LSA silicon material task closed-cycle process development

NASA Technical Reports Server (NTRS)

Roques, R. A.; Wakefield, G. F.; Blocher, J. M., Jr.; Browning, M. F.; Wilson, W.

1979-01-01

The initial effort on feasibility of the closed cycle process was begun with the design of the two major items of untested equipment, the silicon tetrachloride by product converter and the rotary drum reactor for deposition of silicon from trichlorosilane. The design criteria of the initial laboratory equipment included consideration of the reaction chemistry, thermodynamics, and other technical factors. Design and construction of the laboratory equipment was completed. Preliminary silicon tetrachloride conversion experiments confirmed the expected high yield of trichlorosilane, up to 98 percent of theoretical conversion. A preliminary solar-grade polysilicon cost estimate, including capital costs considered extremely conservative, of $6.91/kg supports the potential of this approach to achieve the cost goal. The closed cycle process appears to have a very likely potential to achieve LSA goals.

Oleic Acid enhances all-trans retinoic Acid loading in nano-lipid emulsions.

PubMed

Chinsriwongkul, Akhayachatra; Opanasopit, Praneet; Ngawhirunpat, Tanasait; Rojanarata, Theerasak; Sila-On, Warisada; Ruktanonchai, Uracha

2010-01-01

The aim of this study was to investigate the enhancement of all-trans retinoic acid (ATRA) loading in nano-lipid emulsions and stability by using oleic acid. The effect of formulation factors including initial ATRA concentration and the type of oil on the physicochemical properties, that is, percentage yield, percentage drug release, and photostability of formulations, was determined. The solubility of ATRA was increased in the order of oleic acid > MCT > soybean oil > water. The physicochemical properties of ATRA-loaded lipid emulsion, including mean particle diameter and zeta potential, were modulated by changing an initial ATRA concentration as well as the type and mixing ratio of oil and oleic acid as an oil phase. The particles of lipid emulsions had average sizes of less than 250 nm and negative zeta potential. The addition of oleic acid in lipid emulsions resulted in high loading capacity. The photodegradation rate was found to be dependent on the initial drug concentration but independent of the type of oily phase used in this study. The release rates were not affected by initial ATRA concentration but were affected by the type of oil, where oleic acid showed the highest release rate of ATRA from lipid emulsions.

Effectiveness of a Model Bundle Payment Initiative for Femur Fracture Patients.

PubMed

Lott, Ariana; Belayneh, Rebekah; Haglin, Jack; Konda, Sanjit; Egol, Kenneth A

2018-05-28

Analyze the effectiveness of a BPCI (Bundle Payments for Care Improvement) initiative for patients who would be included in a future potential Surgical Hip and Femur Fracture Treatment (SHFFT) bundle. Retrospective cohort SETTING:: Single Academic Institution PATIENTS/PARTICIPANTS:: Patients discharged with operative fixation of a hip or femur fracture (DRG codes 480-482) between 1/2015-10/2016 were included. A BPCI initiative based upon an established program for BPCI Total Joint Arthroplasty (TJA) was initiated for patients with hip and femur fractures in January 2016. Patients were divided into non-bundle (care before initiative) and bundle (care with initiative) cohorts. Application of BPCI principles MAIN OUTCOME MEASURES:: Length of stay, location of discharge, readmissions RESULTS:: 116 patients participated in the "institutional bundle," and 126 received care prior to the initiative. There was a trend towards decreased mean length of stay, (7.3 ± 6.3 days vs. 6.8 ± 4.0 days, p=0.457) and decreased readmission within 90 days (22.2% vs. 18.1%, p=0.426). The number of patients discharged home doubled (30.2% vs. 14.3%, p=0.008). There was no difference in readmission rates in bundle vs. non-bundle patients based on discharged home status; however, bundle patients discharged to SNF trended towards less readmissions than non-bundle patients discharged to SNF (37.3% vs. 50.6%, p=0.402). Mean episode cost reduction due to initiative was estimated to be $6,450 using Medicare reimbursement data. This study demonstrates the potential success of a BPCI initiative at one institution in decreasing post-acute care facility utilization and cost of care when used for a hip and femur fracture population. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

British Airways' pre-command training program

NASA Technical Reports Server (NTRS)

Holdstock, L. F. J.

1980-01-01

Classroom, flight simulator, and in-flight sessions of an airline pilot training program are briefly described. Factors discussed include initial command potential assessment, precommand airline management studies course, precommand course, and command course.

Nuclear health and safety

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

Glenn, J.

1991-02-01

There has been concern over the Department of Energy's (DOE) dual role of producing nuclear weapons and assessing the potential health hazards associated with operating its facilities has raised questions about DOE's ability to effectively manage its health and health effects (epidemiology) research programs. In March 1990, the secrecy of Energy announced several initiatives to address these concerns. These initiatives include, among others, the development of an occupational health and epidemiology program, the transfer of long-term health effects' studies to the Department of Health and Human Services (HHS), the establishment of an advisory committee to oversee DOE's environmental, safety, andmore » health activities, and the design of a data base to store and retrieve health data. This paper provides a brief description of DOE's initiatives, including their status as of December 1990 and general observations of these initiatives.« less

Probabilistic Reversal Learning in Schizophrenia: Stability of Deficits and Potential Causal Mechanisms.

PubMed

Reddy, Lena Felice; Waltz, James A; Green, Michael F; Wynn, Jonathan K; Horan, William P

2016-07-01

Although individuals with schizophrenia show impaired feedback-driven learning on probabilistic reversal learning (PRL) tasks, the specific factors that contribute to these deficits remain unknown. Recent work has suggested several potential causes including neurocognitive impairments, clinical symptoms, and specific types of feedback-related errors. To examine this issue, we administered a PRL task to 126 stable schizophrenia outpatients and 72 matched controls, and patients were retested 4 weeks later. The task involved an initial probabilistic discrimination learning phase and subsequent reversal phases in which subjects had to adjust their responses to sudden shifts in the reinforcement contingencies. Patients showed poorer performance than controls for both the initial discrimination and reversal learning phases of the task, and performance overall showed good test-retest reliability among patients. A subgroup analysis of patients (n = 64) and controls (n = 49) with good initial discrimination learning revealed no between-group differences in reversal learning, indicating that the patients who were able to achieve all of the initial probabilistic discriminations were not impaired in reversal learning. Regarding potential contributors to impaired discrimination learning, several factors were associated with poor PRL, including higher levels of neurocognitive impairment, poor learning from both positive and negative feedback, and higher levels of indiscriminate response shifting. The results suggest that poor PRL performance in schizophrenia can be the product of multiple mechanisms. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

NEP processing, operations, and disposal

NASA Technical Reports Server (NTRS)

Stancati, Mike

1993-01-01

Several recent studies by ASAO/NPO staff members at LeRC and by other organizations have highlighted the potential benefits of using Nuclear Electric Propulsion (NEP) as the primary transportation means for some of the proposed missions of the Space Exploration Initiative. These include the potential to reduce initial mass in orbit and Mars transit time. Modular NEP configurations also introduce fully redundant main propulsion to Mars flight systems adding several abort or fall back options not otherwise available. Recent studies have also identified mission operations, such as on orbital assembly, refurbishment, and reactor disposal, as important discriminators for propulsion system evaluation. This study is intended to identify and assess 'end-to-end' operational issues associated with using NEP for transporting crews and cargo between Earth and Mars. We also include some consideration of lunar cargo transfer as well.

The Effects of Governmental Protected Areas and Social Initiatives for Land Protection on the Conservation of Mexican Amphibians

PubMed Central

Ochoa-Ochoa, Leticia; Urbina-Cardona, J. Nicolás; Vázquez, Luis-Bernardo; Flores-Villela, Oscar; Bezaury-Creel, Juan

2009-01-01

Traditionally, biodiversity conservation gap analyses have been focused on governmental protected areas (PAs). However, an increasing number of social initiatives in conservation (SICs) are promoting a new perspective for analysis. SICs include all of the efforts that society implements to conserve biodiversity, such as land protection, from private reserves to community zoning plans some of which have generated community-protected areas. This is the first attempt to analyze the status of conservation in Latin America when some of these social initiatives are included. The analyses were focused on amphibians because they are one of the most threatened groups worldwide. Mexico is not an exception, where more than 60% of its amphibians are endemic. We used a niche model approach to map the potential and real geographical distribution (extracting the transformed areas) of the endemic amphibians. Based on remnant distribution, all the species have suffered some degree of loss, but 36 species have lost more than 50% of their potential distribution. For 50 micro-endemic species we could not model their potential distribution range due to the small number of records per species, therefore the analyses were performed using these records directly. We then evaluated the efficiency of the existing set of governmental protected areas and established the contribution of social initiatives (private and community) for land protection for amphibian conservation. We found that most of the species have some proportion of their potential ecological niche distribution protected, but 20% are not protected at all within governmental PAs. 73% of endemic and 26% of micro-endemic amphibians are represented within SICs. However, 30 micro-endemic species are not represented within either governmental PAs or SICs. This study shows how the role of land conservation through social initiatives is therefore becoming a crucial element for an important number of species not protected by governmental PAs. PMID:19721719

Risk Factors for Initiation of Potentially Inappropriate Medications in Community-Dwelling Older Adults with and without Alzheimer's Disease.

PubMed

Hyttinen, Virva; Taipale, Heidi; Tanskanen, Antti; Tiihonen, Jari; Tolppanen, Anna-Maija; Hartikainen, Sirpa; Valtonen, Hannu

2017-01-01

Various criteria have been created to define potentially inappropriate medications (PIMs) to help improve the quality and safety of medicine use in older patients. Individuals with Alzheimer's disease (AD) may be at higher risk of adverse drug events associated with PIMs (such as falls). Our objective was to determine the risk factors for PIM initiation in a nationwide cohort of community dwellers aged ≥65 years with and without AD. The Finnish nationwide MEDALZ cohort includes all patients diagnosed with AD in 2005-2011 (n = 70,718) and two comparison individuals without AD (non-AD) matched for age, sex and region of residence for each person with AD. After a 1-year washout period for PIM use and exclusion of those aged <65 years, we included 50,494 patients with AD and 106,306 comparison subjects. PIM use was defined according to Finnish criteria. Subjects without AD initiated PIMs more frequently than those with AD (16.4 vs. 12.2%, respectively; p < 0.001). The most common PIMs were muscle relaxants and urinary antispasmodics. Older individuals (aged ≥75 years) were less likely to initiate PIMs. In the AD group, women were less likely to initiate PIMs than men. More comorbidities were associated with PIM initiation, especially in the non-AD group. The use of opioids or psychotropic medicines was associated with PIM initiation in both cohorts. Regional differences between university hospital districts were observed. PIM initiation was dependent on patient characteristics and possibly also some healthcare system-related factors such as differing regional treatment practices. It is important that medicines prescribed to the older vulnerable population are assessed regularly to avoid adverse effects and ensure safe pharmacotherapy, especially in those with multiple comorbidities.

Maine Tidal Power Initiative: Environmental Impact Protocols For Tidal Power

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

Peterson, Michael Leroy; Zydlewski, Gayle Barbin; Xue, Huijie

2014-02-02

The Maine Tidal Power Initiative (MTPI), an interdisciplinary group of engineers, biologists, oceanographers, and social scientists, has been conducting research to evaluate tidal energy resources and better understand the potential effects and impacts of marine hydro-kinetic (MHK) development on the environment and local community. Project efforts include: 1) resource assessment, 2) development of initial device design parameters using scale model tests, 3) baseline environmental studies and monitoring, and 4) human and community responses. This work included in-situ measurement of the environmental and social response to the pre-commercial Turbine Generator Unit (TGU®) developed by Ocean Renewable Power Company (ORPC) as wellmore » as considering the path forward for smaller community scale projects.« less

The emerging Haemophilus influenzae serotype a infection and a potential vaccine: Implementation science in action

PubMed Central

Barreto, L; Cox, AD; Ulanova, M; Bruce, MG; Tsang, RSW

2017-01-01

Haemophilus influenzae serotype b (Hib) was a major cause of meningitis in children until Hib conjugate vaccine was introduced into the routine infant immunization program and Hib disease in children was almost eliminated. In Alaska, northern Canada and other countries with Indigenous peoples, H. influenzae serotype a (Hia) has emerged as a significant cause of pneumonia, meningitis and septic arthritis especially in children under 24 months of age. A joint government initiative between the Public Health Agency of Canada (PHAC) and the National Research Council of Canada (NRC) was carried out to assess whether an Hia vaccine could be developed for the common good. The initiative included strategic partnerships with clinician researchers in Thunder Bay, Ontario who provide health services to Indigenous people and the Artic Investigations Program (AIP) of the United States Centers for Disease Control and Prevention (CDC) in Alaska. This government initiated and funded research identified that the development of an Hia vaccine is possible and ongoing surveillance that includes strain characterization is essential to understand the potential spread of Hia in North America and around the world. PMID:29770070

The emerging Haemophilus influenzae serotype a infection and a potential vaccine: Implementation science in action.

PubMed

Barreto, L; Cox, A D; Ulanova, M; Bruce, M G; Tsang, Rsw

2017-05-04

Haemophilus influenzae serotype b (Hib) was a major cause of meningitis in children until Hib conjugate vaccine was introduced into the routine infant immunization program and Hib disease in children was almost eliminated. In Alaska, northern Canada and other countries with Indigenous peoples, H. influenzae serotype a (Hia) has emerged as a significant cause of pneumonia, meningitis and septic arthritis especially in children under 24 months of age. A joint government initiative between the Public Health Agency of Canada (PHAC) and the National Research Council of Canada (NRC) was carried out to assess whether an Hia vaccine could be developed for the common good. The initiative included strategic partnerships with clinician researchers in Thunder Bay, Ontario who provide health services to Indigenous people and the Artic Investigations Program (AIP) of the United States Centers for Disease Control and Prevention (CDC) in Alaska. This government initiated and funded research identified that the development of an Hia vaccine is possible and ongoing surveillance that includes strain characterization is essential to understand the potential spread of Hia in North America and around the world.

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... potential (risk factors) for depression, including current or past experiences with depression or other mood... of depression, which the physician or other qualified nonphysician practitioner may select from...

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... potential (risk factors) for depression, including current or past experiences with depression or other mood... of depression, which the physician or other qualified nonphysician practitioner may select from...

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... potential (risk factors) for depression, including current or past experiences with depression or other mood... of depression, which the physician or other qualified nonphysician practitioner may select from...

New on the Shelf: Teens in the Library--Summary of Key Findings from the Evaluation of Public Libraries as Partners in Youth Development, A Wallace Foundation Initiative. Chapin Hall Discussion Paper

ERIC Educational Resources Information Center

Spielberger, Julie; Horton, Carol; Michels, Lisa

2004-01-01

Public libraries that engage and employ teenagers can realize mutual benefits, including meaningful activities for young people and strengthened ties between libraries and their communities. This report summarizes both the potential benefits and challenges learned from Wallace's Public Libraries as Partners in Youth Development initiative. The…

Differential distribution of voltage-gated ion channels in cortical neurons: implications for epilepsy.

PubMed

Child, Nicholas D; Benarroch, Eduardo E

2014-03-18

Neurons contain different functional somatodendritic and axonal domains, each with a characteristic distribution of voltage-gated ion channels, synaptic inputs, and function. The dendritic tree of a cortical pyramidal neuron has 2 distinct domains, the basal and the apical dendrites, both containing dendritic spines; the different domains of the axon are the axonal initial segment (AIS), axon proper (which in myelinated axons includes the node of Ranvier, paranodes, juxtaparanodes, and internodes), and the axon terminals. In the cerebral cortex, the dendritic spines of the pyramidal neurons receive most of the excitatory synapses; distinct populations of γ-aminobutyric acid (GABA)ergic interneurons target specific cellular domains and thus exert different influences on pyramidal neurons. The multiple synaptic inputs reaching the somatodendritic region and generating excitatory postsynaptic potentials (EPSPs) and inhibitory postsynaptic potentials (IPSPs) sum and elicit changes in membrane potential at the AIS, the site of initiation of the action potential.

Cost analysis for the implementation of a medication review with follow-up service in Spain.

PubMed

Noain, Aranzazu; Garcia-Cardenas, Victoria; Gastelurrutia, Miguel Angel; Malet-Larrea, Amaia; Martinez-Martinez, Fernando; Sabater-Hernandez, Daniel; Benrimoj, Shalom I

2017-08-01

Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.

Assessment of health impacts of decreased smoking prevalence in Copenhagen: Application of the DYNAMO-HIA model.

PubMed

Holm, Astrid Ledgaard; Brønnum-Hansen, Henrik; Robinson, Kirstine Magtengaard; Diderichsen, Finn

2014-07-01

Tobacco smoking is among the leading risk factors for chronic disease and early death in developed countries, including Denmark, where smoking causes 14% of the disease burden. In Denmark, many public health interventions, including smoking prevention, are undertaken by the municipalities, but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark. The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data from Danish population registers. We modelled the effects of four intervention scenarios aimed at different target groups, compared to a reference scenario. The potential effects of each scenario were modelled until 2040. A combined scenario affecting both initiation rates among youth, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re-initiation rates, whereas an intervention targeting only initiation among youth had marginal effects on morbidity and mortality within the modelled time frame. By modifying the DYNAMO-HIA model, we were able to estimate the potential health effects of four interventions to reduce smoking prevalence in the population of Copenhagen. The effect of the interventions on future public health depended on population subgroup(s) targeted, duration of implementation and intervention reach. © 2014 the Nordic Societies of Public Health.

PHP-HT (VitaResc Biotech).

PubMed

Baldwin, A; Wiley, E

2001-04-01

VitaResc (formerly Apex) is developing PHP-HT, pyridoxalated hemoglobin polyoxyethylene conjugate, for the potential treatment of nitric oxide-induced shock (characterized by hypotension), associated with various etiologies, initially in septic shock. A phase I safety study and an initial phase I/II patient trial for NO-induced shock have been completed, and VitaResc has enrolled patients in three of five planned cohorts in a continuation of these trials to include a protocol of continuous infusion and dose escalation [330680,349187,390918]. The results from the dose escalation trials are expected to provide the basis for a randomized, controlled phase II/III pivotal trial of PHP-HT [390918]. VitaResc has licensed PHP-HT exclusively from Ajinomoto for all indications, worldwide, except Japan [275263]. Ajinomoto originally developed the human derived and chemically modified hemoglobin preparation as a blood substitute, but no development has been reported by the company since 1997 [275277,303577]. The other potential indications of PHP-HT include shock associated with burns, pancreatitis, hemodialysis and cytokine therapies [275277]. VitaResc expects the annual market potential of PHP-HT to exceed 1 billion dollars [330680].

The National Nanotechnology Initiative: Potential Impact on DoD

DTIC Science & Technology

2007-03-19

estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data...number. 1 . REPORT DATE 19 MAR 2007 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE The National Nanotechnology Initiative...critical property is attributable to a structure with at least one dimension limited to the nanometer size scale, ~ 1 – 100 nanometers1. Below that size

CCS Activities Being Performed by the U.S. DOE

PubMed Central

Dressel, Brian; Deel, Dawn; Rodosta, Traci; Plasynski, Sean; Litynski, John; Myer, Larry

2011-01-01

The United States Department of Energy (DOE) is the lead federal agency for the development and deployment of carbon sequestration technologies. Its mission includes promoting scientific and technological innovations and transfer of knowledge for safe and permanent storage of CO2 in the subsurface. To accomplish its mission, DOE is characterizing and classifying potential geologic storage reservoirs in basins throughout the U.S. and Canada, and developing best practices for project developers, to help ensure the safety of future geologic storage projects. DOE’s Carbon Sequestration Program, Regional Carbon Sequestration Partnership (RCSP) Initiative, administered by the National Energy Technology Laboratory (NETL), is identifying, characterizing, and testing potential injection formations. The RCSP Initiative consists of collaborations among government, industry, universities, and international organizations. Through this collaborative effort, a series of integrated knowledge-based tools have been developed to help potential sequestration project developers. They are the Carbon Sequestration Atlas of the United States and Canada, National Carbon Sequestration Database and Geographic System (NATCARB), and best practice manuals for CCS including Depositional Reservoir Classification for CO2; Public Outreach and Education for Carbon Storage Projects; Monitoring, Verification, and Accounting of CO2 Stored in Deep Geologic Formation; Site Screening, Site Selection, and Initial Characterization of CO2 Storage in Deep Geologic Formations. DOE’s future research will help with refinement of these tools and additional best practice manuals (BPM) which focus on other technical aspects of project development. PMID:21556188

eHealth and mHealth initiatives in Bangladesh: a scoping study.

PubMed

Ahmed, Tanvir; Lucas, Henry; Khan, Azfar Sadun; Islam, Rubana; Bhuiya, Abbas; Iqbal, Mohammad

2014-06-16

The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O'Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully. Additional formative and operational research is essential to explore the true potential of the technology. Frameworks for regulation in regards to eHealth governance should be the aim of future research on the integration of eHealth and mHealth into the Bangladesh health system.

eHealth and mHealth initiatives in Bangladesh: A scoping study

PubMed Central

2014-01-01

Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. Methods This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Results Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully. Additional formative and operational research is essential to explore the true potential of the technology. Frameworks for regulation in regards to eHealth governance should be the aim of future research on the integration of eHealth and mHealth into the Bangladesh health system. PMID:24934164

ARIES Oxide Production Program Assessment of Risk to Long-term Sustainable Production Rate

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

Whitworth, Julia; Lloyd, Jane Alexandria; Majors, Harry W.

2017-05-04

This report describes an assessment of risks and the development of a risk watch list for the ARIES Oxide Production Program conducted in the Plutonium Facility at LANL. The watch list is an active list of potential risks and opportunities that the management team periodically considers to maximize the likelihood of program success. The initial assessments were made in FY 16. The initial watch list was reviewed in September 2016. The initial report was not issued. Revision 1 has been developed based on management review of the original watch list and includes changes that occurred during FY-16.

Metabolism of pharmaceutical and personal care products by carrot cell cultures.

