Providing a Head Start: Improving Access to Early Childhood Education for Refugees

ERIC Educational Resources Information Center

Morland, Lyn; Ives, Nicole; McNeely, Clea; Allen, Chenoa

2016-01-01

The current research on the benefits of high-quality early childhood education and care (ECEC) leaves little doubt that early interventions have both short- and long-term advantages. Quality ECEC can have substantial positive impacts on young children's social, emotional, cognitive, and language development, with long-term effects on educational…

Silviculture in cooperation with hunters: The Kinzua Quality Deer Cooperative

Treesearch

Scott Reitz; Andrea Hille; Susan Stout

2004-01-01

The long history of deer overabundance in Pennsylvania is associated with very high reforestation costs and substantial threats to diversity and sustainability. In response to this legacy, several landowners and agency personnel formed the Kinzua Quality Deer Cooperative (KQDC) in partnership with the Sand County Foundation. This Cooperative focuses on about 74,000...

48 CFR 217.171 - Multiyear contracts for services.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., vehicles, and other highly complex military equipment; (3) Specialized training requiring high-quality instructor skills (e.g., training for pilots and aircrew members or foreign language training); (4) Base... substantial contingent liabilities for the assembly, training, or transportation of a specialized work force...

EVALUATING THE EFFECTS OF NEAR ROAD SOLID AND VEGETATION BARRIERS ON MSAT EXPOSURES

EPA Science Inventory

Public health concerns for populations living, working and going to school near high-traffic roadways has increased substantially in recent years. Air quality measurement studies indicate high pollutant concentrations can occur near these large roads, impacting population exposu...

[Fundamentals of socio-hygienic monitoring of environmental conditions for students of higher education schools].

PubMed

Blinova, E G; Kuchma, V R

2012-01-01

Socioeconomic transformations and the poor environment of an industrial megalopolis negatively affected quality of life and morbidity rates in students (n = 2160). Academic intensity contributed to an increase in overall morbidity and morbidity from nervous system involvement. The regional sociohygienic monitoring of high-school training conditions within the framework of the surveillance system substantiates programs to prevent worse health and life quality in high school students.

Intersection of Re-Designated National League for Nursing Centers of Excellence(TM) and Quality in Nursing Education

ERIC Educational Resources Information Center

Merriam, Deborah

2013-01-01

Nursing education is challenged to meet a growing demand for nurses, while substantiating the quality of the educational experience as well as the achievement of desired student outcomes. The National League for Nursing (NLN) Centers of Excellence (COE) in Nursing Education(TM) program represents high performing nursing schools which utilize…

The Cost of Quality Out-of-School-Time Programs

ERIC Educational Resources Information Center

Grossman, Jean Baldwin; Lind, Christianne; Hayes, Cheryl; McMaken, Jennifer; Gersick, Andrew

2009-01-01

Funders and program planners want to know: What does it cost to operate a high-quality after-school or summer program? This study answers that question, discovering that there is no "right" number. Cost varies substantially, depending on the characteristics of the participants, the goals of the program, who operates it and where it is located.…

High-Quality TiS2 For Li/TiS2 Cells

NASA Technical Reports Server (NTRS)

Huang, Chen-Kuo; Surampudi, Subbarao; Shen, David H.; Delgiannis, Fotios; Halpert, Gerald

1992-01-01

Modified process for synthesis of battery-grade titanium sulfide (TiS2) yields substantially improved material for Li/TiS2 electrochemical cells. Includes all-vapor-phase reaction between sulfur and titanium. Product less dense and more homogeneous, consists of smaller particles of higher crystalline quality, and purer. Cells have high cathode utilization and long cycle life performance. Expected to find applications in rechargeable lithium batteries for spacecraft, military equipment, telecommunication systems, automobiles, and consumer products.

Molds for cable dielectrics

DOEpatents

Roose, L.D.

1996-12-10

Molds for use in making end moldings for high-voltage cables are described wherein the dielectric insulator of a cable is heated and molded to conform to a desired shape. As a consequence, high quality substantially bubble-free cable connectors suitable for mating to premanufactured fittings are made. 5 figs.

Common Effects Methodology for Pesticides

EPA Pesticide Factsheets

EPA is exploring how to build on the substantial high quality science developed under both OPP programs to develop additional tools and approaches to support a consistent and common set of effects characterization methods using best available information.

Assessing the ecological benefits and opportunity costs of alternative stream management zone widths for eastern hardwoods

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2008-01-01

Leaving buffer zones adjacent to waterways can effectively reduce the water quality concerns associated with timber harvesting. However, riparian areas are also some of the most productive sites and can yield high quality wood. The amount of unharvested timber left in SMZs (Streamside Management Zones) can represent a substantial opportunity cost to landowners. In this...

Assessing the ecological benefits and opportunity costs of alternative stream management zone widths

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2008-01-01

Leaving buffer zones adjacent to waterways can effectively reduce the water quality concerns associated with timber harvesting. However, riparian areas are also some of the most productive sites and can yield high quality wood. The amount of unharvested timber left in SMZs (Streamside Management Zones) can represent a substantial opportunity cost to landowners. In this...

Meaningful Investments in Pre-K: Estimating the Per-Child Costs of Quality Programs. Pre-K Now Research Series

ERIC Educational Resources Information Center

Gault, Barbara; Mitchell, Anne W.; Williams, Erica

2008-01-01

Pre-kindergarten programs are expanding in states around the nation. Decades of research on the impact of these programs show that high quality standards produce substantial benefits for children, working families, and communities. As state leaders seek to increase investments in pre-k, they face a number of choices and potential tradeoffs that…

Development and use of a population based injury surveillance system: the All Wales Injury Surveillance System (AWISS)

PubMed Central

Lyons, R; Jones, S; Kemp, A; Sibert, J; Shepherd, J; Richmond, P; Bartlett, C; Palmer, S

2002-01-01

This report details the development and use of a population based emergency room surveillance system in the UK. Despite some difficulties in accessing high quality data the system has stimulated a considerable number of research and intervention projects. While surveillance systems with high quality data collection and coding parameters remain the gold standard, imperfect systems, particularly if population based, can play a substantial part in stimulating injury prevention initiatives. PMID:11928983

Microbial Risk Assessment of Air Conditioning Condensate Reuse

EPA Science Inventory

Air conditioning condensate can provide a substantial water source for building-scale collection and non-potable use. Although produced water is anticipated to be of generally high quality, the potential for microbial contamination by biofilm-associated opportunistic pathogens t...

Correctional Education: Past Is Prologue to the Future.

ERIC Educational Resources Information Center

Ryan, T. A.

1995-01-01

For two centuries, correctional education's philosophy has alternated between punishment/retribution and reform/rehabilitation. Despite a renewed punitive ethos, a substantial body of research documents the worth of correctional education and the continuing need for high quality programs. (SK)

Common Effects Methodology National Stakeholder Meeting December 1, 2010

EPA Pesticide Factsheets

EPA is exploring how to build on the substantial high quality science developed under both OPP programs to develop additional tools and approaches to support a consistent and common set of effects characterization methods using best available information.

School Quality and the Development of Cognitive Skills between Age Four and Six

PubMed Central

Borghans, Lex; Golsteyn, Bart H. H.; Zölitz, Ulf

2015-01-01

This paper studies the extent to which young children develop their cognitive ability in high and low quality schools. We use a representative panel data set containing cognitive test scores of 4-6 year olds in Dutch schools. School quality is measured by the school’s average achievement test score at age 12. Our results indicate that children in high-quality schools develop their skills substantially faster than those in low-quality schools. The results remain robust to the inclusion of initial ability, parental background, and neighborhood controls. Moreover, using proximity to higher-achieving schools as an instrument for school choice corroborates the results. The robustness of the results points toward a causal interpretation, although it is not possible to erase all doubt about unobserved confounding factors. PMID:26182123

Free smoking cessation mobile apps available in Australia: a quality review and content analysis.

PubMed

Thornton, Louise; Quinn, Catherine; Birrell, Louise; Guillaumier, Ashleigh; Shaw, Brad; Forbes, Erin; Deady, Mark; Kay-Lambkin, Frances

2017-12-01

This review aimed to identify free, high-quality, smoking cessation mobile applications (apps) that adhere to Australian smoking cessation treatment guidelines. A systematic search of smoking cessation apps was conducted using Google. The technical quality of relevant apps was rated using the Mobile Application Rating Scale. The content of apps identified as high quality was assessed for adherence to smoking cessation treatment guidelines. 112 relevant apps were identified. The majority were of poor technical quality and only six 'high-quality' apps were identified. These apps adhered to Australian treatment guidelines in part. The efficacy of two apps had been previously evaluated. In lieu of more substantial research in this area, it is suggested that the high-quality apps identified in this review may be more likely than other available apps to encourage smoking cessation. Implications for public health: Smoking cessation apps have the potential to address many barriers that prevent smoking cessation support being provided; however few high-quality smoking cessation apps are currently available in Australia, very few have been evaluated and the app market is extremely volatile. More research to evaluate smoking cessation apps, and sustained funding for evidence-based apps, is needed. © 2017 The Authors.

SU-F-J-26: Performance of 2.5MV Portal Imaging in Comparison with KV X-Ray and 6MV and Flattening-Filter-Free 6MV Portal Imaging

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

Duan, J; Yang, Y; Faught, A

Purpose: To assess image quality and imaging dose of 2.5MV electronic portal imaging in comparison to kV imaging and 6MV and Flattening-Filter-Free 6MV (6MVFFF) portal imaging using a DMI imager. Methods: Quantitative assessment of image quality was performed with Leeds and Las Vegas test phantoms in conjunction with qualitative evaluation of clinical patient images for kV imaging and 2.5MV, 6MV and 6MVFFF portal imaging. High and low contrast resolutions were evaluated and imaging doses were measured using these x-rays. Phantom test was performed both in air and in solid water. Clinical patient portal images were also reviewed and qualitatively assessedmore » for these three imaging MV energies. Results: Among the 28 objects in Las Vegas phantom, 16, 17 and 26 of them were resolved using Low Dose technique and 18, 22 and 26 were resolved using High Quality technique with 6MV, 6MVFFF and 2.5MV, respectively. The number of Leeds low contrast objects resolved by 6MV, 6MFFFF and 2.5MV was 6, 15 and 18 with Low Dose technique and 14, 17 and 18 with High Quality technique, respectively. When the test phantoms were embedded in 20cm thick solid water, the results were noticeably affected, but the performance of 2.5MV was still substantially better than 6MV and 6MVFFF. Imaging dose with 2.5MV measured at 10 cm depth was about half of that with 6MV or 6MVFFF. Clinical patient portal images were reviewed and qualitatively assessed for different sites including brain, head-and-neck, chest and pelvis. 2.5MV imaging provided more details and substantially higher contrast. Conclusion: While portal imaging with 6MVFFF provides noticeably better image quality than that with 6MV, the performance of 2.5MV portal imaging is substantially better than both 6MV and 6MVFFF in terms of high and low contrast resolutions as well as lower imaging dose. 2.5MV imaging provides near kV imaging quality.« less

Superconductors

DOEpatents

Newkirk, Lawrence R.; Valencia, Flavio A.

1977-02-01

The structural quality of niobium germanide as a high-transition-temperature superconducting material is substantially improved by the presence of about 5 at. % oxygen. Niobium germanide having this oxygen content may readily be prepared as a bulk coating bonded to a metallic substrate by chemical vapor deposition techniques.

Common Effects Methodology National Stakeholder Meeting December 1, 2010 White Papers

EPA Pesticide Factsheets

EPA is exploring how to build on the substantial high quality science developed under both OPP programs to develop additional tools and approaches to support a consistent and common set of effects characterization methods using best available information.

Common Effects Methodology Regional Stakeholder Meeting January 11 -22, 2010

EPA Pesticide Factsheets

EPA is exploring how to build on the substantial high quality science developed under both OPP programs to develop additional tools and approaches to support a consistent and common set of effects characterization methods using best available information.

Development of EPA aircraft piston engine emission standards. [for air quality

NASA Technical Reports Server (NTRS)

Houtman, W.

1976-01-01

Piston engine light aircraft are significant sources of carbon monoxide in the vicinity of high activity general aviation airports. Substantial reductions in carbon monoxide were achieved by fuel mixture leaning using improved fuel management systems. The air quality impact of the hydrocarbon and oxides of nitrogen emissions from piston engine light aircraft were insufficient to justify the design constraints being confronted in present control system developments.

Supporting Early Math--Rationales and Requirements for High Quality Software

ERIC Educational Resources Information Center

Haake, Magnus; Husain, Layla; Gulz, Agneta

2015-01-01

There is substantial evidence that preschooler's performance in early math is highly correlated to math performance throughout school as well as academic skills in general. One way to help children attain early math skills is by using targeted educational software and the paper discusses potential gains of using such software to support early math…

Influence of Solid Noise Barriers on Near-Road and On-Road Air Quality

EPA Science Inventory

Public health concerns regarding adverse health effects for populations spending significant amounts of time near high traffic roadways has increased substantially in recent years. Roadside features, including solid noise barriers, have been investigated as potential methods to ...

Exploring Environmental Variation in Residential Care Facilities for Older People.

PubMed

Nordin, Susanna; McKee, Kevin; Wijk, Helle; Elf, Marie

2017-01-01

The aim of this study was to explore variation in environmental quality in Swedish residential care facilities (RCFs) using the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM). Well-designed physical environments can positively impact on health and well-being among older persons with frail health living in RCFs and are essential for supporting person-centered care. However, the evidence base for informing the design of RCFs is weak, partly due to a lack of valid and reliable instruments that could provide important information on the environmental quality. Twenty RCFs were purposively sampled from several regions, varying in their building design, year of construction, size, and geographic location. The RCFs were assessed using S-SCEAM and the data were analyzed to examine variation in environmental quality between and within facilities. There was substantial variation in the quality of the physical environment between and within RCFs, reflected in S-SCEAM scores related to specific facility locations and with regard to domains reflecting residents' needs. In general, private apartments and dining areas had high S-SCEAM scores, while gardens had lower scores. Scores on the safety domain were high in the majority of RCFs, whereas scores for cognitive support and privacy were relatively low. Despite high building standard requirements, the substantial variations regarding environmental quality between and within RCFs indicate the potential for improvements to support the needs of older persons. We conclude that S-SCEAM is a sensitive and unique instrument representing a valuable contribution to evidence-based design that can support person-centered care.

Improving bladder cancer patient care: a pharmacoeconomic perspective.

PubMed

Gore, John L; Gilbert, Scott M

2013-06-01

Bladder cancer is the most expensive cancer per capita to treat in the US healthcare system. Substantial costs associated with the diagnosis, management and surveillance of bladder cancer account for the bulk of the expense; yet, for that cost, patients may not receive high-quality care. Herein the authors review the sources of expenditure associated with bladder cancer care, review population-level analyses of the quality of bladder cancer care in the USA, and discuss opportunities for quality improvement that may yield greater value for men and women newly diagnosed with bladder cancer.

Access to treatment and educational inequalities in cancer survival.

PubMed

Fiva, Jon H; Hægeland, Torbjørn; Rønning, Marte; Syse, Astri

2014-07-01

The public health care systems in the Nordic countries provide high quality care almost free of charge to all citizens. However, social inequalities in health persist. Previous research has, for example, documented substantial educational inequalities in cancer survival. We investigate to what extent this may be driven by differential access to and utilization of high quality treatment options. Quasi-experimental evidence based on the establishment of regional cancer wards indicates that (i) highly educated individuals utilized centralized specialized treatment to a greater extent than less educated patients and (ii) the use of such treatment improved these patients' survival. Copyright © 2014 Elsevier B.V. All rights reserved.

The impact of flying qualities on helicopter operational agility

NASA Technical Reports Server (NTRS)

Padfield, Gareth D.; Lappos, Nick; Hodgkinson, John

1993-01-01

Flying qualities standards are formally set to ensure safe flight and therefore reflect minimum, rather than optimum, requirements. Agility is a flying quality but relates to operations at high, if not maximum, performance. While the quality metrics and test procedures for flying, as covered for example in ADS33C, may provide an adequate structure to encompass agility, they do not currently address flight at high performance. This is also true in the fixed-wing world and a current concern in both communities is the absence of substantiated agility criteria and possible conflicts between flying qualities and high performance. AGARD is sponsoring a working group (WG19) title 'Operational Agility' that deals with these and a range of related issues. This paper is condensed from contributions by the three authors to WG19, relating to flying qualities. Novel perspectives on the subject are presented including the agility factor, that quantifies performance margins in flying qualities terms; a new parameter, based on maneuver acceleration is introduced as a potential candidate for defining upper limits to flying qualities. Finally, a probabilistic analysis of pilot handling qualities ratings is presented that suggests a powerful relationship between inherent airframe flying qualities and operational agility.

Signal quality of endovascular electroencephalography

NASA Astrophysics Data System (ADS)

He, Bryan D.; Ebrahimi, Mosalam; Palafox, Leon; Srinivasan, Lakshminarayan

2016-02-01

Objective, Approach. A growing number of prototypes for diagnosing and treating neurological and psychiatric diseases are predicated on access to high-quality brain signals, which typically requires surgically opening the skull. Where endovascular navigation previously transformed the treatment of cerebral vascular malformations, we now show that it can provide access to brain signals with substantially higher signal quality than scalp recordings. Main results. While endovascular signals were known to be larger in amplitude than scalp signals, our analysis in rabbits borrows a standard technique from communication theory to show endovascular signals also have up to 100× better signal-to-noise ratio. Significance. With a viable minimally-invasive path to high-quality brain signals, patients with brain diseases could one day receive potent electroceuticals through the bloodstream, in the course of a brief outpatient procedure.

Structure and chemistry of the sorghum grain

USDA-ARS?s Scientific Manuscript database

Sorghum is grown around the world and often under harsh and variable environmental conditions. Combined with the high degree of genetic diversity present in sorghum, this can result in substantial variability in grain composition and grain quality. While similar to other cereal grains such as maize ...

Cutting Costs on Computer Forms.

ERIC Educational Resources Information Center

Rupp, Robert V., Jr.

1989-01-01

Using the experience of Ford Motor Company, Oscar Meyer, and IBM, this article shows that companies are enjoying high quality product performance and substantially lower costs by converting from premium white bond computer stock forms to blended bond forms. School administrators are advised to do likewise. (MLH)

Draft versus finished sequence data for DNA and protein diagnostic signature development

PubMed Central

Gardner, Shea N.; Lam, Marisa W.; Smith, Jason R.; Torres, Clinton L.; Slezak, Tom R.

2005-01-01

Sequencing pathogen genomes is costly, demanding careful allocation of limited sequencing resources. We built a computational Sequencing Analysis Pipeline (SAP) to guide decisions regarding the amount of genomic sequencing necessary to develop high-quality diagnostic DNA and protein signatures. SAP uses simulations to estimate the number of target genomes and close phylogenetic relatives (near neighbors or NNs) to sequence. We use SAP to assess whether draft data are sufficient or finished sequencing is required using Marburg and variola virus sequences. Simulations indicate that intermediate to high-quality draft with error rates of 10−3–10−5 (∼8× coverage) of target organisms is suitable for DNA signature prediction. Low-quality draft with error rates of ∼1% (3× to 6× coverage) of target isolates is inadequate for DNA signature prediction, although low-quality draft of NNs is sufficient, as long as the target genomes are of high quality. For protein signature prediction, sequencing errors in target genomes substantially reduce the detection of amino acid sequence conservation, even if the draft is of high quality. In summary, high-quality draft of target and low-quality draft of NNs appears to be a cost-effective investment for DNA signature prediction, but may lead to underestimation of predicted protein signatures. PMID:16243783

Wire EDM for Refractory Materials

NASA Technical Reports Server (NTRS)

Zellars, G. R.; Harris, F. E.; Lowell, C. E.; Pollman, W. M.; Rys, V. J.; Wills, R. J.

1982-01-01

In an attempt to reduce fabrication time and costs, Wire Electrical Discharge Machine (Wire EDM) method was investigated as tool for fabricating matched blade roots and disk slots. Eight high-strength nickel-base superalloys were used. Computer-controlled Wire EDM technique provided high quality surfaces with excellent dimensional tolerances. Wire EDM method offers potential for substantial reductions in fabrication costs for "hard to machine" alloys and electrically conductive materials in specific high-precision applications.

Chapter 6. Temporal and spatial scales

Treesearch

Robert R. Ziemer

1997-01-01

Human activities have degraded substantial portions of the nation’s ecological resources, including physical and biological aquatic systems. The effects are continuing and cumulative, and few high-quality aquatic ecosystems remain in the United States. Concern about these diminishing resources has resulted in numerous restoration programs. Some are well conceived...

An Evaluation of an Automated Approach to Concept-Based Grammar Instruction

ERIC Educational Resources Information Center

Lyddon, Paul A.

2012-01-01

Acquiring sufficient linguistic proficiency to perform competently in academic and professional contexts generally requires substantial study time beyond what most language programs can offer in the classroom. As such, teachers and students alike would benefit considerably from high quality self-access materials promoting independent learning out…

South Coast Air Quality Management District Truck Testing | Transportation

Science.gov Websites

movement of cargo containers, also known as drayage, creates substantial air pollution in the vicinity of and U.S. Hybrid Corporation, transport cargo containers between the port complex and local rail yards and distribution centers. Utilizing advanced batteries and high-efficiency components, the electric

Early Childhood Education: The Long-Term Benefits

ERIC Educational Resources Information Center

Bakken, Linda; Brown, Nola; Downing, Barry

2017-01-01

This study was designed to substantiate the positive, long-term outcomes demonstrated by children from economically disadvantaged homes who received a high-quality, early education. Children who attended The Opportunity Project (TOP) Early Learning Centers in a midwestern city in the United States were matched with a like control sample from a…

Preschool and Prosperity. Policy Paper No. 2014-017

ERIC Educational Resources Information Center

Bartik, Timothy J.

2014-01-01

Substantial research shows that high-quality early childhood education programs have a large economic payoff. This payoff is increased earnings for former child participants, increased earnings for parents, and increased earnings for all workers when average worker skills improve. A program package of universal pre-K, combined with child care and…

Experiences of Paraprofessionals in US Preschool Special Education and General Education Classrooms

ERIC Educational Resources Information Center

Brown, Tiara Saufley; Stanton-Chapman, Tina L.

2017-01-01

A substantial challenge confronting public education systems across the world is the employment and retention of high-quality paraprofessionals (also known as teaching assistants and educational assistants). The current study expands upon previous research by employing a mixed methods design to examine the relationship between paraprofessionals'…

Estimating Environmental Co-benefits of U.S. CO2 Reduction Pathways Using the GCAM-USA Integrated Assessment Model

EPA Science Inventory

Various technological pathways can lead to reduced CO2 emissions. However, different pathways can have substantially different impacts on other environmental endpoints, such as air quality and energy-related water demand. The Global Change Assessment Model (GCAM) is a high resolu...

The Productivity Push: System-Wide Reform Allows Arizona to Serve More Students. Lumina Foundation Focus[TM]. Summer 2010

ERIC Educational Resources Information Center

Giegerich, Steve

2010-01-01

Today, the United States spends about twice as much on higher education as the average developed nation, but many other countries are doing a better job of graduating more students at substantially lower expense. To provide more high-quality degrees and credentials at lower cost, colleges and universities must become high-performing institutions.…

Average effect estimates remain similar as evidence evolves from single trials to high-quality bodies of evidence: a meta-epidemiologic study.

PubMed

Gartlehner, Gerald; Dobrescu, Andreea; Evans, Tammeka Swinson; Thaler, Kylie; Nussbaumer, Barbara; Sommer, Isolde; Lohr, Kathleen N

2016-01-01

The objective of our study was to use a diverse sample of medical interventions to assess empirically whether first trials rendered substantially different treatment effect estimates than reliable, high-quality bodies of evidence. We used a meta-epidemiologic study design using 100 randomly selected bodies of evidence from Cochrane reports that had been graded as high quality of evidence. To determine the concordance of effect estimates between first and subsequent trials, we applied both quantitative and qualitative approaches. For quantitative assessment, we used Lin's concordance correlation and calculated z-scores; to determine the magnitude of differences of treatment effects, we calculated standardized mean differences (SMDs) and ratios of relative risks. We determined qualitative concordance based on a two-tiered approach incorporating changes in statistical significance and magnitude of effect. First trials both overestimated and underestimated the true treatment effects in no discernible pattern. Nevertheless, depending on the definition of concordance, effect estimates of first trials were concordant with pooled subsequent studies in at least 33% but up to 50% of comparisons. The pooled magnitude of change as bodies of evidence advanced from single trials to high-quality bodies of evidence was 0.16 SMD [95% confidence interval (CI): 0.12, 0.21]. In 80% of comparisons, the difference in effect estimates was smaller than 0.5 SMDs. In first trials with large treatment effects (>0.5 SMD), however, estimates of effect substantially changed as new evidence accrued (mean change 0.68 SMD; 95% CI: 0.50, 0.86). Results of first trials often change, but the magnitude of change, on average, is small. Exceptions are first trials that present large treatment effects, which often dissipate as new evidence accrues. Copyright © 2016 Elsevier Inc. All rights reserved.

Stillbirths: the way forward in high-income countries.

PubMed

Flenady, Vicki; Middleton, Philippa; Smith, Gordon C; Duke, Wes; Erwich, Jan Jaap; Khong, T Yee; Neilson, Jim; Ezzati, Majid; Koopmans, Laura; Ellwood, David; Fretts, Ruth; Frøen, J Frederik

2011-05-14

Stillbirth rates in high-income countries declined dramatically from about 1940, but this decline has slowed or stalled over recent times. The present variation in stillbirth rates across and within high-income countries indicates that further reduction in stillbirth is possible. Large disparities (linked to disadvantage such as poverty) in stillbirth rates need to be addressed by providing more educational opportunities and improving living conditions for women. Placental pathologies and infection associated with preterm birth are linked to a substantial proportion of stillbirths. The proportion of unexplained stillbirths associated with under investigation continues to impede efforts in stillbirth prevention. Overweight, obesity, and smoking are important modifiable risk factors for stillbirth, and advanced maternal age is also an increasingly prevalent risk factor. Intensified efforts are needed to ameliorate the effects of these factors on stillbirth rates. Culturally appropriate preconception care and quality antenatal care that is accessible to all women has the potential to reduce stillbirth rates in high-income countries. Implementation of national perinatal mortality audit programmes aimed at improving the quality of care could substantially reduce stillbirths. Better data on numbers and causes of stillbirth are needed, and international consensus on definition and classification related to stillbirth is a priority. All parents should be offered a thorough investigation including a high-quality autopsy and placental histopathology. Parent organisations are powerful change agents and could have an important role in raising awareness to prevent stillbirth. Future research must focus on screening and interventions to reduce antepartum stillbirth as a result of placental dysfunction. Identification of ways to reduce maternal overweight and obesity is a high priority for high-income countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

Interactions between environmental variables determine immunity in the Indian meal moth Plodia interpunctella.

PubMed

Triggs, Alison; Knell, Robert J

2012-03-01

1. Animals raised in good environmental conditions are expected to have more resources to invest in immunity than those raised in poor conditions. Variation in immune activity and parasite resistance in response to changes in environmental temperature, population density and food quality have been shown in many invertebrate species. 2. Almost all studies to date have examined the effects of individual variables in isolation. The aim of this study was to address whether environmental factors interact to produce synergistic effects on phenoloxidase (PO) activity and haemocyte count, both indicators of immune system activity. Temperature, food quality and density were varied in a fully factorial design for a total of eight treatment combinations. 3. Strong interactions between the three environmental variables led to the magnitude and in some cases the direction of the effect of most variables changing as the other environmental factors were altered. Overall, food quality had the most important and consistent influence, larvae raised on a good-quality diet having substantially higher PO activity in every case and substantially higher haemocyte counts in all treatments except unheated/low density. 4. When food quality was good, the larvae showed 'density-dependent prophylaxis': raising their investment in immunity when population density is high. When food quality was poor and the temperature low, however, those larvae raised at high densities invested less in immunity. 5. Increased temperature is often thought to lead to increased immune reactivity in ectotherms, but we found that the effect of temperature was strongly dependent on the values of other environmental variables. PO activity increased with temperature when larvae were raised on good food or when density was high, but when food was poor and density low, a higher temperature led to reduced PO activity. A higher temperature led to higher haemocyte counts when density was high and food quality was poor, but in all other cases, the effect of increased temperature was either close to zero or somewhat negative. 6. Although PO activity and haemocyte count were weakly correlated across the whole data set, there were a number of treatments where the two measures responded in different ways to environmental change. Overall, effect sizes for PO activity were substantially higher than those for haemocyte count, indicating that the different components of the immune system vary in their sensitivity to environmental change. 7. Predictions of the effect of environmental or population change on immunity and disease dynamics based on laboratory experiments that only investigate the effects of single variable are likely to be inaccurate or even entirely wrong. © 2011 The Authors. Journal of Animal Ecology © 2011 British Ecological Society.

Surface states in the photoionization of high-quality CdSe core/shell nanocrystals.

PubMed

Li, Shu; Steigerwald, Michael L; Brus, Louis E

2009-05-26

We use electric force microscopy (EFM) to study single nanocrystal photoionization in two classes of high-quality nanocrystals whose exciton luminescence quantum yields approach unity in solution. The CdSe/CdS/ZnS core/shell nanocrystals do not photoionize, while the CdSe/CdS nanocrystals do show substantial photoionization. This verifies the theoretical prediction that the ZnS shell confines the excited electron within the nanocrystal. Despite the high luminescence quantum yield, photoionization varies substantially among the CdSe/CdS nanocrystals. We have studied the nanocrystal photoionization with both UV (396 nm) and green (532 nm) light, and we have found that the magnitude of the charge due to photoionization per absorbed photon is greater for UV excitation than for green excitation. A fraction of the photoionization occurs directly via a "hot electron" process, using trap states that are either on the particle surface, within the ligand sphere, or within the silicon oxide layer. This must occur without relaxation to the thermalized, lowest-energy, emitting exciton. We discuss the occurrence of hot carrier processes that are common to photoionization, luminescence blinking, and the fast transient optical absorption that is associated with multiple exciton generation MEG studies.

Most Americans Do Not Believe That There Is An Association Between Health Care Prices And Quality Of Care.

PubMed

Phillips, Kathryn A; Schleifer, David; Hagelskamp, Carolin

2016-04-01

Many organizations are developing health care price information tools for consumers. However, consumers may avoid low-price care if they perceive price to be associated with quality. We conducted a nationally representative survey to examine whether consumers perceive that price and quality are associated and whether the way in which questions are framed affects consumers' responses. Most Americans (58-71 percent, depending on question framing) did not think that price and quality are associated, but a substantial minority did perceive an association (21-24 percent) or were unsure whether there was one (8-16 percent). Responses to questions framed in terms of high price and high quality differed from responses to questions framed in terms of low price and low quality. People who had compared prices were more likely than those who had not compared prices to perceive that price and quality were associated. We explore implications of these findings, including how behavioral economics can inform approaches to helping consumers use price and quality information. Project HOPE—The People-to-People Health Foundation, Inc.

Most Americans Do Not Believe That There Is An Association Between Health Care Prices And Quality Of Care

PubMed Central

Phillips, Kathryn A; Schleifer, David; Hagelskamp, Carolin

2016-01-01

Many organizations are developing health care price information tools for consumers. However, consumers may avoid low-price care if they perceive price to be associated with quality. We conducted a nationally representative survey to examine whether consumers perceive that price and quality are associated and whether the way in which questions are framed affects consumers’ responses. Most Americans (58–71 percent, depending on question framing) did not think that price and quality are associated, but a substantial minority did perceive an association (21–24 percent) or were unsure if there was one (8–16 percent). Responses to questions framed in terms of high price and high quality differed from responses to questions framed in terms of low price and low quality. People who had compared prices were more likely than those who have not compared prices to perceive that price and quality were associated. We explore implications of these findings, including how behavioral economics can inform approaches to helping consumers use price and quality information. PMID:27044965

Improving the quality of EHR recording in primary care: a data quality feedback tool.

PubMed

van der Bij, Sjoukje; Khan, Nasra; Ten Veen, Petra; de Bakker, Dinny H; Verheij, Robert A

2017-01-01

Electronic health record (EHR) data are used to exchange information among health care providers. For this purpose, the quality of the data is essential. We developed a data quality feedback tool that evaluates differences in EHR data quality among practices and software packages as part of a larger intervention. The tool was applied in 92 practices in the Netherlands using different software packages. Practices received data quality feedback in 2010 and 2012. We observed large differences in the quality of recording. For example, the percentage of episodes of care that had a meaningful diagnostic code ranged from 30% to 100%. Differences were highly related to the software package. A year after the first measurement, the quality of recording had improved significantly and differences decreased, with 67% of the physicians indicating that they had actively changed their recording habits based on the results of the first measurement. About 80% found the feedback helpful in pinpointing recording problems. One of the software vendors made changes in functionality as a result of the feedback. Our EHR data quality feedback tool is capable of highlighting differences among practices and software packages. As such, it also stimulates improvements. As substantial variability in recording is related to the software package, our study strengthens the evidence that data quality can be improved substantially by standardizing the functionalities of EHR software packages. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Jahnke, Fred C.

FuelCell Energy and ACuPowder investigated and demonstrated the use of waste anode exhaust gas from a high temperature fuel cell for replacing the reducing gas in a metal processing furnace. Currently companies purchase high pressure or liquefied gases for the reducing gas which requires substantial energy in production, compression/liquefaction, and transportation, all of which is eliminated by on-site use of anode exhaust gas as reducing gas. We performed research on the impact of the gas composition on product quality and then demonstrated at FuelCell Energy’s manufacturing facility in Torrington, Connecticut. This demonstration project continues to operate even though the researchmore » program is completed as it provides substantial benefits to the manufacturing facility by supplying power, heat, and hydrogen.« less

Impact of urban sprawl on water quality in eastern Massachusetts, USA.

PubMed

Tu, Jun; Xia, Zong-Guo; Clarke, Keith C; Frei, Allan

2007-08-01

A study of water quality, land use, and population variations over the past three decades was conducted in eastern Massachusetts to examine the impact of urban sprawl on water quality using geographic information system and statistical analyses. Since 1970, eastern Massachusetts has experienced pronounced urban sprawl, which has a substantial impact on water quality. High spatial correlations are found between water quality indicators (especially specific conductance, dissolved ions, including Ca, Mg, Na, and Cl, and dissolved solid) and urban sprawl indicators. Urbanized watersheds with high population density, high percentage of developed land use, and low per capita developed land use tended to have high concentrations of water pollutants. The impact of urban sprawl also shows clear spatial difference between suburban areas and central cities: The central cities experienced lower increases over time in specific conductance concentration, compared to suburban and rural areas. The impact of urban sprawl on water quality is attributed to the combined effects of population and land-use change. Per capita developed land use is a very important indicator for studying the impact of urban sprawl and improving land use and watershed management, because inclusion of this indicator can better explain the temporal and spatial variations of more water quality parameters than using individual land use or/and population density.

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

PubMed

Hanna, Timothy P; Kangolle, Alfred C T

2010-10-13

Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

Myrmecochores can target high-quality disperser ants: variation in elaiosome traits and ant preferences for myrmecochorous Euphorbiaceae in Brazilian Caatinga.

PubMed

Leal, Laura Carolina; Lima Neto, Mário Correia; de Oliveira, Antônio Fernando Morais; Andersen, Alan N; Leal, Inara R

2014-02-01

Recent evidence suggests that the traditional view of myrmecochory as a highly diffuse interaction between diaspores and a wide range of ant species attracted to their elaiosomes may not be correct. The effectiveness of dispersal varies markedly among ant species, and combined with differential attractiveness of diaspores due to elaiosome size and composition, this raises the potential for myrmecochorous plants to target ant species that offer the highest quality dispersal services. We ask the question: Do particular physical and chemical traits of elaiosomes result in disproportionate removal of Euphorbiaceae diaspores by high-quality disperser ants in Caatinga vegetation of north-eastern Brazil? We offered seeds of five euphorb species that varied in morphological and chemical traits of elaiosomes to seed-dispersing ants. High-quality seed-disperser ants (species of Dinoponera, Ectatomma and Camponotus) were identified as those that rapidly collected and transported diaspores to their nests, often over substantial distances, whereas low-quality disperser ants (primarily species of Pheidole and Solenopsis) typically fed on elaiosomes in situ, and only ever transported diaspores very short distances. Low-quality disperser ants were equally attracted to the elaiosomes of all study species. However, high-quality dispersers showed a strong preference for diaspores with the highest elaiosome mass (and especially proportional mass). As far as we are aware, this is the first study to identify a mechanism of diaspore selection by high-quality ant dispersers based on elaiosome traits under field conditions. Our findings suggest that myrmecochorous plants can preferentially target high-quality seed-disperser ants through the evolution of particular elaiosome traits.

A Preliminary Efficacy and Feasibility of an Obstructive Sleep Apnea Educational Intervention in Oman

ERIC Educational Resources Information Center

Al Mezeini, Khamis Abdallah

2017-01-01

Background: Obstructive sleep apnea (OSA) is chronic disorder that contributes to multiple physiological and psychological conditions. Obstructive sleep apnea contributes to high rates of morbidity and mortality and has substantial impacts on both health care costs and the quality of life for affected individuals and their families. Healthcare…

Construction Management, in a Miami Test, Saves $1.5 Million

ERIC Educational Resources Information Center

Architectural Record, 1977

1977-01-01

In direct comparison with a high school built according to traditional design and contracting, a new prototype for the Dade County School District resulted in substantial savings without sacrificing quality. Available from: McGraw Hill Inc., 1221 Avenue of the Americas, New York, New York 10020, $5.00 single copy. (Author)

Preschool Teacher Education as an Example of an Open Social System

ERIC Educational Resources Information Center

Tekmen, Belkis

2017-01-01

With the realization of the substantial long-term educational, social, and economic benefits produced by high-quality preschool education, preschool teachers' education has come under increasing scrutiny in recent years. Moreover, other than the studies that focus on providing evidence for the impact of preschool education on children's outcomes,…

Software Innovations: The Influence of Quality, Diversity and Structure of Network Ties

ERIC Educational Resources Information Center

Singh, Harpeet

2010-01-01

There is high uncertainty associated with the outcomes of Information Technology (IT) investments and innovations. In such environments, IT actors (firm and individuals) are also unsure about their actions and preferences. The social relationships of these actors create substantial value for these actors in multiple ways (e.g. providing social…

Selective nanoscale growth of lattice mismatched materials

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

Lee, Seung-Chang; Brueck, Steven R. J.

Exemplary embodiments provide materials and methods of forming high-quality semiconductor devices using lattice-mismatched materials. In one embodiment, a composite film including one or more substantially-single-particle-thick nanoparticle layers can be deposited over a substrate as a nanoscale selective growth mask for epitaxially growing lattice-mismatched materials over the substrate.

Time to Reexamine Institutional Cooperation on Financial Aid

ERIC Educational Resources Information Center

Reed, Matthew

2008-01-01

Many public and private colleges give out substantial amounts of financial aid in excess of students' demonstrated financial need to attract the most talented students in a competitive marketplace. These colleges see merit aid as an investment in institutional quality. Since top students are in high demand, colleges may have to bid against each…

Factors Affecting the Quality of Engineering Education in the Four Largest Emerging Economies

ERIC Educational Resources Information Center

Loyalka, Prashant; Carnoy, Martin; Froumin, Isak; Dossani, Raffiq; Tilak, J. B.; Yang, Po

2014-01-01

A huge increase in engineering graduates from the BRIC countries in recent decades potentially threatens the competitiveness of developed countries in producing high value-added products and services, while also holding great promise for substantially increasing the level of global basic and applied innovation. The key question is whether the…

A Peer Assessment System to Improve Student Team Experiences

ERIC Educational Resources Information Center

Anson, Robert; Goodman, James A.

2014-01-01

Groups are frequently used in courses, but there is substantial evidence that insufficient attention is paid to creating conditions for successful teamwork. One key condition is high-quality, individual, and team-level feedback. An online peer assessment system and team improvement process was developed for this test case based on three design…

Use of osmotic dehydration to improve fruits and vegetables quality during processing.

PubMed

Maftoonazad, Neda

2010-11-01

Osmotic treatment describes a preparation step to further processing of foods involving simultaneous transient moisture loss and solids gain when immersing in osmotic solutions, resulting in partial drying and improving the overall quality of food products. The different aspects of the osmotic dehydration (OD) technology namely the solutes employed, solutions characteristics used, process variables influence, as well as, the quality characteristics of the osmodehydrated products will be discussed in this review. As the process is carried out at mild temperatures and the moisture is removed by a liquid diffusion process, phase change that would be present in the other drying processes will be avoided, resulting in high quality products and may also lead to substantial energy savings. To optimize this process, modeling of the mass transfer phenomenon can improve high product quality. Several techniques such as microwave heating, vacuum, high pressure, pulsed electric field, etc. may be employed during or after osmotic treatment to enhance performance of the osmotic dehydration. Moreover new technologies used in osmotic dehydration will be discussed. Patents on osmotic dehydration of fruits and vegetables are also discussed in this article.

Bundled Payments in Total Joint Replacement: Keeping Our Care Affordable and High in Quality.

PubMed

McLawhorn, Alexander S; Buller, Leonard T

2017-09-01

The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control. Early results of bundled payments are promising, but preserving access to care for patients with high comorbidity burdens and those requiring more complex care is a lingering concern. Hospitals, regardless of current participation in bundled payments, should develop care pathways for TJA to maximize efficiency and patient safety.

Historically Black Medical Schools: Addressing the Minority Health Professional Pipeline and the Public Mission of Care For Vulnerable Populations

PubMed Central

Norris, Keith C.; Baker, Richard S.; Taylor, Robert; Montgomery-Rice, Valerie; Higginbotham, Eve J.; Riley, Wayne J.; Maupin, John; Drew-Ivie, Sylvia; Reede, Joan Y.; Gibbons, Gary

2013-01-01

Substantial changes in not only access to care, cost, and quality of care, but also health professions education are needed to ensure effective national healthcare reform. Since the actionable determinants of health such as personal beliefs and behaviors, socioeconomic factors, and the environment disproportionately affect the poor (and often racial/ethnic minorities), many have suggested that focusing efforts on this population will both directly and indirectly improve the overall health of the nation. Key to the success of such strategies are the ongoing efforts by historically black medical schools (HBMSs) as well as other minority serving medical and health professional schools, who produce a disproportionate percentage of the high-quality and diverse health professionals that are dedicated to maintaining the health of an increasingly diverse nation. Despite their public mission, HBMSs receive limited public support threatening their ability to not only meet the increasing minority health workforce needs but to even sustain their existing contributions. Substantial changes in health education policy and funding are needed to ensure HBMSs as well as other minority-serving medical and health professional schools can continue to produce the diverse, high-quality health professional workforce necessary to maintain the health of an increasingly diverse nation. We explore several model initiatives including focused partnerships with legislative and business leaders that are urgently needed to ensure the ability of HBMSs to maintain their legacy of providing compassionate, quality care to the communities in greatest need. PMID:19806842

High-Price And Low-Price Physician Practices Do Not Differ Significantly On Care Quality Or Efficiency

PubMed Central

Roberts, Eric T.; Mehrotra, Ateev; McWilliams, J. Michael

2017-01-01

Provider consolidation has intensified concerns that providers with market power may be able to charge higher prices without having to deliver better care. Providers have argued that higher prices cover the costs of delivering higher-quality care. We examined the relationship between physician practice prices for outpatient services and the quality and efficiency of care provided to their patients. Using commercial claims, we classified practices as high-priced or low-priced. We compared care quality, utilization, and spending between high-priced and low-priced practices in the same areas using data from the Consumer Assessment of Health Care Providers and Systems survey and linked claims for Medicare beneficiaries. Compared with low-priced practices, high-priced practices were much larger and received 36% higher prices. Patients of high-priced practices reported significantly higher scores on some measures of care coordination and management, but did not differ meaningfully in their overall care ratings, other domains of patient experiences (including physician ratings and access to care), receipt of mammography, vaccinations, or diabetes services, acute care use, or total Medicare spending. These findings suggest an overall weak relationship between practices’ prices and the quality and efficiency of care they provide, calling into question claims that high-priced providers deliver substantially higher-value care. PMID:28461352

Optimized ultra-thin manganin alloy passivated fine-pitch damascene compatible bump-less Cu-Cu bonding at sub 200 °C for three-dimensional Integration applications

NASA Astrophysics Data System (ADS)

Panigrahi, Asisa Kumar; Hemanth Kumar, C.; Bonam, Satish; Ghosh, Tamal; Rama Krishna Vanjari, Siva; Govind Singh, Shiv

2018-02-01

Enhanced Cu diffusion, Cu surface passivation, and smooth surface at the bonding interface are the key essentials for high quality Cu-Cu bonding. Previously, we have demonstrated optimized 3 nm thin Manganin metal-alloy passivation from oxidation and also helps to reduce the surface roughness to about 0.8 nm which substantially led to high quality Cu-Cu bonding. In this paper, we demonstrated an ultra fine-pitch (<25 µm) Cu-Cu bonding using an optimized Manganin metal-alloy passivation. This engineered surface passivation approach led to high quality bonding at sub 200 °C temperature and 0.4 MPa. Very low specific contact resistance of 1.4 × 10-7 Ω cm2 and the defect free bonded interface is clear indication of high quality bonding for future multilayer integrations. Furthermore, electrical characterization of the bonded structure was performed under various robust conditions as per International Technology Roadmap for Semiconductors (ITRS Roadmap) in order to satisfy the stability of the bonded structure.

Creating Strong Principals

ERIC Educational Resources Information Center

Mendels, Pamela; Mitgang, Lee D.

2013-01-01

Principals have a substantial effect on the quality of learning in their schools. Likewise, districts have a substantial effect on the quality of their leaders. A growing number of large school districts are focusing on two objectives to strengthen school leadership: (1) building a pipeline of new principals who are ready to tackle the most…

An experiment shows that a well-designed report on costs and quality can help consumers choose high-value health care.

PubMed

Hibbard, Judith H; Greene, Jessica; Sofaer, Shoshanna; Firminger, Kirsten; Hirsh, Judith

2012-03-01

Advocates of health reform continue to pursue policies and tools that will make information about comparative costs and resource use available to consumers. Reformers expect that consumers will use the data to choose high-value providers-those who offer higher quality and lower prices-and thus contribute to the broader goal of controlling national health care spending. However, communicating this information effectively is more challenging than it might first appear. For example, consumers are more interested in the quality of health care than in its cost, and many perceive a low-cost provider to be substandard. In this study of 1,421 employees, we examined how different presentations of information affect the likelihood that consumers will make high-value choices. We found that a substantial minority of the respondents shied away from low-cost providers, and even consumers who pay a larger share of their health care costs themselves were likely to equate high cost with high quality. At the same time, we found that presenting cost data alongside easy-to-interpret quality information and highlighting high-value options improved the likelihood that consumers would choose those options. Reporting strategies that follow such a format will help consumers understand that a doctor who provides higher-quality care than other doctors does not necessarily cost more.

An official American thoracic society workshop report: developing performance measures from clinical practice guidelines.

PubMed

Kahn, Jeremy M; Gould, Michael K; Krishnan, Jerry A; Wilson, Kevin C; Au, David H; Cooke, Colin R; Douglas, Ivor S; Feemster, Laura C; Mularski, Richard A; Slatore, Christopher G; Wiener, Renda Soylemez

2014-05-01

Many health care performance measures are either not based on high-quality clinical evidence or not tightly linked to patient-centered outcomes, limiting their usefulness in quality improvement. In this report we summarize the proceedings of an American Thoracic Society workshop convened to address this problem by reviewing current approaches to performance measure development and creating a framework for developing high-quality performance measures by basing them directly on recommendations from well-constructed clinical practice guidelines. Workshop participants concluded that ideally performance measures addressing care processes should be linked to clinical practice guidelines that explicitly rate the quality of evidence and the strength of recommendations, such as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. Under this framework, process-based performance measures would only be developed from strong recommendations based on high- or moderate-quality evidence. This approach would help ensure that clinical processes specified in performance measures are both of clear benefit to patients and supported by strong evidence. Although this approach may result in fewer performance measures, it would substantially increase the likelihood that quality-improvement programs based on these measures actually improve patient care.

Perceived Friendship Quality of Children with Autism Spectrum Disorder as Compared to their Peers in Mixed and Non-mixed Dyads.

PubMed

Petrina, Neysa; Carter, Mark; Stephenson, Jennifer; Sweller, Naomi

2016-04-01

There has been limited research exploring the similarity of perception of friendship quality between children with Autism Spectrum Disorder (ASD) and their friends. In this study, 45 children with ASD participated together with their friends. Two levels of friendship quality congruency were investigated: reciprocity and mutuality. A high proportion of the friendships were reciprocated for both the mixed and non-mixed friendship groups. Nevertheless, students with ASD reported substantial differences in perceptions of their friendship quality as compared to their nominated friends. The findings of the present study mirrored those of previous research with typically developing children. Further study is required to systematically investigate the differences in friendship quality perceptions within friendship dyads for both typically developing children and those with ASD diagnosis.

Process of modifying a cable end

DOEpatents

Roose, L.D.

1995-08-01

End moldings for high-voltage cables are described wherein the dielectric insulator of the cable is heated and molded to conform to a desired shape. As a consequence, high quality substantially bubble-free cable connectors suitable for mating to premanufactured fittings are made. Disclosed are a method for making the cable connectors either in the field or in a factory, molds suitable for use with the method, and the molded cable connectors, themselves. 5 figs.

Nature and the Outdoor Learning Environment: The Forgotten Resource in Early Childhood Education

ERIC Educational Resources Information Center

Cooper, Allen

2015-01-01

Longitudinal studies now confirm the economic, academic, and social importance of high-quality early childhood education. At the same time, a substantial body of research indicates that an outdoor learning and play environment with diverse natural elements advances and enriches all of the domains relevant to the development, health, and well-being…

Composition and Digestibility of Deer Browse in Southern Forests

Treesearch

Henry L. Short; Robert M. Blair; E.A. Epps

1975-01-01

Twigs were most nutritious and digestible during early growth in spring; they were high in fiber content and low in digestibility during summer, autumn, and winter. Evergreen leaves did not vary substantially in nutrient content and digestibility throughout the year. By contrast, leaves of deciduous species were reduced in quality and digestibility after leaf-fall....

Controlling flooding and water pollution with upland and streamside vegetation systems

Treesearch

Michael Dosskey

2003-01-01

Substantial research and development effort in the U.S. is being spent on developing strategies that address flooding and water pollution problems in agricultural areas. Concerns have been raised about the costs of flood damage, degradation of productive farm land, and declining water quality that are now recognized as unintended consequences of intensive, high-yield...

A promising new device for the prevention of parastomal hernia.

PubMed

Hoffmann, Henry; Oertli, Daniel; Soysal, Savas; Zingg, Urs; Hahnloser, Dieter; Kirchhoff, Philipp

2015-06-01

Parastomal hernia (PSH) is the most frequent long-term stoma complication with serious negative effects on quality of life. Surgical revision is often required and has a substantial morbidity and recurrence rate. The development of PSH requires revisional surgery with a substantial perioperative morbidity and high failure rate in the long-term follow-up. Prophylactic parastomal mesh insertion during stoma creation has the potential to reduce the rate of PSH, but carries the risk of early and late mesh-related complications such as infection, fibrosis, mesh shrinkage, and/or bowel erosion. We developed a new stomaplasty ring (KORING), which is easy to implant, avoids potential mesh-related complications, and has a high potential of long-term prevention of PSH. Here we describe the technique and the first use. © The Author(s) 2014.

Synthesis of high quality phosphorothioate oligonucleotides as antisense drugs. Use of I-linker in the elimination of 3'-terminal phosphorothioate monoesters.

PubMed

Ravikumar, Vasulinga T; Kumar, R Krishna; Capaldi, Daniel C; Cole, Douglas L

2003-01-01

Detritylation of a 5'-O-DMT-2'-deoxyadenosine moiety attached to solid support under acidic condition leads to depurination during oligonucleotide synthesis. Deprotection followed by reversed phase HPLC purification leads to desired oligonucleotide contaminated with significant levels of 3'-terminal phosphorothiaote (3'-TPT) monoester (n-1)-mer. However, it is demonstrated that attachment of dA nucleoside through its exocyclic amino group to solid support leads to substantial reduction of 3'-TPT formation thereby improving the quality of oligonucleotide synthesized.

Associations of work characteristics, employee strain and self-perceived quality of care in Emergency Departments: A cross-sectional study.

PubMed

Weigl, Matthias; Schneider, Anna

2017-01-01

The individual and shared effects of adverse work characteristics on patient care in Emergency Departments (ED) are yet not well understood. We investigated the associations of self-reported ED work characteristics, work-related strain, and perceived quality of care. Questionnaire-based survey with standardized measures among N=53 ED professionals (i.e., nurses, physicians, and administration staff). The study was conducted in the interdisciplinary ED of a German community hospital. A high prevalence of work-related strain was observed: 66.0% of ED professionals showed high levels of emotional exhaustion and 55.6% showed irritation scores above the cut-off value. ED staff reported high supervisor support and autonomy, paired with high time pressure and patient-related stressors. Multivariate analyses revealed that high time pressure and low supervisor support were associated with high work-related strain. Low staffing was related to inferior quality of ED care. ED work systems involve high competing demands for ED professionals with substantial risks for work-related strain. Moreover, adverse ED work characteristics comprise risks for high quality patient care. Our results suggest that promoting work characteristics might foster ED staff functioning on the job as well as improve ED patient care. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Thermal Runaway Failure Model for Low-Voltage BME Ceramic Capacitors with Defects

NASA Technical Reports Server (NTRS)

Teverovsky, Alexander

2017-01-01

Reliability of base metal electrode (BME) multilayer ceramic capacitors (MLCCs) that until recently were used mostly in commercial applications, have been improved substantially by using new materials and processes. Currently, the inception of intrinsic wear-out failures in high quality capacitors became much greater than the mission duration in most high-reliability applications. However, in capacitors with defects degradation processes might accelerate substantially and cause infant mortality failures. In this work, a physical model that relates the presence of defects to reduction of breakdown voltages and decreasing times to failure has been suggested. The effect of the defect size has been analyzed using a thermal runaway model of failures. Adequacy of highly accelerated life testing (HALT) to predict reliability at normal operating conditions and limitations of voltage acceleration are considered. The applicability of the model to BME capacitors with cracks is discussed and validated experimentally.

Density of photonic states in cholesteric liquid crystals

NASA Astrophysics Data System (ADS)

Dolganov, P. V.

2015-04-01

Density of photonic states ρ (ω ) , group vg, and phase vph velocity of light, and the dispersion relation between wave vector k , and frequency ω (k ) were determined in a cholesteric photonic crystal. A highly sensitive method (measurement of rotation of the plane of polarization of light) was used to determine ρ (ω ) in samples of different quality. In high-quality samples a drastic increase in ρ (ω ) near the boundaries of the stop band and oscillations related to Pendellösung beatings are observed. In low-quality samples photonic properties are strongly modified. The maximal value of ρ (ω ) is substantially smaller, and density of photonic states increases near the selective reflection band without oscillations in ρ (ω ) . Peculiarities of ρ (ω ) , vg, and ω (k ) are discussed. Comparison of the experimental results with theory was performed.

Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality.

PubMed

Van Laethem, Michelle; Beckers, Debby G J; Geurts, Sabine A E; Garefelt, Johanna; Magnusson Hanson, Linda L; Leineweber, Constanze

2018-04-01

The aim of this longitudinal three-wave study was to examine (i) reciprocal associations among job demands, work-related perseverative cognition (PC), and sleep quality; (ii) PC as a mediator in-between job demands and sleep quality; and (iii) continuous high job demands in relation to sleep quality and work-related PC over time. A representative sample of the Swedish working population was approached in 2010, 2012, and 2014, and 2316 respondents were included in this longitudinal full-panel survey study. Structural equation modelling was performed to analyse the temporal relations between job demands, work-related PC, and sleep quality. Additionally, a subsample (N = 1149) consisting of individuals who reported the same level of exposure to job demands during all three waves (i.e. stable high, stable moderate, or stable low job demands) was examined in relation to PC and sleep quality over time. Analyses showed that job demands, PC, and poor sleep quality were positively and reciprocally related. Work-related PC mediated the normal and reversed, direct across-wave relations between job demands and sleep quality. Individuals with continuous high job demands reported significantly lower sleep quality and higher work-related PC, compared to individuals with continuous moderate/low job demands. This study substantiated reciprocal relations between job demands, work-related PC, and sleep quality and supported work-related PC as an underlying mechanism of the reciprocal job demands-sleep relationship. Moreover, this study showed that chronically high job demands are a risk factor for low sleep quality.

EDITORIAL: Future developments

NASA Astrophysics Data System (ADS)

Lange, Wulf

2004-02-01

Some five years ago, Ennio Arimondo become Editor-in-Chief of Journal of Optics B: Quantum and Semiclassical Optics, following a change of title and other substantial changes. During that time he has established the journal as a prime platform for presenting scientific material in the field of quantum and semiclassical optics. By diligently incorporating new topics as they arose in neighbouring fields, he has contributed substantially towards creating permanent growth and has demonstrated the vitality of our branch of optics. It is a pleasure and an honour for me to assume now the role of the Editor-in-Chief and to succeed Ennio under these favourable circumstances. At present I do not see a need, nor even any justification, for fundamental changes in the editorial policy of the journal, and propose to follow the proven tradition of my successful predecessors. The journal has already adopted procedures for driving up the overall quality of published articles and, looking to the future, we expect to continue raising the scientific quality and international standing of the journal, coupled with a controlled growth in the number of pages published. Fortunately, there are no limitations for such qualitative improvements. I will seek to maintain and extend the high standards established by Ennio Arimondo, and before him by Paul Mandel, and to continue providing a high-quality product that attracts the best international authors and offers true value for the reader.

The effects of work alienation on organisational commitment, work effort and work-to-family enrichment.

PubMed

Tummers, Lars G; Den Dulk, Laura

2013-09-01

The aim of this study was to analyse the effects of work alienation on organisational commitment, work effort and work-to-family enrichment. There is substantial research on the effects of work alienation on passive job performance, such as organisational commitment. However, studies analysing work alienation on active performance, such as work effort, and outside work, such as work-to-family enrichment, are scarce. Two dimensions of work alienation are considered: powerlessness and meaninglessness. Hypotheses are tested using surveys collected among a national sample of midwives in the Netherlands (respondents: 790, response rate 61%). the findings indicate that work alienation (powerlessness and meaninglessness) influence organisational commitment, work effort and--to a lesser extent--work-to-family enrichment. High work meaninglessness, in particular, has negative effects on these outcomes. When people feel that they have no influence in their work (hence, when they feel 'powerless') and especially when the feel that their work is not worthwhile (when they feel 'meaningless') this has substantial negative effects. Managers should increase the meaningfulness that people attach to their work, thereby maintaining a high-quality workforce. Possible strategies include: (1) improving person-job fit, (2) developing high-quality relationships, (3) better communicating the results people help to deliver. © 2013 John Wiley & Sons Ltd.

Risk of post-fire metal mobilization into surface water resources: A review.

PubMed

Abraham, Joji; Dowling, Kim; Florentine, Singarayer

2017-12-01

One of the significant economic benefits to communities around the world of having pristine forest catchments is the supply of substantial quantities of high quality potable water. This supports a saving of around US$ 4.1 trillion per year globally by limiting the cost of expensive drinking water treatments and provision of unnecessary infrastructure. Even low levels of contaminants specifically organics and metals in catchments when in a mobile state can reduce these economic benefits by seriously affecting the water quality. Contamination and contaminant mobility can occur through natural and anthropogenic activities including forest fires. Moderate to high intensity forest fires are able to alter soil properties and release sequestered metals from sediments, soil organic matter and fragments of vegetation. In addition, the increase in post-fire erosion rate by rainfall runoff and strong winds facilitates the rapid transport of these metals downslope and downstream. The subsequent metal deposition in distal soil and water bodies can influence surface water quality with potential impacts to the larger ecosystems inclusive of negative effects on humans. This is of substantial concern as 4 billion hectares of forest catchments provide high quality water to global communities. Redressing this problem requires quantification of the potential effects on water resources and instituting rigorous fire and environmental management plans to mitigate deleterious effects on catchment areas. This paper is a review of the current state of the art literature dealing with the risk of post-fire mobilization of the metals into surface water resources. It is intended to inform discussion on the preparation of suitable management plans and policies during and after fire events in order to maintain potable water quality in a cost-effective manner. In these times of climate fluctuation and increased incidence of fires, the need for development of new policies and management frameworks are of heighted significance. Copyright © 2017 Elsevier B.V. All rights reserved.

Influence of variable milk quality premiums on observed milk quality.

