Study on Mine Emergency Mechanism based on TARP and ICS

NASA Astrophysics Data System (ADS)

Xi, Jian; Wu, Zongzhi

2018-01-01

By analyzing the experiences and practices of mine emergency in China and abroad, especially the United States and Australia, normative principle, risk management principle and adaptability principle of constructing mine emergency mechanism based on Trigger Action Response Plans (TARP) and Incident Command System (ICS) are summarized. Classification method, framework, flow and subject of TARP and ICS which are suitable for the actual situation of domestic mine emergency are proposed. The system dynamics model of TARP and ICS is established. The parameters such as evacuation ratio, response rate, per capita emergency capability and entry rate of rescuers are set up. By simulating the operation process of TARP and ICS, the impact of these parameters on the emergency process are analyzed, which could provide a reference and basis for building emergency capacity, formulating emergency plans and setting up action plans in the emergency process.

Enabling science support for better decision-making when responding to chemical spills

USGS Publications Warehouse

Weidhass, Jennifer L.; Dietrich, Andrea M.; DeYonker, Nathan J.; Dupont, R. Ryan; Foreman, William T.; Gallagher, Daniel; Gallagher, Jennifer E. G.; Whelton, Andrew J.; Alexander, William

2016-01-01

Chemical spills and accidents contaminate the environment and disrupt societies and economies around the globe. In the United States there were approximately 172,000 chemical spills that affected US waterbodies from 2004 to 2014. More than 8000 of these spills involved non–petroleum-related chemicals. Traditional emergency responses or incident command structures (ICSs) that respond to chemical spills require coordinated efforts by predominantly government personnel from multiple disciplines, including disaster management, public health, and environmental protection. However, the requirements of emergency response teams for science support might not be met within the traditional ICS. We describe the US ICS as an example of emergency-response approaches to chemical spills and provide examples in which external scientific support from research personnel benefitted the ICS emergency response, focusing primarily on nonpetroleum chemical spills. We then propose immediate, near-term, and long-term activities to support the response to chemical spills, focusing on nonpetroleum chemical spills. Further, we call for science support for spill prevention and near-term spill-incident response and identify longer-term research needs. The development of a formal mechanism for external science support of ICS from governmental and nongovernmental scientists would benefit rapid responders, advance incident- and crisis-response science, and aid society in coping with and recovering from chemical spills.

Literature review on medical incident command.

PubMed

Rimstad, Rune; Braut, Geir Sverre

2015-04-01

It is not known what constitutes the optimal emergency management system, nor is there a consensus on how effectiveness and efficiency in emergency response should be measured or evaluated. Literature on the role and tasks of commanders in the prehospital emergency services in the setting of mass-casualty incidents has not been summarized and published. This comprehensive literature review addresses some of the needs for future research in emergency management through three research questions: (1) What are the basic assumptions underlying incident command systems (ICSs)? (2) What are the tasks of ambulance and medical commanders in the field? And (3) How can field commanders' performances be measured and assessed? A systematic literature search in MEDLINE, PubMed, PsycINFO, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, ISI Web of Science, Scopus, International Security & Counter Terrorism Reference Center, Current Controlled Trials, and PROSPERO covering January 1, 1990 through March 1, 2014 was conducted. Reference lists of included literature were hand searched. Included papers were analyzed using Framework synthesis. The literature search identified 6,049 unique records, of which, 76 articles and books where included in qualitative synthesis. Most ICSs are described commonly as hierarchical, bureaucratic, and based on military principles. These assumptions are contested strongly, as is the applicability of such systems. Linking of the chains of command in cooperating agencies is a basic difficulty. Incident command systems are flexible in the sense that the organization may be expanded as needed. Commanders may command by direction, by planning, or by influence. Commanders' tasks may be summarized as: conducting scene assessment, developing an action plan, distributing resources, monitoring operations, and making decisions. There is considerable variation between authors in nomenclature and what tasks are included or highlighted. There are no widely acknowledged measurement tools of commanders' performances, though several performance indicators have been suggested. The competence and experience of the commanders, upon which an efficient ICS has to rely, cannot be compensated significantly by plans and procedures, or even by guidance from superior organizational elements such as coordination centers. This study finds that neither a certain system or structure, or a specific set of plans, are better than others, nor can it conclude what system prerequisites are necessary or sufficient for efficient incident management. Commanders need to be sure about their authority, responsibility, and the functional demands posed upon them.

Managing multiple-casualty incidents: a rural medical preparedness training assessment.

PubMed

Glow, Steven D; Colucci, Vincent J; Allington, Douglas R; Noonan, Curtis W; Hall, Earl C

2013-08-01

The objectives of this study were to develop a novel training model for using mass-casualty incident (MCI) scenarios that trained hospital and prehospital staff together using Microsoft Visio, images from Google Earth and icons representing first responders, equipment resources, local hospital emergency department bed capacity, and trauma victims. The authors also tested participants' knowledge in the areas of communications, incident command systems (ICS), and triage. Participants attended Managing Multiple-Casualty Incidents (MCIs), a one-day training which offered pre- and post-tests, two one-hour functional exercises, and four distinct, one-hour didactic instructional periods. Two MCI functional exercises were conducted. The one-hour trainings focused on communications, National Incident Management Systems/Incident Command Systems (NIMS/ICS) and professional roles and responsibilities in NIMS and triage. The trainings were offered throughout communities in western Montana. First response resource inventories and general manpower statistics for fire, police, Emergency Medical Services (EMS), and emergency department hospital bed capacity were determined prior to MCI scenario construction. A test was given prior to and after the training activities. A total of 175 firefighters, EMS, law enforcement, hospital personnel or other first-responders completed the pre- and post-test. Firefighters produced higher baseline scores than all other disciplines during pre-test analysis. At the end of the training all disciplines demonstrated significantly higher scores on the post-test when compared with their respective baseline averages. Improvements in post-test scores were noted for participants from all disciplines and in all didactic areas: communications, NIMS/ICS, and triage. Mass-casualty incidents offer significant challenges for prehospital and emergency room workers. Fire, Police and EMS personnel must secure the scene, establish communications, define individuals' roles and responsibilities, allocate resources, triage patients, and assign transport priorities. After emergency department notification and in advance of arrival, emergency department personnel must assess available physical resources and availability and type of manpower, all while managing patients already under their care. Mass-casualty incident trainings should strengthen the key, individual elements essential to well-coordinated response such as communications, incident management system and triage. The practice scenarios should be matched to the specific resources of the community. The authors also believe that these trainings should be provided with all disciplines represented to eliminate training "silos," to allow for discussion of overlapping jurisdictional or organizational responsibilities, and to facilitate team building.

Developing a Decision Support System for Flood Response: NIMS/ICS Fundamentals

NASA Astrophysics Data System (ADS)

Gutenson, J. L.; Zhang, X.; Ernest, A. N. S.; Oubeidillah, A.; Zhu, L.

2015-12-01

Effective response to regional disasters such as floods requires a multipronged, non-linear approach to reduce loss of life, property and harm to the environment. These coordinated response actions are typically undertaken by multiple jurisdictions, levels of government, functional agencies and other responsible entities. A successful response is highly dependent on the effectiveness and efficiency of each coordinated response action undertaken across a broad spectrum of organizations and activities. In order to provide a unified framework for those responding to incidents or planned events, FEMA provides a common and flexible approach for managing incidents, regardless of cause, size, location or complexity, referred to as the National Incident Management System (NIMS). Integral to NIMS is the Incident Command System (ICS), which establishes a common, pre-defined organizational structure to ensure coordination and management of procedures, resources and communications, for efficient incident management. While being both efficient and rigorous, NIMS, and ICS to a lesser extent, is an inherently complex framework that requires significant amount of training for planners, responders and managers to master, especially considering the wide array of incident types that Local Emergency Planning Committees (LEPCs) must be prepared to respond to. The existing Water-Wizard Decision Support System (DSS), developed to support water distribution system recovery operations for Decontamination (Decon), Operational Optimization (WDS), and Economic Consequence Assessment (Econ), is being evolved to integrate incident response functions. Water-Wizard runs on both mobile and desktop devices, and is being extended to utilize smartphone and mobile device specific data streams (e.g GPS location) to augment its fact-base in real-time for situational-aware DSS recommendations. In addition, the structured NIMS and ICS frameworks for incident management and response are being incorporated into the Water-Wizard knowledgebase, with a mid-term goal of integrating flood-specific emergency response domain knowledge to provide a real-time flood responder decision support.

Developing Collaboration in Complex Events: A Model for Civil-Military Inter-Organizational Problem-Solving and Decision-Making

DTIC Science & Technology

2011-06-01

2009, p.2). Given the wide adoption of principles and structures associated with the Incident Command System (ICS) in emergency management , it was...relationships in disaster response but also the factors that might lead to a more effective response and management . The cases were analysed...team was guided by the following considerations: 1. Use of an extended timeline – The model was conceptualized within a risk management paradigm in

Addressing the gap between public health emergency planning and incident response

PubMed Central

Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

2013-01-01

Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response. PMID:28228983

Standardized emergency management system and response to a smallpox emergency.

PubMed

Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

2003-01-01

The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring costs related to the smallpox emergency, procurement, and administrative aspects that are not handled by other functional divisions of incident command systems. The plan was developed and is under frequent review by the LAC-DHS Smallpox Planning Working Group, and is reviewed periodically by the LAC Bioterrorism Advisory Committee, and draws upon the Smallpox Response Plan and Guidelines of the Centers for Disease Control and Prevention (CDC) and recommendations of the Advisory Committee on Immunization Practices (ACIP). The Smallpox Preparedness, Response, and Recovery Plan, with its SEMS framework and ICS structure, now is serving as a model for the development of LAC-DHS plans for responses to other terrorist or natural-outbreak responses.

Occupational Safety and Health System for Workers Engaged in Emergency Response Operations in the USA.

PubMed

Toyoda, Hiroyuki; Kubo, Tatsuhiko; Mori, Koji

2016-12-03

To study the occupational safety and health systems used for emergency response workers in the USA, we performed interviews with related federal agencies and conducted research on related studies. We visited the Federal Emergency Management Agency (FEMA) and National Institute for Occupational Safety and Health (NIOSH) in the USA and performed interviews with their managers on the agencies' roles in the national emergency response system. We also obtained information prepared for our visit from the USA's Occupational Safety and Health Administration (OSHA). In addition, we conducted research on related studies and information on the website of the agencies. We found that the USA had an established emergency response system based on their National Incident Management System (NIMS). This enabled several organizations to respond to emergencies cooperatively using a National Response Framework (NRF) that clarifies the roles and cooperative functions of each federal agency. The core system in NIMS was the Incident Command System (ICS), within which a Safety Officer was positioned as one of the command staff supporting the commander. All ICS staff were required to complete a training program specific to their position; in addition, the Safety Officer was required to have experience. The All-Hazards model was commonly used in the emergency response system. We found that FEMA coordinated support functions, and OSHA and NIOSH, which had specific functions to protect workers, worked cooperatively under NRF. These agencies employed certified industrial hygienists that play a professional role in safety and health. NIOSH recently executed support activities during disasters and other emergencies. The USA's emergency response system is characterized by functions that protect the lives and health of emergency response workers. Trained and experienced human resources support system effectiveness. The findings provided valuable information that could be used to improve the occupational safety and health function in the Japanese system.

On a Clear Day, You Can See ICS: The Dying Art of Incident Command and the Normal Accident of NIMS - A Policy Analysis

DTIC Science & Technology

2013-03-01

response in an effort to determine “What can be done better next time?” and “How do we prevent this from happening again?” One basic expectation that...effort to determine “What can be done better next time?” and “How do we prevent this from happening again?” One basic expectation that citizens have of...to determine “What can be done better next time?” and “How do we prevent this from happening again?” After the tragic events of September, 11, 2001

Temperature and Concentration Profiles in Hydrogen-Nitrous Oxide Flames.

DTIC Science & Technology

1986-07-01

SECumvY CLASSIFICATION CF TIS PAGOE(hn Date. 3.,OCO 20. Abstract (Cont’d): est for flame modeler UNCLASSIFIED * SECURITY CL ASSIrIC ATION Or THIS P...Commander Naval Surface Weapons Center Commander ATTN: R. Bernecker, R-13 US Army Tank Automotive G.B. Wilmot , R-16 Command Silver Spring, MD 20902

Instrument Control (iC) – An Open-Source Software to Automate Test Equipment

PubMed Central

Pernstich, K. P.

2012-01-01

It has become common practice to automate data acquisition from programmable instrumentation, and a range of different software solutions fulfill this task. Many routine measurements require sequential processing of certain tasks, for instance to adjust the temperature of a sample stage, take a measurement, and repeat that cycle for other temperatures. This paper introduces an open-source Java program that processes a series of text-based commands that define the measurement sequence. These commands are in an intuitive format which provides great flexibility and allows quick and easy adaptation to various measurement needs. For each of these commands, the iC-framework calls a corresponding Java method that addresses the specified instrument to perform the desired task. The functionality of iC can be extended with minimal programming effort in Java or Python, and new measurement equipment can be addressed by defining new commands in a text file without any programming. PMID:26900522

Instrument Control (iC) - An Open-Source Software to Automate Test Equipment.

PubMed

Pernstich, K P

2012-01-01

It has become common practice to automate data acquisition from programmable instrumentation, and a range of different software solutions fulfill this task. Many routine measurements require sequential processing of certain tasks, for instance to adjust the temperature of a sample stage, take a measurement, and repeat that cycle for other temperatures. This paper introduces an open-source Java program that processes a series of text-based commands that define the measurement sequence. These commands are in an intuitive format which provides great flexibility and allows quick and easy adaptation to various measurement needs. For each of these commands, the iC-framework calls a corresponding Java method that addresses the specified instrument to perform the desired task. The functionality of iC can be extended with minimal programming effort in Java or Python, and new measurement equipment can be addressed by defining new commands in a text file without any programming.

Intracranial suppuration: Review of an 8-year experience at Umtata General Hospital and Nelson Mandela Academic Hospital, Eastern Cape, South Africa.

PubMed

Anwary, M A

2015-09-21

Intracranial suppuration (ICS) is a life-threatening condition caused by various disease processes and consisting of brain abscess and extradural and subdural empyema. The major causes have changed over the decades. To the author's knowledge, the incidence of ICS in South Africa (SA) has not been established. To determine the incidence of ICS, overall and according to age and gender, and to identify the source and distribution of ICS. The archive of the radiology departments at Umtata General Hospital and Nelson Mandela Academic Hospital in the Transkei region, Eastern Cape Province, SA, was searched retrospectively for computed tomography (CT) reports of patients diagnosed with ICS. Cases in which the CT images, patients' clinical information and CT reports were available for an uninterrupted period of at least 1 year were included. Five time frames were established, encompassing 8 years of data. The first time frame established an incidence of ICS of 1/100,000/year for the Transkei region. All the time frames were utilised to determine the incidence according to gender and age, and the source and distribution of ICS. The incidence of ICS was higher among males than females, and highest in the age groups 0-10 and 11-20 years. A seasonal variation in the incidence of sinusitis- and meningitis-related ICS was noted. Numbers of cases declined during the last 3 years of the study period. Sinusitis, head trauma, ear infection and meningitis were the major sources of ICS. A pulmonary source was not a major feature. In the last 4 years, trauma became the commonest source of ICS. A steady decline in ear infection- and meningitis-related ICS was noted.

A packet switched communications system for GRO

NASA Astrophysics Data System (ADS)

Husain, Shabu; Yang, Wen-Hsing; Vadlamudi, Rani; Valenti, Joseph

1993-11-01

This paper describes the packet switched Instrumenters Communication System (ICS) that was developed for the Command Management Facility at GSFC to support the Gamma Ray Observatory (GRO) spacecraft. The GRO ICS serves as a vital science data acquisition link to the GRO scientists to initiate commands for their spacecraft instruments. The system is ready to send and receive messages at any time, 24 hours a day and seven days a week. The system is based on X.25 and the International Standard Organization's (ISO) 7-layer Open Systems Interconnection (OSI) protocol model and has client and server components. The components of the GRO ICS are discussed along with how the Communications Subsystem for Interconnection (CSFI) and Network Control Program Packet Switching Interface (NPSI) software are used in the system.

A novel onset detection technique for brain-computer interfaces using sound-production related cognitive tasks in simulated-online system

NASA Astrophysics Data System (ADS)

Song, YoungJae; Sepulveda, Francisco

2017-02-01

Objective. Self-paced EEG-based BCIs (SP-BCIs) have traditionally been avoided due to two sources of uncertainty: (1) precisely when an intentional command is sent by the brain, i.e., the command onset detection problem, and (2) how different the intentional command is when compared to non-specific (or idle) states. Performance evaluation is also a problem and there are no suitable standard metrics available. In this paper we attempted to tackle these issues. Approach. Self-paced covert sound-production cognitive tasks (i.e., high pitch and siren-like sounds) were used to distinguish between intentional commands (IC) and idle states. The IC states were chosen for their ease of execution and negligible overlap with common cognitive states. Band power and a digital wavelet transform were used for feature extraction, and the Davies-Bouldin index was used for feature selection. Classification was performed using linear discriminant analysis. Main results. Performance was evaluated under offline and simulated-online conditions. For the latter, a performance score called true-false-positive (TFP) rate, ranging from 0 (poor) to 100 (perfect), was created to take into account both classification performance and onset timing errors. Averaging the results from the best performing IC task for all seven participants, an 77.7% true-positive (TP) rate was achieved in offline testing. For simulated-online analysis the best IC average TFP score was 76.67% (87.61% TP rate, 4.05% false-positive rate). Significance. Results were promising when compared to previous IC onset detection studies using motor imagery, in which best TP rates were reported as 72.0% and 79.7%, and which, crucially, did not take timing errors into account. Moreover, based on our literature review, there is no previous covert sound-production onset detection system for spBCIs. Results showed that the proposed onset detection technique and TFP performance metric have good potential for use in SP-BCIs.

Apollo spacecraft Command/Service Module and Lunar Module 3 arrive at VAB

NASA Image and Video Library

1968-12-03

Apollo Spacecraft 104 Command/Service Module and Lunar Module 3 arrive at the Vehicle Assembly Building (VAB) for mating atop the Saturn 504 launch vehicle. The Saturn 504 stack is out of view. The Saturn V first (S-IC) stage in left background is scheduled for a later flight.

Parental intermittent claudication as risk factor for claudication in adults.

PubMed

Prushik, Scott G; Farber, Alik; Gona, Philimon; Shrader, Peter; Pencina, Michael J; D'Agostino, Ralph B; Murabito, Joanne M

2012-03-01

Little is known about the familial aggregation of intermittent claudication (IC). Our objective was to examine whether parental IC increased the risk of IC in adult offspring, independent of the established cardiovascular risk factors. We evaluated the Offspring Cohort Participants of the Framingham Heart Study who were ≥30 years old, cardiovascular disease free, and had both parents enrolled in the Framingham Heart Study (n = 2,970 unique participants, 53% women). Pooled proportional hazards regression analysis was used to examine whether the 12-year risk of incident IC in offspring participants was associated with parental IC, adjusting for age, gender, diabetes, smoking, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and antihypertensive and lipid treatment. Of the 909 person-examinations in the parental IC history group and 5,397 person-examinations in the no-parental IC history group, there were 101 incident IC events (29 with parental IC history and 72 without a parental IC history) during follow-up. The age- and gender-adjusted 12-year cumulative incidence rate per 1,000 person-years was 5.08 (95% confidence interval [CI] 2.74 to 7.33) and 2.34 (95% CI 1.46 to 3.19) in participants with and without a parental IC history. A parental history of IC significantly increased the risk of incident IC in the offspring (multivariable adjusted hazard ratio 1.81, 95% CI 1.14 to 2.88). The hazard ratio was unchanged, with an adjustment for the occurrence of cardiovascular disease (hazard ratio 1.83, 95% CI 1.15 to 2.91). In conclusion, IC in parents increases the risk of IC in adult offspring, independent of the established risk factors. These data suggest a genetic component of peripheral artery disease and support future research into genetic causes. Copyright © 2012 Elsevier Inc. All rights reserved.

Evaluation of a noninvasive command scheme for upper-limb prostheses in a virtual reality reach and grasp task.

PubMed

Kaliki, Rahul R; Davoodi, Rahman; Loeb, Gerald E

2013-03-01

C5/C6 tetraplegic patients and transhumeral amputees may be able to use voluntary shoulder motion as command signals for a functional electrical stimulation system or transhumeral prosthesis. Stereotyped relationships, termed "postural synergies," among the shoulder, forearm, and wrist joints emerge during goal-oriented reaching and transport movements as performed by able-bodied subjects. Thus, the posture of the shoulder can potentially be used to infer the desired posture of the elbow and forearm joints during reaching and transporting movements. We investigated how well able-bodied subjects could learn to use a noninvasive command scheme based on inferences from these postural synergies to control a simulated transhumeral prosthesis in a virtual reality task. We compared the performance of subjects using the inferential command scheme (ICS) with subjects operating the simulated prosthesis in virtual reality according to complete motion tracking of their actual arm and hand movements. Initially, subjects performed poorly with the ICS but improved rapidly with modest amounts of practice, eventually achieving performance only slightly less than subjects using complete motion tracking. Thus, inferring the desired movement of distal joints from voluntary shoulder movements appears to be an intuitive and noninvasive approach for obtaining command signals for prostheses to restore reaching and grasping functions.

Book Analysis: Command and Control of Theater Forces: Adequacy,

DTIC Science & Technology

1988-04-01

COPN R OTIC 11 AIR COMMAND AND STAFF COLLEGE STUDENT REPORT BOOK ANALYSIS: COMMA1ND AND CONTROL OF THEATER FORCES: ADEQUACY1 MA~JOR JOHN J. WRIGHT 88...brIc rNT- PA-- DTIC TAS L DIstrbA(-c & %W1.~b~ ~ Vii D~ , _ _ _ ABOUT THE AUTHOR The author is currently a student at the Air Command and Staff...College, Maxwell AFB AL. A 1973 ROTC graduate from Allegheny College, he attended undergraduate pilot training at Reese AFB TX. From 1975-1980, he was a

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

Shah, Kedar G.; Pannu, Satinderpall S.

An integrated circuit system having an integrated circuit (IC) component which is able to have its functionality destroyed upon receiving a command signal. The system may involve a substrate with the IC component being supported on the substrate. A module may be disposed in proximity to the IC component. The module may have a cavity and a dissolving compound in a solid form disposed in the cavity. A heater component may be configured to heat the dissolving compound to a point of sublimation where the dissolving compound changes from a solid to a gaseous dissolving compound. A triggering mechanism maymore » be used for initiating a dissolution process whereby the gaseous dissolving compound is allowed to attack the IC component and destroy a functionality of the IC component.« less

Incidence and clinical characteristics of interstitial cystitis in the community.

PubMed

Patel, Ronak; Calhoun, Elizabeth A; Meenan, Richard T; O'Keeffe Rosetti, Maureen C; Kimes, Terry; Clemens, J Quentin

2008-08-01

We utilized physician-coded diagnoses and chart reviews to estimate the incidence of interstitial cystitis (IC) in women. A computer search of the Kaiser Permanente database was performed to identify newly coded diagnoses of IC (ICD-9 code 595.1) between May 2002 and May 2005. Chart reviews were performed and patient demographics, diagnosing physicians, and symptom characteristics were recorded. The IC incidence rate was 15 per 100,000 women per year. The mean age of the patients was 51 years (range 31-81 years). The most common presenting symptoms were frequency (70%), dysuria (52%), urgency (50%), suprapubic pain (50%), nocturia (35%), and dyspareunia (13%). Cases diagnosed by primary care physicians had a shorter median symptom duration (9 months) compared with those diagnosed by urologists (1 year) and gynecologists (3 years). IC is an uncommon diagnosis in the community setting, with an incidence rate of 15 per 100,000 women per year.

Applications of instructional design theory to lesson planning for Superfund incident commander training

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

Mansfield, N.J.

1992-01-01

The increasing number of hazardous materials accidents in the United States has resulted in new federal regulations addressing the emergency response activities associated with chemical releases. A significant part of these new federal standards (29 CFR 1910.120 and 40 CFR Part 311) requires compliance with specific criteria by all personnel involved in a hazardous material emergency. This study investigated alternative lesson design models applicable to instruction for hazardous material emergencies. A specialized design checklist was created based on the work of Gagne, Briggs, and Wager (1988), Merrill (1987), and Clark (1989). This checklist was used in the development of lessonmore » plan templates for the hazardous materials incident commander course. Qualitative data for establishing learning objectives was collected by conducting a needs assessment and a job analysis of the incident commander position. Incident commanders from 14 public and private organizations participated in the needs assessment process. Technical information for the lessons was collected from appropriate governmental agencies. The implementation of the checklist and lesson plans can contribute to assuring quality training for incident commanders throughout the United States.« less

Implementation of a medical command and control team in Switzerland.

PubMed

Carron, Pierre-Nicolas; Reigner, Philippe; Vallotton, Laurent; Clouet, Jean-Gabriel; Danzeisen, Claude; Zürcher, Mathias; Yersin, Bertrand

2014-04-01

In case of a major incident or disaster, the advance medical rescue command needs to manage several essential tasks simultaneously. These include the rapid deployment of ambulance, police, fire and evacuation services, and their coordinated activity, as well as triage and emergency medical care on site. The structure of such a medical rescue command is crucial for the successful outcome of medical evacuation at major incidents. However, little data has been published on the nature and structure of the command itself. This study presents a flexible approach to command structure, with two command heads: one emergency physician and one experienced paramedic. This approach is especially suitable for Switzerland, whose federal system allows for different structures in each canton. This article examines the development of these structures and their efficiency, adaptability and limitations with respect to major incident response in the French-speaking part of the country. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Evaluation of medical command and control using performance indicators in a full-scale, major aircraft accident exercise.

PubMed

Gryth, Dan; Rådestad, Monica; Nilsson, Heléne; Nerf, Ola; Svensson, Leif; Castrén, Maaret; Rüter, Anders

2010-01-01

Large, functional, disaster exercises are expensive to plan and execute, and often are difficult to evaluate objectively. Command and control in disaster medicine organizations can benefit from objective results from disaster exercises to identify areas that must be improved. The objective of this pilot study was to examine if it is possible to use performance indicators for documentation and evaluation of medical command and control in a full-scale major incident exercise at two levels: (1) local level (scene of the incident and hospital); and (2) strategic level of command and control. Staff procedure skills also were evaluated. Trained observers were placed in each of the three command and control locations. These observers recorded and scored the performance of command and control using templates of performance indicators. The observers scored the level of performance by awarding 2, 1, or 0 points according to the template and evaluated content and timing of decisions. Results from 11 performance indicators were recorded at each template and scores greater than 11 were considered as acceptable. Prehospital command and control had the lowest score. This also was expressed by problems at the scene of the incident. The scores in management and staff skills were at the strategic level 15 and 17, respectively; and at the hospital level, 17 and 21, respectively. It is possible to use performance indicators in a full-scale, major incident exercise for evaluation of medical command and control. The results could be used to compare similar exercises and evaluate real incidents in the future.

A prototype forensic toolkit for industrial-control-systems incident response

NASA Astrophysics Data System (ADS)

Carr, Nickolas B.; Rowe, Neil C.

2015-05-01

Industrial control systems (ICSs) are an important part of critical infrastructure in cyberspace. They are especially vulnerable to cyber-attacks because of their legacy hardware and software and the difficulty of changing it. We first survey the history of intrusions into ICSs, the more serious of which involved a continuing adversary presence on an ICS network. We discuss some common vulnerabilities and the categories of possible attacks, noting the frequent use of software written a long time ago. We propose a framework for designing ICS incident response under the constraints that no new software must be required and that interventions cannot impede the continuous processing that is the norm for such systems. We then discuss a prototype toolkit we built using the Windows Management Instrumentation Command-Line tool for host-based analysis and the Bro intrusion-detection software for network-based analysis. Particularly useful techniques we used were learning the historical range of parameters of numeric quantities so as to recognize anomalies, learning the usual addresses of connections to a node, observing Internet addresses (usually rare), observing anomalous network protocols such as unencrypted data transfers, observing unusual scheduled tasks, and comparing key files through registry entries and hash values to find malicious modifications. We tested our methods on actual data from ICSs including publicly-available data, voluntarily-submitted data, and researcher-provided "advanced persistent threat" data. We found instances of interesting behavior in our experiments. Intrusions were generally easy to see because of the repetitive nature of most processing on ICSs, but operators need to be motivated to look.

Situational Awareness During Mass-Casualty Events: Command and Control

PubMed Central

Demchak, Barry; Chan, Theordore C.; Griswold, William G.; Lenert, Leslie

2006-01-01

In existing Incident Command systems1, situational awareness is achieved manually through paper tracking systems. Such systems often produce high latencies and incomplete data, resulting in inefficient and ineffective resource deployment. The WIISARD2 system collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to Incident Commanders. The WIISARD Command Center solves the problem of data overload and uncertainty through the careful use of limited screen area and novel visualization techniques. PMID:17238524

A day in the life of a volunteer incident commander: errors, pressures and mitigating strategies.

PubMed

Bearman, Christopher; Bremner, Peter A

2013-05-01

To meet an identified gap in the literature this paper investigates the tasks that a volunteer incident commander needs to carry out during an incident, the errors that can be made and the way that errors are managed. In addition, pressure from goal seduction and situation aversion were also examined. Volunteer incident commanders participated in a two-part interview consisting of a critical decision method interview and discussions about a hierarchical task analysis constructed by the authors. A SHERPA analysis was conducted to further identify potential errors. The results identified the key tasks, errors with extreme risk, pressures from strong situations and mitigating strategies for errors and pressures. The errors and pressures provide a basic set of issues that need to be managed by both volunteer incident commanders and fire agencies. The mitigating strategies identified here suggest some ways that this can be done. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

NHD, riverspill, and the development of the incident command tool for drinking water protection.

Treesearch

William B. Samuels; Rakesh Bahadur; Michael C. Monteith; David E. Amstutz; Jonathan M. Pickus; Katherine Parker; Douglas Ryan

2006-01-01

This project involved the development of an information tool that gives Incident Commanders the critical information they need to make informed decisions regarding the consequences of threats to public water supply intakes.

75 FR 49482 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

... replace with ``Incident Report Records.'' System location: Delete entry and replace with ``Command Support... may be accessed only by the Commander, Deputy Commander, Chief, Command Support Division, or other... and replace with ``Command Support Division, EU1, Defense Information Systems Agency-Europe, APO AE...

Implementing the incident command system in the healthcare setting.

PubMed

Huser, T J

The author discusses a new requirement in NFPA 99 for healthcare facilities--the implementation of an Incident Command System in the event of a disaster. He offers suggestions on how facilities can change their disaster plans to meet this new standard.

Logistics and Maintenance Concepts for a Future Naval Force

DTIC Science & Technology

2001-12-01

Co - opetition . Currency-Doubleday. Retrieved December 10, 2001 from...Navigation CND Can Not Duplicate CO Commanding Officer COMNAVAIRLANT Commander Naval Forces Atlantic COSAL Consolidated Ship Allowance List CPO...ra ul ic s C or ro si on , O pe ra tio na l f lig ht co nt ro ls de gr ad at io n W id es pr ea d W ir e D am ag e X X X X X X X X

Creating a process for incorporating epidemiological modelling into outbreak management decisions.

PubMed

Akselrod, Hana; Mercon, Monica; Kirkeby Risoe, Petter; Schlegelmilch, Jeffrey; McGovern, Joanne; Bogucki, Sandy

2012-01-01

Modern computational models of infectious diseases greatly enhance our ability to understand new infectious threats and assess the effects of different interventions. The recently-released CDC Framework for Preventing Infectious Diseases calls for increased use of predictive modelling of epidemic emergence for public health preparedness. Currently, the utility of these technologies in preparedness and response to outbreaks is limited by gaps between modelling output and information requirements for incident management. The authors propose an operational structure that will facilitate integration of modelling capabilities into action planning for outbreak management, using the Incident Command System (ICS) and Synchronization Matrix framework. It is designed to be adaptable and scalable for use by state and local planners under the National Response Framework (NRF) and Emergency Support Function #8 (ESF-8). Specific epidemiological modelling requirements are described, and integrated with the core processes for public health emergency decision support. These methods can be used in checklist format to align prospective or real-time modelling output with anticipated decision points, and guide strategic situational assessments at the community level. It is anticipated that formalising these processes will facilitate translation of the CDC's policy guidance from theory to practice during public health emergencies involving infectious outbreaks.

Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids: Effect of drug, dose, and device.

PubMed

Dekhuijzen, P N Richard; Batsiou, Maria; Bjermer, Leif; Bosnic-Anticevich, Sinthia; Chrystyn, Henry; Papi, Alberto; Rodríguez-Roisin, Roberto; Fletcher, Monica; Wood, Lucy; Cifra, Alessandra; Soriano, Joan B; Price, David B

2016-11-01

Little information is available on real-life occurrence of oral thrush in COPD patients treated with ICS. We investigated oral thrush incidence in COPD patients prescribed FDC ICS/LABA therapies and assessed whether it is modulated by the ICS type, dose, and delivery device. We conducted a historical, observational, matched cohort study (one baseline year before and one outcome year after initiation of therapy) using data from the UK Optimum Patient Care Research Database. We assessed oral thrush incidence in patients initiating long-acting bronchodilators or FDC ICS/LABA therapy. We then compared different combination therapies (budesonide/formoterol fumarate dihydrate [BUD/FOR] and fluticasone propionate/salmeterol xinafoate [FP/SAL]) and devices (DPI and pMDI). Patients prescribed FDC ICS/LABA had significantly greater odds of experiencing oral thrush than those prescribed long-acting bronchodilators alone (adjusted OR 2.18 [95% CI 1.84-2.59]). Significantly fewer patients prescribed BUD/FOR DPI developed oral thrush compared with FP/SAL DPI (OR 0.77 [0.63-0.94]) when allowing for differences in prescribed doses between the drugs. A significantly smaller proportion of patients developed oral thrush in the FP/SAL pMDI arm than in the FP/SAL DPI arm (OR 0.67 [0.55-0.82]). Additionally, in the FP/SAL cohort (both DPI and pMDI), increased risk of oral thrush was significantly associated with high ICS daily dose (OR 1.97 [1.22-3.17] vs low daily dose). ICS use increases oral thrush incidence in COPD and this effect is dose-dependent for FP/SAL therapies. Of the therapies assessed, FP/SAL pMDI and BUD/FOR DPI may be more protective against oral thrush. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Case Study in the Identification of Critical Factors Leading to Successful Implementation of the Hospital Incident Command System

DTIC Science & Technology

2015-06-01

California EMSA, National Incident Management System, NIMS, hospital preparedness program, Nursing Home Incident Command System, NHICS, Hospital...The International Journal of Trauma Nursing published an article in 2007 entitled “Organization of a Hospital-based Victim Decontamination Plan...Journal of Trauma Nursing 5, no. 4 (October– November 2007): 119–123. 32 Ellen Lanser May, “Scarred but Smarter: Lessons Learned from Florida’s 2004

Command and Control. Radiological Transportation Emergencies Course. Revision Three.

ERIC Educational Resources Information Center

Westinghouse Electric Corp., Carlsbad, NM.

This 12-section course is designed to explain the responsibilities of an incident commander at the scene of a Waste Isolation Pilot Plant (WIPP) transportation incident. It was created for the U.S. Department of Energy WIPP located near Carlsbad, New Mexico, which receives radioactive shipments. The course has two purposes: (1) to provide first…

A Work Station For Control Of Changing Systems

NASA Technical Reports Server (NTRS)

Mandl, Daniel J.

1988-01-01

Touch screen and microcomputer enable flexible control of complicated systems. Computer work station equipped to produce graphical displays used as command panel and status indicator for command-and-control system. Operator uses images of control buttons displayed on touch screen to send prestored commands. Use of prestored library of commands reduces incidence of errors. If necessary, operator uses conventional keyboard to enter commands in real time to handle unforeseeable situations.

Implementing the Hospital Emergency Incident Command System: an integrated delivery system's experience.

PubMed

Zane, Richard D; Prestipino, Ann L

2004-01-01

Hospital disaster manuals and response plans often lack formal command structure; instead, they rely on the presence of key individuals who are familiar with hospital operations, or who are in leadership positions during routine, day-to-day operations. Although this structure occasionally may prove to be successful, it is unreliable, as this leadership may be unavailable at the time of the crisis, and may not be sustainable during a prolonged event. The Hospital Emergency Incident Command System (HEICS) provides a command structure that does not rely on specific individuals, is flexible and expandable, and is ubiquitous in the fire service, emergency medical services, military, and police agencies, thus allowing for ease of communication during event management. A descriptive report of the implementation of the HEICS throughout a large healthcare network is reviewed. Implementation of the HEICS provides a consistent command structure for hospitals that enables consistency and commonality with other hospitals and disaster response entities.

Complication incidence of two implant systems up to six years: a comparison between internal and external connection implants.

PubMed

Chae, Sung-Wook; Kim, Young-Sung; Lee, Yong-Moo; Kim, Won-Kyung; Lee, Young-Kyoo; Kim, Su-Hwan

2015-02-01

This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS). The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test. A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (P<0.001). Within the limitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.

Field Programmable Gate Array Failure Rate Estimation Guidelines for Launch Vehicle Fault Tree Models

NASA Technical Reports Server (NTRS)

Al Hassan, Mohammad; Britton, Paul; Hatfield, Glen Spencer; Novack, Steven D.

2017-01-01

Today's launch vehicles complex electronic and avionics systems heavily utilize Field Programmable Gate Array (FPGA) integrated circuits (IC) for their superb speed and reconfiguration capabilities. Consequently, FPGAs are prevalent ICs in communication protocols such as MILSTD- 1553B and in control signal commands such as in solenoid valve actuations. This paper will identify reliability concerns and high level guidelines to estimate FPGA total failure rates in a launch vehicle application. The paper will discuss hardware, hardware description language, and radiation induced failures. The hardware contribution of the approach accounts for physical failures of the IC. The hardware description language portion will discuss the high level FPGA programming languages and software/code reliability growth. The radiation portion will discuss FPGA susceptibility to space environment radiation.

Strategy for the Long Haul. Special Operations Forces: Future Challenges and Opportunities

DTIC Science & Technology

2008-01-01

College, 2006); and David Tucker and Chris- topher Lamb , “Restructuring Special Operations Forces for Emerging Threats, NDU Strategic Forum, January...Secretary of Defense Gates, SOCOM commander Admiral Eric Olson, and Assistant Secretary of Defense for SOLIC/IC Michael Vickers. See: Stew Mag- nuson

[Oral cancer in Cali, Colombia: a population-based analysis of incidence and mortality trends].

PubMed

Ordóñez, Dora; Aragón, Natalia; García, Luz Stella; Collazos, Paola; Bravo, Luis Eduardo

2014-01-01

To describe the time trends of the incidence and mortality rates of oral cancer (OC) in Cali, Colombia between 1962-2007. Age-standardized (Segi's world population) incidence (ASIR) and mortality (ASMR) rates for oral cancer were estimated using data from the Population-based Cancer Registry of Cali, Colombia and from the database of the Municipal Secretary of Public Health (MSPH) respectively. Annual percentage change (APC) was used to measure the changes in rates over time. 1637 new cases of oral cancer were registered in the CPCR and the mean age upon diagnosis was 60 years. The ASIR decreased from 1962-2007 in men APC= 1.3 (IC95%:-2.0; -0.6) and women APC= -1.0 (IC95%: -1.7; -0.4).The ASMR decreased from 1984-2001 only in men, APC=2.8 (IC95%: -4.1; -1.5). There was a significant decrease in the incidence and mortality rates for OC in Cali, Colombia. The type of tumor associated to these changes was the squamous cell carcinoma.

Cloud Geometry Analysis of the Smoke Week III Obscuration Trials.

DTIC Science & Technology

1982-01-01

GRAPIC 1LJu 4 Cf . .444,44 44- 0. 15, 25, TltME( SErs AOEDET. . **** *HEI HT0F CENTER OP MASS ABOVE DET. PT 42 SMOKE III EVENT # 07 1313 Z 08-12-80 STATION...PORTION OF CLOUD ATMOSPHEdIC SCIENCES LABORATORY WHITE SANDS MISSILE RANGE, N.M. 119 CLI-J000000 ) .0 0 1a 40 M M M MMMMMMMM ul zo w -ZIxJ z z w 0 L- CF ... CF -R (CPT James M. Watson) Dugway, UT 84022 Port Sill, OK 73503 Commander Commandant US Army Dugway Proving Ground US Army Field Artillery School ATTN

Field Programmable Gate Array Reliability Analysis Guidelines for Launch Vehicle Reliability Block Diagrams

NASA Technical Reports Server (NTRS)

Al Hassan, Mohammad; Britton, Paul; Hatfield, Glen Spencer; Novack, Steven D.

2017-01-01

Field Programmable Gate Arrays (FPGAs) integrated circuits (IC) are one of the key electronic components in today's sophisticated launch and space vehicle complex avionic systems, largely due to their superb reprogrammable and reconfigurable capabilities combined with relatively low non-recurring engineering costs (NRE) and short design cycle. Consequently, FPGAs are prevalent ICs in communication protocols and control signal commands. This paper will identify reliability concerns and high level guidelines to estimate FPGA total failure rates in a launch vehicle application. The paper will discuss hardware, hardware description language, and radiation induced failures. The hardware contribution of the approach accounts for physical failures of the IC. The hardware description language portion will discuss the high level FPGA programming languages and software/code reliability growth. The radiation portion will discuss FPGA susceptibility to space environment radiation.

Field Programmable Gate Array Failure Rate Estimation Guidelines for Launch Vehicle Fault Tree Models

NASA Technical Reports Server (NTRS)

Al Hassan, Mohammad; Novack, Steven D.; Hatfield, Glen S.; Britton, Paul

2017-01-01

Today's launch vehicles complex electronic and avionic systems heavily utilize the Field Programmable Gate Array (FPGA) integrated circuit (IC). FPGAs are prevalent ICs in communication protocols such as MIL-STD-1553B, and in control signal commands such as in solenoid/servo valves actuations. This paper will demonstrate guidelines to estimate FPGA failure rates for a launch vehicle, the guidelines will account for hardware, firmware, and radiation induced failures. The hardware contribution of the approach accounts for physical failures of the IC, FPGA memory and clock. The firmware portion will provide guidelines on the high level FPGA programming language and ways to account for software/code reliability growth. The radiation portion will provide guidelines on environment susceptibility as well as guidelines on tailoring other launch vehicle programs historical data to a specific launch vehicle.

Introduction of an Emergency Response Plan for flood loading of Sultan Abu Bakar Dam in Malaysia

NASA Astrophysics Data System (ADS)

Said, N. F. Md; Sidek, L. M.; Basri, H.; Muda, R. S.; Razad, A. Z. Abdul

2016-03-01

Sultan Abu Bakar Dam Emergency Response Plan (ERP) is designed to assist employees for identifying, monitoring, responding and mitigation dam safety emergencies. This paper is outlined to identification of an organization chart, responsibility for emergency management team and triggering level in Sultan Abu Bakar Dam ERP. ERP is a plan that guides responsibilities for proper operation of Sultan Abu Bakar Dam in respond to emergency incidents affecting the dam. Based on this study four major responsibilities are needed for Abu Bakar Dam owing to protect any probable risk for downstream which they can be Incident Commander, Deputy Incident Commander, On-Scene Commander, Civil Engineer. In conclusion, having organization charts based on ERP studies can be helpful for decreasing the probable risks in any projects such as Abu Bakar Dam and it is a way to identify and suspected and actual dam safety emergencies.

Unmanipulated Haploidentical Hematopoietic Stem Cell Transplantation in First Complete Remission Can Abrogate the Poor Outcomes of Children with Acute Myeloid Leukemia Resistant to the First Course of Induction Chemotherapy.

PubMed

Mo, Xiao-Dong; Zhang, Xiao-Hui; Xu, Lan-Ping; Wang, Yu; Yan, Chen-Hua; Chen, Huan; Chen, Yu-Hong; Han, Wei; Wang, Feng-Rong; Wang, Jing-Zhi; Liu, Kai-Yan; Huang, Xiao-Jun

2016-12-01

Allogeneic hematopoietic stem cell transplantation (HSCT) is an important therapy option for children with acute myeloid leukemia (AML) resistant to the first course of induction chemotherapy (IC 1st ). We aimed to identify the efficacy of unmanipulated haploidentical HSCT (haplo-HSCT) in children with AML in the first complete remission and whether children resistant (IC 1st -resistant; n = 38) or sensitive (IC 1st -sensitive; n = 59) to the IC 1st can achieve comparable outcomes. The cumulative incidence of grades III to IV acute graft-versus-host disease (GVHD) and severe chronic GVHD was .0% versus 20.1% (P = .038) and 21.7% versus 13.2% (P = .238), respectively, for the IC 1st -resistant and IC 1st -sensitive groups. The 3-year cumulative incidence of relapse and nonrelapse mortality was 22.2% versus 7.6% (P = .061) and 5.3% versus 10.8% (P = .364), respectively, for the IC 1st -resistant and IC 1st -sensitive groups. The 3-year probability of overall survival and disease-free survival was 76.3% versus 83.0% (P = .657) and 72.5% versus 81.6% (P = .396), respectively, for the IC 1st -resistant and IC 1st -sensitive groups. Multivariate analysis failed to show significant differences in survival rates between the groups. Thus, our results show that unmanipulated haplo-HSCT may overcome the poor prognostic significance of IC 1st -resistance in children with AML, and it is valid as a postremission treatment for children with IC 1st -resistant AML lacking an HLA-matched donor. Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

PubMed

Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

2017-01-01

This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

Summary of Research Academic Departments.

DTIC Science & Technology

1987-10-01

I.C ROBERT F. SMITH ADVISER: LIEUTENANT JOSEPH P. GILIO , USN - Heart Rate Treadmill MIDSHIPMAN 2, C JOHN M. SNIEFEN ADVISER: LIEUTENANT COMMANDER...I B t’ V" R S SGe’.chke, Miark 1., 131 Lander.. Rit, P, 218 Gibb, Arthur. fr., 100, 207, 2 10, 2 13 Langan, ’Thomas 1., 38 Gilio , Joseph P, 58 Lanzer

76 FR 24901 - Privacy Act of 1974; Department of Homeland Security United States Coast Guard-DHS/USCG-002...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

.... USCG Critical Incident Stress Management-related records: Work-Life staff, Peers, Incident commander... leadership personnel regarding alleged work place violence incidents; USCG Critical Incident Stress... Work-Life Offices who are responsible for providing services for the related programs described above...

Measuring Blast-Related Intracranial Pressure Within the Human Head

DTIC Science & Technology

2010-08-01

an d stagnation pressures; stagnation pr essure , also called incident pre ssure, consists of static and dynamic pressure combined and subsequent da...represent a n oticeable decrease in IC pr essure that happened before the IC pressure started to increase. This behavior is very noticeable in all

Discussion Material for Small Unit Leaders: Issues of Battlefield Ethics and Leadership

DTIC Science & Technology

2008-01-01

they may feel comfortable approaching him and asking for clarification of the incident. Because they did not witness the incident, the Platoon...Company XO took command of the scene. Visibly angry, he shouted at the Squad Leader to take some Marines and “clear out those shooters.” The...west he heard shouts and then a brief period of high volume small arms fire. Running to the scene, the Platoon Commander saw a white taxicab with five

Command History 1971. Volume 2. Sanitized

DTIC Science & Technology

1971-01-01

2-71) (U) This inquiry was prompted by racial incidents oc•,urring on 17-15 December 1970 at Camp Baxter. baqse camp of the 5th Trans Comd, US Army...SUPCOM, Da Nang. Tile incident begam ot 17 December with a fist fight in the 329th Trans Co but quickly deteriorated into a racial gang fight. This...Directive for I’,41 tiry. A total of os witnesses were into erviwewad. Of these4 13 presented the view of the $t. Trans Co Commander and #taff and the

76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-04

...-Hazard Position Task Books for Type 3 Incident Management Teams AGENCY: Federal Emergency Management... Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in... Management Teams were developed to assist personnel achieve qualifications in the All-Hazard ICS positions...

Goal-oriented training affects decision-making processes in virtual and simulated fire and rescue environments.

PubMed

Cohen-Hatton, Sabrina R; Honey, R C

2015-12-01

Decisions made by operational commanders at emergency incidents have been characterized as involving a period of information gathering followed by courses of action that are often generated without explicit plan formulation. We examined the efficacy of goal-oriented training in engendering explicit planning that would enable better communication at emergency incidents. While standard training mirrored current operational guidance, goal-oriented training incorporated "decision controls" that highlighted the importance of evaluating goals, anticipated consequences, and risk/benefit analyses once a potential course of action has been identified. In Experiment 1, 3 scenarios (a house fire, road traffic collision, and skip fire) were presented in a virtual environment, and in Experiment 2 they were recreated on the fireground. In Experiment 3, the house fire was recreated as a "live burn," and incident commanders and their crews responded to this scenario as an emergency incident. In all experiments, groups given standard training showed the reported tendency to move directly from information gathering to action, whereas those given goal-oriented training were more likely to develop explicit plans and show anticipatory situational awareness. These results indicate that training can be readily modified to promote explicit plan formulation that could facilitate plan sharing between incident commanders and their teams. (c) 2015 APA, all rights reserved).

Enhanced Methodologies to Enumerate Persons Experiencing Homelessness in a Large Urban Area.

PubMed

Troisi, Catherine L; D'Andrea, Ritalinda; Grier, Gary; Williams, Stephen

2015-10-01

Homelessness is a public health problem, and persons experiencing homelessness are a vulnerable population. Estimates of the number of persons experiencing homelessness inform funding allocations and services planning and directly determine the ability of a community to intervene effectively in homelessness. The point-in-time (PIT) count presents a logistical problem in large urban areas, particularly those covering a vast geographical area. Working together, academia, local government, and community organizations improved the methodology for the count. Specific enhancements include use of incident command system (ICS), increased number of staging areas/teams, specialized outreach and Special Weapons and Tactics teams, and day-after surveying to collect demographic information. This collaboration and enhanced methodology resulted in a more accurate estimate of the number of persons experiencing homelessness and allowed comparison of findings for 4 years. While initial results showed an increase due to improved counting, the number of persons experiencing homelessness counted for the subsequent years showed significant decrease during the same time period as a "housing first" campaign was implemented. The collaboration also built capacity in each sector: The health department used ICS as a training opportunity; the academics enhanced their community health efforts; the service sector was taught and implemented more rigorous quantitative methods; and the community was exposed to public health as a pragmatic and effective discipline. Improvements made to increase the reliability of the PIT count can be adapted for use in other jurisdictions, leading to improved counts and better evaluation of progress in ending homelessness. © The Author(s) 2015.

Intra- and extra-capsular hip fractures in the elderly: Two different pathologies?

PubMed

Dinamarca-Montecinos, J L; Prados-Olleta, N; Rubio-Herrera, R; Castellón-Sánchez del Pino, A; Carrasco-Buvinic, A

2015-01-01

To compare intracapsular (IC) and extracapsular (EC) hip fractures (HIF) in elderly patients in order to determine if they are different pathologies. Longitudinal, observational, descriptive, analytical prospective design, using a non-probabilistic sample from a full sample collection with 647 subjects (male and female), of 60 or more years old, admitted with HIF to the Department of Orthopedics and Traumatology of the Hospital, between January 1, 2010 and December 31, 2012. Follow-up was for 1 year post HIF. Socio-demographic, etiological, developmental, therapeutic and prognostic variables are compared. This is the first study on this subject with Latin American population. EC HIF incidence was superior to IC, contrary to that published in European/American populations. There are significant differences in etiological variables (χ(2)=6.34, p<0.042), with traumatic etiology in EC and non-traumatic in IC. There are also differences in therapeutic interventions performed (osteosynthesis for EC, arthroplasty for IC), with the decision on not to operate being lower in IC (both p<0.0000). The variables associated with the decision on not to perform surgery are age, etiology and postoperative mortality. The results are similar to other studies, adding the IC association with non-traumatic origin, in particular the trend of statistical association between IC and non-primary osteoporotic pathology (neoplasms, renal osteodystrophy, primary hyperparathyroidism). A further analysis was performed on the differences between Latin American and European/American populations in the incidence of either type of HIF. There are important etiological and therapeutic differences between IC and EC HIF; therefore it would be advisable to consider them as distinct disease entities. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

A survey of infection control teaching in U.S. dental schools.

PubMed

Porteous, Nuala B; Bizra, Eamon; Cothron, Annaliese; Yeh, Chih-Ko

2014-02-01

This study was conducted to determine the content of infection control (IC) curricula, the extent of IC monitoring and compliance, and the number of bloodborne pathogen (BBP) exposures/year in U.S. dental schools. A questionnaire was emailed to persons responsible for predoctoral IC programs. The response rate was 60 percent. Most schools did not have an independent course and used classroom lectures and clinic demonstrations to teach IC. Schools with an IC committee were more likely to use online learning (p<0.05), utilize multiple teaching methods (p<0.05), issue written warnings for IC violations (p<0.0001), and use multiple disciplinary actions (p<0.005) than schools without an IC committee. Schools with an IC coordinator were less likely to issue grade reductions for IC violations than schools with no IC coordinator (p<0.05). Thirty-eight percent reported ≥ 16 BBP exposures/year, and 18 percent reported <5. There was significant correlation between BBP exposure incidents and large class size (p<0.005). Respondents were satisfied with their IC curriculum and perceived that dental students had a high level of IC compliance and satisfaction, along with staff IC promotion and compliance. The findings suggest that schools without an IC committee should consider its benefits. Further investigation of schools with high numbers of BBP exposures is recommended.

The Evolution Of Dual Status Command Authorities: A New Construct For Implementation

DTIC Science & Technology

2016-02-13

Unity of Command Tornados in Tuscaloosa, Alabama Highlight Command and Control Gaps The response in Tuscaloosa following a series of devastating... tornados that ripped through the city on 27 April 2011 illustrates how personality and not formal structures were the basis of response. Mayor Walter...Multijurisdictional Incidents None of the cases reviewed—Hurricanes Katrina and Sandy, the Tuscaloosa tornados , and the Boston Marathon bombings

The relationship between perioperative administration of inhaled corticosteroid and postoperative respiratory complications after pulmonary resection for non-small-cell lung cancer in patients with chronic obstructive pulmonary disease.

PubMed

Yamanashi, Keiji; Marumo, Satoshi; Shoji, Tsuyoshi; Fukui, Takamasa; Sumitomo, Ryota; Otake, Yosuke; Sakuramoto, Minoru; Fukui, Motonari; Huang, Cheng-Long

2015-12-01

Inhaled corticosteroid (ICS) treatment has been shown to increase the risk of respiratory complications in patients with stable chronic obstructive pulmonary disease (COPD). However, the effects of perioperative ICS treatment on postoperative respiratory complications after lung cancer surgery have not been elucidated. The aim of this study was to investigate whether perioperative ICS treatment would increase the risk of postoperative respiratory complications after lung cancer surgery in patients with COPD. We retrospectively analyzed 174 consecutive COPD patients with non-small-cell lung cancer (NSCLC) who underwent lobectomy or segmentectomy between January 2007 and December 2014. Subjects were grouped based on whether or not they were administered perioperative ICS treatment. Postoperative cardiopulmonary complications were compared between the groups. There were no statistically significant differences in the incidence of postoperative respiratory complications (P = 0.573) between the perioperative ICS treatment group (n = 16) and the control group (n = 158). Perioperative ICS treatment was not significantly associated with postoperative respiratory complications in the univariate or multivariate analysis (odds ratio [OR] = 0.553, 95% confidence interval [CI] = 0.069-4.452, P = 0.578; OR = 0.635, 95% CI = 0.065-6.158, P = 0.695, respectively). Kaplan-Meier analysis showed that there were no statistically significant differences in the postoperative respiratory complications-free durations between the groups (P = 0.566), even after propensity score matching (P = 0.551). There was no relationship between perioperative ICS administration and the incidences of postoperative respiratory complications after surgical resection for NSCLC in COPD patients.

[Mass maritime casualty incidents in German waters: structures and resources].

PubMed

Castan, J; Paschen, H-R; Wirtz, S; Dörges, V; Wenderoth, S; Peters, J; Blunk, Y; Bielstein, A; Kerner, T

2012-07-01

The Central Command for Maritime Emergencies was founded in Germany in 2003 triggered by the fire on board of the cargo ship "Pallas" in 1998. Its mission is to coordinate and direct measures at or above state level in maritime emergency situations in the North Sea and the Baltic Sea. A special task in this case is to provide firefighting and medical care. To face these challenges at sea emergency doctors and firemen have been specially trained. This form of organization provides a concept to counter mass casualty incidents and peril situations at sea. Since the foundation of the Central Command for Maritime Emergencies there have been 5 operations for firefighting units and 4 for medical response teams. Assignments and structure of the Central Command for Maritime Emergencies are unique in Europe.

Data Quality for Situational Awareness during Mass-Casualty Events

PubMed Central

Demchak, Barry; Griswold, William G.; Lenert, Leslie A.

2007-01-01

Incident Command systems often achieve situational awareness through manual paper-tracking systems. Such systems often produce high latencies and incomplete data, resulting in inefficient and ineffective resource deployment. WIISARD (Wireless Internet Information System for Medical Response in Disasters) collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to incident commanders. Yet, the introduction of IT into a disaster setting is not problem-free. Notably, system component failures can delay the delivery of data. The type and extent of a failure can have varying effects on the usefulness of information displays. We describe a small, coherent set of customizble information overlays to address this problem, and we discuss reactions to these displays by medical commanders. PMID:18693821

INTEGRATED CIRCUITS FROM MOBILE PHONES AS POSSIBLE EMERGENCY OSL/TL DOSIMETERS.

PubMed

Sholom, S; McKeever, S W S

2016-09-01

In this article, optically stimulated luminescence (OSL) data are presented from integrated circuits (ICs) extracted from mobile phones. The purpose is to evaluate the potential of using OSL from components in personal electronic devices such as smart phones as a means of emergency dosimetry in the event of a large-scale radiological incident. ICs were extracted from five different makes and models of mobile phone. Sample preparation procedures are described, and OSL from the IC samples following irradiation using a (90)Sr/(90)Y source is presented. Repeatability, sensitivity, dose responses, minimum measureable doses, stability and fading data were examined and are described. A protocol for measuring absorbed dose is presented, and it was concluded that OSL from these components is a viable method for assessing dose in the days following a radiological incident. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Once more on the equilibrium-point hypothesis (lambda model) for motor control.

PubMed

Feldman, A G

1986-03-01

The equilibrium control hypothesis (lambda model) is considered with special reference to the following concepts: (a) the length-force invariant characteristic (IC) of the muscle together with central and reflex systems subserving its activity; (b) the tonic stretch reflex threshold (lambda) as an independent measure of central commands descending to alpha and gamma motoneurons; (c) the equilibrium point, defined in terms of lambda, IC and static load characteristics, which is associated with the notion that posture and movement are controlled by a single mechanism; and (d) the muscle activation area (a reformulation of the "size principle")--the area of kinematic and command variables in which a rank-ordered recruitment of motor units takes place. The model is used for the interpretation of various motor phenomena, particularly electromyographic patterns. The stretch reflex in the lambda model has no mechanism to follow-up a certain muscle length prescribed by central commands. Rather, its task is to bring the system to an equilibrium, load-dependent position. Another currently popular version defines the equilibrium point concept in terms of alpha motoneuron activity alone (the alpha model). Although the model imitates (as does the lambda model) spring-like properties of motor performance, it nevertheless is inconsistent with a substantial data base on intact motor control. An analysis of alpha models, including their treatment of motor performance in deafferented animals, reveals that they suffer from grave shortcomings. It is concluded that parameterization of the stretch reflex is a basis for intact motor control. Muscle deafferentation impairs this graceful mechanism though it does not remove the possibility of movement.

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Inspection incident to commissioning of ships... The Commanding Officer Special Circumstances/ships in Naval Stations and Shipyards § 700.873 Inspection incident to commissioning of ships. When a ship is to be commissioned, the authority designated to...

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Inspection incident to commissioning of ships... The Commanding Officer Special Circumstances/ships in Naval Stations and Shipyards § 700.873 Inspection incident to commissioning of ships. When a ship is to be commissioned, the authority designated to...

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Inspection incident to commissioning of ships... The Commanding Officer Special Circumstances/ships in Naval Stations and Shipyards § 700.873 Inspection incident to commissioning of ships. When a ship is to be commissioned, the authority designated to...

Training Community Modeling and Simulation Business Plan: 2009 Edition

DTIC Science & Technology

2010-04-01

strategic information assurance 33 33 Provide crisis action procedures training 34 34 Provide the IC SOF-specific training at the operational level... information and products • Collaborative analysis processes • Dissemination of information throughout a command and to subordinates by redundant means...centric M&S capabilities will improve training for information warfare, assist with training for homeland defense operations, crisis -management plan- ning

Automated Design Tools for Integrated Mixed-Signal Microsystems (NeoCAD)

DTIC Science & Technology

2005-02-01

method, Model Order Reduction (MOR) tools, system-level, mixed-signal circuit synthesis and optimization tools, and parsitic extraction tools. A unique...Mission Area: Command and Control mixed signal circuit simulation parasitic extraction time-domain simulation IC design flow model order reduction... Extraction 1.2 Overall Program Milestones CHAPTER 2 FAST TIME DOMAIN MIXED-SIGNAL CIRCUIT SIMULATION 2.1 HAARSPICE Algorithms 2.1.1 Mathematical Background

Peripheral atherectomy practice patterns in the United States from the Vascular Quality Initiative.