PubMed

Wu, Xiaoqin; Fu, Qiuguo; Gan, Jay

2016-04-01

With the increasing use of treated wastewater and biosolids in agriculture, residues of pharmaceutical and personal care products (PPCPs) in these reused resources may contaminate food produce via plant uptake, constituting a route for human exposure. Although various PPCPs have been reported to be taken up by plants in laboratories or under field conditions, at present little information is available on their metabolism in plants. In this study, we applied carrot cell cultures to investigate the plant metabolism of PPCPs. Five phase I metabolites of carbamazepine were identified and the potential metabolism pathways of carbamazepine were proposed. We also used the carrot cell cultures as a rapid screening tool to initially assess the metabolism potentials of 18 PPCPs. Eleven PPCPs, including acetaminophen, caffeine, meprobamate, primidone, atenolol, trimethoprim, DEET, carbamazepine, dilantin, diazepam, and triclocarban, were found to be recalcitrant to metabolism. The other 7 PPCPs, including triclosan, naproxen, diclofenac, ibuprofen, gemfibrozil, sulfamethoxazole, and atorvastatin, displayed rapid metabolism, with 0.4-47.3% remaining in the culture at the end of the experiment. Further investigation using glycosidase hydrolysis showed that 1.3-20.6% of initially spiked naproxen, diclofenac, ibuprofen, and gemfibrozil were transformed into glycoside conjugates. Results from this study showed that plant cell cultures may be a useful tool for initially exploring the potential metabolites of PPCPs in plants as well as for rapidly screening the metabolism potentials of a variety of PPCPs or other emerging contaminants, and therefore may be used for prioritizing compounds for further comprehensive evaluations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Menopausal Estrogen Therapy Benefits and Risks Vary by Age, WHI Analysis Suggests

Cancer.gov

Long-term follow-up data from the Women’s Health Initiative (WHI) provide new information about the potential risks and benefits of hormone therapy to treat symptoms related to menopause, including its effect on breast cancer risk,

Sites in Mass. and Conn. are on EPA's Superfund Redevelopment Focus List

EPA Pesticide Factsheets

Today, the US EPA released its initial list of Superfund National Priorities List sites with the greatest expected redevelopment & commercial potential including two sites in New England: New Bedford Harbor in New Bedford, Mass. & Raymark Industries Inc.

Identification of Potential Chemical Carcinogens in Compendia of Gene Expression Profiles

EPA Science Inventory

Chemicals induce cancer through partially characterized adverse outcome pathways (AOPs) that include molecular initiating events (MIEs) and downstream key events (KEs). Microarray profiling of chemical-induced effects is being increasingly used in medium- and high-throughput form...

TESSX: A Mission for Space Exploration with Tethers

NASA Technical Reports Server (NTRS)

Cosmo, Mario L.; Lorenzini, Enrico C.; Gramer, Daniel J.; Hoffman, John H.; Mazzoleni, Andre P.

2005-01-01

Tethers offer significant potential for substantially increasing payload mass fraction, increasing spacecraft lifetime, enhancing long-term space travel, and enabling the understanding and development of gravity-dependent technologies required for Moon and Mars exploration. The development of the Tether Electrodynamic Spin-up and Survivability Experiment (TESSX) will support applications relevant to NASA's new exploration initiative, including: artificial gravity generation, formation flying, electrodynamic propulsion, momentum exchange, and multi-amp current collection and emission. Under the broad term TESSX, we are currently evaluating several different tether system configurations and operational modes. The initial results of this work are presented, including hardware development, orbital dynamics simulations, and electrodynamics design and analysis.

Subjective Life Expectancy Among College Students.

PubMed

Rodemann, Alyssa E; Arigo, Danielle

2017-09-14

Establishing healthy habits in college is important for long-term health. Despite existing health promotion efforts, many college students fail to meet recommendations for behaviors such as healthy eating and exercise, which may be due to low perceived risk for health problems. The goals of this study were to examine: (1) the accuracy of life expectancy predictions, (2) potential individual differences in accuracy (i.e., gender and conscientiousness), and (3) potential change in accuracy after inducing awareness of current health behaviors. College students from a small northeastern university completed an electronic survey, including demographics, initial predictions of their life expectancy, and their recent health behaviors. At the end of the survey, participants were asked to predict their life expectancy a second time. Their health data were then submitted to a validated online algorithm to generate calculated life expectancy. Participants significantly overestimated their initial life expectancy, and neither gender nor conscientiousness was related to the accuracy of these predictions. Further, subjective life expectancy decreased from initial to final predictions. These findings suggest that life expectancy perceptions present a unique-and potentially modifiable-psychological process that could influence college students' self-care.

The Quebec Rural Emergency Department Project: A Cross-Sectional Study of a Potential Two-Pronged Strategy in the Knowledge Transfer Process

PubMed Central

Poitras, Julien; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Tanguay, Alain; Simard-Racine, Geneviève

2015-01-01

Introduction Health services research generates useful knowledge. Promotion of implementation of this knowledge in medical practice is essential. Prior to initiation of a major study on rural emergency departments (EDs), we deployed two knowledge transfer strategies designed to generate interest and engagement from potential knowledge users. The objective of this paper was to review: 1) a combined project launch and media press release strategy, and 2) a pre-study survey designed to survey potential knowledge users’ opinions on the proposed study variables. Materials and Methods We evaluated the impact of the project launch (presentation at two conferences hosted by key stakeholders) and media press release via a survey of participants/stakeholders and by calculating the number of media interview requests and reports generated. We used a pre-study survey to collect potential key stakeholder’ opinions on the study variables. Results Twenty-one of Quebec’s 26 rural EDs participated in the pre-study survey (81% participation rate). The press release about the study generated 51 press articles and 20 media request for interviews, and contributed to public awareness of a major rural research initiative. In the pre-study survey, thirteen participants (46%) mentioned prior knowledge of the research project. Results from the pre-study survey revealed that all of the potential study variables were considered to be relevant for inclusion in the research project. Respondents also proposed additional variables of interest, including factors promoting retention of human resources. Conclusions The present study demonstrated the potential utility of a two-pronged knowledge transfer strategy, including a combined formal launch and press release, and a pre-study survey designed to ensure that the included variables were of interest to participants and stakeholders. PMID:25849328

Non-isomorphic radial wavenumber dependencies of residual zonal flows in ion and electron Larmor radius scales, and effects of initial parallel flow and electromagnetic potentials in a circular tokamak

NASA Astrophysics Data System (ADS)

Yamagishi, Osamu

2018-04-01

Radial wavenumber dependencies of the residual zonal potential for E × B flow in a circular, large aspect ratio tokamak is investigated by means of the collisionless gyrokinetic simulations of Rosenbluth-Hinton (RH) test and the semi-analytic approach using an analytic solution of the gyrokinetic equation Rosenbluth and Hinton (1998 Phys. Rev. Lett. 80 724). By increasing the radial wavenumber from an ion Larmor radius scale {k}r{ρ }i≲ 1 to an electron Larmor radius scale {k}r{ρ }e≲ 1, the well-known level ˜ O[1/(1+1.6{q}2/\\sqrt{r/{R}0})] is retained, while the level remains O(1) when the wavenumber is decreased from the electron to the ion Larmor radius scale, if physically same adiabatic assumption is presumed for species other than the main species that is treated kinetically. The conclusion is not modified by treating both species kinetically, so that in the intermediate scale between the ion and electron Larmor radius scale it seems difficult to determine the level uniquely. The toroidal momentum conservation property in the RH test is also investigated by including an initial parallel flow in addition to the perpendicular flow. It is shown that by taking a balance between the initial parallel flow and perpendicular flows which include both E × B flow and diamagnetic flow in the initial condition, the mechanical toroidal angular momentum is approximately conserved despite the toroidal symmetry breaking due to the finite radial wavenumber zonal modes. Effect of electromagnetic potentials is also investigated. When the electromagnetic potentials are applied initially, fast oscillations which are faster than the geodesic acoustic modes are introduced in the decay phase of the zonal modes. Although the residual level in the long time limit is not modified, this can make the time required to reach the stationary zonal flows longer and may weaken the effectiveness of the turbulent transport suppression by the zonal flows.

Improving organ donation rates by modifying the family approach process.

PubMed

Ebadat, Aileen; Brown, Carlos V R; Ali, Sadia; Guitierrez, Tim; Elliot, Eric; Dworaczyk, Sarah; Kadric, Carie; Coopwood, Ben

2014-06-01

The purpose of this study was to identify steps during family approach for organ donation that may be modified to improve consent rates of potential organ donors. Retrospective study of our local organ procurement organization (OPO) database of potential organ donors. Modifiable variables involved in the family approach of potential organ donors were collected and included race and sex of OPO representative, individual initiating approach discussion with family (RN or MD vs. OPO), length of donation discussion, use of a translator, and time of day of approach. Of 1137 potential organ donors, 661 (58%) consented and 476 (42%) declined. Consent rates were higher with matched race of donor and OPO representative (66% vs. 52%, p < 0.001), family approach by female OPO representative (67% vs. 56%, p = 0.002), if approach was initiated by OPO representative (69% vs. 49%, p < 0.001), and if consent rate was dependent on time of day the approach occurred: 6:00 am to noon (56%), noon to 6:00 pm (67%), 6:00 pm to midnight (68%), and midnight to 6:00 am (45%), p = 0.04. Family approach that led to consent lasted longer than those declining (67 vs. 43 minutes, p < 0.001). Independent predictors of consent to donation included female OPO representative (odds ratio [OR], 1.7; p = 0.006), approach discussion initiated by OPO representative (OR, 1.9; p = 0.001), and longer approach discussions (OR, 1.02; p < 0.001). The independent predictor of declined donation was the use of a translator (OR, 0.39; p = 0.01). Variables such as race and sex of OPO representative and time of day should be considered before approaching a family for organ donation. Avoiding translators during the approach process may improve donation rates. Education for health care providers should reinforce the importance of allowing OPO representatives to initiate the family approach for organ donation. Epidemiologic study, level IV. Therapeutic study, level IV.

A common evaluation framework for the African Health Initiative.

PubMed

Bryce, Jennifer; Requejo, Jennifer Harris; Moulton, Lawrence H; Ram, Malathi; Black, Robert E

2013-01-01

The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results.

Combat Wound Initiative program.

PubMed

Stojadinovic, Alexander; Elster, Eric; Potter, Benjamin K; Davis, Thomas A; Tadaki, Doug K; Brown, Trevor S; Ahlers, Stephen; Attinger, Christopher E; Andersen, Romney C; Burris, David; Centeno, Jose; Champion, Hunter; Crumbley, David R; Denobile, John; Duga, Michael; Dunne, James R; Eberhardt, John; Ennis, William J; Forsberg, Jonathan A; Hawksworth, Jason; Helling, Thomas S; Lazarus, Gerald S; Milner, Stephen M; Mullick, Florabel G; Owner, Christopher R; Pasquina, Paul F; Patel, Chirag R; Peoples, George E; Nissan, Aviram; Ring, Michael; Sandberg, Glenn D; Schaden, Wolfgang; Schultz, Gregory S; Scofield, Tom; Shawen, Scott B; Sheppard, Forest R; Stannard, James P; Weina, Peter J; Zenilman, Jonathan M

2010-07-01

The Combat Wound Initiative (CWI) program is a collaborative, multidisciplinary, and interservice public-private partnership that provides personalized, state-of-the-art, and complex wound care via targeted clinical and translational research. The CWI uses a bench-to-bedside approach to translational research, including the rapid development of a human extracorporeal shock wave therapy (ESWT) study in complex wounds after establishing the potential efficacy, biologic mechanisms, and safety of this treatment modality in a murine model. Additional clinical trials include the prospective use of clinical data, serum and wound biomarkers, and wound gene expression profiles to predict wound healing/failure and additional clinical patient outcomes following combat-related trauma. These clinical research data are analyzed using machine-based learning algorithms to develop predictive treatment models to guide clinical decision-making. Future CWI directions include additional clinical trials and study centers and the refinement and deployment of our genetically driven, personalized medicine initiative to provide patient-specific care across multiple medical disciplines, with an emphasis on combat casualty care.

Introducing Urban Food Forestry: A Multifunctional Strategy for Enhancing Urban Sustainability

NASA Astrophysics Data System (ADS)

Nicholas, K. A.; Clark, K.

2012-12-01

We propose combining elements of urban agriculture and urban forestry into what we call "urban food forestry" (UFF), the practice of growing perennial woody food-producing species ("food trees") in cities. We used four approaches at different scales to gauge the potential of UFF to enhance urban sustainability, in the context of trends including increasing urbanization, resource demands, and climate change. First, we analyzed 37 current international initiatives based around urban food trees, finding that core activities included planting, mapping, and harvesting food trees, but that only about a quarter of initiatives engaged in more than one of these activities necessary to fully utilize the food potential of urban trees. Second, we analyzed 30 urban forestry master plans, finding that only 13% included human food security among their objectives. Third, we used Burlington, Vermont as a case study to quantify the potential caloric output of publicly accessible open space if planted with Malus domestica (the common apple) under 9 different scenarios. We found that the entire caloric deficit of the very low food security population could be met on as few as 29 hectares (representing 16% of total open space), and that 98% of the daily recommended minimum intake of fruit for the entire city's population could be met under the most ambitious planting scenario. Finally, we developed a decision-making tool for selecting potential food trees appropriate for temperate urban environments, the Climate-Food-Species Matrix. We identified a total of 70 species, 30 of which we deemed "highly suitable" for urban food forestry based on their cold hardiness, drought tolerance, and edibility. We conclude that urban food forestry provides multiple pathways for building urban sustainability through local food production, and that our framework can be used to increase the coordination between and effectiveness of a growing number of related initiatives.

A potential-energy scaling model to simulate the initial stages of thin-film growth

NASA Technical Reports Server (NTRS)

Heinbockel, J. H.; Outlaw, R. A.; Walker, G. H.

1983-01-01

A solid on solid (SOS) Monte Carlo computer simulation employing a potential energy scaling technique was used to model the initial stages of thin film growth. The model monitors variations in the vertical interaction potential that occur due to the arrival or departure of selected adatoms or impurities at all sites in the 400 sq. ft. array. Boltzmann ordered statistics are used to simulate fluctuations in vibrational energy at each site in the array, and the resulting site energy is compared with threshold levels of possible atomic events. In addition to adsorption, desorption, and surface migration, adatom incorporation and diffusion of a substrate atom to the surface are also included. The lateral interaction of nearest, second nearest, and third nearest neighbors is also considered. A series of computer experiments are conducted to illustrate the behavior of the model.

Implementing microbicides in low income countries

PubMed Central

Gengiah, Tanuja; Karim, Quarraisha Abdool

2012-01-01

The magnitude of the global HIV epidemic is determined by women from lower income countries, specifically sub-Saharan Africa. Microbicides offer women who are unable to negotiate safe sex practices a self-initiated HIV prevention method. Of note, is its potential to yield significant public health benefits even with relatively conservative efficacy, coverage and user adherence estimates, making microbicides an effective intervention to invest scarce health care resources. Existing health care delivery systems provide an excellent opportunity to identify women at highest risk for infection and to also provide an access point to initiate microbicide use. Innovative quality improvement approaches, which strengthen existing sexual reproductive health services and include HIV testing, and linkages to care and treatment services provide an opportunity to lay the foundations for wide-scale provision of microbicides. The potential to enhance health outcomes in women and infants and potentially impact rates of new HIV infection may soon be realised. PMID:22498040

Searching for Variable Stars in the SDSS Calibration Fields (Abstract)

NASA Astrophysics Data System (ADS)

Smith, J. A.; Butner, M.; Tucker, D.; Allam, S.

2018-06-01

(Abstract only) We are searching the Sloan Digital Sky Survey (SDSS) calibration fields for variable stars. This long neglected data set, taken with a 0.5-m telescope, contains nearly 200,000 stars in more than 100 fields which were observed over the course of 8+ years during the observing portion of the SDSS-I and SDSS-II surveys. During the course of the survey, each field was visited from 10 to several thousand times, so our initial pass is just to identify potential variable stars. Our initial "quick-look" effort shows several thousand potential candidates and includes at least one nearby supernova. We present our plans for a follow-up observational program for further identification of variable types and period determinations.

Can observations look back to the beginning of inflation?

NASA Astrophysics Data System (ADS)

Wetterich, C.

2016-03-01

The cosmic microwave background can measure the inflaton potential only if inflation lasts sufficiently long before the time of horizon crossing of observable fluctuations, such that non-linear effects in the time evolution of Green's functions lead to a loss of memory of initial conditions for the ultraviolet tail of the spectrum. Within a derivative expansion of the quantum effective action for an interacting scalar field we discuss the most general solution for the correlation function, including arbitrary pure and mixed quantum states. In this approximation no loss of memory occurs - cosmic microwave observations see the initial spectrum at the beginning of inflation, processed only mildly by the scale-violating effects at horizon crossing induced by the inflaton potential.

Teaching Transgender

ERIC Educational Resources Information Center

Wentling, Tre; Windsor, Elroi; Schilt, Kristen; Lucal, Betsy

2008-01-01

The recent visibility of transgender lives demonstrates the dawning of a new period in the potential to include transgender topics in sociology courses. The focus on transgender individuals, communities, and inclusive initiatives are gaining momentum on many public and private college and university campuses, awakening old and new curiosities,…

AIR CONTAMINANT EXPOSURE DURING THE OPERATION OF LAWN AND GARDEN EQUIPMENT

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) initiated the Small Engine Exposure Study (SEES) to evaluate potential exposures among users of small, gasoline-powered, non-road spark-ignition (SI) lawn and garden engines. Equipment tested included riding tractors, walk-behind la...

Comparative Analysis: Potential Barriers to Career Participation by North American Physicians in Global Health

PubMed Central

Rhee, Daniel S.; Heckman, Jennifer E.

2014-01-01

Physician interest in global health, particularly among family physicians, is reflected by an increasing proliferation of field training and service experiences. However, translating initial training involvement into a defined and sustainable global health career remains difficult and beset by numerous barriers. Existing global health literature has largely examined training experiences and related ethical considerations while neglecting the role of career development in global health. To explore this, this paper extrapolates potential barriers to global health career involvement from existing literature and compares these to salary and skills requirements for archetypal physician positions in global health, presenting a framework of possible barriers to sustained physician participation in global health work. Notable barriers identified include financial limitations, scheduling conflicts, security/family concerns, skills limitations, limited awareness of opportunities, and specialty choice, with family practice often closely aligned with global health experience. Proposed solutions include financial support, protected time, family relocation support, and additional training. This framework delineates barriers to career involvement in global health by physicians. Further research regarding these barriers as well as potential solutions may help direct policy and initiatives to better utilize physicians, particularly family physicians, as a valuable global health human resource. PMID:25405030

Expected Improvements in Work Truck Efficiency Through Connectivity and Automation

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

Walkowicz, Kevin A

This presentation focuses on the potential impact of connected and automated technologies on commercial vehicle operations. It includes topics such as the U.S. Department of Energy's Energy Efficient Mobility Systems (EEMS) program and the Systems and Modeling for Accelerated Research in Transportation (SMART) Mobility Initiative. It also describes National Renewable Energy Laboratory (NREL) research findings pertaining to the potential energy impacts of connectivity and automation and stresses the need for integration and optimization to take advantage of the benefits offered by these transformative technologies while mitigating the potential negative consequences.

Potential geographic "hotspots" for drug-injection related transmission of HIV and HCV and for initiation into injecting drug use in New York City, 2011-2015, with implications for the current opioid epidemic in the US.

PubMed

Des Jarlais, D C; Cooper, H L F; Arasteh, K; Feelemyer, J; McKnight, C; Ross, Z

2018-01-01

We identified potential geographic "hotspots" for drug-injecting transmission of HIV and hepatitis C virus (HCV) among persons who inject drugs (PWID) in New York City. The HIV epidemic among PWID is currently in an "end of the epidemic" stage, while HCV is in a continuing, high prevalence (> 50%) stage. We recruited 910 PWID entering Mount Sinai Beth Israel substance use treatment programs from 2011-2015. Structured interviews and HIV/ HCV testing were conducted. Residential ZIP codes were used as geographic units of analysis. Potential "hotspots" for HIV and HCV transmission were defined as 1) having relatively large numbers of PWID 2) having 2 or more HIV (or HCV) seropositive PWID reporting transmission risk-passing on used syringes to others, and 3) having 2 or more HIV (or HCV) seronegative PWID reporting acquisition risk-injecting with previously used needles/syringes. Hotspots for injecting drug use initiation were defined as ZIP codes with 5 or more persons who began injecting within the previous 6 years. Among PWID, 96% injected heroin, 81% male, 34% White, 15% African-American, 47% Latinx, mean age 40 (SD = 10), 7% HIV seropositive, 62% HCV seropositive. Participants resided in 234 ZIP codes. No ZIP codes were identified as potential hotspots due to small numbers of HIV seropositive PWID reporting transmission risk. Four ZIP codes were identified as potential hotspots for HCV transmission. 12 ZIP codes identified as hotspots for injecting drug use initiation. For HIV, the lack of potential hotspots is further validation of widespread effectiveness of efforts to reduce injecting-related HIV transmission. Injecting-related HIV transmission is likely to be a rare, random event. HCV prevention efforts should include focus on potential hotspots for transmission and on hotspots for initiation into injecting drug use. We consider application of methods for the current opioid epidemic in the US.

75 FR 39455 - Homobrassinolide; Exemption from the Requirement of a Tolerance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

... elongation, root growth, floral initiation, etc.). B. Biochemical Pesticide Human Health Assessment Data... at http://www.regulations.gov , or, if only available in hard copy, at the Office of Pesticide... pesticide manufacturer. Potentially affected entities may include, but are not limited to: Crop production...

Geothermal Today: 2003 Geothermal Technologies Program Highlights (Revised)

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

Not Available

2004-05-01

This outreach publication highlights milestones and accomplishments of the DOE Geothermal Technologies Program for 2003. Included in this publication are discussions of geothermal fundamentals, enhanced geothermal systems, direct-use applications, geothermal potential in Idaho, coating technology, energy conversion R&D, and the GeoPowering the West initiative.

The need and approach for characterization - U.S. air force perspectives on materials state awareness

NASA Astrophysics Data System (ADS)

Aldrin, John C.; Lindgren, Eric A.