PubMed

Nightingale, C; Dhuyvetter, K; Mitchell, R; Schukken, Y

2008-03-01

The objective of this study was to evaluate a premium program for very high quality milk in a US cooperative. Data were available on a monthly basis from a large US milk cooperative from April 1998 through December 2005. The data set consisted of 36,930 observations representing producer-months. The actual amount of the low bulk tank somatic cell count (BTSCC) premium varied from $0.15 per hundred pounds (cwt.) of milk to $1.00/cwt. with steps in between of $0.50 and $0.60 per cwt. of milk during the data collection period. Data analysis was done to evaluate the impact of the premium program on average BTSCC and on the probability of a producer to ship milk with <100,000 cells/mL in a given month. The results showed a strong effect of the premium program on both the average BTSCC and the probability of producing milk with very low BTSCC. On average, the BTSCC of all the milk in the cooperative was reduced by 22,000 cells during the high premium period. The probability of producing milk with BTSCC <100,000 doubled during some months of the high premium period from 4 to 8%, and an associated 10% increase in probability to produce milk below 200,000 cells/mL was observed. The data clearly indicate that premium offerings for very high quality milk affect the overall milk quality in the population affected by the premium. Producers responded to the high premiums and the overall impact on milk quality was substantial. We argue that the combination of a penalty program for high BTSCC milk with a premium program for very high quality milk (low BTSCC) provides a strong incentive for improvement of milk quality.

High-Price And Low-Price Physician Practices Do Not Differ Significantly On Care Quality Or Efficiency.

PubMed

Roberts, Eric T; Mehrotra, Ateev; McWilliams, J Michael

2017-05-01

Consolidation of physician practices has intensified concerns that providers with greater market power may be able to charge higher prices without having to deliver better care, compared to providers with less market power. Providers have argued that higher prices cover the costs of delivering higher-quality care. We examined the relationship between physician practice prices for outpatient services and practices' quality and efficiency of care. Using commercial claims data, we classified practices as being high- or low-price. We used national data from the Consumer Assessment of Healthcare Providers and Systems survey and linked claims for Medicare beneficiaries to compare high- and low-price practices in the same geographic area in terms of care quality, utilization, and spending. Compared with low-price practices, high-price practices were much larger and received 36 percent higher prices. Patients of high-price practices reported significantly higher scores on some measures of care coordination and management but did not differ meaningfully in their overall care ratings, other domains of patient experiences (including physician ratings and access to care), receipt of preventive services, acute care use, or total Medicare spending. This suggests an overall weak relationship between practice prices and the quality and efficiency of care and calls into question claims that high-price providers deliver substantially higher-value care. Project HOPE—The People-to-People Health Foundation, Inc.

Population-Based Pediatric Reference Intervals in General Clinical Chemistry: A Swedish Survey.

PubMed

Ridefelt, Peter

2015-01-01

Very few high quality studies on pediatric reference intervals for general clinical chemistry and hematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The Swedish survey included 701 healthy children. Reference intervals for general clinical chemistry and hematology were defined.

Accuracy of Health and Wellness Messages Provided by "ChaCha", the Mobile Answers Text Message Service

ERIC Educational Resources Information Center

Bliss, Kadi; Lodyga, Marc; Bochantin, Shelley; Null, Dawn

2010-01-01

A relatively new mobile text message service, "ChaCha," describes itself as "a smart search engine powered by human intelligence." The service claims to provide high-quality, accurate information, yet there is no research published to date substantiating this claim. The purpose of this study was to assess the extent to which health and…

The Best of Times, the Worst of Times: Rising Standards and Declining Staff Qualifications in Early Childhood Education

ERIC Educational Resources Information Center

French, Robert

2010-01-01

Low pay, meager benefits, poor morale, and high turnover impact the daily experience of many early childhood educators in the United States. While public spending in early childhood education has substantially increased in recent years, it has mainly fueled expansion, not quality enhancement to help programs attract, compensate, and retain…

Meeting the Challenges of Higher Education in India through Open Educational Resources: Policies, Practices, and Implications

ERIC Educational Resources Information Center

Thakran, Archana; Sharma, Ramesh C.

2016-01-01

Over the past two decades, the education sector in India has undergone a substantial transformation. Recent advances in technology have provided access to high quality educational resources and information on the Internet. This article examines the role of open educational resources (OER) in addressing the challenges of higher education in India,…

City Strategies to Engage Older Youth in Afterschool Programs. Strategy Guide

ERIC Educational Resources Information Center

Russell, Lane; Deich, Sharon; Padgette, Heather Clapp; Cox, Amy

2012-01-01

A wide body of research shows that consistent participation in high-quality afterschool and summer programs, also called out-of-school time or OST, provides substantial benefits to children and youth and their communities. Youth are more prone to engage in juvenile delinquency, substance abuse and other risky behaviors after 3:00 p.m. if there are…

Genetic markers on BTA14 predictive for residual feed intake in beef steers and their effects on carcass and meat quality traits

USDA-ARS?s Scientific Manuscript database

With the high cost of feed for animal production, genetic selection for animals that metabolize feed more efficiently could result in substantial cost savings for cattle producers. The purpose of this study was to identify DNA markers predictive for differences among cattle for traits associated wit...

[Relationships of positive and negative affectivity to sleep quality in Japanese civil servants: 3-year follow-up study].

PubMed

Saeki, Urara; Nasermoaddeli, Ali; Sekine, Michikazu; Kagamimori, Sadanobu

2008-11-01

We conducted this longitudinal study to evaluate the relationships of positive and negative affectivity (Affect Balance Scale) to sleep quality among civil servants. For this study we evaluated 827 civil servants of T city in Toyama prefecture in the springs of 2001 (Baseline) and 2004 with complete information in both phases of the study. Based on the median score at each phase, we divided Affect Balance Scale (ABS) scores into high and low groups. We conducted logistic regression analysis to determine the odds ratios (OR) of 3-yr follow-up sleep quality by baseline and follow-up ABS scores. After adjusting for baseline sleep quality scores, age, sex, employment, job strain, and exercise habits, participants who had high ABS scores were more likely (OR: 3.13, 95% confidence interval (CI): 1.78-5.53) to have better sleep quality than those with low ABS scores at both phases. In addition, participants with low ABS scores at baseline and high ABS scores 3 yr later had better sleep quality (OR: 1.81, 95%CI: 1.02-3.20) than those with low ABS scores at both phases. These findings substantiate the relationships of positive and negative affectivity to sleep quality. Improving the affect balance condition as well as maintaining good affect balance condition may be important determinants of sleep quality in civil servants.

The pancreatic surgery registry (StuDoQ|Pancreas) of the German Society for General and Visceral Surgery (DGAV) - presentation and systematic quality evaluation.

PubMed

Wellner, Ulrich F; Klinger, Carsten; Lehmann, Kai; Buhr, Heinz; Neugebauer, Edmund; Keck, Tobias

2017-04-05

Pancreatic resections are among the most complex procedures in visceral surgery. While mortality has decreased substantially over the past decades, morbidity remains high. The volume-outcome correlation in pancreatic surgery is among the strongest in the field of surgery. The German Society for General and Visceral Surgery (DGAV) established a national registry for quality control, risk assessment and outcomes research in pancreatic surgery in Germany (DGAV SuDoQ|Pancreas). Here, we present the aims and scope of the DGAV StuDoQ|Pancreas Registry. A systematic assessment of registry quality is performed based on the recommendations of the German network for outcomes research (DNVF). The registry quality was assessed by consensus criteria of the DNVF in regard to the domains Systematics and Appropriateness, Standardization, Validity of the sampling procedure, Validity of data collection, Validity of statistical analysis and reports, and General demands for registry quality. In summary, DGAV StuDoQ|Pancreas meets most of the criteria of a high-quality clinical registry. The DGAV StuDoQ|Pancreas provides a valuable platform for quality assessment, outcomes research as well as randomized registry trials in pancreatic surgery.

Snapshot gradient-recalled echo-planar images of rat brains at long echo time at 9.4 T

PubMed Central

Lei, Hongxia; Mlynárik, Vladimir; Just, Nathalie; Gruetter, Rolf

2009-01-01

With improved B0 homogeneity along with satisfactory gradient performance at high magnetic fields, snapshot gradient-recalled echo-planar imaging (GRE-EPI) would perform at long echo times (TEs) on the order of T2*, which intrinsically allows obtaining strongly T2*-weighted images with embedded substantial anatomical details in ultrashort time. The aim of this study was to investigate the feasibility and quality of long TE snapshot GRE-EPI images of rat brain at 9.4 T. When compensating for B0 inhomogeneities, especially second-order shim terms, a 200×200 μm2 in-plane resolution image was reproducibly obtained at long TE (>25 ms). The resulting coronal images at 30 ms had diminished geometric distortions and, thus, embedded substantial anatomical details. Concurrently with the very consistent stability, such GRE-EPI images should permit to resolve functional data not only with high specificity but also with substantial anatomical details, therefore allowing coregistration of the acquired functional data on the same image data set. PMID:18486393

Effects of prey of different nutrient quality on elemental nutrient budgets in Noctiluca scintillans.

PubMed

Zhang, Shuwen; Liu, Hongbin; Glibert, Patricia M; Guo, Cui; Ke, Ying

2017-08-08

Noctiluca scintillans (Noctiluca) is a cosmopolitan red tide forming heterotrophic dinoflagellate. In this study, we investigated its ingestion, elemental growth yield and excretion when supplied with different quality food (nutrient-balanced, N-limited and P-limited). Total cellular elemental ratios of Noctiluca were nearly homeostatic, but the ratio of its intracellular NH 4 + and PO 4 3- was weakly regulated. Noctiluca thus seems able to differentially allocate N and P to organic and inorganic pools to maintain overall homeostasis, and it regulated its internal N more strongly and efficiently than P. The latter was substantiated by its comparatively stable C:N ratio and compensatory feeding on N-limited prey. Using both starvation experiments and mass balance models, it was found that excretion of C, N, and P by Noctiluca is highly affected by prey nutritional quality. However, based on modeling results, nutrients seem efficiently retained in actively feeding Noctiluca for reproduction rather than directly released as was shown experimentally in starved cells. Moreover, actively feeding Noctiluca tend to retain P and preferentially release N, highlighting its susceptible to P-limitation. Recycling of N and P by Noctiluca may supply substantial nutrients for phytoplankton growth, especially following bloom senescence.

Challenges ahead: social and institutional factors influencing sustainable urban stormwater management in Australia.

PubMed

Brown, R R; Farrelly, M A

2009-01-01

In a time of climate uncertainty and drought in Australia, improved urban stormwater quality management practices are required not only for protecting waterway health, but also as a fit-for-purpose supply source. To conceive of urban stormwater as an environmental threat as well as a water supply source requires a substantial shift in our traditional linear supply and wastewater structures towards more hybrid and complex infrastructure systems. To understand what drives and limits treatment technology adoption for stormwater management, over 800 urban water professionals in three Australian capital cities completed an online questionnaire survey in November 2006. Using the conceptual framework of receptivity assessment, the results revealed the professional community to be highly associated with the importance of improving stormwater quality for receiving waterway health, yet they do not consider that politicians share this perspective by placing a substantially lower level of importance on stormwater quality management. Significant acquisition barriers within each city, including institutional arrangements, costs, responsibilities, and regulations and approvals processes were all identified as constraining more sustainable practices. Capacity building programs, fostering greater socio-political capital and developing key demonstration projects with training events are recommended as useful policy interventions for addressing current institutional impediments.

Fire Influences on Atmospheric Composition, Air Quality, and Climate

NASA Technical Reports Server (NTRS)

Voulgarakis, Apostolos; Field, Robert D.

2015-01-01

Fires impact atmospheric composition through their emissions, which range from long-lived gases to short-lived gases and aerosols. Effects are typically larger in the tropics and boreal regions but can also be substantial in highly populated areas in the northern mid-latitudes. In all regions, fire can impact air quality and health. Similarly, its effect on large-scale atmospheric processes, including regional and global atmospheric chemistry and climate forcing, can be substantial, but this remains largely unexplored. The impacts are primarily realised in the boundary layer and lower free troposphere but can also be noticeable in upper troposphere/lower stratosphere (UT/LS) region, for the most intense fires. In this review, we summarise the recent literature on findings related to fire impact on atmospheric composition, air quality and climate. We explore both observational and modelling approaches and present information on key regions and on the globe as a whole. We also discuss the current and future directions in this area of research, focusing on the major advances in emission estimates, the emerging efforts to include fire as a component in Earth system modelling and the use of modelling to assess health impacts of fire emissions.

High-quality electron beam generation in a proton-driven hollow plasma wakefield accelerator

NASA Astrophysics Data System (ADS)

Li, Y.; Xia, G.; Lotov, K. V.; Sosedkin, A. P.; Hanahoe, K.; Mete-Apsimon, O.

2017-10-01

Simulations of proton-driven plasma wakefield accelerators have demonstrated substantially higher accelerating gradients compared to conventional accelerators and the viability of accelerating electrons to the energy frontier in a single plasma stage. However, due to the strong intrinsic transverse fields varying both radially and in time, the witness beam quality is still far from suitable for practical application in future colliders. Here we demonstrate the efficient acceleration of electrons in proton-driven wakefields in a hollow plasma channel. In this regime, the witness bunch is positioned in the region with a strong accelerating field, free from plasma electrons and ions. We show that the electron beam carrying the charge of about 10% of 1 TeV proton driver charge can be accelerated to 0.6 TeV with a preserved normalized emittance in a single channel of 700 m. This high-quality and high-charge beam may pave the way for the development of future plasma-based energy frontier colliders.

High-quality bulk hybrid perovskite single crystals within minutes by inverse temperature crystallization

NASA Astrophysics Data System (ADS)

Saidaminov, Makhsud I.; Abdelhady, Ahmed L.; Murali, Banavoth; Alarousu, Erkki; Burlakov, Victor M.; Peng, Wei; Dursun, Ibrahim; Wang, Lingfei; He, Yao; Maculan, Giacomo; Goriely, Alain; Wu, Tom; Mohammed, Omar F.; Bakr, Osman M.

2015-07-01

Single crystals of methylammonium lead trihalide perovskites (MAPbX3; MA=CH3NH3+, X=Br- or I-) have shown remarkably low trap density and charge transport properties; however, growth of such high-quality semiconductors is a time-consuming process. Here we present a rapid crystal growth process to obtain MAPbX3 single crystals, an order of magnitude faster than previous reports. The process is based on our observation of the substantial decrease of MAPbX3 solubility, in certain solvents, at elevated temperatures. The crystals can be both size- and shape-controlled by manipulating the different crystallization parameters. Despite the rapidity of the method, the grown crystals exhibit transport properties and trap densities comparable to the highest quality MAPbX3 reported to date. The phenomenon of inverse or retrograde solubility and its correlated inverse temperature crystallization strategy present a major step forward for advancing the field on perovskite crystallization.

Hydrogen assisted growth of high quality epitaxial graphene on the C-face of 4H-SiC

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

Cai, Tuocheng; Jia, Zhenzhao; Yan, Baoming

2015-01-05

We demonstrate hydrogen assisted growth of high quality epitaxial graphene on the C-face of 4H-SiC. Compared with the conventional thermal decomposition technique, the size of the growth domain by this method is substantially increased and the thickness variation is reduced. Based on the morphology of epitaxial graphene, the role of hydrogen is revealed. It is found that hydrogen acts as a carbon etchant. It suppresses the defect formation and nucleation of graphene. It also improves the kinetics of carbon atoms via hydrocarbon species. These effects lead to increase of the domain size and the structure quality. The consequent capping effectmore » results in smooth surface morphology and suppression of multilayer growth. Our method provides a viable route to fine tune the growth kinetics of epitaxial graphene on SiC.« less

Key Elements for Judging the Quality of a Risk Assessment

PubMed Central

Fenner-Crisp, Penelope A.; Dellarco, Vicki L.

2016-01-01

Background: Many reports have been published that contain recommendations for improving the quality, transparency, and usefulness of decision making for risk assessments prepared by agencies of the U.S. federal government. A substantial measure of consensus has emerged regarding the characteristics that high-quality assessments should possess. Objective: The goal was to summarize the key characteristics of a high-quality assessment as identified in the consensus-building process and to integrate them into a guide for use by decision makers, risk assessors, peer reviewers and other interested stakeholders to determine if an assessment meets the criteria for high quality. Discussion: Most of the features cited in the guide are applicable to any type of assessment, whether it encompasses one, two, or all four phases of the risk-assessment paradigm; whether it is qualitative or quantitative; and whether it is screening level or highly sophisticated and complex. Other features are tailored to specific elements of an assessment. Just as agencies at all levels of government are responsible for determining the effectiveness of their programs, so too should they determine the effectiveness of their assessments used in support of their regulatory decisions. Furthermore, if a nongovernmental entity wishes to have its assessments considered in the governmental regulatory decision-making process, then these assessments should be judged in the same rigorous manner and be held to similar standards. Conclusions: The key characteristics of a high-quality assessment can be summarized and integrated into a guide for judging whether an assessment possesses the desired features of high quality, transparency, and usefulness. Citation: Fenner-Crisp PA, Dellarco VL. 2016. Key elements for judging the quality of a risk assessment. Environ Health Perspect 124:1127–1135; http://dx.doi.org/10.1289/ehp.1510483 PMID:26862984

Case-based learning in education of Traditional Chinese Medicine: a systematic review.

PubMed

Chen, Ji; Li, Ying; Tang, Yong; Zeng, Fang; Wu, Xi; Liang, Fanrong

2013-10-01

To assess the effect of case-based learning (CBL) in the education of Traditional Chinese Medicine (TCM). The studies concerning TCM courses designed with CBL were included by searching the databases of EBSCO, Pubmed, Science Citation Index, China National Knowledge Infrastructure, Chongqing VIP database. The valid data was extracted in accordance with the included criteria. The quality of the studies was assessed with Gemma Flores-Masteo. A total of 22 articles were retrieved that met the selection criteria: one was of high quality; two were of low quality; the rest were categorized as moderate quality. The majority of the studies demonstrated the better effect produced by CBL, while a few studies showed no difference, compared with the didactic format. All included studies confirmed the favorable effect on learners' attitude, skills and ability. CBL showed the desirable results in achieving the goal of learning. Compared to didactic approach, it played a more active role in promoting students' competency. Since the quality of the articles on which the study was based was not so high, the findings still need further research to become substantiated.

The Effect of High School Physics Laboratories on Performance in Introductory College Physics

NASA Astrophysics Data System (ADS)

Maltese, Adam V.; Tai, Robert H.; Sadler, Philip M.

2010-05-01

Laboratory experiences play a substantial role in most high school science courses, and many teachers believe the number of labs they offer is a measure of the quality of their curriculum. While some teachers believe labs are meant to confirm concepts taught during lectures, others feel labs should address students' everyday beliefs about the world. Still other teachers emphasize learning of the scientific method and laboratory techniques. Accordingly, many articles offer advice on "effective" pedagogical practices.2-5

Identification and management of filament-wound case stiffness parameters

NASA Technical Reports Server (NTRS)

Verderaime, V.; Rheinfurth, M.

1983-01-01

The high specific strength and the high specific modules made graphite epoxy laminate an expedient material substitute for the Shuttle Solid Rocket Motor steel case to substantially increase the payload performance without increasing the composite case axial growth during thrust build up which was constrained to minimize liftoff excitation effects on existing structural elements and interfaces. Parameters associated with axial growth were identified for quality and manufacturing controls. Included is an innovative method for experimentally verifying extensional elastic properties on a laminate pressurized test bottle.

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

PubMed Central

2010-01-01

Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important. PMID:20942937

Assessment of family history of substance abuse for preventive interventions with patients experiencing chronic pain: A quality improvement project.

PubMed

Pestka, Elizabeth; Nash, Virginia; Evans, Michele; Cronin, Joan; Bee, Susan; King, Susan; Osborn, Kristine; Gehin, Jessica; Weis, Karen; Loukianova, Larissa

2016-04-01

This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings. © 2015 John Wiley & Sons Australia, Ltd.

Differentiating the Spatiotemporal Distribution of Natural and Anthropogenic Processes on River Water-Quality Variation Using a Self-Organizing Map With Factor Analysis.

PubMed

Wang, Yeuh-Bin; Liu, Chen-Wuing; Lee, Jin-Jing

2015-08-01

To elucidate the historical improvement and advanced measure of river water quality in the Taipei metropolitan area, this study applied the self-organizing map (SOM) technique with factor analysis (FA) to differentiate the spatiotemporal distribution of natural and anthropogenic processes on river water-quality variation spanning two decades. The SOM clustered river water quality into five groups: very low pollution, low pollution, moderate pollution, high pollution, and very high pollution. FA was then used to extract four latent factors that dominated water quality from 1991 to 2011 including three anthropogenic process factors (organic, industrial, and copper pollution) and one natural process factor [suspended solids (SS) pollution]. The SOM revealed that the water quality improved substantially over time. However, the downstream river water quality was still classified as high pollution because of an increase in anthropogenic activity. FA showed the spatiotemporal pattern of each factor score decreasing over time, but the organic pollution factor downstream of the Tamsui River, as well as the SS factor scores in the upstream major tributary (the Dahan Stream), remained within the high pollution level. Therefore, we suggest that public sewage-treatment plants should be upgraded from their current secondary biological processing to advanced treatment processing. The conservation of water and soil must also be reinforced to decrease the SS loading of the Dahan Stream from natural erosion processes in the future.

Preface.

PubMed

Villarreal-Garza, Cynthia; Castro-Sánchez, Andrea

2017-01-01

Young women with breast cancer (BC) are a special population with distinctive genetic, clinical, and psychosocial features and requirements based on at least three considerations: (1) Cancer presentation at young age is often diagnosed at advanced stages, hence its prognosis is worse compared to their older counterparts1,2; (2) young BC patients often receive aggressive and prolonged systemic treatments that can be associated with significant long-term morbidity3; and (3) young women with BC experience substantial psychosocial vulnerability resulting from high levels of distress and depression associated with oncological interventions4. These factors pose complex issues for young patients with BC, particularly in regard to their family dynamics, social and professional lives, and self-development, thereby substantially undermining their quality of life.

Male circumcision and HIV infection risk.

PubMed

Krieger, John N

2012-02-01

Male circumcision is being promoted to reduce human immunodeficiency virus type 1 (HIV) infection rates. This review evaluates the scientific evidence suggesting that male circumcision reduces HIV infection risk in high-risk heterosexual populations. We followed the updated International Consultation on Urological Diseases evidence-based medicine recommendations to critically review the scientific evidence on male circumcision and HIV infection risk. Level 1 evidence supports the concept that male circumcision substantially reduces the risk of HIV infection. Three major lines of evidence support this conclusion: biological data suggesting that this concept is plausible, data from observational studies supported by high-quality meta-analyses, and three randomized clinical trials supported by high-quality meta-analyses. The evidence from these biological studies, observational studies, randomized controlled clinical trials, meta-analyses, and cost-effectiveness studies is conclusive. The challenges to implementation of male circumcision as a public health measure in high-risk populations must now be faced.

Air quality and human health improvements from reduced deforestation in Brazil

NASA Astrophysics Data System (ADS)

Reddington, C.; Butt, E. W.; Ridley, D. A.; Artaxo, P.; Morgan, W.; Coe, H.; Spracklen, D. V.

2015-12-01

Significant areas of the Brazilian Amazon have been deforested over the past few decades, with fire being the dominant method through which forests and vegetation are cleared. Fires emit large quantities of particulate matter into the atmosphere, degrading air quality and negatively impacting human health. Since 2004, Brazil has achieved substantial reductions in deforestation rates and associated deforestation fires. Here we assess the impact of this reduction on air quality and human health. We show that dry season (August - October) aerosol optical depth (AOD) retrieved by satellite over southwest Brazil and Bolivia is positively related to Brazil's annual deforestation rate (r=0.96, P<0.001). Observed dry season AOD is more than a factor two greater in years with high deforestation rates compared to years with low deforestation rates, suggesting regional air quality is degraded substantially by fire emissions associated with deforestation. This link is further demonstrated by the positive relationship between observed AOD and satellite-derived particulate emissions from deforestation fires (r=0.89, P<0.01). Using a global aerosol model with satellite-derived fire emissions, we show that reductions in fires associated with reduced deforestation have reduced regional dry season mean surface particulate matter concentrations by ~30%. Using concentration response functions we estimate that this reduction in particulate matter may be preventing 1060 (388-1721) premature adult mortalities annually across South America. Future increases in Brazil's deforestation rates and associated fires may threaten the improved air quality reported here.

Impacts of a Rural Subdivision on Groundwater Quality: Results of Long-Term Monitoring.

PubMed

Rayne, Todd W; Bradbury, Kenneth R; Krause, Jacob J

2018-03-30

A rural subdivision in south central Wisconsin was instrumented with monitoring wells and lysimeters before, during, and after its construction to examine the impacts of the unsewered subdivision on groundwater quality and quantity. Prior to construction, the 78-acre (32 ha) site was farmland. Sixteen homes were constructed beginning in 2003. Initial monitoring from 2002 to 2005 showed that groundwater beneath the site had been impacted by previous agricultural use, with nitrate-N values as high as 30 mg/L and some detections of the herbicide atrazine. Our 12-year study shows that the transition from agricultural to residential land use has changed groundwater quality in both negative and positive ways. Although groundwater elevations showed typical seasonal fluctuations each year, there were no measurable changes in groundwater levels or general flow directions during the 12-year study period. Chloride values increased in many wells, possibly as a result of road salting or water softener discharge. Nitrate concentrations varied spatially and temporally over the study period, with some initial concentrations substantially above the drinking water standard. In some wells, nitrate and atrazine levels have declined substantially since agriculture ceased. However, atrazine was still present at trace concentrations throughout the site in 2014. Wastewater tracers show there are small but detectable impacts from septic effluent on groundwater quality. Particle traces based on a groundwater flow model are consistent with the hypothesis that septic leachate has impacted groundwater quality. © 2018, National Ground Water Association.

Defensive medicine and outcomes for medical malpractice liability.

PubMed

Genovese, Umberto; Amato, Simona; Del Sordo, Sara; Mobilia, Francesca; Casali, Michelangelo B

2014-01-01

Defensive medicine is a significant force driving the high costs of healthcare systems and has a substantial influence on physicians' behavior because they primarily concern about malpractice liability and not patient's health protection. This attitude disagrees with deontological duties and could impair physicians' ability of judgment and clinical reasoning. Reducing defensive medicine also could mean improving the quality in healthcare systems and eliminating unnecessary costs.

Estimating quality weights for EQ-5D health states with the time trade-off method in South Korea.

PubMed

Jo, Min-Woo; Yun, Sung-Cheol; Lee, Sang-Il

2008-12-01

To estimate quality weights of EQ-5D health states with the time trade-off (TTO) method in the general population of South Korea. A total of 500 respondents valued 42 hypothetical EQ-5D health states using the TTO and visual analog scale. The quality weights for all EQ-5D health states were estimated by a random effects model and compared with those from studies in other countries. Overall estimated quality weights for all EQ-5D health states from this study were highly correlated with those from previous studies, but quality weights of individual states were substantially different from those of their corresponding states in other studies. The Korean value set differed from value sets from other countries. Special caution is needed when a value set from one country is applied to another with a different culture.

Role of boundary layer diffusion in vapor deposition growth of chalcogenide nanosheets: the case of GeS.

PubMed

Li, Chun; Huang, Liang; Snigdha, Gayatri Pongur; Yu, Yifei; Cao, Linyou

2012-10-23

We report a synthesis of single-crystalline two-dimensional GeS nanosheets using vapor deposition processes and show that the growth behavior of the nanosheet is substantially different from those of other nanomaterials and thin films grown by vapor depositions. The nanosheet growth is subject to strong influences of the diffusion of source materials through the boundary layer of gas flows. This boundary layer diffusion is found to be the rate-determining step of the growth under typical experimental conditions, evidenced by a substantial dependence of the nanosheet's size on diffusion fluxes. We also find that high-quality GeS nanosheets can grow only in the diffusion-limited regime, as the crystalline quality substantially deteriorates when the rate-determining step is changed away from the boundary layer diffusion. We establish a simple model to analyze the diffusion dynamics in experiments. Our analysis uncovers an intuitive correlation of diffusion flux with the partial pressure of source materials, the flow rate of carrier gas, and the total pressure in the synthetic setup. The observed significant role of boundary layer diffusions in the growth is unique for nanosheets. It may be correlated with the high growth rate of GeS nanosheets, ~3-5 μm/min, which is 1 order of magnitude higher than other nanomaterials (such as nanowires) and thin films. This fundamental understanding of the effect of boundary layer diffusions may generally apply to other chalcogenide nanosheets that can grow rapidly. It can provide useful guidance for the development of general paradigms to control the synthesis of nanosheets.

Assessing quality in cardiac surgery: why this is necessary in the twenty-first century

NASA Technical Reports Server (NTRS)

Swain, J. A.; Hartz, R. S.

2000-01-01

The cost and high-profile nature of coronary surgery means that this is an area of close public scrutiny. As much pioneering work in data collection and risk analyses has been carried out by cardiac surgeons, substantial information exists and the correct interpretation of that data is identified as an important issue. This paper considers the background and history of risk-adjustment in cardiac surgery, the uses of quality data, examines the observed/expected mortality ratio and looks at issues such as cost and reactions to outliers. The conclusion of the study is that the continuation of accurate data collection by the whole operative team and a strong commitment to constantly improving quality is crucial to its meaningful application.

Uncertainty analyses of the calibrated parameter values of a water quality model

NASA Astrophysics Data System (ADS)

Rode, M.; Suhr, U.; Lindenschmidt, K.-E.

2003-04-01

For river basin management water quality models are increasingly used for the analysis and evaluation of different management measures. However substantial uncertainties exist in parameter values depending on the available calibration data. In this paper an uncertainty analysis for a water quality model is presented, which considers the impact of available model calibration data and the variance of input variables. The investigation was conducted based on four extensive flowtime related longitudinal surveys in the River Elbe in the years 1996 to 1999 with varying discharges and seasonal conditions. For the model calculations the deterministic model QSIM of the BfG (Germany) was used. QSIM is a one dimensional water quality model and uses standard algorithms for hydrodynamics and phytoplankton dynamics in running waters, e.g. Michaelis Menten/Monod kinetics, which are used in a wide range of models. The multi-objective calibration of the model was carried out with the nonlinear parameter estimator PEST. The results show that for individual flow time related measuring surveys very good agreements between model calculation and measured values can be obtained. If these parameters are applied to deviating boundary conditions, substantial errors in model calculation can occur. These uncertainties can be decreased with an increased calibration database. More reliable model parameters can be identified, which supply reasonable results for broader boundary conditions. The extension of the application of the parameter set on a wider range of water quality conditions leads to a slight reduction of the model precision for the specific water quality situation. Moreover the investigations show that highly variable water quality variables like the algal biomass always allow a smaller forecast accuracy than variables with lower coefficients of variation like e.g. nitrate.

Increasing the reliability and quality of important cast products made of chemically active metals and alloys

NASA Astrophysics Data System (ADS)

Varfolomeev, M. S.; Moiseev, V. S.; Shcherbakova, G. I.

2017-01-01

A technology is developed to produce highly thermoresistant ceramic monoxide corundum molds using investment casting and an aluminum-organic binder. This technology is a promising trend in creating ceramic molds for precision complex-shape casting of important ingots made of high-alloy steels, high-temperature and titanium alloys, and refractory metals. The use of the casting molds that have a high thermal and chemical resistance to chemically active metals and alloys under high-temperature casting minimizes the physicochemical interaction and substantially decreases the depth of the hard-to-remove metal oxide layer on important products, which increases their service properties.

Where Would You Go for Your Next Hospitalization?

PubMed Central

Jung, Kyoungrae; Feldman, Roger; Scanlon, Dennis

2014-01-01

We examine the effects of diverse dimensions of hospital quality – including consumers’ perceptions of unobserved attributes – on future hospital choice. We utilize consumers’ stated preference weights to obtain hospital-specific estimates of perceptions about unmeasured attributes such as reputation. We report three findings. First, consumers’ perceptions of reputation and medical services contribute substantially to utility for a hospital choice. Second, consumers tend to select hospitals with high clinical quality scores even before the scores are publicized. However, the effect of clinical quality on hospital choice is relatively small. Third, satisfaction with a prior hospital admission has a large impact on future hospital choice. Our findings suggest that including measures of consumers’ experience in report cards may increase their responsiveness to publicized information, but other strategies are needed to overcome the large effects of consumers’ beliefs about other quality attributes. PMID:21665300

48 CFR 1846.470 - Contract clause.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT MANAGEMENT QUALITY ASSURANCE Government Contract Quality Assurance 1846.470 Contract clause. The contracting officer may insert a clause substantially as stated at 1852.246-71, Government Contract Quality Assurance Functions, in solicitations and contracts to specify the location(s) of quality assurance...

Development and evaluation of oral Cancer quality-of-life questionnaire (QOL-OC).

PubMed

Nie, Min; Liu, Chang; Pan, Yi-Chen; Jiang, Chen-Xi; Li, Bao-Ru; Yu, Xi-Jie; Wu, Xin-Yu; Zheng, Shu-Ning

2018-05-03

In this study scales and items for the Oral Cancer Quality-of-life Questionnaire (QOL-OC) were designed and the instrument was evaluated. The QOL-OC was developed and modified using the international definition of quality of life (QOL) promulgated by the European Organization for Research and Treatment of Cancer (EORTC) and analysis of the precedent measuring instruments. The contents of each item were determined in the context of the specific characteristics of oral cancer. Two hundred thirteen oral cancer patients were asked to complete both the EORTC core quality of life questionnaire (EORTC QLC-C30) and the QOL-OC. Data collected was used to conduct factor analysis, test-retest reliability, internal consistency, and construct validity. Questionnaire compliance was relatively high. Fourteen of the 213 subjects accepted the same tests after 24 to 48 h demonstrating a high test-retest reliability for all five scales. Overall internal consistency surpasses 0.8. The outcome of the factor analysis coincides substantially with our theoretical conception. Each item shows a higher correlation coefficient within its own scale than the others which indicates high construct validity. QOL-OC demonstrates fairly good statistical reliability, validity, and feasibility. However, further tests and modification are needed to ensure its applicability to the quality-of-life assessment of Chinese oral cancer patients.

State “Technical Assistance Programs” for nursing home quality improvement: variations and potential implications

PubMed Central

Li, Yue; Spector, Williams D.; Glance, Laurent G.; Mukamel, Dana B.

2013-01-01

Context To improve nursing home quality, many states developed “Technical Assistance Programs” that provide on-site consultation and training for nursing facility staff. Methods We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. Results As of 2010, 17 states have developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. Conclusion State “Technical Assistance Programs” for nursing homes varies in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives. PMID:23216345

Patient-reported assessment of quality care at end of life: development and validation of Quality Care Questionnaire-End of Life (QCQ-EOL).

PubMed

Yun, Young Ho; Kim, Soo-Hyun; Lee, Kyoung-Min; Park, Sang Min; Lee, Chang Geol; Choi, Youn Seon; Lee, Won Sup; Kim, Si-Young; Heo, Dae Seog

2006-09-01

Our goal was to validate an instrument with which terminally ill patients could evaluate the quality of care they receive at the end of life (EOL). Questionnaire development followed a four-phase process: item generation and reduction, construction, pilot testing, and field-testing. Using relevance and priority criteria and pilot testing, we developed a 16-item questionnaire. Factor analyses of data from 235 patients resulted in the Quality Care Questionnaire-End of Life (QCQ-EOL) covering dignity-conserving care, care by health care professionals, individualised care, and family relationships. All subscales and total scores showed high internal consistency (Cronbach alpha range, 0.73-0.89). The ability of total score and selective subscale scores clearly differentiated patients on the basis of clinical situation, sense of dignity, and general rating of care quality. Correlations of scores between patients and caregivers were substantial. The QCQ-EOL can be adopted to assess the quality of care received by terminally ill patients.

Guaranteeing the quality and integrity of pork - An Australian case study.

PubMed

Channon, H A; D'Souza, D N; Jarrett, R G; Lee, G S H; Watling, R J; Jolley, J Y C; Dunshea, F R

2018-04-27

The Australian pork industry is strongly committed to assuring the integrity of its product, with substantial research investment made over the past ten years to develop and implement systems to assure the consistency and quality of fresh pork and to enable accurate tracing of unpackaged fresh pork back to property of origin using trace elemental profiling. These initiatives are pivotal to allow Australian pork of guaranteed eating quality to be successfully positioned as higher value products, across a range of international and domestic markets, whilst managing any threats of product substitution. This paper describes the current status of the development of a predictive eating quality model for Australian pork, utilizing eating quality datasets generated from recent Australian studies. The implementation of trace elemental profiling, by Physi-Trace™, to verify and defend provenance claims and support the supply of consistently high eating quality Australian pork to its customers, is also discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Estimating reliable paediatric reference intervals in clinical chemistry and haematology.

PubMed

Ridefelt, Peter; Hellberg, Dan; Aldrimer, Mattias; Gustafsson, Jan

2014-01-01

Very few high-quality studies on paediatric reference intervals for general clinical chemistry and haematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The present review summarises current reference interval studies for common clinical chemistry and haematology analyses. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Ozone Lidar Observations for Air Quality Studies

NASA Technical Reports Server (NTRS)

Wang, Lihua; Newchurch, Mike; Kuang, Shi; Burris, John F.; Huang, Guanyu; Pour-Biazar, Arastoo; Koshak, William; Follette-Cook, Melanie B.; Pickering, Kenneth E.; McGee, Thomas J.;

A Disk-Based System for Producing and Distributing Science Products from MODIS

NASA Technical Reports Server (NTRS)

Masuoka, Edward; Wolfe, Robert; Sinno, Scott; Ye Gang; Teague, Michael

2007-01-01

Since beginning operations in 1999, the MODIS Adaptive Processing System (MODAPS) has evolved to take advantage of trends in information technology, such as the falling cost of computing cycles and disk storage and the availability of high quality open-source software (Linux, Apache and Perl), to achieve substantial gains in processing and distribution capacity and throughput while driving down the cost of system operations.

Transparent conducting oxides and production thereof

DOEpatents

Gessert, Timothy A; Yoshida, Yuki; Coutts, Timothy J

2014-05-27

Transparent conducting oxides and production thereof are disclosed. An exemplary method of producing a transparent conducting oxide (TCO) material may comprise: providing a TCO target (110) doped with either a high-permittivity oxide or a low-permittivity oxide in a process chamber (100). The method may also comprise depositing a metal oxide on the target (110) to form a thin film having enhanced optical properties without substantially decreasing electrical quality.

Transparent conducting oxides and production thereof

DOEpatents

Gessert, Timothy A.; Yoshida, Yuki; Coutts, Timothy J.

2014-06-10

Transparent conducting oxides and production thereof are disclosed. An exemplary method of producing a transparent conducting oxide (TCO) material may comprise: providing a TCO target doped with either a high-permittivity oxide or a low-permittivity oxide in a process chamber. The method may also comprise depositing a metal oxide on the target in the process chamber to form a thin film having enhanced optical properties without substantially decreasing electrical quality.

[MODERN INSTRUMENTS FOR EAR, NOSE AND THROAT RENDERING AND EVALUATION IN RESEARCHES ON RUSSIAN SEGMENT OF THE INTERNATIONAL SPACE STATION].

PubMed

Popova, I I; Orlov, O I; Matsnev, E I; Revyakin, Yu G

2016-01-01

The paper reports the results of testing some diagnostic video systems enabling digital rendering of TNT teeth and jaws. The authors substantiate the criteria of choosing and integration of imaging systems in future on Russian segment of the International space station kit LOR developed for examination and download of high-quality images of cosmonauts' TNT, parodentium and teeth.

Accurate and reproducible functional maps in 127 human cell types via 2D genome segmentation

PubMed Central

Hardison, Ross C.

2017-01-01

Abstract The Roadmap Epigenomics Consortium has published whole-genome functional annotation maps in 127 human cell types by integrating data from studies of multiple epigenetic marks. These maps have been widely used for studying gene regulation in cell type-specific contexts and predicting the functional impact of DNA mutations on disease. Here, we present a new map of functional elements produced by applying a method called IDEAS on the same data. The method has several unique advantages and outperforms existing methods, including that used by the Roadmap Epigenomics Consortium. Using five categories of independent experimental datasets, we compared the IDEAS and Roadmap Epigenomics maps. While the overall concordance between the two maps is high, the maps differ substantially in the prediction details and in their consistency of annotation of a given genomic position across cell types. The annotation from IDEAS is uniformly more accurate than the Roadmap Epigenomics annotation and the improvement is substantial based on several criteria. We further introduce a pipeline that improves the reproducibility of functional annotation maps. Thus, we provide a high-quality map of candidate functional regions across 127 human cell types and compare the quality of different annotation methods in order to facilitate biomedical research in epigenomics. PMID:28973456

Final Environmental Impact Statement Second Main Operating Base KC-46A Beddown at Alternative Air National Guard Installations

DTIC Science & Technology

2014-06-01

impacts to air quality. The potential effects of GHG emissions from the Proposed Action are by nature global. Substantial temperature increases...air quality. The potential effects of GHG emissions from the Proposed Action are by nature global. Substantial temperature increases attributable...human health or \\Velfare, including but not lin1ited to effects on 1nunicipal \\vater supplies, plankton, fish , shellfish, wildlife. and special

Irregularities in the effect of potassium phosphate in ynamide synthesis.

PubMed

Dooleweerdt, Karin; Birkedal, Henrik; Ruhland, Thomas; Skrydstrup, Troels

2008-12-05

The yields of ynamides using Hsung's second generation protocol depend substantially on the quality of K(3)PO(4). Samples of K(3)PO(4) from different suppliers were investigated by various techniques, revealing that the use of pure and anhydrous K(3)PO(4) provides higher ynamide yields in comparison to samples contaminated with hydrates (K(3)PO(4) x 1.5 H(2)O and K(3)PO(4) x 7 H(2)O). With high quality K(3)PO(4), a number of ynamides were synthesized in yields of 52-91%. In addition, we report that ynamides can undergo regioselective hydroamination with carbamates.

Obesity utilization and health-related quality of life in Medicare enrollees.

PubMed

Malinoff, Rochelle L; Elliott, Marc N; Giordano, Laura A; Grace, Susan C; Burroughs, James N

2013-01-01

The obese, with disproportionate chronic disease incidence, consume a large share of health care resources and drive up per capita Medicare spending. This study examined the prevalence of obesity and its association with health status, health-related quality of life (HRQOL), function, and outpatient utilization among Medicare Advantage seniors. Results indicate that obese beneficiaries, much more than overweight beneficiaries, have poorer health, functions, and HRQOL than normal weight beneficiaries and have substantially higher outpatient utilization. While weight loss is beneficial to both the overweight and obese, the markedly worse health status and high utilization of obese beneficiaries may merit particular attention.

No-cost manual method for preparation of tissue microarrays having high quality comparable to semiautomated methods.

PubMed

Foda, Abd Al-Rahman Mohammad

2013-05-01

Manual tissue microarray (TMA) construction had been introduced to avoid the high cost of automated and semiautomated techniques. The cheapest and simplest technique for constructing manual TMA was that of using mechanical pencil tips. This study was carried out to modify this method, aiming to raise its quality to reach that of expensive ones. Some modifications were introduced to Shebl's technique. Two conventional mechanical pencil tips of different diameters were used to construct the recipient blocks. A source of mild heat was used, and blocks were incubated at 38°C overnight. With our modifications, 3 high-density TMA blocks were constructed. We successfully performed immunostaining without substantial tissue loss. Our modifications increased the number of cores per block and improved the stability of the cores within the paraffin block. This new, modified technique is a good alternative for expensive machines in many laboratories.

National evaluation of multidisciplinary quality metrics for head and neck cancer.

PubMed

Cramer, John D; Speedy, Sedona E; Ferris, Robert L; Rademaker, Alfred W; Patel, Urjeet A; Samant, Sandeep

2017-11-15

The National Quality Forum has endorsed quality-improvement measures for multiple cancer types that are being developed into actionable tools to improve cancer care. No nationally endorsed quality metrics currently exist for head and neck cancer. The authors identified patients with surgically treated, invasive, head and neck squamous cell carcinoma in the National Cancer Data Base from 2004 to 2014 and compared the rate of adherence to 5 different quality metrics and whether compliance with these quality metrics impacted overall survival. The metrics examined included negative surgical margins, neck dissection lymph node (LN) yield ≥ 18, appropriate adjuvant radiation, appropriate adjuvant chemoradiation, adjuvant therapy within 6 weeks, as well as overall quality. In total, 76,853 eligible patients were identified. There was substantial variability in patient-level adherence, which was 80% for negative surgical margins, 73.1% for neck dissection LN yield, 69% for adjuvant radiation, 42.6% for adjuvant chemoradiation, and 44.5% for adjuvant therapy within 6 weeks. Risk-adjusted Cox proportional-hazard models indicated that all metrics were associated with a reduced risk of death: negative margins (hazard ratio [HR] 0.73; 95% confidence interval [CI], 0.71-0.76), LN yield ≥ 18 (HR, 0.93; 95% CI, 0.89-0.96), adjuvant radiation (HR, 0.67; 95% CI, 0.64-0.70), adjuvant chemoradiation (HR, 0.84; 95% CI, 0.79-0.88), and adjuvant therapy ≤6 weeks (HR, 0.92; 95% CI, 0.89-0.96). Patients who received high-quality care had a 19% reduced adjusted hazard of mortality (HR, 0.81; 95% CI, 0.79-0.83). Five head and neck cancer quality metrics were identified that have substantial variability in adherence and meaningfully impact overall survival. These metrics are appropriate candidates for national adoption. Cancer 2017;123:4372-81. © 2017 American Cancer Society. © 2017 American Cancer Society.

Strategies for Achieving High Sequencing Accuracy for Low Diversity Samples and Avoiding Sample Bleeding Using Illumina Platform

PubMed Central

Mitra, Abhishek; Skrzypczak, Magdalena; Ginalski, Krzysztof; Rowicka, Maga

2015-01-01

Sequencing microRNA, reduced representation sequencing, Hi-C technology and any method requiring the use of in-house barcodes result in sequencing libraries with low initial sequence diversity. Sequencing such data on the Illumina platform typically produces low quality data due to the limitations of the Illumina cluster calling algorithm. Moreover, even in the case of diverse samples, these limitations are causing substantial inaccuracies in multiplexed sample assignment (sample bleeding). Such inaccuracies are unacceptable in clinical applications, and in some other fields (e.g. detection of rare variants). Here, we discuss how both problems with quality of low-diversity samples and sample bleeding are caused by incorrect detection of clusters on the flowcell during initial sequencing cycles. We propose simple software modifications (Long Template Protocol) that overcome this problem. We present experimental results showing that our Long Template Protocol remarkably increases data quality for low diversity samples, as compared with the standard analysis protocol; it also substantially reduces sample bleeding for all samples. For comprehensiveness, we also discuss and compare experimental results from alternative approaches to sequencing low diversity samples. First, we discuss how the low diversity problem, if caused by barcodes, can be avoided altogether at the barcode design stage. Second and third, we present modified guidelines, which are more stringent than the manufacturer’s, for mixing low diversity samples with diverse samples and lowering cluster density, which in our experience consistently produces high quality data from low diversity samples. Fourth and fifth, we present rescue strategies that can be applied when sequencing results in low quality data and when there is no more biological material available. In such cases, we propose that the flowcell be re-hybridized and sequenced again using our Long Template Protocol. Alternatively, we discuss how analysis can be repeated from saved sequencing images using the Long Template Protocol to increase accuracy. PMID:25860802

Mechanical properties of metal-organic frameworks: An indentation study on epitaxial thin films

NASA Astrophysics Data System (ADS)

Bundschuh, S.; Kraft, O.; Arslan, H. K.; Gliemann, H.; Weidler, P. G.; Wöll, C.

2012-09-01

We have determined the hardness and Young's modulus of a highly porous metal-organic framework (MOF) using a standard nanoindentation technique. Despite the very low density of these films, 1.22 g cm-3, Young's modulus reaches values of almost 10 GPa for HKUST-1, demonstrating that this porous coordination polymer is substantially stiffer than normal polymers. This progress in characterizing mechanical properties of MOFs has been made possible by the use of high quality, oriented thin films grown using liquid phase epitaxy on modified Au substrates.

Fertility preservation in children, adolescents, and young adults with cancer: Quality of clinical practice guidelines and variations in recommendations.

PubMed

Font-Gonzalez, Anna; Mulder, Renée L; Loeffen, Erik A H; Byrne, Julianne; van Dulmen-den Broeder, Eline; van den Heuvel-Eibrink, Marry M; Hudson, Melissa M; Kenney, Lisa B; Levine, Jennifer M; Tissing, Wim J E; van de Wetering, Marianne D; Kremer, Leontien C M

2016-07-15

Fertility preservation care for children, adolescents, and young adults (CAYAs) with cancer is not uniform among practitioners. To ensure high-quality care, evidence-based clinical practice guidelines (CPGs) are essential. The authors identified existing CPGs for fertility preservation in CAYAs with cancer, evaluated their quality, and explored differences in recommendations. A systematic search in PubMed (January 2000-October 2014); guideline databases; and Web sites of oncology, pediatric, and fertility organizations was performed. Two reviewers evaluated the quality of the identified CPGs using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). From high-quality CPGs, the authors evaluated concordant and discordant areas among the recommendations. A total of 25 CPGs regarding fertility preservation were identified. The average AGREE II domain scores (scale of 0%-100%) varied from 15% on applicability to 100% on clarity of presentation. The authors considered 8 CPGs (32%) to be of high quality, which was defined as scores ≥60% in any 4 domains. Large variations in the recommendations of the high-quality CPGs were observed, with 87.2% and 88.6%, respectively, of discordant guideline areas among the fertility preservation recommendations for female and male patients with cancer. Only approximately one-third of the identified CPGs were found to be of sufficient quality. Of these CPGs, the fertility preservation recommendations varied substantially, which can be a reflection of inadequate evidence for specific recommendations, thereby hindering the ability of providers to deliver high-quality care. CPGs including a transparent decision process for fertility preservation can help health care providers to deliver optimal and uniform care, thus improving the quality of life of CAYAs with cancer and cancer survivors. Cancer 2016;122:2216-23. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

CellProfiler Tracer: exploring and validating high-throughput, time-lapse microscopy image data.

PubMed

Bray, Mark-Anthony; Carpenter, Anne E

2015-11-04

Time-lapse analysis of cellular images is an important and growing need in biology. Algorithms for cell tracking are widely available; what researchers have been missing is a single open-source software package to visualize standard tracking output (from software like CellProfiler) in a way that allows convenient assessment of track quality, especially for researchers tuning tracking parameters for high-content time-lapse experiments. This makes quality assessment and algorithm adjustment a substantial challenge, particularly when dealing with hundreds of time-lapse movies collected in a high-throughput manner. We present CellProfiler Tracer, a free and open-source tool that complements the object tracking functionality of the CellProfiler biological image analysis package. Tracer allows multi-parametric morphological data to be visualized on object tracks, providing visualizations that have already been validated within the scientific community for time-lapse experiments, and combining them with simple graph-based measures for highlighting possible tracking artifacts. CellProfiler Tracer is a useful, free tool for inspection and quality control of object tracking data, available from http://www.cellprofiler.org/tracer/.

Quality of life in patients with Irritable Bowel Syndrome (IBS), assessed using the IBS-Quality of Life (IBS-QOL) measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide: results of an international prospective observational cohort study in Poland, Egypt, Mexico and China.

PubMed

Hou, Xiaohua; Chen, Shengliang; Zhang, Yali; Sha, Weihong; Yu, Xiaofeng; Elsawah, Hesham; Afifi, Afifi Fahmy; El-Khayat, Hisham Raafat; Nouh, Alaa; Hassan, Mohamed Fathalla; Fatah, Ayman Abdel; Rucker Joerg, Isabel; Sánchez Núñez, Juan Manuel; Osthoff Rueda, Rodolfo; Jurkowska, Grazyna; Walczak, Michal; Malecka-Panas, Ewa; Linke, Krzysztof; Hartleb, Marek; Janssen-van Solingen, Gwendolyn

2014-11-01

Irritable Bowel Syndrome (IBS) has a substantial impact on health-related quality of life (HR-QoL) but high-quality data pre- and post-treatment using the IBS-Quality of Life (IBS-QOL) measure are limited. The objective of this study was to evaluate the changes from baseline of the IBS-QOL scores, symptom scores and health economic data in IBS patients, after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide. This was a prospective observational cohort study in patients with IBS, diagnosed using the Rome III criteria in four countries (Poland, Egypt, Mexico and China). A total of 607 patients were enrolled. At baseline, the IBS-QOL total scores were 52.0 in Poland, 48.9 in Egypt, 51.9 in Mexico, 76.4 in China and 56.4 overall. Increases in IBS-QOL total score were statistically significant at Weeks 4 and 8 overall and in each country (overall: 11.8 at Week 4, 24.3 at Week 8; p < 0.001). Improvements were shown in all IBS-QOL subscales and scores. Symptoms and health economic outcomes were improved. Furthermore, the favourable safety profile of these treatments was confirmed in this study. This study demonstrated that IBS patients have a substantially reduced HR-QoL and that treatment with mebeverine hydrochloride or pinaverium bromide improved HR-QoL.

Functional disability and health-related quality of life in South Africans with early rheumatoid arthritis.

PubMed

Hodkinson, B; Musenge, E; Ally, M; Meyer, P W A; Anderson, R; Tikly, M

2012-10-01

The severity and predictors of functional disability and health-related quality of life (HRQoL) in a cohort of South Africans with early rheumatoid arthritis (RA) were investigated. Changes in the Health Assessment Questionnaire Disability Index (HAQ) and the 36-Item Short Form Health Survey (SF-36) following 12 months of traditional disease-modifying anti-rheumatic drugs (DMARDs) were studied in previously DMARD-naïve adults with disease duration ≤ 2 years. The majority of the 171 patients were female (82%), Black Africans (89%) with a mean (SD) symptom duration of 11.6 (7.0) months. In the 134 patients seen at 12 months, there were significant improvements in the HAQ and all domains of the SF-36 but 92 (69%) still had substantial functional disability (HAQ > 0.5) and 89 (66%) had suboptimal mental health [SF-36 mental composite score (MCS) < 66.6]. Multivariate analysis showed that female sex (p = 0.05) and high baseline HAQ score (p < 0.01) predicted substantial functional disability at 12 months. Unemployment (p = 0.03), high baseline pain (p = 0.02), and HAQ score (p = 0.04) predicted suboptimal mental health, with a trend towards a low level of schooling being significant (p = 0.08). Early RA has a broad impact on HRQoL in indigent South Africans, with a large proportion of patients still showing substantial functional disability and suboptimal mental health despite 12 months of DMARD therapy. Further research is needed to establish the role of interventions including psychosocial support, rehabilitation programmes, and biological therapy to improve physical function and HRQoL in this population.

Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014.

PubMed

Chang, C C; Ananda-Rajah, M; Belcastro, A; McMullan, B; Reid, A; Dempsey, K; Athan, E; Cheng, A C; Slavin, M A

2014-12-01

Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Federal R&D Agenda for Net Zero Energy, High-Performance Green Buildings

DTIC Science & Technology

2008-09-30

Source: 2007 DOE Buildings Energy Data Book . Tables 1.1.3, 1.2.3, 1.3.3 Energy consumption associated with buildings has a substantial impact on...from poor indoor air quality (IAQ) include Legionnaire’s disease, heart disease and lung cancer from secondhand smoke, and carbon monoxide poisoning...publications/pdfs/highperformance/commercialbuildi ngsroadmap.pdf DOE. 2007a. Buildings energy data book . http://buildingsdatabook.eren.doe.gov/ DOE

Free to Choose? Reform, Choice, and Consideration Sets in the English National Health Service.

PubMed

Gaynor, Martin; Propper, Carol; Seiler, Stephan

2016-11-01

Choice in public services is controversial. We exploit a reform in the English National Health Service to assess the effect of removing constraints on patient choice. We estimate a demand model that explicitly captures the removal of the choice constraints imposed on patients. We find that, post-removal, patients became more responsive to clinical quality. This led to a modest reduction in mortality and a substantial increase in patient welfare. The elasticity of demand faced by hospitals increased substantially post- reform and we find evidence that hospitals responded to the enhanced incentives by improving quality. This suggests greater choice can raise quality.

CAIPIRINHA accelerated SPACE enables 10-min isotropic 3D TSE MRI of the ankle for optimized visualization of curved and oblique ligaments and tendons.

PubMed

Kalia, Vivek; Fritz, Benjamin; Johnson, Rory; Gilson, Wesley D; Raithel, Esther; Fritz, Jan

2017-09-01

To test the hypothesis that a fourfold CAIPIRINHA accelerated, 10-min, high-resolution, isotropic 3D TSE MRI prototype protocol of the ankle derives equal or better quality than a 20-min 2D TSE standard protocol. Following internal review board approval and informed consent, 3-Tesla MRI of the ankle was obtained in 24 asymptomatic subjects including 10-min 3D CAIPIRINHA SPACE TSE prototype and 20-min 2D TSE standard protocols. Outcome variables included image quality and visibility of anatomical structures using 5-point Likert scales. Non-parametric statistical testing was used. P values ≤0.001 were considered significant. Edge sharpness, contrast resolution, uniformity, noise, fat suppression and magic angle effects were without statistical difference on 2D and 3D TSE images (p > 0.035). Fluid was mildly brighter on intermediate-weighted 2D images (p < 0.001), whereas 3D images had substantially less partial volume, chemical shift and no pulsatile-flow artifacts (p < 0.001). Oblique and curved planar 3D images resulted in mildly-to-substantially improved visualization of joints, spring, bifurcate, syndesmotic, collateral and sinus tarsi ligaments, and tendons (p < 0.001, respectively). 3D TSE MRI with CAIPIRINHA acceleration enables high-spatial resolution oblique and curved planar MRI of the ankle and visualization of ligaments, tendons and joints equally well or better than a more time-consuming anisotropic 2D TSE MRI. • High-resolution 3D TSE MRI improves visualization of ankle structures. • Limitations of current 3D TSE MRI include long scan times. • 3D CAIPIRINHA SPACE allows now a fourfold-accelerated data acquisition. • 3D CAIPIRINHA SPACE enables high-spatial-resolution ankle MRI within 10 min. • 10-min 3D CAIPIRINHA SPACE produces equal-or-better quality than 20-min 2D TSE.

Work and the Perceived Quality of Life. A Final Report.

DTIC Science & Technology

1986-12-01

The experience of work has the potential to substantially influence the perceived quality of life (pQL). The goal of this research program was to...Job satisfaction, life satisfaction, quality of life , quality of work life, unemployment, work-family conflict, job involvement, family involvement, job importance.

Quality of Life and Quality of Support for People with Severe Intellectual Disability and Complex Needs

ERIC Educational Resources Information Center

Beadle-Brown, J.; Leigh, J.; Whelton, B.; Richardson, L.; Beecham, J.; Baumker, T.; Bradshaw, J.

2016-01-01

Background: People with severe and profound intellectual disabilities often spend substantial time isolated and disengaged. The nature and quality of the support appears to be important in determining quality of life. Methods: Structured observations and staff questionnaires were used to explore the quality of life and quality of support for 110…

Reducing the societal burden of depression: a review of economic costs, quality of care and effects of treatment.

PubMed

Donohue, Julie M; Pincus, Harold Alan

2007-01-01

Depression is a highly prevalent condition that results in substantial functional impairment. Advocates have attempted in recent years to make the 'business case' for investing in quality improvement efforts in depression care, particularly in primary care settings. The business case suggests that the costs of depression treatment may be offset by gains in worker productivity and/or reductions in other healthcare spending. In this paper, we review the evidence in support of this argument for improving the quality of depression treatment. We examined the impact of depression on two of the primary drivers of the societal burden of depression: healthcare utilisation and worker productivity. Depression leads to higher healthcare utilisation and spending, most of which is not the result of depression treatment costs. Depression is also a leading cause of absenteeism and reduced productivity at work. It is clear that the economic burden of depression is substantial; however, critical gaps in the literature remain and need to be addressed. For instance, we do not know the economic burden of untreated and/or inappropriately treated versus appropriately treated depression. There remain considerable problems with access to and quality of depression treatment. Progress has been made in terms of access to care, but quality of care is seldom consistent with national treatment guidelines. A wide range of effective treatments and care programmes for depression are available, yet rigorously tested clinical models to improve depression care have not been widely adopted by healthcare systems. Barriers to improving depression care exist at the patient, healthcare provider, practice, plan and purchaser levels, and may be both economic and non-economic. Studies evaluating interventions to improve the quality of depression treatment have found that the cost per QALY associated with improved depression care ranges from a low of 2519 US dollars to a high of 49,500 US dollars. We conclude from our review of the literature that effective treatment of depression is cost effective, but that evidence of a medical or productivity cost offset for depression treatment remains equivocal, and this points to the need for further research in this area.