PubMed

Mohan, Sathish; Flahive, Julie M; Arous, Edward J; Judelson, Dejah R; Aiello, Francesco A; Schanzer, Andres; Simons, Jessica P

2018-06-21

Peripheral atherectomy has been shown to have technical success in single-arm studies, but clinical advantages over angioplasty and stenting have not been demonstrated, leaving its role unclear. We sought to describe patterns of atherectomy use in a real-world U.S. cohort to understand how it is currently being applied. The Vascular Quality Initiative was queried to identify all patients who underwent peripheral vascular intervention from January 2010 to September 2016. Descriptive statistics were performed to analyze demographics of the patients, comorbidities, indication, treatment modalities, and lesion characteristics. The intermittent claudication (IC) and critical limb ischemia (CLI) cohorts were analyzed separately. Of 85,605 limbs treated, treatment indication was IC in 51% (n = 43,506) and CLI in 49% (n = 42,099). Atherectomy was used in 15% (n = 13,092) of cases, equivalently for IC (15%; n = 6674) and CLI (15%; n = 6418). There was regional variation in use of atherectomy, ranging from a low of 0% in one region to a high of 32% in another region. During the study period, there was a significant increase in the proportion of cases that used atherectomy (11% in 2010 vs 18% in 2016; P < .0001). Compared with nonatherectomy cases, those with atherectomy use had higher incidence of prior peripheral vascular intervention (IC, 55% vs 43% [P < .0001]; CLI, 47% vs 41% [P < .0001]), greater mean number of arteries treated (IC, 1.8 vs 1.6 [P < .0001]; CLI, 2.1 vs 1.7 [P < .0001]), and lower proportion of prior leg bypass (IC, 10% vs 14% [P < .0001]; CLI, 11% vs 17% [P < .0001]). There was lower incidence of failure to cross the lesion (IC, 1% vs 4% [P < .0001]; CLI, 4% vs 7% [P < .0001]) but higher incidence of distal embolization (IC, 1.9% vs 0.8% [P < .0001]; CLI, 3.0% vs 1.4% [P < .0001]) and, in the CLI cohort, arterial perforation (1.4% vs 1.0%; P = .01). Despite a lack of evidence for atherectomy over angioplasty and stenting, its use has increased across the United States from 2010 to 2016. It is applied equally to IC and CLI populations, with no identifiable pattern of comorbidities or lesion characteristics, suggesting that indications are not clearly delineated or agreed on. This study places impetus on further understanding of the optimal role for atherectomy and its long-term clinical benefit in the management of peripheral arterial disease. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Handbook of emergency management for state-level transportation agencies.

DOT National Transportation Integrated Search

2010-03-01

The Department of Homeland Security has mandated specific systems and techniques for the management of emergencies in the United States, including the Incident Command System, the National Incident Management System, Emergency Operations Plans, Emerg...

Infection control challenges in deployed US military treatment facilities.

PubMed

Hospenthal, Duane R; Crouch, Helen K

2009-04-01

Personnel sustaining combat-related injuries in current overseas conflicts continue to have their care complicated by infections caused by multidrug-resistant organisms, including Acinetobacter, Klebsiella, and Pseudomonas. Although presumed to be due to multiple factors both within and outside of the combat theater, concern has been raised about the difficulties in establishing and maintaining standard infection control (IC) practices in deployed medical treatment facilities and in the evacuation of the injured back to the United States. Level III facilities (hospitals capable of holding patients >72 hours) in Iraq and Afghanistan and the evacuation system from Iraq to the continental US were reviewed by an expert IC-infectious disease team. All reviewed facilities had established IC programs, but these were staffed by personnel with limited IC experience, often without perceived adequate time dedicated to perform their duties, and without uniform levels of command emphasis or support. Proper hand hygiene between patients was not always ideal. Isolation and cohorting of patients to decrease multidrug-resistant organism colonization and infection varied among facilities. Review of standard operating procedures found variability among institutions and in quality of these documents. Application of US national and theater-specific guidelines and of antimicrobial control measures also varied among facilities. Effective IC practices are often difficult to maintain in modern US hospitals. In the deployed setting, with ever-changing personnel in a less than optimal practice environment, IC is even more challenging. Standardization of practice with emphasis on the basics of IC practice (e.g., hand hygiene and isolation procedures) needs to be emplaced and maintained in the deployed setting.

32 CFR 750.12 - Claims: Action when suit filed.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Navy, that comes to the attention of any official in connection with his official duties, shall be... report available at the headquarters, a request shall be made to the commanding officer of the appropriate Naval Legal Service Command activity for an investigative report into the incident. If there is...

Factors affecting fire suppression costs as identified by incident management teams

Treesearch

Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones

2006-01-01

This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...

Protecting ICS Systems Within the Energy Sector from Cyber Attacks

NASA Astrophysics Data System (ADS)

Barnes, Shaquille

Advance persistent threat (APT) groups are continuing to attack the energy sector through cyberspace, which poses a risk to our society, national security, and economy. Industrial control systems (ICSs) are not designed to handle cyber-attacks, which is why asset owners need to implement the correct proactive and reactive measures to mitigate the risk to their ICS environments. The Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) responded to 290 incidents for fiscal year 2016, where 59 of those incidents came from the Energy Sector. APT groups know how vulnerable energy sector ICS systems are and the destruction they can cause when they go offline such as loss of production, loss of life, and economic impact. Defending against APT groups requires more than just passive controls such as firewalls and antivirus solutions. Asset owners should implement a combination of best practices and active defense in their environment to defend against APT groups. Cyber-attacks against critical infrastructure will become more complex and harder to detect and respond to with traditional security controls. The purpose of this paper was to provide asset owners with the correct security controls and methodologies to help defend against APT groups.

The hospital incident command system: modified model for hospitals in iran.

PubMed

Djalali, Ahmadreza; Hosseinijenab, Vahid; Peyravi, Mahmoudreza; Nekoei-Moghadam, Mahmood; Hosseini, Bashir; Schoenthal, Lisa; Koenig, Kristi L

2015-03-27

Effectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran. In 2013, a group of 11 subject matter experts participated in an expert consensus modified Delphi to develop modifications to the 2006 version of HICS. The following changes were recommended by the expert panel and subsequently implemented: 1) A Quality Control Officer was added to the Command group; 2) Security was defined as a new section; 3) Infrastructure and Business Continuity Branches were moved from the Operations Section to the Logistics and the Administration Sections, respectively; and 4) the Planning Section was merged within the Finance/Administration Section. An expert consensus group developed a modified HICS that is more feasible to implement given the managerial organization of hospitals in Iran. This new model may enhance hospital performance in managing disasters. Additional studies are needed to test the feasibility and efficacy of the modified HICS in Iran, both during simulations and actual disasters. This process may be a useful model for other countries desiring to improve disaster incident management systems for their hospitals.

Hurricanes Katrina and Rita: role of individuals and collaborative networks in mobilizing/coordinating societal and professional resources for major disasters

PubMed Central

Mattox, Kenneth L

2006-01-01

The medical support for the coordinated effort for Harris County Texas (Houston) to rescue evacuees from New Orleans following Hurricane Katrina was part of an integrated collaborative network. Both public health and operational health care was structured to custom meet the needs of the evacuees and to create an exit strategy for the clinic and shelter. Integrating local hospital and physician resources into the Joint Incident Command was essential. Outside assistance, including federal and national resources must be coordinated through the local incident command. PMID:16420647

Perspectives of Immunization Program Managers on 2009-10 H1N1 Vaccination in the United States: A National Survey

PubMed Central

Seib, Katherine; Wells, Katelyn; Hannan, Claire; Orenstein, Walter A.; Whitney, Ellen A. S.; Hinman, Alan R.; Berkelman, Ruth L.; Omer, Saad B.

2012-01-01

Abstract In June and July 2010, we conducted a national internet-based survey of 64 city, state, and territorial immunization program managers (IPMs) to assess their experiences in managing the 2009-10 H1N1 influenza vaccination campaign. Fifty-four (84%) of the managers or individuals responsible for an immunization program responded to the survey. To manage the campaign, 76% indicated their health department activated an incident command system (ICS) and 49% used an emergency operations center (EOC). Forty percent indicated they shared the leadership of the campaign with their state-level emergency preparedness program. The managers' perceptions of the helpfulness of the emergency preparedness staff was higher when they had collaborated with the emergency preparedness program on actual or simulated mass vaccination events within the previous 2 years. Fifty-seven percent found their pandemic influenza plan helpful, and those programs that mandated that vaccine providers enter data into their jurisdiction's immunization information system (IIS) were more likely than those who did not mandate data entry to rate their IIS as valuable for facilitating registration of nontraditional providers (42% vs. 25%, p<0.05) and tracking recalled influenza vaccine (50% vs. 38%, p<0.05). Results suggest that ICS and EOC structures, pandemic influenza plans, collaborations with emergency preparedness partners during nonemergencies, and expanded use of IIS can enhance immunization programs' ability to successfully manage a large-scale vaccination campaign. Maintaining the close working relationships developed between state-level immunization and emergency preparedness programs during the H1N1 influenza vaccination campaign will be especially important as states prepare for budget cuts in the coming years. PMID:22360580

A Programmable and Configurable Mixed-Mode FPAA SoC

DTIC Science & Technology

2016-03-17

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

CACTUS: Command and Control Training Using Knowledge-Based Simulations

ERIC Educational Resources Information Center

Hartley, Roger; Ravenscroft, Andrew; Williams, R. J.

2008-01-01

The CACTUS project was concerned with command and control training of large incidents where public order may be at risk, such as large demonstrations and marches. The training requirements and objectives of the project are first summarized justifying the use of knowledge-based computer methods to support and extend conventional training…

33 CFR 155.4040 - Response times for each salvage and marine firefighting service.

Code of Federal Regulations, 2014 CFR

2014-07-01

... within the inland waters or the nearshore or offshore area, you must submit in writing, in your plan, the... identified in your response plan for areas OCONUS. (c) Table 155.4040(c) provides additional amplifying... on scene. vii) Salvage plan Plan completed and submitted to Incident Commander/Unified Command. (viii...

33 CFR 155.4040 - Response times for each salvage and marine firefighting service.

Code of Federal Regulations, 2012 CFR

2012-07-01

... within the inland waters or the nearshore or offshore area, you must submit in writing, in your plan, the... identified in your response plan for areas OCONUS. (c) Table 155.4040(c) provides additional amplifying... on scene. vii) Salvage plan Plan completed and submitted to Incident Commander/Unified Command. (viii...

33 CFR 155.4040 - Response times for each salvage and marine firefighting service.

Code of Federal Regulations, 2013 CFR

2013-07-01

... within the inland waters or the nearshore or offshore area, you must submit in writing, in your plan, the... identified in your response plan for areas OCONUS. (c) Table 155.4040(c) provides additional amplifying... on scene. vii) Salvage plan Plan completed and submitted to Incident Commander/Unified Command. (viii...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

Apollo Recovery Operations

NASA Technical Reports Server (NTRS)

Interbartolo, Michael

2009-01-01

Objectives include: a) Describe the organization of recovery force command and control and landing areas; b) Describe the function and timeline use of the Earth Landing System (ELS); c) Describe Stable 1 vs Stable 2 landing configurations and the function of the Command Module Uprighting System; d) Explain the activities of the helicopter and swimmer teams in egress and recovery of the crew; e)Explain the activities of the swimmer teams and primary recovery ship in recovery of the Command Module; and f) Describe several landing incidents that occurred during Apollo.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

PubMed

Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

2011-08-01

Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Essentials of disaster management: the role of the orthopaedic surgeon.

PubMed

Born, Christopher T; Monchik, Keith O; Hayda, Roman A; Bosse, Michael J; Pollak, Andrew N

2011-01-01

Disaster preparedness and management education is essential for allowing orthopaedic surgeons to play a valuable, constructive role in responding to disasters. The National Incident Management System, as part of the National Response Framework, provides coordination between all levels of government and uses the Incident Command System as its unified command structure. An "all-hazards" approach to disasters, whether natural, man-made, intentional, or unintentional, is fundamental to disaster planning. To respond to any disaster, command and control must be established, and emergency management must be integrated with public health and medical care. In the face of increasing acts of terrorism, an understanding of blast injury pathophysiology allows for improved diagnostic and treatment strategies. A practical understanding of potential biologic, chemical, and nuclear agents and their attendant clinical symptoms is also prerequisite. Credentialing and coordination between designated organizations and the federal government are essential to allow civilian orthopaedic surgeons to access systems capable of disaster response.

KSC-08pd2996

NASA Image and Video Library

2008-10-01

CAPE CANAVERAL, Fla. - In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, STS-127 crew members get a look at the antenna in the Inter Orbit Communication System Extended Facility, or ICS-EF. Standing next to a Japanese Aerospace Exploration Agency, or JAXA, technician at left are Mission Specialists Dave Wolf and Christopher Cassidy and Commander Mark Polansky. Equipment familiarization is part of a Crew Equipment Interface Test. The antenna and a pointing mechanism will be used to communicate with JAXA’s Data Relay Test Satellite, or DRTS. The ICS-EF will be launched, along with the Extended Facility and Experiment Logistics Module-Exposed Section, to the International Space Station aboard the space shuttle Endeavour on the STS-127 mission targeted for launch on May 15, 2009. Photo credit: NASA/Kim Shiflett

Simultaneous control of multiple instruments at the Advanced Technology Solar Telescope

NASA Astrophysics Data System (ADS)

Johansson, Erik M.; Goodrich, Bret

2012-09-01

The Advanced Technology Solar Telescope (ATST) is a 4-meter solar observatory under construction at Haleakala, Hawaii. The simultaneous use of multiple instruments is one of the unique capabilities that makes the ATST a premier ground based solar observatory. Control of the instrument suite is accomplished by the Instrument Control System (ICS), a layer of software between the Observatory Control System (OCS) and the instruments. The ICS presents a single narrow interface to the OCS and provides a standard interface for the instruments to be controlled. It is built upon the ATST Common Services Framework (CSF), an infrastructure for the implementation of a distributed control system. The ICS responds to OCS commands and events, coordinating and distributing them to the various instruments while monitoring their progress and reporting the status back to the OCS. The ICS requires no specific knowledge about the instruments. All information about the instruments used in an experiment is passed by the OCS to the ICS, which extracts and forwards the parameters to the appropriate instrument controllers. The instruments participating in an experiment define the active instrument set. A subset of those instruments must complete their observing activities in order for the experiment to be considered complete and are referred to as the must-complete instrument set. In addition, instruments may participate in eavesdrop mode, outside of the control of the ICS. All instrument controllers use the same standard narrow interface, which allows new instruments to be added without having to modify the interface or any existing instrument controllers.

Incident command structure using a daily management system and the Centers for Disease Control and Prevention's Patient Notification Toolkit drives effective response to an infection control breach.

PubMed

Schoonover, Heather; Haydon, Kristin

2018-06-14

When breaches in infection control occur, it is imperative that organizations respond in a manner that is effective, efficient, and rebuilds trust with patients. Readers will learn how the incident command structure, daily management system, and the Centers for Disease Control and Prevention's Patient Notification Toolkit were used to drive an effective response to an infection control breach-resulting in 92% of affected patients completing the recommended testing for hepatitis B, hepatitis C, and human immunodeficiency virus. © 2018 American Society for Healthcare Risk Management of the American Hospital Association.

Site management of health issues in the 2001 World Trade Center disaster.

PubMed

Bradt, David A

2003-06-01

The terrorist destruction of the World Trade Center led to the greatest loss of life from a criminal incident in the history of the United States. There were 2,801 persons killed or missing at the disaster site, including 147 dead on two hijacked aircraft. Hundreds of buildings sustained direct damage or contamination. Forty different agencies responded with command and control exercised by an incident command system as well as an emergency operations center. Dozens of hazards complicated relief and recovery efforts. Five victims were rescued from the rubble. Up to 1,000 personnel worked daily at the World Trade Center disaster site. These workers collectively made an average of 270 daily presentations to health care providers in the first month post-disaster. Of presentations for clinical symptoms, leading clinical diagnoses were ocular injuries, headaches, and lung injuries. Mechanical injury accounted for 39% of clinical presentations and appeared preventable by personal protective equipment. Limitations emerged in the site application of emergency triage and clinical care. Notable assets in the site management of health issues include action plans from the incident command system, geographic information system products, wireless application technology, technical consensus among health and safety authorities, and workers' respite care.

Methods for Integrating Environmental Awareness Training into Army Programs of Instruction

DTIC Science & Technology

1993-06-01

generations. iv NTIS CRA&I ) F -IC TAB U.a’mot’::ed El By .. . ... ....... By .......................... ...... . .. DiO t, ib., tion I CONTENTS...Training Support Package ................... E-1-E-19 Appendix F . Sample of Officer Basic Course Instructor’s Lesson Plan with Embedded Information... F -1- F -7 Appendix G. Samples of Situational Training Exercises ........... G-1-G 9 Appendix H. Samples of Pre-Command Course Guest Speaker

Disasters and mass casualties: I. General principles of response and management.

PubMed

Born, Christopher T; Briggs, Susan M; Ciraulo, David L; Frykberg, Eric R; Hammond, Jeffrey S; Hirshberg, Asher; Lhowe, David W; O'Neill, Patricia A

2007-07-01

Disaster planning and response to a mass casualty incident pose unique demands on the medical community. Because they would be required to confront many casualties with bodily injury and surgical problems, surgeons in particular must become better educated in disaster management. Compared with routine practice, triage principles in disasters require an entirely different approach to evaluation and care and often run counter to training and ethical values. An effective response to disaster and mass casualty events should focus on an "all hazards" approach, defined as the ability to adapt and apply fundamental disaster management principles universally to any mass casualty incident, whether caused by people or nature. Organizational tools such as the Incident Command System and the Hospital Incident Command System help to effect a rapid and coordinated response to specific situations. The United States federal government, through the National Response Plan, has the responsibility to respond quickly and efficiently to catastrophic incidents and to ensure critical life-saving assistance. International medical surgical response teams are capable of providing medical, surgical, and intensive care services in austere environments anywhere in the world.

Social determinants of leprosy in a hyperendemic State in North Brazil.

PubMed

Monteiro, Lorena Dias; Mota, Rosa Maria Salani; Martins-Melo, Francisco Rogerlândio; Alencar, Carlos Henrique; Heukelbach, Jorg

2017-07-20

To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil. This is an ecological study based on secondary data from the Sistema de Informações de Agravos de Notificação in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios. In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95%CI 1.19-1.81) and better Municipal Human Development Index (1.53; 95%CI 1.14-2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95%CI 1.11-1.55) and higher proportion of households with waste collection (1.37; 95%CI 1.11-1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Família Program (0.98; 95%CI 0.96-0.99). Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population. Identificar fatores socioeconômicos, demográficos, operacionais e de serviços de saúde associados à ocorrência da hanseníase em um estado hiperendêmico do norte do Brasil. Estudo ecológico com dados secundários do Sistema de Informações de Agravos de Notificação em municípios do estado do Tocantins de 2001 a 2012. As unidades de análise foram os 139 municípios do estado. Modelos de regressão log linear binomial negativa foram utilizados para estimar as razões de taxas de incidência. Na análise bivariada, a razão de taxa de incidência foi significativamente maior para os municípios com maior razão de renda dos 20,0% mais pobres (1,47; IC95% 1,19-1,81) e melhor Índice de Desenvolvimento Humano Municipal (1,53; IC95% 1,14-2,06). Na múltipla, a razão de taxa de incidência foi significativamente superior em municípios com maior concentração de imigrantes (1,31; IC95% 1,11-1,55) e proporção de domicílios com coleta de lixo (1,37; IC95% 1,11-1,69). Houve redução significativa da razão de taxa de incidência com o aumento da cobertura do programa bolsa família (0,98; IC95% 0,96-0,99). Os programas de controle precisam focar as atividades em municípios de maior vulnerabilidade social com investimentos intersetoriais para a melhoria das condições de vida da população.

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

Faecal haemoglobin concentration influences risk prediction of interval cancers resulting from inadequate colonoscopy quality: analysis of the Taiwanese Nationwide Colorectal Cancer Screening Program

PubMed Central

Chiu, Sherry Yueh-Hsia; Chuang, Shu-Ling; Chen, Sam Li-Sheng; Yen, Amy Ming-Fang; Fann, Jean Ching-Yuan; Chang, Dun-Cheng; Lee, Yi-Chia; Wu, Ming-Shiang; Chou, Chu-Kuang; Hsu, Wen-Feng; Chiou, Shu-Ti; Chiu, Han-Mo

2017-01-01

Objectives Interval colorectal cancer (CRC) after colonoscopy may affect effectiveness and cost-effectiveness of screening programmes. We aimed to investigate whether and how faecal haemoglobin concentration (FHbC) of faecal immunochemical testing (FIT) affected the risk prediction of interval cancer (IC) caused by inadequate colonoscopy quality in a FIT-based population screening programme. Design From 2004 to 2009, 29 969 subjects underwent complete colonoscopy after positive FIT in the Taiwanese Nationwide CRC Screening Program. The IC rate was traced until the end of 2012. The incidence of IC was calculated in relation to patient characteristics, endoscopy-related factors (such adenoma detection rate (ADR)) and FHbC. Poisson regression analysis was performed to assess the potential risk factors for colonoscopy IC. Results One hundred and sixty-two ICs developed after an index colonoscopy and the estimated incidence was 1.14 per 1000 person-years of observation for the entire cohort. Increased risk of IC was most remarkable in the uptake of colonoscopy in settings with ADR lower than 15% (adjusted relative risk (aRR)=3.09, 95% CI 1.55 to 6.18) and then higher FHbC (μg Hb/g faeces) (100–149: aRR=2.55, 95% CI 1.52 to 4.29, ≥150: aRR=2.74, 95% CI 1.84 to 4.09) with adjustment for older age and colorectal neoplasm detected at baseline colonoscopy. Similar findings were observed for subjects with negative index colonoscopy. Conclusions Colonoscopy ICs arising from FIT-based population screening programmes were mainly influenced by inadequate colonoscopy quality and independently predicted by FHbC that is associated with a priori chance of advanced neoplasm. This finding is helpful for future modification of screening logistics based on FHbC. PMID:26515543

KSC-08pd2998

NASA Image and Video Library

2008-10-01

CAPE CANAVERAL, Fla. - In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, STS-127 crew members get a look at the extended antenna in the Inter Orbit Communication System Extended Facility, or ICS-EF, across from them. Standing next to a Japanese Aerospace Exploration Agency, or JAXA, technician at left are Mission Specialists Christopher Cassidy and Dave Wolf and Commander Mark Polansky (pointing). Equipment familiarization is part of a Crew Equipment Interface Test. The antenna and a pointing mechanism will be used to communicate with JAXA’s Data Relay Test Satellite, or DRTS. The ICS-EF will be launched, along with the Extended Facility and Experiment Logistics Module-Exposed Section, to the International Space Station aboard the space shuttle Endeavour on the STS-127 mission targeted for launch on May 15, 2009. Photo credit: NASA/Kim Shiflett

KSC-08pd2997

NASA Image and Video Library

2008-10-01

CAPE CANAVERAL, Fla. - In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, STS-127 crew members get a look at the extended antenna (upper left) in the Inter Orbit Communication System Extended Facility, or ICS-EF. Standing next to a Japanese Aerospace Exploration Agency, or JAXA, technician (at center) are (from left) Mission Specialists Dave Wolf and Christopher Cassidy and Commander Mark Polansky. Equipment familiarization is part of a Crew Equipment Interface Test. The antenna and a pointing mechanism will be used to communicate with JAXA’s Data Relay Test Satellite, or DRTS. The ICS-EF will be launched, along with the Extended Facility and Experiment Logistics Module-Exposed Section, to the International Space Station aboard the space shuttle Endeavour on the STS-127 mission targeted for launch on May 15, 2009. Photo credit: NASA/Kim Shiflett

Signal Processing Distortion Loss in Spread-Spectrum Communication, Command, Control, and Navigation Systems.

DTIC Science & Technology

1980-10-01

Communications, fourth edition; Bell Telephone Laboratories, Western Electric Co., Technical Publications, Winston- Salem , NC (1971). 2. Sunde, E.D...PAI,-A F - IC 1i 1 I o I j q V (:0-(YjX) 093 [’ FF5 Fs PFA \\ / fjl U C. ŗ(:OL ’i IPH, .INJ(𔃾X) 00 U’G! F VFA ANLI 0.0 CYL!0- I1I-L. I3TF AT -, i

[Cost comparison of temporary sickness absence in 2006 between Barcelona and Madrid provinces, Spain].

PubMed

Ballesteros Polo, Mónica; Serra Pujadas, Consol; Miguel Martínez, José; Plana Almuni, Manel; Delclos, George L; Benavides, Fernando G

2009-01-01

Sickness absence due to non work-related conditions is a major public health issue with important socio-economic implications, and is not homogenously distributed in Spain. The objective of this study is to compare cost differences of temporary sickness absence between Barcelona and Madrid. A study was carried out based on incident cases of temporary sickness absence of more than fifteen days of duration, followed to case closure, in a retrospective cohort of workers in 2006. The study population consisted of workers of companies covered by the general regime of the Social Security System, and managed by an insurance company based in the provinces of Barcelona and Madrid in the year 2006. We compared the incidence, median duration and daily income base between Barcelona and Madrid, adjusting by sex, age and economic sector, using statistical models that take into account recurrent events in the period. 24.527 cases of temporary sickness absence were identified, 62% of which originated in Barcelona. The mean cost was 33% higher in Barcelona with respect to Madrid (2.589 euros vs 1941 euros). The incidence was 22% higher in Barcelona than Madrid (1,22, IC95%: 1,10-1,36) and mean daily income base per episode was 7,80 euros higher (IC95% :7,20-8,40). In the duration the time ratio was: 1,03 ( IC95%: 1,01-1,05). The higher incidence and daily income base of temporary sickness absence in Barcelona with respect to Madrid may explain the higher costs observed in the former.

Synergistic effect of sevoflurane and isoflurane on inhibition of the adult-type muscle nicotinic acetylcholine receptor by rocuronium.

PubMed

Liu, Li; Li, Wei; Wei, Ke; Cao, Jun; Luo, Jie; Wang, Bin; Min, Su

2013-06-01

Inhaled anesthetics increase the incidence of postoperative residual neuromuscular blockade, and the mechanism is still unclear. We have investigated the synergistic effect of low-concentration inhaled anesthetics and rocuronium on inhibition of the inward current of the adult-type muscle nicotinic acetylcholine receptor (ε-nAChR). Adult-type mouse muscle ε-nAChR was expressed in HEK293 cells by liposome transfection. The inward current of the ε-nAChR was activated by use of 10 μmol/L acetylcholine alone or in combination with different concentrations of sevoflurane, isoflurane, or rocuronium. The concentration-response curves of five cells were constructed, and the data yielded the 5, 25, and 50 % inhibitory concentrations (IC5, IC25, and IC50, respectively) for single-drug application. Subsequently, the functional channels were perfused by adding 0.5 IC5 of either sevoflurane or isoflurane (aqueous concentrations 140 and 100 μmol/L, respectively) to the solution, followed by addition of IC5, IC25, or IC50 rocuronium. The amount of inhibition was calculated to quantify their synergistic effect. The inhibitory effect of rocuronium was enhanced by sevoflurane or isoflurane in a concentration-dependent manner. Sevoflurane or isoflurane (0.5 IC5) with rocuronium at IC5, IC25, and IC50 synergistically inhibited the current amplitude of adult-type muscle ε-nAChR. When the IC5 of rocuronium was used, isoflurane had a stronger synergistic effect than sevoflurane (p < 0.05). When rocuronium was applied at higher concentrations (IC25 and IC50), sevoflurane had an effect similar to that of isoflurane. For both inhaled anesthetics, the synergistic effect was more intense for rocuronium at IC5 than for rocuronium at IC25 or IC50. Residual-concentration sevoflurane or isoflurane has a strong synergistic effect with rocuronium at clinically relevant residual concentrations. A lower rocuronium concentration resulted in a stronger synergistic effect.

Smoking and Soldier Performance: A Literature Review.

DTIC Science & Technology

1986-06-01

Army Medical Research June 1986 • dud uevelopment Command 13. NUMBER OF PAGES Fort Detrick, Frederick, MD 21701-5012 223 " 14. MONITORING AGENCY NAME...the LIS Army Medical Research and Development Command.- This literature review resulted - from an unsolicited proposal submitted by Research Solutions... medical drugs .1.... % e) Varicocele incidence. ............................ 151,i’ f) Body size and weigh !5. 4’ f de .......................... g

Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model.

PubMed

Yu, Wenya; Lv, Yipeng; Hu, Chaoqun; Liu, Xu; Chen, Haiping; Xue, Chen; Zhang, Lulu

2018-01-01

Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For large-scale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise.

Long-Term Fluticasone Propionate/Formoterol Fumarate Combination Therapy Is Associated with a Low Incidence of Severe Asthma Exacerbations

PubMed Central

Mansur, Adel H.; Pertseva, Tetyana; Kaiser, Kirsten; McIver, Tammy; Grothe, Birgit; Dissanayake, Sanjeeva

2016-01-01

Abstract Background: A primary goal of asthma management is the reduction of exacerbation risk. We assessed the occurrence of oral corticosteroid-requiring exacerbations (OCS exacerbations) with long-term fluticasone/formoterol therapy, and compared it with the occurrence of similar events reported with other inhaled corticosteroid/long acting β2-agonist (ICS/LABA) combinations. Methods: The occurrence of OCS exacerbations was assessed in two open-label trials of fixed-dose fluticasone/formoterol administered for between 26 to 60 weeks in adults and adolescents with asthma. The incidence of OCS exacerbations with fluticasone/formoterol was compared with those reported in three recent Cochrane meta-analyses of other ICS/LABAs. Results: The pooled incidence of OCS exacerbations with long-term fluticasone/formoterol was 2.1% (95% CI: 1.1, 3.2%, n/N = 16/752). In only two of the nineteen treatment arms summarized by Cochrane did OCS exacerbation incidence approximate that seen in the two fluticasone/formoterol trials (single-inhaler fluticasone/salmeterol [2.9%]; separate inhaler budesonide, beclometasone, or flunisolide plus formoterol [3.4%]). In Lasserson's review the pooled incidence of OCS exacerbations for single-inhaler combinations was 9.5% (95% CI: 8.4, 10.6%; n/N = 239/2516) for fluticasone/salmeterol, and 10.6% (95% CI: 9.3, 11.8%; n/N = 257/2433) for budesonide/formoterol. In Ducharme's and Chauhan's meta-analyses (primarily incorporating separate inhaler combinations [fluticasone, budesonide, beclometasone, or flunisolide plus salmeterol or formoterol]), the pooled incidences of OCS exacerbations were 16.0% (95% CI: 14.2, 17.8%, n/N = 258/1615) and 16.7% (95% CI: 14.9, 18.5, n/N = 275/1643), respectively. Conclusions: The incidence of exacerbations in two fixed-dose fluticasone/formoterol studies was low and less than in the majority of comparable published studies involving other ICS/LABA combinations. This difference could not be readily explained by differences in features of the respective studies and may be related to the favorable pharmacological/mechanistic characteristics of the constituent components fluticasone and formoterol compared to other drugs in their respective classes. PMID:27104231

Fire Weather Products for Public and Emergency Use: Extending Professional Resources to the Public

NASA Astrophysics Data System (ADS)

Rogers, M. A.; Schranz, S.; Kriederman, L.

2012-12-01

Large wildfires require significant resources to combat, including dedicated meteorological support to provide accurate and timely forecasts to assist incident commanders in making decisions for logistical and tactical firefighting operations. Smaller fires often require the same capabilities for understanding fire and the fire weather environment, but access to needed resources and tools is often limited due to technical, training, or education limitations. Providing fire weather information and training to incident commanders for smaller wildfires should prove to enhance firefighting capabilities and improve safety for both firefighters and for the public as well. One of the premier tools used to support fire weather forecasting for the largest wildfires is the FX-Net product, a thin-client version of the Advanced Weather Interactive Processing System used by NWS incident meteorologists (IMETs) deployed to large wildfires. We present results from an ongoing project to extend the sophisticated products available from FX-Net to more accessible and mobile software platforms, such as Google Earth. The project involves input from IMETs and fire commanders to identify the key parameters used in fighting wildfires, and involves a large training component for fire responders to utilize simplified products to improve understanding of fire weather in the context of firefighting operations.

Comparative evaluation of subclavian vein catheterisation using supraclavicular versus infraclavicular approach

PubMed Central

Thakur, Anil; Kaur, Kiranpreet; Lamba, Aditya; Taxak, Susheela; Dureja, Jagdish; Singhal, Suresh; Bhardwaj, Mamta

2014-01-01

Background and Aims: Infraclavicular (IC) approach of subclavian vein (SCV) catheterisation is widely used as compared to supraclavicular (SC) approach. The aim of the study was to compare the ease of catheterisation of SCV using SC versus IC approach and also record the incidence of complications related to either approach, if any. Methods: In the study, 60 patients enrolled were randomly divided into two groups of 30 patients each. In Gp. SC right SCV catheterisation was performed using SC approach and in Gp. IC catheterisation was performed using IC approach. Access time, success rate of cannulation, number of attempts to cannulate vein, ease of guidewire and catheter insertion and length of catheter inserted and any associated complications were recorded. Results: The mean access time in group SC for SCV catheterisation was 4.30 ± 1.02 min compared to 6.07 ± 2.14 min in group IC. The overall success rate in catheterisation of the right SCV using SC approach (29 out of 30) was better as compared with group IC (27 out of 30) using IC approach. First attempt success in the SC group was 75.6% as compared with 59.25% in the IC group. All successful subclavian vein  catheterisations in SC group and IC group were associated with smooth insertion of guidewire following subclavian venipuncture. Conclusion: The SC approach of SCV catheterisation is comparable to IC approach in terms of landmarks accessibility, success rate and rate of complications. PMID:24963180

Tax Subsidies for Employer-Sponsored Health Insurance: Updated Microsimulation Estimates and Sensitivity to Alternative Incidence Assumptions

PubMed Central

Miller, G Edward; Selden, Thomas M

2013-01-01

Objective To estimate 2012 tax expenditures for employer-sponsored insurance (ESI) in the United States and to explore the sensitivity of estimates to assumptions regarding the incidence of employer premium contributions. Data Sources Nationally representative Medical Expenditure Panel Survey data from the 2005–2007 Household Component (MEPS-HC) and the 2009–2010 Insurance Component (MEPS IC). Study Design We use MEPS HC workers to construct synthetic workforces for MEPS IC establishments, applying the workers' marginal tax rates to the establishments' insurance premiums to compute the tax subsidy, in aggregate and by establishment characteristics. Simulation enables us to examine the sensitivity of ESI tax subsidy estimates to a range of scenarios for the within-firm incidence of employer premium contributions when workers have heterogeneous health risks and make heterogeneous plan choices. Principal Findings We simulate the total ESI tax subsidy for all active, civilian U.S. workers to be $257.4 billion in 2012. In the private sector, the subsidy disproportionately flows to workers in large establishments and establishments with predominantly high wage or full-time workforces. The estimates are remarkably robust to alternative incidence assumptions. Conclusions The aggregate value of the ESI tax subsidy and its distribution across firms can be reliably estimated using simplified incidence assumptions. PMID:23398400

Review of Criminal Investigations of Alleged Detainee Abuse

DTIC Science & Technology

2006-08-25

reporting requirements published in Anny Regulation (AR) 190-40, "Serious Incident Report," November 30, 1993.13 A serious incident is "[a]ny actual...investigated by commanders under the authority of this regulation . In its purpose statement, the regulation states that the policy is limited to...provisions of this regulation , when made applicable, and the provisions of the specific directive authorizing the 15 AR 190-40, Serious Incident Report

Distributed Sensor Networks

DTIC Science & Technology

1979-09-30

University, Pittsburgh, Pennsylvania (1976). 14. R. L. Kirby, "ULISP for PDP-11s with Memory Management ," Report MCS-76-23763, University of Maryland...teletVpe or 9 raphIc S output. The recor iuL, po , uitist il so mon itot its owvn ( Onmand queue and a( knowlede commands Sent to It hN the UsCtr interfa I...kernel. By a net- work kernel we mean a multicomputer distributed operating system kernel that includes proces- sor schedulers, "core" memory managers , and

Quadratic Hadamard Memories II. Adaptive Stochastic Content. Addressable Memory

DTIC Science & Technology

1990-07-01

No. 6429 Issued by Army Missile Command Under Contract # DAAH1-88-C-0887 D T IC Technical Report #2 E LEC SlD Approved for public release...integrate the N coupled nonlinear 0 differential equations, something I cannot do. In the proportional region these equations d 5 can be integrated in spite...is summed, but Uav a is not. Indices are used as follows. i, j, and k denote components in input space. a, b, c, d , and p denote components in the

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Inspection incident to commissioning of ships. 700.873 Section 700.873 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Commanding Officer Special Circumstances...

IED Campaign in the U.S. Homeland: Are U.S. Military EOD Units Prepared to Respond

DTIC Science & Technology

2017-06-09

Bombing Incident Doctrine .........................................82 Terrorism Incident Law Enforcement Investigation Annex...to the Boston Marathon Bombing ..........................................93 Phase 1 Training and Operations Practice Analysis Raw Data Summary...Bureau of Alcohol Tobacco Firearms and Explosives BMC Bomb Management Center C2 Command and Control CBRNE Chemical, Biological, Radiological

Leadership and Management Education and Training (LMET) Course Requirements for Recruit Company Commanders and ’A’ School Instructors.

DTIC Science & Technology

1983-12-01

integration of TAEG findings with contractor findings. Critical incident interview techniques, as used by the contractor, were specifically prohibited in order...than the critical incident interview technique were to be explored for use in the identification of leadership competencies. These competencies and

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

School Crisis Teams within an Incident Command System

ERIC Educational Resources Information Center

Nickerson, Amanda B.; Brock, Stephen E.; Reeves, Melissa A.

2006-01-01

Despite the increasing attention given to the need for schools to be prepared to respond in a variety of crisis situations, there is a lack of information about how to coordinate with multiple agencies following a crisis. This article describes the U. S. Department of Homeland Security's (2004) National Incident Management System and its Incident…

Phase II Trial of Preoperative Irinotecan-Cisplatin Followed by Concurrent Irinotecan-Cisplatin and Radiotherapy for Resectable Locally Advanced Gastric and Esophagogastric Junction Adenocarcinoma

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

Rivera, Fernando, E-mail: oncrhf@humv.e; Galan, Maica; Tabernero, Josep

Purpose: To determine in a Phase II trial whether preoperative irinotecan-cisplatin (IC) followed by concurrent IC therapy and radiotherapy (IC/RT) improved outcome in patients with resectable, locally advanced gastric adenocarcinoma (GC) or esophagogastric junction cancer (EGJC). Patients and Methods: Patients with resectable Stage II-IV, M0 GC or EGJC made up the study population. The primary endpoint was pathologic complete response (pCR). Two courses of IC (irinotecan, 65mg/m{sup 2}; cisplatin, 30mg/m{sup 2} on Days 1 and 8 every 21 days) were given. Patients without progression then received IC/RT, consisting of daily radiotherapy (45Gy) with concurrent IC (irinotecan, 65mg/m{sup 2}; cisplatin, 30mg/m{supmore » 2} on Days 1, 8, 15, and 22). Surgical resection was performed, if feasible, 5-8 weeks after the end of radiotherapy. Results: Twenty-three patients were included in the study: 10 with EGJC and 13 with GC. Two patients (9%) achieved pCR. The incidences of Grade 3-4 toxicities were as follows: IC: neutropenia 35% (febrile 13%), anemia 22%, diarrhea 22%, emesis 8%; IC/RT: neutropenia 52% (febrile 5%), asthenia 19%, anemia 9%, emesis 9%, diarrhea 5%, cardiotoxicity 5%. No patients died during IC or IC/RT. R0 resection was achieved in 15 patients (65%). Median survival was 14.5 months, and the actuarial 2-year survival rate was 35%. Conclusions: Preoperative IC followed by IC/RT resulted in moderate response and resection rates with mild toxicity in patients with GC and EGJC.« less

Assessing the Utility of Work Team Theory in a Unified Command Environment at Catastrophic Incidents

DTIC Science & Technology

2005-03-01

between agencies that potentially affects command post (CP) interactions . All of the foregoing factors contribute to a turbulent management environment...requiring special strategy consideration with and IMT preparation. “Conflict refers to a process of social interaction involving a struggle over...from interactions . These schemas can be grouped as cultural norms perpetuated generationally from seasoned officers to raw recruits, and shared by

Introduction to Command, Control and Communications (C3) Through Comparative Case Analysis

DTIC Science & Technology

1990-03-01

enhancing the process of learning from experience. Case study allows the student to apply concepts , theories, and techniques to an actual incident within...part of the thesis describes selected principles and concepts of 33 related to cormruication management, interoperability, command structure and...The solutions to the cases require applying the principles and concepts presented in the first rart. The four cases are: (1) the Iran hostage rescue

MO-F-CAMPUS-J-01: Effect of Iodine Contrast Agent Concentration On Cerebrovascular Dose for Synchrotron Radiation Microangiography Based On a Simple Mouse Head Model and a Voxel Mouse Head Phantom

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

Lin, H; Jing, J; Xie, C

Purpose: To find effective setting methods to mitigate the irradiation injure in synchrotron radiation microangiography(SRA) by Monte Carlo simulation. Methods: A mouse 1-D head model and a segmented voxel mouse head phantom were simulated by EGSnrc/Dosxyznrc code to investigate the dose enhancement effect of the iodine contrast agent irradiated by a monochromatic synchrotron radiation(SR) source. The influence of, like iodine concentration (IC), vessel width and depth, with and without skull layer protection and the various incident X ray energies, were simulated. The dose enhancement effect and the absolute dose based on the segmented voxel mouse head phantom were evaluated. Results:more » The dose enhancement ratio depends little on the irradiation depth, but strongly on the IC, which is linearly increases with IC. The skull layer protection cannot be ignored in SRA, the 700µm thick skull could decrease 10% of the dose. The incident X-ray energy can significantly affact the dose. E.g. compared to the dose of 33.2keV for 50mgI/ml, the 32.7keV dose decreases 38%, whereas the dose of 33.7 keV increases 69.2%, and the variation will strengthen more with enhanced IC. The segmented voxel mouse head phantom also showed that the average dose enhancement effect and the maximal voxel dose per photon depends little on the iodine voxel volume ratio, but strongly on IC. Conclusion: To decrease dose damage in SRA, the high-Z contrast agent should be used as little as possible, and try to avoid radiating locally the injected position immediately after the contrast agent injection. The fragile vessel containing iodine should avoid closely irradiating. Avoiding irradiating through the no or thin skull region, or appending thin equivalent material from outside to protect is also a better method. As long as SRA image quality is ensured, using incident X-ray energy as low as possible.« less

Ionospheric Caustics in Solar Radio Observations

NASA Astrophysics Data System (ADS)

Koval, A.; Chen, Y.; Stanislavsky, A.

2016-12-01

The Earth ionosphere possesses by natural focusing and defocusing effects on radio waves due to presence of variable ionospheric irregularities which could act like convergent and divergent lenses on incident radiation. In particular, the focusing of emission from the Sun was firstly detected on the Nançay Decameter Array dynamic spectra in the 1980s. On time-frequency spectrograms the intensity variations form specific structures different from well-known solar radio bursts and clearly distinguishing on a background of solar radiation. Such structures have been identified as ionospheric caustics (ICs) and considered to be the result of radio waves refraction on medium scale travelling ionospheric disturbances (MSTIDs). Although nowadays the ICs are registered by different radio observatories due to augmentation of low-frequency radio telescopes, the most recent papers devoted to ICs in solar radio records date back to the 1980s. In this study, we revisit the ICs issue with some new results by conducting a statistical analysis of occurrence rate of ICs in solar dynamic spectra in meter-decameter wavelength range for long continuous period (15 years). The seasonal variations in ICs appearance have been found for the first time. Besides, we report the possible solar cycle dependence of ICs emergence. The radio waves propagation in the ionosphere comprising MSTIDs will be considered. The present research renews the subject of ICs in the low-frequency solar radio astronomy after about 35-year letup.

Rapid Radiochemical Methods for Selected Radionuclides

EPA Pesticide Factsheets

The rapid methods documents are supplement guidance in a planned series designed to present radioanalytical laboratory personnel, Incident Commanders (and their designees), and other field response personnel.

Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model

PubMed Central

Liu, Xu; Chen, Haiping; Xue, Chen

2018-01-01

Objectives Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. Methods This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Results Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. Conclusion The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For large-scale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise. PMID:29440876

MDCT in ischaemic colitis: how to define the aetiology and acute, subacute and chronic phase of damage in the emergency setting

PubMed Central

Iacobellis, Francesca; Mazzei, Maria Antonietta; Volterrani, Luca; Guglielmi, Giuseppe; Brunese, Luca; Grassi, Roberto

2016-01-01

Ischemic colitis (IC) is the most common vascular disorder of the gastrointestinal tract with a reported incidence of 6.1–44 cases/100,000 person years with confirmatory histopathology. However, the true incidence of IC poses some difficulty, and even vigilant clinicians with patients at high risk often miss the diagnosis, since clinical presentation is non-specific or could have a mild transient nature. Detection of IC results is crucial to plan the correct therapeutic approach and reduce the reported mortality rate (4–12%). Diagnosis of IC is based on a combination of clinical suspicion, radiological, endoscopic and histological findings. Some consider colonoscopy as a diagnostic test of choice; however, preparation is required and it is not without risk, above all in patients who are severely ill. There are two manifestations of vascular colonic insult: ischaemic and reperfusive. The first one occurs above all during ischaemic/non-occlusive mesenteric ischaemia; in this case, the colonic wall appears thinned with dilated lumen and fluid appears in the paracolic space. When reperfusion occurs, the large bowel wall appears thickened and stratified, because of subepithelial oedema and/or haemorrhage, with consequent lumen calibre reduction. Shaggy contour of the involved intestine and misty mesentery are associated with the pericolic fluid. The pericolic fluid results are a crucial finding for IC diagnosis since its evidence suggests the presence of an ongoing damage thus focusing the attention on other pathological aspects which could be otherwise misdiagnosed, such as thinned or thickened colonic wall. Moreover, the pericolic fluid may increase or decrease, depending on the evolution of the ischaemic damage, suggesting the decision of medical or surgical treatment. Radiologists should not forget the hypothesis of IC, being aware that multidetector CT could be sufficient to suggest the diagnosis of IC, allowing for early identification and grading definition, and in a short-term follow-up, discriminating patients who need urgent surgery from patients in whom medical treatment and follow-up can be proposed. PMID:27007462

The Effect of Computer-Based Simulation Training on Fire Ground Incident Commander Decision Making

ERIC Educational Resources Information Center

Hall, Kurt A.

2010-01-01

Since the establishment of the first volunteer fire brigades in the United States, firefighters have lost their lives in fire fighting operations at emergency incidents and live-fire training activities. While there are various reasons for these firefighter deaths and injuries, the United States Fire Administration (2002) reported that many of…

Marius and Trajan: Two Great Roman Strategists

DTIC Science & Technology

1984-04-01

soon respected as a good commander upon whom a soldier could count. His fairness of command is best demonstrated in an incident related by Plutarch ...to their discomfort and problems. (10:343) Plutarch also gave credit to Marius for altering the construction of the javelin. Marius replaced one of...Putnam’s Sons, 1927. 10. Plutarch (Translated by John Dryden, Revised by Arthur Hugh Clough). The Lives of the Noble Grecians and Romans. Chicago

Battalion Commanders Speak Out; An Anthology on the Philosophy of Command

DTIC Science & Technology

1977-05-20

the performance of other battalions in the divi incidents of black- marketing by soldiers of the dropped to almost zero. The participation by a...battalion and relative to slon. Of special note, the 2d Aviation Battalion soldier in black- marketing with a Korean prostitute, discipline...Mile High as immoral and uncontrolled. That required me to make some adjustments, but it did not cquse me to change my basic strategy of

Validation and Clinical Utility of the hERG IC50:Cmax Ratio to Determine the Risk of Drug-Induced Torsades de Pointes: A Meta-Analysis.

PubMed

Lehmann, David F; Eggleston, William D; Wang, Dongliang

2018-03-01

Use of the QT interval corrected for heart rate (QTc) on the electrocardiogram (ECG) to predict torsades de pointes (TdP) risk from culprit drugs is neither sensitive nor specific. The ratio of the half-maximum inhibitory concentration of the hERG channel (hERG IC50) to the peak serum concentration of unbound drug (C max ) is used during drug development to screen out chemical entities likely to cause TdP. To validate the use of the hERG IC50:C max ratio to predict TdP risk from a culprit drug by its correlation with TdP incidence. Medline (between 1966 and March 2017) was accessed for hERG IC50 and C max values from the antihistamine, fluoroquinolone, and antipsychotic classes to identify cases of drug-induced TdP. Exposure to a culprit drug was estimated from annual revenues reported by the manufacturer. Inclusion criteria for TdP cases were provision of an ECG tracing that demonstrated QTc prolongation with TdP and normal serum values of potassium, calcium, and magnesium. Cases reported in patients with a prior rhythm disturbance and those involving a drug interaction were excluded. The Meta-Analysis of Observational Studies in Epidemiology checklist was used for epidemiological data extraction by two authors. Negligible risk drugs were defined by an hERG IC50:C max ratio that correlated with less than a 5% chance of one TdP event for every 100 million exposures (relative risk [RR] 1.0). The hERG IC50:C max ratio correlated with TdP risk (0.312; 95% confidence interval 0.205-0.476, p<0.0001), a ratio of 80 (RR 1.0). The RR from olanzapine is on par with loratadine; ziprasidone is comparable with ciprofloxacin. Drugs with an RR greater than 50 include astemizole, risperidone, haloperidol, and thioridazine. The hERG IC50:C max ratio was correlated with TdP incidence for culprit drugs. This validation provides support for the potential use of the hERG IC50:C max ratio for clinical decision making in instances of drug selection where TdP risk is a concern. © 2018 Pharmacotherapy Publications, Inc.

Mortality Among Confirmed Lassa Fever Cases During the 2015-2016 Outbreak in Nigeria.

PubMed

Buba, Maryam Ibrahim; Dalhat, Mahmood Muazu; Nguku, Patrick Mboya; Waziri, Ndadilnasiya; Mohammad, Jibreel Omar; Bomoi, Idriss Mohammed; Onyiah, Amaka Pamela; Onwujei, Jude; Balogun, Muhammad Shakir; Bashorun, Adebobola Toluwalashe; Nsubuga, Peter; Nasidi, Abdulsalami

2018-02-01

To determine factors associated with mortality among confirmed Lassa fever cases. We reviewed line lists and clinical records of laboratory-confirmed cases of Lassa fever during the 2016 outbreak in Nigeria to determine factors associated with mortality. We activated an incident command system to coordinate response. We documented 47 cases, 28 of whom died (case fatality rate [CFR] = 59.6%; mean age 31.4 years; SD = ±18.4 years). The youngest and the oldest were the most likely to die, with 100% mortality in those aged 5 years or younger and those aged 55 years or older. Patients who commenced ribavirin were more likely to survive (odds ratio [OR] = 0.1; 95% confidence interval [CI] = 0.03, 0.50). Fatality rates went from 100% (wave 1) through 69% (wave 2) to 31% (wave 3; χ 2 for linear trend: P < .01). Patients admitted to a health care center before incident command system activation were more likely to die (OR = 4.4; 95% CI = 1.1, 17.6). The only pregnant patient in the study died postpartum. Effective, coordinated response reduces mortality from public health events. Attention to vulnerable groups during disasters is essential. Public Health Implications. Activating an incident command system improves the outcome of disasters in resource-constrained settings.

An RFID-based on-lens sensor system for long-term IOP monitoring.

PubMed

Hsu, Shun-Hsi; Chiou, Jin-Chern; Liao, Yu-Te; Yang, Tzu-Sen; Kuei, Cheng-Kai; Wu, Tsung-Wei; Huang, Yu-Chieh

2015-01-01

In this paper, an RFID-based on-lens sensor system is proposed for noninvasive long-term intraocular pressure monitoring. The proposed sensor IC, fabricated in a 0.18um CMOS process, consists of capacitive sensor readout circuitry, RFID communication circuits, and digital processing units. The sensor IC is integrated with electroplating capacitive sensors and a receiving antenna on the contact lens. The sensor IC can be wirelessly powered, communicate with RFID compatible equipment, and perform IOP measurement using on-lens capacitive sensor continuously from a 2cm distance while the incident power from an RFID reader is 20 dBm. The proposed system is compatible to Gen2 RFID protocol, extending the flexibility and reducing the self-developed firmware efforts.

Malaria on a military peacekeeping operation: a case study with no cases.

PubMed

Houston, David J K; Tuck, Jeremy J H

2005-03-01

Malaria continues to be a disease of importance to travelers and the military is no exception. Individual protection measures based on advice, bite avoidance, chemoprophylaxis, and diagnosis are advocated for protection against the disease. However, the military has an additional strand to malaria protection--the chain of command. To describe the experience of a British military deployment where the Force Commander took a proactive approach to malaria protection. In 512 person-weeks of exposure in a theater with high rates of transmission of malaria, with an enduring threat of asymmetric military action and with a proactive approach by the chain of command to the implementation of malaria protection policy, no malaria cases developed. The chain of command can have a significant impact on compliance with malaria protection measures, which might reduce incidence of the disease in the deployed population.

Inhaled corticosteroids and the occurrence of oral candidiasis: a prescription sequence symmetry analysis.

PubMed

van Boven, Job F M; de Jong-van den Berg, Lolkje T W; Vegter, Stefan

2013-04-01

The primary aim of the study was to gain insight into the relative risk of clinically relevant oral candidiasis following inhaled corticosteroid (ICS) initiation over time. A secondary aim was to analyse the influence of patient characteristics and co-medication on the occurrence of this adverse effect. Drug prescription data from 1994 to 2011 were retrieved from the IADB.nl database. To study the influence of ICS use on occurrence of oral candidiasis, a prescription symmetry analysis was used, including patients using medication for oral candidiasis up to 1 year before or after ICS initiation. The relative risk was calculated by dividing the number of patients receiving medication for oral candidiasis after ICS initiation by the number of patients receiving the same medication before ICS initiation. Sub-analyses were conducted to compare the relative risks at several time points after ICS initiation and to account for therapy persistence by only including chronic users of ICS. A multivariate logistic regression model was used to identify predictive factors. A total of 52,279 incident users of ICS therapy were identified, of which 1,081 received medication for oral candidiasis up to 1 year before or after ICS initiation. A total of 701 patients received medication for oral candidiasis after ICS initiation, while 361 received these medications in the reversed sequence, resulting in a sequence ratio (SR) of 1.94 (95 % CI 1.71-2.21). In the first 3 months after ICS initiation, the SR was 2.72 (95 % CI 2.19-3.38) and then decreased to 1.47 (95 % CI 1.11-1.95) 9-12 months after ICS initiation. Predictive factors were higher daily dose of ICS and concomitant use of oral corticosteroids. This study found a significant and clinically relevant increased number of patients receiving medication for oral candidiasis in the first year after therapy initiation with ICS. Relative risk is highest in the first 3 months, but remains increased up to at least 1 year after ICS initiation. This study stresses the need for patient education and inhalation instruction.

USN/USMC Antiair Warfare and Command, Control and Communications for Amphibious Operations

DTIC Science & Technology

1992-03-01

NUMBERS W’Vf~ * ic0"W O plows k; to., W..ia 0;41 40A.YWfI 11 TITLE (Inclucle Securily CiaSsifkcaticin) U8N/U8SUC Antiuar Warflire and4 CommaskC~Ual...the CWC to be a manager of all the warfare areas and frees him from becoming entangled in one tactical problem while another grows undetected elsewhere...hostile enemy actions (i.e., jamming) the potential begins to decrease rapidly . [Ref. 19:pp. 185-194] F. MARINE CORPS PRINCIPLES OF AAW There are three

AFRL Commander's Challenge 2015: stopping the active shooter

NASA Astrophysics Data System (ADS)

McIntire, John P.; Boston, Jonathan; Smith, Brandon; Swartz, Pete; Whitney-Rawls, Amy; Martinez Calderon, Julian; Magin, Jonathan

2017-05-01

In this work, we describe a rapid-innovation challenge to combat and deal with the problem of internal, insider physical threats (e.g., active shooters) and associated first-responder situation awareness on military installations. Our team's research and development effort described within focused on several key tech development areas: (1) indoor acoustical gunshot detection, (2) indoor spatial tracking of first responders, (3) bystander safety and protection, (4) two-way mass alerting capability, and (5) spatial information displays for command and control. The technological solutions were specifically designed to be innovative, low-cost, and (relatively) easy-to-implement, and to provide support across the spectrum of possible users including potential victims/bystanders, first responders, dispatch, and incident command.

The timing of control signals underlying fast point-to-point arm movements.

PubMed

Ghafouri, M; Feldman, A G

2001-04-01

It is known that proprioceptive feedback induces muscle activation when the facilitation of appropriate motoneurons exceeds their threshold. In the suprathreshold range, the muscle-reflex system produces torques depending on the position and velocity of the joint segment(s) that the muscle spans. The static component of the torque-position relationship is referred to as the invariant characteristic (IC). According to the equilibrium-point (EP) hypothesis, control systems produce movements by changing the activation thresholds and thus shifting the IC of the appropriate muscles in joint space. This control process upsets the balance between muscle and external torques at the initial limb configuration and, to regain the balance, the limb is forced to establish a new configuration or, if the movement is prevented, a new level of static torques. Taken together, the joint angles and the muscle torques generated at an equilibrium configuration define a single variable called the EP. Thus by shifting the IC, control systems reset the EP. Muscle activation and movement emerge following the EP resetting because of the natural physical tendency of the system to reach equilibrium. Empirical and simulation studies support the notion that the control IC shifts and the resulting EP shifts underlying fast point-to-point arm movements are gradual rather than step-like. However, controversies exist about the duration of these shifts. Some studies suggest that the IC shifts cease with the movement offset. Other studies propose that the IC shifts end early in comparison to the movement duration (approximately, at peak velocity). The purpose of this study was to evaluate the duration of the IC shifts underlying fast point-to-point arm movements. Subjects made fast (hand peak velocity about 1.3 m/s) planar arm movements toward different targets while grasping a handle. Hand forces applied to the handle and shoulder/elbow torques were, respectively, measured from a force sensor placed on the handle, or computed with equations of motion. In some trials, an electromagnetic brake prevented movements. In such movements, the hand force and joint torques reached a steady state after a time that was much smaller than the movement duration in unobstructed movements and was approximately equal to the time to peak velocity (mean difference < 80 ms). In an additional experiment, subjects were instructed to rapidly initiate corrections of the pushing force in response to movement arrest. They were able to initiate such corrections only when the joint torques and the pushing force had practically reached a steady state. The latency of correction onset was, however, smaller than the duration of unobstructed movements. We concluded that during the time at which the steady state torques were reached, the control pattern of IC shifts remained the same despite the movement block. Thereby the duration of these shifts did not exceed the time of reaching the steady state torques. Our findings are consistent with the hypothesis that, in unobstructed movements, the IC shifts and resulting shifts in the EP end approximately at peak velocity. In other words, during the latter part of the movement, the control signals responsible for the equilibrium shift remained constant, and the movement was driven by the arm inertial, viscous and elastic forces produced by the muscle-reflex system. Fast movements may thus be completed without continuous control guidance. As a consequence, central corrections and sequential commands may be issued rapidly, without waiting for the end of kinematic responses to each command, which may be important for many motor behaviours including typing, piano playing and speech. Our study also illustrates that the timing of the control signals may be substantially different from that of the resulting motor output and that the same control pattern may produce different motor outputs depending on external conditions.

Agility through Automated Negotiation for C2 Services

DTIC Science & Technology

2014-06-01

using this e-contract negotiation methodology in a C2 context in Brazil. We have modeled the operations of the Rio de Janeiro Command Center that will be...methodology in a C2 context in Brazil. We have modeled the operations of the Rio de Janeiro Command Center that will be in place for the World Cup (2014...through e-contracts. The scenario chosen to demonstrate this methodology is a security incident in Rio de Janeiro , host city of the next World Cup (2014

’Whiskey on the Rocks’ - The Submarine Incident off Karlskrona (’Whisky on the Rocks’ - Der U-Boot-Zwischefall vor Karlskrona),

DTIC Science & Technology

1982-04-19

kowledg tha hoediee e i sumrieoesgeufr umrednvgain sounded the arm to the "Oertogsbasstaben sic] in Karlskrona, whose chief of staff, Commander Karl...through: "Sweden--small--pfui--nothing, Soviet Union--great-- powerful ." Not quite diplomatic, but perhaps a measure of the master race mentality of...certain Soviet military people. Soviet Demonstration of Power When the alarm was sounded, all conceivable measures were taken by the Swedish commander𔃾n

Time-Of-Travel Tool Protects Drinking Water

EPA Pesticide Factsheets

The Lower Susquehanna Source Water Protection (SWP) Partnership utilizes the Incident Command Tool for Drinking Water Protection (ICWater) to support the Pennsylvania Department of Environmental Protection (PADEP) with real-time spill tracking information.