2018-04-01

This paper expands on the objective and motivation for NDE-based characterization and includes a discussion of the current approach using model-assisted inversion being pursued within the Air Force Research Laboratory (AFRL). This includes a discussion of the multiple model-based methods that can be used, including physics-based models, deep machine learning, and heuristic approaches. The benefits and drawbacks of each method is reviewed and the potential to integrate multiple methods is discussed. Initial successes are included to highlight the ability to obtain quantitative values of damage. Additional steps remaining to realize this capability with statistical metrics of accuracy are discussed, and how these results can be used to enable probabilistic life management are addressed. The outcome of this initiative will realize the long-term desired capability of NDE methods to provide quantitative characterization to accelerate certification of new materials and enhance life management of engineered systems.

A common evaluation framework for the African Health Initiative

PubMed Central

2013-01-01

Background The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. Methods This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. Results and conclusions The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results. PMID:23819778

Study terrestrial applications of solar cell powered systems

NASA Technical Reports Server (NTRS)

Ravin, J. W.

1973-01-01

Terrestrial applications of solar cells and design systems are considered for those applications that show the most promise for becoming practical and accepted by users within the next five years. The study includes the definition, categorization, evaluation and screening of the most attractive potential terrestrial applications for solar cells. Potential markets are initially grouped and categorized in a general sense and are weighted in priority by their business volume, present and future. From a categorized list including marine, transportation, security, communication, meteorological and others, 66 potential solar cell applications have been cataloged. A methodology was formulated to include the criteria for evaluation and screening. The evaluation process covers all parts and components of the complete system required for each application and gives consideration to all factors, such as engineering, economic, production, marketing and other factors that may have an influence on the acceptance of the system.

Unraveling the Links Between the Initiation of Ventilation and Brain Injury in Preterm Infants

PubMed Central

Barton, Samantha K.; Tolcos, Mary; Miller, Suzie L.; Roehr, Charles C.; Schmölzer, Georg M.; Davis, Peter G.; Moss, Timothy J. M.; LaRosa, Domenic A.; Hooper, Stuart B.; Polglase, Graeme R.

2015-01-01

The initiation of ventilation in the delivery room is one of the most important but least controlled interventions a preterm infant will face. Tidal volumes (V T) used in the neonatal intensive care unit are carefully measured and adjusted. However, the V Ts that an infant receives during resuscitation are usually unmonitored and highly variable. Inappropriate V Ts delivered to preterm infants during respiratory support substantially increase the risk of injury and inflammation to the lungs and brain. These may cause cerebral blood flow instability and initiate a cerebral inflammatory cascade. The two pathways increase the risk of brain injury and potential life-long adverse neurodevelopmental outcomes. The employment of new technologies, including respiratory function monitors, can improve and guide the optimal delivery of V Ts and reduce confounders, such as leak. Better respiratory support in the delivery room has the potential to improve both respiratory and neurological outcomes in this vulnerable population. PMID:26618148

Inclusion of Highest Glasgow Coma Scale Motor Component Score in Mortality Risk Adjustment for Benchmarking of Trauma Center Performance.

PubMed

Gomez, David; Byrne, James P; Alali, Aziz S; Xiong, Wei; Hoeft, Chris; Neal, Melanie; Subacius, Harris; Nathens, Avery B

2017-12-01

The Glasgow Coma Scale (GCS) is the most widely used measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor component (mGCS) score is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS score in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including the highest mGCS score on the performance of risk-adjustment models and subsequent external benchmarking results. Data were derived from the Trauma Quality Improvement Program analytic dataset (January 2014 through March 2015) and were limited to the severe TBI cohort (16 years or older, isolated head injury, GCS ≤8). Risk-adjustment models were created that varied in the mGCS covariates only (initial score, highest score, or both initial and highest mGCS scores). Model performance and fit, as well as external benchmarking results, were compared. There were 6,553 patients with severe TBI across 231 trauma centers included. Initial and highest mGCS scores were different in 47% of patients (n = 3,097). Model performance and fit improved when both initial and highest mGCS scores were included, as evidenced by improved C-statistic, Akaike Information Criterion, and adjusted R-squared values. Three-quarters of centers changed their adjusted odds ratio decile, 2.6% of centers changed outlier status, and 45% of centers exhibited a ≥0.5-SD change in the odds ratio of death after including highest mGCS score in the model. This study supports the concept that additional clinical information has the potential to not only improve the performance of current risk-adjustment models, but can also have a meaningful impact on external benchmarking strategies. Highest mGCS score is a good potential candidate for inclusion in additional models. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

7 CFR 1945.19 - Reporting potential natural disasters and initial actions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 13 2012-01-01 2012-01-01 false Reporting potential natural disasters and initial... Assistance-General § 1945.19 Reporting potential natural disasters and initial actions. (a) Purpose. The purpose of reporting potential natural disasters is to provide a systematic procedure for rapid reporting...

7 CFR 1945.19 - Reporting potential natural disasters and initial actions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 13 2011-01-01 2009-01-01 true Reporting potential natural disasters and initial... Assistance-General § 1945.19 Reporting potential natural disasters and initial actions. (a) Purpose. The purpose of reporting potential natural disasters is to provide a systematic procedure for rapid reporting...

7 CFR 1945.19 - Reporting potential natural disasters and initial actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Reporting potential natural disasters and initial... Assistance-General § 1945.19 Reporting potential natural disasters and initial actions. (a) Purpose. The purpose of reporting potential natural disasters is to provide a systematic procedure for rapid reporting...

Where is the spike generator of the cochlear nerve? Voltage-gated sodium channels in the mouse cochlea.

PubMed

Hossain, Waheeda A; Antic, Srdjan D; Yang, Yang; Rasband, Matthew N; Morest, D Kent

2005-07-20

The origin of the action potential in the cochlea has been a long-standing puzzle. Because voltage-dependent Na+ (Nav) channels are essential for action potential generation, we investigated the detailed distribution of Nav1.6 and Nav1.2 in the cochlear ganglion, cochlear nerve, and organ of Corti, including the type I and type II ganglion cells. In most type I ganglion cells, Nav1.6 was present at the first nodes flanking the myelinated bipolar cell body and at subsequent nodes of Ranvier. In the other ganglion cells, including type II, Nav1.6 clustered in the initial segments of both of the axons that flank the unmyelinated bipolar ganglion cell bodies. In the organ of Corti, Nav1.6 was localized in the short segments of the afferent axons and their sensory endings beneath each inner hair cell. Surprisingly, the outer spiral fibers and their sensory endings were well labeled beneath the outer hair cells over their entire trajectory. In contrast, Nav1.2 in the organ of Corti was localized to the unmyelinated efferent axons and their endings on the inner and outer hair cells. We present a computational model illustrating the potential role of the Nav channel distribution described here. In the deaf mutant quivering mouse, the localization of Nav1.6 was disrupted in the sensory epithelium and ganglion. Together, these results suggest that distinct Nav channels generate and regenerate action potentials at multiple sites along the cochlear ganglion cells and nerve fibers, including the afferent endings, ganglionic initial segments, and nodes of Ranvier.

Women and Society: The Mass Media.

ERIC Educational Resources Information Center

Busby, Linda J.

Males and females have become vitally concerned with sex-role images in the mass media because of the ubiquitous nature of the media. Mass media, which have heavily penetrated Americans' lives, have the potential for initiating, reinforcing, or denying certain social values. In studies of various media, including magazine advertising, magazine…

Host range expansion and increased damage potential of Euwallacea nr. fornicatus (Coleoptera: Curculionidae) in Florida

USDA-ARS?s Scientific Manuscript database

Ambrosia beetles in the Euwallacea nr. fornicatus complex (Coleoptera: Curculionidae) vector Fusarium spp. fungi pathogenic to susceptible hosts, including avocado. The Florida avocado production area in Miami-Dade County was surveyed for E. nr. fornicatus upon observations of initial damage in 2016...

Revegetation practices on the Santa Rita Experimental Range

Treesearch

Bruce D. Munda; Mark J. Pater

2003-01-01

This paper discusses the revegetation activites on the Santa Rita Experimental Range since 1903. Revegetation research includes experiments to evaluate adaptation, seedbed preparation, and sowing methods. We also discuss criteria used to determine if a site has the potential for a successful revegetation. Successful revegetation was initially based on plant emergence...

US EPA bioeffects monitoring under the Great Lakes Restoration Initiative: Overview of efforts to assess the biological impacts of CECs

EPA Science Inventory

Product Description:Concern exists regarding the potential biological effects of contaminants of emerging concern (CECs) in the Great Lakes. CECs arise from multiple sources, including agriculture, wastewater effluents, and urban nonpoint sources. The Great Lakes Restoration Init...

The effects of natural and induced short-term floods on four sugarcane accessions

USDA-ARS?s Scientific Manuscript database

A study was initiated at the USDA/ARS Subtropical Horticulture Research Station, Miami, FL to evaluate the potential for flood tolerance in several accessions from Saccharum barberi (Jeswiet) and S. sinense (Roxb. Amend. Jeswiet) sugarcane genera. The experimental design included 4 accessions, Kewal...

EMAP and other tools for measuring biodiversity, habitat conditions, and environmental trends

Treesearch

Eric M. Preston; Christine A. Ribic

1993-01-01

We describe research efforts that contribute to assessment and monitoring of neotropical migratory birds, including: I) use of neotropical migrants in the Environmental Monitoring and Assessment Program (EMAP) as potential indicators of general environmental condition and biodiversity; 2) EPA's Habitat/Biodiversity Research Initiative to assess comparative risks...

THE OCCURRENCE OF A NEW GENERATION OF DBPS (BEYOND THE ICR)

EPA Science Inventory

A nationwide survey of 12 full-scale treatment plants for disinfection by-products (DBPs) was initiated in the U.S. in 2000. Approximately 50DBPs that rated a high priority for potential toxicity and were not included in the Information Collection Rule (ICR) are being quantified...

Focusing on Teacher Learning Opportunities to Identify Potentially Productive Coaching Activities

ERIC Educational Resources Information Center

Gibbons, Lynsey K.; Cobb, Paul

2017-01-01

Instructional improvement initiatives in many districts include instructional coaching as a primary form of job-embedded support for teachers. However, the coaching literature provides little guidance about what activities coaches should engage in with teachers to improve instruction. When researchers do propose activities, they rarely justify why…

H2@Scale Resource and Market Analysis

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

Ruth, Mark

The 'H2@Scale' concept is based on the potential for wide-scale utilization of hydrogen as an energy intermediate where the hydrogen is produced from low cost energy resources and it is used in both the transportation and industrial sectors. H2@Scale has the potential to address grid resiliency, energy security, and cross-sectoral emissions reductions. This presentation summarizes the status of an ongoing analysis effort to quantify the benefits of H2@Scale. It includes initial results regarding market potential, resource potential, and impacts of when electrolytic hydrogen is produced with renewable electricity to meet the potential market demands. It also proposes additional analysis effortsmore » to better quantify each of the factors.« less

29 CFR 1990.142 - Initiation of a rulemaking.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) IDENTIFICATION, CLASSIFICATION, AND REGULATION OF POTENTIAL OCCUPATIONAL CARCINOGENS Regulation of Potential Occupational Carcinogens § 1990.142 Initiation of a rulemaking. Where the Secretary decides to regulate a potential occupational carcinogen, the Secretary shall initiate a rulemaking...

29 CFR 1990.142 - Initiation of a rulemaking.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) IDENTIFICATION, CLASSIFICATION, AND REGULATION OF POTENTIAL OCCUPATIONAL CARCINOGENS Regulation of Potential Occupational Carcinogens § 1990.142 Initiation of a rulemaking. Where the Secretary decides to regulate a potential occupational carcinogen, the Secretary shall initiate a rulemaking...

29 CFR 1990.142 - Initiation of a rulemaking.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) IDENTIFICATION, CLASSIFICATION, AND REGULATION OF POTENTIAL OCCUPATIONAL CARCINOGENS Regulation of Potential Occupational Carcinogens § 1990.142 Initiation of a rulemaking. Where the Secretary decides to regulate a potential occupational carcinogen, the Secretary shall initiate a rulemaking...

29 CFR 1990.142 - Initiation of a rulemaking.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) IDENTIFICATION, CLASSIFICATION, AND REGULATION OF POTENTIAL OCCUPATIONAL CARCINOGENS Regulation of Potential Occupational Carcinogens § 1990.142 Initiation of a rulemaking. Where the Secretary decides to regulate a potential occupational carcinogen, the Secretary shall initiate a rulemaking...

[Effect of the initial anode potential on electricity generation in microbial fuel cell].

PubMed

Fan, Ming-Zhi; Liang, Peng; Cao, Xiao-Xin; Huang, Xia

2008-01-01

The initial anode potential of the microbial fuel cell (MFC) was changed by additional circuit in the anode chamber, and the influence of the initial anode potential on the electricigens was studied. When the initial anode potential was 350 mV (vs Hg/Hg2 Cl2), the growth of microorganisms was much slower than that of the microorganisms which grew on the anode with an initial potential of -200 mV or 200 mV (vs Hg/Hg2 Cl2). After stable electricity generation, the anode resistances of the three MFCs, which had initial anode potentials of 350 mV, 200 mV and -200 mV respectively, were 71 Omega, 43 Omega and 80 Omega. The community structures in MFCs, before and after the electricity generation, were also studied by denaturing gradient gel electrophoresis (DGGE). Clostridium sticklandii, Pseudomonas mendocina and Paenibacillus taejonensis were the three most enriched strains on the anode.

Loss of lower limb motor evoked potentials and spinal cord injury during the initial exposure in scoliosis surgery.

PubMed

Legatt, Alan D; Fried, Stephen J; Amaral, Terry D; Sarwahi, Vishal; Moguilevitch, Marina

2014-04-01

To report a case of motor evoked potential changes and spinal cord injury during the initial dissection in scoliosis surgery. Motor evoked potentials to transcranial electrical stimulation were recorded from multiple muscles. Somatosensory evoked potentials to limb nerve stimulation were recorded from the scalp. Clear motor evoked potentials were initially present in all monitored muscles. The patient was then pharmacologically paralyzed for the initial dissection. More than usual bleeding was encountered during that dissection, prompting transfusion. As the neuromuscular blockade subsided, motor evoked potentials persisted in the hand muscles but disappeared and remained absent in all monitored leg muscles. The spine had not been instrumented. A wake-up test demonstrated paraplegia; the surgery was aborted. There were no adverse somatosensory evoked potential changes. MRI showed an anterior spinal cord infarct. Copious soft tissue bleeding during the initial dissection might have lowered pressures in critical segmental arteries enough to cause spinal cord infarction through a steal phenomenon. The lack of somatosensory evoked potential changes reflected sparing of the dorsal columns. When neuromuscular blockade is used during the initial soft tissue dissection, motor evoked potentials should be assessed after this, but before spinal instrumentation, to determine whether there had been any spinal cord compromise during the initial dissection.

Metronidazole stewardship initiative at Christchurch hospitals-achievable with immediate benefits.

PubMed

Gardiner, Sharon J; Metcalf, Sarah Cl; Chin, Paul Kl; Doogue, Matthew P; Dalton, Simon C; Chambers, Stephen T

2018-04-13

To evaluate an antimicrobial stewardship (AMS) initiative to change hospital prescribing practice for metronidazole. In October 2015, the Canterbury District Health Board (CDHB) AMS committee changed advice for metronidazole to promote two times daily dosing for most indications, prioritisation of the oral route and avoidance of double anaerobic cover. Adoption of the initiative was facilitated via change in prescribing guidelines, education and ongoing pharmacy support. Usage and expenditure on metronidazole for adult inpatients were compared for the five years pre- and two years post-change. Other district health boards (DHBs) were surveyed to determine their dosing recommendation for metronidazole IV. Mean annual metronidazole IV use, as defined daily doses per 1,000 occupied bed days, decreased by 43% post-initiative. Use of non-IV (oral or rectal) formulations increased by 104%. Total savings associated with the initiative were approximately $33,400 in drug costs plus $78,200 per annum in IV giving sets and post-dose flushes. Twelve of 20 (60%) DHBs (including CDHB) endorse twice daily IV dosing. In addition to financial savings, reduction in IV doses has potential benefits, including avoidance of IV catheter-associated complications such as bloodstream infections. Approaches to metronidazole dosing vary across DHBs and could benefit from national coordination.

NASA AVOSS Fast-Time Wake Prediction Models: User's Guide

NASA Technical Reports Server (NTRS)

Ahmad, Nash'at N.; VanValkenburg, Randal L.; Pruis, Matthew

2014-01-01

The National Aeronautics and Space Administration (NASA) is developing and testing fast-time wake transport and decay models to safely enhance the capacity of the National Airspace System (NAS). The fast-time wake models are empirical algorithms used for real-time predictions of wake transport and decay based on aircraft parameters and ambient weather conditions. The aircraft dependent parameters include the initial vortex descent velocity and the vortex pair separation distance. The atmospheric initial conditions include vertical profiles of temperature or potential temperature, eddy dissipation rate, and crosswind. The current distribution includes the latest versions of the APA (3.4) and the TDP (2.1) models. This User's Guide provides detailed information on the model inputs, file formats, and the model output. An example of a model run and a brief description of the Memphis 1995 Wake Vortex Dataset is also provided.

What Are Nursing Facilities Doing to Reduce Potentially Avoidable Hospitalizations?

PubMed

Daras, Laura Coots; Wang, Joyce M; Ingber, Melvin J; Ormond, Catherine; Breg, Nathaniel W; Khatutsky, Galina; Feng, Zhanlian

2017-05-01

Hospitalizations among nursing facility residents are frequent and often potentially avoidable. A number of initiatives and interventions have been developed to reduce excessive hospitalizations; however, little is known about the specific approaches nursing facilities use to address this issue. The objective of this study is to better understand which types of interventions nursing facilities have introduced to reduce potentially avoidable hospitalizations of long-stay nursing facility residents. Cross-sectional survey. 236 nursing facilities from 7 states. Nursing facility administrators. Web-based survey to measure whether facilities introduced any policies or procedures designed specifically to reduce potentially avoidable hospitalizations of long-stay nursing facility residents between 2011 and 2015. We surveyed facilities about seven types of interventions and quality improvement activities related to reducing avoidable hospitalizations, including use of Interventions to Reduce Acute Care Transfers (INTERACT) and American Medical Directors Association tools. Ninety-five percent of responding nursing facilities reported having introduced at least one new policy or procedure to reduce nursing facility resident hospitalizations since January 2011. The most common practice reported was hospitalization rate tracking or review, followed by standardized communication tools, such as Situation, Background, Assessment, Recommendation (SBAR). We found some variation in the extent and types of these reported interventions. Nearly all facilities surveyed reported having introduced a variety of initiatives to reduce potentially avoidable hospitalizations, likely driven by federal, state, and corporate initiatives to decrease hospital admissions and readmissions. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

Initial dynamic load estimates during configuration design

NASA Technical Reports Server (NTRS)

Schiff, Daniel

1987-01-01

This analysis includes the structural response to shock and vibration and evaluates the maximum deflections and material stresses and the potential for the occurrence of elastic instability, fatigue and fracture. The required computations are often performed by means of finite element analysis (FEA) computer programs in which the structure is simulated by a finite element model which may contain thousands of elements. The formulation of a finite element model can be time consuming, and substantial additional modeling effort may be necessary if the structure requires significant changes after initial analysis. Rapid methods for obtaining rough estimates of the structural response to shock and vibration are presented for the purpose of providing guidance during the initial mechanical design configuration stage.

Radiation Detection Material Discovery Initiative at PNNL

NASA Astrophysics Data System (ADS)

Milbrath, Brian

2006-05-01

Today's security threats are being met with 30-year old radiation technology. Discovery of new radiation detection materials is currently a slow and Edisonian process. With heightened concerns over nuclear proliferation, terrorism and unconventional warfare, an alternative strategy for identification and development of potential radiation detection materials must be adopted. Through the Radiation Detection Materials Discovery Initiative, PNNL focuses on the science-based discovery of next generation materials for radiation detection by addressing three ``grand challenges'': fundamental understanding of radiation detection, identification of new materials, and accelerating the discovery process. The new initiative has eight projects addressing these challenges, which will be described, including early work, paths forward and the opportunities for collaboration.

The forward rainbow scattering of low energy protons by a graphene sheet

NASA Astrophysics Data System (ADS)

Ćosić, M.; Petrović, S.; Nešković, N.

2018-05-01

This article studies the rainbow scattering of 5-keV protons by the single sheet of free-standing graphene and its possible use as a tool for investigation of the ion-graphene interaction. The proton-graphene interaction potential was constructed by using the Doyle-Turner, ZBL, and Molière proton-carbon interaction potentials. The thermal motion of carbon atoms was included by averaging the potentials according to the Debye model. Proton trajectories were obtained by numerical solution of the corresponding Newton equations of motion. They were used to obtain the mapping of the proton initial positions to their scattering angles. Morphological properties of the introduced mapping including its multiplicity and the rainbow singularities were used to explain important features of the obtained angular distributions of transmitted protons.

Modeling uranium(VI) adsorption onto montmorillonite under varying carbonate concentrations: A surface complexation model accounting for the spillover effect on surface potential

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

Tournassat, C.; Tinnacher, R. M.; Grangeon, S.

The prediction of U(VI) adsorption onto montmorillonite clay is confounded by the complexities of: (1) the montmorillonite structure in terms of adsorption sites on basal and edge surfaces, and the complex interactions between the electrical double layers at these surfaces, and (2) U(VI) solution speciation, which can include cationic, anionic and neutral species. Previous U(VI)-montmorillonite adsorption and modeling studies have typically expanded classical surface complexation modeling approaches, initially developed for simple oxides, to include both cation exchange and surface complexation reactions. However, previous models have not taken into account the unique characteristics of electrostatic surface potentials that occur at montmorillonitemore » edge sites, where the electrostatic surface potential of basal plane cation exchange sites influences the surface potential of neighboring edge sites (‘spillover’ effect).« less

Modeling uranium(VI) adsorption onto montmorillonite under varying carbonate concentrations: A surface complexation model accounting for the spillover effect on surface potential

DOE PAGES

Tournassat, C.; Tinnacher, R. M.; Grangeon, S.; ...