48 CFR 46.105 - Contractor responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CONTRACT MANAGEMENT QUALITY ASSURANCE General 46.105 Contractor responsibilities. (a) The contractor is responsible for carrying out its obligations under the contract by— (1) Controlling the quality of supplies or..., subassemblies, etc., have an acceptable quality control system; and (4) Maintaining substantiating evidence...

48 CFR 46.105 - Contractor responsibilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CONTRACT MANAGEMENT QUALITY ASSURANCE General 46.105 Contractor responsibilities. (a) The contractor is responsible for carrying out its obligations under the contract by— (1) Controlling the quality of supplies or..., subassemblies, etc., have an acceptable quality control system; and (4) Maintaining substantiating evidence...

48 CFR 46.105 - Contractor responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONTRACT MANAGEMENT QUALITY ASSURANCE General 46.105 Contractor responsibilities. (a) The contractor is responsible for carrying out its obligations under the contract by— (1) Controlling the quality of supplies or..., subassemblies, etc., have an acceptable quality control system; and (4) Maintaining substantiating evidence...

48 CFR 46.105 - Contractor responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CONTRACT MANAGEMENT QUALITY ASSURANCE General 46.105 Contractor responsibilities. (a) The contractor is responsible for carrying out its obligations under the contract by— (1) Controlling the quality of supplies or..., subassemblies, etc., have an acceptable quality control system; and (4) Maintaining substantiating evidence...

AIR EMISSION INVENTORIES IN NORTH AMERICA: A CRITICAL ASSESSMENT

EPA Science Inventory

Although emission inventories are the foundation of air quality management and have supported substantial improvements in North American air quality, they have a number of shortcomings that can potentially lead to ineffective air quality management strategies. New technologies fo...

The High Plains Aquifer, USA: Groundwater development and sustainability

USGS Publications Warehouse

Dennehy, K.F.; Litke, D.W.; McMahon, P.B.

2002-01-01

The High Plains Aquifer, located in the United States, is one of the largest freshwater aquifers in the world and is threatened by continued decline in water levels and deteriorating water quality. Understanding the physical and cultural features of this area is essential to assessing the factors that affect this groundwater resource. About 27% of the irrigated land in the United States overlies this aquifer, which yields about 30% of the nation's groundwater used for irrigation of crops including wheat, corn, sorghum, cotton and alfalfa. In addition, the aquifer provides drinking water to 82% of the 2.3 million people who live within the aquifer boundary. The High Plains Aquifer has been significantly impacted by human activities. Groundwater withdrawals from the aquifer exceed recharge in many areas, resulting in substantial declines in groundwater level. Residents once believed that the aquifer was an unlimited resource of high-quality water, but they now face the prospect that much of the water may be gone in the near future. Also, agricultural chemicals are affecting the groundwater quality. Increasing concentrations of nitrate and salinity can first impair the use of the water for public supply and then affect its suitability for irrigation. A variety of technical and institutional measures are currently being planned and implemented across the aquifer area in an attempt to sustain this groundwater resource for future generations. However, because groundwater withdrawals remain high and water quality impairments are becoming more commonplace, the sustainability of the High Plains Aquifer is uncertain.

Evaluation of the sparse coding super-resolution method for improving image quality of up-sampled images in computed tomography

NASA Astrophysics Data System (ADS)

Ota, Junko; Umehara, Kensuke; Ishimaru, Naoki; Ohno, Shunsuke; Okamoto, Kentaro; Suzuki, Takanori; Shirai, Naoki; Ishida, Takayuki

2017-02-01

As the capability of high-resolution displays grows, high-resolution images are often required in Computed Tomography (CT). However, acquiring high-resolution images takes a higher radiation dose and a longer scanning time. In this study, we applied the Sparse-coding-based Super-Resolution (ScSR) method to generate high-resolution images without increasing the radiation dose. We prepared the over-complete dictionary learned the mapping between low- and highresolution patches and seek a sparse representation of each patch of the low-resolution input. These coefficients were used to generate the high-resolution output. For evaluation, 44 CT cases were used as the test dataset. We up-sampled images up to 2 or 4 times and compared the image quality of the ScSR scheme and bilinear and bicubic interpolations, which are the traditional interpolation schemes. We also compared the image quality of three learning datasets. A total of 45 CT images, 91 non-medical images, and 93 chest radiographs were used for dictionary preparation respectively. The image quality was evaluated by measuring peak signal-to-noise ratio (PSNR) and structure similarity (SSIM). The differences of PSNRs and SSIMs between the ScSR method and interpolation methods were statistically significant. Visual assessment confirmed that the ScSR method generated a high-resolution image with sharpness, whereas conventional interpolation methods generated over-smoothed images. To compare three different training datasets, there were no significance between the CT, the CXR and non-medical datasets. These results suggest that the ScSR provides a robust approach for application of up-sampling CT images and yields substantial high image quality of extended images in CT.

Quality of Voluntary Medical Male Circumcision Services during Scale-Up: A Comparative Process Evaluation in Kenya, South Africa, Tanzania and Zimbabwe

PubMed Central

Jennings, Larissa; Bertrand, Jane; Rech, Dino; Harvey, Steven A.; Hatzold, Karin; Samkange, Christopher A.; Omondi Aduda, Dickens S.; Fimbo, Bennett; Cherutich, Peter; Perry, Linnea; Castor, Delivette; Njeuhmeli, Emmanuel

2014-01-01

Background The rapid expansion of voluntary medical male circumcision (VMMC) has raised concerns whether health systems can deliver and sustain VMMC according to minimum quality criteria. Methods and Findings A comparative process evaluation was used to examine data from SYMMACS, the Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-Up, among health facilities providing VMMC across two years of program scale-up. Site-level assessments examined the availability of guidelines, supplies and equipment, infection control, and continuity of care services. Direct observation of VMMC surgeries were used to assess care quality. Two sample tests of proportions and t-tests were used to examine differences in the percent of facilities meeting requisite preparedness standards and the mean number of directly-observed surgical tasks performed correctly. Results showed that safe, high quality VMMC can be implemented and sustained at-scale, although substantial variability was observed over time. In some settings, facility preparedness and VMMC service quality improved as the number of VMMC facilities increased. Yet, lapses in high performance and expansion of considerably deficient services were also observed. Surgical tasks had the highest quality scores, with lower performance levels in infection control, pre-operative examinations, and post-operative patient monitoring and counseling. The range of scale-up models used across countries additionally underscored the complexity of delivering high quality VMMC. Conclusions Greater efforts are needed to integrate VMMC scale-up and quality improvement processes in sub-Saharan African settings. Monitoring of service quality, not just adverse events reporting, will be essential in realizing the full health impact of VMMC for HIV prevention. PMID:24801073

Recent developments in minimal processing: a tool to retain nutritional quality of food.

PubMed

Pasha, Imran; Saeed, Farhan; Sultan, M Tauseef; Khan, Moazzam Rafiq; Rohi, Madiha

2014-01-01

The modernization during the last century resulted in urbanization coupled with modifications in lifestyles and dietary habits. In the same era, industrial developments made it easier to meet the requirements for processed foods. However, consumers are now interested in minimally processed foods owing to increase in their awareness to have fruits and vegetables with superior quality, and natural integrity with fewer additives. The food products deteriorate as a consequence of physiological aging, biochemical changes, high respiration rat,e and high ethylene production. These factors contribute substantially to discoloration, loss of firmness, development of off-flavors, acidification, and microbial spoilage. Simultaneously, food processors are using emerging approaches to process perishable commodities, along with enhanced nutritional and sensorial quality. The present review article is an effort to utilize the modern approaches to minimize the processing and deterioration. The techniques discussed in this paper include chlorination, ozonation, irradiation, photosensitization, edible coating, natural preservative use, high-pressure processing, microwave heating, ohmic heating, and hurdle technology. The consequences of these techniques on shelf-life stability, microbial safety, preservation of organoleptic and nutritional quality, and residue avoidance are the limelight of the paper. Moreover, the discussion has been made on the feasibility and operability of these techniques in modern-day processing.

High velocity pulsed wire-arc spray

NASA Technical Reports Server (NTRS)

Kincaid, Russell W. (Inventor); Witherspoon, F. Douglas (Inventor); Massey, Dennis W. (Inventor)

1999-01-01

Wire arc spraying using repetitively pulsed, high temperature gas jets, usually referred to as plasma jets, and generated by capillary discharges, substantially increases the velocity of atomized and entrained molten droplets. The quality of coatings produced is improved by increasing the velocity with which coating particles impact the coated surface. The effectiveness of wire-arc spraying is improved by replacing the usual atomizing air stream with a rapidly pulsed high velocity plasma jet. Pulsed power provides higher coating particle velocities leading to improved coatings. 50 micron aluminum droplets with velocities of 1500 m/s are produced. Pulsed plasma jet spraying provides the means to coat the insides of pipes, tubes, and engine block cylinders with very high velocity droplet impact.

24 CFR 968.105 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... purpose of funding physical and management improvements. Modernization program. A PHA's program for... substantially the same kind does qualify, but reconstruction, substantial improvement in the quality or kind of... resident participation in each of the required program components. PHMAP. The Public Housing Management...

Casemix--an AMA perspective.

PubMed

Nelson, B

1994-09-05

The introduction of casemix payment systems into Australia's public hospitals is an inevitability which the Australian Medical Association has now begun to address. A greater involvement of clinicians in the design and implementation of casemix can add substantial quality to these systems. However, there is concern that a proliferation of separate casemix systems may be contrary to overall health policy developments and that governments will not understand the limits of casemix. Recent attempts to include medical payments within a casemix payment system in the private sector faced our united opposition. Finally, special care needs to be taken to ensure that the introduction of a casemix payment system does not further disadvantage access to high quality health care for Aborigines.

Flying qualities design criteria applicable to supersonic cruise aircraft

NASA Technical Reports Server (NTRS)

Chalk, C. R.

1980-01-01

A comprehensive set of flying qualities design criteria was prepared for use in the supersonic cruise research program. The framework for stating the design criteria is established and design criteria are included which address specific failures, approach to dangerous flight conditions, flight at high angle of attack, longitudinal and lateral directional stability and control, the primary flight control system, and secondary flight controls. Examples are given of lateral directional design criteria limiting lateral accelerations at the cockpit, time to roll through 30 deg of bank, and time delay in the pilot's command path. Flight test data from the Concorde certification program are used to substantiate a number of the proposed design criteria.

Forest ecosystem services: Carbon and air quality

Treesearch

David J. Nowak; Neelam C. Poudyal; Steve G. McNulty

2017-01-01

Forests provide various ecosystem services related to air quality that can provide substantial value to society. Through tree growth and alteration of their local environment, trees and forests both directly and indirectly affect air quality. Though forests affect air quality in numerous ways, this chapter will focus on five main ecosystem services or disservices...

An old disease with new insights: Update on diagnosis and treatment of gout

PubMed Central

Bitik, Berivan; Öztürk, M. Akif

2014-01-01

Gout is an acute and chronic inflammatory disorder associated with high morbidity and impaired quality of life. There has been a substantial increase in the prevalence and incidence of gout in recent years. Novel diagnostic and therapeutic options have provided new insights into the pathogenesis and management of hyperuricemia and gout in the last decade. This clinical review aims to summarize the diagnostic process and management of acute and chronic gout. PMID:27708879

Nanowire-templated lateral epitaxial growth of non-polar group III nitrides

DOEpatents

Wang, George T [Albuquerque, NM; Li, Qiming [Albuquerque, NM; Creighton, J Randall [Albuquerque, NM

2010-03-02

A method for growing high quality, nonpolar Group III nitrides using lateral growth from Group III nitride nanowires. The method of nanowire-templated lateral epitaxial growth (NTLEG) employs crystallographically aligned, substantially vertical Group III nitride nanowire arrays grown by metal-catalyzed metal-organic chemical vapor deposition (MOCVD) as templates for the lateral growth and coalescence of virtually crack-free Group III nitride films. This method requires no patterning or separate nitride growth step.

Nitrous oxide emissions from wastewater treatment processes

PubMed Central

Law, Yingyu; Ye, Liu; Pan, Yuting; Yuan, Zhiguo

2012-01-01

Nitrous oxide (N2O) emissions from wastewater treatment plants vary substantially between plants, ranging from negligible to substantial (a few per cent of the total nitrogen load), probably because of different designs and operational conditions. In general, plants that achieve high levels of nitrogen removal emit less N2O, indicating that no compromise is required between high water quality and lower N2O emissions. N2O emissions primarily occur in aerated zones/compartments/periods owing to active stripping, and ammonia-oxidizing bacteria, rather than heterotrophic denitrifiers, are the main contributors. However, the detailed mechanisms remain to be fully elucidated, despite strong evidence suggesting that both nitrifier denitrification and the chemical breakdown of intermediates of hydroxylamine oxidation are probably involved. With increased understanding of the fundamental reactions responsible for N2O production in wastewater treatment systems and the conditions that stimulate their occurrence, reduction of N2O emissions from wastewater treatment systems through improved plant design and operation will be achieved in the near future. PMID:22451112

Volcanic ash in the water column: Physiological impact on the suspension-feeding bivalve Mytilus chilensis.

PubMed

Salas-Yanquin, L P; Navarro, J M; Pechenik, J A; Montory, J A; Chaparro, O R

2018-02-01

Ashes settling into the sea from volcanic explosions expose suspension-feeding species to reduced seston quality. Adults and juveniles of the mussel Mytilus chilensis were exposed for 15days to the phytoplankton Isochrysis galbana together with various concentrations of ashes. We then quantified impact on survival and physiology. Although no individuals died during the experiment, by the end of the study clearance rates and oxygen consumption rates had decreased substantially, and tissue weight of mussels exposed to the highest ash concentrations declined substantially. Gills showed no physical damage, but did show abundant mucus secretion in response to ash particles. Moreover, as the relative proportions of microalgae to ash in the diet decreased, individuals showed increasing preferential ingestion of microalgal particles. Increased ash content in the diet altered physiological rates and activated distinct particle selection with a high production of pseudofeces and high energy costs, with potential long-term consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Investigation of radiometric properties of the LANDSAT-4 multispectral scanner

NASA Technical Reports Server (NTRS)

Malila, W. A. (Principal Investigator); Rice, D. P.

1983-01-01

The radiometric data quality of the LANDSAT 4 multispectral scanner (MSS) was examined using several LANDSAT 4 frames. It was found that LANDSAT 4 MSS produces high-quality data of the caliber experienced with previous LANDSATS. For example, the detector equalization procedure worked well, leaving a residual banding effect of about 0.3 digital counts RMS, close to the theoretical minimum value of quantization error. Nevertheless, artifacts of the data were found, two of which were not experienced in previous MSS data. A low-level coherent noise effect was observed in all bands, with a magnitude of about 0.5 digital counts and a frequency of approximately 28 KHz (representing a wavelength of about 3.6 pixels); a substantial increase in processing complexity would be required to reduce this artifact in the data. Also, a substantial scan-length variation (of up to six pixels) was noted in MSS data when the TM sensor was operating; the LANDSAT 4 correction algorithms being applied routinely by the EROS Data Center to produce a p-type data should remove most of this variation. Between-satellite calibrations were examined in paired LANDSAT 3 and LANDSAT 4 MSS data sets, which were closely matched in acquisition time and place. Radiometric comparisons showed that all bands were highly linear in digital counts, and a well-determined linear transformation between the MSS's was established.

Characterization of Extracellular Vesicles by Size-Exclusion High-Performance Liquid Chromatography (HPLC).

PubMed

Huang, Tao; He, Jiang

2017-01-01

Extracellular vesicles (EVs) have recently attracted substantial attention due to the potential diagnostic and therapeutic relevance. Although a variety of techniques have been used to isolate and analyze EVs, it is still far away from satisfaction. Size-exclusion chromatography (SEC), which separates subjects by size, has been widely applied in protein purification and analysis. The purpose of this chapter is to show the applications of size-exclusion high-performance liquid chromatography (HPLC) as methods for EV characterization of impurities or contaminants of small size, and thus for quality assay for the purity of the samples of EVs.

Integrating High-Resolution Datasets to Target Mitigation Efforts for Improving Air Quality and Public Health in Urban Neighborhoods

PubMed Central

Shandas, Vivek; Voelkel, Jackson; Rao, Meenakshi; George, Linda

2016-01-01

Reducing exposure to degraded air quality is essential for building healthy cities. Although air quality and population vary at fine spatial scales, current regulatory and public health frameworks assess human exposures using county- or city-scales. We build on a spatial analysis technique, dasymetric mapping, for allocating urban populations that, together with emerging fine-scale measurements of air pollution, addresses three objectives: (1) evaluate the role of spatial scale in estimating exposure; (2) identify urban communities that are disproportionately burdened by poor air quality; and (3) estimate reduction in mobile sources of pollutants due to local tree-planting efforts using nitrogen dioxide. Our results show a maximum value of 197% difference between cadastrally-informed dasymetric system (CIDS) and standard estimations of population exposure to degraded air quality for small spatial extent analyses, and a lack of substantial difference for large spatial extent analyses. These results provide the foundation for improving policies for managing air quality, and targeting mitigation efforts to address challenges of environmental justice. PMID:27527205

Effects of advanced treatment of municipal wastewater on the White River near Indianapolis, Indiana; trends in water quality, 1978-86

USGS Publications Warehouse

Crawford, Charles G.; Wangsness, David J.

1993-01-01

The City of Indianapolis has constructed state-of-the-art advanced municipal wastewater-treatment systems to enlarge and upgrade the existing secondary-treatment processes at its Belmont and Southport treatment plants. These new advanced-wastewater-treatment plants became operational in 1983. A nonparametric statistical procedure--a modified form of the Wilcoxon-Mann-Whitney rank-sum test--was used to test for trends in time-series water-quality data from four sites on the White River and from the Belmont and Southport wastewater-treatment plants. Time-series data representative of pre-advanced- (1978-1980) and post-advanced- (1983--86) wastewater-treatment conditions were tested for trends, and the results indicate substantial changes in water quality of treated effluent and of the White River downstream from Indianapolis after implementation of advanced wastewater treatment. Water quality from 1981 through 1982 was highly variable due to plant construction. Therefore, this time period was excluded from the analysis. Water quality at sample sites located upstream from the wastewater-treatment plants was relatively constant during the period of study (1978-86). Analysis of data from the two plants and downstream from the plants indicates statistically significant decreasing trends in effluent concentrations of total ammonia, 5-day biochemical-oxygen demand, fecal-coliform bacteria, total phosphate, and total solids at all sites where sufficient data were available for testing. Because of in-plant nitrification, increases in nitrate concentration were statistically significant in the two plants and in the White River. The decrease in ammonia concentrations and 5-day biochemical-oxygen demand in the White River resulted in a statistically significant increasing trend in dissolved-oxygen concentration in the river because of reduced oxygen demand for nitrification and biochemical oxidation processes. Following implementation of advanced wastewater treatment, the number of river-quality samples that failed to meet the water-quality standards for ammonia and dissolved oxygen that apply to the White River decreased substantially.

Systematic review of communication partner training in aphasia: methodological quality.

PubMed

Cherney, Leora R; Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey

2013-10-01

Twenty-three studies identified from a previous systematic review examining the effects of communication partner training on persons with aphasia and their communication partners were evaluated for methodological quality. Two reviewers rated the studies on defined methodological quality criteria relevant to each study design. There were 11 group studies, seven single-subject participant design studies, and five qualitative studies. Quality scores were derived for each study. The mean inter-rater reliability of scores for each study design ranged from 85-93%, with Cohen's Kappa indicating substantial agreement between raters. Methodological quality of research on communication partner training in aphasia was highly varied. Overall, group studies employed the least rigorous methodology as compared to single subject and qualitative research. Only two of 11 group studies complied with more than half of the quality criteria. No group studies reported therapist blinding and only one group study reported participant blinding. Across all types of studies, the criterion of treatment fidelity was most commonly omitted. Failure to explicitly report certain methodological quality criteria may account for low ratings. Using methodological rating scales specific to the type of study design may help improve the methodological quality of aphasia treatment studies, including those on communication partner training.

Potential and Limitations of Cochrane Reviews in Pediatric Cardiology: A Systematic Analysis.

PubMed

Poryo, Martin; Khosrawikatoli, Sara; Abdul-Khaliq, Hashim; Meyer, Sascha

2017-04-01

Evidence-based medicine has contributed substantially to the quality of medical care in pediatric and adult cardiology. However, our impression from the bedside is that a substantial number of Cochrane reviews generate inconclusive data that are of limited clinical benefit. We performed a systematic synopsis of Cochrane reviews published between 2001 and 2015 in the field of pediatric cardiology. Main outcome parameters were the number and percentage of conclusive, partly conclusive, and inconclusive reviews as well as their recommendations and their development over three a priori defined intervals. In total, 69 reviews were analyzed. Most of them examined preterm and term neonates (36.2%), whereas 33.3% included also non-pediatric patients. Leading topics were pharmacological issues (71.0%) followed by interventional (10.1%) and operative procedures (2.9%). The majority of reviews were inconclusive (42.9%), while 36.2% were conclusive and 21.7% partly conclusive. Although the number of published reviews increased during the three a priori defined time intervals, reviews with "no specific recommendations" remained stable while "recommendations in favor of an intervention" clearly increased. Main reasons for missing recommendations were insufficient data (n = 41) as well as an insufficient number of trials (n = 22) or poor study quality (n = 19). There is still need for high-quality research, which will likely yield a greater number of Cochrane reviews with conclusive results.

Health Advice in a Digital World: Quality and Content of Online Information about the Prevention of Alzheimer's Disease.

PubMed

Robillard, Julie M; Feng, Tanya L

2017-01-01

As the number of older adults turning to the Internet for health information increases, so does the potential for online information to have a substantial impact on the patient-physician relationship and on their health. Inaccurate information may weaken patient-physician relationships or result in increased physician visits and health anxiety, while high quality information may allow Internet users to make better decisions about their health. To assess the quality and content of available online resources about the prevention of Alzheimer's disease (AD). A sample of 308 articles related to the prevention of AD was collected from the first three pages of location-independent keyword searches on Google.com between September 17-30, 2014. Content analysis was applied to articles that met criteria (n = 298) and a quality evaluation tool was developed to generate a quality score for each of the articles (n = 290). We found that articles on the high end of the quality spectrum focused on modifiable risk factors and tended to present balanced information, while articles of low quality emphasized nutrition as a method of prevention and were more likely to be in conflict of interest. This study provides the first insight into the content and quality of prevention information for AD currently available online and highlights the importance of future research to better understand the impact of this information on the patient-physician relationship and health decision-making of older adults.

The State of Software for Evolutionary Biology.

PubMed

Darriba, Diego; Flouri, Tomáš; Stamatakis, Alexandros

2018-05-01

With Next Generation Sequencing data being routinely used, evolutionary biology is transforming into a computational science. Thus, researchers have to rely on a growing number of increasingly complex software. All widely used core tools in the field have grown considerably, in terms of the number of features as well as lines of code and consequently, also with respect to software complexity. A topic that has received little attention is the software engineering quality of widely used core analysis tools. Software developers appear to rarely assess the quality of their code, and this can have potential negative consequences for end-users. To this end, we assessed the code quality of 16 highly cited and compute-intensive tools mainly written in C/C++ (e.g., MrBayes, MAFFT, SweepFinder, etc.) and JAVA (BEAST) from the broader area of evolutionary biology that are being routinely used in current data analysis pipelines. Because, the software engineering quality of the tools we analyzed is rather unsatisfying, we provide a list of best practices for improving the quality of existing tools and list techniques that can be deployed for developing reliable, high quality scientific software from scratch. Finally, we also discuss journal as well as science policy and, more importantly, funding issues that need to be addressed for improving software engineering quality as well as ensuring support for developing new and maintaining existing software. Our intention is to raise the awareness of the community regarding software engineering quality issues and to emphasize the substantial lack of funding for scientific software development.

Methodological quality of randomized trials published in the Journal of the American Podiatric Medical Association, 1999-2013.

PubMed

Landorf, Karl B; Menz, Hylton B; Armstrong, David G; Herbert, Robert D

2015-07-01

Randomized trials must be of high methodological quality to yield credible, actionable findings. The main aim of this project was to evaluate whether there has been an improvement in the methodological quality of randomized trials published in the Journal of the American Podiatric Medical Association (JAPMA). Randomized trials published in JAPMA during a 15-year period (January 1999 to December 2013) were evaluated. The methodological quality of randomized trials was evaluated using the PEDro scale (scores range from 0 to 10, with 0 being lowest quality). Linear regression was used to assess changes in methodological quality over time. A total of 1,143 articles were published in JAPMA between January 1999 and December 2013. Of these, 44 articles were reports of randomized trials. Although the number of randomized trials published each year increased, there was only minimal improvement in their methodological quality (mean rate of improvement = 0.01 points per year). The methodological quality of the trials studied was typically moderate, with a mean ± SD PEDro score of 5.1 ± 1.5. Although there were a few high-quality randomized trials published in the journal, most (84.1%) scored between 3 and 6. Although there has been an increase in the number of randomized trials published in JAPMA, there is substantial opportunity for improvement in the methodological quality of trials published in the journal. Researchers seeking to publish reports of randomized trials should seek to meet current best-practice standards in the conduct and reporting of their trials.

Health related quality of life in men with prostate cancer.

PubMed

Penson, David F; Litwin, Mark S; Aaronson, Neil K

2003-05-01

Quality of life is of great concern to patients considering treatment options for prostate cancer. In the absence of clinical trial data clearly demonstrating that a particular treatment is superior to another for localized prostate cancer, in terms of cause specific survival, patients may value quality of life as much as quantity of life. The goal of this review is to familiarize the reader with the methodology of quality of life research and to review the recent literature on quality of life outcomes in prostate cancer. A structured MEDLINE review of literature on health related quality of life in prostate cancer for the years 1995 to 2001 was performed, and was augmented with highly relevant articles from additional selected journals. In the case of advanced or metastatic disease, where the goal of treatment is palliation and symptom-free survival, quality of life often becomes the primary desired outcome. In localized disease all treatments affect health related quality of life, although the impact of each therapy on sexual, urinary and bowel function is unique. Although a highly personal and subjective entity, health related quality of life can be assessed using rigorous and scientifically stringent methods from the field of psychometric test theory. A substantial amount of literature exists regarding the use of established and validated instruments for assessing the impact of prostate cancer and its treatment on health related quality of life. This information is of critical importance when counseling men with newly diagnosed prostate cancer regarding treatment choices and is also helpful in setting appropriate expectations for men with metastatic disease.

Mindfulness-Based Therapies in the Treatment of Functional Gastrointestinal Disorders: A Meta-Analysis

PubMed Central

2014-01-01

Background. Functional gastrointestinal disorders are highly prevalent and standard treatments are often unsatisfactory. Mindfulness-based therapy has shown benefit in conditions including chronic pain, mood, and somatization disorders. Objectives. To assess the quality and effectiveness reported in existing literature, we conducted a meta-analysis of mindfulness-based therapy in functional gastrointestinal disorders. Methods. Pubmed, EBSCO, and Cochrane databases were searched from inception to May 2014. Study inclusion criteria included randomized, controlled studies of adults using mindfulness-based therapy in the treatment of functional gastrointestinal disorders. Study quality was evaluated using the Cochrane risk of bias. Effect sizes were calculated and pooled to achieve a summary effect for the intervention on symptom severity and quality of life. Results. Of 119 records, eight articles, describing seven studies, met inclusion criteria. In six studies, significant improvements were achieved or maintained at the end of intervention or follow-up time points. The studies had an unclear or high risk of bias. Pooled effects were statistically significant for IBS severity (0.59, 95% CI 0.33 to 0.86) and quality of life (0.56, 95% CI 0.47 to 0.79). Conclusion. Studies suggest that mindfulness based interventions may provide benefit in functional gastrointestinal disorders; however, substantial improvements in methodological quality and reporting are needed. PMID:25295066

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

The quality case for information technology in healthcare

PubMed Central

Bates, David W

2002-01-01

Background As described in the Institute of Medicine's Crossing the Quality Chasm report, the quality of health care in the U.S. today leaves much to be desired. Discussion One major opportunity for improving quality relates to increasing the use of information technology, or IT. Health care organizations currently invest less in IT than in any other information-intensive industry, and not surprisingly current systems are relatively primitive, compared with industries such as banking or aviation. Nonetheless, a number of organizations have demonstrated that quality can be substantially improved in a variety of ways if IT use is increased in ways that improve care. Specifically, computerization of processes that are error-prone and computerized decision support may substantially improve both efficiency and quality, as well as dramatically facilitate quality measurement. This report discusses the current levels of IT and quality in health care, how quality improvement and management are currently done, the evidence that more IT might be helpful, a vision of the future, and the barriers to getting there. Summary This report suggests that there are five key policy domains that need to be addressed: standards, incentives, security and confidentiality, professional involvement, and research, with financial incentives representing the single most important lever. PMID:12396233

30 CFR 700.5 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... substantial physical harm to persons, property, or the environment and to which persons or improvements on... substantially the quality of the environment, prevent or damage the beneficial use of land or water resources.... Reclamation activity means the reclamation, abatement, control, or prevention of adverse effects of past...

30 CFR 700.5 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... substantial physical harm to persons, property, or the environment and to which persons or improvements on... substantially the quality of the environment, prevent or damage the beneficial use of land or water resources.... Reclamation activity means the reclamation, abatement, control, or prevention of adverse effects of past...

RAINBOW LAKE WILDERNESS AND FLYNN LAKE WILDERNESS STUDY AREA, WISCONSIN.

USGS Publications Warehouse

Cannon, W.F.; Dunn, Maynard L.

1984-01-01

The Rainbow Lake Wilderness and Flynn Lake Wilderness study area in Wisconsin are contiguous and were studied as a unit. The rainbow Lake Wilderness contains a demonstrated resource of about 210,000 tons of commercial-quality peat in an area of substantiated peat resource potential. The Flynn Lake Wilderness study area contains a demonstrated resource of about 300,000 tons of commercial-quality peat in an area of substantiated peat resource potential. These deposits, however, are of limited importance because larger deposits of similar material are abundant outside the areas, closer to present markets. Rocks in the subsurface contain a low-grade copper resource identified by mining company exploration drilling. Although this is an area of substantiated copper resource potential, it is a low-grade resource, thin and generally at great depth.

Economic return from the Women's Health Initiative estrogen plus progestin clinical trial: a modeling study.

PubMed

Roth, Joshua A; Etzioni, Ruth; Waters, Teresa M; Pettinger, Mary; Rossouw, Jacques E; Anderson, Garnet L; Chlebowski, Rowan T; Manson, Joann E; Hlatky, Mark; Johnson, Karen C; Ramsey, Scott D

2014-05-06

The findings of the Women's Health Initiative (WHI) estrogen plus progestin (E+P) trial led to a substantial reduction in use of combined hormone therapy (cHT) among postmenopausal women in the United States. The economic effect of this shift has not been evaluated relative to the trial's $260 million cost (2012 U.S. dollars). To estimate the economic return from the WHI E+P trial. Decision model to simulate health outcomes for a "WHI scenario" with observed cHT use and a "no-WHI scenario" with cHT use extrapolated from the pretrial period. Primary analyses of WHI outcomes, peer-reviewed literature, and government sources. Postmenopausal women in the United States, aged 50 to 79 years, who did not have a hysterectomy. 2003 to 2012. Payer. Combined hormone therapy. Disease incidence, expenditure, quality-adjusted life-years, and net economic return. The WHI scenario resulted in 4.3 million fewer cHT users, 126,000 fewer breast cancer cases, 76,000 fewer cardiovascular disease cases, 263,000 more fractures, 145,000 more quality-adjusted life-years, and expenditure savings of $35.2 billion. The corresponding net economic return of the trial was $37.1 billion ($140 per dollar invested in the trial) at a willingness-to-pay level of $100,000 per quality-adjusted life-year. The 95% CI for the net economic return of the trial was $23.1 to $51.2 billion. No evaluation of indirect costs or outcomes beyond 2012. The WHI E+P trial made high-value use of public funds with a substantial return on investment. These results can contribute to discussions about the role of public funding for large, prospective trials with high potential for public health effects. National Heart, Lung, and Blood Institute.

Substance Abuse Intensive Outpatient Programs: Assessing the Evidence

PubMed Central

McCarty, Dennis; Braude, Lisa; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Delphin-Rittmon, Miriam E.

2014-01-01

Objective Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This article assesses their evidence base. Methods Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. They identified 12 individual studies and one review published between 1995 and 2012. They chose from three levels of research evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results Based on the quality of trials, diversity of settings, and consistency of outcomes, the level of evidence for IOP research was considered high. Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up. However, substantial variability in the operationalization of IOPs and outcome measures was apparent. Conclusions IOPs are an important part of the continuum of care for alcohol and drug use disorders. They are as effective as inpatient treatment for most individuals seeking care. Public and commercial health plans should consider IOP treatment as a covered health benefit. Standardization of the elements included in IOPs may improve their quality and effectiveness. PMID:24445620

Half-Fan-Based Intensity-Weighted Region-of-Interest Imaging for Low-Dose Cone-Beam CT in Image-Guided Radiation Therapy.

PubMed

Yoo, Boyeol; Son, Kihong; Pua, Rizza; Kim, Jinsung; Solodov, Alexander; Cho, Seungryong

2016-10-01

With the increased use of computed tomography (CT) in clinics, dose reduction is the most important feature people seek when considering new CT techniques or applications. We developed an intensity-weighted region-of-interest (IWROI) imaging method in an exact half-fan geometry to reduce the imaging radiation dose to patients in cone-beam CT (CBCT) for image-guided radiation therapy (IGRT). While dose reduction is highly desirable, preserving the high-quality images of the ROI is also important for target localization in IGRT. An intensity-weighting (IW) filter made of copper was mounted in place of a bowtie filter on the X-ray tube unit of an on-board imager (OBI) system such that the filter can substantially reduce radiation exposure to the outer ROI. In addition to mounting the IW filter, the lead-blade collimation of the OBI was adjusted to produce an exact half-fan scanning geometry for a further reduction of the radiation dose. The chord-based rebinned backprojection-filtration (BPF) algorithm in circular CBCT was implemented for image reconstruction, and a humanoid pelvis phantom was used for the IWROI imaging experiment. The IWROI image of the phantom was successfully reconstructed after beam-quality correction, and it was registered to the reference image within an acceptable level of tolerance. Dosimetric measurements revealed that the dose is reduced by approximately 61% in the inner ROI and by 73% in the outer ROI compared to the conventional bowtie filter-based half-fan scan. The IWROI method substantially reduces the imaging radiation dose and provides reconstructed images with an acceptable level of quality for patient setup and target localization. The proposed half-fan-based IWROI imaging technique can add a valuable option to CBCT in IGRT applications.

Learning a Health Knowledge Graph from Electronic Medical Records.

PubMed

Rotmensch, Maya; Halpern, Yoni; Tlimat, Abdulhakim; Horng, Steven; Sontag, David

2017-07-20

Demand for clinical decision support systems in medicine and self-diagnostic symptom checkers has substantially increased in recent years. Existing platforms rely on knowledge bases manually compiled through a labor-intensive process or automatically derived using simple pairwise statistics. This study explored an automated process to learn high quality knowledge bases linking diseases and symptoms directly from electronic medical records. Medical concepts were extracted from 273,174 de-identified patient records and maximum likelihood estimation of three probabilistic models was used to automatically construct knowledge graphs: logistic regression, naive Bayes classifier and a Bayesian network using noisy OR gates. A graph of disease-symptom relationships was elicited from the learned parameters and the constructed knowledge graphs were evaluated and validated, with permission, against Google's manually-constructed knowledge graph and against expert physician opinions. Our study shows that direct and automated construction of high quality health knowledge graphs from medical records using rudimentary concept extraction is feasible. The noisy OR model produces a high quality knowledge graph reaching precision of 0.85 for a recall of 0.6 in the clinical evaluation. Noisy OR significantly outperforms all tested models across evaluation frameworks (p < 0.01).

Identify High-Quality Protein Structural Models by Enhanced K-Means.

PubMed

Wu, Hongjie; Li, Haiou; Jiang, Min; Chen, Cheng; Lv, Qiang; Wu, Chuang

2017-01-01

Background. One critical issue in protein three-dimensional structure prediction using either ab initio or comparative modeling involves identification of high-quality protein structural models from generated decoys. Currently, clustering algorithms are widely used to identify near-native models; however, their performance is dependent upon different conformational decoys, and, for some algorithms, the accuracy declines when the decoy population increases. Results. Here, we proposed two enhanced K -means clustering algorithms capable of robustly identifying high-quality protein structural models. The first one employs the clustering algorithm SPICKER to determine the initial centroids for basic K -means clustering ( SK -means), whereas the other employs squared distance to optimize the initial centroids ( K -means++). Our results showed that SK -means and K -means++ were more robust as compared with SPICKER alone, detecting 33 (59%) and 42 (75%) of 56 targets, respectively, with template modeling scores better than or equal to those of SPICKER. Conclusions. We observed that the classic K -means algorithm showed a similar performance to that of SPICKER, which is a widely used algorithm for protein-structure identification. Both SK -means and K -means++ demonstrated substantial improvements relative to results from SPICKER and classical K -means.

Identify High-Quality Protein Structural Models by Enhanced K-Means

PubMed Central

Li, Haiou; Chen, Cheng; Lv, Qiang; Wu, Chuang

2017-01-01

Background. One critical issue in protein three-dimensional structure prediction using either ab initio or comparative modeling involves identification of high-quality protein structural models from generated decoys. Currently, clustering algorithms are widely used to identify near-native models; however, their performance is dependent upon different conformational decoys, and, for some algorithms, the accuracy declines when the decoy population increases. Results. Here, we proposed two enhanced K-means clustering algorithms capable of robustly identifying high-quality protein structural models. The first one employs the clustering algorithm SPICKER to determine the initial centroids for basic K-means clustering (SK-means), whereas the other employs squared distance to optimize the initial centroids (K-means++). Our results showed that SK-means and K-means++ were more robust as compared with SPICKER alone, detecting 33 (59%) and 42 (75%) of 56 targets, respectively, with template modeling scores better than or equal to those of SPICKER. Conclusions. We observed that the classic K-means algorithm showed a similar performance to that of SPICKER, which is a widely used algorithm for protein-structure identification. Both SK-means and K-means++ demonstrated substantial improvements relative to results from SPICKER and classical K-means. PMID:28421198

Low-Energy Electronic Properties of Clean CaRuO3: Elusive Landau Quasiparticles

NASA Astrophysics Data System (ADS)

Schneider, M.; Geiger, D.; Esser, S.; Pracht, U. S.; Stingl, C.; Tokiwa, Y.; Moshnyaga, V.; Sheikin, I.; Mravlje, J.; Scheffler, M.; Gegenwart, P.

2014-05-01

We have prepared high-quality epitaxial thin films of CaRuO3 with residual resistivity ratios up to 55. Shubnikov-de Haas oscillations in the magnetoresistance and a T2 temperature dependence in the electrical resistivity only below 1.5 K, the coefficient of which is substantially suppressed in large magnetic fields, establish CaRuO3 as a Fermi liquid (FL) with an anomalously low coherence scale. At T >1.5 K non-Fermi-liquid (NFL) behavior is found in the electrical resistivity. The high sample quality allows access to the intrinsic electronic properties via THz spectroscopy. For frequencies below 0.6 THz, the conductivity is Drude-like and can be modeled by FL concepts; for higher frequencies, non-Drude behavior is found, which is inconsistent with FL predictions. This establishes CaRuO3 as a prime example of optical NFL behavior in the THz range.

An Overview of Hardware for Protein Crystallization in a Magnetic Field.

PubMed

Yan, Er-Kai; Zhang, Chen-Yan; He, Jin; Yin, Da-Chuan

2016-11-16

Protein crystallization under a magnetic field is an interesting research topic because a magnetic field may provide a special environment to acquire improved quality protein crystals. Because high-quality protein crystals are very useful in high-resolution structure determination using diffraction techniques (X-ray, neutron, and electron diffraction), research using magnetic fields in protein crystallization has attracted substantial interest; some studies have been performed in the past two decades. In this research field, the hardware is especially essential for successful studies because the environment is special and the design and utilization of the research apparatus in such an environment requires special considerations related to the magnetic field. This paper reviews the hardware for protein crystallization (including the magnet systems and the apparatus designed for use in a magnetic field) and progress in this area. Future prospects in this field will also be discussed.

Time--temperature indicator for perishable products based on kinetically programmable Ag overgrowth on Au nanorods.

PubMed

Zhang, Chao; Yin, An-Xiang; Jiang, Ruibin; Rong, Jie; Dong, Lu; Zhao, Tian; Sun, Ling-Dong; Wang, Jianfang; Chen, Xing; Yan, Chun-Hua

2013-05-28

Food safety is a constant concern for humans. Besides adulteration and contamination, another major threat comes from the spontaneous spoilage of perishable products, which is basically inevitable and highly dependent on the temperature history during the custody chain. For advanced quality control and assessment, time-temperature indicators (TTIs) can be deployed to document the temperature history. However, the use of TTIs is currently limited by either relatively high cost or poor programmability. Here we describe a general, kinetically programmable, and cost-efficient TTI protocol constructed from plasmonic nanocrystals. We present proof-of-principle demonstrations that our TTI can be specifically tailored and thus used to track perishables, dynamically mimic the deteriorative processes therein, and indicate product quality through sharp-contrast multicolor changes. The flexible programmability of our TTI, combined with its substantially low cost and low toxicity, promises a general applicability to each single packaged item of a plethora of perishable products.

An Overview of Hardware for Protein Crystallization in a Magnetic Field

PubMed Central

Yan, Er-Kai; Zhang, Chen-Yan; He, Jin; Yin, Da-Chuan

2016-01-01

Protein crystallization under a magnetic field is an interesting research topic because a magnetic field may provide a special environment to acquire improved quality protein crystals. Because high-quality protein crystals are very useful in high-resolution structure determination using diffraction techniques (X-ray, neutron, and electron diffraction), research using magnetic fields in protein crystallization has attracted substantial interest; some studies have been performed in the past two decades. In this research field, the hardware is especially essential for successful studies because the environment is special and the design and utilization of the research apparatus in such an environment requires special considerations related to the magnetic field. This paper reviews the hardware for protein crystallization (including the magnet systems and the apparatus designed for use in a magnetic field) and progress in this area. Future prospects in this field will also be discussed. PMID:27854318

Funding of Graduate Medical Education in a Market-Based Healthcare System.

PubMed

Schuster, Barbara L

2017-02-01

The graduate medical education (GME) process in the United States is considered the most respected model for high-quality education of graduate physicians in the world. With substantial funding through government and private insurers and through structured educational accreditation standards, the American Board of Medical Specialists-certified physicians are recognized for their expertise in delivering high-quality medical care. However, under fiscal constraints and changing social expectations, questions are continually posed about the process of funding and whether the "physician outcomes" are sufficient to continue with the investment. This article reviews the history of postgraduate physician education, the multiple funding pathways, disruptions to a placid educational system and changing social expectations. The ultimate issues involve the core goals of GME and how much GME should shoulder responsibility for changing the healthcare system. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Efficient expulsion of magnetic flux in superconducting radiofrequency cavities for high Q 0 applications

DOE PAGES

Posen, S.; Checchin, M.; Crawford, A. C.; ...

2016-06-03

Even when cooled through its transition temperature in the presence of an external magnetic field, a superconductor can expel nearly all external magnetic flux. This Letter presents an experimental study to identify the parameters that most strongly influence flux trapping in high purity niobium during cooldown. This is critical to the operation of superconducting radiofrequency cavities, in which trapped flux degrades the quality factor and therefore cryogenic efficiency. Flux expulsion was measured on a large survey of 1.3 GHz cavities prepared in various ways. It is shown that both spatial thermal gradient and high temperature treatment are critical to expellingmore » external magnetic fields, while surface treatment has minimal effect. For the first time, it is shown that a cavity can be converted from poor expulsion behavior to strong expulsion behavior after furnace treatment, resulting in a substantial improvement in quality factor. In conclusion, future plans are described to build on this result in order to optimize treatment for future cavities.« less

Coping with Quality Assurance Challenges Faced by Secondary Schools' Headteachers in Gucha District, Kenya

ERIC Educational Resources Information Center

Mobegi, Florence Osiri; Ondigi, Benjamin A.

2011-01-01

Since independence, the Kenyan government has demonstrated its commitment to the provision of quality secondary school education through allocation of financial resources, provision of trained teachers and establishment of quality assurance department. However, despite the substantial allocation of resources, secondary schools still face major…

Trees and Streets as Drivers of Urban Stormwater Nutrient Pollution.

PubMed

Janke, Benjamin D; Finlay, Jacques C; Hobbie, Sarah E

2017-09-05

Expansion of tree cover is a major management goal in cities because of the substantial benefits provided to people, and potentially to water quality through reduction of stormwater volume by interception. However, few studies have addressed the full range of potential impacts of trees on urban runoff, which includes deposition of nutrient-rich leaf litter onto streets connected to storm drains. We analyzed the influence of trees on stormwater nitrogen and phosphorus export across 19 urban watersheds in Minneapolis-St. Paul, MN, U.S.A., and at the scale of individual streets within one residential watershed. Stormwater nutrient concentrations were highly variable across watersheds and strongly related to tree canopy over streets, especially for phosphorus. Stormwater nutrient loads were primarily related to road density, the dominant control over runoff volume. Street canopy exerted opposing effects on loading, where elevated nutrient concentrations from trees near roads outweighed the weak influence of trees on runoff reduction. These results demonstrate that vegetation near streets contributes substantially to stormwater nutrient pollution, and therefore to eutrophication of urban surface waters. Urban landscape design and management that account for trees as nutrient pollution sources could improve water quality outcomes, while allowing cities to enjoy the myriad benefits of urban forests.

Characterising Event-Based DOM Inputs to an Urban Watershed

NASA Astrophysics Data System (ADS)

Croghan, D.; Bradley, C.; Hannah, D. M.; Van Loon, A.; Sadler, J. P.

2017-12-01

Dissolved Organic Matter (DOM) composition in urban streams is dominated by terrestrial inputs after rainfall events. Urban streams have particularly strong terrestrial-riverine connections due to direct input from terrestrial drainage systems. Event driven DOM inputs can have substantial adverse effects on water quality. Despite this, DOM from important catchment sources such as road drains and Combined Sewage Overflows (CSO's) remains poorly characterised within urban watersheds. We studied DOM sources within an urbanised, headwater watershed in Birmingham, UK. Samples from terrestrial sources (roads, roofs and a CSO), were collected manually after the onset of rainfall events of varying magnitude, and again within 24-hrs of the event ending. Terrestrial samples were analysed for fluorescence, absorbance and Dissolved Organic Carbon (DOC) concentration. Fluorescence and absorbance indices were calculated, and Parallel Factor Analysis (PARAFAC) was undertaken to aid sample characterization. Substantial differences in fluorescence, absorbance, and DOC were observed between source types. PARAFAC-derived components linked to organic pollutants were generally highest within road derived samples, whilst humic-like components tended to be highest within roof samples. Samples taken from the CSO generally contained low fluorescence, however this likely represents a dilution effect. Variation within source groups was particularly high, and local land use seemed to be the driving factor for road and roof drain DOM character and DOC quantity. Furthermore, high variation in fluorescence, absorbance and DOC was apparent between all sources depending on event type. Drier antecedent conditions in particular were linked to greater presence of terrestrially-derived components and higher DOC content. Our study indicates that high variations in DOM character occur between source types, and over small spatial scales. Road drains located on main roads appear to contain the poorest quality DOM of the sources studied due to the presence of hydrocarbons. In order to prevent storm-derived DOM degradation of water quality of urban streams, greater knowledge of links between these drainage sources, and their pathways to streams is required.

Understanding the Mechanisms Through Which an Influential Early Childhood Program Boosted Adult Outcomes

PubMed Central

Heckman, James; Pinto, Rodrigo

2013-01-01

A growing literature establishes that high quality early childhood interventions targeted toward disadvantaged children have substantial impacts on later life outcomes. Little is known about the mechanisms producing these impacts. This paper uses longitudinal data on cognitive and personality traits from an experimental evaluation of the influential Perry Preschool program to analyze the channels through which the program boosted both male and female participant outcomes. Experimentally induced changes in personality traits explain a sizable portion of adult treatment effects. PMID:24634518

A Comprehensive Approach to Phonon Control for Enhanced Device Performance

DTIC Science & Technology

2006-07-12

substantially on parameters of the transit space . 300 kV/cm (drift region) but also specifically on the AC com- >, k\\/cm ponent of the tunnel emission... reseracher to grow well-controlled and high quality -, N2/Ar: V 35x 10 (old) multilayers and heterostructures, resulting in record electron . V 3 x 109...reflected from the sample, back through the viewport, and into a CCD camera. Monitoring fractional changes in the spacing between these re- flected spots

The Atlanta Urban Heat Island Mitigation and Air Quality Modeling Project: How High-Resoution Remote Sensing Data Can Improve Air Quality Models

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.; Estes, Maurice G., Jr.; Crosson, William L.; Khan, Maudood N.

2006-01-01

The Atlanta Urban Heat Island and Air Quality Project had its genesis in Project ATLANTA (ATlanta Land use Analysis: Temperature and Air quality) that began in 1996. Project ATLANTA examined how high-spatial resolution thermal remote sensing data could be used to derive better measurements of the Urban Heat Island effect over Atlanta. We have explored how these thermal remote sensing, as well as other imaged datasets, can be used to better characterize the urban landscape for improved air quality modeling over the Atlanta area. For the air quality modeling project, the National Land Cover Dataset and the local scale Landpro99 dataset at 30m spatial resolutions have been used to derive land use/land cover characteristics for input into the MM5 mesoscale meteorological model that is one of the foundations for the Community Multiscale Air Quality (CMAQ) model to assess how these data can improve output from CMAQ. Additionally, land use changes to 2030 have been predicted using a Spatial Growth Model (SGM). SGM simulates growth around a region using population, employment and travel demand forecasts. Air quality modeling simulations were conducted using both current and future land cover. Meteorological modeling simulations indicate a 0.5 C increase in daily maximum air temperatures by 2030. Air quality modeling simulations show substantial differences in relative contributions of individual atmospheric pollutant constituents as a result of land cover change. Enhanced boundary layer mixing over the city tends to offset the increase in ozone concentration expected due to higher surface temperatures as a result of urbanization.

Compacted graphite iron: Cast iron makes a comeback

NASA Astrophysics Data System (ADS)

Dawson, S.

1994-08-01

Although compacted graphite iron has been known for more than four decades, the absence of a reliable mass-production technique has resulted in relatively little effort to exploit its operational benefits. However, a proven on-line process control technology developed by SinterCast allows for series production of complex components in high-quality CGI. The improved mechanical properties of compacted graphite iron relative to conventional gray iron allow for substantial weight reduction in gasoline and diesel engines or substantial increases in horsepower, or an optimal combination of both. Concurrent with these primary benefits, CGI also provides significant emissions and fuel efficiency benefits allowing automakers to meet legislated performance standards. The operational and environmental benefits of compacted graphite iron together with its low cost and recyclability reinforce cast iron as a prime engineering material for the future.

IgE-mediated food allergy in children.

PubMed

Longo, Giorgio; Berti, Irene; Burks, A Wesley; Krauss, Baruch; Barbi, Egidio

2013-11-16

Food allergy is a serious health issue affecting roughly 4% of children, with a substantial effect on quality of life. Prognosis is good for the most frequent allergens with almost all children outgrowing their allergy. However, the long-term implications for disease burden are substantial for children with persistent allergies (eg, peanuts, tree nuts, fish, and shellfish) and for those with high concentrations of milk, egg, and wheat IgE. Antigen avoidance has been the time-honoured approach both for prevention and treatment. However, findings from studies done in the past 5 years show that early contact with food can induce tolerance and desensitisation to foods. We review the epidemiology, natural history, and management of food allergy, and discuss the areas of controversy and future directions in research and clinical practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Objectives and limits of test standards].

PubMed

Kaddick, C; Blömer, W

2014-06-01

Test standards are developed worldwide by extremely committed expert groups working mostly in an honorary capacity and have substantially contributed to the currently achieved safety standards in reconstructive orthopedics. Independent of the distribution and quality of a test specification, the specialist knowledge of the user cannot replace a well founded risk analysis and if used unthinkingly can lead to a false estimation of safety. The limits of standardization are reached where new indications or highly innovative products are concerned. In this case the manufacturer must undertake the time and cost-intensive route of a self-developed testing procedure which in the ideal case leads to a further testing standard. Test standards make a substantial contribution to implant safety but cannot replace the expert knowledge of the user. Tests as an end to themselves take the actual objectives of standardization to absurdity.

Interpretation of fingerprint image quality features extracted by self-organizing maps

NASA Astrophysics Data System (ADS)

Danov, Ivan; Olsen, Martin A.; Busch, Christoph

2014-05-01

Accurate prediction of fingerprint quality is of significant importance to any fingerprint-based biometric system. Ensuring high quality samples for both probe and reference can substantially improve the system's performance by lowering false non-matches, thus allowing finer adjustment of the decision threshold of the biometric system. Furthermore, the increasing usage of biometrics in mobile contexts demands development of lightweight methods for operational environment. A novel two-tier computationally efficient approach was recently proposed based on modelling block-wise fingerprint image data using Self-Organizing Map (SOM) to extract specific ridge pattern features, which are then used as an input to a Random Forests (RF) classifier trained to predict the quality score of a propagated sample. This paper conducts an investigative comparative analysis on a publicly available dataset for the improvement of the two-tier approach by proposing additionally three feature interpretation methods, based respectively on SOM, Generative Topographic Mapping and RF. The analysis shows that two of the proposed methods produce promising results on the given dataset.

Elucidating the Key Role of a Lewis Base Solvent in the Formation of Perovskite Films Fabricated from the Lewis Adduct Approach.

PubMed

Cao, Xiaobing; Zhi, Lili; Li, Yahui; Fang, Fei; Cui, Xian; Yao, Youwei; Ci, Lijie; Ding, Kongxian; Wei, Jinquan

2017-09-27

High-quality perovskite films can be fabricated from Lewis acid-base adducts through molecule exchange. Substantial work is needed to fully understand the formation mechanism of the perovskite films, which helps to further improve their quality. Here, we study the formation of CH 3 NH 3 PbI 3 perovskite films by introducing some dimethylacetamide into the PbI 2 /N,N-dimethylformamide solution. We reveal that there are three key processes during the formation of perovskite films through the Lewis acid-base adduct approach: molecule intercalation of solvent into the PbI 2 lattice, molecule exchange between the solvent and CH 3 NH 3 I, and dissolution-recrystallization of the perovskite grains during annealing. The Lewis base solvents play multiple functions in the above processes. The properties of the solvent, including Lewis basicity and boiling point, play key roles in forming smooth perovskite films with large grains. We also provide some rules for choosing Lewis base additives to prepare high-quality perovskite films through the Lewis adduct approach.

Measuring the quality of melanoma surgery - Highlighting issues with standardization and quality assurance of care in surgical oncology.

PubMed

Pasquali, S; Sommariva, A; Spillane, A J; Bilimoria, K Y; Rossi, C R

2017-03-01

In an attempt to ensure high standards of cancer care, there is increasing interest in determining and monitoring the quality of interventions in surgical oncology. In recent years, this has been particularly the case for melanoma surgery. The vast majority of patients with melanoma undergo surgery. Usually, this is with combinations of wide excision, sentinel lymph node biopsy and lymphadenectomy. The indications for these procedures evolved during a time when no effective systemic adjuvant therapy was available, and whilst the rationale has been sound, the justification for differences in extent and thoroughness has generally been supported by inadequate or low-level evidence. This has led to a substantial variation among melanoma centres or even among surgeons within a centre in how these procedures are done. With recent rapid progress in the efficacy of systemic treatments that are impacting on overall survival, the prospect of long-term survival in these previously high risk patients means that more than ever long-term locoregional control of melanoma is imperative. Furthermore, the understanding of effects of systemic therapy on locoregional disease will only be interpretable if surgeons use standardized, high quality techniques. This article focuses on standardization and evolution of quality indicators for melanoma surgery and how these might have a positive impact on patient care. Copyright © 2016 Elsevier Ltd, BASO ~ the Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Gaze-Aware Streaming Solutions for the Next Generation of Mobile VR Experiences.

PubMed

Lungaro, Pietro; Sjoberg, Rickard; Valero, Alfredo Jose Fanghella; Mittal, Ashutosh; Tollmar, Konrad

2018-04-01

This paper presents a novel approach to content delivery for video streaming services. It exploits information from connected eye-trackers embedded in the next generation of VR Head Mounted Displays (HMDs). The proposed solution aims to deliver high visual quality, in real time, around the users' fixations points while lowering the quality everywhere else. The goal of the proposed approach is to substantially reduce the overall bandwidth requirements for supporting VR video experiences while delivering high levels of user perceived quality. The prerequisites to achieve these results are: (1) mechanisms that can cope with different degrees of latency in the system and (2) solutions that support fast adaptation of video quality in different parts of a frame, without requiring a large increase in bitrate. A novel codec configuration, capable of supporting near-instantaneous video quality adaptation in specific portions of a video frame, is presented. The proposed method exploits in-built properties of HEVC encoders and while it introduces a moderate amount of error, these errors are indetectable by users. Fast adaptation is the key to enable gaze-aware streaming and its reduction in bandwidth. A testbed implementing gaze-aware streaming, together with a prototype HMD with in-built eye tracker, is presented and was used for testing with real users. The studies quantified the bandwidth savings achievable by the proposed approach and characterize the relationships between Quality of Experience (QoE) and network latency. The results showed that up to 83% less bandwidth is required to deliver high QoE levels to the users, as compared to conventional solutions.

Vacuum cooling of meat products: current state-of-the-art research advances.

PubMed

Feng, Chaohui; Drummond, Liana; Zhang, Zhihang; Sun, Da-Wen; Wang, Qijun

2012-01-01

Vacuum cooling (VC) is commonly applied for cooling of several foodstuffs, to provide exceptionally rapid cooling rates with low energy consumption and resulting in high-quality food products. However, for products such as meat and cooked meat products, the higher cooling loss of vacuum cooling compared with established methods still means lower yields, and important meat quality parameters can be negatively affected. Substantial efforts during the past ten years have aimed to improve the technology in order to offer the meat industry, especially the cooked meat industry, optimized production in terms of safety regulations and guidelines, as well as meat quality. This review presents and discusses recent VC developments directed to the cooked meat industry. The principles of VC, and the basis for improvements of this technology, are firstly discussed; future prospects for research and development in this area are later explored, particularly in relation to cooling of cooked meat and meat products.

The role of precipitation type, intensity, and spatial distribution in source water quality after wildfire

NASA Astrophysics Data System (ADS)

Murphy, Sheila F.; Writer, Jeffrey H.; Blaine McCleskey, R.; Martin, Deborah A.

2015-08-01

Storms following wildfires are known to impair drinking water supplies in the southwestern United States, yet our understanding of the role of precipitation in post-wildfire water quality is far from complete. We quantitatively assessed water-quality impacts of different hydrologic events in the Colorado Front Range and found that for a three-year period, substantial hydrologic and geochemical responses downstream of a burned area were primarily driven by convective storms with a 30 min rainfall intensity >10 mm h-1. These storms, which typically occur several times each year in July-September, are often small in area, short-lived, and highly variable in intensity and geographic distribution. Thus, a rain gage network with high temporal resolution and spatial density, together with high-resolution stream sampling, are required to adequately characterize post-wildfire responses. We measured total suspended sediment, dissolved organic carbon (DOC), nitrate, and manganese concentrations that were 10-156 times higher downstream of a burned area compared to upstream during relatively common (50% annual exceedance probability) rainstorms, and water quality was sufficiently impaired to pose water-treatment concerns. Short-term water-quality impairment was driven primarily by increased surface runoff during higher intensity convective storms that caused erosion in the burned area and transport of sediment and chemical constituents to streams. Annual sediment yields downstream of the burned area were controlled by storm events and subsequent remobilization, whereas DOC yields were closely linked to annual runoff and thus were more dependent on interannual variation in spring runoff. Nitrate yields were highest in the third year post-wildfire. Results from this study quantitatively demonstrate that water quality can be altered for several years after wildfire. Because the southwestern US is prone to wildfires and high-intensity rain storms, the role of storms in post-wildfire water-quality impacts must be considered when assessing water-quality vulnerability.

The role of precipitation type, intensity, and spatial distribution in source water quality after wildfire

USGS Publications Warehouse

Murphy, Sheila F.; Writer, Jeffrey H.; McCleskey, R. Blaine; Martin, Deborah A.

