Science Based Human Reliability Analysis: Using Digital Nuclear Power Plant Simulators for Human Reliability Research

NASA Astrophysics Data System (ADS)

Shirley, Rachel Elizabeth

Nuclear power plant (NPP) simulators are proliferating in academic research institutions and national laboratories in response to the availability of affordable, digital simulator platforms. Accompanying the new research facilities is a renewed interest in using data collected in NPP simulators for Human Reliability Analysis (HRA) research. An experiment conducted in The Ohio State University (OSU) NPP Simulator Facility develops data collection methods and analytical tools to improve use of simulator data in HRA. In the pilot experiment, student operators respond to design basis accidents in the OSU NPP Simulator Facility. Thirty-three undergraduate and graduate engineering students participated in the research. Following each accident scenario, student operators completed a survey about perceived simulator biases and watched a video of the scenario. During the video, they periodically recorded their perceived strength of significant Performance Shaping Factors (PSFs) such as Stress. This dissertation reviews three aspects of simulator-based research using the data collected in the OSU NPP Simulator Facility: First, a qualitative comparison of student operator performance to computer simulations of expected operator performance generated by the Information Decision Action Crew (IDAC) HRA method. Areas of comparison include procedure steps, timing of operator actions, and PSFs. Second, development of a quantitative model of the simulator bias introduced by the simulator environment. Two types of bias are defined: Environmental Bias and Motivational Bias. This research examines Motivational Bias--that is, the effect of the simulator environment on an operator's motivations, goals, and priorities. A bias causal map is introduced to model motivational bias interactions in the OSU experiment. Data collected in the OSU NPP Simulator Facility are analyzed using Structural Equation Modeling (SEM). Data include crew characteristics, operator surveys, and time to recognize and diagnose the accident in the scenario. These models estimate how the effects of the scenario conditions are mediated by simulator bias, and demonstrate how to quantify the strength of the simulator bias. Third, development of a quantitative model of subjective PSFs based on objective data (plant parameters, alarms, etc.) and PSF values reported by student operators. The objective PSF model is based on the PSF network in the IDAC HRA method. The final model is a mixed effects Bayesian hierarchical linear regression model. The subjective PSF model includes three factors: The Environmental PSF, the simulator Bias, and the Context. The Environmental Bias is mediated by an operator sensitivity coefficient that captures the variation in operator reactions to plant conditions. The data collected in the pilot experiments are not expected to reflect professional NPP operator performance, because the students are still novice operators. However, the models used in this research and the methods developed to analyze them demonstrate how to consider simulator bias in experiment design and how to use simulator data to enhance the technical basis of a complex HRA method. The contributions of the research include a framework for discussing simulator bias, a quantitative method for estimating simulator bias, a method for obtaining operator-reported PSF values, and a quantitative method for incorporating the variability in operator perception into PSF models. The research demonstrates applications of Structural Equation Modeling and hierarchical Bayesian linear regression models in HRA. Finally, the research demonstrates the benefits of using student operators as a test platform for HRA research.

Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective pain intensity in patients with nontraumatic chronic neck pain.

PubMed

Palmgren, Per J; Sandström, Peter J; Lundqvist, Fredrik J; Heikkilä, Hannu

2006-02-01

The objective of this study was to examine alteration in head repositioning accuracy (HRA), range of motion, and pain intensity in patients with chronic cervical pain syndrome without a history of cervical trauma. The study was a prospective, randomized, controlled trial. Forty-one patients with chronic cervical pain were randomly assigned to either a control group or a chiropractic treatment group. All patients were clinically examined, given general information on cervical pain, and provided with training instructions based on the clinical evaluation. The treatment included sessions with high-velocity and low-amplitude manipulation, proprioceptive neuromuscular facilitation, ischemic compression of myofascial trigger points, and spinal rehabilitation exercises aiming to normalize cervical range of motion (CROM) and HRA. Subjective pain intensity, cervical kinesthetic sensibility, and CROM were recorded before and after the study period. There was no difference between the treatment patients and the control subjects at the beginning with regard to age, sex, subjective pain intensity, range of motion, and HRA. At the 5-week follow-up, the treatment patients showed significant reductions in pain and improvement of all HRA aspects measured whereas the control subjects did not show any reduction in pain and improvement in only one HRA aspect. No significant difference was detected in CROM. The results of this study suggest that chiropractic care can be effective in influencing the complex process of proprioceptive sensibility and pain of cervical origin. Short, specific chiropractic treatment programs with proper patient information may alter the course of chronic cervical pain.

Issues in benchmarking human reliability analysis methods : a literature review.

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

Lois, Erasmia; Forester, John Alan; Tran, Tuan Q.

There is a diversity of human reliability analysis (HRA) methods available for use in assessing human performance within probabilistic risk assessment (PRA). Due to the significant differences in the methods, including the scope, approach, and underlying models, there is a need for an empirical comparison investigating the validity and reliability of the methods. To accomplish this empirical comparison, a benchmarking study is currently underway that compares HRA methods with each other and against operator performance in simulator studies. In order to account for as many effects as possible in the construction of this benchmarking study, a literature review was conducted,more » reviewing past benchmarking studies in the areas of psychology and risk assessment. A number of lessons learned through these studies are presented in order to aid in the design of future HRA benchmarking endeavors.« less

Issues in Benchmarking Human Reliability Analysis Methods: A Literature Review

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

Ronald L. Boring; Stacey M. L. Hendrickson; John A. Forester

There is a diversity of human reliability analysis (HRA) methods available for use in assessing human performance within probabilistic risk assessments (PRA). Due to the significant differences in the methods, including the scope, approach, and underlying models, there is a need for an empirical comparison investigating the validity and reliability of the methods. To accomplish this empirical comparison, a benchmarking study comparing and evaluating HRA methods in assessing operator performance in simulator experiments is currently underway. In order to account for as many effects as possible in the construction of this benchmarking study, a literature review was conducted, reviewing pastmore » benchmarking studies in the areas of psychology and risk assessment. A number of lessons learned through these studies are presented in order to aid in the design of future HRA benchmarking endeavors.« less

Challenges in leveraging existing human performance data for quantifying the IDHEAS HRA method

DOE PAGES

Liao, Huafei N.; Groth, Katrina; Stevens-Adams, Susan

2015-07-29

Our article documents an exploratory study for collecting and using human performance data to inform human error probability (HEP) estimates for a new human reliability analysis (HRA) method, the IntegrateD Human Event Analysis System (IDHEAS). The method was based on cognitive models and mechanisms underlying human behaviour and employs a framework of 14 crew failure modes (CFMs) to represent human failures typical for human performance in nuclear power plant (NPP) internal, at-power events [1]. A decision tree (DT) was constructed for each CFM to assess the probability of the CFM occurring in different contexts. Data needs for IDHEAS quantification aremore » discussed. Then, the data collection framework and process is described and how the collected data were used to inform HEP estimation is illustrated with two examples. Next, five major technical challenges are identified for leveraging human performance data for IDHEAS quantification. Furthermore, these challenges reflect the data needs specific to IDHEAS. More importantly, they also represent the general issues with current human performance data and can provide insight for a path forward to support HRA data collection, use, and exchange for HRA method development, implementation, and validation.« less

A Research Roadmap for Computation-Based Human Reliability Analysis

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

Boring, Ronald; Mandelli, Diego; Joe, Jeffrey

2015-08-01

The United States (U.S.) Department of Energy (DOE) is sponsoring research through the Light Water Reactor Sustainability (LWRS) program to extend the life of the currently operating fleet of commercial nuclear power plants. The Risk Informed Safety Margin Characterization (RISMC) research pathway within LWRS looks at ways to maintain and improve the safety margins of these plants. The RISMC pathway includes significant developments in the area of thermalhydraulics code modeling and the development of tools to facilitate dynamic probabilistic risk assessment (PRA). PRA is primarily concerned with the risk of hardware systems at the plant; yet, hardware reliability is oftenmore » secondary in overall risk significance to human errors that can trigger or compound undesirable events at the plant. This report highlights ongoing efforts to develop a computation-based approach to human reliability analysis (HRA). This computation-based approach differs from existing static and dynamic HRA approaches in that it: (i) interfaces with a dynamic computation engine that includes a full scope plant model, and (ii) interfaces with a PRA software toolset. The computation-based HRA approach presented in this report is called the Human Unimodels for Nuclear Technology to Enhance Reliability (HUNTER) and incorporates in a hybrid fashion elements of existing HRA methods to interface with new computational tools developed under the RISMC pathway. The goal of this research effort is to model human performance more accurately than existing approaches, thereby minimizing modeling uncertainty found in current plant risk models.« less

Evaluation of end-user satisfaction among employees participating in a web-based health risk assessment with tailored feedback.

PubMed

Vosbergen, Sandra; Laan, Eva K; Colkesen, Ersen B; Niessen, Maurice A J; Kraaijenhagen, Roderik A; Essink-Bot, Marie-Louise; Peek, Niels

2012-10-30

Web technology is increasingly being used to provide individuals with health risk assessments (HRAs) with tailored feedback. End-user satisfaction is an important determinant of the potential impact of HRAs, as this influences program attrition and adherence to behavioral advice. The aim of this study was to evaluate end-user satisfaction with a web-based HRA with tailored feedback applied in worksite settings, using mixed (quantitative and qualitative) methods. Employees of seven companies in the Netherlands participated in a commercial, web-based, HRA with tailored feedback. The HRA consisted of four components: 1) a health and lifestyle assessment questionnaire, 2) a biometric evaluation, 3) a laboratory evaluation, and 4) tailored feedback consisting of a personal health risk profile and lifestyle behavior advice communicated through a web portal. HRA respondents received an evaluation questionnaire after six weeks. Satisfaction with different parts of the HRA was measured on 5-point Likert scales. A free-text field provided the opportunity to make additional comments. In total, 2289 employees participated in the HRA program, of which 637 (27.8%) completed the evaluation questionnaire. Quantitative analysis showed that 85.6% of the respondents evaluated the overall HRA positively. The free-text field was filled in by 29.7 % of the respondents (189 out of 637), who made 315 separate remarks. Qualitative evaluation of these data showed that these respondents made critical remarks. Respondents felt restricted by the answer categories of the health and lifestyle assessment questionnaire, which resulted in the feeling that the corresponding feedback could be inadequate. Some respondents perceived the personal risk profile as unnecessarily alarming or suggested providing more explanations, reference values, and a justification of the behavioral advice given. Respondents also requested the opportunity to discuss the feedback with a health professional. Most people were satisfied with the web-based HRA with tailored feedback. Sources of dissatisfaction were limited opportunities for providing additional health information outside of the predefined health and lifestyle assessment questionnaire and insufficient transparency on the generation of the feedback. Information regarding the aim and content of the HRA should be clear and accurate to prevent unrealistic expectations among end-users. Involving trusted health professionals in the implementation of web-based HRAs may enhance the use of and confidence in the HRA.

EPRI/NRC-RES fire human reliability analysis guidelines.

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

Lewis, Stuart R.; Cooper, Susan E.; Najafi, Bijan

2010-03-01

During the 1990s, the Electric Power Research Institute (EPRI) developed methods for fire risk analysis to support its utility members in the preparation of responses to Generic Letter 88-20, Supplement 4, 'Individual Plant Examination - External Events' (IPEEE). This effort produced a Fire Risk Assessment methodology for operations at power that was used by the majority of U.S. nuclear power plants (NPPs) in support of the IPEEE program and several NPPs overseas. Although these methods were acceptable for accomplishing the objectives of the IPEEE, EPRI and the U.S. Nuclear Regulatory Commission (NRC) recognized that they required upgrades to support currentmore » requirements for risk-informed, performance-based (RI/PB) applications. In 2001, EPRI and the USNRC's Office of Nuclear Regulatory Research (RES) embarked on a cooperative project to improve the state-of-the-art in fire risk assessment to support a new risk-informed environment in fire protection. This project produced a consensus document, NUREG/CR-6850 (EPRI 1011989), entitled 'Fire PRA Methodology for Nuclear Power Facilities' which addressed fire risk for at power operations. NUREG/CR-6850 developed high level guidance on the process for identification and inclusion of human failure events (HFEs) into the fire PRA (FPRA), and a methodology for assigning quantitative screening values to these HFEs. It outlined the initial considerations of performance shaping factors (PSFs) and related fire effects that may need to be addressed in developing best-estimate human error probabilities (HEPs). However, NUREG/CR-6850 did not describe a methodology to develop best-estimate HEPs given the PSFs and the fire-related effects. In 2007, EPRI and RES embarked on another cooperative project to develop explicit guidance for estimating HEPs for human failure events under fire generated conditions, building upon existing human reliability analysis (HRA) methods. This document provides a methodology and guidance for conducting a fire HRA. This process includes identification and definition of post-fire human failure events, qualitative analysis, quantification, recovery, dependency, and uncertainty. This document provides three approaches to quantification: screening, scoping, and detailed HRA. Screening is based on the guidance in NUREG/CR-6850, with some additional guidance for scenarios with long time windows. Scoping is a new approach to quantification developed specifically to support the iterative nature of fire PRA quantification. Scoping is intended to provide less conservative HEPs than screening, but requires fewer resources than a detailed HRA analysis. For detailed HRA quantification, guidance has been developed on how to apply existing methods to assess post-fire fire HEPs.« less

Differential Attention to Faces in Infant Siblings of Children with Autism Spectrum Disorder and Associations with Later Social and Language Ability.

PubMed

Wagner, Jennifer B; Luyster, Rhiannon J; Moustapha, Hana; Tager-Flusberg, Helen; Nelson, Charles A

2018-01-01

A growing body of literature has begun to explore social attention in infant siblings of children with autism spectrum disorder (ASD) with hopes of identifying early differences that are associated with later ASD or other aspects of development. The present study used eye-tracking to familiar (mother) and unfamiliar (stranger) faces in two groups of 6-month-old infants: infants with no family history of ASD (low-risk controls; LRC), and infants at high risk for ASD (HRA), by virtue of having an older sibling with ASD. HRA infants were further characterized based on autism classification at 24 months or older as HRA- (HRA without an ASD outcome) or HRA+ (HRA with an ASD outcome). For time scanning faces overall, HRA+ and LRC showed similar patterns of attention, and this was significantly greater than in HRA-. When examining duration of time spent on eyes and mouth, all infants spent more time on eyes than mouth, but HRA+ showed the greatest amount of time looking at these regions, followed by LRC, then HRA-. LRC showed a positive association between 6-month attention to eyes and 18-month social-communicative behavior, while HRA- showed a negative association between attention to eyes at 6 months and expressive language at 18 months (all correlations controlled for non-verbal IQ; HRA- correlations held with and without the inclusion of the small sample of HRA+). Differences found in face scanning at 6 months, as well as associations with social communication at 18 months, point to potential variation in the developmental significance of early social attention in children at low and high risk for ASD.

What is needed to implement a computer-assisted health risk assessment tool? An exploratory concept mapping study.

PubMed

Ahmad, Farah; Norman, Cameron; O'Campo, Patricia

2012-12-19

Emerging eHealth tools could facilitate the delivery of comprehensive care in time-constrained clinical settings. One such tool is interactive computer-assisted health-risk assessments (HRA), which may improve provider-patient communication at the point of care, particularly for psychosocial health concerns, which remain under-detected in clinical encounters. The research team explored the perspectives of healthcare providers representing a variety of disciplines (physicians, nurses, social workers, allied staff) regarding the factors required for implementation of an interactive HRA on psychosocial health. The research team employed a semi-qualitative participatory method known as Concept Mapping, which involved three distinct phases. First, in face-to-face and online brainstorming sessions, participants responded to an open-ended central question: "What factors should be in place within your clinical setting to support an effective computer-assisted screening tool for psychosocial risks?" The brainstormed items were consolidated by the research team. Then, in face-to-face and online sorting sessions, participants grouped the items thematically as 'it made sense to them'. Participants also rated each item on a 5-point scale for its 'importance' and 'action feasibility' over the ensuing six month period. The sorted and rated data was analyzed using multidimensional scaling and hierarchical cluster analyses which produced visual maps. In the third and final phase, the face-to-face Interpretation sessions, the concept maps were discussed and illuminated by participants collectively. Overall, 54 providers participated (emergency care 48%; primary care 52%). Participants brainstormed 196 items thought to be necessary for the implementation of an interactive HRA emphasizing psychosocial health. These were consolidated by the research team into 85 items. After sorting and rating, cluster analysis revealed a concept map with a seven-cluster solution: 1) the HRA's equitable availability; 2) the HRA's ease of use and appropriateness; 3) the content of the HRA survey; 4) patient confidentiality and choice; 5) patient comfort through humanistic touch; 6) professional development, care and workload; and 7) clinical management protocol. Drawing insight from the theoretical lens of Sociotechnical theory, the seven clusters of factors required for HRA implementation could be read as belonging to three overarching aspects : Technical (cluster 1, 2 and 3), Social-Patient (cluster 4 and 5), and Social-Provider (cluster 6 and 7). Participants rated every one of the clusters as important, with mean scores from 4.0 to 4.5. Their scores for feasibility were somewhat lower, ranging from 3.4 to. 4.3. Comparing the scores for importance and feasibility, a significant difference was found for one cluster from each region (cluster 2, 5, 6). The cluster on professional development, care and workload was perceived as especially challenging in emergency department settings, and possible reasons were discussed in the interpretation sessions. A number of intertwined multilevel factors emerged as important for the implementation of a computer-assisted, interactive HRA with a focus on psychosocial health. Future developments in this area could benefit from systems thinking and insights from theoretical perspectives, such as sociotechnical system theory for joint optimization and responsible autonomy, with emphasis on both the technical and social aspects of HRA implementation.

Results of a nuclear power plant application of A New Technique for Human Error Analysis (ATHEANA)

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

Whitehead, D.W.; Forester, J.A.; Bley, D.C.

1998-03-01

A new method to analyze human errors has been demonstrated at a pressurized water reactor (PWR) nuclear power plant. This was the first application of the new method referred to as A Technique for Human Error Analysis (ATHEANA). The main goals of the demonstration were to test the ATHEANA process as described in the frame-of-reference manual and the implementation guideline, test a training package developed for the method, test the hypothesis that plant operators and trainers have significant insight into the error-forcing-contexts (EFCs) that can make unsafe actions (UAs) more likely, and to identify ways to improve the method andmore » its documentation. A set of criteria to evaluate the success of the ATHEANA method as used in the demonstration was identified. A human reliability analysis (HRA) team was formed that consisted of an expert in probabilistic risk assessment (PRA) with some background in HRA (not ATHEANA) and four personnel from the nuclear power plant. Personnel from the plant included two individuals from their PRA staff and two individuals from their training staff. Both individuals from training are currently licensed operators and one of them was a senior reactor operator on shift until a few months before the demonstration. The demonstration was conducted over a 5-month period and was observed by members of the Nuclear Regulatory Commission`s ATHEANA development team, who also served as consultants to the HRA team when necessary. Example results of the demonstration to date, including identified human failure events (HFEs), UAs, and EFCs are discussed. Also addressed is how simulator exercises are used in the ATHEANA demonstration project.« less

Head repositioning accuracy to neutral: a comparative study of error calculation.

PubMed

Hill, Robert; Jensen, Pål; Baardsen, Tor; Kulvik, Kristian; Jull, Gwendolen; Treleaven, Julia

2009-02-01

Deficits in cervical proprioception have been identified in subjects with neck pain through the measure of head repositioning accuracy (HRA). Nevertheless there appears to be no general consensus regarding the construct of measurement of error used for calculating HRA. This study investigated four different mathematical methods of measurement of error to determine if there were any differences in their ability to discriminate between a control group and subjects with a whiplash associated disorder. The four methods for measuring cervical joint position error were calculated using a previous data set consisting of 50 subjects with whiplash complaining of dizziness (WAD D), 50 subjects with whiplash not complaining of dizziness (WAD ND) and 50 control subjects. The results indicated that no one measure of HRA uniquely detected or defined the differences between the whiplash and control groups. Constant error (CE) was significantly different between the whiplash and control groups from extension (p<0.05). Absolute errors (AEs) and root mean square errors (RMSEs) demonstrated differences between the two WAD groups in rotation trials (p<0.05). No differences were seen with variable error (VE). The results suggest that a combination of AE (or RMSE) and CE are probably the most suitable measures for analysis of HRA.

Efficacy of Cladribine Tablets in high disease activity subgroups of patients with relapsing multiple sclerosis: A post hoc analysis of the CLARITY study.

PubMed

Giovannoni, Gavin; Soelberg Sorensen, Per; Cook, Stuart; Rammohan, Kottil W; Rieckmann, Peter; Comi, Giancarlo; Dangond, Fernando; Hicking, Christine; Vermersch, Patrick

2018-04-01

In the CLARITY (CLAdRIbine Tablets treating multiple sclerosis orallY) study, Cladribine Tablets significantly improved clinical and magnetic resonance imaging (MRI) outcomes (vs placebo) in patients with relapsing-remitting multiple sclerosis. Describe two clinically relevant definitions for patients with high disease activity (HDA) at baseline of the CLARITY study (utility verified in patients receiving placebo) and assess the treatment effects of Cladribine Tablets 3.5 mg/kg compared with the overall study population. Outcomes of patients randomised to Cladribine Tablets 3.5 mg/kg or placebo were analysed for subgroups using HDA definitions based on high relapse activity (HRA; patients with ⩾2 relapses during the year prior to study entry, whether on DMD treatment or not) or HRA plus disease activity on treatment (HRA + DAT; patients with ⩾2 relapses during the year prior to study entry, whether on DMD treatment or not, PLUS patients with ⩾1 relapse during the year prior to study entry while on therapy with other DMDs and ⩾1 T1 Gd+ or ⩾9 T2 lesions). In the overall population, Cladribine Tablets 3.5 mg/kg reduced the risk of 6-month-confirmed Expanded Disability Status Scale (EDSS) worsening by 47% vs placebo. A risk reduction of 82% vs placebo was seen in both the HRA and HRA + DAT subgroups (vs 19% for non-HRA and 18% for non-HRA + DAT), indicating greater responsiveness to Cladribine Tablets 3.5 mg/kg in patients with HDA. There were consistent results for other efficacy endpoints. The safety profile in HDA patients was consistent with the overall CLARITY population. Patients with HDA showed clinical and MRI responses to Cladribine Tablets 3.5 mg/kg that were generally better than, or at least comparable with, the outcomes seen in the overall CLARITY population.

Time spent on health related activities associated with chronic illness: a scoping literature review.

PubMed

Jowsey, Tanisha; Yen, Laurann; W, Paul Mathews

2012-12-03

The management of health care, particularly for people with chronic conditions, combines the activities of health professionals, patients, informal carers and social networks that support them. Understanding the non-professional roles in health management requires information about the health related activities (HRA) that are undertaken by patients and informal carers. This understanding allows management planning that incorporates the capacity of patients and informal carers, as well as identifying the particular skills, knowledge and technical support that are necessary. This review was undertaken to identify how much time people with chronic illness and their informal carers spend on HRA. Literature searches of three electronic databases (CINAHL, Medline, and PubMed) and two journals (Time and Society, Sociology of Health and Illness) were carried out in 2011 using the following search terms (and derivatives): chronic illness AND time AND consumer OR carer. The search was aimed at finding studies of time spent on HRA. A scoping literature review method was utilised. Twenty-two peer reviewed articles published between 1990 and 2010 were included for review. The review identified limited but specific studies about time use by people with a chronic illness and/or their carers. While illness work was seen as demanding, few studies combined inquiry about both defined tasks and defined time use. It also identified methodological issues such as consistency of definition and data collection methods, which remain unresolved. While HRA are seen as demanding by people doing them, few studies have measured actual time taken to carry out a comprehensive range of HRA. The results of this review suggest that both patients with chronic illness and informal carers may be spending 2 hours a day or more on HRA. Illnesses such as diabetes may be associated with higher time use. More empirical research is needed to understand the time demands of self-management, particularly for those affected by chronic illness.

An assessment of health hazard/health risk appraisal.

PubMed Central

Wagner, E H; Beery, W L; Schoenbach, V J; Graham, R M

1982-01-01

A state-of-the-art review of a widely-used health promotion technique, the health hazard/health risk appraisal (HHA/HRA), was conducted. The review included preparing a 212-item annotated bibliography, compiling an inventory of 217 programs that have used HHA/HRA, holding discussions with HHA/HRA developers and users, conducting formal site visits to 15 HHA/HRA programs, and consultation with experts on epidemiology, biostatistics, and behavioral science as well as developers and users of HHA/HRA. Programs use HHA/HRA primarily as a promotional device, as a tool for structuring education about health-related behaviors, and as a motivational device for stimulating behavioral change. The scientific basis for HHA/HRA risk predictions is problematic, but their arithmetic imprecision is of less concern than insufficiency of the scientific evidence for certain behavioral recommendations, and inaccuracies in client-supplied data. Widely-held beliefs in HHA/HRA's efficacy for motivating behavioral change cannot be substantiated from available evidence, nor can the assumed absence of adverse effects. The importance of this particular health promotion technique appears to have been exaggerated. PMID:7065313

Proof-of-Concept Demonstrations for Computation-Based Human Reliability Analysis. Modeling Operator Performance During Flooding Scenarios

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

Joe, Jeffrey Clark; Boring, Ronald Laurids; Herberger, Sarah Elizabeth Marie

The United States (U.S.) Department of Energy (DOE) Light Water Reactor Sustainability (LWRS) program has the overall objective to help sustain the existing commercial nuclear power plants (NPPs). To accomplish this program objective, there are multiple LWRS “pathways,” or research and development (R&D) focus areas. One LWRS focus area is called the Risk-Informed Safety Margin and Characterization (RISMC) pathway. Initial efforts under this pathway to combine probabilistic and plant multi-physics models to quantify safety margins and support business decisions also included HRA, but in a somewhat simplified manner. HRA experts at Idaho National Laboratory (INL) have been collaborating with othermore » experts to develop a computational HRA approach, called the Human Unimodel for Nuclear Technology to Enhance Reliability (HUNTER), for inclusion into the RISMC framework. The basic premise of this research is to leverage applicable computational techniques, namely simulation and modeling, to develop and then, using RAVEN as a controller, seamlessly integrate virtual operator models (HUNTER) with 1) the dynamic computational MOOSE runtime environment that includes a full-scope plant model, and 2) the RISMC framework PRA models already in use. The HUNTER computational HRA approach is a hybrid approach that leverages past work from cognitive psychology, human performance modeling, and HRA, but it is also a significant departure from existing static and even dynamic HRA methods. This report is divided into five chapters that cover the development of an external flooding event test case and associated statistical modeling considerations.« less

The Use of Empirical Data Sources in HRA

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

Bruce Hallbert; David Gertman; Julie Marble

This paper presents a review of available information related to human performance to support Human Reliability Analysis (HRA) performed for nuclear power plants (NPPs). A number of data sources are identified as potentially useful. These include NPP licensee event reports (LERs), augmented inspection team (AIT) reports, operator requalification data, results from the literature in experimental psychology, and the Aviation Safety Reporting System (ASRSs). The paper discusses how utilizing such information improves our capability to model and quantify human performance. In particular the paper discusses how information related to performance shaping factors (PSFs) can be extracted from empirical data to determinemore » their size effect, their relative effects, as well as their interactions. The paper concludes that appropriate use of existing sources can help addressing some of the important issues we are currently facing in HRA.« less

Doing battle with "the monster:" how high-risk heterosexuals experience and successfully manage HIV stigma as a barrier to HIV testing.

PubMed

Gwadz, Marya; Leonard, Noelle R; Honig, Sylvie; Freeman, Robert; Kutnick, Alexandra; Ritchie, Amanda S

2018-04-20

Annual HIV testing is recommended for populations at-risk for HIV in the United States, including heterosexuals geographically connected to urban high-risk areas (HRA) with elevated rates of HIV prevalence and poverty, who are primarily African American/Black or Hispanic. Yet this subpopulation of "individuals residing in HRA" (IR-HRA) evidence low rates of regular HIV testing. HIV stigma is a recognized primary barrier to testing, in part due to its interaction with other stigmatized social identities. Guided by social-cognitive and intersectionality theories, this qualitative descriptive study explored stigma as a barrier to HIV testing and identified ways IR-HRA manage stigma. In 2012-2014, we conducted in-depth qualitative interviews with 31 adult IR-HRA (74% male, 84% African American/Black) with unknown or negative HIV status, purposively sampled from a larger study for maximum variation on HIV testing experiences. Interviews were audio-recorded and professionally transcribed verbatim. Data were analyzed using a systematic content analysis approach that was both theory-driven and inductive. Stigma was a primary barrier to HIV testing among IR-HRA. In the context of an under-resourced community, HIV stigma was experienced as emerging from, and being perpetuated by, health care organizations and educational institutions, as well as community members. Participants noted it was "better not to know" one's HIV status, to avoid experiencing HIV-related stigma, which could interact with other stigmatized social identities and threaten vital social relationships, life chances, and resources. Yet most had tested for HIV previously. Factors facilitating testing included health education to boost knowledge of effective treatments for HIV; understanding HIV does not necessitate ending social relationships; and tapping into altruism. In the context of economic and social inequality, HIV stigma operates on multiple, intersecting layers. IR-HRA struggle with an aversion to HIV testing, because adopting another stigmatized status is dangerous. They also find ways to manage stigma to engage in testing, even if not at recommended levels. Findings highlight strategies to reduce HIV stigma at the levels of communities, institutions, and individuals to improve rates of annual HIV testing necessary to eliminate HIV transmission and reduce HIV-related racial and ethnic health disparities among IR-HRA.

Lessons Learned from Dependency Usage in HERA: Implications for THERP-Related HRA Methods

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

April M. Whaley; Ronald L. Boring; Harold S. Blackman

Dependency occurs when the probability of success or failure on one action changes the probability of success or failure on a subsequent action. Dependency may serve as a modifier on the human error probabilities (HEPs) for successive actions in human reliability analysis (HRA) models. Discretion should be employed when determining whether or not a dependency calculation is warranted: dependency should not be assigned without strongly grounded reasons. Human reliability analysts may sometimes assign dependency in cases where it is unwarranted. This inappropriate assignment is attributed to a lack of clear guidance to encompass the range of scenarios human reliability analystsmore » are addressing. Inappropriate assignment of dependency produces inappropriately elevated HEP values. Lessons learned about dependency usage in the Human Event Repository and Analysis (HERA) system may provide clarification and guidance for analysts using first-generation HRA methods. This paper presents the HERA approach to dependency assessment and discusses considerations for dependency usage in HRA, including the cognitive basis for dependency, direction for determining when dependency should be assessed, considerations for determining the dependency level, temporal issues to consider when assessing dependency, (e.g., considering task sequence versus overall event sequence, and dependency over long periods of time), and diagnosis and action influences on dependency.« less

Bridging Human Reliability Analysis and Psychology, Part 2: A Cognitive Framework to Support HRA

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

April M. Whaley; Stacey M. L. Hendrickson; Ronald L. Boring

This is the second of two papers that discuss the literature review conducted as part of the U.S. Nuclear Regulatory Commission (NRC) effort to develop a hybrid human reliability analysis (HRA) method in response to Staff Requirements Memorandum (SRM) SRM-M061020. This review was conducted with the goal of strengthening the technical basis within psychology, cognitive science and human factors for the hybrid HRA method being proposed. An overview of the literature review approach and high-level structure is provided in the first paper, whereas this paper presents the results of the review. The psychological literature review encompassed research spanning the entiretymore » of human cognition and performance, and consequently produced an extensive list of psychological processes, mechanisms, and factors that contribute to human performance. To make sense of this large amount of information, the results of the literature review were organized into a cognitive framework that identifies causes of failure of macrocognition in humans, and connects those proximate causes to psychological mechanisms and performance influencing factors (PIFs) that can lead to the failure. This cognitive framework can serve as a tool to inform HRA. Beyond this, however, the cognitive framework has the potential to also support addressing human performance issues identified in Human Factors applications.« less

Evaluating a web-based health risk assessment with tailored feedback: what does an expert focus group yield compared to a web-based end-user survey?

PubMed

Vosbergen, Sandra; Mahieu, Guy R; Laan, Eva K; Kraaijenhagen, Roderik A; Jaspers, Monique Wm; Peek, Niels

2014-01-02

Increasingly, Web-based health applications are developed for the prevention and management of chronic diseases. However, their reach and utilization is often disappointing. Qualitative evaluations post-implementation can be used to inform the optimization process and ultimately enhance their adoption. In current practice, such evaluations are mainly performed with end-user surveys. However, a review approach by experts in a focus group may be easier to administer and might provide similar results. The aim of this study was to assess whether industrial design engineers in a focus group would address the same issues as end users in a Web-based survey when evaluating a commercial Web-based health risk assessment (HRA) with tailored feedback. Seven Dutch companies used the HRA as part of their corporate health management strategy. Employees using the HRA (N=2289) and 10 independent industrial designers were invited to participate in the study. The HRA consisted of four components: (1) an electronic health questionnaire, (2) biometric measurements, (3) laboratory evaluation, and (4) individually tailored feedback generated by decision support software. After participating in the HRA as end users, both end users and designers evaluated the program. End users completed an evaluation questionnaire that included a free-text field. Designers participated in a focus group discussion. Constructs from user satisfaction and technology acceptance theories were used to categorize and compare the remarks from both evaluations. We assessed and qualitatively analyzed 294 remarks of 189 end users and 337 remarks of 6 industrial designers, pertaining to 295 issues in total. Of those, 137 issues were addressed in the end-user survey and 148 issues in the designer focus group. Only 7.3% (10/137) of the issues addressed in the survey were also addressed in the focus group. End users made more remarks about the usefulness of the HRA and prior expectations that were not met. Designers made more remarks about how the information was presented to end users, quality of the feedback provided by the HRA, recommendations on the marketing and on how to create more unity in the design of the HRA, and on how to improve the HRA based on these issues. End-user surveys should not be substituted for expert focus groups. Issues identified by end users in the survey and designers in the focus group differed considerably, and the focus group produced a lot of new issues. The issues addressed in the focus group often focused on different aspects of user satisfaction and technology acceptance than those addressed by the survey participants; when they did focus on the same aspects, then the nature of issues differed considerably in content.

Philosophy of ATHEANA

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

Bley, D.C.; Cooper, S.E.; Forester, J.A.

ATHEANA, a second-generation Human Reliability Analysis (HRA) method integrates advances in psychology with engineering, human factors, and Probabilistic Risk Analysis (PRA) disciplines to provide an HRA quantification process and PRA modeling interface that can accommodate and represent human performance in real nuclear power plant events. The method uses the characteristics of serious accidents identified through retrospective analysis of serious operational events to set priorities in a search process for significant human failure events, unsafe acts, and error-forcing context (unfavorable plant conditions combined with negative performance-shaping factors). ATHEANA has been tested in a demonstration project at an operating pressurized water reactor.

What is needed to implement a computer-assisted health risk assessment tool? An exploratory concept mapping study

PubMed Central

2012-01-01

Background Emerging eHealth tools could facilitate the delivery of comprehensive care in time-constrained clinical settings. One such tool is interactive computer-assisted health-risk assessments (HRA), which may improve provider-patient communication at the point of care, particularly for psychosocial health concerns, which remain under-detected in clinical encounters. The research team explored the perspectives of healthcare providers representing a variety of disciplines (physicians, nurses, social workers, allied staff) regarding the factors required for implementation of an interactive HRA on psychosocial health. Methods The research team employed a semi-qualitative participatory method known as Concept Mapping, which involved three distinct phases. First, in face-to-face and online brainstorming sessions, participants responded to an open-ended central question: “What factors should be in place within your clinical setting to support an effective computer-assisted screening tool for psychosocial risks?” The brainstormed items were consolidated by the research team. Then, in face-to-face and online sorting sessions, participants grouped the items thematically as ‘it made sense to them’. Participants also rated each item on a 5-point scale for its ‘importance’ and ‘action feasibility’ over the ensuing six month period. The sorted and rated data was analyzed using multidimensional scaling and hierarchical cluster analyses which produced visual maps. In the third and final phase, the face-to-face Interpretation sessions, the concept maps were discussed and illuminated by participants collectively. Results Overall, 54 providers participated (emergency care 48%; primary care 52%). Participants brainstormed 196 items thought to be necessary for the implementation of an interactive HRA emphasizing psychosocial health. These were consolidated by the research team into 85 items. After sorting and rating, cluster analysis revealed a concept map with a seven-cluster solution: 1) the HRA’s equitable availability; 2) the HRA’s ease of use and appropriateness; 3) the content of the HRA survey; 4) patient confidentiality and choice; 5) patient comfort through humanistic touch; 6) professional development, care and workload; and 7) clinical management protocol. Drawing insight from the theoretical lens of Sociotechnical theory, the seven clusters of factors required for HRA implementation could be read as belonging to three overarching aspects : Technical (cluster 1, 2 and 3), Social-Patient (cluster 4 and 5), and Social-Provider (cluster 6 and 7). Participants rated every one of the clusters as important, with mean scores from 4.0 to 4.5. Their scores for feasibility were somewhat lower, ranging from 3.4 to. 4.3. Comparing the scores for importance and feasibility, a significant difference was found for one cluster from each region (cluster 2, 5, 6). The cluster on professional development, care and workload was perceived as especially challenging in emergency department settings, and possible reasons were discussed in the interpretation sessions. Conclusion A number of intertwined multilevel factors emerged as important for the implementation of a computer-assisted, interactive HRA with a focus on psychosocial health. Future developments in this area could benefit from systems thinking and insights from theoretical perspectives, such as sociotechnical system theory for joint optimization and responsible autonomy, with emphasis on both the technical and social aspects of HRA implementation. PMID:23253913

Comparison of the Utility of Two Assessments for Explaining and Predicting Productivity Change: Well-Being Versus an HRA.

PubMed

Gandy, William M; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

2016-01-01

To compare utility of employee well-being to health risk assessment (HRA) as predictors of productivity change. Panel data from 2189 employees who completed surveys 2 years apart were used in hierarchical models comparing the influence of well-being and health risk on longitudinal changes in presenteeism and job performance. Absenteeism change was evaluated in a nonexempt subsample. Change in well-being was the most significant independent predictor of productivity change across all three measures. Comparing hierarchical models, well-being models performed significantly better than HRA models. The HRA added no incremental explanatory power over well-being in combined models. Alone, nonphysical health well-being components outperformed the HRA for all productivity measures. Well-being offers a more comprehensive measure of factors that influence productivity and can be considered preferential to HRA in understanding and addressing suboptimal productivity.

The role of incentive design, incentive value, communications strategy, and worksite culture on health risk assessment participation.

PubMed

Seaverson, Erin L D; Grossmeier, Jessica; Miller, Toni M; Anderson, David R

2009-01-01

To examine the impact of financial incentives, communications strategy, and worksite culture on health risk assessment (HRA) participation rates. A cross-sectional study design was used to examine factors that influence employee participation, including incentive value, incentive design, communications strategy, and worksite culture. Large private-sector and public-sector employers. Thirty-six employers (n = 559,988 employees) that provided financial incentives to promote employee HRA participation. Organizations implemented the HRA as part of a more comprehensive worksite health promotion strategy that included follow-up interventions and a variety of other components. The primary outcome of interest was employee HRA participation. Information on program design and structure, as well as on HRA eligibility and participation, was collected for each organization via standard client report and semistructured interviews with account managers. General linear regression models were used to examine the extent to which factors influence HRA participation independently and when controlled for other factors. Incentive value (r2 = .433; p < .000), benefits-integrated incentive design (r2 = .184; p = .009), culture (r2 = .113; p = .045), and communications strategy (r = .300; p = .001) had positive bivariate associations with HRA participation rates. When all factors were included in the model, incentive value (p = .001) and communications strategy (p = .023) were significantly associated with HRA participation. Variance accounted for by all factors combined was R12 = .584. This study suggests that incentive value, incentive type, supportive worksite culture, and comprehensive communications strategy may all play a role in increasing HRA participation.

Resource utilization, costs and treatment patterns of switching and discontinuing treatment of MS patients with high relapse activity.

PubMed

Raimundo, Karina; Tian, Haijun; Zhou, Huanxue; Zhang, Xin; Kahler, Kristijan H; Agashivala, Neetu; Kim, Edward

2013-04-08

Multiple sclerosis (MS) is a chronic disease that affects mainly adults in the prime of their lives. However, few studies report the impact of high annual relapse rates on outcomes. The purpose of this study was to identify high relapse activity (HRA) in patients with MS, comparing differences in outcomes between patients with and without HRA. A retrospective longitudinal study was conducted using the MarketScan® Commercial Claims and Encounters and Medicare Supplemental Database. Patients had to have at least one ICD-9 for MS (340.XX) in 2009 and one in 2008, be older than 18 years, and have continuous enrolment in the years 2009-2010. HRA was defined as having ≥2 relapses in 2009. Multivariate analyses compared all-cause and MS-specific emergency room (ER) visits, hospitalizations, and all-cause costs, excluding disease modifying therapy (DMT) costs, in 2010 between patients with and without HRA, controlling for baseline characteristics. A subgroup analysis using treatment exposure was also performed. 19,219 patients were included: 5.3% (n=1,017) had ≥2 relapses in 2009. Patients with HRA were more likely to have all-cause and MS-specific resource utilization than patients without HRA. Mean total all-cause non DMT costs were $12,057 higher for the HRA group. In the subgroup analysis, HRA treatment-naïve patients were more likely to start treatment, and HRA treatment-experienced patients were more likely to discontinue or switch index DMT (P<0.01). Patients with ≥2 relapses annually have higher resource utilization and costs. The difference in cost was over twice as large in treatment-naïve patients versus treatment-experienced patients. HRA was also associated with an increased likelihood of starting DMT treatment (treatment-naïve patients), and switching or discontinuing DMT therapy (treatment-experienced patients).

Integration of Human Reliability Analysis Models into the Simulation-Based Framework for the Risk-Informed Safety Margin Characterization Toolkit

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

Boring, Ronald; Mandelli, Diego; Rasmussen, Martin

2016-06-01

This report presents an application of a computation-based human reliability analysis (HRA) framework called the Human Unimodel for Nuclear Technology to Enhance Reliability (HUNTER). HUNTER has been developed not as a standalone HRA method but rather as framework that ties together different HRA methods to model dynamic risk of human activities as part of an overall probabilistic risk assessment (PRA). While we have adopted particular methods to build an initial model, the HUNTER framework is meant to be intrinsically flexible to new pieces that achieve particular modeling goals. In the present report, the HUNTER implementation has the following goals: •more » Integration with a high fidelity thermal-hydraulic model capable of modeling nuclear power plant behaviors and transients • Consideration of a PRA context • Incorporation of a solid psychological basis for operator performance • Demonstration of a functional dynamic model of a plant upset condition and appropriate operator response This report outlines these efforts and presents the case study of a station blackout scenario to demonstrate the various modules developed to date under the HUNTER research umbrella.« less

Demonstration of community pharmacy and managed care organization collaboration on cardiovascular disease risk factor identification using health risk appraisal.

PubMed

Dettloff, Rick W; Morse, Jacqueline A

2009-01-01

To integrate the resources from a local statewide managed care organization (MCO) and a supermarket pharmacy chain to conduct a comprehensive health risk appraisal (HRA). Collected data were used to assess cardiovascular risk factors and identify disease management opportunities. An analysis to determine the prevalence of risk factors was conducted on a cross-sectional HRA survey. The HRA involved point-of-care cholesterol screening (with a follow-up risk factor questionnaire) conducted by pharmacist employees of the employer group (a regional supermarket chain). Those eligible for the screening were employees of the supermarket chain and their dependents covered by the participating MCO. A total of 12,915 completed HRA questionnaires were received. The mean age of the employees participating was approximately 44 years. Of note, 14%, 24%, 21%, and 69% of questionnaires had abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, blood pressure, and body mass index (BMI), respectively. Compared with national benchmarks, low HDL cholesterol and BMI more than 30 kg/m2 were more common in this cohort. More than one-fourth of the employees in this analysis were identified as being at high risk for a coronary heart disease event. The unique collaboration presented here allowed for an expanded role of pharmacists to implement a quality improvement program. In response, the employer decided to continue the HRA screening and offer a employee contribution reduction-based health incentive to covered members. The employer also is considering offering cardiovascular disease management interventions that will be performed by the supermarket chain's pharmacists and targeted toward the identified risk factor trends.

Determination of inadvertent atrial capture during para-Hisian pacing.

PubMed

Obeyesekere, Manoj; Leong-Sit, Peter; Skanes, Allan; Krahn, Andrew; Yee, Raymond; Gula, Lorne J; Bennett, Matthew; Klein, George J

2011-08-01

Inadvertent capture of the atrium will lead to spurious results during para-Hisian pacing. We sought to establish whether the stimulation-to-atrial electrogram interval at the proximal coronary sinus (stim-PCS) or high right atrium (stim-HRA) could signal inadvertent atrial capture. Para-Hisian pacing with and without intentional atrial capture was performed in 31 patients. Stim-HRA and stim-PCS intervals were measured with atrial capture, His plus para-Hisian ventricular (H+V) capture, and para-Hisian ventricular (V) capture alone. The mean stim-HRA interval was significantly shorter with atrial capture (66 ± 18 ms) than with H+V (121 ± 27 ms, P < 0.001) or V capture alone (174 ± 38 ms, P < 0.001). The mean stim-PCS interval was significantly shorter with atrial capture (51 ± 16 ms) than with H+V (92 ± 22 ms, P<0.001) or V capture alone (146 ± 33 ms, P < 0.001). A stim-PCS < 60 ms (stim-HRA < 70 ms) was observed only with atrial capture. A stim-PCS >90 ms (stim-HRA >100 ms) was observed only in the absence of atrial capture. A stim-HRA of < 85 ms was highly specific and stim-PCS of < 85 ms highly sensitive at identifying atrial capture. Stim-HRA intervals of 75 to 97 ms and stim-PCS intervals of 65 to 88 ms were observed with either atrial, His, or para-Hisian ventricular capture without atrial capture. In this overlap zone, all patients demonstrated a stim-PCS or stim-HRA interval prolongation of at least 20 ms when the catheter was advanced to avoid deliberate atrial pacing. The QRS morphology was of limited value in distinguishing atrial capture due to concurrent ventricular or H+V capture, as observed in 20 of 31 (65%) patients. Stim-PCS and stim-HRA intervals can be used to monitor for inadvertent atrial capture during para-Hisian pacing. A stim-PCS < 60 ms (or stim-HRA < 70 ms) and stim-PCS > 90 ms (or stim-HRA > 100 ms) were observed only with and without atrial capture, respectively, but there was significant overlap between these values. Deliberate atrial capture and loss of capture reliably identifies atrial capture regardless of intervals.

The role of oncogenic human papillomavirus determination for diagnosis of high-grade anal intraepithelial neoplasia in HIV-infected MSM.

PubMed

Burgos, Joaquin; Hernández-Losa, Javier; Landolfi, Stefania; Guelar, Ana; Dinares, MªCarmen; Villar, Judith; Navarro, Jordi; Ribera, Esteve; Falcó, Vicenç; Curran, Adria

2017-10-23

To assess the oncogenic human papillomavirus (HPV) determination and the cotesting HPV and anal cytology value to detect high-grade anal intraepithelial neoplasia (HGAIN) in a cohort of HIV-MSM. Prospective study of HIV-infected MSM who underwent screening for anal dysplasia. Screening program includes anal cytology, HPV testing, and high-resolution anoscopy (HRA) at each visit. Histological samples were obtained if suspicious lesions were revealed by HRA. Sensitivity and specificity of the different tests were calculated by using histological results of HRA-guided biopsy as the reference test for HGAIN diagnosis. From May 2009 to August 2016, 692 HIV-infected MSM underwent 1827 anal cytologies, 1841 HRA examinations, and 1607 HPV testing. At first screening visit, anal cytology results were abnormal in 418 (60.4%) of 692 patients, and oncogenic HPV genotypes were found in 482 (79.5%) of 606 patients. Anal cytology showed a sensitivity of 89.2% [95% confidence interval (CI); 80.7-94.2] and a specificity of 44.2% (95% CI; 40.2-48.2) to detect HGAIN. Oncogenic HPV testing had 90.4% sensitivity (95% CI; 82-86.8) and 24.4% specificity (95% CI; 20.8-28.3). Cotesting showed a 97.4% sensitivity (95% CI; 91-99.3) and 14% specificity (95% CI; 11.2-17.3). In patients with atypical squamous cells of uncertain significance on cytology, oncogenic HPV testing had 91.3% sensitivity and 28.3% specificity to detect HGAIN. Abnormal cytology and oncogenic HPV determination showed similar sensitivity for detecting HGAIN. The two tests used together improved the sensitivity but with lowered specificity. In our opinion, HPV testing does not improve HGAIN detection and should not replace anal cytology as a standard screening test for HIV-infected MSM.

Comparison of Four Recruiting Strategies in a Smoking Cessation Trial

PubMed Central

Buller, David B.; Meenan, Richard; Severson, Herb; Halperin, Abigail; Edwards, Erika; Magnusson, Brooke

2012-01-01

Objectives To compare 4 on-line and off-line recruiting methods. Methods Young adult smokers (n=3353) were recruited to a trial comparing smoking cessation services with an on-line health risk assessment (HRA), on-line ads, off-line materials, and quit line screening. Results On-line ads (n=1426; $41.35) and off-line materials recruited the most smokers (n=1341; $56.23) for the lowest cost. Quit line screening was more expensive (n=189; $133.61), but enrollees used cessation services the most (34%-82%). On-line HRA was least successful and most costly (n=397; $630.85) but had the highest follow-up (45%-55%). Conclusions On-line ads and off-line materials were most effective and cost-effective methods. PMID:22584086

A Multi-Methods Approach to HRA and Human Performance Modeling: A Field Assessment

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

Jacques Hugo; David I Gertman

2012-06-01

The Advanced Test Reactor (ATR) is a research reactor at the Idaho National Laboratory is primarily designed and used to test materials to be used in other, larger-scale and prototype reactors. The reactor offers various specialized systems and allows certain experiments to be run at their own temperature and pressure. The ATR Canal temporarily stores completed experiments and used fuel. It also has facilities to conduct underwater operations such as experiment examination or removal. In reviewing the ATR safety basis, a number of concerns were identified involving the ATR canal. A brief study identified ergonomic issues involving the manual handlingmore » of fuel elements in the canal that may increase the probability of human error and possible unwanted acute physical outcomes to the operator. In response to this concern, that refined the previous HRA scoping analysis by determining the probability of the inadvertent exposure of a fuel element to the air during fuel movement and inspection was conducted. The HRA analysis employed the SPAR-H method and was supplemented by information gained from a detailed analysis of the fuel inspection and transfer tasks. This latter analysis included ergonomics, work cycles, task duration, and workload imposed by tool and workplace characteristics, personal protective clothing, and operational practices that have the potential to increase physical and mental workload. Part of this analysis consisted of NASA-TLX analyses, combined with operational sequence analysis, computational human performance analysis (CHPA), and 3D graphical modeling to determine task failures and precursors to such failures that have safety implications. Experience in applying multiple analysis techniques in support of HRA methods is discussed.« less

40 CFR 174.533 - Glycine max Herbicide-Resistant Acetolactate Synthase (GM-HRA) inert ingredient; exemption from...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Glycine max Herbicide-Resistant... Glycine max Herbicide-Resistant Acetolactate Synthase (GM-HRA) inert ingredient; exemption from the requirement of a tolerance. Residues of Glycine max herbicide-resistant acetolactate synthase (GM-HRA) enzyme...

40 CFR 174.533 - Glycine max Herbicide-Resistant Acetolactate Synthase (GM-HRA) inert ingredient; exemption from...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Glycine max Herbicide-Resistant... Glycine max Herbicide-Resistant Acetolactate Synthase (GM-HRA) inert ingredient; exemption from the requirement of a tolerance. Residues of Glycine max herbicide-resistant acetolactate synthase (GM-HRA) enzyme...

Comparison of 4 recruiting strategies in a smoking cessation trial.

PubMed

Buller, David B; Meenan, Richard; Severson, Herb; Halperin, Abigail; Edwards, Erika; Magnusson, Brooke

2012-09-01

To compare 4 online and off-line recruiting methods. Young adult smokers (n=3353) were recruited to a trial comparing smoking cessation services with an online health risk assessment (HRA), online ads, offline materials, and quit-line screening. Online ads (n=1426; $41.35) and off-line materials recruited the most smokers (n=1341; $56.23) for the lowest cost. Quitline screening was more expensive (n=189; $132.22), but enrollees used cessation services the most (34%-82%). Online HRA was least successful and most costly (n=397; $630.85) but had the highest follow-up (45%-55%). Online ads and off-line materials were most effective and cost-effective methods.

Risk of Metachronous High-Risk Adenomas and Large Serrated Polyps in Individuals With Serrated Polyps on Index Colonoscopy: Data From the New Hampshire Colonoscopy Registry.

PubMed

Anderson, Joseph C; Butterly, Lynn F; Robinson, Christina M; Weiss, Julia E; Amos, Christopher; Srivastava, Amitabh

2018-01-01

Surveillance guidelines for serrated polyps (SPs) are based on limited data on longitudinal outcomes of patients. We used the New Hampshire Colonoscopy Registry to evaluate risk of clinically important metachronous lesions associated with SPs detected during index colonoscopies. We collected data from a population-based colonoscopy registry that has been collecting and analyzing data on colonoscopies across the state of New Hampshire since 2004, including rates of adenoma and SP detection. Patients completed a questionnaire to determine demographic characteristics, health history, and risk factors for colorectal cancer, and were followed from index colonoscopy through all subsequent surveillance colonoscopies. Our analyses included 5433 participants (median age, 61 years; 49.7% male) with 2 colonoscopies (median time to surveillance, 4.9 years). We used multivariable logistic regression models to assess effects of index SPs (n = 1016), high-risk adenomas (HRA, n = 817), low-risk adenomas (n = 1418), and no adenomas (n = 3198) on subsequent HRA or large SPs (>1 cm) on surveillance colonoscopy (metachronous lesions). Synchronous SPs, within each index risk group, were assessed for size and by histology. SPs comprise hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas. In this study, SSA/Ps and traditional serrated adenomas are referred to collectively as STSAs. HRA and synchronous large SP (odds ratio [OR], 5.61; 95% confidence interval [CI], 1.72-18.28), HRA with synchronous STSA (OR, 16.04; 95% CI, 6.95-37.00), and HRA alone (OR, 3.86; 95% CI, 2.77-5.39) at index colonoscopy significantly increased the risk of metachronous HRA compared to the reference group (no index adenomas or SPs). Large index SPs alone (OR, 14.34; 95% CI, 5.03-40.86) or index STSA alone (OR, 9.70; 95% CI, 3.63-25.92) significantly increased the risk of a large metachronous SP. In an analysis of data from a population-based colonoscopy registry, we found index large SP or index STSA with no index HRA increased risk of metachronous large SPs but not metachronous HRA. HRA and synchronous SPs at index colonoscopy significantly increased risk of metachronous HRA. Individuals with HRA and synchronous large SP or any STSA could therefore benefit from close surveillance. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

The Reliability and Validity of the Self-Reported Drinking Measures in the Army’s Health Risk Appraisal Survey

PubMed Central

Bell, Nicole S.; Williams, Jeffrey O.; Senier, Laura; Strowman, Shelley R.; Amoroso, Paul J.

2007-01-01

Background The reliability and validity of self-reported drinking behaviors from the Army Health Risk Appraisal (HRA) survey are unknown. Methods We compared demographics and health experiences of those who completed the HRA with those who did not (1991–1998). We also evaluated the reliability and validity of eight HRA alcohol-related items, including the CAGE, weekly drinking quantity, and drinking and driving measures. We used Cohen’s κ and Pearson’s r to assess reliability and convergent validity. To assess criterion (predictive) validity, we used proportional hazards and logistical regression models predicting alcohol-related hospitalizations and alcohol-related separations from the Army, respectively. Results A total of 404,966 soldiers completed an HRA. No particular demographic group seems to be over- or underrepresented. Although few respondents skipped alcohol items, those who did tended to be older and of minority race. The alcohol items demonstrate a reasonable degree of reliability, with Cronbach’s α = 0.69 and test-retest reliability associations in the 0.75–0.80 range for most items over 2- to 30-day interims between surveys. The alcohol measures showed good criterion-related validity: those consuming more than 21 drinks per week were at 6 times the risk for subsequent alcohol-related hospitalization versus those who abstained from drinking (hazard ratio, 6.36; 95% confidence interval=5.79, 6.99). Those who said their friends worried about their drinking were almost 5 times more likely to be discharged due to alcoholism (risk ratio, 4.9; 95% confidence interval=4.00, 6.04) and 6 times more likely to experience an alcohol-related hospitalization (hazard ratio, 6.24; 95% confidence interval=5.74, 6.77). Conclusions The Army’s HRA alcohol items seem to elicit reliable and valid responses. Because HRAs contain identifiers, alcohol use can be linked with subsequent health and occupational outcomes, making the HRA a useful epidemiological research tool. Associations between perceived peer opinions of drinking and subsequent problems deserve further exploration. PMID:12766628

Differing Developmental Trajectories in Heart Rate Responses to Speech Stimuli in Infants at High and Low Risk for Autism Spectrum Disorder.

PubMed

Perdue, Katherine L; Edwards, Laura A; Tager-Flusberg, Helen; Nelson, Charles A

2017-08-01

We investigated heart rate (HR) in infants at 3, 6, 9, and 12 months of age, at high (HRA) and low (LRC) familial risk for ASD, to identify potential endophenotypes of ASD risk related to attentional responses. HR was extracted from functional near-infrared spectroscopy recordings while infants listened to speech stimuli. Longitudinal analysis revealed that HRA infants and males generally had lower baseline HR than LRC infants and females. HRA infants showed decreased HR responses to early trials over development, while LRC infants showed increased responses. These findings suggest altered developmental trajectories in physiological responses to speech stimuli over the first year of life, with HRA infants showing less social orienting over time.

Evaluation of a New Scoring System for Retinal Nerve Fiber Layer Photography Using HRA1 in 964 Eyes

PubMed Central

Hong, Samin; Moon, Jong Wook; Ha, Seung Joo; Kim, Chan Yun; Seong, Gong Je

2007-01-01

Purpose To evaluate retinal nerve fiber layer (RNFL) defect by a new scoring system for RNFL photography using the Heidelberg Retina Angiograph 1 (HRA1). Methods This retrospective study included 128 healthy eyes and 836 primary open-angle glaucoma eyes. The RNFL photography using HRA1 was interpreted using a new scoring system, and correlated with visual field indices of standard automated perimetry (SAP). Using the presence of RNFL defect, darkness, width, and location, we established the new scoring system of RNFL photos. Results The mean RNFL defect score I in the early, moderate, severe, and control groups were 7.3, 9.2, 10.4, and 3.6, respectively. The mean RNFL defect score II in the early, moderate, severe, and control groups were 14.5, 28.5, 43.4, and 3.4, respectively. Correlations between the RNFL defect score II and the mean deviation of SAP was the strongest of the various combinations (r=-0.675, P<.001). Conclusions Using a new scoring system, we propose a method for semi-quantitative interpretation of RNFL photographs. This scoring system may be helpful to distinguish between normal and glaucomatous eyes, and the score is associated with the severity of visual field loss. PMID:18063886

Indications for MARS-MRI in Patients Treated With Metal-on-Metal Hip Resurfacing Arthroplasty.

PubMed

Connelly, James W; Galea, Vincent P; Matuszak, Sean J; Madanat, Rami; Muratoglu, Orhun; Malchau, Henrik

2018-06-01

Currently, there are no universally accepted guidelines on when to obtain metal artifact reduction sequence magnetic resonance imaging (MARS-MRI) in metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) patients. Our primary aims were to identify which patient and clinical factors are predictive of adverse local tissue reaction (ALTR) and create an algorithm for indicating MARS-MRI in patients with Articular Surface Replacement (ASR) HRA. The secondary aim was to compare our algorithm to existing guidelines on when to perform MARS-MRI in MoM HRA patients. The study cohort consisted of 182 patients with unilateral ASR HRA from a prospective, multicenter study. Subjects received MARS-MRI at a mean of 7.8 years from surgery, regardless of symptoms. We determined which variables were predictive of ALTR and generated cutoffs for each variable. Finally, we created an algorithm to predict ALTR and indicate MARS-MRI in ASR HRA patients using these cutoffs and compared it to existing guidelines. We found high blood cobalt (Co) (odds ratio = 1.070; P = .011) and high blood chromium (Cr) (odds ratio = 1.162; P = .002) to be significant predictors of ALTR presence. Our algorithm using a blood Co cutoff of 1.15 ppb and a Cr cutoff of 1.09 ppb achieved 96.6% sensitivity and 35.3% specificity in predicting ALTR, which outperformed the existing guidelines. Blood Co and Cr levels are predictive of ALTR in ASR HRA patients. Our algorithm considering blood Co and Cr levels predicts ALTR in ASR HRA patients with higher sensitivity than previously established guidelines. Copyright © 2018 Elsevier Inc. All rights reserved.

SUPPLEMENTARY COMPARISON: Final report of the bilateral comparison APMP.M.H-S2 of hardness measurement for Rockwell scales A and B between PTB and NIMT

NASA Astrophysics Data System (ADS)

Sanponpute, Tassanai; Meesaplak, Apichaya; Herrmann, Konrad; Menelao, Febo

2009-01-01

The bilateral comparison APMP.M.H-S2 of hardness measurement for Rockwell scales A and B was arranged by the National Institute of Metrology of Thailand, NIMT, as the pilot laboratory, comparing with Physikalisch-Technische Bundesanstalt of Germany, PTB. The objective of this comparison was to confirm the calibration and measurement capabilities of NIMT in hardness measurement. The period of measurement covered March to August 2009. There were two sets of artefacts: scale A artefact set and scale B artefact set. The scale A artefact set consisted of seven hardness blocks: 35 HRA, 40 HRA, 55 HRA, 60 HRA, 70 HRA, 80 HRA, 85 HRA. The artefact set for scale B consisted of nine hardness blocks: 25 HRB, 30 HRB, 40 HRB, 50 HRB, 60 HRB, 70 HRB, 80 HRB, 90 HRB, 100 HRB. Laboratories had to ensure that the primary Rockwell hardness machines passed the verification process according to ISO 6508-3. Then participants measured the hardness value by making ten indentations in a designated area of each artefact block. Hardness measurement results and uncertainty budget were then reported to the pilot laboratory and were used to compute the degrees of equivalence in terms of the Comparison Reference Value (CRV) and En ratio. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by APMP, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).

Space Mission Human Reliability Analysis (HRA) Project

NASA Technical Reports Server (NTRS)

Boyer, Roger

2014-01-01

The purpose of the Space Mission Human Reliability Analysis (HRA) Project is to extend current ground-based HRA risk prediction techniques to a long-duration, space-based tool. Ground-based HRA methodology has been shown to be a reasonable tool for short-duration space missions, such as Space Shuttle and lunar fly-bys. However, longer-duration deep-space missions, such as asteroid and Mars missions, will require the crew to be in space for as long as 400 to 900 day missions with periods of extended autonomy and self-sufficiency. Current indications show higher risk due to fatigue, physiological effects due to extended low gravity environments, and others, may impact HRA predictions. For this project, Safety & Mission Assurance (S&MA) will work with Human Health & Performance (HH&P) to establish what is currently used to assess human reliabiilty for human space programs, identify human performance factors that may be sensitive to long duration space flight, collect available historical data, and update current tools to account for performance shaping factors believed to be important to such missions. This effort will also contribute data to the Human Performance Data Repository and influence the Space Human Factors Engineering research risks and gaps (part of the HRP Program). An accurate risk predictor mitigates Loss of Crew (LOC) and Loss of Mission (LOM).The end result will be an updated HRA model that can effectively predict risk on long-duration missions.

An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

PubMed

Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

2015-01-01

To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

Human reliability assessment: tools for law enforcement

NASA Astrophysics Data System (ADS)

Ryan, Thomas G.; Overlin, Trudy K.

1997-01-01

This paper suggests ways in which human reliability analysis (HRA) can assist the United State Justice System, and more specifically law enforcement, in enhancing the reliability of the process from evidence gathering through adjudication. HRA is an analytic process identifying, describing, quantifying, and interpreting the state of human performance, and developing and recommending enhancements based on the results of individual HRA. It also draws on lessons learned from compilations of several HRA. Given the high legal standards the Justice System is bound to, human errors that might appear to be trivial in other venues can make the difference between a successful and unsuccessful prosecution. HRA has made a major contribution to the efficiency, favorable cost-benefit ratio, and overall success of many enterprises where humans interface with sophisticated technologies, such as the military, ground transportation, chemical and oil production, nuclear power generation, commercial aviation and space flight. Each of these enterprises presents similar challenges to the humans responsible for executing action and action sequences, especially where problem solving and decision making are concerned. Nowhere are humans confronted, to a greater degree, with problem solving and decision making than are the diverse individuals and teams responsible for arrest and adjudication of criminal proceedings. This paper concludes that because of the parallels between the aforementioned technologies and the adjudication process, especially crime scene evidence gathering, there is reason to believe that the HRA technology, developed and enhanced in other applications, can be transferred to the Justice System with minimal cost and with significant payoff.

Health risk appraisal and safety belt use

DOT National Transportation Integrated Search

1987-05-01

The primary objective of this study was to determine the effectiveness of health risk appraisal (HRA) programs for increasing claimed and observed safety belt use. HRA programs were field tested with and without supplemental educational materials on ...

Similarities and differences in philanthropic and federal support for medical research in the United States: an analysis of funding by nonprofits in 2006-2008.

PubMed

Myers, Elizabeth R; Alciati, Marianne H; Ahlport, Kathryn N; Sung, Nancy S

2012-11-01

The medical community currently has no detailed source of information on philanthropic research funding. The authors sought to identify trends in research funding by members of the Health Research Alliance (HRA), a consortium of nonprofit funders of biomedical research, and compare findings with research support from the federal government. Thirty-two HRA members uploaded information about grants with start dates in 2006, 2007, and 2008. Data were collected about each grant, investigator, and recipient institution. Disease categorization codes were assigned by a computer process similar to that used by the National Institutes of Health (NIH). In the three years under study, HRA members awarded 9,934 grants, totaling $2,712,418,254 in research and training support. Grant funding increased by 26% between 2006 and 2008. In contrast, NIH research spending increased by only 3% over the same time. Fifty-six percent of HRA grant dollars supported research projects, whereas 30% supported career development and training. During the same period, more than two-thirds of NIH grant dollars supported research projects, although NIH invested proportionally less in career development and training (7%). The largest proportion of HRA grant dollars addressed cancer, followed by diabetes and genetics. Sixty-three percent of HRA-supported investigators were men and 36% were women; 66% of investigators were white, 32% Asian, and fewer than 2% black. These results indicate that nonprofit organizations play an important role in developing careers and advancing research in significant disease areas such as cancer and diabetes, and in basic science areas such as genetics.

Individual Differences in Human Reliability Analysis

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

Jeffrey C. Joe; Ronald L. Boring

2014-06-01

While human reliability analysis (HRA) methods include uncertainty in quantification, the nominal model of human error in HRA typically assumes that operator performance does not vary significantly when they are given the same initiating event, indicators, procedures, and training, and that any differences in operator performance are simply aleatory (i.e., random). While this assumption generally holds true when performing routine actions, variability in operator response has been observed in multiple studies, especially in complex situations that go beyond training and procedures. As such, complexity can lead to differences in operator performance (e.g., operator understanding and decision-making). Furthermore, psychological research hasmore » shown that there are a number of known antecedents (i.e., attributable causes) that consistently contribute to observable and systematically measurable (i.e., not random) differences in behavior. This paper reviews examples of individual differences taken from operational experience and the psychological literature. The impact of these differences in human behavior and their implications for HRA are then discussed. We propose that individual differences should not be treated as aleatory, but rather as epistemic. Ultimately, by understanding the sources of individual differences, it is possible to remove some epistemic uncertainty from analyses.« less

Behavioral science perspectives on health hazard/health risk appraisal.

PubMed Central

Becker, M H; Janz, N K

1987-01-01

Health-promotion efforts often employ HRA as a device for providing an individual with quantitative information about the consequences of personal health-related behaviors and as an attempt to motivate the client to adopt recommendations directed at establishing a healthier lifestyle. From a behavioral science perspective, the HRA approach and process contain elements that (at least in retrospective analysis) appear to be founded in relevant bodies of theory. First, HRA seems to be a reasonably efficient mechanism for transmitting information relative to associations between personal health behaviors and mortality risks. Moreover, while general knowledge and advice about the untoward consequences of risk factors (such as smoking, obesity, high blood pressure, etc.) are currently widespread, HRA provides new and specific information: the client's own relative risks. Some individuals who voluntarily participate in HRA bring to the experience an already high level of readiness to take action; for them, the technique may constitute the final necessary stimulus or "cue to action" [12]. Referring to a "borrowing from the future" phenomenon, Green points out that "some educational efforts are really only triggers to behavior that would have changed eventually anyway" [44, p. 159]. Thus, where motivation is sufficiently high, receipt of HRA feedback information may by itself be capable of inducing behavior change. Second, the focus on awareness and personalization of mortality risk fits well with most theoretical formulations concerning attitudes and beliefs involved in health-related decision making. Although the emphasis on mortality and often distant negative outcomes is problematic, increasing the client's perception of personal vulnerability is a psychologically defensible approach, and fear arousal can generate attitude change (although questions of appropriate level, duration of effects obtained, acceptability, etc. still need to be resolved). Third, HRA might be expected to enhance the client's perception of the benefits associated with lifestyle modifications and may even increase personal belief in his or her ability to undertake such changes in behavior. However, in light of the fact that the behaviors to be altered are complex, usually well-established and repetitive, and require different skills to extinguish, the provision of typical HRA feedback should not (on a theoretical basis) ordinarily be expected to accomplish much beyond information transmission, belief or attitude change, and the induction of some level of motivation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3679842

The effect of normalizing the sagittal cervical configuration on dizziness, neck pain, and cervicocephalic kinesthetic sensibility: a 1-year randomized controlled study.

PubMed

Moustafa, Ibrahim M; Diab, Aliaa A; Harrison, Deed E

2017-02-01

Cervicogenic dizziness is a disabling condition commonly associated with cervical dysfunction. Although the growing interest with the importance of normal sagittal configuration of cervical spine, the missing component in the management of cervicogenic dizziness might be altered structural alignment of the cervical spinal region itself. To investigate the immediate and long-term effects of a 1-year multimodal program, with the addition of cervical lordosis restoration and anterior head translation (AHT) correction, on the severity of dizziness, disability, cervicocephalic kinesthetic sensibility, and cervical pain in patients with cervicogenic dizziness. A randomized controlled study with a 1 year and 10 weeks' follow-up. University research laboratory. Seventy-two patients (25 female) between 40 and 55 years with cervicogenic dizziness, a definite hypolordotic cervical spine and AHT posture were randomly assigned to the control or an experimental group. Both groups received the multimodal program; additionally, the experimental group received the Denneroll™ cervical traction. Outcome measures included AHT distance, cervical lordosis, dizziness handicap inventory (DHI), severity of dizziness, dizziness frequency, head repositioning accuracy (HRA) and cervical pain. Measures were assessed at three time intervals: baseline, 10 weeks, and follow-up at 1 year and 10 weeks. Significant group × time effects at both the 10 week post treatment and the 1-year follow-up were identified favoring the experimental group for measures of cervical lordosis (P<0.0005) and anterior head translation (P<0.0005). At 10 weeks, the between group analysis showed equal improvements in dizziness outcome measures, pain intensity, and HRA; DHI scale (P=0.5), severity of dizziness (P=0.2), dizziness frequency (P=0.09), HRA (P=0.1) and neck pain (P=0.3). At 1-year follow-up, the between-group analysis identified statistically significant differences for all of the measured variables including anterior head translation (2.4 cm [-2.3;-1.8], P<0.0005), cervical lordosis (-14.4° [-11.6;-8.3], P<0.0005), dizziness handicap inventory (29.9 [-34.4;-29.9], P<0.0005), severity of dizziness (5.4 [-5.9;-4.9], P<0.0005), dizziness frequency (2.6 [-3.1;-2.5], P<0.0005), HRA for right rotation (2.8 [-3.9;-3.3], P<0.005), HRA for left rotation (3.1 [-3.5;-3.4, P<0.0005], neck pain (4.97 [-5.3;-4.3], P<0.0005); indicating greater improvements in the experimental group. The addition of Denneroll™ cervical extension traction to a multimodal program positively affected pain, cervicocephalic kinesthetic sensibility, dizziness management outcomes at long-term follow-up. Appropriate physical therapy rehabilitation for cervicogenic dizziness should include structural rehabilitation of the cervical spine (lordosis and head posture correction), as it might to lead greater and longer lasting improved function.

Association of Wage With Employee Participation in Health Assessments and Biometric Screening.

PubMed

Sherman, Bruce W; Addy, Carol

2018-02-01

To understand differences in health risk assessment (HRA) and biometric screening participation rates among benefits-enrolled employees in association with wage category. Cross-sectional analysis of employee eligibility file and health benefits (wellness and claims) data. Data from self-insured employers participating in the RightOpt private exchange (Conduent HR Services) during 2014. Active employees from 4 companies continuously enrolled in health insurance for which wage data were available. Measures included HRA and biometric screening participation rates and wage status, with employee age, sex, employer, job tenure, household income, geographic location, and health benefits deductible as a percentage of total wages serving as covariates. Employees were separated into 5 groups based on wage status. Logistic regression analysis incorporated other measures as covariates to adjust for differences between groups, with HRA and biometric screening participation rates determined as binary outcomes. Participation rates for HRA and biometric screening were 90% and 87%, respectively, in the highest wage category, decreasing to 67% and 60%, respectively, among the lowest wage category. Employee wage status is associated with significant differences in HRA and biometric participation rates. Generalizing the results generated by modest participation in these offerings to entire populations may risk misinterpretation of results based on variable participation rates across wage categories.

Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part I—Efficacy

PubMed Central

Rothstein, Mark A.; Harrell, Heather L.

2011-01-01

Objective We sought to determine whether workplace health risk reduction programs (HRRPs) using health risk assessments (HRAs), individually focused risk reduction, and financial incentives succeeded in improving employee health and reducing employer health benefit costs. Methods We reviewed the proprietary HRA available to us and conducted a literature review to determine the efficacy of HRRPs using HRAs, individualized employee interventions, and financial incentives for employee participation. Results There is some evidence that HRRPs in employer-sponsored programs improve measures of employee health, but the results of these studies are somewhat equivocal. Conclusion Employer-sponsored HRRPs may have some benefits, but problems in plan design and in the studies assessing their efficacy complicate drawing conclusions. PMID:19625972

[Braking capacity after hip arthroplasty - effect of prosthesis design and preoperative status].

PubMed

Franz, A; Mannel, H; Brüggemann, G-P; Schmidt, J

2012-10-01

Driving a car is an important everyday activity. However, the patients' desire to resume driving at an early stage after hip arthroplasty is often faced by the uncertainty about their driving ability. Only little evidence is available to support the clinical decision-making with regard to driving competence after conventional total hip arthroplasty (THA). However, there is no proof that the results observed after THA can be transferred to hip resurfacing arthroplasty (HRA) patients. Due to physiological advantages, i.e., patient age and activity, as well as the special biomechanical implant characteristics, HRA patients could be expected to achieve normal braking capacity at an earlier stage in the rehabilitation process than THA patients. This could be achieved by an accelerated postoperative recovery or could depend on the preoperative vantage point concerning the patients' braking capacity. To verify this hypothesis HRA and THA patients were compared to healthy subjects concerning their ability to perform an emergency braking manoeuvre in a car simulator before surgery, and at 6 weeks and 3 months after operation. Furthermore, postoperative recovery rates were compared between the two groups of patients. In addition, correlations between pre- and postoperative braking capacity were tested. Reaction time, movement time and force-time integral on the brake pedal were analysed. Except for a deficient preoperative force-time integral, no significant differences were detected in HRA patients compared to healthy controls. In contrast THA patients required, pre- as well as postoperatively, a longer movement time and exhibited a smaller force-time integral. The two patient groups did not show any significant difference in recovery rates of movement time and force-time integral. However, considering the two patient groups as a whole, a significant correlation was detected between existing pre- and postoperative deficits. In conclusion, it can be confirmed that HRA patients resume normal braking capacity at an earlier stage in their rehabilitation process than THA patients. Patients recommended for HRA recover braking capacity at the latest six weeks after surgery. This capacity clearly depends on the better preoperative status of the HRA patients and is not determined by a faster recovery rate. General patient-related advantages as well as biomechanical aspects of HRA have thus no influence on the recovery rates of braking capacity during the first three months after surgery. Due to the increasing outpatient rehabilitation regime after HRA, further studies are necessary to detect the turning point after surgical impairment within the first six weeks after surgery. Concerning the THA patients we recommend a longer safety distance when driving a car for up to three months after the operation. However, patients, especially those assigned to THA, should be made aware of their most likely already existing preoperative deficit. For clinical practice a rough estimation of postoperative braking capacity seems to be possible based on group assignment (HRA/THA). Nevertheless, deviators cannot be detected by this group classification. As driving simulator systems usually are not available in hospitals, a more accurate prognosis, i.e., based on established clinical scores, would be helpful. Georg Thieme Verlag KG Stuttgart · New York.