2017-10-06

The prediction of U(VI) adsorption onto montmorillonite clay is confounded by the complexities of: (1) the montmorillonite structure in terms of adsorption sites on basal and edge surfaces, and the complex interactions between the electrical double layers at these surfaces, and (2) U(VI) solution speciation, which can include cationic, anionic and neutral species. Previous U(VI)-montmorillonite adsorption and modeling studies have typically expanded classical surface complexation modeling approaches, initially developed for simple oxides, to include both cation exchange and surface complexation reactions. However, previous models have not taken into account the unique characteristics of electrostatic surface potentials that occur at montmorillonitemore » edge sites, where the electrostatic surface potential of basal plane cation exchange sites influences the surface potential of neighboring edge sites (‘spillover’ effect).« less

From a lunar outpost to Mars - Science, policy and the U.S. Space Exploration Initiative

NASA Technical Reports Server (NTRS)

Pilcher, Carl B.

1992-01-01

The technological developments required for the Space Exploration Initiative (SEI) objectives are discussed in terms of scientific investigation and present U.S. space policy. The results of the 90-Day Study are listed which include explicit suggestions for the successful exploration of the moon and Mars. The Outreach/Synthesis program is described which provides four methods for eliciting ideas, technologies, and research venues for lunar and Martian missions. The results of the studies include 5 scientific objectives such as the relationship between the sun, planetary atmospheres, and climate. The protection of human life from potential extraterrestrial hazards such as radiation is also found to be a key objective of SEI as are the theoretical and practical issues of scientific research.

Initiation into prescription opioid injection and associated trends in heroin use among people who use illicit drugs.

PubMed

Lake, Stephanie; Milloy, M-J; Dong, Huiru; Hayashi, Kanna; Wood, Evan; Kerr, Thomas; DeBeck, Kora

2016-12-01

Prescription opioid (PO) injection among people who use illicit drugs (PWUD) is an ongoing concern, yet little is known about drug use trajectories associated with initiating PO injection, including potential associations with heroin use. This study aimed to identify predictors of PO injection initiation among PWUD, and examine trends in heroin use before and after initiating PO injection. Data were merged from three cohorts of PWUD recruited between September 2005 and November 2015. Predictors of PO injection initiation were identified using extended Cox regression models. Trends in heroin use pre- and post-initiation were examined with McNemar's test and compared to matched controls with linear growth curve models. Among 1580 participants, 247 initiated PO injection yielding an incidence density of 3.9 (95% Confidence Interval [CI]: 3.4-4.4) per 100 person-years. In a multivariable analysis, independent predictors of PO injection initiation included heroin injection (Adjusted Hazard Ratio [AHR]=4.39, 95% CI: 3.24-5.95) and non-injection PO use (AHR=1.99, 95% CI: 1.25-3.17). In a sub-analysis, compared to matched controls, PO injection corresponded with elevated heroin use post-initiation (p≤0.05). In this study, heroin use and non-injection PO use strongly predicted PO injection initiation. Those who initiated PO injecting had elevated heroin use patterns post-initiation compared to controls. These findings suggest that transitioning to PO injection does not appear to be a substitute for heroin use among PWUD. These findings highlight the importance of addressing PO injection in harm reduction and treatment settings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Fatigue crack initiation of magnesium alloys under elastic stress amplitudes: A review

NASA Astrophysics Data System (ADS)

Wang, B. J.; Xu, D. K.; Wang, S. D.; Han, E. H.

2017-12-01

The most advantageous property of magnesium (Mg) alloys is their density, which is lower compared with traditional metallic materials. Mg alloys, considered the lightest metallic structural material among others, have great potential for applications as secondary load components in the transportation and aerospace industries. The fatigue evaluation of Mg alloys under elastic stress amplitudes is very important in ensuring their service safety and reliability. Given their hexagonal close packed structure, the fatigue crack initiation of Mg and its alloys is closely related to the deformation mechanisms of twinning and basal slips. However, for Mg alloys with shrinkage porosities and inclusions, fatigue cracks will preferentially initiate at these defects, remarkably reducing the fatigue lifetime. In this paper, some fundamental aspects about the fatigue crack initiation mechanisms of Mg alloys are reviewed, including the 3 followings: 1) Fatigue crack initiation of as-cast Mg alloys, 2) influence of microstructure on fatigue crack initiation of wrought Mg alloys, and 3) the effect of heat treatment on fatigue initiation mechanisms. Moreover, some unresolved issues and future target on the fatigue crack initiation mechanism of Mg alloys are also described.

Mesoscale Modeling, Forecasting and Remote Sensing Research.

DTIC Science & Technology

remote sensing , cyclonic scale diagnostic studies and mesoscale numerical modeling and forecasting are summarized. Mechanisms involved in the release of potential instability are discussed and simulated quantitatively, giving particular attention to the convective formulation. The basic mesoscale model is documented including the equations, boundary condition, finite differences and initialization through an idealized frontal zone. Results of tests including a three dimensional test with real data, tests of convective/mesoscale interaction and tests with a detailed

A Modeling Framework for Predicting the Size of Sediments Produced on Hillslopes and Supplied to Channels

NASA Astrophysics Data System (ADS)

Sklar, L. S.; Mahmoudi, M.

2016-12-01

Landscape evolution models rarely represent sediment size explicitly, despite the importance of sediment size in regulating rates of bedload sediment transport, river incision into bedrock, and many other processes in channels and on hillslopes. A key limitation has been the lack of a general model for predicting the size of sediments produced on hillslopes and supplied to channels. Here we present a framework for such a model, as a first step toward building a `geomorphic transport law' that balances mechanistic realism with computational simplicity and is widely applicable across diverse landscapes. The goal is to take as inputs landscape-scale boundary conditions such as lithology, climate and tectonics, and predict the spatial variation in the size distribution of sediments supplied to channels across catchments. The model framework has two components. The first predicts the initial size distribution of particles produced by erosion of bedrock underlying hillslopes, while the second accounts for the effects of physical and chemical weathering during transport down slopes and delivery to channels. The initial size distribution can be related to the spacing and orientation of fractures within bedrock, which depend on the stresses and deformation experienced during exhumation and on rock resistance to fracture propagation. Other controls on initial size include the sizes of mineral grains in crystalline rocks, the sizes of cemented particles in clastic sedimentary rocks, and the potential for characteristic size distributions produced by tree throw, frost cracking, and other erosional processes. To model how weathering processes transform the initial size distribution we consider the effects of erosion rate and the thickness of soil and weathered bedrock on hillslope residence time. Residence time determines the extent of size reduction, for given values of model terms that represent the potential for chemical and physical weathering. Chemical weathering potential is parameterized in terms of mean annual precipitation and temperature, and the fraction of soluble minerals. Physical weathering potential can be parameterized in terms of topographic attributes, including slope, curvature and aspect. Finally, we compare model predictions with field data from Inyo Creek in the Sierra Nevada Mtns, USA.

Potential for ag residue collection, economics and environmental benefits

NASA Astrophysics Data System (ADS)

Hettenhaus, J. R.

2003-12-01

Removing excess corn stover and cereal straws after erosion requirements have been satisfied offers much potential as a renewable feedstock for initial biorefineries, producing fuels, chemicals and materials while reducing crop inputs, increasing farm income and offsetting greenhouse gas emissions. Two biorefinery site studies are presented for the production of fuel ethanol: SW Nebraska and Western Oklahoma. Results include excess available, delivered cost, net income to the farmer, improved SOM from move to no-till and GHG reduction from fossil fuel offset

Metastatic potential of tumor-initiating cells in solid tumors.

PubMed

Adhikari, Amit S; Agarwal, Neeraj; Iwakuma, Tomoo

2011-01-01

The lethality of cancer is mainly caused by its properties of metastasis, drug resistance, and subsequent recurrence. Understanding the mechanisms governing these properties and developing novel strategies to overcome them will greatly improve the survival of cancer patients. Recent findings suggest that tumors are comprised of heterogeneous cell populations, and only a small fraction of these are tumorigenic with the ability to self-renew and produce phenotypically diverse tumor cell populations. Cells in this fraction are called tumor-initiating cells (TICs) or cancer stem cells (CSCs). TICs have been identified from many types of cancer. They share several similarities with normal adult stem cells including sphere-forming ability, self-renewability, and expression of stem cell surface markers and transcription factors. TICs have also been proposed to be responsible for cancer metastasis, however, scarce evidence for their metastatic potential has been provided. In this review article, we have attempted to summarize the studies which have examined the metastatic potential of TICs in solid tumors.

Priorities for Implementation of the Northern Pacific Coast Regional Shorebird Management Plan

Treesearch

Joseph B. Buchanan

2005-01-01

Marine and upland habitats in western Washington and Oregon provide essential conditions for many wintering and migratory shorebird species along the Pacific Flyway. Known or potential threats to shorebirds include loss or degradation of habitat, invasion of exotic vegetation and invertebrates, environmental pollution, and human disturbance. Initial priority activities...

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... preventive examination not more than 1 year after the effective date of his or her first Medicare Part B... potential (risk factors) for depression, including current or past experiences with depression or other mood... use of appropriate screening questions or a screening questionnaire, which the physician or other...

42 CFR 410.16 - Initial preventive physical examination: Conditions for and limitations on coverage.

Code of Federal Regulations, 2011 CFR

2011-10-01

... risk factors for disease, as those terms are defined in this section. (2) Review of the beneficiary's potential (risk factors) for depression, including current or past experiences with depression or other mood... visual acuity screen, and other factors as deemed appropriate, based on the beneficiary's medical and...

Low-cost high purity production

NASA Technical Reports Server (NTRS)

Kapur, V. K.

1978-01-01

Economical process produces high-purity silicon crystals suitable for use in solar cells. Reaction is strongly exothermic and can be initiated at relatively low temperature, making it potentially suitable for development into low-cost commercial process. Important advantages include exothermic character and comparatively low process temperatures. These could lead to significant savings in equipment and energy costs.

The Annual Squeeze into Hotels, Homes, and Those Dreaded "Converted Triples."

ERIC Educational Resources Information Center

Gose, Ben

1999-01-01

Colleges and universities face an annual challenge to distribute housing to students. Initial student numbers usually exceed housing potential, but no-shows and early departures often even the numbers in the first few weeks of the year. Complicating factors include families' increasing ability to pay for dormitory housing, better campus housing…

Raw materials in the manufacture of biotechnology products: regulatory considerations.

PubMed

Cordoba-Rodriguez, Ruth

2010-01-01

The Food and Drug Administration's Pharmaceutical cGMPs for the 21st Century initiative emphasizes science and risk-based approaches in the manufacture of drugs. These approaches are reflected in the International Conference on Harmonization (ICH) guidances ICH Q8, Q9, and Q10 and encourage a comprehensive assessment of the manufacture of a biologic, including all aspects of manufacture that have the potential to affect the finished drug product. Appropriate assessment and management of raw materials are an important part of this initiative. Ideally, a raw materials program should strive to assess and minimize the risk to product quality. With this in mind, risk-assessment concepts and control strategies will be discussed and illustrated by examples, with an emphasis on the impact of raw materials on cell substrates. Finally, the life cycle of the raw material will be considered, including its potential to affect the drug product life cycle. In this framework, the supply chain and the vendor-manufacturer relationship will be explored as important parts of an adequate raw materials control strategy.

Co-Optimization of Fuels & Engines: Fuel Blendstocks with the Potential to Optimize Future Gasoline Engine Performance; Identification of Five Chemical Families for Detailed Evaluation

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

Farrell, John T; Holladay, John; Wagner, Robert

The U.S. Department of Energy's (DOE's) Co-Optimization of Fuels & Engines (Co-Optima) initiative is conducting the early-stage research needed to accelerate the market introduction of advanced fuel and engine technologies. The research includes both spark-ignition (SI) and compression-ignition (CI) combustion approaches, targeting applications that impact the entire on-road fleet (light-, medium-, and heavy-duty vehicles). The initiative's major goals include significant improvements in vehicle fuel economy, lower-cost pathways to reduce emissions, and leveraging diverse U.S. fuel resources. A key objective of Co-Optima's research is to identify new blendstocks that enhance current petroleum blending components, increase blendstock diversity, and provide refiners withmore » increased flexibility to blend fuels with the key properties required to optimize advanced internal combustion engines. This report identifies eight representative blendstocks from five chemical families that have demonstrated the potential to increase boosted SI engine efficiency, meet key fuel quality requirements, and be viable for production at commercial scale by 2025-2030.« less

The Wisconsin Early Childhood Obesity Prevention Initiative: An Example of Statewide Collective Impact.

PubMed

Meinen, Amy; Hilgendorf, Amy; Korth, Amy L; Christens, Brian D; Breuer, Catherine; Joyner, Hilary; Polzin, Molle; Adams, Alexandra; Wolfe, Daithi; Braun, Abbe; Hoiting, Jill; Paulson, Jeanette; Cullen, Bridget; Stader, Kelli

2016-11-01

The Wisconsin Early Childhood Obesity Prevention Initiative (Initiative), established in 2007, seeks to address and prevent obesity in the early care and education system through nutrition and physical activity environmental and policy changes. The collaborative includes professionals from 3 state of Wisconsin Departments, the University of Wisconsin-Extension, the University of Wisconsin-Madison, and public health and early care and education organizations. This paper explores the efforts of the Initiative to advance our understanding of collective impact in practice and its value to health promotion efforts. Evaluators conducted a mixed methods case study to evaluate the application of collective impact principles by the Initiative. This included a survey of Initiative partners, review of archival documents, and qualitative interviews with Initiative leaders. Initiative partners noted progress in establishing the conditions for collective impact. Archival documents and interviews describe both formal and informal practices that helped set a common agenda, align and coordinate partner activities, and promote communication among Initiative leaders. Results also detail the important current and potential roles of “backbone” staff from healthTIDE to support the Initiative. Additionally, results suggest particularly challenging aspects of the Initiative’s impact model related to shared measurement and broader stakeholder communication. While the Initiative is still setting in place the conditions for collective impact, it has achieved significant policy, systems, and environment changes since its formation. Inclusion of nutrition and physical activity criteria in the state’s quality rating improvement system for child care centers is one of its outcomes. This case study offers several important insights about the application of collective impact in health promotion efforts, particularly in relation to the transition from previous collaborative activities, the value of establishing a clear common agenda among partners, the roles of backbone staff, and time and partner relationships in collective impact.

Breakthrough Listen - A New Search for Life in the Universe

NASA Astrophysics Data System (ADS)

Worden, Pete

On July 20, 2015 Yuri Milner and Stephen Hawking announced a new set of scientific initiatives - a SETI search called Breakthrough Listen and a contest to devise potential messages in response to a detection entitled Breakthrough Message. These are the first of several privately-funded Breakthrough Initiatives, designed to answer the fundamental science questions surrounding the origin, extent and nature of life in the universe. The initiatives are managed by the Breakthrough Prize Foundation. With Breakthrough Listen, Radio SETI observations have begun at the Green Bank Radio Telescope (GBT) and optical SETI at the Lick Observatory Automated Planet Finder (APF). Observations will soon commence at the CSIRO Parkes Radio Telescope. Other SETI instruments and observations are under consideration. In addition, several other initiatives are under development including an expanded search for life in the universe.

Analog Design for Digital Deployment of a Serious Leadership Game

NASA Technical Reports Server (NTRS)

Maxwell, Nicholas; Lang, Tristan; Herman, Jeffrey L.; Phares, Richard

2012-01-01

This paper presents the design, development, and user testing of a leadership development simulation. The authors share lessons learned from using a design process for a board game to allow for quick and inexpensive revision cycles during the development of a serious leadership development game. The goal of this leadership simulation is to accelerate the development of leadership capacity in high-potential mid-level managers (GS-15 level) in a federal government agency. Simulation design included a mixed-method needs analysis, using both quantitative and qualitative approaches to determine organizational leadership needs. Eight design iterations were conducted, including three user testing phases. Three re-design iterations followed initial development, enabling game testing as part of comprehensive instructional events. Subsequent design, development and testing processes targeted digital application to a computer- and tablet-based environment. Recommendations include pros and cons of development and learner testing of an initial analog simulation prior to full digital simulation development.

Electronic health record - public health (EHR-PH) system prototype for interoperability in 21st century healthcare systems.

PubMed

Orlova, Anna O; Dunnagan, Mark; Finitzo, Terese; Higgins, Michael; Watkins, Todd; Tien, Allen; Beales, Steven

2005-01-01

Information exchange, enabled by computable interoperability, is the key to many of the initiatives underway including the development of Regional Health Information Exchanges, Regional Health Information Organizations, and the National Health Information Network. These initiatives must include public health as a full partner in the emerging transformation of our nation's healthcare system through the adoption and use of information technology. An electronic health record - public health (EHR-PH)system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal element for a potential technical architecture for a NHIN.

ON BECOMING ABLE TO PLAY: INDIVIDUAL CHILD PSYCHOANALYTIC PSYCHODRAMA AND THE DEVELOPMENT OF SYMBOLIZATION.

PubMed

Quagelli, Luca; Solano, Paola

2017-10-01

In this paper, the authors analyze the relevance and transformative potential of individual psychoanalytic psychodrama in the treatment of children with severe impairments in symbolization. Central features of this modality, including promoting the representation of early traumatic experiences, are presented and discussed. Specific features include double-envelope containment of the co-therapists' group and play leader, consequent diffraction of the transference-determining portrayal, gradual integration, and initial figuration of coexisting split-off fragments. Drawing on in-depth clinical material, the authors show how psychodrama tempers the potentially traumatic effects of the encounter with the object, allowing these patients to access the transitional area of play. © 2017 The Psychoanalytic Quarterly, Inc.

The legacy of nanotechnology: revolution and prospects in neurosurgery.

PubMed

Khawaja, Ayaz Mahmood

2011-01-01

Nanotechnology has been an ever-growing field since the discovery of carbon fullerenes, and is being assimilated progressively into a variety of other disciplines including medical science. The association with neurosurgery had initially been less well characterized compared to other organ systems, but has recently offered promising future potential for a wide range of utilities including new therapeutic options for Glioblastoma Multiforme, neurprotection against oxidative stress, nerve nanorepair, nanodiagnosis of Alzheimer's disease, nanoimaging with nanoparticles and quantum dots, nanomanipulation of CNS with surgical nanobots, and nanoneuromodulation with nanofibres & nanowires. This article examines such potentials as well as others, of the utility of nanotechnology in Neurosurgery. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Post-transcriptional control by bacteriophage T4: mRNA decay and inhibition of translation initiation

PubMed Central

2010-01-01

Over 50 years of biological research with bacteriophage T4 includes notable discoveries in post-transcriptional control, including the genetic code, mRNA, and tRNA; the very foundations of molecular biology. In this review we compile the past 10 - 15 year literature on RNA-protein interactions with T4 and some of its related phages, with particular focus on advances in mRNA decay and processing, and on translational repression. Binding of T4 proteins RegB, RegA, gp32 and gp43 to their cognate target RNAs has been characterized. For several of these, further study is needed for an atomic-level perspective, where resolved structures of RNA-protein complexes are awaiting investigation. Other features of post-transcriptional control are also summarized. These include: RNA structure at translation initiation regions that either inhibit or promote translation initiation; programmed translational bypassing, where T4 orchestrates ribosome bypass of a 50 nucleotide mRNA sequence; phage exclusion systems that involve T4-mediated activation of a latent endoribonuclease (PrrC) and cofactor-assisted activation of EF-Tu proteolysis (Gol-Lit); and potentially important findings on ADP-ribosylation (by Alt and Mod enzymes) of ribosome-associated proteins that might broadly impact protein synthesis in the infected cell. Many of these problems can continue to be addressed with T4, whereas the growing database of T4-related phage genome sequences provides new resources and potentially new phage-host systems to extend the work into a broader biological, evolutionary context. PMID:21129205

Potential geographic "hotspots" for drug-injection related transmission of HIV and HCV and for initiation into injecting drug use in New York City, 2011-2015, with implications for the current opioid epidemic in the US

PubMed Central

Cooper, H. L. F.; Arasteh, K.; Feelemyer, J.; McKnight, C.; Ross, Z.

2018-01-01

Objective We identified potential geographic “hotspots” for drug-injecting transmission of HIV and hepatitis C virus (HCV) among persons who inject drugs (PWID) in New York City. The HIV epidemic among PWID is currently in an “end of the epidemic” stage, while HCV is in a continuing, high prevalence (> 50%) stage. Methods We recruited 910 PWID entering Mount Sinai Beth Israel substance use treatment programs from 2011–2015. Structured interviews and HIV/ HCV testing were conducted. Residential ZIP codes were used as geographic units of analysis. Potential “hotspots” for HIV and HCV transmission were defined as 1) having relatively large numbers of PWID 2) having 2 or more HIV (or HCV) seropositive PWID reporting transmission risk—passing on used syringes to others, and 3) having 2 or more HIV (or HCV) seronegative PWID reporting acquisition risk—injecting with previously used needles/syringes. Hotspots for injecting drug use initiation were defined as ZIP codes with 5 or more persons who began injecting within the previous 6 years. Results Among PWID, 96% injected heroin, 81% male, 34% White, 15% African-American, 47% Latinx, mean age 40 (SD = 10), 7% HIV seropositive, 62% HCV seropositive. Participants resided in 234 ZIP codes. No ZIP codes were identified as potential hotspots due to small numbers of HIV seropositive PWID reporting transmission risk. Four ZIP codes were identified as potential hotspots for HCV transmission. 12 ZIP codes identified as hotspots for injecting drug use initiation. Discussion For HIV, the lack of potential hotspots is further validation of widespread effectiveness of efforts to reduce injecting-related HIV transmission. Injecting-related HIV transmission is likely to be a rare, random event. HCV prevention efforts should include focus on potential hotspots for transmission and on hotspots for initiation into injecting drug use. We consider application of methods for the current opioid epidemic in the US. PMID:29596464

Use of a Quality Improvement Initiative to Achieve Consistent Reporting of Level of Suspicion for Tumor on Multiparametric Prostate MRI.