2015-01-01

Storms following wildfires are known to impair drinking water supplies in the southwestern United States, yet our understanding of the role of precipitation in post-wildfire water quality is far from complete. We quantitatively assessed water-quality impacts of different hydrologic events in the Colorado Front Range and found that for a three-year period, substantial hydrologic and geochemical responses downstream of a burned area were primarily driven by convective storms with a 30 min rainfall intensity >10 mm h−1. These storms, which typically occur several times each year in July–September, are often small in area, short-lived, and highly variable in intensity and geographic distribution. Thus, a rain gage network with high temporal resolution and spatial density, together with high-resolution stream sampling, are required to adequately characterize post-wildfire responses. We measured total suspended sediment, dissolved organic carbon (DOC), nitrate, and manganese concentrations that were 10–156 times higher downstream of a burned area compared to upstream during relatively common (50% annual exceedance probability) rainstorms, and water quality was sufficiently impaired to pose water-treatment concerns. Short-term water-quality impairment was driven primarily by increased surface runoff during higher intensity convective storms that caused erosion in the burned area and transport of sediment and chemical constituents to streams. Annual sediment yields downstream of the burned area were controlled by storm events and subsequent remobilization, whereas DOC yields were closely linked to annual runoff and thus were more dependent on interannual variation in spring runoff. Nitrate yields were highest in the third year post-wildfire. Results from this study quantitatively demonstrate that water quality can be altered for several years after wildfire. Because the southwestern US is prone to wildfires and high-intensity rain storms, the role of storms in post-wildfire water-quality impacts must be considered when assessing water-quality vulnerability.

Quantitative properties of clustering within modern microscopic nuclear models

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

Volya, A.; Tchuvil’sky, Yu. M., E-mail: tchuvl@nucl-th.sinp.msu.ru

2016-09-15

A method for studying cluster spectroscopic properties of nuclear fragmentation, such as spectroscopic amplitudes, cluster form factors, and spectroscopic factors, is developed on the basis of modern precision nuclear models that take into account the mixing of large-scale shell-model configurations. Alpha-cluster channels are considered as an example. A mathematical proof of the need for taking into account the channel-wave-function renormalization generated by exchange terms of the antisymmetrization operator (Fliessbach effect) is given. Examples where this effect is confirmed by a high quality of the description of experimental data are presented. By and large, the method in question extends substantially themore » possibilities for studying clustering phenomena in nuclei and for improving the quality of their description.« less

Does substantiated childhood maltreatment lead to poor quality of life in young adulthood? Evidence from an Australian birth cohort study.

PubMed

Abajobir, Amanuel Alemu; Kisely, Steve; Williams, Gail; Strathearn, Lane; Clavarino, Alexandra; Najman, Jake Moses

2017-07-01

To examine the independent effect of single and multiple forms of substantiated childhood maltreatment (CM) on quality of life (QoL), controlling for selected potential confounders and/or covariates, and concurrent depressive symptoms. We used data from a prospective pre-birth cohort of 8556 mothers recruited consecutively during their first antenatal clinic visit at the Mater Hospital from 1981 to 1983 in Brisbane, Australia. The data were linked to substantiated cases of CM reported to the child protection government agency up to the age of 14 years. The sample consisted of 3730 (49.7% female) young adults for whom there were complete data on QoL at the 21-year follow-up. The mean age of participants was 20.6 years. Logistic regression models were used to assess the association between CM and QoL measured at the 21-year follow-up. There were statistically significant associations between exposure to substantiated CM and poorer QoL. This also applied to the subcategories of childhood physical abuse, childhood emotional abuse (CEA), and neglect. These associations were generally stable after adjusting for confounders/covariates and concurrent depressive symptoms, except physical abuse. CEA with or without neglect significantly and particularly predicted worse subsequent QoL. Exposure to any substantiated maltreatment substantially contributed to worse QoL in young adulthood, with a particular association with CEA and neglect. Prior experiences of CM may have a substantial association with subsequent poorer QoL.

Assessing Quality of Life in Older Adult Patients with Skin Disorders

PubMed Central

Farage, Miranda A.; Miller, Kenneth W.; Sherman, Susan N.; Tsevat, Joel

2012-01-01

Significance for Public Health The global population is aging. In the industrial world, adults over 65 outnumber children and comprise almost 20% of the population in some countries. Older adults experience a number of skin diseases and disorders that substantially affect their quality of life. Opportunity exists for developing and validating health-related quality of life (HRQoL) measures specifically for dermatological conditions most pertinent to older patients. Older adults experience a number of skin diseases and disorders that substantially affect quality of life. In the last two decades, a number of instruments have been developed for use among general dermatology patients to assess the effects of treatment and disease progression, perceptions of well-being, and the value that patients place on their dermatologic state of health. This chapter reviews some health-related quality of life (HRQoL) (HRQoL) measures developed and validated specifically for dermatological conditions. However, opportunity exists for developing and validating HRQoL measures specifically for dermatological conditions most pertinent to older patients. PMID:22980159

A flood tide of systematic reviews on endodontic posts: methodological assessment using of R-AMSTAR.

PubMed

Schmitter, M; Sterzenbach, G; Faggion, C M; Krastl, G

2013-06-01

To help the dental practitioner solve a specific clinical problem, systematic reviews (SRs) are seen as the best guide. In addition to the unmanageable quantity of SRs, however, one should be aware of their variable quality. The present review describes the methodological quality of SRs on postendodontic restorations to work out the value of these reviews for the dental practitioner. SRs were searched in April 2012, independently and in triplicate. Post survival was used as measure of outcome. The methodological quality of included SRs was assessed with the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Kappa statistics were used to assess reviewer agreement. Three hundred sixty-three papers were retrieved from the initial search. Ten SRs were included. One SR achieved a high R-AMSTAR score, whereas the other nine SRs achieved scores that indicate a substantial lack of methodological quality. Especially the items "grey literature," "combination of findings," "likelihood of publication bias," and conflict of interest" showed low R-AMSTAR scores. The three reviews with the highest R-AMSTAR scores tended to conclude that fewer failures occurred when using nonmetal posts. The reviewer agreement was excellent (kappa ranged from 0.79 to 0.85) in the R-AMSTAR classification. The approach presented revealed a lack of SRs with high methodological quality. Thus, no decisive conclusion can be drawn with respect to this topic. It appears that there is a trend for the superiority of fiber-reinforced posts. SRs must be of high methodological quality. This can be achieved by taking into consideration the results of this review. Improved methodological quality would make SRs more supportive for the general practitioner.

Very high resolution Earth Observation features for testing the direct and indirect effects of landscape structure on local habitat quality

NASA Astrophysics Data System (ADS)

Mairota, Paola; Cafarelli, Barbara; Labadessa, Rocco; Lovergine, Francesco P.; Tarantino, Cristina; Nagendra, Harini; Didham, Raphael K.

2015-02-01

Modelling the empirical relationships between habitat quality and species distribution patterns is the first step to understanding human impacts on biodiversity. It is important to build on this understanding to develop a broader conceptual appreciation of the influence of surrounding landscape structure on local habitat quality, across multiple spatial scales. Traditional models which report that 'habitat amount' in the landscape is sufficient to explain patterns of biodiversity, irrespective of habitat configuration or spatial variation in habitat quality at edges, implicitly treat each unit of habitat as interchangeable and ignore the high degree of interdependence between spatial components of land-use change. Here, we test the contrasting hypothesis, that local habitat units are not interchangeable in their habitat attributes, but are instead dependent on variation in surrounding habitat structure at both patch- and landscape levels. As the statistical approaches needed to implement such hierarchical causal models are observation-intensive, we utilise very high resolution (VHR) Earth Observation (EO) images to rapidly generate fine-grained measures of habitat patch internal heterogeneities over large spatial extents. We use linear mixed-effects models to test whether these remotely-sensed proxies for habitat quality were influenced by surrounding patch or landscape structure. The results demonstrate the significant influence of surrounding patch and landscape context on local habitat quality. They further indicate that such an influence can be direct, when a landscape variable alone influences the habitat structure variable, and/or indirect when the landscape and patch attributes have a conjoined effect on the response variable. We conclude that a substantial degree of interaction among spatial configuration effects is likely to be the norm in determining the ecological consequences of habitat fragmentation, thus corroborating the notion of the spatial context dependence of habitat quality.

A Critical Analysis of the INQAAHE Guidelines of Good Practice for Higher Education Quality Assurance Agencies

ERIC Educational Resources Information Center

Blackmur, Douglas

2008-01-01

The International Network of Quality Assurance Agencies in Higher Education's Guidelines of Good Practice by higher education quality assurance agencies need substantial revision before they can be considered adequate by stakeholders in any national higher education system. Various revisions are proposed in this article. But the International…

The Research of the Personality Qualities of Future Educational Psychologists

ERIC Educational Resources Information Center

Dolgova, V. I.; Salamatov, A. A.; Potapova, M. V.; Yakovleva, N. O.

2016-01-01

In this article, the authors substantiate the existence of the personality qualities of future educational psychologists (PQFEP) that are, in fact, a sum of knowledge, skills, abilities, socially required qualities of personality allowing the psychologist to solve problems in all the fields of professional activities. A model of PQFEP predicts the…

Assessing the Quality of Parent-Teacher Relationships for Students with ADHD

ERIC Educational Resources Information Center

Mautone, Jennifer A.; Marcelle, Enitan; Tresco, Katy E.; Power, Thomas J.

2015-01-01

Family involvement in education, including the quality of family-school communication, has been demonstrated repeatedly to have a substantial effect on child development and success in school; however, measures of this construct are limited. The purpose this study was to examine the factor structure and concurrent validity of the Quality of the…

Thermal springs of Malaysia and their potentialdevelopment

NASA Astrophysics Data System (ADS)

Rahim Samsudin, Abdul; Hamzah, Umar; Rahman, Rakmi Ab.; Siwar, Chamhuri; Fauzi Mohd. Jani, Mohd; Othman, Redzuan

The study on the potential development of hot springs for the tourism industry in Malaysiawas conducted. Out of the 40 hot springs covered, the study identified 9 hot springs having a high potential for development, 14 having medium potential and the remaining 17 having low or least potential for development. This conclusion was arrived at after considering the technical and economic feasibility of the various hot springs. Technical feasibility criteria includes geological factors, water quality, temperature and flow rate. The economic feasibility criteria considers measures such as accessibility, current and market potentials in terms of visitors, surrounding attractions and existing inventory and facilities available. A geological input indicates that high potential hot springs are located close to or within the granite body and associated with major permeable fault zones. They normally occur at low elevation adjacent to topographic highs. High potential hot springs are also characterised by high water temperature, substantial flowrate and very good water quality which is important for water-body contact activities such as soaking. Economic criteria for high potential hot springs are associated with good accessibility, good market, good surrounding attractions like rural and village setting and well developed facilities and infrastructures.

Friction pull plug welding: chamfered heat sink pull plug design

NASA Technical Reports Server (NTRS)

Coletta, Edmond R. (Inventor); Cantrell, Mark A. (Inventor)

2005-01-01

The average strength of a pull plug weld is increased and weak bonding eliminated by providing a dual included angle at the top one third of the pull plug. Plugs using the included angle of the present invention had consistent high strength, no weak bonds and were substantially defect free. The dual angle of the pull plug body increases the heat and pressure of the weld in the region of the top one third of the plug. This allows the plug to form a tight high quality solid state bond. The dual angle was found to be successful in elimination of defects on both small and large plugs.

Patient safety in anesthesia: learning from the culture of high-reliability organizations.

PubMed

Wright, Suzanne M

2015-03-01

There has been an increased awareness of and interest in patient safety and improved outcomes, as well as a growing body of evidence substantiating medical error as a leading cause of death and injury in the United States. According to The Joint Commission, US hospitals demonstrate improvements in health care quality and patient safety. Although this progress is encouraging, much room for improvement remains. High-reliability organizations, industries that deliver reliable performances in the face of complex working environments, can serve as models of safety for our health care system until plausible explanations for patient harm are better understood. Copyright © 2015 Elsevier Inc. All rights reserved.

The State of Software for Evolutionary Biology

PubMed Central

Darriba, Diego; Flouri, Tomáš; Stamatakis, Alexandros

2018-01-01

Abstract With Next Generation Sequencing data being routinely used, evolutionary biology is transforming into a computational science. Thus, researchers have to rely on a growing number of increasingly complex software. All widely used core tools in the field have grown considerably, in terms of the number of features as well as lines of code and consequently, also with respect to software complexity. A topic that has received little attention is the software engineering quality of widely used core analysis tools. Software developers appear to rarely assess the quality of their code, and this can have potential negative consequences for end-users. To this end, we assessed the code quality of 16 highly cited and compute-intensive tools mainly written in C/C++ (e.g., MrBayes, MAFFT, SweepFinder, etc.) and JAVA (BEAST) from the broader area of evolutionary biology that are being routinely used in current data analysis pipelines. Because, the software engineering quality of the tools we analyzed is rather unsatisfying, we provide a list of best practices for improving the quality of existing tools and list techniques that can be deployed for developing reliable, high quality scientific software from scratch. Finally, we also discuss journal as well as science policy and, more importantly, funding issues that need to be addressed for improving software engineering quality as well as ensuring support for developing new and maintaining existing software. Our intention is to raise the awareness of the community regarding software engineering quality issues and to emphasize the substantial lack of funding for scientific software development. PMID:29385525

Image Quality in High-resolution and High-cadence Solar Imaging

NASA Astrophysics Data System (ADS)

Denker, C.; Dineva, E.; Balthasar, H.; Verma, M.; Kuckein, C.; Diercke, A.; González Manrique, S. J.

2018-03-01

Broad-band imaging and even imaging with a moderate bandpass (about 1 nm) provides a photon-rich environment, where frame selection (lucky imaging) becomes a helpful tool in image restoration, allowing us to perform a cost-benefit analysis on how to design observing sequences for imaging with high spatial resolution in combination with real-time correction provided by an adaptive optics (AO) system. This study presents high-cadence (160 Hz) G-band and blue continuum image sequences obtained with the High-resolution Fast Imager (HiFI) at the 1.5-meter GREGOR solar telescope, where the speckle-masking technique is used to restore images with nearly diffraction-limited resolution. The HiFI employs two synchronized large-format and high-cadence sCMOS detectors. The median filter gradient similarity (MFGS) image-quality metric is applied, among others, to AO-corrected image sequences of a pore and a small sunspot observed on 2017 June 4 and 5. A small region of interest, which was selected for fast-imaging performance, covered these contrast-rich features and their neighborhood, which were part of Active Region NOAA 12661. Modifications of the MFGS algorithm uncover the field- and structure-dependency of this image-quality metric. However, MFGS still remains a good choice for determining image quality without a priori knowledge, which is an important characteristic when classifying the huge number of high-resolution images contained in data archives. In addition, this investigation demonstrates that a fast cadence and millisecond exposure times are still insufficient to reach the coherence time of daytime seeing. Nonetheless, the analysis shows that data acquisition rates exceeding 50 Hz are required to capture a substantial fraction of the best seeing moments, significantly boosting the performance of post-facto image restoration.

Changes in the relationship between nursing home financial performance and quality of care under public reporting.

PubMed

Park, Jeongyoung; Werner, Rachel M

2011-07-01

The relationship between financial performance and quality of care in nursing homes is not well defined and prior work has been mixed. The recent focus on improving the quality of nursing homes through market-based incentives such as public reporting may have changed this relationship, as public reporting provides nursing homes with increased incentives to engage in quality-based competition. If quality improvement activities require substantial production costs, nursing home profitability may become a more important predictor of quality under public reporting. This study explores the relationship between financial performance and quality of care and test whether this relationship changes under public reporting. Using a 10-year (fiscal years 1997-2006) panel data set of 9444 skilled nursing facilities in the US, this study employs a facility fixed-effects with and without instrumental variables approach to test the effect of finances on quality improvement and correct for potential endogeneity. The results show that better financial performance, as reflected by the 1-year lagged total profit margin, is modestly associated with higher quality but only after public reporting is initiated. These findings have important policy implications as federal and state governments use market-based incentives to increase demand for high-quality care and induce providers to compete based on quality. Copyright © 2010 John Wiley & Sons, Ltd.

Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

PubMed Central

2012-01-01

Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands. PMID:22824415

Childhood maltreatment and adulthood poor sleep quality: a longitudinal study.

PubMed

Abajobir, Amanuel A; Kisely, Steve; Williams, Gail; Strathearn, Lane; Najman, Jake M

2017-08-01

Available evidence from cross-sectional studies suggests that childhood maltreatment may be associated with a range of sleep disorders. However, these studies have not controlled for potential individual-, familial- and environmental-level confounders. To determine the association between childhood maltreatment and lower sleep quality after adjusting for potential confounders. Data for the present study were obtained from a pre-birth cohort study of 3778 young adults (52.6% female) of the Mater Hospital-University of Queensland Study of Pregnancy follow up at a mean age of 20.6 years. The Mater Hospital-University of Queensland Study of Pregnancy is a prospective Australian pre-birth cohort study of mothers consecutively recruited during their first obstetric clinic visit at Brisbane's Mater Hospital in 1981-1983. Participants completed the Pittsburgh Sleep Quality Index at the 21-year follow up. We linked this dataset to agency-recorded substantiated cases of childhood maltreatment. A series of separate logistic regression models was used to test whether childhood maltreatment predicted lower sleep quality after adjustment for selected confounders. Substantiated physical abuse significantly predicted lower sleep quality in males. Single and multiple forms of childhood maltreatment, including age of maltreatment and number of substantiations, did not predict lower sleep quality in either gender in both crude and adjusted models. Not being married, living in a residential problem area, cigarette smoking and internalising were significantly associated with lower sleep quality in a fully adjusted model for the male-female combined sample. Childhood maltreatment does not appear to predict young adult poor sleep quality, with the exception of physical abuse for males. While childhood maltreatment has been found to predict a range of mental health problems, childhood maltreatment does not appear to predict sleep problems occurring in young adults. Poor sleep quality was accounted for by concurrent social disadvantage, cigarette smoking and internalising. © 2017 Royal Australasian College of Physicians.

American surgery and the Affordable Care Act.

PubMed

Stain, Steven C; Hoyt, David B; Hunter, John G; Joyce, Geoffrey; Hiatt, Jonathan R

2014-09-01

The Affordable Care Act (ACA) attempts to change the way we finance and deliver health care by coordinating the delivery of primary, specialty, and hospital services in accountable care organizations. The ways in which accountable care organizations will develop and evolve is unclear; however, the effects on surgeons and their patients will be substantial. High-value care in the ACA emphasizes quality, safety, resource use and appropriateness, and the patient's experience of care. Payment will be linked to these principles. Department chairs overseeing a clinical enterprise in academic medical centers now must add financial and quality measures to the traditional missions of education, research, and clinical service. At a time when surgical training is in dramatic evolution, with work hour limitations for residents and an emphasis on quality, productivity, and increasing oversight of trainees for faculty, residency programs will need to meet the increasing demands of an aging population and newly insured patients under the ACA. The American College of Surgeons, with its century-long commitment to quality improvement, research-based standards, and performance measurement and verification, has begun its Inspiring Quality Campaign, is developing new educational tools, and is preparing proposals for payment reform based on surgeons' participation in quality programs.

Constructing Carbon Fiber Motion-Detection Loops for Simultaneous EEG–fMRI

PubMed Central

Abbott, David F.; Masterton, Richard A. J.; Archer, John S.; Fleming, Steven W.; Warren, Aaron E. L.; Jackson, Graeme D.

2015-01-01

One of the most significant impediments to high-quality EEG recorded in an MRI scanner is subject motion. Availability of motion artifact sensors can substantially improve the quality of the recorded EEG. In the study of epilepsy, it can also dramatically increase the confidence that one has in discriminating true epileptiform activity from artifact. This is due both to the reduction in artifact and the ability to visually inspect the motion sensor signals when reading the EEG, revealing whether or not head motion is present. We have previously described the use of carbon fiber loops for detecting and correcting artifact in EEG acquired simultaneously with MRI. The loops, attached to the subject’s head, are electrically insulated from the scalp. They provide a simple and direct measure of specific artifact that is contaminating the EEG, including both subject motion and residual artifact arising from magnetic field gradients applied during MRI. Our previous implementation was used together with a custom-built EEG–fMRI system that differs substantially from current commercially available EEG–fMRI systems. The present technical note extends this work, describing in more detail how to construct the carbon fiber motion-detection loops, and how to interface them with a commercially available simultaneous EEG–fMRI system. We hope that the information provided may help those wishing to utilize a motion-detection/correction solution to improve the quality of EEG recorded within an MRI scanner. PMID:25601852

Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries.

PubMed

Bain, Rob E S; Gundry, Stephen W; Wright, Jim A; Yang, Hong; Pedley, Steve; Bartram, Jamie K

2012-03-01

To determine how data on water source quality affect assessments of progress towards the 2015 Millennium Development Goal (MDG) target on access to safe drinking-water. Data from five countries on whether drinking-water sources complied with World Health Organization water quality guidelines on contamination with thermotolerant coliform bacteria, arsenic, fluoride and nitrates in 2004 and 2005 were obtained from the Rapid Assessment of Drinking-Water Quality project. These data were used to adjust estimates of the proportion of the population with access to safe drinking-water at the MDG baseline in 1990 and in 2008 made by the Joint Monitoring Programme for Water Supply and Sanitation, which classified all improved sources as safe. Taking account of data on water source quality resulted in substantially lower estimates of the percentage of the population with access to safe drinking-water in 2008 in four of the five study countries: the absolute reduction was 11% in Ethiopia, 16% in Nicaragua, 15% in Nigeria and 7% in Tajikistan. There was only a slight reduction in Jordan. Microbial contamination was more common than chemical contamination. The criterion used by the MDG indicator to determine whether a water source is safe can lead to substantial overestimates of the population with access to safe drinking-water and, consequently, also overestimates the progress made towards the 2015 MDG target. Monitoring drinking-water supplies by recording both access to water sources and their safety would be a substantial improvement.

Depression in Age-Related Macular Degeneration

ERIC Educational Resources Information Center

Casten, Robin; Rovner, Barry

2008-01-01

Age-related macular degeneration (AMD) is a major cause of disability in the elderly, substantially degrades the quality of their lives, and is a risk factor for depression. Rates of depression in AMD are substantially greater than those found in the general population of older people, and are on par with those of other chronic and disabling…

Choosing Wisely: assessment of current US top five list recommendations’ trustworthiness using a pragmatic approach

PubMed Central

Horvath, Karl; Semlitsch, Thomas; Jeitler, Klaus; Abuzahra, Muna E; Posch, Nicole; Domke, Andreas; Siebenhofer, Andrea

2016-01-01

Objectives Identification of sufficiently trustworthy top 5 list recommendations from the US Choosing Wisely campaign. Setting Not applicable. Participants All top 5 list recommendations available from the American Board of Internal Medicine Foundation website. Main outcome measures/interventions Compilation of US top 5 lists and search for current German highly trustworthy (S3) guidelines. Extraction of guideline recommendations, including grade of recommendation (GoR), for suggestions comparable to top 5 list recommendations. For recommendations without guideline equivalents, the methodological quality of the top 5 list development process was assessed using criteria similar to that used to judge guidelines, and relevant meta-literature was identified in cited references. Judgement of sufficient trustworthiness of top 5 list recommendations was based either on an ‘A’ GoR of guideline equivalents or on high methodological quality and citation of relevant meta-literature. Results 412 top 5 list recommendations were identified. For 75 (18%), equivalents were found in current German S3 guidelines. 44 of these recommendations were associated with an ‘A’ GoR, or a strong recommendation based on strong evidence, and 26 had a ‘B’ or a ‘C’ GoR. No GoR was provided for 5 recommendations. 337 recommendations had no equivalent in the German S3 guidelines. The methodological quality of the development process was high and relevant meta-literature was cited for 87 top 5 list recommendations. For a further 36, either the methodological quality was high without any meta-literature citations or meta-literature citations existed but the methodological quality was lacking. For the remaining 214 recommendations, either the methodological quality was lacking and no literature was cited or the methodological quality was generally unsatisfactory. Conclusions 131 of current US top 5 list recommendations were found to be sufficiently trustworthy. For a substantial number of current US top 5 list recommendations, their trustworthiness remains unclear. Methodological requirements for developing top 5 lists are recommended. PMID:27855098

Service Quality in Postgraduate Education

ERIC Educational Resources Information Center

Angell, Robert J.; Heffernan, Troy W.; Megicks, Phil

2008-01-01

Purpose: Measuring service quality in higher education is increasingly important for attracting and retaining tuition-based revenues. Nonetheless, whilst undergraduates have received substantial academic exposure, postgraduate-based research has been scant. Consequently, the objectives of this paper are threefold: first, to identify the service…

The Simons Genome Diversity Project: 300 genomes from 142 diverse populations.

PubMed

Mallick, Swapan; Li, Heng; Lipson, Mark; Mathieson, Iain; Gymrek, Melissa; Racimo, Fernando; Zhao, Mengyao; Chennagiri, Niru; Nordenfelt, Susanne; Tandon, Arti; Skoglund, Pontus; Lazaridis, Iosif; Sankararaman, Sriram; Fu, Qiaomei; Rohland, Nadin; Renaud, Gabriel; Erlich, Yaniv; Willems, Thomas; Gallo, Carla; Spence, Jeffrey P; Song, Yun S; Poletti, Giovanni; Balloux, Francois; van Driem, George; de Knijff, Peter; Romero, Irene Gallego; Jha, Aashish R; Behar, Doron M; Bravi, Claudio M; Capelli, Cristian; Hervig, Tor; Moreno-Estrada, Andres; Posukh, Olga L; Balanovska, Elena; Balanovsky, Oleg; Karachanak-Yankova, Sena; Sahakyan, Hovhannes; Toncheva, Draga; Yepiskoposyan, Levon; Tyler-Smith, Chris; Xue, Yali; Abdullah, M Syafiq; Ruiz-Linares, Andres; Beall, Cynthia M; Di Rienzo, Anna; Jeong, Choongwon; Starikovskaya, Elena B; Metspalu, Ene; Parik, Jüri; Villems, Richard; Henn, Brenna M; Hodoglugil, Ugur; Mahley, Robert; Sajantila, Antti; Stamatoyannopoulos, George; Wee, Joseph T S; Khusainova, Rita; Khusnutdinova, Elza; Litvinov, Sergey; Ayodo, George; Comas, David; Hammer, Michael F; Kivisild, Toomas; Klitz, William; Winkler, Cheryl A; Labuda, Damian; Bamshad, Michael; Jorde, Lynn B; Tishkoff, Sarah A; Watkins, W Scott; Metspalu, Mait; Dryomov, Stanislav; Sukernik, Rem; Singh, Lalji; Thangaraj, Kumarasamy; Pääbo, Svante; Kelso, Janet; Patterson, Nick; Reich, David

2016-10-13

Here we report the Simons Genome Diversity Project data set: high quality genomes from 300 individuals from 142 diverse populations. These genomes include at least 5.8 million base pairs that are not present in the human reference genome. Our analysis reveals key features of the landscape of human genome variation, including that the rate of accumulation of mutations has accelerated by about 5% in non-Africans compared to Africans since divergence. We show that the ancestors of some pairs of present-day human populations were substantially separated by 100,000 years ago, well before the archaeologically attested onset of behavioural modernity. We also demonstrate that indigenous Australians, New Guineans and Andamanese do not derive substantial ancestry from an early dispersal of modern humans; instead, their modern human ancestry is consistent with coming from the same source as that of other non-Africans.

The Simons Genome Diversity Project: 300 genomes from 142 diverse populations

PubMed Central

Mallick, Swapan; Li, Heng; Lipson, Mark; Mathieson, Iain; Gymrek, Melissa; Racimo, Fernando; Zhao, Mengyao; Chennagiri, Niru; Nordenfelt, Susanne; Tandon, Arti; Skoglund, Pontus; Lazaridis, Iosif; Sankararaman, Sriram; Fu, Qiaomei; Rohland, Nadin; Renaud, Gabriel; Erlich, Yaniv; Willems, Thomas; Gallo, Carla; Spence, Jeffrey P.; Song, Yun S.; Poletti, Giovanni; Balloux, Francois; van Driem, George; de Knijff, Peter; Romero, Irene Gallego; Jha, Aashish R.; Behar, Doron M.; Bravi, Claudio M.; Capelli, Cristian; Hervig, Tor; Moreno-Estrada, Andres; Posukh, Olga L.; Balanovska, Elena; Balanovsky, Oleg; Karachanak-Yankova, Sena; Sahakyan, Hovhannes; Toncheva, Draga; Yepiskoposyan, Levon; Tyler-Smith, Chris; Xue, Yali; Abdullah, M. Syafiq; Ruiz-Linares, Andres; Beall, Cynthia M.; Di Rienzo, Anna; Jeong, Choongwon; Starikovskaya, Elena B.; Metspalu, Ene; Parik, Jüri; Villems, Richard; Henn, Brenna M.; Hodoglugil, Ugur; Mahley, Robert; Sajantila, Antti; Stamatoyannopoulos, George; Wee, Joseph T. S.; Khusainova, Rita; Khusnutdinova, Elza; Litvinov, Sergey; Ayodo, George; Comas, David; Hammer, Michael; Kivisild, Toomas; Klitz, William; Winkler, Cheryl; Labuda, Damian; Bamshad, Michael; Jorde, Lynn B.; Tishkoff, Sarah A.; Watkins, W. Scott; Metspalu, Mait; Dryomov, Stanislav; Sukernik, Rem; Singh, Lalji; Thangaraj, Kumarasamy; Pääbo, Svante; Kelso, Janet; Patterson, Nick; Reich, David

2016-01-01

We report the Simons Genome Diversity Project (SGDP) dataset: high quality genomes from 300 individuals from 142 diverse populations. These genomes include at least 5.8 million base pairs that are not present in the human reference genome. Our analysis reveals key features of the landscape of human genome variation, including that the rate of accumulation of mutations has accelerated by about 5% in non-Africans compared to Africans since divergence. We show that the ancestors of some pairs of present-day human populations were substantially separated by 100,000 years ago, well before the archaeologically attested onset of behavioral modernity. We also demonstrate that indigenous Australians, New Guineans and Andamanese do not derive substantial ancestry from an early dispersal of modern humans; instead, their modern human ancestry is consistent with coming from the same source as that in other non-Africans. PMID:27654912

Dissecting the indirect effects caused by vaccines into the basic elements.

PubMed

Scarbrough Lefebvre, Carla D; Terlinden, Augustin; Standaert, Baudouin

2015-01-01

Vaccination directly protects vaccinated individuals, but it also has the potential for indirectly protecting the unvaccinated in a population (herd protection). Unintended negative consequences such as the re-manifestation of infection, mainly expressed as age shifts, result from vaccination programs as well. We discuss the necessary conditions for achieving optimal herd protection (i.e., high quality vaccine-induced immunity, substantial effect on the force of infection, and appropriate vaccine coverage and distribution), as well as the conditions under which age shifts are likely to occur. We show examples to illustrate these effects. Substantial ambiguity in observing and quantifying these indirect vaccine effects makes accurate evaluation troublesome even though the nature of these outcomes may be critical for accurate assessment of the economic value when decision makers are evaluating a novel vaccine for introduction into a particular region or population group. More investigation is needed to identify and develop successful assessment methodologies for precisely analyzing these outcomes.

Stakeholders' perception of the nutrition and health claim regulation.

PubMed

de Boer, Alie; Bast, Aalt

2015-05-01

In 2007, the Nutrition and Health Claim Regulation (NHCR) entered into force, which required scientific substantiation of health claims. In the field of antioxidants, most proposed claims were negatively assessed by the European Food Safety Authority (EFSA). This study reviews the perception of the NHCR of 14 Dutch stakeholders to unravel the grounds for disproving the putative health claims. Most claims are shown to be refused based on the quality of scientific substantiation, due to usage of scientific methods on which no consensus has been reached and the differences in expectations and requirements. Three themes exemplify the need for improvement in applying the NHCR: (i) enforcement; (ii) methodology; and (iii) perceived impact of the NHCR. With highly diverging perceptions of stakeholders, the current effectiveness of the NHCR can be questioned. The views of different stakeholders on these themes help to focus the discussion on the NCHR in capturing health effects.

Strategic supplementation of cassava top silage to enhance rumen fermentation and milk production in lactating dairy cows in the tropics.

PubMed

Wanapat, Metha; Phesatcha, Kampanat; Viennasay, Bounnaxay; Phesatcha, Burarat; Ampapon, Thiwakorn; Kang, Sungchhang

2018-04-19

High-quality protein roughage is an important feed for productive ruminants. This study examined the effects of strategic feeding of lactating cows with cassava (Manihot esculenta) top silage (CTS) on rumen fermentation, feed intake, milk yield, and quality. Four early lactating crossbred dairy cows (75% Holstein-Friesian and 25% Thai) with body weight (BW) 410 ± 30 kg and milk yield 12 ± 2 kg/day were randomly allotted in a 4 × 4 Latin square design to four different supplementation levels of CTS namely, 0, 0.75, 1.50, and 2.25 kg/day of dry matter (DM). Strategic supplementation of CTS significantly affected ruminal fermentation end-products, especially increased propionate production, decreased protozoal population and suppressed methane production (P < 0.05). Increasing the CTS supplementation level substantially enhanced milk yield and the 3.5% FCM from 12.7 to 14.0 kg/day and from 14.6 to 17.2 kg/day (P < 0.05) for non-supplemented group and for the 2.25 kg/day supplemented group, respectively. We conclude that high-quality protein roughage significantly enhances rumen fermentation end-products, milk yield, and quality in dairy cows.

Impact assessment of mechanical harvest on fruit physiology and consequences on oil physicochemical and sensory quality from 'Manzanilla de Sevilla' and 'Manzanilla Cacereña' super-high-density hedgerows. A preliminary study.

PubMed

Morales-Sillero, Ana; García, José M

2015-09-01

Super-intensive cultivation facilitates olive mechanized harvesting, allowing substantial savings in the production cost of virgin olive oil (VOO). However, the number of varieties adapted to this type of cultivation is small. This study explores the impact that harvesting with a grape straddle harvester of 'Manzanilla de Sevilla' and 'Manzanilla Cacereña' olives grown in super-intensive cultivation has on the physiology of the fruit and the quality of the oil subsequently extracted. For both cultivars, fruits harvested mechanically showed higher respiration and ethylene production and lower firmness than fruits harvested by hand. Their oils exhibited lower phenol contents, lower oxidative stability and lower presence of positive sensory attributes. However, in these oils the values of parameters used to assess the level of quality of VOO remained within the limits required for the best commercial category. Mechanical harvesting of 'Manzanilla de Sevilla' and 'Manzanilla Cacereña' super-high-density hedgerows induced physiological alterations in the fruits and a reduction in the contents of natural antioxidants and flavour components in the oils, though it did not result in a loss of the 'Extra' level of quality. © 2014 Society of Chemical Industry.

Motion artifact detection in four-dimensional computed tomography images

NASA Astrophysics Data System (ADS)

Bouilhol, G.; Ayadi, M.; Pinho, R.; Rit, S.; Sarrut, D.

2014-03-01

Motion artifacts appear in four-dimensional computed tomography (4DCT) images because of suboptimal acquisition parameters or patient breathing irregularities. Frequency of motion artifacts is high and they may introduce errors in radiation therapy treatment planning. Motion artifact detection can be useful for image quality assessment and 4D reconstruction improvement but manual detection in many images is a tedious process. We propose a novel method to evaluate the quality of 4DCT images by automatic detection of motion artifacts. The method was used to evaluate the impact of the optimization of acquisition parameters on image quality at our institute. 4DCT images of 114 lung cancer patients were analyzed. Acquisitions were performed with a rotation period of 0.5 seconds and a pitch of 0.1 (74 patients) or 0.081 (40 patients). A sensitivity of 0.70 and a specificity of 0.97 were observed. End-exhale phases were less prone to motion artifacts. In phases where motion speed is high, the number of detected artifacts was systematically reduced with a pitch of 0.081 instead of 0.1 and the mean reduction was 0.79. The increase of the number of patients with no artifact detected was statistically significant for the 10%, 70% and 80% respiratory phases, indicating a substantial image quality improvement.

Forest survey results for higher grade hardwood sawtimber

Treesearch

Roy C. Beltz

1991-01-01

The 1987 Forest Survey of Mississippi shows a slight increase in forest area and a substantial gain in hardwood inventory. Hardwood gains, appearing in all diameter classes, suggest an increase in quality but hardwood users generally believe quality is declining. By our analysis, volume of top quality hardwood declined while volume in other grades increased. Forest...

A Value-Added Estimate of Higher Education Quality of US States

ERIC Educational Resources Information Center

Zhang, Lei

2009-01-01

States differ substantially in higher education policies. Little is known about the effects of state policies on the performance of public colleges and universities, largely because no clear measures of college quality exist. In this paper, I estimate the average quality of public colleges of US states based on the value-added to individuals'…

Defining and managing the quality of wilderness recreation experiences

Treesearch

Robert E. Manning; David W. Lime

2000-01-01

There is a substantial body of scientific literature on defining and managing the quality of wilderness experiences. Two conceptual frameworks derived from this literature—carrying capacity and the Recreation Opportunity Spectrum (ROS)—suggest that wilderness recreation experiences can be defined through indicators and standards of quality, and that wilderness...

Conceptual Principles of Quality of Life: An Empirical Exploration

ERIC Educational Resources Information Center

Bramston, P.; Chipuer, H.; Pretty, G.

2005-01-01

Background: Quality of life is a popular measure of outcomes and its widespread use has led to recent calls for a better understanding of the construct, emphasizing the need to build a substantial body of knowledge around what determines perceptions of life quality. Three widely reported and used conceptual principles are examined in this study.…

Are we in the dark ages of environmental toxicology?

PubMed

McCarty, L S

2013-12-01

Environmental toxicity is judged to be in a "dark ages" period due to longstanding limitations in the implementation of the simple conceptual model that is the basis of current aquatic toxicity testing protocols. Fortunately, the environmental regulatory revolution of the last half-century is not substantially compromised as development of past regulatory guidance was designed to deal with limited amounts of relatively poor quality toxicity data. However, as regulatory objectives have substantially increased in breadth and depth, aquatic toxicity data derived with old testing methods are no longer adequate. In the near-term explicit model description and routine assumption validation should be mandatory. Updated testing methods could provide some improvements in toxicological data quality. A thorough reevaluation of toxicity testing objectives and methods resulting in substantially revised standard testing methods, plus a comprehensive scheme for classification of modes/mechanisms of toxic action, should be the long-term objective. Copyright © 2013 Elsevier Inc. All rights reserved.

Regional variations in health care intensity and physician perceptions of quality of care.

PubMed

Sirovich, Brenda E; Gottlieb, Daniel J; Welch, H Gilbert; Fisher, Elliott S

2006-05-02

Research has documented dramatic differences in health care utilization and spending across U.S. regions with similar levels of patient illness. Although patient outcomes and quality of care have been found to be no better in regions of high health care intensity, it is unknown whether physicians in these regions feel more capable of providing good patient care than those in low-intensity regions. To determine whether physicians in high-intensity regions feel better able to care for patients than physicians in low-intensity regions. Physician telephone survey. 51 metropolitan and 9 nonmetropolitan areas of the United States and a supplemental national sample. 10,577 physicians who provided care to adults in 1998 or 1999 were surveyed for the Community Tracking Study (response rate, 61%). The End-of-Life Expenditure Index, a measure of spending that reflects differences in the overall quantity of medical services provided rather than differences in illness or price, was used to determine health care intensity in the physicians' community. Outcomes included physicians' perceived availability of clinical services, ability to provide high-quality care to patients, and career satisfaction. Although the highest-intensity regions have substantially more hospital beds and specialists per capita, physicians in these regions reported more difficulty obtaining needed services for their patients. The proportion of physicians who felt able to obtain elective hospital admissions ranged from 50% in high-intensity regions to 64% in the lowest-intensity region (P < 0.001 for the relationship between intensity and perceived ability to obtain hospital admissions); the proportion of physicians who felt able to obtain high-quality specialist referrals ranged from 64% in high-intensity regions to 79% in low-intensity regions (P < 0.001). Compared with low-intensity regions, fewer physicians in high-intensity regions felt able to maintain good ongoing patient relationships (range, 62% to 70%; P < 0.001) or able to provide high-quality care (range, 72% to 77%; P = 0.009). In most cases, differences persisted but were attenuated in magnitude after adjustment for physician attributes, practice characteristics, and local market factors (for example, managed care penetration); the difference in perceived ability to provide high-quality care was no longer statistically significant (P = 0.099). The cross-sectional design prevented demonstration of a causal relationship between intensity and physician perceptions of quality. Despite more resources, physicians in regions of high health care intensity did not report greater ease in obtaining needed services or greater ability to provide high-quality care.

Image quality in low-dose coronary computed tomography angiography with a new high-definition CT scanner.

PubMed

Kazakauskaite, Egle; Husmann, Lars; Stehli, Julia; Fuchs, Tobias; Fiechter, Michael; Klaeser, Bernd; Ghadri, Jelena R; Gebhard, Catherine; Gaemperli, Oliver; Kaufmann, Philipp A

2013-02-01

A new generation of high definition computed tomography (HDCT) 64-slice devices complemented by a new iterative image reconstruction algorithm-adaptive statistical iterative reconstruction, offer substantially higher resolution compared to standard definition CT (SDCT) scanners. As high resolution confers higher noise we have compared image quality and radiation dose of coronary computed tomography angiography (CCTA) from HDCT versus SDCT. Consecutive patients (n = 93) underwent HDCT, and were compared to 93 patients who had previously undergone CCTA with SDCT matched for heart rate (HR), HR variability and body mass index (BMI). Tube voltage and current were adapted to the patient's BMI, using identical protocols in both groups. The image quality of all CCTA scans was evaluated by two independent readers in all coronary segments using a 4-point scale (1, excellent image quality; 2, blurring of the vessel wall; 3, image with artefacts but evaluative; 4, non-evaluative). Effective radiation dose was calculated from DLP multiplied by a conversion factor (0.014 mSv/mGy × cm). The mean image quality score from HDCT versus SDCT was comparable (2.02 ± 0.68 vs. 2.00 ± 0.76). Mean effective radiation dose did not significantly differ between HDCT (1.7 ± 0.6 mSv, range 1.0-3.7 mSv) and SDCT (1.9 ± 0.8 mSv, range 0.8-5.5 mSv; P = n.s.). HDCT scanners allow low-dose 64-slice CCTA scanning with higher resolution than SDCT but maintained image quality and equally low radiation dose. Whether this will translate into higher accuracy of HDCT for CAD detection remains to be evaluated.

Reliable cues and signals of fruit quality are contingent on the habitat in black elder (Sambucus nigra).

PubMed

Schaefer, H Martin; Braun, Julius

2009-06-01

Communication mediates interactions between organisms and can be based on signals or cues. Signals are selected for their signaling function, whereas cues evolve for reasons other than signaling. To be evolutionarily stable, communication needs to be reliable on average, but the mechanisms that enforce reliability are hotly debated in light of strong environmental influence on signals and cues. While fruit quality in black elder (Sambucus nigra) is unrelated to fruit color, it is indicated by alternative pedicel phenotypes. Information on fruit quality has thus been transferred from the fruit to the developmentally associated pedicels, which are environmentally determined cues. Within each phenotype, color variation indicates fruit quality. Communication by black elder is thus reliable, but the proximate mechanisms enforcing reliability are habitat specific. High irradiance increases both the contrasts of the visual cue and fruit quality in the anthocyanin-based red pedicel phenotype, while shaded plants of the chlorophyll-based green phenotype apparently use signals by forgoing photosynthesis. This is because lower chlorophyll content in green pedicels creates contrasting pedicels, and higher contrasts indicate higher sugar content in the fruits of green pedicels. Because anthocyanins are light-induced, plants use cues when exposed to high irradiance, whereas they apparently use costly signals in the shade by reducing chlorophyll content in the pedicels. In behavioral field and laboratory experiments we document that avian seed dispersers select among pedicel phenotypes that indicate different fruit quality. Plants can thus increase their reproductive success by sending highly informative cues. Our results indicate how reliable information transfer can be maintained both in cues and signals in spite of substantial environmental influence on visual traits.

Assessment of medical care by elderly people: general satisfaction and physician quality.

PubMed Central

Lee, Y; Kasper, J D

1998-01-01

OBJECTIVE: To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the elderly people's satisfaction with medical care. DATA SOURCES/STUDY SETTING: Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8,859 persons age 65 and over living in the community. STUDY DESIGN: Items reflecting general satisfaction with care and views of physician quality are examined and, based on factor analysis, grouped in dimensions of two (global quality, access) and three (technical skills, interpersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteristics of elderly people, and to measures of access and utilization, is assessed using logistic regression. PRINCIPAL FINDINGS: While satisfaction is high, with over 90 percent surveyed expressing some satisfaction, there is substantial variation with less likelihood of high satisfaction among those 80 or older, with less education and income and in poorer health. Longer waiting time at visits and less frequent visits are factors in lower satisfaction as well. A favorable perception of physician quality, especially regarding technical skills, appears to play a significant role in satisfaction with global quality of care. CONCLUSIONS: Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on earlier studies, were, e.g., better health and shorter waiting time, while others were not, e.g., increasing age. Elderly people appear to place greater importance on physician technical skills, as opposed to interpersonal dimensions, in assessing global quality. These findings suggest the need for a better understanding of how elderly people evaluate care and what they value in interactions with the healthcare system. Images Figure 1 PMID:9460484

Behavioral intervention for problem behavior in children with fragile X syndrome.

PubMed

Moskowitz, Lauren J; Carr, Edward G; Durand, V Mark

2011-11-01

Parents and professionals typically report problem behavior as a significant concern for children with fragile X syndrome. In the present study, the authors explored whether behaviorally based interventions would result in a reduction in problem behavior and an improvement in quality of life for 3 children with fragile X syndrome and their families. A multiple baseline design was used to demonstrate intervention effects for specific high-priority contexts (i.e., bedtime, running errands, and toileting). A multicomponent intervention plan was developed to teach the parents and child to effectively cope with the particular context. After intervention, there were substantial improvements in problem behavior and family quality of life within the given contexts. Results of this study demonstrated the effectiveness of behavioral intervention for children with fragile X syndrome.

Modern banking, collection, compatibility testing and storage of blood and blood components.

PubMed

Green, L; Allard, S; Cardigan, R

2015-01-01

The clinical practice of blood transfusion has changed considerably over the last few decades. The potential risk of transfusion transmissible diseases has directed efforts towards the production of safe and high quality blood. All transfusion services now operate in an environment of ever-increasing regulatory controls encompassing all aspects of blood collection, processing and storage. Stringent donor selection, identification of pathogens that can be transmitted through blood, and development of technologies that can enhance the quality of blood, have all led to a substantial reduction in potential risks and complications associated with blood transfusion. In this article, we will discuss the current standards required for the manufacture of blood, starting from blood collection, through processing and on to storage. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

Relationship between white spot syndrome virus (WSSV) loads and characterizations of water quality in Litopenaeus vannamei culture ponds during the tropical storm.

PubMed

Zhang, J S; Li, Z J; Wen, G L; Wang, Y L; Luo, L; Zhang, H J; Dong, H B

2016-01-01

An in-situ experiment was conducted to investigate the effect of tropical storm on the white spot syndrome virus (WSSV) loads in Litopenaeus vannamei rearing ponds. White spot syndrome virus loads, heterotrophic bacteria, Vibrio and water quality (including temperature, dissolved oxygen (DO), salinity, pH, NH 4 -N, and NO 2 -N) were continually monitored through one tropical storm. The WSSV loads decreased when tropical storm made landfall, and substantially increased when typhoon passed. The variation of WSSV loads was correlated with DO, temperature, heterotrophic bacteria count, and ammonia-N concentrations. These results suggested that maintaining high level DO and promoting heterotrophic bacteria growth in the shrimp ponds might prevent the diseases' outbreak after the landfall of tropical storm.

Relationship between white spot syndrome virus (WSSV) loads and characterizations of water quality in Litopenaeus vannamei culture ponds during the tropical storm

PubMed Central

Zhang, J. S.; Li, Z. J.; Wen, G. L.; Wang, Y. L.; Luo, L.; Zhang, H. J.; Dong, H. B.

2016-01-01

An in-situ experiment was conducted to investigate the effect of tropical storm on the white spot syndrome virus (WSSV) loads in Litopenaeus vannamei rearing ponds. White spot syndrome virus loads, heterotrophic bacteria, Vibrio and water quality (including temperature, dissolved oxygen (DO), salinity, pH, NH4-N, and NO2-N) were continually monitored through one tropical storm. The WSSV loads decreased when tropical storm made landfall, and substantially increased when typhoon passed. The variation of WSSV loads was correlated with DO, temperature, heterotrophic bacteria count, and ammonia-N concentrations. These results suggested that maintaining high level DO and promoting heterotrophic bacteria growth in the shrimp ponds might prevent the diseases’ outbreak after the landfall of tropical storm. PMID:27822254

Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective.

PubMed

Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn

2017-06-01

The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.

Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective

PubMed Central

Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn

2017-01-01

Aim The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. Methods A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. Results The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Conclusions Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers. PMID:28276780

Evaluation of prospective motion correction of high-resolution 3D-T2-FLAIR acquisitions in epilepsy patients.

PubMed

Vos, Sjoerd B; Micallef, Caroline; Barkhof, Frederik; Hill, Andrea; Winston, Gavin P; Ourselin, Sebastien; Duncan, John S

2018-03-02

T2-FLAIR is the single most sensitive MRI contrast to detect lesions underlying focal epilepsies but 3D sequences used to obtain isotropic high-resolution images are susceptible to motion artefacts. Prospective motion correction (PMC) - demonstrated to improve 3D-T1 image quality in a pediatric population - was applied to high-resolution 3D-T2-FLAIR scans in adult epilepsy patients to evaluate its clinical benefit. Coronal 3D-T2-FLAIR scans were acquired with a 1mm isotropic resolution on a 3T MRI scanner. Two expert neuroradiologists reviewed 40 scans without PMC and 40 with navigator-based PMC. Visual assessment addressed six criteria of image quality (resolution, SNR, WM-GM contrast, intensity homogeneity, lesion conspicuity, diagnostic confidence) on a seven-point Likert scale (from non-diagnostic to outstanding). SNR was also objectively quantified within the white matter. PMC scans had near-identical scores on the criteria of image quality to non-PMC scans, with the notable exception that intensity homogeneity was generally worse. Using PMC, the percentage of scans with bad image quality was substantially lower than without PMC (3.25% vs. 12.5%) on the other five criteria. Quantitative SNR estimates revealed that PMC and non-PMC had no significant difference in SNR (P=0.07). Application of prospective motion correction to 3D-T2-FLAIR sequences decreased the percentage of low-quality scans, reducing the number of scans that need to be repeated to obtain clinically useful data. Copyright © 2018 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Climatic factors directly impact the volatile organic compound fingerprint in green Arabica coffee bean as well as coffee beverage quality.

PubMed

Bertrand, B; Boulanger, R; Dussert, S; Ribeyre, F; Berthiot, L; Descroix, F; Joët, T

2012-12-15

Coffee grown at high elevations fetches a better price than that grown in lowland regions. This study was aimed at determining whether climatic conditions during bean development affected sensory perception of the coffee beverage and combinations of volatile compounds in green coffee. Green coffee samples from 16 plots representative of the broad range of climatic variations in Réunion Island were compared by sensory analysis. Volatiles were extracted by solid phase micro-extraction and the volatile compounds were analysed by GC-MS. The results revealed that, among the climatic factors, the mean air temperature during seed development greatly influenced the sensory profile. Positive quality attributes such as acidity, fruity character and flavour quality were correlated and typical of coffees produced at cool climates. Two volatile compounds (ethanal and acetone) were identified as indicators of these cool temperatures. Among detected volatiles, most of the alcohols, aldehydes, hydrocarbons and ketones appeared to be positively linked to elevated temperatures and high solar radiation, while the sensory profiles displayed major defects (i.e. green, earthy flavour). Two alcohols (butan-1,3-diol and butan-2,3-diol) were closely correlated with a reduction in aromatic quality, acidity and an increase in earthy and green flavours. We assumed that high temperatures induce accumulation of these compounds in green coffee, and would be detected as off-flavours, even after roasting. Climate change, which generally involves a substantial increase in average temperatures in mountainous tropical regions, could be expected to have a negative impact on coffee quality. Copyright © 2012 Elsevier Ltd. All rights reserved.

Variation in Adherence to External Beam Radiotherapy Quality Measures Among Elderly Men With Localized Prostate Cancer

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

Bekelman, Justin E.; Zelefsky, Michael J.; Jang, Thomas L.

2007-12-01

Purpose: To characterize the variation in adherence to quality measures of external beam radiotherapy (EBRT) for localized prostate cancer and its relation to patient and provider characteristics in a population-based, representative sample of U.S. men. Methods and Materials: We evaluated EBRT quality measures proposed by a RAND expert panel of physicians among men aged {>=}65 years diagnosed between 2000 and 2002 with localized prostate cancer and treated with primary EBRT using data from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare program. We assessed the adherence to five EBRT quality measures that were amenable to analysis using SEER-Medicare data: (1)more » use of conformal RT planning; (2) use of high-energy (>10-MV) photons; (3) use of custom immobilization; (4) completion of two follow-up visits with a radiation oncologist in the year after therapy; and (5) radiation oncologist board certification. Results: Of the 11,674 patients, 85% had received conformal RT planning, 75% had received high-energy photons, and 97% had received custom immobilization. One-third of patients had completed two follow-up visits with a radiation oncologist, although 91% had at least one visit with a urologist or radiation oncologist. Most patients (85%) had been treated by a board-certified radiation oncologist. Conclusions: The overall high adherence to EBRT quality measures masked substantial variation in geography, socioeconomic status in the area of residence, and teaching affiliation of the RT facility. Future research should examine the reasons for the variations in these measures and whether the variation is associated with important clinical outcomes.« less

Environmental Setting and Implications on Water Quality, Upper Colorado River Basin, Colorado and Utah

USGS Publications Warehouse

Apodaca, Lori E.; Driver, Nancy E.; Stephens, Verlin C.; Spahr, Norman E.

1995-01-01

The Upper Colorado River Basin in Colorado and Utah is 1 of 60 study units selected for water-quality assessment as part of the U.S. Geological Survey's National Water-Quality Assessment program, which began full implementation in 1991. Understanding the environmental setting of the Upper Colorado River Basin study unit is important in evaluating water-quality issues in the basin. Natural and human factors that affect water quality in the basin are presented, including an overview of the physiography, climatic conditions, general geology and soils, ecoregions, population, land use, water management and use, hydrologic characteristics, and to the extent possible aquatic biology. These factors have substantial implications on water-quality conditions in the basin. For example, high concentrations of dissolved solids and selenium are present in the natural background water conditions of surface and ground water in parts ofthe basin. In addition, mining, urban, and agricultural land and water uses result in the presence of certain constituents in the surface and ground water of the basin that can detrimentally affect water quality. The environmental setting of the study unit provides a framework of the basin characteristics, which is important in the design of integrated studies of surface water, ground water, and biology.

Low cost composite manufacturing utilizing intelligent pultrusion and resin transfer molding (IPRTM)

NASA Astrophysics Data System (ADS)

Bradley, James E.; Wysocki, Tadeusz S., Jr.

1993-02-01

This article describes an innovative method for the economical manufacturing of large, intricately-shaped tubular composite parts. Proprietary intelligent process control techniques are combined with standard pultrusion and RTM methodologies to provide high part throughput, performance, and quality while substantially reducing scrap, rework costs, and labor requirements. On-line process monitoring and control is achieved through a smart tooling interface consisting of modular zone tiles installed on part-specific die assemblies. Real-time archiving of process run parameters provides enhanced SPC and SQC capabilities.

Microstructural Evolution in Intensively Melt Sheared Direct Chill Cast Al-Alloys

NASA Astrophysics Data System (ADS)

Jones, S.; Rao, A. K. Prasada; Patel, J. B.; Scamans, G. M.; Fan, Z.

The work presented here introduces the novel melt conditioned direct chill casting (MC-DC) technology, where intensive melt shearing is applied to the conventional direct-chill casting process. MC-DC casting can successfully produce high quality Al-alloy billets. The results obtained from 80 mm diameter billets cast at speed of 200 mm/min show that MC-DC casting of Al-alloys, substantially refines the microstructure and reduces macro-segregation. In this paper, we present the preliminary results and discuss microstructural evolution during MC-DC casting of Al-alloys.

Association of Maltreatment With High-Risk Internet Behaviors and Offline Encounters

PubMed Central

Shenk, Chad E.; Barnes, Jaclyn E.; Haralson, Katherine J.

2013-01-01

OBJECTIVE: High-risk Internet behaviors, including viewing sexually explicit content, provocative social networking profiles, and entertaining online sexual solicitations, were examined in a sample of maltreated and nonmaltreated adolescent girls aged 14 to 17 years. The impact of Internet behaviors on subsequent offline meetings was observed over 12 to 16 months. This study tested 2 main hypotheses: (1) maltreatment would be a unique contributor to high-risk Internet behaviors and (2) high-quality parenting would dampen adolescents’ propensity to engage in high-risk Internet behaviors and to participate in offline meetings. METHODS: Online and offline behaviors and parenting quality were gleaned from 251 adolescent girls, 130 of whom experienced substantiated maltreatment and 121 of whom were demographically matched comparison girls. Parents reported on adolescent behaviors and on the level of Internet monitoring in the home. Social networking profiles were objectively coded for provocative self-presentations. Offline meetings with persons first met online were assessed 12 to 16 months later. RESULTS: Thirty percent of adolescents reported having offline meetings. Maltreatment, adolescent behavioral problems, and low cognitive ability were uniquely associated with high-risk Internet behaviors. Exposure to sexual content, creating high-risk social networking profiles, and receiving online sexual solicitations were independent predictors of subsequent offline meetings. High-quality parenting and parental monitoring moderated the associations between adolescent risk factors and Internet behaviors, whereas use of parental control software did not. CONCLUSIONS: Treatment modalities for maltreated adolescents should be enhanced to include Internet safety literacy. Adolescents and parents should be aware of how online self-presentations and other Internet behaviors can increase vulnerability for Internet-initiated victimization. PMID:23319522

Association of maltreatment with high-risk internet behaviors and offline encounters.

PubMed

Noll, Jennie G; Shenk, Chad E; Barnes, Jaclyn E; Haralson, Katherine J

2013-02-01

High-risk Internet behaviors, including viewing sexually explicit content, provocative social networking profiles, and entertaining online sexual solicitations, were examined in a sample of maltreated and nonmaltreated adolescent girls aged 14 to 17 years. The impact of Internet behaviors on subsequent offline meetings was observed over 12 to 16 months. This study tested 2 main hypotheses: (1) maltreatment would be a unique contributor to high-risk Internet behaviors and (2) high-quality parenting would dampen adolescents' propensity to engage in high-risk Internet behaviors and to participate in offline meetings. Online and offline behaviors and parenting quality were gleaned from 251 adolescent girls, 130 of whom experienced substantiated maltreatment and 121 of whom were demographically matched comparison girls. Parents reported on adolescent behaviors and on the level of Internet monitoring in the home. Social networking profiles were objectively coded for provocative self-presentations. Offline meetings with persons first met online were assessed 12 to 16 months later. Thirty percent of adolescents reported having offline meetings. Maltreatment, adolescent behavioral problems, and low cognitive ability were uniquely associated with high-risk Internet behaviors. Exposure to sexual content, creating high-risk social networking profiles, and receiving online sexual solicitations were independent predictors of subsequent offline meetings. High-quality parenting and parental monitoring moderated the associations between adolescent risk factors and Internet behaviors, whereas use of parental control software did not. Treatment modalities for maltreated adolescents should be enhanced to include Internet safety literacy. Adolescents and parents should be aware of how online self-presentations and other Internet behaviors can increase vulnerability for Internet-initiated victimization.

Using the SWAT model to improve process descriptions and define hydrologic partitioning in South Korea

NASA Astrophysics Data System (ADS)

Shope, C. L.; Maharjan, G. R.; Tenhunen, J.; Seo, B.; Kim, K.; Riley, J.; Arnhold, S.; Koellner, T.; Ok, Y. S.; Peiffer, S.; Kim, B.; Park, J.-H.; Huwe, B.