Strategic operations planning - it's not just for wilderness! How the Strategic Operations Planner can help

Treesearch

Charles W. McHugh; Stu Hoyt; Brett Fay

2015-01-01

The Strategic Operational Planner (SOPL) wildland fire management position was created in the United States in 2009 to reflect updated terminology. SOPL merges the former Fire Use Manager positions (FUM1 and FUM2) and is now an established position within the Incident Command System. Traditionally, the FUM positions and the SOPL have been used on incidents managed for...

An Investigation of Operational Decision Making in Situ: Incident Command in the U.K. Fire and Rescue Service.

PubMed

Cohen-Hatton, Sabrina R; Butler, Philip C; Honey, Robert C

2015-08-01

The aim of this study was to better understand the nature of decision making at operational incidents in order to inform operational guidance and training. Normative models of decision making have been adopted in the guidance and training for emergency services. In these models, it is assumed that decision makers assess the current situation, formulate plans, and then execute the plans. However, our understanding of how decision making unfolds at operational incidents remains limited. Incident commanders, attending 33 incidents across six U.K. Fire and Rescue Services, were fitted with helmet-mounted cameras, and the resulting video footage was later independently coded and used to prompt participants to provide a running commentary concerning their decisions. The analysis revealed that assessment of the operational situation was most often followed by plan execution rather than plan formulation, and there was little evidence of prospection about the potential consequences of actions. This pattern of results was consistent across different types of incident, characterized by level of risk and time pressure, but was affected by the operational experience of the participants. Decision making did not follow the sequence of phases assumed by normative models and conveyed in current operational guidance but instead was influenced by both reflective and reflexive processes. These results have clear implications for understanding operational decision making as it occurs in situ and suggest a need for future guidance and training to acknowledge the role of reflexive processes. © 2015, Human Factors and Ergonomics Society.

The need to scale up HIV indicator condition-guided testing for early case-finding: a case-control study in primary care.

PubMed

Joore, Ivo K; Twisk, Denise E; Vanrolleghem, Ann M; de Ridder, Maria; Geerlings, Suzanne E; van Bergen, Jan E A M; van den Broek, Ingrid V

2016-11-17

European guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to HIV diagnosis. We did a cross-sectional search in an electronic general practice database using a matched case-control design to identify which predefined ICs registered by Dutch GPs were most associated with an HIV-positive status prior to the time of diagnosis. We included 224 HIV cases diagnosed from 2009 to 2013, which were matched with 2,193 controls. Almost two thirds (n = 136, 60.7%) of cases were diagnosed with one or more ICs in the period up to five years prior to the index date compared to 18.7% (n = 411) of controls. Cases were more likely to have an IC than controls: in the one year prior to the index date, the odds ratio (OR) for at least one condition was 11.7 (95% CI: 8.3 to 16.4). No significant differences were seen in the strength of the association between HIV diagnosis and ICs when comparing genders, age groups or urbanisation levels. There is no indication that subgroups require a different testing strategy. Our study shows that there are opportunities for IC-guided testing in primary care. We recommend that IC-guided testing be more integrated in GPs' future guidelines and that education strategies be used to facilitate its implementation in daily practice.

ICS logging solution for network-based attacks using Gumistix technology

NASA Astrophysics Data System (ADS)

Otis, Jeremy R.; Berman, Dustin; Butts, Jonathan; Lopez, Juan

2013-05-01

Industrial Control Systems (ICS) monitor and control operations associated with the national critical infrastructure (e.g., electric power grid, oil and gas pipelines and water treatment facilities). These systems rely on technologies and architectures that were designed for system reliability and availability. Security associated with ICS was never an inherent concern, primarily due to the protections afforded by network isolation. However, a trend in ICS operations is to migrate to commercial networks via TCP/IP in order to leverage commodity benefits and cost savings. As a result, system vulnerabilities are now exposed to the online community. Indeed, recent research has demonstrated that many exposed ICS devices are being discovered using readily available applications (e.g., ShodanHQ search engine and Google-esque queries). Due to the lack of security and logging capabilities for ICS, most knowledge about attacks are derived from real world incidents after an attack has already been carried out and the damage has been done. This research provides a method for introducing sensors into the ICS environment that collect information about network-based attacks. The sensors are developed using an inexpensive Gumstix platform that can be deployed and incorporated with production systems. Data obtained from the sensors provide insight into attack tactics (e.g., port scans, Nessus scans, Metasploit modules, and zero-day exploits) and characteristics (e.g., attack origin, frequency, and level of persistence). Findings enable security professionals to draw an accurate, real-time awareness of the threats against ICS devices and help shift the security posture from reactionary to preventative.

Risk of Pneumonia with Inhaled Corticosteroid versus Long-Acting Bronchodilator Regimens in Chronic Obstructive Pulmonary Disease: A New-User Cohort Study

PubMed Central

DiSantostefano, Rachael L.; Sampson, Tim; Le, Hoa Van; Hinds, David; Davis, Kourtney J.; Bakerly, Nawar Diar

2014-01-01

Introduction Observational studies using case-control designs have showed an increased risk of pneumonia associated with inhaled corticosteroid (ICS)-containing medications in patients with chronic obstructive pulmonary disease (COPD). New-user observational cohort designs may minimize biases associated with previous case-control designs. Objective To estimate the association between ICS and pneumonia among new users of ICS relative to inhaled long-acting bronchodilator (LABD) monotherapy. Methods Pneumonia events in COPD patients ≥45 years old were compared among new users of ICS medications (n = 11,555; ICS, ICS/long-acting β2-agonist [LABA] combination) and inhaled LABD monotherapies (n = 6,492; LABA, long-acting muscarinic antagonists) using Cox proportional hazards models, with propensity scores to adjust for confounding. Setting: United Kingdom electronic medical records with linked hospitalization and mortality data (2002–2010). New users were censored at earliest of: pneumonia event, death, changing/discontinuing treatment, or end of follow-up. Outcomes: severe pneumonia (primary) and any pneumonia (secondary). Results Following adjustment, new use of ICS-containing medications was associated with an increased risk of pneumonia hospitalization (n = 322 events; HR = 1.55, 95% CI: 1.14, 2.10) and any pneumonia (n = 702 events; HR = 1.49, 95% CI: 1.22, 1.83). Crude incidence rates of any pneumonia were 48.7 and 30.9 per 1000 person years among the ICS-containing and LABD cohorts, respectively. Excess risk of pneumonia with ICS was reduced when requiring ≥1 month or ≥ 6 months of new use. There was an apparent dose-related effect, with greater risk at higher daily doses of ICS. There was evidence of channeling bias, with more severe patients prescribed ICS, for which the analysis may not have completely adjusted. Conclusions The results of this new-user cohort study are consistent with published findings; ICS were associated with a 20–50% increased risk of pneumonia in COPD, which reduced with exposure time. This risk must be weighed against the benefits when prescribing ICS to patients with COPD. PMID:24878543

Intermittent catheterization with a hydrophilic-coated catheter delays urinary tract infections in acute spinal cord injury: a prospective, randomized, multicenter trial.

PubMed

Cardenas, Diana D; Moore, Katherine N; Dannels-McClure, Amy; Scelza, William M; Graves, Daniel E; Brooks, Monifa; Busch, Anna Karina

2011-05-01

To investigate whether intermittent catheterization (IC) with a hydrophilic-coated catheter delays the onset of the first symptomatic urinary tract infection (UTI) and reduces the number of symptomatic UTIs in patients with acute spinal cord injury (SCI) compared with IC with standard, uncoated catheters. A prospective, randomized, parallel-group trial. Fifteen North American SCI centers. Participants were followed up while in the hospital or rehabilitation unit (institutional period) and up to 3 months after institutional discharge (community period). The maximal study period was 6 months. A total of 224 subjects with traumatic SCI of less than 3 months' duration who use IC. The participants were randomized within 10 days of starting IC to either single-use hydrophilic-coated (SpeediCath) or polyvinyl chloride uncoated (Conveen) catheters. The time from the first catheterization to the first antibiotic-treated symptomatic UTI was measured as well as the total number of symptomatic UTIs during the study period. The time to the first antibiotic-treated symptomatic UTI was significantly delayed in the hydrophilic-coated catheter group compared with the uncoated catheter group. The delay corresponded to a 33% decrease in the daily risk of developing the first symptomatic UTI among participants who used the hydrophilic-coated catheter. In the institutional period, the incidence of antibiotic-treated symptomatic UTIs was reduced by 21% (P < .05) in the hydrophilic-coated catheter group. The use of a hydrophilic-coated catheter for IC is associated with a delay in the onset of the first antibiotic-treated symptomatic UTI and with a reduction in the incidence of symptomatic UTI in patients with acute SCI during the acute inpatient rehabilitation. Using a hydrophilic-coated catheter could minimize UTI-related complications, treatment costs, and rehabilitation delays in this group of patients, and reduce the emergence of antibiotic-resistant organisms. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Policy Options to Address Crucial Communication Gaps in the Incident Command System

DTIC Science & Technology

2012-09-01

California Department of Forestry and Fire Protection COML Communications Unit Leader COMT Communication Technician EBRPD East Bay Regional Parks...Laguna Fire 1970 - One of California’s Worst Wildfires.” Available at http://www.cccarto.com/cal_wildfire/laguna/fire.html, Accessed August 10, 2012...NIMS - The Evolution of the National Incident Management System.” Fire Rescue Magazine, August 2011. 15 compatibility, and department emergency

KSC-69PC-413

NASA Image and Video Library

1969-07-16

KENNEDY SPACE CENTER, FLA. - The Apollo 11 Saturn V space vehicle climbs toward orbit after liftoff from Pad 39A at 9:32 a.m. EDT. In two-and-a-half minutes of powered flight, the S-IC booster lifts the vehicle to an altitude of about 39 miles approximately 55 miles downrange. This photo was taken with a 70-mm telescopic camera mounted in an Air force EC-135N plane. Onboard are astronauts Neil A. Armstrong, Michael Collins and Edwin E. Aldrin Jr. During the planned eight-day mission, Armstrong and Aldrin will descend in a Lunar Module (LM) to the Moon's surface while Collins orbits overhead in the Command Module. The two astronauts are to spend 22 hours on the Moon, including two-and-one-half hours outside the LM. They will gather samples of lunar material and will deploy scientific experiments that will transmit data about the lunar environment. They will rejoin Collins in the Command Module for the return trip to Earth.

Final report : PATTON Alliance gazetteer evaluation project.

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

Bleakly, Denise Rae

2007-08-01

In 2005 the National Ground Intelligence Center (NGIC) proposed that the PATTON Alliance provide assistance in evaluating and obtaining the Integrated Gazetteer Database (IGDB), developed for the Naval Space Warfare Command Research group (SPAWAR) under Advance Research and Development Activity (ARDA) funds by MITRE Inc., fielded to the text-based search tool GeoLocator, currently in use by NGIC. We met with the developers of GeoLocator and identified their requirements for a better gazetteer. We then validated those requirements by reviewing the technical literature, meeting with other members of the intelligence community (IC), and talking with both the United States Geologic Surveymore » (USGS) and the National Geospatial Intelligence Agency (NGA), the authoritative sources for official geographic name information. We thus identified 12 high-level requirements from users and the broader intelligence community. The IGDB satisfies many of these requirements. We identified gaps and proposed ways of closing these gaps. Three important needs have not been addressed but are critical future needs for the broader intelligence community. These needs include standardization of gazetteer data, a web feature service for gazetteer information that is maintained by NGA and USGS but accessible to users, and a common forum that brings together IC stakeholders and federal agency representatives to provide input to these activities over the next several years. Establishing a robust gazetteer web feature service that is available to all IC users may go a long way toward resolving the gazetteer needs within the IC. Without a common forum to provide input and feedback, community adoption may take significantly longer than anticipated with resulting risks to the war fighter.« less

Factors Associated With Intestinal Constipation in Chronic Patients With Stroke Sequelae Undergoing Rehabilitation.

PubMed

Engler, Tânia Mara Nascimento de Miranda; Aguiar, Márcia Helena de Assis; Furtado, Íris Aline Brito; Ribeiro, Samile Pereira; de Oliveira, Pérola; Mello, Paulo Andrade; Padula, Marcele Pescuma Capeletti; Beraldo, Paulo Sérgio Siebra

The objective of this study was to define which stroke-related factors constitute independent variables in the incidence of intestinal constipation (IC) of chronic patients admitted to a hospital rehabilitation program. All patients consecutively admitted for rehabilitation were recruited for the study. In the Poisson multiple regression analysis using a hierarchical model, sociodemographic variables, comorbidities, medication, previous history of constipation, life habits, and stroke-related variables were considered for defining factors associated with IC. A 31% prevalence (95% confidence interval [CI]: 25.3-37.1) of IC was detected. Among the factors associated, female gender (adjusted prevalence ratio [PRadjusted] = 1.79; 95% CI: 1.20-2.68), intestinal complaints prior to stroke (PRadjusted = 3.71; 95% CI: 2.60-5.31), intake of less than 800 ml of fluid per day (PRadjusted = 1.72; 95% CI: 1.20- 2.45), age greater than 65 years at brain injury (PRadjusted = 1.67; 95% CI: 1.01-2.75), and partially impaired anterior brain circulation (PRadjusted = 3.35; 95% CI: 1.02-10.97) were associated with IC. Female gender, elderly, prior history of IC, low fluid intake, and partial impairment of anterior brain circulation were factors independently associated with IC in stroke survivors undergoing rehabilitation. These findings require further validation and may serve toward improving bowel retraining programs for this patient group.

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

Improving Situational Awareness for First Responders via Mobile Computing

NASA Technical Reports Server (NTRS)

Betts, Bradley J.; Mah, Robert W.; Papasin, Richard; Del Mundo, Rommel; McIntosh, Dawn M.; Jorgensen, Charles

2006-01-01

This project looks to improve first responder incident command, and an appropriately managed flow of situational awareness using mobile computing techniques. The prototype system combines wireless communication, real-time location determination, digital imaging, and three-dimensional graphics. Responder locations are tracked in an outdoor environment via GPS and uploaded to a central server via GPRS or an 802. II network. Responders can also wireless share digital images and text reports, both with other responders and with the incident commander. A pre-built three dimensional graphics model of the emergency scene is used to visualize responder and report locations. Responders have a choice of information end points, ranging from programmable cellular phones to tablet computers. The system also employs location-aware computing to make responders aware of particular hazards as they approach them. The prototype was developed in conjunction with the NASA Ames Disaster Assistance and Rescue Team and has undergone field testing during responder exercises at NASA Ames.

Using Earth Observations to Assess the Socioeconomic Impact of Human Decision Making during the Suppression of a Wildland Fire

NASA Astrophysics Data System (ADS)

Miller, V. V.; Kochanski, A.; Mandel, J.; Herr, V.; Schranz, S.

2016-12-01

This presentation will discuss the fire simulation system based on WRF-SFIRE and assimilation of satellite Active Fires detection to estimate the socio-economic impact of Earth observations and fire behavior modeling for the 2011 Las Conchas fire in New Mexico. Multiple scenarios will be developed with the WRF-SFIRE simulation based on value of information (VOI) provided by retired incident commanders, whose decision inputs will steer scenario development and simulation. The scenarios will differ according to the Earth observations available through NASA and then deemed useful to incident commanders. Each scenario will be evaluated in terms of its socio-economic impact as specified by NASA (2012) for its wildland fire program. This presentation is a proposed supplement to NASA grant NNX13AH59G Wildland Fire Behavior and Risk Forecasting, Sher Schranz, PI.

Characterization of Crystallographic Structure and Internal Stress of Chromium Coatings Plated under Current Interruptions.

DTIC Science & Technology

1983-09-01

phase has a preferred orientation as most other electrodeposits, this peak found off the equatorial direction provided a way of measuring...40 (S)IoA) 1IliN3i0d , STANDARD HARD CHROM (KiC) INTERRUPTED PLATED CHROME (tC) -4’? 1001 1000X KC Chrome IC Chrome Bath Temperature *C 55 55 Current...COMMANDER ATTN: DRSNC- LC (D) I US ARMY TANK-AUTMV COWD DRSMC-LCE(D) 1 ATTN: DRSTA-RC DRSC-LCM(D) (BLDG 321) 1 WARREN, MI 48090 DRSMC- LCS (D) 1 DRSNC-LCU

[Determinant factors and conduct in post-accident with biological material among pre-hospital professionals].

PubMed

Paiva, Maria Henriqueta Rocha Siqueira; Oliveira, Adriana Cristina

2011-01-01

This transversal study was carried out with a multiprofessional team in the pre-hospital care in Minas Gerais, Brazil. It aimed to estimate the incidence of occupational accidents by exposure to biological material and post-accidents conductsta. Descriptive analysis and logistic regression were used. Incidence of accidents was 19.8%: 39,1% perforating-cutting materials and 56.5% body fluids. Doctors (33.3%) and drivers (24.0%) were most involved. Inadequate subsequent measures were highly prevalent: no medical assessment (69.6%), no work accident communication issued (91.3%), no measures (52.2%) and no serological follow-up (52.2%). Variables associated with accidents were: age >31 years old (OR = 3,02; IC95%: 1,25 - 7,33; p = 0,014) and working in basic support units (OR = 5,36; IC95%: 1,51 19,08; p = 0,010). The implementation of post-accidents protocols is suggested in order to reduce accidents and under-notification, and increase post-accident follow-up.

[Test and programme sensitivities of screening for colorectal cancer in Reggio Emilia].

PubMed

Campari, Cinzia; Sassatelli, Romano; Paterlini, Luisa; Camellini, Lorenzo; Menozzi, Patrizia; Cattani, Antonella

2011-01-01

to estimate the sensitivity of the immunochemical test for faecal occult blood (FOBT) and the sensitivity of the colorectal tumour screening programme in the province of Reggio Emilia. retrospective cohort study, including a sample of 80,357 people of both genders, aged 50-69, who underwent FOBT, during the first round of the screening programme in the province of Reggio Emilia, from April 2005 to December 2007. incidence of interval cancer. The proportional incidence method was used to estimate the sensitivity of FOBT and of the screening programme. Data were stratified according to gender, age and year of interval. the overall sensitivity of FOBT was 73.2% (95%IC 63.8-80.7). The sensitivity of FOBT was lower in females (70.5% vs 75.1%), higher in the 50-59 age group (78.6% vs 70.2%) and higher in the colon than rectum (75.1% vs 68.9%). The test had a significantly higher sensitivity in the 1st year of interval than in the 2nd (84.4% vs 60.5%; RR=0.39, 95%IC 0.22-0.70), a difference which was confirmed, also when data were stratified according to gender. The overall sensitivity of the programme is 70.9% (95%IC 61.5-78.5). No statistically significant differences were shown, if data were stratified according to gender, age or site. Again the sensitivity in the 1st year was significantly higher than in the 2nd year of interval (83.2% vs 57.0%; RR=0.41, 95%IC 0.24-0.69). Overall our data confirmed the findings of similar Italian studies, despite subgroup analysis showed some differences in sensitivity in our study.

Neuromuscular dysfunction that may predict ACL injury risk: a case report.

PubMed

Saunders, Natalie; McLean, Scott G; Fox, Aaron S; Otago, Leonie

2014-06-01

This case report examined the neuromuscular function of a competitive female netball player six days prior to an incident where she sustained an acute anterior cruciate ligament injury during normal sports activity. Electromyography was used to examine activation onsets of four lower limb muscles (rectus femoris, biceps femoris, medial hamstrings and gluteus medius) relative to initial contact (IC) during netball-specific landings of varying complexity. The results of the injured participant were compared to the remaining participants in the study (n=8), and the injured participant's injured limb was compared to the contralateral limb. The injured participant was the only player to record delayed pre-injury muscle onsets after IC for all muscles tested in the injured limb, while her non-injured limb was comparable to the other participants tested. Furthermore, delayed muscle onset after IC occurred more frequently as landing complexity increased. This case report suggests that delayed muscle activity onset after IC during landing may be an important risk factor for ACL injury. Copyright © 2014 Elsevier B.V. All rights reserved.

Assessing hospital disaster preparedness: a comparison of an on-site survey, directly observed drill performance, and video analysis of teamwork.

PubMed

Kaji, Amy H; Langford, Vinette; Lewis, Roger J

2008-09-01

There is currently no validated method for assessing hospital disaster preparedness. We determine the degree of correlation between the results of 3 methods for assessing hospital disaster preparedness: administration of an on-site survey, drill observation using a structured evaluation tool, and video analysis of team performance in the hospital incident command center. This was a prospective, observational study conducted during a regional disaster drill, comparing the results from an on-site survey, a structured disaster drill evaluation tool, and a video analysis of teamwork, performed at 6 911-receiving hospitals in Los Angeles County, CA. The on-site survey was conducted separately from the drill and assessed hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity, decontamination capability, and pharmaceutical stockpiles. The drill evaluation tool, developed by Johns Hopkins University under contract from the Agency for Healthcare Research and Quality, was used to assess various aspects of drill performance, such as the availability of the hospital disaster plan, the geographic configuration of the incident command center, whether drill participants were identifiable, whether the noise level interfered with effective communication, and how often key information (eg, number of available staffed floor, intensive care, and isolation beds; number of arriving victims; expected triage level of victims; number of potential discharges) was received by the incident command center. Teamwork behaviors in the incident command center were quantitatively assessed, using the MedTeams analysis of the video recordings obtained during the disaster drill. Spearman rank correlations of the results between pair-wise groupings of the 3 assessment methods were calculated. The 3 evaluation methods demonstrated qualitatively different results with respect to each hospital's level of disaster preparedness. The Spearman rank correlation coefficient between the results of the on-site survey and the video analysis of teamwork was -0.34; between the results of the on-site survey and the structured drill evaluation tool, 0.15; and between the results of the video analysis and the drill evaluation tool, 0.82. The disparate results obtained from the 3 methods suggest that each measures distinct aspects of disaster preparedness, and perhaps no single method adequately characterizes overall hospital preparedness.

Inter-crystal scatter identification for a depth-sensitive detector using support vector machine for small animal positron emission tomography

NASA Astrophysics Data System (ADS)

Yoshida, Eiji; Kitamura, Keishi; Kimura, Yuichi; Nishikido, Fumihiko; Shibuya, Kengo; Yamaya, Taiga; Murayama, Hideo

2007-02-01

In a conventional positron emission tomography (PET) detector, detected events are projected onto a 2D position histogram by an Anger calculation for crystal identification. However, the measured histogram is affected by inter-crystal scatterings (ICS) which occur in the entire detector. Peaks which are projected for each crystal in the histogram are blurred, and this causes ICS mispositioning. A depth-of-interaction (DOI) detector has been developed for the small animal PET scanner jPET-RD. This DOI detector uses 32×32 crystals with four layers and a 256-channel multi-anode flat panel photomultiplier tube (FP-PMT) which was developed by Hamamatsu Photonics K.K. Each crystal element is 1.45×1.45×4.5 mm 3. The FP-PMT has a large detective area (49×49 mm 2) and a small anode pitch (3.04 mm). Therefore, the FP-PMT can extensively trace the behavior of incident γ rays in the crystals including ICS event. We, therefore, propose a novel method for ICS estimation using a statistical pattern recognition algorithm based on a support vector machine (SVM). In this study, we applied the SVM for discriminating photoelectric events from ICS events generated from multiple-anode outputs. The SVM was trained by uniform irradiation events generated from a detector simulator using a Monte Carlo calculation. The success rate for ICS event identification is about 78% for non-training data. The SVM can achieve a true subtraction of ICS events from measured events, and it is also useful for random correction in PET.

[Methods of traditional chinese medicine in the treatment of patients with interstitial cystitis/bladder pain syndrome].

PubMed

Ignashov, A Yu; Deng, B; Kuzmin, I V; Slesarevskaya, M N

2018-03-01

In recent years, there has been an increasing interest in alternative (complementary) treatments of interstitial cystitis/bladder pain syndrome (IC/BPS). This is due both to the high incidence of IC/BPS and to a lack of effectiveness of conventional treatments. One of the directions of alternative therapies is a traditional Chinese medicine using a special diet, various animal and plant-derived medicines, breathing exercises and acupuncture. This review analyzes the accumulated experience in using traditional Chinese medicine in the treatment of patients with IC/BPS. The presented data indicate that these methods appear to be promising, since they are effective in a significant number of patients, lead to an improvement in their quality of life, are non-invasive and well tolerated. However, due to the lack of clinical studies, the efficacy of this treatment modalities needs to be confirmed.

Autonomous mobile platform for enhanced situational awareness in Mass Casualty Incidents.

PubMed

Yang, Dongyi; Schafer, James; Wang, Sili; Ganz, Aura

2014-01-01

To enhance the efficiency of the search and rescue process of a Mass Casualty Incident, we introduce a low cost autonomous mobile platform. The mobile platform motion is controlled by an Android Smartphone mounted on a robot. The pictures and video captured by the Smartphone camera can significantly enhance the situational awareness of the incident commander leading to a more efficient search and rescue process. Moreover, the active RFID readers mounted on the mobile platform can improve the localization accuracy of victims in the disaster site in areas where the paramedics are not present, reducing the triage and evacuation time.

The instrument control software package for the Habitable-Zone Planet Finder spectrometer

NASA Astrophysics Data System (ADS)

Bender, Chad F.; Robertson, Paul; Stefansson, Gudmundur Kari; Monson, Andrew; Anderson, Tyler; Halverson, Samuel; Hearty, Frederick; Levi, Eric; Mahadevan, Suvrath; Nelson, Matthew; Ramsey, Larry; Roy, Arpita; Schwab, Christian; Shetrone, Matthew; Terrien, Ryan

2016-08-01

We describe the Instrument Control Software (ICS) package that we have built for The Habitable-Zone Planet Finder (HPF) spectrometer. The ICS controls and monitors instrument subsystems, facilitates communication with the Hobby-Eberly Telescope facility, and provides user interfaces for observers and telescope operators. The backend is built around the asynchronous network software stack provided by the Python Twisted engine, and is linked to a suite of custom hardware communication protocols. This backend is accessed through Python-based command-line and PyQt graphical frontends. In this paper we describe several of the customized subsystem communication protocols that provide access to and help maintain the hardware systems that comprise HPF, and show how asynchronous communication benefits the numerous hardware components. We also discuss our Detector Control Subsystem, built as a set of custom Python wrappers around a C-library that provides native Linux access to the SIDECAR ASIC and Hawaii-2RG detector system used by HPF. HPF will be one of the first astronomical instruments on sky to utilize this native Linux capability through the SIDECAR Acquisition Module (SAM) electronics. The ICS we have created is very flexible, and we are adapting it for NEID, NASA's Extreme Precision Doppler Spectrometer for the WIYN telescope; we will describe this adaptation, and describe the potential for use in other astronomical instruments.

32 CFR 536.13 - Chief, National Guard Bureau.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., National Guard Bureau (NGB), shall: (a) Ensure the designation of a point of contact for claims matters in... points of contact to the Commander USARCS. (c) Designate claims officers to investigate claims generated... area in which the claims incident occurred. ...

Real-Life Outcomes for Patients with Asthma Prescribed Spacers for Use with Either Extrafine- or Fine-Particle Inhaled Corticosteroids.

PubMed

Guilbert, Theresa W; Colice, Gene; Grigg, Jonathan; van Aalderen, Wim; Martin, Richard J; Israel, Elliot; Postma, Dirkje S; Roche, Nicolas; Phipatanakul, Wanda; Hillyer, Elizabeth V; Evans, Jennifer M; Dolovich, Myrna B; Price, David B

Spacers are often used with pressurized metered-dose inhalers (pMDIs) to eliminate the need for coordinating inhalation with actuation. To investigate the real-life effectiveness of spacers prescribed for use with either extrafine- or fine-particle inhaled corticosteroids (ICSs). This historical matched cohort study examined anonymous medical record data over 2 years (1-year baseline, 1-year outcome) for patients with asthma aged 12 to 80 years initiating ICSs by pMDI with or without prescribed spacer. We compared outcomes for spacer versus no-spacer arms, matched for key baseline and asthma-related characteristics, within 2 ICS cohorts: (1) extrafine-particle ICS (beclomethasone) and (2) fine-particle ICS (fluticasone). Effectiveness end points were compared using conditional regression methods. Matched spacer and no-spacer arms of the extrafine-particle ICS cohort each included 2090 patients (69% females; median age, 46-47 years) and the 2 arms of the fine-particle ICS cohort each included 444 patients (67% females; median age, 45 years). With extrafine-particle ICS, we observed no significant difference between spacer and no-spacer arms in severe exacerbation rate (primary end point): adjusted rate ratio, 1.01 (95% CI, 0.83-1.23). With fine-particle ICS, the severe exacerbation rate ratio with spacers was 0.77 (0.47-1.25). Oropharyngeal candidiasis incidence was low and similar in spacer and no-spacer arms for both ICS cohorts. We found no evidence that prescribed spacer devices are associated with improved asthma outcomes for extrafine- or fine-particle ICS administered by pMDI. These findings challenge long-standing assumptions that spacers should improve pMDI effectiveness and indicate the need for pragmatic trials of spacers in clinical practice. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Decontamination Workshop for Emergency Responding Personnel How Clean is Clean Enough 12-14 September 2007

DTIC Science & Technology

2008-09-01

refers to a Medical Treatment Facility (MTF), can we assume that disrobing is sufficient? Is it possible to develop specific site clearance criteria ...o First responders , medical personnel, and the HAZMAT team o Incident Commanders o Public information officials o Hospitals and hospital networks ...clean personnel (both victims and first responders ) need to be when they are released from the incident site (or treatment facility for those that make

The Benefits of Collaborative Processes for Establishing All Hazard Incident Management Teams in Urban Area Security Initiative Regions

DTIC Science & Technology

2013-09-01

incidents beyond wild land fires.15 This journal article also noted that national IMTs provided command functions at the World Trade Center on September...11, 2001, Hurricane Katrina in 2005 and search and recovery efforts following the Space Shuttle Columbia disaster.16 Because of the utility and...Management Team SWA Southwest Area SWCC Southwest Coordination Center UASI Urban Area Security Initiative UAWG Urban Area Working Group

A semi-quantitative translational pharmacology analysis to understand the relationship between in vitro ENT1 inhibition and the clinical incidence of dyspnoea and bronchospasm

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

Rosenbrier Ribeiro, Lyn, E-mail: Lyn.Rosenbrierrib

Adenosine contributes to the pathophysiology of respiratory disease, and adenosine challenge leads to bronchospasm and dyspnoea in patients. The equilibrative nucleoside transporter 1 (ENT1) terminates the action of adenosine by removal from the extracellular environment. Therefore, it is proposed that inhibition of ENT1 in respiratory disease patients leads to increased adenosine concentrations, triggering bronchospasm and dyspnoea. This study aims to assess the translation of in vitro ENT1 inhibition to the clinical incidence of bronchospasm and dyspnoea in respiratory disease, cardiovascular disease and healthy volunteer populations. Four marketed drugs with ENT1 activity were assessed; dipyridamole, ticagrelor, draflazine, cilostazol. For each patientmore » population, the relationship between in vitro ENT1 [{sup 3}H]-NBTI binding affinity (K{sub i}) and [{sup 3}H]-adenosine uptake (IC{sub 50}) to the incidence of: (1) bronchospasm/severe dyspnoea; (2) tolerated dyspnoea and; (3) no adverse effects, was evaluated. A high degree of ENT1 inhibition (≥ 13.3x K{sub i}, ≥ 4x IC{sub 50}) associated with increased incidence of bronchospasm/severe dyspnoea for patients with respiratory disease only, whereas a lower degree of ENT1 inhibition (≥ 0.1x K{sub i}, ≥ 0.05x IC{sub 50}) associated with a tolerable level of dyspnoea in both respiratory and cardiovascular disease patients. ENT1 inhibition had no effect in healthy volunteers. Furthermore, physicochemical properties correlative with ENT1 binding were assessed using a set of 1625 diverse molecules. Binding to ENT1 was relatively promiscuous (22% compounds K{sub i} < 1 μM) especially for neutral or basic molecules, and greater incidence tracked with higher lipophilicity (clogP > 5). This study rationalises inclusion of an assessment of ENT1 activity during early safety profiling for programs targeting respiratory disorders. - Highlights: • ENT1 inhibition causes bronchospasm and severe dyspnoea in respiratory patients. • Neutral or basic compounds with clogP > 5 have increased promiscuity to bind ENT1. • ENT1 should be assessed within safety strategies for respiratory research programs. • Quantitative translation enables informed risk-assessment of off-target ENT1 activity.« less

[Lower incidence of severe damage to target organs in mexican patients with systemic sclerosis and diffuse skin affection].

PubMed

Rojas-Serrano, Jorge; Codina-Velásquez, Helga; Medrano-Ramírez, Gabriel; Abraham Simón, J; Vera-Lastra, Olga; Vázquez-Mellado, Janitzia

2008-01-01

To determine the cumulative incidence of severe organ involvement in Mexican patients with systemic sclerosis (SS) and diffuse scleroderma at 3 years from the onset of SS symptoms, and to compare itwith the cumulative incidence observed in a cohort of white patients with SS. Patients with SS and diffuse scleroderma were evaluated within the first 2 years from the onset of SS symptoms and were included. An estimation of the cumulative incidence of severe involvement to the skin, kidney, heart, lungs, and gastrointestinal track at 3 years from the onset of SS symptoms was carried out. This cumulative incidence was compared with that of white SS patients with diffuse scleroderma, using the one sample test for a binomial proportion. Sixty-three patients were included. The cumulative incidence of severe involvement to the skin was 3.17% (2/63) (95% CI, 0.04%-11); kidney involvement in 4.17% (3/63) (95% CI, 0.99%-13.29%); heart involvement in 1.6% (1/63) (95% CI, 0.04%-8.5%); lung involvement in 11.11% (7/63) (95% IC, 4.5%-21.5%); and gastrointestinal involvement in 4.7% (3/63) (95% IC, 0.99%-13.3%). Mexican patients had a lower Reumatol Clin. 2008;4(1):3-7 3 02 ORIG 2582 (3-7).qxp 23/1/08 11:09 Página 4 Rojas-Serrano J et al. Incidencia de daño grave en pacientes mexicanos con esclerosis sistémica incidence of severe skin involvement (P=.0001), kidney involvement (P=.03) and heart involvement (P=.03) compared to white SS patients with diffuse scleroderma. The cumulative incidence of severe organ involvement in SS Mexican patients with diffuse scleroderma was determined. The incidence of severe skin, kidney and heart involvement is lower than in white SS patients with diffuse scleroderma. Copyright © 2008 Elsevier España. Reumatología Clínica ® Sociedad Española de Reumatología and ® Colegio Mexicano de Reumatología. Published by Elsevier Espana. All rights reserved.

Preparing for a Crisis.

ERIC Educational Resources Information Center

Perea, Rosalie D.; Morrison, Shirley

1997-01-01

To handle unforeseen crises, Albuquerque Public Schools established a critical-incident response team with a simple, understandable chain of command. The group aims to ensure maximum safety and people' well-being, develop a districtwide crisis-response-management plan, coordinate necessary training, and collaborate with community agencies…

Interface between hospital and fire authorities--a concept for management of incidents in hospitals.

PubMed

Gretenkort, Peter; Harke, Henning; Blazejak, Jan; Pache, Bernd; Leledakis, Georgios

2002-01-01

Although every hospital needs a security plan for the support of immobile patients who do not possess autonomous escape capabilities, little information exists to assist in the development of practical patient evacuation methods. 1) In hospitals during disasters, incident leadership of the fire authorities can be supported effectively by hospital executives experienced in the management of mass casualties; and 2) As an alternative for canvas carry sheets, rescue drag sheets can be employed for emergency, elevator-independent, patient evacuation. A hospital evacuation exercise was planned and performed to obtain experiences in incident command and to permit calculation of elevator-independent patient transport times. Performance of incident leadership was observed by means of pre-defined checklists. The effectiveness and efficiency of carrying teams with five persons each were compared to those with a rescue drag sheet employed by a single person. Incident command for hospitals during a disaster is enhanced considerably by pre-defined and trained executives who are placed at the immediate disposal of the fire authorities. For elevator-independent patient transport, the rescue drag sheet was superior to conventional carrying measures because of a reduced number of transport personnel required to move each patient. With this method, patient transport times averaged 54 m/min. flat and 18 seconds for one floor descent. Experiences from a hospital during an evacuation exercise provided decision criteria for changes in the disaster preparedness plan. Hospital incident leadership was assigned to executives-in-charge in close co-operation with the fire authorities. All beds were equipped with a rescue drag sheet. Both concepts may help to cope with an emergency evacuation of a hospital.

Understanding Organizational Commitment and Satisfaction of TACOM Life Cycle Management Command Acquisition, Technology, and Logistics Associates

DTIC Science & Technology

2012-04-01

y B e n e fi ts P h y s ic a l...J o b A ff e c ti v e C o m m it m e n t C o n ti n o u s C o m m it m e n t N o rm a ti v e C o m m it m e n t Pa y 1.00 Be ne fits 0.42 1.00...group is sometimes called the “ Millennial Group”. Research in the area of leading millennials at TACOM was completed by Pamela Demeulenaere

Automation of the Marine Corps Planning Process

DTIC Science & Technology

2014-06-01

I & IV P ro b le m Fr am in g C h ap te r II  JT C W  C P O F  IO Sv 1 C O A D e ve lo p m e n t C O A W ar -G am e C O A C o m p...S  JA D IC S  P SS -S O F  St ri ke Li n k  C ID N E  IO Sv 2  IO Sv 3  M ar in e Li n k Command & Control C h ap te r II I

Presentation to US-Canada Bilateral Technical Working ...

EPA Pesticide Factsheets

DHS and EPA have collaborated in the development of a draft charter for Technical Working Group (TWG) to serve as the basis of negotiations of bilateral agreements with other countries. The TWG would provide a mechanism for sharing both response and R&D expertise and experience in the event of a CBRN incident. The membership of each TWG was tailored to provide appropriate support to the incident commander for the particular situation. Some of the same expertise has been engaged in response to the

Making Sense in the Edge of Chaos: A Framework for Effective Initial Response Efforts to Large-Scale Incidents

DTIC Science & Technology

2010-09-01

working with equally experienced partners who can, cumulatively, help each other make sense of chaotic situations. “Human brains collect, organize...but a process reinforced by years of Fire Department training. No matter what we do, even an optimally functioning human brain will prepare for...trick or reorganize the brain of those who will be first responding incident commanders to an edge-of-chaos event into creatively making sense of

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

Emergency Preparedness in the Workplace: The Flulapalooza Model for Mass Vaccination.

PubMed

Swift, Melanie D; Aliyu, Muktar H; Byrne, Daniel W; Qian, Keqin; McGown, Paula; Kinman, Patricia O; Hanson, Katherine Louise; Culpepper, Demoyne; Cooley, Tamara J; Yarbrough, Mary I

2017-09-01

To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011-2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency. A total of 66 591 influenza vaccines were administered at 5 annual Flulapalooza events; 13 318 vaccines per event on average. Changes to the physical layout, staffing mix, and documentation processes improved vaccination efficiency 74%, from approximately 38 to 67 vaccines per hour per vaccinator, while reducing overall staffing needs by 38%. An unexpected finding was the role of social media in facilitating active engagement. Health care organizations can use a closed point-of-dispensing model and Hospital Incident Command System to conduct mass vaccination events, and can adopt the "Flulapalooza method" as a best practice model to enhance efficiency.

Does use of intraoperative cell-salvage delay recovery in patients undergoing elective abdominal aortic surgery?

PubMed

Tavare, Aniket N; Parvizi, Nassim

2011-06-01

A best evidence topic in vascular surgery was written according to a structured protocol. The question addressed was whether the use of intraoperative cell-salvage (ICS) leads to negative outcomes in patients undergoing elective abdominal aortic surgery? Altogether 305 papers were found using the reported search, of which 10 were judged to represent the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. None of the 10 papers included in the analysis demonstrated that ICS use led to significantly higher incidence of cardiac or septic postoperative complications. Similarly, length of intensive treatment unit (ITU) or hospital stay and mortality in elective abdominal aortic surgery were not adversely affected. Indeed two trials actually show a significantly shorter hospital stay after ICS use, one a shorter ITU stay and another suggests lower rates of chest sepsis. Based on these papers, we concluded that the use of ICS does not cause increased morbidity or mortality when compared to standard practise of transfusion of allogenic blood, and may actually improve some clinical outcomes. As abdominal aortic surgery inevitably causes significant intraoperative blood loss, in the range of 661-3755 ml as described in the papers detailed in this review, ICS is a useful and safe strategy to minimise use of allogenic blood.

Kangaroo care and behavioral and physiologic pain responses in very-low-birth-weight twins: a case study.

PubMed

Cong, Xiaomei; Cusson, Regina M; Hussain, Naveed; Zhang, Di; Kelly, Sharon P

2012-09-01

The purpose of this case study was to describe pain responses in three study conditions: longer (30 minutes) kangaroo care (KC) before and throughout heel stick (KC30), shorter (15 minutes) KC before and throughout heel stick (KC15), and incubator care throughout heel stick (IC) in 28-week gestational age twins. Pain responses were measured by crying time, Preterm Infant Pain Profile (PIPP), and heart rate variability indexes, including low-frequency power (LF, representing sympathetic activity), high-frequency power (HF, parasympathetic activity), and LF/HF ratio (sympathetic-parasympathetic balance). Both twins cried more and had higher PIPP pain scores and tachycardia during heel stick in the IC condition. Infant B had an incident of apnea and tachycardia by the end of the heel stick and a bradycardia episode during recovery in the IC condition. The twins had lower LF/HF ratios (better autonomic nervous system balance) during recovery in both longer and shorter KC conditions compared with the IC condition. Infant B had difficulty returning to LF/HF ratio baseline level after the painful procedure in the IC condition. These data suggest that both longer and shorter KC before and throughout painful procedures can be helpful in reducing behavioral and physiologic pain responses in preterm infants. Copyright © 2012 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Behavior and handling of physically and immunologically castrated market pigs on farm and going to market.

PubMed

Guay, K; Salgado, G; Thompson, G; Backus, B; Sapkota, A; Chaya, W; McGlone, J J

2013-11-01

Physical castration is a common management practice on commercial swine farms in the United States to reduce the incidence of boar taint and aggressive behavior. One alternative to physical castration (PC) is to immunologically castrate (IC) male pigs by blocking the gonadotropin-releasing factor (GnRF), thereby reducing levels of LH, FSH, testosterone, and androstenone. The objectives of this study were to evaluate the effects of IC on pig behavior, human-pig interactions, and handling during and after transport. Pigs were given the first immunization at wk 7 of the grower-finisher period, and second immunizations were given at wk 11, 13, or 14 of the grower-finisher period. Behaviors of PC and IC barrows were sampled at 3 time points after entering finishing at 9 wk of age: 7 wk before first injection, 16 wk (after immunization was complete) into finishing, and 1 d before marketing (16 to 19 wk into finishing). Handling during loading and unloading of trailers going to market was also quantified. Before the first injection, intact males showed increased aggression (P=0.014) and mounting (P=0.048), whereas PC barrows spent more (P=0.003) time feeding than intact males. There were treatment×time interactions for lying (P=0.018), aggression (P<0.001), and standing (P=0.009) behaviors. Few differences were observed in pig-human interactions between PC and IC barrows, with IC and PC approaching people in the same amount of time, but IC barrows were more (P<0.001) aggressive in chewing and rubbing on the test person's pant leg and boots. When handling and loading for processing in the home barn, PC barrows were more (P<0.05) vocal than IC barrows. Fewer dead and down pigs were observed among IC (0%) compared with PC barrows (1.17%). Immunological castration may result in similar or improved animal welfare compared to the stress of physical castration without pain relief.

Efficacy and safety in pharmacological cardioversion of recent-onset atrial fibrillation: a propensity score matching to compare amiodarone vs class IC antiarrhythmic drugs.

PubMed

Bonora, Antonio; Turcato, Gianni; Franchi, Elena; Taioli, Gabriele; Dilda, Alice; Zerman, Germana; Maccagnani, Antonio; Pistorelli, Claudio; Olivieri, Oliviero

2017-09-01

The acute management of recent-onset (<48 h) atrial fibrillation (AF) is still debated. Aim of our study was to compare efficacy and safety of intravenously administered class IC antidysrhythmic agents vs amiodarone in a propensity score matched series of patients acutely treated for AF in the emergency department. During a 3-year period, we retrospectively evaluated all episodes of recent-onset (<48 h) AF pharmacologically treated for sinus rhythm restoration in the emergency department. By means of a propensity score matching considering the main statistically different covariates, we selected two accurately matched treatment groups. We analysed the differences between amiodarone and class IC group in terms of efficacy and safety that is conversion to sinus rhythm rates within 12 and 48 h after starting treatment, time to conversion, and adverse drug effects. An overall number of 817 episodes of recent-onset AF were collected (amiodarone group = 406, class IC group = 411). After matching, we obtained 358 episodes equally divided (amiodarone group = 179 and class IC group = 179). Conversion rates within 12 h were 139 (53.1 %) in amiodarone group and 95 (72.6 %) in class IC group (p < 0.05). Median time for cardioversion was 420 min (331.6-508.3 CI 95 %) in amiodarone and 55 min (44.9-65.1 CI 95 %) in class IC group (p < 0.05). The incidence of adverse events in both groups was very low and equally distributed (p = ns). Intravenously administration of class IC agents, when compared with amiodarone, proved to be more rapid and effective, and equally safe in the acute management of recent-onset AF.

Benefits, barriers, and limitations on the use of Hospital Incident Command System.

PubMed

Shooshtari, Shahin; Tofighi, Shahram; Abbasi, Shirin

2017-01-01

Hospital Incident Command System (HICS) has been established with the mission of prevention, response, and recovery in hazards. Regarding the key role of hospitals in medical management of events, the present study is aimed at investigating benefits, barriers, and limitations of applying HICS in hospital. Employing a review study, articles related to the aforementioned subject published from 1995 to 2016 were extracted from accredited websites and databases such as PubMed, Google Scholar, Elsevier, and SID by searching keywords such as HICS, benefits, barriers, and limitations. Then, those articles were summarized and reported. Using of HICS can cause creating preparedness in facing disasters, constructive management in strategies of controlling events, and disasters. Therefore, experiences indicate that there are some limitations in the system such as failure to assess the strength and severity of vulnerabilities of hospital, no observation of standards for disaster management in the design, constructing and equipping hospitals, and the absence of a model for evaluating the system. Accordingly, the conducted studies were investigated for probing the performance HICS. With regard to the role of health in disaster management, it requires advanced international methods in facing disasters. Using accurate models for assessing, the investigation of preparedness of hospitals in precrisis conditions based on components such as command, communications, security, safety, development of action plans, changes in staff's attitudes through effective operational training and exercises and creation of required maneuvers seems necessary.

Express railway disaster in Amagasaki: a review of urban disaster response capacity in Japan.

PubMed

Nagata, Takashi; Rosborough, Stephanie N; Rosborogh, Stephanie N; VanRooyen, Michael J; Kozawa, Shuichi; Ukai, Takashi; Nakayama, Shinichi

2006-01-01

On the morning of 25 April 2005, a Japan Railway express train derailed in an urban area of Amagasaki, Japan. The crash was Japan's worst rail disaster in 40 years. This study chronicles the rescue efforts and highlights the capacity of Japan's urban disaster response. Public reports were gathered from the media, Internet, government, fire department, and railway company. Four key informants, who were close to the disaster response, were interviewed to corroborate public data and highlight challenges facing the response. The crash left 107 passengers dead and 549 injured. First responders, most of whom were volunteers, were helpful in the rescue effort, and no lives were lost due to transport delays or faulty triage. Responders criticized an early decision to withdraw rescue efforts, a delay in heliport set-up, the inefficiency of the information and instruction center, and emphasized the need for training in confined space medicine. Communication and chain-of-command problems created confusion at the scene. The urban disaster response to the train crash in Amagasaki was rapid and effective. The Kobe Earthquake and other incidents sparked changes that improved disaster preparedness in Amagasaki. However, communication and cooperation among responders were hampered, as in previous disasters, by the lack of a structured command system. Application of an incident command system may improve disaster coordination in Japan.

Command Relationships of Active and National Guard Forces During Domestic Disaster Response in California

DTIC Science & Technology

2007-06-15

is replacing the term Military Assistance to Civil Authorities ( MACA ). Emergency Management. The provision of overall operational control or...both public and private, to organize field-level incident management operations. Military Assistance to Civil Authorities ( MACA ). The broad mission of

A Wireless Local Area Network Command and Control System for Explosive Ordnance Disposal Incident Response

DTIC Science & Technology

2001-09-01

43 4. GPS ......................................................................................................44 E. POWER SUPPLY HARDWARE...44 Figure 5.6 Earthmate GPS Receiver ........................................................................................45...and 5Watts at 25 Ft Effective Range Minimum range of wireless link is 5 miles. Positional awareness System requires GPS input to determine

NOAA Homeland Security Program Office

Science.gov Websites

Emergency Managment Institute IS 100.b - Introduction to Incident Command System IS 700.a - NIMS An Introduction IS 701.b - NIMS Multiagency Coordination System (MACS) Course IS 800.b - National Response Framework, An Introduction United States Coast Guard; Maritime Domain Awareness Privacy Act Statement

Apollo 16 Mission: Oxidizer Deservicing Tank Failure. No. 1; Anomaly Report

NASA Technical Reports Server (NTRS)

1972-01-01

An explosive failure of a ground support equipment decontamination unit tank occurred during the postflight deactivation of the oxidizer (nitrogen tetroxide) portion of the Apollo 16 command module reaction control system. A discussion of the significant aspects of the incident and conclusions are included.

Inflammatory bowel disease in Bahrain: single-center experience

PubMed Central

Abdulla, Maheeba; Al Saeed, Mahmood; Fardan, Rawdha Hameed; Alalwan, Hawra Faisal; Ali Almosawi, Zahra S; Almahroos, Amal Fuad; Al Qamish, Jehad

2017-01-01

Purpose The number of newly diagnosed inflammatory bowel disease (IBD) cases such as ulcerative colitis (UC), Crohn’s disease (CD), and indeterminate colitis (IC) is rapidly increasing in Gulf countries and Saudi Arabia. The aim of this study was to investigate the incidence and prevalence of IBD in patients who have attended the Salmaniya Medical Complex, Bahrain, between the years 1984 and 2014. Patients and methods All patients who had attended the Salmaniya Medical Complex, Bahrain, and had been diagnosed with UC, CD, or IC, between the years 1984 and 2014, were included in the analysis. Data collected were: patient demographics, symptoms, clinical signs, complications, surgical interventions, extent of disease, endoscopic findings, histopathology, and lab measurements. Results A total of 187 cases were included; 61 had CD, 123 had UC, and a further 3 cases presented with IC. A clear increase in the incidence and prevalence of IBD can be seen in this cohort. The prevalence of IBD was calculated to be 26.25/105 cases. The average number of IBD cases increased from 3 cases (average for the years 1984–2001) to 12 cases (average for the years 2002–2014). A number of factors correlate positively or negatively with CD and UC. In the current study, a link between gastrointestinal complications in CD cases and the use of steroids as a treatment was noted (p-value −0.02). Age also had a significant influence on the need for surgery in CD cases (p-value −0.04), and a family history of UC was statistically linked to surgical intervention (p-value −0.05). Conclusions IBD can no longer be considered a rare disease in Bahrain. The incidence of both UC and CD is steadily increasing. There is a need for increasing awareness of the Bahraini public to IBD in order for proper medical care to be given. PMID:28765713

[Malaria's seroepidemiology in a group of migrants in transit (Chiapas, 2008)].

PubMed

Betanzos-Reyes, Angel Francisco; González-Cerón, Lilia; Rodríguez, Mario Henry; Torres-Monzón, Jorge Aurelio

2012-10-01

To know the prevalence of malaria and the factors associated with the infection in migrants in the southern border of Mexico, during 2008. In 706 migrants, active malaria infection was investigated using a rapid diagnostic test and PCR and past infection using serology. A questionnaire was applied to investigate the conditions associated to infection. 85.6% originated from Central America, none presented an active infection, although 4.2% were seropositive, most of these came from the countries with the highest malaria incidence in the region. Seropositivity was associated with the number of previous malaria episodes (OR=1.44; IC95% 1.04-2.00), years living in their community of origin (OR=1.03; IC95% 1.00-1.07), and knowledge and self-medication with anti-malaria drugs (OR=3.38; IC95% 1.48-7.67). . The previous exposure of migrants and the difficulties for their detection indicate the need of new strategies for the epidemiological surveillance for these populations.

32 CFR 750.2 - Investigations: In general.

Code of Federal Regulations, 2011 CFR

2011-07-01

... give rise to a claim against the United States shall include the following: This investigation has been... command where the incident giving rise to the claim is alleged to have happened is responsible for... result in a claim against or in favor of the United States shall be promptly and thoroughly investigated...

Radiofrequency/Microwave Radiation Biological Effects and Safety Standards: A Review

DTIC Science & Technology

1994-06-01

reported that a 50 year old woman had developed cataracts after intermittent exposure to a 2.45 GHz microwave oven. The incident power density levels were...include: Survelance, Communications, Command and Control, Intelligence, Signal Processing, Computer Sience and Technology, Electrom Technology, Photoracs and laiity Saences. S* I l I

DOD Civil Support During the 2007 and 2008 California Wildland Fires

DTIC Science & Technology

2009-11-13

removing DOD assets from the electric grid so that the electricity could be used elsewhere. We reviewed:  prior audits;  the Stafford Act...42, section 1856a. Understanding the distinction between a local incident invo lving local mil itary commanders and local civilian officia ls verses

Keeping Haines Real - Or Really Changing Haines?

Treesearch

Brian E. Potter; Dan Borsum; Don Haines

2002-01-01

Most incident command teams can handle low- to moderate-intensity fires with few unanticipated problems. However, high-intensity situations, especially the plume-dominated fires that often develop when winds are low and erratic behavior is unexpected, can create dangerous situations even for well-trained, experienced fire crews (Rothermel 1991). Plume-dominated fires...

Force Protection for Fire Fighters: Warm Zone Operations at Paramilitary Style Active Shooter Incidents in a Multi-Hazard Environment as a Fire Service Core Competency

DTIC Science & Technology

2012-03-01

weapon. The paramilitary style assault by two students at Columbine High School in 1999 revealed serious shortcomings in the fire service “standby...1158 hours, four of those students were still lying on the lawn in front of the school cafeteria . Even though the scene was not secure, paramedics...Lance Kirklin, one of the severely injured students rescued from in front of the cafeteria , briefly stopped at the incident command post en route to

Saturn Apollo Program

NASA Image and Video Library

1967-03-01

The Saturn V configuration is shown in inches and meters as illustrated by the Boeing Company. The Saturn V vehicle consisted of three stages: the S-IC (first) stage powered by five F-1 engines, the S-II (second) stage powered by five J-2 engines, the S-IVB (third) stage powered by one J-2 engine. A top for the first three stages was designed to contain the instrument unit, the guidance system, the Apollo spacecraft, and the escape system. The Apollo spacecraft consisted of the lunar module, the service module, and the command module. The Saturn V was designed perform lunar and planetary missions and it was capable of placing 280,000 pounds into Earth orbit.

Peripheral Vascular Disease: The Beneficial Effect of Exercise in Peripheral Vascular Diseases Based on Clinical Trials.

PubMed

Elnady, Basant M; Saeed, Ayman

2017-01-01

Intermittent claudication (IC) due to peripheral artery diseases (PAD) is one of the disabling disease that can affect quality of life (QOL) and functional status of capacity. It is characterized by cramping pain which develops with exercise and eliminated by rest secondary to decrease blood flow to the muscles. The annual incidence rate is increased with age. Exercise rehabilitation has a great impact in improving the functional capacity and prevent the functional disability. The available evidences from current studies have showed that exercise therapy is considered the primary treatment in PAD, which in consequently improves the QOL. In this chapter we will illustrate the current available evidences which support exercise benefit and outcomes in PAD with IC.

Response Protocol Toolbox: Planning for and Responding to Drinking Water Contamination Threats and Incidents. Response Guidelines

DTIC Science & Technology

2004-08-01

sp ec if ic ra d io n u cl id es 9 0 0 S er ie s 3 2 In te ri m F in al – A u g u st 2 0 0 4 R E S...in je ct io n , h ea d sp ac e S ee M o d u le 4 A n a ly si s: G C /M S , G C , H P L C , L C -M S U n k n o w n in o rg an ic s 1 L...er f o r th e m et er o r k it u se d d u ri n g s

Upgrade of the LHC magnet interconnections thermal shielding

NASA Astrophysics Data System (ADS)

Musso, Andrea; Barlow, Graeme; Bastard, Alain; Charrondiere, Maryline; Chrul, Anna; Damianoglou, Dimitrios; Deferne, Guy; Dib, Gaëlle; Duret, Max; Guinchard, Michael; Prin, Hervé; Strychalski, Michał; Craen, Arnaud Vande; Villiger, Gilles; Wright, Loren

2014-01-01

The about 1700 interconnections (ICs) between the Large Hadron Collider (LHC) superconducting magnets include thermal shielding at 50-75 K, providing continuity to the thermal shielding of the magnet cryostats to reduce the overall radiation heat loads to the 1.9 K helium bath of the magnets. The IC shield, made of aluminum, is conduction-cooled via a welded bridge to the thermal shield of the adjacent magnets which is actively cooled. TIG welding of these bridges made in the LHC tunnel at installation of the magnets induced a considerable risk of fire hazard due to the proximity of the multi-layer insulation of the magnet shields. A fire incident occurred in one of the machine sectors during machine installation, but fortunately with limited consequences thanks to prompt intervention of the operators. LHC is now undergoing a 2 years technical stop during which all magnet's ICs will have to be opened to consolidate the magnet electrical connections. The IC thermal shields will therefore have to be removed and re-installed after the work is completed. In order to eliminate the risk of fire hazard when re-welding, it has been decided to review the design of the IC shields, by replacing the welded bridges with a mechanical clamping which also preserves its thermal function. An additional advantage of this new solution is the ease in dismantling for maintenance, and eliminating weld-grinding operations at removal needing radioprotection measures because of material activation after long-term operation of the LHC. This paper describes the new design of the IC shields and in particular the theoretical and experimental validation of its thermal performance. Furthermore a status report of the on-going upgrade work in the LHC is given.

Immune status does not predict high-risk HPV in anal condyloma.

PubMed

Lee, Janet T; Goldberg, Stanley M; Madoff, Robert D; Tawadros, Patrick S

2016-03-01

More than 90% of anal condyloma is attributed to nonhigh risk strains of human papillomavirus (HPV), thus patients with anal condyloma do not necessarily undergo HPV serotyping unless they are immunocompromised (IC). We hypothesized that IC patients with anal condyloma have a higher risk of high-risk HPV and dysplasia than nonimmunocompromised (NIC) patients. We performed a retrospective chart review of patients who underwent surgical treatment by a single surgeon for anal condyloma from 1/2000 to 1/2012. HPV serotyping was performed on all patient samples. We compared incidence of high-risk HPV and dysplasia in condyloma specimens from IC and NIC patients. High-risk HPV was identified in 14 specimens with serotypes 16, 18, 31, 33, 51, 52, and 67. Twenty-two cases (18.3%) had dysplasia. Invasive carcinoma was identified in one IC patient. The prevalence of dysplasia or high-risk HPV was not significantly different between IC and NIC groups. High-risk HPV was a significant independent predictor of dysplasia (odds ratio [OR] = 5.2; 95% CI = 1.24-21.62). Immune status, however, was not a significant predictor of high-risk HPV (OR = 1.11; 95% CI = 0.16-5.12) nor dysplasia (OR = 0.27; 95% CI = 0.037-1.17). IC patients did not have a significantly higher prevalence or risk of high-risk HPV or dysplasia in our study. HPV typing of all condylomata, regardless of immune status, should be considered as it may help predict risk of neoplastic transformation or identify NIC patients with an increased risk of developing anal intraepithelial neoplasia. Copyright © 2016 Elsevier Inc. All rights reserved.

Timing of Emergency Department Visits for Childhood Asthma after Initial Inhaled Corticosteroid Use

PubMed Central

Zhang, Shun; Holloway, Kelvin; Tyler-Hill, Yasmin

2015-01-01

Abstract Inhaled corticosteroids can prevent acute exacerbations and emergency visits when used as part of a chronic care plan for long-term control of asthma, but low patient adherence and inadequate provider prescribing (clinical inertia) can limit these benefits. State Medicaid programs are a major source of insurance coverage for low-income children, paying for medications and preventive care, as well as bearing the cost of adverse outcomes for common chronic conditions in childhood, such as asthma. This study measured the incidence and timing of emergency department (ED) visits in the first 90 days after an initial inhaled corticosteroid prescription (ICS-Rx) among 43,156 Medicaid-enrolled children with a diagnosis of asthma in 14 southern states in 2007. One in 5 children (19.6%) with asthma had at least 1 ED visit in the first 90 days after initial ICS-Rx; 10% of these visits occurred within the first 48 hours, and 25% occurred within the first week. Continued ICS-Rx use was associated with lower risk of an ED visit. There were no racial differences in the ED visit rates. Initial ICS-Rx for Medicaid-enrolled children is a warning flag for short-term risk of asthma-related ED visits, whereas continued ICS-Rx use is protective for at least 90 days. Primary care follow-up may be needed within the first 2 days after initial ICS-Rx to prevent adverse outcomes. Medicaid programs could use claims data for surveillance of adherence to guideline-concordant therapy and for sentinel events marking windows of a higher risk for ED visits. Population Health Management 2015;18:54–60. PMID:25046059

Extended intestinal metaplasia. A survey of 1392 gastrectomies from dwellers of the Pacific basin.

PubMed

Rubio, C A; Hirota, T; Itabashi, M; Mandai, K; Yanagisawa, A; Kitagawa, T; Sugano, H; Kato, Y

2004-01-01

To assess the extent of gastric intestinal metaplasia (IM) in gastrectomy specimens in populations of the Pacific basin having different incidence of gastric carcinoma. One thousand three hundred and nine-two gastrectomies were investigated: 1088 had a gastric carcinoma and 304 miscellaneous gastric diseases. Twenty-one thousand three hundred and fourteen histological sections were reviewed under low-power (4X). IM was either spotty (SIM) or extended (EIM= encompassing one or more entire low-power fields/section). Widespread IM (WIM) was regarded as EIM if present in > or =5 histological sections. The percent of gastrectomies harboring a carcinoma increased significantly with increasing age more notably in those with diffuse carcinomas (DC) than in those with intestinal carcinomas (IC). The percent of gastrectomies with EIM was significantly higher in specimens with IC than with DC, particularly among elderly patients, and in specimens from countries with a high cancer incidence. The percent of gastrectomies with WIM was higher in specimens having IC than in those having DC. Migration per se did not influence the frequency of specimens with EIM in elderly Japanese patients: Japanese migrants to Hawaii had a similarly high frequency of EIM as those dwelling in Japan. Japanese patients with a gastric carcinoma showed atypical mitoses in areas with EIM far from the tumor, suggesting that cellular mutation(s) play a role in the evolution of EIM towards gastric dysplasia and carcinoma in that ethnic group. The drawback of gastric biopsies in assessing the extent of gastric intestinal metaplasia and, thereby, estimating possible cancer risk in long-term studies has been stressed.

Evaluation of the incidence and risk factors associated with persistent frequency in interstitial cystitis/bladder pain syndrome and the efficacy of antimuscarinic treatment.

PubMed

Kim, Aram; Hoe, Kyeong-Ok; Shin, Jung Hyun; Choo, Myung-Soo

2017-09-01

To investigate the incidence and risk factors associated with persistent urinary frequency, and to evaluate the efficacy of antimuscarinic treatment. Interstitial cystitis/bladder pain syndrome (IC/BPS) patients complaining of persistent urinary frequency despite improved pain were evaluated. Before initial conventional treatment, each patient completed a voiding diary and symptom questionnaires. After conventional treatment, patients were divided according to the presence of pain and frequency. Improved pain was defined as lesser than 3 points in visual analogue scale, and persistent urinary frequency as >10 times/d. Risk factors for persistent frequency were identified through multivariate analysis. The efficacy of antimuscarinic treatment was assessed by the mean change of frequency. Of 171 IC/BPS patients treated with conventional therapy, 132 had improved pain after 3 months, but 72 had persistent frequency (72 of 132, 54.5%). Patients with persistent frequency had lower voided volume (p=0.008), lower maximal flow rate (p<0.001), lower maximal bladder capacity (p=0.003), and more frequent micturition (p<0.001) at baseline compared to those with improved frequency. Patients who took antimuscarinic agents showed slightly decreased urinary frequency, from 14.6 times/d to 13.5 times/d (p=0.438) after 3 months of medication. No patients showed more than a 20% decrease in frequency with antimuscarinics. About half of the patients with IC/BPS showed persistent frequency, with poor voiding function identified as a risk factor; antimuscarinic treatment was not effective in these patients.

Incident Command Systems: Because Life Happens

ERIC Educational Resources Information Center

Isaac, Gayle; Moore, Brian

2011-01-01

Preparing for every possible contingency seems daunting, but with teamwork and some help from the government, it's almost do-able. There is a great system out there that will help business professionals and educators develop a strong, effective emergency preparedness plan. If they haven't done a good job of implementing a solid emergency response…

75 FR 37712 - Temporary Suspension of Certain Oil Spill Response Time Requirements To Support Deepwater Horizon...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

.... (Memorandum from Rear Admiral J.A. Watson, FOSC BP Deepwater Horizon Oil Spill, to National Incident Command... Temporary Suspension of Certain Oil Spill Response Time Requirements To Support Deepwater Horizon Oil Spill... Protection Agency (EPA) temporary interim rule will suspend oil spill response time requirements, and certain...

Rectal culture-directed antibiotic prophylaxis before transrectal prostate biopsy: Reduced infectious complications and healthcare costs.

PubMed

Baldissera-Aradas, J V; Rodríguez-Villamil, L; Blanco-Fernández, R; Pérez-García, C; Viejo de la Guerra, G; González-Rodríguez, I; Mosquera-Madera, J

2018-01-10

Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and an empiric prophylaxis (EP) group. We assessed the financial impact of GP. The GP group was studied prospectively (June 2013 to July 2014). We collected rectal cultures (RCs) before the TUPB, which were seeded on selective media with ciprofloxacin to determine the presence of CRB. The patients with sensitive bacteria were administered ciprofloxacin. Patients with resistant bacteria were administered GP according to the RC antibiogram. The EP group was studied retrospectively (January 2011 to June 2009). RCs were not performed, and all patients were treated with ciprofloxacin as prophylaxis. The ICs in both groups were recorded during a period no longer than 30 days following TUPB (electronic medical history). Three hundred patients underwent TUPB, 145 underwent GP, and 155 underwent EP. In the GP group, 23 patients (15.86%) presented CRB in the RCs. Only one patient (0.7%) experienced a UTI. In the EP group, 26 patients (16.8%) experienced multiple ICs (including 2 cases of sepsis) (P<.005). The estimated total cost, including the management of the ICs, was €57,076 with EP versus €4802.33 with GP. The average cost per patient with EP was €368.23 versus €33.11 with GP. GP achieved an estimated total savings of €52,273.67. Six patients had to undergo GP to prevent an IC. GP is associated with a marked decrease in the incidence of ICs caused by CRB and reduced healthcare costs. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Topographic and functional neuroanatomical study of GABAergic disinhibitory striatum-nigral inputs and inhibitory nigrocollicular pathways: neural hodology recruiting the substantia nigra, pars reticulata, for the modulation of the neural activity in the inferior colliculus involved with panic-like emotions.

PubMed

Castellan-Baldan, Lissandra; da Costa Kawasaki, Mateus; Ribeiro, Sandro José; Calvo, Fabrício; Corrêa, Vani Maria Alves; Coimbra, Norberto Cysne

2006-08-01

Considering the influence of the substantia nigra on mesencephalic neurons involved with fear-induced reactions organized in rostral aspects of the dorsal midbrain, the present work investigated the topographical and functional neuroanatomy of similar influence on caudal division of the corpora quadrigemina, addressing: (a) the neural hodology connecting the neostriatum, the substantia nigra, periaqueductal gray matter and inferior colliculus (IC) neural networks; (b) the influence of the inhibitory neostriatonigral-nigrocollicular GABAergic links on the control of the defensive behavior organized in the IC. The effects of the increase or decrease of activity of nigrocollicular inputs on defensive responses elicited by either electrical or chemical stimulation of the IC were also determined. Electrolytic or chemical lesions of the substantia nigra, pars reticulata (SNpr), decreased the freezing and escape behaviors thresholds elicited by electrical stimulation of the IC, and increased the behavioral responses evoked by the GABAA blockade in the same sites of the mesencephalic tectum (MT) electrically stimulated. These findings were corroborated by similar effects caused by microinjections of the GABAA-receptor agonist muscimol in the SNpr, followed by electrical and chemical stimulations of the IC. The GABAA blockade in the SNpr caused a significant increase in the defensive behavior thresholds elicited by electrical stimulation of the IC and a decrease in the mean incidence of panic-like responses induced by microinjections of bicuculline in the mesencephalic tectum (inferior colliculus). These findings suggest that the substantia nigra receives GABAergic inputs that modulate local and also inhibitory GABAergic outputs toward the IC. In fact, neurotracing experiments with fast blue and iontophoretic microinjections of biotinylated dextran amine either into the inferior colliculus or in the reticular division of the substantia nigra demonstrated a neural link between these structures, as well as between the neostriatum and SNpr.

Chest Wall Thickness and Decompression Failure: A Systematic Review and Meta-analysis Comparing Anatomic Locations in Needle Thoracostomy

PubMed Central

Laan, Danuel V.; Vu, Trang Diem N.; Thiels, Cornelius A.; Pandian, T. K.; Schiller, Henry J.; Murad, M. Hassan; Aho, Johnathon M.

2015-01-01

Introduction Current Advanced Trauma Life Support guidelines recommend decompression for thoracic tension physiology using a 5-cm angiocatheter at the second intercostal space (ICS) on the midclavicular line (MCL). High failure rates occur. Through systematic review and meta-analysis, we aimed to determine the chest wall thickness (CWT) of the 2nd ICS-MCL, the 4th/5th ICS at the anterior axillary line (AAL), the 4th/5th ICS mid axillary line (MAL) and needle thoracostomy failure rates using the currently recommended 5-cm angiocatheter. Methods A comprehensive search of several databases from their inception to July 24, 2014 was conducted. The search was limited to the English language, and all study populations were included. Studies were appraised by two independent reviewers according to a priori defined PRISMA inclusion and exclusion criteria. Continuous outcomes (CWT) were evaluated using weighted mean difference and binary outcomes (failure with 5-cm needle) were assessed using incidence rate. Outcomes were pooled using the random-effects model. Results The search resulted in 34,652 studies of which 15 were included for CWT analysis, 13 for NT effectiveness. Mean CWT was 42.79 mm (95% CI, 38.78–46.81) at 2nd ICS-MCL, 39.85 mm (95% CI, 28.70–51.00) at MAL, and 34.33 mm (95% CI, 28.20–40.47) at AAL (P=0.08). Mean failure rate was 38% (95% CI, 24–54) at 2nd ICS-MCL, 31% (95% CI, 10–64) at MAL, and 13% (95% CI, 8–22) at AAL (P=0.01). Conclusion Evidence from observational studies suggests that the 4th/5th ICS-AAL has the lowest predicted failure rate of needle decompression in multiple populations. PMID:26724173

Chest wall thickness and decompression failure: A systematic review and meta-analysis comparing anatomic locations in needle thoracostomy.

PubMed

Laan, Danuel V; Vu, Trang Diem N; Thiels, Cornelius A; Pandian, T K; Schiller, Henry J; Murad, M Hassan; Aho, Johnathon M

2016-04-01

Current Advanced Trauma Life Support guidelines recommend decompression for thoracic tension physiology using a 5-cm angiocatheter at the second intercostal space (ICS) on the midclavicular line (MCL). High failure rates occur. Through systematic review and meta-analysis, we aimed to determine the chest wall thickness (CWT) of the 2nd ICS-MCL, the 4th/5th ICS at the anterior axillary line (AAL), the 4th/5th ICS mid axillary line (MAL) and needle thoracostomy failure rates using the currently recommended 5-cm angiocatheter. A comprehensive search of several databases from their inception to July 24, 2014 was conducted. The search was limited to the English language, and all study populations were included. Studies were appraised by two independent reviewers according to a priori defined PRISMA inclusion and exclusion criteria. Continuous outcomes (CWT) were evaluated using weighted mean difference and binary outcomes (failure with 5-cm needle) were assessed using incidence rate. Outcomes were pooled using the random-effects model. The search resulted in 34,652 studies of which 15 were included for CWT analysis, 13 for NT effectiveness. Mean CWT was 42.79 mm (95% CI, 38.78-46.81) at 2nd ICS-MCL, 39.85 mm (95% CI, 28.70-51.00) at MAL, and 34.33 mm (95% CI, 28.20-40.47) at AAL (P=.08). Mean failure rate was 38% (95% CI, 24-54) at 2nd ICS-MCL, 31% (95% CI, 10-64) at MAL, and 13% (95% CI, 8-22) at AAL (P=.01). Evidence from observational studies suggests that the 4th/5th ICS-AAL has the lowest predicted failure rate of needle decompression in multiple populations. Level 3 SR/MA with up to two negative criteria. Therapeutic. Copyright © 2015 Elsevier Ltd. All rights reserved.

Emergency Preparedness in the Workplace: The Flulapalooza Model for Mass Vaccination

PubMed Central

Aliyu, Muktar H.; Byrne, Daniel W.; Qian, Keqin; McGown, Paula; Kinman, Patricia O.; Hanson, Katherine Louise; Culpepper, Demoyne; Cooley, Tamara J.; Yarbrough, Mary I.

2017-01-01

Objectives. To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. Methods. We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011–2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency. Results. A total of 66 591 influenza vaccines were administered at 5 annual Flulapalooza events; 13 318 vaccines per event on average. Changes to the physical layout, staffing mix, and documentation processes improved vaccination efficiency 74%, from approximately 38 to 67 vaccines per hour per vaccinator, while reducing overall staffing needs by 38%. An unexpected finding was the role of social media in facilitating active engagement. Conclusions. Health care organizations can use a closed point-of-dispensing model and Hospital Incident Command System to conduct mass vaccination events, and can adopt the “Flulapalooza method” as a best practice model to enhance efficiency. PMID:28892449

[An analysis of clinical characteristics and risk factors for ulceration in ischemic colitis].

PubMed

Liu, Wenhui; Liao, Liang; Shi, Hui; Wu, Benyan; Li, Xiaodong; Liu, Yan

2014-08-01

To investigate the clinical manifestations and risk factors related to ulcer in patients with ischemic colitis (IC). Clinical data of sixty-three IC patients with definite diagnosis from June 2002 to June 2012 in the PLA General Hospital were retrospectively analyzed. All patients were classified into ulcer group (23 cases) and non-ulcer group (40 cases) according to the presence of ulcer or not. Clinical manifestations and risk factors related to ulcer lesions were compared in the two groups. Logistic regression model was used for statistical analysis. There were 50 men and 13 women enrolled, with an average age of 70 years old. The main clinical manifestations included abdominal pain [85.7% (54/63) ], diarrhea [54.0% (34/63)], hematochezia [41.3% (26/63)]. In comparison with non-ulcer group, the ulcer group showed higher incidences of chronic constipation [34.8% (8/23) vs 12.5% (5/40) , P = 0.03], enteric-coated aspirin intake [52.2% (12/23) vs 25.0% (10/40), P = 0.03] and abdomen tenderness [82.6% (19/23) vs 52.5% (21/40), P = 0.02]. Chronic constipation and enteric-coated aspirin intake were independent risk factors related to ulcer lesions (OR = 3.38, P = 0.04; OR = 5.91, P = 0.03). Patients with abdomen tenderness had higher incidence of ulcer lesion (OR = 3.12, P = 0.04). The most common location of IC was left colon [69.8% (44/63)]. No difference of site distribution was found in ulcer and non-ulcer group (P = 0.066). Splanchnic atherosclerosis in the ulcer group was more common than in non-ulcer group [88.2% (15/17) vs 58.3% (14/24), P = 0.038]. The duration of hospitalization was significantly longer in ulcer group [ (14.3 ± 7.1) d vs (6.2 ± 4.1) d, P < 0.01]. Higher white blood cell (WBC) count and lower hemoglobin (Hb) were seen in ulcer group than those in non-ulcer group [(10.17 ± 3.32) ×10(9)/L vs (7.25 ± 3.15)×10(9)/L, P = 0.018; (98 ± 27) g/L vs (126 ± 35) g/L, P = 0.041]. Chronic constipation, enteric-coated aspirin intake and splanchnic atherosclerosis are risk factors related to ulcer in IC patients. Abdomen tenderness, high WBC and low Hb strongly indicate possible IC with ulcer.

Investment, managerial capacity, and bias in public health preparedness.

PubMed

Langabeer, James R; DelliFraine, Jami L; Tyson, Sandra; Emert, Jamie M; Herbold, John

2009-01-01

Nearly $7 billion has been invested through national cooperative funding since 2002 to strengthen state and local response capacity. Yet, very little outcome evidence exists to analyze funding effectiveness. The objective of this research is to analyze the relationship between investment (funding) and capacity (readiness) for public health preparedness (PHP). The aim of the authors is to use a management framework to evaluate capacity, and to explore the "immediacy bias" impact on investment stability. This study employs a longitudinal study design, incorporating survey research of the entire population of 68 health departments in the state of Texas. The authors assessed the investment-capacity relationship through several statistical methods. The authors created a structural measure of managerial capacity through principal components analysis, factorizing 10 independent variables and augment this with a perceived readiness level reported from PHP managers. The authors then employ analysis of variance, correlation analyses, and other descriptive statistics. There has been a 539 percent coefficient of variation in funding at the local level between the years 2004 and 2008, and a 63 percent reduction in total resources since the peak of funding, using paired sample data. Results suggest that investment is positively associated with readiness and managerial capacity in local health departments. The authors also find that investment was related to greater community collaboration, higher adoption of Incident Command System (ICS) structure, and more frequent operational drills and exercises. Greater investment is associated with higher levels of capacity and readiness. The authors conclude from this that investment should be stabilized and continued, and not be influenced by historical cognitive biases.

Striking elevation in incidence and prevalence of inflammatory bowel disease in a province of western Hungary between 1977-2001

PubMed Central

Lakatos, Laszlo; Mester, Gabor; Erdelyi, Zsuzsanna; Balogh, Mihaly; Szipocs, Istvan; Kamaras, Gyorgy; Lakatos, Peter Laszlo

2004-01-01

AIM: An investigation into inflammatory bowel disease and colorectal cancer in Veszprem Province was conducted from 1977 to 2001. METHODS: Both hospital and outpatient records were collected and reviewed comprehensively. The majority of patients were followed up regularly. RESULTS: The population of the province was decreased from 386000 to 376000 during the period. Five hundred sixty new cases of ulcerative colitis (UC), 212 of Crohn’s disease (CD), and 40 of indeterminate colitis (IC) were diagnosed. The incidence rates increased from 1.66 to 11.01 cases per 100000 persons for UC, from 0.41 to 4.68 for CD and from 0.26 to 0.74 for IC. The prevalence rate at the end of 2001 was 142.6 for UC and 52.9 cases per 100000 persons for CD. The peak onset age in UC patients was between 30 and 40 years, in CD between 20 and 30 years. A family history of IBD was present in 3.4 % in UC and 9.9 % in CD patients. Smoking increased the risk for CD (OR = 1.94) while it decreased the risk for UC (OR = 0.25). Twelve colorectal carcinomas were observed in this cohort, the cumulative colorectal cancer risk after 10 years in UC was 2%, after 20 years 8.8%, after 30 years 13.3%. CONCLUSION: The incidence and prevalence rates of IBD have increased steadily in Veszprem Province, now equivalent to that in Western European countries. Rapid increase in incidence rates supports a probable role for environmental factors. The rate of colorectal cancers in IBD is similar to that observed in Western countries. PMID:14760767

Sports-related sudden cardiac death in Switzerland classified by static and dynamic components of exercise.

PubMed

Gräni, Christoph; Chappex, Nina; Fracasso, Tony; Vital, Cristina; Kellerhals, Christoph; Schmied, Christian; Saguner, Ardan M; Trachsel, Lukas D; Eser, Prisca; Michaud, Katarzyna; Wilhelm, Matthias

2016-07-01

Sports-related sudden cardiac deaths (SrSCDs) occur most frequently in highly dynamic and/or static sports. We aimed to assess the incidence and characteristics of SrSCDs in Switzerland and to compare SrSCD occurrence according to sports categories with the sports participation behaviour in the general population. Between 1999 and 2010, forensic reports of SrSCDs in young individuals (10-39 years of age) were retrospectively reviewed and categorised based on peak static (increasing from I to III) and dynamic sports components (increasing from A to C). Data were compared to the sports participation behaviour of the Swiss population. Sixty-nine SrSCDs were identified. Forty-eight (69.6%) occurred during recreational sports (REC) and 21 (30.4%) during competitive sports (COMP). Incidences (per 100,000 athlete person-years) for COMP and REC were 0.90 and 0.52, respectively (p = 0.001). Most SrSCDs occurred in IC (23 cases, 33.3%), followed by IIC (13, 18.9%), IIIA and IIIC (11 each, 15.9%), IIIB (6, 8.7%), IIA (4, 5.8%) and IB sports categories (1, 1.5%). No SrSCDs were found in IA and IIB sports categories. Incidences between sports categories (IIIA 0.25, IB 0.25, IC 0.18, IIC 0.33 and IIIC 0.25) were not significantly different except to IIA (0.94, p < 0.001), due to the fact that few people were involved in this sports category. Coronary artery disease (CAD) was the most common underlying pathology of SrSCD. In this Swiss cohort, incidence of SrSCD was very low and similar in all sports categories classified by their static and dynamic components. However, the incidence was higher in COMP compared to REC, and CAD proved to be the most common underlying cause of SrSCD. © The European Society of Cardiology 2016.

Corporate crisis management managing a major crisis in a chemical facility.

PubMed

Marwitz, Steve; Maxson, Neil; Koch, Bill; Aukerman, Todd; Cassidy, Jim; Belonger, David

2008-11-15

Chemical sites should have well trained and organized emergency response plans to manage an incident within the plant or during transport. The implementation of an incident command system utilizing either internal resources or external response through mutual aid agreements is generally sufficient to address the direct impact of an event on the site. When the site resources become overwhelmed in addressing resulting issues such as press releases, medical advice/support, employees and family support, Agency notifications, etc, Corporate should be ready and able to respond. This paper, taken from an in-depth CCPS workshop led by the author, describes an outline for corporate assistance in the event of a major incident at a site or during transportation.

Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident.

PubMed

Wachira, Benjamin W; Abdalla, Ramadhani O; Wallis, Lee A

2014-10-01

At approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital. This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.

Intimate partner violence and incidence of common mental disorder.

PubMed

Mendonça, Marcela Franklin Salvador de; Ludermir, Ana Bernarda

2017-04-10

To investigate the association of intimate partner violence against women reported in the last 12 months and seven years with the incidence of common mental disorders. A prospective cohort study with 390 women from 18 to 49 years, registered in the Family Health Program of the city of Recife, State of Pernambuco; from July 2013 to December 2014. The Self Reporting Questionnaire-20 (SRQ-20) assessed mental health. Intimate partner violence consists of concrete acts of psychological, physical or sexual violence that the partner inflicts on the woman. Poisson regression was used to estimate crude and adjusted relative risks (RR) of the association between common mental disorders and intimate partner violence. The incidence of common mental disorders was 44.6% among women who reported intimate partner violence in the last 12 months and 43.4% among those who reported in the past seven years. Mental disorders remained associated with psychological violence (RR = 3.0; 95%CI 1.9-4.7 and RR = 1.8; 95%CI 1.0-3.7 in the last 12 months, and seven years, respectively), even in the absence of physical or sexual violence. When psychological violence were related to physical or sexual violence, the risk of common mental disorders was even higher, both in the last 12 months (RR = 3.1; 95%CI 2.1-4.7) and in the last seven years (RR = 2.5; 95%CI 1.7-3.8). Intimate partner violence is associated with the incidence of common mental disorders in women. The treatment of the consequences of IPV and support for women in seeking protection for themselves for public services is essential. Investigar a associação da violência por parceiros íntimos relatada contra as mulheres nos últimos 12 meses e últimos sete anos com a incidência dos transtornos mentais comuns. Estudo de coorte prospectivo com 390 mulheres de 18 a 49 anos, cadastradas no Programa Saúde da Família da cidade do Recife, PE, entre julho de 2013 e dezembro de 2014. A saúde mental foi avaliada pelo Self Reporting Questionnaire-20 (SRQ-20). A violência por parceiro íntimo foi definida por atos concretos de violência psicológica, física ou sexual infligidos à mulher pelo parceiro. A regressão de Poisson foi utilizada para estimar os riscos relativos (RR) brutos e ajustados da associação entre transtorno mental comum e violência por parceiro íntimo. A incidência dos transtornos mentais comuns foi de 44,6% entre as mulheres que relataram violência nos últimos 12 meses e de 43,4% nas que relataram violência nos últimos sete anos. Os transtornos mentais mantiveram-se associados à violência psicológica (RR = 3,0; IC95% 1,9-4,7 e RR = 1,8; IC95% 1,0-3,7 nos últimos 12 meses, e sete anos, respectivamente), mesmo na ausência de violência física ou sexual. Quando a violência psicológica esteve combinada com violência física ou sexual, o risco dos transtornos mentais comuns foi ainda mais elevado, tanto nos últimos 12 meses (RR = 3,1; IC95% 2,1-4,7) quanto nos últimos sete anos (RR = 2,5; IC95% 1,7-3,8). A violência por parceiro íntimo está associada à incidência de transtornos mentais comuns nas mulheres. É fundamental o tratamento das consequências da VPI e o apoio às mulheres na busca de proteção para si pelos serviços públicos.

Infrared Sensor on Unmanned Aircraft Transmits Time-Critical Wildfire Data

NASA Technical Reports Server (NTRS)

Pestana, Mark

2010-01-01

Since 2006, NASA fs Dryden Flight Research Center (DFRC) and Ames Research Center have been perfecting and demonstrating a new capability for geolocation of wildfires and the real-time delivery of data to firefighters. Managed for the Western States Fire Mission, the Ames-developed Autonomous Modular Scanner (AMS), mounted beneath a wing of DFRC fs MQ-9 Ikhana remotely piloted aircraft, contains an infrared sensor capable of discriminating temperatures within 0.5 F (approx. = 0.3 C), up to 1,000 F (approx. = 540 C). The AMS operates like a digital camera with specialized filters to detect light energy at visible, infrared, and thermal wavelengths. By placing the AMS aboard unmanned aircraft, one can gather information and imaging for thousands of square miles, and provide critical information about the location, size, and terrain around fires to commanders in the field. In the hands of operational agencies, the benefits of this NASA research and development effort can support nationwide wildfire fighting efforts. The sensor also provides data for post-burn and vegetation regrowth analyses. The MQ-9 Unmanned Aircraft System (UAS), a version of the Predator-B, can operate over long distances, staying aloft for over 24 hours, and controlled via a satellite-linked command and control system. This same link is used to deliver the fire location data directly to fire incident commanders, in less than 10 minutes from the time of overflight. In the current method, similarly equipped short-duration manned aircraft, with limited endurance and range, must land, hand-carry, and process data, and then deliver information to the firefighters, sometimes taking several hours in the process. Meanwhile, many fires would have moved over great distances and changed direction. Speed is critical. The fire incident commanders must assess a very dynamic situation, and task resources such as people, ground equipment, and retardant-dropping aircraft, often in mountainous terrain obscured by dense smoke.

Fine-Tuning of Molecular Packing and Energy Level through Methyl Substitution Enabling Excellent Small Molecule Acceptors for Nonfullerene Polymer Solar Cells with Efficiency up to 12.54.

PubMed

Luo, Zhenghui; Bin, Haijun; Liu, Tao; Zhang, Zhi-Guo; Yang, Yankang; Zhong, Cheng; Qiu, Beibei; Li, Guanghao; Gao, Wei; Xie, Dongjun; Wu, Kailong; Sun, Yanming; Liu, Feng; Li, Yongfang; Yang, Chuluo

2018-03-01

A novel small molecule acceptor MeIC with a methylated end-capping group is developed. Compared to unmethylated counterparts (ITCPTC), MeIC exhibits a higher lowest unoccupied molecular orbital (LUMO) level value, tighter molecular packing, better crystallites quality, and stronger absorption in the range of 520-740 nm. The MeIC-based polymer solar cells (PSCs) with J71 as donor, achieve high power conversion efficiency (PCE), up to 12.54% with a short-circuit current (J SC ) of 18.41 mA cm -2 , significantly higher than that of the device based on J71:ITCPTC (11.63% with a J SC of 17.52 mA cm -2 ). The higher J SC of the PSC based on J71:MeIC can be attributed to more balanced μ h /μ e , higher charge dissociation and charge collection efficiency, better molecular packing, and more proper phase separation features as indicated by grazing incident X-ray diffraction and resonant soft X-ray scattering results. It is worth mentioning that the as-cast PSCs based on MeIC also yield a high PCE of 11.26%, which is among the highest value for the as-cast nonfullerene PSCs so far. Such a small modification that leads to so significant an improvement of the photovoltaic performance is a quite exciting finding, shining a light on the molecular design of the nonfullerene acceptors. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Benefits and Costs of Improved Cookstoves: Assessing the Implications of Variability in Health, Forest and Climate Impacts

PubMed Central

Jeuland, Marc A.; Pattanayak, Subhrendu K.

2012-01-01

Current attention to improved cook stoves (ICS) focuses on the “triple benefits” they provide, in improved health and time savings for households, in preservation of forests and associated ecosystem services, and in reducing emissions that contribute to global climate change. Despite the purported economic benefits of such technologies, however, progress in achieving large-scale adoption and use has been remarkably slow. This paper uses Monte Carlo simulation analysis to evaluate the claim that households will always reap positive and large benefits from the use of such technologies. Our analysis allows for better understanding of the variability in economic costs and benefits of ICS use in developing countries, which depend on unknown combinations of numerous uncertain parameters. The model results suggest that the private net benefits of ICS will sometimes be negative, and in many instances highly so. Moreover, carbon financing and social subsidies may help enhance incentives to adopt, but will not always be appropriate. The costs and benefits of these technologies are most affected by their relative fuel costs, time and fuel use efficiencies, the incidence and cost-of-illness of acute respiratory illness, and the cost of household cooking time. Combining these results with the fact that households often find these technologies to be inconvenient or culturally inappropriate leads us to understand why uptake has been disappointing. Given the current attention to the scale up of ICS, this analysis is timely and important for highlighting some of the challenges for global efforts to promote ICS. PMID:22348005

Prospective Vigilance: Assessing Complex Coordinated Attack Preparedness Programs

DTIC Science & Technology

2017-12-01

for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and...significant challenges with incident command, strategic communication, and information management ; limitations in both training and equipment; and... information management ; limitations in both training and equipment; and inadequate response protocols.9 During the Mumbai CCA, fire and emergency

32 CFR 536.111 - Investigation of claims arising under international agreements (for those claims arising in the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Investigation of claims arising under international agreements (for those claims arising in the United States). 536.111 Section 536.111 National... for the geographic area in which the incident occurred. The Commander USARCS, an ACO, and a CPO are...

Building a Collaborative Governance System: A Comparative Case Analysis

DTIC Science & Technology

2015-06-01

additional resources. Bandwagon effects occur. As the process emerges and appears to be achieving success, more resources are attracted. Consensus...97 C. WHAT ARE THE ENABLERS AND BARRIERS TO EFFECTIVE COLLABORATION IN THIS CASE...seems as though the challenges are getting bigger as well as more frequent, across many disciplines.”1 Effective incident response requires command

32 CFR 536.111 - Investigation of claims arising under international agreements (for those claims arising in the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Investigation of claims arising under international agreements (for those claims arising in the United States). 536.111 Section 536.111 National... for the geographic area in which the incident occurred. The Commander USARCS, an ACO, and a CPO are...

32 CFR 536.111 - Investigation of claims arising under international agreements (for those claims arising in the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Investigation of claims arising under international agreements (for those claims arising in the United States). 536.111 Section 536.111 National... for the geographic area in which the incident occurred. The Commander USARCS, an ACO, and a CPO are...

25-KVA Amorphous Metal-Core Transformer Developmental Test Report

DTIC Science & Technology

1989-08-01

N-1801 August 1989 By G.V. Urata and J.O. Franchi Sponsored By Naval Facilites Engineering Command Technical Note and Office of Naval Research 25-kVA...wt’c.i,,., di.shtr tlion iswilm ihed 89 11 1.3 108 C4C E .0>. .4) C L ’TU m ’D ’s n C w o o en o’ 0. 1 0 4 = ~ E 0 0 -~CI u 0 44 E N N M Cn E E E~ E EE...REPRODUCE LEGIBLY. REPORT DOCUMENTATION PAGE OM No. o70-o , Pub €ic r o t r b e to jhm, t o ,im io n of Anf rflut,O . m e, o .e, *. du .a. e o ., nte tve

Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses.

PubMed

Iqbal, Ahmar; Barnes, Neil C; Brooks, Jean

2015-10-01

Chronic obstructive pulmonary disease (COPD) patients with blood eosinophil (EOS) count ≥ 2% benefit from exacerbation reductions with inhaled corticosteroids (ICSs). We conducted post hoc analyses to determine if EOS count ≥ 2% is a marker for greater responsiveness to the bronchodilators umeclidinium (UMEC; long-acting muscarinic antagonist), vilanterol (VI; long-acting β2-agonist) or UMEC/VI combination. Effects of once-daily UMEC/VI 62.5/25, UMEC 62.5 and VI 25 µg versus placebo on trough forced expiratory volume in one second (FEV1), Transition Dyspnoea Index (TDI), St George's Respiratory Questionnaire (SGRQ) scores and adverse event (AE) incidences in four completed, 6-month studies were assessed by EOS subgroup. Trough FEV1 was also evaluated by ICS use and EOS subgroup. Analyses were performed using a repeated measures model. At baseline, 2437 of 4647 (52%) patients had EOS count ≥ 2%. Overall, ≈ 50% of patients used ICSs. At day 169, no notable variations were observed in trough FEV1 least squares mean differences between EOS subgroups versus placebo for UMEC/VI, UMEC and VI; results according to ICS use were similar. No differences were reported between EOS subgroups in TDI and SGRQ scores on day 168, or for incidences of AEs, serious AEs and AEs leading to withdrawal. Response to UMEC/VI, UMEC and VI in terms of trough FEV1, dyspnoea and health-related quality of life was similar for COPD patients with baseline EOS counts ≥ 2 or <2%. EOS count did not appear to predict bronchodilator response in either ICS users or non-users.

Public health incident management: Logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Public health incident management: logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Effects of Command and Control Vehicle (C2V) operational environment on soldier health and performance

NASA Technical Reports Server (NTRS)

Cowings, P. S.; Toscano, W. B.; DeRoshia, C.; Tauso, R.

2001-01-01

The purpose of this project was to use NASA technology to assist the US Army in the assessment of motion sickness incidences and effects on soldier performance and mood states within the Command and Control Vehicle (C2V). Specific objectives were (1) to determine if there was a significant difference between three internal configurations of the C2V and/or between seats within these vehicles; (2) to determine if there was a significant difference between the park, move, or short-halt field conditions; and (3) to validate a method of converging indicators developed by NASA to assess environmental impact of long duration spaceflight on crewmembers, using a large sample of subjects under ground-based operational conditions.

TOPAS/Geant4 configuration for ionization chamber calculations in proton beams

NASA Astrophysics Data System (ADS)

Wulff, Jörg; Baumann, Kilian-Simon; Verbeek, Nico; Bäumer, Christian; Timmermann, Beate; Zink, Klemens

2018-06-01

Monte Carlo (MC) calculations are a fundamental tool for the investigation of ionization chambers (ICs) in radiation fields, and for calculations in the scope of IC reference dosimetry. Geant4, as used for the toolkit TOPAS, is a major general purpose code, generally suitable for investigating ICs in primary proton beams. To provide reliable results, the impact of parameter settings and the limitations of the underlying condensed history (CH) algorithm need to be known. A Fano cavity test was implemented in Geant4 (10.03.p1) for protons, based on the existing version for electrons distributed with the Geant4 release. This self-consistent test allows the calculation to be compared with the expected result for the typical IC-like geometry of an air-filled cavity surrounded by a higher density material. Various user-selectable parameters of the CH implementation in the EMStandardOpt4 physics-list were tested for incident proton energies between 30 and 250 MeV. Using TOPAS (3.1.p1) the influence of production cuts was investigated for bare air-cavities in water, irradiated by primary protons. Detailed IC geometries for an NACP-02 plane-parallel chamber and an NE2571 Farmer-chamber were created. The overall factor f Q as a ratio between the dose-to-water and dose to the sensitive air-volume was calculated for incident proton energies between 70 and 250 MeV. The Fano test demonstrated the EMStandardOpt4 physics-list with the WentzelIV multiple scattering model as appropriate for IC calculations. If protons start perpendicular to the air cavity, no further step-size limitations are required to pass the test within 0.1%. For an isotropic source, limitations of the maximum step length within the air cavity and its surrounding as well as a limitation of the maximum fractional energy loss per step were required to pass within 0.2%. A production cut of  ⩽5 μm or  ∼15 keV for all particles yielded a constant result for f Q of bare air-filled cavities. The overall factor f Q for the detailed NACP-02 and NE2571 chamber models calculated with TOPAS agreed with the values of Gomà et al (2016 Phys. Med. Biol. 61 2389) within statistical uncertainties (1σ) of  <0.3% for almost all energies with a maximum deviation of 0.6% at 250 MeV for the NE2571. The selection of hadronic scattering models (QGSP_BIC versus QGSP_BERT) in TOPAS impacted the results at the highest energies by 0.3%  ±  0.1%. Based on the Fano cavity test, the Geant4/TOPAS Monte Carlo code, in its investigated version, can provide reliable results for IC calculations. Agreement with the detailed IC models and the published values of Gomà et al can be achieved when production cuts are reduced from the TOPAS default values. The calculations confirm the reported agreement of Gomà et al for with IAEA-TRS398 values within the given uncertainties. An additional uncertainty for the MC-calculated of  ∼0.3% by hadronic interaction models should be considered.

TOPAS/Geant4 configuration for ionization chamber calculations in proton beams.

PubMed

Wulff, Jörg; Baumann, Kilian-Simon; Verbeek, Nico; Bäumer, Christian; Timmermann, Beate; Zink, Klemens

2018-06-07

Monte Carlo (MC) calculations are a fundamental tool for the investigation of ionization chambers (ICs) in radiation fields, and for calculations in the scope of IC reference dosimetry. Geant4, as used for the toolkit TOPAS, is a major general purpose code, generally suitable for investigating ICs in primary proton beams. To provide reliable results, the impact of parameter settings and the limitations of the underlying condensed history (CH) algorithm need to be known. A Fano cavity test was implemented in Geant4 (10.03.p1) for protons, based on the existing version for electrons distributed with the Geant4 release. This self-consistent test allows the calculation to be compared with the expected result for the typical IC-like geometry of an air-filled cavity surrounded by a higher density material. Various user-selectable parameters of the CH implementation in the EMStandardOpt4 physics-list were tested for incident proton energies between 30 and 250 MeV. Using TOPAS (3.1.p1) the influence of production cuts was investigated for bare air-cavities in water, irradiated by primary protons. Detailed IC geometries for an NACP-02 plane-parallel chamber and an NE2571 Farmer-chamber were created. The overall factor f Q as a ratio between the dose-to-water and dose to the sensitive air-volume was calculated for incident proton energies between 70 and 250 MeV. The Fano test demonstrated the EMStandardOpt4 physics-list with the WentzelIV multiple scattering model as appropriate for IC calculations. If protons start perpendicular to the air cavity, no further step-size limitations are required to pass the test within 0.1%. For an isotropic source, limitations of the maximum step length within the air cavity and its surrounding as well as a limitation of the maximum fractional energy loss per step were required to pass within 0.2%. A production cut of  ⩽5 μm or  ∼15 keV for all particles yielded a constant result for f Q of bare air-filled cavities. The overall factor f Q for the detailed NACP-02 and NE2571 chamber models calculated with TOPAS agreed with the values of Gomà et al (2016 Phys. Med. Biol. 61 2389) within statistical uncertainties (1σ) of  <0.3% for almost all energies with a maximum deviation of 0.6% at 250 MeV for the NE2571. The selection of hadronic scattering models (QGSP_BIC versus QGSP_BERT) in TOPAS impacted the results at the highest energies by 0.3%  ±  0.1%. Based on the Fano cavity test, the Geant4/TOPAS Monte Carlo code, in its investigated version, can provide reliable results for IC calculations. Agreement with the detailed IC models and the published values of Gomà et al can be achieved when production cuts are reduced from the TOPAS default values. The calculations confirm the reported agreement of Gomà et al for [Formula: see text] with IAEA-TRS398 values within the given uncertainties. An additional uncertainty for the MC-calculated [Formula: see text] of  ∼0.3% by hadronic interaction models should be considered.

Analysis of good practice of public health Emergency Operations Centers.

PubMed

Xu, Min; Li, Shi-Xue

2015-08-01

To study the public health Emergency Operations Centers (EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Literature review was conducted to explore the EOCs of selected countries. The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

Evaluation of the Virtual Squad Training System

DTIC Science & Technology

2010-01-01

ABSTRACT (Maximum 200 words): The Virtual Squad Training System ( VSTS ) is a network of nine individual immersive simulators with Helmet-Mounted...Displays (HMDs), and a command station for controlling computer generated entities. The VSTS includes both tethered and wearable simulators. The VSTS was...affected Soldiers’ ratings of the VSTS . Simulator sickness incidence was low compared to previous evaluations of antecedent systems using HMDs

A Theory of Electromagnetic Shielding with Applications to MIL-STD-285, IEEE-299, and EMP Simulation

DTIC Science & Technology

1985-02-01

in a building sized enclosure slot-like discontinuities may not all be small compar- ed to all wavelengths in the incident field, and slot resonan ...OFFICE OF RESEARCH/ NPP US AIR FORCE SPACE COMMAND ATTN STATE & LOCAL PROG SUPPORT O ATTN KKO 500 C STREET, SW ATTN KRQ WASHINGTON, DC 20472 ATTN XPOW

Department of Defense Utilization of the Incident Command System

DTIC Science & Technology

2008-01-01

the Los Angeles City Fire Department as an Assistant Chief with...response planning for fire, rescue and EMS for the 51 .. ; 1984 Los Angeles Summer Olympics. He was worked with the Park City, Utah Fire department in...Director of Operations of the Los Angeles Fire Department Historical Society. He is a member of many organizations and associations including the

Forest Fire Advanced System Technology (FFAST): A Conceptual Design for Detection and Mapping

Treesearch

J. David Nichols; John R. Warren

1987-01-01

The Forest Fire Advanced System Technology (FFAST) project is developing a data system to provide near-real-time forest fire information to fire management at the fire Incident Command Post (ICP). The completed conceptual design defined an integrated forest fire detection and mapping system that is based upon technology available in the 1990's. System component...

Nociceptive neuronal Fc-gamma receptor I is involved in IgG immune complex induced pain in the rat.

PubMed

Jiang, Haowu; Shen, Xinhua; Chen, Zhiyong; Liu, Fan; Wang, Tao; Xie, Yikuan; Ma, Chao

2017-05-01

Antigen-specific immune diseases such as rheumatoid arthritis are often accompanied by pain and hyperalgesia. Our previous studies have demonstrated that Fc-gamma-receptor type I (FcγRI) is expressed in a subpopulation of rat dorsal root ganglion (DRG) neurons and can be directly activated by IgG immune complex (IgG-IC). In this study we investigated whether neuronal FcγRI contributes to antigen-specific pain in the naïve and rheumatoid arthritis model rats. In vitro calcium imaging and whole-cell patch clamp recordings in dissociated DRG neurons revealed that only the small-, but not medium- or large-sized DRG neurons responded to IgG-IC. Accordingly, in vivo electrophysiological recordings showed that intradermal injection of IgG-IC into the peripheral receptive field could sensitize only the C- (but not A-) type sensory neurons and evoke action potential discharges. Pain-related behavioral tests showed that intradermal injection of IgG-IC dose-dependently produced mechanical and thermal hyperalgesia in the hindpaw of rats. These behavioral effects could be alleviated by localized administration of non-specific IgG or an FcγRI antibody, but not by mast cell stabilizer or histamine antagonist. In a rat model of antigen-induced arthritis (AIA) produced by methylated bovine serum albumin, FcγRI were found upregulated exclusively in the small-sized DRG neurons. In vitro calcium imaging revealed that significantly more small-sized DRG neurons responded to IgG-IC in the AIA rats, although there was no significant difference between the AIA and control rats in the magnitude of calcium changes in the DRG neurons. Moreover, in vivo electrophysiological recordings showed that C-nociceptive neurons in the AIA rats exhibited a greater incidence of action potential discharges and stronger responses to mechanical stimuli after IgG-IC was injected to the receptive fields. These results suggest that FcγRI expressed in the peripheral nociceptors might be directly activated by IgG-IC and contribute to antigen-specific pain in pathological conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

The Influence of Task and Personality Characteristics on Employee Turnover and Absenteeism Incidents.

DTIC Science & Technology

1981-01-01

E oc vc li.’ r .IIuaJry 1.981 Office of’ Nav;il Rcs,.il vh Q# ,. 4 ,lL1 , 0r4i gT...Ic It, toil ill Who, (-, o) r i n partC ~S lort’Iic L o i f. 111V llll~ of tIc Ul ilLI7 )LA . .. L: 0 I [Ile:; . Sb c ~ T c It A I 1’: 1 w1 -iid ex...UlmA ioctlt.y Vc v jn- Ilic . P’or c v i ) L c1) 1 W I S I I t’,.ItL IV e y 10r- ILI I L v J c o 1) t, )I c rflv or ind ah- - tce isi - W 4i e L

Police Self-Deployment at Critical Incidents: A Wicked Problem or a Part of the Solution

DTIC Science & Technology

2017-09-01

bombings , this thesis explored police self-deployment through the lens of wicked problems. A better understanding of the definition resulted in...police, ICS, wicked problems, Boston Marathon bombings , edge of chaos, apperception, phronesis, self-initiated, Cynefin framework, after-action...manhunt and 2013 Boston Marathon bombings , this thesis explored police self-deployment through the lens of wicked problems. A better understanding of

Inhaled Corticosteroid Use in Chronic Obstructive Pulmonary Disease and Risk of Pneumonia: A Nested Case-Control Population-based Study in Lazio (Italy)-The OUTPUL Study.

PubMed

Cascini, Silvia; Kirchmayer, Ursula; Belleudi, Valeria; Bauleo, Lisa; Pistelli, Riccardo; Di Martino, Mirko; Formoso, Giulio; Davoli, Marina; Agabiti, Nera

2017-06-01

Inhaled corticosteroid (ICS) use in chronic obstructive pulmonary disease (COPD) patients is associated with a reduction of exacerbations and a potential risk of pneumonia. The objective was to determine if ICS use, with or without long-acting β 2 -agonist, increases pneumonia risk in COPD patients. A cohort study was performed using linked hospital and drug prescription databases in the Lazio region. Patients (45+) discharged with COPD in 2006-2009 were enrolled and followed from cohort entry until first admission for pneumonia, death or study end, 31 December, 2012. A nested case-control approach was used to estimate the rate ratio (RR) associated with current or past use of ICS adjusted for age, gender, number of exacerbations in the previous year and co-morbidities. Current users were defined as patients with their last ICS prescribed in the 60 days prior to the event. Past users were those with the last prescription between 61 and 365 days before the event. Current use was classified into three levels (high, medium, low) according to the medication possession ratio. Among the cohort of 19288 patients, 3141 had an event of pneumonia (incidence rate for current use 87/1000py, past use 32/1000py). After adjustment, patients with current use were 2.29 (95% confidence interval [CI]: 1.99-2.63) times more likely to be hospitalised for pneumonia with respect to no use; for past use RR was 1.23 (95% CI: 1.07-1.42). For older patients (80+), the rate was higher than that for younger patients. ICS use was associated with an excess risk of pneumonia. The effect was greatest for higher doses and in the very elderly.

Substance use by soldiers who abuse their spouses.

PubMed

Martin, Sandra L; Gibbs, Deborah A; Johnson, Ruby E; Sullivan, Kristen; Clinton-Sherrod, Monique; Walters, Jennifer L Hardison; Rentz, E Danielle

2010-11-01

Data on 7,424 soldier spouse abuse offenders were analyzed to determine the prevalence of substance use during abusive incidents, and to examine differences between substance-using and non-substance-using offenders. Results showed that 25% of all offenders used substances during abusive incidents, with males and non-Hispanic Whites being more likely to hav e used substances. Substance-using offenders were more likely to perpetrate physical spouse abuse and more severe spouse abuse. These findings underscore the importance of educating military personnel (including commanders) about links between substance use and domestic violence, and of coordinating preventive and therapeutic substance abuse and violence-related interventions.

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

Mahan, Robert E.; Fluckiger, Jerry D.; Clements, Samuel L.

This document was developed to provide guidance for the implementation of secure data transfer in a complex computational infrastructure representative of the electric power and oil and natural gas enterprises and the control systems they implement. For the past 20 years the cyber security community has focused on preventative measures intended to keep systems secure by providing a hard outer shell that is difficult to penetrate. Over time, the hard exterior, soft interior focus changed to focus on defense-in-depth adding multiple layers of protection, introducing intrusion detection systems, more effective incident response and cleanup, and many other security measures. Despitemore » much larger expenditures and more layers of defense, successful attacks have only increased in number and severity. Consequently, it is time to re-focus the conventional approach to cyber security. While it is still important to implement measures to keep intruders out, a new protection paradigm is warranted that is aimed at discovering attempted or real compromises as early as possible. Put simply, organizations should take as fact that they have been, are now, or will be compromised. These compromises may be intended to steal information for financial gain as in the theft of intellectual property or credentials that lead to the theft of financial resources, or to lie silent until instructed to cause physical or electronic damage and/or denial of services. This change in outlook has been recently confirmed by the National Security Agency [19]. The discovery of attempted and actual compromises requires an increased focus on monitoring events by manual and/or automated log monitoring, detecting unauthorized changes to a system's hardware and/or software, detecting intrusions, and/or discovering the exfiltration of sensitive information and/or attempts to send inappropriate commands to ICS/SCADA (Industrial Control System/Supervisory Control And Data Acquisition) systems.« less

Insights into cellular and molecular basis for urinary tract infection in autosomal-dominant polycystic kidney disease.

PubMed

Gao, Chao; Zhang, Long; Zhang, Ye; Wallace, Darren P; Lopez-Soler, Reynold I; Higgins, Paul J; Zhang, Wenzheng

2017-11-01

Urinary tract infection (UTI) is a broad term referring to an infection of the kidneys, ureters, bladder, and/or urethra. Because of its prevalence, frequent recurrence, and rising resistance to antibiotics, UTI has become a challenge in clinical practice. Autosomal-dominant polycystic kidney disease (ADPKD) is the most common monogenic disorder of the kidney and is characterized by the growth of fluid-filled cysts in both kidneys. Progressive cystic enlargement, inflammation, and interstitial fibrosis result in nephron loss with subsequent decline in kidney function. ADPKD patients frequently develop UTI; however, the cellular and molecular mechanisms responsible for the high UTI incidence in ADPKD patients remain virtually unaddressed. Emerging evidence suggests that α-intercalated cells (α-ICs) of the collecting ducts function in the innate immune defense against UTI. α-ICs inhibit bacterial growth by acidifying urine and secreting neutrophil gelatinase-associated lipocalin (NGAL) that chelates siderophore-containing iron. It is necessary to determine, therefore, if ADPKD patients with recurrent UTI have a reduced number and/or impaired function of α-ICs. Identification of the underlying cellular and molecular mechanisms may lead to the development of novel strategies to reduce UTI in ADPKD. Copyright © 2017 the American Physiological Society.

A stochastic optimal feedforward and feedback control methodology for superagility

NASA Technical Reports Server (NTRS)

Halyo, Nesim; Direskeneli, Haldun; Taylor, Deborah B.

1992-01-01

A new control design methodology is developed: Stochastic Optimal Feedforward and Feedback Technology (SOFFT). Traditional design techniques optimize a single cost function (which expresses the design objectives) to obtain both the feedforward and feedback control laws. This approach places conflicting demands on the control law such as fast tracking versus noise atttenuation/disturbance rejection. In the SOFFT approach, two cost functions are defined. The feedforward control law is designed to optimize one cost function, the feedback optimizes the other. By separating the design objectives and decoupling the feedforward and feedback design processes, both objectives can be achieved fully. A new measure of command tracking performance, Z-plots, is also developed. By analyzing these plots at off-nominal conditions, the sensitivity or robustness of the system in tracking commands can be predicted. Z-plots provide an important tool for designing robust control systems. The Variable-Gain SOFFT methodology was used to design a flight control system for the F/A-18 aircraft. It is shown that SOFFT can be used to expand the operating regime and provide greater performance (flying/handling qualities) throughout the extended flight regime. This work was performed under the NASA SBIR program. ICS plans to market the software developed as a new module in its commercial CACSD software package: ACET.

King has no clothes: The role of the military in responding to a terrorist chemical/biological attack. Final report

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

Osterman, J.L.

1996-06-14

The United States has begun a program of counterproliferation in order to preempt the use of WMD by such elements, however, the ability to respond to the terrorist employment of biological/chemical weapons is absent. Given the structure, capability and technical expertise in the Federal Emergency Management Agency (FEMA) and the Federal Bureau of Investigation (FBI), the Department of Defense (DoD) will be tasked to conduct the response to such an incident. The geographical Commander in Chief (CINC) and the appointed Joint Task Force (JTF) commander will ultimately be assigned the response mission. Planning, training and coordination is required to developmore » a force capable of responding in a timely and coordinated manner.« less

Defense.gov - Special Report - Media Roundtable with the Commander-in-Chief

Science.gov Websites

incidents of post-traumatic stress disorder. Story Obama: Health Care Reform Won’t Impact VA, Tricare works with Congress to shore up gaps in Post-9/11 GI Bill benefits, President Barack Obama said he wants Secretary Eric Shinseki discuss Post-9/11 GI Bill benefits and health care reform with military journalists

Disaster management: using Internet-based technology.

PubMed

Dimitruk, Paul

2007-01-01

Disasters impose operational challenges and substantial financial burdens on hospitals. Internet-based disaster management technology can help. This technology should: Capture, analyze, and track relevant data. Be available 24/7. Guide decision makers in setting up an incident command center and monitor the completion of jobs by ICC role. Provide assistance in areas that hospitals are not used to dealing with, e.g., chemical or bio-terror agents.

Local Area Defense (LAD) Demonstration

DTIC Science & Technology

2004-09-01

Prozac ? Fentanyl? Institution, incident command, community drills - use of internet - digital photos of all victims to follow them through the system...and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503 1. AGENCY USE ONLY 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED (Leave...detection and rapid response system for local area defense using the University of Maryland Baltimore (UMB) Campus as a testbed. Additional goals includes

Connecting Our Nation’s Crisis Information Management Systems

DTIC Science & Technology

2008-12-01

Voice Alert is a communications solution that uses a combination of database and GIS mapping technologies to deliver outbound notifications.85 EOC...needing to be accessed through an extension is necessary. With many businesses, hotels , and other locations requiring an extension to reach...built around five major management activities of an incident.130  Command  Operations  Planning  Logistics  Finance/administration. The new

DoD Needs a Comprehensive Approach to Address Workplace Violence

DTIC Science & Technology

2015-10-15

respond to an act of workplace violence, which could jeopardize their safety during a workplace violence threat or incident. Workplace Violence Prevention... Management Command (IMCOM) Prevention of Workplace Violence Program (U),” September 21, 2012. 18 OPORD 14-091, “U.S. Army Installation Management ... Safety and Health Administration’s definition of workplace violence25 and applies to military, civilian, and contractor personnel. 22 SECNAVINST

A comparison of command center activations versus disaster drills at three institutions from 2013 to 2015.

PubMed

Ebbeling, Laura G; Goralnick, Eric; Bivens, Matthew J; Femino, Meg; Berube, Claire G; Sears, Bryan; Sanchez, Leon D

2016-01-01

Disaster exercises often simulate rare, worst-case scenario events that range from mass casualty incidents to severe weather events. In actuality, situations such as information system downtimes and physical plant failures may affect hospital continuity of operations far more significantly. The objective of this study is to evaluate disaster drills at two academic and one community hospital to compare the frequency of planned drills versus real-world events that led to emergency management command center activation. Emergency management exercise and command center activation data from January 1, 2013 to October 1, 2015 were collected from a database. The activations and drills were categorized according to the nature of the event. Frequency of each type of event was compared to determine if the drills were representative of actual activations. From 2013 to 2015, there were a total of 136 command center activations and 126 drills at the three hospital sites. The most common reasons for command center activations included severe weather (25 percent, n = 34), maintenance failure (19.9 percent, n = 27), and planned mass gathering events (16.9 percent, n = 23). The most frequent drills were process tests (32.5 percent, n = 41), hazardous material-related events (22.2 percent, n = 28), and in-house fires (15.10 percent, n = 19). Further study of the reasons behind why hospitals activate emergency management plans may inform better preparedness drills. There is no clear methodology used among all hospitals to create drills and their descriptions are often vague. There is an opportunity to better design drills to address specific purposes and events.

Plane down in the city: Operation Crash and Surge.

PubMed

Kann, Duane F; Draper, Thomas W

2014-01-01

This article is about the experiences gained from the largest full-scale exercise ever conducted in the State of Florida, specifically regarding the Orlando International Airport (MCO) venues. The exercise was centred on an airplane crashing into a hotel just outside of MCO property. The scenario clarified details regarding Incident Command and the unique jurisdictional responsibilities associated with a large-scale mass casualty incident. There were additional challenges with airline operations, walking wounded, and information sharing that provided valuable experiences toward enhancing emergency operations. This article also outlines information gained by the MCO "go team" that traveled to San Francisco following the crash of Asiana flight 214. This real-life incident shone a light on many of the strengths and opportunities found throughout the MCO exercise and this article shows the interrelationship of both of these invaluable experiences.

Command Center Training Tool (C2T2)

NASA Technical Reports Server (NTRS)

Jones, Phillip; Drucker, Nich; Mathews, Reejo; Stanton, Laura; Merkle, Ed

2012-01-01

This abstract presents the training approach taken to create a management-centered, experiential learning solution for the Virginia Port Authority's Port Command Center. The resultant tool, called the Command Center Training Tool (C2T2), follows a holistic approach integrated across the training management cycle and within a single environment. The approach allows a single training manager to progress from training design through execution and AAR. The approach starts with modeling the training organization, identifying the organizational elements and their individual and collective performance requirements, including organizational-specific performance scoring ontologies. Next, the developer specifies conditions, the problems, and constructs that compose exercises and drive experiential learning. These conditions are defined by incidents, which denote a single, multi-media datum, and scenarios, which are stories told by incidents. To these layered, modular components, previously developed meta-data is attached, including associated performance requirements. The components are then stored in a searchable library An event developer can create a training event by searching the library based on metadata and then selecting and loading the resultant modular pieces. This loading process brings into the training event all the previously associated task and teamwork material as well as AAR preparation materials. The approach includes tools within an integrated management environment that places these materials at the fingertips of the event facilitator such that, in real time, the facilitator can track training audience performance and resultantly modify the training event. The approach also supports the concentrated knowledge management requirements for rapid preparation of an extensive AAR. This approach supports the integrated training cycle and allows a management-based perspective and advanced tools, through which a complex, thorough training event can be developed.

Stage progression and need for renal replacement therapy in a renal protection programme in Colombia. A cohort study.

PubMed

Yepes Delgado, Carlos Enrique; Pérez Dávila, Sara; Montoya Jaramillo, Marcela; Orrego Orozco, Beatriz Elena

Due to the global burden represented by chronic kidney disease (CKD), the World Health Organization encouraged the implementation of renal protection programmes (RPP) to affect its incidence through prevention and control measures. To assess the effectiveness of a Colombian RPP in terms of its effect on the stage progression of CKD and the need for renal replacement therapy (RRT). An analytical study that monitored 2cohorts of patients diagnosed with CKD. The study compares the behaviour of clinical and renal impairment indicators from patients exposed to a RPP with that of patients following conventional treatment (CT). The population of both intervention groups was considered when determining the sample size. The incidence rate was calculated as well as patient survival (Kaplan Meier). In addition, a multivariate analysis (Cox) was used to calculate the influence that exposure to the RPP had on the outcomes of the patients following the RPP and those following CT. The patients exposed to the RPP took longer to advance to the next CKD stage and require RRT. The incidence rate for progression is higher for the patients following CT (0.050, IC 95%: 0.040-0.064) compared to those in the RPP (0.034, IC 95%: 0.030-0.039). The ratio of incidence rates was 1.480 (IC 95% 1.21-1.90). The hazard of progression was lower for the RPP (HR: 0.855, IC 95%: 0.74- 0.98), as was the hazard of requiring RRT (HR: 0.797, IC 95%: 0.606-1.049). The RPP is a secondary prevention strategy against CKD which has an effect on the stage progression of CKD and the need for RRT. Early patient detection has a positive effect on the outcomes studied. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

A one-year proprioceptive exercise programme reduces the incidence of falls in community-dwelling elderly people: A before-after non-randomised intervention study.

PubMed

Pérez-Ros, Pilar; Martinez-Arnau, Francisco M; Malafarina, Vincenzo; Tarazona-Santabalbina, Francisco J

2016-12-01

The risk of falls increases with age. Balance alteration and polypharmacy are independent contributors to an increased risk of falls. The primary aim was to assess whether a proprioceptive exercise programme reduces the incidence of falls. A secondary aim was to assess the association between drugs and falls. This was a before-after non-randomised intervention study. The study recruited independent and cognitively intact community-dwelling people aged over 69 years, from December 2012 to May 2014. The intervention was done by a nurse and consisted of a monthly supervised group session of proprioceptive training for 1 year, supplemented by a home diary exercise. Daily medication was reviewed. We included 572 subjects (63.3% women), mean age 76.1±3.9 years. The mean number of drugs prescribed at the start of the study was 4.7±3.0and 353 of the participants (61.7%) were taking four or more drugs a day. The elderly who fell were more dependent in their activities of daily living (Barthel index), and their balance was worse (determined using the Tinetti scale), as were their results on a cognitive scale (the MEC). After the intervention, an increase in self-perceived quality of life (EQ5D) was reported. The incidence of falls was reduced from 37.5% in the 12 months prior to the intervention to 25.7% in the 12 months after the intervention. During the follow-up, beta-blocker use was associated with an increased incidence of falls (OR=2.05; 95%IC: 1.24-3.39; p=0.005). In contrast, antiplatelet/anticoagulation drugs were associated with a lower risk of falls (OR=0.7; 95%IC: 0.55-0.88; p=0.003). The proprioceptive exercise programme reduced the incidence of falls in community-dwelling older people. Multiple drug use was an independent predictor of an increased risk of falls, and specific drug groups were associated with falls. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Medical events during the 2009 Los Angeles County Station Fire: lessons for wildfire EMS planning.

PubMed

Squire, Benjamin; Chidester, Cathy; Raby, Stephanie

2011-01-01

Little is known about the types of injuries and medical problems encountered by fire department personnel during suppression of large campaign-type wildland fires. Such information could help to plan for response to medical incidents during future wildfires. To describe the injuries and medical problems experienced by firefighters during the 2009 Los Angeles County Station Fire. This was a retrospective analysis of case records of patients treated during the Los Angeles County Station Fire. Data were abstracted from two sources: the incident command medical tracking sheet and prehospital patient care reports (PCRs). The sample included 183 patient contacts, of which PCRs were available for 65. For the remaining 118 patients, data were abstracted from the incident command medical tracking sheet. The most common chief complaint was extremity injury, accounting for 44 patient contacts (24% of all patients), with smoke inhalation second, at 32 patient contacts (17%). Of the 65 patients with PCRs, 31 (52%) were treated with oxygen, 26 (40%) had intravenous (IV) lines started, and 15 (23%) received an IV fluid bolus. Half of the patients were transported to an emergency department (ED); the remainder were treated on scene or self-transported to a non-acute care facility. Most firefighter injuries and illnesses encountered during the Los Angeles Station Fire were minor. The prevalence of injuries observed should be taken into consideration in creation of protocols and mandatory equipment lists for fireline paramedics. Furthermore, advanced training for paramedics in the diagnosis and treatment of minor medical conditions may be useful.

The epidemiology of invasive disease due to Haemophilus influenzae serotype a in the Canadian North from 2000 to 2010.

PubMed

Rotondo, Jenny L; Sherrard, Lindsey; Helferty, Melissa; Tsang, Raymond; Desai, Shalini

2013-01-01

The International Circumpolar Surveillance (ICS) project is a population-based surveillance network. Since 2000, Canada has participated in the ICS Invasive Bacterial Disease Working Group's surveillance of invasive disease due to Haemophilus influenzae (Hi). A standardized case report form containing demographic and clinical information was completed for all reported Hi cases in the study regions. Isolates were sent to a reference laboratory for confirmation and serotyping. Analysis was conducted on all Hi serotype a (Hia) cases reported from 2000 to 2010. The northern Canadian population was estimated using Statistics Canada information. Of the 130 Hi cases reported from 2000 to 2010, 72 (56% of cases with serotype information) were due to Hia. The number of Hia cases reported each year ranged from 2 in 2008 to 13 in 2010. The average Hia incidence over the 11 years was 4.6 cases per 100,000 population per year. The majority of Hia occurred in infants less than 2 years of age (73% of cases). This age group had an average annual incidence of 87.5 cases per 100,000 population. Among cases for which ethnicity was indicated, 91% of Hia cases reported Aboriginal status with the average incidence being 6.9 cases per 100,000 population per year. The most common clinical presentation was meningitis (reported in 37% of cases), followed by bacteraemia (34%) and pneumonia (27%). More than 90% of cases were hospitalized, and there were 4 deaths, resulting in a case fatality ratio of 5.6%. In the last decade, Hia has become an important cause of morbidity and mortality in the Canadian North. More detailed surveillance information from a national perspective is needed. Further work on vaccine development should be encouraged.

Active Duty-U.S. Army Noise Induced Hearing Injury Quarterly Surveillance Q3 2011 thru Q4 2013

DTIC Science & Technology

2014-06-30

incident case rates for sensorineural hearing loss significant threshold shift, tinnitus , and Noise-Induced Hearing Loss. RECOMMENDATIONS: Commanders...2013 A-1 APPENDIX A REFERENCES Humes LE, Jollenbeck LM, Durch JS: Noise and military service: Implications for hearing loss and tinnitus . Washington...FUNCTION STUDIES TINN Tinnitus 38830 TINNITUS UNSPECIFIED TINN Tinnitus 38831 SUBJECTIVE TINNITUS TINN Tinnitus 38832 OBJECTIVE TINNITUS CPT Codes

Examination of the home destruction in Los Alamos associated with the Cerro Grande Fire - July 10, 2000

Treesearch

Jack D. Cohen

2000-01-01

I arrived at Los Alamos on May 14, 2000 to conduct an examination of the home destruction associated with the Cerro Grande Fire. My examination occurred between the afternoon of 5/14 and late afternoon on 5/16. I had contact with the southern command post incident management team, the Los Alamos Fire Department, and the Santa Fe National Forest.The...

Unity of Command for Homeland Security: Title 32, Title 10, or a Combination.

DTIC Science & Technology

2006-01-01

the absence of Los Angeles Police Department ( LAPD ) officers. Hundreds of arson and looting incidents begin. 2100 The California governor’s...time there were over 1,200 CANG soldiers deployed in support of the LOS ANGELES police department , 1,600 in support of the LOS ANGELES County... the streets, but most active component Army and Marine Corps personnel remained in staging areas preparing for

Hospital Administration and Nursing Leadership in Disasters: An Exploratory Study Using Concept Mapping.

PubMed

Veenema, Tener Goodwin; Deruggiero, Katherine; Losinski, Sarah; Barnett, Daniel

Strong leadership is critical in disaster situations when "patient surge" challenges a hospital's capacity to respond and normally acceptable patterns of care are disrupted. Activation of the emergency operations plan triggers an incident command system structure for leadership decision making. Yet, implementation of the emergency operations plan and incident command system protocols is ultimately subject to nursing and hospital leadership at the service- and unit level. The results of these service-/unit-based leadership decisions have the potential to directly impact staff and patient safety, quality of care, and ultimately, patient outcomes. Despite the critical nature of these events, nurse leaders and administrators receive little education regarding leadership and decision making during disaster events. The purpose of this study is to identify essential competencies of nursing and hospital administrators' leadership during disaster events. An integrative mixed-methods design combining qualitative and quantitative approaches to data collection and analysis was used. Five focus groups were conducted with nurse leaders and hospital administrators at a large urban hospital in the Northeastern United States in a collaborative group process to generate relevant leadership competencies. Concept Systems Incorporated was used to sort, prioritize, and analyze the data (http://conceptsystemsinc.com/). The results suggest that participants' institutional knowledge (of existing resources, communications, processes) and prior disaster experience increase leadership competence.

Operational Experience with Long Duration Wildfire Mapping: UAS Missions Over the Western United States

NASA Technical Reports Server (NTRS)

Hall, Philip; Cobleigh, Brent; Buoni, Greg; Howell, Kathleen

2008-01-01

The National Aeronautics and Space Administration, United States Forest Service, and National Interagency Fire Center have developed a partnership to develop and demonstrate technology to improve airborne wildfire imaging and data dissemination. In the summer of 2007, a multi-spectral infrared scanner was integrated into NASA's Ikhana Unmanned Aircraft System (UAS) (a General Atomics Predator-B) and launched on four long duration wildfire mapping demonstration missions covering eight western states. Extensive safety analysis, contingency planning, and mission coordination were key to securing an FAA certificate of authorization (COA) to operate in the national airspace. Infrared images were autonomously geo-rectified, transmitted to the ground station by satellite communications, and networked to fire incident commanders within 15 minutes of acquisition. Close coordination with air traffic control ensured a safe operation, and allowed real-time redirection around inclement weather and other minor changes to the flight plan. All objectives of the mission demonstrations were achieved. In late October, wind-driven wildfires erupted in five southern California counties. State and national emergency operations agencies requested Ikhana to help assess and manage the wildfires. Four additional missions were launched over a 5-day period, with near realtime images delivered to multiple emergency operations centers and fire incident commands managing 10 fires.

Small-Quantity Lipid-Based Nutrient Supplements, Regardless of Their Zinc Content, Increase Growth and Reduce the Prevalence of Stunting and Wasting in Young Burkinabe Children: A Cluster-Randomized Trial

PubMed Central

Hess, Sonja Y.; Abbeddou, Souheila; Jimenez, Elizabeth Yakes; Somé, Jérôme W.; Vosti, Stephen A.; Ouédraogo, Zinéwendé P.; Guissou, Rosemonde M.; Ouédraogo, Jean-Bosco; Brown, Kenneth H.

2015-01-01

Small-quantity lipid-based nutrient supplements (SQ-LNS) are promising home fortification products, but the optimal zinc level needed to improve growth and reduce morbidity is uncertain. We aimed to assess the impact of providing SQ-LNS with varied amounts of zinc, along with illness treatment, on zinc-related outcomes compared with standard care. In a placebo-controlled, cluster-randomized trial, 34 communities were stratified to intervention (IC) or non-intervention cohorts (NIC). 2435 eligible IC children were randomly assigned to one of four groups:1) SQ-LNS without zinc, placebo tablet; 2) SQ-LNS containing 5mg zinc, placebo tablet; 3) SQ-LNS containing 10mg zinc, placebo tablet; or 4) SQ-LNS without zinc and 5mg zinc tablet from 9–18 months of age. During weekly morbidity surveillance, oral rehydration salts were provided for reported diarrhea and antimalarial therapy for confirmed malaria. Children in NIC (n = 785) did not receive SQ-LNS, tablets, illness surveillance or treatment. At 9 and 18 months, length, weight and hemoglobin were measured in all children. Reported adherence was 97±6% for SQ-LNS and tablets. Mean baseline hemoglobin was 89±15g/L. At 18 months, change in hemoglobin was greater in IC than NIC (+8 vs -1g/L, p<0.0001), but 79.1% of IC were still anemic (vs. 91.1% in NIC). Final plasma zinc concentration did not differ by group. During the 9-month observation period, the incidence of diarrhea was 1.10±1.03 and of malaria 0.54±0.50 episodes per 100 child-days, and did not differ by group. Length at 18 months was significantly greater in IC compared to NIC (77.7±3.0 vs. 76.9±3.4cm; p<0.001) and stunting prevalence was significantly lower in IC (29.3%) than NIC (39.3%; p<0.0001), but did not differ by intervention group within IC. Wasting prevalence was also significantly lower in IC (8.7%) than in NIC (13.5%; p = 0.0003). Providing SQ-LNS daily with or without zinc, along with malaria and diarrhea treatment, significantly increased growth and reduced stunting, wasting and anemia prevalence in young children. Trial Registration ClinicalTrials.gov NCT00944281 PMID:25816354

Using fractional exhaled nitric oxide (FeNO) to diagnose steroid-responsive disease and guide asthma management in routine care.

PubMed

Price, David; Ryan, Dermot; Burden, Annie; Von Ziegenweidt, Julie; Gould, Shuna; Freeman, Daryl; Gruffydd-Jones, Kevin; Copland, Anne; Godley, Clifford; Chisholm, Alison; Thomas, Mike

2013-11-07

Fractional exhaled nitric oxide (FeNO) is a surrogate marker of eosinophilic airway inflammation and good predictor of corticosteroid response. To evaluate how FeNO is being used to guide primary care asthma management in the United Kingdom (UK) with a view to devising practical algorithms for the use of FeNO in the diagnosis of steroid-responsive disease and to guide on-going asthma management. Eligible patients (n = 678) were those in the Optimum Patient Care Research Database (OPCRD) aged 4-80 years who, at an index date, had their first FeNO assessment via NIOX MINO® or Flex®. Eligible practices were those using FeNO measurement in at least ten patients during the study period. Patients were characterized over a one-year baseline period immediately before the index date. Outcomes were evaluated in the year immediately following index date for two patient cohorts: (i) those in whom FeNO measurement was being used to identify steroid-responsive disease and (ii) those in whom FeNO monitoring was being used to guide on-going asthma management. Outcomes for cohort (i) were incidence of new ICS initiation at, or within the one-month following, their first FeNO measurement, and ICS dose during the outcome year. Outcomes for cohort (ii) were adherence, change in adherence (from baseline) and ICS dose. In cohort (i) (n = 304) the higher the FeNO category, the higher the percentage of patients that initiated ICS at, or in the one month immediately following, their first FeNO measurement: 82%, 46% and 26% of patients with high, intermediate and low FeNO, respectively. In cohort (ii) (n = 374) high FeNO levels were associated with poorer baseline adherence (p = 0.005) but greater improvement in adherence in the outcome year (p = 0.017). Across both cohorts, patients with high FeNO levels were associated with significantly higher ICS dosing (p < 0.001). In the UK, FeNO is being used in primary practice to guide ICS initiation and dosing decisions and to identify poor ICS adherence. Simple algorithms to guide clinicians in the practical use of FeNO could improved diagnostic accuracy and better tailored asthma regimens.

Using social media to communicate during crises: an analytic methodology

NASA Astrophysics Data System (ADS)

Greene, Marjorie

2011-06-01

The Emerging Media Integration Team at the Department of the Navy Office of Information (CHINFO) has recently put together a Navy Command Social Media Handbook designed to provide information needed to safely and effectively use social media. While not intended to be a comprehensive guide on command use of social media or to take the place of official policy, the Handbook provides a useful guide for navigating a dynamic communications environment. Social media are changing the way information is diffused and decisions are made, especially for Humanitarian Assistance missions when there is increased emphasis on Navy commands to share critical information with other Navy command sites, government, and official NGO (nongovernmental organization) sites like the American Red Cross. In order to effectively use social media to support such missions, the Handbook suggests creating a centralized location to funnel information. This suggests that as the community of interest (COI) grows during a crisis, it will be important to ensure that information is shared with appropriate organizations for different aspects of the mission such as evacuation procedures, hospital sites, location of seaports and airports, and other topics relevant to the mission. For example, in the first 14 days of the U.S. Southern Command's Haiti HA/DR (Humanitarian Assistance/Disaster Relief) mission, the COI grew to over 1,900 users. In addition, operational conditions vary considerably among incidents, and coordination between different groups is often set up in an ad hoc manner. What is needed is a methodology that will help to find appropriate people with whom to share information for particular aspects of a mission during a wide range of events related to the mission. CNA has developed such a methodology and we would like to test it in a small scale lab experiment.

Behavioural and cognitive abnormalities in an imprinting centre deletion mouse model for Prader-Willi syndrome.

PubMed

Relkovic, Dinko; Doe, Christine M; Humby, Trevor; Johnstone, Karen A; Resnick, James L; Holland, Anthony J; Hagan, Jim J; Wilkinson, Lawrence S; Isles, Anthony R

2010-01-01

The genes in the imprinted cluster on human chromosome 15q11-q13 are known to contribute to psychiatric conditions such as schizophrenia and autism. Major disruptions of this interval leading to a lack of paternal allele expression give rise to Prader-Willi syndrome (PWS), a neurodevelopmental disorder with core symptoms of a failure to thrive in infancy and, on emergence from infancy, learning disabilities and over-eating. Individuals with PWS also display a number of behavioural problems and an increased incidence of neuropsychiatric abnormalities, which recent work indicates involve aspects of frontal dysfunction. To begin to examine the contribution of genes in this interval to relevant psychological and behavioural phenotypes, we exploited the imprinting centre (IC) deletion mouse model for PWS (PWS-IC(+/-)) and the five-choice serial reaction time task (5-CSRTT), which is primarily an assay of visuospatial attention and response control that is highly sensitive to frontal manipulations. Locomotor activity, open-field behaviour and sensorimotor gating were also assessed. PWS-IC(+/-) mice displayed reduced locomotor activity, increased acoustic startle responses and decreased prepulse inhibition of startle responses. In the 5-CSRTT, the PWS-IC(+/-) mice showed deficits in discriminative response accuracy, increased correct reaction times and increased omissions. Task manipulations confirmed that these differences were likely to be due to impaired attention. Our data recapitulate several aspects of the PWS clinical condition, including findings consistent with frontal abnormalities, and may indicate novel contributions of the imprinted genes found in 15q11-q13 to behavioural and cognitive function generally.

GNSS-based emergency management system

NASA Astrophysics Data System (ADS)

Wu, Yuhang; Chen, Xiuwan; Ma, Lei

2009-06-01

Public safety and public service is a particularly challenging task. The questions of how to use the limited resources efficiently, how to improve the Government's emergency rapid response and ability of risk resistance, and how to provide a more efficient emergency service for the public, have increasingly become the focus to strengthen urban management. Emergency Response Management System is a highly efficient and powerful command system dealing with natural and social disasters, by using all aspects of the force being gathered in a short period of time, sudden events can be handled efficiently, and further development of the incident can be controlled. In this paper, based on the analysis of development status of the emergency management system at home and abroad, and the key technologies of the emergency management system based on GNSS, research and development on emergency command system based on GNSS has been done. Meanwhile, test in Sichuan earthquake has also been carried out. Practice in Sichuan province earthquake relief work has proved that the emergency management command system based on GNSS can play the advantage function and exert the maximum potential, and can play the role of "lifeline" in the critical moment.

[The role of cooperation between the command and district medical service in prophylaxis of acute respiratory diseases].

PubMed

Kalmykov, A A; Nosarev, V G; Aminev, R M; Konovalov, P P

2014-11-01

The problem of increased incidence of respiratory diseases in troops is significant due to reorganization of military staff and redeployment of military units, which led to the deterioration of the terms of accommodation and living conditions of personnel. Significant contribution to the growth of this disease has brought an increase in the number of young recruits after the transition to a one-year compulsory military service, as well as reducing the number of doctors in the military echelon. In the Central Military District has developed a unified system of sanitary and anti-epidemic and preventive measures, an understanding commanders associations, military units and formations of the order and timing of their implementation, establish a uniform procedure for reporting on the sanitary and epidemiological situation in the garrisons as in operational duty, and on medical service. All this allows us time to carry out or correct preventive measures, to achieve a positive result of work on the health of military personnel. Due to the close interaction between the command and the medical service in the district after 2012 reduced the number of cases with respiratory diseases.

Operational Art and the Incident Command System: Public Health’s Bridge in Bioterrorism Preparedness and Response

DTIC Science & Technology

2003-03-22

e.g., tuberculosis screening or a maximal treadmill test ); and 3) tertiary prevention limits disability and rehabilitation where the disease or injury...major city/county laboratories to develop the capacity to conduct rapid and accurate diagnostic and reference testing for select biologic agents likely...system, but it has not been thoroughly tested and coordinated in the civilian sector. The association of mass casualty care with hospital

Validating a Method for Enhanced Communications and Situational Awareness at the Incident Command Level

DTIC Science & Technology

2006-03-01

operations, and other applications for the MITOC that are beneficial to national security. It will illustrate how the concept was validated by the...of the potential impact on funding, a concern was noted in discussion among members of the National Emergency Management Association (NEMA) in their...This concept of a “virtual” Homeland Security-focused National Laboratory was comprised of the combined resources of the public and private

Seeing Eye Drones: How The DOD Can Transform CBM And Disaster Response In The Homeland

DTIC Science & Technology

2016-12-01

thesis explores the possibility of integrating small unmanned aircraft systems (sUAS) with video capability and CBRN detection and identification sensors...small, unmanned aircraft systems (sUAS) with video capability and CBRN detection and identification sensors for use by National Guard civil support...CBRN) and hazardous material (HAZMAT) materials, as well as providing video to the incident commander. One of the primary benefits of providing

A meta-analysis and meta-regression of outcomes including biliary complications in donation after cardiac death liver transplantation.

PubMed

O'Neill, Stephen; Roebuck, Amanda; Khoo, Emily; Wigmore, Stephen J; Harrison, Ewen M

2014-11-01

Donation after cardiac death (DCD) liver transplantation is increasingly common but concerns exist over the development of biliary complications and ischemic cholangiopathy (IC). This study aimed to compare outcomes between DCD and donation after brain death (DBD) liver grafts. Studies reporting on post-transplantation outcomes after Maastricht category III DCD liver transplantation were screened for inclusion. Odds ratios (OR) with 95% confidence intervals were produced using random-effects models for the incidence of biliary complications, IC, graft and recipient survival. Meta-regression was undertaken to identify between-study predictors of effect size for biliary complications and IC. PROSPERO Record: CRD42012002113. Twenty-five studies with 62 184 liver transplant recipients (DCD = 2478 and DBD = 59 706) were included. In comparison with DBD, there was a significant increase in biliary complications [OR = 2.4 (1.9, 3.1); P < 0.00001] and IC [OR = 10.5 (5.7, 19.5); P < 0.00001] following DCD liver transplantation. In comparison with DBD, at 1 year [OR = 0.7 (0.5, 0.8); P = 0.0002] and 3 years [OR = 0.6 (0.5, 0.8); P = 0.001], there was a significant decrease in graft survival following DCD liver transplantation. At 1 year, there was also a nonsignificant decrease [OR = 0.8 (0.6, 1.0); P = 0.08] and by 3 years a significant decrease [OR = 0.7 (0.5, 1.0); P = 0.04] found in recipient survival following DCD liver transplantation. Eleven factors were entered into meta-regression models, but none explained the variability in effect size between studies. DCD liver transplantation is associated with an increase in biliary complications, IC, graft loss and mortality. Significant unexplained differences in effect size exist between centers. © 2014 Steunstichting ESOT.

Peridomestic Infection as a Determining Factor of Dengue Transmission

PubMed Central

Martínez-Vega, Ruth Aralí; Danis-Lozano, Rogelio; Díaz-Quijano, Fredi Alexander; Velasco-Hernández, Jorge; Santos-Luna, René; Román-Pérez, Susana; Kuri-Morales, Pablo; Ramos-Castañeda, José

2015-01-01

Background The study of endemic dengue transmission is essential for proposing alternatives to impact its burden. The traditional paradigm establishes that transmission starts around cases, but there are few studies that determine the risk. Methods To assess the association between the peridomestic dengue infection and the exposure to a dengue index case (IC), a cohort was carried out in two Mexican endemic communities. People cohabitating with IC or living within a 50-meter radius (exposed cohort) and subjects of areas with no ICs in a 200-meter radius (unexposed cohort) were included. Results Exposure was associated with DENV infection in cohabitants (PRa 3.55; 95%CI 2.37–5.31) or neighbors (PRa 1.82; 95%CI 1.29–2.58). Age, location, toilets with no direct water discharge, families with children younger than 5 and the House Index, were associated with infection. Families with older than 13 were associated with a decreased frequency. After a month since the IC fever onset, the infection incidence was not influenced by exposure to an IC or vector density; it was influenced by the local seasonal behavior of dengue and the age. Additionally, we found asymptomatic infections accounted for 60% and a greater age was a protective factor for the presence of symptoms (RR 0.98; 95%CI 0.97–0.99). Conclusion The evidence suggests that dengue endemic transmission in these locations is initially peridomestic, around an infected subject who may be asymptomatic due to demographic structure and endemicity, and it is influenced by other characteristics of the individual, the neighborhood and the location. Once the transmission chain has been established, dengue spreads in the community probably by the adults who, despite being the group with lower infection frequency, mostly suffer asymptomatic infections and have higher mobility. This scenario complicates the opportunity and the effectiveness of control programs and highlights the need to apply multiple measures for dengue control. PMID:26671573

Peridomestic Infection as a Determining Factor of Dengue Transmission.

PubMed

Martínez-Vega, Ruth Aralí; Danis-Lozano, Rogelio; Díaz-Quijano, Fredi Alexander; Velasco-Hernández, Jorge; Santos-Luna, René; Román-Pérez, Susana; Kuri-Morales, Pablo; Ramos-Castañeda, José

2015-12-01

The study of endemic dengue transmission is essential for proposing alternatives to impact its burden. The traditional paradigm establishes that transmission starts around cases, but there are few studies that determine the risk. To assess the association between the peridomestic dengue infection and the exposure to a dengue index case (IC), a cohort was carried out in two Mexican endemic communities. People cohabitating with IC or living within a 50-meter radius (exposed cohort) and subjects of areas with no ICs in a 200-meter radius (unexposed cohort) were included. Exposure was associated with DENV infection in cohabitants (PRa 3.55; 95%CI 2.37-5.31) or neighbors (PRa 1.82; 95%CI 1.29-2.58). Age, location, toilets with no direct water discharge, families with children younger than 5 and the House Index, were associated with infection. Families with older than 13 were associated with a decreased frequency. After a month since the IC fever onset, the infection incidence was not influenced by exposure to an IC or vector density; it was influenced by the local seasonal behavior of dengue and the age. Additionally, we found asymptomatic infections accounted for 60% and a greater age was a protective factor for the presence of symptoms (RR 0.98; 95%CI 0.97-0.99). The evidence suggests that dengue endemic transmission in these locations is initially peridomestic, around an infected subject who may be asymptomatic due to demographic structure and endemicity, and it is influenced by other characteristics of the individual, the neighborhood and the location. Once the transmission chain has been established, dengue spreads in the community probably by the adults who, despite being the group with lower infection frequency, mostly suffer asymptomatic infections and have higher mobility. This scenario complicates the opportunity and the effectiveness of control programs and highlights the need to apply multiple measures for dengue control.

The effect of budesonide/formoterol maintenance and reliever therapy on the risk of severe asthma exacerbations following episodes of high reliever use: an exploratory analysis of two randomised, controlled studies with comparisons to standard therapy

PubMed Central

2012-01-01

Background Divergent strategies have emerged for the management of severe asthma. One strategy utilises high and fixed doses of maintenance treatment, usually inhaled corticosteroid/long-acting β2-agonist (ICS/LABA), supplemented by a short-acting β2-agonist (SABA) as needed. Alternatively, budesonide/formoterol is used as both maintenance and reliever therapy. The latter is superior to fixed-dose treatment in reducing severe exacerbations while achieving similar or better asthma control in other regards. Exacerbations may be reduced by the use of budesonide/formoterol as reliever medication during periods of unstable asthma. We examined the risk of a severe exacerbation in the period after a single day with high reliever use. Methods Episodes of high reliever use were quantified and exacerbations occurring post-index day with these episodes were examined post hoc in two double-blind studies comparing the efficacy and safety of budesonide/formoterol maintenance and reliever therapy (Symbicort SMART™, Turbuhaler®) 160/4.5 μg twice daily plus as needed with similar or higher maintenance doses of ICS/LABA plus SABA or formoterol. Results Budesonide/formoterol maintenance and reliever therapy significantly reduced the risk of episodes of high reliever use (>6 inhalations/day) vs. all alternative ICS/LABA regimens. With conventional fixed-dose treatment the need for exacerbation treatment within 21 days ranged from 6.0–10.1% of days post-index for all regimens compared with 2.5–3.4% of days with budesonide/formoterol maintenance and reliever therapy. Conclusions Budesonide/formoterol maintenance and reliever therapy reduces the incidence of high reliever episodes and the exacerbation burden immediately following these episodes vs. alternative ICS/LABA plus SABA regimens at up to double the maintenance dose of ICS. Trial registration These studies do not have registration numbers as they were conducted before clinical trial registration was required PMID:22816878

C2-Related Incidents Reported by UAS Pilots

NASA Technical Reports Server (NTRS)

Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

2016-01-01

It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. This presentation focuses on incidents that involved the management of the command and control (C2) link. The identified issues include loss of link, interference from undesired transmissions, voice latency, accidental control transfer, and the use of the lost link timer, or lost link OK features.

A biological decontamination process for small, privately owned buildings.

PubMed

Krauter, Paula; Tucker, Mark

2011-09-01

An urban wide-area recovery and restoration effort following a large-scale biological release will require extensive resources and tax the capabilities of government authorities. Further, the number of private decontamination contractors available may not be sufficient to respond to the needs. These resource limitations could create the need for decontamination by the building owner/occupant. This article provides owners/occupants with a simple method to decontaminate a building or area following a wide-area release of Bacillus anthracis using liquid sporicidal decontamination materials, such as pH-amended bleach or activated peroxide; simple application devices; and high-efficiency particulate air-filtered vacuums. Owner/occupant decontamination would be recommended only after those charged with overseeing decontamination-the Unified Command/Incident Command-identify buildings and areas appropriate for owner/occupant decontamination based on modeling and environmental sampling and conduct health and safety training for cleanup workers.

Anticoagulation Therapy for Venous Thromboembolism in the Real World　- From the COMMAND VTE Registry.

PubMed

Yamashita, Yugo; Morimoto, Takeshi; Amano, Hidewo; Takase, Toru; Hiramori, Seiichi; Kim, Kitae; Konishi, Takashi; Akao, Masaharu; Kobayashi, Yohei; Inoue, Takeshi; Oi, Maki; Izumi, Toshiaki; Takahashi, Kotaro; Tada, Tomohisa; Chen, Po-Min; Murata, Koichiro; Tsuyuki, Yoshiaki; Sakai, Hiroshi; Saga, Syunsuke; Sasa, Tomoki; Sakamoto, Jiro; Yamada, Chinatsu; Kinoshita, Minako; Togi, Kiyonori; Ikeda, Tomoyuki; Ishii, Katsuhisa; Kaneda, Kazuhisa; Mabuchi, Hiroshi; Otani, Hideo; Takabayashi, Kensuke; Takahashi, Mamoru; Shiomi, Hiroki; Makiyama, Takeru; Ono, Koh; Kimura, Takeshi

2018-04-25

Venous thromboembolism (VTE) has a long-term risk of recurrence, which can be prevented by anticoagulation therapy.Methods and Results:The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive patients with acute symptomatic VTE between January 2010 and August 2014. The entire cohort was divided into the transient risk (n=855, 28%), unprovoked (n=1,477, 49%), and cancer groups (n=695, 23%). The rate of anticoagulation discontinuation was highest in the cancer group (transient risk: 37.3% vs. unprovoked: 21.4% vs. cancer: 43.5% at 1 year, P<0.001). The cumulative 5-year incidences of recurrent VTE, major bleeding and all-cause death were highest in the cancer group (recurrent VTE: 7.9% vs. 9.3% vs. 17.7%, P<0.001; major bleeding: 9.0% vs. 9.4% vs. 26.6%, P<0.001; and all-cause death: 17.4% vs. 15.3% vs. 73.1%, P<0.001). After discontinuation of anticoagulation therapy, the cumulative 3-year incidence of recurrent VTE was lowest in the transient risk group (transient risk: 6.1% vs. unprovoked: 15.3% vs. cancer: 13.2%, P=0.001). The cumulative 3-year incidence of recurrent VTE beyond 1 year was lower in patients on anticoagulation than in patients off anticoagulation at 1 year in the unprovoked group (on: 3.7% vs. off: 12.2%, P<0.001), but not in the transient risk and cancer groups (respectively, 1.6% vs. 2.5%, P=0.30; 5.6% vs. 8.6%, P=0.44). The duration of anticoagulation therapy varied widely in discordance with current guideline recommendations. Optimal duration of anticoagulation therapy should be defined according to the risk of recurrent VTE and bleeding as well as death.

Socializing the human factors analysis and classification system: incorporating social psychological phenomena into a human factors error classification system.

PubMed

Paletz, Susannah B F; Bearman, Christopher; Orasanu, Judith; Holbrook, Jon

2009-08-01

The presence of social psychological pressures on pilot decision making was assessed using qualitative analyses of critical incident interviews. Social psychological phenomena have long been known to influence attitudes and behavior but have not been highlighted in accident investigation models. Using a critical incident method, 28 pilots who flew in Alaska were interviewed. The participants were asked to describe a situation involving weather when they were pilot in command and found their skills challenged. They were asked to describe the incident in detail but were not explicitly asked to identify social pressures. Pressures were extracted from transcripts in a bottom-up manner and then clustered into themes. Of the 28 pilots, 16 described social psychological pressures on their decision making, specifically, informational social influence, the foot-in-the-door persuasion technique, normalization of deviance, and impression management and self-consistency motives. We believe accident and incident investigations can benefit from explicit inclusion of common social psychological pressures. We recommend specific ways of incorporating these pressures into theHuman Factors Analysis and Classification System.

[Mass casualty incidents : preparedness of German soccer arenas].

PubMed

Luiz, T; Preisegger, T; Madler, C

2013-04-01

Each weekend soccer arenas attract hundreds of thousands of spectators with the German Bundesliga being one of the most attractive sport series worldwide. In 2006 when the FIFA soccer World Cup™ took place in Germany, the precautions in the participating arenas against mass casualty incidents (MCI) reached a level formerly unknown in Germany. However, it is unknown how soccer arenas are prepared to deal with such incidents in everyday life. In 2011 all German major soccer league clubs were questioned about medical precautions in case of MCIs occurring in the stadium. The questionnaire included the following items: stadium capacity, the number of paramedic personnel, emergency physicians and ambulance vehicles, the command and communication structures, the availability of MCI plans, recent MCI drills and the frequency of MCI. Out of 39, 15 (38.4 %) participated, 50 % from the first league and 20.8 % from the second league. The mean stadium capacity was 41,800 spectators (minimum 10,600, maximum 80,700). Depending on the number of spectators and the individual risk score of the match the following resources were available within the stadiums (average, minimum, maximum,): emergency medical technicians 61-67 (15, 120), emergency physicians 2.3-2.5 (1, 5) and transport capacity 5.3-5.8 patients (1, 15). In 14 arenas (93.3 %) the medical personnel were trained in mass casualty care and had prepared MCI operation schedules. All stadiums had mission control centers equipped with a variety of wired and wireless communication tools, although only eight (52.3 %) arenas used a joint command structure and five (33.3 %) arenas reported MCIs (defined as a scenario involving more than 10 patients) within the past 10 years. In 40 % of the participants the last MCI-related exercise was conducted more than 36 months ago. Most of the participating arenas were adequately staffed to manage the first phase of MCIs but in contrast command structures and transport capacities often focused on individual emergencies. Although most of the participants stated that they planned the resources provision according to well established algorithms, the resources actually available at the arenas varied considerably. The frequency of MCIs in soccer arenas was surprisingly high in contrast to the frequency of MCI-related drills.

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2016-12-01

the study for the presence or absence of ectopic bone formation at the indicated time points post injury (Table 1.). 8 Table 1. Incidence of HO...1 Award Number: W81XWH-12-2-0119 TITLE: Early Diagnosis and Intervention Strategies for Post -Traumatic Heterotopic Ossification in Severely...2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT

Civil Support: DOD Needs to Clarify Its Roles and Responsibilities for Defense Support of Civil Authorities during Cyber Incidents

DTIC Science & Technology

2016-04-01

resources in response to requests for assistance from civil authorities for domestic emergencies (e.g., hurricanes and wildfires ), special events (e.g...in its DSCA mission, DOD supports civil authorities by providing them with resources for responses to disasters like Hurricane Sandy and wildfires ...since 2004. For example, DOD used the dual-status commander for the 2012 Colorado wildfire response. In its technical comments, DOD identified four

Decreasing Variance in Response Time to Singular Incidents of Piracy in the Horn of Africa Area of Operation

DTIC Science & Technology

2010-06-01

must be considered when forces are (notionally) allocated . The model in this thesis will attempt to show the amount of time each person in the 2...Command and Control organization will allocate to this mission. This thesis then intends to demonstrate that an organizational structure that...Indian Ocean. Focusing on this geographic area helps to frame the structure of the Department of Defense forces that monitor, assess, allocate

Amphibian conservation: clarifications to comments from Andreone

USGS Publications Warehouse

Muths, Erin L.; Fisher, Robert N.

2017-01-01

We appreciate the comments from Andreone (2016) regarding our proposed alternative strategy for addressing the amphibian crisis. Andreone recognizes the utility of an Incident Command System approach but doubts the feasibility of implementation at an international level. We stated in our original article, however, that ‘the feasibility of our suggestion is debatable, but our point is that radically different approaches are necessary to effectively manage the largest extinction event in modern history’ (Muths & Fisher, 2015). There are examples of where such top-down strategies are being applied; e.g. for the brown tree snake Boiga irregularis (Stanford & Rodda, 2007), and biosecurity planning for Micronesia and Hawaii (NAVFAC Pacific, 2016). Another example is presented by Andreone. In Madagascar a community-wide conservation plan has been developed complete with prioritization of specific actions (Andreone, 2016). As with any top-down strategy, challenges will surface, especially when making decisions that affect economics. We note this caveat in our article, and Andreone points out such issues in Madagascar, where there are mismatches in priorities between biodiversity conservation and civil needs. Our suggestion is that a new paradigm needs to be considered given the gravity of amphibian decline, and one option may be to take a global approach focusing on specific, major threats. Application of an Incident Command System would not necessitate competition with, or emasculation of, local conservation priorities or actions.

Barriers to surge capacity of an overcrowded emergency department for a serious foodborne disease outbreak.

PubMed

Lee, Wen-Huei; Ghee, Chew; Wu, Kuan-Han; Hung, Shih-Chiang

2010-10-01

The purpose of this study was to investigate barriers to surge capacity of an overcrowded emergency department (ED) for a foodborne disease outbreak (FBDO) and to identify solutions to the problems. The emergency response of an overcrowded ED to a serious FBDO with histamine fish poisoning was reviewed. The ED of a tertiary academic medical centre (study hospital) with 1600 acute beds in southern Taiwan. Among the 346 patients in the outbreak, 333 (96.2%) were transferred to the study hospital without prehospital management within about 2 h. The most common symptoms were dizziness (58.9%), nausea and vomiting (36.3%). 181 patients (54.4%) received intravenous fluid infusion and blood tests were ordered for 82 (24.6%). All patients were discharged except one who required admission. The prominent problems with surge capacity of the study hospital were shortage of spare space in the ED, lack of biological incident response plan, poor command system, inadequate knowledge and experience of medical personnel to manage the FBDO. Patients with FBDO could arrive at the hospital shortly after exposure without field triage and management. The incident command system and emergency operation plan of the study hospital did not address the clinical characteristics of the FBDO and the problem of ED overcrowding. Further planning and training of foodborne disease and surge capacity would be beneficial for hospital preparedness for an FBDO.

Risk factors for neovascular glaucoma after carbon ion radiotherapy of choroidal melanoma using dose-volume histogram analysis

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

Hirasawa, Naoki; Tsuji, Hiroshi; Ishikawa, Hitoshi

2007-02-01

Purpose: To determine the risk factors for neovascular glaucoma (NVG) after carbon ion radiotherapy (C-ion RT) of choroidal melanoma. Methods and Materials: A total of 55 patients with choroidal melanoma were treated between 2001 and 2005 with C-ion RT based on computed tomography treatment planning. All patients had a tumor of large size or one located close to the optic disk. Univariate and multivariate analyses were performed to identify the risk factors of NVG for the following parameters; gender, age, dose-volumes of the iris-ciliary body and the wall of eyeball, and irradiation of the optic disk (ODI). Results: Neovascular glaucomamore » occurred in 23 patients and the 3-year cumulative NVG rate was 42.6 {+-} 6.8% (standard error), but enucleation from NVG was performed in only three eyes. Multivariate analysis revealed that the significant risk factors for NVG were V50{sub IC} (volume irradiated {>=}50 GyE to iris-ciliary body) (p = 0.002) and ODI (p = 0.036). The 3-year NVG rate for patients with V50{sub IC} {>=}0.127 mL and those with V50{sub IC} <0.127 mL were 71.4 {+-} 8.5% and 11.5 {+-} 6.3%, respectively. The corresponding rate for the patients with and without ODI were 62.9 {+-} 10.4% and 28.4 {+-} 8.0%, respectively. Conclusion: Dose-volume histogram analysis with computed tomography indicated that V50{sub IC} and ODI were independent risk factors for NVG. An irradiation system that can reduce the dose to both the anterior segment and the optic disk might be worth adopting to investigate whether or not incidence of NVG can be decreased with it.« less

The course of peripheral vascular disease in non-insulin-dependent diabetes.

PubMed

Kreines, K; Johnson, E; Albrink, M; Knatterud, G L; Levin, M E; Lewitan, A; Newberry, W; Rose, F A

1985-01-01

The present report is an analysis of the course of peripheral vascular disease (PVD) in 619 patients with non-insulin-dependent diabetes (NIDDM) recruited within 1 yr of diagnosis and followed quarterly for up to 14 yr (X = 10.5 yr). At 13 yr duration, the actuarially determined cumulative risks for intermittent claudication (IC), nonpalpable dorsalis pedis pulse (NPUL), and arterial calcification (CALC) were, respectively, 37.9%, 34.5%, and 60.9% for men and 24.3%, 37.6%, and 32.2% for women. Major amputations (AMP) occurred in only 1.3% of the patients, equivalent to approximately one case per 1000 patients per year. The corresponding incidences of IC, NPUL, and CALC were, respectively, 29, 27, and 47 per 1000 men and 19, 27, and 25 per 1000 women per year. CALC and NPUL were strongly related to mortality. Baseline risk factors with probability levels that suggest a relationship to PVD were, in women, age versus CALC (P less than 0.01), age versus NPUL (P less than 0.05), weight versus NPUL (P less than 0.05), systolic BP versus CALC (P less than 0.01), summed glucose tolerance test versus CALC (P less than 0.01), and triglyceride level versus CALC (P less than 0.05). In men, the only significant risk factors were diminished vibration perception, which was related to NPUL (P less than 0.05), and the serum triglyceride level, which was related to IC (P less than 0.05). In patients who are carefully followed prospectively, IC is far more common, but AMP is far less common than has been generally appreciated. Further studies are needed to clarify the roles of the diverse risk factors that are possibly related.

Selective effects of Euterpe oleracea (açai) on Leishmania (Leishmania) amazonensis and Leishmania infantum.

PubMed

Da Silva, Bruno José Martins; Souza-Monteiro, José Rogério; Rogez, Herve; Crespo-López, Maria Elena; Do Nascimento, Jose Luiz M; Silva, Edilene O

2018-01-01

Leishmania (Leishmania) amazonensis and Leishmania infantum (=Leishmania chagasi) are protozoa that cause American cutaneous and visceral leishmaniasis, respectively. These diseases show a high incidence in developing countries such as Brazil. The treatments used for leishmaniasis are still limited due to their high cost and toxicity. Currently, some natural products are considered an important alternative source of new leishmanicidal agents. Euterpe oleracea Martius, a palm producing black fruits, is frequently consumed in the Amazon region, as a juice, known as açai, with potent antioxidant, anti-inflammatory and anticonvulsant properties. Interestingly, the biological activity of clarified açai juice (EO) on L. (L.) amazonensis and L. infantum (=L. chagasi) is unknown. Therefore, the mechanism of anti-leishmanial action of EO has been evaluated on L. (L.) amazonensis and L. infantum (=L. chagasi). EO reduced the number of promastigotes and caused morphological alterations, increased the production of reactive oxygen species (ROS) and induced cell death phenotypes probably seems by apoptosis in the promastigotes of L. (L.) amazonensis (IC 50  = 1:40) and L. infantum (=L. chagasi) (IC 50  = 1:38). EO also presented activity against Leishmania amastigotes. Treatment with EO for 72 h strongly reduced IL-17 cytokine levels at all tested concentrations and decreased the number of intracellular amastigotes in macrophages infected with L. (L.) amazonensis (IC 50  = 1:30) and L. infantum (=L. chagasi) (IC 50  = 1:38). Additionally, no cytotoxic effect was observed in murine macrophages treated with EO (72 h - CC 50  > 1:1). Our results demonstrated that EO has leishmanicidal activity against two different species that cause American visceral and cutaneous leishmaniasis without cytotoxic effects for the host cell. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Glucocorticoid-augmented efferocytosis inhibits pulmonary pneumococcal clearance in mice by reducing alveolar macrophage bactericidal function

PubMed Central

Stolberg, Valerie R.; McCubbrey, Alexandra L.; Freeman, Christine M.; Brown, Jeanette P.; Crudgington, Sean W.; Taitano, Sophina H.; Saxton, Bridget L.; Mancuso, Peter; Curtis, Jeffrey L.

2015-01-01

Inhaled corticosteroid(s) (ICS) increase community-acquired pneumonia (CAP) incidence in patients with chronic obstructive pulmonary disease (COPD) by unknown mechanisms. Apoptosis is increased in the lungs of COPD patients. Uptake of apoptotic cells (AC) (“efferocytosis”) by alveolar macrophages (AMø) reduces their ability to combat microbes, including Streptococcus pneumoniae, the most common cause of CAP in COPD patients. Having shown that ICS significantly increase AMø efferocytosis, we hypothesized that this process, termed glucocorticoid-augmented efferocytosis (GCAE), might explain the association of CAP with ICS therapy in COPD. To test this hypothesis, we studied the effects of fluticasone, AC or both on AMø of C57BL/6 mice in vitro and in an established model of pneumococcal pneumonia. Fluticasone plus AC significantly reduced TLR4-stimulated AMø IL-12 production, relative to either treatment alone, and decreased TNF-α, CCL3, CCL5 and KC, relative to AC. Mice treated with fluticasone plus AC before infection with viable pneumococci developed significantly more lung CFU at 48 h. However, none of the pretreatments altered inflammatory cell recruitment to the lungs at 48 h post-infection, and fluticasone plus AC less markedly reduced in vitro mediator production to heat-killed pneumococci. Fluticasone plus AC significantly reduced in vitro AMø killing of pneumococci, relative to other conditions, in part by delaying phagolysosome acidification without affecting production of reactive oxygen or nitrogen species. These results support GCAE as a potential explanation for the epidemiological association of ICS therapy of COPD patients with increased risk of CAP, and establish murine experimental models to dissect underlying molecular mechanisms. PMID:25987742

LLNL/LANS mission committee meeting

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

Burns, Michael J

2010-12-06

Recent events continue to show the national security imperative of the global security mission: (1) Fighting Proliferation - (a) At Yongbyon, 'a modern, industrial-scale U-enrichment facility w/2000 centrifuges' seen Nov. 2010, (b) In Iran, fueling began at Bushehr while P5+1/lran talks delayed to Dec. 2010; (2) Continuing need to support the warfighter and IC - (a) tensions on the Korean peninsula, (b) primitative IEDs a challenge in Afghanistan, (c) cyber command, (d)another Georgian smuggling event; and (3) Countering terrorisms on US soil - (a) toner cartridge bomb, (b) times square bomb, (c) christmas tree bomb. Joint Technical Operations Team (JTOT)more » and Accident Response Group (ARG) elements deployed to two East Coast locations in November to work a multi-weapon scenario. LANL provided 70% of on-duty field and reconstitution teams for both Marble Challenge 11-01 and JD 11-01. There were a total of 14 deployments in FY10.« less

Case ascertainment of heat illness in the British Army: evidence of under-reporting from analysis of Medical and Command notifications, 2009-2013.

PubMed

Stacey, Michael J; Brett, S; Woods, D; Jackson, S; Ross, D

2016-12-01

Heat illness in the Armed Forces is considered preventable. The UK military relies upon dual Command and Medical reporting for case ascertainment, investigation of serious incidents and improvement of preventive practices and policy. This process could be vulnerable to under-reporting. To establish whether heat illness in the British Army has been under-reported, by reviewing concordance of reporting to the Army Incident Notification Cell (AINC) and the Army Health Unit (AHU) and to characterise the burden of heat illness reported by these means. Analysis of anonymised reporting databases held by the AHU and AINC, for the period 2009-2013. 565 unique cases of heat illness were identified. Annual concordance of reporting ranged from 9.6% to 16.5%. The overall rate was 13.3%. July was the month with the greatest number of heat illness reports (24.4% of total reporting) and the highest concordance rate (30%). Reports of heat illness from the UK (n=343) exceeded overseas notifications (n=221) and showed better concordance (17.1% vs 12.8%). The annual rate of reported heat illness varied widely, being greater in full-time than reservist personnel (87 vs 23 per100 000) and highest in full-time untrained personnel (223 per100 000). The risk of heat illness was global, year-round and showed dynamic local variation. Failure to dual-report casualties impaired case ascertainment of heat illness across Command and Medical chains. Current preventive guidance, as applied in training and on operations, should be critically evaluated to ensure that risk of heat illness is reduced as low as possible. Clear procedures for casualty notification and surveillance are required in support of this and should incorporate communication within and between the two reporting chains. 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/.

Case ascertainment of heat illness in the British Army: evidence of under-reporting from analysis of Medical and Command notifications, 2009–2013

PubMed Central

Stacey, Michael J; Brett, S; Woods, D; Jackson, S; Ross, D

2016-01-01

Background Heat illness in the Armed Forces is considered preventable. The UK military relies upon dual Command and Medical reporting for case ascertainment, investigation of serious incidents and improvement of preventive practices and policy. This process could be vulnerable to under-reporting. Objectives To establish whether heat illness in the British Army has been under-reported, by reviewing concordance of reporting to the Army Incident Notification Cell (AINC) and the Army Health Unit (AHU) and to characterise the burden of heat illness reported by these means. Methods Analysis of anonymised reporting databases held by the AHU and AINC, for the period 2009–2013. Results 565 unique cases of heat illness were identified. Annual concordance of reporting ranged from 9.6% to 16.5%. The overall rate was 13.3%. July was the month with the greatest number of heat illness reports (24.4% of total reporting) and the highest concordance rate (30%). Reports of heat illness from the UK (n=343) exceeded overseas notifications (n=221) and showed better concordance (17.1% vs 12.8%). The annual rate of reported heat illness varied widely, being greater in full-time than reservist personnel (87 vs 23 per100 000) and highest in full-time untrained personnel (223 per100 000). Conclusions The risk of heat illness was global, year-round and showed dynamic local variation. Failure to dual-report casualties impaired case ascertainment of heat illness across Command and Medical chains. Current preventive guidance, as applied in training and on operations, should be critically evaluated to ensure that risk of heat illness is reduced as low as possible. Clear procedures for casualty notification and surveillance are required in support of this and should incorporate communication within and between the two reporting chains. PMID:25717054

An Evaluation of the Frequency and Severity of Motion Sickness Incidences in Personnel Within the Command and Control Vehicle (C2V)

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.; DeRoshia, Charles

1998-01-01

The purpose of this study was to assess the frequency and severity of motion sickness in personnel during a field exercise in the Command and Control Vehicle (C2V). This vehicle contains four workstations where military personnel are expected to perform command decisions in the field during combat conditions. Eight active duty military men (U.S. Army) at the Yuma Proving Grounds in Arizona participated in this study. All subjects were given baseline performance tests while their physiological responses were monitored on the first day. On the second day of their participation, subjects rode in the C2V while their physiological responses and performance measures were recorded. Self-reports of motion sickness were also recorded. Results showed that only one subject experienced two incidences of emesis. However, seven out of the eight subjects reported other motion sickness symptoms; most predominant was the report of drowsiness, which occurred a total of 19 times. Changes in physiological responses were observed relative to motion sickness symptoms reported and the different environmental conditions (i.e., level, hills, gravel) during the field exercise. Performance data showed an overall decrement during the C2V exercise. These findings suggest that malaise and severe drowsiness can potentially impact the operational efficiency of the C2V crew. It was concluded that conflicting sensory information from the subject's visual displays and movements of the vehicle during the field exercise significantly contributed to motion sickness symptoms. It was recommended that a second study be conducted to further evaluate the impact of seat position or orientation and C2V experience on motion sickness susceptibility. Further, it was recommended that an investigation be performed on behavioral methods for improving crew alertness, motivation, and performance and for reducing malaise.

How do hospital professionals involved in a randomised controlled trial perceive the value of genotyping vs. PCR-ribotyping for control of hospital acquired C. difficile infections?

PubMed Central

2014-01-01

Background Despite scientific advances in typing of C. difficile strains very little is known about how hospital staff use typing results during periods of increased incidence (PIIs). This qualitative study, undertaken alongside a randomised controlled trial (RCT), explored this issue. The trial compared ribotyping versus more rapid genotyping (MLVA or multilocus variable repeat analysis) and found no significant difference in post 48 hour cases (C difficile transmissions). Methods In-depth qualitative interviews with senior staff in 11/16 hospital trusts in the trial (5 MLVA and 6 Ribotyping). Semi-structured interviews were conducted at end of the trial period. Transcripts were content analysed using framework analysis supported by NVivo-8 software. Common sub-themes were extracted by two researchers independently. These were compared and organised into over-arching categories or ‘super-ordinate themes’. Results The trial recorded that 45% of typing tests had some impact on infection control (IC) activities. Interviews indicated that tests had little impact on initial IC decisions. These were driven by hospital protocols and automatically triggered when a PII was identified. To influence decision-making, a laboratory turnaround time < 3 days (ideally 24 hours) was suggested; MLVA turnaround time was 5.3 days. Typing results were predominantly used to modify initiated IC activities such as ward cleaning, audits of practice or staff training; major decisions (e.g. ward closure) were unaffected. Organisational factors could limit utilisation of MLVA results. Results were twice as likely to be reported as ‘aiding management’ (indirect benefit) than impacting on IC activities (direct effect). Some interviewees considered test results provided reassurance about earlier IC decisions; others identified secondary benefits on organisational culture. An underlying benefit of improved discrimination provided by MLVA typing was the ability to explore epidemiology associated with CDI cases in a hospital more thoroughly. Conclusions Ribotyping and MLVA are both valued by users. MLVA had little additional direct impact on initial infection control decisions. This would require reduced turnaround time. The major impact is adjustments to earlier IC measures and retrospective reassurance. For this, turnaround time is less important than discriminatory power. The potential remains for wider use of genotyping to examine transmission routes. PMID:24656142

Landsat's international partners

USGS Publications Warehouse

Byrnes, Raymond A.

2012-01-01

Since the launch of the first Landsat satellite 40 years ago, International Cooperators (ICs) have formed a key strategic alliance with the U.S. Geological Survey (USGS) to not only engage in Landsat data downlink services but also to enable a foundation for scientific and technical collaboration. The map below shows the locations of all ground stations operated by the United States and IC ground station network for the direct downlink and distribution of Landsat 5 (L5) and Landsat 7 (L7) image data. The circles show the approximate area over which each station has the capability for direct reception of Landsat data. The red circles show the components of the L5 ground station network, the green circles show components of the L7 station network, and the dashed circles show stations with dual (L5 and L7) status. The yellow circles show L5 short-term ("campaign") stations that contribute to the USGS Landsat archive. Ground stations in South Dakota and Australia currently serve as the primary data capture facilities for the USGS Landsat Ground Network (LGN). The Landsat Ground Station (LGS) is located at the USGS Earth Resources Observation and Science (EROS) Center in Sioux Falls, South Dakota. The Alice Springs (ASN) ground station is located at the Geoscience Australia facility in Alice Springs, Australia. These sites receive the image data, via X-band Radio Frequency (RF) link, and the spacecraft housekeeping data, via S-band RF link. LGS also provides tracking services and a command link to the spacecrafts.

Prospective Investigation of Injury Rates and Injury Risk Factors Among Federal Bureau of Investigation New Agent Trainees, Quantico, Virginia, 2009-2010

DTIC Science & Technology

2010-08-01

assistance of the United States Army Public Health Command (USAPHC) in injury prevention efforts at the FBI New Agent Training Program at the FBI...personnel to apply their experience in injury prevention programs in military training to assist in injury prevention efforts in the FBI New Agent... prevention recommendations USAPHC had made Army-wide. USAPHC personnel proposed a methodology to evaluate injury incidence and injury risk factors

Severe infections in sarcoidosis: Incidence, predictors and long-term outcome in a cohort of 585 patients.

PubMed

Duréault, Amélie; Chapelon, Catherine; Biard, Lucie; Domont, Fanny; Savey, Léa; Bodaghi, Bahram; Pourcher, Valérie; Rigon, Matthieu Resche; Cacoub, Patrice; Saadoun, David

2017-12-01

Sarcoidosis is associated with cell-mediated immunodeficiency and treatment of symptomatic sarcoidosis usually includes systemic immunosuppressants. Data relative to incidence, prognosis factors, and outcome of infections are scarce.Retrospective cohort study of 585 patients with biopsy proven sarcoidosis in a tertiary referral specialist clinic, with a nested case-control analysis. Twenty nine patients (4.9%) with severe infections were compared to 116 controls subjects with sarcoidosis, matched according to their gender, ethnicity, age at diagnosis, and treatment with corticosteroids.After a median follow-up of 8 years [range; 1-46], 38 severe infections [mycobacterial infections (n = 14), fungal infections (n = 10), bacterial (n = 8), viral (n = 3) and parasitic (n = 1)] were observed in 30 patients. The incidence of severe infections was 0.71% persons-year (CI 95% 0.5-0.98) and 0.43% persons-year (CI 95% 0.27-0.66). Patients with severe infection were more frequently of male gender (60% vs 46%) and were more likely treated by ≥ 3 immunosuppressive agents (OR = 3.8, IC 95% [1.5-9.64], P = .005) and by cyclophosphamide (OR = 5.55, IC 95% [1.9-16.1], P = .002), and with neurological (OR = 3.36 CI 95% [1.37-8.25], P = .008), or cardiac (OR = 2.65 CI 95% [1.09-6.43], P = .031) involvement of the sarcoidosis, compared to the controls. Two patients died within the 6 months following infection, due to progressive multifocal leucoencephalopathy (n = 1), and of peritonitis (n = 1).Severe infections are observed in 5.1% of our patients with sarcoidosis after a median follow-up of 8 years. Risk factors for severe infections included neurological or cardiac involvement of sarcoidosis, the use of immunosuppressive agents and mainly cyclophosphamide.

[The incidence and distribution of accidents with biological fluids among health personnel and the general population].

PubMed

Imaz Iglesia, I; Gómez López, L I; Fernández Martínez, J A; Mareca Doñate, R; Sangrador Arenas, L A

1996-01-01

To assess the informative usefulness of the Registry, to calculate the incidence rates of accident with biological fluids among health care workers and in the community, to know about the postaccident rate of seroconversion to HIV and to identify risk groups. A descriptive study of the HIV records file of the Registry of Accidental Contacts to Biological Fluids in the Clinic Hospital of Zaragoza was conducted, between January 1987 and September 1993. The registry includes the reports of health care workers and the general population of Health Area III in Aragón (Spain), except for the Calatayud's Hospital. Incidence rates, rate ratios and their 95% confidence intervals were calculated. A total number of 595 accidents were reported, in none of them and HIV infection occurred subsequently. The incidence rate in health care workers was of 1.7 reports per 100 workers per year, while in the community it was of 8.1 per 100,000 people. The housekeeping staff was the group with a higher incidence (rate = 6.7; 95% IC: 3-14.8) and the type of accident more frequently described was needlestick injury. The incidence of reported accidents has increased in the community and in health care workers, which may be due to the increase in the reporting. In health care workers, the incidence in 1993 was within the range reported from other countries. The perception of risk is universal after accidents with unknown biological fluids. The correct disposal of material with biological contamination should be the more important preventive action.

Secular trend analysis of lung cancer incidence in Sihui city, China between 1987 and 2011.

PubMed

Du, Jin-Lin; Lin, Xiao; Zhang, Li-Fang; Li, Yan-Hua; Xie, Shang-Hang; Yang, Meng-Jie; Guo, Jie; Lin, Er-Hong; Liu, Qing; Hong, Ming-Huang; Huang, Qi-Hong; Liao, Zheng-Er; Cao, Su-Mei

2015-07-31

With industrial and econom ic development in recent decades in South China, cancer incidence may have changed due to the changing lifestyle and environment. However, the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear. The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends. Joinpoint regression analysis and the age-period-cohort (APC) model were used to analyze the lung cancer incidence trends in Sihui, Guangdong province, China between 1987 and 2011, and explore the possible causes of these trends. A total of 2,397 lung cancer patients were involved in this study. A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period. Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period, a sharp acceleration was observed in males starting in 2005. The full APC model was selected to describe age, period, and birth cohort effects on lung cancer incidence trends in Sihui. The age cohorts in both sexes showed a continuously significant increase in the relative risk (RR) of lung cancer, with a peak in the eldest age group (80-84 years). The RR of lung cancer showed a fluctuating curve in both sexes. The birth cohorts identified an increased trend in both males and females; however, males had a plateau in the youngest cohorts who were born during 1955-1969. Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts. Social aging, smoking, and environmental changes may play important roles in such trends.

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

Ha, Kyoo-Man, E-mail: ha1999@hotmail.com

In Korea, there is a pervasive feeling of invincibility to the point that people and organizations do not believe that disasters can strike them. This has impact on the level of preparedness for disasters. This study aims to delve into how Korea has to change its governmental policies/practices with some private partners' efforts to mitigate disaster risks. A case study was utilized as the major methodology by comparing exclusive management with inclusive management. These two approaches have been comparatively analyzed via four variables, namely the central government, the local governments, the incident commander, and other stakeholders. The major finding ismore » that Korea's practices and policies have to evolve from the current exclusive management into future-oriented inclusive management. Moreover, the importance of communication, cooperation, collaboration, and multi-discipline coordination is discussed. Additionally, the problem of reductionism and equal participation among all stakeholders, as well as the resistance from vested interests, are recognized and elaborated for Korea and the international community. - Highlights: • Only a few stakeholders in Korea believe that disaster can happen to anyone. This study aims to delve into how Korea has to change its current practices to mitigate disaster risks. • To compare exclusive management with inclusive management, we have examined four comparative variables, namely the central government's policy, local government's strategy, the incident commander's post, and other stakeholders' efforts. • The major finding is that Korea's practices and policies have to evolve from the current exclusive management into future-oriented inclusive management.« less

Prehospital care in Hong Kong.

PubMed

Lo, C B; Lai, K K; Mak, K P

2000-09-01

A quick and efficient prehospital emergency response depends on immediate ambulance dispatch, patient assessment, triage, and transport to hospital. During 1999, the Ambulance Command of the Hong Kong Fire Services Department responded to 484,923 calls, which corresponds to 1329 calls each day. Cooperation between the Fire Services Department and the Hospital Authority exists at the levels of professional training of emergency medical personnel, quality assurance, and a coordinated disaster response. In response to the incident at the Hong Kong International Airport in the summer of 1999, when an aircraft overturned during landing, the pre-set quota system was implemented to send patients to designated accident and emergency departments. Furthermore, the 'first crew at the scene' model has been adopted, whereby the command is established and triage process started by the first ambulance crew members to reach the scene. The development of emergency protocols should be accompanied by good field-to-hospital and interhospital communication, the upgrading of decision-making skills, a good monitoring and auditing structure, and commitment to training and skills maintenance.

Crew/Automation Interaction in Space Transportation Systems: Lessons Learned from the Glass Cockpit

NASA Technical Reports Server (NTRS)

Rudisill, Marianne

2000-01-01

The progressive integration of automation technologies in commercial transport aircraft flight decks - the 'glass cockpit' - has had a major, and generally positive, impact on flight crew operations. Flight deck automation has provided significant benefits, such as economic efficiency, increased precision and safety, and enhanced functionality within the crew interface. These enhancements, however, may have been accrued at a price, such as complexity added to crew/automation interaction that has been implicated in a number of aircraft incidents and accidents. This report briefly describes 'glass cockpit' evolution. Some relevant aircraft accidents and incidents are described, followed by a more detailed description of human/automation issues and problems (e.g., crew error, monitoring, modes, command authority, crew coordination, workload, and training). This paper concludes with example principles and guidelines for considering 'glass cockpit' human/automation integration within space transportation systems.

A Single-Chip Solar Energy Harvesting IC Using Integrated Photodiodes for Biomedical Implant Applications.

PubMed

Chen, Zhiyuan; Law, Man-Kay; Mak, Pui-In; Martins, Rui P

2017-02-01

In this paper, an ultra-compact single-chip solar energy harvesting IC using on-chip solar cell for biomedical implant applications is presented. By employing an on-chip charge pump with parallel connected photodiodes, a 3.5 × efficiency improvement can be achieved when compared with the conventional stacked photodiode approach to boost the harvested voltage while preserving a single-chip solution. A photodiode-assisted dual startup circuit (PDSC) is also proposed to improve the area efficiency and increase the startup speed by 77%. By employing an auxiliary charge pump (AQP) using zero threshold voltage (ZVT) devices in parallel with the main charge pump, a low startup voltage of 0.25 V is obtained while minimizing the reversion loss. A 4 V in gate drive voltage is utilized to reduce the conduction loss. Systematic charge pump and solar cell area optimization is also introduced to improve the energy harvesting efficiency. The proposed system is implemented in a standard 0.18- [Formula: see text] CMOS technology and occupies an active area of 1.54 [Formula: see text]. Measurement results show that the on-chip charge pump can achieve a maximum efficiency of 67%. With an incident power of 1.22 [Formula: see text] from a halogen light source, the proposed energy harvesting IC can deliver an output power of 1.65 [Formula: see text] at 64% charge pump efficiency. The chip prototype is also verified using in-vitro experiment.

Novel 1-[4-(Aminosulfonyl)phenyl]-1H-1,2,4-triazole derivatives with remarkable selective COX-2 inhibition: design, synthesis, molecular docking, anti-inflammatory and ulcerogenicity studies.

PubMed

Abuo-Rahma, Gamal El-Din A A; Abdel-Aziz, Mohamed; Farag, Nahla A; Kaoud, Tamer S

2014-08-18

A novel series of 1,2,4-triazole derivatives were synthesized and confirmed with different spectroscopic techniques. The prepared compounds exhibited remarkable anti-inflammatory activity comparable to that of indomethacin and celecoxib after 3 h. The tested compounds exhibited very low incidence of gastric ulceration compared to indomethacin. Most of the newly developed compounds showed excellent selectivity towards human COX-2 with selectivity indices (COX-1 IC50/COX-2 IC50) ranged from 62.5 to 2127. Docking studies results revealed that the highly selective tested compounds 6h and 6j showed lower CDOCKER energies, which means that they require less energy for proper interaction with the enzyme. The additional H-bonds with the oxygen of the amide and/or H of NH of the amide with the amino acid residues may be responsible for the higher binding affinity of this group of compounds towards COX-2. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil.

PubMed

Dal Ponte, Silvana T; Dornelles, Carlos F D; Arquilla, Bonnie; Bloem, Christina; Roblin, Patricia

2015-02-01

On January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.

Role of the dental team in mass fatality incidents.

PubMed

Fixott, R H; Arendt, D; Chrz, B; Filippi, J; McGivney, J; Warnick, A

2001-04-01

The process of dental identification for a mass fatality incident has unique aspects in comparison with that of a routine dental identification, outside of the obvious increase in the number of victims and responders. The dental team is a small part of a large effort to resolve the incident. Incident command structure applies to the dental team as a unit as well as to the entire organization of the response. Teamwork and planning are essential on all levels. Discussing the casework is limited to the public information officer; only the public information officer is authorized to talk to anyone outside the medical examiner's office. For the team, communication is essential between the team members and between the team and other morgue sections. Daily meetings not only update progress, but also identify and solve problems as they arise. Redundancy and cross-checking occur each step in each section. A core team of trained individuals provides a framework for the use of less experienced members. Use of a dental identification computer program is extremely beneficial, especially as the amount of fragmentation or number of victims increases. Because of the magnitude of the response, the physical and mental stresses require critical incident stress debriefing for all responders, regardless of their experience. The past and future service of the dental profession to the victims of mass fatality incidents and their families is an excellent example of the ideal of service on which the profession is based.

Application of a plume model for decision makers' situation awareness during an outdoor airborne HAZMAT release.

PubMed

Meris, Ronald G; Barbera, Joseph A

2014-01-01

In a large-scale outdoor, airborne, hazardous materials (HAZMAT) incident, such as ruptured chlorine rail cars during a train derailment, the local Incident Commanders and HAZMAT emergency responders must obtain accurate information quickly to assess the situation and act promptly and appropriately. HAZMAT responders must have a clear understanding of key information and how to integrate it into timely and effective decisions for action planning. This study examined the use of HAZMAT plume modeling as a decision support tool during incident action planning in this type of extreme HAZMAT incident. The concept of situation awareness as presented by Endsley's dynamic situation awareness model contains three levels: perception, comprehension, and projection. It was used to examine the actions of incident managers related to adequate data acquisition, current situational understanding, and accurate situation projection. Scientists and engineers have created software to simulate and predict HAZMAT plume behavior, the projected hazard impact areas, and the associated health effects. Incorporating the use of HAZMAT plume projection modeling into an incident action plan may be a complex process. The present analysis used a mixed qualitative and quantitative methodological approach and examined the use and limitations of a "HAZMAT Plume Modeling Cycle" process that can be integrated into the incident action planning cycle. HAZMAT response experts were interviewed using a computer-based simulation. One of the research conclusions indicated the "HAZMAT Plume Modeling Cycle" is a critical function so that an individual/team can be tasked with continually updating the hazard plume model with evolving data, promoting more accurate situation awareness.

Ikhana UAS Overview

NASA Technical Reports Server (NTRS)

Rivas, Mauricio

2017-01-01

Ikhana demonstrates capabilities of UAS to overfly and collect sensor data on widespread fires throughout Western US and also demonstrate long-endurance mission capabilities (20-hours+). Ikhana images multiple fires (greater than 4 fires per mission), to showcase extendable mission configuration and ability to either linger over key fires or station over disparate regional fires. Ikhana also demonstrates new UAV-compatible, autonomous sensor for improved thermal characterization of fires. Also it provides automated, on-board, terrain and geo-rectified sensor imagery over the horizon SATCOM links to national fire personnel and Incident commanders.

Early asthma prophylaxis, natural history, skeletal development and economy (EASE): a pilot randomised controlled trial.

PubMed

Baxter-Jones, A D; Helms, P J; Russell, G; Grant, A; Ross, S; Cairns, J A; Ritchie, L; Taylor, R; Reid, D M; Osman, L M; Robins, S; Fletcher, M E

2000-01-01

(1) To establish recruitment rates of newly presenting asthmatic children. (2) To establish acceptability of study protocols. (3) To pilot age-specific quality of life (QoL) assessment. (4) To assess short-term (6 months) outcomes of inhaled corticosteroids (ICS) treatment. (5) To refine sample size calculations for a definitive study. A randomised pragmatic longitudinal trial design was used, with no blinding or placebo, to examine early ICS introduction similar to its use in practice. Subjects were assessed at entry, 3 and 6 months. Subjects were recruited from six general practices. Children under 6 years were assessed at the Craig Research and Investigation Unit, Royal Aberdeen Children's Hospital, or their family home, and subjects 6 years and over were assessed at their general practice. Children (aged 6 months-16 years) with symptoms suggestive of asthma/wheeze that had commenced no longer than 12 months before were identified retrospectively and prospectively from general practices. Subjects were also required to be naïve to prophylactic therapy with no other lung disease/concomitant illness. Subjects were randomised to ss2-agonist (ss2-only group) or ss2-agonist and ICS (ICS group) for 6 months. Physicians could later prescribe ICS in controls if needed. (1) Pulmonary function. (2) Asthma symptom diary. (3) Symptomatic health status questionnaire. (4) Caregiver's and child's QoL. (5) Growth. (6) Bone mass. (7) Bone turnover. (8) Economic issues. Of over 15,000 children yielded from general practice records, 11% had symptoms suggestive of asthma/wheeze, and two-thirds of these already used ICS. Of the remaining, 141 subjects met the criterion of early asthma, and 86 were randomised. Two-thirds of those randomised were < 6 years old, the males:females ratio was 2:1, and 67% had a family history of atopy. RESULTS - PHYSIOLOGICAL DEVELOPMENT: Pulmonary function did not significantly improve in the older children. Although tidal breathing measures in the pre-school children were significantly higher at 6 months in the ss2-only group, there was great variability. Incidence of wheeze and night-time cough reduced equally in both groups. Reduction of night-time symptom score and reliever use, and increase in symptom-free days were only significant in the ss2-only group. No significant differences were found in growth and bone mass between the two groups, but bone metabolism was significantly reduced at 6 months in the ICS group. RESULTS - PSYCHOLOGICAL DEVELOPMENT: The caregiver's QoL questionnaire was sensitive to child symptom changes over 3 months, but absolute impact of child symptoms on their QoL varied, whereas the child-centred questionnaire was not sensitive to change. RESULTS - ECONOMICS: There were no significant differences in medical consultation costs between the groups, but, as expected, prescription costs in the ICS group were higher over 6 months. Combined healthcare costs were significantly higher for patients assigned to ICS, but there were no significant differences in any effectiveness measures between the groups. Most (96%) of the proposed sample was recruited, and the low drop-out rate (8%) demonstrated acceptability of the study protocol. Most children first presenting with symptoms suggestive of asthma were < 6 years old and represented a group biased towards mild to moderate asthma, or virally induced wheeze. The caregiver's QoL questionnaire was found to better reflect a child's symptom changes than a child-centred instrument. In the short term, no adverse effects were seen on growth, but ICS treatment significantly reduced bone metabolism. Most of the young children with asthma/wheeze improved over time with ss2-agonist treatment alone, and clinical benefits of early ICS intervention amongst these children were not detected; however, there was inadequate power in this pilot study to establish this. (AB

Incidence of admission to the Physical Training and Rehabilitation Programs in Initial Entry Training during fiscal year 2011.

PubMed

Devlin, Jevettra D; Knapik, Joseph J; Solomon, Zack; Hauret, Keith G; Morris, Krystal; Carter, Robert; McGill, Ryan; Paoli, Latondra

2014-05-01

The Physical Training and Rehabilitation Program (PTRP) is a recovery and reintegration program for recruits in Initial Entry Training (IET) who are unable to continue training because of serious injury. This investigation examined PTRP admission incidence among recruits in IET at Forts Jackson, Leonard Wood, Benning, and Sill during Fiscal Year 2011 (FY11). PTRP admission data were collected from a spreadsheet completed monthly by PTRP commanders. Total number of recruits was obtained from each post's Directorate of Programs, Training, and Management. In FY11, 368 men and 268 women were admitted into PTRPs at all installations. For Forts Jackson, Leonard Wood, Benning, and Sill, male admission incidences (cases/1,000 recruits) were 2.6, 3.0, 6.2, and 5.4, respectively; female admission incidences for Forts Jackson, Leonard Wood, and Sill, were 11.1, 10.1, and 22.6, respectively. Most injuries sent to PTRP were bone stress injuries (65%) or fractures (21%). 76% of recruits were returned to duty. Differences in admission incidence between posts appear primarily related to different local policies regarding convalescent leave and admission criteria. PTRP admission rates are lower than in the past, presumably related to policy changes and injury-reduction efforts. A cost-benefit analysis would assist in determining the value of the PTRP. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Intracoronary Adenosine: Dose-Response Relationship With Hyperemia.

PubMed

Adjedj, Julien; Toth, Gabor G; Johnson, Nils P; Pellicano, Mariano; Ferrara, Angela; Floré, Vincent; Di Gioia, Giuseppe; Barbato, Emanuele; Muller, Olivier; De Bruyne, Bernard

2015-09-01

The present study sought to establish the dosage of intracoronary (IC) adenosine associated with minimal side effects and above which no further increase in flow can be expected. Despite the widespread adoption of IC adenosine in clinical practice, no wide-ranging, dose-response study has been conducted. A recurring debate still exists regarding its optimal dose. In 30 patients, Doppler-derived flow velocity measurements were obtained in 10 right coronary arteries (RCAs) and 20 left coronary arteries (LCAs) free of stenoses >20% in diameter. Flow velocity was measured at baseline and after 8 ml bolus administrations of arterial blood, saline, contrast medium, and 9 escalating doses of adenosine (4 to 500 μg). The hyperemic value was expressed in percent of the maximum flow velocity reached in a given artery (Q/Qmax, %). Q/Qmax did not increase significantly beyond dosages of 60 μg for the RCA and 160 μg for LCA. Heart rate did not change, whereas mean arterial blood pressure decreased by a maximum of 7% (p < 0.05) after bolus injections of IC adenosine. The incidence of transient A-V blocks was 40% after injection of 100 μg in the RCA and was 15% after injection of 200 μg in the LCA. The duration of the plateau reached 12 ± 13 s after injection of 100 μg in the RCA and 21 ± 6 s after the injection of 200 μg in the LCA. A progressive prolongation of the time needed to return to baseline was observed. Hyperemic response after injection of 8 ml of contrast medium reached 65 ± 36% of that achieved after injection of 200 μg of adenosine. This wide-ranging, dose-response study indicates that an IC adenosine bolus injection of 100 μg in the RCA and 200 μg in the LCA induces maximum hyperemia while being associated with minimal side effects. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cortical control of intraspinal microstimulation: Toward a new approach for restoration of function after spinal cord injury.

PubMed

Shahdoost, Shahab; Frost, Shawn; Dunham, Caleb; DeJong, Stacey; Barbay, Scott; Nudo, Randolph; Mohseni, Pedram

2015-08-01

Approximately 6 million people in the United States are currently living with paralysis in which 23% of the cases are related to spinal cord injury (SCI). Miniaturized closed-loop neural interfaces have the potential for restoring function and mobility lost to debilitating neural injuries such as SCI by leveraging recent advancements in bioelectronics and a better understanding of the processes that underlie functional and anatomical reorganization in an injured nervous system. This paper describes our current progress toward developing a miniaturized brain-machine-spinal cord interface (BMSI) that converts in real time the neural command signals recorded from the cortical motor regions to electrical stimuli delivered to the spinal cord below the injury level. Using a combination of custom integrated circuit (IC) technology for corticospinal interfacing and field-programmable gate array (FPGA)-based technology for embedded signal processing, we demonstrate proof-of-concept of distinct muscle pattern activation via intraspinal microstimulation (ISMS) controlled in real time by intracortical neural spikes in an anesthetized laboratory rat.

Air Force Office of Scientific Research, Air Force Systems Command Technical Report Summaries. First Quarter 1986.

DTIC Science & Technology

1986-03-01

wi 41 t4 0- Sw ? cL 1 CCCWC ." L ILmL C +o 00W 04 N ~ -C W. CD 0o -0 00 G CL Fr - -3 0 4 - .. CO C4 C1 OD C - - V.. 3 z LL (AC C )C’L -C 4.- Z.’ MCD...0 r -113W 4--L-0 L + *0 * Inm NOC IDn. *m ai u 0- 0 >% ~0C NC Fr IC NC1 CS L.. 0 4)4 0O L Lu * L %C. ii ~ B* LL CC0 z*- 0 > (a> 41r L X 0 mJ L... www U W A. ’-4 L IX z L o t iS o N AU w . C4 U CD4 UIa IL CD Li 0 -i. x - O cc 0 0 WL 4 4 si 4w IA- SnIA in (A C :I- c * i . V z < L 0) 6a L It 0

Incidence, disease phenotype at diagnosis, and early disease course in inflammatory bowel diseases in Western Hungary, 2002-2006.

PubMed

Lakatos, Laszlo; Kiss, Lajos S; David, Gyula; Pandur, Tunde; Erdelyi, Zsuzsanna; Mester, Gabor; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Lakatos, Peter Laszlo

2011-12-01

Recent trends indicate a change in the epidemiology of inflammatory bowel diseases (IBD), with previously low incidence areas now reporting a progressive rise in the incidence. Our aim was to analyze the incidence and disease phenotype at diagnosis in IBD in the population-based Veszprem Province database, which included incident patients diagnosed between January 1, 2002 and December 31, 2006. Data of 393 incident patients were analyzed (ulcerative colitis [UC]: 220, age-at-diagnosis: 40.5 years; Crohn's disease [CD]: 163, age-at-diagnosis: 32.5 years; and indeterminate colitis [IC]: 10). Both hospital and outpatient records were collected and comprehensively reviewed. Adjusted mean incidence rates were 8.9/10(5) person-years for CD and 11.9/10(5) person-years in UC. Peak onset age in both CD and UC patients was 21-30 years old. Location at diagnosis in UC was proctitis in 26.8%, left-sided colitis in 50.9%, and pancolitis in 22.3%. The probability of proximal extension and colectomy after 5 years was 12.7% and 2.8%. The disease location in CD was ileal in 20.2%, colonic in 35.6%, ileocolonic in 44.2%, and upper gastrointestinal in four patients. Behavior at diagnosis was stenosing/penetrating in 35.6% and perianal in 11.1%. Patients with colonic disease were older at diagnosis compared to patients with ileal or ileocolonic disease. In a Kaplan-Meier analysis, probability of surgical resection was 9.8%, 18.5%, and 21.3% after 1, 3, and 5 years of disease duration, respectively. The incidence of IBD in Veszprem Province in the last decade was high, equal to that in high-incidence areas in Western European countries. Early disease course is milder compared to data reported in the literature. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

Emergency operations program is an excellent platform to deal with in-hospital operation disaster.

PubMed

Rogers, Frederick B; McCune, William; Jammula, Shreya; Gross, Brian W; Bradburn, Eric H; Riley, Deborah K; Manning, Jeffrey

2017-01-01

Described herein is the utilization of the hospital's Emergency Operations Plan and incident command structure to mitigate damage caused by the sudden loss of the heating, ventilation, and air conditioning system within the entire operating room suite. The ability to ameliorate a devastating situation that occurred during working hours at a busy Level II trauma center can be ascribed to the dedication of the leadership and clinical teams working seamlessly together. Their concerted efforts were augmented by adherence to an established protocol that had been thoroughly substantiated and practiced during numerous training simulations. This resulted in successful and timely resolution of an internal crisis that crippled the surgical capabilities of the sole trauma center in the county. After thorough investigation and identification of the issues that contributed to the malfunction, redundancies were built into the system to ensure that a similar incident did not occur again.

Real-time physiological monitoring with distributed networks of sensors and object-oriented programming techniques

NASA Astrophysics Data System (ADS)

Wiesmann, William P.; Pranger, L. Alex; Bogucki, Mary S.

1998-05-01

Remote monitoring of physiologic data from individual high- risk workers distributed over time and space is a considerable challenge. This is often due to an inadequate capability to accurately integrate large amounts of data into usable information in real time. In this report, we have used the vertical and horizontal organization of the 'fireground' as a framework to design a distributed network of sensors. In this system, sensor output is linked through a hierarchical object oriented programing process to accurately interpret physiological data, incorporate these data into a synchronous model and relay processed data, trends and predictions to members of the fire incident command structure. There are several unique aspects to this approach. The first includes a process to account for variability in vital parameter values for each individual's normal physiologic response by including an adaptive network in each data process. This information is used by the model in an iterative process to baseline a 'normal' physiologic response to a given stress for each individual and to detect deviations that indicate dysfunction or a significant insult. The second unique capability of the system orders the information for each user including the subject, local company officers, medical personnel and the incident commanders. Information can be retrieved and used for training exercises and after action analysis. Finally this system can easily be adapted to existing communication and processing links along with incorporating the best parts of current models through the use of object oriented programming techniques. These modern software techniques are well suited to handling multiple data processes independently over time in a distributed network.

[Cancer incidence and mortality among persons having been exposed to ionizing waves in a school in Val-de-Marne].

PubMed

Germonneau, P; Castor, C

2006-09-01

The Marie Curie School of Nogent-Sur-Mame (Val-de-Marne, France) was built in 1969 on the site of a former radium extracting plant. Due to remaining radioactive waste in the subsoil, school staff and students who attended the school have been exposed to radiation. A retrospective cohort study was conducted on the 3,403 persons who had attended the school regularly until it closed down in 1998. The national health insurance register was used to trace people. Incidence of cancers, leukaemia and mortality were analysed. In the population of the pupils a significant excess risk for leukaemia was observed (Standardized Incidence Ratio = 4.6 IC 95% [1.66 - 9.89]). These results are not conclusive because of the high proportion of those who could not be traced and were lost to any opportunity for follow-up (42%), and because of preferential recruitment due to a bias generated by the query of the records being centred on searching specifically for those who were sick. The difficulties met by the authors justify that when faced with similar problems in the future, greater attention should be paid to the feasibility study before any involvement or action.

The First 40 Million Years of Circumstellar Disk Evolution: The Signature of Terrestrial Planet Formation

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

Meng, Huan Y. A.; Rieke, George H.; Su, Kate Y. L.

2017-02-10

We characterize the first 40 Myr of evolution of circumstellar disks through a unified study of the infrared properties of members of young clusters and associations with ages from 2 Myr up to ∼40 Myr: NGC 1333, NGC 1960, NGC 2232, NGC 2244, NGC 2362, NGC 2547, IC 348, IC 2395, IC 4665, Chamaeleon I, Orion OB1a and OB1b, Taurus, the β Pictoris Moving Group, ρ Ophiuchi, and the associations of Argus, Carina, Columba, Scorpius–Centaurus, and Tucana–Horologium. Our work features: (1) a filtering technique to flag noisy backgrounds; (2) a method based on the probability distribution of deflections, P (more » D ), to obtain statistically valid photometry for faint sources; and (3) use of the evolutionary trend of transitional disks to constrain the overall behavior of bright disks. We find that the fraction of disks three or more times brighter than the stellar photospheres at 24 μ m decays relatively slowly initially and then much more rapidly by ∼10 Myr. However, there is a continuing component until ∼35 Myr, probably due primarily to massive clouds of debris generated in giant impacts during the oligarchic/chaotic growth phases of terrestrial planets. If the contribution from primordial disks is excluded, the evolution of the incidence of these oligarchic/chaotic debris disks can be described empirically by a log-normal function with the peak at 12–20 Myr, including ∼13% of the original population, and with a post-peak mean duration of 10–20 Myr.« less

Potential of Polygonum cuspidatum Root as an Antidiabetic Food: Dual High-Resolution α-Glucosidase and PTP1B Inhibition Profiling Combined with HPLC-HRMS and NMR for Identification of Antidiabetic Constituents.

PubMed

Zhao, Yong; Chen, Martin Xiaoyong; Kongstad, Kenneth Thermann; Jäger, Anna Katharina; Staerk, Dan

2017-06-07

The worldwide increasing incidence of type 2 diabetes has fueled an intensified search for food and herbal remedies with preventive and/or therapeutic properties. Polygonum cuspidatum Siebold & Zucc. (Polygonaceae) is used as a functional food in Japan and South Korea, and it is also a well-known traditional antidiabetic herb used in China. In this study, dual high-resolution α-glucosidase and protein-tyrosine phosphatase 1B (PTP1B) inhibition profiling was used for the identification of individual antidiabetic constituents directly from the crude ethyl acetate extract and fractions of P. cuspidatum. Subsequent preparative-scale HPLC was used to isolate a series of α-glucosidase inhibitors, which after HPLC-HRMS and NMR analysis were identified as procyanidin B2 3,3″-O-digallate (3) and (-)-epicatechin gallate (5) with IC 50 values of 0.42 ± 0.02 and 0.48 ± 0.0004 μM, respectively, as well as a series of stilbene analogues with IC 50 value in the range from 6.05 ± 0.05 to 116.10 ± 2.04 μM. In addition, (trans)-emodin-physcion bianthrone (15b) and (cis)-emodin-physcion bianthrone (15c) were identified as potent PTP1B inhibitors with IC 50 values of 2.77 ± 1.23 and 7.29 ± 2.32 μM, respectively. These findings show that P. cuspidatum is a potential functional food for management of type 2 diabetes.

Cyber Security Testing and Training Programs for Industrial Control Systems

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

Daniel Noyes

2012-03-01

Service providers rely on industrial control systems (ICS) to manage the flow of water at dams, open breakers on power grids, control ventilation and cooling in nuclear power plants, and more. In today's interconnected environment, this can present a serious cyber security challenge. To combat this growing challenge, government, private industry, and academia are working together to reduce cyber risks. The Idaho National Laboratory (INL) is a key contributor to the Department of Energy National SCADA Test Bed (NSTB) and the Department of Homeland Security (DHS) Control Systems Security Program (CSSP), both of which focus on improving the overall securitymore » posture of ICS in the national critical infrastructure. In support of the NSTB, INL hosts a dedicated SCADA testing facility which consists of multiple control systems supplied by leading national and international manufacturers. Within the test bed, INL researchers systematically examine control system components and work to identify vulnerabilities. In support of the CSSP, INL develops and conducts training courses which are designed to increase awareness and defensive capabilities for IT/Control System professionals. These trainings vary from web-based cyber security trainings for control systems engineers to more advanced hands-on training that culminates with a Red Team/ Blue Team exercise that is conducted within an actual control systems environment. INL also provides staffing and operational support to the DHS Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) Security Operations Center which responds to and analyzes control systems cyber incidents across the 18 US critical infrastructure sectors.« less

Results of Prospective Cohort Study on Symptomatic Cerebrovascular Occlusive Disease Showing Mild Hemodynamic Compromise [Japanese Extracranial-Intracranial Bypass Trial (JET)-2 Study

PubMed Central

KATAOKA, Hiroharu; MIYAMOTO, Susumu; OGASAWARA, Kuniaki; IIHARA, Koji; TAKAHASHI, Jun C.; NAKAGAWARA, Jyoji; INOUE, Tooru; MORI, Etsuro; OGAWA, Akira

The purpose of this study is to determine the true threshold of cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) for subsequent ischemic stroke without extracranial-intracranial (EC-IC) bypass surgery in patients with hemodynamic ischemia due to symptomatic major cerebral arterial occlusive diseases. Patients were categorized based on rest CBF and CVR into four subgroups as follows: Group A, 80% < CBF < 90% and CVR < 10%; Group B, CBF < 80% and 10% < CVR < 20%; Group C, 80% < CBF < 90% and 10% < CVR < 20%; and Group D, CBF < 90% and 20% < CVR < 30%. Patients were followed up for 2 years under best medical treatment by the stroke neurologists. Primary and secondary end points were defined as all adverse events and ipsilateral stroke recurrence respectively. A total of 132 patients were enrolled. All adverse events were observed in 9 patients (3.5%/year) and ipsilateral stroke recurrence was observed only in 2 patients (0.8%/year). There was no significant difference among the four subgroups in terms of the rate of both primary and secondary end points. Compared with the medical arm of the Japanese EC-IC bypass trial (JET) study including patients with CBF < 80% and CVR < 10% as a historical control, the incidence of ipsilateral stroke recurrence was significantly lower in the present study. Patients with symptomatic major cerebral arterial occlusive diseases and mild hemodynamic compromise have a good prognosis under medical treatment. EC-IC bypass surgery is unlikely to benefit patients with CBF > 80% or CVR > 10%. PMID:26041628

A survey assessment of the level of preparedness for domestic terrorism and mass casualty incidents among Eastern Association for the Surgery of Trauma members.

PubMed

Ciraulo, David L; Frykberg, Eric R; Feliciano, David V; Knuth, Thomas E; Richart, Charles M; Westmoreland, Christy D; Williams, Kathryn A

2004-05-01

The goal of this survey was to establish a benchmark for trauma surgeons' level of operational understanding of the command structure for a pre-hospital incident, a mass casualty incident (MCI), and weapons of mass destruction (WMD). The survey was distributed before the World Trade Center destruction on September 11, 2001. The survey was developed by the authors and reviewed by a statistician for clarity and performance. The survey was sent to the membership of the 2000 Eastern Association for the Surgery of Trauma spring mailing, with two subsequent mailings and a final sampling at the Eastern Association for the Surgery of Trauma 2001 meeting. Of 723 surveys mailed, 243 were returned and statistically analyzed (significance indicated by p < 0.05). No statistical difference existed between level of designation of a trauma center (state or American College of Surgeons) and a facility's level of pre-paredness for MCIs or WMD. Physicians in communities with chemical plants, railways, and waterway traffic were statistically more likely to work at facilities with internal disaster plans addressing chemical and biological threats. Across all variables, physicians with military training were significantly better prepared for response to catastrophic events. With the exception of cyanide (50%), less than 30% of the membership was prepared to manage exposure to a nerve agent, less than 50% was prepared to manage illness from intentional biological exposure, and only 73% understood and were prepared to manage blast injury. Mobile medical response teams were present in 46% of the respondents' facilities, but only 30% of those teams deployed a trauma surgeon. Approximately 70% of the membership had been involved in an MCI, although only 60% understood the command structure for a prehospital incident. Only 33% of the membership had training regarding hazardous materials. Of interest, 76% and 65%, respectively, felt that education about MCIs and WMD should be included in residency training. A facility's level of pre-paredness for MCIs or WMD was not related to level of designation as a trauma center, but may be positively influenced by local physicians with prior military background. Benchmark information from this survey will provide the architecture for the development and implementation of further training in these areas for trauma surgeons.

Establishments licensed to serve alcohol and their contribution to police-recorded crime in Australia: further opportunities for harm reduction.

PubMed

Rowe, Shelley C; Wiggers, John H; Wolfenden, Luke; Francis, J Lynn

2010-11-01

Although strategies exist to minimize alcohol-related harms associated with establishments licensed to serve alcohol, such establishments are associated with a disproportionate level of harm. To date, understanding the association between such establishments and alcohol-related harms, and hence the opportunities for reducing harm, has been limited by inadequate information regarding incidents of alcohol-related crime. To address this deficiency, this study was undertaken to describe the association between such establishments and incidents of crime using enhanced police-recorded, alcohol-related crime intelligence. A descriptive analysis was undertaken of intoxicated people who had last consumed alcohol in establishments licensed to serve alcohol (841 bars, 551 licensed social clubs, 11 nightclubs, and 18 other locations) preceding their involvement in police-recorded incidents of violence, disorder, or motor vehicle crashes. The study area encompassed 21 nonmetropolitan police commands in the state of New South Wales, Australia. Among intoxicated persons involved in incidents of violence, disorder, or motor vehicle crashes, the risk of being recorded as having last consumed alcohol in a bar or nightclub before the incident was at least twice that of licensed social clubs and other establishments. Approximately 20% of establishments accounted for 80% of intoxicated persons involved in such incidents, and 6% of establishments were in the top 20% of establishments for all three offense types. The disproportionate burden of alcohol-related crime associated with establishments licensed to serve alcohol may be reduced if harm-reduction strategies address the specific risks posed by bars and nightclubs, and individual high-risk establishments.

Transfusion service disaster planning.

PubMed

Bundy, K L; Foss, M L; Stubbs, J R

2008-01-01

The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

Simple motor tasks independently predict extubation failure in critically ill neurological patients.

PubMed

Kutchak, Fernanda Machado; Rieder, Marcelo de Mello; Victorino, Josué Almeida; Meneguzzi, Carla; Poersch, Karla; Forgiarini, Luiz Alberto; Bianchin, Marino Muxfeldt

2017-01-01

To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and were eligible for weaning were included in the study. The ability of patients to perform simple motor tasks such as hand grasping and tongue protrusion was evaluated as a predictor of extubation failure. Data regarding duration of mechanical ventilation, length of ICU stay, length of hospital stay, mortality, and incidence of ventilator-associated pneumonia were collected. A total of 132 intubated patients who had been receiving mechanical ventilation for at least 24 h and who passed a spontaneous breathing trial were included in the analysis. Logistic regression showed that patient inability to grasp the hand of the examiner (relative risk = 1.57; 95% CI: 1.01-2.44; p < 0.045) and protrude the tongue (relative risk = 6.84; 95% CI: 2.49-18.8; p < 0.001) were independent risk factors for extubation failure. Acute Physiology and Chronic Health Evaluation II scores (p = 0.02), Glasgow Coma Scale scores at extubation (p < 0.001), eye opening response (p = 0.001), MIP (p < 0.001), MEP (p = 0.006), and the rapid shallow breathing index (p = 0.03) were significantly different between the failed extubation and successful extubation groups. The inability to follow simple motor commands is predictive of extubation failure in critically ill neurological patients. Hand grasping and tongue protrusion on command might be quick and easy bedside tests to identify neurocritical care patients who are candidates for extubation. Avaliar a utilidade de tarefas motoras simples, tais como preensão de mão e protrusão da língua, para predizer extubação malsucedida em pacientes neurológicos críticos. Estudo prospectivo de coorte realizado na UTI neurológica de um hospital terciário em Porto Alegre (RS). Pacientes adultos que haviam sido intubados por motivos neurológicos e que eram candidatos ao desmame foram incluídos no estudo. O estudo avaliou se a capacidade dos pacientes de realizar tarefas motoras simples como apertar as mãos do examinador e pôr a língua para fora seria um preditor de extubação malsucedida. Foram coletados dados referentes ao tempo de ventilação mecânica, tempo de internação na UTI, tempo de internação hospitalar, mortalidade e incidência de pneumonia associada à ventilação mecânica. Foram incluídos na análise 132 pacientes intubados que haviam recebido ventilação mecânica durante pelo menos 24 h e que passaram no teste de respiração espontânea. A regressão logística mostrou que a incapacidade dos pacientes de apertar a mão do examinador (risco relativo = 1,57; IC95%: 1,01-2,44; p < 0,045) e de pôr a língua para fora (risco relativo = 6,84; IC95%: 2,49-18,8; p < 0,001) foram fatores independentes de risco de extubação malsucedida. Houve diferenças significativas entre os pacientes nos quais a extubação foi malsucedida e aqueles nos quais a extubação foi bem-sucedida quanto à pontuação obtida no Acute Physiology and Chronic Health Evaluation II (p = 0,02), pontuação obtida na Escala de Coma de Glasgow no momento da extubação (p < 0,001), abertura dos olhos em resposta ao comando (p = 0,001), PImáx (p < 0,001), PEmáx (p = 0,006) e índice de respiração rápida e superficial (p = 0,03). A incapacidade de obedecer a comandos motores simples é preditora de extubação malsucedida em pacientes neurológicos críticos. Preensão de mão e protrusão da língua em resposta ao comando podem ser testes rápidos e fáceis realizados à beira do leito para identificar pacientes neurológicos críticos que sejam candidatos à extubação.

Exploring the perception of aid organizations' staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study.

PubMed

Bazeli, Javad; Aryankhesal, Aidin; Khorasani-Zavareh, Davoud

2017-07-01

Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding. Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims. It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.

Human Factors Issues for Controlling Uninhabited Aerial Vehicles: Preliminary Findings in Support of the Canadian Forces Joint Unmanned Aerial Vehicle Surveillance Target Acquisition System Project (Incidence des Facteurs Humains sur le Pilotage des Vehicules Aeriens Telepilotes: Constatations Preliminaires a L’Appui du Projet de Systeme Interarmees D’Acquisition D’Objectif au Moyen de Vehicules Aeriens Telepilotes de Surveillance des Forces Canadiennes)

DTIC Science & Technology

2010-11-01

Misinterpreted communications, crew coordination, rank imbalance or pilot in command and co-pilot syndrome , crew composition, intra-cockpit communication...of sustained operations. They found that MQ-1 Predator crews experienced higher levels of fatigue, emotional exhaustion and burnout relative to 20

Factors Influencing Manual Performance in Cold Water Diving

DTIC Science & Technology

2008-04-01

montrent que « l’engourdissement » n’avait pas d’incidence sur la dextérité à une profondeur de 40 m (p > 0,05). Dans l’eau à 25 ºC, les gants en ...sensibilité tactile et la dextérité proprement dite. Le rendement ( en anglais performance ou p) a été évalué à des profondeurs de 0,4 m et de 40 m, avec...communication et d’affichage fait en sorte que l’aptitude des plongeurs à utiliser des systèmes de commande complexes constitue un facteur important de la

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

Barr, Jonathan L.; Taira, Randal Y.; Orr, Heather M.

The purpose of this document is to describe the operating concepts, capabilities, and benefits of RAMS including descriptions of how the system implementations can improve emergency response, damage assessment, task prioritization, and situation awareness. This CONOPS provides general information on operational processes and procedures required to utilize RAMS, and expected performance benefits of the system. The primary audiences for this document are the end users of RAMS (including flight operators and incident commanders) and the RAMS management team. Other audiences include interested offices within the Department of Homeland Security (DHS), and officials from other state and local jurisdictions who wantmore » to implement similar systems.« less

The concentration principle applied to spaceborne solar arrays. AGORA mission: Studies synthesis

NASA Astrophysics Data System (ADS)

Laget, R.

1986-01-01

Studies that led to selection of the distributed 25 kW SARA LOUVRE concept for the solar cell generator to be flown on the AGORA asteroid mission, and the major characteristics of such a spaceborne solar array are summarized. In the SARA LOUVRE concept, a parabolic cross section reflector concentrates incident light over the rear face of the identical, preceding reflector dish. The whole set of reflectors is pivotally commanded, thus compensating the effects of depointing. Geometric concentration factor is 10. End of life power level at 2.5 AU is 4.5 kW.

Clinical comparison of two linear-quadratic model-based isoeffect fractionation schemes of high-dose-rate intracavitary brachytherapy for cervical cancer.

PubMed

Wang, Chong-Jong; Huang, Eng-Yen; Sun, Li-Min; Chen, Hui-Chun; Fang, Fu-Min; Hsu, Hsuan-Chih; Changchien, Chan-Chao; Leung, Stephen Wan

2004-05-01

Two linear-quadratic model-based isoeffect fractionation schemes of high-dose-rate intracavitary brachytherapy (HDR-IC) were used to treat cervical cancer in two consecutive periods. Patient outcomes and complications were analyzed and compared. Between November 1987 and December 1996, a total of 541 women diagnosed with cervical cancer were treated with curative-intent radiotherapy. Patients were categorized into two groups according to the two isoeffect schemes used. Group 1 consisted of 254 patients treated with external beam radiotherapy (EBRT) plus 7.2 Gy HDR-IC to Point A for three fractions in the first period. Group 2 consisted of 284 patients treated with EBRT plus 4.8 Gy HDR-IC for five fractions in the second period. The goal of the new scheme for the latter group was to deliver an isoeffect dose that maintained similar tumor control but reduced normal tissue complications. The calculated biologically effective dose (BED(10), assuming an alpha/beta ratio = 10) of EBRT plus HDR-IC for tumor and acute responding tissue in Groups 1 and 2 was 90 Gy(10) (52.8 + 37.2 Gy) and 88.6 Gy(10) (53.1 + 35.5 Gy), respectively. The corresponding BED(3) for late responding tissue (assuming an alpha/beta ratio = 3) in Groups 1 and 2 was 146.7 Gy(3) (73.3 + 73.4 Gy) and 134.4 Gy(3) (72 + 62.4 Gy), respectively. Patients were followed for 6.1-15.2 years (median, 9.8 years). Overall, 66 patients (12.2%) developed pelvic recurrence. Of these, 53 patients had central recurrence. Of the 53 patients with central recurrence, 24 (9.4%) were in Group 1 and 29 (10.1%) in Group 2 (p = 0.722). The actuarial pelvic control rate for Groups 1 and 2 was 88.2% and 86.3% at 5 years and 87.3% and 85.5% at 10 years, respectively (p = 0.504). The actuarial overall survival rate for Groups 1 and 2 was 63.5% and 56.1% at 5 years and 47.8% and 49.3% at 10 years, respectively (p = 0.734). The actuarial proctitis rate for Groups 1 and 2 was 49.7% and 32.7% at 5 years and 50.5% and 32.7% at 10 years, respectively (p <0.001). Most of the decrease in the rate of proctitis was a result of a decrease in the incidence of low-grade proctitis (38% vs. 22%). The incidence of high-grade complications remained unchanged, 8% vs. 7%. The actuarial cystitis rate for Groups 1 and 2 was 14.3% vs. 11.4% at 5 years and 24.1% vs. 15% at 10 years, respectively (p = 0.134). Multivariate analysis revealed that the fractionation scheme (three fractions vs. five fractions) was a significant factor influencing the proctitis rate (p = 0.004, hazard ratio = 0.807; 95% confidence interval, 0.697-0.934), but not the local pelvic control rate, overall survival rate, or cystitis rate. The treatment results of the two groups maintained similar outcomes, while the complications decreased. The linear-quadratic model correctly predicted this outcome. Biologically, the manipulation of the fraction size in our study suggested that the sensitivity of the late responding tissue to the fractional change from 7.2 Gy to 4.8 Gy in HDR-IC is high and detectable clinically. The success, however, had its limitations, and the improvement was confined to low-grade complications.

Faraday Cup Array Integrated with a Readout IC and Method for Manufacture Thereof

NASA Technical Reports Server (NTRS)

Temple, Dorota (Inventor); Bower, Christopher A. (Inventor); Hedgepath Gilchrist, Kristin (Inventor); Stoner, Brian R. (Inventor)

2014-01-01

A detector array and method for making the detector array. The array includes a substrate including a plurality of trenches formed therein, and includes a plurality of collectors electrically isolated from each other, formed on the walls of the trenches, and configured to collect charge particles incident on respective ones of the collectors and to output from said collectors signals indicative of charged particle collection. The array includes a plurality of readout circuits disposed on a side of the substrate opposite openings to the collectors. The readout circuits are configured to read charge collection signals from respective ones of the plurality of collectors.

Incidence of Foscarnet Resistance and Cidofovir Resistance in Patients Treated for Cytomegalovirus Retinitis

PubMed Central

Jabs, Douglas A.; Enger, Cheryl; Forman, Michael; Dunn, J. P.; Retinitis, for The Cytomegalovirus; Group, Viral Resistance Study

1998-01-01

Cytomegalovirus (CMV) retinitis is a common opportunistic infection in patients with AIDS. With long-term therapy for CMV retinitis, resistant CMV may develop. In a prospective study of 122 patients with CMV retinitis, 2.4 and 0.8% of patients had foscarnet-resistant blood culture isolates (50% inhibitory concentration [IC50], >400 μM) and urine culture isolates, respectively, at diagnosis of CMV retinitis prior to treatment, whereas 4.1 and 6.6% had cidofovir-resistant (IC50, >2 μM) blood and urine culture isolates, respectively. Patients were treated according to best medical judgement. Of 44 foscarnet-treated patients, 26% had a resistant blood or urine culture isolate by 6 months of treatment and 37% had a resistant isolate by 9 months; of 13 cidofovir-treated patients, 29% had a resistant blood or urine culture isolate by 3 months of therapy. The probabilities of developing foscarnet resistance while on foscarnet and developing cidofovir resistance while on cidofovir were not significantly different from that for developing ganciclovir resistance while on ganciclovir (odds ratios, 1.87 [P = 0.19] and 2.28 [P = 0.15], respectively). PMID:9736542

Broad Halpha Wing Formation in the Planetary Nebula IC 4997.

PubMed

Lee; Hyung

2000-02-10

The young and compact planetary nebula IC 4997 is known to exhibit very broad wings with a width exceeding 5000 km s-1 around Halpha. We propose that the broad wings are formed through Rayleigh-Raman scattering that involves atomic hydrogen, by which Lybeta photons with a velocity width of a few 102 km s-1 are converted to optical photons and fill the Halpha broad wing region. The conversion efficiency reaches 0.6 near the line center, where the scattering optical depth is much larger than 1, and rapidly decreases in the far wings. Assuming that close to the central star there exists an unresolved inner compact core of high density, nH approximately 109-1010 cm-3, we use the photoionization code "CLOUDY" to show that sufficient Lybeta photons for scattering are produced. Using a top-hat-incident profile for the Lybeta flux and a scattering region with a H i column density NHi=2x1020 cm-2 and a substantial covering factor, we perform a profile-fitting analysis in order to obtain a satisfactory fit to the observed flux. We briefly discuss the astrophysical implications of the Rayleigh-Raman processes in planetary nebulae and other emission objects.

In-vitro antiviral efficacy of ribavirin and interferon-alpha against canine distemper virus.

PubMed

Carvalho, Otávio V; Saraiva, Giuliana L; Ferreira, Caroline G T; Felix, Daniele M; Fietto, Juliana L R; Bressan, Gustavo C; Almeida, Márcia R; Silva Júnior, Abelardo

2014-10-01

Canine distemper is a highly contagious disease with high incidence and lethality in the canine population. The objective of this study was to evaluate the efficacy of antiviral action with ribavirin (RBV), interferon-alpha (IFNα), and combinations of RBV and IFNα against canine distemper virus (CDV). Vero cells inoculated with CDV were treated with RBV, IFNα, and combinations of these drugs. The efficacy to inhibit viral replication was evaluated by adding the compounds at different times to determine which step of the viral replicative process was affected. Both drugs were effective against CDV in vitro. The IFNα was the most active compound, with an average IC50 (50% inhibitory concentration) value lower than the IC50 of the RBV. Ribavirin (RBV) was more selective than IFNα, however, and neither drug showed extracellular antiviral activity. The combination of RBV and IFNα exhibited antiviral activity for the intra- and extracellular stages of the replicative cycle of CDV, although the intracellular viral inhibition was higher. Both RBV and IFNα showed high antiviral efficacy against CDV, and furthermore, RBV + IFNα combinations have shown greater interference range in viral infectivity. These compounds could potentially be used to treat clinical disease associated with CDV infection.

In-vitro antiviral efficacy of ribavirin and interferon-alpha against canine distemper virus

PubMed Central

Carvalho, Otávio V.; Saraiva, Giuliana L.; Ferreira, Caroline G.T.; Felix, Daniele M.; Fietto, Juliana L.R.; Bressan, Gustavo C.; Almeida, Márcia R.; Silva Júnior, Abelardo

2014-01-01

Canine distemper is a highly contagious disease with high incidence and lethality in the canine population. The objective of this study was to evaluate the efficacy of antiviral action with ribavirin (RBV), interferon-alpha (IFNα), and combinations of RBV and IFNα against canine distemper virus (CDV). Vero cells inoculated with CDV were treated with RBV, IFNα, and combinations of these drugs. The efficacy to inhibit viral replication was evaluated by adding the compounds at different times to determine which step of the viral replicative process was affected. Both drugs were effective against CDV in vitro. The IFNα was the most active compound, with an average IC50 (50% inhibitory concentration) value lower than the IC50 of the RBV. Ribavirin (RBV) was more selective than IFNα, however, and neither drug showed extracellular antiviral activity. The combination of RBV and IFNα exhibited antiviral activity for the intra- and extracellular stages of the replicative cycle of CDV, although the intracellular viral inhibition was higher. Both RBV and IFNα showed high antiviral efficacy against CDV, and furthermore, RBV + IFNα combinations have shown greater interference range in viral infectivity. These compounds could potentially be used to treat clinical disease associated with CDV infection. PMID:25355997

Phlorotannins from Alaskan Seaweed Inhibit Carbolytic Enzyme Activity

PubMed Central

Kellogg, Joshua; Grace, Mary H.; Lila, Mary Ann

2014-01-01

Global incidence of type 2 diabetes has escalated over the past few decades, necessitating a continued search for natural sources of enzyme inhibitors to offset postprandial hyperglycemia. The objective of this study was to evaluate coastal Alaskan seaweed inhibition of α-glucosidase and α-amylase, two carbolytic enzymes involved in serum glucose regulation. Of the six species initially screened, the brown seaweeds Fucus distichus and Alaria marginata possessed the strongest inhibitory effects. F. distichus fractions were potent mixed-mode inhibitors of α-glucosidase and α-amylase, with IC50 values of 0.89 and 13.9 μg/mL, respectively; significantly more efficacious than the pharmaceutical acarbose (IC50 of 112.0 and 137.8 μg/mL, respectively). The activity of F. distichus fractions was associated with phlorotannin oligomers. Normal-phase liquid chromatography-mass spectrometry (NPLC-MS) was employed to characterize individual oligomers. Accurate masses and fragmentation patterns confirmed the presence of fucophloroethol structures with degrees of polymerization from 3 to 18 monomer units. These findings suggest that coastal Alaskan seaweeds are sources of α-glucosidase and α-amylase inhibitory phlorotannins, and thus have potential to limit the release of sugar from carbohydrates and thus alleviate postprandial hyperglycemia. PMID:25341030

Standardizing Imperata cylindrica--source material for quality allergen preparations.

PubMed

Bijli, Kaiser M; Singh, B P; Sridhara, Susheela; Gaur, S N; Arora, Naveen

2002-02-01

Tropical countries experience wide variations in daytime temperature and relative humidity. This affects the quality of the source material used for allergen extracts. The present study was undertaken to standardize the processing and preservation conditions of Imperata cylindrica grass pollen. I. cylindrica (Ic) inflorescence were freeze-dried, pollens sieved out and stored at -70 degrees C (IcA). Alternatively, the inflorescence were dried at room temperature and then at 37 degrees C, pollens sieved out and stored at 4 degrees C (IcB). The extracts prepared in PBS were analyzed in vivo by skin tests and in vitro by immunochemical methods. Reduced SDS-PAGE revealed 37 protein bands in IcA extract and 23 in IcB extract. IgE immunoblot with a pool of sera from Ic hypersensitive patients showed 30 allergenic bands in IcA and 14 in IcB. Immunoblot using anti-Ic rabbit sera revealed 33 antigenic bands in IcA and 22 in IcB. In both blots, the IcA extract exhibited sharp bands and the IcB extract exhibited diffuse bands. ELISA, ELISA inhibition and skin test procedures showed that IcA extracts had a higher potency than IcB extracts. Extracts prepared from -70 degrees C processed and preserved pollens (IcA) are allergenically more potent and contain a greater number of major and minor allergens than IcB extracts.

Light-induced voltage alteration for integrated circuit analysis

DOEpatents

Cole, Jr., Edward I.; Soden, Jerry M.

1995-01-01

An apparatus and method are described for analyzing an integrated circuit (IC), The invention uses a focused light beam that is scanned over a surface of the IC to generate a light-induced voltage alteration (LIVA) signal for analysis of the IC, The LIVA signal may be used to generate an image of the IC showing the location of any defects in the IC; and it may be further used to image and control the logic states of the IC. The invention has uses for IC failure analysis, for the development of ICs, for production-line inspection of ICs, and for qualification of ICs.

Light-induced voltage alteration for integrated circuit analysis

DOEpatents

Cole, E.I. Jr.; Soden, J.M.

1995-07-04

An apparatus and method are described for analyzing an integrated circuit (IC). The invention uses a focused light beam that is scanned over a surface of the IC to generate a light-induced voltage alteration (LIVA) signal for analysis of the IC. The LIVA signal may be used to generate an image of the IC showing the location of any defects in the IC; and it may be further used to image and control the logic states of the IC. The invention has uses for IC failure analysis, for the development of ICs, for production-line inspection of ICs, and for qualification of ICs. 18 figs.

IC97 Is a Novel Intermediate Chain of I1 Dynein That Interacts with Tubulin and Regulates Interdoublet Sliding

PubMed Central

Wirschell, Maureen; Yang, Chun; Yang, Pinfen; Fox, Laura; Yanagisawa, Haru-aki; Kamiya, Ritsu; Witman, George B.; Porter, Mary E.

2009-01-01

Our goal is to understand the assembly and regulation of flagellar dyneins, particularly the Chlamydomonas inner arm dynein called I1 dynein. Here, we focus on the uncharacterized I1-dynein IC IC97. The IC97 gene encodes a novel IC without notable structural domains. IC97 shares homology with the murine lung adenoma susceptibility 1 (Las1) protein—a candidate tumor suppressor gene implicated in lung tumorigenesis. Multiple, independent biochemical assays determined that IC97 interacts with both α- and β-tubulin subunits within the axoneme. I1-dynein assembly mutants suggest that IC97 interacts with both the IC138 and IC140 subunits within the I1-dynein motor complex and that IC97 is part of a regulatory complex that contains IC138. Microtubule sliding assays, using axonemes containing I1 dynein but devoid of IC97, show reduced microtubule sliding velocities that are not rescued by kinase inhibitors, revealing a critical role for IC97 in I1-dynein function and control of dynein-driven motility. PMID:19420136

Binding of benzocaine in batrachotoxin-modified Na+ channels. State- dependent interactions

PubMed Central

1994-01-01

Hille (1977. Journal of General Physiology. 69:497-515) first proposed a modulated receptor hypothesis (MRH) to explain the action of benzocaine in voltage-gated Na+ channels. Using the MRH as a framework, we examined benzocaine binding in batrachotoxin (BTX)-modified Na+ channels under voltage-clamp conditions using either step or ramp command signals. We found that benzocaine binding is strongly voltage dependent. At -70 mV, the concentration of benzocaine that inhibits 50% of BTX-modified Na+ currents in GH3 cells (IC50) is 0.2 mM, whereas at +50 mV, the IC50 is 1.3 mM. Dose-response curves indicate that only one molecule of benzocaine is required to bind with one BTX-modified Na+ channel at -70 mV, whereas approximately two molecules are needed at +50 mV. Upon treatment with the inactivation modifier chloramine-T, the binding affinity of benzocaine is reduced significantly at -70 mV, probably as a result of the removal of the inactivated state of BTX- modified Na+ channels. The same treatment, however, enhances the binding affinity of cocaine near this voltage. External Na+ ions appear to have little effect on benzocaine binding, although they do affect cocaine binding. We conclude that two mechanisms underlie the action of local anesthetics in BTX-modified Na+ channels. Unlike open-channel blockers such as cocaine and bupivacaine, neutral benzocaine binds preferentially with BTX-modified Na+ channels in a closed state. Furthermore, benzocaine can be modified chemically so that it behaves like an open-channel blocker. This compound also elicits a use- dependent block in unmodified Na+ channels after repetitive depolarizations, whereas benzocaine does not. The implications of these findings for the MRH theory will be discussed. PMID:8195785

Reusable experiment controllers, case studies

NASA Astrophysics Data System (ADS)

Buckley, Brian A.; Gaasbeck, Jim Van

1996-03-01

Congress has given NASA and the science community a reality check. The tight and ever shrinking budgets are trimming the fat from many space science programs. No longer can a Principal Investigator (PI) afford to waste development dollars on re-inventing spacecraft controllers, experiment/payload controllers, ground control systems, or test sets. Inheritance of the Ground Support Equipment (GSE) from one program to another is not a significant re-use of technology to develop a science mission in these times. Reduction of operational staff and highly autonomous experiments are needed to reduce the sustaining cost of a mission. The re-use of an infrastructure from one program to another is needed to truly attain the cost and time savings required. Interface and Control Systems, Inc. (ICS) has a long history of re-usable software. Navy, Air Force, and NASA programs have benefited from the re-use of a common control system from program to program. Several standardization efforts in the AIAA have adopted the Spacecraft Command Language (SCL) architecture as a point solution to satisfy requirements for re-use and autonomy. The Environmental Research Institute of Michigan (ERIM) has been a long-standing customer of ICS and are working on their 4th generation system using SCL. Much of the hardware and software infrastructure has been re-used from mission to mission with little cost for re-hosting a new experiment. The same software infrastructure has successfully been used on Clementine, and an end-to-end system is being deployed for the Far Ultraviolet Spectroscopic Explorer (FUSE) for Johns Hopkins University. A case study of the ERIM programs, Clementine and FUSE will be detailed in this paper.

Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

PubMed

Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

2014-10-01

On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

Are emergency care nurses prepared for chemical, biological, radiological, nuclear or explosive incidents?

PubMed

Mitchell, Christina J; Kernohan, W George; Higginson, Ray

2012-07-01

Two main areas exist within emergency care where chemical, biological, radiological, nuclear and explosive preparedness can be focused: departmental preparedness and staff preparedness. This study focused upon the latter. To identify areas where nurses require training in order to improve preparedness for a CBRNe incident. A competency questionnaire was developed from the literature and completed by 50 nursing staff across three Emergency Departments within one NHS Trust in Northern Ireland. Descriptive analysis was used for the quantitative data along with content analysis for the qualitative questions. Six key areas were identified for training; waste management (including clinical waste, contaminated clothing, contaminated water and the management of the contaminated deceased), Triage, Chain of command, PODs, awareness of the range of Personal Protective Equipment and its appropriate use and the decontamination of people and equipment. There is a need for a standardised 'blueprint' of role-specific competency criteria for a CBRNe incident for all emergency healthcare staff. The assessment tool used in this study can help to assess levels of preparedness amongst nursing staff and, if adapted accordingly, help gauge preparedness of other key healthcare professionals. Copyright © 2011 Elsevier Ltd. All rights reserved.

Homeland security: sharing and managing critical incident information

NASA Astrophysics Data System (ADS)

Ashley, W. R., III

2003-09-01

Effective critical incident response for homeland security requires access to real-time information from many organizations. Command and control, as well as basic situational awareness, are all dependant on quickly communicating a dynamically changing picture to a variety of decision makers. For the most part, critical information management is not unfamiliar or new to the public safety community. However, new challenges present themselves when that information needs to be seamlessly shared across multiple organizations at the local, state and federal level in real-time. The homeland security problem does not lend itself to the traditional military joint forces planning model where activities shift from a deliberate planning process to a crisis action planning process. Rather, the homeland security problem is more similar to a traditional public safety model where the current activity state moves from complete inactivity or low-level attention to immediate crisis action planning. More often than not the escalation occurs with no warning or baseline information. This paper addresses the challenges of sharing critical incident information and the impacts new technologies will have on this problem. The value of current and proposed approaches will be critiqued for operational value and areas will be identified for further development.

Add-on LABA in a separate inhaler as asthma step-up therapy versus increased dose of ICS or ICS/LABA combination inhaler.

PubMed

Price, David B; Colice, Gene; Israel, Elliot; Roche, Nicolas; Postma, Dirkje S; Guilbert, Theresa W; van Aalderen, Willem M C; Grigg, Jonathan; Hillyer, Elizabeth V; Thomas, Victoria; Martin, Richard J

2016-04-01

Asthma management guidelines recommend adding a long-acting β 2 -agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12-80 years) prescribed step-up therapy as a ≥50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler. Risk-domain asthma control was the primary end-point in comparisons of cohorts matched for asthma severity and control during the baseline year. After 1:2 cohort matching, the increased extrafine ICS versus separate ICS+LABA cohorts included 3232 and 6464 patients, respectively, and the fine-particle ICS/LABA FDC versus separate ICS+LABA cohorts included 7529 and 15 058 patients, respectively (overall mean age 42 years; 61-62% females). Over one outcome year, adjusted OR (95% CI) for achieving asthma control were 1.25 (1.13-1.38) for increased ICS versus separate ICS+LABA and 1.06 (1.05-1.09) for ICS/LABA FDC versus separate ICS+LABA. For patients with asthma, increased dose of extrafine-particle ICS, or add-on LABA via ICS/LABA combination inhaler, is associated with significantly better outcomes than ICS+LABA via separate inhalers.