PubMed

Rosenkrantz, Andrew B; Pujara, Akshat C; Taneja, Samir S

2016-05-01

The purpose of this article is to evaluate the utility of a quality improvement (QI) initiative in achieving long-term adherence to an evolving structured format for reporting the level of suspicion for tumor on prostate MRI examinations. The original QI initiative occurred over a 4-month period in 2010, before which prostate MRI was reported using free text. The initiative consisted of development of a section-wide macro, an initial group training session, ordering physician input regarding the structured report's value, subsequent weekly sessions for ongoing review, and timely individualized feedback in instances of nonuse. The initial structured report included pick lists for describing the level of suspicion for tumor as negative, low, medium, or high. Pick lists were modified in 2011 to incorporate a 5-point Likert scale and again in 2015 to incorporate Prostate Imaging Data and Reporting System (PI-RADS) version 2. These refinements were implemented after accelerated training periods. The frequency of reports providing an MRI-based suspicion level during these periods was assessed. Fifty-five percent of reports provided an MRI-based level of suspicion for tumor before the initiative. For various cohorts evaluated after the initiative (using structured reports based on the low, medium, or high scheme; a numeric Likert scale; or PI-RADS), this frequency improved to 95-100% (p < 0.001). Among reports without a suspicion level, potential confounding factors included marked artifact from hip prosthesis and overt diffuse tumor. The QI initiative achieved excellent adherence in reporting a suspicion level for tumor on prostate MRI examinations. The described components of the initiative were useful for maintaining long-term adherence that persisted after serial modifications to the report lexicon.

The potential for microtechnology applications in energy systems: Results of an experts workshop

NASA Astrophysics Data System (ADS)

1995-02-01

Microscale technologies, or microelectromechanical systems (MEMS), are currently under development in the United States and abroad. Examples include microsensors, microactuators (including micromotors), and microscale heat exchangers. Typically, microscale devices have features ranging in size from a few microns to several millimeters, with fabrication methods adapted from those developed for the semiconductor industry. Microtechnologies are already being commercialized; initial markets include the biomedical and transportation industries. Applications are being developed in other industries as well. Researchers at the Pacific Northwest Laboratory (PNL) hypothesize that a significant number of energy applications are possible. These applications range from environmental sensors that support enhanced control of building (or room) temperature and ventilation to microscale heat pumps and microscale heat engines that could collectively provide for kilowatt quantities of energy conversion. If efficient versions of these devices are developed, they could significantly advance the commercialization of distributed energy conversion systems, thereby reducing the energy losses associated with energy distribution. Based upon the potential for energy savings, the U.S. Department of Energy (DOE) Office of Building Technologies (OBT) has proposed a new initiative in energy systems miniaturization. The program would focus on the development of microtechnologies for the manufactured housing sector and would begin in either FY 1997 or FY 1998, ramping up to $5 million per year investment by FY 2001.

Effects of Soil Type on the Damage Potential of Meloidogyne incognita on Soybean.

PubMed

Windham, G L; Barker, K R

1986-07-01

Effects of soil type on the reproduction and damage potential of Meloidogyne incognita on soybean, Glycine max (L.) Merr., were determined at five locations in North Carolina, including one site where plots with six soil types were established. M. incognita reproduced readily on a susceptible soybean cultivar in most soil types, with somewhat limited reproduction in muck soils. The relationship between initial population densities and yield varied among soil types and nematode populations. Yield losses were greatest in sandy and muck soil types, with less nematode damage occurring in the clay soil types. A North Carolina and a Georgia population of M. incognita differed greatly in their ability to reproduce on soybean and suppress growth. The North Carolina population had a moderate effect on yield in 1981 and only a slight effect in 1982. In contrast, a Georgia population severely limited soybean growth and yield at lower initial population densities in 1983, Initial population densities of the nematodes and physical and chemical edaphic factors accounted for much of the variation of soybean yield and nematode reproduction.

Potential advantages associated with implementing a risk-based inspection program by a nuclear facility

NASA Astrophysics Data System (ADS)

McNeill, Alexander, III; Balkey, Kenneth R.

1995-05-01

The current inservice inspection activities at a U.S. nuclear facility are based upon the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code, Section XI. The Code selects examination locations based upon a sampling criteria which includes component geometry, stress, and usage among other criteria. This can result in a significant number of required examinations. As a result of regulatory action each nuclear facility has conducted probabilistic risk assessments (PRA) or individual plant examinations (IPE), producing plant specific risk-based information. Several initiatives have been introduced to apply this new plant risk information. Among these initiatives is risk-based inservice inspection. A code case has been introduced for piping inspections based upon this new risk- based technology. This effort brought forward to the ASME Section XI Code committee, has been initiated and championed by the ASME Research Task Force on Risk-Based Inspection Guidelines -- LWR Nuclear Power Plant Application. Preliminary assessments associated with the code case have revealed that potential advantages exist in a risk-based inservice inspection program with regard to a number of exams, risk, personnel exposure, and cost.

A Feasibility Study to Evaluate Wind Energy Potential on the Navajo Nation

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

Terry Battiest

2012-11-30

The project, A Feasibility Study to Evaluate Wind Energy Potential on the Navajo Nation, is funded under a solicitation issued by the U.S. Department of Energy Tribal Energy Program. Funding provided by the grant allowed the Navajo Nation to measure wind potential at two sites, one located within the boundaries of the Navajo Nation and the other off-reservation during the project period (September 5, 2005 - September 30, 2009). The recipient for the grant award is the Navajo Tribal Utility Authority (NTUA). The grant allowed the Navajo Nation and NTUA manage the wind feasibility from initial site selection through themore » decision-making process to commit to a site for wind generation development. The grant activities help to develop human capacity at NTUA and help NTUA to engage in renewable energy generation activities, including not only wind but also solar and biomass. The final report also includes information about development activities regarding the sited included in the grant-funded feasibility study.« less

[Left ventricular projectile migration after an accidental close-range gunshot wound].

PubMed

Driessen, A; Tjardes, T; Eikermann, C; Trojan, S; Fröhlich, M; Grimaldi, G; Kosse, N

2016-07-01

We report the case of a 24-year-old female after sustaining a shotgun wound in the left upper extremity and chest. Initial emergency diagnostics revealed numerous shotgun pellets scattered throughout the left-side soft tissue, chest and upper lung lobe with one pellet having migrated into the left ventricle of the heart.Due to the devastating injury pattern, gunshot wounds are interdisciplinarily challenging and should include extended initial diagnostics, such as contrast agent CT. The potential toxicity of elevated lead blood levels have to be taken into further account.

Vasomotor and Related Menopause Symptoms.

PubMed

Stuenkel, Cynthia A

2018-05-31

Vasomotor symptoms are the most common manifestation of the menopause transition and postmenopausal phases of reproductive life. They interfere not only in quality of life, but also contribute to sleep and mood disturbances that potentially compromise home and work effectiveness. Treatment options include hormone therapy (HT), nonhormonal prescription drugs, mind body and behavior therapies, and over-the-counter preparations. Evidence confirms that HT is the most effective option. The initial reticence to prescribe HT immediately following publication of the Women's Health Initiative has been replaced by clear guidelines for confidently identifying women for whom this therapy will be safe.

Exploring the cause of initially reactive bovine brains on rapid tests for BSE

PubMed Central

Dudas, Sandor; James, Jace; Anderson, Renee; Czub, Stefanie

2015-01-01

ABSTRACT Bovine spongiform encephalopathy (BSE) is an invariably fatal prion disease of cattle. The identification of the zoonotic potential of BSE prompted safety officials to initiate surveillance testing for this disease. In Canada, BSE surveillance is primarily focused on high risk cattle including animals which are dead, down and unable to rise, diseased or distressed. This targeted surveillance results in the submission of brain samples with a wide range of tissue autolysis and associated contaminants. These contaminants have the potential to interfere with important steps of surveillance tests resulting in initially positive test results requiring additional testing to confirm the disease status of the animal. The current tests used for BSE screening in Canada utilize the relative protease resistance of the prion protein gained when it misfolds from PrPC to PrPSc as part of the disease process. Proteinase K completely digests PrPC in normal brains, but leaves most of the PrPSc in BSE positive brains intact which is detected using anti-prion antibodies. These tests are highly reliable but occasionally give rise to initially reactive/false positive results. Test results for these reactive samples were close to the positive/negative cut-off on a sub set of test platforms. This is in contrast to all of the previous Canadian positive samples whose numeric values on these same test platforms were 10 to 100 fold greater than the test positive/negative cut-off. Here we explore the potential reason why a sample is repeatedly positive on a sub-set of rapid surveillance tests, but negative on other test platforms. In order to better understand and identify what might cause these initial reactions, we have conducted a variety of rapid and confirmatory assays as well as bacterial isolation and identification on BSE positive, negative and initially reactive samples. We observed high levels of viable bacterial contamination in initially reactive samples suggesting that the reactivity may be related to bacterial factors. Several bacteria isolated from the initially reactive samples have characteristics of biofilm forming bacteria and this extracellular matrix might play a role in preventing complete digestion of PrPC in these samples. PMID:26689488

Screening the ToxCast Phase 1 Chemical Library for Inhibition of Deiodinase Type 1 Activity.

PubMed

Hornung, Michael W; Korte, Joseph J; Olker, Jennifer H; Denny, Jeffrey S; Knutsen, Carsten; Hartig, Phillip C; Cardon, Mary C; Degitz, Sigmund J

2018-04-01

Thyroid hormone (TH) homeostasis is dependent upon coordination of multiple key events including iodide uptake, hormone synthesis, metabolism, and elimination, to maintain proper TH signaling. Deiodinase enzymes catalyze iodide release from THs to interconvert THs between active and inactive forms, and are integral to hormone metabolism. The activity of deiodinases has been identified as an important endpoint to include in the context of screening chemicals for TH disruption. To begin to address the potential for chemicals to inhibit these enzymes an adenovirus expression system was used to produce human deiodinase type 1 (DIO1) enzyme, established robust assay parameters for nonradioactive determination of iodide release by the Sandell-Kolthoff method, and employed a 96-well plate format for screening chemical libraries. An initial set of 18 chemicals was used to establish the assay, along with the known DIO1 inhibitor 6-propylthiouracil as a positive control. An additional 292 unique chemicals from the EPA's ToxCast phase 1_v2 chemical library were screened. Chemicals were initially screened at a single high concentration of 200 µM to identify potential DIO1 inhibitors. There were 50 chemicals, or 17% of the TCp1_v2 chemicals tested, that produced >20% inhibition of DIO1 activity. Eighteen of these inhibited DIO1 activity >50% and were further tested in concentration-response mode to determine IC50s. This work presents an initial effort toward identifying chemicals with potential for affecting THs via inhibition of deiodinases and sets the foundation for further testing of large chemical libraries against DIO1 and the other deiodinase enzymes involved in TH function.

A Randomized Trial Assessing the Impact of a Personal Printed Feedback Portrait on Statin Prescribing in Primary Care

ERIC Educational Resources Information Center

Dormuth, Colin R.; Carney, Greg; Taylor, Suzanne; Bassett, Ken; Maclure, Malcolm

2012-01-01

Introduction: Knowledge translation (KT) initiatives have the potential to improve prescribing quality and produce savings that exceed the cost of the KT program itself, including the cost of evaluation using pragmatic study methods. Our objective was to measure the impact and estimated savings resulting from the distribution of individualized…

76 FR 77467 - Endangered and Threatened Species; Initiation of Status Review for Ribbon Seal

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... management on ribbon seals; (2) Information on the effects of climate change and sea ice change on the...) Information on the effects of other potential threat factors, including oil and gas exploration and... concern about threats to this species' habitat from climate warming and loss of sea ice. The Petitioner...

Dealing with Free-Riders in Assessed Group Work: Results from a Study at a UK University

ERIC Educational Resources Information Center

Maiden, Barbara; Perry, Bob

2011-01-01

Potential employers require graduates to be able to demonstrate competent teamwork skills in initiating ideas and solving problems cooperatively. Teamwork is prevalent in educational institutions and often included as a way of enriching learning and assessment. Whilst group working can provide a rich opportunity for cooperative learning, its…

Resisting Smoking when a Best Friend Smokes: Do Intrapersonal and Contextual Factors Matter?

ERIC Educational Resources Information Center

Tucker, Joan S.; Edelen, Maria Orlando; Go, Myung-Hyun; Pollard, Michael S.; Green, Harold D., Jr.; Kennedy, David P.

2012-01-01

This longitudinal study examines individual differences in the tendency to initiate (N = 4,612) and escalate (N = 2,837) smoking when adolescents gain a best friend who smokes. Potential moderating factors include self-esteem, depression, problem behavior, school and family bonds, and household access to cigarettes. In addition to acquiring a…

A Guide for the Identification of a Student Meriting Special Dropout Prevention Initiatives.

ERIC Educational Resources Information Center

Mizell, M. Hayes

A risk assessment instrument for identifying potential dropouts at the middle and high school levels and an accompanying explanation of the instrument are provided in this document. The instrument provides a checklist of 21 criteria; the more criteria the student meets, the greater his risk of dropping out. Criteria include age in comparison to…

The Use of Ultrasound in Remediation of North American English /r/ in 2 Adolescents

ERIC Educational Resources Information Center

Adler-Bock, Marcy; Bernhardt, Barbara May; Gick, Bryan; Bacsfalvi, Penelope

2007-01-01

Purpose: Ultrasound can provide images of the tongue during speech production. The present study set out to examine the potential utility of ultrasound in remediation of North American English /r/. Method: The participants were 2 Canadian English-speaking adolescents who had not yet acquired /r/. The study included an initial period without…

A Multi-Agency Effort for Assessing the Occurrence and Biological Impacts of CECs in Support of the Great Lakes Restoration Initiative

EPA Science Inventory

In recent years, there has been a substantial increase in the detection of a variety of contaminants for which little is known regarding their potential impact(s) on Great Lakes ecosystems. These contaminants of emerging concern, or CECs, include an assortment of industrial (e.g....

Saving seeds: Optimally planning our Ex Situ conservation collections to ensure species' evolutionary potential

Treesearch

Sean M. Hoban

2017-01-01

In the face of ongoing environmental change, conservation and natural resource agencies are initiating or expanding ex situ seed collections from natural plant populations. Seed collections have many uses, including in provenance trials, breeding programs, seed orchards, gene banks for long-term conservation (live plants or seeds), restoration, reforestation, and...

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 2: Policies and Standards.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Seven papers and one abstract of a paper are presented from the 1995 CAUSE conference track on policies and standards issues faced by managers of information technology at colleges and universities. The papers include: (1) "University/College Information System Structures and Policies: Do They Make a Difference? An Initial Assessment"…

Energy Savings Potential and Research, Development, & Demonstration Opportunities for Commercial Building Heating, Ventilation, and Air Conditioning Systems

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

none,

2011-09-01

This report covers an assessment of 182 different heating, ventilation, and air-conditioning (HVAC) technologies for U.S. commercial buildings to identify and provide analysis on 17 priority technology options in various stages of development. The analyses include an estimation of technical energy-savings potential, description of technical maturity, description of non-energy benefits, description of current barriers for market adoption, and description of the technology’s applicability to different building or HVAC equipment types. From these technology descriptions, are suggestions for potential research, development and demonstration (RD&D) initiatives that would support further development of the priority technology options.

Prevalence of, and Resident and Facility Characteristics Associated With Antipsychotic Use in Assisted Living vs. Long-Term Care Facilities: A Cross-Sectional Analysis from Alberta, Canada.

PubMed

Stock, Kathryn J; Amuah, Joseph E; Lapane, Kate L; Hogan, David B; Maxwell, Colleen J

2017-01-01

Potentially inappropriate antipsychotic use in long-term care (LTC) facilities has been the focus of significant policy and clinical attention over the past 20 years. However, most initiatives aimed at reducing the use of these medications have overlooked assisted living (AL) settings. We sought to compare the prevalence of antipsychotic use (including potentially inappropriate use) among older AL and LTC residents and to explore the resident and facility-level factors associated with use in these two populations. We performed cross-sectional analyses of 1089 residents (mean age 85 years; 77% female) from 59 AL facilities and 1000 residents (mean age 85 years; 66% female) from 54 LTC facilities, in Alberta, Canada. Research nurses completed comprehensive resident assessments at baseline (2006-2007). Facility-level factors were assessed using standardized administrator interviews. Generalized linear models were used to estimate odds ratios for associations, accounting for clustering by facility. Over a quarter of residents in AL (26.4%) and LTC (31.8%) were using antipsychotics (p = 0.006). Prevalence of potentially inappropriate use was similar in AL and LTC (23.4 vs. 26.8%, p = 0.09). However, among users, the proportion of antipsychotic use deemed potentially inappropriate was significantly higher in AL than LTC (AL: 231/287 = 80.5%; LTC: 224/318 = 70.4%; p = 0.004). In both settings, comparable findings regarding associations between resident characteristics (including dementia, psychiatric disorders, frailty, behavioral symptoms, and antidepressant use) and antipsychotic use were observed. Few facility characteristics were associated with overall antipsychotic use, but having a pharmacist on staff (AL), or an affiliated physician (LTC) was associated with a lower likelihood of potentially inappropriate antipsychotic use. Our findings illustrate the importance of including AL settings in clinical and policy initiatives aimed at reducing inappropriate antipsychotic use among older vulnerable residents.

Geologic constraints on the setting and dynamics of subduction initiation

NASA Astrophysics Data System (ADS)

Encarnacion, John; Keenan, Timothy

2017-04-01

Understanding where and how subduction zones have and can initiate is important because, besides being a critical step in the plate tectonic system, it can provide insight into the complex interactions of crust and mantle rheology, forces acting on the plates, strain, metamorphic reactions, and erosional and depositional processes at the surface. Insight into the possibilities of where and how subduction zones start has been provided by numerical and analog modeling. All sites for subduction initiation are potential weak zones in the lithosphere and include the continent-ocean boundary, oceanic arc-oceanic crust boundary, oceanic transform faults and fracture zones, oceanic detachment faults, and active or recently extinct oceanic ridges/spreading centers. Within the constraints of modeling, it has also been shown that the forces involved in the initiation of subduction can be largely horizontal (induced by a collision, say, or through 'ridge push') or vertical (driven by density contrasts). The latter scenario is often referred to as "spontaneous" subduction initiation, whereas the former situation may be called "forced"or "induced" subduction initiation. It is prudent, however, not to assume that "what can happen, did happen." So, the challenge for geologists is to infer from the rock record, through structural mapping, thermochronology, thermobarometry, geochemistry, paleomagnetics, and sedimentological studies, how any given subduction zone began. Even with a complete data set, it is not always possible to fully constrain the specific geologic setting or dynamics involved in the initiation of a given subduction zone. One can, however, often rule out certain scenarios, increasing the probability of others. Part of the geologic record of subduction initiation preserved at some subduction zones are so-called "metamorphic soles," which include high-temperature (T) and high-pressure (P) metamorphosed oceanic crust that was underthrust to asthenospheric mantle depths, metamorphosed, and then preserved in the hanging wall of the eventual subduction zone. These metamorphic soles may preserve important information bearing on the timing of subduction initiation, the evolving P and T conditions during subduction initiation, and, importantly, the protolith age of the initially subducted crust. The latter parameter—the age of the initially subducted oceanic crust at the time of subduction initiation—is an important constraint that has been lacking in many previous geologic studies of subduction initiation. Recent work on metamorphic soles has provided new information on subduction initiation, including the possibility of rapidly converting oceanic divergent boundaries into subduction zones.

Structure of a bacterial RNA polymerase holoenzyme open promoter complex

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

Bae, Brian; Feklistov, Andrey; Lass-Napiorkowska, Agnieszka

2015-09-08

Initiation of transcription is a primary means for controlling gene expression. In bacteria, the RNA polymerase (RNAP) holoenzyme binds and unwinds promoter DNA, forming the transcription bubble of the open promoter complex (RPo). We have determined crystal structures, refined to 4.14 Å-resolution, of RPo containing Thermus aquaticus RNAP holoenzyme and promoter DNA that includes the full transcription bubble. The structures, combined with biochemical analyses, reveal key features supporting the formation and maintenance of the double-strand/single-strand DNA junction at the upstream edge of the -10 element where bubble formation initiates. The results also reveal RNAP interactions with duplex DNA just upstreammore » of the -10 element and potential protein/DNA interactions that direct the DNA template strand into the RNAP active site. Addition of an RNA primer to yield a 4 base-pair post-translocated RNA:DNA hybrid mimics an initially transcribing complex at the point where steric clash initiates abortive initiation and σA dissociation.« less

Structure of a bacterial RNA polymerase holoenzyme open promoter complex

DOE PAGES

Bae, Brian; Feklistov, Andrey; Lass-Napiorkowska, Agnieszka; ...

2015-09-08

Initiation of transcription is a primary means for controlling gene expression. In bacteria, the RNA polymerase (RNAP) holoenzyme binds and unwinds promoter DNA, forming the transcription bubble of the open promoter complex (RPo). We have determined crystal structures, refined to 4.14 Å-resolution, of RPo containing Thermus aquaticus RNAP holoenzyme and promoter DNA that includes the full transcription bubble. The structures, combined with biochemical analyses, reveal key features supporting the formation and maintenance of the double-strand/single-strand DNA junction at the upstream edge of the -10 element where bubble formation initiates. The results also reveal RNAP interactions with duplex DNA just upstreammore » of the -10 element and potential protein/DNA interactions that direct the DNA template strand into the RNAP active site. Additionally a RNA primer to yield a 4 base-pair post-translocated RNA:DNA hybrid mimics an initially transcribing complex at the point where steric clash initiates abortive initiation and σ A dissociation.« less

Use of electrochemical potential noise to detect initiation and propagation of stress corrosion cracks in a 17-4 PH steel

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

Gonzalez-Rodriguez, J.G.; Salinas-Bravo, V.M.; Garcia-Ochoa, E.