2014-02-01

Watershed-scale modeling can be a valuable tool to aid in quantification of water quality and yield; however, several challenges remain. In many watersheds, it is difficult to adequately quantify hydrologic partitioning. Data scarcity is prevalent, accuracy of spatially distributed meteorology is difficult to quantify, forest encroachment and land use issues are common, and surface water and groundwater abstractions substantially modify watershed-based processes. Our objective is to assess the capability of the Soil and Water Assessment Tool (SWAT) model to capture event-based and long-term monsoonal rainfall-runoff processes in complex mountainous terrain. To accomplish this, we developed a unique quality-control, gap-filling algorithm for interpolation of high-frequency meteorological data. We used a novel multi-location, multi-optimization calibration technique to improve estimations of catchment-wide hydrologic partitioning. The interdisciplinary model was calibrated to a unique combination of statistical, hydrologic, and plant growth metrics. Our results indicate scale-dependent sensitivity of hydrologic partitioning and substantial influence of engineered features. The addition of hydrologic and plant growth objective functions identified the importance of culverts in catchment-wide flow distribution. While this study shows the challenges of applying the SWAT model to complex terrain and extreme environments; by incorporating anthropogenic features into modeling scenarios, we can enhance our understanding of the hydroecological impact.

Increased genomic prediction accuracy in wheat breeding using a large Australian panel.

PubMed

Norman, Adam; Taylor, Julian; Tanaka, Emi; Telfer, Paul; Edwards, James; Martinant, Jean-Pierre; Kuchel, Haydn

2017-12-01

Genomic prediction accuracy within a large panel was found to be substantially higher than that previously observed in smaller populations, and also higher than QTL-based prediction. In recent years, genomic selection for wheat breeding has been widely studied, but this has typically been restricted to population sizes under 1000 individuals. To assess its efficacy in germplasm representative of commercial breeding programmes, we used a panel of 10,375 Australian wheat breeding lines to investigate the accuracy of genomic prediction for grain yield, physical grain quality and other physiological traits. To achieve this, the complete panel was phenotyped in a dedicated field trial and genotyped using a custom Axiom TM Affymetrix SNP array. A high-quality consensus map was also constructed, allowing the linkage disequilibrium present in the germplasm to be investigated. Using the complete SNP array, genomic prediction accuracies were found to be substantially higher than those previously observed in smaller populations and also more accurate compared to prediction approaches using a finite number of selected quantitative trait loci. Multi-trait genetic correlations were also assessed at an additive and residual genetic level, identifying a negative genetic correlation between grain yield and protein as well as a positive genetic correlation between grain size and test weight.

A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: Overview

PubMed Central

Cohen, Jeffrey; Stuve, Olaf; Trojano, Maria; Sørensen, Per Soelberg; Reingold, Stephen; Cutter, Gary; Reider, Nadia

2015-01-01

Background: Comorbidity is an area of increasing interest in multiple sclerosis (MS). Objective: The objective of this review is to estimate the incidence and prevalence of comorbidity in people with MS and assess the quality of included studies. Methods: We searched the PubMed, SCOPUS, EMBASE and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles. Two reviewers independently screened abstracts. One reviewer abstracted data using a standardized form and the abstraction was verified by a second reviewer. We assessed study quality using a standardized approach. We quantitatively assessed population-based studies using the I2 statistic, and conducted random-effects meta-analyses. Results: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting findings. Prevalence was reported more frequently than incidence; estimates for prevalence and incidence varied substantially for all conditions. Heterogeneity was high. Conclusion: This review highlights substantial gaps in the epidemiological knowledge of comorbidity in MS worldwide. Little is known about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population. PMID:25623244

A Two-Stage Framework for 3D Face Reconstruction from RGBD Images.

PubMed

Wang, Kangkan; Wang, Xianwang; Pan, Zhigeng; Liu, Kai

2014-08-01

This paper proposes a new approach for 3D face reconstruction with RGBD images from an inexpensive commodity sensor. The challenges we face are: 1) substantial random noise and corruption are present in low-resolution depth maps; and 2) there is high degree of variability in pose and face expression. We develop a novel two-stage algorithm that effectively maps low-quality depth maps to realistic face models. Each stage is targeted toward a certain type of noise. The first stage extracts sparse errors from depth patches through the data-driven local sparse coding, while the second stage smooths noise on the boundaries between patches and reconstructs the global shape by combining local shapes using our template-based surface refinement. Our approach does not require any markers or user interaction. We perform quantitative and qualitative evaluations on both synthetic and real test sets. Experimental results show that the proposed approach is able to produce high-resolution 3D face models with high accuracy, even if inputs are of low quality, and have large variations in viewpoint and face expression.

Efficient expulsion of magnetic flux in superconducting radiofrequency cavities for high Q{sub 0} applications

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

Posen, S., E-mail: sposen@fnal.gov; Checchin, M.; Crawford, A. C.

2016-06-07

Even when cooled through its transition temperature in the presence of an external magnetic field, a superconductor can expel nearly all external magnetic flux. This paper presents an experimental study to identify the parameters that most strongly influence flux trapping in high purity niobium during cooldown. This is critical to the operation of superconducting radiofrequency cavities, in which trapped flux degrades the quality factor and therefore cryogenic efficiency. Flux expulsion was measured on a large survey of 1.3 GHz cavities prepared in various ways. It is shown that both spatial thermal gradient and high temperature treatment are critical to expelling externalmore » magnetic fields, while surface treatment has minimal effect. For the first time, it is shown that a cavity can be converted from poor expulsion behavior to strong expulsion behavior after furnace treatment, resulting in a substantial improvement in quality factor. Microscopic investigations are performed to study the relevant changes in the material from this treatment. Future plans are described to build on this result in order to optimize treatment for future cavities.« less

The Pre-Primary Education Voucher Scheme of Hong Kong: A Promise of Quality Education Provision?

ERIC Educational Resources Information Center

Fung, Chanel Kit-Ho; Lam, Chi-Chung

2008-01-01

The issue of education vouchers has been widely researched as they are seen by many people as an effective strategy for improving the quality of education services. Striving to enhance the quality of the kindergarten education service in Hong Kong, the government of the Hong Kong Special Administrative Region has committed a substantial sum of…

The climate-wildfire-air quality system: interactions and feedbacks across spatial and temporal scales

Treesearch

E. Natasha Stavros; Donald McKenzie; Narasimhan Larkin

2014-01-01

Future climate change and its effects on social and ecological systems present challenges for preserving valued ecosystem services, including local and regional air quality. Wildfire is a major source of air-quality impact in some locations, and a substantial contributor to pollutants of concern, including nitrogen oxides and particulate matter, which are regulated to...

Are Hip-Specific Items Useful in a Quality of Life Questionnaire for Patients with Hip Fractures?

ERIC Educational Resources Information Center

Yao, Kai-Ping Grace; Lee, Hsin-Yi; Tsauo, Jau-Yih

2009-01-01

Researchers measure the significance of hip fracture by the patient's impairment. The patient's quality of life (QOL) is usually also substantially affected. However, there is no specific quality of life (QOL) questionnaire for patients with hip fractures. This study was designed to determine whether adding a new set of specific questions about…

Regulators' Views of Quality in Early Childhood Care and Education Settings in Ireland

ERIC Educational Resources Information Center

Hanafin, Sinéad

2016-01-01

There is a substantial literature on the importance of good-quality early childhood care and education services. There is also, however, some agreement that service quality is a nebulous concept which is difficult to define and therefore difficult to assess. While there is growing literature in the area, the views of one stakeholder group--that of…

Stagnant neonatal mortality and persistent health inequality in middle-income countries: a case study of the Philippines.

PubMed

Kraft, Aleli D; Nguyen, Kim-Huong; Jimenez-Soto, Eliana; Hodge, Andrew

2013-01-01

The probability of survival through childhood continues to be unequal in middle-income countries. This study uses data from the Philippines to assess trends in the prevalence and distribution of child mortality and to evaluate the country's socioeconomic-related child health inequality. Using data from four Demographic and Health Surveys we estimated levels and trends of neonatal, infant, and under-five mortality from 1990 to 2007. Mortality estimates at national and subnational levels were produced using both direct and indirect methods. Concentration indices were computed to measure child health inequality by wealth status. Multivariate regression analyses were used to assess the contribution of interventions and socioeconomic factors to wealth-related inequality. Despite substantial reductions in national under-five and infant mortality rates in the early 1990s, the rates of declines have slowed in recent years and neonatal mortality rates remain stubbornly high. Substantial variations across urban-rural, regional, and wealth equity-markers are evident, and suggest that the gaps between the best and worst performing sub-populations will either be maintained or widen in the future. Of the variables tested, recent wealth-related inequalities are found to be strongly associated with social factors (e.g. maternal education), regional location, and access to health services, such as facility-based delivery. The Philippines has achieved substantial progress towards Millennium Development Goal 4, but this success masks substantial inequalities and stagnating neonatal mortality trends. This analysis supports a focus on health interventions of high quality--that is, not just facility-based delivery, but delivery by trained staff at well-functioning facilities and supported by a strong referral system--to re-start the long term decline in neonatal mortality and to reduce persistent within-country inequalities in child health.

Quantitative estimates of the impact of sensitivity and specificity in mammographic screening in Germany.

PubMed Central

Warmerdam, P G; de Koning, H J; Boer, R; Beemsterboer, P M; Dierks, M L; Swart, E; Robra, B P

1997-01-01

STUDY OBJECTIVE: To estimate quantitatively the impact of the quality of mammographic screening (in terms of sensitivity and specificity) on the effects and costs of nationwide breast cancer screening. DESIGN: Three plausible "quality" scenarios for a biennial breast cancer screening programme for women aged 50-69 in Germany were analysed in terms of costs and effects using the Microsimulation Screening Analysis model on breast cancer screening and the natural history of breast cancer. Firstly, sensitivity and specificity in the expected situation (or "baseline" scenario) were estimated from a model based analysis of empirical data from 35,000 screening examinations in two German pilot projects. In the second "high quality" scenario, these properties were based on the more favourable diagnostic results from breast cancer screening projects and the nationwide programme in The Netherlands. Thirdly, a worst case, "low quality" hypothetical scenario with a 25% lower sensitivity than that experienced in The Netherlands was analysed. SETTING: The epidemiological and social situation in Germany in relation to mass screening for breast cancer. RESULTS: In the "baseline" scenario, an 11% reduction in breast cancer mortality was expected in the total German female population, ie 2100 breast cancer deaths would be prevented per year. It was estimated that the "high quality" scenario, based on Dutch experience, would lead to the prevention of an additional 200 deaths per year and would also cut the number of false positive biopsy results by half. The cost per life year gained varied from Deutsche mark (DM) 15,000 on the "high quality" scenario to DM 21,000 in the "low quality" setting. CONCLUSIONS: Up to 20% of the total costs of a screening programme can be spent on quality improvement in order to achieve a substantially higher reduction in mortality and reduce undesirable side effects while retaining the same cost effectiveness ratio as that estimated from the German data. PMID:9196649

Applications of the chemical oxygen-iodine laser

NASA Astrophysics Data System (ADS)

Latham, W. Pete; Kendrick, Kip R.; Quillen, Brian

2000-01-01

The Chemical Oxygen-Iodine Laser (COIL) has been developed at the Air Force Research Laboratory for military applications. For example, the COIL is to be use as the laser device for the ABL. A high power laser is useful for applications that require the delivery of a substantial amount of energy to a very small focused laser spot. The COIL is a member of the class of high power lasers that are also useful for industrial applications, including the materials processing task of high speed cutting and drilling. COIL technology has received considerable interest over the last several years due to its short, fiber- deliverable wavelength, scalability to very high powers, and demonstrated nearly diffraction-limited optical quality. These unique abilities make it an ideal candidate for nuclear reactor decommissioning and nuclear warhead dismantlement. Japanese researchers envision using a COIL for disaster cleanup and survivor rescue. It is also being studied by the oil and gas industry for well drilling. Any commercial or industrial application that requires very rapid, precise, and noninvasive cutting or drilling, could be readily accomplished with a COIL. Because of the substantial power levels available with a COIL, the laser could also be used for broad area applications such as paint stripping. This paper includes a collection of experiments accomplished at the Air Force Research Laboratory Chemical Laser Facility, including metal cutting, hole drilling, high power fiber optic transmission, and rock crushing.

PREDICTING CHLORINE RESIDUAL LOSSES IN UNLINED METALIC PIPES

EPA Science Inventory

There is substantial evidence that as water moves through a water distribution system its quality can deteriorate through interactions between the bulk phase and the pipe wall. One of the most serious aspects of water quality deterioration, in a network, is the loss of disinfect...

MEASURING & MODELING VARIATIONS IN DISTRIBUTION WATER QUALITY

EPA Science Inventory

Until recently most interest in drinking water quality has been in the finished water as it leaves the treatment plant. he Safe Drinking Water requires that MCLs be met at the consumers tap. ecause finished water may undergo substantial changes while being transported through the...

Methodological aspects of clinical trials in tinnitus: A proposal for an international standard

PubMed Central

Landgrebe, Michael; Azevedo, Andréia; Baguley, David; Bauer, Carol; Cacace, Anthony; Coelho, Claudia; Dornhoffer, John; Figueiredo, Ricardo; Flor, Herta; Hajak, Goeran; van de Heyning, Paul; Hiller, Wolfgang; Khedr, Eman; Kleinjung, Tobias; Koller, Michael; Lainez, Jose Miguel; Londero, Alain; Martin, William H.; Mennemeier, Mark; Piccirillo, Jay; De Ridder, Dirk; Rupprecht, Rainer; Searchfield, Grant; Vanneste, Sven; Zeman, Florian; Langguth, Berthold

2013-01-01

Chronic tinnitus is a common condition with a high burden of disease. While many different treatments are used in clinical practice, the evidence for the efficacy of these treatments is low and the variance of treatment response between individuals is high. This is most likely due to the great heterogeneity of tinnitus with respect to clinical features as well as underlying pathophysiological mechanisms. There is a clear need to find effective treatment options in tinnitus, however, clinical trials differ substantially with respect to methodological quality and design. Consequently, the conclusions that can be derived from these studies are limited and jeopardize comparison between studies. Here, we discuss our view of the most important aspects of trial design in clinical studies in tinnitus and make suggestions for an international methodological standard in tinnitus trials. We hope that the proposed methodological standard will stimulate scientific discussion and will help to improve the quality of trials in tinnitus. PMID:22789414

The high-quality draft genome of peach (Prunus persica) identifies unique patterns of genetic diversity, domestication and genome evolution.

PubMed

Verde, Ignazio; Abbott, Albert G; Scalabrin, Simone; Jung, Sook; Shu, Shengqiang; Marroni, Fabio; Zhebentyayeva, Tatyana; Dettori, Maria Teresa; Grimwood, Jane; Cattonaro, Federica; Zuccolo, Andrea; Rossini, Laura; Jenkins, Jerry; Vendramin, Elisa; Meisel, Lee A; Decroocq, Veronique; Sosinski, Bryon; Prochnik, Simon; Mitros, Therese; Policriti, Alberto; Cipriani, Guido; Dondini, Luca; Ficklin, Stephen; Goodstein, David M; Xuan, Pengfei; Del Fabbro, Cristian; Aramini, Valeria; Copetti, Dario; Gonzalez, Susana; Horner, David S; Falchi, Rachele; Lucas, Susan; Mica, Erica; Maldonado, Jonathan; Lazzari, Barbara; Bielenberg, Douglas; Pirona, Raul; Miculan, Mara; Barakat, Abdelali; Testolin, Raffaele; Stella, Alessandra; Tartarini, Stefano; Tonutti, Pietro; Arús, Pere; Orellana, Ariel; Wells, Christina; Main, Dorrie; Vizzotto, Giannina; Silva, Herman; Salamini, Francesco; Schmutz, Jeremy; Morgante, Michele; Rokhsar, Daniel S

2013-05-01

Rosaceae is the most important fruit-producing clade, and its key commercially relevant genera (Fragaria, Rosa, Rubus and Prunus) show broadly diverse growth habits, fruit types and compact diploid genomes. Peach, a diploid Prunus species, is one of the best genetically characterized deciduous trees. Here we describe the high-quality genome sequence of peach obtained from a completely homozygous genotype. We obtained a complete chromosome-scale assembly using Sanger whole-genome shotgun methods. We predicted 27,852 protein-coding genes, as well as noncoding RNAs. We investigated the path of peach domestication through whole-genome resequencing of 14 Prunus accessions. The analyses suggest major genetic bottlenecks that have substantially shaped peach genome diversity. Furthermore, comparative analyses showed that peach has not undergone recent whole-genome duplication, and even though the ancestral triplicated blocks in peach are fragmentary compared to those in grape, all seven paleosets of paralogs from the putative paleoancestor are detectable.

Introducing INSPIRE: an implementation research collaboration between the Department of Foreign Affairs, Trade and Development Canada and the World Health Organization.

PubMed

Blais, Pierre; Hirnschall, Gottfried; Mason, Elizabeth; Shaffer, Nathan; Lipa, Zuzanna; Baller, April; Rollins, Nigel

2014-11-01

The government of Canada, through the Department of Foreign Affairs, Trade and Development (DFATD) has supported global efforts to reduce the impact of the HIV pandemic. In 2012, WHO and DFATD launched an implementation research initiative to increase access to interventions that were known to be effective in the prevention of mother-to-child transmission of HIV and to learn how these could be successfully integrated with other essential services for mothers and children. In addition to facilitating the implementation research projects, DFATD and WHO promoted four approaches: (1) Country-specific implementation research prioritization exercises, (2) Ministry of Health involvement, (3) Country-led, innovative, high-quality research, and (4) Leveraging regional networks and learning opportunities. While no single aspect of INSPIRE is unique, the process endeavors to promote and support high-quality, rigorous, locally-led implementation research that will have a substantial impact on the health and survival of HIV-infected women and their children.

The effects of socioeconomic status on stroke risk and outcomes.

PubMed

Marshall, Iain J; Wang, Yanzhong; Crichton, Siobhan; McKevitt, Christopher; Rudd, Anthony G; Wolfe, Charles D A

2015-12-01

The latest evidence on socioeconomic status and stroke shows that stroke not only disproportionately affects low-income and middle-income countries, but also socioeconomically deprived populations within high-income countries. These disparities are reflected not only in risk of stroke but also in short-term and long-term outcomes after stroke. Increased average levels of conventional risk factors (eg, hypertension, hyperlipidaemia, excessive alcohol intake, smoking, obesity, and sedentary lifestyle) in populations with low socioeconomic status account for about half of these effects. In many countries, evidence shows that people with lower socioeconomic status are less likely to receive good-quality acute hospital and rehabilitation care than people with higher socioeconomic status. For clinical practice, better implementation of well established treatments, effective management of risk factors, and equity of access to high-quality acute stroke care and rehabilitation will probably reduce inequality substantially. Overcoming barriers and adapting evidence-based interventions to different countries and health-care settings remains a research priority. Copyright © 2015 Elsevier Ltd. All rights reserved.

Correlation of neonatal intensive care unit performance across multiple measures of quality of care.

PubMed

Profit, Jochen; Zupancic, John A F; Gould, Jeffrey B; Pietz, Kenneth; Kowalkowski, Marc A; Draper, David; Hysong, Sylvia J; Petersen, Laura A

2013-01-01

To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Twenty-two regional NICUs in California. In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Pneumothorax, growth velocity, health care-associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations, 6 were significant (ρ < .05). Correlations between pairs of measures of quality of care were strong (ρ ≥ .5) for 1 pair, moderate (range, ρ ≥ .3 to ρ < .5) for 8 pairs, weak (range, ρ ≥ .1 to ρ < .3) for 5 pairs, and negligible (ρ < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care-associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest.

Correlation of Neonatal Intensive Care Unit Performance Across Multiple Measures of Quality of Care

PubMed Central

Profit, J; Zupancic, JAF; Gould, JB; Pietz, K; Kowalkowski, MA; Draper, D; Hysong, SJ; Petersen, LA

2014-01-01

Objectives To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. Design We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Setting Twenty-two regional NICUs in California. Patients In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Main Outcomes Measures Pneumothorax, growth velocity, health care–associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. Results The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations only 6 were significant (P < .05). Correlations between pairs of quality measures were strong (ρ > .5) for 1 pair, moderate (.3 < |ρ| < .5) for 8 pairs, weak (.1 < |ρ| < .3) for 5 pairs and negligible (|ρ| < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care–associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. Conclusion In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest. PMID:23403539

Quantity and quality benefits of in-service invasive cleaning of trunk mains

NASA Astrophysics Data System (ADS)

Sunny, Iftekhar; Husband, Stewart; Drake, Nick; Mckenzie, Kevan; Boxall, Joby

2017-07-01

Trunk mains are high risk critical infrastructure where poor performance can impact on large numbers of customers. Both quantity (e.g. hydraulic capacity) and quality (e.g. discolouration) of trunk main performance are affected by asset deterioration in the form of particle accumulation at the pipe wall. Trunk main cleaning techniques are therefore desirable to remove such material. However, little is quantified regarding the efficacy of different maintenance interventions or longer-term changes following such cleaning. This paper presents an assessment of quantity and quality performance of a trunk main system pre, post and for 12 months following cleaning using pigging with ice slurry. Hydraulic calibration showed a 7 times roughness height reduction after ice slurry pigging, evidencing substantially improved hydraulic capacity and reduced headloss. Turbidity response due to carefully imposed shear stress increase remained significant after the cleaning intervention, showing that relatively loose material had not been fully removed from the pipe wall. Overall the results demonstrate that cleaning by pigging with ice slurry can be beneficial for quantity performance, but care and further assessment may be necessary to realise the full quality benefits.

Cladophora in the Great Lakes: impacts on beach water quality and human health.

PubMed

Verhougstraete, M P; Byappanahalli, M N; Rose, J B; Whitman, R L

2010-01-01

Cladophora in the Great Lakes grows rapidly during the warm summer months, detaches, and becomes free-floating mats as a result of environmental conditions, eventually becoming stranded on recreational beaches. Cladophora provides protection and nutrients, which allow enteric bacteria such as Escherichia coli, enterococci, Shigella, Campylobacter, and Salmonella to persist and potentially regrow in the presence of the algae. As a result of wind and wave action, these microorganisms can detach and be released to surrounding waters and can influence water quality. Enteric bacterial pathogens have been detected in Cladophora mats; E. coli and enterococci may populate to become part of the naturalized microbiota in Cladophora; the high densities of these bacteria may affect water quality, resulting in unnecessary beach closures. The continued use of traditional fecal indicators at beaches with Cladophora presence is inadequate at accurately predicting the presence of fecal contamination. This paper offers a substantial review of available literature to improve the knowledge of Cladophora impacts on water quality, recreational water monitoring, fecal indicator bacteria and microorganisms, and public health and policy.

Cladophora in the Great Lakes: Impacts on beach water quality and human health

USGS Publications Warehouse

Verhougstraete, M.P.; Byappanahalli, Muruleedhara N.; Rose, J.B.; Whitman, Richard L.

2010-01-01

Cladophora in the Great Lakes grows rapidly during the warm summer months, detaches, and becomes free-floating mats as a result of environmental conditions, eventually becoming stranded on recreational beaches. Cladophora provides protection and nutrients, which allow enteric bacteria such as Escherichia coli, enterococci, Shigella, Campylobacter, and Salmonella to persist and potentially regrow in the presence of the algae. As a result of wind and wave action, these microorganisms can detach and be released to surrounding waters and can influence water quality. Enteric bacterial pathogens have been detected in Cladophora mats; E. coli and enterococci may populate to become part of the naturalized microbiota in Cladophora; the high densities of these bacteria may affect water quality, resulting in unnecessary beach closures. The continued use of traditional fecal indicators at beaches with Cladophora presence is inadequate at accurately predicting the presence of fecal contamination. This paper offers a substantial review of available literature to improve the knowledge of Cladophora impacts on water quality, recreational water monitoring, fecal indicator bacteria and microorganisms, and public health and policy.

Scater: pre-processing, quality control, normalization and visualization of single-cell RNA-seq data in R.

PubMed

McCarthy, Davis J; Campbell, Kieran R; Lun, Aaron T L; Wills, Quin F

2017-04-15

Single-cell RNA sequencing (scRNA-seq) is increasingly used to study gene expression at the level of individual cells. However, preparing raw sequence data for further analysis is not a straightforward process. Biases, artifacts and other sources of unwanted variation are present in the data, requiring substantial time and effort to be spent on pre-processing, quality control (QC) and normalization. We have developed the R/Bioconductor package scater to facilitate rigorous pre-processing, quality control, normalization and visualization of scRNA-seq data. The package provides a convenient, flexible workflow to process raw sequencing reads into a high-quality expression dataset ready for downstream analysis. scater provides a rich suite of plotting tools for single-cell data and a flexible data structure that is compatible with existing tools and can be used as infrastructure for future software development. The open-source code, along with installation instructions, vignettes and case studies, is available through Bioconductor at http://bioconductor.org/packages/scater . davis@ebi.ac.uk. Supplementary data are available at Bioinformatics online. © The Author 2017. Published by Oxford University Press.

The medical director and quality requirements in the dialysis facility.

PubMed

Schiller, Brigitte

2015-03-06

Four decades after the successful implementation of the ESRD program currently providing life-saving dialysis therapy to >430,000 patients, the definitions of and demands for a high-quality program have evolved and increased at the same time. Through substantial technological advances ESRD care improved, with a predominant focus on the technical aspects of care and the introduction of medications such as erythropoiesis-stimulating agents and active vitamin D for anemia and bone disease management. Despite many advances, the size of the program and the increasingly older and multimorbid patient population have contributed to continuing challenges for providing consistently high-quality care. Medicare's Final Rule of the Conditions for Coverage (April 2008) define the medical director of the dialysis center as the leader of the interdisciplinary team and the person ultimately accountable for quality, safety, and care provided in the center. Knowledge and active leadership with a hands-on approach in the quality assessment and performance improvement process (QAPI) is essential for the achievement of high-quality outcomes in dialysis centers. A collaborative approach between the dialysis provider and medical director is required to optimize outcomes and deliver evidence-based quality care. In 2011 the Centers for Medicare & Medicaid Services introduced a pay-for-performance program-the ESRD quality incentive program (QIP)- with yearly varying quality metrics that result in payment reductions in subsequent years when targets are not achieved during the performance period. Success with the QIP requires a clear understanding of the structure, metrics, and scoring methods. Information on achievement and nonachievement is publicly available, both in facilities (through the facility performance score card) and on public websites (including Medicare's Dialysis Facility Compare). By assuming the leadership role in the quality program of dialysis facilities, the medical director is given an important opportunity to improve patients' lives and effect true change in a patient population dealing with a very challenging chronic disease. This article in the series on the role of the medical director summarizes the medical director's specific role in the quality improvement process in the dialysis facility and the associated requirements and programs, including QAPI and QIP. Copyright © 2015 by the American Society of Nephrology.

Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries

PubMed Central

Bain, Rob ES; Wright, Jim A; Yang, Hong; Pedley, Steve; Bartram, Jamie K

2012-01-01

Abstract Objective To determine how data on water source quality affect assessments of progress towards the 2015 Millennium Development Goal (MDG) target on access to safe drinking-water. Methods Data from five countries on whether drinking-water sources complied with World Health Organization water quality guidelines on contamination with thermotolerant coliform bacteria, arsenic, fluoride and nitrates in 2004 and 2005 were obtained from the Rapid Assessment of Drinking-Water Quality project. These data were used to adjust estimates of the proportion of the population with access to safe drinking-water at the MDG baseline in 1990 and in 2008 made by the Joint Monitoring Programme for Water Supply and Sanitation, which classified all improved sources as safe. Findings Taking account of data on water source quality resulted in substantially lower estimates of the percentage of the population with access to safe drinking-water in 2008 in four of the five study countries: the absolute reduction was 11% in Ethiopia, 16% in Nicaragua, 15% in Nigeria and 7% in Tajikistan. There was only a slight reduction in Jordan. Microbial contamination was more common than chemical contamination. Conclusion The criterion used by the MDG indicator to determine whether a water source is safe can lead to substantial overestimates of the population with access to safe drinking-water and, consequently, also overestimates the progress made towards the 2015 MDG target. Monitoring drinking-water supplies by recording both access to water sources and their safety would be a substantial improvement. PMID:22461718

ProSens: integrated production control by automated inspection planning and efficient multisensor metrology

NASA Astrophysics Data System (ADS)

Glaser, Ulf; Li, Zhichao; Bichmann, Stephan, II; Pfeifer, Tilo

2003-05-01

By China's entry into the WTO, Chinese as well as German companies are facing the question, how to minimize the risk of unfamiliar cooperation partners when developing products. The rise of customer demands concerning quality, product diversity and the reduction of expenses require flexibility and efficiency with reliable component suppliers. In order to build and strengthen sino-german cooperations, a manufacturing control using homogenized and efficient measures to assure high quality is of vital importance. Lack of unifications may cause identical measurements conducted at subcontractors or customers to be carried out with different measurement processes which leads to incomparable results. Rapidly growing company cooperations and simultaneously decreasing of manufacturing scope cause substantial difficulties when coordinating joint quality control activities. "ProSens," a sino-german project consortium consisting of industrial users, technology producers and research institutes, aims at improving selected production processes by: Creation of a homogeneous quality awareness in sino-german cooperations. Sensitization for process accompanying metrology at an early stage of product development. Increase of the process performance by the use of integrated metrology. Reduction of production time and cost. Unification of quality control of complex products by means of efficient measurement strategies and CAD-based inspection planning.

Impact of fuel quality regulation and speed reductions on shipping emissions: implications for climate and air quality.

PubMed

Lack, Daniel A; Cappa, Christopher D; Langridge, Justin; Bahreini, Roya; Buffaloe, Gina; Brock, Charles; Cerully, Kate; Coffman, Derek; Hayden, Katherine; Holloway, John; Lerner, Brian; Massoli, Paola; Li, Shao-Meng; McLaren, Robert; Middlebrook, Ann M; Moore, Richard; Nenes, Athanasios; Nuaaman, Ibraheem; Onasch, Timothy B; Peischl, Jeff; Perring, Anne; Quinn, Patricia K; Ryerson, Tom; Schwartz, Joshua P; Spackman, Ryan; Wofsy, Steven C; Worsnop, Doug; Xiang, Bin; Williams, Eric

2011-10-15

Atmospheric emissions of gas and particulate matter from a large ocean-going container vessel were sampled as it slowed and switched from high-sulfur to low-sulfur fuel as it transited into regulated coastal waters of California. Reduction in emission factors (EFs) of sulfur dioxide (SO₂), particulate matter, particulate sulfate and cloud condensation nuclei were substantial (≥ 90%). EFs for particulate organic matter decreased by 70%. Black carbon (BC) EFs were reduced by 41%. When the measured emission reductions, brought about by compliance with the California fuel quality regulation and participation in the vessel speed reduction (VSR) program, are placed in a broader context, warming from reductions in the indirect effect of SO₄ would dominate any radiative changes due to the emissions changes. Within regulated waters absolute emission reductions exceed 88% for almost all measured gas and particle phase species. The analysis presented provides direct estimations of the emissions reductions that can be realized by California fuel quality regulation and VSR program, in addition to providing new information relevant to potential health and climate impact of reduced fuel sulfur content, fuel quality and vessel speed reductions.

Separation of pigment formulations by high-performance thin-layer chromatography with automated multiple development.

PubMed

Stiefel, Constanze; Dietzel, Sylvia; Endress, Marc; Morlock, Gertrud E

2016-09-02

Food packaging is designed to provide sufficient protection for the respective filling, legally binding information for the consumers like nutritional facts or filling information, and an attractive appearance to promote the sale. For quality and safety of the package, a regular quality control of the used printing materials is necessary to get consistently good print results, to avoid migration of undesired ink components into the food and to identify potentially faulty ink batches. Analytical approaches, however, have hardly been considered for quality assurance so far due to the lack of robust, suitable methods for the analysis of rarely soluble pigment formulations. Thus, a simple and generic high-performance thin-layer chromatography (HPTLC) method for the separation of different colored pigment formulations was developed on HPTLC plates silica gel 60 by automated multiple development. The gradient system provided a sharp resolution for differently soluble pigment constituents like additives and coating materials. The results of multi-detection allowed a first assignment of the differently detectable bands to particular chemical substance classes (e.g., lipophilic components), enabled the comparison of different commercially available pigment batches and revealed substantial variations in the composition of the batches. Hyphenation of HPTLC with high resolution mass spectrometry and infrared spectroscopy allowed the characterization of single unknown pigment constituents, which may partly be responsible for known quality problems during printing. The newly developed, precise and selective HPTLC method can be used as part of routine quality control for both, incoming pigment batches and monitoring of internal pigment production processes, to secure a consistent pigment composition resulting in consistent ink quality, a faultless print image and safe products. Hyphenation of HPTLC with the A. fischeri bioassay gave first information on the bioactivity or rather on the toxicological potential of different compounds of the pigment formulations. The results of the bioassay might be helpful to choose pigment compositions that provide both, a high printing quality but at the same time guarantee a high consumer safety, especially in regard to smaller pigment components, which tend to migrate through the packaging. Copyright © 2016 Elsevier B.V. All rights reserved.

High resolution T2(*)-weighted Magnetic Resonance Imaging at 3 Tesla using PROPELLER-EPI.

PubMed

Krämer, Martin; Reichenbach, Jürgen R

2014-05-01

We report the application of PROPELLER-EPI for high resolution T2(*)-weighted imaging with sub-millimeter in-plane resolution on a clinical 3 Tesla scanner. Periodically rotated blades of a long-axis PROPELLER-EPI sequence were acquired with fast gradient echo readout and acquisition matrix of 320 × 50 per blade. Images were reconstructed by using 2D-gridding, phase and geometric distortion correction and compensation of resonance frequency drifts that occurred during extended measurements. To characterize these resonance frequency offsets, short FID calibration measurements were added to the PROPELLER-EPI sequence. Functional PROPELLER-EPI was performed with volunteers using a simple block design of right handed finger tapping. Results indicate that PROPELLER-EPI can be employed for fast, high resolution T2(*)-weighted imaging provided geometric distortions and possible resonance frequency drifts are properly corrected. Even small resonance frequency drifts below 10 Hz as well as non-corrected geometric distortions degraded image quality substantially. In the initial fMRI experiment image quality and signal-to-noise ratio was sufficient for obtaining high resolution functional activation maps. Copyright © 2014. Published by Elsevier GmbH.

How bio-questionable are the different recombinant human erythropoietin copy products in Thailand?

PubMed

Halim, Liem Andhyk; Brinks, Vera; Jiskoot, Wim; Romeijn, Stefan; Praditpornsilpa, Kearkiat; Assawamakin, Anunchai; Schellekens, Huub

2014-05-01

The high prevalence of pure red cell aplasia in Thailand has been associated with the sharp increase in number of recombinant human erythropoietin (rhEPO) copy products, based on a classical generic regulatory pathway, which have entered the market. This study aims to assess the quality of rhEPO copy products being used in Thailand. Twelve rhEPO copy products were purchased from pharmacies in Thailand, shipped under controlled cold chain conditions to the Netherlands and characterized using (1) high performance size-exclusion chromatography, (2) asymmetrical flow field-flow fractionation, (3) sodium dodecyl sulfate polyacrylamide gel electrophoresis in combination with (4) Western blotting and additionally tested for (5) host cell protein impurities as well as (6) endotoxin contamination. Some of the tested rhEPO copy products showed high aggregate levels and contained a substantial amount of protein fragments. Also, one of rhEPO copy products had a high endotoxin level, exceeding the FDA limit. Our observations show that some of the tested copy products on the Thai market differ significantly from the originator rhEPO product, Epogen®. This comparison study supports a link between the quality attributes of copy rhEPO products and their immunogenicity.

A high-quality high-fidelity visualization of the September 11 attack on the World Trade Center.

PubMed

Rosen, Paul; Popescu, Voicu; Hoffmann, Christoph; Irfanoglu, Ayhan

2008-01-01

In this application paper, we describe the efforts of a multidisciplinary team towards producing a visualization of the September 11 Attack on the North Tower of New York's World Trade Center. The visualization was designed to meet two requirements. First, the visualization had to depict the impact with high fidelity, by closely following the laws of physics. Second, the visualization had to be eloquent to a nonexpert user. This was achieved by first designing and computing a finite-element analysis (FEA) simulation of the impact between the aircraft and the top 20 stories of the building, and then by visualizing the FEA results with a state-of-the-art commercial animation system. The visualization was enabled by an automatic translator that converts the simulation data into an animation system 3D scene. We built upon a previously developed translator. The translator was substantially extended to enable and control visualization of fire and of disintegrating elements, to better scale with the number of nodes and number of states, to handle beam elements with complex profiles, and to handle smoothed particle hydrodynamics liquid representation. The resulting translator is a powerful automatic and scalable tool for high-quality visualization of FEA results.

PREDICTING CHLORINE RESIDUAL LOSSES IN UNLINED METALLIC PIPES (PRESENTATION)

EPA Science Inventory

There is substantial evidence that as water moves through a water distribution system its quality can deteriorate through interactions between the bulk phase and the pipe wall. One of the most serious aspects of water quality deterioration, in a network, is the loss of disinfecta...

PREDICTING CHLORINE RESIDUAL LOSSES IN UNLINED METALLIC PIPES (POSTER)

EPA Science Inventory

There is substantial evidence that as water moves through a water distribution system its quality can deteriorate through interactions between the bulk phase and the pipe wall. One of the most serious aspects of water quality deterioration, in a network, is the loss of disinfect...

Validation of FAA's emissions and dispersion modeling system (EDMS): carbon monoxide study

DOT National Transportation Integrated Search

2003-06-22

Air quality at airports has received substantial attention in recent years. In a 2000 report : by the U.S. General Accounting Office (GAO), air quality was cited as the number two : environmental concern (after noise) by the 50 busiest airports in th...

Imaging quality evaluation method of pixel coupled electro-optical imaging system

NASA Astrophysics Data System (ADS)

He, Xu; Yuan, Li; Jin, Chunqi; Zhang, Xiaohui

2017-09-01

With advancements in high-resolution imaging optical fiber bundle fabrication technology, traditional photoelectric imaging system have become ;flexible; with greatly reduced volume and weight. However, traditional image quality evaluation models are limited by the coupling discrete sampling effect of fiber-optic image bundles and charge-coupled device (CCD) pixels. This limitation substantially complicates the design, optimization, assembly, and evaluation image quality of the coupled discrete sampling imaging system. Based on the transfer process of grayscale cosine distribution optical signal in the fiber-optic image bundle and CCD, a mathematical model of coupled modulation transfer function (coupled-MTF) is established. This model can be used as a basis for following studies on the convergence and periodically oscillating characteristics of the function. We also propose the concept of the average coupled-MTF, which is consistent with the definition of traditional MTF. Based on this concept, the relationships among core distance, core layer radius, and average coupled-MTF are investigated.

Evaluating Land-Atmosphere Interactions with the North American Soil Moisture Database

NASA Astrophysics Data System (ADS)

Giles, S. M.; Quiring, S. M.; Ford, T.; Chavez, N.; Galvan, J.

2015-12-01

The North American Soil Moisture Database (NASMD) is a high-quality observational soil moisture database that was developed to study land-atmosphere interactions. It includes over 1,800 monitoring stations the United States, Canada and Mexico. Soil moisture data are collected from multiple sources, quality controlled and integrated into an online database (soilmoisture.tamu.edu). The period of record varies substantially and only a few of these stations have an observation record extending back into the 1990s. Daily soil moisture observations have been quality controlled using the North American Soil Moisture Database QAQC algorithm. The database is designed to facilitate observationally-driven investigations of land-atmosphere interactions, validation of the accuracy of soil moisture simulations in global land surface models, satellite calibration/validation for SMOS and SMAP, and an improved understanding of how soil moisture influences climate on seasonal to interannual timescales. This paper provides some examples of how the NASMD has been utilized to enhance understanding of land-atmosphere interactions in the U.S. Great Plains.

Stream water temperature limits occupancy of salamanders in mid-Atlantic protected areas

USGS Publications Warehouse

Grant, Evan H. Campbell; Wiewel, Amber N. M.; Rice, Karen C.

2014-01-01

Stream ecosystems are particularly sensitive to urbanization, and tolerance of water-quality parameters is likely important to population persistence of stream salamanders. Forecasted climate and landscape changes may lead to significant changes in stream flow, chemical composition, and temperatures in coming decades. Protected areas where landscape alterations are minimized will therefore become increasingly important for salamander populations. We surveyed 29 streams at three national parks in the highly urbanized greater metropolitan area of Washington, DC. We investigated relationships among water-quality variables and occupancy of three species of stream salamanders (Desmognathus fuscus, Eurycea bislineata, and Pseudotriton ruber). With the use of a set of site-occupancy models, and accounting for imperfect detection, we found that stream-water temperature limits salamander occupancy. There was substantial uncertainty about the effects of the other water-quality variables, although both specific conductance (SC) and pH were included in competitive models. Our estimates of occupancy suggest that temperature, SC, and pH have some importance in structuring stream salamander distribution.

Education of eye health professionals to meet the needs of the Pacific.

PubMed

du Toit, Renee; Brian, Garry; Palagyi, Anna; Williams, Carmel; Ramke, Jacqueline

2009-03-13

Vision impairment has significant impact on quality of life and substantial economic consequences. Yet, in the Pacific Islands, as in other low resource settings, it is predominantly caused by chronic conditions that can be treated or prevented. A whole of health approach is required to rectify this, and must include an increase in workforce capacity, both in size and effectiveness, by providing competency-based education for eye care professionals. Training in curative clinical skills is not sufficient: broader competencies--including those for chronic conditions, issues of care quality, integration into the wider health care system, and commitment to professionalism and life-long learning--need to be addressed. Using current best practice approaches in education, and taking into consideration local needs, The Pacific Eye Institute, an initiative of The Fred Hollows Foundation New Zealand, aims to produce graduates with these core competencies who are capable of effectively and acceptably working in community or hospital settings to provide sustainable high quality, comprehensive eye care with ongoing desirable and consistent eye health outcomes.

The application of quantitative methods for identifying and exploring the presence of bias in systematic reviews: PDE-5 inhibitors for erectile dysfunction.

PubMed

Bekkering, G E; Abou-Setta, A M; Kleijnen, J

2008-01-01

A systematic review of PDE-5 inhibitors for erectile dysfunction was performed to evaluate the utility of quantitative methods for identifying and exploring the influence of bias and study quality on pooled outcomes from meta-analyses. We included 123 randomized controlled trials (RCTs). Methodological quality was poorly reported. All three drugs appeared highly effective. Indirect adjusted analyses showed no differences between the three drugs. Funnel plots and statistical tests showed no evidence of small-study effects for sildenafil whereas there was evidence of such bias for tadalafil and vardenafil. Adjustment for missing studies using trim and fill techniques did not alter the pooled estimates substantially. The exclusion of previous sildenafil nonresponders was associated with larger treatment effects for tadalafil. This investigation was hampered by poor reporting of methodological quality, a low number of studies, heterogeneity and large effect sizes. Despite such limitations, a comprehensive assessment of biases should be a routine in systematic reviews.

The Current Status of Islet Transplantation and its Perspectives

PubMed Central

Kobayashi, Naoya

2008-01-01

Transplantation of human pancreatic isolated islets can restore beta-cell function but it requires chronic immunosuppression. The outcome of islet transplantation mainly depends on both the quality of islet preparations, and the survival of the graft. The quality of islet preparations can be evaluated by the results of isolation, which determines the chance to achieve insulin independence. The survival of islet grafts is reflected by the amount of engrafted functional tissue that maintains metabolic control. Immunosuppressive therapy prevents the immunological rejection of grafts, but impairs their function and impedes their regenerative capacity. Therefore, the selection of high quality islet preparations and the reduction of toxic effects of immunosuppressive regimens might dramatically improve the outcomes. The application of stem cell therapy in islet transplantation may contribute to a better understanding of the mechanisms responsible for tissue homeostasis and immune tolerance. Xenogeneic islets may serve as an unlimited source if immune tolerance can be achieved. This may be a strategy to enable a substantial improvement in function while overcoming potentially deleterious risks. PMID:19099085

Fault Tree Analysis.

PubMed

McElroy, Lisa M; Khorzad, Rebeca; Rowe, Theresa A; Abecassis, Zachary A; Apley, Daniel W; Barnard, Cynthia; Holl, Jane L

The purpose of this study was to use fault tree analysis to evaluate the adequacy of quality reporting programs in identifying root causes of postoperative bloodstream infection (BSI). A systematic review of the literature was used to construct a fault tree to evaluate 3 postoperative BSI reporting programs: National Surgical Quality Improvement Program (NSQIP), Centers for Medicare and Medicaid Services (CMS), and The Joint Commission (JC). The literature review revealed 699 eligible publications, 90 of which were used to create the fault tree containing 105 faults. A total of 14 identified faults are currently mandated for reporting to NSQIP, 5 to CMS, and 3 to JC; 2 or more programs require 4 identified faults. The fault tree identifies numerous contributing faults to postoperative BSI and reveals substantial variation in the requirements and ability of national quality data reporting programs to capture these potential faults. Efforts to prevent postoperative BSI require more comprehensive data collection to identify the root causes and develop high-reliability improvement strategies.

Assessment of nonpoint-source contamination of the High Plains Aquifer in south-central Kansas, 1987

USGS Publications Warehouse

Helgesen, John O.; Stullken, Lloyd E.; Rutledge, A.T.

1994-01-01

Ground-water quality was assessed in a 5,000-square-mile area of the High Plains aquifer in south-central Kansas that is susceptible to nonpoint-source contamination from agricultural and petroleum-production activities. Of particular interest was the presence of agricultural chemicals and petroleum-derived hydrocarbons that might have been associated with brines that formerly were disposed into unlined ponds. Random sampling of ground water was done within a framework of discrete land-use areas (irrigated cropland, petroleum-production land containing former brine-disposal ponds, and undeveloped rangeland) of 3-10 square miles. Although true baseline water-quality conditions probably are rare, in this region they are represented most closely by ground water in areas of undeveloped rangeland. The sampling design enabled statistical hypothesis testing, using nonparametric procedures, of the effects of land use, unsaturated-zone lithology, and type of well sampled. Results indicate that regional ground-water quality has been affected by prevailing land-use activities, as shown by increased concentrations of several inorganic constituents. Ground water beneath irrigated cropland was characterized by significantly larger concentrations of hardness, alkalinity, calcium, magnesium, potassium, fluofide, and nitrite plus nitrate than was water beneath undeveloped rangeland. Few nondegraded pesticides were detected in the aquifer, probably because of degradation and sorption. Atrazine was the most common, but only in small concentrations. round water beneath petroleum-production land was characterized by significantly larger concentrations of hardness, alkalinity, dissolved solids, sodium, and chloride than was water beneath undeveloped rangeland. Nonpoint-source contamination by oil-derived hydrocarbons was not discernible. The occurrences of trace organic compounds were similar between petroleum-production land and undeveloped rangeland, which indicates a natural origin for these compounds. The unsaturated zone in the study area is lithologically heterogeneous and contains substantial amounts of clay that inhibit the downward movement of water and solutes. Within the aquifer, the rate of lateral regional flow and solute transport is slow enough so that the ground-water quality reflects overlying land use in discrete areas of several square miles, but it is still sufficiently rapid so that the type of well sampled is not important in regional characterizations of water quality beneath irrigated cropland; the seasonal pumping of irrigation wells does not appear to divert regional flow enough to cause substantial local anomalies of more mineralized ground water.

Comparison of Erosion Rates Estimated by Sediment Budget Techniques and Suspended Sediment Monitoring and Regulatory Implications

NASA Astrophysics Data System (ADS)

O'Connor, M.; Eads, R.

2007-12-01

Watersheds in the northern California Coast Range have been designated as "impaired" with respect to water quality because of excessive sediment loads and/or high water temperature. Sediment budget techniques have typically been used by regulatory authorities to estimate current erosion rates and to develop targets for future desired erosion rates. This study examines erosion rates estimated by various methods for portions of the Gualala River watershed, designated as having water quality impaired by sediment under provisions of the Clean Water Act Section 303(d), located in northwest Sonoma County (~90 miles north of San Francisco). The watershed is underlain by Jurassic age sedimentary and meta-sedimentary rocks of the Franciscan formation. The San Andreas Fault passes through the western edge of watershed, and other active faults are present. A substantial portion of the watershed is mantled by rock slides and earth flows, many of which are considered dormant. The Coast Range is geologically young, and rapid rates of uplift are believed to have contributed to high erosion rates. This study compares quantitative erosion rate estimates developed at different spatial and temporal scales. It is motivated by a proposed vineyard development project in the watershed, and the need to document conditions in the project area, assess project environmental impacts and meet regulatory requirements pertaining to water quality. Erosion rate estimates were previously developed using sediment budget techniques for relatively large drainage areas (~100 to 1,000 km2) by the North Coast Regional Water Quality Control Board and US EPA and by the California Geological Survey. In this study, similar sediment budget techniques were used for smaller watersheds (~3 to 8 km2), and were supplemented by a suspended sediment monitoring program utilizing Turbidity Threshold Sampling techniques (as described in a companion study in this session). The duration of the monitoring program to date spanned the winter runoff seasons of Water Years 2006 and 2007. These were unusually wet and dry years, respectively, providing perspective on the range of measured sediment yield in relation to sediment budget estimates. The measured suspended sediment yields were substantially lower than predicted by sediment budget methods. Variation in geomorphic processes over time and space and methodological problems of sediment budgets may be responsible for these apparent discrepancies. The implications for water quality policy are discussed.

Ozone from Wildfires: Peering through the Smog

NASA Astrophysics Data System (ADS)

Jaffe, D. A.; Baylon, P.; Wigder, N. L.; Collier, S.; Zhou, S.; Zhang, Q.; Alvarado, M. J.

2014-12-01

In the western US, many areas are near the current air quality standard for O3. Yet there is substantial inter-annual variability (IAV) in the number of days that exceed the O3 air quality threshold (currently 75 ppbv for an 8-hour average). We propose that wildfires are the dominant cause for this IAV. However there are large uncertainties around O3 production from wildfires due to numerous complicating factors. Ozone formation in wildfire plumes differs substantially from urban O3 production in several ways: substantial variations in the emissions, much larger aerosol loadings, a much greater variety of reactive and oxygenated VOCs, rapid and substantial formation of PAN and very different sources of HOx in the plume. These factors make it challenging to model wildfire impacts on photochemistry in the usual way. In this presentation we will show examples of three common situations based on data from the Mt. Bachelor Observatory: Rapid O3 formation (within one day) in a wildfire plume. Slow, but substantial, O3 formation (over days to a week) in a wildfire plume. No detectable O3 formation in a wildfire plume. We will interpret these results with respect to the observed NOy mixing ratios, the photochemical environment, the combustion efficiency, the plume transport and other factors and suggest some key experiments and modeling studies that can help further our understanding of wildfire O3 production.

Relationship between Individual Quality of Life and Family Quality of Life for People with Intellectual Disability Living in Italy

ERIC Educational Resources Information Center

Bertelli, M.; Bianco, A.; Rossi, M.; Scuticchio, D.; Brown, I.

2011-01-01

Background: There is substantial literature investigating quality of life (QoL) of individuals with intellectual disability (ID). QoL of families of people with ID is emerging as an important field of research. Despite this, there is a lack of studies regarding their relationship. Aim: The present paper aimed to study the relationship between QoL…

Economic Return From the Women’s Health Initiative Estrogen Plus Progestin Clinical Trial

PubMed Central

Roth, Joshua A.; Etzioni, Ruth; Waters, Teresa M.; Pettinger, Mary; Rossouw, Jacques E.; Anderson, Garnet L.; Chlebowski, Rowan T.; Manson, JoAnn E.; Hlatky, Mark; Johnson, Karen C.; Ramsey, Scott D.

2014-01-01

Background The findings of the Women’s Health Initiative (WHI) estrogen plus progestin (E+P) trial led to a substantial reduction in use of combined hormone therapy (cHT) among postmenopausal women in the United States. The economic effect of this shift has not been evaluated relative to the trial’s $260 million cost (2012 U.S. dollars). Objective To estimate the economic return from the WHI E+P trial. Design Decision model to simulate health outcomes for a “WHI scenario” with observed cHT use and a “no-WHI scenario” with cHT use extrapolated from the pretrial period. Data Sources Primary analyses of WHI outcomes, peer-reviewed literature, and government sources. Target Population Postmenopausal women in the United States, aged 50 to 79 years, who did not have a hysterectomy. Time Horizon 2003 to 2012. Perspective Payer. Intervention Combined hormone therapy. Outcome Measures Disease incidence, expenditure, quality-adjusted life-years, and net economic return. Results of Base-Case Analysis The WHI scenario resulted in 4.3 million fewer cHT users, 126 000 fewer breast cancer cases, 76 000 fewer cardiovascular disease cases, 263 000 more fractures, 145 000 more quality-adjusted life-years, and expenditure savings of $35.2 billion. The corresponding net economic return of the trial was $37.1 billion ($140 per dollar invested in the trial) at a willingness-to-pay level of $100 000 per quality-adjusted life-year. Results of Sensitivity Analysis The 95% CI for the net economic return of the trial was $23.1 to $51.2 billion. Limitation No evaluation of indirect costs or outcomes beyond 2012. Conclusion The WHI E+P trial made high-value use of public funds with a substantial return on investment. These results can contribute to discussions about the role of public funding for large, prospective trials with high potential for public health effects. Primary Funding Source National Heart, Lung, and Blood Institute. PMID:24798522

Post-Mastectomy and Phantom Breast Pain: Risk Factors, Natural History, and Impact on Quality of Life

DTIC Science & Technology

1999-07-01

be significantly disabled by their chronic pain and can suffer from substantial reductions in quality of life . The primary aims of this research...and examine their impact on quality of life using a prospective research design. To date, 40 women scheduled for surgical procedures for breast cancer...with periodic assessments of pain, health-related quality of life , and psychosocial variables. This allows risk factors for PMPS and phantom breast

Quality assessment of osteoporosis clinical practice guidelines for physical activity and safe movement: an AGREE II appraisal.

PubMed

Armstrong, James Jacob; Rodrigues, Isabel Braganca; Wasiuta, Tom; MacDermid, Joy C

2016-01-01

Many osteoporosis clinical practice guidelines are published, and the extent to which physical activity and safe movement is addressed varies. To better inform clinical decision-making, a quality assessment and structured analysis of recommendations was undertaken. Guideline quality varied substantially, and improvement is necessary in physical activity and safe movement recommendations. The purpose of the present study is to survey available osteoporosis clinical practice guidelines (CPGs) containing physical activity and safe movement recommendations in order to assess the methodological quality with which they were developed. An analysis of the various physical activity and safe movement recommendations was conducted to determine variability between CPGs. An online literature search revealed 19 CPGs meeting our inclusion criteria. Three independent scorers evaluated CPG quality using the Appraisal of Guidelines for Research and Evaluation version II (AGREE II) instrument. Two separate individuals used a standard table to extract relevant recommendations. Intra-reviewer AGREE II score agreement ranged from fair to good (intra-class correlation coefficient (ICC) = 0.34 to 0.65). The quality of the 19 included CPGs was variable (AGREE sub-scores: 14 to 100%). CPGs scored higher in the "scope and purpose" and "clarity of presentation" domains. They scored the lowest in "applicability" and "editorial independence." Four CPGs were classified as high quality, ten average quality, and five low quality. Most CPGs recommended weight-bearing, muscle-strengthening, and resistance exercises. Information on exercise dosage, progression, and contraindications was often absent. Immobility and movements involving spinal flexion and/or torsion were discouraged. There were several high-quality CPGs; however, variability in quality and lack of specific parameters for implementation necessitates caution and critical examination by readers. CPG development groups should pay special attention to the clinical applicability of their CPGs as well as fully disclosing conflicts of interest. CPGs were in general an agreement regarding safe physical activity and safe movement recommendations. However, recommendations were often vague and the more specific recommendations were inconsistent between CPGs.

Historical water-quality data for the High Plains Regional Ground-Water Study Area in Colorado, Kansas, Nebraska, New Mexico, Oklahoma, South Dakota, Texas, and Wyoming, 1930-98

USGS Publications Warehouse

Litke, David W.

2001-01-01

The High Plains aquifer underlies 174,000 square miles in parts of eight States and includes eight primary hydrogeologic units, including the well-known Ogallala Formation. The High Plains aquifer is an important resource, providing water for 27 percent of the Nation?s irrigated agricultural lands in an otherwise dry landscape. Since the 1980?s there has been concern over the sustainability of the aquifer due to water-level declines caused by substantial pumping. Water quality of the aquifer is a more recent concern. As part of the U.S. Geological Survey?s National Water-Quality Assessment Program, historical water-quality data have been gathered for the High Plains Regional Ground-Water Study Area into a retrospective data base, which can be used to evaluate the occurrence and distribution of water-quality constituents of concern.Data from the retrospective data base verify that nitrate, pesticides, and dissolved solids (salinity) are important water-quality concerns in the High Plains study area. Sixteen percent of all measured nitrate concentrations were larger than the U.S. Environmental Protection Agency drinking-water standard of 10 milligrams per liter. In about 70 percent of the counties within the High Plains study area, nitrate concentrations for 1980-98 were significantly larger than for 1930-69. While nitrate concentrations are largest where depth to water is shallow, concentrations also have increased in the Ogallala Formation where depth to water is large. Pesticide data primarily are available only in the northern half of the study area. About 50 pesticides were detected in the High Plains study area, but only four pesticides (atrazine, alachlor, cyanazine, and simazine) had concentrations exceeding a drinking-water standard. The occasional detection of pesticides in deeper parts of the Ogallala Formation indicates that contamination pathways exist. Dissolved solids, which are a direct measure of salinity, had 29 percent of measured concentrations in excess of the secondary drinking-water standard of 500 milligrams per liter. Comparison of dissolved-solids concentrations prior to 1980 to concentrations after 1980 indicates dissolved-solids concentrations have increased in the alluvial valleys of the Platte, the Republican, and the Arkansas Rivers, as well as in the Ogallala Formation?South hydrogeologic unit.Water-quality results indicate that human activities are affecting the water of the High Plains aquifer. Because there is a potential for water quality to become impaired relative to the historical uses of the aquifer, water quality needs to be considered when evaluating the sustainability of the High Plains aquifer. Data collected as part of the High Plains Regional Ground-Water Study will help to fill in gaps in water-quality information and provide additional information for understanding the factors that govern ambient water quality.

The role of dialyzer membrane flux in bio-incompatibility.

PubMed

Davenport, Andrew

2008-10-01

Dialyzer membrane flux is currently defined according to beta(2)-microglobulin (a middle molecule) clearance. Traditionally, high flux membranes were synthetic, and caused less inflammatory reaction in the extracorporeal circuit, compared with standard low-flux cuprophan bio-incompatible dialyzers. Initial reports suggested improved patient outcomes in acute renal failure when noncuprophan dialyzer membranes were used. However, over time these positive observations have not been substantiated. As the price differential between these dialyzer membrane types has become marginal, more high-flux dialyzers are now used in routine clinical practice. Two multicenter trials have recently reported a survival advantage for high-flux dialyzers. Whether this is directly consequent upon the choice of dialyzer membrane, or related to improvements in dialysate water quality, or changes in other clinical practices remains to be determined.

Video on phone lines: technology and applications

NASA Astrophysics Data System (ADS)

Hsing, T. Russell

1996-03-01

Recent advances in communications signal processing and VLSI technology are fostering tremendous interest in transmitting high-speed digital data over ordinary telephone lines at bit rates substantially above the ISDN Basic Access rate (144 Kbit/s). Two new technologies, high-bit-rate digital subscriber lines and asymmetric digital subscriber lines promise transmission over most of the embedded loop plant at 1.544 Mbit/s and beyond. Stimulated by these research promises and rapid advances on video coding techniques and the standards activity, information networks around the globe are now exploring possible business opportunities of offering quality video services (such as distant learning, telemedicine, and telecommuting etc.) through this high-speed digital transport capability in the copper loop plant. Visual communications for residential customers have become more feasible than ever both technically and economically.

Substantial difference in target surface chemistry between reactive dc and high power impulse magnetron sputtering

NASA Astrophysics Data System (ADS)

Greczynski, G.; Mráz, S.; Schneider, J. M.; Hultman, L.

2018-02-01

The nitride layer formed in the target race track during the deposition of stoichiometric TiN thin films is a factor 2.5 thicker for high power impulse magnetron sputtering (HIPIMS), compared to conventional dc processing (DCMS). The phenomenon is explained using x-ray photoelectron spectroscopy analysis of the as-operated Ti target surface chemistry supported by sputter depth profiles, dynamic Monte Carlo simulations employing the TRIDYN code, and plasma chemical investigations by ion mass spectrometry. The target chemistry and the thickness of the nitride layer are found to be determined by the implantation of nitrogen ions, predominantly N+ and N2+ for HIPIMS and DCMS, respectively. Knowledge of this method-inherent difference enables robust processing of high quality functional coatings.

Historical return on investment and improved quality resulting from development and mining of a hospital laboratory relational database.

PubMed

Brimhall, Bradley B; Hall, Timothy E; Walczak, Steven

2006-01-01

A hospital laboratory relational database, developed over eight years, has demonstrated significant cost savings and a substantial financial return on investment (ROI). In addition, the database has been used to measurably improve laboratory operations and the quality of patient care.

