Clinical photographic observation of plantar corns and callus associated with a nominal scale classification and inter- observer reliability study in a student population.

PubMed

Tollafield, David R

2017-01-01

The management of plantar corns and callus has a low cost-benefit with reduced prioritisation in healthcare. The distinction between types of keratin lesions that forms corns and callus has attracted limited interest. Observation is imperative to improving diagnostic predictions and a number of studies point to some confusion as to how best to achieve this. The use of photographic observation has been proposed to improve our understanding of intractable keratin lesions. Students from a podiatry school reviewed photographs where plantar keratin lesions were divided into four nominal groups; light callus (Grade 1), heavy defined callus (Grade 2), concentric keratin plugs (Grade 3) and callus with deeper density changes under the forefoot (Grade 4). A group of 'experts' assigned from qualified podiatrists validated the observer rated responses by the students. Cohen's weighted statistic (k) was used to measure inter-observer reliability. First year students (unskilled) performed less well when viewing photographs ( k  = 0.33) compared to third year students (semi-skilled, k  = 0.62). The experts performed better than students ( k  = 0.88) providing consistency with wound care models in other studies. Improved clinical annotation of clinical features, supported by classification of keratin- based lesions, combined with patient outcome tools, could improve the scientific rationale to prioritise patient care. Problems associated with photographic assessment involves trying to differentiate similar lesions without the benefit of direct palpation. Direct observation of callus with and without debridement requires further investigation alongside the model proposed in this paper.

Improving a Spectral Bin Microphysical Scheme Using TRMM Satellite Observations

NASA Technical Reports Server (NTRS)

Li, Xiaowen; Tao, Wei-Kuo; Matsui, Toshihisa; Liu, Chuntao; Masunaga, Hirohiko

2010-01-01

Comparisons between cloud model simulations and observations are crucial in validating model performance and improving physical processes represented in the mod Tel.hese modeled physical processes are idealized representations and almost always have large rooms for improvements. In this study, we use data from two different sensors onboard TRMM (Tropical Rainfall Measurement Mission) satellite to improve the microphysical scheme in the Goddard Cumulus Ensemble (GCE) model. TRMM observed mature-stage squall lines during late spring, early summer in central US over a 9-year period are compiled and compared with a case simulation by GCE model. A unique aspect of the GCE model is that it has a state-of-the-art spectral bin microphysical scheme, which uses 33 different bins to represent particle size distribution of each of the seven hydrometeor species. A forward radiative transfer model calculates TRMM Precipitation Radar (PR) reflectivity and TRMM Microwave Imager (TMI) 85 GHz brightness temperatures from simulated particle size distributions. Comparisons between model outputs and observations reveal that the model overestimates sizes of snow/aggregates in the stratiform region of the squall line. After adjusting temperature-dependent collection coefficients among ice-phase particles, PR comparisons become good while TMI comparisons worsen. Further investigations show that the partitioning between graupel (a high-density form of aggregate), and snow (a low-density form of aggregate) needs to be adjusted in order to have good comparisons in both PR reflectivity and TMI brightness temperature. This study shows that long-term satellite observations, especially those with multiple sensors, can be very useful in constraining model microphysics. It is also the first study in validating and improving a sophisticated spectral bin microphysical scheme according to long-term satellite observations.

Instructional Improvement and Student Engagement in Post-Secondary Engineering Courses: The Complexity Underlying Small Effect Sizes

ERIC Educational Resources Information Center

Hilpert, Jonathan C.; Husman, Jenefer

2017-01-01

The current study leveraged a professional development programme for engineering faculty at a large research university to examine the impact of instructional improvement on student engagement. Professors who participated in the professional development were observed three times and rated using an existing observation protocol. Students in courses…

Big Earth Data Initiative: Metadata Improvement: Case Studies

NASA Technical Reports Server (NTRS)

Kozimor, John; Habermann, Ted; Farley, John

2016-01-01

Big Earth Data Initiative (BEDI) The Big Earth Data Initiative (BEDI) invests in standardizing and optimizing the collection, management and delivery of U.S. Government's civil Earth observation data to improve discovery, access use, and understanding of Earth observations by the broader user community. Complete and consistent standard metadata helps address all three goals.

Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement

PubMed Central

Hawwash, Dana; Ocké, Marga C.; Berg, Christina; Forsum, Elisabet; Sonestedt, Emily; Wirfält, Elisabet; Åkesson, Agneta; Kolsteren, Patrick; Byrnes, Graham; De Keyzer, Willem; Van Camp, John; Slimani, Nadia; Cevallos, Myriam; Egger, Matthias; Huybrechts, Inge

2016-01-01

Background Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut). Methods and Findings Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. Conclusion When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health. PMID:27270749

The quality of feeding assistance care practices for long-term care veterans: implications for quality improvement efforts.

PubMed

Simmons, Sandra F; Sims, Nichole; Durkin, Daniel W; Shotwell, Matthew S; Erwin, Scott; Schnelle, John F

2013-09-01

The primary purpose of this study was to determine the quality of feeding assistance care and identify areas in need of improvement for a sample of long-term care veterans. A secondary purpose was to compare these findings with the results of previous studies in community facilities to determine ways in which the VA sample might differ. A repeated measures observational study was conducted in two VA facilities with 200 long-stay residents. Research staff conducted standardized observations during and between meals for 3 months. There was a trend for better feeding assistance care quality during meals in the VA sample, but there were still multiple aspects of care in need of improvement both during and between meals. Higher licensed nurse staffing levels in the VA should enable effective supervision and management, but observation-based measures of care quality are necessary for accurate information about daily feeding assistance care provision.

Improvement of the clinical outcome in Ankylosing spondylitis by balneotherapy.

PubMed

Yurtkuran, Merih; Ay, Alev; Karakoç, Yüksel

2005-07-01

This study is designed to show the efficacy of balneotherapy and balneotherapy (BT) + nonsteroid antiinflammatory drug (NSAID) use in Ankylosing spondylitis (AS) patients. In this prospective study, BT, BT+ NSAID and NSAID therapy in 61 patients with AS were evaluated by ASAS core set. BT group (21 patients) was treated only with BT for 20 min, once a day, 5 days a week, over a period of 3 weeks. BT+NSAID group (20 patients) was treated with 1000 mg naproxen as well as BT. NSAID group (20 patients) was treated with 1000 mg naproxen. All of the participants did respiratory and postural exercises for 20 min a day and for the whole study period. Each patient was evaluated on admission (before treatment), at the end of the therapy and 6 months after the treatment. At the end of the study, statistically significant improvement was observed in all the clinical parameters of the patients in BT (G1), BT+NSAID (G2) and NSAID (G3) groups. This significant symptomatic and clinical improvement was maintained even 6 months after the treatment. The changes from baseline to follow up were similar in G1 and G2 except duration of morning stiffness (DMS) and chest expansion (CE). Improvements in CE and DMS were better in G1 and G2, respectively. Improvements observed in G1 and G2 were superior to the improvements observed in G3 for the variables of morning pain, nocturnal pain, DMS, global well being of the patient, occiput-wall distance, CE, finger to floor distance and functional index. In Schober test, improvement observed in G1 was statistically superior to G3. We concluded that BT can be suggested as an effective symptomatic treatment modality in patients with AS. Furthermore, sufficient improvement in clinical parameters can be obtained by BT alone.

A randomised controlled trial among cleaners--effects on strength, balance and kinesiophobia.

PubMed

Jørgensen, Marie Birk; Ektor-Andersen, John; Sjøgaard, Gisela; Holtermann, Andreas; Søgaard, Karen

2011-10-10

Cleaners constitute a job group with poor health and low socioeconomic resources. Therefore, there is a great need for scientifically documented health promoting initiatives for cleaners. However, both workplace initiatives and high quality intervention studies are lacking. The aim of this study was to evaluate the effects of a 3-month workplace trial with interventions to improve physical or cognitive behavioural resources among cleaners. A cluster randomised controlled trial was conducted among 294 female cleaners from 9 workplaces. The participants were allocated to three groups: Physical coordination training (PCT, n = 95), Cognitive behavioural theory-based training (CBTr, n = 99) and Reference group (REF, n = 100). Interventions were conducted during work hours for an average of 1 hour/week. Muscle strength was measured by maximal voluntary contractions in trunk/extension, and shoulder abduction/elevation. Postural balance was measured on a force platform. Kinesiophobia was measured with Tampa Scale for Kinesiophobia. Test and questionnaires were completed at baseline and at 3-month follow-up and analyses followed the intention-to-treat (ITT) principle with last observation carried forward in case of missing data at follow-up. Reports and analyses are given on true observations as well. ITT-analyses revealed that PCT improved strength of the trunk (p < .05) and postural balance (p < .05) compared to CBTr and REF. Based on true observations the strength and balance improvements corresponded to ~20% and ~16%, respectively. ITT-analyses showed that CBTr reduced kinesiophobia compared to PCT and REF (p < .05). Based on true observations, the improvement corresponded to a ~16% improvement. This workplace-based intervention study including PCT and CBTr among cleaners improved strength and postural balance from PCT, and kinesiophobia from CBTr. The improved strength, postural balance and kinesiophobia may improve the cleaners' tolerance for high physical work demands. Future studies should investigate the potential in the combination of PCT and CBTr in a workplace intervention. Current controlled trials ISRCTN96241850.

Contribution of spontaneous improvement to placebo response in depression: a meta-analytic review.

PubMed

Rutherford, Bret R; Mori, Shoko; Sneed, Joel R; Pimontel, Monique A; Roose, Steven P

2012-06-01

It is unknown to what degree spontaneous improvement accounts for the large placebo response observed in antidepressant trials for Major Depressive Disorder (MDD). The purpose of this study was to estimate the spontaneous improvement observed in treatment-seeking individuals with acute MDD by determining the symptom change in depressed patients assigned to wait-list controls in psychotherapy studies. The databases PubMed and PsycINFO were searched to identify randomized, prospective studies randomizing outpatients to psychotherapy or a wait-list control condition for the treatment of acute MDD. Standardized effect sizes calculated from each identified study were aggregated in a meta-analysis to obtain a summary statistic for the change in depression scores during participation in a wait-list control. Ten trials enrolling 340 participants in wait-list control conditions were identified. The estimated effect size for the change in depression scores during wait-list control was 0.505 (95% CI 0.271-0.739, p < 0.001), representing an average improvement of 4 points on the Hamilton Rating Scale for Depression. Depressed patients acutely experience improvement even without treatment, but spontaneous improvement is unlikely to account for the magnitude of placebo response typically observed in antidepressant trials. These findings must be interpreted in light of the small number wait-list control participants available for analysis as well as certain methodological heterogeneity in the psychotherapy studies analyzed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Improved Estimation of Orbits and Physical Properties of Objects in GEO

NASA Astrophysics Data System (ADS)

Bradley, B.; Axelrad, P.

2013-09-01

Orbital debris is a major concern for satellite operators, both commercial and military. Debris in the geosynchronous (GEO) belt is of particular concern because this unique region is such a valuable, limited resource, and, from the ground we cannot reliably track and characterize GEO objects smaller than 1 meter in diameter. Space-based space surveillance (SBSS) is required to observe GEO objects without weather restriction and with improved viewing geometry. SBSS satellites have thus far been placed in Sun-synchronous orbits. This paper investigates the benefits to GEO orbit determination (including the estimation of mass, area, and shape) that arises from placing observing satellites in geosynchronous transfer orbit (GTO) and a sub-GEO orbit. Recently, several papers have reported on simulation studies to estimate orbits and physical properties; however, these studies use simulated objects and ground-based measurements, often with dense and long data arcs. While this type of simulation provides valuable insight into what is possible, as far as state estimation goes, it is not a very realistic observing scenario and thus may not yield meaningful accuracies. Our research improves upon simulations published to date by utilizing publicly available ephemerides for the WAAS satellites (Anik F1R and Galaxy 15), accurate at the meter level. By simulating and deliberately degrading right ascension and declination observations, consistent with these ephemerides, a realistic assessment of the achievable orbit determination accuracy using GTO and sub-GEO SBSS platforms is performed. Our results show that orbit accuracy is significantly improved as compared to a Sun-synchronous platform. Physical property estimation is also performed using simulated astrometric and photometric data taken from GTO and sub-GEO sensors. Simulations of SBSS-only as well as combined SBSS and ground-based observation tracks are used to study the improvement in area, mass, and shape estimation gained by the proposed systems. Again our work improves upon previous research by investigating realistic observation scheduling scenarios to gain insight into achievable accuracies.

The effects of action observation training and mirror therapy on gait and balance in stroke patients.

PubMed

Lee, Ho Jeong; Kim, Young Mi; Lee, Dong Kyu

2017-03-01

[Purpose] The aim of this study was to evaluate the effects of action observation training and mirror therapy to improve on balance and gait function of stroke patients. [Subjects and Methods] The participants were randomly allocated to one of three groups: The action observation training with activity group practiced additional action observation training with activity for three 30-minute session for six weeks (n=12). The mirror therapy with activity group practiced additional mirror therapy with activity for three 30-minute sessions for six weeks (n=11). The only action observation training group practiced additional action observation training for three 30-minute sessions for weeks (n=12). All groups received conventional therapy for five 60-minute sessions over a six-week period. [Results] There were significant improvements in balance and gait function. The action observation training with activity group significantly improved subjects' static balance. The action observation training with activity group and the mirror therapy with activity group significantly improved subjects' gait ability. [Conclusion] The activation of mirror neurons combined with a conventional stroke physiotherapy program enhances lower-extremity motor recovery and motor functioning in stroke patients.

Improving BeiDou precise orbit determination using observations of onboard MEO satellite receivers

NASA Astrophysics Data System (ADS)

Ge, Haibo; Li, Bofeng; Ge, Maorong; Shen, Yunzhong; Schuh, Harald

2017-12-01

In recent years, the precise orbit determination (POD) of the regional Chinese BeiDou Navigation Satellite System (BDS) has been a hot spot because of its special constellation consisting of five geostationary earth orbit (GEO) satellites and five inclined geosynchronous satellite orbit (IGSO) satellites besides four medium earth orbit (MEO) satellites since the end of 2012. GEO and IGSO satellites play an important role in regional BDS applications. However, this brings a great challenge to the POD, especially for the GEO satellites due to their geostationary orbiting. Though a number of studies have been carried out to improve the POD performance of GEO satellites, the result is still much worse than that of IGSO and MEO, particularly in the along-track direction. The major reason is that the geostationary characteristic of a GEO satellite results in a bad geometry with respect to the ground tracking network. In order to improve the tracking geometry of the GEO satellites, a possible strategy is to mount global navigation satellite system (GNSS) receivers on MEO satellites to collect the signals from GEO/IGSO GNSS satellites so as that these observations can be used to improve GEO/IGSO POD. We extended our POD software package to simulate all the related observations and to assimilate the MEO-onboard GNSS observations in orbit determination. Based on GPS and BDS constellations, simulated studies are undertaken for various tracking scenarios. The impact of the onboard GNSS observations is investigated carefully and presented in detail. The results show that MEO-onboard observations can significantly improve the orbit precision of GEO satellites from metres to decimetres, especially in the along-track direction. The POD results of IGSO satellites also benefit from the MEO-onboard data and the precision can be improved by more than 50% in 3D direction.

Intra- and inter-observer agreement in MRI assessment of rotator cuff healing using the Sugaya classification 10years after surgery.

PubMed

Niglis, L; Collin, P; Dosch, J-C; Meyer, N; Kempf, J-F

2017-10-01

The long-term outcomes of rotator cuff repair are unclear. Recurrent tears are common, although their reported frequency varies depending on the type and interpretation challenges of the imaging method used. The primary objective of this study was to assess the intra- and inter-observer reproducibility of the MRI assessment of rotator cuff repair using the Sugaya classification 10years after surgery. The secondary objective was to determine whether poor reproducibility, if found, could be improved by using a simplified yet clinically relevant classification. Our hypothesis was that reproducibility was limited but could be improved by simplifying the classification. In a retrospective study, we assessed intra- and inter-observer agreement in interpreting 49 magnetic resonance imaging (MRI) scans performed 10years after rotator cuff repair. These 49 scans were taken at random among 609 cases that underwent re-evaluation, with imaging, for the 2015 SoFCOT symposium on 10-year and 20-year clinical and anatomical outcomes of rotator cuff repair for full-thickness tears. Each of three observers read each of the 49 scans on two separate occasions. At each reading, they assessed the supra-spinatus tendon according to the Sugaya classification in five types. Intra-observer agreement for the Sugaya type was substantial (κ=0.64) but inter-observer agreement was only fair (κ=0.39). Agreement improved when the five Sugaya types were collapsed into two categories (1-2-3 and 4-5) (intra-observer κ=0.74 and inter-observer κ=0.68). Using the Sugaya classification to assess post-operative rotator cuff healing was associated with substantial intra-observer and fair inter-observer agreement. A simpler classification into two categories improved agreement while remaining clinically relevant. II, prospective randomised low-power study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Science Journals in the Garden: Developing the Skill of Observation in Elementary Age Students

NASA Astrophysics Data System (ADS)

Kelly, Karinsa Michelle

The ability to make and record scientific observations is critical in order for students to engage in successful inquiry, and provides a sturdy foundation for children to develop higher order cognitive processes. Nevertheless, observation is taken for granted in the elementary classroom. This study explores how linking school garden experience with the use of science journals can support this skill. Students participated in a month-long unit in which they practiced their observation skills in the garden and recorded those observations in a science journal. Students' observational skills were assessed using pre- and post-assessments, student journals, and student interviews using three criteria: Accuracy, Detail, and Quantitative Data. Statistically significant improvements were found in the categories of Detail and Quantitative Data. Scores did improve in the category of Accuracy, but it was not found to be a statistically significant improvement.

Improving Assimilated Global Data Sets using TMI Rainfall and Columnar Moisture Observations

NASA Technical Reports Server (NTRS)

Hou, Arthur Y.; Zhang, Sara Q.; daSilva, Arlindo M.; Olson, William S.

1999-01-01

A global analysis that optimally combine observations from diverse sources with physical models of atmospheric and land processes can provide a comprehensive description of the climate systems. Currently, such data products contain significant errors in primary hydrological fields such as precipitation and evaporation, especially in the tropics. In this study, we show that assimilating precipitation and total precipitable water (TPW) retrievals derived from the TRMM Microwave Imager (TMI) improves not only the hydrological cycle but also key climate parameters such as clouds, radiation, and the large-scale circulation produced by the Goddard Earth Observing System (GEOS) data assimilation system (DAS). In particular, assimilating TMI rain improves clouds and radiation in areas of active convection, as well as the latent heating distribution and the large-scale motion field in the tropics, while assimilating TMI TPW heating distribution and the large-scale motion field in the tropics, while assimilating TMI TPW retrievals leads to reduced moisture biases and improved radiative fluxes in clear-sky regions. The improved analysis also improves short-range forecasts in the tropics. Ensemble forecasts initialized with the GEOS analysis incorporating TMI rain rates and TPW yield smaller biases in tropical precipitation forecasts beyond 1 day and better 500 hPa geopotential height forecasts up to 5 days. Results of this study demonstrate the potential of using high-quality space-borne rainfall and moisture observations to improve the quality of assimilated global data for climate analysis and weather forecasting applications

[Preparation and effect of a behavioral science-based education program for sleep improvement among medical students].

PubMed

Ueda, Masumi; Adachi, Yoshiko; Hayama, Junko; Yamagami, Toshiko

2008-01-01

The present study aimed to investigate a simple education program that is effective for sleep improvement among medical students who will be medical doctors in the future. The education program applied in the present study was developed for sleep improvement based on behavioral science and changes in knowledge and sleeping habits were observed. Subjects were 6th-year medical students of 2002 and 2003. Students of 2002 attended a program including a 90-minute lecture and a 2-week practice learning session, and students of 2003 attended only the lecture. In the lecture, behavior therapy for chronic insomnia was explained using a booklet. In the practice learning session, students set a target behavior for improvement and conducted self-monitoring of their sleep and the targeted behavior. Changes in knowledge about sleep, attitude toward the therapy, sleep, and sleep-related habits were observed and compared between the 2 groups of subjects immediately and 2-weeks after the lecture. It was found that after both programs subjects had more knowledge about sleep than before. In the program including practice learning session, subjects' attitude for managing patients changed from before the lecture to after the lecture, and after the practice learning session. It was found that more than half of the students thought that they could provide sleep guidance based on the behavior therapy. Regarding the subjects' sleep, significant improvements were observed for "having nightmares upon falling asleep," "sleepiness during daytime," "sense of getting a sound sleep," and "mood upon waking up." Regarding sleep-related habits, significant improvements were observed for "taking a nap," "dozing off," and "eating breakfast." On the other hand, only the lecture subjects improved irregularity of bedtime and sleeping time. Although an increase in knowledge and improvement of sleep were observed among students who attended only the lecture, a further increase in knowledge and improvement of sleeping habits were observed among students who also attended the practice learning session. The results described herein suggest developing and providing a simple and convenient education program for sleep improvement was effective for increasing students' knowledge about sleep, developing improved coping methods regarding sleep, and improving sleep. It is also suggested that behavioral scientific instructive methods, including practice learning, are effective for medical education.

Assimilating uncertain, dynamic and intermittent streamflow observations in hydrological models

NASA Astrophysics Data System (ADS)

Mazzoleni, Maurizio; Alfonso, Leonardo; Chacon-Hurtado, Juan; Solomatine, Dimitri

2015-09-01

Catastrophic floods cause significant socio-economical losses. Non-structural measures, such as real-time flood forecasting, can potentially reduce flood risk. To this end, data assimilation methods have been used to improve flood forecasts by integrating static ground observations, and in some cases also remote sensing observations, within water models. Current hydrologic and hydraulic research works consider assimilation of observations coming from traditional, static sensors. At the same time, low-cost, mobile sensors and mobile communication devices are becoming also increasingly available. The main goal and innovation of this study is to demonstrate the usefulness of assimilating uncertain streamflow observations that are dynamic in space and intermittent in time in the context of two different semi-distributed hydrological model structures. The developed method is applied to the Brue basin, where the dynamic observations are imitated by the synthetic observations of discharge. The results of this study show how model structures and sensors locations affect in different ways the assimilation of streamflow observations. In addition, it proves how assimilation of such uncertain observations from dynamic sensors can provide model improvements similar to those of streamflow observations coming from a non-optimal network of static physical sensors. This can be a potential application of recent efforts to build citizen observatories of water, which can make the citizens an active part in information capturing, evaluation and communication, helping simultaneously to improvement of model-based flood forecasting.

Pilot Study for Managing Complex Chronic Care Medicaid Patients With Diabetes Using a Mobile Health Application Achieves "Triple Aim" Improvement in a Primary Care Setting.

PubMed

Bovbjerg, Marit L; Lee, Jenney; Wolff, Rosa; Bangs, Bobby; May, Michael A

2017-10-01

IN BRIEF Cost-effective innovations to improve health and health care in patients with complex chronic diseases are urgently needed. Mobile health (mHealth) remote monitoring applications (apps) are a promising technology to meet this need. This article reports on a study evaluating patients' use of a tablet device with an mHealth app and a cellular-enabled glucose meter that automatically uploaded blood glucose values to the app. Improvements were observed across all three components of the Patient Protection and Affordable Care Act's "triple aim." Self-rated wellness and numerous quality-of-care metrics improved, billed charges and paid claims decreased, but no changes in clinical endpoints were observed.

Upper ocean response to Hurricane Gonzalo (2014): Salinity effects revealed by targeted and sustained underwater glider observations

NASA Astrophysics Data System (ADS)

Domingues, Ricardo; Goni, Gustavo; Bringas, Francis; Lee, Sang-Ki; Kim, Hyun-Sook; Halliwell, George; Dong, Jili; Morell, Julio; Pomales, Luis

2015-09-01

During October 2014, Hurricane Gonzalo traveled within 85 km from the location of an underwater glider situated north of Puerto Rico. Observations collected before, during, and after the passage of this hurricane were analyzed to improve our understanding of the upper ocean response to hurricane winds. The main finding in this study is that salinity potentially played an important role on changes observed in the upper ocean; a near-surface barrier layer likely suppressed the hurricane-induced upper ocean cooling, leading to smaller than expected temperature changes. Poststorm observations also revealed a partial recovery of the ocean to prestorm conditions 11 days after the hurricane. Comparison with a coupled ocean-atmosphere hurricane model indicates that model-observations discrepancies are largely linked to salinity effects described. Results presented in this study emphasize the value of underwater glider observations for improving our knowledge of how the ocean responds to tropical cyclone winds and for tropical cyclone intensification studies and forecasts.

Evaluation of a hand hygiene campaign in outpatient health care clinics.

PubMed

Kukanich, Kate Stenske; Kaur, Ramandeep; Freeman, Lisa C; Powell, Douglas A

2013-03-01

To improve hand hygiene in two outpatient health care clinics through the introduction of a gel sanitizer and an informational poster. In this interventional study, health care workers at two outpatient clinics were observed for frequency of hand hygiene (attempts versus opportunities). Gel sanitizer and informational posters were introduced together as an intervention. Direct observation of the frequency of hand hygiene was performed during baseline, intervention, and follow-up. A poststudy survey of health care workers was also distributed and collected. In both clinics, the frequency of hand hygiene was poor at baseline (11% and 21%) but improved significantly after intervention (36% and 54%) and was maintained through the follow-up period (32% and 51%). Throughout the study, postcontact hand hygiene was observed significantly more often than precontact hand hygiene. In both clinics, health care workers reported a preference for soap and water; yet observations showed that when the intervention made gel sanitizer available, sanitizer use predominated. Fifty percent of the surveyed health care workers considered the introduction of gel sanitizer to be an effective motivating tool for improving hand hygiene. Hand hygiene performance by health care workers in outpatient clinics may be improved through promoting the use of gel sanitizer and using informational posters. Compared with surveys, direct observation by trained observers may provide more accurate information about worker preferences for hand hygiene tools.

Effect of Aerobic Exercise Training on Mood in People With Traumatic Brain Injury: A Pilot Study.

PubMed

Weinstein, Ali A; Chin, Lisa M K; Collins, John; Goel, Divya; Keyser, Randall E; Chan, Leighton

Exercise training is associated with elevations in mood in patients with various chronic illnesses and disabilities. However, little is known regarding the effect of exercise training on short and long-term mood changes in those with traumatic brain injury (TBI). The purpose of this study was to examine the time course of mood alterations in response to a vigorous, 12-week aerobic exercise training regimen in ambulatory individuals with chronic TBI (>6 months postinjury). Short and long-term mood changes were measured using the Profile of Mood States-Short Form, before and after specific aerobic exercise bouts performed during the 12-week training regimen. Ten subjects with nonpenetrating TBI (6.6 ± 6.8 years after injury) completed the training regimen. A significant improvement in overall mood was observed following 12 weeks of aerobic exercise training (P = .04), with moderate to large effect sizes observed for short-term mood improvements following individual bouts of exercise. Specific improvements in long-term mood state and short-term mood responses following individual exercise sessions were observed in these individuals with TBI. The largest improvement in overall mood was observed at 12 weeks of exercise training, with improvements emerging as early as 4 weeks into the training regimen.

A Randomized Controlled Study of Art Observation Training to Improve Medical Student Ophthalmology Skills.

PubMed

Gurwin, Jaclyn; Revere, Karen E; Niepold, Suzannah; Bassett, Barbara; Mitchell, Rebecca; Davidson, Stephanie; DeLisser, Horace; Binenbaum, Gil

2018-01-01

Observation and description are critical to the practice of medicine, and to ophthalmology in particular. However, medical education does not provide explicit training in these areas, and medical students are often criticized for deficiencies in these skills. We sought to evaluate the effects of formal observation training in the visual arts on the general and ophthalmologic observational skills of medical students. Randomized, single-masked, controlled trial. Thirty-six first-year medical students, randomized 1:1 into art-training and control groups. Students in the art-training group were taught by professional art educators at the Philadelphia Museum of Art, during 6 custom-designed, 1.5-hour art observation sessions over a 3-month period. All subjects completed pre- and posttesting, in which they described works of art, retinal pathology images, and external photographs of eye diseases. Grading of written descriptions for observational and descriptive abilities by reviewers using an a priori rubric and masked to group assignment and pretesting/posttesting status. Observational skills, as measured by description testing, improved significantly in the training group (mean change +19.1 points) compared with the control group (mean change -13.5 points), P = 0.001. There were significant improvements in the training vs. control group for each of the test subscores. In a poststudy questionnaire, students reported applying the skills they learned in the museum in clinically meaningful ways at medical school. Art observation training for first-year medical students can improve clinical ophthalmology observational skills. Principles from the field of visual arts, which is reputed to excel in teaching observation and descriptive abilities, can be successfully applied to medical training. Further studies can examine the impact of such training on clinical care. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Improving Air Quality Forecasts with AURA Observations

NASA Technical Reports Server (NTRS)

Newchurch, M. J.; Biazer, A.; Khan, M.; Koshak, W. J.; Nair, U.; Fuller, K.; Wang, L.; Parker, Y.; Williams, R.; Liu, X.

2008-01-01

Past studies have identified model initial and boundary conditions as sources of reducible errors in air-quality simulations. In particular, improving the initial condition improves the accuracy of short-term forecasts as it allows for the impact of local emissions to be realized by the model and improving boundary conditions improves long range transport through the model domain, especially in recirculating anticyclones. During the August 2006 period, we use AURA/OMI ozone measurements along with MODIS and CALIPSO aerosol observations to improve the initial and boundary conditions of ozone and Particulate Matter. Assessment of the model by comparison of the control run and satellite assimilation run to the IONS06 network of ozonesonde observations, which comprise the densest ozone sounding campaign ever conducted in North America, to AURA/TES ozone profile measurements, and to the EPA ground network of ozone and PM measurements will show significant improvement in the CMAQ calculations that use AURA initial and boundary conditions. Further analyses of lightning occurrences from ground and satellite observations and AURA/OMI NO2 column abundances will identify the lightning NOx signal evident in OMI measurements and suggest pathways for incorporating the lightning and NO2 data into the CMAQ simulations.

Scoring haemophilic arthropathy on X-rays: improving inter- and intra-observer reliability and agreement using a consensus atlas.

PubMed

Foppen, Wouter; van der Schaaf, Irene C; Beek, Frederik J A; Verkooijen, Helena M; Fischer, Kathelijn

2016-06-01

The radiological Pettersson score (PS) is widely applied for classification of arthropathy to evaluate costly haemophilia treatment. This study aims to assess and improve inter- and intra-observer reliability and agreement of the PS. Two series of X-rays (bilateral elbows, knees, and ankles) of 10 haemophilia patients (120 joints) with haemophilic arthropathy were scored by three observers according to the PS (maximum score 13/joint). Subsequently, (dis-)agreement in scoring was discussed until consensus. Example images were collected in an atlas. Thereafter, second series of 120 joints were scored using the atlas. One observer rescored the second series after three months. Reliability was assessed by intraclass correlation coefficients (ICC), agreement by limits of agreement (LoA). Median Pettersson score at joint level (PSjoint) of affected joints was 6 (interquartile range 3-9). Using the consensus atlas, inter-observer reliability of the PSjoint improved significantly from 0.94 (95 % confidence interval (CI) 0.91-0.96) to 0.97 (CI 0.96-0.98). LoA improved from ±1.7 to ±1.1 for the PSjoint. Therefore, true differences in arthropathy were differences in the PSjoint of >2 points. Intra-observer reliability of the PSjoint was 0.98 (CI 0.97-0.98), intra-observer LoA were ±0.9 points. Reliability and agreement of the PS improved by using a consensus atlas. • Reliability of the Pettersson score significantly improved using the consensus atlas. • The presented consensus atlas improved the agreement among observers. • The consensus atlas could be recommended to obtain a reproducible Pettersson score.

Interprofessional primary care team meetings: a qualitative approach comparing observations with personal opinions.

PubMed

van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia; Daniëls, Ramon; Lenzen, Stephanie Anna; van der Weijden, Trudy; Beurskens, Anna

2017-02-01

The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions. Qualitative study involving observations of team meetings and interviews with participants. Eight different IPT meetings (n = 8) in different primary care practices were observed by means of video recordings. Experiences were explored by conducting individual semi-structured interviews (n = 60) with participants (i.e. health care professionals from different disciplines) of the observed team meetings. The data were analysed by means of content analysis. Most participants expressed favourable opinions about their team meetings. However, observations showed that team meetings were more or less hectic, and lacked a clear structure and team coordinator or leader. There appears to be a discrepancy between findings from observations and interviews. From the interviews, four main themes were extracted: (1) Team structure and composition, (2) Patient-centredness, (3) Interaction and (4) Attitude and motivation. IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members' awareness of aspects that could be improved before training them in dealing with specific challenges. © The Author 2016. Published by Oxford University Press.

Effect of formative evaluation using direct observation of procedural skills in assessment of postgraduate students of obstetrics and gynecology: Prospective study.

PubMed

Kumar, Naina; Singh, Namit Kant; Rudra, Samar; Pathak, Swanand

2017-01-01

Direct Observation of Procedural Skills (DOPS) is a way of evaluating procedural skills through observation in the workplace. The purpose of this study was to assess the role of DOPS in teaching and assessment of postgraduate students and to know the effect of repeated DOPS on improvement of the skills and confidence of the students. In both phases, significant difference was observed between the two groups on first DOPS comparison (1st phase: p=0.000; 2nd phase: p=0.002), with simulation group performing better. Comparison of sixth DOPS in the two groups revealed no difference in both phases, but significant difference on first and sixth DOPS comparison in each group (p=0.000). Repeated DOPS results in improved skills and confidence of students in managing real life obstetric emergencies irrespective of the teaching modality. Repeated DOPS results in improved skills and confidence of students in managing real life obstetric emergencies irrespective of the teaching modality.

Interventions to Improve the Breaking of Bad or Difficult News by Physicians, Medical Students, and Interns/Residents: A Systematic Review and Meta-Analysis.

PubMed

Johnson, Judith; Panagioti, Maria

2018-06-05

To assess the effectiveness of news delivery interventions to improve observer-rated skills, physician confidence, and patient-reported depression/anxiety. MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Register of Controlled Trials databases were searched from inception to September 5, 2016 (updated February 2017). Eligible studies included randomized controlled trials (RCTs), non-RCTs, and controlled before-after studies of interventions to improve the communication of bad or difficult news by physicians, medical students, and residents/interns. The EPOC risk of bias tool was used to conduct a risk of bias assessment. Main and secondary meta-analyses examined the effectiveness of the identified interventions for improving observer-rated news delivery skills and for improving physician confidence in delivering news and patient-reported depression/anxiety, respectively. Seventeen studies were included in the systematic review and meta-analysis, including 19 independent comparisons on 1,322 participants and 9 independent comparisons on 985 participants for the main and secondary (physician confidence) analyses (mean [SD] age = 35 [7] years; 46% male), respectively. Interventions were associated with large, significant improvements in observer-rated news delivery skills (19 comparisons: standardized mean difference [SMD] = 0.74, 95% CI = 0.47-1.01) and moderate, significant improvements in physician confidence (9 comparisons: SMD = 0.60, 95% CI = 0.26-0.95). One study reported intervention effects on patient-reported depression/anxiety. The risk of bias findings did not influence the significance of the results. Interventions are effective for improving news delivery and physician confidence. Further research is needed to test the impact of interventions on patient outcomes and determine optimal components and length.

[Mexidol in treatment of children with generalized epilepsy and febrile seizures].

PubMed

Natriashvili, G; Natriashvili, S; Kapanadze, N

2005-05-01

The aim of our study was to estimate the role of Mexidol in ceasing of epileptic fits and improving electroencephalographic (EEG) pathological patterns in children. 120 patients with generalized epilepsy (from 4 to 16 years old) were investigated. All patients were treated by Depakin chrono 30 mg/kg. Children were divided into 2 groups: 1st--study group consisted of 60 children with combined treatment with Depakin and Mexidol (5 mg/kg). In the control group (60 children) treatment was performed only by Depakin. 100 children with the first episode of febrile seizures (from 6 months to 4 years old) were investigated. 50 children composed the study group with monotheraphy by Mexidol and 50 patients--the control group, without any treatment. The EEG examination was done by computer EEG Topography "Brain Surveyor Saico". Using Depakin in combination with Mexidol in the study group of patients with generalized epilepsy, improvement of clinical picture of disease and normalization of EEG patterns in 93% of cases has been observed. In the study group of patients with febrile seizures, normalization of EEG pathological patterns was observed in 82% cases and in 18% its improvement was seen. The relapse of seizures at high temperature was observed in 3 patients. In control group EEG patterns were improved only in 20%, in 48% no positive effect was observed and in 41% the worsening of EEG findings was seen. The relapse of febrile seizures was observed in 26 cases. Mexidol titrated to the target doze of 5mg/kg may be effective in combination with Depakin for treatment of patients with generalized epilepsy and as monotherapy in patients with first episode of febrile seizures.

Teacher Effectiveness and Causal Inference in Observational Studies

ERIC Educational Resources Information Center

Rose, Roderick A.

2013-01-01

An important target of education policy is to improve overall teacher effectiveness using evidence-based policies. Randomized control trials (RCTs), which randomly assign study participants or groups of participants to treatment and control conditions, are not always practical or possible and observational studies using rigorous quasi-experimental…

Phosphatidylserine containing omega-3 Fatty acids may improve memory abilities in nondemented elderly individuals with memory complaints: results from an open-label extension study.

PubMed

Vakhapova, Veronika; Cohen, Tzafra; Richter, Yael; Herzog, Yael; Kam, Yossi; Korczyn, Amos D

2014-01-01

The present study is an open-label extension (OLE) aimed at evaluating the effect of 100 mg/day of phosphatidylserine enriched with docosahexaenoic acid (PS-DHA) on cognitive performance in nondemented elderly individuals with memory complaints. From the participants who completed the core study, 122 continued with a 15-week OLE. Efficacy was assessed using a computerized tool and the Clinical Global Impression of Change (CGI-C) rating scale. A significant improvement in sustained attention and memory recognition was observed in the PS-DHA naïve group, while the PS-DHA continuers maintained their cognitive status. Additionally, a significant improvement in CGI-C was observed in the naïve group. The results demonstrate that consumption of 100 mg/day of PS-DHA might be associated with improving or maintaining cognitive status in elderly subjects with memory complaints.

Use of In-Situ and Remotely Sensed Snow Observations for the National Water Model in Both an Analysis and Calibration Framework.

NASA Astrophysics Data System (ADS)

Karsten, L. R.; Gochis, D.; Dugger, A. L.; McCreight, J. L.; Barlage, M. J.; Fall, G. M.; Olheiser, C.

2017-12-01

Since version 1.0 of the National Water Model (NWM) has gone operational in Summer 2016, several upgrades to the model have occurred to improve hydrologic prediction for the continental United States. Version 1.1 of the NWM (Spring 2017) includes upgrades to parameter datasets impacting land surface hydrologic processes. These parameter datasets were upgraded using an automated calibration workflow that utilizes the Dynamic Data Search (DDS) algorithm to adjust parameter values using observed streamflow. As such, these upgrades to parameter values took advantage of various observations collected for snow analysis. In particular, in-situ SNOTEL observations in the Western US, volunteer in-situ observations across the entire US, gamma-derived snow water equivalent (SWE) observations courtesy of the NWS NOAA Corps program, gridded snow depth and SWE products from the Jet Propulsion Laboratory (JPL) Airborne Snow Observatory (ASO), gridded remotely sensed satellite-based snow products (MODIS,AMSR2,VIIRS,ATMS), and gridded SWE from the NWS Snow Data Assimilation System (SNODAS). This study explores the use of these observations to quantify NWM error and improvements from version 1.0 to version 1.1, along with subsequent work since then. In addition, this study explores the use of snow observations for use within the automated calibration workflow. Gridded parameter fields impacting the accumulation and ablation of snow states in the NWM were adjusted and calibrated using gridded remotely sensed snow states, SNODAS products, and in-situ snow observations. This calibration adjustment took place over various ecological regions in snow-dominated parts of the US for a retrospective period of time to capture a variety of climatological conditions. Specifically, the latest calibrated parameters impacting streamflow were held constant and only parameters impacting snow physics were tuned using snow observations and analysis. The adjusted parameter datasets were then used to force the model over an independent period for analysis against both snow and streamflow observations to see if improvements took place. The goal of this work is to further improve snow physics in the NWM, along with identifying areas where further work will take place in the future, such as data assimilation or further forcing improvements.

Effect of citizen engagement levels in flood forecasting by assimilating crowdsourced observations in hydrological models

NASA Astrophysics Data System (ADS)

Mazzoleni, Maurizio; Cortes Arevalo, Juliette; Alfonso, Leonardo; Wehn, Uta; Norbiato, Daniele; Monego, Martina; Ferri, Michele; Solomatine, Dimitri

2017-04-01

In the past years, a number of methods have been proposed to reduce uncertainty in flood prediction by means of model updating techniques. Traditional physical observations are usually integrated into hydrological and hydraulic models to improve model performances and consequent flood predictions. Nowadays, low-cost sensors can be used for crowdsourced observations. Different type of social sensors can measure, in a more distributed way, physical variables such as precipitation and water level. However, these crowdsourced observations are not integrated into a real-time fashion into water-system models due to their varying accuracy and random spatial-temporal coverage. We assess the effect in model performance due to the assimilation of crowdsourced observations of water level. Our method consists in (1) implementing a Kalman filter into a cascade of hydrological and hydraulic models. (2) defining observation errors depending on the type of sensor either physical or social. Randomly distributed errors are based on accuracy ranges that slightly improve according to the citizens' expertise level. (3) Using a simplified social model to realistically represent citizen engagement levels based on population density and citizens' motivation scenarios. To test our method, we synthetically derive crowdsourced observations for different citizen engagement levels from a distributed network of physical and social sensors. The observations are assimilated during a particular flood event occurred in the Bacchiglione catchment, Italy. The results of this study demonstrate that sharing crowdsourced water level observations (often motivated by a feeling of belonging to a community of friends) can help in improving flood prediction. On the other hand, a growing participation of individual citizens or weather enthusiasts sharing hydrological observations in cities can help to improve model performance. This study is a first step to assess the effects of crowdsourced observations in flood model predictions. Effective communication and feedback about the quality of observations from water authorities to engaged citizens are further required to minimize their intrinsic low-variable accuracy.

Improving resident engagement in quality improvement and patient safety initiatives at the bedside: the Advocate for Clinical Education (ACE).

PubMed

Schleyer, Anneliese M; Best, Jennifer A; McIntyre, Lisa K; Ehrmantraut, Ross; Calver, Patty; Goss, J Richard

2013-01-01

Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment. In a pilot, the ACE observed 2862 physician-patient interactions and 178 physicians. Self-reported compliance often was greater than the behaviors observed. Following ACE implementation, observed professionalism behaviors trended toward improvement; infection control also improved. Physicians were highly satisfied with the program. The ACE initiative is one coaching/feedback model for engaging residents in QI/PS that may warrant further study.

Minimal effects of visual memory training on the auditory performance of adult cochlear implant users

PubMed Central

Oba, Sandra I.; Galvin, John J.; Fu, Qian-Jie

2014-01-01

Auditory training has been shown to significantly improve cochlear implant (CI) users’ speech and music perception. However, it is unclear whether post-training gains in performance were due to improved auditory perception or to generally improved attention, memory and/or cognitive processing. In this study, speech and music perception, as well as auditory and visual memory were assessed in ten CI users before, during, and after training with a non-auditory task. A visual digit span (VDS) task was used for training, in which subjects recalled sequences of digits presented visually. After the VDS training, VDS performance significantly improved. However, there were no significant improvements for most auditory outcome measures (auditory digit span, phoneme recognition, sentence recognition in noise, digit recognition in noise), except for small (but significant) improvements in vocal emotion recognition and melodic contour identification. Post-training gains were much smaller with the non-auditory VDS training than observed in previous auditory training studies with CI users. The results suggest that post-training gains observed in previous studies were not solely attributable to improved attention or memory, and were more likely due to improved auditory perception. The results also suggest that CI users may require targeted auditory training to improve speech and music perception. PMID:23516087

A Systematic Investigation of the Effect of Action Observation Training and Motor Imagery Training on the Development of Mental Representation Structure and Skill Performance

PubMed Central

Kim, Taeho; Frank, Cornelia; Schack, Thomas

2017-01-01

Action observation training and motor imagery training have independently been studied and considered as an effective training strategy for improving motor skill learning. However, comparative studies of the two training strategies are relatively few. The purpose of this study was to investigate the effects of action observation training and motor imagery training on the development of mental representation structure and golf putting performance as well as the relation between the changes in mental representation structure and skill performance during the early learning stage. Forty novices were randomly assigned to one of four groups: action observation training, motor imagery training, physical practice and no practice. The mental representation structure and putting performance were measured before and after 3 days of training, then after a 2-day retention period. The results showed that mental representation structure and the accuracy of the putting performance were improved over time through the two types of cognitive training (i.e., action observation training and motor imagery training). In addition, we found a significant positive correlation between changes in mental representation structure and skill performance for the action observation training group only. Taken together, these results suggest that both cognitive adaptations and skill improvement occur through the training of the two simulation states of action, and that perceptual-cognitive changes are associated with the change of skill performance for action observation training. PMID:29089881

Enhancement in ferroelectric, pyroelectric and photoluminescence properties in dye doped TGS crystals

NASA Astrophysics Data System (ADS)

Sinha, Nidhi; Goel, Neeti; Singh, B. K.; Gupta, M. K.; Kumar, Binay

2012-06-01

Pure and dye doped (0.1 and 0.2 mol%) Triglycine Sulfate (TGS) single crystals were grown by slow evaporation technique. A pyramidal coloring pattern, along with XRD and FT-IR studies confirmed the dye doping. Decrease in dielectric constant and increase in Curie temperature (Tc) were observed with increasing doping concentration. Low absorption cut off (231 nm) and high optical transparency (>90%) resulting in large band gap was observed in UV-VIS studies. In addition, strong hyper-luminescent emission bands at 350 and 375 nm were observed in which the relative intensity were found to be reversed as a result of doping. In P-E hysteresis loop studies, a higher curie temperature and an improved and more uniform figure of merit over a large region of the ferroelectric phase were observed. The improved dielectric, optical and ferroelectric/pyroelectric properties make the dye doped TGS crystals better candidate for various opto- and piezo-electronics applications.

Relationships Between Long-Range Lightning Networks and TRMM/LIS Observations

NASA Technical Reports Server (NTRS)

Rudlosky, Scott D.; Holzworth, Robert H.; Carey, Lawrence D.; Schultz, Chris J.; Bateman, Monte; Cummins, Kenneth L.; Cummins, Kenneth L.; Blakeslee, Richard J.; Goodman, Steven J.

2012-01-01

Recent advances in long-range lightning detection technologies have improved our understanding of thunderstorm evolution in the data sparse oceanic regions. Although the expansion and improvement of long-range lightning datasets have increased their applicability, these applications (e.g., data assimilation, atmospheric chemistry, and aviation weather hazards) require knowledge of the network detection capabilities. The present study intercompares long-range lightning data with observations from the Lightning Imaging Sensor (LIS) aboard the Tropical Rainfall Measurement Mission (TRMM) satellite. The study examines network detection efficiency and location accuracy relative to LIS observations, describes spatial variability in these performance metrics, and documents the characteristics of LIS flashes that are detected by the long-range networks. Improved knowledge of relationships between these datasets will allow researchers, algorithm developers, and operational users to better prepare for the spatial and temporal coverage of the upcoming GOES-R Geostationary Lightning Mapper (GLM).

Evaluation of Long-Range Lightning Detection Networks Using TRMM/LIS Observations

NASA Technical Reports Server (NTRS)

Rudlosky, Scott D.; Holzworth, Robert H.; Carey, Lawrence D.; Schultz, Chris J.; Bateman, Monte; Cecil, Daniel J.; Cummins, Kenneth L.; Petersen, Walter A.; Blakeslee, Richard J.; Goodman, Steven J.

2011-01-01

Recent advances in long-range lightning detection technologies have improved our understanding of thunderstorm evolution in the data sparse oceanic regions. Although the expansion and improvement of long-range lightning datasets have increased their applicability, these applications (e.g., data assimilation, atmospheric chemistry, and aviation weather hazards) require knowledge of the network detection capabilities. Toward this end, the present study evaluates data from the World Wide Lightning Location Network (WWLLN) using observations from the Lightning Imaging Sensor (LIS) aboard the Tropical Rainfall Measurement Mission (TRMM) satellite. The study documents the WWLLN detection efficiency and location accuracy relative to LIS observations, describes the spatial variability in these performance metrics, and documents the characteristics of LIS flashes that are detected by WWLLN. Improved knowledge of the WWLLN detection capabilities will allow researchers, algorithm developers, and operational users to better prepare for the spatial and temporal coverage of the upcoming GOES-R Geostationary Lightning Mapper (GLM).

Connection, regulation, and care plan innovation: a case study of four nursing homes.

PubMed

Colón-Emeric, Cathleen S; Lekan-Rutledge, Deborah; Utley-Smith, Queen; Ammarell, Natalie; Bailey, Donald; Piven, Mary L; Corazzini, Kirsten; Anderson, Ruth A

2006-01-01

We describe how connections among nursing home staff impact the care planning process using a complexity science framework. We completed six-month case studies of four nursing homes. Field observations (n = 274), shadowing encounters (n = 69), and in-depth interviews (n = 122) of 390 staff at all levels were conducted. Qualitative analysis produced a conceptual/thematic description and complexity science concepts were used to produce conceptual insights. We observed that greater levels of staff connection were associated with higher care plan specificity and innovation. Connection of the frontline nursing staff was crucial for (1) implementation of the formal care plan and (2) spontaneous informal care planning responsive to changing resident needs. Although regulations could theoretically improve cognitive diversity and information flow in care planning, we observed instances of regulatory oversight resulting in less specific care plans and abandonment of an effective care planning process. Interventions which improve staff connectedness may improve resident outcomes.

Data Assimilation using observed streamflow and remotely-sensed soil moisture for improving sub-seasonal-to-seasonal forecasting

NASA Astrophysics Data System (ADS)

Arumugam, S.; Mazrooei, A.; Lakshmi, V.; Wood, A.

2017-12-01

Subseasonal-to-seasonal (S2S) forecasts of soil moisture and streamflow provides critical information for water and agricultural systems to support short-term planning and mangement. This study evaluates the role of observed streamflow and remotely-sensed soil moisture from SMAP (Soil Moisture Active Passive) mission in improving S2S streamflow and soil moisture forecasting using data assimilation (DA). We first show the ability to forecast soil moisture at monthly-to-seaasonal time scale by forcing climate forecasts with NASA's Land Information System and then compares the developed soil moisture forecast with the SMAP data over the Southeast US. Our analyses show significant skill in forecasting real-time soil moisture over 1-3 months using climate information. We also show that the developed soil moisture forecasts capture the observed severe drought conditions (2007-2008) over the Southeast US. Following that, we consider both SMAP data and observed streamflow for improving S2S streamflow and soil moisture forecasts for a pilot study area, Tar River basin, in NC. Towards this, we consider variational assimilation (VAR) of gauge-measured daily streamflow data in improving initial hydrologic conditions of Variable Infiltration Capacity (VIC) model. The utility of data assimilation is then assessed in improving S2S forecasts of streamflow and soil moisture through a retrospective analyses. Furthermore, the optimal frequency of data assimilation and optimal analysis window (number of past observations to use) are also assessed in order to achieve the maximum improvement in S2S forecasts of streamflow and soil moisture. Potential utility of updating initial conditions using DA and providing skillful forcings are also discussed.

Effects of the oral Janus kinase inhibitor tofacitinib on patient-reported outcomes in patients with active rheumatoid arthritis: results of two Phase 2 randomised controlled trials.

PubMed

Wallenstein, Gene V; Kanik, Keith S; Wilkinson, Bethanie; Cohen, Stanley; Cutolo, Maurizio; Fleischmann, Roy; Genovese, Mark C; Gomez Reino, Juan; Gruben, David; Kremer, Joel; Krishnaswami, Sriram; Lee, Eun Bong; Pascual-Ramos, Virginia; Strand, Vibeke; Zwillich, Samuel H

2016-01-01

Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Here we investigated the effects of tofacitinib on patient-reported outcomes (PRO) in patients with active RA. Two, 6-month, double-blind, placebo-controlled Phase 2b studies were performed. The combination study evaluated patients with inadequate response to methotrexate who received tofacitinib 1-15 mg twice daily (BID), 20 mg once daily or placebo, on background methotrexate. In the monotherapy study, patients with inadequate response to disease-modifying anti-rheumatic drugs received tofacitinib 1-15 mg BID, adalimumab 40 mg once every other week or placebo. PROs measured were: Patient's Assessment of Arthritis Pain (PAAP), Patient's Assessment of Disease Activity, HAQ-DI, FACIT-F and SF-36. In the combination study (n=507), significant improvements (p<0.05) versus placebo were observed at Week 12 in PAAP (visual analogue scale) and HAQ-DI for all tofacitinib groups. In the monotherapy study (n=384), significant improvements in PAAP were observed at Week 12 for tofacitinib 5, 10 and 15 mg BID, and in HAQ-DI for tofacitinib 3, 5, 10 and 15 mg BID. Significant improvements versus placebo were seen at Week 2 in PAAP (both studies) and HAQ‑DI (monotherapy study) with tofacitinib, and were maintained throughout each study. In both studies, improvements in several domains of the SF-36 in the tofacitinib groups were observed at Weeks 12 and 24. In patients with active RA, tofacitinib, either in combination with methotrexate or as monotherapy, demonstrated rapid and sustained improvement in pain, physical functioning and health-related quality of life.

Medical Therapy Versus Balloon Angioplasty for CTEPH: A Systematic Review and Meta-Analysis.

PubMed

Phan, Kevin; Jo, Helen E; Xu, Joshua; Lau, Edmund M

2018-01-01

A significant number of chronic thromboembolic pulmonary hypertension (CTEPH) patients will have an inoperable disease. Medical therapy and balloon pulmonary angioplasty (BPA) have provided alternate therapeutic options for patients with inoperable CTEPH, although there are a limited number of published studies examining the outcomes. Thus, our study aims to evaluate and compare the efficacy of medical therapy and BPA in patients with inoperable CTEPH. An electronic search of six databases was performed and the search results were screened against established criteria for inclusion into this study. Data was extracted and meta-analytical techniques were used to analyse the data. Pooled data from RCTs revealed that medical therapy, compared with a placebo, was associated with a significant improvement of at least one functional class (p=0.038). With regards to pulmonary haemodynamics, medical therapy also resulted in a significant reduction in both mean pulmonary arterial pressure (mPAP) (p=0.002) and pulmonary vascular resistance (PVR) (p<0.001). From the included observational studies, the 6-minute walk distance (6MWD) significantly increased following medical therapy by an average of 22.8% (p<0.001). The pooled improvement in 6MWD was found to be significantly higher in the BPA group when compared to medical therapy for CTEPH (p=0.001). Pooled data from available observational studies of medical therapy or BPA all demonstrated significant improvements in mPAP and PVR for pre versus post intervention comparisons. The improvement in mPAP (p=0.002) and PVR (p=0.002) were significantly greater for BPA intervention when compared to medical therapy. High-quality evidence supports the use of targeted medical therapy in improving haemodynamics in patients with inoperable CTEPH. There is only moderate-quality evidence from observational studies supporting the efficacy of BPA in improving both haemodynamics and exercise capacity. Further RCTs and prospective observational studies comparing medical therapy and BPA in patients with inoperable CTEPH are required. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Improving college science teaching through peer coaching and classroom assessment

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

Sode, J.R.

Peer coaching involves the observation of one teacher by another. This observation is accompanied by open and honest reflective discussion. The three main components of peer coaching are pre conference (for setting observation guidelines and building trust), observation (the sytematic collection of classroom data), and post conference (a non evaluative examination and discussion of the classroom). The non-evaluative post conference involves an examination of the teaching/learning process that occurred during the observation phase. In effective assessment, information on what and how well students are learning is used to make decisions about overall program improvement and to implement continuous classroom improvement.more » During peer coaching and assessment neither the instructor nor the students are formally evaluated. This session presents a sequential process in which the peer coaching steps of pre conference, observation, and post conference are combined with assessment to provide instructional guidance. An actual cast study, using the student complaint, {open_quotes}Lectures are boring and useless,{close_quotes} is used to demonstrate the process.« less

The effects of workstation changes and behavioral interventions on safe typing postures in an office.

PubMed

Gravina, Nicole; Lindstrom-Hazel, Debra; Austin, John

2007-01-01

The purpose of the present study was to determine the effectiveness of an ergonomic and behavioral safety intervention for improving participants' safe typing postures in a library office setting. A single-subject multiple baseline design across five participants was employed to evaluate the effects of the four independent variables (workstation adjustment, equipment trial (rollermouse mouse alternative), peer observations, and graphic feedback). Six participant postures were observed repeatedly while participants worked at their workstations throughout the study. Each of the interventions resulted in improvements in safety for more than one posture compared to the previous phase. Results of the study indicate that a comprehensive ergonomic program that includes a workstation adjustment and a behavioral safety approach may be helpful to produce maximum improvements in employees' safe ergonomic postures.

Formation process of graphite film on Ni substrate with improved thickness uniformity through precipitation control

NASA Astrophysics Data System (ADS)

Kim, Seul-Gi; Hu, Qicheng; Nam, Ki-Bong; Kim, Mun Ja; Yoo, Ji-Beom

2018-04-01

Large-scale graphitic thin film with high thickness uniformity needs to be developed for industrial applications. Graphitic films with thicknesses ranging from 3 to 20 nm have rarely been reported, and achieving the thickness uniformity in that range is a challenging task. In this study, a process for growing 20 nm-thick graphite films on Ni with improved thickness uniformity is demonstrated and compared with the conventional growth process. In the film grown by the process, the surface roughness and coverage were improved and no wrinkles were observed. Observations of the film structure reveal the reasons for the improvements and growth mechanisms.

Use of a hand-held computer observational tool to improve communication for care planning and psychosocial well-being

PubMed Central

Corazzini, Kirsten; Rapp, Carla Gene; McConnell, Eleanor S.; Anderson, Ruth A.

2013-01-01

Staff development nurses in long-term care are challenged to implement training programs that foster quality unlicensed assistive personnel (UAP) care and improve the transfer of their observations to licensed nursing staff for care planning. This study describes the outcomes of a program where UAP recorded behavioral problems of residents to inform care. Findings suggest staff development nurses who aim to improve UAP reporting without simultaneously targeting licensed nursing staff behaviors may worsen nursing staff relationships. PMID:19182546

Intravesical Glycosaminoglycan Replacement with Chondroitin Sulphate (Gepan(®) instill) in Patients with Chronic Radiotherapy- or Chemotherapy-Associated Cystitis.

PubMed

Schwalenberg, Thilo; Berger, Frank Peter; Horn, Lars Christian; Thi, Phuc Ho; Stolzenburg, Jens-Uwe; Neuhaus, Jochen

2015-08-01

Intravesical instillation of glycosaminoglycans is a promising option for the treatment of chronic cystitis, as it supports the regeneration of the damaged urothelial layer. We investigated the efficacy of short-term intravesical chondroitin sulphate treatment (six courses of instillation) in patients with chronic radiotherapy- or chemotherapy-associated cystitis. This prospective, observational study included patients with chronic radiotherapy- or chemotherapy-associated cystitis, who received six once-weekly intravesical instillations of 0.2% chondroitin sulphate 40 mL. Every week, patients recorded their symptoms and their benefits and tolerance of treatment, using a self-completed questionnaire. The study included 16 patients (mean age 68.5 years; 50% male). During the study, a reduction in all evaluated parameters was observed. After one dose of chondroitin sulphate, symptom improvement was observed in 38% of patients, and after the second dose, an additional 31% of patients showed improvement. At week 6, 80% of patients had either improved or were symptom free, and significant improvements in urinary urgency (p = 0.0082), pollakisuria (p = 0.0022), urge frequency (p = 0.0033) and lower abdominal pain (p = 0.0449) were observed. Haematuria, present in 9 of the 16 patients at baseline, was completely resolved in all cases after 6 weeks. The majority of patients (93%) evaluated the tolerance of chondroitin sulphate as 'good' or 'very good'. No treatment-related adverse events were reported. Intravesical administration of chondroitin sulphate was effective for the treatment of radiotherapy- or chemotherapy-associated cystitis. Even short-term treatment appears to be effective in reducing symptoms and improving the quality of life of patients.

The role of observational research in improving faculty lecturing skills: A qualitative study in an Italian dental school.

PubMed

Visioli, Sonia; Lodi, Giovanni; Carrassi, Antonio; Zannini, Lucia

2009-08-01

This pilot study is based on observational research of lecturing skills during the annual Oral Medicine course at the Milan Dentistry School. Our goals were to explore how teachers exhibited desirable lecturing skills, to observe how their attitudes and lecturing skills affected students' attention and thereby learning, and to provide feedback. We prepared a structured observational grid divided into four categories: explaining, questioning, visual aids, and lecturer attitude. The grid was filled in by a participant, nonactive researcher. Two main types of lecture were observed: "traditional" and "interactive". Both of these can result in a high level of attention among students. Among the categories, only "lecturer attitude" appeared to affect student attention. In particular, the skills of "speaking aloud" and "sustaining verbal communication with vocal inflection" appeared to have the greatest impact on lecturer attitude. The data were then presented blindly to the five lecturers, who were able to identify their own lesson. Our grid proved to be a valid instrument although it was very expensive. When integrated with other strategies for improving lecturing, such as student scoring, peer evaluation, and microteaching, observational research can be a cost-effective method to stimulate guided reflection and to improve the lecturing skills of faculty members.

New angles on energy correlation functions

DOE PAGES

Moult, Ian; Necib, Lina; Thaler, Jesse

2016-12-29

Jet substructure observables, designed to identify specific features within jets, play an essential role at the Large Hadron Collider (LHC), both for searching for signals beyond the Standard Model and for testing QCD in extreme phase space regions. In this paper, we systematically study the structure of infrared and collinear safe substructure observables, defining a generalization of the energy correlation functions to probe n-particle correlations within a jet. These generalized correlators provide a flexible basis for constructing new substructure observables optimized for specific purposes. Focusing on three major targets of the jet substructure community — boosted top tagging, boosted W/Z/Hmore » tagging, and quark/gluon discrimination — we use power-counting techniques to identify three new series of powerful discriminants: M i, N i, and U i. The Mi series is designed for use on groomed jets, providing a novel example of observables with improved discrimination power after the removal of soft radiation. The N i series behave parametrically like the N -subjettiness ratio observables, but are defined without respect to subjet axes, exhibiting improved behavior in the unresolved limit. Finally, the U i series improves quark/gluon discrimination by using higher-point correlators to simultaneously probe multiple emissions within a jet. Taken together, these observables broaden the scope for jet substructure studies at the LHC.« less

New angles on energy correlation functions

NASA Astrophysics Data System (ADS)

Moult, Ian; Necib, Lina; Thaler, Jesse

2016-12-01

Jet substructure observables, designed to identify specific features within jets, play an essential role at the Large Hadron Collider (LHC), both for searching for signals beyond the Standard Model and for testing QCD in extreme phase space regions. In this paper, we systematically study the structure of infrared and collinear safe substructure observables, defining a generalization of the energy correlation functions to probe n-particle correlations within a jet. These generalized correlators provide a flexible basis for constructing new substructure observables optimized for specific purposes. Focusing on three major targets of the jet substructure community — boosted top tagging, boosted W/Z/H tagging, and quark/gluon discrimination — we use power-counting techniques to identify three new series of powerful discriminants: M i , N i , and U i . The M i series is designed for use on groomed jets, providing a novel example of observables with improved discrimination power after the removal of soft radiation. The N i series behave parametrically like the N -subjettiness ratio observables, but are defined without respect to subjet axes, exhibiting improved behavior in the unresolved limit. Finally, the U i series improves quark/gluon discrimination by using higher-point correlators to simultaneously probe multiple emissions within a jet. Taken together, these observables broaden the scope for jet substructure studies at the LHC.

Seeing Is Believing: The Benefits of Peer Observation

ERIC Educational Resources Information Center

Hendry, Graham D.; Oliver, Gary R.

2012-01-01

Peer observation of teaching is seen as a supportive and developmental process for improving the quality of teaching in universities. Evidence is emerging that the process of observing is just as if not more valuable than being observed and given feedback. In this study lecturers completing a Foundations program in university learning and teaching…

Academic outcomes in Asian children aged 8-11 years with attention-deficit/hyperactivity disorder treated with atomoxetine hydrochloride.

PubMed

Mendez, Luis; Singh, Pritibha; Harrison, Gavan; Huang, Yu-Shu; Jin, Xingming; Cho, Soo Churl

2011-06-01

To investigate the relationship between changes in attention-deficit/hyperactivity disorder (ADHD) core symptoms and changes in academic outcome of Asian children treated with atomoxetine. This open-label study enrolled patients aged 8-11 years with DSM-IV-TR-defined ADHD, who were naïve to ADHD medications and met the symptomatic severity threshold of 1.5 standard deviations above the age and gender norm for the ADHDRS-IV-Parent:Inv (ADHDRS) total score. Data collection occurred for 24 weeks and included academic outcome, measured by the school grade average (SGA). Of 228 patients enrolled from China (n = 82), Taiwan (n = 76), and Korea (n = 70), 77.2% completed the study. Statistically significant (P < 0.001) baseline to last observation improvements in ADHDRS and SGA scores were observed. However, no linear correlation between change in ADHDRS total score and SGA (-0.083, P = 0.293) was observed. Despite significant independent improvements in core ADHD symptoms and academic grades over 24 weeks, the mean improvements observed in these measures did not appear to be correlated.

Arctic Sea ice studies with passive microwave satellite observations

NASA Technical Reports Server (NTRS)

Cavalieri, D. J.

1988-01-01

The objectives of this research are: (1) to improve sea ice concentration determinations from passive microwave space observations; (2) to study the role of Arctic polynyas in the production of sea ice and the associated salinization of Arctic shelf water; and (3) to study large scale sea ice variability in the polar oceans. The strategy is to analyze existing data sets and data acquired from both the DMSP SSM/I and recently completed aircraft underflights. Special attention will be given the high resolution 85.5 GHz SSM/I channels for application to thin ice algorithms and processes studies. Analysis of aircraft and satellite data sets is expected to provide a basis for determining the potential of the SSM/I high frequency channels for improving sea ice algorithms and for investigating oceanic processes. Improved sea ice algorithms will aid the study of Arctic coastal polynyas which in turn will provide a better understanding of the role of these polynyas in maintaining the Arctic watermass structure. Analysis of satellite and archived meteorological data sets will provide improved estimates of annual, seasonal and shorter-term sea ice variability.

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

Dolen, James; Harris, Philip; Marzani, Simone

Here, we explore the scale-dependence and correlations of jet substructure observables to improve upon existing techniques in the identification of highly Lorentz-boosted objects. Modified observables are designed to remove correlations from existing theoretically well-understood observables, providing practical advantages for experimental measurements and searches for new phenomena. We study such observables in W jet tagging and provide recommendations for observables based on considerations beyond signal and background efficiencies.

Effects of Lexical and Somatosensory Feedback on Long-Term Improvements in Intelligibility of Dysarthric Speech

ERIC Educational Resources Information Center

Borrie, Stephanie A.; Schäfer, Martina C. M.

2017-01-01

Purpose: Intelligibility improvements immediately following perceptual training with dysarthric speech using lexical feedback are comparable to those observed when training uses somatosensory feedback (Borrie & Schäfer, 2015). In this study, we investigated if these lexical and somatosensory guided improvements in listener intelligibility of…

Computational and human observer image quality evaluation of low dose, knowledge-based CT iterative reconstruction

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

Eck, Brendan L.; Fahmi, Rachid; Miao, Jun

2015-10-15

Purpose: Aims in this study are to (1) develop a computational model observer which reliably tracks the detectability of human observers in low dose computed tomography (CT) images reconstructed with knowledge-based iterative reconstruction (IMR™, Philips Healthcare) and filtered back projection (FBP) across a range of independent variables, (2) use the model to evaluate detectability trends across reconstructions and make predictions of human observer detectability, and (3) perform human observer studies based on model predictions to demonstrate applications of the model in CT imaging. Methods: Detectability (d′) was evaluated in phantom studies across a range of conditions. Images were generated usingmore » a numerical CT simulator. Trained observers performed 4-alternative forced choice (4-AFC) experiments across dose (1.3, 2.7, 4.0 mGy), pin size (4, 6, 8 mm), contrast (0.3%, 0.5%, 1.0%), and reconstruction (FBP, IMR), at fixed display window. A five-channel Laguerre–Gauss channelized Hotelling observer (CHO) was developed with internal noise added to the decision variable and/or to channel outputs, creating six different internal noise models. Semianalytic internal noise computation was tested against Monte Carlo and used to accelerate internal noise parameter optimization. Model parameters were estimated from all experiments at once using maximum likelihood on the probability correct, P{sub C}. Akaike information criterion (AIC) was used to compare models of different orders. The best model was selected according to AIC and used to predict detectability in blended FBP-IMR images, analyze trends in IMR detectability improvements, and predict dose savings with IMR. Predicted dose savings were compared against 4-AFC study results using physical CT phantom images. Results: Detection in IMR was greater than FBP in all tested conditions. The CHO with internal noise proportional to channel output standard deviations, Model-k4, showed the best trade-off between fit and model complexity according to AIC{sub c}. With parameters fixed, the model reasonably predicted detectability of human observers in blended FBP-IMR images. Semianalytic internal noise computation gave results equivalent to Monte Carlo, greatly speeding parameter estimation. Using Model-k4, the authors found an average detectability improvement of 2.7 ± 0.4 times that of FBP. IMR showed greater improvements in detectability with larger signals and relatively consistent improvements across signal contrast and x-ray dose. In the phantom tested, Model-k4 predicted an 82% dose reduction compared to FBP, verified with physical CT scans at 80% reduced dose. Conclusions: IMR improves detectability over FBP and may enable significant dose reductions. A channelized Hotelling observer with internal noise proportional to channel output standard deviation agreed well with human observers across a wide range of variables, even across reconstructions with drastically different image characteristics. Utility of the model observer was demonstrated by predicting the effect of image processing (blending), analyzing detectability improvements with IMR across dose, size, and contrast, and in guiding real CT scan dose reduction experiments. Such a model observer can be applied in optimizing parameters in advanced iterative reconstruction algorithms as well as guiding dose reduction protocols in physical CT experiments.« less

Administrator Observation and Feedback: Does It Lead toward Improvement in Inquiry-Oriented Math Instruction?

ERIC Educational Resources Information Center

Rigby, Jessica G.; Larbi-Cherif, Adrian; Rosenquist, Brooks A.; Sharpe, Charlotte J.; Cobb, Paul; Smith, Thomas

2017-01-01

Purpose: This study examines the content and efficacy of instructional leaders' expectations and feedback (press) in relation to the improvement of middle school mathematics teachers' instruction in the context of coherent systems of supports. Research Method/Approach: This mixed methods study is a part of a larger, 8-year longitudinal study in…

Effect of Sameera Pannaga Rasa (arsenomercurial formulation) in the management of Tamaka Shwasa (bronchial asthma) - Randomized double blind clinical study

PubMed Central

Mashru, Mayur; Galib, R.; Shukla, Vinay J.; Ravishankar, B.; Prajapati, Pradeep Kumar

2013-01-01

Asthma represents a profound world-wide public health problem. The most effective anti-asthmatic drugs currently available include β2-agonists and glucocorticoids which can controls asthma in about 90-95% of patients. In Ayurveda, this miserable condition is comparable with Tamaka Shwasa type of Shwasa Roga. In the present study, 52 patients were treated with Sameera Pannaga Rasa at a dose of 30 mg twice a day for 4 weeks along with Nagavallidala (leaf of Piper betel Linn.) The results were assessed in terms of clinical recovery, symptomatic relief, pulmonary function improvement and on subjective and objective parameters. A significant improvement in subjective parameters, control on asthma, recurrence of asthma, increase in peak expiratory flow rate, considerable decrease in total and absolute, acute eosinophil count and erythrocyte sedimentation rate were observed. Overall marked improvement was found in 33.33%, moderate improvement in 44.44% and mild improvement in 20.00% was observed. The study reveals that Sameera Pannaga Rasa can be used as an effective drug in bronchial asthma. PMID:24696570

Effect of Sameera Pannaga Rasa (arsenomercurial formulation) in the management of Tamaka Shwasa (bronchial asthma) - Randomized double blind clinical study.

PubMed

Mashru, Mayur; Galib, R; Shukla, Vinay J; Ravishankar, B; Prajapati, Pradeep Kumar

2013-10-01

Asthma represents a profound world-wide public health problem. The most effective anti-asthmatic drugs currently available include β2-agonists and glucocorticoids which can controls asthma in about 90-95% of patients. In Ayurveda, this miserable condition is comparable with Tamaka Shwasa type of Shwasa Roga. In the present study, 52 patients were treated with Sameera Pannaga Rasa at a dose of 30 mg twice a day for 4 weeks along with Nagavallidala (leaf of Piper betel Linn.) The results were assessed in terms of clinical recovery, symptomatic relief, pulmonary function improvement and on subjective and objective parameters. A significant improvement in subjective parameters, control on asthma, recurrence of asthma, increase in peak expiratory flow rate, considerable decrease in total and absolute, acute eosinophil count and erythrocyte sedimentation rate were observed. Overall marked improvement was found in 33.33%, moderate improvement in 44.44% and mild improvement in 20.00% was observed. The study reveals that Sameera Pannaga Rasa can be used as an effective drug in bronchial asthma.