1997-09-01

Corrosion potential transients were associated with nucleation and propagation of stress corrosion cracks in a 17-4 precipitation-hardenable (PH) martensitic stainless steel (SS) during slow strain rate tests (SSRT) at 90 C in deaerated sodium chloride (NaCl) solutions, Test solutions included 20 wt% NaCl at pH 3 and 7, similar to normal and faulted steam turbine environments, respectively. Time series were analyzed using the fast Fourier transform method. At the beginning of straining, the consistent noise behavior was perturbed with small potential transients, probably associated with rupture of the surface oxide layer. After yielding, these transients increased in intensity. At maximummore » load, the transients were still higher in intensity and frequency. These potential transients were related to crack nucleation and propagation. When the steel did not fail by stress corrosion cracking (SCC), such transients were found only at the beginning of the test. The power spectra showed some differences in all cases in roll-off slope and voltage magnitude, but these were not reliable tools to monitor the initiation and propagation of stress corrosion cracks.« less

Tropic lightning: myth or menace?

PubMed

McCarthy, John

2014-11-01

Lightning is one of the leading causes of death related to environmental disaster. Of all lightning fatalities documented between 2006 and 2012, leisure activities contributed the largest proportion of deaths, with water-associated, sports, and camping being the most common. Despite the prevalence of these activities throughout the islands, Hawai'i has had zero documented lightning fatalities since weather data tracking was initiated in 1959. There is a common misconception that lightning does not strike the ground in Hawai'i. This myth may contribute to a potentially dangerous false sense of security, and recognition of warning signs and risk factor modification remain the most important prevention strategies. Lightning damage occurs on a spectrum, from minor burns to multi-organ dysfunction. After injury, initial treatment should focus on "reverse triage" and immediate cardiopulmonary resuscitation when indicated, followed by transfer to a healthcare facility. Definitive treatment entails monitoring and management of potential sequelae, to include cardiovascular, neurologic, dermatologic, ophthalmologic, audiovestibular, and psychiatric complications.

The Toxic Exposure Surveillance System (TESS): Risk assessment and real-time toxicovigilance across United States poison centers

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

Watson, William A.; Litovitz, Toby L.; Belson, Martin G.

2005-09-01

The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations. Consideration of the strengths and limitations of TESS data must be incorporated into data interpretation. Real-time toxicovigilance was initiated in 2003 with continuous uploading of new cases from all poison centers to a central database. Real-timemore » toxicovigilance utilizing general and specific approaches is systematically run against TESS, further increasing the potential utility of poison center experiences as a means of early identification of potential public health threats.« less

Performance potential of gas-core and fusion rockets - A mission applications survey.

NASA Technical Reports Server (NTRS)

Fishbach, L. H.; Willis, E. A., Jr.

1971-01-01

This paper reports an evaluation of the performance potential of five nuclear rocket engines for four mission classes. These engines are: the regeneratively cooled gas-core nuclear rocket; the light bulb gas-core nuclear rocket; the space-radiator cooled gas-core nuclear rocket; the fusion rocket; and an advanced solid-core nuclear rocket which is included for comparison. The missions considered are: earth-to-orbit launch; near-earth space missions; close interplanetary missions; and distant interplanetary missions. For each of these missions, the capabilities of each rocket engine type are compared in terms of payload ratio for the earth launch mission or by the initial vehicle mass in earth orbit for space missions (a measure of initial cost). Other factors which might determine the engine choice are discussed. It is shown that a 60 day manned round trip to Mars is conceivable.-

Speed of CMEs and the Magnetic Non-Potentiality of Their Source ARs

NASA Technical Reports Server (NTRS)

Tiwari, Sanjiv K.; Falconer, David A.; Moore, Ronald L.; Venkatakrishnan, P.

2014-01-01

Most fast coronal mass ejections (CMEs) originate from solar active regions (ARs). Non-potentiality of ARs is expected to determine the speed and size of CMEs in the outer corona. Several other unexplored parameters might be important as well. To find out the correlation between the initial speed of CMEs and the non-potentiality of source ARs, we associated over a hundred of CMEs with source ARs via their co-produced flares. The speed of the CMEs are collected from the SOHO LASCO CME catalog. We have used vector magnetograms obtained mainly with HMI/SDO, also with Hinode (SOT/SP) when available within an hour of a CME occurrence, to evaluate various magnetic non-potentiality parameters, e.g. magnetic free-energy proxies, computed magnetic free energy, twist, shear angle, signed shear angle etc. We have also included several other parameters e.g. total unsigned flux, net current, magnetic area of ARs, area of sunspots, to investigate their correlation, if any, with the initial speeds of CMEs. Our preliminary results show that the ARs with larger non-potentiality and area mostly produce fast CMEs but they can also produce slower ones. The ARs with lesser non-potentiality and area generally produce only slower CMEs, however, there are a few exceptions. The total unsigned flux correlate with the non-potentiality parameters and area of ARs but some ARs with large unsigned flux are also found to be least non-potential. A more detailed analysis is underway.

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

PubMed

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

2013-12-01

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

Autonomous initiation and propagation of action potentials in neurons of the subthalamic nucleus.

PubMed

Atherton, Jeremy F; Wokosin, David L; Ramanathan, Sankari; Bevan, Mark D

2008-12-01

The activity of the subthalamic nucleus (STN) is intimately related to movement and is generated, in part, by voltage-dependent Na(+) (Na(v)) channels that drive autonomous firing. In order to determine the principles underlying the initiation and propagation of action potentials in STN neurons, 2-photon laser scanning microscopy was used to guide tight-seal whole-cell somatic and loose-seal cell-attached axonal/dendritic patch-clamp recordings and compartment-selective ion channel manipulation in rat brain slices. Action potentials were first detected in a region that corresponded most closely to the unmyelinated axon initial segment, as defined by Golgi and ankyrin G labelling. Following initiation, action potentials propagated reliably into axonal and somatodendritic compartments with conduction velocities of approximately 5 m s(-1) and approximately 0.7 m s(-1), respectively. Action potentials generated by neurons with axons truncated within or beyond the axon initial segment were not significantly different. However, axon initial segment and somatic but not dendritic or more distal axonal application of low [Na(+)] ACSF or the selective Na(v) channel blocker tetrodotoxin consistently depolarized action potential threshold. Finally, somatodendritic but not axonal application of GABA evoked large, rapid inhibitory currents in concordance with electron microscopic analyses, which revealed that the somatodendritic compartment was the principal target of putative inhibitory inputs. Together the data are consistent with the conclusions that in STN neurons the axon initial segment and soma express an excess of Na(v) channels for the generation of autonomous activity, while synaptic activation of somatodendritic GABA(A) receptors regulates the axonal initiation of action potentials.

Autonomous initiation and propagation of action potentials in neurons of the subthalamic nucleus

PubMed Central

Atherton, Jeremy F; Wokosin, David L; Ramanathan, Sankari; Bevan, Mark D

2008-01-01

The activity of the subthalamic nucleus (STN) is intimately related to movement and is generated, in part, by voltage-dependent Na+ (Nav) channels that drive autonomous firing. In order to determine the principles underlying the initiation and propagation of action potentials in STN neurons, 2-photon laser scanning microscopy was used to guide tight-seal whole-cell somatic and loose-seal cell-attached axonal/dendritic patch-clamp recordings and compartment-selective ion channel manipulation in rat brain slices. Action potentials were first detected in a region that corresponded most closely to the unmyelinated axon initial segment, as defined by Golgi and ankyrin G labelling. Following initiation, action potentials propagated reliably into axonal and somatodendritic compartments with conduction velocities of ∼5 m s−1 and ∼0.7 m s−1, respectively. Action potentials generated by neurons with axons truncated within or beyond the axon initial segment were not significantly different. However, axon initial segment and somatic but not dendritic or more distal axonal application of low [Na+] ACSF or the selective Nav channel blocker tetrodotoxin consistently depolarized action potential threshold. Finally, somatodendritic but not axonal application of GABA evoked large, rapid inhibitory currents in concordance with electron microscopic analyses, which revealed that the somatodendritic compartment was the principal target of putative inhibitory inputs. Together the data are consistent with the conclusions that in STN neurons the axon initial segment and soma express an excess of Nav channels for the generation of autonomous activity, while synaptic activation of somatodendritic GABAA receptors regulates the axonal initiation of action potentials. PMID:18832425

Religion and adolescent sexuality.

PubMed

Stayton, W R

1985-06-01

The health professional can be helpful to the adolescent, the adolescent's family, and the community through participating in and initiating local sex education programs. Religious settings provide a great potential for sexuality education within a value framework. A helpful curriculum will include the meaning of sexuality; developing a positive concept of sexuality, and a healthy sexual identity; present the issues of adolescent sexuality, including the various health issues; and an understanding of quality relationships within the family and among peers. If health professions and the community religious institutions can joint together, they can reach the goals of most programs in human sexuality, namely, "learning to appreciate our sexuality as a positive potential for self-expression, fulfillment and intimacy; respect for the personhood and well-being of others; and responsible decision-making."

Using the Periscope Live Video-Streaming Application for Global Pathology Education: A Brief Introduction.

PubMed

Fuller, Maren Y; Mukhopadhyay, Sanjay; Gardner, Jerad M

2016-07-21

Periscope is a live video-streaming smartphone application (app) that allows any individual with a smartphone to broadcast live video simultaneously to multiple smartphone users around the world. The aim of this review is to describe the potential of this emerging technology for global pathology education. To our knowledge, since the launch of the Periscope app (2015), only a handful of educational presentations by pathologists have been streamed as live video via Periscope. This review includes links to these initial attempts, a step-by-step guide for those interested in using the app for pathology education, and a summary of the pros and cons, including ethical/legal issues. We hope that pathologists will appreciate the potential of Periscope for sharing their knowledge, expertise, and research with a live (and potentially large) audience without the barriers associated with traditional video equipment and standard classroom/conference settings.

Comparing the risks of hospitalized heart failure associated with glinide, sulfonylurea, and acarbose use in type 2 diabetes: A nationwide study.

PubMed

Lee, Yen-Chieh; Chang, Chia-Hsuin; Dong, Yaa-Hui; Lin, Jou-Wei; Wu, Li-Chiu; Hwang, Jing-Shiang; Chuang, Lee-Ming

2017-02-01

Increasing evidence suggests that certain newer anti-diabetic drugs are associated with an increased risk of hospitalized heart failure (HHF). However, the potential risks associated with the use of sulfonylurea and glinide have not been carefully evaluated. A retrospective cohort study using the Taiwan National Health Insurance claims database was conducted to examine the risks of HHF among newly diagnosed type 2 diabetic patients who initiated glinide, sulfonylurea, or acarbose therapy during 2006-2012. The outcome of interest was hospitalization due to heart failure after treatment initiation, defined by ICD-9-CM code. A Cox proportional hazard regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) using acarbose as the reference group. A total of 25,638 glinide, 272,140 sulfonylurea, and 29,376 acarbose initiators were included in the analysis. Patients who initiated glinide had the highest crude HHF incidence. In the analysis adjusted for baseline differences, a significantly higher risk of HHF was found for glinide (adjusted HR, 1.53; 95% CI, 1.24-1.88), but not for sulfonylurea (adjusted HR, 0.94; 95% CI, 0.80-1.11), as compared with acarbose. The elevated risk remained consistent across different subgroups of patients as well as several sensitivity analyses including exploring the impact of potential unmeasured confounding. These findings indicated that, as compared with acarbose, glinide may be associated with a higher risk of HHF for type 2 diabetic patients. Further researchis needed to fully evaluate the risks and benefits of glinide therapy relative to other oral anti-diabetic agents. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Floral Morphology and Development in Quillajaceae and Surianaceae (Fabales), the Species-poor Relatives of Leguminosae and Polygalaceae

PubMed Central

Bello, M. A.; Hawkins, J. A.; Rudall, P. J.

2007-01-01

Background and Aims Molecular phylogenies have suggested a new circumscription for Fabales to include Leguminosae, Quillajaceae, Surianaceae and Polygalaceae. However, recent attempts to reconstruct the interfamilial relationships of the order have resulted in several alternative hypotheses, including a sister relationship between Quillajaceae and Surianaceae, the two species-poor families of Fabales. Here, floral morphology and ontogeny of these two families are investigated to explore evidence of a potential relationship between them. Floral traits are discussed with respect to early radiation in the order. Method Floral buds of representatives of Quillajaceae and Surianaceae were dissected and observed using light microscopy and scanning electron microscopy. Key Results Quillajaceae and Surianaceae possess some common traits, such as inflorescence morphology and perianth initiation, but development and organization of their reproductive whorls differ. In Quillaja, initiation of the diplostemonous androecium is unidirectional, overlapping with the petal primordia. In contrast, Suriana is obdiplostemonous, and floral organ initiation is simultaneous. Independent initiation of five carpels is common to both Quillaja and Suriana, but subsequent development differs; the antesepalous carpels of Quillaja become fused proximally and exhibit two rows of ovules, and in Suriana the gynoecium is apocarpous, gynobasic, with antepetalous biovulate carpels. Conclusions Differences in the reproductive development and organization of Quillajaceae and Surianaceae cast doubt on their potential sister relationship. Instead, Quillaja resembles Leguminosae in some floral traits, a hypothesis not suggested by molecular-based phylogenies. Despite implicit associations of zygomorphy with species-rich clades and actinomorphy with species-poor families in Fabales, this correlation sometimes fails due to high variation in floral symmetry. Studies considering specific derived clades and reproductive biology could address more precise hypotheses of key innovation and differential diversification in the order. PMID:17906327

Floral morphology and development in Quillajaceae and Surianaceae (Fabales), the species-poor relatives of Leguminosae and Polygalaceae.

PubMed

Bello, M A; Hawkins, J A; Rudall, P J

2008-06-01

Molecular phylogenies have suggested a new circumscription for Fabales to include Leguminosae, Quillajaceae, Surianaceae and Polygalaceae. However, recent attempts to reconstruct the interfamilial relationships of the order have resulted in several alternative hypotheses, including a sister relationship between Quillajaceae and Surianaceae, the two species-poor families of Fabales. Here, floral morphology and ontogeny of these two families are investigated to explore evidence of a potential relationship between them. Floral traits are discussed with respect to early radiation in the order. Floral buds of representatives of Quillajaceae and Surianaceae were dissected and observed using light microscopy and scanning electron microscopy. Quillajaceae and Surianaceae possess some common traits, such as inflorescence morphology and perianth initiation, but development and organization of their reproductive whorls differ. In Quillaja, initiation of the diplostemonous androecium is unidirectional, overlapping with the petal primordia. In contrast, Suriana is obdiplostemonous, and floral organ initiation is simultaneous. Independent initiation of five carpels is common to both Quillaja and Suriana, but subsequent development differs; the antesepalous carpels of Quillaja become fused proximally and exhibit two rows of ovules, and in Suriana the gynoecium is apocarpous, gynobasic, with antepetalous biovulate carpels. Differences in the reproductive development and organization of Quillajaceae and Surianaceae cast doubt on their potential sister relationship. Instead, Quillaja resembles Leguminosae in some floral traits, a hypothesis not suggested by molecular-based phylogenies. Despite implicit associations of zygomorphy with species-rich clades and actinomorphy with species-poor families in Fabales, this correlation sometimes fails due to high variation in floral symmetry. Studies considering specific derived clades and reproductive biology could address more precise hypotheses of key innovation and differential diversification in the order.

Funding community medicines by exception: a descriptive epidemiological study from New Zealand.

PubMed

Rasiah, Dilky; Edwards, Richard; Crampton, Peter

2012-02-24

To assess rates of approval and identify factors associated with successful applications for funding to the New Zealand Community Exceptional Circumstances (CEC) scheme. Descriptive quantitative analysis of data in CEC applications database. The main outcome was initial application approval rate. Analysis included calculation of unadjusted and adjusted associations between potential determinants (for example patient age, gender) and outcomes using logistic regression analysis. All CEC applications with a decision about approval or decline 1 October 2001 to 30 September 2008 were included. Application numbers were high, but had reduced since 2001. A small number of medicines (11) and indications comprised about a third of the applications to the scheme. While some common applications were clearly outside the remit of the scheme, many applications were for patients who fitted the scheme's eligibility criteria. The overall initial application approval rate was 16% and the renewal application approval rate was 88%. Approval rates varied widely by type of medicine, therapeutic group and indication. After adjusting for other potential determinants there were no statistically significant differences in initial approval rates by gender, ethnicity or socioeconomic status of the patient. There were however, significant differences in initial application approval by age of the patient, type of applicant doctor and by geographical location of the applicant doctor. There was no evidence that gender, ethnicity and socioeconomic status of patients were factors associated with successful applications. However, applications for younger patients, those made by specialists, and those made by applying clinicians from the Auckland District Health Board area were more likely to be successful. It is possible that this may to some degree be appropriate, but requires further research.

Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1. Volume 5: Analysis of core damage frequency from seismic events during mid-loop operations

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

Budnitz, R.J.; Davis, P.R.; Ravindra, M.K.

1994-08-01

In 1989 the US Nuclear Regulatory Commission (NRC) initiated an extensive program to examine carefully the potential risks during low-power and shutdown operations. The program included two parallel projects, one at Brookhaven National Laboratory studying a pressurized water reactor (Surry Unit 1) and the other at Sandia National Laboratories studying a boiling water reactor (Grand Gulf). Both the Brookhaven and Sandia projects have examined only accidents initiated by internal plant faults--so-called ``internal initiators.`` This project, which has explored the likelihood of seismic-initiated core damage accidents during refueling shutdown conditions, is complementary to the internal-initiator analyses at Brookhaven and Sandia. Thismore » report covers the seismic analysis at Surry Unit 1. All of the many systems modeling assumptions, component non-seismic failure rates, and human error rates that were used in the internal-initiator study at Surry have been adopted here, so that the results of the two studies can be as comparable as possible. Both the Brookhaven study and this study examine only two shutdown plant operating states (POSs) during refueling outages at Surry, called POS 6 and POS 10, which represent mid-loop operation before and after refueling, respectively. This analysis has been limited to work analogous to a level-1 seismic PRA, in which estimates have been developed for the core-damage frequency from seismic events during POSs 6 and 10. The results of the analysis are that the core-damage frequency of earthquake-initiated accidents during refueling outages in POS 6 and POS 10 is found to be low in absolute terms, less than 10{sup {minus}6}/year.« less

Evaluation of potential severe accidents during low power and shutdown operations at Grand Gulf, Unit 1. Volume 5: Analysis of core damage frequency from seismic events for plant operational state 5 during a refueling outage

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

Budnitz, R.J.; Davis, P.R.; Ravindra, M.K.

In 1989 the US Nuclear Regulatory Commission (NRC) initiated an extensive program to examine carefully the potential risks during low-power and shutdown operations. The program included two parallel projects, one at Sandia National Laboratories studying a boiling water reactor (Grand Gulf), and the other at Brookhaven National Laboratory studying a pressurized water reactor (Surry Unit 1). Both the Sandia and Brookhaven projects have examined only accidents initiated by internal plant faults---so-called ``internal initiators.`` This project, which has explored the likelihood of seismic-initiated core damage accidents during refueling outage conditions, is complementary to the internal-initiator analyses at Brookhaven and Sandia. Thismore » report covers the seismic analysis at Grand Gulf. All of the many systems modeling assumptions, component non-seismic failure rates, and human effort rates that were used in the internal-initiator study at Grand Gulf have been adopted here, so that the results of the study can be as comparable as possible. Both the Sandia study and this study examine only one shutdown plant operating state (POS) at Grand Gulf, namely POS 5 representing cold shutdown during a refueling outage. This analysis has been limited to work analogous to a level-1 seismic PRA, in which estimates have been developed for the core-damage frequency from seismic events during POS 5. The results of the analysis are that the core-damage frequency for earthquake-initiated accidents during refueling outages in POS 5 is found to be quite low in absolute terms, less than 10{sup {minus}7}/year.« less

ER stress inducer tunicamycin suppresses the self-renewal of glioma-initiating cell partly through inhibiting Sox2 translation.

PubMed

Xing, Yang; Ge, Yuqing; Liu, Chanjuan; Zhang, Xiaobiao; Jiang, Jianhai; Wei, Yuanyan

2016-06-14

Glioma-initiating cells possess tumor-initiating potential and are relatively resistant to conventional chemotherapy and irradiation. Therefore, their elimination is an essential factor for the development of efficient therapy. Here, we report that endoplasmic reticulum (ER) stress inducer tunicamycin inhibits glioma-initiating cell self-renewal as determined by neurosphere formation assay. Moreover, tunicamycin decreases the efficiency of glioma-initiating cell to initiate tumor formation. Although tunicamycin induces glioma-initiating cell apoptosis, apoptosis inhibitor z-VAD-fmk only partly abrogates the reduction in glioma-initiating cell self-renewal induced by tunicamycin. Indeed, tunicamycin reduces the expression of self-renewal regulator Sox2 at translation level. Overexpression of Sox2 obviously abrogates the reduction in glioma-initiating cell self-renewal induced by tunicamycin. Taken together, tunicamycin suppresses the self-renewal and tumorigenic potential of glioma-initiating cell partly through reducing Sox2 translation. This finding provides a cue to potential effective treatment of glioblastoma through controlling stem cells.

Empowering potential: a theory of wellness motivation.

PubMed

Fleury, J D

1991-01-01

Data were collected from 29 individuals who were attempting to initiate and sustain programs of cardiac risk factor modification. Data were analyzed through the technique of constant comparative analysis. Empowering potential, the basic social process identified from the data, explained individual motivation to initiate and sustain cardiovascular health behavior. Empowering potential was a continuous process of individual growth and development which facilitated the emergence of new and positive health patterns. Within the process of empowering potential, individuals use a variety of strategies which guide the initiation and maintenance of health-related change. The process of empowering potential consists of three stages: appraising readiness, changing, and integrating change. Two categories occurred throughout the process of empowering potential: imaging and social support systems. These findings provide a better understanding of how motivated action is initiated and reinitiated over time.