Using Value-Added Measures of Teacher Quality. Brief 9

ERIC Educational Resources Information Center

Hanushek, Eric A.; Rivkin, Steven G.

2010-01-01

Extensive education research on the contribution of teachers to student achievement produces two generally accepted results. First, teacher quality varies substantially as measured by the value added to student achievement or future academic attainment or earnings. Second, variables often used to determine entry into the profession and…

7 CFR 3406.15 - Evaluation criteria for teaching proposals.

Code of Federal Regulations, 2010 CFR

2010-01-01

... have a substantial impact upon and advance the quality of food and agricultural sciences higher... food and agricultural sciences? If successful, is the project likely to lead to education reform? 10... it expand upon other major efforts to improve the quality of food and agricultural sciences higher...

Schooling Quality in Eastern Europe: Educational Production during Transition

ERIC Educational Resources Information Center

Ammermuller, A.; Heijke, H.; Woszmann, L.

2005-01-01

This paper uses student-level Third International Mathematics and Science Study (TIMSS) data to analyze the determinants of schooling quality for seven Eastern European transition countries by estimating educational production functions. The results show substantial effects of student background on educational performance and a much lower impact…

Top 10 Reasons for Quality Physical Education

ERIC Educational Resources Information Center

Le Masurier, Guy; Corbin, Charles B.

2006-01-01

Substantial scientific evidence supports the role of physical activity in disease prevention and healthy lifestyle promotion, and quality physical education represents our best opportunity to provide all children with experiences that promote physical activity now and for a lifetime. The purpose of this article is to document the need for quality…

The effects of different dry roast parameters on peanut quality using an industrial, belt-type roaster simulator

USDA-ARS?s Scientific Manuscript database

Recent lab scale experiments demonstrated that peanuts roasted to equivalent surface colors at different temperature/time combinations can vary substantially in chemical and physical properties related to product quality. This study expanded that approach to a pilot plant scale roaster that simulate...

Storms do not alter long-term watershed development influences on coastal water quality

EPA Science Inventory

A twelve year (2000 − 2011) study of three coastal lagoons in the Gulf of Mexico was conducted to assess the impacts of local watershed development and tropical storms on water quality. The lagoons have similar physical and hydrological characteristics, but differ substantially i...

Maternal experiences of caring for an infant with neurological impairment after neonatal encephalopathy in Uganda: a qualitative study

PubMed Central

Nakamanya, Sarah; Siu, Godfrey E.; Lassman, Rachel; Seeley, Janet; Tann, Cally J.

2015-01-01

Abstract Purpose: The study investigated maternal experiences of caring for a child affected by neurological impairment after neonatal encephalopathy (NE) (“birth asphyxia”) in Uganda. Methods: Between September 2011 and October 2012 small group and one-on-one in-depths interviews were conducted with mothers recruited to the ABAaNA study examining outcomes from NE in Mulago hospital, Kampala. Data were analysed thematically with the aid of Nvivo 8 software. Findings: Mothers reported caring for an infant with impairment was often complicated by substantial social, emotional and financial difficulties and stigma. High levels of emotional distress, feelings of social isolation and fearfulness about the future were described. Maternal health-seeking ability was exacerbated by high transport costs, lack of paternal support and poor availability of rehabilitation and counselling services. Meeting and sharing experiences with similarly affected mothers was associated with more positive maternal caring experiences. Conclusion: Mothering a child with neurological impairment after NE is emotionally, physically and financially challenging but this may be partly mitigated by good social support and opportunities to share caring experiences with similarly affected mothers. A facilitated, participatory, community-based approach to rehabilitation training may have important impacts on maximising participation and improving the quality of life of affected mothers and infants.Implications for RehabilitationCaring for an infant with neurological impairment after NE in Uganda has substantial emotional, social and financial impacts on families and is associated with high levels of emotional stress, feelings of isolation and stigma amongst mothers.Improved social support and the opportunity to share experiences with other similarly affected mothers are associated with a more positive maternal caring experience. High transport costs, lack of paternal support and poor availability of counselling and support services were barriers to maternal healthcare seeking.Studies examining the feasibility, acceptability and impact of early intervention programmes are warranted to maximise participation and improve the quality of life for affected mothers and their infants. PMID:25323396

Applications of high resolution rainfall radar data to quantify water temperature dynamics in urban catchments

NASA Astrophysics Data System (ADS)

Croghan, Danny; Van Loon, Anne; Bradley, Chris; Sadler, Jon; Hannnah, David

2017-04-01

Studies relating rainfall events to river water quality are frequently hindered by the lack of high resolution rainfall data. Local studies are particularly vulnerable due to the spatial variability of precipitation, whilst studies in urban environments require precipitation data at high spatial and temporal resolutions. The use of point-source data makes identifying causal effects of storms on water quality problematic and can lead to erroneous interpretations. High spatial and temporal resolution rainfall radar data offers great potential to address these issues. Here we use rainfall radar data with a 1km spatial resolution and 5 minute temporal resolution sourced from the UK Met Office Nimrod system to study the effects of storm events on water temperature (WTemp) in Birmingham, UK. 28 WTemp loggers were placed over 3 catchments on a rural-urban land use gradient to identify trends in WTemp during extreme events within urban environments. Using GIS, the catchment associated with each logger was estimated, and 5 min. rainfall totals and intensities were produced for each sub-catchment. Comparisons of rainfall radar data to meteorological stations in the same grid cell revealed the high accuracy of rainfall radar data in our catchments (<5% difference for studied months). The rainfall radar data revealed substantial differences in rainfall quantity between the three adjacent catchments. The most urban catchment generally received more rainfall, with this effect greatest in the highest intensity storms, suggesting the possibility of urban heat island effects on precipitation dynamics within the catchment. Rainfall radar data provided more accurate sub-catchment rainfall totals allowing better modelled estimates of storm flow, whilst spatial fluctuations in both discharge and WTemp can be simply related to precipitation intensity. Storm flow inputs for each sub-catchment were estimated and linked to changes in WTemp. WTemp showed substantial fluctuations (>1 °C) over short durations (<30 minutes) during storm events in urbanised sub-catchments, however WTemp recovery times were more prolonged. Use of the rainfall radar data allowed increased accuracy in estimates of storm flow timings and rainfall quantities at each sub-catchment, from which the impact of storm flow on WTemp could be quantified. We are currently using the radar data to derive thresholds for rainfall amount and intensity at which these storm deviations occur for each logger, from which the relative effects of land use and other catchment characteristics in each sub-catchment can be assessed. Our use of the rainfall radar data calls into question the validity of using station based data for small scale studies, particularly in urban areas, with high variation apparent in rainfall intensity both spatially and temporally. Variation was particularly high within the heavily urbanised catchment. For water quality studies, high resolution rainfall radar can be implemented to increase the reliability of interpretations of the response of water quality variables to storm water inputs in urban catchments.

Considerations for the Use of Remote Gaze Tracking to Assess Behavior in Flight Simulators

NASA Technical Reports Server (NTRS)

Kalar, Donald J.; Liston, Dorion; Mulligan, Jeffrey B.; Beutter, Brent; Feary, Michael

2016-01-01

Complex user interfaces (such as those found in an aircraft cockpit) may be designed from first principles, but inevitably must be evaluated with real users. User gaze data can provide valuable information that can help to interpret other actions that change the state of the system. However, care must be taken to ensure that any conclusions drawn from gaze data are well supported. Through a combination of empirical and simulated data, we identify several considerations and potential pitfalls when measuring gaze behavior in high-fidelity simulators. We show that physical layout, behavioral differences, and noise levels can all substantially alter the quality of fit for algorithms that segment gaze measurements into individual fixations. We provide guidelines to help investigators ensure that conclusions drawn from gaze tracking data are not artifactual consequences of data quality or analysis techniques.

Separation and collection of coarse aggregate from waste concrete by electric pulsed power

NASA Astrophysics Data System (ADS)

Shigeishi, Mitsuhiro

2017-09-01

Waste concrete accounts for a substantial fraction of construction waste, and the recycling of waste concrete as concrete aggregate for construction is an important challenge associated with the rapid increase in the amount of waste concrete and the tight supply of natural aggregate. In this study, we propose a technique based on the use of high-voltage pulsed electric discharge into concrete underwater for separating and collecting aggregate from waste concrete with minimal deterioration of quality. By using this technique, the quality of the coarse aggregate separated and collected from concrete test specimens is comparable to that of coarse aggregate recycled by heating and grinding methods, thus satisfying the criteria in Japan Industrial Standard (JIS) A 5021 for the oven-dry density and the water absorption of coarse aggregate by advanced recycling.

Health Services Research for Drug and Alcohol Treatment and Prevention.

PubMed

McCarty, Dennis; Roman, Paul M; Sorensen, James; Weisner, Constance

2009-01-01

Health services research is a multidisciplinary field that examines ways to organize, manage, finance, and deliver high-quality care. This specialty within substance abuse research developed from policy analyses and needs assessments that shaped federal policy and promoted system development in the 1970s. After the authorization of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), patient information systems supported studies of treatment processes and outcomes. Health services research grew substantially in the 1990s when NIAAA and NIDA moved into the National Institutes of Health and legislation allocated 15% of their research portfolio to services research. The next decade will emphasize research on quality of care, adoption and use of evidence-based practices (including medication), financing reforms and integration of substance abuse treatment with primary care and mental health services.

Cone beam computed tomography and intraoral radiography for diagnosis of dental abnormalities in dogs and cats

PubMed Central

Silva, Luiz Antonio F.; Barriviera, Mauricio; Januário, Alessandro L.; Bezerra, Ana Cristina B.; Fioravanti, Maria Clorinda S.

2011-01-01

The development of veterinary dentistry has substantially improved the ability to diagnose canine and feline dental abnormalities. Consequently, examinations previously performed only on humans are now available for small animals, thus improving the diagnostic quality. This has increased the need for technical qualification of veterinary professionals and increased technological investments. This study evaluated the use of cone beam computed tomography and intraoral radiography as complementary exams for diagnosing dental abnormalities in dogs and cats. Cone beam computed tomography was provided faster image acquisition with high image quality, was associated with low ionizing radiation levels, enabled image editing, and reduced the exam duration. Our results showed that radiography was an effective method for dental radiographic examination with low cost and fast execution times, and can be performed during surgical procedures. PMID:22122905

Process mapping as a framework for performance improvement in emergency general surgery.

PubMed

DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

2017-12-01

Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

Process mapping as a framework for performance improvement in emergency general surgery.

PubMed

DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

2018-02-01

Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

Breaking the news on mobile TV: user requirements of a popular mobile content

NASA Astrophysics Data System (ADS)

Knoche, Hendrik O.; Sasse, M. Angela

2006-02-01

This paper presents the results from three lab-based studies that investigated different ways of delivering Mobile TV News by measuring user responses to different encoding bitrates, image resolutions and text quality. All studies were carried out with participants watching News content on mobile devices, with a total of 216 participants rating the acceptability of the viewing experience. Study 1 compared the acceptability of a 15-second video clip at different video and audio encoding bit rates on a 3G phone at a resolution of 176x144 and an iPAQ PDA (240x180). Study 2 measured the acceptability of video quality of full feature news clips of 2.5 minutes which were recorded from broadcast TV, encoded at resolutions ranging from 120x90 to 240x180, and combined with different encoding bit rates and audio qualities presented on an iPAQ. Study 3 improved the legibility of the text included in the video simulating a separate text delivery. The acceptability of News' video quality was greatly reduced at a resolution of 120x90. The legibility of text was a decisive factor in the participants' assessment of the video quality. Resolutions of 168x126 and higher were substantially more acceptable when they were accompanied by optimized high quality text compared to proportionally scaled inline text. When accompanied by high quality text TV news clips were acceptable to the vast majority of participants at resolutions as small as 168x126 for video encoding bitrates of 160kbps and higher. Service designers and operators can apply this knowledge to design a cost-effective mobile TV experience.

An efficient fast response and high-gain solar-blind flexible ultraviolet photodetector employing hybrid geometry

NASA Astrophysics Data System (ADS)

Hussain, Amreen A.; Pal, Arup R.; Patil, Dinkar S.

2014-05-01

We report high performance flexible hybrid ultraviolet photodetector with solar-blind sensitivity using nanocomposite film of plasma polymerized aniline-titanium dioxide. A facile solvent-free plasma technique is used to synthesize superior quality hybrid material with high yield. The hybrid photodetector exhibited high photoconductive gain of the order of ˜105 and fast speed with response and recovery time of 22.87 ms and 34.23 ms. This is an excellent result towards getting a balance in the response speed and photoconductive gain trade-off of the photodetectors reported so far. In addition, the device has the advantages of enhanced photosensitivity ((Ilight - Idark)/Idark) of the order of ˜102 and high responsivity of ˜104 AW-1. All the merits substantiates that, to prepare hybrid material, plasma based method holds potential to be an easy way for realizing large scale nanostructured photodetectors for practical applications.

A profile of women at the highest risk of maternal death in Pakistan.

PubMed

Agha, Sohail

2015-09-01

Traditionally, health interventions implemented in Pakistan have been designed to increase the supply of maternal health services, but have not focused on reaching the poorest women or on providing high-quality services. Demand-side barriers to the utilization of health services are substantial in Pakistan, as are supply-side constraints to the provision of quality health care. This study uses data from the Pakistan Demographic and Health Survey 2006-07 to develop a profile of the poorest women in Pakistan in order to understand demand-side barriers to accessing maternal health care. The study shows stark differences in human capital, material and demographic resources between the poorest women and other women. It illustrates how these differences translate into low levels of service utilization among the poorest women. The purpose of the study is to stimulate a discussion of both the difficulty and the importance of reaching the poorest women with high-quality maternal health interventions. The findings from several pilot projects in Pakistan suggest that the poorest women can be reached at disproportionately higher rates than non-poor women through targeted, community-based, interventions. There is little demonstrable evidence, however, that high-quality care has been provided through these interventions. Evidence-based approaches, which have the potential to overcome financial and sociocultural barriers to service utilization, should be scaled up as soon as possible. However, measures should be taken to ensure that the quality of care provided through these interventions is adequate and able to lead to significant reductions in mortality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Lightweight, compact, and high-performance 3T MR system for imaging the brain and extremities.

PubMed

Foo, Thomas K F; Laskaris, Evangelos; Vermilyea, Mark; Xu, Minfeng; Thompson, Paul; Conte, Gene; Van Epps, Christopher; Immer, Christopher; Lee, Seung-Kyun; Tan, Ek T; Graziani, Dominic; Mathieu, Jean-Baptise; Hardy, Christopher J; Schenck, John F; Fiveland, Eric; Stautner, Wolfgang; Ricci, Justin; Piel, Joseph; Park, Keith; Hua, Yihe; Bai, Ye; Kagan, Alex; Stanley, David; Weavers, Paul T; Gray, Erin; Shu, Yunhong; Frick, Matthew A; Campeau, Norbert G; Trzasko, Joshua; Huston, John; Bernstein, Matt A

2018-03-13

To build and evaluate a small-footprint, lightweight, high-performance 3T MRI scanner for advanced brain imaging with image quality that is equal to or better than conventional whole-body clinical 3T MRI scanners, while achieving substantial reductions in installation costs. A conduction-cooled magnet was developed that uses less than 12 liters of liquid helium in a gas-charged sealed system, and standard NbTi wire, and weighs approximately 2000 kg. A 42-cm inner-diameter gradient coil with asymmetric transverse axes was developed to provide patient access for head and extremity exams, while minimizing magnet-gradient interactions that adversely affect image quality. The gradient coil was designed to achieve simultaneous operation of 80-mT/m peak gradient amplitude at a slew rate of 700 T/m/s on each gradient axis using readily available 1-MVA gradient drivers. In a comparison of anatomical imaging in 16 patients using T 2 -weighted 3D fluid-attenuated inversion recovery (FLAIR) between the compact 3T and whole-body 3T, image quality was assessed as equivalent to or better across several metrics. The ability to fully use a high slew rate of 700 T/m/s simultaneously with 80-mT/m maximum gradient amplitude resulted in improvements in image quality across EPI, DWI, and anatomical imaging of the brain. The compact 3T MRI system has been in continuous operation at the Mayo Clinic since March 2016. To date, over 200 patient studies have been completed, including 96 comparison studies with a clinical 3T whole-body MRI. The increased gradient performance has reliably resulted in consistently improved image quality. © 2018 International Society for Magnetic Resonance in Medicine.

In silico carbon molecular beam epitaxial growth of graphene on the h-BN substrate: carbon source effect on van der Waals epitaxy

NASA Astrophysics Data System (ADS)

Lee, Jonghoon; Varshney, Vikas; Park, Jeongho; Farmer, Barry L.; Roy, Ajit K.

2016-05-01

Against the presumption that hexagonal boron-nitride (h-BN) should provide an ideal substrate for van der Waals (vdW) epitaxy to grow high quality graphene films, carbon molecular beam epitaxy (CMBE) techniques using solid carbon sublimation have reported relatively poor quality of the graphene. In this article, the CMBE growth of graphene on the h-BN substrate is numerically studied in order to identify the effect of the carbon source on the quality of the graphene film. The carbon molecular beam generated by the sublimation of solid carbon source materials such as graphite and glassy carbon is mostly composed of atomic carbon, carbon dimers and carbon trimers. Therefore, the graphene film growth becomes a complex process involving various deposition characteristics of a multitude of carbon entities. Based on the study of surface adsorption and film growth characteristics of these three major carbon entities comprising graphite vapour, we report that carbon trimers convey strong traits of vdW epitaxy prone to high quality graphene growth, while atomic carbon deposition is a surface-reaction limited process accompanied by strong chemisorption. The vdW epitaxial behaviour of carbon trimers is found to be substantial enough to nucleate and develop into graphene like planar films within a nanosecond of high flux growth simulation, while reactive atomic carbons tend to impair the structural integrity of the crystalline h-BN substrate upon deposition to form an amorphous interface between the substrate and the growing carbon film. The content of reactive atomic carbons in the molecular beam is suspected to be the primary cause of low quality graphene reported in the literature. A possible optimization of the molecular beam composition towards the synthesis of better quality graphene films is suggested.Against the presumption that hexagonal boron-nitride (h-BN) should provide an ideal substrate for van der Waals (vdW) epitaxy to grow high quality graphene films, carbon molecular beam epitaxy (CMBE) techniques using solid carbon sublimation have reported relatively poor quality of the graphene. In this article, the CMBE growth of graphene on the h-BN substrate is numerically studied in order to identify the effect of the carbon source on the quality of the graphene film. The carbon molecular beam generated by the sublimation of solid carbon source materials such as graphite and glassy carbon is mostly composed of atomic carbon, carbon dimers and carbon trimers. Therefore, the graphene film growth becomes a complex process involving various deposition characteristics of a multitude of carbon entities. Based on the study of surface adsorption and film growth characteristics of these three major carbon entities comprising graphite vapour, we report that carbon trimers convey strong traits of vdW epitaxy prone to high quality graphene growth, while atomic carbon deposition is a surface-reaction limited process accompanied by strong chemisorption. The vdW epitaxial behaviour of carbon trimers is found to be substantial enough to nucleate and develop into graphene like planar films within a nanosecond of high flux growth simulation, while reactive atomic carbons tend to impair the structural integrity of the crystalline h-BN substrate upon deposition to form an amorphous interface between the substrate and the growing carbon film. The content of reactive atomic carbons in the molecular beam is suspected to be the primary cause of low quality graphene reported in the literature. A possible optimization of the molecular beam composition towards the synthesis of better quality graphene films is suggested. Electronic supplementary information (ESI) available: Three movie files: 3mer-physorption.mpg and 3mer-chemisorption.mpg feature examples of the adsorption state sampling of a carbon trimer on the heated h-BN substrate as mentioned in the ``Single Molecule Adsorption Study'' section. In 3mer-film-growth.mpg, an instance of honey comb formation during the initial phase of graphene growth simulation using a carbon trimer beam is captured. An initially sp hybridized carbon atom (red colored) becomes sp2 hybridized as a result of additional covalent bonding with the impinging carbon trimer. As the bond angle around the red carbon changes from 180 degree (sp) to 120 degree (sp2), nearby carbon atoms enclose to form a hexagon structure composed of 6 carbon atoms. See DOI: 10.1039/c6nr01396a

Development of quality standards in inflammatory bowel disease management and design of an evaluation tool of nursing care.

PubMed

Torrejón, Antonio; Oltra, Lorena; Hernández-Sampelayo, Paloma; Marín, Laura; García-Sánchez, Valle; Casellas, Francesc; Alfaro, Noelia; Lázaro, Pablo; Vera, María Isabel

2013-01-01

nursing management of inflammatory bowel disease (IBD) is highly relevant for patient care and outcomes. However, there is evidence of substantial variability in clinical practices. The objectives of this study were to develop standards of healthcare quality for nursing management of IBD and elaborate the evaluation tool "Nursing Care Quality in IBD Assessment" (NCQ-IBD) based on these standards. a 178-item healthcare quality questionnaire was developed based on a systematic review of IBD nursing management literature. The questionnaire was used to perform two 2-round Delphi studies: Delphi A included 27 IBD healthcare professionals and Delphi B involved 12 patients. The NCQ-IBD was developed from the list of items resulting from both Delphi studies combined with the Scientific Committee´s expert opinion. the final NCQ-IBD consists of 90 items, organized in13 sections measuring the following aspects of nursing management of IBD: infrastructure, services, human resources, type of organization, nursing responsibilities, nurse-provided information to the patient, nurses training, annual audits of nursing activities, and nursing research in IBD. Using the NCQ-IBD to evaluate these components allows the rating of healthcare quality for nursing management of IBD into 4 categories: A (highest quality) through D (lowest quality). the use of the NCQ-IBD tool to evaluate nursing management quality of IBD identifies areas in need of improvement and thus contribute to an enhancement of care quality and reduction in clinical practice variations.

The association between chronic care management and the quality of thrombosis care

PubMed Central

Drewes, H.W.; Baan, C.A.; Westert, G.P.; Meijboom, B.R.; Lambooij, M.

2010-01-01

Introduction The oral anticoagulant therapy (OAT), used to prevent thrombosis, is associated with substantial avoidable hospitalization. Aim Identify the associations between chronic care management and the quality of OAT as suggested by the chronic care model (CCM) of Wagner. Methods Regression analysis with data of 61 thrombosis clinics and inductive analysis with 63 interviews with health care professionals of 23 thrombosis clinics. Results Results show substantial differences between regions in the quality of thrombosis care and the CCM activities. However, the variation in quality of care was not associated with the differences in CCM activities. The inductive analysis indicates that there are problems in the cooperation between caregivers. Several preferred CCM activities (e.g., multidisciplinary protocol) as well as the barriers to implement these activities (e.g., conflicting interests) were put forward by the health care professionals. Conclusion It can be concluded that there is variation in quality of thrombosis care between regions. This variation could not be explained by the observed differences in CCM activities. However, fragmentation is a major source of inefficiency according to health care professionals. The paper concludes with suggestions to improve chronic care management for thrombosis.

Influence of Ship Emissions on Urban Air Quality: A Comprehensive Study Using Highly Time-Resolved Online Measurements and Numerical Simulation in Shanghai.

PubMed

Liu, Zhanmin; Lu, Xiaohui; Feng, Junlan; Fan, Qianzhu; Zhang, Yan; Yang, Xin

2017-01-03

Shanghai has become an international shipping center in the world. In this study, the multiyear measurements and the high resolution air quality model with hourly ship emission inventory were combined to determine the influence of ship emissions on urban Shanghai. The aerosol time-of-flight mass spectrometer (ATOFMS) measurements were carried out at an urban site from April 2009 to January 2013. During the entire sampling time, most of the half-hourly averaged number fractions of primary ship emitted particles varied between 1.0-10.0%. However, the number fraction could reach up to 50% during the ship plume cases. Ship-plume-influenced periods usually occurred in spring and summer. The simulation of Weather Research and Forecasting/Community Multiscale Air Quality model (WRF/CMAQ) with hourly ship emission inventory provided the highly time-resolved concentrations of ship-related air pollutants during a ship plume case. It showed ships could contribute 20-30% (2-7 μg/m 3 ) of the total PM 2.5 within tens of kilometers of coastal and riverside Shanghai during ship-plume-influenced periods. Our results showed that ship emissions have substantial contribution to the air pollution in urban Shanghai. The control measures of ship emission should be taken considering its negative environment and human health effects.

Standard care quality determines treatment outcomes in control groups of HAART-adherence intervention studies: implications for the interpretation and comparison of intervention effects.

PubMed

de Bruin, Marijn; Viechtbauer, Wolfgang; Hospers, Harm J; Schaalma, Herman P; Kok, Gerjo

2009-11-01

Clinical trials of behavioral interventions seek to enhance evidence-based health care. However, in case the quality of standard care provided to control conditions varies between studies and affects outcomes, intervention effects cannot be directly interpreted or compared. The objective of the present study was to examine whether standard care quality (SCQ) could be reliably assessed, varies between studies of highly active antiretroviral HIV-adherence interventions, and is related to the proportion of patients achieving an undetectable viral load ("success rate"). Databases were searched for relevant articles. Authors of selected studies retrospectively completed a checklist with standard care activities, which were coded to compute SCQ scores. The relationship between SCQ and the success rates was examined using meta-regression. Cronbach's alpha, variability in SCQ, and relation between SCQ and success rate. Reliability of the SCQ instrument was high (Cronbach's alpha = .91). SCQ scores ranged from 3.7 to 27.8 (total range = 0-30) and were highly predictive of success rate (p = .002). Variation in SCQ provided to control groups may substantially influence effect sizes of behavior change interventions. Future trials should therefore assess and report SCQ, and meta-analyses should control for variability in SCQ, thereby producing more accurate estimates of the effectiveness of behavior change interventions. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review

PubMed Central

Carabotti, Marilia; Annibale, Bruno; Severi, Carola; Lahner, Edith

2017-01-01

Symptomatic uncomplicated diverticular disease (SUDD) is a syndrome characterized by recurrent abdominal symptoms in patients with colonic diverticula. There is some evidence that a high-fiber diet or supplemental fibers may reduce symptoms in SUDD patients and a high-fiber diet is commonly suggested for these patients. This systematic review aims to update the evidence on the efficacy of fiber treatment in SUDD, in terms of a reduction in symptoms and the prevention of acute diverticulitis. According to PRISMA, we identified studies on SUDD patients treated with fibers (PubMed and Scopus). The quality of these studies was evaluated by the Jadad scale. The main outcome measures were a reduction of abdominal symptoms and the prevention of acute diverticulitis. Nineteen studies were included, nine with dietary fiber and 10 with supplemental fiber, with a high heterogeneity concerning the quantity and quality of fibers employed. Single studies suggest that fibers, both dietary and supplemental, could be beneficial in SUDD, even if the quality is very low, with just one study yielding an optimal score. The presence of substantial methodological limitations, the heterogeneity of the therapeutic regimens employed, and the lack of ad hoc designed studies, did not permit a summary of the outcome measure. Thus, the benefit of dietary or supplemental fiber in SUDD patients still needs to be established. PMID:28230737

Physical complications in acute lung injury survivors: a two-year longitudinal prospective study.

PubMed

Fan, Eddy; Dowdy, David W; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A; Sevransky, Jonathan E; Shanholtz, Carl; Himmelfarb, Cheryl R Dennison; Desai, Sanjay V; Ciesla, Nancy; Herridge, Margaret S; Pronovost, Peter J; Needham, Dale M

2014-04-01

Survivors of severe critical illness frequently develop substantial and persistent physical complications, including muscle weakness, impaired physical function, and decreased health-related quality of life. Our objective was to determine the longitudinal epidemiology of muscle weakness, physical function, and health-related quality of life and their associations with critical illness and ICU exposures. A multisite prospective study with longitudinal follow-up at 3, 6, 12, and 24 months after acute lung injury. Thirteen ICUs from four academic teaching hospitals. Two hundred twenty-two survivors of acute lung injury. None. At each time point, patients underwent standardized clinical evaluations of extremity, hand grip, and respiratory muscle strength; anthropometrics (height, weight, mid-arm circumference, and triceps skin fold thickness); 6-minute walk distance, and the Medical Outcomes Short-Form 36 health-related quality of life survey. During their hospitalization, survivors also had detailed daily evaluation of critical illness and related treatment variables. Over one third of survivors had objective evidence of muscle weakness at hospital discharge, with most improving within 12 months. This weakness was associated with substantial impairments in physical function and health-related quality of life that persisted at 24 months. The duration of bed rest during critical illness was consistently associated with weakness throughout 24-month follow-up. The cumulative dose of systematic corticosteroids and use of neuromuscular blockers in the ICU were not associated with weakness. Muscle weakness is common after acute lung injury, usually recovering within 12 months. This weakness is associated with substantial impairments in physical function and health-related quality of life that continue beyond 24 months. These results provide valuable prognostic information regarding physical recovery after acute lung injury. Evidence-based methods to reduce the duration of bed rest during critical illness may be important for improving these long-term impairments.

Health and Disease at Age 100.

PubMed

Jopp, Daniela S; Boerner, Kathrin; Rott, Christoph

2016-03-25

Centenarian studies from around the world have shown that reaching age 100 typically involves substantial health issues. The present study adds to the existing knowledge from other countries by describing health conditions in German centenarians. A total of 112 centenarians or their primary contacts provided information on acute and chronic health conditions and pain in the context of the Second Heidelberg Centenarian Study (mean age = 100.45 years, standard deviation [SD] = 0.47, 89% females). Participants showed high comorbidity, with an average of five illnesses (mean = 5.3; SD = 2.20). Health conditions with highest prevalence were sensory (vision, hearing; 94%), mobility (72%) and musculoskeletal conditions (60%). Cardiovascular conditions (57%) and urinary system ailments (55%) were also common. Pain was experienced often by 30% of the participants. Of those reporting any pain, 36% indicated pain exceeding bearable levels. German centenarians experienced a substantial number of ill nesses, dominated by sensory and mobility conditions. Cardiovascular diseases were the only potentially lethal illnesses with high prevalence. Evidence of unaddressed pain seems alarming, requiring future research. Emerging health profiles indicate that even in very advanced age, quality of life may be improved by enhanced diagnostics and optimal disease management. Mobility limitations may be addressed with preventive efforts.

The Wide-Field Imaging Interferometry Testbed: Recent Progress

NASA Technical Reports Server (NTRS)

Rinehart, Stephen A.

2010-01-01

The Wide-Field Imaging Interferometry Testbed (WIIT) at NASA's Goddard Space Flight Center was designed to demonstrate the practicality and application of techniques for wide-field spatial-spectral ("double Fourier") interferometry. WIIT is an automated system, and it is now producing substantial amounts of high-quality data from its state-of-the-art operating environment, Goddard's Advanced Interferometry and Metrology Lab. In this paper, we discuss the characterization and operation of the testbed and present the most recent results. We also outline future research directions. A companion paper within this conference discusses the development of new wide-field double Fourier data analysis algorithms.

Genome of Drosophila suzukii, the Spotted Wing Drosophila

PubMed Central

Chiu, Joanna C.; Jiang, Xuanting; Zhao, Li; Hamm, Christopher A.; Cridland, Julie M.; Saelao, Perot; Hamby, Kelly A.; Lee, Ernest K.; Kwok, Rosanna S.; Zhang, Guojie; Zalom, Frank G.; Walton, Vaughn M.; Begun, David J.

2013-01-01

Drosophila suzukii Matsumura (spotted wing drosophila) has recently become a serious pest of a wide variety of fruit crops in the United States as well as in Europe, leading to substantial yearly crop losses. To enable basic and applied research of this important pest, we sequenced the D. suzukii genome to obtain a high-quality reference sequence. Here, we discuss the basic properties of the genome and transcriptome and describe patterns of genome evolution in D. suzukii and its close relatives. Our analyses and genome annotations are presented in a web portal, SpottedWingFlyBase, to facilitate public access. PMID:24142924

Control of target-normal-sheath-accelerated protons from a guiding cone

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

Zou, D. B.; Institut für Theoretische Physik I, Heinrich-Heine-Universität Düsseldorf, Düsseldorf 40225; Zhuo, H. B., E-mail: hongbin.zhuo@gmail.com

2015-06-15

It is demonstrated through particle-in-cell simulations that target-normal-sheath-accelerated protons can be well controlled by using a guiding cone. Compared to a conventional planar target, both the collimation and number density of proton beams are substantially improved, giving a high-quality proton beam which maintained for a longer distance without degradation. The effect is attributed to the radial electric field resulting from the charge due to the hot target electrons propagating along the cone surface. This electric field can effectively suppress the spatial spread of the protons after the expansion of the hot electrons.

Method for depositing layers of high quality semiconductor material

DOEpatents

Guha, Subhendu; Yang, Chi C.

2001-08-14

Plasma deposition of substantially amorphous semiconductor materials is carried out under a set of deposition parameters which are selected so that the process operates near the amorphous/microcrystalline threshold. This threshold varies as a function of the thickness of the depositing semiconductor layer; and, deposition parameters, such as diluent gas concentrations, must be adjusted as a function of layer thickness. Also, this threshold varies as a function of the composition of the depositing layer, and in those instances where the layer composition is profiled throughout its thickness, deposition parameters must be adjusted accordingly so as to maintain the amorphous/microcrystalline threshold.

Fossil Energy: Drivers and Challenges.

NASA Astrophysics Data System (ADS)

Friedmann, Julio

2007-04-01

Concerns about rapid economic growth, energy security, and global climate change have created a new landscape for fossil energy exploration, production, and utilization. Since 85% of primary energy supply comes from fossil fuels, and 85% of greenhouse gas emissions come from fossil fuel consumption, new and difficult technical and political challenges confront commercial, governmental, and public stakeholders. As such, concerns over climate change are explicitly weighed against security of international and domestic energy supplies, with economic premiums paid for either or both. Efficiency improvements, fuel conservation, and deployment of nuclear and renewable supplies will help both concerns, but are unlikely to offset growth in the coming decades. As such, new technologies and undertakings must both provide high quality fossil energy with minimal environmental impacts. The largest and most difficult of these undertakings is carbon management, wherein CO2 emissions are sequestered indefinitely at substantial incremental cost. Geological formations provide both high confidence and high capacity for CO2 storage, but present scientific and technical challenges. Oil and gas supply can be partially sustained and replaced through exploitation of unconventional fossil fuels such as tar-sands, methane hydrates, coal-to-liquids, and oil shales. These fuels provide enormous reserves that can be exploited at current costs, but generally require substantial energy to process. In most cases, the energy return on investment (EROI) is dropping, and unconventional fuels are generally more carbon intensive than conventional, presenting additional carbon management challenges. Ultimately, a large and sustained science and technology program akin to the Apollo project will be needed to address these concerns. Unfortunately, real funding in energy research has dropped dramatically (75%) in the past three decades, and novel designs in fission and fusion are not likely to provide any substantial offset in the next 30 years when they are most needed internationally.

Analysis of environmental setting, surface-water and groundwater data, and data gaps for the Citizen Potawatomi Nation Tribal Jurisdictional Area, Oklahoma, through 2011

USGS Publications Warehouse

Andrews, William J.; Harich, Christopher R.; Smith, S. Jerrod; Lewis, Jason M.; Shivers, Molly J.; Seger, Christian H.; Becker, Carol J.

2013-01-01

The Citizen Potawatomi Nation Tribal Jurisdictional Area, consisting of approximately 960 square miles in parts of three counties in central Oklahoma, has an abundance of water resources, being underlain by three principal aquifers (alluvial/terrace, Central Oklahoma, and Vamoosa-Ada), bordered by two major rivers (North Canadian and Canadian), and has several smaller drainages. The Central Oklahoma aquifer (also referred to as the Garber-Wellington aquifer) underlies approximately 3,000 square miles in central Oklahoma in parts of Cleveland, Logan, Lincoln, Oklahoma, and Pottawatomie Counties and much of the tribal jurisdictional area. Water from these aquifers is used for municipal, industrial, commercial, agricultural, and domestic supplies. The approximately 115,000 people living in this area used an estimated 4.41 million gallons of fresh groundwater, 12.12 million gallons of fresh surface water, and 8.15 million gallons of saline groundwater per day in 2005. Approximately 8.48, 2.65, 2.24, 1.55, 0.83, and 0.81 million gallons per day of that water were used for domestic, livestock, commercial, industrial, crop irrigation, and thermoelectric purposes, respectively. Approximately one-third of the water used in 2005 was saline water produced during petroleum production. Future changes in use of freshwater in this area will be affected primarily by changes in population and agricultural practices. Future changes in saline water use will be affected substantially by changes in petroleum production. Parts of the area periodically are subject to flooding and severe droughts that can limit available water resources, particularly during summers, when water use increases and streamflows substantially decrease. Most of the area is characterized by rural types of land cover such as grassland, pasture/hay fields, and deciduous forest, which may limit negative effects on water quality by human activities because of lesser emissions of man-made chemicals on such areas than in more urbanized areas. Much of the water in the area is of good quality, though some parts of this area have water quality impaired by very hard surface water and groundwater; large chloride concentrations in some smaller streams; relatively large concentrations of nutrients and counts of fecal-indicator bacteria in the North Canadian River; and chloride, iron, manganese, and uranium concentrations that exceed primary or secondary drinking-water standards in water samples collected from small numbers of wells. Substantial amounts of hydrologic and water-quality data have been collected in much of this area, but there are gaps in those data caused by relatively few streamflow-gaging stations, uneven distribution of surface-water quality sampling sites, lack of surface-water quality sampling at high-flow and low-flow conditions, and lack of a regularly measured and sampled groundwater network. This report summarizes existing water-use, climatic, geographic, hydrologic, and water-quality data and describes several means of filling gaps in hydrologic data for this area.

Methodology and reporting of diagnostic accuracy studies of automated perimetry in glaucoma: evaluation using a standardised approach.

PubMed

Fidalgo, Bruno M R; Crabb, David P; Lawrenson, John G

2015-05-01

To evaluate methodological and reporting quality of diagnostic accuracy studies of perimetry in glaucoma and to determine whether there had been any improvement since the publication of the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines. A systematic review of English language articles published between 1993 and 2013 reporting the diagnostic accuracy of perimetry in glaucoma. Articles were appraised for methodological quality using the 14-item Quality assessment tool for diagnostic accuracy studies (QUADAS) and evaluated for quality of reporting by applying the STARD checklist. Fifty-eight articles were appraised. Overall methodological quality of these studies was moderate with a median number of QUADAS items rated as 'yes' equal to nine (out of a maximum of 14) (IQR 7-10). The studies were often poorly reported; median score of STARD items fully reported was 11 out of 25 (IQR 10-14). A comparison of the studies published in 10-year periods before and after the publication of the STARD checklist in 2003 found quality of reporting had not substantially improved. Methodological and reporting quality of diagnostic accuracy studies of perimetry is sub-optimal and appears not to have improved substantially following the development of the STARD reporting guidance. This observation is consistent with previous studies in ophthalmology and in other medical specialities. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

Gluten-free food database: the nutritional quality and cost of packaged gluten-free foods

PubMed Central

Schwingshackl, Lukas; Billmann, Alina; Mystek, Aleksandra; Hickelsberger, Melanie; Bauer, Gregor; König, Jürgen

2015-01-01

Notwithstanding a growth in popularity and consumption of gluten-free (GF) food products, there is a lack of substantiated analysis of the nutritional quality compared with their gluten-containing counterparts. To put GF foods into proper perspective both for those who need it (patients with celiac disease) and for those who do not, we provide contemporary data about cost and nutritional quality of GF food products. The objective of this study is to develop a food composition database for seven discretionary food categories of packaged GF products. Nutrient composition, nutritional information and cost of foods from 63 GF and 126 gluten-containing counterparts were systematically obtained from 12 different Austrian supermarkets. The nutrition composition (macro and micronutrients) was analyzed by using two nutrient composition databases in a stepwise approximation process. A total of 63 packaged GF foods were included in the analysis representing a broad spectrum of different GF categories (flour/bake mix, bread and bakery products, pasta and cereal-based food, cereals, cookies and cakes, snacks and convenience food). Our results show that the protein content of GF products is >2 fold lower across 57% of all food categories. In 65% of all GF foods, low sodium content was observed (defined as <120 mg/100 g). Across all GF products, 19% can be classified as source high in fiber (defined as >6g/100 g). On average, GF foods were substantially higher in cost, ranging from +205% (cereals) to +267% (bread and bakery products) compared to similar gluten-containing products. In conclusion, our results indicate that for GF foods no predominant health benefits are indicated; in fact, some critical nutrients must be considered when being on a GF diet. For individuals with celiac disease, the GF database provides a helpful tool to identify the food composition of their medical diet. For healthy consumers, replacing gluten-containing products with GF foods is aligned with substantial cost differences but GF foods do not provide additional health benefits from a nutritional perspective. PMID:26528408

Defining wilderness quality: the role of standards in wilderness management—a workshop proceedings.

Treesearch

B. Shelby; G. Stankey; B. Shindler

1992-01-01

Integral to maintaining wilderness quality is the implementation of ecological, social, and management standards. A substantial body of wilderness research management experience exists nationwide as a common-pool resource for professionals with a specialized interest in incorporating standards into planning processes. In a 2-day interactive workshop, wilderness...

"Parisara": Developing a Collaborative, Free, Public Domain Knowledge Resource on Indian Environment

ERIC Educational Resources Information Center

Gadgil, Madhav

2012-01-01

To address the important challenge of taking good care of India's environment, substantial, good quality information is crucial. Unfortunately, pertinent information is in very short supply. Much of the nationally collected information lacks quality and is incomplete. Modern science has demonstrated that good information flows from an open,…

Quality in Family Child Care: A Focus Group Study with Canadian Providers

ERIC Educational Resources Information Center

Doherty, Gillian

2015-01-01

A substantial proportion of American, Canadian and English preschoolers regularly participate in family child care making its quality of vital importance for the children concerned, their parents, the school system and the society in which they live. This article discusses the seven key caregiver behaviors and physical space characteristics…

Beyond Averages: School Quality in Denver Public Schools

ERIC Educational Resources Information Center

Ooms, Alexander

2014-01-01

Since 2009, academic outcomes for students in Denver Public Schools (DPS) have slowly improved. The primary mechanism for increasing academic performance lies within the district's schools, and on an aggregate level Denver has seen a substantial rise in both the number of quality schools and the percentage of students they serve. Every child…

Elevated CO2 induces substantial and persistent declines in forage quality irrespective of warming in mixed grass prairie

USDA-ARS?s Scientific Manuscript database

Increasing atmospheric [CO2] and temperature are expected to affect the productivity, species composition, biogeochemistry, and therefore the quantity and quality of forage available to herbivores in rangeland ecosystems. Both elevated CO2 (eCO2) and warming affect plant tissue chemistry through mul...

Species composition of regeneration after clearcutting Southern Appalachian hardwoods

Treesearch

David L. Loftis

1989-01-01

Regeneration after clearcutting of Southern Appalachian hardwood stands varies substantially in species composition not only among sites of different quality and previous-stand composition, but also among sites of similar quality and similar previous-stand composition. Severe competition from less desirable species for available growing space is cOllDlon in regenerated...

77 FR 39458 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Section 110(a)(2...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... for the 2008 Lead National Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA... (CAA) section 110(a)(2) necessary to implement, maintain, and enforce the 2008 lead national ambient... On October 15, 2008, EPA substantially strengthened the primary and secondary lead NAAQS (hereafter...

Job-Embedded Professional Learning Essential to Improving Teaching and Learning in Early Education

ERIC Educational Resources Information Center

Pacchiano, Debra; Klein, Rebecca; Hawley, Marsha Shigeyo

2016-01-01

Improving classroom teaching improves children's learning outcomes. In pursuit of those goals, the early education field has made substantial investments aimed at increasing the quality of classroom environments and teacher-child interactions. Yet, in publicly funded programs across the country, the quality of instruction remains low and…

Predictors of Global Quality in Family Child Care Homes: Structural and Belief Characteristics

ERIC Educational Resources Information Center

Hughes-Belding, Kere; Hegland, Susan; Stein, Amanda; Sideris, John; Bryant, Donna

2012-01-01

Research Findings: With a substantial number of young children receiving care in family child care settings, an examination of the characteristics, both structural and attitudinal, that predict program quality is warranted. The current study examines gaps in the research by examining both structural characteristics and provider beliefs that…

A systematic review of instruments that assess the implementation of hospital quality management systems.

PubMed

Groene, Oliver; Botje, Daan; Suñol, Rosa; Lopez, Maria Andrée; Wagner, Cordula

2013-10-01

Health-care providers invest substantial resources to establish and implement hospital quality management systems. Nevertheless, few tools are available to assess implementation efforts and their effect on quality and safety outcomes. This review aims to (i) identify instruments to assess the implementation of hospital quality management systems, (ii) describe their measurement properties and (iii) assess the effects of quality management on quality improvement and quality of care outcomes. We performed a systematic literature search from 1990 to 2011 in PubMed, CINAHL, EMBASE, Cochrane Library and Web of Science. In addition, we used snowball strategies, screened the reference lists of eligible papers, reviewed grey literature and contacted experts in the field. and data extraction Two reviewers screened eligible papers based on pre-defined inclusion and exclusion criteria and all authors extracted data. Eligible papers are described in terms of general characteristics (settings, type and level of respondents, mode of data collection), methodological properties (sampling strategy, item derivation, conceptualization of quality management, assessment of reliability and validity, scoring) and application/implementation (accounting for context, organizational adaptations, sensitivity to change, deployment and effect size). Eighteen papers were deemed eligible for inclusion. While some common domains emerged in measurement conceptualization, substantial differences in scope persist. The instruments' measurement properties were insufficiently described and only few instruments assessed links between the implementation of quality management systems (QMS) and improvement strategies or outcomes. There is currently no well-established measure to assess the implementation and effectiveness of quality management systems. Future research should address this gap.

Quality of life in children surviving cancer: a personality and multi-informant perspective.

PubMed

De Clercq, Barbara; De Fruyt, Filip; Koot, Hans M; Benoit, Yves

2004-12-01

To describe quality of life (QoL) of children surviving cancer in relation to their personality, using self- and maternal reports and examining differences with healthy referents. Sixty-seven children who survived childhood cancer were compared with eighty-one healthy children on QoL and personality characteristics. Children who survived cancer reported higher QoL than healthy children, whereas there were no differences for personality. Two main effects emerged for informant with children rating themselves as less neurotic and more conscientious than their mothers. The correspondence between mothers and children was substantially higher for survivors for QoL and personality ratings. QoL and trait measures share substantial variance, and personality traits significantly predict QoL. Parental personality ratings explained child QoL beyond children's personality ratings. Personality traits contribute to quality of life, indicating that personality significantly influences child's quality of life beyond the experience of a negative life event such as surviving cancer and its treatment. From a diagnostic perspective, parental trait ratings are informative in addition to children's ratings of personality to understand children's QoL.

Water quality of the Little Arkansas River and Equus Beds Aquifer before and concurrent with large-scale artificial recharge, south-central Kansas, 1995-2012

USGS Publications Warehouse

Tappa, Daniel J.; Lanning-Rush, Jennifer L.; Klager, Brian J.; Hansen, Cristi V.; Ziegler, Andrew C.

2015-01-01

Recharge activities at Phase I recharge wells have not resulted in substantial effects on groundwater quality in the area, likely because the total amount of water recharged is relatively small (1 billion gallons) compared to aquifer storage volume (greater than 990 billion gallons in winter 2012). The eastward movement of the Burrton chloride plume is likely being slowed by a line of recharge locations associated with Phase I; however, chloride concentrations in deep groundwater still advanced to less than one half mile from the central part of the study area. Water-quality constituents of concern (major ions, nutrients, trace elements, triazine herbicides, and fecal indicator bacteria) have not increased substantially and are likely more affected by climatological (natural recharge by precipitation) and natural (geochemical oxidation/reduction, metabolic and decay rates) processes than artificial recharge. Arsenic remains a water-quality constituent of concern because of natural and continued persistence of concentrations exceeding the Federal maximum contaminant level of 10 micrograms per liter, especially in the deeper parts of theEquus Beds aquifer.

Little Evidence That Time in Child Care Causes Externalizing Problems During Early Childhood in Norway

PubMed Central

Zachrisson, Henrik Daae; Dearing, Eric; Lekhal, Ratib; Toppelberg, Claudio O.

2012-01-01

Associations between maternal reports of hours in child care and children’s externalizing problems at 18 and 36 months of age were examined in a population-based Norwegian sample (n = 75,271). Within a sociopolitical context of homogenously high-quality child care, there was little evidence that high quantity of care causes externalizing problems. Using conventional approaches to handling selection bias and listwise deletion for substantial attrition in this sample, more hours in care predicted higher problem levels, yet with small effect sizes. The finding, however, was not robust to using multiple imputation for missing values. Moreover, when sibling and individual fixed-effects models for handling selection bias were used, no relation between hours and problems was evident. PMID:23311645

High Photoluminescence Quantum Yield in Band Gap Tunable Bromide Containing Mixed Halide Perovskites.

PubMed

Sutter-Fella, Carolin M; Li, Yanbo; Amani, Matin; Ager, Joel W; Toma, Francesca M; Yablonovitch, Eli; Sharp, Ian D; Javey, Ali

2016-01-13

Hybrid organic-inorganic halide perovskite based semiconductor materials are attractive for use in a wide range of optoelectronic devices because they combine the advantages of suitable optoelectronic attributes and simultaneously low-cost solution processability. Here, we present a two-step low-pressure vapor-assisted solution process to grow high quality homogeneous CH3NH3PbI3-xBrx perovskite films over the full band gap range of 1.6-2.3 eV. Photoluminescence light-in versus light-out characterization techniques are used to provide new insights into the optoelectronic properties of Br-containing hybrid organic-inorganic perovskites as a function of optical carrier injection by employing pump-powers over a 6 orders of magnitude dynamic range. The internal luminescence quantum yield of wide band gap perovskites reaches impressive values up to 30%. This high quantum yield translates into substantial quasi-Fermi level splitting and high "luminescence or optically implied" open-circuit voltage. Most importantly, both attributes, high internal quantum yield and high optically implied open-circuit voltage, are demonstrated over the entire band gap range (1.6 eV ≤ Eg ≤ 2.3 eV). These results establish the versatility of Br-containing perovskite semiconductors for a variety of applications and especially for the use as high-quality top cell in tandem photovoltaic devices in combination with industry dominant Si bottom cells.

Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program.

PubMed

Guertin, Marie-Hélène; Théberge, Isabelle; Zomahoun, Hervé Tchala Vignon; Dufresne, Michel-Pierre; Pelletier, Éric; Brisson, Jacques

2018-05-01

The study sought to determine if mammography quality is associated with the false positive (FP) rate in the Quebec breast cancer screening program in 2004 and 2005. Mammography quality of a random sample of screen-film mammograms was evaluated by an expert radiologist following the criteria of the Canadian Association of Radiologists. For each screening examination, scores ranging from 1 (poor quality) to 5 (excellent quality) were attributed for positioning, compression, contrast, exposure level, sharpness, and artifacts. A final overall quality score (lower or higher) was also given. Poisson regression models with robust estimation of variance and adjusted for potential confounding factors were used to assess associations of mammography quality with the FP rate. Among 1,209 women without cancer, there were 104 (8.6%) FPs. Lower overall mammography quality is associated with an increase in the FP rate (risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.1; P = .07) but this increase was not statistically significant. Artifacts were associated with an increase in the FP rate (RR, 2.1; 95% CI, 1.3-3.3; P = .01) whereas lower quality of exposure level was related to a reduction of the FP rate (RR, 0.4; 95% CI, 0.1-1.0; P = .01). Lower quality scores for all other quality attributes were related to a nonstatistically significant increase in the FP rate of 10%-30%. Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

HerzMobil Tirol network: rationale for and design of a collaborative heart failure disease management program in Austria.

PubMed

Von der Heidt, Andreas; Ammenwerth, Elske; Bauer, Karl; Fetz, Bettina; Fluckinger, Thomas; Gassner, Andrea; Grander, Willhelm; Gritsch, Walter; Haffner, Immaculata; Henle-Talirz, Gudrun; Hoschek, Stefan; Huter, Stephan; Kastner, Peter; Krestan, Susanne; Kufner, Peter; Modre-Osprian, Robert; Noebl, Josef; Radi, Momen; Raffeiner, Clemens; Welte, Stefan; Wiseman, Andreas; Poelzl, Gerhard

2014-11-01

Heart failure (HF) is approaching epidemic proportions worldwide and is the leading cause of hospitalization in the elderly population. High rates of readmission contribute substantially to excessive health care costs and highlight the fragmented nature of care available to HF patients. Disease management programs (DMPs) have been implemented to improve health outcomes, patient satisfaction, and quality of life, and to reduce health care costs. Telemonitoring systems appear to be effective in the vulnerable phase after discharge from hospital to prevent early readmissions. DMPs that emphasize comprehensive patient education and guideline-adjusted therapy have shown great promise to result in beneficial long-term effects. It can be speculated that combining core elements of the aforementioned programs may substantially improve long-term cost-effectiveness of patient management.We introduce a collaborative post-discharge HF disease management program (HerzMobil Tirol network) that incorporates physician-controlled telemonitoring and nurse-led care in a multidisciplinary network approach.

Transient structural variations have strong effects on quantitative traits and reproductive isolation in fission yeast

PubMed Central

Jeffares, Daniel C.; Jolly, Clemency; Hoti, Mimoza; Speed, Doug; Shaw, Liam; Rallis, Charalampos; Balloux, Francois; Dessimoz, Christophe; Bähler, Jürg; Sedlazeck, Fritz J.

2017-01-01

Large structural variations (SVs) within genomes are more challenging to identify than smaller genetic variants but may substantially contribute to phenotypic diversity and evolution. We analyse the effects of SVs on gene expression, quantitative traits and intrinsic reproductive isolation in the yeast Schizosaccharomyces pombe. We establish a high-quality curated catalogue of SVs in the genomes of a worldwide library of S. pombe strains, including duplications, deletions, inversions and translocations. We show that copy number variants (CNVs) show a variety of genetic signals consistent with rapid turnover. These transient CNVs produce stoichiometric effects on gene expression both within and outside the duplicated regions. CNVs make substantial contributions to quantitative traits, most notably intracellular amino acid concentrations, growth under stress and sugar utilization in winemaking, whereas rearrangements are strongly associated with reproductive isolation. Collectively, these findings have broad implications for evolution and for our understanding of quantitative traits including complex human diseases. PMID:28117401

Demographics and run timing of adult Lost River (Deltistes luxatus) and shortnose (Chasmistes brevirostris) suckers in Upper Klamath Lake, Oregon, 2011

USGS Publications Warehouse

Hewitt, David A.; Janney, Eric C.; Hayes, Brian S.; Harris, Alta C.

2012-01-01

Despite relatively high survival in most years, both species have experienced substantial declines in the abundance of spawning fish because losses from mortality have not been balanced by recruitment of new individuals. Although capture-recapture data indicate substantial recruitment of new individuals into the adult spawning populations for SNS and river spawning LRS in some years, size data do not corroborate these estimates. In fact, fork length data indicate that all populations are largely comprised of fish that were present in the late 1990s and early 2000s. As a result, the status of the endangered sucker populations in Upper Klamath Lake remains worrisome, and the situation is most dire for shortnose suckers. Future investigations should explore the connections between sucker recruitment and survival and various environmental factors, such as water quality and disease. Our monitoring program provides a robust platform for estimating vital population parameters, evaluating the status of the populations, and assessing the effectiveness of conservation and recovery efforts.

Dissecting the indirect effects caused by vaccines into the basic elements

PubMed Central

Scarbrough Lefebvre, Carla D; Terlinden, Augustin; Standaert, Baudouin

2015-01-01

Vaccination directly protects vaccinated individuals, but it also has the potential for indirectly protecting the unvaccinated in a population (herd protection). Unintended negative consequences such as the re-manifestation of infection, mainly expressed as age shifts, result from vaccination programs as well. We discuss the necessary conditions for achieving optimal herd protection (i.e., high quality vaccine-induced immunity, substantial effect on the force of infection, and appropriate vaccine coverage and distribution), as well as the conditions under which age shifts are likely to occur. We show examples to illustrate these effects. Substantial ambiguity in observing and quantifying these indirect vaccine effects makes accurate evaluation troublesome even though the nature of these outcomes may be critical for accurate assessment of the economic value when decision makers are evaluating a novel vaccine for introduction into a particular region or population group. More investigation is needed to identify and develop successful assessment methodologies for precisely analyzing these outcomes. PMID:26186100

Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review

PubMed Central

Merlin, Jessica S.; Bulls, Hailey W.; Vucovich, Lee A.; Edelman, E. Jennifer; Starrels, Joanna L.

2016-01-01

Chronic pain occurs in as many as 85% of individuals with HIV and is associated with substantial functional impairment. Little guidance is available for HIV providers seeking to address their patients’ chronic pain. We conducted a systematic review to identify clinical trials and observational studies that examined the impact of pharmacologic or non-pharmacologic interventions on pain and/or functional outcomes among HIV-infected individuals with chronic pain in high-development countries. Eleven studies met inclusion criteria and were mostly low or very low quality. Seven examined pharmacologic interventions (gabapentin, pregabalin, capsaicin, analgesics including opioids) and four examined non-pharmacologic interventions (cognitive behavioral therapy, self-hypnosis, smoked cannabis). The only controlled studies with positive results were of capsaicin and cannabis, and had short-term follow-up (≤12 weeks). Among the seven studies of pharmacologic interventions, five had substantial pharmaceutical industry sponsorship. These findings highlight several important gaps in the HIV/chronic pain literature that require further research. PMID:27267445

Playing Chemical Plant Environmental Protection Games with Historical Monitoring Data.

PubMed

Zhu, Zhengqiu; Chen, Bin; Reniers, Genserik; Zhang, Laobing; Qiu, Sihang; Qiu, Xiaogang

2017-09-29

The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a result, the deterioration of surrounding ecosystems and a quality decrease of the atmospheric environment can be observed. Previous works in this domain fail to generate executable and pragmatic solutions for inspection agencies due to practical challenges. In addressing these challenges, we introduce a so-called Chemical Plant Environment Protection Game (CPEP) to generate reasonable schedules of high-accuracy air quality monitoring stations (i.e., daily management plans) for inspection agencies. First, so-called Stackelberg Security Games (SSGs) in conjunction with source estimation methods are applied into this research. Second, high-accuracy air quality monitoring stations as well as gas sensor modules are modeled in the CPEP game. Third, simplified data analysis on the regularly discharging of chemical plants is utilized to construct the CPEP game. Finally, an illustrative case study is used to investigate the effectiveness of the CPEP game, and a realistic case study is conducted to illustrate how the models and algorithms being proposed in this paper, work in daily practice. Results show that playing a CPEP game can reduce operational costs of high-accuracy air quality monitoring stations. Moreover, evidence suggests that playing the game leads to more compliance from the chemical plants towards the inspection agencies. Therefore, the CPEP game is able to assist the environmental protection authorities in daily management work and reduce the potential risks of gaseous pollutants dispersion incidents.

Diffusion tensor imaging (DTI) with retrospective motion correction for large-scale pediatric imaging.

PubMed

Holdsworth, Samantha J; Aksoy, Murat; Newbould, Rexford D; Yeom, Kristen; Van, Anh T; Ooi, Melvyn B; Barnes, Patrick D; Bammer, Roland; Skare, Stefan

2012-10-01

To develop and implement a clinical DTI technique suitable for the pediatric setting that retrospectively corrects for large motion without the need for rescanning and/or reacquisition strategies, and to deliver high-quality DTI images (both in the presence and absence of large motion) using procedures that reduce image noise and artifacts. We implemented an in-house built generalized autocalibrating partially parallel acquisitions (GRAPPA)-accelerated diffusion tensor (DT) echo-planar imaging (EPI) sequence at 1.5T and 3T on 1600 patients between 1 month and 18 years old. To reconstruct the data, we developed a fully automated tailored reconstruction software that selects the best GRAPPA and ghost calibration weights; does 3D rigid-body realignment with importance weighting; and employs phase correction and complex averaging to lower Rician noise and reduce phase artifacts. For select cases we investigated the use of an additional volume rejection criterion and b-matrix correction for large motion. The DTI image reconstruction procedures developed here were extremely robust in correcting for motion, failing on only three subjects, while providing the radiologists high-quality data for routine evaluation. This work suggests that, apart from the rare instance of continuous motion throughout the scan, high-quality DTI brain data can be acquired using our proposed integrated sequence and reconstruction that uses a retrospective approach to motion correction. In addition, we demonstrate a substantial improvement in overall image quality by combining phase correction with complex averaging, which reduces the Rician noise that biases noisy data. Copyright © 2012 Wiley Periodicals, Inc.