Clinical review: Statins and trauma - a systematic review

PubMed Central

2013-01-01

Statins, in addition to their lipid-lowering properties, have anti-inflammatory actions. The aim of this review is to evaluate the effect of pre-injury statin use, and statin treatment following injury. MEDLINE, EMBASE, and CENTRAL databases were searched to January 2012 for randomised and observational studies of statins in trauma patients in general, and in patients who have suffered traumatic brain injury, burns, and fractures. Of 985 identified citations, 7 (4 observational studies and 3 randomised controlled trials (RCTs)) met the inclusion criteria. Two studies (both observational) were concerned with trauma patients in general, two with patients who had suffered traumatic brain injury (one observational, one RCT), two with burns patients (one observational, one RCT), and one with fracture healing (RCT). Two of the RCTs relied on surrogate outcome measures. The observational studies were deemed to be at high risk of confounding, and the RCTs at high risk of bias. Three of the observational studies suggested improvements in a number of clinical outcomes in patients taking statins prior to injury (mortality, infection, and septic shock in burns patients; mortality in trauma patients in general; mortality in brain injured patients) whereas one, also of trauma patients in general, showed no difference in mortality or infection, and an increased risk of multi-organ failure. Two of three RCTs on statin treatment in burns patients and brain injured patients showed improvements in E-selectin levels and cognitive function. The third, of patients with radial fractures, showed no acceleration in fracture union. In conclusion, there is some evidence that pre-injury statin use and post-injury statin treatment may have a beneficial effect in patients who have suffered general trauma, traumatic brain injury, and burns. However, these studies are at high risk of confounding and bias, and should be regarded as 'hypothesisgenerating'. A well-designed RCT is required to determine the therapeutic efficacy in improving outcomes in this patient population. PMID:23751018

Intensive precipitation observation greatly improves hydrological modelling of the poorly gauged high mountain Mabengnong catchment in the Tibetan Plateau

NASA Astrophysics Data System (ADS)

Wang, Li; Zhang, Fan; Zhang, Hongbo; Scott, Christopher A.; Zeng, Chen; Shi, Xiaonan

2018-01-01

Precipitation is one of the most critical inputs for models used to improve understanding of hydrological processes. In high mountain areas, it is challenging to generate a reliable precipitation data set capturing the spatial and temporal heterogeneity due to the harsh climate, extreme terrain and the lack of observations. This study conducts intensive observation of precipitation in the Mabengnong catchment in the southeast of the Tibetan Plateau during July to August 2013. Because precipitation is greatly influenced by altitude, the observed data are used to characterize the precipitation gradient (PG) and hourly distribution (HD), showing that the average PG is 0.10, 0.28 and 0.26 mm/d/100 m and the average duration is around 0.1, 0.8 and 5.2 h for trace, light and moderate rain, respectively. A distributed biosphere hydrological model based on water and energy budgets with improved physical process for snow (WEB-DHM-S) is applied to simulate the hydrological processes with gridded precipitation data derived from a lower altitude meteorological station and the PG and HD characterized for the study area. The observed runoff, MODIS/Terra snow cover area (SCA) data, and MODIS/Terra land surface temperature (LST) data are used for model calibration and validation. Runoff, SCA and LST simulations all show reasonable results. Sensitivity analyses illustrate that runoff is largely underestimated without considering PG, indicating that short-term intensive precipitation observation has the potential to greatly improve hydrological modelling of poorly gauged high mountain catchments.

Reductions in indoor black carbon concentrations from improved biomass stoves in rural India.

PubMed

Patange, Omkar S; Ramanathan, Nithya; Rehman, I H; Tripathi, Sachi Nand; Misra, Amit; Kar, Abhishek; Graham, Eric; Singh, Lokendra; Bahadur, Ranjit; Ramanathan, V

2015-04-07

Deployment of improved biomass burning cookstoves is recognized as a black carbon (BC) mitigation measure that has the potential to achieve health benefits and climate cobenefits. Yet, few field based studies document BC concentration reductions (and resulting human exposure) resulting from improved stove usage. In this paper, data are presented from 277 real-world cooking sessions collected during two field studies to document the impacts on indoor BC concentrations inside village kitchens as a result of switching from traditional stoves to improved forced draft (FD) stoves. Data collection utilized new low-cost cellphone methods to monitor BC, cooking duration, and fuel consumption. A cross sectional study recorded a reduction of 36% in BC during cooking sessions. An independent paired sample study demonstrated a statistically significant reduction of 40% in 24 h BC concentrations when traditional stoves were replaced with FD stoves. Reductions observed in these field studies differ from emission factor reductions (up to 99%) observed under controlled conditions in laboratory studies. Other nonstove sources (e.g., kerosene lamps, ambient concentrations) likely offset the reductions. Health exposure studies should utilize reductions determined by field measurements inside village kitchens, in conjunction with laboratory data, to assess the health impacts of new cooking technologies.

Methodology in diagnostic laboratory test research in clinical chemistry and clinical chemistry and laboratory medicine.

PubMed

Lumbreras-Lacarra, Blanca; Ramos-Rincón, José Manuel; Hernández-Aguado, Ildefonso

2004-03-01

The application of epidemiologic principles to clinical diagnosis has been less developed than in other clinical areas. Knowledge of the main flaws affecting diagnostic laboratory test research is the first step for improving its quality. We assessed the methodologic aspects of articles on laboratory tests. We included articles that estimated indexes of diagnostic accuracy (sensitivity and specificity) and were published in Clinical Chemistry or Clinical Chemistry and Laboratory Medicine in 1996, 2001, and 2002. Clinical Chemistry has paid special attention to this field of research since 1996 by publishing recommendations, checklists, and reviews. Articles were identified through electronic searches in Medline. The strategy combined the Mesh term "sensitivity and specificity" (exploded) with the text words "specificity", "false negative", and "accuracy". We examined adherence to seven methodologic criteria used in the study by Reid et al. (JAMA1995;274:645-51) of papers published in general medical journals. Three observers evaluated each article independently. Seventy-nine articles fulfilled the inclusion criteria. The percentage of studies that satisfied each criterion improved from 1996 to 2002. Substantial improvement was observed in reporting of the statistical uncertainty of indices of diagnostic accuracy, in criteria based on clinical information from the study population (spectrum composition), and in avoidance of workup bias. Analytical reproducibility was reported frequently (68%), whereas information about indeterminate results was rarely provided. The mean number of methodologic criteria satisfied showed a statistically significant increase over the 3 years in Clinical Chemistry but not in Clinical Chemistry and Laboratory Medicine. The methodologic quality of the articles on diagnostic test research published in Clinical Chemistry and Clinical Chemistry and Laboratory Medicine is comparable to the quality observed in the best general medical journals. The methodologic aspects that most need improvement are those linked to the clinical information of the populations studied. Editorial actions aimed to increase the quality of reporting of diagnostic studies could have a relevant positive effect, as shown by the improvement observed in Clinical Chemistry.

Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

PubMed

Janicak, Philip G; Dunner, David L; Aaronson, Scott T; Carpenter, Linda L; Boyadjis, Terrence A; Brock, David G; Cook, Ian A; Lanocha, Karl; Solvason, Hugh B; Bonneh-Barkay, Dafna; Demitrack, Mark A

2013-12-01

Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS. Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase. Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity. These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

Interventions to Improve Safe Sleep Among Hospitalized Infants at Eight Children's Hospitals.

PubMed

Kuhlmann, Stephanie; Ahlers-Schmidt, Carolyn R; Lukasiewicz, Gloria; Truong, Therese Macasiray

2016-02-01

Within hospital pediatric units, there is a lack of consistent application or modeling of the American Academy of Pediatrics recommendations for safe infant sleep. The purpose of this study was to improve safe sleep practices for infants in nonneonatal pediatric units with implementation of specific interventions. This multi-institutional study was conducted by using baseline observations collected for sleep location, position, and environment (collectively, "safe sleep") of infants admitted to pediatric units. Interventions consisted of: (1) staff education, including a commitment to promote safe sleep; (2) implementing site-generated safe sleep policies; (3) designating supply storage in patient rooms; and/or (4) caregiver education. Postintervention observations of safe sleep were collected. Eight hospitals participated from the Inpatient FOCUS Group of the Children's Hospital Association. Each site received institutional review board approval/exemption. Safe sleep was observed for 4.9% of 264 infants at baseline and 31.2% of 234 infants postintervention (P<.001). Extra blankets, the most common of unsafe items, were present in 77% of cribs at baseline and 44% postintervention. However, the mean number of unsafe items observed in each sleeping environment was reduced by >50% (P=.001). Implementation of site-specific interventions seems to improve overall safe sleep in inpatient pediatric units, although continued improvement is needed. Specifically, extra items are persistently left in the sleeping environment. Moving forward, hospitals should evaluate their compliance with American Academy of Pediatrics recommendations and embrace initiatives to improve modeling of safe sleep. Copyright © 2016 by the American Academy of Pediatrics.

Promoting mental health recovery and improving clinical assessment using video technology.

PubMed

Bradford, Daniel W; Cuddeback, Gary; Elbogen, Eric B

2017-12-01

Although individuals with medical problems (e.g., diabetes, hypertension) can monitor their symptoms using objective measures (e.g., blood glucose, blood pressure), objective measures are not typically used by individuals with psychotic disorders to monitor symptoms of mental illness. To examine the benefits and limitations of the use of video self-observation for treatment of individuals with psychotic disorders. The authors reviewed studies examining video self-observation among individuals with severe mental illnesses. Individuals with psychotic disorders who viewed videos of themselves while symptomatic reported some benefit to this approach, with 1 study showing sustained improvement in understanding of mental illness. Still, some individuals reported negative feelings about the process, and also attributed symptoms to stress or drug abuse rather than their psychotic disorder. The authors found no studies examining the potential for video self-observation as a strategy to improve clinical decision-making in the context of mental health care. Implications of this approach for mental health recovery and clinical practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Distinct Functional Networks Associated with Improvement of Affective Symptoms and Cognitive Function During Citalopram Treatment in Geriatric Depression

PubMed Central

Diaconescu, Andreea Oliviana; Kramer, Elisse; Hermann, Carol; Ma, Yilong; Dhawan, Vijay; Chaly, Thomas; Eidelberg, David; McIntosh, Anthony Randal; Smith, Gwenn S.

2010-01-01

Variability in the affective and cognitive symptom response to antidepressant treatment has been observed in geriatric depression. The underlying neural circuitry is poorly understood. The current study evaluated the cerebral glucose metabolic effects of citalopram treatment and applied multivariate, functional connectivity analyses to identify brain networks associated with improvements in affective symptoms and cognitive function. Sixteen geriatric depressed patients underwent resting Positron Emission Tomography (PET) studies of cerebral glucose metabolism and assessment of affective symptoms and cognitive function before and after eight weeks of selective serotonin reuptake inhibitor treatment (citalopram). Voxel-wise analyses of the normalized glucose metabolic data showed decreased cerebral metabolism during citalopram treatment in the anterior cingulate gyrus, middle temporal gyrus, precuneus, amygdala, and parahippocampal gyrus. Increased metabolism was observed in the putamen, occipital cortex and cerebellum. Functional connectivity analyses revealed two networks which were uniquely associated with improvement of affective symptoms and cognitive function during treatment. A subcortical-limbic-frontal network was associated with improvement in affect (depression and anxiety), while a medial temporal-parietal-frontal network was associated with improvement in cognition (immediate verbal learning/memory and verbal fluency). The regions that comprise the cognitive network overlap with the regions that are affected in Alzheimer’s dementia. Thus, alterations in specific brain networks associated with improvement of affective symptoms and cognitive function are observed during citalopram treatment in geriatric depression. PMID:20886575

Improving Factor Score Estimation Through the Use of Observed Background Characteristics

PubMed Central

Curran, Patrick J.; Cole, Veronica; Bauer, Daniel J.; Hussong, Andrea M.; Gottfredson, Nisha

2016-01-01

A challenge facing nearly all studies in the psychological sciences is how to best combine multiple items into a valid and reliable score to be used in subsequent modelling. The most ubiquitous method is to compute a mean of items, but more contemporary approaches use various forms of latent score estimation. Regardless of approach, outside of large-scale testing applications, scoring models rarely include background characteristics to improve score quality. The current paper used a Monte Carlo simulation design to study score quality for different psychometric models that did and did not include covariates across levels of sample size, number of items, and degree of measurement invariance. The inclusion of covariates improved score quality for nearly all design factors, and in no case did the covariates degrade score quality relative to not considering the influences at all. Results suggest that the inclusion of observed covariates can improve factor score estimation. PMID:28757790

Effect of supportive supervision on routine immunization service delivery-a randomized post-test study in Odisha.

PubMed

Som, Meena; Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Anasuya, Anita; Chauhan, Abhimanyu Singh; Sen, Ashish Kumar; Zodpey, Sanjay

2014-06-30

Routine immunization is a key child survival intervention. Issues related to quality of service delivery pose operational challenges in delivering effective immunization services. Accumulated evidences suggest that "supportive supervision" improves the quality of health care services. During 2009-10, Govt. of Odisha (GoO) and UNICEF jointly piloted this strategy in four districts to improve routine immunization. The present study aims to assess the effect of supportive supervision strategy on improvement of knowledge and practices on routine immunization among service providers. We adopted a 'post-test only' study design to compare the knowledge and practices of frontline health workers and their supervisors in four intervention districts with that of two control districts. Altogether we interviewed 170 supervisors and supervisees (health workers), each, using semi-structured interview schedules. We also directly observed 25 ice lined refrigerator (ILR) points in both groups of districts. The findings were compared with the baseline information, available only for the intervention districts. The health workers in the intervention districts displayed a higher knowledge score in selected items than in the control group. No significant difference in knowledge was observed between control and intervention supervisors. The management practices at ILR points on key routine immunization components were found to have improved significantly in intervention districts. The observed improvements in the ILR management practices indicate positive influence of supportive supervision. Higher level of domain knowledge among intervention health workers on specific items related to routine immunization could be due to successful transfer of knowledge from supervisors. A 'pre-post' study design should be undertaken to gain insights into the effectiveness of supportive supervision in improving routine immunization services.

The Application of Observational Practice and Educational Networking in Simulation-Based and Distributed Medical Education Contexts.

PubMed

Welsher, Arthur; Rojas, David; Khan, Zain; VanderBeek, Laura; Kapralos, Bill; Grierson, Lawrence E M

2018-02-01

Research has revealed that individuals can improve technical skill performance by viewing demonstrations modeled by either expert or novice performers. These findings support the development of video-based observational practice communities that augment simulation-based skill education and connect geographically distributed learners. This study explores the experimental replicability of the observational learning effect when demonstrations are sampled from a community of distributed learners and serves as a context for understanding learner experiences within this type of training protocol. Participants from 3 distributed medical campuses engaged in a simulation-based learning study of the elliptical excision in which they completed a video-recorded performance before being assigned to 1 of 3 groups for a 2-week observational practice intervention. One group observed expert demonstrations, another observed novice demonstrations, and the third observed a combination of both. Participants returned for posttesting immediately and 1 month after the intervention. Participants also engaged in interviews regarding their perceptions of the usability and relevance of video-based observational practice to clinical education. Checklist (P < 0.0001) and global rating (P < 0.0001) measures indicate that participants, regardless of group assignment, improved after the intervention and after a 1-month retention period. Analyses revealed no significant differences between groups. Qualitative analyses indicate that participants perceived the observational practice platform to be usable, relevant, and potentially improved with enhanced feedback delivery. Video-based observational practice involving expert and/or novice demonstrations enhances simulation-based skill learning in a group of geographically distributed trainees. These findings support the use of Internet-mediated observational learning communities in distributed and simulation-based medical education contexts.

Learning about Teachers' Literacy Instruction from Classroom Observations

ERIC Educational Resources Information Center

Kelcey, Ben; Carlisle, Joanne F.

2013-01-01

The purpose of this study is to contribute to efforts to improve methods for gathering and analyzing data from classroom observations in early literacy. The methodological approach addresses current problems of reliability and validity of classroom observations by taking into account differences in teachers' uses of instructional actions (e.g.,…

Effect of donepezil in patients with Alzheimer's disease previously untreated or treated with memantine or nootropic agents in Germany: an observational study.

PubMed

Klinger, Tatjana; Ibach, Bernd; Schoenknecht, Peter; Kamleiter, Martin; Silver, Gabrielle; Schroeder, Johannes; Mielke, Ruediger

2005-05-01

This open-label, prospective, observational, Post-Marketing Surveillance (PMS) study assessed the efficacy and safety of donepezil in patients who had been switched from therapies currently used in Germany to treat Alzheimer's disease (AD), such as memantine and nootropics, due to insufficient efficacy or poor tolerability. A treatment-naive population was included as a comparator. Patients with AD were treated with donepezil and observed for a period of approximately 3 months. A cognitive assessment was made using the Mini-Mental State Examination (MMSE). Quality of life (QoL) was assessed by the investigators who answered the question 'How did therapy with donepezil influence the QoL of the patient and/or his family over the observation period?' and was graded using three ratings: improved/unchanged/worsened. Adverse events (AEs) were also monitored. A total of 913 patients entered the study (mean +/- SD MMSE score 18.03 +/- 5.34). Efficacy assessments were analyzed for three groups: an overall group of patients who had received any form of prior AD drug therapy (N+ group; n = 709); a subgroup of patients from the N+ group who had received prior memantine therapy only (M+ group; n = 111) and patients who were drug treatment naive (N- group; n = 204). In the evaluable population donepezil improved MMSE scores by 2.21 +/- 3.47 points on average, with similar improvements observed in all three groups. QoL was judged to be improved in at least 70% of patients, again with similar results obtained for all three groups. Donepezil was well tolerated, with 85 of 913 (9.3%) patients reporting AEs. The most common AEs were those typically seen with cholinergic therapies (i.e., diarrhoea, vomiting and nausea). In this observational PMS study, donepezil was shown to be efficacious and well tolerated in patients who were being insufficiently treated with memantine or nootropic therapy. The magnitude of response was similar to that observed in patients who were previously treatment naive, suggesting prior medication does not effect donepezil's efficacy.

Using smartphone video “selfies” to monitor change in toothbrushing behavior after a brief intervention: A pilot study

PubMed Central

Kumar, Parangimalai Diwakar Madan; Mohandoss, Anusa Arunachalam; Walls, Theodore; Rooban, Thavarajah; Vernon, Lance T

2018-01-01

Background Attempts to refine toothbrushing (TB) technique, an ingrained habit in adults, can meet with some challenges. Recently, the role of proactive interference as a barrier to improving the learning of proper brushing has been proposed. This pilot feasibility study was designed to investigate TB behavior and to see how it changes after training. Smartphone video “selfies” (SPVSs) are increasingly being used in the medical field to assess, monitor, and determine the progression of diseases. Materials and Methods We used SPVS to study TB skills in a small sample of volunteers. Over a period of 14 days, after a one-time group training session, we observed TB behavior of volunteers using self-captured SPVS. Results Following the brief intervention, we observed an 8% of improvement in TB skills. Discussion To the best of our knowledge, this is the first report using SPVS to study TB behavior. We demonstrated initial feasibility of using SPVS in the dental setting. We observed modest improvements in toothbrushing accuracy and quality, and we generated important experiences about the use of Selfies for TB monitoring and intervention, and some interesting insights about where in the toothbrushing is more or less effective. Conclusion Further investigation using a larger sample size is needed to thoroughly assess the effectiveness of this approach to improve TB skills and better understand the role of proactive interference. PMID:27411655

Expectation-Based Efficiency and Quality Improvements in Research Administration: Multi-Institutional Case Studies

ERIC Educational Resources Information Center

Saha, Dhanonjoy C.; Ahmed, Abrar; Hanumandla, Shailaja

2011-01-01

Conventional wisdom may support the presumed notion that higher expectations increase efficiency and improve quality. However, this claim may only be validated when workers are equipped with appropriate tools, training, and a conducive work environment. This study implements various interventions, observes outcomes, and analyzes data collected in…

Evaluation of observational research reports published in Turkish nursing journals.

PubMed

Karaçam, Z; Şen, E; Yildirim, B

2015-09-01

The aim of this literature-based descriptive study was to examine the reporting of the observational research studies published in peer-reviewed nursing journals in Turkey. Eleven peer-reviewed nursing journals printed on a regular basis in Turkey between 2007 and 2012 were selected. These journals were searched for observational research studies, and 502 studies were selected and examined by using the Strengthening the Reporting of Observational Studies in Epidemiology Statement. Of the 502 studies, 495 were cross-sectional, 3 were cohort, and 4 were case controlled. Summary and introduction and aim sections were sufficient in most of the studies. The methods sections of the reports were mostly not reported: 64.3% of the reports did not indicate eligibility/inclusion criteria; sampling method, 67.0%; possible sources of bias, 99.2%; ways to reach sample size, 92.6%. In the results section, the number of individuals participating in each stage of the studies (44.0%) and in other analyses made (39.2%) was not reported. In the discussion section, a main comment about research findings was partly made (97.4%), and limitations of the studies and possible sources of bias were not written in 99.0% of the studies. This study clearly revealed that the observational research studies published in nursing journals in Turkey did not fulfil the important criteria and needed to be improved. Information obtained from this study can contribute to improvement of the quality of reporting observational studies in nursing and thus using obtained findings in practice. © 2015 International Council of Nurses.

Use of lean sigma principles in a tertiary care otolaryngology clinic to improve efficiency.

PubMed

Lin, Sandra Y; Gavney, Dean; Ishman, Stacey L; Cady-Reh, Julie

2013-11-01

To apply Lean Sigma, a quality-improvement strategy supported by tactical tools to eliminate waste and reduce variation, to improve efficiency of patient flow in a large tertiary otolaryngology clinic. The project goals were to decrease overall lead time from patient arrival to start of interaction with care provider, improve on-time starts of patient visits, and decrease excess staff/patient motion. Prospective observational study. Patient flow was mapped through the clinic, including preregistration processes. A time-stamp observation study was performed on 188 patient visits over 5 days. Using Lean Sigma principles, time stamps were analyzed to identify patient flow constraints and areas for potential interventions. Interventions were evaluated and adjusted based on feedback from shareholders: removal of bottlenecks in clinic flow, elimination of non-value added registration staff tasks, and alignment of staff hours to accommodate times of high patient census. A postintervention time observation study of 141 patients was performed 5 months later. Patient lead time from clinic arrival to exam start time decreased by 12.2% on average (P = .042). On-time starts for patient exams improved by 34% (χ(2) = 16.091, P < .001). Excess patient motion was reduced by 74 feet per patient, which represents a 34% reduction in motion per visit. Use of Lean Sigma principles in a large tertiary otolaryngology clinic led to decreased patient wait time and significant improvements in on-time patient exam start time. Process mapping, engagement of leadership and staff, and elimination of non-value added steps or processes were key to improvement. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Interventions to Improve Access to Primary Care for People Who Are Homeless: A Systematic Review

PubMed Central

2016-01-01

Background People who are homeless encounter barriers to primary care despite having greater needs for health care, on average, than people who are not homeless. We evaluated the effectiveness of interventions to improve access to primary care for people who are homeless. Methods We performed a systematic review to identify studies in English published between January 1, 1995, and July 8, 2015, comparing interventions to improve access to a primary care provider with usual care among people who are homeless. The outcome of interest was access to a primary care provider. The risk of bias in the studies was evaluated, and the quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Results From a total of 4,047 citations, we identified five eligible studies (one randomized controlled trial and four observational studies). With the exception of the randomized trial, the risk of bias was considered high in the remaining studies. In the randomized trial, people who were homeless, without serious mental illness, and who received either an outreach intervention plus clinic orientation or clinic orientation alone, had improved access to a primary care provider compared with those receiving usual care. An observational study that compared integration of primary care and other services for people who are homeless with usual care did not observe any difference in access to a primary care provider between the two groups. A small observational study showed improvement among participants with a primary care provider after receiving an intervention consisting of housing and supportive services compared with the period before the intervention. The quality of the evidence was considered moderate for both the outreach plus clinic orientation and clinic orientation alone, and low to very low for the other interventions. Despite limitations, the literature identified reports of interventions developed to overcome barriers in access to primary care in people who are homeless. The interventions studied are complex and include multiple components that are consistent with proposed dimensions of access to care (availability, affordability, and acceptability). Conclusions Our systematic review of the literature identified various types of interventions that seek to improve access to primary care by attempting to address barriers to care encountered by people who are homeless. Moderate-quality evidence indicates that orientation to clinic services (either alone or combined with outreach) improves access to a primary care provider in adults who are homeless, without serious mental illness, and living in urban centres. PMID:27099645

Interventions to Improve Access to Primary Care for People Who Are Homeless: A Systematic Review.

PubMed

2016-01-01

People who are homeless encounter barriers to primary care despite having greater needs for health care, on average, than people who are not homeless. We evaluated the effectiveness of interventions to improve access to primary care for people who are homeless. We performed a systematic review to identify studies in English published between January 1, 1995, and July 8, 2015, comparing interventions to improve access to a primary care provider with usual care among people who are homeless. The outcome of interest was access to a primary care provider. The risk of bias in the studies was evaluated, and the quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. From a total of 4,047 citations, we identified five eligible studies (one randomized controlled trial and four observational studies). With the exception of the randomized trial, the risk of bias was considered high in the remaining studies. In the randomized trial, people who were homeless, without serious mental illness, and who received either an outreach intervention plus clinic orientation or clinic orientation alone, had improved access to a primary care provider compared with those receiving usual care. An observational study that compared integration of primary care and other services for people who are homeless with usual care did not observe any difference in access to a primary care provider between the two groups. A small observational study showed improvement among participants with a primary care provider after receiving an intervention consisting of housing and supportive services compared with the period before the intervention. The quality of the evidence was considered moderate for both the outreach plus clinic orientation and clinic orientation alone, and low to very low for the other interventions. Despite limitations, the literature identified reports of interventions developed to overcome barriers in access to primary care in people who are homeless. The interventions studied are complex and include multiple components that are consistent with proposed dimensions of access to care (availability, affordability, and acceptability). Our systematic review of the literature identified various types of interventions that seek to improve access to primary care by attempting to address barriers to care encountered by people who are homeless. Moderate-quality evidence indicates that orientation to clinic services (either alone or combined with outreach) improves access to a primary care provider in adults who are homeless, without serious mental illness, and living in urban centres.

The Local Ensemble Transform Kalman Filter with the Weather Research and Forecasting Model: Experiments with Real Observations

NASA Astrophysics Data System (ADS)

Miyoshi, Takemasa; Kunii, Masaru

2012-03-01

The local ensemble transform Kalman filter (LETKF) is implemented with the Weather Research and Forecasting (WRF) model, and real observations are assimilated to assess the newly-developed WRF-LETKF system. The WRF model is a widely-used mesoscale numerical weather prediction model, and the LETKF is an ensemble Kalman filter (EnKF) algorithm particularly efficient in parallel computer architecture. This study aims to provide the basis of future research on mesoscale data assimilation using the WRF-LETKF system, an additional testbed to the existing EnKF systems with the WRF model used in the previous studies. The particular LETKF system adopted in this study is based on the system initially developed in 2004 and has been continuously improved through theoretical studies and wide applications to many kinds of dynamical models including realistic geophysical models. Most recent and important improvements include an adaptive covariance inflation scheme which considers the spatial and temporal inhomogeneity of inflation parameters. Experiments show that the LETKF successfully assimilates real observations and that adaptive inflation is advantageous. Additional experiments with various ensemble sizes show that using more ensemble members improves the analyses consistently.

Scientific and Ethical Approaches for Observational Exposure ...

EPA Pesticide Factsheets

Researchers conduct observational human exposure studies to understand how and the extent to which people come into contact with chemicals and environmental stressors in their everyday lives, through the air they breathe, the food and liquids they consume, and the things they touch. The U.S. Environmental Protection Agency’s (EPA’s) National Exposure Research Laboratory (NERL) has conducted observational human exposure studies for several decades and uses the information and data from these studies to improve the Agency’s understanding of human exposures to chemicals and other stressors and ultimately to support efforts to improve public health. Because these studies involve people as research participants, they are complex and raise numerous scientific and ethical issues that have to be addressed prior to and during their design and implementation. To ensure that EPA’s research continues to be based on the most up-to-date science and the highest ethical standards, the Agency has developed this document that contains state-of-the-science approaches for conducting observational human exposure studies. This document is not meant to represent an official Agency “guidance document” but, rather, serves as a resource tool and source of information for NERL and other researchers on which to rely as they develop and conduct observational human exposure studies.

Multi-epoch very long baseline interferometric observations of the nuclear starburst region of NGC 253: Improved modeling of the supernova and star formation rates

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

Rampadarath, H.; Morgan, J. S.; Tingay, S. J.

2014-01-01

The results of multi-epoch observations of the southern starburst galaxy, NGC 253, with the Australian Long Baseline Array at 2.3 GHz are presented. As with previous radio interferometric observations of this galaxy, no new sources were discovered. By combining the results of this survey with Very Large Array observations at higher frequencies from the literature, spectra were derived and a free-free absorption model was fitted of 20 known sources in NGC 253. The results were found to be consistent with previous studies. The supernova remnant, 5.48-43.3, was imaged with the highest sensitivity and resolution to date, revealing a two-lobed morphology.more » Comparisons with previous observations of similar resolution give an upper limit of 10{sup 4} km s{sup –1} for the expansion speed of this remnant. We derive a supernova rate of <0.2 yr{sup –1} for the inner 300 pc using a model that improves on previous methods by incorporating an improved radio supernova peak luminosity distribution and by making use of multi-wavelength radio data spanning 21 yr. A star formation rate of SFR(M ≥ 5 M {sub ☉}) < 4.9 M {sub ☉} yr{sup –1} was also estimated using the standard relation between supernova and star formation rates. Our improved estimates of supernova and star formation rates are consistent with studies at other wavelengths. The results of our study point to the possible existence of a small population of undetected supernova remnants, suggesting a low rate of radio supernova production in NGC 253.« less

A hierarchical Bayesian approach to adaptive vision testing: A case study with the contrast sensitivity function.

PubMed

Gu, Hairong; Kim, Woojae; Hou, Fang; Lesmes, Luis Andres; Pitt, Mark A; Lu, Zhong-Lin; Myung, Jay I

2016-01-01

Measurement efficiency is of concern when a large number of observations are required to obtain reliable estimates for parametric models of vision. The standard entropy-based Bayesian adaptive testing procedures addressed the issue by selecting the most informative stimulus in sequential experimental trials. Noninformative, diffuse priors were commonly used in those tests. Hierarchical adaptive design optimization (HADO; Kim, Pitt, Lu, Steyvers, & Myung, 2014) further improves the efficiency of the standard Bayesian adaptive testing procedures by constructing an informative prior using data from observers who have already participated in the experiment. The present study represents an empirical validation of HADO in estimating the human contrast sensitivity function. The results show that HADO significantly improves the accuracy and precision of parameter estimates, and therefore requires many fewer observations to obtain reliable inference about contrast sensitivity, compared to the method of quick contrast sensitivity function (Lesmes, Lu, Baek, & Albright, 2010), which uses the standard Bayesian procedure. The improvement with HADO was maintained even when the prior was constructed from heterogeneous populations or a relatively small number of observers. These results of this case study support the conclusion that HADO can be used in Bayesian adaptive testing by replacing noninformative, diffuse priors with statistically justified informative priors without introducing unwanted bias.

A hierarchical Bayesian approach to adaptive vision testing: A case study with the contrast sensitivity function

PubMed Central

Gu, Hairong; Kim, Woojae; Hou, Fang; Lesmes, Luis Andres; Pitt, Mark A.; Lu, Zhong-Lin; Myung, Jay I.

2016-01-01

Measurement efficiency is of concern when a large number of observations are required to obtain reliable estimates for parametric models of vision. The standard entropy-based Bayesian adaptive testing procedures addressed the issue by selecting the most informative stimulus in sequential experimental trials. Noninformative, diffuse priors were commonly used in those tests. Hierarchical adaptive design optimization (HADO; Kim, Pitt, Lu, Steyvers, & Myung, 2014) further improves the efficiency of the standard Bayesian adaptive testing procedures by constructing an informative prior using data from observers who have already participated in the experiment. The present study represents an empirical validation of HADO in estimating the human contrast sensitivity function. The results show that HADO significantly improves the accuracy and precision of parameter estimates, and therefore requires many fewer observations to obtain reliable inference about contrast sensitivity, compared to the method of quick contrast sensitivity function (Lesmes, Lu, Baek, & Albright, 2010), which uses the standard Bayesian procedure. The improvement with HADO was maintained even when the prior was constructed from heterogeneous populations or a relatively small number of observers. These results of this case study support the conclusion that HADO can be used in Bayesian adaptive testing by replacing noninformative, diffuse priors with statistically justified informative priors without introducing unwanted bias. PMID:27105061

Preventing back injuries in hospital settings: the effects of video modeling on safe patient lifting by nurses.

PubMed

Nielsen, Don; Sigurdsson, Sigurdur O; Austin, John

2009-01-01

This study evaluated video scoring and feedback about scoring as a safety intervention among 6 nursing staff. The dependent variable was safety behavior on one-person transfers. Following baseline, 5 nursing staff participated in an information phase. A video scoring phase was then introduced for all 6. A feedback phase was added for 2 participants. All participants experienced treatment withdrawal. Information resulted in improvements for all 5 participants who received it. Further improvements were observed during video scoring for the 5 participants who improved following information. No improvements were observed for the participant who received only video scoring. Safety feedback further improved safety for the 2 participants who received it. However, participants' behavior returned to video scoring levels during withdrawal.

PREVENTING BACK INJURIES IN HOSPITAL SETTINGS: THE EFFECTS OF VIDEO MODELING ON SAFE PATIENT LIFTING BY NURSES

PubMed Central

Nielsen, Don; Sigurdsson, Sigurdur O; Austin, John

2009-01-01

This study evaluated video scoring and feedback about scoring as a safety intervention among 6 nursing staff. The dependent variable was safety behavior on one-person transfers. Following baseline, 5 nursing staff participated in an information phase. A video scoring phase was then introduced for all 6. A feedback phase was added for 2 participants. All participants experienced treatment withdrawal. Information resulted in improvements for all 5 participants who received it. Further improvements were observed during video scoring for the 5 participants who improved following information. No improvements were observed for the participant who received only video scoring. Safety feedback further improved safety for the 2 participants who received it. However, participants' behavior returned to video scoring levels during withdrawal. PMID:20190918

Reciprocal peer review for quality improvement: an ethnographic case study of the Improving Lung Cancer Outcomes Project.

PubMed

Aveling, Emma-Louise; Martin, Graham; Jiménez García, Senai; Martin, Lisa; Herbert, Georgia; Armstrong, Natalie; Dixon-Woods, Mary; Woolhouse, Ian

2012-12-01

Peer review offers a promising way of promoting improvement in health systems, but the optimal model is not yet clear. We aimed to describe a specific peer review model-reciprocal peer-to-peer review (RP2PR)-to identify the features that appeared to support optimal functioning. We conducted an ethnographic study involving observations, interviews and documentary analysis of the Improving Lung Cancer Outcomes Project, which involved 30 paired multidisciplinary lung cancer teams participating in facilitated reciprocal site visits. Analysis was based on the constant comparative method. Fundamental features of the model include multidisciplinary participation, a focus on discussion and observation of teams in action, rather than paperwork; facilitated reflection and discussion on data and observations; support to develop focused improvement plans. Five key features were identified as important in optimising this model: peers and pairing methods; minimising logistic burden; structure of visits; independent facilitation; and credibility of the process. Facilitated RP2PR was generally a positive experience for participants, but implementing improvement plans was challenging and required substantial support. RP2PR appears to be optimised when it is well organised; a safe environment for learning is created; credibility is maximised; implementation and impact are supported. RP2PR is seen as credible and legitimate by lung cancer teams and can act as a powerful stimulus to produce focused quality improvement plans and to support implementation. Our findings have identified how RP2PR functioned and may be optimised to provide a constructive, open space for identifying opportunities for improvement and solutions.

The utility of observational studies in clinical decision making: lessons learned from statin trials.

PubMed

Foody, JoAnne M; Mendys, Phillip M; Liu, Larry Z; Simpson, Ross J

2010-05-01

Contemporary clinical decision making is well supported by a wide variety of information sources, including clinical practice guidelines, position papers, and insights from randomized controlled trials (RCTs). Much of our fundamental understanding of cardiovascular risk factors is based on multiple observations from major epidemiologic studies, such as The Seven Country Studies and the US-based Framingham Heart Study. These studies provided the framework for the development of clinical practice guidelines, including the National Cholesterol Education Program Adult Treatment Panel series. The objective of this article is to highlight the value of observational studies as a complement to clinical trial data for clinical decision making in real-world practice. Although RCTs are still the benchmark for assessing clinical efficacy and safety of a specific therapeutic approach, they may be of limited utility to practitioners who must then adapt the lessons learned from the trial into the patient care environment. The use of well-structured observational studies can improve our understanding of the translation of clinical trials into clinical practice, as demonstrated here with the example of statins. Although such studies have their own limitations, improved techniques for design and analysis have reduced the impact of bias and confounders. The introduction of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines has provided more uniformity for such studies. When used together with RCTs, observational studies can enhance our understanding of effectiveness and utility in real-world clinical practice. In the examples of statin observational studies, the results suggest that relative effectiveness of different statins and potential impact of switching statins should be carefully considered in treating individual patients by practicing physicians.

Pediatric functional constipation treatment with Bifidobacterium-containing yogurt: a crossover, double-blind, controlled trial.

PubMed

Guerra, Paula V P; Lima, Luiza N; Souza, Tassia C; Mazochi, Vanessa; Penna, Francisco J; Silva, Andreia M; Nicoli, Jacques R; Guimarães, Elizabet V

2011-09-14

To evaluate the treatment of pediatric functional chronic intestinal constipation (FCIC) with a probiotic goat yogurt. A crossover double-blind formula-controlled trial was carried out on 59 students (age range: 5-15 years) of a public school in Belo Horizonte, MG, Brazil, presenting a FCIC diagnostic, according to Roma III criteria. The students were randomized in two groups to receive a goat yogurt supplemented with 10(9) colony forming unit/mL Bifidobacterium longum (B. longum) (probiotic) daily or only the yogurt for a period of 5 wk (formula). Afterwards, the groups were intercrossed for another 5 wk. Defecation frequency, stool consistency and abdominal and defecation pain were assessed. Both treatment groups demonstrated improvement in defecation frequency compared to baseline. However, the group treated with probiotic showed most significant improvement in the first phase of the study. An inversion was observed after crossing over, resulting in a reduction in stool frequency when this group was treated by formula. Probiotic and formula improved stool consistency in the first phase of treatment, but the improvement obtained with probiotic was significantly higher (P = 0.03). In the second phase of treatment, the group initially treated with probiotic showed worsening stool consistency when using formula. However, the difference was not significant. A significant improvement in abdominal pain and defecation pain was observed with both probiotic and formula in the first phase of treatment, but again the improvement was more significant for the group treated with B. longum during phase I (P < 0.05). When all data of the crossover study were analyzed, significant differences were observed between probiotic yogurt and yogurt only for defecation frequency (P = 0.012), defecation pain (P = 0.046) and abdominal pain (P = 0.015). An improvement in defecation frequency and abdominal pain was observed using both supplemented and non-supplemented yogurt, but an additional improvement with B. longum supplementation was obtained.

Knowledge translation interventions for critically ill patients: a systematic review*.

PubMed

Sinuff, Tasnim; Muscedere, John; Adhikari, Neill K J; Stelfox, Henry T; Dodek, Peter; Heyland, Daren K; Rubenfeld, Gordon D; Cook, Deborah J; Pinto, Ruxandra; Manoharan, Venika; Currie, Jan; Cahill, Naomi; Friedrich, Jan O; Amaral, Andre; Piquette, Dominique; Scales, Damon C; Dhanani, Sonny; Garland, Allan

2013-11-01

We systematically reviewed ICU-based knowledge translation studies to assess the impact of knowledge translation interventions on processes and outcomes of care. We searched electronic databases (to July, 2010) without language restrictions and hand-searched reference lists of relevant studies and reviews. Two reviewers independently identified randomized controlled trials and observational studies comparing any ICU-based knowledge translation intervention (e.g., protocols, guidelines, and audit and feedback) to management without a knowledge translation intervention. We focused on clinical topics that were addressed in greater than or equal to five studies. Pairs of reviewers abstracted data on the clinical topic, knowledge translation intervention(s), process of care measures, and patient outcomes. For each individual or combination of knowledge translation intervention(s) addressed in greater than or equal to three studies, we summarized each study using median risk ratio for dichotomous and standardized mean difference for continuous process measures. We used random-effects models. Anticipating a small number of randomized controlled trials, our primary meta-analyses included randomized controlled trials and observational studies. In separate sensitivity analyses, we excluded randomized controlled trials and collapsed protocols, guidelines, and bundles into one category of intervention. We conducted meta-analyses for clinical outcomes (ICU and hospital mortality, ventilator-associated pneumonia, duration of mechanical ventilation, and ICU length of stay) related to interventions that were associated with improvements in processes of care. From 11,742 publications, we included 119 investigations (seven randomized controlled trials, 112 observational studies) on nine clinical topics. Interventions that included protocols with or without education improved continuous process measures (seven observational studies and one randomized controlled trial; standardized mean difference [95% CI]: 0.26 [0.1, 0.42]; p = 0.001 and four observational studies and one randomized controlled trial; 0.83 [0.37, 1.29]; p = 0.0004, respectively). Heterogeneity among studies within topics ranged from low to extreme. The exclusion of randomized controlled trials did not change our results. Single-intervention and lower-quality studies had higher standardized mean differences compared to multiple-intervention and higher-quality studies (p = 0.013 and 0.016, respectively). There were no associated improvements in clinical outcomes. Knowledge translation interventions in the ICU that include protocols with or without education are associated with the greatest improvements in processes of critical care.

Improving the primary school science learning unit about force and motion through lesson study

NASA Astrophysics Data System (ADS)

Phaikhumnam, Wuttichai; Yuenyong, Chokchai

2018-01-01

The study aimed to develop primary school science lesson plan based on inquiry cycle (5Es) through lesson study. The study focused on the development of 4 primary school science lesson plans of force and motion for Grade 3 students in KKU Demonstration Primary School (Suksasart), first semester of 2015 academic year. The methodology is mixed method. The Inthaprasitha (2010) lesson study cycle was implemented in group of KKU Demonstration Primary School. Instruments of reflection of lesson plan developing included participant observation, meeting and reflection report, lesson plan and other document. The instruments of examining students' learning include classroom observation and achievement test. Data was categorized from these instruments to find the issues of changing and improving the good lesson plan of Thai primary school science learning. The findings revealed that teachers could develop the lesson plans through lesson study. The issues of changing and improving were disused by considering on engaging students related to societal issues, students' prior knowledge, scientific concepts for primary school students, and what they learned from their changing. It indicated that the Lesson Study allowed primary school science teachers to share ideas and develop ideas to improve the lesson. The study may have implications for Thai science teacher education through Lesson Study.

Report of the panel on earth rotation and reference frames, section 7

NASA Technical Reports Server (NTRS)

Dickey, Jean O.; Dickman, Steven R.; Eubanks, Marshall T.; Feissel, Martine; Herring, Thomas A.; Mueller, Ivan I.; Rosen, Richard D.; Schutz, Robert E.; Wahr, John M.; Wilson, Charles R.

1991-01-01

Objectives and requirements for Earth rotation and reference frame studies in the 1990s are discussed. The objectives are to observe and understand interactions of air and water with the rotational dynamics of the Earth, the effects of the Earth's crust and mantle on the dynamics and excitation of Earth rotation variations over time scales of hours to centuries, and the effects of the Earth's core on the rotational dynamics and the excitation of Earth rotation variations over time scales of a year or longer. Another objective is to establish, refine and maintain terrestrial and celestrial reference frames. Requirements include improvements in observations and analysis, improvements in celestial and terrestrial reference frames and reference frame connections, and improved observations of crustal motion and mass redistribution on the Earth.

The next generation Antarctic digital magnetic anomaly map

USGS Publications Warehouse

von Frese, R.R.B; Golynsky, A.V.; Kim, H.R.; Gaya-Piqué, L.; Thébault, E.; Chiappinii, M.; Ghidella, M.; Grunow, A.; ,

2007-01-01

S (Golynsky et al., 2001). This map synthesized over 7.1 million line-kms of survey data available up through 1999 from marine, airborne and Magsat satellite observations. Since the production of the initial map, a large number of new marine and airborne surveys and improved magnetic observations from the Ørsted and CHAMP satellite missions have become available. In addition, an improved core field model for the Antarctic has been developed to better isolate crustal anomalies in these data. The next generation compilation also will likely represent the magnetic survey observations of the region in terms of a high-resolution spherical cap harmonic model. In this paper, we review the progress and problems of developing an improved magnetic anomaly map to facilitate studies of the Antarctic crustal magnetic field

Biofeedback for anismus: has placebo effect been overlooked?

PubMed

Meagher; Sun; Kennedy; Smart; Lubowski

1999-03-01

Multiple uncontrolled studies have concluded that biofeedback is successful in treating anismus. This study's objective was to assess the physiological effects of placebo and biofeedback treatment on patients with anismus and to correlate changes with clinical improvement. Twelve patients with symptoms and electrophysiological findings of anismus were studied. Initial assessment included a detailed history, symptom assessment by linear analogue scales, anorectal manometric and electrophysiological studies, colon transit scintigraphy, and scintigraphic proctography. Patients underwent 5 days of placebo treatment, followed 1 week later by re-assessment of symptoms and physiological studies. Five days of biofeedback was then given followed by another complete re-assessment 1 week later. A final interview was performed 2 months later. All assessments were by an independent observer who was not responsible for the treatments. Seven patients reported an overall improvement in symptoms following placebo treatment. A total of seven patients reported improvement following biofeedback, three of whom had already reported an improvement with placebo. One patient who reported improvement following placebo had worsening of symptoms following biofeedback. The only symptoms or tests which changed more with biofeedback than placebo were anal pressure and electromyographic activity on attempted defaecation in the left lateral position. There was no demonstrable correlation between change in symptoms and change in physiological tests. The scintigraphic 'ejection fraction' of the rectum was unchanged by treatment. Clinical improvement in previous studies may in part be due to placebo effect and observer bias. Improvement with biofeedback may be due to physiological changes which are not detected with conventional anorectal physiological tests.

Investigating Postsecondary Self-Regulated Learning Instructional Practices: The Development of the Self-Regulated Learning Observation Protocol

ERIC Educational Resources Information Center

Hoops, Leah D.; Yu, Shirley L.; Wang, Qianqian; Hollyer, Virginia L.

2016-01-01

Promoting students' self-regulated learning (SRL) is one way to improve postsecondary student success. However, few studies have investigated the instructional practices of postsecondary instructors that may support students' SRL. This study sought to fill this gap. An undergraduate mathematics course was observed to determine instruction utilized…

Three-phase bone scintigraphy for diagnosis of Charcot neuropathic osteoarthropathy in the diabetic foot - does quantitative data improve diagnostic value?

PubMed

Fosbøl, M; Reving, S; Petersen, E H; Rossing, P; Lajer, M; Zerahn, B

2017-01-01

To investigate whether inclusion of quantitative data on blood flow distribution compared with visual qualitative evaluation improve the reliability and diagnostic performance of 99 m Tc-hydroxymethylene diphosphate three-phase bone scintigraphy (TPBS) in patients suspected for charcot neuropathic osteoarthropathy (CNO) of the foot. A retrospective cohort study of TPBS performed on 148 patients with suspected acute CNO referred from a single specialized diabetes care centre. The quantitative blood flow distribution was calculated based on the method described by Deutsch et al. All scintigraphies were re-evaluated by independent, blinded observers twice with and without quantitative data on blood flow distribution at ankle and focus level, respectively. The diagnostic validity of TPBS was determined by subsequent review of clinical data and radiological examinations. A total of 90 patients (61%) had confirmed diagnosis of CNO. The sensitivity, specificity and accuracy of three-phase bone scintigraphy without/with quantitative data were 89%/88%, 58%/62% and 77%/78%, respectively. The intra-observer agreement improved significantly by adding quantitative data in the evaluation (Kappa value 0·79/0·94). The interobserver agreement was not significantly improved. Adding quantitative data on blood flow distribution in the interpretation of TBPS improves intra-observer variation, whereas no difference in interobserver variation was observed. The sensitivity of TPBS in the diagnosis of CNO is high, but holds limited specificity. Diagnostic performance does not improve using quantitative data in the evaluation. This may be due to the reference intervals applied in the study or the absence of a proper gold standard diagnostic procedure for comparison. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Science and applications-driven OSSE platform for terrestrial hydrology using NASA Land Information System

NASA Astrophysics Data System (ADS)

Kumar, S.; Peters-Lidard, C. D.; Harrison, K.; Santanello, J. A.; Bach Kirschbaum, D.

2014-12-01

Observing System Simulation Experiments (OSSEs) are often conducted to evaluate the worth of existing data and data yet to be collected from proposed new missions. As missions increasingly require a broader ``Earth systems'' focus, it is important that the OSSEs capture the potential benefits of the observations on end-use applications. Towards this end, the results from the OSSEs must also be evaluated with a suite of metrics that capture the value, uncertainty, and information content of the observations while factoring in both science and societal impacts. In this presentation, we present the development of an end-to-end and end-use application oriented OSSE platform using the capabilities of the NASA Land Information System (LIS) developed for terrestrial hydrology. Four case studies that demonstrate the capabilities of the system will be presented: (1) A soil moisture OSSE that employs simulated L-band measurements and examines their impacts towards applications such as floods and droughts. The experiment also uses a decision-theory based analysis to assess the economic utility of observations towards improving drought and flood risk estimates, (2) A GPM-relevant study quantifies the impact of improved precipitation retrievals from GPM towards improving landslide forecasts, (3) A case study that examines the utility of passive microwave soil moisture observations towards weather prediction, and (4) OSSEs used for developing science requirements for the GRACE-2 mission. These experiments also demonstrate the value of a comprehensive modeling environment such as LIS for conducting end-to-end OSSEs by linking satellite observations, physical models, data assimilation algorithms and end-use application models in a single integrated framework.

Improving proprioceptive deficits after stroke through robot-assisted training of the upper limb: a pilot case report study.

PubMed

Colombo, R; Sterpi, I; Mazzone, A; Delconte, C; Pisano, F

2016-01-01

The purpose of this study was to determine whether a conventional robot-assisted therapy of the upper limb was able to improve proprioception and motor recovery of an individual after stroke who exhibited proprioceptive deficits. After robotic sensorimotor training, significant changes were observed in kinematic performance variables. Two quantitative parameters evaluating position sense improved after training. Range of motion during shoulder and wrist flexion improved, but only wrist flexion remained improved at 3-month follow-up. These preliminary results suggest that intensive robot-aided rehabilitation may play an important role in the recovery of sensory function. However, further studies are required to confirm these data.

Nontoxic Goiter (NTG) and Radioiodine: What Do Patients Think About It? Quality of Life in Patients with NTG Before and After 131-I Therapy.

PubMed

Kaniuka-Jakubowska, Sonia; Lewczuk, Anna; Majkowicz, Mikołaj; Piskunowicz, Maciej; Mizan-Gross, Krystyna; Zapaśnik, Adam; Kaszubowski, Mariusz; Lass, Piotr; Sworczak, Krzysztof

2018-01-01

Despite numerous publications regarding nontoxic goiter (NTG) treatment and an increasing interest in patients' quality of life, few studies present the outcome of 131-I treatment from the patients' perspective. Our study's main aim was to verify whether there is any improvement in life quality following 131-I treatment. Thirty-five patients with NTG qualified to participate in the study. All patients completed a Thyroid-Related Health-Related Quality of Life (Thy-R-HRQoL) questionnaire created by us and the Medical Outcomes Study 36-item Short Form (SF-36), right before and 1 year after 131-I. We observed an improvement in six out of eight SF-36 and three out of seven Thy-R-HRQoL domains. In comparison with the control group, we observed worse results in two out of eight, prior to treatment, and one out of eight SF-36 afterward, as well as in all Thy-R-HRQoL domains. We did not find any correlation between improvement of Thy-R-HRQoL and SF-36 and goiter size reduction, except for Bodily Pain. There was also no correlation between improvement of SF-36 and Thy-R-HRQoL domains, and goiter size before treatment. The older the patient, the less noticeable improvement was observed in Physical and Social Functioning, and Vitality in SF-36, but age had no influence on the assessment by Thy-R-HRQoL. Radioiodine treatment improves life quality in patients with NTG. Use of the Health-Related Quality of Life questionnaire should be taken into consideration when evaluating life quality of patients with NTG. Relentless pursuit of maximal goiter size reduction in 131-I treatment is worth consideration. In our study, life quality improvement did not depend directly on the goiter size reduction. Life quality improvement after 131-I might not depend on initial goiter size, and for certain domains of SF-36 might be less clearly expressed in older patients.

Observed cloud reflectivities and liquid water paths: An update

NASA Technical Reports Server (NTRS)

Coakley, James A., Jr.; Snider, Jack B.

1990-01-01

The FIRE microwave radiometer observations of liquid water path from San Nicolas Island and simultaneous NOAA AVHRR observations of cloud reflectivity were used to test a relationship between cloud liquid water path and cloud reflectivity that is often used in general circulation climate models (Stephens, 1978). The results of attempts to improve the data analysis which was described at the previous FIRE Science Team Workshop and elsewhere (Coakley and Snider, 1989) are reported. The improvements included the analysis of additional satellite passes over San Nicolas and sensitivity studies to estimate the effects on the observed reflectivities due to: (1) nonzero surface reflectivities beneath the clouds; (2) the anisotropy of the reflected radiances observed by the AVHRR; (3) small scale spatial structure in the liquid water path; and (4) adjustments to the calibration of AVHRR.

An improved empirical model of electron and ion fluxes at geosynchronous orbit based on upstream solar wind conditions

DOE PAGES

Denton, M. H.; Henderson, M. G.; Jordanova, V. K.; ...

2016-07-01

In this study, a new empirical model of the electron fluxes and ion fluxes at geosynchronous orbit (GEO) is introduced, based on observations by Los Alamos National Laboratory (LANL) satellites. The model provides flux predictions in the energy range ~1 eV to ~40 keV, as a function of local time, energy, and the strength of the solar wind electric field (the negative product of the solar wind speed and the z component of the magnetic field). Given appropriate upstream solar wind measurements, the model provides a forecast of the fluxes at GEO with a ~1 h lead time. Model predictionsmore » are tested against in-sample observations from LANL satellites and also against out-of-sample observations from the Compact Environmental Anomaly Sensor II detector on the AMC-12 satellite. The model does not reproduce all structure seen in the observations. However, for the intervals studied here (quiet and storm times) the normalized root-mean-square deviation < ~0.3. It is intended that the model will improve forecasting of the spacecraft environment at GEO and also provide improved boundary/input conditions for physical models of the magnetosphere.« less

Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

PubMed Central

van der Eem, Lisette; Nyanza, Elias C.; van Pelt, Sandra; Ndaki, Pendo; Basinda, Namanya; Sundby, Johanne

2017-01-01

Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client’s wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria. PMID:29236699

Video observation in HIT development: lessons learned on benefits and challenges.

PubMed

Høstgaard, Anna Marie; Bertelsen, Pernille

2012-08-22

Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. In contemporary clinical work practice, clinical work and health information technology are integrated, and part of the practice is tacit. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall. This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice. The objective of this paper is 1) to argue for the video observation technique to inform and improve health-information-technology development and 2) to share insights and lessons learned on benefits and challenges when using the video observation technique within healthcare settings. A multiple case study including nine case studies conducted by DaCHI researchers 2004-2011 using audio-visual, non-participant video observation for data collection within different healthcare settings. In HIT development, video observation is beneficial for 1) informing and improving system design 2) studying changes in work practice 3) identifying new potentials and 4) documenting current work practices. The video observation technique used within healthcare settings is superior to other ethnographic research methods when it comes to disclosing the complexity in clinical work practice. The insights gained are far more realistic compared to traditional ethnographic studies or usability studies and studies in clinical set ups. Besides, the data generated through video recordings provide a solid basis for dialog between the health care professionals involved. The most important lessons learned are that a well considered methodology and clear formulated objectives are imperative, in order to stay focused during the data rich analysis phase. Additionally, the video observation technique is primarily recommended for studies of specific clinical work practices within delimited clinical settings. Overall, the video observation technique has proven to be capable of improving our understanding of the interwoven relation between clinical work practice and HIT and to inform us about user requirements and needs for HIT, which is a precondition for the development of more successful HIT systems in the future.

An Action Research Study Designed to Implement Student Negotiation to Improve Speaking Classroom Practice in Turkey

ERIC Educational Resources Information Center

Uztosun, Mehmet Sercan; Skinner, Nigel; Cadorath, Jill

2014-01-01

This paper reports the second stage of an action research study designed to improve the effectiveness of speaking classes through negotiating the lesson contents with students. The data were collected through interviews, questionnaires and observations as a way of eliciting students' views. The research, conducted in an English language teaching…

Improved Picture Naming in Chronic Aphasia after Tms to Part of Right Broca's Area: An Open-Protocol Study

ERIC Educational Resources Information Center

Naeser, M.A.; Martin, P.I.; Nicholas, M.; Baker, E.H.; Seekins, H.; Kobayashi, M.; Theoret, H.; Fregni, F.; Maria-Tormos, J.; Kurland, J.; Doron, K.W.; Pascual-Leone, A.

2005-01-01

Functional imaging studies with nonfluent aphasia patients have observed ''over-activation'' in right (R) language homologues. This may represent a maladaptive strategy; suppression may result in language improvement. We applied slow, 1 Hz repetitive transcranial magnetic stimulation (rTMS) to an anterior portion of R Broca's homologue daily, for…

Improved Diagnostic Validity of the ADOS Revised Algorithms: A Replication Study in an Independent Sample

ERIC Educational Resources Information Center

Oosterling, Iris; Roos, Sascha; de Bildt, Annelies; Rommelse, Nanda; de Jonge, Maretha; Visser, Janne; Lappenschaar, Martijn; Swinkels, Sophie; van der Gaag, Rutger Jan; Buitelaar, Jan

2010-01-01

Recently, Gotham et al. ("2007") proposed revised algorithms for the Autism Diagnostic Observation Schedule (ADOS) with improved diagnostic validity. The aim of the current study was to replicate predictive validity, factor structure, and correlations with age and verbal and nonverbal IQ of the ADOS revised algorithms for Modules 1 and 2…

[Construction of the study platform for Meridians and Acupoints and the application in the flipped classroom].

PubMed

Hu, Rong

2016-11-12

To construct the study platform for meridians and acupoints by analyzing the status and current problems of teaching Meridians and Acupoints and in accordance with the principles as "knowledge fragmentation, game breakthrough and overall assessment" and observe the application effect in the flipped classroom. Totally two hundred and five 2014 grade bachelor candidates from four classes of the department of acupuncture-moxibustion and tuina were selected from Hunan Junior College of TCM. They were randomized into an observation group (102 cases) and a control group (103 cases). in the observation group, the flipped classroom was performed by adopting the study platform of meridians and acupoints. Additionally, the team cooperation learning and overall assessment were conducted. In the control group, the traditional teaching system was adopted, in which, the mode of "teacher's demonstration-to-discussion in group-to-teachers' assessment" and the operation check at the end of the semester were applied. The learning effect and the self-learning ability were evaluated at the end of semester in the two groups. The satisfaction survey was conducted in the observation group. In the observation group, the drawing of meridian running course and locating the acupoints, as well as the self-learning ability were better than those in the control group, indicating the significant differences (all P <0.05). The interests in platform, interaction, contribution to knowledge learning and the improvement of the self-learning ability were much more obvious and the satisfaction was quite high, accounting for over 90%. The acceptance to the flipped classroom and the satisfaction of participation were slightly low. The study platform of learning Meridians and Acupoints was applied in the flipped classroom and has effectively improved the practical manipulation results and self-learning ability. However, the interestingness and interactivity of the platform are expected to be improved. The effective teaching design should be adopted in the flipped classroom to improve the students' desire of participation.

Home Videophones Improve Direct Observation in Tuberculosis Treatment: A Mixed Methods Evaluation

PubMed Central

Wade, Victoria A.; Karnon, Jonathan; Eliott, Jaklin A.; Hiller, Janet E.

2012-01-01

Background The use of direct observation to monitor tuberculosis treatment is controversial: cost, practical difficulties, and lack of patient acceptability limit effectiveness. Telehealth is a promising alternative delivery method for improving implementation. This study aimed to evaluate the clinical and cost-effectiveness of a telehealth service delivering direct observation, compared to an in-person drive-around service. Methodology/Principal Findings The study was conducted within a community nursing service in South Australia. Telehealth patients received daily video calls at home on a desktop videophone provided by the nursing call center. A retrospective cohort study assessed the effectiveness of the telehealth and traditional forms of observation, defined by the proportion of missed observations recorded in case notes. This data was inputted to a model, estimating the incremental cost-effectiveness ratio (ICER) of telehealth. Semi-structured interviews were conducted with current patients, community nursing and Chest Clinic staff, concerning service acceptability, usability and sustainability. The percentage of missed observations for the telehealth service was 12.1 (n = 58), compared to 31.1 for the in-person service (n = 70). Most of the difference of 18.9% (95% CI: 12.2 – 25.4) was due to fewer pre-arranged absences. The economic analysis calculated the ICER to be AUD$1.32 (95% CI: $0.51 – $2.26) per extra day of successful observation. The video service used less staff time, and became dominant if implemented on a larger scale and/or with decreased technology costs. Qualitative analysis found enabling factors of flexible timing, high patient acceptance, staff efficiency, and Chest Clinic support. Substantial technical problems were manageable, and improved liaison between the nursing service and Chest Clinic was an unexpected side-benefit. Conclusions/Significance Home video observation is a patient-centered, resource efficient way of delivering direct observation for TB, and is cost-effective when compared with a drive-around service. Future research is recommended to determine applicability and effectiveness in other settings. PMID:23226243

Observational Study Designs for Comparative Effectiveness Research: An Alternative Approach to Close Evidence Gaps in Head-and-Neck Cancer

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

Goulart, Bernardo H.L., E-mail: bhg@uw.edu; University of Washington, Seattle, Washington; Ramsey, Scott D.

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H and N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H and N RCTs, which limits the validity of their results to the broader H and N cancer patient population seenmore » in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H and N cancer, including treatment comparisons for rare types of H and N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H and N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H and N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design.« less

Observational study designs for comparative effectiveness research: an alternative approach to close evidence gaps in head-and-neck cancer.

PubMed

Goulart, Bernardo H L; Ramsey, Scott D; Parvathaneni, Upendra

2014-01-01

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H&N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H&N RCTs, which limits the validity of their results to the broader H&N cancer patient population seen in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H&N cancer, including treatment comparisons for rare types of H&N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H&N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H&N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design. Copyright © 2014 Elsevier Inc. All rights reserved.

The Pain Course: Exploring the Feasibility of an Internet-delivered Pain Management Program When Offered by a Tertiary Pain Management Service.

PubMed

Dear, Blake F; Courtney, Catherine; Khor, Kok Eng; McDonald, Sarah; Ricciardi, Tahlia; Gandy, Milena; Fogliati, Vincent J; Titov, Nick

2018-06-01

This study examined the acceptability and preliminary outcomes of an internet-delivered pain management program, the Pain Course, when offered by a specialist pain management clinic in a large public hospital. A single-group feasibility open-trial design was used and 39 patients participated in the program, which ran for 8 weeks. Participants were supported through the program with weekly contact from a Clinical Psychologist at the clinic. All participants provided data at posttreatment and >90% of participants completed all 5 lessons of the course. High levels of satisfaction were observed and relatively little clinician time (M=71.99 min/participant; SD=32.82 min) was required to support patients through the program. Preliminary evidence of clinical improvements in depression symptoms (avg. improvement=38%; Cohen d=0.74), but not disability levels or anxiety symptoms, was observed in the overall sample. However, evidence of improvements was observed across all the primary outcomes among patients who had clinical levels of difficulties with disability (n=20; avg. improvement=11%; Cohen d=0.64), depression (n=17; avg. improvement=35%; Cohen d=1.24) and anxiety (n=8; avg. improvement=29%; Cohen d=0.57). These findings highlight the potential value of internet-delivered programs when provided by specialist pain management clinics as a part of their services and the value of larger scale studies in this area.

Transdiagnostic internet-delivered cognitive-behaviour therapy (CBT) for adults with functional gastrointestinal disorders (FGID): A feasibility open trial.

PubMed

Dear, B F; Fogliati, V J; Fogliati, R; Gandy, M; McDonald, S; Talley, N; Holtmann, G; Titov, N; Jones, M

2018-05-01

Many people with functional gastrointestinal disorders (FGIDs) face significant barriers in accessing psychological treatments that are known to reduce symptoms and their psychological sequelae. This study examined the feasibility and initial outcomes of a transdiagnostic and internet-delivered cognitive behaviour therapy (iCBT) intervention, the Chronic Conditions Course, for adults with functional gastrointestinal disorders (FGIDs). A single-group feasibility open trial design was employed and administered to twenty seven participants. The course ran for 8 weeks and was provided with weekly contact from a Clinical Psychologist. Seventy percent of participants completed the course within the 8 weeks and 81.5% provided data at post-treatment. High levels of satisfaction were observed and relatively little clinician time (M = 42.70 min per participant; SD = 46.25 min) was required. Evidence of clinical improvements in FGID symptoms (ds ≥ 0.46; avg. improvement ≥21%), anxiety symptoms (ds ≥ 0.99; avg. improvement ≥42%), and depression symptoms (ds ≥ 0.75; avg. improvement ≥35%) were observed, which either maintained or continued to improve to 3-month follow-up. Evidence of improvement was also observed in pain catastrophising and mental-health related quality of life, but not physical-health related quality of life. These findings highlight the potential value of transdiagnostic internet-delivered programs for adults with FGIDs and support for the conduct of larger-scale controlled studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Quality versus Quantity: The Use of Observation by Early Childhood Educators in Improving the Performance of Children Enrolled in Preschool Programs in Ghana

ERIC Educational Resources Information Center

Tackie-Ofosu, Vivian; Bentum, Kwesi

2013-01-01

In the current study, the authors explored how early childhood educators used observation to support children in the learning environment. The objectives set were to find out the observation methods teachers used, ascertain their understanding of child observation, find out activities children undertook, and how teachers documented what children…

Assessing video games to improve driving skills: a literature review and observational study.

PubMed

Sue, Damian; Ray, Pradeep; Talaei-Khoei, Amir; Jonnagaddala, Jitendra; Vichitvanichphong, Suchada

2014-08-07

For individuals, especially older adults, playing video games is a promising tool for improving their driving skills. The ease of use, wide availability, and interactivity of gaming consoles make them an attractive simulation tool. The objective of this study was to look at the feasibility and effects of installing video game consoles in the homes of individuals looking to improve their driving skills. A systematic literature review was conducted to assess the effect of playing video games on improving driving skills. An observatory study was performed to evaluate the feasibility of using an Xbox 360 Kinect console for improving driving skills. Twenty-nine articles, which discuss the implementation of video games in improving driving skills were found in literature. On our study, it was found the Xbox 360 with Kinect is capable of improving physical and mental activities. Xbox Video games were introduced to engage players in physical, visual and cognitive activities including endurance, postural sway, reaction time, eyesight, eye movement, attention and concentration, difficulties with orientation, and semantic fluency. However, manual dexterity, visuo-spatial perception and binocular vision could not be addressed by these games. It was observed that Xbox Kinect (by incorporating Kinect sensor facilities) combines physical, visual and cognitive engagement of players. These results were consistent with those from the literature review. From the research that has been carried out, we can conclude that video game consoles are a viable solution for improving user's physical and mental state. In future we propose to carry a thorough evaluation of the effects of video games on driving skills in elderly people.

State estimation improves prospects for ocean research

NASA Astrophysics Data System (ADS)

Stammer, Detlef; Wunsch, C.; Fukumori, I.; Marshall, J.

Rigorous global ocean state estimation methods can now be used to produce dynamically consistent time-varying model/data syntheses, the results of which are being used to study a variety of important scientific problems. Figure 1 shows a schematic of a complete ocean observing and synthesis system that includes global observations and state-of-the-art ocean general circulation models (OGCM) run on modern computer platforms. A global observing system is described in detail in Smith and Koblinsky [2001],and the present status of ocean modeling and anticipated improvements are addressed by Griffies et al. [2001]. Here, the focus is on the third component of state estimation: the synthesis of the observations and a model into a unified, dynamically consistent estimate.

Converting Soil Moisture Observations to Effective Values for Improved Validation of Remotely Sensed Soil Moisture

NASA Technical Reports Server (NTRS)

Laymon, Charles A.; Crosson, William L.; Limaye, Ashutosh; Manu, Andrew; Archer, Frank

2005-01-01

We compare soil moisture retrieved with an inverse algorithm with observations of mean moisture in the 0-6 cm soil layer. A significant discrepancy is noted between the retrieved and observed moisture. Using emitting depth functions as weighting functions to convert the observed mean moisture to observed effective moisture removes nearly one-half of the discrepancy noted. This result has important implications in remote sensing validation studies.

Thinking outside the ROCs: Designing decorrelated taggers (DDT) for jet substructure

DOE PAGES

Dolen, James; Harris, Philip; Marzani, Simone; ...

2016-05-26

Here, we explore the scale-dependence and correlations of jet substructure observables to improve upon existing techniques in the identification of highly Lorentz-boosted objects. Modified observables are designed to remove correlations from existing theoretically well-understood observables, providing practical advantages for experimental measurements and searches for new phenomena. We study such observables in W jet tagging and provide recommendations for observables based on considerations beyond signal and background efficiencies.

Lifted worm algorithm for the Ising model

NASA Astrophysics Data System (ADS)

Elçi, Eren Metin; Grimm, Jens; Ding, Lijie; Nasrawi, Abrahim; Garoni, Timothy M.; Deng, Youjin

2018-04-01

We design an irreversible worm algorithm for the zero-field ferromagnetic Ising model by using the lifting technique. We study the dynamic critical behavior of an energylike observable on both the complete graph and toroidal grids, and compare our findings with reversible algorithms such as the Prokof'ev-Svistunov worm algorithm. Our results show that the lifted worm algorithm improves the dynamic exponent of the energylike observable on the complete graph and leads to a significant constant improvement on toroidal grids.

Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection.

PubMed

Lam, Barbara C C; Lee, Josephine; Lau, Y L

2004-11-01

Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this study was to assess the frequency and nature of patient contacts in neonatal intensive care units and observe the compliance and technique of hand hygiene among HCWs before and after the implementation of a multimodal intervention program. The nature and frequency of patient contacts, the hand hygiene compliance, and hand-washing techniques of HCWs were observed unobtrusively to reflect the baseline compliance and to investigate factors for noncompliance. The intervention consisted of problem-based and task-orientated hand hygiene education, enhancement of minimal handling protocol and clustering of nursing care, liberal provision of alcohol-based hand antiseptic, improvement in hand hygiene facilities, ongoing regular hand hygiene audit, and implementation of health care-associated infection surveillance. The observational study was repeated 6 months after the completion of the intervention program, which extended over 1-year period. Overall hand hygiene compliance increased from 40% to 53% before patient contact and 39% to 59% after patient contact. More marked improvement was observed for high-risk procedures (35%-60%). The average number of patient contacts also decreased from 2.8 to 1.8 per patient per hour. There was improvement in most aspects of hand-washing technique in the postintervention stage. The health care-associated infection rate decreased from 11.3 to 6.2 per 1000 patient-days. A problem-based and task-orientated education program can improve hand hygiene compliance. Enhancement of minimal handling and clustering of nursing procedures reduced the total patient contact episodes, which could help to overcome the major barrier of time constraints. A concurrent decrease in health care-associated infection rate and increase in hand hygiene compliance was observed in this study. The observational study could form part of an ongoing audit to provide regular feedback to HCWs to sustain the compliance.

Towards real-time assimilation of crowdsourced observations in hydrological modeling

NASA Astrophysics Data System (ADS)

Mazzoleni, Maurizio; Verlaan, Martin; Alfonso, Leonardo; Norbiato, Daniele; Monego, Martina; Ferri, Michele; Solomatine, Dimitri

2016-04-01

The continued technological advances have stimulated the spread of low-cost sensors that can be used by citizens to provide crowdsourced observations (CO) of different hydrological variables. An example of such low-cost sensors is a staff gauge connected to a QR code on which people can read the water level indication and send the measurement via a mobile phone application. The goal of this study is to assess the combined effect of the assimilation of CO coming from a distributed network of low-cost sensors, and the existing streamflow observations from physical sensors, on the performance of a semi-distributed hydrological model. The methodology is applied to the Bacchiglione catchment, North East of Italy, where an early warning system is used by the Alto Adriatico Water Authority to issue forecasted water level along the river network which cross important cities such as Vicenza and Padua. In this study, forecasted precipitation values are used as input in the hydrological model to estimate the simulated streamflow hydrograph used as boundary condition for the hydraulic model. Observed precipitation values are used to generate realistic synthetic streamflow values with various characteristics of arrival frequency and accuracy, to simulate CO coming at irregular time steps. These observations are assimilated into the semi-distributed model using a Kalman filter based method. The results of this study show that CO, asynchronous in time and with variable accuracy, can still improve flood prediction when integrated in hydrological models. When both physical and low-cost sensors are located at the same places, the assimilation of CO gives the same model improvement than the assimilation of physical observations only for high number of non-intermittent sensors. However, the integration of observations from low-cost sensors and single physical sensors can improve the flood prediction even when small a number of intermittent CO are available. This study is part of the FP7 European Project WeSenseIt Citizen Water Observatory (www.http://wesenseit.eu/).

An improved electrothermal model for the ERBE nonscanning radiometer - Comparison of predicted and measured behavior during solar observations

NASA Technical Reports Server (NTRS)

Tira, Nour E.; Mahan, J. R.; Lee, Robert B., III

1989-01-01

The improved Earth Radiation Budget Experiment nonscanning-channels electrothermal model presented is used to model two types of solar observations: those obtained through the solar port during solar calibration, and and those obtained during the satellite pitch-over maneuver, in which the sun is observed by the radiometer while it is in earth-viewing configuration. Thermal noise has been separately studied to evaluate its contribution to the radiative energy absorbed by the active cavity. It is found that the scattering of the collimated solar radiation contributes an average of 0.071 mW during solar calibration.

An exploratory, large-scale study of pain and quality of life outcomes in cancer patients with moderate or severe pain, and variables predicting improvement.

PubMed

Maximiano, Constanza; López, Iker; Martín, Cristina; Zugazabeitia, Luis; Martí-Ciriquián, Juan L; Núñez, Miguel A; Contreras, Jorge; Herdman, Michael; Traseira, Susana; Provencio, Mariano

2018-01-01

There have been few large-scale, real world studies in Spain to assess change in pain and quality of life (QOL) outcomes in cancer patients with moderate to severe pain. This study aimed to assess changes on both outcomes after 3 months of usual care and to investigate factors associated with change in QoL. Large, multi-centre, observational study in patients with lung, head and neck, colorectal or breast cancer experiencing a first episode of moderate to severe pain while attending one of the participating centres. QoL was assessed using the EuroQol-5D questionnaire and pain using the Brief Pain Inventory (BPI). Instruments were administered at baseline and after 3 months of follow up. Multivariate analyses were used to assess the impact of treatment factors, demographic and clinical variables, pain and other symptoms on QoL scores. 1711 patients were included for analysis. After 3 months of usual care, a significant improvement was observed in pain and QoL in all four cancer groups (p<0.001). Effect sizes were medium to large on the BPI and EQ-5D Index and Visual Analogue Scale (VAS). Improvements were seen on the majority of EQ-5D dimensions in all patient groups, though breast cancer patients showed the largest gains. Poorer baseline performance status (ECOG) and the presence of anxiety/depression were associated with significantly poorer QOL outcomes. Improvements in BPI pain scores were associated with improved QoL. In the four cancer types studied, pain and QoL outcomes improved considerably after 3 months of usual care. Improvements in pain made a substantial contribution to QoL gains whilst the presence of anxiety and depression and poor baseline performance status significantly constrained improvement.

Kinematic and kinetic improvements associated with action observation facilitated learning of the power clean in Australian footballers.

PubMed

Sakadjian, Alex; Panchuk, Derek; Pearce, Alan J

2014-06-01

This study investigated the effectiveness of action observation (AO) on facilitating learning of the power clean technique (kinematics) compared with traditional strength coaching methods and whether improvements in performance (kinetics) were associated with an improvement in lifting technique. Fifteen subjects (age, 20.9 ± 2.3 years) with no experience in performing the power clean exercise attended 12 training and testing sessions over a 4-week period. Subjects were assigned to 2 matched groups, based on preintervention power clean performance and performed 3 sets of 5 repetitions of the power clean exercise at each training session. Subjects in the traditional coaching group (TC; n = 7) received the standard coaching feedback (verbal cues and physical practice), whereas subjects in the AO group (n = 8) received similar verbal coaching cues and physical practice but also observed a video of a skilled model before performing each set. Kinematic data were collected from video recordings of subjects who were fitted with joint center markings during testing, whereas kinetic data were collected from a weightlifting analyzer attached to the barbell. Subjects were tested before intervention, at the end of weeks 2 and 3, and at after intervention at the end of week 4. Faster improvements (3%) were observed in power clean technique with AO-facilitated learning in the first week and performance improvements (mean peak power of the subject's 15 repetitions) over time were significant (p < 0.001). In addition, performance improvement was significantly associated (R = 0.215) with technique improvements. In conclusion, AO combined with verbal coaching and physical practice of the power clean exercise resulted in significantly faster technique improvements and improvement in performance compared with traditional coaching methods.

Fifteen years of continuous improvement of quality care of type 2 diabetes mellitus in primary care in Catalonia, Spain.

PubMed

Mata-Cases, M; Roura-Olmeda, P; Berengué-Iglesias, M; Birulés-Pons, M; Mundet-Tuduri, X; Franch-Nadal, J; Benito-Badorrey, B; Cano-Pérez, J F

2012-03-01

To assess the evolution of type 2 diabetes mellitus (T2DM) quality indicators in primary care centers (PCC) as part of the Group for the Study of Diabetes in Primary Care (GEDAPS) Continuous Quality Improvement (GCQI) programme in Catalonia. Sequential cross-sectional studies were performed during 1993-2007. Process and outcome indicators in random samples of patients from each centre were collected. The results of each evaluation were returned to each centre to encourage the implementation of correcting interventions. Sixty-four different educational activities were performed during the study period with the participation of 2041 professionals. Clinical records of 23,501 patients were evaluated. A significant improvement was observed in the determination of some annual process indicators: HbA(1c) (51.7% vs. 88.9%); total cholesterol (75.9% vs. 90.9%); albuminuria screening (33.9% vs. 59.4%) and foot examination (48.9% vs. 64.2%). The intermediate outcome indicators also showed significant improvements: glycemic control [HbA(1c) ≤ 7% (< 57 mmol/mol); (41.5% vs. 64.2%)]; total cholesterol [≤ 200 mg/dl (5.17 mmol/l); (25.5% vs. 65.6%)]; blood pressure [≤ 140/90 mmHg; (45.4% vs. 66.1%)]. In addition, a significant improvement in some final outcome indicators such as prevalence of foot ulcers (7.6% vs. 2.6%); amputations (1.9% vs. 0.6%) and retinopathy (18.8% vs. 8.6%) was observed. Although those changes should not be strictly attributed to the GCQI programme, significant improvements in some process indicators, parameters of control and complications were observed in a network of primary care centres in Catalonia. © 2012 Blackwell Publishing Ltd.

Fifteen years of continuous improvement of quality care of type 2 diabetes mellitus in primary care in Catalonia, Spain

PubMed Central

Mata-Cases, M; Roura-Olmeda, P; Berengué-Iglesias, M; Birulés-Pons, M; Mundet-Tuduri, X; Franch-Nadal, J; Benito-Badorrey, B; Cano-Pérez, J F

2012-01-01

Aims To assess the evolution of type 2 diabetes mellitus (T2DM) quality indicators in primary care centers (PCC) as part of the Group for the Study of Diabetes in Primary Care (GEDAPS) Continuous Quality Improvement (GCQI) programme in Catalonia. Methods Sequential cross-sectional studies were performed during 1993–2007. Process and outcome indicators in random samples of patients from each centre were collected. The results of each evaluation were returned to each centre to encourage the implementation of correcting interventions. Sixty-four different educational activities were performed during the study period with the participation of 2041 professionals. Results Clinical records of 23,501 patients were evaluated. A significant improvement was observed in the determination of some annual process indicators: HbA1c (51.7% vs. 88.9%); total cholesterol (75.9% vs. 90.9%); albuminuria screening (33.9% vs. 59.4%) and foot examination (48.9% vs. 64.2%). The intermediate outcome indicators also showed significant improvements: glycemic control [HbA1c ≤ 7% (< 57 mmol/mol); (41.5% vs. 64.2%)]; total cholesterol [≤ 200 mg/dl (5.17 mmol/l); (25.5% vs. 65.6%)]; blood pressure [≤ 140/90 mmHg; (45.4% vs. 66.1%)]. In addition, a significant improvement in some final outcome indicators such as prevalence of foot ulcers (7.6% vs. 2.6%); amputations (1.9% vs. 0.6%) and retinopathy (18.8% vs. 8.6%) was observed. Conclusions Although those changes should not be strictly attributed to the GCQI programme, significant improvements in some process indicators, parameters of control and complications were observed in a network of primary care centres in Catalonia. PMID:22340449

The Modulation of Tropical Storm Activity in the Western North Pacific by the Madden-Julian Oscillation in GEOS-5 AGCM Experiments

NASA Technical Reports Server (NTRS)

Kim, Dongmin; Lee, Myong-In; Kim, Hye-Mi; Schubert, Siegfried D.; Yoo, Jin Ho

2014-01-01

This study examines the influence of the Madden-Julian Oscillation (MJO) on tropical storm (TS) activity in the western North Pacific, using observations and GEOS-5 simulations at 50-km horizontal resolution. While GEOS-5 produces an MJO of faster propagation and weaker amplitude, it nevertheless reproduces the observed modulation of TS activity by the MJO with the highest TS genesis and increased track density in the active phases of MJO. The study suggests that the simulation of the sub-seasonal variability of TS activity could be improved by improving the simulations of the MJO in climate models.

The Wind Forecast Improvement Project (WFIP): A Public/Private Partnership for Improving Short Term Wind Energy Forecasts and Quantifying the Benefits of Utility Operations. The Southern Study Area, Final Report

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

Freedman, Jeffrey M.; Manobianco, John; Schroeder, John

This Final Report presents a comprehensive description, findings, and conclusions for the Wind Forecast Improvement Project (WFIP) -- Southern Study Area (SSA) work led by AWS Truepower (AWST). This multi-year effort, sponsored by the Department of Energy (DOE) and National Oceanographic and Atmospheric Administration (NOAA), focused on improving short-term (15-minute - 6 hour) wind power production forecasts through the deployment of an enhanced observation network of surface and remote sensing instrumentation and the use of a state-of-the-art forecast modeling system. Key findings from the SSA modeling and forecast effort include: 1. The AWST WFIP modeling system produced an overall 10more » - 20% improvement in wind power production forecasts over the existing Baseline system, especially during the first three forecast hours; 2. Improvements in ramp forecast skill, particularly for larger up and down ramps; 3. The AWST WFIP data denial experiments showed mixed results in the forecasts incorporating the experimental network instrumentation; however, ramp forecasts showed significant benefit from the additional observations, indicating that the enhanced observations were key to the model systems’ ability to capture phenomena responsible for producing large short-term excursions in power production; 4. The OU CAPS ARPS simulations showed that the additional WFIP instrument data had a small impact on their 3-km forecasts that lasted for the first 5-6 hours, and increasing the vertical model resolution in the boundary layer had a greater impact, also in the first 5 hours; and 5. The TTU simulations were inconclusive as to which assimilation scheme (3DVAR versus EnKF) provided better forecasts, and the additional observations resulted in some improvement to the forecasts in the first 1 - 3 hours.« less

A physical fitness programme during paid working hours - impact on health and work ability among women working in the social service sector: a three year follow up study.

PubMed

Vingård, Eva; Blomkvist, Vanja; Rosenblad, Andreas; Lindberg, Per; Voss, Margaretha; Alfredsson, Lars; Josephson, Malin

2009-01-01

In order to study the influence of a physical fitness programme on work ability among women employed in the social sector an intervention was offered to 205 women working in the social care sector in a municipality in Sweden. The reference group comprised 165 women from the same sector working in another municipality. All participants were employed and answered questionnaires at baseline and after 36 months. For women younger than 45 years, work ability and general health improved significantly while for women, 45 years or older, future work expectations improved. For women with less musculoskeletal pain, improvements were observed regarding future work expectations, as well as work ability and general health while for women with more musculoskeletal pain, improvements were observed for general health and future work expectations. Well-structured physical fitness programmes at the worksite can be useful in contributing to individual's experiences of improvements in their own capacity as well as increased health and wellbeing.

Modafinil for the Improvement of Patient Outcomes Following Traumatic Brain Injury.

PubMed

Borghol, Amne; Aucoin, Michael; Onor, Ifeanyichukwu; Jamero, Dana; Hawawini, Fadi

2018-04-01

Objective : The authors sought to assess the literature evidence on the efficacy of modafinil use in patients with fatigue or excessive daytime sleepiness (EDS) secondary to traumatic brain injury (TBI). Method of Research : A literature search of Medline and PubMed was performed using the EBSCOhost database. Primary literature, observational studies, meta-analyses, case reports, and systematic reviews were assessed for content regarding modafinil and psychostimulant use in patients with TBI. Of the 23 articles collected, three randomized, controlled studies, three observational studies, one case report, and two systematic reviews gave a description of modafinil use in TBI patients. Results and Conclusion : Modafinil is a central nervous system stimulant with well-established effectiveness in the treatment of narcolepsy and shift-work sleep disorder. There is conflicting evidence about the benefits of modafinil in the treatment of fatigue and EDS secondary to TBI. One randomized, controlled study states that modafinil does not significantly improve patient wakefulness, while another concludes that modafinil corrects EDS but not fatigue. An observational study provides evidence that modafinil increases alertness in fatigued patients with past medical history of brainstem diencephalic stroke or multiple sclerosis. Modafinil appears to have the potential to improve wakefulness in patients with TBI. A prospective, double-blinded, randomized, crossover trial of modafinil for the management of fatigue in ischemic stroke patients is currently being conducted, and further studies demonstrating consistent results are needed before making a conclusive decision.

The role of haemorrhage and exudate detection in automated grading of diabetic retinopathy.

PubMed

Fleming, Alan D; Goatman, Keith A; Philip, Sam; Williams, Graeme J; Prescott, Gordon J; Scotland, Graham S; McNamee, Paul; Leese, Graham P; Wykes, William N; Sharp, Peter F; Olson, John A

2010-06-01

Automated grading has the potential to improve the efficiency of diabetic retinopathy screening services. While disease/no disease grading can be performed using only microaneurysm detection and image-quality assessment, automated recognition of other types of lesions may be advantageous. This study investigated whether inclusion of automated recognition of exudates and haemorrhages improves the detection of observable/referable diabetic retinopathy. Images from 1253 patients with observable/referable retinopathy and 6333 patients with non-referable retinopathy were obtained from three grading centres. All images were reference-graded, and automated disease/no disease assessments were made based on microaneurysm detection and combined microaneurysm, exudate and haemorrhage detection. Introduction of algorithms for exudates and haemorrhages resulted in a statistically significant increase in the sensitivity for detection of observable/referable retinopathy from 94.9% (95% CI 93.5 to 96.0) to 96.6% (95.4 to 97.4) without affecting manual grading workload. Automated detection of exudates and haemorrhages improved the detection of observable/referable retinopathy.

Peer Observation: A Key Factor to Improve Iranian EFL Teachers' Professional Development

ERIC Educational Resources Information Center

Motallebzadeh, Khalil; Hosseinnia, Mansooreh; Domskey, Javad G. H.

2017-01-01

This study reports on the perspectives of a group of Iranian EFL teachers about peer observation effects. The aim was to investigate if peer observation as a reflective tool could significantly affect EFL teachers' professional development. It has been done based on a mixed method approach. The participants have stated their viewpoints on the…

Rotigotine Objectively Improves Sleep in Parkinson's Disease: An Open-Label Pilot Study with Actigraphic Recording.

PubMed

Calandra-Buonaura, Giovanna; Guaraldi, Pietro; Doria, Andrea; Zanigni, Stefano; Nassetti, Stefania; Favoni, Valentina; Cevoli, Sabina; Provini, Federica; Cortelli, Pietro

2016-01-01

Sleep disturbances represent important predictors of poor quality of life (QoL) in Parkinson's disease (PD). This open-label pilot study aimed to objectively assess, by means of actigraphic recording, effect of rotigotine on sleep in PD patients with self-reported sleep complaints. 15 PD patients underwent one-week actigraphic recording before (T0) and during (T1) rotigotine treatment, which was titrated to the dose subjectively improving motor symptoms (4-8 mg/24 h). Sleep disturbances, daytime sleepiness, cognitive performance, QoL, and depression were also evaluated with questionnaires. Actigraphic recordings showed a significant reduction in nocturnal motor activity and mean duration of wake episodes after sleep onset during rotigotine treatment compared to baseline. In 10 patients presenting objective evidence of poor sleep quality at T0 (sleep efficiency ≤ 85%), rotigotine also significantly improved other sleep parameters and further reduced nocturnal motor activity and mean duration of wake episodes. A significant decrease in number and duration of daytime sleep episodes was also observed at T1. Finally we confirmed that rotigotine significantly improves perceived sleep quality and QoL. Our study showed for the first time that rotigotine is associated with an objective improvement of nocturnal and diurnal sleep disturbances in PD patients with self-reported sleep complaints. This study is registered with AIFA-observational study registry number 12021.

Improvements in newborn care and newborn resuscitation following a quality improvement program at scale: results from a before and after study in Tanzania.

PubMed

Makene, Christina Lulu; Plotkin, Marya; Currie, Sheena; Bishanga, Dunstan; Ugwi, Patience; Louis, Henry; Winani, Kiholeth; Nelson, Brett D

2014-11-19

Every year, more than a million of the world's newborns die on their first day of life; as many as two-thirds of these deaths could be saved with essential care at birth and the early newborn period. Simple interventions to improve the quality of essential newborn care in health facilities - for example, improving steps to help newborns breathe at birth - have demonstrated up to 47% reduction in newborn mortality in health facilities in Tanzania. We conducted an evaluation of the effects of a large-scale maternal-newborn quality improvement intervention in Tanzania that assessed the quality of provision of essential newborn care and newborn resuscitation. Cross-sectional health facility surveys were conducted pre-intervention (2010) and post intervention (2012) in 52 health facilities in the program implementation area. Essential newborn care provided by health care providers immediately following birth was observed for 489 newborns in 2010 and 560 in 2012; actual management of newborns with trouble breathing were observed in 2010 (n = 18) and 2012 (n = 40). Assessments of health worker knowledge were conducted with case studies (2010, n = 206; 2012, n = 217) and a simulated resuscitation using a newborn mannequin (2010, n = 299; 2012, n = 213). Facility audits assessed facility readiness for essential newborn care. Index scores for quality of observed essential newborn care showed significant overall improvement following the quality-of-care intervention, from 39% to 73% (p <0.0001). Health worker knowledge using a case study significantly improved as well, from 23% to 41% (p <0.0001) but skills in resuscitation using a newborn mannequin were persistently low. Availability of essential newborn care supplies, which was high at baseline in the regional hospitals, improved at the lower-level health facilities. Within two years, the quality improvement program was successful in raising the quality of essential newborn care services in the program facilities. Some gaps in newborn care were persistent, notably practical skills in newborn resuscitation. Continued investment in life-saving improvements to newborn care through the health services is a priority for reduction of newborn mortality in Tanzania.

Improvement of psoriatic arthritis in a patient treated with bromocriptine for hyperprolactinemia.

PubMed

Buskila, D; Sukenik, S; Holcberg, G; Horowitz, J

1991-04-01

We describe a woman with psoriatic arthritis who experienced a remarkable improvement of her skin and joint disease while only taking bromocriptine therapy. She was treated with bromocriptine for primary infertility due to hyperprolactinemia. The improvement in joint symptoms appeared to parallel that of the skin. More studies are required to determine the reproducibility of this observation.

Assessment of colon polyp morphology: Is education effective?

PubMed Central

Kim, Jae Hyun; Nam, Kyoung Sik; Kwon, Hye Jung; Choi, Youn Jung; Jung, Kyoungwon; Kim, Sung Eun; Moon, Won; Park, Moo In; Park, Seun Ja

2017-01-01

AIM To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers. METHODS For purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test). To determine if the effectiveness of education was sustained, four months later, a third, follow-up test was performed with the same participants. RESULTS The overall Fleiss’ kappa value of the inter-observer agreement was 0.510 in the pre-test, 0.618 in the post-test, and 0.580 in the follow-up test. The overall diagnostic accuracy of the estimation for polyp morphology in the pre-, post-, and follow-up tests was 0.662, 0.797, and 0.761, respectively. After education, the inter-observer agreement and diagnostic accuracy of all participants improved. However, after four months, the inter-observer agreement and diagnostic accuracy of expert groups were markedly decreased, and those of beginner and nurse groups remained similar to pre-test levels. CONCLUSION The education program used in this study can improve inter-observer agreement and diagnostic accuracy in assessing the morphology of colon polyps; it is especially effective when first learning endoscopy. PMID:28974894

Assessment of colon polyp morphology: Is education effective?

PubMed

Kim, Jae Hyun; Nam, Kyoung Sik; Kwon, Hye Jung; Choi, Youn Jung; Jung, Kyoungwon; Kim, Sung Eun; Moon, Won; Park, Moo In; Park, Seun Ja

2017-09-14

To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers. For purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test). To determine if the effectiveness of education was sustained, four months later, a third, follow-up test was performed with the same participants. The overall Fleiss' kappa value of the inter-observer agreement was 0.510 in the pre-test, 0.618 in the post-test, and 0.580 in the follow-up test. The overall diagnostic accuracy of the estimation for polyp morphology in the pre-, post-, and follow-up tests was 0.662, 0.797, and 0.761, respectively. After education, the inter-observer agreement and diagnostic accuracy of all participants improved. However, after four months, the inter-observer agreement and diagnostic accuracy of expert groups were markedly decreased, and those of beginner and nurse groups remained similar to pre-test levels. The education program used in this study can improve inter-observer agreement and diagnostic accuracy in assessing the morphology of colon polyps; it is especially effective when first learning endoscopy.

Service innovation through social robot engagement to improve dementia care quality.

PubMed

Chu, Mei-Tai; Khosla, Rajiv; Khaksar, Seyed Mohammad Sadegh; Nguyen, Khanh

2017-01-01

Assistive technologies, such as robots, have proven to be useful in a social context and to improve the quality of life for people with dementia (PwD). This study aims to show how the engagement between two social robots and PwD in Australian residential care facilities can improve care quality. An observational method is adopted in the research methodology to discover behavioural patterns during interactions between the robots and PwD. This observational study has undertaken to explore the improvement arising from: (1) approaching social baby-face robots (AR), (2) experiencing pleasure engaging with the robots (P), (3) interacting with the robots (IR), and (4) interacting with others (IO). The findings show that social robots can improve diversion therapy service value to PwD through sensory enrichment, positive social engagement, and entertainment. More than 11,635 behavioral reactions, such as facial expressions and gestures, from 139 PwD over 5 years were coded, in order to identify the engagement effectiveness between PwD and two social robots named Sophie and Jack. The results suggest that these innovative social robots can improve the quality of care for people suffering from dementia.

Memantine reduces stealing behavior and impulsivity in kleptomania: a pilot study.

PubMed

Grant, Jon E; Odlaug, Brian L; Schreiber, Liana R N; Chamberlain, Samuel R; Won Kim, Suck

2013-03-01

Kleptomania is characterized by repetitive stealing behavior and has been associated with deleterious unwanted outcomes including forensic contact and increased rates of suicidal behavior. Very few trials have been conducted to investigate pharmacological treatment options for this neglected condition. Memantine is an NMDA-receptor antagonist that has shown promising results in the treatment of other behavioral addictions and substance addictions. Twelve individuals with kleptomania received memantine (10 mg/day, titrated to 30 mg/day maximum depending on clinical response and tolerability) over the course of 8 weeks, in an open-label trial. The effects of treatment were quantified using well-validated measures and select neurocognitive tests (last observation carried forward analyses). Kleptomania disease severity scores decreased across all measures considered, and 11 (91.7%) of the participants met the responder criteria (35% improvement on the primary effectiveness measure plus CGI improved/very much improved; significant improvements were also observed in terms of mood, anxiety, and disability scores along with a significant improvement in stop-signal response inhibition. Memantine was generally well tolerated. This study shows the effectiveness of memantine in reducing urges to shoplift and shoplifting behavior along with improving impulsivity, mood, anxiety, and psychosocial functioning.

A study on impact of an educational programme on immunization behaviour of parents.

PubMed

Khanom, K; Salahuddin, A K

1983-06-01

A study was conducted to measure the knowledge, attitude and practices (KAP) of parents of children 0-5 years of age in respect of expanded programme on immunization (EPI) target diseases. These variables were studied before and after educational programme. Before education of the parents, it was observed that increase in awareness of the target diseases was quite impressive, while improvement in knowledge about signs and symptoms of diseases, vaccines to prevent the diseases and immunization schedule were less evident. The attitude towards immunization was good and improved further with education. It was also observed that the increase in knowledge with regard to location of immunization centre and days on which services available was significant. Compared with improvement in knowledge and attitude ranging from 30 to almost 100 percent, the improvement in acceptance of vaccines was only within 6 to 10 per cent. Since the study time was short, the acceptance of all the required doses of all the vaccines could not be ascertained. Furthermore, the gap between KAP was as expected. However, strong motives are required or if motives are week, a compensatory strengthening of situational factors is called for to make the KAP easy and possible.

The effects of lifestyle modification on symptoms and quality of life in patients with irritable bowel syndrome: a prospective observational study.

PubMed

Kang, Sun Hyung; Choi, Seong-Woo; Lee, Seung Jun; Chung, Woo Suk; Lee, Hye Ran; Chung, Ki-Young; Lee, Eaum Seok; Moon, Hee Seok; Kim, Seok Hyun; Sung, Jae Kyu; Lee, Byung Seok; Jeong, Hyun Yong

2011-12-01

Although notably common, irritable bowel syndrome (IBS) has no specific cure. Lifestyle modification may be as important as medication; however, few studies support the effectiveness of such modifications. We performed this observational study of IBS patients to explore further the role of lifestyle changes in treatment. This study included 831 men who enlisted in 2010 as armed surgeon cadets and 85 women who concurrently entered the Armed Forces Nursing Academy. Of these 916 participants, 89 were diagnosed with IBS using the Rome III criteria. Subjective changes in bowel habits, quality of life, pain, stress, stool frequency and stool consistency were surveyed before and after 9 weeks of army training. We evaluated the lifestyle risk factors that impacted improvement in IBS symptoms by comparing those who responded to lifestyle modification (the responding group) to those who did not respond (the nonresponding group). More than half of the participants (63%) reported that their symptoms improved after training. The quality of life and levels of pain and stress significantly improved after military training. Initial stress levels before military training and smoking history affected IBS symptom improvement. Lifestyle modification may be effective in managing IBS patients.

Virtual reality in stroke rehabilitation: a meta-analysis and implications for clinicians.

PubMed

Saposnik, Gustavo; Levin, Mindy

2011-05-01

Approximately two thirds of stroke survivors continue to experience motor deficits of the arm resulting in diminished quality of life. Conventional rehabilitation provides modest and sometimes delayed effects. Virtual reality (VR) technology is a novel adjunctive therapy that could be applied in neurorehabilitation. We performed a meta-analysis to determine the added benefit of VR technology on arm motor recovery after stroke. We searched Medline, EMBASE, and Cochrane literature from 1966 to July 2010 with the terms "stroke," "virtual reality," and "upper arm/extremity." We evaluated the effect of VR on motor function improvement after stroke. From the 35 studies identified, 12 met the inclusion/exclusion criteria totaling 195 participants. Among them, there were 5 randomized clinical trials and 7 observational studies with a pre-/postintervention design. Interventions were delivered within 4 to 6 weeks in 9 of the studies and within 2 to 3 weeks in the remaining 3. Eleven of 12 studies showed a significant benefit toward VR for the selected outcomes. In the pooled analysis of all 5 randomized controlled trials, the effect of VR on motor impairment (Fugl-Meyer) was OR=4.89 (95% CI, 1.31 to 18.3). No significant difference was observed for Box and Block Test or motor function. Among observational studies, there was a 14.7% (95% CI, 8.7%-23.6%) improvement in motor impairment and a 20.1% (95% CI, 11.0%-33.8%) improvement in motor function after VR. VR and video game applications are novel and potentially useful technologies that can be combined with conventional rehabilitation for upper arm improvement after stroke.

Home parenteral nutrition improves quality of life and nutritional status in patients with cancer: a French observational multicentre study.

PubMed

Culine, S; Chambrier, C; Tadmouri, A; Senesse, P; Seys, P; Radji, A; Rotarski, M; Balian, A; Dufour, P

2014-07-01

Malnutrition is a predictor of poor outcomes in patients with cancer. Little is known about the benefit of nutritional support in these patients. The purpose of this study was to assess the impact of home parenteral nutrition (HPN) on quality of life (Qol) in cancer patients. We performed an observational prospective study to determine the impact of HPN on Qol in a population of patients with heterogeneous cancer. Physicians, patients and family members had to complete a questionnaire before HPN administration and 28 days after the course of HPN. Qol was evaluated using the self-administered questionnaire FACT-G. We included 767 patients with cancer of whom 437 ended the study. Mean patient age was 63±11.4 years and 60.5% were men. Primary gastrointestinal cancer was reported in 50% of patients and 65.3% were presenting metastases. Malnutrition was reported in 98.3%. After 28 days of HPN intake, significant improvement was observed in the Qol (49.95±5.82 vs. 48.35±5.01 at baseline, p<0.0001). The mean weight, serum albumin and the nutrition risk index had also improved significantly. Most patients (78%) had perceived a positive impact of the HPN. A significant improvement in patient's well-being was perceived also by family members and physicians. Our data suggest that preventing and correcting malnutrition using HPN in patients with cancer might have a significant benefit on their well-being. Randomized controlled studies are required to confirm this finding.

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

DTIC Science & Technology

2015-08-27

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

Fundamental and methodological investigations for the improvement of elemental analysis by inductively coupled plasma mass soectrometry

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

Ebert, Christopher Hysjulien

This dissertation describes a variety of studies meant to improve the analytical performance of inductively coupled plasma mass spectrometry (ICP-MS) and laser ablation (LA) ICP-MS. The emission behavior of individual droplets and LA generated particles in an ICP is studied using a high-speed, high frame rate digital camera. Phenomena are observed during the ablation of silicate glass that would cause elemental fractionation during analysis by ICP-MS. Preliminary work for ICP torch developments specifically tailored for the improvement of LA sample introduction are presented. An abnormal scarcity of metal-argon polyatomic ions (MAr{sup +}) is observed during ICP-MS analysis. Evidence shows thatmore » MAr{sup +} ions are dissociated by collisions with background gas in a shockwave near the tip of the skimmer cone. Method development towards the improvement of LA-ICP-MS for environmental monitoring is described. A method is developed to trap small particles in a collodion matrix and analyze each particle individually by LA-ICP-MS.« less

Intercontinental telehealth coaching of therapists to improve verbalizations by children with autism.

PubMed

Barkaia, Ana; Stokes, Trevor F; Mikiashvili, Tamar

2017-07-01

This study examined the effects of intercontinental telehealth coaching on the mastery of therapists' skills and improvements in verbalizations by children with autism, testing whether telehealth can be a solution for underserved communities in developing countries such as Georgia-Sakartvelo in Eastern Europe. Three therapists delivering and three children with autism receiving early-intervention services from the nongovernmental organization Children of Georgia in Tbilisi participated. Experimenters provided coaching from Virginia, USA to therapists in Georgia-Sakartvelo. Observers in Georgia-Sakartvelo and in Virginia conducted the behavioral observations. We used inexpensive communications technology to provide the coaching and a multiple-baseline design across participants to evaluate the effects of the intervention. Therapists demonstrated improvements in two classes of behaviors: correct command sequences and positive consequences. The children demonstrated improvements with echoics and mands. The study demonstrated that telehealth can be a good model for delivering early-intervention services to children with autism in underserved and distant regions of the world. © 2017 Society for the Experimental Analysis of Behavior.

Evaluation on surface current observing network of high frequency ground wave radars in the Gulf of Thailand

NASA Astrophysics Data System (ADS)

Yin, Xunqiang; Shi, Junqiang; Qiao, Fangli

2018-05-01

Due to the high cost of ocean observation system, the scientific design of observation network becomes much important. The current network of the high frequency radar system in the Gulf of Thailand has been studied using a three-dimensional coastal ocean model. At first, the observations from current radars have been assimilated into this coastal model and the forecast results have improved due to the data assimilation. But the results also show that further optimization of the observing network is necessary. And then, a series of experiments were carried out to assess the performance of the existing high frequency ground wave radar surface current observation system. The simulated surface current data in three regions were assimilated sequentially using an efficient ensemble Kalman filter data assimilation scheme. The experimental results showed that the coastal surface current observation system plays a positive role in improving the numerical simulation of the currents. Compared with the control experiment without assimilation, the simulation precision of surface and subsurface current had been improved after assimilated the surface currents observed at current networks. However, the improvement for three observing regions was quite different and current observing network in the Gulf of Thailand is not effective and a further optimization is required. Based on these evaluations, a manual scheme has been designed by discarding the redundant and inefficient locations and adding new stations where the performance after data assimilation is still low. For comparison, an objective scheme based on the idea of data assimilation has been obtained. Results show that all the two schemes of observing network perform better than the original network and optimal scheme-based data assimilation is much superior to the manual scheme that based on the evaluation of original observing network in the Gulf of Thailand. The distributions of the optimal network of radars could be a useful guidance for future design of observing system in this region.

Performance changes in lung nodule detection following perceptual feedback of eye movements

NASA Astrophysics Data System (ADS)

Donovan, T.; Manning, D. J.; Crawford, T.

2008-03-01

In a previously reported study we demonstrated that expert performance can decline following perceptual feedback of eye movements in the relatively simple radiological task of wrist fracture detection. This study was carried out to determine if the same effect could be observed using a more complicated radiological task of identifying lung nodules on chest radiographs. Four groups (n=10 in each group) of observers with different levels of expertise were tested. The groups were naÃve observers, level 1 radiography students, level 2 radiography students and experts. Feedback was presented to the observers in the form of their scan paths and fixations. Half the observers had feedback and half had no perceptual feedback. JAFROC analysis was used to measure observer performance. A repeated measures ANOVA was carried out. There was no significant effect between the pre and post "no feedback" condition. There was a significant difference between the pre and post "feedback" condition with a significant improvement following feedback (F(1,16)=6.6,p = 0.021). Overall the mean percentage improvement was small of 3.3%, with most of the improvement due to the level 1 group where the percentage increase in the figure of merit (FOM) was 8.4% and this was significant (p<0.05). Eye tracking metrics indicate that the expert and naÃve observers were less affected by feedback or a second look whereas there were mixed results between the level 1 and level 2 students possibly reflecting the different search strategies used. Perceptual feedback may be beneficial for those early in their training.

Impact of Assimilation of Conventional and Satellite Radiance GTS Observations on Simulation of Mesoscale Convective System Over Southeast India Using WRF-3DVar

NASA Astrophysics Data System (ADS)

Madhulatha, A.; Rajeevan, M.; Bhowmik, S. K. Roy; Das, A. K.

2018-01-01

The primary goal of present study is to investigate the impact of assimilation of conventional and satellite radiance observations in simulating the mesoscale convective system (MCS) formed over south east India. An assimilation methodology based on Weather Research and Forecasting model three dimensional variational data assimilation is considered. Few numerical experiments are carried out to examine the individual and combined impact of conventional and non-conventional (satellite radiance) observations. After the successful inclusion of additional observations, strong analysis increments of temperature and moisture fields are noticed and contributed to significant improvement in model's initial fields. The resulting model simulations are able to successfully reproduce the prominent synoptic features responsible for the initiation of MCS. Among all the experiments, the final experiment in which both conventional and satellite radiance observations assimilated has showed considerable impact on the prediction of MCS. The location, genesis, intensity, propagation and development of rain bands associated with the MCS are simulated reasonably well. The biases of simulated temperature, moisture and wind fields at surface and different pressure levels are reduced. Thermodynamic, dynamic and vertical structure of convective cells associated with the passage of MCS are well captured. Spatial distribution of rainfall is fairly reproduced and comparable to TRMM observations. It is demonstrated that incorporation of conventional and satellite radiance observations improved the local and synoptic representation of temperature, moisture fields from surface to different levels of atmosphere. This study highlights the importance of assimilation of conventional and satellite radiances in improving the models initial conditions and simulation of MCS.

Nutrition and physical activity in child care centers: the impact of a wellness policy initiative on environment and policy assessment and observation outcomes, 2011.

PubMed

Lyn, Rodney; Maalouf, Joyce; Evers, Sarah; Davis, Justin; Griffin, Monica

2013-05-23

The child care environment has emerged as an ideal setting in which to implement policies that promote healthy body weight of children. The purpose of this study was to assess the effect of a wellness policy and training program on the physical activity and nutrition environment in 24 child care centers in Georgia. We used the Environment and Policy Assessment and Observation instrument to identify changes to foods served, staff behaviors, and physical activity opportunities. Observations were performed over 1 day, beginning with breakfast and concluding when the program ended for the day. Observations were conducted from February 2010 through April 2011 for a total of 2 observations in each center. Changes to nutrition and physical activity in centers were assessed on the basis of changes in scores related to the physical activity and nutrition environment documented in the observations. Paired t test analyses were performed to determine significance of changes. Significant improvements to total nutrition (P < .001) and physical activity scores (P < .001) were observed. Results indicate that centers significantly improved the physical activity environments of centers by enhancing active play (P = .02), the sedentary environment (P = .005), the portable environment (P = .002), staff behavior (P = .004), and physical activity training and education (P < .001). Significant improvements were found for the nutrition environment (P < .001), and nutrition training and education (P < .001). Findings from this study suggest that implementing wellness policies and training caregivers in best practices for physical activity and nutrition can promote healthy weight for young children in child care settings.

An overview of the Software Engineering Laboratory

NASA Technical Reports Server (NTRS)

1994-01-01

This report describes the background and structure of the SEL organization, the SEL process improvement approach, and its experimentation and data collection process. Results of some sample SEL studies are included. It includes a discussion of the overall implication of trends observed over 17 years of process improvement efforts and looks at the return on investment based on a comparison of total investment in process improvement with the measurable improvements seen in the organization's software product.

On the assimilation set-up of ASCAT soil moisture data for improving streamflow catchment simulation

NASA Astrophysics Data System (ADS)

Loizu, Javier; Massari, Christian; Álvarez-Mozos, Jesús; Tarpanelli, Angelica; Brocca, Luca; Casalí, Javier

2018-01-01

Assimilation of remotely sensed surface soil moisture (SSM) data into hydrological catchment models has been identified as a means to improve streamflow simulations, but reported results vary markedly depending on the particular model, catchment and assimilation procedure used. In this study, the influence of key aspects, such as the type of model, re-scaling technique and SSM observation error considered, were evaluated. For this aim, Advanced SCATterometer ASCAT-SSM observations were assimilated through the ensemble Kalman filter into two hydrological models of different complexity (namely MISDc and TOPLATS) run on two Mediterranean catchments of similar size (750 km2). Three different re-scaling techniques were evaluated (linear re-scaling, variance matching and cumulative distribution function matching), and SSM observation error values ranging from 0.01% to 20% were considered. Four different efficiency measures were used for evaluating the results. Increases in Nash-Sutcliffe efficiency (0.03-0.15) and efficiency indices (10-45%) were obtained, especially when linear re-scaling and observation errors within 4-6% were considered. This study found out that there is a potential to improve streamflow prediction through data assimilation of remotely sensed SSM in catchments of different characteristics and with hydrological models of different conceptualizations schemes, but for that, a careful evaluation of the observation error and re-scaling technique set-up utilized is required.

Management Modalities for Traumatic Macular Hole: A Systematic Review and Single-Arm Meta-Analysis.

PubMed

Gao, Min; Liu, Kun; Lin, Qiurong; Liu, Haiyun

2017-02-01

The purposes of this study were to (i) determine macular hole (MH) closure rates and visual outcomes by comparing two methods of managing traumatic MH (TMH)-an event resulting in severe loss of visual acuity (VA); (ii) characterize patients who undergo spontaneous TMH closure; (iii) determine which TMH patients should be observed before resorting to surgical repair; and (iv) elucidate factors that influence postoperative visual outcomes. Studies (n=10) of patients who were managed by surgery or observation for TMH were meta-analyzed retrospectively. Management modalities included surgical repair (surgery group) and observation for spontaneous hole closure (observation group). In addition, a 12-case series of articles (1990-2014) on spontaneous hole closure was statistically summarized. SAS and Comprehensive Meta-Analysis (CMA) (version 3.0) were used for analysis. For surgery group patients, the fixed-model pooled event rate for hole closure was 0.919 (range, 0.861-0.954) and for observation group patients, 0.368 (range, 0.236-0.448). The random-model pooled event rate for improvement of visual acuity (VA) for surgery group patients was 0.748 (range, 0.610-0.849) and for observation group patients, 0.505 (range, 0.397-0.613). For patients in both groups, the mean age of spontaneous closure was 18.71±10.64 years; mean size of TMHs, 0.18±0.06 decimal degrees (DD); and mean time for hole closure, 3.38±3.08 months. The pooled event rate for visual improvement was 0.748 (0.610-0.849). Hole closure and VA improvement rates of surgery group patients were significantly higher than those for observation group patients. Patients of ≤ 24 years of age with MH sizes of ≤ 0.2DD were more likely to achieve spontaneous hole closure. The interval of time from injury to surgery was statistically significantly associated with the level of visual improvement.

Self-Compassion Promotes Personal Improvement From Regret Experiences via Acceptance.

PubMed

Zhang, Jia Wei; Chen, Serena

2016-02-01

Why do some people report more personal improvement from their regret experiences than others? Three studies examined whether self-compassion promotes personal improvement derived from recalled regret experiences. In Study 1, we coded anonymous regret descriptions posted on a blog website. People who spontaneously described their regret with greater self-compassion were also judged as having expressed more personal improvement. In Study 2, higher trait self-compassion predicted greater self-reported and observer-rated personal improvement derived from recalled regret experiences. In Study 3, people induced to take a self-compassionate perspective toward a recalled regret experience reported greater acceptance, forgiveness, and personal improvement. A multiple mediation analysis comparing acceptance and forgiveness showed self-compassion led to greater personal improvement, in part, through heightened acceptance. Furthermore, self-compassion's effects on personal improvement were distinct from self-esteem and were not explained by adaptive emotional responses. Overall, the results suggest that self-compassion spurs positive adjustment in the face of regrets. © 2015 by the Society for Personality and Social Psychology, Inc.

Mirror neuron system and observational learning: behavioral and neurophysiological evidence.

PubMed

Lago-Rodriguez, Angel; Lopez-Alonso, Virginia; Fernández-del-Olmo, Miguel

2013-07-01

Three experiments were performed to study observational learning using behavioral, perceptual, and neurophysiological data. Experiment 1 investigated whether observing an execution model, during physical practice of a transitive task that only presented one execution strategy, led to performance improvements compared with physical practice alone. Experiment 2 investigated whether performing an observational learning protocol improves subjects' action perception. In experiment 3 we evaluated whether the type of practice performed determined the activation of the Mirror Neuron System during action observation. Results showed that, compared with physical practice, observing an execution model during a task that only showed one execution strategy does not provide behavioral benefits. However, an observational learning protocol allows subjects to predict more precisely the outcome of the learned task. Finally, intersperse observation of an execution model with physical practice results in changes of primary motor cortex activity during the observation of the motor pattern previously practiced, whereas modulations in the connectivity between primary and non primary motor areas (PMv-M1; PPC-M1) were not affected by the practice protocol performed by the observer. Copyright © 2013 Elsevier B.V. All rights reserved.

Acetyl-DL-leucine improves gait variability in patients with cerebellar ataxia-a case series.

PubMed

Schniepp, Roman; Strupp, Michael; Wuehr, Max; Jahn, Klaus; Dieterich, Marianne; Brandt, Thomas; Feil, Katharina

2016-01-01

Acetyl-DL-leucine is a modified amino acid that was observed to improve ataxic symptoms in patients with sporadic and hereditary forms of ataxia. Here, we investigated the effect of the treatment with Acetyl-DL-leucine on the walking stability of patients with cerebellar ataxia (10x SAOA, 2x MSA-C, 2x ADA, 1x CACNA-1A mutation, 2x SCA 2, 1x SCA 1). Treatment with Acetyl-DL-leucine (500 mg; 3-3-4) significantly improved the coefficient of variation of stride time in 14 out of 18 patients. Moreover, subjective ambulatory scores (FES-I and ABC) and the SARA scores were also improved under treatment. Further prospective studies are necessary to support these class III observational findings.

Mirror neurons: action observation treatment as a tool in stroke rehabilitation.

PubMed

Franceschini, M; Agosti, M; Cantagallo, A; Sale, P; Mancuso, M; Buccino, G

2010-12-01

The observation of actions performed by others activate in an observer the same neural structures (including mirror neurons) as when he/she actually performs the same actions. The aim of the present study was to assess whether action observation treatment may improve upper limb motor impairment in chronic stroke patients. This was an observational study. Patients were recruited by three Italian Centres for Neurorehabilitation between 2006 and 2008. Twenty-eight chronic stroke patients with upper limb impairment have undergone for four weeks, five days a week, a rehabilitation treatment based on observation of video-clips presenting hand daily actions, followed by the imitation of those same actions with the affected limb. Functional evaluation by means of Modified Barthel Index (MBI), Frenchay Arm Test (FAT) and Fugl Meyer (FM) was carried out twice before treatment (BT1 and BT2), at an interval of 15 days, then after treatment (AT1) and finally at a two-month follow-up (AT2). Wilcoxon Signed Rank test was applied to test differences between scores obtained from functional scales before and after treatment (BT1 vs. BT2; BT2 vs. AT1; AT1 vs. AT2). In all scales, scores did not differ when comparing BT1 with BT2. Scores improved significantly in all scales at AT1 as compared to BT2 (MBI, P=0.026; FAT, P=0.005; FM, P=0.001). This improvement was still present at the two-month follow-up as testified by no score difference between AT1 and AT2. Action Observation Treatment may become a useful strategy in the rehabilitation of stroke patients. The present preliminary study suggests that stimulation of neural structures (including mirror neurons), activated when the patients actually perform the same actions as those observed could constitute a good alternative rehabilitative approach in chronic stroke patients.

The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study

PubMed Central

Rossignol, Daniel A; Rossignol, Lanier W; James, S Jill; Melnyk, Stepan; Mumper, Elizabeth

2007-01-01

Background Recently, hyperbaric oxygen therapy (HBOT) has increased in popularity as a treatment for autism. Numerous studies document oxidative stress and inflammation in individuals with autism; both of these conditions have demonstrated improvement with HBOT, along with enhancement of neurological function and cognitive performance. In this study, children with autism were treated with HBOT at atmospheric pressures and oxygen concentrations in current use for this condition. Changes in markers of oxidative stress and inflammation were measured. The children were evaluated to determine clinical effects and safety. Methods Eighteen children with autism, ages 3–16 years, underwent 40 hyperbaric sessions of 45 minutes duration each at either 1.5 atmospheres (atm) and 100% oxygen, or at 1.3 atm and 24% oxygen. Measurements of C-reactive protein (CRP) and markers of oxidative stress, including plasma oxidized glutathione (GSSG), were assessed by fasting blood draws collected before and after the 40 treatments. Changes in clinical symptoms, as rated by parents, were also assessed. The children were closely monitored for potential adverse effects. Results At the endpoint of 40 hyperbaric sessions, neither group demonstrated statistically significant changes in mean plasma GSSG levels, indicating intracellular oxidative stress appears unaffected by either regimen. A trend towards improvement in mean CRP was present in both groups; the largest improvements were observed in children with initially higher elevations in CRP. When all 18 children were pooled, a significant improvement in CRP was found (p = 0.021). Pre- and post-parental observations indicated statistically significant improvements in both groups, including motivation, speech, and cognitive awareness (p < 0.05). No major adverse events were observed. Conclusion In this prospective pilot study of children with autism, HBOT at a maximum pressure of 1.5 atm with up to 100% oxygen was safe and well tolerated. HBOT did not appreciably worsen oxidative stress and significantly decreased inflammation as measured by CRP levels. Parental observations support anecdotal accounts of improvement in several domains of autism. However, since this was an open-label study, definitive statements regarding the efficacy of HBOT for the treatment of individuals with autism must await results from double-blind, controlled trials. Trial Registration clinicaltrials.gov NCT00324909 PMID:18005455

Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles.

PubMed

Lee, Soo-Hoon; Khanuja, Harpal S; Blanding, Renee J; Sedgwick, Jeanne; Pressimone, Kathleen; Ficke, James R; Jones, Lynne C

2017-10-30

Teamwork training improves short-term teamwork behaviors. However, improvements are often not sustained. The purpose of this study was to explore the extent to which teamwork reinforcement activities for orthopedic surgery teams lead to sustained teamwork behaviors. Seven months after 104 staff from an orthopedic surgical unit were trained in Team Strategies and Tools to Enhance Performance and Patient Safety principles, 4 reinforcement activities were implemented regarding leadership and communication: lectures with videos on leadership skills for nursing staff; an online self-paced learning program on communication skills for nursing staff; a 1-page summary on leadership skills e-mailed to surgical staff; and a 1-hour perioperative grand rounds on Team Strategies and Tools to Enhance Performance and Patient Safety principles for anesthesia staff and new staff. Twenty-four orthopedic surgical teams were evaluated on teamwork behaviors during surgery by 2 observers before and after the reinforcement period using the Observational Teamwork Assessment for Surgery tool. After reinforcement, leadership (P = 0.022) and communication (P = 0.044) behaviors improved compared with prereinforcement levels. Specifically, nursing staff improved in leadership (P = 0.016) and communication (P = 0.028) behaviors, surgical staff improved in leadership behaviors (P = 0.009), but anesthesia staff did not improve in any teamwork behaviors. Sustained improvement in teamwork behaviors requires reinforcement. Level III, prospective pre-post cohort study.

Evaluation of the Community Multiscale Air Quality Model for Simulating Winter Ozone Formation in the Uinta Basin

NASA Astrophysics Data System (ADS)

Matichuk, Rebecca; Tonnesen, Gail; Luecken, Deborah; Gilliam, Rob; Napelenok, Sergey L.; Baker, Kirk R.; Schwede, Donna; Murphy, Ben; Helmig, Detlev; Lyman, Seth N.; Roselle, Shawn

2017-12-01

The Weather Research and Forecasting (WRF) and Community Multiscale Air Quality (CMAQ) models were used to simulate a 10 day high-ozone episode observed during the 2013 Uinta Basin Winter Ozone Study (UBWOS). The baseline model had a large negative bias when compared to ozone (O3) and volatile organic compound (VOC) measurements across the basin. Contrary to other wintertime Uinta Basin studies, predicted nitrogen oxides (NOx) were typically low compared to measurements. Increases to oil and gas VOC emissions resulted in O3 predictions closer to observations, and nighttime O3 improved when reducing the deposition velocity for all chemical species. Vertical structures of these pollutants were similar to observations on multiple days. However, the predicted surface layer VOC mixing ratios were generally found to be underestimated during the day and overestimated at night. While temperature profiles compared well to observations, WRF was found to have a warm temperature bias and too low nighttime mixing heights. Analyses of more realistic snow heat capacity in WRF to account for the warm bias and vertical mixing resulted in improved temperature profiles, although the improved temperature profiles seldom resulted in improved O3 profiles. While additional work is needed to investigate meteorological impacts, results suggest that the uncertainty in the oil and gas emissions contributes more to the underestimation of O3. Further, model adjustments based on a single site may not be suitable across all sites within the basin.

Edge geometry effects on resonance response of electroplated cylindrical Ni/PZT/Ni magnetoelectric composites

NASA Astrophysics Data System (ADS)

Yakubov, Vladislav; Xu, Lirong; Volinsky, Alex A.; Qiao, Lijie; Pan, De'an

2017-08-01

Trilayer Ni/PZT/Ni cylindrical magnetoelectric (ME) composites were prepared by electrodeposition, a process, which creates sub-millimeter raised edges due to current concentration near sharp points. The ME response in both axial and vertical modes was measured with the edges, with only outer edges removed, and with both outer and inner edges removed. The ME voltage coefficient improved at resonance by 40% and 147% without the edges in the vertical and axial modes, respectively. The observed improvements in three different samples were only present at the ME resonance and no changes were detected outside of the ME resonance. Mechanical quality factor at resonance also improved with no effect on the resonant frequency. Experimentally demonstrated minor geometry changes resulted in substantial ME improvement at resonant frequency. This study demonstrates device performance optimization. The observed effects have been attributed to improved vibrations in terms of decreased damping coefficient and enhanced vibration amplitude at resonance.

The origin of consistent protein structure refinement from structural averaging.

PubMed

Park, Hahnbeom; DiMaio, Frank; Baker, David

2015-06-02

Recent studies have shown that explicit solvent molecular dynamics (MD) simulation followed by structural averaging can consistently improve protein structure models. We find that improvement upon averaging is not limited to explicit water MD simulation, as consistent improvements are also observed for more efficient implicit solvent MD or Monte Carlo minimization simulations. To determine the origin of these improvements, we examine the changes in model accuracy brought about by averaging at the individual residue level. We find that the improvement in model quality from averaging results from the superposition of two effects: a dampening of deviations from the correct structure in the least well modeled regions, and a reinforcement of consistent movements towards the correct structure in better modeled regions. These observations are consistent with an energy landscape model in which the magnitude of the energy gradient toward the native structure decreases with increasing distance from the native state. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assimilating solar-induced chlorophyll fluorescence into the terrestrial biosphere model BETHY-SCOPE v1.0: model description and information content

NASA Astrophysics Data System (ADS)

Norton, Alexander J.; Rayner, Peter J.; Koffi, Ernest N.; Scholze, Marko

2018-04-01

The synthesis of model and observational information using data assimilation can improve our understanding of the terrestrial carbon cycle, a key component of the Earth's climate-carbon system. Here we provide a data assimilation framework for combining observations of solar-induced chlorophyll fluorescence (SIF) and a process-based model to improve estimates of terrestrial carbon uptake or gross primary production (GPP). We then quantify and assess the constraint SIF provides on the uncertainty in global GPP through model process parameters in an error propagation study. By incorporating 1 year of SIF observations from the GOSAT satellite, we find that the parametric uncertainty in global annual GPP is reduced by 73 % from ±19.0 to ±5.2 Pg C yr-1. This improvement is achieved through strong constraint of leaf growth processes and weak to moderate constraint of physiological parameters. We also find that the inclusion of uncertainty in shortwave down-radiation forcing has a net-zero effect on uncertainty in GPP when incorporated into the SIF assimilation framework. This study demonstrates the powerful capacity of SIF to reduce uncertainties in process-based model estimates of GPP and the potential for improving our predictive capability of this uncertain carbon flux.

Improved Satellite-based Photosysnthetically Active Radiation (PAR) for Air Quality Studies

NASA Astrophysics Data System (ADS)

Pour Biazar, A.; McNider, R. T.; Cohan, D. S.; White, A.; Zhang, R.; Dornblaser, B.; Doty, K.; Wu, Y.; Estes, M. J.

2015-12-01

One of the challenges in understanding the air quality over forested regions has been the uncertainties in estimating the biogenic hydrocarbon emissions. Biogenic volatile organic compounds, BVOCs, play a critical role in atmospheric chemistry, particularly in ozone and particulate matter (PM) formation. In southeastern United States, BVOCs (mostly as isoprene) are the dominant summertime source of reactive hydrocarbon. Despite significant efforts in improving BVOC estimates, the errors in emission inventories remain a concern. Since BVOC emissions are particularly sensitive to the available photosynthetically active radiation (PAR), model errors in PAR result in large errors in emission estimates. Thus, utilization of satellite observations to estimate PAR can help in reducing emission uncertainties. Satellite-based PAR estimates rely on the technique used to derive insolation from satellite visible brightness measurements. In this study we evaluate several insolation products against surface pyranometer observations and offer a bias correction to generate a more accurate PAR product. The improved PAR product is then used in biogenic emission estimates. The improved biogenic emission estimates are compared to the emission inventories over Texas and used in air quality simulation over the period of August-September 2013 (NASA's Discover-AQ field campaign). A series of sensitivity simulations will be performed and evaluated against Discover-AQ observations to test the impact of satellite-derived PAR on air quality simulations.

[Quality analysis of observational studies on pelvic organ prolapse in China].

PubMed

Wang, Y T; Tao, L Y; He, H J; Han, J S

2017-06-25

Objective: To evaluate the quality of observational studies on pelvic organ prolapse in China. Methods: The checklist of strengthening the reporting of observational studies in epidemiology (STROBE) statement was applied to evaluate the observational studies. The articles were searched in the SinoMed database using the terms: prolapse, uterine prolapse, cystocele, rectal prolapse and pelvic floor; limited to Chinese core journals in obstetrics and gynecology from January 1996 to December 2015. With two 10-year groups (1996-2005 and 2006-2015), the χ(2) test was used to evaluate inter-group differences. Results: (1) A total of 386 observational studies were selected, including 15.5%(60/386) of case-control studies, 80.6%(311/386) of cohort studies and 3.9% (15/386) of cross-sectional studies. (2) There were totally 22 items including 34 sub-items in the checklist. There were 17 sub-items (50.0%, 17/34) had a reporting ratio less than 50% in all of aticles, including: 1a (study's design) 3.9% (15/386), 6a (participants) 24.6% (95/386), 6b (matched studies) 0 (0/386), 9 (bias) 8.3% (32/386), 10 (study size) 3.9%, 11 (quantitative variables) 41.2% (159/386), 12b-12e (statistical methods in detail) 0-2.6% (10/386), 13a (numbers of individuals at each stage of study) 18.9% (73/386), 13b (reasons for non-participation at each stage) 18.9%, 13c (flow diagram) 0, 16b and 16c (results of category boundaries and relative risk) 9.6% (37/386) and 0, 19 (limitations) 31.6% (122/386), 22 (funding) 20.5% (79/386). (3) The quality of articles published in the two decades (1996-2005 and 2006-2015) were compared, and 38.2%(13/34) of sub-items had been significantly improved in the second 10-year (all P< 0.05). The improved items were as follows: 1b (integrity of abstract), 2 (background/rationale), 6a (participants), 7 (variables), 8 (data sources/measurement), 9 (bias), 11 (quantitative variables), 12a (statistical methods), 17 (other analyses), 18 (key results), 19 (limitations), 21 (generalisability), 22 (funding). Conclusions: The quality of observational studies on POP in China is suboptimal in half of evaluation items. However, the quality of articles published in the second 10-year have significantly improved.

Do Callous-Unemotional Traits Moderate the Relative Importance of Parental Coercion versus Warmth in Child Conduct Problems? An Observational Study

ERIC Educational Resources Information Center

Pasalich, Dave S.; Dadds, Mark R.; Hawes, David J.; Brennan, John

2011-01-01

Background: Research suggests that parenting has little influence on the development of antisocial behavior in children with callous-unemotional (CU) traits. We aimed to extend and improve on prior studies examining the moderating role of CU traits on associations between parenting and conduct problems, by using independent observations of two key…

Improving patient safety during insertion of peripheral venous catheters: an observational intervention study.

PubMed

Kampf, Günter; Reise, Gesche; James, Claudia; Gittelbauer, Kirsten; Gosch, Jutta; Alpers, Birgit

2013-01-01

Peripheral venous catheters are frequently used in hospitalized patients but increase the risk of nosocomial bloodstream infection. Evidence-based guidelines describe specific steps that are known to reduce infection risk. However, the degree of guideline implementation in clinical practice is not known. The aim of this study was to determine the use of specific steps for insertion of peripheral venous catheters in clinical practice and to implement a multimodal intervention aimed at improving both compliance and the optimum order of the steps. The study was conducted at University Hospital Hamburg. An optimum procedure for inserting a peripheral venous catheter was defined based on three evidence-based guidelines (WHO, CDC, RKI) including five steps with 1A or 1B level of evidence: hand disinfection before patient contact, skin antisepsis of the puncture site, no palpation of treated puncture site, hand disinfection before aseptic procedure, and sterile dressing on the puncture site. A research nurse observed and recorded procedures for peripheral venous catheter insertion for healthcare workers in four different departments (endoscopy, central emergency admissions, pediatrics, and dermatology). A multimodal intervention with 5 elements was established (teaching session, dummy training, e-learning tool, tablet and poster, and direct feedback), followed by a second observation period. During the last observation week, participants evaluated the intervention. In the control period, 207 insertions were observed, and 202 in the intervention period. Compliance improved significantly for four of five steps (e.g., from 11.6% to 57.9% for hand disinfection before patient contact; p<0.001, chi-square test). Compliance with skin antisepsis of the puncture site was high before and after intervention (99.5% before and 99.0% after). Performance of specific steps in the correct order also improved (e.g., from 7.7% to 68.6% when three of five steps were done; p<0.001). The intervention was described as helpful by 46.8% of the participants, as neutral by 46.8%, and as disruptive by 6.4%. A multimodal strategy to improve both compliance with safety steps for peripheral venous catheter insertion and performance of an optimum procedure was effective and was regarded helpful by healthcare workers.

Improving Soil Moisture Estimation through the Joint Assimilation of SMOS and GRACE Satellite Observations

NASA Technical Reports Server (NTRS)

Girotto, Manuela

2018-01-01

Observations from recent soil moisture dedicated missions (e.g. SMOS or SMAP) have been used in innovative data assimilation studies to provide global high spatial (i.e., approximately10-40 km) and temporal resolution (i.e., daily) soil moisture profile estimates from microwave brightness temperature observations. These missions are only sensitive to near-surface soil moisture 0-5 cm). In contrast, the Gravity Recovery and Climate Experiment (GRACE) mission provides accurate measurements of the entire vertically integrated terrestrial water storage (TWS) column but, it is characterized by low spatial (i.e., 150,000 km2) and temporal (i.e., monthly) resolutions. Data assimilation studies have shown that GRACE-TWS primarily affects (in absolute terms) deeper moisture storages (i.e., groundwater). In this presentation I will review benefits and drawbacks associated to the assimilation of both types of observations. In particular, I will illustrate the benefits and drawbacks of their joint assimilation for the purpose of improving the entire profile of soil moisture (i.e., surface and deeper water storages).

Improving correlations between MODIS aerosol optical thickness and ground-based PM 2.5 observations through 3D spatial analyses

NASA Astrophysics Data System (ADS)

Hutchison, Keith D.; Faruqui, Shazia J.; Smith, Solar

The Center for Space Research (CSR) continues to focus on developing methods to improve correlations between satellite-based aerosol optical thickness (AOT) values and ground-based, air pollution observations made at continuous ambient monitoring sites (CAMS) operated by the Texas commission on environmental quality (TCEQ). Strong correlations and improved understanding of the relationships between satellite and ground observations are needed to formulate reliable real-time predictions of air quality using data accessed from the moderate resolution imaging spectroradiometer (MODIS) at the CSR direct-broadcast ground station. In this paper, improvements in these correlations are demonstrated first as a result of the evolution in the MODIS retrieval algorithms. Further improvement is then shown using procedures that compensate for differences in horizontal spatial scales between the nominal 10-km MODIS AOT products and CAMS point measurements. Finally, airborne light detection and ranging (lidar) observations, collected during the Texas Air Quality Study of 2000, are used to examine aerosol profile concentrations, which may vary greatly between aerosol classes as a result of the sources, chemical composition, and meteorological conditions that govern transport processes. Further improvement in correlations is demonstrated with this limited dataset using insights into aerosol profile information inferred from the vertical motion vectors in a trajectory-based forecast model. Analyses are ongoing to verify these procedures on a variety of aerosol classes using data collected by the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite (Calipso) lidar.

Computerized clinical documentation system in the pediatric intensive care unit

PubMed Central

2001-01-01

Background To determine whether a computerized clinical documentation system (CDS): 1) decreased time spent charting and increased time spent in patient care; 2) decreased medication errors; 3) improved clinical decision making; 4) improved quality of documentation; and/or 5) improved shift to shift nursing continuity. Methods Before and after implementation of CDS, a time study involving nursing care, medication delivery, and normalization of serum calcium and potassium values was performed. In addition, an evaluation of completeness of documentation and a clinician survey of shift to shift reporting were also completed. This was a modified one group, pretest-posttest design. Results With the CDS there was: improved legibility and completeness of documentation, data with better accessibility and accuracy, no change in time spent in direct patient care or charting by nursing staff. Incidental observations from the study included improved management functions of our nurse manager; improved JCAHO documentation compliance; timely access to clinical data (labs, vitals, etc); a decrease in time and resource use for audits; improved reimbursement because of the ability to reconstruct lost charts; limited human data entry by automatic data logging; eliminated costs of printing forms. CDS cost was reasonable. Conclusions When compared to a paper chart, the CDS provided a more legible, compete, and accessible patient record without affecting time spent in direct patient care. The availability of the CDS improved shift to shift reporting. Other observations showed that the CDS improved management capabilities; helped physicians deliver care; improved reimbursement; limited data entry errors; and reduced costs. PMID:11604105

Technical improvements for the dynamic measurement of general scour and landslides

NASA Astrophysics Data System (ADS)

Chung Yang, Han; Su, Chih Chiang

2017-04-01

Disasters occurring near riverbeds, such as landslides, earth slides, debris flow, and general scour, are easily caused by flooding from typhoons. The occurrence of each type of disaster involves a process, so if a disaster event can be monitored in real time, hazards can be predicted, thereby enabling early warnings that could reduce the degree of loss engendered by the disaster. The study of technical improvements for the dynamic measurement of general scour and landslides could help to release these early warnings. In this study, improved wireless tracers were set up on site to ensure the feasibility of the improved measurement technology. A wireless tracer signal transmission system was simultaneously set up to avoid danger to surveyors caused by them having to be on site to take measurements. In order to understand the real-time dynamic riverbed scouring situation, after the flow path of the river was confirmed, the sites for riverbed scouring observation were established at the P30 pier of the Dajia River Bridge of National Highway No. 3, and approximately 100 m both upstream and downstream (for a total of three sites). A rainy event that caused riverbed erosion occurred in May 2015, and subsequently, Typhoons Soudelor, Goni, and Dujuan caused further erosion in the observed area. The results of the observations of several flood events revealed that wireless tracers can reflect the change in riverbed scour depth caused by typhoons and flooding in real time. The wireless tracer technique can be applied to real-time dynamic scouring observation of rivers, and these improvements in measurement technology could be helpful in preventing landslides in the future.

Do convection-permitting models improve the representation of the impact of LUC?

NASA Astrophysics Data System (ADS)

Vanden Broucke, Sam; Van Lipzig, Nicole

2017-10-01

In this study we assess the added value of convection permitting scale (CPS) simulations in studies using regional climate models to quantify the bio-geophysical climate impact of land-use change (LUC). To accomplish this, a comprehensive model evaluation methodology is applied to both non-CPS and CPS simulations. The main characteristics of the evaluation methodology are (1) the use of paired eddy-covariance site observations (forest vs open land) and (2) a simultaneous evaluation of all surface energy budget components. Results show that although generally satisfactory, non-CPS simulations fall short of completely reproducing the observed LUC signal because of three key biases. CPS scale simulations succeed at significantly reducing two of these biases, namely, those in daytime shortwave radiation and daytime sensible heat flux. Also, CPS slightly reduces a third bias in nighttime incoming longwave radiation. The daytime improvements can be attributed partially to the switch from parameterized to explicit convection, the associated improvement in the simulation of afternoon convective clouds, and resulting surface energy budget and atmospheric feedbacks. Also responsible for the improvements during daytime is a better representation of surface heterogeneity and thus, surface roughness. Meanwhile, the modest nighttime longwave improvement can be attributed to increased vertical atmospheric resolution. However, the model still fails at reproducing the magnitude of the observed nighttime longwave difference. One possible explanation for this persistent bias is the nighttime radiative effect of biogenic volatile organic compound emissions over the forest site. A correlation between estimated emission rates and the observed nighttime longwave difference, as well as the persistence of the longwave bias provide support for this hypothesis. However, more research is needed to conclusively determine if the effect indeed exists.

Clinical implementation of a knowledge based planning tool for prostate VMAT.

PubMed

Powis, Richard; Bird, Andrew; Brennan, Matthew; Hinks, Susan; Newman, Hannah; Reed, Katie; Sage, John; Webster, Gareth

2017-05-08

A knowledge based planning tool has been developed and implemented for prostate VMAT radiotherapy plans providing a target average rectum dose value based on previously achievable values for similar rectum/PTV overlap. The purpose of this planning tool is to highlight sub-optimal clinical plans and to improve plan quality and consistency. A historical cohort of 97 VMAT prostate plans was interrogated using a RayStation script and used to develop a local model for predicting optimum average rectum dose based on individual anatomy. A preliminary validation study was performed whereby historical plans identified as "optimal" and "sub-optimal" by the local model were replanned in a blinded study by four experienced planners and compared to the original clinical plan to assess whether any improvement in rectum dose was observed. The predictive model was then incorporated into a RayStation script and used as part of the clinical planning process. Planners were asked to use the script during planning to provide a patient specific prediction for optimum average rectum dose and to optimise the plan accordingly. Plans identified as "sub-optimal" in the validation study observed a statistically significant improvement in average rectum dose compared to the clinical plan when replanned whereas plans that were identified as "optimal" observed no improvement when replanned. This provided confidence that the local model can identify plans that were suboptimal in terms of rectal sparing. Clinical implementation of the knowledge based planning tool reduced the population-averaged mean rectum dose by 5.6Gy. There was a small but statistically significant increase in total MU and femoral head dose and a reduction in conformity index. These did not affect the clinical acceptability of the plans and no significant changes to other plan quality metrics were observed. The knowledge-based planning tool has enabled substantial reductions in population-averaged mean rectum dose for prostate VMAT patients. This suggests plans are improved when planners receive quantitative feedback on plan quality against historical data.

Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

PubMed

Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

How Do Teachers Make Sense of Peer Observation Professional Development in an Urban School

ERIC Educational Resources Information Center

Dos Santos, Luis Miguel

2017-01-01

The purpose of the research study is to explore how a peer observation training programme could be beneficial to the professional development of English teachers in an East Asian environment. The research objectives were to improve teaching practice, examine how teachers make sense of the peer observation programme after they have taken part in,…

New insight of Arctic cloud parameterization from regional climate model simulations, satellite-based, and drifting station data

NASA Astrophysics Data System (ADS)

Klaus, D.; Dethloff, K.; Dorn, W.; Rinke, A.; Wu, D. L.

2016-05-01

Cloud observations from the CloudSat and CALIPSO satellites helped to explain the reduced total cloud cover (Ctot) in the atmospheric regional climate model HIRHAM5 with modified cloud physics. Arctic climate conditions are found to be better reproduced with (1) a more efficient Bergeron-Findeisen process and (2) a more generalized subgrid-scale variability of total water content. As a result, the annual cycle of Ctot is improved over sea ice, associated with an almost 14% smaller area average than in the control simulation. The modified cloud scheme reduces the Ctot bias with respect to the satellite observations. Except for autumn, the cloud reduction over sea ice improves low-level temperature profiles compared to drifting station data. The HIRHAM5 sensitivity study highlights the need for improving accuracy of low-level (<700 m) cloud observations, as these clouds exert a strong impact on the near-surface climate.

Model Uncertainty Quantification Methods In Data Assimilation

NASA Astrophysics Data System (ADS)

Pathiraja, S. D.; Marshall, L. A.; Sharma, A.; Moradkhani, H.

2017-12-01

Data Assimilation involves utilising observations to improve model predictions in a seamless and statistically optimal fashion. Its applications are wide-ranging; from improving weather forecasts to tracking targets such as in the Apollo 11 mission. The use of Data Assimilation methods in high dimensional complex geophysical systems is an active area of research, where there exists many opportunities to enhance existing methodologies. One of the central challenges is in model uncertainty quantification; the outcome of any Data Assimilation study is strongly dependent on the uncertainties assigned to both observations and models. I focus on developing improved model uncertainty quantification methods that are applicable to challenging real world scenarios. These include developing methods for cases where the system states are only partially observed, where there is little prior knowledge of the model errors, and where the model error statistics are likely to be highly non-Gaussian.

A concentrated electrolyte for zinc hexacyanoferrate electrodes in aqueous rechargeable zinc-ion batteries

NASA Astrophysics Data System (ADS)

Kim, D.; Lee, C.; Jeong, S.

2018-01-01

In this study, a concentrated electrolyte was applied in an aqueous rechargeable zinc-ion battery system with a zinc hexacyanoferrate (ZnHCF) electrode to improve the electrochemical performance by changing the hydration number of the zinc ions. To optimize the active material, ZnHCF was synthesized using aqueous solutions of zinc nitrate with three different concentrations. The synthesized materials exhibited some differences in structure, crystallinity, and particle size, as observed by X-ray diffraction and scanning electron microscopy. Subsequently, these well-structured materials were applied in electrochemical tests. A more than two-fold improvement in the charge/discharge capacities was observed when the concentrated electrolyte was used instead of the dilute electrolyte. Additionally, the cycling performance observed in the concentrated electrolyte was superior to that in the dilute electrolyte. This improvement in the electrochemical performance may result from a decrease in the hydration number of the zinc ions in the concentrated electrolyte.

Effectiveness of computer aided detection for solitary pulmonary nodules

NASA Astrophysics Data System (ADS)

Yan, Jiayong; Li, Wenjie; Du, Xiangying; Lu, Huihai; Xu, Jianrong; Xu, Mantao; Rong, Dongdong

2009-02-01

This study is to investigate the incremental effect of using a high performance computer-aided detection (CAD) system in detection of solitary pulmonary nodules in chest radiographs. The Kodak Chest CAD system was evaluated by a panel of six radiologists at different levels of experience. The observer study consisted of two independent phases: readings without CAD and readings with assistance of CAD. The study was conducted over a set of chest radiographs comprising 150 cancer cases and 150 cancer-free cases. The actual sensitivity of the CAD system is 72% with 3.7 false positives per case. Receiver operating characteristic (ROC) analysis was used to assess the overall observer performance. The AUZ (area under ROC curve) showed a significantly improvement (P=0.0001) from 0.844 to 0.884 after using CAD. The ROC analysis was also applied for observer performances on nodules in different sizes and visibilities. The average AUZs are improved from 0.798 to 0.835 (P=0.0003) for 5-10mm nodules, 0.853 to 0.907 (P=0.001) for 10-15mm nodules, 0.864 to 0.897 (P=0.051) for 15-20 mm nodules and 0.859 to 0.896 (P=0.0342) for 20-30mm nodules, respectively. For different visibilities, the average AUZs are improved from 0.886 to 0.915 (P=0.0337), 0.803 to 0.840 (P=0.063), 0.830 to 0.893 (P=0.0001), and 0.813 to 0.847 (P=0.152), for nodules clearly visible, hidden by ribs, partially overlap with ribs, and overlap with other structures, respectively. These results showed that observer performance could be greatly improved when the CAD system is employed as a second reader, especially for small nodules and nodules occluded by ribs.

Improving the quality of preclinical research echocardiography: Observations, training and guidelines for measurement.

PubMed

Donner, Daniel G; Kiriazis, Helen; Du, Xiao-Jun; Marwick, Thomas H; McMullen, Julie R

2018-04-20

Informal training in preclinical research may be a contributor to the poor reproducibility of preclinical cardiology research and low rates of translation into clinical research and practice. Mouse echocardiography is a widely used technique to assess cardiac structure and function in drug intervention studies using disease models. The inter-observer variability (IOV) of clinical echocardiographic measurements has been shown to improve with formalized training, but preclinical echocardiography lacks similarly critical standardization of training. The aims of this investigation were to assess the IOV of echocardiographic measurements from studies in mice, and address any technical impediments to reproducibility by implementing standardized guidelines through formalized training. In this prospective, single-site, observational cohort study, 13 scientists performing preclinical echocardiographic image analysis were assessed for measurement of short-axis M-mode-derived dimensions and calculated left ventricular mass (LVMass). Ten M-mode images of mouse hearts acquired and analyzed by an expert researcher with a spectrum of LVMass were selected for assessment, and validated by autopsy weight. Following the initial observation, a structured formal training program was introduced, and accuracy and reproducibility were re-evaluated. Mean absolute percentage error (MAPE) for Expert-calculated LVMass was 6{plus minus}4% compared to autopsy LVMass, and 25{plus minus}21% for participants before training. Standardized formal training improved participant MAPE by approximately 30% relative to expert-calculated LVMass (p<0.001). Participants initially categorized with high-range error (25-45%) improved to low-moderate error ranges (<15-25%). This report reveals an example of technical skill training insufficiency likely endemic to preclinical research and provides validated guidelines for echocardiographic measurement for adaptation to formalized in-training programs.

Implementation research to improve quality of maternal and newborn health care, Malawi.

PubMed

Brenner, Stephan; Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

2017-07-01

To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities' essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants' adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care.

[The effectiveness of comprehensive rehabilitation after a first episode of ischemic stroke].

PubMed

Starosta, Michał; Niwald, Marta; Miller, Elżbieta

2015-05-01

Ischemic stroke is the most common cause of hospitalization in the Department of Neurological Rehabilitation. Comprehensive rehabilitation is essential for regaining lost functional efficiency. The aim of study was to evaluate the effectiveness of specific disorder rehabilitation program in 57 patients with first-ever ischemic stroke. The study included 57 patients (27 women, 30 men) aged from 47 to 89. Patients were admitted for comprehensive rehabilitation, lasted an average of 25 days. The treatment program consisted of exercises aimed at reeducation of posture and gait. In addition, physical treatments were used. Evaluation of the effectiveness of rehabilitation was measured using the Activity Daily Living scale, Modified Rankin Scale, Rivermead Measure Assessment (RMA1-global movements, RMA2-lower limb and trunk, RMA3-upper limb) and the psychological tests - Geriatric Depression Scale (GDS) and Beck Depression Inventory (BDI). As a result of comprehensive rehabilitation treatment, functional status and mental health improvement was observed in relation to the ADL scale by 32% (woman 36%, man 30%), Rankin scale by 22% (woman 22%, man 21%). In the RMA, improvement was observed with the statistical significance of p=0.001 in all of the subscales. The highest rate of improvement affected upper limb function: RMA/3 (41%). In other subscales women have achieved statistically more significant improvement than men (RMA/1-43% versus 25%; RMA/2-41% versus 30%). The results related to the psychological assessment showed statistically significant GDS improvement p<0.001 (<60 years old) and BDI (> 60 years old) in test men (p=0.038). Spearman correlation coefficient showed no relation between mental state and functional improvement (GDS versus ADL; BDI versus ADL). The 25 days comprehensive rehabilitation program during the subacute stroke phase affects mainly the improvement of upper limb function. Women have achieved better functional improvement in all of the parameters. In addition, it was observed that symptoms of depression were presented in all study group, and the improvement of mental focused primarily on patients after 60 years old. © 2015 MEDPRESS.

Upper-ocean Response to Hurricane Gonzalo (2014): Salinity Effects Revealed by Targeted and Sustained Underwater Glider Observation

NASA Astrophysics Data System (ADS)

Domingues, R. M.; Goni, G. J.; Bringas, F.; Lee, S. K.; Kim, H. S. S.; Halliwell, G. R., Jr.; Dong, J.; Morell, J. M.; Pomales, L.

2016-02-01

In July 2014, two underwater gliders were deployed off Puerto Rico as part of a multi-institutional effort lead by NOAA/AOML funded by the Disaster Appropriations Relief Act of 2013 known as Sandy Supplemental. The goal of this work is to collect ocean observations to: (1) investigate the response of the ocean to tropical cyclone (TC) wind conditions; (2) improve understanding on the role that the ocean plays in the intensification of TCs; and (3) help improve TC seasonal and intensity forecasts. The two gliders were piloted along predetermined tracks in the Caribbean Sea and in the North Atlantic Ocean (Figure 1), where TCs very often travel and intensify. On October 12, 2014, TC Gonzalo developed in the tropical North Atlantic, reaching the status of Category 3 hurricane on October 14 as it travelled 85 km northeast of the location of the glider (site B, Figure 1). The sampling strategy adopted during the passage of Hurricane Gonzalo consisted of carrying out observations: along a repeat section three times between sites A and B, one before and two after the passage of the hurricane; and at a fixed location at site B during the passage of the hurricane. Observations collected before, during, and after the passage of this hurricane were analyzed to improve our understanding of the upper-ocean response to hurricane winds. The main finding in this study is that salinity played an important role on the upper-ocean response to Hurricane Gonzalo; where a near-surface barrier-layer has likely suppressed the hurricane-induced upper-ocean cooling, leading to smaller than expected temperature changes of -0.4°C. Post-storm observations also revealed a partial recovery of the ocean to pre-storm conditions 11 days after the hurricane. Glider observations were further compared with outputs from a numerical coupled atmospheric-ocean model used for hurricane prediction to evaluate the model performance in simulating the upper-ocean response during Hurricane Gonzalo. The comparison revealed that model-observations discrepancies were largely linked to salinity effects. Results presented in this study emphasize the value of underwater glider observations for improving our knowledge of how the ocean responds to tropical cyclone winds and for tropical cyclone intensification studies and forecasts.

Paliperidone Palmitate Improves and Maintains Functioning in Asia-Pacific Patients with Schizophrenia.

PubMed

Zhang, Hongyan; Turkoz, Ibrahim; Zhuo, Jianmin; Mathews, Maju; Tan, Wilson; Feng, Yu

2017-11-01

Post hoc analyses (two single-arm studies) were conducted to determine the impact of once-monthly injection of paliperidone palmitate on functioning in adult patients with schizophrenia in the Asia-Pacific region. Study 1 enrolled hospitalized patients with acute exacerbation of schizophrenia, and study 2 enrolled patients with recently diagnosed schizophrenia unsatisfactorily treated with oral antipsychotics. Patients received paliperidone palmitate, 150 mg eq. on day 1, 100 mg eq. on day 8, then once monthly (50-150 mg eq.) (study 1, days 36 and 64; study 2, 18 months). Functional status was evaluated by Personal and Social Performance score in both studies and employment only in study 2. In study 1, 54 of 184 patients (29.4%) with an unfavorable level of functioning at the baseline improved to a favorable level (Personal and Social Performance score greater than 70) at day 92. This improvement was significantly greater among patients with recently diagnosed schizophrenia (5 years or less) compared with patients with chronic schizophrenia (more than 5 years): 40% versus 22% (p < 0.0001). Improvements were observed in all four domains (socially useful activities, personal and social relationships, self-care, disturbing/aggressive behavior). In study 2, significant (p < 0.0001) improvement in functioning was observed at all visits, beginning at week 5. Almost half (48.7%, 247/507) of patients showed clinically meaningful improvement in functioning (i.e., 10 point or greater increase in Personal and Social Performance score) at month 18. The proportion of patients fully/partially employed was greater at all postbaseline visits (134 of 280, 47.9%, at month 18) as compared with the baseline. Functioning, including employment, was improved after short-term, once-monthly paliperidone palmitate injection, and was sustained to 18 months in Asia-Pacific patients with schizophrenia. Janssen-Cilag Asia-Pacific Medical Affairs.

Does ownership of improved dairy cow breeds improve child nutrition? A pathway analysis for Uganda.

PubMed

Kabunga, Nassul S; Ghosh, Shibani; Webb, Patrick

2017-01-01

The promotion of livestock production is widely believed to support enhanced diet quality and child nutrition, but the empirical evidence for this causal linkage remains narrow and ambiguous. This study examines whether adoption of improved dairy cow breeds is linked to farm-level outcomes that translate into household-level benefits including improved child nutrition outcomes in Uganda. Using nationwide data from Uganda's National Panel Survey, propensity score matching is used to create an unbiased counterfactual, based on observed characteristics, to assess the net impacts of improved dairy cow adoption. All estimates were tested for robustness and sensitivity to variations in observable and unobservable confounders. Results based on the matched samples showed that households adopting improved dairy cows significantly increased milk yield-by over 200% on average. This resulted in higher milk sales and milk intakes, demonstrating the potential of this agricultural technology to both integrate households into modern value chains and increase households' access to animal source foods. Use of improved dairy cows increased household food expenditures by about 16%. Although undernutrition was widely prevalent in the study sample and in matched households, the adoption of improved dairy cows was associated with lower child stunting in adopter household. In scale terms, results also showed that holding larger farms tends to support adoption, but that this also stimulates the household's ability to achieve gains from adoption, which can translate into enhanced nutrition.

Exercise Performance and Corticospinal Excitability during Action Observation

PubMed Central

Wrightson, James G.; Twomey, Rosie; Smeeton, Nicholas J.

2016-01-01

Purpose: Observation of a model performing fast exercise improves simultaneous exercise performance; however, the precise mechanism underpinning this effect is unknown. The aim of the present study was to investigate whether the speed of the observed exercise influenced both upper body exercise performance and the activation of a cortical action observation network (AON). Method: In Experiment 1, 10 participants completed a 5 km time trial on an arm-crank ergometer whilst observing a blank screen (no-video) and a model performing exercise at both a typical (i.e., individual mean cadence during baseline time trial) and 15% faster than typical speed. In Experiment 2, 11 participants performed arm crank exercise whilst observing exercise at typical speed, 15% slower and 15% faster than typical speed. In Experiment 3, 11 participants observed the typical, slow and fast exercise, and a no-video, whilst corticospinal excitability was assessed using transcranial magnetic stimulation. Results: In Experiment 1, performance time decreased and mean power increased, during observation of the fast exercise compared to the no-video condition. In Experiment 2, cadence and power increased during observation of the fast exercise compared to the typical speed exercise but there was no effect of observation of slow exercise on exercise behavior. In Experiment 3, observation of exercise increased corticospinal excitability; however, there was no difference between the exercise speeds. Conclusion: Observation of fast exercise improves simultaneous upper-body exercise performance. However, because there was no effect of exercise speed on corticospinal excitability, these results suggest that these improvements are not solely due to changes in the activity of the AON. PMID:27014037

Meteorology Research in DOE's Atmosphere to Electrons (A2e) Program

NASA Astrophysics Data System (ADS)

Cline, J.; Haupt, S. E.; Shaw, W. J.

2017-12-01

DOE's Atmosphere to electrons (A2e) program is performing cutting edge research to allow optimization of wind plants. This talk will summarize the atmospheric science portion of A2e, with an overview of recent and planned observation and modeling projects designed to bridge the terra incognita between the mesoscale and the microscales that affect wind plants. Introduction A2e is a major focus of the Wind Energy Technologies Office (WETO) within the Office of Energy Efficiency & Renewable Energy (EERE) at the DOE. The overall objective of A2e is to optimize wind power production and integrates improved knowledge of atmospheric inflow (fuel), turbine and plant aerodynamics, and control systems. The atmospheric component of the work addresses both the need for improved forecasting of hub-height winds and the need for improved turbulence characterization for turbine inflows under realistic atmospheric conditions and terrain. Several projects will be discussed to address observations of meteorological variables in regions not typically observed. The modelling needs are addressed through major multi-institutional integrated studies comprising both theoretical and numerical advances to improve models and field observations for physical insight. Model improvements are subjected to formal verification and validation, and numerical and observational data are archived and disseminated to the public through the A2e Data Archive and Portal (DAP; http://a2e.energy.gov). The overall outcome of this work will be increased annual energy production from wind plants and improved turbine lifetimes through a better understanding of atmospheric loading. We will briefly describe major components of the atmospheric part of the A2e strategy and work being done and planned.

Assessing Video Games to Improve Driving Skills: A Literature Review and Observational Study

PubMed Central

Sue, Damian; Vichitvanichphong, Suchada

2014-01-01

Background For individuals, especially older adults, playing video games is a promising tool for improving their driving skills. The ease of use, wide availability, and interactivity of gaming consoles make them an attractive simulation tool. Objective The objective of this study was to look at the feasibility and effects of installing video game consoles in the homes of individuals looking to improve their driving skills. Methods A systematic literature review was conducted to assess the effect of playing video games on improving driving skills. An observatory study was performed to evaluate the feasibility of using an Xbox 360 Kinect console for improving driving skills. Results Twenty–nine articles, which discuss the implementation of video games in improving driving skills were found in literature. On our study, it was found the Xbox 360 with Kinect is capable of improving physical and mental activities. Xbox Video games were introduced to engage players in physical, visual and cognitive activities including endurance, postural sway, reaction time, eyesight, eye movement, attention and concentration, difficulties with orientation, and semantic fluency. However, manual dexterity, visuo-spatial perception and binocular vision could not be addressed by these games. It was observed that Xbox Kinect (by incorporating Kinect sensor facilities) combines physical, visual and cognitive engagement of players. These results were consistent with those from the literature review. Conclusions From the research that has been carried out, we can conclude that video game consoles are a viable solution for improving user’s physical and mental state. In future we propose to carry a thorough evaluation of the effects of video games on driving skills in elderly people. PMID:25654355

Generating Academic Urgency through Improved Classroom Management: A Case Study of a University and Urban Charter High School Partnership

ERIC Educational Resources Information Center

Morales, Erik E.

2017-01-01

This case study documents a university and secondary school partnership designed to improve classroom management and student time on task at an urban charter high school. The initiative utilized the expertise and knowledge of college of education faculty to identify and ameliorate the high school's observed barriers to students' time on task, and…

Improving Early Reading Skills in Young Children through an iPad App: Small-Group Instruction and Observational Learning

ERIC Educational Resources Information Center

Chai, Zhen

2017-01-01

This study evaluated the effectiveness of using a researcher-developed iPad app with a 0- to 5-s constant time delay procedure to improve phonological awareness skills of young children with mild developmental delays in a small-group arrangement in a rural public elementary school in Southwest United States. The study was conducted using a…

Omalizumab Effectiveness by Biomarker Status in Patients with Asthma: Evidence From PROSPERO, A Prospective Real-World Study.

PubMed

Casale, Thomas B; Luskin, Allan T; Busse, William; Zeiger, Robert S; Trzaskoma, Benjamin; Yang, Ming; Griffin, Noelle M; Chipps, Bradley E

2018-05-22

Omalizumab has demonstrated efficacy in clinical trials of patients with asthma, but real-world data are needed. To assess outcomes after omalizumab initiation in patients with asthma in a real-world setting. Patients aged 12 years and older with allergic asthma who were candidates for omalizumab on the basis of physician-assessed need were enrolled in a US-based, prospective, single-arm, 48-week multicenter study, the Prospective Observational Study to Evaluate Predictors of Clinical Effectiveness in Response to Omalizumab. Monthly assessments included exacerbations, health care utilization, asthma control test (ACT), and adverse events. At baseline, 6 months, and end of study, biomarkers (blood eosinophils and fractional exhaled nitric oxide) were collected and spirometry performed. Of 806 enrollees, 801 (99.4%) received omalizumab and 622 (77.2%) completed the study. The exacerbation rate significantly improved from a mean of 3.00 ± 3.28 in the 12 months before baseline to 0.78 ± 1.37 through month 12 (P < .001) and was similar in adults and adolescents; there was a reduction of 81.9% in the percentage of patients with 1 or more hospitalizations. Lung function remained generally unchanged. A mean improvement of 4.4 ± 4.9 in ACT scores was observed. Eighty-seven percent of patients were responders on the basis of clinical improvement in exacerbations, lung function, or ACT scores. Baseline biomarker status was associated with ACT scores and lung function improvement, but the magnitude of this improvement was not clinically relevant. No new safety signals emerged. Omalizumab initiation in patients with asthma resulted in improved exacerbation rates, reduced hospitalizations, and improved ACT scores compared with pretreatment values, regardless of biomarker status. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Cancer survival among Alaska Native people.

PubMed

Nash, Sarah H; Meisner, Angela L W; Zimpelman, Garrett L; Barry, Marc; Wiggins, Charles L

2018-03-26

Recent cancer survival trends among American Indian and Alaska Native (AN) people are not well understood; survival has not been reported among AN people since 2001. This study examined cause-specific survival among AN cancer patients for lung, colorectal, female breast, prostate, and kidney cancers. It evaluated whether survival differed between cancers diagnosed in 1992-2002 (the earlier period) and cancers diagnosed in 2003-2013 (the later period) and by the age at diagnosis (<65 vs ≥65 years), stage at diagnosis (local or regional/distant/unknown), and sex. Kaplan-Meier and Cox proportional hazards models were used to estimate univariate and multivariate-adjusted cause-specific survival for each cancer. An improvement was observed in 5-year survival over time from lung cancer (hazard ratio [HR] for the later period vs the earlier period, 0.83; 95% confidence interval [CI], 0.72-0.97), and a marginally nonsignificant improvement was observed for colorectal cancer (HR, 0.81; 95% CI, 0.66-1.01). Site-specific differences in survival were observed by age and stage at diagnosis. This study presents the first data on cancer survival among AN people in almost 2 decades. During this time, AN people have experienced improvements in survival from lung and colorectal cancers. The reasons for these improvements may include increased access to care (including screening) as well as improvements in treatment. Improving cancer survival should be a priority for reducing the burden of cancer among AN people and eliminating cancer disparities. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Changes in cardiopulmonary function in normal adults after the Rockport 1 mile walking test: a preliminary study.

PubMed

Kim, Kyoung; Lee, Hye-Young; Lee, Do-Youn; Nam, Chan-Woo

2015-08-01

[Purpose] The purpose of this study was to investigate the changes of cardiopulmonary function in normal adults after the Rockport 1 mile walking test. [Subjects and Methods] University students (13 males and 27 females) participated in this study. Before and after the Rockport 1 mile walking test, pulmonary function, respiratory pressure, and maximal oxygen uptake were measured. [Results] Significant improvements in forced vital capacity and maximal inspiratory pressure were observed after the Rockport 1 mile walking test in males, and significant improvements in forced vital capacity, forced expiratory volume at 1 s, maximal inspiratory pressure, and maximal expiratory pressure were observed after the Rockport 1 mile walking test in females. However, the maximal oxygen uptake was not significantly different. [Conclusion] Our findings indicate that the Rockport 1 mile walking test changes cardiopulmonary function in males and females, and that it may improve cardiopulmonary function in middle-aged and older adults and provide basic data on cardiopulmonary endurance.

Changes in cardiopulmonary function in normal adults after the Rockport 1 mile walking test: a preliminary study

PubMed Central

Kim, Kyoung; Lee, Hye-Young; Lee, Do-Youn; Nam, Chan-Woo

2015-01-01

[Purpose] The purpose of this study was to investigate the changes of cardiopulmonary function in normal adults after the Rockport 1 mile walking test. [Subjects and Methods] University students (13 males and 27 females) participated in this study. Before and after the Rockport 1 mile walking test, pulmonary function, respiratory pressure, and maximal oxygen uptake were measured. [Results] Significant improvements in forced vital capacity and maximal inspiratory pressure were observed after the Rockport 1 mile walking test in males, and significant improvements in forced vital capacity, forced expiratory volume at 1 s, maximal inspiratory pressure, and maximal expiratory pressure were observed after the Rockport 1 mile walking test in females. However, the maximal oxygen uptake was not significantly different. [Conclusion] Our findings indicate that the Rockport 1 mile walking test changes cardiopulmonary function in males and females, and that it may improve cardiopulmonary function in middle-aged and older adults and provide basic data on cardiopulmonary endurance. PMID:26356048

The relation between maternal ADHD symptoms & improvement in child behavior following brief behavioral parent training is mediated by change in negative parenting.

PubMed

Chronis-Tuscano, Andrea; O'Brien, Kelly A; Johnston, Charlotte; Jones, Heather A; Clarke, Tana L; Raggi, Veronica L; Rooney, Mary E; Diaz, Yamalis; Pian, Jessica; Seymour, Karen E

2011-10-01

This study examined the extent to which maternal attention-deficit/hyperactivity disorder (ADHD) symptoms predict improvement in child behavior following brief behavioral parent training. Change in parenting was examined as a potential mediator of the negative relationship between maternal ADHD symptoms and improvement in child behavior. Seventy mothers of 6-10 year old children with ADHD underwent a comprehensive assessment of adult ADHD prior to participating in an abbreviated parent training program. Before and after treatment, parenting was assessed via maternal reports and observations and child disruptive behavior was measured via maternal report. Controlling for pre-treatment levels, maternal ADHD symptomatology predicted post-treatment child disruptive behavior problems. The relation between maternal ADHD symptomatology and improvement in child behavior was mediated by change in observed maternal negative parenting. This study replicated findings linking maternal ADHD symptoms with attenuated child improvement following parent training, and is the first to demonstrate that negative parenting at least partially explains this relationship. Innovative approaches combining evidence-based treatment for adult ADHD with parent training may therefore be necessary for families in which both the mother and child have ADHD. Larger-scale studies using a full evidence-based parent training program are needed to replicate these findings.

A novel approach to rater training and certification in multinational trials.

PubMed

Jeglic, Elizabeth; Kobak, Kenneth A; Engelhardt, Nina; Williams, Janet B W; Lipsitz, Joshua D; Salvucci, Donna; Bryson, Heather; Bellew, Kevin

2007-07-01

Clinical trials are becoming increasingly international in scope. Global studies pose unique challenges in training and calibrating raters owing to language and cultural differences. Recent findings that poorly conducted interviews reduce study power, makes attention to raters' clinical skills critical. In this study, 109 raters from 14 countries went through a two-step certification process on the Hamilton Depression and Anxiety Rating Scales: (i) an online didactic tutorial on scoring conventions, and (ii) applied clinical training, consisting of small language-specific groups in which raters took turns interviewing patients while observed by an expert trainer, and observation and evaluation of individual interviews. Translators were used when native-language trainers were unavailable. Those who were unable to attend the startup meeting received the training individually via telephone. Results found a significant improvement in raters' knowledge of scoring conventions, with the mean number of correct answers on the 20-item test improving from 14.59 to 17.83, P<0.0001. In addition, raters' clinical skills improved significantly, with the mean score on the Rater Applied Performance Scale improving from their first to their second testing from 10.25 to 11.31, P=0.003. These results support the efficacy of this applied training model in improving raters' applied clinical skills in multinational trials.

The Relation Between Maternal ADHD Symptoms & Improvement in Child Behavior Following Brief Behavioral Parent Training is Mediated by Change in Negative Parenting

PubMed Central

Chronis-Tuscano, Andrea; O’Brien, Kelly A.; Johnston, Charlotte; Jones, Heather A.; Clarke, Tana L.; Raggi, Veronica L.; Rooney, Mary E.; Diaz, Yamalis; Pian, Jessica; Seymour, Karen E.

2012-01-01

This study examined the extent to which maternal attention-deficit/hyperactivity disorder (ADHD) symptoms predict improvement in child behavior following brief behavioral parent training. Change in parenting was examined as a potential mediator of the negative relationship between maternal ADHD symptoms and improvement in child behavior. Seventy mothers of 6–10 year old children with ADHD underwent a comprehensive assessment of adult ADHD prior to participating in an abbreviated parent training program. Before and after treatment, parenting was assessed via maternal reports and observations and child disruptive behavior was measured via maternal report. Controlling for pre-treatment levels, maternal ADHD symptomatology predicted post-treatment child disruptive behavior problems. The relation between maternal ADHD symptomatology and improvement in child behavior was mediated by change in observed maternal negative parenting. This study replicated findings linking maternal ADHD symptoms with attenuated child improvement following parent training, and is the first to demonstrate that negative parenting at least partially explains this relationship. Innovative approaches combining evidence-based treatment for adult ADHD with parent training may therefore be necessary for families in which both the mother and child have ADHD. Larger-scale studies using a full evidence-based parent training program are needed to replicate these findings. PMID:21537894

Improving Hydrological Simulations by Incorporating GRACE Data for Parameter Calibration

NASA Astrophysics Data System (ADS)

Bai, P.

2017-12-01

Hydrological model parameters are commonly calibrated by observed streamflow data. This calibration strategy is questioned when the modeled hydrological variables of interest are not limited to streamflow. Well-performed streamflow simulations do not guarantee the reliable reproduction of other hydrological variables. One of the reasons is that hydrological model parameters are not reasonably identified. The Gravity Recovery and Climate Experiment (GRACE) satellite-derived total water storage change (TWSC) data provide an opportunity to constrain hydrological model parameterizations in combination with streamflow observations. We constructed a multi-objective calibration scheme based on GRACE-derived TWSC and streamflow observations, with the aim of improving the parameterizations of hydrological models. The multi-objective calibration scheme was compared with the traditional single-objective calibration scheme, which is based only on streamflow observations. Two monthly hydrological models were employed on 22 Chinese catchments with different hydroclimatic conditions. The model evaluation was performed using observed streamflows, GRACE-derived TWSC, and evapotranspiraiton (ET) estimates from flux towers and from the water balance approach. Results showed that the multi-objective calibration provided more reliable TWSC and ET simulations without significant deterioration in the accuracy of streamflow simulations than the single-objective calibration. In addition, the improvements of TWSC and ET simulations were more significant in relatively dry catchments than in relatively wet catchments. This study highlights the importance of including additional constraints besides streamflow observations in the parameter estimation to improve the performances of hydrological models.

How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies.

PubMed

Chastin, Sebastien F M; De Craemer, Marieke; De Cocker, Katrien; Powell, Lauren; Van Cauwenberg, Jelle; Dall, Philippa; Hamer, Mark; Stamatakis, Emmanuel

2018-04-25

To assess the relationship between time spent in light physical activity and cardiometabolic health and mortality in adults. Systematic review and meta-analysis. Searches in Medline, Embase, PsycInfo, CINAHL and three rounds of hand searches. Experimental (including acute mechanistic studies and physical activity intervention programme) and observational studies (excluding case and case-control studies) conducted in adults (aged ≥18 years) published in English before February 2018 and reporting on the relationship between light physical activity (<3 metabolic equivalents) and cardiometabolic health outcomes or all-cause mortality. Study quality appraisal with QUALSYST tool and random effects inverse variance meta-analysis. Seventy-two studies were eligible including 27 experimental studies (and 45 observational studies). Mechanistic experimental studies showed that short but frequent bouts of light-intensity activity throughout the day reduced postprandial glucose (-17.5%; 95% CI -26.2 to -8.7) and insulin (-25.1%; 95% CI -31.8 to -18.3) levels compared with continuous sitting, but there was very limited evidence for it affecting other cardiometabolic markers. Three light physical activity programme intervention studies (n ranging from 12 to 58) reduced adiposity, improved blood pressure and lipidaemia; the programmes consisted of activity of >150 min/week for at least 12 weeks. Six out of eight prospective observational studies that were entered in the meta-analysis reported that more time spent in daily light activity reduced risk of all-cause mortality (pooled HR 0.71; 95% CI 0.62 to 0.83). Light-intensity physical activity could play a role in improving adult cardiometabolic health and reducing mortality risk. Frequent short bouts of light activity improve glycaemic control. Nevertheless, the modest volume of the prospective epidemiological evidence base and the moderate consistency between observational and laboratory evidence inhibits definitive conclusions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PPB | About

Cancer.gov

The Pleuropulmonary Blastoma (PPB) DICER1 Syndrome Study ‹an observational clinical research study is enrolling children with PPB and their families. The goal of the study is to improve the care of children with PPB and other tumors associated with DICER1.

Early impact of treatment with tiotropium, long-acting anticholinergic preparation, in patients with COPD – real-life experience from an observational study

PubMed Central

Jahnz-Różyk, Karina; Szepiel, Paweł

2015-01-01

Background Long-acting inhaled bronchodilators, including anticholinergic tiotropium, are recommended for the maintenance therapy of chronic obstructive pulmonary disease (COPD). It has been shown in a number of studies that treatment with tiotropium alleviates symptoms, improves exercise tolerance, health status, and reduces exacerbations in patients with moderate to very severe stage COPD. Aim The aim of this noninterventional study was to observe the early effects of the maintenance treatment with tiotropium in patients with COPD of different severities, who had been previously treated on a regular basis, or as required, with at least one short-acting bronchodilator, in a real-life setting in Poland. The effect of the treatment was assessed through the collection of COPD Assessment Test (CAT) data. Patients and methods The MATHS clinical study was an observational, noninterventional, open-label, prospective, uncontrolled, single-arm, postmarketing, surveillance, real-life study conducted with the involvement of 236 pulmonology clinics based in Poland. The tiotropium observational period was 3 months. The health and COPD status was measured with the CAT questionnaire. The primary efficacy endpoint was the mean change from the baseline in the total CAT score at the end of the 3-month observational period. Results Patients treated with 18 μg of tiotropium once daily for 3 months showed a statistically significant result, with a clinically meaningful mean reduction (improvement) of 7.0 points in the total CAT score. The improvement was slightly greater in patients with more severe COPD; the mean change in the total CAT score was 7.6 in the subgroup of patients with more severe COPD and 6.7 points in the subgroup of patients with moderate COPD. Conclusion Results of this real-life study provide further support for the use of tiotropium as a first-line maintenance treatment for patients with COPD of different severities in Poland. PMID:25834420

Combination of 595-nm pulsed dye laser, long-pulsed 755-nm alexandrite laser, and microdermabrasion treatment for keratosis pilaris: retrospective analysis of 26 Korean patients.

PubMed

Lee, Sang Ju; Choi, Min Ju; Zheng, Zhenlong; Chung, Won Soon; Kim, Young Koo; Cho, Sung Bin

2013-06-01

Keratosis pilaris (KP) has beenpresented as small keratotic follicular papules with or without surrounding erythema. Various treatments with laser or light therapy have been used for the management of KP with various clinical outcomes. In the present study, we investigated the efficacy and safety of a combination therapy for KP. A total of 29 anatomical sites with KP in 26 patients were treated using a 595-nm pulsed dye laser (PDL) with nonpurpuragenic fluences, a long-pulsed 755-nm alexandrite laser, and microdermabrasion. Clinical improvement was assessed by comparing preand posttreatment clinical photographs and patient satisfaction rates. Evaluation of the clinical results three months after the treatments showed that 12 of the 29 anatomical sites (41.4%) demonstrated Grade 3 clinical improvement, ten (34.5%) had Grade 2 clinical improvement, four (13.8%) showed Grade 1 improvement, and three (10.3%) showed Grade 4 improvement. We observed that KP lesions improved not only in erythema and skin texture, but also in brownish dyschromias. Potential adverse events were not observed, except prolonged posttherapy scaling. Our observations demonstrate that combination therapy using a 595-nm PDL, a long-pulsed 755-nm alexandrite laser, and microdermabrasion can have a positive therapeutic effect on KP.

Classroom observation data and instruction in primary mathematics education: improving design and rigour

NASA Astrophysics Data System (ADS)

Thompson, Carla J.; Davis, Sandra B.

2014-06-01

The use of formal observation in primary mathematics classrooms is supported in the literature as a viable method of determining effective teaching strategies and appropriate tasks for inclusion in the early years of mathematics learning. The twofold aim of this study was to (a) investigate predictive relationships between primary mathematics classroom observational data and student achievement data, and (b) to examine the impact of providing periodic classroom observational data feedback to teachers using a Relational-Feedback-Intervention (RFI) Database Model. This observational research effort focused on an empirical examination of student engagement levels in time spent on specific learning activities observed in primary mathematics classrooms as predictors of student competency outcomes in mathematics. Data were collected from more than 2,000 primary classroom observations in 17 primary schools during 2009-2011 and from standardised end-of-year tests for mathematics achievement. Results revealed predictive relationships among several types of teaching and learning tasks with student achievement. Specifically, the use of mathematics concepts, technology and hands-on materials in primary mathematics classrooms was found to produce substantive predictors of increased student mathematics achievement. Additional findings supported the use of periodic classroom observation data reporting as a positive influence on teachers' decisions in determining instructional tasks for inclusion in primary mathematics classrooms. Study results indicate classroom observational research involving a RFI Database Model is a productive tool for improving teaching and learning in primary mathematics classrooms.

Ten Ways To Provide a High-Quality Acoustical Environment in Schools.

ERIC Educational Resources Information Center

Siebein, Gary W.; Gold, Martin A.; Siebein, Glenn W.; Ermann, Michael G.

2000-01-01

A study used impulse response measures and observations in 10 Florida classrooms to develop 10 recommendations for improving the acoustical environment in schools. Recommendations include improving air-conditioning systems, limiting room volume, providing sound-absorbing surfaces, using carpeting, reducing distance between teachers and students,…

Standardized Test Results: An Opportunity for English Program Improvement

ERIC Educational Resources Information Center

Jiménez, Maureyra; Rodríguez, Caroll; Rey Paba, Lourdes

2017-01-01

This case study explores the relationship between the results obtained by a group of Industrial Engineering students on a national standardized English test and the impact these results had on language program improvement. The instruments used were interviews, document analysis, observations, surveys, and test results analysis. Findings indicate…

Effects of Cogmed working memory training on cognitive performance.

PubMed

Etherton, Joseph L; Oberle, Crystal D; Rhoton, Jayson; Ney, Ashley

2018-04-16

Research on the cognitive benefits of working memory training programs has produced inconsistent results. Such research has frequently used laboratory-specific training tasks, or dual-task n-back training. The current study used the commercial Cogmed Working Memory (WM) Training program, involving several different training tasks involving visual and auditory input. Healthy college undergraduates were assigned to either the full Cogmed training program of 25, 40-min training sessions; an abbreviated Cogmed program of 25, 20-min training sessions; or a no-contact control group. Pretest and posttest measures included multiple measures of attention, working memory, fluid intelligence, and executive functions. Although improvement was observed for the full training group for a digit span task, no training-related improvement was observed for any of the other measures. Results of the study suggest that WM training does not improve performance on unrelated tasks or enhance other cognitive abilities.

On the Reprocessing and Reanalysis of Observations for Climate

NASA Technical Reports Server (NTRS)

Bosilovich, Michael G.; Kennedy, John; Dee, Dick; ONeill, Alan

2012-01-01

The long observational record is critical to our understanding of the Earth s climate, but most observing systems were not developed with a climate objective in mind. As a result, tremendous efforts have gone into assessing and reprocessing the data records to improve their usefulness in climate studies. Many challenges remain, such as tracking the improvement of processing algorithms and limited spatial coverage. Reanalyses have fostered significant research, yet reliable global trends in many physical fields are not yet attainable, despite significant advances in data assimilation and numerical modeling. Communication of the strengths, limitations and uncertainties of reprocessed observations and reanalysis data, not only among the community of developers, but also with the extended research community, including the new generations of researchers and the decision makers is crucial for further advancement of the observational data records. WCRP provides the means to bridge the different motivating objectives on which national efforts focus.

Intelligent Photovoltaic Systems by Combining the Improved Perturbation Method of Observation and Sun Location Tracking.

PubMed

Wang, Yajie; Shi, Yunbo; Yu, Xiaoyu; Liu, Yongjie

2016-01-01

Currently, tracking in photovoltaic (PV) systems suffers from some problems such as high energy consumption, poor anti-interference performance, and large tracking errors. This paper presents a solar PV tracking system on the basis of an improved perturbation and observation method, which maximizes photoelectric conversion efficiency. According to the projection principle, we design a sensor module with a light-intensity-detection module for environmental light-intensity measurement. The effect of environmental factors on the system operation is reduced, and intelligent identification of the weather is realized. This system adopts the discrete-type tracking method to reduce power consumption. A mechanical structure with a level-pitch double-degree-of-freedom is designed, and attitude correction is performed by closed-loop control. A worm-and-gear mechanism is added, and the reliability, stability, and precision of the system are improved. Finally, the perturbation and observation method designed and improved by this study was tested by simulated experiments. The experiments verified that the photoelectric sensor resolution can reach 0.344°, the tracking error is less than 2.5°, the largest improvement in the charge efficiency can reach 44.5%, and the system steadily and reliably works.

Intelligent Photovoltaic Systems by Combining the Improved Perturbation Method of Observation and Sun Location Tracking

PubMed Central

Wang, Yajie; Shi, Yunbo; Yu, Xiaoyu; Liu, Yongjie

2016-01-01

Currently, tracking in photovoltaic (PV) systems suffers from some problems such as high energy consumption, poor anti-interference performance, and large tracking errors. This paper presents a solar PV tracking system on the basis of an improved perturbation and observation method, which maximizes photoelectric conversion efficiency. According to the projection principle, we design a sensor module with a light-intensity-detection module for environmental light-intensity measurement. The effect of environmental factors on the system operation is reduced, and intelligent identification of the weather is realized. This system adopts the discrete-type tracking method to reduce power consumption. A mechanical structure with a level-pitch double-degree-of-freedom is designed, and attitude correction is performed by closed-loop control. A worm-and-gear mechanism is added, and the reliability, stability, and precision of the system are improved. Finally, the perturbation and observation method designed and improved by this study was tested by simulated experiments. The experiments verified that the photoelectric sensor resolution can reach 0.344°, the tracking error is less than 2.5°, the largest improvement in the charge efficiency can reach 44.5%, and the system steadily and reliably works. PMID:27327657

Measuring effectiveness of drugs in observational databanks: promises and perils

PubMed Central

Krishnan, Eswar; Fries, James F

2004-01-01

Observational databanks have inherent strengths and shortcomings. As in randomized controlled trials, poor design of these databanks can either exaggerate or reduce estimates of drug effectiveness and can limit generalizability. This commentary highlights selected aspects of study design, data collection and statistical analysis that can help overcome many of these inadequacies. An international metaRegister and a formal mechanism for standardizing and sharing drug data could help improve the utility of databanks. Medical journals have a vital role in enforcing a quality checklist that improves reporting. PMID:15059263

Forecasting and analyzing high O3 time series in educational area through an improved chaotic approach

NASA Astrophysics Data System (ADS)

Hamid, Nor Zila Abd; Adenan, Nur Hamiza; Noorani, Mohd Salmi Md

2017-08-01

Forecasting and analyzing the ozone (O3) concentration time series is important because the pollutant is harmful to health. This study is a pilot study for forecasting and analyzing the O3 time series in one of Malaysian educational area namely Shah Alam using chaotic approach. Through this approach, the observed hourly scalar time series is reconstructed into a multi-dimensional phase space, which is then used to forecast the future time series through the local linear approximation method. The main purpose is to forecast the high O3 concentrations. The original method performed poorly but the improved method addressed the weakness thereby enabling the high concentrations to be successfully forecast. The correlation coefficient between the observed and forecasted time series through the improved method is 0.9159 and both the mean absolute error and root mean squared error are low. Thus, the improved method is advantageous. The time series analysis by means of the phase space plot and Cao method identified the presence of low-dimensional chaotic dynamics in the observed O3 time series. Results showed that at least seven factors affect the studied O3 time series, which is consistent with the listed factors from the diurnal variations investigation and the sensitivity analysis from past studies. In conclusion, chaotic approach has been successfully forecast and analyzes the O3 time series in educational area of Shah Alam. These findings are expected to help stakeholders such as Ministry of Education and Department of Environment in having a better air pollution management.

A multicenter trial of aviation-style training for surgical teams.

PubMed

Catchpole, Ken R; Dale, Trevor J; Hirst, D Guy; Smith, J Phillip; Giddings, Tony A E B

2010-09-01

This study measured the effect of aviation-style team training on 3 surgical teams from different specialties. It focused on team working and communication, particularly briefing, time-out, and debriefing, and sought to understand how improvements in team skills could be implemented in a broad range of naturalistic surgical environments to improve safety, quality, and efficiency. Surgical teams performing maxillofacial, vascular, and neurosurgery were studied during 112 operations: 51 before and 61 after intervention. Human factors experts delivered the training of up to 2 days in the classroom followed by 6 days of coaching in theater for each team. Trained observers measured teamwork using the Oxford NOTECHS and the frequency of preoperative briefings, pre-incision time-outs, and postoperative debriefings. The Safety Attitudes Questionnaire and ethnographic observations were used to provide contextual details. There were significantly more time-outs (chi = 18.17, P < 0.001), briefings (chi = 8.62, P = 0.004), and debriefings (chi = 8.58, P = 0.004) after the intervention. The NOTECHS scores showed an interaction between site and intervention (F2,106 = 7.57, P = 0.001). The Safety Attitudes Questionnaire and ethnographic observations helped understand these differences. Aviation-style teamwork training can increase compliance and team performance, but this was influenced by the attitude and collaboration of key individuals, and the effect was reduced by significant latent failures. This study demonstrates the need to improve organizational and personal management factors in the National Health Service if training in patient safety is to be effective and sustained. It also shows the influence of working conditions on clinical studies of quality improvement.

Post-marketing observational program of the effectiveness of fluvoxamine for the treatment of depression in patients with neurological disorders: the FRIENDS study.

PubMed

Yahno, Nikolay N; Fedotova, Anastasia V

2017-01-01

In a prospective, non-blinded, uncontrolled, multicenter, post-marketing, observational study (FRIENDS; NCT02043197), fluvoxamine (50-300 mg/day for 90 days) was effective for the treatment of depression in 299 adult patients (age ≥18 years) with neurological disorders at baseline. The therapeutic effect of fluvoxamine was measured by means of changes in the Hospital Anxiety and Depression Scale depression and anxiety scores (HADS-D and HADS-A, respectively), global severity of illness, and clinical condition (measured using the Clinical Global Improvement [CGI] scale). The mean HADS-D subscale score at baseline in the per-protocol cohort (n=296) was 11.7±3.1 points and the corresponding mean HADS-A score was 12.6±3.2. Significant ( P <0.0001) improvements in both scores were recorded during fluvoxamine treatment and later follow-up. Most patients (>85%) recorded reductions versus baseline in both indices. In the CGI-based assessment, most evaluated patients (>200) experienced moderate to very substantial clinical improvement, with no or limited side effects. Significant improvements were also recorded in the exploratory outcomes of sleep quality, assessed using the Insomnia Severity Index, and cognitive function, assessed using the Montreal Cognitive Assessment ( P <0.0001 vs baseline for both). No death or serious adverse drug reactions were reported during the study. The results of this observational study affirm that fluvoxamine is effective and well tolerated for the treatment of depression in the context of neurological disorders. The effects on the exploratory endpoints of this research merit evaluation in controlled trials.

Effectiveness of a Mindfulness-Based Childbirth Education pilot study on maternal self-efficacy and fear of childbirth.

PubMed

Byrne, Jean; Hauck, Yvonne; Fisher, Colleen; Bayes, Sara; Schutze, Robert

2014-01-01

This pilot study tested the feasibility and effectiveness of using Mindfulness-Based Childbirth Education (MBCE), a novel integration of mindfulness meditation and skills-based childbirth education, for mental health promotion with pregnant women. The MBCE protocol aimed to reduce fear of birth, anxiety, and stress and improve maternal self-efficacy. This pilot study also aimed to determine the acceptability and feasibility of the MBCE protocol. A single-arm pilot study of the MBCE intervention using a repeated-measures design was used to analyze data before and after the MBCE intervention to determine change trends with key outcome variables: mindfulness; depression, anxiety, and stress; childbirth self-efficacy; and fear of childbirth. Pregnant women (18-28 weeks' gestation) and their support companions attended weekly MBCE group sessions over 8 weeks in an Australian community setting. Of the 18 women who began and completed the intervention, missing data allowed for complete data from 12 participants to be analyzed. Statistically significant improvements and large effect sizes were observed for childbirth self-efficacy and fear of childbirth. Improvements in depression, mindfulness, and birth outcome expectations were underpowered. At postnatal follow-up significant improvements were found in anxiety, whereas improvements in mindfulness, stress, and fear of birth were significant at a less conservative alpha level. This pilot study demonstrated that a blended mindfulness and skills-based childbirth education intervention was acceptable to women and was associated with improvements in women's sense of control and confidence in giving birth. Previous findings that low self-efficacy and high childbirth fear are linked to greater labor pain, stress reactivity, and trauma suggest the observed improvements in these variables have important implications for improving maternal mental health and associated child health outcomes. Ways in which these outcomes can be achieved through improved childbirth education are discussed. © 2013 by the American College of Nurse-Midwives.

Applications of propensity score methods in observational comparative effectiveness and safety research: where have we come and where should we go?

PubMed

Borah, Bijan J; Moriarty, James P; Crown, William H; Doshi, Jalpa A

2014-01-01

Propensity score (PS) methods have proliferated in recent years in observational studies in general and in observational comparative effectiveness research (CER) in particular. PS methods are an important set of tools for estimating treatment effects in observational studies, enabling adjustment for measured confounders in an easy-to-understand and transparent way. This article demonstrates how PS methods have been used to address specific CER questions from 2001 through to 2012 by identifying six impactful studies from this period. This article also discusses areas for improvement, including data infrastructure, and a unified set of guidelines in terms of PS implementation and reporting, which will boost confidence in evidence generated through observational CER using PS methods.

Reports of unintended consequences of financial incentives to improve management of hypertension.

PubMed

Hysong, Sylvia J; SoRelle, Richard; Broussard Smitham, Kristen; Petersen, Laura A

2017-01-01

Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT) of financial incentives. We conducted a qualitative observational study nested within a larger RCT of financial incentives to improve hypertension care. We conducted 30-minute telephone interviews with primary care personnel at facilities participating in the RCT housed at12 geographically dispersed Veterans Affairs Medical Centers nationwide. Participants answered questions about unintended effects, clinic team dynamics, organizational impact on care delivery, study participation. We employed a blend of inductive and deductive qualitative techniques for analysis. Sixty-five participants were recruited from RCT enrollees and personnel not enrolled in the larger RCT, plus one primary care leader per site. Emergent themes included possible patient harm, emphasis on documentation over improving care, reduced professional morale, and positive spillover. All discussions of unintended consequences involving patient harm were only concerns, not actual events. Several unintended consequences concerned ancillary initiatives for quality improvement (e.g., practice guidelines and performance measurement systems) rather than financial incentives. Many unintended consequences of financial incentives noted were either only concerns or attributable to ancillary quality-improvement initiatives. Actual unintended consequences included improved documentation of care without necessarily improving actual care, and positive unintended consequences. Clinicaltrials.gov Identifier: NCT00302718.

An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: Direct observation of catheter insertion procedure.

PubMed

Galiczewski, Janet M; Shurpin, Kathleen M

2017-06-01

Healthcare associated infections from indwelling urinary catheters lead to increased patient morbidity and mortality. The purpose of this study was to determine if direct observation of the urinary catheter insertion procedure, as compared to the standard process, decreased catheter utilization and urinary tract infection rates. This case control study was conducted in a medical intensive care unit. During phase I, a retrospective data review was conducted on utilsiation and urinary catheter infection rates when practitioners followed the institution's standard insertion algorithm. During phase II, an intervention of direct observation was added to the standard insertion procedure. The results demonstrated no change in utilization rates, however, CAUTI rates decreased from 2.24 to 0 per 1000 catheter days. The findings from this study may promote changes in clinical practice guidelines leading to a reduction in urinary catheter utilization and infection rates and improved patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Observations on the correlation between posture and jaw position: a pilot study.

PubMed

Bracco, P; Deregibus, A; Piscetta, R; Ferrario, G

1998-10-01

The aim of this pilot study was twofold. The first was to show a method for having an objective and dynamic analysis of body posture, evaluating weight distribution and its connections with different mandibular positions. The second was to verify if a neuromuscularly stimulated occlusal position, called myocentric occlusal position, is associated with a positive or negative postural charge. For the second aim a group of 20 subjects (including both males and females), was chosen. Posture of each subject was analyzed in three different conditions: centric occlusion, rest position and myocentric position. To evaluate the dynamic of posture a platform capable of measuring the weight on the feet supporting points and the related variations during time of observation and the swinging of body barycenter was used. The data showed that there is an improvement in the position of the barycenter from the centric occlusion to the myocentric position. Such an improvement can't be observed from the intercuspal position to the rest position. The results of this pilot study are discussed.

Primary mass discrimination of high energy cosmic rays using PNN and k-NN methods

NASA Astrophysics Data System (ADS)

Rastegarzadeh, G.; Nemati, M.

2018-02-01

Probabilistic neural network (PNN) and k-Nearest Neighbors (k-NN) methods are widely used data classification techniques. In this paper, these two methods have been used to classify the Extensive Air Shower (EAS) data sets which were simulated using the CORSIKA code for three primary cosmic rays. The primaries are proton, oxygen and iron nuclei at energies of 100 TeV-10 PeV. This study is performed in the following of the investigations into the primary cosmic ray mass sensitive observables. We propose a new approach for measuring the mass sensitive observables of EAS in order to improve the primary mass separation. In this work, the EAS observables measurement has performed locally instead of total measurements. Also the relationships between the included number of observables in the classification methods and the prediction accuracy have been investigated. We have shown that the local measurements and inclusion of more mass sensitive observables in the classification processes can improve the classifying quality and also we have shown that muons and electrons energy density can be considered as primary mass sensitive observables in primary mass classification. Also it must be noted that this study is performed for Tehran observation level without considering the details of any certain EAS detection array.

Assimilation of Sentinel-1 and SMAP observations to improve GEOS-5 soil moisture

NASA Astrophysics Data System (ADS)

Lievens, Hans; Reichle, Rolf; Wagner, Wolfgang; De Lannoy, Gabrielle; Liu, Qing; Verhoest, Niko

2017-04-01

The SMAP (Soil Moisture Active and Passive) mission carries an L-band radiometer that provides brightness temperature observations at a nominal resolution of 40 km. These radiance observations are routinely assimilated into GEOS-5 (Goddard Earth Observing System version 5) to generate the SMAP Level 4 Soil Moisture product. The use of C-band radar backscatter observations from Sentinel-1 has the potential to add value to the radiance assimilation by increasing the level of spatial detail. The specifications of Sentinel-1 are appealing, particularly its high spatial resolution (5 by 20 m in interferometric wide swath mode) and frequent revisit time (potentially every 3 days for the Sentinel-1A and Sentinel-1B constellation). However, the shorter wavelength of Sentinel-1 observations implies less sensitivity to soil moisture. This study investigates the value of Sentinel-1 data for hydrologic simulations by assimilating the radar observations into GEOS-5, either separately from or simultaneously with SMAP radiometer observations. The assimilation can be performed if either or both Sentinel-1 or SMAP observations are available, and is thus not restricted to synchronised overpasses. To facilitate the assimilation of the radar observations, GEOS-5 is coupled to the water cloud model, simulating the radar backscatter as observed by Sentinel-1. The innovations, i.e. differences between observations and simulations, are converted into increments to the model soil moisture state through an Ensemble Kalman Filter. The model runs are performed at 9-km spatial and 3-hourly temporal resolution, over the period from May 2015 to October 2016. The impact of the assimilation on surface and root-zone soil moisture simulations is assessed using in situ measurements from SMAP core validation sites and sparse networks. The assimilation of Sentinel-1 backscatter is found to consistently improve surface and root-zone soil moisture, relative to the open loop (no assimilation). However, the improvements are less pronounced than those with the assimilation of SMAP observations, likely because of less frequent observations. The best performance was obtained with the simultaneous assimilation of Sentinel-1 and SMAP data, indicating the complementary value of both types of observations for improving hydrologic simulations.

Neuroimaging Mechanisms of Therapeutic Transcranial Magnetic Stimulation for Major Depressive Disorder.

PubMed

Philip, Noah S; Barredo, Jennifer; Aiken, Emily; Carpenter, Linda L

2018-03-01

Research into therapeutic transcranial magnetic stimulation (TMS) for major depression has dramatically increased in the last decade. Understanding the mechanism of action of TMS is crucial to improve efficacy and develop the next generation of therapeutic stimulation. Early imaging research provided initial data supportive of widely held assumptions about hypothesized inhibitory or excitatory consequences of stimulation. Early work also indicated that while TMS modulated brain activity under the stimulation site, effects at deeper regions, in particular, the subgenual anterior cingulate cortex, were associated with clinical improvement. Concordant with earlier findings, functional connectivity studies also demonstrated that clinical improvements were related to changes distal, rather than proximal, to the site of stimulation. Moreover, recent work suggests that TMS modulates and potentially normalizes functional relationships between neural networks. An important observation that emerged from this review is that similar patterns of connectivity changes are observed across studies regardless of TMS parameters. Though promising, we stress that these imaging findings must be evaluated cautiously given the widespread reliance on modest sample sizes and little implementation of statistical validation. Additional limitations included use of imaging before and after a course of TMS, which provided little insight into changes that might occur during the weeks of stimulation. Furthermore, as studies to date have focused on depression, it is unclear whether our observations were related to mechanisms of action of TMS for depression or represented broader patterns of functional brain changes associated with clinical improvement. Published by Elsevier Inc.

An observational study investigating the impact of simulated patients in teaching communication skills in preclinical dietetic students.

PubMed

Gibson, S J; Davidson, Z E

2016-08-01

Simulated patients (SPs) are often used in dietetics for the teaching and assessment of communication skills. The present study aimed to determine the impact of a SP encounter on communication skills in undergraduate preclinical dietetic students in the context of the resources required for delivering this educational strategy. This observational study collected assessment data from four cohorts of third-year dietetic students to examine the effect of participation in SP-embedded Objective Structured Clinical Exams. Students completed two SP interviews, 2 weeks apart, and communication skills were measured on both occasions. A subgroup of students received a video of their SP encounter. Differences between the two SP interview scores were compared to assess the impact of the SP encounter on communication skills. The required staff and resources were described. Data were collected involving 215 students. Out of 30 marks, there was a modest mean (SD) improvement in communication skills from the first to the second SP interview of 2.5 (4.2) (P < 0.01). There was an association between student ability and improvement in communication skills, with failing students demonstrating the greatest improvement between SP encounters. There were no observed benefits for the subset of students who received videos. Providing repeat SP interview opportunities results in only modest improvement in communication skills for most students. The use of SPs needs to be considered in context of the substantial costs and resources involved and tailored to student ability. © 2015 The British Dietetic Association Ltd.

A multiscale modeling framework model (superparameterized CAM5) with a higher-order turbulence closure: Model description and low-cloud simulations

DOE PAGES

Wang, Minghuai; Larson, Vincent E.; Ghan, Steven; ...

2015-04-18

In this study, a higher-order turbulence closure scheme, called Cloud Layers Unified by Binormals (CLUBB), is implemented into a Multi-scale Modeling Framework (MMF) model to improve low cloud simulations. The performance of CLUBB in MMF simulations with two different microphysics configurations (one-moment cloud microphysics without aerosol treatment and two-moment cloud microphysics coupled with aerosol treatment) is evaluated against observations and further compared with results from the Community Atmosphere Model, Version 5 (CAM5) with conventional cloud parameterizations. CLUBB is found to improve low cloud simulations in the MMF, and the improvement is particularly evident in the stratocumulus-to-cumulus transition regions. Compared tomore » the single-moment cloud microphysics, CLUBB with two-moment microphysics produces clouds that are closer to the coast, and agrees better with observations. In the stratocumulus-to cumulus transition regions, CLUBB with two-moment cloud microphysics produces shortwave cloud forcing in better agreement with observations, while CLUBB with single moment cloud microphysics overestimates shortwave cloud forcing. CLUBB is further found to produce quantitatively similar improvements in the MMF and CAM5, with slightly better performance in the MMF simulations (e.g., MMF with CLUBB generally produces low clouds that are closer to the coast than CAM5 with CLUBB). As a result, improved low cloud simulations in MMF make it an even more attractive tool for studying aerosol-cloud-precipitation interactions.« less

Applying a Theory-Driven Framework to Guide Quality Improvement Efforts in Nursing Homes: The LOCK Model.

PubMed

Mills, Whitney L; Pimentel, Camilla B; Palmer, Jennifer A; Snow, A Lynn; Wewiorski, Nancy J; Allen, Rebecca S; Hartmann, Christine W

2018-05-08

Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning. We adapted these concepts to QI in the nursing home setting, creating the "LOCK" framework. The LOCK framework is currently being disseminated across the Veterans Health Administration. The LOCK framework has five tenets: (a) Look for the bright spots, (b) Observe, (c) Collaborate in huddles, (d) Keep it bite-sized, and (e) facilitation. Each tenet is described. We also present a case study documenting how a fictional nursing home can implement the LOCK framework as part of a QI effort to improve engagement between staff and residents. The case study describes sample observations, processes, and outcomes. We also discuss practical applications for nursing home staff, the adaptability of LOCK for different QI projects, the specific role of facilitation, and lessons learned. The proposed framework complements national efforts to improve quality of care and quality of life for nursing home residents and may be valuable across long-term care settings and QI project types.

Clinical audit of emergency unit before and after establishment of the emergency medicine department.

PubMed

Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

2012-02-01

To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

Small lung cancers: improved detection by use of bone suppression imaging--comparison with dual-energy subtraction chest radiography.

PubMed

Li, Feng; Engelmann, Roger; Pesce, Lorenzo L; Doi, Kunio; Metz, Charles E; Macmahon, Heber

2011-12-01

To determine whether use of bone suppression (BS) imaging, used together with a standard radiograph, could improve radiologists' performance for detection of small lung cancers compared with use of standard chest radiographs alone and whether BS imaging would provide accuracy equivalent to that of dual-energy subtraction (DES) radiography. Institutional review board approval was obtained. The requirement for informed consent was waived. The study was HIPAA compliant. Standard and DES chest radiographs of 50 patients with 55 confirmed primary nodular cancers (mean diameter, 20 mm) as well as 30 patients without cancers were included in the observer study. A new BS imaging processing system that can suppress the conspicuity of bones was applied to the standard radiographs to create corresponding BS images. Ten observers, including six experienced radiologists and four radiology residents, indicated their confidence levels regarding the presence or absence of a lung cancer for each lung, first by using a standard image, then a BS image, and finally DES soft-tissue and bone images. Receiver operating characteristic (ROC) analysis was used to evaluate observer performance. The average area under the ROC curve (AUC) for all observers was significantly improved from 0.807 to 0.867 with BS imaging and to 0.916 with DES (both P < .001). The average AUC for the six experienced radiologists was significantly improved from 0.846 with standard images to 0.894 with BS images (P < .001) and from 0.894 to 0.945 with DES images (P = .001). Use of BS imaging together with a standard radiograph can improve radiologists' accuracy for detection of small lung cancers on chest radiographs. Further improvements can be achieved by use of DES radiography but with the requirement for special equipment and a potential small increase in radiation dose. © RSNA, 2011.

Data assimilation in integrated hydrological modelling in the presence of observation bias

NASA Astrophysics Data System (ADS)

Rasmussen, J.; Madsen, H.; Jensen, K. H.; Refsgaard, J. C.

2015-08-01

The use of bias-aware Kalman filters for estimating and correcting observation bias in groundwater head observations is evaluated using both synthetic and real observations. In the synthetic test, groundwater head observations with a constant bias and unbiased stream discharge observations are assimilated in a catchment scale integrated hydrological model with the aim of updating stream discharge and groundwater head, as well as several model parameters relating to both stream flow and groundwater modeling. The Colored Noise Kalman filter (ColKF) and the Separate bias Kalman filter (SepKF) are tested and evaluated for correcting the observation biases. The study found that both methods were able to estimate most of the biases and that using any of the two bias estimation methods resulted in significant improvements over using a bias-unaware Kalman Filter. While the convergence of the ColKF was significantly faster than the convergence of the SepKF, a much larger ensemble size was required as the estimation of biases would otherwise fail. Real observations of groundwater head and stream discharge were also assimilated, resulting in improved stream flow modeling in terms of an increased Nash-Sutcliffe coefficient while no clear improvement in groundwater head modeling was observed. Both the ColKF and the SepKF tended to underestimate the biases, which resulted in drifting model behavior and sub-optimal parameter estimation, but both methods provided better state updating and parameter estimation than using a bias-unaware filter.

Data assimilation in integrated hydrological modelling in the presence of observation bias

NASA Astrophysics Data System (ADS)

Rasmussen, Jørn; Madsen, Henrik; Høgh Jensen, Karsten; Refsgaard, Jens Christian

2016-05-01

The use of bias-aware Kalman filters for estimating and correcting observation bias in groundwater head observations is evaluated using both synthetic and real observations. In the synthetic test, groundwater head observations with a constant bias and unbiased stream discharge observations are assimilated in a catchment-scale integrated hydrological model with the aim of updating stream discharge and groundwater head, as well as several model parameters relating to both streamflow and groundwater modelling. The coloured noise Kalman filter (ColKF) and the separate-bias Kalman filter (SepKF) are tested and evaluated for correcting the observation biases. The study found that both methods were able to estimate most of the biases and that using any of the two bias estimation methods resulted in significant improvements over using a bias-unaware Kalman filter. While the convergence of the ColKF was significantly faster than the convergence of the SepKF, a much larger ensemble size was required as the estimation of biases would otherwise fail. Real observations of groundwater head and stream discharge were also assimilated, resulting in improved streamflow modelling in terms of an increased Nash-Sutcliffe coefficient while no clear improvement in groundwater head modelling was observed. Both the ColKF and the SepKF tended to underestimate the biases, which resulted in drifting model behaviour and sub-optimal parameter estimation, but both methods provided better state updating and parameter estimation than using a bias-unaware filter.

[The effectiveness of cevimeline hydrochloride on dry cough in Sjögren's syndrome].

PubMed

Nishinarita, Makoto; Hanzawa, Midori; Iikuni, Noriko; Ota, Syuji

2004-04-01

Dry cough in Sjögren syndrome (SS) is not an uncommon symptom observed in clinical fields. However, effective treatments for the cough have not been established. The recently introduced cevimeline hydrochloride, a muscarinic receptor stimulant, has been confirmed to be definitely effective for xerostomia of SS. In the present study, the effectiveness of cevimeline hydrochloride on dry cough was studied in 9 Sjögren patients and evaluated using the visual analog scale (VAS) and face scale. Improvement of dry cough was observed in 8 out of the 9 patients, suggesting the effectiveness of cevimeline hydrochloride. Although the detailed etiology of dry cough in SS is unknown, the result of the study suggested the mechanism that cevimeline hydrochloride increased the secretion in the airway mucus, improving dry bronchial conditions. Further studies are needed with more subjects.

Improving irrigation and groundwater parameterizations in the Community Land Model (CLM) using in-situ observations and satellite data

NASA Astrophysics Data System (ADS)

Felfelani, F.; Pokhrel, Y. N.

2017-12-01

In this study, we use in-situ observations and satellite data of soil moisture and groundwater to improve irrigation and groundwater parameterizations in the version 4.5 of the Community Land Model (CLM). The irrigation application trigger, which is based on the soil moisture deficit mechanism, is enhanced by integrating soil moisture observations and the data from the Soil Moisture Active Passive (SMAP) mission which is available since 2015. Further, we incorporate different irrigation application mechanisms based on schemes used in various other land surface models (LSMs) and carry out a sensitivity analysis using point simulations at two different irrigated sites in Mead, Nebraska where data from the AmeriFlux observational network are available. We then conduct regional simulations over the entire High Plains region and evaluate model results with the available irrigation water use data at the county-scale. Finally, we present results of groundwater simulations by implementing a simple pumping scheme based on our previous studies. Results from the implementation of current irrigation parameterization used in various LSMs show relatively large difference in vertical soil moisture content profile (e.g., 0.2 mm3/mm3) at point scale which is mostly decreased when averaged over relatively large regions (e.g., 0.04 mm3/mm3 in the High Plains region). It is found that original irrigation module in CLM 4.5 tends to overestimate the soil moisture content compared to both point observations and SMAP, and the results from the improved scheme linked with the groundwater pumping scheme show better agreement with the observations.

A Kalman Filter for SINS Self-Alignment Based on Vector Observation.

PubMed

Xu, Xiang; Xu, Xiaosu; Zhang, Tao; Li, Yao; Tong, Jinwu

2017-01-29

In this paper, a self-alignment method for strapdown inertial navigation systems based on the q -method is studied. In addition, an improved method based on integrating gravitational apparent motion to form apparent velocity is designed, which can reduce the random noises of the observation vectors. For further analysis, a novel self-alignment method using a Kalman filter based on adaptive filter technology is proposed, which transforms the self-alignment procedure into an attitude estimation using the observation vectors. In the proposed method, a linear psuedo-measurement equation is adopted by employing the transfer method between the quaternion and the observation vectors. Analysis and simulation indicate that the accuracy of the self-alignment is improved. Meanwhile, to improve the convergence rate of the proposed method, a new method based on parameter recognition and a reconstruction algorithm for apparent gravitation is devised, which can reduce the influence of the random noises of the observation vectors. Simulations and turntable tests are carried out, and the results indicate that the proposed method can acquire sound alignment results with lower standard variances, and can obtain higher alignment accuracy and a faster convergence rate.

Observability-Based Guidance and Sensor Placement

NASA Astrophysics Data System (ADS)

Hinson, Brian T.

Control system performance is highly dependent on the quality of sensor information available. In a growing number of applications, however, the control task must be accomplished with limited sensing capabilities. This thesis addresses these types of problems from a control-theoretic point-of-view, leveraging system nonlinearities to improve sensing performance. Using measures of observability as an information quality metric, guidance trajectories and sensor distributions are designed to improve the quality of sensor information. An observability-based sensor placement algorithm is developed to compute optimal sensor configurations for a general nonlinear system. The algorithm utilizes a simulation of the nonlinear system as the source of input data, and convex optimization provides a scalable solution method. The sensor placement algorithm is applied to a study of gyroscopic sensing in insect wings. The sensor placement algorithm reveals information-rich areas on flexible insect wings, and a comparison to biological data suggests that insect wings are capable of acting as gyroscopic sensors. An observability-based guidance framework is developed for robotic navigation with limited inertial sensing. Guidance trajectories and algorithms are developed for range-only and bearing-only navigation that improve navigation accuracy. Simulations and experiments with an underwater vehicle demonstrate that the observability measure allows tuning of the navigation uncertainty.

A Kalman Filter for SINS Self-Alignment Based on Vector Observation

PubMed Central

Xu, Xiang; Xu, Xiaosu; Zhang, Tao; Li, Yao; Tong, Jinwu

2017-01-01

In this paper, a self-alignment method for strapdown inertial navigation systems based on the q-method is studied. In addition, an improved method based on integrating gravitational apparent motion to form apparent velocity is designed, which can reduce the random noises of the observation vectors. For further analysis, a novel self-alignment method using a Kalman filter based on adaptive filter technology is proposed, which transforms the self-alignment procedure into an attitude estimation using the observation vectors. In the proposed method, a linear psuedo-measurement equation is adopted by employing the transfer method between the quaternion and the observation vectors. Analysis and simulation indicate that the accuracy of the self-alignment is improved. Meanwhile, to improve the convergence rate of the proposed method, a new method based on parameter recognition and a reconstruction algorithm for apparent gravitation is devised, which can reduce the influence of the random noises of the observation vectors. Simulations and turntable tests are carried out, and the results indicate that the proposed method can acquire sound alignment results with lower standard variances, and can obtain higher alignment accuracy and a faster convergence rate. PMID:28146059

Feedback on Teaching from Observations of Teaching: What Do Administrators Say and What Do Teachers Think about It?

ERIC Educational Resources Information Center

Khachatryan, Edit

2015-01-01

Teachers crave yet rarely receive qualitative performance feedback. Though student feedback has been studied, we know little about what kinds of feedback are useful to teachers for improving practice. This study begins to address the need in research on the nature of feedback teachers receive from classroom observations as well as on how teachers…

Elementary Preservice Teachers' Mathematical Knowledge for Teaching: Using Situated Case Studies and Educative Experiences to Examine and Improve the Development of MKT in Teacher Education

ERIC Educational Resources Information Center

Johnson, Tracy L.

2011-01-01

This study examined pre-service teachers' development of mathematical knowledge for teaching (MKT) over their final year in a university based teacher education program. This was done through analyzing written reflections, focus group interviews, individual interviews, teaching observations, and post-observation interviews as well as through the…

[The use of lamotrigine in female patients].

PubMed

Schmitz, B; Bergmann, L

2007-08-01

Gender aspects are important when assessing the tolerability of antiepileptic drugs (AED). Due to its broad spectrum of action and to the lack of evidence for teratogenicity in monotherapy, lamotrigine (LTG) is an AED of first choice for women with epilepsy with child-bearing potential. In an observational study over 6 months including 832 women with epilepsy, we evaluated the efficacy and tolerability of LTG in monotherapy and add-on therapy, with a special focus on parameters of particular importance for women including changes in weight, skin, hair, and patterns of menstruation. Of the treated patients, 94% had seizure reduction of at least 50%. Adverse events occurred in 7.3%; 1% experienced serious adverse events, all of which were reversible. Ninety-six percent continued treatment throughout the observation period, and 83% reported improvement in quality of life by the end of the study. Cognition, functioning at work, and mood improved in 43-54% of patients. In most of them, weight remained stable. Those who were switched from valporate (VPA) or carbamazepine (CPZ) to LTG lost 3.2 kg and 3.1 kg (means), respectively. Many of the women described problems related to menstruation at the beginning of the study: variability in cycle length (31.2%), hypermenorrhea (17.3%), and pains (10%). Skin and hair problems were reported by 18.4% and 17.3%, respectively. There was improvement in all of these aspects at the end of the study, particularly for those women switched from VPA or CBZ to LTG. In summary, this observational study confirms the good tolerability of LTG with respect to issues particularly relevant to women. More complete elucidation of the correct LTG dosage, which varies widely according to the accompanying medication, will further improve treatment safety.

Lithium as an adjunct to radioactive iodine for the treatment of hyperthyroidism: a systematic review and meta-analysis.

PubMed

Kessler, Lynn; Palla, Jyothsna; Baru, Joshua S; Onyenwenyi, Chioma; George, Amrutha M; Lucas, Brian P

2014-07-01

Radioactive iodine (RAI) is commonly used in the treatment of hyperthyroidism but is not uniformly successful. Lithium increases thyroidal iodine retention without reducing iodide uptake, increasing the radiation dose to the thyroid when administered with RAI. Although these actions suggest that adjuvant lithium may increase the efficacy of RAI, its role as an adjunct to RAI remains contentious. To evaluate the safety and efficacy of adding lithium to RAI to treat hyperthyroidism. Relevant studies were identified by a search of Medline and the Cochrane Central Register of Controlled Trials. To be included, a study had to be a controlled trial comparing the effect of RAI alone to RAI with lithium in the treatment of hyperthyroidism. Relevant data were extracted and meta-analyses were performed. Of the 75 identified studies, 6 met the inclusion criteria; 4 of these studies were interventional and 2 were observational trials. Meta-analysis of the observational trials (N = 851), both of which were retrospective cohort studies, showed significant improvement in the primary outcome (i.e., cure rate) with adjunctive lithium (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.24 to 2.96). The combined interventional trials (N = 485) also showed an improvement in cure rate, but the difference did not reach statistical significance (OR, 1.28; 95% CI, 0.85 to 1.91). Adjunctive lithium reduced time to cure and blunted thyroid hormone excursions after RAI. Lithium-related side effects were infrequent and usually mild. The observational trials demonstrated significant improvement in the cure rate of hyperthyroidism when lithium is added to RAI. The improvements shown in the interventional trials did not reach statistical significance due to the effect of a single, large negative trial.

Clinical research on postoperative trauma care: has the position of observational studies changed?

PubMed

Smeeing, D P J; Houwert, R M; Kruyt, M C; van der Meijden, O A J; Hietbrink, F

2017-02-01

The postoperative care regimes of ankle fractures are studied for over 30 years and recommendations have shifted only slightly in the last decades. However, study methodology might have evolved. The aim of this study was to evaluate the changes in time in the design, quality and outcome measures of studies investigating the postoperative care of ankle fractures. The MEDLINE and EMBASE database were searched for both RCTs and cohort studies. The original studies were divided into decades of publication over the last 30 years. The methodological quality of the studies was assessed using the 'traditional' risk of bias assessment tool provided by The Cochrane Collaboration and the 'newer' MINORS criteria. The percentage of RCTs on this subject declined from 67 to 38 % in the last decades. According to the Cochrane tool, the reported quality of RCTs has improved in the last three decades whereas the reported quality of observational studies has remained unchanged. However, when quality was evaluated with the MINORS criteria, equal improvement was observed for both RCTs and observational studies. In the 80s, 67 % of all studies used the range of motion as the primary outcome measure, which decreased to 45 % in the 90s. In the 00s, none of the studies used the range of motion as the primary outcome. For postoperative care of ankle fractures, results of this study showed a relative decrease in the published number of RCTs. The overall quality of the published articles did not decline. In addition, a gradual shift from physician measured to patient-reported outcome variables was observed. However, it should be borne in mind that the findings are based on a small sample (n = 25).

Change in Adverse Events After Enrollment in the National Surgical Quality Improvement Program: A Systematic Review and Meta-Analysis

PubMed Central

Montroy, Joshua; Breau, Rodney H.; Cnossen, Sonya; Witiuk, Kelsey; Binette, Andrew; Ferrier, Taylor; Lavallée, Luke T.; Fergusson, Dean A.; Schramm, David

2016-01-01

Background The American College of Surgeons’ National Surgical Quality Improvement Program (NSQIP) is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery. Study Design A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR) and 95% confidence intervals (CI). Results Eleven articles reporting on 35 health care institutions were included. Nine (82%) of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72–0.91), deep (pRR 0.82; 95% CI0.64–1.05) and organ space (pRR 1.15; 95% CI 0.96–1.37) infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39–0.77; deep pRR 0.61, 95% CI 0.50–0.75, and organ space pRR 0.60, 95% CI 0.50–0.71). Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program. Conclusions These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities. PMID:26812596

Improved accuracy and precision of tracer kinetic parameters by joint fitting to variable flip angle and dynamic contrast enhanced MRI data.

PubMed

Dickie, Ben R; Banerji, Anita; Kershaw, Lucy E; McPartlin, Andrew; Choudhury, Ananya; West, Catharine M; Rose, Chris J

2016-10-01

To improve the accuracy and precision of tracer kinetic model parameter estimates for use in dynamic contrast enhanced (DCE) MRI studies of solid tumors. Quantitative DCE-MRI requires an estimate of precontrast T1 , which is obtained prior to fitting a tracer kinetic model. As T1 mapping and tracer kinetic signal models are both a function of precontrast T1 it was hypothesized that its joint estimation would improve the accuracy and precision of both precontrast T1 and tracer kinetic model parameters. Accuracy and/or precision of two-compartment exchange model (2CXM) parameters were evaluated for standard and joint fitting methods in well-controlled synthetic data and for 36 bladder cancer patients. Methods were compared under a number of experimental conditions. In synthetic data, joint estimation led to statistically significant improvements in the accuracy of estimated parameters in 30 of 42 conditions (improvements between 1.8% and 49%). Reduced accuracy was observed in 7 of the remaining 12 conditions. Significant improvements in precision were observed in 35 of 42 conditions (between 4.7% and 50%). In clinical data, significant improvements in precision were observed in 18 of 21 conditions (between 4.6% and 38%). Accuracy and precision of DCE-MRI parameter estimates are improved when signal models are fit jointly rather than sequentially. Magn Reson Med 76:1270-1281, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Active-comparator design and new-user design in observational studies

PubMed Central

Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

2015-01-01

SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

Improving the Efficiency of Virtual Reality Training by Integrating Partly Observational Learning

ERIC Educational Resources Information Center

Yuviler-Gavish, Nirit; Rodríguez, Jorge; Gutiérrez, Teresa; Sánchez, Emilio; Casado, Sara

2014-01-01

The current study hypothesized that integrating partly observational learning into virtual reality training systems (VRTS) can enhance training efficiency for procedural tasks. A common approach in designing VRTS is the enactive approach, which stresses the importance of physical actions within the environment to enhance perception and improve…

“Assessment of the two-way Coupled WRF-CMAQ Model with Observations from the CARES”

EPA Science Inventory

The main goal of this assessment is to evaluate the improved aerosol component of two-way coupled WRF-CMAQ model particularly in representing aerosol physical and optical properties by utilizing observations from the Carbonaceous Aerosol and Radiative Effects Study (CARES) in May...

Joint Sentinel-1 and SMAP data assimilation to improve soil moisture estimates

USDA-ARS?s Scientific Manuscript database

SMAP (Soil Moisture Active and Passive) radiometer observations at 40 km resolution are routinely assimilated into the NASA Catchment Land Surface Model to generate the 9-km SMAP Level-4 Soil Moisture product. This study demonstrates that adding high-resolution radar observations from Sentinel-1 to ...

Eccentric exercise in treatment of Achilles tendinopathy.

PubMed

Nørregaard, J; Larsen, C C; Bieler, T; Langberg, H

2007-04-01

Prognosis and treatment of Achilles tendon pain (achillodynia) has been insufficiently studied. The purpose of the present study was to examine the long-term effect of eccentric exercises compared with stretching exercises on patients with achillodynia. Patients with achillodynia for at least 3 months were randomly allocated to one of two exercise regimens. Exercise was performed daily for a 3-month period. Symptom severity was evaluated by tendon tenderness, ultrasonography, a questionnaire on pain and other symptoms, and a global assessment of improvement. Follow-up was performed at time points 3, 6, 9, 12 weeks and 1 year. Of 53 patients with achillodynia 45 patients were randomized to either eccentric exercises or stretching exercises. Symptoms gradually improved during the 1-year follow-up period and were significantly better assessed by pain and symptoms after 3 weeks and all later visits. However, no significant differences could be observed between the two groups. Women and patients with symptoms from the distal part of the tendon had significantly less improvement. Marked improvement in symptoms and findings could be gradually observed in both groups during the 1-year follow-up period. To that extent this is due to effect of both regimens or the spontaneous improvement is unsettled.

Attention-deficit/hyperactivity disorder Under Treatment Outcomes Research (AUTOR): a European observational study in pediatric subjects.

PubMed

Haynes, Virginia; Lopez-Romero, Pedro; Anand, Ernie

2015-12-01

The ADHD Under Treatment Observational Research (AUTOR) study was a European prospective, observational study that assessed factors associated with changes in ADHD severity, estimated change from baseline in quality of life (QoL), and characterized changes in ADHD symptoms over a 2-year period as a function of baseline treatment. The primary objective was to identify factors associated with worsening in ADHD severity during a 2-year follow-up period for subjects aged 6-17 years, who were receiving the same pharmacotherapy for 3-8 months before enrollment and had a Clinical Global Impression (CGI)-ADHD-Severity score of mild/lower and a CGI-ADHD-Improvement score of improved/very much improved. Multivariate logistic regression examined the association of factors with worsening in ADHD. Mixed-model repeated measures regression analyzed QoL in terms of change from baseline in CHIP-CE PRF scores. There were 704 subjects analyzed. Variables associated with worsening ADHD severity were parental occupation, poorer school outcomes, and use of psychoeducation; baseline treatment was not significant. Among the secondary objectives, initial use of atomoxetine (vs. stimulants) was associated with a significant improvement on the CHIP-CE PRF total score, with an adjusted treatment difference of -6.0 (95 % CI -7.9, -4.1) at 24 months. Additionally, the odds of stability (CGI-ADHD-S ≤ 3 over the 2-year period) were significantly lower for subjects initially responding to stimulants compared with atomoxetine (OR 0.5; 95 % CI 0.3, 0.8). ADHD symptom worsening was associated with initial use of psychoeducation, parental occupation, and poorer school outcomes. Response to initial treatment with atomoxetine was associated with improved QoL over 2 years.

Consumer food handling in the home: a review of food safety studies.

PubMed

Redmond, Elizabeth C; Griffith, Christopher J

2003-01-01

Epidemiological data from Europe, North America, Australia, and New Zealand indicate that a substantial proportion of foodborne disease is attributable to improper food preparation practices in consumers' homes. International concern about consumer food safety has prompted considerable research to evaluate domestic food-handling practices. The majority of consumer food safety studies in the last decade have been conducted in the United Kingdom and Northern Ireland (48%) and in the United States (42%). Surveys (questionnaires and interviews), the most frequent means of data collection, were used in 75% of the reviewed studies. Focus groups and observational studies have also been used. One consumer food safety study examined the relationship between pathogenic microbial contamination from raw chicken and observed food-handling behaviors, and the results of this study indicated extensive Campylobacter cross-contamination during food preparation sessions. Limited information about consumers' attitudes and intentions with regard to safe food-handling behaviors has been obtained, although a substantial amount of information about consumer knowledge and self-reported practices is available. Observation studies suggest that substantial numbers of consumers frequently implement unsafe food-handling practices. Knowledge, attitudes, intentions, and self-reported practices did not correspond to observed behaviors, suggesting that observational studies provide a more realistic indication of the food hygiene actions actually used in domestic food preparation. An improvement in consumer food-handling behavior is likely to reduce the risk and incidence of foodborne disease. The need for the development and implementation of food safety education strategies to improve specific food safety behaviors is reviewed in this paper.

Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study.

PubMed

Lotan, Itay; Treves, Therese A; Roditi, Yaniv; Djaldetti, Ruth

2014-01-01

The use of cannabis as a therapeutic agent for various medical conditions has been well documented. However, clinical trials in patients with Parkinson disease (PD) have yielded conflicting results. The aim of the present open-label observational study was to assess the clinical effect of cannabis on motor and non-motor symptoms of PD. Twenty-two patients with PD attending the motor disorder clinic of a tertiary medical center in 2011 to 2012 were evaluated at baseline and 30 minutes after smoking cannabis using the following battery: Unified Parkinson Disease Rating Scale, visual analog scale, present pain intensity scale, Short-Form McGill Pain Questionnaire, as well as Medical Cannabis Survey National Drug and Alcohol Research Center Questionnaire. Mean (SD) total score on the motor Unified Parkinson Disease Rating Scale score improved significantly from 33.1 (13.8) at baseline to 23.2 (10.5) after cannabis consumption (t = 5.9; P < 0.001). Analysis of specific motor symptoms revealed significant improvement after treatment in tremor (P < 0.001), rigidity (P = 0.004), and bradykinesia (P < 0.001). There was also significant improvement of sleep and pain scores. No significant adverse effects of the drug were observed. The study suggests that cannabis might have a place in the therapeutic armamentarium of PD. Larger, controlled studies are needed to verify the results.

Pulsars at the Highest Energies: Questions for AGILE, Fermi (GLAST) and Atmospheric Cherenkov Telescopes

NASA Technical Reports Server (NTRS)

Thompson, D.J.

2008-01-01

Observational studies of gamma-ray pulsars languished in recent years, while theoretical studies made significant strides. Now, with new and improved gamma-ray telescopes coming online, opportunities present themselves for dramatic improvements in our understanding of these objects. The new facilities and better modeling of processes at work in high-energy pulsars should address a number of important open questions, some of which are summarized.

The Intelligence of Observation: Improving High School Students' Spatial Ability by Means of Intervention Unit

ERIC Educational Resources Information Center

Patkin, Dorit; Dayan, Ester

2013-01-01

This case study of one class versus a control group focused on the impact of an intervention unit, which is not part of the regular curriculum, on the improvement of spatial ability of high school students (forty-six 12th-graders, aged 17-18, both boys and girls) in general as well as from a gender perspective. The study explored three…

Association of Cryoprecipitate and Tranexamic Acid with Improved Survival Following Wartime Injury: Findings from the MATTERs II Study

DTIC Science & Technology

2012-11-19

ONLINE FIRST ORIGINAL ARTICLE Association of Cryoprecipitate and Tranexamic Acid With Improved Survival Following Wartime Injury Findings From the... tranexamic acid on survival in combat injured. Design: Retrospective observational study comparing the mortalityof4groups: tranexamicacidonly...and com- posed the following groups: tranexamic acid (n=148), cryoprecipitate (n=168), tranexamic acid /cryoprecipi- tate (n=258), and no tranexamic

Astrometric and Photometric Follow-Up of Faint Near Earth Objects

NASA Technical Reports Server (NTRS)

Spahr, Timothy

2004-01-01

During the last year, the Near-Earth Object (NEO) follow-up program at Mt. Hopkins funded by the Near-Earth Object Observations (NEOO) program continued to improve. The Principal Investigator was again granted all the requested observing time. In addition to the requested time on the 4 8 in. telescope, 2 nights were also granted on the MMT for observations of extremely faint main-belt asteroids and NEOs. It is expected that the MMT can easily reach V = 25 over a 24 X 24 arcminute field of view. Improvements in the last year included more tweaks to the automatic astrometric routine for higher-quality astrometric fits. Use of the new USNO-B1.0 reference catalog has allowed the PI to push the average RMS of reference star solutions below 0.2 in.. Shift-and- stack techniques are used to improve the signal-to-noise ratio of the target objects. The 48 in. telescope at Mt. Hopkins is completely automated, and can be run remotely from either the Principal Investigator's office at SAO, or even his study at home. Most observing runs are now done remotely.

Assimilation of GRACE Terrestrial Water Storage Observations into a Land Surface Model for the Assessment of Regional Flood Potential

NASA Technical Reports Server (NTRS)

Reager, John T.; Thomas, Alys C.; Sproles, Eric A.; Rodell, Matthew; Beaudoing, Hiroko K.; Li, Bailing; Famiglietti, James S.

2015-01-01

We evaluate performance of the Catchment Land Surface Model (CLSM) under flood conditions after the assimilation of observations of the terrestrial water storage anomaly (TWSA) from NASA's Gravity Recovery and Climate Experiment (GRACE). Assimilation offers three key benefits for the viability of GRACE observations to operational applications: (1) near-real time analysis; (2) a downscaling of GRACE's coarse spatial resolution; and (3) state disaggregation of the vertically-integrated TWSA. We select the 2011 flood event in the Missouri river basin as a case study, and find that assimilation generally made the model wetter in the months preceding flood. We compare model outputs with observations from 14 USGS groundwater wells to assess improvements after assimilation. Finally, we examine disaggregated water storage information to improve the mechanistic understanding of event generation. Validation establishes that assimilation improved the model skill substantially, increasing regional groundwater anomaly correlation from 0.58 to 0.86. For the 2011 flood event in the Missouri river basin, results show that groundwater and snow water equivalent were contributors to pre-event flood potential, providing spatially-distributed early warning information.

High-resolution urban observation network for user-specific meteorological information service in the Seoul Metropolitan Area, South Korea

NASA Astrophysics Data System (ADS)

Park, Moon-Soo; Park, Sung-Hwa; Chae, Jung-Hoon; Choi, Min-Hyeok; Song, Yunyoung; Kang, Minsoo; Roh, Joon-Woo

2017-04-01

To improve our knowledge of urban meteorology, including those processes applicable to high-resolution meteorological models in the Seoul Metropolitan Area (SMA), the Weather Information Service Engine (WISE) Urban Meteorological Observation System (UMS-Seoul) has been designed and installed. The UMS-Seoul incorporates 14 surface energy balance (EB) systems, 7 surface-based three-dimensional (3-D) meteorological observation systems and applied meteorological (AP) observation systems, and the existing surface-based meteorological observation network. The EB system consists of a radiation balance system, sonic anemometers, infrared CO2/H2O gas analyzers, and many sensors measuring the wind speed and direction, temperature and humidity, precipitation, and air pressure. The EB-produced radiation, meteorological, and turbulence data will be used to quantify the surface EB according to land use and to improve the boundary-layer and surface processes in meteorological models. The 3-D system, composed of a wind lidar, microwave radiometer, aerosol lidar, or ceilometer, produces the cloud height, vertical profiles of backscatter by aerosols, wind speed and direction, temperature, humidity, and liquid water content. It will be used for high-resolution reanalysis data based on observations and for the improvement of the boundary-layer, radiation, and microphysics processes in meteorological models. The AP system includes road weather information, mosquito activity, water quality, and agrometeorological observation instruments. The standardized metadata for networks and stations are documented and renewed periodically to provide a detailed observation environment. The UMS-Seoul data are designed to support real-time acquisition and display and automatically quality check within 10 min from observation. After the quality check, data can be distributed to relevant potential users such as researchers and policy makers. Finally, two case studies demonstrate that the observed data have a great potential to help to understand the boundary-layer structures more deeply, improve the performance of high-resolution meteorological models, and provide useful information customized based on the user demands in the SMA.

Closing the quality gap: revisiting the state of the science (vol. 4: medication adherence interventions: comparative effectiveness).

PubMed

Viswanathan, Meera; Golin, Carol E; Jones, Christine D; Ashok, Mahima; Blalock, Susan; Wines, Roberta C M; Coker-Schwimmer, Emmanuel J L; Grodensky, Catherine A; Rosen, David L; Yuen, Andrea; Sista, Priyanka; Lohr, Kathleen N

2012-09-01

To assess the effectiveness of patient, provider, and systems interventions (Key Question [KQ] 1) or policy interventions (KQ 2) in improving medication adherence for an array of chronic health conditions. For interventions that are effective in improving adherence, we then assessed their effectiveness in improving health, health care utilization, and adverse events. MEDLINE®, the Cochrane Library. Additional studies were identified from reference lists and technical experts. Two people independently selected, extracted data from, and rated the risk of bias of relevant trials and systematic reviews. We synthesized the evidence for effectiveness separately for each clinical condition, and within each condition, by type of intervention. We also evaluated the prevalence of intervention components across clinical conditions and the effectiveness of interventions for a range of vulnerable populations. Two reviewers graded the strength of evidence using established criteria. We found a total of 62 eligible studies (58 trials and 4 observational studies) from our review of 3,979 abstracts. These studies included patients with diabetes, hyperlipidemia, hypertension, heart failure, myocardial infarction, asthma, depression, glaucoma, multiple sclerosis, musculoskeletal diseases, and multiple chronic conditions. Fifty-seven trials of patient, provider, or systems interventions (KQ 1) evaluated 20 different types of interventions; 4 observational studies and one trial of policy interventions (KQ 2) evaluated the effect of reduced out-of-pocket expenses or improved prescription drug coverage. We found the most consistent evidence of improvement in medication adherence for interventions to reduce out-of-pocket expenses or improve prescription drug coverage, case management, and educational interventions across clinical conditions. Within clinical conditions, we found the strongest support for self-management of medications for short-term improvement in adherence for asthma patients; collaborative care or case management programs for short-term improvement of adherence and to improve symptoms for patients taking depression medications; and pharmacist-led approaches for hypertensive patients to improve systolic blood pressure. Diverse interventions offer promising approaches to improving medication adherence for chronic conditions, particularly for the short term. Evidence on whether these approaches have broad applicability for clinical conditions and populations is limited, as is evidence regarding long-term medication adherence or health outcomes.

Improving the power of an efficacy study of a social and emotional learning program: application of generalizability theory to the measurement of classroom-level outcomes.

PubMed

Mashburn, Andrew J; Downer, Jason T; Rivers, Susan E; Brackett, Marc A; Martinez, Andres

2014-04-01

Social and emotional learning programs are designed to improve the quality of social interactions in schools and classrooms in order to positively affect students' social, emotional, and academic development. The statistical power of group randomized trials to detect effects of social and emotional learning programs and other preventive interventions on setting-level outcomes is influenced by the reliability of the outcome measure. In this paper, we apply generalizability theory to an observational measure of the quality of classroom interactions that is an outcome in a study of the efficacy of a social and emotional learning program called The Recognizing, Understanding, Labeling, Expressing, and Regulating emotions Approach. We estimate multiple sources of error variance in the setting-level outcome and identify observation procedures to use in the efficacy study that most efficiently reduce these sources of error. We then discuss the implications of using different observation procedures on both the statistical power and the monetary costs of conducting the efficacy study.

Trust Me: Design Patterns for Constructing Trustworthy Trust Indicators

DTIC Science & Technology

2009-04-01

contacted by Microsoft to participate in user studies, and screened out participants who either did not use Hotmail for their email or did not use IE as...purpose. We decided to tell participants that we were working on improvements for Windows Live Hotmail , and therefore we would be observing them interacting...minutes. At this point, the experimenter observed them log into their Hotmail accounts, and then left the room to observe them from our observation

Does the parental stretching programs improve metatarsus adductus in newborns?

PubMed

Eamsobhana, Perajit; Rojjananukulpong, Karn; Ariyawatkul, Thanase; Chotigavanichaya, Chatupon; Kaewpornsawan, Kamolporn

2017-01-01

Metatarsus adductus (MA) is a common pediatric foot deformity. Current recommendations suggest observation until 4-6 months, then casting if the deformity persists. Based on our review of the literatures, no randomized controlled trial has been conducted to study the effectiveness of parental stretching in the correction of MA in newborn. Ninety-four newborn feet that were diagnosed as MA by clinical examination were enrolled. Feet were randomized into two groups: observation group and stretching group. Outcome measurements were performed to compare success rate between groups. According to Pearson's χ 2 test, there were no statistically significant differences between groups with regard to the overall success of the parental stretching program ( p = 0.191). There was also no significant difference between groups for mild degree or moderate-to-severe degree ( p = 0.134, p = 0.274, respectively). A more rapid success rate was observed in the stretching group at the first month follow-up, but rate of improvement then decreased. The stretching group tended to have a lower success rate compared to the observation group in moderate-to-severe feet, but the difference was not statistically significant. Parental stretching program found no benefit over observation group in this study. Parental stretching program should not be applied for newborn babies with moderate-to-severe MA as the result from the study appeared to have lower success rate compared to observation group. Observe until 4-6 months, then corrective casting for the persisting deformity is recommended.

Information Technology-Based Interventions to Improve Drug-Drug Interaction Outcomes: A Systematic Review on Features and Effects.

PubMed

Nabovati, Ehsan; Vakili-Arki, Hasan; Taherzadeh, Zhila; Saberi, Mohammad Reza; Medlock, Stephanie; Abu-Hanna, Ameen; Eslami, Saeid

2017-01-01

The purpose of this systematic review was to identify features and effects of information technology (IT)-based interventions on outcomes related to drug-drug interactions (DDI outcomes). A literature search was conducted in Medline, EMBASE, and the Cochrane Library for published English-language studies. Studies were included if a main outcome was related to DDIs, the intervention involved an IT-based system, and the study design was experimental or observational with controls. Study characteristics, including features and effects of IT-based interventions, were extracted. Nineteen studies comprising five randomized controlled trials (RCT), five non-randomized controlled trials (NRCT) and nine observational studies with controls (OWC) were included. Sixty-four percent of prescriber-directed interventions, and all non-prescriber interventions, were effective. Each of the following characteristics corresponded to groups of studies of which a majority were effective: automatic provision of recommendations within the providers' workflow, intervention at the time of decision-making, integration into other systems, and requiring the reason for not following the recommendations. Only two studies measured clinical outcomes: an RCT that showed no significant improvement and an OWC that showed improvement, but did not statistically assess the effect. Most studies that measured surrogate outcomes (e.g. potential DDIs) and other outcomes (e.g. adherence to alerts) showed improvements. IT-based interventions improve surrogate clinical outcomes and adherence to DDI alerts. However, there is lack of robust evidence about their effectiveness on clinical outcomes. It is recommended that researchers consider the identified features of effective interventions in the design of interventions and evaluate the effectiveness on DDI outcomes, particularly clinical outcomes.

Combined Radio and Space-Based Solar Observations: From Techniques to New Results - Preface

NASA Astrophysics Data System (ADS)

Kontar, Eduard P.; Nindos, Alexander

2018-06-01

The phenomena observed at the Sun have a variety of unique radio signatures that can be used to diagnose the processes in the solar atmosphere. The insights provided by radio observations are further enhanced when they are combined with observations from space-based telescopes. This Topical collection demonstrates the power of combination methodology at work and provides new results on i) type I solar radio bursts and thermal emission to study active regions; ii) type II and IV bursts to better understand the structure of coronal mass ejections; and iii) non-thermal gyro-synchrotron and/or type III bursts to improve the characterisation of particle acceleration in solar flares. The ongoing improvements in time, frequency, and spatial resolutions of ground-based telescopes reveal new levels in the complexity of solar phenomena and pose new questions.

An application of artificial intelligence to automatic telescopes

NASA Technical Reports Server (NTRS)

Swanson, Keith; Drummond, Mark; Bresina, John

1992-01-01

Automatic Photoelectric Telescopes (APT's) allow an astronomer to be removed form the telescope site in both time and space. APT's 'execute' an observation program (a set of observation requests) expressed in an ASCII-based language (ATIS) and collect observation results expressed in this same language. The observation program is currently constructed by a Principal Astronomer from the requests of multiple users; the execution is currently controlled by a simple heuristic dispatch scheduler. Research aimed at improving the use of APT's is being carried out by the Entropy Reduction Engine (ERE) project at NASA Ames. The overall goal of the ERE project is the study and construction of systems that integrate planning, scheduling, and control. This paper discusses the application of some ERE technical results to the improvement of both the scheduling and the operation of APT's.

Improved health behaviors persist over two years for employees in a worksite wellness program.

PubMed

LeCheminant, James D; Merrill, Ray M

2012-10-01

This study evaluates whether improvements in health behaviors related to a worksite wellness program persist through 2 years. The program was designed to build behavioral capability and self-efficacy by yielding immediately applicable skills and tools and segmenting the behavior change process into weekly, manageable doses. Analyses are based on 267 individuals employed from 2009 through 2011. Significant improvements were observed in the frequency and volume of exercise, and the consumption of vegetables and fruits over 12 and 24 months. Requests for health coaching significantly increased over the study period. Thus, the type of wellness program evaluated in this study produced sustainable health behaviors through 24 months, which likely will translate into future positive health outcomes and improved employee productivity.

Learning Curves Among All Patients Undergoing Transcatheter Aortic Valve Implantation in Germany: A Retrospective Observational Study.

PubMed

Kaier, Klaus; Reinecke, Holger; Schmoor, Claudia; Frankenstein, Lutz; Vach, Werner; Hehn, Philip; Zirlik, Andreas; Bode, Christoph; Zehender, Manfred; Reinöhl, Jochen

2017-05-15

Transcatheter aortic valve implantation (TAVI) is a rapidly evolving technique for therapy of aortic stenosis. Previous studies report learning curves with respect to in-hospital mortality and clinical complications. We aim to determine whether observed improvements of in-hospital outcomes after TAVI are the result of improvements in procedures or due to a change in the patient population, and whether improvements differ between the transfemoral (TF) and the transapical (TA) approach. Data was analyzed using risk-adjusted regression analyses in order to track the development of clinical outcomes of all isolated TAVI procedures performed in Germany from 2008 to 2013 (N=32.436) in all German hospitals performing TAVI. Measurements include in-hospital mortality, stroke, bleeding, and mechanical ventilation. Unadjusted mortality rates decrease over time for both TA-TAVI and TF-TAVI. Reductions in mortality were smaller for TA-TAVI than for TF-TAVI. These trends could also be observed for risk-adjusted (standardized) mortality rates, indicating that time trends and differences between TA-TAVI (around 7% in 2013) and TF-TAVI (around 4% in 2013) cannot be explained by changes in the risk factor composition of the patient populations. Bleeding complications decreased for both access routes. Both unadjusted and standardized bleeding rates were substantially higher for TA-TAVI. In addition, TA-TAVI procedures were associated with an increased likelihood of requiring >48h of mechanical ventilation. Observed improvements in TAVI-related in-hospital mortality are not due to a change in patient population. The results indicate the superiority of a TF-first approach. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Perceptual learning improves visual performance in juvenile amblyopia.

PubMed

Li, Roger W; Young, Karen G; Hoenig, Pia; Levi, Dennis M

2005-09-01

To determine whether practicing a position-discrimination task improves visual performance in children with amblyopia and to determine the mechanism(s) of improvement. Five children (age range, 7-10 years) with amblyopia practiced a positional acuity task in which they had to judge which of three pairs of lines was misaligned. Positional noise was produced by distributing the individual patches of each line segment according to a Gaussian probability function. Observers were trained at three noise levels (including 0), with each observer performing between 3000 and 4000 responses in 7 to 10 sessions. Trial-by-trial feedback was provided. Four of the five observers showed significant improvement in positional acuity. In those four observers, on average, positional acuity with no noise improved by approximately 32% and with high noise by approximately 26%. A position-averaging model was used to parse the improvement into an increase in efficiency or a decrease in equivalent input noise. Two observers showed increased efficiency (51% and 117% improvements) with no significant change in equivalent input noise across sessions. The other two observers showed both a decrease in equivalent input noise (18% and 29%) and an increase in efficiency (17% and 71%). All five observers showed substantial improvement in Snellen acuity (approximately 26%) after practice. Perceptual learning can improve visual performance in amblyopic children. The improvement can be parsed into two important factors: decreased equivalent input noise and increased efficiency. Perceptual learning techniques may add an effective new method to the armamentarium of amblyopia treatments.

Teachers' Perspectives of Improvement of Instruction When Engaging in Self-Assessment in a Standards-Based Appraisal Process

ERIC Educational Resources Information Center

Davis, Amanda L.

2013-01-01

The purpose of this study is to contribute to existing research on teacher supervision, instructional leadership, and teacher reflectivity and teacher reflexivity by examining: teachers' personal perceptions and reflections about improving instructional effectiveness through observations of their own lessons when using a standards-based appraisal…

Increasing Capacity: Practice Effects in Absolute Identification

ERIC Educational Resources Information Center

Dodds, Pennie; Donkin, Christopher; Brown, Scott D.; Heathcote, Andrew

2011-01-01

In most of the long history of the study of absolute identification--since Miller's (1956) seminal article--a severe limit on performance has been observed, and this limit has resisted improvement even by extensive practice. In a startling result, Rouder, Morey, Cowan, and Pfaltz (2004) found substantially improved performance with practice in the…

Improving Student Comprehension in Content Areas through the Use of Reading Strategies.

ERIC Educational Resources Information Center

Langford, Patricia A.; Rizzo, Sandra K.; Roth, Jean M.

This study was an action research project designed to improve students' reading comprehension. Students in the targeted kindergarten, second, and third grade classes exhibited a lack of reading comprehension, which interfered with their academic achievement. Data was collected by student and parent surveys, observations, and document analysis.…

Improving the Students' Spiritual Intelligence in English Writing through Whole Brain Learning

ERIC Educational Resources Information Center

Santoso, Didik

2016-01-01

The objective of this research was to improve the students' spiritual intelligence in English writing through Whole Brain Learning strategy. Therefore, this study was conducted as a classroom action research. The research pocedure followed the cyclonic process of planning, action, observation, and reflection. This process was preceeded by…

Advanced Computer Image Generation Techniques Exploiting Perceptual Characteristics. Final Report.

ERIC Educational Resources Information Center

Stenger, Anthony J.; And Others

This study suggests and identifies computer image generation (CIG) algorithms for visual simulation that improve the training effectiveness of CIG simulators and identifies areas of basic research in visual perception that are significant for improving CIG technology. The first phase of the project entailed observing three existing CIG simulators.…

Leadership to Improve Student Achievement: Focus the Culture on Learning

ERIC Educational Resources Information Center

Taylor, Rosemarye T.

2010-01-01

This study on leadership for second order change and improved student achievement represents interview and observational research with 62 leaders at the district and school levels in 10 states. Seven consistent leader action themes emerged across all participants regardless of demographics of the school, demographics of the leader, or position…

Risk of decline and chance of improvement in olfaction among patients with post-traumatic olfactory loss.

PubMed

Kuo, C-L; Shu, C-H

2015-12-01

To evaluate the chance of improvement and risk of decline in olfaction among patients with post-traumatic olfactory loss. This study comprised 80 patients. Changes in olfaction were determined using a visual analogue scale and the 'Sniffin' Sticks' test. Logistic regression was used to identify predictors for olfactory changes. Olfactory changes were observed in 9-35 per cent of patients. The rates of improvement and decline according to visual analogue scale scores were 35 per cent and 10 per cent respectively, whereas those in the Sniffin' Sticks test were 9 per cent and 11 per cent respectively. There was a predictive link between non-anosmia and decline in Sniffin' Sticks test scores (odds ratio = 16.61, p = 0.003). A positive correlation was observed between the scores in the first and last examinations (rho = 0.532, p < 0.001). Patients should be informed that they may experience an improvement or decline in olfaction following post-traumatic olfactory dysfunction. This study provides evidence to support comprehensive counselling regarding prognosis as an integral part of management strategies.

Improved Conceptual Models Methodology (ICoMM) for Validation of Non-Observable Systems

DTIC Science & Technology

2015-12-01

distribution is unlimited IMPROVED CONCEPTUAL MODELS METHODOLOGY (ICoMM) FOR VALIDATION OF NON-OBSERVABLE SYSTEMS by Sang M. Sok December 2015...REPORT TYPE AND DATES COVERED Dissertation 4. TITLE AND SUBTITLE IMPROVED CONCEPTUAL MODELS METHODOLOGY (ICoMM) FOR VALIDATION OF NON-OBSERVABLE...importance of the CoM. The improved conceptual model methodology (ICoMM) is developed in support of improving the structure of the CoM for both face and

Effectiveness of interventions to reduce household air pollution and/or improve health in homes using solid fuel in low-and-middle income countries: A systematic review and meta-analysis.

PubMed

Quansah, Reginald; Semple, Sean; Ochieng, Caroline A; Juvekar, Sanjar; Armah, Frederick Ato; Luginaah, Isaac; Emina, Jacques

2017-06-01

Cookstove intervention programs have been increasing over the past two (2) decades in Low and Middle Income Countries (LMICs) across the globe. However, there remains uncertainty regarding the effects of these interventions on household air pollution concentrations, personal exposure concentrations and health outcomes. The primary objective was to determine if household air pollution (HAP) interventions were associated with improved indoor air quality (IAQ) in households in LMICs. Given the potential impact of HAP interventions on health, a secondary objective was to evaluate the effectiveness of HAP interventions to improve health in populations receiving these interventions. OVID Medline, Ovid Embase, SCOPUS and PubMED were searched from their inception until December 2015 with no restrictions on study design. The WHO Global database of household air pollution measurements and Members' archives were also reviewed together with the reference lists of identified reviews and relevant articles. We considered randomized controlled trials, or non-randomized control trials, or before-and-after studies; original studies; studies conducted in a LMIC (based on the United Nations Human Development Report released in March 2013 (World Bank, 2013); interventions that were explicitly aimed at improving IAQ and/or health from solid fuel use; studies published in a peer-reviewed journal or student theses or reports; studies that reported on outcomes which was indicative of IAQ or/and health. There was no restriction on the type of comparator (e.g. household receiving plancha vs. household using traditional cookstove) used in the intervention study. Five review authors independently used pre-designed data collection forms to extract information from the original studies and assessed risk of bias using the Effective Public Health Practice Project (EPHPP). We computed standardized weighted mean difference (SMD) using random-effects models. Heterogeneity was computed using the Q and I2-statistics. We examined the influence of various characteristics on the study-specific effect estimates by stratifying the analysis by population type, study design, intervention type, and duration of exposure monitoring. The trim and fill method was used to assess the potential impact of missing studies. Fifty-five studies met our a priori inclusion criteria and were included in the systematic review. Fifteen studies provided 43 effect estimates for our meta-analysis. The largest improvement in HAP was observed for average particulate matter (PM) (SMD=1.57) concentrations in household kitchens (1.03), followed by daily personal average concentrations of PM (1.18), and carbon monoxide (CO) concentrations in kitchens. With respect to personal PM, significant improvement was observed in studies of children (1.26) and studies monitoring PM for ≥24h (1.32). This observation was also noted in terms of studies of kitchen concentrations of CO. A significant improvement was also observed for kitchen levels of PM in both adult populations (1.56) and in RCT/cohort designs (1.59) involving replacing cookstoves without chimneys. Our findings on health outcomes were inconclusive. We observed high statistical between study variability in the study-specific estimate. Thus, care should be taken in concluding that HAP interventions - as currently designed and implemented - support reductions in the average kitchen and personal levels of PM and CO. Further, there is limited evidence that current stand-alone HAP interventions yield any health benefits. Post-intervention levels of pollutants were generally still greatly in excess of the relevant WHO guideline and thus a need to promote cleaner fuels in LMICs to reduce HAP levels below the WHO guidelines. The review has been registered with PROSPERO (registration number CRD42014009768). Copyright © 2016. Published by Elsevier Ltd.

Soil moisture estimation by assimilating L-band microwave brightness temperature with geostatistics and observation localization.

PubMed

Han, Xujun; Li, Xin; Rigon, Riccardo; Jin, Rui; Endrizzi, Stefano

2015-01-01

The observation could be used to reduce the model uncertainties with data assimilation. If the observation cannot cover the whole model area due to spatial availability or instrument ability, how to do data assimilation at locations not covered by observation? Two commonly used strategies were firstly described: One is covariance localization (CL); the other is observation localization (OL). Compared with CL, OL is easy to parallelize and more efficient for large-scale analysis. This paper evaluated OL in soil moisture profile characterizations, in which the geostatistical semivariogram was used to fit the spatial correlated characteristics of synthetic L-Band microwave brightness temperature measurement. The fitted semivariogram model and the local ensemble transform Kalman filter algorithm are combined together to weight and assimilate the observations within a local region surrounding the grid cell of land surface model to be analyzed. Six scenarios were compared: 1_Obs with one nearest observation assimilated, 5_Obs with no more than five nearest local observations assimilated, and 9_Obs with no more than nine nearest local observations assimilated. The scenarios with no more than 16, 25, and 36 local observations were also compared. From the results we can conclude that more local observations involved in assimilation will improve estimations with an upper bound of 9 observations in this case. This study demonstrates the potentials of geostatistical correlation representation in OL to improve data assimilation of catchment scale soil moisture using synthetic L-band microwave brightness temperature, which cannot cover the study area fully in space due to vegetation effects.

Soil Moisture Estimation by Assimilating L-Band Microwave Brightness Temperature with Geostatistics and Observation Localization

PubMed Central

Han, Xujun; Li, Xin; Rigon, Riccardo; Jin, Rui; Endrizzi, Stefano

2015-01-01

The observation could be used to reduce the model uncertainties with data assimilation. If the observation cannot cover the whole model area due to spatial availability or instrument ability, how to do data assimilation at locations not covered by observation? Two commonly used strategies were firstly described: One is covariance localization (CL); the other is observation localization (OL). Compared with CL, OL is easy to parallelize and more efficient for large-scale analysis. This paper evaluated OL in soil moisture profile characterizations, in which the geostatistical semivariogram was used to fit the spatial correlated characteristics of synthetic L-Band microwave brightness temperature measurement. The fitted semivariogram model and the local ensemble transform Kalman filter algorithm are combined together to weight and assimilate the observations within a local region surrounding the grid cell of land surface model to be analyzed. Six scenarios were compared: 1_Obs with one nearest observation assimilated, 5_Obs with no more than five nearest local observations assimilated, and 9_Obs with no more than nine nearest local observations assimilated. The scenarios with no more than 16, 25, and 36 local observations were also compared. From the results we can conclude that more local observations involved in assimilation will improve estimations with an upper bound of 9 observations in this case. This study demonstrates the potentials of geostatistical correlation representation in OL to improve data assimilation of catchment scale soil moisture using synthetic L-band microwave brightness temperature, which cannot cover the study area fully in space due to vegetation effects. PMID:25635771

Merging bioreactor technology with 3D hepatocyte-fibroblast culturing approaches: Improved in vitro models for toxicological applications.

PubMed

Leite, Sofia B; Teixeira, Ana P; Miranda, Joana P; Tostões, Rui M; Clemente, João J; Sousa, Marcos F; Carrondo, Manuel J T; Alves, Paula M

2011-06-01

During the last years an increasing number of in vitro models have been developed for drug screening and toxicity testing. Primary cultures of hepatocytes are, by far, the model of choice for those high-throughput studies but their spontaneous dedifferentiation after some time in culture hinders long-term studies. Thus, novel cell culture systems allowing extended hepatocyte maintenance and more predictive long term in vitro studies are required. It has been shown that hepatocytes functionality can be improved and extended in time when cultured as 3D-cell aggregates in environmental controlled stirred bioreactors. In this work, aiming at further improving hepatocytes functionality in such 3D cellular structures, co-cultures with fibroblasts were performed. An inoculum concentration of 1.2×10(5) cell/mL and a 1:2 hepatocyte:mouse embryonic fibroblast ratio allowed to improve significantly the albumin secretion rate and both ECOD (phase I) and UGT (phase II) enzymatic activities in 3D co-cultures, as compared to the routinely used 2D hepatocyte monocultures. Significant improvements were also observed in relation to 3D monocultures of hepatocytes. Furthermore, hepatocytes were able to respond to the addition of beta-Naphtoflavone by increasing ECOD activity showing CYP1A inducibility. The dependence of CYP activity on oxygen concentration was also observed. In summary, the improved hepatocyte specific functions during long term incubation of 3D co-cultures of hepatocytes with fibroblasts indicate that this system is a promising in vitro model for long term toxicological studies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Injectable nanosilica-chitosan microparticles for bone regeneration applications.

PubMed

Gaihre, Bipin; Lecka-Czernik, Beata; Jayasuriya, Ambalangodage C

2018-01-01

This study was aimed at assessing the effects of silica nanopowder incorporation into chitosan-tripolyphosphate microparticles with the ultimate goal of improving their osteogenic properties. The microparticles were prepared by simple coacervation technique and silica nanopowder was added at 0% (C), 2.5% (S1), 5% (S2) and 10% (S3) (w/w) to chitosan. We observed that this simple incorporation of silica nanopowder improved the growth and proliferation of osteoblasts along the surface of the microparticles. In addition, the composite microparticles also showed the increased expression of alkaline phosphatase and osteoblast specific genes. We observed a significant increase ( p < 0.05) in the expression of alkaline phosphatase by the cells growing on all sample groups compared to the control (C) groups at day 14. The morphological characterization of these microparticles through scanning electron microscopy showed that these microparticles were well suited to be used as the injectable scaffolds with perfectly spherical shape and size. The incorporation of silica nanopowder altered the nano-roughness of the microparticles as observed through atomic force microscopy scans with roughness values going down from C to S3. The results in this study, taken together, show the potential of chitosan-tripolyphosphate-silica nanopowder microparticles for improved bone regeneration applications.

A comprehensive method for GNSS data quality determination to improve ionospheric data analysis.

PubMed

Kim, Minchan; Seo, Jiwon; Lee, Jiyun

2014-08-14

Global Navigation Satellite Systems (GNSS) are now recognized as cost-effective tools for ionospheric studies by providing the global coverage through worldwide networks of GNSS stations. While GNSS networks continue to expand to improve the observability of the ionosphere, the amount of poor quality GNSS observation data is also increasing and the use of poor-quality GNSS data degrades the accuracy of ionospheric measurements. This paper develops a comprehensive method to determine the quality of GNSS observations for the purpose of ionospheric studies. The algorithms are designed especially to compute key GNSS data quality parameters which affect the quality of ionospheric product. The quality of data collected from the Continuously Operating Reference Stations (CORS) network in the conterminous United States (CONUS) is analyzed. The resulting quality varies widely, depending on each station and the data quality of individual stations persists for an extended time period. When compared to conventional methods, the quality parameters obtained from the proposed method have a stronger correlation with the quality of ionospheric data. The results suggest that a set of data quality parameters when used in combination can effectively select stations with high-quality GNSS data and improve the performance of ionospheric data analysis.

Saponification of fatty slaughterhouse wastes for enhancing anaerobic biodegradability.

PubMed

Battimelli, Audrey; Carrère, Hélène; Delgenès, Jean-Philippe

2009-08-01

The thermochemical pretreatment by saponification of two kinds of fatty slaughterhouse waste--aeroflotation fats and flesh fats from animal carcasses--was studied in order to improve the waste's anaerobic degradation. The effect of an easily biodegradable compound, ethanol, on raw waste biodegradation was also examined. The aims of the study were to enhance the methanisation of fatty waste and also to show a link between biodegradability and bio-availability. The anaerobic digestion of raw waste, saponified waste and waste with a co-substrate was carried out in batch mode under mesophilic and thermophilic conditions. The results showed little increase in the total volume of biogas, indicating a good biodegradability of the raw wastes. Mean biogas volume reached 1200 mL/g VS which represented more than 90% of the maximal theoretical biogas potential. Raw fatty wastes were slowly biodegraded whereas pretreated wastes showed improved initial reaction kinetics, indicating a better initial bio-availability, particularly for mesophilic runs. The effects observed for raw wastes with ethanol as co-substrate depended on the process temperature: in mesophilic conditions, an initial improvement was observed whereas in thermophilic conditions a significant decrease in biodegradability was observed.

A Comprehensive Method for GNSS Data Quality Determination to Improve Ionospheric Data Analysis

PubMed Central

Kim, Minchan; Seo, Jiwon; Lee, Jiyun

2014-01-01

Global Navigation Satellite Systems (GNSS) are now recognized as cost-effective tools for ionospheric studies by providing the global coverage through worldwide networks of GNSS stations. While GNSS networks continue to expand to improve the observability of the ionosphere, the amount of poor quality GNSS observation data is also increasing and the use of poor-quality GNSS data degrades the accuracy of ionospheric measurements. This paper develops a comprehensive method to determine the quality of GNSS observations for the purpose of ionospheric studies. The algorithms are designed especially to compute key GNSS data quality parameters which affect the quality of ionospheric product. The quality of data collected from the Continuously Operating Reference Stations (CORS) network in the conterminous United States (CONUS) is analyzed. The resulting quality varies widely, depending on each station and the data quality of individual stations persists for an extended time period. When compared to conventional methods, the quality parameters obtained from the proposed method have a stronger correlation with the quality of ionospheric data. The results suggest that a set of data quality parameters when used in combination can effectively select stations with high-quality GNSS data and improve the performance of ionospheric data analysis. PMID:25196005

Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review.

PubMed

Rao, Anirudh; Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S; Jager, Kitty J; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

2016-01-01

The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and study design quality in the nephrology literature. Systematic literature review. European and North American, Pre-dialysis Chronic Kidney Disease (CKD) cohort studies. Studies assessing the association between CKD and mortality in the elderly (>65 years) published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE. Time period before and after the publication of the STROBE statement. Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS), Scottish Intercollegiate Guidelines Network (SIGN) and Critical Appraisal Skills Programme (CASP) tools. 37 papers (11 Pre & 26 Post STROBE) were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis) showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7-82.0) vs 83% (IQR, 78.4-84.9, p = 0.05). There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9), SIGN (Manuscript SIGN score 83.3) and CASP (Manuscript CASP score 91.7) tools. Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good reporting. This study highlights continuing deficiencies in the reporting of STROBE items and their sub-criteria in cohort studies in nephrology. There was weak evidence of improvement in the overall reporting quality, with no improvement in methodological quality of CKD cohort studies between the period before and after publication of the STROBE statement.

Determination of Nutrient Intakes by a Modified Visual Estimation Method and Computerized Nutritional Analysis for Dietary Assessments

DTIC Science & Technology

1987-09-01

a useful average for population studies, do not delay data processing , and is relatively Inexpensive. Using MVEN and observing recipe preparation...for population studies, do not delay data processing , and is relatively inexpensive. Using HVEM and observing recipe preparation procedures improve the...extensive review of the procedures and problems in design, collection, analysis, processing and interpretation of dietary survey data for individuals

Implementation research to improve quality of maternal and newborn health care, Malawi

PubMed Central

Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

2017-01-01

Abstract Objective To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. Methods We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities’ essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. Findings We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants’ adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Conclusion Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care. PMID:28670014

Improved inter-observer agreement of an expert review panel in an oncology treatment trial--Insights from a structured interventional process.

PubMed

Nestle, Ursula; Rischke, Hans Christian; Eschmann, Susanne Martina; Holl, Gabriele; Tosch, Marco; Miederer, Matthias; Plotkin, Michail; Essler, Markus; Puskas, Cornelia; Schimek-Jasch, Tanja; Duncker-Rohr, Viola; Rühl, Friederike; Leifert, Anja; Mix, Michael; Grosu, Anca-Ligia; König, Jochem; Vach, Werner

2015-11-01

Oncologic imaging is a key for successful cancer treatment. While the quality assurance (QA) of image acquisition protocols has already been focussed, QA of reading and reporting offers still room for improvement. The latter was addressed in the context of a prospective multicentre trial on fluoro-deoxyglucose (FDG)-positron-emission tomography (PET)/CT-based chemoradiotherapy for locally advanced non-small cell lung cancer (NSCLC). An expert panel was prospectively installed performing blinded reviews of mediastinal NSCLC involvement in FDG-PET/CT. Due to a high initial reporting inter-observer disagreement, the independent data monitoring committee (IDMC) triggered an interventional harmonisation process, which overall involved 11 experts uttering 6855 blinded diagnostic statements. After assessing the baseline inter-observer agreement (IOA) of a blinded re-review (phase 1), a discussion process led to improved reading criteria (phase 2). Those underwent a validation study (phase 3) and were then implemented into the study routine. After 2 months (phase 4) and 1 year (phase 5), the IOA was reassessed. The initial overall IOA was moderate (kappa 0.52 CT; 0.53 PET). After improvement of reading criteria, the kappa values improved substantially (kappa 0.61 CT; 0.66 PET), which was retained until the late reassessment (kappa 0.71 CT; 0.67 PET). Subjective uncertainty was highly predictive for low IOA. The IOA of an expert panel was significantly improved by a structured interventional harmonisation process which could be a model for future clinical trials. Furthermore, the low IOA in reporting nodal involvement in NSCLC may bear consequences for individual patient care. Copyright © 2015 Elsevier Ltd. All rights reserved.

Short- and long-term clinical outcomes following a standardized protocol of orthopedic manual physical therapy and exercise in individuals with osteoarthritis of the hip: a case series

PubMed Central

Hando, Ben R; Gill, Norman W; Walker, Michael J; Garber, Mathew

2012-01-01

Objectives: Describe short- and long-term outcomes observed in individuals with hip osteoarthritis (OA) treated with a pre-selected, standardized set of best-evidence manual therapy and therapeutic exercise interventions. Methods: Fifteen consecutive subjects (9 males, 6 females; mean age: 52±7.5 years) with unilateral hip OA received an identical protocol of manual therapy and therapeutic exercise interventions. Subjects attended 10 treatment sessions over an 8-week period for manual therapy interventions and performed the therapeutic exercise as a home program. Results: Baseline to 8-week follow-up outcomes were as follows: Harris Hip Scale (HHS) scores improved from 60.3(±10.4) to 80.7(±10.5), Numerical Pain Rating Scale (NPRS) scores improved from 4.3(±1.9) to 2.0(±1.9), hip flexion range of motion (ROM) improved from 99 degrees (±10.6) to 127 degrees (±6.3) and hip internal rotation ROM improved from 19 degrees (±9.1) to 31 degrees (±11.5). Improvements in HHS, NPRS, and hip ROM measures reached statistical significance (P<0.05) at 8-weeks and remained significant at the 29-week follow-up. Mean changes in NPRS and HHS scores exceeded the minimal clinically important difference (MCID) at 8-weeks and for the HHS scores alone at 29 weeks. The 8 and 29 week mean Global Rating of Change scores were 5.1(±1.4) and 2.1(±4.2), respectively. Improved outcomes observed following a pre-selected, standardized treatment protocol were similar to those observed in previous studies involving impairment-based manual therapy and therapeutic exercise for hip OA. Future studies might directly compare the two approaches. Discussion: PMID:24179327

Short- and long-term clinical outcomes following a standardized protocol of orthopedic manual physical therapy and exercise in individuals with osteoarthritis of the hip: a case series.

PubMed

Hando, Ben R; Gill, Norman W; Walker, Michael J; Garber, Mathew

2012-11-01

Describe short- and long-term outcomes observed in individuals with hip osteoarthritis (OA) treated with a pre-selected, standardized set of best-evidence manual therapy and therapeutic exercise interventions. Fifteen consecutive subjects (9 males, 6 females; mean age: 52±7.5 years) with unilateral hip OA received an identical protocol of manual therapy and therapeutic exercise interventions. Subjects attended 10 treatment sessions over an 8-week period for manual therapy interventions and performed the therapeutic exercise as a home program. Baseline to 8-week follow-up outcomes were as follows: Harris Hip Scale (HHS) scores improved from 60.3(±10.4) to 80.7(±10.5), Numerical Pain Rating Scale (NPRS) scores improved from 4.3(±1.9) to 2.0(±1.9), hip flexion range of motion (ROM) improved from 99 degrees (±10.6) to 127 degrees (±6.3) and hip internal rotation ROM improved from 19 degrees (±9.1) to 31 degrees (±11.5). Improvements in HHS, NPRS, and hip ROM measures reached statistical significance (P<0.05) at 8-weeks and remained significant at the 29-week follow-up. Mean changes in NPRS and HHS scores exceeded the minimal clinically important difference (MCID) at 8-weeks and for the HHS scores alone at 29 weeks. The 8 and 29 week mean Global Rating of Change scores were 5.1(±1.4) and 2.1(±4.2), respectively. Improved outcomes observed following a pre-selected, standardized treatment protocol were similar to those observed in previous studies involving impairment-based manual therapy and therapeutic exercise for hip OA. Future studies might directly compare the two approaches.

Embedding clinical interventions into observational studies

PubMed Central

Newman, Anne B.; Avilés-Santa, M. Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm. James; Krucoff, Mitchell; Kuller, Lewis H.; Lewis, Cora E.; Robinson, Jennifer G.; Taylor, Herman; Treviño, Roberto P.; Weintraub, William

2017-01-01

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

Improvements in the delivery of resuscitation and newborn care after Helping Babies Breathe training.

PubMed

Kamath-Rayne, B D; Josyula, S; Rule, A R L; Vasquez, J C

2017-10-01

To evaluate changes in neonatal resuscitation and postnatal care following Helping Babies Breathe (HBB) training at a community hospital in rural Honduras. We hypothesized that HBB training would improve resuscitation and essential newborn care interventions. Direct observation and video recording of delivery room care spanned before and after an initial HBB workshop held in August 2013. Rates of essential newborn care interventions were compared in resuscitations performed by individuals who had and had not received HBB training, and run charts recording performance of newborn care practices over time were developed. Ten percent of deliveries (N=250) were observed over the study period, with 156 newborn resuscitations performed by individuals without HBB training, compared to 94 resuscitations performed by HBB trainees. After HBB training, significant improvements were seen in skin-to-skin care, breastfeeding within 60 min of age, and delayed cord clamping after 1 min (all P<0.01). More babies cared for by HBB trainees received basic neonatal resuscitation such as drying and stimulation. Run charts tracking these practices over time showed significant improvements after HBB training that were sustained during the study period, but remained below ideal goals. With improvement in drying/stimulation practices, fewer babies required bag/mask ventilation. In a rural Honduran community hospital, improvements in basic neonatal resuscitation and postnatal essential newborn care practices can be seen after HBB training. Further improvements in newborn care practices may require focused quality improvement initiatives for hospitals to sustain high quality care.

Quality of life improvement in HIV-1 patients treated with raltegravir in a real-life observational study: RACING.

PubMed

Spire, Bruno; Nait-Ighil, Lella; Pugliese, Pascal; Poizot-Martin, Isabelle; Jullien, Vincent; Marcelin, Anne-Geneviève; Billaud, Eric

2017-01-01

Good efficacy and safety of raltegravir in person living with HIV was demonstrated in clinical trials over five years, but real-life data, particularly about quality of life (QoL), are lacking. QoL was evaluated over time in adult patients first treated or switched to regimens containing raltegravir in an observational cohort study. Patient QoL was evaluated using the Fatigue Impact Scale (FIS) and the HIV Symptom Index (HSI). Data were collected at baseline and at 1, 3, 6, 12, 18, and 24 months. Baseline FIS and HSI subscores were compared with the scores at each visit using the paired Wilcoxon test. The impact of time, sociodemographic and medical variables upon patient-perceived fatigue and symptoms was also assessed using mixed multivariate models. From baseline, all FIS and HSI subscores improved significantly after one month of treatment. In addition, psychosocial FIS subscores and both the frequency of bothersome symptoms and HSI subscores improved significantly at each visit. Physical FIS subscores also improved significantly, except at month 18, whereas both cognitive and total FIS subscores improved only after 6 months and 24 months, respectively. In multivariate analysis, employment was independently associated over time with improved improvement in both FIS and HSI subscores. Patient QoL improved significantly over a 24-month period of treatment with a raltegravir-containing regimen. FIS and HSI are sensitive tools to measure the impact of new antiretroviral combinations on a patient's perception of QoL.

GABA editing with macromolecule suppression using an improved MEGA-SPECIAL sequence.

PubMed

Gu, Meng; Hurd, Ralph; Noeske, Ralph; Baltusis, Laima; Hancock, Roeland; Sacchet, Matthew D; Gotlib, Ian H; Chin, Frederick T; Spielman, Daniel M

2018-01-01

The most common γ-aminobutyric-acid (GABA) editing approach, MEGA-PRESS, uses J-editing to measure GABA distinct from larger overlapping metabolites, but suffers contamination from coedited macromolecules (MMs) comprising 40 to 60% of the observed signal. MEGA-SPECIAL is an alternative method with better MM suppression, but is not widely used primarily because of its relatively poor spatial localization. Our goal was to develop an improved MM-suppressed GABA editing sequence at 3 Tesla. We modified a single-voxel MEGA-SPECIAL sequence with an oscillating readout gradient for improved spatial localization, and used very selective 30-ms editing pulses for improved suppression of coedited MMs. Simulation and in vivo experiments confirmed excellent MM suppression, insensitive to the range of B 0 frequency drifts typically encountered in vivo. Both intersubject and intrasubject studies showed that MMs, when suppressed by the improved MEGA-SPECIAL method, contributed approximately 40% to the corresponding MEGA-PRESS measurements. From the intersubject study, the coefficient of variation for GABA+/Cre (MEGA-PRESS) was 11.2% versus 7% for GABA/Cre (improved MEGA-SPECIAL), demonstrating significantly reduced variance (P = 0.005), likely coming from coedited MMs. This improved MEGA-SPECIAL sequence provides unbiased GABA measurements with reduced variance as compared with conventional MEGA-PRESS. This approach is also relatively insensitive to the range of B 0 drifts typically observed in in vivo human studies. Magn Reson Med 79:41-47, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Improvement of walking distance by defibrotide in patients with intermittent claudication--results of a randomized, placebo-controlled study (the DICLIS study). Defibrotide Intermittent CLaudication Italian Study.

PubMed

Violi, F; Marubini, E; Coccheri, S; Nenci, G G

2000-05-01

Defibrotide is an antithrombotic drug which enhances prostacyclin production and activates fibrinolytic system. The aim of this study was to investigate the improvement of walking distance in patients with intermittent claudication treated with defibrotide. DICLIS was a double blind, placebo-controlled study which included patients with walking distance autonomy at a standardized treadmill test < or =350 > or =100 meters. A total of 310 patients were randomly allocated to placebo (n = 101), defibrotide 800 mg/day (n = 104) or defibrotide 1200 mg/day (n = 105). During a one year follow-up, the Absolute Walking Distance (AWD) was measured six times (0, 30, 60, 90, 180, 360 days). Similar improvement in walking distance was found in the three groups until the 90th day; thereafter placebo group showed no further increase, while AWD continued to increase in the defibrotide groups. Between the 180th and 360th day visits, AWD was significantly higher (P <0.01) in patients given defibrotide than in patients given placebo. No difference in efficacy was observed between the two dosages of defibrotide. No differences in side effects were observed among the three groups. The results of the present trial suggest that long-term administration of defibrotide improves walking distance in patients with intermittent claudication.

Operational Impact of Data Collected from the Global Hawk Unmanned Aircraft During SHOUT

NASA Astrophysics Data System (ADS)

Wick, G. A.; Dunion, J. P.; Sippel, J.; Cucurull, L.; Aksoy, A.; Kren, A.; Christophersen, H.; Black, P.

2017-12-01

The primary scientific goal of the Sensing Hazards with Operational Unmanned Technology (SHOUT) Project was to determine the potential utility of observations from high-altitude, long-endurance unmanned aircraft systems such as the Global Hawk (GH) aircraft to improve operational forecasts of high-impact weather events or mitigate potential degradation of forecasts in the event of a future gap in satellite coverage. Hurricanes and tropical cyclones are among the most potentially destructive high-impact weather events and pose a major forecasting challenge to NOAA. Major winter storms over the Pacific Ocean, including atmospheric river events, which make landfall and bring strong winds and extreme precipitation to the West Coast and Alaska are also important to forecast accurately because of their societal impact in those parts of the country. In response, the SHOUT project supported three field campaigns with the GH aircraft and dedicated data impact studies exploring the potential for the real-time data from the aircraft to improve the forecasting of both tropical cyclones and landfalling Pacific storms. Dropsonde observations from the GH aircraft were assimilated into the operational Hurricane Weather Research and Forecasting (HWRF) and Global Forecast System (GFS) models. The results from several diverse but complementary studies consistently demonstrated significant positive forecast benefits spanning the regional and global models. Forecast skill improvements within HWRF reached up to about 9% for track and 14% for intensity. Within GFS, track skill improvements for multi-storm averages exceeded 10% and improvements for individual storms reached over 20% depending on forecast lead time. Forecasted precipitation was also improved. Impacts for Pacific winter storms were smaller but still positive. The results are highly encouraging and support the potential for operational utilization of data from a platform like the GH. This presentation summarizes the observations collected and highlights the multiple impact studies completed.

The clinical course of low back pain: a meta-analysis comparing outcomes in randomised clinical trials (RCTs) and observational studies

PubMed Central

2014-01-01

Background Evidence suggests that the course of low back pain (LBP) symptoms in randomised clinical trials (RCTs) follows a pattern of large improvement regardless of the type of treatment. A similar pattern was independently observed in observational studies. However, there is an assumption that the clinical course of symptoms is particularly influenced in RCTs by mere participation in the trials. To test this assumption, the aim of our study was to compare the course of LBP in RCTs and observational studies. Methods Source of studies CENTRAL database for RCTs and MEDLINE, CINAHL, EMBASE and hand search of systematic reviews for cohort studies. Studies include individuals aged 18 or over, and concern non-specific LBP. Trials had to concern primary care treatments. Data were extracted on pain intensity. Meta-regression analysis was used to compare the pooled within-group change in pain in RCTs with that in cohort studies calculated as the standardised mean change (SMC). Results 70 RCTs and 19 cohort studies were included, out of 1134 and 653 identified respectively. LBP symptoms followed a similar course in RCTs and cohort studies: a rapid improvement in the first 6 weeks followed by a smaller further improvement until 52 weeks. There was no statistically significant difference in pooled SMC between RCTs and cohort studies at any time point:- 6 weeks: RCTs: SMC 1.0 (95% CI 0.9 to 1.0) and cohorts 1.2 (0.7to 1.7); 13 weeks: RCTs 1.2 (1.1 to 1.3) and cohorts 1.0 (0.8 to 1.3); 27 weeks: RCTs 1.1 (1.0 to 1.2) and cohorts 1.2 (0.8 to 1.7); 52 weeks: RCTs 0.9 (0.8 to 1.0) and cohorts 1.1 (0.8 to 1.6). Conclusions The clinical course of LBP symptoms followed a pattern that was similar in RCTs and cohort observational studies. In addition to a shared ‘natural history’, enrolment of LBP patients in clinical studies is likely to provoke responses that reflect the nonspecific effects of seeking and receiving care, independent of the study design. PMID:24607083

Testosterone and the metabolic syndrome.

PubMed

Muraleedharan, Vakkat; Jones, T Hugh

2010-10-01

Metabolic syndrome and testosterone deficiency in men are closely Linked. Epidemiological studies have shown that Low testosterone Levels are associated with obesity, insulin resistance and an adverse Lipid profile in men. Conversely in men with metabolic syndrome and type 2 diabetes have a high prevalence of hypogonadism. Metabolic syndrome and Low testosterone status are both independently associated with increased all-cause and cardiovascular mortality. Observational and experimental data suggest that physiological replacement of testosterone produces improvement in insulin resistance, obesity, dyslipidae-mia and sexual dysfunction along with improved quality of Life. However, there are no Long-term interventional studies to assess the effect of testosterone replacement on mortality in men with Low testosterone Levels. This article reviews the observational and interventional clinical data in relation to testosterone and metabolic syndrome.

Using the Fire Weather Index (FWI) to improve the estimation of fire emissions from fire radiative power (FRP) observations

NASA Astrophysics Data System (ADS)

Di Giuseppe, Francesca; Rémy, Samuel; Pappenberger, Florian; Wetterhall, Fredrik

2018-04-01

The atmospheric composition analysis and forecast for the European Copernicus Atmosphere Monitoring Services (CAMS) relies on biomass-burning fire emission estimates from the Global Fire Assimilation System (GFAS). The GFAS is a global system and converts fire radiative power (FRP) observations from MODIS satellites into smoke constituents. Missing observations are filled in using persistence, whereby observed FRP values from the previous day are progressed in time until a new observation is recorded. One of the consequences of this assumption is an increase of fire duration, which in turn translates into an increase of emissions estimated from fires compared to what is available from observations. In this study persistence is replaced by modelled predictions using the Canadian Fire Weather Index (FWI), which describes how atmospheric conditions affect the vegetation moisture content and ultimately fire duration. The skill in predicting emissions from biomass burning is improved with the new technique, which indicates that using an FWI-based model to infer emissions from FRP is better than persistence when observations are not available.

Mechanical Strength and Broadband Transparency Improvement of Glass Wafers via Surface Nanostructures.

PubMed

Kumar, Amarendra; Kashyap, Kunal; Hou, Max T; Yeh, J Andrew

2016-06-17

In this study, we mechanically strengthened a borosilicate glass wafer by doubling its bending strength and simultaneously enhancing its transparency using surface nanostructures for different applications including sensors, displays and panels. A fabrication method that combines dry and wet etching is used for surface nanostructure fabrication. Specifically, we improved the bending strength of plain borosilicate glass by 96% using these surface nanostructures on both sides. Besides bending strength improvement, a limited optical transmittance enhancement of 3% was also observed in the visible light wavelength region (400-800 nm). Both strength and transparency were improved by using surface nanostructures of 500 nm depth on both sides of the borosilicate glass without affecting its bulk properties or the glass manufacturing process. Moreover, we observed comparatively smaller fragments during the breaking of the nanostructured glass, which is indicative of strengthening. The range for the nanostructure depth is defined for different applications with which improvements of the strength and transparency of borosilicate glass substrate are obtained.

A patellar bandage improves mobility but not static balance in elderly female fallers.

PubMed

Scheicher, Marcos Eduardo; Fonseca, Ligia Cristiane Santos; Bortolloto, Tiago Buso; de Carvalho, Isabela Feitosa

2018-04-01

The deterioration in the somatosensory and motor systems observed with increasing age can cause balance problems. Studies have shown that the use of infrapatellar bandages can enhance proprioception and improve postural balance. To evaluate the effect of an infrapatellar bandage on static balance and mobility in elderly female fallers and non-fallers. Forty older women (20 fallers and 20 non-fallers) were evaluated. Mobility (Timed Up and Go test) and balance (force platform) were measured in the presence and absence of additional sensory information (elastic infrapatellar bandage). Mobility differed in fallers (p = 0.0001), but not in non-fallers (p = 0.27), when the patellar bandage was applied. Additional sensory information did not improve static balance in either group (p > 0.05), but a trend towards improvement was observed in fallers. Additional sensory input from an infrapatellar bandage improves mobility but not bipedal stance in elderly fallers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mechanical Strength and Broadband Transparency Improvement of Glass Wafers via Surface Nanostructures

PubMed Central

Kumar, Amarendra; Kashyap, Kunal; Hou, Max T.; Yeh, J. Andrew

2016-01-01

In this study, we mechanically strengthened a borosilicate glass wafer by doubling its bending strength and simultaneously enhancing its transparency using surface nanostructures for different applications including sensors, displays and panels. A fabrication method that combines dry and wet etching is used for surface nanostructure fabrication. Specifically, we improved the bending strength of plain borosilicate glass by 96% using these surface nanostructures on both sides. Besides bending strength improvement, a limited optical transmittance enhancement of 3% was also observed in the visible light wavelength region (400–800 nm). Both strength and transparency were improved by using surface nanostructures of 500 nm depth on both sides of the borosilicate glass without affecting its bulk properties or the glass manufacturing process. Moreover, we observed comparatively smaller fragments during the breaking of the nanostructured glass, which is indicative of strengthening. The range for the nanostructure depth is defined for different applications with which improvements of the strength and transparency of borosilicate glass substrate are obtained. PMID:27322276

The effect of Ai Chi aquatic therapy on individuals with knee osteoarthritis: a pilot study.

PubMed

So, Billy C L; Kong, Iris S Y; Lee, Roy K L; Man, Ryan W F; Tse, William H K; Fong, Adalade K W; Tsang, William W N

2017-05-01

[Purpose] To examine the efficacy of Ai Chi in relieving the pain and stiffness of knee osteoarthritis and improving, physical functioning, proprioception and quality of life. [Subjects and Methods] Twenty-five persons with knee osteoarthritis completed 5 weeks Ai Chi practice (60 minutes per session, twice per week, 10 sessions in total). Knee pain and stiffness were measured before and after the intervention program. [Results] Significant improvements in pain, self-perceived physical functioning and self-perceived stiffness were observed after the Ai-Chi intervention. On average, no significant change in knee range of motion, 6-minute walk test distances or proprioception was observed. [Conclusion] A five-week Ai Chi intervention can improve the pain and stiffness of knee osteoarthritis and self-perceived physical functions and quality of life improvement. Ai Chi may be another treatment choice for people with knee OA to practice in the community.

wfip2.model/refcst.02.fcst.01

DOE Data Explorer

Macduff, Matt

2017-10-26

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

Unmanned Aerial Systems (UAS) Evaluation of Routine Atmospheric Sounding Measurements using Unmanned Systems (ERASMUS)

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

De Boer, Gijs

Data were collected to improve understanding of the Arctic troposphere, and to provide researchers with a focused case-study period for future observational and modeling studies pertaining to Arctic atmospheric processes.

Improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics in south-western and south-eastern Nigeria - A service development report.

PubMed

Bakare, Muideen O; Bello-Mojeed, Mashudat A; Munir, Kerim M; Duduyemi, Olaniyi O; Orovwigho, Andrew O; Odetunde, Odutola I; Taiwo, Olufemi G; Olofinlade, Jushua A; Omotoso, Olakunle N; Famurewa, Olayinka H; Omolabi, Oladipupo O; Jejeloye, Adebayo O

2017-01-01

We investigate the possibility of improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics randomly selected from Lagos and Enugu States in south-western and south-eastern Nigeria respectively. The principle of human centred design was employed by engaging the mothers screened positive for PPD to be part of the decision making regarding their further assessment and intervention services. The study brought intervention services to primary healthcare centre at the NPI clinics. Improvement in willingness to seek interventions was observed among the mothers screened positive for PPD in this study when compared to our observation in a previous report, where mothers diagnosed with PPD were referred and requested to visit a mental health facility closer to their NPI clinics for further assessment and interventions (95.2% versus 33.7%). Interventional services for the mothers diagnosed with PPD also impact positively on the growth parameters of their infants on follow-up. Principle of human centred design improved access to intervention services among the mothers and infants studied. NPI clinics at primary healthcare level would provide appropriate forum for early screening of mothers for PPD and interventions in low-resource setting like Nigeria. There would be improvement in maternal and child health coverage if the Nigerian Government can adapt human centred design principles employed in this study nationwide.

Improved self-exclusion program: preliminary results.

PubMed

Tremblay, Nicole; Boutin, Claude; Ladouceur, Robert

2008-12-01

The gambling industry has offered self-exclusion programs for quite a long time. Such measures are designed to limit access to gaming opportunities and provide problem gamblers with the help they need to cease or limit their gambling behaviour. However, few studies have empirically evaluated these programs. This study has three objectives: (1) to observe the participation in an improved self-exclusion program that includes an initial voluntary evaluation, phone support, and a mandatory meeting, (2) to evaluate satisfaction and usefulness of this service as perceived by self-excluders, (3) to measure the preliminary impact of this improved program. One hundred sixteen self-excluders completed a questionnaire about their satisfaction and their perception of the usefulness during the mandatory meeting. Among those participants, 39 attended an initial meeting. Comparisons between data collected at the initial meeting and data taken at the final meeting were made for those 39 participants. Data showed that gamblers chose the improved self-exclusion program 75% of the time; 25% preferred to sign a regular self-exclusion contract. Among those who chose the improved service, 40% wanted an initial voluntary evaluation and 37% of these individuals actually attended that meeting. Seventy percent of gamblers came to the mandatory meeting, which was a required condition to end their self-exclusion. The majority of participants were satisfied with the improved self-exclusion service and perceived it as useful. Major improvements were observed between the final and the initial evaluation on time and money spent, consequences of gambling, DSM-IV score, and psychological distress. The applicability of an improved self-exclusion program is discussed and, as shown in our study, the inclusion of a final mandatory meeting might not be so repulsive for self-excluders. Future research directives are also proposed.

Dual n-back training increases the capacity of the focus of attention.

PubMed

Lilienthal, Lindsey; Tamez, Elaine; Shelton, Jill Talley; Myerson, Joel; Hale, Sandra

2013-02-01

Working memory (WM) training has been reported to benefit abilities as diverse as fluid intelligence (Jaeggi et al., Proceedings of the National Academy of Sciences of the United States of America, 105:6829-6833, 2008) and reading comprehension (Chein & Morrison, Psychonomic Bulletin & Review, 17:193-199, 2010), but transfer is not always observed (for reviews, see Morrison & Chein, Psychonomics Bulletin & Review, 18:46-60, 2011; Shipstead et al., Psychological Bulletin, 138:628-654, 2012). In contrast, recent WM training studies have consistently reported improvement on the trained tasks. The basis for these training benefits has received little attention, however, and it is not known which WM components and/or processes are being improved. Therefore, the goal of the present study was to investigate five possible mechanisms underlying the effects of adaptive dual n-back training on working memory (i.e., improvements in executive attention, updating, and focus switching, as well as increases in the capacity of the focus of attention and short-term memory). In addition to a no-contact control group, the present study also included an active control group whose members received nonadaptive training on the same task. All three groups showed significant improvements on the n-back task from pretest to posttest, but adaptive training produced larger improvements than did nonadaptive training, which in turn produced larger improvements than simply retesting. Adaptive, but not nonadaptive, training also resulted in improvements on an untrained running span task that measured the capacity of the focus of attention. No other differential improvements were observed, suggesting that increases in the capacity of the focus of attention underlie the benefits of adaptive dual n-back training.

Leveraging Observation Tools for Instructional Improvement: Exploring Variability in Uptake of Ambitious Instructional Practices

ERIC Educational Resources Information Center

Cohen, Julie; Schuldt, Lorien Chambers; Brown, Lindsay; Grossman, Pamela

2016-01-01

Background/Context: Current efforts to build rigorous teacher evaluation systems has increased interest in standardized classroom observation tools as reliable measures for assessing teaching. However, many argue these instruments can also be used to effect change in classroom practice. This study investigates a model of professional development…

Classroom Observation Data and Instruction in Primary Mathematics Education: Improving Design and Rigour

ERIC Educational Resources Information Center

Thompson, Carla J.; Davis, Sandra B.

2014-01-01

The use of formal observation in primary mathematics classrooms is supported in the literature as a viable method of determining effective teaching strategies and appropriate tasks for inclusion in the early years of mathematics learning. The twofold aim of this study was to (a) investigate predictive relationships between primary mathematics…

Evaluating the Effectiveness of READ 180: A Reading Program for Struggling Middle School Students

ERIC Educational Resources Information Center

Johnson, Latonya R.

2011-01-01

This study was conducted using a qualitative approach to evaluate the effectiveness of READ 180 Program in improving students reading interests and achievement at West Bolivar Middle School (WBMS). A number of interviews and observations were conducted. Two teachers and nine students were interviewed, and nine classroom observations were…

Seeing How It Sounds: Observation, Imitation, and Improved Learning in Piano Playing

ERIC Educational Resources Information Center

Simones, Lilian; Rodger, Matthew; Schroeder, Franziska

2017-01-01

This study centers upon a piano learning and teaching environment in which beginners and intermediate piano students (N = 48) learning to perform a specific type of staccato were submitted to three different (group-exclusive) teaching conditions: "audio-only" demonstration of the musical task; observation of the teacher's action…

Data Assimilation of AirSWOT and Synthetically Derived SWOT Observations of Water Surface Elevation in a Multichannel River

NASA Astrophysics Data System (ADS)

Altenau, E. H.; Pavelsky, T.; Andreadis, K.; Bates, P. D.; Neal, J. C.

2017-12-01

Multichannel rivers continue to be challenging features to quantify, especially at regional and global scales, which is problematic because accurate representations of such environments are needed to properly monitor the earth's water cycle as it adjusts to climate change. It has been demonstrated that higher-complexity, 2D models outperform lower-complexity, 1D models in simulating multichannel river hydraulics at regional scales due to the inclusion of the channel network's connectivity. However, new remote sensing measurements from the future Surface Water and Ocean Topography (SWOT) mission and it's airborne analog AirSWOT offer new observations that can be used to try and improve the lower-complexity, 1D models to achieve accuracies closer to the higher-complexity, 2D codes. Here, we use an Ensemble Kalman Filter (EnKF) to assimilate AirSWOT water surface elevation (WSE) measurements from a 2015 field campaign into a 1D hydrodynamic model along a 90 km reach of Tanana River, AK. This work is the first to test data assimilation methods using real SWOT-like data from AirSWOT. Additionally, synthetic SWOT observations of WSE are generated across the same study site using a fine-resolution 2D model and assimilated into the coarser-resolution 1D model. Lastly, we compare the abilities of AirSWOT and the synthetic-SWOT observations to improve spatial and temporal model outputs in WSEs. Results indicate 1D model outputs of spatially distributed WSEs improve as observational coverage increases, and improvements in temporal fluctuations in WSEs depend on the number of observations. Furthermore, results reveal that assimilation of AirSWOT observations produce greater error reductions in 1D model outputs compared to synthetic SWOT observations due to lower measurement errors. Both AirSWOT and the synthetic SWOT observations significantly lower spatial and temporal errors in 1D model outputs of WSEs.

A multi-source data assimilation framework for flood forecasting: Accounting for runoff routing lags

NASA Astrophysics Data System (ADS)

Meng, S.; Xie, X.

2015-12-01

In the flood forecasting practice, model performance is usually degraded due to various sources of uncertainties, including the uncertainties from input data, model parameters, model structures and output observations. Data assimilation is a useful methodology to reduce uncertainties in flood forecasting. For the short-term flood forecasting, an accurate estimation of initial soil moisture condition will improve the forecasting performance. Considering the time delay of runoff routing is another important effect for the forecasting performance. Moreover, the observation data of hydrological variables (including ground observations and satellite observations) are becoming easily available. The reliability of the short-term flood forecasting could be improved by assimilating multi-source data. The objective of this study is to develop a multi-source data assimilation framework for real-time flood forecasting. In this data assimilation framework, the first step is assimilating the up-layer soil moisture observations to update model state and generated runoff based on the ensemble Kalman filter (EnKF) method, and the second step is assimilating discharge observations to update model state and runoff within a fixed time window based on the ensemble Kalman smoother (EnKS) method. This smoothing technique is adopted to account for the runoff routing lag. Using such assimilation framework of the soil moisture and discharge observations is expected to improve the flood forecasting. In order to distinguish the effectiveness of this dual-step assimilation framework, we designed a dual-EnKF algorithm in which the observed soil moisture and discharge are assimilated separately without accounting for the runoff routing lag. The results show that the multi-source data assimilation framework can effectively improve flood forecasting, especially when the runoff routing has a distinct time lag. Thus, this new data assimilation framework holds a great potential in operational flood forecasting by merging observations from ground measurement and remote sensing retrivals.

Software and electronic developments for TUG - T60 robotic telescope

NASA Astrophysics Data System (ADS)

Parmaksizoglu, M.; Dindar, M.; Kirbiyik, H.; Helhel, S.

2014-12-01

A robotic telescope is a telescope that can make observations without hands-on human control. Its low level behavior is automatic and computer-controlled. Robotic telescopes usually run under the control of a scheduler, which provides high-level control by selecting astronomical targets for observation. TUBITAK National Observatory (TUG) T60 Robotic Telescope is controlled by open source OCAAS software, formally named TALON. This study introduces the improvements on TALON software, new electronic and mechanic designs. The designs and software improvements were implemented in the T60 telescope control software and tested on the real system successfully.

Improved large-scale hydrological modelling through the assimilation of streamflow and downscaled satellite soil moisture observations.

NASA Astrophysics Data System (ADS)

López López, Patricia; Wanders, Niko; Sutanudjaja, Edwin; Renzullo, Luigi; Sterk, Geert; Schellekens, Jaap; Bierkens, Marc

2015-04-01

The coarse spatial resolution of global hydrological models (typically > 0.25o) often limits their ability to resolve key water balance processes for many river basins and thus compromises their suitability for water resources management, especially when compared to locally-tunes river models. A possible solution to the problem may be to drive the coarse resolution models with high-resolution meteorological data as well as to assimilate ground-based and remotely-sensed observations of key water cycle variables. While this would improve the modelling resolution of the global model, the impact of prediction accuracy remains largely an open question. In this study we investigated the impact that assimilating streamflow and satellite soil moisture observations have on global hydrological model estimation, driven by coarse- and high-resolution meteorological observations, for the Murrumbidgee river basin in Australia. The PCR-GLOBWB global hydrological model is forced with downscaled global climatological data (from 0.5o downscaled to 0.1o resolution) obtained from the WATCH Forcing Data (WFDEI) and local high resolution gauging station based gridded datasets (0.05o), sourced from the Australian Bureau of Meteorology. Downscaled satellite derived soil moisture (from 0.5o downscaled to 0.1o resolution) from AMSR-E and streamflow observations collected from 25 gauging stations are assimilated using an ensemble Kalman filter. Several scenarios are analysed to explore the added value of data assimilation considering both local and global climatological data. Results show that the assimilation of streamflow observations result in the largest improvement of the model estimates. The joint assimilation of both streamflow and downscaled soil moisture observations leads to further improved in streamflow simulations (10% reduction in RMSE), mainly in the headwater catchments (up to 10,000 km2). Results also show that the added contribution of data assimilation, for both soil moisture and streamflow, is more pronounced when the global meteorological data are used to force the models. This is caused by the higher uncertainty and coarser resolution of the global forcing. This study demonstrates that it is possible to improve hydrological simulations forced by coarse resolution meteorological data with downscaled satellite soil moisture and streamflow observations and bring them closer to a hydrological model forced with local climatological data. These findings are important in light of the efforts that are currently done to go to global hyper-resolution modelling and can significantly help to advance this research.

Stop Stroke© Acute Care Coordination Medical Application: A Brief Report on Postimplementation Performance at a Primary Stroke Center.

PubMed

Dickson, Robert L; Sumathipala, Dineth; Reeves, Jennifer

2016-05-01

The objective of our study was to evaluate the effect of the Pulsara Stop Stroke© medical application on door-to-needle (DTN) time in patients presenting to our emergency department with acute ischemic stroke (AIS). The secondary objective was to evaluate the DTN performance of dedicated neurohospitalists versus private practice neurologists covering emergency department stroke call. We conducted a retrospective cohort study of the Good Shepherd Health System stroke quality improvement dashboard for an 18-month period. The primary outcome was mean DTN time performance in cases with and without Stop Stroke© usage. Secondary outcome was mean DTN time between neurohospitalist and private neurologists with and without use of Stop Stroke©. During the study period, there were 85 stroke activations receiving tissue plasminogen activator (63 with Stop Stroke©, 22 without Stop Stroke©). In cases where the app was used, we observed a reduction in mean DTN time of 40 minutes (87-47 minutes), a 46% reduction. There was no significant difference in DTN time observed between the neurohospitalist and private neurologist performance independent of app usage. Mean DTN less than 60 minutes improved with app use from 18% to 85% with Stop Stroke©. In patients arriving to our primary stroke center with AIS, use of Pulsara Stop Stroke© acute care coordination app decreased mean DTN time by 40 minutes, a significant 46% improvement in this metric and is consistent with other studies of the app. We further observed a 3.7× improvement in DTN less than 60 minutes with use of the app. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

An Optimal Design for Placements of Tsunami Observing Systems Around the Nankai Trough, Japan

NASA Astrophysics Data System (ADS)

Mulia, I. E.; Gusman, A. R.; Satake, K.

2017-12-01

Presently, there are numerous tsunami observing systems deployed in several major tsunamigenic regions throughout the world. However, documentations on how and where to optimally place such measurement devices are limited. This study presents a methodological approach to select the best and fewest observation points for the purpose of tsunami source characterizations, particularly in the form of fault slip distributions. We apply the method to design a new tsunami observation network around the Nankai Trough, Japan. In brief, our method can be divided into two stages: initialization and optimization. The initialization stage aims to identify favorable locations of observation points, as well as to determine the initial number of observations. These points are generated based on extrema of an empirical orthogonal function (EOF) spatial modes derived from 11 hypothetical tsunami events in the region. In order to further improve the accuracy, we apply an optimization algorithm called a mesh adaptive direct search (MADS) to remove redundant measurements from the initially generated points by the first stage. A combinatorial search by the MADS will improve the accuracy and reduce the number of observations simultaneously. The EOF analysis of the hypothetical tsunamis using first 2 leading modes with 4 extrema on each mode results in 30 observation points spread along the trench. This is obtained after replacing some clustered points within the radius of 30 km with only one representative. Furthermore, the MADS optimization can improve the accuracy of the EOF-generated points by approximately 10-20% with fewer observations (23 points). Finally, we compare our result with the existing observation points (68 stations) in the region. The result shows that the optimized design with fewer number of observations can produce better source characterizations with approximately 20-60% improvement of accuracies at all the 11 hypothetical cases. It should be note, however, that our design is a tsunami-based approach, some of the existing observing systems are equipped with additional devices to measure other parameter of interests, i.e., for monitoring seismic activities.

Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC)

NASA Astrophysics Data System (ADS)

Dethloff, Klaus; Rex, Markus; Shupe, Matthew

2016-04-01

The Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) is an international initiative under the International Arctic Science Committee (IASC) umbrella that aims to improve numerical model representations of sea ice, weather, and climate processes through coupled system observations and modeling activities that link the central Arctic atmosphere, sea ice, ocean, and the ecosystem. Observations of many critical parameters such as cloud properties, surface energy fluxes, atmospheric aerosols, small-scale sea-ice and oceanic processes, biological feedbacks with the sea-ice ice and ocean, and others have never been made in the central Arctic in all seasons, and certainly not in a coupled system fashion. The primary objective of MOSAiC is to develop a better understanding of these important coupled-system processes so they can be more accurately represented in regional- and global-scale weather- and climate models. Such enhancements will contribute to improved modeling of global climate and weather, and Arctic sea-ice predictive capabilities. The MOSAiC observations are an important opportunity to gather the high quality and comprehensive observations needed to improve numerical modeling of critical, scale-dependent processes impacting Arctic predictability given diminished sea ice coverage and increased model complexity. Model improvements are needed to understand the effects of a changing Arctic on mid-latitude weather and climate. MOSAiC is specifically designed to provide the multi-parameter, coordinated observations needed to improve sub-grid scale model parameterizations especially with respect to thinner ice conditions. To facilitate, evaluate, and develop the needed model improvements, MOSAiC will employ a hierarchy of modeling approaches ranging from process model studies, to regional climate model intercomparisons, to operational forecasts and assimilation of real-time observations. Model evaluations prior to the field program will be used to identify specific gaps and parameterization needs. Preliminary modeling and operational forecasting will also be necessary to directly guide field planning and optimal implementation of field resources, and to support the safety of the project. The MOSAiC Observatory will be deployed in, and drift with, the Arctic sea-ice pack for at least a full annual cycle, starting in fall 2019 and ending in autumn 2020. Initial plans are for the drift to start in the newly forming autumn sea-ice in, or near, the East Siberian Sea. The specific location will be selected to allow for the observatory to follow the Transpolar Drift towards the North Pole and on to the Fram Strait. IASC has adopted MOSAiC as a key international activity, the German Alfred Wegener Institute has made the huge contribution of the icebreaker Polarstern to serve as the central drifting observatory for this year long endeavor, and the US Department of Energy has committed a comprehensive atmospheric measurement suite. Many other nations and agencies have expressed interest in participation and in gaining access to this unprecedented observational dataset. International coordination is needed to support this groundbreaking endeavor.

Improved Blood Biomarkers but No Cognitive Effects from 16 Weeks of Multivitamin Supplementation in Healthy Older Adults

PubMed Central

Harris, Elizabeth; Macpherson, Helen; Pipingas, Andrew

2015-01-01

Supplementation with vitamins, minerals and phytonutrients may be beneficial for cognition, especially in older adults. The aim of this study was to assess the effects of multivitamin supplementation in older adults on cognitive function and associated blood biomarkers. In a randomised, double blind, placebo-controlled trial, healthy women (n = 68) and men (n = 48) aged 55–65 years were supplemented daily for 16 weeks with women’s and men’s formula multivitamin supplements. Assessments at baseline and post-supplementation included computerised cognitive tasks and blood biomarkers relevant to cognitive aging. No cognitive improvements were observed after supplementation with either formula; however, several significant improvements were observed in blood biomarkers including increased levels of vitamins B6 and B12 in women and men; reduced C-reactive protein in women; reduced homocysteine and marginally reduced oxidative stress in men; as well as improvements to the lipid profile in men. In healthy older people, multivitamin supplementation improved a number of blood biomarkers that are relevant to cognition, but these biomarker changes were not accompanied by improved cognitive function. PMID:25996285

Functional training reduces body fat and improves functional fitness and cholesterol levels in postmenopausal women: a randomized clinical trial.

PubMed

Neves, Lucas M; Fortaleza, Ana C; Rossi, Fabrício E; Diniz, Tiego A; Codogno, Jamile S; Gobbo, Luis A; Gobbi, Sebastião; Freitas, Ismael F

2017-04-01

This randomized clinical trial with concealed allocations, and blinding of the assessors and the data analyst, was aimed at determining the effects of 16 weeks of functional training on the body composition, functional fitness and lipid profiles in postmenopausal women. The study began with 64 subjects (N.=32 functional training and N.=32 control group) and ended with 50 subjects (N.=28 functional training and N.=22 control group). The exercise was conducted in circuit training format with 8 stations related to the development of muscular strength (using elastic bands for resistance) plus 3 stations focused on balance, coordination, and agility. The training session also incorporated an 18 to 30 minute walk. The control group did not participate in the exercise programs during the period of study. The participants were evaluated before and after the training period as regards their body composition (fat and lean mass), functional fitness, abdominal strength and blood chemistry variables. Significant reductions were observed in all body composition variables related to fat (FM= -3.4 and Android FM= -7.7%) (P<0.05). The functional fitness components had significant improvements in coordination (-33.3%), strength (66.5%), agility (-19.5%) and aerobic capacity (-7%), and significant improvement in abdominal strength (188.2%). We observed significant improvements in total cholesterol (-4.4%) and HDL (-9.9%). The observed data lead us to conclude that functional training utilizing with elastic bands and unstable bases causes significantly improved in body composition, functional fitness and lipid profiles.

The use of low-level laser therapy (LLLT) in the treatment of trigger points that are associated with rotator cuff tendonitis

NASA Astrophysics Data System (ADS)

Al-Shenqiti, A.; Oldham, J.

2003-12-01

The purpose of this study was to investigate the efficacy of LLLT in the treatment of trigger points (TrPs) that are associated with rotator cuff tendonitis. A double-blind randomized controlled trail was conducted. Sixty patients were randomly allocated to one of two groups: sham or laser therapy. The laser (Excel, Omega Universal Technologies Ltd, London, UK) parameters used were a wavelength of 820 nm, a power output of 100 mW, a frequency of 5000 Hz (modulated) and energy density of 32 J/cm2. The two groups received a course of 12 treatment sessions for four weeks (3 sessions per week). Pain, functional activities (as measured using the Shoulder Pain and Disability Index, SPADI), pressure pain threshold (PPT) and range of motion (ROM) were assessed pre and post treatment, with a three month follow-up assessment. Significant improvements in pain (p < 0.001) were observed for the laser group (6 cm median improvement on a 10 cm VAS) compared to the sham group (2 cm median improvement) immediately post treatment. The improvements in the laser group continued post treatment with a 7 cm median improvement observed at three month follow-up. Similar between group differences were observed for ROM (p < 0.01), functional activities (p <= 0.001) and PPT (p <= 0.05). The findings of the current study suggested that LLLT is effective in treating patients with TrPs associated with rotator cuff tendonitis, when using the parameters described. However, the mechanism of its action is not yet clear, and will require further investigation.

Improving Arctic Sea Ice Observations and Data Access to Support Advances in Sea Ice Forecasting

NASA Astrophysics Data System (ADS)

Farrell, S. L.

2017-12-01

The economic and strategic importance of the Arctic region is becoming apparent. One of the most striking and widely publicized changes underway is the declining sea ice cover. Since sea ice is a key component of the climate system, its ongoing loss has serious, and wide-ranging, socio-economic implications. Increasing year-to-year variability in the geographic location, concentration, and thickness of the Arctic ice cover will pose both challenges and opportunities. The sea ice research community must be engaged in sustained Arctic Observing Network (AON) initiatives so as to deliver fit-for-purpose remote sensing data products to a variety of stakeholders including Arctic communities, the weather forecasting and climate modeling communities, industry, local, regional and national governments, and policy makers. An example of engagement is the work currently underway to improve research collaborations between scientists engaged in obtaining and assessing sea ice observational data and those conducting numerical modeling studies and forecasting ice conditions. As part of the US AON, in collaboration with the Interagency Arctic Research Policy Committee (IARPC), we are developing a strategic framework within which observers and modelers can work towards the common goal of improved sea ice forecasting. Here, we focus on sea ice thickness, a key varaible of the Arctic ice cover. We describe multi-sensor, and blended, sea ice thickness data products under development that can be leveraged to improve model initialization and validation, as well as support data assimilation exercises. We will also present the new PolarWatch initiative (polarwatch.noaa.gov) and discuss efforts to advance access to remote sensing satellite observations and improve communication with Arctic stakeholders, so as to deliver data products that best address societal needs.

Quantifying Vegetation Structure with Lightweight, Rapid-Scanning Terrestrial Lidar

NASA Astrophysics Data System (ADS)

Paynter, I.; Genest, D.; Saenz, E. J.; Strahler, A. H.; Li, Z.; Peri, F.; Schaaf, C.

2016-12-01

Light Detection and Ranging (lidar) is proving a competent technology for observing vegetation structure. Terrestrial laser scanners (TLS) are ground-based instruments which utilize hundreds of thousands to millions of lidar observations to provide detailed structural and reflective information of their surroundings. TLS has enjoyed initial success as a validation tool for satellite and airborne estimates of vegetation structure, and are producing independent estimates with increasing accuracy. Reconstruction techniques for TLS observations of vegetation have also improved rapidly, especially for trees. However, uncertainties and challenges still remain in TLS modelling of vegetation structure, especially in geometrically complex ecosystems such as tropical forests (where observation extent and density is hampered by occlusion) and highly temporally dynamic coastal ecosystems (such as saltmarshes and mangroves), where observations may be restricted to narrow microstates. Some of these uncertainties can be mitigated, and challenges met, through the use of lidar instruments optimized for favorable deployment logistics through low weight, rapid scanning, and improved durability. We have conducted studies of vegetation structure in temperate and tropical forests, saltmarshes and mangroves, utilizing a highly portable TLS with considerable deployment flexibility, the Compact Biomass Lidar (CBL). We show results from studies in the temperate Long Term Ecological Research site of Harvard Forest (MA, USA); the tropical forested long-term Carbono sites of La Selva Biological Station (Sarapiqui, Costa Rica); and the saltmarsh LTER of Plum Island (MA, USA). These results demonstrate the improvements to observations in these ecosystems which are facilitated by the specifications of the CBL (and similar TLS) which are optimized for favorable deployment logistics and flexibility. We show the benefits of increased numbers of scanning positions, and specialized deployment platforms to meet ecosystem challenges.

Experiments for improved positioning by means of integrated Doppler satellite observations and the NNSS broadcast ephemeris

NASA Technical Reports Server (NTRS)

Arur, M. G.

1977-01-01

An effort to improve station position recovery using broadcast ephemeris in Doppler data reduction was studied. A comparison of precise and broadcast ephemerides, treating the former as the standard, yielded information about the state disturbance that can be associated with the broadcast ephemeris. Statistical information about the state disturbance was used with current observational data for improved position recovery. The rank deficiency problem encountered in the short arc geodetic adjustment procedure was analysed and it was deduced that the fundamental rank deficiency is six, scale information being derivable from the wavelength of transmission. Coordinate differences between stations coobserving a pass are estimable. The uncertainty of the broadcast ephemeris, now in the WGS72 system, was assessed. It was conservatively estimated that its positional uncertainty may vary between 19 to 26 m in-track, 15 to 20 m cross-track and 9 to 10 m in radial directions depending on the incidence of the epoch of observations in the interinjection period.

The utilization of mind map painting on 3D shapes with curved faces

NASA Astrophysics Data System (ADS)

Nur Sholikhah, Ayuk; Usodo, Budi; Pramudya, Ikrar

2017-12-01

This paper aims to study on the use of mind map painting media on material with 3D shapes with curved faces and its effect on student’s interest. Observation and literature studies were applied as the research method with the sake design of utilization of mind map painting. The result of this research is the design of mind map painting media can improve students' ability to solve problems, improve the ability to think, and maximize brain power. In relation, mind map painting in learning activities is considered to improve student interest.

Compliance with Seat Belt Use in Makurdi, Nigeria: An Observational Study

PubMed Central

Popoola, SO; Oluwadiya, KS; Kortor, JN; Denen-Akaa, P; Onyemaechi, NOC

2013-01-01

Background: Seat belts are designed to reduce injuries due to road crash among vehicle occupants. Aims: This study aims to determine the availability of seat belt in vehicles and compliance with seat belt use among vehicle occupants. Materials and methods: This was a 24-h direct observational study of seat belt usage among vehicle occupants in Makurdi, Benue State, Nigeria. By direct surveillance and using a datasheet, we observed 500 vehicles and their occupants for seat belt availability and compliance with its use. Chi-square test was used for test of significance between variables. Results: Twenty-five (5.0%) of the observed 500 vehicles had no seat belt at all. Overall, compliance was 277/486 (57.0%). Use of seat belt was highest in the afternoon with 124/194 (64.4%), followed by 111/188 (59.0%) in the morning and 42/95 (44.2%) at night. Compliance was highest among car occupants [209/308 (67.9%)] and private vehicles, and lowest among commercial vehicle occupants. Compliance among female drivers was 77.1% compared with 51.4% among male drivers. Among drivers, the mean age of seat belt users was 38.4 (7.7) years, which was significantly younger than the 41.3 (8.7) years mean age of non-users. Similar figures were obtained among other vehicle occupants. Conclusions: Compared with previous studies, seat belt usage has improved among Nigerian road users, but there is still room for improvement, especially early in the mornings and at nights. Since these were times when law enforcement agencies were not likely to be on the roads, we advocate for improved coverage by enforcement agents to enforce better compliance. PMID:24116327

Prospective Epidemiological Observations on the Course of the Disease in Fibromyalgia Patients

PubMed Central

Nöller, Vera; Sprott, Haiko

2003-01-01

Objectives The aim of the study was to carry out a survey in patients with fibromyalgia (FM), to examine their general health status and work incapacity (disability-pension status), and their views on the effectiveness of therapy received, over a two-year observation period. Methods 48 patients diagnosed with FM, according to the American College of Rheumatology (ACR) criteria, took part in the study. At baseline, and on average two years later, the patients underwent clinical investigation (dolorimetry, laboratory diagnostics, medical history taking) and completed the Fibromyalgia questionnaire (Dettmer and Chrostek [1]). Results 27/48 (56%) patients participated in the two-year follow-up. In general, the patients showed no improvement in their symptoms over the observation period, regardless of the type of therapy they had received. General satisfaction with quality of life improved, as did satisfaction regarding health status and the family situation, although the degree of pain experienced remain unchanged. In comparison with the initial examination, there was no change in either work-capacity or disability-pension status. Conclusions The FM patients showed no improvement in pain, despite the many various treatments received over the two-year period. The increase in general satisfaction over the observation period was believed to be the result of patient instruction and education about the disease. To what extent a population of patients with FM would show similar outcomes if they did not receive any instruction/education about their disorder, cannot be ascertained from the present study; and, indeed, the undertaking of a study to investigate this would be ethically questionable. As present, no conclusions can be made regarding the influence of therapy on the primary and secondary costs associated with FM. PMID:12969513

Improving patient safety during insertion of peripheral venous catheters: an observational intervention study

PubMed Central

Kampf, Günter; Reise, Gesche; James, Claudia; Gittelbauer, Kirsten; Gosch, Jutta; Alpers, Birgit

2013-01-01

Background: Peripheral venous catheters are frequently used in hospitalized patients but increase the risk of nosocomial bloodstream infection. Evidence-based guidelines describe specific steps that are known to reduce infection risk. However, the degree of guideline implementation in clinical practice is not known. The aim of this study was to determine the use of specific steps for insertion of peripheral venous catheters in clinical practice and to implement a multimodal intervention aimed at improving both compliance and the optimum order of the steps. Methods: The study was conducted at University Hospital Hamburg. An optimum procedure for inserting a peripheral venous catheter was defined based on three evidence-based guidelines (WHO, CDC, RKI) including five steps with 1A or 1B level of evidence: hand disinfection before patient contact, skin antisepsis of the puncture site, no palpation of treated puncture site, hand disinfection before aseptic procedure, and sterile dressing on the puncture site. A research nurse observed and recorded procedures for peripheral venous catheter insertion for healthcare workers in four different departments (endoscopy, central emergency admissions, pediatrics, and dermatology). A multimodal intervention with 5 elements was established (teaching session, dummy training, e-learning tool, tablet and poster, and direct feedback), followed by a second observation period. During the last observation week, participants evaluated the intervention. Results: In the control period, 207 insertions were observed, and 202 in the intervention period. Compliance improved significantly for four of five steps (e.g., from 11.6% to 57.9% for hand disinfection before patient contact; p<0.001, chi-square test). Compliance with skin antisepsis of the puncture site was high before and after intervention (99.5% before and 99.0% after). Performance of specific steps in the correct order also improved (e.g., from 7.7% to 68.6% when three of five steps were done; p<0.001). The intervention was described as helpful by 46.8% of the participants, as neutral by 46.8%, and as disruptive by 6.4%. Conclusions: A multimodal strategy to improve both compliance with safety steps for peripheral venous catheter insertion and performance of an optimum procedure was effective and was regarded helpful by healthcare workers. PMID:24327944

Evaluating and improving a model of nursing care delivery: a process of partnership.

PubMed

Hall, Catherine; McCutcheon, Helen; Deuter, Kate; Matricciani, Lisa

2012-01-01

Evaluating and improving a model of nursing care is a fundamental part of clinical practice improvement. While Australian nurses are showing increasing interest in improving models of care delivery, more research is needed that addresses and articulates the processes attendant upon evaluating, re-designing and implementing improvements to the provision of nursing care. Providing nurses with an open opportunity to plan, act, observe and reflect on their practice promotes successful partnerships between academics and clinicians. The aim of this study was to evaluate and improve the model of nursing care delivery to patients in a general surgical ward using participatory action research. Researchers conducted non-participant observations (n = 9) of two hours duration across the 24 h period. Focus groups (n = 3) were used to share non-participant observation data with staff, providing them with an opportunity to reflect on their practice and explore possible solutions. Data was collected in 2008-2009. Two main problem areas were identified as impeding the nurses' ability to provide care to patients: (i) practices and behaviours of nurses and (ii) infrastructure and physical layout of the ward. An overview of issues within each problem area is presented. Shifting the focus of task-centred care towards a more patient-centred care approach, results directly in improvements in resource utilisation, improved cost-effectiveness and job satisfaction for nursing staff. New ways of thinking about nursing processes and systems, workflow design and skill allocation will guide hospital administrators and managers in the effective and efficient allocation of nursing work in similar settings.

Sustaining Fidelity Following the Nationwide PMTO™ Implementation in Norway

PubMed Central

Forgatch, Marion S.; DeGarmo, David S.

2011-01-01

This report describes three studies from the nationwide Norwegian implementation of Parent Management Training – Oregon Model (PMTO™), an empirically supported treatment for families of children with behavior problems (Forgatch and Patterson 2010). Separate stages of the implementation were evaluated using a fidelity measure based on direct observation of intervention sessions. Study 1 assessed growth in fidelity observed early, mid, and late in the training of a group of practitioners. We hypothesized increased fidelity and decreased variability in practice. Study 2 evaluated method fidelity over the course of three generations of practitioners trained in PMTO. Generation 1 (G1) was trained by the PMTO developer/purveyors; Generation 2 (G2) was trained by selected G1 Norwegian trainers; and Generation 3 (G3) was trained by G1 and G2 trainers. We hypothesized decrease in fidelity with each generation. Study 3 tested the predictive validity of fidelity in a cross-cultural replication, hypothesizing that higher fidelity scores would correlate with improved parenting practices observed in parent-child interactions before and after treatment. In Study 1, trainees' performance improved and became more homogeneous as predicted. In Study 2, a small decline in fidelity followed the transfer from the purveyor trainers to Norwegian trainers in G2, but G3 scores were equivalent to those attained by G1. Thus, the hypothesis was not fully supported. Finally, the FIMP validity model replicated; PMTO fidelity significantly contributed to improvements in parenting practices from pre- to post-treatment. The data indicate that PMTO was transferred successfully to Norwegian implementation with sustained fidelity and cross-cultural generalization. PMID:21671090

Efficacy and tolerability of rasagiline in daily clinical use--a post-marketing observational study in patients with Parkinson's disease.

PubMed

Reichmann, H; Jost, W H

2010-09-01

The MAO-B inhibitor rasagiline is indicated for the treatment of idiopathic Parkinson's disease (PD), and its use is supported by evidence from large-scale, controlled clinical studies. The post-marketing observational study presented here investigated the efficacy and tolerability of rasagiline treatment (monotherapy or combination therapy) in daily clinical practice. The study included patients with idiopathic PD who received rasagiline (recommended dose 1 mg, once daily) as monotherapy or combination therapy. The treatment and observation period was approximately 4 months. Outcome measures included the change from baseline in the Columbia University Rating Scale (CURS), the Unified PD Rating Scale fluctuation subscale, daily OFF time (patient home diaries) and the PD Questionnaire-39. Adverse drug reactions/adverse events (ADRs/AEs) and the physician's global judgement of tolerability and efficacy were also examined. Overall, 754 patients received rasagiline during the study. Patients treated with rasagiline (monotherapy or combination therapy) showed significant improvements from baseline in symptom severity (including classical motor and non-classical motor/non-motor symptoms) and quality of life (QoL). Patients receiving combination therapy also experienced significant reductions in daily OFF time. Tolerability was rated as good/very good in over 90% of patients. In daily clinical practice, monotherapy or combination therapy with rasagiline is able to improve PD symptoms, reduce OFF time, and improve QoL, whilst demonstrating favourable tolerability. In addition, rasagiline has a simple dosing schedule of one tablet, once daily, with no titration. These results are consistent with the pivotal rasagiline clinical studies (TEMPO, LARGO and PRESTO).

[Changes in quality of life and work function during phase prophylactic lamotrigine treatment in bipolar patients: 6 month, prospective, observational study].

PubMed

Gonda, Xenia; Kalman, Janos; Dome, Peter; Rihmer, Zoltan

2016-03-01

Bipolar disorder is a lifelong illness requiring lifelong pharmacotherapy. Therefore besides symptomatic remission, achievement of full work-related functioning and restoration of quality of life is a priority during successful treatment. The present prospective, observational, non-intervention study focused on investigating the effect of lamotrigine therapy on the quality of life and work-related function of bipolar patients in outpatient care. 969 bipolar or schizoaffective outpatients participated in the study who previously did not receive lamotrigine therapy. Our present phase-prophylactic study was a prospective, observational, non-intervention study with a six-month follow-up. Evaluations took place at baseline and at months 1, 2, 3 and 6. Patients were followed with a Clinical Global Impression-Severity (CGI-S) and Clinical Global Impression-Improvement (CGI-I). Changes in work-related function was evaluated using Social Adjustment Scale (SAS), while quality of life was assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) scale. SAS scoreds showed a consistent decrease in the overall sample and in all CGI-S initial groups reflecting the improvement of work-related function during the six months of the follow-up. Q-LES-Q values in the whole sample and in all initial CGI-S groups showed a steady increase indicating a continuous increase in quality of life during the study. Our results indicate that during long-term prophylactic lamotrigine therapy the work function and quality of life of bipolar patients shows a significant improvement, therefore lamotrigine provides a possibility for full functional remission and restoration of quality of life.

Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal infection research.

PubMed

Fitchett, Elizabeth J A; Seale, Anna C; Vergnano, Stefania; Sharland, Michael; Heath, Paul T; Saha, Samir K; Agarwal, Ramesh; Ayede, Adejumoke I; Bhutta, Zulfiqar A; Black, Robert; Bojang, Kalifa; Campbell, Harry; Cousens, Simon; Darmstadt, Gary L; Madhi, Shabir A; Meulen, Ajoke Sobanjo-Ter; Modi, Neena; Patterson, Janna; Qazi, Shamim; Schrag, Stephanie J; Stoll, Barbara J; Wall, Stephen N; Wammanda, Robinson D; Lawn, Joy E

2016-10-01

Neonatal infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines. Copyright © 2016 Elsevier Ltd. All rights reserved.

Tropical cyclones-Pacific Asian Research Campaign for Improvement of Intensity estimations/forecasts (T-PARCII): A research plan of typhoon aircraft observations in Japan

NASA Astrophysics Data System (ADS)

Tsuboki, Kazuhisa

2017-04-01

Typhoons are the most devastating weather system occurring in the western North Pacific and the South China Sea. Violent wind and heavy rainfall associated with a typhoon cause huge disaster in East Asia including Japan. In 2013, Supertyphoon Haiyan struck the Philippines caused a very high storm surge and more than 7000 people were killed. In 2015, two typhoons approached the main islands of Japan and severe flood occurred in the northern Kanto region. Typhoons are still the largest cause of natural disaster in East Asia. Moreover, many researches have projected increase of typhoon intensity with the climate change. This suggests that a typhoon risk is increasing in East Asia. However, the historical data of typhoon include large uncertainty. In particular, intensity data of the most intense typhoon category have larger error after the US aircraft reconnaissance of typhoon was terminated in 1987.The main objective of the present study is improvements of typhoon intensity estimations and of forecasts of intensity and track. We will perform aircraft observation of typhoon and the observed data are assimilated to numerical models to improve intensity estimation. Using radars and balloons, observations of thermodynamical and cloud-microphysical processes of typhoons will be also performed to improve physical processes of numerical model. In typhoon seasons (mostly in August and September), we will perform aircraft observations of typhoons. Using dropsondes from the aircraft, temperature, humidity, pressure, and wind are measured in surroundings of the typhoon inner core region. The dropsonde data are assimilated to a cloud-resolving model which has been developed in Nagoya University and named the Cloud Resolving Storm Simulator (CReSS). Then, more accurate estimations and forecasts of the typhoon intensity will be made as well as typhoon tracks. Furthermore, we will utilize a ground-based balloon with microscope camera, X-band precipitation radar, Ka-band cloud radar, aerosol sonde, and a drone to observe typhoon-associated clouds and precipitation. After a test flight in March 2017, typhoon observations will be made for next 4 years; 2017-2020. The main target area of observation is the south of Okinawa where a typhoon reaches the maximum intensity and often changes its moving direction. This research will advance aircraft observation technique of typhoon in Japan. The aircraft observation will be a breakthrough to improve typhoon intensity estimations. Assimilation of the aircraft observation data to the cloud-resolving model will improve intensity estimations and forecasts of typhoons. This is the first step for the future advanced aircraft observation and will contribute to prevention or reduction of typhoon disasters.

Solid Polymer Electrolyte (SPE) fuel cell technology program

NASA Technical Reports Server (NTRS)

1978-01-01

Many previously demonstrated improved fuel cell features were consolidated to (1) obtain a better understanding of the observed characteristics of the operating laboratory-sized cells; (2) evaluate appropriate improved fuel cell features in 0.7 sq ft cell hardware; and (3) study the resultant fuel cell capability and determine its impact on various potential fuel cell space missions. The observed performance characteristics of the fuel cell at high temperatures and high current densities were matched with a theoretical model based on the change in Gibbs free energy voltage with respect to temperature and internal resistance change with current density. Excellent agreement between the observed and model performance was obtained. The observed performance decay with operational time on cells with very low noble metal loadings (0.05 mg/sq cm) were shown to be related to loss in surface area. Cells with the baseline amount of noble catalyst electrode loading demonstrated over 40,000 hours of stable performance.

Telescope Scientist on the Advanced X-ray Astrophysics Observatory

NASA Technical Reports Server (NTRS)

VanSpeybroeck, L.; Smith, Carl M. (Technical Monitor)

2002-01-01

This period included many scientific observations made with the Chandra Observatory. The results, as is well known, are spectacular. Fortunately, the High Resolution Mirror Assembly (HRMA) performance continues to be essentially identical to that predicted from ground calibration data. The Telescope Scientist Team has improved the mirror model to provide a more accurate description to the Chandra observers and enable them to reduce the systematic errors and uncertainties in their data reduction. We also have made considerable progress in improving the scattering model. There also has been progress in the scientific program. At this time 58 distant clusters of galaxies have been observed. We are performing a systematic analysis of this rather large data set for the purpose of determining absolute distances utilizing the Sunyaev Zel'dovich effect. These observations also have been used to study the evolution of the cluster baryon mass function and the cosmological constraints which result from this evolution.

Classroom Walkthroughs: Does Such an Approach to Supervision Contribute to District Improvement?

ERIC Educational Resources Information Center

Fields, Cary

2013-01-01

The purpose of this study was to examine what types of data collection currently exist and what kind of information should be provided through a walkthrough observation process that attempts to enhance teaching practice, contribute to student learning and assist a district's overall improvement planning. In fulfilling this purpose the…

Repeated Measures in Case Studies Relating Social Competence and Weight Loss in Two Obese Adolescents

ERIC Educational Resources Information Center

Meyer, Sonia Beatriz; Barbosa, Debora Regina

2007-01-01

In individual behavior therapy two clients were evaluated using behavior categories created by the therapist. Both clients were observed to improve in terms of social competence. One demonstrated a significant inverse correlation between improvement of social competence and weight loss during treatment (16 sessions) and lost weight. The other…

Repeated Measures in Case Studies Relating Social Competence and Weight Loss in Two Obese Adolescents

ERIC Educational Resources Information Center

Meyer, Sonia Beatriz; Barbosa, Debora Regina

2009-01-01

In individual behavior therapy two clients were evaluated using behavior categories created by the therapist. Both clients were observed to improve in terms of social competence. One demonstrated a significant inverse correlation between improvement of social competence and weight loss during treatment (16 sessions) and lost weight. The other…

Improving Process Writing with the Use Authentic Assessment

ERIC Educational Resources Information Center

bin Abdul Aziz, Muhammad Noor; Yusoff, Nurahimah Mohd

2016-01-01

The paper discusses on how process writing is improved with the use of authentic assessment in an English Language classroom. Eleven primary school children from Year 4 in a rural school in Sabah are the participants of the study. Data were collected by observing them during the English Language lessons and at the end of the series of…

Lessons Learned from Secondary Schools Using Technology for School Improvement: It's Just Not That Simple!

ERIC Educational Resources Information Center

Levin, Barbara B.; Schrum, Lynne

2014-01-01

The purpose of this article is to describe lessons learned from studying the leadership in eight award-winning secondary schools and districts that were recognized for successfully leveraging technology as part of their efforts for school improvement. Data were collected through observations, interviews, and document analysis in schools and…

Evaluation of Knowledge Development in a Healthcare Setting

NASA Astrophysics Data System (ADS)

Schaffer, Scott P.

Healthcare organizations worldwide have recently increased efforts to improve performance, quality, and knowledge transfer using information and communication technologies. Evaluation of the effectiveness and quality of such efforts is challenging. A macro and micro-level system evaluation conducted with a 14000 member US hospital administrative services organization examined the appropriateness of a blended face-to-face and technology-enabled performance improvement and knowledge development system. Furthermore, a successful team or microsystem in a high performing hospital was studied in-depth. Several types of data methods including interview, observation, and questionnaire were used to address evaluation questions within a knowledge development framework created for the study. Results of this preliminary study focus on how this organization attempted to organize clinical improvement efforts around quality and performance improvement processes supported by networked technologies.

Epidemiology, quality and reporting characteristics of meta-analyses of observational studies published in Chinese journals.

PubMed

Zhang, Zhe-wen; Cheng, Juan; Liu, Zhuan; Ma, Ji-chun; Li, Jin-long; Wang, Jing; Yang, Ke-hu

2015-12-07

The aim of this study was to examine the epidemiological and reporting characteristics as well as the methodological quality of meta-analyses (MAs) of observational studies published in Chinese journals. 5 Chinese databases were searched for MAs of observational studies published from January 1978 to May 2014. Data were extracted into Excel spreadsheets, and Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Assessment of Multiple Systematic Reviews (AMSTAR) checklists were used to assess reporting characteristics and methodological quality, respectively. A total of 607 MAs were included. Only 52.2% of the MAs assessed the quality of the included primary studies, and the retrieval information was not comprehensive in more than half (85.8%) of the MAs. In addition, 50 (8.2%) MAs did not search any Chinese databases, while 126 (20.8%) studies did not search any English databases. Approximately 41.2% of the MAs did not describe the statistical methods in sufficient details, and most (95.5%) MAs did not report on conflicts of interest. However, compared with the before publication of the MOOSE Checklist, the quality of reporting improved significantly for 20 subitems after publication of the MOOSE Checklist, and 7 items of the included MAs demonstrated significant improvement after publication of the AMSTAR Checklist (p<0.05). Although many MAs of observational studies have been published in Chinese journals, the reporting quality is questionable. Thus, there is an urgent need to increase the use of reporting guidelines and methodological tools in China; we recommend that Chinese journals adopt the MOOSE and AMSTAR criteria. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Modifying patterns of movement in people with low back pain -does it help? A systematic review.

PubMed

Laird, Robert A; Kent, Peter; Keating, Jennifer L

2012-09-07

Physiotherapy for people with low back pain frequently includes assessment and modification of lumbo-pelvic movement. Interventions commonly aim to restore normal movement and thereby reduce pain and improve activity limitation. The objective of this systematic review was to investigate: (i) the effect of movement-based interventions on movement patterns (muscle activation, lumbo-pelvic kinematics or postural patterns) of people with low back pain (LBP), and (ii) the relationship between changes in movement patterns and subsequent changes in pain and activity limitation. MEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2012. Randomised controlled trials or controlled clinical trials of people with LBP were eligible for inclusion. The intervention must have been designed to influence (i) muscle activity patterns, (ii) lumbo-pelvic kinematic patterns or (iii) postural patterns, and included measurement of such deficits before and after treatment, to allow determination of the success of the intervention on the lumbo-pelvic movement. Twelve trials (25% of retrieved studies) met the inclusion criteria. Two reviewers independently identified, assessed and extracted data. The PEDro scale was used to assess method quality. Intervention effects were described using standardised differences between group means and 95% confidence intervals. The included trials showed inconsistent, mostly small to moderate intervention effects on targeted movement patterns. There was considerable heterogeneity in trial design, intervention type and outcome measures. A relationship between changes to movement patterns and improvements in pain or activity limitation was observed in one of six studies on muscle activation patterns, one of four studies that examined the flexion relaxation response pattern and in two of three studies that assessed lumbo-pelvic kinematics or postural characteristics. Movement-based interventions were infrequently effective for changing observable movement patterns. A relationship between changes in movement patterns and improvement in pain or activity limitation was also infrequently observed. No independent studies confirm any observed relationships. Challenges for future research include defining best methods for measuring (i) movement aberrations, (ii) improvements in movements, and (iii) the relationship between changes in how people move and associated changes in other health indicators such as activity limitation.

Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial.

PubMed

Michopoulos, Vasiliki; Mancini, Fulvia; Loucks, Tammy L; Berga, Sarah L

2013-06-01

To determine whether cognitive behavior therapy (CBT), which we had shown in a previous study to restore ovarian function in women with functional hypothalamic amenorrhea (FHA), could also ameliorate hypercortisolemia and improve other neuroendocrine and metabolic concomitants of in FHA. Randomized controlled trial. Clinical research center at an academic medical university. Seventeen women with FHA were randomized either to CBT or observation. CBT versus observation. Circulatory concentrations of cortisol, leptin, thyroid-stimulating hormone (TSH), total and free thyronine (T(3)), and total and free thyroxine (T(4)) before and immediately after completion of CBT or observation. (Each woman served as her own control.) Cognitive behavior therapy but not observation reduced cortisol levels in women with FHA. There were no changes in cortisol, leptin, TSH, T(3), or T(4) levels in women randomized to observation. Women treated with CBT showed increased levels of leptin and TSH, but their levels of T(3) and T(4) remained unchanged. In women with FHA, CBT ameliorated hypercortisolism and improved the neuroendocrine and metabolic concomitants of FHA while observation did not. We conclude that a cognitive, nonpharmacologic approach aimed at alleviating problematic attitudes not only can restore ovarian activity but also improve neuroendocrine and metabolic function in women with FHA. NCT01674426. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

In situ Observations of Heliospheric Current Sheets Evolution

NASA Astrophysics Data System (ADS)

Liu, Yong; Peng, Jun; Huang, Jia; Klecker, Berndt

2017-04-01

We investigate the Heliospheric current sheet observation time difference of the spacecraft using the STEREO, ACE and WIND data. The observations are first compared to a simple theory in which the time difference is only determined by the radial and longitudinal separation between the spacecraft. The predictions fit well with the observations except for a few events. Then the time delay caused by the latitudinal separation is taken in consideration. The latitude of each spacecraft is calculated based on the PFSS model assuming that heliospheric current sheets propagate at the solar wind speed without changing their shapes from the origin to spacecraft near 1AU. However, including the latitudinal effects does not improve the prediction, possibly because that the PFSS model may not locate the current sheets accurately enough. A new latitudinal delay is predicted based on the time delay using the observations on ACE data. The new method improved the prediction on the time lag between spacecraft; however, further study is needed to predict the location of the heliospheric current sheet more accurately.

Assimilation of Tropical Cyclone Track and Wind Radius Data with an Ensemble Kalman Filter

NASA Astrophysics Data System (ADS)

Kunii, M.

2014-12-01

Improving tropical cyclone (TC) forecasts is one of the most important issues in meteorology, but TC intensity forecasts are a challenging task. Because the lack of observations near TCs usually results in degraded accuracy of initial fields, utilizing TC advisory data in data assimilation typically has started with an ensemble Kalman filtering (EnKF). In this study, TC intensity and position information was directly assimilated using the EnKF, and the impact of these observations was investigated by comparing different assimilation strategies. Another experiment with TC wind radius data was carried out to examine the influence of TC shape parameters. Sensitivity experiments indicated that the assimilation of TC intensity and position data yielded results that were superior to those based on conventional assimilation of TC minimum sea level pressure as a standard surface pressure observation. Assimilation of TC radius data modified TC outer circulations closer to observations. The impacts of these TC parameters were also evaluated using the case of Typhoon Talas in 2011. The TC intensity, position, and wind radius data led to improved TC track forecasts and thence to improved precipitation forecasts. These results imply that initialization with these TC-related observations benefits TC forecasts, offering promise for the prevention and mitigation of natural disasters caused by TCs.

Improved imputation accuracy in Hispanic/Latino populations with larger and more diverse reference panels: applications in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

PubMed Central

Nelson, Sarah C.; Stilp, Adrienne M.; Papanicolaou, George J.; Taylor, Kent D.; Rotter, Jerome I.; Thornton, Timothy A.; Laurie, Cathy C.

2016-01-01

Imputation is commonly used in genome-wide association studies to expand the set of genetic variants available for analysis. Larger and more diverse reference panels, such as the final Phase 3 of the 1000 Genomes Project, hold promise for improving imputation accuracy in genetically diverse populations such as Hispanics/Latinos in the USA. Here, we sought to empirically evaluate imputation accuracy when imputing to a 1000 Genomes Phase 3 versus a Phase 1 reference, using participants from the Hispanic Community Health Study/Study of Latinos. Our assessments included calculating the correlation between imputed and observed allelic dosage in a subset of samples genotyped on a supplemental array. We observed that the Phase 3 reference yielded higher accuracy at rare variants, but that the two reference panels were comparable at common variants. At a sample level, the Phase 3 reference improved imputation accuracy in Hispanic/Latino samples from the Caribbean more than for Mainland samples, which we attribute primarily to the additional reference panel samples available in Phase 3. We conclude that a 1000 Genomes Project Phase 3 reference panel can yield improved imputation accuracy compared with Phase 1, particularly for rare variants and for samples of certain genetic ancestry compositions. Our findings can inform imputation design for other genome-wide association studies of participants with diverse ancestries, especially as larger and more diverse reference panels continue to become available. PMID:27346520

High Performing Ternary Solar Cells through Förster Resonance Energy Transfer between Nonfullerene Acceptors.

PubMed

Yang, Lei; Gu, Wenxing; Hong, Ling; Mi, Yang; Liu, Feng; Liu, Ming; Yang, Yufei; Sharma, Bigyan; Liu, Xinfeng; Huang, Hui

2017-08-16

Nonradiative Förster resonance energy transfer (FRET) is an important mechanism of organic solar cells, which can improve the exciton migration over a long distance, resulting in improvement of efficiency of solar cells. However, the current observations of FRET are very limited, and the efficiencies are less than 9%. In this study, FRET effect was first observed between two nonfullerene acceptors in ternary solar cells, which improved both the absorption range and exciton harvesting, leading to the dramatic enhancement in the short circuit current and power conversion efficiency. Moreover, this strategy is proved to be a versatile platform for conjugated polymers with different bandgaps, resulting in a remarkable efficiency of 10.4%. These results demonstrated a novel method to enhance the efficiency of organic soar cells.

Exploring the influence of citizen involvement on the assimilation of crowdsourced observations: a modelling study based on the 2013 flood event in the Bacchiglione catchment (Italy)

NASA Astrophysics Data System (ADS)

Mazzoleni, Maurizio; Cortes Arevalo, Vivian Juliette; Wehn, Uta; Alfonso, Leonardo; Norbiato, Daniele; Monego, Martina; Ferri, Michele; Solomatine, Dimitri P.

2018-01-01

To improve hydrological predictions, real-time measurements derived from traditional physical sensors are integrated within mathematic models. Recently, traditional sensors are being complemented with crowdsourced data (social sensors). Although measurements from social sensors can be low cost and more spatially distributed, other factors like spatial variability of citizen involvement, decreasing involvement over time, variable observations accuracy and feasibility for model assimilation play an important role in accurate flood predictions. Only a few studies have investigated the benefit of assimilating uncertain crowdsourced data in hydrological and hydraulic models. In this study, we investigate the usefulness of assimilating crowdsourced observations from a heterogeneous network of static physical, static social and dynamic social sensors. We assess improvements in the model prediction performance for different spatial-temporal scenarios of citizen involvement levels. To that end, we simulate an extreme flood event that occurred in the Bacchiglione catchment (Italy) in May 2013 using a semi-distributed hydrological model with the station at Ponte degli Angeli (Vicenza) as the prediction-validation point. A conceptual hydrological model is implemented by the Alto Adriatico Water Authority and it is used to estimate runoff from the different sub-catchments, while a hydraulic model is implemented to propagate the flow along the river reach. In both models, a Kalman filter is implemented to assimilate the crowdsourced observations. Synthetic crowdsourced observations are generated for either static social or dynamic social sensors because these measures were not available at the time of the study. We consider two sets of experiments: (i) assuming random probability of receiving crowdsourced observations and (ii) using theoretical scenarios of citizen motivations, and consequent involvement levels, based on population distribution. The results demonstrate the usefulness of integrating crowdsourced observations. First, the assimilation of crowdsourced observations located at upstream points of the Bacchiglione catchment ensure high model performance for high lead-time values, whereas observations at the outlet of the catchments provide good results for short lead times. Second, biased and inaccurate crowdsourced observations can significantly affect model results. Third, the theoretical scenario of citizens motivated by their feeling of belonging to a community of friends has the best effect in the model performance. However, flood prediction only improved when such small communities are located in the upstream portion of the Bacchiglione catchment. Finally, decreasing involvement over time leads to a reduction in model performance and consequently inaccurate flood forecasts.

Potential clinical impact of advanced imaging and computer-aided diagnosis in chest radiology: importance of radiologist's role and successful observer study.

PubMed

Li, Feng

2015-07-01

This review paper is based on our research experience in the past 30 years. The importance of radiologists' role is discussed in the development or evaluation of new medical images and of computer-aided detection (CAD) schemes in chest radiology. The four main topics include (1) introducing what diseases can be included in a research database for different imaging techniques or CAD systems and what imaging database can be built by radiologists, (2) understanding how radiologists' subjective judgment can be combined with technical objective features to improve CAD performance, (3) sharing our experience in the design of successful observer performance studies, and (4) finally, discussing whether the new images and CAD systems can improve radiologists' diagnostic ability in chest radiology. In conclusion, advanced imaging techniques and detection/classification of CAD systems have a potential clinical impact on improvement of radiologists' diagnostic ability, for both the detection and the differential diagnosis of various lung diseases, in chest radiology.

Gutuo Jiejiu decoction improves survival of patients with severe alcoholic hepatitis: A retrospective cohort study.

PubMed

Mou, Hong-Yuan; Nie, Hong-Ming; Hu, Xiao-Yu

2017-04-28

To verify the value of Gutuo Jiejiu decoction in improving the survival of patients with severe alcoholic hepatitis (SAH). We performed a retrospective cohort study in consecutive patients diagnosed with SAH at the Teaching Hospital of Chengdu University of Traditional Chinese Medicine and Shuguang Hospital, Shanghai University of Traditional Chinese Medicine. The traditional Chinese medicine formula Gutuo Jiejiu decoction was employed as an exposure factor. Patients from the Teaching Hospital of Chengdu University of Traditional Chinese Medicine who had been treated with Gutuo Jiejiu decoction + prednisone were assigned to an observation group, and patients from Shuguang Hospital, Shanghai University of Traditional Chinese Medicine who had been treated with prednisone alone were selected as a control group. A retrospective analysis was performed by comparing age, alcohol intake, and clinical parameters of liver injury before and after treatment. Additionally, the 3- and 12-mo survival rates and the occurrence of complications were analyzed. One hundred and twenty-eight eligible patients were selected from 175 cases with SAH, of which 68 were assigned to the observation group and the other 60 to the control group. No significant difference was found in the patients' baseline characteristics ( P > 0.05). However, significant improvements of 90-d survival rate [56/68 (82.4%) vs 27/60 (45.0%), P = 0.0000] and 365-d survival rate [48/68 (70.6%) vs 13/60 (21.7%), P = 00000] were observed in the observation group after treatment. After the first 3 mo of treatment, more improvements in the clinical parameters and scoring systems related to liver injury occurred in the observation group than in the control group ( P < 0.05). After treatment for 12 mo, the differences in the clinical parameters and scoring systems related to liver injury between the two groups were more significant ( P < 0.05). No significant differences in complications and adverse effects were found between the two groups. Gutuo Jiejiu decoction could improve the survival rates and clinical parameters of liver injury in patients with SAH, and may represent a new option for treating SAH.

Improving the City-scale Emission Inventory of Anthropogenic Air Pollutants: A Case Study of Nanjing

NASA Astrophysics Data System (ADS)

Qiu, L.; Zhao, Y.; Xu, R.; Xie, F.; Wang, H.; Qin, H.; Wu, X.; Zhang, J.

2014-12-01

To evaluate the improvement of city-scale emission inventory, a high-resolution emission inventory of air pollutants for Nanjing is first developed combining detailed source information, and then justified through quantitative analysis with observations. The best available domestic emission factors and unit-/facility-based activity level data were compiled based on a thorough field survey on major emission sources. Totally 1089 individual emission sources were identified as point sources and all the emission-related parameters including burner type, combustion technology, fuel quality, and removal efficiency of pollution control devices, are carefully investigated and analyzed. Some new data such as detailed information of city fueling-gas stations, construction sites, monthly activity level, data from continuous emission monitoring systems and traffic flow information were combined to improve spatiotemporal distribution of this inventory. For SO2, NOX and CO, good spatial correlations were found between ground observation (9 state controlling air sampling sites in Nanjing) and city-scale emission inventory (R2=0.34, 0.38 and 0.74, respectively). For TSP, PM10 and PM2.5, however, poorer correlation was found due to relatively weaker accuracy in emission estimation and spatial distribution of road dust. The mixing ratios between specific pollutants including OC/EC, BC/CO and CO2/CO, are well correlated between those from ground observation and emission. Compared to MEIC (Multi-resolution Emission Inventory for China), there is a better spatial consistence between this city-scale emission inventory and NO2 measured by OMI (Ozone Monitoring Instrument). In particular, the city-scale emission inventory still correlated well with satellite observations (R2=0.28) while the regional emission inventory showed little correlation with satellite observations (R2=0.09) when grids containing power plants are excluded. It thus confirms the improvement of city-scale emission inventory on industrial and transportation sources other than big power plants. Through the inventory evaluation, the necessity to develop high-resolution emission inventory with comprehensive emission source information is revealed for atmospheric science studies and air quality improvement at local scale.

Joint Sentinel-1 and SMAP data assimilation to improve soil moisture estimates

NASA Astrophysics Data System (ADS)

Lievens, H.; Reichle, R. H.; Liu, Q.; De Lannoy, G.; Dunbar, R. S.; Kim, S.; Das, N. N.; Cosh, M. H.; Walker, J. P.; Wagner, W.

2017-12-01

SMAP (Soil Moisture Active and Passive) radiometer observations at 40 km resolution are routinely assimilated into the NASA Catchment Land Surface Model (CLSM) to generate the SMAP Level 4 Soil Moisture product. The use of C-band radar backscatter observations from Sentinel-1 has the potential to add value to the radiance assimilation by increasing the level of spatial detail. The specifications of Sentinel-1 are appealing, particularly its high spatial resolution (5 by 20 m in interferometric wide swath mode) and frequent revisit time (6 day repeat cycle for the Sentinel-1A and Sentinel-1B constellation). However, the shorter wavelength of Sentinel-1 observations implies less sensitivity to soil moisture. This study investigates the value of Sentinel-1 data for hydrologic simulations by assimilating the radar observations into CLSM, either separately from or simultaneously with SMAP radiometer observations. To facilitate the assimilation of the radar observations, CLSM is coupled to the water cloud model, simulating the radar backscatter as observed by Sentinel-1. The innovations, i.e. differences between observations and simulations, are converted into increments to the model soil moisture state through an Ensemble Kalman Filter. The assimilation impact is assessed by comparing 3-hourly, 9 km surface and root-zone soil moisture simulations with in situ measurements from 9 km SMAP core validation sites and sparse networks, from May 2015 to 2017. The Sentinel-1 assimilation consistently improves surface soil moisture, whereas root-zone impacts are mostly neutral. Relatively larger improvements are obtained from SMAP assimilation. The joint assimilation of SMAP and Sentinel-1 observations performs best, demonstrating the complementary value of radar and radiometer observations.

Repeated Blood Pressure Measurements in Childhood in Prediction of Hypertension in Adulthood.

PubMed

Oikonen, Mervi; Nuotio, Joel; Magnussen, Costan G; Viikari, Jorma S A; Taittonen, Leena; Laitinen, Tomi; Hutri-Kähönen, Nina; Jokinen, Eero; Jula, Antti; Cheung, Michael; Sabin, Matthew A; Daniels, Stephen R; Raitakari, Olli T; Juonala, Markus

2016-01-01

Hypertension may be predicted from childhood risk factors. Repeated observations of abnormal blood pressure in childhood may enhance prediction of hypertension and subclinical atherosclerosis in adulthood compared with a single observation. Participants (1927, 54% women) from the Cardiovascular Risk in Young Finns Study had systolic and diastolic blood pressure measurements performed when aged 3 to 24 years. Childhood/youth abnormal blood pressure was defined as above 90th or 95th percentile. After a 21- to 31-year follow-up, at the age of 30 to 45 years, hypertension (>140/90 mm Hg or antihypertensive medication) prevalence was found to be 19%. Carotid intima-media thickness was examined, and high-risk intima-media was defined as intima-media thickness >90th percentile or carotid plaques. Prediction of adulthood hypertension and high-risk intima-media was compared between one observation of abnormal blood pressure in childhood/youth and multiple observations by improved Pearson correlation coefficients and area under the receiver operating curve. When compared with a single measurement, 2 childhood/youth observations improved the correlation for adult systolic (r=0.44 versus 0.35, P<0.001) and diastolic (r=0.35 versus 0.17, P<0.001) blood pressure. In addition, 2 abnormal childhood/youth blood pressure observations increased the prediction of hypertension in adulthood (0.63 for 2 versus 0.60 for 1 observation, P=0.003). When compared with 2 measurements, third observation did not provide any significant improvement for correlation or prediction (P always >0.05). A higher number of childhood/youth observations of abnormal blood pressure did not enhance prediction of adult high-risk intima-media thickness. Compared with a single measurement, the prediction of adult hypertension was enhanced by 2 observations of abnormal blood pressure in childhood/youth. © 2015 American Heart Association, Inc.

Three-year clinical outcome of single implant-retained mandibular overdentures--results of preliminary prospective study.

PubMed

Harder, Sönke; Wolfart, Stefan; Egert, Christopher; Kern, Matthias

2011-10-01

The aim of this preliminary prospective study was to evaluate the clinical outcome, the oral health-related quality of life (OHRQoL), and the subjective chewing ability of patients with mandibular complete dentures retained by a single implant placed in the mandible midline. Patients wearing complete dentures were treated with a single implant in the mandible, followed by relining of the dentures and incorporation of ball attachments for implant retention. Implant outcome, prosthodontic maintenance, subjective chewing ability, and the oral health impact profile of the patients were assessed at baseline and at four weeks after connecting the denture and implant. Eleven patients were enrolled in this investigation, and the mean observation period was 43.4 months (minimum period: 35, maximum period: 52 months). No implants were lost during observation period, but four dentures needed repair because of the fracture of the denture base in the midline area. A significant improvement was observed in the OHRQoL of the patients after the attachment of the mandibular dentures with a single midline implant. Furthermore, the subjective chewing ability of the patients was significantly improved after implant connection. Within the limitations of this preliminary prospective clinical study, single implant-supported mandibular overdentures were a successful treatment option for older edentulous patients who showed improvements in their OHRQoL and chewing ability. Copyright © 2011 Elsevier Ltd. All rights reserved.

Change in Adverse Events After Enrollment in the National Surgical Quality Improvement Program: A Systematic Review and Meta-Analysis.

PubMed

Montroy, Joshua; Breau, Rodney H; Cnossen, Sonya; Witiuk, Kelsey; Binette, Andrew; Ferrier, Taylor; Lavallée, Luke T; Fergusson, Dean A; Schramm, David

2016-01-01

The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery. A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR) and 95% confidence intervals (CI). Eleven articles reporting on 35 health care institutions were included. Nine (82%) of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72-0.91), deep (pRR 0.82; 95% CI0.64-1.05) and organ space (pRR 1.15; 95% CI 0.96-1.37) infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39-0.77; deep pRR 0.61, 95% CI 0.50-0.75, and organ space pRR 0.60, 95% CI 0.50-0.71). Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program. These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities.

wfip2.model/realtime.hrrr_esrl.graphics.01 (Model: Real Time)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/realtime.rap_esrl.icbc.01 (Model: Real Time)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/refcst.01.fcst.02 (Model: Year-Long Reforecast)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/refcst.coldstart.icbc.02 (Model: Year-Long Reforecast)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/realtime.hrrr_esrl.icbc.01 (Model: Real Time)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/realtime.rap_esrl.graphics.01 (Model: Real Time)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/refcst.01.fcst.01 (Model: Year-Long Reforecast)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/refcst.coldstart.icbc.01 (Model: Year-Long Reforecast)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/refcst.02.fcst.02 (Model: Year-Long Reforecast)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

Can a smart chair improve the sitting behavior of office workers?

PubMed

Roossien, C C; Stegenga, J; Hodselmans, A P; Spook, S M; Koolhaas, W; Brouwer, S; Verkerke, G J; Reneman, M F

2017-11-01

Prolonged sitting can cause health problems and musculoskeletal discomfort. There is a need for objective and non-obstructive means of measuring sitting behavior. A 'smart' office chair can monitor sitting behavior and provide tactile feedback, aiming to improve sitting behavior. This study aimed to investigate the effect of the feedback signal on sitting behavior and musculoskeletal discomfort. In a 12-week prospective cohort study (ABCB design) among office workers (n = 45) was measured sitting duration and posture, feedback signals and musculoskeletal discomfort. Between the study phases, small changes were observed in mean sitting duration, posture and discomfort. After turning off the feedback signal, a slight increase in sitting duration was observed (10 min, p = 0.04), a slight decrease in optimally supported posture (2.8%, p < 0.01), and musculoskeletal discomfort (0.8, p < 0.01) was observed. We conclude that the 'smart' chair is able to monitor the sitting behavior, the feedback signal, however, led to small or insignificant changes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relationship between observational learning and health belief with physical activity among adolescents girl in Isfahan, Iran.

PubMed

Rostamian, Marzieh; Kazemi, Ashraf

2016-01-01

Physical activities among adolescents affects health during pubescence and adolescence and decrease in physical activities among adolescents has become a global challenge. The aim of the present study was to define the relation between the level of physical activity among adolescent girls and their health beliefs as personal factor and level of observational learning as environmental factor. The present study was a cross-sectional study that was conducted on 400 students aged from 11 to 19 years in Isfahan, Iran. Information regarding the duration of physical activity with moderate/severe intensity was measured in four dimensions of leisure time (exercising and hiking), daily activities, and transportation-related activities using the International Physical Activity questionnaire. Health belief structures included perceived sensitivity, intensity of perceived threat, perceived benefits, and barriers and self-efficacy; observational learning was measured using a researcher-made questionnaire. Results showed that perceived barriers, observational learning, and level of self-efficacy were related to the level of physical activity in all dimensions. In addition, the level of physical activity at leisure time, transportation, and total physical activity were dependent on the intensity of perceived threats ( P < 0.05). This study showed that the intensity of perceived threats, perceived barriers and self-efficacy structures, and observational learning are some of the factors related to physical activity among adolescent girls, and it is possible that by focusing on improving these variables through interventional programs physical activity among adolescent girls can be improved.

Training-related improvements in musculoskeletal health and balance: a 13-week pilot study of female cancer survivors.

PubMed

Almstedt, H C; Grote, S; Perez, S E; Shoepe, T C; Strand, S L; Tarleton, H P

2017-03-01

Cancer survivors often experience poor post-treatment musculoskeletal health. This study examined the feasibility of combined aerobic and resistant training (CART) for improving strength, skeletal health and balance. Cancer survivors (n = 24) were identified by convenience sampling in Los Angeles County with 11 survivors consenting to 13 weeks of CART. Pre- and post-intervention assessments of bone mineral density (BMD), strength, flexibility and biomarker analysis were performed. Paired t-test analysis suggested increases in lower and upper body strength. The average T-score for BMD at the femoral neck improved from -1.46 to -1.36 and whole body BMD improved from -1.65 to -1.55. From baseline to follow-up, participants also displayed decreases in sway velocity on the eyes open (7%) and eyes closed (27%) conditions. Improvement in lower body strength was associated with increases in lean body mass (LBM) (r = 0.721) and an inverse association was observed between sway velocity and LBM (r = 0.838). Age and time since last treatment were related with biomarkers of anabolic growth (IGF-1, IGFbp-3) and bone (DPD, BAP). In summary, observed physiological changes were consistent with functional improvements, suggesting that isometric and dynamic exercise prescription may reduce the risk for falls and fall-related fractures among survivors. © 2016 John Wiley & Sons Ltd.

Behavioral training to improve collision detection

PubMed Central

DeLoss, Denton J.; Bian, Zheng; Watanabe, Takeo; Andersen, George J.

2015-01-01

Young drivers are a high-risk group for vehicle crashes due to inexperience in detecting an impending collision and are one group that may benefit from perceptual learning (PL) training. The present study assessed whether PL could be used to improve performance in collision detection. Ten college-aged subjects participated in the first experiment, which consisted of seven 1-hr sessions conducted on separate days. Thresholds at three observer/object speeds were measured prior to training using a two-alternative forced choice procedure during which they indicated whether an approaching object would result in a collision or noncollision event. Participants were then trained near threshold at one of these speeds for 5 days. After training, participants showed a significant reduction in the time needed to detect a collision at the trained speed. This improvement was also found to transfer to the higher observer speed condition. A second experiment was conducted to determine whether this improvement was due to training near threshold or whether this improvement was merely due to practice with the task. Training with stimuli well above threshold showed no significant improvement in performance, indicating that the improvement seen in the first experiment was not solely due to task practice. PMID:26230917

Microcirculatory Improvement Induced by Laparoscopic Sleeve Gastrectomy Is Related to Insulin Sensitivity Retrieval.

PubMed

Ministrini, Stefano; Fattori, Chiara; Ricci, Maria Anastasia; Bianconi, Vanessa; Paltriccia, Rita; Boni, Marcello; Paganelli, Maria Teresa; Vaudo, Gaetano; Lupattelli, Graziana; Pasqualini, Leonella

2018-05-12

Microvascular dysfunction is a potential factor explaining the association of obesity, insulin resistance, and vascular damage in morbidly obese subjects. The purpose of the study was to evaluate possible determinants of microcirculatory improvement 1 year after laparoscopic sleeve gastrectomy (LSG) intervention. Thirty-seven morbidly obese subjects eligible for bariatric surgery were included in the study. Post-occlusive reactive hyperemia (PORH) of the forearm skin was measured as area of hyperemia (AH) by laser-Doppler flowmetry before LSG and after a 1-year follow-up. After intervention, we observed a significant reduction in BMI, HOMA index, HbA1c, and a significant increase of AH in all patients after surgery; this variation was significant only in those patients having insulin resistance or prediabetes/diabetes. Although significant correlation between the increase of AH and the reduction of both BMI, HOMA index, and HbA1c was observed, BMI was the only independent predictor of AH variation after LSG at the linear regression analysis. Our study shows that LSG intervention is correlated with a significant improvement in the microvascular function of morbidly obese subjects; this improvement seems to be related to the baseline degree of insulin-resistance and to the retrieval of insulin-sensitivity post-intervention.

Carpal tunnel and median nerve volume changes after tunnel release in patients with the carpal tunnel syndrome: a magnetic resonance imaging (MRI) study.

PubMed

Crnković, T; Trkulja, V; Bilić, R; Gašpar, D; Kolundžić, R

2016-05-01

Our aim was to study the dynamics of the post-surgical canal and nerve volumes and their relationships to objective [electromyoneurography (EMNG)] and subjective (pain) outcomes. Forty-seven patients with carpal tunnel syndrome (CTS) (median age 52, range 23-75 years) with a prominent narrowing of the median nerve within the canal (observed during carpal tunnel release) were evaluated clinically using EMNG and magnetic resonance imagining (MRI) before and at 90 and 180 days post-surgery. Canal and nerve volumes increased, EMNG findings improved and pain resolved during the follow-up. Increase in tunnel volume was independently associated with increased nerve volume. A greater post-surgical nerve volume was independently associated with a more prominent resolution of pain, but not with the extent of EMNG improvement, whereas EMNG improvement was not associated with pain resolution. Data confirm that MRI can detect even modest changes in the carpal tunnel and median nerve volume and that tunnel release results in tunnel and nerve-volume increases that are paralleled by EMNG and clinical improvements. Taken together, these observations suggest that MRI could be used to objectivise persistent post-surgical difficulties in CTS patients. Level of evidence 3 (follow-up study).

Characterizing biospheric carbon balance using CO2 observations from the OCO-2 satellite

NASA Astrophysics Data System (ADS)

Miller, Scot M.; Michalak, Anna M.; Yadav, Vineet; Tadić, Jovan M.

2018-05-01

NASA's Orbiting Carbon Observatory 2 (OCO-2) satellite launched in summer of 2014. Its observations could allow scientists to constrain CO2 fluxes across regions or continents that were previously difficult to monitor. This study explores an initial step toward that goal; we evaluate the extent to which current OCO-2 observations can detect patterns in biospheric CO2 fluxes and constrain monthly CO2 budgets. Our goal is to guide top-down, inverse modeling studies and identify areas for future improvement. We find that uncertainties and biases in the individual OCO-2 observations are comparable to the atmospheric signal from biospheric fluxes, particularly during Northern Hemisphere winter when biospheric fluxes are small. A series of top-down experiments indicate how these errors affect our ability to constrain monthly biospheric CO2 budgets. We are able to constrain budgets for between two and four global regions using OCO-2 observations, depending on the month, and we can constrain CO2 budgets at the regional level (i.e., smaller than seven global biomes) in only a handful of cases (16 % of all regions and months). The potential of the OCO-2 observations, however, is greater than these results might imply. A set of synthetic data experiments suggests that retrieval errors have a salient effect. Advances in retrieval algorithms and to a lesser extent atmospheric transport modeling will improve the results. In the interim, top-down studies that use current satellite observations are best-equipped to constrain the biospheric carbon balance across only continental or hemispheric regions.

Improving subjective perception of personal cancer risk: systematic review and meta-analysis of educational interventions for people with cancer or at high risk of cancer.

PubMed

Dieng, Mbathio; Watts, Caroline G; Kasparian, Nadine A; Morton, Rachael L; Mann, Graham J; Cust, Anne E

2014-06-01

Newly diagnosed patients with cancer require education about the disease, the available treatments and potential consequences of treatment. Greater understanding of cancer risk has been found to be associated with greater health-related quality of life, improved psychological adjustment and greater health-related behaviours. The aim of this sytematic review was to assess the effectiveness of educational interventions in improving subjective cancer risk perception and to appraise the quality of the studies. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective observational studies. Eligible studies were identified via Medline, PsycINFO, AMED, CINAHL and Embase databases. After screening titles and abstracts, two reviewers independently assessed the eligibility of 206 full-text articles. Forty papers were included in the review; the majority of studies were conducted among breast cancer patients (n = 29) and evaluated the effect of genetic counselling on personal perceived risk (n = 25). Pooled results from RCTs (n = 12) showed that, both in the short and long term, educational interventions did not significantly influence risk perception level (standardised mean difference 0.05, 95% CI -0.24-0.34; p = 0.74) or accuracy (odds ratio = 1.96, 95% CI: 0.61-6.25; p = 0.26). Only one RCT reported a short-term difference in risk ratings (p = 0.01). Of prospective observational studies (n = 28), many did demonstrate changes in the level of perceived risk and improved risk accuracy and risk ratings in both the short and long term. However, only one (of three) observational studies reported a short-term difference in risk ratings (p < = 0.003). Further development and investigation of educational interventions using good quality, RCTs are warranted. Copyright © 2014 John Wiley & Sons, Ltd.

Science Enhancements by the MAVEN Participating Scientists

NASA Technical Reports Server (NTRS)

Grebowsky, J.; Fast, K.; Talaat, E.; Combi, M.; Crary, F.; England, S.; Ma, Y.; Mendillo, M.; Rosenblatt, P.; Seki, K.

2014-01-01

NASA implemented a Participating Scientist Program and released a solicitation for the Mars Atmosphere and Volatile EvolutioN mission (MAVEN) proposals on February 14, 2013. After a NASA peer review panel evaluated the proposals, NASA Headquarters selected nine on June 12, 2013. The program's intent is to enhance the science return from the mission by including new investigations that broaden and/or complement the baseline investigations, while still addressing key science goals. The selections cover a broad range of science investigations. Included are: a patching of a 3D exosphere model to an improved global ionosphere-thermosphere model to study the generation of the exosphere and calculate the escape rates; the addition of a focused study of upper atmosphere variability and waves; improvement of a multi-fluid magnetohydrodynamic model that will be adjusted according to MAVEN observations to enhance the understanding of the solar-wind plasma interaction; a global study of the state of the ionosphere; folding MAVEN measurements into the Mars International Reference Ionosphere under development; quantification of atmospheric loss by pick-up using ion cyclotron wave observations; the reconciliation of remote and in situ observations of the upper atmosphere; the application of precise orbit determination of the spacecraft to measure upper atmospheric density and in conjunction with other Mars missions improve the static gravity field model of Mars; and an integrated ion/neutral study of ionospheric flows and resultant heavy ion escape. Descriptions of each of these investigations are given showing how each adds to and fits seamlessly into MAVEN mission science design.

Science Enhancements by the MAVEN Participating Scientists

NASA Astrophysics Data System (ADS)

Grebowsky, J.; Fast, K.; Talaat, E.; Combi, M.; Crary, F.; England, S.; Ma, Y.; Mendillo, M.; Rosenblatt, P.; Seki, K.; Stevens, M.; Withers, P.

2015-12-01

NASA implemented a Participating Scientist Program and released a solicitation for the Mars Atmosphere and Volatile EvolutioN mission (MAVEN) proposals on February 14, 2013. After a NASA peer review panel evaluated the proposals, NASA Headquarters selected nine on June 12, 2013. The program's intent is to enhance the science return from the mission by including new investigations that broaden and/or complement the baseline investigations, while still addressing key science goals. The selections cover a broad range of science investigations. Included are: a patching of a 3D exosphere model to an improved global ionosphere-thermosphere model to study the generation of the exosphere and calculate the escape rates; the addition of a focused study of upper atmosphere variability and waves; improvement of a multi-fluid magnetohydrodynamic model that will be adjusted according to MAVEN observations to enhance the understanding of the solar-wind plasma interaction; a global study of the state of the ionosphere; folding MAVEN measurements into the Mars International Reference Ionosphere under development; quantification of atmospheric loss by pick-up using ion cyclotron wave observations; the reconciliation of remote and in situ observations of the upper atmosphere; the application of precise orbit determination of the spacecraft to measure upper atmospheric density and in conjunction with other Mars missions improve the static gravity field model of Mars; and an integrated ion/neutral study of ionospheric flows and resultant heavy ion escape. Descriptions of each of these investigations are given showing how each adds to and fits seamlessly into MAVEN mission science design.

Public health campaign to promote hand hygiene before meals in a college of veterinary medicine.

PubMed

Heinrich, Ellen R E; KuKanich, Kate S; Davis, Elizabeth; White, Brad J

2014-01-01

Veterinary students can be exposed to environmental infectious agents in school that may include zoonotic pathogens. Encouraging effective hand hygiene can minimize the spread of zoonoses and promote public health and the One Health concept among veterinary students. The purpose of this study was to determine if a campaign could improve hand hygiene among veterinary students at extracurricular meetings serving meals. Nine Kansas State University College of Veterinary Medicine (KSU-CVM) extracurricular organizations participated in the study, sanitizer was provided at each meeting, and baseline hand-hygiene data were observed. A hand-hygiene opportunity was defined as any student observed to approach the buffet food line. Sanitizer use (yes/no) and gender (male/female) were recorded. Campaign interventions included a 3.5-minute educational video and a novel motivational poster. The video was presented to all first-year, second-year, and third-year veterinary students. Posters encouraging hand sanitization were displayed on doors and tables alongside sanitizers at each meeting. Observational hand-hygiene data were collected immediately after introduction of interventions and again 3 months later. Environmental sampling for presence of bacteria in and around meeting locations was also performed. Observed hand hygiene was lowest during baseline (11.0% ± 1.7), improved significantly post-intervention (48.8% ± 3.2), and remained improved at 3-month follow-up (33.5% ± 4.0). Females had higher probability of hand sanitizing (35.9% ± 2.2) than males (21.4% ± 2.4) (p<.01). Clostridium perfringens was isolated from 2/42 samples, and Salmonella spp. were isolated from 4/42 samples. A short-term public health campaign targeting veterinary students successfully improved hand hygiene before meals.

Development of a Method for Selecting Optimum Sites for the Automatic Mountain Meteorology Observation Station (AMOS) to Improve Predictability of Forest Fires in Inaccessible Area

NASA Astrophysics Data System (ADS)

Yoon, S.; Won, M.; Jang, K.; Lim, J.

2016-12-01

As there has been a recent increase in the case of forest fires in North Korea descending southward through the De-Militarized Zone (DMZ), ensuring proper response to such events has been a challenge. Therefore, in order to respond and manage these forest fires appropriately, an improvement in the forest fire predictability through integration of mountain weather information observed at the most optimal site is necessary. This study is a proactive case in which a spatial analysis and an on-site assessment method were developed for selecting an optimum site for a mountain weather observation in national forest. For spatial analysis, the class 1 and 2 forest fire danger areas for the past 10 years, accessibility maximum 100m, Automatic Weather Station (AWS) redundancy within 2.5km, and mountain terrains higher than 200m were analyzed. A final overlay analysis was performed to select the candidates for the field assessment. The sites selected through spatial analysis were quantitatively evaluated based on the optimal meteorological environment, forest and hiking trail accessibility, AWS redundancy, and supply of wireless communication and solar powered electricity. The sites with total score of 70 and higher were accepted as adequate. At the final selected sites, an AMOS was established, and integration of mountain and Korea Meteorological Administration (KMA) weather data improved the forest fire predictability in South Korea by 10%. Given these study results, we expect that establishing an automatic mountain meteorology observation station at the optimal sites in inaccessible area and integrating mountain weather data will improve the predictability of forest fires.

Does successful rotator cuff repair improve muscle atrophy and fatty infiltration of the rotator cuff? A retrospective magnetic resonance imaging study performed shortly after surgery as a reference.

PubMed

Hamano, Noritaka; Yamamoto, Atsushi; Shitara, Hitoshi; Ichinose, Tsuyoshi; Shimoyama, Daisuke; Sasaki, Tsuyoshi; Kobayashi, Tsutomu; Kakuta, Yohei; Osawa, Toshihisa; Takagishi, Kenji

2017-06-01

Muscle atrophy and fatty infiltration in the rotator cuff muscles are often observed in patients with chronic rotator cuff tears. The recovery from these conditions has not been clarified. Ninety-four patients were included in this study. The improvement in muscle atrophy and fatty infiltration in successfully repaired rotator cuff tears was evaluated by magnetic resonance imaging at 1 year and 2 years after surgery and was compared with muscle atrophy and fatty infiltration observed on magnetic resonance imaging at 2 weeks after surgery to discount any changes due to the medial retraction of the torn tendon. The patients' muscle strength was evaluated in abduction and external rotation. Muscle atrophy and fatty infiltration of the supraspinatus were significantly improved at 2 years after surgery in comparison to 2 weeks after surgery. The subjects' abduction and external rotation strength was also significantly improved at 2 years after surgery in comparison to the preoperative values. Patients whose occupation ratio was improved had a better abduction range of motion, stronger abduction strength, and higher Constant score. Patients whose fatty infiltration was improved had a better range of motion in flexion and abduction, whereas the improvements of muscle strength and the Constant score were similar in the group that showed an improvement of fatty infiltration and the group that did not. Muscle atrophy and fatty infiltration can improve after rotator cuff repair. The strengths of abduction and external rotation were also improved at 2 years after surgery. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Improved estimation of heavy rainfall by weather radar after reflectivity correction and accounting for raindrop size distribution variability

NASA Astrophysics Data System (ADS)

Hazenberg, Pieter; Leijnse, Hidde; Uijlenhoet, Remko

2015-04-01

Between 25 and 27 August 2010 a long-duration mesoscale convective system was observed above the Netherlands, locally giving rise to rainfall accumulations exceeding 150 mm. Correctly measuring the amount of precipitation during such an extreme event is important, both from a hydrological and meteorological perspective. Unfortunately, the operational weather radar measurements were affected by multiple sources of error and only 30% of the precipitation observed by rain gauges was estimated. Such an underestimation of heavy rainfall, albeit generally less strong than in this extreme case, is typical for operational weather radar in The Netherlands. In general weather radar measurement errors can be subdivided into two groups: (1) errors affecting the volumetric reflectivity measurements (e.g. ground clutter, radar calibration, vertical profile of reflectivity) and (2) errors resulting from variations in the raindrop size distribution that in turn result in incorrect rainfall intensity and attenuation estimates from observed reflectivity measurements. A stepwise procedure to correct for the first group of errors leads to large improvements in the quality of the estimated precipitation, increasing the radar rainfall accumulations to about 65% of those observed by gauges. To correct for the second group of errors, a coherent method is presented linking the parameters of the radar reflectivity-rain rate (Z-R) and radar reflectivity-specific attenuation (Z-k) relationships to the normalized drop size distribution (DSD). Two different procedures were applied. First, normalized DSD parameters for the whole event and for each precipitation type separately (convective, stratiform and undefined) were obtained using local disdrometer observations. Second, 10,000 randomly generated plausible normalized drop size distributions were used for rainfall estimation, to evaluate whether this Monte Carlo method would improve the quality of weather radar rainfall products. Using the disdrometer information, the best results were obtained in case no differentiation between precipitation type (convective, stratiform and undefined) was made, increasing the event accumulations to more than 80% of those observed by gauges. For the randomly optimized procedure, radar precipitation estimates further improve and closely resemble observations in case one differentiates between precipitation type. However, the optimal parameter sets are very different from those derived from disdrometer observations. It is therefore questionable if single disdrometer observations are suitable for large-scale quantitative precipitation estimation, especially if the disdrometer is located relatively far away from the main rain event, which was the case in this study. In conclusion, this study shows the benefit of applying detailed error correction methods to improve the quality of the weather radar product, but also confirms the need to be cautious using locally obtained disdrometer measurements.

The impact of reflectivity correction and accounting for raindrop size distribution variability to improve precipitation estimation by weather radar for an extreme low-land mesoscale convective system

NASA Astrophysics Data System (ADS)

Hazenberg, Pieter; Leijnse, Hidde; Uijlenhoet, Remko

2014-11-01

Between 25 and 27 August 2010 a long-duration mesoscale convective system was observed above the Netherlands, locally giving rise to rainfall accumulations exceeding 150 mm. Correctly measuring the amount of precipitation during such an extreme event is important, both from a hydrological and meteorological perspective. Unfortunately, the operational weather radar measurements were affected by multiple sources of error and only 30% of the precipitation observed by rain gauges was estimated. Such an underestimation of heavy rainfall, albeit generally less strong than in this extreme case, is typical for operational weather radar in The Netherlands. In general weather radar measurement errors can be subdivided into two groups: (1) errors affecting the volumetric reflectivity measurements (e.g. ground clutter, radar calibration, vertical profile of reflectivity) and (2) errors resulting from variations in the raindrop size distribution that in turn result in incorrect rainfall intensity and attenuation estimates from observed reflectivity measurements. A stepwise procedure to correct for the first group of errors leads to large improvements in the quality of the estimated precipitation, increasing the radar rainfall accumulations to about 65% of those observed by gauges. To correct for the second group of errors, a coherent method is presented linking the parameters of the radar reflectivity-rain rate (Z - R) and radar reflectivity-specific attenuation (Z - k) relationships to the normalized drop size distribution (DSD). Two different procedures were applied. First, normalized DSD parameters for the whole event and for each precipitation type separately (convective, stratiform and undefined) were obtained using local disdrometer observations. Second, 10,000 randomly generated plausible normalized drop size distributions were used for rainfall estimation, to evaluate whether this Monte Carlo method would improve the quality of weather radar rainfall products. Using the disdrometer information, the best results were obtained in case no differentiation between precipitation type (convective, stratiform and undefined) was made, increasing the event accumulations to more than 80% of those observed by gauges. For the randomly optimized procedure, radar precipitation estimates further improve and closely resemble observations in case one differentiates between precipitation type. However, the optimal parameter sets are very different from those derived from disdrometer observations. It is therefore questionable if single disdrometer observations are suitable for large-scale quantitative precipitation estimation, especially if the disdrometer is located relatively far away from the main rain event, which was the case in this study. In conclusion, this study shows the benefit of applying detailed error correction methods to improve the quality of the weather radar product, but also confirms the need to be cautious using locally obtained disdrometer measurements.

Feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy in chronic stroke: A randomized controlled pilot study.

PubMed

Rodrigues, Letícia Cardoso; Farias, Nayara Correa; Gomes, Raquel Pinheiro; Michaelsen, Stella Maris

2016-01-01

To evaluate the feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy (MT) to improve upper limb (UL) activity in chronic stroke patients. Sixteen patients with moderate UL impairment were randomly allocated to either the experimental (EG) or control (CG) group. Both groups performed 1 hour sessions, 3 days/week for 4 weeks, involving object-related bilateral symmetrical training. EG performed the tasks observing their nonparetic UL reflected in the mirror, while CG observed the paretic UL directly. The primary outcome measure was unilateral and bilateral UL activity according to the Test d'Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA). All measurements were taken at baseline, post-training, and follow-up (2 weeks). TEMPA total score showed the main effect of time. Significant improvement was found for bilateral but not unilateral tasks. Both groups showed gains after training, with no differences between them. This study showed the feasibility of adding object-related bilateral training to MT. Both types of training improved UL bilateral activity; however, a larger sample is required for a definitive study. Other studies need to be carried out to evaluate the effectiveness of combining more distal-oriented movements and object-related unilateral training to improve these effects in chronic stroke patients.

Constraining the range of Yukawa gravity interaction from S2 star orbits III: improvement expectations for graviton mass bounds

NASA Astrophysics Data System (ADS)

Zakharov, A. F.; Jovanović, P.; Borka, D.; Borka Jovanović, V.

2018-04-01

Recently, the LIGO-Virgo collaboration discovered gravitational waves and in their first publication on the subject the authors also presented a graviton mass constraint as mg < 1.2 × 10‑22 eV [1] (see also more details in a complimentary paper [2]). In our previous papers we considered constraints on Yukawa gravity parameters [3] and on graviton mass from analysis of the trajectory of S2 star near the Galactic Center [4]. In the paper we analyze a potential to reduce upper bounds for graviton mass with future observational data on trajectories of bright stars near the Galactic Center. Since gravitational potentials are different for these two cases, expressions for relativistic advance for general relativity and Yukawa potential are different functions on eccentricity and semimajor axis, it gives an opportunity to improve current estimates of graviton mass with future observational facilities. In our considerations of an improvement potential for a graviton mass estimate we adopt a conservative strategy and assume that trajectories of bright stars and their apocenter advance will be described with general relativity expressions and it gives opportunities to improve graviton mass constraints. In contrast with our previous studies, where we present current constraints on parameters of Yukawa gravity [5] and graviton mass [6] from observations of S2 star, in the paper we express expectations to improve current constraints for graviton mass, assuming the GR predictions about apocenter shifts will be confirmed with future observations. We concluded that if future observations of bright star orbits during around fifty years will confirm GR predictions about apocenter shifts of bright star orbits it give an opportunity to constrain a graviton mass at a level around 5 × 10‑23 eV or slightly better than current estimates obtained with LIGO observations.

Effect of time-of-flight and point spread function modeling on detectability of myocardial defects in PET

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

Schaefferkoetter, Joshua, E-mail: dnrjds@nus.edu.sg; Ouyang, Jinsong; Rakvongthai, Yothin

2014-06-15

Purpose: A study was designed to investigate the impact of time-of-flight (TOF) and point spread function (PSF) modeling on the detectability of myocardial defects. Methods: Clinical FDG-PET data were used to generate populations of defect-present and defect-absent images. Defects were incorporated at three contrast levels, and images were reconstructed by ordered subset expectation maximization (OSEM) iterative methods including ordinary Poisson, alone and with PSF, TOF, and PSF+TOF. Channelized Hotelling observer signal-to-noise ratio (SNR) was the surrogate for human observer performance. Results: For three iterations, 12 subsets, and no postreconstruction smoothing, TOF improved overall defect detection SNR by 8.6% as comparedmore » to its non-TOF counterpart for all the defect contrasts. Due to the slow convergence of PSF reconstruction, PSF yielded 4.4% less SNR than non-PSF. For reconstruction parameters (iteration number and postreconstruction smoothing kernel size) optimizing observer SNR, PSF showed larger improvement for faint defects. The combination of TOF and PSF improved mean detection SNR as compared to non-TOF and non-PSF counterparts by 3.0% and 3.2%, respectively. Conclusions: For typical reconstruction protocol used in clinical practice, i.e., less than five iterations, TOF improved defect detectability. In contrast, PSF generally yielded less detectability. For large number of iterations, TOF+PSF yields the best observer performance.« less

Using electronic technology to improve clinical care - results from a before-after cluster trial to evaluate assessment and classification of sick children according to Integrated Management of Childhood Illness (IMCI) protocol in Tanzania.

PubMed

Mitchell, Marc; Hedt-Gauthier, Bethany L; Msellemu, Daniel; Nkaka, Melania; Lesh, Neal

2013-08-27

Poor adherence to the Integrated Management of Childhood Illness (IMCI) protocol reduces the potential impact on under-five morbidity and mortality. Electronic technology could improve adherence; however there are few studies demonstrating the benefits of such technology in a resource-poor settings. This study estimates the impact of electronic technology on adherence to the IMCI protocols as compared to the current paper-based protocols in Tanzania. In four districts in Tanzania, 18 clinics were randomly selected for inclusion. At each site, observers documented critical parts of the clinical assessment of children aged 2 months to 5 years. The first set of observations occurred during examination of children using paper-based IMCI (pIMCI) and the next set of observations occurred during examination using the electronic IMCI (eIMCI). Children were re-examined by an IMCI expert and the diagnoses were compared. A total of 1221 children (671 paper, 550 electronic) were observed. For all ten critical IMCI items included in both systems, adherence to the protocol was greater for eIMCI than for pIMCI. The proportion assessed under pIMCI ranged from 61% to 98% compared to 92% to 100% under eIMCI (p < 0.05 for each of the ten assessment items). Use of electronic systems improved the completeness of assessment of children with acute illness in Tanzania. With the before-after nature of the design, potential for temporal confounding is the primary limitation. However, the data collection for both phases occurred over a short period (one month) and so temporal confounding was expected to be minimal. The results suggest that the use of electronic IMCI protocols can improve the completeness and consistency of clinical assessments and future studies will examine the long-term health and health systems impact of eIMCI.

Peer Observation of Teaching: Perceptions and Experiences of Teachers in a Primary School in Cyprus

ERIC Educational Resources Information Center

Karagiorgi, Yiasemina

2012-01-01

This article examines teachers' perceptions of, and experiences with, professional development opportunities involving a school-based project on peer observation of teaching. The study aims to reveal the ways in which seven teachers in one primary school in Cyprus see themselves as agents improving their own and peers' teaching through informal…

Using Bona Adaptation to Improve Accent Defects as a Voice Training Method

ERIC Educational Resources Information Center

Aycan, Kivanc

2017-01-01

Purpose: In this research, it is observed that if solfeggio syllables, consonants, and vowels are spoken properly, voice intensity (accent), duration, pitch (high pitch-low pitch) and intonation (the ability to carry a musical voice) related to proper pitch level. In this study, it is observed that rhythmic structures do not form without…

An Evaluation of the Effectiveness of an Automated Observation and Feedback System on Safe Sitting Postures

ERIC Educational Resources Information Center

Yu, Eunjeong; Moon, Kwangsu; Oah, Shezeen; Lee, Yohaeng

2013-01-01

This study evaluated the effectiveness of an automated observation and feedback system in improving safe sitting postures. Participants were four office workers. The dependent variables were the percentages of time participants spent in five safe body positions during experimental sessions. We used a multiple-baseline design counterbalanced across…

Embedding clinical interventions into observational studies.

PubMed

Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

2016-01-01

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. Copyright © 2015. Published by Elsevier Inc.

Embodied Action Improves Cognition in Children: Evidence from a Study Based on Piagetian Conservation Tasks.

PubMed

Lozada, Mariana; Carro, Natalia

2016-01-01

Converging evidence highlights the relevance of embodied cognition in learning processes. In this study we evaluate whether embodied action (enaction) improves cognitive understanding in children. Using the Piagetian conservation tasks in 6-7 year olds, we analyzed quantity conservation conceptualization in children who were active participants in the transformation process and compared these results to those of children who were mere observers of an adult's demonstration (as traditionally conducted). The investigation was performed with 105 first-graders. Conservation tasks were demonstrated to half the children, while the other half actively carried out the transformation of matter. Our findings showed that active manipulation of the material helped children recognize quantity invariance in a higher proportion than when the demonstration was only observed. That is, their enactive experience enabled them to comprehend conservation phenomena more easily than if they were merely passive observers. The outcome of this research thus emphasizes how active participation benefits cognitive processes in learning contexts, promoting autonomy, and agency during childhood.

Embodied Action Improves Cognition in Children: Evidence from a Study Based on Piagetian Conservation Tasks

PubMed Central

Lozada, Mariana; Carro, Natalia

2016-01-01

Converging evidence highlights the relevance of embodied cognition in learning processes. In this study we evaluate whether embodied action (enaction) improves cognitive understanding in children. Using the Piagetian conservation tasks in 6–7 year olds, we analyzed quantity conservation conceptualization in children who were active participants in the transformation process and compared these results to those of children who were mere observers of an adult's demonstration (as traditionally conducted). The investigation was performed with 105 first-graders. Conservation tasks were demonstrated to half the children, while the other half actively carried out the transformation of matter. Our findings showed that active manipulation of the material helped children recognize quantity invariance in a higher proportion than when the demonstration was only observed. That is, their enactive experience enabled them to comprehend conservation phenomena more easily than if they were merely passive observers. The outcome of this research thus emphasizes how active participation benefits cognitive processes in learning contexts, promoting autonomy, and agency during childhood. PMID:27047420

Improving Wind Predictions in the Marine Atmospheric Boundary Layer through Parameter Estimation in a Single-Column Model

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

Lee, Jared A.; Hacker, Joshua P.; Delle Monache, Luca

2016-12-14

A current barrier to greater deployment of offshore wind turbines is the poor quality of numerical weather prediction model wind and turbulence forecasts over open ocean. The bulk of development for atmospheric boundary layer (ABL) parameterization schemes has focused on land, partly due to a scarcity of observations over ocean. The 100-m FINO1 tower in the North Sea is one of the few sources worldwide of atmospheric profile observations from the sea surface to turbine hub height. These observations are crucial to developing a better understanding and modeling of physical processes in the marine ABL. In this study, we usemore » the WRF single column model (SCM), coupled with an ensemble Kalman filter from the Data Assimilation Research Testbed (DART), to create 100-member ensembles at the FINO1 location. The goal of this study is to determine the extent to which model parameter estimation can improve offshore wind forecasts.« less

Decreasing handoff-related care failures in children's hospitals.

PubMed

Bigham, Michael T; Logsdon, Tina R; Manicone, Paul E; Landrigan, Christopher P; Hayes, Leslie W; Randall, Kelly H; Grover, Purva; Collins, Susan B; Ramirez, Dana E; O'Guin, Crystal D; Williams, Catherine I; Warnick, Robin J; Sharek, Paul J

2014-08-01

Patient handoffs in health care require transfer of information, responsibility, and authority between providers. Suboptimal patient handoffs pose a serious safety risk. Studies demonstrating the impact of improved patient handoffs on care failures are lacking. The primary objective of this study was to evaluate the effect of a multihospital collaborative designed to decrease handoff-related care failures. Twenty-three children's hospitals participated in a quality improvement collaborative aimed at reducing handoff-related care failures. The improvement was guided by evidence-based recommendations regarding handoff intent and content, standardized handoff tools/methods, and clear transition of responsibility. Hospitals tailored handoff elements to locally important handoff types. Handoff-related care failures were compared between baseline and 3 intervention periods. Secondary outcomes measured compliance to specific change package elements and balancing measure of staff satisfaction. Twenty-three children's hospitals evaluated 7864 handoffs over the 12-month study period. Handoff-related care failures decreased from baseline (25.8%) to the final intervention period (7.9%) (P < .05). Significant improvement was observed in every handoff type studied. Compliance to change package elements improved (achieving a common understanding about the patient from 86% to 96% [P < .05]; clear transition of responsibility from 92% to 96% [P < .05]; and minimized interruptions and distractions from 84% to 90% [P < .05]) as did overall satisfaction with the handoff (from 55% to 70% [P < .05]). Implementation of a standardized evidence-based handoff process across 23 children's hospitals resulted in a significant decrease in handoff-related care failures, observed over all handoff types. Compliance to critical components of the handoff process improved, as did provider satisfaction. Copyright © 2014 by the American Academy of Pediatrics.

Clinical Mechanism of the Cystic Fibrosis Transmembrane Conductance Regulator Potentiator Ivacaftor in G551D-mediated Cystic Fibrosis

PubMed Central

Heltshe, Sonya L.; Gonska, Tanja; Donaldson, Scott H.; Borowitz, Drucy; Gelfond, Daniel; Sagel, Scott D.; Khan, Umer; Mayer-Hamblett, Nicole; Van Dalfsen, Jill M.; Joseloff, Elizabeth; Ramsey, Bonnie W.

2014-01-01

Rationale: Ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator recently approved for patients with CF age 6 and older with the G551D mutation. Objectives: To evaluate ivacaftor in a postapproval setting and determine mechanism of action and response of clinically relevant markers. Methods: We conducted a longitudinal cohort study in 2012–2013 in G551D CF patients age 6 and older with no prior exposure to ivacaftor. Study assessments were performed at baseline, 1, 3, and 6 months after ivacaftor initiation. Substudies evaluated mucociliary clearance, β-adrenergic sweat secretion rate, gastrointestinal pH, and sputum inflammation and microbiology Measurements and Main Results: A total of 151 of 153 subjects were prescribed ivacaftor and 88% completed the study through 6 months. FEV1 % predicted improved from baseline to 6 months (mean absolute change, 6.7%; P < 0.001). Similarly, body mass index improved from baseline to 6 months (mean change, 0.8 kg/m2; P < 0.001). Sweat chloride decreased from baseline to 6 months (mean change, −53.8 mmol/L; 95% confidence interval, −57.7 to −49.9; P < 0.001), reflecting augmented CFTR function. There was significant improvement in hospitalization rate (P < 0.001) and Pseudomonas aeruginosa burden (P < 0.01). Significant improvements in mucociliary clearance (P < 0.001), gastrointestinal pH (P = 0.001), and microbiome were also observed, providing clinical mechanisms underlying the therapeutic benefit of ivacaftor. Conclusions: Significant clinical and physiologic improvements were observed on initiation of ivacaftor in a broad patient population, including reduced infection with P. aeruginosa. Biomarker studies substantially improve the understanding of the mechanistic consequences of CFTR modulation on pulmonary and gastrointestinal physiology. PMID:24927234

Impact of Lidar Wind Sounding on Mesoscale Forecast

NASA Technical Reports Server (NTRS)

Miller, Timothy L.; Chou, Shih-Hung; Goodman, H. Michael (Technical Monitor)

2001-01-01

An Observing System Simulation Experiment (OSSE) was conducted to study the impact of airborne lidar wind sounding on mesoscale weather forecast. A wind retrieval scheme, which interpolates wind data from a grid data system, simulates the retrieval of wind profile from a satellite lidar system. A mesoscale forecast system based on the PSU/NCAR MM5 model is developed and incorporated the assimilation of the retrieved line-of-sight wind. To avoid the "identical twin" problem, the NCEP reanalysis data is used as our reference "nature" atmosphere. The simulated space-based lidar wind observations were retrieved by interpolating the NCEP values to the observation locations. A modified dataset obtained by smoothing the NCEP dataset was used as the initial state whose forecast was sought to be improved by assimilating the retrieved lidar observations. Forecasts using wind profiles with various lidar instrument parameters has been conducted. The results show that to significantly improve the mesoscale forecast the satellite should fly near the storm center with large scanning radius. Increasing lidar firing rate also improves the forecast. Cloud cover and lack of aerosol degrade the quality of the lidar wind data and, subsequently, the forecast.

Advancing land surface model development with satellite-based Earth observations

NASA Astrophysics Data System (ADS)

Orth, Rene; Dutra, Emanuel; Trigo, Isabel F.; Balsamo, Gianpaolo

2017-04-01

The land surface forms an essential part of the climate system. It interacts with the atmosphere through the exchange of water and energy and hence influences weather and climate, as well as their predictability. Correspondingly, the land surface model (LSM) is an essential part of any weather forecasting system. LSMs rely on partly poorly constrained parameters, due to sparse land surface observations. With the use of newly available land surface temperature observations, we show in this study that novel satellite-derived datasets help to improve LSM configuration, and hence can contribute to improved weather predictability. We use the Hydrology Tiled ECMWF Scheme of Surface Exchanges over Land (HTESSEL) and validate it comprehensively against an array of Earth observation reference datasets, including the new land surface temperature product. This reveals satisfactory model performance in terms of hydrology, but poor performance in terms of land surface temperature. This is due to inconsistencies of process representations in the model as identified from an analysis of perturbed parameter simulations. We show that HTESSEL can be more robustly calibrated with multiple instead of single reference datasets as this mitigates the impact of the structural inconsistencies. Finally, performing coupled global weather forecasts we find that a more robust calibration of HTESSEL also contributes to improved weather forecast skills. In summary, new satellite-based Earth observations are shown to enhance the multi-dataset calibration of LSMs, thereby improving the representation of insufficiently captured processes, advancing weather predictability and understanding of climate system feedbacks. Orth, R., E. Dutra, I. F. Trigo, and G. Balsamo (2016): Advancing land surface model development with satellite-based Earth observations. Hydrol. Earth Syst. Sci. Discuss., doi:10.5194/hess-2016-628

Optical Studies of Excitonic Effects at Two-Dimensional Nanostructure Interfaces

NASA Astrophysics Data System (ADS)

Ajayi, Obafunso Ademilolu

Atomically thin two-dimensional nanomaterials such as graphene and transition metal dichalcogenides (TMDCs) have seen a rapid growth of exploration since the isolation of monolayer graphene. These materials provide a rich field of study for physics and optoelectronics applications. Many applications seek to combine a two dimensional (2D) material with another nanomaterial, either another two dimensional material or a zero (0D) or one dimensional (1D) material. The work in this thesis explores the consequences of these interactions from 0D to 2D. We begin in Chapter 2 with a study of energy transfer at 0D-2D interfaces with quantum dots and graphene. In our work we seek to maximize the rate of energy transfer by reducing the distance between the materials. We observe an interplay with the distance-dependence and surface effects from our halogen terminated quantum dots that affect our observed energy transfer. In Chapter 3 we study supercapacitance in composite graphene oxide-carbon nanotube electrodes. At this 2D-1D interface we observe a compounding effect between graphene oxide and carbon nanotubes. Carbon nanotubes increase the accessible surface area of the supercapacitors and improve conductivity by forming a conductive pathway through electrodes. In Chapter 4 we investigate effective means of improving sample quality in TMDCs and discover the importance of the monolayer interface. We observe a drastic improvement in photoluminescence when encapsulating our TMDCs with Boron Nitride. We measure spectral linewidths approaching the intrinsic limit due to this 2D-2D interface. We also effectively reduce excess charge and thus the trion-exciton ratio in our samples through substrate surface passivation. In Chapter 5 we briefly discuss our investigations on chemical doping, heterostructures and interlayer decoupling in ReS2. We observe an increase in intensity for p-doped MoS2 samples. We investigated the charge transfer exciton previously identified in heterostructures. Spectral observation of this interlayer exciton remained elusive in our work but provided the motivation for our work in Chapter 4. We also discuss our preliminary results on interlayer decoupling in ReS2.

Testosterone and the metabolic syndrome

PubMed Central

Muraleedharan, Vakkat; Jones, T. Hugh

2010-01-01

Metabolic syndrome and testosterone deficiency in men are closely Linked. Epidemiological studies have shown that Low testosterone Levels are associated with obesity, insulin resistance and an adverse Lipid profile in men. Conversely in men with metabolic syndrome and type 2 diabetes have a high prevalence of hypogonadism. Metabolic syndrome and Low testosterone status are both independently associated with increased all-cause and cardiovascular mortality. Observational and experimental data suggest that physiological replacement of testosterone produces improvement in insulin resistance, obesity, dyslipidae-mia and sexual dysfunction along with improved quality of Life. However, there are no Long-term interventional studies to assess the effect of testosterone replacement on mortality in men with Low testosterone Levels. This article reviews the observational and interventional clinical data in relation to testosterone and metabolic syndrome. PMID:23148165

Implementation of WHO multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a Traditional Chinese Medicine hospital in Xi'an, China.

PubMed

Shen, Li; Wang, Xiaoqing; An, Junming; An, Jialu; Zhou, Ning; Sun, Lu; Chen, Hong; Feng, Lin; Han, Jing; Liu, Xiaorong

2017-01-01

Hand hygiene (HH) is an essential component for preventing and controlling of healthcare-associated infection (HAI), whereas compliance with HH among health care workers (HCWs) is frequently poor. This study aimed to assess compliance and correctness with HH before and after the implementation of a multimodal HH improvement strategy launched by the World Health Organization (WHO). A quasi-experimental study design including questionnaire survey generalizing possible factors affecting HH behaviors of HCWs and direct observation method was used to evaluate the effectiveness of WHO multimodal HH strategy in a hospital of Traditional Chinese Medicine. Multimodal HH improvement strategy was drawn up according to the results of questionnaire survey. Compliance and correctness with HH among HCWs were compared before and after intervention. Also HH practices for different indications based on WHO "My Five Moments for Hand Hygiene" were recorded. In total, 553 HCWs participated in the questionnaire survey and multimodal HH improvement strategy was developed based on individual, environment and management levels. A total of 5044 observations in 23 wards were recorded in this investigation. The rate of compliance and correctness with HH improved from 66.27% and 47.75% at baseline to 80.53% and 88.35% after intervention. Doctors seemed to have better compliance with HH after intervention (84.04%) than nurses and other HCWs (81.07% and 69.42%, respectively). When stratified by indication, compliance with HH improved for all indications after intervention ( P  < 0.05) except for "after body fluid exposure risk" and "after touching patient surroundings". Implementing the WHO multimodal HH strategy can significantly improve HH compliance and correctness among HCWs.

Autologous Myoblast Transplantation for Oculopharyngeal Muscular Dystrophy: a Phase I/Iia Clinical Study

PubMed Central

Périé, Sophie; Trollet, Capucine; Mouly, Vincent; Vanneaux, Valérie; Mamchaoui, Kamel; Bouazza, Belaïd; Marolleau, Jean Pierre; Laforêt, Pascal; Chapon, Françoise; Eymard, Bruno; Butler-Browne, Gillian; Larghero, Jérome; St Guily, Jean Lacau

2014-01-01

Oculopharyngeal muscular dystrophy (OPMD) is a late-onset autosomal dominant genetic disease mainly characterized by ptosis and dysphagia. We conducted a phase I/IIa clinical study (ClinicalTrials.gov NCT00773227) using autologous myoblast transplantation following myotomy in adult OPMD patients. This study included 12 patients with clinical diagnosis of OPMD, indication for cricopharyngeal myotomy, and confirmed genetic diagnosis. The feasibility and safety end points of both autologous myoblast transplantation and the surgical procedure were assessed by videoendoscopy in addition to physical examinations. Potential therapeutic benefit was also assessed through videoendoscopy and videofluoroscopy of swallowing, quality of life score, dysphagia grade, and a drink test. Patients were injected with a median of 178 million myoblasts following myotomy. Short and long-term (2 years) safety and tolerability were observed in all the patients, with no adverse effects. There was an improvement in the quality of life score for all 12 patients, and no functional degradation in swallowing was observed for 10 patients. A cell dose-dependant improvement in swallowing was even observed in this study. This trial supports the hypothesis that a local injection of autologous myoblasts in the pharyngeal muscles is a safe and efficient procedure for OPMD patients. PMID:23831596

Improvement of Storm Forecasts Using Gridded Bayesian Linear Regression for Northeast United States

NASA Astrophysics Data System (ADS)

Yang, J.; Astitha, M.; Schwartz, C. S.

2017-12-01

Bayesian linear regression (BLR) is a post-processing technique in which regression coefficients are derived and used to correct raw forecasts based on pairs of observation-model values. This study presents the development and application of a gridded Bayesian linear regression (GBLR) as a new post-processing technique to improve numerical weather prediction (NWP) of rain and wind storm forecasts over northeast United States. Ten controlled variables produced from ten ensemble members of the National Center for Atmospheric Research (NCAR) real-time prediction system are used for a GBLR model. In the GBLR framework, leave-one-storm-out cross-validation is utilized to study the performances of the post-processing technique in a database composed of 92 storms. To estimate the regression coefficients of the GBLR, optimization procedures that minimize the systematic and random error of predicted atmospheric variables (wind speed, precipitation, etc.) are implemented for the modeled-observed pairs of training storms. The regression coefficients calculated for meteorological stations of the National Weather Service are interpolated back to the model domain. An analysis of forecast improvements based on error reductions during the storms will demonstrate the value of GBLR approach. This presentation will also illustrate how the variances are optimized for the training partition in GBLR and discuss the verification strategy for grid points where no observations are available. The new post-processing technique is successful in improving wind speed and precipitation storm forecasts using past event-based data and has the potential to be implemented in real-time.

Improving Lightning and Precipitation Prediction of Severe Convection Using Lightning Data Assimilation With NCAR WRF-RTFDDA

NASA Astrophysics Data System (ADS)

Wang, Haoliang; Liu, Yubao; Cheng, William Y. Y.; Zhao, Tianliang; Xu, Mei; Liu, Yuewei; Shen, Si; Calhoun, Kristin M.; Fierro, Alexandre O.

2017-11-01

In this study, a lightning data assimilation (LDA) scheme was developed and implemented in the National Center for Atmospheric Research Weather Research and Forecasting-Real-Time Four-Dimensional Data Assimilation system. In this LDA method, graupel mixing ratio (qg) is retrieved from observed total lightning. To retrieve qg on model grid boxes, column-integrated graupel mass is first calculated using an observation-based linear formula between graupel mass and total lightning rate. Then the graupel mass is distributed vertically according to the empirical qg vertical profiles constructed from model simulations. Finally, a horizontal spread method is utilized to consider the existence of graupel in the adjacent regions of the lightning initiation locations. Based on the retrieved qg fields, latent heat is adjusted to account for the latent heat releases associated with the formation of the retrieved graupel and to promote convection at the observed lightning locations, which is conceptually similar to the method developed by Fierro et al. Three severe convection cases were studied to evaluate the LDA scheme for short-term (0-6 h) lightning and precipitation forecasts. The simulation results demonstrated that the LDA was effective in improving the short-term lightning and precipitation forecasts by improving the model simulation of the qg fields, updrafts, cold pool, and front locations. The improvements were most notable in the first 2 h, indicating a highly desired benefit of the LDA in lightning and convective precipitation nowcasting (0-2 h) applications.

Masitinib in the treatment of active rheumatoid arthritis: results of a multicentre, open-label, dose-ranging, phase 2a study

PubMed Central

Tebib, Jacques; Mariette, Xavier; Bourgeois, Pierre; Flipo, René-Marc; Gaudin, Philippe; Le Loët, Xavier; Gineste, Paul; Guy, Laurent; Mansfield, Colin D; Moussy, Alain; Dubreuil, Patrice; Hermine, Olivier; Sibilia, Jean

2009-01-01

Introduction Since current treatment options for patients suffering from active rheumatoid arthritis (RA) remain inadequate, especially for those unresponsive to disease-modifying antirheumatic drugs (DMARDs), new and improved medication is needed. This study evaluates the safety and efficacy of masitinib (AB1010), a potent and selective protein tyrosine kinase inhibitor of c-KIT, in the monotherapy treatment of DMARD-refractory RA. Methods This was a multicentre, uncontrolled, open-label, randomised, dose-ranging, phase 2a trial. Masitinib was administered orally to 43 patients who had inadequate response to DMARDs, at initial randomised dosing levels of 3 and 6 mg/kg per day over a 12-week period. Dose adjustment was permitted based upon tolerability and response criteria. Efficacy was assessed via American College of Rheumatology 20%/50%/70% improvement criteria (ACR20/50/70) responses, disease activity score using 28 joint counts (DAS28), index of improvement in RA (ACRn) and C-reactive protein (CRP) improvement, relative to baseline at week 12. Results Improvement was observed in all efficacy endpoints, including ACR20/50/70 scores of 54%, 26% and 8%, respectively, and a reduction in CRP level by greater than 50% for approximately half the population. This improvement was sustainable throughout an extension phase (> 84 weeks) and was also independent of initial DMARD resistance (anti-tumour necrosis factor-alpha and/or methotrexate). A relatively high patient withdrawal rate (37%) required the use of last observation carried forward (LOCF) data imputation. Incidence of adverse events was high (95%), although the majority were of mild or moderate severity with a considerable decline in frequency observed after 12 weeks of treatment. Two nonfatal serious adverse events were reported. Dose-response analyses tentatively indicate that an initial dosing level of 6.0 mg/kg per day administered orally in two daily intakes is the most appropriate, based upon potency and tolerability trends. Conclusions Treatment with masitinib improved DMARD-refractory active RA. Following an initial high incidence of mostly mild to moderate side effects during the first 12 weeks of treatment, masitinib appears to be generally well tolerated. This, together with evidence of a sustainable efficacy response, suggests that masitinib is suitable for long-term treatment regimens. Since this was the first study of masitinib in a nononcologic pathology, the relatively high patient withdrawal rate observed can be partly attributed to a highly cautious response to adverse events. There is sufficient compelling evidence to warrant further placebo-controlled investigation. Trial registration ClinicalTrials.gov NCT00831922. PMID:19549290

Improving MAVEN-IUVS Lyman-Alpha Apoapsis Images

NASA Astrophysics Data System (ADS)

Chaffin, M.; AlMannaei, A. S.; Jain, S.; Chaufray, J. Y.; Deighan, J.; Schneider, N. M.; Thiemann, E.; Mayyasi, M.; Clarke, J. T.; Crismani, M. M. J.; Stiepen, A.; Montmessin, F.; Epavier, F.; McClintock, B.; Stewart, I. F.; Holsclaw, G.; Jakosky, B. M.

2017-12-01

In 2013, the Mars Atmosphere and Volatile EvolutioN (MAVEN) mission was launched to study the Martian upper atmosphere and ionosphere. MAVEN orbits through a very thin cloud of hydrogen gas, known as the hydrogen corona, that has been used to explore the planet's geologic evolution by detecting the loss of hydrogen from the atmosphere. Here we present various methods of extracting properties of the hydrogen corona from observations using MAVEN's Imaging Ultraviolet Spectograph (IUVS) instrument. The analysis presented here uses the IUVS Far Ultraviolet mode apoapase data. From apoapse, IUVS is able to obtain images of the hydrogen corona by detecting the Lyman-alpha airglow using a combination of instrument scan mirror and spacecraft motion. To complete one apoapse observation, eight scan swaths are performed to collect the observations and construct a coronal image. However, these images require further processing to account for the atmospheric MUV background that hinders the quality of the data. Here, we present new techniques for correcting instrument data. For the background subtraction, a multi-linear regression (MLR) routine of the first order MUV radiance was used to improve the images. A flat field correction was also applied by fitting a polynomial to periapse radiance observations. The apoapse data was re-binned using this fit.The results are presented as images to demonstrate the improvements in the data reduction. Implementing these methods for more orbits will improve our understanding of seasonal variability and H loss. Asymmetries in the Martian hydrogen corona can also be assessed to improve current model estimates of coronal H in the Martian atmosphere.

Improving Learning Analytics--Combining Observational and Self-Report Data on Student Learning

ERIC Educational Resources Information Center

Ellis, Robert A.; Han, Feifei; Pardo, Abelardo

2017-01-01

The field of education technology is embracing a use of learning analytics to improve student experiences of learning. Along with exponential growth in this area is an increasing concern of the interpretability of the analytics from the student experience and what they can tell us about learning. This study offers a way to address some of the…

Improving the Students' Activity and Learning Outcomes on Social Sciences Subject Using Round Table and Rally Coach of Cooperative Learning Model

ERIC Educational Resources Information Center

Ningsih; Soetjipto, Budi Eko; Sumarmi

2017-01-01

The purpose of this study was: (1) to analyze increasing students' learning activity and learning outcomes. Student activities which were observed include the visual, verbal, listening, writing and mental visual activity; (2) to analyze the improvement of student learning outcomes using "Round Table" and "Rally Coach" Model of…

Minocycline in leprosy patients with recent onset clinical nerve function impairment.

PubMed

Narang, Tarun; Arshdeep; Dogra, Sunil

2017-01-01

Nerve function impairment (NFI) in leprosy may occur and progress despite multidrug therapy alone or in combination with corticosteroids. We observed improvement in neuritis when minocycline was administered in patients with type 2 lepra reaction. This prompted us to investigate the role of minocycline in recent onset NFI, especially in corticosteroid unresponsive leprosy patients. Leprosy patients with recent onset clinical NFI (<6 months), as determined by Monofilament Test (MFT) and Voluntary Muscle Test (VMT), were recruited. Minocycline 100mg/day was given for 3 months to these patients. The primary outcome was the proportion of patients with 'restored,' 'improved,' 'stabilized,' or 'deteriorated' NFI. Secondary outcomes included any improvement in nerve tenderness and pain. In this pilot study, 11 patients were recruited. The progression of NFI was halted in all; with 9 out of 11 patients (81.82%) showing ?restored? or ?improved? sensory or motor nerve functions, on assessment with MFT and VMT. No serious adverse effects due to minocycline were observed. Our pilot study demonstrates the efficacy and safety of minocycline in recent onset NFI in leprosy patients. However, larger and long term comparative trials are needed to validate the efficacy of minocycline in leprosy neuropathy. © 2016 Wiley Periodicals, Inc.

Inquiry-based Science Instruction in High School Biology Courses: A Multiple Case Study

NASA Astrophysics Data System (ADS)

Aso, Eze

A lack of research exists about how secondary school science teachers use inquiry-based instruction to improve student learning. The purpose of this qualitative study was to explore how science teachers used inquiry-based instruction to improve student learning in high school biology courses. The conceptual framework was based on Banchi and Bell's model of increasing levels of complexity for inquiry-based instruction. A multiple case study research design was conducted of biology programs at 3 high schools in an urban school district in the northeastern region of the United States. Participants included 2 biology teachers from each of the 3 high schools. Data were collected from individual interviews with biology teachers, observations of lessons in biology, and documents related to state standards, assessments, and professional development. The first level of data analysis involved coding and categorizing the interview and observation data. A content analysis was used for the documents. The second level of data analysis involved examining data across all sources and all cases for themes and discrepancies. According to study findings, biology teachers used confirmation, structure, and guided inquiry to improve student learning. However, they found open inquiry challenging and frustrating to implement because professional development about scaffolding of instruction over time was needed, and students' reading and writing skills needed to improve. This study contributes to positive social change by providing educators and researchers with a deeper understanding about how to scaffold levels of inquiry-based science instruction in order to help students become scientifically literate citizens.

Organization of care for persons with HIV-infection: a systematic review.

PubMed

Handford, Curtis D; Tynan, Anne-Marie; Agha, Ayda; Rzeznikiewiz, Damian; Glazier, Richard H

2017-07-01

The objective of this systematic review was to examine the effectiveness of the organization of care: case management, multidisciplinary care, multi-faceted treatment, hours of service, outreach programs and health information systems on medical, immunological, virological, psychosocial and economic outcomes for persons living with HIV/AIDS. We searched PubMed (MEDLINE) and 10 other electronic databases from 1 January 1980 to April, 2012 for both experimental and controlled observational studies. Thirty-three studies met the inclusion criteria. Eleven studies were randomized controlled trials (RCTs), three of which were conducted in low-middle income settings. Patient characteristics, study design, organization measures and outcomes data were abstracted independently by two reviewers from all studies. A risk of bias tool was applied to RCTs and a separate tool was used to assess the quality of observational studies. This review concludes that case management interventions were most consistently associated with improvements in immunological outcomes but case management demonstrates no clear association with other outcome measures. The same mixed results were also identified for multidisciplinary and multi-faceted care interventions. Eight studies with an outreach intervention were identified and demonstrated improvements or non-inferiority with respect to mortality, receipt of antiretroviral medications, immunological outcomes, improvements in healthcare utilization and lower reported healthcare costs when compared to usual care. Of the interventions examined in this review, sustained in-person case management and outreach interventions were most consistently associated with improved medical and economic outcomes, in particular antiretroviral prescribing, immunological outcomes and healthcare utilization. No firm conclusions can be reached about the impact of any one intervention on patient mortality.

Multiple model analysis with discriminatory data collection (MMA-DDC): A new method for improving measurement selection

NASA Astrophysics Data System (ADS)

Kikuchi, C.; Ferre, P. A.; Vrugt, J. A.

2011-12-01

Hydrologic models are developed, tested, and refined based on the ability of those models to explain available hydrologic data. The optimization of model performance based upon mismatch between model outputs and real world observations has been extensively studied. However, identification of plausible models is sensitive not only to the models themselves - including model structure and model parameters - but also to the location, timing, type, and number of observations used in model calibration. Therefore, careful selection of hydrologic observations has the potential to significantly improve the performance of hydrologic models. In this research, we seek to reduce prediction uncertainty through optimization of the data collection process. A new tool - multiple model analysis with discriminatory data collection (MMA-DDC) - was developed to address this challenge. In this approach, multiple hydrologic models are developed and treated as competing hypotheses. Potential new data are then evaluated on their ability to discriminate between competing hypotheses. MMA-DDC is well-suited for use in recursive mode, in which new observations are continuously used in the optimization of subsequent observations. This new approach was applied to a synthetic solute transport experiment, in which ranges of parameter values constitute the multiple hydrologic models, and model predictions are calculated using likelihood-weighted model averaging. MMA-DDC was used to determine the optimal location, timing, number, and type of new observations. From comparison with an exhaustive search of all possible observation sequences, we find that MMA-DDC consistently selects observations which lead to the highest reduction in model prediction uncertainty. We conclude that using MMA-DDC to evaluate potential observations may significantly improve the performance of hydrologic models while reducing the cost associated with collecting new data.

Cell therapy attempted as a novel approach for chronic traumatic brain injury - a pilot study.

PubMed

Sharma, Alok; Sane, Hemangi; Kulkarni, Pooja; Yadav, Jayanti; Gokulchandran, Nandini; Biju, Hema; Badhe, Prerna

2015-01-01

Traumatic brain injury is an injury to the brain parenchyma resulting from external factors such as vehicular accidents, falls, or sports injuries. Its outcome involves primary insult followed by a cascade of secondary insult, resulting in diffuse axonal injury further causing white matter damage. Surgical intervention targets the primary damage, whereas only few treatment alternatives are available to treat the secondary damage. Cellular therapy could be one of the prospective therapeutic options, as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain. We conducted a pilot study on 14 cases who were administered with autologous bone marrow mononuclear cells, intrathecally. The follow up was done at 1 week, 3 months and 6 months after the intervention. The Functional Independence Measure scale, the SF-8 Health Survey Scoring and the disability rating scale were used as outcome measures. These scales showed a positive shift in scores at the end of 6 months. Improvements were observed in various symptoms, along with activities of daily living. Improvement in PET CT scan performed before and 6 months after the intervention in 3 patients corresponded to the clinical and functional improvements observed in these patients. The results of this study suggest that cell therapy may promote functional recovery leading to an improved quality of life in chronic TBI. Although the results are positive, the improvements after cell therapy are not optimal. Hence, additional multicenter, controlled studies are required to establish cell therapy as a standard therapeutic approach.

Computer simulation of the effect of dDAVP with saline loading on fluid balance after 24-hour head-down tilt

NASA Technical Reports Server (NTRS)

Srinivasan, R. S.; Simanonok, K. E.; Charles, J. B.

1994-01-01

Fluid loading (FL) before Shuttle reentry is a countermeasure currently in use by NASA to improve the orthostatic tolerance of astronauts during reentry and postflight. The fluid load consists of water and salt tablets equivalent to 32 oz (946 ml) of isotonic saline. However, the effectiveness of this countermeasure has been observed to decrease with the duration of spaceflight. The countermeasure's effectiveness may be improved by enhancing fluid retention using analogs of vasopressin such as lypressin (LVP) and desmopressin (dDAVP). In a computer simulation study reported previously, we attempted to assess the improvement in fluid retention obtained by the use of LVP administered before FL. The present study is concerned with the use of dDAVP. In a recent 24-hour, 6 degree head-down tilt (HDT) study involving seven men, dDAVP was found to improve orthostatic tolerance as assessed by both lower body negative pressure (LBNP) and stand tests. The treatment restored Luft's cumulative stress index (cumulative product of magnitude and duration of LBNP) to nearly pre-bedrest level. The heart rate was lower and stroke volume was marginally higher at the same LBNP levels with administration of dDAVP compared to placebo. Lower heart rates were also observed with dDAVP during stand test, despite the lower level of cardiovascular stress. These improvements were seen with only a small but significant increase in plasma volume of approximately 3 percent. This paper presents a computer simulation analysis of some of the results of this HDT study.

Reducing patients' falls rate in an Academic Medical Center (AMC) using Six Sigma "DMAIC" approach.

PubMed

Kuwaiti, Ahmed Al; Subbarayalu, Arun Vijay

2017-05-08

Purpose The purpose of this paper is to evaluate the impact of adopting the Six Sigma define, measure, analyze, improve and control (DMAIC) approach in reducing patients fall rate in an Academic Medical Center, Saudi Arabia. Design/methodology/approach A prospective study design was adopted and this study was conducted at King Fahd Hospital of the University (KFHU) during the year 2014. Based on the historical data of the patients' falls reported at KFHU during the year 2013, the goal was fixed to reduce the falls rate from 7.18 to<3 (over 60 percent reduction) by the end of December 2014. This study was conducted through the five phases of "DMAIC" approach using various quality tools. Three time periods were identified, namely, pre-intervention phase; intervention phase; and post-intervention phase. Appropriate strategies were identified through the process of brainstorming and were implemented to study the potential causes leading to the occurrence of falls. Findings The pre-intervention falls rate was reported as 6.57 whereas the post-intervention falls rate was measured as 1.91 (demonstrating a 70.93 percent reduction) after the implementation of improvement strategies. The adherence rate toward the practice of carrying falls risk assessment and hourly rounding was observed to be high where 88 percent of nurses are regularly practicing it. A control plan was also executed to sustain the improvements obtained. Originality/value The Six Sigma "DMAIC" approach improves the processes related to the prevention of falls. A greater reduction in patients falls rate (over 70 percent) was observed after the implementation of the improvement strategy.

Group-based microfinance for collective empowerment: a systematic review of health impacts

PubMed Central

Pennington, Andy; Nayak, Shilpa; Sowden, Amanda; White, Martin; Whitehead, Margaret

2016-01-01

Abstract Objective To assess the impact on health-related outcomes, of group microfinance schemes based on collective empowerment. Methods We searched the databases Social Sciences Citation Index, Embase, MEDLINE, MEDLINE In-Process, PsycINFO, Social Policy & Practice and Conference Proceedings Citation Index for articles published between 1 January 1980 and 29 February 2016. Articles reporting on health impacts associated with group-based microfinance were included in a narrative synthesis. Findings We identified one cluster-randomized control trial and 22 quasi-experimental studies. All of the included interventions targeted poor women living in low- or middle-income countries. Some included a health-promotion component. The results of the higher quality studies indicated an association between membership of a microfinance scheme and improvements in the health of women and their children. The observed improvements included reduced maternal and infant mortality, better sexual health and, in some cases, lower levels of interpersonal violence. According to the results of the few studies in which changes in empowerment were measured, membership of the relatively large and well-established microfinance schemes generally led to increased empowerment but this did not necessarily translate into improved health outcomes. Qualitative evidence suggested that increased empowerment may have contributed to observed improvements in contraceptive use and mental well-being and reductions in the risk of violence from an intimate partner. Conclusion Membership of the larger, well-established group-based microfinance schemes is associated with improvements in some health outcomes. Future studies need to be designed to cope better with bias and to assess negative as well as positive social and health impacts. PMID:27708475

Group-based microfinance for collective empowerment: a systematic review of health impacts.

PubMed

Orton, Lois; Pennington, Andy; Nayak, Shilpa; Sowden, Amanda; White, Martin; Whitehead, Margaret

2016-09-01

To assess the impact on health-related outcomes, of group microfinance schemes based on collective empowerment. We searched the databases Social Sciences Citation Index, Embase, MEDLINE, MEDLINE In-Process, PsycINFO, Social Policy & Practice and Conference Proceedings Citation Index for articles published between 1 January 1980 and 29 February 2016. Articles reporting on health impacts associated with group-based microfinance were included in a narrative synthesis. We identified one cluster-randomized control trial and 22 quasi-experimental studies. All of the included interventions targeted poor women living in low- or middle-income countries. Some included a health-promotion component. The results of the higher quality studies indicated an association between membership of a microfinance scheme and improvements in the health of women and their children. The observed improvements included reduced maternal and infant mortality, better sexual health and, in some cases, lower levels of interpersonal violence. According to the results of the few studies in which changes in empowerment were measured, membership of the relatively large and well-established microfinance schemes generally led to increased empowerment but this did not necessarily translate into improved health outcomes. Qualitative evidence suggested that increased empowerment may have contributed to observed improvements in contraceptive use and mental well-being and reductions in the risk of violence from an intimate partner. Membership of the larger, well-established group-based microfinance schemes is associated with improvements in some health outcomes. Future studies need to be designed to cope better with bias and to assess negative as well as positive social and health impacts.

The Detection and Attribution Model Intercomparison Project (DAMIP v1.0)contribution to CMIP6

DOE PAGES

Gillett, Nathan P.; Shiogama, Hideo; Funke, Bernd; ...

2016-10-18

Detection and attribution (D&A) simulations were important components of CMIP5 and underpinned the climate change detection and attribution assessments of the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. The primary goals of the Detection and Attribution Model Intercomparison Project (DAMIP) are to facilitate improved estimation of the contributions of anthropogenic and natural forcing changes to observed global warming as well as to observed global and regional changes in other climate variables; to contribute to the estimation of how historical emissions have altered and are altering contemporary climate risk; and to facilitate improved observationally constrained projections of futuremore » climate change. D&A studies typically require unforced control simulations and historical simulations including all major anthropogenic and natural forcings. Such simulations will be carried out as part of the DECK and the CMIP6 historical simulation. In addition D&A studies require simulations covering the historical period driven by individual forcings or subsets of forcings only: such simulations are proposed here. Key novel features of the experimental design presented here include firstly new historical simulations with aerosols-only, stratospheric-ozone-only, CO2-only, solar-only, and volcanic-only forcing, facilitating an improved estimation of the climate response to individual forcing, secondly future single forcing experiments, allowing observationally constrained projections of future climate change, and thirdly an experimental design which allows models with and without coupled atmospheric chemistry to be compared on an equal footing.« less

The Detection and Attribution Model Intercomparison Project (DAMIP v1.0) contribution to CMIP6

NASA Astrophysics Data System (ADS)

Gillett, Nathan P.; Shiogama, Hideo; Funke, Bernd; Hegerl, Gabriele; Knutti, Reto; Matthes, Katja; Santer, Benjamin D.; Stone, Daithi; Tebaldi, Claudia

2016-10-01

Detection and attribution (D&A) simulations were important components of CMIP5 and underpinned the climate change detection and attribution assessments of the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. The primary goals of the Detection and Attribution Model Intercomparison Project (DAMIP) are to facilitate improved estimation of the contributions of anthropogenic and natural forcing changes to observed global warming as well as to observed global and regional changes in other climate variables; to contribute to the estimation of how historical emissions have altered and are altering contemporary climate risk; and to facilitate improved observationally constrained projections of future climate change. D&A studies typically require unforced control simulations and historical simulations including all major anthropogenic and natural forcings. Such simulations will be carried out as part of the DECK and the CMIP6 historical simulation. In addition D&A studies require simulations covering the historical period driven by individual forcings or subsets of forcings only: such simulations are proposed here. Key novel features of the experimental design presented here include firstly new historical simulations with aerosols-only, stratospheric-ozone-only, CO2-only, solar-only, and volcanic-only forcing, facilitating an improved estimation of the climate response to individual forcing, secondly future single forcing experiments, allowing observationally constrained projections of future climate change, and thirdly an experimental design which allows models with and without coupled atmospheric chemistry to be compared on an equal footing.

First Real-World Insights into Belimumab Use and Outcomes in Routine Clinical Care of Systemic Lupus Erythematosus in Germany: Results from the OBSErve Germany Study.

PubMed

Schwarting, Andreas; Schroeder, Johann O; Alexander, Tobias; Schmalzing, Marc; Fiehn, Christoph; Specker, Christof; Perna, Alessandra; Cholmakow-Bodechtel, Constanze; Koscielny, Volker B; Carnarius, Heike

2016-12-01

OBSErve Germany was the first observational study of belimumab as add-on treatment for systemic lupus erythematosus (SLE) in routine clinical care in Germany, retrospectively collecting data from 102 SLE patients, 6 months before and after belimumab initiation. Most patients had moderate or severe SLE and several SLE manifestations. After 6 months of belimumab treatment, 78% of patients showed an improvement in overall disease activity of at least 20% in their physician's judgment and for 42% of patients the improvement was at least 50%. Similar results were observed for the most common manifestations: arthritis, fatigue, rash, alopecia, increased anti-dsDNA antibody levels, and low complement. The SLE Disease Activity Index (SLEDAI/SELENA-SLEDAI) decreased from 10.6 to 5.6 (n = 65), with other indices also showing improvement. A notable dose reduction was seen for concomitant oral corticosteroids, from 13.7 to 7.6 mg/day overall (n = 91), and from 17.5 to 8.6 mg/day in patients with a high corticosteroid dose at belimumab initiation (≥7.5 mg; n = 63). Six patients discontinued belimumab therapy within 6 months. Overall, belimumab showed promising results for SLE patients in real-world settings. After 6 months of belimumab treatment, disease activity and corticosteroid use were reduced. The discontinuation rate was low and belimumab appeared to be well tolerated. Funding GlaxoSmithKline UK.

[Pilot study about the effectivity of an intervention based on games in nutritional status and muscle strength on children].

PubMed

Soto-Sánchez, Johana Patricia; Pavez Saldiviar, Nicolás Fernando; Bravo-Gatica, Javier Ignacio; White Ortiz, Alan Rigoberto; Jaque Fernández, Francisco Ignacio; Vargas-Gyllen, Cristian Ignacio; Arriagada Cárdenas, Sandra; Carrasco Naranjo, Fernando; Cano-Cappellacci, Marcelo Antonio

2014-07-01

The overnutrition is a constant on developing countries; Chile is not an exception because it has a marked tendency to overweight and obesity in schoolchildren. The muscular strength has been associated with cardiovascular and metabolic health status in scholars. Effective interventions using games are needed to improve the nutritional status and physical fitness in school children. To assess the intervention effectiveness based on games played at school time to improve the nutritional status and physical fitness in schoolchildren. 156 students aged between 7 to 15 years, attending to two public schools with full school day, to which a pilot program was applied. This pilot program was based on dynamic recreational games during 45 minutes from monday to friday for 3 months in the largest playtime of the school day. At the end of the intervention, we observed a significant modification on children nutritional status, which highlights an increase in the number of children that reached the normal nutritional status (p < 0.001). We also observed a significant number of obese children who reached overweight nutritional status (p < 0.001). We also observed a decrease of leg muscular strength at the end of the study. We found a positive effect of a program based on dynamic recreational games in the largest school playtime, improving nutritional status. However, we didn't observed modifications in the muscular strength. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

PubMed

McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

2015-09-01

Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reconstruction of Long-Term Discharge Data in a Snow Dominant Region considering Uncertainty in Snow Measurement

NASA Astrophysics Data System (ADS)

Kim, S.

2016-12-01

This study to improve the accuracy of discharge simulation at the head water of the Tone River Basin (Yagisawa Dam Basin; 167 km2 and Naramata Dam Basin; 67 km2), Japan, where the river discharge is governed by the snowmelt and thus much uncertainty was originated in our previous study (Kim et al, 2011). To decrease the uncertainty in our hydrological modeling and simulation, snowmelt amounts are estimated rigorously using an improved degree-day method. The degree-day method, which is the simplest method to estimate snowmelt, is adopted with an improved degree-day factor estimation method. The degree-day factor for the target area is estimated using the observed temperature and the observed river discharge of the snowmelt season. Using long-term observed data, the unique relationship between the degree-day factor and temperature are extracted, and the estimated degree-day factor as a function of temperature is applied for the winter season discharge simulation. Rainfall-runoff simulation for the rest of season is done by the kinematic wave model based on the stage-discharge relationship, considering surface-subsurface flow generation. Finally, long-term (1979-2008) simulation output for the dam inflow is reconstructed and compared with the observed one. ( Kim, S., Tachikawa, Y., Nakakita, E., Yorozu, K. and Shiiba, M. 2011. Climate change impact on river flow of the Tone river basin, Japan, Annual Journal of Hydraulic Engneering, JSCE, 55:S_85-S_90.)

wfip2.model/retro.hrrr.01.fcst.01 (Model: 10-Day Retrospective)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/retro.hrrr.02.fcst.01 (Model: 10-Day Retrospective)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/retro.hrrr.02.fcst.02 (Model: 10-Day Retrospective)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/retro.rap.01.fcst.01 (Model: 10-Day Retrospective)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/realtime.hrrr_wfip2.graphics.02 (Model: Real Time)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/retro.rap.02.fcst.01 (Model: 10-Day Retrospective)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/realtime.hrrr_wfip2.icbc.02 (Model: Real Time)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

wfip2.model/retro.hrrr.01.fcst.02 (Model: 10-Day Retrospective)

DOE Data Explorer

Macduff, Matt

2017-10-27

The primary purpose of WFIP2 Model Development Team is to improve existing numerical weather prediction models in a manner that leads to improved wind forecasts in regions of complex terrain. Improvements in the models will come through better understanding of the physics associated with the wind flow in and around the wind plant across a range of temporal and spatial scales, which will be gained through WFIP2’s observational field study and analysis.

A View of Hurricane Katrina with Early 2lSt Century Technology

NASA Technical Reports Server (NTRS)

Lin, Xin; Li, J.-L.; Suarez, M. J.; Tompkins, A. M.; Waliser, D. E.; Rienecker, M. M.; Bacmeister, J.; Jiang, J.; Wu, H.-T.; Tassone, C. M.

2006-01-01

Recent advances in space-borne observations and numerical weather prediction models provide new opportunities for improving hurricane forecasts. In this study, state-of-the-art satellite observations are used to document the evolution of one of the most devastating tropical cyclones ever to hit the United States: Hurricane Katrina. The ECMWF and NASA global high-resolution forecasts, the latter being run in experimental mode, are compared with satellite observations, with a focus on precipitation and cloud processes. Future directions on modeling and observations are briefly discussed.

Perceptual Learning Improves Stereoacuity in Amblyopia

PubMed Central

Xi, Jie; Jia, Wu-Li; Feng, Li-Xia; Lu, Zhong-Lin; Huang, Chang-Bing

2014-01-01

Purpose. Amblyopia is a developmental disorder that results in both monocular and binocular deficits. Although traditional treatment in clinical practice (i.e., refractive correction, or occlusion by patching and penalization of the fellow eye) is effective in restoring monocular visual acuity, there is little information on how binocular function, especially stereopsis, responds to traditional amblyopia treatment. We aim to evaluate the effects of perceptual learning on stereopsis in observers with amblyopia in the current study. Methods. Eleven observers (21.1 ± 5.1 years, six females) with anisometropic or ametropic amblyopia were trained to judge depth in 10 to 13 sessions. Red–green glasses were used to present three different texture anaglyphs with different disparities but a fixed exposure duration. Stereoacuity was assessed with the Fly Stereo Acuity Test and visual acuity was assessed with the Chinese Tumbling E Chart before and after training. Results. Averaged across observers, training significantly reduced disparity threshold from 776.7″ to 490.4″ (P < 0.01) and improved stereoacuity from 200.3″ to 81.6″ (P < 0.01). Interestingly, visual acuity also significantly improved from 0.44 to 0.35 logMAR (approximately 0.9 lines, P < 0.05) in the amblyopic eye after training. Moreover, the learning effects in two of the three retested observers were largely retained over a 5-month period. Conclusions. Perceptual learning is effective in improving stereo vision in observers with amblyopia. These results, together with previous evidence, suggest that structured monocular and binocular training might be necessary to fully recover degraded visual functions in amblyopia. Chinese Abstract PMID:24508791

A Prototype Balloon-borne GPS Occultation Profiling System for Polar Studies

NASA Astrophysics Data System (ADS)

Haase, J. S.; Maldonado Vargas, J.; Cocquerez, P.; Rabier, F.; Guidard, V.

2011-12-01

Global warming has focused attention on the polar regions and recent changes in the distribution of sea and land ice. This provides motivation for improving climate and weather models in order to understand the potential future evolution of the cryosphere. Accurate modeling of climate and weather relies heavily on remote sensing observations because of the inaccessibility to in-situ meteorological observations. However, validating satellite observations over the poles, and testing their reliable assimilation into numerical weather prediction models, is challenging because of the extreme environment, topography, and land surface characteristics. Any additional upper-air observations to help confirm and improve the results from satellite data assimilation are useful for this long-term objective. We have developed a stratospheric balloon-borne GPS radio occultation system, in order to provide refractivity and derived temperature profiles for this purpose. We present the prototype instrument that flew in the first research campaign of its type during October-November 2010, as part of the Antarctic CONCORDIASI campaign to demonstrate the feasibility of the concept. Preliminary comparisons of observed excess phase delay profiles agree with those simulated from nearby Météofrance ARPEGE model profiles. During the two balloon flights, which lasted a combined total of 107 days, more than 700 occultations were recorded, this number being limited by the data transmission rates. More than 35% of the profiles descended as low as 5km above sea level. The potential for contributing to the goal of improving atmospheric models in the Antarctic is discussed, and several suggestions are made for further improvements to the system.

Brain plasticity in Parkinson's disease with freezing of gait induced by action observation training.

PubMed

Agosta, Federica; Gatti, Roberto; Sarasso, Elisabetta; Volonté, Maria Antonietta; Canu, Elisa; Meani, Alessandro; Sarro, Lidia; Copetti, Massimiliano; Cattrysse, Erik; Kerckhofs, Eric; Comi, Giancarlo; Falini, Andrea; Filippi, Massimo

2017-01-01

Gait disorders represent a therapeutic challenge in Parkinson's disease (PD). This study investigated the efficacy of 4-week action observation training (AOT) on disease severity, freezing of gait and motor abilities in PD, and evaluated treatment-related brain functional changes. 25 PD patients with freezing of gait were randomized into two groups: AOT (action observation combined with practicing the observed actions) and "Landscape" (same physical training combined with landscape-videos observation). At baseline and 4-week, patients underwent clinical evaluation and fMRI. Clinical assessment was repeated at 8-week. At 4-week, both groups showed reduced freezing of gait severity, improved walking speed and quality of life. Moreover, AOT was associated with reduced motor disability and improved balance. AOT group showed a sustained positive effect on motor disability, walking speed, balance and quality of life at 8-week, with a trend toward a persisting reduced freezing of gait severity. At 4-week vs. baseline, AOT group showed increased recruitment of fronto-parietal areas during fMRI tasks, while the Landscape group showed a reduced fMRI activity of the left postcentral and inferior parietal gyri and right rolandic operculum and supramarginal gyrus. In AOT group, functional brain changes were associated with clinical improvements at 4-week and predicted clinical evolution at 8-week. AOT has a more lasting effect in improving motor function, gait and quality of life in PD patients relative to physical therapy alone. AOT-related performance gains are associated with an increased recruitment of motor regions and fronto-parietal mirror neuron and attentional control areas.

Perceptual learning improves stereoacuity in amblyopia.

PubMed

Xi, Jie; Jia, Wu-Li; Feng, Li-Xia; Lu, Zhong-Lin; Huang, Chang-Bing

2014-04-15

Amblyopia is a developmental disorder that results in both monocular and binocular deficits. Although traditional treatment in clinical practice (i.e., refractive correction, or occlusion by patching and penalization of the fellow eye) is effective in restoring monocular visual acuity, there is little information on how binocular function, especially stereopsis, responds to traditional amblyopia treatment. We aim to evaluate the effects of perceptual learning on stereopsis in observers with amblyopia in the current study. Eleven observers (21.1 ± 5.1 years, six females) with anisometropic or ametropic amblyopia were trained to judge depth in 10 to 13 sessions. Red-green glasses were used to present three different texture anaglyphs with different disparities but a fixed exposure duration. Stereoacuity was assessed with the Fly Stereo Acuity Test and visual acuity was assessed with the Chinese Tumbling E Chart before and after training. Averaged across observers, training significantly reduced disparity threshold from 776.7″ to 490.4″ (P < 0.01) and improved stereoacuity from 200.3″ to 81.6″ (P < 0.01). Interestingly, visual acuity also significantly improved from 0.44 to 0.35 logMAR (approximately 0.9 lines, P < 0.05) in the amblyopic eye after training. Moreover, the learning effects in two of the three retested observers were largely retained over a 5-month period. Perceptual learning is effective in improving stereo vision in observers with amblyopia. These results, together with previous evidence, suggest that structured monocular and binocular training might be necessary to fully recover degraded visual functions in amblyopia. Chinese Abstract.

Validity and reliability of the Paprosky acetabular defect classification.

PubMed

Yu, Raymond; Hofstaetter, Jochen G; Sullivan, Thomas; Costi, Kerry; Howie, Donald W; Solomon, Lucian B

2013-07-01

The Paprosky acetabular defect classification is widely used but has not been appropriately validated. Reliability of the Paprosky system has not been evaluated in combination with standardized techniques of measurement and scoring. This study evaluated the reliability, teachability, and validity of the Paprosky acetabular defect classification. Preoperative radiographs from a random sample of 83 patients undergoing 85 acetabular revisions were classified by four observers, and their classifications were compared with quantitative intraoperative measurements. Teachability of the classification scheme was tested by dividing the four observers into two groups. The observers in Group 1 underwent three teaching sessions; those in Group 2 underwent one session and the influence of teaching on the accuracy of their classifications was ascertained. Radiographic evaluation showed statistically significant relationships with intraoperative measurements of anterior, medial, and superior acetabular defect sizes. Interobserver reliability improved substantially after teaching and did not improve without it. The weighted kappa coefficient went from 0.56 at Occasion 1 to 0.79 after three teaching sessions in Group 1 observers, and from 0.49 to 0.65 after one teaching session in Group 2 observers. The Paprosky system is valid and shows good reliability when combined with standardized definitions of radiographic landmarks and a structured analysis. Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Resolved Observations of Transition Disks

NASA Astrophysics Data System (ADS)

Casassus, Simon

2016-04-01

Resolved observations are bringing new constraints on the origin of radial gaps in protoplanetary disks. The kinematics, sampled in detail in one case-study, are indicative of non-Keplerian flows, corresponding to warped structures and accretion which may both play a role in the development of cavities. Disk asymmetries seen in the radio continuum are being interpreted in the context of dust segregation via aerodynamic trapping. We summarise recent observational progress, and describe prospects for improvements in the near term.

Integration of Local Observations into the One Dimensional Fog Model PAFOG

NASA Astrophysics Data System (ADS)

Thoma, Christina; Schneider, Werner; Masbou, Matthieu; Bott, Andreas

2012-05-01

The numerical prediction of fog requires a very high vertical resolution of the atmosphere. Owing to a prohibitive computational effort of high resolution three dimensional models, operational fog forecast is usually done by means of one dimensional fog models. An important condition for a successful fog forecast with one dimensional models consists of the proper integration of observational data into the numerical simulations. The goal of the present study is to introduce new methods for the consideration of these data in the one dimensional radiation fog model PAFOG. First, it will be shown how PAFOG may be initialized with observed visibilities. Second, a nudging scheme will be presented for the inclusion of measured temperature and humidity profiles in the PAFOG simulations. The new features of PAFOG have been tested by comparing the model results with observations of the German Meteorological Service. A case study will be presented that reveals the importance of including local observations in the model calculations. Numerical results obtained with the modified PAFOG model show a distinct improvement of fog forecasts regarding the times of fog formation, dissipation as well as the vertical extent of the investigated fog events. However, model results also reveal that a further improvement of PAFOG might be possible if several empirical model parameters are optimized. This tuning can only be realized by comprehensive comparisons of model simulations with corresponding fog observations.

Motor-Enriched Learning Activities Can Improve Mathematical Performance in Preadolescent Children.

PubMed

Beck, Mikkel M; Lind, Rune R; Geertsen, Svend S; Ritz, Christian; Lundbye-Jensen, Jesper; Wienecke, Jacob

2016-01-01

Objective: An emerging field of research indicates that physical activity can benefit cognitive functions and academic achievements in children. However, less is known about how academic achievements can benefit from specific types of motor activities (e.g., fine and gross) integrated into learning activities. Thus, the aim of this study was to investigate whether fine or gross motor activity integrated into math lessons (i.e., motor-enrichment) could improve children's mathematical performance. Methods: A 6-week within school cluster-randomized intervention study investigated the effects of motor-enriched mathematical teaching in Danish preadolescent children ( n = 165, age = 7.5 ± 0.02 years). Three groups were included: a control group (CON), which received non-motor enriched conventional mathematical teaching, a fine motor math group (FMM) and a gross motor math group (GMM), which received mathematical teaching enriched with fine and gross motor activity, respectively. The children were tested before (T0), immediately after (T1) and 8 weeks after the intervention (T2). A standardized mathematical test (50 tasks) was used to evaluate mathematical performance. Furthermore, it was investigated whether motor-enriched math was accompanied by different effects in low and normal math performers. Additionally, the study investigated the potential contribution of cognitive functions and motor skills on mathematical performance. Results: All groups improved their mathematical performance from T0 to T1. However, from T0 to T1, the improvement was significantly greater in GMM compared to FMM (1.87 ± 0.71 correct answers) ( p = 0.02). At T2 no significant differences in mathematical performance were observed. A subgroup analysis revealed that normal math-performers benefitted from GMM compared to both CON 1.78 ± 0.73 correct answers ( p = 0.04) and FMM 2.14 ± 0.72 correct answers ( p = 0.008). These effects were not observed in low math-performers. The effects were partly accounted for by visuo-spatial short-term memory and gross motor skills. Conclusion: The study demonstrates that motor enriched learning activities can improve mathematical performance. In normal math performers GMM led to larger improvements than FMM and CON. This was not the case for the low math performers. Future studies should further elucidate the neurophysiological mechanisms underlying the observed behavioral effects.

Motor-Enriched Learning Activities Can Improve Mathematical Performance in Preadolescent Children

PubMed Central

Beck, Mikkel M.; Lind, Rune R.; Geertsen, Svend S.; Ritz, Christian; Lundbye-Jensen, Jesper; Wienecke, Jacob

2016-01-01

Objective: An emerging field of research indicates that physical activity can benefit cognitive functions and academic achievements in children. However, less is known about how academic achievements can benefit from specific types of motor activities (e.g., fine and gross) integrated into learning activities. Thus, the aim of this study was to investigate whether fine or gross motor activity integrated into math lessons (i.e., motor-enrichment) could improve children's mathematical performance. Methods: A 6-week within school cluster-randomized intervention study investigated the effects of motor-enriched mathematical teaching in Danish preadolescent children (n = 165, age = 7.5 ± 0.02 years). Three groups were included: a control group (CON), which received non-motor enriched conventional mathematical teaching, a fine motor math group (FMM) and a gross motor math group (GMM), which received mathematical teaching enriched with fine and gross motor activity, respectively. The children were tested before (T0), immediately after (T1) and 8 weeks after the intervention (T2). A standardized mathematical test (50 tasks) was used to evaluate mathematical performance. Furthermore, it was investigated whether motor-enriched math was accompanied by different effects in low and normal math performers. Additionally, the study investigated the potential contribution of cognitive functions and motor skills on mathematical performance. Results: All groups improved their mathematical performance from T0 to T1. However, from T0 to T1, the improvement was significantly greater in GMM compared to FMM (1.87 ± 0.71 correct answers) (p = 0.02). At T2 no significant differences in mathematical performance were observed. A subgroup analysis revealed that normal math-performers benefitted from GMM compared to both CON 1.78 ± 0.73 correct answers (p = 0.04) and FMM 2.14 ± 0.72 correct answers (p = 0.008). These effects were not observed in low math-performers. The effects were partly accounted for by visuo-spatial short-term memory and gross motor skills. Conclusion: The study demonstrates that motor enriched learning activities can improve mathematical performance. In normal math performers GMM led to larger improvements than FMM and CON. This was not the case for the low math performers. Future studies should further elucidate the neurophysiological mechanisms underlying the observed behavioral effects. PMID:28066215

A Vision of Improvement of Learning: South African Teachers' Conceptions of Classroom Assessment

ERIC Educational Resources Information Center

Sethusha, Mantsose Jane

2013-01-01

This article explored conceptions that teachers hold about classroom assessment and how these conceptions influence their classroom assessment practices. The qualitative study employed a case study approach. Semi-structured interviews, observations and document analyses were used. The study utilized Brown's (2004) conceptual framework on…

Use of EO-1 Hyperion Data for Inter-Sensor Calibration of Vegetation Indices

NASA Technical Reports Server (NTRS)

Huete, Alfredo; Miura, Tomoaki; Kim, HoJin; Yoshioka, Hiroki

2004-01-01

Numerous satellite sensor systems useful in terrestrial Earth observation and monitoring have recently been launched and their derived products are increasingly being used in regional and global vegetation studies. The increasing availability of multiple sensors offer much opportunity for vegetation studies aimed at understanding the terrestrial carbon cycle, climate change, and land cover conversions. Potential applications include improved multiresolution characterization of the surface (scaling); improved optical-geometric characterization of vegetation canopies; improved assessments of surface phenology and ecosystem seasonal dynamics; and improved maintenance of long-term, inter-annual, time series data records. The Landsat series of sensors represent one group of sensors that have produced a long-term, archived data set of the Earth s surface, at fine resolution and since 1972, capable of being processed into useful information for global change studies (Hall et al., 1991).

Cognitex supplementation in elderly adults with memory complaints: an uncontrolled open label trial.

PubMed

Richter, Yael; Herzog, Yael; Eyal, Inbal; Cohen, Tzafra

2011-06-01

The components of the nutritional supplement Cognitex have been individually shown to have beneficial effects on cognitive function. We evaluated the efficacy of the nutritional supplement in improving cognitive function in elderly with memory complaints. Thirty participants received three capsules of the nutritional supplement per day for 12 weeks in an open label study. Efficacy and safety measures, assessed at baseline, 2 weeks, and 12 weeks of treatment, included cognitive evaluation using a computerized cognitive assessment tool, vital signs measurements, and physical examination. Twenty-six participants completed the 12-week study. A significant improvement in memory abilities (recall, recognition, and spatial short term) was observed following 2 weeks of Cognitex treatment (mean change from baseline: 11.15 ± 2.90, 8.68 ± 2.50, and 19.85 ± 6.19, respectively). Attention (sustained and focused), visual learning, and activities of daily living (executive functions and mental flexibility) were improved as well following this short supplementation period (mean change from baseline: 9.46 ± 3.80, 3.76 ± 1.50, 17.31 ± 5.33, 9.45 ± 3.73, and 9.92 ± 4.08, respectively). After 10 additional treatment weeks, activities of daily living demonstrated an additional statistically significant improvement while the beneficial effect observed for the rest of the tested parameters remained unchanged. The results indicate that the nutritional supplement may improve cognitive performance in elderly with memory complaints; however, further blinded and placebo-controlled studies are needed. Clinicaltrials.gov, Identifier: NCT00719953.

Assessing the value of diagnostic imaging: the role of perception

NASA Astrophysics Data System (ADS)

Potchen, E. J.; Cooper, Thomas G.

2000-04-01

The value of diagnostic radiology rests in its ability to provide information. Information is defined as a reduction in randomness. Quality improvement in any system requires diminution in the variation in its performance. The major variation in performance of the system of diagnostic radiology occurs in observer performance and in the communication of information from the observer to someone who will apply that information to the benefit of the patient. The ability to provide information can be determined by observer performance studies using a receiver-operating characteristic (ROC) curve analysis. The amount of information provided by each observer can be measured in terms of the uncertainty they reduce. Using a set of standardized radiographs, some normal and some abnormal, sorting them randomly, and then asking an observer to redistribute them according to their probability of normality can measure the difference in the value added by different observers. By applying this observer performance measure, we have been able to characterize individual radiologists, groups of radiologists, and regions of the United States in their ability to add value in chest radiology. The use of these technologies in health care may improve upon the contribution of diagnostic imaging.

Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review

PubMed Central

Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S.; Jager, Kitty J.; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

2016-01-01

Background The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and study design quality in the nephrology literature. Study Design Systematic literature review. Setting & Population European and North American, Pre-dialysis Chronic Kidney Disease (CKD) cohort studies. Selection Criteria for Studies Studies assessing the association between CKD and mortality in the elderly (>65 years) published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE. Predictor Time period before and after the publication of the STROBE statement. Outcome Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS), Scottish Intercollegiate Guidelines Network (SIGN) and Critical Appraisal Skills Programme (CASP) tools. Results 37 papers (11 Pre & 26 Post STROBE) were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis) showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7–82.0) vs 83% (IQR, 78.4–84.9, p = 0.05). There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9), SIGN (Manuscript SIGN score 83.3) and CASP (Manuscript CASP score 91.7) tools. Limitations Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good reporting. Conclusions This study highlights continuing deficiencies in the reporting of STROBE items and their sub-criteria in cohort studies in nephrology. There was weak evidence of improvement in the overall reporting quality, with no improvement in methodological quality of CKD cohort studies between the period before and after publication of the STROBE statement. PMID:27168187

Management of augmentation of restless legs syndrome with rotigotine: a 1-year observational study.

PubMed

Trenkwalder, Claudia; Canelo, Monica; Lang, Michael; Schroeder, Hanna; Kelling, Daniela; Berkels, Reinhard; Schollmayer, Erwin; Heidbrede, Tanja; Benes, Heike

2017-02-01

The aim of this study is to assess the effect of switching to rotigotine transdermal patch on severity of restless legs syndrome (RLS) in patients who experienced acute augmentation with previous oral dopaminergics. In this 13-month observational study, adults with moderate-to-severe RLS and augmentation were switched to rotigotine per the physician's independent decision. Assessments included Clinical Global Impression severity score (CGI-1); (primary), treatment regimen for switching (secondary), RLS-6, International RLS Study Group Rating Scale (IRLS), and augmentation severity rating scale (ASRS). A total of 99 patients received rotigotine, of whom 46 completed observational period, and 43 were assessed for effectiveness. A total of 5 patients switched to rotigotine after a >1-day drug holiday, 23 switched overnight, 9 had an overlapping switch, and 6 received ongoing oral dopaminergics with rotigotine for ≥28 days. Of the 99 patients, 57 took concomitant RLS medications (excluding switching medications) on at least 1 day. At the final visit, median change in CGI-1 (Hodges-Lehman estimate [95% CI]) was -2.0 (-2.5, -1.50); 37 of the 43 patients improved by ≥1 CGI-1 category, and 16 of 43 were responders (≥50% improvement). RLS-6 and IRLS scores also improved. Patients had median ASRS of 0 at the final visit indicating "no worsening/occurrence of augmentation." ASRS item 1 showed a shift in mean time of symptom onset (24-h clock) from 12:38 (baseline) to 18:25 (final visit). Most common reasons for withdrawal of rotigotine were adverse events (26 patients) and lack of efficacy (14 patients). Switching from oral therapies to rotigotine was effective in improving RLS symptoms in 37 of the 43 patients (from the original population of 99 patients) who remained in the study over 13 months. ClinicalTrials.govNCT01386944. Copyright © 2015 Elsevier B.V. All rights reserved.

Light Augmentation Device: A New Surgical Tool for Improved Laparoscopic Visibility and Transillumination: Proof-of-Concept Study.

PubMed

Asti, Emanuele; Nebbia, Fabio; Sironi, Andrea; Bottino, Vincenzo; Bonitta, Gianluca; Bonavina, Luigi

2016-12-01

The light augmentation device (LAD ® ) is a new disposable tool designed to improve observation by transillumination in laparoscopic surgery. It can be introduced into the abdomen through an 11-12 mm port as a supplementary light source. The miniaturized design allows the surgeon to pick up the device with an endograsper and to place it under direct vision where needed. This proof-of-concept study demonstrated safety and efficacy of the device in the animal model.

Sleep-dependent consolidation benefits fast transfer of time interval training.

PubMed

Chen, Lihan; Guo, Lu; Bao, Ming

2017-03-01

Previous study has shown that short training (15 min) for explicitly discriminating temporal intervals between two paired auditory beeps, or between two paired tactile taps, can significantly improve observers' ability to classify the perceptual states of visual Ternus apparent motion while the training of task-irrelevant sensory properties did not help to improve visual timing (Chen and Zhou in Exp Brain Res 232(6):1855-1864, 2014). The present study examined the role of 'consolidation' after training of temporal task-irrelevant properties, or whether a pure delay (i.e., blank consolidation) following pretest of the target task would give rise to improved ability of visual interval timing, typified in visual Ternus display. A procedure of pretest-training-posttest was adopted, with the probe of discriminating Ternus apparent motion. The extended implicit training of timing in which the time intervals between paired auditory beeps or paired tactile taps were manipulated but the task was discrimination of the auditory pitches or tactile intensities, did not lead to the training benefits (Exps 1 and 3); however, a delay of 24 h after implicit training of timing, including solving 'Sudoku puzzles,' made the otherwise absent training benefits observable (Exps 2, 4, 5 and 6). The above improvements in performance were not due to a practice effect of Ternus motion (Exp 7). A general 'blank' consolidation period of 24 h also made improvements of visual timing observable (Exp 8). Taken together, the current findings indicated that sleep-dependent consolidation imposed a general effect, by potentially triggering and maintaining neuroplastic changes in the intrinsic (timing) network to enhance the ability of time perception.

Voice analysis before and after vocal rehabilitation in patients following open surgery on vocal cords.

PubMed

Bunijevac, Mila; Petrović-Lazić, Mirjana; Jovanović-Simić, Nadica; Vuković, Mile

2016-02-01

The major role of larynx in speech, respiration and swallowing makes carcinomas of this region and their treatment very influential for patients' life quality. The aim of this study was to assess the importance of voice therapy in patients after open surgery on vocal cords. This study included 21 male patients and the control group of 19 subjects. The vowel (A) was recorded and analyzed for each examinee. All the patients were recorded twice: firstly, when they contacted the clinic and secondly, after a three-month vocal therapy, which was held twiceper week on an outpatient basis. The voice analysis was carried out in the Ear, Nose and Throat (ENT) Clinic, Clinical Hospital Center "Zvezdara" in Belgrade. The values of the acoustic parameters in the patients submitted to open surgery on the vocal cords before vocal rehabilitation and the control group subjects were significantly different in all specified parameters. These results suggest that the voice of the patients was damaged before vocal rehabilitation. The results of the acoustic parameters of the vowel (A) before and after vocal rehabilitation of the patients with open surgery on vocal cords were statistically significantly different. Among the parameters--Jitter (%), Shimmer (%)--the observed difference was highly statistically significant (p < 0.01). The voice turbulence index and the noise/harmonic ratio were also notably improved, and the observed difference was statistically significant (p < 0.05). The analysis of the tremor intensity index showed no significant improvement and the observed difference was not statistically significant (p > 0.05 ). CONCLUSION. There was a significant improvement of the acoustic parameters of the vowel (A) in the study subjects three months following vocal therapy. Only one out of five representative parameters showed no significant improvement.

a Single-Exposure Dual-Energy Computed Radiography Technique for Improved Nodule Detection and Classification in Chest Imaging

NASA Astrophysics Data System (ADS)

Zink, Frank Edward

The detection and classification of pulmonary nodules is of great interest in chest radiography. Nodules are often indicative of primary cancer, and their detection is particularly important in asymptomatic patients. The ability to classify nodules as calcified or non-calcified is important because calcification is a positive indicator that the nodule is benign. Dual-energy methods offer the potential to improve both the detection and classification of nodules by allowing the formation of material-selective images. Tissue-selective images can improve detection by virtue of the elimination of obscuring rib structure. Bone -selective images are essentially calcium images, allowing classification of the nodule. A dual-energy technique is introduced which uses a computed radiography system to acquire dual-energy chest radiographs in a single-exposure. All aspects of the dual-energy technique are described, with particular emphasis on scatter-correction, beam-hardening correction, and noise-reduction algorithms. The adaptive noise-reduction algorithm employed improves material-selective signal-to-noise ratio by up to a factor of seven with minimal sacrifice in selectivity. A clinical comparison study is described, undertaken to compare the dual-energy technique to conventional chest radiography for the tasks of nodule detection and classification. Observer performance data were collected using the Free Response Observer Characteristic (FROC) method and the bi-normal Alternative FROC (AFROC) performance model. Results of the comparison study, analyzed using two common multiple observer statistical models, showed that the dual-energy technique was superior to conventional chest radiography for detection of nodules at a statistically significant level (p < .05). Discussion of the comparison study emphasizes the unique combination of data collection and analysis techniques employed, as well as the limitations of comparison techniques in the larger context of technology assessment.

Effects of wheat bran extract rich in arabinoxylan oligosaccharides and resistant starch on overnight glucose tolerance and markers of gut fermentation in healthy young adults.

PubMed

Boll, Elin V Johansson; Ekström, Linda M N K; Courtin, Christophe M; Delcour, Jan A; Nilsson, Anne C; Björck, Inger M E; Östman, Elin M

2016-06-01

Specific combinations of dietary fiber (DF) have been observed to result in improved glucose tolerance at a subsequent standardized breakfast. Arabinoxylan oligosaccharides (AXOS) are considered as DF with prebiotic potential, but so far no studies have investigated their metabolic effects in humans. This randomized cross-over study evaluated the overnight impact of breads containing AXOS-rich wheat bran extract and resistant starch (RS, Hi-Maize), separately or combined, on glucose tolerance, related metabolic parameters and markers of gut fermentation in healthy subjects. Evening reference and test products were: (1) reference white wheat flour bread (WWB), WWB supplemented with (2) AXOS and RS (WWB + AXOS + RS), (3) an increased content of either AXOS (WWB + hiAXOS) or (4) RS (WWB + hiRS). At the subsequent standardized breakfast, blood was sampled for 3 h to monitor glucose, insulin, nonesterified fatty acids, glucagon-like peptide (GLP)-1 and GLP-2. Breath hydrogen (H2) and short chain fatty acids (SCFA) were measured as markers of gut fermentation, and subjective appetite was rated using visual analog scales. Dose-dependent decreases in glucose responses were observed with increased AXOS over the duration of 3 h. Insulin sensitivity index was improved in the morning after the WWB + hiAXOS evening meal. An increase in breath H2 concentration and circulating SCFA was observed in the morning after both evening meals containing AXOS. The present study indicates that AXOS have the potential of improving glucose tolerance in an overnight perspective and suggested mechanisms are improved insulin sensitivity and increased gut fermentation.

Therapeutic fasting in patients with metabolic syndrome and impaired insulin resistance.

PubMed

Stange, Rainer; Pflugbeil, Christine; Michalsen, Andreas; Uehleke, Bernhard

2013-01-01

In this study, we evaluated whether a short- to mid-term fasting therapy (7-18 days) might improve insulin resistance according to the homeostasis model assessment for insulin resistance (HOMA-IR), measured during mid-term (80 days) follow-up observation in patients with metabolic syndrome. In this open label observational study in inpatients, criteria of metabolic syndrome were defined. Before medically controlled Buchinger fasting, a wash-out period for hypoglycemic agents was conducted. Further evaluation was carried out on day 80. 25 patients (13 males, 12 females, mean age 61.3 years) were included in this study (mean fasting duration 11.5 days). Out of 16 inpatients with type 2 diabetes, 4 had been treated with metformin, 3 with insulin, and 1 with glimepiride before the intervention. After therapy, body mass index (BMI), fasting insulin, fasting glucose, and HOMA-IR were all significantly reduced. Compared to baseline, HOMA-IR decreased by 33% in all patients, by 38% in patients with type 2 diabetes, and by 23% in patients without diabetes. At day 80, BMI further improved, while other parameters showed complete (insulin) or partial (glucose, HOMA-IR) rebound. At this time, HOMA-IR values showed an only insignificant improvement in 15% of all patients, in 20% of patients with type 2 diabetes, and in 6% of patients without diabetes. There was no correlation between change in BMI and change in HOMA-IR (r(2) = 0.008, baseline minus day 80). No serious side effects were observed. Fasting as a safe and acceptable procedure may cause short- and mid-term improvement of increased insulin resistance (HOMA-IR). Patients with type 2 diabetes benefit more than those without diabetes. A possible clinical significance of this effect should be explored in larger and controlled clinical trials. © 2014 S. Karger GmbH, Freiburg.

Biomarkers and echocardiography for evaluating the improvement of the ventricular diastolic function after surgical relief of hydronephrosis

PubMed Central

Yeh, Huei-Ming; Lin, Ting-Tse; Yeh, Chih-Fan; Huang, Ho-Shiang; Chang, Sheng-Nan; Lin, Jou-Wei; Tsai, Chia-Ti; Lai, Ling-Ping; Huang, Yi-You

2017-01-01

The pathophysiology of cardio-renal syndrome (CRS) is complex. Hydronephrosis caused by urolithiasis may cause cytokine release and lead to cardiac dysfunction. The aim of this study was to evaluate cardiac function changes observed in patients who received double J placement using feasible biomarkers and echocardiography. This was a prospective, single-center study. Eighty-seven patients who presented with acute unilateral hydronephrosis and received ureteroscope stone manipulation were enrolled. Echocardiography and cytokines were measured on the day of the operation and 24 hours after the procedure. Changes before and after surgery were assessed by the paired t-test and Wilcoxon test. Correlation analyses between echocardiographic diastolic indices and cytokine levels were performed using Pearson’s correlation coefficients. Patients with hydronephrosis showed a higher left atrium volume index (LAVI), decreased E', and increased E/ E' ratio, which indicated diastolic dysfunction. Patients with hydronephrosis also exhibited decreased global strain rates during isovolumetric relaxation (SRIVR) and E/ SRIVR, which confirmed the diastolic dysfunction. Significant reductions in LAVI, increases in SRIVR and decreases in E/ SRIVR were observed after the operation. Biomarkers, such as TGF-β and serum NT-proBNP, were significantly decreased after surgery. In addition, a significant correlation was observed between the post-surgical decrease in TGF-β1 and increase in SRIVR. Unilateral hydronephrosis causes cardiac diastolic dysfunction, and relieving hydronephrosis could improve diastolic function. Improvements in cardiac dysfunction can be evaluated by echocardiography and measuring cytokine levels. The results of this study will inform efforts to improve the early diagnosis of CRS and prevent further deterioration of cardiac function when treating patients with hydronephrosis. PMID:29161313

Biomarkers and echocardiography for evaluating the improvement of the ventricular diastolic function after surgical relief of hydronephrosis.

PubMed

Yeh, Huei-Ming; Lin, Ting-Tse; Yeh, Chih-Fan; Huang, Ho-Shiang; Chang, Sheng-Nan; Lin, Jou-Wei; Tsai, Chia-Ti; Lai, Ling-Ping; Huang, Yi-You; Chu, Chun-Lin

2017-01-01

The pathophysiology of cardio-renal syndrome (CRS) is complex. Hydronephrosis caused by urolithiasis may cause cytokine release and lead to cardiac dysfunction. The aim of this study was to evaluate cardiac function changes observed in patients who received double J placement using feasible biomarkers and echocardiography. This was a prospective, single-center study. Eighty-seven patients who presented with acute unilateral hydronephrosis and received ureteroscope stone manipulation were enrolled. Echocardiography and cytokines were measured on the day of the operation and 24 hours after the procedure. Changes before and after surgery were assessed by the paired t-test and Wilcoxon test. Correlation analyses between echocardiographic diastolic indices and cytokine levels were performed using Pearson's correlation coefficients. Patients with hydronephrosis showed a higher left atrium volume index (LAVI), decreased E', and increased E/ E' ratio, which indicated diastolic dysfunction. Patients with hydronephrosis also exhibited decreased global strain rates during isovolumetric relaxation (SRIVR) and E/ SRIVR, which confirmed the diastolic dysfunction. Significant reductions in LAVI, increases in SRIVR and decreases in E/ SRIVR were observed after the operation. Biomarkers, such as TGF-β and serum NT-proBNP, were significantly decreased after surgery. In addition, a significant correlation was observed between the post-surgical decrease in TGF-β1 and increase in SRIVR. Unilateral hydronephrosis causes cardiac diastolic dysfunction, and relieving hydronephrosis could improve diastolic function. Improvements in cardiac dysfunction can be evaluated by echocardiography and measuring cytokine levels. The results of this study will inform efforts to improve the early diagnosis of CRS and prevent further deterioration of cardiac function when treating patients with hydronephrosis.

FSH treatment in infertile males candidate to assisted reproduction improved sperm DNA fragmentation and pregnancy rate.

PubMed

Garolla, Andrea; Ghezzi, Marco; Cosci, Ilaria; Sartini, Barbara; Bottacin, Alberto; Engl, Bruno; Di Nisio, Andrea; Foresta, Carlo

2017-05-01

The purpose of this study is to evaluate whether follicle-stimulating hormone treatment improves sperm DNA parameters and pregnancy outcome in infertile male candidates to in-vitro fertilization.Observational study in 166 infertile male partners of couples undergoing in-vitro fertilization. Eighty-four patients were receiving follicle-stimulating hormone treatment (cases) and 82 refused treatment (controls). Semen parameters, sexual hormones, and sperm nucleus (fluorescence in-situ hybridization, acridine orange, TUNEL, and γH2AX) were evaluated at baseline (T0) and after 3 months (T1), when all subjects underwent assisted reproduction techniques. Statistical analysis was performed by analysis of variance.Compared to baseline, cases showed significant improvements in seminal parameters and DNA fragmentation indexes after follicle-stimulating hormone therapy (all P < 0.05), whereas no changes were observed in controls. Within cases, follicle-stimulating hormone treatment allowed to perform intrauterine insemination in 35 patients with a pregnancy rate of 23.2 %. Intracytoplasmic sperm injection was performed in all controls and in 49 patients from cases, with pregnancy rates of 23.2 and 40.8 %, respectively (P < 0.05). After 3 months (T0 vs. T1) of follicle-stimulating hormone therapy, cases with positive outcome had reduced DNA fragmentation index and lower double strand breaks (P < 0.05 and P < 0.001 vs. negative outcome, respectively).In this observational study, we showed that follicle-stimulating hormone treatment improves sperm DNA fragmentation, which in turn leads to increased pregnancy rates in infertile males undergoing in-vitro fertilization. In particular, double strand breaks (measured with γH2AX test) emerged as the most sensible parameter to follicle-stimulating hormone treatment in predicting reproductive outcome.

Sustainability of quality improvement following removal of pay-for-performance incentives.

PubMed

Benzer, Justin K; Young, Gary J; Burgess, James F; Baker, Errol; Mohr, David C; Charns, Martin P; Kaboli, Peter J

2014-01-01

Although pay-for-performance (P4P) has become a central strategy for improving quality in US healthcare, questions persist about the effectiveness of these programs. A key question is whether quality improvement that occurs as a result of P4P programs is sustainable, particularly if incentives are removed. To investigate sustainability of performance levels following removal of performance-based incentives. Observational cohort study that capitalized on a P4P program within the Veterans Health Administration (VA) that included adoption and subsequent removal of performance-based incentives for selected inpatient quality measures. The study sample comprised 128 acute care VA hospitals where performance was assessed between 2004 and 2010. VA system managers set annual performance goals in consultation with clinical leaders, and report performance scores to medical centers on a quarterly basis. These scores inform performance-based incentives for facilities and their managers. Bonuses are distributed based on the attainment of these performance goals. Seven quality of care measures for acute coronary syndrome, heart failure, and pneumonia linked to performance-based incentives. Significant improvements in performance were observed for six of seven quality of care measures following adoption of performance-based incentives and were maintained up to the removal of the incentive; subsequently, the observed performance levels were sustained. This is a quasi-experimental study without a comparison group; causal conclusions are limited. The maintenance of performance levels after removal of a performance-based incentive has implications for the implementation of Medicare's value-based purchasing initiative and other P4P programs. Additional research is needed to better understand human and system-level factors that mediate sustainability of performance-based incentives.

Improving the wave forecast in the Catalan Coast

NASA Astrophysics Data System (ADS)

Pallares, Elena; Sanchez-Arcilla, Agustin; Espino, Manuel

2014-05-01

This study has been motivated by the limited accuracy of wave models under short-duration, fetch-limited conditions. This applies particularly to the wave period, and can be illustrated by the case of semi-enclosed domains with highly variable wind patterns such as the Catalan coast in the Spanish Mediterranean. The wave model SWAN version 40.91A is used here in three nested grids covering all the North-western Mediterranean Sea with resolution from 9 to 1 km, forced with high resolution wind patterns from BSC (Barcelona Supercomputing Center) for two study periods, the winter 2010 and the spring 2011. The results are validated in eight locations with different types of instrumentation. In order to improve the results, a modification of the whitecapping well-known formulation of Hasselmann (1974) has been considered. The delta coefficient is increased to adapt the dissipation to the growth rates actually observed in the region. This correction introduces a dependence on the squared wave number, improving the prediction of the energy spectra at lower frequencies. However, one may note that an over-prediction will occur for waves with longer fetch and/or duration. The results obtained show a clear improvement of the mean and peak wave periods for the study area, decreasing considerably the negative bias observed previously, while almost no change is observed in wave height due to the proposed modifications. These results can be generalized to the Spanish Mediterranean coast and could be exported to similar environments, characterized by young/moderate sea wave conditions due to limited fetch and transient wind driving. References: - Hasselmann, K., 1974. On the spectral dissipation of ocean waves due to whitecapping. Boundary-layer Meteorology,6,107-127.

Skylab-4 visual observations project: Geological features of southwestern North America

NASA Technical Reports Server (NTRS)

Silver, L. T.

1975-01-01

Visual observations conducted by Skylab-4 crewmen on seven designated geological target areas and other targets of opportunity in parts of southwestern United States and northwestern Mexico were described. The experiments were designed to learn how effectively geologic features could be observed from orbit and what research information could be obtained from the observations when supported by ground studies. For the limited preparation they received, the crewmen demonstrated exceptional observational ability and produced outstanding photographic studies. They also formulated cogent opinions on how to improve future observational and photo-documentation techniques. From the photographs and other observations, it was possible to obtain significant research contributions to on-going field investigations. These contributions were integrated into other aspects of the ground investigations to the following topics: major faults, regional stratigraphy, occurrence of Precambrian crystalline rocks, mapping of Mesozoic volcanic rocks, regional geology.

Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies.

PubMed

Zeng, Chao; Wei, Jie; Persson, Monica S M; Sarmanova, Aliya; Doherty, Michael; Xie, Dongxing; Wang, YiLun; Li, Xiaoxiao; Li, Jiatian; Long, Huizhong; Lei, Guanghua; Zhang, Weiya

2018-05-01

To compare the efficacy and safety of topical non-steroidal anti-inflammatory drugs (NSAIDs), including salicylate, for the treatment of osteoarthritis (OA). PubMed, Embase, Cochrane Library and Web of Science were searched from 1966 to January 2017. Randomised controlled trials (RCTs) comparing topical NSAIDs with placebo or each other in patients with OA and observational studies comparing topical NSAIDs with no treatment or each other irrespective of disease were included. Two investigators identified studies and independently extracted data. Bayesian network and conventional meta-analyses were conducted. The primary outcomes were pain relief for RCTs and risk of adverse effects (AEs) for observational studies. 43 studies, comprising 36 RCTs (7 900 patients with OA) and seven observational studies (218 074 participants), were included. Overall, topical NSAIDs were superior to placebo for relieving pain (standardised mean difference (SMD)=-0.30, 95% CI -0.40 to -0.20) and improving function (SMD=-0.35, 95% CI -0.45 to -0.24) in OA. Of all topical NSAIDs, diclofenac patches were most effective for OA pain (SMD=-0.81, 95% CI -1.12 to -0.52) and piroxicam was most effective for functional improvement (SMD=-1.04, 95% CI -1.60 to -0.48) compared with placebo. Although salicylate gel was associated with higher withdrawal rates due to AEs, the remaining topical NSAIDs were not associated with any increased local or systemic AEs. Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population. However, confirmation of the cardiovascular safety of topical NSAIDs still warrants further observational study. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies

PubMed Central

Persson, Monica S M; Sarmanova, Aliya; Doherty, Michael; Xie, Dongxing; Wang, YiLun; Li, Xiaoxiao; Li, Jiatian; Long, Huizhong

2018-01-01

Objectives To compare the efficacy and safety of topical non-steroidal anti-inflammatory drugs (NSAIDs), including salicylate, for the treatment of osteoarthritis (OA). Methods PubMed, Embase, Cochrane Library and Web of Science were searched from 1966 to January 2017. Randomised controlled trials (RCTs) comparing topical NSAIDs with placebo or each other in patients with OA and observational studies comparing topical NSAIDs with no treatment or each other irrespective of disease were included. Two investigators identified studies and independently extracted data. Bayesian network and conventional meta-analyses were conducted. The primary outcomes were pain relief for RCTs and risk of adverse effects (AEs) for observational studies. Results 43 studies, comprising 36 RCTs (7 900 patients with OA) and seven observational studies (218 074 participants), were included. Overall, topical NSAIDs were superior to placebo for relieving pain (standardised mean difference (SMD)=−0.30, 95% CI −0.40 to –0.20) and improving function (SMD=−0.35, 95% CI −0.45 to –0.24) in OA. Of all topical NSAIDs, diclofenac patches were most effective for OA pain (SMD=−0.81, 95% CI −1.12 to –0.52) and piroxicam was most effective for functional improvement (SMD=−1.04, 95% CI −1.60 to –0.48) compared with placebo. Although salicylate gel was associated with higher withdrawal rates due to AEs, the remaining topical NSAIDs were not associated with any increased local or systemic AEs. Conclusions Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population. However, confirmation of the cardiovascular safety of topical NSAIDs still warrants further observational study. PMID:29436380

Treatment of atopic dermatitis eczema with a high concentration of Lactobacillus salivarius LS01 associated with an innovative gelling complex: a pilot study on adults.

PubMed

Drago, Lorenzo; De Vecchi, Elena; Toscano, Marco; Vassena, Christian; Altomare, Gianfranco; Pigatto, Paolo

2014-01-01

To evaluate the efficacy of a highly concentrated Lactobacillus salivarius preparation containing a gelling complex formed by Streptococcus thermophilus ST10 and tara gum in the treatment of atopic dermatitis (AD). Previous studies have demonstrated an improvement in AD symptoms after administration of the probiotic strain L. salivarius LS01. S. thermophilus ST10 and tara gum create a gelling complex that adheres to intestinal mucus and improves barrier function. A prospective, controlled pilot trial was carried out to evaluate how the association of S. thermophilus ST10 and tara gum could improve the activity of L. salivarius LS01 administered at high doses to adults with AD. Twenty-five patients were included into the study: 13 were treated for 1 month with the active formulation, whereas 12 represented the placebo group. Scoring Atopic Dermatitis index was determined before and at the end of probiotic administration. Fecal samples were also collected to evaluate changes in bacterial counts of Staphylococcus aureus and clostridia. A significant improvement in SCORAD index was observed in the probiotic group after 1 month of treatment, whereas no significant changes occurred in placebo patients. A slight decrease in fecal S. aureus count was observed in probiotic-treated patients. Data obtained in this study suggest a potential role for L. salivarius LS01 in the treatment of AD. The addition of tara gum and S. thermophilus ST10 seems to improve the overall efficacy of the probiotic strain, in particular shortening the time required for the onset of the positive effects. Further studies to investigate the activity of this preparation are advisable.

Behavioral Interventions to Improve Asthma Outcomes for Adolescents: A Systematic Review.

PubMed

Mosnaim, Giselle S; Pappalardo, Andrea A; Resnick, Scott E; Codispoti, Christopher D; Bandi, Sindhura; Nackers, Lisa; Malik, Rabia N; Vijayaraghavan, Vimala; Lynch, Elizabeth B; Powell, Lynda H

2016-01-01

Factors at multiple ecological levels, including the child, family, home, medical care, and community, impact adolescent asthma outcomes. This systematic review characterizes behavioral interventions at the child, family, home, medical system, and community level to improve asthma management among adolescents. A systematic search of PubMed, SCOPUS, OVID, PsycINFO, CINAHL, and reference review databases was conducted from January 1, 2000, through August 10, 2014. Articles were included if the title or abstract included asthma AND intervention AND (education OR self-management OR behavioral OR technology OR trigger reduction), and the mean and/or median age of participants was between 11 and 16 years. We compared populations, intervention characteristics, study designs, outcomes, settings, and intervention levels across studies to evaluate behavioral interventions to improve asthma management for adolescents. Of 1230 articles identified and reviewed, 24 articles (21 unique studies) met inclusion criteria. Promising approaches to improving adherence to daily controller medications include objective monitoring of inhaled corticosteroid adherence with allergist and/or immunologist feedback on medication-taking behavior and school nurse directly observed therapy. Efficacy at increasing asthma self-management skills was demonstrated using group interactive learning in the school setting. This systematic review is not a meta-analysis, thus limiting its quantitative assessment of studies. Publication bias may also limit our findings. Novel strategies to objectively increase controller medication adherence for adolescents include allergist and/or immunologist feedback and school nurse directly observed therapy. Schools, the most common setting across studies in this review, provide the opportunity for group interactive learning to improve asthma knowledge and self-management skills. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Improvement of interfacial and electrical properties of Al2O3/ n-Ga0.47In0.53As for III-V impact ionization MOSFETs

NASA Astrophysics Data System (ADS)

Lechaux, Y.; Fadjie, A.; Bollaert, S.; Talbo, V.; Mateos, J.; González, T.; Vasallo, B. G.; Wichmann, N.

2015-10-01

In this work, Metal - Oxide - Semiconductor Capacitors (MOSCaps) based on Al2O3/ n-Ga0.47In0.53As interface have been studied. In order to have high MOSFETs performance, it is necessary to improve the semiconductor - oxide interface quality. It is observed that the (NH4)2S passivation shows lower interface trap density in the order of 6×1011cm-2.eV-1. Also, it is observed that O2 plasma densification after a passivation in a NH4OH solution improves the electrical behaviour of the charge control. Low interface trap density in the order of 1×1012cm-2.eV-1 was obtained for different treatments presented in this work.

Auditory maturation in premature infants: a potential pitfall for early cochlear implantation.

PubMed

Hof, Janny R; Stokroos, Robert J; Wix, Eduard; Chenault, Mickey; Gelders, Els; Brokx, Jan

2013-08-01

To describe spontaneous hearing improvement in the first years of life of a number of preterm neonates relative to cochlear implant candidacy. Retrospective case study. Hearing levels of 14 preterm neonates (mean gestational age at birth = 29 weeks) referred after newborn hearing screening were evaluated. Initial hearing thresholds ranged from 40 to 105 dBHL (mean = 85 dBHL). Hearing level improved to normal levels for four neonates and to moderate levels for five, whereas for five neonates, no improvement in hearing thresholds was observed and cochlear implantation was recommended. Three of the four neonates in whom the hearing improved to normal levels were born prior to 28 weeks gestational age. Hearing improvement was mainly observed prior to a gestational age of 80 weeks. Delayed maturation of an immature auditory pathway might be an important reason for referral after newborn hearing screening in premature infants. Caution is advised regarding early cochlear implantation in preterm born infants. Audiological follow-ups until at least 80 weeks gestational age are therefore recommended. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Fighting Against Disuse of the Masticatory System in Duchenne Muscular Dystrophy: A Pilot Study Using Chewing Gum.

PubMed

van Bruggen, H Willemijn; van den Engel-Hoek, Lenie; Steenks, Michel H; van der Bilt, Andries; Bronkhorst, Ewald M; Creugers, Nico H J; de Groot, Imelda J M; Kalaykova, Stanimira I

2015-10-01

Duchenne muscular dystrophy patients report masticatory problems. The aim was to determine the efficacy of mastication training in Duchenne muscular dystrophy using chewing gum for 4 weeks. In all, 17 patients and 17 healthy age-matched males participated. The masticatory performance was assessed using a mixing ability test and measuring anterior bite force before, shortly after and 1 month after the training. In the patient group the masticatory performance improved and remained after 1-month follow-up, no significant changes in anterior maximum bite force was observed after mastication training. In the healthy subject the bite force increased and remained at the 1-month follow-up; no significant differences in masticatory performance were observed. Mastication training by using sugar-free chewing gum in Duchenne muscular dystrophy patients improved their masticatory performance. Since bite force did not improve, the working mechanism of the improvement in chewing may relate to changes of the neuromuscular function and coordination, resulting in improvement of skills in performing mastication. © The Author(s) 2015.

Effectiveness of the Medtep Hemophilia online platform for adherence to prophylactic treatment in haemophilia patients: Results from a 1-year observational study.

PubMed

Cuesta-Barriuso, R; López-Pina, J A; Nieto-Munuera, J; Sagarra-Valls, G; Panisello-Royo, J M; Torres-Ortuño, A

2018-03-01

Medtep Hemophilia platform is an online tool that allows patients with congenital coagulopathies to keep track of their daily condition-related events with the objective of ensuring successful adherence to therapy. To assess the effectiveness of Medtep Hemophilia in improving adherence to prophylactic treatment in haemophilia A and B patients in a 1-year prospective observational study, as well as its impact on the patient's disease status. Patients (>13 years old) received support material to familiarize themselves with Medtep Hemophilia. Adherence to treatment, quality of life (QoL) and illness perception were assessed. Values at baseline, 1, 6 and 12 months, and changes from baseline value were analysed. The Hemophilia Joint Health Score (HJHS) test was applied at baseline and study completion. Forty-six patients were enrolled (43 evaluable). After 1 year, 56.4% patients showed continued use of the platform (100% compliance) whereas 25.6% were inactive. Treatment adherence increased both significantly (P < .001) and progressively during the study. Similarly, improved QoL and illness perception were observed with respect to baseline in most of the questionnaire components (P < .05 after 12 months). A patient's age had no influence on the results, whereas compliant patients (>80% of platform use) tended to score better than noncompliant. The HJHS test values remained similar during the study. The Medtep Hemophilia online platform helped the studied patients with haemophilia to improve their adherence to prophylactic treatment, while increasing their QoL and illness perception, as well as joint arthropathies stabilization. © 2018 John Wiley & Sons Ltd.

Relationships of multitasking, physicians' strain, and performance: an observational study in ward physicians.

PubMed

Weigl, Matthias; Müller, Andreas; Sevdalis, Nick; Angerer, Peter

2013-03-01

Simultaneous task performance ("multitasking") is common in hospital physicians' work and is implicated as a major determinant for enhanced strain and detrimental performance. The aim was to determine the impact of multitasking by hospital physicians on their self reported strain and performance. A prospective observational time-and-motion study in a Community Hospital was conducted. Twenty-seven hospital physicians (surgical and internal specialties) were observed in 40 full-shift observations. Observed physicians reported twice on their self-monitored strain and performance during the observation time. Associations of observed multitasking events and subsequent strain and performance appraisals were calculated. About 21% of the working time physicians were engaged in simultaneous activities. The average time spent in multitasking activities correlated significantly with subsequently reported strain (r = 0.27, P = 0.018). The number of instances of multitasking activities correlated with self-monitored performance to a marginally significant level (r = 0.19, P = 0.098). Physicians who engage in multitasking activities tend to self-report better performance but at the cost of enhanced psychophysical strain. Hence, physicians do not perceive their own multitasking activities as a source for deficient performance, for example, medical errors. Readjustment of workload, improved organization of work for hospital physicians, and training programs to improve physicians' skills in dealing with multiple clinical demands, prioritization, and efficient task allocation may be useful avenues to explore to reduce the potentially negative impact of simultaneous task performance in clinical settings.

Sequestration of PDC-109 protein improves freezability of crossbred bull spermatozoa.

PubMed

Srivastava, N; Srivastava, S K; Ghosh, S K; Singh, L P; Prasad, J K; Kumar, Amit; Perumal, P; Jerome, A; Thamizharasan, A

2012-03-01

A study was carried out to assess the effect of sequestration of PDC-109 protein, a majority constituent of heparin binding proteins (HBP) of seminal plasma, on freezability and in vitro fertilizing ability of crossbred bull spermatozoa after cryopreservation. The study consisted of isolation and characterization of PDC-109 protein to raise anti-sera against it in rabbits. Following which, raised antibodies against PDC-109 protein was quantitated and coated in tubes used for collection of ejaculates. Semen ejaculates thus collected were cryopreserved using EYTG extender. Physico-morphological characteristics, viz. motility, viability, acrosomal integrity and HOS response as an indicator of freezability of cryopreserved spermatozoa were determined at pre freeze as well as post thaw stage. At pre freeze stage, a significant (p<0.05) improvement in viability (83.83 ± 2.18 vs 75.17 ± 2.42) and acrosome integrity (81.33 ± 2.38 vs 72.83 ± 2.39) in antibodies treated group than control was observed. Similarly, increase in HOS responsive spermatozoa was highly significant (p<0.01) than control (78.83 ± 1.69 vs 67.5 ± 1.75). At post thaw stage, significant (p<0.05) improvement in viability (69.50 ± 2.16 vs 60.33 ± 2.19) and HOS responsive spermatozoa (68.67 ± 1.62 vs 58.50 ± 1.32) and highly significant (p<0.01) increase in individual motility (56.17 ± 1.83 vs 47.00 ± 1.86) and acrosome integrity (75.17 ± 2.38 vs 61.83 ± 2.1) was observed in antibodies treated group when compared to control was observed. The results from the study revealed that sequestration of PDC-109 protein from semen samples leads to significant improvement in pre-freeze and post-thaw values of above parameters in cryopreserved spermatozoa. It is thus concluded that sequestration of PDC-109 protein from ejaculates improves freezability of crossbred bull spermatozoa. Copyright © 2012 Elsevier B.V. All rights reserved.

Improving Ebola infection prevention and control in primary healthcare facilities in Sierra Leone: a single-group pretest post-test, mixed-methods study.

PubMed

Ratnayake, Ruwan; Ho, Lara S; Ansumana, Rashid; Brown, Hannah; Borchert, Matthias; Miller, Laura; Kratz, Thomas; McMahon, Shannon A; Sahr, Foday

2016-01-01

Accomplishing infection prevention and control (IPC) in health facilities in Sub-Saharan Africa is challenging. Owing to poor IPC, healthcare workers (HCWs) were frequently infected during Sierra Leone's Ebola epidemic. In late 2014, IPC was rapidly and nationally scaled up. We carried out workshops in sampled facilities to further improve adherence to IPC. We investigated HCW experiences and observed practice gaps, before and after the workshops. We conducted an uncontrolled, before and after, mixed-methods study in eight health facilities in Bo and Kenema Districts during December 2014 and January 2015. Quantitative methods administered to HCWs at baseline and follow-up included a survey on attitudes and self-efficacy towards IPC, and structured observations of behaviours. The intervention involved a workshop for HCWs to develop improvement plans for their facility. We analysed the changes between rounds in survey responses and behaviours. We used interviews to explore attitudes and self-efficacy throughout the study period. HCWs described IPC as 'life-saving' and personal protective equipment (PPE) as uncomfortable for providers and frightening for patients. At baseline, self-efficacy was high (median=4/strongly agree). Responses reflecting unfavourable attitudes were low for glove use (median=1/strongly disagree, IQR, 1-2) and PPE use with ill family members (median=1, IQR, 1-2), and mixed for PPE use with ill HCWs (median=2/disagree, IQR, 1-4). Observations demonstrated consistent glove reuse and poor HCW handwashing. The maintenance of distance (RR 1.09, 95% CI 1.02 to 1.16) and patient handwashing (RR 1.19, 95% CI 1.3 to 1.25) improved to >90%. We found favourable attitudes towards IPC and gaps in practice. Risk perceptions of HCWs and tendencies to ration PPE where chronic supply chain issues normally lead to PPE stock-outs may affect practice. As Sierra Leone's Ebola Recovery Strategy aims to make all facilities IPC compliant, socio-behavioural improvements and a secure supply chain are essential.

The validation of the Yonsei CArbon Retrieval algorithm with improved aerosol information using GOSAT measurements

NASA Astrophysics Data System (ADS)

Jung, Yeonjin; Kim, Jhoon; Kim, Woogyung; Boesch, Hartmut; Goo, Tae-Young; Cho, Chunho

2017-04-01

Although several CO2 retrieval algorithms have been developed to improve our understanding about carbon cycle, limitations in spatial coverage and uncertainties due to aerosols and thin cirrus clouds are still remained as a problem for monitoring CO2 concentration globally. Based on an optimal estimation method, the Yonsei CArbon Retrieval (YCAR) algorithm was developed to retrieve the column-averaged dry-air mole fraction of carbon dioxide (XCO2) using the Greenhouse Gases Observing SATellite (GOSAT) measurements with optimized a priori CO2 profiles and aerosol models over East Asia. In previous studies, the aerosol optical properties (AOP) are the most important factors in CO2 retrievals since AOPs are assumed as fixed parameters during retrieval process, resulting in significant XCO2 retrieval error up to 2.5 ppm. In this study, to reduce these errors caused by inaccurate aerosol optical information, the YCAR algorithm improved with taking into account aerosol optical properties as well as aerosol vertical distribution simultaneously. The CO2 retrievals with two difference aerosol approaches have been analyzed using the GOSAT spectra and have been evaluated throughout the comparison with collocated ground-based observations at several Total Carbon Column Observing Network (TCCON) sites. The improved YCAR algorithm has biases of 0.59±0.48 ppm and 2.16±0.87 ppm at Saga and Tsukuba sites, respectively, with smaller biases and higher correlation coefficients compared to the GOSAT operational algorithm. In addition, the XCO2 retrievals will be validated at other TCCON sites and error analysis will be evaluated. These results reveal that considering better aerosol information can improve the accuracy of CO2 retrieval algorithm and provide more useful XCO2 information with reduced uncertainties. This study would be expected to provide useful information in estimating carbon sources and sinks.

Pilates Method for Lung Function and Functional Capacity in Obese Adults.

PubMed

Niehues, Janaina Rocha; Gonzáles, Inês; Lemos, Robson Rodrigues; Haas, Patrícia

2015-01-01

Obesity is defined as the condition in which the body mass index (BMI) is ≥ 30 kg/m2 and is responsible for decreased quality of life and functional limitations. The harmful effects on ventilatory function include reduced lung capacity and volume; diaphragmatic muscle weakness; decreased lung compliance and stiffness; and weakness of the abdominal muscles, among others. Pilates is a method of resistance training that works with low-impact muscle exercises and is based on isometric exercises. The current article is a review of the literature that aims to investigate the hypothesis that the Pilates method, as a complementary method of training, might be beneficial to pulmonary function and functional capacity in obese adults. The intent of the review was to evaluate the use of Pilates as an innovative intervention in the respiratory dysfunctions of obese adults. In studies with other populations, it has been observed that Pilates can be effective in improving chest capacity and expansion and lung volume. That finding is due to the fact that Pilates works through the center of force, made ​​up of the abdominal muscles and gluteus muscles lumbar, which are responsible for the stabilization of the static and dynamic body that is associated with breath control. It has been observed that different Pilates exercises increase the activation and recruitment of the abdominal muscles. Those muscles are important in respiration, both in expiration and inspiration, through the facilitation of diaphragmatic action. In that way, strengthening the abdominal muscles can help improve respiratory function, leading to improvements in lung volume and capacity. The results found in the current literature review support the authors' observations that Pilates promotes the strengthening of the abdominal muscles and that improvements in diaphragmatic function may result in positive outcomes in respiratory function, thereby improving functional capacity. However, the authors did not find specific studies with obese people, justifying the need for future studies.

Satellite-Scale Snow Water Equivalent Assimilation into a High-Resolution Land Surface Model

NASA Technical Reports Server (NTRS)

De Lannoy, Gabrielle J.M.; Reichle, Rolf H.; Houser, Paul R.; Arsenault, Kristi R.; Verhoest, Niko E.C.; Paulwels, Valentijn R.N.

2009-01-01

An ensemble Kalman filter (EnKF) is used in a suite of synthetic experiments to assimilate coarse-scale (25 km) snow water equivalent (SWE) observations (typical of satellite retrievals) into fine-scale (1 km) model simulations. Coarse-scale observations are assimilated directly using an observation operator for mapping between the coarse and fine scales or, alternatively, after disaggregation (re-gridding) to the fine-scale model resolution prior to data assimilation. In either case observations are assimilated either simultaneously or independently for each location. Results indicate that assimilating disaggregated fine-scale observations independently (method 1D-F1) is less efficient than assimilating a collection of neighboring disaggregated observations (method 3D-Fm). Direct assimilation of coarse-scale observations is superior to a priori disaggregation. Independent assimilation of individual coarse-scale observations (method 3D-C1) can bring the overall mean analyzed field close to the truth, but does not necessarily improve estimates of the fine-scale structure. There is a clear benefit to simultaneously assimilating multiple coarse-scale observations (method 3D-Cm) even as the entire domain is observed, indicating that underlying spatial error correlations can be exploited to improve SWE estimates. Method 3D-Cm avoids artificial transitions at the coarse observation pixel boundaries and can reduce the RMSE by 60% when compared to the open loop in this study.

Moon-based Earth Observation for Large Scale Geoscience Phenomena

NASA Astrophysics Data System (ADS)

Guo, Huadong; Liu, Guang; Ding, Yixing

2016-07-01

The capability of Earth observation for large-global-scale natural phenomena needs to be improved and new observing platform are expected. We have studied the concept of Moon as an Earth observation in these years. Comparing with manmade satellite platform, Moon-based Earth observation can obtain multi-spherical, full-band, active and passive information,which is of following advantages: large observation range, variable view angle, long-term continuous observation, extra-long life cycle, with the characteristics of longevity ,consistency, integrity, stability and uniqueness. Moon-based Earth observation is suitable for monitoring the large scale geoscience phenomena including large scale atmosphere change, large scale ocean change,large scale land surface dynamic change,solid earth dynamic change,etc. For the purpose of establishing a Moon-based Earth observation platform, we already have a plan to study the five aspects as follows: mechanism and models of moon-based observing earth sciences macroscopic phenomena; sensors' parameters optimization and methods of moon-based Earth observation; site selection and environment of moon-based Earth observation; Moon-based Earth observation platform; and Moon-based Earth observation fundamental scientific framework.

Task Equivalence for Model and Human-Observer Comparisons in SPECT Localization Studies

NASA Astrophysics Data System (ADS)

Sen, Anando; Kalantari, Faraz; Gifford, Howard C.

2016-06-01

While mathematical model observers are intended for efficient assessment of medical imaging systems, their findings should be relevant for human observers as the primary clinical end users. We have investigated whether pursuing equivalence between the model and human-observer tasks can help ensure this goal. A localization receiver operating characteristic (LROC) study tested prostate lesion detection in simulated In-111 SPECT imaging with anthropomorphic phantoms. The test images were 2D slices extracted from reconstructed volumes. The iterative ordered sets expectation-maximization (OSEM) reconstruction algorithm was used with Gaussian postsmoothing. Variations in the number of iterations and the level of postfiltering defined the test strategies in the study. Human-observer performance was compared with that of a visual-search (VS) observer, a scanning channelized Hotelling observer, and a scanning channelized nonprewhitening (CNPW) observer. These model observers were applied with precise information about the target regions of interest (ROIs). ROI knowledge was a study variable for the human observers. In one study format, the humans read the SPECT image alone. With a dual-modality format, the SPECT image was presented alongside an anatomical image slice extracted from the density map of the phantom. Performance was scored by area under the LROC curve. The human observers performed significantly better with the dual-modality format, and correlation with the model observers was also improved. Given the human-observer data from the SPECT study format, the Pearson correlation coefficients for the model observers were 0.58 (VS), -0.12 (CH), and -0.23 (CNPW). The respective coefficients based on the human-observer data from the dual-modality study were 0.72, 0.27, and -0.11. These results point towards the continued development of the VS observer for enhancing task equivalence in model-observer studies.

The Development and Validation of Test Instruments to Measure Observation and Comparison in Junior High School Science.

ERIC Educational Resources Information Center

Hungerford, Harold Ralph

This study attempted to design tests for the purpose of measuring the acquisition of the science skills of observation and comparison, to determine if these skills, as measured by these tests, could be differentially improved using differing amounts of training, and to determine the effects of race and cultural status on performance with the…

The Use of Videotape Recordings to Teach Clinical Skills (Evaluation and Remediation) In the Fields of Communicative Disorders.

ERIC Educational Resources Information Center

Billeaud, Frances P.

A study was undertaken to evaluate the benefits derived by speech and language pathology students who used video tape recordings to learn diagnosis of communication disorders, to observe professional therapists and therapy programs, and to improve their own clinical techniques through self-observation. The use of video tapes to teach clinical…

Data-Based Decision-Making Teams in Middle School: Observations and Implications from the Middle School Intervention Project

ERIC Educational Resources Information Center

Crone, Deanne A.; Carlson, Sarah E.; Haack, Marcia K.; Kennedy, Patrick C.; Baker, Scott K.; Fien, Hank

2016-01-01

The use of data-based decision making (DBDM) in schools to drive educational improvement and success has been strongly promoted by educational experts and policymakers, yet very little is documented about the actual DBDM practices used in schools. This study examines DBDM practices in 25 middle schools through 80 standardized observations of data…

Cylinder valve packing nut studies

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

Blue, S.C.

1991-12-31

The design, manufacture, and use of cylinder valve packing nuts have been studied to improve their resistance to failure from stress corrosion cracking. Stress frozen photoelastic models have been analyzed to measure the stress concentrations at observed points of failure. The load effects induced by assembly torque and thermal expansion of stem packing were observed by strain gaging nuts. The effects of finishing operations and heat treatment were studied by the strain gage hole boring and X-ray methods. Modifications of manufacturing and operation practices are reducing the frequency of stress corrosion failures.

Cut-off characterisation of energy spectra of bright fermi sources: Current instrument limits and future possibilities

NASA Astrophysics Data System (ADS)

Romoli, C.; Taylor, A. M.; Aharonian, F.

2017-02-01

In this paper some of the brightest GeV sources observed by the Fermi-LAT were analysed, focusing on their spectral cut-off region. The sources chosen for this investigation were the brightest blazar flares of 3C 454.3 and 3C 279 and the Vela pulsar with a reanalysis with the latest Fermi-LAT software. For the study of the spectral cut-off we first explored the Vela pulsar spectrum, whose statistics in the time interval of the 3FGL catalog allowed strong constraints to be obtained on the parameters. We subsequently performed a new analysis of the flaring blazar SEDs. For these sources we obtained constraints on the cut-off parameters under the assumption that their underlying spectral distribution is described by a power-law with a stretched exponential cut-off. We then highlighted the significant potential improvements on such constraints by observations with next generation ground based Cherenkov telescopes, represented in our study by the Cherenkov Telescope Array (CTA). Adopting currently available simulations for this future observatory, we demonstrate the considerable improvement in cut-off constraints achievable by observations with this new instrument when compared with that achievable by satellite observations.

Ankle Dorsiflexion in Childhood Cancer Patients: A Review of the Literature.

PubMed

Beulertz, Julia; Wurz, Amanda; Culos-Reed, Nicole; Chamorro Viña, Carolina; Bloch, Wilhelm; Baumann, Freerk T

2015-01-01

Improved treatment protocols necessary for survival in pediatric oncology are associated with the development of serious late effects. Of particular importance, especially with regard to physical activity, may be ankle dorsiflexion (DF). This review summarizes the results of observational and exercise intervention studies exploring ankle DF-range of motion (DF-ROM) and/or ankle DF strength in pediatric oncology. PUBMED, Medline, Cochrane library, and SportDiscus were searched by 2 researchers using predefined search terms. The reference lists of included papers and Google scholar were then searched to that ensure all appropriate articles were included. Twelve studies were identified and were observational (n = 8), providing information regarding the status of DF-ROM and/or DF strength, or intervention studies (n = 4) using exercise as a strategy to improve DF function. All observational studies reported some degree of impairment in ankle DF. Two intervention studies found a positive effect of exercise on ankle DF-ROM. The preliminary results suggest that pediatric cancer patients and survivors suffer from limitations in ankle DF with interventions varying in efficacy. It is hoped that this review will enhance the recognition of the limited ankle DF function in pediatric oncology and initiate further research programs focused on targeting and evaluating ankle DF.

A method to improve visual similarity of breast masses for an interactive computer-aided diagnosis environment.

PubMed

Zheng, Bin; Lu, Amy; Hardesty, Lara A; Sumkin, Jules H; Hakim, Christiane M; Ganott, Marie A; Gur, David

2006-01-01

The purpose of this study was to develop and test a method for selecting "visually similar" regions of interest depicting breast masses from a reference library to be used in an interactive computer-aided diagnosis (CAD) environment. A reference library including 1000 malignant mass regions and 2000 benign and CAD-generated false-positive regions was established. When a suspicious mass region is identified, the scheme segments the region and searches for similar regions from the reference library using a multifeature based k-nearest neighbor (KNN) algorithm. To improve selection of reference images, we added an interactive step. All actual masses in the reference library were subjectively rated on a scale from 1 to 9 as to their "visual margins speculations". When an observer identifies a suspected mass region during a case interpretation he/she first rates the margins and the computerized search is then limited only to regions rated as having similar levels of spiculation (within +/-1 scale difference). In an observer preference study including 85 test regions, two sets of the six "similar" reference regions selected by the KNN with and without the interactive step were displayed side by side with each test region. Four radiologists and five nonclinician observers selected the more appropriate ("similar") reference set in a two alternative forced choice preference experiment. All four radiologists and five nonclinician observers preferred the sets of regions selected by the interactive method with an average frequency of 76.8% and 74.6%, respectively. The overall preference for the interactive method was highly significant (p < 0.001). The study demonstrated that a simple interactive approach that includes subjectively perceived ratings of one feature alone namely, a rating of margin "spiculation," could substantially improve the selection of "visually similar" reference images.

Natural and Anthropogenic Aerosol Trends from Satellite and Surface Observations and Model Simulations over the North Atlantic Ocean from 2002 to 2012

NASA Technical Reports Server (NTRS)

Jongeward, Andrew R.; Li, Zhanqing; He, Hao; Xiong, Xiaoxiong

2016-01-01

Aerosols contribute to Earths radiative budget both directly and indirectly, and large uncertainties remain in quantifying aerosol effects on climate. Variability in aerosol distribution and properties, as might result from changing emissions and transport processes, must be characterized. In this study, variations in aerosol loading across the eastern seaboard of theUnited States and theNorthAtlanticOcean during 2002 to 2012 are analyzed to examine the impacts of anthropogenic emission control measures using monthly mean data from MODIS, AERONET, and IMPROVE observations and Goddard Chemistry Aerosol Radiation and Transport (GOCART) model simulation.MODIS observes a statistically significant negative trend in aerosol optical depth (AOD) over the midlatitudes (-0.030 decade(sup-1)). Correlation analyses with surface AOD from AERONET sites in the upwind region combined with trend analysis from GOCART component AOD confirm that the observed decrease in the midlatitudes is chiefly associated with anthropogenic aerosols that exhibit significant negative trends from the eastern U.S. coast extending over the western North Atlantic. Additional analysis of IMPROVE surface PM(sub 2.5) observations demonstrates statistically significant negative trends in the anthropogenic components with decreasing mass concentrations over the eastern United States. Finally, a seasonal analysis of observational datasets is performed. The negative trend seen by MODIS is strongest during spring (MAM) and summer (JJA) months. This is supported by AERONET seasonal trends and is identified from IMPROVE seasonal trends as resulting from ammonium sulfate decreases during these seasons.

Simulation of Twin Telescopes at Onsala and Wettzell for the VLBI Global Observing System

NASA Astrophysics Data System (ADS)

Schönberger, Caroline; Gnilsen, Paul; Böhm, Johannes; Haas, Rüdiger

2015-04-01

The VLBI2010 committee of the International VLBI Service for Geodesy and Astrometry (IVS) developed a concept to achieve an improvement of the accuracy of geodetic Very Long Baseline Interferometry (VLBI) to 1 mm for station positions and 0.1 mm/yr for station velocities. This so-called VLBI2010 concept includes broadband observations with fast slewing telescopes and proposes twin telescopes to improve the handling of atmospheric turbulence that has been identified as a limiting factor for geodetic VLBI. There are several VLBI sites that have projects to install a Twin Telescope. The Wettzell Twin Telescope in Germany has already been constructed, and Twin Telescopes will be installed in the coming years at Onsala (Sweden), Ny-Ålesund (Spitsbergen, Norway) and Kazan (Russia). In this study, the Vienna VLBI Software (VieVS) is used to schedule and simulate a global VLBI network following the example of the CONT11 campaign, with and without the Twin Telescopes in Onsala and Wettzell. Different scheduling approaches (e.g., source-based scheduling, Twin Telescope observing in multidirectional mode, Twin Telescopes in continuous mode) were compared by evaluating the numbers of observations and scans as well as baseline length repeatabilities, station positions, Earth orientation parameters, atmospheric parameters and clock estimates. Comparison of the results show an improvement in estimated parameters with Twin Telescopes, especially with the Onsala Twin Telescope in a continuous observing mode and a strategy with four sources observed simultaneously.

Very Long Baseline Array Astrometric Observations of the Cassini Spacecraft at Saturn

NASA Astrophysics Data System (ADS)

Jones, Dayton L.; Fomalont, Ed; Dhawan, Vivek; Romney, Jon; Folkner, William M.; Lanyi, Gabor; Border, James; Jacobson, Robert A.

2011-02-01

The planetary ephemeris is an essential tool for interplanetary spacecraft navigation, studies of solar system dynamics (including, for example, barycenter corrections for pulsar timing ephemerides), the prediction of occultations, and tests of general relativity. We are carrying out a series of astrometric very long baseline interferometry observations of the Cassini spacecraft currently in orbit around Saturn, using the Very Long Baseline Array (VLBA). These observations provide positions for the center of mass of Saturn in the International Celestial Reference Frame (ICRF) with accuracies ~0.3 mas (1.5 nrad) or about 2 km at the average distance of Saturn. This paper reports results from eight observing epochs between 2006 October and 2009 April. These data are combined with two VLBA observations by other investigators in 2004 and a Cassini-based gravitational deflection measurement by Fomalont et al. in 2009 to constrain a new ephemeris (DE 422). The DE 422 post-fit residuals for Saturn with respect to the VLBA data are generally 0.2 mas, but additional observations are needed to improve the positions of all of our phase reference sources to this level. Over time we expect to be able to improve the accuracy of all three coordinates in the Saturn ephemeris (latitude, longitude, and range) by a factor of at least three. This will represent a significant improvement not just in the Saturn ephemeris but also in the link between the inner and outer solar system ephemerides and in the link to the inertial ICRF.

[BRAVO and CRUISE: ranibizumab for the treatment of macular edema secondary to retinal vein occlusion].

PubMed

Figueroa, M S; Ruiz Moreno, J M

2012-12-01

This article summarizes the results of the BRAVO and CRUISE trials, two randomized multicenter studies in patients with macular edema secondary to branch and central retinal vein occlusion, respectively. Randomization was 1:1:1 to 0.3 mg of ranibizumab, 0.5 mg of ranibizumab or placebo. Monthly injections were administered for 6 months followed by a 6-month observation period in which treatment on an on-demand (PRN) basis was applied with 0.5 mg ranibizumab. Patients in the control group were also eligible for 0.5 mg ranibizumab treatment in the observation period. The results showed a significant anatomical and visual improvement in both treatment groups 7 days after the intravitreal injection. PRN treatment with monthly follow-up maintained the visual improvements achieved after the first 6 months of treatment. Patients in the control group who received PRN treatment after the first 6 months showed an anatomical improvement similar to that in the treatment groups but less visual improvement.

Improving membrane protein expression by optimizing integration efficiency

PubMed Central

2017-01-01

The heterologous overexpression of integral membrane proteins in Escherichia coli often yields insufficient quantities of purifiable protein for applications of interest. The current study leverages a recently demonstrated link between co-translational membrane integration efficiency and protein expression levels to predict protein sequence modifications that improve expression. Membrane integration efficiencies, obtained using a coarse-grained simulation approach, robustly predicted effects on expression of the integral membrane protein TatC for a set of 140 sequence modifications, including loop-swap chimeras and single-residue mutations distributed throughout the protein sequence. Mutations that improve simulated integration efficiency were 4-fold enriched with respect to improved experimentally observed expression levels. Furthermore, the effects of double mutations on both simulated integration efficiency and experimentally observed expression levels were cumulative and largely independent, suggesting that multiple mutations can be introduced to yield higher levels of purifiable protein. This work provides a foundation for a general method for the rational overexpression of integral membrane proteins based on computationally simulated membrane integration efficiencies. PMID:28918393