C-Band Airport Surface Communications System Standards Development. Phase II Final Report. Volume 1: Concepts of Use, Initial System Requirements, Architecture, and AeroMACS Design Considerations

NASA Technical Reports Server (NTRS)

Hall, Edward; Isaacs, James; Henriksen, Steve; Zelkin, Natalie

2011-01-01

This report is provided as part of ITT s NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract NNC05CA85C, Task 7: New ATM Requirements-Future Communications, C-Band and L-Band Communications Standard Development and was based on direction provided by FAA project-level agreements for New ATM Requirements-Future Communications. Task 7 included two subtasks. Subtask 7-1 addressed C-band (5091- to 5150-MHz) airport surface data communications standards development, systems engineering, test bed and prototype development, and tests and demonstrations to establish operational capability for the Aeronautical Mobile Airport Communications System (AeroMACS). Subtask 7-2 focused on systems engineering and development support of the L-band digital aeronautical communications system (L-DACS). Subtask 7-1 consisted of two phases. Phase I included development of AeroMACS concepts of use, requirements, architecture, and initial high-level safety risk assessment. Phase II builds on Phase I results and is presented in two volumes. Volume I (this document) is devoted to concepts of use, system requirements, and architecture, including AeroMACS design considerations. Volume II describes an AeroMACS prototype evaluation and presents final AeroMACS recommendations. This report also describes airport categorization and channelization methodologies. The purposes of the airport categorization task were (1) to facilitate initial AeroMACS architecture designs and enable budgetary projections by creating a set of airport categories based on common airport characteristics and design objectives, and (2) to offer high-level guidance to potential AeroMACS technology and policy development sponsors and service providers. A channelization plan methodology was developed because a common global methodology is needed to assure seamless interoperability among diverse AeroMACS services potentially supplied by multiple service providers.

[Discover potential inhibitors of 5-LOX and LTA4H from Rhei Radix et Rhizoma, Notopterygii Rhizoma et Radix and Genitana Macrophyllae Radix based on molecular simulation methods].

PubMed

Gu, Yu; Zhang, Xu; Chen, Yan-Kun; Zhao, Bo-Wen; Zhang, Yan-Ling

2017-12-01

5-lipoxygenase (5-LOX) and leukotriene A4 hydrolase (LTA4H), as the major targets of 5-LOX branch in the arachidonic acid (AA) metabolic pathway, play an important role in the treatment of inflammation. Rhei Radix et Rhizoma, Notopterygii Rhizoma et Radix and Genitana Macrophyllae Radix have clear anti-inflammation activities. In this paper, the targets of 5-LOX and LTA4H were used as the research carrier, and Hiphop module in DS4.0 (Discovery studio) was used to construct ingredients database for preliminary screening of three traditional Chinese medicines based on target inhibitor pharmacophore, so as to obtain 5-LOX and LTA4H potential active ingredients. The ingredients obtained in initial pharmacophore screening were further screened by using CDOCKER module, and the screening rules were established based on the score of initial compound and the key amino acids to obtain 12 potential 5-LOX inhibitors and 7 potential LTA4H inhibitors. To be more specific, the potential 5-LOX inhibitors included 6 ingredients in Rhei Radix et Rhizoma, such as procyanidins B2-3,3'-O-double gallate and revandchinone 2; four ingredients in notopterygium, such as dodecanoic acid and so on. On the other hand, potential LTA4H inhibitors included revandchinone 1, revandchinone 4 in Rhei Radix et Rhizoma, tridecanoic acid, tetracosanoic acid and methyl eicosanoate in Notopterygii Rhizoma et Radix, montanic acid methyl ester and N-docosanoyl-O-aminobenzoate in Genitana Macrophyllae Radix and so on. The molecular simulation methods were highly efficient and time-saving to obtain the potential inhibitors of 5-LOX and LTA4H, which could provide assistance for discovering the chemical quality indicators of anti-inflammatory efficacy of three Chinese herbs, and may be helpful to promote the whole-process quality control of three Chinese herbs. Copyright© by the Chinese Pharmaceutical Association.

Altered mental status in a U.S. Army Special Forces Soldier.

PubMed

Brandon, Jonathan; Hill, Guyon J

2011-01-01

Special Operations medical provider must be familiar with the differential diagnosis for a patient with altered mental status since it includes multiple life-threatening illnesses. Potential diagnoses include meningitis, encephalitis, malaria and many others. While preparing to evacuate to definitive care from an austere location, they must also be prepared to initiate empiric therapy that is specific to the patient and the area of operations. We present a case of a U.S. Army Special Forces Soldier that developed limbic encephalitis of presumed Herpes Simplex Virus (HSV) origin. We will review the key differential diagnoses for this presentation with a focus on infectious etiologies. We will also summarize current diagnostic and therapeutic strategies. Our recommendation is to initiate oral acyclovir when IV acyclovir is not available and this diagnosis cannot be excluded. 2011.

Impact trajectories of the asteroid Apophis in the 21st century

NASA Astrophysics Data System (ADS)

Sokolov, L. L.; Bashakov, A. A.; Borisova, T. P.; Petrov, N. A.; Pitjev, N. P.; Shaidulin, V. S.

2012-07-01

The asteroid Apophis is one of the most hazardous near-Earth asteroids. As a result of the scattering of Apophis' potential trajectories after its close approach in 2029, and its possible approach in 2036, there are many dangerous trajectories including impact trajectories after 2036. The purpose of this study is to identify and investigate these trajectories. We use the Everhart integrator; the DE405, DE423, and EPM2008 ephemerides; and two sets of initial data for Apophis (those collected by NASA in 2006 and by the IAA in 2010). More than 50 possible encounters in this century are presented, including 13 encounters between 2036 and 2050. The minimum geocentric distances obtained using a different ephemeris and initial conditions differ little between themselves. Analogous results in (Yeomans et al., 2009) are consistent with our results.

Initiatives and Challenges in Consequence Management after a WMD Attack

DTIC Science & Technology

2004-08-01

Challenges in Consequence Management people to seek shelter or other protection when possible, to avoid exposure to weapons of mass destruction effects . The...Potential Effects .........................................9 V. Methods for Managing the Consequences of WMD Use.................14 VI. Toward a...mass destruction (WMD). Consequence management1 is a process to mitigate the effects of the use of weapons of mass destruction, including

Effects of thinning intensity and crown class on cherrybark oak epicormic branching five years after treatment

Treesearch

Luben D. Dimov; Erika Stelzer; Kristi Wharton; James S. Meadows; Jim L. Chambers; Kenny Ribbeck; E. Barry Moser

2006-01-01

Thinning in oak-dominated stands may have many desirable consequences, including increases in tree growth and mast production. One of the potential disadvantages, however, is the proliferation of epicormic branches, which leads to reduction in lumber quality and value. We assessed the effects of thinning intensity and initial crown class on cherrybark oak (...

Epinephrine (adrenaline) in anaphylaxis.

PubMed

Simons, F Estelle R; Simons, Keith J

2010-01-01

Epinephrine (adrenaline) is universally recommended as the initial drug of choice for the treatment of anaphylaxis. No other medication has similar life-saving pharmacologic effects in multiple organ systems, including prevention and relief of both upper and lower airway obstruction, and of shock. Failure to inject epinephrine promptly contributes to anaphylaxis fatalities. It is most effective when given immediately after the onset of anaphylaxis symptoms. The initial recommended adult dose is 0.3-0.5 mg, injected intramuscularly in the anterolateral aspect of the mid-thigh. Injected by other routes, epinephrine appears to have a less satisfactory therapeutic window; for example, onset of action is potentially delayed when it is injected subcutaneously, and risk of adverse effects potentially increases when it is injected intravenously. The possibility of randomized, controlled trials of epinephrine in anaphylaxis should be considered. For ethical reasons, these trials will not be placebo-controlled. They might involve comparison of one epinephrine dose versus another, or one route of epinephrine administration versus another. For first-aid treatment of people with anaphylaxis in the community, novel epinephrine formulations are being developed. These include epinephrine autoinjectors that are safer and easier to use, and epinephrine formulations that can be administered through non-invasive routes. Copyright 2010 S. Karger AG, Basel.

Idiopathic Intracranial Hypertension-A Comparison of Clinical Characteristics Between 4 Medical Centers in Different Geographic Regions of the World.

PubMed

Rosenblatt, Amir; Klein, Ainat; Roemer, Ségolène; Borruat, François-Xavier; Meira, Dália; Silva, Marta; Gökçay, Figen; Çelebisoy, Neşe; Kesler, Anat

2016-09-01

Idiopathic intracranial hypertension (IIH) is a well-characterized syndrome, most commonly affecting obese women of childbearing age. Differences in its prevalence have been reported in various populations. The aim of this article was to determine whether differences in clinical presentation and management exist for patients with IIH between different regions the world. Retrospective database analysis of adult patients with IIH from 4 different neuro-ophthalmology clinics. The data collected included gender, age of onset, body mass index (BMI), lumbar puncture opening pressure, initial visual acuity (VA), initial visual field (VF) mean deviation (MD), pharmacological or surgical treatment, length of follow-up, final VA, and final VF MD. The study population consisted of 244 patients, with significant regional variations of female to male ratio. Overall, there was no significant difference regarding the age of diagnosis or the BMI. Acetazolamide was the first line of treatment in all groups but there was a difference between countries regarding second-line treatment, including the use of surgical interventions. Mean initial VA differed between groups but the final change in VA was the same among all the study groups. There are differences in IIH presentation, treatment, and response to therapy among different countries. International prospective studies involving multiple centers are needed to determine the potential influence of environmental and genetic factors on the development of IIH and to improve the management of this potentially blinding disorder.

The impact of initial antibiotic treatment failure: Real-world insights in healthcare-associated or nosocomial pneumonia.

PubMed

Ryan, Kellie; Karve, Sudeep; Peeters, Pascale; Baelen, Elisa; Potter, Danielle; Rojas-Farreras, Sonia; Pascual, Esther; Rodríguez-Baño, Jesús

2018-05-06

To assess real-world treatment patterns and clinical outcomes associated with initial antibiotic therapy (IAT, antibiotics received ≤ 48 h post-initiation of antibiotic therapy), including level of IAT failure, and potential risk factors for IAT failure in healthcare-associated infections. Data were obtained from medical records of adult patients hospitalized with healthcare-associated pneumonia (HCAP) and nosocomial pneumonia (NP), including ventilator-associated pneumonia, from 1 July 2013 to 30 June 2014 in Brazil, France, Italy, Russia and Spain during the retrospective, observational study, RECOMMEND (NCT02364284; D4280R00005). Potential risk factors for IAT failure were explored using logistic regression analyses. Mean (standard deviation) age and Deyo-Charlson Comorbidity Score were 66.0 (16.2) years and 2.4 (2.4), respectively (N = 451). Most patients (62.5%) received monotherapy. Mean (standard deviation) duration of IAT was 8.8 (7.2) days. Multidrug-resistant (MDR) pathogens were identified in 52.4% of patients with ≥ 1 pathogen isolated (154/294). IAT failure was recorded in 72.5% of patients and was significantly associated with isolation of a MDR pathogen and country using multivariate analyses. Real-world data demonstrate the burden of HCAP/NP, with high rates of IAT failure. The association of IAT failure with MDR pathogens highlights the urgent need to understand and account for local prevalence of MDR pathogens when selecting IAT for the management of HCAP/NP. Copyright © 2018. Published by Elsevier Ltd.

Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence.

PubMed

Dube, Shanta R; Miller, Jacqueline W; Brown, David W; Giles, Wayne H; Felitti, Vincent J; Dong, Maxia; Anda, Robert F

2006-04-01

Alcohol is the most common and frequently used drug and has the potential to cause multiple deleterious effects throughout the lifespan. Because early age at initiation of alcohol use increases this potential and programs and laws are in place to attempt to delay the onset of alcohol use, we studied the relationship between multiple adverse childhood experiences (ACEs) and both the likelihood of ever drinking and the age at initiating alcohol use. This was a retrospective cohort study of 8417 adult health maintenance organization (HMO) members in California who completed a survey about ACEs, which included childhood abuse and neglect, growing up with various forms of household dysfunction and alcohol use in adolescence and adulthood. The main outcomes measured were ever drinking and age at initiating alcohol use among ever-drinkers for four age categories: < or = 14 years (early adolescence), 15 to 17 years (mid adolescence), and 18 to 20 years (late adolescence); age > or = 21 years was the referent. The relationship between the total number of adverse childhood experiences (ACE score) and early initiation of alcohol use (< or =14 years) among four birth cohorts dating back to 1900 was also examined. Eighty-nine percent of the cohort reported ever drinking; all individual ACEs except physical neglect increased the risk of ever using alcohol (p < .05). Among ever drinkers, initiating alcohol use by age 14 years was increased two- to threefold by individual ACEs (p < .05). ACEs also accounted for a 20% to 70% increased likelihood of alcohol use initiated during mid adolescence (15-17 years). The total number of ACEs (ACE score) had a very strong graded relationship to initiating alcohol use during early adolescence and a robust but somewhat less strong relationship to initiation during mid adolescence. For each of the four birth cohorts, the ACE score had a strong, graded relationship to initiating alcohol use by age 14 years (p < .05). Adverse childhood experiences are strongly related to ever drinking alcohol and to alcohol initiation in early and mid adolescence, and the ACE score had a graded or "dose-response" relationship to these alcohol use behaviors. The persistent graded relationship between the ACE score and initiation of alcohol use by age 14 for four successive birth cohorts dating back to 1900 suggests that the stressful effects of ACEs transcend secular changes, including the increased availability of alcohol, alcohol advertising, and the recent campaigns and health education programs to prevent alcohol use. These findings strongly suggest that efforts to delay the age of onset of drinking must recognize the contribution of multiple traumatic and stressful events to alcohol-seeking behavior among children and adolescents.

Energy savings for heat-island reduction strategies in Chicago and Houston (including updates for Baton Rouge, Sacramento, and Salt Lake City)

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

Konopacki, S.; Akbari, H.

2002-02-28

In 1997, the U.S. Environmental Protection Agency (EPA) established the ''Heat Island Reduction Initiative'' to quantify the potential benefits of Heat-Island Reduction (HIR) strategies (i.e., shade trees, reflective roofs, reflective pavements and urban vegetation) to reduce cooling-energy use in buildings, lower the ambient air temperature and improve urban air quality in cities, and reduce CO2 emissions from power plants. Under this initiative, the Urban Heat Island Pilot Project (UHIPP) was created with the objective of investigating the potential of HIR strategies in residential and commercial buildings in three initial UHIPP cities: Baton Rouge, LA; Sacramento, CA; and Salt Lake City,more » UT. Later two other cities, Chicago, IL and Houston, TX were added to the UHIPP. In an earlier report we summarized our efforts to calculate the annual energy savings, peak power avoidance, and annual CO2 reduction obtainable from the introduction of HIR strategies in the initial three cities. This report summarizes the results of our study for Chicago and Houston. In this analysis, we focused on three building types that offer the highest potential savings: single-family residence, office and retail store. Each building type was characterized in detail by vintage and system type (i.e., old and new building constructions, and gas and electric heat). We used the prototypical building characteristics developed earlier for each building type and simulated the impact of HIR strategies on building cooling- and heating-energy use and peak power demand using the DOE-2.1E model. Our simulations included the impact of (1) strategically-placed shade trees near buildings [direct effect], (2) use of high-albedo roofing material on the building [direct effect], (3) urban reforestation with high-albedo pavements and building surfaces [indirect effect] and (4) combined strategies 1, 2, and 3 [direct and indirect effects]. We then estimated the total roof area of air-conditioned buildings in each city using readily obtainable data to calculate the metropolitan-wide impact of HIR strategies. The results show that in Chicago, potential annual energy savings of $30M could be realized by ratepayers from the combined direct and indirect effects of HIR strategies. Additionally, peak power avoidance is estimated at 400 MW and the reduction in annual carbon emissions at 58 ktC. In Houston, the potential annual energy savings are estimated at $82M, with an avoidance of 730 MW in peak power and a reduction in annual carbon emissions of 170 ktC.« less

Circulating carotenoid concentrations are positively correlated with later clutch initiation in Florida Scrub-Jays (Aphelocoma coerulescens).

PubMed

Heiss, Rebecca S; Cohen, Alan A; Bowman, Reed; Boughton, Raoul K; Bridge, Eli; McGraw, Kevin J; Schoech, Stephan J

2011-02-01

Antioxidants play key roles in preventing free radical damage to various molecules, cells, and tissues, but it is not well understood how variation in antioxidant levels may relate to the reproductive success or health of wild animals. We explored the relationship between circulating antioxidant concentrations and both body condition and timing of reproduction in male and female Florida Scrub-Jays (Aphelocoma coerulescens), a cooperatively breeding passerine bird. We examined whether levels of uric acid, vitamin E, and carotenoids (all potentially important antioxidants) were linked to body condition and timing of reproduction, two measures that are directly related to reproductive success. Antioxidant concentrations were not correlated with body condition, but they were related to timing of first clutch initiation, though not always in the predicted direction. Elevated circulating levels of carotenoids were associated with delayed clutch initiation in female breeders. Relatively higher vitamin E levels in control birds were associated with earlier clutch initiation, whereas male breeders that received long-term food supplementation had elevated levels of vitamin E and delayed reproduction. Several potential explanations for the link between elevated levels of antioxidants and delayed clutch initiation are discussed. Separate explanations for each sex include, but are not limited to, oxidative stress as a result of territory defense efforts in males, different dietary regimes due to supplementation, and mobilized plasma antioxidants in females that were coping with a stressor. © 2010 Wiley-Liss, Inc.

Regionalization as an approach to regulatory systems strengthening: a case study in CARICOM member states.

PubMed

Preston, Charles; Chahal, Harinder S; Porrás, Analia; Cargill, Lucette; Hinds, Maryam; Olowokure, Babatunde; Cummings, Rudolph; Hospedales, James

2016-05-01

Improving basic capacities for regulation of medicines and health technologies through regulatory systems strengthening is particularly challenging in resource-constrained settings. "Regionalization"-an approach in which countries with common histories, cultural values, languages, and economic conditions work together to establish more efficient systems-may be one answer. This report describes the Caribbean Regulatory System (CRS), a regionalization initiative being implemented in the mostly small countries of the Caribbean Community and Common Market (CARICOM). This initiative is an innovative effort to strengthen regulatory systems in the Caribbean, where capacity is limited compared to other subregions of the Americas. The initiative's concept and design includes a number of features and steps intended to enhance sustainability in resource-constrained contexts. The latter include 1) leveraging existing platforms for centralized cooperation, governance, and infrastructure; 2) strengthening regulatory capacities with the largest potential public health impact; 3) incorporating policies that promote reliance on reference authorities; 4) changing the system to encourage industry to market their products in CARICOM (e.g., using a centralized portal of entry to reduce regulatory burdens); and 5) building human resource capacity. If implemented properly, the CRS will be self-sustaining through user fees. The experience and lessons learned thus far in implementing this initiative, described in this report, can serve as a case study for the development of similar regulatory strengthening initiatives in resource-constrained environments.

A heuristic neural network initialization scheme for modeling nonlinear functions in engineering mechanics: continuous development

NASA Astrophysics Data System (ADS)

Pei, Jin-Song; Mai, Eric C.

2007-04-01

This paper introduces a continuous effort towards the development of a heuristic initialization methodology for constructing multilayer feedforward neural networks to model nonlinear functions. In this and previous studies that this work is built upon, including the one presented at SPIE 2006, the authors do not presume to provide a universal method to approximate arbitrary functions, rather the focus is given to the development of a rational and unambiguous initialization procedure that applies to the approximation of nonlinear functions in the specific domain of engineering mechanics. The applications of this exploratory work can be numerous including those associated with potential correlation and interpretation of the inner workings of neural networks, such as damage detection. The goal of this study is fulfilled by utilizing the governing physics and mathematics of nonlinear functions and the strength of the sigmoidal basis function. A step-by-step graphical procedure utilizing a few neural network prototypes as "templates" to approximate commonly seen memoryless nonlinear functions of one or two variables is further developed in this study. Decomposition of complex nonlinear functions into a summation of some simpler nonlinear functions is utilized to exploit this prototype-based initialization methodology. Training examples are presented to demonstrate the rationality and effciency of the proposed methodology when compared with the popular Nguyen-Widrow initialization algorithm. Future work is also identfied.

Universal Surface-initiated Polymerization of Antifouling Zwitterionic Brushes Using A Mussel-Mimetic Peptide Initiator

PubMed Central

Kuang, Jinghao; Messersmith, Phillip B.

2012-01-01

We report a universal method for the surface-initated polymerization (SIP) of a antifouling polymer brush on various classes of surfaces, including noble metals, metal oxides and inert polymers. Inspired by the versatility of mussel adhesive proteins, we synthesized a novel bifunctional tripeptide bromide (BrYKY) which combines an atom transfer radical polymerization (ATRP) initiating alkyl bromide with l-3,4-dihydroxyphenylalanine (DOPA) and lysine. Simple dip-coating of substrates with variable wetting properties and compositions, including Teflon®, in a BrYKY solution at pH 8.5 led to formation of a thin film of cross-linked BrYKY. Subsequently, we showed that the BrYKY layer initiated the ATRP of a zwitterionic monomer, sulfobetaine methacrylate (SBMA) on all substrates, resulting in high density antifouling pSBMA brushes. Both BrYKY deposition and pSBMA grafting were unambiguously confirmed by ellipsometry, X-ray photoelectron spectroscopy and goniometry. All substrates that were coated with BrYKY/pSBMA dramatically reduced bacterial adhesion for 24 h and also resisted mammalian cell adhesion for at least 4 months, demonstrating the long-term stability of the BrYKY anchoring and antifouling properties of pSBMA. The use of BrYKY as a primer and polymerization initiator has the potential to be widely employed in surface grafted polymer brush modifications for biomedical and other applications. PMID:22506651

Initial results from the Solar Dynamic (SD) Ground Test Demonstration (GTD) project at NASA Lewis

NASA Technical Reports Server (NTRS)

Shaltens, Richard K.; Boyle, Robert V.

1995-01-01

A government/industry team designed, built, and tested a 2 kWe solar dynamic space power system in a large thermal/vacuum facility with a simulated sun at the NASA Lewis Research Center. The Lewis facility provides an accurate simulation of temperatures, high vacuum, and solar flux as encountered in low earth orbit. This paper reviews the goals and status of the Solar Dynamic (SD) Ground Test Demonstration (GTD) program and describes the initial testing, including both operational and performance data. This SD technology has the potential as a future power source for the International Space Station Alpha.