Dynamical Competition of IC-Industry Clustering from Taiwan to China

NASA Astrophysics Data System (ADS)

Tsai, Bi-Huei; Tsai, Kuo-Hui

2009-08-01

Most studies employ qualitative approach to explore the industrial clusters; however, few research has objectively quantified the evolutions of industry clustering. The purpose of this paper is to quantitatively analyze clustering among IC design, IC manufacturing as well as IC packaging and testing industries by using the foreign direct investment (FDI) data. The Lotka-Volterra system equations are first adopted here to capture the competition or cooperation among such three industries, thus explaining their clustering inclinations. The results indicate that the evolution of FDI into China for IC design industry significantly inspire the subsequent FDI of IC manufacturing as well as IC packaging and testing industries. Since IC design industry lie in the upstream stage of IC production, the middle-stream IC manufacturing and downstream IC packing and testing enterprises tend to cluster together with IC design firms, in order to sustain a steady business. Finally, Taiwan IC industry's FDI amount into China is predicted to cumulatively increase, which supports the industrial clustering tendency for Taiwan IC industry. Particularly, the FDI prediction of Lotka-Volterra model performs superior to that of the conventional Bass model after the forecast accuracy of these two models are compared. The prediction ability is dramatically improved as the industrial mutualism among each IC production stage is taken into account.

Simulation and management games for training command and control in emergencies.

PubMed

Levi, Leon; Bregman, David

2003-01-01

The aim of our project was to introduce and implement simulation techniques in a problematic field of increasing health care system preparedness for disasters. This field was chosen as knowledge is gained by few experienced staff members who need to disperse it to others during the busy routine work of the system personnel. Knowledge management techniques ranging from classifying the current data, centralized organizational knowledge storage and using it for decision making and dispersing it through the organization--were used in this project. In the first stage we analyzed the current system of building a preparedness protocol (set of orders). We identified the pitfalls of changing personnel and loosing knowledge gained through lessons from local and national experience. For this stage we developed a database of resources and objects (casualties) to be used in the simulation in different possibilities. One of those was the differentiation between drills with trainer and those in front of computers enable to set the needed solution. The model rules for different scenarios of multi-casualty incidents from conventional warfare trauma to combined chemical/toxicological as well as, levels of care pre and inside hospitals--were incorporated to the database management system (we used Microsoft Access' DBMS). The hardware for management game was comprised of serial computers with network and possibility of projection of scenes. For prehospital phase the possibility of portable PC's and connections to central server was used to assess bidirectional flow of information. Simulation software (ARENA) and graphical interfase (Visual Basic, GUI) as shown in the attached figure. We hereby conclude that our system provides solutions which are in use in different levels of healthcare system to assess and improve management command and control for different scenarios of multi-casualty incidents.

Trend of leprosy in individuals under the age of 15 in Mato Grosso (Brazil), 2001-2013.

PubMed

Freitas, Bruna Hinnah Borges Martins de; Cortela, Denise da Costa Boamorte; Ferreira, Silvana Margarida Benevides

2017-04-10

To identify the historical trend of leprosy epidemiological indicators in individuals under the age of 15 in the state of Mato Grosso. Descriptive study with trend analysis of leprosy indicators in individuals under the age of fifteen registered in the Mato Grosso's System for Notifiable Diseases between 2001 and 2013. We used the Prais-Winsten procedure for analyzing generalized linear regression at a significance level of 5%. We considered as increasing time series when the annual percent change was positive, decreasing when negative and stationary when there was no significant difference between its value and zero. We analyzed 2455 cases of leprosy and the average detection rate in individuals under the age of fifteen was 22.7 per 100 thousand inhabitants. The trend of the general coefficient of incidence was decreasing, with an average annual rate of -5.5% (95%CI -7.5--3.5). Increasing trend was observed with an increase of 6.7% (95%CI 2.7-10.8) in the proportion of multibacillary cases, 9.4% (95%CI 4.4-14.7) of cases diagnosed with dimorphic clinical form and 14% (95%CI 7.9-20.4) of cases with physical disability level 2 at the time of diagnosis. There was an increasing trend in the average proportion of examined contacts, with a growth of 4.1% (95%CI 1.2-7.1) and average proportion of healing was precarious (39.7%), with stationary trend. The historical trend of leprosy cases in individuals under the age of fifteen proved to be decreasing in the period, however the trends of epidemiological indicators such as the proportion of multibacillary cases, physical disability level 2 and healing, indicate late diagnosis with stay sources of transmission and consequent worsening of the disease in the state of Mato Grosso. Identificar a tendência histórica dos indicadores epidemiológicos de hanseníase em menores de 15 anos no estado de Mato Grosso. Estudo descritivo com análise de tendência dos indicadores de hanseníase em menores de 15 anos registrados no Sistema Nacional de Agravos de Notificação de Mato Grosso, no período de 2001 a 2013. Utilizou-se o procedimento de Prais-Winsten para análise de regressão linear generalizada, adotando-se nível de significância de 5%. Consideraram-se como série temporal crescente quando a annual percent change era positiva, decrescente quando negativa e estacionária quando não havia diferença significante entre seu valor e o zero. Foram analisados 2.455 casos de hanseníase e o coeficiente médio de incidência em menores de 15 anos foi de 22,7/100 mil habitantes. A tendência geral do coeficiente de incidência foi decrescente, com uma annual percent change de -5,5% (IC95% -7,5-3,5). Observou-se tendência de crescimento, com incremento de 6,7% (IC95% 2,7-10,8) na proporção dos casos multibacilares, de 9,4% (IC95% 4,4-14,7) nos casos com forma clínica dimorfa e de 14% (IC95% 7,9-20,4) nos casos com incapacidade física grau 2 no momento do diagnóstico da doença. Verificou-se crescimento na proporção dos contatos de casos novos examinados, com incremento de 4,1% (IC95% 1,2-7,1) e média da proporção de cura considerada precária (39,7%) com tendência estacionária. A tendência histórica dos casos de hanseníase em menores de 15 anos mostrou-se decrescente no período. Entretanto, as tendências dos indicadores epidemiológicos, como a proporção de casos multibacilares, de incapacidade física grau 2 e de cura, indicam o diagnóstico tardio com permanência de fontes de transmissibilidade e consequente agravo da endemia no estado de Mato Grosso.

Mechanisms of activation of the paternally expressed genes by the Prader-Willi imprinting center in the Prader-Willi/Angelman syndromes domains

PubMed Central

Rabinovitz, Shiri; Kaufman, Yotam; Ludwig, Guy; Razin, Aharon; Shemer, Ruth

2012-01-01

The Prader-Willi syndrome/Angelman syndrome (PWS/AS) imprinted domain is regulated by a bipartite imprinting control center (IC) composed of a sequence around the SNRPN promoter (PWS-IC) and a 880-bp sequence located 35 kb upstream (AS-IC). The AS-IC imprint is established during gametogenesis and confers repression upon PWS-IC on the maternal allele. Mutation at PWS-IC on the paternal allele leads to gene silencing across the entire PWS/AS domain. This silencing implies that PWS-IC functions on the paternal allele as a bidirectional activator. Here we examine the mechanism by which PWS-IC activates the paternally expressed genes (PEGs) using transgenes that include the PWS-IC sequence in the presence or absence of AS-IC and NDN, an upstream PEG, as an experimental model. We demonstrate that PWS-IC is in fact an activator of NDN. This activation requires an unmethylated PWS-IC in the gametes and during early embryogenesis. PWS-IC is dispensable later in development. Interestingly, a similar activation of a nonimprinted gene (APOA1) was observed, implying that PWS-IC is a universal activator. To decipher the mechanism by which PWS-IC confers activation of remote genes, we performed methylated DNA immunoprecipitation (MeDIP) array analysis on lymphoblast cell lines that revealed dispersed, rather than continued differential methylation. However, chromatin conformation capture (3c) experiments revealed a physical interaction between PWS-IC and the PEGs, suggesting that activation of PEGs may require their proximity to PWS-IC. PMID:22529396

Accidental awareness during general anaesthesia - a narrative review.

PubMed

Tasbihgou, S R; Vogels, M F; Absalom, A R

2018-01-01

Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness. For example, the ConsCIOUS-1 study showed an incidence of responsiveness around the time of laryngoscopy of 1:25. On the other hand, the 5th Royal College of Anaesthetists National Audit Project, which reported the largest ever cohort of patients who had experienced accidental awareness, used a system to identify patients who spontaneously self-reported accidental awareness. In this latter study, the incidence of accidental awareness was 1:19,600. In the recently published SNAP-1 observational study, in which structured postoperative interviews were performed, the incidence was 1:800. In almost all reported cases of intra-operative responsiveness, there was no subsequent explicit recall of intra-operative events. To date, there is no evidence that this occurrence has any psychological consequences. Among patients who experience accidental awareness and can later remember details of their experience, the consequences are better known. In particular, when awareness occurs in a patient who has been given neuromuscular blocking agents, it may result in serious sequelae such as symptoms of post-traumatic stress disorder and a permanent aversion to surgery and anaesthesia, and is feared by patients and anaesthetists. In this article, the published literature on the incidence, consequences and management of accidental awareness under general anaesthesia with subsequent recall will be reviewed. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Coronal plane socket stability during gait in persons with transfemoral amputation: Pilot study.

PubMed

Fatone, Stefania; Dillon, Michael; Stine, Rebecca; Tillges, Robert

2014-01-01

Little research describes which transfemoral socket design features are important for coronal plane stability, socket comfort, and gait. Our study objectives were to (1) relate socket comfort during gait to a rank order of changes in ischial containment (IC) and tissue loading and (2) compare socket comfort during gait when tissue loading and IC were systematically manipulated. Six randomly assigned socket conditions (IC and tissue compression) were assessed: (1) IC and high, (2) IC and medium, (3) IC and low, (4) no IC and high, (5) no IC and medium, and (6) no IC and low. For the six subjects in this study, there was a strong, negative relationship between comfort and changes in IC and tissue loading (rho = -0.89). With the ischium contained, tissue loading did not influence socket comfort (p = 0.47). With no IC, the socket was equally comfortable with high tissue loading (p = 0.36) but the medium (p = 0.04) and low (p = 0.02) tissue loading conditions decreased comfort significantly. Coronal plane hip moments, lateral trunk lean, step width, and walking speed were invariant to changes in IC and/or tissue loading. Our results suggest that in an IC socket, medial tissue loading mattered little in terms of comfort. Sockets without IC required high tissue loading to be as comfortable as those with IC, while suboptimal tissue loading compromised comfort.

Dihydropyrimidones: As novel class of β-glucuronidase inhibitors.

PubMed

Ali, Farman; Khan, Khalid Mohammed; Salar, Uzma; Iqbal, Sarosh; Taha, Muhammad; Ismail, Nor Hadiani; Perveen, Shahnaz; Wadood, Abdul; Ghufran, Mehreen; Ali, Basharat

2016-08-15

Dihydropyrimidones 1-37 were synthesized via a 'one-pot' three component reaction according to well-known Biginelli reaction by utilizing Cu(NO3)2·3H2O as catalyst, and screened for their in vitro β-glucuronidase inhibitory activity. It is worth mentioning that amongst the active molecules, compounds 8 (IC50=28.16±.056μM), 9 (IC50=18.16±0.41μM), 10 (IC50=22.14±0.43μM), 13 (IC50=34.16±0.65μM), 14 (IC50=17.60±0.35μM), 15 (IC50=15.19±0.30μM), 16 (IC50=27.16±0.48μM), 17 (IC50=48.16±1.06μM), 22 (IC50=40.16±0.85μM), 23 (IC50=44.16±0.86μM), 24 (IC50=47.16±0.92μM), 25 (IC50=18.19±0.34μM), 26 (IC50=33.14±0.68μM), 27 (IC50=44.16±0.94μM), 28 (IC50=24.16±0.50μM), 29 (IC50=34.24±0.47μM), 31 (IC50=14.11±0.21μM) and 32 (IC50=9.38±0.15μM) found to be more potent than the standard d-saccharic acid 1,4-lactone (IC50=48.4±1.25μM). Molecular docking study was conducted to establish the structure-activity relationship (SAR) which demonstrated that a number of structural features of dihydropyrimidone derivatives were involved to exhibit the inhibitory potential. All compounds were characterized by spectroscopic techniques such as (1)H, (13)C NMR, EIMS and HREI-MS. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

Liu, Yu-Qian; Modjaz, Maryam; Bianco, Federica B., E-mail: YL1260@nyu.edu, E-mail: mmodjaz@nyu.edu

Super-luminous supernovae (SLSNe) are tremendously luminous explosions whose power sources and progenitors are highly debated. Broad-lined SNe Ic (SNe Ic-bl) are the only type of SNe that are connected with long-duration gamma-ray bursts (GRBs). Studying the spectral similarity and difference between the populations of hydrogen-poor SLSNe (SLSNe Ic) and of hydrogen-poor stripped-envelope core-collapse SNe, in particular SNe Ic and SNe Ic-bl, can provide crucial observations to test predictions of theories based on various power source models and progenitor models. In this paper, we collected all of the published optical spectra of 32 SLSNe Ic, 21 SNe Ic-bl, as well asmore » 17 SNe Ic, quantified their spectral features, constructed average spectra, and compared them in a systematic way using new tools we have developed. We find that SLSNe Ic and SNe Ic-bl, including those connected with GRBs, have comparable widths for their spectral features and average absorption velocities at all phases. Thus, our findings strengthen the connection between SLSNe Ic and GRBs. In particular, SLSNe Ic have average Fe ii λ 5169 absorption velocities of −15,000 ± 2600 km s{sup −1} at 10 days after peak, which are higher than those of SNe Ic by ∼7000 km s{sup −1} on average. SLSNe Ic also have significantly broader Fe ii λ 5169 lines than SNe Ic. Moreover, we find that such high absorption and width velocities of SLSNe Ic may be hard to explain with the interaction model, and none of the 13 SLSNe Ic with measured absorption velocities spanning over 10 days has a convincing flat velocity evolution, which is inconsistent with the magnetar model in one dimension. Lastly, we compare SN 2011kl, the first SN connected with an ultra-long GRB, with the mean spectrum of SLSNe Ic and of SNe Ic-bl.« less

Experimental colitis in mice is attenuated by topical administration of chlorogenic acid.

PubMed

Zatorski, Hubert; Sałaga, Maciej; Zielińska, Marta; Piechota-Polańczyk, Aleksandra; Owczarek, Katarzyna; Kordek, Radzisław; Lewandowska, Urszula; Chen, Chunqiu; Fichna, Jakub

2015-06-01

Epidemiological data suggest that the consumption of polyphenol-rich foods reduces the incidence of cancer, coronary heart disease, and inflammation. Chlorogenic acid (CGA), an ester of caffeic and quinic acids, is one of the most abundant polyphenol compounds in human diet with proven biological effectiveness both in vitro and in vivo. The aim of the study is to investigate the possible anti-inflammatory effect of CGA in the gastrointestinal (GI) tract and its mechanism of action. We used a well-established model of colitis, induced by intracolonic (i.c.) administration of trinitrobenzenesulfonic acid (TNBS) in mice. The anti-inflammatory effect of CGA in the colon was evaluated based on the clinical and macroscopic and microscopic parameters. To investigate the mechanism of protective action of CGA, myeloperoxidase (MPO), H2O2, and NF-κB levels were assessed in the colon tissue. CGA administered i.c. at the dose of 20 mg/kg (two times daily) protected against TNBS-induced colitis more effectively than the same dose administered orally (p.o.), as evidenced by significantly lower macroscopic and ulcer scores. Furthermore, CGA (20 mg/kg, i.c.) reduced neutrophil infiltration, as demonstrated by decreased MPO activity. Moreover, CGA suppressed activation of NF-κB, as evidenced by lower levels of phospho-NF-κB/NF-κB ratio in the tissue. CGA did not affect the oxidative stress pathways. CGA exhibits anti-inflammatory properties through reduction of neutrophil infiltration and inhibition of NF-κB-dependent pathways. Our results suggest that CGA may have the potential to become a valuable supplement in the treatment of GI diseases.

Phenoxyacetohydrazide Schiff bases: β-glucuronidase inhibitors.

PubMed

Jamil, Waqas; Perveen, Shagufta; Shah, Syed Adnan Ali; Taha, Muhammad; Ismail, Nor Hadiani; Perveen, Shahnaz; Ambreen, Nida; Khan, Khalid M; Choudhary, Muhammad I

2014-06-25

Phenoxyacetohydrazide Schiff base analogs 1-28 have been synthesized and their in vitro β-glucouoronidase inhibition potential studied. Compounds 1 (IC50=9.20±0.32 µM), 5 (IC50=9.47±0.16 µM), 7 (IC50=14.7±0.19 µM), 8 (IC50=15.4±1.56 µM), 11 (IC50=19.6±0.62 µM), 12 (IC50=30.7±1.49 µM), 15 (IC50=12.0±0.16 µM), 21 (IC50=13.7±0.40 µM) and 22 (IC50=22.0±0.14 µM) showed promising β-glucuronidase inhibition activity, better than the standard (D-saccharic acid-1,4-lactone, IC50=48.4±1.25 µM).

The role of diffusion tensor imaging tractography for Gamma Knife thalamotomy planning.

PubMed

Gomes, João Gabriel Ribeiro; Gorgulho, Alessandra Augusta; de Oliveira López, Amanda; Saraiva, Crystian Wilian Chagas; Damiani, Lucas Petri; Pássaro, Anderson Martins; Salvajoli, João Victor; de Oliveira Siqueira, Ludmila; Salvajoli, Bernardo Peres; De Salles, Antônio Afonso Ferreira

2016-12-01

OBJECTIVE The role of tractography in Gamma Knife thalamotomy (GK-T) planning is still unclear. Pyramidal tractography might reduce the risk of radiation injury to the pyramidal tract and reduce motor complications. METHODS In this study, the ventralis intermedius nucleus (VIM) targets of 20 patients were bilaterally defined using Iplannet Stereotaxy Software, according to the anterior commissure-posterior commissure (AC-PC) line and considering the localization of the pyramidal tract. The 40 targets and tractography were transferred as objects to the GammaPlan Treatment Planning System (GP-TPS). New targets were defined, according to the AC-PC line in the functional targets section of the GP-TPS. The target offsets required to maintain the internal capsule (IC) constraint of < 15 Gy were evaluated. In addition, the strategies available in GP-TPS to maintain the minimum conventional VIM target dose at > 100 Gy were determined. RESULTS A difference was observed between the positions of both targets and the doses to the IC. The lateral (x) and the vertical (z) coordinates were adjusted 1.9 mm medially and 1.3 mm cranially, respectively. The targets defined considering the position of the pyramidal tract were more medial and superior, based on the constraint of 15 Gy touching the object representing the IC in the GP-TPS. The best strategy to meet the set constraints was 90° Gamma angle (GA) with automatic shaping of dose distribution; this was followed by 110° GA. The worst GA was 70°. Treatment time was substantially increased by the shaping strategy, approximately doubling delivery time. CONCLUSIONS Routine use of DTI pyramidal tractography might be important to fine-tune GK-T planning. DTI tractography, as well as anisotropy showing the VIM, promises to improve Gamma Knife functional procedures. They allow for a more objective definition of dose constraints to the IC and targeting. DTI pyramidal tractography introduced into the treatment planning may reduce the incidence of motor complications and improve efficacy. This needs to be validated in a large clinical series.

Efficacy and safety of budesonide/formoterol pMDI vs budesonide pMDI in asthmatic children (6-<12 years).

PubMed

Pearlman, David S; Eckerwall, Göran; McLaren, Julie; Lamarca, Rosa; Puu, Margareta; Gilbert, Ileen; Jorup, Carin; Sandin, Kristina; Lanz, Miguel J

2017-04-01

The efficacy and safety of budesonide/formoterol pressurized metered-dose inhaler (pMDI) have been demonstrated in patients with asthma at least 12 years old. To evaluate the efficacy of 2 formoterol doses added to budesonide as fixed combinations vs budesonide alone in children 6 to younger than 12 years with asthma. This randomized, double-blinded, parallel-group, multicenter study (NCT02091986; CHASE 3) included children 6 to younger than 12 years with asthma previously receiving a medium-dose inhaled corticosteroid (ICS) or an ICS plus a long-acting β 2 -agonist. Children symptomatic during a 7-28-day run-in on low-dose ICS, 1 inhalation of budesonide dry powder inhaler 90 μg twice daily (BID), were randomized to receive 2 inhalations of budesonide/formoterol pMDI 80/4.5 μg (160/9 μg) BID (n = 92), budesonide/formoterol pMDI 80/2.25 μg (160/4.5 μg) BID (n = 95), or budesonide pMDI 80 μg (160 μg) BID (n = 92) for 12 weeks. Change in forced expiratory volume in 1 second from baseline to 1 hour after dosing (primary end point), change in forced expiratory volume in 1 second 15 minutes after dosing, and peak expiratory flow 1 hour after dosing at week 12 were statistically significantly greater for budesonide/formoterol 160/9 μg vs budesonide (P ≤ .015 for all comparisons), but not for budesonide/formoterol 160/4.5 μg vs budesonide. Bronchodilator effects, evident 15 minutes after the dose on day 1, were maintained at week 12. Incidence of protocol-defined asthma exacerbations and improvements in asthma symptom-related and quality-of-life outcomes were similar across treatments. There were no notable safety differences among treatments. Budesonide/formoterol pMDI 160/9 μg showed statistically significant and clinically meaningful lung function improvements vs budesonide pMDI 160 μg, demonstrating appropriateness as a therapeutic option for children 6 to younger than 12 years with asthma symptomatic on ICS alone. ClinicalTrials.gov Identifier: NCT02091986. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Advanced consequence management program: challenges and recent real-world implementations

NASA Astrophysics Data System (ADS)

Graser, Tom; Barber, K. S.; Williams, Bob; Saghir, Feras; Henry, Kurt A.

2002-08-01

The Enhanced Consequence Management, Planning and Support System (ENCOMPASS) was developed under DARPA's Advanced Consequence Management program to assist decision-makers operating in crisis situations such as terrorist attacks using conventional and unconventional weapons and natural disasters. ENCOMPASS provides the tools for first responders, incident commanders, and officials at all levels to share vital information and consequently, plan and execute a coordinated response to incidents of varying complexity and size. ENCOMPASS offers custom configuration of components with capabilities ranging from map-based situation assessment, situation-based response checklists, casualty tracking, and epidemiological surveillance. Developing and deploying such a comprehensive system posed significant challenges for DARPA program management, due to an inherently complex domain, a broad spectrum of customer sites and skill sets, an often inhospitable runtime environment, demanding development-to-deployment transition requirements, and a technically diverse and geographically distributed development team. This paper introduces ENCOMPASS and explores these challenges, followed by an outline of selected ENCOMPASS deployments, demonstrating how ENCOMPASS can enhance consequence management in a variety real world contexts.

Wide-temperature integrated operational amplifier

NASA Technical Reports Server (NTRS)

Mojarradi, Mohammad (Inventor); Levanas, Greg (Inventor); Chen, Yuan (Inventor); Cozy, Raymond S. (Inventor); Greenwell, Robert (Inventor); Terry, Stephen (Inventor); Blalock, Benjamin J. (Inventor)

2009-01-01

The present invention relates to a reference current circuit. The reference circuit comprises a low-level current bias circuit, a voltage proportional-to-absolute temperature generator for creating a proportional-to-absolute temperature voltage (VPTAT), and a MOSFET-based constant-IC regulator circuit. The MOSFET-based constant-IC regulator circuit includes a constant-IC input and constant-IC output. The constant-IC input is electrically connected with the VPTAT generator such that the voltage proportional-to-absolute temperature is the input into the constant-IC regulator circuit. Thus the constant-IC output maintains the constant-IC ratio across any temperature range.

Mod 1 ICS TI Report: ICS Conversion of a 140% HPGe Detector

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

Bounds, John Alan

This report evaluates the Mod 1 ICS, an electrically cooled 140% HPGe detector. It is a custom version of the ORTEC Integrated Cooling System (ICS) modified to make it more practical for us to use in the field. Performance and operating characteristics of the Mod 1 ICS are documented, noting both pros and cons. The Mod 1 ICS is deemed a success. Recommendations for a Mod 2 ICS, a true field prototype, are provided.

Special investigation report: Commercial space launch incident, launch procedure anomaly orbital sciences corporation PEGASUS/SCD-1, 80 nautical miles east of Cape Canaveral, Florida, February 9, 1993

NASA Astrophysics Data System (ADS)

This report explains the procedural anomaly that occurred during the launch sequence of an Orbital Sciences Corporation Pegasus expendable launch vehicle, which was subsequently deployed successfully from an NB-52B airplane, on 9 Feb. 1993. The safety issues discussed in the report include command, control and communications responsibility, launch crew fatigue, launch interphone procedures, efficiency of launch constraints, and the lack of common launch documents. Safety recommendations concerning these issues were made to the Department of Transportation, the National Aeronautics and Space Administration, and the Orbital Sciences Corporation.

Special Investigation Report: Commercial Space Launch Incident, Launch Procedure Anomaly Orbital Sciences Corporation PEGASUS/SCD-1, 80 Nautical Miles East of Cape Canaveral, Florida, February 9, 1993

NASA Technical Reports Server (NTRS)

1993-01-01

This report explains the procedural anomaly that occurred during the launch sequence of an Orbital Sciences Corporation Pegasus expendable launch vehicle, which was subsequently deployed successfully from an NB-52B airplane, on 9 Feb. 1993. The safety issues discussed in the report include command, control and communications responsibility, launch crew fatigue, launch interphone procedures, efficiency of launch constraints, and the lack of common launch documents. Safety recommendations concerning these issues were made to the Department of Transportation, the National Aeronautics and Space Administration, and the Orbital Sciences Corporation.

Sustainable Model for Public Health Emergency Operations Centers for Global Settings.

PubMed

Balajee, S Arunmozhi; Pasi, Omer G; Etoundi, Alain Georges M; Rzeszotarski, Peter; Do, Trang T; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A; Phu, Tran Dac; Mounts, Anthony W

2017-10-01

Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidemiology, surveillance, or equivalent department rather than exist as a stand-alone space and serve as operational hubs during nonoutbreak times but in emergencies can scale up according to the traditional Incident Command System structure.

Results of a Longitudinal Study of Airsickness Incidence during Naval Flight Officer Training,

DTIC Science & Technology

1984-11-01

Dt .0 Cie 0 A .0oW b V ~0 4-)4) S ) 4-)4)O L 0 4) 4.) H. Z 4)4.(4-)0 0.. V ) S .~ 4.0.04) 0. 0) .0 0 0) B-0 W I.. 0 AU )( s I 󈧓 ~044.0.’-4 IM 04.) L.14 4...Naval Aerospace Medical Research Laboratory Pensacola, Florida 32508 U.S.A. - S SUMMARV’ This paper outlines the results of a longitudinal study of...cooperation of the training . . command who allowed a large segment of the NFO study population to be exposed on a ..... .... .... .. s .7- 30-2 one-time

An experimental study on the preparation of tochilinite-originated intercalation compounds comprised of Fe 1-xS host layers and various kinds of guest layers

NASA Astrophysics Data System (ADS)

Peng, Yiya; Xi, Guangcheng; Zhong, Chang; Wang, Linping; Lu, Jun; Sun, Ximeng; Zhu, Lu; Han, Qikun; Chen, Lin; Shi, Lei; Sun, Mei; Li, Qianrong; Yu, Min; Yin, Mingwen

2009-08-01

Tochilinite represents a mineral group of ordered mixed-layer structures containing alternating Fe 1-xS layers with mackinawite-like structure and metal hydroxide layers with Mg(OH) 2-like structure. In this article, we report the preparation of a series of tochilinite-originated (or Fe 1-xS-based) intercalation compounds (ICs). According to their preparation procedures, these ICs can be divided into four kinds. The first kind of IC was sodium tochilinite (Na-tochilinite), which was prepared by the hydrothermal reaction of metallic Fe particles with concentrated Na 2S·9H 2O aqueous solutions. The hydroxide layer of the Na-tochilinite was a mixed hydroxide of Na + ions along with a certain amount of Fe 2+ ions. When the hydroxide layer of the Na-tochilinite completely dissolved in aqueous solutions, a Fe-deficient mackinawite-like phase Fe 1-xS was obtained, which was probably an electron-deficient p-type conductor. The second kind of ICs was prepared by 'low-temperature direct intercalation in aqueous solutions, using Na-tochilinite as a parental precursor. When the Na-tochilinite was ultrasonicated in aqueous solutions containing Lewis basic complexing agents (like NH 3, N 2H 4, 2,2'-bipyridine (bipy), and 1,10-phenanthroline (phen)), the Na + ions of the Na-tochilinite were removed and the Lewis basic complexing agents entered the hydroxide layer of the Na-tochilinite and became coordinated with the Fe 2+ ions, and the second kind of ICs was thus produced. The second kind of ICs includes NH 3 IC, N 2H 4 IC, N 2H 4-NH 3 IC, [Fe(bipy) 3] 2+-containing IC and [Fe(phen) 3] 2+-containing IC. The third kind of ICs, which includes NH 3 IC, N 2H 4-NH 3 IC and N 2H 4-LiOH (NaOH) IC, was prepared by the hydrothermal reaction of metallic Fe particles with (NH 4) 2S aqueous solution, S (elemental) + N 2H 4·H 2O aqueous solution, and S + N 2H 4·H 2O + LiOH (NaOH) aqueous solution, respectively. The third kind of ICs has a close relationship with the second kind of ICs both in composition and structure. The fourth kind of ICs was prepared by the oxidation and reduction of some of the N 2H 4-containing ICs mentioned above, which include N 2H 2 (diazene or diimide) IC, N 2 (dinitrogen) IC and NH 3 IC. The N 2H 2 IC was prepared by mild air oxidation of the N 2H 4-LiOH IC. The N 2 IC was prepared by strong air oxidation of the N 2H 4-LiOH IC, however, we have not been able to separate the pure phase N 2 IC. Hydrothermal reduction of the N 2H 4 IC made by the direct intercalation method in strong reducing environment by H 2S + Fe (metal) led to the production of the NH 3 IC of the fourth kind of ICs. The NH 3 ICs prepared by the three methods had similar compositions and structures. As almost all the ICs reported in this paper were extremely sensitive both to air and to the electron beam, they were mainly characterized by XRD. The properties and interrelationships (or mutual transformations) of the Fe 1-xS-based ICs revealed novel chemistry occurring in the sub-nanoscopic space between the micrometer- to nanometer-sized electron-deficient Fe 1-xS layers. An important finding of this novel chemistry was that the Fe 1-xS-based ICs tended to oxidize or reduce the intercalated species when the redox state of their environments varied. The results of our experiments potentially have many cosmochemical implications. The most important implication is that our experimental results, along with previous studies, strongly suggested that some of the ammonium salts, ammonia and carbonates existing in the matrix of the CM carbonaceous chondrites may have been formed by abiotic reactions employing molecular nitrogen as the nitrogen source and carbon monoxide as the carbon source and iron sulfide and/or iron hydroxide as catalysts.

Live Cell Imaging Reveals Differential Modifications to Cytoplasmic Dynein Properties by Phospho- and Dephospho-mimic Mutations of the Intermediate Chain 2C S84

PubMed Central

Blasier, Kiev R.; Humsi, Michael K.; Ha, Junghoon; Ross, Mitchell W.; Smiley, W. Russell; Inamdar, Nirja A.; Mitchell, David J.; Lo, Kevin W.-H.; Pfister, K. Kevin

2014-01-01

Cytoplasmic dynein is a multi-subunit motor protein responsible for intracellular cargo transport toward microtubule minus ends. There are multiple isoforms of the dynein intermediate chain (DYNC1I, IC) which is encoded by two genes. One way to regulate cytoplasmic dynein is by IC phosphorylation. The IC-2C isoform is expressed in all cells and the functional significance of phosphorylation on IC-2C serine 84 was investigated using live cell imaging of fluorescent protein-tagged wild type IC-2C (WT) and phospho- and dephospho-mimic mutant isoforms in axonal transport model systems. Both mutations modulated dynein functional properties. The dephospho-mimic mutant IC-2C S84A had greater co-localization with mitochondria than IC-2C wild-type (WT) or the phospho-mimic mutant IC-2C S84D. The dephospho-mimic mutant IC-2C S84A was also more likely to be motile than the phospho-mimic mutant IC-2C S84D or IC-2C WT. In contrast, the phospho-mimic mutant IC-2C S84D mutant was more likely to move in the retrograde direction than was the IC-2C S84A mutant. The phospho-mimic IC-2C S84D was also as likely as IC-2C WT to co-localize with mitochondria. Both the S84D phospho- and S84A, dephospho-mimic mutants were found to be capable of microtubule minus end directed (retrograde) movement in axons. They were also observed to be passively transported in the anterograde direction. These data suggest that the IC-2C S84 has a role in modulating dynein properties. PMID:24798412

The influence of ATC message length and timing on pilot communication

NASA Technical Reports Server (NTRS)

Morrow, Daniel; Rodvold, Michelle

1993-01-01

Pilot-controller communication is critical to safe and efficient flight. It is often a challenging component of piloting, which is reflected in the number of incidents and accidents involving miscommunication. Our previous field study identified communication problems that disrupt routine communication between pilots and controllers. The present part-task simulation study followed up the field results with a more controlled investigation of communication problems. Pilots flew a simulation in which they were frequently vectored by Air Traffic Control (ATC), requiring intensive communication with the controller. While flying, pilots also performed a secondary visual monitoring task. We examined the influence of message length (one message with four commands vs. two messages with two commands each) and noncommunication workload on communication accuracy and length. Longer ATC messages appeared to overload pilot working memory, resulting in more incorrect or partial readbacks, as well as more requests to repeat the message. The timing between the two short messages also influenced communication. The second message interfered with memory for or response to the first short message when it was delivered too soon after the first message. Performing the secondary monitoring task did not influence communication. Instead, communication reduced monitoring accuracy.

SSRL Emergency Response Shore Tool

NASA Technical Reports Server (NTRS)

Mah, Robert W.; Papasin, Richard; McIntosh, Dawn M.; Denham, Douglas; Jorgensen, Charles; Betts, Bradley J.; Del Mundo, Rommel

2006-01-01

The SSRL Emergency Response Shore Tool (wherein SSRL signifies Smart Systems Research Laboratory ) is a computer program within a system of communication and mobile-computing software and hardware being developed to increase the situational awareness of first responders at building collapses. This program is intended for use mainly in planning and constructing shores to stabilize partially collapsed structures. The program consists of client and server components, runs in the Windows operating system on commercial off-the-shelf portable computers, and can utilize such additional hardware as digital cameras and Global Positioning System devices. A first responder can enter directly, into a portable computer running this program, the dimensions of a required shore. The shore dimensions, plus an optional digital photograph of the shore site, can then be uploaded via a wireless network to a server. Once on the server, the shore report is time-stamped and made available on similarly equipped portable computers carried by other first responders, including shore wood cutters and an incident commander. The staff in a command center can use the shore reports and photographs to monitor progress and to consult with structural engineers to assess whether a building is in imminent danger of further collapse.

Interagency Evaluation of the Section 1206 Global Train and Equip Program

DTIC Science & Technology

2009-08-31

Capabilities, Joint Staff, U.S. Africa Command, U.S. Central Command, U.S Joint Forces Command, U.S. Pacific Command, U.S. Southern Command, U.S. Special...Intensity Conflict & Interdependent Capabilities; Commanders of U.S. Africa Command, U.S. Central Command, U.S. Joint Forces Command, U.S. Pacific... Central Command, commented that coordinating the Section 1206 project proposal with the partner nation prior to submission would inflate the

Emerging Epidemic of Inflammatory Bowel Disease in a Middle Income Country: A Nation-wide Study from Iran.

PubMed

Malekzadeh, Masoud M; Vahedi, Homayoon; Gohari, Kimiya; Mehdipour, Parinaz; Sepanlou, Sadaf G; Ebrahimi Daryani, Nasser; Zali, Mohammad-Reza; Mansour-Ghanaei, Fariborz; Safaripour, Alireza; Aghazadeh, Rahim; Vossoughinia, Hassan; Fakheri, Hafez; Somi, Mohammad H; Maleki, Iradj; Hoseini, Vahid; Ghadir, Mohammad-Reza; Daghaghzadeh, Hamed; Adibi, Payman; Tavakoli, Hamid; Taghavi, Alireza; Zahedi, Mohammad-Javad; Amiriani, Taghi; Tabib, Masoud; Alipour, Zainab; Nobakht, Hossein; Yazdanbod, Abbas; Sadreddini, Masoud; Bakhshipour, Alireza; Khosravi, Ahmad; Khosravi, Pejman; Nasseri-Moghaddam, Siavosh; Merat, Shahin; Sotoudehmanesh, Rasoul; Barazandeh, Farhad; Arab, Peyman; Baniasadi, Nadieh; Pournaghi, Seyyed-Javad; Parsaeian, Mahboubeh; Farzadfar, Farshad; Malekzadeh, Reza

2016-01-01

The burden of inflammatory bowel disease (IBD) hasn't been reported in Iran. We aimed to estimate the prevalence and incidence of IBD and its trend in Iran at national and subnational level from 1990 to 2012. We conducted a systematic review of English and Persian databases about the epidemiology of IBD. We also collected outpatient data from 17 provinces of Iran using almost all public and private referral gastroenterology clinics. Prevalence and incidence rate was calculated at national and subnational levels. The Kriging method was used to extrapolate provinces with missing data and GPR model to calculate time trends of rates at subnational level. We found 16 case series, two population-based studies, and two review articles. We collected 11,000 IBD cases from outpatient databases. Among them, 9,269 (84.26%) had ulcerative colitis (UC), 1,646 (14.96%) had Crohn's disease (CD), and 85 had intermediate colitis (IC). A total of 5,452 (49.56%) patients were male. Mean age at diagnosis was 32.80 years (CI: 13 - 61) for UC and 29.98 years (CI: 11 - 58) for CD. Annual incidences of IBD, UC, and CD in 2012 were 3.11, 2.70, and 0.41 per 100,000 subjects respectively. Prevalence of IBD, UC, and CD in 2012 were 40.67, 35.52, and 5.03 per 100,000 subjects respectively. The incidence of UC and CD showed a significant increase during the study period (P for trend < 0.05). The incidence and prevalence of IBD are increasing in Iran. Establishing a national IBD registry seems necessary for comprehensive care of IBD patients in Iran.

Cancer incidence and mortality in the Bucaramanga metropolitan area, 2003-2007.

PubMed

Uribe, Claudia; Osma, Sonia; Herrera, Víctor

2012-10-01

Cancer is an important cause of morbidity and mortality worldwide. Population-based cancer registries (PBCRs) make possible to estimate the burden of this condition. To estimate cancer incidence and mortality rates in the Bucaramanga Metropolitan Area (BMA) during 2003-2007. Incident cases of invasive cancer diagnosed during 2003-2007 were identified from the Bucaramanga Metropolitan Area PBCR (BMA-PBCR). Population counts and mortality were obtained from the Colombian National Administrative Department of Statistics (NADS). We estimated total and cancer-specific crude incidence and mortality rates by age group and sex, as well as age-standardized (Segi's world population) incidence (ASIR(W)) and mortality (ASMR(W)) rates. Statistical analyses were conducted using CanReg4 and Stata/IC 10.1. We identified 8,225 new cases of cancer excluding non-melanoma skin cancer (54.3% among women). Of all cases, 6,943 (84.4%) were verified by microscopy and 669 (8.1%) were detected only by death certificate. ASIR(W) for all invasive cancers was 162.8 per 100,000 women and 177.6 per 100,000 men. Breast, cervix, colorectal, stomach and thyroid were the most common types of cancer in women. In men, the corresponding malignancies were prostate, stomach, colorectal, lung and lymphoma. ASMR(W) was 84.5 per 100,000 person-years in women and 106.2 per 100,000 person-years in men. Breast and stomach cancer ranked first as causes of death in those groups, respectively. Overall, mortality rates in our region are higher than national estimates possibly due to limited effectiveness of secondary prevention strategies. Our work emphasizes the importance of maintaining high-quality, nationwide PBCRs.

Cancer incidence and mortality in the Bucaramanga metropolitan area, 2003-2007

PubMed Central

Osma, Sonia; Herrera, Víctor

2012-01-01

Introduction: Cancer is an important cause of morbidity and mortality worldwide. Population-based cancer registries (PBCRs) make possible to estimate the burden of this condition. Aim: To estimate cancer incidence and mortality rates in the Bucaramanga Metropolitan Area (BMA) during 2003-2007. Methods: Incident cases of invasive cancer diagnosed during 2003-2007 were identified from the Bucaramanga Metropolitan Area PBCR (BMA-PBCR). Population counts and mortality were obtained from the Colombian National Administrative Department of Statistics (NADS). We estimated total and cancer-specific crude incidence and mortality rates by age group and sex, as well as age-standardized (Segi's world population) incidence (ASIR(W)) and mortality (ASMR(W)) rates. Statistical analyses were conducted using CanReg4 and Stata/IC 10.1. Results: We identified 8,225 new cases of cancer excluding non-melanoma skin cancer (54.3% among women). Of all cases, 6,943 (84.4%) were verified by microscopy and 669 (8.1%) were detected only by death certificate. ASIR(W) for all invasive cancers was 162.8 per 100,000 women and 177.6 per 100,000 men. Breast, cervix, colorectal, stomach and thyroid were the most common types of cancer in women. In men, the corresponding malignancies were prostate, stomach, colorectal, lung and lymphoma. ASMR(W) was 84.5 per 100,000 person-years in women and 106.2 per 100,000 person-years in men. Breast and stomach cancer ranked first as causes of death in those groups, respectively. Conclusion: Overall, mortality rates in our region are higher than national estimates possibly due to limited effectiveness of secondary prevention strategies. Our work emphasizes the importance of maintaining high-quality, nationwide PBCRs. PMID:24893302

Comparative study of the organisation and phenotypes of bladder interstitial cells in human, mouse and rat.

PubMed

Gevaert, Thomas; Neuhaus, Jochen; Vanstreels, Els; Daelemans, Dirk; Everaerts, Wouter; Der Aa, Frank Van; Timmermans, Jean-Pierre; Roskams, Tania; Steiner, Clara; Pintelon, Isabel; De Ridder, Dirk

2017-12-01

With most research on interstitial cells (IC) in the bladder being conducted on animal models, it remains unclear whether all structural and functional data on IC from animal models can be translated to the human context. This prompted us to compare the structural and immunohistochemical properties of IC in bladders from mouse, rat and human. Tissue samples were obtained from the bladder dome and subsequently processed for immunohistochemistry and electron microscopy. The ultrastructural properties of IC were compared by means of electron microscopy and IC were additionally characterized with single/double immunohistochemistry/immunofluorescence. Our results reveal a similar organization of the IC network in the upper lamina propria (ULP), the deep lamina propria (DLP) and the detrusor muscle in human, rat and mouse bladders. Furthermore, despite several similarities in IC phenotypes, we also found several obvious inter-species differences in IC, especially in the ULP. Most remarkably in this respect, ULP IC in human bladder predominantly displayed a myoid phenotype with abundant presence of contractile micro-filaments, while those in rat and mouse bladders showed a fibroblast phenotype. In conclusion, the organization of ULP IC, DLP IC and detrusor IC is comparable in human, rat and mouse bladders, although several obvious inter-species differences in IC phenotypes were found. The present data show that translating research data on IC in laboratory animals to the human setting should be carried out with caution.

Acute Stress Impairs Inhibitory Control based on Individual Differences in Parasympathetic Nervous System Activity

PubMed Central

Roos, Leslie E.; Knight, Erik L.; Beauchamp, Kathryn G.; Berkman, Elliot T.; Faraday, Kelsie; Hyslop, Katie; Fisher, Philip A.

2017-01-01

Identifying environmental influences on inhibitory control (IC) may help promote positive behavioral and social adjustment. Although chronic stress is known to predict lower IC, the immediate effects of acute stress are unknown. The parasympathetic nervous system (PNS) may be a mechanism of the stress-IC link, given its psychophysiological regulatory role and connections to prefrontal brain regions critical to IC. We used a focused assessment of IC (the stop-signal task) to test whether an acute social stressor (the Trier Social Stress Test) affected participants’ pre- to post-IC performance (n = 58), compared to a control manipulation (n = 31). High frequency heart-rate variability was used as an index of PNS activity in response to the manipulation. Results indicated that stress impaired IC performance, blocking the practice effects observed in control participants. We also investigated the associations between PNS activity and IC; higher resting PNS activity predicted better pre-manipulation IC, and greater PNS stressor reactivity protected against the negative effects of stress on IC. Together, these results are the first to document the immediate effects of acute stress on IC and a phenotypic marker (PNS reactivity to stressors) of susceptibility to stress-induced IC impairment. This study suggests a new way to identify situations in which individuals are likely to exhibit IC vulnerability and related consequences such as impulsivity and risk taking behavior. Targeting PNS regulation may represent a novel target for IC-focused interventions. PMID:28268165

Evaluation of bisindole as potent β-glucuronidase inhibitors: synthesis and in silico based studies.

PubMed

Khan, Khalid Mohammed; Rahim, Fazal; Wadood, Abdul; Taha, Muhammad; Khan, Momin; Naureen, Shagufta; Ambreen, Nida; Hussain, Shafqat; Perveen, Shahnaz; Choudhary, Mohammad Iqbal

2014-04-01

Bisindole analogs 1-17 were synthesized and evaluated for their in vitro β-glucuronidase inhibitory potential. Out of seventeen compounds, the analog 1 (IC50=1.62±0.04 μM), 6 (IC50=1.86±0.05 μM), 10 (IC50=2.80±0.29 μM), 9 (IC50=3.10±0.28 μM), 14 (IC50=4.30±0.08 μM), 2 (IC50=18.40±0.09 μM), 19 (IC50=19.90±1.05 μM), 4 (IC50=20.90±0.62 μM), 7 (IC50=21.50±0.77 μM), and 3 (IC50=22.30±0.02 μM) showed superior β-glucuronidase inhibitory activity than the standard (d-saccharic acid 1,4-lactone, IC50=48.40±1.25 μM). In addition, molecular docking studies were performed to investigate the binding interactions of bisindole derivatives with the enzyme. This study has identified a new class of potent β-glucouronidase inhibitors. Copyright © 2014 Elsevier Ltd. All rights reserved.

5. Command center doors at command center entry, building 501, ...

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

5. Command center doors at command center entry, building 501, looking north - Offutt Air Force Base, Strategic Air Command Headquarters & Command Center, Command Center, 901 SAC Boulevard, Bellevue, Sarpy County, NE

Influence of regular exercise on body fat and eating patterns of patients with intermittent claudication.

PubMed

Leicht, Anthony; Crowther, Robert; Golledge, Jonathan

2015-05-18

This study examined the impact of regular supervised exercise on body fat, assessed via anthropometry, and eating patterns of peripheral arterial disease patients with intermittent claudication (IC). Body fat, eating patterns and walking ability were assessed in 11 healthy adults (Control) and age- and mass-matched IC patients undertaking usual care (n = 10; IC-Con) or supervised exercise (12-months; n = 10; IC-Ex). At entry, all groups exhibited similar body fat and eating patterns. Maximal walking ability was greatest for Control participants and similar for IC-Ex and IC-Con patients. Supervised exercise resulted in significantly greater improvements in maximal walking ability (IC-Ex 148%-170% vs. IC-Con 29%-52%) and smaller increases in body fat (IC-Ex -2.1%-1.4% vs. IC-Con 8.4%-10%). IC-Con patients exhibited significantly greater increases in body fat compared with Control at follow-up (8.4%-10% vs. -0.6%-1.4%). Eating patterns were similar for all groups at follow-up. The current study demonstrated that regular, supervised exercise significantly improved maximal walking ability and minimised increase in body fat amongst IC patients without changes in eating patterns. The study supports the use of supervised exercise to minimize cardiovascular risk amongst IC patients. Further studies are needed to examine the additional value of other lifestyle interventions such as diet modification.

Stable gastric pentadecapeptide BPC 157 in the treatment of colitis and ischemia and reperfusion in rats: New insights.

PubMed

Duzel, Antonija; Vlainic, Josipa; Antunovic, Marko; Malekinusic, Dominik; Vrdoljak, Borna; Samara, Mariam; Gojkovic, Slaven; Krezic, Ivan; Vidovic, Tinka; Bilic, Zdenko; Knezevic, Mario; Sever, Marko; Lojo, Nermin; Kokot, Antonio; Kolovrat, Marijan; Drmic, Domagoj; Vukojevic, Jaksa; Kralj, Tamara; Kasnik, Katarina; Siroglavic, Marko; Seiwerth, Sven; Sikiric, Predrag

2017-12-28

To provide new insights in treatment of colitis and ischemia and reperfusion in rats using stable gastric pentadecapeptide BPC 157. Medication [BPC 157, L-NAME, L-arginine (alone/combined), saline] was bath at the blood deprived colon segment. During reperfusion, medication was BPC 157 or saline. We recorded (USB microscope camera) vessel presentation through next 15 min of ischemic colitis (IC-rats) or reperfusion (removed ligations) (IC + RL-rats); oxidative stress as MDA (increased (IC- and IC + RL-rats)) and NO levels (decreased (IC-rats); increased (IC + RL-rats)) in colon tissue. IC + OB-rats [IC-rats had additional colon obstruction (OB)] for 3 d (IC + OB-rats), then received BPC 157 bath. Commonly, in colon segment (25 mm, 2 ligations on left colic artery and vein, 3 arcade vessels within ligated segment), in IC-, IC + RL-, IC + OB-rats, BPC 157 (10 μg/kg) bath (1 mL/rat) increased vessel presentation, inside/outside arcade interconnections quickly reappeared, mucosal folds were preserved and the pale areas were small and markedly reduced. BPC 157 counteracted worsening effects induced by L-NAME (5 mg) and L-arginine (100 mg). MDA- and NO-levels were normal in BPC 157 treated IC-rats and IC + RL-rats. In addition, on day 10, BPC 157-treated IC + OB-rats presented almost completely spared mucosa with very small pale areas and no gross mucosal defects; the treated colon segment was of normal diameter, and only small adhesions were present. BPC 157 is a fundamental treatment that quickly restores blood supply to the ischemically injured area and rapidly activates collaterals. This effect involves the NO system.

Stable gastric pentadecapeptide BPC 157 in the treatment of colitis and ischemia and reperfusion in rats: New insights

PubMed Central

Duzel, Antonija; Vlainic, Josipa; Antunovic, Marko; Malekinusic, Dominik; Vrdoljak, Borna; Samara, Mariam; Gojkovic, Slaven; Krezic, Ivan; Vidovic, Tinka; Bilic, Zdenko; Knezevic, Mario; Sever, Marko; Lojo, Nermin; Kokot, Antonio; Kolovrat, Marijan; Drmic, Domagoj; Vukojevic, Jaksa; Kralj, Tamara; Kasnik, Katarina; Siroglavic, Marko; Seiwerth, Sven; Sikiric, Predrag

2017-01-01

AIM To provide new insights in treatment of colitis and ischemia and reperfusion in rats using stable gastric pentadecapeptide BPC 157. METHODS Medication [BPC 157, L-NAME, L-arginine (alone/combined), saline] was bath at the blood deprived colon segment. During reperfusion, medication was BPC 157 or saline. We recorded (USB microscope camera) vessel presentation through next 15 min of ischemic colitis (IC-rats) or reperfusion (removed ligations) (IC + RL-rats); oxidative stress as MDA (increased (IC- and IC + RL-rats)) and NO levels (decreased (IC-rats); increased (IC + RL-rats)) in colon tissue. IC + OB-rats [IC-rats had additional colon obstruction (OB)] for 3 d (IC + OB-rats), then received BPC 157 bath. RESULTS Commonly, in colon segment (25 mm, 2 ligations on left colic artery and vein, 3 arcade vessels within ligated segment), in IC-, IC + RL-, IC + OB-rats, BPC 157 (10 μg/kg) bath (1 mL/rat) increased vessel presentation, inside/outside arcade interconnections quickly reappeared, mucosal folds were preserved and the pale areas were small and markedly reduced. BPC 157 counteracted worsening effects induced by L-NAME (5 mg) and L-arginine (100 mg). MDA- and NO-levels were normal in BPC 157 treated IC-rats and IC + RL-rats. In addition, on day 10, BPC 157-treated IC + OB-rats presented almost completely spared mucosa with very small pale areas and no gross mucosal defects; the treated colon segment was of normal diameter, and only small adhesions were present. CONCLUSION BPC 157 is a fundamental treatment that quickly restores blood supply to the ischemically injured area and rapidly activates collaterals. This effect involves the NO system. PMID:29358856

Transforming and differentiation-inducing potential of constitutively activated c-kit mutant genes in the IC-2 murine interleukin-3-dependent mast cell line.

PubMed Central

Hashimoto, K.; Tsujimura, T.; Moriyama, Y.; Yamatodani, A.; Kimura, M.; Tohya, K.; Morimoto, M.; Kitayama, H.; Kanakura, Y.; Kitamura, Y.

1996-01-01

Two mutations of c-kit receptor tyrosine kinase (KIT), valine-559 to glycine (G559) and aspartic acid-814 to valine (V814), resulted in its constitutive activation. To examine the transforming and differentiation-inducing potential of the mutant KIT, we used the murine interleukin-3-dependent IC-2 mast cell line as a transfectant. The IC-2 cells contained few basophilic granules and did not express KIT on the surface. The KITG559 or KITV814 gene was introduced into IC-2 cells using a retroviral vector. KITG559 and KITV814 expressed in IC-2 cells were constitutively phosphorylated on tyrosine and demonstrated kinase activity in the absence of stem cell factor, which is a ligand for KIT. IC-2 cells expressing either KITG559 or KITV814 (IC-2G559 or IC-2V814 cells) showed factor-independent growth in suspension culture and produced tumors in nude athymic mice. In addition, IC-2G559 and IC-2V814 cells showed a more mature phenotype compared with the phenotype of the original IC-2 cells, especially after transplantation into nude mice. The number of basophilic granules and the content of histamine increased remarkably. KITG559 and KITV814 also influenced the transcriptional phenotype of mouse mast cell proteases (MMCP) in IC-2 cells. The expression of MMCP-2, MMCP-4, and MMCP-6 was much greater in IC-2G559 and IC-2V814 cells than in the original IC-2 cells. The results indicated that constitutively activated KIT had not only oncogenic activity but also differentiation-inducing activity in mast cells. Images Figure 1 Figure 4 Figure 5 Figure 6 PMID:8546206

The relationship between combination inhaled corticosteroid and long-acting beta-agonist use and severe asthma exacerbations in a diverse population

PubMed Central

Wells, Karen E.; Peterson, Edward L.; Ahmedani, Brian K.; Severson, Richard K.; Gleason-Comstock, Julie; Williams, L. Keoki

2012-01-01

Background Safety concerns surround the use of long-acting beta agonists (LABA) for the treatment of asthma, even in combination with inhaled corticosteroids (ICS) and particularly in high-risk subgroups. Objective To estimate the effect ICS therapy and fixed-dose ICS/LABA combination therapy on severe asthma exacerbations in a racially diverse population. Methods Inhaled corticosteroid and ICS/LABA exposure was estimated from pharmacy data for patients with asthma age 12 to 56 years who were members of a large health maintenance organization. Inhaled corticosteroid and ICS/LABA use was estimated for each day of follow-up to create a moving window of exposure. Proportional hazard models were used to assess the relationship between ICS and ICS/LABA combination therapy and severe asthma exacerbations (i.e., use of oral corticosteroids, asthma-related emergency department visit, or asthma-related hospitalization). Results Among the 1,828 patients who met the inclusion criteria, 37% were African American, 46% were treated with ICS therapy alone, and 54% were treated with an ICS/LABA combination. Models assessing the risk of severe asthma exacerbations among individuals using ICS treatment alone and ICS/LABA combination therapy suggested that the overall protective effect was as good or better for ICS/LABA combination therapy when compared with ICS treatment alone (hazard ratio [HR]=0.65 vs. HR=0.72, respectively). Analyses in several subgroups, including African American patients, showed a similar statistically significant protective association for combination therapy. Conclusion Treatment with ICS/LABA fixed combination therapy appeared to perform as well or better than ICS alone in reducing severe asthma exacerbations; this included multiple high-risk subgroups. PMID:22281166

Synthesis of 6-chloro-2-Aryl-1H-imidazo[4,5-b]pyridine derivatives: Antidiabetic, antioxidant, β-glucuronidase inhibiton and their molecular docking studies.

PubMed

Taha, Muhammad; Ismail, Nor Hadiani; Imran, Syahrul; Rashwan, Hesham; Jamil, Waqas; Ali, Sajjad; Kashif, Syed Muhammad; Rahim, Fazal; Salar, Uzma; Khan, Khalid Mohammed

2016-04-01

6-Chloro-2-Aryl-1H-imidazo[4,5-b]pyridine derivatives 1-26 were synthesized and characterized by various spectroscopic techniques. All these derivatives were evaluated for their antiglycation, antioxidant and β-glucuronidase potential followed their docking studies. In antiglycation assay, compound 2 (IC50=240.10±2.50μM) and 4 (IC50=240.30±2.90μM) was found to be most active compound of this series, while compounds 3 (IC50=260.10±2.50μM), 6 (IC50=290.60±3.60μM), 13 (IC50=288.20±3.00μM) and 26 (IC50=292.10±3.20μM) also showed better activities than the standard rutin (IC50=294.50±1.50μM). In antioxidant assay, compound 1 (IC50=69.45±0.25μM), 2 (IC50=58.10±2.50μM), 3 (IC50=74.25±1.10μM), and 4 (IC50=72.50±3.30μM) showed good activities. In β-glucuronidase activity, compounds 3 (IC50=29.25±0.50μM), compound 1 (IC50=30.10±0.60μM) and compound 4 (IC50=46.10±1.10μM) showed a significant activity as compared to than standard D-Saccharic acid 1,4-lactonec (IC50=48.50±1.25μM) and their interaction with the enzyme was confirm by docking studies. Copyright © 2016 Elsevier Inc. All rights reserved.

Renal Cell Toxicity of Water-Soluble Coal Extracts from the Gulf Coast

NASA Astrophysics Data System (ADS)

Ojeda, A. S.; Ford, S.; Ihnat, M.; Gallucci, R. M.; Philp, P. R.

2017-12-01

In the Gulf Coast, many rural residents rely on private well water for drinking, cooking, and other domestic needs. A large portion of this region contains lignite coal deposits within shallow aquifers that potentially leach organic matter into the water supply. It is proposed that the organic matter leached from low-rank coal deposits contributes to the development of kidney disease, however, little work has been done to investigate the toxicity of coal extracts. In this study, human kidney cells (HK-2) were exposed to water-soluble extracts of Gulf Coast Coals to assess toxicity. Cell viability was measured by direct counts of total and necrotic cells. A dose-response curve was used to generate IC50 values, and the extracts showed significant toxicity that ranged from 0.5% w/v to 3% w/v IC50. The most toxic extract was from Louisiana where coal-derived organic material has been previously linked to high incidents of renal pelvic cancer (RPC). Although the toxic threshold measured in this study is significantly higher than the concentration of organic matter in the groundwater, typically <5 mg/L (0.005% w/v), residents in the affected areas may consume contaminated water over a lifetime. It is possible that the cumulative toxic effects of coal-derived material contribute to the development of disease.

Urinary Iodine Concentrations in Cancer Patients

PubMed Central

Kargar, Saeed; Shiryazdi, Seyed Mostafa; Atashi, Seyed Reza; Neamatzadeh, Hossein; Kamali, Mahdieh

2017-01-01

Background: It has been suggested that incidence of some cancers, especially examples in the breast and stomach may be influenced by the iodine intake. However, only few studies are available at present. Therefore, we have conducted the present assessment of iodine status in Iranian patients diagnosed with a malignancy. Materials and Methods: This cross-sectional study was conducted in 85 patients diagnosed with different types of cancer at Shahid Sadoughi Hospital, Yazd, Iran. The method used was based on the Sandell–Kolthoff reaction. Results: The median urinary iodine concentration (UIC) was 17.4 μg/L, with ≤20 μg/L indicative of severe iodine deficiency. According to the WHO/IC C IDD/UNIC EF classification, 88.1%, 7.1% and 2.4% of patients had a UIC <20 (severe), 20–49 (mild), and 50–99 μg/L (moderate), respectively. There was no statistically significant differences in UIC between men and women. Conclusion: The UIC values indicate that Iranian cancer patients were seriously iodine deficient according to WHO/UNIC EF/IC C IDD, and that this is a suitable index to assess iodine status in Iranians. Daily consumption of salt fortified with iodine or other approaches to increase intake might be effective strategies for prevention or reduction of malignancies. PMID:28441792

New generation QuIC assays for prion seeding activity.

PubMed

Orrù, Christina D; Wilham, Jason M; Vascellari, Sarah; Hughson, Andrew G; Caughey, Byron

2012-01-01

The ability of abnormal TSE-associated forms of PrP to seed the formation of amyloid fibrils from recombinant PrP(Sen) has served as the basis for several relatively rapid and highly sensitive tests for prion diseases. These tests include rPrP-PMCA (rPMCA), standard quaking-induced conversion (S-QuIC), amyloid seeding assay (ASA), real-time QuIC (RT-QuIC) and enhanced QuIC (eQuIC). Here, we summarize recent improvements in the RT-QuIC-based assays that enhance the practicality, sensitivity and quantitative attributes of assays QuIC and promote the detection of prion seeding activity in dilute, inhibitor-laden fluids such as blood plasma.

Apparatus and method for defect testing of integrated circuits

DOEpatents

Cole, Jr., Edward I.; Soden, Jerry M.

2000-01-01

An apparatus and method for defect and failure-mechanism testing of integrated circuits (ICs) is disclosed. The apparatus provides an operating voltage, V.sub.DD, to an IC under test and measures a transient voltage component, V.sub.DDT, signal that is produced in response to switching transients that occur as test vectors are provided as inputs to the IC. The amplitude or time delay of the V.sub.DDT signal can be used to distinguish between defective and defect-free (i.e. known good) ICs. The V.sub.DDT signal is measured with a transient digitizer, a digital oscilloscope, or with an IC tester that is also used to input the test vectors to the IC. The present invention has applications for IC process development, for the testing of ICs during manufacture, and for qualifying ICs for reliability.

Network, system, and status software enhancements for the autonomously managed electrical power system breadboard. Volume 3: Commands specification

NASA Technical Reports Server (NTRS)

Mckee, James W.

1990-01-01

This volume (3 of 4) contains the specification for the command language for the AMPS system. The volume contains a requirements specification for the operating system and commands and a design specification for the operating system and command. The operating system and commands sits on top of the protocol. The commands are an extension of the present set of AMPS commands in that the commands are more compact, allow multiple sub-commands to be bundled into one command, and have provisions for identifying the sender and the intended receiver. The commands make no change to the actual software that implement the commands.

Modeling the propagation, transformation and the impact of tsunami on urban areas using the coupling STOC-ML/IC/CADMAS in nested grids - Application to specific sites of Chile to improve the tsunami induced loads prediction.

NASA Astrophysics Data System (ADS)

Mokrani, C.; Catalan, P. A.; Cienfuegos, R.; Arikawa, T.

2016-02-01

A large part of coasts around the world are affected by tsunami impacts, which supposes a challenge when designing coastal protection structures. Numerical models provide predictions of tsunami-induced loads and there time evolution, which can be used to improve sizing rules of coastal structures. However, the numerical assessment of impact loads is an hard stake. Indeed, recent experimental studies have shown that pressure dynamics generated during tsunami impacts are highly sensitive to the incident local shape of the tsunami. Therefore, high numerical resolutions and very accurate models are required to model all stages during which the tsunami shape is modified before the impact. Given the large distances involved in tsunami events, this can be disregarded in favor of computing time. The Port and Airport Research Institute (PARI) has recently developed a three-way coupled model which allows to accurately model the incident tsunami shape while maintaining reasonable computational time. This coupling approach uses three models used in nested grids (cf. Figure 1). The first one (STOC-ML) solves Nonlinear Shallow Water Equations with hydrostatic pressure. It is used to model the tsunami propagation off the coast. The second one (STOC-IC) is a 3D non-hydrostatic model, on which the free-surface position is estimated through the integrated continuity equation. It has shown to accurately describe dispersive and weakly linear effects occurring at the coast vicinity. The third model (CADMAS-SURF) solves fully three-dimensional Navier-Stokes equations and use a VOF method. Highly nonlinear, dispersive effects and wave breaking processes can be included at the wave scale and therefore, a very accurate description of the incident tsunami is provided. Each model have been separately validated from analytical and/or experimental data. The present objective is to highlight recent advances in Coastal Ocean modeling for tsunami modeling and loads prediction by applying this coupling approach to different sites of the Chilean coast. We first present validation tests to highlight the numerical abilities of this coupling. Then, two tsunami cases are considered and both near-shore processes and tsunami-induced loads on structures are analyzed.

Comparison of ion chromatographic methods based on conductivity detection, post-column-reaction and on-line-coupling IC-ICP-MS for the determination of bromate.

PubMed

Schminke, G; Seubert, A

2000-02-01

An established method for the determination of the disinfection by-product bromate is ion chromatography (IC). This paper presents a comparison of three IC methods based on either conductivity detection (IC-CD), a post-column-reaction (IC-PCR-VIS) or the on-line-coupling with inductively coupled plasma mass spectrometry (IC-ICP-MS). Main characteristics of the methods such as method detection limits (MDL), time of analysis and sample pretreatment are compared and applicability for routine analysis is critically discussed. The most sensitive and rugged method is IC-ICP-MS, followed by IC-PCR-VIS. The photometric detection is subject to a minor interference in real world samples, presumably caused by carbonate. The lowest sensitivity is shown by the IC-CD method as slowest method compared, which, in addition, requires a sample pretreatment. The highest amount of information is delivered by IC-PCR-VIS, which allows the simultaneous determination of the seven standard anions and bromate.

Incidence and risk factors for post-ERCP pancreatitis in chronic pancreatitis.

PubMed

Zhao, Zhen-Hua; Hu, Liang-Hao; Ren, Hong-Bo; Zhao, An-Jing; Qian, Yang-Yang; Sun, Xiao-Tian; Su, Song; Zhu, Shu-Guang; Yu, Jin; Zou, Wen-Bin; Guo, Xiao-Rong; Wang, Lei; Li, Zhao-Shen; Liao, Zhuan

2017-09-01

Almost all studies on post-ERCP pancreatitis (PEP) have mainly involved patients with biliary diseases rather than chronic pancreatitis (CP), and the concept that CP seems to be a protective factor associated with PEP has not been studied in detail. The aim of this study was to determine the incidence of PEP in patients with CP at different clinical stages and to identify the predictive and protective factors of PEP in a large cohort. In this observational cohort study, medical records of patients with CP (CP group) and biliary diseases (BD group) in a tertiary hospital from January 2011 to May 2015 were examined. The difference in the incidence of PEP between CP group and BD group and the risk of PEP at different clinical stages of CP were calculated by the χ 2 test or the Fisher exact test. The predictive and protective factors for PEP were investigated by univariate and multivariate analysis. In total, 2028 ERCP procedures were performed in 1301 patients with CP and 2000 procedures in 1655 patients with BD. The overall incidence of PEP in CP group (4.5%) was similar to that in the BD group (4.8%; P = .747). However, CP patients had significantly lower rates of moderate and severe attacks (0% vs 1.3%, P < .01). According to the M-ANNHEIM classification, the PEP incidences of CP at stages 0, I, II, III, and IV were 4.4%, 5.1%, 3.8%, 2.0%, and 2.0%, respectively. CP patients at stage Ia had the highest PEP incidence (8.0%) among all CP patients, significantly higher than that at stages Ib + Ic (3.9%) and II (3.8%). Female gender, history of acute pancreatitis, and prior PEP were independent risk factors of PEP, whereas extracorporeal shock wave lithotripsy was a protective factor. Compared with BD patients, CP patients had similar incidence of PEP overall but lower grades of severity. The incidence of PEP in CP patients decreased significantly with disease progression. (Clinical trial registration number: NCT02781987.). Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Joint Chiefs of Staff > Media > Photos

Science.gov Websites

U.S. Army Gen. Curtis M. Scaparrotti, left, Commander of U.S. European Command and Supreme Allied , Commander of U.S. European Command and Supreme Allied Commander, Europe; speaks after receiving the . U.S. Army Gen. Curtis M. Scaparrotti, Commander of U.S. European Command and Supreme Allied Commander

Definition of intercultural competence (IC) in undergraduate students at a private university in the USA: A mixed-methods study.

PubMed

Gierke, Lioba; Binder, Nadine; Heckmann, Mark; Odağ, Özen; Leiser, Anne; Kedzior, Karina Karolina

2018-01-01

Intercultural competence (IC) is an important skill to be gained from higher education. However, it remains unclear what IC means to students and what factors might influence their definitions of IC. The aim of the current study was to qualitatively assess how students at one higher education institution in the USA define IC and to quantitatively test for relationships among IC components and various demographic characteristics, including intercultural experience and study context. A further aim was to descriptively compare the IC definitions from the US sample with the definitions obtained from another sample of university students in Germany. A purposive sample of n = 93 undergraduate, second semester students at Dickinson College, USA, participated in the study by completing an online questionnaire. The qualitative data were content-analyzed to define the dimensions of IC. The quantitative data were cluster-analyzed to assess the multivariate relationships among the IC components and the demographic characteristics of the sample. The most important dimensions of IC were Knowledge, External Outcomes (interaction, communication), and Attitudes (respect, tolerance) according to the US sample. The most frequently chosen dimensions of IC differed between both samples: Knowledge was chosen by the sample in the USA while External Outcomes was chosen by the sample in Germany. Relative to the US sample, significantly more students chose Attitudes, External Outcomes, and Intrapersonal Skills in the sample in Germany. The relationships among IC components and demographic characteristics were only weak in the US sample. A person with IC was rated as Open-minded and Respectful by students who lived predominantly in the USA or Tolerant and Curious by those who lived outside the USA for at least six months. The current results suggest that students residing in two countries (USA or Germany) define IC using similar dimensions. However, IC definitions may depend on the intercultural experience and the current global discourse. Longitudinal studies with representative samples are required to assess how IC definitions change over time.

32 CFR 700.1053 - Commander of a task force.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Commander of a task force. 700.1053 Section 700... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any other naval commander, may detail in command of a task force, or other task command, any eligible...

Incidence of herpes zoster and seroprevalence of varicella-zoster virus in young adults of South Korea.

PubMed

Kang, Cheol-In; Choi, Chang-Min; Park, Tae-Sung; Lee, Dong-Jun; Oh, Myoung-don; Choe, Kang-Won

2008-05-01

This study was performed to determine the incidence of herpes zoster and seroprevalence of varicella-zoster virus (VZV) in young adults of South Korea, where VZV seroprevalence remains relatively high. In South Korea, military service is compulsory for all healthy young men and hence those in military service might provide a reflection of the general population. The computerized database of the Armed Forces Medical Command was examined to identify the number of reported herpes zoster cases. In order to evaluate VZV seroprevalence, serum samples were obtained from randomly selected subjects among those who had been admitted to the Armed Forces Capital Hospital. A total of 705 cases of herpes zoster were reported between June 2004 and May 2005. The annual incidence rate of herpes zoster was 141 (95% CI 131.0-151.8) per 100000 population. A total of 192 subjects were enrolled for the analysis of VZV seroprevalence. All subjects were male and their median age was 21 (range 19-24) years. The overall anti-VZV IgG seropositivity prevalence was 92.7% (178/192, 95% CI 88.0-95.7%). We have described a population-based study of the epidemiology of VZV infections in the military personnel of South Korea.

IgM, IgG and IgA rheumatoid factors and circulating immune complexes in patients with AIDS and AIDS-related complex with serological abnormalities.

PubMed Central

Procaccia, S; Lazzarin, A; Colucci, A; Gasparini, A; Forcellini, P; Lanzanova, D; Foppa, C U; Novati, R; Zanussi, C

1987-01-01

To investigate some humoral aspects which may reflect the involvement of B lymphocytes in the acquired immunodeficiency syndrome (AIDS), we used an enzyme-linked immunoassay (ELISA) to determine the levels of IgM, IgG and IgA rheumatoid factors (RF) in 16 patients suffering from full-blown AIDS and 32 patients with AIDS-related complex (ARC), in the clinical form of lymphoadenopathy syndrome (LAS), compared with 40 healthy, young heterosexual subjects. Both AIDS and ARC patients showed a greater incidence of high IgM RF levels, with mean values significantly higher than controls, but with no differences between the two pathological groups. IgG RF behaviour was similar in the two patient populations and the healthy subjects. IgA RF were significantly raised in AIDS and ARC. Further information on RF was obtained by determination of the immunoglobulin levels of the respective isotypes in the same patients. Mean IgG levels were above normal in AIDS and ARC patients, but the latter group showed a higher incidence of increased values and higher mean levels. The IgA isotype was significantly increased mainly in AIDS patients. The behaviour of IgM was virtually the same in the three groups studied. A difference between AIDS and ARC patients was established by the detection of circulating immune-complexes (IC) by the C1q-binding and CIC-conglutinin assays. IC were significantly high, by both methods, only in the ARC group, but normal or very low in AIDS. These overall findings suggest once again the impairment of B cell function in AIDS, with prevalent hyperactivation in ARC and exhaustion in full-blown AIDS, and apparent preservation, in the latter group, of the antibody responses which are more closely related to the activity of subsets of T helper cells. PMID:3608224

Development and validation of a risk score to predict the probability of postoperative vomiting in pediatric patients: the VPOP score.

PubMed

Bourdaud, Nathalie; Devys, Jean-Michel; Bientz, Jocelyne; Lejus, Corinne; Hebrard, Anne; Tirel, Olivier; Lecoutre, Damien; Sabourdin, Nada; Nivoche, Yves; Baujard, Catherine; Nikasinovic, Lydia; Orliaguet, Gilles A

2014-09-01

Few data are available in the literature on risk factors for postoperative vomiting (POV) in children. The aim of the study was to establish independent risk factors for POV and to construct a pediatric specific risk score to predict POV in children. Characteristics of 2392 children operated under general anesthesia were recorded. The dataset was randomly split into an evaluation set (n = 1761), analyzed with a multivariate analysis including logistic regression and backward stepwise procedure, and a validation set (n = 450), used to confirm the accuracy of prediction using the area under the receiver operating characteristic curve (ROCAUC ), to optimize sensitivity and specificity. The overall incidence of POV was 24.1%. Five independent risk factors were identified: stratified age (>3 and <6 or >13 years: adjusted OR 2.46 [95% CI 1.75-3.45]; ≥6 and ≤13 years: aOR 3.09 [95% CI 2.23-4.29]), duration of anesthesia (aOR 1.44 [95% IC 1.06-1.96]), surgery at risk (aOR 2.13 [95% IC 1.49-3.06]), predisposition to POV (aOR 1.81 [95% CI 1.43-2.31]), and multiple opioids doses (aOR 2.76 [95% CI 2.06-3.70], P < 0.001). A simplified score was created, ranging from 0 to 6 points. Respective incidences of POV were 5%, 6%, 13%, 21%, 36%, 48%, and 52% when the risk score ranged from 0 to 6. The model yielded a ROCAUC of 0.73 [95% CI 0.67-0.78] when applied to the validation dataset. Independent risk factors for POV were identified and used to create a new score to predict which children are at high risk of POV. © 2014 John Wiley & Sons Ltd.

Synthesis of novel amides based on acridone scaffold with interesting antineoplastic activity.

PubMed

Mahajan, Anand A; Rane, Rajesh A; Amritkar, Anish A; Naphade, Shital S; Miniyar, Pankaj B; Bangalore, Pavan Kumar; Karpoormath, Rajshekhar

2015-01-01

In search of novel cytotoxic agents based on acridone scaffold, twenty five derivatives of acridone-2- carboxamide were synthesized and evaluated against a panel of eleven cancer cell lines by using MTT assay. Amides, A5 and A8 (IC50 = 0.3 µM) exhibited good cytotoxicity against MCF7. Compound A22 (IC50 = 4.3 µM) was found to be selectively cytotoxic against cancer cell line MCF7 and KB403. Particularly, promising cytotoxic activities were shown by amides A6 (IC50 = 0.7 µM), A16 (IC50 = 6.3 µM), A8 (IC50 = 0.9 µM ), A21 (IC50 = 1.3 µM), A5 (IC50 = 2.9 µM), A8 (IC50 = 2.8 µM), A14 (IC50 = 0.8 µM), A9 (IC50 = 0.8 µM) and A8 (IC50 = 0.4 µM) against cell lines; PA1, WRL68, CaCO2, TK-10, K-562, PC-3, HOP-92, ECV-304 and UACC-257, respectively. The favorable cytotoxic profile and non-toxicity towards normal human cells displayed by the derivative revealed their potential for further anticancer drug developments.

An integrated conceptual framework for evaluating and improving 'understanding' in informed consent.

PubMed

Bossert, Sabine; Strech, Daniel

2017-10-17

The development of understandable informed consent (IC) documents has proven to be one of the most important challenges in research with humans as well as in healthcare settings. Therefore, evaluating and improving understanding has been of increasing interest for empirical research on IC. However, several conceptual and practical challenges for the development of understandable IC documents remain unresolved. In this paper, we will outline and systematize some of these challenges. On the basis of our own experiences in empirical user testing of IC documents as well as the relevant literature on understanding in IC, we propose an integrated conceptual model for the development of understandable IC documents. The proposed conceptual model integrates different methods for the participatory improvement of written information, including IC, as well as quantitative methods for measuring understanding in IC. In most IC processes, understandable written information is an important prerequisite for valid IC. To improve the quality of IC documents, a conceptual model for participatory procedures of testing, revising, and retesting can be applied. However, the model presented in this paper needs further theoretical and empirical elaboration and clarification of several conceptual and practical challenges.

6-Nitrobenzimidazole derivatives: potential phosphodiesterase inhibitors: synthesis and structure-activity relationship.

PubMed

Khan, K M; Shah, Zarbad; Ahmad, V U; Ambreen, N; Khan, M; Taha, M; Rahim, F; Noreen, S; Perveen, S; Choudhary, M I; Voelter, W

2012-02-15

6-Nitrobenzimidazole derivatives (1-30) synthesized and their phosphodiesterase inhibitory activities determined. Out of thirty tested compounds, ten showed a varying degrees of phosphodiesterase inhibition with IC(50) values between 1.5±0.043 and 294.0±16.7 μM. Compounds 30 (IC(50)=1.5±0.043 μM), 1 (IC(50)=2.4±0.049 μM), 11 (IC(50)=5.7±0.113 μM), 13 (IC(50)=6.4±0.148 μM), 14 (IC(50)=10.5±0.51 μM), 9 (IC(50)=11.49±0.08 μM), 3 (IC(50)=63.1±1.48 μM), 10 (IC(50)=120.0±4.47 μM), and 6 (IC(50)=153.2±5.6 μM) showed excellent phosphodiesterase inhibitory activity, much superior to the standard EDTA (IC(50)=274±0.007 μM), and thus are potential molecules for the development of a new class of phosphodiesterase inhibitors. A structure-activity relationship is evaluated. All compounds are characterized by spectroscopic parameters. Copyright © 2011 Elsevier Ltd. All rights reserved.

Association between lower air pressure and the onset of ischemic colitis: a case-control study.

PubMed

Kimura, Takefumi; Shinji, Akihiro; Tanaka, Naoki; Koinuma, Masayoshi; Yamaura, Maki; Nagaya, Tadanobu; Joshita, Satoru; Komatsu, Michiharu; Umemura, Takeji; Horiuchi, Akira; Wada, Shuichi; Tanaka, Eiji

2017-09-01

Ischemic colitis (IC) often affects the elderly. Proarteriosclerotic factors, such as hypertension and smoking, and cardiovascular disease are considered major contributors to IC. Although a possible link between certain cerebrocardiovascular disorders and meteorological phenomena has been reported, the relationship between IC onset and weather changes remains uninvestigated. This study examined whether specific meteorological factors were associated with the occurrence of IC. We retrospectively enrolled 303 patients who had been diagnosed with IC between January 2003 and June 2010 at Suwa Red Cross Hospital in Nagano Prefecture, Japan. The meteorological data of the days on which IC patients visited the hospital (IC+ days) were compared with those of the days on which IC patients did not (IC- days). Univariate analysis indicated that IC+ days had significantly lower air pressure (P<0.001), depressed air pressure from the previous day (P<0.001), and fewer daylight hours (P<0.001), as well as higher air temperature (P=0.017), air humidity (P=0.004), wind velocity (P<0.001), and rainfall (P=0.012) compared with IC- days. Multivariate logistic regression analysis of the meteorological data showed that air pressure (odds ratio: 0.935, P<0.001) and change in air pressure from the previous day (odds ratio: 0.934, P<0.001) were related to onset of IC. Lower air pressure and decrease in air pressure from the previous day are possible novel factors associated with the development of IC.

Taking advantage of public reporting: An infection composite score to assist evaluating hospital performance for infection prevention efforts.

PubMed

Fakih, Mohamad G; Skierczynski, Boguslow; Bufalino, Angelo; Groves, Clariecia; Roberts, Phillip; Heavens, Michelle; Hendrich, Ann; Haydar, Ziad

2016-12-01

The standardized infection ratio (SIR) evaluates individual publicly reported health care-associated infections, but it may not assess overall performance. We piloted an infection composite score (ICS) in 82 hospitals of a single health system. The ICS is a combined score for central line-associated bloodstream infections, catheter-associated urinary tract infections, colon and abdominal hysterectomy surgical site infections, and hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and Clostridium difficile infections. Individual facility ICSs were calculated by normalizing each of the 6 SIR events to the system SIR for baseline and performance periods (ICS ib and ICS ip , respectively). A hospital ICS ib reflected its baseline performance compared with system baseline, whereas a ICS ip provided information of its outcome changes compared with system baseline. Both the ICS ib (baseline 2013) and ICS ip (performance 2014) were calculated for 63 hospitals (reporting at least 4 of the 6 event types). The ICS ip improved in 36 of 63 (57.1%) hospitals in 2014 when compared with the ICS ib in 2013. The ICS ib 2013 median was 0.96 (range, 0.13-2.94) versus the 2014 ICS ip median of 0.92 (range, 0-6.55). Variation was more evident in hospitals with ≤100 beds. The system performance score (ICS sp ) in 2014 was 0.95, a 5% improvement compared with 2013. The proposed ICS may help large health systems and state hospital associations better evaluate key infectious outcomes, comparing them with historic and concurrent performance of peers. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The C3-System User. Volume II. Workshop Notes

DTIC Science & Technology

1977-02-01

system that provides the means for operational direction and technical administrative support involved in the function of command and control of U.S...information systems of the Headquarters of the Military Depart- ments; the command and control systems of the Headquarters of the Service Component Commands...the Service Component Commands - Military Airlift Command - Military Sealift Command - Military Traffic Management Command - 3.2.5 Command and

32 CFR 700.703 - To announce assumption of command.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false To announce assumption of command. 700.703... Chief and Other Commanders Titles and Duties of Commanders § 700.703 To announce assumption of command. (a) Upon assuming command, commanders shall so advise appropriate superiors, and the units of their...

32 CFR 700.703 - To announce assumption of command.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false To announce assumption of command. 700.703... Chief and Other Commanders Titles and Duties of Commanders § 700.703 To announce assumption of command. (a) Upon assuming command, commanders shall so advise appropriate superiors, and the units of their...

32 CFR 536.8 - Responsibilities and operations of command claims services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Responsibilities and operations of command claims... operations of command claims services. (a) Chiefs of command claims services. Chiefs of command claims... Commander USARCS, and assigned an office code. However, the chief of a command claims service may...

32 CFR 700.703 - To announce assumption of command.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false To announce assumption of command. 700.703... Chief and Other Commanders Titles and Duties of Commanders § 700.703 To announce assumption of command. (a) Upon assuming command, commanders shall so advise appropriate superiors, and the units of their...

32 CFR 700.703 - To announce assumption of command.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false To announce assumption of command. 700.703... Chief and Other Commanders Titles and Duties of Commanders § 700.703 To announce assumption of command. (a) Upon assuming command, commanders shall so advise appropriate superiors, and the units of their...

32 CFR 700.703 - To announce assumption of command.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false To announce assumption of command. 700.703... Chief and Other Commanders Titles and Duties of Commanders § 700.703 To announce assumption of command. (a) Upon assuming command, commanders shall so advise appropriate superiors, and the units of their...

32 CFR 536.8 - Responsibilities and operations of command claims services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Responsibilities and operations of command claims... operations of command claims services. (a) Chiefs of command claims services. Chiefs of command claims... Commander USARCS, and assigned an office code. However, the chief of a command claims service may...

32 CFR 536.8 - Responsibilities and operations of command claims services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Responsibilities and operations of command claims... operations of command claims services. (a) Chiefs of command claims services. Chiefs of command claims... Commander USARCS, and assigned an office code. However, the chief of a command claims service may...

Integrated circuit failure analysis by low-energy charge-induced voltage alteration

DOEpatents

Cole, E.I. Jr.

1996-06-04

A scanning electron microscope apparatus and method are described for detecting and imaging open-circuit defects in an integrated circuit (IC). The invention uses a low-energy high-current focused electron beam that is scanned over a device surface of the IC to generate a charge-induced voltage alteration (CIVA) signal at the location of any open-circuit defects. The low-energy CIVA signal may be used to generate an image of the IC showing the location of any open-circuit defects. A low electron beam energy is used to prevent electrical breakdown in any passivation layers in the IC and to minimize radiation damage to the IC. The invention has uses for IC failure analysis, for production-line inspection of ICs, and for qualification of ICs. 5 figs.

Integrated circuit failure analysis by low-energy charge-induced voltage alteration

DOEpatents

Cole, Jr., Edward I.

1996-01-01

A scanning electron microscope apparatus and method are described for detecting and imaging open-circuit defects in an integrated circuit (IC). The invention uses a low-energy high-current focused electron beam that is scanned over a device surface of the IC to generate a charge-induced voltage alteration (CIVA) signal at the location of any open-circuit defects. The low-energy CIVA signal may be used to generate an image of the IC showing the location of any open-circuit defects. A low electron beam energy is used to prevent electrical breakdown in any passivation layers in the IC and to minimize radiation damage to the IC. The invention has uses for IC failure analysis, for production-line inspection of ICs, and for qualification of ICs.

Temporal and developmental requirements for the Prader–Willi imprinting center

PubMed Central

DuBose, Amanda J.; Smith, Emily Y.; Johnstone, Karen A.; Resnick, James L.

2012-01-01

Imprinted gene expression associated with Prader–Willi syndrome (PWS) and Angelman syndrome (AS) is controlled by two imprinting centers (ICs), the PWS-IC and the AS-IC. The PWS-IC operates in cis to activate transcription of genes that are expressed exclusively from the paternal allele. We have created a conditional allele of the PWS-IC to investigate its developmental activity. Deletion of the paternal PWS-IC in the embryo before implantation abolishes expression of the paternal-only genes in the neonatal brain. Surprisingly, deletion of the PWS-IC in early brain progenitors does not affect the subsequent imprinted status of PWS/AS genes in the newborn brain. These results indicate that the PWS-IC functions to protect the paternal epigenotype at the epiblast stage of development but is dispensable thereafter. PMID:22331910

Effectiveness of Six Improved Cookstoves in Reducing Household Air Pollution and Their Acceptability in Rural Western Kenya

PubMed Central

Pilishvili, Tamara; Loo, Jennifer D.; Schrag, Stephanie; Stanistreet, Debbi; Christensen, Bryan; Yip, Fuyuen; Nyagol, Ronald; Quick, Robert; Sage, Mike; Bruce, Nigel

2016-01-01

Background Household air pollution (HAP) from biomass fuel burning is linked to poor health outcomes. Improved biomass cookstoves (ICS) have the potential to improve HAP. Objectives A pre-/post- intervention study assessed the impact of six ICS on indoor air quality and acceptability of ICS to local users in rural Western Kenya. Methods We measured mean personal and kitchen level concentrations of particulate matter <2.5μm in diameter (PM2.5, μg/m3) and carbon monoxide (CO, ppm) during the 48-hour period of each ICS use in 45 households. We compared these levels to those observed with traditional 3-stone fire (TSF) use. We assessed ICS acceptability through interviews and focus groups. We evaluated association of stove type, fuel use, and factors related to cooking practices with mean kitchen PM2.5 and CO using multivariable regression. Results Stove type, exclusive ICS use (vs. concurrent TSF use), and the amount of fuel used were independently associated with kitchen PM2.5 and CO levels. Reductions (95%CI) in mean PM2.5 compared to TSF, ranged by ICS from 11.9% (-2.8–24.5) to 42.3% (32.3–50.8). Reductions in kitchen CO compared to TSF, ranged by ICS from -5.8% (-21.9–8.2) to 34.5% (23.2–44.1). Mean kitchen PM2.5 ranged from 319μg/m3 to 518μg/m3 by ICS. Women thought ICS were easy to use, more efficient, produced less smoke, and cooked faster, compared to TSF. Women also reported limitations for each ICS. Conclusions We documented reductions in HAP from ICS compared to TSF. The PM2.5 levels with ICS use were still considerably higher than WHO indoor air quality guidelines. Achieving maximal potential of ICS requires adherence to more exclusive use and addressing user reported ICS limitations. PMID:27846224

(Epi)genotype–phenotype correlations in Beckwith–Wiedemann syndrome

PubMed Central

Mussa, Alessandro; Russo, Silvia; De Crescenzo, Agostina; Freschi, Andrea; Calzari, Luciano; Maitz, Silvia; Macchiaiolo, Marina; Molinatto, Cristina; Baldassarre, Giuseppina; Mariani, Milena; Tarani, Luigi; Bedeschi, Maria Francesca; Milani, Donatella; Melis, Daniela; Bartuli, Andrea; Cubellis, Maria Vittoria; Selicorni, Angelo; Cirillo Silengo, Margherita; Larizza, Lidia; Riccio, Andrea; Ferrero, Giovanni Battista

2016-01-01

Beckwith–Wiedemann syndrome (BWS) is characterized by cancer predisposition, overgrowth and highly variable association of macroglossia, abdominal wall defects, nephrourological anomalies, nevus flammeus, ear malformations, hypoglycemia, hemihyperplasia, and organomegaly. BWS molecular defects, causing alteration of expression or activity of the genes regulated by two imprinting centres (IC) in the 11p15 chromosomal region, are also heterogeneous. In this paper we define (epi)genotype–phenotype correlations in molecularly confirmed BWS patients. The characteristics of 318 BWS patients with proven molecular defect were compared among the main four molecular subclasses: IC2 loss of methylation (IC2-LoM, n=190), IC1 gain of methylation (IC1-GoM, n=31), chromosome 11p15 paternal uniparental disomy (UPD, n=87), and cyclin-dependent kinase inhibitor 1C gene (CDKN1C) variants (n=10). A characteristic growth pattern was found in each group; neonatal macrosomia was almost constant in IC1-GoM, postnatal overgrowth in IC2-LoM, and hemihyperplasia more common in UPD (P<0.001). Exomphalos was more common in IC2/CDKN1C patients (P<0.001). Renal defects were typical of UPD/IC1 patients, uretheral malformations of IC1-GoM cases (P<0.001). Ear anomalies and nevus flammeus were associated with IC2/CDKN1C genotype (P<0.001). Macroglossia was less common among UPD patients (P<0.001). Wilms' tumor was associated with IC1-GoM or UPD and never observed in IC2-LoM patients (P<0.001). Hepatoblastoma occurred only in UPD cases. Cancer risk was lower in IC2/CDKN1C, intermediate in UPD, and very high in IC1 cases (P=0.009). In conclusion, (epi)genotype–phenotype correlations define four different phenotypic BWS profiles with some degree of clinical overlap. These observations impact clinical care allowing to move toward (epi) genotype-based follow-up and cancer screening. PMID:25898929

Effectiveness of Six Improved Cookstoves in Reducing Household Air Pollution and Their Acceptability in Rural Western Kenya.

PubMed

Pilishvili, Tamara; Loo, Jennifer D; Schrag, Stephanie; Stanistreet, Debbi; Christensen, Bryan; Yip, Fuyuen; Nyagol, Ronald; Quick, Robert; Sage, Mike; Bruce, Nigel

2016-01-01

Household air pollution (HAP) from biomass fuel burning is linked to poor health outcomes. Improved biomass cookstoves (ICS) have the potential to improve HAP. A pre-/post- intervention study assessed the impact of six ICS on indoor air quality and acceptability of ICS to local users in rural Western Kenya. We measured mean personal and kitchen level concentrations of particulate matter <2.5μm in diameter (PM2.5, μg/m3) and carbon monoxide (CO, ppm) during the 48-hour period of each ICS use in 45 households. We compared these levels to those observed with traditional 3-stone fire (TSF) use. We assessed ICS acceptability through interviews and focus groups. We evaluated association of stove type, fuel use, and factors related to cooking practices with mean kitchen PM2.5 and CO using multivariable regression. Stove type, exclusive ICS use (vs. concurrent TSF use), and the amount of fuel used were independently associated with kitchen PM2.5 and CO levels. Reductions (95%CI) in mean PM2.5 compared to TSF, ranged by ICS from 11.9% (-2.8-24.5) to 42.3% (32.3-50.8). Reductions in kitchen CO compared to TSF, ranged by ICS from -5.8% (-21.9-8.2) to 34.5% (23.2-44.1). Mean kitchen PM2.5 ranged from 319μg/m3 to 518μg/m3 by ICS. Women thought ICS were easy to use, more efficient, produced less smoke, and cooked faster, compared to TSF. Women also reported limitations for each ICS. We documented reductions in HAP from ICS compared to TSF. The PM2.5 levels with ICS use were still considerably higher than WHO indoor air quality guidelines. Achieving maximal potential of ICS requires adherence to more exclusive use and addressing user reported ICS limitations.

A high ratio of IC31® adjuvant to antigen is necessary for H4 TB vaccine immunomodulation

PubMed Central

Aboutorabian, Sepideh; Hakimi, Jalil; Boudet, Florence; Montano, Sandrine; Dookie, Annie; Roque, Cristopher; Ausar, Salvador F; Rahman, Nausheen; Brookes, Roger H

2015-01-01

A tuberculosis (TB) vaccine consisting of a recombinant fusion protein (H4) and a novel TLR9 adjuvant (IC31) is in clinical development. To better understand the H4-IC31 ratio, we measured the binding capacity of IC31 for H4 protein and immunized mice with formulations that contained limiting to excess ratios of IC31 to H4. An immunomodulated H4-specific IFNγ response was only observed when IC31 was present in excess of H4. Since TLR expression is species-specific and the vaccine is intended to boost BCG-primed immunity, we questioned whether data in mice would translate to humans. To address this question, we used the fresh human Whole Blood (hWB) recovered from BCG-vaccinated subjects to screen H4-IC31 formulations. We found IC31 modulation in hWB to be quite distinct from the TLR4-Adjuvant. Unlike TLR4-Adjuvant, IC31 formulations did not induce the pro-inflammatory cytokine TNFα, but modulated a robust H4-specific IFNγ response after 12 d of culture. We then re-stimulated the fresh hWB of 5 BCG-primed subjects with formulations that had excess or limiting IC31 binding for H4 protein and again found that an immunomodulated H4-specific IFNγ response needed an excess of IC31. Finally, we monitored the zeta (ζ) potential of H4-IC31 formulations and found that the overall charge of H4-IC31 particles changes from negative to positive once IC31 is in greater than 9-fold excess. Using two diverse yet mutually supportive approaches, we confirm the need for an excess of IC31 adjuvant in H4 TB vaccine formulations and suggest surface potential may be an important factor. PMID:25997147

A high ratio of IC31(®) adjuvant to antigen is necessary for H4 TB vaccine immunomodulation.

PubMed

Aboutorabian, Sepideh; Hakimi, Jalil; Boudet, Florence; Montano, Sandrine; Dookie, Annie; Roque, Cristopher; Ausar, Salvador F; Rahman, Nausheen; Brookes, Roger H

2015-01-01

A tuberculosis (TB) vaccine consisting of a recombinant fusion protein (H4) and a novel TLR9 adjuvant (IC31) is in clinical development. To better understand the H4-IC31 ratio, we measured the binding capacity of IC31 for H4 protein and immunized mice with formulations that contained limiting to excess ratios of IC31 to H4. An immunomodulated H4-specific IFNγ response was only observed when IC31 was present in excess of H4. Since TLR expression is species-specific and the vaccine is intended to boost BCG-primed immunity, we questioned whether data in mice would translate to humans. To address this question, we used the fresh human Whole Blood (hWB) recovered from BCG-vaccinated subjects to screen H4-IC31 formulations. We found IC31 modulation in hWB to be quite distinct from the TLR4-Adjuvant. Unlike TLR4-Adjuvant, IC31 formulations did not induce the pro-inflammatory cytokine TNFα, but modulated a robust H4-specific IFNγ response after 12 d of culture. We then re-stimulated the fresh hWB of 5 BCG-primed subjects with formulations that had excess or limiting IC31 binding for H4 protein and again found that an immunomodulated H4-specific IFNγ response needed an excess of IC31. Finally, we monitored the zeta (ζ) potential of H4-IC31 formulations and found that the overall charge of H4-IC31 particles changes from negative to positive once IC31 is in greater than 9-fold excess. Using two diverse yet mutually supportive approaches, we confirm the need for an excess of IC31 adjuvant in H4 TB vaccine formulations and suggest surface potential may be an important factor.

Response ofMeteorus leviventris, (Hymenoptera: Braconidae) to mustard oils in field trapping experiments.

PubMed

Pivnick, K A

1993-09-01

Trapping experiments were carried out near Saskatoon, Canada, from May through August 1990 to assess the response of the braconid wasp,Meteorus leviventris, to four selected mustard oils or isothiocyanates (IC) at a release rate of 4 mg/day, and for allyl IC only, at 40 mg/day. Only allyl IC at 4 mg/day was significantly attractive when trap captures were compared to the captures in the control traps. The others (n-propyl IC, 2-phenylethyl IC., and ethyl IC) were not attractive, nor was allyl IC at the higher dose, although trap captures with the latter bait were the second highest.

Individual Differences in Inhibitory Control Skills at Three Years of Age

PubMed Central

Watson, Amanda J.; Bell, Martha Ann

2013-01-01

Sixty-eight 3-year-old children participated in an investigation of inhibitory control (IC). Child IC was measured using various tasks in order to determine the impact on child performance of manipulating task demands. Performance on a nonverbal IC task, but not performance on more difficult motivational or traditional IC tasks, was explained by medial frontal electroencephalographic activity and by language abilities. Because of the unique relations of nonverbal IC with concurrent developmental measures, and because of its potential to predict later social problems, we conclude that it is important to include nonverbal IC measures in investigative IC batteries in early childhood. PMID:23311312

Prenatal immune challenge in rats: effects of polyinosinic-polycytidylic acid on spatial learning, prepulse inhibition, conditioned fear, and responses to MK-801 and amphetamine.

PubMed

Vorhees, Charles V; Graham, Devon L; Braun, Amanda A; Schaefer, Tori L; Skelton, Matthew R; Richtand, Neil M; Williams, Michael T

2015-01-01

Prenatal maternal immune activation increases risk for schizophrenia and/or autism. Previous data suggest that maternal weight change in response to the immune activator polyinosinic-polycytidylic (Poly IC) in rats influences the severity of effect in the offspring as does the exposure period. We treated gravid Sprague-Dawley rats from E14 to 18 with 8mg/kg/day Poly IC or saline. The Poly IC group was divided into those that gained the least weight or lost (Poly IC (L)) and those that gained the most (Poly IC (H)) weight. There were no effects of Poly IC on anxiety (elevated zero-maze, open-field, object burying), or Morris water maze cued learning or working memory or Cincinnati water maze egocentric learning. The Poly IC (H) group males had decreased acoustic startle whereas Poly IC (L) females had reduced startle and increased PPI. Poly IC offspring showed exaggerated hyperactivity in response to amphetamine (primarily in the Poly IC (H) group) and attenuated hyperactivity in response to MK-801 challenge (primarily in the Poly IC (L) group). Poly IC (L) males showed reduced cued conditioned freezing; both sexes showed less time in the dark in a light-dark test, and the Poly IC groups showed impaired Morris water maze hidden platform acquisition and probe performance. The data demonstrate that offspring from the most affected dams were more affected than those from less reactive dams indicating that degree of maternal immune activation predicts severity of effects on offspring behavior. Copyright © 2014 Elsevier Inc. All rights reserved.

Bladder pain syndrome/interstitial cystitis as a functional somatic syndrome.

PubMed

Warren, John W

2014-12-01

To determine whether bladder pain syndrome/interstitial cystitis (BPS/IC) has the characteristics of a functional somatic syndrome (FSS). There is no accepted definition of an FSS. Consequently, this paper reviewed the literature for common FSS characteristics and for reports that BPS/IC has these characteristics. Eleven articles met inclusion and exclusion criteria and yielded 18 FSS characteristics. BPS/IC patients manifest all but two: the exceptions were normal light microscopic anatomy (after hydrodistention under anesthesia, some BPS/IC bladders have Hunner's lesions and most have petechial hemorrhages) and normal laboratory tests (many BPS/IC patients have hematuria). Petechial hemorrhages and hematuria are probably related and may appear during naturally-occurring bladder distention. Without such distention, then, the 90% of BPS/IC patients without a Hunner's lesion have all the characteristics of an FSS. Comparisons in the opposite direction were consistent: several additional features of BPS/IC were found in FSSs. This systematic but untested method is consistent with but does not test the hypothesis that BPS/IC in some patients might best be understood as an FSS. Like most conditions, BPS/IC is probably heterogeneous; hence only a proportion of BPS/IC cases are likely to be manifestations of an FSS. This hypothesis has several implications. Explorations of processes that connect the FSSs might contribute to understanding the pathogenesis of BPS/IC. Patients with FSSs are at risk for BPS/IC and may benefit from future preventive strategies. Therapies that are useful in FSSs also may be useful in some cases of BPS/IC. Copyright © 2014 Elsevier Inc. All rights reserved.

--No Title--

Science.gov Websites

/ARW1 : IC/BC from 6-h old GFS Alaska ARW2 : IC from current NAM, BC from 6-h old NAM CONUS NMMB/ARW1 : IC from current RAP, BC from 6-h old GFS CONUS ARW2 ; IC from current NAM, BC from 6-h old NAM Hawaii NMMB/ARW1: IC/BC from 6-h old GFS Hawaii ARW2 : IC from current NAM, BC from 6-h old NAM Puerto Rico

The United States Navy Arctic Roadmap for 2014 to 2030

DTIC Science & Technology

2014-02-01

of the Oceanographer of the Navy; the Chief of Naval Research; Commander, Naval Meteorology and Oceanography Command; Commander, Office of Naval...Q3, FY14 Q3, FY15 FY15-18 FY18 2.3.4: Improve traditional meteorological forecast capability in the polar regions through the...CNE Commander Naval Forces Europe CNIC Commander Navy Installations Command CNMOC Commander Naval Meteorology and Oceanography Command CNO Chief

Fast-Dissolving, Prolonged Release, and Antibacterial Cyclodextrin/Limonene-Inclusion Complex Nanofibrous Webs via Polymer-Free Electrospinning.

PubMed

Aytac, Zeynep; Yildiz, Zehra Irem; Kayaci-Senirmak, Fatma; San Keskin, Nalan Oya; Kusku, Semran Ipek; Durgun, Engin; Tekinay, Turgay; Uyar, Tamer

2016-10-05

We have proposed a new strategy for preparing free-standing nanofibrous webs from an inclusion complex (IC) of a well-known flavor/fragrance compound (limonene) with three modified cyclodextrins (HPβCD, MβCD, and HPγCD) via electrospinning (CD/limonene-IC-NFs) without using a polymeric matrix. The experimental and computational modeling studies proved that the stoichiometry of the complexes was 1:1 for CD/limonene systems. MβCD/limonene-IC-NF released much more limonene at 37, 50, and 75 °C than HPβCD/limonene-IC-NF and HPγCD/limonene-IC-NF because of the greater amount of preserved limonene. Moreover, MβCD/limonene-IC-NF has released only 25% (w/w) of its limonene, whereas HPβCD/limonene-IC-NF and HPγCD/limonene-IC-NF released 51 and 88% (w/w) of their limonene in 100 days, respectively. CD/limonene-IC-NFs exhibited high antibacterial activity against E. coli and S. aureus. The water solubility of limonene increased significantly and CD/limonene-IC-NFs were dissolved in water in a few seconds. In brief, CD/limonene-IC-NFs with fast-dissolving character enhanced the thermal stability and prolonged the shelf life along with antibacterial properties could be quite applicable in food and oral care applications.

Definition of intercultural competence (IC) in undergraduate students at a private university in the USA: A mixed-methods study

PubMed Central

Gierke, Lioba; Binder, Nadine; Heckmann, Mark; Odağ, Özen; Leiser, Anne

2018-01-01

Introduction Intercultural competence (IC) is an important skill to be gained from higher education. However, it remains unclear what IC means to students and what factors might influence their definitions of IC. The aim of the current study was to qualitatively assess how students at one higher education institution in the USA define IC and to quantitatively test for relationships among IC components and various demographic characteristics, including intercultural experience and study context. A further aim was to descriptively compare the IC definitions from the US sample with the definitions obtained from another sample of university students in Germany. Materials and methods A purposive sample of n = 93 undergraduate, second semester students at Dickinson College, USA, participated in the study by completing an online questionnaire. The qualitative data were content-analyzed to define the dimensions of IC. The quantitative data were cluster-analyzed to assess the multivariate relationships among the IC components and the demographic characteristics of the sample. Results The most important dimensions of IC were Knowledge, External Outcomes (interaction, communication), and Attitudes (respect, tolerance) according to the US sample. The most frequently chosen dimensions of IC differed between both samples: Knowledge was chosen by the sample in the USA while External Outcomes was chosen by the sample in Germany. Relative to the US sample, significantly more students chose Attitudes, External Outcomes, and Intrapersonal Skills in the sample in Germany. The relationships among IC components and demographic characteristics were only weak in the US sample. A person with IC was rated as Open-minded and Respectful by students who lived predominantly in the USA or Tolerant and Curious by those who lived outside the USA for at least six months. Discussion The current results suggest that students residing in two countries (USA or Germany) define IC using similar dimensions. However, IC definitions may depend on the intercultural experience and the current global discourse. Longitudinal studies with representative samples are required to assess how IC definitions change over time. PMID:29698525

32 CFR 536.12 - Commanding General, U.S. Army Medical Command.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Commanding General, U.S. Army Medical Command... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.12 Commanding General, U.S. Army Medical Command. (a) After consulting with the Commander USARCS on the selection of medical claims...

32 CFR 536.14 - Commanders of major Army commands.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Commanders of major Army commands. 536.14 Section... CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.14 Commanders of major Army commands... respective commands for compliance with the responsibilities assigned in §§ 536.9 and 536.10. (b) Assist...

32 CFR 536.12 - Commanding General, U.S. Army Medical Command.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Commanding General, U.S. Army Medical Command... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.12 Commanding General, U.S. Army Medical Command. (a) After consulting with the Commander USARCS on the selection of medical claims...

32 CFR 536.14 - Commanders of major Army commands.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Commanders of major Army commands. 536.14 Section... CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.14 Commanders of major Army commands... respective commands for compliance with the responsibilities assigned in §§ 536.9 and 536.10. (b) Assist...

32 CFR 536.14 - Commanders of major Army commands.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Commanders of major Army commands. 536.14... ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.14 Commanders of major Army commands... respective commands for compliance with the responsibilities assigned in §§ 536.9 and 536.10. (b) Assist...

32 CFR 536.14 - Commanders of major Army commands.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Commanders of major Army commands. 536.14 Section... CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.14 Commanders of major Army commands... respective commands for compliance with the responsibilities assigned in §§ 536.9 and 536.10. (b) Assist...

32 CFR 536.12 - Commanding General, U.S. Army Medical Command.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Commanding General, U.S. Army Medical Command... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.12 Commanding General, U.S. Army Medical Command. (a) After consulting with the Commander USARCS on the selection of medical claims...

32 CFR 536.12 - Commanding General, U.S. Army Medical Command.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Commanding General, U.S. Army Medical Command... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.12 Commanding General, U.S. Army Medical Command. (a) After consulting with the Commander USARCS on the selection of medical claims...

32 CFR 536.14 - Commanders of major Army commands.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Commanders of major Army commands. 536.14... ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.14 Commanders of major Army commands... respective commands for compliance with the responsibilities assigned in §§ 536.9 and 536.10. (b) Assist...

32 CFR 536.12 - Commanding General, U.S. Army Medical Command.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Commanding General, U.S. Army Medical Command... AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.12 Commanding General, U.S. Army Medical Command. (a) After consulting with the Commander USARCS on the selection of medical claims...

The SAS-3 delayed command system

NASA Technical Reports Server (NTRS)

Hoffman, E. J.

1975-01-01

To meet the requirements arising from the increased complexity of the power, attitude control and telemetry systems, a full redundant high-performance control section with delayed command capability was designed for the Small Astronomy Satellite-3 (SAS-3). The relay command system of SAS-3 is characterized by 56 bystate relay commands, with capability for handling up to 64 commands in future versions. The 'short' data command service of SAS-1 and SAS-2 consisting of shifting 24-bit words to two users was expanded to five users and augmented with a 'long load' data command service (up to 4080 bits) used to program the telemetry system and the delayed command subsystem. The inclusion of a delayed command service ensures a program of up to 30 relay or short data commands to be loaded for execution at designated times. The design and system operation of the SAS-3 command section are analyzed, with special attention given to the delayed command subsystem.

Global structure of mantle isotopic heterogeneity and its implications for mantle differentiation and convection

NASA Astrophysics Data System (ADS)

Iwamori, Hikaru; Albaréde, Francis; Nakamura, Hitomi

2010-11-01

In order to further our understanding of the global geochemical structure and mantle dynamics, a global isotopic data set of oceanic basalts was analyzed by Independent Component Analysis (ICA), a relatively new method of multivariate analysis. The data set consists of 2773 mid-ocean ridge basalts (MORB) and 1515 ocean island basalts (OIB) with five isotopic ratios of Pb, Nd and Sr. The data set spatially covers the major oceans and enables us to compare the results with global geophysical observations. Three independent components (ICs) have been found, two of which are essentially identical to those previously found for basalts from the Atlantic and Indian Oceans. The two ICs (IC1 and IC2) span a compositional plane that accounts for 95.7% of the sample variance, while the third IC (IC3) accounts for 3.7%. Based on the geochemical nature of ICs and a forward model concerning trace elemental and isotopic compositions, the origin of the ICs is discussed. IC1 discriminates OIB from MORB, and may be related to elemental fractionation associated with melting and the subsequent radiogenic in growth with an average recycling time of 0.8 to 2.4 Ga. IC2 tracks the regional provenance of both MORB and OIB and may be related to aqueous fluid-rock interaction and the subsequent radiogenic ingrowth with an average recycling time of 0.3 to 0.9 Ga. IC3 fingerprints upper continental crustal material and its high value appears in limited geographical and tectonic settings. Variations in the melt component (IC1) and in the aqueous fluid component (IC2) inherited in the mantle most likely reflect mid-ocean ridge and subduction zone processes, respectively. Long-term accumulation of dense materials rich in the IC1 melt component at the base of the convective mantle accounts for its longer recycling time with respect to that for less dense materials rich in the aqueous fluid component (IC2). IC2 broadly correlates with the seismic velocity structures of the lowermost mantle and electric conductivity around the mantle transition zones. We propose that IC2 reflects hydrogen distribution within the mantle and that several global domains enriched in hydrogen could exist as vertical sectors extending all the way down to the core-mantle boundary.

Muscle sympathetic nerve responses to passive and active one-legged cycling: insights into the contributions of central command.

PubMed

Doherty, Connor J; Incognito, Anthony V; Notay, Karambir; Burns, Matthew J; Slysz, Joshua T; Seed, Jeremy D; Nardone, Massimo; Burr, Jamie F; Millar, Philip J

2018-01-01

The contribution of central command to the peripheral vasoconstrictor response during exercise has been investigated using primarily handgrip exercise. The purpose of the present study was to compare muscle sympathetic nerve activity (MSNA) responses during passive (involuntary) and active (voluntary) zero-load cycling to gain insights into the effects of central command on sympathetic outflow during dynamic exercise. Hemodynamic measurements and contralateral leg MSNA (microneurography) data were collected in 18 young healthy participants at rest and during 2 min of passive and active zero-load one-legged cycling. Arterial baroreflex control of MSNA burst occurrence and burst area were calculated separately in the time domain. Blood pressure and stroke volume increased during exercise ( P < 0.0001) but were not different between passive and active cycling ( P > 0.05). In contrast, heart rate, cardiac output, and total vascular conductance were greater during the first and second minute of active cycling ( P < 0.001). MSNA burst frequency and incidence decreased during passive and active cycling ( P < 0.0001), but no differences were detected between exercise modes ( P > 0.05). Reductions in total MSNA were attenuated during the first ( P < 0.0001) and second ( P = 0.0004) minute of active compared with passive cycling, in concert with increased MSNA burst amplitude ( P = 0.02 and P = 0.005, respectively). The sensitivity of arterial baroreflex control of MSNA burst occurrence was lower during active than passive cycling ( P = 0.01), while control of MSNA burst strength was unchanged ( P > 0.05). These results suggest that central feedforward mechanisms are involved primarily in modulating the strength, but not the occurrence, of a sympathetic burst during low-intensity dynamic leg exercise. NEW & NOTEWORTHY Muscle sympathetic nerve activity burst frequency decreased equally during passive and active cycling, but reductions in total muscle sympathetic nerve activity were attenuated during active cycling. These results suggest that central command primarily regulates the strength, not the occurrence, of a muscle sympathetic burst during low-intensity dynamic leg exercise.

14 CFR 91.1031 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Pilot in command or second in command... RULES Fractional Ownership Operations Program Management § 91.1031 Pilot in command or second in command: Designation required. (a) Each program manager must designate a— (1) Pilot in command for each program flight...

32 CFR 724.405 - Commandant of the Marine Corps or the Commander, Naval Military Personnel Command.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Commandant of the Marine Corps or the Commander, Naval Military Personnel Command. 724.405 Section 724.405 National Defense Department of Defense... Personnel Command. Personnel managers of the Marine Corps and the Navy; responsible for providing limited...

32 CFR 700.1058 - Command of a submarine.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Command of a submarine. 700.1058 Section 700... Command Detail to Duty § 700.1058 Command of a submarine. The officer detailed to command a submarine shall be an officer of the line in the Navy, eligible for command at sea and qualified for command of...

14 CFR 135.109 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Pilot in command or second in command... ON BOARD SUCH AIRCRAFT Flight Operations § 135.109 Pilot in command or second in command: Designation required. (a) Each certificate holder shall designate a— (1) Pilot in command for each flight; and (2...

32 CFR 724.405 - Commandant of the Marine Corps or the Commander, Naval Military Personnel Command.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Commandant of the Marine Corps or the Commander, Naval Military Personnel Command. 724.405 Section 724.405 National Defense Department of Defense... Personnel Command. Personnel managers of the Marine Corps and the Navy; responsible for providing limited...

14 CFR 1214.703 - Chain of command.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Chain of command. 1214.703 Section 1214.703... Shuttle Commander § 1214.703 Chain of command. (a) The Commander is a career NASA astronaut who has been... particular flight and is second in command of the flight. If the commander is unable to carry out the...

14 CFR 135.109 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Pilot in command or second in command... ON BOARD SUCH AIRCRAFT Flight Operations § 135.109 Pilot in command or second in command: Designation required. (a) Each certificate holder shall designate a— (1) Pilot in command for each flight; and (2...

32 CFR 724.405 - Commandant of the Marine Corps or the Commander, Naval Military Personnel Command.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Commandant of the Marine Corps or the Commander, Naval Military Personnel Command. 724.405 Section 724.405 National Defense Department of Defense... Personnel Command. Personnel managers of the Marine Corps and the Navy; responsible for providing limited...

32 CFR 724.405 - Commandant of the Marine Corps or the Commander, Naval Military Personnel Command.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Commandant of the Marine Corps or the Commander, Naval Military Personnel Command. 724.405 Section 724.405 National Defense Department of Defense... Personnel Command. Personnel managers of the Marine Corps and the Navy; responsible for providing limited...

14 CFR 91.1031 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Pilot in command or second in command... RULES Fractional Ownership Operations Program Management § 91.1031 Pilot in command or second in command: Designation required. (a) Each program manager must designate a— (1) Pilot in command for each program flight...

32 CFR 700.1058 - Command of a submarine.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Command of a submarine. 700.1058 Section 700... Command Detail to Duty § 700.1058 Command of a submarine. The officer detailed to command a submarine shall be an officer of the line in the Navy, eligible for command at sea and qualified for command of...

14 CFR 1214.703 - Chain of command.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Chain of command. 1214.703 Section 1214.703... Shuttle Commander § 1214.703 Chain of command. (a) The Commander is a career NASA astronaut who has been... particular flight and is second in command of the flight. If the commander is unable to carry out the...

14 CFR 91.1031 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Pilot in command or second in command... RULES Fractional Ownership Operations Program Management § 91.1031 Pilot in command or second in command: Designation required. (a) Each program manager must designate a— (1) Pilot in command for each program flight...

32 CFR 700.1058 - Command of a submarine.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Command of a submarine. 700.1058 Section 700... Command Detail to Duty § 700.1058 Command of a submarine. The officer detailed to command a submarine shall be an officer of the line in the Navy, eligible for command at sea and qualified for command of...

32 CFR 700.1058 - Command of a submarine.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Command of a submarine. 700.1058 Section 700... Command Detail to Duty § 700.1058 Command of a submarine. The officer detailed to command a submarine shall be an officer of the line in the Navy, eligible for command at sea and qualified for command of...

14 CFR 135.109 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Pilot in command or second in command... ON BOARD SUCH AIRCRAFT Flight Operations § 135.109 Pilot in command or second in command: Designation required. (a) Each certificate holder shall designate a— (1) Pilot in command for each flight; and (2...

14 CFR 135.109 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Pilot in command or second in command... ON BOARD SUCH AIRCRAFT Flight Operations § 135.109 Pilot in command or second in command: Designation required. (a) Each certificate holder shall designate a— (1) Pilot in command for each flight; and (2...

32 CFR 700.1058 - Command of a submarine.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Command of a submarine. 700.1058 Section 700... Command Detail to Duty § 700.1058 Command of a submarine. The officer detailed to command a submarine shall be an officer of the line in the Navy, eligible for command at sea and qualified for command of...

32 CFR 724.405 - Commandant of the Marine Corps or the Commander, Naval Military Personnel Command.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Commandant of the Marine Corps or the Commander, Naval Military Personnel Command. 724.405 Section 724.405 National Defense Department of Defense... Personnel Command. Personnel managers of the Marine Corps and the Navy; responsible for providing limited...

14 CFR 1214.703 - Chain of command.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Chain of command. 1214.703 Section 1214.703... Shuttle Commander § 1214.703 Chain of command. (a) The Commander is a career NASA astronaut who has been... particular flight and is second in command of the flight. If the commander is unable to carry out the...

14 CFR 1214.703 - Chain of command.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Chain of command. 1214.703 Section 1214.703... Shuttle Commander § 1214.703 Chain of command. (a) The Commander is a career NASA astronaut who has been... particular flight and is second in command of the flight. If the commander is unable to carry out the...

14 CFR 135.109 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Pilot in command or second in command... ON BOARD SUCH AIRCRAFT Flight Operations § 135.109 Pilot in command or second in command: Designation required. (a) Each certificate holder shall designate a— (1) Pilot in command for each flight; and (2...

14 CFR 91.1031 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Pilot in command or second in command... RULES Fractional Ownership Operations Program Management § 91.1031 Pilot in command or second in command: Designation required. (a) Each program manager must designate a— (1) Pilot in command for each program flight...

14 CFR 91.1031 - Pilot in command or second in command: Designation required.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Pilot in command or second in command... RULES Fractional Ownership Operations Program Management § 91.1031 Pilot in command or second in command: Designation required. (a) Each program manager must designate a— (1) Pilot in command for each program flight...

The Fort McMurray, Alberta wildfires: Emergency and recovery management of healthcare services.

PubMed

Matear, David

2017-01-01

One of the largest wildfires in Canadian history raged through northern Alberta in May to July 2016, and prompted the largest emergency air evacuation in Canadian history. Central to the challenges were the evacuation of a regional hospital, and the emergency and recovery management associated with healthcare services. This paper describes multiple phases of emergency and recovery management, which employed and adapted the Incident Command System to healthcare services. There were no injuries reported throughout the medical evacuation and recovery of medical services. The leadership and management of healthcare services achieved the goals of evacuating patients and staff effectively, supporting emergency first responders and the re-entry of the population to Fort McMurray.

2007 Ikhana Western States and Southern California Emergency UAS Fire Missions

NASA Technical Reports Server (NTRS)

Cobleigh, Brent

2008-01-01

Four demonstration and four emergency fire imaging missions completed: a) Thermal infrared imagery delivered in near real-time (5 to 15 minutes) to: 1) SoCal Emergency: FEMA, NIFC, NorthCom, California EOC; 2) Demo Flights: NIFC, Individual Fire Incident Commands. Imagery used for tactical and strategic decision making. Air Traffic Control gave excellent support. Mission plans flown in reverse. Real time requests for revisits of active fires. Added new fire during mission. Moved fire loiter points as fires moved. Real-time reroute around thunderstorm activity. Pre & Post flight telecons with FAA were held to review mission and discuss operational improvements. No issues with air traffic control during the 8 fire missions flown.

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

Brouillette, Greg A.

These are slides for various presentations on C41SR and urban disasters disasters response and recovery tools. These are all mainly charts and images of disaster response and recovery tools. Slides included have headings such as the following: vignette of a disaster response, situational awareness and common operating picture available to EOC, plume modeling capability, Program ASPECT Chemical Response Products, EPA ASPECT - Hurricane RITA Response 9/25/2005, Angel Fire Imagery, incident commander's view/police chief's view/ EMS' view, common situational awareness and collaborative planning, exercise, training capability, systems diagram, Austere Challenge 06 Sim/C4 Requirements, common situational awareness and collaborative planning, exercise, trainingmore » environment, common situational awareness, real world, crisis response, and consequence management.« less

Preparing for veterinary emergencies: disaster management and the Incident Command System.

PubMed

Madigan, J; Dacre, I

2009-08-01

An important question that all veterinary schools should consider is whether veterinary students should be trained to deal with local or regional states of emergency or disasters, such as hurricanes, tornadoes, wildfires, hail and ice storms, wind storms, fires, earthquakes, tsunamis, floods and epidemics. When a large-scale emergency or disaster does strike, the consequences can be dire for the domestic and wild animals of the region and for the humans within the vicinity of seriously and painfully injured animals. The authors argue that emergency preparedness is essential for the veterinary profession to meet its obligations to both animals and humans. The four basic components of disaster management are: mitigation, preparedness, response/emergency relief and recovery.