Science-based HRA: experimental comparison of operator performance to IDAC (Information-Decision-Action Crew) simulations

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

Shirley, Rachel; Smidts, Carol; Boring, Ronald

Information-Decision-Action Crew (IDAC) operator model simulations of a Steam Generator Tube Rupture are compared to student operator performance in studies conducted in the Ohio State University’s Nuclear Power Plant Simulator Facility. This study is presented as a prototype for conducting simulator studies to validate key aspects of Human Reliability Analysis (HRA) methods. Seven student operator crews are compared to simulation results for crews designed to demonstrate three different decision-making strategies. The IDAC model used in the simulations is modified slightly to capture novice behavior rather that expert operators. Operator actions and scenario pacing are compared. A preliminary review of availablemore » performance shaping factors (PSFs) is presented. After the scenario in the NPP Simulator Facility, student operators review a video of the scenario and evaluate six PSFs at pre-determined points in the scenario. This provides a dynamic record of the PSFs experienced by the OSU student operators. In this preliminary analysis, Time Constraint Load (TCL) calculated in the IDAC simulations is compared to TCL reported by student operators. We identify potential modifications to the IDAC model to develop an “IDAC Student Operator Model.” This analysis provides insights into how similar experiments could be conducted using expert operators to improve the fidelity of IDAC simulations.« less

Prevalence of Metabolic Syndrome in an Employed Population as Determined by Analysis of Three Data Sources.

PubMed

Goetzel, Ron Z; Kent, Karen; Henke, Rachel Mosher; Pack, Cory; D'Arco, Malinda; Thomas, Jordana; Luckett, James; Arthur-Hartranft, Traci

2017-02-01

The aim of this study was to compare estimates of the prevalence and incidence of metabolic syndrome (MetS) using various data sources. We integrated health risk assessment (HRA), claims, and biometric screening data from Lockheed Martin Corporation. We measured the extent to which MetS risk factors measured using HRA and medical claims correlated with biometric screening data. Using biometric data, 24.9% of employees were identified as having MetS. Prevalence estimates were much lower using HRA data (6.8%) and claims (3.7%). Between 2012 and 2014, 10.4% of the sample newly acquired MetS. The number of MetS risk factors per employee was predictive of diabetes, heart disease, health care costs, and utilization. MetS is prevalent and associated with progression to disease. It is more easily tracked with biometric screening data than with HRA or claims data. Employers should consider efforts to manage and prevent this condition in their workforce.

IDHEAS – A NEW APPROACH FOR HUMAN RELIABILITY ANALYSIS

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

G. W. Parry; J.A Forester; V.N. Dang

2013-09-01

This paper describes a method, IDHEAS (Integrated Decision-Tree Human Event Analysis System) that has been developed jointly by the US NRC and EPRI as an improved approach to Human Reliability Analysis (HRA) that is based on an understanding of the cognitive mechanisms and performance influencing factors (PIFs) that affect operator responses. The paper describes the various elements of the method, namely the performance of a detailed cognitive task analysis that is documented in a crew response tree (CRT), and the development of the associated time-line to identify the critical tasks, i.e. those whose failure results in a human failure eventmore » (HFE), and an approach to quantification that is based on explanations of why the HFE might occur.« less

The implications of the Human Rights Act 1998 for the removal and detention of persons in need of care and attention.

PubMed

Hewitt, D

2002-03-01

The Human Rights Act 1998 ('HRA 1998') requires public authorities to act compatibly with the European Convention on Human Rights ('ECHR'). The ECHR contains rights, inter alia, to liberty and to respect for private life. Those rights--and, therefore, the HRA 1998--may be breached by provisions in the National Assistance Act 1948 and the National Assistance (Amendment) Act 1951 that enable persons in need of care and attention to be removed compulsorily to hospital. However, legal proceedings brought against a public authority that invoked its statuatory powers of removal may themselves be defensible under the HRA.

Multi-Unit Considerations for Human Reliability Analysis

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

St. Germain, S.; Boring, R.; Banaseanu, G.

This paper uses the insights from the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) methodology to help identify human actions currently modeled in the single unit PSA that may need to be modified to account for additional challenges imposed by a multi-unit accident as well as identify possible new human actions that might be modeled to more accurately characterize multi-unit risk. In identifying these potential human action impacts, the use of the SPAR-H strategy to include both errors in diagnosis and errors in action is considered as well as identifying characteristics of a multi-unit accident scenario that may impact themore » selection of the performance shaping factors (PSFs) used in SPAR-H. The lessons learned from the Fukushima Daiichi reactor accident will be addressed to further help identify areas where improved modeling may be required. While these multi-unit impacts may require modifications to a Level 1 PSA model, it is expected to have much more importance for Level 2 modeling. There is little currently written specifically about multi-unit HRA issues. A review of related published research will be presented. While this paper cannot answer all issues related to multi-unit HRA, it will hopefully serve as a starting point to generate discussion and spark additional ideas towards the proper treatment of HRA in a multi-unit PSA.« less

The Answer Is Blowing in the Wind. Investment in Training from a Human Resource Accounting Perspective.

ERIC Educational Resources Information Center

Johanson, Ulf

1998-01-01

Presents components of human resource accounting (HRA)--description of human resource costs, estimation of return on investment, estimation of human resource values. Reviews research on the influence of HRA on decision making, concluding that a number of factors inhibit its effective use. (SK)

Adherence to Cancer Screening Guidelines and Predictors of Improvement Among Participants in the Kansas State Employee Wellness Program

PubMed Central

Engelman, Kimberly K.; Shireman, Theresa I.; Ellerbeck, Edward F.

2013-01-01

Introduction Employee wellness programs (EWPs) have been used to implement worksite-based cancer prevention and control interventions. However, little is known about whether these programs result in improved adherence to cancer screening guidelines or how participants’ characteristics affect subsequent screening. This study was conducted to describe cancer screening behaviors among participants in a state EWP and identify factors associated with screening adherence among those who were initially nonadherent. Methods We identified employees and their dependents who completed health risk assessments (HRAs) as part of the Kansas state EWP in both 2008 and 2009. We examined baseline rates of adherence to cancer screening guidelines in 2008 and factors associated with adherence in 2009 among participants who were initially nonadherent. Results Of 53,095 eligible participants, 13,222 (25%) participated in the EWP in 2008 and 6,205 (12%) participated in both years. Among the multiyear participants, adherence was high at baseline to screening for breast (92.5%), cervical (91.8%), and colorectal cancer (72.7%). Of participants who were initially nonadherent in 2008, 52.4%, 41.3%, and 33.5%, respectively, became adherent in the following year to breast, cervical, and colorectal cancer screening. Suburban/urban residence and more frequent doctor visits predicted adherence to breast and colorectal cancer screening guidelines. Conclusion The effectiveness of EWPs for increasing cancer screening is limited by low HRA participation rates, high rates of adherence to screening at baseline, and failure of nonadherent participants to get screening. Improving overall adherence to cancer screening guidelines among employees will require efforts to increase HRA participation, stronger interventions for nonadherent participants, and better access to screening for rural employees. PMID:23845176

Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

PubMed Central

Lee, Han Suk; Chung, Hyung Kuk; Park, Sun Wook

2015-01-01

Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP). Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA) test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation and calculated the root mean square error in trials for each subject. Spearman's rank correlation coefficients and regression analysis were used to assess the degree of correlation between the trunk posture and HRA value, and a significance level of α = 0.05 was considered. Results. There were significant correlations between the HRA value of right side neck flexion and pelvic side tilt angle (p < 0.05). If pelvic side tilting angle increases by 1 degree, right side neck flexion increased by 0.76 degrees (p = 0.026). However, there were no significant correlations between other neck motions and trunk postures. Conclusion. Verifying pelvic postures should be prioritized when movement is limited due to the vitiation of the proprioceptive sense of neck caused by FHP. PMID:26583125

A Coaching by Telephone Intervention for Veterans and Care Team Engagement (ACTIVATE): A study protocol for a Hybrid Type I effectiveness-implementation randomized controlled trial.

PubMed

Oddone, Eugene Z; Damschroder, Laura J; Gierisch, Jennifer; Olsen, Maren; Fagerlin, Angela; Sanders, Linda; Sparks, Jordan; Turner, Marsha; May, Carrie; McCant, Felicia; Curry, David; White-Clark, Courtney; Juntilla, Karen

2017-04-01

A large proportion of deaths and many illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. Health risk assessments (HRAs) are widely available online but have not been consistently used in healthcare systems to activate patients to participate in prevention programs aimed at improving lifestyle behaviors. The goal of this study is to test whether adding telephone-based coaching to use of a comprehensive HRA increases at-risk patients' activation and enrollment into a prevention program compared to HRA use alone. Participants were randomized to either complete an HRA alone or in conjunction with a telephone coaching intervention. To be eligible Veterans had to have at least one modifiable risk factor (current smoker, overweight/obese, or physically inactive). The primary outcome is enrollment and participation in a prevention program by 6months. Secondary outcomes include change in a Patient Activation Measure and Framingham Risk Score. This study is the first to test a web-based health risk assessment coupled with a health coaching intervention within a large healthcare system. Results from this study will help the Veterans Health Administration (VHA) implement its national plan to include comprehensive health risk assessments as a tool to engage Veterans in prevention. The results will also inform health systems outside VHA who seek to implement Medicare's advisement that health risk assessment become a mandatory component of care under the Affordable Care Act. © 2016.

Quality of Kelantan drinking water and knowledge, attitude and practice among the population of Pasir Mas, Malaysia.

PubMed

Ab Razak, N H; Praveena, S M; Aris, A Z; Hashim, Z

2016-02-01

Information about the quality of drinking water, together with analysis of knowledge, attitude and practice (KAP) analysis and health risk assessment (HRA) remain limited. The aims of this study were: (1) to ascertain the level of KAP regarding heavy metal contamination of drinking water in Pasir Mas; (2) to determine the concentration of heavy metals (Al, Cr, Cu, Fe, Ni, Pb, Zn and Cd) in drinking water in Pasir Mas; and (3) to estimate the health risks (non-carcinogenic and carcinogenic) caused by heavy metal exposure through drinking water using hazard quotient and lifetime cancer risk. Information on KAP was collected using a standardized questionnaire. Heavy metal analysis of drinking water samples was performed using graphite furnace atomic absorption spectrophotometry. The population of Pasir Mas has good knowledge (80%), a less positive attitude (93%) and good practice (81%) towards heavy metal contamination of drinking water. The concentrations of heavy metals analysed in this study were found to be below the permissible limits for drinking water set by the Malaysian Ministry of Health and the World Health Organization. The HRA showed no potential non-carcinogenic and carcinogenic risks from the intake of heavy metal through drinking water. By investigating the quality of drinking water, KAP and HRA, the results of this study will provide authorities with the knowledge and resources to improve the management of drinking water quality in the future. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Do Complication Rates Differ by Gender After Metal-on-metal Hip Resurfacing Arthroplasty? A Systematic Review.

PubMed

Haughom, Bryan D; Erickson, Brandon J; Hellman, Michael D; Jacobs, Joshua J

2015-08-01

Although metal-on-metal (MoM) bearing surfaces provide low rates of volumetric wear and increased stability, evidence suggests that certain MoM hip arthroplasties have high rates of complication and failure. Some evidence indicates that women have higher rates of failure compared with men; however, the orthopaedic literature as a whole has poorly reported such complications stratified by gender. This systematic review aimed to: (1) compare the rate of adverse local tissue reaction (ALTR); (2) dislocation; (3) aseptic loosening; and (4) revision between men and women undergoing primary MoM hip resurfacing arthroplasty (HRA). Systematic MEDLINE and EMBASE searches identified all level I to III articles published in peer-reviewed journals, reporting on the outcomes of interest, for MoM HRA. Articles were limited to those with 2-year followup that reported outcomes by gender. Ten articles met inclusion criteria. Study quality was evaluated using the Modified Coleman Methodology Score; the overall quality was poor. Heterogeneity and bias were analyzed using a Mantel-Haenszel statistical method. Women demonstrated an increased odds of developing ALTR (odds ratio [OR], 5.70 [2.71-11.98]; p<0.001), dislocation (OR, 3.04 [1.2-7.5], p=0.02), aseptic loosening (OR, 3.18 [2.21-4.58], p<0.001), and revision (OR, 2.50 [2.25-2.78], p<0.001) after primary MoM HRA. A systematic review of the currently available literature reveals a higher rate of complications (ALTR, dislocation, aseptic loosening, and revision) after MoM HRA in women compared with men. Although femoral head size has been frequently implicated as a prime factor in the higher rate of complication in women, further research is necessary to specifically probe this relationship. Retrospective studies of data available (eg, registry data) should be undertaken, and moving forward studies should report outcomes by gender (particularly complications). Level III, therapeutic study.

The impact of alternative incentive schemes on completion of health risk assessments.

PubMed

Haisley, Emily; Volpp, Kevin G; Pellathy, Thomas; Loewenstein, George

2012-01-01

The biggest challenge for corporate wellness initiatives is low rates of employee participation. We test whether a behavioral economic approach to incentive design (i.e., a lottery) is more effective than a direct economic payment of equivalent monetary value (i.e., a grocery gift certificate) in encouraging employees to complete health risk assessments (HRAs). Employees were assigned to one of three arms. Assignment to a treatment arm versus the nontreatment arm was determined by management. Assignment to an arm among those eligible for treatment was randomized by office. A large health care management and information technology consulting company. A total of 1299 employees across 14 offices participated. All employees were eligible to receive $25 for completing the HRA. Those in the lottery condition were assigned to teams of four to eight people and, conditional on HRA completion, were entered into a lottery with a prize of $100 (expected value, $25) and a bonus value of an additional $25 if 80% of team members participated. Those in the grocery gift certificate condition who completed an HRA received a $25 grocery gift certificate. Those in the comparison condition received no additional incentive. HRA completion rates. Logistic regression analysis. HRA completion rates were significantly higher among participations in the lottery incentive condition (64%) than in both the grocery gift certificate condition (44%) and the comparison condition (40%). Effects were larger for lower-income employees, as indicated by a significant interaction between income and the lottery incentive. Lottery incentives that incorporate regret aversion and social pressure can provide higher impact for the same amount of money as simple economic incentives.

A randomized trial of effects of health risk appraisal combined with group sessions or home visits on preventive behaviors in older adults.

PubMed

Dapp, Ulrike; Anders, Jennifer A M; von Renteln-Kruse, Wolfgang; Minder, Christoph E; Meier-Baumgartner, Hans Peter; Swift, Cameron G; Gillmann, Gerhard; Egger, Matthias; Beck, John C; Stuck, Andreas E

2011-05-01

To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany. Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into intervention (n = 878) and control (n = 1,702) groups. Patients (n = 746) of seven additional matched general practitioners who did not receive this training served as a comparison group. Patients allocated to the intervention group, and their general practitioners, received computer-tailored written recommendations, and patients were offered the choice between interdisciplinary group sessions (geriatrician, physiotherapist, social worker, and nutritionist) and home visits (nurse). Among the intervention group, 580 (66%) persons made use of personal reinforcement (group sessions: 503 [87%], home visits: 77 [13%]). At 1-year follow-up, persons in the intervention group had higher use of preventive services (eg, influenza vaccinations, adjusted odds ratio 1.7; 95% confidence interval 1.4-2.1) and more favorable health behavior (eg, high fruit/fiber intake, odds ratio 2.0; 95% confidence interval 1.6-2.6), as compared with controls. Comparisons between intervention and comparison group data revealed similar effects, suggesting that physician training alone had no effect. Subgroup analyses indicated favorable effects for HRA-O with personal reinforcement, but not for HRA-O without reinforcement. HRA-O combined with physician training and personal reinforcement had favorable effects on preventive care use and health behavior.

Assessing the transfer of risk due to transportation of agricultural products.

PubMed

Li, Pei-Chiun; Shih, Hsiu-Ching; Ma, Hwong-Wen

2015-02-01

Health risk assessment (HRA) is the process used to estimate adverse health effects on humans. The importance and sensitivity of food chains to HRA have been observed, but the impact of the transportation of food has generally been ignored. This study developed an exposure assessment to demonstrate the significance of the transportation of agricultural products in HRA. The associated case study estimated the health risks derived from various sources of arsenic emissions in Taiwan. Two assessment scenarios, self-sufficiency and transportation of agricultural products, were compared to calculate risk transfer ratios that show the impact of agriculture transportation. The risk transfer ratios found by the study range from 0.22 to 42.10, indicating that the quantity of transportation of agricultural products is the critical factor. High air deposition and high agricultural production are the two main contributors to the effect of the transportation of agricultural products on HRA. Risk reduction measures could be applied to high-pollution areas as well as to areas with high agricultural productivity to reduce ingestion risks to residents. Certain areas that are sensitive to the transportation of agricultural products may incur more risks if emissions increase in agriculturally productive counties. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Impact of Two Workplace-Based Health Risk Appraisal Interventions on Employee Lifestyle Parameters, Mental Health and Work Ability: Results of a Randomized Controlled Trial

ERIC Educational Resources Information Center

Addley, K.; Boyd, S.; Kerr, R.; McQuillan, P.; Houdmont, J.; McCrory, M.

2014-01-01

Health risk appraisals (HRA) are a common type of workplace health promotion programme offered by American employers. In the United Kingdom, evidence of their effectiveness for promoting health behaviour change remains inconclusive. This randomized controlled trial examined the effects of two HRA interventions on lifestyle parameters, mental…

Effects of health risk assessment and counselling on physical activity in older people: A pragmatic randomised trial.

PubMed

Herghelegiu, Anna Marie; Moser, André; Prada, Gabriel Ioan; Born, Stephan; Wilhelm, Matthias; Stuck, Andreas E

2017-01-01

Interventions to increase physical activity (PA) among older community-dwelling adults may be enhanced by using multidimensional health risk assessment (HRA) as a basis for PA counselling. The study was conducted among nondisabled but mostly frail persons 65 years of age and older at an ambulatory geriatric clinic in Bucharest, Romania. From May to July 2014, 200 participants were randomly allocated to intervention and control groups. Intervention group participants completed an initial HRA questionnaire and then had monthly counselling sessions with a geriatrician over a period of six months that were aimed at increasing low or maintaining higher PA. Counselling also addressed the older persons' concomitant health risks and problems. The primary outcome was PA at six months (November 2014 to February 2015) evaluated with the International Physical Activity Questionnaire. At baseline, PA levels were similar in intervention and control groups (median 1089.0, and 1053.0 MET [metabolic equivalent of task] minutes per week, interquartile ranges 606.0-1401.7, and 544.5-1512.7 MET minutes per week, respectively). Persons in the intervention group had an average of 11.2 concomitant health problems and risks (e.g., pain, depressive mood, hypertension). At six months, PA increased in the intervention group by a median of 180.0 MET minutes per week (95% confidence interval (CI) 43.4-316.6, p = 0.01) to 1248.8 MET minutes per week. In the control group, PA decreased by a median of 346.5 MET minutes per week (95% CI 178.4-514.6, p<0.001) to 693.0 MET minutes per week due to a seasonal effect, resulting in a difference of 420.0 MET minutes per week (95% CI 212.7-627.3, p< 0.001) between groups. The use of HRA to inform individualized PA counselling is a promising method for achieving improvements in PA, and ultimately health and longevity among large groups of community-dwelling older persons. International Standard Randomized Controlled Trial Number: ISRCTN11166046.

A mid-layer model for human reliability analysis : understanding the cognitive causes of human failure events.

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

Shen, Song-Hua; Chang, James Y. H.; Boring,Ronald L.

2010-03-01

The Office of Nuclear Regulatory Research (RES) at the US Nuclear Regulatory Commission (USNRC) is sponsoring work in response to a Staff Requirements Memorandum (SRM) directing an effort to establish a single human reliability analysis (HRA) method for the agency or guidance for the use of multiple methods. As part of this effort an attempt to develop a comprehensive HRA qualitative approach is being pursued. This paper presents a draft of the method's middle layer, a part of the qualitative analysis phase that links failure mechanisms to performance shaping factors. Starting with a Crew Response Tree (CRT) that has identifiedmore » human failure events, analysts identify potential failure mechanisms using the mid-layer model. The mid-layer model presented in this paper traces the identification of the failure mechanisms using the Information-Diagnosis/Decision-Action (IDA) model and cognitive models from the psychological literature. Each failure mechanism is grouped according to a phase of IDA. Under each phase of IDA, the cognitive models help identify the relevant performance shaping factors for the failure mechanism. The use of IDA and cognitive models can be traced through fault trees, which provide a detailed complement to the CRT.« less

Atypical hemispheric specialization for faces in infants at risk for autism spectrum disorder.

PubMed

Keehn, Brandon; Vogel-Farley, Vanessa; Tager-Flusberg, Helen; Nelson, Charles A

2015-04-01

Among the many experimental findings that tend to distinguish those with and without autism spectrum disorder (ASD) are face processing deficits, reduced hemispheric specialization, and atypical neurostructural and functional connectivity. To investigate the earliest manifestations of these features, we examined lateralization of event-related gamma-band coherence to faces during the first year of life in infants at high risk for autism (HRA; defined as having an older sibling with ASD) who were compared with low-risk comparison (LRC) infants, defined as having no family history of ASD. Participants included 49 HRA and 46 LRC infants who contributed a total of 127 data sets at 6 and 12 months. Electroencephalography was recorded while infants viewed images of familiar/unfamiliar faces. Event-related gamma-band (30-50 Hz) phase coherence between anterior-posterior electrode pairs for left and right hemispheres was computed. Developmental trajectories for lateralization of intra-hemispheric coherence were significantly different in HRA and LRC infants: by 12 months, HRA infants showed significantly greater leftward lateralization compared with LRC infants who showed rightward lateralization. Preliminary results indicate that infants who later met criteria for ASD were those that showed the greatest leftward lateralization. HRA infants demonstrate an aberrant pattern of leftward lateralization of intra-hemispheric coherence by the end of the first year of life, suggesting that the network specialized for face processing may develop atypically. Further, infants with the greatest leftward asymmetry at 12 months where those that later met criteria for ASD, providing support to the growing body of evidence that atypical hemispheric specialization may be an early neurobiological marker for ASD. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

High-resolution anoscopy screening of HIV-positive MSM: longitudinal results from a pilot study.

PubMed

Dalla Pria, Alessia; Alfa-Wali, Maryam; Fox, Paul; Holmes, Paul; Weir, Justin; Francis, Nicholas; Bower, Mark

2014-03-27

The ability to detect and treat pre-malignant anal lesions suggests screening may prevent anal cancer. The incidence of anal cancer in men who have sex with men (MSM) living with HIV exceeds that of cervical cancer before screening was introduced. High-resolution anoscopy (HRA) with intervention for high-grade squamous intraepithelial lesions (HSILs) was offered to asymptomatic HIV-positive MSM. Patients with HSILs were treated and follow-up HRA performed after 6 months, whilst patients with low-grade squamous intraepithelial lesions had a repeat HRA after 12 months. Three hundred and sixty-eight asymptomatic MSM had a total of 1497 HRAs during a median follow-up of 4.2 years (maximum 13 years). At first HRA, 36% had normal appearances, 16% had no dysplasia, 15% anal intraepithelial neoplasia (AIN)-1, 19% AIN-2 and 13% AIN-3. During follow-up, five patients (1.4%) developed invasive anal cancer (incidence 2.7 per 1000 person-years). The 5-year cancer rate for the 368 patients was 0.3% [95% confidence interval (CI) 0-0.6%]. Progression to cancer was associated with higher age (P=0.049) and AIN-3 (P=0.024). Ninety patients had AIN-3 present at least at one HRA. The cumulative risk of cancer from first AIN-3 diagnosis was 3.2% (95% CI 0-7.8%) at 5 years. One hundred and seventy-one patients had HSILs (AIN-2 or 3) present at least once. The cumulative risk of cancer from first HSIL diagnosis was 0.6% (95% CI 0-1.8%) at 5 years. AIN-3 is a significant risk factor for subsequent anal cancer, although the tumours detected in screened patients were small localized, and generally the outcomes were favourable.

Acute kidney injury is a powerful independent predictor of mortality in critically ill patients: a multicenter prospective cohort study from Kinshasa, the Democratic Republic of Congo.

PubMed

Masewu, Angèle; Makulo, Jean-Robert; Lepira, François; Amisi, Eric Bibonge; Sumaili, Ernest Kiswaya; Bukabau, Justine; Mokoli, Vieux; Longo, Augustin; Nlandu, Yannick; Engole, Yannick; Ilunga, Cedric; Mosolo, Alphonse; Ngalala, Alex; Kazadi, Justin; Mvuala, Richard; Athombo, Jackson; Aliocha, Nkodila; Akilimali, Pierre Zalagile; Kilembe, Adolphe; Nseka, Nazaire; Jadoul, Michel

2016-08-24

Despite the growing incidence of acute kidney injury (AKI) worldwide, there is little data on the burden and outcomes of AKI in intensive care unit (ICU) in low resource settings. The present study assessed the incidence of AKI and its impact on mortality in ICU in Kinshasa (Democratic Republic of Congo). In a prospective cohort study, 476 consecutive critically ill patients (mean age 52 years, 57 % male) were screened for the presence of AKI in seven ICU from January 1st to March 30th, 2015. Serum creatinine was measured by the enzymatic method (Cobas C111 device®). AKI and its stages (no AKI, AKI 1, AKI 2 and AKI 3) were defined according to AKIN recommendations. The primary outcome was 28 days mortality. Survival (time-to death) curves were built using the Kaplan Meier methods. Predictors of mortality were assessed by Cox proportional hazards regression models. p < 0.05 defined the level of statistical significance. The cumulative incidence of AKI was 52.7 % with AKI stage 1, 2 and 3 in 23.7 %, 16.2 % and 12.8 % of patients, respectively. Among patients who developed AKI, 146 died (58 %) vs 62 patients (28 %) in the group without AKI. Only 6.5 % of the patients with AKI stage 3 benefited from dialysis. Median survival time was 15.0 days in patients without AKI and 3.0 days, 6.0 days and 8.0 days in patients with AKI stage 3, 2 and 1 (p < 0.001), respectively. In addition to respiratory distress-induced polypnea (HRa 1.60; 95 % CI: 1.08-2.37; p = 0.018), oxygen desaturation (HRa 1.53; 95 % CI: 1.13-2.08; p = 0.006) and multi-organic involvement (HRa 1.63; 95 % CI: 1.15-2.30), AKI emerged as an independent predictor of death (HRa 1.82; 95 % CI: 1.34-2.48; p < 0.001). More than half of critically ill patients in the present cohort developed AKI which contributed substantially to short-term mortality, highlighting the need for its prevention, early detection and management as well as the availability of dialysis in ICU.

Article 8 of the human rights act 1998: a review of case law related to forensic psychiatry and prisoners in the United Kingdom.

PubMed

Curtice, Martin J R; Sandford, John J

2009-01-01

The Human Rights Act 1998 (HRA) was introduced into United Kingdom domestic law in 2000 and incorporated most of the European Convention on Human Rights. Article 8 of the HRA provides the right to respect for private and family life, home, and correspondence. It is a qualified right, underpinned by the core HRA principle of proportionality and therefore can be dynamically interpreted. The forensic and prison settings in the United Kingdom have produced numerous cases based on perceived infringements that may or may not have breached Article 8. These cases, when analyzed, help both to demonstrate how Article 8 may be breached in clinical practice and to illustrate key Article 8 principles that can be used and implemented in clinical practice to safeguard both clinicians and patients.

The SACADA database for human reliability and human performance

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

Y. James Chang; Dennis Bley; Lawrence Criscione

2014-05-01

Lack of appropriate and sufficient human performance data has been identified as a key factor affecting human reliability analysis (HRA) quality especially in the estimation of human error probability (HEP). The Scenario Authoring, Characterization, and Debriefing Application (SACADA) database was developed by the U.S. Nuclear Regulatory Commission (NRC) to address this data need. An agreement between NRC and the South Texas Project Nuclear Operating Company (STPNOC) was established to support the SACADA development with aims to make the SACADA tool suitable for implementation in the nuclear power plants' operator training program to collect operator performance information. The collected data wouldmore » support the STPNOC's operator training program and be shared with the NRC for improving HRA quality. This paper discusses the SACADA data taxonomy, the theoretical foundation, the prospective data to be generated from the SACADA raw data to inform human reliability and human performance, and the considerations on the use of simulator data for HRA. Each SACADA data point consists of two information segments: context and performance results. Context is a characterization of the performance challenges to task success. The performance results are the results of performing the task. The data taxonomy uses a macrocognitive functions model for the framework. At a high level, information is classified according to the macrocognitive functions of detecting the plant abnormality, understanding the abnormality, deciding the response plan, executing the response plan, and team related aspects (i.e., communication, teamwork, and supervision). The data are expected to be useful for analyzing the relations between context, error modes and error causes in human performance.« less

Comparing excess costs across multiple corporate populations.

PubMed

Wright, Douglas; Adams, Laura; Beard, Marshall J; Burton, Wayne N; Hirschland, David; McDonald, Timothy; Napier, Deborah; Galante, Salvatore; Smith, Thomas; Edington, D W

2004-09-01

The purpose of this study was to examine the relationship of health risk level to charged medical costs and determine the excess cost of higher risk individuals compared to low risk. Two years of medical claims from six corporations were used to determine costs of health risk assessment (HRA) participants and nonparticipants. A total of 165,770 employees, 21,124 of which took an HRA, were used for the study. Costs increased as risk level increased. There were no significant differences within a risk level between companies for the cost ratio. Percent of medical costs due to excess risk ranged from 15.0-30.8% for HRA participants and 23.8-38.3% for the study population. Cost patterns were consistent across companies. Excess cost as the result of increased risk level accounted for a substantial portion of the cost at each company. These results can be used to justify the need for a health-promotion program and to estimate potential savings as the result of excess risk. Even without the use of an HRA, health practitioners should feel confident stating that excess risk accounts for at least 25% to 30% of medical costs per year across a wide variety of companies, regardless of industry or demographics. The numbers can be used as a realistic estimate for any health promotion program financial proposal.

Atypical Hemispheric Specialization for Faces in Infants At-Risk for Autism Spectrum Disorder

PubMed Central

Keehn, Brandon; Vogel-Farley, Vanessa; Tager-Flusberg, Helen; Nelson, Charles A.

2014-01-01

Behavioral and neuroimaging findings from typically developing infants and children have demonstrated that the right hemisphere becomes specialized for processing faces. Face processing impairments and atypical hemispheric specialization have previously been reported in individuals with autism spectrum disorder (ASD). The goal of this study was to examine the emergence of the right-lateralized face processing network in infants at high-risk for autism (HRA; defined as having an older sibling with ASD) and low-risk comparison (LRC) infants, defined as having no family history of ASD. To investigate the earliest appearance of these features, we examined lateralization of event-related gamma-band coherence (a measure of intra-hemispheric connectivity) to faces during the first year of life. Forty-nine HRA and 46 LRC infants contributed a total of 127 data sets at 6- and/or 12-months. EEG was recorded while infants viewed pictures of either their mother or a stranger. Event-related gamma-band (30-50Hz) phase coherence between anterior-posterior regions for left and right hemispheres was computed. HRA infants showed an aberrant pattern of leftward lateralization of intra-hemispheric coherence by the end of the first year of life, suggesting that the network specialized for face processing may develop atypically in these infants. Further, infants with the greatest leftward asymmetry at 12-months were those that later met diagnostic criteria for ASD, providing support to the growing body of evidence that atypical hemispheric specialization may be an early neurobiological marker for ASD. Among the many experimental findings that tend to distinguish those with and without autism spectrum disorder (ASD) are face processing deficits, reduced hemispheric specialization, and atypical neurostructural and functional connectivity. To investigate the earliest manifestations of these features, we examined lateralization of event-related gamma-band coherence to faces during the first year of life in infants at high-risk for autism (HRA; defined as having an older sibling with ASD) who were compared low-risk comparison (LRC) infants, defined as having no family history of ASD. Participants included 49 HRA and 46 LRC infants who contributed a total of 127 data sets at 6- and 12-months. EEG was recorded while infants viewed images of familiar/unfamiliar faces. Event-related gamma-band (30-50Hz) phase coherence between anterior-posterior electrode pairs for left and right hemispheres was computed. Developmental trajectories for lateralization of intra-hemispheric coherence were significantly different in HRA and LRC infants: by 12-months HRA infants showed significantly greater leftward lateralization compared to LRC infants who showed rightward lateralization. Preliminary results indicate that infants who later met criteria for ASD were those that showed the greatest leftward lateralization. HRA infants demonstrate an aberrant pattern of leftward lateralization of intra-hemispheric coherence by the end of the first year of life, suggesting that the network specialized for face processing may develop atypically. Further, infants with the greatest leftward asymmetry at 12-months where those that later met criteria for ASD, providing support to the growing body of evidence that atypical hemispheric specialization may be an early neurobiological marker for ASD. PMID:25808162

Trajectories of Depressive Symptoms Among Web-Based Health Risk Assessment Participants.

PubMed

Bedrosian, Richard; Hawrilenko, Matt; Cole-Lewis, Heather

2017-03-31

Health risk assessments (HRAs), which often screen for depressive symptoms, are administered to millions of employees and health plan members each year. HRA data provide an opportunity to examine longitudinal trends in depressive symptomatology, as researchers have done previously with other populations. The primary research questions were: (1) Can we observe longitudinal trajectories in HRA populations like those observed in other study samples? (2) Do HRA variables, which primarily reflect modifiable health risks, help us to identify predictors associated with these trajectories? (3) Can we make meaningful recommendations for population health management, applicable to HRA participants, based on predictors we identify? This study used growth mixture modeling (GMM) to examine longitudinal trends in depressive symptomatology among 22,963 participants in a Web-based HRA used by US employers and health plans. The HRA assessed modifiable health risks and variables such as stress, sleep, and quality of life. Five classes were identified: A "minimal depression" class (63.91%, 14,676/22,963) whose scores were consistently low across time, a "low risk" class (19.89%, 4568/22,963) whose condition remained subthreshold, a "deteriorating" class (3.15%, 705/22,963) who began at subthreshold but approached severe depression by the end of the study, a "chronic" class (4.71%, 1081/22,963) who remained highly depressed over time, and a "remitting" class (8.42%, 1933/22,963) who had moderate depression to start, but crossed into minimal depression by the end. Among those with subthreshold symptoms, individuals who were male (P<.001) and older (P=.01) were less likely to show symptom deterioration, whereas current depression treatment (P<.001) and surprisingly, higher sleep quality (P<.001) were associated with increased probability of membership in the "deteriorating" class as compared with "low risk." Among participants with greater symptomatology to start, those in the "severe" class tended to be younger than the "remitting" class (P<.001). Lower baseline sleep quality (P<.001), quality of life (P<.001), stress level (P<.001), and current treatment involvement (P<.001) were all predictive of membership in the "severe" class. The trajectories identified were consistent with trends in previous research. The results identified some key predictors: we discuss those that mirror prior studies and offer some hypotheses as to why others did not. The finding that 1 in 5 HRA participants with subthreshold symptoms deteriorated to the point of clinical distress during succeeding years underscores the need to learn more about such individuals. We offer additional recommendations for follow-up research, which should be designed to reflect changes in health plan demographics and HRA delivery platforms. In addition to utilizing additional variables such as cognitive style to refine predictive models, future research could also begin to test the impact of more aggressive outreach strategies aimed at participants who are likely to deteriorate or remain significantly depressed over time. ©Richard Bedrosian, Matt Hawrilenko, Heather Cole-Lewis. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 31.03.2017.

User-centered design and usability testing of an innovative health-related quality of life module.

PubMed

Nagykaldi, Z J; Jordan, M; Quitoriano, J; Ciro, C A; Mold, J W

2014-01-01

Various computerized health risk appraisals (HRAs) are available, but few of them assess health-related quality of life (HRQoL) in a goal-directed framework. This study describes the user-centered development and usability testing of an innovative HRQoL module that extends a validated HRA tool in primary care settings. Systematic user-centered design, usability testing, and qualitative methods were used to develop the HRQoL module in primary care practices. Twenty two patients and 5 clinicians participated in two rounds of interactive technology think-out-loud sessions (TOLs) and semi-structured interviews (SSIs) to iteratively develop a four-step, computerized process that collects information on patient goals for meaningful life activities and current level of disability and presents a personalized and prioritized list of preventive recommendations linked to online resources. Analysis of TOLs and SSIs generated 5 categories and 11 sub-categories related to facilitators and barriers to usability and human-technology interaction. The categories included: Understanding the Purpose, Usability, Perceived Value, Literacy, and Participant Motivation. Some categories were inter-connected. The technology was continually and iteratively improved between sessions until saturation of positive feedback was achieved in 4 categories (addressing motivation will require more research). Usability of all screen units of the module was improved substantially. Clinician feedback emphasized the importance of the module's ability to translate the patient-centered HRQoL Report into actionable items for clinicians to facilitate shared decision-making. Complete integration of the HRQoL module into the existing HRA will require further development and testing. Systematic application of user-centered design and human factors principles in technology development and testing may significantly improve the usability and clinical value of health information systems. This more sophisticated approach helped us translate complex clinical concepts, goal-setting steps, and decision-support processes into an accepted and value-added technology.

Effect of Health Risk Assessment and Counselling on Health Behaviour and Survival in Older People: A Pragmatic Randomised Trial

PubMed Central

Stuck, Andreas E.; Moser, André; Morf, Ueli; Wirz, Urban; Wyser, Joseph; Gillmann, Gerhard; Born, Stephan; Zwahlen, Marcel; Iliffe, Steve; Harari, Danielle; Swift, Cameron; Beck, John C.; Egger, Matthias

2015-01-01

Background Potentially avoidable risk factors continue to cause unnecessary disability and premature death in older people. Health risk assessment (HRA), a method successfully used in working-age populations, is a promising method for cost-effective health promotion and preventive care in older individuals, but the long-term effects of this approach are unknown. The objective of this study was to evaluate the effects of an innovative approach to HRA and counselling in older individuals for health behaviours, preventive care, and long-term survival. Methods and Findings This study was a pragmatic, single-centre randomised controlled clinical trial in community-dwelling individuals aged 65 y or older registered with one of 19 primary care physician (PCP) practices in a mixed rural and urban area in Switzerland. From November 2000 to January 2002, 874 participants were randomly allocated to the intervention and 1,410 to usual care. The intervention consisted of HRA based on self-administered questionnaires and individualised computer-generated feedback reports, combined with nurse and PCP counselling over a 2-y period. Primary outcomes were health behaviours and preventive care use at 2 y and all-cause mortality at 8 y. At baseline, participants in the intervention group had a mean ± standard deviation of 6.9 ± 3.7 risk factors (including unfavourable health behaviours, health and functional impairments, and social risk factors) and 4.3 ± 1.8 deficits in recommended preventive care. At 2 y, favourable health behaviours and use of preventive care were more frequent in the intervention than in the control group (based on z-statistics from generalised estimating equation models). For example, 70% compared to 62% were physically active (odds ratio 1.43, 95% CI 1.16–1.77, p = 0.001), and 66% compared to 59% had influenza vaccinations in the past year (odds ratio 1.35, 95% CI 1.09–1.66, p = 0.005). At 8 y, based on an intention-to-treat analysis, the estimated proportion alive was 77.9% in the intervention and 72.8% in the control group, for an absolute mortality difference of 4.9% (95% CI 1.3%–8.5%, p = 0.009; based on z-test for risk difference). The hazard ratio of death comparing intervention with control was 0.79 (95% CI 0.66–0.94, p = 0.009; based on Wald test from Cox regression model), and the number needed to receive the intervention to prevent one death was 21 (95% CI 12–79). The main limitations of the study include the single-site study design, the use of a brief self-administered questionnaire for 2-y outcome data collection, the unavailability of other long-term outcome data (e.g., functional status, nursing home admissions), and the availability of long-term follow-up data on mortality for analysis only in 2014. Conclusions This is the first trial to our knowledge demonstrating that a collaborative care model of HRA in community-dwelling older people not only results in better health behaviours and increased use of recommended preventive care interventions, but also improves survival. The intervention tested in our study may serve as a model of how to implement a relatively low-cost but effective programme of disease prevention and health promotion in older individuals. Trial Registration International Standard Randomized Controlled Trial Number: ISRCTN 28458424 PMID:26479077

Human Risk Assessment and Its Application to Nanotechnology: A Challenge for Assessors

NASA Astrophysics Data System (ADS)

Emond, C.; Britos, T. N.

2015-05-01

Scientific literature suggests that exposure to nanoparticles (NPs) might be associated with adverse health effects. A well-developed human risk assessment (HRA) that applies to NPs has never been established and optimized-until now. Furthermore, no government regulations are in place that establish what is considered to be an adequate and secure level of exposure and supported by a strong scientific approach for nanotechnology. It is important to implement the HRA to ensure that workers producing NPs, users of NPs and the general population are protected from deleterious issues related to NPs. In this work, a methodology is described based on the HRA. An effort is required during synthesis before the commercialization phase to evaluate the results of a systematic and rigorous assessment because this could significantly reduce the health risks of those exposed to NPs, including workers and the population.

Psychosis proneness and ADHD in young relatives of schizophrenia patients.

PubMed

Keshavan, Matcheri S; Sujata, Mandayam; Mehra, Akhil; Montrose, Debra M; Sweeney, John A

2003-01-01

Symptoms resembling the attentional deficit hyperactivity disorder (ADHD) are frequently observed in young relatives at risk for schizophrenia (HR). We examined the frequency of the ADHD syndrome and its relationship to psychosis related psychopathology and neurobehavioral abnormalities in young HR subjects (n=29) and healthy comparison subjects (HC; n=30). Thirty-one percent of HR subjects (n=9) had ADHD as a lifetime Axis-I diagnosis (HR-A). Compared to healthy comparison subjects, the HR-A group had impaired neurological function. The HR-A group but not the HR subjects without ADHD had higher scores on the Chapman's magical ideation and perceptual aberration scales. Thus, ADHD-like features are more prevalent in the HR population than the one described in the general population and are associated with more frequent psychosis-like clinical features. Longitudinal studies can clarify whether an "ADHD subgroup" within HR subjects predict an increased risk for future emergence of schizophrenia.

Metal-on-Metal Hip Resurfacing Arthroplasty

PubMed Central

Sehatzadeh, S; Kaulback, K; Levin, L

2012-01-01

Background Metal-on-metal (MOM) hip resurfacing arthroplasty (HRA) is in clinical use as an appropriate alternative to total hip arthroplasty in young patients. In this technique, a metal cap is placed on the femoral head to cover the damaged surface of the bone and a metal cup is placed in the acetabulum. Objectives The primary objective of this analysis was to compare the revision rates of MOM HRA using different implants with the benchmark set by the National Institute of Clinical Excellence (NICE). The secondary objective of this analysis was to review the literature regarding adverse biological effects associated with implant material. Review Methods A literature search was performed on February 13, 2012, to identify studies published from January 1, 2009, to February 13, 2012. Results The revision rates for MOM HRA using 6 different implants were reviewed. The revision rates for MOM HRA with 3 implants met the NICE criteria, i.e., a revision rate of 10% or less at 10 years. Two implants had short-term follow-ups and MOM HRA with one of the implants failed to meet the NICE criteria. Adverse tissue reactions resulting in failure of the implants have been reported by several studies. With a better understanding of the factors that influence the wear rate of the implants, adverse tissue reactions and subsequent implant failure can be minimized. Many authors have suggested that patient selection and surgical technique affect the wear rate and the risk of tissue reactions. The biological effects of high metal ion levels in the blood and urine of patients with MOM HRA implants are not known. Studies have shown an increase in chromosomal aberrations in patients with MOM articulations, but the clinical implications and long-term consequences of this increase are still unknown. Epidemiological studies have shown that patients with MOM HRA implants did not have an overall increase in mortality or risk of cancer. There is insufficient clinical data to confirm the teratogenicity of MOM implants in humans. Conclusions Metal-on-metal HRA can be beneficial for appropriately selected patients, provided the surgeon has the surgical skills required for performing this procedure. Plain Language Summary There are many young patients with hip diseases who need to have hip replacement surgery. Although a traditional hip replacement is an acceptable procedure for these patients, some surgeons prefer using a newer technique in young patients called hip resurfacing. In this technique, instead of removing the head of the femoral bone, a metal cap is placed on the femoral head to cover the damaged surface of the bone and a metal cup is placed in the hip socket, similar to the cups used in traditional hip replacement. The analysis of the revision rates (i.e., how soon and in how many patients the surgery needs to be redone) and safety of resurfacing implants showed that generally these implants can last 10 years or more for the majority of young people. Good outcomes can be expected when skilled surgeons perform the surgery in properly selected patients. However, since these implants are made of metal (cobalt and chromium alloy), there is concern about excess metal debris production due to friction between the 2 metal components leading to high levels of metal ions in the blood and urine of patients. The production of metal debris may result in inflammation in the joint or development of a benign soft tissue mass leading to implant failure. However, it has been shown that this risk can be reduced by proper positioning of the implant and the careful selection of patients for this procedure. Little is known about the long-term biological effects of high levels of metal ions in the blood and urine of patients who have received metal implants. There is concern about potential increases in the risk of cancer and the risk of fetal abnormalities, but these effects have not been established yet. However, since cobalt and chromium can pass the placental barrier, implants that are not metal-on-metal are recommended for women at childbearing ages if they need a hip replacement. PMID:23074429

Value of laboratory tests in employer-sponsored health risk assessments for newly identifying health conditions: analysis of 52,270 participants.

PubMed

Kaufman, Harvey W; Williams, Fred R; Odeh, Mouneer A

2011-01-01

Employer-sponsored health risk assessments (HRA) may include laboratory tests to provide evidence of disease and disease risks for common medical conditions. We evaluated the ability of HRA-laboratory testing to provide new disease-risk information to participants. We performed a cross-sectional analysis of HRA-laboratory results for participating adult employees and their eligible spouses or their domestic partners, focusing on three common health conditions: hyperlipidemia, diabetes mellitus, and chronic kidney disease. HRA with laboratory results of 52,270 first-time participants were analyzed. Nearly all participants had access to health insurance coverage. Twenty-four percent (12,392) self-reported one or more of these medical conditions: 21.1% (11,017) self-identified as having hyperlipidemia, 4.7% (2,479) self-identified as having diabetes, and 0.7% (352) self-identified as having chronic kidney disease. Overall, 36% (n = 18,540) of participants had laboratory evidence of at least one medical condition newly identified: 30.7% (16,032) had laboratory evidence of hyperlipidemia identified, 1.9% (984) had laboratory evidence of diabetes identified, and 5.5% (2,866) had laboratory evidence of chronic kidney disease identified. Of all participants with evidence of hyperlipidemia 59% (16,030 of 27,047), were newly identified through the HRA. Among those with evidence of diabetes 28% (984 of 3,463) were newly identified. The highest rate of newly identified disease risk was for chronic kidney disease: 89% (2,866 of 3,218) of participants with evidence of this condition had not self-reported it. Men (39%) were more likely than women (33%) to have at least one newly identified condition (p<0.0001). Among men, lower levels of educational achievement were associated with modestly higher rates of newly identified disease risk (p<0.0001); the association with educational achievement among women was unclear. Even among the youngest age range (20 to 29 year olds), nearly 1 in 4 participants (24%) had a newly identified risk for disease. These results support the important role of employer-sponsored laboratory testing as an integral element of HRA for identifying evidence of previously undiagnosed common medical conditions in individuals of all working age ranges, regardless of educational level and gender.

Health Risk Management for Bioenvironmental Engineering

DTIC Science & Technology

2013-06-01

success. • Health Risk Estimate ( HRE ). HRE is the probability and severity of loss from exposure to the health threat ( HRE is a function of...probability and severity; when either or both increase the HRE increases). The HRE is also referred to as a health risk level. An HRE is a measure of the...assessments) OEH threats in populations or at locations over time (HRA = f [(health risk) “+” ( HRE ) “+” (COA)]). The HRA “product” is the validated

High-resolution anoscopy: Unchartered territory for gastroenterologists?

PubMed

Albuquerque, Andreia

2015-09-25

High-resolution anoscopy (HRA) is a procedure where patients with an increased risk of anal cancer, like men who have sex with men, human immunodeficiency virus infected individuals, transplant patients and women with a history of lower genital tract neoplasia, with abnormal anal cytology results, are submitted to anal and perianal visualization under magnification. This will allow for a better detection of anal high-grade lesions that can be treated, in an effort to prevent anal cancer. Anal cancer screening follows the same principles that cervical cancer screening. During this procedure, an anoscope is inserted and a colposcope is used to examine systematically the squamocolumnar junction, the transformation zone and the perianal skin. Initially the observation is done with no staining and then with the application of acetic acid and Lugol's iodine solution, allowing for better lesion identification and characterization. Any suspicious lesion seen should be carefully evaluated and biopsied. Without HRA only a small percentage of suspicious lesions are identified. High-grade lesions that are detected can be ablated under HRA. This is a challenging exam to perform, with a long learning curve and the number of clinicians performing it is limited, although the growing number of patients that need to been screened. Specific equipment is required, with these patients ideally been followed by a multidisciplinary team, in a reference centre. HRA remains unfamiliar for many gastroenterologists.

Greater Pupil Size in Response to Emotional Faces as an Early Marker of Social-Communicative Difficulties in Infants at High Risk for Autism

PubMed Central

Wagner, Jennifer B.; Luyster, Rhiannon J.; Tager-Flusberg, Helen; Nelson, Charles A.

2016-01-01

When scanning faces, individuals with autism spectrum disorder (ASD) have shown reduced visual attention (e.g., less time on eyes) and atypical autonomic responses (e.g., heightened arousal). To understand how these differences might explain sub-clinical variability in social functioning, 9-month-olds, with or without a family history of ASD, viewed emotionally-expressive faces, and gaze and pupil diameter (a measure of autonomic activation) were recorded using eye-tracking. Infants at high-risk for ASD with no subsequent clinical diagnosis (HRA-) and low-risk controls (LRC) showed similar face scanning and attention to eyes and mouth. Attention was overall greater to eyes than mouth, but this varied as a function of the emotion presented. HRA- showed significantly larger pupil size than LRC. Correlations between scanning at 9 months, pupil size at 9 months, and 18-month social-communicative behavior, revealed positive associations between pupil size and attention to both face and eyes at 9 months in LRC, and a negative association between 9-month pupil size and 18-month social-communicative behavior in HRA-. The present findings point to heightened autonomic arousal in HRA-. Further, with greater arousal relating to worse social-communicative functioning at 18 months, this work points to a mechanism by which unaffected siblings might develop atypical social behavior. PMID:27616938

Greater Pupil Size in Response to Emotional Faces as an Early Marker of Social-Communicative Difficulties in Infants at High Risk for Autism.

PubMed

Wagner, Jennifer B; Luyster, Rhiannon J; Tager-Flusberg, Helen; Nelson, Charles A

2016-01-01

When scanning faces, individuals with autism spectrum disorder (ASD) have shown reduced visual attention (e.g., less time on eyes) and atypical autonomic responses (e.g., heightened arousal). To understand how these differences might explain sub-clinical variability in social functioning, 9-month-olds, with or without a family history of ASD, viewed emotionally-expressive faces, and gaze and pupil diameter (a measure of autonomic activation) were recorded using eye-tracking. Infants at high-risk for ASD with no subsequent clinical diagnosis (HRA-) and low-risk controls (LRC) showed similar face scanning and attention to eyes and mouth. Attention was overall greater to eyes than mouth, but this varied as a function of the emotion presented. HRA- showed significantly larger pupil size than LRC. Correlations between scanning at 9 months, pupil size at 9 months, and 18-month social-communicative behavior, revealed positive associations between pupil size and attention to both face and eyes at 9 months in LRC, and a negative association between 9-month pupil size and 18-month social-communicative behavior in HRA-. The present findings point to heightened autonomic arousal in HRA-. Further, with greater arousal relating to worse social-communicative functioning at 18 months, this work points to a mechanism by which unaffected siblings might develop atypical social behavior.

Regulatory experience of TOPS: an internet-based system to prevent healthy subjects from over-volunteering for UK clinical trials.

PubMed

Allen, C; Francis, G; Martin, J; Boyce, M

2017-12-01

The aim was to review the use of The Over-volunteering Prevention System (TOPS) since the HRA began hosting it in 2013, and the Medicines and Healthcare products Regulatory Agency (MHRA) experience of monitoring its use by UK clinical research units. The HRA searched the TOPS database for the number, type and location of units and the number of entries. The MHRA inspectors reviewed their findings from routine inspections. Twenty-two additional UK units registered to use TOPS during 2013-2016, making a total of 84 units since TOPS was established in 2002. Use of TOPS is now a condition of research ethics committee approval of a phase 1 study and fulfils MHRA accreditation requirements for preventing over-volunteering. The total number of entries by all active units during 2013-2016 was 89,335, of which 84% were UK citizens and 16% non-UK citizens. The total number of entries during 2002-2016 was 249,612. Only 15 of 24,531 subjects (1/1600) and 18 of 18,745 subjects (1/1040) entered in 2015 and 2016, respectively, were deemed potential over-volunteers. The findings continue to support the concept that TOPS not only helps to prevent over-volunteering, but also deters subjects from trying to do so. Regulation of TOPS by the HRA and MHRA has enhanced its effectiveness, benefited all users and helped to improve the safety of volunteers who participate in non-therapeutic trials in the UK. The UK is still the only country with a national database to prevent over-volunteering that has published data on its widespread use and effectiveness.

Determinants of participation in a web-based health risk assessment and consequences for health promotion programs.

PubMed

Niessen, Maurice A J; Laan, Eva L; Robroek, Suzan J W; Essink-Bot, Marie-Louise; Peek, Niels; Kraaijenhagen, Roderik A; Van Kalken, Coen K; Burdorf, Alex

2013-08-09

The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. To analyze whether individual characteristics including demographics, health behavior, self-rated health, and work-related factors are associated with participation and nonparticipation in a Web-based HRA. Determinants of participation and nonparticipation were investigated in a cross-sectional study among individuals employed at five Dutch organizations. Multivariate logistic regression was performed to identify determinants of participation and nonparticipation in the HRA after controlling for organization and all other variables. Of the 8431 employees who were invited, 31.9% (2686/8431) enrolled in the HRA. The online questionnaire was completed by 27.2% (1564/5745) of the nonparticipants. Determinants of participation were some periods of stress at home or work in the preceding year (OR 1.62, 95% CI 1.08-2.42), a decreasing number of weekdays on which at least 30 minutes were spent on moderate to vigorous physical activity (OR(dayPA)0.84, 95% CI 0.79-0.90), and increasing alcohol consumption. Determinants of nonparticipation were less-than-positive self-rated health (poor/very poor vs very good, OR 0.25, 95% CI 0.08-0.81) and tobacco use (at least weekly vs none, OR 0.65, 95% CI 0.46-0.90). This study showed that with regard to isolated health behaviors (insufficient physical activity, excess alcohol consumption, and stress), those who could benefit most from the HRA were more likely to participate. However, tobacco users and those who rated their overall health as less than positive were less likely to participate. A strong communication strategy, with recruitment messages that take reasons for nonparticipation into account, could prove to be an essential tool for organizations trying to reach employees who are less likely to participate.

A Mid-Layer Model for Human Reliability Analysis: Understanding the Cognitive Causes of Human Failure Events

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

Stacey M. L. Hendrickson; April M. Whaley; Ronald L. Boring

The Office of Nuclear Regulatory Research (RES) is sponsoring work in response to a Staff Requirements Memorandum (SRM) directing an effort to establish a single human reliability analysis (HRA) method for the agency or guidance for the use of multiple methods. As part of this effort an attempt to develop a comprehensive HRA qualitative approach is being pursued. This paper presents a draft of the method’s middle layer, a part of the qualitative analysis phase that links failure mechanisms to performance shaping factors. Starting with a Crew Response Tree (CRT) that has identified human failure events, analysts identify potential failuremore » mechanisms using the mid-layer model. The mid-layer model presented in this paper traces the identification of the failure mechanisms using the Information-Diagnosis/Decision-Action (IDA) model and cognitive models from the psychological literature. Each failure mechanism is grouped according to a phase of IDA. Under each phase of IDA, the cognitive models help identify the relevant performance shaping factors for the failure mechanism. The use of IDA and cognitive models can be traced through fault trees, which provide a detailed complement to the CRT.« less

Task Decomposition in Human Reliability Analysis

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

Boring, Ronald Laurids; Joe, Jeffrey Clark

2014-06-01

In the probabilistic safety assessments (PSAs) used in the nuclear industry, human failure events (HFEs) are determined as a subset of hardware failures, namely those hardware failures that could be triggered by human action or inaction. This approach is top-down, starting with hardware faults and deducing human contributions to those faults. Elsewhere, more traditionally human factors driven approaches would tend to look at opportunities for human errors first in a task analysis and then identify which of those errors is risk significant. The intersection of top-down and bottom-up approaches to defining HFEs has not been carefully studied. Ideally, both approachesmore » should arrive at the same set of HFEs. This question remains central as human reliability analysis (HRA) methods are generalized to new domains like oil and gas. The HFEs used in nuclear PSAs tend to be top-down— defined as a subset of the PSA—whereas the HFEs used in petroleum quantitative risk assessments (QRAs) are more likely to be bottom-up—derived from a task analysis conducted by human factors experts. The marriage of these approaches is necessary in order to ensure that HRA methods developed for top-down HFEs are also sufficient for bottom-up applications.« less

Temporal uncertainty analysis of human errors based on interrelationships among multiple factors: a case of Minuteman III missile accident.

PubMed

Rong, Hao; Tian, Jin; Zhao, Tingdi

2016-01-01

In traditional approaches of human reliability assessment (HRA), the definition of the error producing conditions (EPCs) and the supporting guidance are such that some of the conditions (especially organizational or managerial conditions) can hardly be included, and thus the analysis is burdened with incomprehensiveness without reflecting the temporal trend of human reliability. A method based on system dynamics (SD), which highlights interrelationships among technical and organizational aspects that may contribute to human errors, is presented to facilitate quantitatively estimating the human error probability (HEP) and its related variables changing over time in a long period. Taking the Minuteman III missile accident in 2008 as a case, the proposed HRA method is applied to assess HEP during missile operations over 50 years by analyzing the interactions among the variables involved in human-related risks; also the critical factors are determined in terms of impact that the variables have on risks in different time periods. It is indicated that both technical and organizational aspects should be focused on to minimize human errors in a long run. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Poster - 30: Use of a Hazard-Risk Analysis for development of a new eye immobilization tool for treatment of choroidal melanoma

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

Prooijen, Monique van; Breen, Stephen

Purpose: Our treatment for choroidal melanoma utilizes the GTC frame. The patient looks at a small LED to stabilize target position. The LED is attached to a metal arm attached to the GTC frame. A camera on the arm allows therapists to monitor patient compliance. To move to mask-based immobilization we need a new LED/camera attachment mechanism. We used a Hazard-Risk Analysis (HRA) to guide the design of the new tool. Method: A pre-clinical model was built with input from therapy and machine shop personnel. It consisted of an aluminum frame placed in aluminum guide posts attached to the couchmore » top. Further development was guided by the Department of Defense Standard Practice - System Safety hazard risk analysis technique. Results: An Orfit mask was selected because it allowed access to indexes on the couch top which assist with setup reproducibility. The first HRA table was created considering mechanical failure modes of the device. Discussions with operators and manufacturers identified other failure modes and solutions. HRA directed the design towards a safe clinical device. Conclusion: A new immobilization tool has been designed using hazard-risk analysis which resulted in an easier-to-use and safer tool compared to the initial design. The remaining risks are all low probability events and not dissimilar from those currently faced with the GTC setup. Given the gains in ease of use for therapists and patients as well as the lower costs for the hospital, we will implement this new tool.« less

HRA Aerospace Challenges

NASA Technical Reports Server (NTRS)

DeMott, Diana

2013-01-01

Compared to equipment designed to perform the same function over and over, humans are just not as reliable. Computers and machines perform the same action in the same way repeatedly getting the same result, unless equipment fails or a human interferes. Humans who are supposed to perform the same actions repeatedly often perform them incorrectly due to a variety of issues including: stress, fatigue, illness, lack of training, distraction, acting at the wrong time, not acting when they should, not following procedures, misinterpreting information or inattention to detail. Why not use robots and automatic controls exclusively if human error is so common? In an emergency or off normal situation that the computer, robotic element, or automatic control system is not designed to respond to, the result is failure unless a human can intervene. The human in the loop may be more likely to cause an error, but is also more likely to catch the error and correct it. When it comes to unexpected situations, or performing multiple tasks outside the defined mission parameters, humans are the only viable alternative. Human Reliability Assessments (HRA) identifies ways to improve human performance and reliability and can lead to improvements in systems designed to interact with humans. Understanding the context of the situation that can lead to human errors, which include taking the wrong action, no action or making bad decisions provides additional information to mitigate risks. With improved human reliability comes reduced risk for the overall operation or project.

Associations among psychological distress, high-risk activism, and conflict between ethnic-racial and sexual minority identities in lesbian, gay, bisexual racial/ethnic minority adults.

PubMed

Santos, Carlos E; VanDaalen, Rachel A

2018-03-01

In this brief report, we present results from a study exploring the associations of high-risk activism (HRA) orientation in lesbian, gay, and bisexual (LGB) issues; HRA orientation in racial/ethnic issues; conflicts in allegiances (CIA) between one's ethnic-racial and sexual minority identities; and anxiety among LGB racial/ethnic minority adults. A racially and ethnically diverse sample of 208 LGB racial/ethnic minority adults (age: M = 27.52, SD = 8.76) completed an online survey. Bivariate correlations showed that HRA orientation in LGB and in racial/ethnic issues, as well as CIA, were each positively associated with anxiety. However, regression analyses indicated that CIA moderated the association between anxiety and HRA orientation in LGB issues (but not racial/ethnic minority issues) such that this association was significant and positive at low levels of CIA and nonsignificant at high levels of CIA. These findings can be used to not only inform psychological practice with this population (e.g., by encouraging practitioners to be more attentive to these issues as potential sources of stress), but also more broadly, as knowledge that can inform the burgeoning psychological literature on collective action. We highlight, for example, the importance of distinguishing between types of activism (i.e., high- vs. low-risk types) in relation to mental health outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Tailoring a Human Reliability Analysis to Your Industry Needs

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2016-01-01

Companies at risk of accidents caused by human error that result in catastrophic consequences include: airline industry mishaps, medical malpractice, medication mistakes, aerospace failures, major oil spills, transportation mishaps, power production failures and manufacturing facility incidents. Human Reliability Assessment (HRA) is used to analyze the inherent risk of human behavior or actions introducing errors into the operation of a system or process. These assessments can be used to identify where errors are most likely to arise and the potential risks involved if they do occur. Using the basic concepts of HRA, an evolving group of methodologies are used to meet various industry needs. Determining which methodology or combination of techniques will provide a quality human reliability assessment is a key element to developing effective strategies for understanding and dealing with risks caused by human errors. There are a number of concerns and difficulties in "tailoring" a Human Reliability Assessment (HRA) for different industries. Although a variety of HRA methodologies are available to analyze human error events, determining the most appropriate tools to provide the most useful results can depend on industry specific cultures and requirements. Methodology selection may be based on a variety of factors that include: 1) how people act and react in different industries, 2) expectations based on industry standards, 3) factors that influence how the human errors could occur such as tasks, tools, environment, workplace, support, training and procedure, 4) type and availability of data, 5) how the industry views risk & reliability, and 6) types of emergencies, contingencies and routine tasks. Other considerations for methodology selection should be based on what information is needed from the assessment. If the principal concern is determination of the primary risk factors contributing to the potential human error, a more detailed analysis method may be employed versus a requirement to provide a numerical value as part of a probabilistic risk assessment. Industries involved with humans operating large equipment or transport systems (ex. railroads or airlines) would have more need to address the man machine interface than medical workers administering medications. Human error occurs in every industry; in most cases the consequences are relatively benign and occasionally beneficial. In cases where the results can have disastrous consequences, the use of Human Reliability techniques to identify and classify the risk of human errors allows a company more opportunities to mitigate or eliminate these types of risks and prevent costly tragedies.

Lost in Translation: the Case for Integrated Testing

NASA Technical Reports Server (NTRS)

Young, Aaron

2017-01-01

The building of a spacecraft is complex and often involves multiple suppliers and companies that have their own designs and processes. Standards have been developed across the industries to reduce the chances for critical flight errors at the system level, but the spacecraft is still vulnerable to the introduction of critical errors during integration of these systems. Critical errors can occur at any time during the process and in many cases, human reliability analysis (HRA) identifies human error as a risk driver. Most programs have a test plan in place that is intended to catch these errors, but it is not uncommon for schedule and cost stress to result in less testing than initially planned. Therefore, integrated testing, or "testing as you fly," is essential as a final check on the design and assembly to catch any errors prior to the mission. This presentation will outline the unique benefits of integrated testing by catching critical flight errors that can otherwise go undetected, discuss HRA methods that are used to identify opportunities for human error, lessons learned and challenges over ownership of testing will be discussed.

Defining Human Failure Events for Petroleum Risk Analysis

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

Ronald L. Boring; Knut Øien

2014-06-01

In this paper, an identification and description of barriers and human failure events (HFEs) for human reliability analysis (HRA) is performed. The barriers, called target systems, are identified from risk significant accident scenarios represented as defined situations of hazard and accident (DSHAs). This report serves as the foundation for further work to develop petroleum HFEs compatible with the SPAR-H method and intended for reuse in future HRAs.

Top-down and bottom-up definitions of human failure events in human reliability analysis

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

Boring, Ronald Laurids

2014-10-01

In the probabilistic risk assessments (PRAs) used in the nuclear industry, human failure events (HFEs) are determined as a subset of hardware failures, namely those hardware failures that could be triggered by human action or inaction. This approach is top-down, starting with hardware faults and deducing human contributions to those faults. Elsewhere, more traditionally human factors driven approaches would tend to look at opportunities for human errors first in a task analysis and then identify which of those errors is risk significant. The intersection of top-down and bottom-up approaches to defining HFEs has not been carefully studied. Ideally, both approachesmore » should arrive at the same set of HFEs. This question is crucial, however, as human reliability analysis (HRA) methods are generalized to new domains like oil and gas. The HFEs used in nuclear PRAs tend to be top-down—defined as a subset of the PRA—whereas the HFEs used in petroleum quantitative risk assessments (QRAs) often tend to be bottom-up—derived from a task analysis conducted by human factors experts. The marriage of these approaches is necessary in order to ensure that HRA methods developed for top-down HFEs are also sufficient for bottom-up applications.« less

Panel Discussion: New Directions in Human Reliability Analysis for Oil & Gas, Cybersecurity, Nuclear, and Aviation

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

Harold S. Blackman; Ronald Boring; Julie L. Marble

This panel will discuss what new directions are necessary to maximize the usefulness of HRA techniques across different areas of application. HRA has long been a part of Probabilistic Risk Assessment in the nuclear industry as it offers a superior standard for risk-based decision-making. These techniques are continuing to be adopted by other industries including oil & gas, cybersecurity, nuclear, and aviation. Each participant will present his or her ideas concerning industry needs followed by a discussion about what research is needed and the necessity to achieve cross industry collaboration.

Fundus autofluorescence findings in central serous chorioretinopathy using two different confocal scanning laser ophthalmoscopes: correlation with functional and structural status.

PubMed

Shin, Joo Youn; Choi, Hun Jin; Lee, Jonghyun; Choi, Moonjung; Chung, Byunghoon; Byeon, Suk Ho

2016-08-01

To compare autofluorescence (AF) findings using wide-field (Optomap) and conventional (HRA-AF) confocal scanning laser ophthalmoscopy (cSLO) systems in patients with central serous chorioretinopathy (CSC), and to investigate the correlations between AF findings and functional and anatomical status. Optical coherence tomography (OCT) and AF images were compared in 73 eyes with serous retinal detachment (SRD) (group A) and 30 eyes without SRD (group B). We evaluated AF findings from the SRD region, atrophic area, and foveola. Correlations between AF findings and outer retinal abnormalities in OCT and visual acuity (VA) were analyzed. Optomap-AF was more effective than HRA-AF in identifying the margins of a detached area (P = 0.001) in group A, and for monitoring mild outer retinal damage (P = 0.041) in group B. The foveolar AF grades in both instruments were significantly correlated with VA and central foveal thickness (CFT) in both group A (Optomap, VA r s = 0.33, P = 0.012; CFT r s = -0.38, P = 0.002; HRA, VA r s = 0.62, P < 0.001; CFT r s = -0.70, P < 0.001) and group B (Optomap, VA r s = 0.71, P < 0.001, CFT r s = -0.78, P < 0.001; HRA, VA r s = 0.40, P = 0.026, CFT r s = -0.40, P = 0.030). Optomap-AF was found to be advantageous for monitoring subretinal status in eyes with SRD, and more accurately reflected mild outer retinal changes in eyes without SRD. Foveolar AF grades of both imaging modalities were significantly correlated with functional and anatomical status.

Factors Associated with High-Grade Anal Intraepithelial Lesion in HIV-Positive Men in a Southern U.S. City.

PubMed

Frank, Melanie; Lahiri, Cecile D; Nguyen, Minh Ly; Mehta, Cyra Christina; Mosunjac, Marina; Flowers, Lisa

2018-05-02

The incidence of anal cancer is increased in HIV-infected patients compared with the general population. Risk factors associated with the anal cancer precursor, high-grade squamous intraepithelial lesion (HSIL), have not been extensively studied in an urban black population with late-stage HIV disease. We performed a retrospective chart review of HIV-infected men at the Grady Ponce de Leon Center HIV Clinic (Atlanta, GA) referred for high-resolution anoscopy (HRA), a procedure where anal tissue is examined under magnification and abnormal areas are biopsied. Between December 2013 and September 2015, 147 men underwent HRA: 72% were black, and 94% were men who have sex with men. CD4 count closest to time of HRA was a median 325 cells/mm 3 (interquartile range 203-473), and 69% had an undetectable HIV viral load. Ninety-four percent had abnormal anal cytology [80% atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (LSIL) and 20% atypical squamous cells, cannot exclude HSIL/HSIL], and 97% had abnormal histology (35% LSIL, 65% HSIL). Statistically significant variables associated with HSIL included number of biopsies [odds ratio (OR) 1.55, 95% confidence interval (CI) 1.13-2.14] and having ≥1 high-grade anal cytology in the last 12 months (OR 3.76, 95% CI 1.38-10.23). No significant association was found between HSIL and CD4, HIV viral load, or recent sexually transmitted infection. In this population, the burden of anal HSIL was extremely high, regardless of most recent anal cytology result. In newly diagnosed HIV-infected men with no history of anal cancer screening, performing HRA as primary anal cancer screening instead of cytology appears to be a viable option.

The Study of the Prevention of Anal Cancer (SPANC): design and methods of a three-year prospective cohort study

PubMed Central

2013-01-01

Background The incidence of human papillomavirus (HPV)-associated anal cancer is increasing in men who have sex with men (MSM). Screening for the presumed cancer precursor, high-grade anal squamous intraepithelial lesions (HSIL) in a manner analogous to cervical cancer screening has been proposed. Uncertainty remains regarding anal HPV natural history and the role of anal cytology and high-resolution anoscopy (HRA) as screening tests. Well-designed cohort studies are required to address these issues. Methods/design The SPANC study is a prospective study of the epidemiology of low-risk and high-risk anal HPV infection and related cytological and histological abnormalities in HIV-negative and HIV-positive homosexual men aged 35 years and over. The study aims to recruit 600 men from community-based settings in Sydney, Australia. There are six study visits over three years. At the first five visits men undergo a digital ano-rectal examination (DARE), an anal “Papanicolaou” (Pap) test for HPV detection, genotyping and anal cytology, followed by HRA and directed biopsy of any visible abnormalities. The men also complete a behavioural questionnaire before each visit. Questions include a detailed history of sexual behaviour, of anal symptoms, possible anal cancer risk factors and validated quality of life and psychosocial questions. Questionnaires are also completed 2 weeks and 3 months following the provision of test results and include questions on participant experience during the procedure and post-procedure symptoms, including pain and bleeding in addition to quality of life/ psychosocial outcomes. Discussion Recruitment for the study began in September 2010 and will conclude in mid-2015, with follow up continuing to 2018. Thus far, over 350 men have been recruited from a variety of community-based settings and are broadly representative of the target screening population. The SPANC study is one of only a small number of cohort studies globally to perform HPV, cytology and HRA screening on all participants over multiple time points. The study results will contribute to understanding of the natural history of anal HPV and inform the possible development of guidelines for implementing anal cancer screening programs in this population. PMID:24107134

Relationship between Physical Inactivity and Health Characteristics among Participants in an Employee Wellness Program

PubMed Central

Birdee, Gurjeet S.; Byrne, Daniel W.; McGown, Paula W.; Rothman, Russell L.; Rolando, Lori A.; Holmes, Marilyn C.; Yarbrough, Mary I.

2013-01-01

Objective To characterize factors associated with physical inactivity among employees with access to workplace wellness program. Methods We examined data on physical inactivity, defined as exercise less than once a week, from the 2010 health risk assessment (HRA) completed by employees at a major academic institution (n=16,976). Results Among employees, 18% individuals reported physical activity less than once a week. Individuals who were physically inactive as compared with physically active reported higher prevalence of cardiovascular diseases (AOR 1.36 [1.23–1.51], fair or poor health status (AOR 3.52 [2.97–4.17]) and absenteeism from work (AOR 1.59 [1.41–1.79]). Overall, physically inactive employees as compared to physically active employees reported more interest in health education programs. Conclusions Future research is needed to address barriers to physical inactivity to improve employee wellness and potentially lower health utility costs. PMID:23618884

The role of health-risk appraisals in disease management.

PubMed

Hudson, Laurel R; Pope, James E

2006-02-01

Managed care organizations and disease management vendors often find themselves in the position of responding to employers who want to administer a health-risk appraisal (HRA) without committing to implementation of a comprehensive health promotion program. The assumption appears to be that information on health risks is sufficient to motivate employees to change their health behaviors in order to reduce estimated health risks. A review of the relevant literature does not substantiate the efficacy of a stand-alone HRA for motivating behavior change. The challenge is to engage employers in informed conversations on what works in health promotion and achieve cost-effective benefits.

Hybrid employment recommendation algorithm based on Spark

NASA Astrophysics Data System (ADS)

Li, Zuoquan; Lin, Yubei; Zhang, Xingming

2017-08-01

Aiming at the real-time application of collaborative filtering employment recommendation algorithm (CF), a clustering collaborative filtering recommendation algorithm (CCF) is developed, which applies hierarchical clustering to CF and narrows the query range of neighbour items. In addition, to solve the cold-start problem of content-based recommendation algorithm (CB), a content-based algorithm with users’ information (CBUI) is introduced for job recommendation. Furthermore, a hybrid recommendation algorithm (HRA) which combines CCF and CBUI algorithms is proposed, and implemented on Spark platform. The experimental results show that HRA can overcome the problems of cold start and data sparsity, and achieve good recommendation accuracy and scalability for employment recommendation.

Design and baseline characteristics of the PerfectFit study: a multicenter cluster-randomized trial of a lifestyle intervention in employees with increased cardiovascular risk.

PubMed

Kouwenhoven-Pasmooij, Tessa A; Djikanovic, Bosiljka; Robroek, Suzan J W; Helmhout, Pieter; Burdorf, Alex; Hunink, M G Myriam

2015-07-28

The prevalence of unhealthy lifestyles and preventable chronic diseases is high. They lead to disabilities and sickness absence, which might be reduced if health promotion measures were applied. Therefore, we developed the PerfectFit health promotion intervention with a "blended care"-approach, which consists of a web-based health risk assessment (HRA) including tailored and personalized advice, followed by motivational interviewing (MI). We hypothesize that adding MI to a web-based HRA leads to better health outcomes. The objective is to describe the design and baseline characteristics of the PerfectFit study, which is being conducted among employees with high cardiovascular risk in the military workforce, the police organization and an academic hospital. PerfectFit is a cluster randomized controlled trial, consisting of two arms. Based on cardiovascular risk profiling, done between 2012 and 2014, we included employees based on one or more risk factors and motivation to participate. One arm is the 'limited' health program (control) that consists of: (a) an HRA as a decision aid for lifestyle changes, including tailored and personalized advice, and pros and cons of the options, and (b) a newsletter every 3 months. The other arm is the 'extensive' program (intervention), which is additionally offered MI-sessions by trained occupational physicians, 4 face-to-face and 3 by telephone, and is offered more choices of health promotion activities in the HRA. During the follow-up period, participants choose the health promotion activities they personally prefer. After six and twelve months, outcomes will be assessed by online questionnaires. After twelve months the cardiovascular risk profiling will be repeated. The primary outcome is self-reported general health. Secondary outcomes are self-reported work ability, CVD-risk score, sickness absence, productivity loss at work, participation in health promotion activities, changes in lifestyle (smoking, alcohol consumption, physical activity, stress management) and body mass index. Furthermore, a process evaluation and an economic analysis will be performed. Additional coaching using MI is expected to be a key factor for success of the web-based HRA in employees with increased cardiovascular risk. This "blended care"-approach may be an essential strategy for effective health promotion activities. Dutch Trial Register by registration number NTR4894 , 14/11/2014.

Color Doppler sonography and angioscintigraphy in hepatic Hodgkin’s lymphoma

PubMed Central

Stojković, Mirjana V; Artiko, Vera M; Radoman, Irena B; Knežević, Slavko J; Lukić, Snezana M; Kerkez, Mirko D; Lekić, Nebojsa S; Antić, Andrija A; Žuvela, Marinko M; Ranković, Vitomir I; Petrović, Milorad N; Šobić, Dragana P; Obradović, Vladimir B

2009-01-01

AIM: To estimate the characteristics of Color Doppler findings and the results of hepatic radionuclide angiography (HRA) in secondary Hodgkin’s hepatic lymphoma. METHODS: The research included patients with a diagnosis of Hodgkin’s lymphoma with metastatic focal lesions in the liver and controls. Morphologic characteristics of focal liver lesions and hemodynamic parameters were examined by pulsed and Color Doppler in the portal, hepatic and splenic veins were examined. Hepatic perfusion index (HPI) estimated by HRA was calculated. RESULTS: In the majority of patients, hepatomegaly was observed. Lesions were mostly hypoechoic and mixed, solitary or multiple. Some of the patients presented with dilated splenic veins and hepatofugal blood flow. A pulse wave was registered in the centre and at the margins of lymphoma. The average velocity of the pulse wave was higher at the margins (P > 0.05). A continuous venous wave was found only at the margins of lymphoma. There was no linear correlation between lymphoma size and velocity of pulse and continuous wave (r = 390, P < 0.01). HPI was significantly lower in patients with lymphomas than in controls (P < 0.05), pointing out increased arterial perfusion in comparison to portal perfusion. CONCLUSION: Color Doppler ultrasonography is a sensitive method for the detection of neovascularization in Hodgkin’s hepatic lymphoma and estimation of its intensity. Hepatic radionuclide angiography can additionally help in the assesment of vascularisation of liver lesions. PMID:19598303

Adherence to cancer screening guidelines and predictors of improvement among participants in the Kansas State Employee Wellness Program.

PubMed

Hui, Siu-kuen Azor; Engelman, Kimberly K; Shireman, Theresa I; Ellerbeck, Edward F

2013-07-11

Employee wellness programs (EWPs) have been used to implement worksite-based cancer prevention and control interventions. However, little is known about whether these programs result in improved adherence to cancer screening guidelines or how participants' characteristics affect subsequent screening. This study was conducted to describe cancer screening behaviors among participants in a state EWP and identify factors associated with screening adherence among those who were initially nonadherent. We identified employees and their dependents who completed health risk assessments (HRAs) as part of the Kansas state EWP in both 2008 and 2009. We examined baseline rates of adherence to cancer screening guidelines in 2008 and factors associated with adherence in 2009 among participants who were initially nonadherent. Of 53,095 eligible participants, 13,222 (25%) participated in the EWP in 2008 and 6,205 (12%) participated in both years. Among the multiyear participants, adherence was high at baseline to screening for breast (92.5%), cervical (91.8%), and colorectal cancer (72.7%). Of participants who were initially nonadherent in 2008, 52.4%, 41.3%, and 33.5%, respectively, became adherent in the following year to breast, cervical, and colorectal cancer screening. Suburban/urban residence and more frequent doctor visits predicted adherence to breast and colorectal cancer screening guidelines. The effectiveness of EWPs for increasing cancer screening is limited by low HRA participation rates, high rates of adherence to screening at baseline, and failure of nonadherent participants to get screening. Improving overall adherence to cancer screening guidelines among employees will require efforts to increase HRA participation, stronger interventions for nonadherent participants, and better access to screening for rural employees.

A Focus Group Assessment to Determine Motivations, Barriers and Effectiveness of a University-Based Worksite Wellness Program

PubMed Central

Hill-Mey, Patricia E.; Merrill, Ray M.; Kumpfer, Karol L.; Reel, Justine; Hyatt-Neville, Beverly

2013-01-01

Background: This study explores university employee perceptions and under­standing about its Worksite Health Promotion Program (WHPP). The WHPP included a Health Risk Appraisal (HRA), biometric screening, publicity for on-campus health programs and facilities, and health coaching. Methods: A qualitative design was used based on a grounded theory ap­proach. Four 90 minutes focus groups with 6-8 participants in each were conducted within a two 2 week period among employees, representing fac­ulty/participants, fac­ulty/nonparticipants, staff/participants, and staff/nonparticipants. Responses to questions about motivations, barriers, and perceived health benefits that impacted participation in the WHPP were digi­tally recorded, transcribed and coded for themes. Results: Incentives effectively motivated participation. Biometric screening had the largest impact on behavior change, followed by the information learned from the HRA. However, despite two-thirds of the employees partici­pating in the pro­gram, lack of a full understanding of WHPP benefits and services lowered partici­pation in follow-up services and supplemental pro­grams. Conclusions: Biometric screening and HRAs effectively motivate program par­ticipation. Communication of benefits and services are important when providing WHPPs. PMID:24688965

Monitoring emerging contaminants in the drinking water of Milan and assessment of the human risk.

PubMed

Riva, Francesco; Castiglioni, Sara; Fattore, Elena; Manenti, Angela; Davoli, Enrico; Zuccato, Ettore

2018-04-01

Emerging Contaminants (ECs) are ubiquitous in waters, arousing concern because of their potential risks for human health and the environment. This study investigated the presence of multiple classes of ECs in 21 wells over the drinking water network of Milan, in the most inhabited and industrialized area of Italy, and assessed the risks for consumers. Samples were analyzed using liquid chromatography coupled to mass spectrometry. Human risk assessment (HRA) was conducted by comparing the measured concentrations with drinking water thresholds from guidelines or calculated in this study; first considering the exposure to each single EC and then the entire mixture. Thirteen ECs were measured in the low ng/L range, and were generally detected in less than half of the wells. Pharmaceuticals, perfluorinated substances, personal care products, and anthropogenic markers were the most frequently detected. The results of the HRA excluded any risks for consumers in each scenario considered. This is one of the most comprehensive studies assessing the presence of a large number of ECs in the whole drinking water network of a city, and the risks for human health. Results improve the limited information on ECs sources and occurrence in drinking water and help establishing guidelines for regulatory purposes. Copyright © 2018 Elsevier GmbH. All rights reserved.

Ketoconazole inhibits the in vitro and in vivo metabolism of all-trans-retinoic acid

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

Van Wauwe, J.P.; Coene, M.C.; Goossens, J.

1988-05-01

Ketoconazole, an antifungal agent and inhibitor of certain mammalian cytochrome P-450-dependent enzymes, was studied for its effects on the in vitro and in vivo metabolism of all-trans-retinoic acid (RA). In vitro, ketoconazole (Ki = 0.75 microM) inhibited, in an apparently competitive manner, the cytochrome P-450-mediated metabolism to 4-hydroxy- and 4-keto-retinoic acids by hamster liver microsomes. In vivo, ketoconazole suppressed the formation of polar RA metabolites by normal rats dosed intrajugularly with 200 ng of (/sup 3/H)RA. After p.o. treatment with ketoconazole (2.5-40 mg/kg) given 1 hr before the (/sup 3/H)RA injection, the radioactivity extracted from the liver consisted of 25more » to 50% polar metabolites (control 66 +/- 1%) and 50 to 75% undegraded RA (control 34 +/- 1%) as evidenced by reverse-phase high-performance liquid chromatography. Time course experiments showed that ketoconazole's inhibitory effects lasted for 3 hr. Our data indicate the quantitative importance of the cytochrome P-450 enzymatic pathway in the biotransformation of RA. They also suggest that ketoconazole is capable of prolonging the biological half-life of RA and of improving the tissue levels of this compound.« less

Atypical lateralization of ERP response to native and non-native speech in infants at risk for autism spectrum disorder.

PubMed

Seery, Anne M; Vogel-Farley, Vanessa; Tager-Flusberg, Helen; Nelson, Charles A

2013-07-01

Language impairment is common in autism spectrum disorders (ASD) and is often accompanied by atypical neural lateralization. However, it is unclear when in development language impairment or atypical lateralization first emerges. To address these questions, we recorded event-related-potentials (ERPs) to native and non-native speech contrasts longitudinally in infants at risk for ASD (HRA) over the first year of life to determine whether atypical lateralization is present as an endophenotype early in development and whether these infants show delay in a very basic precursor of language acquisition: phonemic perceptual narrowing. ERP response for the HRA group to a non-native speech contrast revealed a trajectory of perceptual narrowing similar to a group of low-risk controls (LRC), suggesting that phonemic perceptual narrowing does not appear to be delayed in these high-risk infants. In contrast there were significant group differences in the development of lateralized ERP response to speech: between 6 and 12 months the LRC group displayed a lateralized response to the speech sounds, while the HRA group failed to display this pattern. We suggest the possibility that atypical lateralization to speech may be an ASD endophenotype over the first year of life. Copyright © 2012 Elsevier Ltd. All rights reserved.

The effect of atrial pacing site on electrophysiological properties of the atrioventricular junction and induction of atrioventricular nodal reentry in patients with typical atrioventricular nodal reentrant tachycardia.

PubMed

Kiedrowicz, Radosław M; Kaźmierczak, Jarosław; Wielusiński, Maciej

2017-01-01

Clinical studies in humans have shown the site of atrial stimulation to influence atrioventricular (AV) conduction times and refractory periods, the demonstration of dual AV nodal (AVN) pathways, and induction of AVN reentry. These studies often found conflicting results. Moreover, among enrolled patients a minority of them were found to have AVN reentrant tachycardia (AVNRT). The purpose of this study was to investigate the effect of right and left atrial pacing on the electrophysiological properties of the AV junction in the typical AVNRT population. Ninety-two consecutive patients with typical AVNRT were included. Atrial pacing was performed from the high right atrium (HRA) and the left atrium via the proximal coronary sinus (CS). Stimulation from either the HRA or the CS could result in dual AVN physiology and AVNRT. No site-dependent differences in the ease of induction of dual AVN pathways with variability of initiation from either site were found. However, AVNRT was easier to induce from the HRA. With CS pacing the leftward but not the rightward AVN approaches were the entry point to the AV node because of significantly shorter AH conduction times compared to HRA pacing. Conduction over the leftward AVN extensions could initiate the tachycardia with significantly shorter critical AH interval compared to conduction over the rightward AVN extensions; however, the AH interval during AVNRT and its cycle length were not significantly different. Rightward and leftward AVN extensions are regular features of the AV node. Their different electrophysiological properties lead to variation in the demonstration of discontinuous AVN conduction and AVNRT during right and left atrial pacing. Despite the observation that the left AVN extensions could compose the entry point to the reentrant circuit, there is no evidence that they constitute the critical component of sustained typical AVNRT.

The Effects of Non-Contingent Feedback on the Incidence of Plateau at V̇O2max.

PubMed

Gordon, Dan; Gernigon, Marie; Baker, James; Merzbach, Viviane; Scruton, Adrian

2017-03-01

The purpose of this study was to examine the effects of non-contingent feedback in the form of heart rate (HR) on the incidence of plateau at V̇O 2max . Ten physically active males (age 24.8 yrs ± 4.2; mass 81.4 ± 9.0 kg; stature 1.80 ± 0.11 m, V̇O 2max 53.2 ± 5.8 ml·kg -1. min -1 ) who were V̇O 2max testing naïve but were cognisant as to the heart rate responses to exercise completed four incremental tests to volitional exhaustion, separated by ~72 h for the determination of V̇O 2max and gas exchange threshold. The first trial served as a familiarisation with the remaining three being experimental conditions where HR was presented in a screen projection as either the actual response (HR-A) or 10 b·min -1 higher than recorded (HR-H) or 10 b·min -1 lower (HR-L). Throughout all trials V̇O 2 was recorded on a breath-by-breath basis with plateau criteria of ≤ 50 ml·min -1 . A significant difference was observed for Δ V̇O 2 over the final two consecutive 30s sampling periods between HR-A, both HR-L and HR-H (p = 0.049) and for the incidence of plateau response between condition (p = 0.021). An additional significant difference was observed for sub-maximal Δ V̇O 2 responses between HR-A and HR-H (p = 0.049) and HR-A and HR-L (p = 0.006). Non-significant differences were observed for all other criteria. These data indicate that when presented with non-contingent feedback in the form of HR, that the perceptually orientated pacing schema becomes disrupted promoting a sparing of the finite anaerobic capacity to compensate for the imbalance between the afferent signal and perception of effort.

Central serous chorioretinopathy fundus autofluorescence comparison with two different confocal scanning laser ophthalmoscopes.

PubMed

Nam, Ki Tae; Yun, Cheol Min; Kim, Jee Taek; Yang, Kyung-Sook; Kim, Hyun Joo; Kim, Seong-Woo; Oh, Jaeryung; Huh, Kuhl

2015-12-01

To compare the lesion characteristics of two different types of confocal scanning laser ophthalmoscopy (cSLO) autofluorescence (AF) images in central serous chorioretinopathy (CSC). The study included 63 eyes of 61 patients; 63 pairs of fundus autofluorescence (FAF) images were compared before CSC resolution in 63 eyes, FAF images of 31 eyes were also compared after CSC resolution. The lesion characteristics (brightness and composite pattern) were compared between Heidelberg Retina Angiograph 2 (HRA2; Heidelberg Engineering, Germany) and Optomap Tx (Optomap; Optos, Scotland) FAF images. The lesion composite pattern was categorized as diffuse or granular. Diffuse AF was defined as homogenously increased or decreased AF, and granular AF was defined as dot-like, coarse changes in AF. The mean disease duration and subretinal fluid (SRF) height in the spectral domain optical coherence tomography were compared according to the FAF image characteristics. Lesion brightness before CSC resolution was hypo-AF in 48 eyes (76.2 %), hyper-AF in three (4.8 %), and mixed-AF in 12 (19.0 %) in HRA2 FAF images. In comparison, nine (14.3 %) images were hypo-AF, 44 (69.8 %) were hyper-AF, and 10 (15.9 %) were mixed-AF in Optomap FAF images (P < 0.0001). There was no significant difference in lesion composite pattern between the two FAF image wavelengths. Patients with lesions that were hyper-AF in Optomap FAF and hypo-AF in HRA2 FAF had a shorter disease duration and greater SRF height (1 month, 281 um) than those who were hyper-AF in both Optomap and HRA2 images (26 months, 153 um; P = 0.004, 0.001). The two types of FAF images of CSC showed different lesion brightness before and after CSC resolution but demonstrated similar lesion composite patterns.

The association of two productivity measures with health risks and medical conditions in an Australian employee population.

PubMed

Musich, Shirley; Hook, Dan; Baaner, Stephanie; Edington, Dee W

2006-01-01

To investigate the impact of health on job performance using two measures of productivity loss: (1) a self-reported measure of health-related presenteeism and (2) an objective measure of absenteeism. A cross-sectional survey using a Health Risk Appraisal (HRA) to evaluate self-reported presenteeism and the prevalence of 12 health risks and eight medical conditions. Employees (n=224) of a private insurance provider in Australia. A Health Risk Appraisal (HRA) questionnaire was used to evaluate self-reported presenteeism on different aspects of job demands and to assess the prevalence of 12 health risks and eight medical conditions. Illness absent hours were obtained from company administrative records. Increased presenteeism was significantly associated with high stress, life dissatisfaction, and back pain, while increased illness absenteeism was significantly associated with overweight, poor perception of health, and diabetes. Excess presenteeism associated with excess health risks (productivity loss among those with medium- or high-risk status compared to those with low-risk status) was independently calculated at 19.0% for presenteeism and 12.8% for illness absenteeism. This study demonstrates an association between health metrics and self-reported work impairment (presenteeism) and measured absenteeism. The study provides a first indication of the potential benefits of health promotion programming to Australian employees in improving health and to the corporation in minimizing health-related productivity loss.

The effectiveness and cost-effectiveness of a rural employer-based wellness program.

PubMed

Saleh, Shadi S; Alameddine, Mohamad S; Hill, Dan; Darney-Beuhler, Jessica; Morgan, Ann

2010-01-01

The cost-effectiveness of employer-based wellness programs has been previously investigated with favorable financial and nonfinancial outcomes being detected. However, these investigations have mainly focused on large employers in urban settings. Very few studies examined wellness programs offered in rural settings. This paper aims to explore the effectiveness and cost-effectiveness of a rural employer-based wellness program. Six rural employers were categorized into 3 groups: a control group and 2 intervention groups with varying degrees of wellness activities. Participants were asked to complete an annual health risk assessment (HRA) that addressed 16 wellness areas. At the conclusion of 4 years, HRA and effectiveness data were utilized to examine program effectiveness and combined with program costs to estimate cost-effectiveness. The "Coaching and Referral" group-the highest in intensity of participant engagement-exhibited superior improvement in several wellness areas and in percentage of employees with good health indicators compared to the control and the Trail Marker, lower-intensity intervention groups. However, the Trail Markers had more favorable cost-effectiveness ratios. Rural worksite wellness programs have shown great potential in their effectiveness and cost-effectiveness. Such programs need not be too aggressive, tedious, and costly to generate a favorable return for employers and funders. However, employers should be encouraged to experiment with different levels of wellness program intensities until a more favorable outcome can be realized.

The association of corporate work environment factors, health risks, and medical conditions with presenteeism among Australian employees.

PubMed

Musich, Shirley; Hook, Dan; Baaner, Stephanie; Spooner, Michelle; Edington, Dee W

2006-01-01

To investigate the impact of selected corporate environment factors, health risks, and medical conditions on job performance using a self-reported measure of presenteeism. A cross-sectional survey utilizing health risk appraisal (HRA) data merging presenteeism with corporate environment factors, health risks, and medical conditions. Approximately 8000 employees across ten diverse Australian corporations. Employees (N = 1523; participation rate, 19%) who completed an HRA questionnaire. Self-reported HRA data were used to test associations of defined adverse corporate environment factors with presenteeism. Stepwise multivariate logistic regression modeling assessed the relative associations of corporate environment factors, health risks, and medical conditions with increased odds of any presenteeism. Increased presenteeism was significantly associated with poor working conditions, ineffective management/leadership, and work/life imbalance (adjusting for age, gender, health risks, and medical conditions). In multivariate logistic regression models, work/life imbalance, poor working conditions, life dissatisfaction, high stress, back pain, allergies, and younger age were significantly associated with presenteeism. Although the study has some limitations, including a possible response bias caused by the relatively low participation rate across the corporations, the study does demonstrate significant associations between corporate environment factors, health risks, and medical conditions and self-reported presenteeism. The study provides initial evidence that health management programming may benefit on-the-job productivity outcomes if expanded to include interventions targeting work environments.

Brillouin Light Scattering study of the rotatable magnetic anisotropy in exchange biased bilayers of Ni81 Fe19 Ir20 Mn80

NASA Astrophysics Data System (ADS)

Rodríguez, Roberto; Oliveira, Alexandre; Estrada, Francisco; Santos, Obed; Azevedo, Antonio; Rezende, Sergio

It is known that when a ferromagnet (FM) is in atomic contact with an antiferromagnet (AF) the exchange coupling between the FM and AF spins at the interface induces a unidirectional anisotropy in the ferromagnetic film. This effect is known as exchange bias (EB). Despite the large amount of research on this topic there are still several aspects of the EB mechanism that are not well understood. One of this aspects is the origin of the rotatable anisotropy in polycrystalline AFs. By means of Brillouin Light Scattering (BLS) measurements, we investigated the dependence of the rotatable anisotropy field HRA and exchange field HE with the magnitude of the external magnetic field (Ho) in FM/AM bilayers of Ni81Fe19(10nm)/Ir20Mn80(tAF) . We developed an algorithm to numerically fit the in-plane angular dependence of the magnon frequency, at a fixed value of Ho measured by BLS. From the fit parameters we were able to investigate HRA and HE dependency on Ho. The results reveal that HRA value depends on Ho, so we argue that AF grain distribution at the interface is partially modified by the applied field strength. Contrary to this, the relation between HE and Ho is not straightforward, remaining constant at high values of Ho.

Marker-based or model-based RSA for evaluation of hip resurfacing arthroplasty? A clinical validation and 5-year follow-up.

PubMed

Lorenzen, Nina Dyrberg; Stilling, Maiken; Jakobsen, Stig Storgaard; Gustafson, Klas; Søballe, Kjeld; Baad-Hansen, Thomas

2013-11-01

The stability of implants is vital to ensure a long-term survival. RSA determines micro-motions of implants as a predictor of early implant failure. RSA can be performed as a marker- or model-based analysis. So far, CAD and RE model-based RSA have not been validated for use in hip resurfacing arthroplasty (HRA). A phantom study determined the precision of marker-based and CAD and RE model-based RSA on a HRA implant. In a clinical study, 19 patients were followed with stereoradiographs until 5 years after surgery. Analysis of double-examination migration results determined the clinical precision of marker-based and CAD model-based RSA, and at the 5-year follow-up, results of the total translation (TT) and the total rotation (TR) for marker- and CAD model-based RSA were compared. The phantom study showed that comparison of the precision (SDdiff) in marker-based RSA analysis was more precise than model-based RSA analysis in TT (p CAD < 0.001; p RE = 0.04) and TR (p CAD = 0.01; p RE < 0.001). The clinical precision (double examination in 8 patients) comparing the precision SDdiff was better evaluating the TT using the marker-based RSA analysis (p = 0.002), but showed no difference between the marker- and CAD model-based RSA analysis regarding the TR (p = 0.91). Comparing the mean signed values regarding the TT and the TR at the 5-year follow-up in 13 patients, the TT was lower (p = 0.03) and the TR higher (p = 0.04) in the marker-based RSA compared to CAD model-based RSA. The precision of marker-based RSA was significantly better than model-based RSA. However, problems with occluded markers lead to exclusion of many patients which was not a problem with model-based RSA. HRA were stable at the 5-year follow-up. The detection limit was 0.2 mm TT and 1° TR for marker-based and 0.5 mm TT and 1° TR for CAD model-based RSA for HRA.

Development of a risk assessment tool for projecting individualized probabilities of developing breast cancer for Chinese women.

PubMed

Wang, Yuan; Gao, Ying; Battsend, Munkhzul; Chen, Kexin; Lu, Wenli; Wang, Yaogang

2014-11-01

The optimal approach regarding breast cancer screening for Chinese women is unclear due to the relative low incidence rate. A risk assessment tool may be useful for selection of high-risk subsets of population for mammography screening in low-incidence and resource-limited developing country. The odd ratios for six main risk factors of breast cancer were pooled by review manager after a systematic research of literature. Health risk appraisal (HRA) model was developed to predict an individual's risk of developing breast cancer in the next 5 years from current age. The performance of this HRA model was assessed based on a first-round screening database. Estimated risk of breast cancer increased with age. Increases in the 5-year risk of developing breast cancer were found with the existence of any of included risk factors. When individuals who had risk above median risk (3.3‰) were selected from the validation database, the sensitivity is 60.0% and the specificity is 47.8%. The unweighted area under the curve (AUC) was 0.64 (95% CI = 0.50-0.78). The risk-prediction model reported in this article is based on a combination of risk factors and shows good overall predictive power, but it is still weak at predicting which particular women will develop the disease. It would be very helpful for the improvement of a current model if more population-based prospective follow-up studies were used for the validation.

75 FR 22146 - Advisory Committee for Reproductive Health Drugs; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

..., 30 milligrams (mg), by Laboratoire HRA Pharma. Ulipristal is an emergency contraceptive for the... suspected contraceptive failure. FDA intends to make background material available to the public no later...

Correlation between Spectral Optical Coherence Tomography and Fundus Autofluorescence at the margins of Geographic Atrophy

PubMed Central

Brar, Manpreet; Kozak, Igor; Cheng, Lingyun; Bartsch, Dirk-Uwe G.; Yuson, Ritchie; Nigam, Nitin; Oster, Stephen F.; Mojana, Francesca; Freeman, William R.

2009-01-01

Purpose We studied the appearance of margins of Geographic atrophy in high- resolution optical coherence tomography (OCT) images and correlate those changes with fundus autofluorescence imaging. Design Retrospective observational case study. Methods Patients with geographic atrophy secondary to dry age related macular degeneration (ARMD) were assessed by means of Spectral Domain OCT (Spectralis HRA/OCT; Heidelberg Engineering, Heidelberg, Germany or OTI, Inc, Toronto, Canada) as well as Autofluoresence Imaging (HRA or Spectralis Heidelberg Engineering, Heidelberg, Germany): The outer retinal layer alterations were analyzed in the junctional zone between normal retina and atrophic retina, and correlated with corresponding fundus autofluorescence. Results 23 eyes of 16 patients aged between 62 years to 96 years were examined. There was a significant association between OCT findings and the fundus autofluorescence findings(r=0.67, p<0.0001). Severe alterations of the outer retinal layers at margins on Spectral OCT correspond significantly to increased autofluorescence; Smooth margins on OCT correspond significantly to normal fundus autofluorescence. (Kappa-0.7348, p<0.0001). Conclusion Spectral OCT provides in vivo insight into the pathogenesis of geographic atrophy and its progression. Visualization of reactive changes in the retinal pigment epithelial cells at the junctional zone and correlation with increased fundus autofluorescence; secondary to increased lipofuscin may together serve as determinants of progression of geographic atrophy. PMID:19541290

Savings account for health care costs

MedlinePlus

... These accounts are approved or regulated by the Internal Revenue Service (IRS). The accounts differ based on how much ... MSA; FSA; HRA References Department of the Treasury - Internal Revenue Service. Health Savings Accounts and Other Tax-Favored Health ...

Human Reliability Assessments: Using the Past (Shuttle) to Predict the Future (ORION)

NASA Technical Reports Server (NTRS)

Mott, Diana L.; Bigler, Mark A.

2017-01-01

NASA uses two HRA assessment methodologies. The first is a simplified method which is based on how much time is available to complete the action, with consideration included for environmental and personal factors that could influence the human's reliability. This method is expected to provide a conservative value or placeholder as a preliminary estimate. This preliminary estimate is used to determine which placeholder needs a more detailed assessment. The second methodology is used to develop a more detailed human reliability assessment on the performance of critical human actions. This assessment needs to consider more than the time available, this would include factors such as: the importance of the action, the context, environmental factors, potential human stresses, previous experience, training, physical design interfaces, available procedures/checklists and internal human stresses. The more detailed assessment is still expected to be more realistic than that based primarily on time available. When performing an HRA on a system or process that has an operational history, we have information specific to the task based on this history and experience. In the case of a PRA model that is based on a new design and has no operational history, providing a "reasonable" assessment of potential crew actions becomes more problematic. In order to determine what is expected of future operational parameters, the experience from individuals who had relevant experience and were familiar with the system and process previously implemented by NASA was used to provide the "best" available data. Personnel from Flight Operations, Flight Directors, Launch Test Directors, Control Room Console Operators and Astronauts were all interviewed to provide a comprehensive picture of previous NASA operations. Verification of the assumptions and expectations expressed in the assessments will be needed when the procedures, flight rules and operational requirements are developed and then finalized.

One Size Does Not Fit All: Human Failure Event Decomposition and Task Analysis

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

Ronald Laurids Boring, PhD

2014-09-01

In the probabilistic safety assessments (PSAs) used in the nuclear industry, human failure events (HFEs) are determined as a subset of hardware failures, namely those hardware failures that could be triggered or exacerbated by human action or inaction. This approach is top-down, starting with hardware faults and deducing human contributions to those faults. Elsewhere, more traditionally human factors driven approaches would tend to look at opportunities for human errors first in a task analysis and then identify which of those errors is risk significant. The intersection of top-down and bottom-up approaches to defining HFEs has not been carefully studied. Ideally,more » both approaches should arrive at the same set of HFEs. This question remains central as human reliability analysis (HRA) methods are generalized to new domains like oil and gas. The HFEs used in nuclear PSAs tend to be top-down—defined as a subset of the PSA—whereas the HFEs used in petroleum quantitative risk assessments (QRAs) are more likely to be bottom-up—derived from a task analysis conducted by human factors experts. The marriage of these approaches is necessary in order to ensure that HRA methods developed for top-down HFEs are also sufficient for bottom-up applications. In this paper, I first review top-down and bottom-up approaches for defining HFEs and then present a seven-step guideline to ensure a task analysis completed as part of human error identification decomposes to a level suitable for use as HFEs. This guideline illustrates an effective way to bridge the bottom-up approach with top-down requirements.« less

Mid-term changes in blood metal ion levels after Articular Surface Replacement arthroplasty of the hip.

PubMed

Galea, V P; Laaksonen, I; Matuszak, S J; Connelly, J W; Muratoglu, O; Malchau, H

2017-04-01

Our first aim was to determine whether there are significant changes in the level of metal ions in the blood at mid-term follow-up, in patients with an Articular Surface Replacement (ASR) arthroplasty. Secondly, we sought to identify risk factors for any increases. The study involved 435 patients who underwent unilateral, metal-on-metal (MoM) hip resurfacing (HRA) or total hip arthroplasty (THA). These patients all had one measurement of the level of metal ions in the blood before seven years had passed post-operatively (early evaluation) and one after seven years had passed post-operatively (mid-term evaluation). Changes in ion levels were tested using a Wilcoxon signed-rank test. We identified subgroups at the highest risk of increase using a multivariable linear logistic regression model. There were significant increases in the levels of metal ions for patients who underwent both MoM HRA (Chromium (Cr): 0.5 parts per billion (ppb); Cobalt (Co): 1.1 ppb) and MoM THA (Cr: 0.5 ppb; Co: 0.7 ppb). In a multivariable model considering MoM HRAs, the change in the levels of metal ions was influenced by female gender (Co: Odds Ratio (OR) 1.42; p = 0.002 and Cr: OR 1.08; p = 0.006). The change was found to be irrespective of the initial level for the MoM HRAs, whereas there was a negative relationship between the initial level and the change in the level for those with a MoM THA (Co: OR -0.43; p < 0.001 and Cr: OR -0.14; p = 0.033). The levels of metal ions in the blood increase significantly over the period until mid-term follow-up in patients with both a MoM HRA and those with a MoM THA. We recommend that the levels of metal ions be measured most frequently for women with a MoM HRA. While those with a MoM THA appear to stabilise at a certain level, the accuracy of this trend is not yet clear. Vigilant follow-up is still recommended. Cite this article: Bone Joint J 2017;99-B(4 Supple B):33-40. ©2017 Galea et al.

Office-Based Tools and Primary Care Visit Communication, Length, and Preventive Service Delivery.

PubMed

Lafata, Jennifer Elston; Shay, L Aubree; Brown, Richard; Street, Richard L

2016-04-01

The use of physician office-based tools such as electronic health records (EHRs), health risk appraisal (HRA) instruments, and written patient reminder lists is encouraged to support efficient, high-quality, patient-centered care. We evaluate the association of exam room use of EHRs, HRA instruments, and self-generated written patient reminder lists with patient-physician communication behaviors, recommended preventive health service delivery, and visit length. Observational study of 485 office visits with 64 primary care physicians practicing in a health system serving the Detroit metropolitan area. Study data were obtained from patient surveys, direct observation, office visit audio-recordings, and automated health system records. Outcome measures included visit length in minutes, patient use of active communication behaviors, physician use of supportive talk and partnership-building communication behaviors, and percentage of delivered guideline-recommended preventive health services for which patients are eligible and due. Simultaneous linear regression models were used to evaluate associations between tool use and outcomes. Adjusted models controlled for patient characteristics, physician characteristics, characteristics of the relationship between the patient and physician, and characteristics of the environment in which the visit took place. Prior to adjusting for other factors, visits in which the EHR was used on average were significantly (p < .05) longer (27.6 vs. 23.8 minutes) and contained fewer preventive services for which patients were eligible and due (56.5 percent vs. 62.7 percent) compared to those without EHR use. Patient written reminder lists were also significantly associated with longer visits (30.0 vs. 26.5 minutes), and less use of physician communication behaviors facilitating patient involvement (2.1 vs. 2.6 occurrences), but more use of active patient communication behaviors (4.4 vs. 2.6). Likewise, HRA use was significantly associated with increased preventive services delivery (62.1 percent vs. 57.0 percent). All relationships remained significant (p > .05) in adjusted models with the exception of that between HRA use and preventive service delivery. Office-based tools intended to facilitate the implementation of desired primary care practice redesign are associated with both positive and negative cost and quality outcomes. Findings highlight the need for monitoring both intended and unintended consequences of office-based tools commonly used in primary care practice redesign. © Health Research and Educational Trust.

Human Reliability Analysis in Support of Risk Assessment for Positive Train Control

DOT National Transportation Integrated Search

2003-06-01

This report describes an approach to evaluating the reliability of human actions that are modeled in a probabilistic risk assessment : (PRA) of train control operations. This approach to human reliability analysis (HRA) has been applied in the case o...

Cervical Proprioception in a Young Population Who Spend Long Periods on Mobile Devices: A 2-Group Comparative Observational Study.

PubMed

Portelli, Andrew; Reid, Susan A

2018-02-01

The purpose of this study was to evaluate if young people with insidious-onset neck pain who spend long periods on mobile electronic devices (known as "text neck") have impaired cervical proprioception and if this is related to time on devices. A 2-group comparative observational study was conducted at an Australian university. Twenty-two participants with text neck and 22 asymptomatic controls, all of whom were 18 to 35 years old and spent ≥4 hours per day on unsupported electronic devices, were assessed using the head repositioning accuracy (HRA) test. Differences between groups were calculated using independent sample t-tests, and correlations between neck pain intensity, time on devices, and HRA test were performed using Pearson's bivariate analysis. During cervical flexion, those with text neck (n = 22, mean age ± standard deviation [SD]: 21 ± 4 years, 59% female) had a 3.9° (SD: 1.4°) repositioning error, and the control group (n = 22, 20 ± 1 years, 68% female) had a 2.9° (SD: 1.2°) error. The mean difference was 1° (95% confidence interval: 0-2, P = .02). For other cervical movements, there was no difference between groups. There was a moderately significant correlation (P ≤ .05) between time spent on electronic devices and cervical pain intensity and between cervical pain intensity and HRA during flexion. The participants with text neck had a greater proprioceptive error during cervical flexion compared with controls. This could be related to neck pain and time spent on electronic devices. Copyright © 2018. Published by Elsevier Inc.

Adolescent views on comprehensive health risk assessment and counseling: assessing gender differences.

PubMed

Kadivar, Hajar; Thompson, Lindsay; Wegman, Martin; Chisholm, TaJuana; Khan, Maryum; Eddleton, Katie; Muszynski, Michael; Shenkman, Elizabeth

2014-07-01

Adolescence is an important time for the detection of health risk behaviors and factors with subsequent counseling and intervention. Limited research has examined adolescent perceptions of comprehensive health risk assessments (HRAs) and counseling with an assessment of gender differences. Participants were identified using Florida's Medicaid and State Children's Health Insurance Program databases. A total of 35 low-income, racially/ethnically diverse adolescents (ages 14-18 years) participated in eight focus groups stratified by gender. Adolescents completed an internet-based, tablet-administered, comprehensive HRA and then participated in a semi-structured interview. Discussions were recorded, transcribed, and analyzed using a multi-step, team-based approach applying grounded theory to determine major themes. Male adolescents desired less parental involvement, had less understanding of the protections of clinical confidentiality and the need for comprehensive HRA, and placed greater emphasis on the importance of professional appearance. In contrast, more females valued face-to-face interactions and stressed the importance of concern from the health risk assessor. Overall, adolescents placed importance on their relationship with the health risk assessor, and on valuing trust, confidentiality, and nonjudgmental care. Adolescents preferred to complete HRAs in clinical, private, and professional settings, and reported that tablet technology supported their confidentially in completing the HRA. Furthermore, they stressed the importance of autonomy and learning about the health risk outcomes for risk reduction. Gender differences exist in adolescent perceptions of comprehensive HRAs. Adolescent perceptions of HRAs support their use in confidential primary care settings using modalities that emphasize nonjudgmental, private care, and the use of communication techniques that respect adolescents' autonomy to change health risks. Copyright © 2014. Published by Elsevier Inc.

Cardiovascular responses to railway noise during sleep in young and middle-aged adults.

PubMed

Tassi, Patricia; Saremi, Mahnaz; Schimchowitsch, Sarah; Eschenlauer, Arnaud; Rohmer, Odile; Muzet, Alain

2010-03-01

The aim of this study was to investigate the effects of nocturnal railway noise on cardiovascular reactivity in young (25.8 +/- 2.6 years) and middle-aged (52.2 +/- 2.5 years) adults during sleep. Thirty-eight subjects slept three nights in the laboratory at 1-week interval. They were exposed to 48 randomized pass-bys of Freight, Passenger and Automotive trains either at an 8-h equivalent sound level of 40 dBA (Moderate) and 50 dBA (High) or at a silent Control night. Heart rate response (HRR), heart response amplitude (HRA), heart response latency (HRL) and finger pulse response (FPR), finger pulse amplitude (FPA) and finger pulse latency (FPL) were recorded to measure cardiovascular reactivity after each noise onset and for time-matched pseudo-noises in the control condition. Results show that Freight trains produced the highest cardiac response (increased HRR, HRA and HRL) compared to Passenger and Automotive. But the vascular response was similar whatever the type of train. Juniors exhibited an increased HRR and HRA as compared to seniors, but there was no age difference on vasoconstriction, except a shorter FPL in seniors. Noise level produced dose-dependent effects on all the cardiovascular indices. Sleep stage at noise occurrence was ineffective for cardiac response, but FPA was reduced when noise occurred during REM sleep. In conclusion, our study is in favor of an important impact of nocturnal railway noise on the cardiovascular system of sleeping subjects. In the limit of the samples studied, Freight trains are the most harmful, probably more because of their special length (duration) than because of their speed (rise time).

Venous Thromboembolism Following Hip and Knee Replacement Arthroplasty in Korea: A Nationwide Study Based on Claims Registry

PubMed Central

2016-01-01

The aim of this study was to examine the incidence and trends of clinically relevant venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip and knee replacement arthroplasty (HKRA) in Korea. Between January 1 and December 31, 2010, 22,127 hip replacement arthroplasty (HRA) patients and 52,882 knee replacement arthroplasty (KRA) patients were enrolled in the analysis using the administrative claims database of the Health Insurance Review and Assessment Service (HIRA). All available parameters including procedure history and clinically relevant VTE during the 90 days after HKRA were identified based on diagnostic and electronic data interchange (EDI) codes. The overall incidence of VTE, DVT, and PE during the 90 days was 3.9% (n=853), 2.7% (n=597), and 1.5% (n=327) after HRA, while the incidence was 3.8% (n=1,990), 3.2% (n=1,699), and 0.7% (n=355) after KRA. The incidence of VTE after HKRA was significantly higher in patients who had previous VTE history (odds ratio [OR], 10.8 after HRA, OR, 8.5 after KRA), chronic heart failure (2.1, 1.3), arrhythmia (1.8, 1.7), and atrial fibrillation (3.4, 2.1) than in patients who did not. The VTE incidence in patients with chemoprophylaxis was higher than that in patients without chemoprophylaxis. The incidence of VTEs revealed in this retrospective review was not low compared with the results of the studies targeting other Asian or Caucasian populations. It may warrant routine prevention including employment of chemoprophylaxis. However, the limitation of the reviewed data mandates large scale prospective investigation to affirm this observation. PMID:26770042

Is Educational Attainment Associated with Increased Risk of Mortality in People with Dementia? A Population-based Study.

PubMed

Contador, Israel; Stern, Yaakov; Bermejo-Pareja, Felix; Sanchez-Ferro, Alvaro; Benito-Leon, Julian

2017-01-01

The association between higher education and increased mortality in Alzheimer's disease (AD) is controversial. Further it is unknown whether education predicts survival in all dementia subtypes. We assessed mortality rates and death causes of persons with dementia compared to participants without dementia. Participants derive from the Neurological Disorders in Central Spain, a prospective population- based cohort study of older adults. We compared 269 persons with dementia to 2944 participants without dementia. We carried out Cox regression models to predict the risk of mortality dependent on the educational attainment adjusting for covariates. Reasons of death were obtained from the National Population Register. During a median follow-up of 5.4 years, 400 individuals died (171 with dementia, 229 without dementia). Among the participants with dementia, those with higher educational attainment had an increased risk of death than those with lower education; the adjusted hazard ratio (HRa) was 1.40 (95% confidence interval [CI], 1.01 to 1.94). When the analysis was restricted to patients with AD the HRa increased to 1.51 (95% CI = 1.01-2.24). By contrast, educational attainment was not associated with increased mortality among participants without dementia (HRa = 0.92, 95% CI = 0.71-1.20, p = 0.55), whereas education did not influence mortality in QD. Our findings suggest that high educational attainment is associated with increased mortality risk in people with dementia. This observation implies that neuropathology is more advanced in patients with higher education at any level of clinical severity, leading these individuals to an earlier death after diagnosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Combined effects of lanthanum (III) chloride and acid rain on photosynthetic parameters in rice.

PubMed

Wang, Lihong; Wang, Wen; Zhou, Qing; Huang, Xiaohua

2014-10-01

Rare earth elements (REEs) pollution and acid rain are environmental issues, and their deleterious effects on plants attract worldwide attention. These two issues exist simultaneously in many regions, especially in some rice-growing areas. However, little is known about the combined effects of REEs and acid rain on plants. Here, the combined effects of lanthanum chloride (LaCl3), one type of REE salt, and acid rain on photosynthesis in rice were investigated. We showed that the combined treatment of 81.6 μM LaCl3 and acid rain at pH 4.5 increased net photosynthetic rate (Pn), stomatic conductance (Gs), intercellular CO2 concentration (Ci), Hill reaction activity (HRA), apparent quantum yield (AQY) and carboxylation efficiency (CE) in rice. The combined treatment of 81.6 μM LaCl3 and acid rain at pH 3.5 began to behave toxic effects on photosynthesis (decreasing Pn, Gs, HRA, AQY and CE, and increasing Ci), and the maximally toxic effects were observed in the combined treatment of 2449.0 μM LaCl3 and acid rain at pH 2.5. Moreover, the combined effects of LaCl3 and acid rain on photosynthesis in rice depended on the growth stage of rice, with the maximal effects occurring at the booting stage. Furthermore, the combined treatment of high-concentration LaCl3 and low-pH acid rain had more serious effects on photosynthesis in rice than LaCl3 or acid rain treatment alone. Finally, the combined effect of LaCl3 and acid rain on Pn in rice resulted from the changes in stomatic (Gs, Ci) and non-stomatic (HRA, AQY and CE) factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

A global, cross cultural study examining the relationship between employee health risk status and work performance metrics.

PubMed

Howarth, Ana; Quesada, Jose; Mills, Peter R

2017-01-01

Health risk assessments (HRA) are used by many organisations as a basis for developing relevant and targeted employee health and well-being interventions. However, many HRA's have a western-centric focus and therefore it is unclear whether the results can be directly extrapolated to those from non-western countries. More information regarding the differences in the associations between country status and health risks is needed along with a more global perspective of employee health risk factors and well-being overall. Therefore we aimed to i) quantify and compare associations for a number of health risk factors based on country status, and then ii) explore which characteristics can aid better prediction of well-being levels and in turn workplace productivity globally. Online employee HRA data collected from 254 multi-national companies, for the years 2013 through 2016 was analysed (n = 117,274). Multiple linear regression models were fitted, adjusting for age and gender, to quantify associations between country status and health risk factors. Separate regression models were used to assess the prediction of well-being measures related to productivity. On average, the developing countries were comprised of younger individuals with lower obesity rates and markedly higher job satisfaction compared to their developed country counterparts. However, they also reported higher levels of anxiety and depression, a greater number of health risks and lower job effectiveness. Assessment of key factors related to productivity found that region of residency was the biggest predictor of presenteeism and poor pain management was the biggest predictor of absenteeism. Clear differences in health risks exist between employees from developed and developing countries and these should be considered when addressing well-being and productivity in the global workforce.

Acute macular neuroretinopathy: contribution of spectral-domain optical coherence tomography and multifocal ERG.

PubMed

Maschi, Célia; Schneider-Lise, Bérengère; Paoli, Vincent; Gastaud, Pierre

2011-06-01

Acute macular neuroretinopathy is a rare disease which occurs in young women and causes sudden paracentral scotoma and typical reddish-brown macular lesions. We report two cases of young women suffering from acute macular neuroretinopathy which we observed with spectral-domain Spectralis HRA-OCT and multifocal ERG at 3 and 7 months. Imaging revealed an early hyper-reflectivity of the photoreceptor layer, which changed into hyporeflectivity in the first week and remained the same in the following months, whereas visual field improved. Our findings show involvement primarly of the outer retina, and confirm OCT and mf ERG as important tools for diagnosis and follow-up of pathologic changes in AMNR, as other diagnostic tests often remain normal.

76 FR 38743 - Proposed Information Collection (Complaint of Employment Discrimination) Activity: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... (Complaint of Employment Discrimination) Activity: Comment Request AGENCY: Human Resources and Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Human Resources and Administration (HRA... http://www.Regulations.gov or to Lillette Turner-Nelson, Human Resources and Administration, Office of...

78 FR 24468 - Proposed Information Collection (Inquiry Concerning Applicant for Employment) Activity; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... (Inquiry Concerning Applicant for Employment) Activity; Comment Request AGENCY: Office of Human Resources and Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of Human Resources and Administration (HRA), Department of Veterans Affairs (VA), is announcing an opportunity for...

75 FR 13210 - Proposed Information Collection (Inquiry Concerning Applicant for Employment) Activity: Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... (Inquiry Concerning Applicant for Employment) Activity: Comment Request AGENCY: Office of Human Resources and Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of Human Resources and Administration (HRA), Department of Veterans Affairs (VA), is announcing an opportunity for...

Commentary: recognizing and tracking philanthropy's critical support of health research.

PubMed

Bond, Queta; Gallin, Elaine K

2012-11-01

Given the current fiscal climate limiting both government and industry support for health research, philanthropic support of health research is increasingly relevant because it provides some of the critical "risk capital" that stimulates innovation, helps translate basic research findings into clinical applications, helps support the career development of investigators, builds new infrastructure, and helps fill key funding gaps. Unfortunately, because of the philanthropic sector's diversity and scope, it is challenging to track the sector's health research investments. The authors briefly review the landscape of philanthropic organizations, identify several success stories resulting from philanthropic investments, and finally underscore the importance of gaining more knowledge about the sector through purposeful data collection efforts such as those of the Health Research Alliance (HRA), a consortium of nonprofit funders of biomedical research and training. Recent HRA efforts of this type are highlighted in this commentary and described in detail in the report by Myers et al in this issue of Academic Medicine.

The Effects of Non-Contingent Feedback on the Incidence of Plateau at V̇O2max

PubMed Central

Gordon, Dan; Gernigon, Marie; Baker, James; Merzbach, Viviane; Scruton, Adrian

2017-01-01

The purpose of this study was to examine the effects of non-contingent feedback in the form of heart rate (HR) on the incidence of plateau at V̇O2max. Ten physically active males (age 24.8 yrs ± 4.2; mass 81.4 ± 9.0 kg; stature 1.80 ± 0.11 m, V̇O2max 53.2 ± 5.8 ml·kg-1.min-1) who were V̇O2max testing naïve but were cognisant as to the heart rate responses to exercise completed four incremental tests to volitional exhaustion, separated by ~72 h for the determination of V̇O2max and gas exchange threshold. The first trial served as a familiarisation with the remaining three being experimental conditions where HR was presented in a screen projection as either the actual response (HR-A) or 10 b·min-1 higher than recorded (HR-H) or 10 b·min-1 lower (HR-L). Throughout all trials V̇O2 was recorded on a breath-by-breath basis with plateau criteria of ≤ 50 ml·min-1. RESULTS: A significant difference was observed for Δ V̇O2 over the final two consecutive 30s sampling periods between HR-A, both HR-L and HR-H (p = 0.049) and for the incidence of plateau response between condition (p = 0.021). An additional significant difference was observed for sub-maximal Δ V̇O2 responses between HR-A and HR-H (p = 0.049) and HR-A and HR-L (p = 0.006). Non-significant differences were observed for all other criteria. These data indicate that when presented with non-contingent feedback in the form of HR, that the perceptually orientated pacing schema becomes disrupted promoting a sparing of the finite anaerobic capacity to compensate for the imbalance between the afferent signal and perception of effort. Key points The manifestation of the plateau at V̇O2max is disrupted (lower incidence rates) when participants are exposed to non-contingent feedback in the form of heart rate. Non-contingent feedback in the form of heart rate does not affect the V̇O2max score or associated cardio-respiratory parameters. Given the association between the V̇O2-plateau and the finite anaerobic capacity it is proposed that non-contingent feedback creates a sparing of this resource due to an imbalance between the perception of effort and the bio-feedback. PMID:28344458

Assessment of American Heart Association's Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization: The Baptist Health South Florida Employee Study.

PubMed

Ogunmoroti, Oluseye; Younus, Adnan; Rouseff, Maribeth; Spatz, Erica S; Das, Sankalp; Parris, Don; Aneni, Ehimen; Holzwarth, Leah; Guzman, Henry; Tran, Thinh; Roberson, Lara; Ali, Shozab S; Agatston, Arthur; Maziak, Wasim; Feldman, Theodore; Veledar, Emir; Nasir, Khurram

2015-07-01

Healthcare organizations and their employees are critical role models for healthy living in their communities. The American Heart Association (AHA) 2020 impact goal provides a national framework that can be used to track the success of employee wellness programs with a focus on improving cardiovascular (CV) health. This study aimed to assess the CV health of the employees of Baptist Health South Florida (BHSF), a large nonprofit healthcare organization. HRAs and wellness examinations can be used to measure the cardiovascular health status of an employee population. The AHA's 7 CV health metrics (diet, physical activity, smoking, body mass index, blood pressure, total cholesterol, and blood glucose) categorized as ideal, intermediate, or poor were estimated among employees of BHSF participating voluntarily in an annual health risk assessment (HRA) and wellness fair. Age and gender differences were analyzed using χ(2) test. The sample consisted of 9364 employees who participated in the 2014 annual HRA and wellness fair (mean age [standard deviation], 43 [12] years, 74% women). Sixty (1%) individuals met the AHA's definition of ideal CV health. Women were more likely than men to meet the ideal criteria for more than 5 CV health metrics. The proportion of participants meeting the ideal criteria for more than 5 CV health metrics decreased with age. A combination of HRAs and wellness examinations can provide useful insights into the cardiovascular health status of an employee population. Future tracking of the CV health metrics will provide critical feedback on the impact of system wide wellness efforts as well as identifying proactive programs to assist in making substantial progress toward the AHA 2020 Impact Goal. © 2015 Wiley Periodicals, Inc.

78 FR 9317 - Glycine max

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-08

... synthase (GM-HRA) enzyme when used as a plant-incorporated protectant inert ingredient in or on the food and feed commodities of soybean. Pioneer Hi-Bred International, Inc. (DuPont Pioneer), submitted a... petition (PP 2E8059) by Pioneer Hi-Bred International, Inc. (DuPont Pioneer), 7100 NW., 62nd Avenue, P.O...

Relationship between Escherichia coli virulence factors and postpartum metritis in dairy cows.

PubMed

Kassé, F N; Fairbrother, J M; Dubuc, J

2016-06-01

The objectives of this study were to report the prevalence of Escherichia coli and Trueperella pyogenes in the uterus of postpartum dairy cows before the onset of postpartum metritis (PPM) and to quantify their association with subsequent occurrence of PPM, to quantify the association between the presence of genes encoding E. coli virulence factors (VF) and PPM, and to determine the accuracy of using early postpartum uterine bacteriology results (bacteria and VF) to identify cows at risk of PPM. A prospective cohort study was conducted on 3 commercial dairy farms. Uterine swabs were collected from 371 Holstein dairy cows (3 commercial herds) at 1 to 7d in milk and submitted to the laboratory for identification of E. coli, T. pyogenes, and E. coli VF. A total of 40 VF were tested using the radioactive probe hybridization method. Postpartum metritis was defined as the presence of a fetid watery red-brown uterine discharge, associated with fever (rectal temperature >39.5°C), and systemic signs of illness (dullness, reduced appetite, and milk production). Surveillance of PPM was done by trained farmers blinded to laboratory results and cows were followed until 21d in milk. Statistical analyses were conducted using 2×2 tables and mixed logistical regression models. Prevalences of E. coli, T. pyogenes, and PPM were 42, 34, and 15%, respectively. A total of 32 VF were found in E. coli isolates. Most prevalent VF were extraintestinal pathogenic genes such as fimH (89%), hlyE (87%), and iss (70%). Cows positive for intrauterine E. coli were 3.2 times more likely to have subsequent PPM compared with bacteriologically negative cows. Cows with VF hra1 in their uterus were 2.7 times more likely to have PPM than cows positive for E. coli and negative for hra1 and 5.9 times more likely than bacteriologically negative cows. Cows with VF kpsMTII in their uterus were 3.2 times more likely to have PPM than cows positive for E. coli and negative for kpsMTII and 6.2 times more likely than bacteriologically negative cows. Using E. coli, hra1, and kpsMTII as predictors for subsequent PPM, positive predictive values were 23, 31, and 42%, respectively, whereas the negative predictive values were 91, 80, and 78%, respectively. Overall, these results showed that E. coli and some VF were associated with PPM. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

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

Herberger, Sarah M.; Boring, Ronald L.

Abstract Objectives: This paper discusses the differences between classical human reliability analysis (HRA) dependence and the full spectrum of probabilistic dependence. Positive influence suggests an error increases the likelihood of subsequent errors or success increases the likelihood of subsequent success. Currently the typical method for dependence in HRA implements the Technique for Human Error Rate Prediction (THERP) positive dependence equations. This assumes that the dependence between two human failure events varies at discrete levels between zero and complete dependence (as defined by THERP). Dependence in THERP does not consistently span dependence values between 0 and 1. In contrast, probabilistic dependencemore » employs Bayes Law, and addresses a continuous range of dependence. Methods: Using the laws of probability, complete dependence and maximum positive dependence do not always agree. Maximum dependence is when two events overlap to their fullest amount. Maximum negative dependence is the smallest amount that two events can overlap. When the minimum probability of two events overlapping is less than independence, negative dependence occurs. For example, negative dependence is when an operator fails to actuate Pump A, thereby increasing his or her chance of actuating Pump B. The initial error actually increases the chance of subsequent success. Results: Comparing THERP and probability theory yields different results in certain scenarios; with the latter addressing negative dependence. Given that most human failure events are rare, the minimum overlap is typically 0. And when the second event is smaller than the first event the max dependence is less than 1, as defined by Bayes Law. As such alternative dependence equations are provided along with a look-up table defining the maximum and maximum negative dependence given the probability of two events. Conclusions: THERP dependence has been used ubiquitously for decades, and has provided approximations of the dependencies between two events. Since its inception, computational abilities have increased exponentially, and alternative approaches that follow the laws of probability dependence need to be implemented. These new approaches need to consider negative dependence and identify when THERP output is not appropriate.« less

Smartphone app uses loyalty point incentives and push notifications to encourage influenza vaccine uptake.

PubMed

Dale, Leila Pfaeffli; White, Lauren; Mitchell, Marc; Faulkner, Guy

2018-04-23

Carrot Rewards is a free, incentive-based, smartphone health app available in participating provinces in Canada. One feature of Carrot was designed to incentivize influenza vaccine education messages and encourage vaccine uptake for users in the province of British Columbia. This study aimed to evaluate the uptake of the Carrot Flu Campaign educational quiz and to determine if mobile "push" notifications, plus loyalty point incentives, resulted in users visiting a sponsored pharmacy to discuss and receive the influenza vaccine. The Carrot Flu Campaign delivered an in-app quiz, educating users on the importance of the influenza vaccine. Push notifications were then sent to users when they came within 200 m of a sponsored pharmacy. Those who visited the pharmacy collected bonus points and completed a follow up quiz tracking influenza vaccine behaviour. A sub-sample of users completed the Flu Campaign between their baseline and follow up Health Risk Assessment (HRA), a survey which asked about influenza vaccine uptake behaviour. Descriptive statistics were summarized. A total of 38.1% (30,538/80,228) registered Carrot users completed the Flu Campaign quiz. Of those in participating cities (n = 21,469), 41% clicked on the map to show the nearest sponsored pharmacy and 78% enabled their smartphone's "locations" feature, allowing them to receive the push notifications. A small number of users spoke to a pharmacist (n = 96) and less than half reported receiving the influenza vaccine (38/96; 39.6%). From the HRA sub-sample (n = 3693), approximately 5% more users reported receiving the influenza vaccine during the 2017 influenza season compared to the previous year. Carrot Rewards used a novel delivery method to educate the general population and showed geolocation could be used to facilitate influenza vaccine uptake. Future iterations could tailor content to target those most at risk and should consider more robust evaluation methods to determine the app's effectiveness. Copyright © 2018 Elsevier Ltd. All rights reserved.

Human Reliability Assessments: Using the Past (Shuttle) to Predict the Future (Orion)

NASA Technical Reports Server (NTRS)

DeMott, Diana L.; Bigler, Mark A.

2017-01-01

NASA (National Aeronautics and Space Administration) Johnson Space Center (JSC) Safety and Mission Assurance (S&MA) uses two human reliability analysis (HRA) methodologies. The first is a simplified method which is based on how much time is available to complete the action, with consideration included for environmental and personal factors that could influence the human's reliability. This method is expected to provide a conservative value or placeholder as a preliminary estimate. This preliminary estimate or screening value is used to determine which placeholder needs a more detailed assessment. The second methodology is used to develop a more detailed human reliability assessment on the performance of critical human actions. This assessment needs to consider more than the time available, this would include factors such as: the importance of the action, the context, environmental factors, potential human stresses, previous experience, training, physical design interfaces, available procedures/checklists and internal human stresses. The more detailed assessment is expected to be more realistic than that based primarily on time available. When performing an HRA on a system or process that has an operational history, we have information specific to the task based on this history and experience. In the case of a Probabilistic Risk Assessment (PRA) that is based on a new design and has no operational history, providing a "reasonable" assessment of potential crew actions becomes more challenging. To determine what is expected of future operational parameters, the experience from individuals who had relevant experience and were familiar with the system and process previously implemented by NASA was used to provide the "best" available data. Personnel from Flight Operations, Flight Directors, Launch Test Directors, Control Room Console Operators, and Astronauts were all interviewed to provide a comprehensive picture of previous NASA operations. Verification of the assumptions and expectations expressed in the assessments will be needed when the procedures, flight rules, and operational requirements are developed and then finalized.

Human Reliability Assessments: Using the Past (Shuttle) to Predict the Future (Orion)

NASA Technical Reports Server (NTRS)

DeMott, Diana; Bigler, Mark

2016-01-01

NASA (National Aeronautics and Space Administration) Johnson Space Center (JSC) Safety and Mission Assurance (S&MA) uses two human reliability analysis (HRA) methodologies. The first is a simplified method which is based on how much time is available to complete the action, with consideration included for environmental and personal factors that could influence the human's reliability. This method is expected to provide a conservative value or placeholder as a preliminary estimate. This preliminary estimate or screening value is used to determine which placeholder needs a more detailed assessment. The second methodology is used to develop a more detailed human reliability assessment on the performance of critical human actions. This assessment needs to consider more than the time available, this would include factors such as: the importance of the action, the context, environmental factors, potential human stresses, previous experience, training, physical design interfaces, available procedures/checklists and internal human stresses. The more detailed assessment is expected to be more realistic than that based primarily on time available. When performing an HRA on a system or process that has an operational history, we have information specific to the task based on this history and experience. In the case of a Probabilistic Risk Assessment (PRA) that is based on a new design and has no operational history, providing a "reasonable" assessment of potential crew actions becomes more challenging. In order to determine what is expected of future operational parameters, the experience from individuals who had relevant experience and were familiar with the system and process previously implemented by NASA was used to provide the "best" available data. Personnel from Flight Operations, Flight Directors, Launch Test Directors, Control Room Console Operators and Astronauts were all interviewed to provide a comprehensive picture of previous NASA operations. Verification of the assumptions and expectations expressed in the assessments will be needed when the procedures, flight rules and operational requirements are developed and then finalized.

Classroom Practice--Pilots and Copilots for Better Reading

ERIC Educational Resources Information Center

Herring, Alice

2005-01-01

A cooperative project between middle-schoolers and elementary students makes clever use of a flight theme, and, as the author reports in this article, students' learning soars. In this project, the pilots are enthusiastic members of Ms. Herring's eighth-grade English class at Hampton Roads Academy (HRA) in Newport News, Virginia. The copilots are…

Human Resource Accounting: Interests and Conflicts. A Discussion Paper. CEDEFOP Panorama.

ERIC Educational Resources Information Center

Frederiksen, Jens V.; Westphalen, Sven-Age

This document examines the principles, use, and benefits of human resource accounting (HRA), which uses numerical and nonnumerical data on items such as costs and benefits of training, staff turnover, absenteeism, and the value of employees' knowledge to measure the value of human resources in enterprises. The introduction presents an overview of…

[In vivo spetrometric analysis of the electrical impedance of the first leaf of maize (Zea mays L.) as a function of soil and atmosphere hydrous conditions].

PubMed

Laarabi, Saïd; El Kinani, Khalifa; Ettouhami, Aziz; Limouri, Mohammed

2005-05-01

In vivo spectrometric analysis of the electrical impedance of the first leaf of maize (Zea mays L.) as a function of soil and atmosphere hydrous conditions. We have measured the electrical resistance and capacitance of the first leaf of maize aged 14 days. The plants were cultivated at different levels of soil and atmospheric humidity and submitted to quiet or agitated air. In 'control' plants cultivated in quiet air under moderate relative humidity (HRA) (50 to 60%), the amplitude of the spectrometric bioimpedance spectrum (CSB) increased with the quantity of water available to the roots. Agitated air or elevated HRA increased the magnitude of the CSB in plants cultivated at 40% of the maximal retention capacity (CRM) of the soil. On the other hand, the CSB decreased in plants cultivated at 60% of the CRM or in hydroponics. This was accompanied by a dramatic decrease in the electrical resistance. The action of the atmospheric factors studied depends on the quantity of water where the roots are bathing.

Psychosocial variables and time to injury onset: a hurdle regression analysis model.

PubMed

Sibold, Jeremy; Zizzi, Samuel

2012-01-01

Psychological variables have been shown to be related to athletic injury and time missed from participation in sport. We are unaware of any empirical examination of the influence of psychological variables on time to onset of injury. To examine the influence of orthopaedic and psychosocial variables on time to injury in college athletes. One hundred seventy-seven (men 5 116, women 5 61; age 5 19.45 6 1.39 years) National Collegiate Athletic Association Division II athletes. Hurdle regression analysis (HRA) was used to determine the influence of predictor variables on days to first injury. Worry (z = 2.98, P = .003), concentration disruption (z = -3.95, P < .001), and negative life-event stress (z = 5.02, P < .001) were robust predictors of days to injury. Orthopaedic risk score was not a predictor (z = 1.28, P = .20). These findings support previous research on the stress-injury relationship, and our group is the first to use HRA in athletic injury data. These data support the addition of psychological screening as part of preseason health examinations for collegiate athletes.

Uncertainty analysis in geospatial merit matrix–based hydropower resource assessment

DOE PAGES

Pasha, M. Fayzul K.; Yeasmin, Dilruba; Saetern, Sen; ...

2016-03-30

Hydraulic head and mean annual streamflow, two main input parameters in hydropower resource assessment, are not measured at every point along the stream. Translation and interpolation are used to derive these parameters, resulting in uncertainties. This study estimates the uncertainties and their effects on model output parameters: the total potential power and the number of potential locations (stream-reach). These parameters are quantified through Monte Carlo Simulation (MCS) linking with a geospatial merit matrix based hydropower resource assessment (GMM-HRA) Model. The methodology is applied to flat, mild, and steep terrains. Results show that the uncertainty associated with the hydraulic head ismore » within 20% for mild and steep terrains, and the uncertainty associated with streamflow is around 16% for all three terrains. Output uncertainty increases as input uncertainty increases. However, output uncertainty is around 10% to 20% of the input uncertainty, demonstrating the robustness of the GMM-HRA model. Hydraulic head is more sensitive to output parameters in steep terrain than in flat and mild terrains. Furthermore, mean annual streamflow is more sensitive to output parameters in flat terrain.« less

The impact of behavioral and mental health risk assessments on goal setting in primary care.

PubMed

Krist, Alex H; Glasgow, Russell E; Heurtin-Roberts, Suzanne; Sabo, Roy T; Roby, Dylan H; Gorin, Sherri N Sheinfeld; Balasubramanian, Bijal A; Estabrooks, Paul A; Ory, Marcia G; Glenn, Beth A; Phillips, Siobhan M; Kessler, Rodger; Johnson, Sallie Beth; Rohweder, Catherine L; Fernandez, Maria E

2016-06-01

Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice patients to be asked about each of eight risks (range of differences 5.3-15.8 %, p < 0.001), set goals for six risks (range of differences 3.8-16.6 %, p < 0.01), and improve five risks (range of differences 5.4-13.6 %, p < 0.01). Compared to controls, intervention patients felt clinicians cared more for them and showed more interest in their concerns. Patient-centered health risk assessments improve screening and goal setting.Trial RegistrationClinicaltrials.gov identifier: NCT01825746.

Human health risk assessment case study: an abandoned metal smelter site in Poland.

PubMed

Wcisło, Eleonora; Ioven, Dawn; Kucharski, Rafal; Szdzuj, Jerzy

2002-05-01

United States Environmental Protection Agency methodologies for human health risk assessment (HRA) were applied in a Brownfields Demonstration Project on the Warynski smelter site (WSS), an abandoned industrial site at Piekary Slaskie town, Upper Silesia, Poland. The HRA included the baseline risk assessment (BRA) and the development of risk-based preliminary remedial goals (RBPRGs). The HRA focused on surface area covered with waste materials, which were evaluated with regard to the potential risks they may pose to humans. Cadmium, copper, iron, manganese, lead, and zinc were proposed as the contaminants of potential concern (COPCs) at WSS based on archive data on chemical composition of waste located on WSS. For the defined future land use patterns, the industrial (I) and recreational (II) exposure scenarios were assumed and evaluated. The combined hazard index for all COPCs was 3.1E+00 for Scenario I and 3.2E+00 for Scenario II. Regarding potential carcinogenic risks associated with the inhalation route, only cadmium was a contributor, with risks of 1.6E-06 and 2.6E-07 for Scenario I and Scenario II, respectively. The results of the BRA indicated that the potential health risks at WSS were mainly associated with waste material exposure to cadmium (industrial and recreational scenarios) and lead (industrial scenario). RBPRGs calculated under the industrial scenario were 1.17E+03 and 1.62E+03 mg/kg for cadmium and lead, respectively. The RBPRG for cadmium was 1.18E+03 mg/kg under the recreational scenario. The BRA results, as well as RBCs, are comparable for both scenarios, so it is impossible to prioritize land use patterns for WSS based on these results. For choosing a future land use pattern or an appropriate redevelopment option, different factors would be decisive in the decision-making process, e.g., social, market needs, technical feasibility and costs of redevelopment actions or acceptance of local community.

Using routinely collected data to augment the management of health and productivity loss.

PubMed

Allen, Harris

2008-06-01

To test models of productivity loss developed from data collected using a health risk appraisal (HRA) designed to examine health in the broader context of work, mental well-being, and the demands of organizational and family life. Secondary analyses of a data extract provided by the HRA's developer. These analyses focused on 17,821 respondents whose version of the HRA included the Work Limitation Questionnaire. Structural equation techniques were used to estimate a series of models featuring 38 measures and a four-step hypothesized sequence. The tests confirmed the presence of two distinct but interrelated components driven by health issues--Presenteeism (impaired performance at work) and Absenteeism (time away from work)--posited to describe productivity loss. The tests also documented the predictive power of eight categories of measures in accounting for the phenomenon. Preeminent among these predictors was a heterogeneous set of measures encompassing current and future aspects of Health. But measures from seven other categories--Work-Life Balance, Personal Life Impact, Stress, Financial Concerns, and Job, Employee, and Company Characteristics--also made significant contributions. Combined, their unique contribution was five times that of Health alone. This case study illustrates how data routinely captured via an instrument that is an example of a class of self-reports surveys increasingly being used to address a variety of workforce issues can be tapped to describe and predict productivity loss. The results confirm the key role that Health plays in determining the phenomenon. They also affirm the advisability of incorporating into interventions undertaken to reduce productivity loss an orientation that is paralleled by the recent emergence of the use of quality of life measures in provider settings. This orientation is predicated on the need to take into better account other contextual factors that exert considerable influences through as well as above and beyond Health.

Evaluation of the nutritional equivalency of soybean meal with the genetically modified trait DP-3O5423-1 when fed to laying hens.

PubMed

Mejia, L; Jacobs, C M; Utterback, P L; Parsons, C M; Rice, D; Sanders, C; Smith, B; Iiams, C; Sauber, T

2010-12-01

An experiment using 336 Hy-Line W-36 Single Comb White Leghorn hens was conducted to evaluate transgenic soybeans containing the gm-fad2-1 gene fragment and the gm-hra gene. Transcription of the gm-fad2-1 gene fragment results in an increased level of oleic acid (18:1) in the seed, and expression of the soybean acetolactate synthase protein (GM-HRA) encoded by the modified gm-hra gene, is used as a selectable marker during transformation. Pullets (20 wk of age) were placed in cage lots (7 hens/cage, 2 cages/lot) and were randomly assigned to 1 of 4 corn-soybean meal dietary treatments (6 lots/treatment) formulated with the following soybean meals: nontransgenic near-isoline control (control), nontransgenic commercial reference soybean meal A (92M72), nontransgenic commercial reference soybean meal B (93B15), or transgenic soybean meal produced from soybeans containing event DP-3Ø5423-1 (305423). Weeks 20 to 24 were a preconditioning period, and the 4 experimental diets were then fed from 25 to 36 wk of age. Differences between the 305423 and control group means were evaluated, with statistical significance at P < 0.05. Body weight, hen-day egg production, egg mass, feed consumption, and feed efficiency for hens fed the 305423 soybean meal were not significantly different from the respective values for hens fed diets formulated with the near-isoline soybean meal. Likewise, egg component weights, Haugh unit measures, and egg weights were similar regardless of the soybean meal source. This research indicates that performance of hens fed diets containing 305423 soybean meal, as measured by egg production and egg quality, was similar to that of hens fed diets formulated with the near-isoline control and commercial soybean meals.

High Rates of Anal High-Grade Squamous Intraepithelial Lesions in HIV-Infected Women Who Do Not Meet Screening Guidelines.

PubMed

Gaisa, Michael; Ita-Nagy, Fanny; Sigel, Keith; Arens, Yotam; Hennessy, Mary Ann; Rodriguez-Caprio, Gabriela; Mullen, Michael; Aberg, Judith A; Cespedes, Michelle

2017-02-01

Human immunodeficiency virus (HIV)-infected women have a higher burden of anal high-grade squamous intraepithelial lesions (HSIL) and anal cancer (AC) compared with HIV-uninfected women. Guidelines for AC screening in this population are heterogeneous. Here we report outcomes and risk factors for anal HSIL following implementation of universal AC screening offered to all HIV-infected women. Data from women who underwent AC screening with anal cytology from April 2009 to July 2014 were analyzed. Routine clinical data included anal and cervical cytology, demographic/behavioral data, and high-resolution anoscopy (HRA) results. We evaluated the association of cytology with HRA results, and predictors of HSIL pathology, and compared rates of HSIL pathology among women meeting screening guidelines to those who did not. Seven hundred forty-five HIV-infected women were screened with anal cytology. Thirty-nine percent had abnormal anal cytology on initial screen and 15% on secondary screen; 208 women underwent HRA following abnormal anal cytology. HSIL was found in 26% and 18% of anal biopsies following initial and secondary screening, respectively. One woman had AC. Cigarette smoking more than doubled HSIL risk. Among women who underwent AC screening despite not meeting existing guideline criteria, 21% and 10%, respectively, were found to have HSIL on biopsy. Neither meeting criteria for screening nor history of receptive anal sex was significantly associated with HSIL. Anal HSIL is common in HIV-infected women. Substantial numbers of HSIL would have been missed by strictly adhering to existing AC screening guidelines. These results support routine screening of all HIV-infected women regardless of human papillomavirus history or sexual practices. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer.

PubMed

Sjöström, Olle; Lindholm, Lars; Tavelin, Björn; Melin, Beatrice

2016-10-01

Although colonoscopic surveillance is recommended both for individuals with known hereditary colorectal cancer (HCRC) syndromes and those with a more moderate familial colorectal cancer (FCRC) history, the evidence for the benefits of surveillance is limited and surveillance practices vary. This study evaluates the preventive effect for individuals with a family history of CRC of decentralized colonoscopic surveillance with the guidance of a cancer prevention clinic. We performed a population based prospective study of 261 patients with HCRC or FCRC, recorded in the colonoscopic surveillance registry at the Cancer genetics clinic, University Hospital of Umeå, Sweden. Colonoscopic surveillance was conducted every second (HCRC) or fifth (FCRC) year at local hospitals in Northern Sweden. Main outcome measures were findings of high-risk adenomas (HRA) or CRC, and patient compliance to surveillance. Estimations of the expected numbers of CRC without surveillance were made. During a total of 1256 person years of follow-up, one case of CRC was found. The expected numbers of cancers in the absence of surveillance was between 9.5 and 10.5, resulting in a standardized incidence ratio, observed versus expected cases of CRC, between 0.10 (CI 95 % 0.0012-0.5299) and 0.11 (CI 95 % 0.0014-0.5857). No CRC mortality was reported, but three patients needed surgical intervention. HRA were found in 5.9 % (14/237) of the initial and in 3.4 % (12/356) of the follow-up colonoscopies. Patient compliance to the surveillance program was 90 % as 597 of the planned 662 colonoscopies were performed. The study concludes that colonoscopic surveillance with high patient compliance to the program is effective in preventing CRC when using a decentralized method for colonoscopy surveillance with the guidance of a cancer prevention clinic.

A Hybrid Memetic Framework for Coverage Optimization in Wireless Sensor Networks.

PubMed

Chen, Chia-Pang; Mukhopadhyay, Subhas Chandra; Chuang, Cheng-Long; Lin, Tzu-Shiang; Liao, Min-Sheng; Wang, Yung-Chung; Jiang, Joe-Air

2015-10-01

One of the critical concerns in wireless sensor networks (WSNs) is the continuous maintenance of sensing coverage. Many particular applications, such as battlefield intrusion detection and object tracking, require a full-coverage at any time, which is typically resolved by adding redundant sensor nodes. With abundant energy, previous studies suggested that the network lifetime can be maximized while maintaining full coverage through organizing sensor nodes into a maximum number of disjoint sets and alternately turning them on. Since the power of sensor nodes is unevenly consumed over time, and early failure of sensor nodes leads to coverage loss, WSNs require dynamic coverage maintenance. Thus, the task of permanently sustaining full coverage is particularly formulated as a hybrid of disjoint set covers and dynamic-coverage-maintenance problems, and both have been proven to be nondeterministic polynomial-complete. In this paper, a hybrid memetic framework for coverage optimization (Hy-MFCO) is presented to cope with the hybrid problem using two major components: 1) a memetic algorithm (MA)-based scheduling strategy and 2) a heuristic recursive algorithm (HRA). First, the MA-based scheduling strategy adopts a dynamic chromosome structure to create disjoint sets, and then the HRA is utilized to compensate the loss of coverage by awaking some of the hibernated nodes in local regions when a disjoint set fails to maintain full coverage. The results obtained from real-world experiments using a WSN test-bed and computer simulations indicate that the proposed Hy-MFCO is able to maximize sensing coverage while achieving energy efficiency at the same time. Moreover, the results also show that the Hy-MFCO significantly outperforms the existing methods with respect to coverage preservation and energy efficiency.

Mayor de Blasio: Comprehensive Homeless Services Plan Increases Focus on

Science.gov Websites

HRA management structure based on the veterans move out initiative will focus on finding permanent structure based on the veterans move out initiative to promote move outs to reduce the shelter census Focus on Prevention & Rehousing Result of 90-day review includes streamlined management structure

Associations between poor sleep quality and stages of change of multiple health behaviors among participants of employee wellness program

PubMed Central

Hui, Siu-kuen Azor; Grandner, Michael A.

2015-01-01

Objective Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. Methods The current study is an analysis of data collected in 2008 from an online health risk assessment (HRA) survey completed by participants of the Kansas State employee wellness program (N = 13,322). Using multinomial logistic regression, associations between self-reported sleep quality and stages of change (i.e. precontemplation, contemplation, preparation, action, maintenance) in five health behaviors (stress management, weight management, physical activities, alcohol use, and smoking) were analyzed. Results Adjusted for covariates, poor sleep quality was associated with an increased likelihood of contemplation, preparation, and in some cases action stage when engaging in the health behavior change process, but generally a lower likelihood of maintenance of the healthy behavior. Conclusions The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population. PMID:26046013

The U.S. Army’s Health Risk Appraisal (HRA) Survey, Part I, History, Reliability, and Validity

DTIC Science & Technology

2003-08-01

reports as a clinical decision-making rule in deciding whether or not to administer the screening test. Second, accuracy of patient self-reports may...10): 1665-1669, 1997. 6. Baker, F., S. R. Ainsworth, J. T. Dye, C. Crammer , M. J. Thun, D. Hoffmann, J. L. Repace, J. E. Henningfield, J. Slade, J

The Association of Sleep Duration and Morbid Obesity in a Working Population: The Baptist Health South Florida Employee Study.

PubMed

Aziz, Muhammad; Osondu, Chukwuemeka U; Younus, Adnan; Malik, Rehan; Rouseff, Maribeth; Das, Sankalp; Guzman, Henry; Maziak, Wasim; Virani, Salim; Feldman, Theodore; Agatston, Arthur S; Veledar, Emir; Aneni, Ehimen C; Nasir, Khurram

2017-03-01

The current study aimed to determine the relationship between self-reported sleep duration and morbid obesity in an employee population. Baptist Health South Florida conducts an annual Health Risk Assessment (HRA) for its employees. Data for this cross-sectional study was collected via this HRA in 2014, and included information on self-reported sleep duration, height and weight for body mass index (BMI), and other biometric measures. Average sleep duration was categorized as short sleep (<6 hr), optimal sleep (6-7.9 hr), and long sleep duration (≥8 hr), while obesity status was categorized as nonobese (BMI <30 kg/m 2 ), obese (30-34.9 kg/m 2 ), and morbid obese (≥35 kg/m 2 ). A total of 9505 participants (mean age 42.8 ± 12.1 years, 75% females, and 55% Hispanic) were included in this study. Prevalence of morbid obesity was about 24% among employees who were sleeping for less than 6 hr compared to 13% and 14% among those sleeping for 6-7.9 hours, and 8 or more hours respectively. In regression analyses, persons who slept less than 6 hr had almost twice the odds of morbid obesity compared to those who slept 6-7.9 hr (odds ratio = 1.8; 1.5-2.2). Our finding that short sleep duration (<6 hr) is significantly associated with a higher risk of morbid obesity should facilitate the development of workplace-based programs that focus on improving sleep among at-risk employees, especially those who work in shift duties to reduce the risk of morbid obesity and other comorbid conditions. Future studies are needed to further explore the relationship of sleep duration and morbid obesity in employee populations.

Culture Representation in Human Reliability Analysis

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

David Gertman; Julie Marble; Steven Novack

Understanding human-system response is critical to being able to plan and predict mission success in the modern battlespace. Commonly, human reliability analysis has been used to predict failures of human performance in complex, critical systems. However, most human reliability methods fail to take culture into account. This paper takes an easily understood state of the art human reliability analysis method and extends that method to account for the influence of culture, including acceptance of new technology, upon performance. The cultural parameters used to modify the human reliability analysis were determined from two standard industry approaches to cultural assessment: Hofstede’s (1991)more » cultural factors and Davis’ (1989) technology acceptance model (TAM). The result is called the Culture Adjustment Method (CAM). An example is presented that (1) reviews human reliability assessment with and without cultural attributes for a Supervisory Control and Data Acquisition (SCADA) system attack, (2) demonstrates how country specific information can be used to increase the realism of HRA modeling, and (3) discusses the differences in human error probability estimates arising from cultural differences.« less

Differing Developmental Trajectories in Heart Rate Responses to Speech Stimuli in Infants at High and Low Risk for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Perdue, Katherine L.; Edwards, Laura A.; Tager-Flusberg, Helen; Nelson, Charles A.

2017-01-01

We investigated heart rate (HR) in infants at 3, 6, 9, and 12 months of age, at high (HRA) and low (LRC) familial risk for ASD, to identify potential endophenotypes of ASD risk related to attentional responses. HR was extracted from functional near-infrared spectroscopy recordings while infants listened to speech stimuli. Longitudinal analysis…

Predictive Ability of Pender's Health Promotion Model for Physical Activity and Exercise in People with Spinal Cord Injuries: A Hierarchical Regression Analysis

ERIC Educational Resources Information Center

Keegan, John P.; Chan, Fong; Ditchman, Nicole; Chiu, Chung-Yi

2012-01-01

The main objective of this study was to validate Pender's Health Promotion Model (HPM) as a motivational model for exercise/physical activity self-management for people with spinal cord injuries (SCIs). Quantitative descriptive research design using hierarchical regression analysis (HRA) was used. A total of 126 individuals with SCI were recruited…

Lateralization of ERPs to speech and handedness in the early development of Autism Spectrum Disorder.

PubMed

Finch, Kayla H; Seery, Anne M; Talbott, Meagan R; Nelson, Charles A; Tager-Flusberg, Helen

2017-01-01

Language is a highly lateralized function, with typically developing individuals showing left hemispheric specialization. Individuals with autism spectrum disorder (ASD) often show reduced or reversed hemispheric lateralization in response to language. However, it is unclear when this difference emerges and whether or not it can serve as an early ASD biomarker. Additionally, atypical language lateralization is not specific to ASD as it is also seen more frequently in individuals with mixed- and left-handedness. Here, we examined early asymmetry patterns measured through neural responses to speech sounds at 12 months and behavioral observations of handedness at 36 months in children with and without ASD. Three different groups of children participated in the study: low-risk controls (LRC), high risk for ASD (HRA; infants with older sibling with ASD) without ASD, and HRA infants who later receive a diagnosis of ASD (ASD). Event-related potentials (ERPs) to speech sounds were recorded at 12 months. Utilizing a novel observational approach, handedness was measured by hand preference on a variety of behaviors at 36 months. At 12 months, lateralization patterns of ERPs to speech stimuli differed across the groups with the ASD group showing reversed lateralization compared to the LRC group. At 36 months, factor analysis of behavioral observations of hand preferences indicated a one-factor model with medium to high factor loadings. A composite handedness score was derived; no group differences were observed. There was no association between lateralization to speech at 12 months and handedness at 36 months in the LRC and HRA groups. However, children with ASD did show an association such that infants with lateralization patterns more similar to the LRC group at 12 months were stronger right-handers at 36 months. These results highlight early developmental patterns that might be specific to ASD, including a potential early biomarker of reversed lateralization to speech stimuli at 12 months, and a relation between behavioral and neural asymmetries. Future investigations of early asymmetry patterns, especially atypical hemispheric specialization, may be informative in the early identification of ASD.

Final report on APMP.M.H-S3: Comparison on hardness measurement Rockwell scale A and B

NASA Astrophysics Data System (ADS)

Sanponpute, Tassanai; Meesaplak, Apichaya; Menelao, Febo; Chan, T. K.; Bahng, Gun-Woong; Titus, S. S. K.; Jain, S. K.

2012-01-01

The APMP.M.H-S3 Rockwell hardness intercomparison was initiated by NIMT, Thailand and the required protocol was prepared by NIMT and checked by Dr John Man, MNIA, Australia, in 2009. PTB, Germany, Standards and Calibration Laboratory (SCL), Hong Kong, National Physical Laboratory (NPLI), India, and Korea Research Institute of Standards and Science (KRISS), Korea, participated in this comparison. This comparison exercise was focused on the measurement range of 25 to 100 HRBW scale and 35 to 85 HRA scale. The round robin test was done during the period from April 2010 to October 2010. The participating laboratories have demonstrated the capability of the machine and the operating conditions according to ISO 6508 Part 3 to perform the measurements. However, SCL, Hong Kong, could demonstrate their capability to perform the measurements only according to ISO 6508 Part 2. The CMCs declared by the different laboratories lie in the range of 0.30 HRA to 0.40 HRA and 0.40 HRBW to 0.75 HRBW. The CMC declared by SCL for the Rockwell B scale is 1.5 HRBW for the reason described above. It is observed from the results that the measurement uncertainty is estimated not less than the CMCs declared by the laboratories. From the measurement results provided by all the participating laboratories, the En ratio was determined to establish the degrees of equivalence. The En ratio was calculated by including as well as by excluding the results of the laboratory which has performed the test according to ISO 6508 Part 2 in order to make sure that it does not affect the overall results. It is noticed that the En ratio was still found to remain less than 1. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the APMP, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Comparison of broiler performance when fed diets containing event DP-3O5423-1, nontransgenic near-isoline control, or commercial reference soybean meal, hulls, and oil.

PubMed

McNaughton, J; Roberts, M; Smith, B; Rice, D; Hinds, M; Sanders, C; Layton, R; Lamb, I; Delaney, B

2008-12-01

DP-3Ø5423-1 (305423) is a genetically modified soybean that was produced by biolistic insertion of the gm-fad2-1 gene fragment and gm-hra genes into the germline of soybean seeds. Expression of gm-fad2-1 results in greater concentrations of oleic acid (18:1) by suppressing expression of the endogenous FAD2-1 gene, which encodes an n-6 fatty acid desaturase enzyme that catalyzes desaturation of 18:1 to linoleic acid (18:2). The GM-HRA protein expressed by the gm-hra gene is a modified version of the soybean acetolactate synthase enzyme that is used as a selectable marker during transformation. A 42-d feeding trial was conducted with broiler chickens to compare the nutritional performance of 305423 soybeans with nontransgenic soybeans. Diets were prepared using processed fractions (meal, hulls, and oil) from 305423 soybean plants. For comparison, additional diets were produced with soybean fractions obtained from a nontransgenic near-isoline (control) and nontransgenic commercial Pioneer brand varieties (93B86, 93B15, and 93M40). Diets were fed to Ross x Cobb broilers (n = 120/group, 50% male and 50% female) in 3 phases. Starter, grower, and finisher diets contained 26.5, 23, and 21.5% soybean meal, respectively. Soybean hulls and oil were added at 1.0 and 0.5%, respectively, across all diets in each phase. No statistically significant differences were observed in growth performance (BW, mortality, feed efficiency), organ yield (liver and kidney), or carcass yield (breast, thigh, leg, wing, and abdominal fat) variables between broilers consuming diets prepared with isolated fractions from 305423 or near-isoline control soybean. Additionally, all performance and carcass variables from control and 305423 soybean treatment groups fell within tolerance intervals constructed for each response variable using data from broilers fed diets prepared with reference soybean fractions. Based on the results from this study, it was concluded that 305423 soybeans were nutritionally equivalent to non-transgenic control soybeans with a comparable genetic background.

78 FR 77144 - Announcement of Funding Awards for Fiscal Year 2013 for the Housing Choice Voucher Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

..., HOPEWELL, VA 23860. VA: VIRGINIA HSG REDEV AUTH.. 601 SOUTH 0 9,400 BELVIDERE ST, RICHMOND, VA 23220. VT...: HENDERSON HA 111 SOUTH ADAMS 0 17,800 ST, HENDERSON, KY 42420. KY: CYNTHIANA HA 149 FEDERAL ST, 0 4,200... 20895. MI: MICHIGAN STATE HSG DEV PO BOX 30044, 0 84,800 AUTH. LANSING, MI 48909. MN: VIRGINIA HRA PO...

Risk Assessment of Potentially Toxic Elements (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned Metallurgy Factory in North China

PubMed Central

Chen, Jiajun

2018-01-01

The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key PTEs were measured. The soil properties and speciation of the PTEs were also identified. Extremely high concentrations of As, Cd, Pb, and Zn were observed in the surface soils. Using the PTEs concentration in the top soils of the rural industrial wasteland, the following indices of pollution were calculated: the pollution load index (PLI), the geo-accumulation Index (Igeo), the risk assessment code (RAC), and the health risk assessment (HRA). The analysis of the PLI and Igeo indicated that site #1 was relatively clean, while sites #2 and #3 were heavily polluted. The results of the RAC showed that PTEs in top soils at sites #2 and #3 were significantly increased (p  <  0.05) for Cd and Zn. The HRA indicated that both As and Pb presented non-carcinogenic risks to children and adults at sites #2 and #3. Our findings can be a reference for risk prevention of industrially abandoned land in rural China. PMID:29316642

Risk Assessment of Potentially Toxic Elements (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned Metallurgy Factory in North China.

PubMed

Sun, Zheng; Chen, Jiajun

2018-01-06

The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key PTEs were measured. The soil properties and speciation of the PTEs were also identified. Extremely high concentrations of As, Cd, Pb, and Zn were observed in the surface soils. Using the PTEs concentration in the top soils of the rural industrial wasteland, the following indices of pollution were calculated: the pollution load index (PLI), the geo-accumulation Index (I geo ), the risk assessment code (RAC), and the health risk assessment (HRA). The analysis of the PLI and I geo indicated that site #1 was relatively clean, while sites #2 and #3 were heavily polluted. The results of the RAC showed that PTEs in top soils at sites #2 and #3 were significantly increased ( p <  0.05) for Cd and Zn. The HRA indicated that both As and Pb presented non-carcinogenic risks to children and adults at sites #2 and #3. Our findings can be a reference for risk prevention of industrially abandoned land in rural China.

Probabilistic risk assessment for a loss of coolant accident in McMaster Nuclear Reactor and application of reliability physics model for modeling human reliability

NASA Astrophysics Data System (ADS)

Ha, Taesung

A probabilistic risk assessment (PRA) was conducted for a loss of coolant accident, (LOCA) in the McMaster Nuclear Reactor (MNR). A level 1 PRA was completed including event sequence modeling, system modeling, and quantification. To support the quantification of the accident sequence identified, data analysis using the Bayesian method and human reliability analysis (HRA) using the accident sequence evaluation procedure (ASEP) approach were performed. Since human performance in research reactors is significantly different from that in power reactors, a time-oriented HRA model (reliability physics model) was applied for the human error probability (HEP) estimation of the core relocation. This model is based on two competing random variables: phenomenological time and performance time. The response surface and direct Monte Carlo simulation with Latin Hypercube sampling were applied for estimating the phenomenological time, whereas the performance time was obtained from interviews with operators. An appropriate probability distribution for the phenomenological time was assigned by statistical goodness-of-fit tests. The human error probability (HEP) for the core relocation was estimated from these two competing quantities: phenomenological time and operators' performance time. The sensitivity of each probability distribution in human reliability estimation was investigated. In order to quantify the uncertainty in the predicted HEPs, a Bayesian approach was selected due to its capability of incorporating uncertainties in model itself and the parameters in that model. The HEP from the current time-oriented model was compared with that from the ASEP approach. Both results were used to evaluate the sensitivity of alternative huinan reliability modeling for the manual core relocation in the LOCA risk model. This exercise demonstrated the applicability of a reliability physics model supplemented with a. Bayesian approach for modeling human reliability and its potential usefulness of quantifying model uncertainty as sensitivity analysis in the PRA model.

Prevention of atrial fibrillation by inter-atrial septum pacing guided by electrophysiological testing, in patients with delayed interatrial conduction.

PubMed

Manolis, A G; Katsivas, A G; Vassilopoulos, C; Koutsogeorgis, D; Louvros, N E

2002-04-01

Interatrial septum (IAS) pacing seems efficient in synchronizing atrial depolarization in patients (pts) with delayed inter-atrial conduction, but its clinical role in preventing atrial tachyarrhythmias is still debated. This study was conducted in order to evaluate the clinical efficacy of IAS pacing guided by pace mapping of the IAS, as an alternative treatment modality in pts with drug refractory paroxysmal atrial fibrillation (PAF). We evaluated 29 pts (13 male, 16 female, 60 +/- 11 years), with drug refractory PAF, normal sinus node function and prolonged inter-atrial conduction time (P wave 142 +/- 10 ms). Multipolar catheters were inserted and the electrograms from the high right atrium (HRA) and proximal, middle and distal coronary sinus (CS) were recorded. The IAS was paced from multiple sites. The site of IAS where the timing between HRA and distal CS was <20 ms was considered the most suitable for synchronizing the atria. This site was found to be superior to the CS os. near the fossa ovalis in all pts. An active fixation atrial lead was positioned at this site and a standard lead was placed in the right ventricle. During IAS pacing, the P wave duration decreased significantly to 107 +/- 15 ms (P<0.001). At implant, the atrial sensing was 2.3 +/- 0.7 mV, the atrial pacing threshold was 0.95 +/- 0.15 V (0.5 ms) and the impedance was 760 +/- 80 Ohm. We evaluated the pts during four periods of 3 months duration each. The first period (control) was before pacemaker implantation, while the pts were under antiarrhythmic treatment. During the subsequent two periods, we evaluated the clinical efficacy of IAS pacing to prevent PAF recurrences, in AAT (75 bpm) and AAIR (75-140 bpm) mode, with random selection of the order and after discontinuation of antiarrhythmic treatment. During the fourth period, the same AAIR mode was assessed, but antiarrhythmic drugs were also administered. We compared the arrhythmia free interval among the four periods. The proportion of atrial paced beats in AAIR pacing mode plus antiarrhythmics was significantly higher compared with the drug-free period in AAIR mode (57 +/- 9% and 49 +/- 9% respectively, P=0017) and with AAT pacing mode (44 +/- 10%,(, P<0.001). In AAT mode, the arrhythmia free interval was 24.2 +/- 5.1 days, while it was 26.2 +/- 5.7 days in AAIR mode. These intervals did not differ significantly from the pre-implantation period (24.1 +/- 6.3 days). The arrhythmia free interval in AAIR pacing in combination with antiarrhythmic drug therapy was 38.7 +/- 8.1 days and this was significantly longer than the previous periods (P<0.05). Atrial septal pacing in combination with antiarrhythmic drug therapy reduced the incidence of PAF in pts with prolonged inter-atrial conduction times. Pace mapping of the IAS is an attractive technique to assess the shortest atrial activation time between HRA and distal CS. Whether placement of the atrial lead based on the shortest HRA--distal CS time is the best place in the IAS to prevent PAF still remains to be proven.

Human health risk assessment in restoring safe and productive use of abandoned contaminated sites.

PubMed

Wcisło, Eleonora; Bronder, Joachim; Bubak, Anicenta; Rodríguez-Valdés, Eduardo; Gallego, José Luis R

2016-09-01

In Europe soil contamination has been recognized as a serious problem. The needs to remediate contaminated sites are not questionable, although the remediation actions are often hindered by their very high financial costs. On the other hand, the abandoned contaminated sites may have the potential for redevelopment and creating conditions appropriate for their productive reuse bringing social, economic and environmental benefits. The main concern associated with the contaminated sites is their potential adverse health impact. Therefore, in the process of contaminated site redevelopment the risk assessment and the subsequent risk management decisions will play a crucial role. The main objective of this study was to illustrate the role of the human health risk assessment (HRA) in supporting site remediation and reuse decisions. To exemplify the significance of the HRA process in this field the Nitrastur site, located in Asturias, Spain was used. Risks resulting from soil contamination with arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), nickel (Ni), mercury (Hg), zinc (Zn) and lead (Pb) were assessed under three potential future land use patterns: industrial, residential and recreational. The results of the study indicated that soil at the Nitrastur site might pose non-cancer and cancer risks to potential future receptors - industrial workers, residents and recreational users. Arsenic and lead are the main substances responsible for the health risk and the primary drivers of remedial decisions at the site. The highest total cancer risks were observed under the residential scenario, followed in descending order by the recreational and industrial ones. The remedial maps illustrate in which areas remediation activities are required, depending on a given land use pattern. The obtained results may be used to develop, analyse, compare and select the remedial options within the intended land use pattern. They may also be used to support the decisions concerning the reuse of the site or to create different redevelopment plans for different parts of the site. The study may help improve understanding and interaction between risk assessors and risk managers which are necessary to make proper, fully informed decisions enhancing public trust and credibility. Copyright © 2016 Elsevier Ltd. All rights reserved.

A HUMAN RELIABILITY-CENTERED APPROACH TO THE DEVELOPMENT OF JOB AIDS FOR REVIEWERS OF MEDICAL DEVICES THAT USE RADIOLOGICAL BYPRODUCT MATERIALS.

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

COOPER, S.E.; BROWN, W.S.; WREATHALL, J.

2005-02-02

The U.S. Nuclear Regulatory Commission (NRC) is engaged in an initiative to risk-inform the regulation of byproduct materials. Operating experience indicates that human actions play a dominant role in most of the activities involving byproduct materials, which are radioactive materials other than those used in nuclear power plants or in weapons production, primarily for medical or industrial purposes. The overall risk of these activities is strongly influenced by human performance. Hence, an improved understanding of human error, its causes and contexts, and human reliability analysis (HRA) is important in risk-informing the regulation of these activities. The development of the humanmore » performance job aids was undertaken by stages, with frequent interaction with the prospective users. First, potentially risk significant human actions were identified based on reviews of available risk studies for byproduct material applications and of descriptions of events for byproduct materials applications that involved potentially significant human actions. Applications from the medical and the industrial domains were sampled. Next, the specific needs of the expected users of the human performance-related capabilities were determined. To do this, NRC headquarters and region staff were interviewed to identify the types of activities (e.g., license reviews, inspections, event assessments) that need HRA support and the form in which such support might best be offered. Because the range of byproduct uses regulated by NRC is so broad, it was decided that initial development of knowledge and tools would be undertaken in the context of a specific use of byproduct material, which was selected in consultation with NRC staff. Based on needs of NRC staff and the human performance related characteristics of the context chosen, knowledge resources were then compiled to support consideration of human performance issues related to the regulation of byproduct materials. Finally, with information sources and an application context identified, a set of strawman job aids was developed, which was then presented to prospective users for critique and comment. Work is currently under way to develop training materials and refine the job aids in preparation for a pilot evaluation.« less

DNA Barcoding of Zooplankton in the Hampton Roads Area: A Biodiversity Assessment

NASA Astrophysics Data System (ADS)

Salcedo, A.; Rodríguez, Á. E.; Gibson, D. M.

2016-02-01

The study of zooplankton biodiversity and distribution is crucial to understand oceanic ecosystems and anticipate the effects of climate change. Previously, identification of zooplankton relied in morphological identification employed by expert taxonomists. DNA barcoding, a technique that uses the mitochondrial DNA (mtDNA) Cytochrome Oxidase 1 (CO1) gene is widely used for taxonomic identification. Thus, this molecular technique will be used to begin a detailed characterization of zooplankton diversity, abundance and community structure in the Hampton Roads Area (HRA). Stations 1 (Jones Creek) and 3 (lower Chesapeake Bay) were sampled in June 19, 2015. Stations 1, 2 (James River), and 3 were sampled in September 2015. Zooplankton samples were collected in triplicates with a 0.5m, 200 µm mesh net. Physical parameters (dissolved oxygen, salinity, temperature and, water transparency) were measured. Species identified as Opistonema oglinum (Atlantic Thread Herring) and Paracalanus parvus copepods were found at station 3; Anchoa mitchilli and Acartia tonsa copepods were found at stations 1 and 3. This study indicates that mtDNA-CO1 barcoding is suitable to identify zooplankton to the species level and helps validate DNA barcoding as a faster, more accurate taxonomic approach. The long term objective of this project is to provide a comprehensive assessment of zooplankton in the HRA and to generate a reference record for broad monitoring programs; vital for a better understanding and management of ecologically and commercially important species.

[Prevalence of HPV-induced lesions in the anal canal among women with cervical intraepithelial neoplasia 2 and 3: cross-sectional study].

PubMed

Heráclio, Sandra de Andrade; de Araujo, Thaís Antunes; Souza, Alex Sandro Rolland; Cahen, Kristiane; Lima Junior, Sergio Ferreira; de Souza, Paulo Roberto Eleutério; Amorim, Melania Maria Ramos

2015-10-01

To determine the prevalence of HPV-induced lesions in the anal canal of women with cervical intraepithelial neoplasia (CIN) grade 2/3. A cross-sectional study was carried out from December 2008 to June 2009, in Pernambuco, northeastern Brazil. Only women with grade 2/3 CIN were included, and those who could not undergo anoscopy during their first visit were excluded. A cyttobrush was used for sample collection in order to identify HPV DNA through PCR and anal cytology. An anal biopsy was obtained in cases of abnormal anal cytology or major alterations in high resolution anoscopy (HRA). Thirty-two percent (n=37/115) of HRA were normal and 63.5% (n=73/115) showed acetowhite epithelium. Twenty-two percent (n=26/115) of anal cytologies were abnormal. Among the latter, 12.2% (n=14/26) were low-grade anal intraepithelial lesions and 3.4% (n=4/26) were high-grade anal intraepithelial lesions. Twenty-two anal biopsies were performed, 13.7% of which (n=3/22) were grade 2 anal intraepithelial neoplasia (AIN2) and 9% (n=2/22) were grade 3 AIN. Th HPV DNA was identified in 72.1% of cases (n=83/115). Women with CIN grade 2/3 showed a high prevalence of anal HPV infection and HPV-induced lesions.

TPH-contaminated Mexican refinery soil: health risk assessment and the first year of changes.

PubMed

Iturbe, Rosario; Flores, Rosa M; Flores, Carlos R; Torres, Luis G

2004-02-01

The soil of a coastal Mexican refinery is quite contaminated, especially by hydrocarbons, with detected concentrations up to 130000 mg kg(-1) as TPHs (total petroleum hydrocarbons). The main sources of contamination are pipelines, valves, and old storage tanks, besides the land disposal of untreated hydrocarbon sediments derived from the cleaning of storage tanks. A health risk assessment (HRA) was carried out in order to measure the risk hazard indexes and clean-up standards for the refinery soil. HRA suggested the following actions to be taken: benzene concentrations must be reduced in eight of the 16 studied refinery zones to 0.0074-0.0078 mg kg(-1). Also, vanadium concentration must be reduced in two zones up to a concentration of 100 mg kg(-1). In only one of all of the studied zones, benzo(a)pyrene concentration must be reduced to 0.1 mg kg(-1). After 1 yr, TPHs showed a diminution of about 52%. Even though TPHs concentrations were variable, during 1999 the average concentrations were as much as 15.5 times the goal concentration. For year 2000, TPHs concentrations were only 7.4-fold the proposed value. For the 1999-2000 period, PAHs (polycyclic aromatic hydrocarbons) concentrations decreased by 82%. Some PAHs with 2, 3, 4, and 5 aromatic rings were removed up to 100% values.

The relationship between modifiable health risks and group-level health care expenditures. Health Enhancement Research Organization (HERO) Research Committee.

PubMed

Anderson, D R; Whitmer, R W; Goetzel, R Z; Ozminkowski, R J; Dunn, R L; Wasserman, J; Serxner, S

2000-01-01

To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Eleven risk factors (exercise, alcohol use, eating, current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.

Partnership in employee health. A workplace health program for British Columbia Public Service Agency (Canada).

PubMed

Tarride, J E; Harrington, K; Balfour, R; Simpson, P; Foord, L; Anderson, L; Lakey, W

2011-01-01

To evaluate the My Health Matters! (MHM) program, a multifaceted workplace intervention relying on education and awareness, early detection and disease management with a focus on risk factors for metabolic syndrome. The MHM program was offered to 2,000 public servants working in more than 30 worksites in British Columbia, Canada. The MHM program included a health risk assessment combined with an opportunity to attend an on-site screening and face-to-face call back visits and related on-site educational programs. Clinical and economic outcomes were collected over time in this one-year prospective study coupled with administrative and survey data. Forty three per cent of employees (N=857) completed the online HRA and 23 per cent (N=447) attended the initial clinical visit with the nurse. Risk factors for metabolic syndrome were identified in more than half of those attending the clinical visit. The number of risk factors significantly decreased by 15 per cent over six months (N=141). The cost per employee completing the HRA was $205 while the cost per employee attending the initial clinical visit was $394. Eighty-two per cent of employees would recommend the program to other employers. This study supports that workplace interventions are feasible, sustainable and valued by employees. As such, this study provides a new framework for implementing and evaluating workplace interventions focussing on metabolic disorders.

Design and Performance of the ARIANNA HRA-3 Neutrino Detector Systems

NASA Astrophysics Data System (ADS)

Barwick, S. W.; Berg, E. C.; Besson, D. Z.; Duffin, T.; Hanson, J. C.; Klein, S. R.; Kleinfelder, S. A.; Ratzlaff, K.; Reed, C.; Roumi, M.; Stezelberger, T.; Tatar, J.; Walker, J.; Young, R.; Zou, L.

2015-10-01

We report on the development, installation, and operation of the first three of seven stations deployed at the ARIANNA site's pilot Hexagonal Radio Array (HRA) in Antarctica. The primary goal of the ARIANNA project is to observe ultrahigh energy ( > 100 PeV) cosmogenic neutrino signatures using a large array of autonomous stations, each 1 km apart on the surface of the Ross Ice Shelf. Sensing radio emissions of 100 MHz to 1 GHz, each station in the array contains RF antennas, amplifiers, 1.92 G-sample/s, 850 MHz bandwidth signal acquisition circuitry, pattern-matching trigger capabilities, an embedded CPU, 32 GB of solid-state data storage, and long-distance wireless and satellite communications. Power is provided by the sun and buffered in LiFePO 4 storage batteries, and each station consumes an average of 7 W of power. Operation on solar power has resulted in ≥58% per calendar-year live-time. The station's pattern-trigger capabilities reduce the trigger rates to a few milli-Hertz with 4-sigma voltage thresholds while retaining good stability and high efficiency for neutrino signals. The timing resolution of the station has been found to be 0.049 ns, RMS, and the angular precision of event reconstructions of signals bounced off of the sea-ice interface of the Ross Ice Shelf ranged from 0.14 to 0.17 °.

Mind the gaps in research on the control of gastrointestinal nematodes of farmed ruminants and pigs.

PubMed

Charlier, J; Thamsborg, S M; Bartley, D J; Skuce, P J; Kenyon, F; Geurden, T; Hoste, H; Williams, A R; Sotiraki, S; Höglund, J; Chartier, C; Geldhof, P; van Dijk, J; Rinaldi, L; Morgan, E R; von Samson-Himmelstjerna, G; Vercruysse, J; Claerebout, E

2018-05-01

Gastrointestinal (GI) nematode control has an important role to play in increasing livestock production from a limited natural resource base and to improve animal health and welfare. In this synthetic review, we identify key research priorities for GI nematode control in farmed ruminants and pigs, to support the development of roadmaps and strategic research agendas by governments, industry and policymakers. These priorities were derived from the DISCONTOOLS gap analysis for nematodes and follow-up discussions within the recently formed Livestock Helminth Research Alliance (LiHRA). In the face of ongoing spread of anthelmintic resistance (AR), we are increasingly faced with a failure of existing control methods against GI nematodes. Effective vaccines against GI nematodes are generally not available, and anthelmintic treatment will therefore remain a cornerstone for their effective control. At the same time, consumers and producers are increasingly concerned with environmental issues associated with chemical parasite control. To address current challenges in GI nematode control, it is crucial to deepen our insights into diverse aspects of epidemiology, AR, host immune mechanisms and the socio-psychological aspects of nematode control. This will enhance the development, and subsequent uptake, of the new diagnostics, vaccines, pharma-/nutraceuticals, control methods and decision support tools required to respond to the spread of AR and the shifting epidemiology of GI nematodes in response to climatic, land-use and farm husbandry changes. More emphasis needs to be placed on the upfront evaluation of the economic value of these innovations as well as the socio-psychological aspects to prioritize research and facilitate uptake of innovations in practice. Finally, targeted regulatory guidance is needed to create an innovation-supportive environment for industries and to accelerate the access to market of new control tools. © 2017 Blackwell Verlag GmbH.

EEG complexity as a biomarker for autism spectrum disorder risk

PubMed Central

2011-01-01

Background Complex neurodevelopmental disorders may be characterized by subtle brain function signatures early in life before behavioral symptoms are apparent. Such endophenotypes may be measurable biomarkers for later cognitive impairments. The nonlinear complexity of electroencephalography (EEG) signals is believed to contain information about the architecture of the neural networks in the brain on many scales. Early detection of abnormalities in EEG signals may be an early biomarker for developmental cognitive disorders. The goal of this paper is to demonstrate that the modified multiscale entropy (mMSE) computed on the basis of resting state EEG data can be used as a biomarker of normal brain development and distinguish typically developing children from a group of infants at high risk for autism spectrum disorder (ASD), defined on the basis of an older sibling with ASD. Methods Using mMSE as a feature vector, a multiclass support vector machine algorithm was used to classify typically developing and high-risk groups. Classification was computed separately within each age group from 6 to 24 months. Results Multiscale entropy appears to go through a different developmental trajectory in infants at high risk for autism (HRA) than it does in typically developing controls. Differences appear to be greatest at ages 9 to 12 months. Using several machine learning algorithms with mMSE as a feature vector, infants were classified with over 80% accuracy into control and HRA groups at age 9 months. Classification accuracy for boys was close to 100% at age 9 months and remains high (70% to 90%) at ages 12 and 18 months. For girls, classification accuracy was highest at age 6 months, but declines thereafter. Conclusions This proof-of-principle study suggests that mMSE computed from resting state EEG signals may be a useful biomarker for early detection of risk for ASD and abnormalities in cognitive development in infants. To our knowledge, this is the first demonstration of an information theoretic analysis of EEG data for biomarkers in infants at risk for a complex neurodevelopmental disorder. PMID:21342500

Heavy metal exposure from cooked rice grain ingestion and its potential health risks to humans from total and bioavailable forms analysis.

PubMed

Praveena, S M; Omar, N A

2017-11-15

Heavy metal in rice studies has attracted a greater concern worldwide. However, there have been limited studies on marketed rice samples although it represents a vital ingestion portion for a real estimation of human health risk. This study was aimed to determine both total and bioaccessible of trace elements and heavy metals (Cd, Cr, Cu, Co, Al, Zn, As, Pb and Fe) in 22 varieties of cooked rice using an inductively coupled plasma-optical emission spectroscopy. Both total and bioaccessible of trace elements and heavy metals were digested using closed-nitric acid digestion and Rijksinstituut voor Volksgezondheid en Milieu (RIVM) in vitro digestion model, respectively. Human health risks via Health Risk Assessment (HRA) were conducted to understand exposure risks involving adults and children representing Malaysian population. Zinc was the highest while As was the lowest contents for total and in their bioavailable forms. Four clusters were identified: (1) Pb, As, Co, Cd and Cr; (2) Cu and Al; (3) Fe and (4) Zn. For HRA, there was no any risks found from single element exposure. While potential carcinogenic health risks present for both adult and children from single As exposure (Life time Cancer Risk, LCR>1×10 -4 ). Total Hazard Quotient values for adult and children were 27.0 and 18.0, respectively while total LCR values for adult and children were 0.0049 and 0.0032, respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prolonged antiretroviral therapy is associated with fewer anal high-grade squamous intraepithelial lesions in HIV-positive MSM in a cross-sectional study.

PubMed

Libois, Agnès; Feoli, Francesco; Nkuize, Marcel; Delforge, Marc; Konopnicki, Deborah; Clumeck, Nathan; De Wit, Stéphane

2017-02-01

HIV-positive men who have sex with men (MSM) are at increased risk of anal cancer. We evaluate the risk factors for anal high-grade squamous intraepithelial lesion (HSIL) (the precursor of anal cancer) in HIV-positive MSM. In this cross-sectional study within a cohort, 320 HIV-positive MSM were screened by anal cytology followed by high-resolution anoscopy (HRA) in case of abnormal cytology. Risk factors for anal HSIL were analysed. Men were mostly middle-aged Caucasians with median CD4+ T lymphocytes of 638 cells/µL, 87% on combined antiretroviral therapy (cART) for a median of 5 years. 198 anal cytology samples were normal. In the 122 patients with abnormal cytology, HRA with biopsies were performed: 12% (n=15) normal, 36% (n=44) anal low-grade squamous intraepithelial lesion (LSIL) and 51% (n=63) anal HSIL. Comparing patients with or without anal HSIL (normal cytology or normal biopsy or LSIL), we found in multivariate analysis significantly fewer anal HSIL in patients with cART ≥24 months (OR 0.32 CI 95% 0.162 to 0.631, p=0.001). Prolonged cART (≥24 months) is associated with fewer anal HSIL. 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/.

SIMULATED HUMAN ERROR PROBABILITY AND ITS APPLICATION TO DYNAMIC HUMAN FAILURE EVENTS

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

Herberger, Sarah M.; Boring, Ronald L.

Abstract Objectives: Human reliability analysis (HRA) methods typically analyze human failure events (HFEs) at the overall task level. For dynamic HRA, it is important to model human activities at the subtask level. There exists a disconnect between dynamic subtask level and static task level that presents issues when modeling dynamic scenarios. For example, the SPAR-H method is typically used to calculate the human error probability (HEP) at the task level. As demonstrated in this paper, quantification in SPAR-H does not translate to the subtask level. Methods: Two different discrete distributions were generated for each SPAR-H Performance Shaping Factor (PSF) tomore » define the frequency of PSF levels. The first distribution was a uniform, or uninformed distribution that assumed the frequency of each PSF level was equally likely. The second non-continuous distribution took the frequency of PSF level as identified from an assessment of the HERA database. These two different approaches were created to identify the resulting distribution of the HEP. The resulting HEP that appears closer to the known distribution, a log-normal centered on 1E-3, is the more desirable. Each approach then has median, average and maximum HFE calculations applied. To calculate these three values, three events, A, B and C are generated from the PSF level frequencies comprised of subtasks. The median HFE selects the median PSF level from each PSF and calculates HEP. The average HFE takes the mean PSF level, and the maximum takes the maximum PSF level. The same data set of subtask HEPs yields starkly different HEPs when aggregated to the HFE level in SPAR-H. Results: Assuming that each PSF level in each HFE is equally likely creates an unrealistic distribution of the HEP that is centered at 1. Next the observed frequency of PSF levels was applied with the resulting HEP behaving log-normally with a majority of the values under 2.5% HEP. The median, average and maximum HFE calculations did yield different answers for the HFE. The HFE maximum grossly over estimates the HFE, while the HFE distribution occurs less than HFE median, and greater than HFE average. Conclusions: Dynamic task modeling can be perused through the framework of SPAR-H. Identification of distributions associated with each PSF needs to be defined, and may change depending upon the scenario. However it is very unlikely that each PSF level is equally likely as the resulting HEP distribution is strongly centered at 100%, which is unrealistic. Other distributions may need to be identified for PSFs, to facilitate the transition to dynamic task modeling. Additionally discrete distributions need to be exchanged for continuous so that simulations for the HFE can further advance. This paper provides a method to explore dynamic subtask to task translation and provides examples of the process using the SPAR-H method.« less

The ARIANNA Hexagonal Radio Array - performance and prospects

NASA Astrophysics Data System (ADS)

Hallgren, Allan

2016-04-01

The origin of the highest energy cosmic rays at ˜1020 eV is still unknown. Ultra-high energy neutrinos from the GZK process should provide information on the sources and their properties. A promising and cost effective method for observing GZK-neutrinos is based on detection of Askaryan radio pulses with antennas installed in ice. The ARIANNA project aims at instrumenting a 36*36 km2 large area on the Ross Ice Shelf with an array of radio detection stations. The deployment of a test system for ARIANNA, the Hexagonal Radio Array (HRA), was completed in December 2014. The three first stations were installed in 2012. Solar panels are used to drive the < 10 W stations. The system hibernated at sunset in April and all stations returned to operation in September. The site is essentially free of anthropogenic noise. Simple cuts eliminate background and provides for efficient selection of neutrino events. Prospects for the sensitivity of the full ARIANNA array to the flux of GZK neutrinos are shown.

[Discovery of potential LXRβ agonists from Chinese herbs using molecular simulation methods].

PubMed

Luo, Gang-Gang; Lu, Fang; Qiao, Lian-Sheng; Li, Yong; Zhang, Yan-Ling

2016-08-01

Liver X receptor β (LXRβ) has been a new target in the treatment of hyperlipemia, which was related to the cholesterol homeostasis. In this study, the quantitative pharmacophores were constructed by 3D-QSAR pharmacophore (Hypogen) method based on the LXRβ agonists. The optimal pharmacophore model containing one hydrogen bond acceptor, two hydrophobics and one ring aromatic was obtained based on five assessment indictors, including the correlation between predicted value and experimental value of the compounds in training set (correlation), Δcost of the models (Δcost), hit rate of active compounds (HRA), identification of effectiveness index (IEI) and comprehensive evaluation index (CAI). And the values of the five assessment indicators were 0.95, 128.65, 84.44%, 2.58 and 2.18 respectively. The best model as a query to screen the traditional Chinese medicine database (TCMD), a list of 309 compounds was obtained andwere then refined using Libdock program. Finally, based on the screening rules of the Libdock score of initial compound and the key interactions between initial compound and receptor, four compounds, demethoxycurcumin, isolicoflavonol, licochalcone E and silydianin, were selected as potential LXRβ agonists. The molecular simulation methods were high-efficiency and time-saving to obtainthe potential LXRβ agonists, which could provide assistance for further researchingnovel anti-hyperlipidemia drugs. Copyright© by the Chinese Pharmaceutical Association.

Iris autofluorescence in Fuchs' heterochromic uveitis.

PubMed

Liu, Qian; Jia, Yading; Zhang, Suhua; Xie, Juan; Chang, Xin; Hou, Jia; Li, Gaiyun; Koch, Douglas D; Wang, Li

2016-10-01

To explore the characteristic autofluorescence patterns of iris depigmentation in eyes diagnosed with Fuchs' heterochromic uveitis (FHU). Near-infrared autofluorescence images and colour images of iris were taken in 21 eyes of 21 patients with FHU, 30 eyes of 15 normal subjects, 30 eyes of 15 normal age-related iris atrophy and 33 eyes of 20 patients with uveitis other than FHU. The confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2, HRA2) was used for melanin-related autofluorescence imaging. The indocyanine green angiography mode of HRA2 was applied for near-infrared laser imaging, and the wavelength of the excitation laser was 795 nm. Iris colour images were also taken with the slit lamp. In normal iris, moderately intense autofluorescence was noted for the pigment ruff at the pupillary border, the crests in the pupillary zone and the collarette; and there was mild autofluorescence in the ciliary zone. In eyes with age-related iris atrophy and uveitis, much less autofluorescence was seen than the healthy normal irides. In eyes with FHU, there was moderate but discontinuous autofluorescence in the pigment ruff, a petaloid pattern of autofluorescence in the pupillary zone, moderate autofluorescence in the collarette and reticular pattern of autofluorescence in the ciliary zone. Characteristic autofluorescence patterns appeared in eyes diagnosed with FHU. Near-infrared autofluorescence is a promising objective technique to document the iris changes in FHU. 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/

Effect of Dietary Supplementation With Lutein, Zeaxanthin, and ω-3 on Macular Pigment: A Randomized Clinical Trial.

PubMed

Korobelnik, Jean-François; Rougier, Marie-Bénédicte; Delyfer, Marie-Noëlle; Bron, Alain; Merle, Bénédicte M J; Savel, Hélène; Chêne, Geneviève; Delcourt, Cécile; Creuzot-Garcher, Catherine

2017-11-01

Nutritional uptake of lutein, zeaxanthin, and ω-3 polyunsaturated fatty acids may increase macular pigment optical density (MPOD) and thereby protect against the development of age-related macular degeneration (AMD). To estimate the efficiency of dietary supplementation containing lutein, zeaxanthin, ω-3 polyunsaturated fatty acids, and vitamins to increase the density of macular pigment in first-generation offspring of parents with neovascular AMD. This study was a randomized clinical trial (Lutein Influence on Macula of Persons Issued From AMD Parents [LIMPIA]) with a 6-month treatment period, followed by a 6-month follow-up period. Analyses were based on the intent-to-treat principle. The setting was 2 university hospitals in France (at Bordeaux and Dijon) from January 2011 (first participant first visit) to February 2013 (last participant last visit). The analysis was conducted from January to November 2016. Participants were 120 individuals free of any retinal ocular disease. They were first-generation offspring of parents with neovascular AMD. Participants were randomized in a 1:1 ratio to receive either 2 daily dietary supplementation capsules or placebo for 6 months. The primary assessment criterion was the evolution of MPOD after 6 months of supplementation (value of both eligible eyes) measured using the modified MPD-Visucam 200 (Carl Zeiss Meditec) and the modified Heidelberg Retina Angiograph (Heidelberg Engineering) (HRA) at 0.98° eccentricity. The statistical analysis was adjusted for hospital and for risk factors. Overall, 120 participants (60 in each group) were included, and 239 eyes were analyzed (119 in the lutein plus zeaxanthin [L + Z] group and 120 in the placebo group). Their mean (SD) age was 56.7 (6.6) years, and 71.7% (n = 86) were female. A statistically significant increase in plasma lutein and zeaxanthin was shown in the L + Z group after 3 months and 6 months of treatment compared with the placebo group. However, the difference between groups in the evolution of MPOD measured by HRA 0.98° eccentricity between 6 months and baseline was 0.036 (95% CI, -0.037 to 0.110) (P = .33). Among first-generation offspring of parents with neovascular AMD in the LIMPIA trial, MPOD as measured with the modified HRA and the MPD-Visucam was not modified after 6 months of lutein and zeaxanthin dietary supplementation despite plasma levels showing continuous exposure to lutein and zeaxanthin. Further research is necessary to understand the mechanism of absorption and metabolism of these nutrients in the macula, the best way to measure MPOD, and the clinical benefit for the patients. clinicaltrials.gov Identifier: NCT01269697.

Protocol for a qualitative study exploring perspectives on the INternational CLassification of Diseases (11th revision); Using lived experience to improve mental health Diagnosis in NHS England: INCLUDE study

PubMed Central

Hackmann, Corinna; Green, Amanda; Notley, Caitlin; Perkins, Amorette; Reed, Geoffrey M; Ridler, Joseph; Wilson, Jon; Shakespeare, Tom

2017-01-01

Introduction Developed in dialogue with WHO, this research aims to incorporate lived experience and views in the refinement of the International Classification of Diseases Mental and Behavioural Disorders 11th Revision (ICD-11). The validity and clinical utility of psychiatric diagnostic systems has been questioned by both service users and clinicians, as not all aspects reflect their lived experience or are user friendly. This is critical as evidence suggests that diagnosis can impact service user experience, identity, service use and outcomes. Feedback and recommendations from service users and clinicians should help minimise the potential for unintended negative consequences and improve the accuracy, validity and clinical utility of the ICD-11. Methods and analysis The name INCLUDE reflects the value of expertise by experience as all aspects of the proposed study are co-produced. Feedback on the planned criteria for the ICD-11 will be sought through focus groups with service users and clinicians. The data from these groups will be coded and inductively analysed using a thematic analysis approach. Findings from this will be used to form the basis of co-produced recommendations for the ICD-11. Two service user focus groups will be conducted for each of these diagnoses: Personality Disorder, Bipolar I Disorder, Schizophrenia, Depressive Disorder and Generalised Anxiety Disorder. There will be four focus groups with clinicians (psychiatrists, general practitioners and clinical psychologists). Ethics and dissemination This study has received ethical approval from the Coventry and Warwickshire HRA Research Ethics Committee (16/WM/0479). The output for the project will be recommendations that reflect the views and experiences of experts by experience (service users and clinicians). The findings will be disseminated via conferences and peer-reviewed publications. As the ICD is an international tool, the aim is for the methodology to be internationally disseminated for replication by other groups. Trial registration number ClinicalTrials.gov: NCT03131505. PMID:28871029

Is stress a trigger factor for migraine?

PubMed

Schoonman, G G; Evers, D J; Ballieux, B E; de Geus, E J; de Kloet, E R; Terwindt, G M; van Dijk, J G; Ferrari, M D

2007-06-01

Although mental stress is commonly considered to be an important trigger factor for migraine, experimental evidence for this belief is yet lacking. To study the temporal relationship between changes in stress-related parameters (both subjective and objective) and the onset of a migraine attack. This was a prospective, ambulatory study in 17 migraine patients. We assessed changes in perceived stress and objective biological measures for stress (saliva cortisol, heart rate average [HRA], and heart rate variability [low-frequency power and high-frequency power]) over 4 days prior to the onset of spontaneous migraine attacks. Analyses were repeated for subgroups of patients according to whether or not they felt their migraine to be triggered by stress. There were no significant temporal changes over time for the whole group in perceived stress (p=0.50), morning cortisol (p=0.73), evening cortisol (p=0.55), HRA (p=0.83), low-frequency power (p=0.99) and high-frequency power (p=0.97) prior to or during an attack. Post hoc analysis of the subgroup of nine stress-sensitive patients who felt that >2/3 of their migraine attacks were triggered by psychosocial stress, revealed an increase for perceived stress (p=0.04) but no changes in objective stress response measures. At baseline, this group also showed higher scores on the Penn State Worry Questionnaire (p=0.003) and the Cohen Perceived Stress Scale (p=0.001) compared to non-stress-sensitive patients. Although stress-sensitive patients, in contrast to non-stress-sensitive patients, may perceive more stress in the days before an impending migraine attack, we failed to detect any objective evidence for a biological stress response before or during migraine attacks.

Assessing the Reliability of Regional Depth-Duration-Frequency Equations for Gauged and Ungauged Sites

NASA Astrophysics Data System (ADS)

Castellarin, A.; Montanari, A.; Brath, A.

2002-12-01

The study derives Regional Depth-Duration-Frequency (RDDF) equations for a wide region of northern-central Italy (37,200 km 2) by following an adaptation of the approach originally proposed by Alila [WRR, 36(7), 2000]. The proposed RDDF equations have a rather simple structure and allow an estimation of the design storm, defined as the rainfall depth expected for a given storm duration and recurrence interval, in any location of the study area for storm durations from 1 to 24 hours and for recurrence intervals up to 100 years. The reliability of the proposed RDDF equations represents the main concern of the study and it is assessed at two different levels. The first level considers the gauged sites and compares estimates of the design storm obtained with the RDDF equations with at-site estimates based upon the observed annual maximum series of rainfall depth and with design storm estimates resulting from a regional estimator recently developed for the study area through a Hierarchical Regional Approach (HRA) [Gabriele and Arnell, WRR, 27(6), 1991]. The second level performs a reliability assessment of the RDDF equations for ungauged sites by means of a jack-knife procedure. Using the HRA estimator as a reference term, the jack-knife procedure assesses the reliability of design storm estimates provided by the RDDF equations for a given location when dealing with the complete absence of pluviometric information. The results of the analysis show that the proposed RDDF equations represent practical and effective computational means for producing a first guess of the design storm at the available raingauges and reliable design storm estimates for ungauged locations. The first author gratefully acknowledges D.H. Burn for sponsoring the submission of the present abstract.

Synergic effects of renin and aldosterone on right ventricular function in hypertension: a tissue Doppler study.

PubMed

Gregori, Mario; Giammarioli, Benedetta; Tocci, Giuliano; Befani, Alberto; Ciavarella, Giuseppino Massimo; Ferrucci, Andrea; Paneni, Francesco

2015-12-01

Right ventricular dysfunction (RVD) is associated with poor cardiovascular outcome. The renin-angiotensin-aldosterone system is involved in alterations of the left ventricular geometry and function. Detrimental effects of the renin-angiotensin-aldosterone system on the right ventricular function are being postulated, but data supporting this assumption are still lacking. The aim of the study was to assess the impact of hyperreninemia, hyperaldosteronism or their combination on right ventricular function in hypertensive individuals. Plasma renin activity (PRA) and plasma aldosterone concentrations (PACs) were measured in 116 hypertensive patients, divided as follows: normal PRA and PAC (n = 38); high PRA and normal PAC (hypereninemia) (n = 26); normal PRA and high PAC (hyperaldosternism) (n = 27); high PRA and PAC (HRA) (n = 25). Echocardiographic evaluation of the left and right ventricles (RV), including tissue Doppler imaging, was performed. RVD was identified by tissue Doppler Imaging-derived Myocardial Performance Index, calculated with a multisegmental approach. Indices of the right ventricular structure and function, as well as the prevalence of RVD, were higher in hyperreninemia and hyperaldosternism groups as compared with the normal group, and a further increase was observed in the HRA patients. Regression models showed a similar risk of RVD in the hyperreninemia and hyperaldosternism patients, regardless of systemic and pulmonary pressure, as well as left ventricular dysfunction. Notably, patients with both hyperreninemia and hyperaldosternism exhibited the strongest association with RVD as compared with patients with only hyperreninemia or hyperaldosternism. Isolated hyperreninemia or hyperaldosternism determines a similar impairment of the right ventricular function, whereas their combination is further detrimental. Renin and aldosterone may represent early biomarkers of right ventricular dysfunction in hypertension.

Squamous cell dysplasia in the proximal rectum of three patients treated for ulcerative colitis on immunomodulators.

PubMed

Connolly, James G; Goldstone, Stephen E

2017-05-01

Anal canal high-grade squamous intraepithelial lesion (HSIL) is the precursor to anal cancer. Immunocompromised patients are at increased risk and disease is usually within 3 cm from the anal verge. High-resolution anoscopy (HRA) with an 8-cm anoscope is used to identify and guide cautery treatment of HSIL. We report three patients with a long-term history of ulcerative colitis (UC) treated with systemic immunomodulators who developed proximally located rectal HSIL. Two patients were HIV-negative women, 63 and 48 years old, and the third was a 51-year-old HIV-positive man with underlying UC for 10, 16, and 3 years, respectively. They each presented with a HPV-positive HSIL visibly extending above the limits of the anoscope used for HRA. None developed cancer. All had episodes of active UC. It is unclear what causative role systemic immunomodulators play in predisposing UC patients to proximal HSIL. HSIL probably developed on a tongue of HPV-infected squamous epithelium growing proximally over the inflamed rectum. Islands developed when areas of squamous epithelium degenerated, creating skip areas. This study highlights the potential for HSIL to extend into the rectum either as a contiguous patch or isolated islands and the need for heightened surveillance in patients with extensive anal canal HSIL treated with immunodulator therapy. HSIL identified at the limit of the anoscope should be investigated further with colonoscopy, and argon plasma coagulation (APC) ablation can serve as an effective treatment option. Patients are at risk for stricture, but it is unclear what role the UC or the ablation played in stricture formation.

The value of a transformation zone component in anal cytology to detect HSIL.

PubMed

Roberts, Jennifer M; Jin, Fengyi; Thurloe, Julia K; Ekman, Deborah; Adams, Marjorie K; McDonald, Ross L; Biro, Clare; Poynten, I Mary; Grulich, Andrew E; Farnsworth, Annabelle

2016-08-01

In a cytology-based screening program intended to prevent anal cancer, the anal transformation zone (TZ) should be adequately sampled because it is the site most susceptible to the development of the cancer precursor, high-grade squamous intraepithelial lesion (HSIL). An adequate TZ component is defined as comprising at least 10 rectal columnar or squamous metaplastic cells. In the current study, the authors examined whether the presence of a TZ component in anal cytology correlated with the detection of histological HSIL. In a natural history study of anal human papillomavirus infection in homosexual men, all participants underwent liquid-based cytology and high-resolution anoscopy (HRA) with or without biopsy at each visit. True-negative cytology (negative cytology with non-HSIL biopsy or negative HRA), false-negative cytology (negative cytology with HSIL biopsy), and true-positive cytology (abnormal cytology with HSIL biopsy) were compared with regard to the presence or absence of a TZ component. Of 617 participants, baseline results included 155 true-positive results, 191 true-negative results, and 31 false-negative results. The absence of an adequate TZ component was found to be significantly higher for false-negative (32.3%) than for either true-positive (11.0%; P = .0034) or true-negative (13.1%; P = .0089) results. Significantly more false-negative cases lacked a TZ component compared with either true-positive or true-negative cases. TZ cells may be an important indicator of sample quality for anal cytology because, unlike cervical sampling, the anal canal is not visualized during cytology sampling. Cancer Cytopathol 2016;124:596-601. © 2016 American Cancer Society. © 2016 American Cancer Society.

Investigation on microstructure and mechanical properties of Mo2FeB2 based cermets with and without PVA

NASA Astrophysics Data System (ADS)

Shen, Yupeng; Huang, Zhifu; Jian, Yongxin; Yang, Ming; Li, Kemin

2018-03-01

Mo2FeB2 based cermets with and without PVA have been investigated by x-ray diffractometry (XRD), x-ray photoelectron spectroscope (XPS) and scanning electron microscopy (SEM). The density and transverse rupture strength (TRS) of green compact, relative density, hardness (HRA), fracture toughness (KIC) and TRS of Mo2FeB2 based cermets were also measured. The results indicate that, compared with the Mo2FeB2 based cermets without PVA, the density of green compact with PVA can be improved slightly at the same pressure. However, the much higher TRS is obtained for the green compact without PVA. Meanwhile, Mo2FeB2 particles exhibit the finer and less congruity feature for Mo2FeB2 based cermets without PVA. In addition, the higher relative density, hardness, fracture toughness and TRS can be acquired for the cermets without PVA. Obviously, considering the mechanical properties and preparation period of Mo2FeB2 based cermets, no adding PVA is the optimized process of powder molding in the manufacture of Mo2FeB2 based cermets.

Associations between Poor Sleep Quality and Stages of Change of Multiple Health Behaviors among Participants of Employee Wellness Program.

PubMed

Hui, Siu-Kuen Azor; Grandner, Michael A

2015-01-01

Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. The current study is an analysis of data collected in 2008 from an online health risk assessment (HRA) survey completed by participants of the Kansas State employee wellness program (N=13,322). Using multinomial logistic regression, associations between self-reported sleep quality and stages of change (i.e. precontemplation, contemplation, preparation, action, maintenance) in five health behaviors (stress management, weight management, physical activities, alcohol use, and smoking) were analyzed. Adjusted for covariates, poor sleep quality was associated with an increased likelihood of contemplation, preparation, and in some cases action stage when engaging in the health behavior change process, but generally a lower likelihood of maintenance of the healthy behavior. The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population.

Risk Selection into Consumer-Directed Health Plans: An Analysis of Family Choices within Large Employers

PubMed Central

McDevitt, Roland D; Haviland, Amelia M; Lore, Ryan; Laudenberger, Laura; Eisenberg, Matthew; Sood, Neeraj

2014-01-01

Objective To identify the degree of selection into consumer-directed health plans (CDHPs) versus traditional plans over time, and factors that influence choice and temper risk selection. Data Sources/Study Setting Sixteen large employers offering both CDHP and traditional plans during the 2004–2007 period, more than 200,000 families. Study Design We model CDHP choice with logistic regression; predictors include risk scores, in addition to family, choice setting, and plan characteristics. Additional models stratify by account type or single enrollee versus family. Data Collection/Extraction Methods Risk scores, family characteristics, and enrollment decisions are derived from medical claims and enrollment files. Interviews with human resources executives provide additional data. Principal Findings CDHP risk scores were 74 percent of traditional plan scores in the first year, and this difference declined over time. Employer contributions to accounts and employee premium savings fostered CDHP enrollment and reduced risk selection. Having to make an active choice of plan increased CDHP enrollment but also increased risk selection. Risk selection was greater for singles than families and did not differ between HRA and HSA-based CDHPs. Conclusions Risk selection was not severe and it was well managed. Employers have effective methods to encourage CDHP enrollment and temper selection against traditional plans. PMID:24800305

Occupational and environmental health nursing in the era of consumer-directed health care.

PubMed

Sherman, Bruce; Click, Elizabeth

2007-05-01

Consumer-directed health care plans (CDHPs) present an opportunity to control health care costs. Health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are two different approaches to providing pre-tax funding for CDHP enrollees. Each has a significant impact on the nature and business aspects of worksite health care. Worksite clinics can provide support via on-site education, expanded acute care services, and referral to other health-related benefits and resources for all CDHP enrollees. With attention to the type of employee health benefits funding support (HSA or HRA), occupational health nurses can maximize the effectiveness and value of worksite clinic services for CDHP enrollees.

Risk selection into consumer-directed health plans: an analysis of family choices within large employers.

PubMed

McDevitt, Roland D; Haviland, Amelia M; Lore, Ryan; Laudenberger, Laura; Eisenberg, Matthew; Sood, Neeraj

2014-04-01

To identify the degree of selection into consumer-directed health plans (CDHPs) versus traditional plans over time, and factors that influence choice and temper risk selection. Sixteen large employers offering both CDHP and traditional plans during the 2004–2007 period, more than 200,000 families. We model CDHP choice with logistic regression; predictors include risk scores, in addition to family, choice setting, and plan characteristics. Additional models stratify by account type or single enrollee versus family. Risk scores, family characteristics, and enrollment decisions are derived from medical claims and enrollment files. Interviews with human resources executives provide additional data. CDHP risk scores were 74 percent of traditional plan scores in the first year, and this difference declined over time. Employer contributions to accounts and employee premium savings fostered CDHP enrollment and reduced risk selection. Having to make an active choice of plan increased CDHP enrollment but also increased risk selection. Risk selection was greater for singles than families and did not differ between HRA and HSA-based CDHPs. Risk selection was not severe and it was well managed. Employers have effective methods to encourage CDHP enrollment and temper selection against traditional plans.

Multilevel analysis of the physical health perception of employees: community and individual factors.

PubMed

Sathyanarayanan, Sudhakar; Brooks, Ambyr J; Hagen, Susan E; Edington, Dee W

2012-01-01

To investigate whether the communities where employees reside are associated with employee perception of overall physical health after adjusting for individual factors. Retrospective cross-sectional. Active employees from a large manufacturing company representing 157 zip code tabulation areas (ZCTAs) in Michigan. 22,012 active employees who completed at least one voluntary health risk appraisal (HRA) during 1999-2001. Community deprivation and racial segregation at the ZCTA level were obtained using indices created from 2000 U.S. Census data. Demographics and HRA-related data (health-related behaviors, medical history, and quality of life indicators) at the individual level were used as independent variables. A two-level logistic regression model (employees nested in ZCTA) was used to model the probability of better self-rated health perception (SRH) (better health: 89.1% versus poor health: 10.9%). Relative to those living in highly deprived communities, employees residing in less-deprived communities showed 2.06 (95% confidence interval [CI], 1.57-2.72) and those living in moderately deprived communities showed 1.83 (95% CI, 1.42-2.35) increased odds of better SRH. After adjusting for individual-level variables, employees living in less-deprived communities had increased odds (1.31 [95% CI, 1.07-1.60]) and those living in moderately deprived communities had increased odds (1.33 [95% CI, 1.11-1.59]) of better SRH compared with individuals from highly deprived communities. The association of racial segregation with employees' SRH was mediated after adjusting for other variables. Individual-level variables showed significant statistical associations with SRH. Communities do have a modest association with SRH of the employees living there. After adjusting for individual-level and demographic variables, employees living in less/moderately deprived communities are more likely to perceive better physical health relative to those who live in highly deprived communities.

A review of heavy metals in indoor dust and its human health-risk implications.

PubMed

Tan, Sock Yin; Praveena, Sarva Mangala; Abidin, Emilia Zainal; Cheema, Manraj Singh

2016-12-01

Indoor dust acts as a media for heavy metal deposition. Past studies have shown that heavy metal concentration in indoor dust is affected by local human activities and atmospheric transport can have harmful effects on human health. Additionally, children are more sensitive to heavy metals due to their hand-to-mouth behaviour and rapid body development. However, limited information on health risks were found in past dust studies as these studies aimed to identify heavy metal concentrations and sources of indoor dust. The objective of this review is to discuss heavy metal concentration and sources influencing its concentration in indoor dust. Accordingly, high lead (Pb) concentration (639.10 μg/g) has been reported in heavy traffic areas. In addition, this review paper aims to estimate the health risk to children from heavy metals in indoor dust via multiple exposure pathways using the health-risk assessment (HRA). Urban areas and industrial sites have revealed high heavy metal concentration in comparison to rural areas. Hazard index (HI) values found in arsenic (As), chromium (Cr) and Pb were 21.30, 1.10 and 2.40, respectively, indicate that non-carcinogenic elements are found in children. Furthermore, most of the past studies have found that carcinogenic risks for As, cadmium (Cd), Cr and Pb were below the acceptable total lifetime cancer risk (TLCR) range (1×10-6-1×10-4). The results of health risk assessment in this review show that carcinogenic risk exists among children. Hence, this proves that future studies need to focus on children's carcinogenic risk in indoor dust studies in order to find out the sources of heavy metals in indoor dust. This review highlights the importance of having the HRA application using bioavailable heavy metal concentration as it provides more accurate health-risk estimation. Moreover, this review is also useful as a reference for policy decision making in protecting children's health.

Multiple Evolutionary Events Involved in Maintaining Homologs of Resistance to Powdery Mildew 8 in Brassica napus.

PubMed

Li, Qin; Li, Jing; Sun, Jin-Long; Ma, Xian-Feng; Wang, Ting-Ting; Berkey, Robert; Yang, Hui; Niu, Ying-Ze; Fan, Jing; Li, Yan; Xiao, Shunyuan; Wang, Wen-Ming

2016-01-01

The Resistance to Powdery Mildew 8 (RPW8) locus confers broad-spectrum resistance to powdery mildew in Arabidopsis thaliana. There are four Homologous to RPW8s (BrHRs) in Brassica rapa and three in Brassica oleracea (BoHRs). Brassica napus (Bn) is derived from diploidization of a hybrid between B. rapa and B. oleracea, thus should have seven homologs of RPW8 (BnHRs). It is unclear whether these genes are still maintained or lost in B. napus after diploidization and how they might have been evolved. Here, we reported the identification and sequence polymorphisms of BnHRs from a set of B. napus accessions. Our data indicated that while the BoHR copy from B. oleracea is highly conserved, the BrHR copy from B. rapa is relatively variable in the B. napus genome owing to multiple evolutionary events, such as gene loss, point mutation, insertion, deletion, and intragenic recombination. Given the overall high sequence homology of BnHR genes, it is not surprising that both intragenic recombination between two orthologs and two paralogs were detected in B. napus, which may explain the loss of BoHR genes in some B. napus accessions. When ectopically expressed in Arabidopsis, a C-terminally truncated version of BnHRa and BnHRb, as well as the full length BnHRd fused with YFP at their C-termini could trigger cell death in the absence of pathogens and enhanced resistance to powdery mildew disease. Moreover, subcellular localization analysis showed that both BnHRa-YFP and BnHRb-YFP were mainly localized to the extra-haustorial membrane encasing the haustorium of powdery mildew. Taken together, our data suggest that the duplicated BnHR genes might have been subjected to differential selection and at least some may play a role in defense and could serve as resistance resource in engineering disease-resistant plants.

Quantification of the specific yield in a two-layer hard-rock aquifer model

NASA Astrophysics Data System (ADS)

Durand, Véronique; Léonardi, Véronique; de Marsily, Ghislain; Lachassagne, Patrick

2017-08-01

Hard rock aquifers (HRA) have long been considered to be two-layer systems, with a mostly capacitive layer just below the surface, the saprolite layer, and a mainly transmissive layer underneath, the fractured layer. Although this hydrogeological conceptual model is widely accepted today within the scientific community, it is difficult to quantify the respective storage properties of each layer with an equivalent porous medium model. Based on an HRA field site, this paper attempts to quantify in a distinct manner the respective values of the specific yield (Sy) in the saprolite and the fractured layer, with the help of a deterministic hydrogeological model. The study site is the Plancoët migmatitic aquifer located in north-western Brittany, France, with piezometric data from 36 observation wells surveyed every two weeks for eight years. Whereas most of the piezometers (26) are located where the water table lies within the saprolite, thus representing the specific yield of the unconfined layer (Sy1), 10 of them are representative of the unconfined fractured layer (Sy2), due to their position where the saprolite is eroded or unsaturated. The two-layer model, based on field observations of the layer geometry, runs with the MODFLOW code. 81 values of the Sy1/Sy2 parameter sets were tested manually, as an inverse calibration was not able to calibrate these parameters. In order to calibrate the storage properties, a new quality-of-fit criterion called ;AdVar; was also developed, equal to the mean squared deviation of the seasonal piezometric amplitude variation. Contrary to the variance, AdVar is able to select the best values for the specific yield in each layer. It is demonstrated that the saprolite layer is about 2.5 times more capacitive than the fractured layer, with Sy1 = 10% (7% < Sy1 < 15%) against Sy2 = 2% (1% < Sy2 < 3%), in this particular example.

Genetic polymorphisms of alcohol dehydrogense-1B and aldehyde dehydrogenase-2, alcohol flushing, mean corpuscular volume, and aerodigestive tract neoplasia in Japanese drinkers.

PubMed

Yokoyama, Akira; Mizukami, Takeshi; Yokoyama, Tetsuji

2015-01-01

Genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) modulate exposure levels to ethanol/acetaldehyde. Endoscopic screening of 6,014 Japanese alcoholics yielded high detection rates of esophageal squamous cell carcinoma (SCC; 4.1%) and head and neck SCC (1.0%). The risks of upper aerodigestive tract SCC/dysplasia, especially of multiple SCC/dysplasia, were increased in a multiplicative fashion by the presence of a combination of slow-metabolizing ADH1B*1/*1 and inactive heterozygous ALDH2*1/*2 because of prolonged exposure to higher concentrations of ethanol/acetaldehyde. A questionnaire asking about current and past facial flushing after drinking a glass (≈180 mL) of beer is a reliable tool for detecting the presence of inactive ALDH2. We invented a health-risk appraisal (HRA) model including the flushing questionnaire and drinking, smoking, and dietary habits. Esophageal SCC was detected at a high rate by endoscopic mass-screening in high HRA score persons. A total of 5.0% of 4,879 alcoholics had a history of (4.0%) or newly diagnosed (1.0%) gastric cancer. Their high frequency of a history of gastric cancer is partly explained by gastrectomy being a risk factor for alcoholism because of altered ethanol metabolism, e.g., by blood ethanol level overshooting. The combination of H. pylori-associated atrophic gastritis and ALDH2*1/*2 showed the greatest risk of gastric cancer in alcoholics. High detection rates of advanced colorectal adenoma/carcinoma were found in alcoholics, 15.7% of 744 immunochemical fecal occult blood test (IFOBT)-negative alcoholics and 31.5% of the 393 IFOBT-positive alcoholics. Macrocytosis with an MCV≥106 fl increased the risk of neoplasia in the entire aerodigestive tract of alcoholics, suggesting that poor nutrition as well as ethanol/acetaldehyde exposure plays an important role in neoplasia.

EPHECT III: Health risk assessment of exposure to household consumer products.

PubMed

Trantallidi, M; Dimitroulopoulou, C; Wolkoff, P; Kephalopoulos, S; Carrer, P

2015-12-01

In the framework of the EU EPHECT project (Emissions, Exposure Patterns and Health Effects of Consumer Products in the EU), irritative and respiratory effects were assessed in relation to acute (30-min) and long-term (24-h) inhalation exposure to key and emerging indoor air pollutants emitted during household use of selected consumer products. A detailed Health Risk Assessment (HRA) was performed for five selected pollutants of respiratory health relevance, namely acrolein, formaldehyde, naphthalene, d-limonene and α-pinene. For each pollutant, the Critical Exposure Limit (CEL) was compared to indoor air concentrations and exposure estimates for the use of 15 selected consumer products by two population groups (housekeepers and retired people) in the four geographical regions of Europe (North, West, South, East), which were derived previously based on microenvironmental modelling. For the present HRA, health-based CELs were derived for certain compounds in case indoor air quality guidelines were not available by the World Health Organization for end-points relevant to the current study. For each pollutant, the highest indoor air concentrations in each microenvironment and exposure estimates across home microenvironments during the day were lower than the corresponding acute and long-term CELs. However, considerable contributions, especially to acute exposures, were obtained in some cases, such as formaldehyde emissions resulting from single product use of a floor cleaning agent (82% CEL), a candle (10% CEL) and an electric air freshener (17% CEL). Regarding multiple product use, the case of 30-min formaldehyde exposure reaching 34% CEL when eight product classes were used across home microenvironments, i.e. all-purpose/kitchen/floor cleaning agents, furniture/floor polish, combustible/electric air fresheners, and perfume, needs to be highlighted. Such estimated values should be evaluated with caution, as these may be attributed to the exposure scenarios specifically constructed for the present study, following a 'most-representative worst-case scenario' approach for exposure and health risk assessment. Copyright © 2015 Elsevier B.V. All rights reserved.

Patterns of Walkability, Transit, and Recreation Environment for Physical Activity.

PubMed

Adams, Marc A; Todd, Michael; Kurka, Jonathan; Conway, Terry L; Cain, Kelli L; Frank, Lawrence D; Sallis, James F

2015-12-01

Diverse combinations of built environment (BE) features for physical activity (PA) are understudied. This study explored whether patterns of GIS-derived BE features explained objective and self-reported PA, sedentary behavior, and BMI. Neighborhood Quality of Life Study participants (N=2,199, aged 20-65 years, 48.2% female, 26% ethnic minority) were sampled in 2001-2005 from Seattle / King County WA and Baltimore MD / Washington DC regions. Their addresses were geocoded to compute net residential density, land use mix, retail floor area ratio, intersection density, public transit, and public park and private recreation facility densities using a 1-km network buffer. Latent profile analyses (LPAs) were estimated from these variables. Multilevel regression models compared profiles on accelerometer-measured moderate to vigorous PA (MVPA) and self-reported PA, adjusting for covariates and clustering. Analyses were conducted in 2013-2014. Seattle region LPAs yielded four profiles, including low walkability/transit/recreation (L-L-L); mean walkability/transit/recreation (M-M-M); moderately high walkability/transit/recreation (MH-MH-MH); and high walkability/transit/recreation (H-HH). All measures were higher in the HHH than the LLL profile (difference of 17.1 minutes/day for MVPA, 146.5 minutes/week for walking for transportation, 58.2 minutes/week for leisure-time PA, and 2.2 BMI points; all p<0.05). Baltimore region LPAs yielded four profiles, including L-L-L; M-M-M; high land use mix, transit, and recreation (HLU-HT-HRA); and high intersection density, high retail floor area ratio (HID-HRFAR). HLU-HT-HRA and L-L-L differed by 12.3 MVPA minutes/day; HID-HRFAR and L-L-L differed by 157.4 minutes/week for walking for transportation (all p<0.05). Patterns of environmental features explain greater differences in adults' PA than the four-component walkability index. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Health risk assessment of kerosene usage in an informal settlement in Durban, South Africa

NASA Astrophysics Data System (ADS)

Muller, E.; Diab, R. D.; Binedell, M.; Hounsome, R.

In Durban, South Africa studies have shown that more than seven out of ten households in low-income metropolitan areas rely on kerosene for domestic purposes, leading to widespread problems of poor indoor air quality. In light of the known health effects of kerosene usage, this study aimed to quantify the health risk for people living in a densely populated informal settlement known as Cato Crest within the Durban metropolitan area. The pollutants investigated included nitrogen dioxide, benzene and toluene. Nitrogen dioxide is known to affect both respiratory and immune systems, benzene is carcinogenic while toluene has a neurological health end point. All three pollutants are harmful when inhaled. The United States Environmental Protection Agency (US EPA) health risk assessment (HRA) framework was applied. Information on the exposure patterns of residents in Cato Crest were acquired through questionnaires in which data on fuel use, building structure, cooking habits and time-activity patterns were collected. Air quality monitoring of nitrogen dioxide and volatile organic compounds was also conducted in the households. The time-activity pattern survey revealed that the exposure periods of individuals in Cato Crest were far greater than the default exposure periods used by the US EPA. The results of the HRA showed that the residents of Cato Crest may experience significant health risks as a result of kerosene usage in their homes. Exposure to 1-h nitrogen dioxide concentration is not likely to produce adverse health effects, whereas exposure over a 24-h period indicates a potential health risk to sensitive individuals in two of the households when US EPA exposure values are used and in all of the households when locally derived exposure values are used. Benzene poses a health risk to sensitive individuals in 50% of the households when local exposure parameters are used, whereas there is no health risk associated with exposure to toluene.

Fully Automatic Segmentation of Fluorescein Leakage in Subjects With Diabetic Macular Edema

PubMed Central

Rabbani, Hossein; Allingham, Michael J.; Mettu, Priyatham S.; Cousins, Scott W.; Farsiu, Sina

2015-01-01

Purpose. To create and validate software to automatically segment leakage area in real-world clinical fluorescein angiography (FA) images of subjects with diabetic macular edema (DME). Methods. Fluorescein angiography images obtained from 24 eyes of 24 subjects with DME were retrospectively analyzed. Both video and still-frame images were obtained using a Heidelberg Spectralis 6-mode HRA/OCT unit. We aligned early and late FA frames in the video by a two-step nonrigid registration method. To remove background artifacts, we subtracted early and late FA frames. Finally, after postprocessing steps, including detection and inpainting of the vessels, a robust active contour method was utilized to obtain leakage area in a 1500-μm-radius circular region centered at the fovea. Images were captured at different fields of view (FOVs) and were often contaminated with outliers, as is the case in real-world clinical imaging. Our algorithm was applied to these images with no manual input. Separately, all images were manually segmented by two retina specialists. The sensitivity, specificity, and accuracy of manual interobserver, manual intraobserver, and automatic methods were calculated. Results. The mean accuracy was 0.86 ± 0.08 for automatic versus manual, 0.83 ± 0.16 for manual interobserver, and 0.90 ± 0.08 for manual intraobserver segmentation methods. Conclusions. Our fully automated algorithm can reproducibly and accurately quantify the area of leakage of clinical-grade FA video and is congruent with expert manual segmentation. The performance was reliable for different DME subtypes. This approach has the potential to reduce time and labor costs and may yield objective and reproducible quantitative measurements of DME imaging biomarkers. PMID:25634978

Fully automatic segmentation of fluorescein leakage in subjects with diabetic macular edema.

PubMed

Rabbani, Hossein; Allingham, Michael J; Mettu, Priyatham S; Cousins, Scott W; Farsiu, Sina

2015-01-29

To create and validate software to automatically segment leakage area in real-world clinical fluorescein angiography (FA) images of subjects with diabetic macular edema (DME). Fluorescein angiography images obtained from 24 eyes of 24 subjects with DME were retrospectively analyzed. Both video and still-frame images were obtained using a Heidelberg Spectralis 6-mode HRA/OCT unit. We aligned early and late FA frames in the video by a two-step nonrigid registration method. To remove background artifacts, we subtracted early and late FA frames. Finally, after postprocessing steps, including detection and inpainting of the vessels, a robust active contour method was utilized to obtain leakage area in a 1500-μm-radius circular region centered at the fovea. Images were captured at different fields of view (FOVs) and were often contaminated with outliers, as is the case in real-world clinical imaging. Our algorithm was applied to these images with no manual input. Separately, all images were manually segmented by two retina specialists. The sensitivity, specificity, and accuracy of manual interobserver, manual intraobserver, and automatic methods were calculated. The mean accuracy was 0.86 ± 0.08 for automatic versus manual, 0.83 ± 0.16 for manual interobserver, and 0.90 ± 0.08 for manual intraobserver segmentation methods. Our fully automated algorithm can reproducibly and accurately quantify the area of leakage of clinical-grade FA video and is congruent with expert manual segmentation. The performance was reliable for different DME subtypes. This approach has the potential to reduce time and labor costs and may yield objective and reproducible quantitative measurements of DME imaging biomarkers. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

Ultra-widefield retinal imaging through a black intraocular lens.

PubMed

Yusuf, Imran H; Fung, Timothy H M; Patel, Chetan K

2015-09-01

To evaluate the feasibility of ultra-widefield retinal imaging in patients with near infrared (IR)-transmitting black intraocular lenses (IOLs). Oxford Eye Hospital, Oxford, United Kingdom. Laboratory evaluation of a diagnostic technology with interventional case report. The field of retinal imaging through a Morcher poly(methyl methacrylate) (PMMA) black IOL was determined in a purpose-built adult schematic model eye with the HRA2 Spectralis confocal scanning laser ophthalmoscope using standard imaging, Staurenghi retina lens-assisted imaging, and ultra-widefield noncontact imaging. Retinal imaging using each modality was then performed on a patient implanted with another Morcher PMMA black IOL model. Ultra-widefield noncontact imaging and lens-assisted imaging captured up to 150 degrees of field (versus 40 degrees with a standard confocal scanning laser ophthalmoscope). Ultra-widefield retinal images were successfully acquired in a patient eye with a black IOL. This study has identified the first ultra-widefield retinal imaging modalities for patients with near IR-transmitting black IOLs. Should larger studies confirm this finding, noncontact ultra-widefield confocal scanning laser ophthalmoscopy might be considered the gold standard imaging technique for retinal surveillance in patients with near IR-transmitting black IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Targeting aminopeptidase N (APN/CD13) with cyclic-imide peptidomimetics derivative CIP-13F inhibits the growth of human ovarian carcinoma cells.

PubMed

Cui, Shu-Xiang; Qu, Xian-Jun; Gao, Zu-Hua; Zhang, Yu-Sheng; Zhang, Xiao-Fan; Zhao, Cui-Rong; Xu, Wen-Fang; Li, Qian-Bin; Han, Jin-Xiang

2010-06-28

Aminopeptidase N (APN/CD13) is an essential peptidase involved in the process of tumor growth, metastasis and angiogenesis. Inhibition of APN/CD13 may be an effective strategy for cancer treatment. CIP-13F is a cyclic-imide peptidomimetics compound designed to fit the active pockets S1 and S'1 of APN/CD13 that act in tumor proliferation. Our aim in this study was to evaluate the efficacy of CIP-13F as a candidate compound for cancer treatment. The experiments were performed on the human ovarian carcinoma (OVCA) ES-2 and HRA cell lines, which have high and low levels of APN/CD13 respectively. CIP-13F significantly blocked APN/CD13 activity on the surface of ES-2 cells as measured by quantitating the enzymatic cleavage of the substrate l-leucine-p-nitroanilide. CIP-13F effectively inhibited ES-2 cell growth and migration without significant cytotoxic effect. In contrast, CIP-13F did not significantly inhibit HRA cell growth, indicating that CIP-13F may inhibit ES-2 cell growth via suppression of APN/CD13. The suppression of APN/CD13 was also observed by using the assays of flow cytometry and Western blot analysis. Further, the inhibitory effects of CIP-13F on APN/CD13 and on ES-2 proliferation were supported by the induction of ES-2 apoptosis. CIP-13F-treated ES-2 cells resulted apoptotic characteristics, such as induction of externalization of phosphatidylserine and DNA laddering fragment. The activation of caspase-3 and poly ADP-ribose polymerase (PARP) was also enhanced. The inhibitory effects of CIP-13F on APN/CD13 expression and on ES-2 proliferation were confirmed in mice bearing ES-2 xenografts. CIP-13F delayed the growth of ES-2 xenografts in mice after 2 weeks of vena caudalis injection. These results suggest that CIP-13F has a high inhibitory effect on the growth of OVCA cells via decreasing the activity and expression of APN/CD13. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Characteristics of atrial fibrillation cycle length predict restoration of sinus rhythm by catheter ablation.

PubMed

Di Marco, Luigi Yuri; Raine, Daniel; Bourke, John P; Langley, Philip

2013-09-01

Successful termination of atrial fibrillation (AF) during catheter ablation (CA) is associated with arrhythmia-free follow-up. Preablation factors such as mean atrial fibrillation cycle length (AFCL) predict the likelihood of AF termination during ablation but recurring patterns and AFCL stability have not been evaluated. To investigate novel predictors of acute and postoperative ablation outcomes from intracardiac electrograms: (1) recurring AFCL patterns and (2) localization index (LI) of the instantaneous fibrillatory rate distribution. Sixty-two patients with AF (32 paroxysmal AF; 45 men; age 57 ± 10 years) referred for CA were enrolled. One-minute electrogram was recorded from coronary sinus (CS; 5 bipoles) and right atrial appendage (HRA; 2 bipoles). Atrial activations were detected automatically to derive the AFCL and instantaneous fibrillatory rate (inverse of AFCL) time series. Recurring AFCL patterns were quantified by using recurrence plot indices (RPIs): percentage determinism, entropy of determinism, and maximum diagonal length. AFCL stability was determined by using the LI. The CA outcome predictivity of individual indices was assessed. Patients with terminated atrial fibrillation (T-AF) had higher RPI (P < .05 in CS7-8) and LI than did those with nonterminated atrial fibrillation (P < .005 in CS3-4; P < .05 in CS5-6, CS7-8, and HRA). Patients free of arrhythmia after 3-month follow-up had higher RPI and LI (all P < .05 in CS7-8). All indices except percentage determinism predicted T-AF in CS7-8 (area under the curve [AUC] ≥ 0.71; odds ratio [OR] ≥ 4.50; P < .05). The median AFCL and LI predicted T-AF in HRAD (AUC ≥ 0.75; OR ≥ 7.76; P < .05). The RPI and LI predicted 3-month follow-up in CS7-8 (AUC ≥ 0.68; OR ≥ 4.17; P < .05). AFCL recurrence and stability indices could be used in selecting patients more likely to benefit from CA. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Fundus autofluorescence and fate of glycoxidized particles injected into subretinal space in rabbit age-related macular degeneration model.

PubMed

Hirata, Megumi; Yasukawa, Tsutomu; Wiedemann, Peter; Kimura, Erika; Kunou, Noriyuki; Eichler, Wolfram; Takase, Ayae; Sato, Rina; Ogura, Yuichiro

2009-07-01

Abnormal fundus autofluorescence (FAF) is associated with the incidence or progression of dry and wet age-related macular degeneration (AMD). We previously developed a rabbit AMD model with drusen and type-1 choroidal neovascularization (CNV) that mimics the accumulation of lipofuscin using artificial glycoxidized particles. The objective of the current study was to investigate in vitro effects of glycoxidized particles on retinal pigment epithelial (RPE) cells, and the FAF and fate of injected particles in this model. Glycoxidized particles were prepared by a 4-day incubation of water-in-oil emulsions of serum albumin and glycolaldehyde to allow glycoxidation and consequent cross-linking. After particles were added in the culture medium of confluent human RPE cells, cell viability, adhesion activity, and proliferation activity were assessed by cell counting. In anesthetized rabbits, 250 microg of glycoxidized particles were injected into the subretinal space to induce experimental AMD. FAF measurement and angiography with sodium fluorescein and indocyanine green were performed periodically using the Heidelberg Retina Angiograph 2 (HRA2). The eyes enucleated, and the lung and the spleen, excised at week 4 or 12, were histologically evaluated by light and fluorescence microscopy. Glycoxidized particles phagocytosed did not impair the cell viability, adhesion, and proliferation of RPE cells, as compared with RPE cells in controls. HRA2 showed different patterns of abnormal FAF in the area with the implanted glycoxidized particles, similar to pathological FAF patterns in aging human eyes with or without AMD. Histologic examination showed accumulated glycoxidized particles and large lipofuscin granules with green autofluorescence in and under the RPE and at the margins of or beneath drusen, possibly associated with abnormal FAF. In addition, some particles were detected in the lung and the spleen. Glycoxidized particles phagocytosed might stay in RPE cells without any acute biological reaction. Our rabbit model of AMD simulated abnormal FAF patterns observed in aging human eyes with or without AMD. Glycoxidized particles phagocytosed by RPE cells could be deposited on Bruch's membrane in rabbits, possibly excreted in part into choroidal circulation. This model may be useful for understanding various patterns of abnormal FAF histologically, and for elucidating the pathogenesis of AMD.

Comparison of broiler performance and carcass yields when fed transgenic maize grain containing event DP-O9814O-6 and processed fractions from transgenic soybeans containing event DP-356O43-5.

PubMed

McNaughton, J; Roberts, M; Rice, D; Smith, B; Hinds, M; Delaney, B; Iiams, C; Sauber, T

2011-08-01

The performance of broilers fed diets containing maize grain from event DP-Ø9814Ø-6 (98140; gat4621 and zm-hra genes) and processed fractions (meal, hulls, and oil) from soybeans containing event DP-356Ø43-5 (356043; gat4601 and gm-hra genes) was evaluated in a 42-d feeding study. Diets were produced with nontransgenic maize grain and soybean fractions from controls with comparable genetic backgrounds to 98140 and 356043 (control), 98140 maize and 356043 soybean (98140 + 356043), or 3 commercially available nontransgenic maize and soybean combinations. Ross 708 broilers (n = 120/group; 50% male, 50% female) were fed diets in 3 phases: starter (d 0 to 21), grower (d 22 to 35), and finisher (d 36 to 42). Starter diets contained (on average) 63% maize and 28% soybean meal, grower diets 66% maize and 26% soybean meal, and finisher diets 72% maize and 21% soybean meal; soybean hulls and oils were held constant at 1.0 and 0.5%, respectively, across all diets in all phases. Weight gain, feed intake, and mortality-adjusted feed efficiency were calculated for d 0 to 42. Standard organ and carcass yield data were collected on d 42. Data were analyzed using a mixed model ANOVA with differences between control and 98140 + 356043 group means considered significant at P < 0.05. Reference group data were used only to estimate experimental variability and to generate tolerance intervals. No significant differences were observed in weight gain, mortality, mortality-adjusted feed efficiency, organ yields, or carcass yields between broilers consuming diets produced with 98140 + 356043 and those consuming diets produced with control maize and soybean fractions. All values of response variables evaluated in the control and 98140 + 356043 groups fell within calculated tolerance intervals. Based on these results, it was concluded that the combination of genetically modified 98140 maize and 356043 soybean fractions was nutritionally equivalent to nontransgenic maize and soybean controls with comparable genetic backgrounds.

Nutritional equivalency evaluation of transgenic maize grain from event DP-O9814O-6 and transgenic soybeans containing event DP-356O43-5: laying hen performance and egg quality measures.

PubMed

McNaughton, J; Roberts, M; Rice, D; Smith, B; Hinds, M; Delaney, B; Iiams, C; Sauber, T

2011-02-01

The objective of this study was to compare the nutritional performance of laying hens fed maize grain from event DP-Ø9814Ø-6 (98140; gat4621 and zm-hra genes) and processed soybean meal from soybeans containing event DP-356Ø43-5 (356043; gat4601 and gm-hra genes), individually or in combination, with the performance of hens fed diets containing nontransgenic maize and soybean meal. Healthy pullets (n = 216) placed in cages (3 hens/cage) were randomly assigned to 9 dietary treatments (8 cages/treatment): nontransgenic controls 1, 2, and 3 (comparable genetic background controls for 98140, 356043, and 98140 + 356043, respectively); reference 1, reference 2, and reference 3 (commercially available nontransgenic maize-soybean meal sources); and 98140 (test 1), 356043 (test 2), and 98140 + 356043 (test 3). The experiment was divided into three 4-wk phases (24 to 28 wk, 28 to 32 wk, and 32 to 36 wk of age), during which time hens were fed mash diets. Performance (BW, feed intake, and egg production) and egg quality data were collected. Data were analyzed using a mixed model ANOVA; differences between the control and respective test group means were considered significant at P < 0.05. Data generated from the reference groups were used only in the estimation of experimental variability and in generating the tolerance interval. Body weight and BW gain, egg production, and production efficiency for hens fed the test diets were similar to the respective values for hens fed the corresponding control diets. Haugh unit measures and egg component weights were similar between the respective test and control groups, and no differences were observed in quality grades or crack measures. All observed values of the control and test groups were within the calculated tolerance intervals. This research indicates that the performance and egg quality of hens fed diets containing 98140 maize grain, 356043 soybean meal, or a combination of the 2 was comparable with that of hens fed diets formulated with nontransgenic maize grain or soybean meal control diets with comparable genetic backgrounds.

The Impact of Dose and Simultaneous Use of Acid-Reducing Agents on the Effectiveness of Vemurafenib in Metastatic BRAF V600 Mutated Melanoma: a Retrospective Cohort Study.

PubMed

Knapen, Lotte M; Koornstra, Rutger H T; Driessen, Johanna H M; van Vlijmen, Bas; Croes, Sander; Schalkwijk, Stein; Colbers, Angela; Gerritsen, Winald R; Burger, David M; de Vries, Frank; van Erp, Nielka P

2018-04-11

The impact of dose and simultaneous use of acid-reducing agents (ARAs) on the effectiveness of vemurafenib is unknown. To determine the association between progression of metastatic BRAF V600 mutated melanoma and (1) dose reductions of vemurafenib and (2) simultaneous use of vemurafenib and ARAs. A retrospective cohort study of 112 first-line vemurafenib users for melanoma was conducted (March 2012-March 2016), using electronic patient records and pharmacy dispensing records of a Dutch academic hospital. Cox regression analysis was used to estimate the risk of progression with full-dose (n = 64) versus reduced-dose vemurafenib (n = 48) and with simultaneous use of vemurafenib and ARAs (n = 35) versus vemurafenib alone (n = 77). Analyses were adjusted for age and sex. In total, disease progression occurred in 55% of treated patients on vemurafenib, with a median progression-free survival of 6.0 (95% confidence interval [CI] 5.0-6.9) months. Compared to patients on vemurafenib alone, there was no increased risk of progression among patients requiring vemurafenib at a reduced dose or among patients receiving simultaneous therapy with vemurafenib and ARAs. In addition, there was no increased risk of progression among patients who used reduced-dose vemurafenib and ARAs versus those receiving full-dose vemurafenib as sole therapy. However, a tendency for progression was observed among patients who used full-dose vemurafenib and ARAs versus full-dose vemurafenib alone (adjusted hazard ratio [HRa] 2.37; 95% CI 0.97-5.76), which became statistically significant in a sensitivity analysis (HRa 4.56; 95% CI 1.51-13.75). There was no association between the use of vemurafenib in a reduced dose or the simultaneous use of vemurafenib and ARAs and the risk of progression. In addition, there was no association between the simultaneous use of vemurafenib in a reduced dose and ARAs and the risk of progression. However, patients tolerating  full-dose vemurafenib simultaneously with ARAs might have an increased risk of progression. This finding requires prospective validation.

An interactional test of the reformulated helplessness theory of depression in women receiving clinical treatment for eating disorders.

PubMed

Rotenberg, Ken J; Costa, Paula; Trueman, Mark; Lattimore, Paul

2012-08-01

The study tested the Reformulated Helplessness model that individuals who show combined internal locus of control, high stability and high globality attributions for negative life events are prone to depression. Thirty-six women (M=29 years-8 months of age) receiving clinical treatment for eating disorders completed: the Attribution Style Questionnaire, the Beck Depression Inventory, and the Stirling Eating Disorder Scales. An HRA yielded a three-way interaction among the attributional dimensions on depressive symptoms. Plotting of the slopes showed that the attribution of negative life events to the combination of internal locus of control, high stability, and a high globality, was associated with the optimal level of depressive symptoms. The findings supported the Reformulated Helplessness as a model of depression. Copyright © 2012 Elsevier Ltd. All rights reserved.

Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs.

PubMed

Treleaven, Julia; Peterson, Gunnel; Ludvigsson, Maria Landén; Kammerlind, Ann-Sofi; Peolsson, Anneli

2016-04-01

Dizziness and unsteadiness are common symptoms following a whiplash injury. To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizziness. A sub-analysis of a randomized study. One hundred and forty subjects were randomized to either a physiotherapist-guided neck-specific exercise (NSE), physiotherapist-guided neck-specific exercise, with a behavioural approach (NSEB) or prescription of general physical activity (PPA) group. Pre intervention, 3, 6 and 12 months post baseline they completed the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Visual Analogue Scales (VAS) for, dizziness at rest and during activity and physical measures (static and dynamic clinical balance tests and head repositioning accuracy (HRA)). There were significant time by group differences with respect to dizziness during activity and UCLA-Q favouring the physiotherapy led neck specific exercise group with a behavioural approach. Within group analysis of changes over time also revealed significant changes in most variables apart from static balance. Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Fundus autofluorescence: applications and perspectives.

PubMed

Cuba, J; Gómez-Ulla, F

2013-02-01

To describe the findings of the study of autofluorescence of the different retinal diseases included in the study. To determine in which diseases autofluorescence may be more, or just as, useful as fluorescein angiography (FAG) in terms of diagnostic information. We studied the retinal autofluorescence of 123 eyes of 93 patients, including various diseases of the eye fundus. In all cases we explored the fundus, retinal autofluorescence, and, if indicated, FAG was performed. Analysis of the autofluorescence was performed using the Heidelberg Retina angiography Angiograph 2 (HRA2) Heidelberg Engineering (Germany). The autofluorescence information provided was equal or better (than FAG) in: 68.18% of cases of macular edema, 50% of pigment epithelium detachments, 100% of pigment epithelium atrophies, 100% of central serous chorioretinopathy; 55.55% of choroidal neovascularization, 100% of retinal dystrophies with deposition of lipofuscin, 100% of hard exudates and pre-retinal hemorrhages. Autofluorescence is a quick and non-invasive examination method, comfortable for both patient and examiner, and with a very short learning curve. It provides diagnostic information about many eye fundus diseases. While more studies and more experience with its use are needed, its interest lies in the possibility of avoiding the performing of angiography in patients with these diseases, and in the additional information autofluorescence provides about the functional situation of cells and retinal pigments. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Examining individual factors according to health risk appraisal data as determinants of absenteeism among US utility employees.

PubMed

Marzec, Mary L; Scibelli, Andrew F; Edington, Dee W

2013-07-01

To investigate predictors of absenteeism and discuss potential implications for policy/program design. Health Risk Appraisal (HRA) data and self-reported and objective absenteeism (personnel records) were used to develop a structural equation model, controlling for age, sex, and job classification. A Medical Condition Burden Index (MCBI) was created by summing the number of self-reported medical conditions. Higher MCBI and stress were direct predictors of absenteeism. Physical activity was not associated with absenteeism but mediated both stress and MCBI. Because stress impacted both absenteeism and MCBI, organizations may benefit by placing stress management as a priority for wellness program and policy focus. Physical activity was not directly associated with absenteeism but was a mediating variable for stress and MCBI. Measures of stress and physical health may be more meaningful as outcome measures for physical activity programs than absenteeism.

VizieR Online Data Catalog: MWACS (Hurley-Walker+, 2014)

NASA Astrophysics Data System (ADS)

Hurley-Walker, N.; Morgan, J.; Wayth, R. B.; Hancock, P. J.; Bell, M. E.; Bernardi, G.; Bhat, N. D. R.; Briggs, F.; Deshpande, A. A.; Ewall-Wice, A.; Feng, L.; Hazelton, B. J.; Hindson, L.; Jacobs, D. C.; Kaplan, D. L.; Kudryavtseva, N.; Lenc, E.; McKinley, B.; Mitchell, D.; Pindor, B.; Procopio, P.; Oberoi, D.; Offringa, A.; Ord, S.; Riding, J.; Bowman, J. D.; Cappallo, R.; Corey, B.; Emrich, D.; Gaensler, B. M.; Goeke, R.; Greenhill, L.; Hewitt, J.; Johnston-Hollitt, M.; Kasper, J.; Kratzenberg, E.; Lonsdale, C.; Lynch, M.; McWhirter, R.; Morales, M. F.; Morgan, E.; Prabu, T.; Rogers, A.; Roshi, A.; Shankar, U.; Srivani, K.; Subrahmanyan, R.; Tingay, S.; Waterson, M.; Webster, R.; Whitney, A.; Williams, A.; Williams, C.

2014-10-01

The Murchison Widefield Array Commissioning Survey (MWACS) is a ~6100deg2 104-196MHz radio sky survey performed with the Murchison Widefield Array during instrument commissioning between 2012 September and 2012 December. The data were taken as meridian drift scans with two different 32-antenna sub-arrays that were available during the commissioning period. The data were combined in the visibility plane before being imaged, and then mosaicked. The survey covers approximately 20.5h

The Association of Employee Engagement at Work With Health Risks and Presenteeism.

PubMed

Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B

2017-10-01

Employee engagement is a key factor in work performance and employee retention. The current study seeks to examine the relationship between employee engagement and health risks and productivity. In 2012, employees of a global financial services corporation participated in a health risk appraisal (HRA) which measured employee engagement, health risks, and on-the-job productivity loss (presenteeism). Three engagement categories were created. The highest engaged employees had significantly fewer health risk factors (69.7% overall low-risk status; 1.91 average health risks) and significantly less presenteeism (7.7%) than the mid engagement (67.9% low-risk, 1.98 risks, 9.2% presenteeism) and worst engagement (55.0% low-risk, 2.53 risks, 14.0% presenteeism) groups. Work engagement appears to be good for both the organization and the individual. Organizations may wish to make use of strategies which increase employee engagement.

Are we there yet? An examination of online tailored health communication.

PubMed

Suggs, L Suzanne; McIntyre, Chris

2009-04-01

Increasingly, the Internet is playing an important role in consumer health and patient-provider communication. Seventy-three percent of American adults are now online, and 79% have searched for health information on the Internet. This study provides a baseline understanding of the extent to which health consumers are able to find tailored communication online. It describes the current behavioral focus, the channels being used to deliver the tailored content, and the level of tailoring in online-tailored communication. A content analysis of 497 health Web sites found few examples of personalized, targeted, or tailored health sites freely available online. Tailored content was provided in 13 Web sites, although 15 collected individual data. More health risk assessment (HRA) sites included tailored feedback than other topics. The patterns that emerged from the analysis demonstrate that online health users can access a number of Web sites with communication tailored to their needs.

Genetic Information Nondiscrimination Act. Final rule.

PubMed

2016-05-17

The Equal Employment Opportunity Commission (EEOC or Commission) is issuing a final rule to amend the regulations implementing Title II of the Genetic Information Nondiscrimination Act of 2008 as they relate to employer-sponsored wellness programs. This rule addresses the extent to which an employer may offer an inducement to an employee for the employee's spouse to provide information about the spouse's manifestation of disease or disorder as part of a health risk assessment (HRA) administered in connection with an employer-sponsored wellness program. Several technical changes to the existing regulations are included. Published elsewhere in this issue of the Federal Register, the EEOC also issued a final rule to amend the regulations and interpretive guidance implementing Title I of the Americans with Disabilities Act (ADA) that addresses the extent to which employers may use incentives to encourage employees to participate in wellness programs that ask them to respond to disability-related inquiries and/or undergo medical examinations.

Semantic Interoperability of Health Risk Assessments

PubMed Central

Rajda, Jay; Vreeman, Daniel J.; Wei, Henry G.

2011-01-01

The health insurance and benefits industry has administered Health Risk Assessments (HRAs) at an increasing rate. These are used to collect data on modifiable health risk factors for wellness and disease management programs. However, there is significant variability in the semantics of these assessments, making it difficult to compare data sets from the output of 2 different HRAs. There is also an increasing need to exchange this data with Health Information Exchanges and Electronic Medical Records. To standardize the data and concepts from these tools, we outline a process to determine presence of certain common elements of modifiable health risk extracted from these surveys. This information is coded using concept identifiers, which allows cross-survey comparison and analysis. We propose that using LOINC codes or other universal coding schema may allow semantic interoperability of a variety of HRA tools across the industry, research, and clinical settings. PMID:22195174

The relationship between National Heart, Lung, and Blood Institute Weight Guidelines and concurrent medical costs in a manufacturing population.

PubMed

Wang, Feifei; Schultz, Alyssa B; Musich, Shirley; McDonald, Tim; Hirschland, David; Edington, Dee W

2003-01-01

To explore the relationship between the 1998 National Heart, Lung, and Blood Institute (NHLBI) weight guidelines and concurrent medical costs. Cross-sectional study. In a nationwide manufacturing corporation (General Motors Corporation). A total of 177,971 employees, retirees, and their adult dependents who were enrolled in Indemnity/PPO health insurance plan during the years 1996 and 1997 and completed one health risk appraisal (HRA) in the same period. The participants were categorized into six weight groups according to the NHLBI 1998 guidelines (body mass index [BMI] < 18.5, 18.5-24.9, 25-29.9, 30-34.9, 35-39.9, > or = 40 kg/m2). The height and weight data were collected by self-reported values on an HRA or biometric screening completed during 1996 to 1997. To represent the typical medical costs in a given group, the median, instead of mean, medical charges were used in this article. The annual median medical charges (including drug charges) for years 1996 and 1997 were compared among the six weight groups by using Wilcoxon rank sum tests. The differences in median charges were also tested between the normal weight group and the other five groups for each of the 10 gender-age subgroups (five age groups: 19-44, 45-54, 55-64, 65-74, 75+). Overall median medical costs were consistent with the NHLBI weight guidelines. The normal-weight group costs the least and both underweight and overweight-obesity groups cost more. The median medical costs of the six weight groups were $3184, $2225, $2388, $2801, $3182, and $3753, respectively, with statistical differences existing between any two groups of the last five categories. The underweight groups, especially in females, were not consistent with the guidelines in the two young groups (ages 19-44 and 45-54). An inconsistent relationship between medical costs and BMI groups was seen in the oldest males (age 75+). The six weight groups defined by the 1998 NHLBI guidelines are consistent with concurrent medical costs. Except for the underweight group (BMI < 18.5 kg/m2), medical costs gradually increased with BMI. Given that the prevalence of obesity continues to increase in western countries, effective weight control programs would help avoid a substantial amount of medical costs associated with overweight/obesity and related diseases.

Fifty Years of THERP and Human Reliability Analysis

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

Ronald L. Boring

2012-06-01

In 1962 at a Human Factors Society symposium, Alan Swain presented a paper introducing a Technique for Human Error Rate Prediction (THERP). This was followed in 1963 by a Sandia Laboratories monograph outlining basic human error quantification using THERP and, in 1964, by a special journal edition of Human Factors on quantification of human performance. Throughout the 1960s, Swain and his colleagues focused on collecting human performance data for the Sandia Human Error Rate Bank (SHERB), primarily in connection with supporting the reliability of nuclear weapons assembly in the US. In 1969, Swain met with Jens Rasmussen of Risø Nationalmore » Laboratory and discussed the applicability of THERP to nuclear power applications. By 1975, in WASH-1400, Swain had articulated the use of THERP for nuclear power applications, and the approach was finalized in the watershed publication of the NUREG/CR-1278 in 1983. THERP is now 50 years old, and remains the most well known and most widely used HRA method. In this paper, the author discusses the history of THERP, based on published reports and personal communication and interviews with Swain. The author also outlines the significance of THERP. The foundations of human reliability analysis are found in THERP: human failure events, task analysis, performance shaping factors, human error probabilities, dependence, event trees, recovery, and pre- and post-initiating events were all introduced in THERP. While THERP is not without its detractors, and it is showing signs of its age in the face of newer technological applications, the longevity of THERP is a testament of its tremendous significance. THERP started the field of human reliability analysis. This paper concludes with a discussion of THERP in the context of newer methods, which can be seen as extensions of or departures from Swain’s pioneering work.« less

Optimum hospice at home services for end-of-life care: protocol of a mixed-methods study employing realist evaluation.

PubMed

Butler, Claire; Brigden, Charlotte; Gage, Heather; Williams, Peter; Holdsworth, Laura; Greene, Kay; Wee, Bee; Barclay, Stephen; Wilson, Patricia

2018-05-16

Hospice at home (HAH) services aim to enable patients to be cared for and die in their place of choice, if that is at home, and to achieve a 'good death'. There is a considerable range of HAH services operating in England. The published evidence focuses on evaluations of individual services which vary considerably, and there is a lack of consistency in terms of the outcome measures reported. The evidence, therefore, does not provide generalisable information, so the question 'What are the features of hospice at home service models that work, for whom, and under what circumstances?' remains unanswered. The study aims to answer this question. This is a mixed-methods study in three phases informed by realist evaluation methodology. All HAH services in England will be invited to participate in a telephone survey to enable the development of a typology of services. In the second phase, case study sites representing the different service types will collect patient data and recruit carers, service managers and commissioners to gather quantitative and qualitative data about service provision and outcomes. A third phase will synthesise and refine the results through consensus workshops. The first survey phase has university ethics approval and the second phase, Integrated Research Application System (IRAS) and Health Research Authority (HRA) approval (IRAS ID:205986, REC:17/LO/0880); the third phase does not require ethics approval. Dissemination will be facilitated by project coapplicants with established connections to national policy-making forums, in addition to publications, conference presentations and reports targeted to service providers and commissioners. © 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.

Reduction of Cr (VI) into Cr (III) by organelles of Chlorella vulgaris in aqueous solution: An organelle-level attempt.

PubMed

Chen, Zunwei; Song, Shufang; Wen, Yuezhong

2016-12-01

The priority pollutant chromium (Cr) was ubiquitous and great efforts have been made to reduce Cr (VI) into less-toxic Cr (III) by alga for the convenient availability and low expense. However, the functional role of organelle inside the algal cell in Cr (VI) reduction was poorly understood. In this study, organelles in green algae Chlorella vulgaris were extracted and further decorated for Cr (VI) reduction tests. Results showed that the chloroplast exhibited not only adsorption ability of total Cr (21.18% comparing to control) but also reduction potential of Cr (VI) (almost 70% comparing to control), whose most suitable working concentration was at 17μg/mL. Furtherly, the isolated thylakoid membrane (ITM) showed better Cr (VI) reduction potential with the presence of sodium alginate (SA), even though the Hill reaction activity (HRA) was inhibited. As for photosystem II (PSII), the addition of mesoporous silica SBA-15 enhanced the reduction ability through improving the light-harvesting complex (LHC) II efficiency and electron transport rate. On the whole, the reduction ability order of the three kinds of materials based on chloroplast in C. vulgaris was PSII@SBA-15>Chloroplast>ITM@SA. The attempt made in this study to reduce the Cr (VI) with C. vulgaris organelles might not only offer basement to detect the potential action mechanism of Cr (VI) reduction by C. vulgaris but also provide a new sight for the scavenge of heavy metal with biological materials. Copyright © 2016 Elsevier B.V. All rights reserved.

Fundus Autofluorescence Findings in a Mouse Model of Retinal Detachment

PubMed Central

Secondi, Roberta; Kong, Jian; Blonska, Anna M.; Staurenghi, Giovanni; Sparrow, Janet R.

2012-01-01

Purpose. Fundus autofluorescence (fundus AF) changes were monitored in a mouse model of retinal detachment (RD). Methods. RD was induced by transscleral injection of hyaluronic acid (Healon) or sterile balanced salt solution (BSS) into the subretinal space of 4–5-day-old albino Abca4 null mutant and Abca4 wild-type mice. Images acquired by confocal scanning laser ophthalmoscopy (Spectralis HRA) were correlated with spectral domain optical coherence tomography (SD-OCT), infrared reflectance (IR), fluorescence spectroscopy, and histologic analysis. Results. In the area of detached retina, multiple hyperreflective spots in IR images corresponded to punctate areas of intense autofluorescence visible in fundus AF mode. The puncta exhibited changes in fluorescence intensity with time. SD-OCT disclosed undulations of the neural retina and hyperreflectivity of the photoreceptor layer that likely corresponded to histologically visible photoreceptor cell rosettes. Fluorescence emission spectra generated using flat-mounted retina, and 488 and 561 nm excitation, were similar to that of RPE lipofuscin. With increased excitation wavelength, the emission maximum shifted towards longer wavelengths, a characteristic typical of fundus autofluorescence. Conclusions. In detached retinas, hyper-autofluorescent spots appeared to originate from photoreceptor outer segments that were arranged within retinal folds and rosettes. Consistent with this interpretation is the finding that the autofluorescence was spectroscopically similar to the bisretinoids that constitute RPE lipofuscin. Under the conditions of a RD, abnormal autofluorescence may arise from excessive production of bisretinoid by impaired photoreceptor cells. PMID:22786896

Use of limited data to construct Bayesian networks for probabilistic risk assessment.

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

Groth, Katrina M.; Swiler, Laura Painton

2013-03-01

Probabilistic Risk Assessment (PRA) is a fundamental part of safety/quality assurance for nuclear power and nuclear weapons. Traditional PRA very effectively models complex hardware system risks using binary probabilistic models. However, traditional PRA models are not flexible enough to accommodate non-binary soft-causal factors, such as digital instrumentation&control, passive components, aging, common cause failure, and human errors. Bayesian Networks offer the opportunity to incorporate these risks into the PRA framework. This report describes the results of an early career LDRD project titled %E2%80%9CUse of Limited Data to Construct Bayesian Networks for Probabilistic Risk Assessment%E2%80%9D. The goal of the work was tomore » establish the capability to develop Bayesian Networks from sparse data, and to demonstrate this capability by producing a data-informed Bayesian Network for use in Human Reliability Analysis (HRA) as part of nuclear power plant Probabilistic Risk Assessment (PRA). This report summarizes the research goal and major products of the research.« less

A universal formula for the field enhancement factor

NASA Astrophysics Data System (ADS)

Biswas, Debabrata

2018-04-01

The field enhancement factor (FEF) is an important quantity in field emission calculations since the tunneling electron current depends very sensitively on its magnitude. The exact dependence of FEF on the emitter height h, the radius of curvature at the apex Ra, as well as the shape of the emitter base are still largely unknown. In this work, a universal formula for the field enhancement factor is derived for a single emitter. It depends on the ratio h/Ra and has the form γ a = ( 2 h / R a ) / [ α 1 ln ( 4 h / R a ) - α 2 ] , where α1 and α2 depend on the charge distribution on the emitter. Numerical results show that a simpler form γ a = ( 2 h / R a ) / [ ln ( 4 h / R a ) - α ] is equally valid with α depending on the emitter-base. Thus, for the hyperboloid, conical, and ellipsoid emitters, the value of α is 0, 0.88, and 2, while for the cylindrical base, α ≃ 2.6.

VizieR Online Data Catalog: 180MHz Murchison Commissioning Survey (MWACS) (Hurley-Walker+, 2014)

NASA Astrophysics Data System (ADS)

Hurley-Walker, N.; Morgan, J.; Wayth, R. B.; Hancock, P. J.; Bell, M. E.; Bernardi, G.; Bhat, N. D. R.; Briggs, F.; Deshpande, A. A.; Ewall-Wice, A.; Feng, L.; Hazelton, B. J.; Hindson, L.; Jacobs, D. C.; Kaplan, D. L.; Kudryavtseva, N.; Lenc, E.; McKinley, B.; Mitchell, D.; Pindor, B.; Procopio, P.; Oberoi, D.; Offringa, A.; Ord, S.; Riding, J.; Bowman, J. D.; Cappallo, R.; Corey, B.; Emrich, D.; Gaensler, B. M.; Goeke, R.; Greenhill, L.; Hewitt, J.; Johnston-Hollitt, M.; Kasper, J.; Kratzenberg, E.; Lonsdale, C.; Lynch, M.; McWhirter, R.; Morales, M. F.; Morgan, E.; Prabu, T.; Rogers, A.; Roshi, A.; Shankar, U.; Srivani, K.; Subrahmanyan, R.; Tingay, S.; Waterson, M.; Webster, R.; Whitney, A.; Williams, A.; Williams, C.

2014-10-01

The Murchison Widefield Array Commissioning Survey (MWACS) is a ~6100deg2 104-196MHz radio sky survey performed with the Murchison Widefield Array during instrument commissioning between 2012 September and 2012 December. The data were taken as meridian drift scans with two different 32-antenna sub-arrays that were available during the commissioning period. The data were combined in the visibility plane before being imaged, and then mosaicked. The survey covers approximately 20.5h

Optical Coherence Tomography Angiography of Pigmented Paravenous Retinochoroidal Atrophy.

PubMed

Cicinelli, Maria Vittoria; Giuffrè, Chiara; Rabiolo, Alessandro; Parodi, Maurizio Battaglia; Bandello, Francesco

2018-05-01

A 58-year-old man with bilateral pigmented paravenous retinochoroidal atrophy (PPRCA) associated with macular coloboma in the right eye underwent color fundus photography and fundus autofluorescence with the California ultra-widefield retinal imaging system (Optos, Dunfermline, UK), spectral-domain optical coherence tomography (SD-OCT) (Heidelberg Spectralis HRA + OCT; Heidelberg Engineering, Heidelberg, Germany), and en face OCT angiography (OCTA) (AngioPlex, Cirrus HD-OCT 5000; Carl Zeiss Meditec, Dublin, CA). The patient presented with a visual acuity of counting fingers in the right eye and 20/32 in the left eye. Fundus examination and SD-OCT showed typical PPRCA alterations in both eyes and a macular coloboma in the right eye. The OCTA showed relative sparing of the retinal capillary plexuses, with diffuse defects in the choriocapillaris. The authors concluded OCTA imaging of PPRCA suggests more insights of the pathogenesis of this disease, showing that the disease primarily affects the choroidal vascular network, with a relative sparing of the retinal vasculature. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:381-383.]. Copyright 2018, SLACK Incorporated.

Critical thickness investigation of magnetic properties in exchange-coupled bilayers

NASA Astrophysics Data System (ADS)

Rodríguez-Suárez, R. L.; Vilela-Leão, L. H.; Bueno, T.; Oliveira, A. B.; de Almeida, J. R. L.; Landeros, P.; Rezende, S. M.; Azevedo, A.

2011-06-01

We present a systematic investigation of the magnetic properties of two series of polycrystalline ferromagnetic-antiferromagnetic bilayers (FM-AF) of Ni81Fe19(10nm)/Ir20Mn80(tAF) grown by dc magnetron sputtering. One series was grown at an oblique angle of 50° and the other one was grown at 0°. Ferromagnetic resonance (FMR) was used to measure the exchange bias field HE, the rotatable anisotropy field HRA, and the FMR linewidth ΔH as a function of the antiferromagnetic layer thickness tAF. Three relaxation channels due to isotropic Gilbert damping, anisotropic two-magnon scattering, and mosaicity effects are simultaneously distinguished through the angular dependence of the FMR linewidth. In the regime of small IrMn layer thicknesses, not enough to establish the exchange bias anisotropy, the FMR linewidth shows a sharp peak due to the contribution of the two-magnon scattering mechanism. The results presented here are of general importance for understanding the dynamics of magnetization in the FM-AF structures.

VizieR Online Data Catalog: South Galactic cap MCT blue objects (Lamontagne+, 2000)

NASA Astrophysics Data System (ADS)

Lamontagne, R.; Demers, S.; Wesemael, F.; Fontaine, G.; Irwin, M. J.

2016-07-01

A detailed description of the first part of our survey, namely, the photographic observations (including plate scanning, photometric calibrations, and candidate selection), has been presented by Demers et al. (1986AJ.....92..878D). Briefly summarized, the MCT survey consists of 430 doubly exposed U and B plates, taken with the Curtis Schmidt telescope at the Cerro Tololo Inter-American Observatory (CTIO) and covering 6750 deg2 (~15% of the whole sky) in a region defined by 19h<~RA<~7h and -90°<=DE<=0°. Our survey blankets most of the south Galactic cap of our Galaxy accessible from CTIO, up to b=-30°. The bulk of our spectroscopic material was gathered at CTIO with the 1.5m and 4m telescopes in the course of several observing runs since 1985. We have identified all 228 selected blue candidates [(U-B)pg<=-0.6] brighter than Bpg=16.5 in this region of the sky. (1 data file).

Drinking and other risk taking behaviors of enlisted male soldiers in the US Army

PubMed Central

Williams, Jeffrey O.; Bell, Nicole S.; Amoroso, Paul J.

2007-01-01

High-risk drinking is among the top three prevention priorities of the Department of Defense. Research suggests that enlisted male soldiers are particularly at risk for unhealthy drinking behaviors. 292,023 enlisted male soldiers who responded to a Health Risk Appraisal (HRA) survey between 1990 and 1998 were dichotomized into high and low-risk drinking groups. Logistic regression analysis showed that high-risk drinkers wore seatbelts less frequently, were more likely to drive > 15 mph over the speed limit, and to smoke more than 20 cigarettes/day. This high-risk group was predominately young (< 25), Caucasian, high school educated or less, and most likely employed as infantrymen or craftsworkers. The two highest risk occupational groups (infantrymen and craftsworkers) differ from each other, and from other Army occupations. Intervention programs should include safe driving habits and smoking cessation, as well as high-risk drinking, and should be tailored to the specific needs of the group at highest risk. PMID:12441578

A prospective, open-label, single arm, multicentre study to evaluate efficacy, safety and acceptability of pericoital oral contraception using levonorgestrel 1.5 mg

PubMed Central

Festin, Mario P.R.; Bahamondes, Luis; Nguyen, Thi My Huong; Habib, Ndema; Thamkhantho, Manopchai; Singh, Kuldip; Gosavi, Arundhati; Bartfai, Gyorgy; Bito, Tamas; Bahamondes, M. Valeria; Kapp, Nathalie

2016-01-01

STUDY QUESTION Will the use of levonorgestrel (LNG) 1.5 mg taken at each day of coitus by women who have relatively infrequent sex be an efficacious, safe and acceptable contraceptive method? SUMMARY ANSWER Typical use of LNG 1.5 mg taken pericoitally, before or within 24 h of sexual intercourse, provides contraceptive efficacy of up to 11.0 pregnancies per 100 women-years (W-Y) in the primary evaluable population and 7.1 pregnancies per 100 W-Y in the evaluable population. WHAT IS KNOWN ALREADY LNG 1.5 mg is an effective emergency contraception following unprotected intercourse. Some users take it repeatedly, as their means of regular contraception. STUDY DESIGN, SIZE, DURATION This was a prospective, open-label, single-arm, multicentre Phase III trial study with women who have infrequent coitus (on up to 6 days a month). Each woman had a follow-up visit at 2.5, 4.5 and 6.5 months after admission or until pregnancy occurs if sooner, or she decided to interrupt participation. The study was conducted between 10 January 2012 and 15 November 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 330 healthy fertile women aged 18–45 years at risk of pregnancy who reported sexual intercourse on up to 6 days a month, were recruited from four university centres located in Bangkok, Thailand; Campinas, Brazil; Singapore and Szeged, Hungary to use LNG 1.5 mg pericoitally (24 h before or after coitus) as their primary method of contraception. The participants were instructed to take one tablet every day she had sex, without taking more than one tablet in any 24-h period, and to maintain a paper diary for recording date and time for every coital act and ingestion of the study tablet, use of other contraceptive methods and vaginal bleeding patterns. Anaemia was assessed by haemoglobin evaluation. Pregnancy tests were performed monthly and pregnancies occurring during product use were assessed by ultrasound. At the 2.5-month and final visit at 6.5 months, acceptability questions were administered. MAIN RESULTS AND THE ROLE OF CHANCE There were 321 women included in the evaluable population (which includes all eligible women enrolled), with 141.9 woman-years (W-Y) of observation and with a rate (95% confidence interval [CI]) of 7.1 (3.8; 13.1) pregnancies per 100 W-Y of typical use (which reflects use of the study drug as main contraceptive method, but also includes possible use of other contraceptives from admission to end of study) and 7.5 (4.0; 13.9) pregnancies per 100 W-Y of sole use. In the primary evaluable population (which includes only eligible enrolled women <35 years old), the rate was 10.3 (5.4; 19.9) pregnancies per 100 W-Y of typical use, and 11.0 (5.7; 13.1) pregnancies per 100 W-Y of sole use. There were three reported severe adverse events and 102 other mild adverse events (most common were headache, nausea, abdominal and pelvic pain), with high recovery rate. The vaginal bleeding patterns showed a slight decrease in volume of bleeding and the number of bleeding-free days increased over time. There was only one case of severe anaemia, found at the final visit (0.4%). The method was considered acceptable, as over 90% of participants would choose to use it in the future or would recommend it to others. LIMITATIONS, REASONS FOR CAUTION This was a single-arm study with small sample size, without a control group, designed as a proof of concept study to explore the feasibility of this type of contraception. WIDER IMPLICATIONS OF THE FINDINGS A larger clinical study evaluating pericoital contraception with LNG is feasible and our data show that this method would be acceptable to many women. STUDY FUNDING/COMPETING INTEREST(S) This study received partial financial support from the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR) and the World Health Organization. Gynuity and the Bill and Melinda Gates Foundation (BMGF) provided financial support for project monitoring. HRA Pharma donated the LNG product. N.K. was the initial project manager when she was with WHO/HRP and was employed by HRA Pharma, which distributes LNG for emergency contraception. The other authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER This study was registered on ANZCTR, Trial ID ACTRN12611001037998. TRIAL REGISTRATION DATE 4 October 2011. DATE OF FIRST PATIENT'S ENROLMENT 10 January 2012. PMID:26830816

Quantum dot labeling and tracking of cultured limbal epithelial cell transplants in-vitro

PubMed Central

Genicio, Nuria; Paramo, Juan Gallo; Shortt, Alex J.

2015-01-01

PURPOSE Cultured human limbal epithelial cells (HLEC) have shown promise in the treatment of limbal stem cell deficiency but little is known about their survival, behaviour and long-term fate post transplantation. The aim of this research was to evaluate, in-vitro, quantum dot (QDot) technology as a tool for tracking transplanted HLEC. METHODS In-vitro cultured HLEC were labeled with Qdot nanocrystals. Toxicity was assessed using live-dead assays. The effect on HLEC function was assessed using colony forming efficiency assays and expression of CK3, P63alpha and ABCG2. Sheets of cultured HLEC labeled with Qdot nanocrystals were transplanted onto decellularised human corneo-scleral rims in an organ culture model and observed to investigate the behaviour of transplanted cells. RESULTS Qdot labeling had no detrimental effect on HLEC viability or function in-vitro. Proliferation resulted in a gradual reduction in Qdot signal but sufficient signal was present to allow tracking of cells through multiple generations. Cells labeled with Qdots could be reliably detected and observed using confocal microscopy for at least 2 weeks post transplantation in our organ culture model. In addition it was possible to label and observe epithelial cells in intact human corneas using the Rostock corneal module adapted for use with the Heidelberg HRA. CONCLUSIONS This work demonstrates that Qdots combined with existing clinical equipment could be used to track HLEC for up to 2 weeks post transplantation, however, our model does not permit the assessment of cell labeling beyond 2 weeks. Further characterisation in in-vivo models are required. PMID:26024089

A prospective, open-label, single arm, multicentre study to evaluate efficacy, safety and acceptability of pericoital oral contraception using levonorgestrel 1.5 mg.

PubMed

Festin, Mario P R; Bahamondes, Luis; Nguyen, Thi My Huong; Habib, Ndema; Thamkhantho, Manopchai; Singh, Kuldip; Gosavi, Arundhati; Bartfai, Gyorgy; Bito, Tamas; Bahamondes, M Valeria; Kapp, Nathalie

2016-03-01

Will the use of levonorgestrel (LNG) 1.5 mg taken at each day of coitus by women who have relatively infrequent sex be an efficacious, safe and acceptable contraceptive method? Typical use of LNG 1.5 mg taken pericoitally, before or within 24 h of sexual intercourse, provides contraceptive efficacy of up to 11.0 pregnancies per 100 women-years (W-Y) in the primary evaluable population and 7.1 pregnancies per 100 W-Y in the evaluable population. LNG 1.5 mg is an effective emergency contraception following unprotected intercourse. Some users take it repeatedly, as their means of regular contraception. This was a prospective, open-label, single-arm, multicentre Phase III trial study with women who have infrequent coitus (on up to 6 days a month). Each woman had a follow-up visit at 2.5, 4.5 and 6.5 months after admission or until pregnancy occurs if sooner, or she decided to interrupt participation. The study was conducted between 10 January 2012 and 15 November 2014. A total of 330 healthy fertile women aged 18-45 years at risk of pregnancy who reported sexual intercourse on up to 6 days a month, were recruited from four university centres located in Bangkok, Thailand; Campinas, Brazil; Singapore and Szeged, Hungary to use LNG 1.5 mg pericoitally (24 h before or after coitus) as their primary method of contraception. The participants were instructed to take one tablet every day she had sex, without taking more than one tablet in any 24-h period, and to maintain a paper diary for recording date and time for every coital act and ingestion of the study tablet, use of other contraceptive methods and vaginal bleeding patterns. Anaemia was assessed by haemoglobin evaluation. Pregnancy tests were performed monthly and pregnancies occurring during product use were assessed by ultrasound. At the 2.5-month and final visit at 6.5 months, acceptability questions were administered. There were 321 women included in the evaluable population (which includes all eligible women enrolled), with 141.9 woman-years (W-Y) of observation and with a rate (95% confidence interval [CI]) of 7.1 (3.8; 13.1) pregnancies per 100 W-Y of typical use (which reflects use of the study drug as main contraceptive method, but also includes possible use of other contraceptives from admission to end of study) and 7.5 (4.0; 13.9) pregnancies per 100 W-Y of sole use. In the primary evaluable population (which includes only eligible enrolled women <35 years old), the rate was 10.3 (5.4; 19.9) pregnancies per 100 W-Y of typical use, and 11.0 (5.7; 13.1) pregnancies per 100 W-Y of sole use. There were three reported severe adverse events and 102 other mild adverse events (most common were headache, nausea, abdominal and pelvic pain), with high recovery rate. The vaginal bleeding patterns showed a slight decrease in volume of bleeding and the number of bleeding-free days increased over time. There was only one case of severe anaemia, found at the final visit (0.4%). The method was considered acceptable, as over 90% of participants would choose to use it in the future or would recommend it to others. This was a single-arm study with small sample size, without a control group, designed as a proof of concept study to explore the feasibility of this type of contraception. A larger clinical study evaluating pericoital contraception with LNG is feasible and our data show that this method would be acceptable to many women. This study received partial financial support from the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR) and the World Health Organization. Gynuity and the Bill and Melinda Gates Foundation (BMGF) provided financial support for project monitoring. HRA Pharma donated the LNG product. N.K. was the initial project manager when she was with WHO/HRP and was employed by HRA Pharma, which distributes LNG for emergency contraception. The other authors declare no conflicts of interest. This study was registered on ANZCTR, Trial ID ACTRN12611001037998. 4 October 2011. 10 January 2012. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.

Performance of Sub-Array of ARIANNA Detector Stations during First Year of Operation

NASA Astrophysics Data System (ADS)

Tatar, Joulien Erdintch

The ARIANNA high energy neutrino telescope is designed to search for ultrahigh energy neutrinos produced by the collision of cosmic rays with the cosmic microwave background. ARIANNA exploits the recent development of low noise, low power data acquisition technology to measure the brief radio pulses created by neutrino-induced charged particle showers in the Ross Ice Shelf of Antarctica. Three stations were installed and commissioned in early December 2012 as part of a pilot program to construct a hexagonal array of 7 radio stations. Each station required only 10 Watts of power and operated autonomously using both solar panels and wind generators. In addition, an environmental station was deployed at the ARIANNA site. Data is stored locally and reliably transmitted from Antarctica over high speed wireless internet and Iridium satellite modem during special transmission windows. The wireless internet ceased operation on March 15, corresponding to the fading light condition just before Austral winter. With the aid of wind generation, the stations operated until late May before winter hibernation. Communication was re-established after winter hibernation on September 11, 2013 for three of the four stations. Overall, the stations operated for 65% of the year. The station acquired three types of events: (1) forced, (2) thermal, and (3) signals from an external transmitter, which are called "heartbeat" events. The forced trigger captures the ambient RF conditions at a random snapshot in time. The thermal trigger configuration usually required any 2 of the 4 antenna channels to exceed a voltage level of ˜ 6 · Vrms, where Vrms is the root mean square of the random voltage fluctuations. Individual channel thresholds were adjusted to account for temperature dependences in the electronics. The vast majority of thermal triggers are consistent random gaussian noise expected from thermal processes in the ice and amplifier. Excess power, but no increase is trigger rates, is observed when wind speeds exceed ˜ 6 mph. The frequency components of the excess noise are compatible with noise emitted by the wind generator. There are several periods of impulsive noise with durations of minutes to hours in January and narrowband, suggesting an origin from external transmitters. On one occasion, the noise was contemporaneous with rescue operations at McMurdo Station. Heartbeat events were collected in special runs in 4 separate time periods. They indicate that LPDA coupling to ice medium increased over the first few weeks as the pits with the receiver antennas filled in with snow, and then increased slowly as the snow overburden increased on the transmitting antenna, initially placed flat on the snow surface. We conducted a search for neutrino events in the data from Station 3 between December 6, 2012 and March 13, 2013 by cross-correlating observed waveforms in parallel receiver channels with the expected neutrino template in the time domain. The cross-correlation analysis rejects all thermal triggers and retains more than 90% of the simulated neutrino events. It is clear that none of the collected events contain waveforms that match the shape expected for neutrino signals in two parallel channels, but cross-correlation of waveforms with excess power during windy periods are systematically larger than thermal noise events. Thermal triggers with the largest cross-correlation values are clustered in time and, as described in the text, possess unusual characteristics that clearly indicate they are background processes. This analysis indicates that the ARIANNA site is RF quiet, and meets requirements of the ARIANNA project. Using the effective volume per station and measured live-time, a preliminary flux limit was obtained to be E2φ ≤ 10-5 GeV cm-2 s-1 sr -1, assuming a E-2 differential energy spectrum. Based on initial experience with station operation and control, data transmission, and event analysis, we conclude that main scientific and technological objectives HRA pilot program are met. Initially, it was planned to complete HRA this upcoming season, but due to the government shutdown and subsequent drawdown of Antarctic operations, HRA completion has been postponed until November 2014. The focus of those efforts will be to reduce the time and manpower to deploy a station, reduce the level of logistical support to transport equipment to field and maintain the field camp, and reduce the cost of station construction and testing.

Reproducibility of Macular Pigment Optical Density Measurement by Two-wave Length Auto-fluorescence in a Clinical Setting

PubMed Central

You, Qi-Sheng; Bartsch, Dirk-Uwe G.; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William

2015-01-01

Purpose Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration (AMD), likely due to filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of current study is to determine the reproducibility of MPOD measurement by two-wave length auto-fluorescence method using scanning laser ophthalmoscopy. Methods Sixty eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet AMD, 16 eyes with dry AMD, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia and 14 eyes with tractional maculopathy including vitreomacular traction, epiretinal membrane or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) auto-fluorescence method with the Spectralis HRA+OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The Analysis of variance (ANOVA) and Bland-Altman plot were used to assess the reproducibility between the two measurements. Results The mean MPOD at eccentricities of 1° and 2° was 0.36±0.17 (range: 0.04–0.69) and 0.15±0.08(range: −0.03, 0.35) for the first measurement and 0.35±0.17 (range: 0.02, 0.68) and 0.15±0.08 (range: −0.01, 0.33) for the second measurement respectively. The difference between the two measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2° and 6° radius, and the Bland-Altman plot showed 8.8%, 2.9% and 4.4% points outside the 95% limits of agreement respectively. The data for the reproducibility did not differ significantly among the various disease and normal eyes. Conclusion Under routine examination conditions with pupil dilation, MPOD measurement by two-wave length auto-fluorescence method showed a high reproducibility. PMID:26655614

Protocol for a qualitative study exploring perspectives on the INternational CLassification of Diseases (11th revision); Using lived experience to improve mental health Diagnosis in NHS England: INCLUDE study.

PubMed

Hackmann, Corinna; Green, Amanda; Notley, Caitlin; Perkins, Amorette; Reed, Geoffrey M; Ridler, Joseph; Wilson, Jon; Shakespeare, Tom

2017-09-03

Developed in dialogue with WHO, this research aims to incorporate lived experience and views in the refinement of the International Classification of Diseases Mental and Behavioural Disorders 11th Revision (ICD-11). The validity and clinical utility of psychiatric diagnostic systems has been questioned by both service users and clinicians, as not all aspects reflect their lived experience or are user friendly. This is critical as evidence suggests that diagnosis can impact service user experience, identity, service use and outcomes. Feedback and recommendations from service users and clinicians should help minimise the potential for unintended negative consequences and improve the accuracy, validity and clinical utility of the ICD-11. The name INCLUDE reflects the value of expertise by experience as all aspects of the proposed study are co-produced. Feedback on the planned criteria for the ICD-11 will be sought through focus groups with service users and clinicians. The data from these groups will be coded and inductively analysed using a thematic analysis approach. Findings from this will be used to form the basis of co-produced recommendations for the ICD-11. Two service user focus groups will be conducted for each of these diagnoses: Personality Disorder, Bipolar I Disorder, Schizophrenia, Depressive Disorder and Generalised Anxiety Disorder. There will be four focus groups with clinicians (psychiatrists, general practitioners and clinical psychologists). This study has received ethical approval from the Coventry and Warwickshire HRA Research Ethics Committee (16/WM/0479). The output for the project will be recommendations that reflect the views and experiences of experts by experience (service users and clinicians). The findings will be disseminated via conferences and peer-reviewed publications. As the ICD is an international tool, the aim is for the methodology to be internationally disseminated for replication by other groups. ClinicalTrials.gov: NCT03131505. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Caregiving for ill dependents and its association with employee health risks and productivity.

PubMed

Burton, Wayne N; Chen, Chin-Yu; Conti, Daniel J; Pransky, Glenn; Edington, Dee W

2004-10-01

This study examined the loss of productivity and health risk status associated with employees who provide care for an ill dependent. A total of 16,651 employees (23% response rate) of a major financial services company completed a confidential Health Risk Appraisal (HRA) that included an eight-item version of the Work Limitations Questionnaire and a self-report of time missed from work during the previous 2 weeks to care for an ill dependent. A total of 10.6% of the respondents reported an average of 7.7 hours absent from work during the previous 2-week period to provide care for an ill dependent. Caregiving also was associated with a significant increase in the number of health risks for the employee. As the demand for caregiving time increased, caregivers reported a significant increase in work limitations. Caregiving for an ill dependent is associated with increased absenteeism and significant work limitations while on the job. Programs and work organization that helps employees balance their caregiving responsibilities for ill dependents may have a positive effect on health and productivity.

And the Humans Save the Day or Maybe They Ruin It: The Importance of Humans in the Loop

NASA Technical Reports Server (NTRS)

DeMott, Diana; Boyer, Roger; Bigler, Mark

2017-01-01

Flying a mission in space requires a massive commitment of resources, and without the talent and commitment of the people involved in this effort we would never leave the atmosphere of Earth. When we use the phrase "humans in the loop", it could apply to almost any endeavor since everything starts with humans developing a concept, completing the design process, building or implementing a product and using the product to achieve a goal or purpose. Narrowing the focus to spaceflights, there are a variety of individuals involved throughout the preparations for flight and the flight itself. All of the humans involved add value and support for program success. The purpose of this paper focuses on how a Probabilistic Risk Assessment (PRA) accounts for the human in the loop for potential missions using a technique called Human Reliability Analysis (HRA). Human actions can increase or decrease the overall risk via initiating events or mitigating them, thus removing the human from the loop doesn't always lower the risk.

Superplastic Forming/Diffusion Bonding Without Interlayer of 5A90 Al-Li Alloy Hollow Double-Layer Structure

NASA Astrophysics Data System (ADS)

Jiang, Shaosong; Jia, Yong; Lu, Zhen; Shi, Chengcheng; Zhang, Kaifeng

2017-09-01

The hollow double-layer structure of 5A90 Al-Li alloy was fabricated by SPF/DB process in this study. The characteristics and mechanism of 5A90 Al-Li alloy with respect to superplasticity and diffusion bonding were investigated. Tensile tests showed that the optimal elongation of tensile specimens was 243.97% at the temperature of 400 °C and the strain rate of 0.001 s-1. Effect of the surface roughness, bonding temperature and bonding time to determine the microstructure and mechanical properties of diffusion bonding joints was investigated, and the optimum bonding parameters were 540 °C/2.5 h/Ra18. Through the finite element simulation, it could be found that the SPF/DB process of hollow double-layer structure was feasible. The hollow double-layer structure of 5A90 Al-Li alloy was manufactured, showing that the thickness distribution of the bonding area was uniform and the thinnest part was the round corner. The SEM images of diffusion bonding joints showed that sound bonding interfaces were obtained in which no discontinuity existed.

REPRODUCIBILITY OF MACULAR PIGMENT OPTICAL DENSITY MEASUREMENT BY TWO-WAVELENGTH AUTOFLUORESCENCE IN A CLINICAL SETTING.

PubMed

You, Qi Sheng; Bartsch, Dirk-Uwe G; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William R

2016-07-01

Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration, likely because of filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of this study is to determine the reproducibility of MPOD measurement by two-wavelength autofluorescence method using scanning laser ophthalmoscopy. Sixty-eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet age-related macular degeneration, 16 eyes with dry age-related macular degeneration, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia, and 14 eyes with tractional maculopathy, including vitreomacular traction, epiretinal membrane, or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) autofluorescence method with the Spectralis HRA + OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The analysis of variance and Bland-Altman plot were used to assess the reproducibility between the two measurements. The mean MPOD at eccentricities of 1° and 2° was 0.36 ± 0.17 (range: 0.04-0.69) and 0.15 ± 0.08 (range: -0.03 to 0.35) for the first measurement and 0.35 ± 0.17 (range: 0.02-0.68) and 0.15 ± 0.08 (range: -0.01 to 0.33) for the second measurement, respectively. The difference between the 2 measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2°, and 6° radius, and the Bland-Altman plot showed 8.8%, 2.9%, and 4.4% points outside the 95% limits of agreement, respectively. The data for the reproducibility did not differ significantly among the various disease and normal eyes. Under routine examination conditions with pupil dilation, MPOD measurement by two-wavelength autofluorescence method showed a high reproducibility.

Early simultaneous fundus autofluorescence and optical coherence tomography features after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

PubMed

Dell'Omo, Roberto; Mura, Marco; Lesnik Oberstein, Sarit Y; Bijl, Heico; Tan, H Stevie

2012-04-01

To describe fundus autofluorescence and optical coherence tomography (OCT) features of the macula after pars plana vitrectomy for rhegmatogenous retinal detachment. Thirty-three eyes of 33 consecutive patients with repaired rhegmatogenous retinal detachment with or without the involvement of the macula were prospectively investigated with simultaneous fundus autofluorescence and OCT imaging using the Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) within a few weeks after the operation. Fundus autofluorescence imaging of the macula showed lines of increased and decreased autofluorescence in 19 cases (57.6%). On OCT, these lines corresponded to the following abnormalities: outer retinal folds, inner retinal folds, and skip reflectivity abnormalities of the photoreceptor inner segment/outer segment band. Other OCT findings, not related to abnormal lines on fundus autofluorescence, consisted of disruption of photoreceptor inner segment/outer segment band and collection of intraretinal or subretinal fluid. The presence of outer retinal folds significantly related to metamorphopsia but did not relate to poor postoperative visual acuity. Partial-thickness retinal folds occur commonly after vitrectomy for rhegmatogenous retinal detachment repair and may represent an important anatomical substrate for postoperative metamorphopsia. Fundus autofluorescence and OCT are both sensitive techniques for the detection of these abnormalities.

And the Human Saves the Day or Maybe They Ruin It, The Importance of Humans in the Loop

NASA Technical Reports Server (NTRS)

DeMott, Diana L.; Boyer, Roger L.

2017-01-01

Flying a mission in space requires a massive commitment of resources, and without the talent and commitment of the people involved in this effort we would never leave the atmosphere of Earth as safely as we have. When we use the phrase "humans in the loop", it could apply to almost any endeavor since everything starts with humans developing a concept, completing the design process, building or implementing a product and using the product to achieve a goal or purpose. Narrowing the focus to spaceflight, there are a variety of individuals involved throughout the preparations for flight and the flight itself. All of the humans involved add value and support for program success. The paper discusses the concepts of human involvement in technological programs, how a Probabilistic Risk Assessment (PRA) accounts for the human in the loop for potential missions using a technique called Human Reliability Analysis (HRA) and the tradeoffs between having a human in the loop or not. Human actions can increase or decrease the overall risk via initiating events or mitigating them, thus removing the human from the loop doesn't always lowers the risk.

Identifying high energy density stream-reaches through refined geospatial resolution in hydropower resource assessment

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

Pasha, M. Fayzul K.; Yang, Majntxov; Yeasmin, Dilruba

Benefited from the rapid development of multiple geospatial data sets on topography, hydrology, and existing energy-water infrastructures, the reconnaissance level hydropower resource assessment can now be conducted using geospatial models in all regions of the US. Furthermore, the updated techniques can be used to estimate the total undeveloped hydropower potential across all regions, and may eventually help identify further hydropower opportunities that were previously overlooked. To enhance the characterization of higher energy density stream-reaches, this paper explored the sensitivity of geospatial resolution on the identification of hydropower stream-reaches using the geospatial merit matrix based hydropower resource assessment (GMM-HRA) model. GMM-HRAmore » model simulation was conducted with eight different spatial resolutions on six U.S. Geological Survey (USGS) 8-digit hydrologic units (HUC8) located at three different terrains; Flat, Mild, and Steep. The results showed that more hydropower potential from higher energy density stream-reaches can be identified with increasing spatial resolution. Both Flat and Mild terrains exhibited lower impacts compared to the Steep terrain. Consequently, greater attention should be applied when selecting the discretization resolution for hydropower resource assessments in the future study.« less

Identifying high energy density stream-reaches through refined geospatial resolution in hydropower resource assessment

DOE PAGES

Pasha, M. Fayzul K.; Yang, Majntxov; Yeasmin, Dilruba; ...

2016-01-07

Benefited from the rapid development of multiple geospatial data sets on topography, hydrology, and existing energy-water infrastructures, the reconnaissance level hydropower resource assessment can now be conducted using geospatial models in all regions of the US. Furthermore, the updated techniques can be used to estimate the total undeveloped hydropower potential across all regions, and may eventually help identify further hydropower opportunities that were previously overlooked. To enhance the characterization of higher energy density stream-reaches, this paper explored the sensitivity of geospatial resolution on the identification of hydropower stream-reaches using the geospatial merit matrix based hydropower resource assessment (GMM-HRA) model. GMM-HRAmore » model simulation was conducted with eight different spatial resolutions on six U.S. Geological Survey (USGS) 8-digit hydrologic units (HUC8) located at three different terrains; Flat, Mild, and Steep. The results showed that more hydropower potential from higher energy density stream-reaches can be identified with increasing spatial resolution. Both Flat and Mild terrains exhibited lower impacts compared to the Steep terrain. Consequently, greater attention should be applied when selecting the discretization resolution for hydropower resource assessments in the future study.« less

Using Patient-Reported Outcome Measures (PROMs) to promote quality of care and safety in the management of patients with Advanced Chronic Kidney disease (PRO-trACK project): a mixed-methods project protocol.

PubMed

Aiyegbusi, Olalekan Lee; Kyte, Derek; Cockwell, Paul; Marshall, Tom; Dutton, Mary; Slade, Anita; Marklew, Neil; Price, Gary; Verdi, Rav; Waters, Judi; Sharpe, Keeley; Calvert, Melanie

2017-06-30

Advanced chronic kidney disease (CKD) has a major effect on the quality of life and health status of patients and requires accurate and responsive management. The use of electronic patient-reported outcome measures (ePROMs) could assist patients with advanced pre-dialysis CKD, and the clinicians responsible for their care, by identifying important changes in symptom burden in real time. We report the protocol for 'Using Patient-Reported Outcome measures (PROMs) to promote quality of care and safety in the management of patients with Advanced Chronic Kidney Disease' (PRO-trACK) project, which will explore the feasibility and validity of an ePROM system for use in patients with advanced CKD. The project will use a mixed-methods approach in three studies: (1) usability testing of the ePROM system involving up to 30 patients and focusing on acceptability and technical performance/stability; (2) ascertaining the views of patient and clinician stakeholders on the optimal use and administration of the CKD ePROM system-this will involve qualitative face-to-face/telephone interviewing with up to 30 patients or until saturation is achieved, focus groups with up to 15 clinical staff, management and IT team members; (3) psychometric assessment of the system, within a cohort of at least 180 patients with advanced CKD, to establish the measurement properties of the ePROM. This project was approved by the West Midlands Edgbaston Research Ethics Committee (Reference 17/WM/0010) and received Health Research Authority (HRA) approval on 24 February 2017.The findings from this project will be provided to clinicians at the Department of Renal Medicine, Queen Elizabeth Hospitals, Birmingham (QEHB), NHS England, presented at conferences and to the Kidney Patients' Association, British Kidney Patient Association and the British Renal Society. Articles based on the findings will be written and submitted for publication in peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Light-Dependent OCT Structure Changes in Photoreceptor Degenerative rd 10 Mouse Retina

PubMed Central

Li, Yichao; Zhang, Yikui; Chen, Sonia; Vernon, Gregory; Wong, Wai T.

2018-01-01

Purpose Using optical coherence tomography (OCT) to analyze the effects of light/dark adaptation in a mouse model of inherited photoreceptor degeneration (rd10), and to study dynamics of subretinal fluid during the progress of retinal degeneration. Methods rd10 and wild-type (WT) C57BL/6J mice were reared in cyclic light or darkness and imaged with Bioptigen UHR-OCT or Spectralis HRA+OCT after adaptation to either light or darkness. Results OCT images from rd10 mice were analyzed at three progressive stages of degeneration. After light-adaptation, stage I (postnatal age [P]26–29) eyes demonstrated no apparent subretinal fluid. At stage II (P32–38), subretinal fluid was present and restricted to parapapillary area, while at stage III (P44–45) extensive subretinal fluid was present across many retinal areas. Following overnight dark-adaptation, WT eyes showed a large reduction in outer retinal thickness (4.6 ± 1.4 μm, n = 16), whereas this change was significantly smaller in stage I rd10 eyes (1.5 ± 0.5 μm, n = 14). In stage II rd10 eyes, dark-adaptation significantly reduced the extent of subretinal fluid, with the amount of reduction correlating with the amount of fluid pre-existing in the light-adapted state. However, dark-adaptation did not significantly alter the amount of subretinal fluid observed in stage III rd10 mice. In addition, dark-rearing of rd10 mice from P6 to P30 slowed retinal degeneration. Conclusions Visual experience in the form of light/dark adaptation exerts a significant effect on outer retinal structure in the context of photoreceptor degeneration. This effect may arise from light-dependent alterations in fluid transport across the RPE monolayer, and promote photoreceptor survival as induced by dark-rearing. PMID:29490345

Screening for colorectal cancer in Tianhe, Guangzhou: results of combining fecal immunochemical tests and risk factors for selecting patients requiring colonoscopy.

PubMed

Liao, Yi; Li, Senmao; Chen, Chunyu; He, Xuan; Lin, Feng; Wang, Jianping; Yang, Zuli; Lan, Ping

2018-05-01

To explore the performance of a protocol combining fecal immunochemical test (FIT) and a high-risk factor questionnaire (HRFQ) for selecting patients requiring colonoscopy as part of a population-based colorectal cancer (CRC) screening program in China. From 2015 to 2016, we conducted a CRC screening program for all residents aged 45 years or older in Tianhe District, Guangzhou City, China. Participants underwent an FIT and received an HRFQ as part of primary screening. Those with positive FIT and/or HRFQ results were considered to be at high risk and were recommended to undergo colonoscopy. A total of 10 074 subjects were recruited and enrolled in the screening program. In the enrolled population, 17.5% had positive FIT results and 19.4% had positive HRFQ results. Of those recommended to undergo diagnostic colonoscopy, 773 did so. The screening method's overall positive predictive value (PPV) was 4.9% for non-adenomatous polyps, 11.4% for low-risk adenomas (LRAs), 15.9% for high-risk adenomas (HRAs) and 1.6% for CRC. The PPVs of positive FIT results for non-adenomatous polyps, LRAs, HRAs and CRC were 5.2%, 15.9%, 22.5% and 2.5%, respectively. The PPVs of positive HRFQ results for non-adenomatous polyps, LRA, HRA and CRC were 4.1%, 10.2%, 14.3% and 1.4%, respectively. The PPVs associated with combined positive FIT and HRFQ results for non-adenomatous polyps, LRAs, HRAs and CRC were 4.5%, 16.4%, 23.7% and 2.8%, respectively. Our results suggest that this two-step CRC screening strategy, involving a combination of FIT and HRFQ followed by colonoscopy, is useful to identify early-stage CRC. The high detection rates and PPVs for CRC and adenomas encourage this strategy's use in ongoing screening programs.

Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand

PubMed Central

Ruanpeng, Darin; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

2016-01-01

Background Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Methods Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Results Mean age was 27.2 years (range 18–54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells—cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). Conclusions ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population. PMID:27227684

Laser injury and in vivo multimodal imaging using a mouse model

NASA Astrophysics Data System (ADS)

Pocock, Ginger M.; Boretsky, Adam; Gupta, Praveena; Oliver, Jeff W.; Motamedi, Massoud

2011-03-01

Balb/c wild type mice were used to perform in vivo experiments of laser-induced thermal damage to the retina. A Heidelberg Spectralis HRA confocal scanning laser ophthalmoscope with a spectral domain optical coherence tomographer was used to obtain fundus and cross-sectional images of laser induced injury in the retina. Sub-threshold, threshold, and supra-threshold lesions were observed using optical coherence tomography (OCT), infrared reflectance, red-free reflectance, fluorescence angiography, and autofluorescence imaging modalities at different time points post-exposure. Lesions observed using all imaging modalities, except autofluorescence, were not visible immediately after exposure but did resolve within an hour and grew in size over a 24 hour period. There was a decrease in fundus autofluorescence at exposure sites immediately following exposure that developed into hyper-fluorescence 24-48 hours later. OCT images revealed threshold damage that was localized to the RPE but extended into the neural retina over a 24 hour period. Volumetric representations of the mouse retina were created to visualize the extent of damage within the retina over a 24 hour period. Multimodal imaging provides complementary information regarding damage mechanisms that may be used to quantify the extent of the damage as well as the effectiveness of treatments without need for histology.

Macular auto-fluorescence is a follow-up parameter for cystoids macular edema.

PubMed

Zhang, XinYuan; Gong, XiaoHong; Wang, YanHong; Wang, NingLi

2015-08-01

This study aimed to evaluate if macular autofluorescence (MAF) is a valuable, non-invasive follow-up parameter for cystoid macular edema. A total of 71 eyes (71 cases) with cystoid macular edema (CME) were included in the study. Macular pigment (MP) was evaluated using HRA2 (infrared) IF and FA models. The density of MP was graded into three categories: without, partial, and normal amount of MP. A comparison was made between the baseline (before the first administration) level and at the fourth month, following three consecutive intravitreal lucentis injections every month. The morphology and distribution of MAF, and the density and distribution of MP were regarded as the main outcome measures. At the baseline visit, all eyes with CME had petaloid/irregular-shaped MAF in the macular area (100%). No MAF was detected in the control eyes (0). There was significant difference in MAF between the CME and normal groups (P=0.000). At the fourth monthly visit, normal levels of MP density without MAF was detected in 68 eyes (95.8%) with the best corrected spectacular visual acuity increasing to at least 1 line accordingly. We conclude that macular MAF can be used as a follow-up parameter for patients with CME. MP and MAF can indirectly reflect the fovea cone function.

Ultraviolet carcinogenesis in the hairless mouse skin. Influence of the sunscreen 2-ethylhexyl-p-methoxycinnamate.

PubMed

Gallagher, C H; Greenoak, G E; Reeve, V E; Canfield, P J; Baker, R S; Bonin, A M

1984-10-01

The mutagenicity of some samples of a commonly used sunscreen, 2-ethylhexyl-p-methoxycinnamate (2-EHMC), led to these studies of its potential carcinogenicity in the HRA/Skh hairless mouse. In a daily treatment regime, repeated for 9 weeks, groups of mice were painted on the dorsum with 2-EHMC, and were then exposed to low doses of one of two artificial ultraviolet (UV) light sources. Mice were also treated with UV alone and with 2-EHMC alone. The accumulated UV exposure alone produced tumours in 40-100% of mice. However, 2-EHMC-treated mice were protected. Subsequent treatment of the 2-EHMC-protected mice, and mice previously treated with 2-EHMC alone, with the tumour promoter, croton oil, produced tumours on a significant number of animals. We conclude that 2-EHMC protects from UV tumorigenesis in the absence of a tumour promoter. However, although tumours appeared on only 4 out of 160 2-EHMC-treated mice exposed to UV, the carcinogenic process had been initiated in others, as application of the tumour promoter, croton oil, produced tumours. Statistical analysis of the incidence of promoted tumours inferred that prior irradiation with UV may not have been implicated. Therefore, 2-EHMC itself may initiate tumours in this strain of hairless mouse.

Discrepancy between fluorescein angiography and optical coherence tomography in detection of macular disease.

PubMed

Kozak, Igor; Morrison, Victoria L; Clark, Thomas M; Bartsch, Dirk-Uwe; Lee, Byung Ro; Falkenstein, Iryna; Tammewar, Ajay M; Mojana, Francesca; Freeman, William R

2008-04-01

To compare high-resolution optical coherence tomography (OCT) and fluorescein angiography (FA) in detection of macular edema (ME) of various etiologies. In a retrospective study over a 12-month period at one retina center, data for consecutive eyes that had undergone simultaneous conventional FA (HRA; Heidelberg Engineering, Vista, CA) and StratusOCT (Carl Zeiss Meditec, Dublin, CA) to rule out ME were reviewed. A subset of patients underwent additional examination with extremely high-resolution (6-microm)/ultrahigh-speed spectral OCT/scanning laser ophthalmoscopy (OTI, Inc., Toronto, Ontario, Canada). Of 1,272 eyes, 1,208 (94.97%) had the finding of ME or subretinal fluid confirmed by both techniques. There were 49 eyes (3.86%) for which FA showed dye leakage in the macular area and OCT showed normal foveal contour. Of 10 eyes in this group that underwent imaging with ultrahigh-speed spectral OCT/scanning laser ophthalmoscopy, 8 had subtle diffuse lucencies in the retina. For 15 eyes (1.17%), OCT showed intraretinal and subretinal fluid, which was missed by FA. Both FA and high-resolution OCT are highly sensitive techniques and correlate well in detection of ME. However, there is a small chance that when performed alone they might miss existing subtle ME.

MULTILEVEL ISCHEMIA IN DISORGANIZATION OF THE RETINAL INNER LAYERS ON PROJECTION-RESOLVED OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PubMed

Onishi, Alex C; Ashraf, Mohammed; Soetikno, Brian T; Fawzi, Amani A

2018-04-10

To examine the relationship between ischemia and disorganization of the retinal inner layers (DRIL). Cross-sectional retrospective study of 20 patients (22 eyes) with diabetic retinopathy presenting to a tertiary academic referral center, who had DRIL on structural optical coherence tomography (OCT) using Spectralis HRA + OCT (Heidelberg Engineering, Heidelberg, Germany) and OCT angiography with XR Avanti (Optovue Inc, Fremont, CA) on the same day. Optical coherence tomography angiography images were further processed to remove flow signal projection artifacts using a software algorithm adapted from recent studies. Retinal capillary perfusion in the superficial capillary plexuses, middle capillary plexuses, and deep capillary plexuses, as well as integrity of the photoreceptor lines on OCT was compared in areas with DRIL to control areas without DRIL in the same eye. Qualitative assessment of projection-resolved OCT angiography of eyes with DRIL on structural OCT demonstrated significant perfusion deficits compared with adjacent control areas (P < 0.001). Most lesions (85.7%) showed superimposed superficial capillary plexus and/or middle capillary plexus nonperfusion in addition to deep capillary plexus nonflow. Areas of DRIL were significantly associated with photoreceptor disruption (P = 0.035) compared with adjacent DRIL-free areas. We found that DRIL is associated with multilevel retinal capillary nonperfusion, suggesting an important role for ischemia in this OCT phenotype.

Immune competence assessment in marine medaka (Orzyias melastigma)-a holistic approach for immunotoxicology.

PubMed

Ye, Roy R; Peterson, Drew R; Seemann, Frauke; Kitamura, Shin-Ichi; Lee, J S; Lau, Terrance C K; Tsui, Stephen K W; Au, Doris W T

2017-12-01

Many anthropogenic pollutants in coastal marine environments can induce immune impairments in wild fish and reduce their survival fitness. There is a pressing need to establish sensitive and high throughput in vivo tools to systematically evaluate the immunosuppressive effects of contaminants in marine teleosts. This study reviewed a battery of in vivo immune function detection technologies established for different biological hierarchies at molecular (immune function pathways and genes by next generation sequencing (NGS)), cellular (leukocytes profiles by flow cytometry), tissues/organ system (whole adult histo-array), and organism (host resistance assays (HRAs)) levels, to assess the immune competence of marine medaka Oryzias melastigma. This approach enables a holistic assessment of fish immune competence under different chemical exposure or environmental scenarios. The data obtained will also be useful to unravel the underlying immunotoxic mechanisms. Intriguingly, NGS analysis of hepatic immune gene expression profiles (male > female) are in support of the bacterial HRA findings, in which infection-induced mortality was consistently higher in females than in males. As such, reproductive stages and gender-specific responses must be taken into consideration when assessing the risk of immunotoxicants in the aquatic environment. The distinct phenotypic sexual dimorphism and short generation time (3 months) of marine medaka offer additional advantages for sex-related immunotoxicological investigation.

COMPARISON OF RETINAL PATHOLOGY VISUALIZATION IN MULTISPECTRAL SCANNING LASER IMAGING.

PubMed

Meshi, Amit; Lin, Tiezhu; Dans, Kunny; Chen, Kevin C; Amador, Manuel; Hasenstab, Kyle; Muftuoglu, Ilkay Kilic; Nudleman, Eric; Chao, Daniel; Bartsch, Dirk-Uwe; Freeman, William R

2018-03-16

To compare retinal pathology visualization in multispectral scanning laser ophthalmoscope imaging between the Spectralis and Optos devices. This retrospective cross-sectional study included 42 eyes from 30 patients with age-related macular degeneration (19 eyes), diabetic retinopathy (10 eyes), and epiretinal membrane (13 eyes). All patients underwent retinal imaging with a color fundus camera (broad-spectrum white light), the Spectralis HRA-2 system (3-color monochromatic lasers), and the Optos P200 system (2-color monochromatic lasers). The Optos image was cropped to a similar size as the Spectralis image. Seven masked graders marked retinal pathologies in each image within a 5 × 5 grid that included the macula. The average area with detected retinal pathology in all eyes was larger in the Spectralis images compared with Optos images (32.4% larger, P < 0.0001), mainly because of better visualization of epiretinal membrane and retinal hemorrhage. The average detection rate of age-related macular degeneration and diabetic retinopathy pathologies was similar across the three modalities, whereas epiretinal membrane detection rate was significantly higher in the Spectralis images. Spectralis tricolor multispectral scanning laser ophthalmoscope imaging had higher rate of pathology detection primarily because of better epiretinal membrane and retinal hemorrhage visualization compared with Optos bicolor multispectral scanning laser ophthalmoscope imaging.

Health and well-being factors associated with international business travel.

PubMed

Burkholder, Justin D; Joines, Ron; Cunningham-Hill, Mark; Xu, Baowei

2010-01-01

International travel by US business travelers is continuing to increase with the globalization of the economy. The objective of this study was to determine if the frequency and duration of international business travel is associated with differences in travelers' health and well-being. This study expands our limited knowledge of the impact of long-haul travel on healthy lifestyle choices and traveler's perceptions of their health and well-being. 12,942 unique health risk appraisal (HRA) records of US employees of a multinational corporation were analyzed according to self-reported (objective and subjective) travel history and lifestyle habits. Comparing 2,962 international travelers and 9,980 non-travelers, international business travel was significantly associated with a lower body mass index, lower blood pressure, excess alcohol consumption, sleep deprivation, and diminished confidence to keep up with the pace of work. This study demonstrated both positive and negative associations on the health risks and well-being of a large sample of US-based international business travelers from an US multinational company. This study identifies targeted areas for pretrip screening and counseling to proactively address potential negative effects of travel and may assist in the design of corporate travel health and employee assistance programs. © 2010 International Society of Travel Medicine.

Trends in Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization (from the Baptist Health South Florida Employee Study).

PubMed

Ogunmoroti, Oluseye; Utuama, Ovie; Spatz, Erica S; Rouseff, Maribeth; Parris, Don; Das, Sankalp; Younus, Adnan; Guzman, Henry; Tran, Thinh; Agatston, Arthur; Feldman, Theodore; Virani, Salim S; Maziak, Wasim; Veledar, Emir; Nasir, Khurram

2016-03-01

The American Heart Association (AHA)'s 2020 goal is to improve the cardiovascular health (CVH) of people living in the United States (US) by 20% and reduce mortality from cardiovascular diseases and stroke by 20%. Given that 155 million adults are in the US workforce, and >60% have employee-based insurance, workplace studies provide an important opportunity to assess and potentially advance CVH through the use of comprehensive workplace wellness programs. Among a cohort of employees of the Baptist Health System, CVH was assessed annually during voluntary health fairs and health risk assessments (HRA) from 2011 to 2014 using the AHA's 7 CVH metrics: smoking, body mass index (BMI), physical activity, diet, blood pressure, total cholesterol, and blood glucose. Each metric was categorized as ideal, intermediate, or poor according to the AHA criteria. Cochrane-Armitage test was used to detect trends in CVH by year. Ideal CVH, defined as meeting ideal criteria for all 7 metrics, was assessed and compared across years. The overall cohort was 34,746 with 4,895 employees in 2011, 10,724 in 2012, 9,763 in 2013, and 9,364 in 2014. Mean age (SD) was between 43 (±12) and 46 years (±12). Female to male ratio was 3:1. The prevalence of study participants who met the ideal criteria for diet, physical activity, and blood pressure increased significantly from 2011 to 2014 but for BMI, total cholesterol, and blood glucose, a significant decrease was noticed. In addition, the prevalence of study participants in ideal CVH although low, increased significantly over time (0.3% to 0.6%, p <0.0001). In conclusion, this study shows the trends of the AHA's CVH metrics in a large health care organization. The positive findings noted for the metrics of smoking, physical activity, total cholesterol, and blood glucose should be reinforced. However, the metrics of diet, BMI, and blood pressure need more attention. Copyright © 2016 Elsevier Inc. All rights reserved.

Fundus autofluorescence findings in a mouse model of retinal detachment.

PubMed

Secondi, Roberta; Kong, Jian; Blonska, Anna M; Staurenghi, Giovanni; Sparrow, Janet R

2012-08-07

Fundus autofluorescence (fundus AF) changes were monitored in a mouse model of retinal detachment (RD). RD was induced by transscleral injection of hyaluronic acid (Healon) or sterile balanced salt solution (BSS) into the subretinal space of 4-5-day-old albino Abca4 null mutant and Abca4 wild-type mice. Images acquired by confocal scanning laser ophthalmoscopy (Spectralis HRA) were correlated with spectral domain optical coherence tomography (SD-OCT), infrared reflectance (IR), fluorescence spectroscopy, and histologic analysis. Results. In the area of detached retina, multiple hyperreflective spots in IR images corresponded to punctate areas of intense autofluorescence visible in fundus AF mode. The puncta exhibited changes in fluorescence intensity with time. SD-OCT disclosed undulations of the neural retina and hyperreflectivity of the photoreceptor layer that likely corresponded to histologically visible photoreceptor cell rosettes. Fluorescence emission spectra generated using flat-mounted retina, and 488 and 561 nm excitation, were similar to that of RPE lipofuscin. With increased excitation wavelength, the emission maximum shifted towards longer wavelengths, a characteristic typical of fundus autofluorescence. In detached retinas, hyper-autofluorescent spots appeared to originate from photoreceptor outer segments that were arranged within retinal folds and rosettes. Consistent with this interpretation is the finding that the autofluorescence was spectroscopically similar to the bisretinoids that constitute RPE lipofuscin. Under the conditions of a RD, abnormal autofluorescence may arise from excessive production of bisretinoid by impaired photoreceptor cells.

Molecular dynamics analysis of conformational change of paramyxovirus F protein during the initial steps of membrane fusion

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

Martin-Garcia, Fernando; Mendieta-Moreno, Jesus Ignacio; Mendieta, Jesus

2012-03-30

Highlights: Black-Right-Pointing-Pointer Initial conformational change of paramyxovirus F protein is caused only by mechanical forces. Black-Right-Pointing-Pointer HRA region undergoes a structural change from a beta + alpha conformation to an extended coil and then to an all-alpha conformation. Black-Right-Pointing-Pointer HRS domains of F protein form three single {alpha}-helices prior to generation of the coiled coil. -- Abstract: The fusion of paramyxovirus to the cell membrane is mediated by fusion protein (F protein) present in the virus envelope, which undergoes a dramatic conformational change during the process. Unlike hemagglutinin in orthomyxovirus, this change is not mediated by an alteration of environmentalmore » pH, and its cause remains unknown. Steered molecular dynamics analysis leads us to suggest that the conformational modification is mediated only by stretching mechanical forces once the transmembrane fusion peptide of the protein is anchored to the cell membrane. Such elongating forces will generate major secondary structure rearrangement in the heptad repeat A region of the F protein; from {beta}-sheet conformation to an elongated coil and then spontaneously to an {alpha}-helix. In addition, it is proposed that the heptad repeat A region adopts a final three-helix coiled coil and that this structure appears after the formation of individual helices in each monomer.« less

Detection of posterior vortex veins in eyes with pathologic myopia by ultra-widefield indocyanine green angiography.

PubMed

Moriyama, Muka; Cao, Kejia; Ogata, Satoko; Ohno-Matsui, Kyoko

2017-09-01

To analyse the characteristics of posterior vortex veins detected in highly myopic eyes by wide-field indocyanine green angiography (ICGA). One hundred and fifty-eight consecutive patients (302 eyes) with high myopia (myopic refractive error >8.0 dioptres (D) or axial length ≥26.5 mm) were studied. Wide-field ICGA was performed with the Spectralis HRA module. Posterior vortex veins were found in 80 eyes (26%). The prevalence of posterior staphyloma was significantly higher in eyes in which posterior vortex vein was detected than in eyes without posterior vortex vein. The posterior vortex veins were classified into five types according to the site of exit from the eye; around the optic nerve in 28%, in the macular area in 17%, along the border of staphyloma in 6%, along the margin of macular atrophy or large peripapillary conus in 21%, and elsewhere in 28%. In one eye, two posterior vortex veins collected the choroidal venous blood from the entire fundus. Wide-field ICGA can analyse the characteristic features of choroidal blood outflow system through posterior vortex veins in highly myopic eyes. They may play an important role as routes of choroidal outflow in highly myopic eyes. 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/.

[Optical coherence tomography and microperimetry after internal limiting membrane peeling for epiretinal membrane].

PubMed

Grimbert, P; Lebreton, O; Weber, M

2014-06-01

To evaluate the anatomical and functional consequences of internal limiting membrane (ILM) peeling in epiretinal membrane (ERM) surgery. Retrospective single-center study including consecutive patients operated on for idiopathic ERM. The integrity of the ILM was assessed by ILM Blue® staining after removal of the ERM: either the peeling was spontaneous (group 1) or a complementary peeling was required (group 2). Pre- and post-operatively (1 and 6 months), all patients were analyzed using visual acuity, SD-OCT (Spectralis HRA OCT, Heidelberg, Germany) and microperimetry (OPKO/OTI, Miami, USA). Twenty-one eyes of 21 patients were included: 12 "active ILM peelings" and 9 "spontaneous peelings". In both groups, visual acuity increased significantly after surgery. Microperimetry revealed more microscotomata at 1 and 6 months for active peeling (P<0.05). Their location corresponded more often to the site where the ERM or ILM was grasped, based on surgical videos (P<0.05), and with the appearance of inner retinal defects using en face OCT. ILM peeling is frequently performed to reduce ERM recurrence. Despite lack of effect on visual acuity, active ILM peeling increases the incidence of microscotomas related to the site where the ERM or ILM is grasped. Active ILM peeling may be responsible for postoperative visual discomfort related to microscopic trauma during peeling. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Study of Retinal Nerve Fibre Layer Thickness and Visual Contrast Sensitivity in HIV Positive Individuals.

PubMed

Paul, Rudrajit; Ghosh, Asim K; Nag, Adwaita; Biswas, Shyamapada; Naiya, Britisundar; Mondal, Jayati

2017-06-01

Measurement of Retinal Nerve Fibre Layer Thickness (RNFLT) by Optical Coherence Tomography (OCT) is a sensitive, non invasive and cheap method of detecting early retinal changes in a variety of diseases. In HIV infection, RNFLT is altered and this may have effect on other visual functions like Contrast Sensitivity (CS) and visual acuity. Such ocular pathology can affect the daily life and profession (especially driving) of HIV infected individuals. However, studies on this topic in HIV infected population are rare from India. To study RNFLT, CS and their correlation in a sample of HIV positive Indian population. The present cross-sectional study was done in a tertiary care medical college hospital of Eastern India between May 2016 and September 2016. We did this study on HIV positive subjects with no clinically apparent ocular infection or other pathology. In this study, we have measured the RNFLT using the HRA-OCT Spectralis machine. The CS was tested using a smartphone version of the Pellie-Robson chart. CD4 count, visual acuity and colour vision were also tested. The data was analysed using SPSS version 20.0 for any correlation between these parameters. Pearson coefficient was used for continuous data and Spearman rank correlation was used for categorical data. A p-value <0.05 was considered significant. We had 17 patients, that is 34 eyes. RNFLT loss was found in 21% of the eyes and borderline thinning was found in a further 26%. Predominantly, the temporal quadrant was involved. The mean of log CS was 1.33±0.38. Taking 1.5 as the cut-off value for normalcy, 47% of the eyes tested showed decreased CS. Log CS showed significant correlation with RNFLT of the temporal quadrant only (r=0.37; 95% C.I. 0.041 to 0.631; p=0.02). Temporal RNFLT also showed statistical correlation with the CD4 count. The low CS was also significantly correlated with low visual acuity (r=0.5). In HIV infected persons, subtle ocular changes may occur and this may affect visual functions quite early. Hence, a comprehensive eye check-up should include parameters like CS and OCT.

12 A multi-centre randomised feasibility study evaluating the impact of a prognostic model for management of blunt chest wall trauma patients: stumbl trial.

PubMed

Battle, Ceri; Hutchings, Hayley; Abbott, Zoe; O'neill, Claire; Groves, Sam; Watkins, Alan; Lecky, Fiona; Jones, Sally; Gagg, James; Body, Rick; Evans, Phillip

2017-12-01

A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the Emergency Department (ED). A definitive randomised controlled trial (impact trial), is required to assess the clinical and cost effectiveness of the new model, before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design. This feasibility trial is designed to test the methods of a multi-centre, cluster-randomised (stepped wedge) trial, with a substantial qualitative component. Four EDs in England and Wales will collect data for all blunt chest wall trauma patients over a five month period; in the initial period acting as the controls (normal care) and the second period, acting as the interventions (in which the new model will be used). Baseline measurements including completion of the SF-12v2 will be obtained on initial assessment in the ED. Patient outcome data will then be collected for any subsequent hospitalisations. Data collection will conclude with a six week follow-up completion of two surveys (SF-12v2 and Client Services Receipt Inventory).Analysis of outcomes will focus on feasibility, acceptability and trial processes and will include recruitment and retention rates, attendance at clinician training rates and use of model in the ED. Qualitative feedback will be obtained through clinician interviews and a research nurse focus group. An evaluation of the feasibility of health economics outcomes data will be completed. Wales Research Ethics Committee 6 granted approval for the trial in September 2016. Health Care Research Wales Research Permissions and the HRA have granted approval for the study. Patient recruitment commenced in February 2017. Planned dissemination is through publication in a peer-reviewed Emergency Medicine Journal, presentation at appropriate conferences and to stakeholders at Professional Meetings. © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Reliability of drivers in urban intersections.

PubMed

Gstalter, Herbert; Fastenmeier, Wolfgang

2010-01-01

The concept of human reliability has been widely used in industrial settings by human factors experts to optimise the person-task fit. Reliability is estimated by the probability that a task will successfully be completed by personnel in a given stage of system operation. Human Reliability Analysis (HRA) is a technique used to calculate human error probabilities as the ratio of errors committed to the number of opportunities for that error. To transfer this notion to the measurement of car driver reliability the following components are necessary: a taxonomy of driving tasks, a definition of correct behaviour in each of these tasks, a list of errors as deviations from the correct actions and an adequate observation method to register errors and opportunities for these errors. Use of the SAFE-task analysis procedure recently made it possible to derive driver errors directly from the normative analysis of behavioural requirements. Driver reliability estimates could be used to compare groups of tasks (e.g. different types of intersections with their respective regulations) as well as groups of drivers' or individual drivers' aptitudes. This approach was tested in a field study with 62 drivers of different age groups. The subjects drove an instrumented car and had to complete an urban test route, the main features of which were 18 intersections representing six different driving tasks. The subjects were accompanied by two trained observers who recorded driver errors using standardized observation sheets. Results indicate that error indices often vary between both the age group of drivers and the type of driving task. The highest error indices occurred in the non-signalised intersection tasks and the roundabout, which exactly equals the corresponding ratings of task complexity from the SAFE analysis. A comparison of age groups clearly shows the disadvantage of older drivers, whose error indices in nearly all tasks are significantly higher than those of the other groups. The vast majority of these errors could be explained by high task load in the intersections, as they represent difficult tasks. The discussion shows how reliability estimates can be used in a constructive way to propose changes in car design, intersection layout and regulation as well as driver training.

OCT angiography of acute non-arteritic anterior ischemic optic neuropathy.

PubMed

Rougier, M-B; Delyfer, M-N; Korobelnik, J-F

2017-02-01

To describe changes of the retinal peripapillary microvasculature on optical coherence tomography angiography (OCT-A) in non-arteritic anterior ischemic optic (NAION) neuropathy. Observational study of 10 patients at the acute phase of NAION. OCT-A was performed using a 3mm×3mm square centered on the optic disc (Cirrus HD-OCT with Angioplex, Carl Zeiss Meditec, Dublin, CA). A qualitative comparison was made with the healthy fellow eye of each patient. All patients had a fluorescein angiography (HRA2, Heidelberg, Germany) and a visual field examination (Octopus 101 ® , Haag-Streit, USA). In the affected eyes, OCT-A showed clear modifications in the radial peripapillary network. In all these eyes, a focal disappearance of the superficial capillary radial pattern was present, twisted and irregular. In 8 eyes, there was also a lack of vascularization in some focal areas, appearing as dark areas. No correlation was found between the topography of the vascular alteration shown on OCT-A and visual field pattern defects. OCT-A is a new imaging technology able to demonstrate easily and safely the changes in the peripapillary capillary network during the acute phase of NAION. These changes are likely related to a decrease of the prelaminar optic nerve blood flow during the acute phase of NAION. Visual field defects are not correlated with OCT-A images, suggesting that they may be due mainly to disturbances in posterior ciliary artery blood flow. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Spectral Domain Optical Coherence Tomographic Findings of Bietti Crystalline Dystrophy

PubMed Central

Öner, Ferit Hakan

2014-01-01

We analyzed the OCT features of 24 eyes of 12 patients with Bietti crystalline dystrophy (BCD) with the Heidelberg HRA2-OCT. Seventeen of 24 eyes were in intermediate stage of the disease and seven in advanced stage of the disease at the time of latest OCT examination performed in 2014. Outer retinal tubulations and retinal hyperreflective dots were present in 20 of 24 eyes. The remaining four eyes had advanced disease with very thin retina. Appearance of bright plaque on top of RPE-Bruch membrane was present in all eyes. Choroidal hyperreflective spots were noted in 19 of 24 eyes. The remaining five eyes had advanced disease stage with very thin choroid. Mean central macular thickness was 163.08 μm ± 62.52 for all eyes (170.35 μm ± 56.46 in eyes with intermediate disease and 145.42 μm ± 77.2 in eyes with advanced disease). Mean subfoveal choroidal thickness was 95.37 μm ± 55.93 for the study eyes (116.47 ± 46.92 μm in eyes with intermediate disease and 44.14 μm ± 42.43 in eyes with advanced disease). Choroidal hyperreflective spots were noted in 21 of 24 eyes (87.5%). SD-OCT shows the disease progression in retinal and choroidal layers delicately in eyes with BCD and expands our knowledge about the ongoing disease process. PMID:25505979

Human Reliability and the Cost of Doing Business

NASA Technical Reports Server (NTRS)

DeMott, Diana

2014-01-01

Most businesses recognize that people will make mistakes and assume errors are just part of the cost of doing business, but does it need to be? Companies with high risk, or major consequences, should consider the effect of human error. In a variety of industries, Human Errors have caused costly failures and workplace injuries. These have included: airline mishaps, medical malpractice, administration of medication and major oil spills have all been blamed on human error. A technique to mitigate or even eliminate some of these costly human errors is the use of Human Reliability Analysis (HRA). Various methodologies are available to perform Human Reliability Assessments that range from identifying the most likely areas for concern to detailed assessments with human error failure probabilities calculated. Which methodology to use would be based on a variety of factors that would include: 1) how people react and act in different industries, and differing expectations based on industries standards, 2) factors that influence how the human errors could occur such as tasks, tools, environment, workplace, support, training and procedure, 3) type and availability of data and 4) how the industry views risk & reliability influences ( types of emergencies, contingencies and routine tasks versus cost based concerns). The Human Reliability Assessments should be the first step to reduce, mitigate or eliminate the costly mistakes or catastrophic failures. Using Human Reliability techniques to identify and classify human error risks allows a company more opportunities to mitigate or eliminate these risks and prevent costly failures.

In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging.

PubMed

Göbel, Arno P; Fleckenstein, Monika; Heeren, Tjebo F C; Holz, Frank G; Schmitz-Valckenberg, Steffen

2016-01-01

To determine fundus autofluorescence (FAF) signal variations and corresponding microstructural alterations on spectral-domain optical coherence tomography (SD-OCT) in areas of funduscopically visible drusen associated with age-related macular degeneration (AMD). Thirty eyes from 22 patients with geographic atrophy (GA) secondary to AMD (median age 74, range 64-87 years), who had undergone retinal imaging including color fundus photography (CFP), FAF and SD-OCT (Spectralis HRA+OCT; Heidelberg Engineering GmbH, Heidelberg, Germany) were retrospectively analyzed. In each eye, at least one druse (≥ 63 μm) in the perilesional zone of GA recorded on CFP was analyzed. Relative FAF intensities and alterations in SD-OCT bands at the site of each druse were evaluated. A total of 73 drusen were analyzed, which were associated with heterogeneous corresponding alterations on FAF and SD-OCT. The FAF signal was normal, increased, decreased or not evaluable in 32 (44 %), 27 (37 %), 12 (16 %), and 2 (3 %) drusen, respectively. Focal hyperreflectivity overlying drusen was most frequently spatially confined to increased FAF (present in 9 (33 %) of 27 drusen with increased FAF). Outer nuclear layer thinning and choroidal hyperreflectivity were associated with decreased FAF (present in 7 [58 %] of 12 and 6 [50 %] of 12 drusen with decreased FAF, respectively). The appearance of soft drusen on CFP does not allow for differentiation between preserved and markedly compromised outer retinal integrity, including incipient atrophy and focal neurosensory alterations of reflectivity overlying extracellular sub-retinal pigment epithelium (RPE) deposits. Multimodal imaging reveals a broad spectrum of microstructural changes, which may reflect different stages in the evolution of drusen.

Health assessment instruments for people with intellectual disabilities-A systematic review.

PubMed

Bakker-van Gijssel, E J; Lucassen, P L B J; Olde Hartman, T C; van Son, L; Assendelft, W J J; van Schrojenstein Lantman-de Valk, H M J

2017-05-01

People with intellectual disabilities (ID) experience health disparities and are less likely to undergo recommended age- and gender-specific screening and health promotion. New diagnoses are frequently missed. Assessments with the aid of health assessment instruments are a way to address these problems. The aim of this review is to find the available health assessment instruments for people with ID used in primary care and evaluate their quality. We conducted an electronic literature search of papers published between January 2000 and May 2016. After a two-phase selection process (kappa: 0.81 and 0.77) we collected data from the 29 included peer-reviewed articles on the following four domains; development, clinimetric properties (i.e. validity, reliability, feasibility, acceptability), content (i.e. ID-related health problems, prevention and health promotion topics) and effectiveness of the instruments. We distinguished 20 different health assessment instruments. Limited information was found on the development of the instruments as well as on their clinimetric properties. The content of the instruments was rather diverse. The included papers agreed that health assessment instruments are effective. However, only three instruments evaluated effectiveness in a randomised controlled trial. Patients with ID, carers and general practitioners (GPs) generally appreciated the health assessment instruments. Two instruments, "Stay well and healthy -Health risk appraisal (SWH-HRA)"and the "Comprehensive Health Assessment Programme (CHAP)", appeared to have the highest quality. These instruments can be used to construct a health assessment instrument for people with ID that meets scientific standards. Copyright © 2017 Elsevier Ltd. All rights reserved.

Retinal nerve fiber layer thickness in normals measured by spectral domain OCT.

PubMed

Bendschneider, Delia; Tornow, Ralf P; Horn, Folkert K; Laemmer, Robert; Roessler, Christopher W; Juenemann, Anselm G; Kruse, Friedrich E; Mardin, Christian Y

2010-09-01

To determine normal values for peripapillary retinal nerve fiber layer thickness (RNFL) measured by spectral domain Optical Coherence Tomography (SOCT) in healthy white adults and to examine the relationship of RNFL with age, gender, and clinical variables. The peripapillary RNFL of 170 healthy patients (96 males and 74 females, age 20 to 78 y) was imaged with a high-resolution SOCT (Spectralis HRA+OCT, Heidelberg Engineering) in an observational cross-sectional study. RNFL thickness was measured around the optic nerve head using 16 automatically averaged, consecutive circular B-scans with 3.4-mm diameter. The automatically segmented RNFL thickness was divided into 32 segments (11.25 degrees each). One randomly selected eye per subject entered the study. Mean RNFL thickness in the study population was 97.2 ± 9.7 μm. Mean RNFL thickness was significantly negatively correlated with age (r = -0.214, P = 0.005), mean RNFL decrease per decade was 1.90 μm. As age dependency was different in different segments, age-correction of RNFL values was made for all segments separately. Age-adjusted RNFL thickness showed a significant correlation with axial length (r = -0.391, P = 0.001) and with refractive error (r = 0.396, P<0.001), but not with disc size (r = 0.124). Normal RNFL results with SOCT are comparable to those reported with time-domain OCT. In accordance with the literature on other devices, RNFL thickness measured with SOCT was significantly correlated with age and axial length. For creating a normative database of SOCT RNFL values have to be age adjusted.

Potential combined effects of maternal smoking and coffee intake on foetal death within the Danish National Birth Cohort.

PubMed

Morales-Suárez-Varela, Maria; Nohr, Ellen A; Olsen, Jørn; Bech, Bodil H

2018-04-01

Several studies have linked coffee intake and smoking to foetal death, but a possible interaction between both exposures remains unknown. We studied, within the Danish National Birth Cohort, the potential interaction between smoking and coffee drinking while pregnant on the risk of foetal (early and late) death. The study included 90 086 pregnant women, with information about their smoking habit and coffee intake in early pregnancy, and several potential confounding factors. Interaction was studied by calculating both the hazard ratio (HR) in Cox's regression (linear and smoothed restricted cubic spline) and the interaction contrast ratio (ICR). Women who neither smoked nor drank coffee were used as the reference group. Drinking more than 3 cups/d of coffee was associated with the highest risk of foetal death, spontaneous abortion and stillbirth for all smoking status (non-smoker, ≤10 or > 10 cigarettes/d). Among smokers, the combination with drinking <3 cups/d of coffee presented the lowest HRa for foetal death, spontaneous abortion and stillbirth. The ICRs were negative when considering smokers who had a coffee intake up to 3 cups/d, but they were positive for those who had a higher coffee intake, suggesting the effect of coffee intake may be non-linear. Our results suggest that the combined effect of smoking and coffee intake during pregnancy on the risk of foetal death is coffee-dose-dependent. A low coffee intake may reduce the risk of foetal death associated with smoking while a high coffee intake increases the risk.

Polyclonal and monoclonal antibodies specific for the six-helix bundle of the human respiratory syncytial virus fusion glycoprotein as probes of the protein post-fusion conformation

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

Palomo, Concepción; Mas, Vicente; Vázquez, Mónica

Human respiratory syncytial virus (hRSV) has two major surface glycoproteins (G and F) anchored in the lipid envelope. Membrane fusion promoted by hRSV{sub F} occurs via refolding from a pre-fusion form to a highly stable post-fusion state involving large conformational changes of the F trimer. One of these changes results in assembly of two heptad repeat sequences (HRA and HRB) into a six-helix bundle (6HB) motif. To assist in distinguishing pre- and post-fusion conformations of hRSV{sub F}, we have prepared polyclonal (α-6HB) and monoclonal (R145) rabbit antibodies specific for the 6HB. Among other applications, these antibodies were used to exploremore » the requirements of 6HB formation by isolated protein segments or peptides and by truncated mutants of the F protein. Site-directed mutagenesis and electron microscopy located the R145 epitope in the post-fusion hRSV{sub F} at a site distantly located from previously mapped epitopes, extending the repertoire of antibodies that can decorate the F molecule. - Highlights: • Antibodies specific for post-fusion respiratory syncytial virus fusion protein are described. • Polyclonal antibodies were obtained in rabbit inoculated with chimeric heptad repeats. • Antibody binding required assembly of a six-helix bundle in the post-fusion protein. • A monoclonal antibody with similar structural requirements is also described. • Binding of this antibody to the post-fusion protein was visualized by electron microscopy.« less

Concordance of Macular Pigment Measurement Using Customized Heterochromatic Flicker Photometry and Fundus Autofluorescence in Age-Related Macular Degeneration.

PubMed

Akuffo, Kwadwo Owusu; Beatty, Stephen; Stack, Jim; Peto, Tunde; Leung, Irene; Corcoran, Laura; Power, Rebecca; Nolan, John M

2015-12-01

We compared macular pigment (MP) measurements using customized heterochromatic flicker photometry (Macular Metrics Densitometer) and dual-wavelength fundus autofluorescence (Heidelberg Spectralis HRA + OCT MultiColor) in subjects with early age-related macular degeneration (AMD). Macular pigment was measured in 117 subjects with early AMD (age, 44-88 years) using the Densitometer and Spectralis, as part of the Central Retinal Enrichment Supplementation Trial (CREST; ISRCTN13894787). Baseline and 6-month study visits data were used for the analyses. Agreement was investigated at four different retinal eccentricities, graphically and using indices of agreement, including Pearson correlation coefficient (precision), accuracy coefficient, and concordance correlation coefficient (ccc). Agreement was poor between the Densitometer and Spectralis at all eccentricities, at baseline (e.g., at 0.25° eccentricity, accuracy = 0.63, precision = 0.35, ccc = 0.22) and at 6 months (e.g., at 0.25° eccentricity, accuracy = 0.52, precision = 0.43, ccc = 0.22). Agreement between the two devices was significantly greater for males at 0.5° and 1.0° of eccentricity. At all eccentricities, agreement was unaffected by cataract grade. In subjects with early AMD, MP measurements obtained using the Densitometer and Spectralis are not statistically comparable and should not be used interchangeably in either the clinical or research setting. Despite this lack of agreement, statistically significant increases in MP, following 6 months of supplementation with macular carotenoids, were detected with each device, confirming that these devices are capable of measuring change in MP within subjects over time. (http://www.controlled-trials.com number, ISRCTN13894787.).

How valid are self-reports of illness-related absence? Evidence from a university employee health management program.

PubMed

Jenkins, Kristi Rahrig

2014-08-01

The present study uses a focused approach to compare self-reported versus administratively recorded measures of absences related to health or illness. To date, the few studies that focus on this topic produced mixed results. To help shed light on this issue, the present research has 2 related objectives: (1) examine how highly correlated self-reported and administratively recorded measures of absences related to health or illness might be, and (2) how each measure predicts various aspects of health. Using data from the 2012 StayWell® Health Management health risk appraisal (HRA) and 1 year (2011) of administratively recorded timekeeping data, bivariate analyses for continuous variables and generalized linear modeling for variables with greater than 2 response categories were used. For the multivariate analyses, linear regression models controlling for sex, age, race, income, job status, and campus location were calculated for the continuous outcomes (ie, self-rated health and chronic conditions). Results indicate that self-reported and administratively recorded absences related to health or illness were moderately correlated (correlation coefficient of 0.47). In addition, each measure functioned similarly (in direction and magnitude) to predict health outcomes. Both greater self-reported and recorded illness-related absenteeism was associated with poorer self-rated health and greater numbers of chronic conditions. These results suggest that self-rated illness-related absenteeism may be a reasonable way to assess various program outcomes meaningful to employers, particularly if administratively recorded measures are unavailable or too time consuming or expensive to analyze.

Dysflective cones: Visual function and cone reflectivity in long-term follow-up of acute bilateral foveolitis.

PubMed

Tu, Joanna H; Foote, Katharina G; Lujan, Brandon J; Ratnam, Kavitha; Qin, Jia; Gorin, Michael B; Cunningham, Emmett T; Tuten, William S; Duncan, Jacque L; Roorda, Austin

2017-09-01

Confocal adaptive optics scanning laser ophthalmoscope (AOSLO) images provide a sensitive measure of cone structure. However, the relationship between structural findings of diminished cone reflectivity and visual function is unclear. We used fundus-referenced testing to evaluate visual function in regions of apparent cone loss identified using confocal AOSLO images. A patient diagnosed with acute bilateral foveolitis had spectral-domain optical coherence tomography (SD-OCT) (Spectralis HRA + OCT system [Heidelberg Engineering, Vista, CA, USA]) images indicating focal loss of the inner segment-outer segment junction band with an intact, but hyper-reflective, external limiting membrane. Five years after symptom onset, visual acuity had improved from 20/80 to 20/25, but the retinal appearance remained unchanged compared to 3 months after symptoms began. We performed structural assessments using SD-OCT, directional OCT (non-standard use of a prototype on loan from Carl Zeiss Meditec) and AOSLO (custom-built system). We also administered fundus-referenced functional tests in the region of apparent cone loss, including analysis of preferred retinal locus (PRL), AOSLO acuity, and microperimetry with tracking SLO (TSLO) (prototype system). To determine AOSLO-corrected visual acuity, the scanning laser was modulated with a tumbling E consistent with 20/30 visual acuity. Visual sensitivity was assessed in and around the lesion using TSLO microperimetry. Complete eye examination, including standard measures of best-corrected visual acuity, visual field tests, color fundus photos, and fundus auto-fluorescence were also performed. Despite a lack of visible cone profiles in the foveal lesion, fundus-referenced vision testing demonstrated visual function within the lesion consistent with cone function. The PRL was within the lesion of apparent cone loss at the fovea. AOSLO visual acuity tests were abnormal, but measurable: for trials in which the stimulus remained completely within the lesion, the subject got 48% correct, compared to 78% correct when the stimulus was outside the lesion. TSLO microperimetry revealed reduced, but detectible, sensitivity thresholds within the lesion. Fundus-referenced visual testing proved useful to identify functional cones despite apparent photoreceptor loss identified using AOSLO and SD-OCT. While AOSLO and SD-OCT appear to be sensitive for the detection of abnormal or absent photoreceptors, changes in photoreceptors that are identified with these imaging tools do not correlate completely with visual function in every patient. Fundus-referenced vision testing is a useful tool to indicate the presence of cones that may be amenable to recovery or response to experimental therapies despite not being visible on confocal AOSLO or SD-OCT images.

Fundus autofluorescence and retinal structure as determined by spectral domain optical coherence tomography, and retinal function in retinitis pigmentosa.

PubMed

Iriyama, Aya; Yanagi, Yasuo

2012-03-01

To investigate the association between fundus autofluorescence (FAF) and retinal structure and function in retinitis pigmentosa (RP). For image acquisition, HRA2 (Heidelberg Engineering) and 3D-OCT1000 (Topcon Corp.) were used. Based on FAF examination, 88 eyes of 44 RP patients were categorized into three types. The area within the hyperautofluorescent ring and the area of preserved retinal autofluorescence with FAF was calculated. The association between the pattern of FAF and the residual area of the junction between the inner and outer segments of the photoreceptors (IS/OS line), and the relationship between the area within hyperautofluorescent ring, the area of preserved retinal autofluorescence and the mean deviation (MD) of static perimetry were assessed. Twenty-four eyes were with preserved retinal autofluorescence without hyperautofluorescent ring, 54 eyes were with hyperautofluorescent ring and ten eyes were with abnormal foveal autofluorescence both in the fovea and the periphery of the 30° scan. In the first type, the IS/OS line was clearly detected. In the second type, the residual area of the partially distinct IS/OS line corresponded with the area within hyperautofluorescent ring with significant correlation between the area within hyperautofluorescent ring and the MD (R(2) = 0.705, p < 0.001); however, there was no correlation between the area of preserved retinal autofluorescence and the MD, or between the area of preserved retinal autofluorescence and the area within hyperautofluorescent ring. In the third type, the IS/OS line was completely absent. The residual IS/OS line can be found in the area inside the hyperautofluorescent ring and correlates with residual visual function.

Hydrological resiliency in the Western Boreal Plains: classification of hydrological responses using wavelet analysis to assess landscape resilience

NASA Astrophysics Data System (ADS)

Probert, Samantha; Kettridge, Nicholas; Devito, Kevin; Hannah, David; Parkin, Geoff

2017-04-01

The Boreal represents a system of substantial resilience to climate change, with minimal ecological change over the past 6000 years. However, unprecedented climatic warming, coupled with catchment disturbances could exceed thresholds of hydrological function in the Western Boreal Plains. Knowledge of ecohydrological and climatic feedbacks that shape the resilience of boreal forests has advanced significantly in recent years, but this knowledge is yet to be applied and understood at landscape scales. Hydrological modelling at the landscape scale is challenging in the WBP due to diverse, non-topographically driven hydrology across the mosaic of terrestrial and aquatic ecosystems. This study functionally divides the geologic and ecological components of the landscape into Hydrologic Response Areas (HRAs) and wetland, forestland, interface and pond Hydrologic Units (HUs) to accurately characterise water storage and infer transmission at multiple spatial and temporal scales. Wavelet analysis is applied to pond and groundwater levels to describe the patterns of water storage in response to climate signals; to isolate dominant controls on hydrological responses and to assess the relative importance of physical controls between wet and dry climates. This identifies which components of the landscape exhibit greater magnitude and frequency of variability to wetting and drying trends, further to testing the hierarchical framework for hydrological storage controls of: climate, bedrock geology, surficial geology, soil, vegetation, and topography. Classifying HRA and HU hydrological function is essential to understand and predict water storage and redistribution through drought cycles and wet periods. This work recognises which landscape components are most sensitive under climate change and disturbance and also creates scope for hydrological resiliency research in Boreal systems by recognising critical landscape components and their role in landscape collapse or catastrophic shift in ecosystem function under future climatic scenarios.

Population-based age group specific annual incidence rates of symptomatic age-related macular degeneration.

PubMed

Saari, Jukka M

2014-01-01

To study the population-based annual incidence rates of exudative, dry and all cases of symptomatic age-related macular degeneration (AMD) in different age and sex groups. This is a one year, prospective, population-based study on all consecutive new patients with AMD in the hospital district of Central Finland. The diagnosis was confirmed in all patients with slit lamp biomicroscopy, optical coherence tomography (OCT) using a Spectralis HRA + OCT device, and the Heidelberg Eye Explorer 1.6.2.0 program. Fluorescein angiograms were taken when needed. The population-based annual incidence rates of all cases of symptomatic AMD increased from 0.03% (95% CI, 0.01-0.05%) in the age group 50-59 years to 0.82% (95% CI, 0.55-1.09%) in the age group 85-89 years and were 0.2% (95% CI, 0.17-0.24%) in exudative, 0.11% (95% CI, 0.09-0.14%) in dry, and 0.32% (95% CI, 0.28-0.36%) in all cases of AMD in the age group 60 years and older. During the next 20 years in Central Finland the population-based annual incidence rates can be estimated to increase to 0.27% (95% CI, 0.24-0.30%) in exudative, to 0.13% (95% CI, 0.11-0.15%) in dry, and to 0.41% (95% CI, 0.37-0.45%) in all cases of AMD in the age group 60 years and older. The population-based annual incidence of AMD did not show statistically significant differences between males and females (p>0.1). The population-based age-group specific annual incidence rates of symptomatic AMD of this study may help to plan health care provision for patients of AMD.

Enhanced depth imaging optical coherence tomography of choroidal metastasis in 14 eyes.

PubMed

Al-Dahmash, Saad A; Shields, Carol L; Kaliki, Swathi; Johnson, Timothy; Shields, Jerry A

2014-08-01

To describe the imaging features of choroidal metastasis using enhanced depth imaging optical coherence tomography (EDI-OCT). This retrospective observational case series included 31 eyes with choroidal metastasis. Spectral domain EDI-OCT was performed using Heidelberg Spectralis HRA + OCT. The main outcome measures were imaging features by EDI-OCT. Of 31 eyes with choroidal metastasis imaged with EDI-OCT, 14 (45%) eyes displayed image detail suitable for study. The metastasis originated from carcinoma of the breast (n = 7, 50%), lung (n = 5, 36%), pancreas (n = 1, 7%), and thyroid gland (n = 1, 7%). The mean tumor basal diameter was 6.4 mm, and mean thickness was 2.3 mm by B-scan ultrasonography. The tumor location was submacular in 6 (43%) eyes and extramacular in 8 (57%) eyes. By EDI-OCT, the mean tumor thickness was 987 μm. The most salient EDI-OCT features of the metastasis included anterior compression/obliteration of the overlying choriocapillaris (n = 13, 93%), an irregular (lumpy bumpy) anterior contour (n = 9, 64%), and posterior shadowing (n = 12, 86%). Overlying retinal pigment epithelial abnormalities were noted (n = 11, 78%). Outer retinal features included structural loss of the interdigitation of the cone outer segment tips (n = 9, 64%), the ellipsoid portion of photoreceptors (n = 8, 57%), external limiting membrane (n = 4, 29%), outer nuclear layer (n = 1, 7%), and outer plexiform layer (n = 1, 7%). The inner retinal layers (inner nuclear layer to nerve fiber layer) were normal. Subretinal fluid (n = 11, 79%), subretinal lipofuscin pigment (n = 1, 7%), and intraretinal edema (n = 2, 14%) were identified. The EDI-OCT of choroidal metastasis shows a characteristic lumpy bumpy anterior tumor surface and outer retinal layer disruption with preservation of inner retinal layers.

Molecular epidemiology and phylogenetic distribution of the Escherichia coli pks genomic island.

PubMed

Johnson, James R; Johnston, Brian; Kuskowski, Michael A; Nougayrede, Jean-Philippe; Oswald, Eric

2008-12-01

Epidemiological and phylogenetic associations of the pks genomic island of extraintestinal pathogenic Escherichia coli (ExPEC), which encodes the genotoxin colibactin, are incompletely defined. clbB and clbN (as markers for the 5' and 3' regions of the pks island, respectively), clbA and clbQ (as supplemental pks island markers), and 12 other putative ExPEC virulence genes were newly sought by PCR among 131 published E. coli isolates from hospitalized veterans (62 blood isolates and 69 fecal isolates). Blood and fecal isolates and clbB-positive and -negative isolates were compared for 66 newly and previously assessed traits. Among the 14 newly sought traits, clbB and clbN (colibactin polyketide synthesis system), hra (heat-resistant agglutinin), and vat (vacuolating toxin) were significantly associated with bacteremia. clbB and clbN identified a subset within phylogenetic group B2 with extremely high virulence scores and a high proportion of blood isolates. However, by multivariable analysis, other traits were more predictive of blood source than clbB and clbN were; indeed, among the newly sought traits, only pic significantly predicted bacteremia (negative association). By correspondence analysis, clbB and clbN were closely associated with group B2 and multiple B2-associated traits; by principal coordinate analysis, clbB and clbN partitioned the data set better than did blood versus fecal source. Thus, the pks island was significantly associated with bacteremia, multiple ExPEC-associated virulence genes, and group B2, and within group B2, it identified an especially high-virulence subset. This extends previous work regarding the pks island and supports investigation of the colibactin system as a potential therapeutic target.

A pilot study: Horticulture-related activities significantly reduce stress levels and salivary cortisol concentration of maladjusted elementary school children.

PubMed

Lee, Min Jung; Oh, Wook; Jang, Ja Soon; Lee, Ju Young

2018-04-01

The effects of three horticulture-related activities (HRAs), including floral arranging, planting, and flower pressing were compared to see if they influenced changes on a stress scale and on salivary cortisol concentrations (SCC) in maladjusted elementary school children. Twenty maladjusted elementary school children were randomly assigned either to an experimental or control group. The control group carried out individual favorite indoor activities under the supervision of a teacher. Simultaneously, the ten children in the experimental group participated in a HRA program consisting of flower arrangement (FA), planting (P), and flower pressing (PF) activities, in which the other ten children in the control group did not take part. During nine sessions, the activities were completed as follows: FA-FA-FA, P-P-P, and PF-PF-PF; each session lasted 40 min and took place once a week. For the quantitative analysis of salivary cortisol, saliva was collected from the experimental group one week before the HRAs and immediately after the activities for 9 consecutive weeks at the same time each session. In the experimental group, stress scores of interpersonal relationship, school life, personal problems, and home life decreased after the HRAs by 1.3, 1.8, 4.2, and 1.3 points, respectively. In particular, the stress score of school life was significantly reduced (P < 0.01). In addition, from the investigation of the SCCs for the children before and after repeating HRAs three times, it was found that flower arrangement, planting, and flower pressing activities reduced the SCCs by ≥37% compared to the SCCs prior to taking part in the HRAs. These results indicate that HRAs are associated with a reduction in the stress levels of maladjusted elementary school children. Copyright © 2018. Published by Elsevier Ltd.

The Mechanical Properties and In Vitro Biocompatibility of PM-Fabricated Ti-28Nb-35.4Zr Alloy for Orthopedic Implant Applications.

PubMed

Xu, Wei; Li, Ming; Wen, Cuie; Lv, Shaomin; Liu, Chengcheng; Lu, Xin; Qu, Xuanhui

2018-03-30

A biocompatible Ti-28Nb-35.4Zr alloy used as bone implant was fabricated through the powder metallurgy process. The effects of mechanical milling and sintering temperatures on the microstructure and mechanical properties were investigated systematically, before in vitro biocompatibility of full dense Ti-28Nb-35.4Zr alloy was evaluated by cytotoxicity tests. The results show that the mechanical milling and sintering temperatures have significantly effects on the density and mechanical properties of the alloys. The relative density of the alloy fabricated by the atomized powders at 1500 °C is only 83 ± 1.8%, while the relative density of the alloy fabricated by the ball-milled powders can rapidly reach at 96.4 ± 1.3% at 1500 °C. When the temperature was increased to 1550 °C, the alloy fabricated by ball-milled powders achieve full density (relative density is 98.1 ± 1.2%). The PM-fabricated Ti-28Nb-35.4Zr alloy by ball-milled powders at 1550 °C can achieve a wide range of mechanical properties, with a compressive yield strength of 1058 ± 35.1 MPa, elastic modulus of 50.8 ± 3.9 GPa, and hardness of 65.8 ± 1.5 HRA. The in vitro cytotoxicity test suggests that the PM-fabricated Ti-28Nb-35.4Zr alloy by ball-milled powders at 1550 °C has no adverse effects on MC3T3-E1 cells with cytotoxicity ranking of 0 grade, which is nearly close to ELI Ti-6Al-4V or CP Ti. These properties and the net-shape manufacturability makes PM-fabricated Ti-28Nb-35.4Zr alloy a low-cost, highly-biocompatible, Ti-based biomedical alloy.

Imaging of Corneal Neovascularization: Optical Coherence Tomography Angiography and Fluorescence Angiography.

PubMed

Brunner, Matthias; Romano, Vito; Steger, Bernhard; Vinciguerra, Riccardo; Lawman, Samuel; Williams, Bryan; Hicks, Nicholas; Czanner, Gabriela; Zheng, Yalin; Willoughby, Colin E; Kaye, Stephen B

2018-03-01

The purpose of this study was to compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) for the assessment of corneal neovascularization (CoNV). Patients with CoNV extending at least 3 mm into the cornea were included. All patients underwent corneal imaging at the same visit. Images were recorded using the AngioVue OCTA system (Optovue, Inc.) with the long corneal adaptor module (CAM-L). ICGA images were recorded with fluorescent filters using the Heidelberg system (HRA2 Scanning Laser Ophthalmoscope; Heidelberg Engineering). Images were graded for quality by two independent observers. Vessel parameters: area, number, diameter, branch and end points, and tortuosity, were compared between devices. Bland-Altman plots were used to assess differences between parameters. Fifteen patients with CoNV predominantly associated with microbial keratitis were included. Mean subjective image quality score was better for ICGA (3.3 ± 0.9) than for OCTA (2.1 ± 1.2, P = 0.002), with almost perfect interobserver agreement for ICGA images (κ = 0.83) and substantial agreement for OCTA images (κ = 0.69). Agreement of grading of all investigated vessel parameters between ICGA and OCT images was slight to moderate, with significant differences found for vessel diameter (-8.98 μm, P = 0.01, 95% limits of agreement [LOA]: -15.89 to -2.07), number of branch (25.93, P = 0.09, 95% LOA: -4.31 to 56.17), and terminal points (49, P = 0.05, 95% LOA: 0.78 to 97.22). Compared with ICGA, current OCTA systems are less precise in capturing small vessels in CoNV complexes, and validation studies are needed for OCTA segmentation software. OCTA, however, complements ICGA by providing evidence of red blood cell flow, which together with depth information, may be helpful when planning treatment of CoNV.

Risk factors for infection by oncogenic human papillomaviruses in HIV-positive MSM patients in the ART era (2010-2016).

PubMed

Hidalgo-Tenorio, Carmen; Gil-Anguita, Concepción; Ramírez-Taboada, Jessica; Esquivias, Javier; López-Ruz, Miguel A; Balgahata, Omar Mohamed; Javier-Martinez, Rosario; Pasquau, Juan

2017-09-01

Squamous cell carcinoma of anus (SCCA) is one of the most frequent non-AIDS-defining diseases in HIV patients, mainly in men who have sex with men (MSM), and it is associated with human papillomavirus (HPV) infection.To determine the prevalence of high-risk HPV (HR-HPV) genotypes, premalignant lesions (HSIL) and SCCA in a cohort of HIV-positive MSM; to study the distribution of HPV genotypes according to anal histology results; and to analyze risk factors for this infection.This prospective single-center study was conducted between May 2010 and September 2016. At the study visit, cotton swabs were used to collect anal samples for cytology study in ThinPrep Pap Test liquid medium (Thin Prep Processor 2000, Hologic Corp, USA), and for HPV PCR (Linear Array HPV Genotyping Test). After, high-resolution anoscopy (HRA) (Zeiss 150 fc) was carried out. Logistic regression analysis was performed to identify risk factors for HR-HPV infection.The study included 319 patients, with mean age of 36.7 years; HR-HPV was detected in 81.3%. The prevalence of HSIL was 13.5% and SCCA was 0.3%. With regard to the distribution of HPV genotypes according to histology results, HPV 16 was the most frequent genotype in normal anal mucosa (26.7%), in LSILs (36.9%), and in HSILs (38%). In multivariate analysis, CD4 nadir < 200 cells/μL was the factor associated with infection by HR-HPV (OR 3.66, 95% CI 1.05%-12.75%).HIV-positive MSM showed a high prevalence of HSIL+ lesions and of infection by oncogenic HPV, which appears to be favored by a deficient immune system. HPV 16 was the most frequently isolated genotype in anal mucosa, regardless of lesion type.

Process safety improvement--quality and target zero.

PubMed

Van Scyoc, Karl

2008-11-15

Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The "plan, do, check, act" improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given.

Through Their Eyes: Lessons Learned Using Participatory Methods in Health Care Quality Improvement Projects

PubMed Central

Balbale, Salva N.; Locatelli, Sara M.; LaVela, Sherri L.

2016-01-01

In this methodological article, we examine participatory methods in-depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care. PMID:26667882

Improved nonlinear prediction method

NASA Astrophysics Data System (ADS)

Adenan, Nur Hamiza; Md Noorani, Mohd Salmi

2014-06-01

The analysis and prediction of time series data have been addressed by researchers. Many techniques have been developed to be applied in various areas, such as weather forecasting, financial markets and hydrological phenomena involving data that are contaminated by noise. Therefore, various techniques to improve the method have been introduced to analyze and predict time series data. In respect of the importance of analysis and the accuracy of the prediction result, a study was undertaken to test the effectiveness of the improved nonlinear prediction method for data that contain noise. The improved nonlinear prediction method involves the formation of composite serial data based on the successive differences of the time series. Then, the phase space reconstruction was performed on the composite data (one-dimensional) to reconstruct a number of space dimensions. Finally the local linear approximation method was employed to make a prediction based on the phase space. This improved method was tested with data series Logistics that contain 0%, 5%, 10%, 20% and 30% of noise. The results show that by using the improved method, the predictions were found to be in close agreement with the observed ones. The correlation coefficient was close to one when the improved method was applied on data with up to 10% noise. Thus, an improvement to analyze data with noise without involving any noise reduction method was introduced to predict the time series data.

Improved methods of vibration analysis of pretwisted, airfoil blades

NASA Technical Reports Server (NTRS)

Subrahmanyam, K. B.; Kaza, K. R. V.

1984-01-01

Vibration analysis of pretwisted blades of asymmetric airfoil cross section is performed by using two mixed variational approaches. Numerical results obtained from these two methods are compared to those obtained from an improved finite difference method and also to those given by the ordinary finite difference method. The relative merits, convergence properties and accuracies of all four methods are studied and discussed. The effects of asymmetry and pretwist on natural frequencies and mode shapes are investigated. The improved finite difference method is shown to be far superior to the conventional finite difference method in several respects. Close lower bound solutions are provided by the improved finite difference method for untwisted blades with a relatively coarse mesh while the mixed methods have not indicated any specific bound.

A comparison theorem for the SOR iterative method

NASA Astrophysics Data System (ADS)

Sun, Li-Ying

2005-09-01

In 1997, Kohno et al. have reported numerically that the improving modified Gauss-Seidel method, which was referred to as the IMGS method, is superior to the SOR iterative method. In this paper, we prove that the spectral radius of the IMGS method is smaller than that of the SOR method and Gauss-Seidel method, if the relaxation parameter [omega][set membership, variant](0,1]. As a result, we prove theoretically that this method is succeeded in improving the convergence of some classical iterative methods. Some recent results are improved.

Through Their Eyes: Lessons Learned Using Participatory Methods in Health Care Quality Improvement Projects.

PubMed

Balbale, Salva N; Locatelli, Sara M; LaVela, Sherri L

2016-08-01

In this methodological article, we examine participatory methods in depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers, and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care. © The Author(s) 2015.

The influence of spatial resolution on human health risk co-benefit estimates for global climate policy assessments.

PubMed

Shih, Hsiu-Ching; Crawford-Brown, Douglas; Ma, Hwong-wen

2015-03-15

Assessment of the ability of climate policies to produce desired improvements in public health through co-benefits of air pollution reduction can consume resources in both time and research funds. These resources increase significantly as the spatial resolution of models increases. In addition, the level of spatial detail available in macroeconomic models at the heart of climate policy assessments is much lower than that available in traditional human health risk modeling. It is therefore important to determine whether increasing spatial resolution considerably affects risk-based decisions; which kinds of decisions might be affected; and under what conditions they will be affected. Human health risk co-benefits from carbon emissions reductions that bring about concurrent reductions in Particulate Matter (PM10) emissions is therefore examined here at four levels of spatial resolution (Uniform Nation, Uniform Region, Uniform County/city, Health Risk Assessment) in a case study of Taiwan as one of the geographic regions of a global macroeceonomic model, with results that are representative of small, industrialized nations within that global model. A metric of human health risk mortality (YOLL, years of life lost in life expectancy) is compared under assessments ranging from a "uniform simulation" in which there is no spatial resolution of changes in ambient air concentration under a policy to a "highly spatially resolved simulation" (called here Health Risk Assessment). PM10 is chosen in this study as the indicator of air pollution for which risks are assessed due to its significance as a co-benefit of carbon emissions reductions within climate mitigation policy. For the policy examined, the four estimates of mortality in the entirety of Taiwan are 747 YOLL, 834 YOLL, 984 YOLL and 916 YOLL, under Uniform Taiwan, Uniform Region, Uniform County and Health Risk Assessment respectively; or differences of 18%, 9%, 7% if the HRA methodology is taken as the baseline. While these differences are small compared to uncertainties in health risk assessment more generally, the ranks of different regions and of emissions categories as the focus of regulatory efforts estimated at these four levels of spatial resolution are quite different. The results suggest that issues of risk equity within a nation might be missed by the lower levels of spatial resolution, suggesting that low resolution models are suited to calculating national cost-benefit ratios but not as suited to assessing co-benefits of climate policies reflecting intersubject variability in risk, or in identifying sub-national regions and emissions sectors on which to focus attention (although even here, the errors introduced by low spatial resolution are generally less than 40%). Copyright © 2014 Elsevier Ltd. All rights reserved.

An improved partial least-squares regression method for Raman spectroscopy

NASA Astrophysics Data System (ADS)

Momenpour Tehran Monfared, Ali; Anis, Hanan

2017-10-01

It is known that the performance of partial least-squares (PLS) regression analysis can be improved using the backward variable selection method (BVSPLS). In this paper, we further improve the BVSPLS based on a novel selection mechanism. The proposed method is based on sorting the weighted regression coefficients, and then the importance of each variable of the sorted list is evaluated using root mean square errors of prediction (RMSEP) criterion in each iteration step. Our Improved BVSPLS (IBVSPLS) method has been applied to leukemia and heparin data sets and led to an improvement in limit of detection of Raman biosensing ranged from 10% to 43% compared to PLS. Our IBVSPLS was also compared to the jack-knifing (simpler) and Genetic Algorithm (more complex) methods. Our method was consistently better than the jack-knifing method and showed either a similar or a better performance compared to the genetic algorithm.

TBDQ: A Pragmatic Task-Based Method to Data Quality Assessment and Improvement

PubMed Central

Vaziri, Reza; Mohsenzadeh, Mehran; Habibi, Jafar

2016-01-01

Organizations are increasingly accepting data quality (DQ) as a major key to their success. In order to assess and improve DQ, methods have been devised. Many of these methods attempt to raise DQ by directly manipulating low quality data. Such methods operate reactively and are suitable for organizations with highly developed integrated systems. However, there is a lack of a proactive DQ method for businesses with weak IT infrastructure where data quality is largely affected by tasks that are performed by human agents. This study aims to develop and evaluate a new method for structured data, which is simple and practical so that it can easily be applied to real world situations. The new method detects the potentially risky tasks within a process, and adds new improving tasks to counter them. To achieve continuous improvement, an award system is also developed to help with the better selection of the proposed improving tasks. The task-based DQ method (TBDQ) is most appropriate for small and medium organizations, and simplicity in implementation is one of its most prominent features. TBDQ is case studied in an international trade company. The case study shows that TBDQ is effective in selecting optimal activities for DQ improvement in terms of cost and improvement. PMID:27192547

Replica amplification of nucleic acid arrays

DOEpatents

Church, George M.; Mitra, Robi D.

2010-08-31

Disclosed are improved methods of making and using immobilized arrays of nucleic acids, particularly methods for producing replicas of such arrays. Included are methods for producing high density arrays of nucleic acids and replicas of such arrays, as well as methods for preserving the resolution of arrays through rounds of replication. Also included are methods which take advantage of the availability of replicas of arrays for increased sensitivity in detection of sequences on arrays. Improved methods of sequencing nucleic acids immobilized on arrays utilizing single copies of arrays and methods taking further advantage of the availability of replicas of arrays are disclosed. The improvements lead to higher fidelity and longer read lengths of sequences immobilized on arrays. Methods are also disclosed which improve the efficiency of multiplex PCR using arrays of immobilized nucleic acids.

Improved method for calculating neoclassical transport coefficients in the banana regime

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

Taguchi, M., E-mail: taguchi.masayoshi@nihon-u.ac.jp

The conventional neoclassical moment method in the banana regime is improved by increasing the accuracy of approximation to the linearized Fokker-Planck collision operator. This improved method is formulated for a multiple ion plasma in general tokamak equilibria. The explicit computation in a model magnetic field shows that the neoclassical transport coefficients can be accurately calculated in the full range of aspect ratio by the improved method. The some neoclassical transport coefficients for the intermediate aspect ratio are found to appreciably deviate from those obtained by the conventional moment method. The differences between the transport coefficients with these two methods aremore » up to about 20%.« less

Improved Cell Culture Method for Growing Contracting Skeletal Muscle Models

NASA Technical Reports Server (NTRS)

Marquette, Michele L.; Sognier, Marguerite A.

2013-01-01

An improved method for culturing immature muscle cells (myoblasts) into a mature skeletal muscle overcomes some of the notable limitations of prior culture methods. The development of the method is a major advance in tissue engineering in that, for the first time, a cell-based model spontaneously fuses and differentiates into masses of highly aligned, contracting myotubes. This method enables (1) the construction of improved two-dimensional (monolayer) skeletal muscle test beds; (2) development of contracting three-dimensional tissue models; and (3) improved transplantable tissues for biomedical and regenerative medicine applications. With adaptation, this method also offers potential application for production of other tissue types (i.e., bone and cardiac) from corresponding precursor cells.

An improved correlation method for determining the period of a torsion pendulum

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

Luo Jie; Wang Dianhong

Considering variation of environment temperature and unhomogeneity of background gravitational field, an improved correlation method was proposed to determine the variational period of a torsion pendulum with high precision. The result of processing experimental data shows that the uncertainty of determining the period with this method has been improved about twofolds than traditional correlation method, which is significant for the determination of gravitational constant with time-of-swing method.

Improved Filon-type asymptotic methods for highly oscillatory differential equations with multiple time scales

NASA Astrophysics Data System (ADS)

Wang, Bin; Wu, Xinyuan

2014-11-01

In this paper we consider multi-frequency highly oscillatory second-order differential equations x″ (t) + Mx (t) = f (t , x (t) ,x‧ (t)) where high-frequency oscillations are generated by the linear part Mx (t), and M is positive semi-definite (not necessarily nonsingular). It is known that Filon-type methods are effective approach to numerically solving highly oscillatory problems. Unfortunately, however, existing Filon-type asymptotic methods fail to apply to the highly oscillatory second-order differential equations when M is singular. We study and propose an efficient improvement on the existing Filon-type asymptotic methods, so that the improved Filon-type asymptotic methods can be able to numerically solving this class of multi-frequency highly oscillatory systems with a singular matrix M. The improved Filon-type asymptotic methods are designed by combining Filon-type methods with the asymptotic methods based on the variation-of-constants formula. We also present one efficient and practical improved Filon-type asymptotic method which can be performed at lower cost. Accompanying numerical results show the remarkable efficiency.

Infrared Ship Target Segmentation Based on Spatial Information Improved FCM.

PubMed

Bai, Xiangzhi; Chen, Zhiguo; Zhang, Yu; Liu, Zhaoying; Lu, Yi

2016-12-01

Segmentation of infrared (IR) ship images is always a challenging task, because of the intensity inhomogeneity and noise. The fuzzy C-means (FCM) clustering is a classical method widely used in image segmentation. However, it has some shortcomings, like not considering the spatial information or being sensitive to noise. In this paper, an improved FCM method based on the spatial information is proposed for IR ship target segmentation. The improvements include two parts: 1) adding the nonlocal spatial information based on the ship target and 2) using the spatial shape information of the contour of the ship target to refine the local spatial constraint by Markov random field. In addition, the results of K -means are used to initialize the improved FCM method. Experimental results show that the improved method is effective and performs better than the existing methods, including the existing FCM methods, for segmentation of the IR ship images.

Improving the Service with the Servqual Method

NASA Astrophysics Data System (ADS)

Midor, Katarzyna; Kučera, Marian

2018-03-01

At the time when economy is growing, there is strong competition in the market, and customers have increasingly higher expectations as regards quality of service and products. Under such conditions, organizations need to improve. One of the areas of improvement for an organization is to research the level of customer satisfaction. The article presents results of customer satisfaction surveys conducted by the Servqual method in a pharmaceutical service company. Use of this method allowed to improve the services provided by that pharmaceutical wholesaler, identify areas that need to be improved as soon as possible in order to improve the level of service provided.

[An Improved Spectral Quaternion Interpolation Method of Diffusion Tensor Imaging].

PubMed

Xu, Yonghong; Gao, Shangce; Hao, Xiaofei

2016-04-01

Diffusion tensor imaging(DTI)is a rapid development technology in recent years of magnetic resonance imaging.The diffusion tensor interpolation is a very important procedure in DTI image processing.The traditional spectral quaternion interpolation method revises the direction of the interpolation tensor and can preserve tensors anisotropy,but the method does not revise the size of tensors.The present study puts forward an improved spectral quaternion interpolation method on the basis of traditional spectral quaternion interpolation.Firstly,we decomposed diffusion tensors with the direction of tensors being represented by quaternion.Then we revised the size and direction of the tensor respectively according to different situations.Finally,we acquired the tensor of interpolation point by calculating the weighted average.We compared the improved method with the spectral quaternion method and the Log-Euclidean method by the simulation data and the real data.The results showed that the improved method could not only keep the monotonicity of the fractional anisotropy(FA)and the determinant of tensors,but also preserve the tensor anisotropy at the same time.In conclusion,the improved method provides a kind of important interpolation method for diffusion tensor image processing.

Infrastructure for Large-Scale Quality-Improvement Projects: Early Lessons from North Carolina Improving Performance in Practice

ERIC Educational Resources Information Center

Newton, Warren P.; Lefebvre, Ann; Donahue, Katrina E.; Bacon, Thomas; Dobson, Allen

2010-01-01

Introduction: Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods: Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3)…

The Mechanical Properties and In Vitro Biocompatibility of PM-Fabricated Ti-28Nb-35.4Zr Alloy for Orthopedic Implant Applications

PubMed Central

Xu, Wei; Li, Ming; Wen, Cuie; Lv, Shaomin; Liu, Chengcheng; Lu, Xin

2018-01-01

A biocompatible Ti-28Nb-35.4Zr alloy used as bone implant was fabricated through the powder metallurgy process. The effects of mechanical milling and sintering temperatures on the microstructure and mechanical properties were investigated systematically, before in vitro biocompatibility of full dense Ti-28Nb-35.4Zr alloy was evaluated by cytotoxicity tests. The results show that the mechanical milling and sintering temperatures have significantly effects on the density and mechanical properties of the alloys. The relative density of the alloy fabricated by the atomized powders at 1500 °C is only 83 ± 1.8%, while the relative density of the alloy fabricated by the ball-milled powders can rapidly reach at 96.4 ± 1.3% at 1500 °C. When the temperature was increased to 1550 °C, the alloy fabricated by ball-milled powders achieve full density (relative density is 98.1 ± 1.2%). The PM-fabricated Ti-28Nb-35.4Zr alloy by ball-milled powders at 1550 °C can achieve a wide range of mechanical properties, with a compressive yield strength of 1058 ± 35.1 MPa, elastic modulus of 50.8 ± 3.9 GPa, and hardness of 65.8 ± 1.5 HRA. The in vitro cytotoxicity test suggests that the PM-fabricated Ti-28Nb-35.4Zr alloy by ball-milled powders at 1550 °C has no adverse effects on MC3T3-E1 cells with cytotoxicity ranking of 0 grade, which is nearly close to ELI Ti-6Al-4V or CP Ti. These properties and the net-shape manufacturability makes PM-fabricated Ti-28Nb-35.4Zr alloy a low-cost, highly-biocompatible, Ti-based biomedical alloy. PMID:29601517

Angiography reveals novel features of the retinal vasculature in healthy and diabetic mice.

PubMed

McLenachan, Samuel; Magno, Aaron Len; Ramos, David; Catita, Joana; McMenamin, Paul G; Chen, Fred Kuanfu; Rakoczy, Elizabeth Piroska; Ruberte, Jesus

2015-09-01

The mouse retina is a commonly used animal model for the study of pathogenesis and treatment of blinding retinal vascular diseases such as diabetic retinopathy. In this study, we aimed to characterize normal and pathological variations in vascular anatomy in the mouse retina using fluorescein angiography visualized with scanning laser ophthalmoscopy and optical coherence tomography (SLO-OCT). We examined eyes from C57BL/6J wild type mice as well as the Ins2(Akita) and Akimba mouse models of diabetic retinopathy using the Heidelberg Retinal Angiography (HRA) and OCT system. Angiography was performed on three focal planes to examine distinct vascular layers. For comparison with angiographic data, ex vivo analyses, including Indian ink angiography, histology and 3D confocal scanning laser microscopy were performed in parallel. All layers of the mouse retinal vasculature could be readily visualized during fluorescein angiography by SLO-OCT. Blood vessel density was increased in the deep vascular plexus (DVP) compared with the superficial vascular plexus (SVP). Arteriolar and venular typologies were established and structural differences were observed between venular types. Unexpectedly, the hyaloid artery was found to persist in 15% of C57BL/6 mice, forming anastomoses with peripheral retinal capillaries. Fluorescein leakage was easily detected in Akimba retinae by angiography, but was not observed in Ins2(Akita) mice. Blood vessel density was increased in the DVP of 6 month old Ins2(Akita) mice, while the SVP displayed reduced branching in precapillary arterioles. In summary, we present the first comprehensive characterization of the mouse retinal vasculature by SLO-OCT fluorescein angiography. Using this clinical imaging technique, we report previously unrecognized variations in C57BL/6J vascular anatomy and novel features of vascular retinopathy in the Ins2(Akita) mouse model of diabetes. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Cytological Anal Squamous Intraepithelial Lesions Associated with Anal High-Risk Human Papillomavirus Infections among Men Who Have Sex with Men in Northern Thailand.

PubMed

Ruanpeng, Darin; Chariyalertsak, Suwat; Kaewpoowat, Quanhathai; Supindham, Taweewat; Settakorn, Jongkolnee; Sukpan, Kornkanok; Utaipat, Utaiwan; Miura, Toshiyuki; Kosashunhanan, Natthapol; Saokhieo, Pongpun; Songsupa, Radchanok; Wongthanee, Antika

2016-01-01

Anal cancer, one of human papillomavirus (HPV) related malignancies, has increased in recent decades, particularly among men who have sex with men (MSM) and HIV-infected (HIV+) persons. We aimed to explore the prevalence of anal squamous intraepithelial lesions (ASIL) using Papanicolau (Pap) screening among MSM in northern Thailand and its associated factors. Two hundreds MSM aged ≥18 years reporting receptive anal intercourse in the prior 6 months were recruited from July 2012 through January 2013. Medical history and behavioral data were collected by staff interview and computer-assisted self interview. Anal Pap smear, HPV genotyping, and HIV testing were performed. Two pathologists blinded to HPV and HIV status reported cytologic results by Bethesda classification. Mean age was 27.2 years (range 18-54). Overall, 86 (43.0%) had ASIL: 28 (14.2%) with atypical cells of undetermined significance (ASCUS), 1 (0.5%) with atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 56 (28.4%) with low-grade squamous intraepithelial lesion (LSIL), and 1 (0.5%) with high-grade squamous intraepithelial lesion (HSIL). ASIL was associated by univariate analysis (p ≤0.05) with older age, gender identity other than bisexual (i.e., gay men and transgender women), rectal douching, anal symptoms, genital warts, HIV positivity, and high-risk-HPV infection. However, on multiple logistic regression ASIL was associated only with high-risk HPV type (p = 0.002) and HIV infection (p = 0.01). ASIL is quite common in high-risk MSM in northern Thailand and is associated with high-risk HPV types and HIV infection. Routine anal Pap screening should be considered, given the high frequency of ASIL, particularly in the HIV+. High resolution anoscopy (HRA), not done here, should be to confirm PAP smears whose sensitivity and specificity are quite variable. Timely HPV vaccination should be considered for this population.

Applying Process Improvement Methods to Clinical and Translational Research: Conceptual Framework and Case Examples

PubMed Central

Selker, Harry P.; Leslie, Laurel K.

2015-01-01

Abstract There is growing appreciation that process improvement holds promise for improving quality and efficiency across the translational research continuum but frameworks for such programs are not often described. The purpose of this paper is to present a framework and case examples of a Research Process Improvement Program implemented at Tufts CTSI. To promote research process improvement, we developed online training seminars, workshops, and in‐person consultation models to describe core process improvement principles and methods, demonstrate the use of improvement tools, and illustrate the application of these methods in case examples. We implemented these methods, as well as relational coordination theory, with junior researchers, pilot funding awardees, our CTRC, and CTSI resource and service providers. The program focuses on capacity building to address common process problems and quality gaps that threaten the efficient, timely and successful completion of clinical and translational studies. PMID:26332869

A comparative study on methods of improving SCR for ship detection in SAR image

NASA Astrophysics Data System (ADS)

Lang, Haitao; Shi, Hongji; Tao, Yunhong; Ma, Li

2017-10-01

Knowledge about ship positions plays a critical role in a wide range of maritime applications. To improve the performance of ship detector in SAR image, an effective strategy is improving the signal-to-clutter ratio (SCR) before conducting detection. In this paper, we present a comparative study on methods of improving SCR, including power-law scaling (PLS), max-mean and max-median filter (MMF1 and MMF2), method of wavelet transform (TWT), traditional SPAN detector, reflection symmetric metric (RSM), scattering mechanism metric (SMM). The ability of SCR improvement to SAR image and ship detection performance associated with cell- averaging CFAR (CA-CFAR) of different methods are evaluated on two real SAR data.

Engaging Direct Care Providers in Improving Infection Prevention and Control Practices Using Participatory Visual Methods.

PubMed

Backman, Chantal; Bruce, Natalie; Marck, Patricia; Vanderloo, Saskia

2016-01-01

The purpose of this quality improvement project was to determine the feasibility of using provider-led participatory visual methods to scrutinize 4 hospital units' infection prevention and control practices. Methods included provider-led photo walkabouts, photo elicitation sessions, and postimprovement photo walkabouts. Nurses readily engaged in using the methods to examine and improve their units' practices and reorganize their work environment.

Construction of Pancreatic Cancer Classifier Based on SVM Optimized by Improved FOA

PubMed Central

Ma, Xiaoqi

2015-01-01

A novel method is proposed to establish the pancreatic cancer classifier. Firstly, the concept of quantum and fruit fly optimal algorithm (FOA) are introduced, respectively. Then FOA is improved by quantum coding and quantum operation, and a new smell concentration determination function is defined. Finally, the improved FOA is used to optimize the parameters of support vector machine (SVM) and the classifier is established by optimized SVM. In order to verify the effectiveness of the proposed method, SVM and other classification methods have been chosen as the comparing methods. The experimental results show that the proposed method can improve the classifier performance and cost less time. PMID:26543867

Canine Hip Dysplasia: Diagnostic Imaging.

PubMed

Butler, J Ryan; Gambino, Jennifer

2017-07-01

Diagnostic imaging is the principal method used to screen for and diagnose hip dysplasia in the canine patient. Multiple techniques are available, each having advantages, disadvantages, and limitations. Hip-extended radiography is the most used method and is best used as a screening tool and for assessment for osteoarthritis. Distraction radiographic methods such as the PennHip method allow for improved detection of laxity and improved ability to predict future osteoarthritis development. More advanced techniques such as MRI, although expensive and not widely available, may improve patient screening and allow for improved assessment of cartilage health. Copyright © 2017 Elsevier Inc. All rights reserved.

Human body region enhancement method based on Kinect infrared imaging

NASA Astrophysics Data System (ADS)

Yang, Lei; Fan, Yubo; Song, Xiaowei; Cai, Wenjing

2016-10-01

To effectively improve the low contrast of human body region in the infrared images, a combing method of several enhancement methods is utilized to enhance the human body region. Firstly, for the infrared images acquired by Kinect, in order to improve the overall contrast of the infrared images, an Optimal Contrast-Tone Mapping (OCTM) method with multi-iterations is applied to balance the contrast of low-luminosity infrared images. Secondly, to enhance the human body region better, a Level Set algorithm is employed to improve the contour edges of human body region. Finally, to further improve the human body region in infrared images, Laplacian Pyramid decomposition is adopted to enhance the contour-improved human body region. Meanwhile, the background area without human body region is processed by bilateral filtering to improve the overall effect. With theoretical analysis and experimental verification, the results show that the proposed method could effectively enhance the human body region of such infrared images.

Extractions of High Quality RNA from the Seeds of Jerusalem Artichoke and Other Plant Species with High Levels of Starch and Lipid.

PubMed

Mornkham, Tanupat; Wangsomnuk, Preeya Puangsomlee; Fu, Yong-Bi; Wangsomnuk, Pinich; Jogloy, Sanun; Patanothai, Aran

2013-04-29

Jerusalem artichoke (Helianthus tuberosus L.) is an important tuber crop. However, Jerusalem artichoke seeds contain high levels of starch and lipid, making the extraction of high-quality RNA extremely difficult and the gene expression analysis challenging. This study was aimed to improve existing methods for extracting total RNA from Jerusalem artichoke dry seeds and to assess the applicability of the improved method in other plant species. Five RNA extraction methods were evaluated on Jerusalem artichoke seeds and two were modified. One modified method with the significant improvement was applied to assay seeds of diverse Jerusalem artichoke accessions, sunflower, rice, maize, peanut and marigold. The effectiveness of the improved method to extract total RNA from seeds was assessed using qPCR analysis of four selected genes. The improved method of Ma and Yang (2011) yielded a maximum RNA solubility and removed most interfering substances. The improved protocol generated 29 to 41 µg RNA/30 mg fresh weight. An A260/A280 ratio of 1.79 to 2.22 showed their RNA purity. Extracted RNA was effective for downstream applications such as first-stranded cDNA synthesis, cDNA cloning and qPCR. The improved method was also effective to extract total RNA from seeds of sunflower, rice, maize and peanut that are rich in polyphenols, lipids and polysaccharides.

Degradation of learned skills. Static practice effectiveness for visual approach and landing skill retention

NASA Technical Reports Server (NTRS)

Sitterley, T. E.

1974-01-01

The effectivess of an improved static retraining method was evaluated for a simulated space vehicle approach and landing under instrument and visual flight conditions. Experienced pilots were trained and then tested after 4 months without flying to compare their performance using the improved method with three methods previously evaluated. Use of the improved static retraining method resulted in no practical or significant skill degradation and was found to be even more effective than methods using a dynamic presentation of visual cues. The results suggested that properly structured open loop methods of flight control task retraining are feasible.

Improving the S-Shape Solar Radiation Estimation Method for Supporting Crop Models

PubMed Central

Fodor, Nándor

2012-01-01

In line with the critical comments formulated in relation to the S-shape global solar radiation estimation method, the original formula was improved via a 5-step procedure. The improved method was compared to four-reference methods on a large North-American database. According to the investigated error indicators, the final 7-parameter S-shape method has the same or even better estimation efficiency than the original formula. The improved formula is able to provide radiation estimates with a particularly low error pattern index (PIdoy) which is especially important concerning the usability of the estimated radiation values in crop models. Using site-specific calibration, the radiation estimates of the improved S-shape method caused an average of 2.72 ± 1.02 (α = 0.05) relative error in the calculated biomass. Using only readily available site specific metadata the radiation estimates caused less than 5% relative error in the crop model calculations when they were used for locations in the middle, plain territories of the USA. PMID:22645451

Partial branch and bound algorithm for improved data association in multiframe processing

NASA Astrophysics Data System (ADS)

Poore, Aubrey B.; Yan, Xin

1999-07-01

A central problem in multitarget, multisensor, and multiplatform tracking remains that of data association. Lagrangian relaxation methods have shown themselves to yield near optimal answers in real-time. The necessary improvement in the quality of these solutions warrants a continuing interest in these methods. These problems are NP-hard; the only known methods for solving them optimally are enumerative in nature with branch-and-bound being most efficient. Thus, the development of methods less than a full branch-and-bound are needed for improving the quality. Such methods as K-best, local search, and randomized search have been proposed to improve the quality of the relaxation solution. Here, a partial branch-and-bound technique along with adequate branching and ordering rules are developed. Lagrangian relaxation is used as a branching method and as a method to calculate the lower bound for subproblems. The result shows that the branch-and-bound framework greatly improves the resolution quality of the Lagrangian relaxation algorithm and yields better multiple solutions in less time than relaxation alone.

Application of Numerical Integration and Data Fusion in Unit Vector Method

NASA Astrophysics Data System (ADS)

Zhang, J.

2012-01-01

The Unit Vector Method (UVM) is a series of orbit determination methods which are designed by Purple Mountain Observatory (PMO) and have been applied extensively. It gets the conditional equations for different kinds of data by projecting the basic equation to different unit vectors, and it suits for weighted process for different kinds of data. The high-precision data can play a major role in orbit determination, and accuracy of orbit determination is improved obviously. The improved UVM (PUVM2) promoted the UVM from initial orbit determination to orbit improvement, and unified the initial orbit determination and orbit improvement dynamically. The precision and efficiency are improved further. In this thesis, further research work has been done based on the UVM: Firstly, for the improvement of methods and techniques for observation, the types and decision of the observational data are improved substantially, it is also asked to improve the decision of orbit determination. The analytical perturbation can not meet the requirement. So, the numerical integration for calculating the perturbation has been introduced into the UVM. The accuracy of dynamical model suits for the accuracy of the real data, and the condition equations of UVM are modified accordingly. The accuracy of orbit determination is improved further. Secondly, data fusion method has been introduced into the UVM. The convergence mechanism and the defect of weighted strategy have been made clear in original UVM. The problem has been solved in this method, the calculation of approximate state transition matrix is simplified and the weighted strategy has been improved for the data with different dimension and different precision. Results of orbit determination of simulation and real data show that the work of this thesis is effective: (1) After the numerical integration has been introduced into the UVM, the accuracy of orbit determination is improved obviously, and it suits for the high-accuracy data of available observation apparatus. Compare with the classical differential improvement with the numerical integration, its calculation speed is also improved obviously. (2) After data fusion method has been introduced into the UVM, weighted distribution accords rationally with the accuracy of different kinds of data, all data are fully used and the new method is also good at numerical stability and rational weighted distribution.

Development of Predictive Energy Management Strategies for Hybrid Electric Vehicles

NASA Astrophysics Data System (ADS)

Baker, David

Studies have shown that obtaining and utilizing information about the future state of vehicles can improve vehicle fuel economy (FE). However, there has been a lack of research into the impact of real-world prediction error on FE improvements, and whether near-term technologies can be utilized to improve FE. This study seeks to research the effect of prediction error on FE. First, a speed prediction method is developed, and trained with real-world driving data gathered only from the subject vehicle (a local data collection method). This speed prediction method informs a predictive powertrain controller to determine the optimal engine operation for various prediction durations. The optimal engine operation is input into a high-fidelity model of the FE of a Toyota Prius. A tradeoff analysis between prediction duration and prediction fidelity was completed to determine what duration of prediction resulted in the largest FE improvement. Results demonstrate that 60-90 second predictions resulted in the highest FE improvement over the baseline, achieving up to a 4.8% FE increase. A second speed prediction method utilizing simulated vehicle-to-vehicle (V2V) communication was developed to understand if incorporating near-term technologies could be utilized to further improve prediction fidelity. This prediction method produced lower variation in speed prediction error, and was able to realize a larger FE improvement over the local prediction method for longer prediction durations, achieving up to 6% FE improvement. This study concludes that speed prediction and prediction-informed optimal vehicle energy management can produce FE improvements with real-world prediction error and drive cycle variability, as up to 85% of the FE benefit of perfect speed prediction was achieved with the proposed prediction methods.

Contrast-dependent saturation adjustment for outdoor image enhancement.

PubMed

Wang, Shuhang; Cho, Woon; Jang, Jinbeum; Abidi, Mongi A; Paik, Joonki

2017-01-01

Outdoor images captured in bad-weather conditions usually have poor intensity contrast and color saturation since the light arriving at the camera is severely scattered or attenuated. The task of improving image quality in poor conditions remains a challenge. Existing methods of image quality improvement are usually effective for a small group of images but often fail to produce satisfactory results for a broader variety of images. In this paper, we propose an image enhancement method, which makes it applicable to enhance outdoor images by using content-adaptive contrast improvement as well as contrast-dependent saturation adjustment. The main contribution of this work is twofold: (1) we propose the content-adaptive histogram equalization based on the human visual system to improve the intensity contrast; and (2) we introduce a simple yet effective prior for adjusting the color saturation depending on the intensity contrast. The proposed method is tested with different kinds of images, compared with eight state-of-the-art methods: four enhancement methods and four haze removal methods. Experimental results show the proposed method can more effectively improve the visibility and preserve the naturalness of the images, as opposed to the compared methods.

Cryptanalysis of "an improvement over an image encryption method based on total shuffling"

NASA Astrophysics Data System (ADS)

Akhavan, A.; Samsudin, A.; Akhshani, A.

2015-09-01

In the past two decades, several image encryption algorithms based on chaotic systems had been proposed. Many of the proposed algorithms are meant to improve other chaos based and conventional cryptographic algorithms. Whereas, many of the proposed improvement methods suffer from serious security problems. In this paper, the security of the recently proposed improvement method for a chaos-based image encryption algorithm is analyzed. The results indicate the weakness of the analyzed algorithm against chosen plain-text.

Locked-wrap fuel rod

DOEpatents

Kaplan, Samuel; Chertock, Alan J.; Punches, James R.

1977-01-01

A method for spacing fast reactor fuel rods using a wire wrapper improved by orienting the wire-wrapped fuel rods in a unique manner which introduces desirable performance characteristics not attainable by previous wire-wrapped designs. Use of this method in a liquid metal fast breeder reactor results in: (a) improved mechanical performance, (b) improved rod-to-rod contact, (c) reduced steel volume, and (d) improved thermal-hydraulic performance. The method produces a "locked wrap" design which tends to lock the rods together at each of the wire cluster locations.

An Improved Pansharpening Method for Misaligned Panchromatic and Multispectral Data

PubMed Central

Jing, Linhai; Tang, Yunwei; Ding, Haifeng

2018-01-01

Numerous pansharpening methods were proposed in recent decades for fusing low-spatial-resolution multispectral (MS) images with high-spatial-resolution (HSR) panchromatic (PAN) bands to produce fused HSR MS images, which are widely used in various remote sensing tasks. The effect of misregistration between MS and PAN bands on quality of fused products has gained much attention in recent years. An improved method for misaligned MS and PAN imagery is proposed, through two improvements made on a previously published method named RMI (reduce misalignment impact). The performance of the proposed method was assessed by comparing with some outstanding fusion methods, such as adaptive Gram-Schmidt and generalized Laplacian pyramid. Experimental results show that the improved version can reduce spectral distortions of fused dark pixels and sharpen boundaries between different image objects, as well as obtain similar quality indexes with the original RMI method. In addition, the proposed method was evaluated with respect to its sensitivity to misalignments between MS and PAN bands. It is certified that the proposed method is more robust to misalignments between MS and PAN bands than the other methods. PMID:29439502

An Improved Pansharpening Method for Misaligned Panchromatic and Multispectral Data.

PubMed

Li, Hui; Jing, Linhai; Tang, Yunwei; Ding, Haifeng

2018-02-11

Numerous pansharpening methods were proposed in recent decades for fusing low-spatial-resolution multispectral (MS) images with high-spatial-resolution (HSR) panchromatic (PAN) bands to produce fused HSR MS images, which are widely used in various remote sensing tasks. The effect of misregistration between MS and PAN bands on quality of fused products has gained much attention in recent years. An improved method for misaligned MS and PAN imagery is proposed, through two improvements made on a previously published method named RMI (reduce misalignment impact). The performance of the proposed method was assessed by comparing with some outstanding fusion methods, such as adaptive Gram-Schmidt and generalized Laplacian pyramid. Experimental results show that the improved version can reduce spectral distortions of fused dark pixels and sharpen boundaries between different image objects, as well as obtain similar quality indexes with the original RMI method. In addition, the proposed method was evaluated with respect to its sensitivity to misalignments between MS and PAN bands. It is certified that the proposed method is more robust to misalignments between MS and PAN bands than the other methods.

Improving the spectral measurement accuracy based on temperature distribution and spectra-temperature relationship

NASA Astrophysics Data System (ADS)

Li, Zhe; Feng, Jinchao; Liu, Pengyu; Sun, Zhonghua; Li, Gang; Jia, Kebin

2018-05-01

Temperature is usually considered as a fluctuation in near-infrared spectral measurement. Chemometric methods were extensively studied to correct the effect of temperature variations. However, temperature can be considered as a constructive parameter that provides detailed chemical information when systematically changed during the measurement. Our group has researched the relationship between temperature-induced spectral variation (TSVC) and normalized squared temperature. In this study, we focused on the influence of temperature distribution in calibration set. Multi-temperature calibration set selection (MTCS) method was proposed to improve the prediction accuracy by considering the temperature distribution of calibration samples. Furthermore, double-temperature calibration set selection (DTCS) method was proposed based on MTCS method and the relationship between TSVC and normalized squared temperature. We compare the prediction performance of PLS models based on random sampling method and proposed methods. The results from experimental studies showed that the prediction performance was improved by using proposed methods. Therefore, MTCS method and DTCS method will be the alternative methods to improve prediction accuracy in near-infrared spectral measurement.

Applying Process Improvement Methods to Clinical and Translational Research: Conceptual Framework and Case Examples.

PubMed

Daudelin, Denise H; Selker, Harry P; Leslie, Laurel K

2015-12-01

There is growing appreciation that process improvement holds promise for improving quality and efficiency across the translational research continuum but frameworks for such programs are not often described. The purpose of this paper is to present a framework and case examples of a Research Process Improvement Program implemented at Tufts CTSI. To promote research process improvement, we developed online training seminars, workshops, and in-person consultation models to describe core process improvement principles and methods, demonstrate the use of improvement tools, and illustrate the application of these methods in case examples. We implemented these methods, as well as relational coordination theory, with junior researchers, pilot funding awardees, our CTRC, and CTSI resource and service providers. The program focuses on capacity building to address common process problems and quality gaps that threaten the efficient, timely and successful completion of clinical and translational studies. © 2015 The Authors. Clinical and Translational Science published by Wiley Periodicals, Inc.

Adaptive slab laser beam quality improvement using a weighted least-squares reconstruction algorithm.

PubMed

Chen, Shanqiu; Dong, LiZhi; Chen, XiaoJun; Tan, Yi; Liu, Wenjin; Wang, Shuai; Yang, Ping; Xu, Bing; Ye, YuTang

2016-04-10

Adaptive optics is an important technology for improving beam quality in solid-state slab lasers. However, there are uncorrectable aberrations in partial areas of the beam. In the criterion of the conventional least-squares reconstruction method, it makes the zones with small aberrations nonsensitive and hinders this zone from being further corrected. In this paper, a weighted least-squares reconstruction method is proposed to improve the relative sensitivity of zones with small aberrations and to further improve beam quality. Relatively small weights are applied to the zones with large residual aberrations. Comparisons of results show that peak intensity in the far field improved from 1242 analog digital units (ADU) to 2248 ADU, and beam quality β improved from 2.5 to 2.0. This indicates the weighted least-squares method has better performance than the least-squares reconstruction method when there are large zonal uncorrectable aberrations in the slab laser system.

Methods for consistent forewarning of critical events across multiple data channels

DOEpatents

Hively, Lee M.

2006-11-21

This invention teaches further method improvements to forewarn of critical events via phase-space dissimilarity analysis of data from biomedical equipment, mechanical devices, and other physical processes. One improvement involves conversion of time-serial data into equiprobable symbols. A second improvement is a method to maximize the channel-consistent total-true rate of forewarning from a plurality of data channels over multiple data sets from the same patient or process. This total-true rate requires resolution of the forewarning indications into true positives, true negatives, false positives and false negatives. A third improvement is the use of various objective functions, as derived from the phase-space dissimilarity measures, to give the best forewarning indication. A fourth improvement uses various search strategies over the phase-space analysis parameters to maximize said objective functions. A fifth improvement shows the usefulness of the method for various biomedical and machine applications.

An improved method to detect correct protein folds using partial clustering.

PubMed

Zhou, Jianjun; Wishart, David S

2013-01-16

Structure-based clustering is commonly used to identify correct protein folds among candidate folds (also called decoys) generated by protein structure prediction programs. However, traditional clustering methods exhibit a poor runtime performance on large decoy sets. We hypothesized that a more efficient "partial" clustering approach in combination with an improved scoring scheme could significantly improve both the speed and performance of existing candidate selection methods. We propose a new scheme that performs rapid but incomplete clustering on protein decoys. Our method detects structurally similar decoys (measured using either C(α) RMSD or GDT-TS score) and extracts representatives from them without assigning every decoy to a cluster. We integrated our new clustering strategy with several different scoring functions to assess both the performance and speed in identifying correct or near-correct folds. Experimental results on 35 Rosetta decoy sets and 40 I-TASSER decoy sets show that our method can improve the correct fold detection rate as assessed by two different quality criteria. This improvement is significantly better than two recently published clustering methods, Durandal and Calibur-lite. Speed and efficiency testing shows that our method can handle much larger decoy sets and is up to 22 times faster than Durandal and Calibur-lite. The new method, named HS-Forest, avoids the computationally expensive task of clustering every decoy, yet still allows superior correct-fold selection. Its improved speed, efficiency and decoy-selection performance should enable structure prediction researchers to work with larger decoy sets and significantly improve their ab initio structure prediction performance.

An improved method to detect correct protein folds using partial clustering

PubMed Central

2013-01-01

Background Structure-based clustering is commonly used to identify correct protein folds among candidate folds (also called decoys) generated by protein structure prediction programs. However, traditional clustering methods exhibit a poor runtime performance on large decoy sets. We hypothesized that a more efficient “partial“ clustering approach in combination with an improved scoring scheme could significantly improve both the speed and performance of existing candidate selection methods. Results We propose a new scheme that performs rapid but incomplete clustering on protein decoys. Our method detects structurally similar decoys (measured using either Cα RMSD or GDT-TS score) and extracts representatives from them without assigning every decoy to a cluster. We integrated our new clustering strategy with several different scoring functions to assess both the performance and speed in identifying correct or near-correct folds. Experimental results on 35 Rosetta decoy sets and 40 I-TASSER decoy sets show that our method can improve the correct fold detection rate as assessed by two different quality criteria. This improvement is significantly better than two recently published clustering methods, Durandal and Calibur-lite. Speed and efficiency testing shows that our method can handle much larger decoy sets and is up to 22 times faster than Durandal and Calibur-lite. Conclusions The new method, named HS-Forest, avoids the computationally expensive task of clustering every decoy, yet still allows superior correct-fold selection. Its improved speed, efficiency and decoy-selection performance should enable structure prediction researchers to work with larger decoy sets and significantly improve their ab initio structure prediction performance. PMID:23323835

Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

ERIC Educational Resources Information Center

Aluri, Rao

1993-01-01

Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

A stable second order method for training back propagation networks

NASA Technical Reports Server (NTRS)

Nachtsheim, Philip R.

1993-01-01

A simple method for improving the learning rate of the back-propagation algorithm is described. The basis of the method is that approximate second order corrections can be incorporated in the output units. The extended method leads to significant improvements in the convergence rate.

Topological soliton solutions for three shallow water waves models

NASA Astrophysics Data System (ADS)

Liu, Jiangen; Zhang, Yufeng; Wang, Yan

2018-07-01

In this article, we investigate three distinct physical structures for shallow water waves models by the improved ansatz method. The method was improved and can be used to obtain more generalized form topological soliton solutions than the original method. As a result, some new exact solutions of the shallow water equations are successfully established and the obtained results are exhibited graphically. The results showed that the improved ansatz method can be applied to solve other nonlinear differential equations arising from mathematical physics.

Comparison of ultra-widefield fluorescein angiography with the Heidelberg Spectralis® noncontact ultra-widefield module versus the Optos® Optomap®

PubMed Central

Witmer, Matthew T; Parlitsis, George; Patel, Sarju; Kiss, Szilárd

2013-01-01

Purpose To compare ultra-widefield fluorescein angiography imaging using the Optos® Optomap® and the Heidelberg Spectralis® noncontact ultra-widefield module. Methods Five patients (ten eyes) underwent ultra-widefield fluorescein angiography using the Optos® panoramic P200Tx imaging system and the noncontact ultra-widefield module in the Heidelberg Spectralis® HRA+OCT system. The images were obtained as a single, nonsteered shot centered on the macula. The area of imaged retina was outlined and quantified using Adobe® Photoshop® C5 software. The total area and area within each of four visualized quadrants was calculated and compared between the two imaging modalities. Three masked reviewers also evaluated each quadrant per eye (40 total quadrants) to determine which modality imaged the retinal vasculature most peripherally. Results Optos® imaging captured a total retinal area averaging 151,362 pixels, ranging from 116,998 to 205,833 pixels, while the area captured using the Heidelberg Spectralis® was 101,786 pixels, ranging from 73,424 to 116,319 (P = 0.0002). The average area per individual quadrant imaged by Optos® versus the Heidelberg Spectralis® superiorly was 32,373 vs 32,789 pixels, respectively (P = 0.91), inferiorly was 24,665 vs 26,117 pixels, respectively (P = 0.71), temporally was 47,948 vs 20,645 pixels, respectively (P = 0.0001), and nasally was 46,374 vs 22,234 pixels, respectively (P = 0.0001). The Heidelberg Spectralis® was able to image the superior and inferior retinal vasculature to a more distal point than was the Optos®, in nine of ten eyes (18 of 20 quadrants). The Optos® was able to image the nasal and temporal retinal vasculature to a more distal point than was the Heidelberg Spectralis®, in ten of ten eyes (20 of 20 quadrants). Conclusion The ultra-widefield fluorescein angiography obtained with the Optos® and Heidelberg Spectralis® ultra-widefield imaging systems are both excellent modalities that provide views of the peripheral retina. On a single nonsteered image, the Optos® Optomap® covered a significantly larger total retinal surface area, with greater image variability, than did the Heidelberg Spectralis® ultra-widefield module. The Optos® captured an appreciably wider view of the retina temporally and nasally, albeit with peripheral distortion, while the ultra-widefield Heidelberg Spectralis® module was able to image the superior and inferior retinal vasculature more peripherally. The clinical significance of these findings as well as the area imaged on steered montaged images remains to be determined. PMID:23458976

An Improved Method for Studying the Enzyme-Catalyzed Oxidation of Glucose Using Luminescent Probes

ERIC Educational Resources Information Center

Bare, William D.; Pham, Chi V.; Cuber, Matthew; Demas, J. N.

2007-01-01

A new method is presented for measuring the rate of the oxidation of glucose in the presence of glucose oxidase. The improved method employs luminescence measurements to directly determine the concentration of oxygen in real time, thus obviating complicated reaction schemes employed in previous methods. Our method has been used to determine…

The Measurement of the Specific Latent Heat of Fusion of Ice: Two Improved Methods.

ERIC Educational Resources Information Center

Mak, S. Y.; Chun, C. K. W.

2000-01-01

Suggests two methods for measuring the specific latent heat of ice fusion for high school physics laboratories. The first method is an ice calorimeter which is made from simple materials. The second method improves the thermal contact and allows for a more accurate measurement. Lists instructions for both methods. (Author/YDS)

Some New Mathematical Methods for Variational Objective Analysis

NASA Technical Reports Server (NTRS)

Wahba, G.; Johnson, D. R.

1984-01-01

New and/or improved variational methods for simultaneously combining forecast, heterogeneous observational data, a priori climatology, and physics to obtain improved estimates of the initial state of the atmosphere for the purpose of numerical weather prediction are developed. Cross validated spline methods are applied to atmospheric data for the purpose of improved description and analysis of atmospheric phenomena such as the tropopause and frontal boundary surfaces.

Using Lean Process Improvement to Enhance Safety and Value in Orthopaedic Surgery: The Case of Spine Surgery.

PubMed

Sethi, Rajiv; Yanamadala, Vijay; Burton, Douglas C; Bess, Robert Shay

2017-11-01

Lean methodology was developed in the manufacturing industry to increase output and decrease costs. These labor organization methods have become the mainstay of major manufacturing companies worldwide. Lean methods involve continuous process improvement through the systematic elimination of waste, prevention of mistakes, and empowerment of workers to make changes. Because of the profit and productivity gains made in the manufacturing arena using lean methods, several healthcare organizations have adopted lean methodologies for patient care. Lean methods have now been implemented in many areas of health care. In orthopaedic surgery, lean methods have been applied to reduce complication rates and create a culture of continuous improvement. A step-by-step guide based on our experience can help surgeons use lean methods in practice. Surgeons and hospital centers well versed in lean methodology will be poised to reduce complications, improve patient outcomes, and optimize cost/benefit ratios for patient care.

Method of freezing living cells and tissues with improved subsequent survival

DOEpatents

Senkan, Selim M.; Hirsch, Gerald P.

1980-01-01

This invention relates to an improved method for freezing red blood cells, ther living cells, or tissues with improved subsequent survival, wherein constant-volume freezing is utilized that results in significantly improved survival compared with constant-pressure freezing; optimization is attainable through the use of different vessel geometries, cooling baths and warming baths, and sample concentrations.

System and method for networking electrochemical devices

DOEpatents

Williams, Mark C.; Wimer, John G.; Archer, David H.

1995-01-01

An improved electrochemically active system and method including a plurality of electrochemical devices, such as fuel cells and fluid separation devices, in which the anode and cathode process-fluid flow chambers are connected in fluid-flow arrangements so that the operating parameters of each of said plurality of electrochemical devices which are dependent upon process-fluid parameters may be individually controlled to provide improved operating efficiency. The improvements in operation include improved power efficiency and improved fuel utilization in fuel cell power generating systems and reduced power consumption in fluid separation devices and the like through interstage process fluid parameter control for series networked electrochemical devices. The improved networking method includes recycling of various process flows to enhance the overall control scheme.

Existing methods for improving the accuracy of digital-to-analog converters

NASA Astrophysics Data System (ADS)

Eielsen, Arnfinn A.; Fleming, Andrew J.

2017-09-01

The performance of digital-to-analog converters is principally limited by errors in the output voltage levels. Such errors are known as element mismatch and are quantified by the integral non-linearity. Element mismatch limits the achievable accuracy and resolution in high-precision applications as it causes gain and offset errors, as well as harmonic distortion. In this article, five existing methods for mitigating the effects of element mismatch are compared: physical level calibration, dynamic element matching, noise-shaping with digital calibration, large periodic high-frequency dithering, and large stochastic high-pass dithering. These methods are suitable for improving accuracy when using digital-to-analog converters that use multiple discrete output levels to reconstruct time-varying signals. The methods improve linearity and therefore reduce harmonic distortion and can be retrofitted to existing systems with minor hardware variations. The performance of each method is compared theoretically and confirmed by simulations and experiments. Experimental results demonstrate that three of the five methods provide significant improvements in the resolution and accuracy when applied to a general-purpose digital-to-analog converter. As such, these methods can directly improve performance in a wide range of applications including nanopositioning, metrology, and optics.

Application of ALOS and Envisat Data in Improving Multi-Temporal InSAR Methods for Monitoring Damavand Volcano and Landslide Deformation in the Center of Alborz Mountains, North Iran

NASA Astrophysics Data System (ADS)

Vajedian, S.; Motagh, M.; Nilfouroushan, F.

2013-09-01

InSAR capacity to detect slow deformation over terrain areas is limited by temporal and geometric decorrelations. Multitemporal InSAR techniques involving Persistent Scatterer (Ps-InSAR) and Small Baseline (SBAS) are recently developed to compensate the decorrelation problems. Geometric decorrelation in mountainous areas especially for Envisat images makes phase unwrapping process difficult. To improve this unwrapping problem, we first modified phase filtering to make the wrapped phase image as smooth as possible. In addition, in order to improve unwrapping results, a modified unwrapping method has been developed. This method includes removing possible orbital and tropospheric effects. Topographic correction is done within three-dimensional unwrapping, Orbital and tropospheric corrections are done after unwrapping process. To evaluate the effectiveness of our improved method we tested the proposed algorithm by Envisat and ALOS dataset and compared our results with recently developed PS software (StaMAPS). In addition we used GPS observations for evaluating the modified method. The results indicate that our method improves the estimated deformation significantly.

Facial expression recognition based on improved local ternary pattern and stacked auto-encoder

NASA Astrophysics Data System (ADS)

Wu, Yao; Qiu, Weigen

2017-08-01

In order to enhance the robustness of facial expression recognition, we propose a method of facial expression recognition based on improved Local Ternary Pattern (LTP) combined with Stacked Auto-Encoder (SAE). This method uses the improved LTP extraction feature, and then uses the improved depth belief network as the detector and classifier to extract the LTP feature. The combination of LTP and improved deep belief network is realized in facial expression recognition. The recognition rate on CK+ databases has improved significantly.

An Improved Computing Method for 3D Mechanical Connectivity Rates Based on a Polyhedral Simulation Model of Discrete Fracture Network in Rock Masses

NASA Astrophysics Data System (ADS)

Li, Mingchao; Han, Shuai; Zhou, Sibao; Zhang, Ye

2018-06-01

Based on a 3D model of a discrete fracture network (DFN) in a rock mass, an improved projective method for computing the 3D mechanical connectivity rate was proposed. The Monte Carlo simulation method, 2D Poisson process and 3D geological modeling technique were integrated into a polyhedral DFN modeling approach, and the simulation results were verified by numerical tests and graphical inspection. Next, the traditional projective approach for calculating the rock mass connectivity rate was improved using the 3D DFN models by (1) using the polyhedral model to replace the Baecher disk model; (2) taking the real cross section of the rock mass, rather than a part of the cross section, as the test plane; and (3) dynamically searching the joint connectivity rates using different dip directions and dip angles at different elevations to calculate the maximum, minimum and average values of the joint connectivity at each elevation. In a case study, the improved method and traditional method were used to compute the mechanical connectivity rate of the slope of a dam abutment. The results of the two methods were further used to compute the cohesive force of the rock masses. Finally, a comparison showed that the cohesive force derived from the traditional method had a higher error, whereas the cohesive force derived from the improved method was consistent with the suggested values. According to the comparison, the effectivity and validity of the improved method were verified indirectly.

Image enhancement in positron emission mammography

NASA Astrophysics Data System (ADS)

Slavine, Nikolai V.; Seiler, Stephen; McColl, Roderick W.; Lenkinski, Robert E.

2017-02-01

Purpose: To evaluate an efficient iterative deconvolution method (RSEMD) for improving the quantitative accuracy of previously reconstructed breast images by commercial positron emission mammography (PEM) scanner. Materials and Methods: The RSEMD method was tested on breast phantom data and clinical PEM imaging data. Data acquisition was performed on a commercial Naviscan Flex Solo II PEM camera. This method was applied to patient breast images previously reconstructed with Naviscan software (MLEM) to determine improvements in resolution, signal to noise ratio (SNR) and contrast to noise ratio (CNR.) Results: In all of the patients' breast studies the post-processed images proved to have higher resolution and lower noise as compared with images reconstructed by conventional methods. In general, the values of SNR reached a plateau at around 6 iterations with an improvement factor of about 2 for post-processed Flex Solo II PEM images. Improvements in image resolution after the application of RSEMD have also been demonstrated. Conclusions: A rapidly converging, iterative deconvolution algorithm with a novel resolution subsets-based approach RSEMD that operates on patient DICOM images has been used for quantitative improvement in breast imaging. The RSEMD method can be applied to clinical PEM images to improve image quality to diagnostically acceptable levels and will be crucial in order to facilitate diagnosis of tumor progression at the earliest stages. The RSEMD method can be considered as an extended Richardson-Lucy algorithm with multiple resolution levels (resolution subsets).

Fuel cell tubes and method of making same

DOEpatents

Borglum, Brian P.

1999-11-30

A method of manufacturing porous ceramic tubes for fuel cells with improved properties and higher manufacturing yield is disclosed. The method involves extruding a closed end fuel cell tube, such as an air electrode of a solid oxide fuel cell, in which the closed end also functions as the sintering support. The resultant fuel cell tube has a superior porosity distribution which allows improved diffusion of oxygen at the closed end of the tube during operation of the fuel cell. Because this region has the highest current density, performance enhancement and improved reliability of the fuel cell tube result. Furthermore, the higher manufacturing yield associated with the present method decreases the overall fuel cell cost. A method of manufacturing porous ceramic tubes for fuel cells with improved properties and higher manufacturing yield is disclosed. The method involves extruding a closed end fuel cell tube, such as an air electrode of a solid oxide fuel cell, in which the closed end also functions as the sintering support. The resultant fuel cell tube has a superior porosity distribution which allows improved diffusion of oxygen at the closed end of the tube during operation of the fuel cell. Because this region has the highest current density, performance enhancement and improved reliability of the fuel cell tube result. Furthermore, the higher manufacturing yield associated with the present method decreases the overall fuel cell cost.

Vascular input function correction of inflow enhancement for improved pharmacokinetic modeling of liver DCE-MRI.

PubMed

Ning, Jia; Schubert, Tilman; Johnson, Kevin M; Roldán-Alzate, Alejandro; Chen, Huijun; Yuan, Chun; Reeder, Scott B

2018-06-01

To propose a simple method to correct vascular input function (VIF) due to inflow effects and to test whether the proposed method can provide more accurate VIFs for improved pharmacokinetic modeling. A spoiled gradient echo sequence-based inflow quantification and contrast agent concentration correction method was proposed. Simulations were conducted to illustrate improvement in the accuracy of VIF estimation and pharmacokinetic fitting. Animal studies with dynamic contrast-enhanced MR scans were conducted before, 1 week after, and 2 weeks after portal vein embolization (PVE) was performed in the left portal circulation of pigs. The proposed method was applied to correct the VIFs for model fitting. Pharmacokinetic parameters fitted using corrected and uncorrected VIFs were compared between different lobes and visits. Simulation results demonstrated that the proposed method can improve accuracy of VIF estimation and pharmacokinetic fitting. In animal study results, pharmacokinetic fitting using corrected VIFs demonstrated changes in perfusion consistent with changes expected after PVE, whereas the perfusion estimates derived by uncorrected VIFs showed no significant changes. The proposed correction method improves accuracy of VIFs and therefore provides more precise pharmacokinetic fitting. This method may be promising in improving the reliability of perfusion quantification. Magn Reson Med 79:3093-3102, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Photovoltaic device and method

DOEpatents

Cleereman, Robert J; Lesniak, Michael J; Keenihan, James R; Langmaid, Joe A; Gaston, Ryan; Eurich, Gerald K; Boven, Michelle L

2015-01-27

The present invention is premised upon an improved photovoltaic device ("PVD") and method of use, more particularly to an improved photovoltaic device with an integral locator and electrical terminal mechanism for transferring current to or from the improved photovoltaic device and the use as a system.

Photovoltaic device and method

DOEpatents

Cleereman, Robert; Lesniak, Michael J.; Keenihan, James R.; Langmaid, Joe A.; Gaston, Ryan; Eurich, Gerald K.; Boven, Michelle L.

2015-11-24

The present invention is premised upon an improved photovoltaic device ("PVD") and method of use, more particularly to an improved photovoltaic device with an integral locator and electrical terminal mechanism for transferring current to or from the improved photovoltaic device and the use as a system.

Improved Monte Carlo Renormalization Group Method

DOE R&D Accomplishments Database

Gupta, R.; Wilson, K. G.; Umrigar, C.

1985-01-01

An extensive program to analyze critical systems using an Improved Monte Carlo Renormalization Group Method (IMCRG) being undertaken at LANL and Cornell is described. Here we first briefly review the method and then list some of the topics being investigated.

Standardisation of Gymnema sylvestre R.Br. by high-performance thin-layer chromatography: an improved method.

PubMed

Raju, Valivarthi S R; Kannababu, S; Subbaraju, Gottumukkala V

2006-01-01

An improved high-performance thin-layer chromatographic (HPTLC) method for the standardisation of Gymnema sylvestre is reported. The method involves the initial hydrolysis of gymnemic acids, the active ingredients, to a common aglycone followed by the quantitative estimation of gymnemagenin. The present method rectifies an error found in an HPTLC method reported recently.

An exploratory survey of methods used to develop measures of performance

NASA Astrophysics Data System (ADS)

Hamner, Kenneth L.; Lafleur, Charles A.

1993-09-01

Nonmanufacturing organizations are being challenged to provide high-quality products and services to their customers, with an emphasis on continuous process improvement. Measures of performance, referred to as metrics, can be used to foster process improvement. The application of performance measurement to nonmanufacturing processes can be very difficult. This research explored methods used to develop metrics in nonmanufacturing organizations. Several methods were formally defined in the literature, and the researchers used a two-step screening process to determine the OMB Generic Method was most likely to produce high-quality metrics. The OMB Generic Method was then used to develop metrics. A few other metric development methods were found in use at nonmanufacturing organizations. The researchers interviewed participants in metric development efforts to determine their satisfaction and to have them identify the strengths and weaknesses of, and recommended improvements to, the metric development methods used. Analysis of participants' responses allowed the researchers to identify the key components of a sound metrics development method. Those components were incorporated into a proposed metric development method that was based on the OMB Generic Method, and should be more likely to produce high-quality metrics that will result in continuous process improvement.

Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice.

PubMed

Apekey, Tanefa A; McSorley, Gerry; Tilling, Michelle; Siriwardena, A Niroshan

2011-04-01

Leadership and innovation are currently seen as essential elements for the development and maintenance of high-quality care. Little is known about the relationship between leadership and culture of innovation and the extent to which quality improvement methods are used in general practice. This study aimed to assess the relationship between leadership behaviour, culture of innovation and adoption of quality improvement methods in general practice. Self-administered postal questionnaires were sent to general practitioner quality improvement leads in one county in the UK between June and December 2007. The questionnaire consisted of background information, a 12-item scale to assess leadership behaviour, a seven-dimension self-rating scale for culture of innovation and questions on current use of quality improvement tools and techniques. Sixty-three completed questionnaires (62%) were returned. Leadership behaviours were not commonly reported. Most practices reported a positive culture of innovation, featuring relationship most strongly, followed by targets and information but rated lower on other dimensions of rewards, risk and resources. There was a significant positive correlation between leadership behaviour and the culture of innovation (r = 0.57; P < 0.001). Apart from clinical audit and significant event analysis, quality improvement methods were not adopted by most participating practices. Leadership behaviours were infrequently reported and this was associated with a limited culture of innovation in participating general practices. There was little use of quality improvement methods beyond clinical and significant event audit. Practices need support to enhance leadership skills, encourage innovation and develop quality improvement skills if improvements in health care are to accelerate. © 2010 Blackwell Publishing Ltd.

Improved omit set displacement recoveries in dynamic analysis

NASA Technical Reports Server (NTRS)

Allen, Tom; Cook, Greg; Walls, Bill

1993-01-01

Two related methods for improving the dependent (OMIT set) displacements after performing a Guyan reduction are presented. The theoretical bases for the methods are derived. The NASTRAN DMAP ALTERs used to implement the methods in a NASTRAN execution are described. Data are presented that verify the methods and the NASTRAN DMAP ALTERs.

An Improved Manual Method for NOx Emission Measurement.

ERIC Educational Resources Information Center

Dee, L. A.; And Others

The current manual NO (x) sampling and analysis method was evaluated. Improved time-integrated sampling and rapid analysis methods were developed. In the new method, the sample gas is drawn through a heated bed of uniquely active, crystalline, Pb02 where NO (x) is quantitatively absorbed. Nitrate ion is later extracted with water and the…

An improved panel method for the solution of three-dimensional leading-edge vortex flows. Volume 1: Theory document

NASA Technical Reports Server (NTRS)

Johnson, F. T.; Lu, P.; Tinoco, E. N.

1980-01-01

An improved panel method for the solution of three dimensional flow and wing and wing-body combinations with leading edge vortex separation is presented. The method employs a three dimensional inviscid flow model in which the configuration, the rolled-up vortex sheets, and the wake are represented by quadratic doublet distributions. The strength of the singularity distribution as well as shape and position of the vortex spirals are computed in an iterative fashion starting with an assumed initial sheet geometry. The method calculates forces and moments as well as detail surface pressure distributions. Improvements include the implementation of improved panel numerics for the purpose of elimination the highly nonlinear effects of ring vortices around double panel edges, and the development of a least squares procedure for damping vortex sheet geometry update instabilities. A complete description of the method is included. A variety of cases generated by the computer program implementing the method are presented which verify the mathematical assumptions of the method and which compare computed results with experimental data to verify the underlying physical assumptions made by the method.

An efficient optimization method to improve the measuring accuracy of oxygen saturation by using triangular wave optical signal

NASA Astrophysics Data System (ADS)

Li, Gang; Yu, Yue; Zhang, Cui; Lin, Ling

2017-09-01

The oxygen saturation is one of the important parameters to evaluate human health. This paper presents an efficient optimization method that can improve the accuracy of oxygen saturation measurement, which employs an optical frequency division triangular wave signal as the excitation signal to obtain dynamic spectrum and calculate oxygen saturation. In comparison to the traditional method measured RMSE (root mean square error) of SpO2 which is 0.1705, this proposed method significantly reduced the measured RMSE which is 0.0965. It is notable that the accuracy of oxygen saturation measurement has been improved significantly. The method can simplify the circuit and bring down the demand of elements. Furthermore, it has a great reference value on improving the signal to noise ratio of other physiological signals.

Adapting improvements to context: when, why and how?

PubMed Central

Ovretveit, John; Dolan-Branton, Lisa; Marx, Michael; Reid, Amy; Reed, Julie; Agins, Bruce

2018-01-01

Abstract There is evidence that practitioners applying quality improvements often adapt the improvement method or the change they are implementing, either unknowingly, or intentionally to fit their service or situation. This has been observed especially in programs seeking to spread or ‘scale up’ an improvement change to other services. Sometimes their adaptations result in improved outcomes, sometimes they do not, and sometimes they do not have data make this assessment or to describe the adaptation. The purpose of this paper is to summarize key points about adaptation and context discussed at the Salzburg Global Seminar in order to help improvers judge when and how to adapt an improvement change. It aims also to encourage more research into such adaptations to develop our understanding of the when, why and how of effective adaptation and to provide more research informed guidance to improvers. The paper gives examples to illustrate key issues in adaptation and to consider more systematic and purposeful adaptation of improvements so as to increase the chances of achieving improvements in different settings for different participants. We describe methods for assessing whether adaptation is necessary or likely to reduce the effectiveness of an improvement intervention, which adaptations might be required, and methods for collecting data to assess whether the adaptations are successful. We also note areas where research is most needed in order to enable more effective scale up of quality improvements changes and wider take up and use of the methods.

An Improved Text Localization Method for Natural Scene Images

NASA Astrophysics Data System (ADS)

Jiang, Mengdi; Cheng, Jianghua; Chen, Minghui; Ku, Xishu

2018-01-01

In order to extract text information effectively from natural scene image with complex background, multi-orientation perspective and multilingual languages, we present a new method based on the improved Stroke Feature Transform (SWT). Firstly, The Maximally Stable Extremal Region (MSER) method is used to detect text candidate regions. Secondly, the SWT algorithm is used in the candidate regions, which can improve the edge detection compared with tradition SWT method. Finally, the Frequency-tuned (FT) visual saliency is introduced to remove non-text candidate regions. The experiment results show that, the method can achieve good robustness for complex background with multi-orientation perspective, various characters and font sizes.

Improved Savitzky-Golay-method-based fluorescence subtraction algorithm for rapid recovery of Raman spectra.

PubMed

Chen, Kun; Zhang, Hongyuan; Wei, Haoyun; Li, Yan

2014-08-20

In this paper, we propose an improved subtraction algorithm for rapid recovery of Raman spectra that can substantially reduce the computation time. This algorithm is based on an improved Savitzky-Golay (SG) iterative smoothing method, which involves two key novel approaches: (a) the use of the Gauss-Seidel method and (b) the introduction of a relaxation factor into the iterative procedure. By applying a novel successive relaxation (SG-SR) iterative method to the relaxation factor, additional improvement in the convergence speed over the standard Savitzky-Golay procedure is realized. The proposed improved algorithm (the RIA-SG-SR algorithm), which uses SG-SR-based iteration instead of Savitzky-Golay iteration, has been optimized and validated with a mathematically simulated Raman spectrum, as well as experimentally measured Raman spectra from non-biological and biological samples. The method results in a significant reduction in computing cost while yielding consistent rejection of fluorescence and noise for spectra with low signal-to-fluorescence ratios and varied baselines. In the simulation, RIA-SG-SR achieved 1 order of magnitude improvement in iteration number and 2 orders of magnitude improvement in computation time compared with the range-independent background-subtraction algorithm (RIA). Furthermore the computation time of the experimentally measured raw Raman spectrum processing from skin tissue decreased from 6.72 to 0.094 s. In general, the processing of the SG-SR method can be conducted within dozens of milliseconds, which can provide a real-time procedure in practical situations.

Are students' impressions of improved learning through active learning methods reflected by improved test scores?

PubMed

Everly, Marcee C

2013-02-01

To report the transformation from lecture to more active learning methods in a maternity nursing course and to evaluate whether student perception of improved learning through active-learning methods is supported by improved test scores. The process of transforming a course into an active-learning model of teaching is described. A voluntary mid-semester survey for student acceptance of the new teaching method was conducted. Course examination results, from both a standardized exam and a cumulative final exam, among students who received lecture in the classroom and students who had active learning activities in the classroom were compared. Active learning activities were very acceptable to students. The majority of students reported learning more from having active-learning activities in the classroom rather than lecture-only and this belief was supported by improved test scores. Students who had active learning activities in the classroom scored significantly higher on a standardized assessment test than students who received lecture only. The findings support the use of student reflection to evaluate the effectiveness of active-learning methods and help validate the use of student reflection of improved learning in other research projects. Copyright © 2011 Elsevier Ltd. All rights reserved.

Improved Net-Level Filling And Finishing Of Large Castings

NASA Technical Reports Server (NTRS)

Johnson, Erik P.; Brown, Richard F.

1995-01-01

Improved method of vacuum casting of large, generally cylindrical objects to net sizes and shapes reduces amount of direct manual labor by workers in proximity to cast material. Original application for which method devised is fabrication of solid rocket-motor segments containing solid propellant, wherein need to minimize exposure of workers to propellant material being cast. Improved method adaptable to other applications involving large castings of toxic, flammable, or otherwise hazardous materials.

An improved method of continuous LOD based on fractal theory in terrain rendering

NASA Astrophysics Data System (ADS)

Lin, Lan; Li, Lijun

2007-11-01

With the improvement of computer graphic hardware capability, the algorithm of 3D terrain rendering is going into the hot topic of real-time visualization. In order to solve conflict between the rendering speed and reality of rendering, this paper gives an improved method of terrain rendering which improves the traditional continuous level of detail technique based on fractal theory. This method proposes that the program needn't to operate the memory repeatedly to obtain different resolution terrain model, instead, obtains the fractal characteristic parameters of different region according to the movement of the viewpoint. Experimental results show that the method guarantees the authenticity of landscape, and increases the real-time 3D terrain rendering speed.

Multiscale Methods for Nuclear Reactor Analysis

NASA Astrophysics Data System (ADS)

Collins, Benjamin S.

The ability to accurately predict local pin powers in nuclear reactors is necessary to understand the mechanisms that cause fuel pin failure during steady state and transient operation. In the research presented here, methods are developed to improve the local solution using high order methods with boundary conditions from a low order global solution. Several different core configurations were tested to determine the improvement in the local pin powers compared to the standard techniques, that use diffusion theory and pin power reconstruction (PPR). Two different multiscale methods were developed and analyzed; the post-refinement multiscale method and the embedded multiscale method. The post-refinement multiscale methods use the global solution to determine boundary conditions for the local solution. The local solution is solved using either a fixed boundary source or an albedo boundary condition; this solution is "post-refinement" and thus has no impact on the global solution. The embedded multiscale method allows the local solver to change the global solution to provide an improved global and local solution. The post-refinement multiscale method is assessed using three core designs. When the local solution has more energy groups, the fixed source method has some difficulties near the interface: however the albedo method works well for all cases. In order to remedy the issue with boundary condition errors for the fixed source method, a buffer region is used to act as a filter, which decreases the sensitivity of the solution to the boundary condition. Both the albedo and fixed source methods benefit from the use of a buffer region. Unlike the post-refinement method, the embedded multiscale method alters the global solution. The ability to change the global solution allows for refinement in areas where the errors in the few group nodal diffusion are typically large. The embedded method is shown to improve the global solution when it is applied to a MOX/LEU assembly interface, the fuel/reflector interface, and assemblies where control rods are inserted. The embedded method also allows for multiple solution levels to be applied in a single calculation. The addition of intermediate levels to the solution improves the accuracy of the method. Both multiscale methods considered here have benefits and drawbacks, but both can provide improvements over the current PPR methodology.

Analytical Models of Exoplanetary Atmospheres. IV. Improved Two-stream Radiative Transfer for the Treatment of Aerosols

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

Heng, Kevin; Kitzmann, Daniel, E-mail: kevin.heng@csh.unibe.ch, E-mail: daniel.kitzmann@csh.unibe.ch

We present a novel generalization of the two-stream method of radiative transfer, which allows for the accurate treatment of radiative transfer in the presence of strong infrared scattering by aerosols. We prove that this generalization involves only a simple modification of the coupling coefficients and transmission functions in the hemispheric two-stream method. This modification originates from allowing the ratio of the first Eddington coefficients to depart from unity. At the heart of the method is the fact that this ratio may be computed once and for all over the entire range of values of the single-scattering albedo and scattering asymmetrymore » factor. We benchmark our improved two-stream method by calculating the fraction of flux reflected by a single atmospheric layer (the reflectivity) and comparing these calculations to those performed using a 32-stream discrete-ordinates method. We further compare our improved two-stream method to the two-stream source function (16 streams) and delta-Eddington methods, demonstrating that it is often more accurate at the order-of-magnitude level. Finally, we illustrate its accuracy using a toy model of the early Martian atmosphere hosting a cloud layer composed of carbon dioxide ice particles. The simplicity of implementation and accuracy of our improved two-stream method renders it suitable for implementation in three-dimensional general circulation models. In other words, our improved two-stream method has the ease of implementation of a standard two-stream method, but the accuracy of a 32-stream method.« less

An Improved Heuristic Method for Subgraph Isomorphism Problem

NASA Astrophysics Data System (ADS)

Xiang, Yingzhuo; Han, Jiesi; Xu, Haijiang; Guo, Xin

2017-09-01

This paper focus on the subgraph isomorphism (SI) problem. We present an improved genetic algorithm, a heuristic method to search the optimal solution. The contribution of this paper is that we design a dedicated crossover algorithm and a new fitness function to measure the evolution process. Experiments show our improved genetic algorithm performs better than other heuristic methods. For a large graph, such as a subgraph of 40 nodes, our algorithm outperforms the traditional tree search algorithms. We find that the performance of our improved genetic algorithm does not decrease as the number of nodes in prototype graphs.

Prospects and Problems of Transferring Quality-Improvement Methods from Health Care to Social Services: Two Case Studies

PubMed Central

Neubeck, Truls; Elg, Mattias; Schneider, Thomas; Andersson-Gäre, Boel

2014-01-01

Introduction: This study examines the use of quality-improvement (QI) methods in social services. Particularly the key aspects—generalizable knowledge, interprofessional teamwork, and measurements—are studied in projects from the QI program Forum for Values in Sweden. Methods: This is a mixed-method case study. Two projects using standard QI methods and tools as used in health care were chosen as critical cases to highlight some problems and prospects with the use of QI in social services. The cases were analyzed through documented results and qualitative interviews with participants one year after the QI projects ended. Results: The social service QI projects led to measurable improvements when they used standard methods and tools for QI in health care. One year after the projects, the improvements were either not continuously measured or not reported in any infrastructure for measurements. The study reveals that social services differ from health care regarding the availability and use of evidence, the role of professional expertise, and infrastructure for measurements. Conclusions: We argue that QI methods as used in health care are applicable in social services and can lead to measurable improvements. The study gives valuable insights for QI, not only in social services but also in health care, on how to assess and sustain improvements when infrastructures for measurements are lacking. In addition, when one forms QI teams, the focus should be on functions instead of professions, and QI methods can be used to support implementation of evidence-based practice. PMID:24867549

Improved BC method of Compomat G4 for expression of BCs twice from whole blood in top and top bags.

PubMed

Deng, Xiao-Yan; Wu, Xiao-Man; Zhao, Yang; Luo, Hong; Jia, Hong-Yun; Wang, Zhong-Ying; He, Bo; Wang, Chuan-Xi

2011-05-01

The aim of this paper was to evaluate an improved buffy coat (BC) method of Compomat G4 for automated expression of BCs twice from whole blood (WB) in top and top (T&T) bags. WB was separated using hard spin centrifugation (2,988g, 10 min) into layers of blood components by specific gravity, and different components were subsequently expressed into satellite bags in the T&T system using the manual BC method, the conventional BC method of G4, and our improved BC method of G4. In the improved BC method, an accessorial device we have named a 'gravity press' was designed and installed on the top flat of G4 to produce gravitational pressure on the plasma bag so as to exclude air and some of plasma to the upper compartment of the slide after BCs were expressed for the first time. The residual BCs in the upper compartment were expressed a second time by extending the upper press once more. All of the pooled BCs were centrifuged by soft spin (402g, 10 min) and upper platelet-rich supernatant was manually expressed into a platelet container by the plasma extractor. In vitro studies of blood components and pooled platelet concentrates (PCs) revealed no significant differences in BC blood components and platelet recovery of pooled platelets (61 ± 9 vs. 60 ± 7%, n = 12, p > 0.05) between the improved BC method and the conventional BC method; all components met our specifications for blood products. We suggest that the new BC method for use of T&T bags may improve the collection of BCs.

Facial expression recognition based on improved deep belief networks

NASA Astrophysics Data System (ADS)

Wu, Yao; Qiu, Weigen

2017-08-01

In order to improve the robustness of facial expression recognition, a method of face expression recognition based on Local Binary Pattern (LBP) combined with improved deep belief networks (DBNs) is proposed. This method uses LBP to extract the feature, and then uses the improved deep belief networks as the detector and classifier to extract the LBP feature. The combination of LBP and improved deep belief networks is realized in facial expression recognition. In the JAFFE (Japanese Female Facial Expression) database on the recognition rate has improved significantly.

Development of an improved rapid BACpro® protocol and a method for direct identification from blood-culture-positive bottles using matrix-assisted laser desorption ionization time-of-flight mass spectrometry.

PubMed

Yonezawa, Takatoshi; Watari, Tomohisa; Ashizawa, Kazuho; Hanada, Daisuke; Yanagiya, Takako; Watanabe, Naoki; Terada, Takashi; Tomoda, Yutaka; Fujii, Satoshi

2018-05-01

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been incorporated into pathogenic bacterial identification methods and has improved their rapidity. Various methods have been reported to directly identify bacteria with MALDI-TOF MS by pretreating culture medium in blood culture bottles. Rapid BACpro® (Nittobo Medical Co., Ltd.) is a pretreatment kit for effective collection of bacteria with cationic copolymers. However, the Rapid BACpro® pretreatment kit is adapted only for MALDI Biotyper (Bruker Daltonics K.K.), and there has been a desire to expand its use to VITEK MS (VMS; bioMerieux SA). We improved the protocol and made it possible to analyze with VMS. The culture medium bacteria collection method was changed to a method with centrifugation after hemolysis using saponin; the cationic copolymer concentration was changed to 30% of the original concentration; the sequence with which reagents were added was changed; and a change was made to an ethanol/formic acid extraction method. The improved protocol enhanced the identification performance. When VMS was used, the identification rate was 100% with control samples. With clinical samples, the identification agreement rate with the cell smear method was 96.3%. The improved protocol is effective in blood culture rapid identification, being both simpler and having an improved identification performance compared with the original. Copyright © 2018 Elsevier B.V. All rights reserved.

Using Hypnoteaching Strategy to Improve Students' Writing Ability

ERIC Educational Resources Information Center

Dj, Muhammad Zuhri; Sukarnianti

2015-01-01

This research discusses about using hypnoteaching strategy to improve students' writing ability. The objective of this research is to find out hypnoteaching strategy in improving students' writing ability. The method used in this research was pre-experimental method by using one groups' pretest-posttest design. The group was given pretest and…

Improved harvesting systems for wet sites

Treesearch

Bryce J. Stokes; Alvin Schilling

1997-01-01

Environmentally acceptable and economical forest operations are needed for sustainable management of forest resources. Improved methods for harvesting and transporting timber are especially needed for wet sites. As the demand for hardwood lumber continues to increase, improved and alternative methods are needed to ensure acceptance of timber harvesting for the wet site...

Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques

PubMed Central

Bayani, Azadeh; Langarizadeh, Mostafa; Radmard, Amir Reza; Nejad, Ahmadreza Farzaneh

2016-01-01

Background: Liver ultrasound images are so common and are applied so often to diagnose diffuse liver diseases like fatty liver. However, the low quality of such images makes it difficult to analyze them and diagnose diseases. The purpose of this study, therefore, is to improve the contrast and quality of liver ultrasound images. Methods: In this study, a number of image contrast enhancement algorithms which are based on fuzzy logic were applied to liver ultrasound images - in which the view of kidney is observable - using Matlab2013b to improve the image contrast and quality which has a fuzzy definition; just like image contrast improvement algorithms using a fuzzy intensification operator, contrast improvement algorithms applying fuzzy image histogram hyperbolization, and contrast improvement algorithms by fuzzy IF-THEN rules. Results: With the measurement of Mean Squared Error and Peak Signal to Noise Ratio obtained from different images, fuzzy methods provided better results, and their implementation - compared with histogram equalization method - led both to the improvement of contrast and visual quality of images and to the improvement of liver segmentation algorithms results in images. Conclusion: Comparison of the four algorithms revealed the power of fuzzy logic in improving image contrast compared with traditional image processing algorithms. Moreover, contrast improvement algorithm based on a fuzzy intensification operator was selected as the strongest algorithm considering the measured indicators. This method can also be used in future studies on other ultrasound images for quality improvement and other image processing and analysis applications. PMID:28077898

Evaluating Exercise Prescription and Instructional Methods Used in Tai Chi Studies Aimed at Improving Balance in Older Adults: A Systematic Review.

PubMed

Wu, Yin; MacDonald, Hayley V; Pescatello, Linda S

2016-10-01

To develop an evaluation instrument to determine to what extent Tai Chi interventions aimed at improving the balance of older adults disclosed their exercise prescription (Ex R x ) and instructional methods and met best-practice exercise recommendations for balance improvement. Review. PubMed, Scopus, and CINAHL databases were searched from their inception until August 22, 2014. Adults aged 60 and older without debilitating disease. Three electronic databases were searched to identify randomized controlled trials (RCTs) of Tai Chi interventions aimed at improving balance in older adults without severe debilitating diseases. Three Ex R x (frequency, time, intervention length) and 10 instructional (e.g., style, number of forms) methods of the included RCTs were evaluated. Twenty-seven interventions were identified from 26 RCTs. On average, Tai Chi was performed for a mean 56.5 ± 14.4 minutes per session for 2.8 ± 1.4 sessions per week for 19.7 ± 12.7 weeks. Most interventions reported all three Ex R x methods items, with a mean reporting rate of 92.6 ± 19.2%. For the 10 instructional methods items, the mean reporting rate was 41.1 ± 18.0%, significantly lower than for the Ex R x methods items (P < .001). Fewer than half of the interventions reported unsupervised practice (15%), progression (22%), or the use of breathing (30%) and relaxation (15%) techniques. The instructional methods items most important for targeting Tai Chi practice to improve balance were not routinely disclosed, with only 15% reporting names of forms and 52% reporting movement principles. Most Tai Chi interventions disclosed their Ex R x methods yet routinely failed to report instructional methods. To increase the effectiveness of Tai Chi to improve balance in older adults, future RCTs should disclose their Ex R x and instructional methods, especially methods that target balance. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Performance Evaluation of an Improved GC-MS Method to Quantify Methylmercury in Fish.

PubMed

Watanabe, Takahiro; Kikuchi, Hiroyuki; Matsuda, Rieko; Hayashi, Tomoko; Akaki, Koichi; Teshima, Reiko

2015-01-01

Here, we set out to improve our previously developed methylmercury analytical method, involving phenyl derivatization and gas chromatography-mass spectrometry (GC-MS). In the improved method, phenylation of methylmercury with sodium tetraphenylborate was carried out in a toluene/water two-phase system, instead of in water alone. The modification enabled derivatization at optimum pH, and the formation of by-products was dramatically reduced. In addition, adsorption of methyl phenyl mercury in the GC system was suppressed by co-injection of PEG200, enabling continuous analysis without loss of sensitivity. The performance of the improved analytical method was independently evaluated by three analysts using certified reference materials and methylmercury-spiked fresh fish samples. The present analytical method was validated as suitable for determination of compliance with the provisional regulation value for methylmercury in fish, set in the Food Sanitation haw.

Improved Dot Diffusion For Image Halftoning

DTIC Science & Technology

1999-01-01

The dot diffusion method for digital halftoning has the advantage of parallelism unlike the error diffusion method. The method was recently improved...by optimization of the so-called class matrix so that the resulting halftones are comparable to the error diffused halftones . In this paper we will...first review the dot diffusion method. Previously, 82 class matrices were used for dot diffusion method. A problem with this size of class matrix is

Sliding-mode control combined with improved adaptive feedforward for wafer scanner

NASA Astrophysics Data System (ADS)

Li, Xiaojie; Wang, Yiguang

2018-03-01

In this paper, a sliding-mode control method combined with improved adaptive feedforward is proposed for wafer scanner to improve the tracking performance of the closed-loop system. Particularly, In addition to the inverse model, the nonlinear force ripple effect which may degrade the tracking accuracy of permanent magnet linear motor (PMLM) is considered in the proposed method. The dominant position periodicity of force ripple is determined by using the Fast Fourier Transform (FFT) analysis for experimental data and the improved feedforward control is achieved by the online recursive least-squares (RLS) estimation of the inverse model and the force ripple. The improved adaptive feedforward is given in a general form of nth-order model with force ripple effect. This proposed method is motivated by the motion controller design of the long-stroke PMLM and short-stroke voice coil motor for wafer scanner. The stability of the closed-loop control system and the convergence of the motion tracking are guaranteed by the proposed sliding-mode feedback and adaptive feedforward methods theoretically. Comparative experiments on a precision linear motion platform can verify the correctness and effectiveness of the proposed method. The experimental results show that comparing to traditional method the proposed one has better performance of rapidity and robustness, especially for high speed motion trajectory. And, the improvements on both tracking accuracy and settling time can be achieved.

Combining qualitative and quantitative operational research methods to inform quality improvement in pathways that span multiple settings

PubMed Central

Crowe, Sonya; Brown, Katherine; Tregay, Jenifer; Wray, Jo; Knowles, Rachel; Ridout, Deborah A; Bull, Catherine; Utley, Martin

2017-01-01

Background Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors. Methods Soft systems methodology was used to consider systematically changes to services from the perspectives of community, primary, secondary and tertiary care professionals and a patient group, incorporating relevant evidence. Classification and regression tree (CART) analysis of national audit datasets was conducted along with data visualisation designed to inform service improvement within the context of limited resources. Results A ‘Rich Picture’ was developed capturing the main features of services for infants with CHD pertinent to service improvement. This was used, along with a graphical summary of the CART analysis, to guide discussions about targeting interventions at specific patient risk groups. Agreement was reached across representatives of relevant health professions and patients on a coherent set of targeted recommendations for quality improvement. These fed into national decisions about service provision and commissioning. Conclusions When tackling complex problems in service provision across multiple settings, it is important to acknowledge and work with multiple perspectives systematically and to consider targeting service improvements in response to confined resources. Our research demonstrates that applying a combination of qualitative and quantitative operational research methods is one approach to doing so that warrants further consideration. PMID:28062603

Applications of fuzzy ranking methods to risk-management decisions

NASA Astrophysics Data System (ADS)

Mitchell, Harold A.; Carter, James C., III

1993-12-01

The Department of Energy is making significant improvements to its nuclear facilities as a result of more stringent regulation, internal audits, and recommendations from external review groups. A large backlog of upgrades has resulted. Currently, a prioritization method is being utilized which relies on a matrix of potential consequence and probability of occurrence. The attributes of the potential consequences considered include likelihood, exposure, public health and safety, environmental impact, site personnel safety, public relations, legal liability, and business loss. This paper describes an improved method which utilizes fuzzy multiple attribute decision methods to rank proposed improvement projects.

New technology in dietary assessment: a review of digital methods in improving food record accuracy.

PubMed

Stumbo, Phyllis J

2013-02-01

Methods for conducting dietary assessment in the United States date back to the early twentieth century. Methods of assessment encompassed dietary records, written and spoken dietary recalls, FFQ using pencil and paper and more recently computer and internet applications. Emerging innovations involve camera and mobile telephone technology to capture food and meal images. This paper describes six projects sponsored by the United States National Institutes of Health that use digital methods to improve food records and two mobile phone applications using crowdsourcing. The techniques under development show promise for improving accuracy of food records.

Improved reading performance using individualized compensation filters for observers with losses in central vision

NASA Technical Reports Server (NTRS)

Lawton, Teri B.

1989-01-01

A method to improve the reading performance of subjects with losses in central vision is proposed in which the amplitudes of the intermediate spatial frequencies are boosted relative to the lower spatial frequencies. In the method, words are filtered using an image enhancement function which is based on a subject's losses in visual function relative to a normal subject. It was found that 30-70 percent less magnification was necessary, and that reading rates were improved 2-3 times, using the method. The individualized compensation filters improved the clarity and visibility of words. The shape of the enhancement function was shown to be important in determining the optimum compensation filter for improving reading performance.

Improved Method for Prediction of Attainable Wing Leading-Edge Thrust

NASA Technical Reports Server (NTRS)

Carlson, Harry W.; McElroy, Marcus O.; Lessard, Wendy B.; McCullers, L. Arnold

1996-01-01

Prediction of the loss of wing leading-edge thrust and the accompanying increase in drag due to lift, when flow is not completely attached, presents a difficult but commonly encountered problem. A method (called the previous method) for the prediction of attainable leading-edge thrust and the resultant effect on airplane aerodynamic performance has been in use for more than a decade. Recently, the method has been revised to enhance its applicability to current airplane design and evaluation problems. The improved method (called the present method) provides for a greater range of airfoil shapes from very sharp to very blunt leading edges. It is also based on a wider range of Reynolds numbers than was available for the previous method. The present method, when employed in computer codes for aerodynamic analysis, generally results in improved correlation with experimental wing-body axial-force data and provides reasonable estimates of the measured drag.

A novel pretreatment method combining sealing technique with direct injection technique applied for improving biosafety.

PubMed

Wang, Xinyu; Gao, Jing-Lin; Du, Chaohui; An, Jing; Li, MengJiao; Ma, Haiyan; Zhang, Lina; Jiang, Ye

2017-01-01

People today have a stronger interest in the risk of biosafety in clinical bioanalysis. A safe, simple, effective method of preparation is needed urgently. To improve biosafety of clinical analysis, we used antiviral drugs of adefovir and tenofovir as model drugs and developed a safe pretreatment method combining sealing technique with direct injection technique. The inter- and intraday precision (RSD %) of the method were <4%, and the extraction recoveries ranged from 99.4 to 100.7%. Meanwhile, the results showed that standard solution could be used to prepare calibration curve instead of spiking plasma, acquiring more accuracy result. Compared with traditional methods, the novel method not only improved biosecurity of the pretreatment method significantly, but also achieved several advantages including higher precision, favorable sensitivity and satisfactory recovery. With these highly practical and desirable characteristics, the novel method may become a feasible platform in bioanalysis.

Improved CEEMDAN-wavelet transform de-noising method and its application in well logging noise reduction

NASA Astrophysics Data System (ADS)

Zhang, Jingxia; Guo, Yinghai; Shen, Yulin; Zhao, Difei; Li, Mi

2018-06-01

The use of geophysical logging data to identify lithology is an important groundwork in logging interpretation. Inevitably, noise is mixed in during data collection due to the equipment and other external factors and this will affect the further lithological identification and other logging interpretation. Therefore, to get a more accurate lithological identification it is necessary to adopt de-noising methods. In this study, a new de-noising method, namely improved complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN)-wavelet transform, is proposed, which integrates the superiorities of improved CEEMDAN and wavelet transform. Improved CEEMDAN, an effective self-adaptive multi-scale analysis method, is used to decompose non-stationary signals as the logging data to obtain the intrinsic mode function (IMF) of N different scales and one residual. Moreover, one self-adaptive scale selection method is used to determine the reconstruction scale k. Simultaneously, given the possible frequency aliasing problem between adjacent IMFs, a wavelet transform threshold de-noising method is used to reduce the noise of the (k-1)th IMF. Subsequently, the de-noised logging data are reconstructed by the de-noised (k-1)th IMF and the remaining low-frequency IMFs and the residual. Finally, empirical mode decomposition, improved CEEMDAN, wavelet transform and the proposed method are applied for analysis of the simulation and the actual data. Results show diverse performance of these de-noising methods with regard to accuracy for lithological identification. Compared with the other methods, the proposed method has the best self-adaptability and accuracy in lithological identification.

Improved volumetric measurement of brain structure with a distortion correction procedure using an ADNI phantom.

PubMed

Maikusa, Norihide; Yamashita, Fumio; Tanaka, Kenichiro; Abe, Osamu; Kawaguchi, Atsushi; Kabasawa, Hiroyuki; Chiba, Shoma; Kasahara, Akihiro; Kobayashi, Nobuhisa; Yuasa, Tetsuya; Sato, Noriko; Matsuda, Hiroshi; Iwatsubo, Takeshi

2013-06-01

Serial magnetic resonance imaging (MRI) images acquired from multisite and multivendor MRI scanners are widely used in measuring longitudinal structural changes in the brain. Precise and accurate measurements are important in understanding the natural progression of neurodegenerative disorders such as Alzheimer's disease. However, geometric distortions in MRI images decrease the accuracy and precision of volumetric or morphometric measurements. To solve this problem, the authors suggest a commercially available phantom-based distortion correction method that accommodates the variation in geometric distortion within MRI images obtained with multivendor MRI scanners. The authors' method is based on image warping using a polynomial function. The method detects fiducial points within a phantom image using phantom analysis software developed by the Mayo Clinic and calculates warping functions for distortion correction. To quantify the effectiveness of the authors' method, the authors corrected phantom images obtained from multivendor MRI scanners and calculated the root-mean-square (RMS) of fiducial errors and the circularity ratio as evaluation values. The authors also compared the performance of the authors' method with that of a distortion correction method based on a spherical harmonics description of the generic gradient design parameters. Moreover, the authors evaluated whether this correction improves the test-retest reproducibility of voxel-based morphometry in human studies. A Wilcoxon signed-rank test with uncorrected and corrected images was performed. The root-mean-square errors and circularity ratios for all slices significantly improved (p < 0.0001) after the authors' distortion correction. Additionally, the authors' method was significantly better than a distortion correction method based on a description of spherical harmonics in improving the distortion of root-mean-square errors (p < 0.001 and 0.0337, respectively). Moreover, the authors' method reduced the RMS error arising from gradient nonlinearity more than gradwarp methods. In human studies, the coefficient of variation of voxel-based morphometry analysis of the whole brain improved significantly from 3.46% to 2.70% after distortion correction of the whole gray matter using the authors' method (Wilcoxon signed-rank test, p < 0.05). The authors proposed a phantom-based distortion correction method to improve reproducibility in longitudinal structural brain analysis using multivendor MRI. The authors evaluated the authors' method for phantom images in terms of two geometrical values and for human images in terms of test-retest reproducibility. The results showed that distortion was corrected significantly using the authors' method. In human studies, the reproducibility of voxel-based morphometry analysis for the whole gray matter significantly improved after distortion correction using the authors' method.

[Application of adaptive canceling methods in temperature control in ultrasonic therapeutical treatment].

PubMed

Deng, Jun; Liu, Du-ren

2002-12-01

Objective. To improve the quality of ultrasonic therapeutical treatment by improving the accuracy of temperature control. Method. Adaptive canceling methods were used to reduce the noise of temperature signal gained, and enhance signal-to-noise ratio. Result. The test's result corresponds basically to the theoretical curve. Conclusion. Adaptive canceling methods can be applied to clinic treatment.

A method of improving sensitivity of carbon/oxygen well logging for low porosity formation

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

Liu, Juntao; Zhang, Feng; Zhang, Quanying

Carbon/Oxygen (C/O) spectral logging technique has been widely used to determine residual oil saturation and the evaluation of water flooded layer. In order to improve the sensitivity of the technique for low – porosity formation, Gaussian and linear models are applied to fit the peaks of measured spectra to obtain the characteristic coefficients. Standard spectra of carbon and oxygen are combined to establish a new carbon /oxygen value calculation method, and the robustness of the new method is cross – validated with known mixed gamma ray spectrum. Formation models for different porosities and saturations are built using Monte Carlo method.more » The responses of carbon/oxygen which are calculated by conventional energy window method, and the new method is applied to oil saturation under low porosity conditions. The results show the new method can reduce the effects of gamma rays contaminated by the interaction between neutrons and other elements on carbon/oxygen ratio, and therefore can significantly improve the response sensitivity of carbon/oxygen well logging to oil saturation. The new method improves greatly carbon/oxygen well logging in low porosity conditions.« less

A method of improving sensitivity of carbon/oxygen well logging for low porosity formation

DOE PAGES

Liu, Juntao; Zhang, Feng; Zhang, Quanying; ...

2016-12-01

Carbon/Oxygen (C/O) spectral logging technique has been widely used to determine residual oil saturation and the evaluation of water flooded layer. In order to improve the sensitivity of the technique for low – porosity formation, Gaussian and linear models are applied to fit the peaks of measured spectra to obtain the characteristic coefficients. Standard spectra of carbon and oxygen are combined to establish a new carbon /oxygen value calculation method, and the robustness of the new method is cross – validated with known mixed gamma ray spectrum. Formation models for different porosities and saturations are built using Monte Carlo method.more » The responses of carbon/oxygen which are calculated by conventional energy window method, and the new method is applied to oil saturation under low porosity conditions. The results show the new method can reduce the effects of gamma rays contaminated by the interaction between neutrons and other elements on carbon/oxygen ratio, and therefore can significantly improve the response sensitivity of carbon/oxygen well logging to oil saturation. The new method improves greatly carbon/oxygen well logging in low porosity conditions.« less

Esther Wilcox | NREL

Science.gov Websites

Research Associate, University of Colorado, 2004-2007 Patents "Methods for improving syngas-to-alcohol catalyst activity and selectivity," U.S. Patent No. 8,318,986 (2012) "Methods for improving

Improvement Technology Classification and Composition in Multimodel Environments

DTIC Science & Technology

2008-03-01

ISO 15504, ISO 12207 , and others COBIT, ITIL, SOX, and...Practice Elements CMMI PAs and PLA ISO 15504 and ISO 12207 COBIT EFQM ISO 9001 Improvement Method Elements Change management techniques: IDEAL and Six...others EFQM and others ISO 9001, ISO 61508, ISO 16949, and others Improvement Method Elements Change management techniques: IDEAL, Six Sigma,

The Data-to-Action Framework: A Rapid Program Improvement Process

ERIC Educational Resources Information Center

Zakocs, Ronda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn; Freire, Kimberley E.

2015-01-01

Although health education programs may benefit from quality improvement methods, scant resources exist to help practitioners apply these methods for program improvement. The purpose of this article is to describe the Data-to-Action framework, a process that guides practitioners through rapid-feedback cycles in order to generate actionable data to…

Improvements of the Profil Cultural Method for a better Low-tech Field Assessment of Soil Structure under no-till

NASA Astrophysics Data System (ADS)

Roger-Estrade, Jean; Boizard, Hubert; Peigné, Josephine; Sasal, Maria Carolina; Guimaraes, Rachel; Piron, Denis; Tomis, Vincent; Vian, Jean-François; Cadoux, Stephane; Ralisch, Ricardo; Filho, Tavares; Heddadj, Djilali; de Battista, Juan; Duparque, Annie

2016-04-01

In France, agronomists have studied the effects of cropping systems on soil structure, using a field method based on a visual description of soil structure. The "profil cultural" method (Manichon and Gautronneau, 1987) has been designed to perform a field diagnostic of the effects of tillage and compaction on soil structure dynamics. This method is of great use to agronomists improving crop management for a better preservation of soil structure. However, this method was developed and mainly used in conventional tillage systems, with ploughing. As several forms of reduced, minimum and no tillage systems are expanding in many parts of the world, it is necessary to re-evaluate the ability of this method to describe and interpret soil macrostructure in unploughed situations. In unploughed fields, soil structure dynamics of untilled layers is mainly driven by compaction and regeneration by natural agents (climatic conditions, root growth and macrofauna) and it is of major importance to evaluate the importance of these natural processes on soil structure regeneration. These concerns have led us to adapt the standard method and to propose amendments based on a series of field observations and experimental work in different situations of cropping systems, soil types and climatic conditions. We improved the description of crack type and we introduced an index of biological activity, based on the visual examination of clods. To test the improved method, a comparison with the reference method was carried out and the ability of the "profil cultural" method to make a diagnosis was tested on five experiments in France, Brazil and Argentina. Using the improved method, the impact of cropping systems on soil functioning was better assessed when natural processes were integrated into the description.

Socio-economic comparison between traditional and improved cultivation methods in agroforestry systems, East Usambara Mountains, Tanzania.

PubMed

Reyes, Teija; Quiroz, Roberto; Msikula, Shija

2005-11-01

The East Usambara Mountains, recognized as one of the 25 most important biodiversity hot spots in the world, have a high degree of species diversity and endemism that is threatened by increasing human pressure on resources. Traditional slash and burn cultivation in the area is no longer sustainable. However, it is possible to maintain land productivity, decrease land degradation, and improve rural people's livelihood by ameliorating cultivation methods. Improved agroforestry seems to be a very convincing and suitable method for buffer zones of conservation areas. Farmers could receive a reasonable net income from their farm with little investment in terms of time, capital, and labor. By increasing the diversity and production of already existing cultivations, the pressure on natural forests can be diminished. The present study shows a significant gap between traditional cultivation methods and improved agroforestry systems in socio-economic terms. Improved agroforestry systems provide approximately double income per capita in comparison to traditional methods. More intensified cash crop cultivation in the highlands of the East Usambara also results in double income compared to that in the lowlands. However, people are sensitive to risks of changing farming practices. Encouraging farmers to apply better land management and practice sustainable cultivation of cash crops in combination with multipurpose trees would be relevant in improving their economic situation in the relatively short term. The markets of most cash crops are already available. Improved agroforestry methods could ameliorate the living conditions of the local population and protect the natural reserves from human disturbance.

Courtney E. Payne | NREL

Science.gov Websites

improved and higher throughput methods for analysis of biomass feedstocks Agronomics-using NIR spectroscopy in-house and external client training. She has also developed improved and high-throughput methods

Improved Adjoint-Operator Learning For A Neural Network

NASA Technical Reports Server (NTRS)

Toomarian, Nikzad; Barhen, Jacob

1995-01-01

Improved method of adjoint-operator learning reduces amount of computation and associated computational memory needed to make electronic neural network learn temporally varying pattern (e.g., to recognize moving object in image) in real time. Method extension of method described in "Adjoint-Operator Learning for a Neural Network" (NPO-18352).

Interdisciplinary Curriculum Development in Hospital Methods Improvement. Final Report.

ERIC Educational Resources Information Center

Watt, John R.

The major purpose of this project was to develop a "package" curriculum of Hospital Methods Improvement techniques for college students in health related majors. The elementary Industrial Engineering methods for simplifying work and saving labor were applied to the hospital environment and its complex of problems. The report's…

An evaluation of known remaining oil resources in the United States: Appendix. Volume 10

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

NONE

Volume ten contains the following appendices: overview of improved oil recovery methods which covers enhanced oil recovery methods and advanced secondary recovery methods; the benefits of improved oil recovery, selected data for the analyzed states; and list of TORIS fields and reservoirs.

Improving the Ar I and II branching ratio calibration method: Monte Carlo simulations of effects from photon scattering/reflecting in hollow cathodes

NASA Astrophysics Data System (ADS)

Lawler, J. E.; Den Hartog, E. A.

2018-03-01

The Ar I and II branching ratio calibration method is discussed with the goal of improving the technique. This method of establishing a relative radiometric calibration is important in ongoing research to improve atomic transition probabilities for quantitative spectroscopy in astrophysics and other fields. Specific suggestions are presented along with Monte Carlo simulations of wavelength dependent effects from scattering/reflecting of photons in a hollow cathode.

Dynamic frame resizing with convolutional neural network for efficient video compression

NASA Astrophysics Data System (ADS)

Kim, Jaehwan; Park, Youngo; Choi, Kwang Pyo; Lee, JongSeok; Jeon, Sunyoung; Park, JeongHoon

2017-09-01

In the past, video codecs such as vc-1 and H.263 used a technique to encode reduced-resolution video and restore original resolution from the decoder for improvement of coding efficiency. The techniques of vc-1 and H.263 Annex Q are called dynamic frame resizing and reduced-resolution update mode, respectively. However, these techniques have not been widely used due to limited performance improvements that operate well only under specific conditions. In this paper, video frame resizing (reduced/restore) technique based on machine learning is proposed for improvement of coding efficiency. The proposed method features video of low resolution made by convolutional neural network (CNN) in encoder and reconstruction of original resolution using CNN in decoder. The proposed method shows improved subjective performance over all the high resolution videos which are dominantly consumed recently. In order to assess subjective quality of the proposed method, Video Multi-method Assessment Fusion (VMAF) which showed high reliability among many subjective measurement tools was used as subjective metric. Moreover, to assess general performance, diverse bitrates are tested. Experimental results showed that BD-rate based on VMAF was improved by about 51% compare to conventional HEVC. Especially, VMAF values were significantly improved in low bitrate. Also, when the method is subjectively tested, it had better subjective visual quality in similar bit rate.

The improved business valuation model for RFID company based on the community mining method.

PubMed

Li, Shugang; Yu, Zhaoxu

2017-01-01

Nowadays, the appetite for the investment and mergers and acquisitions (M&A) activity in RFID companies is growing rapidly. Although the huge number of papers have addressed the topic of business valuation models based on statistical methods or neural network methods, only a few are dedicated to constructing a general framework for business valuation that improves the performance with network graph (NG) and the corresponding community mining (CM) method. In this study, an NG based business valuation model is proposed, where real options approach (ROA) integrating CM method is designed to predict the company's net profit as well as estimate the company value. Three improvements are made in the proposed valuation model: Firstly, our model figures out the credibility of the node belonging to each community and clusters the network according to the evolutionary Bayesian method. Secondly, the improved bacterial foraging optimization algorithm (IBFOA) is adopted to calculate the optimized Bayesian posterior probability function. Finally, in IBFOA, bi-objective method is used to assess the accuracy of prediction, and these two objectives are combined into one objective function using a new Pareto boundary method. The proposed method returns lower forecasting error than 10 well-known forecasting models on 3 different time interval valuing tasks for the real-life simulation of RFID companies.

The improved business valuation model for RFID company based on the community mining method

PubMed Central

Li, Shugang; Yu, Zhaoxu

2017-01-01

Nowadays, the appetite for the investment and mergers and acquisitions (M&A) activity in RFID companies is growing rapidly. Although the huge number of papers have addressed the topic of business valuation models based on statistical methods or neural network methods, only a few are dedicated to constructing a general framework for business valuation that improves the performance with network graph (NG) and the corresponding community mining (CM) method. In this study, an NG based business valuation model is proposed, where real options approach (ROA) integrating CM method is designed to predict the company’s net profit as well as estimate the company value. Three improvements are made in the proposed valuation model: Firstly, our model figures out the credibility of the node belonging to each community and clusters the network according to the evolutionary Bayesian method. Secondly, the improved bacterial foraging optimization algorithm (IBFOA) is adopted to calculate the optimized Bayesian posterior probability function. Finally, in IBFOA, bi-objective method is used to assess the accuracy of prediction, and these two objectives are combined into one objective function using a new Pareto boundary method. The proposed method returns lower forecasting error than 10 well-known forecasting models on 3 different time interval valuing tasks for the real-life simulation of RFID companies. PMID:28459815

An improved parallel fuzzy connected image segmentation method based on CUDA.

PubMed

Wang, Liansheng; Li, Dong; Huang, Shaohui

2016-05-12

Fuzzy connectedness method (FC) is an effective method for extracting fuzzy objects from medical images. However, when FC is applied to large medical image datasets, its running time will be greatly expensive. Therefore, a parallel CUDA version of FC (CUDA-kFOE) was proposed by Ying et al. to accelerate the original FC. Unfortunately, CUDA-kFOE does not consider the edges between GPU blocks, which causes miscalculation of edge points. In this paper, an improved algorithm is proposed by adding a correction step on the edge points. The improved algorithm can greatly enhance the calculation accuracy. In the improved method, an iterative manner is applied. In the first iteration, the affinity computation strategy is changed and a look up table is employed for memory reduction. In the second iteration, the error voxels because of asynchronism are updated again. Three different CT sequences of hepatic vascular with different sizes were used in the experiments with three different seeds. NVIDIA Tesla C2075 is used to evaluate our improved method over these three data sets. Experimental results show that the improved algorithm can achieve a faster segmentation compared to the CPU version and higher accuracy than CUDA-kFOE. The calculation results were consistent with the CPU version, which demonstrates that it corrects the edge point calculation error of the original CUDA-kFOE. The proposed method has a comparable time cost and has less errors compared to the original CUDA-kFOE as demonstrated in the experimental results. In the future, we will focus on automatic acquisition method and automatic processing.

Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

PubMed

Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

2008-10-01

The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

Improved nuclear fuel assembly grid spacer

DOEpatents

Marshall, John; Kaplan, Samuel

1977-01-01

An improved fuel assembly grid spacer and method of retaining the basic fuel rod support elements in position within the fuel assembly containment channel. The improvement involves attachment of the grids to the hexagonal channel and of forming the basic fuel rod support element into a grid structure, which provides a design which is insensitive to potential channel distortion (ballooning) at high fluence levels. In addition the improved method eliminates problems associated with component fabrication and assembly.

Method for producing ethanol and co-products from cellulosic biomass

DOEpatents

Nguyen, Quang A

2013-10-01

The present invention generally relates to processes for production of ethanol from cellulosic biomass. The present invention also relates to production of various co-products of preparation of ethanol from cellulosic biomass. The present invention further relates to improvements in one or more aspects of preparation of ethanol from cellulosic biomass including, for example, improved methods for cleaning biomass feedstocks, improved acid impregnation, and improved steam treatment, or "steam explosion."

Improved accuracy in quantitative laser-induced breakdown spectroscopy using sub-models

USGS Publications Warehouse

Anderson, Ryan; Clegg, Samuel M.; Frydenvang, Jens; Wiens, Roger C.; McLennan, Scott M.; Morris, Richard V.; Ehlmann, Bethany L.; Dyar, M. Darby

2017-01-01

Accurate quantitative analysis of diverse geologic materials is one of the primary challenges faced by the Laser-Induced Breakdown Spectroscopy (LIBS)-based ChemCam instrument on the Mars Science Laboratory (MSL) rover. The SuperCam instrument on the Mars 2020 rover, as well as other LIBS instruments developed for geochemical analysis on Earth or other planets, will face the same challenge. Consequently, part of the ChemCam science team has focused on the development of improved multivariate analysis calibrations methods. Developing a single regression model capable of accurately determining the composition of very different target materials is difficult because the response of an element’s emission lines in LIBS spectra can vary with the concentration of other elements. We demonstrate a conceptually simple “sub-model” method for improving the accuracy of quantitative LIBS analysis of diverse target materials. The method is based on training several regression models on sets of targets with limited composition ranges and then “blending” these “sub-models” into a single final result. Tests of the sub-model method show improvement in test set root mean squared error of prediction (RMSEP) for almost all cases. The sub-model method, using partial least squares regression (PLS), is being used as part of the current ChemCam quantitative calibration, but the sub-model method is applicable to any multivariate regression method and may yield similar improvements.

The cost-effectiveness of three methods of disseminating information to improve medical male circumcision in Uganda

PubMed Central

Karamagi, Esther; Kigonya, Angella; Lawino, Anna; Marquez, Lani; Lunsford, Sarah Smith; Twinomugisha, Albert

2018-01-01

Background Uganda is working to increase voluntary medical male circumcision (VMMC) to prevent HIV infection. To support VMMC quality improvement, this study compared three methods of disseminating information to facilities on how to improve VMMC quality: M—providing a written manual; MH—providing the manual plus a handover meeting in which clinicians shared advice on implementing key changes and participated in group discussion; and MHC—manual, handover meeting, and three site visits to the facility in which a coach provided individualized guidance and mentoring on improvement. We determined the different effects these had on compliance with indicators of quality of care. Methods This controlled pre-post intervention study randomized health facility groups to receive M, MH, or MHC. Observations of VMMCs performance determined compliance with quality indicators. Intervention costs per patient receiving VMMC were used in a decision-tree cost-effectiveness model to calculate the incremental cost per additional patient treated to compliance with indicators of informed consent, history taking, anesthesia administration, and post-operative instructions. Results The most intensive method (MHC) cost $28.83 per patient and produced the biggest gains in history taking (35% improvement), anesthesia administration (20% improvement), and post-operative instructions (37% improvement). The least intensive method (M; $1.13 per patient) was most efficient because it produced small gains for a very low cost. The handover meeting (MH) was the most expensive among the three interventions but did not have a corresponding positive effect on quality. Conclusion Health workers in facilities that received the VMMC improvement manual and participated in the handover meeting and coaching visits showed more improvement in VMMC quality indicators than those in the other two intervention groups. Providing the manual alone cost the least but was also the least effective in achieving improvements. The MHC intervention is recommended for broader implementation to improve VMMC quality in Uganda. PMID:29672578

Measuring Glial Metabolism in Repetitive Brain Trauma and Alzheimer’s Disease

DTIC Science & Technology

2016-09-01

Six methods: Single value decomposition (SVD), wavelet, sliding window, sliding window with Gaussian weighting, spline and spectral improvements...comparison of a range of different denoising methods for dynamic MRS. Six denoising methods were considered: Single value decomposition (SVD), wavelet...project by improving the software required for the data analysis by developing six different denoising methods. He also assisted with the testing

Integrating qualitative research methods into care improvement efforts within a learning health system: addressing antibiotic overuse.

PubMed

Munoz-Plaza, Corrine E; Parry, Carla; Hahn, Erin E; Tang, Tania; Nguyen, Huong Q; Gould, Michael K; Kanter, Michael H; Sharp, Adam L

2016-08-15

Despite reports advocating for integration of research into healthcare delivery, scant literature exists describing how this can be accomplished. Examples highlighting application of qualitative research methods embedded into a healthcare system are particularly needed. This article describes the process and value of embedding qualitative research as the second phase of an explanatory, sequential, mixed methods study to improve antibiotic stewardship for acute sinusitis. Purposive sampling of providers for in-depth interviews improved understanding of unwarranted antibiotic prescribing and elicited stakeholder recommendations for improvement. Qualitative data collection, transcription and constant comparative analyses occurred iteratively. Emerging themes and sub-themes identified primary drivers of unwarranted antibiotic prescribing patterns and recommendations for improving practice. These findings informed the design of a health system intervention to improve antibiotic stewardship for acute sinusitis. Core components of the intervention are also described. Qualitative research can be effectively applied in learning healthcare systems to elucidate quantitative results and inform improvement efforts.

Using Deep Learning for Compound Selectivity Prediction.

PubMed

Zhang, Ruisheng; Li, Juan; Lu, Jingjing; Hu, Rongjing; Yuan, Yongna; Zhao, Zhili

2016-01-01

Compound selectivity prediction plays an important role in identifying potential compounds that bind to the target of interest with high affinity. However, there is still short of efficient and accurate computational approaches to analyze and predict compound selectivity. In this paper, we propose two methods to improve the compound selectivity prediction. We employ an improved multitask learning method in Neural Networks (NNs), which not only incorporates both activity and selectivity for other targets, but also uses a probabilistic classifier with a logistic regression. We further improve the compound selectivity prediction by using the multitask learning method in Deep Belief Networks (DBNs) which can build a distributed representation model and improve the generalization of the shared tasks. In addition, we assign different weights to the auxiliary tasks that are related to the primary selectivity prediction task. In contrast to other related work, our methods greatly improve the accuracy of the compound selectivity prediction, in particular, using the multitask learning in DBNs with modified weights obtains the best performance.

Highly undersampled MR image reconstruction using an improved dual-dictionary learning method with self-adaptive dictionaries.

PubMed

Li, Jiansen; Song, Ying; Zhu, Zhen; Zhao, Jun

2017-05-01

Dual-dictionary learning (Dual-DL) method utilizes both a low-resolution dictionary and a high-resolution dictionary, which are co-trained for sparse coding and image updating, respectively. It can effectively exploit a priori knowledge regarding the typical structures, specific features, and local details of training sets images. The prior knowledge helps to improve the reconstruction quality greatly. This method has been successfully applied in magnetic resonance (MR) image reconstruction. However, it relies heavily on the training sets, and dictionaries are fixed and nonadaptive. In this research, we improve Dual-DL by using self-adaptive dictionaries. The low- and high-resolution dictionaries are updated correspondingly along with the image updating stage to ensure their self-adaptivity. The updated dictionaries incorporate both the prior information of the training sets and the test image directly. Both dictionaries feature improved adaptability. Experimental results demonstrate that the proposed method can efficiently and significantly improve the quality and robustness of MR image reconstruction.

An iterative method for obtaining the optimum lightning location on a spherical surface

NASA Technical Reports Server (NTRS)

Chao, Gao; Qiming, MA

1991-01-01

A brief introduction to the basic principles of an eigen method used to obtain the optimum source location of lightning is presented. The location of the optimum source is obtained by using multiple direction finders (DF's) on a spherical surface. An improvement of this method, which takes the distance of source-DF's as a constant, is presented. It is pointed out that using a weight factor of signal strength is not the most ideal method because of the inexact inverse signal strength-distance relation and the inaccurate signal amplitude. An iterative calculation method is presented using the distance from the source to the DF as a weight factor. This improved method has higher accuracy and needs only a little more calculation time. Some computer simulations for a 4DF system are presented to show the improvement of location through use of the iterative method.

Guided particle swarm optimization method to solve general nonlinear optimization problems

NASA Astrophysics Data System (ADS)

Abdelhalim, Alyaa; Nakata, Kazuhide; El-Alem, Mahmoud; Eltawil, Amr

2018-04-01

The development of hybrid algorithms is becoming an important topic in the global optimization research area. This article proposes a new technique in hybridizing the particle swarm optimization (PSO) algorithm and the Nelder-Mead (NM) simplex search algorithm to solve general nonlinear unconstrained optimization problems. Unlike traditional hybrid methods, the proposed method hybridizes the NM algorithm inside the PSO to improve the velocities and positions of the particles iteratively. The new hybridization considers the PSO algorithm and NM algorithm as one heuristic, not in a sequential or hierarchical manner. The NM algorithm is applied to improve the initial random solution of the PSO algorithm and iteratively in every step to improve the overall performance of the method. The performance of the proposed method was tested over 20 optimization test functions with varying dimensions. Comprehensive comparisons with other methods in the literature indicate that the proposed solution method is promising and competitive.

Evaluating core technology capacity based on an improved catastrophe progression method: the case of automotive industry

NASA Astrophysics Data System (ADS)

Zhao, Shijia; Liu, Zongwei; Wang, Yue; Zhao, Fuquan

2017-01-01

Subjectivity usually causes large fluctuations in evaluation results. Many scholars attempt to establish new mathematical methods to make evaluation results consistent with actual objective situations. An improved catastrophe progression method (ICPM) is constructed to overcome the defects of the original method. The improved method combines the merits of the principal component analysis' information coherence and the catastrophe progression method's none index weight and has the advantage of highly objective comprehensive evaluation. Through the systematic analysis of the influencing factors of the automotive industry's core technology capacity, the comprehensive evaluation model is established according to the different roles that different indices play in evaluating the overall goal with a hierarchical structure. Moreover, ICPM is developed for evaluating the automotive industry's core technology capacity for the typical seven countries in the world, which demonstrates the effectiveness of the method.

Effects of audio coaching and visual feedback on the stability of respiration during radiotherapy.

PubMed

Baba, Fumiya; Tanaka, Satoshi; Nonogaki, Yoshinori; Hasegawa, Shinji; Nishihashi, Minami; Ayakawa, Shiho; Yamada, Maho; Shibamoto, Yuta

2016-08-01

The aim of this study is to compare the respiration-stabilizing abilities of audio coaching (AC) and AC with visual feedback (VF) with that of free breathing (FB). Ten healthy volunteers were told to breathe in FB, under AC and under AC + VF in random order. The standard deviation (SD) values of the respiratory cycle, the amplitude, the lowest points (exhalation), and the highest points (inhalation) of respiratory wave were used as indices of respiratory stability. Compared with FB, the AC method significantly improved respiratory cycle stability (p = 0.001). The AC + VF method improved the stability of the respiratory cycle, the amplitude and the lowest point of respiratory wave (all p < 0.001). In analyses of each subject's data, compared with FB, the AC method significantly improved the respiratory cycle stability in five subjects, and the AC + VF method improved the stability of the respiratory cycle, the amplitude and the lowest point of respiratory wave in 4, 5, and 4 subjects, respectively. In two cases, coaching did not improve respiratory stability. The AC + VF method had the most beneficial effects on respiratory stability. However, coaching is not necessarily effective in all cases. Therefore, the most suitable method should be chosen on an individual basis.

Improved scaling of temperature-accelerated dynamics using localization

NASA Astrophysics Data System (ADS)

Shim, Yunsic; Amar, Jacques G.

2016-07-01

While temperature-accelerated dynamics (TAD) is a powerful method for carrying out non-equilibrium simulations of systems over extended time scales, the computational cost of serial TAD increases approximately as N3 where N is the number of atoms. In addition, although a parallel TAD method based on domain decomposition [Y. Shim et al., Phys. Rev. B 76, 205439 (2007)] has been shown to provide significantly improved scaling, the dynamics in such an approach is only approximate while the size of activated events is limited by the spatial decomposition size. Accordingly, it is of interest to develop methods to improve the scaling of serial TAD. As a first step in understanding the factors which determine the scaling behavior, we first present results for the overall scaling of serial TAD and its components, which were obtained from simulations of Ag/Ag(100) growth and Ag/Ag(100) annealing, and compare with theoretical predictions. We then discuss two methods based on localization which may be used to address two of the primary "bottlenecks" to the scaling of serial TAD with system size. By implementing both of these methods, we find that for intermediate system-sizes, the scaling is improved by almost a factor of N1/2. Some additional possible methods to improve the scaling of TAD are also discussed.

Intelligent fault diagnosis of rolling bearings using an improved deep recurrent neural network

NASA Astrophysics Data System (ADS)

Jiang, Hongkai; Li, Xingqiu; Shao, Haidong; Zhao, Ke

2018-06-01

Traditional intelligent fault diagnosis methods for rolling bearings heavily depend on manual feature extraction and feature selection. For this purpose, an intelligent deep learning method, named the improved deep recurrent neural network (DRNN), is proposed in this paper. Firstly, frequency spectrum sequences are used as inputs to reduce the input size and ensure good robustness. Secondly, DRNN is constructed by the stacks of the recurrent hidden layer to automatically extract the features from the input spectrum sequences. Thirdly, an adaptive learning rate is adopted to improve the training performance of the constructed DRNN. The proposed method is verified with experimental rolling bearing data, and the results confirm that the proposed method is more effective than traditional intelligent fault diagnosis methods.

An improved method for predicting the lightning performance of high and extra-high-voltage substation shielding

NASA Astrophysics Data System (ADS)

Vinh, T.

1980-08-01

There is a need for better and more effective lightning protection for transmission and switching substations. In the past, a number of empirical methods were utilized to design systems to protect substations and transmission lines from direct lightning strokes. The need exists for convenient analytical lightning models adequate for engineering usage. In this study, analytical lightning models were developed along with a method for improved analysis of the physical properties of lightning through their use. This method of analysis is based upon the most recent statistical field data. The result is an improved method for predicting the occurrence of sheilding failure and for designing more effective protection for high and extra high voltage substations from direct strokes.

A novel shape from focus method based on 3D steerable filters for improved performance on treating textureless region

NASA Astrophysics Data System (ADS)

Fan, Tiantian; Yu, Hongbin

2018-03-01

A novel shape from focus method combining 3D steerable filter for improved performance on treating textureless region was proposed in this paper. Different from conventional spatial methods focusing on the search of maximum edges' response to estimate the depth map, the currently proposed method took both of the edges' response and the axial imaging blur degree into consideration during treatment. As a result, more robust and accurate identification for the focused location can be achieved, especially when treating textureless objects. Improved performance in depth measurement has been successfully demonstrated from both of the simulation and experiment results.

Improving Cardiac Action Potential Measurements: 2D and 3D Cell Culture.

PubMed

Daily, Neil J; Yin, Yue; Kemanli, Pinar; Ip, Brian; Wakatsuki, Tetsuro

2015-11-01

Progress in the development of assays for measuring cardiac action potential is crucial for the discovery of drugs for treating cardiac disease and assessing cardiotoxicity. Recently, high-throughput methods for assessing action potential using induced pluripotent stem cell (iPSC) derived cardiomyocytes in both two-dimensional monolayer cultures and three-dimensional tissues have been developed. We describe an improved method for assessing cardiac action potential using an ultra-fast cost-effective plate reader with commercially available dyes. Our methods improve dramatically the detection of the fluorescence signal from these dyes and make way for the development of more high-throughput methods for cardiac drug discovery and cardiotoxicity.

Improved dynamical scaling analysis using the kernel method for nonequilibrium relaxation.

PubMed

Echinaka, Yuki; Ozeki, Yukiyasu

2016-10-01

The dynamical scaling analysis for the Kosterlitz-Thouless transition in the nonequilibrium relaxation method is improved by the use of Bayesian statistics and the kernel method. This allows data to be fitted to a scaling function without using any parametric model function, which makes the results more reliable and reproducible and enables automatic and faster parameter estimation. Applying this method, the bootstrap method is introduced and a numerical discrimination for the transition type is proposed.

Improvement of Accuracy for Background Noise Estimation Method Based on TPE-AE

NASA Astrophysics Data System (ADS)

Itai, Akitoshi; Yasukawa, Hiroshi

This paper proposes a method of a background noise estimation based on the tensor product expansion with a median and a Monte carlo simulation. We have shown that a tensor product expansion with absolute error method is effective to estimate a background noise, however, a background noise might not be estimated by using conventional method properly. In this paper, it is shown that the estimate accuracy can be improved by using proposed methods.

Soliton solutions of the quantum Zakharov-Kuznetsov equation which arises in quantum magneto-plasmas

NASA Astrophysics Data System (ADS)

Sindi, Cevat Teymuri; Manafian, Jalil

2017-02-01

In this paper, we extended the improved tan(φ/2)-expansion method (ITEM) and the generalized G'/G-expansion method (GGEM) proposed by Manafian and Fazli (Opt. Quantum Electron. 48, 413 (2016)) to construct new types of soliton wave solutions of nonlinear partial differential equations (NPDEs). Moreover, we use of the improvement of the Exp-function method (IEFM) proposed by Jahani and Manafian (Eur. Phys. J. Plus 131, 54 (2016)) for obtaining solutions of NPDEs. The merit of the presented three methods is they can find further solutions to the considered problems, including soliton, periodic, kink, kink-singular wave solutions. This paper studies the quantum Zakharov-Kuznetsov (QZK) equation by the aid of the improved tan(φ/2)-expansion method, the generalized G'/G-expansion method and the improvement of the Exp-function method. Moreover, the 1-soliton solution of the modified QZK equation with power law nonlinearity is obtained by the aid of traveling wave hypothesis with the necessary constraints in place for the existence of the soliton. Comparing our new results with Ebadi et al. results (Astrophys. Space Sci. 341, 507 (2012)), namely, G'/G-expansion method, exp-function method, modified F-expansion method, shows that our results give further solutions. Finally, these solutions might play an important role in engineering, physics and applied mathematics fields.

[Continual improvement of quantitative analytical method development of Panax notogineng saponins based on quality by design].

PubMed

Dai, Sheng-Yun; Xu, Bing; Shi, Xin-Yuan; Xu, Xiang; Sun, Ying-Qiang; Qiao, Yan-Jiang

2017-03-01

This study is aimed to propose a continual improvement strategy based on quality by design (QbD). An ultra high performance liquid chromatography (UPLC) method was developed to accomplish the method transformation from HPLC to UPLC of Panax notogineng saponins (PNS) and achieve the continual improvement of PNS based on QbD, for example. Plackett-Burman screening design and Box-Behnken optimization design were employed to further understand the relationship between the critical method parameters (CMPs) and critical method attributes (CMAs). And then the Bayesian design space was built. The separation degree of the critical peaks (ginsenoside Rg₁ and ginsenoside Re) was over 2.0 and the analysis time was less than 17 min by a method chosen from the design space with 20% of the initial concentration of the acetonitrile, 10 min of the isocratic time and 6%•min⁻¹ of the gradient slope. At last, the optimum method was validated by accuracy profile. Based on the same analytical target profile (ATP), the comparison of HPLC and UPLC including chromatograph method, CMA identification, CMP-CMA model and system suitability test (SST) indicated that the UPLC method could shorten the analysis time, improve the critical separation and satisfy the requirement of the SST. In all, HPLC method could be replaced by UPLC for the quantity analysis of PNS. Copyright© by the Chinese Pharmaceutical Association.

Opportunities and Obstacles: Implementing Stimulus-Funded School Improvement Grants in Maryland, Michigan, and Idaho. Study Methods

ERIC Educational Resources Information Center

Center on Education Policy, 2012

2012-01-01

This paper presents the study methods used for the "Opportunities and Obstacles: Implementing Stimulus-Funded School Improvement Grants in Maryland, Michigan, and Idaho" report. The purpose of this study was to describe how Title I 1003(g) School Improvement Grants awarded through the American Reinvestment and Recovery Act (ARRA) in the…

Improved methods for operating public transportation services.

DOT National Transportation Integrated Search

2013-03-01

In this joint project, West Virginia University and the University of Maryland collaborated in developing improved methods for analyzing and managing public transportation services. Transit travel time data were collected using GPS tracking services ...

A Pragmatic Smoothing Method for Improving the Quality of the Results in Atomic Spectroscopy

NASA Astrophysics Data System (ADS)

Bennun, Leonardo

2017-07-01

A new smoothing method for the improvement on the identification and quantification of spectral functions based on the previous knowledge of the signals that are expected to be quantified, is presented. These signals are used as weighted coefficients in the smoothing algorithm. This smoothing method was conceived to be applied in atomic and nuclear spectroscopies preferably to these techniques where net counts are proportional to acquisition time, such as particle induced X-ray emission (PIXE) and other X-ray fluorescence spectroscopic methods, etc. This algorithm, when properly applied, does not distort the form nor the intensity of the signal, so it is well suited for all kind of spectroscopic techniques. This method is extremely effective at reducing high-frequency noise in the signal much more efficient than a single rectangular smooth of the same width. As all of smoothing techniques, the proposed method improves the precision of the results, but in this case we found also a systematic improvement on the accuracy of the results. We still have to evaluate the improvement on the quality of the results when this method is applied over real experimental results. We expect better characterization of the net area quantification of the peaks, and smaller Detection and Quantification Limits. We have applied this method to signals that obey Poisson statistics, but with the same ideas and criteria, it could be applied to time series. In a general case, when this algorithm is applied over experimental results, also it would be required that the sought characteristic functions, required for this weighted smoothing method, should be obtained from a system with strong stability. If the sought signals are not perfectly clean, this method should be carefully applied

Systematic review of the application of the plan–do–study–act method to improve quality in healthcare

PubMed Central

Taylor, Michael J; McNicholas, Chris; Nicolay, Chris; Darzi, Ara; Bell, Derek; Reed, Julie E

2014-01-01

Background Plan–do–study–act (PDSA) cycles provide a structure for iterative testing of changes to improve quality of systems. The method is widely accepted in healthcare improvement; however there is little overarching evaluation of how the method is applied. This paper proposes a theoretical framework for assessing the quality of application of PDSA cycles and explores the consistency with which the method has been applied in peer-reviewed literature against this framework. Methods NHS Evidence and Cochrane databases were searched by three independent reviewers. Empirical studies were included that reported application of the PDSA method in healthcare. Application of PDSA cycles was assessed against key features of the method, including documentation characteristics, use of iterative cycles, prediction-based testing of change, initial small-scale testing and use of data over time. Results 73 of 409 individual articles identified met the inclusion criteria. Of the 73 articles, 47 documented PDSA cycles in sufficient detail for full analysis against the whole framework. Many of these studies reported application of the PDSA method that failed to accord with primary features of the method. Less than 20% (14/73) fully documented the application of a sequence of iterative cycles. Furthermore, a lack of adherence to the notion of small-scale change is apparent and only 15% (7/47) reported the use of quantitative data at monthly or more frequent data intervals to inform progression of cycles. Discussion To progress the development of the science of improvement, a greater understanding of the use of improvement methods, including PDSA, is essential to draw reliable conclusions about their effectiveness. This would be supported by the development of systematic and rigorous standards for the application and reporting of PDSAs. PMID:24025320

A New Feature-Enhanced Speckle Reduction Method Based on Multiscale Analysis for Ultrasound B-Mode Imaging.

PubMed

Kang, Jinbum; Lee, Jae Young; Yoo, Yangmo

2016-06-01

Effective speckle reduction in ultrasound B-mode imaging is important for enhancing the image quality and improving the accuracy in image analysis and interpretation. In this paper, a new feature-enhanced speckle reduction (FESR) method based on multiscale analysis and feature enhancement filtering is proposed for ultrasound B-mode imaging. In FESR, clinical features (e.g., boundaries and borders of lesions) are selectively emphasized by edge, coherence, and contrast enhancement filtering from fine to coarse scales while simultaneously suppressing speckle development via robust diffusion filtering. In the simulation study, the proposed FESR method showed statistically significant improvements in edge preservation, mean structure similarity, speckle signal-to-noise ratio, and contrast-to-noise ratio (CNR) compared with other speckle reduction methods, e.g., oriented speckle reducing anisotropic diffusion (OSRAD), nonlinear multiscale wavelet diffusion (NMWD), the Laplacian pyramid-based nonlinear diffusion and shock filter (LPNDSF), and the Bayesian nonlocal means filter (OBNLM). Similarly, the FESR method outperformed the OSRAD, NMWD, LPNDSF, and OBNLM methods in terms of CNR, i.e., 10.70 ± 0.06 versus 9.00 ± 0.06, 9.78 ± 0.06, 8.67 ± 0.04, and 9.22 ± 0.06 in the phantom study, respectively. Reconstructed B-mode images that were developed using the five speckle reduction methods were reviewed by three radiologists for evaluation based on each radiologist's diagnostic preferences. All three radiologists showed a significant preference for the abdominal liver images obtained using the FESR methods in terms of conspicuity, margin sharpness, artificiality, and contrast, p<0.0001. For the kidney and thyroid images, the FESR method showed similar improvement over other methods. However, the FESR method did not show statistically significant improvement compared with the OBNLM method in margin sharpness for the kidney and thyroid images. These results demonstrate that the proposed FESR method can improve the image quality of ultrasound B-mode imaging by enhancing the visualization of lesion features while effectively suppressing speckle noise.

Improved Method for Determining the Heat Capacity of Metals

ERIC Educational Resources Information Center

Barth, Roger; Moran, Michael J.

2014-01-01

An improved procedure for laboratory determination of the heat capacities of metals is described. The temperature of cold water is continuously recorded with a computer-interfaced temperature probe and the room temperature metal is added. The method is more accurate and faster than previous methods. It allows students to get accurate measurements…

An improved method for determining force balance calibration accuracy

NASA Technical Reports Server (NTRS)

Ferris, Alice T.

1993-01-01

The results of an improved statistical method used at Langley Research Center for determining and stating the accuracy of a force balance calibration are presented. The application of the method for initial loads, initial load determination, auxiliary loads, primary loads, and proof loads is described. The data analysis is briefly addressed.

Actively Teaching Research Methods with a Process Oriented Guided Inquiry Learning Approach

ERIC Educational Resources Information Center

Mullins, Mary H.

2017-01-01

Active learning approaches have shown to improve student learning outcomes and improve the experience of students in the classroom. This article compares a Process Oriented Guided Inquiry Learning style approach to a more traditional teaching method in an undergraduate research methods course. Moving from a more traditional learning environment to…

The Effect of Vocal Training Methods on Improving Turkish Accent Defects

ERIC Educational Resources Information Center

Aycan, Kivanc; Evren, Gul Fahriye

2016-01-01

Problem Statement: Despite analyses of how vocal training methods can correct or improve Turkish-language accent defects, for most voice educators, the most important methods continue to be breathe management control and correct vocalization exercises. We therefore sought to demonstrate the relationship of song lyrics to breathe control, accent…

An evaluation of known remaining oil resources in the United States. Appendix, Project on Advanced Oil Recovery and the States

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

Not Available

This volume contains appendices for the following: Overview of improved oil recovery methods (enhanced oil recovery methods and advanced secondary recovery methods); Benefits of improved oil recovery, selected data for the analyzed states; and List of TORIS fields and reservoirs.

Method of Evaluating the Life Cycle Cost of Small Earth Dams Considering the Risk of Heavy Rainfall and Selection Method of the Optimum Countermeasure

NASA Astrophysics Data System (ADS)

Hori, Toshikazu; Mohri, Yoshiyuki; Matsushima, Kenichi; Ariyoshi, Mitsuru

In recent years the increase in the number of heavy rainfall occurrences such as through unpredictable cloudbursts have resulted in the safety of the embankments of small earth dams needing to be improved. However, the severe financial condition of the government and local autonomous bodies necessitate the cost of improving them to be reduced. This study concerns the development of a method of evaluating the life cycle cost of small earth dams considered to pose a risk and in order to improve the safety of the downstream areas of small earth dams at minimal cost. Use of a safety evaluation method that is based on a combination of runoff analysis, saturated and unsaturated seepage analysis, and slope stability analysis enables the probability of a dam breach and its life cycle cost with the risk of heavy rainfall taken into account to be calculated. Moreover, use of the life cycle cost evaluation method will lead to the development of a technique for selecting the method of the optimal improvement or countermeasures against heavy rainfall.

Improved GO/PO method and its application to wideband SAR image of conducting objects over rough surface

NASA Astrophysics Data System (ADS)

Jiang, Wang-Qiang; Zhang, Min; Nie, Ding; Jiao, Yong-Chang

2018-04-01

To simulate the multiple scattering effect of target in synthetic aperture radar (SAR) image, the hybrid method GO/PO method, which combines the geometrical optics (GO) and physical optics (PO), is employed to simulate the scattering field of target. For ray tracing is time-consuming, the Open Graphics Library (OpenGL) is usually employed to accelerate the process of ray tracing. Furthermore, the GO/PO method is improved for the simulation in low pixel situation. For the improved GO/PO method, the pixels are arranged corresponding to the rectangular wave beams one by one, and the GO/PO result is the sum of the contribution values of all the rectangular wave beams. To get high-resolution SAR image, the wideband echo signal is simulated which includes information of many electromagnetic (EM) waves with different frequencies. Finally, the improved GO/PO method is used to simulate the SAR image of targets above rough surface. And the effects of reflected rays and the size of pixel matrix on the SAR image are also discussed.

Elevation data fitting and precision analysis of Google Earth in road survey

NASA Astrophysics Data System (ADS)

Wei, Haibin; Luan, Xiaohan; Li, Hanchao; Jia, Jiangkun; Chen, Zhao; Han, Leilei

2018-05-01

Objective: In order to improve efficiency of road survey and save manpower and material resources, this paper intends to apply Google Earth to the feasibility study stage of road survey and design. Limited by the problem that Google Earth elevation data lacks precision, this paper is focused on finding several different fitting or difference methods to improve the data precision, in order to make every effort to meet the accuracy requirements of road survey and design specifications. Method: On the basis of elevation difference of limited public points, any elevation difference of the other points can be fitted or interpolated. Thus, the precise elevation can be obtained by subtracting elevation difference from the Google Earth data. Quadratic polynomial surface fitting method, cubic polynomial surface fitting method, V4 interpolation method in MATLAB and neural network method are used in this paper to process elevation data of Google Earth. And internal conformity, external conformity and cross correlation coefficient are used as evaluation indexes to evaluate the data processing effect. Results: There is no fitting difference at the fitting point while using V4 interpolation method. Its external conformity is the largest and the effect of accuracy improvement is the worst, so V4 interpolation method is ruled out. The internal and external conformity of the cubic polynomial surface fitting method both are better than those of the quadratic polynomial surface fitting method. The neural network method has a similar fitting effect with the cubic polynomial surface fitting method, but its fitting effect is better in the case of a higher elevation difference. Because the neural network method is an unmanageable fitting model, the cubic polynomial surface fitting method should be mainly used and the neural network method can be used as the auxiliary method in the case of higher elevation difference. Conclusions: Cubic polynomial surface fitting method can obviously improve data precision of Google Earth. The error of data in hilly terrain areas meets the requirement of specifications after precision improvement and it can be used in feasibility study stage of road survey and design.

Extended polarization in 3rd order SCC-DFTB from chemical potential equilization

PubMed Central

Kaminski, Steve; Giese, Timothy J.; Gaus, Michael; York, Darrin M.; Elstner, Marcus

2012-01-01

In this work we augment the approximate density functional method SCC-DFTB (DFTB3) with the chemical potential equilization (CPE) approach in order to improve the performance for molecular electronic polarizabilities. The CPE method, originally implemented for NDDO type methods by Giese and York, has been shown to emend minimal basis methods wrt response properties significantly, and has been applied to SCC-DFTB recently. CPE allows to overcome this inherent limitation of minimal basis methods by supplying an additional response density. The systematic underestimation is thereby corrected quantitatively without the need to extend the atomic orbital basis, i.e. without increasing the overall computational cost significantly. Especially the dependency of polarizability as a function of molecular charge state was significantly improved from the CPE extension of DFTB3. The empirical parameters introduced by the CPE approach were optimized for 172 organic molecules in order to match the results from density functional methods (DFT) methods using large basis sets. However, the first order derivatives of molecular polarizabilities, as e.g. required to compute Raman activities, are not improved by the current CPE implementation, i.e. Raman spectra are not improved. PMID:22894819

Refinement of Fread s Method for improved tracking of stream discharges during unsteady flows

DOE PAGES

Lee, Kyutae; Muste, Marian

2017-02-07

There are a plethora of analytical approaches to account for the effect of unsteady flow (a.k.a. hysteretic behavior) on the conventionally-built steady rating curves (RCs) used to continuously estimate discharges in open channel flow. One of the most complete correction methods is Fread s method (Fread, 1975) which is based on fully dynamic one-dimensional wave equation. Proposed herein is a modified Fread s method which is adjusted to account for the actual geometry of the cross section. This method improves the accuracy associated with the estimation of conveyance factor and energy slope, so it is particularly useful for small tomore » mid-size streams/rivers where the original method s assumption does not properly hold. The modified Fread s method is tested for the sites in Clear Creek (Iowa, USA) and Ebro River (Spain) to illustrate the significance of its improvement in discharge estimation. While the degree of improvement is apparent for the conveyance factor because the hydraulic depth is replaced by hydraulic radius, that for the energy slope term specifically depends on the site and event conditions.« less

Refinement of Fread s Method for improved tracking of stream discharges during unsteady flows

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

Lee, Kyutae; Muste, Marian

There are a plethora of analytical approaches to account for the effect of unsteady flow (a.k.a. hysteretic behavior) on the conventionally-built steady rating curves (RCs) used to continuously estimate discharges in open channel flow. One of the most complete correction methods is Fread s method (Fread, 1975) which is based on fully dynamic one-dimensional wave equation. Proposed herein is a modified Fread s method which is adjusted to account for the actual geometry of the cross section. This method improves the accuracy associated with the estimation of conveyance factor and energy slope, so it is particularly useful for small tomore » mid-size streams/rivers where the original method s assumption does not properly hold. The modified Fread s method is tested for the sites in Clear Creek (Iowa, USA) and Ebro River (Spain) to illustrate the significance of its improvement in discharge estimation. While the degree of improvement is apparent for the conveyance factor because the hydraulic depth is replaced by hydraulic radius, that for the energy slope term specifically depends on the site and event conditions.« less

Spectra library assisted de novo peptide sequencing for HCD and ETD spectra pairs.

PubMed

Yan, Yan; Zhang, Kaizhong

2016-12-23

De novo peptide sequencing via tandem mass spectrometry (MS/MS) has been developed rapidly in recent years. With the use of spectra pairs from the same peptide under different fragmentation modes, performance of de novo sequencing is greatly improved. Currently, with large amount of spectra sequenced everyday, spectra libraries containing tens of thousands of annotated experimental MS/MS spectra become available. These libraries provide information of the spectra properties, thus have the potential to be used with de novo sequencing to improve its performance. In this study, an improved de novo sequencing method assisted with spectra library is proposed. It uses spectra libraries as training datasets and introduces significant scores of the features used in our previous de novo sequencing method for HCD and ETD spectra pairs. Two pairs of HCD and ETD spectral datasets were used to test the performance of the proposed method and our previous method. The results show that this proposed method achieves better sequencing accuracy with higher ranked correct sequences and less computational time. This paper proposed an advanced de novo sequencing method for HCD and ETD spectra pair and used information from spectra libraries and significant improved previous similar methods.

Improved Quasi-Newton method via PSB update for solving systems of nonlinear equations

NASA Astrophysics Data System (ADS)

Mamat, Mustafa; Dauda, M. K.; Waziri, M. Y.; Ahmad, Fadhilah; Mohamad, Fatma Susilawati

2016-10-01

The Newton method has some shortcomings which includes computation of the Jacobian matrix which may be difficult or even impossible to compute and solving the Newton system in every iteration. Also, the common setback with some quasi-Newton methods is that they need to compute and store an n × n matrix at each iteration, this is computationally costly for large scale problems. To overcome such drawbacks, an improved Method for solving systems of nonlinear equations via PSB (Powell-Symmetric-Broyden) update is proposed. In the proposed method, the approximate Jacobian inverse Hk of PSB is updated and its efficiency has improved thereby require low memory storage, hence the main aim of this paper. The preliminary numerical results show that the proposed method is practically efficient when applied on some benchmark problems.

Analysis on accuracy improvement of rotor-stator rubbing localization based on acoustic emission beamforming method.

PubMed

He, Tian; Xiao, Denghong; Pan, Qiang; Liu, Xiandong; Shan, Yingchun

2014-01-01

This paper attempts to introduce an improved acoustic emission (AE) beamforming method to localize rotor-stator rubbing fault in rotating machinery. To investigate the propagation characteristics of acoustic emission signals in casing shell plate of rotating machinery, the plate wave theory is used in a thin plate. A simulation is conducted and its result shows the localization accuracy of beamforming depends on multi-mode, dispersion, velocity and array dimension. In order to reduce the effect of propagation characteristics on the source localization, an AE signal pre-process method is introduced by combining plate wave theory and wavelet packet transform. And the revised localization velocity to reduce effect of array size is presented. The accuracy of rubbing localization based on beamforming and the improved method of present paper are compared by the rubbing test carried on a test table of rotating machinery. The results indicate that the improved method can localize rub fault effectively. Copyright © 2013 Elsevier B.V. All rights reserved.

Design and analysis of a worm gear turntable off-axis assembly method in a three-grating monochromator.

PubMed

Chen, Jianjun; Cui, Jicheng; Yao, Xuefeng; Liu, Jianan; Sun, Ci

2018-04-01

To solve the problem where the actual grating aperture decreases with an increasing scanning angle during the scanning of a three-grating monochromator, we propose an off-axis assembly method for the worm gear turntable that makes it possible to suppress this aperture reduction. We simulated and compared the traditional assembly method with the off-axis assembly method in the three-grating monochromator. Results show that the actual grating aperture can be improved by the off-axis assembly method. In fact, for any one of the three gratings, when the monochromator outputs the longest wavelength in the corresponding wavelength band, the actual grating aperture increases by 45.93%. Over the entire monochromator output band, the actual grating aperture increased by an average of 32.56% and can thus improve the monochromator's output energy. Improvement of the actual grating aperture can also reduce the stray light intensity in the monochromator and improve its output signal-to-noise ratio.

An Improved Algorithm of Congruent Matching Cells (CMC) Method for Firearm Evidence Identifications

PubMed Central

Tong, Mingsi; Song, John; Chu, Wei

2015-01-01

The Congruent Matching Cells (CMC) method was invented at the National Institute of Standards and Technology (NIST) for firearm evidence identifications. The CMC method divides the measured image of a surface area, such as a breech face impression from a fired cartridge case, into small correlation cells and uses four identification parameters to identify correlated cell pairs originating from the same firearm. The CMC method was validated by identification tests using both 3D topography images and optical images captured from breech face impressions of 40 cartridge cases fired from a pistol with 10 consecutively manufactured slides. In this paper, we discuss the processing of the cell correlations and propose an improved algorithm of the CMC method which takes advantage of the cell correlations at a common initial phase angle and combines the forward and backward correlations to improve the identification capability. The improved algorithm is tested by 780 pairwise correlations using the same optical images and 3D topography images as the initial validation. PMID:26958441

A robust pointer segmentation in biomedical images toward building a visual ontology for biomedical article retrieval

NASA Astrophysics Data System (ADS)

You, Daekeun; Simpson, Matthew; Antani, Sameer; Demner-Fushman, Dina; Thoma, George R.

2013-01-01

Pointers (arrows and symbols) are frequently used in biomedical images to highlight specific image regions of interest (ROIs) that are mentioned in figure captions and/or text discussion. Detection of pointers is the first step toward extracting relevant visual features from ROIs and combining them with textual descriptions for a multimodal (text and image) biomedical article retrieval system. Recently we developed a pointer recognition algorithm based on an edge-based pointer segmentation method, and subsequently reported improvements made on our initial approach involving the use of Active Shape Models (ASM) for pointer recognition and region growing-based method for pointer segmentation. These methods contributed to improving the recall of pointer recognition but not much to the precision. The method discussed in this article is our recent effort to improve the precision rate. Evaluation performed on two datasets and compared with other pointer segmentation methods show significantly improved precision and the highest F1 score.

An Improved Algorithm of Congruent Matching Cells (CMC) Method for Firearm Evidence Identifications.

PubMed

Tong, Mingsi; Song, John; Chu, Wei

2015-01-01

The Congruent Matching Cells (CMC) method was invented at the National Institute of Standards and Technology (NIST) for firearm evidence identifications. The CMC method divides the measured image of a surface area, such as a breech face impression from a fired cartridge case, into small correlation cells and uses four identification parameters to identify correlated cell pairs originating from the same firearm. The CMC method was validated by identification tests using both 3D topography images and optical images captured from breech face impressions of 40 cartridge cases fired from a pistol with 10 consecutively manufactured slides. In this paper, we discuss the processing of the cell correlations and propose an improved algorithm of the CMC method which takes advantage of the cell correlations at a common initial phase angle and combines the forward and backward correlations to improve the identification capability. The improved algorithm is tested by 780 pairwise correlations using the same optical images and 3D topography images as the initial validation.

An Improved Teaching-Learning-Based Optimization with the Social Character of PSO for Global Optimization.

PubMed

Zou, Feng; Chen, Debao; Wang, Jiangtao

2016-01-01

An improved teaching-learning-based optimization with combining of the social character of PSO (TLBO-PSO), which is considering the teacher's behavior influence on the students and the mean grade of the class, is proposed in the paper to find the global solutions of function optimization problems. In this method, the teacher phase of TLBO is modified; the new position of the individual is determined by the old position, the mean position, and the best position of current generation. The method overcomes disadvantage that the evolution of the original TLBO might stop when the mean position of students equals the position of the teacher. To decrease the computation cost of the algorithm, the process of removing the duplicate individual in original TLBO is not adopted in the improved algorithm. Moreover, the probability of local convergence of the improved method is decreased by the mutation operator. The effectiveness of the proposed method is tested on some benchmark functions, and the results are competitive with respect to some other methods.

[Analysis of the stability and adaptability of near infrared spectra qualitative analysis model].

PubMed

Cao, Wu; Li, Wei-jun; Wang, Ping; Zhang, Li-ping

2014-06-01

The stability and adaptability of model of near infrared spectra qualitative analysis were studied. Method of separate modeling can significantly improve the stability and adaptability of model; but its ability of improving adaptability of model is limited. Method of joint modeling can not only improve the adaptability of the model, but also the stability of model, at the same time, compared to separate modeling, the method can shorten the modeling time, reduce the modeling workload; extend the term of validity of model, and improve the modeling efficiency. The experiment of model adaptability shows that, the correct recognition rate of separate modeling method is relatively low, which can not meet the requirements of application, and joint modeling method can reach the correct recognition rate of 90%, and significantly enhances the recognition effect. The experiment of model stability shows that, the identification results of model by joint modeling are better than the model by separate modeling, and has good application value.

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

Tang, Yanmei; Li, Xinli; Bai, Yan

The measurement of multiphase flow parameters is of great importance in a wide range of industries. In the measurement of multiphase, the signals from the sensors are extremely weak and often buried in strong background noise. It is thus desirable to develop effective signal processing techniques that can detect the weak signal from the sensor outputs. In this paper, two methods, i.e., lock-in-amplifier (LIA) and improved Duffing chaotic oscillator are compared to detect and process the weak signal. For sinusoidal signal buried in noise, the correlation detection with sinusoidal reference signal is simulated by using LIA. The improved Duffing chaoticmore » oscillator method, which based on the Wigner transformation, can restore the signal waveform and detect the frequency. Two methods are combined to detect and extract the weak signal. Simulation results show the effectiveness and accuracy of the proposed improved method. The comparative analysis shows that the improved Duffing chaotic oscillator method can restrain noise strongly since it is sensitive to initial conditions.« less

Vertebrate species introductions in the United States and its territories

USGS Publications Warehouse

Witmer, Gary W.; Fuller, Pam L.

2011-01-01

At least 1,065 introduced vertebrate species have been introduced in the United States and its territories, including at least 86 mammalian, 127 avian, 179 reptilian/amphibian, and 673 fish species. Examples in each major taxonomic group include domestic cat, small Indian mongoose, red fox, goat, pig, rabbit, rats, house mouse, gray squirrel, nutria, starling, Indian common myna, red-vented bulbul, brown treesnake, red-eared slider, brown trout, tilapia, and grass carp. We briefly review some of these species and the types of damage they cause. We then review the basic types of methods used for control or eradication of each taxonomic group, including physical, chemical, biological, and cultural methods. We discuss some of the challenges in managing these species, including issues with the use of toxicants, land access, public attitudes, and monitoring difficulties. Finally, we list some ongoing research and future research needs, including improved detection methods, improved attractants, improved barriers, improved capture methods, fertility control, and risk assessment methods.

Accurate reconstruction of viral quasispecies spectra through improved estimation of strain richness

PubMed Central

2015-01-01

Background Estimating the number of different species (richness) in a mixed microbial population has been a main focus in metagenomic research. Existing methods of species richness estimation ride on the assumption that the reads in each assembled contig correspond to only one of the microbial genomes in the population. This assumption and the underlying probabilistic formulations of existing methods are not useful for quasispecies populations where the strains are highly genetically related. The lack of knowledge on the number of different strains in a quasispecies population is observed to hinder the precision of existing Viral Quasispecies Spectrum Reconstruction (QSR) methods due to the uncontrolled reconstruction of a large number of in silico false positives. In this work, we formulated a novel probabilistic method for strain richness estimation specifically targeting viral quasispecies. By using this approach we improved our recently proposed spectrum reconstruction pipeline ViQuaS to achieve higher levels of precision in reconstructed quasispecies spectra without compromising the recall rates. We also discuss how one other existing popular QSR method named ShoRAH can be improved using this new approach. Results On benchmark data sets, our estimation method provided accurate richness estimates (< 0.2 median estimation error) and improved the precision of ViQuaS by 2%-13% and F-score by 1%-9% without compromising the recall rates. We also demonstrate that our estimation method can be used to improve the precision and F-score of ShoRAH by 0%-7% and 0%-5% respectively. Conclusions The proposed probabilistic estimation method can be used to estimate the richness of viral populations with a quasispecies behavior and to improve the accuracy of the quasispecies spectra reconstructed by the existing methods ViQuaS and ShoRAH in the presence of a moderate level of technical sequencing errors. Availability http://sourceforge.net/projects/viquas/ PMID:26678073

Controlled dehydration improves the diffraction quality of two RNA crystals.

PubMed

Park, HaJeung; Tran, Tuan; Lee, Jun Hyuck; Park, Hyun; Disney, Matthew D

2016-11-03

Post-crystallization dehydration methods, applying either vapor diffusion or humidity control devices, have been widely used to improve the diffraction quality of protein crystals. Despite the fact that RNA crystals tend to diffract poorly, there is a dearth of reports on the application of dehydration methods to improve the diffraction quality of RNA crystals. We use dehydration techniques with a Free Mounting System (FMS, a humidity control device) to recover the poor diffraction quality of RNA crystals. These approaches were applied to RNA constructs that model various RNA-mediated repeat expansion disorders. The method we describe herein could serve as a general tool to improve diffraction quality of RNA crystals to facilitate structure determinations.

The efficacy of a continuous quality improvement (CQI) method in a radiological department. Comparison with non-CQI control material.

PubMed

Laurila, J; Standertskjöld-Nordenstam, C G; Suramo, I; Tolppanen, E M; Tervonen, O; Korhola, O; Brommels, M

2001-01-01

To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00-22:00 and a radiographer was moved from the morning shift to 15:00-22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

A Novel Locally Linear KNN Method With Applications to Visual Recognition.

PubMed

Liu, Qingfeng; Liu, Chengjun

2017-09-01

A locally linear K Nearest Neighbor (LLK) method is presented in this paper with applications to robust visual recognition. Specifically, the concept of an ideal representation is first presented, which improves upon the traditional sparse representation in many ways. The objective function based on a host of criteria for sparsity, locality, and reconstruction is then optimized to derive a novel representation, which is an approximation to the ideal representation. The novel representation is further processed by two classifiers, namely, an LLK-based classifier and a locally linear nearest mean-based classifier, for visual recognition. The proposed classifiers are shown to connect to the Bayes decision rule for minimum error. Additional new theoretical analysis is presented, such as the nonnegative constraint, the group regularization, and the computational efficiency of the proposed LLK method. New methods such as a shifted power transformation for improving reliability, a coefficients' truncating method for enhancing generalization, and an improved marginal Fisher analysis method for feature extraction are proposed to further improve visual recognition performance. Extensive experiments are implemented to evaluate the proposed LLK method for robust visual recognition. In particular, eight representative data sets are applied for assessing the performance of the LLK method for various visual recognition applications, such as action recognition, scene recognition, object recognition, and face recognition.

PARTNERING TO IMPROVE HUMAN EXPOSURE METHODS

EPA Science Inventory

Methods development research is an application-driven scientific area that addresses programmatic needs. The goals are to reduce measurement uncertainties, address data gaps, and improve existing analytical procedures for estimating human exposures. Partnerships have been develop...

Improved Design of Tunnel Supports : Executive Summary

DOT National Transportation Integrated Search

1979-12-01

This report focuses on improvement of design methodologies related to the ground-structure interaction in tunneling. The design methods range from simple analytical and empirical methods to sophisticated finite element techniques as well as an evalua...

Improved convolutional coding

NASA Technical Reports Server (NTRS)

Doland, G. D.

1970-01-01

Convolutional coding, used to upgrade digital data transmission under adverse signal conditions, has been improved by a method which ensures data transitions, permitting bit synchronizer operation at lower signal levels. Method also increases decoding ability by removing ambiguous condition.

Investigation of KDP crystal surface based on an improved bidimensional empirical mode decomposition method

NASA Astrophysics Data System (ADS)

Lu, Lei; Yan, Jihong; Chen, Wanqun; An, Shi

2018-03-01

This paper proposed a novel spatial frequency analysis method for the investigation of potassium dihydrogen phosphate (KDP) crystal surface based on an improved bidimensional empirical mode decomposition (BEMD) method. Aiming to eliminate end effects of the BEMD method and improve the intrinsic mode functions (IMFs) for the efficient identification of texture features, a denoising process was embedded in the sifting iteration of BEMD method. With removing redundant information in decomposed sub-components of KDP crystal surface, middle spatial frequencies of the cutting and feeding processes were identified. Comparative study with the power spectral density method, two-dimensional wavelet transform (2D-WT), as well as the traditional BEMD method, demonstrated that the method developed in this paper can efficiently extract texture features and reveal gradient development of KDP crystal surface. Furthermore, the proposed method was a self-adaptive data driven technique without prior knowledge, which overcame shortcomings of the 2D-WT model such as the parameters selection. Additionally, the proposed method was a promising tool for the application of online monitoring and optimal control of precision machining process.

Affine Projection Algorithm with Improved Data-Selective Method Using the Condition Number

NASA Astrophysics Data System (ADS)

Ban, Sung Jun; Lee, Chang Woo; Kim, Sang Woo

Recently, a data-selective method has been proposed to achieve low misalignment in affine projection algorithm (APA) by keeping the condition number of an input data matrix small. We present an improved method, and a complexity reduction algorithm for the APA with the data-selective method. Experimental results show that the proposed algorithm has lower misalignment and a lower condition number for an input data matrix than both the conventional APA and the APA with the previous data-selective method.

Improved numerical methods for turbulent viscous recirculating flows

NASA Technical Reports Server (NTRS)

Turan, A.; Vandoormaal, J. P.

1988-01-01

The performance of discrete methods for the prediction of fluid flows can be enhanced by improving the convergence rate of solvers and by increasing the accuracy of the discrete representation of the equations of motion. This report evaluates the gains in solver performance that are available when various acceleration methods are applied. Various discretizations are also examined and two are recommended because of their accuracy and robustness. Insertion of the improved discretization and solver accelerator into a TEACH mode, that has been widely applied to combustor flows, illustrates the substantial gains to be achieved.

Implementation of an improved adaptive-implicit method in a thermal compositional simulator

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

Tan, T.B.

1988-11-01

A multicomponent thermal simulator with an adaptive-implicit-method (AIM) formulation/inexact-adaptive-Newton (IAN) method is presented. The final coefficient matrix retains the original banded structure so that conventional iterative methods can be used. Various methods for selection of the eliminated unknowns are tested. AIM/IAN method has a lower work count per Newtonian iteration than fully implicit methods, but a wrong choice of unknowns will result in excessive Newtonian iterations. For the problems tested, the residual-error method described in the paper for selecting implicit unknowns, together with the IAN method, had an improvement of up to 28% of the CPU time over the fullymore » implicit method.« less

Improved bacterial identification directly from urine samples with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

PubMed

Kitagawa, Koichi; Shigemura, Katsumi; Onuma, Ken-Ichiro; Nishida, Masako; Fujiwara, Mayu; Kobayashi, Saori; Yamasaki, Mika; Nakamura, Tatsuya; Yamamichi, Fukashi; Shirakawa, Toshiro; Tokimatsu, Issei; Fujisawa, Masato

2018-03-01

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) contributes to rapid identification of pathogens in the clinic but has not yet performed especially well for Gram-positive cocci (GPC) causing complicated urinary tract infection (UTI). The goal of this study was to investigate the possible clinical use of MALDI-TOF MS as a rapid method for bacterial identification directly from urine in complicated UTI. MALDI-TOF MS was applied to urine samples gathered from 142 suspected complicated UTI patients in 2015-2017. We modified the standard procedure (Method 1) for sample preparation by adding an initial 10 minutes of ultrasonication followed by centrifugation at 500 g for 1 minutes to remove debris such as epithelial cells and leukocytes from the urine (Method 2). In 133 urine culture-positive bacteria, the rate of corresponded with urine culture in GPC by MALDI-TOF MS in urine with standard sample preparation (Method 1) was 16.7%, but the modified sample preparation (Method 2) significantly improved that rate to 52.2% (P=.045). Method 2 also improved the identification accuracy for Gram-negative rods (GNR) from 77.1% to 94.2% (P=.022). The modified Method 2 significantly improved the average MALDI score from 1.408±0.153 to 2.166±0.045 (P=.000) for GPC and slightly improved the score from 2.107±0.061 to 2.164±0.037 for GNR. The modified sample preparation for MALDI-TOF MS can improve identification accuracy for complicated UTI causative bacteria. This simple modification offers a rapid and accurate routine diagnosis for UTI, and may possibly be a substitute for urine cultures. © 2017 Wiley Periodicals, Inc.

Comparison of two thermal-optical methods for the determination of organic carbon and elemental carbon: Results from the southeastern United States

NASA Astrophysics Data System (ADS)

Cheng, Yuan; Zheng, Mei; He, Ke-bin; Chen, Yingjun; Yan, Bo; Russell, Armistead G.; Shi, Wenyan; Jiao, Zheng; Sheng, Guoying; Fu, Jiamo; Edgerton, Eric S.

2011-02-01

A total of 333 PM 2.5 samples were collected at four sites in the southeastern Aerosol Research and Characterization Study (SEARCH) network during four seasons from 2003 to 2005 and were simultaneously analyzed by two common thermal-optical methods, the National Institute of Occupational Safety and Health (NIOSH) method and the Interagency Monitoring of Protected Visual Environments (IMPROVE) method. The concentrations of total carbon measured by the two methods were comparable, whereas the split of organic carbon (OC) and elemental carbon (EC) was significantly different. The NIOSH-defined EC was lower (up to 80%) than that defined by IMPROVE since the NIOSH method applied the transmittance charring correction and a much higher peak inert mode temperature. The discrepancy between NIOSH- and IMPROVE-defined EC showed distinct seasonal and spatial variations. Potential factors contributing to this discrepancy besides the analytical method were investigated. The discrepancy between NIOSH- and IMPROVE-defined EC was larger in the spring compared to winter due to the influence of biomass burning, which is known to emit significant amount of brown carbon that would complicate the split of OC and EC. The NIOSH-defined EC to IMPROVE-defined EC ratio reached its minimum (0.2-0.5) in the summer, when the largest discrepancy was observed. This was most likely to be attributed to the influence of secondary organic aerosol (SOA). Moreover, the discrepancy between NIOSH- and IMPROVE-defined EC was larger in the coastal and the rural sites where the presence of abundant SOA was found based on previous studies in this region, providing supporting evidence that SOA could contribute to the observed discrepancy in summer.

Directed evolution methods for improving polypeptide folding and solubility and superfolder fluorescent proteins generated thereby

DOEpatents

Waldo, Geoffrey S.

2007-09-18

The current invention provides methods of improving folding of polypeptides using a poorly folding domain as a component of a fusion protein comprising the poorly folding domain and a polypeptide of interest to be improved. The invention also provides novel green fluorescent proteins (GFPs) and red fluorescent proteins that have enhanced folding properties.

Improving Schools through Collaboration: A Mixed Methods Study of School-to-School Partnerships in the Primary Sector

ERIC Educational Resources Information Center

Muijs, Daniel

2015-01-01

The principle of schools collaborating to improve is one that has seen growing interest in recent years, and there is emerging evidence that in particular collaboration between high and lower performing schools can be an effective school improvement method. However, this evidence relates primarily to secondary schools, and little research has been…

A Mixed-Methods Study of the Transformation Model for Rapid Improvement of Low Achieving Rural Schools

ERIC Educational Resources Information Center

Atkinson Duina, Angela

2013-01-01

New regulations attached to ARRA funding of federal School Improvement Fund grants aimed at producing rapid turnaround of low performing schools were highly criticized as unsuitable for rural schools. This mixed-methods study looked at the implementation of the School Improvement Fund Transformation Model in two rural Maine high schools during the…

Integrating Multiple Criteria in Selection Procedures for Improving Student Quality and Reducing Cost Per Graduate. AIR Forum 1979 Paper.

ERIC Educational Resources Information Center

Jones, Gerald L.; Westen, Risdon J.

The multivariate approach of canonical correlation was used to assess selection procedures of the Air Force Academy. It was felt that improved student selection methods might reduce the number of dropouts while maintaining or improving the quality of graduates. The method of canonical correlation was designed to maximize prediction of academic…

Combined electrophoresis-electrospray interface and method

DOEpatents

Smith, Richard D.; Udseth, Harold R.; Barinaga, Charles J.

1995-01-01

An improvement to the system and method for analyzing molecular constituents of a composition sample that comprises improvements to an electrospray ionization source for interfacing to mass spectrometers and other detection devices. The improvement consists of establishing a unique electrical circuit pattern and nozzle configuration, a metallic coated and conical shaped capillary outlet, coupled with sizing of the capillary to obtain maximum sensitivity.