Pick and Eat Crop Testing: Dwarf Tomato and Pepper as Candidate Space Crops

NASA Technical Reports Server (NTRS)

Wheeler, R. M.; Massa, G. D.; Stutte, G. W.; Spencer, L. E.; Hummerick, M. E.; Sirmons, T.; Douglas, G. L.

2016-01-01

Dwarf tomato and pepper plants were grown in controlled environment chambers to assess their potential as space crops for supplementing the crew's diet. Six cultivars of each species were compared in initial tests and then down-selected to three cultivars of each. Initial selection criteria included fruit yield, growth height, and nutritional value. Following completion of a second production test with the three best performing cultivars, sample fruits of both tomato and peppers were then assessed for acceptance using tasting panels. Based on the criteria considered in these studies, Red Robin tomato and Pompeii pepper were recommended for consideration for use in space.

NREL Screens Universities for Solar and Battery Storage Potential

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

In support of the U.S. Department of Energy's SunShot initiative, NREL provided solar photovoltaic (PV) screenings in 2016 for eight universities seeking to go solar. NREL conducted an initial technoeconomic assessment of PV and storage feasibility at the selected universities using the REopt model, an energy planning platform that can be used to evaluate RE options, estimate costs, and suggest a mix of RE technologies to meet defined assumptions and constraints. NREL provided each university with customized results, including the cost-effectiveness of PV and storage, recommended system size, estimated capital cost to implement the technology, and estimated life cycle costmore » savings.« less

Action potentials in retinal ganglion cells are initiated at the site of maximal curvature of the extracellular potential.

PubMed

Eickenscheidt, Max; Zeck, Günther

2014-06-01

The initiation of an action potential by extracellular stimulation occurs after local depolarization of the neuronal membrane above threshold. Although the technique shows remarkable clinical success, the site of action and the relevant stimulation parameters are not completely understood. Here we identify the site of action potential initiation in rabbit retinal ganglion cells (RGCs) interfaced to an array of extracellular capacitive stimulation electrodes. We determine which feature of the extracellular potential governs action potential initiation by simultaneous stimulation and recording RGCs interfaced in epiretinal configuration. Stimulation electrodes were combined to areas of different size and were presented at different positions with respect to the RGC. Based on stimulation by electrodes beneath the RGC soma and simultaneous sub-millisecond latency measurement we infer axonal initiation at the site of maximal curvature of the extracellular potential. Stimulation by electrodes at different positions along the axon reveals a nearly constant threshold current density except for a narrow region close to the cell soma. These findings are explained by the concept of the activating function modified to consider a region of lower excitability close to the cell soma. We present a framework how to estimate the site of action potential initiation and the stimulus required to cross threshold in neurons tightly interfaced to capacitive stimulation electrodes. Our results underscore the necessity of rigorous electrical characterization of the stimulation electrodes and of the interfaced neural tissue.

The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit.

PubMed

Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

2017-04-01

The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care.

Healthy urban environments for children and young people: A systematic review of intervention studies.

PubMed

Audrey, Suzanne; Batista-Ferrer, Harriet

2015-11-01

This systematic review collates, and presents as a narrative synthesis, evidence from interventions which included changes to the urban environment and reported at least one health behaviour or outcome for children and young people. Following a comprehensive search of six databases, 33 primary studies relating to 27 urban environment interventions were included. The majority of interventions related to active travel. Others included park and playground renovations, road traffic safety, and multi-component community-based initiatives. Public health evidence for effectiveness of such interventions is often weak because study designs tend to be opportunistic, non-randomised, use subjective outcome measures, and do not incorporate follow-up of study participants. However, there is some evidence of potential health benefits to children and young people from urban environment interventions relating to road safety and active travel, with evidence of promise for a multi-component obesity prevention initiative. Future research requires more robust study designs incorporating objective outcome measures. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

An Electronic Health Record - Public Health (EHR-PH) System Prototype for Interoperability in 21st Century Healthcare Systems

PubMed Central

Orlova, Anna O.; Dunnagan, Mark; Finitzo, Terese; Higgins, Michael; Watkins, Todd; Tien, Allen; Beales, Steven

2005-01-01

Information exchange, enabled by computable interoperability, is the key to many of the initiatives underway including the development of Regional Health Information Exchanges, Regional Health Information Organizations, and the National Health Information Network. These initiatives must include public health as a full partner in the emerging transformation of our nation’s healthcare system through the adoption and use of information technology. An electronic health record - public health (EHR-PH) system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal element for a potential technical architecture for a NHIN. PMID:16779105

The value of demonstration projects for new interventions: The case of human papillomavirus vaccine introduction in low- and middle-income countries.

PubMed

Howard, N; Mounier-Jack, S; Gallagher, K E; Kabakama, S; Griffiths, U K; Feletto, M; LaMontagne, D S; Burchett, H E D; Watson-Jones, D

2016-09-01

Demonstration projects or pilots of new public health interventions aim to build learning and capacity to inform country-wide implementation. Authors examined the value of HPV vaccination demonstration projects and initial national programmes in low-income and lower-middle-income countries, including potential drawbacks and how value for national scale-up might be increased. Data from a systematic review and key informant interviews, analyzed thematically, included 55 demonstration projects and 8 national programmes implemented between 2007-2015 (89 years' experience). Initial demonstration projects quickly provided consistent lessons. Value would increase if projects were designed to inform sustainable national scale-up. Well-designed projects can test multiple delivery strategies, implementation for challenging areas and populations, and integration with national systems. Introduction of vaccines or other health interventions, particularly those involving new target groups or delivery strategies, needs flexible funding approaches to address specific questions of scalability and sustainability, including learning lessons through phased national expansion.

Space Technology Mission Directorate Game Changing Development Program FY2015 Annual Program Review: Advanced Manufacturing Technology

NASA Technical Reports Server (NTRS)

Vickers, John; Fikes, John

2015-01-01

The Advance Manufacturing Technology (AMT) Project supports multiple activities within the Administration's National Manufacturing Initiative. A key component of the Initiative is the Advanced Manufacturing National Program Office (AMNPO), which includes participation from all federal agencies involved in U.S. manufacturing. In support of the AMNPO the AMT Project supports building and Growing the National Network for Manufacturing Innovation through a public-private partnership designed to help the industrial community accelerate manufacturing innovation. Integration with other projects/programs and partnerships: STMD (Space Technology Mission Directorate), HEOMD, other Centers; Industry, Academia; OGA's (e.g., DOD, DOE, DOC, USDA, NASA, NSF); Office of Science and Technology Policy, NIST Advanced Manufacturing Program Office; Generate insight within NASA and cross-agency for technology development priorities and investments. Technology Infusion Plan: PC; Potential customer infusion (TDM, HEOMD, SMD, OGA, Industry); Leverage; Collaborate with other Agencies, Industry and Academia; NASA roadmap. Initiatives include: Advanced Near Net Shape Technology Integrally Stiffened Cylinder Process Development (launch vehicles, sounding rockets); Materials Genome; Low Cost Upper Stage-Class Propulsion; Additive Construction with Mobile Emplacement (ACME); National Center for Advanced Manufacturing.

ENVRI PLUS: European initiative towards technical and research cultural solutions for across-disciplines accessible Research Infrastructure products

NASA Astrophysics Data System (ADS)

Asmi, A.; Kutsch, W. L.

2015-12-01

Environmental Research Infrastructures are often built as bottom-up initiatives to provide products for specific target group, which often is very discipline specific. However, the societal or environmental challenges are typically not concentrated on specific disciplines, and require usage of data sets from many RIs. ENVRI PLUS is an initiative where the European environmental RIs work together to provide common technical background (in physical observation technologies and in data products and descriptions) to make the RI products more usable to user groups outside of the original RI target groups. ENVRI PLUS also includes many policy and dissemination concentrated actions to make the RI operations coherent and understandable to both scientists and other potential users. The actions include building common technological capital of the RIs (physical and data-oriented), creating common access procedures (especially for cross-diciplinary access), developing ethical guidelines and related policies, distributing know-how between RIs and building common communication and collaboration system for European environmental RIs. All ENVRI PLUS products are free to use, e.g. for use of new or existing environmental RIs worldwide.

Benefits and drawbacks of electronic health record systems

PubMed Central

Menachemi, Nir; Collum, Taleah H

2011-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the “stimulus package” represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way. PMID:22312227

Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion.

PubMed

Ellis, Michael J; Cordingley, Dean M; Vis, Sara; Reimer, Karen M; Leiter, Jeff; Russell, Kelly

2017-01-01

OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015. Acute SRS was defined as presenting < 30 days postinjury, and PCS was defined according to the International Classification of Diseases, 10th Revision criteria and included being symptomatic 30 days or longer postinjury. The initial assessment included clinical history and physical examination performed by 1 neurosurgeon. Patients were assessed for VOD, defined as the presence of more than 1 subjective vestibular and oculomotor complaint (dizziness, diplopia, blurred vision, etc.) and more than 1 objective physical examination finding (abnormal near point of convergence, smooth pursuits, saccades, or vestibulo-ocular reflex testing). Poisson regression analysis was used to identify factors that increased the risk of VOD at initial presentation and the development of PCS. RESULTS Three hundred ninety-nine children, including 306 patients with acute SRC and 93 with PCS, were included. Of these patients, 30.1% of those with acute SRC (65.0% male, mean age 13.9 years) and 43.0% of those with PCS (41.9% male, mean age 15.4 years) met the criteria for VOD at initial consultation. Independent predictors of VOD at initial consultation included female sex, preinjury history of depression, posttraumatic amnesia, and presence of dizziness, blurred vision, or difficulty focusing at the time of injury. Independent predictors of PCS among patients with acute SRC included the presence of VOD at initial consultation, preinjury history of depression, and posttraumatic amnesia at the time of injury. CONCLUSIONS This study identified important potential risk factors for the development of VOD following pediatric SRC. These results provide confirmatory evidence that VOD at initial consultation is associated with prolonged recovery and is an independent predictor for the development of PCS. Future studies examining clinical prediction rules in pediatric concussion should include VOD. Additional research is needed to elucidate the natural history of VOD following SRC and establish evidence-based indications for targeted vestibular rehabilitation.

De-implementation of inappropriately tight control (of hypoglycemia) for health: protocol with an example of a research grant application.

PubMed

Aron, David C; Lowery, Julie; Tseng, Chin-lin; Conlin, Paul; Kahwati, Leila

2014-05-19

Implementation of practice change is difficult and large scale implementation is particularly difficult. Among the challenges facing the healthcare system in general and healthcare organizations is the overuse of low value care. Improving medication safety also constitutes an attempt to reduce low value or potentially harmful care. Critical issues of overuse of low value practices and medication safety intersect in overtreatment of diabetes. Specifically, (over)intensive glycemic control increases hypoglycemia risk and morbidity without providing meaningful benefit. Our work indicates that among patients with diabetes who are at high risk for hypoglycemia, potential overtreatment is common. The Choosing Wisely Initiative to reduce low value care led by the American Board of Internal Medicine Foundation recommends not to treat most persons over 65 years of age with medications to reduce the A1c<7.5%. For most physicians this involves a change in practice. We will study the implementation of the Veterans Health Administration's Choosing Wisely Initiative (which includes hypoglycemic safety as a targeted condition) with three specific aims: (1) to assess the overall impact, both intended and unintended, of the Choosing Wisely Initiative to reduce overtreatment of diabetes in especially vulnerable populations; (2) to assess the impact of commitment to quality, teaching intensity, and safety culture on likelihood of overtreatment; and (3) to identify configurations of the implementation strategy, provider characteristics and organizational level factors that are associated with successful reduction of overtreatment rates by comparing high and low performers. Because focus on this initiative could have the unintended consequence of paying less attention to poor glycemic control (A1c>9%), we will also assess undertreatment. We will take advantage of a natural experiment and use a Type III Hybrid Design that focuses on study of implementation while at the same time observing and gathering information on clinical interventions and outcomes. This mixed methods study will use longitudinal data and qualitative methods including Qualitative Comparative Analyses. Our multi-paradigm approach to examining potential mechanisms to explain the variation in reduction of rates of overtreatment will contribute to a better understanding of implementation of national dissemination projects and multi-component interventions in complex systems.

International Geo-Years: Cooperation Between Planet Earth and Electronic Years

NASA Astrophysics Data System (ADS)

de Mulder, E.

2005-05-01

Momentum is growing behind an ambitious international multidisciplinary Earth science initiative. The International Year of Planet Earth project was conceived by the International Union of Geological Sciences (IUGS) finding UNESCO's Earth Sciences Division ready as co-initiator. It now enjoys the backing of all relevant IUGS's sister unions in ICSU, including IUGG, and through a Declaration adopted at the International Geological Congress (2004) of the global geoscience community. It has now won the full political backing of 14 nations, together representing half of the world population. The aim of the Year, encapsulated in its subtitle Earth sciences for Society, is to build awareness of the relationship between humankind and Planet Earth, and to demonstrate that geoscientists are key players in creating a balanced, sustainable future for both. 2007 or 2008 is aimed for the officially endorsed UN-year, but the whole project will begin one year ahead and run through to at least one year after the UN-year. The International Year includes a Science and an Outreach Programme, both of equal financial size. The eight Themes (Groundwater, Hazards, Health, Climate, Resources, Deep Earth, Ocean, and Megacities) in the Science Programme were selected for their societal impact, their potential for outreach, as well as their multidisciplinary nature and high scientific potential. Applications for more Themes (on `Soil' and on `Life') are being considered. Brochures with key questions and invitations for scientists to submit project proposals are being printed for each Theme and can be downloaded from www.esfs.org. The same bottom-up mode is applied for the Outreach Programme which will operate as a funding body, receiving bids for financial support - for anything from web-based educational resources to commissioning works of art that will help reinforce to the general public the central message of the Year. There are many potential interfaces and links between this initiative and the eGY, ranging from data and information handling in the Science Themes, virtual observatories, to participation in the Outreach Programme (nicknamed `The Greatest Show on Earth'). Examples on such cooperation with eGY and with other Geo-Year initiatives (International Heliophysical Year and International Polar Year) will be discussed in the presentation.

The informal use of antiretroviral medications for HIV prevention by men who have sex with men in South Florida: initiation, use practices, medications and motivations.

PubMed

Buttram, Mance E

2018-01-23

Limited data suggest that some gay and other men who have sex with men are using antiretroviral medications informally, without a prescription, for HIV prevention. This qualitative study examined this phenomenon among gay and other men who have sex with men in South Florida. Participants initiated informal antiretroviral medication use as a means of protecting each other and because of the confidence in knowledge of antiretroviral medications shared by their friends and sex partners. The most commonly used medications included Truvada and Stribild. Motivations for use included condom avoidance, risk reduction, and fear of recent HIV exposure. Participants described positive and negative sentiments related to informal use, including concerns about informal antiretroviral medications offering sufficient protection against HIV, and limited knowledge about pre-exposure prophylaxis (PrEP). Because the antiretroviral medications used for PrEP have the potential to prevent HIV infection, future research must consider the informal antiretroviral medication use and related concerns, including adherence, diversion and viral resistance.

The Effect of Surface Patterning on Corrosion Resistance of Biomedical Devices

NASA Astrophysics Data System (ADS)

Guo, Mengnan; Toloei, Alisina; Rotermund, Harm H.

2016-10-01

In this study, two styles of surface topographies have been created on stainless steel wires to test their corrosion resistance as simulated implanted biomedical devices. Grade 316 LVM stainless steel wire was initially polished to G1500 surface finish before treatment to produce the two different topographies: 1. Unidirectional roughness was created using SiC papers and 2. Various patterns were created with specific hole diameter and inter-hole spacing using focused ion beam (FIB). In order to simulate the environment of implanted biomedical devices, a three-electrode electrochemical cell with 0.9% (by mass) NaCl solution has been used to test the corrosion resistance of the samples by potentiodynamic polarization test method. SEM and EDS analyzed the appearance and chemical composition of different elements including oxygen on the surface. The potential of stable pitting, time related to the initiation of the stable pitting, and the highest corrosion current associated with stable pitting have been compared for samples with the two styles of topography. It was found that surfaces with patterns have a relatively higher pitting potential and it takes longer time to initiate stable pitting than the surface without any patterns.

Laser-Induced Modification Of Energy Bands Of Transparent Solids

NASA Astrophysics Data System (ADS)

Gruzdev, Vitaly

2010-10-01

Laser-induced variations of electron energy bands of transparent solids significantly affect the initial stages of laser-induced ablation (LIA) influencing rates of ionization and light absorption by conduction-band electrons. We analyze fast variations with characteristic duration in femto-second time domain that include: 1) switching electron functions from bonding to anti-bonding configuration due to laser-induced ionization; 2) laser-driven oscillations of electrons in quasi-momentum space; and 3) direct distortion of the inter-atomic potential by electric field of laser radiation. Among those effects, the latter two have zero delay and reversibly modify band structure taking place from the beginning of laser action. They are of special interest due to their strong influence on the initial stage and threshold of laser ablation. The oscillations modify the electron-energy bands by adding pondermotive potential. The direct action of radiation's electric field leads to high-frequency Franz-Keldysh effect (FKE) spreading the allowed electron states into the forbidden-energy bands. FKE provides decrease of the effective band gap while the electron oscillations lead either to monotonous increase or oscillatory variations of the gap. We analyze the competition between those two opposite trends and their role in initiating LIA.

Power System Concepts for the Lunar Outpost: A Review of the Power Generation, Energy Storage, Power Management and Distribution (PMAD) System Requirements and Potential Technologies for Development of the Lunar Outpost

NASA Technical Reports Server (NTRS)

Khan, Z.; Vranis, A.; Zavoico, A.; Freid, S.; Manners, B.

2006-01-01

This paper will review potential power system concepts for the development of the lunar outpost including power generation, energy storage, and power management and distribution (PMAD). In particular, the requirements of the initial robotic missions will be discussed and the technologies considered will include cryogenics and regenerative fuel cells (RFC), AC and DC transmission line technology, high voltage and low voltage power transmission, conductor materials of construction and power beaming concepts for transmitting power to difficult to access locations such as at the bottom of craters. Operating conditions, component characteristics, reliability, maintainability, constructability, system safety, technology gaps/risk and adaptability for future lunar missions will be discussed for the technologies considered.

Potentially Preventable Hospital and Emergency Department Events: Lessons from a Large Innovation Project.

PubMed

Solberg, Leif I; Ohnsorg, Kris A; Parker, Emily D; Ferguson, Robert; Magnan, Sanne; Whitebird, Robin R; Neely, Claire; Brandenfels, Emily; Williams, Mark D; Dreskin, Mark; Hinnenkamp, Todd; Ziegenfuss, Jeanette Y

2018-06-04

There are few proven strategies to reduce the frequency of potentially preventable hospitalizations and Emergency Department (ED) visits. To facilitate strategy development, we documented these events among complex patients and the factors that contribute to them in a large care-improvement initiative. Observational study with retrospective audits and selective interviews by the patients' care managers among 12 diverse medical groups in California, Minnesota, Pennsylvania, and Washington that participated in an initiative to implement collaborative care for patients with both depression and either uncontrolled diabetes, uncontrolled hypertension, or both. We reviewed information about 373 adult patients with the required conditions who belonged to these medical groups and had experienced 389 hospitalizations or ED visits during the 12-month study period from March 30, 2014, through March 29, 2015. The main outcome measures were potentially preventable hospitalizations or ED visit events. Of the studied events, 28% were considered to be potentially preventable (39% of ED visits and 14% of hospitalizations) and 4.6% of patients had 40% of events. Only type of insurance coverage; patient lack of resources, caretakers, or understanding of care; and inability to access clinic care were more frequent in those with potentially preventable events. Neither disease control nor ambulatory care-sensitive conditions were associated with potentially preventable events. Among these complex patients, patient characteristics, disease control, and the presence of ambulatory care-sensitive conditions were not associated with likelihood of ED visits or hospital admissions, including those considered to be potentially preventable. The current focus on using ambulatory care-sensitive conditions as a proxy for potentially preventable events needs further evaluation.

Development of the water-analysis screening tool used in the initial screening for the Pennsylvania State Water Plan update of 2008

USGS Publications Warehouse

Stuckey, Marla H.

2008-01-01

The Water Resources Planning Act, Act 220 of 2002, requires the Pennsylvania Department of Environmental Protection (PaDEP) to update the State Water Plan by 2008. As part of this update, a water-analysis screening tool (WAST) was developed by the U.S. Geological Survey, in cooperation with the PaDEP, to provide assistance to the state in the identification of critical water-planning areas. The WAST has two primary inputs: net withdrawals and the initial screening criteria. A comprehensive water-use database that includes data from registration, estimation, discharge monitoring reports, mining data, and other sources was developed as input into the WAST. Water use in the following categories was estimated using water-use factors: residential, industrial, commercial, agriculture, and golf courses. A percentage of the 7-day, 10-year low flow is used for the initial screenings using the WAST to identify potential critical water-planning areas. This quantity, or initial screening criteria, is 50 percent of the 7-day, 10-year low flow for most streams. Using a basic water-balance equation, a screening indicator is calculated that indicates the potential influences of net withdrawals on aquatic-resource uses for watersheds generally larger than 15 square miles. Points representing outlets of these watersheds are colored-coded within the WAST to show the screening criteria for each watershed.

The Environmental Health/Home Safety Education Project: a successful and practical U.S.-Mexico border initiative.

PubMed

Forster-Cox, Susan C; Mangadu, Thenral; Jacquez, Benjamín; Fullerton, Lynne

2010-05-01

The Environmental Health/Home Safety Education Project (Proyecto de Salud Ambiental y Seguridad en el Hogar) has been developed in response to a wide array of severe and often preventable environmental health issues occurring in and around homes on the U.S.-Mexico border. Utilizing well-trained community members, called promotoras , homes are visited and assessed for potential environmental hazards, including home fire and food safety issues. Data analyzed from project years 2002 to 2005 shows a significant impact in knowledge levels and initial behavior change among targeted participants as it relates to fire and food safety issues. Since the initiation of the project in 1999, hundreds of participants have improved their quality of life by making their homes safer. The project has proven to be sustainable, replicable, flexible, and attractive to funders.

Initiating therapy: when to start, what to use.

PubMed

Hirsch, