignRT 3D surface system and a Calypso magnetic fiducial tracking system were measured to have mean gate ON/OFF lag times of 356/529 and 209/60 ms, respectively. Conclusions: Temporal resolution of the method was high enough to allow characterization of individual gate cycles and was primary limited by the sampling speed of the data recording device. Significant variation of mean gate ON/OFF lag time was found between different gating systems. For certain gating devices, individual gating cycle lag times can vary significantly. PMID:27277028

Patients' adoption of the e-appointment scheduling service: A case study in primary healthcare.

PubMed

Zhang, Xiaojun; Yu, Ping; Yan, Jun

2014-01-01

The aim of this study is to investigate patients' initial acceptance and ongoing use of a simple but typical type of consumer e-health service - an e-appointment scheduling (EAS) system - in order to identify facilitators and barriers for patients' adoption of e-health services in primary healthcare. In-depth, semi-structured interviews were conducted to gather patients' background information, their awareness of the system, their feedbacks on the characteristics of the system, and their reasons for use or not use the system. A total of 125 patients aged between 17 and 74 were interviewed. Study results show that 89% of the interviewed patients had shown reluctance to adopt this online service. The identified barriers for acceptance include many patients' lack of access to the internet, lack of awareness of the service, low computer skills and incompatibility of the online appointment service with many patients' habits of face-to-face or phone-call based medical appointment making. Health service providers need to consider the general public's acceptance for online services before implementing consumer e-health systems.

FAPA: Faculty Appointment Policy Archive, 1998. [CD-ROM.

ERIC Educational Resources Information Center

Trower, C. Ann

This CD-ROM presents 220 documents collected in Harvard University's Faculty Appointment Policy Archive (FAPA), the ZyFIND search and retrieval system, and instructions for their use. The FAPA system and ZyFIND allow browsing through documents, inserting bookmarks in documents, attaching notes to documents without modifying them, and selecting…

Around Marshall

NASA Image and Video Library

1998-09-01

Mr. Arthur G. Stephenson has been serving as the ninth Director of NASA's Marshall Space Flight Center since his appointment on September 11, 1998. Prior to his appointment, Mr. Stephenson worked for TRW, Redondo Beach, California, for 28 years and was president of Oceaneering Advanced Technologies in Houston, Texas, at the time of his appointment. Mr. Stephenson has over 30 years of experience as a manager in spacecraft and high-technology systems.

Technical Note: High temporal resolution characterization of gating response time

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

Wiersma, Rodney D., E-mail: rwiersma@uchicago.edu; McCabe, Bradley P.; Belcher, Andrew H.

2016-06-15

Purpose: Low temporal latency between a gating ON/OFF signal and the LINAC beam ON/OFF during respiratory gating is critical for patient safety. Here the authors describe a novel method to precisely measure gating lag times at high temporal resolutions. Methods: A respiratory gating simulator with an oscillating platform was modified to include a linear potentiometer for position measurement. A photon diode was placed at linear accelerator isocenter for beam output measurement. The output signals of the potentiometer and diode were recorded simultaneously at 2500 Hz with an analog to digital converter for four different commercial respiratory gating systems. The ONmore » and OFF of the beam signal were located and compared to the expected gating window for both phase and position based gating and the temporal lag times extracted. Results: For phase based gating, a real-time position management (RPM) infrared marker tracking system with a single camera and a RPM system with a stereoscopic camera were measured to have mean gate ON/OFF lag times of 98/90 and 86/44 ms, respectively. For position based gating, an AlignRT 3D surface system and a Calypso magnetic fiducial tracking system were measured to have mean gate ON/OFF lag times of 356/529 and 209/60 ms, respectively. Conclusions: Temporal resolution of the method was high enough to allow characterization of individual gate cycles and was primary limited by the sampling speed of the data recording device. Significant variation of mean gate ON/OFF lag time was found between different gating systems. For certain gating devices, individual gating cycle lag times can vary significantly.« less

Web-Based Medical Appointment Systems: A Systematic Review

PubMed Central

Zhao, Peng; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

2017-01-01

Background Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. Objective The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. Methods In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. Results A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients’ reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Conclusions Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies. PMID:28446422

Web-Based Medical Appointment Systems: A Systematic Review.

PubMed

Zhao, Peng; Yoo, Illhoi; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

2017-04-26

Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients' reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies. ©Peng Zhao, Illhoi Yoo, Jaie Lavoie, Beau James Lavoie, Eduardo Simoes. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2017.

Access to Care for Youth in a State Mental Health System: A Simulated Patient Approach.

PubMed

Olin, Su-Chin Serene; O'Connor, Briannon C; Storfer-Isser, Amy; Clark, Lisa J; Perkins, Matthew; Hudson Scholle, Sarah; Whitmyre, Emma D; Hoagwood, Kimberly; Horwitz, Sarah McCue

2016-05-01

To examine access to psychiatric care for adolescents with depression in outpatient specialty clinics within a state mental health system, using a simulated patient approach. Trained callers posed as the mother of a 14-year-old girl with depression, following a script. A stratified random sample (n = 264) of 340 state-licensed outpatient mental health clinics that serve youth was selected. Clinics were randomly assigned to season and insurance condition. We examined whether access varied by season, clinic characteristics, and caller insurance type. Weighted logistic and linear mixed effects regression models were fitted to examine associations with appointment availability and wait times. Among clinics at which a treatment appointment could be scheduled, appointment availability differed by season. Clinics that had participated in state-sponsored trainings targeting access were more available. Wait times for treatment appointments varied by season and region. Wait times in New York City were shorter than in some other regions. Although callers were 4.1 times more likely to be able to schedule a psychiatry appointment in the spring, wait times for psychiatry appointments were significantly longer in the spring than in the summer (49.9 vs. 36.7 days). Wait times for therapy appointments were significantly shorter in community than in hospital clinics (19.1 days vs. 35.3 days). Access to psychiatric care for youth with depression was found to be variable in a state system. State-sponsored trainings on strategies to reduce wait times appear to improve care access. The simulated patient approach has promise for monitoring the impact of health care policy reforms on care quality measures. Published by Elsevier Inc.

Access to Care for Youth in a State Mental Health System: A Simulated Patient Approach

PubMed Central

Olin, Su-chin Serene; O'Connor, Briannon C.; Storfer-Isser, Amy; Clark, Lisa J.; Perkins, Matthew; Scholle, Sarah Hudson; Whitmyre, Emma D.; Hoagwood, Kimberly; Horwitz, Sarah McCue

2016-01-01

Objective To examine access to psychiatric care for adolescents with depression in outpatient specialty clinics within a state mental health system, using a simulated patient approach. Method Trained callers posed as the mother of a 14-year-old female with depression, following a script. A stratified random sample (n = 264) of 340 state-licensed outpatient mental health clinics that serve youth was selected. Clinics were randomly assigned to season and insurance condition. We examined if access varied by season, clinic characteristics, and caller insurance type. Weighted logistic and linear mixed effects regression models were fitted to examine associations with appointment availability and wait times. Results Among clinics where a treatment appointment could be scheduled, appointment availability differed by season. Clinics who had participated in state-sponsored trainings targeting access were more available. Wait times for treatment appointments varied by season and region. Wait times in New York City were shorter than in some other regions. Although callers were 4.1 times more likely to be able to schedule a psychiatry appointment in the spring, wait times for psychiatry appointments were significantly longer in the spring than in the summer (49.9 vs. 36.7 days). Wait times for therapy appointments were significantly shorter in community than hospital clinics (19.1 days vs. 35.3 days). Conclusion Access to psychiatric care for youth with depression was found to be variable in a state system. State-sponsored trainings on strategies to reduce wait times appear to improve care access. The simulated patient approach has promise for monitoring the impact of healthcare policy reforms on care quality measures. PMID:27126853

76 FR 13997 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

... Corps: appointment; duties; Rules for Courts-Martial (RCM) Rule 109, Manual for Courts-Martial United... Advocate General's Corps: Appointment; duties; Rules for Courts-Martial (RCM) Rule 109, Manual for Courts...

Health-related quality of life as a main determinant of access to rheumatologic care.

PubMed

Leon, Leticia; Jover, Juan Angel; Loza, Estibaliz; Zunzunegui, Maria Victoria; Lajas, Cristina; Vadillo, Cristina; Fontsere, Oscar; Rodriguez-Rodriguez, Luis; Martinez, Cristina; Fernandez-Gutierrez, Benjamin; Abasolo, Lydia

2013-07-01

To evaluate a rheumatology outpatient consultation access system for new patients. New patients seen from April 2005 to April 2006 at our rheumatology clinic (n = 4,460) were included and classified according to their appointment type: ordinary appointments (OA) to be seen within 30 days, urgent appointments (UA) and work disability appointments (WDA) to be seen within 3 days. Age, sex, diagnosis, and health-related quality of life (HRQoL) as determined by the Rosser Index were recorded. Logistic regression models were run to identify factors that contribute to each type of appointment. OA was the method of access for 1,938 new patients, while 1,194 and 1,328 patients were seen through WDA and UA appointments, respectively. Younger male patients, and those with microcrystalline arthritis, sciatica, shoulder, back, or neck pain, were more likely to use the faster access systems (UA or WDA), whereas patients with a degenerative disease were mainly seen through OA (<0.001). Subjects with poor (3.96; 95 % CI, 2.8-5.5) or very poor HRQoL (70.8; 95 % CI, 14.9-334) were strongly associated to visiting a rheumatologist through the WDA or UA access systems, respectively, compared to OA. Age, gender, diagnosis, and mainly health-related quality of life are associated with the referral pattern of access to rheumatologic outpatient care. Among new patients subjects with the worst HRQoL were more likely to access with faster methods (UA or WDA) than those with better HRQoL.

Factors related to noncompliance with screening mammogram appointments among low-income African-American women.

PubMed Central

Crump, S. R.; Mayberry, R. M.; Taylor, B. D.; Barefield, K. P.; Thomas, P. E.

2000-01-01

Despite current mammography recommendations, screening rates among African-American women are suboptimal. The purpose of this case-control study was to identify the psychological, demographic, and health care system barriers to screening mammography use among low-income African-American women. A total of 574 women with screening mammogram appointments at an urban hospital were interviewed to determine the predictors of mammogram appointment noncompliance. Predictor variables included: demographics; breast cancer knowledge, attitudes, beliefs, and screening practices; and type of health care provider making the referral. Age was inversely related to mammogram appointment noncompliance. Relative to women 40 to 49 years old, women 70 years of age and older were the least likely to miss their appointments (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.2, 0.5). Women referred for mammography by a physician's assistant or nurse practitioner were less likely to miss their appointments than women referred by a physician (OR, 0.3; 95% CI, 0.1, 0.8). Embarrassment, lack of breast symptoms, and forgetfulness also contributed to noncompliance. Key demographic, attitudinal, and health care system factors hinder low-income African-American women from obtaining screening mammograms. These findings have significant health education and policy implications for health care delivery to women in this population. PMID:10881473

Depression and literacy are important factors for missed appointments.

PubMed

Miller-Matero, Lisa Renee; Clark, Kalin Burkhardt; Brescacin, Carly; Dubaybo, Hala; Willens, David E

2016-09-01

Multiple variables are related to missed clinic appointments. However, the prevalence of missed appointments is still high suggesting other factors may play a role. The purpose of this study was to investigate the relationship between missed appointments and multiple variables simultaneously across a health care system, including patient demographics, psychiatric symptoms, cognitive functioning and literacy status. Chart reviews were conducted on 147 consecutive patients who were seen by a primary care psychologist over a six month period and completed measures to determine levels of depression, anxiety, sleep, cognitive functioning and health literacy. Demographic information and rates of missed appointments were also collected from charts. The average rate of missed appointments was 15.38%. In univariate analyses, factors related to higher rates of missed appointments included younger age (p = .03), lower income (p = .05), probable depression (p = .05), sleep difficulty (p = .05) and limited reading ability (p = .003). There were trends for a higher rate of missed appointments for patients identifying as black (p = .06), government insurance (p = .06) and limited math ability (p = .06). In a multivariate model, probable depression (p = .02) and limited reading ability (p = .003) were the only independent predictors. Depression and literacy status may be the most important factors associated with missed appointments. Implications are discussed including regular screening for depression and literacy status as well as interventions that can be utilized to help improve the rate of missed appointments.

Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population

PubMed Central

Sewell, Justin L.; Kushel, Margot B.; Inadomi, John M.; Yee, Hal F.

2009-01-01

Goals We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. Background Missed clinic appointments reduce the efficiency and availability of healthcare, but subspecialty clinic attendance among patients with established healthcare access has not been studied. Study We performed an observational study using secondary data from administrative sources to study patients referred to, and scheduled for an appointment in, the adult gastroenterology clinic serving the safety net healthcare system of San Francisco, California. Our dependent variable was whether subjects attended or missed a scheduled appointment. Analysis included multivariable logistic regression and classification tree analysis. 1,833 patients were referred and scheduled for an appointment between 05/2005 and 08/2006. Prisoners were excluded. All patients had a primary care provider. Results 683 patients (37.3%) missed their appointment; 1,150 (62.7%) attended. Language was highly associated with attendance in the logistic regression; non-English speakers were less likely than English speakers to miss an appointment (adjusted odds ratio 0.42 [0.28,0.63] for Spanish, 0.56 [0.38,0.82] for Asian language, p < 0.001). Other factors were also associated with attendance, but classification tree analysis identified language to be the most highly associated variable. Conclusions In an urban safety net healthcare population, among patients with established healthcare access and a scheduled gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access. PMID:19169147

SU-F-T-479: Estimation of the Accuracy in Respiratory-Gated Radiotherapy

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

Kurosawa, T; Miyakawa, S; Sato, M

Purpose: Irregular respiratory patterns affects dose outputs in respiratorygated radiotherapy and there is no commercially available quality assurance (QA) system for it. We designed and developed a patient specific QA system for respiratory-gated radiotherapy to estimate irradiated output. Methods: Our in-house QA system for gating was composed of a personal computer with the USB-FSIO electronic circuit connecting to the linear accelerator (ONCOR-K, Toshiba Medical Systems). The linac implements a respiratory gating system (AZ-733V, Anzai Medical). During the beam was on, 4.2 V square-wave pulses were continually sent to the system. Our system can receive and count the pulses. At first,more » our system and an oscilloscope were compared to check the performance of our system. Next, basic estimation models were generated when ionization-chamber measurements were performed in gating using regular sinusoidal wave patterns (2.0, 2.5, 4.0, 8.0, 15 sec/cycle). During gated irradiation with the regular patterns, the number of the pulses per one gating window was measured using our system. Correlation between the number of the pulses per one gating and dose per the gating window were assessed to generate the estimation model. Finally, two irregular respiratory patterns were created and the accuracy of the estimation was evaluated. Results: Compared to the oscilloscope, our system worked similarly. The basic models were generated with the accuracy within 0.1%. The results of the gated irradiations with two irregular respiratory patterns show good agreement within 0.4% estimation accuracy. Conclusion: Our developed system shows good estimation for even irregular respiration patterns. The system would be a useful tool to verify the output for respiratory-gated radiotherapy.« less

Patients' experiences of an open access follow up arrangement in managing inflammatory bowel disease

PubMed Central

Rogers, A; Kennedy, A; Nelson, E; Robinson, A

2004-01-01

Background: Improving access is a key policy issue in improving quality of care and extending patient choice and participation. People's experience of changing from fixed outpatient appointments to more flexible direct access arrangements for chronic disease has been underexplored. Objectives: To examine patients' views on using an open system of access compared with fixed outpatient appointments as part of a guided self-management intervention for inflammatory bowel disease (IBD). Design: Embedded qualitative study undertaken alongside a randomised controlled trial. Semi-structured interviews were undertaken to obtain an in depth understanding of patients' experience of the change in access arrangements. Participants: A purposive sample (n = 30) was drawn from the intervention group (n = 700) according to a range of responses to the trial baseline and follow up quantitative measures. Results: 28 interviews were included in the analysis. Compared with the previous system of fixed appointments, preference for the new open access system was based on enhanced personal control in contacting services and the view that it fitted better with everyday routine management and the requirement for urgent medical contact when symptoms fail to respond to medication. Preference for retaining fixed appointments was based on a sense of security from gaining access which did not require the individual to initiate the request for medical help. Conclusions: Open access may fit better with patients' self-management of their condition and everyday routines, roles and responsibilities. Ensuring that outpatient organisational arrangements and personnel are responsive to patient initiated requests for appointments is likely to impact on the acceptability of this type of access arrangement. Some people may continue to prefer the fixed appointment system which should be retained if patient choice is to be respected. PMID:15465941

Questionnaire survey about use of an online appointment booking system in one large tertiary public hospital outpatient service center in China

PubMed Central

2014-01-01

Background As a part of nationwide healthcare reforms, the Chinese government launched web-based appointment systems (WAS) to provide a solution to problems around outpatient appointments and services. These have been in place in all Chinese public tertiary hospitals since 2009. Methods Questionnaires were collected from both patients and doctors in one large tertiary public hospital in Shanghai, China.Data were analyzed to measure their satisfaction and views about the WAS. Results The 1000 outpatients randomly selected for the survey were least satisfied about the waiting time to see a doctor. Even though the WAS provided a much more convenient booking method, only 17% of patients used it. Of the 197 doctors surveyed, over 90% thought it was necessary to provide alternative forms of appointment booking systems for outpatients. However, about 80% of those doctors who were not associated professors would like to provide an ‘on-the-spot’ appointment option, which would lead to longer waits for patients. Conclusions Patients were least satisfied about the waiting times. To effectively reduce appointment-waiting times is therefore an urgent issue. Despite the benefits of using the WAS, most patients still registered via the usual method of queuing, suggesting that hospitals and health service providers should promote and encourage the use of the WAS. Furthermore, Chinese health providers need to help doctors to take others’ opinions or feedback into consideration when treating patients to minimize the gap between patients’ and doctors’ opinions. These findings may provide useful information for both practitioners and regulators, and improve recognition of this efficient and useful booking system, which may have far-reaching and positive implications for China’s ongoing reforms. PMID:24912568

The effect of fines on nonattendance in public hospital outpatient clinics: study protocol for a randomized controlled trial.

PubMed

Blæhr, Emely Ek; Kristensen, Thomas; Væggemose, Ulla; Søgaard, Rikke

2016-06-13

Nonattendance at scheduled appointments in public hospitals presents a challenge for efficient resource use and may ultimately affect health outcomes due to longer waiting times. Seven percent of all scheduled outpatient appointments in the United Kingdom are estimated to be nonattended. Various reminder systems have been shown to moderately reduce nonattendance, although the effect of issuing fines for nonattendance has not yet been tested in a randomized context. However, such use of financial incentives could impact access to care differently across the different socioeconomic groups. The aim of this study is to assess the effect of fines on hospital outpatient nonattendance. A 1:1 randomized controlled trial of scheduled outpatient appointments was used, with follow-ups until the date of appointment. The setting is an orthopedic clinic at a regional hospital in Denmark. Appointments for users who are scheduled for diagnostics, treatment, surgery, or follow-ups were included from May 2015 to November 2015. Appointments assigned to the intervention arm include an attachment of the appointment letter explaining that a fine will be issued in the case of nonattendance without prior notice. Appointments assigned to the control arm follow usual practice (same system but no letter attachment). The primary outcome is the proportion of nonattendance. Secondary outcomes are proportions of cancellations, sociodemographics, and health-problem characteristics. Furthermore, the intervention costs and production value of nonattended appointments will be measured. An analysis of effect and cost-effectiveness will be conducted based on a 5 % significance level. The study is initiated and funded by the Danish Regions, which have the responsibility for the Danish public healthcare sector. The results are expected to inform future decisions about the introduction of fines for nonattendance at public hospitals. Current Controlled Trials, ISRCTN61925912 . Registered on 6 July 2015.

Teachers Candidates' Reviews on Teacher Candidate Training System

ERIC Educational Resources Information Center

Altintas, Sedat; Görgen, Izzet

2017-01-01

In our country, as a result of the appointment in some different disciplines, nearly 30000 teacher candidates could be a part of education system. Also, a new revision has been completed on teacher candidate training and it has been put into action. Teacher candidates have been trained for six months after they have been appointed. These teachers…

Simulation and video animation of canal flushing created by a tide gate

USGS Publications Warehouse

Schoellhamer, David H.

1988-01-01

A tide-gate algorithm was added to a one-dimensional unsteady flow model that was calibrated, verified, and used to determine the locations of as many as five tide gates that would maximize flushing in two canal systems. Results from the flow model were used to run a branched Lagrangian transport model to simulate the flushing of a conservative constituent from the canal systems both with and without tide gates. A tide gate produces a part-time riverine flow through the canal system that improves flushing along the flow path created by the tide gate. Flushing with no tide gates and with a single optimally located tide gate are shown with a video animation.

Usefulness of a new online patient-specific quality assurance system for respiratory-gated radiotherapy.

PubMed

Kurosawa, Tomoyuki; Tachibana, Hidenobu; Moriya, Shunsuke; Miyakawa, Shin; Nishio, Teiji; Sato, Masanori

2017-11-01

The accuracy of gated irradiation may decrease when treatment is performed with short "beam-on" times. Also, the dose is subject to variation between treatment sessions if the respiratory rate is irregular. We therefore evaluated the impact of the differences between gated and non-gated treatment on doses using a new online quality assurance (QA) system for respiratory-gated radiotherapy. We generated dose estimation models to associate dose and pulse information using a 0.6 cc Farmer chamber and our QA system. During gated irradiation with each of seven regular and irregular respiratory patterns, with the Farmer chamber readings as references, we evaluated our QA system's accuracy. We then used the QA system to assess the impact of respiratory patterns on dose distribution for three lung and three liver radiotherapy plans. Gated and non-gated plans were generated and compared. There was agreement within 1.7% between the ionization chamber and our system for several regular and irregular motion patterns. For dose distributions with measured errors, there were larger differences between gated and non-gated treatment for high-dose regions within the planned treatment volume (PTV). Compared with a non-gated plan, PTV D 95% for a gated plan decreased by -1.5% to -2.6%. Doses to organs at risk were similar with both plans. Our simple system estimated the radiation dose to the patient using only pulse information from the linac, even during irregular respiration. The quality of gated irradiation for each patient can be verified fraction by fraction. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

It is more efficient to type: innovative self-registration and appointment self-arrival system improves the patient reception process.

PubMed

Knight, Vickie; Guy, Rebecca J; Handan, Wand; Lu, Heng; McNulty, Anna

2014-06-01

In 2010, we introduced an express sexually transmitted infection/HIV testing service at a large metropolitan sexual health clinic, which significantly increased clinical service capacity. However, it also increased reception staff workload and caused backlogs of patients waiting to register or check in for appointments. We therefore implemented a new electronic self-registration and appointment self-arrival system in March 2012 to increase administrative efficiency and reduce waiting time for patients. We compared the median processing time overall and for each step of the registration and arrival process as well as the completeness of patient contact information recorded, in a 1-week period before and after the redesign of the registration system. χ2 Test and rank sum tests were used. Before the redesign, the median processing time was 8.33 minutes (interquartile range [IQR], 6.82-15.43), decreasing by 30% to 5.83 minutes (IQR, 4.75-7.42) when the new electronic self-registration and appointment self-arrival system was introduced (P < 0.001). The largest gain in efficiency was in the time taken to prepare the medical record for the clinician, reducing from a median of 5.31 minutes (IQR, 4.02-8.29) to 0.57 minutes (IQR, 0.38-1) in the 2 periods. Before implementation, 20% of patients provided a postal address and 31% an e-mail address, increasing to 60% and 70% post redesign, respectively (P < 0.001). Our evaluation shows that an electronic patient self-registration and appointment self-arrival system can improve clinic efficiency and save patient time. Systems like this one could be used by any outpatient service with large patient volumes as an integrated part of the electronic patient management system or as a standalone feature.

Improving Appointment Adherence among Young Adults with HIV in Peru with an mHealth Intervention: a Feasibility Study

PubMed Central

Prochazka, Mateo; Batey, D Scott; Zinski, Anne; Dionne-Odom, Jodie; Otero, Larissa; Rodriguez, J Martin; González, Elsa

2017-01-01

Abstract Background Mobile Health (mHealth) interventions, including short message services (SMS) reminders and motivational messages, are associated with improved HIV appointment adherence, though feasibility is context-dependent. We assessed the feasibility of an mHealth intervention to improve appointment adherence among young adults with HIV in Lima, Peru. Methods Between November 2016 and April 2017, we implemented a one-way mHealth pilot intervention in an outpatient hospital without electronic medical records. We enrolled young adults (age 18–29) entering HIV care in a 3-component intervention: (i) reminder SMS prior to scheduled appointments (provider, laboratory, pharmacy); (ii) motivational SMS after each visit; and (iii) phone call following a missed visit. Feasibility evaluation included enrollment acceptance, visit tracking (information captured in the study database within 3 days of attendance), and proportion of intervention delivery (threshold >90%). We performed a qualitative assessment to identify implementation challenges reviewing staff field notes and meeting minutes. Results We enrolled 80/94 (85.1%) eligible participants. The median age was 25 years and 83% were male. The median time of follow-up after enrollment was 115 [interquartile range (IQR): 84–141] days, and participants had a median of 10 (IQR: 8–14) visits during the study period. Among 850 total participant visits, study personnel tracked 751 (88.4%); most (80.8%) untracked visits were pharmacy pickups. Of all tracked visits, most (78.7%) were scheduled appointments and 160 (21.3%) were unscheduled walk-ins. Intervention delivery reached 556/591 (94.1%) for reminder SMS; 733/751 (97.6%) for motivational messages, and 169/170 (99.4%) phone calls for missed visits, 127 (75.1%) of which were answered. Qualitative assessment revealed 2 major themes: real-time appointment tracking in a paper-based system consumed most staff time and resources, and meticulous in-person coordination between the implementation and hospital staff was essential for tracking. Conclusion An mHealth intervention to improve appointment adherence among young adults with HIV in Peru appears feasible with dedicated staff and a reliable appointment tracking system. Digitalized appointment systems may be needed to address challenges for scale-up. Disclosures All authors: No reported disclosures.

5 CFR 9901.511 - Appointing authorities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9901.511 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND LABOR RELATIONS SYSTEMS (DEPARTMENT OF DEFENSE-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF DEFENSE NATIONAL SECURITY... these authorities will be given career, career conditional, term or temporary appointments in the...

[The Appointment of Paediatric Professorships in the Soviet Occupation Zone and the early GDR. The Impact of the Political System Change after 1945].

PubMed

Hinz-Wessels, Annette

2016-01-01

This paper examines the impact of the political system change after 1945 on the appointment of paediatric professorships in the Soviet Occupation Zone and the GDR up until the time the Wall was built in 1961. It can be demonstrated that the political purge in the post-war period had only minor impact on the appointment of professorships and the National Socialist past no longer mattered after the conclusion of denazification. In 1957, the proportion of former NSDAP members among East German university professors of paediatrics was 100 per cent. When it came to new appointments, both members of the "bourgeois" academic non-professorial teaching staff from the GDR as well as paediatricians from West Germany, who had largely gained their scientifically qualifications under National Socialism, were in the running. A politically-controlled elite exchange did not take place until the construction of the Wall. State and party organs generally followed the personnel proposals of the universities since an insufficient number of qualified candidates was available for the systematic appointment of ,,progressive" paediatricians. Given the lack of staff, the SED personnel policy was aimed at the integration of previous elites, as long as they behaved loyally towards the new state. Since the East German faculties continued to make the questioning of the professionally competent professors in West Germany and East Germany the basis for their appointment lists, West German university paediatricians were able to exert considerable influence on the appointment of East German paediatric professorship until 1960s.

Preclinic group education sessions reduce waiting times and costs at public pain medicine units.

PubMed

Davies, Stephanie; Quintner, John; Parsons, Richard; Parkitny, Luke; Knight, Paul; Forrester, Elizabeth; Roberts, Mary; Graham, Carl; Visser, Eric; Antill, Tracy; Packer, Tanya; Schug, Stephan A

2011-01-01

To assess the effects of preclinic group education sessions and system redesign on tertiary pain medicine units and patient outcomes. Prospective cohort study. Two public hospital multidisciplinary pain medicine units. People with persistent pain. A system redesign from a "traditional" model (initial individual medical appointments) to a model that delivers group education sessions prior to individual appointments. Based on Patient Triage Questionnaires patients were scheduled to attend Self-Training Educative Pain Sessions (STEPS), a two day eight hour group education program, followed by optional patient-initiated clinic appointments. Number of patients completing STEPS who subsequently requested individual outpatient clinic appointment(s); wait-times; unit cost per new patient referred; recurrent health care utilization; patient satisfaction; Global Perceived Impression of Change (GPIC); and utilized pain management strategies. Following STEPS 48% of attendees requested individual outpatient appointments. Wait times reduced from 105.6 to 16.1 weeks at one pain unit and 37.3 to 15.2 weeks at the second. Unit cost per new patient appointed reduced from $1,805 Australian Dollars (AUD) to AUD$541 (for STEPS). At 3 months, patients scored their satisfaction with "the treatment received for their pain" more positively than at baseline (change score=0.88; P=0.0003), GPIC improved (change score=0.46; P<0.0001) and mean number of active strategies utilized increased by 4.12 per patient (P=0.0004). The introduction of STEPS was associated with reduced wait-times and costs at public pain medicine units and increased both the use of active pain management strategies and patient satisfaction. Wiley Periodicals, Inc.

Photonic ququart logic assisted by the cavity-QED system.

PubMed

Luo, Ming-Xing; Deng, Yun; Li, Hui-Ran; Ma, Song-Ya

2015-08-14

Universal quantum logic gates are important elements for a quantum computer. In contrast to previous constructions of qubit systems, we investigate the possibility of ququart systems (four-dimensional states) dependent on two DOFs of photon systems. We propose some useful one-parameter four-dimensional quantum transformations for the construction of universal ququart logic gates. The interface between the spin of a photon and an electron spin confined in a quantum dot embedded in a microcavity is applied to build universal ququart logic gates on the photon system with two freedoms. Our elementary controlled-ququart gates cost no more than 8 CNOT gates in a qubit system, which is far less than the 104 CNOT gates required for a general four-qubit logic gate. The ququart logic is also used to generate useful hyperentanglements and hyperentanglement-assisted quantum error-correcting code, which may be available in modern physical technology.

Photonic ququart logic assisted by the cavity-QED system

PubMed Central

Luo, Ming-Xing; Deng, Yun; Li, Hui-Ran; Ma, Song-Ya

2015-01-01

Universal quantum logic gates are important elements for a quantum computer. In contrast to previous constructions of qubit systems, we investigate the possibility of ququart systems (four-dimensional states) dependent on two DOFs of photon systems. We propose some useful one-parameter four-dimensional quantum transformations for the construction of universal ququart logic gates. The interface between the spin of a photon and an electron spin confined in a quantum dot embedded in a microcavity is applied to build universal ququart logic gates on the photon system with two freedoms. Our elementary controlled-ququart gates cost no more than 8 CNOT gates in a qubit system, which is far less than the 104 CNOT gates required for a general four-qubit logic gate. The ququart logic is also used to generate useful hyperentanglements and hyperentanglement-assisted quantum error-correcting code, which may be available in modern physical technology. PMID:26272869

Wait times for physical and occupational therapy in the public system for people with arthritis in quebec.

PubMed

Delaurier, Ashley; Bernatsky, Sasha; Raymond, Marie-Hélène; Feldman, Debbie Ehrmann

2013-01-01

Although arthritis is the leading cause of pain and disability in Canada, and physical therapy (PT) and occupational therapy (OT) are beneficial both for chronic osteoarthritis (OA) and for inflammatory arthritis such as rheumatoid arthritis (RA), there appear to be problems with access to such services. The aim of this study was to document wait times from referral by physician to consultation with PT or OT in the public health care system for people with arthritis in Quebec, Canada. Appointments were requested by telephone, using hypothetical case scenarios; wait times were defined as the time between initial request and appointment date. Descriptive statistics were used to examine the wait times in relation to diagnosis, service provider and geographic area. For both scenarios (OA and RA) combined, 13% were offered an appointment within 6 months, 13% offered given an appointment within 6-12 months, 24% were told they would need to wait longer than 12 months, and 22% were refused services. The remaining 28% were told they would require an evaluation appointment for functional assessment before being given an appointment for therapy. No difference was found between RA and OA diagnoses. Our study suggests that most people with arthritis living in the province of Quebec are not receiving publicly accessible PT or OT intervention in a timely manner.

Audiologist-patient communication profiles in hearing rehabilitation appointments.

PubMed

Meyer, Carly; Barr, Caitlin; Khan, Asaduzzaman; Hickson, Louise

2017-08-01

To profile the communication between audiologists and patients in initial appointments on a biomedical-psychosocial continuum; and explore the associations between these profiles and 1) characteristics of the appointment and 2) patients' decisions to pursue hearing aids. Sixty-three initial hearing assessment appointments were filmed and audiologist-patient communication was coded using the Roter Interaction Analysis System. A hierarchical cluster analysis was conducted to profile audiologist-patient communication, after which regression modelling and Chi-squared analyses were conducted. Two distinct audiologist-patient communication profiles were identified during both the history taking phase (46=biopsychosocial profile, 15=psychosocial profile) and diagnosis and management planning phase (45=expanded biomedical profile, 11=narrowly biomedical profile). Longer appointments were significantly more likely to be associated with an expanded biomedical interaction during the diagnosis and management planning phase. No significant associations were found between audiologist-patient communication profile and patients' decisions to pursue hearing aids. Initial audiology consultations appear to remain clinician-centred. Three quarters of appointments began with a biopsychosocial interaction; however, 80% ended with an expanded biomedical interaction. Findings suggest that audiologists could consider modifying their communication in initial appointments to more holistically address the needs of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Factors Associated With Adherence to 14-Day Office Appointments After Heart Failure Discharge.

PubMed

Distelhorst, Karen; Claussen, Renee; Dion, Kelly; Bena, James F; Morrison, Shannon L; Walker, Donna; Tai, Hua-Li; Albert, Nancy M

2018-06-01

Follow-up within 14 days after hospital discharge for heart failure (HF) may prevent 30-day hospital readmission, but adherence varies. The purpose of this study was to determine predictors of nonadherence to scheduled appointments. A medical record review included patients hospitalized for decompensated HF at 3 health system hospitals who had a scheduled 14-day office appointment. Patient demographics, and social, HF, and hospital factors were studied for association with appointment adherence. Multivariable modeling was used to determine the odds of missing scheduled appointments. Of 701 cases, mean (standard deviation) age was 73.5 (13.8) years, 46.4% were female and 38.9% were nonwhite. Appointment nonadherence was 16.2%. In multivariate analyses, 4 factors predicted missed appointments: drug use history (odds ratio [OR], 3.95; 95% confidence interval [CI], 1.70-9.20; P < .001), nonwhite race (OR, 1.85; 95% CI, 1.08-3.16; P = .024), pulmonary disease (OR, 1.80; 95% CI, 1.12-2.87; P = .014), and anemia (OR, 1.58; 95% CI, 1.01-2.46; P = .044). Scheduling appointments postdischarge vs predischarge was not associated with missed appointments (OR, 0.72; 95% CI, 0.45-1.15; P = .17). Findings may help practitioners identify patients who are likely to miss a follow-up visit; all 4 predictors were easily retrievable from medical records during hospitalization. Copyright © 2018 Elsevier Inc. All rights reserved.

Factors Associated With Missed and Cancelled Colonoscopy Appointments at Veterans Health Administration Facilities.

PubMed

Partin, Melissa R; Gravely, Amy; Gellad, Ziad F; Nugent, Sean; Burgess, James F; Shaukat, Aasma; Nelson, David B

2016-02-01

Cancelled and missed colonoscopy appointments waste resources, increase colonoscopy delays, and can adversely affect patient outcomes. We examined individual and organizational factors associated with missed and cancelled colonoscopy appointments in Veteran Health Administration facilities. From 69 facilities meeting inclusion criteria, we identified 27,994 patients with colonoscopy appointments scheduled for follow-up, on the basis of positive fecal occult blood test results, between August 16, 2009 and September 30, 2011. We identified factors associated with colonoscopy appointment status (completed, cancelled, or missed) by using hierarchical multinomial regression. Individual factors examined included age, race, sex, marital status, residence, drive time to nearest specialty care facility, limited life expectancy, comorbidities, colonoscopy in the past decade, referring facility type, referral month, and appointment lead time. Organizational factors included facility region, complexity, appointment reminders, scheduling, and prep education practices. Missed appointments were associated with limited life expectancy (odds ratio [OR], 2.74; P = .0004), no personal history of polyps (OR, 2.74; P < .0001), high facility complexity (OR, 2.69; P = .007), dual diagnosis of psychiatric disorders and substance abuse (OR, 1.82; P < .0001), and opt-out scheduling (OR, 1.57; P = .02). Cancelled appointments were associated with age (OR, 1.61; P = .0005 for 85 years or older and OR, 1.44; P < .0001 for 65-84 years old), no history of polyps (OR, 1.51; P < .0001), and opt-out scheduling (OR, 1.26; P = .04). Additional predictors of both outcomes included race, marital status, and lead time. Several factors within Veterans Health Administration clinic control can be targeted to reduce missed and cancelled colonoscopy appointments. Specifically, developing systems to minimize referrals for patients with limited life expectancy could reduce missed appointments, and use of opt-in scheduling and reductions in appointment lead time could improve both outcomes. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Same-day booking: success in a Canadian family practice.

PubMed

Mitchell, Victoria

2008-03-01

Patients in a family practice had to wait 6 weeks for an appointment. To improve patient care by facilitating access to timely appointments. An FP from Halifax, NS, implemented advanced access in her practice. Advanced access is a same-day booking system, which has been shown to reduce or eliminate patient backlogs without the addition of resources. Theoretically, it can be put into effect in any practice with a stable backlog (which indicates that supply and demand are well matched). The first step to implement the advanced access system was to clear the existing appointment backlog. During a 6-week "boot camp" period, all prebooked patients and patients who called requesting same-day appointments were seen (between 50 and 60 patients per day). Same-day appointment rules apply to almost all patients. Staff begin accepting calls at 8:00 AM, and patients request the most convenient time available. Baseline and postimplementation data are not available, as this was not a formal research study. Nevertheless, this FP from Halifax who implemented advanced access experienced the following in her practice: elimination of patient backlog, fewer no-shows, patients' happiness with the system, increase in physician and staff morale, and stability in physician income. Formal feasibility studies and research evaluating patient outcomes, cost effectiveness, and physician and patient satisfaction in a variety of practice settings would help Canadian FPs decide if same-day booking could be successfully implemented in their practices.

Primary care access improvement: an empowerment-interaction model.

PubMed

Ledlow, G R; Bradshaw, D M; Shockley, C

2000-05-01

Improving community primary care access is a difficult and dynamic undertaking. Realizing a need to improve appointment availability, a systematic approach based on measurement, empowerment, and interaction was developed. The model fostered exchange of information and problem solving between interdependent staff sections within a managed care system. Measuring appointments demanded but not available proved to be a credible customer-focused approach to benchmark against set goals. Changing the organizational culture to become more sensitive to changing beneficiary needs was a paramount consideration. Dependent-group t tests were performed to compare the pretreatment and posttreatment effect. The empowerment-interaction model significantly improved the availability of routine and wellness-type appointments. The availability of urgent appointments improved but not significantly; a better prospective model needs to be developed. In aggregate, appointments demanded but not available (empowerment-interaction model) were more than 10% before the treatment and less than 3% with the treatment.

5 CFR 9901.408 - Employees on time-limited appointments.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... 9901.408 Section 9901.408 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND LABOR RELATIONS SYSTEMS (DEPARTMENT OF DEFENSE-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF DEFENSE..., accomplishments and contributions during that appointment; and (2) May serve as documentation and justification...

5 CFR 9901.408 - Employees on time-limited appointments.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... 9901.408 Section 9901.408 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND LABOR RELATIONS SYSTEMS (DEPARTMENT OF DEFENSE-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF DEFENSE..., accomplishments and contributions during that appointment; and (2) May serve as documentation and justification...

Development of patient-controlled respiratory gating system based on visual guidance for magnetic-resonance image-guided radiation therapy.

PubMed

Kim, Jung-In; Lee, Hanyoung; Wu, Hong-Gyun; Chie, Eui Kyu; Kang, Hyun-Cheol; Park, Jong Min

2017-09-01

The aim of this study is to develop a visual guidance patient-controlled (VG-PC) respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy (MR-IGRT) and to evaluate the performance of the developed system. The near-real-time cine planar MR image of a patient acquired during treatment was transmitted to a beam projector in the treatment room through an optical fiber cable. The beam projector projected the cine MR images inside the bore of the ViewRay system in order to be visible to a patient during treatment. With this visual information, patients voluntarily controlled their respiration to put the target volume into the gating boundary (gating window). The effect of the presence of the beam projector in the treatment room on the image quality of the MRI was investigated by evaluating the signal-to-noise ratio (SNR), uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity with the VG-PC gating system. To evaluate the performance of the developed system, we applied the VG-PC gating system to a total of seven patients; six patients received stereotactic ablative radiotherapy (SABR) and one patient received conventional fractionated radiation therapy. The projected cine MR images were visible even when the room light was on. No image data loss or additional time delay during delivery of image data were observed. Every indicator representing MRI quality, including SNR, uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity exhibited values higher than the tolerance levels of the manufacturer with the VG-PC gating system; therefore, the presence of the VG-PC gating system in the treatment room did not degrade the MR image quality. The average beam-off times due to respiratory gating with and without the VG-PC gating system were 830.3 ± 278.2 s and 1264.2 ± 302.1 s respectively (P = 0.005). Consequently, the total treatment times excluding the time for patient setup with and without the VG-PC gating system were 1453.3 ± 297.3 s and 1887.2 ± 469.6 s, respectively, on average (P = 0.005). The average number of beam-off events during whole treatment session was reduced from 457 ± 154 times to 195 ± 90 times by using the VG-PC gating system (P < 0.001). The developed system could improve treatment efficiency when performing respiratory-gated MR-IGRT. The VG-PC gating system could be applied to any kind of bore-type radiotherapy machine. © 2017 American Association of Physicists in Medicine.

Walter Reed Army Medical Center's Internet-based electronic health portal.

PubMed

Abbott, Kevin C; Boocks, Carl E; Sun, Zhengyi; Boal, Thomas R; Poropatich, Ronald K

2003-12-01

Use of the World Wide Web (WWW) and electronic media to facilitate medical care has been the subject of many reports in the popular press. However, few reports have documented the results of implementing electronic health portals for essential medical tasks, such as prescription refills and appointments. At Walter Reed Army Medical Center, "Search & Learn" medical information, Internet-based prescription refills and patient appointments were established in January 2001. A multiphase retrospective analysis was conducted to determine the use of the "Search & Learn" medical information and the relative number of prescription refills and appointments conducted via the WWW compared with conventional methods. From January 2001 to May 2002, there were 34,741 refills and 819 appointments made over the Internet compared with 2,275,112 refills and approximately 500,000 appointments made conventionally. WWW activity accounted for 1.52% of refills and 0.16% of appointments. There was a steady increase in this percentage over the time of the analysis. In April of 2002, the monthly average of online refills had risen to 4.57% and online appointments were at 0.27%. Online refills were projected to account for 10% of all prescriptions in 2 years. The "Search & Learn" medical information portion of our web site received 147,429 unique visits during this same time frame, which was an average of 326 visitors per day. WWW-based methods of conducting essential medical tasks accounted for a small but rapidly increasing percentage of total activity at Walter Reed Army Medical Center. Subsequent phases of analysis will assess demographic and geographic factors and aid in the design of future systems to increase use of the Internet-based systems.

Statistical Determination of the Gating Windows for Respiratory-Gated Radiotherapy Using a Visible Guiding System.

PubMed

Oh, Se An; Yea, Ji Woon; Kim, Sung Kyu

2016-01-01

Respiratory-gated radiation therapy (RGRT) is used to minimize the radiation dose to normal tissue in lung-cancer patients. Although determining the gating window in the respiratory phase of patients is important in RGRT, it is not easy. Our aim was to determine the optimal gating window when using a visible guiding system for RGRT. Between April and October 2014, the breathing signals of 23 lung-cancer patients were recorded with a real-time position management (RPM) respiratory gating system (Varian, USA). We performed statistical analysis with breathing signals to find the optimal gating window for guided breathing in RGRT. When we compared breathing signals before and after the breathing training, 19 of the 23 patients showed statistically significant differences (p < 0.05). The standard deviation of the respiration signals after breathing training was lowest for phases of 30%-70%. The results showed that the optimal gating window in RGRT is 40% (30%-70%) with respect to repeatability for breathing after respiration training with the visible guiding system. RGRT was performed with the RPM system to confirm the usefulness of the visible guiding system. The RPM system and our visible guiding system improve the respiratory regularity, which in turn should improve the accuracy and efficiency of RGRT.

[Nonattendance to medical specialists’ appointments and its relation to regional environmental and socioeconomic indicators in the Chilean public health system].

PubMed

Rebolledo, Elizabeth Angélica Salinas; Mesía, Rolando De la Cruz; Silva, Gabriel Bastías

2014-10-16

Medical care provided by medical specialists is one of the scarcest resources in the public system. It is costly and difficult to access for the general population. Availability and accessibility of specialized care is related to economic, social and cultural aspects that vary among geographical areas. An aggravating factor for this situation is patients’ failure to appear on the date of their appointment, which is defined as the nonattendance of patients to medical specialist appointments without notice. To measure and analyze the phenomenon of nonattendance of patients to medical appointments with specialists in the public healthcare system of Chile and its relationship with environmental and socioeconomic regional indicators. Ecological design study, using medical care records in the public system and environmental and socioeconomic regional indicators potentially related to the absence of patients, between the years 2005-2010. Poisson regression models with random components were used for assessing associations. There is 16.5% of nonattendance of patients, with a range between regions from 8.8 to 20.2%. Nonattendance is higher in the specialties of dermatology, geriatrics and nutrition (20.0%), in children (3.1% more than in adults), in areas with highest indigenous population (RR=1.3), in areas with low diversity of specialties (RR=1.1) and in the months of February, July, November and December (RR>1.1). In Chile, socioeconomic factors and the management of healthcare resources have greater influence on the nonattendance of patients to medical specialists’ appointments than environmental factors; therefore, this phenomenon may be avoidable.

Reduction of missed appointments at an urban primary care clinic: a randomised controlled study.

PubMed

Perron, Noelle Junod; Dao, Melissa Dominicé; Kossovsky, Michel P; Miserez, Valerie; Chuard, Carmen; Calmy, Alexandra; Gaspoz, Jean-Michel

2010-10-25

Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile) reminder; 2. If no phone response: a Short Message Service (SMS) reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122) in the control group and 7.8% (n = 82) in the intervention group (p < 0.005), and allowed to reallocate 28% of cancelled appointments. It also proved to be cost effective in providing a total net benefit of 1846. - EUR/3 months. A satisfaction survey conducted with 241 patients showed that 93% of them were not bothered by the reminders and 78% considered them to be useful. By multivariate analysis, the following characteristics were significant predictors of missed appointments: younger age (OR per additional decade 0.82; CI 0.71-0.94), male gender (OR 1.72; CI 1.18-2.50), follow-up appointment >1 year (OR 2.2; CI: 1.15-4.2), substance abuse (2.09, CI 1.21-3.61), and being an asylum seeker (OR 2.73: CI 1.22-6.09). A practical reminder system can significantly increase patient attendance at medical outpatient clinics. An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders.

Reduction of missed appointments at an urban primary care clinic: a randomised controlled study

PubMed Central

2010-01-01

Background Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. Methods We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile) reminder; 2. If no phone response: a Short Message Service (SMS) reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. Results 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122) in the control group and 7.8% (n = 82) in the intervention group (p < 0.005), and allowed to reallocate 28% of cancelled appointments. It also proved to be cost effective in providing a total net benefit of 1846. - EUR/3 months. A satisfaction survey conducted with 241 patients showed that 93% of them were not bothered by the reminders and 78% considered them to be useful. By multivariate analysis, the following characteristics were significant predictors of missed appointments: younger age (OR per additional decade 0.82; CI 0.71-0.94), male gender (OR 1.72; CI 1.18-2.50), follow-up appointment >1year (OR 2.2; CI: 1.15-4.2), substance abuse (2.09, CI 1.21-3.61), and being an asylum seeker (OR 2.73: CI 1.22-6.09). Conclusion A practical reminder system can significantly increase patient attendance at medical outpatient clinics. An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders. PMID:20973950

Improving rates of screening and prevention by leveraging existing information systems.

PubMed

Neil, Nancy

2003-11-01

In 1997 Virginia Mason Health System (VMMC), a vertically integrated hospital and multispecialty group practice, had no process or system to deliver the right patient clinical data, in the right form, at the right place--when providers needed it for effective patient care. Without any new investment in technology, a work group of five individuals leveraged existing, primarily paper-based information systems to launch development and implementation of a provider prompting tool--a primary care and prevention (PCP) report--which prompted providers to complete screening, prevention, and disease management services at every patient appointment. The work group developed and pilot tested the report and created a mechanism by which the report could be delivered just in time before each patient's appointment. The report integrated information from independent appointment scheduling, laboratory results reporting, patient demographics, and billing data sources. MEASURING THE PCP REPORT'S IMPACT: The results of two separate analyses demonstrate improvement in rates of screening and prevention across VMMC soon after the PCP report became available. These results led senior leadership to make the PCP report's utilization a systemwide imperative. The PCP report is used by nearly all primary care providers as a prompt to complete screening, prevention, and disease management services at every patient appointment.

Quantum computing gates via optimal control

NASA Astrophysics Data System (ADS)

Atia, Yosi; Elias, Yuval; Mor, Tal; Weinstein, Yossi

2014-10-01

We demonstrate the use of optimal control to design two entropy-manipulating quantum gates which are more complex than the corresponding, commonly used, gates, such as CNOT and Toffoli (CCNOT): A two-qubit gate called polarization exchange (PE) and a three-qubit gate called polarization compression (COMP) were designed using GRAPE, an optimal control algorithm. Both gates were designed for a three-spin system. Our design provided efficient and robust nuclear magnetic resonance (NMR) radio frequency (RF) pulses for 13C2-trichloroethylene (TCE), our chosen three-spin system. We then experimentally applied these two quantum gates onto TCE at the NMR lab. Such design of these gates and others could be relevant for near-future applications of quantum computing devices.

SU-F-T-518: Development and Characterization of a Gated Treatment System Implemented with An In-House Optical Tracking System and the Elekta Response Interface

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

Barraclough, B; Park, J; Li, F

2016-06-15

Purpose: To report the development and characterization of the first in-house gating system implemented with an optical tracking system (OTS) and the Elekta Response™ interface. Methods: The Response™ connects a patient tracking system with a linac, enabling the tracking system to control radiation delivery. The developed system uses an in-house OTS to monitor patient breathing. The OTS consists of two infrared-based cameras, tracking markers affixed on patient. It achieves gated or breath-held (BH) treatment by calling beam ON/OFF functions in the Response™ dynamic-link library (DLL). A 4D motion phantom was used to evaluate its dosimetric and time delay characteristics. Twomore » FF- and two FFF-IMRT beams were delivered in non-gated, BH and gated mode. The sinusoidal gating signal had a 6 sec period and 15 mm amplitude. The duty cycle included 10%, 20%, 30% and 50%. The BH signal was adapted from the sinusoidal wave by inserting 15 sec BHs. Each delivery was measured with a 2D diode array (MapCHECK™) and compared with the non-gated delivery using gamma analysis (3%). The beam ON/OFF time was captured using the service graphing utility of the linac. Results: The gated treatments were successfully delivered except the 10% duty cycle. The BH delivery had perfect agreement (100%) with non-gated delivery; the agreement of gated delivery decreased from 99% to 88% as duty cycle reduced from 50% to 20%. The beam on/off delay was on average 0.25/0.06 sec. The delivery time for the 50%, 30% and 20% duty cycle increased by 29%, 71% and 139%, respectively. No dosimetric or time delay difference was noticed between FF- and FFF-IMRT beams. Conclusion: The in-house gating system was successfully developed with dosimetric and time delay characteristics in line with published results for commercial systems. It will be an important platform for further research and clinical development of gated treatment.« less

An Analysis of the Patient Appointing System of the 121st Combat Support Hospital to Determine an Optimal Appointing System

DTIC Science & Technology

2008-06-01

Their dedication and hard work for the students has ensured the success of myself and all other students who have had the privilege to earn their...Defense Inspector General, 2006). As the next generation medical and dental clinical information system, AHLTA will produce and maintain a life-long...of being focused only on a specific clinic or section. Cross training will also help to prevent burnout by providing staff with a change of pace. A

41 CFR 302-2.4 - What is my effective transfer or appointment date?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What is my effective transfer or appointment date? 302-2.4 Section 302-2.4 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES INTRODUCTION 2-EMPLOYEES ELIGIBILITY REQUIREMENTS General...

75 FR 65673 - Appointments to Performance Review Board for Senior Executive Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... appointed as members of the NRC Performance Review Board (PRB) responsible for making recommendations to the... Executives and Senior Level System employees: Darren B. Ash, Deputy Executive Director for Corporate... of the NRC PRB Panel that was established to review appraisals and make recommendations to the...

Technical Note: Evaluation of the latency and the beam characteristics of a respiratory gating system using an Elekta linear accelerator and a respiratory indicator device, Abches.

PubMed

Saito, Masahide; Sano, Naoki; Ueda, Koji; Shibata, Yuki; Kuriyama, Kengo; Komiyama, Takafumi; Marino, Kan; Aoki, Shinichi; Onishi, Hiroshi

2018-01-01

To evaluate the basic performance of a respiratory gating system using an Elekta linac and an Abches respiratory-monitoring device. The gating system was comprised of an Elekta Synergy linac equipped with a Response TM gating interface module and an Abches respiratory-monitoring device. The latencies from a reference respiratory signal to the resulting Abches gating output signal and the resulting monitor-ion-chamber output signal were measured. Then, the flatness and symmetry of the gated beams were measured using a two-dimensional ionization chamber array for fixed and arc beams, respectively. Furthermore, the beam quality, TPR 20,10 , and the output of the fixed gated beams were also measured using a Farmer chamber. Each of the beam characteristics was compared with each of those for nongated irradiation. The full latencies at beam-on and beam-off for 6-MV gated beams were 336.4 ± 23.4 ms and 87.6 ± 7.1 ms, respectively. The differences in flatness between the gated and nongated beams were within 0.91% and 0.87% for the gun-target and left-right directions, respectively. In the same manner, the beam symmetries were within 0.68% and 0.82%, respectively. The percentage differences in beam quality and beam output were below 1% for a beam-on time range of 1.1-7 s. The latency of the Elekta gating system combined with Abches was found to be acceptable using our measurement method. Furthermore, we demonstrated that the beam characteristics of the gating system using our respiratory indicator were comparable with the nongated beams for a single-arc gated beam delivery. © 2017 American Association of Physicists in Medicine.

Children's missed healthcare appointments: professional and organisational responses.

PubMed

Appleton, Jane; Powell, Catherine; Coombes, Lindsey

2016-09-01

This National Society for the Prevention of Cruelty to Children (NSPCC) funded UK study sought to examine organisational and professional responses to children's missed healthcare appointments. The study comprised two parts: phase I was a web-based scoping and systematic analysis of UK National Health Service healthcare organisations' internal policies on missed appointments. Phase II involved a case study of how missed appointments were managed within one hospital trust, including interviews with hospital-based staff, review of organisational data and examination of policies and 'systems' in place. Policies accessed were of variable quality when benchmarked against a predetermined set of evidence-based standards. Additional material (eg, board minutes) gleaned through the searches found an apparent disconnect between nationally determined safeguarding requirements and strategies to reduce the cost pressures arising from missed appointments. Findings from the case study included the continuing use of the adult-centric term 'did not attend' (DNA), the challenges that may be inherent in attending appointments (with concomitant sympathy for parents) and a need to further explore general practitioner responses to DNA notifications, particularly given the acknowledged association between missed appointments and child maltreatment. The web-based scoping exercise yielded a small number of organisational policies. These were of variable quality when rated against predetermined standards. Other material gathered through the search strategy found evidence that 'missed appointment' strategies aimed at reducing costs did not always acknowledge the discrete needs of children. The case study findings contribute to an understanding of the complexities and challenges of responding to a missed appointment and the importance of taking a child-centred approach. 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/

Integrating respiratory gating into a megavoltage cone-beam CT system

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

Chang Jenghwa; Sillanpaa, Jussi; Ling, Clifton C.

2006-07-15

We have previously described a low-dose megavoltage cone beam computed tomography (MV CBCT) system capable of producing projection image using one beam pulse. In this study, we report on its integration with respiratory gating for gated radiotherapy. The respiratory gating system tracks a reflective marker on the patient's abdomen midway between the xiphoid and umbilicus, and disables radiation delivery when the marker position is outside predefined thresholds. We investigate two strategies for acquiring gated scans. In the continuous rotation-gated acquisition, the linear accelerator (LINAC) is set to the fixed x-ray mode and the gantry makes a 5 min, 360 deg.continuousmore » rotation, during which the gating system turns the radiation beam on and off, resulting in projection images with an uneven distribution of projection angles (e.g., in 70 arcs each covering 2 deg.). In the gated rotation-continuous acquisition, the LINAC is set to the dynamic arc mode, which suspends the gantry rotation when the gating system inhibits the beam, leading to a slightly longer (6-7 min) scan time, but yielding projection images with more evenly distributed projection angles (e.g., {approx}0.8 deg.between two consecutive projection angles). We have tested both data acquisition schemes on stationary (a contrast detail and a thoracic) phantoms and protocol lung patients. For stationary phantoms, a separate motion phantom not visible in the images is used to trigger the RPM system. Frame rate is adjusted so that approximately 450 images (13 MU) are acquired for each scan and three-dimensional tomographic images reconstructed using a Feldkamp filtered backprojection algorithm. The gated rotation-continuous acquisition yield reconstructions free of breathing artifacts. The tumor in parenchymal lung and normal tissues are easily discernible and the boundary between the diaphragm and the lung sharply defined. Contrast-to-noise ratio (CNR) is not degraded relative to nongated scans of stationary phantoms. The continuous rotation-gated acquisition scan also yields tomographic images with discernible anatomic features; however, streak artifacts are observed and CNR is reduced by approximately a factor of 4. In conclusion, we have successfully developed a gated MV CBCT system to verify the patient positioning for gated radiotherapy.« less

Holonomic Quantum Control with Continuous Variable Systems.

PubMed

Albert, Victor V; Shu, Chi; Krastanov, Stefan; Shen, Chao; Liu, Ren-Bao; Yang, Zhen-Biao; Schoelkopf, Robert J; Mirrahimi, Mazyar; Devoret, Michel H; Jiang, Liang

2016-04-08

Universal computation of a quantum system consisting of superpositions of well-separated coherent states of multiple harmonic oscillators can be achieved by three families of adiabatic holonomic gates. The first gate consists of moving a coherent state around a closed path in phase space, resulting in a relative Berry phase between that state and the other states. The second gate consists of "colliding" two coherent states of the same oscillator, resulting in coherent population transfer between them. The third gate is an effective controlled-phase gate on coherent states of two different oscillators. Such gates should be realizable via reservoir engineering of systems that support tunable nonlinearities, such as trapped ions and circuit QED.

Technical Note: Validation and implementation of a wireless transponder tracking system for gated stereotactic ablative radiotherapy of the liver

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

James, Joshua, E-mail: joshua.james@louisville.edu; Dunlap, Neal E.; Nguyen, Vi Nhan

Purpose: Tracking soft-tissue targets has recently been cleared as a new application of Calypso, an electromagnetic wireless transponder tracking system, allowing for gated treatment of the liver based on the motion of the target volume itself. The purpose of this study is to describe the details of validating the Calypso system for wireless transponder tracking of the liver and to present the clinical workflow for using it to deliver gated stereotactic ablative radiotherapy (SABR). Methods: A commercial 3D diode array motion system was used to evaluate the dynamic tracking accuracy of Calypso when tracking continuous large amplitude motion. It wasmore » then used to perform end-to-end tests to evaluate the dosimetric accuracy of gated beam delivery for liver SABR. In addition, gating limits were investigated to determine how large the gating window can be while still maintaining dosimetric accuracy. The gating latency of the Calypso system was also measured using a customized motion phantom. Results: The average absolute difference between the measured and expected positional offset was 0.3 mm. The 2%/2 mm gamma pass rates for the gated treatment delivery were greater than 97%. When increasing the gating limits beyond the known extent of planned motion, the gamma pass rates decreased as expected. The 2%/2 mm gamma pass rate for a 1, 2, and 3 mm increase in gating limits was measured to be 97.8%, 82.9%, and 61.4%, respectively. The average gating latency was measured to be 63.8 ms for beam-hold and 195.8 ms for beam-on. Four liver patients with 17 total fractions have been successfully treated at our institution. Conclusions: Wireless transponder tracking was validated as a dosimetrically accurate way to provide gated SABR of the liver. The dynamic tracking accuracy of the Calypso system met manufacturer’s specification, even for continuous large amplitude motion that can be encountered when tracking liver tumors close to the diaphragm. The measured beam-hold gating latency was appropriate for targets that will traverse the gating limit each respiratory cycle causing the beam to be interrupted constantly throughout treatment delivery.« less

SU-E-T-401: Feasibility Study of Using ABC to Gate Lung SBRT Treatment

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

Cao, D; Xie, X; Shepard, D

2014-06-01

Purpose: The current SBRT treatment techniques include free breathing (FB) SBRT and gated FB SBRT. Gated FB SBRT has smaller target and less lung toxicity with longer treatment time. The recent development of direct connectivity between the ABC and linac allowing for automated beam gating. In this study, we have examined the feasibility of using ABC system to gate the lung SBRT treatment. Methods: A CIRS lung phantom with a 3cm sphere-insert and a moving chest plate was used in this study. Sinusoidal motion was used for the FB pattern. An ABC signal was imported to simulate breath holds. 4D-CTmore » was taken in FB mode and average-intensity-projection (AIP) was used to create FB and 50% gated FB SBRT planning CT. A manually gated 3D CT scan was acquired for ABC gated SBRT planning.An SBRT plan was created for each treatment option. A surface-mapping system was used for 50% gating and ABC system was used for ABC gating. A manually gated CBCT scan was also performed to verify setup. Results: Among three options, the ABC gated plan has the smallest PTV of 35.94cc, which is 35% smaller comparing to that of the FB plan. Consequently, the V20 of the left lung reduced by 15% and 23% comparing to the 50% gated FB and FB plans, respectively. The FB plan took 4.7 minutes to deliver, while the 50% gated FB plan took 18.5 minutes. The ABC gated plan delivery took only 10.6 minutes. A stationary target with 3cm diameter was also obtained from the manually gated CBCT scan. Conclusion: A strategy for ABC gated lung SBRT was developed. ABC gating can significantly reduce the lung toxicity while maintaining the target coverage. Comparing to the 50% gated FB SBRT, ABC gated treatment can also provide less lung toxicity as well as improved delivery efficiency. This research is funded by Elekta.« less

Potential means of cost reduction in grade crossing automatic gate systems. volume II : improved gate arm concepts for railroad/highway grade crossings gate systems

DOT National Transportation Integrated Search

1977-02-28

This report, Volume II of a two-volume study, examines the potential for reduction of the cost of installing and maintaining automatic gates at railroad-highway grade crossings. It includes a review of current practices, equipment, and standards; con...

4. PULLEY SYSTEM AND CABLE FOR GATELIFTING MECHANISM, MOUNTED ABOVE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. PULLEY SYSTEM AND CABLE FOR GATE-LIFTING MECHANISM, MOUNTED ABOVE THE THREE GATE OPENINGS, LOOKING SOUTH/SOUTHEAST. - Washington Water Power Spokane River Upper Falls Hydroelectric Development, Gates & Gate-Lifting Mechanisms, Spokane River, approximately 0.5 mile northeast of intersection of Spokane Falls Boulevard & Post Street, Spokane, Spokane County, WA

Field test of an alternative longwall gate road design

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

Cox, R.M.; Vandergrift, T.L.; McDonnell, J.P.

1994-01-01

The US Bureau of Mines (USBM) MULSIM/ML modeling technique has been used to analyze anticipated stress distributions for a proposed alternative longwall gate road design for a western Colorado coal mine. The model analyses indicated that the alternative gate road design would reduce stresses in the headgate entry. To test the validity of the alternative gate road design under actual mining conditions, a test section of the alternative system was incorporated into a subsequent set of gate roads developed at the mine. The alternative gate road test section was instrumented with borehole pressure cells, as part of an ongoing USBMmore » research project to monitor ground pressure changes as longwall mining progressed. During the excavation of the adjacent longwall panels, the behavior of the alternative gate road system was monitored continuously using the USBM computer-assisted Ground Control Management System. During these field tests, the alternative gate road system was first monitored and evaluated as a headgate, and later monitored and evaluated as a tailgate. The results of the field tests confirmed the validity of using the MULSIM/NL modeling technique to evaluate mine designs.« less

Barriers to Obtaining Diagnostic Testing for Coronary Artery Disease Among Veterans

PubMed Central

Hausmann, Leslie R. M.; Ibrahim, Said

2008-01-01

Objectives. We sought to identify factors associated with appointment nonattendance for diagnostic testing of coronary artery disease among veterans. For patients with possible heart disease, appointment nonattendance may seriously compromise short- and long-term outcomes. Understanding factors associated with nonattendance may help improve care while reducing inefficiency in service delivery. Methods. We surveyed patients who attended (n = 240) or did not attend (n = 139) a scheduled cardiac appointment at a midwestern Veterans Administration medical center. Multivariable regression models were used to assess factors associated with nonattendance. Results. Younger age, lower income, unemployment, and longer wait times for appointments were predictive of nonattendance. Nonattenders reported fewer cardiac symptoms and were more likely to attribute their symptoms to something other than heart disease. Nonattendance was also associated with a coping style characterized by avoidance of aversive information. Logistical issues, fear of diagnostic procedures, disbelief that one had heart disease, and medical mistrust were some of the reasons given for missed appointments. Conclusions. Appointment nonattendance among veterans scheduled for cardiology evaluation was associated with several important cognitive factors. These factors should be considered when one is designing clinical systems to reduce patient nonattendance. PMID:18381987

Understanding repeated non-attendance in health services: a pilot analysis of administrative data and full study protocol for a national retrospective cohort.

PubMed

Williamson, Andrea E; Ellis, David A; Wilson, Philip; McQueenie, Ross; McConnachie, Alex

2017-02-14

Understanding the causes of low engagement in healthcare is a pre-requisite for improving health services' contribution to tackling health inequalities. Low engagement includes missing healthcare appointments. Serially (having a pattern of) missing general practice (GP) appointments may provide a risk marker for vulnerability and poorer health outcomes. A proof of concept pilot using GP appointment data and a focus group with GPs informed the development of missed appointment categories: patients can be classified based on the number of appointments missed each year. The full study, using a retrospective cohort design, will link routine health service and education data to determine the relationship between GP appointment attendance, health outcomes, healthcare usage, preventive health activity and social circumstances taking a life course approach and using data from the whole journey in the National Health Service (NHS) healthcare. 172 practices will be recruited (∼900 000 patients) across Scotland. The statistical analysis will focus on 2 key areas: factors that predict patients who serially miss appointments, and serial missed appointments as a predictor of future patient outcomes. Regression models will help understand how missed appointment patterns are associated with patient and practice characteristics. We shall identify key factors associated with serial missed appointments and potential interactions that might predict them. The results of the project will inform debates concerning how best to reduce non-attendance and increase patient engagement within healthcare systems. Significant non-academic beneficiaries include governments, policymakers and medical practitioners. Results will be disseminated via a combination of academic outputs (papers, conferences), social media and through collaborative public health/policy fora. 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/.

SU-E-T-350: Verification of Gating Performance of a New Elekta Gating Solution: Response Kit and Catalyst System

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

Xie, X; Cao, D; Housley, D

2014-06-01

Purpose: In this work, we have tested the performance of new respiratory gating solutions for Elekta linacs. These solutions include the Response gating and the C-RAD Catalyst surface mapping system.Verification measurements have been performed for a series of clinical cases. We also examined the beam on latency of the system and its impact on delivery efficiency. Methods: To verify the benefits of tighter gating windows, a Quasar Respiratory Motion Platform was used. Its vertical-motion plate acted as a respiration surrogate and was tracked by the Catalyst system to generate gating signals. A MatriXX ion-chamber array was mounted on its longitudinal-movingmore » platform. Clinical plans are delivered to a stationary and moving Matrix array at 100%, 50% and 30% gating windows and gamma scores were calculated comparing moving delivery results to the stationary result. It is important to note that as one moves to tighter gating windows, the delivery efficiency will be impacted by the linac's beam-on latency. Using a specialized software package, we generated beam-on signals of lengths of 1000ms, 600ms, 450ms, 400ms, 350ms and 300ms. As the gating windows get tighter, one can expect to reach a point where the dose rate will fall to nearly zero, indicating that the gating window is close to beam-on latency. A clinically useful gating window needs to be significantly longer than the latency for the linac. Results: As expected, the use of tighter gating windows improved delivery accuracy. However, a lower limit of the gating window, largely defined by linac beam-on latency, exists at around 300ms. Conclusion: The Response gating kit, combined with the C-RAD Catalyst, provides an effective solution for respiratorygated treatment delivery. Careful patient selection, gating window design, even visual/audio coaching may be necessary to ensure both delivery quality and efficiency. This research project is funded by Elekta.« less

Reversible logic gates based on enzyme-biocatalyzed reactions and realized in flow cells: a modular approach.

PubMed

Fratto, Brian E; Katz, Evgeny

2015-05-18

Reversible logic gates, such as the double Feynman gate, Toffoli gate and Peres gate, with 3-input/3-output channels are realized using reactions biocatalyzed with enzymes and performed in flow systems. The flow devices are constructed using a modular approach, where each flow cell is modified with one enzyme that biocatalyzes one chemical reaction. The multi-step processes mimicking the reversible logic gates are organized by combining the biocatalytic cells in different networks. This work emphasizes logical but not physical reversibility of the constructed systems. Their advantages and disadvantages are discussed and potential use in biosensing systems, rather than in computing devices, is suggested. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

What Are Women Told When Requesting Family Planning Services at Clinics Associated with Catholic Hospitals? A Mystery Caller Study.

PubMed

Guiahi, Maryam; Teal, Stephanie B; Swartz, Maryke; Huynh, Sandy; Schiller, Georgia; Sheeder, Jeanelle

2017-12-01

Catholic Church directives restrict family planning service provision at Catholic health care institutions. It is unclear whether obstetrics and gynecology clinics that are owned by or have business affiliations with Catholic hospitals offer family planning appointments. Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion. Chi-square and Fisher's exact tests assessed potential correlates of appointment availability, and multivariable logistic regressions were computed if bivariate testing suggested multiple correlates. Although 95% of clinics would schedule birth control appointments, smaller proportions would schedule appointments for copper IUDs (68%) or tubal ligation (58%); only 2% would schedule an abortion. Smaller proportions of Catholic-owned than of Catholic-affiliated clinics would schedule appointments for birth control (84% vs. 100%), copper IUDs (4% vs. 97%) and tubal ligation (29% vs. 72%); for birth control and copper IUD services, no other clinic characteristics were related to appointment availability. Multivariable analysis confirmed that tubal ligation appointments were less likely to be offered at Catholic-owned than at Catholic-affiliated clinics (odds ratio. 0.1); location and association with one of the top 10 Catholic health care systems also were significant. Adherence to church directives is inconsistent at Catholic-associated clinics. Women visiting such clinics who want highly effective methods may need to rely on less effective methods or delay method uptake while seeking services elsewhere. Copyright © 2017 by the Guttmacher Institute.

Effectiveness and cost-effectiveness of fining non-attendance at public hospitals: a randomised controlled trial from Danish outpatient clinics.

PubMed

Blæhr, Emely Ek; Væggemose, Ulla; Søgaard, Rikke

2018-04-13

Fines have been proposed as means for reducing non-attendance in healthcare. The empirical evidence of the effect of fines is however limited. The objective of this study is to investigate the effectiveness and cost-effectiveness of fining non-attendance at outpatient clinics. 1:1 randomised controlled trial of appointments for an outpatient clinic, posted to Danish addresses, between 1 May 2015 and 30 November 2015. Only first appointment for users was included. Healthcare professionals and investigators were masked. A fine of DKK250 (€34) was issued for non-attendance. Users were informed about the fine in case of non-attendance by the appointment letter, and were able to reschedule or cancel until the appointment. A central administration office administered the fine system. The main outcome measures were non-attendance of non-cancelled appointments, fine policy administration costs, net of productivity consequences and probability of fining non-attendance being cost-effective over no fining for a range of hypothetical values of reduced non-attendance. All of the 6746 appointments included were analysed. Of the 3333 appointments randomised to the fine policy, 130 (5%) of non-cancelled appointments were unattended, and of the 3413 appointments randomised to no-fine policy, 131 (5%) were unattended. The cost per appointment of non-attendance was estimated at DKK 56 (SE 5) in the fine group and DKK47 (SE 4) in the no-fine group, leading to a non-statistically significant difference of DKK10 (95% CI -9 to 22) per appointment attributable to the fine policy. The probability of cost-effectiveness remained around 50%, irrespective of increased values of reduced non-attendance or various alternative assumptions used for sensitivity analyses. At a baseline level of around 5%, fining non-attendance does not seem to further reduce non-attendance. Future studies should focus on other means for reduction of non-attendance such as nudging or negative reinforcement. ISRCTN61925912. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effectiveness and cost-effectiveness of fining non-attendance at public hospitals: a randomised controlled trial from Danish outpatient clinics

PubMed Central

Væggemose, Ulla; Søgaard, Rikke

2018-01-01

Objectives Fines have been proposed as means for reducing non-attendance in healthcare. The empirical evidence of the effect of fines is however limited. The objective of this study is to investigate the effectiveness and cost-effectiveness of fining non-attendance at outpatient clinics. Design, participants and setting 1:1 randomised controlled trial of appointments for an outpatient clinic, posted to Danish addresses, between 1 May 2015 and 30 November 2015. Only first appointment for users was included. Healthcare professionals and investigators were masked. Intervention A fine of DKK250 (€34) was issued for non-attendance. Users were informed about the fine in case of non-attendance by the appointment letter, and were able to reschedule or cancel until the appointment. A central administration office administered the fine system. Main outcome measures The main outcome measures were non-attendance of non-cancelled appointments, fine policy administration costs, net of productivity consequences and probability of fining non-attendance being cost-effective over no fining for a range of hypothetical values of reduced non-attendance. Results All of the 6746 appointments included were analysed. Of the 3333 appointments randomised to the fine policy, 130 (5%) of non-cancelled appointments were unattended, and of the 3413 appointments randomised to no-fine policy, 131 (5%) were unattended. The cost per appointment of non-attendance was estimated at DKK 56 (SE 5) in the fine group and DKK47 (SE 4) in the no-fine group, leading to a non-statistically significant difference of DKK10 (95% CI –9 to 22) per appointment attributable to the fine policy. The probability of cost-effectiveness remained around 50%, irrespective of increased values of reduced non-attendance or various alternative assumptions used for sensitivity analyses. Conclusions At a baseline level of around 5%, fining non-attendance does not seem to further reduce non-attendance. Future studies should focus on other means for reduction of non-attendance such as nudging or negative reinforcement. Trial registration number ISRCTN61925912. PMID:29654019

CASA Fact Sheet.

ERIC Educational Resources Information Center

National Court Appointed Special Advocate Association, Seattle WA.

Each year nearly 400,000 children in the United States are thrust into court through no fault of their own. Often these children also become victims of the United States' overburdened child welfare system. A Court Appointed Special Advocate (CASA) volunteer is a trained citizen who is appointed by a judge to represent the best interests of a child…

SU-E-T-266: Development of Evaluation System of Optimal Synchrotron Controlling Parameter for Spot Scanning Proton Therapy with Multiple Gate Irradiations in One Operation Cycle

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

Yamada, T; Fujii, Y; Hitachi Ltd., Hitachi-shi, Ibaraki

2015-06-15

Purpose: We have developed a gated spot scanning proton beam therapy system with real-time tumor-tracking. This system has the ability of multiple-gated irradiation in a single synchrotron operation cycle controlling the wait-time for consecutive gate signals during a flat-top phase so that the decrease in irradiation efficiency induced by irregular variation of gate signal is reduced. Our previous studies have shown that a 200 ms wait-time is appropriate to increase the average irradiation efficiency, but the optimal wait-time can vary patient by patient and day by day. In this research, we have developed an evaluation system of the optimal wait-timemore » in each irradiation based on the log data of the real-time-image gated proton beam therapy (RGPT) system. Methods: The developed system consists of logger for operation of RGPT system and software for evaluation of optimal wait-time. The logger records timing of gate on/off, timing and the dose of delivered beam spots, beam energy and timing of X-ray irradiation. The evaluation software calculates irradiation time in the case of different wait-time by simulating the multiple-gated irradiation operation using several timing information. Actual data preserved in the log data are used for gate on and off time, spot irradiation time, and time moving to the next spot. Design values are used for the acceleration and deceleration times. We applied this system to a patient treated with the RGPT system. Results: The evaluation system found the optimal wait-time of 390 ms that reduced the irradiation time by about 10 %. The irradiation time with actual wait-time used in treatment was reproduced with accuracy of 0.2 ms. Conclusion: For spot scanning proton therapy system with multiple-gated irradiation in one synchrotron operation cycle, an evaluation system of the optimal wait-time in each irradiation based on log data has been developed. Funding Support: Japan Society for the Promotion of Science (JSPS) through the FIRST Program.« less

High-Dimensional Single-Photon Quantum Gates: Concepts and Experiments.

PubMed

Babazadeh, Amin; Erhard, Manuel; Wang, Feiran; Malik, Mehul; Nouroozi, Rahman; Krenn, Mario; Zeilinger, Anton

2017-11-03

Transformations on quantum states form a basic building block of every quantum information system. From photonic polarization to two-level atoms, complete sets of quantum gates for a variety of qubit systems are well known. For multilevel quantum systems beyond qubits, the situation is more challenging. The orbital angular momentum modes of photons comprise one such high-dimensional system for which generation and measurement techniques are well studied. However, arbitrary transformations for such quantum states are not known. Here we experimentally demonstrate a four-dimensional generalization of the Pauli X gate and all of its integer powers on single photons carrying orbital angular momentum. Together with the well-known Z gate, this forms the first complete set of high-dimensional quantum gates implemented experimentally. The concept of the X gate is based on independent access to quantum states with different parities and can thus be generalized to other photonic degrees of freedom and potentially also to other quantum systems.

GATE: a simulation toolkit for PET and SPECT.

PubMed

Jan, S; Santin, G; Strul, D; Staelens, S; Assié, K; Autret, D; Avner, S; Barbier, R; Bardiès, M; Bloomfield, P M; Brasse, D; Breton, V; Bruyndonckx, P; Buvat, I; Chatziioannou, A F; Choi, Y; Chung, Y H; Comtat, C; Donnarieix, D; Ferrer, L; Glick, S J; Groiselle, C J; Guez, D; Honore, P F; Kerhoas-Cavata, S; Kirov, A S; Kohli, V; Koole, M; Krieguer, M; van der Laan, D J; Lamare, F; Largeron, G; Lartizien, C; Lazaro, D; Maas, M C; Maigne, L; Mayet, F; Melot, F; Merheb, C; Pennacchio, E; Perez, J; Pietrzyk, U; Rannou, F R; Rey, M; Schaart, D R; Schmidtlein, C R; Simon, L; Song, T Y; Vieira, J M; Visvikis, D; Van de Walle, R; Wieërs, E; Morel, C

2004-10-07

Monte Carlo simulation is an essential tool in emission tomography that can assist in the design of new medical imaging devices, the optimization of acquisition protocols and the development or assessment of image reconstruction algorithms and correction techniques. GATE, the Geant4 Application for Tomographic Emission, encapsulates the Geant4 libraries to achieve a modular, versatile, scripted simulation toolkit adapted to the field of nuclear medicine. In particular, GATE allows the description of time-dependent phenomena such as source or detector movement, and source decay kinetics. This feature makes it possible to simulate time curves under realistic acquisition conditions and to test dynamic reconstruction algorithms. This paper gives a detailed description of the design and development of GATE by the OpenGATE collaboration, whose continuing objective is to improve, document and validate GATE by simulating commercially available imaging systems for PET and SPECT. Large effort is also invested in the ability and the flexibility to model novel detection systems or systems still under design. A public release of GATE licensed under the GNU Lesser General Public License can be downloaded at http:/www-lphe.epfl.ch/GATE/. Two benchmarks developed for PET and SPECT to test the installation of GATE and to serve as a tutorial for the users are presented. Extensive validation of the GATE simulation platform has been started, comparing simulations and measurements on commercially available acquisition systems. References to those results are listed. The future prospects towards the gridification of GATE and its extension to other domains such as dosimetry are also discussed.

GATE - Geant4 Application for Tomographic Emission: a simulation toolkit for PET and SPECT

PubMed Central

Jan, S.; Santin, G.; Strul, D.; Staelens, S.; Assié, K.; Autret, D.; Avner, S.; Barbier, R.; Bardiès, M.; Bloomfield, P. M.; Brasse, D.; Breton, V.; Bruyndonckx, P.; Buvat, I.; Chatziioannou, A. F.; Choi, Y.; Chung, Y. H.; Comtat, C.; Donnarieix, D.; Ferrer, L.; Glick, S. J.; Groiselle, C. J.; Guez, D.; Honore, P.-F.; Kerhoas-Cavata, S.; Kirov, A. S.; Kohli, V.; Koole, M.; Krieguer, M.; van der Laan, D. J.; Lamare, F.; Largeron, G.; Lartizien, C.; Lazaro, D.; Maas, M. C.; Maigne, L.; Mayet, F.; Melot, F.; Merheb, C.; Pennacchio, E.; Perez, J.; Pietrzyk, U.; Rannou, F. R.; Rey, M.; Schaart, D. R.; Schmidtlein, C. R.; Simon, L.; Song, T. Y.; Vieira, J.-M.; Visvikis, D.; Van de Walle, R.; Wieërs, E.; Morel, C.

2012-01-01

Monte Carlo simulation is an essential tool in emission tomography that can assist in the design of new medical imaging devices, the optimization of acquisition protocols, and the development or assessment of image reconstruction algorithms and correction techniques. GATE, the Geant4 Application for Tomographic Emission, encapsulates the Geant4 libraries to achieve a modular, versatile, scripted simulation toolkit adapted to the field of nuclear medicine. In particular, GATE allows the description of time-dependent phenomena such as source or detector movement, and source decay kinetics. This feature makes it possible to simulate time curves under realistic acquisition conditions and to test dynamic reconstruction algorithms. This paper gives a detailed description of the design and development of GATE by the OpenGATE collaboration, whose continuing objective is to improve, document, and validate GATE by simulating commercially available imaging systems for PET and SPECT. Large effort is also invested in the ability and the flexibility to model novel detection systems or systems still under design. A public release of GATE licensed under the GNU Lesser General Public License can be downloaded at the address http://www-lphe.ep.ch/GATE/. Two benchmarks developed for PET and SPECT to test the installation of GATE and to serve as a tutorial for the users are presented. Extensive validation of the GATE simulation platform has been started, comparing simulations and measurements on commercially available acquisition systems. References to those results are listed. The future prospects toward the gridification of GATE and its extension to other domains such as dosimetry are also discussed. PMID:15552416

Implementing a patient-initiated review system for people with rheumatoid arthritis: a prospective, comparative service evaluation.

PubMed

Goodwin, Victoria A; Paudyal, Priyamvada; Perry, Mark G; Day, Nikki; Hawton, Annie; Gericke, Christian; Ukoumunne, Obioha C; Byng, Richard

2016-06-01

The management of rheumatoid arthritis (RA) usually entails regular hospital reviews with a specialist often when the patient is well rather than during a period of exacerbation. An alternative approach where patients initiate appointments when they need them can improve patient satisfaction and resource use whilst being safe. This service evaluation reports a system-wide implementation of a patient-initiated review appointment system called Direct Access (DA) for people with RA. The aim was to establish the impact on patient satisfaction of the new system versus usual care as well as evaluate the implementation processes. As all patients could not start on the new system at once, in order to manage the implementation, patients were randomly allocated to DA or to usual care. Instead of regular follow-up appointments, DA comprised an education session and access to a nurse-led telephone advice line where appointments could be accessed within two weeks. Usual care comprised routine follow-ups with the specialist. Data were collected on patient satisfaction, service use and outcomes of any contact to the advice line. Three hundred and eleven patients with RA were assessed as being suitable for DA. In terms of patient satisfaction, between-group differences were found in favour of DA for accessibility and convenience, ease of contacting the nurse and overall satisfaction with the service. Self-reported visits to the general practitioner were also significantly lower. DA resulted in a greater number of telephone contacts (incidence rate ratio = 1.69; 95% confidence interval 1.07 to 2.68). Hospital costs of the two different service models were similar. Mean waiting time for an appointment was 10.8 days This service evaluation found that DA could be implemented and it demonstrated patient benefit in a real-world setting. Further research establishing the broader cost-consequences across the whole patient pathway would add to our findings. © 2016 John Wiley & Sons, Ltd.

Teachers' Attitudes toward the Appointment of Women as School Leaders: The Case of the Arab Education System in Israel

ERIC Educational Resources Information Center

Arar, Khalid; Abramovitz, Ruth

2013-01-01

The trend towards gender equality in principalship appointments continues to interest researchers, especially when it appears in traditional societies that maintain patriarchal, anti-feminist attitudes and values. Arab society in Israel is undergoing transition from traditionalism to modernism. Arab women hold the majority of Arab school teaching…

Research on China's System of Evaluating Teachers in Institutions of Higher Education for Professional Titles and Appointments

ERIC Educational Resources Information Center

Meirong, Che

2005-01-01

Evaluation for and appointment to professional titles is a major aspect of personnel management in institutions of higher education. Diligence in this area is important for firing the enthusiasm of the broad mass of teachers for their work and for the stable and sustainable development of university research work.

Scheduling rules to achieve lead-time targets in outpatient appointment systems.

PubMed

Nguyen, Thu-Ba T; Sivakumar, Appa Iyer; Graves, Stephen C

2017-12-01

This paper considers how to schedule appointments for outpatients, for a clinic that is subject to appointment lead-time targets for both new and returning patients. We develop heuristic rules, which are the exact and relaxed appointment scheduling rules, to schedule each new patient appointment (only) in light of uncertainty about future arrivals. The scheduling rules entail two decisions. First, the rules need to determine whether or not a patient's request can be accepted; then, if the request is not rejected, the rules prescribe how to assign the patient to an available slot. The intent of the scheduling rules is to maximize the utilization of the planned resource (i.e., the physician staff), or equivalently to maximize the number of patients that are admitted, while maintaining the service targets on the median, the 95th percentile, and the maximum appointment lead-times. We test the proposed scheduling rules with numerical experiments using real data from the chosen clinic of Tan Tock Seng hospital in Singapore. The results show the efficiency and the efficacy of the scheduling rules, in terms of the service-target satisfaction and the resource utilization. From the sensitivity analysis, we find that the performance of the proposed scheduling rules is fairly robust to the specification of the established lead-time targets.

Interventions to increase initial appointment attendance in mental health services: a systematic review.

PubMed

Schauman, Oliver; Aschan, Lisa Ellinor; Arias, Nicole; Beards, Stephanie; Clement, Sarah

2013-12-01

OBJECTIVE Although nonattendance at initial appointments in mental health services is a substantial problem, the phenomenon is poorly understood. This review synthesized findings of randomized controlled trials (RCTs) of interventions to increase initial appointment attendance and determined whether theories or models contributed to intervention design. METHODS Six electronic databases were systematically searched, and reference lists of identified studies were also examined. Studies included were RCTs (including "quasi-randomized" controlled trials) that compared standard practice with an intervention to increase attendance at initial appointments in a sample of adults who had a scheduled initial appointment in a mental health or substance abuse service setting. RESULTS Of 144 potentially relevant studies, 21 met inclusion criteria. These studies were reported in 20 different research papers. Of these, 16 studies (N=3,673 participants) were included in the analyses (five were excluded because they reported only nonattendance at the initial appointment). Separate analyses were conducted for each intervention type (opt-in systems, telephone reminders and prompts, orientation and reminder letters, accelerated intake, preappointment completion of psychodynamic questionnaires, and "other"). Narrative synthesis was used for analysis because the high level of heterogeneity between studies precluded a meta-analysis. The results were mixed for all types of intervention. Some isolated high-quality studies of opt-in systems, orientation and reminder letters, and more novel interventions demonstrated a beneficial effect. CONCLUSIONS The synthesized findings indicated that orientation and reminder letters may have a small beneficial effect. Consistent evidence for the efficacy of other types of common interventions is lacking. More novel interventions, such as asking clients to formulate plans to deal with obstacles to attendance and giving clients a choice of therapist style, showed some promise, but studies require replication.

Improving the patient booking service to reduce the number of missed appointments at East London NHS Foundation Trust Community Musculoskeletal Physiotherapy Service.

PubMed

Tan, Elizabeth; Shah, Amar; De Souza, Warren; Harrison, Mark; Chettur, Chris; Onathukattil, Maimoona; Smart, Michelle; Mata, Marlon; Chitewe, Auzewell; Binley, Emma

2017-01-01

The East London National Health Service Foundation Trust (ELFT) Community Musculoskeletal (MSK) Physiotherapy Service had reported a high rate of non-attendance at scheduled appointments. This was leading to delayed access to treatment for patients and a reduced capacity for service users, as well as a waste of clinical resources. The aim of this quality improvement project was therefore to reduce the percentage of missed appointments within this department. This study was undertaken by the ELFT community MSK service, with support from the ELFT Quality Improvement team. To begin with, patient complaints were explored; these indicated that the main reason for missing appointments was due to issues with the patient booking service. Baseline data were initially collected for both new referrals and follow-up patients. The proposed changes were then introduced, which included text message reminders, first via a manual platform and then via an automated system. Ongoing data were recorded to note the effectiveness of these changes. Following the intervention, non-attendance of newly referred patients reduced by 43.35% (23.76%-13.46%) after both cycles. Non-attendance of follow-up patients reduced by 44.14% (23.74%-13.26%) after the second cycle alone. By listening to the opinions of service users, it was possible to improve the patient booking system and the flexibility of appointments. This resulted in a reduction in the percentage of appointments missed. These changes will continue to be monitored within this department to ensure sustainability but there is also now potential for similar interventions to be trialled in other health service departments.

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

The online outpatient booking system 'Choose and Book' improves attendance rates at an audiology clinic: a comparative audit.

PubMed

Parmar, Vijal; Large, Ann; Madden, Colm; Das, Vijay

2009-01-01

The 'Choose and Book' system provides an online booking service which primary care professionals can book in real time or soon after a patient's consultation. It aims to offer patients choice and improve outpatient clinic attendance rates. An audit comparing attendance rates of new patients booked into the Audiological Medicine Clinic using the 'Choose and Book' system with that of those whose bookings were made through the traditional booking system. Data accrued between 1 April 2008 and 31 October 2008 were retrospectively analysed for new patient attendance at the department, and the age and sex of the patients, method of appointment booking used and attendance record were collected. Patients were grouped according to booking system used - 'Choose and Book' or the traditional system. The mean ages of the groups were compared by a t test. The standard error of the difference between proportions was used to compare the data from the two groups. A P value of < or = 0.05 was considered to be significant. 'Choose and Book' patients had a significantly better rate of attendance than traditional appointment patients, P < 0.01 (95% CI 4.3, 20.5%). There was no significant difference between the two groups in terms of sex, P > 0.1 (95% CI-3.0, 16.2%). The 'Choose and Book' patients, however, were significantly older than the traditional appointment patients, P < 0.001 (95% CI 4.35, 12.95%). This audit suggests that when primary care agents book outpatient clinic appointments online it improves outpatient attendance.

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

PubMed Central

Kalyango, Joan Nakayaga; Hall, Maurice; Karamagi, Charles

2014-01-01

Introduction Proper management of chronic diseases is important for prevention of disease complications and yet some patients miss appointments for medical review thereby missing the opportunity for proper monitoring of their disease conditions. There is limited information on missed appointments among chronic disease patients in resource limited settings. This study aimed to determine the prevalence of missed appointments for medical review and associated factors among chronic disease patients in an urban area of Uganda. Methods Patients or caregivers of children with chronic diseases were identified as they bought medicines from a community pharmacy. They were visited at home to access their medical documents and those whose chronic disease status was ascertained were enrolled. The data was collected using: questionnaires, review of medical documents, and in-depth interviews with chronic disease patients. Results The prevalence of missed appointments was 42% (95%CI = 35-49%). The factors associated with missed appointments were: monthly income ≤30US Dollars (OR = 2.56, CI = 1.25–5.26), affording less than half of prescribed drugs (OR = 3.92, CI = 1.64–9.40), not experiencing adverse events (OR = 2.66, CI = 1.26–5.61), not sure if treatment helps (OR = 2.84, CI = 1.047.77), not having a medicines administration schedule (OR = 6.77, CI = 2.11–21.68), and increasing number of drugs (OR = 0.72, CI = 0.53–0.98). Conclusion Patients missed appointments mainly due to: financial and health system barriers, conflicting commitments with appointments, and perceptions of the disease condition. Patients should be supported with accessible and affordable health services. PMID:25838857

Catalytic nucleic acids (DNAzymes) as functional units for logic gates and computing circuits: from basic principles to practical applications.

PubMed

Orbach, Ron; Willner, Bilha; Willner, Itamar

2015-03-11

This feature article addresses the implementation of catalytic nucleic acids as functional units for the construction of logic gates and computing circuits, and discusses the future applications of these systems. The assembly of computational modules composed of DNAzymes has led to the operation of a universal set of logic gates, to field programmable logic gates and computing circuits, to the development of multiplexers/demultiplexers, and to full-adder systems. Also, DNAzyme cascades operating as logic gates and computing circuits were demonstrated. DNAzyme logic systems find important practical applications. These include the use of DNAzyme-based systems for sensing and multiplexed analyses, for the development of controlled release and drug delivery systems, for regulating intracellular biosynthetic pathways, and for the programmed synthesis and operation of cascades.

Evaluation of the clinical efficacy of the PeTrack motion tracking system for respiratory gating in cardiac PET imaging

NASA Astrophysics Data System (ADS)

Manwell, Spencer; Chamberland, Marc J. P.; Klein, Ran; Xu, Tong; deKemp, Robert

2017-03-01

Respiratory gating is a common technique used to compensate for patient breathing motion and decrease the prevalence of image artifacts that can impact diagnoses. In this study a new data-driven respiratory gating method (PeTrack) was compared with a conventional optical tracking system. The performance of respiratory gating of the two systems was evaluated by comparing the number of respiratory triggers, patient breathing intervals and gross heart motion as measured in the respiratory-gated image reconstructions of rubidium-82 cardiac PET scans in test and control groups consisting of 15 and 8 scans, respectively. We found evidence suggesting that PeTrack is a robust patient motion tracking system that can be used to retrospectively assess patient motion in the event of failure of the conventional optical tracking system.

Gating geometry studies of thin-walled 17-4PH investment castings

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

Maguire, M.C.; Zanner, F.J.

1992-11-01

The ability to design gating systems that reliably feed and support investment castings is often the result of ``cut-and-try`` methodology. Factors such as hot tearing, porosity, cold shuts, misruns, and shrink are defects often corrected by several empirical gating design iterations. Sandia National Laboratories is developing rules that aid in removing the uncertainty involved in the design of gating systems for investment castings. In this work, gating geometries used for filling of thin walled investment cast 17-4PH stainless steel flat plates were investigated. A full factorial experiment evaluating the influence of metal pour temperature, mold preheat temperature, and mold channelmore » thickness were conducted for orientations that filled a horizontal flat plate from the edge. A single wedge gate geometry was used for the edge-gated configuration. Thermocouples placed along the top of the mold recorded metal front temperatures, and a real-time x-ray imaging system tracked the fluid flow behavior during filling of the casting. Data from these experiments were used to determine the terminal fill volumes and terminal fill times for each gate design.« less

Gating geometry studies of thin-walled 17-4PH investment castings

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

Maguire, M.C.; Zanner, F.J.

1992-01-01

The ability to design gating systems that reliably feed and support investment castings is often the result of cut-and-try'' methodology. Factors such as hot tearing, porosity, cold shuts, misruns, and shrink are defects often corrected by several empirical gating design iterations. Sandia National Laboratories is developing rules that aid in removing the uncertainty involved in the design of gating systems for investment castings. In this work, gating geometries used for filling of thin walled investment cast 17-4PH stainless steel flat plates were investigated. A full factorial experiment evaluating the influence of metal pour temperature, mold preheat temperature, and mold channelmore » thickness were conducted for orientations that filled a horizontal flat plate from the edge. A single wedge gate geometry was used for the edge-gated configuration. Thermocouples placed along the top of the mold recorded metal front temperatures, and a real-time x-ray imaging system tracked the fluid flow behavior during filling of the casting. Data from these experiments were used to determine the terminal fill volumes and terminal fill times for each gate design.« less

Appointment Template Redesign in a Women's Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency.

PubMed

Huang, Y; Verduzco, S

2015-01-01

Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability. This study was conducted in a Women's Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints. The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The re-classification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type. The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients. This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate.

Appointment Template Redesign in a Women’s Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency

PubMed Central

Verduzco, S.

2015-01-01

Summary Background Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability. Objectives This study was conducted in a Women’s Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints. Methods The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The re-classification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type. Results The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients. Conclusions This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate. PMID:26171075

Realization of quantum gates with multiple control qubits or multiple target qubits in a cavity

NASA Astrophysics Data System (ADS)

Waseem, Muhammad; Irfan, Muhammad; Qamar, Shahid

2015-06-01

We propose a scheme to realize a three-qubit controlled phase gate and a multi-qubit controlled NOT gate of one qubit simultaneously controlling n-target qubits with a four-level quantum system in a cavity. The implementation time for multi-qubit controlled NOT gate is independent of the number of qubit. Three-qubit phase gate is generalized to n-qubit phase gate with multiple control qubits. The number of steps reduces linearly as compared to conventional gate decomposition method. Our scheme can be applied to various types of physical systems such as superconducting qubits coupled to a resonator and trapped atoms in a cavity. Our scheme does not require adjustment of level spacing during the gate implementation. We also show the implementation of Deutsch-Joza algorithm. Finally, we discuss the imperfections due to cavity decay and the possibility of physical implementation of our scheme.

Multi-element logic gates for trapped-ion qubits

NASA Astrophysics Data System (ADS)

Tan, T. R.; Gaebler, J. P.; Lin, Y.; Wan, Y.; Bowler, R.; Leibfried, D.; Wineland, D. J.

2015-12-01

Precision control over hybrid physical systems at the quantum level is important for the realization of many quantum-based technologies. In the field of quantum information processing (QIP) and quantum networking, various proposals discuss the possibility of hybrid architectures where specific tasks are delegated to the most suitable subsystem. For example, in quantum networks, it may be advantageous to transfer information from a subsystem that has good memory properties to another subsystem that is more efficient at transporting information between nodes in the network. For trapped ions, a hybrid system formed of different species introduces extra degrees of freedom that can be exploited to expand and refine the control of the system. Ions of different elements have previously been used in QIP experiments for sympathetic cooling, creation of entanglement through dissipation, and quantum non-demolition measurement of one species with another. Here we demonstrate an entangling quantum gate between ions of different elements which can serve as an important building block of QIP, quantum networking, precision spectroscopy, metrology, and quantum simulation. A geometric phase gate between a 9Be+ ion and a 25Mg+ ion is realized through an effective spin-spin interaction generated by state-dependent forces induced with laser beams. Combined with single-qubit gates and same-species entangling gates, this mixed-element entangling gate provides a complete set of gates over such a hybrid system for universal QIP. Using a sequence of such gates, we demonstrate a CNOT (controlled-NOT) gate and a SWAP gate. We further demonstrate the robustness of these gates against thermal excitation and show improved detection in quantum logic spectroscopy. We also observe a strong violation of a CHSH (Clauser-Horne-Shimony-Holt)-type Bell inequality on entangled states composed of different ion species.

Multi-element logic gates for trapped-ion qubits.

PubMed

Tan, T R; Gaebler, J P; Lin, Y; Wan, Y; Bowler, R; Leibfried, D; Wineland, D J

2015-12-17

Precision control over hybrid physical systems at the quantum level is important for the realization of many quantum-based technologies. In the field of quantum information processing (QIP) and quantum networking, various proposals discuss the possibility of hybrid architectures where specific tasks are delegated to the most suitable subsystem. For example, in quantum networks, it may be advantageous to transfer information from a subsystem that has good memory properties to another subsystem that is more efficient at transporting information between nodes in the network. For trapped ions, a hybrid system formed of different species introduces extra degrees of freedom that can be exploited to expand and refine the control of the system. Ions of different elements have previously been used in QIP experiments for sympathetic cooling, creation of entanglement through dissipation, and quantum non-demolition measurement of one species with another. Here we demonstrate an entangling quantum gate between ions of different elements which can serve as an important building block of QIP, quantum networking, precision spectroscopy, metrology, and quantum simulation. A geometric phase gate between a (9)Be(+) ion and a (25)Mg(+) ion is realized through an effective spin-spin interaction generated by state-dependent forces induced with laser beams. Combined with single-qubit gates and same-species entangling gates, this mixed-element entangling gate provides a complete set of gates over such a hybrid system for universal QIP. Using a sequence of such gates, we demonstrate a CNOT (controlled-NOT) gate and a SWAP gate. We further demonstrate the robustness of these gates against thermal excitation and show improved detection in quantum logic spectroscopy. We also observe a strong violation of a CHSH (Clauser-Horne-Shimony-Holt)-type Bell inequality on entangled states composed of different ion species.

Who attends out-of-hours general practice appointments? Analysis of a patient cohort accessing new out-of-hours units.

PubMed

Kelly, Shona J; Piercy, Hilary; Ibbotson, Rachel; Fowler Davis, Sally V

2018-06-09

This report describes the patients who used additional out-of-hours (OOH) appointments offered through a UK scheme intended to increase patient access to primary care by extending OOH provision. Cohort study and survey data. OOH appointments offered in four units in one region in England (October 2015 to November 2016). Unidentifiable data on all patients were abstracted from a bespoke appointment system and the responses to a patient opinion questionnaire about this service. Descriptive analysis of the appointment data was conducted. Multivariate analysis of the opinion survey data examined the characteristics of the patients who would have gone to the emergency department (ED) had the OOH appointments not been available. There were 24 448 appointments for 19 701 different patients resulting in 29 629 service outcomes. Women dominated the uptake and patients from the poorest fifth of the population used nearly 40% of appointments. The patient survey found OOH appointments were extremely popular-93% selecting 'extremely likely' or 'likely' to recommend the service. Multivariate analysis of patient opinion survey data on whether ED would have been an alternative to the OOH service found that men, young children, people of Asian heritage and the most deprived were more likely to have gone to ED without this service. The users of the OOH service were substantially different from in-hours service users with a large proportion of children under age 5, and the poor, which support the idea that there may be unmet need as the poor have the least flexible working conditions. These results demonstrate the need for equality impact assessment in planning service improvements associated with policy implementation. It suggests that OOH need to take account of patients expectations about convenience of appointments and how patients use services for urgent care needs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Endodontic interappointment flare-ups: a prospective study of incidence and related factors.

PubMed

Walton, R; Fouad, A

1992-04-01

Severe pain and/or swelling following a root canal treatment appointment are serious sequelae. Information varies or is incomplete as to the incidence of these conditions and related factors. In this study, data were collected at root canal treatment appointments on demographics, pulp/periapical diagnoses, presenting symptoms, treatment procedures, and number of appointments. Patients that then experienced a flare-up (a severe problem requiring an unscheduled visit and treatment) had the correlating factors examined. Statistical determinations were by chi-square analysis with significance at 0.05 or less. Nine hundred forty-six visits resulted in an incidence of 3.17% flare-ups. Flare-ups were positively correlated with more severe presenting symptoms, pulp necrosis with painful apical pathosis, and patients on analgesics. Fewer flare-ups occurred in undergraduate patients and following obturation procedures. There was no correlation between patient demographics or systemic conditions, number of appointments, treatment procedures, or taking antibiotics.

Influence of range-gated intensifiers on underwater imaging system SNR

NASA Astrophysics Data System (ADS)

Wang, Xia; Hu, Ling; Zhi, Qiang; Chen, Zhen-yue; Jin, Wei-qi

2013-08-01

Range-gated technology has been a hot research field in recent years due to its high effective back scattering eliminating. As a result, it can enhance the contrast between a target and its background and extent the working distance of the imaging system. The underwater imaging system is required to have the ability to image in low light level conditions, as well as the ability to eliminate the back scattering effect, which means that the receiver has to be high-speed external trigger function, high resolution, high sensitivity, low noise, higher gain dynamic range. When it comes to an intensifier, the noise characteristics directly restrict the observation effect and range of the imaging system. The background noise may decrease the image contrast and sharpness, even covering the signal making it impossible to recognize the target. So it is quite important to investigate the noise characteristics of intensifiers. SNR is an important parameter reflecting the noise features of a system. Through the use of underwater laser range-gated imaging prediction model, and according to the linear SNR system theory, the gated imaging noise performance of the present market adopted super second generation and generation Ⅲ intensifiers were theoretically analyzed. Based on the active laser underwater range-gated imaging model, the effect to the system by gated intensifiers and the relationship between the system SNR and MTF were studied. Through theoretical and simulation analysis to the image intensifier background noise and SNR, the different influence on system SNR by super second generation and generation Ⅲ ICCD was obtained. Range-gated system SNR formula was put forward, and compared the different effect influence on the system by using two kind of ICCDs was compared. According to the matlab simulation, a detailed analysis was carried out theoretically. All the work in this paper lays a theoretical foundation to further eliminating back scattering effect, improving image SNR, designing and manufacturing higher performance underwater range-gated imaging systems.

76 FR 73521 - Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... 3206-AM06 Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law... particular agency, if the agency fails to carry out the function in accordance with applicable law. If OPM... Selective Service System, but who knowingly and willfully failed to register before reaching age 26. The new...

Social Cultural Factors Influencing Appointment of Headteachers in Primary Schools in Eldoret East Sub-County, Kenya

ERIC Educational Resources Information Center

Suter, Esther J.

2017-01-01

Headteachers' position is at the critical point of which all the mechanism of Education system: planning, delivery and management rest. The purpose of the study was to investigate social cultural factors influencing appointment of headteachers in primary schools in Eldoret East Sub-County, Uasin Gishu County. The target population comprised of 275…

Counterfactual Rydberg gate for photons

NASA Astrophysics Data System (ADS)

Garcia-Escartin, Juan Carlos; Chamorro-Posada, Pedro

2012-03-01

Quantum computation with photons requires efficient two-photon gates. We put forward a two-photon entangling gate which uses an intermediate atomic system. The system includes a single Rydberg atom which can switch on and off photon absorption in an ensemble using the dipole blockade. The gate is based in a counterfactual protocol. The mere possibility of an absorption that can only occur with a vanishing probability steers the photons to the desired final state.

A radar vehicle detection system for four-quadrant gate warning systems and blocked crossing detection.

DOT National Transportation Integrated Search

2012-12-01

The Wavetronix Matrix Radar was adapted for use at four-quadrant gate railroad crossings for the purpose of influencing exit gate behavior upon the detection of vehicles, as an alternative to buried inductive loops. Two radar devices were utilized, o...

An Integrated Gate Turnaround Management Concept Leveraging Big Data/Analytics for NAS Performance Improvements

NASA Technical Reports Server (NTRS)

Chung, William; Chachad, Girish; Hochstetler, Ronald

2016-01-01

The Integrated Gate Turnaround Management (IGTM) concept was developed to improve the gate turnaround performance at the airport by leveraging relevant historical data to support optimization of airport gate operations, which include: taxi to the gate, gate services, push back, taxi to the runway, and takeoff, based on available resources, constraints, and uncertainties. By analyzing events of gate operations, primary performance dependent attributes of these events were identified for the historical data analysis such that performance models can be developed based on uncertainties to support descriptive, predictive, and prescriptive functions. A system architecture was developed to examine system requirements in support of such a concept. An IGTM prototype was developed to demonstrate the concept using a distributed network and collaborative decision tools for stakeholders to meet on time pushback performance under uncertainties.

Validation of the Spatial Accuracy of the ExacTracRTM Adaptive Gating System

NASA Astrophysics Data System (ADS)

Twork, Gregory

Stereotactic body radiation therapy (SBRT) is a method of treatment that is used in extracranial locations, including the abdominal and thoracic cavities, as well as spinal and paraspinal locations. At the McGill University Health Centre, liver SBRT treatments include gating, which places the treatment beam on a duty cycle controlled by tracking of fiducial markers moving with the patient's breathing cycle. Respiratory gated treatments aim to spare normal tissue, while delivering a dose properly to a moving target. The ExacTracRTM system (BrainLAB AG Germany) is an image-guided radiotherapy system consisting of a combination of infra-red (IR) cameras and dual kilovoltage (kV) X-ray tubes. The IR system is used to track patient positioning and respiratory motion, while the kV X-rays are used to determine a positional shift based on internal anatomy or fiducial markers. In order to validate the system's ability to treat under gating conditions, each step of the SBRT process was evaluated quantitatively. Initially the system was tested under ideal static conditions, followed by a study including gated parameters. The uncertainties of the isocenters, positioning algorithm, planning computed tomography (CT) and four dimensional CT (4DCT) scans, gating window size and tumor motion were evaluated for their contributions to the total uncertainty in treatment. The mechanical isocenter and 4DCT were found to be the largest sources of uncertainty. However, for tumors with large internal amplitudes (>2.25 cm) that are treated with large gating windows (>30%) the gating parameters can contribute more than 1.1 +/- 1.8 mm.

A real-time respiration position based passive breath gating equipment for gated radiotherapy: A preclinical evaluation

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

Hu Weigang; Xu Anjie; Li Guichao

2012-03-15

Purpose: To develop a passive gating system incorporating with the real-time position management (RPM) system for the gated radiotherapy. Methods: Passive breath gating (PBG) equipment, which consists of a breath-hold valve, a controller mechanism, a mouthpiece kit, and a supporting frame, was designed. A commercial real-time positioning management system was implemented to synchronize the target motion and radiation delivery on a linear accelerator with the patient's breathing cycle. The respiratory related target motion was investigated by using the RPM system for correlating the external markers with the internal target motion while using PBG for passively blocking patient's breathing. Six patientsmore » were enrolled in the preclinical feasibility and efficiency study of the PBG system. Results: PBG equipment was designed and fabricated. The PBG can be manually triggered or released to block or unblock patient's breathing. A clinical workflow was outlined to integrate the PBG with the RPM system. After implementing the RPM based PBG system, the breath-hold period can be prolonged to 15-25 s and the treatment delivery efficiency for each field can be improved by 200%-400%. The results from the six patients showed that the diaphragm motion caused by respiration was reduced to less than 3 mm and the position of the diaphragm was reproducible for difference gating periods. Conclusions: A RPM based PBG system was developed and implemented. With the new gating system, the patient's breath-hold time can be extended and a significant improvement in the treatment delivery efficiency can also be achieved.« less

5 CFR 316.402 - Procedures for making temporary appointments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... appointments. Such appointments are not VRA appointments and do not lead to conversion to career-conditional appointment; (3) Career-conditional appointment under § 315.601, 315.604, 315.605, 315.606, 315.607, 315.608... the General Accounting Office; (6) Appointment under 28 U.S.C. 602 for current and former employees of...

Harnessing energy-sharing collisions of Manakov solitons to implement universal NOR and OR logic gates

NASA Astrophysics Data System (ADS)

Vijayajayanthi, M.; Kanna, T.; Murali, K.; Lakshmanan, M.

2018-06-01

The energy-sharing collision of bright optical solitons in the Manakov system, governing pulse propagation in high birefringent fiber, is employed theoretically to realize optical logic gates. In particular, we successfully construct (theoretically) the universal NOR gate and the OR gate from the energy-sharing collisions of just four bright solitons which can be well described by the exact bright four-soliton solution of the Manakov system. This construction procedure has important merits such as realizing the two input gates with a minimal number of soliton collisions and possibilities of multistate logic. The recent experiments on Manakov solitons suggest the possibility of implementation of this theoretical construction of such gates and ultimately an all-optical computer.

A two-qubit photonic quantum processor and its application to solving systems of linear equations

PubMed Central

Barz, Stefanie; Kassal, Ivan; Ringbauer, Martin; Lipp, Yannick Ole; Dakić, Borivoje; Aspuru-Guzik, Alán; Walther, Philip

2014-01-01

Large-scale quantum computers will require the ability to apply long sequences of entangling gates to many qubits. In a photonic architecture, where single-qubit gates can be performed easily and precisely, the application of consecutive two-qubit entangling gates has been a significant obstacle. Here, we demonstrate a two-qubit photonic quantum processor that implements two consecutive CNOT gates on the same pair of polarisation-encoded qubits. To demonstrate the flexibility of our system, we implement various instances of the quantum algorithm for solving of systems of linear equations. PMID:25135432

System and Method for Scan Range Gating

NASA Technical Reports Server (NTRS)

Lindemann, Scott (Inventor); Zuk, David M. (Inventor)

2017-01-01

A system for scanning light to define a range gated signal includes a pulsed coherent light source that directs light into the atmosphere, a light gathering instrument that receives the light modified by atmospheric backscatter and transfers the light onto an image plane, a scanner that scans collimated light from the image plane to form a range gated signal from the light modified by atmospheric backscatter, a control circuit that coordinates timing of a scan rate of the scanner and a pulse rate of the pulsed coherent light source so that the range gated signal is formed according to a desired range gate, an optical device onto which an image of the range gated signal is scanned, and an interferometer to which the image of the range gated signal is directed by the optical device. The interferometer is configured to modify the image according to a desired analysis.

Gated frequency-resolved optical imaging with an optical parametric amplifier

DOEpatents

Cameron, S.M.; Bliss, D.E.; Kimmel, M.W.; Neal, D.R.

1999-08-10

A system for detecting objects in a turbid media utilizes an optical parametric amplifier as an amplifying gate for received light from the media. An optical gating pulse from a second parametric amplifier permits the system to respond to and amplify only ballistic photons from the object in the media. 13 figs.

Gated frequency-resolved optical imaging with an optical parametric amplifier

DOEpatents

Cameron, Stewart M.; Bliss, David E.; Kimmel, Mark W.; Neal, Daniel R.

1999-01-01

A system for detecting objects in a turbid media utilizes an optical parametric amplifier as an amplifying gate for received light from the media. An optical gating pulse from a second parametric amplifier permits the system to respond to and amplify only ballistic photons from the object in the media.

Potential means of cost reduction in grade crossing automatic gate systems. volume I : overview and low cost railroad/highway grade crossing gate systems

DOT National Transportation Integrated Search

1977-02-28

This report, Volume I of a two-volume study, examines the potential for reduction of the cost of installing and maintaining automatic gates at railroad-highway grade crossings. It comprises a general overview; a review of current practices, equipment...

Universal quantum gates for photon-atom hybrid systems assisted by bad cavities

PubMed Central

Wang, Guan-Yu; Liu, Qian; Wei, Hai-Rui; Li, Tao; Ai, Qing; Deng, Fu-Guo

2016-01-01

We present two deterministic schemes for constructing a CNOT gate and a Toffoli gate on photon-atom and photon-atom-atom hybrid quantum systems assisted by bad cavities, respectively. They are achieved by cavity-assisted photon scattering and work in the intermediate coupling region with bad cavities, which relaxes the difficulty of their implementation in experiment. Also, bad cavities are feasible for fast quantum operations and reading out information. Compared with previous works, our schemes do not need any auxiliary qubits and measurements. Moreover, the schematic setups for these gates are simple, especially that for our Toffoli gate as only a quarter wave packet is used to interact the photon with each of the atoms every time. These atom-cavity systems can be used as the quantum nodes in long-distance quantum communication as their relatively long coherence time is suitable for multi-time operations between the photon and the system. Our calculations show that the average fidelities and efficiencies of our two universal hybrid quantum gates are high with current experimental technology. PMID:27067992

Transistor-based particle detection systems and methods

DOEpatents

Jain, Ankit; Nair, Pradeep R.; Alam, Muhammad Ashraful

2015-06-09

Transistor-based particle detection systems and methods may be configured to detect charged and non-charged particles. Such systems may include a supporting structure contacting a gate of a transistor and separating the gate from a dielectric of the transistor, and the transistor may have a near pull-in bias and a sub-threshold region bias to facilitate particle detection. The transistor may be configured to change current flow through the transistor in response to a change in stiffness of the gate caused by securing of a particle to the gate, and the transistor-based particle detection system may configured to detect the non-charged particle at least from the change in current flow.

Getting patients in the door: medical appointment reminder preferences.

PubMed

Crutchfield, Trisha M; Kistler, Christine E

2017-01-01

Between 23% and 34% of outpatient appointments are missed annually. Patients who frequently miss medical appointments have poorer health outcomes and are less likely to use preventive health care services. Missed appointments result in unnecessary costs and organizational inefficiencies. Appointment reminders may help reduce missed appointments; particular types may be more effective than other types. We used a survey with a discrete choice experiment (DCE) to learn why individuals miss appointments and to assess appointment reminder preferences. We enrolled a national sample of adults from an online survey panel to complete demographic and appointment habit questions as well as a 16-task DCE designed in Sawtooth Software's Discover tool. We assessed preferences for four reminder attributes - initial reminder type, arrival of initial reminder, reminder content, and number of reminders. We derived utilities and importance scores. We surveyed 251 adults nationally, with a mean age of 43 (range 18-83) years: 51% female, 84% White, and 8% African American. Twenty-three percent of individuals missed one or more appointments in the past 12 months. Two primary reasons given for missing an appointment include transportation problems (28%) and forgetfulness (26%). Participants indicated the initial reminder type (21%) was the most important attribute, followed by the number of reminders (10%). Overall, individuals indicated a preference for a single reminder, arriving via email, phone call, or text message, delivered less than 2 weeks prior to an appointment. Preferences for reminder content were less clear. The number of missed appointments and reasons for missing appointments are consistent with prior research. Patient-centered appointment reminders may improve appointment attendance by addressing some of the reasons individuals report missing appointments and by meeting patients' needs. Future research is necessary to determine if preferred reminders used in practice will result in improved appointment attendance in clinical settings.

When open access might not work: Understanding patient attitudes in appointment scheduling.

PubMed

Finkelstein, Stacey R; Liu, Nan; Rosenthal, David; Poghosyan, Lusine

2017-01-25

Open-access (OA) systems aim to reduce delays to care. However, recent evidence suggests that OA systems might reduce patient satisfaction and result in poorer patient experiences due to patients' inability to obtain appointments with their usual care provider. We conducted a series of experiments to explore the role of risk attitudes, an individual difference variable that measures preferences for risky options, in patients' perception of OA systems. The aim of the study was to investigate the relationship between patient's risk attitudes and attitudes toward OA systems and demonstrate whether patients' attitudes toward OA systems will vary as a function of their risk attitudes. Three separate experiments were conducted to assess the relationship between patient risk attitudes and their attitudes about OA systems. Study 1 (patient population) explored the aforementioned relationship. We explored two potential moderators for this effect: how salient the tradeoff is between delays to care and quality of care (Study 2; online population) and the severity of the patient's health condition (Study 3; patient population). Compared to risk-averse patients, risk-seeking patients have more favorable attitudes toward OA systems (a 1-point increase in risk attitudes on a 7-point scale resulted in a 0.44-point boost in attitudes toward OA systems on a 7-point scale). This relationship holds even when the tradeoff between access to care and quality of care is made salient (e.g., a practice informs patients they can have a same-day appointment but are unlikely to see their regular provider) and when people consider having a minor health condition. This relationship is attenuated when patients imagine having a serious medical condition because speedy access to care becomes a top priority. Risk-seeking patients have more favorable attitudes toward OA systems. Risk-seeking patients are primarily driven by speed to access at the potential expense of continuity of care. Organizations that better understand patient motives in scheduling medical appointments can introduce more effective interventions and positively impact patient experiences of care.

Fast photomultiplier tube gating system for underwater laser detector

NASA Astrophysics Data System (ADS)

Lei, Xuanhua; Yang, Kecheng; Rao, Jionghui; Zhang, Xiaohui; Xia, Min; Zheng, Yi; Li, Wei

2007-01-01

Laser will attenuate during its propagation in water and also be backward scattered by water when it is used to detect bubbles in the ocean. Meanwhile backward scattering intensity of the bubbles is feeble, its dynamic range reaches to the order of 6, which saturates PMT and its post-treatment circuit. Timely gating system is used to solve the problem. The system contains pulsed laser and gating PMT receiver. The wavelength of the laser is 532nm, with pulse width of several nanometers. Its operational delay is matched with the time period between laser traveling forward and back after scattered by the target. By doing this, the light scattered by other object is eliminated, dynamic range of the signal reduces, and consequently SNR increases. In order to avoid Signal Induced Noise(SIN), we choose PMT R1333 having no HA coating. TTL logical level, which is used as gating signal, controls the first dynode voltage of PMT to implement gating. Gating speed is about 100ns, of which the width is tunable. By carefully designing the electronic system, SNR is eliminated to a level as low as possible, and the output signal of PMT is fast integrated in order to reduce the influences of signal induced by opening the gate.

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

Ravindran, P; Wui Ann, W; Lim, Y

Purpose: In general, the linear accelerator is gated using respiratory signal obtained by way of external sensors to account for the breathing motion during radiotherapy. One of the commonly used gating devices is the Varian RPM device. Calypso system that uses electromagnetic tracking of implanted or surface transponders could also be used for gating. The aim of this study is to compare the gating efficiency of RPM device and the calypso system by phantom studies. Methods: An ArcCheck insert was used as the phantom with a Gafchromic film placed in its holder. The ArcCheck insert was placed on a Motionmore » Sim platform and moved in the longitudinal direction simulating a respiratory motion with a period of 5 seconds and amplitude of ±6mm. The Gafchromic film was exposed to a 2 × 2cm{sup 2} field, i) with the phantom static, ii) phantom moving but ungated iii) gated with gating window of 2mm and 3mm. This was repeated with Calypso system using surface transponders with the same gating window. The Gafchromic films were read with an EPSON 11000 flatbed scanner and analysed with ‘Medphysto’ software. Results: The full width at half maximum (FWHM) as measured with film at the level of the film holder was 1.65cm when the phantom was static. FWHM measured with phantom moving and without gating was 1.16 cm and penumbra was 7 mm (80–20%) on both sides. When the beam was gated with 2 mm gating window the FWHM was 1.8 cm with RPM device and 1.9 cm with Calypso. Similarly, when the beam was gated with 3 mm window, the FWHM was 1.9cm with RPM device and 2cm with Calypso. Conclusion: This work suggests that the gating efficiency of RPM device is better than that of the Calypso with surface transponder, with reference to the latency in gating.« less

Method and Apparatus for Simultaneous Processing of Multiple Functions

NASA Technical Reports Server (NTRS)

Stoica, Adrian (Inventor); Andrei, Radu (Inventor)

2017-01-01

Electronic logic gates that operate using N logic state levels, where N is greater than 2, and methods of operating such gates. The electronic logic gates operate according to truth tables. At least two input signals each having a logic state that can range over more than two logic states are provided to the logic gates. The logic gates each provide an output signal that can have one of N logic states. Examples of gates described include NAND/NAND gates having two inputs A and B and NAND/NAND gates having three inputs A, B, and C, where A, B and C can take any of four logic states. Systems using such gates are described, and their operation illustrated. Optical logic gates that operate using N logic state levels are also described.

Method and Apparatus for Simultaneous Processing of Multiple Functions

NASA Technical Reports Server (NTRS)

Stoica, Adrian (Inventor); Andrei, Radu (Inventor); Zhu, David (Inventor); Mojarradi, Mohammad Mehdi (Inventor); Vo, Tuan A. (Inventor)

2015-01-01

Electronic logic gates that operate using N logic state levels, where N is greater than 2, and methods of operating such gates. The electronic logic gates operate according to truth tables. At least two input signals each having a logic state that can range over more than two logic states are provided to the logic gates. The logic gates each provide an output signal that can have one of N logic states. Examples of gates described include NAND/NAND gates having two inputs A and B and NAND/NAND gates having three inputs A, B, and C, where A, B and C can take any of four logic states. Systems using such gates are described, and their operation illustrated. Optical logic gates that operate using N logic state levels are also described.

Offsetting Faculty and Institutional Inflexibility: A Case Study in Developing an Alternative to Tenure with Reference to Faculty Development and Evaluation.

ERIC Educational Resources Information Center

Steinkrauss, Philip J.

This in-progress program and resource study presents an actual case study in developing an alternative to tenure. The College of St. Francis implemented during the 1979-80 academic year an alternative system, the Three Year Rolling Contract. It stated that all faculty members have academic freedom under any form of appointment; upon appointment as…

Targeting zero non-attendance in healthcare clinics.

PubMed

Chan, Ka C; Chan, David B

2012-01-01

Non-attendance represents a significant cost to many health systems, resulting in inefficiency, wasted resources, poorer service delivery and lengthened waiting queues. Past studies have considered extensively the reasons for non-attendance and have generally concluded that the use of reminder systems is effective. Despite this, there will always be a certain level of non-attendance arising from unforeseeable and unpreventable circumstances, such as illness or accidents, leading to unfilled appointments. This paper reviews current approaches to the non-attendance problem, and presents a high-level approach to fill last minute appointments arising out of unforeseeable non-attendance. However, no single approach will work for all clinics and implementation of these ideas must occur at a local level. These approaches include use of social networks, such as Twitter and Facebook, as a communication tool in order to notify prospective patients when last-minute appointments become available. In addition, teleconsultation using video-conferencing technologies would be suitable for certain last-minute appointments where travel time would otherwise be inhibiting. Developments of new and innovative technologies and the increasing power of social media, means that zero non-attendance is now an achievable target. We hope that this will lead to more evidence-based evaluations from the implementation of these strategies in various settings at a local level.

All-fibre optical gating system for measuring a complex-shaped periodic broadband signal with picosecond resolution in a nanosecond time window

NASA Astrophysics Data System (ADS)

Andrianov, A. V.

2018-04-01

We have developed an optical gating system for continuously monitoring a complex-shaped periodic optical signal with picosecond resolution in a nanosecond time window using an all-fibre optical gate in the form of a nonlinear loop mirror and a passively mode-locked femtosecond laser. The distinctive features of the system are the possibility of characterizing signals with a very large spectral bandwidth, the possibility of using a gating pulse source with a wavelength falling in the band of the signal under study and its all-fibre design with the use of standard fibres and telecom components.

Dose verification for respiratory-gated volumetric modulated arc therapy (VMAT)

PubMed Central

Qian, Jianguo; Xing, Lei; Liu, Wu; Luxton, Gary

2011-01-01

A novel commercial medical linac system (TrueBeam™, Varian Medical Systems, Palo Alto, CA) allows respiratory-gated volumetric modulated arc therapy (VMAT), a new modality for treating moving tumors with high precision and improved accuracy by allowing for regular motion associated with a patient's breathing during VMAT delivery. The purpose of this work is to adapt a previously-developed dose reconstruction technique to evaluate the fidelity of VMAT treatment during gated delivery under clinic-relevant periodic motion related to patient breathing. A Varian TrueBeam system was used in this study. VMAT plans were created for three patients with lung or pancreas tumors. Conventional 6 MV and 15 MV beams with flattening filter and high dose-rate 10 MV beams with no flattening filter were used in these plans. Each patient plan was delivered to a phantom first without gating and then with gating for three simulated respiratory periods (3, 4.5 and 6 seconds). Using the adapted log file-based dose reconstruction procedure supplemented with ion chamber array (Seven29™, PTW, Freiburg, Germany) measurements, the delivered dose was used to evaluate the fidelity of gated VMAT delivery. Comparison of Seven29 measurements with and without gating showed good agreement with gamma-index passing rates above 99% for 1%/1mm dose accuracy/distance-to-agreement criteria. With original plans as reference, gamma-index passing rates were 100% for the reconstituted plans (1%/1 mm criteria) and 93.5–100% for gated Seven29 measurements (3%/3 mm criteria). In the presence of leaf error deliberately introduced into the gated delivery of a pancreas patient plan, both dose reconstruction and Seven29 measurement consistently indicated substantial dosimetric differences from the original plan. In summary, a dose reconstruction procedure was demonstrated for evaluating the accuracy of respiratory-gated VMAT delivery. This technique showed that under clinical operation, the TrueBeam system faithfully realized treatment plans with gated delivery. This methodology affords a useful tool for machine and patient-specific quality assurance of the newly available respiratory-gated VMAT. PMID:21753232

Enzyme-based logic gates and circuits-analytical applications and interfacing with electronics.

PubMed

Katz, Evgeny; Poghossian, Arshak; Schöning, Michael J

2017-01-01

The paper is an overview of enzyme-based logic gates and their short circuits, with specific examples of Boolean AND and OR gates, and concatenated logic gates composed of multi-step enzyme-biocatalyzed reactions. Noise formation in the biocatalytic reactions and its decrease by adding a "filter" system, converting convex to sigmoid response function, are discussed. Despite the fact that the enzyme-based logic gates are primarily considered as components of future biomolecular computing systems, their biosensing applications are promising for immediate practical use. Analytical use of the enzyme logic systems in biomedical and forensic applications is discussed and exemplified with the logic analysis of biomarkers of various injuries, e.g., liver injury, and with analysis of biomarkers characteristic of different ethnicity found in blood samples on a crime scene. Interfacing of enzyme logic systems with modified electrodes and semiconductor devices is discussed, giving particular attention to the interfaces functionalized with signal-responsive materials. Future perspectives in the design of the biomolecular logic systems and their applications are discussed in the conclusion. Graphical Abstract Various applications and signal-transduction methods are reviewed for enzyme-based logic systems.

Gated IR imaging with 128 × 128 HgCdTe electron avalanche photodiode FPA

NASA Astrophysics Data System (ADS)

Beck, Jeff; Woodall, Milton; Scritchfield, Richard; Ohlson, Martha; Wood, Lewis; Mitra, Pradip; Robinson, Jim

2007-04-01

The next generation of IR sensor systems will include active imaging capabilities. One example of such a system is a gated-active/passive system. The gated-active/passive system promises long-range target detection and identification. A detector that is capable of both active and passive modes of operation opens up the possibility of a self-aligned system that uses a single focal plane. The detector would need to be sensitive in the 3-5 μm band for passive mode operation. In the active mode, the detector would need to be sensitive in eye-safe range, e.g. 1.55 μm, and have internal gain to achieve the required system sensitivity. The MWIR HgCdTe electron injection avalanche photodiode (e-APD) not only provides state-of-the-art 3-5 μm spectral sensitivity, but also high avalanche photodiode gain without minimal excess noise. Gains of greater than 1000 have been measured in MWIR e-APDs with a gain independent excess noise factor of 1.3. This paper reports the application of the mid-wave HgCdTe e-APD for near-IR gated-active/passive imaging. Specifically a 128x128 FPA composed of 40 μm pitch, 4.2 μm to 5 μm cutoff, APD detectors with a custom readout integrated circuit was designed, fabricated, and tested. Median gains as high as 946 at 11 V bias with noise equivalent inputs as low as 0.4 photon were measured at 80 K. A gated imaging demonstration system was designed and built using commercially available parts. High resolution gated imagery out to 9 km was obtained with this system that demonstrated predicted MTF, precision gating, and sub 10 photon sensitivity.

"Nudge" and the epidemic of missed appointments.

PubMed

Aggarwal, Ajay; Davies, Joanna; Sullivan, Richard

2016-06-20

Purpose - Missed appointments constitute a significant problem in the UK National Health Service (NHS) and this remains an area where improvements could yield substantial efficiency savings. The purpose of this paper is to suggest that nudge policies based on behavioural theories may help target interventions to improve patient motivation to attend appointments. Design/methodology/approach - The authors propose two policies to reduce missed appointments. The first attempts to empower patients through making the appointment system more individualised to them and utilising their intrinsic feelings of social responsibility. The second policy utilises a financial commitment given by the patient at the time of booking. The different mechanisms of influencing patient behaviour are based on two different views of what motivates individuals' actions. The first policy is based on individuals being "knights". They are altruistic and have well-intentioned values. The second policy option is constructed on the premise that an individual is governed by self-interest, and they are in fact "knaves". Findings - A policy, which avoids the use of financial penalties is likely to be more culturally acceptable within the NHS. It could also prevent the phenomenon of "crowding out" whereby the desire to act dutifully gets displaced by the motivation to avoid incurring a monetary fine. Originality/value - Testing both strategies would provide insight into patient attitudes towards health care and society. This would help optimise behavioural strategies which may influence not only appointment attendances but also have wider implications for encouraging rational health care consumption.

Alstom Francis Turbine Ring Gates: from Retrofitting to Commissioning

NASA Astrophysics Data System (ADS)

A, Nguyen P.; G, Labrecque; M-O, Thibault; M, Bergeron; A, Steinhilber; D, Havard

2014-03-01

The Ring Gate synchronisation system developed by Alstom is new and patented. It uses hydraulic cylinders connected in pairs by a serial connection. The new hydraulic synchronisation system, when compared to the previous mechanical synchronisation system, has several advantages. It is a compact design; it reduces the number of mechanical components as well as maintenance costs. The new system maintains the Ring Gates robustness. The new approach is an evolution from mechanical to hydraulic synchronization assisted by electronic control. The new synchronization system eliminates several mechanical components that used to add wear and friction and which are usually difficult to adjust during maintenance. Tension chains and sprockets and associated controls are eliminated. Through the position sensors, the redundancy of the ring gate synchronization system makes it predictable and reliable. The electronic control compensates for any variation in operation, for example a leak in the hydraulic system. An emergency closing is possible without the electronic control system due to the stiffness of hydraulic serial connection in the hydraulic cylinder pairs. The Ring Gate can work safely against uneven loads and frictions. The development will be reviewed and its application discussed through commissioning results.

Getting patients in the door: medical appointment reminder preferences

PubMed Central

Crutchfield, Trisha M; Kistler, Christine E

2017-01-01

Purpose Between 23% and 34% of outpatient appointments are missed annually. Patients who frequently miss medical appointments have poorer health outcomes and are less likely to use preventive health care services. Missed appointments result in unnecessary costs and organizational inefficiencies. Appointment reminders may help reduce missed appointments; particular types may be more effective than other types. We used a survey with a discrete choice experiment (DCE) to learn why individuals miss appointments and to assess appointment reminder preferences. Methods We enrolled a national sample of adults from an online survey panel to complete demographic and appointment habit questions as well as a 16-task DCE designed in Sawtooth Software’s Discover tool. We assessed preferences for four reminder attributes – initial reminder type, arrival of initial reminder, reminder content, and number of reminders. We derived utilities and importance scores. Results We surveyed 251 adults nationally, with a mean age of 43 (range 18–83) years: 51% female, 84% White, and 8% African American. Twenty-three percent of individuals missed one or more appointments in the past 12 months. Two primary reasons given for missing an appointment include transportation problems (28%) and forgetfulness (26%). Participants indicated the initial reminder type (21%) was the most important attribute, followed by the number of reminders (10%). Overall, individuals indicated a preference for a single reminder, arriving via email, phone call, or text message, delivered less than 2 weeks prior to an appointment. Preferences for reminder content were less clear. Conclusion The number of missed appointments and reasons for missing appointments are consistent with prior research. Patient-centered appointment reminders may improve appointment attendance by addressing some of the reasons individuals report missing appointments and by meeting patients’ needs. Future research is necessary to determine if preferred reminders used in practice will result in improved appointment attendance in clinical settings. PMID:28182131

Mesoscopic Field-Effect-Induced Devices in Depleted Two-Dimensional Electron Systems

NASA Astrophysics Data System (ADS)

Bachsoliani, N.; Platonov, S.; Wieck, A. D.; Ludwig, S.

2017-12-01

Nanoelectronic devices embedded in the two-dimensional electron system (2DES) of a GaAs /(Al ,Ga )As heterostructure enable a large variety of applications ranging from fundamental research to high-speed transistors. Electrical circuits are thereby commonly defined by creating barriers for carriers by the selective depletion of a preexisting 2DES. We explore an alternative approach: we deplete the 2DES globally by applying a negative voltage to a global top gate and screen the electric field of the top gate only locally using nanoscale gates placed on the wafer surface between the plane of the 2DES and the top gate. Free carriers are located beneath the screen gates, and their properties can be controlled by means of geometry and applied voltages. This method promises considerable advantages for the definition of complex circuits by the electric-field effect, as it allows us to reduce the number of gates and simplify gate geometries. Examples are carrier systems with ring topology or large arrays of quantum dots. We present a first exploration of this method pursuing field effect, Hall effect, and Aharonov-Bohm measurements to study electrostatic, dynamic, and coherent properties.

High-Fidelity Single-Shot Toffoli Gate via Quantum Control.

PubMed

Zahedinejad, Ehsan; Ghosh, Joydip; Sanders, Barry C

2015-05-22

A single-shot Toffoli, or controlled-controlled-not, gate is desirable for classical and quantum information processing. The Toffoli gate alone is universal for reversible computing and, accompanied by the Hadamard gate, forms a universal gate set for quantum computing. The Toffoli gate is also a key ingredient for (nontopological) quantum error correction. Currently Toffoli gates are achieved by decomposing into sequentially implemented single- and two-qubit gates, which require much longer times and yields lower overall fidelities compared to a single-shot implementation. We develop a quantum-control procedure to construct a single-shot Toffoli gate for three nearest-neighbor-coupled superconducting transmon systems such that the fidelity is 99.9% and is as fast as an entangling two-qubit gate under the same realistic conditions. The gate is achieved by a nongreedy quantum control procedure using our enhanced version of the differential evolution algorithm.

The effect of care coordination on pediatric dental patient attendance.

PubMed

Casaverde, Nina B; Douglass, Joanna M

2007-01-01

The objectives of this retrospective study were to determine if care coordination improved appointment-keeping behavior, and identify factors associated with patient attendance at an urban Medicaid dental clinic. Children with sedation appointments received care coordination comprising telephone reminders, education regarding the appointment, and were mailed reminders or home visits if necessary. Collected chart audit data included age, behavior, appointment history and caries status. After several months, care coordination services were extended to routine, nonsedation appointments. Sedation and routine appointment controls were matched by appointment date and selected from the previous year. Attendance information was obtained from appointment and patient records. Sixty-one sedation appointments and 698 routine appointments were analyzed along with 61 and 931 control appointments, respectively. Sedation patients with care coordination had an attendance rate of 59% compared to 53% in the control group (P>.05). Routine patients with care coordination had an attendance rate of 70% compared to 62% in the control group (P<.001).) Data trends suggest that the children least likely to attend their appointments are those with: (1) high caries scores; (2) poor behavior; (3) long wait times between appointments; (4) multiple missed appointments; and (5) lack of a serviceable phone. Care coordination can improve attendance at an urban Medicaid dental clinic, but improvements are modest. Prospective studies are needed to better delineate which interventions and which patient predictors result in the most improvement in attendance-keeping behavior.

Appointment Wait Time, Primary Care Provider Status, and Patient Demographics are Associated With Nonattendance at Outpatient Gastroenterology Clinic.

PubMed

Shrestha, Manish P; Hu, Chengcheng; Taleban, Sasha

2016-09-22

We intended to identify the factors associated with missed appointments at a gastroenterology (GI) clinic in an academic setting. Missed clinic appointments reduce clinic efficiency, waste resources, and increase costs. Limited data exist on subspecialty clinic attendance. We performed a case-control study using data from the electronic health record of patients scheduled for an appointment at the adult GI clinic at the Banner University Medical Center between March and October of 2014. Patients who missed their appointment during the study period served as cases. Controls were randomly selected from patients who completed their appointment during the study period. Analysis included univariate and multivariate logistic regression analysis. Of 2331 scheduled clinic appointments, 195 (8.4%) were missed appointments. Longer waiting time from referral to scheduled appointment was significantly associated with missed appointment (AOR=1.014; 95% CI, 1.01-1.02; P<0.001). Patients with primary care providers (PCPs) were less likely to miss their appointment than those without PCPs (AOR=0.35; 95% CI, 0.18-0.66; P=0.001). Among patient demographic characteristics, ethnicity and marital status were associated with missed appointment. Wait time, ethnicity, marital status, and PCP status were associated with missed GI clinic appointments. Further investigations are needed to assess the effects of intervention strategies directed at reducing appointment wait time and increasing PCP-based care.

Integration of SimSET photon history generator in GATE for efficient Monte Carlo simulations of pinhole SPECT.

PubMed

Chen, Chia-Lin; Wang, Yuchuan; Lee, Jason J S; Tsui, Benjamin M W

2008-07-01

The authors developed and validated an efficient Monte Carlo simulation (MCS) workflow to facilitate small animal pinhole SPECT imaging research. This workflow seamlessly integrates two existing MCS tools: simulation system for emission tomography (SimSET) and GEANT4 application for emission tomography (GATE). Specifically, we retained the strength of GATE in describing complex collimator/detector configurations to meet the anticipated needs for studying advanced pinhole collimation (e.g., multipinhole) geometry, while inserting the fast SimSET photon history generator (PHG) to circumvent the relatively slow GEANT4 MCS code used by GATE in simulating photon interactions inside voxelized phantoms. For validation, data generated from this new SimSET-GATE workflow were compared with those from GATE-only simulations as well as experimental measurements obtained using a commercial small animal pinhole SPECT system. Our results showed excellent agreement (e.g., in system point response functions and energy spectra) between SimSET-GATE and GATE-only simulations, and, more importantly, a significant computational speedup (up to approximately 10-fold) provided by the new workflow. Satisfactory agreement between MCS results and experimental data were also observed. In conclusion, the authors have successfully integrated SimSET photon history generator in GATE for fast and realistic pinhole SPECT simulations, which can facilitate research in, for example, the development and application of quantitative pinhole and multipinhole SPECT for small animal imaging. This integrated simulation tool can also be adapted for studying other preclinical and clinical SPECT techniques.

77 FR 58424 - Drucker, Inc., DynaMotive Energy Systems Corp., and Gate to Wire Solutions, Inc., Order of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Drucker, Inc., DynaMotive Energy Systems Corp., and Gate to Wire Solutions, Inc., Order of Suspension of Trading September 18, 2012. It appears to the... that there is a lack of current and accurate information concerning the securities of Gate to Wire...

Field Programmable Gate Array Control of Power Systems in Graduate Student Laboratories

DTIC Science & Technology

2008-03-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited FIELD PROGRAMMABLE...REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Field Programmable Gate Array Control of Power Systems in Graduate Student...Electronics curriculum track is the development of a design center that explores Field Programmable Gate Array (FPGA) control of power electronics

A combined electron beam/optical lithography process step for the fabrication of sub-half-micron-gate-length MMIC chips

NASA Technical Reports Server (NTRS)

Sewell, James S.; Bozada, Christopher A.

1994-01-01

Advanced radar and communication systems rely heavily on state-of-the-art microelectronics. Systems such as the phased-array radar require many transmit/receive (T/R) modules which are made up of many millimeter wave - microwave integrated circuits (MMIC's). The heart of a MMIC chip is the Gallium Arsenide (GaAs) field-effect transistor (FET). The transistor gate length is the critical feature that determines the operating frequency of the radar system. A smaller gate length will typically result in a higher frequency. In order to make a phased array radar system economically feasible, manufacturers must be capable of producing very large quantities of small-gate-length MMIC chips at a relatively low cost per chip. This requires the processing of a large number of wafers with a large number of chips per wafer, minimum processing time, and a very high chip yield. One of the bottlenecks in the fabrication of MIMIC chips is the transistor gate definition. The definition of sub-half-micron gates for GaAs-based field-effect transistors is generally performed by direct-write electron beam lithography (EBL). Because of the throughput limitations of EBL, the gate-layer fabrication is conventionally divided into two lithographic processes where EBL is used to generate the gate fingers and optical lithography is used to generate the large-area gate pads and interconnects. As a result, two complete sequences of resist application, exposure, development, metallization and lift-off are required for the entire gate structure. We have baselined a hybrid process, referred to as EBOL (electron beam/optical lithography), in which a single application of a multi-level resist is used for both exposures. The entire gate structure, (gate fingers, interconnects and pads), is then formed with a single metallization and lift-off process. The EBOL process thus retains the advantages of the high-resolution E-beam lithography and the high throughput of optical lithography while essentially eliminating an entire lithography/metallization/lift-off process sequence. This technique has been proven to be reliable for both trapezoidal and mushroom gates and has been successfully applied to metal-semiconductor and high-electron-mobility field-effect transistor (MESFET and HEMT) wafers containing devices with gate lengths down to 0.10 micron and 75 x 75 micron gate pads. The yields and throughput of these wafers have been very high with no loss in device performance. We will discuss the entire EBOL process technology including the multilayer resist structure, exposure conditions, process sensitivities, metal edge definition, device results, comparison to the standard gate-layer process, and its suitability for manufacturing.

A combined electron beam/optical lithography process step for the fabrication of sub-half-micron-gate-length MMIC chips

NASA Astrophysics Data System (ADS)

Sewell, James S.; Bozada, Christopher A.

1994-02-01

Advanced radar and communication systems rely heavily on state-of-the-art microelectronics. Systems such as the phased-array radar require many transmit/receive (T/R) modules which are made up of many millimeter wave - microwave integrated circuits (MMIC's). The heart of a MMIC chip is the Gallium Arsenide (GaAs) field-effect transistor (FET). The transistor gate length is the critical feature that determines the operating frequency of the radar system. A smaller gate length will typically result in a higher frequency. In order to make a phased array radar system economically feasible, manufacturers must be capable of producing very large quantities of small-gate-length MMIC chips at a relatively low cost per chip. This requires the processing of a large number of wafers with a large number of chips per wafer, minimum processing time, and a very high chip yield. One of the bottlenecks in the fabrication of MIMIC chips is the transistor gate definition. The definition of sub-half-micron gates for GaAs-based field-effect transistors is generally performed by direct-write electron beam lithography (EBL). Because of the throughput limitations of EBL, the gate-layer fabrication is conventionally divided into two lithographic processes where EBL is used to generate the gate fingers and optical lithography is used to generate the large-area gate pads and interconnects. As a result, two complete sequences of resist application, exposure, development, metallization and lift-off are required for the entire gate structure. We have baselined a hybrid process, referred to as EBOL (electron beam/optical lithography), in which a single application of a multi-level resist is used for both exposures. The entire gate structure, (gate fingers, interconnects and pads), is then formed with a single metallization and lift-off process. The EBOL process thus retains the advantages of the high-resolution E-beam lithography and the high throughput of optical lithography while essentially eliminating an entire lithography/metallization/lift-off process sequence. This technique has been proven to be reliable for both trapezoidal and mushroom gates and has been successfully applied to metal-semiconductor and high-electron-mobility field-effect transistor (MESFET and HEMT) wafers containing devices with gate lengths down to 0.10 micron and 75 x 75 micron gate pads. The yields and throughput of these wafers have been very high with no loss in device performance. We will discuss the entire EBOL process technology including the multilayer resist structure, exposure conditions, process sensitivities, metal edge definition, device results, comparison to the standard gate-layer process, and its suitability for manufacturing.

MEMS Gate Structures for Electric Propulsion Applications

DTIC Science & Technology

2006-07-12

distance between gates of dual gate system V = grid voltage Dsheath = sheath thickness Va = anode voltage E = electric field Vemitter = emitter voltage Es...minutes. A hot pressed boron nitride target (4N) in the hexagonal phase (h- BN) was sputtered in a RF magnetron sputtering gun. To promote the nucleation...and nanoFETs. This paper concludes with a discussion on using MEMS gates for dual -grid electron field emission applications. II. Gate Design I I

A biochemical logic gate using an enzyme and its inhibitor. Part II: The logic gate.

PubMed

Sivan, Sarit; Tuchman, Samuel; Lotan, Noah

2003-06-01

Enzyme-Based Logic Gates (ENLOGs) are key components in bio-molecular systems for information processing. This report and the previous one in this series address the characterization of two bio-molecular switching elements, namely the alpha-chymotrypsin (alphaCT) derivative p-phenylazobenzoyl-alpha-chymotrypsin (PABalphaCT) and its inhibitor (proflavine), as well as their assembly into a logic gate. The experimental output of the proposed system is expressed in terms of enzymic activity and this was translated into logic output (i.e. "1" or "0") relative to a predetermined threshold value. We have found that an univalent link exists between the dominant isomers of PABalphaCT (cis or trans), the dominant form of either acridine (proflavine) or acridan and the logic output of the system. Thus, of all possible combinations, only the trans-PABalphaCT and the acridan lead to an enzymic activity that can be defined as logic output "1". The system operates under the rules of Boolean algebra and performs as an "AND" logic gate.

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

Lee, S; Zheng, Y; Albani, D

Purpose: To reduce internal target volume (ITV), respiratory management is a must in imaging and treatment for lung, liver, and breast cancers. We investigated the dosimetric accuracy of VMAT treatment delivery with a Response™ gating system linked to linear accelerator. Methods: The Response™ gating module designed to directly control radiation beam by breath-holding with a ABC system (Elekta AB, Stockholm, Sweden) was tested for VMAT treatments. Seven VMAT plans including three conventional and four stereotactic body radiotherapy (SBRT) cases were evaluated. Each plan was composed of two or four arcs of 6MV radiation beam with prescribed dose ranged from 1.8more » to 9 Gy per fraction. Each plan was delivered continuously without gating and delivered with multiple interruptions by the ResponseTM gating module with a 20 or 30 second breath-holding period. MapCheck2 and Gafchromic EBT3 films sandwiched in MapPHAN were used to measure the delivered dose with and without gating. Films were scanned on a flatbed color scanner, and red channel was extracted for film dosimetry. Gamma analysis was performed to analyze the dosimetrical accuracy of the radiation delivery with gating. Results: The measured doses with gating remarkably agree with the planned dose distributions in the results of gamma index passing rate (within 20% isodose; >98% for 3%/3mm and >92% for 2%/2mm in MapCheck2, and >91% for 3%/3mm criteria in EBT3 film except one case which was for large target and highly modulated). No significant difference (student t-test: p-value < 0.0005) was shown between the doses delivered with and without gating. There was no indication of radiation gap or overlapping during deliver interruption in film dosimetry. Conclusion: The Response™ gating system can be safely used during VMAT treatment. The accurate performance of the gating system linked to ABC can contribute to ITV reduction for SBRT using VMAT.« less

Dynamic Scheduling for Veterans Health Administration Patients using Geospatial Dynamic Overbooking.

PubMed

Adams, Stephen; Scherer, William T; White, K Preston; Payne, Jason; Hernandez, Oved; Gerber, Mathew S; Whitehead, N Peter

2017-10-12

The Veterans Health Administration (VHA) is plagued by abnormally high no-show and cancellation rates that reduce the productivity and efficiency of its medical outpatient clinics. We address this issue by developing a dynamic scheduling system that utilizes mobile computing via geo-location data to estimate the likelihood of a patient arriving on time for a scheduled appointment. These likelihoods are used to update the clinic's schedule in real time. When a patient's arrival probability falls below a given threshold, the patient's appointment is canceled. This appointment is immediately reassigned to another patient drawn from a pool of patients who are actively seeking an appointment. The replacement patients are prioritized using their arrival probability. Real-world data were not available for this study, so synthetic patient data were generated to test the feasibility of the design. The method for predicting the arrival probability was verified on a real set of taxicab data. This study demonstrates that dynamic scheduling using geo-location data can reduce the number of unused appointments with minimal risk of double booking resulting from incorrect predictions. We acknowledge that there could be privacy concerns with regards to government possession of one's location and offer strategies for alleviating these concerns in our conclusion.

30 CFR 27.3 - Consultation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.3 Consultation. By appointment... qualified MSHA personnel proposed methane-monitoring systems to be submitted in accordance with the...

The feasibility, time savings and economic impact of a designated time appointment system at a busy HIV care clinic in Kenya: a randomized controlled trial.

PubMed

Kwena, Zachary A; Njoroge, Betty W; Cohen, Craig R; Oyaro, Patrick; Shikari, Rosemary; Kibaara, Charles K; Bukusi, Elizabeth A

2015-01-01

As efforts are made to reach universal access to ART in Kenya, the problem of congestion at HIV care clinics is likely to worsen. We evaluated the feasibility and the economic benefits of a designated time appointment system as a solution to decongest HIV care clinics. This was an explanatory two-arm open-label randomized controlled trial that enrolled 354 consenting participants during their normal clinic days and followed-up at subsequent clinic appointments for up to nine months. Intervention arm participants were given specific dates and times to arrive at the clinic for their next appointment while those in the control arm were only given the date and had the discretion to decide on the time to arrive as is the standard practice. At follow-up visits, we recorded arrival and departure times and asked the monetary value of work participants engaged in before and after clinic. We conducted multiple imputation to replace missing data in our primary outcome variables to allow for intention-to-treat analysis; and analyzed the data using Mann-Whitney U test. Overall, 72.1% of the intervention participants arrived on time, 13.3% arrived ahead of time and 14.6% arrived past scheduled time. Intervention arm participants spent a median of 65 [interquartile range (IQR), 52-87] minutes at the clinic compared to 197 (IQR, 173-225) minutes for control participants (p<0.01). Furthermore, intervention arm participants were more productively engaged on their clinic days valuing their cumulative work at a median of USD 10.5 (IQR, 60.0-16.8) compared to participants enrolled in the control arm who valued their work at USD 8.3 (IQR, 5.5-12.9; p=0.02). A designated time appointment system is feasible and provides substantial time savings associated with greater economic productivity for HIV patients attending a busy HIV care clinic.

Patients' Perspective on the Value of Medication Management Appointments.

PubMed

Cruz, Mario; Cruz, Robyn Flaum; Pincus, Harold Alan

2015-05-20

There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients' views and opinions about the value of psychiatric medication management appointments. Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients' views and opinions about the value of attending medication management appointments. An iterative thematic analysis was performed. Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Patients' perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.

Pediatric Return Appointment Adherence for Child Welfare-Involved Children in Los Angeles California.

PubMed

Schneiderman, Janet U; Smith, Caitlin; Arnold-Clark, Janet S; Fuentes, Jorge; Kennedy, Andrea K

2016-02-01

This study of primarily Latino caregivers and Latino child welfare-involved children had the following aims: (1) explore the return appointment adherence patterns at a pediatric medical clinic; and (2) determine the relationship of adherence to return appointments and caregiver, child, and clinic variables. The sample consisted of caregivers of child welfare-involved children who were asked to make a pediatric outpatient clinic return appointment (N = 87). Predictors included caregiver demographics, child medical diagnoses and age, and clinic/convenience factors including distance from the clinic to caregiver's home, days until the return appointment, reminder telephone call, Latino provider, and additional specialty appointment. Predictors were examined using χ(2) and t tests of significance. Thirty-nine percent of all caregivers were nonadherent in returning for pediatric appointments. When return appointments were scheduled longer after the initial appointment, caregivers were less likely to bring children back for medical care. The 39 % missed return appointment rate in this study is higher than other similar pediatric populations. Better coordination between pediatricians and caregivers in partnership with child welfare case workers is needed to ensure consistent follow-up regarding health problems, especially when appointments are not scheduled soon after the initial appointment.

Defense Health Care: DOD Is Meeting Most Mental Health Care Access Standards, but It Needs a Standard for Follow-up Appointments

DTIC Science & Technology

2016-04-01

domestically and overseas. GAO analyzed recent, available data on MHS mental health utilization , staffing, and appointment access and compared... utilization of mental health treatment services in both the direct and purchased care systems by active duty servicemembers, including activated...reservists, from fiscal years 2009 to 2014.5 To determine the reliability of the utilization data, we reviewed relevant documentation, discussed this

Evaluation of effective dose with chest digital tomosynthesis system using Monte Carlo simulation

NASA Astrophysics Data System (ADS)

Kim, Dohyeon; Jo, Byungdu; Lee, Youngjin; Park, Su-Jin; Lee, Dong-Hoon; Kim, Hee-Joung

2015-03-01

Chest digital tomosynthesis (CDT) system has recently been introduced and studied. This system offers the potential to be a substantial improvement over conventional chest radiography for the lung nodule detection and reduces the radiation dose with limited angles. PC-based Monte Carlo program (PCXMC) simulation toolkit (STUK, Helsinki, Finland) is widely used to evaluate radiation dose in CDT system. However, this toolkit has two significant limits. Although PCXMC is not possible to describe a model for every individual patient and does not describe the accurate X-ray beam spectrum, Geant4 Application for Tomographic Emission (GATE) simulation describes the various size of phantom for individual patient and proper X-ray spectrum. However, few studies have been conducted to evaluate effective dose in CDT system with the Monte Carlo simulation toolkit using GATE. The purpose of this study was to evaluate effective dose in virtual infant chest phantom of posterior-anterior (PA) view in CDT system using GATE simulation. We obtained the effective dose at different tube angles by applying dose actor function in GATE simulation which was commonly used to obtain the medical radiation dosimetry. The results indicated that GATE simulation was useful to estimate distribution of absorbed dose. Consequently, we obtained the acceptable distribution of effective dose at each projection. These results indicated that GATE simulation can be alternative method of calculating effective dose in CDT applications.

Methodology for Analysis, Modeling and Simulation of Airport Gate-waiting Delays

NASA Astrophysics Data System (ADS)

Wang, Jianfeng

This dissertation presents methodologies to estimate gate-waiting delays from historical data, to identify gate-waiting-delay functional causes in major U.S. airports, and to evaluate the impact of gate operation disruptions and mitigation strategies on gate-waiting delay. Airport gates are a resource of congestion in the air transportation system. When an arriving flight cannot pull into its gate, the delay it experiences is called gate-waiting delay. Some possible reasons for gate-waiting delay are: the gate is occupied, gate staff or equipment is unavailable, the weather prevents the use of the gate (e.g. lightning), or the airline has a preferred gate assignment. Gate-waiting delays potentially stay with the aircraft throughout the day (unless they are absorbed), adding costs to passengers and the airlines. As the volume of flights increases, ensuring that airport gates do not become a choke point of the system is critical. The first part of the dissertation presents a methodology for estimating gate-waiting delays based on historical, publicly available sources. Analysis of gate-waiting delays at major U.S. airports in the summer of 2007 identifies the following. (i) Gate-waiting delay is not a significant problem on majority of days; however, the worst delay days (e.g. 4% of the days at LGA) are extreme outliers. (ii) The Atlanta International Airport (ATL), the John F. Kennedy International Airport (JFK), the Dallas/Fort Worth International Airport (DFW) and the Philadelphia International Airport (PHL) experience the highest gate-waiting delays among major U.S. airports. (iii) There is a significant gate-waiting-delay difference between airlines due to a disproportional gate allocation. (iv) Gate-waiting delay is sensitive to time of a day and schedule peaks. According to basic principles of queueing theory, gate-waiting delay can be attributed to over-scheduling, higher-than-scheduled arrival rate, longer-than-scheduled gate-occupancy time, and reduced gate availability. Analysis of the worst days at six major airports in the summer of 2007 indicates that major gate-waiting delays are primarily due to operational disruptions---specifically, extended gate occupancy time, reduced gate availability and higher-than-scheduled arrival rate (usually due to arrival delay). Major gate-waiting delays are not a result of over-scheduling. The second part of this dissertation presents a simulation model to evaluate the impact of gate operational disruptions and gate-waiting-delay mitigation strategies, including building new gates, implementing common gates, using overnight off-gate parking and adopting self-docking gates. Simulation results show the following effects of disruptions: (i) The impact of arrival delay in a time window (e.g. 7 pm to 9 pm) on gate-waiting delay is bounded. (ii) The impact of longer-than-scheduled gate-occupancy times in a time window on gate-waiting delay can be unbounded and gate-waiting delay can increase linearly as the disruption level increases. (iii) Small reductions in gate availability have a small impact on gate-waiting delay due to slack gate capacity, while larger reductions have a non-linear impact as slack gate capacity is used up. Simulation results show the following effects of mitigation strategies: (i) Implementing common gates is an effective mitigation strategy, especially for airports with a flight schedule not dominated by one carrier, such as LGA. (ii) The overnight off-gate rule is effective in mitigating gate-waiting delay for flights stranded overnight following departure cancellations. This is especially true at airports where the gate utilization is at maximum overnight, such as LGA and DFW. The overnight off-gate rule can also be very effective to mitigate gate-waiting delay due to operational disruptions in evenings. (iii) Self-docking gates are effective in mitigating gate-waiting delay due to reduced gate availability.

Energy-loss return gate via liquid dielectric polarization.

PubMed

Kim, Taehun; Yong, Hyungseok; Kim, Banseok; Kim, Dongseob; Choi, Dukhyun; Park, Yong Tae; Lee, Sangmin

2018-04-12

There has been much research on renewable energy-harvesting techniques. However, owing to increasing energy demands, significant energy-related issues remain to be solved. Efforts aimed at reducing the amount of energy loss in electric/electronic systems are essential for reducing energy consumption and protecting the environment. Here, we design an energy-loss return gate system that reduces energy loss from electric/electronic systems by utilizing the polarization of liquid dielectrics. The use of a liquid dielectric material in the energy-loss return gate generates electrostatic potential energy while reducing the dielectric loss of the electric/electronic system. Hence, an energy-loss return gate can make breakthrough impacts possible by amplifying energy-harvesting efficiency, lowering the power consumption of electronics, and storing the returned energy. Our study indicates the potential for enhancing energy-harvesting technologies for electric/electronics systems, while increasing the widespread development of these systems.

A hydrogel capsule as gate dielectric in flexible organic field-effect transistors

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

Dumitru, L. M.; Manoli, K.; Magliulo, M.

2015-01-01

A jellified alginate based capsule serves as biocompatible and biodegradable electrolyte system to gate an organic field-effect transistor fabricated on a flexible substrate. Such a system allows operating thiophene based polymer transistors below 0.5 V through an electrical double layer formed across an ion-permeable polymeric electrolyte. Moreover, biological macro-molecules such as glucose-oxidase and streptavidin can enter into the gating capsules that serve also as delivery system. An enzymatic bio-reaction is shown to take place in the capsule and preliminary results on the measurement of the electronic responses promise for low-cost, low-power, flexible electronic bio-sensing applications using capsule-gated organic field-effect transistors.

Underwater Turbulence Detection Using Gated Wavefront Sensing Technique

PubMed Central

Bi, Ying; Xu, Xiping; Chow, Eddy Mun Tik

2018-01-01

Laser sensing has been applied in various underwater applications, ranging from underwater detection to laser underwater communications. However, there are several great challenges when profiling underwater turbulence effects. Underwater detection is greatly affected by the turbulence effect, where the acquired image suffers excessive noise, blurring, and deformation. In this paper, we propose a novel underwater turbulence detection method based on a gated wavefront sensing technique. First, we elaborate on the operating principle of gated wavefront sensing and wavefront reconstruction. We then setup an experimental system in order to validate the feasibility of our proposed method. The effect of underwater turbulence on detection is examined at different distances, and under different turbulence levels. The experimental results obtained from our gated wavefront sensing system indicate that underwater turbulence can be detected and analyzed. The proposed gated wavefront sensing system has the advantage of a simple structure and high detection efficiency for underwater environments. PMID:29518889

Phase-modulated decoupling and error suppression in qubit-oscillator systems.

PubMed

Green, Todd J; Biercuk, Michael J

2015-03-27

We present a scheme designed to suppress the dominant source of infidelity in entangling gates between quantum systems coupled through intermediate bosonic oscillator modes. Such systems are particularly susceptible to residual qubit-oscillator entanglement at the conclusion of a gate period that reduces the fidelity of the target entangling operation. We demonstrate how the exclusive use of discrete shifts in the phase of the field moderating the qubit-oscillator interaction is sufficient to both ensure multiple oscillator modes are decoupled and to suppress the effects of fluctuations in the driving field. This approach is amenable to a wide variety of technical implementations including geometric phase gates in superconducting qubits and the Molmer-Sorensen gate for trapped ions. We present detailed example protocols tailored to trapped-ion experiments and demonstrate that our approach has the potential to enable multiqubit gate implementation with a significant reduction in technical complexity relative to previously demonstrated protocols.

Comparison Of Intake Gate Closure Methods At Lower Granite, Little Goose, Lower Monumental, And Mcnary Dams Using Risk-Based Analysis

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

Gore, Bryan F.; Blackburn, Tyrone R.; Heasler, Patrick G.

2001-01-19

The objective of this report is to compare the benefits and costs of modifications proposed for intake gate closure systems at four hydroelectric stations on the Lower Snake and Upper Columbia Rivers in the Walla Walla District that are unable to meet the COE 10-minute closure rule due to the installation of fish screens. The primary benefit of the proposed modifications is to reduce the risk of damage to the station and environs when emergency intake gate closure is required. Consequently, this report presents the results and methodology of an extensive risk analysis performed to assess the reliability of powerhousemore » systems and the costs and timing of potential damages resulting from events requiring emergency intake gate closure. As part of this analysis, the level of protection provided by the nitrogen emergency closure system was also evaluated. The nitrogen system was the basis for the original recommendation to partially disable the intake gate systems. The risk analysis quantifies this protection level.« less

5 CFR 9901.511 - Appointing authorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Appointing authorities. (a) Competitive and excepted appointing authorities. The Secretary may continue to use excepted and competitive appointing authorities under chapter 33 of title 5, U.S. Code... competitive service or permanent, time-limited, or temporary appointments in the excepted service, as...

Optimization and evaluation of multiple gating beam delivery in a synchrotron-based proton beam scanning system using a real-time imaging technique.

PubMed

Yamada, Takahiro; Miyamoto, Naoki; Matsuura, Taeko; Takao, Seishin; Fujii, Yusuke; Matsuzaki, Yuka; Koyano, Hidenori; Umezawa, Masumi; Nihongi, Hideaki; Shimizu, Shinichi; Shirato, Hiroki; Umegaki, Kikuo

2016-07-01

To find the optimum parameter of a new beam control function installed in a synchrotron-based proton therapy system. A function enabling multiple gated irradiation in the flat top phase has been installed in a real-time-image gated proton beam therapy (RGPT) system. This function is realized by a waiting timer that monitors the elapsed time from the last gate-off signal in the flat top phase. The gated irradiation efficiency depends on the timer value, Tw. To find the optimum Tw value, gated irradiation efficiency was evaluated for each configurable Tw value. 271 gate signal data sets from 58 patients were used for the simulation. The highest mean efficiency 0.52 was obtained in TW=0.2s. The irradiation efficiency was approximately 21% higher than at TW=0s, which corresponds to ordinary synchrotron operation. The irradiation efficiency was improved in 154 (57%) of the 271 cases. The irradiation efficiency was reduced in 117 cases because the TW value was insufficient or the function introduced an unutilized wait time for the next gate-on signal in the flat top phase. In the actual treatment of a patient with a hepatic tumor at Tw=0.2s, 4.48GyE irradiation was completed within 250s. In contrast, the treatment time of ordinary synchrotron operation was estimated to be 420s. The results suggest that the multiple gated-irradiation function has potential to improve the gated irradiation efficiency and to reduce the treatment time. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Behaviour of a series of reservoirs separated by drowned gates

NASA Astrophysics Data System (ADS)

Kolechkina, Alla; van Nooijen, Ronald

2017-04-01

Modern control systems tend to be based on computers and therefore to operate by sending commands to structures at given intervals (discrete time control system). Moreover, for almost all water management control systems there are practical lower limits on the time interval between structure adjustments and even between measurements. The water resource systems that are being controlled are physical systems whose state changes continuously. If we combine a continuously changing system and a discrete time controller we get a hybrid system. We use material from recent control theory literature to examine the behaviour of a series of reservoirs separated by drowned gates where the gates are under computer control.

A comparative survey of missed initial and follow-up appointments to psychiatric specialties in the United kingdom.

PubMed

Mitchell, Alex J; Selmes, Thomas

2007-06-01

Missed appointments are common in psychiatry. Nonattendance at the initial appointment may have different prognostic significance than nonattendance at subsequent appointments. This study examined the frequency of missed appointments among 9,511 initial outpatient appointments and 7,700 follow-up appointments across ten psychiatric subspecialties in a publicly funded mental health service in the United Kingdom. The pooled missed appointment rate was 15.9%, higher than in previous studies on primary and secondary care attendance in the United Kingdom. Nonattendance was lowest on Fridays, in winter months, and in geriatric psychiatry and highest for substance abuse services and in community psychiatry. In most services, attendance improved after the initial appointment, but in psychosomatic medicine and geriatric psychiatry this pattern was reversed. There was a low rate of missed appointments in geriatric psychiatry, rehabilitation psychiatry, cognitive-behavioral therapy, and psychosocial medicine. A high nonattendance rate was found among persons with drug and alcohol difficulties and to a lesser extent in general adult psychiatry. Future studies should consider initial and follow-up appointments as distinct.

Multiplexed charge-locking device for large arrays of quantum devices

NASA Astrophysics Data System (ADS)

Puddy, R. K.; Smith, L. W.; Al-Taie, H.; Chong, C. H.; Farrer, I.; Griffiths, J. P.; Ritchie, D. A.; Kelly, M. J.; Pepper, M.; Smith, C. G.

2015-10-01

We present a method of forming and controlling large arrays of gate-defined quantum devices. The method uses an on-chip, multiplexed charge-locking system and helps to overcome the restraints imposed by the number of wires available in cryostat measurement systems. The device architecture that we describe here utilises a multiplexer-type scheme to lock charge onto gate electrodes. The design allows access to and control of gates whose total number exceeds that of the available electrical contacts and enables the formation, modulation and measurement of large arrays of quantum devices. We fabricate such devices on n-type GaAs/AlGaAs substrates and investigate the stability of the charge locked on to the gates. Proof-of-concept is shown by measurement of the Coulomb blockade peaks of a single quantum dot formed by a floating gate in the device. The floating gate is seen to drift by approximately one Coulomb oscillation per hour.

Queue theory for triangular and weibull arrival distribution models (case study of Banyumanik toll)

NASA Astrophysics Data System (ADS)

Sugito; Rahmawati, Rita; Kusuma Wardhani, Jenesia

2018-05-01

Queuing is one of the most common phenomena in daily life. Queued also happens on highway during busy time. The Electronic Toll Collection (ETC) was the new system of the Banyumanik toll gate which operates in 2014. Before ETC, Banyumanik toll gate users got regular service (regular toll gate) by paying in cash only. The ETC benefits more than regular service, but automatic toll gate (ETC) users are still few compared to regular toll gate users. To know the effectiveness of substance service, this paper used analysis of queuing system. The research was conducted at Toll Gate Banyumanik with the implementation time on 26-28 December 2016 for Ungaran-Semarang direction, and 29-31 December 2016 for Semarang- Ungaran direction. In one day, observation was done for 11 hours. That was at 07.00 a.m. until 06.00 p.m. There are 4 models of queues at Banyumanik toll gate. Here the four models will be used on the number of arrival and service time. Based on the simulation with Arena, the result showed that queue model regular toll gate in Ugaran-Semarang direction is (Tria/G/3):(GD/∞/∞) and the queue model for automatic toll gate is (G/G/3):(GD/∞/∞). While the queue model for the direction of Semarang-Ungaran regular toll gate is (G/G/3):(GD/∞/∞) and the queue model of automatic toll gate is (Weib/G/3):(GD/∞/∞).

Implementation of quantum logic gates via Stark-tuned Förster resonance in Rydberg atoms

NASA Astrophysics Data System (ADS)

Huang, Xi-Rong; Hu, Chang-Sheng; Shen, Li-Tuo; Yang, Zhen-Biao; Wu, Huai-Zhi

2018-02-01

We present a scheme for implementation of controlled-Z and controlled-NOT gates via rapid adiabatic passage and Stark-tuned Förster resonance. By sweeping the Förster resonance once without passing through it and adiabatically tuning the angle-dependent Rydberg-Rydberg interaction of the dipolar nature, the system can be effectively described by a two-level system with the adiabatic theorem. The single adiabatic passage leads to a gate fidelity as high as 0.999 and a greatly reduced gate operation time. We investigate the scheme by considering an actual atomic level configuration with rubidium atoms, where the fidelity of the controlled-Z gate is still higher than 0.99 under the influence of the Zeeman effect.

Enhanced ν-optical time domain reflectometry using gigahertz sinusoidally gated InGaAs/InP single-photon avalanche detector

NASA Astrophysics Data System (ADS)

Zhang, Xuping; Shi, Yuanlei; Shan, Yuanyuan; Sun, Zhenhong; Qiao, Weiyan; Zhang, Yixin

2016-09-01

Optical time domain reflectometry (OTDR) is one of the most successful diagnostic tools for nondestructive attenuation measurement of a fiber link. To achieve better sensitivity, spatial resolution, and avoid dead-zone in conversional OTDR, a single-photon detector has been introduced to form the photon-counting OTDR (ν-OTDR). We have proposed a ν-OTDR system using a gigahertz sinusoidally gated InGaAs/InP single-photon avalanche detector (SPAD). Benefiting from the superior performance of a sinusoidal gated SPAD on dark count probability, gating frequency, and gate duration, our ν-OTDR system has achieved a dynamic range (DR) of 33.4 dB with 1 μs probe pulse width after an equivalent measurement time of 51 s. This obtainable DR corresponds to a sensing length over 150 km. Our system has also obtained a spatial resolution of 5 cm at the end of a 5-km standard single-mode fiber. By employing a sinusoidal gating technique, we have improved the ν-OTDR spatial resolution and significantly reduced the measurement time.

Method and infrastructure for cycle-reproducible simulation on large scale digital circuits on a coordinated set of field-programmable gate arrays (FPGAs)

DOEpatents

Asaad, Sameh W; Bellofatto, Ralph E; Brezzo, Bernard; Haymes, Charles L; Kapur, Mohit; Parker, Benjamin D; Roewer, Thomas; Tierno, Jose A

2014-01-28

A plurality of target field programmable gate arrays are interconnected in accordance with a connection topology and map portions of a target system. A control module is coupled to the plurality of target field programmable gate arrays. A balanced clock distribution network is configured to distribute a reference clock signal, and a balanced reset distribution network is coupled to the control module and configured to distribute a reset signal to the plurality of target field programmable gate arrays. The control module and the balanced reset distribution network are cooperatively configured to initiate and control a simulation of the target system with the plurality of target field programmable gate arrays. A plurality of local clock control state machines reside in the target field programmable gate arrays. The local clock state machines are configured to generate a set of synchronized free-running and stoppable clocks to maintain cycle-accurate and cycle-reproducible execution of the simulation of the target system. A method is also provided.

Dosimetric verification of gated delivery of electron beams using a 2D ion chamber array

PubMed Central

Yoganathan, S. A.; Das, K. J. Maria; Raj, D. Gowtham; Kumar, Shaleen

2015-01-01

The purpose of this study was to compare the dosimetric characteristics; such as beam output, symmetry and flatness between gated and non-gated electron beams. Dosimetric verification of gated delivery was carried for all electron beams available on Varian CL 2100CD medical linear accelerator. Measurements were conducted for three dose rates (100 MU/min, 300 MU/min and 600 MU/min) and two respiratory motions (breathing period of 4s and 8s). Real-time position management (RPM) system was used for the gated deliveries. Flatness and symmetry values were measured using Imatrixx 2D ion chamber array device and the beam output was measured using plane parallel ion chamber. These detector systems were placed over QUASAR motion platform which was programmed to simulate the respiratory motion of target. The dosimetric characteristics of gated deliveries were compared with non-gated deliveries. The flatness and symmetry of all the evaluated electron energies did not differ by more than 0.7 % with respect to corresponding non-gated deliveries. The beam output variation of gated electron beam was less than 0.6 % for all electron energies except for 16 MeV (1.4 %). Based on the results of this study, it can be concluded that Varian CL2100 CD is well suitable for gated delivery of non-dynamic electron beams. PMID:26170552

5 CFR 330.1106 - Appointment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... receive noncompetitive appointments to the competitive service under the authority of Public Law 105-274... excepted appointments made under section 11203(b) of Public Law 105-33 to competitive service appointments under Public Law 105-274. For employees appointed before October 21, 1998, the conversion will be...

5 CFR 330.1106 - Appointment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... receive noncompetitive appointments to the competitive service under the authority of Public Law 105-274... excepted appointments made under section 11203(b) of Public Law 105-33 to competitive service appointments under Public Law 105-274. For employees appointed before October 21, 1998, the conversion will be...

CBCT Assessment of Root Dentine Removal by Gates-Glidden Drills and Two Engine-Driven Root Preparation Systems.

PubMed

Harandi, Azade; Mohammadpour Maleki, Fatemeh; Moudi, Ehsan; Ehsani, Maryam; Khafri, Soraya

2017-01-01

The aim of this study was to compare the dentine removing efficacy of Gates-Glidden drills with hand files, ProTaper and OneShape single-instrument system using cone-beam computed tomography (CBCT). A total of 39 extracted bifurcated maxillary first premolars were divided into 3 groups ( n =13) and were prepared using either Gates-Glidden drills and hand instruments, ProTaper and OneShape systems. Pre- and post-instrumentation CBCT images were obtained. The dentin thickness of canals was measured at furcation, and 1 and 2 mm from the furcation area in buccal, palatal, mesial and distal walls. Data were analyzed using one-way ANOVA test. Tukey's post hoc tests were used for two-by-two comparisons. Gates-Glidden drills with hand files removed significantly more ( P <0.001) dentine than the engine-driven systems in all canal walls (buccal, palatal, mesial and distal). There were no significant differences between OneShape and ProTaper rotary systems ( P >0.05). The total cervical dentine removal during canal instrumentation was significantly less with engine-driven file systems compared to Gates-Glidden drills. There were no significant differences between residual dentine thicknesses left between the various canal walls.

Towards component-based validation of GATE: aspects of the coincidence processor

PubMed Central

Moraes, Eder R.; Poon, Jonathan K.; Balakrishnan, Karthikayan; Wang, Wenli; Badawi, Ramsey D.

2014-01-01

GATE is public domain software widely used for Monte Carlo simulation in emission tomography. Validations of GATE have primarily been performed on a whole-system basis, leaving the possibility that errors in one sub-system may be offset by errors in others. We assess the accuracy of the GATE PET coincidence generation sub-system in isolation, focusing on the options most closely modeling the majority of commercially available scanners. Independent coincidence generators were coded by teams at Toshiba Medical Research Unit (TMRU) and UC Davis. A model similar to the Siemens mCT scanner was created in GATE. Annihilation photons interacting with the detectors were recorded. Coincidences were generated using GATE, TMRU and UC Davis code and results compared to “ground truth” obtained from the history of the photon interactions. GATE was tested twice, once with every qualified single event opening a time window and initiating a coincidence check (the “multiple window method”), and once where a time window is opened and a coincidence check initiated only by the first single event to occur after the end of the prior time window (the “single window method”). True, scattered and random coincidences were compared. Noise equivalent count rates were also computed and compared. The TMRU and UC Davis coincidence generators agree well with ground truth. With GATE, reasonable accuracy can be obtained if the single window method option is chosen and random coincidences are estimated without use of the delayed coincidence option. However in this GATE version, other parameter combinations can result in significant errors. PMID:25240897

A missed primary care appointment correlates with a subsequent emergency department visit among children with asthma.

PubMed

McGovern, Colleen Marie; Redmond, Margaret; Arcoleo, Kimberly; Stukus, David R

2017-11-01

Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits. Longitudinal, retrospective review at a children's hospital was conducted for children with diagnosed asthma (ICD-9 493.xx), ages 2-18 years, scheduled for a PC visit between January 1, 2010, and June 30, 2012 (N = 3895). Records were cross-referenced with all asthma-related ED visits from January 1, 2010 to December 31, 2012. Logistic regression with maximum likelihood estimation was conducted. None of the children who completed a PC appointment experienced an ED visit in the subsequent 6 months whereas 2.7% of those with missed PC appointments had an ED visit (χ 2 = 64.28, p <.0001). Males were significantly more likely to have an ED visit following a missed PC appointment than females (χ 2 = 34.37, p <.0001). There was a statistically significant interaction of sex × age. Younger children (<12 years) made more visits than older children. The importance of adherence to PC appointments for children with asthma as one mechanism for preventing ED visits was demonstrated. Interventions targeting missed visits could decrease asthma-related morbidity, preventable ED visits, and healthcare costs.

Realization of the three-qubit quantum controlled gate based on matching Hermitian generators

NASA Astrophysics Data System (ADS)

Gautam, Kumar; Rawat, Tarun Kumar; Parthasarathy, Harish; Sharma, Navneet; Upadhyaya, Varun

2017-05-01

This paper deals with the design of quantum unitary gate by matching the Hermitian generators. A given complicated quantum controlled gate is approximated by perturbing a simple quantum system with a small time-varying potential. The basic idea is to evaluate the generator H_φ of the perturbed system approximately using first-order perturbation theory in the interaction picture. H_φ depends on a modulating signal φ(t){:} 0≤t≤T which modulates a known potential V. The generator H_φ of the given gate U_g is evaluated using H_g=ι log U_g. The optimal modulating signal φ(t) is chosen so that \\Vert H_g - H_φ \\Vert is a minimum. The simple quantum system chosen for our simulation is harmonic oscillator with charge perturbed by an electric field that is a constant in space but time varying and is controlled externally. This is used to approximate the controlled unitary gate obtained by perturbing the oscillator with an anharmonic term proportional to q^3. Simulations results show significantly small noise-to-signal ratio. Finally, we discuss how the proposed method is particularly suitable for designing some commonly used unitary gates. Another example was chosen to illustrate this method of gate design is the ion-trap model.

5 CFR 301.203 - Duration of appointment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Duration of appointment. 301.203 Section... EMPLOYMENT Overseas Limited Appointment § 301.203 Duration of appointment. (a) An appointment under this subpart is of indefinite duration unless otherwise limited. (b) An agency may make an overseas limited...

Construction of a fuzzy and Boolean logic gates based on DNA.

PubMed

Zadegan, Reza M; Jepsen, Mette D E; Hildebrandt, Lasse L; Birkedal, Victoria; Kjems, Jørgen

2015-04-17

Logic gates are devices that can perform logical operations by transforming a set of inputs into a predictable single detectable output. The hybridization properties, structure, and function of nucleic acids can be used to make DNA-based logic gates. These devices are important modules in molecular computing and biosensing. The ideal logic gate system should provide a wide selection of logical operations, and be integrable in multiple copies into more complex structures. Here we show the successful construction of a small DNA-based logic gate complex that produces fluorescent outputs corresponding to the operation of the six Boolean logic gates AND, NAND, OR, NOR, XOR, and XNOR. The logic gate complex is shown to work also when implemented in a three-dimensional DNA origami box structure, where it controlled the position of the lid in a closed or open position. Implementation of multiple microRNA sensitive DNA locks on one DNA origami box structure enabled fuzzy logical operation that allows biosensing of complex molecular signals. Integrating logic gates with DNA origami systems opens a vast avenue to applications in the fields of nanomedicine for diagnostics and therapeutics. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A two-qubit logic gate in silicon.

PubMed

Veldhorst, M; Yang, C H; Hwang, J C C; Huang, W; Dehollain, J P; Muhonen, J T; Simmons, S; Laucht, A; Hudson, F E; Itoh, K M; Morello, A; Dzurak, A S

2015-10-15

Quantum computation requires qubits that can be coupled in a scalable manner, together with universal and high-fidelity one- and two-qubit logic gates. Many physical realizations of qubits exist, including single photons, trapped ions, superconducting circuits, single defects or atoms in diamond and silicon, and semiconductor quantum dots, with single-qubit fidelities that exceed the stringent thresholds required for fault-tolerant quantum computing. Despite this, high-fidelity two-qubit gates in the solid state that can be manufactured using standard lithographic techniques have so far been limited to superconducting qubits, owing to the difficulties of coupling qubits and dephasing in semiconductor systems. Here we present a two-qubit logic gate, which uses single spins in isotopically enriched silicon and is realized by performing single- and two-qubit operations in a quantum dot system using the exchange interaction, as envisaged in the Loss-DiVincenzo proposal. We realize CNOT gates via controlled-phase operations combined with single-qubit operations. Direct gate-voltage control provides single-qubit addressability, together with a switchable exchange interaction that is used in the two-qubit controlled-phase gate. By independently reading out both qubits, we measure clear anticorrelations in the two-spin probabilities of the CNOT gate.

Primary care access for new patients on the eve of health care reform.

PubMed

Rhodes, Karin V; Kenney, Genevieve M; Friedman, Ari B; Saloner, Brendan; Lawson, Charlotte C; Chearo, David; Wissoker, Douglas; Polsky, Daniel

2014-06-01

Current measures of access to care have intrinsic limitations and may not accurately reflect the capacity of the primary care system to absorb new patients. To assess primary care appointment availability by state and insurance status. We conducted a simulated patient study. Trained field staff, randomly assigned to private insurance, Medicaid, or uninsured, called primary care offices requesting the first available appointment for either routine care or an urgent health concern. The study included a stratified random sample of primary care practices treating nonelderly adults within each of 10 states (Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas), selected for diversity along numerous dimensions. Collectively, these states comprise almost one-third of the US nonelderly, Medicaid, and currently uninsured populations. Sampling was based on enrollment by insurance type by county. Analyses were weighted to obtain population-based estimates for each state. The ability to schedule an appointment and number of days to the appointment. We also examined cost and payment required at the visit for the uninsured. Between November 13, 2012, and April 4, 2013, we made 12,907 calls to 7788 primary care practices requesting new patient appointments. Across the 10 states, 84.7% (95% CI, 82.6%-86.8%) of privately insured and 57.9% (95% CI, 54.8%-61.0%) of Medicaid callers received an appointment. Appointment rates were 78.8% (95% CI, 75.6%-82.0%) for uninsured patients with full cash payment but only 15.4% (95% CI, 13.2%-17.6%) if payment required at the time of the visit was restricted to $75 or less. Conditional on getting an appointment, median wait times were typically less than 1 week (2 weeks in Massachusetts), with no differences by insurance status or urgency of health concern. Although most primary care physicians are accepting new patients, access varies widely across states and insurance status. Navigator programs are needed, not only to help patients enroll but also to identify practices accepting new patients within each plan's network. Tracking new patient appointment availability over time can inform policies designed to strengthen primary care capacity and enhance the effectiveness of the coverage expansions with the Patient Protection and Affordable Care Act.

Hydraulic and geochemical performance of a permeable reactive barrier containing zero-valent iron, Denver Federal Center

USGS Publications Warehouse

McMahon, P.B.; Dennehy, K.F.; Sandstrom, M.W.

1999-01-01

The hydraulic and geochemical performance of a 366 m long permeable reactive barrier (PRB) at the Denver Federal Center; Denver, Colorado, was evaluated. The funnel and gate system, which was installed in 1996 to intercept and remediate ground water contaminated with chlorinated aliphatic hydrocarbons (CAHs), contained four 12.2 m wide gates filled with zero-valent iron. Ground water mounding on the upgradient side of the PRB resulted in a tenfold increase in the hydraulic gradient and ground water velocity through the gates compared to areas of the aquifer unaffected by the PRB. Water balance calculations for April 1997 indicate that about 75% of the ground water moving toward the PRB from upgradient areas moved through the gates. The rest of the water either accumulated on the upgradient side of the PRB or bypassed the PRB. Chemical data from monitoring wells screened down-gradient, beneath, and at the ends of the PRB indicate that contaminants had not bypassed the PRB, except in a few isolated areas. Greater than 99% of the CAH mass entering the gates was retained by the iron. Fifty-one percent of the CAH carbon entering one gate was accounted for in dissolved C1 and C2 hydrocarbons, primarily ethane and ethene, which indicates that CAHs may adsorb to the iron prior to being dehalogenated. Treated water exiting the gates displaced contaminated ground water at a distance of at least 3 m downgradient from the PRB by the end of 1997. Measurements of dissolved inorganic ions in one gate indicate that calcite and siderite precipitation in the gate could reduce gate porosity by about 0.35% per year. Results from this study indicate that funnel and gate systems containing zero-valent iron can effectively treat ground water contaminated with CAHs. However, the hydrologic impacts of the PRB on the flow system need to be fully understood to prevent contaminants from bypassing the PRB.

Striking the Balance between Discipline and Justice: The Commander’s Role in the Military Justice System and its Impact on the Military Profession

DTIC Science & Technology

2015-06-12

the Commander of the 49th Air Defense Artillery Battalion, Fort Greeley, Alaska, for condoning adultery and fraternization.33...majority of civilians” appointed by the President and the Secretary of Defense , would appoint a Director of Military Prosecutions and personnel for a...moving all judge advocates under the Secretary of Defense and increasing the penalty for attempting to influence a court-

A Study of an Appointment Scheduling System for Outpatients at the United States Air Force Academy Hospital.

DTIC Science & Technology

1988-07-30

8a. NAME OF FUNDING/SPONSORING 8b. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION (If applicable) 8c. ADDRESS (City, State...Services are provided in General Dentistry, Oral Surgery, Periodontics, Prosthodontics, Endodontics , and Orthodontics (MHR 1987, 4-5). The hospital also...appointment D. Shields 4 clerks using a rotary wheel file. Schedules were forwarded to outpatien records to pull the patient record prior to the clinic

Semiconductor systems utilizing materials that form rectifying junctions in both N and P-type doping regions, whether metallurgically or field induced, and methods of use

DOEpatents

Welch, James D.

2000-01-01

Disclosed are semiconductor systems, such as integrated circuits utilizing Schotky barrier and/or diffused junction technology, which semiconductor systems incorporate material(s) that form rectifying junctions in both metallurgically and/or field induced N and P-type doping regions, and methods of their use. Disclosed are Schottky barrier based inverting and non-inverting gate voltage channel induced semiconductor single devices with operating characteristics similar to multiple device CMOS systems and which can be operated as modulators, N and P-channel MOSFETS and CMOS formed therefrom, and (MOS) gate voltage controlled rectification direction and gate voltage controlled switching devices, and use of such material(s) to block parasitic current flow pathways. Simple demonstrative five mask fabrication procedures for inverting and non-inverting gate voltage channel induced semiconductor single devices with operating characteristics similar to multiple device CMOS systems are also presented.

Accuracy Verification of Respiratory-gated Radiotherapy that Combines the Respiration-Monitoring Device and Respiratory-gated System.

PubMed

Shintani, Naoya; Monzen, Hajime; Tamura, Masaya; Asai, Yoshiyuki; Shimomura, Kouhei; Matsumoto, Kenji; Okumura, Masahiko; Nishimura, Yasumasa

2016-01-01

The purpose of this study is to evaluate the mechanical accuracy of a respiratory-gated radiation system that combines the Linear Indicator-equipped Abches respiration-monitoring device and the Varian Real-time Position Management system (LI-RPM system). This combined configuration, implemented for the first time in Japan, was compared with the stand-alone Varian RPM system (RPM system). The delay times, dose profiles, and output waveforms of the LI-RPM and RPM systems were evaluated using a self-produced dynamic phantom. The delay times for the LI-RPM and RPM systems were both 0.1 s for 4 s and 8 s test periods. The corresponding output waveform correlation factors (R 2 ) for the 4 s and 8 s test periods were 0.9981 and 0.9975, respectively. No difference was observed in the dose profiles of the two systems. Thus, the present results indicate that the proposed LI-RPM combined respiratory-gated radiation system has similar properties to the RPM system. However, it offers several advantages in terms of its versatility, including its alignment assistance capabilities for non-coplanar treatments.

5 CFR 8.2 - Appointment of United States citizens.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Appointment of United States citizens. 8... APPOINTMENTS TO OVERSEAS POSITIONS (RULE VIII) § 8.2 Appointment of United States citizens. United States... appointments for United States citizens recruited within the continental limits of the United States whenever...

5 CFR 8.2 - Appointment of United States citizens.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Appointment of United States citizens. 8... APPOINTMENTS TO OVERSEAS POSITIONS (RULE VIII) § 8.2 Appointment of United States citizens. United States... appointments for United States citizens recruited within the continental limits of the United States whenever...

5 CFR 8.2 - Appointment of United States citizens.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Appointment of United States citizens. 8... APPOINTMENTS TO OVERSEAS POSITIONS (RULE VIII) § 8.2 Appointment of United States citizens. United States... appointments for United States citizens recruited within the continental limits of the United States whenever...

5 CFR 8.2 - Appointment of United States citizens.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Appointment of United States citizens. 8... APPOINTMENTS TO OVERSEAS POSITIONS (RULE VIII) § 8.2 Appointment of United States citizens. United States... appointments for United States citizens recruited within the continental limits of the United States whenever...

Managing patient demand: a qualitative study of appointment making in general practice.

PubMed

Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

2001-04-01

Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. A qualitative study using participant observation. Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria.

Managing patient demand: a qualitative study of appointment making in general practice.

PubMed Central

Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

2001-01-01

BACKGROUND: Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. AIM: To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. DESIGN OF STUDY: A qualitative study using participant observation. SETTING: Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. METHOD: Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. RESULTS: Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. CONCLUSION: Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria. PMID:11458480

Eye tracking and gating system for proton therapy of orbital tumors

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

Shin, Dongho; Yoo, Seung Hoon; Moon, Sung Ho

2012-07-15

Purpose: A new motion-based gated proton therapy for the treatment of orbital tumors using real-time eye-tracking system was designed and evaluated. Methods: We developed our system by image-pattern matching, using a normalized cross-correlation technique with LabVIEW 8.6 and Vision Assistant 8.6 (National Instruments, Austin, TX). To measure the pixel spacing of an image consistently, four different calibration modes such as the point-detection, the edge-detection, the line-measurement, and the manual measurement mode were suggested and used. After these methods were applied to proton therapy, gating was performed, and radiation dose distributions were evaluated. Results: Moving phantom verification measurements resulted in errorsmore » of less than 0.1 mm for given ranges of translation. Dosimetric evaluation of the beam-gating system versus nongated treatment delivery with a moving phantom shows that while there was only 0.83 mm growth in lateral penumbra for gated radiotherapy, there was 4.95 mm growth in lateral penumbra in case of nongated exposure. The analysis from clinical results suggests that the average of eye movements depends distinctively on each patient by showing 0.44 mm, 0.45 mm, and 0.86 mm for three patients, respectively. Conclusions: The developed automatic eye-tracking based beam-gating system enabled us to perform high-precision proton radiotherapy of orbital tumors.« less

Catheter-based time-gated near-infrared fluorescence/OCT imaging system

NASA Astrophysics Data System (ADS)

Lu, Yuankang; Abran, Maxime; Cloutier, Guy; Lesage, Frédéric

2018-02-01

We developed a new dual-modality intravascular imaging system based on fast time-gated fluorescence intensity imaging and spectral domain optical coherence tomography (SD-OCT) for the purpose of interventional detection of atherosclerosis. A pulsed supercontinuum laser was used for fluorescence and OCT imaging. A double-clad fiber (DCF)- based side-firing catheter was designed and fabricated to have a 23 μm spot size at a 2.2 mm working distance for OCT imaging. Its single-mode core is used for OCT, while its inner cladding transports fluorescence excitation light and collects fluorescent photons. The combination of OCT and fluorescence imaging was achieved by using a DCF coupler. For fluorescence detection, we used a time-gated technique with a novel single-photon avalanche diode (SPAD) working in an ultra-fast gating mode. A custom-made delay chip was integrated in the system to adjust the delay between the excitation laser pulse and the SPAD gate-ON window. This technique allowed to detect fluorescent photons of interest while rejecting most of the background photons, thus leading to a significantly improved signal to noise ratio (SNR). Experiments were carried out in turbid media mimicking tissue with an indocyanine green (ICG) inclusion (1 mM and 100 μM) to compare the time-gated technique and the conventional continuous detection technique. The gating technique increased twofold depth sensitivity, and tenfold SNR at large distances. The dual-modality imaging capacity of our system was also validated with a silicone-based tissue-mimicking phantom.

A Programmable and Configurable Mixed-Mode FPAA SoC

DTIC Science & Technology

2016-03-17

A Programmable and Configurable Mixed-Mode FPAA SoC Sahil Shah, Sihwan Kim, Farhan Adil, Jennifer Hasler, Suma George, Michelle Collins, Richard...Abstract: The authors present a Floating-Gate based, System-On-Chip large-scale Field- Programmable Analog Array IC that integrates divergent concepts...Floating-Gate, SoC, Command Word Classification This paper presents a Floating-Gate (FG) based, System- On-Chip (SoC) large-scale Field- Programmable

Nanowire systems: technology and design

PubMed Central

Gaillardon, Pierre-Emmanuel; Amarù, Luca Gaetano; Bobba, Shashikanth; De Marchi, Michele; Sacchetto, Davide; De Micheli, Giovanni

2014-01-01

Nanosystems are large-scale integrated systems exploiting nanoelectronic devices. In this study, we consider double independent gate, vertically stacked nanowire field effect transistors (FETs) with gate-all-around structures and typical diameter of 20 nm. These devices, which we have successfully fabricated and evaluated, control the ambipolar behaviour of the nanostructure by selectively enabling one type of carriers. These transistors work as switches with electrically programmable polarity and thus realize an exclusive or operation. The intrinsic higher expressive power of these FETs, when compared with standard complementary metal oxide semiconductor technology, enables us to realize more efficient logic gates, which we organize as tiles to realize nanowire systems by regular arrays. This article surveys both the technology for double independent gate FETs as well as physical and logic design tools to realize digital systems with this fabrication technology. PMID:24567471

Implementation of cascade logic gates and majority logic gate on a simple and universal molecular platform.

PubMed

Gao, Jinting; Liu, Yaqing; Lin, Xiaodong; Deng, Jiankang; Yin, Jinjin; Wang, Shuo

2017-10-25

Wiring a series of simple logic gates to process complex data is significantly important and a large challenge for untraditional molecular computing systems. The programmable property of DNA endows its powerful application in molecular computing. In our investigation, it was found that DNA exhibits excellent peroxidase-like activity in a colorimetric system of TMB/H 2 O 2 /Hemin (TMB, 3,3', 5,5'-Tetramethylbenzidine) in the presence of K + and Cu 2+ , which is significantly inhibited by the addition of an antioxidant. According to the modulated catalytic activity of this DNA-based catalyst, three cascade logic gates including AND-OR-INH (INHIBIT), AND-INH and OR-INH were successfully constructed. Interestingly, by only modulating the concentration of Cu 2+ , a majority logic gate with a single-vote veto function was realized following the same threshold value as that of the cascade logic gates. The strategy is quite straightforward and versatile and provides an instructive method for constructing multiple logic gates on a simple platform to implement complex molecular computing.

Multi-target-qubit unconventional geometric phase gate in a multi-cavity system

NASA Astrophysics Data System (ADS)

Liu, Tong; Cao, Xiao-Zhi; Su, Qi-Ping; Xiong, Shao-Jie; Yang, Chui-Ping

2016-02-01

Cavity-based large scale quantum information processing (QIP) may involve multiple cavities and require performing various quantum logic operations on qubits distributed in different cavities. Geometric-phase-based quantum computing has drawn much attention recently, which offers advantages against inaccuracies and local fluctuations. In addition, multiqubit gates are particularly appealing and play important roles in QIP. We here present a simple and efficient scheme for realizing a multi-target-qubit unconventional geometric phase gate in a multi-cavity system. This multiqubit phase gate has a common control qubit but different target qubits distributed in different cavities, which can be achieved using a single-step operation. The gate operation time is independent of the number of qubits and only two levels for each qubit are needed. This multiqubit gate is generic, e.g., by performing single-qubit operations, it can be converted into two types of significant multi-target-qubit phase gates useful in QIP. The proposal is quite general, which can be used to accomplish the same task for a general type of qubits such as atoms, NV centers, quantum dots, and superconducting qubits.

Multi-target-qubit unconventional geometric phase gate in a multi-cavity system.

PubMed

Liu, Tong; Cao, Xiao-Zhi; Su, Qi-Ping; Xiong, Shao-Jie; Yang, Chui-Ping

2016-02-22

Cavity-based large scale quantum information processing (QIP) may involve multiple cavities and require performing various quantum logic operations on qubits distributed in different cavities. Geometric-phase-based quantum computing has drawn much attention recently, which offers advantages against inaccuracies and local fluctuations. In addition, multiqubit gates are particularly appealing and play important roles in QIP. We here present a simple and efficient scheme for realizing a multi-target-qubit unconventional geometric phase gate in a multi-cavity system. This multiqubit phase gate has a common control qubit but different target qubits distributed in different cavities, which can be achieved using a single-step operation. The gate operation time is independent of the number of qubits and only two levels for each qubit are needed. This multiqubit gate is generic, e.g., by performing single-qubit operations, it can be converted into two types of significant multi-target-qubit phase gates useful in QIP. The proposal is quite general, which can be used to accomplish the same task for a general type of qubits such as atoms, NV centers, quantum dots, and superconducting qubits.

Diminished auditory sensory gating during active auditory verbal hallucinations.

PubMed

Thoma, Robert J; Meier, Andrew; Houck, Jon; Clark, Vincent P; Lewine, Jeffrey D; Turner, Jessica; Calhoun, Vince; Stephen, Julia

2017-10-01

Auditory sensory gating, assessed in a paired-click paradigm, indicates the extent to which incoming stimuli are filtered, or "gated", in auditory cortex. Gating is typically computed as the ratio of the peak amplitude of the event related potential (ERP) to a second click (S2) divided by the peak amplitude of the ERP to a first click (S1). Higher gating ratios are purportedly indicative of incomplete suppression of S2 and considered to represent sensory processing dysfunction. In schizophrenia, hallucination severity is positively correlated with gating ratios, and it was hypothesized that a failure of sensory control processes early in auditory sensation (gating) may represent a larger system failure within the auditory data stream; resulting in auditory verbal hallucinations (AVH). EEG data were collected while patients (N=12) with treatment-resistant AVH pressed a button to indicate the beginning (AVH-on) and end (AVH-off) of each AVH during a paired click protocol. For each participant, separate gating ratios were computed for the P50, N100, and P200 components for each of the AVH-off and AVH-on states. AVH trait severity was assessed using the Psychotic Symptoms Rating Scales AVH Total score (PSYRATS). The results of a mixed model ANOVA revealed an overall effect for AVH state, such that gating ratios were significantly higher during the AVH-on state than during AVH-off for all three components. PSYRATS score was significantly and negatively correlated with N100 gating ratio only in the AVH-off state. These findings link onset of AVH with a failure of an empirically-defined auditory inhibition system, auditory sensory gating, and pave the way for a sensory gating model of AVH. Copyright © 2017 Elsevier B.V. All rights reserved.

A comparison study: image-based vs signal-based retrospective gating on microCT

NASA Astrophysics Data System (ADS)

Liu, Xuan; Salmon, Phil L.; Laperre, Kjell; Sasov, Alexander

2017-09-01

Retrospective gating on animal studies with microCT has gained popularity in recent years. Previously, we use ECG signals for cardiac gating and breathing airflow or video signals of abdominal motion for respiratory gating. This method is adequate and works well for most applications. However, through the years, researchers have noticed some pitfalls in the method. For example, the additional signal acquisition step may increase failure rate in practice. X-Ray image-based gating, on the other hand, does not require any extra step in the scanning. Therefore we investigate imagebased gating techniques. This paper presents a comparison study of the image-based versus signal-based approach to retrospective gating. The two application areas we have studied are respiratory and cardiac imaging for both rats and mice. Image-based respiratory gating on microCT is relatively straightforward and has been done by several other researchers and groups. This method retrieves an intensity curve of a region of interest (ROI) placed in the lung area on all projections. From scans on our systems based on step-and-shoot scanning mode, we confirm that this method is very effective. A detailed comparison between image-based and signal-based gating methods is given. For cardiac gating, breathing motion is not negligible and has to be dealt with. Another difficulty in cardiac gating is the relatively smaller amplitude of cardiac movements comparing to the respirational movements, and the higher heart rate. Higher heart rate requires high speed image acquisition. We have been working on our systems to improve the acquisition speed. A dual gating technique has been developed to achieve adequate cardiac imaging.

Poor appointment-keeping behaviour among repeat blood donors and its relationship to the intent to donate again.

PubMed

Mousavi, S A; Hermundstad, B; Kjustad Frøyland, E M; Llohn, A H; Knutsen, T R

2014-08-01

Anecdotal evidence suggests that missed donation appointments among repeat whole-blood donors are associated with decreased likelihood of future blood donation. This study sought to examine the relationship between missed donation appointments and intention to donate again among repeat whole-blood donors and to examine whether demographic variables are related to appointment-keeping behaviour. During the period February-June 2013, telephone interviews were conducted with repeat donors who either did not show up for or cancelled their donation appointments on the day of the appointment. We asked them whether or not they wanted to schedule appointments for subsequent donations. Rates of missed donation appointments varied by age, but not gender. Although a statistically significant difference between male and female donors was not found with regard to willingness to donate again, female donors were more likely than male donors to call and cancel their appointment. Finally, compared with repeat donors who called and cancelled their appointment, no-show donors were 2.5 times less likely to schedule appointments for subsequent donations (P < 0.001). The results demonstrate that poor appointment-keeping behaviour, and in particular no-show behaviour, is significantly associated with decreased likelihood of future blood donation among repeat whole-blood donors. © 2014 The Authors. Transfusion Medicine © 2014 British Blood Transfusion Society.

A preliminary analysis of the US dental health care system's capacity to treat children with special health care needs.

PubMed

Kerins, Carolyn; Casamassimo, Paul S; Ciesla, David; Lee, Yosuk; Seale, N Sue

2011-01-01

The purpose of this study was to use existing data to determine capacity of the US dental care system to treat children with special health care needs (CSHCN). A deductive analysis using recent existing data was used to determine the: possible available appointments for CSHCN in hospitals and educational programs/institutions; and the ratio of CSHCN to potential available and able providers in the United States sorted by 6 American Academy of Pediatric Dentistry (AAPD) districts. Using existing data sets, this analysis found 57 dental schools, 61 advanced education in general dentistry programs, 174 general practice residencies, and 87 children's hospital dental clinics in the United States. Nationally, the number of CSHCN was determined to be 10,221,436. The distribution, on average, of CSHCN per care source/provider ranged from 1,327 to 2,357 in the 6 AAPD districts. Children's hospital dental clinics had fewer than 1 clinic appointment or 1 operating room appointment available per CSHCN. The mean number of CSHCN patients per provider, if distributed equally, was 1,792. The current US dental care system has extremely limited capacity to care for children with special health care needs.

Perinatal Health Belief Scales: A Cost Effective Technique for Predicting Prenatal Appointment Keeping Rates amongst Pregnant Teenagers.

ERIC Educational Resources Information Center

Wells, Robert D.; And Others

Prenatal appointment keeping is an important predictor of birth outcomes, yet many pregnant adolescents miss an excessive number of appointments. Since effective strategies for increasing appointment keeping require costly staff time, methods to predict relative risk for noncompliance with appointments might help delineate a circumscribed…

75 FR 74748 - Senior Executive Service; Appointment of Members to the Performance Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-01

... Compensation--appointment expires on 09/30/11 SOL Katherine E. Bissell, Associate Solicitor for Civil Rights and Labor Management--appointment expires on 09/30/11 SOL Michael D. Felsen, Regional Solicitor, Boston--appointment expires on 09/30/12 SOL Deborah Greenfield, Deputy Solicitor--appointment expires on...

5 CFR 316.302 - Selection of term employees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... appointments not excepted VRA appointments and do not lead to conversion to career-conditional appointment; (3) Career-conditional appointment under § 315.601, 315.604, 315.605, 315.606, 315.607, 315.608, 315.609, 315... Accounting Office; (6) Appointment under 28 U.S.C. 602 for current and former employees of the Administrative...

Construction of high-dimensional universal quantum logic gates using a Λ system coupled with a whispering-gallery-mode microresonator.

PubMed

He, Ling Yan; Wang, Tie-Jun; Wang, Chuan

2016-07-11

High-dimensional quantum system provides a higher capacity of quantum channel, which exhibits potential applications in quantum information processing. However, high-dimensional universal quantum logic gates is difficult to achieve directly with only high-dimensional interaction between two quantum systems and requires a large number of two-dimensional gates to build even a small high-dimensional quantum circuits. In this paper, we propose a scheme to implement a general controlled-flip (CF) gate where the high-dimensional single photon serve as the target qudit and stationary qubits work as the control logic qudit, by employing a three-level Λ-type system coupled with a whispering-gallery-mode microresonator. In our scheme, the required number of interaction times between the photon and solid state system reduce greatly compared with the traditional method which decomposes the high-dimensional Hilbert space into 2-dimensional quantum space, and it is on a shorter temporal scale for the experimental realization. Moreover, we discuss the performance and feasibility of our hybrid CF gate, concluding that it can be easily extended to a 2n-dimensional case and it is feasible with current technology.

[Analysis of economic cost of missed outpatient appointments].

PubMed

Jabalera Mesa, M L; Morales Asencio, J M; Rivas Ruiz, F; Porras González, M H

To estimate the economic costs of missed Outpatient appointments by the Costa del Sol Health Agency (ASCS). An analysis was performed on the costs arising from missed outpatient appointments (first appointment and examinations) of each of the specialities in the Centres belonging to the ASCS. A formula was used to determine the unit cost per appointment and per centre and speciality. This involved the direct imputation of the controllable costs and the indirect imputation of the service costs, together with an estimated cost of re-appointments based on a previous case-control study. The cost of missed appointments per centre in the Costa del Sol Hospital was €2,475,640, with a failure rate of 14.2% (256,377 appointments). In the Benalmádena High Resolution Hospital it was €515,936, with an absence rate of 12.2% (44,848 appointments), and in the Mijas High Resolution Centre, a cost of €395,342 with an absence rate of the 13.5% (99,536 appointments). The mean extra cost of a re-appointment was €12.95. The specialities with a higher medium cost were Digestive Diseases, Internal Medicine, and Rehabilitation. The economic cost of patients not turning up for scheduled appointments in the ASCS was greater than 3 million Euros for a non-attendance rate of the 13.8%, with Mijas High Resolution Centre being the centre that showed the lowest mean unitary cost per medical appointment. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

"Why not stoichiometry" versus "Stoichiometry--why not?" Part II: GATES in context with redox systems.

PubMed

Michałowska-Kaczmarczyk, Anna Maria; Asuero, Agustin G; Toporek, Marcin; Michałowski, Tadeusz

2015-01-01

Redox equilibria and titration play an important role in chemical analysis, and the formulation of an accurate mathematical description is a challenge. This article is devoted to static and (mainly) dynamic redox systems; the dynamic systems are represented by redox titrations. An overview addresses earlier approaches to static redox systems (redox diagram plots, including Pourbaix diagrams) and to titration redox systems, thereby covering a gap in the literature. After this short review, the generalized approach to electrolytic systems (GATES) is introduced, with generalized electron balance (GEB) as its inherent part within GATES/GEB. Computer simulation, performed according to GATES/GEB, enables following the changes in potential and pH of the solution, together with chemical speciation at each step of a titration, thus providing better insight into this procedure. The undeniable advantages of GATES/GEB over earlier approaches are indicated. Formulation of GEB according to two approaches (I and II) is presented on the respective examples. A general criterion distinguishing between non-redox and redox systems is presented. It is indicated that the formulation of GEB according to Approach II does not need the knowledge of oxidation degrees of particular elements; knowledge of the composition, expressed by chemical formula of the species and its charge, is sufficient for this purpose. Approach I to GEB, known also as the "short" version of GEB, is applicable if oxidation degrees for all elements of the system are known beforehand. The roles of oxidants and reductants are not ascribed to particular components forming a system and to the species thus formed. This is the complete opposite of earlier approaches to redox titrations, based on the stoichiometric redox reaction, formulated for this purpose. GEB, perceived as a law of matter conservation, is fully compatible with other (charge and concentration) balances related to the system in question. The applicability of GATES/GEB in optimization a priori of chemical analyses made with use of redox titration is indicated. The article is illustrated with many examples of static and dynamic redox systems. The related plots are obtained from calculations made according to iterative computer programs. This way, GATES/GEB enables seeing details invisible in real experiments.

Facility-level intervention to improve attendance and adherence among patients on anti-retroviral treatment in Kenya--a quasi-experimental study using time series analysis.

PubMed

Boruett, Patrick; Kagai, Dorine; Njogo, Susan; Nguhiu, Peter; Awuor, Christine; Gitau, Lillian; Chalker, John; Ross-Degnan, Dennis; Wahlström, Rolf; Tomson, Göran

2013-07-01

Achieving high rates of adherence to antiretroviral therapy (ART) in resource-poor settings comprises serious, but different, challenges in both the first months of treatment and during the life-long maintenance phase. We measured the impact of a health system-oriented, facility-based intervention to improve clinic attendance and patient adherence. This was a quasi-experimental, longitudinal, controlled intervention study using interrupted time series analysis. The intervention consisted of (1) using a clinic appointment diary to track patient attendance and monitor monthly performance; (2) changing the mode of asking for self-reported adherence; (3) training staff on adherence concepts, intervention methods, and use of monitoring data; (4) conducting visits to support facility teams with the implementation.We conducted the study in 12 rural district hospitals (6 intervention, 6 control) in Kenya and randomly selected 1894 adult patients over 18 years of age in two cohorts: experienced patients on treatment for at least one year, and newly treated patients initiating ART during the study. Outcome measures were: attending the clinic on or before the date of a scheduled appointment, attending within 3 days of a scheduled appointment, reporting perfect adherence, and experiencing a gap in medication supply of more than 14 days. Among experienced patients, the percentage attending the clinic on or before a scheduled appointment increased in both level (average total increase immediately after intervention) (+5.7%; 95% CI=2.1, 9.3) and trend (increase per month) (+1.0% per month; 95% CI=0.6, 1.5) following the intervention, as did the level and trend of those keeping appointments within three days (+4.2%; 95% CI=1.6, 6.7; and +0.8% per month; 95% CI=0.6, 1.1, respectively). The relative difference between the intervention and control groups based on the monthly difference in visit rates increased significantly in both level (+6.5; 95% CI=1.4, 11.6) and trend (1.0% per month; 95% CI=0.2, 1.8) following the intervention for experienced patients attending the clinic within 3 days of their scheduled appointments.The decrease in the percentage of experienced patients with a medication gap greater than 14 days approached statistical significance (-11.3%; 95% CI=-22.7, 0.1), and the change seemed to persist over 11 months after the intervention. All facility staff used appointment-keeping data to calculate adherence and discussed outcomes regularly. The appointment-tracking system and monthly performance monitoring was strengthened, and patient attendance was improved. Scale-up to national level may be considered.

Towards component-based validation of GATE: aspects of the coincidence processor.

PubMed

Moraes, Eder R; Poon, Jonathan K; Balakrishnan, Karthikayan; Wang, Wenli; Badawi, Ramsey D

2015-02-01

GATE is public domain software widely used for Monte Carlo simulation in emission tomography. Validations of GATE have primarily been performed on a whole-system basis, leaving the possibility that errors in one sub-system may be offset by errors in others. We assess the accuracy of the GATE PET coincidence generation sub-system in isolation, focusing on the options most closely modeling the majority of commercially available scanners. Independent coincidence generators were coded by teams at Toshiba Medical Research Unit (TMRU) and UC Davis. A model similar to the Siemens mCT scanner was created in GATE. Annihilation photons interacting with the detectors were recorded. Coincidences were generated using GATE, TMRU and UC Davis code and results compared to "ground truth" obtained from the history of the photon interactions. GATE was tested twice, once with every qualified single event opening a time window and initiating a coincidence check (the "multiple window method"), and once where a time window is opened and a coincidence check initiated only by the first single event to occur after the end of the prior time window (the "single window method"). True, scattered and random coincidences were compared. Noise equivalent count rates were also computed and compared. The TMRU and UC Davis coincidence generators agree well with ground truth. With GATE, reasonable accuracy can be obtained if the single window method option is chosen and random coincidences are estimated without use of the delayed coincidence option. However in this GATE version, other parameter combinations can result in significant errors. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Flow monitoring and control system for injection wells

DOEpatents

Corey, John C.

1993-01-01

A system for monitoring and controlling the injection rate of fluid by an injection well of an in-situ remediation system for treating a contaminated groundwater plume. The well is fitted with a gated insert, substantially coaxial with the injection well. A plurality of openings, some or all of which are equipped with fluid flow sensors and gates, are spaced along the insert. The gates and sensors are connected to a surface controller. The insert may extend throughout part of, or substantially the entire length of the injection well. Alternatively, the insert may comprise one or more movable modules which can be positioned wherever desired along the well. The gates are opened part-way at the start of treatment. The sensors monitor and display the flow rate of fluid passing through each opening on a controller. As treatment continues, the gates are opened to increase flow in regions of lesser flow, and closed to decrease flow in regions of greater flow, thereby approximately equalizing the amount of fluid reaching each part of the plume.

Flow monitoring and control system for injection wells

DOEpatents

Corey, J.C.

1993-02-16

A system for monitoring and controlling the injection rate of fluid by an injection well of an in-situ remediation system for treating a contaminated groundwater plume. The well is fitted with a gated insert, substantially coaxial with the injection well. A plurality of openings, some or all of which are equipped with fluid flow sensors and gates, are spaced along the insert. The gates and sensors are connected to a surface controller. The insert may extend throughout part of, or substantially the entire length of the injection well. Alternatively, the insert may comprise one or more movable modules which can be positioned wherever desired along the well. The gates are opened part-way at the start of treatment. The sensors monitor and display the flow rate of fluid passing through each opening on a controller. As treatment continues, the gates are opened to increase flow in regions of lesser flow, and closed to decrease flow in regions of greater flow, thereby approximately equalizing the amount of fluid reaching each part of the plume.

Nanogranular SiO2 proton gated silicon layer transistor mimicking biological synapses

NASA Astrophysics Data System (ADS)

Liu, M. J.; Huang, G. S.; Feng, P.; Guo, Q. L.; Shao, F.; Tian, Z. A.; Li, G. J.; Wan, Q.; Mei, Y. F.

2016-06-01

Silicon on insulator (SOI)-based transistors gated by nanogranular SiO2 proton conducting electrolytes were fabricated to mimic synapse behaviors. This SOI-based device has both top proton gate and bottom buried oxide gate. Electrical transfer properties of top proton gate show hysteresis curves different from those of bottom gate, and therefore, excitatory post-synaptic current and paired pulse facilitation (PPF) behavior of biological synapses are mimicked. Moreover, we noticed that PPF index can be effectively tuned by the spike interval applied on the top proton gate. Synaptic behaviors and functions, like short-term memory, and its properties are also experimentally demonstrated in our device. Such SOI-based electronic synapses are promising for building neuromorphic systems.

Robust Deterministic Controlled Phase-Flip Gate and Controlled-Not Gate Based on Atomic Ensembles Embedded in Double-Sided Optical Cavities

NASA Astrophysics Data System (ADS)

Liu, A.-Peng; Cheng, Liu-Yong; Guo, Qi; Zhang, Shou

2018-02-01

We first propose a scheme for controlled phase-flip gate between a flying photon qubit and the collective spin wave (magnon) of an atomic ensemble assisted by double-sided cavity quantum systems. Then we propose a deterministic controlled-not gate on magnon qubits with parity-check building blocks. Both the gates can be accomplished with 100% success probability in principle. Atomic ensemble is employed so that light-matter coupling is remarkably improved by collective enhancement. We assess the performance of the gates and the results show that they can be faithfully constituted with current experimental techniques.

Field-effect P-N junction

DOEpatents

Regan, William; Zettl, Alexander

2015-05-05

This disclosure provides systems, methods, and apparatus related to field-effect p-n junctions. In one aspect, a device includes an ohmic contact, a semiconductor layer disposed on the ohmic contact, at least one rectifying contact disposed on the semiconductor layer, a gate including a layer disposed on the at least one rectifying contact and the semiconductor layer and a gate contact disposed on the layer. A lateral width of the rectifying contact is less than a semiconductor depletion width of the semiconductor layer. The gate contact is electrically connected to the ohmic contact to create a self-gating feedback loop that is configured to maintain a gate electric field of the gate.

Deterministic quantum controlled-PHASE gates based on non-Markovian environments

NASA Astrophysics Data System (ADS)

Zhang, Rui; Chen, Tian; Wang, Xiang-Bin

2017-12-01

We study the realization of the quantum controlled-PHASE gate in an atom-cavity system beyond the Markovian approximation. The general description of the dynamics for the atom-cavity system without any approximation is presented. When the spectral density of the reservoir has the Lorentz form, by making use of the memory backflow from the reservoir, we can always construct the deterministic quantum controlled-PHASE gate between a photon and an atom, no matter the atom-cavity coupling strength is weak or strong. While, the phase shift in the output pulse hinders the implementation of quantum controlled-PHASE gates in the sub-Ohmic, Ohmic or super-Ohmic reservoirs.

A Study of an Appointment Scheduling System for Outpatients at the United States Air Force Academy Hospital

DTIC Science & Technology

1988-06-30

INSTRUMENT IDEtIFICATION NUMBER Se. ADDRESS City. State d ZIP Code) 10. SOURCE OF F JNOING NOS. _____ 11. TITLE ( ct Secure l w i a i n A S tu O f...Services are provided in General Dentistry, Oral Surgery, Periodontics, Prosthodontics, Endodontics , and Orthodontics (MHR 1987, 4-5). The hospital also...appointment w 1 ~ -*~*~’ . ~ *~ V -, . ~ ~. ~ £~ £ *~%~ * D. Shields 4 clerks using a rotary wheel file. Schedules were forwarded to outpatient records

Noise-aided computation within a synthetic gene network through morphable and robust logic gates

NASA Astrophysics Data System (ADS)

Dari, Anna; Kia, Behnam; Wang, Xiao; Bulsara, Adi R.; Ditto, William

2011-04-01

An important goal for synthetic biology is to build robust and tunable genetic regulatory networks that are capable of performing assigned operations, usually in the presence of noise. In this work, a synthetic gene network derived from the bacteriophage λ underpins a reconfigurable logic gate wherein we exploit noise and nonlinearity through the application of the logical stochastic resonance paradigm. This biological logic gate can emulate or “morph” the AND and OR operations through varying internal system parameters in a noisy background. Such genetic circuits can afford intriguing possibilities in the realization of engineered genetic networks in which the actual function of the gate can be changed after the network has been built, via an external control parameter. In this article, the full system characterization is reported, with the logic gate performance studied in the presence of external and internal noise. The robustness of the gate, to noise, is studied and illustrated through numerical simulations.

CBCT Assessment of Root Dentine Removal by Gates-Glidden Drills and Two Engine-Driven Root Preparation Systems

PubMed Central

Harandi, Azade; Mohammadpour Maleki, Fatemeh; Moudi, Ehsan; Ehsani, Maryam; Khafri, Soraya

2017-01-01

Introduction: The aim of this study was to compare the dentine removing efficacy of Gates-Glidden drills with hand files, ProTaper and OneShape single-instrument system using cone-beam computed tomography (CBCT). Methods and Materials: A total of 39 extracted bifurcated maxillary first premolars were divided into 3 groups (n=13) and were prepared using either Gates-Glidden drills and hand instruments, ProTaper and OneShape systems. Pre- and post-instrumentation CBCT images were obtained. The dentin thickness of canals was measured at furcation, and 1 and 2 mm from the furcation area in buccal, palatal, mesial and distal walls. Data were analyzed using one-way ANOVA test. Tukey’s post hoc tests were used for two-by-two comparisons. Results: Gates-Glidden drills with hand files removed significantly more (P<0.001) dentine than the engine-driven systems in all canal walls (buccal, palatal, mesial and distal). There were no significant differences between OneShape and ProTaper rotary systems (P>0.05). Conclusion: The total cervical dentine removal during canal instrumentation was significantly less with engine-driven file systems compared to Gates-Glidden drills. There were no significant differences between residual dentine thicknesses left between the various canal walls. PMID:28179920

Real-time passenger counting by active linear cameras

NASA Astrophysics Data System (ADS)

Khoudour, Louahdi; Duvieubourg, Luc; Deparis, Jean-Pierre

1996-03-01

The companies operating subways are very much concerned with counting the passengers traveling through their transport systems. One of the most widely used systems for counting passengers consists of a mechanical gate equipped with a counter. However, such simple systems are not able to count passengers jumping above the gates. Moreover, passengers carrying large luggage or bags may meet some difficulties when going through such gates. The ideal solution is a contact-free counting system that would bring more comfort of use for the passengers. For these reasons, we propose to use a video processing system instead of these mechanical gates. The optical sensors discussed in this paper offer several advantages including well defined detection areas, fast response time and reliable counting capability. A new technology has been developed and tested, based on linear cameras. Preliminary results show that this system is very efficient when the passengers crossing the optical gate are well separated. In other cases, such as in compact crowd conditions, reasonable accuracy has been demonstrated. These results are illustrated by means of a number of sequences shot in field conditions. It is our belief that more precise measurements could be achieved, in the case of compact crowd, by other algorithms and acquisition techniques of the line images that we are presently developing.

Homeless patients' perceptions about using cell phones to manage medications and attend appointments.

PubMed

Moczygemba, Leticia R; Cox, Lauren S; Marks, Samantha A; Robinson, Margaret A; Goode, Jean-Venable R; Jafari, Nellie

2017-06-01

The objectives of this study were to (1) describe homeless persons' access and use of cell phones and their perceptions about using cell phone alerts to help manage medications and attend health care appointments and (2) identify demographic characteristics, medication use and appointment history and perceptions associated with interest in receiving cell phone alerts to manage medications and appointments. A cross-sectional survey was conducted in 2013 at a homeless clinic in Virginia. The questionnaire comprised items about cell phone usage, ownership and functions such as text messaging. Participants reported medication use and appointment history, perceptions about cell phone alerts and interest in receiving alerts to manage medications and appointments. Descriptive statistics for all variables are reported. Logistic regression was used to examine predictors of interest in using a cell phone to manage medications and appointments. A total of 290 participants completed the survey; 89% had a cell phone. Seventy-seven percent were interested in appointment reminders, whereas 66%, 60% and 54% were interested in refill reminders, medication taking reminders and medication information messages respectively. Those who believed reminders were helpful were more likely to be interested in medication taking, refill and appointment reminder messages compared to those who did not believe reminders were helpful. A history of running out of medicine and forgetting appointments were predictors of interest in refill and appointment reminders. Mobile technology is a feasible method for communicating medication and appointment information to those experiencing or at risk for homelessness. © 2016 Royal Pharmaceutical Society.

NOTE: Implementation of angular response function modeling in SPECT simulations with GATE

NASA Astrophysics Data System (ADS)

Descourt, P.; Carlier, T.; Du, Y.; Song, X.; Buvat, I.; Frey, E. C.; Bardies, M.; Tsui, B. M. W.; Visvikis, D.

2010-05-01

Among Monte Carlo simulation codes in medical imaging, the GATE simulation platform is widely used today given its flexibility and accuracy, despite long run times, which in SPECT simulations are mostly spent in tracking photons through the collimators. In this work, a tabulated model of the collimator/detector response was implemented within the GATE framework to significantly reduce the simulation times in SPECT. This implementation uses the angular response function (ARF) model. The performance of the implemented ARF approach has been compared to standard SPECT GATE simulations in terms of the ARF tables' accuracy, overall SPECT system performance and run times. Considering the simulation of the Siemens Symbia T SPECT system using high-energy collimators, differences of less than 1% were measured between the ARF-based and the standard GATE-based simulations, while considering the same noise level in the projections, acceleration factors of up to 180 were obtained when simulating a planar 364 keV source seen with the same SPECT system. The ARF-based and the standard GATE simulation results also agreed very well when considering a four-head SPECT simulation of a realistic Jaszczak phantom filled with iodine-131, with a resulting acceleration factor of 100. In conclusion, the implementation of an ARF-based model of collimator/detector response for SPECT simulations within GATE significantly reduces the simulation run times without compromising accuracy.

A simple laser locking system based on a field-programmable gate array.

PubMed

Jørgensen, N B; Birkmose, D; Trelborg, K; Wacker, L; Winter, N; Hilliard, A J; Bason, M G; Arlt, J J

2016-07-01

Frequency stabilization of laser light is crucial in both scientific and industrial applications. Technological developments now allow analog laser stabilization systems to be replaced with digital electronics such as field-programmable gate arrays, which have recently been utilized to develop such locking systems. We have developed a frequency stabilization system based on a field-programmable gate array, with emphasis on hardware simplicity, which offers a user-friendly alternative to commercial and previous home-built solutions. Frequency modulation, lock-in detection, and a proportional-integral-derivative controller are programmed on the field-programmable gate array and only minimal additional components are required to frequency stabilize a laser. The locking system is administered from a host-computer which provides comprehensive, long-distance control through a versatile interface. Various measurements were performed to characterize the system. The linewidth of the locked laser was measured to be 0.7 ± 0.1 MHz with a settling time of 10 ms. The system can thus fully match laser systems currently in use for atom trapping and cooling applications.

A simple laser locking system based on a field-programmable gate array

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

Jørgensen, N. B.; Birkmose, D.; Trelborg, K.

Frequency stabilization of laser light is crucial in both scientific and industrial applications. Technological developments now allow analog laser stabilization systems to be replaced with digital electronics such as field-programmable gate arrays, which have recently been utilized to develop such locking systems. We have developed a frequency stabilization system based on a field-programmable gate array, with emphasis on hardware simplicity, which offers a user-friendly alternative to commercial and previous home-built solutions. Frequency modulation, lock-in detection, and a proportional-integral-derivative controller are programmed on the field-programmable gate array and only minimal additional components are required to frequency stabilize a laser. The lockingmore » system is administered from a host-computer which provides comprehensive, long-distance control through a versatile interface. Various measurements were performed to characterize the system. The linewidth of the locked laser was measured to be 0.7 ± 0.1 MHz with a settling time of 10 ms. The system can thus fully match laser systems currently in use for atom trapping and cooling applications.« less

Amplitude gating for a coached breathing approach in respiratory gated 10 MV flattening filter‐free VMAT delivery

PubMed Central

Lee, Richard; Gete, Ermias; Duzenli, Cheryl

2015-01-01

The purpose of this study was to investigate amplitude gating combined with a coached breathing strategy for 10 MV flattening filter‐free (FFF) volumetric‐modulated arc therapy (VMAT) on the Varian TrueBeam linac. Ten patient plans for VMAT SABR liver were created using the Eclipse treatment planning system (TPS). The verification plans were then transferred to a CT‐scanned Quasar phantom and delivered on a TrueBeam linac using a 10 MV FFF beam and Varian's real‐time position management (RPM) system for respiratory gating based on breathing amplitude. Breathing traces were acquired from ten patients using two kinds of breathing patterns: free breathing and an interrupted (~5 s pause) end of exhale coached breathing pattern. Ion chamber and Gafchromic film measurements were acquired for a gated delivery while the phantom moved under the described breathing patterns, as well as for a nongated stationary phantom delivery. The gate window was set to obtain a range of residual target motion from 2–5 mm. All gated deliveries on a moving phantom have been shown to be dosimetrically equivalent to the nongated deliveries on a static phantom, with differences in point dose measurements under 1% and average gamma 2%/2 mm agreement above 98.7%. Comparison with the treatment planning system also resulted in good agreement, with differences in point‐dose measurements under 2.5% and average gamma 3%/3 mm agreement of 97%. The use of a coached breathing pattern significantly increases the duty cycle, compared with free breathing, and allows for shorter treatment times. Patients' free‐breathing patterns contain considerable variability and, although dosimetric results for gated delivery may be acceptable, it is difficult to achieve efficient treatment delivery. A coached breathing pattern combined with a 5 mm amplitude gate, resulted in both high‐quality dose distributions and overall shortest gated beam delivery times. PACS number: 87.55.Qr PMID:26219000

Structured back gates for high-mobility two-dimensional electron systems using oxygen ion implantation

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

Berl, M., E-mail: mberl@phys.ethz.ch; Tiemann, L.; Dietsche, W.

2016-03-28

We present a reliable method to obtain patterned back gates compatible with high mobility molecular beam epitaxy via local oxygen ion implantation that suppresses the conductivity of an 80 nm thick silicon doped GaAs epilayer. Our technique was optimized to circumvent several constraints of other gating and implantation methods. The ion-implanted surface remains atomically flat which allows unperturbed epitaxial overgrowth. We demonstrate the practical application of this gating technique by using magneto-transport spectroscopy on a two-dimensional electron system (2DES) with a mobility exceeding 20 × 10{sup 6} cm{sup 2}/V s. The back gate was spatially separated from the Ohmic contacts of the 2DES,more » thus minimizing the probability for electrical shorts or leakage and permitting simple contacting schemes.« less

Identifying demographic variables related to failed dental appointments in a university hospital-based residency program.

PubMed

Mathu-Muju, Kavita R; Li, Hsin-Fang; Hicks, James; Nash, David A; Kaplan, Alan; Bush, Heather M

2014-01-01

The objective of this study was to identify characteristics of pediatric patients who failed to keep the majority of their scheduled dental appointments in a pediatric dental clinic staffed by pediatric dental residents and faculty members. The electronic records of all patients appointed over a continuous 54 month period were analyzed. Appointment history and demographic variables were collected. The rate of failed appointments was calculated by dividing the number of failed appointments with the total number of appointments scheduled for the patient. There were 7,591 patients in the analyzable dataset scheduled with a total of 48,932 appointments. Factors associated with an increased rate of failed appointments included self-paying for dental care, having a resident versus a faculty member as the provider, rural residence, and adolescent aged patients. Multivariable regression models indicated self-paying patients had higher odds and rates of failed appointments than patients with Medicaid and private insurance. Access to care for children may be improved by increasing the availability of private and public insurance. The establishment of a dental home and its relationship to a child receiving continuous care in an institutional setting depends upon establishing a relationship with a specific dentist.

Specific timely appointments for triage reduced waiting lists in an outpatient physiotherapy service.

PubMed

Harding, K E; Bottrell, J

2016-12-01

Waiting lists with triage systems are commonly used in outpatient physiotherapy but may not be effective. Could an alternative model of access and triage reduce waiting times over a sustained period with no additional resources? Observational study comparing retrospective data for 11 months prior to the introduction of a new model of access compared with data for the equivalent 11 months afterwards. Patients referred to a physiotherapy outpatient department at an outer metropolitan hospital before (n=721) and after (n=707) the introduction of the new model. A model of access and triage known as 'specific timely appointments for triage' (STAT), in which appointment slots are preserved in advance specifically for new patients based on calculation of average demand. Time from referral to first assessment, number of appointments per patient, occasions of non-attendance and total length of stay in the service. Median time from referral to first appointment was 18 days [interquartile range (IQR) 11 to 33 days] in the pre-intervention group, compared with 14 days (IQR 9 to 21 days) in the post-intervention group (P<0.01). The number of physiotherapy appointments also reduced (IQR 2 to 6 vs IQR 1 to 4; P<0.01). There were no changes in non-attendance rates or total time in the service. Waiting time for outpatient physiotherapy was 22% lower in the year following the introduction of the STAT model. While acknowledging the limitations of a pre- and post-measurement design, this model may have potential for reducing waiting times for outpatient physiotherapy without additional resources. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Reducing non-attendance rates in a community mental health team.

PubMed

Filippidou, Maria; Lingwood, Susie; Mirza, Ilyas

2014-01-01

The project aimed to improve productivity of psychiatric out patient clinic using quality improvement techniques through "Listening Into Action", a national programme designed to engage and support front-line clinicians to make improvements to patient care. We identified reasons as to why our patients missed appointments and then introduced a system to reduce "did not attend" (DNA) rates. Non-attendance at appointments results in a waste of resources and increases waiting times. It has been reported that DNA rates in mental health are higher compared to other settings. Therefore, reducing DNA rates are a priority for mental health care providers. We collected DNA rates over a period of months over May 2013 to September 2013. We conducted a patient survey to inquire why the patients missed their appointments. The aim of the project and results from the survey were presented and discussed at the multi-disciplinary team meeting to generate ideas for improvement and engage the team with the project. As the most frequent response from the survey was 'forgetting the appointment', we decided to introduce text messaging as an intervention to remind patients of their appointments. We also ensured that staff updated the mobile phone records for the patients at each appointment. We monitored the DNA rates after introducing this change on a monthly basis. Following our intervention, there was an overall reduction in DNA rates for all disciplines from 11.4% to 10.62% with the greatest change for medical DNA's from 17.7% to 11.8 %. Results from a patient survey showed that the reasons for non-attendance are multi-factorial and require a complex approach. Our intervention was a simple one but still it demonstrated some effectiveness. Reducing DNA rates requires interventions to be regularly monitored so that their effect is sustained over a period of time.

TH-CD-207A-04: Optimized Respiratory Gating for Abnormal Breathers in Pancreatic SBRT

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

Campbell, W; Miften, M; Schefter, T

Purpose: Pancreatic SBRT is uniquely challenging due to both the erratic/unstable motion of the pancreas and the close proximity of the radiosensitive small bowel. Respiratory gating can mitigate this effect, but the irregularity of motion severely affects traditional phase-based gating. The purpose of this study was to analyze real-time motion data of pancreatic tumors to optimize the efficacy and accuracy of respiratory gating, with the overall goal of enabling dose escalated pancreatic SBRT. Methods: Fifteen pancreatic SBRT patients received 30–33 Gy in 5 fractions on a Varian TrueBeam STx unit. Abdominal compression was used to reduce the amplitude of tumormore » motion, and daily cone-beam computed tomography (CBCT) scans were acquired prior to each treatment for target localization purposes. For this study, breathing data (phase and amplitude) were collected during each CBCT scan using Varian’s Real-Time Position Management system. An in-house template matching technique was used to track the superior-inferior motion of implanted fiducial markers in CBCT projection images. Using tumor motion and breathing data, phase-based or amplitude-based respiratory gating was simulated for all 75 fractions, targeting either end-exhalation or end-inhalation phases of breathing. Results: For the average patient, gating at end-exhalation offered the best reductions in effective motion for equal duty cycles. However, optimal central phase angle varied widely (range: 0–92%, mean±SD: 49±12%), and phase-based gating windows typically associated with end-exhalation (i.e., “30–70%”) were rarely ideal. Amplitude-based gating significantly outperformed phase-based gating, with average effective ranges for amplitude-based gating 25% lower than phase-based gating ranges (as much as 73% lower). Amplitude-based gating was consistently better suited to accommodate abnormal breathing patterns. For both phase-based and amplitude-based gating, end-exhalation provided significantly better results than end-inhalation. Conclusion: Amplitude-based gating reliably outperformed phase-based gating, and end-exhalation was more suitable than end-inhalation. These results will be used to guide future dose-escalation trials. Research funding provided by Varian Medical Systems to Miften and Jones.« less

Healthcare information technology infrastructures in Turkey.

PubMed

Dogac, A; Yuksel, M; Ertürkmen, G L; Kabak, Y; Namli, T; Yıldız, M H; Ay, Y; Ceyhan, B; Hülür, U; Oztürk, H; Atbakan, E

2014-05-22

The objective of this paper is to describe some of the major healthcare information technology (IT) infrastructures in Turkey, namely, Sağlık-Net (Turkish for "Health-Net"), the Centralized Hospital Appointment System, the Basic Health Statistics Module, the Core Resources Management System, and the e-prescription system of the Social Security Institution. International collaboration projects that are integrated with Sağlık-Net are also briefly summarized. The authors provide a survey of the some of the major healthcare IT infrastructures in Turkey. Sağlık-Net has two main components: the National Health Information System (NHIS) and the Family Medicine Information System (FMIS). The NHIS is a nation-wide infrastructure for sharing patients' Electronic Health Records (EHRs). So far, EHRs of 78.9 million people have been created in the NHIS. Similarly, family medicine is operational in the whole country via FMIS. Centralized Hospital Appointment System enables the citizens to easily make appointments in healthcare providers. Basic Health Statistics Module is used for collecting information about the health status, risks and indicators across the country. Core Resources Management System speeds up the flow of information between the headquarters and Provincial Health Directorates. The e-prescription system is linked with Sağlık-Net and seamlessly integrated with the healthcare provider information systems. Finally, Turkey is involved in several international projects for experience sharing and disseminating national developments. With the introduction of the "Health Transformation Program" in 2003, a number of successful healthcare IT infrastructures have been developed in Turkey. Currently, work is going on to enhance and further improve their functionality.

Size reduction techniques for vital compliant VHDL simulation models

DOEpatents

Rich, Marvin J.; Misra, Ashutosh

2006-08-01

A method and system select delay values from a VHDL standard delay file that correspond to an instance of a logic gate in a logic model. Then the system collects all the delay values of the selected instance and builds super generics for the rise-time and the fall-time of the selected instance. Then, the system repeats this process for every delay value in the standard delay file (310) that correspond to every instance of every logic gate in the logic model. The system then outputs a reduced size standard delay file (314) containing the super generics for every instance of every logic gate in the logic model.

Efficient Measurement of Quantum Gate Error by Interleaved Randomized Benchmarking

NASA Astrophysics Data System (ADS)

Magesan, Easwar; Gambetta, Jay M.; Johnson, B. R.; Ryan, Colm A.; Chow, Jerry M.; Merkel, Seth T.; da Silva, Marcus P.; Keefe, George A.; Rothwell, Mary B.; Ohki, Thomas A.; Ketchen, Mark B.; Steffen, M.

2012-08-01

We describe a scalable experimental protocol for estimating the average error of individual quantum computational gates. This protocol consists of interleaving random Clifford gates between the gate of interest and provides an estimate as well as theoretical bounds for the average error of the gate under test, so long as the average noise variation over all Clifford gates is small. This technique takes into account both state preparation and measurement errors and is scalable in the number of qubits. We apply this protocol to a superconducting qubit system and find a bounded average error of 0.003 [0,0.016] for the single-qubit gates Xπ/2 and Yπ/2. These bounded values provide better estimates of the average error than those extracted via quantum process tomography.

Energy Saving Melting and Revert Reduction Technology (Energy-SMARRT): Clean Steel Casting Production

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

Kuyucak, Selcuk; Li, Delin

2013-12-31

Inclusions in steel castings can cause rework, scrap, poor machining, and reduced casting performance, which can obviously result in excess energy consumption. Significant progress in understanding inclusion source, formation and control has been made. Inclusions can be defined as non-metallic materials such as refractory, sand, slag, or coatings, embedded in a metallic matrix. This research project has focused on the mold filling aspects to examine the effects of pouring methods and gating designs on the steel casting cleanliness through water modeling, computer modeling, and melting/casting experiments. Early in the research project, comprehensive studies of bottom-pouring water modeling and low-alloy steelmore » casting experiments were completed. The extent of air entrainment in bottom-poured large castings was demonstrated by water modeling. Current gating systems are designed to prevent air aspiration. However, air entrainment is equally harmful and no prevention measures are in current practice. In this study, new basin designs included a basin dam, submerged nozzle, and nozzle extension. The entrained air and inclusions from the gating system were significantly reduced using the new basin method. Near the end of the project, there has been close collaboration with Wescast Industries Inc., a company manufacturing automotive exhaust components. Both computer modeling using Magma software and melting/casting experiments on thin wall turbo-housing stainless steel castings were completed in this short period of time. Six gating designs were created, including the current gating on the pattern, non-pressurized, partially pressurized, naturally pressurized, naturally pressurized without filter, and radial choke gating without filter, for Magma modeling. The melt filling velocity and temperature were determined from the modeling. Based on the simulation results, three gating designs were chosen for further melting and casting experiments on the same casting pattern using the lip pouring method. It was observed again that gating designs greatly influenced the melt filling velocity and the number of inclusion defects. The radial choked gating showed improvements in casting cleanliness and yield over the other gatings, even though no mold filters were used in the gating system.« less

Penn State DOE GATE Program

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

Anstrom, Joel

2012-08-31

The Graduate Automotive Technology Education (GATE) Program at The Pennsylvania State University (Penn State) was established in October 1998 pursuant to an award from the U.S. Department of Energy (U.S. DOE). The focus area of the Penn State GATE Program is advanced energy storage systems for electric and hybrid vehicles.

40. HYDRAULIC OIL LINES, VALVES AND GAUGE FOR SLIDE GATE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

40. HYDRAULIC OIL LINES, VALVES AND GAUGE FOR SLIDE GATE HOISTS IN MACHINERY CHAMBER FOR SLUICE GATE WORKS ON GALLERY 1. NOTE HYDRAULIC OIL TANK AT UPPER RIGHT AND SCHEMATIC DRAWING OF PUMPING SYSTEM AT LEFT. VIEW TO NORTHWEST. - Owyhee Dam, Across Owyhee River, Nyssa, Malheur County, OR

Electronic gating circuit and ultraviolet laser excitation permit improved dosimeter sensitivity

NASA Technical Reports Server (NTRS)

Eggenberger, D.; King, D.; Longnecker, A.; Schutt, D.

1968-01-01

Standard dosimeter reader, modified by adding an electronic gating circuit to trigger the intensity level photomultiplier, increases readout sensitivity of photoluminescent dosimeter systems. The gating circuit is controlled by a second photomultiplier which senses a short ultraviolet pulse from a laser used to excite the dosimeter.

niSWAP and NTCP gates realized in a circuit QED system

NASA Astrophysics Data System (ADS)

Essammouni, K.; Chouikh, A.; Said, T.; Bennai, M.

Based on superconducting qubit coupled to a resonator driven by a strong microwave field, we propose a method to implement two quantum logic gates (niSWAP and NTCP gates) of one qubit simultaneously controlling n qubits selected from N qubits in a circuit QED (1 < n < N) by introducing qubit-qubit interaction. The interaction between the qubits and the circuit QED can be achieved by tuning the gate voltage and the external flux. The operation times of the logic gates are much smaller than the decoherence time and dephasing time. Moreover, the numerical simulation under the influence of the gates operations shows that the scheme could be achieved efficiently with presently available techniques.

Compact quantum gates on electron-spin qubits assisted by diamond nitrogen-vacancy centers inside cavities

NASA Astrophysics Data System (ADS)

Wei, Hai-Rui; Deng, Fu-Guo

2013-10-01

Constructing compact quantum circuits for universal quantum gates on solid-state systems is crucial for quantum computing. We present some compact quantum circuits for a deterministic solid-state quantum computing, including the cnot, Toffoli, and Fredkin gates on the diamond NV centers confined inside cavities, achieved by some input-output processes of a single photon. Our quantum circuits for these universal quantum gates are simple and economic. Moreover, additional electron qubits are not employed, but only a single-photon medium. These gates have a long coherent time. We discuss the feasibility of these universal solid-state quantum gates, concluding that they are feasible with current technology.

A comparison of the sealing ability of various temporary restorative materials to seal the access cavity: An in vitro study.

PubMed

Markose, Aji; Krishnan, Ramesh; Ramesh, Maya; Singh, Shishir

2016-10-01

In multiple-appointment root canal treatment, a temporary filling material is used to seal the access cavity between visits. The primary function of this material is to prevent the contamination of the root canal system by fluids, organic debris, and bacteria from the oral cavity. A total of fifty extracted noncarious unrestored human maxillaryanterior teeth with intact crowns and roots were selected The canals were instrumented using stepback technique and sodium hypochlorite (3%) and hydrogen peroxide (3%) were used as irrigants for each specimen alternatively. The coronal two-thirds of each canal were flared using Gates-Glidden drills up to no. 3 size and obturated with Gutta-percha using zinc oxide-eugenol (ZnOE) as sealer. The teeth were then randomly selected and divided into six groups out of which four were experimental groups and two control groups. The teeth were then immersed in 2% methylene blue dye solution for 3 days. All sealing materials and Gutta-percha were gently removed from the walls of the canal, and the entire circumference of the canal wall examined for dye penetration. The lowest mean leakage was in the Fermit-N group followed by Cavit-W, ZnOE, intermediate restorative materials (IRM), and positive control. Fermit-N showed better sealing ability compared to cavit, ZnOE and IRM.

Improving access for patients – a practice manager questionnaire

PubMed Central

Meade, James G; Brown, James S

2006-01-01

Background The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting. Methods A four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire. Results There was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062). Conclusion The findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study. PMID:16784530

Development of a text messaging system to improve receipt of survivorship care in adolescent and young adult survivors of childhood cancer.

PubMed

Casillas, Jacqueline; Goyal, Anju; Bryman, Jason; Alquaddoomi, Faisal; Ganz, Patricia A; Lidington, Emma; Macadangdang, Joshua; Estrin, Deborah

2017-08-01

This study aimed to develop and examine the acceptability, feasibility, and usability of a text messaging, or Short Message Service (SMS), system for improving the receipt of survivorship care for adolescent and young adult (AYA) survivors of childhood cancer. Researchers developed and refined the text messaging system based on qualitative data from AYA survivors in an iterative three-stage process. In stage 1, a focus group (n = 4) addressed acceptability; in stage 2, key informant interviews (n = 10) following a 6-week trial addressed feasibility; and in stage 3, key informant interviews (n = 23) following a 6-week trial addressed usability. Qualitative data were analyzed using a constant comparative analytic approach exploring in-depth themes. The final system includes programmed reminders to schedule and attend late effect screening appointments, tailored suggestions for community resources for cancer survivors, and messages prompting participant feedback regarding the appointments and resources. Participants found the text messaging system an acceptable form of communication, the screening reminders and feedback prompts feasible for improving the receipt of survivorship care, and the tailored suggestions for community resources usable for connecting survivors to relevant services. Participants suggested supplementing survivorship care visits and forming AYA survivor social networks as future implementations for the text messaging system. The text messaging system may assist AYA survivors by coordinating late effect screening appointments, facilitating a partnership with the survivorship care team, and connecting survivors with relevant community resources. The text messaging system has the potential to improve the receipt of survivorship care.

16 CFR 1018.17 - Appointments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Appointments. 1018.17 Section 1018.17 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL ADVISORY COMMITTEE MANAGEMENT Establishment of Advisory Committees § 1018.17 Appointments. (a) The Chairman shall appoint as members to advisory...

Nongeometric conditional phase shift via adiabatic evolution of dark eigenstates: a new approach to quantum computation.

PubMed

Zheng, Shi-Biao

2005-08-19

We propose a new approach to quantum phase gates via the adiabatic evolution. The conditional phase shift is neither of dynamical nor geometric origin. It arises from the adiabatic evolution of the dark state itself. Taking advantage of the adiabatic passage, this kind of quantum logic gates is robust against moderate fluctuations of experimental parameters. In comparison with the geometric phase gates, it is unnecessary to drive the system to undergo a desired cyclic evolution to obtain a desired solid angle. Thus, the procedure is simplified, and the fidelity may be further improved since the errors in obtaining the required solid angle are avoided. We illustrate such a kind of quantum logic gates in the ion trap system. The idea can also be realized in other systems, opening a new perspective for quantum information processing.

Low-photon-number optical switch and AND/OR logic gates based on quantum dot-bimodal cavity coupling system.

PubMed

Ma, Shen; Ye, Han; Yu, Zhong-Yuan; Zhang, Wen; Peng, Yi-Wei; Cheng, Xiang; Liu, Yu-Min

2016-01-11

We propose a new scheme based on quantum dot-bimodal cavity coupling system to realize all-optical switch and logic gates in low-photon-number regime. Suppression of mode transmission due to the destructive interference effect is theoretically demonstrated by driving the cavity with two orthogonally polarized pulsed lasers at certain pulse delay. The transmitted mode can be selected by designing laser pulse sequence. The optical switch with high on-off ratio emerges when considering one driving laser as the control. Moreover, the AND/OR logic gates based on photon polarization are achieved by cascading the coupling system. Both proposed optical switch and logic gates work well in ultra-low energy magnitude. Our work may enable various applications of all-optical computing and quantum information processing.

Low-photon-number optical switch and AND/OR logic gates based on quantum dot-bimodal cavity coupling system

PubMed Central

Ma, Shen; Ye, Han; Yu, Zhong-Yuan; Zhang, Wen; Peng, Yi-Wei; Cheng, Xiang; Liu, Yu-Min

2016-01-01

We propose a new scheme based on quantum dot-bimodal cavity coupling system to realize all-optical switch and logic gates in low-photon-number regime. Suppression of mode transmission due to the destructive interference effect is theoretically demonstrated by driving the cavity with two orthogonally polarized pulsed lasers at certain pulse delay. The transmitted mode can be selected by designing laser pulse sequence. The optical switch with high on-off ratio emerges when considering one driving laser as the control. Moreover, the AND/OR logic gates based on photon polarization are achieved by cascading the coupling system. Both proposed optical switch and logic gates work well in ultra-low energy magnitude. Our work may enable various applications of all-optical computing and quantum information processing. PMID:26750557

Picosecond imaging of sprays

NASA Technical Reports Server (NTRS)

Breisacher, Kevin; Liou, Larry; Wang, L.; Liang, X.; Galland, P.; Ho, P. P.; Alfano, R. R.

1994-01-01

Preliminary results from applying a Kerr-Fourier imaging system to a water/air spray produced by a shear coaxial element are presented. The physics behind ultrafast time-gated optical techniques is discussed briefly. A typical setup of a Kerr-Fourier time gating system is presented.

Microfluidic pressure amplifier circuits and electrostatic gates for pneumatic microsystems

DOEpatents

Tice, Joshua D.; Bassett, Thomas A.; Desai, Amit V.; Apblett, Christopher A.; Kenis, Paul J. A.

2016-09-20

An electrostatic actuator is provide that can include a fluidic line, a first electrode, and a second electrode such that a gate chamber portion of the fluidic line is sandwiched between the first electrode and the second electrode. The electrostatic actuator can also include a pressure-balancing channel in fluid communication with the gate chamber portion where the first electrode is sandwiched between the pressure-balancing channel and the gate chamber portion. A pneumatic valve system is provided which includes an electrostatic gate and a fluidic channel fluidly separate from a fluidic control line. A pneumatic valve portion of the fluidic control line can be positioned relative to a portion of the fluidic channel such that expansion of the pneumatic valve portion restricts fluid flow through the fluidic channel. Methods of using an electrostatic actuator and a pneumatic valve system are also provided.

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

Ngo, Anh T.; Kim, Eugene H.; Ulloa, Sergio E.

Single-atom gating, achieved by manipulation of adatoms on a surface, has been shown in experiments to allow precise control over superposition of electronic states in quantum corrals. Using a Green's function approach, we demonstrate theoretically that such atom gating can also be used to control the coupling between magnetic degrees of freedom in these systems. Atomic gating enables control not only on the direct interaction between magnetic adatoms, but also over superpositions of many-body states which can then control long distance interactions. We illustrate this effect by considering the competition between direct exchange between magnetic impurities and the Kondo screeningmore » mediated by the host electrons, and how this is affected by gating. These results suggest that both magnetic and nonmagnetic single-atom gating may be used to investigate magnetic impurity systems with tailored interactions, and may allow the control of entanglement of different spin states.« less

Efficient Nonlocal M-Control and N-Target Controlled Unitary Gate Using Non-symmetric GHZ States

NASA Astrophysics Data System (ADS)

Chen, Li-Bing; Lu, Hong

2018-03-01

Efficient local implementation of a nonlocal M-control and N-target controlled unitary gate is considered. We first show that with the assistance of two non-symmetric qubit(1)-qutrit(N) Greenberger-Horne-Zeilinger (GHZ) states, a nonlocal 2-control and N-target controlled unitary gate can be constructed from 2 local two-qubit CNOT gates, 2 N local two-qutrit conditional SWAP gates, N local qutrit-qubit controlled unitary gates, and 2 N single-qutrit gates. At each target node, the two third levels of the two GHZ target qutrits are used to expose one and only one initial computational state to the local qutrit-qubit controlled unitary gate, instead of being used to hide certain states from the conditional dynamics. This scheme can be generalized straightforwardly to implement a higher-order nonlocal M-control and N-target controlled unitary gate by using M non-symmetric qubit(1)-qutrit(N) GHZ states as quantum channels. Neither the number of the additional levels of each GHZ target particle nor that of single-qutrit gates needs to increase with M. For certain realistic physical systems, the total gate time may be reduced compared with that required in previous schemes.

Applicability of the NANDA-I and Nursing Interventions Classification taxonomies to mental health nursing practice.

PubMed

Thomé, Emi da Silva; Centena, Renata Cardoso; Behenck, Andressa da Silva; Marini, Maiko; Heldt, Elizeth

2014-10-01

To assess the applicability of the systematization of nursing care (NCS) to outpatient nursing appointments using the NANDA-I and Nursing Interventions Classification (NIC) taxonomies. Data were collected from 40 patients who had appointments with a nurse who specialized in mental health. Nursing diagnoses (NDs) and interventions were classified using the NANDA-I and NIC taxonomies, respectively. A total of 14 different NDs were detected (minimum of one and maximum of three per appointment). The most frequently made diagnoses were impaired social interaction (00052), anxiety (00146), and ineffective self-health management (00078). A total of 23 nursing interventions were prescribed (approximately two per appointment), of which the most frequent were socialization enhancement (5100), self-care assistance (1800), and exercise promotion (0200). Significant associations were found between the most frequently detected NDs and the most commonly prescribed interventions (p > .05). The NCS through the use of classification systems allows mental health nurses to better identify and assist poorly adjusted patients. The assessment of the applicability of the NCS to different areas of health care and types of medical assistance contributes significantly to the quality of nursing care. © 2014 NANDA International, Inc.

Advanced access: reducing waiting and delays in primary care.

PubMed

Murray, Mark; Berwick, Donald M

2003-02-26

Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support.

Water gate array for current flow or tidal movement pneumatic harnessing system

DOEpatents

Gorlov, Alexander M.

1991-01-01

The invention, which provides a system for harnessing power from current flow or tidal movement in a body of water, comprises first and second hydro-pneumatic chambers each having ingress and egress below the water surface near the river or ocean floor and water gates operative to open or seal the ports to the passage of water. In an exemplary embodiment, the gates are sychronized by shafts so that the ingress ports of each chamber are connected to the egress ports of each other chamber. Thus, one set of gates is closed, while the other is open, thereby allowing water to flow into one chamber and build air pressure therein and allowing water to flow out of the other chamber and create a partial vacuum therein. A pipe connects the chambers, and an air turbine harnesses the air movement within the pipe. When water levels are equilibrated, the open set of gates is closed by a counterweight, and the other set is allowed to open by natural force of the water differential. The water gates may be comprised of a plurality of louvers which are ganged for simultaneous opening and closing. The system is designed to operate with air turbines or other pneumatic devices. Its design minimizes construction cost and environmental impact, yet provides a clean renewable energy source.

76 FR 66332 - Appointments to Performance Review Boards for Senior Executive Service

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0249] Appointments to Performance Review Boards for Senior Executive Service AGENCY: U.S. Nuclear Regulatory Commission. ACTION: Appointment to Performance Review... the following appointments to the NRC Performance Review Boards. The following individuals are...

Treatment dropout and missed appointments among adults with attention-deficit/hyperactivity disorder: associations with patient- and disorder-related factors.

PubMed

Soendergaard, Helle M; Thomsen, Per H; Pedersen, Pernille; Pedersen, Erik; Poulsen, Agnethe E; Nielsen, Jette M; Winther, Lars; Henriksen, Anne; Rungoe, Berit; Soegaard, Hans J

2016-02-01

Knowledge of factors associated with treatment dropout and missed appointments in adults with attention-deficit/hyperactivity disorder (ADHD) is very limited. On the basis of proposed hypotheses that past behavior patterns are more predictive of current behaviors of treatment dropout and missed appointments than are sociodemographic and clinical characteristics, we examined the associations of sociodemographic variables, clinical variables, risk-taking behavior, educational and occupational instability, and behaviors during mandatory schooling with the primary outcome measures of treatment dropout and missed appointments. In a naturalistic cohort study of 151 adult outpatients with ADHD initiating assessment in a Danish ADHD unit from September 1, 2010, to September 1, 2011, the Adult ADHD Self-Report Scale v1.1 symptom checklist (ASRS) and a thorough clinical interview were used to assess ADHD according to DSM-IV-TR criteria. Stepwise logistic regression analysis was used to estimate reported associations. A total of 27% of patients dropped out of treatment and a total of 42% had ≥ 3 missed appointments during treatment. Mood and anxiety disorders significantly lowered the odds of treatment dropout (odds ratio [OR] = 0.18; 95% confidence interval [CI], 0.05-0.65), whereas having started but not completed 2 or more educational programs apart from mandatory schooling significantly increased the odds of dropout (OR = 3.01; 95% CI, 1.32-6.89). Variables significantly associated with most missed appointments were low educational level (OR = 2.19; 95% CI, 1.12-4.31), 3 or more employments of less than 3 months' duration (OR = 2.86; 95% CI, 1.30-6.28), and having skipped class often/very often during mandatory schooling (OR = 2.65; 95% CI, 1.29-5.43). Additionally, the predominantly inattentive ADHD (ADHD-I) subtype lowered the odds of missed appointments (OR = 0.17; 95% CI, 0.05-0.62). Our results suggest that past behavior in terms of highest dropout rates in the educational and occupational systems and highest rates of skipping class during mandatory schooling is equally associated with current behavior of treatment dropout and missed appointments as are sociodemographic and clinical factors. ClinicalTrials.gov identifier: NCT02226445. © Copyright 2015 Physicians Postgraduate Press, Inc.

Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance.

PubMed

Lu, Jimmy C; Lowery, Ray; Yu, Sunkyung; Ghadimi Mahani, Maryam; Agarwal, Prachi P; Dorfman, Adam L

2017-07-01

Congenital cardiac magnetic resonance is a limited resource because of scanner and physician availability. Missed appointments decrease scheduling efficiency, have financial implications and represent missed care opportunities. To characterize the rate of missed appointments and identify modifiable predictors. This single-center retrospective study included all patients with outpatient congenital or pediatric cardiac MR appointments from Jan. 1, 2014, through Dec. 31, 2015. We identified missed appointments (no-shows or same-day cancellations) from the electronic medical record. We obtained demographic and clinical factors from the medical record and assessed socioeconomic factors by U.S. Census block data by patient ZIP code. Statistically significant variables (P<0.05) were included into a multivariable analysis. Of 795 outpatients (median age 18.5 years, interquartile range 13.4-27.1 years) referred for congenital cardiac MR, a total of 91 patients (11.4%) missed appointments; 28 (3.5%) missed multiple appointments. Reason for missed appointment could be identified in only 38 patients (42%), but of these, 28 (74%) were preventable or could have been identified prior to the appointment. In multivariable analysis, independent predictors of missed appointments were referral by a non-cardiologist (adjusted odds ratio [AOR] 5.8, P=0.0002), referral for research (AOR 3.6, P=0.01), having public insurance (AOR 2.1, P=0.004), and having scheduled cardiac MR from November to April (AOR 1.8, P=0.01). Demographic factors can identify patients at higher risk for missing appointments. These data may inform initiatives to limit missed appointments, such as targeted education of referring providers and patients. Further data are needed to evaluate the efficacy of potential interventions.

Model-based restoration using light vein for range-gated imaging systems.

PubMed

Wang, Canjin; Sun, Tao; Wang, Tingfeng; Wang, Rui; Guo, Jin; Tian, Yuzhen

2016-09-10

The images captured by an airborne range-gated imaging system are degraded by many factors, such as light scattering, noise, defocus of the optical system, atmospheric disturbances, platform vibrations, and so on. The characteristics of low illumination, few details, and high noise make the state-of-the-art restoration method fail. In this paper, we present a restoration method especially for range-gated imaging systems. The degradation process is divided into two parts: the static part and the dynamic part. For the static part, we establish the physical model of the imaging system according to the laser transmission theory, and estimate the static point spread function (PSF). For the dynamic part, a so-called light vein feature extraction method is presented to estimate the fuzzy parameter of the atmospheric disturbance and platform movement, which make contributions to the dynamic PSF. Finally, combined with the static and dynamic PSF, an iterative updating framework is used to restore the image. Compared with the state-of-the-art methods, the proposed method can effectively suppress ringing artifacts and achieve better performance in a range-gated imaging system.

U.S. Army Contracting CommandRock Island Needs to Improve Contracting Officers Representative Training and Appointment for Contingency Contracts

DTIC Science & Technology

2015-07-10

PCO Did Not Properly Appoint and Train CORs ____________________________________________ 12 PCO Did Not Delegate COR Appointment Authority and...the ACC–RI procuring contracting officer ( PCO ) did not appoint CORs in accordance with DoD requirements. Specifically, the PCO did not... PCO did not include COR appointment authority in the ACO delegation letter as she intended. As a result, ACC–RI officials did not ensure qualified

Getting more out of biomedical documents with GATE's full lifecycle open source text analytics.

PubMed

Cunningham, Hamish; Tablan, Valentin; Roberts, Angus; Bontcheva, Kalina

2013-01-01

This software article describes the GATE family of open source text analysis tools and processes. GATE is one of the most widely used systems of its type with yearly download rates of tens of thousands and many active users in both academic and industrial contexts. In this paper we report three examples of GATE-based systems operating in the life sciences and in medicine. First, in genome-wide association studies which have contributed to discovery of a head and neck cancer mutation association. Second, medical records analysis which has significantly increased the statistical power of treatment/outcome models in the UK's largest psychiatric patient cohort. Third, richer constructs in drug-related searching. We also explore the ways in which the GATE family supports the various stages of the lifecycle present in our examples. We conclude that the deployment of text mining for document abstraction or rich search and navigation is best thought of as a process, and that with the right computational tools and data collection strategies this process can be made defined and repeatable. The GATE research programme is now 20 years old and has grown from its roots as a specialist development tool for text processing to become a rather comprehensive ecosystem, bringing together software developers, language engineers and research staff from diverse fields. GATE now has a strong claim to cover a uniquely wide range of the lifecycle of text analysis systems. It forms a focal point for the integration and reuse of advances that have been made by many people (the majority outside of the authors' own group) who work in text processing for biomedicine and other areas. GATE is available online <1> under GNU open source licences and runs on all major operating systems. Support is available from an active user and developer community and also on a commercial basis.

Getting More Out of Biomedical Documents with GATE's Full Lifecycle Open Source Text Analytics

PubMed Central

Cunningham, Hamish; Tablan, Valentin; Roberts, Angus; Bontcheva, Kalina

2013-01-01

This software article describes the GATE family of open source text analysis tools and processes. GATE is one of the most widely used systems of its type with yearly download rates of tens of thousands and many active users in both academic and industrial contexts. In this paper we report three examples of GATE-based systems operating in the life sciences and in medicine. First, in genome-wide association studies which have contributed to discovery of a head and neck cancer mutation association. Second, medical records analysis which has significantly increased the statistical power of treatment/outcome models in the UK's largest psychiatric patient cohort. Third, richer constructs in drug-related searching. We also explore the ways in which the GATE family supports the various stages of the lifecycle present in our examples. We conclude that the deployment of text mining for document abstraction or rich search and navigation is best thought of as a process, and that with the right computational tools and data collection strategies this process can be made defined and repeatable. The GATE research programme is now 20 years old and has grown from its roots as a specialist development tool for text processing to become a rather comprehensive ecosystem, bringing together software developers, language engineers and research staff from diverse fields. GATE now has a strong claim to cover a uniquely wide range of the lifecycle of text analysis systems. It forms a focal point for the integration and reuse of advances that have been made by many people (the majority outside of the authors' own group) who work in text processing for biomedicine and other areas. GATE is available online <1> under GNU open source licences and runs on all major operating systems. Support is available from an active user and developer community and also on a commercial basis. PMID:23408875

[HIV infection and syphilis prevalence among men who have sex with men receiving voluntary counseling and testing appointed through a web-based registering system and related factors].

PubMed

Wu, Qiongmiao; Cheng, Weibin; Zhong, Fei; Xu, Huifang; Liu, Qi; Lin, Peng

2015-05-01

To understand the human immunodeficiency virus (HIV) infection status and syphilis prevalence among men who have sex with men (MSM) receiving voluntary counseling and testing appointed through a web-based registering system and related factors. The MSM receiving web appointed HIV counseling and testing from 2011 to 2012 in Guangzhou were recruited and a questionnaire survey was conduct among them to obtain the information about their demographic characteristics and sexual behavior. Binary and multivariate logistic regression model were used to identify the factors associated with HIV infection or syphilis prevalence. A total of 4,904 MSM were enrolled in the study, the average age of the MSM was (28.77±7.24) years, and 70.3% of them had high education level; the unmarried MSM accounted for 72.7%. The HIV infection rate and syphilis prevalence were 8.7% and 4.4% respectively. The co-infection rate of HIV and Treponema pallidum was 1.2% (59/4 904). About one in three MSM did not use condom at latest homosexual behavior, 43.5% did not use condoms at each homosexual behavior in the past three months. Lower education level, occupation (worker or farmer), non-consistent condom use at each sex with men in the past three months, receiving HIV test or not and Treponema pallidum infection were associated with HIV infection. Age≥40 years, lower education level, multi male sex partners in the past three months and HIV infection were associated with Treponema pallidum infection. MSM receiving web appointed HIV counseling and testing had high prevalence of risk behaviors and high HIV infection rate, but had low previous HIV testing rate. It is necessary to strengthen the promotion of HIV test through web based appointment and conduct target behavior intervention in older MSM with lower education level.

A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance.

PubMed

Hung, Susanna Lok Lam; Fu, Sau Nga; Lau, Po Shan; Wong, Samuel Yeung Shan

2015-01-31

This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer patients to the appropriate multidisciplinary team in public outpatient primary care setting. We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged ≥ 60 who failed to attend the nurse-led case manager clinic were interviewed. They all came from a socially deprived urban district in Hong Kong. Content and thematic analysis was performed. Seven men and twelve women aged 60 to 89 were interviewed. Nine of them received no formal education and ten of them attended up to primary school. The reasons for non-attendance included attitude and poor knowledge towards diabetes complication screening and confusion of the nurse-led clinic as an educational talk. Most respondents could not understand the reason for the screening of diabetic complications, the concept of multidisciplinary care and the procedure and outcomes of nurse assessment. Five respondents were unable to follow multiple appointments because they could not read. Other reasons included physical barriers and comorbidity, family and financial constraint. They either had a tight daily schedule because of the need to take care of family members, or the family members who brought them to clinic had difficulty in attending multiple appointments. Enhanced understanding of the importance and procedure of diabetes multidisciplinary management, a flexible appointment system and a single clear appointment sheet may facilitate their attendance. Poorly-educated Chinese elderly with DM and their care givers faced physical, social and psychological barriers when attending the nurse-led case manager clinic. Strategies targeting on their low literacy include effective communication and education by health care professionals to arrive a shared understanding of care plan as well as a flexible appointment and schedule system.

Appointment attendance at a remote rural dental training facility in Australia.

PubMed

Lalloo, Ratilal; McDonald, Jenny M

2013-08-02

Non-attended appointments have impacts on the operations of dental clinics. These impacts vary from lost productivity, loss of income and loss of clinical teaching hours. Appointment data were analysed to assess the percentage of completed, failed to attend (FTA) and cancelled appointments at an Australian remote rural student dental clinic training facility. The demographic and time characteristics of FTA and cancelled appointments were analysed using simple and multivariate multinomial regression analysis, to inform interventions that may be necessary. Over the 2-year study period a total of 3,042 appointments were made. The percentage of FTA was 21.3% (N = 648) and cancelled appointments 13.7% (N = 418). The odds of an FTA were in excess of 4 times higher in patients aged 19-25 years (OR = 4.1; 95% CI = 2.3-7.3) and 26-35 years (OR = 4.4; 95% CI = 2.5-7.9) compared to patients 65 years and older. The odds of an FTA was 2.3 (95% CI = 1.8-3.1) times higher in public patients compared to private patients. The odds of a cancellation was 1.7 (95% CI = 1.1-2.6) times higher on a Friday compared to a Monday and 1.8 (95% CI = 1.1-2.9) times higher on the last appointment of the day compared to the first appointment. For cancelled appointments, 71.3% were cancelled on the day of the appointment and 16.6% on the day before. Non-attended appointments (FTA or cancelled) were common at this remote rural dental clinic training facility. Efforts to reduce these need to be implemented; including telephonic reminders, educating the community on the importance of attending their appointments, block booking school children and double booking or arranging alternative activities for the students at times when non-attendance is common.

32 CFR 154.15 - Military appointment, enlistment, and induction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Military appointment, enlistment, and induction... Requirements § 154.15 Military appointment, enlistment, and induction. (a) General. The appointment, enlistment... tendered to immigrant alien health professionals, chaplains, and attorneys. (e) Mobilization of military...

Super-resolution depth information from a short-wave infrared laser gated-viewing system by using correlated double sampling

NASA Astrophysics Data System (ADS)

Göhler, Benjamin; Lutzmann, Peter

2017-10-01

Primarily, a laser gated-viewing (GV) system provides range-gated 2D images without any range resolution within the range gate. By combining two GV images with slightly different gate positions, 3D information within a part of the range gate can be obtained. The depth resolution is higher (super-resolution) than the minimal gate shift step size in a tomographic sequence of the scene. For a state-of-the-art system with a typical frame rate of 20 Hz, the time difference between the two required GV images is 50 ms which may be too long in a dynamic scenario with moving objects. Therefore, we have applied this approach to the reset and signal level images of a new short-wave infrared (SWIR) GV camera whose read-out integrated circuit supports correlated double sampling (CDS) actually intended for the reduction of kTC noise (reset noise). These images are extracted from only one single laser pulse with a marginal time difference in between. The SWIR GV camera consists of 640 x 512 avalanche photodiodes based on mercury cadmium telluride with a pixel pitch of 15 μm. A Q-switched, flash lamp pumped solid-state laser with 1.57 μm wavelength (OPO), 52 mJ pulse energy after beam shaping, 7 ns pulse length and 20 Hz pulse repetition frequency is used for flash illumination. In this paper, the experimental set-up is described and the operating principle of CDS is explained. The method of deriving super-resolution depth information from a GV system by using CDS is introduced and optimized. Further, the range accuracy is estimated from measured image data.

Liquid-based gating mechanism with tunable multiphase selectivity and antifouling behaviour

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

Hou, X; Hu, YH; Grinthal, A

Living organisms make extensive use of micro- and nanometre-sized pores as gatekeepers for controlling the movement of fluids, vapours and solids between complex environments. The ability of such pores to coordinate multiphase transport, in a highly selective and subtly triggered fashion and without clogging, has inspired interest in synthetic gated pores for applications ranging from fluid processing to 3D printing and lab-on-chip systems(1-10). But although specific gating and transport behaviours have been realized by precisely tailoring pore surface chemistries and pore geometries(6,11-17), a single system capable of controlling complex, selective multiphase transport has remained a distant prospect, and fouling ismore » nearly inevitable(11,12). Here we introduce a gating mechanism that uses a capillary-stabilized liquid as a reversible, reconfigurable gate that fills and seals pores in the closed state, and creates a non-fouling, liquid-lined pore in the open state. Theoretical modelling and experiments demonstrate that for each transport substance, the gating threshold-the pressure needed to open the pores-can be rationally tuned over a wide pressure range. This enables us to realize in one system differential response profiles for a variety of liquids and gases, even letting liquids flow through the pore while preventing gas from escaping. These capabilities allow us to dynamically modulate gas-liquid sorting in a microfluidic flow and to separate a three-phase air-water-oil mixture, with the liquid lining ensuring sustained antifouling behaviour. Because the liquid gating strategy enables efficient long-term operation and can be applied to a variety of pore structures and membrane materials, and to micro- as well as macroscale fluid systems, we expect it to prove useful in a wide range of applications.« less

Liquid-based gating mechanism with tunable multiphase selectivity and antifouling behaviour

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

Hou, Xu; Hu, Yuhang; Grinthal, Alison

Living organisms make extensive use of micro- and nanometre-sized pores as gatekeepers for controlling the movement of fluids, vapours and solids between complex environments. In addition, the ability of such pores to coordinate multiphase transport, in a highly selective and subtly triggered fashion and without clogging, has inspired interest in synthetic gated pores for applications ranging from fluid processing to 3D printing and lab-on-chip systems 1-10.But although specific gating and transport behaviours have been realized by precisely tailoring pore surface chemistries and pore geometries 6,11–17, a single system capable of controlling complex, selective multiphase transport has remained a distant prospect,more » and fouling is nearly inevitable.Here we introduce a gating mechanism that uses a capillary-stabilized liquid as a reversible, reconfigurable gate that fills and seals pores in the closed state, and creates a non-fouling, liquid-lined pore in the open state.Theoretical modelling and experiments demonstrate that for each transport substance, the gating threshold—the pressure needed to open the pores—can be rationally tuned over a wide pressure range. This enables us to realize in one system differential response profiles for a variety of liquids and gases, even letting liquids flow through the pore while preventing gas from escaping.These capabilities allow us to dynamically modulate gas–liquid sorting in a microfluidic flow and to separate a three-phase air water–oil mixture, with the liquid lining ensuring sustained antifouling behaviour. Because the liquid gating strategy enables efficient long-term operation and can be applied to a variety of pore structures and membrane materials, and to micro- as well as macroscale fluid systems, we expect it to prove useful in a wide range of applications.« less

Liquid-based gating mechanism with tunable multiphase selectivity and antifouling behaviour

NASA Astrophysics Data System (ADS)

Hou, Xu; Hu, Yuhang; Grinthal, Alison; Khan, Mughees; Aizenberg, Joanna

2015-03-01

Living organisms make extensive use of micro- and nanometre-sized pores as gatekeepers for controlling the movement of fluids, vapours and solids between complex environments. The ability of such pores to coordinate multiphase transport, in a highly selective and subtly triggered fashion and without clogging, has inspired interest in synthetic gated pores for applications ranging from fluid processing to 3D printing and lab-on-chip systems. But although specific gating and transport behaviours have been realized by precisely tailoring pore surface chemistries and pore geometries, a single system capable of controlling complex, selective multiphase transport has remained a distant prospect, and fouling is nearly inevitable. Here we introduce a gating mechanism that uses a capillary-stabilized liquid as a reversible, reconfigurable gate that fills and seals pores in the closed state, and creates a non-fouling, liquid-lined pore in the open state. Theoretical modelling and experiments demonstrate that for each transport substance, the gating threshold--the pressure needed to open the pores--can be rationally tuned over a wide pressure range. This enables us to realize in one system differential response profiles for a variety of liquids and gases, even letting liquids flow through the pore while preventing gas from escaping. These capabilities allow us to dynamically modulate gas-liquid sorting in a microfluidic flow and to separate a three-phase air-water-oil mixture, with the liquid lining ensuring sustained antifouling behaviour. Because the liquid gating strategy enables efficient long-term operation and can be applied to a variety of pore structures and membrane materials, and to micro- as well as macroscale fluid systems, we expect it to prove useful in a wide range of applications.

Liquid-based gating mechanism with tunable multiphase selectivity and antifouling behaviour

DOE PAGES

Hou, Xu; Hu, Yuhang; Grinthal, Alison; ...

2015-03-04

Living organisms make extensive use of micro- and nanometre-sized pores as gatekeepers for controlling the movement of fluids, vapours and solids between complex environments. In addition, the ability of such pores to coordinate multiphase transport, in a highly selective and subtly triggered fashion and without clogging, has inspired interest in synthetic gated pores for applications ranging from fluid processing to 3D printing and lab-on-chip systems 1-10.But although specific gating and transport behaviours have been realized by precisely tailoring pore surface chemistries and pore geometries 6,11–17, a single system capable of controlling complex, selective multiphase transport has remained a distant prospect,more » and fouling is nearly inevitable.Here we introduce a gating mechanism that uses a capillary-stabilized liquid as a reversible, reconfigurable gate that fills and seals pores in the closed state, and creates a non-fouling, liquid-lined pore in the open state.Theoretical modelling and experiments demonstrate that for each transport substance, the gating threshold—the pressure needed to open the pores—can be rationally tuned over a wide pressure range. This enables us to realize in one system differential response profiles for a variety of liquids and gases, even letting liquids flow through the pore while preventing gas from escaping.These capabilities allow us to dynamically modulate gas–liquid sorting in a microfluidic flow and to separate a three-phase air water–oil mixture, with the liquid lining ensuring sustained antifouling behaviour. Because the liquid gating strategy enables efficient long-term operation and can be applied to a variety of pore structures and membrane materials, and to micro- as well as macroscale fluid systems, we expect it to prove useful in a wide range of applications.« less

Liquid-based gating mechanism with tunable multiphase selectivity and antifouling behaviour.

PubMed

Hou, Xu; Hu, Yuhang; Grinthal, Alison; Khan, Mughees; Aizenberg, Joanna

2015-03-05

Living organisms make extensive use of micro- and nanometre-sized pores as gatekeepers for controlling the movement of fluids, vapours and solids between complex environments. The ability of such pores to coordinate multiphase transport, in a highly selective and subtly triggered fashion and without clogging, has inspired interest in synthetic gated pores for applications ranging from fluid processing to 3D printing and lab-on-chip systems. But although specific gating and transport behaviours have been realized by precisely tailoring pore surface chemistries and pore geometries, a single system capable of controlling complex, selective multiphase transport has remained a distant prospect, and fouling is nearly inevitable. Here we introduce a gating mechanism that uses a capillary-stabilized liquid as a reversible, reconfigurable gate that fills and seals pores in the closed state, and creates a non-fouling, liquid-lined pore in the open state. Theoretical modelling and experiments demonstrate that for each transport substance, the gating threshold-the pressure needed to open the pores-can be rationally tuned over a wide pressure range. This enables us to realize in one system differential response profiles for a variety of liquids and gases, even letting liquids flow through the pore while preventing gas from escaping. These capabilities allow us to dynamically modulate gas-liquid sorting in a microfluidic flow and to separate a three-phase air-water-oil mixture, with the liquid lining ensuring sustained antifouling behaviour. Because the liquid gating strategy enables efficient long-term operation and can be applied to a variety of pore structures and membrane materials, and to micro- as well as macroscale fluid systems, we expect it to prove useful in a wide range of applications.

44 CFR 208.11 - Federal status of System Members.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Federal status of System..., DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE NATIONAL URBAN SEARCH AND RESCUE RESPONSE SYSTEM General § 208.11 Federal status of System Members. The Assistant Administrator will appoint all Activated System...

44 CFR 208.11 - Federal status of System Members.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Federal status of System..., DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE NATIONAL URBAN SEARCH AND RESCUE RESPONSE SYSTEM General § 208.11 Federal status of System Members. The Assistant Administrator will appoint all Activated System...

44 CFR 208.11 - Federal status of System Members.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Federal status of System..., DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE NATIONAL URBAN SEARCH AND RESCUE RESPONSE SYSTEM General § 208.11 Federal status of System Members. The Assistant Administrator will appoint all Activated System...

44 CFR 208.11 - Federal status of System Members.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Federal status of System..., DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE NATIONAL URBAN SEARCH AND RESCUE RESPONSE SYSTEM General § 208.11 Federal status of System Members. The Assistant Administrator will appoint all Activated System...

44 CFR 208.11 - Federal status of System Members.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Federal status of System..., DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE NATIONAL URBAN SEARCH AND RESCUE RESPONSE SYSTEM General § 208.11 Federal status of System Members. The Assistant Administrator will appoint all Activated System...

38 CFR 17.100 - Refusal of treatment by unnecessarily breaking appointments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and satisfactory reasons are advanced for breaking the appointment and circumstances were such that... unnecessarily breaking appointments. 17.100 Section 17.100 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Breaking Appointments § 17.100 Refusal of treatment by unnecessarily breaking...

Rules of Appointment at Franklin Pierce College.

ERIC Educational Resources Information Center

Franklyn Pierce Coll., Rindge, NH.

This memorandum sets forth the regulations and procedures affecting appointments to the instructional faculty of Franklin Pierce College. Part A: General Provisions, includes information on faculty ranks, the procedure of appointment, the regular review, and normal retirement. Part B deals with the terms and conditions of appointment, including…

5 CFR 930.204 - Appointments and conditions of employment.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... 930.204 Section 930.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL...) Administrative Law Judge Program § 930.204 Appointments and conditions of employment. (a) Appointment. An agency may appoint an individual to an administrative law judge position only with prior approval of OPM...

5 CFR 930.204 - Appointments and conditions of employment.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... 930.204 Section 930.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL...) Administrative Law Judge Program § 930.204 Appointments and conditions of employment. (a) Appointment. An agency may appoint an individual to an administrative law judge position only with prior approval of OPM...

5 CFR 315.705 - Employees serving under transitional or veterans recruitment appointments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... veterans recruitment appointments. 315.705 Section 315.705 Administrative Personnel OFFICE OF PERSONNEL... veterans recruitment appointments. (a) Agency action. (1) An agency shall convert the employment of an... substantially continuous service under a veterans recruitment appointment or under a combination of transitional...

SU-G-JeP1-08: Dual Modality Verification for Respiratory Gating Using New Real- Time Tumor Tracking Radiotherapy System

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

Shiinoki, T; Hanazawa, H; Shibuya, K

Purpose: The respirato ry gating system combined the TrueBeam and a new real-time tumor-tracking radiotherapy system (RTRT) was installed. The RTRT system consists of two x-ray tubes and color image intensifiers. Using fluoroscopic images, the fiducial marker which was implanted near the tumor was tracked and was used as the internal surrogate for respiratory gating. The purposes of this study was to develop the verification technique of the respiratory gating with the new RTRT using cine electronic portal image device images (EPIDs) of TrueBeam and log files of the RTRT. Methods: A patient who underwent respiratory gated SBRT of themore » lung using the RTRT were enrolled in this study. For a patient, the log files of three-dimensional coordinate of fiducial marker used as an internal surrogate were acquired using the RTRT. Simultaneously, the cine EPIDs were acquired during respiratory gated radiotherapy. The data acquisition was performed for one field at five sessions during the course of SBRT. The residual motion errors were calculated using the log files (E{sub log}). The fiducial marker used as an internal surrogate into the cine EPIDs was automatically extracted by in-house software based on the template-matching algorithm. The differences between the the marker positions of cine EPIDs and digitally reconstructed radiograph were calculated (E{sub EPID}). Results: Marker detection on EPID using in-house software was influenced by low image contrast. For one field during the course of SBRT, the respiratory gating using the RTRT showed the mean ± S.D. of 95{sup th} percentile E{sub EPID} were 1.3 ± 0.3 mm,1.1 ± 0.5 mm,and those of E{sub log} were 1.5 ± 0.2 mm, 1.1 ± 0.2 mm in LR and SI directions, respectively. Conclusion: We have developed the verification method of respiratory gating combined TrueBeam and new real-time tumor-tracking radiotherapy system using EPIDs and log files.« less

JPRS Report, China, State Council Bulletin, Number 30, 30 November 1986; Number 31, 10 December 1986

DTIC Science & Technology

1987-07-02

avoidance of double taxation and other agreements relating to taxation ; and (3) Benefits accorded by either contracting party to investors of a third...8) "Nationals of the appointing country" means the natural and juridical persons of the appointing country; (9) "Vessels of the appointing country...appointing country or by natural or juridical persons representing the appointing country for any of the special purposes mentioned in Article 9, as

Reading Gate Positions with a Smartphone

NASA Astrophysics Data System (ADS)

van Overloop, Peter-Jules; Hut, Rolf

2015-04-01

Worldwide many flow gates are built in water networks in order to direct water to appropriate locations. Most of these gates are adjusted manually by field operators of water management organizations and it is often centrally not known what the new position of the gate is. This makes centralized management of the entire water network difficult. One of the reasons why the measurement of the gate position is usually not executed, is that for certain gates it is not easy to do such a reading. Tilting weirs or radial gates are examples where operators need special equipment (measuring rod and long level) to determine the position and it could even be a risky procedure. Another issue is that once the measurement is done, the value is jotted down in a notebook and later, at the office, entered in a computer system. So the entire monitoring procedure is not real-time and prone to human errors. A new way of monitoring gate positions is introduced. It consists of a level that is attached to the gate and an app with which a picture can be taken from the level. Using dedicated pattern recognition algorithms, the gate position can be read by using the angle of the level versus reference points on the gate, the radius of that gate and the absolute level of the joint around which the gate turn. The method uses gps-localization of the smartphone to store the gate position in the right location in the central database.

Automated detection of follow-up appointments using text mining of discharge records.

PubMed

Ruud, Kari L; Johnson, Matthew G; Liesinger, Juliette T; Grafft, Carrie A; Naessens, James M

2010-06-01

To determine whether text mining can accurately detect specific follow-up appointment criteria in free-text hospital discharge records. Cross-sectional study. Mayo Clinic Rochester hospitals. Inpatients discharged from general medicine services in 2006 (n = 6481). Textual hospital dismissal summaries were manually reviewed to determine whether the records contained specific follow-up appointment arrangement elements: date, time and either physician or location for an appointment. The data set was evaluated for the same criteria using SAS Text Miner software. The two assessments were compared to determine the accuracy of text mining for detecting records containing follow-up appointment arrangements. Agreement of text-mined appointment findings with gold standard (manual abstraction) including sensitivity, specificity, positive predictive and negative predictive values (PPV and NPV). About 55.2% (3576) of discharge records contained all criteria for follow-up appointment arrangements according to the manual review, 3.2% (113) of which were missed through text mining. Text mining incorrectly identified 3.7% (107) follow-up appointments that were not considered valid through manual review. Therefore, the text mining analysis concurred with the manual review in 96.6% of the appointment findings. Overall sensitivity and specificity were 96.8 and 96.3%, respectively; and PPV and NPV were 97.0 and 96.1%, respectively. of individual appointment criteria resulted in accuracy rates of 93.5% for date, 97.4% for time, 97.5% for physician and 82.9% for location. Text mining of unstructured hospital dismissal summaries can accurately detect documentation of follow-up appointment arrangement elements, thus saving considerable resources for performance assessment and quality-related research.

Thermodynamics of quasideterministic digital computers

NASA Astrophysics Data System (ADS)

Chu, Dominique

2018-02-01

A central result of stochastic thermodynamics is that irreversible state transitions of Markovian systems entail a cost in terms of an infinite entropy production. A corollary of this is that strictly deterministic computation is not possible. Using a thermodynamically consistent model, we show that quasideterministic computation can be achieved at finite, and indeed modest cost with accuracies that are indistinguishable from deterministic behavior for all practical purposes. Concretely, we consider the entropy production of stochastic (Markovian) systems that behave like and and a not gates. Combinations of these gates can implement any logical function. We require that these gates return the correct result with a probability that is very close to 1, and additionally, that they do so within finite time. The central component of the model is a machine that can read and write binary tapes. We find that the error probability of the computation of these gates falls with the power of the system size, whereas the cost only increases linearly with the system size.

A Rout to Protect Quantum Gates constructed via quantum walks from Noises.

PubMed

Du, Yi-Mu; Lu, Li-Hua; Li, You-Quan

2018-05-08

The continuous-time quantum walk on a one-dimensional graph of odd number of sites with an on-site potential at the center is studied. We show that such a quantum-walk system can construct an X-gate of a single qubit as well as a control gate for two qubits, when the potential is much larger than the hopping strength. We investigate the decoherence effect and find that the coherence time can be enhanced by either increasing the number of sites on the graph or the ratio of the potential to the hopping strength, which is expected to motivate the design of the quantum gate with long coherence time. We also suggest several experimental proposals to realize such a system.

"Plug and play" logic gates based on fluorescence switching regulated by self-assembly of nucleotide and lanthanide ions.

PubMed

Pu, Fang; Ren, Jinsong; Qu, Xiaogang

2014-06-25

Molecular logic gates in response to chemical, biological, or optical input signals at a molecular level have received much interest over the past decade. Herein, we construct "plug and play" logic systems based on the fluorescence switching of guest molecules confined in coordination polymer nanoparticles generated from nucleotide and lanthanide ions. In the system, the addition of new modules directly enables new logic functions. PASS 0, YES, PASS 1, NOT, IMP, OR, and AND gates are successfully constructed in sequence. Moreover, different logic gates (AND, INH, and IMP) can be constructed using different guest molecules and the same input combinations. The work will be beneficial to the future logic design and expand the applications of coordination polymers.

5 CFR 316.402 - Procedures for making temporary appointments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... an individual who is qualified for the position and who is eligible for: (1) Reinstatement under... appointments. Such appointments are not VRA appointments and do not lead to conversion to career-conditional... any position for which the individual is qualified. Reappointment must be for a minimum of 120 days...

5 CFR 315.607 - Noncompetitive appointment of present and former Peace Corps personnel.

Code of Federal Regulations, 2011 CFR

2011-01-01

... this period. (c) Conditions. Any law, Executive order, or regulation which disqualifies an applicant for appointment in the competitive service also disqualifies an applicant for appointment under this section. (d) Acquisition of competitive status. A person appointed under paragraph (a) of this section...

5 CFR 930.204 - Appointments and conditions of employment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... served under 5 U.S.C. 3105, passed an OPM administrative law judge competitive examination, and meets the...) Administrative Law Judge Program § 930.204 Appointments and conditions of employment. (a) Appointment. An agency may appoint an individual to an administrative law judge position only with prior approval of OPM...

5 CFR 930.204 - Appointments and conditions of employment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... served under 5 U.S.C. 3105, passed an OPM administrative law judge competitive examination, and meets the...) Administrative Law Judge Program § 930.204 Appointments and conditions of employment. (a) Appointment. An agency may appoint an individual to an administrative law judge position only with prior approval of OPM...

5 CFR 315.607 - Noncompetitive appointment of present and former Peace Corps personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... this period. (c) Conditions. Any law, Executive order, or regulation which disqualifies an applicant for appointment in the competitive service also disqualifies an applicant for appointment under this section. (d) Acquisition of competitive status. A person appointed under paragraph (a) of this section...

5 CFR 531.211 - Setting pay for a newly appointed employee.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Setting pay for a newly appointed employee. 531.211 Section 531.211 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... Position Changes § 531.211 Setting pay for a newly appointed employee. (a) First appointment. An agency...

Lydia Finney appointed WIST program initiator - Argonne Today

Science.gov Websites

Home Mission People Work/Life Connections Focal Point Inside Argonne Argonne Public Website Argonne Today Argonne Today Mission People Work/Life Connections Focal Point Lydia Finney appointed WIST program initiator Home People Lydia Finney appointed WIST program initiator Lydia Finney appointed WIST

5 CFR 531.211 - Setting pay for a newly appointed employee.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Setting pay for a newly appointed employee. 531.211 Section 531.211 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... Position Changes § 531.211 Setting pay for a newly appointed employee. (a) First appointment. An agency...

SU-F-J-151: Evaluation of a Magnetic Resonance Image Gated Radiotherapy System Using a Motion Phantom and Radiochromic Film

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

Lamb, J; Ginn, J; O’Connell, D

Purpose: Magnetic resonance image (MRI) guided radiotherapy enables gating directly on target position for soft-tissue targets in the lung and abdomen. We present a dosimetric evaluation of a commercially-available FDA-approved MRI-guided radiotherapy system’s gating performance using a MRI-compatible respiratory motion phantom and radiochromic film. Methods: The MRI-compatible phantom was capable of one-dimensional motion. The phantom consisted of a target rod containing high-contrast target inserts which moved inside a body structure containing background contrast material. The target rod was equipped with a radiochromic film insert. Treatment plans were generated for a 3 cm diameter spherical target, and delivered to the phantommore » at rest and in motion with and without gating. Both sinusoidal and actual tumor trajectories (two free-breathing trajectories and one repeated-breath hold) were used. Gamma comparison at 5%/3mm was used to measure fidelity to the static target dose distribution. Results: Without gating, gamma pass rates were 24–47% depending on motion trajectory. Using our clinical standard of repeated breath holds and a gating window of 3 mm with 10% of the target allowed outside the gating boundary, the gamma pass rate was 99.6%. Relaxing the gating window to 5 mm resulted in gamma pass rate of 98.6% with repeated breath holds. For all motion trajectories gated with 3 mm margin and 10% allowed out, gamma pass rates were between 64–100% (mean:87.5%). For a 5 mm margin and 10% allowed out, gamma pass rates were between 57–98% (mean: 82.49%), significantly lower than for 3 mm by paired t-test (p=0.01). Conclusion: We validated the performance of respiratory gating based on real-time cine MRI images with the only FDA-approved MRI-guided radiotherapy system. Our results suggest that repeated breath hold gating should be used when possible for best accuracy. A 3 mm gating margin is statistically significantly more accurate than a 5 mm gating margin.« less

The development of an interim generalized gate logic software simulator

NASA Technical Reports Server (NTRS)

Mcgough, J. G.; Nemeroff, S.

1985-01-01

A proof-of-concept computer program called IGGLOSS (Interim Generalized Gate Logic Software Simulator) was developed and is discussed. The simulator engine was designed to perform stochastic estimation of self test coverage (fault-detection latency times) of digital computers or systems. A major attribute of the IGGLOSS is its high-speed simulation: 9.5 x 1,000,000 gates/cpu sec for nonfaulted circuits and 4.4 x 1,000,000 gates/cpu sec for faulted circuits on a VAX 11/780 host computer.

76 FR 20994 - Privacy Act of 1974; Deletion of an Existing System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

... for review at this location, by appointment, during regular business hours, Monday through Friday from... hospital space where the elderly Hansen's disease resident patients resided. The purpose of this System of...

A one-dimensional diffusion analogy model for estimation of tide heights in selected tidal marshes in Connecticut

USGS Publications Warehouse

Bjerklie, David M.; O’Brien, Kevin; Rozsa, Ron

2013-01-01

A one-dimensional diffusion analogy model for estimating tide heights in coastal marshes was developed and calibrated by using data from previous tidal-marsh studies. The method is simpler to use than other one- and two-dimensional hydrodynamic models because it does not require marsh depth and tidal prism information; however, the one-dimensional diffusion analogy model cannot be used to estimate tide heights, flow velocities, and tide arrival times for tide conditions other than the highest tide for which it is calibrated. Limited validation of the method indicates that it has an accuracy within 0.3 feet. The method can be applied with limited calibration information that is based entirely on remote sensing or geographic information system data layers. The method can be used to estimate high-tide heights in tidal wetlands drained by tide gates where tide levels cannot be observed directly by opening the gates without risk of flooding properties and structures. A geographic information system application of the method is demonstrated for Sybil Creek marsh in Branford, Connecticut. The tidal flux into this marsh is controlled by two tide gates that prevent full tidal inundation of the marsh. The method application shows reasonable tide heights for the gates-closed condition (the normal condition) and the one-gate-open condition on the basis of comparison with observed heights. The condition with all tide gates open (two gates) was simulated with the model; results indicate where several structures would be flooded if the gates were removed as part of restoration efforts or if the tide gates were to fail.

A gating grid driver for time projection chambers

NASA Astrophysics Data System (ADS)

Tangwancharoen, S.; Lynch, W. G.; Barney, J.; Estee, J.; Shane, R.; Tsang, M. B.; Zhang, Y.; Isobe, T.; Kurata-Nishimura, M.; Murakami, T.; Xiao, Z. G.; Zhang, Y. F.; SπRIT Collaboration

2017-05-01

A simple but novel driver system has been developed to operate the wire gating grid of a Time Projection Chamber (TPC). This system connects the wires of the gating grid to its driver via low impedance transmission lines. When the gating grid is open, all wires have the same voltage allowing drift electrons, produced by the ionization of the detector gas molecules, to pass through to the anode wires. When the grid is closed, the wires have alternating higher and lower voltages causing the drift electrons to terminate at the more positive wires. Rapid opening of the gating grid with low pickup noise is achieved by quickly shorting the positive and negative wires to attain the average bias potential with N-type and P-type MOSFET switches. The circuit analysis and simulation software SPICE shows that the driver restores the gating grid voltage to 90% of the opening voltage in less than 0.20 μs, for small values of the termination resistors. When tested in the experimental environment of a time projection chamber larger termination resistors were chosen so that the driver opens the gating grid in 0.35 μs. In each case, opening time is basically characterized by the RC constant given by the resistance of the switches and terminating resistors and the capacitance of the gating grid and its transmission line. By adding a second pair of N-type and P-type MOSFET switches, the gating grid is closed by restoring 99% of the original charges to the wires within 3 μs.

GRAMPS: An Automated Ambulatory Geriatric Record

PubMed Central

Hammond, Kenric W.; King, Carol A.; Date, Vishvanath V.; Prather, Robert J.; Loo, Lawrence; Siddiqui, Khwaja

1988-01-01

GRAMPS (Geriatric Record and Multidisciplinary Planning System) is an interactive MUMPS system developed for VA outpatient use. It allows physicians to effectively document care in problem-oriented format with structured narrative and free text, eliminating handwritten input. We evaluated the system in a one-year controlled cohort study. When the computer, was used, appointment times averaged 8.2 minutes longer (32.6 vs. 24.4 minutes) compared to control visits with the same physicians. Computer use was associated with better quality of care as measured in the management of a common problem, hypertension, as well as decreased overall costs of care. When a faster computer was installed, data entry times improved, suggesting that slower processing had accounted for a substantial portion of the observed difference in appointment lengths. The GRAMPS system was well-accepted by providers. The modular design used in GRAMPS has been extended to medical-care applications in Nursing and Mental Health.

Healthcare Information Technology Infrastructures in Turkey

PubMed Central

Yuksel, M.; Ertürkmen, G. L.; Kabak, Y.; Namli, T.; Yıldız, M. H.; Ay, Y.; Ceyhan, B.; Hülür, Ü.; Öztürk, H.; Atbakan, E.

2014-01-01

Summary Objectives The objective of this paper is to describe some of the major healthcare information technology (IT) infrastructures in Turkey, namely, Sağlık-Net (Turkish for “Health-Net”), the Centralized Hospital Appointment System, the Basic Health Statistics Module, the Core Resources Management System, and the e-prescription system of the Social Security Institution. International collaboration projects that are integrated with Sağlık-Net are also briefly summarized. Methods The authors provide a survey of the some of the major healthcare IT infrastructures in Turkey. Results Sağlık-Net has two main components: the National Health Information System (NHIS) and the Family Medicine Information System (FMIS). The NHIS is a nation-wide infrastructure for sharing patients’ Electronic Health Records (EHRs). So far, EHRs of 78.9 million people have been created in the NHIS. Similarly, family medicine is operational in the whole country via FMIS. Centralized Hospital Appointment System enables the citizens to easily make appointments in healthcare providers. Basic Health Statistics Module is used for collecting information about the health status, risks and indicators across the country. Core Resources Management System speeds up the flow of information between the headquarters and Provincial Health Directorates. The e-prescription system is linked with Sağlık-Net and seamlessly integrated with the healthcare provider information systems. Finally, Turkey is involved in several international projects for experience sharing and disseminating national developments. Conclusion With the introduction of the “Health Transformation Program” in 2003, a number of successful healthcare IT infrastructures have been developed in Turkey. Currently, work is going on to enhance and further improve their functionality. PMID:24853036

Deutsch, Toffoli, and cnot Gates via Rydberg Blockade of Neutral Atoms

NASA Astrophysics Data System (ADS)

Shi, Xiao-Feng

2018-05-01

Universal quantum gates and quantum error correction (QEC) lie at the heart of quantum-information science. Large-scale quantum computing depends on a universal set of quantum gates, in which some gates may be easily carried out, while others are restricted to certain physical systems. There is a unique three-qubit quantum gate called the Deutsch gate [D (θ )], from which a circuit can be constructed so that any feasible quantum computing is attainable. We design an easily realizable D (θ ) by using the Rydberg blockade of neutral atoms, where θ can be tuned to any value in [0 ,π ] by adjusting the strengths of external control fields. Using similar protocols, we further show that both the Toffoli and controlled-not gates can be achieved with only three laser pulses. The Toffoli gate, being universal for classical reversible computing, is also useful for QEC, which plays an important role in quantum communication and fault-tolerant quantum computation. The possibility and speed of realizing these gates shed light on the study of quantum information with neutral atoms.

GATE: software for the analysis and visualization of high-dimensional time series expression data.

PubMed

MacArthur, Ben D; Lachmann, Alexander; Lemischka, Ihor R; Ma'ayan, Avi

2010-01-01

We present Grid Analysis of Time series Expression (GATE), an integrated computational software platform for the analysis and visualization of high-dimensional biomolecular time series. GATE uses a correlation-based clustering algorithm to arrange molecular time series on a two-dimensional hexagonal array and dynamically colors individual hexagons according to the expression level of the molecular component to which they are assigned, to create animated movies of systems-level molecular regulatory dynamics. In order to infer potential regulatory control mechanisms from patterns of correlation, GATE also allows interactive interroga-tion of movies against a wide variety of prior knowledge datasets. GATE movies can be paused and are interactive, allowing users to reconstruct networks and perform functional enrichment analyses. Movies created with GATE can be saved in Flash format and can be inserted directly into PDF manuscript files as interactive figures. GATE is available for download and is free for academic use from http://amp.pharm.mssm.edu/maayan-lab/gate.htm

Quantitative Determination on Ionic-Liquid-Gating Control of Interfacial Magnetism

DOE PAGES

Zhao, Shishun; Zhou, Ziyao; Peng, Bin; ...

2017-03-03

Ionic-liquid gating on a functional thin film with a low voltage has drawn a lot of attention due to rich chemical, electronic, and magnetic phenomena at the interface. A key challenge in quantitative determination of voltage-controlled magnetic anisotropy (VCMA) in Au/[DEME] +[TFSI] -/Co field-effect transistor heterostructures is addressed. The magnetic anisotropy change as response to the gating voltage is precisely detected by in situ electron spin resonance measurements. Furthermore, a reversible change of magnetic anisotropy up to 219 Oe is achieved with a low gating voltage of 1.5 V at room temperature, corresponding to a record high VCMA coefficient ofmore » ≈146 Oe V -1. Two gating effects, the electrostatic doping and electrochemical reaction, are distinguished at various gating voltage regions, as confirmed by X-ray photoelectron spectroscopy and atomic force microscopy experiments. Our work shows a unique ionic-liquid-gating system for strong interfacial magnetoelectric coupling with many practical advantages, paving the way toward ion-liquid-gating spintronic/electronic devices.« less

ON states as resource units for universal quantum computation with photonic architectures

NASA Astrophysics Data System (ADS)

Sabapathy, Krishna Kumar; Weedbrook, Christian

2018-06-01

Universal quantum computation using photonic systems requires gates the Hamiltonians of which are of order greater than quadratic in the quadrature operators. We first review previous proposals to implement such gates, where specific non-Gaussian states are used as resources in conjunction with entangling gates such as the continuous-variable versions of controlled-phase and controlled-not gates. We then propose ON states which are superpositions of the vacuum and the N th Fock state, for use as non-Gaussian resource states. We show that ON states can be used to implement the cubic and higher-order quadrature phase gates to first order in gate strength. There are several advantages to this method such as reduced number of superpositions in the resource state preparation and greater control over the final gate. We also introduce useful figures of merit to characterize gate performance. Utilizing a supply of on-demand resource states one can potentially scale up implementation to greater accuracy, by repeated application of the basic circuit.

Quantitative Determination on Ionic-Liquid-Gating Control of Interfacial Magnetism

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

Zhao, Shishun; Zhou, Ziyao; Peng, Bin

Ionic-liquid gating on a functional thin film with a low voltage has drawn a lot of attention due to rich chemical, electronic, and magnetic phenomena at the interface. A key challenge in quantitative determination of voltage-controlled magnetic anisotropy (VCMA) in Au/[DEME] +[TFSI] -/Co field-effect transistor heterostructures is addressed. The magnetic anisotropy change as response to the gating voltage is precisely detected by in situ electron spin resonance measurements. Furthermore, a reversible change of magnetic anisotropy up to 219 Oe is achieved with a low gating voltage of 1.5 V at room temperature, corresponding to a record high VCMA coefficient ofmore » ≈146 Oe V -1. Two gating effects, the electrostatic doping and electrochemical reaction, are distinguished at various gating voltage regions, as confirmed by X-ray photoelectron spectroscopy and atomic force microscopy experiments. Our work shows a unique ionic-liquid-gating system for strong interfacial magnetoelectric coupling with many practical advantages, paving the way toward ion-liquid-gating spintronic/electronic devices.« less

Impact of gate geometry on ionic liquid gated ionotronic systems

DOE PAGES

Wong, Anthony T.; Noh, Joo Hyon; Pudasaini, Pushpa Raj; ...

2017-01-23

Ionic liquid electrolytes are gaining widespread application as a gate dielectric used to control ion transport in functional materials. This letter systematically examines the important influence that device geometry in standard “side gate” 3-terminal geometries plays in device performance of a well-known oxygen ion conductor. We show that the most influential component of device design is the ratio between the area of the gate electrode and the active channel, while the spacing between these components and their individual shapes has a negligible contribution. Finally, these findings provide much needed guidance in device design intended for ionotronic gating with ionic liquids.

Deterministic nonlinear phase gates induced by a single qubit

NASA Astrophysics Data System (ADS)

Park, Kimin; Marek, Petr; Filip, Radim

2018-05-01

We propose deterministic realizations of nonlinear phase gates by repeating a finite sequence of non-commuting Rabi interactions between a harmonic oscillator and only a single two-level ancillary qubit. We show explicitly that the key nonclassical features of the ideal cubic phase gate and the quartic phase gate are generated in the harmonic oscillator faithfully by our method. We numerically analyzed the performance of our scheme under realistic imperfections of the oscillator and the two-level system. The methodology is extended further to higher-order nonlinear phase gates. This theoretical proposal completes the set of operations required for continuous-variable quantum computation.

Management of the baseline shift using a new and simple method for respiratory-gated radiation therapy: Detectability and effectiveness of a flexible monitoring system

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

Tachibana, Hidenobu; Kitamura, Nozomi; Ito, Yasushi

2011-07-15

Purpose: In respiratory-gated radiation therapy, a baseline shift decreases the accuracy of target coverage and organs at risk (OAR) sparing. The effectiveness of audio-feedback and audio-visual feedback in correcting the baseline shift in the breathing pattern of the patient has been demonstrated previously. However, the baseline shift derived from the intrafraction motion of the patient's body cannot be corrected by these methods. In the present study, the authors designed and developed a simple and flexible system. Methods: The system consisted of a web camera and a computer running our in-house software. The in-house software was adapted to template matching andmore » also to no preimage processing. The system was capable of monitoring the baseline shift in the intrafraction motion of the patient's body. Another marker box was used to monitor the baseline shift due to the flexible setups required of a marker box for gated signals. The system accuracy was evaluated by employing a respiratory motion phantom and was found to be within AAPM Task Group 142 tolerance (positional accuracy <2 mm and temporal accuracy <100 ms) for respiratory-gated radiation therapy. Additionally, the effectiveness of this flexible and independent system in gated treatment was investigated in healthy volunteers, in terms of the results from the differences in the baseline shift detectable between the marker positions, which the authors evaluated statistically. Results: The movement of the marker on the sternum [1.599 {+-} 0.622 mm (1 SD)] was substantially decreased as compared with the abdomen [6.547 {+-} 0.962 mm (1 SD)]. Additionally, in all of the volunteers, the baseline shifts for the sternum [-0.136 {+-} 0.868 (2 SD)] were in better agreement with the nominal baseline shifts than was the case for the abdomen [-0.722 {+-} 1.56 mm (2 SD)]. The baseline shifts could be accurately measured and detected using the monitoring system, which could acquire the movement of the marker on the sternum. The baseline shift-monitoring system with the displacement-based methods for highly accurate respiratory-gated treatments should be used to make most of the displacement-based gating methods. Conclusions: The advent of intensity modulated radiation therapy and volumetric modulated radiation therapy facilitates margin reduction for the planning target volumes and the OARs, but highly accurate irradiation is needed to achieve target coverage and OAR sparing with a small margin. The baseline shifts can affect treatment not only with the respiratory gating system but also without the system. Our system can manage the baseline shift and also enables treatment irradiation to be undertaken with high accuracy.« less

Development of paper-gate transistor toward direct detection from microbiological fluids

NASA Astrophysics Data System (ADS)

Kajisa, Taira; Sakata, Toshiya

2017-04-01

In this study, a paper-gate transistor was developed to detect glucose using an extended-gate field-effect transistor (FET). A filter paper was used as an extended gate electrode, in which Au nanoparticles (AuNPs) modified with phenylboronic acids (PBAs) were included. PBA-AuNPs play an important role as a support to not only be entrapped in cellulose fibrils but also bind to the targeted glucose in a paper. The surface properties of PBA-AuNPs were investigated to elucidate the electrical properties of the paper-gate electrode using an absorption spectrum and a zeta potential analysis. Moreover, the paper-gate electrode enabled us to detect glucose at the micromolar level on the basis of the principle of FET devices. A platform based on the paper-gate transistor is suitable for a highly sensitive system to detect glucose in trace samples such as tears, sweat, and saliva in the future.

Mølmer-Sørensen entangling gate for cavity QED systems

NASA Astrophysics Data System (ADS)

Takahashi, Hiroki; Nevado, Pedro; Keller, Matthias

2017-10-01

The Mølmer-Sørensen gate is a state-of-the-art entangling gate in ion trap quantum computing where the gate fidelity can exceed 99%. Here we propose an analogous implementation in the setting of cavity QED. The cavity photon mode acts as the bosonic degree of freedom in the gate in contrast to that played by the phonon mode in ion traps. This is made possible by utilising cavity assisted Raman transitions interconnecting the logical qubit states embedded in a four-level energy structure, making the ‘anti-Jaynes-Cummings’ term available under the rotating-wave approximation. We identify practical sources of infidelity and discuss their effects on the gate performance. Our proposal not only demonstrates an alternative entangling gate scheme but also sheds new light on the relationship between ion traps and cavity QED, in the sense that many techniques developed in the former are transferable to the latter through our framework.

EFFECTS OF SUBSCUTE EXPOSURE TO NANOMOLAR CONCENTRATIONS OF METHYLMERCURY ON VOLTAGE-GATES SODIUM AND CALCIUM CURRENTS IN PC12 CELLS.

EPA Science Inventory

Methylmercury (CH3Hg+) alters the function of voltage-gated Na+ and Ca2+ channels in neuronal preparations following acute, in vitro, exposure. Because the developing nervous system is particularly sensitive to CH3Hg+ neurotoxicity, effects on voltage-gated Na+ (INa) and Ca2+ (IC...

Accuracy and Consistency of Respiratory Gating in Abdominal Cancer Patients

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

Ge, Jiajia; Santanam, Lakshmi; Yang, Deshan

2013-03-01

Purpose: To evaluate respiratory gating accuracy and intrafractional consistency for abdominal cancer patients treated with respiratory gated treatment on a regular linear accelerator system. Methods and Materials: Twelve abdominal patients implanted with fiducials were treated with amplitude-based respiratory-gated radiation therapy. On the basis of daily orthogonal fluoroscopy, the operator readjusted the couch position and gating window such that the fiducial was within a setup margin (fiducial-planning target volume [f-PTV]) when RPM indicated “beam-ON.” Fifty-five pre- and post-treatment fluoroscopic movie pairs with synchronized respiratory gating signal were recorded. Fiducial motion traces were extracted from the fluoroscopic movies using a template matchingmore » algorithm and correlated with f-PTV by registering the digitally reconstructed radiographs with the fluoroscopic movies. Treatment was determined to be “accurate” if 50% of the fiducial area stayed within f-PTV while beam-ON. For movie pairs that lost gating accuracy, a MATLAB program was used to assess whether the gating window was optimized, the external-internal correlation (EIC) changed, or the patient moved between movies. A series of safety margins from 0.5 mm to 3 mm was added to f-PTV for reassessing gating accuracy. Results: A decrease in gating accuracy was observed in 44% of movie pairs from daily fluoroscopic movies of 12 abdominal patients. Three main causes for inaccurate gating were identified as change of global EIC over time (∼43%), suboptimal gating setup (∼37%), and imperfect EIC within movie (∼13%). Conclusions: Inconsistent respiratory gating accuracy may occur within 1 treatment session even with a daily adjusted gating window. To improve or maintain gating accuracy during treatment, we suggest using at least a 2.5-mm safety margin to account for gating and setup uncertainties.« less

Transportation barriers to accessing health care for urban children.

PubMed

Yang, Serena; Zarr, Robert L; Kass-Hout, Taha A; Kourosh, Atoosa; Kelly, Nancy R

2006-11-01

The Texas Children's Hospital Residents' Primary Care Group Clinic provides primary care to urban low-income children. The objective of this cross-sectional study was to investigate the impact of transportation problems on a family's ability to keep an appointment. One hundred eighty-three caregivers of children with an appointment were interviewed. Caregivers who kept their appointment were compared with those who did not with respect to demographic and transportation-related characteristics. Logistic regression modeling predicted caregivers with the following characteristics were more likely not to keep an appointment: not using a car to the last kept appointment, not keeping an appointment in the past due to transportation problems, having more than two people in the household, and not keeping an appointment in the past due to reasons other than transportation problems. Future research should focus on developing interventions to help low-income urban families overcome non-financial access barriers, including transportation problems.

Prototyping of Poly(dimethylsiloxane) Interfaces for Flow Gating, Reagent Mixing, and Tubing Connection in Capillary Electrophoresis

PubMed Central

Zhang, Qiyang; Gong, Maojun

2014-01-01

Integrated microfluidic systems coupled with electrophoretic separations have broad application in biological and chemical analysis. Interfaces for the connection of various functional parts play a major role in the performance of a system. Here we developed a rapid prototyping method to fabricate monolithic poly(dimethylsiloxane) (PDMS) Interfaces for flow-gated injection, online reagent mixing, and tube-to-tube connection in an integrated capillary electrophoresis (CE) system. The basic idea was based on the properties of PDMS: elasticity, transparency, and suitability for prototyping. The molds for these interfaces were prepared by using commercially available stainless steel wires and nylon lines or silica capillaries. A steel wire was inserted through the diameter of a nylon line and a cross format was obtained as the mold for PDMS casting of flow gates and 4-way mixers. These interfaces accommodated tubing connection through PDMS elasticity and provided easy visual trouble shooting. The flow gate used smaller channel diameters thus reducing flow rate by 25 fold for effective gating compared with mechanically machined counterparts. Both PDMS mixers and the tube-to-tube connectors could minimize the sample dead volume by using an appropriate capillary configuration. As a whole, the prototyped PDMS interfaces are reusable, inexpensive, convenient for connection, and robust when integrated with the CE detection system. Therefore, these interfaces could see potential applications in CE and CE-coupled systems. PMID:24331370

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

Nielsen, Erik; Blume-Kohout, Robin; Rudinger, Kenneth

PyGSTi is an implementation of Gate Set Tomography in the python programming language. Gate Set Tomography (GST) is a theory and protocol for simultaneously estimating the state preparation, gate operations, and measurement effects of a physical system of one or many quantum bits (qubits). These estimates are based entirely on the statistics of experimental measurements, and their interpretation and analysis can provide a detailed understanding of the types of errors/imperfections in the physical system. In this way, GST provides not only a means of certifying the "goodness" of qubits but also a means of debugging (i.e. improving) them.

5 CFR 316.302 - Selection of term employees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... requirements of parts 332 and 333 of this chapter, to an individual who is qualified for the position and who... appointments not excepted VRA appointments and do not lead to conversion to career-conditional appointment; (3... qualifies. Combined service under the original term appointment and reappointment must not exceed the 4-year...

25 CFR 214.30 - Lessees must appoint local representative.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Lessees must appoint local representative. 214.30 Section... OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS § 214.30 Lessees must appoint local... assignee shall appoint a local or resident representative within the State, on whom the superintendent or...

25 CFR 214.30 - Lessees must appoint local representative.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Lessees must appoint local representative. 214.30 Section... OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS § 214.30 Lessees must appoint local... assignee shall appoint a local or resident representative within the State, on whom the superintendent or...

42 CFR 21.32 - Boards; appointment of; powers and duties.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Boards; appointment of; powers and duties. 21.32 Section 21.32 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.32 Boards; appointment of; powers and duties. The Surgeon General shall...

42 CFR 21.32 - Boards; appointment of; powers and duties.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Boards; appointment of; powers and duties. 21.32 Section 21.32 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.32 Boards; appointment of; powers and duties. The Surgeon General shall...

42 CFR 21.32 - Boards; appointment of; powers and duties.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Boards; appointment of; powers and duties. 21.32 Section 21.32 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.32 Boards; appointment of; powers and duties. The Surgeon General shall...

22 CFR 501.2 - Eligibility for appointment as Foreign Service Officer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICE OFFICERS § 501.2 Eligibility for appointment as Foreign Service Officer. Cross-reference: The regulations governing eligibility for appointment as a Foreign Service Officer are codified in part 11 of this... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Eligibility for appointment as Foreign Service...

78 FR 69491 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... Change Relating to Market Maker Appointment Cost Rebalances November 13, 2013. Pursuant to Section 19(b... its rules regarding Market-Maker appointment cost rebalances. The text of the proposed rule change is... amend its rules regarding Market-Maker appointment cost rebalances. Appointments to act as a Market...

78 FR 69918 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... fulfillment of market- making obligations in their appointments. The Exchange believes the elimination of an...-appointments. RMMs only qualify for defined benefits in exchange for fulfillment of market- making obligations... appointments, which are similar to the market-making obligations within appointments imposed by other exchanges...

75 FR 38566 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

...- Demutualization Trading Permits, Tier Appointment and Bandwidth Packets June 25, 2010. Pursuant to Section 19(b)(1...-demutualization Trading Permits, tier appointment and bandwidth packets. The text of the proposed rule change is..., tier appointment and bandwidth packets. These post-demutualization Trading Permits, tier appointment...

10 CFR 10.26 - Appointment of Hearing Examiner.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Appointment of Hearing Examiner. 10.26 Section 10.26... RESTRICTED DATA OR NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.26 Appointment of Hearing Examiner. The appointment of a Hearing Examiner, pursuant to § 10.24 of this part, shall be from a...

10 CFR 10.26 - Appointment of Hearing Examiner.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Appointment of Hearing Examiner. 10.26 Section 10.26... RESTRICTED DATA OR NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.26 Appointment of Hearing Examiner. The appointment of a Hearing Examiner, pursuant to § 10.24 of this part, shall be from a...

10 CFR 10.26 - Appointment of Hearing Examiner.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Appointment of Hearing Examiner. 10.26 Section 10.26... RESTRICTED DATA OR NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.26 Appointment of Hearing Examiner. The appointment of a Hearing Examiner, pursuant to § 10.24 of this part, shall be from a...

10 CFR 10.26 - Appointment of Hearing Examiner.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Appointment of Hearing Examiner. 10.26 Section 10.26... RESTRICTED DATA OR NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.26 Appointment of Hearing Examiner. The appointment of a Hearing Examiner, pursuant to § 10.24 of this part, shall be from a...

10 CFR 10.26 - Appointment of Hearing Examiner.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Appointment of Hearing Examiner. 10.26 Section 10.26... RESTRICTED DATA OR NATIONAL SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.26 Appointment of Hearing Examiner. The appointment of a Hearing Examiner, pursuant to § 10.24 of this part, shall be from a...

42 CFR 21.32 - Boards; appointment of; powers and duties.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Boards; appointment of; powers and duties. 21.32 Section 21.32 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.32 Boards; appointment of; powers and duties. The Surgeon General shall...

42 CFR 21.32 - Boards; appointment of; powers and duties.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Boards; appointment of; powers and duties. 21.32 Section 21.32 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.32 Boards; appointment of; powers and duties. The Surgeon General shall...

Electronic Medical Records and Same Day Patient Tracing Improves Clinic Efficiency and Adherence to Appointments in a Community Based HIV/AIDS Care Program, in Uganda

PubMed Central

Alamo, Stella T.; Wagner, Glenn J.; Sunday, Pamela; Wanyenze, Rhoda K.; Ouma, Joseph; Kamya, Moses; Colebunders, Robert; Wabwire-Mangen, Fred

2013-01-01

Patients who miss clinic appointments make unscheduled visits which compromise the ability to plan for and deliver quality care. We implemented Electronic Medical Records (EMR) and same day patient tracing to minimize missed appointments in a community-based HIV clinic in Kampala. Missed, early, on-schedule appointments and waiting times were evaluated before (pre-EMR) and 6 months after implementation of EMR and patient tracing (post-EMR). Reasons for missed appointments were documented pre and post-EMR. The mean daily number of missed appointments significantly reduced from 21 pre-EMR to 8 post-EMR. The main reason for missed appointments was forgetting (37%) but reduced significantly by 30% post-EMR. Loss to follow-up (LTFU) also significantly decreased from 10.9 to 4.8% The total median waiting time to see providers significantly decreased from 291 to 94 min. Our findings suggest that EMR and same day patient tracing can significantly reduce missed appointments, and LTFU and improve clinic efficiency. PMID:21739285

Assessing the relationship between technology readiness and continuance intention in an E-appointment system: relationship quality as a mediator.

PubMed

Chen, Shih-Chih; Jong, Din; Lai, Min-Tsai

2014-09-01

Numerous types of self-service technologies have prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to use the e-appointment system are crucial. Previous investigations discussed only the relationships between the technology readiness of users and their continuance intentions, and ignored the most important mediator, relationship quality. This study explored the relationships among technology readiness, relationship quality, and continuance intention. The research results demonstrated that both optimism and innovativeness significantly and positively influenced continuance intention through the mediating effect of relationship quality. However, discomfort and insecurity hid not significantly influence relationship quality or continuance intention. Finally, theoretical contributions, managerial implications and future research directions were discussed.

Coordination of appointments for anesthesia care outside of operating rooms using an enterprise-wide scheduling system.

PubMed

Dexter, Franklin; Xiao, Yan; Dow, Angella J; Strader, Melissa M; Ho, Danny; Wachtel, Ruth E

2007-12-01

An anesthesia department implemented scheduling of anesthetics outside of operating rooms (non-OR) by clerks and nurses from other departments using its hospital's enterprise-wide scheduling system. Observational studies chronicled the change over 2 yr as non-OR time was allocated by specialty, and nonanesthesia clerks and nurses scheduled anesthesia teams. Experimental studies investigated how tabular and graphical displays affected the scheduling of milestones (e.g., NPO times) and appointments before anesthetics. Anesthetics performed in allocated time increased progressively from 0% to 75%. Scheduling of anesthetics by nonanesthesia clerks and nurses increased progressively from 0% to 77%. Consistency of patient instructions was improved. The quality of resulting schedules was good. Implementation was not associated with worsening of multiple operational measures of performance such as cancellation rates, turnover times, or complaints. However, schedulers struggled to understand fasting and arrival times of patients, despite using a web site with statistically generated values in tabular formats. Experiments revealed that people ignored their knowledge that anesthetics can start earlier than scheduled. Participants made good decisions with both tabular and graphical displays when scheduling appointments preceding anesthesia. Enterprise-wide scheduling can coordinate anesthetics with other appointments on the same date and improve consistency and accuracy of patient instructions customized to the probability of an anesthetic starting early. The usefulness of implementation depends on the value in having more patient-centered care and/or in having patients arrive just in time for non-OR anesthesia, surgery, or regional block placement (e.g., at facilities with limited physical space).

Hybrid Toffoli gate on photons and quantum spins

PubMed Central

Luo, Ming-Xing; Ma, Song-Ya; Chen, Xiu-Bo; Wang, Xiaojun

2015-01-01

Quantum computation offers potential advantages in solving a number of interesting and difficult problems. Several controlled logic gates, the elemental building blocks of quantum computer, have been realized with various physical systems. A general technique was recently proposed that significantly reduces the realization complexity of multiple-control logic gates by harnessing multi-level information carriers. We present implementations of a key quantum circuit: the three-qubit Toffoli gate. By exploring the optical selection rules of one-sided optical microcavities, a Toffoli gate may be realized on all combinations of photon and quantum spins in the QD-cavity. The three general controlled-NOT gates are involved using an auxiliary photon with two degrees of freedom. Our results show that photons and quantum spins may be used alternatively in quantum information processing. PMID:26568078

Hybrid Toffoli gate on photons and quantum spins.

PubMed

Luo, Ming-Xing; Ma, Song-Ya; Chen, Xiu-Bo; Wang, Xiaojun

2015-11-16

Quantum computation offers potential advantages in solving a number of interesting and difficult problems. Several controlled logic gates, the elemental building blocks of quantum computer, have been realized with various physical systems. A general technique was recently proposed that significantly reduces the realization complexity of multiple-control logic gates by harnessing multi-level information carriers. We present implementations of a key quantum circuit: the three-qubit Toffoli gate. By exploring the optical selection rules of one-sided optical microcavities, a Toffoli gate may be realized on all combinations of photon and quantum spins in the QD-cavity. The three general controlled-NOT gates are involved using an auxiliary photon with two degrees of freedom. Our results show that photons and quantum spins may be used alternatively in quantum information processing.

Dynamic allocation of same-day requests in multi-physician primary care practices in the presence of prescheduled appointments.

PubMed

Balasubramanian, Hari; Biehl, Sebastian; Dai, Longjie; Muriel, Ana

2014-03-01

Appointments in primary care are of two types: 1) prescheduled appointments, which are booked in advance of a given workday; and 2) same-day appointments, which are booked as calls come during the workday. The challenge for practices is to provide preferred time slots for prescheduled appointments and yet see as many same-day patients as possible during regular work hours. It is also important, to the extent possible, to match same-day patients with their own providers (so as to maximize continuity of care). In this paper, we present a mathematical framework (a stochastic dynamic program) for same-day patient allocation in multi-physician practices in which calls for same-day appointments come in dynamically over a workday. Allocation decisions have to be made in the presence of prescheduled appointments and without complete demand information. The objective is to maximize a weighted measure that includes the number of same-day patients seen during regular work hours as well as the continuity provided to these patients. Our experimental design is motivated by empirical data we collected at a 3-provider family medicine practice in Massachusetts. Our results show that the location of prescheduled appointments - i.e. where in the day these appointments are booked - has a significant impact on the number of same-day patients a practice can see during regular work hours, as well as the continuity the practice is able to provide. We find that a 2-Blocks policy which books prescheduled appointments in two clusters - early morning and early afternoon - works very well. We also provide a simple, easily implementable policy for schedulers to assign incoming same-day requests to appointment slots. Our results show that this policy provides near-optimal same-day assignments in a variety of settings.

Decision Support Model for Optimal Management of Coastal Gate

NASA Astrophysics Data System (ADS)

Ditthakit, Pakorn; Chittaladakorn, Suwatana

2010-05-01

The coastal areas are intensely settled by human beings owing to their fertility of natural resources. However, at present those areas are facing with water scarcity problems: inadequate water and poor water quality as a result of saltwater intrusion and inappropriate land-use management. To solve these problems, several measures have been exploited. The coastal gate construction is a structural measure widely performed in several countries. This manner requires the plan for suitably operating coastal gates. Coastal gate operation is a complicated task and usually concerns with the management of multiple purposes, which are generally conflicted one another. This paper delineates the methodology and used theories for developing decision support modeling for coastal gate operation scheduling. The developed model was based on coupling simulation and optimization model. The weighting optimization technique based on Differential Evolution (DE) was selected herein for solving multiple objective problems. The hydrodynamic and water quality models were repeatedly invoked during searching the optimal gate operations. In addition, two forecasting models:- Auto Regressive model (AR model) and Harmonic Analysis model (HA model) were applied for forecasting water levels and tide levels, respectively. To demonstrate the applicability of the developed model, it was applied to plan the operations for hypothetical system of Pak Phanang coastal gate system, located in Nakhon Si Thammarat province, southern part of Thailand. It was found that the proposed model could satisfyingly assist decision-makers for operating coastal gates under various environmental, ecological and hydraulic conditions.

Evaluating the Effectiveness of Text Messaging and Phone Call Reminders to Minimize No Show at Pediatric Outpatient Clinics in Pakistan: Protocol for a Mixed-Methods Study.

PubMed

Saeed, Sana; Somani, Noureen; Sharif, Fatima; Kazi, Abdul Momin

2018-04-10

Missing health care appointments without canceling in advance results in a no show, a vacant appointment slot that cannot be offered to others. No show can be reduced by reminding patients about their appointment in advance. In this regard, mobile health (mHealth) strategy is to use text messaging (short message service, SMS), which is available on all cellular phones, including cheap low-end handsets. Nonattendance for appointments in health care results in wasted resources and disturbs the planned work schedules. The purpose of this study is to evaluate the efficacy of the current text messaging (SMS) and call-based reminder system and further explore how to improve the attendance at the pediatric outpatient clinics. The primary objectives are to (1) determine the efficacy of the current clinic appointment reminder service at pediatric outpatient clinics at Aga Khan University Hospital, (2) assess the mobile phone access and usage among caregivers visiting pediatrics consultant clinics, and (3) explore the perception and barriers of parents regarding the current clinic appointment reminder service at the pediatric outpatient clinics at Aga Khan University Hospital. The study uses a mixed-method design that consists of 3 components: (1) retrospective study (component A) which aims to determine the efficacy of text messaging (SMS) and phone call-based reminder service on patient's clinic attendance during January to June 2017 (N=58,517); (2) quantitative (component B) in which a baseline survey will be conducted to assess the mobile phone access and usage among parents/caregivers of children visiting pediatrics consultant clinics (n=300); and (3) qualitative (component C) includes in-depth interviews and focus group discussion with parents/caregivers of children visiting the pediatric consultancy clinic and with health care providers and administrative staff. Main constructs will be to explore perceptions and barriers related to existing clinic appointment reminder service. Ethics approval has been obtained from the Ethical Review Committee, Aga Khan University, Pakistan (4770-Ped-ERC-17). Results will be disseminated to pediatric quality public health and mHealth communities through scientific meetings and through publications, nationally and internationally. This study will provide insight regarding efficacy of using mHealth-based reminder services for patient's appointments in low- and middle-income countries setup. The finding of this study will be used to recommend further enhanced mHealth-based solutions to improve patient appointments and decrease no show. ©Sana Saeed, Noureen Somani, Fatima Sharif, Abdul Momin Kazi. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.04.2018.

Computation of Flow Through Water-Control Structures Using Program DAMFLO.2

USGS Publications Warehouse

Sanders, Curtis L.; Feaster, Toby D.

2004-01-01

As part of its mission to collect, analyze, and store streamflow data, the U.S. Geological Survey computes flow through several dam structures throughout the country. Flows are computed using hydraulic equations that describe flow through sluice and Tainter gates, crest gates, lock gates, spillways, locks, pumps, and siphons, which are calibrated using flow measurements. The program DAMFLO.2 was written to compute, tabulate, and plot flow through dam structures using data that describe the physical properties of dams and various hydraulic parameters and ratings that use time-varying data, such as lake elevations or gate openings. The program uses electronic computer files of time-varying data, such as lake elevation or gate openings, retrieved from the U.S. Geological Survey Automated Data Processing System. Computed time-varying flow data from DAMFLO.2 are output in flat files, which can be entered into the Automated Data Processing System database. All computations are made in units of feet and seconds. DAMFLO.2 uses the procedures and language developed by the SAS Institute Inc.

Appointment breaking: causes and solutions.

PubMed

Bean, A G; Talaga, J

1992-12-01

From a review of research on health care appointment breaking, the authors find that patient demographic characteristics, psychosocial problems, previous appointment keeping, health beliefs, and situational factors predict no-show behavior. Suggestions are offered for designing the marketing mix to increase patient appointment keeping. Methods for mitigating the negative effects of no-shows on health care providers are described.

The Interaction of Publications and Appointments: New Evidence on Academic Economists in Germany

ERIC Educational Resources Information Center

Beckmann, Klaus; Schneider, Andrea

2013-01-01

Using a new panel data set comprising publication and appointment data for 889 German academic economists over a quarter of a century, we confirm the familiar hypothesis that publications are important for professorial appointments, but find only a small negative effect of appointments on subsequent research productivity, in particular if one…

13 CFR 120.950 - SBA and CDC must appoint agents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false SBA and CDC must appoint agents... Development Company Loan Program (504) Debenture Sales and Service Agents § 120.950 SBA and CDC must appoint agents. SBA and the CDC must appoint the following agents to facilitate the sale and service of the...

13 CFR 120.950 - SBA and CDC must appoint agents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false SBA and CDC must appoint agents... Development Company Loan Program (504) Debenture Sales and Service Agents § 120.950 SBA and CDC must appoint agents. SBA and the CDC must appoint the following agents to facilitate the sale and service of the...

13 CFR 120.950 - SBA and CDC must appoint agents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false SBA and CDC must appoint agents... Development Company Loan Program (504) Debenture Sales and Service Agents § 120.950 SBA and CDC must appoint agents. SBA and the CDC must appoint the following agents to facilitate the sale and service of the...

13 CFR 120.950 - SBA and CDC must appoint agents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false SBA and CDC must appoint agents... Development Company Loan Program (504) Debenture Sales and Service Agents § 120.950 SBA and CDC must appoint agents. SBA and the CDC must appoint the following agents to facilitate the sale and service of the...

13 CFR 120.950 - SBA and CDC must appoint agents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false SBA and CDC must appoint agents... Development Company Loan Program (504) Debenture Sales and Service Agents § 120.950 SBA and CDC must appoint agents. SBA and the CDC must appoint the following agents to facilitate the sale and service of the...

Improving Health Care Accessibility: Strategies and Recommendations.

PubMed

Almorsy, Lamia; Khalifa, Mohamed

2016-01-01

Access time refers to the interval between requesting and actual outpatient appointment. It reflects healthcare accessibility and has a great influence on patient treatment and satisfaction. King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia studied the accessibility to outpatient services in order to develop useful strategies and recommendations for improvement. Utilized, unutilized and no-show appointments were analyzed. It is crucial to manage no-shows and short notice appointment cancellations by preparing a waiting list for those patients who can be called in to an appointment on the same day using an open access policy. An overlapping appointment scheduling model can be useful to minimize patient waiting time and doctor idle time in addition to the sensible use of appointment overbooking that can significantly improve productivity.

SU-E-T-439: Fundamental Verification of Respiratory-Gated Spot Scanning Proton Beam Therapy

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

Hamano, H; Yamakawa, T; Hayashi, N

Purpose: The spot-scanning proton beam irradiation with respiratory gating technique provides quite well dose distribution and requires both dosimetric and geometric verification prior to clinical implementation. The purpose of this study is to evaluate the impact of gating irradiation as a fundamental verification. Methods: We evaluated field width, flatness, symmetry, and penumbra in the gated and non-gated proton beams. The respiration motion was distinguished into 3 patterns: 10, 20, and 30 mm. We compared these contents between the gated and non-gated beams. A 200 MeV proton beam from PROBEAT-III unit (Hitachi Co.Ltd) was used in this study. Respiratory gating irradiationmore » was performed by Quasar phantom (MODUS medical devices) with a combination of dedicated respiratory gating system (ANZAI Medical Corporation). For radiochromic film dosimetry, the calibration curve was created with Gafchromic EBT3 film (Ashland) on FilmQA Pro 2014 (Ashland) as film analysis software. Results: The film was calibrated at the middle of spread out Bragg peak in passive proton beam. The field width, flatness and penumbra in non-gated proton irradiation with respiratory motion were larger than those of reference beam without respiratory motion: the maximum errors of the field width, flatness and penumbra in respiratory motion of 30 mm were 1.75% and 40.3% and 39.7%, respectively. The errors of flatness and penumbra in gating beam (motion: 30 mm, gating rate: 25%) were 0.0% and 2.91%, respectively. The results of symmetry in all proton beams with gating technique were within 0.6%. Conclusion: The field width, flatness, symmetry and penumbra were improved with the gating technique in proton beam. The spot scanning proton beam with gating technique is feasible for the motioned target.« less

Motion management within two respiratory-gating windows: feasibility study of dual quasi-breath-hold technique in gated medical procedures

NASA Astrophysics Data System (ADS)

Kim, Taeho; Kim, Siyong; Park, Yang-Kyun; Youn, Kaylin K.; Keall, Paul; Lee, Rena

2014-11-01

A dual quasi-breath-hold (DQBH) technique is proposed for respiratory motion management (a hybrid technique combining breathing-guidance with breath-hold task in the middle). The aim of this study is to test a hypothesis that the DQBH biofeedback system improves both the capability of motion management and delivery efficiency. Fifteen healthy human subjects were recruited for two respiratory motion measurements (free breathing and DQBH biofeedback breathing for 15 min). In this study, the DQBH biofeedback system utilized the abdominal position obtained using an real-time position management (RPM) system (Varian Medical Systems, Palo Alto, USA) to audio-visually guide a human subject for 4 s breath-hold at EOI and 90% EOE (EOE90%) to improve delivery efficiency. We investigated the residual respiratory motion and the delivery efficiency (duty-cycle) of abdominal displacement within the gating window. The improvement of the abdominal motion reproducibility was evaluated in terms of cycle-to-cycle displacement variability, respiratory period and baseline drift. The DQBH biofeedback system improved the abdominal motion management capability compared to that with free breathing. With a phase based gating (mean ± std: 55  ±  5%), the averaged root mean square error (RMSE) of the abdominal displacement in the dual-gating windows decreased from 2.26 mm of free breathing to 1.16 mm of DQBH biofeedback (p-value = 0.007). The averaged RMSE of abdominal displacement over the entire respiratory cycles reduced from 2.23 mm of free breathing to 1.39 mm of DQBH biofeedback breathing in the dual-gating windows (p-value = 0.028). The averaged baseline drift dropped from 0.9 mm min-1 with free breathing to 0.09 mm min-1 with DQBH biofeedback (p-value = 0.048). The averaged duty-cycle with an 1 mm width of displacement bound increased from 15% of free breathing to 26% of DQBH biofeedback (p-value = 0.003). The study demonstrated that the DQBH biofeedback system has the potential to significantly reduce the residual respiratory motion with the improved duty cycle during the respiratory gating procedure.

Optimized cross-resonance gate for coupled transmon systems

NASA Astrophysics Data System (ADS)

Kirchhoff, Susanna; Keßler, Torsten; Liebermann, Per J.; Assémat, Elie; Machnes, Shai; Motzoi, Felix; Wilhelm, Frank K.

2018-04-01

The cross-resonance (CR) gate is an entangling gate for fixed-frequency superconducting qubits. While being simple and extensible, it is comparatively slow, at 160 ns, and thus of limited fidelity due to on-going incoherent processes. Using two different optimal control algorithms, we estimate the quantum speed limit for a controlled-not cnot gate in this system to be 10 ns, indicating a potential for great improvements. We show that the ability to approach this limit depends strongly on the choice of ansatz used to describe optimized control pulses and limitations placed on their complexity. Using a piecewise-constant ansatz, with a single carrier and bandwidth constraints, we identify an experimentally feasible 70-ns pulse shape. Further, an ansatz based on the two dominant frequencies involved in the optimal control problem allows for an optimal solution more than twice as fast again, at under 30 ns, with smooth features and limited complexity. This is twice as fast as gate realizations using tunable-frequency, resonantly coupled qubits. Compared to current CR-gate implementations, we project our scheme will provide a sixfold speed-up and thus a sixfold reduction in fidelity loss due to incoherent effects.

Goos-Hänchen-like shift in biased silicene

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

Zhu, Bang-Shan; Wang, Yu, E-mail: ywang@semi.ac.cn; Lou, Yi-Yi

2016-04-28

We have theoretically studied the Goos-Hänchen-like shift of spinor-unpolarized beams tunneling through various gate-biased silicene nanostructures. Following the stationary-phase method, lateral displacement in single-, dual-, and multiple-gated silicene systems has been systematically demonstrated. It is shown for simple single-gated silicene that lateral displacement can be generally enhanced by Fabry-Perot interference, and near the transition point turning on the evanescent mode a very large lateral shift could be observed. For the dual-gated structure, we have also shown the crucial role of localized modes like quantum well states in enhancing the beam lateral displacement, while for the multiple gate-biased systems the resultingmore » superlattice subbands are also favorable for lateral displacement enhancement. Importantly, including the degeneracy-broken mechanisms such as gate-field and magnetic modulations, a fully spinor-resolved beam can be distinguished from the rest counterparts by aligning the incident beam with a proper spinor-resolved transition point, localized state, and subband, all of which can be flexibly modulated via electric means, offering the very desirable strategies to achieve the fully spinor-polarized beam for functional electronic applications.« less

Cell-to-Cell Communication Circuits: Quantitative Analysis of Synthetic Logic Gates

PubMed Central

Hoffman-Sommer, Marta; Supady, Adriana; Klipp, Edda

2012-01-01

One of the goals in the field of synthetic biology is the construction of cellular computation devices that could function in a manner similar to electronic circuits. To this end, attempts are made to create biological systems that function as logic gates. In this work we present a theoretical quantitative analysis of a synthetic cellular logic-gates system, which has been implemented in cells of the yeast Saccharomyces cerevisiae (Regot et al., 2011). It exploits endogenous MAP kinase signaling pathways. The novelty of the system lies in the compartmentalization of the circuit where all basic logic gates are implemented in independent single cells that can then be cultured together to perform complex logic functions. We have constructed kinetic models of the multicellular IDENTITY, NOT, OR, and IMPLIES logic gates, using both deterministic and stochastic frameworks. All necessary model parameters are taken from literature or estimated based on published kinetic data, in such a way that the resulting models correctly capture important dynamic features of the included mitogen-activated protein kinase pathways. We analyze the models in terms of parameter sensitivity and we discuss possible ways of optimizing the system, e.g., by tuning the culture density. We apply a stochastic modeling approach, which simulates the behavior of whole populations of cells and allows us to investigate the noise generated in the system; we find that the gene expression units are the major sources of noise. Finally, the model is used for the design of system modifications: we show how the current system could be transformed to operate on three discrete values. PMID:22934039

Three-input majority logic gate and multiple input logic circuit based on DNA strand displacement.

PubMed

Li, Wei; Yang, Yang; Yan, Hao; Liu, Yan

2013-06-12

In biomolecular programming, the properties of biomolecules such as proteins and nucleic acids are harnessed for computational purposes. The field has gained considerable attention due to the possibility of exploiting the massive parallelism that is inherent in natural systems to solve computational problems. DNA has already been used to build complex molecular circuits, where the basic building blocks are logic gates that produce single outputs from one or more logical inputs. We designed and experimentally realized a three-input majority gate based on DNA strand displacement. One of the key features of a three-input majority gate is that the three inputs have equal priority, and the output will be true if any of the two inputs are true. Our design consists of a central, circular DNA strand with three unique domains between which are identical joint sequences. Before inputs are introduced to the system, each domain and half of each joint is protected by one complementary ssDNA that displays a toehold for subsequent displacement by the corresponding input. With this design the relationship between any two domains is analogous to the relationship between inputs in a majority gate. Displacing two or more of the protection strands will expose at least one complete joint and return a true output; displacing none or only one of the protection strands will not expose a complete joint and will return a false output. Further, we designed and realized a complex five-input logic gate based on the majority gate described here. By controlling two of the five inputs the complex gate can realize every combination of OR and AND gates of the other three inputs.

Outpatient Office Wait Times And Quality Of Care For Medicaid Patients.

PubMed

Oostrom, Tamar; Einav, Liran; Finkelstein, Amy

2017-05-01

The time patients spend in a doctor's waiting room prior to a scheduled appointment is an important component of the quality of the overall health care experience. We analyzed data on twenty-one million outpatient visits obtained from electronic health record systems, which allowed us to measure time spent in the waiting room beyond the scheduled appointment time. Median wait time was a little more than four minutes. Almost one-fifth of visits had waits longer than twenty minutes, and 10 percent were more than thirty minutes. Waits were shorter for early-morning appointments, for younger patients, and at larger practices. Median wait time was 4.1 minutes for privately insured patients and 4.6 minutes for Medicaid patients. After adjustment for patient and appointment characteristics, Medicaid patients were 20 percent more likely than the privately insured patients to wait longer than twenty minutes, with most of this disparity explained by differences in practices and providers they saw. Wait times for Medicaid patients relative to privately insured patients were longer in states with relatively lower Medicaid reimbursement rates. The study complements other work that suggests that Medicaid patients face some additional barriers in the receipt of care. Project HOPE—The People-to-People Health Foundation, Inc.

Scientific profile and professional responsibility of Court-appointed Medical Technical Consultants in Italy: time for a specific educational curriculum?

PubMed

Conti, Andrea Alberto

2014-08-20

Court-appointed Technical Consultants (CTCs) are fundamental figures in the Italian judicial system. CTCs are experts appointed by judges in order to supplement their activities by ascertaining, collecting and analyzing facts concerning the specific subject of a lawsuit. These experts formulate opinions, gather motivations and perform checks to provide clear, objective and irrefutable answers to the questions posed by judges. With direct reference to the medical field, while police doctors (specialists in forensic medicine) follow an academic, dedicated, well-structured educational curriculum, the University specialty school in Forensic Medicine, other medical CTCs, though not infrequently luminaries with one or many medical specialties and professional acknowledgments, may have no specific legal-medicine and juridical expertise, precisely because a similar expertise is not formally required of them. In the light of these considerations, in Italy some professionals of the legal world, and of the health context too, have proposed for medical CTCs targeted educational pathways, which would provide these experts with formal specific qualifications. In synthesis and in conclusion, a full knowledge and a rigorous respect of the rules of legal proceedings emerge as increasingly important characteristics for current and future Court-appointed Technical Consultants, together with a specific educational curriculum.

Complete all-optical processing polarization-based binary logic gates and optical processors.

PubMed

Zaghloul, Y A; Zaghloul, A R M

2006-10-16

We present a complete all-optical-processing polarization-based binary-logic system, by which any logic gate or processor can be implemented. Following the new polarization-based logic presented in [Opt. Express 14, 7253 (2006)], we develop a new parallel processing technique that allows for the creation of all-optical-processing gates that produce a unique output either logic 1 or 0 only once in a truth table, and those that do not. This representation allows for the implementation of simple unforced OR, AND, XOR, XNOR, inverter, and more importantly NAND and NOR gates that can be used independently to represent any Boolean expression or function. In addition, the concept of a generalized gate is presented which opens the door for reconfigurable optical processors and programmable optical logic gates. Furthermore, the new design is completely compatible with the old one presented in [Opt. Express 14, 7253 (2006)], and with current semiconductor based devices. The gates can be cascaded, where the information is always on the laser beam. The polarization of the beam, and not its intensity, carries the information. The new methodology allows for the creation of multiple-input-multiple-output processors that implement, by itself, any Boolean function, such as specialized or non-specialized microprocessors. Three all-optical architectures are presented: orthoparallel optical logic architecture for all known and unknown binary gates, singlebranch architecture for only XOR and XNOR gates, and the railroad (RR) architecture for polarization optical processors (POP). All the control inputs are applied simultaneously leading to a single time lag which leads to a very-fast and glitch-immune POP. A simple and easy-to-follow step-by-step algorithm is provided for the POP, and design reduction methodologies are briefly discussed. The algorithm lends itself systematically to software programming and computer-assisted design. As examples, designs of all binary gates, multiple-input gates, and sequential and non-sequential Boolean expressions are presented and discussed. The operation of each design is simply understood by a bullet train traveling at the speed of light on a railroad system preconditioned by the crossover states predetermined by the control inputs. The presented designs allow for optical processing of the information eliminating the need to convert it, back and forth, to an electronic signal for processing purposes. All gates with a truth table, including for example Fredkin, Toffoli, testable reversible logic, and threshold logic gates, can be designed and implemented using the railroad architecture. That includes any future gates not known today. Those designs and the quantum gates are not discussed in this paper.

Plastic fiber scintillator response to fast neutrons

NASA Astrophysics Data System (ADS)

Danly, C. R.; Sjue, S.; Wilde, C. H.; Merrill, F. E.; Haight, R. C.

2014-11-01

The Neutron Imaging System at NIF uses an array of plastic scintillator fibers in conjunction with a time-gated imaging system to form an image of the neutron emission from the imploded capsule. By gating on neutrons that have scattered from the 14.1 MeV DT energy to lower energy ranges, an image of the dense, cold fuel around the hotspot is also obtained. An unmoderated spallation neutron beamline at the Weapons Neutron Research facility at Los Alamos was used in conjunction with a time-gated imaging system to measure the yield of a scintillating fiber array over several energy bands ranging from 1 to 15 MeV. The results and comparison to simulation are presented.

Plastic fiber scintillator response to fast neutrons.

PubMed

Danly, C R; Sjue, S; Wilde, C H; Merrill, F E; Haight, R C

2014-11-01

The Neutron Imaging System at NIF uses an array of plastic scintillator fibers in conjunction with a time-gated imaging system to form an image of the neutron emission from the imploded capsule. By gating on neutrons that have scattered from the 14.1 MeV DT energy to lower energy ranges, an image of the dense, cold fuel around the hotspot is also obtained. An unmoderated spallation neutron beamline at the Weapons Neutron Research facility at Los Alamos was used in conjunction with a time-gated imaging system to measure the yield of a scintillating fiber array over several energy bands ranging from 1 to 15 MeV. The results and comparison to simulation are presented.

Active Site Gate Dynamics Modulate the Catalytic Activity of the Ubiquitination Enzyme E2-25K.

PubMed

Rout, Manoj K; Lee, Brian L; Lin, Aiyang; Xiao, Wei; Spyracopoulos, Leo

2018-05-03

The ubiquitin proteasome system (UPS) signals for degradation of proteins through attachment of K48-linked polyubiquitin chains, or alterations in protein-protein recognition through attachment of K63-linked chains. Target proteins are ubiquitinated in three sequential chemical steps by a three-component enzyme system. Ubiquitination, or E2 enzymes, catalyze the central step by facilitating reaction of a target protein lysine with the C-terminus of Ub that is attached to the active site cysteine of the E2 through a thioester bond. E2 reactivity is modulated by dynamics of an active site gate, whose central residue packs against the active site cysteine in a closed conformation. Interestingly, for the E2 Ubc13, which specifically catalyzes K63-linked ubiquitination, the central gate residue adopts an open conformation. We set out to determine if active site gate dynamics play a role in catalysis for E2-25K, which adopts the canonical, closed gate conformation, and which selectively synthesizes K48-linked ubiquitin chains. Gate dynamics were characterized using mutagenesis of key residues, combined with enzyme kinetics measurements, and main chain NMR relaxation. The experimental data were interpreted with all atom MD simulations. The data indicate that active site gate opening and closing rates for E2-25K are precisely balanced.

Highly Efficient Gating of Electrically Actuated Nanochannels for Pulsatile Drug Delivery Stemming from a Reversible Wettability Switch.

PubMed

Zhang, Qianqian; Kang, Jianxin; Xie, Zhiqiang; Diao, Xungang; Liu, Zhaoyue; Zhai, Jin

2018-01-01

Many ion channels in the cell membrane are believed to function as gates that control the water and ion flow through the transitions between an inherent hydrophobic state and a stimuli-induced hydration state. The construction of nanofluidic gating systems with high gating efficiency and reversibility is inspired by this hydrophobic gating behavior. A kind of electrically actuated nanochannel is developed by integrating a polypyrrole (PPy) micro/nanoporous film doped with perfluorooctanesulfonate ions onto an anodic aluminum oxide nanoporous membrane. Stemming from the reversible wettability switch of the doped PPy film in response to the applied redox potentials, the nanochannels exhibit highly efficient and reversible gating behaviors. The optimized gating ratio is over 10 5 , which is an ultrahigh value when compared with that of the existing reversibly gated nanochannels with comparable pore diameters. Furthermore, the gating behavior of the electrically actuated nanochannels shows excellent repeatability and stability. Based on this highly efficient and reversible gating function, the electrically actuated nanochannels are further applied for drug delivery, which achieves the pulsatile release of two water-soluble drug models. The electrically actuated nanochannels may find potential applications in accurate and on-demand drug therapy. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

42 CFR 21.51 - Appointment of officers having specialized training or experience in administration and management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Appointment of officers having specialized training or experience in administration and management. 21.51 Section 21.51 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.51 Appointment of officers having specialized training...

Appointment-keeping behavior of Medicaid-enrolled pediatric dental patients in eastern Iowa.

PubMed

Iben, P; Kanellis, M J; Warren, J

2000-01-01

The purpose of this prospective study was to assess the appointment-keeping behavior of Medicaid-enrolled pediatric dental patients in three Eastern Iowa practices. During the month of October 1998, a tally was kept of all patient appointments at a private pediatric dental office, a public health dental clinic, and a university-based pediatric dentistry clinic. Patients were categorized as either Medicaid or non-Medicaid. Appointment behavior categories were defined as: On time; Failure; Late-notice Cancellation (less than 24 hours notice); and Tardy (greater than 10 minutes). The data was entered in SPSS and analyzed using the chi square statistic. Statistical significance was P < 0.05. A total of 1,406 appointments were recorded for all three sites. Overall, patients on Iowa Medicaid had higher appointment failure, late-notice cancellation, and tardiness rates than non-Medicaid patients at all three clinics. However, these differences were only statistically significant for the private office and the university-based clinic. Failed appointment rates for Medicaid patients were much higher at the private office (38%) than at the other two sites. Consistent with anecdotal reports from dentists, Medicaid patients had higher rates of broken appointments than did non-Medicaid patients, particularly in a private practice setting.

Predicting appointment misses in hospitals using data analytics

PubMed Central

Karpagam, Sylvia; Ma, Nang Laik

2017-01-01

Background There is growing attention over the last few years about non-attendance in hospitals and its clinical and economic consequences. There have been several studies documenting the various aspects of non-attendance in hospitals. Project Predicting Appoint Misses (PAM) was started with the intention of being able to predict the type of patients that would not come for appointments after making bookings. Methods Historic hospital appointment data merged with “distance from hospital” variable was used to run Logistic Regression, Support Vector Machine and Recursive Partitioning to decide the contributing variables to missed appointments. Results Variables that are “class”, “time”, “demographics” related have an effect on the target variable, however, prediction models may not perform effectively due to very subtle influence on the target variable. Previously assumed major contributors like “age”, “distance” did not have a major effect on the target variable. Conclusions With the given data it will be very difficult to make any moderate/strong prediction of the Appointment misses. That being said with the help of the cut off we are able to capture all of the “appointment misses” in addition to also capturing the actualized appointments. PMID:28567409

EXTENSION EDUCATION SYMPOSIUM: Getting the most out of your extension appointment and still having a life.

PubMed

Powers, W; Cockett, N; Lardy, G

2017-04-01

Managing the demands of an academic appointment in extension can be a challenging task. Demands from constituent groups, expectations of supervisors, and rigors of promotion and tenure processes can create pressures that young faculty did not expect. Throw in spousal and family duties and you have created a situation that many will find hard to navigate. However, there are ways to cope and, even better news, there are ways to excel in meeting the demands of an academic appointment and enjoying life. Because many new extension faculty members do not have prior experience in extension, best practices in documenting programs and extension scholarship over the pretenure period are provided in this paper. Appointments that include both research and extension are quite common at many land grant universities. The advantages of joint appointments are numerous and include the fact that more and more grant agencies are seeking integrated research, teaching, and/or extension projects. However, the time demands of joint appointments can be challenging. Joint appointments can be designed to help faculty members conduct important translational research and have it be applied in a production setting. By seeking commonalities in research and extension efforts, joint appointments can be very synergistic. Development of highly successful programs requires planning on the front end with an emphasis on an in-depth needs assessment to determine stakeholder needs for both research and extension. Impact assessment should be part of this planning effort. Performing as a successful extension faculty member while maintaining relationships outside of work is challenging and requires deliberate effort on the part of employees and supervisors to realize there is more to life than work. Some authors have referred to this as work-life balance, but it may be more helpful to think of it as work-life effectiveness. To do this, one needs to 1) define what success looks like, 2) set boundaries and maintain control including control of your schedule, and 3) find time to ensure your physical, emotional, and spiritual well-being are nurtured in addition to your professional development. In summary, extension careers can be challenging at times as demands and expectations of stakeholders, supervisors, and rigors of the tenure system create formidable obstacles. However, by keeping a focus on the priorities of the position and looking for synergy in research and extension work, they can actually be quite enjoyable and very rewarding.

Coherent molecular transistor: control through variation of the gate wave function.

PubMed

Ernzerhof, Matthias

2014-03-21

In quantum interference transistors (QUITs), the current through the device is controlled by variation of the gate component of the wave function that interferes with the wave function component joining the source and the sink. Initially, mesoscopic QUITs have been studied and more recently, QUITs at the molecular scale have been proposed and implemented. Typically, in these devices the gate lead is subjected to externally adjustable physical parameters that permit interference control through modifications of the gate wave function. Here, we present an alternative model of a molecular QUIT in which the gate wave function is directly considered as a variable and the transistor operation is discussed in terms of this variable. This implies that we specify the gate current as well as the phase of the gate wave function component and calculate the resulting current through the source-sink channel. Thus, we extend on prior works that focus on the phase of the gate wave function component as a control parameter while having zero or certain discrete values of the current. We address a large class of systems, including finite graphene flakes, and obtain analytic solutions for how the gate wave function controls the transistor.

Direct detector for terahertz radiation

DOEpatents

Wanke, Michael C [Albuquerque, NM; Lee, Mark [Albuquerque, NM; Shaner, Eric A [Albuquerque, NM; Allen, S James [Santa Barbara, CA

2008-09-02

A direct detector for terahertz radiation comprises a grating-gated field-effect transistor with one or more quantum wells that provide a two-dimensional electron gas in the channel region. The grating gate can be a split-grating gate having at least one finger that can be individually biased. Biasing an individual finger of the split-grating gate to near pinch-off greatly increases the detector's resonant response magnitude over prior QW FET detectors while maintaining frequency selectivity. The split-grating-gated QW FET shows a tunable resonant plasmon response to FIR radiation that makes possible an electrically sweepable spectrometer-on-a-chip with no moving mechanical optical parts. Further, the narrow spectral response and signal-to-noise are adequate for use of the split-grating-gated QW FET in a passive, multispectral terahertz imaging system. The detector can be operated in a photoconductive or a photovoltaic mode. Other embodiments include uniform front and back gates to independently vary the carrier densities in the channel region, a thinned substrate to increase bolometric responsivity, and a resistive shunt to connect the fingers of the grating gate in parallel and provide a uniform gate-channel voltage along the length of the channel to increase the responsivity and improve the spectral resolution.

36 CFR 13.1002 - Subsistence resident zone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Gates of the Arctic National Park and... resident zone for Gates of the Arctic National Park: Alatna, Allakaket, Ambler, Anaktuvuk Pass, Bettles...

36 CFR 13.1002 - Subsistence resident zone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Gates of the Arctic National Park and... resident zone for Gates of the Arctic National Park: Alatna, Allakaket, Ambler, Anaktuvuk Pass, Bettles...

NextGen Far-Term Concept Exploration for Integrated Gate-to-Gate Trajectory-Based Operations

NASA Technical Reports Server (NTRS)

Johnson, Sally C.; Barmore, Bryan E.

2016-01-01

NASA is currently conducting concept exploration studies toward the definition of a far-term, gate-to-gate concept for Trajectory-Based Operations. This paper presents a basic architectural framework for the far-term concept and discusses some observations about implementation of trajectory-based operations in the National Airspace System. Within the concept, operators and service providers collaboratively negotiate aircraft trajectories, providing agile, optimized, aircraft-specific routing to meet service provider gate-to-gate flow-management constraints and increasing capacity by smoothly and effectively combining flight-deck-based and ground-based metering, merging, and spacing in a mixed-equipage environment. The far-term TBO concept is intended to influence the direction of mid-term TBO research and to inform the definition of stable requirements and standards for TBO communications infrastructure and user equipage.

A Pilot Study of Reasons and Risk Factors for "No-Shows" in a Pediatric Neurology Clinic.

PubMed

Guzek, Lindsay M; Fadel, William F; Golomb, Meredith R

2015-09-01

Missed clinic appointments lead to decreased patient access, worse patient outcomes, and increased healthcare costs. The goal of this pilot study was to identify reasons for and risk factors associated with missed pediatric neurology outpatient appointments ("no-shows"). This was a prospective cohort study of patients scheduled for 1 week of clinic. Data on patient clinical and demographic information were collected by record review; data on reasons for missed appointments were collected by phone interviews. Univariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression to assess risk factors for missed appointments. Fifty-nine (25%) of 236 scheduled patients were no-shows. Scheduling conflicts (25.9%) and forgetting (20.4%) were the most common reasons for missed appointments. When controlling for confounding factors in the logistic regression, Medicaid (odds ratio 2.36), distance from clinic, and time since appointment was scheduled were associated with missed appointments. Further work in this area is needed. © The Author(s) 2014.

Graduate Automotive Technology Education (GATE) Center

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

Jeffrey Hodgson; David Irick

2005-09-30

The Graduate Automotive Technology Education (GATE) Center at the University of Tennessee, Knoxville has completed its sixth year of operation. During this period the Center has involved thirteen GATE Fellows and ten GATE Research Assistants in preparing them to contribute to advanced automotive technologies in the center's focus area: hybrid drive trains and control systems. Eighteen GATE students have graduated, and three have completed their course work requirements. Nine faculty members from three departments in the College of Engineering have been involved in the GATE Center. In addition to the impact that the Center has had on the students andmore » faculty involved, the presence of the center has led to the acquisition of resources that probably would not have been obtained if the GATE Center had not existed. Significant industry interaction such as internships, equipment donations, and support for GATE students has been realized. The value of the total resources brought to the university (including related research contracts) exceeds $4,000,000. Problem areas are discussed in the hope that future activities may benefit from the operation of the current program.« less

77 FR 65898 - Agency Information Collection Activities: InfoPass System, No Form Number; Extension, Without...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

...-0113] Agency Information Collection Activities: InfoPass System, No Form Number; Extension, Without...) Title of the Form/Collection: InfoPass System. (3) Agency form number, if any, and the applicable... InfoPass system allows an applicant or petitioner to schedule an interview appointment with USCIS...

Somatosensory Gating Is Dependent on the Rate of Force Recruitment in the Human Orofacial System

ERIC Educational Resources Information Center

Andreatta, Richard D.; Barlow, Steven M.

2009-01-01

Purpose: Functional orofacial behaviors vary in their force endpoint and rate of recruitment. This study assessed the gating of orofacial cutaneous somatosensation during different cyclic lip force recruitment rates. Understanding how differences in the rate of force recruitment influences trigeminal system function is an important step toward…

Fast Dynamical Decoupling of the Mølmer-Sørensen Entangling Gate.

PubMed

Manovitz, Tom; Rotem, Amit; Shaniv, Ravid; Cohen, Itsik; Shapira, Yotam; Akerman, Nitzan; Retzker, Alex; Ozeri, Roee

2017-12-01

Engineering entanglement between quantum systems often involves coupling through a bosonic mediator, which should be disentangled from the systems at the operation's end. The quality of such an operation is generally limited by environmental and control noise. One of the prime techniques for suppressing noise is by dynamical decoupling, where one actively applies pulses at a rate that is faster than the typical time scale of the noise. However, for boson-mediated gates, current dynamical decoupling schemes require executing the pulses only when the boson and the quantum systems are disentangled. This restriction implies an increase of the gate time by a factor of sqrt[N], with N being the number of pulses applied. Here we propose and realize a method that enables dynamical decoupling in a boson-mediated system where the pulses can be applied while spin-boson entanglement persists, resulting in an increase in time that is at most a factor of π/2, independently of the number of pulses applied. We experimentally demonstrate the robustness of our entangling gate with fast dynamical decoupling to σ_{z} noise using ions in a Paul trap.

41 CFR 102-2.35 - How is the FMR distributed?

Code of Federal Regulations, 2010 CFR

2010-07-01

... distributed? 102-2.35 Section 102-2.35 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION GENERAL 2-FEDERAL MANAGEMENT REGULATION SYSTEM Regulation System General § 102-2.35 How is the FMR distributed? (a) A liaison appointed by each agency...

Empowerment Schools. Luncheon Series

ERIC Educational Resources Information Center

Kane, Kristen

2006-01-01

For the past half a century, the New York City public school system has undergone major transformations in its organization. The 1950s and 1960s community control movement led to decentralization of the school system in 1969. The school system broke into 32 community school districts, with superintendents appointed by local community school…

Organic/inorganic hybrid synaptic transistors gated by proton conducting methylcellulose films

NASA Astrophysics Data System (ADS)

Wan, Chang Jin; Zhu, Li Qiang; Wan, Xiang; Shi, Yi; Wan, Qing

2016-01-01

The idea of building a brain-inspired cognitive system has been around for several decades. Recently, electric-double-layer transistors gated by ion conducting electrolytes were reported as the promising candidates for synaptic electronics and neuromorphic system. In this letter, indium-zinc-oxide transistors gated by proton conducting methylcellulose electrolyte films were experimentally demonstrated with synaptic plasticity including paired-pulse facilitation and spatiotemporal-correlated dynamic logic. More importantly, a model based on proton-related electric-double-layer modulation and stretched-exponential decay function was proposed, and the theoretical results are in good agreement with the experimentally measured synaptic behaviors.

Organic/inorganic hybrid synaptic transistors gated by proton conducting methylcellulose films

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

Wan, Chang Jin; Wan, Qing, E-mail: wanqing@nju.edu.cn, E-mail: yshi@nju.edu.cn; Ningbo Institute of Material Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201

The idea of building a brain-inspired cognitive system has been around for several decades. Recently, electric-double-layer transistors gated by ion conducting electrolytes were reported as the promising candidates for synaptic electronics and neuromorphic system. In this letter, indium-zinc-oxide transistors gated by proton conducting methylcellulose electrolyte films were experimentally demonstrated with synaptic plasticity including paired-pulse facilitation and spatiotemporal-correlated dynamic logic. More importantly, a model based on proton-related electric-double-layer modulation and stretched-exponential decay function was proposed, and the theoretical results are in good agreement with the experimentally measured synaptic behaviors.

Preliminary analysis for integration of spot-scanning proton beam therapy and real-time imaging and gating.

PubMed

Shimizu, S; Matsuura, T; Umezawa, M; Hiramoto, K; Miyamoto, N; Umegaki, K; Shirato, H

2014-07-01

Spot-scanning proton beam therapy (PBT) can create good dose distribution for static targets. However, there exists larger uncertainty for tumors that move due to respiration, bowel gas or other internal circumstances within the patients. We have developed a real-time tumor-tracking radiation therapy (RTRT) system that uses an X-ray linear accelerator gated to the motion of internal fiducial markers introduced in the late 1990s. Relying on more than 10 years of clinical experience and big log data, we established a real-time image gated proton beam therapy system dedicated to spot scanning. Using log data and clinical outcomes derived from the clinical usage of the RTRT system since 1999, we have established a library to be used for in-house simulation for tumor targeting and evaluation. Factors considered to be the dominant causes of the interplay effects related to the spot scanning dedicated proton therapy system are listed and discussed. Total facility design, synchrotron operation cycle, and gating windows were listed as the important factors causing the interplay effects contributing to the irradiation time and motion-induced dose error. Fiducial markers that we have developed and used for the RTRT in X-ray therapy were suggested to have the capacity to improve dose distribution. Accumulated internal motion data in the RTRT system enable us to improve the operation and function of a Spot-scanning proton beam therapy (SSPT) system. A real-time-image gated SSPT system can increase accuracy for treating moving tumors. The system will start clinical service in early 2014. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Measurement scheme for purity based on two two-body gates

NASA Astrophysics Data System (ADS)

Nakazato, H.; Tanaka, T.; Yuasa, K.; Florio, G.; Pascazio, S.

2012-04-01

A scheme for measuring the purity of a quantum system with a finite number of levels is presented. The method makes use of two swap gates and hinges only on measurements performed on a reference system, prepared in a certain pure state and coupled with the target system. Neither tomographic methods, with the complete reconstruction of the state, nor interferometric setups are needed.

Cardiac gating with a pulse oximeter for dual-energy imaging

NASA Astrophysics Data System (ADS)

Shkumat, N. A.; Siewerdsen, J. H.; Dhanantwari, A. C.; Williams, D. B.; Paul, N. S.; Yorkston, J.; Van Metter, R.

2008-11-01

The development and evaluation of a prototype cardiac gating system for double-shot dual-energy (DE) imaging is described. By acquiring both low- and high-kVp images during the resting phase of the cardiac cycle (diastole), heart misalignment between images can be reduced, thereby decreasing the magnitude of cardiac motion artifacts. For this initial implementation, a fingertip pulse oximeter was employed to measure the peripheral pulse waveform ('plethysmogram'), offering potential logistic, cost and workflow advantages compared to an electrocardiogram. A gating method was developed that accommodates temporal delays due to physiological pulse propagation, oximeter waveform processing and the imaging system (software, filter-wheel, anti-scatter Bucky-grid and flat-panel detector). Modeling the diastolic period allowed the calculation of an implemented delay, timp, required to trigger correctly during diastole at any patient heart rate (HR). The model suggests a triggering scheme characterized by two HR regimes, separated by a threshold, HRthresh. For rates at or below HRthresh, sufficient time exists to expose on the same heartbeat as the plethysmogram pulse [timp(HR) = 0]. Above HRthresh, a characteristic timp(HR) delays exposure to the subsequent heartbeat, accounting for all fixed and variable system delays. Performance was evaluated in terms of accuracy and precision of diastole-trigger coincidence and quantitative evaluation of artifact severity in gated and ungated DE images. Initial implementation indicated 85% accuracy in diastole-trigger coincidence. Through the identification of an improved HR estimation method (modified temporal smoothing of the oximeter waveform), trigger accuracy of 100% could be achieved with improved precision. To quantify the effect of the gating system on DE image quality, human observer tests were conducted to measure the magnitude of cardiac artifact under conditions of successful and unsuccessful diastolic gating. Six observers independently measured the artifact in 111 patient DE images. The data indicate that successful diastolic gating results in a statistically significant reduction (p < 0.001) in the magnitude of cardiac motion artifact, with residual artifact attributed primarily to gross patient motion.

A 14 × 14 μm2 footprint polarization-encoded quantum controlled-NOT gate based on hybrid waveguide

PubMed Central

Wang, S. M.; Cheng, Q. Q.; Gong, Y. X.; Xu, P.; Sun, C.; Li, L.; Li, T.; Zhu, S. N.

2016-01-01

Photonic quantum information processing system has been widely used in communication, metrology and lithography. The recent emphasis on the miniaturized photonic platform is thus motivated by the urgent need for realizing large-scale information processing and computing. Although the integrated quantum logic gates and quantum algorithms based on path encoding have been successfully demonstrated, the technology for handling another commonly used polarization-encoded qubits has yet to be fully developed. Here, we show the implementation of a polarization-dependent beam-splitter in the hybrid waveguide system. With precisely design, the polarization-encoded controlled-NOT gate can be implemented using only single such polarization-dependent beam-splitter with the significant size reduction of the overall device footprint to 14 × 14 μm2. The experimental demonstration of the highly integrated controlled-NOT gate sets the stage to develop large-scale quantum information processing system. Our hybrid design also establishes the new capabilities in controlling the polarization modes in integrated photonic circuits. PMID:27142992

ELECTRICAL LOAD ANTICIPATOR AND RECORDER

DOEpatents

Russell, J.B.; Thomas, R.J.

1961-07-25

A system is descrbied in which an indication of the prevailing energy consumption in an electrical power metering system and a projected Power demand for one demand interval is provided at selected increments of time withm the demand interval. Each watthour meter in the system is provided with an impulse generator that generates two impulses for each revolution of the meter disc. The total pulses received frorn all the meters are continuously totaled and are fed to a plurality of parallel connected gated counters. Each counter has its gate opened at different sub-time intervals during the demand interval. A multiplier is connected to each of the gated counters except the last one and each multiplier is provided with a different multiplier constant so as to provide an estimate of the power to be drawn over the entire demand interval at the end of each of the different sub-time intervals. Means are provided for recording the ontputs from the different circuits in synchronism with the actuation oi each gate circuit.

A 14 × 14 μm(2) footprint polarization-encoded quantum controlled-NOT gate based on hybrid waveguide.

PubMed

Wang, S M; Cheng, Q Q; Gong, Y X; Xu, P; Sun, C; Li, L; Li, T; Zhu, S N

2016-05-04

Photonic quantum information processing system has been widely used in communication, metrology and lithography. The recent emphasis on the miniaturized photonic platform is thus motivated by the urgent need for realizing large-scale information processing and computing. Although the integrated quantum logic gates and quantum algorithms based on path encoding have been successfully demonstrated, the technology for handling another commonly used polarization-encoded qubits has yet to be fully developed. Here, we show the implementation of a polarization-dependent beam-splitter in the hybrid waveguide system. With precisely design, the polarization-encoded controlled-NOT gate can be implemented using only single such polarization-dependent beam-splitter with the significant size reduction of the overall device footprint to 14 × 14 μm(2). The experimental demonstration of the highly integrated controlled-NOT gate sets the stage to develop large-scale quantum information processing system. Our hybrid design also establishes the new capabilities in controlling the polarization modes in integrated photonic circuits.

Quantum phase gate based on electromagnetically induced transparency in optical cavities

NASA Astrophysics Data System (ADS)

Borges, Halyne S.; Villas-Bôas, Celso J.

2016-11-01

We theoretically investigate the implementation of a quantum controlled-phase gate in a system constituted by a single atom inside an optical cavity, based on the electromagnetically induced transparency effect. First we show that a probe pulse can experience a π phase shift due to the presence or absence of a classical control field. Considering the interplay of the cavity-EIT effect and the quantum memory process, we demonstrated a controlled-phase gate between two single photons. To this end, first one needs to store a (control) photon in the ground atomic states. In the following, a second (target) photon must impinge on the atom-cavity system. Depending on the atomic state, this second photon will be either transmitted or reflected, acquiring different phase shifts. This protocol can then be easily extended to multiphoton systems, i.e., keeping the control photon stored, it may induce phase shifts in several single photons, thus enabling the generation of multipartite entangled states. We explore the relevant parameter space in the atom-cavity system that allows the implementation of quantum controlled-phase gates using the recent technologies. In particular, we have found a lower bound for the cooperativity of the atom-cavity system which enables the implementation of phase shift on single photons. The induced shift on the phase of a photonic qubit and the controlled-phase gate between single photons, combined with optical devices, enable one to perform universal quantum computation.

Parallel Photonic Quantum Computation Assisted by Quantum Dots in One-Side Optical Microcavities

PubMed Central

Luo, Ming-Xing; Wang, Xiaojun

2014-01-01

Universal quantum logic gates are important elements for a quantum computer. In contrast to previous constructions on one degree of freedom (DOF) of quantum systems, we investigate the possibility of parallel quantum computations dependent on two DOFs of photon systems. We construct deterministic hyper-controlled-not (hyper-CNOT) gates operating on the spatial-mode and the polarization DOFs of two-photon or one-photon systems by exploring the giant optical circular birefringence induced by quantum-dot spins in one-sided optical microcavities. These hyper-CNOT gates show that the quantum states of two DOFs can be viewed as independent qubits without requiring auxiliary DOFs in theory. This result can reduce the quantum resources by half for quantum applications with large qubit systems, such as the quantum Shor algorithm. PMID:25030424

Parallel photonic quantum computation assisted by quantum dots in one-side optical microcavities.

PubMed

Luo, Ming-Xing; Wang, Xiaojun

2014-07-17

Universal quantum logic gates are important elements for a quantum computer. In contrast to previous constructions on one degree of freedom (DOF) of quantum systems, we investigate the possibility of parallel quantum computations dependent on two DOFs of photon systems. We construct deterministic hyper-controlled-not (hyper-CNOT) gates operating on the spatial-mode and the polarization DOFs of two-photon or one-photon systems by exploring the giant optical circular birefringence induced by quantum-dot spins in one-sided optical microcavities. These hyper-CNOT gates show that the quantum states of two DOFs can be viewed as independent qubits without requiring auxiliary DOFs in theory. This result can reduce the quantum resources by half for quantum applications with large qubit systems, such as the quantum Shor algorithm.

Logic reversibility and thermodynamic irreversibility demonstrated by DNAzyme-based Toffoli and Fredkin logic gates.

PubMed

Orbach, Ron; Remacle, Françoise; Levine, R D; Willner, Itamar

2012-12-26

The Toffoli and Fredkin gates were suggested as a means to exhibit logic reversibility and thereby reduce energy dissipation associated with logic operations in dense computing circuits. We present a construction of the logically reversible Toffoli and Fredkin gates by implementing a library of predesigned Mg(2+)-dependent DNAzymes and their respective substrates. Although the logical reversibility, for which each set of inputs uniquely correlates to a set of outputs, is demonstrated, the systems manifest thermodynamic irreversibility originating from two quite distinct and nonrelated phenomena. (i) The physical readout of the gates is by fluorescence that depletes the population of the final state of the machine. This irreversible, heat-releasing process is needed for the generation of the output. (ii) The DNAzyme-powered logic gates are made to operate at a finite rate by invoking downhill energy-releasing processes. Even though the three bits of Toffoli's and Fredkin's logically reversible gates manifest thermodynamic irreversibility, we suggest that these gates could have important practical implication in future nanomedicine.

Realization of a quantum gate using gravitational search algorithm by perturbing three-dimensional harmonic oscillator with an electromagnetic field

NASA Astrophysics Data System (ADS)

Sharma, Navneet; Rawat, Tarun Kumar; Parthasarathy, Harish; Gautam, Kumar

2016-06-01

The aim of this paper is to design a current source obtained as a representation of p information symbols \\{I_k\\} so that the electromagnetic (EM) field generated interacts with a quantum atomic system producing after a fixed duration T a unitary gate U( T) that is as close as possible to a given unitary gate U_g. The design procedure involves calculating the EM field produced by \\{I_k\\} and hence the perturbing Hamiltonian produced by \\{I_k\\} finally resulting in the evolution operator produced by \\{I_k\\} up to cubic order based on the Dyson series expansion. The gate error energy is thus obtained as a cubic polynomial in \\{I_k\\} which is minimized using gravitational search algorithm. The signal to noise ratio (SNR) in the designed gate is higher as compared to that using quadratic Dyson series expansion. The SNR is calculated as the ratio of the Frobenius norm square of the desired gate to that of the desired gate error.

Facile fabrication of highly controllable gating systems based on the combination of inverse opal structure and dynamic covalent chemistry.

PubMed

Wang, Chen; Yang, Haowei; Tian, Li; Wang, Shiqiang; Gao, Ning; Zhang, Wanlin; Wang, Peng; Yin, Xianpeng; Li, Guangtao

2017-06-01

A three-dimensional (3D) inverse opal with periodic and porous structures has shown great potential for applications not only in optics and optoelectronics, but also in functional membranes. In this work, the benzaldehyde group was initially introduced into a 3D nanoporous inverse opal, serving as a platform for fabricating functional membranes. By employing the dynamic covalent approach, a highly controllable gating system was facilely fabricated to achieve modulable and reversible transport features. It was found that the physical/chemical properties and pore size of the gating system could easily be regulated through post-modification with amines. As a demonstration, the gated nanopores were modified with three kinds of amines to control the wettability, surface charge and nanopore size which in turn was exploited to achieve selective mass transport, including hydrophobic molecules, cations and anions, and the transport with respect to the physical steric hindrance. In particular, the gating system showed extraordinary reversibility and could recover to its pristine state by simply changing pH values. Due to the unlimited variety provided by the Schiff base reaction, the inverse opal described here exhibits a significant extendibility and could be easily post-modified with stimuli-responsive molecules for special purposes. Furthermore, this work can be extended to employ other dynamic covalent routes, for example Diels-Alder, ester exchange and disulfide exchange-based routes.

Predicting appointment breaking.

PubMed

Bean, A G; Talaga, J

1995-01-01

The goal of physician referral services is to schedule appointments, but if too many patients fail to show up, the value of the service will be compromised. The authors found that appointment breaking can be predicted by the number of days to the scheduled appointment, the doctor's specialty, and the patient's age and gender. They also offer specific suggestions for modifying the marketing mix to reduce the incidence of no-shows.

43 CFR 30.121 - May a judge appoint a master in a probate case?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false May a judge appoint a master in a probate... PROBATE HEARINGS PROCEDURES Judicial Authority and Duties § 30.121 May a judge appoint a master in a probate case? (a) In the exercise of any authority under this part, a judge may appoint a master to do all...

43 CFR 30.121 - May a judge appoint a master in a probate case?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false May a judge appoint a master in a probate... PROBATE HEARINGS PROCEDURES Judicial Authority and Duties § 30.121 May a judge appoint a master in a probate case? (a) In the exercise of any authority under this part, a judge may appoint a master to do all...

43 CFR 30.121 - May a judge appoint a master in a probate case?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true May a judge appoint a master in a probate... PROBATE HEARINGS PROCEDURES Judicial Authority and Duties § 30.121 May a judge appoint a master in a probate case? (a) In the exercise of any authority under this part, a judge may appoint a master to do all...

43 CFR 30.121 - May a judge appoint a master in a probate case?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false May a judge appoint a master in a probate... PROBATE HEARINGS PROCEDURES Judicial Authority and Duties § 30.121 May a judge appoint a master in a probate case? (a) In the exercise of any authority under this part, a judge may appoint a master to do all...

43 CFR 30.121 - May a judge appoint a master in a probate case?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false May a judge appoint a master in a probate... PROBATE HEARINGS PROCEDURES Judicial Authority and Duties § 30.121 May a judge appoint a master in a probate case? (a) In the exercise of any authority under this part, a judge may appoint a master to do all...

26 CFR 20.2056(b)-6 - Marital deduction; life insurance or annuity payments with power of appointment in surviving spouse.

Code of Federal Regulations, 2010 CFR

2010-04-01

... payments with power of appointment in surviving spouse. 20.2056(b)-6 Section 20.2056(b)-6 Internal Revenue... insurance or annuity payments with power of appointment in surviving spouse. (a) In general. Section 2056(b... after the decedent's death. (3) The surviving spouse must have the power to appoint all or a specific...

Fluoroscopic evaluation of diaphragmatic motion reduction with a respiratory gated radiotherapy system.

PubMed

Mageras, G S; Yorke, E; Rosenzweig, K; Braban, L; Keatley, E; Ford, E; Leibel, S A; Ling, C C

2001-01-01

We report on initial patient studies to evaluate the performance of a commercial respiratory gating radiotherapy system. The system uses a breathing monitor, consisting of a video camera and passive infrared reflective markers placed on the patient's thorax, to synchronize radiation from a linear accelerator with the patient's breathing cycle. Six patients receiving treatment for lung cancer participated in a study of system characteristics during treatment simulation with fluoroscopy. Breathing synchronized fluoroscopy was performed initially without instruction, followed by fluoroscopy with recorded verbal instruction (i.e., when to inhale and exhale) with the tempo matched to the patient's normal breathing period. Patients tended to inhale more consistently when given instruction, as assessed by an external marker movement. This resulted in smaller variation in expiration and inspiration marker positions relative to total excursion, thereby permitting more precise gating tolerances at those parts of the breathing cycle. Breathing instruction also reduced the fraction of session times having irregular breathing as measured by the system software, thereby potentially increasing the accelerator duty factor and decreasing treatment times. Fluoroscopy studies showed external monitor movement to correlate well with that of the diaphragm in four patients, whereas time delays of up to 0.7 s in diaphragm movement were observed in two patients with impaired lung function. From fluoroscopic observations, average patient diaphragm excursion was reduced from 1.4 cm (range 0.7-2.1 cm) without gating and without breathing instruction, to 0.3 cm (range 0.2-0.5 cm) with instruction and with gating tolerances set for treatment at expiration for 25% of the breathing cycle. Patients expressed no difficulty with following instruction for the duration of a session. We conclude that the external monitor accurately predicts internal respiratory motion in most cases; however, it may be important to check with fluoroscopy for possible time delays in patients with impaired lung function. Furthermore, we observe that verbal instruction can improve breathing regularity, thus improving the performance of gated treatments with this system.

Ultrafast quantum computation in ultrastrongly coupled circuit QED systems.

PubMed

Wang, Yimin; Guo, Chu; Zhang, Guo-Qiang; Wang, Gangcheng; Wu, Chunfeng

2017-03-10

The latest technological progress of achieving the ultrastrong-coupling regime in circuit quantum electrodynamics (QED) systems has greatly promoted the developments of quantum physics, where novel quantum optics phenomena and potential computational benefits have been predicted. Here, we propose a scheme to accelerate the nontrivial two-qubit phase gate in a circuit QED system, where superconducting flux qubits are ultrastrongly coupled to a transmission line resonator (TLR), and two more TLRs are coupled to the ultrastrongly-coupled system for assistant. The nontrivial unconventional geometric phase gate between the two flux qubits is achieved based on close-loop displacements of the three-mode intracavity fields. Moreover, as there are three resonators contributing to the phase accumulation, the requirement of the coupling strength to realize the two-qubit gate can be reduced. Further reduction in the coupling strength to achieve a specific controlled-phase gate can be realized by adding more auxiliary resonators to the ultrastrongly-coupled system through superconducting quantum interference devices. We also present a study of our scheme with realistic parameters considering imperfect controls and noisy environment. Our scheme possesses the merits of ultrafastness and noise-tolerance due to the advantages of geometric phases.

Ultrafast quantum computation in ultrastrongly coupled circuit QED systems

PubMed Central

Wang, Yimin; Guo, Chu; Zhang, Guo-Qiang; Wang, Gangcheng; Wu, Chunfeng

2017-01-01

The latest technological progress of achieving the ultrastrong-coupling regime in circuit quantum electrodynamics (QED) systems has greatly promoted the developments of quantum physics, where novel quantum optics phenomena and potential computational benefits have been predicted. Here, we propose a scheme to accelerate the nontrivial two-qubit phase gate in a circuit QED system, where superconducting flux qubits are ultrastrongly coupled to a transmission line resonator (TLR), and two more TLRs are coupled to the ultrastrongly-coupled system for assistant. The nontrivial unconventional geometric phase gate between the two flux qubits is achieved based on close-loop displacements of the three-mode intracavity fields. Moreover, as there are three resonators contributing to the phase accumulation, the requirement of the coupling strength to realize the two-qubit gate can be reduced. Further reduction in the coupling strength to achieve a specific controlled-phase gate can be realized by adding more auxiliary resonators to the ultrastrongly-coupled system through superconducting quantum interference devices. We also present a study of our scheme with realistic parameters considering imperfect controls and noisy environment. Our scheme possesses the merits of ultrafastness and noise-tolerance due to the advantages of geometric phases. PMID:28281654

36 CFR 13.1006 - Customary trade.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Gates of the Arctic National Park and Preserve § 13.1006 Customary trade. In the Gates of the Arctic National Preserve unit which contains the Kobuk...

36 CFR 13.1006 - Customary trade.

Code of Federal Regulations, 2011 CFR

2011-07-01

... NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Gates of the Arctic National Park and Preserve § 13.1006 Customary trade. In the Gates of the Arctic National Preserve unit which contains the Kobuk...

Oxide-based synaptic transistors gated by solution-processed gelatin electrolytes

NASA Astrophysics Data System (ADS)

He, Yinke; Sun, Jia; Qian, Chuan; Kong, Ling-An; Gou, Guangyang; Li, Hongjian

2017-04-01

In human brain, a large number of neurons are connected via synapses. Simulation of the synaptic behaviors using electronic devices is the most important step for neuromorphic systems. In this paper, proton conducting gelatin electrolyte-gated oxide field-effect transistors (FETs) were used for emulating synaptic functions, in which the gate electrode is regarded as pre-synaptic neuron and the channel layer as the post-synaptic neuron. In analogy to the biological synapse, a potential spike can be applied at the gate electrode and trigger ionic motion in the gelatin electrolyte, which in turn generates excitatory post-synaptic current (EPSC) in the channel layer. Basic synaptic behaviors including spike time-dependent EPSC, paired-pulse facilitation (PPF), self-adaptation, and frequency-dependent synaptic transmission were successfully mimicked. Such ionic/electronic hybrid devices are beneficial for synaptic electronics and brain-inspired neuromorphic systems.

Enzymatic AND logic gates operated under conditions characteristic of biomedical applications.

PubMed

Melnikov, Dmitriy; Strack, Guinevere; Zhou, Jian; Windmiller, Joshua Ray; Halámek, Jan; Bocharova, Vera; Chuang, Min-Chieh; Santhosh, Padmanabhan; Privman, Vladimir; Wang, Joseph; Katz, Evgeny

2010-09-23

Experimental and theoretical analyses of the lactate dehydrogenase and glutathione reductase based enzymatic AND logic gates in which the enzymes and their substrates serve as logic inputs are performed. These two systems are examples of the novel, previously unexplored class of biochemical logic gates that illustrate potential biomedical applications of biochemical logic. They are characterized by input concentrations at logic 0 and 1 states corresponding to normal and pathophysiological conditions. Our analysis shows that the logic gates under investigation have similar noise characteristics. Both significantly amplify random noise present in inputs; however, we establish that for realistic widths of the input noise distributions, it is still possible to differentiate between the logic 0 and 1 states of the output. This indicates that reliable detection of pathophysiological conditions is indeed possible with such enzyme logic systems.

High-κ gate dielectrics: Current status and materials properties considerations

NASA Astrophysics Data System (ADS)

Wilk, G. D.; Wallace, R. M.; Anthony, J. M.

2001-05-01

Many materials systems are currently under consideration as potential replacements for SiO2 as the gate dielectric material for sub-0.1 μm complementary metal-oxide-semiconductor (CMOS) technology. A systematic consideration of the required properties of gate dielectrics indicates that the key guidelines for selecting an alternative gate dielectric are (a) permittivity, band gap, and band alignment to silicon, (b) thermodynamic stability, (c) film morphology, (d) interface quality, (e) compatibility with the current or expected materials to be used in processing for CMOS devices, (f) process compatibility, and (g) reliability. Many dielectrics appear favorable in some of these areas, but very few materials are promising with respect to all of these guidelines. A review of current work and literature in the area of alternate gate dielectrics is given. Based on reported results and fundamental considerations, the pseudobinary materials systems offer large flexibility and show the most promise toward successful integration into the expected processing conditions for future CMOS technologies, especially due to their tendency to form at interfaces with Si (e.g. silicates). These pseudobinary systems also thereby enable the use of other high-κ materials by serving as an interfacial high-κ layer. While work is ongoing, much research is still required, as it is clear that any material which is to replace SiO2 as the gate dielectric faces a formidable challenge. The requirements for process integration compatibility are remarkably demanding, and any serious candidates will emerge only through continued, intensive investigation.

SU-C-210-03: Impact of Breathing Irregularities On Gated Treatments

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

Schiuma, D; Arheit, M; Schmelzer, P

2015-06-15

Purpose: To evaluate the effect of breathing irregularities on target location in gated treatments using amplitude and phase gating. Methods: 111 breathing patterns acquired using RPM system were categorized based on period and amplitude STD as regular (STD period ≤ 0.5 s, STD amplitude ≤ 1.5 mm), medium (0.5 s < STD period ≤ 1 s, 1.5 mm < STD amplitude ≤ 3 mm) and irregular (STD period > 1 s, STD amplitude > 3 mm). One pattern representative of the average defined population was selected per category and corresponding target motion reproduced using Quasar Respiratory Motion Phantom. Phantom inmore » motion underwent 4D-CT scan with phase reconstruction. Gated window was defined at end of exhale and DRRs reconstructed in treatment planning at 40% (beam on) and 60% phase (beam off). Target location uncertainty was assessed by comparing gated kV triggered images continuously acquired at beam on/off on a True Beam 2.0 with corresponding DRRs. Results: Average target uncertainty with amplitude gating was in [0.4 – 1.9] mm range for the different scenarios with maximum STD of 1.2 mm for the irregular pattern. Average target uncertainty with phase gating was [1.1 – 2.2] mm for regular and medium patterns, while it increased to [3.6 – 9.6] mm for the irregular pattern. Live gated motion was stable with amplitude gating, while increasing with phase gating for the irregular pattern. Treatment duration range was [68 – 160] s with amplitude and [70 – 74] s with phase gating. Conclusion: Breathing irregularities were found to affect gated treatments only when using phase gating. For regular and medium patterns no significant difference was found between the two gating strategies. Amplitude gating ensured stable gated motion within the different patterns, thus reducing intra-fraction target location variability for the irregular pattern and resulting in longer treatment duration.« less

48 CFR 9901.304 - Membership.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Section 9901.304 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL... Administrator. (d) An individual who is particularly knowledgeable about cost accounting problems and systems... members with experience in Government contract cost accounting who are to be appointed as follows: (a) A...

Outpatient Office Wait Times and Quality of Care for Medicaid Patients

PubMed Central

Oostrom, Tamar; Einav, Liran; Finkelstein, Amy

2018-01-01

Time spent in the doctor’s waiting room captures an important aspect of the healthcare experience. We analyzed data on 21 million outpatient visits obtained from electronic health record systems, allowing us to measure time spent in the waiting room beyond the scheduled appointment time. Median wait time was just over 4 minutes. Almost one-fifth of visits had waits longer than 20 minutes, and 10% were over 30 minutes. Waits were shorter for early morning appointments, younger patients, and at larger practices. Median wait time was 4.1 minutes for privately-insured and 4.6 minutes for Medicaid patients; adjusting for patient and appointment characteristics, Medicaid patients were 20% more likely than the privately-insured to wait longer than 20 minutes (P<0.001), with most of this disparity explained by differences in practices and providers they saw. Wait time for Medicaid patients relative to the privately-insured was longer in states with relatively lower Medicaid reimbursement rates. PMID:28461348

[Establishment and management of electronic appointment library for dental implant patients].

PubMed

Dong, Zheng-jie; Xu, Kan

2013-10-01

To design an excel form which can prompt dental implant patient appointment through color change, which can scientifically manage implant EMR library through appropriate interlinkage and number. An excel form based on operating system Windows XP was designed and software 2003 Microsoft excel was used, which was configured to change color with the passage of time by the use of command "conditional format". An excel form was designed. The color turned to red automatically on the day the patient underwent implant surgery. It turned to yellow when the patient recalled 2 weeks after the first operation, to green when the patient underwent secondary operation. It was designed to be gray when all the procedures of implant restoration was finished. In addition, we could know patients' main implant situation through directly opening his EMR when clicking on his name or number. Dentists can remind the implant patient appointment schedule through color change of an excel form, and can consult the implant patient EMR directly through interlinkage or number.

Modifying factors of the health belief model associated with missed clinic appointments among individuals with sickle cell disease.

PubMed

Cronin, Robert M; Hankins, Jane S; Byrd, Jeannie; Pernell, Brandi M; Kassim, Adetola; Adams-Graves, Patricia; Thompson, Alexis A; Kalinyak, Karen; DeBaun, Michael R; Treadwell, Marsha

2018-03-29

Outpatient care is critical in the management of chronic diseases, including sickle cell disease (SCD). Risk factors for poor adherence with clinic appointments in SCD are poorly defined. This exploratory study evaluated associations between modifying variables from the Health Belief Model and missed appointments. We surveyed adults with SCD (n = 211) and caregivers of children with SCD (n = 331) between October 2014 and March 2016 in six centres across the U.S. The survey tool utilized the framework of the Health Belief Model, and included: social determinants, psychosocial variables, social support, health literacy and spirituality. A majority of adults (87%) and caregivers of children (65%) reported they missed a clinic appointment. Children (as reported by caregivers) were less likely to miss appointments than adults (OR:0.22; 95% CI:(0.13,0.39)). In adults, financial insecurity (OR:4.49; 95% CI:(1.20, 20.7)), health literacy (OR:4.64; 95% CI:(1.33, 16.15)), and age (OR:0.95; 95% CI:(0.91,0.99)) were significantly associated with missed appointments. In all participants, lower spirituality was associated with missed appointments (OR:1.83; 95%CI:(1.13, 2.94)). The most common reason for missing an appointment was forgetfulness (adults: 31%, children: 26%). A majority thought reminders would help (adults: 83%, children: 71%) using phone calls (adults: 62%, children: 61%) or text messages (adults: 56%, children: 51%). Our findings demonstrate that modifying components of the Health Belief Model, including age, financial security, health literacy, spirituality, and lacking cues to action like reminders, are important in missed appointments and addressing these factors could improve appointment-keeping for adults and children with SCD.

33 CFR 40.1 - Program for appointing cadets.

Code of Federal Regulations, 2010 CFR

2010-07-01

... appointed by the Superintendent of the Coast Guard Academy, which reviews each applicant's personal... appointment. Applications must be submitted online at http://www.uscga.edu using Coast Guard forms CGA-14, CGA...

Impact of Appointment Waiting Time on Attendance Rates at a Clinical Cancer Genetics Service.

PubMed

Shaw, Tarryn; Metras, Julie; Ting, Zoe Ang Li; Courtney, Eliza; Li, Shao-Tzu; Ngeow, Joanne

2018-05-24

The increase in demand for clinical cancer genetics services has impacted the ability to provide services timeously. Given limited resources, this often results in extended appointment waiting times. Over the last 3 years, the Cancer Genetics Service at the National Cancer Centre Singapore has continued to experience a steady increase in demand for its service. Nevertheless, significant no-show rates have been reported. This study sought to determine whether an association exists between appointment waiting times and attendance rates. Data was gathered for all participants meeting inclusion criteria. Attendance rates and appointment waiting times were calculated. The relationship between mean waiting times for those who did and did not attend their scheduled appointments was evaluated using Welch's t test and linear regression model. The results showed a significant difference in mean appointment waiting times between patients who did and did not attend (32.66 versus 43.50 days respectively; p < 0.0001). Furthermore, patients who waited for longer than 37 days were significantly less likely to attend. No-show rates increased as the waiting time increased, at a rate of 19.60% per 20 days and 21.40% per 30 days. In conclusion, appointment waiting time is a significant predictor for patient attendance. Strategies to ensure patients receive an appointment within the necessary timeframe at the desired setting are important to ensure that individuals at increased cancer risk attend their appointments in order to manage their cancer risks effectively.

Experimental Demonstration of a Resonator-Induced Phase Gate in a Multiqubit Circuit-QED System.

PubMed

Paik, Hanhee; Mezzacapo, A; Sandberg, Martin; McClure, D T; Abdo, B; Córcoles, A D; Dial, O; Bogorin, D F; Plourde, B L T; Steffen, M; Cross, A W; Gambetta, J M; Chow, Jerry M

2016-12-16

The resonator-induced phase (RIP) gate is an all-microwave multiqubit entangling gate that allows a high degree of flexibility in qubit frequencies, making it attractive for quantum operations in large-scale architectures. We experimentally realize the RIP gate with four superconducting qubits in a three-dimensional circuit-QED architecture, demonstrating high-fidelity controlled-z (cz) gates between all possible pairs of qubits from two different 4-qubit devices in pair subspaces. These qubits are arranged within a wide range of frequency detunings, up to as large as 1.8 GHz. We further show a dynamical multiqubit refocusing scheme in order to isolate out 2-qubit interactions, and combine them to generate a 4-qubit Greenberger-Horne-Zeilinger state.

A parallel algorithm for multi-level logic synthesis using the transduction method. M.S. Thesis

NASA Technical Reports Server (NTRS)

Lim, Chieng-Fai

1991-01-01

The Transduction Method has been shown to be a powerful tool in the optimization of multilevel networks. Many tools such as the SYLON synthesis system (X90), (CM89), (LM90) have been developed based on this method. A parallel implementation is presented of SYLON-XTRANS (XM89) on an eight processor Encore Multimax shared memory multiprocessor. It minimizes multilevel networks consisting of simple gates through parallel pruning, gate substitution, gate merging, generalized gate substitution, and gate input reduction. This implementation, called Parallel TRANSduction (PTRANS), also uses partitioning to break large circuits up and performs inter- and intra-partition dynamic load balancing. With this, good speedups and high processor efficiencies are achievable without sacrificing the resulting circuit quality.

Experimental Demonstration of a Resonator-Induced Phase Gate in a Multiqubit Circuit-QED System

NASA Astrophysics Data System (ADS)

Paik, Hanhee; Mezzacapo, A.; Sandberg, Martin; McClure, D. T.; Abdo, B.; Córcoles, A. D.; Dial, O.; Bogorin, D. F.; Plourde, B. L. T.; Steffen, M.; Cross, A. W.; Gambetta, J. M.; Chow, Jerry M.

2016-12-01

The resonator-induced phase (RIP) gate is an all-microwave multiqubit entangling gate that allows a high degree of flexibility in qubit frequencies, making it attractive for quantum operations in large-scale architectures. We experimentally realize the RIP gate with four superconducting qubits in a three-dimensional circuit-QED architecture, demonstrating high-fidelity controlled-z (cz) gates between all possible pairs of qubits from two different 4-qubit devices in pair subspaces. These qubits are arranged within a wide range of frequency detunings, up to as large as 1.8 GHz. We further show a dynamical multiqubit refocusing scheme in order to isolate out 2-qubit interactions, and combine them to generate a 4-qubit Greenberger-Horne-Zeilinger state.

Measurement of time delay for a prospectively gated CT simulator.

PubMed

Goharian, M; Khan, R F H

2010-04-01

For the management of mobile tumors, respiratory gating is the ideal option, both during imaging and during therapy. The major advantage of respiratory gating during imaging is that it is possible to create a single artifact-free CT data-set during a selected phase of the patient's breathing cycle. The purpose of the present work is to present a simple technique to measure the time delay during acquisition of a prospectively gated CT. The time delay of a Philips Brilliance BigBore (Philips Medical Systems, Madison, WI) scanner attached to a Varian Real-Time Position Management (RPM) system (Varian Medical Systems, Palo Alto, CA) was measured. Two methods were used to measure the CT time delay: using a motion phantom and using a recorded data file from the RPM system. In the first technique, a rotating wheel phantom was altered by placing two plastic balls on its axis and rim, respectively. For a desired gate, the relative positions of the balls were measured from the acquired CT data and converted into corresponding phases. Phase difference was calculated between the measured phases and the desired phases. Using period of motion, the phase difference was converted into time delay. The Varian RPM system provides an external breathing signal; it also records transistor-transistor logic (TTL) 'X-Ray ON' status signal from the CT scanner in a text file. The TTL 'X-Ray ON' indicates the start of CT image acquisition. Thus, knowledge of the start time of CT acquisition, combined with the real-time phase and amplitude data from the external respiratory signal, provides time-stamping of all images in an axial CT scan. The TTL signal with time-stamp was used to calculate when (during the breathing cycle) a slice was recorded. Using the two approaches, the time delay between the prospective gating signal and CT simulator has been determined to be 367 +/- 40 ms. The delay requires corrections both at image acquisition and while setting gates for the treatment delivery; otherwise the simulation and treatment may not be correlated with the patient's breathing.

Verification of respiratory-gated radiotherapy with new real-time tumour-tracking radiotherapy system using cine EPID images and a log file

NASA Astrophysics Data System (ADS)

Shiinoki, Takehiro; Hanazawa, Hideki; Yuasa, Yuki; Fujimoto, Koya; Uehara, Takuya; Shibuya, Keiko

2017-02-01

A combined system comprising the TrueBeam linear accelerator and a new real-time tumour-tracking radiotherapy system, SyncTraX, was installed at our institution. The objectives of this study are to develop a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine electronic portal image device (EPID) images and a log file and to verify this treatment in clinical cases. Respiratory-gated radiotherapy was performed using TrueBeam and the SyncTraX system. Cine EPID images and a log file were acquired for a phantom and three patients during the course of the treatment. Digitally reconstructed radiographs (DRRs) were created for each treatment beam using a planning CT set. The cine EPID images, log file, and DRRs were analysed using a developed software. For the phantom case, the accuracy of the proposed method was evaluated to verify the respiratory-gated radiotherapy. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker used as an internal surrogate were calculated to evaluate the gating accuracy and set-up uncertainty in the superior-inferior (SI), anterior-posterior (AP), and left-right (LR) directions. The proposed method achieved high accuracy for the phantom verification. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker were  ⩽3 mm and  ±3 mm in the SI, AP, and LR directions. We proposed a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine EPID images and a log file and showed that this treatment is performed with high accuracy in clinical cases. This work was partly presented at the 58th Annual meeting of American Association of Physicists in Medicine.

Verification of respiratory-gated radiotherapy with new real-time tumour-tracking radiotherapy system using cine EPID images and a log file.

PubMed

Shiinoki, Takehiro; Hanazawa, Hideki; Yuasa, Yuki; Fujimoto, Koya; Uehara, Takuya; Shibuya, Keiko

2017-02-21

A combined system comprising the TrueBeam linear accelerator and a new real-time tumour-tracking radiotherapy system, SyncTraX, was installed at our institution. The objectives of this study are to develop a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine electronic portal image device (EPID) images and a log file and to verify this treatment in clinical cases. Respiratory-gated radiotherapy was performed using TrueBeam and the SyncTraX system. Cine EPID images and a log file were acquired for a phantom and three patients during the course of the treatment. Digitally reconstructed radiographs (DRRs) were created for each treatment beam using a planning CT set. The cine EPID images, log file, and DRRs were analysed using a developed software. For the phantom case, the accuracy of the proposed method was evaluated to verify the respiratory-gated radiotherapy. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker used as an internal surrogate were calculated to evaluate the gating accuracy and set-up uncertainty in the superior-inferior (SI), anterior-posterior (AP), and left-right (LR) directions. The proposed method achieved high accuracy for the phantom verification. For the clinical cases, the intra- and inter-fractional variations of the fiducial marker were  ⩽3 mm and  ±3 mm in the SI, AP, and LR directions. We proposed a method for the verification of respiratory-gated radiotherapy with SyncTraX using cine EPID images and a log file and showed that this treatment is performed with high accuracy in clinical cases.

77 FR 42735 - Appointments to the Medicare Payment Advisory Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

..., South Shore Hospital; Jack Hoadley, Ph.D., Research Professor, Health Policy Institute, Georgetown... Ford Health System; Rita Redberg, MD, Professor, Clinical Medicine, University of California at San...

Volumetric measurement of human red blood cells by MOSFET-based microfluidic gate.

PubMed

Guo, Jinhong; Ai, Ye; Cheng, Yuanbing; Li, Chang Ming; Kang, Yuejun; Wang, Zhiming

2015-08-01

In this paper, we present a MOSFET-based (metal oxide semiconductor field-effect transistor) microfluidic gate to characterize the translocation of red blood cells (RBCs) through a gate. In the microfluidic system, the bias voltage modulated by the particles or biological cells is connected to the gate of MOSFET. The particles or cells can be detected by monitoring the MOSFET drain current instead of DC/AC-gating method across the electronic gate. Polystyrene particles with various standard sizes are utilized to calibrate the proposed device. Furthermore, RBCs from both adults and newborn blood sample are used to characterize the performance of the device in distinguishing the two types of RBCs. As compared to conventional DC/AC current modulation method, the proposed device demonstrates a higher sensitivity and is capable of being a promising platform for bioassay analysis. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Hybrid quantum gates between flying photon and diamond nitrogen-vacancy centers assisted by optical microcavities

PubMed Central

Wei, Hai-Rui; Lu Long, Gui

2015-01-01

Hybrid quantum gates hold great promise for quantum information processing since they preserve the advantages of different quantum systems. Here we present compact quantum circuits to deterministically implement controlled-NOT, Toffoli, and Fredkin gates between a flying photon qubit and diamond nitrogen-vacancy (NV) centers assisted by microcavities. The target qubits of these universal quantum gates are encoded on the spins of the electrons associated with the diamond NV centers and they have long coherence time for storing information, and the control qubit is encoded on the polarizations of the flying photon and can be easily manipulated. Our quantum circuits are compact, economic, and simple. Moreover, they do not require additional qubits. The complexity of our schemes for universal three-qubit gates is much reduced, compared to the synthesis with two-qubit entangling gates. These schemes have high fidelities and efficiencies, and they are feasible in experiment. PMID:26271899

High-fidelity quantum gates on quantum-dot-confined electron spins in low-Q optical microcavities

NASA Astrophysics Data System (ADS)

Li, Tao; Gao, Jian-Cun; Deng, Fu-Guo; Long, Gui-Lu

2018-04-01

We propose some high-fidelity quantum circuits for quantum computing on electron spins of quantum dots (QD) embedded in low-Q optical microcavities, including the two-qubit controlled-NOT gate and the multiple-target-qubit controlled-NOT gate. The fidelities of both quantum gates can, in principle, be robust to imperfections involved in a practical input-output process of a single photon by converting the infidelity into a heralded error. Furthermore, the influence of two different decay channels is detailed. By decreasing the quality factor of the present microcavity, we can largely increase the efficiencies of these quantum gates while their high fidelities remain unaffected. This proposal also has another advantage regarding its experimental feasibility, in that both quantum gates can work faithfully even when the QD-cavity systems are non-identical, which is of particular importance in current semiconductor QD technology.

Quality management: reduction of waiting time and efficiency enhancement in an ENT-university outpatients' department

PubMed Central

Helbig, Matthias; Helbig, Silke; Kahla-Witzsch, Heike A; May, Angelika

2009-01-01

Background Public health systems are confronted with constantly rising costs. Furthermore, diagnostic as well as treatment services become more and more specialized. These are the reasons for an interdisciplinary project on the one hand aiming at simplification of planning and scheduling patient appointments, on the other hand at fulfilling all requirements of efficiency and treatment quality. Methods As to understanding procedure and problem solving activities, the responsible project group strictly proceeded with four methodical steps: actual state analysis, analysis of causes, correcting measures, and examination of effectiveness. Various methods of quality management, as for instance opinion polls, data collections, and several procedures of problem identification as well as of solution proposals were applied. All activities were realized according to the requirements of the clinic's ISO 9001:2000 certified quality management system. The development of this project is described step by step from planning phase to inauguration into the daily routine of the clinic and subsequent control of effectiveness. Results Five significant problem fields could be identified. After an analysis of causes the major remedial measures were: installation of a patient telephone hotline, standardization of appointment arrangements for all patients, modification of the appointments book considering the reason for coming in planning defined working periods for certain symptoms and treatments, improvement of telephonic counselling, and transition to flexible time planning by daily updates of the appointments book. After implementation of these changes into the clinic's routine success could be demonstrated by significantly reduced waiting times and resulting increased patient satisfaction. Conclusion Systematic scrutiny of the existing organizational structures of the outpatients' department of our clinic by means of actual state analysis and analysis of causes revealed the necessity of improvement. According to rules of quality management correcting measures and subsequent examination of effectiveness were performed. These changes resulted in higher satisfaction of patients, referring colleagues and clinic staff the like. Additionally the clinic is able to cope with an increasing demand for appointments in outpatients' departments, and the clinic's human resources are employed more effectively. PMID:19183496

A group randomized trial using an appointment system to improve adherence to ART at reproductive and child health clinics implementing Option B+ in Tanzania

PubMed Central

Liana, Jafary; Kajoka, Mwikemo Deborah; Valimba, Richard; Kimatta, Suleiman; Dillip, Angel; Vialle-Valentin, Catherine; Embrey, Martha; Lieber, Rachel; Johnson, Keith

2017-01-01

Introduction In October 2013, Tanzania adopted Option B+ under which HIV-positive pregnant women are initiated on antiretroviral therapy in reproductive and child health clinics at diagnosis. Studies have shown that adherence and retention to antiretroviral treatment can be problematic. Methods We implemented a group randomized controlled trial in 24 reproductive and child health clinics in eight districts in Mbeya region. The trial tested the impact of implementing paper-based appointment tracking and community outreach systems on the rate of missed appointments and number of days covered by dispensed antiretroviral medications among women previously established on antiretroviral therapy. We used interrupted time series analysis to assess study outcomes. Clinic staff and patients in intervention clinics were aware of the intervention because of change in clinic procedures; data collectors knew the study group assignment. Results Three months pre-intervention, we identified 1924 and 1226 patients established on antiretroviral therapy for six months or more in intervention and control clinics, respectively, of whom 83.4% and 86.9% had one or more post-intervention visits. The unadjusted rate of missed visits declined from 36.5% to 34.4% in intervention clinics and increased from 38.9% to 45.5% in control clinics following the intervention. Interrupted time series analyses demonstrated a net decrease of 13.7% (95% CI [-15.4,-12.1]) for missed visits at six months post-intervention. Similar differential changes were observed for visits missed by 3, 7, 15, or 60 days. Conclusion Appointment-tracking and community outreach significantly improved appointment-keeping for women on antiretroviral therapy. The facility staff controlled their workload better, identified missing patients rapidly, and worked with existing community organizations. There is now enough evidence to scale up this approach to all antiretroviral therapy and Option B+ reproductive and child health clinics in Tanzania as well as to evaluate the intervention in medical clinics that treat other chronic health conditions. Trial registration Registry for International Development Impact Evaluations ID-55310280d8757 PMID:28957381

Appointment "no-shows" are an independent predictor of subsequent quality of care and resource utilization outcomes.

PubMed

Hwang, Andrew S; Atlas, Steven J; Cronin, Patrick; Ashburner, Jeffrey M; Shah, Sachin J; He, Wei; Hong, Clemens S

2015-10-01

Identifying individuals at high risk for suboptimal outcomes is an important goal of healthcare delivery systems. Appointment no-shows may be an important risk predictor. To test the hypothesis that patients with a high propensity to "no-show" for appointments will have worse clinical and acute care utilization outcomes compared to patients with a lower propensity. We calculated the no-show propensity factor (NSPF) for patients of a large academic primary care network using 5 years of outpatient appointment data. NSPF corrects for patients with fewer appointments to avoid over-weighting of no-show visits in such patients. We divided patients into three NSPF risk groups and evaluated the association between NSPF and clinical and acute care utilization outcomes after adjusting for baseline patient characteristics. A total of 140,947 patients who visited a network practice from January 1, 2007, through December 31, 2009, and were either connected to a primary care physician or to a primary care practice, based on a previously validated algorithm. Outcomes of interest were incomplete colorectal, cervical, and breast cancer screening, and above-goal hemoglobin A1c (HbA1c) and low-density lipoprotein (LDL) levels at 1-year follow-up, and hospitalizations and emergency department visits in the subsequent 3 years. Compared to patients in the low NSPF group, patients in the high NSPF group (n=14,081) were significantly more likely to have incomplete preventive cancer screening (aOR 2.41 [2.19-.66] for colorectal, aOR 1.85 [1.65-.08] for cervical, aOR 2.93 [2.62-3.28] for breast cancer), above-goal chronic disease control measures (aOR 2.64 [2.22-3.14] for HbA1c, aOR 1.39 [1.15-1.67] for LDL], and increased rates of acute care utilization (aRR 1.37 [1.31-1.44] for hospitalization, aRR 1.39 [1.35-1.43] for emergency department visits). NSPF is an independent predictor of suboptimal primary care outcomes and acute care utilization. NSPF may play an important role in helping healthcare systems identify high-risk patients.

Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic.

PubMed

Zhang, Xiaojun; Yu, Ping; Yan, Jun; Ton A M Spil, Ir

2015-02-21

Consumer e-Health is a potential solution to the problems of accessibility, quality and costs of delivering public healthcare services to patients. Although consumer e-Health has proliferated in recent years, it remains unclear if patients are willing and able to accept and use this new and rapidly developing technology. Therefore, the aim of this research is to study the factors influencing patients' acceptance and usage of consumer e-health innovations. A simple but typical consumer e-health innovation--an e-appointment scheduling service--was developed and implemented in a primary health care clinic in a regional town in Australia. A longitudinal case study was undertaken for 29 months after system implementation. The major factors influencing patients' acceptance and use of the e-appointment service were examined through the theoretical lens of Rogers' innovation diffusion theory. Data were collected from the computer log records of 25,616 patients who visited the medical centre in the entire study period, and from in-depth interviews with 125 patients. The study results show that the overall adoption rate of the e-appointment service increased slowly from 1.5% at 3 months after implementation, to 4% at 29 months, which means only the 'innovators' had used this new service. The majority of patients did not adopt this innovation. The factors contributing to the low the adoption rate were: (1) insufficient communication about the e-appointment service to the patients, (2) lack of value of the e-appointment service for the majority of patients who could easily make phone call-based appointment, and limitation of the functionality of the e-appointment service, (3) incompatibility of the new service with the patients' preference for oral communication with receptionists, and (4) the limitation of the characteristics of the patients, including their low level of Internet literacy, lack of access to a computer or the Internet at home, and a lack of experience with online health services. All of which are closely associated with the low socio-economic status of the study population. The findings point to a need for health care providers to consider and address the identified factors before implementing more complicated consumer e-health innovations.

A quality improvement intervention to increase access to pediatric subspecialty practice.

PubMed

Heptulla, Rubina A; Choi, Steven J; Belamarich, Peter F

2013-02-01

To improve access to new pediatric endocrinology appointments in an urban academic hospital faculty-based practice. Three strategies were implemented to increase the number of appointment slots: new patient appointments were protected from conversion to follow-up appointments; all physicians, including senior faculty, were scheduled to see 3 to 4 new patients per session; and sessions devoted exclusively to follow-up appointments were added based on demand. The main outcomes for this quality improvement activity were waiting times for new and follow-up appointments, monthly visit volume, the per-provider visit volume, differences in the proportion of new visits, and clinic arrival rates pre- and postintervention. Thirteen months after the intervention, average wait for a new patient appointment decreased from 11.4 to 1.7 weeks (P < .001) and follow-up appointment wait time decreased from 8.2 to 2.9 weeks (P < .001). Mean monthly total visit volume increased from 284 to 366 patient visits (P < .01) and mean monthly visit volume per provider increased from 36.8 to 41.0 patients (P = .08). New patients were 27% of the visit volume and 35% after the intervention. Access to our pediatric specialty care clinic was improved without increasing the number of providers by improved scheduling.

Lead Time to Appointment and No-Show Rates for New and Follow-up Patients in an Ambulatory Clinic.

PubMed

Drewek, Rupali; Mirea, Lucia; Adelson, P David

High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.

Radiation Issues and Applications of Floating Gate Memories

NASA Technical Reports Server (NTRS)

Scheick, L. Z.; Nguyen, D. N.

2000-01-01

The radiation effects that affect various systems that comprise floating gate memories are presented. The wear-out degradation results of unirradiated flash memories are compared to irradiated flash memories. The procedure analyzes the failure to write and erase caused by wear-out and degradation of internal charge pump circuits. A method is described for characterizing the radiation effects of the floating gate itself. The rate dependence, stopping power dependence, SEU susceptibility and applications of floating gate in radiation environment are presented. The ramifications for dosimetry and cell failure are discussed as well as for the long term use aspects of non-volatile memories.

Electron lithography STAR design guidelines. Part 2: The design of a STAR for space applications

NASA Technical Reports Server (NTRS)

Trotter, J. D.; Newman, W.

1982-01-01

The STAR design system developed by NASA enables any user with a logic diagram to design a semicustom digital MOS integrated circuit. The system is comprised of a library of standard logic cells and computr programs to place, route, and display designs implemented with cells from the library. Also described is the development of a radiation-hard array designed for the STAR system. The design is based on the CMOS silicon gate technology developed by SANDIA National Laboratories. The design rules used are given as well as the model parameters developed for the basic array element. Library cells of the CMOS metal gate and CMOS silicon gate technologies were simulated using SPICE, and the results are shown and compared.

Distribution and function of voltage-gated sodium channels in the nervous system.

PubMed

Wang, Jun; Ou, Shao-Wu; Wang, Yun-Jie

2017-11-02

Voltage-gated sodium channels (VGSCs) are the basic ion channels for neuronal excitability, which are crucial for the resting potential and the generation and propagation of action potentials in neurons. To date, at least nine distinct sodium channel isoforms have been detected in the nervous system. Recent studies have identified that voltage-gated sodium channels not only play an essential role in the normal electrophysiological activities of neurons but also have a close relationship with neurological diseases. In this study, the latest research findings regarding the structure, type, distribution, and function of VGSCs in the nervous system and their relationship to neurological diseases, such as epilepsy, neuropathic pain, brain tumors, neural trauma, and multiple sclerosis, are reviewed in detail.

Actuation and transduction of resonant vibrations in GaAs/AlGaAs-based nanoelectromechanical systems containing two-dimensional electron gas

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

Shevyrin, A. A., E-mail: shevandrey@isp.nsc.ru; Pogosov, A. G.; Bakarov, A. K.

2015-05-04

Driven vibrations of a nanoelectromechanical system based on GaAs/AlGaAs heterostructure containing two-dimensional electron gas are experimentally investigated. The system represents a conductive cantilever with the free end surrounded by a side gate. We show that out-of-plane flexural vibrations of the cantilever are driven when alternating signal biased by a dc voltage is applied to the in-plane side gate. We demonstrate that these vibrations can be on-chip linearly transduced into a low-frequency electrical signal using the heterodyne down-mixing method. The obtained data indicate that the dominant physical mechanism of the vibrations actuation is capacitive interaction between the cantilever and the gate.

Marmet Locks and Dam, Kanawha River, West Virginia

DTIC Science & Technology

2015-07-01

emptying system has a through-the-sill intake, an in-chamber longitudinal culvert system, and Stoney gate valves. The lock was monitored using time... culvert system experienced peak average velocities of 18 feet per second, although no adverse pressures were found. A remotely operated vehicle...inspection indicated the walls of the culverts were in good condition. The Stoney gate valves are performing well and not showing any signs of unusual

Implementing biological logic gates using gold nanoparticles conjugated to fluorophores

NASA Astrophysics Data System (ADS)

Barnoy, Eran A.; Popovtzer, Rachela; Fixler, Dror

2018-02-01

We describe recent research in which we explored biologically relevant logic gates using gold nanoparticles (GNPs) conjugated to fluorophores and tracing the results remotely by time-domain fluorescence lifetime imaging microscopy (FLIM). GNPs have a well-known effect on nearby fluorophores in terms of their fluorescence intensity (FI - increase or decrease) as well as fluorescence lifetime (FLT). We have designed a few bio-switch systems in which the FLIMdetected fluorescence varies after biologically relevant stimulation. Some of our tools include fluorescein diacetate (FDA) which can be activated by either esterases or pH, peptide chains cleavable by caspase 3, and the polymer polyacrylic acid which varies in size based on surrounding pH. After conjugating GNPs to chosen fluorophores, we have successfully demonstrated the logic gates of NOT, AND, OR, NAND, NOR, and XOR by imaging different stages of activation. These logic gates have been demonstrated both in solutions as well as within cultured cells, thereby possibly opening the door for nanoparticulate in vivo smart detection. While these initial probes are mainly tools for intelligent detection systems, they lay the foundation for logic gates functioning in conjunction so as to lead to a form of in vivo biological computing, where the system would be able to release proper treatment options in specific situations without external influence.

Influence of target reflection on three-dimensional range gated reconstruction.

PubMed

Chua, Sing Yee; Wang, Xin; Guo, Ningqun; Tan, Ching Seong

2016-08-20

The range gated technique is a promising laser ranging method that is widely used in different fields such as surveillance, industry, and military. In a range gated system, a reflected laser pulse returned from the target scene contains key information for range reconstruction, which directly affects the system performance. Therefore, it is necessary to study the characteristics and effects of the target reflection factor. In this paper, theoretical and experimental analyses are performed to investigate the influence of target reflection on three-dimensional (3D) range gated reconstruction. Based on laser detection and ranging (LADAR) and bidirectional reflection distribution function (BRDF) theory, a 3D range gated reconstruction model is derived and the effect on range accuracy is analyzed from the perspectives of target surface reflectivity and angle of laser incidence. Our theoretical and experimental study shows that the range accuracy is proportional to the target surface reflectivity, but it decreases when the angle of incidence increases to adhere to the BRDF model. The presented findings establish a comprehensive understanding of target reflection in 3D range gated reconstruction, which is of interest to various applications such as target recognition and object modeling. This paper provides a reference for future improvement to perform accurate range compensation or correction.

A decision support system for quality of life in head and neck oncology patients.

PubMed

Gonçalves, Joaquim J; Rocha, Alvaro M

2012-02-16

The assessment of Quality of Life (QoL) is a Medical goal; it is used in clinical research, medical practice, health-related economic studies and in planning health management measures and strategies. The objective of this project is to develop an informational platform to achieve a patient self-assessment with standardized QoL measuring instruments, through friendly software, easy for the user to adapt, which should aid the study of QoL, by promoting the creation of databases and accelerating its statistical treatment and yet generating subsequent useful results in graphical format for the physician analyzes in an appointment immediately after the answers collection. First, a software platform was designed and developed in an action-research process with patients, physicians and nurses. The computerized patient self-assessment with standardized QoL measuring instruments was compared with traditional one, to verify if its use did not influence the patient's answers. For that, the Wilcoxon and t-Student tests were applied. After, we adopted and adapted the mathematic Rash model to make possible the use of QoL measure in the routine appointments. The results show that the computerized patient self-assessment does not influence the patient's answers and can be used as a suitable tool in the routine appointment, because indicates problems which are more difficult to identify in a traditional appointment, improving thus the physician's decisions. The possibility of representing graphically useful results that physician needs to analyze in the appointment, immediately after the answer collection, in an useful time, makes this QoL assessment platform a diagnosis instrument ready to be used routinely in clinical practice.

Graphene-based aptamer logic gates and their application to multiplex detection.

PubMed

Wang, Li; Zhu, Jinbo; Han, Lei; Jin, Lihua; Zhu, Chengzhou; Wang, Erkang; Dong, Shaojun

2012-08-28

In this work, a GO/aptamer system was constructed to create multiplex logic operations and enable sensing of multiplex targets. 6-Carboxyfluorescein (FAM)-labeled adenosine triphosphate binding aptamer (ABA) and FAM-labeled thrombin binding aptamer (TBA) were first adsorbed onto graphene oxide (GO) to form a GO/aptamer complex, leading to the quenching of the fluorescence of FAM. We demonstrated that the unique GO/aptamer interaction and the specific aptamer-target recognition in the target/GO/aptamer system were programmable and could be utilized to regulate the fluorescence of FAM via OR and INHIBIT logic gates. The fluorescence changed according to different input combinations, and the integration of OR and INHIBIT logic gates provided an interesting approach for logic sensing applications where multiple target molecules were present. High-throughput fluorescence imagings that enabled the simultaneous processing of many samples by using the combinatorial logic gates were realized. The developed logic gates may find applications in further development of DNA circuits and advanced sensors for the identification of multiple targets in complex chemical environments.

Two-qubit logical operations in three quantum dots system.

PubMed

Łuczak, Jakub; Bułka, Bogdan R

2018-06-06

We consider a model of two interacting always-on, exchange-only qubits for which controlled phase (CPHASE), controlled NOT (CNOT), quantum Fourier transform (QFT) and SWAP operations can be implemented only in a few electrical pulses in a nanosecond time scale. Each qubit is built of three quantum dots (TQD) in a triangular geometry with three electron spins which are always kept coupled by exchange interactions only. The qubit states are encoded in a doublet subspace and are fully electrically controlled by a voltage applied to gate electrodes. The two qubit quantum gates are realized by short electrical pulses which change the triangular symmetry of TQD and switch on exchange interaction between the qubits. We found an optimal configuration to implement the CPHASE gate by a single pulse of the order 2.3 ns. Using this gate, in combination with single qubit operations, we searched for optimal conditions to perform the other gates: CNOT, QFT and SWAP. Our studies take into account environment effects and leakage processes as well. The results suggest that the system can be implemented for fault tolerant quantum computations.

DOE-FG02-00ER62797 Final Report

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

Sweedler, J.V.

2004-12-01

Specific Aims The overall goal of this proposal has been to develop and interface a new technology, molecular gates, with microfabricated systems to add an important capability to microfabricated DNA measurement systems. This project specifically focused on demonstrating how molecular gates could be used to capture a single analyte band, among a stream of bands from a separation or a flow injection analysis experiment, and release it for later measurement, thus allowing further manipulations on the selected analyte. Since the original proposal, the molecular gate concept has been greatly expanded to allow the gates to be used as externally controllablemore » intelligent interconnects in multilayer microfluidic networks. We have demonstrated: (1) the ability of the molecular gates to work with a much wider range of biological molecules including DNA, proteins and small metabolites; and (2) the capability of performing an electrophoretic separation and sequestering individual picoliter volume components (or even classes of components) into separate channels for further analysis. Both capabilities will enable characterization of small mass amounts of complex mixtures of DNA, proteins and even small molecules--allowing them to be further separated and chemically characterized.« less

Optimization of a solid-state electron spin qubit using Gate Set Tomography

DOE PAGES

Dehollain, Juan P.; Muhonen, Juha T.; Blume-Kohout, Robin J.; ...

2016-10-13

Here, state of the art qubit systems are reaching the gate fidelities required for scalable quantum computation architectures. Further improvements in the fidelity of quantum gates demands characterization and benchmarking protocols that are efficient, reliable and extremely accurate. Ideally, a benchmarking protocol should also provide information on how to rectify residual errors. Gate Set Tomography (GST) is one such protocol designed to give detailed characterization of as-built qubits. We implemented GST on a high-fidelity electron-spin qubit confined by a single 31P atom in 28Si. The results reveal systematic errors that a randomized benchmarking analysis could measure but not identify, whereasmore » GST indicated the need for improved calibration of the length of the control pulses. After introducing this modification, we measured a new benchmark average gate fidelity of 99.942(8)%, an improvement on the previous value of 99.90(2)%. Furthermore, GST revealed high levels of non-Markovian noise in the system, which will need to be understood and addressed when the qubit is used within a fault-tolerant quantum computation scheme.« less

Noise filtering of composite pulses for singlet-triplet qubits

PubMed Central

Yang, Xu-Chen; Wang, Xin

2016-01-01

Semiconductor quantum dot spin qubits are promising candidates for quantum computing. In these systems, the dynamically corrected gates offer considerable reduction of gate errors and are therefore of great interest both theoretically and experimentally. They are, however, designed under the static-noise model and may be considered as low-frequency filters. In this work, we perform a comprehensive theoretical study of the response of a type of dynamically corrected gates, namely the supcode for singlet-triplet qubits, to realistic 1/f noises with frequency spectra 1/ωα. Through randomized benchmarking, we have found that supcode offers improvement of the gate fidelity for α  1 and the improvement becomes exponentially more pronounced with the increase of the noise exponent in the range 1  α ≤ 3 studied. On the other hand, for small α, supcode will not offer any improvement. The δJ-supcode, specifically designed for systems where the nuclear noise is absent, is found to offer additional error reduction than the full supcode for charge noises. The computed filter transfer functions of the supcode gates are also presented. PMID:27383129

Development of the compact proton beam therapy system dedicated to spot scanning with real-time tumor-tracking technology

NASA Astrophysics Data System (ADS)

Umezawa, Masumi; Fujimoto, Rintaro; Umekawa, Tooru; Fujii, Yuusuke; Takayanagi, Taisuke; Ebina, Futaro; Aoki, Takamichi; Nagamine, Yoshihiko; Matsuda, Koji; Hiramoto, Kazuo; Matsuura, Taeko; Miyamoto, Naoki; Nihongi, Hideaki; Umegaki, Kikuo; Shirato, Hiroki

2013-04-01

Hokkaido University and Hitachi Ltd. have started joint development of the Gated Spot Scanning Proton Therapy with Real-Time Tumor-Tracking System by integrating real-time tumor tracking technology (RTRT) and the proton therapy system dedicated to discrete spot scanning techniques under the "Funding Program for World-Leading Innovative R&D on Science and Technology (FIRST Program)". In this development, we have designed the synchrotron-based accelerator system by using the advantages of the spot scanning technique in order to realize a more compact and lower cost proton therapy system than the conventional system. In the gated irradiation, we have focused on the issues to maximize irradiation efficiency and minimize the dose errors caused by organ motion. In order to understand the interplay effect between scanning beam delivery and target motion, we conducted a simulation study. The newly designed system consists of the synchrotron, beam transport system, one compact rotating gantry treatment room with robotic couch, and one experimental room for future research. To improve the irradiation efficiency, the new control function which enables multiple gated irradiations per synchrotron cycle has been applied and its efficacy was confirmed by the irradiation time estimation. As for the interplay effect, we confirmed that the selection of a strict gating width and scan direction enables formation of the uniform dose distribution.

Chemotherapy appointment scheduling under uncertainty using mean-risk stochastic integer programming.

PubMed

Alvarado, Michelle; Ntaimo, Lewis

2018-03-01

Oncology clinics are often burdened with scheduling large volumes of cancer patients for chemotherapy treatments under limited resources such as the number of nurses and chairs. These cancer patients require a series of appointments over several weeks or months and the timing of these appointments is critical to the treatment's effectiveness. Additionally, the appointment duration, the acuity levels of each appointment, and the availability of clinic nurses are uncertain. The timing constraints, stochastic parameters, rising treatment costs, and increased demand of outpatient oncology clinic services motivate the need for efficient appointment schedules and clinic operations. In this paper, we develop three mean-risk stochastic integer programming (SIP) models, referred to as SIP-CHEMO, for the problem of scheduling individual chemotherapy patient appointments and resources. These mean-risk models are presented and an algorithm is devised to improve computational speed. Computational results were conducted using a simulation model and results indicate that the risk-averse SIP-CHEMO model with the expected excess mean-risk measure can decrease patient waiting times and nurse overtime when compared to deterministic scheduling algorithms by 42 % and 27 %, respectively.

Assessing the Queuing Process Using Data Envelopment Analysis: an Application in Health Centres.

PubMed

Safdar, Komal A; Emrouznejad, Ali; Dey, Prasanta K

2016-01-01

Queuing is one of the very important criteria for assessing the performance and efficiency of any service industry, including healthcare. Data Envelopment Analysis (DEA) is one of the most widely-used techniques for performance measurement in healthcare. However, no queue management application has been reported in the health-related DEA literature. Most of the studies regarding patient flow systems had the objective of improving an already existing Appointment System. The current study presents a novel application of DEA for assessing the queuing process at an Outpatients' department of a large public hospital in a developing country where appointment systems do not exist. The main aim of the current study is to demonstrate the usefulness of DEA modelling in the evaluation of a queue system. The patient flow pathway considered for this study consists of two stages; consultation with a doctor and pharmacy. The DEA results indicated that waiting times and other related queuing variables included need considerable minimisation at both stages.

Visual Schedule System in Dental Care for Patients with Autism: A Pilot Study.

PubMed

Mah, Janet Wt; Tsang, Phoebe

A pilot study to test whether a visual schedule system using picture communication symbols can help children with autism have successful routine dental cleaning visits. 14 boys with autism between three- to eight-years-old presented to the dental clinic for four weekly consecutive dental appointments. Patients were randomly assigned to either the control group who received the tell-show-do method (i.e., standard of care), or the test group who received the tell-show-do method plus the visual schedule system. Patients in the test group completed an average of 1.38 more steps, at 35.52 seconds per step faster, and with 18.7% lower levels of behavioral distress than those in the control group. The use of a visual schedule system, along with repeated weekly visits, showed some promise in helping children with autism successfully complete more steps, progress at a quicker rate, and exhibit lower levels of behavioral distress within a dental appointment, compared to a traditional tell-show-do approach.

TRICARE, Military Health System

MedlinePlus

... Doctor All Provider Directories Change My Primary Care Manager Book Appointments Getting Care When Traveling Costs Health ... Authorizations Download a Form Change My Primary Care Manager File or Check a Claim Get Proof of ...

A National Model for Diabetes Prevention and Treatment Program in Civilian and Military Beneficiary Populations (FY07)

DTIC Science & Technology

2013-09-24

examination was performed by one of the investigators (medical doctors) or certified nurse practitioners. Prior to initiating the intervention...3 days before their scheduled appointment. If a patient did not show or cancelled their appointment without rescheduling , the study team...additionally tried to reach them by phone to identify the reason for missing an appointment and to attempt to reschedule another appointment. It was

Technical aspects of real time positron emission tracking for gated radiotherapy

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

Chamberland, Marc; Xu, Tong, E-mail: txu@physics.carleton.ca; McEwen, Malcolm R.

2016-02-15

Purpose: Respiratory motion can lead to treatment errors in the delivery of radiotherapy treatments. Respiratory gating can assist in better conforming the beam delivery to the target volume. We present a study of the technical aspects of a real time positron emission tracking system for potential use in gated radiotherapy. Methods: The tracking system, called PeTrack, uses implanted positron emission markers and position sensitive gamma ray detectors to track breathing motion in real time. PeTrack uses an expectation–maximization algorithm to track the motion of fiducial markers. A normalized least mean squares adaptive filter predicts the location of the markers amore » short time ahead to account for system response latency. The precision and data collection efficiency of a prototype PeTrack system were measured under conditions simulating gated radiotherapy. The lung insert of a thorax phantom was translated in the inferior–superior direction with regular sinusoidal motion and simulated patient breathing motion (maximum amplitude of motion ±10 mm, period 4 s). The system tracked the motion of a {sup 22}Na fiducial marker (0.34 MBq) embedded in the lung insert every 0.2 s. The position of the was marker was predicted 0.2 s ahead. For sinusoidal motion, the equation used to model the motion was fitted to the data. The precision of the tracking was estimated as the standard deviation of the residuals. Software was also developed to communicate with a Linac and toggle beam delivery. In a separate experiment involving a Linac, 500 monitor units of radiation were delivered to the phantom with a 3 × 3 cm photon beam and with 6 and 10 MV accelerating potential. Radiochromic films were inserted in the phantom to measure spatial dose distribution. In this experiment, the period of motion was set to 60 s to account for beam turn-on latency. The beam was turned off when the marker moved outside of a 5-mm gating window. Results: The precision of the tracking in the IS direction was 0.53 mm for a sinusoidally moving target, with an average count rate ∼250 cps. The average prediction error was 1.1 ± 0.6 mm when the marker moved according to irregular patient breathing motion. Across all beam deliveries during the radiochromic film measurements, the average prediction error was 0.8 ± 0.5 mm. The maximum error was 2.5 mm and the 95th percentile error was 1.5 mm. Clear improvement of the dose distribution was observed between gated and nongated deliveries. The full-width at halfmaximum of the dose profiles of gated deliveries differed by 3 mm or less than the static reference dose distribution. Monitoring of the beam on/off times showed synchronization with the location of the marker within the latency of the system. Conclusions: PeTrack can track the motion of internal fiducial positron emission markers with submillimeter precision. The system can be used to gate the delivery of a Linac beam based on the position of a moving fiducial marker. This highlights the potential of the system for use in respiratory-gated radiotherapy.« less

Quantification and characterization of leakage errors

NASA Astrophysics Data System (ADS)

Wood, Christopher J.; Gambetta, Jay M.

2018-03-01

We present a general framework for the quantification and characterization of leakage errors that result when a quantum system is encoded in the subspace of a larger system. To do this we introduce metrics for quantifying the coherent and incoherent properties of the resulting errors and we illustrate this framework with several examples relevant to superconducting qubits. In particular, we propose two quantities, the leakage and seepage rates, which together with average gate fidelity allow for characterizing the average performance of quantum gates in the presence of leakage and show how the randomized benchmarking protocol can be modified to enable the robust estimation of all three quantities for a Clifford gate set.

Illinois high-speed rail four-quadrant gate reliability assessment

DOT National Transportation Integrated Search

2009-10-01

The Federal Railroad Administration (FRA) tasked the John A. Volpe National Transportation Systems Center (Volpe Center) to conduct a reliability analysis of the four-quadrant gate/vehicle detection equipment installed on the future high-speed rail (...

6. POWERHOUSE INTERIOR SHOWING EXCITER No. 1. HANDCONTROLLED GATE VALVE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. POWERHOUSE INTERIOR SHOWING EXCITER No. 1. HAND-CONTROLLED GATE VALVE SHOWN ON NOZZLE TO PELTON-DOBLE IMPULSE WHEEL. VIEW TO NORTHEAST. - Rush Creek Hydroelectric System, Powerhouse Exciters, Rush Creek, June Lake, Mono County, CA

Thin membrane sensor with biochemical switch

NASA Technical Reports Server (NTRS)

Worley, III, Jennings F. (Inventor); Case, George D. (Inventor)

1994-01-01

A modular biosensor system for chemical or biological agent detection utilizes electrochemical measurement of an ion current across a gate membrane triggered by the reaction of the target agent with a recognition protein conjugated to a channel blocker. The sensor system includes a bioresponse simulator or biochemical switch module which contains the recognition protein-channel blocker conjugate, and in which the detection reactions occur, and a transducer module which contains a gate membrane and a measuring electrode, and in which the presence of agent is sensed electrically. In the poised state, ion channels in the gate membrane are blocked by the recognition protein-channel blocker conjugate. Detection reactions remove the recognition protein-channel blocker conjugate from the ion channels, thus eliciting an ion current surge in the gate membrane which subsequently triggers an output alarm. Sufficiently large currents are generated that simple direct current electronics are adequate for the measurements. The biosensor has applications for environmental, medical, and industrial use.

ECG-gated imaging of the left atrium and pulmonary veins: Intra-individual comparison of CTA and MRA.

PubMed

Fahlenkamp, U L; Lembcke, A; Roesler, R; Schwenke, C; Huppertz, A; Streitparth, F; Taupitz, M; Hamm, B; Wagner, M

2013-10-01

To compare electrocardiography (ECG)-gated computed tomography angiography (CTA) with ECG-gated magnetic resonance angiography (MRA) for assessment of the left atrium (LA) and pulmonary veins (PVs). Twenty-nine consecutive patients who underwent both cardiac CTA and MRA were evaluated. Contrast-enhanced CTA was performed with prospective ECG-gating using a 320 detector row CT system. Contrast-enhanced MRA was performed with prospective ECG-gating using a 1.5 T MRI system equipped with a 32 channel cardiac coil. MRA was acquired during free-breathing with a navigator-gated inversion-recovery prepared steady-state free precession sequence. Two readers independently assessed the CTA and MRA images for vascular definition of the PVs (from 0, not visualized, to 4, excellent definition) and ostial PV diameters. Variants of LA anatomy were assessed in consensus. CTA was successfully performed in all patients with a mean radiation exposure of 5.1 ± 2.2 mSv. MRA was successfully performed in 27 of 29 patients (93 %). Visual definition of PVs was rated significantly higher on CTA compared to MRA (p < 0.0001; reader 1: excellent/good ratings of CTA versus MRA: 100% versus 86%; reader 2: excellent/good ratings of CTA versus MRA: 99% versus 89%). Assessment of ostial PV diameters showed good correlation between CTA and MRA (reader 1: Pearson r = 0.91; reader 2: Pearson r = 0.82). Moreover, agreement between both imaging methods for evaluation of variants of LA anatomy was high (agreement rate of 95% (95% CI: 92-99%). ECG-gated CTA provides higher image quality compared to ECG-gated MRA. Nevertheless, both CTA and MRA provided similar information of LA anatomy and ostial PV diameters. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Accessibility and Barriers to Oncology Appointments at 40 National Cancer Institute-Designated Comprehensive Cancer Centers: Results of a Mystery Shopper Project.

PubMed

Hamlyn, Geoffrey S; Hutchins, Kathryn E; Johnston, Abby L; Thomas, Rishonda T; Tian, James; Kamal, Arif H

2016-10-01

Patients turn to National Cancer Institute (NCI) -designated comprehensive cancer centers because of perceived better quality and more timely access to care. However, recent studies have found that patients at various institutions may struggle to gain access to an appointment or obtain consistent information from attendants. Our study employs a mystery shopper format to identify and quantify barriers faced by patients seeking to make a first consultation appointment across a homogenous sample of 40 NCI-designated comprehensive cancer centers. Five mystery shoppers used a standardized call script to inquire about first available appointment times and service offerings. When inquiring about a date for a first available appointment, 29% of callers were unable to secure an estimated date without registering into the center's database, 51% were able to secure an estimated date, and 20% were provided with an actual date. Of estimated or actual dates for a first available appointment, 74% were greater than 1 week away. There was no statistically significant variation between appointment availability across insurance type or US region. Our study highlights the difficulty of accessing information about appointment availability. Although not statistically significant, inquiries regarding first available appointments for Medicaid patients resulted in longer estimated or actual wait times than those for patients with private insurance, and Medicaid shoppers noted qualitative differences. Although our study was limited by small sample size and imperfect analytic methods, our results suggest the need for more efficient and accessible care for patients at our nation's top cancer centers.

Primary care appointment availability and nonphysician providers one year after Medicaid expansion.

PubMed

Tipirneni, Renuka; Rhodes, Karin V; Hayward, Rodney A; Lichtenstein, Richard L; Choi, HwaJung; Reamer, Elyse N; Davis, Matthew M

2016-06-01

With insurance enrollment greater than expected under the Affordable Care Act, uncertainty about the availability and timeliness of healthcare services for newly insured individuals has increased. We examined primary care appointment availability and wait times for new Medicaid and privately insured patients before and after Medicaid expansion in Michigan. Simulated patient ("secret shopper") study. Extended follow-up of a previously reported simulated patient ("secret shopper") study assessing accessibility of routine new patient appointments in a stratified proportionate random sample of Michigan primary care practices before versus 4, 8, and 12 months after Medicaid expansion. During the study period, approximately 600,000 adults enrolled in Michigan's Medicaid expansion program, representing 57% of the previously uninsured nonelderly adult population. One year after expansion, we found that appointment availability remained increased by 6 percentage points for new Medicaid patients (95% CI, 1.6-11.1) and decreased by 2 percentage points for new privately insured patients (95% CI, -0.5 to -3.8). Over the same period, the proportion of appointments scheduled with nonphysician providers (nurse practitioners or physician assistants) increased from 8% to 21% of Medicaid appointments (95% CI, 5.6-20.2) and from 11% to 19% of private-insurance appointments (95% CI, 1.3-14.1). Median wait times remained stable for new Medicaid patients and increased slightly for new privately insured patients, both remaining within 2 weeks. During the first year following Medicaid expansion in Michigan, appointment availability for new Medicaid patients increased, a greater proportion of appointments could be obtained with nonphysician providers, and wait times remained within 2 weeks.

75 FR 70778 - Privacy Act of 1974

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-18

... information in this system will be used to evaluate the qualifications of physicians, dentists, nurses, and..., dentists and nurses; health occupations trainees including residents appointed under 38 U.S.C. 7406 whose...

25 CFR 23.13 - Payment for appointed counsel in involuntary Indian child custody proceedings in state courts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... fees and expenses to be paid appointed counsel in state juvenile delinquency proceedings; and (2... appointed counsel in state juvenile delinquency proceedings. (e) The Area Director shall authorize the...

25 CFR 23.13 - Payment for appointed counsel in involuntary Indian child custody proceedings in state courts.

Code of Federal Regulations, 2014 CFR

2014-04-01

... fees and expenses to be paid appointed counsel in state juvenile delinquency proceedings; and (2... appointed counsel in state juvenile delinquency proceedings. (e) The Area Director shall authorize the...

25 CFR 23.13 - Payment for appointed counsel in involuntary Indian child custody proceedings in state courts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... fees and expenses to be paid appointed counsel in state juvenile delinquency proceedings; and (2... appointed counsel in state juvenile delinquency proceedings. (e) The Area Director shall authorize the...

25 CFR 23.13 - Payment for appointed counsel in involuntary Indian child custody proceedings in state courts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... fees and expenses to be paid appointed counsel in state juvenile delinquency proceedings; and (2... appointed counsel in state juvenile delinquency proceedings. (e) The Area Director shall authorize the...

25 CFR 23.13 - Payment for appointed counsel in involuntary Indian child custody proceedings in state courts.

Code of Federal Regulations, 2013 CFR

2013-04-01

... fees and expenses to be paid appointed counsel in state juvenile delinquency proceedings; and (2... appointed counsel in state juvenile delinquency proceedings. (e) The Area Director shall authorize the...

Simulation of the effects of proposed tide gates on circulation, flushing, and water quality in residential canals, Cape Coral Florida

USGS Publications Warehouse

Goodwin, Carl R.

1991-01-01

Decades of dredging and filling of Florida's low-lying coastal wetlands have produced thousands of miles of residential tidal canals and adjacent waterfront property. Typically, these canals are poorly flushed, and over time, accumulated organic-rich bottom materials, contribute to an increasingly severe degraded water quality. One-dimensional hydrodynamic and constituent-transport models were applied to two dead-end canal systems to determine the effects of canal system interconnection using tide gates on water circulation and constituent flushing. The model simulates existing and possible future circulation and flushing conditions in about 29 miles of the approximately 130 miles of tidally influenced canals in Cape Coral, located on the central west coast of peninsular Florida. Model results indicate that tidal water-level differences between the two canal systems can be converted to kinetic energy, in the form of increased water circulation, but the use of one-way tide gate interconnections. Computations show that construction of from one to four tide gates will cause replacement of a volume of water equivalent to the total volume of canals in both systems in 15 to 9 days, respectively. Because some canals flush faster than others, 47 and 21 percent of the original canal water will remain in both systems 50 days after start of operation of one and four tide gates, respectively. Some of the effects that such increased flushing are expected to have include reduced density stratification and associated dissolved-oxygen depletion in canal bottom waters, increased localized reaeration, and more efficient discharge of stormwater runoff entering the canals.

Email for the coordination of healthcare appointments and attendance reminders.

PubMed

Atherton, Helen; Sawmynaden, Prescilla; Meyer, Barbara; Car, Josip

2012-08-15

Email is a popular and commonly-used method of communication, but its use in health care is not routine. Where email communication has been utilised in health care, its purposes have included the coordination of healthcare appointments and attendance reminders, but the effects of using email in this way are not known. This review considers the use of email for the coordination of healthcare appointments and reminders for attendance; particularly scheduling, rescheduling and cancelling healthcare appointments, and providing prompts/reminders for attendance at appointments. To assess the effects of using email for the coordination of healthcare appointments and attendance reminders, compared to other forms of coordinating appointments and reminders, on outcomes for health professionals, patients and carers, and health services, including harms. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010),and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies of interventions that use email for scheduling health appointments, for reminders for a scheduled health appointment or for ongoing coordination of health appointments and that took the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two review authors independently assessed the titles and abstracts of retrieved citations. No studies were identified for inclusion. Consequently, no data collection or analysis was possible. No studies met the inclusion criteria, therefore there are no results to report on the use of email for the coordination of healthcare appointments and attendance reminders. No conclusions on the effects of using email for the coordination of healthcare appointments and attendance reminders could be made and thus no recommendations for practice can be stipulated. Given the significant theoretical opportunities that email presents, there is a need for rigorous studies addressing the review question, but this may involve addressing barriers concerning trial development and implementation.