Appraisal of Emissions from Ocean-going Vessels Coming to Kolkata Port, India

NASA Astrophysics Data System (ADS)

Mandal, Anindita; Biswas, Jhumoor; Roychowdhury, Soma; Farooqui, Zuber M.

2017-12-01

Rapid economic growth has escalated India's share in international trade. The pressure on these ports, which handle a substantial portion of the trade, has increased to perform with optimal efficiency, and decrease turnaround time so as to increase the number of ships visiting the port area. The caveat is that increased shipping activity is accompanied by enhanced emissions of harmful pollutants and green house gases. This study has revealed increased turnaround time for ships resulting in substantial emissions from auxiliary engines. There should be an optimum balance between operational control and environmental control of pollutants. Kolkata is a megacity with active riverine ports that can generate high levels of air quality emissions, especially NOx, SOx and particulate matter. An exhaustive annual emissions inventory based on ocean going vessels activity has been developed for 2013-2014 for Kolkata port, using recent EPA approved methodology. This includes greenhouse gas emissions from marine engines as well. The study indicates that amongst the different categories of ocean going ships, containers contribute the most (49%) of air and greenhouse gas emissions in 75th percentile class and above followed by general cargo (14%) and oil tankers (13%). The study depicts existing status of marine emissions in Kolkata port from ocean going vessels, which would serve in development of integrated air quality and climate change management plans and serve as a prototype for other major ports of India.

Controlling costs without compromising quality: paying hospitals for total knee replacement.

PubMed

Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

2010-10-01

Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P < 0.001; χ) and 9.9% lower risk-adjusted total costs ($12,773-$11,512; P < 0.001; t test) than all study hospitals. Inefficiency accounted for 96% of excess costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

10 CFR 503.32 - Lack of alternate fuel supply at a cost which does not substantially exceed the cost of using...

Code of Federal Regulations, 2012 CFR

2012-01-01

... reliable supply of an alternate fuel for use as a primary energy source of the quality and quantity... 10 Energy 4 2012-01-01 2012-01-01 false Lack of alternate fuel supply at a cost which does not substantially exceed the cost of using imported petroleum. 503.32 Section 503.32 Energy DEPARTMENT OF ENERGY...

10 CFR 503.32 - Lack of alternate fuel supply at a cost which does not substantially exceed the cost of using...

Code of Federal Regulations, 2014 CFR

2014-01-01

... reliable supply of an alternate fuel for use as a primary energy source of the quality and quantity... 10 Energy 4 2014-01-01 2014-01-01 false Lack of alternate fuel supply at a cost which does not substantially exceed the cost of using imported petroleum. 503.32 Section 503.32 Energy DEPARTMENT OF ENERGY...

10 CFR 503.32 - Lack of alternate fuel supply at a cost which does not substantially exceed the cost of using...

Code of Federal Regulations, 2013 CFR

2013-01-01

... reliable supply of an alternate fuel for use as a primary energy source of the quality and quantity... 10 Energy 4 2013-01-01 2013-01-01 false Lack of alternate fuel supply at a cost which does not substantially exceed the cost of using imported petroleum. 503.32 Section 503.32 Energy DEPARTMENT OF ENERGY...

Adherence to Treatment Guidelines and Therapeutic Regimens: A US Claims-Based Benchmark of a Commercial Population

PubMed Central

Priest, Julie L.; Cook, Christopher L.; Fincham, Jack; Burch, Steven P.

2011-01-01

Abstract The objective of this cross-sectional, retrospective study assessing commercially insured patients was to provide a useful benchmark to US health care payers and decision makers to assess quality of care, medication use and adherence, and health care resource utilization/costs associated with common chronic diseases. Measures of quality of care were suboptimal and substantial numbers of patients were not using any pharmacotherapy considered acceptable according to treatment guidelines. The widespread nature of undertreatment, poor medication adherence, and substantial health care costs highlights deficits and points to the need for comprehensive, multifaceted strategies to improve clinical and economic outcomes for chronic diseases. (Population Health Management 2011;14:33–41) PMID:21142978

Solidification structures grown under induced flow and continuous casting of steel

NASA Technical Reports Server (NTRS)

Tsavaras, A. A.

1984-01-01

The use of induced flow as a means to control solidification structures in strand cast steel is investigated. The quality problems in strand cast steel stemming from columnar growth can be partially controlled, by Electro Magnetic Stirring (EMS). Induced flow changes the normal morphology of dendrites. Solids grown under intense stirring conditions show both negative and positive segregation which is considered unacceptable by some steel producers. The inclusion size and population is strongly affected by induced flow (EMS). Laboratory and industrial data show substantial reduction in inclusion size and content, but the overall effect of flow on inclusions is affected by the particular type of flow patterns utilized in each case. Productivity and quality are raised substantially in steel strand casting by utilizing EMS.

Spectral optical coherence tomography: a novel technique for cornea imaging.

PubMed

Kaluzny, Bartłomiej J; Kaluzy, Bartłomiej J; Kałuzny, Jakub J; Szkulmowska, Anna; Gorczyńska, Iwona; Szkulmowski, Maciej; Bajraszewski, Tomasz; Wojtkowski, Maciej; Targowski, Piotr

2006-09-01

Spectral optical coherence tomography (SOCT) is a new, noninvasive, noncontact, high-resolution technique that provides cross-sectional images of the objects that weakly absorb and scatter light. SOCT, because of very short acquisition time and high sensitivity, is capable of providing tomograms of substantially better quality than the conventional OCT. The aim of this paper is to show the application of the SOCT to cross-sectional imaging of the cornea and its pathologies. Eleven eyes with different corneal pathologies were examined with a slit lamp and the use of a prototype SOCT instrument constructed in the Institute of Physics, Nicolaus Copernicus University, Toruń, Poland. Our SOCT system provides high-resolution (4 microm axial, 10 microm transversal) tomograms composed of 3000-5000 A-scans with an acquisition time of 120-200 ms. The quality of the images is adequate for detailed cross-sectional evaluation of various corneal pathologies. Objective assessment of the localization, size, shape, and light-scattering properties of the changed tissue is possible. Corneal and epithelial thickness and the depth and width of lesions can be estimated. SOCT technique allows acquiring clinically valuable cross-sectional optical biopsy of the cornea and its pathologies.

Personality disorder and treatment outcome in alcohol use disorder.

PubMed

Newton-Howes, Giles; Foulds, James

2018-01-01

As personality disorder impacts the outcome of most major mental disorders, it would be consistent for it to impact negatively on the outcome of alcohol use disorders (AUDs). This update is to provide an up-to-date overview of the recent literature examining the impact of personality disorder and personality traits on the treatment outcome of AUDs. Comorbidity between personality disorder and AUD is significant and approaches 50%. Patients with AUD and comorbid personality disorder are substantially less likely to remain in treatment, drink more per drinking day and drink more frequently. If retained in treatment, comorbidity does not, however, lead to poorer outcomes. Relapse to drinking is more common in patient with high novelty seeking and lower reward dependence and persistence. Reporting from most studies is of moderate-to-poor quality and a single high-quality study may alter these findings. Landmark alcohol studies are notably quiet on the impact of personality on AUD treatment outcome. Both personality disorder and higher novelty seeking impact negatively on the treatment outcome of AUD. As personality disorder is common in this group, clinicians engaged in AUD treatment should screen for personality disturbance, either disorder or high novelty seeking.

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

Aldrich, Robb; Butterfield, Karla

Kaplan Thompson Architects (KTA) has specialized in sustainable, energy-efficient buildings, and they have designed several custom, zero-energy homes in New England. These zero-energy projects have generally been high-end, custom homes with budgets that could accommodate advanced energy systems. In an attempt to make zero energy homes more affordable and accessible to a larger demographic, KTA explored modular construction as way to provide high-quality homes at lower costs. In the mid-2013, KTA formalized this concept when they launched BrightBuilt Home (BBH). The BBH mission is to offer a line of architect-designed, high-performance homes that are priced to offer substantial savings offmore » the lifetime cost of a typical home and can be delivered in less time. For the past two years, CARB has worked with BBH and Keiser Homes (the primary modular manufacturer for BBH) to discuss challenges related to wall systems, HVAC, and quality control. In Spring of 2014, CARB and BBH began looking in detail on a home to be built in Lincolnville, ME by Black Bros. Builders. This report details the solution package specified for this modular plan and the challenges that arose during the project.« less

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

Kaplan Thompson Architects (KTA) has specialized in sustainable, energy-efficient buildings, and they have designed several custom, zero-energy homes in New England. These zero-energy projects have generally been high-end, custom homes with budgets that could accommodate advanced energy systems. In an attempt to make zero energy homes more affordable and accessible to a larger demographic, KTA explored modular construction as way to provide high-quality homes at lower costs. In mid-2013, KTA formalized this concept when they launched BrightBuilt Home (BBH). The BBH mission is to offer 'a line of architect-designed, high-performance homes that are priced to offer substantial savings off themore » lifetime cost of a typical home and can be delivered in less time.' For the past two years, CARB has worked with BBH and Keiser Homes (the primary modular manufacturer for BBH) to discuss challenges related to wall systems, HVAC, and quality control. In Spring of 2014, CARB and BBH began looking in detail on a home to be built in Lincolnville, Maine, by Black Bros. Builders. This report details the solution package specified for this modular plan and the challenges that arose during the project.« less

SIRF: Simultaneous Satellite Image Registration and Fusion in a Unified Framework.

PubMed

Chen, Chen; Li, Yeqing; Liu, Wei; Huang, Junzhou

2015-11-01

In this paper, we propose a novel method for image fusion with a high-resolution panchromatic image and a low-resolution multispectral (Ms) image at the same geographical location. The fusion is formulated as a convex optimization problem which minimizes a linear combination of a least-squares fitting term and a dynamic gradient sparsity regularizer. The former is to preserve accurate spectral information of the Ms image, while the latter is to keep sharp edges of the high-resolution panchromatic image. We further propose to simultaneously register the two images during the fusing process, which is naturally achieved by virtue of the dynamic gradient sparsity property. An efficient algorithm is then devised to solve the optimization problem, accomplishing a linear computational complexity in the size of the output image in each iteration. We compare our method against six state-of-the-art image fusion methods on Ms image data sets from four satellites. Extensive experimental results demonstrate that the proposed method substantially outperforms the others in terms of both spatial and spectral qualities. We also show that our method can provide high-quality products from coarsely registered real-world IKONOS data sets. Finally, a MATLAB implementation is provided to facilitate future research.

“Bad Romance”: Links between Psychological and Physical Aggression and Relationship Functioning in Adolescent Couples

PubMed Central

Seiffge-Krenke, Inge; Burk, William J.

2015-01-01

Assortative mating is an important issue in explaining antisocial, aggressive behavior. It is yet unclear, whether the similarity paradigm fully explains frequent displays of aggression in adolescents’ romantic relationships. In a sample of 194 romantic partner dyads, differences between female and male partners’ reports of aggression (psychological and physical) and different measures of relationship functioning (e.g., jealousy, conflicts, and the affiliative and romantic quality of the relationship) were assessed. A hierarchical cluster analysis identified five distinct subgroups of dyads based on male and female reports of psychological and physical aggression: nonaggressive couples, couples with higher perceived aggressiveness (both physical and psychological) by females, couples with higher aggressiveness perceived by males and mutually aggressive couples. A substantial number of non-aggressive dyads emerged. Of note was the high number of females showing one-sided aggression, which was, however, not countered by their partner. The mutually aggressive couples showed the least adaptive relationship functioning, with a lack of supportive, trusting relationship qualities, high conflict rates and high jealousy. The discussion focuses on the different functions of aggression in these early romantic relations, and the aggravating impact of mutual aggression on relationship functioning and its potential antisocial outcomes. PMID:26067515

Convex relaxations for gas expansion planning

DOE PAGES

Borraz-Sanchez, Conrado; Bent, Russell Whitford; Backhaus, Scott N.; ...

2016-01-01

Expansion of natural gas networks is a critical process involving substantial capital expenditures with complex decision-support requirements. Here, given the non-convex nature of gas transmission constraints, global optimality and infeasibility guarantees can only be offered by global optimisation approaches. Unfortunately, state-of-the-art global optimisation solvers are unable to scale up to real-world size instances. In this study, we present a convex mixed-integer second-order cone relaxation for the gas expansion planning problem under steady-state conditions. The underlying model offers tight lower bounds with high computational efficiency. In addition, the optimal solution of the relaxation can often be used to derive high-quality solutionsmore » to the original problem, leading to provably tight optimality gaps and, in some cases, global optimal solutions. The convex relaxation is based on a few key ideas, including the introduction of flux direction variables, exact McCormick relaxations, on/off constraints, and integer cuts. Numerical experiments are conducted on the traditional Belgian gas network, as well as other real larger networks. The results demonstrate both the accuracy and computational speed of the relaxation and its ability to produce high-quality solution« less

Does enrollment status in community-based insurance lead to poorer quality of care? Evidence from Burkina Faso

PubMed Central

2013-01-01

Introduction In 2004, a community-based health insurance (CBI) scheme was introduced in Nouna health district, Burkina Faso, with the objective of improving financial access to high quality health services. We investigate the role of CBI enrollment in the quality of care provided at primary-care facilities in Nouna district, and measure differences in objective and perceived quality of care and patient satisfaction between enrolled and non-enrolled populations who visit the facilities. Methods We interviewed a systematic random sample of 398 patients after their visit to one of the thirteen primary-care facilities contracted with the scheme; 34% (n = 135) of the patients were currently enrolled in the CBI scheme. We assessed objective quality of care as consultation, diagnostic and counselling tasks performed by providers during outpatient visits, perceived quality of care as patient evaluations of the structures and processes of service delivery, and overall patient satisfaction. Two-sample t-tests were performed for group comparison and ordinal logistic regression (OLR) analysis was used to estimate the association between CBI enrollment and overall patient satisfaction. Results Objective quality of care evaluations show that CBI enrollees received substantially less comprehensive care for outpatient services than non-enrollees. In contrast, CBI enrollment was positively associated with overall patient satisfaction (aOR = 1.51, p = 0.014), controlling for potential confounders such as patient socio-economic status, illness symptoms, history of illness and characteristics of care received. Conclusions CBI patients perceived better quality of care, while objectively receiving worse quality of care, compared to patients who were not enrolled in CBI. Systematic differences in quality of care expectations between CBI enrollees and non-enrollees may explain this finding. One factor influencing quality of care may be the type of provider payment used by the CBI scheme, which has been identified as a leading factor in reducing provider motivation to deliver high quality care to CBI enrollees in previous studies. Based on this study, it is unlikely that perceived quality of care and patient satisfaction explain the low CBI enrollment rates in this community. PMID:23680066

The regulation of patient-reported outcome claims: need for a flexible standard.

PubMed

Morris, Louis A; Miller, David W

2002-01-01

We review the FDA's policies for the regulation of patient-reported outcome (PRO) claims such as quality of life, productivity, satisfaction and symptom reports and suggest alternative standards for substantiation. We base our review on FDA regulatory activities and public statements in the field of advertising substantiation. We compare these activities to the FDA's label substantiation policies and policies for health-economic (HE) claim substantiation. There is an overt inconsistency between the FDA's policies for substantiation of PRO claims in product labels and substantiation for such claims in advertising materials. This results in a higher standard for PRO claims in promotional vehicles than in product labels. Rather than relying on a "substantial evidence" standard, the FDA should consider a more flexible standard, such as the one currently applied to information included in the Clinical Trials section of product labels, or adopting a "competent and reliable scientific evidence" standard as set forth in Section 114 of the Food and Drug Administration Modernization Act (FDAMA) for HE data. We conclude that there needs to be greater consistency for substantiation in product labels and promotional materials. Furthermore, reconceptualizing most PRO claims as benefit extrapolations as opposed to efficacy information suggests a less rigorous standard is necessary.

Off-Line Quality Control In Integrated Circuit Fabrication Using Experimental Design

NASA Astrophysics Data System (ADS)

Phadke, M. S.; Kackar, R. N.; Speeney, D. V.; Grieco, M. J.

1987-04-01

Off-line quality control is a systematic method of optimizing production processes and product designs. It is widely used in Japan to produce high quality products at low cost. The method was introduced to us by Professor Genichi Taguchi who is a Deming-award winner and a former Director of the Japanese Academy of Quality. In this paper we will i) describe the off-line quality control method, and ii) document our efforts to optimize the process for forming contact windows in 3.5 Aim CMOS circuits fabricated in the Murray Hill Integrated Circuit Design Capability Laboratory. In the fabrication of integrated circuits it is critically important to produce contact windows of size very near the target dimension. Windows which are too small or too large lead to loss of yield. The off-line quality control method has improved both the process quality and productivity. The variance of the window size has been reduced by a factor of four. Also, processing time for window photolithography has been substantially reduced. The key steps of off-line quality control are: i) Identify important manipulatable process factors and their potential working levels. ii) Perform fractional factorial experiments on the process using orthogonal array designs. iii) Analyze the resulting data to determine the optimum operating levels of the factors. Both the process mean and the process variance are considered in this analysis. iv) Conduct an additional experiment to verify that the new factor levels indeed give an improvement.

Reporting Quality of Randomized, Controlled Trials Evaluating Combined Chemoradiotherapy in Nasopharyngeal Carcinoma

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

Chen, Yu-Pei; Chen, Lei; Li, Wen-Fei

Purpose: To comprehensively assess the reporting quality of randomized, controlled trials (RCTs) in nasopharyngeal carcinoma (NPC), and to identify significant predictors of quality. Methods and Materials: Two investigators searched MEDLINE and EMBASE for RCTs published between January 1988 and December 2015 that assessed the effect of combined chemoradiotherapy for NPC. The overall quality of each report was assessed using a 28-point overall quality score (OQS) based on the 2010 Consolidated Standards of Reporting Trials (CONSORT) statement. To provide baseline data for further evaluation, we also investigated the reporting quality of certain important issues in detail, including key methodologic items (allocationmore » concealment, blinding, intention-to-treat principle), endpoints, follow-up, subgroup analyses, and adverse events. Results: We retrieved 24 relevant RCTs including 6591 patients. Median 2010 OQS was 15.5 (range, 10-24). Half of the items in the 2010 OQS were poorly reported in at least 40% of trials. Multivariable regression models revealed that publication after 2010 and high impact factor were significant predictors of improved 2010 OQS. Additionally, many issues that we consider significant were not reported adequately. Conclusions: Despite publication of the CONSORT statement more than a decade ago, overall reporting quality for RCTs in NPC was unsatisfactory. Additionally, substantial selectivity and heterogeneity exists in reporting of certain crucial issues. This survey provides the first prompt for NPC trial investigators to improve reporting quality according to the CONSORT statement; increased scrutiny and diligence by editors and peer reviewers is also required.« less

Design and Testing of a Tool for Evaluating the Quality of Diabetes Consumer-Information Web Sites

PubMed Central

Steinwachs, Donald; Rubin, Haya R

2003-01-01

Background Most existing tools for measuring the quality of Internet health information focus almost exclusively on structural criteria or other proxies for quality information rather than evaluating actual accuracy and comprehensiveness. Objective This research sought to develop a new performance-measurement tool for evaluating the quality of Internet health information, test the validity and reliability of the tool, and assess the variability in diabetes Web site quality. Methods An objective, systematic tool was developed to evaluate Internet diabetes information based on a quality-of-care measurement framework. The principal investigator developed an abstraction tool and trained an external reviewer on its use. The tool included 7 structural measures and 34 performance measures created by using evidence-based practice guidelines and experts' judgments of accuracy and comprehensiveness. Results Substantial variation existed in all categories, with overall scores following a normal distribution and ranging from 15% to 95% (mean was 50% and median was 51%). Lin's concordance correlation coefficient to assess agreement between raters produced a rho of 0.761 (Pearson's r of 0.769), suggesting moderate to high agreement. The average agreement between raters for the performance measures was 0.80. Conclusions Diabetes Web site quality varies widely. Alpha testing of this new tool suggests that it could become a reliable and valid method for evaluating the quality of Internet health sites. Such an instrument could help lay people distinguish between beneficial and misleading information. PMID:14713658

Low toxicity high temperature PMR polyimide

NASA Technical Reports Server (NTRS)

Pater, Ruth H. (Inventor)

1992-01-01

In-situ polymerization of monomer reactants (PMR) type polyimides constitute an important class of ultra high performance composite matrix resins. PMR-15 is the best known and most widely used PMR polyimide. An object of the present invention is to provide a substantially improved high temperature PMR-15 system that exhibits better processability, toughness, and thermo-oxidative stability than PMR-15, as well as having a low toxicity. Another object is to provide new PMR polyimides that are useful as adhesives, moldings, and composite matrices. By the present invention, a new PMR polyimide comprises a mixture of the following compounds: 3,4'-oxydianiline (3,4'-ODA), NE, and BTDE which are then treated with heat. This PMR was designated LaRC-RP46 and has a broader processing window, better reproducibility of high quality composite parts, better elevated temperature mechanical properties, and higher retention of mechanical properties at an elevated temperature, particularly, at 371 C.

Using Publicly Available Data to Construct a Transparent Measure of Health Care Value: A Method and Initial Results.

PubMed

Weeks, William B; Kotzbauer, Gregory R; Weinstein, James N

2016-06-01

Using publicly available Hospital Compare and Medicare data, we found a substantial range of hospital-level performance on quality, expenditure, and value measures for 4 common reasons for admission. Hospitals' ability to consistently deliver high-quality, low-cost care varied across the different reasons for admission. With the exception of coronary artery bypass grafting, hospitals that provided the highest-value care had more beds and a larger average daily census than those providing the lowest-value care. Transparent data like those we present can empower patients to compare hospital performance, make better-informed treatment decisions, and decide where to obtain care for particular health care problems. In the United States, the transition from volume to value dominates discussions of health care reform. While shared decision making might help patients determine whether to get care, transparency in procedure- and hospital-specific value measures would help them determine where to get care. Using Hospital Compare and Medicare expenditure data, we constructed a hospital-level measure of value from a numerator composed of quality-of-care measures (satisfaction, use of timely and effective care, and avoidance of harms) and a denominator composed of risk-adjusted 30-day episode-of-care expenditures for acute myocardial infarction (1,900 hospitals), coronary artery bypass grafting (884 hospitals), colectomy (1,252 hospitals), and hip replacement surgery (1,243 hospitals). We found substantial variation in aggregate measures of quality, cost, and value at the hospital level. Value calculation provided additional richness when compared to assessment based on quality or cost alone: about 50% of hospitals in an extreme quality- (and about 65% more in an extreme cost-) quintile were in the same extreme value quintile. With the exception of coronary artery bypass grafting, higher-value hospitals were larger and had a higher average daily census than lower-value hospitals, but were no more likely to be accredited by the Joint Commission or to have a residency program accredited by the American Council of Graduate Medical Education. While future efforts to compose value measures will certainly be modified and expanded to examine other reasons for admission, the construct that we present could allow patients to transparently compare procedure- and hospital-specific quality, spending, and value and empower them to decide where to obtain care. © 2016 Milbank Memorial Fund.

Risk of bias in overviews of reviews: a scoping review of methodological guidance and four-item checklist.

PubMed

Ballard, Madeleine; Montgomery, Paul

2017-03-01

To assess the conditions under which employing an overview of systematic reviews is likely to lead to a high risk of bias. To synthesise existing guidance concerning overview practice, a scoping review was conducted. Four electronic databases were searched with a pre-specified strategy (PROSPERO 2015:CRD42015027592) ending October 2015. Included studies needed to describe or develop overview methodology. Data were narratively synthesised to delineate areas highlighted as outstanding challenges or where methodological recommendations conflict. Twenty-four papers met the inclusion criteria. There is emerging debate regarding overlapping systematic reviews; systematic review scope; quality of included research; updating; and synthesizing and reporting results. While three functions for overviews have been proposed-identify gaps, explore heterogeneity, summarize evidence-overviews cannot perform the first; are unlikely to achieve the second and third simultaneously; and can only perform the third under specific circumstances. Namely, when identified systematic reviews meet the following four conditions: (1) include primary trials that do not substantially overlap, (2) match overview scope, (3) are of high methodological quality, and (4) are up-to-date. Considering the intended function of proposed overviews with the corresponding methodological conditions may improve the quality of this burgeoning publication type. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

EVALUATING THE EFFECTS OF NEAR ROAD SOLID AND ...

EPA Pesticide Factsheets

Public health concerns for populations living, working and going to school near high-traffic roadways has increased substantially in recent years. Air quality measurement studies indicate high pollutant concentrations can occur near these large roads, impacting population exposures and health effects. Roadside features have been shown to alter pollutant transport and dispersion from the road, affecting near-road concentrations and exposures for nearby populations. Air quality, wind tunnel and tracer gas measurement studies have identified the potential for noise barriers and roadside vegetation to reduce near-road air pollution concentrations, under some conditions by over 50 percent. However, some roadside conditions have been shown to result in increased downwind pollutant concentrations. The data from these studies have been used to develop and evaluate air dispersion model algorithms to simulate pollutant transport and dispersion around and over these features. This presentation will provide an overview of field and wind tunnel studies which have investigated how roadside features alter near-road air quality, how these studies have led to the development of dispersion model algorithms, and recommendations on the design and location of these features to maximize opportunities for pollution reduction and minimize potential increases in near-road pollutant concentrations. Presentation for the CRC MSAT workshop; requested by organizing committee and OTAQ

Strategies for improved French-language health services: Perspectives of family physicians in northeastern Ontario.

PubMed

Gauthier, Alain P; Timony, Patrick E; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

2015-08-01

To identify strategies to improve the quality of health services for Francophone patients. A series of semistructured key informant interviews. Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist.

Effect of high-pressure processing and thermal pasteurization on overall quality parameters of white grape juice.

PubMed

Chang, Yin-Hsuan; Wu, Sz-Jie; Chen, Bang-Yuan; Huang, Hsiao-Wen; Wang, Chung-Yi

2017-08-01

The aim of this study was to investigate the microbial levels, physicochemical and antioxidant properties and polyphenol oxidase (PPO) and peroxidase (POD) activities as well as to conduct a sensory analysis of white grape juice treated with high-pressure processing (HPP) and thermal pasteurization (TP), over a period of 20 days of refrigerated storage. HPP treatment of 600 MPa and TP significantly reduced aerobic bacteria, coliform and yeast/mold counts. At day 20 of storage, HPP-600 juice displayed no significant differences compared with fresh juice in terms of physicochemical properties such as titratable acidity, pH and soluble solids, and retained less than 50% PPO and POD activities. Although significant differences were observed in the color, antioxidant contents and antioxidant capacity of HPP-treated juice, the extent of these differences was substantially lower than that in TP-treated juice, indicating that HPP treatment can better retain the quality of grape juice. Sensory testing showed no significant difference between HPP-treated juice and fresh juice, while TP reduced the acceptance of grape juice. This study shows that HPP treatment maintained the overall quality parameters of white grape juice, thus effectively extending the shelf life during refrigerated storage. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Management issues for women with epilepsy-Focus on pregnancy (an evidence-based review): I. Obstetrical complications and change in seizure frequency: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society.

PubMed

Harden, Cynthia L; Hopp, Jennifer; Ting, Tricia Y; Pennell, Page B; French, Jacqueline A; Allen Hauser, W; Wiebe, Samuel; Gronseth, Gary S; Thurman, David; Meador, Kimford J; Koppel, Barbara S; Kaplan, Peter W; Robinson, Julian N; Gidal, Barry; Hovinga, Collin A; Wilner, Andrew N; Vazquez, Blanca; Holmes, Lewis; Krumholz, Allan; Finnell, Richard; Le Guen, Claire

2009-05-01

A committee assembled by the American Academy of Neurology (AAN) reassessed the evidence related to the care of women with epilepsy (WWE) during pregnancy, including the risk of pregnancy complications or other medical problems during pregnancy, change in seizure frequency, the risk of status epilepticus, and the rate of remaining seizure-free during pregnancy. The committee evaluated the available evidence according to a structured literature review and classification of relevant articles. For WWE who are taking antiepileptic drugs (AEDs), there is probably no substantially increased risk (>2 times expected) of cesarean delivery or late pregnancy bleeding, and probably no moderately increased risk (>1.5 times expected) of premature contractions or premature labor and delivery. There is possibly a substantially increased risk of premature contractions and premature labor and delivery during pregnancy for WWE who smoke. WWE should be counseled that seizure freedom for at least 9 months prior to pregnancy is probably associated with a high likelihood (84-92%) of remaining seizure-free during pregnancy. WWE who smoke should be counseled that they possibly have a substantially increased risk of premature contractions and premature labor and delivery.

Increasing quality and managing complexity in neuroinformatics software development with continuous integration.

PubMed

Zaytsev, Yury V; Morrison, Abigail

2012-01-01

High quality neuroscience research requires accurate, reliable and well maintained neuroinformatics applications. As software projects become larger, offering more functionality and developing a denser web of interdependence between their component parts, we need more sophisticated methods to manage their complexity. If complexity is allowed to get out of hand, either the quality of the software or the speed of development suffer, and in many cases both. To address this issue, here we develop a scalable, low-cost and open source solution for continuous integration (CI), a technique which ensures the quality of changes to the code base during the development procedure, rather than relying on a pre-release integration phase. We demonstrate that a CI-based workflow, due to rapid feedback about code integration problems and tracking of code health measures, enabled substantial increases in productivity for a major neuroinformatics project and additional benefits for three further projects. Beyond the scope of the current study, we identify multiple areas in which CI can be employed to further increase the quality of neuroinformatics projects by improving development practices and incorporating appropriate development tools. Finally, we discuss what measures can be taken to lower the barrier for developers of neuroinformatics applications to adopt this useful technique.

Increasing quality and managing complexity in neuroinformatics software development with continuous integration

PubMed Central

Zaytsev, Yury V.; Morrison, Abigail

2013-01-01

High quality neuroscience research requires accurate, reliable and well maintained neuroinformatics applications. As software projects become larger, offering more functionality and developing a denser web of interdependence between their component parts, we need more sophisticated methods to manage their complexity. If complexity is allowed to get out of hand, either the quality of the software or the speed of development suffer, and in many cases both. To address this issue, here we develop a scalable, low-cost and open source solution for continuous integration (CI), a technique which ensures the quality of changes to the code base during the development procedure, rather than relying on a pre-release integration phase. We demonstrate that a CI-based workflow, due to rapid feedback about code integration problems and tracking of code health measures, enabled substantial increases in productivity for a major neuroinformatics project and additional benefits for three further projects. Beyond the scope of the current study, we identify multiple areas in which CI can be employed to further increase the quality of neuroinformatics projects by improving development practices and incorporating appropriate development tools. Finally, we discuss what measures can be taken to lower the barrier for developers of neuroinformatics applications to adopt this useful technique. PMID:23316158

Effects of selected pectinolytic bacterial strains on water-retting of hemp and fibre properties.

PubMed

Di Candilo, M; Bonatti, P M; Guidetti, C; Focher, B; Grippo, C; Tamburini, E; Mastromei, G

2010-01-01

To study the effect of selected bacterial strains on hemp water-retting and properties of retted fibre. The trials were performed in laboratory tanks. The traditional water-retting process, without inoculum addition, was compared to a process modified by inoculating water tanks with two selected pectinolytic bacteria: the anaerobic strain Clostridium sp. L1/6 and the aerobic strain Bacillus sp. ROO40B. Six different incubation times were compared. Half the fibre obtained from each tank was combed. Micromorphological analyses were performed by scanning electron microscopy on uncombed and combed fibres. Moreover, organoleptic and chemical analyses of uncombed fibres were performed. The inoculum, besides speeding up the process, significantly improved the fibre quality. The fibre was not damaged by mechanical hackling, thanks to the good retting level obtained by the addition of selected strains, differently to what happened with the traditionally retted fibre. The best fibre quality was obtained after 3-4 days of retting with the addition of the bacterial inoculum. Retting is the major limitation to an efficient production of high-quality hemp fibres. The water-retting process and fibre quality were substantially improved by simultaneously inoculating water tanks with two selected pectinolytic strains.

A simulation investigation of scout/attack helicopter directional control requirements for hover and low-speed tasks

NASA Technical Reports Server (NTRS)

Bivens, Courtland C.; Guercio, Joseph G.

1987-01-01

A piloted simulator experiment was conducted to investigate directional axis handling qualities requirements for low speed and hover tasks performed by a Scout/Attack helicopter. Included were the directional characteristics of various candidate light helicopter family configurations. Also, the experiment focused on conventional single main/tail rotor configurations of the OH-58 series aircraft, where the first-order yaw-axis dynamic effects that contributed to the loss of tail rotor control were modeled. Five pilots flew 22 configurations under various wind conditions. Cooper-Harper handling quality ratings were used as the primary measure of merit of each configuration. The results of the experiment indicate that rotorcraft configurations with high directional gust sensitivity require greater minimum yaw damping to maintain satisfactory handling qualities during nap-of-the-Earth flying tasks. It was also determined that both yaw damping and control response are critical handling qualities parameters in performing the air-to-air target acquisition and tracking task. Finally, the lack of substantial yaw damping and larger values of gust sensitivity increased the possibility of loss of directional control at low airspeeds for the single main/tail rotor configurations.

Engineering of Machine tool’s High-precision electric drives

NASA Astrophysics Data System (ADS)

Khayatov, E. S.; Korzhavin, M. E.; Naumovich, N. I.

2018-03-01

In the article it is shown that in mechanisms with numerical program control, high quality of processes can be achieved only in systems that provide adjustment of the working element’s position with high accuracy, and this requires an expansion of the regulation range by the torque. In particular, the use of synchronous reactive machines with independent excitation control makes it possible to substantially increase the moment overload in the sequential excitation circuit. Using mathematical and physical modeling methods, it is shown that in the electric drive with a synchronous reactive machine with independent excitation in a circuit with sequential excitation, it is possible to significantly expand the range of regulation by the torque and this is achieved by the effect of sequential excitation, which makes it possible to compensate for the transverse reaction of the armature.

Experimental realization of underdense plasma photocathode wakefield acceleration at FACET

NASA Astrophysics Data System (ADS)

Scherkl, Paul

2017-10-01

Novel electron beam sources from compact plasma accelerator concepts currently mature into the driving technology for next generation high-energy physics and light source facilities. Particularly electron beams of ultra-high brightness could pave the way for major advances for both scientific and commercial applications, but their generation remains tremendously challenging. The presentation outlines the experimental demonstration of the world's first bright electron beam source from spatiotemporally synchronized laser pulses injecting electrons into particle-driven plasma wakefields at FACET. Two distinctive types of operation - laser-triggered density downramp injection (``Plasma Torch'') and underdense plasma photocathode acceleration (``Trojan Horse'') - and their intermediate transitions are characterized and contrasted. Extensive particle-in-cell simulations substantiate the presentation of experimental results. In combination with novel techniques to minimize the beam energy spread, the acceleration scheme presented here promises ultra-high beam quality and brightness.

Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans.

PubMed

Losina, Elena; Walensky, Rochelle P; Reichmann, William M; Holt, Holly L; Gerlovin, Hanna; Solomon, Daniel H; Jordan, Joanne M; Hunter, David J; Suter, Lisa G; Weinstein, Alexander M; Paltiel, A David; Katz, Jeffrey N

2011-02-15

Obesity and knee osteoarthritis are among the most frequent chronic conditions affecting Americans aged 50 to 84 years. To estimate quality-adjusted life-years lost due to obesity and knee osteoarthritis and health benefits of reducing obesity prevalence to levels observed a decade ago. The U.S. Census and obesity data from national data sources were combined with estimated prevalence of symptomatic knee osteoarthritis to assign persons aged 50 to 84 years to 4 subpopulations: nonobese without knee osteoarthritis (reference group), nonobese with knee osteoarthritis, obese without knee osteoarthritis, and obese with knee osteoarthritis. The Osteoarthritis Policy Model, a computer simulation model of knee osteoarthritis and obesity, was used to estimate quality-adjusted life-year losses due to knee osteoarthritis and obesity in comparison with the reference group. United States. U.S. population aged 50 to 84 years. Quality-adjusted life-years lost owing to knee osteoarthritis and obesity. Estimated total losses of per-person quality-adjusted life-years ranged from 1.857 in nonobese persons with knee osteoarthritis to 3.501 for persons affected by both conditions, resulting in a total of 86.0 million quality-adjusted life-years lost due to obesity, knee osteoarthritis, or both. Quality-adjusted life-years lost due to knee osteoarthritis and/or obesity represent 10% to 25% of the remaining quality-adjusted survival of persons aged 50 to 84 years. Hispanic and black women had disproportionately high losses. Model findings suggested that reversing obesity prevalence to levels seen 10 years ago would avert 178,071 cases of coronary heart disease, 889,872 cases of diabetes, and 111,206 total knee replacements. Such a reduction in obesity would increase the quantity of life by 6,318,030 years and improve life expectancy by 7,812,120 quality-adjusted years in U.S. adults aged 50 to 84 years. Comorbidity incidences were derived from prevalence estimates on the basis of life expectancy of the general population, potentially resulting in conservative underestimates. Calibration analyses were conducted to ensure comparability of model-based projections and data from external sources. The number of quality-adjusted life-years lost owing to knee osteoarthritis and obesity seems to be substantial, with black and Hispanic women experiencing disproportionate losses. Reducing mean body mass index to the levels observed a decade ago in this population would yield substantial health benefits. The National Institutes of Health and the Arthritis Foundation.

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

PubMed Central

2014-01-01

Background To ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implications about the usefulness of paediatric oral health interventions in practice. Methods We conducted a methodological survey including all paediatric dentistry reviews from the COHG. We extracted data on characteristics of included reviews, then assessed the methodological quality using a validated 11-item quality assessment tool (AMSTAR). Finally, we coded each review to indicate whether its authors concluded that an intervention should be implemented in practice, was not supported or was refuted by the evidence, or should be used only in research (inconclusive evidence). Results We selected 37 reviews; most concerned the prevention of caries. The methodological quality was high, except for the assessment of reporting bias. In 7 reviews (19%), the research showed that benefits outweighed harms; in 1, the experimental intervention was found ineffective; and in 29 (78%), evidence was insufficient to assess benefits and harms. In the 7 reviews, topical fluoride treatments (with toothpaste, gel or varnish) were found effective for permanent and deciduous teeth in children and adolescents, and sealants for occlusal tooth surfaces of permanent molars. Conclusions Cochrane reviews of paediatric dentistry were of high quality. They provided strong evidence that topical fluoride treatments and sealants are effective for children and adolescents and thus should be implemented in practice. However, a substantial number of reviews yielded inconclusive evidence. PMID:24716532

The effectiveness and safety of acupuncture for poor semen quality in infertile males: a systematic review and meta-analysis

PubMed Central

Jerng, Ui Min; Jo, Jun-Young; Lee, Seunghoon; Lee, Jin-Moo; Kwon, Ohmin

2014-01-01

The aim of this review is to evaluate the effectiveness and safety of acupuncture for poor semen quality in infertile men. We searched for relevant trials registered up to May 2013 in 14 databases. We selected randomized controlled trials (RCTs) that compared acupuncture, with or without additional treatment, against placebo, sham, no treatment, or the same additional treatment. Two reviewers independently performed the study selection, data extraction, risk of bias and reporting quality appraisal. Risk of bias and reporting quality were appraised by the Cochrane risk of bias tool, the consolidated standards of reporting trials and Standards for Reporting Interventions in Clinical Trials of Acupuncture. The outcomes were sperm motility, sperm concentration, pregnancy rate, and adverse events. Pregnancy was defined as a positive pregnancy test. Four RCTs met the eligibility criteria. Acupuncture increased the percentage of sperm with rapid progression (mean difference - 6.35, 95% confidence interval (CI): 4.38–8.32, P< 0.00001) and sperm concentration (mean difference - 6.42, 95% CI: 4.91–7.92, P< 0.00001), but these two outcomes were substantially heterogeneous among the studies (I2 = 72% and 58%, respectively). No differences in pregnancy rate were found between acupuncture and control groups (odds ratio 1.60, 95% CI: 0.70–3.69, P= 0.27, I2 = 0%). No participants experienced adverse events. The current evidence showing that acupuncture might improve poor semen quality is insufficient because of the small number of studies, inadequacy of procedures and/or insufficient information for semen analysis, high levels of heterogeneity, high risk of bias, and poor quality of reporting. Further large, well-designed RCTs are required. PMID:25038176

A guide to calculating habitat-quality metrics to inform conservation of highly mobile species

USGS Publications Warehouse

Bieri, Joanna A.; Sample, Christine; Thogmartin, Wayne E.; Diffendorfer, James E.; Earl, Julia E.; Erickson, Richard A.; Federico, Paula; Flockhart, D. T. Tyler; Nicol, Sam; Semmens, Darius J.; Skraber, T.; Wiederholt, Ruscena; Mattsson, Brady J.

2018-01-01

Many metrics exist for quantifying the relative value of habitats and pathways used by highly mobile species. Properly selecting and applying such metrics requires substantial background in mathematics and understanding the relevant management arena. To address this multidimensional challenge, we demonstrate and compare three measurements of habitat quality: graph-, occupancy-, and demographic-based metrics. Each metric provides insights into system dynamics, at the expense of increasing amounts and complexity of data and models. Our descriptions and comparisons of diverse habitat-quality metrics provide means for practitioners to overcome the modeling challenges associated with management or conservation of such highly mobile species. Whereas previous guidance for applying habitat-quality metrics has been scattered in diversified tracks of literature, we have brought this information together into an approachable format including accessible descriptions and a modeling case study for a typical example that conservation professionals can adapt for their own decision contexts and focal populations.Considerations for Resource ManagersManagement objectives, proposed actions, data availability and quality, and model assumptions are all relevant considerations when applying and interpreting habitat-quality metrics.Graph-based metrics answer questions related to habitat centrality and connectivity, are suitable for populations with any movement pattern, quantify basic spatial and temporal patterns of occupancy and movement, and require the least data.Occupancy-based metrics answer questions about likelihood of persistence or colonization, are suitable for populations that undergo localized extinctions, quantify spatial and temporal patterns of occupancy and movement, and require a moderate amount of data.Demographic-based metrics answer questions about relative or absolute population size, are suitable for populations with any movement pattern, quantify demographic processes and population dynamics, and require the most data.More real-world examples applying occupancy-based, agent-based, and continuous-based metrics to seasonally migratory species are needed to better understand challenges and opportunities for applying these metrics more broadly.

The Application and Future of Big Database Studies in Cardiology: A Single-Center Experience.

PubMed

Lee, Kuang-Tso; Hour, Ai-Ling; Shia, Ben-Chang; Chu, Pao-Hsien

2017-11-01

As medical research techniques and quality have improved, it is apparent that cardiovascular problems could be better resolved by more strict experiment design. In fact, substantial time and resources should be expended to fulfill the requirements of high quality studies. Many worthy ideas and hypotheses were unable to be verified or proven due to ethical or economic limitations. In recent years, new and various applications and uses of databases have received increasing attention. Important information regarding certain issues such as rare cardiovascular diseases, women's heart health, post-marketing analysis of different medications, or a combination of clinical and regional cardiac features could be obtained by the use of rigorous statistical methods. However, there are limitations that exist among all databases. One of the key essentials to creating and correctly addressing this research is through reliable processes of analyzing and interpreting these cardiologic databases.

Electrical characterization and modeling of the Au/CaF{sub 2}/nSi(111) structures with high-quality tunnel-thin fluoride layer

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

Vexler, M. I.; A. F. Ioffe Physical-Technical Institute of the Russian Academy of Sciences, 26 Polytechnicheskaya Str., 194021 St.-Petersburg; Sokolov, N. S.

2009-04-15

Au/CaF{sub 2}/nSi(111) structures with 4-5 monolayers of epitaxial fluoride are fabricated and electrically tested. The leakage current in these structures was substantially smaller than in similar samples reported previously. Simulations adopting a Franz-type dispersion relation with Franz mass of m{sub F}approx1.2m{sub 0} for carriers in the forbidden band of CaF{sub 2} reproduced the measured current-voltage curves quite satisfactorily. Roughly, these curves could also be reproduced using the parabolic dispersion law with the electron mass of m{sub e}=1.0m{sub 0}, which is a material constant rather than a fitting parameter. Experimental facts and their comparison to modeling results allow qualification of themore » crystalline quality of fabricated structures as sufficient for device applications.« less

Markets for hospital services in Zambia.

PubMed

Nakamba, Pamela; Hanson, Kara; McPake, Barbara

2002-01-01

Hospital reforms involving the introduction of measures to increase competition in hospital markets are being implemented in a range of low and middle-income countries. However, little is understood about the operation of hospital markets outside the USA and the UK. This paper assesses the degree of competition for hospital services in two hospital markets in Zambia (Copperbelt and Midlands), and the implications for prices, quality and efficiency. We found substantial differences among different hospital types in prices, costs and quality, suggesting that the hospital service market is a segmented market. The two markets differ significantly in their degree of competition, with the high cost inpatient services market in Copperbelt relatively more competitive than that in the Midlands market. The implications of these differences are discussed in terms of the potential for competition to improve hospital performance, the impact of market structure on equity of access, and how the government should address the problem of the mine hospitals.

"Targeting to zero" in pediatric oncology: a review of central venous catheter-related bloodstream infections.

PubMed

Secola, Rita; Lewis, Mary Ann; Pike, Nancy; Needleman, Jack; Doering, Lynn

2012-01-01

Reducing or eliminating hospital acquired infections is a national quality of care priority. The majority of the 12,400 children diagnosed with cancer each year require long-term intravenous access to receive intensive and complex therapies. These children are at high risk for infection by nature of their disease and treatment, which often involves use of a central venous catheter (CVC). Throughout the nation, nurses assume frontline responsibility for safe, quality CVC care to minimize the risk of potentially life-threatening infections. Substantial financial and human costs are associated with CVC-related bloodstream infections, including prolonged hospital lengths of stay and increased care required to treat these infections. The purpose of this review of the literature is to summarize existing adult and pediatric data on CVC-related bloodstream infections and explore nursing models of CVC care that may improve pediatric oncology patient outcomes.

Benchmarking heart rate variability toolboxes.

PubMed

Vest, Adriana N; Li, Qiao; Liu, Chengyu; Nemati, Shamim; Shah, Amit; Clifford, Gari D

Heart rate variability (HRV) metrics hold promise as potential indicators for autonomic function, prediction of adverse cardiovascular outcomes, psychophysiological status, and general wellness. Although the investigation of HRV has been prevalent for several decades, the methods used for preprocessing, windowing, and choosing appropriate parameters lack consensus among academic and clinical investigators. A comprehensive and open-source modular program is presented for calculating HRV implemented in Matlab with evidence-based algorithms and output formats. We compare our software with another widely used HRV toolbox written in C and available through PhysioNet.org. Our findings show substantially similar results when using high quality electrocardiograms (ECG) free from arrhythmias. Our software shows equivalent performance alongside an established predecessor and includes validated tools for performing preprocessing, signal quality, and arrhythmia detection to help provide standardization and repeatability in the field, leading to fewer errors in the presence of noise or arrhythmias. Copyright © 2017 Elsevier Inc. All rights reserved.

Isotope Labeling for Solution and Solid-State NMR Spectroscopy of Membrane Proteins

PubMed Central

Verardi, Raffaello; Traaseth, Nathaniel J.; Masterson, Larry R.; Vostrikov, Vitaly V.; Veglia, Gianluigi

2013-01-01

In this chapter, we summarize the isotopic labeling strategies used to obtain high-quality solution and solid-state NMR spectra of biological samples, with emphasis on integral membrane proteins (IMPs). While solution NMR is used to study IMPs under fast tumbling conditions, such as in the presence of detergent micelles or isotropic bicelles, solid-state NMR is used to study the structure and orientation of IMPs in lipid vesicles and bilayers. In spite of the tremendous progress in biomolecular NMR spectroscopy, the homogeneity and overall quality of the sample is still a substantial obstacle to overcome. Isotopic labeling is a major avenue to simplify overlapped spectra by either diluting the NMR active nuclei or allowing the resonances to be separated in multiple dimensions. In the following we will discuss isotopic labeling approaches that have been successfully used in the study of IMPs by solution and solid-state NMR spectroscopy. PMID:23076578

Lognormal kriging for the assessment of reliability in groundwater quality control observation networks

USGS Publications Warehouse

Candela, L.; Olea, R.A.; Custodio, E.

1988-01-01

Groundwater quality observation networks are examples of discontinuous sampling on variables presenting spatial continuity and highly skewed frequency distributions. Anywhere in the aquifer, lognormal kriging provides estimates of the variable being sampled and a standard error of the estimate. The average and the maximum standard error within the network can be used to dynamically improve the network sampling efficiency or find a design able to assure a given reliability level. The approach does not require the formulation of any physical model for the aquifer or any actual sampling of hypothetical configurations. A case study is presented using the network monitoring salty water intrusion into the Llobregat delta confined aquifer, Barcelona, Spain. The variable chloride concentration used to trace the intrusion exhibits sudden changes within short distances which make the standard error fairly invariable to changes in sampling pattern and to substantial fluctuations in the number of wells. ?? 1988.

Birth outcome racial disparities: A result of intersecting social and environmental factors.

PubMed

Burris, Heather H; Hacker, Michele R

2017-10-01

Adverse birth outcomes such as preterm birth, low-birth weight, and infant mortality continue to disproportionately affect black and poor infants in the United States. Improvements in healthcare quality and access have not eliminated these disparities. The objective of this review was to consider societal factors, including suboptimal education, income inequality, and residential segregation, that together lead to toxic environmental exposures and psychosocial stress. Many toxic chemicals, as well as psychosocial stress, contribute to the risk of adverse birth outcomes and black women often are more highly exposed than white women. The extent to which environmental exposures combine with stress and culminate in racial disparities in birth outcomes has not been quantified but is likely substantial. Primary prevention of adverse birth outcomes and elimination of disparities will require a societal approach to improve education quality, income equity, and neighborhoods. Copyright © 2017 Elsevier Inc. All rights reserved.

Genes of the bovine lungworm Dictyocaulus viviparus associated with transition from pasture to parasitism.

PubMed

Strube, C; Buschbaum, S; Schnieder, T

2012-08-01

Genes necessary to enable nematode parasitic life after free-living larval life are of substantial interest to understand parasitism. We investigated transcriptional changes during transition to parasitism in the bovine lungworm Dictyocaulus viviparus, one of the most important parasites in cattle farming due to substantial economic losses. Upregulated transcripts in either free-living, developmentally arrested L3 or parasitic immature L5 were identified by suppression subtractive hybridization (SSH) followed by differential screening and subsequent virtual Northern blot verification. From 400 sequenced clones of parasitic L5, 372 (93.0%) upregulated high quality ESTs were obtained clustering into 30 contigs and 38 singletons. Most conceptual translated peptides were SCP/TAPS "family" members also known as pathogenesis-related protein (PRP) superfamily (28.5% of total ESTs), cysteine proteases (24.5%), and H-gal-GP orthologues (9.9%). These proteins are predicted to play key roles in fundamental biological processes such as nutrition and development but also parasite-host interactions and immune defense mechanisms. Increased energy requirement of the rapidly developing L5 lungworm stage was obvious in a proportion of 12.2% upregulated ESTs being components of the respiratory chain. From the developmentally arrested L3 stage sequencing of 200 clones resulted in 195 high quality ESTs (97.0%) clustering into 7 contigs and 3 singletons only. Besides a hypothetical protein (70.1% of total ESTs) most transcripts encoded the cleavage stimulation factor subunit 2 (17.5%), which is a component of the poly(A(+)) machinery and found to be involved in gene silencing. Obtained data provide the basis for future fundamental research into genes associated with parasitic lifestyle but also applied research like vaccine and/or drug development. Copyright © 2012 Elsevier B.V. All rights reserved.

Parameter estimation methods for gene circuit modeling from time-series mRNA data: a comparative study.

PubMed

Fan, Ming; Kuwahara, Hiroyuki; Wang, Xiaolei; Wang, Suojin; Gao, Xin

2015-11-01

Parameter estimation is a challenging computational problem in the reverse engineering of biological systems. Because advances in biotechnology have facilitated wide availability of time-series gene expression data, systematic parameter estimation of gene circuit models from such time-series mRNA data has become an important method for quantitatively dissecting the regulation of gene expression. By focusing on the modeling of gene circuits, we examine here the performance of three types of state-of-the-art parameter estimation methods: population-based methods, online methods and model-decomposition-based methods. Our results show that certain population-based methods are able to generate high-quality parameter solutions. The performance of these methods, however, is heavily dependent on the size of the parameter search space, and their computational requirements substantially increase as the size of the search space increases. In comparison, online methods and model decomposition-based methods are computationally faster alternatives and are less dependent on the size of the search space. Among other things, our results show that a hybrid approach that augments computationally fast methods with local search as a subsequent refinement procedure can substantially increase the quality of their parameter estimates to the level on par with the best solution obtained from the population-based methods while maintaining high computational speed. These suggest that such hybrid methods can be a promising alternative to the more commonly used population-based methods for parameter estimation of gene circuit models when limited prior knowledge about the underlying regulatory mechanisms makes the size of the parameter search space vastly large. © The Author 2015. Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Assimilation of flood extent data with 2D flood inundation models for localised intense rainfall events

NASA Astrophysics Data System (ADS)

Neal, J. C.; Wood, M.; Bermúdez, M.; Hostache, R.; Freer, J. E.; Bates, P. D.; Coxon, G.

2017-12-01

Remote sensing of flood inundation extent has long been a potential source of data for constraining and correcting simulations of floodplain inundation. Hydrodynamic models and the computing resources to run them have developed to the extent that simulation of flood inundation in two-dimensional space is now feasible over large river basins in near real-time. However, despite substantial evidence that there is useful information content within inundation extent data, even from low resolution SAR such as that gathered by Envisat ASAR in wide swath mode, making use of the information in a data assimilation system has proved difficult. He we review recent applications of the Ensemble Kalman Filter (EnKF) and Particle Filter for assimilating SAR data, with a focus on the River Severn UK and compare these with complementary research that has looked at the internal error sources and boundary condition errors using detailed terrestrial data that is not available in most locations. Previous applications of the EnKF to this reach have focused on upstream boundary conditions as the source of flow error, however this description of errors was too simplistic for the simulation of summer flood events where localised intense rainfall can be substantial. Therefore, we evaluate the introduction of uncertain lateral inflows to the ensemble. A further limitation of the existing EnKF based methods is the need to convert flood extent to water surface elevations by intersecting the shoreline location with a high quality digital elevation model (e.g. LiDAR). To simplify this data processing step, we evaluate a method to directly assimilate inundation extent as a EnKF model state rather than assimilating water heights, potentially allowing the scheme to be used where high-quality terrain data are sparse.

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

Sutter-Fella, Carolin M.; Li, Yanbo; Amani, Matin

Hybrid organic-inorganic halide perovskite based semiconductor materials are attractive for use in a wide range of optoelectronic devices because they combine the advantages of suitable optoelectronic attributes and simultaneously low-cost solution processability. Here, we present a two-step low-pressure vapor-assisted solution process to grow high quality homogeneous CH 3NH 3PbI 3-xBr x perovskite films over the full band gap range of 1.6-2.3 eV. Photoluminescence light-in versus light-out characterization techniques are used to provide new insights into the optoelectronic properties of Br-containing hybrid organic-inorganic perovskites as a function of optical carrier injection by employing pump-powers over a 6 orders of magnitude dynamicmore » range. The internal luminescence quantum yield of wide band gap perovskites reaches impressive values up to 30%. This high quantum yield translates into substantial quasi-Fermi level splitting and high "luminescence or optically implied" open-circuit voltage. Most importantly, both attributes, high internal quantum yield and high optically implied open-circuit voltage, are demonstrated over the entire band gap range (1.6 eV ≤ E g ≤ 2.3 eV). These results establish the versatility of Br-containing perovskite semiconductors for a variety of applications and especially for the use as high-quality top cell in tandem photovoltaic devices in combination with industry dominant Si bottom cells. (Figure Presented).« less

An Experiment with Air Purifiers in Delhi during Winter 2015-2016

PubMed Central

Vyas, Sangita

2016-01-01

Particulate pollution has important consequences for human health, and is an issue of global concern. Outdoor air pollution has become a cause for alarm in India in particular because recent data suggest that ambient pollution levels in Indian cities are some of the highest in the world. We study the number of particles between 0.5μm and 2.5μm indoors while using affordable air purifiers in the highly polluted city of Delhi. Though substantial reductions in indoor number concentrations are observed during air purifier use, indoor air quality while using an air purifier is frequently worse than in cities with moderate pollution, and often worse than levels observed even in polluted cities. When outdoor pollution levels are higher, on average, indoor pollution levels while using an air purifier are also higher. Moreover, the ratio of indoor air quality during air purifier use to two comparison measures of air quality without an air purifier are also positively correlated with outdoor pollution levels, suggesting that as ambient air quality worsens there are diminishing returns to improvements in indoor air quality during air purifier use. The findings of this study indicate that although the most affordable air purifiers currently available are associated with significant improvements in the indoor environment, they are not a replacement for public action in regions like Delhi. Although private solutions may serve as a stopgap, reducing ambient air pollution must be a public health and policy priority in any region where air pollution is as high as Delhi’s during the winter. PMID:27978542

Assessing the nutritional stress hypothesis: Relative influence of diet quantity and quality on seabird productivity

USGS Publications Warehouse

Jodice, Patrick G.R.; Roby, Daniel D.; Turco, K.R.; Suryan, Robert M.; Irons, David B.; Piatt, John F.; Shultz, Michael T.; Roseneau, David G.; Kettle, Arthur B.; Anthony, Jill A.

2006-01-01

Food availability comprises a complex interaction of factors that integrates abundance, taxonomic composition, accessibility, and quality of the prey base. The relationship between food availability and reproductive performance can be assessed via the nutritional stress (NSH) and junk-food (JFH) hypotheses. With respect to reproductive success, NSH posits that a deficiency in any of the aforementioned metrics can have a deleterious effect on a population via poor reproductive success. JFH, a component of NSH, posits specifically that it is a decline in the quality of food (i.e. energy density and lipid content) that leads to poor reproductive success. We assessed each in relation to reproductive success in a piscivorous seabird, the black-legged kittiwake Rissa tridactyla. We measured productivity, taxonomic composition, frequency, size, and quality of meals delivered to nestlings from 1996 to 1999 at 6 colonies in Alaska, USA, 3 each in Prince William Sound and Lower Cook Inlet. Productivity varied widely among colony-years. Pacific herring Clupea pallasi, sand lance Ammodytes hexapterus, and capelin Mallotus villosus comprised ca. 80% of the diet among colony-years, and each was characterized by relatively high energy density. Diet quality for kittiwakes in this region therefore remained uniformly high during this study. Meal delivery rate and meal size were quite variable among colony-years, however, and best explained the variability in productivity. Parent kittiwakes appeared to select prey that were energy dense and that maximized the biomass provisioned to broods. While these results fail to support JFH, they do provide substantial support for NSH.

Medical information on the Internet: Quality assessment of lumbar puncture and neuroaxial block techniques on YouTube.

PubMed

Rössler, Bernhard; Lahner, Daniel; Schebesta, Karl; Chiari, Astrid; Plöchl, Walter

2012-07-01

The Internet has become the largest, most up-to-date source for medical information. Besides enhancing patients' knowledge, the freely accessible audio-visual files have an impact on medical education. However little is known about their characteristics. In this manuscript the quality of lumbar puncture (LP) and spinal anaesthesia (SA) videos available on YouTube is assessed. This retrospective analysis was based on a search for LP and SA on YouTube. Videos were evaluated using essential key points (5 in SA, 4 in LP) and 3 safety indicators. Furthermore, violation of sterile working techniques and a rating whether the video must be regarded as dangerously misleading was performed. From 2321 hits matching the keywords, 38 videos were eligible for evaluation. In LP videos, 14% contained information on all, 4.5% on 3 and 4.5% on 2 key points, 59% on 1 and 18% on no key point. Regarding SA, no video contained information on all 5 key points, 56% on 2-4 and 25% on 1 key point, 19% did not contain any essential information. A sterility violation occurred in 11%, and 13% were classified as dangerously misleading. Even though high quality videos are available, the quality of video clips is generally low. The fraction of videos that were not performed in an aseptic manner is low, but these pose a substantial risk to patients. Consequently, more high-quality, institutional medical learning videos must be made available in the light of the increased utilization on the Internet. Copyright © 2012 Elsevier B.V. All rights reserved.

Characterisation of extra virgin olive oils from Galician autochthonous varieties and their co-crushings with Arbequina and Picual cv.

PubMed

Reboredo-Rodríguez, P; González-Barreiro, C; Cancho-Grande, B; Fregapane, G; Salvador, M D; Simal-Gándara, J

2015-06-01

The current trend of the olive oil market is the production of high quality extra from traditional minor olive varieties with peculiar and differentiated characteristics (especially with respect to the aromatic and phenolic composition). In this way, the interest of Galician oil producers (NW Spain) in recovering old autochthonous Local olive fruits has increased substantially in recent years. In order to investigate the potential of the Local olives by either producing high quality monovarietal oils or mixing with the most widespread olives in Galicia (Arbequina and Picual cv.), quality indices, and fatty acid composition as well as volatile and phenolic profiles were determined and compared. All EVOOs studied in this work can be considered as "extra virgin olive oil" due to quality indices fell within the ranges established in legislation. Picual and Local olive oils as well as those resulting from their co-crushing reach values which are required by EU legislation to add the specific health claim on the oil label. Co-crushing Picual:Local (80:20) provided a significant enhancement of grass and apple nuances and a decrease of banana notes with respect to Picual oils. The co-crushing process improved sensory and health properties of Picual extra virgin olive oils. The effect of co-crushing on phenolics, ester volatiles and banana nuances cannot be easily modulated, contrary to quality indices and fatty acid composition, both changing linearly in strict correlation with the fruit mass ratio. Copyright © 2014 Elsevier Ltd. All rights reserved.

Western USA groundwater drilling

NASA Astrophysics Data System (ADS)

Jasechko, S.; Perrone, D.

2016-12-01

Groundwater in the western US supplies 40% of the water used for irrigated agriculture, and provides drinking water to individuals living in rural regions distal to perennial rivers. Unfortunately, current groundwater use is not sustainable in a number of key food producing regions. While substantial attention has been devoted to mapping groundwater depletion rates across the western US, the response of groundwater users via well drilling to changing land uses, water demands, pump and drilling technologies, pollution vulnerabilities, and economic conditions remains unknown. Here we analyze millions of recorded groundwater drilling events in the western US that span years 1850 to 2015. We show that groundwater wells are being drilled deeper in some, but not all, regions where groundwater levels are declining. Groundwater wells are generally deeper in arid and mountainous regions characterized by deep water tables (e.g., unconfined alluvial and fractured bedrock aquifers), and in regions that have productive aquifers with high water quality deep under the ground (e.g., confined sedimentary aquifers). Further, we relate water quality and groundwater drilling depths in 40 major aquifer systems across the western US. We show that there is substantial room for improvement to the existing 2-D continental-scale assessments of domestic well water vulnerability to pollution if one considers the depth that the domestic well is screened in addition to pollutant loading, surficial geology, and vertical groundwater flow rates. These new continental-scale maps can be used to (i) better assess economic, water quality, and water balance limitations to groundwater usage, (ii) steer domestic well drilling into productive strata bearing clean and protected groundwater resources, and (iii) assess groundwater management schemes across the western US.

Growth rate and surfactant-assisted enhancements of rare-earth arsenide InGaAs nanocomposites for terahertz generation

NASA Astrophysics Data System (ADS)

Salas, R.; Guchhait, S.; Sifferman, S. D.; McNicholas, K. M.; Dasika, V. D.; Jung, D.; Krivoy, E. M.; Lee, M. L.; Bank, S. R.

2017-09-01

We report the effects of the growth rate on the properties of iii-v nanocomposites containing rare-earth-monopnictide nanoparticles. In particular, the beneficial effects of surfactant-assisted growth of LuAs:In0.53Ga0.47As nanocomposites were found to be most profound at reduced LuAs growth rates. Substantial enhancement in the electrical and optical properties that are beneficial for ultrafast photoconductors was observed and is attributed to the higher structural quality of the InGaAs matrix in this new growth regime. The combined enhancements enabled a >50% increase in the amount of LuAs that could be grown without degrading the quality of the InGaAs overgrowth. Dark resistivity increased by ˜25× while maintaining carrier mobilities over 3000 cm2/V s; carrier lifetimes were reduced by >2×, even at high depositions of LuAs. The combined growth rate and surfactant enhancements offer a previously unexplored regime to enable high-performance fast photoconductors that may be integrated with telecom components for compact, broadly tunable, heterodyne THz source and detectors.

Rapid cloning of genes in hexaploid wheat using cultivar-specific long-range chromosome assembly.

PubMed

Thind, Anupriya Kaur; Wicker, Thomas; Šimková, Hana; Fossati, Dario; Moullet, Odile; Brabant, Cécile; Vrána, Jan; Doležel, Jaroslav; Krattinger, Simon G

2017-08-01

Cereal crops such as wheat and maize have large repeat-rich genomes that make cloning of individual genes challenging. Moreover, gene order and gene sequences often differ substantially between cultivars of the same crop species. A major bottleneck for gene cloning in cereals is the generation of high-quality sequence information from a cultivar of interest. In order to accelerate gene cloning from any cropping line, we report 'targeted chromosome-based cloning via long-range assembly' (TACCA). TACCA combines lossless genome-complexity reduction via chromosome flow sorting with Chicago long-range linkage to assemble complex genomes. We applied TACCA to produce a high-quality (N50 of 9.76 Mb) de novo chromosome assembly of the wheat line CH Campala Lr22a in only 4 months. Using this assembly we cloned the broad-spectrum Lr22a leaf-rust resistance gene, using molecular marker information and ethyl methanesulfonate (EMS) mutants, and found that Lr22a encodes an intracellular immune receptor homologous to the Arabidopsis thaliana RPM1 protein.

Nutrient budget for Saguling Reservoir, West Java, Indonesia.

PubMed

Hart, Barry T; van Dok, Wendy; Djuangsih, Nani

2002-04-01

A preliminary nutrient budget for Saguling Reservoir is reported as a first attempt to quantify the behaviour of nutrients entering this reservoir. This work is part of a larger Indonesia-Australia collaborative research and training project, involving Padjadjaran University and Monash University, established to study nutrient dynamics in Saguling Reservoir. Saguling Reservoir, the first of a chain of three large reservoirs (Saguling, Cirata and Jatilahur), built on the Citarum River in central Java, was completed in 1985. It has already become highly polluted, particularly with domestic and industrial effluent (organic matter, nutrients, heavy metals) from the urban areas of Bandung (population 2 million). The reservoir experiences major water quality problems, including excessive growths of floating plants, toxic cyanobacterial blooms and regular fish-kills. The work reported in this paper shows that Saguling receives a very large nutrient load from the city of Bandung and because of this, is highly eutrophic. It is unlikely that the water quality of Saguling will improve until a substantial part of Bandung is sewered and adequate discharge controls are placed on the many industries in the region upstream of the reservoir.

Subscribing to Databases: How Important Is Depth and Quality of Indexing?

ERIC Educational Resources Information Center

Delong, Linwood

2007-01-01

This paper compares the subject indexing on articles pertaining to Immanuel Kant, agriculture, and aging that are found simultaneously in Humanities Index, Academic Search Elite (EBSCO) and Periodicals Research II (Micromedia ProQuest), in order to show that there are substantial variations in the depth and quality of indexing in these databases.…

A Longitudinal Study of Applicants for the Superintendency.

ERIC Educational Resources Information Center

O'Connell, Raymond W.

This study documents trends in the number and quality of applicants for superintendency over time and the success rate of female applicants throughout the search process. Substantial data indicate a gender bias in selecting superintendents. Data collected in New York in 1999 were compared to 1995 data to determine if the size and quality of the…

Child Care Quality and Children's Cortisol in Basque Country and the Netherlands

ERIC Educational Resources Information Center

Vermeer, Harriet J.; Groeneveld, Marleen G.; Larrea, Inaki; van IJzendoorn, Marinus H.; Barandiaran, Alexander; Linting, Marielle

2010-01-01

A cross-country comparison of children's cortisol levels at child care was performed in relation to their cortisol levels at home and the quality and quantity of child care they received. Participants were toddlers visiting child care centers in Spanish Basque Country (N = 60) and the Netherlands (N = 25) with substantial variation in structural…

Improving the Nutritional Quality of the Lunches of Elementary School Children

ERIC Educational Resources Information Center

Farris, Alisha R.

2015-01-01

Over 50 million children attend public elementary and secondary schools in the United States each day. Children spend a substantial portion of their waking hours in school and consume one-third to one-half of their daily calories there, making schools a promising site to influence dietary quality and potentially the risk of childhood obesity.…

Has It Always Been This Way? Tracing the Evolution of Teacher Quality Gaps in U.S. Public Schools

ERIC Educational Resources Information Center

Goldhaber, Dan; Quince, Vanessa; Theobald, Roddy

2018-01-01

There is mounting evidence of substantial "teacher quality gaps" (TQGs) between advantaged and disadvantaged students but practically no empirical evidence about their history. We use longitudinal data on public school students, teachers, and schools from two states--North Carolina and Washington--to provide a descriptive history of the…

Performance Appraisal vs. Quality Management: Getting Past the Paradox.

ERIC Educational Resources Information Center

Marcum, James W.

A primary goal of the quality movement, like the traditional management techniques that preceded it, is to get the most committed effort possible from the members of the organization. This document surveys the literature in order to summarize the substantial debate on how to achieve that goal, and then offers a theoretical context of strategic…

Quality assessment of expert answers to lay questions about cystic fibrosis from various language zones in Europe: the ECORN-CF project.

PubMed

d'Alquen, Daniela; De Boeck, Kris; Bradley, Judy; Vávrová, Věra; Dembski, Birgit; Wagner, Thomas O F; Pfalz, Annette; Hebestreit, Helge

2012-02-06

The European Centres of Reference Network for Cystic Fibrosis (ECORN-CF) established an Internet forum which provides the opportunity for CF patients and other interested people to ask experts questions about CF in their mother language. The objectives of this study were to: 1) develop a detailed quality assessment tool to analyze quality of expert answers, 2) evaluate the intra- and inter-rater agreement of this tool, and 3) explore changes in the quality of expert answers over the time frame of the project. The quality assessment tool was developed by an expert panel. Five experts within the ECORN-CF project used the quality assessment tool to analyze the quality of 108 expert answers published on ECORN-CF from six language zones. 25 expert answers were scored at two time points, one year apart. Quality of answers was also assessed at an early and later period of the project. Individual rater scores and group mean scores were analyzed for each expert answer. A scoring system and training manual were developed analyzing two quality categories of answers: content and formal quality. For content quality, the grades based on group mean scores for all raters showed substantial agreement between two time points, however this was not the case for the grades based on individual rater scores. For formal quality the grades based on group mean scores showed only slight agreement between two time points and there was also poor agreement between time points for the individual grades. The inter-rater agreement for content quality was fair (mean kappa value 0.232 ± 0.036, p < 0.001) while only slight agreement was observed for the grades of the formal quality (mean kappa value 0.105 ± 0.024, p < 0.001). The quality of expert answers was rated high (four language zones) or satisfactory (two language zones) and did not change over time. The quality assessment tool described in this study was feasible and reliable when content quality was assessed by a group of raters. Within ECORN-CF, the tool will help ensure that CF patients all over Europe have equal possibility of access to high quality expert advice on their illness. © 2012 d’Alquen et al; licensee BioMed Central Ltd.

Dynamic intensity-weighted region of interest imaging for conebeam CT

PubMed Central

Pearson, Erik; Pan, Xiaochuan; Pelizzari, Charles

2017-01-01

BACKGROUND Patient dose from image guidance in radiotherapy is small compared to the treatment dose. However, the imaging beam is untargeted and deposits dose equally in tumor and healthy tissues. It is desirable to minimize imaging dose while maintaining efficacy. OBJECTIVE Image guidance typically does not require full image quality throughout the patient. Dynamic filtration of the kV beam allows local control of CT image noise for high quality around the target volume and lower quality elsewhere, with substantial dose sparing and reduced scatter fluence on the detector. METHODS The dynamic Intensity-Weighted Region of Interest (dIWROI) technique spatially varies beam intensity during acquisition with copper filter collimation. Fluence is reduced by 95% under the filters with the aperture conformed dynamically to the ROI during cone-beam CT scanning. Preprocessing to account for physical effects of the collimator before reconstruction is described. RESULTS Reconstructions show image quality comparable to a standard scan in the ROI, with higher noise and streak artifacts in the outer region but still adequate quality for patient localization. Monte Carlo modeling shows dose reduction by 10–15% in the ROI due to reduced scatter, and up to 75% outside. CONCLUSIONS The presented technique offers a method to reduce imaging dose by accepting increased image noise outside the ROI, while maintaining full image quality inside the ROI. PMID:27257875

Nursing home 5-star rating system exacerbates disparities in quality, by payer source.

PubMed

Konetzka, R Tamara; Grabowski, David C; Perraillon, Marcelo Coca; Werner, Rachel M

2015-05-01

Market-based reforms in health care, such as public reporting of quality, may inadvertently exacerbate disparities. We examined how the Centers for Medicare and Medicare Services' five-star rating system for nursing homes has affected residents who are dually enrolled in Medicare and Medicaid ("dual eligibles"), a particularly vulnerable and disadvantaged population. Specifically, we assessed the extent to which dual eligibles and non-dual eligibles avoided the lowest-rated nursing homes and chose the highest-rated homes once the five-star rating system began, in late 2008. We found that both populations resided in better-quality homes over time but that by 2010 the increased likelihood of choosing the highest-rated homes was substantially smaller for dual eligibles than for non-dual eligibles. Thus, the gap in quality, as measured by a nursing home's star rating, grew over time. Furthermore, we found that the benefit of the five-star system to dual eligibles was largely due to providers' improving their ratings, not to consumers' choosing different providers. We present evidence suggesting that supply constraints play a role in limiting dual eligibles' responses to quality ratings, since high-quality providers tend to be located close to relatively affluent areas. Increases in Medicaid payment rates for nursing home services may be the only long-term solution. Project HOPE—The People-to-People Health Foundation, Inc.

Quality of life and illness costs in irritable bowel syndrome.

PubMed

Simrén, Magnus; Brazier, John; Coremans, Georges; Dapoigny, Michel; Müller-Lissner, Stefan A; Pace, Fabio; Smout, André J P M; Stockbrügger, Reinhold W; Vatn, Morten H; Whorwell, Peter J

2004-01-01

Quality of life is reduced in patients with irritable bowel syndrome, and the costs for this disease are substantial to society. During a meeting in London, UK, the IBiS club reviewed the literature on these subjects. Drawbacks and advantages with existing instruments to assess quality of life and costs were discussed and the clinical and scientific relevance of the current knowledge was assessed. A summary from the meeting is presented in this paper.

Good jobs, good pay, better health? The effects of job quality on health among older European workers.

PubMed

Henseke, Golo

2018-01-01

Using data from the Survey of Health, Ageing and Retirement in Europe, this study presents new evidence on the effects of job quality on the occurrence of severe acute conditions, the level of cardiovascular risk factors, musculoskeletal disorders, mental health, functional disabilities and self-assessed health among workers aged 50+. By combining intrinsic job quality with job insecurity and pay the study maps out multiple potential pathways through which work may affect health and well-being. Levering longitudinal data and external information on early retirement ages allows for accounting of unobserved heterogeneity, selection bias and reverse causality. The empirical findings suggest that inequities in health correlate with inequities in job quality, though a substantial fraction of these associations reflect time-constant unobserved heterogeneity. Still, there is evidence for genuine protective effects of better jobs on musculoskeletal disorders, mental health and general health. The effect could contribute to a substantial number of avoidable disorders among older workers, despite relatively modest effect sizes at the level of individuals. Mental health, in particular, responds to changes in job quality. Selection bias such as the healthy worker effect does not alter the results. But the influence of job quality on health may be transitional among older workers. An in-depth analysis of health dynamics reveals no evidence for persistence.

On-line, continuous monitoring in solar cell and fuel cell manufacturing using spectral reflectance imaging

DOEpatents

Sopori, Bhushan; Rupnowski, Przemyslaw; Ulsh, Michael

2016-01-12

A monitoring system 100 comprising a material transport system 104 providing for the transportation of a substantially planar material 102, 107 through the monitoring zone 103 of the monitoring system 100. The system 100 also includes a line camera 106 positioned to obtain multiple line images across a width of the material 102, 107 as it is transported through the monitoring zone 103. The system 100 further includes an illumination source 108 providing for the illumination of the material 102, 107 transported through the monitoring zone 103 such that light reflected in a direction normal to the substantially planar surface of the material 102, 107 is detected by the line camera 106. A data processing system 110 is also provided in digital communication with the line camera 106. The data processing system 110 is configured to receive data output from the line camera 106 and further configured to calculate and provide substantially contemporaneous information relating to a quality parameter of the material 102, 107. Also disclosed are methods of monitoring a quality parameter of a material.

Chronic pain and opioid misuse: a review of reviews.

PubMed

Voon, Pauline; Karamouzian, Mohammad; Kerr, Thomas

2017-08-15

The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse. A systematic database search was conducted to identify systematic reviews published between 2000 and 2016. Eligible studies were systematic reviews related to chronic non-cancer pain and PO or other substance misuse. Evidence from the included reviews was synthesized according to epidemiology and clinical management themes. Of 1908 identified articles, 18 systematic reviews were eligible for final inclusion. Two meta-analyses estimated the prevalence of chronic non-cancer pain in individuals using POs non-medically to be approximately 48% to 60%, which is substantially higher than the prevalence of chronic non-cancer pain in general population samples (11% to 19%). Five systematic reviews estimated the rates of PO or other opioid use in chronic pain populations with substantial variation in results (0.05% to 81%), likely due to widely varying definitions of dependence, substance use disorder, misuse, addiction, and abuse. Several clinical assessment and treatment approaches were identified, including: standardized assessment instruments; urine drug testing; medication counts; prescription drug monitoring programs; blood level monitoring; treatment agreements; opioid selection; dosing and dispensing strategies; and opioid agonist treatment. However, the reviews commonly noted serious limitations, inconsistencies, and imprecision of studies, and a lack of evidence on effectiveness or clinical utility for the majority of these strategies. Overall, current systematic reviews have found a lack of high-quality evidence or consistent findings on the prevalence, risk factors, and optimal clinical assessment and treatment approaches related to concurrent chronic pain and substance misuse. Given the role of systematic reviews in guiding evidence-based medicine and health policy, there is an urgent need for high-quality primary research to guide future systematic reviews to address the escalating epidemic of harms related to chronic pain and substance misuse.

The Cross-Sectional Association between Diet Quality and Depressive Symptomology amongst Fijian Adolescents

PubMed Central

Sinclair, Rachael; Millar, Lynne; Allender, Steven; Snowdon, Wendy; Waqa, Gade; Jacka, Felice; Moodie, Marj; Petersen, Solveig; Swinburn, Boyd

2016-01-01

Objective To examine the relationship between diet quality and depressive symptomology amongst a community-based sample of Fijian adolescents. Methods Participants included 7,237 adolescents (52.6% girls; mean age 15.6 years) at baseline (2005) and 2,948 (56% girls; mean age 17.4 years) at follow-up (2007/2008), from the Pacific Obesity Prevention in Communities Project. Intervention schools (n = 7) were selected from Nasinu, near Suva on the main Fijian island Viti Levu, and comparison schools (n = 11) were chosen from towns on the opposite, west side of the island. A dietary questionnaire was used to measure diet quality. Factor analysis clustered dietary variables into two unique and independent factors, referred to as healthy diet quality and unhealthy diet quality. Depressive symptomology was assessed via the emotional subscale of the Paediatric Quality of Life Inventory. Both measures were self-reported and self-administered. Multiple linear regression was used to test cross-sectional associations (at baseline and follow-up) between diet quality and depressive symptomology. Variables controlled for included gender, age, ethnicity, study condition, BMI-z scores, and physical activity. Findings Strong, positive dose-response associations between healthy diet and high emotional scores (lower depressive symptomology) were found in cross-sectional analyses at baseline and follow-up, among boys and girls. No association was found between emotional health and unhealthy diet. Conclusions This study suggests that cross-sectional relationships exist between a high quality diet during adolescence and less depressive symptoms, however more evidence is required to determine if these two variables are linked causally. Trial population health strategies that use dietary interventions as a mechanism for mental health promotion provide an opportunity to further test these associations. If this is indeed a true relationship, these forms of interventions have the potential to be inexpensive and have substantial reach, especially in Low and Middle Income Countries. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12608000345381 PMID:27560960

Effects of continuing professional development on clinical performance

PubMed Central

Goulet, François; Hudon, Eveline; Gagnon, Robert; Gauvin, Eliane; Lemire, Francine; Arsenault, Isabelle

2013-01-01

Abstract Objective To evaluate the link between the quantity and quality of continuing professional development (CPD) activities completed by family physicians in Quebec and the quality of their practice. Design Retrospective analysis of data collected during professional inspection visits (PIVs). Setting Quebec. Participants Three groups were created from among Quebec family physicians who had been subject to PIVs (peer evaluation) by the Collège des médecins du Québec between 1998 and 2005. Group 1 was composed of physicians who were members of the College of Family Physicians of Canada, which requires participation in 250 hours of CPD in every 5-year cycle. Group 2 was composed of family physicians who were not members of the College of Family Physicians of Canada but who had declared at least 50 hours a year of CPD on their Collège des médecins du Québec annual notice of assessment for the same period. Group 3 was composed of family physicians who had declared fewer than 10 hours of CPD a year. Main outcome measures During the PIV, the following characteristics were examined: record keeping, quality and number of hours of CPD activities, and quality of professional practice based on 3 components— clinical investigation, accuracy of diagnosis, and appropriateness of treatment plan and follow-up. Results The factors associated with a high quality of practice were privileges in a hospital or local community health centre (institution) and a substantial number of accredited CPD hours (Mainpro-M1, Credit I, or Mainpro-C). The factors associated with a poor quality of practice were advanced age of the physician, absence of privileges in an institution (hospital or local community health centre), and participation in CPD activities that were more informal, such as reading and non-accredited activities (Mainpro-M2). Conclusion This study supports earlier research showing that CPD activities of sufficient quality and quantity are correlated with a high quality of professional practice by family physicians. PMID:23673591

Community drinking water quality monitoring data: utility for public health research and practice.

PubMed

Jones, Rachael M; Graber, Judith M; Anderson, Robert; Rockne, Karl; Turyk, Mary; Stayner, Leslie T

2014-01-01

Environmental Public Health Tracking (EPHT) tracks the occurrence and magnitude of environmental hazards and associated adverse health effects over time. The EPHT program has formally expanded its scope to include finished drinking water quality. Our objective was to describe the features, strengths, and limitations of using finished drinking water quality data from community water systems (CWSs) for EPHT applications, focusing on atrazine and nitrogen compounds in 8 Midwestern states. Water quality data were acquired after meeting with state partners and reviewed and merged for analysis. Data and the coding of variables, particularly with respect to censored results (nondetects), were not standardized between states. Monitoring frequency varied between CWSs and between atrazine and nitrates, but this was in line with regulatory requirements. Cumulative distributions of all contaminants were not the same in all states (Peto-Prentice test P < .001). Atrazine results were highly censored in all states (76.0%-99.3%); higher concentrations were associated with increased measurement frequency and surface water as the CWS source water type. Nitrate results showed substantial state-to-state variability in censoring (20.5%-100%) and in associations between concentrations and the CWS source water type. Statistical analyses of these data are challenging due to high rates of censoring and uncertainty about the appropriateness of parametric assumptions for time-series data. Although monitoring frequency was consistent with regulations, the magnitude of time gaps coupled with uncertainty about CWS service areas may limit linkage with health outcome data.

Automating PACS quality control with the Vanderbilt image processing enterprise resource

NASA Astrophysics Data System (ADS)

Esparza, Michael L.; Welch, E. Brian; Landman, Bennett A.

2012-02-01

Precise image acquisition is an integral part of modern patient care and medical imaging research. Periodic quality control using standardized protocols and phantoms ensures that scanners are operating according to specifications, yet such procedures do not ensure that individual datasets are free from corruption; for example due to patient motion, transient interference, or physiological variability. If unacceptable artifacts are noticed during scanning, a technologist can repeat a procedure. Yet, substantial delays may be incurred if a problematic scan is not noticed until a radiologist reads the scans or an automated algorithm fails. Given scores of slices in typical three-dimensional scans and widevariety of potential use cases, a technologist cannot practically be expected inspect all images. In large-scale research, automated pipeline systems have had great success in achieving high throughput. However, clinical and institutional workflows are largely based on DICOM and PACS technologies; these systems are not readily compatible with research systems due to security and privacy restrictions. Hence, quantitative quality control has been relegated to individual investigators and too often neglected. Herein, we propose a scalable system, the Vanderbilt Image Processing Enterprise Resource (VIPER) to integrate modular quality control and image analysis routines with a standard PACS configuration. This server unifies image processing routines across an institutional level and provides a simple interface so that investigators can collaborate to deploy new analysis technologies. VIPER integrates with high performance computing environments has successfully analyzed all standard scans from our institutional research center over the course of the last 18 months.

Stability of Cell Wall Composition and Saccharification Efficiency in Miscanthus across Diverse Environments

PubMed Central

van der Weijde, Tim; Dolstra, Oene; Visser, Richard G. F.; Trindade, Luisa M.

2017-01-01

To investigate the potential effects of differences between growth locations on the cell wall composition and saccharification efficiency of the bioenergy crop miscanthus, a diverse set of 15 accessions were evaluated in six locations across Europe for the first 3 years following establishment. High-throughput quantification of cellulose, hemicellulose and lignin contents, as well as cellulose and hemicellulose conversion rates was achieved by combining near-infrared reflectance spectroscopy (NIRS) and biochemical analysis. Prediction models were developed and found to predict biomass quality characteristics with high accuracy. Location significantly affected biomass quality characteristics in all three cultivation years, but location-based differences decreased toward the third year as the plants reached maturity and the effect of location-dependent differences in the rate of establishment reduced. In all locations extensive variation in accession performance was observed for quality traits. The performance of the different accessions in the second and third cultivation year was strongly correlated, while accession performance in the first cultivation year did not correlate well with performance in later years. Significant genotype-by-environment (G × E) interactions were observed for most traits, revealing differences between accessions in environmental sensitivity. Stability analysis of accession performance for calculated ethanol yields suggested that selection for good and stable performance is a viable approach. Environmental influence on biomass quality is substantial and should be taken into account in order to match genotype, location and end-use of miscanthus as a lignocellulose feedstock. PMID:28111583

Stability of Cell Wall Composition and Saccharification Efficiency in Miscanthus across Diverse Environments.

PubMed

van der Weijde, Tim; Dolstra, Oene; Visser, Richard G F; Trindade, Luisa M

2016-01-01

To investigate the potential effects of differences between growth locations on the cell wall composition and saccharification efficiency of the bioenergy crop miscanthus, a diverse set of 15 accessions were evaluated in six locations across Europe for the first 3 years following establishment. High-throughput quantification of cellulose, hemicellulose and lignin contents, as well as cellulose and hemicellulose conversion rates was achieved by combining near-infrared reflectance spectroscopy (NIRS) and biochemical analysis. Prediction models were developed and found to predict biomass quality characteristics with high accuracy. Location significantly affected biomass quality characteristics in all three cultivation years, but location-based differences decreased toward the third year as the plants reached maturity and the effect of location-dependent differences in the rate of establishment reduced. In all locations extensive variation in accession performance was observed for quality traits. The performance of the different accessions in the second and third cultivation year was strongly correlated, while accession performance in the first cultivation year did not correlate well with performance in later years. Significant genotype-by-environment (G × E) interactions were observed for most traits, revealing differences between accessions in environmental sensitivity. Stability analysis of accession performance for calculated ethanol yields suggested that selection for good and stable performance is a viable approach. Environmental influence on biomass quality is substantial and should be taken into account in order to match genotype, location and end-use of miscanthus as a lignocellulose feedstock.

Low-rate image coding using vector quantization

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

Makur, A.

1990-01-01

This thesis deals with the development and analysis of a computationally simple vector quantization image compression system for coding monochrome images at low bit rate. Vector quantization has been known to be an effective compression scheme when a low bit rate is desirable, but the intensive computation required in a vector quantization encoder has been a handicap in using it for low rate image coding. The present work shows that, without substantially increasing the coder complexity, it is indeed possible to achieve acceptable picture quality while attaining a high compression ratio. Several modifications to the conventional vector quantization coder aremore » proposed in the thesis. These modifications are shown to offer better subjective quality when compared to the basic coder. Distributed blocks are used instead of spatial blocks to construct the input vectors. A class of input-dependent weighted distortion functions is used to incorporate psychovisual characteristics in the distortion measure. Computationally simple filtering techniques are applied to further improve the decoded image quality. Finally, unique designs of the vector quantization coder using electronic neural networks are described, so that the coding delay is reduced considerably.« less

Coupling temporal and spatial gradient information in high-density unstructured Lagrangian measurements

NASA Astrophysics Data System (ADS)

Wong, Jaime G.; Rosi, Giuseppe A.; Rouhi, Amirreza; Rival, David E.

2017-10-01

Particle tracking velocimetry (PTV) produces high-quality temporal information that is often neglected when computing spatial gradients. A method is presented here to utilize this temporal information in order to improve the estimation of spatial gradients for spatially unstructured Lagrangian data sets. Starting with an initial guess, this method penalizes any gradient estimate where the substantial derivative of vorticity along a pathline is not equal to the local vortex stretching/tilting. Furthermore, given an initial guess, this method can proceed on an individual pathline without any further reference to neighbouring pathlines. The equivalence of the substantial derivative and vortex stretching/tilting is based on the vorticity transport equation, where viscous diffusion is neglected. By minimizing the residual of the vorticity-transport equation, the proposed method is first tested to reduce error and noise on a synthetic Taylor-Green vortex field dissipating in time. Furthermore, when the proposed method is applied to high-density experimental data collected with `Shake-the-Box' PTV, noise within the spatial gradients is significantly reduced. In the particular test case investigated here of an accelerating circular plate captured during a single run, the method acts to delineate the shear layer and vortex core, as well as resolve the Kelvin-Helmholtz instabilities, which were previously unidentifiable without the use of ensemble averaging. The proposed method shows promise for improving PTV measurements that require robust spatial gradients while retaining the unstructured Lagrangian perspective.

Stagnant Neonatal Mortality and Persistent Health Inequality in Middle-Income Countries: A Case Study of the Philippines

PubMed Central

Kraft, Aleli D.; Nguyen, Kim-Huong; Jimenez-Soto, Eliana; Hodge, Andrew

2013-01-01

Background The probability of survival through childhood continues to be unequal in middle-income countries. This study uses data from the Philippines to assess trends in the prevalence and distribution of child mortality and to evaluate the country’s socioeconomic-related child health inequality. Methodology Using data from four Demographic and Health Surveys we estimated levels and trends of neonatal, infant, and under-five mortality from 1990 to 2007. Mortality estimates at national and subnational levels were produced using both direct and indirect methods. Concentration indices were computed to measure child health inequality by wealth status. Multivariate regression analyses were used to assess the contribution of interventions and socioeconomic factors to wealth-related inequality. Findings Despite substantial reductions in national under-five and infant mortality rates in the early 1990s, the rates of declines have slowed in recent years and neonatal mortality rates remain stubbornly high. Substantial variations across urban-rural, regional, and wealth equity-markers are evident, and suggest that the gaps between the best and worst performing sub-populations will either be maintained or widen in the future. Of the variables tested, recent wealth-related inequalities are found to be strongly associated with social factors (e.g. maternal education), regional location, and access to health services, such as facility-based delivery. Conclusion The Philippines has achieved substantial progress towards Millennium Development Goal 4, but this success masks substantial inequalities and stagnating neonatal mortality trends. This analysis supports a focus on health interventions of high quality – that is, not just facility-based delivery, but delivery by trained staff at well-functioning facilities and supported by a strong referral system – to re-start the long term decline in neonatal mortality and to reduce persistent within-country inequalities in child health. PMID:23308278

Urban sprawl leaves its PAH signature

USGS Publications Warehouse

Van Metre, P.C.; Mahler, B.J.; Furlong, E.T.

2000-01-01

The increasing vehicle traffic associated with urban sprawl in the United States is frequently linked to degradation of air quality, but its effect on aquatic sediment is less well-recognized. This study evaluates trends in PAHs, a group of contaminants with multiple urban sources, in sediment cores from 10 reservoirs and lakes in six U.S. metropolitan areas. The watersheds chosen represent a range in degree and age of urbanization. Concentrations of PAHs in all 10 reservoirs and lakes increased during the past 20-40 years. PAH contamination of the most recently deposited sediment at all sites exceeded sediment-quality guidelines established by Environment Canada, in some cases by several orders of magnitude. These results add a new chapter to the story told by previous coring studies that reported decreasing concentrations of PAHs after reaching highs in the 1950s. Concurrent with the increase in concentrations is a change in the assemblage of PAHs that indicates the increasing trends are driven by combustion sources. The increase in PAH concentrations tracks closely with increases in automobile use, even in watersheds that have not undergone substantial changes in urban land-use levels since the 1970s.The increasing vehicle traffic associated with urban sprawl in the United States is frequently linked to degradation of air quality, but its effect on aquatic sediment is less well-recognized. This study evaluates trends in PAHs, a group of contaminants with multiple urban sources, in sediment cores from 10 reservoirs and lakes in six U.S. metropolitan areas. The watersheds chosen represent a range in degree and age of urbanization. Concentrations of PAHs in all 10 reservoirs and lakes increased during the past 20-40 years. PAH contamination of the most recently deposited sediment at all sites exceeded sediment-quality guidelines established by Environment Canada, in some cases by several orders of magnitude. These results add a new chapter to the story told by previous coring studies that reported decreasing concentrations of PAHs after reaching highs in the 1950s. Concurrent with the increase in concentrations is a change in the assemblage of PAHs that indicates the increasing trends are driven by combustion sources. The increase in PAH concentrations tracks closely with increases in automobile use, even in watersheds that have not undergone substantial changes in urban land-use levels since the 1970s.

TU-EF-204-02: Hiigh Quality and Sub-MSv Cerebral CT Perfusion Imaging

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

Li, Ke; Niu, Kai; Wu, Yijing

2015-06-15

Purpose: CT Perfusion (CTP) imaging is of great importance in acute ischemic stroke management due to its potential to detect hypoperfused yet salvageable tissue and distinguish it from definitely unsalvageable tissue. However, current CTP imaging suffers from poor image quality and high radiation dose (up to 5 mSv). The purpose of this work was to demonstrate that technical innovations such as Prior Image Constrained Compressed Sensing (PICCS) have the potential to address these challenges and achieve high quality and sub-mSv CTP imaging. Methods: (1) A spatial-temporal 4D cascaded system model was developed to indentify the bottlenecks in the current CTPmore » technology; (2) A task-based framework was developed to optimize the CTP system parameters; (3) Guided by (1) and (2), PICCS was customized for the reconstruction of CTP source images. Digital anthropomorphic perfusion phantoms, animal studies, and preliminary human subject studies were used to validate and evaluate the potentials of using these innovations to advance the CTP technology. Results: The 4D cascaded model was validated in both phantom and canine stroke models. Based upon this cascaded model, it has been discovered that, as long as the spatial resolution and noise properties of the 4D source CT images are given, the 3D MTF and NPS of the final CTP maps can be analytically derived for a given set of processing methods and parameters. The cascaded model analysis also identified that the most critical technical factor in CTP is how to acquire and reconstruct high quality source images; it has very little to do with the denoising techniques often used after parametric perfusion calculations. This explained why PICCS resulted in a five-fold dose reduction or substantial improvement in image quality. Conclusion: Technical innovations generated promising results towards achieving high quality and sub-mSv CTP imaging for reliable and safe assessment of acute ischemic strokes. K. Li, K. Niu, Y. Wu: Nothing to disclose. G.-H. Chen: Research funded, GE Healthcare; Research funded, Siemens AX.« less

Wildfires and storms: Increased vulnerability of water quality in the southwestern U.S. in the face of climate change

NASA Astrophysics Data System (ADS)

Murphy, S. F.; Writer, J. H.; McCleskey, R. B.; Martin, D. A.

2014-12-01

Communities in the southwestern U.S. rely on forested watersheds to provide high-quality water, but these watersheds are prone to major disturbance by wildfire. The loss of vegetation and litter can decrease water storage and infiltration and decrease nutrient uptake, leading to enhanced surface runoff, erosion, and nutrient export compared to undisturbed watersheds. Post-wildfire impacts on water quality vary widely across geographic regions, and are largely driven by post-fire storm timing and intensity. In the southwestern U.S., the North American Monsoon can produce high-intensity rain from July through September. A better understanding of the post-fire water-quality response of watersheds to monsoonal storms in this region is therefore critical. The Fourmile Canyon Fire burned 2600 ha near Boulder, Colorado in September 2010, including 23% of the Fourmile Creek watershed. This watershed had been recovering from historical mining activity, and dispersed waste rock and mine tailings were only partially revegetated before the wildfire. We collected water quality, hydrological, and meteorological data with high temporal and spatial density upstream and downstream of the burned area for 4 years post-fire. For 9 months post-fire, the area received snow or low-intensity rain, and the difference in stream water chemistry between burned and unburned watersheds was minimal. However, in the summer of 2011, and in the following two summers, relatively common monsoonal storms caused dramatic, but short-lived, increases in discharge, sediment, nitrate, dissolved organic carbon, and metals downstream of the burned area. Such pulses can degrade aquatic ecosystems, impair water treatability, and decrease reservoir capacity. Climate change is projected to increase wildfire frequency and size and lead to an earlier and longer wildfire season. Simultaneously, storm frequency and intensity are predicted to increase, and the monsoon season may occur later in the year, potentially decreasing the average length of time between wildfire and subsequent high-intensity rain events. This suggests that substantial water-quality impacts may be more common in the future, resulting in a new paradigm for water treatment in the southwestern U.S.

Assessment of nonpoint-source contamination of the High Plains Aquifer in south-central Kansas, 1987

USGS Publications Warehouse

Helgesen, John O.; Stullken, Lloyd E.; Rutledge, A.T.

1992-01-01

Ground-water quality was assessed in a 5,000-square-mile area of the High Plains aquifer in south-central Kansas that is susceptible to nonpoint-source contamination from agricultural and petroleum-production activities. Of particular interest were agricultural chemicals, mainly atrazine, and oil-derived hydrocarbons, which might occur in association with brines that formerly were disposed into unlined ponds.Random sampling of ground water was done within a framework of discrete land-use areas (irrigated cropland, petroleum-production land containing former brine-disposal ponds, and undeveloped rangeland) of 3 to 10 square miles. Although true baseline water-quality conditions probably are rare, these baseline conditions are represented most closely by ground water beneath the areas of undeveloped rangeland. The sampling design enabled statistical hypothesis testing of the effects of land use, unsaturated-zone lithology, and type of well sampled. Statistical testing was based on nonparametric procedures.Results indicate that regional ground-water quality has been affected by prevailing land-use activities, as shown mainly by increased concentrations of several inorganic constituents. Ground water beneath irrigated cropland is characterized by significantly (95-percent confidence level) larger concentrations of hardness, alkalinity, calcium, magnesium, potassium, fluoride, and nitrite plus nitrate than is water beneath undeveloped rangeland. Nondegraded pesticides generally were not detected in the aquifer, probably because of degradation and sorption. Atrazine is present locally in ground water in small concentrations.Ground water beneath petroleum-production land is characterized by significantly (95-percent confidence level) larger concentrations of hardness, alkalinity, dissolved solids, sodium, and chloride than is water beneath undeveloped rangeland. Nonpoint-source ground-water contamination by oil-derived hydrocarbons was not discernible. The occurrences of trace-organic compounds were similar between petroleum-production land and undeveloped rangeland, which indicates a natural origin for these compounds.The unsaturated zone in the study area is lithologically heterogeneous and contains substantial amounts of clay that inhibit the downward movement of water and solutes. Within the aquifer, the rate of regional lateral flow and solute transport is sufficiently slow so that the ground-water quality reflects overlying land use in discrete areas of several square miles. Regional flow, however, is sufficiently rapid so that the type of well sampled is not important in regional characterization of water quality beneath irrigated cropland; the seasonal pumping of irrigation wells does not appear to divert regional flow enough to cause substantial local anomalies of more mineralized ground water.

Space telescope scientific instruments

NASA Technical Reports Server (NTRS)

Leckrone, D. S.

1979-01-01

The paper describes the Space Telescope (ST) observatory, the design concepts of the five scientific instruments which will conduct the initial observatory observations, and summarizes their astronomical capabilities. The instruments are the wide-field and planetary camera (WFPC) which will receive the highest quality images, the faint-object camera (FOC) which will penetrate to the faintest limiting magnitudes and achieve the finest angular resolution possible, and the faint-object spectrograph (FOS), which will perform photon noise-limited spectroscopy and spectropolarimetry on objects substantially fainter than those accessible to ground-based spectrographs. In addition, the high resolution spectrograph (HRS) will provide higher spectral resolution with greater photometric accuracy than previously possible in ultraviolet astronomical spectroscopy, and the high-speed photometer will achieve precise time-resolved photometric observations of rapidly varying astronomical sources on short time scales.

A super resolution framework for low resolution document image OCR

NASA Astrophysics Data System (ADS)

Ma, Di; Agam, Gady

2013-01-01

Optical character recognition is widely used for converting document images into digital media. Existing OCR algorithms and tools produce good results from high resolution, good quality, document images. In this paper, we propose a machine learning based super resolution framework for low resolution document image OCR. Two main techniques are used in our proposed approach: a document page segmentation algorithm and a modified K-means clustering algorithm. Using this approach, by exploiting coherence in the document, we reconstruct from a low resolution document image a better resolution image and improve OCR results. Experimental results show substantial gain in low resolution documents such as the ones captured from video.

The Role of Bacteria, Probiotics and Diet in Irritable Bowel Syndrome

PubMed Central

Harper, Ashton; Naghibi, Malwina M.; Garcha, Davinder

2018-01-01

Irritable bowel syndrome is a highly prevalent gastrointestinal disorder that threatens the quality of life of millions and poses a substantial financial burden on healthcare systems around the world. Intense research into the human microbiome has led to fascinating discoveries which directly and indirectly implicate the diversity and function of this occult organ in irritable bowel syndrome (IBS) pathophysiology. The benefit of manipulating the gastrointestinal microbiota with diet and probiotics to improve symptoms has been demonstrated in a wealth of both animal and human studies. The positive and negative mechanistic roles bacteria play in IBS will be explored and practical probiotic and dietary choices offered. PMID:29373532

[The dermatological indications of laser: beyond cosmetic target.

PubMed

Abosaleh, Marem; Boehncke, Wolf-Henning; Laubach, Hans

2017-01-11

During the last 30 years, the use of lasers in dermatology has gone far beyond the spectrum of aesthetic and cosmetic applications. Techniques are more than simple removal by CO2 Laser. Increasing knowledge, understanding, and experience have helped to effectively treat numerous important skin diseaes by the use of lasers. However, high-quality clinical trials are sparse in this domain. Consequently, so far only the treatment of hemangiomas and warts is a laser indication reimbursed by insurance companies. This article discusses three types of skin diseases where substantial progress has been reported in the scientific literature in 2016, namely pigmentary disorders, vascular diseases, and inflammatory dermatoses.

Innovative technology conserves resources and generates savings: a case study from the Sunnybrook Regional Processing Centre.

PubMed

Karim, Abdool Z

2009-01-01

The regional processing centre at Sunnybrook Health Sciences Centre recently faced the substantial challenge of increasing cleaning capacity to meet the current workload and anticipated future demand without increasing its operating budget. The solution, upgrading its cleaning and decontamination system to a highly automated system, met both objectives. An analysis of the impact of the change found that the new system provided additional benefits, including improved productivity and cleaning quality; decreased costs; reduced water, electricity and chemical use; improved worker safety and morale; and decreased overtime. Investing in innovative technology improved key departmental outcomes while meeting institutional environmental and cost savings objectives.

Detection and validation of QTLs for milky-white grains caused by high temperature during the ripening period in Japonica rice

PubMed Central

Miyahara, Katsunori; Wada, Takuya; Sonoda, Jun-ya; Tsukaguchi, Tadashi; Miyazaki, Masayuki; Tsubone, Masao; Yamaguchi, Osamu; Ishibashi, Masafumi; Iwasawa, Norio; Umemoto, Takayuki; Kondo, Motohiko

2017-01-01

The occurrence of chalky rice (Oryza sativa L.) grains caused by high temperature is a serious problem in rice production. Of the several kinds of chalky grains, milky-white grains are not well analyzed. The milky-white rice grain phenomenon is caused by genetic factors as well as environmental and nutritional conditions. To analyze the genetic control system for rice grain quality, we raised recombinant inbred lines from progeny produced from ‘Tsukushiroman’ (high temperature sensitive) and ‘Chikushi 52’ (high temperature tolerant) cultivars. Quantitative trait locus (QTL) analysis revealed that the QTL on chromosome 4, linked to the simple sequence repeat marker RM16424, contributed substantially to the occurrence of milky-white grains, as it was detected over two experimental years. To validate the effect of the QTL, we developed near isogenic lines that have the ‘Chikushi 52’ segment on the short arm of chromosome 4 in the ‘Tsukushiroman’ genetic background, and that had a lower milky-white grain ratio than that of ‘Tsukushiroman’ when exposed to high temperatures during the ripening period. These results suggest that the ‘Chikushi 52’ allele on chromosome 4 suppresses the occurrence of milky-white grains and improves rice grain quality under heat stress during the grain ripening period. PMID:29085242

Techniques of fisheries management: water quality assessment with stream insects

Treesearch

A. Dennis Lemly

2000-01-01

Nutrient enrichment of streams is a long-standing problem that continues to have substantial local and regional consequences. For example, water quality of streams in the southern Appalachian Mountains of the U.S. can be seriously degraded by organic nutrients leached from animal wastes if cattle or other livestock are allowed to graze in the riparian zone. Local...

The Couple that Prays Together: Race and Ethnicity, Religion, and Relationship Quality among Working-Age Adults

ERIC Educational Resources Information Center

Ellison, Christopher G.; Burdette, Amy M.; Wilcox, W. Bradford

2010-01-01

A substantial body of research has shown that relationship quality tends to be (a) lower among racial and ethnic minorities and (b) higher among more religious persons and among couples in which partners share common religious affiliations, practices, and beliefs. However, few studies have examined the interplay of race or ethnicity and religion…

The Children of the Cost, Quality, and Outcomes Study Go to School. Technical Report.

ERIC Educational Resources Information Center

Peisner-Feinberg, Ellen. S.; Burchinal, Margaret R.; Clifford, Richard M.; Yazejian, Noreen; Culkin, Mary L.; Zelazo, Janice; Howes, Carollee; Byler, Patricia; Kagan, Sharon Lynn; Rustici, Jean

Since a substantial majority of preschoolers participate in some form of child care before coming to school, the Cost, Quality, and Child Outcomes in Child Care Centers Study (CQO) was designed to examine the influence of typical center-based child care on children's development during their preschool years and as they move into formal elementary…

Estimating emissions from fires in North America for air quality modeling.

Treesearch

Christine Wiedinmyer; Brad Quayle; Chris Geron; Angie Belote; Don McKenzie; Xiaoyang Zhang; Susan O' Neill; Kristina Klos Wynne

2006-01-01

Fires contribute substantial emissions of trace gases and particles to the atmosphere. These emissions can impact air quality and even climate. We have developed a modeling framework to estimate the emissions from fires in North and parts of Central America (10-71 ˚N and 55-175 ˚W) by taking advantage of a combination of complementary satellite and...

Has It Always Been This Way? Tracing the Evolution of Teacher Quality Gaps in U.S. Public Schools. Working Paper 171

ERIC Educational Resources Information Center

Goldhaber, Dan; Quince, Vanessa; Theobald, Roddy

2016-01-01

There is mounting evidence of substantial "teacher quality gaps" (TQGs) between advantaged and disadvantaged students, but practically no empirical evidence about their history. We use longitudinal data on public school students, teachers, and schools from two states--North Carolina and Washington--to provide a descriptive history of the…

U.S. Air Quality and Health Benefits from Avoided Climate Change under Greenhouse Gas Mitigation.

PubMed

Garcia-Menendez, Fernando; Saari, Rebecca K; Monier, Erwan; Selin, Noelle E

2015-07-07

We evaluate the impact of climate change on U.S. air quality and health in 2050 and 2100 using a global modeling framework and integrated economic, climate, and air pollution projections. Three internally consistent socioeconomic scenarios are used to value health benefits of greenhouse gas mitigation policies specifically derived from slowing climate change. Our projections suggest that climate change, exclusive of changes in air pollutant emissions, can significantly impact ozone (O3) and fine particulate matter (PM2.5) pollution across the U.S. and increase associated health effects. Climate policy can substantially reduce these impacts, and climate-related air pollution health benefits alone can offset a significant fraction of mitigation costs. We find that in contrast to cobenefits from reductions to coemitted pollutants, the climate-induced air quality benefits of policy increase with time and are largest between 2050 and 2100. Our projections also suggest that increasing climate policy stringency beyond a certain degree may lead to diminishing returns relative to its cost. However, our results indicate that the air quality impacts of climate change are substantial and should be considered by cost-benefit climate policy analyses.

Redefining Quality Measurement in Cancer Care.

PubMed

Nardi, Elizabeth A; McCanney, James; Winckworth-Prejsnar, Katy; Schatz, Alyssa A; Adelson, Kerin; Neubauer, Marcus; Smith, Mary Lou; Walters, Ronald; Carlson, Robert W

2018-05-01

Quality measurement in oncology is increasing in significance as payment schemes shift from volume to value. As demand for quality measures increases, challenges in the development of quality measures, standardization across measures, and the limitations of health information technology have become apparent. Moreover, the time and financial burden associated with developing, tracking, and reporting quality measures are substantial. Despite these challenges, best practices and leaders in the field of quality measurement in oncology have emerged. To understand the current challenges and promising practices in quality measurement and to explore future considerations for measure development and measure reporting in oncology, NCCN convened the NCCN Policy Summit: Redefining Quality Measurement in Oncology. The summit included discussion of the current quality landscape and efforts to develop quality measures, use of quality measures in various programs, patient perspective of quality, and challenges and best practices for quality reporting. Copyright © 2018 by the National Comprehensive Cancer Network.

Post-Mastectomy and Phantom Pain: Risk Factors, Natural History, and Impact on Quality of Life

DTIC Science & Technology

2000-07-01

significantly disabled by their chronic pain and can suffer from substantial reductions in quality of life . The primary aims of this research project are to... of life , and psychosocial variables. This allows risk factors for chronic pain to be identified and its impact on quality of life to be determined. The... of life using a prospective research design. To date, 83 women scheduled for breast cancer surgery have been assessed with respect to hypothesized

Chemical quality of ground water in San Joaquin and part of Contra Costa Counties, California

USGS Publications Warehouse

Sorenson, Stephen K.

1981-01-01

Chemical water-quality conditions were investigated in San Joaquin and part of Contra Costa Counties by canvassing available wells and sampling water from 324 representative wells. Chemical water types varied, with 73 percent of the wells sampled containing either calcium-magnesium bicarbonate, or calcium-sodium bicarbonate type water. Substantial areas contain ground water exceeding water-quality standards for boron, manganese, and nitrate. Trace elements, with the exception of boron and manganese, were present in negligible amounts. (USGS)

Reliability of a visual scoring system with fluorescent tracers to assess dermal pesticide exposure.

PubMed

Aragon, Aurora; Blanco, Luis; Lopez, Lylliam; Liden, Carola; Nise, Gun; Wesseling, Catharina

2004-10-01

We modified Fenske's semi-quantitative 'visual scoring system' of fluorescent tracer deposited on the skin of pesticide applicators and evaluated its reproducibility in the Nicaraguan setting. The body surface of 33 farmers, divided into 31 segments, was videotaped in the field after spraying with a pesticide solution containing a fluorescent tracer. A portable UV lamp was used for illumination in a foldaway dark room. The videos of five farmers were randomly selected. The scoring was based on a matrix with extension of fluorescent patterns (scale 0-5) on the ordinate and intensity (scale 0-5) on the abscissa, with the product of these two ranks as the final score for each body segment (0-25). Five medical students rated and evaluated the quality of 155 video images having undergone 4 h of training. Cronbach alpha coefficients and two-way random effects intraclass correlation coefficients (ICC) with absolute agreement were computed to assess inter-rater reliability. Consistency was high (Cronbach alpha = 0.96), but the scores differed substantially between raters. The overall ICC was satisfactory [0.75; 95% confidence interval (CI) = 0.62-0.83], but it was lower for intensity (0.54; 95% CI = 0.40-0.66) and higher for extension (0.80; 95% CI = 0.71-0.86). ICCs were lowest for images with low scores and evaluated as low quality, and highest for images with high scores and high quality. Inter-rater reliability coefficients indicate repeatability of the scoring system. However, field conditions for recording fluorescence should be improved to achieve higher quality images, and training should emphasize a better mechanism for the reading of body areas with low contamination.

Playing Chemical Plant Environmental Protection Games with Historical Monitoring Data

PubMed Central

Reniers, Genserik; Zhang, Laobing; Qiu, Xiaogang

2017-01-01

The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a result, the deterioration of surrounding ecosystems and a quality decrease of the atmospheric environment can be observed. Previous works in this domain fail to generate executable and pragmatic solutions for inspection agencies due to practical challenges. In addressing these challenges, we introduce a so-called Chemical Plant Environment Protection Game (CPEP) to generate reasonable schedules of high-accuracy air quality monitoring stations (i.e., daily management plans) for inspection agencies. First, so-called Stackelberg Security Games (SSGs) in conjunction with source estimation methods are applied into this research. Second, high-accuracy air quality monitoring stations as well as gas sensor modules are modeled in the CPEP game. Third, simplified data analysis on the regularly discharging of chemical plants is utilized to construct the CPEP game. Finally, an illustrative case study is used to investigate the effectiveness of the CPEP game, and a realistic case study is conducted to illustrate how the models and algorithms being proposed in this paper, work in daily practice. Results show that playing a CPEP game can reduce operational costs of high-accuracy air quality monitoring stations. Moreover, evidence suggests that playing the game leads to more compliance from the chemical plants towards the inspection agencies. Therefore, the CPEP game is able to assist the environmental protection authorities in daily management work and reduce the potential risks of gaseous pollutants dispersion incidents. PMID:28961188

Year 7 dietary intake: a comparison of two schools with middle-high socio-economic status.

PubMed

Greatwood, H C; Daly-Smith, A; McGregor, S; McKenna, J

2013-12-01

With an established, yet avoidable, link between dietary intake and poor health, the nutritional habits of adolescents remains a public health concern. Previous studies report an inverse relationship between dietary intake and socio-economic status (SES), although few studies have considered the influence of the SES gradient. The present study compared the nutritional profiles of neighbouring schools with pupils from middle to high economic backgrounds. One hundred and ninety pupils from a high SES school (HSESS) and 159 pupils from a middle SES school (MSESS) (aged 11-12 years) completed a 63-item validated food frequency questionnaire. Pupils rated their diet quality and this was compared with a composite Healthy Eating Index (HEI). Children attending MSESS consumed significantly higher intakes of energy (P < 0.001), carbohydrate (P = 0.001), fat (P < 0.001) and protein (P = 0.001). As a percentage of energy contribution, pupils in both schools consumed excess saturated fat (HSESS, +5% boys, +4% girls; MSESS, +4% both boys and girls) and sugar (HSESS, +9% boys, +11% girls; MSESS, +10% boys, +11% girls). When HEI was compared with self-report diet quality, 96% HSESS pupils and 94% MSESS pupils over-rated the quality of their diet. The present study identified that, although pupils from MSESS consume a significantly higher intake of energy and macronutrient compared to a nearby HSESS, the percentage of energy contribution of saturated fat and sugar is above government recommendations for pupils from both schools. Additionally, the majority of pupils from both schools substantially over-rated their diet quality compared to a HEI. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Pero Vaz de Caminha: an-interchange program for quality control between Brazil and Portugal.

PubMed

Utagawa, Maria Lúcia; di Loreto, Celso; de Freitas, Cristina; Milanezi, Fernanda; Longatto Filho, Adhemar; Pereira, Sónia Maria Miranda; Maeda, Marina Yoshiê Sakamoto; Schmitt, Fernando C

2006-01-01

To start an interexchange program for quality control in cervical cytology and discuss conceptual criteria for diagnosis. Slides were selected in the archives of the 2 institutes and included cases with unsatisfactory, negative and positive results. Sets of slides were changed between the partners every 3 months. At the end of each year a senior cytopathologist was invited to discuss the major discrepancies found in the study. A total of 1,041 cases were analyzed. Full concordance was obtained in 74.4% (774) of cases and discrepancies in 25.6% (267 cases). Full agreement was achieved in 276 (39%) of 707 cases categorized as negative. In 421 negative cases from laboratory A, this concordance represents 65.5% and 96.5% for laboratory B, which submitted 286 negative cases. The main discordance was the high number of atypical squamous cells of undetermined significance cases: 3.1% for A and 128 (33.2%) for B. Samples with discrepancies related to the quality of the material was another controversial issue: of 16 cases from laboratory A, 6 (37.5%) unsatisfactory cases were the same and 10 (62.5%) different. Laboratory B presented 20 unsatisfactory cases, and 14 (70.0%) had other diagnoses. Low grade squamous intraepithelial lesion and high grade squamous intraepithelial lesion concordance ranged from 75% to 80%, and invasive carcinoma has 4 discordances (28.5%), 3 previously screened as high grade squamous intraepithelial lesion and 1 as atypical squamous cells of undetermined significance. The kappa value obtained was 0.65, indicating substantial agreement. Our results indicated that atypical squamous cells of undetermined significance diagnoses are the crucial point of controversies and concern the quality of routine diagnosis in cytopathology.

[The substantiation of the use of high-frequency intrapulmonary ventilation in the patients presenting with chronic obstructive pulmonary disease at the spa and health resort stage of rehabilitation].

PubMed

Zaripova, T N; Zhilyakova, L V; Bulanova, Z P

The importance of the development of the new methods for the rehabilitation of the patients presenting with chronic obstructive pulmonary disease under conditions of the spa and health resort-based treatment arises from the high prevalence and the progressive character of this disease, poor quality of the patients' life, great economic losses due to the reduction of the working capacity of the patients, and the high cost of COPD treatment. The objective of the present study was to substantiate the advisability of inclusion of high-frequency intrapulmonary ventilation in the program of the therapeutic and rehabilitative treatment of the patients with COPD based at a spa and health resort facility. The analysis of the results of examination and rehabilitative treatment included 49 patients treated at the «Belokurikha» health resort (14 women and 35 men presenting with stage 1 and 2 COPD). The patients were divided into two groups. The main one included 23 patients while the group of comparison consisted of 26 patients. Those of the main group were given the treatment that included the mineral water baths, inhalations, exercise therapy for the training of skeletal muscles, manual massage, high-frequency intrapulmonary ventilation, intake of extract maral root (Rhaponticum carthamoides) and the «Yantar antiox» (amber antiox) preparation. The patients of the comparison group received the same rehabilitative treatment but without high-frequency intrapulmonary ventilation. The effectiveness of the rehabilitative measures was comprehensively estimated from the dynamics of the clinical data, indices of the inflammatory activity, the results of spirography and 6 minute walking test. It has been shown that the introduction of high-frequency intrapulmonary ventilation into the spa and health resort-based rehabilitative program facilitates the elimination of clinical manifestation of the disease, promotes recovery of the external respiration function due to sputum recruiting and stimulation of mucociliary clearance that in turn decreases the activity of the inflammatory processes. Simultaneously, the thoracic mobility and physical efficiency of the patients increased. The overall result of the treatment was the enhanced quality of rehabilitation of the patients suffering COPD within 14-16 days of their stay at the health resort with excellent tolerability of the proposed therapeutic modality.

Hospital cost and quality performance in relation to market forces: an examination of U.S. community hospitals in the "post-managed care era".

PubMed

Jiang, H Joanna; Friedman, Bernard; Jiang, Shenyi

2013-03-01

Managed care substantially transformed the U.S. healthcare sector in the last two decades of the twentieth century, injecting price competition among hospitals for the first time in history. However, total HMO enrollment has declined since 2000. This study addresses whether managed care and hospital competition continued to show positive effects on hospital cost and quality performance in the "post-managed care era." Using data for 1,521 urban hospitals drawn from the Healthcare Cost and Utilization Project, we examined hospital cost per stay and mortality rate in relation to HMO penetration and hospital competition between 2001 and 2005, controlling for patient, hospital, and other market characteristics. Regression analyses were employed to examine both cross-sectional and longitudinal variation in hospital performance. We found that in markets with high HMO penetration, increase in hospital competition over time was associated with decrease in mortality but no change in cost. In markets without high HMO penetration, increase in hospital competition was associated with increase in cost but no change in mortality. Overall, hospitals in high HMO penetration markets consistently showed lower average costs, and hospitals in markets with high hospital competition consistently showed lower mortality rates. Hospitals in markets with high HMO penetration also showed lower mortality rates in 2005 with no such difference found in 2001. Our findings suggest that while managed care may have lost its strength in slowing hospital cost growth, differences in average hospital cost associated with different levels of HMO penetration across markets still persist. Furthermore, these health plans appear to put quality of care on a higher priority than before.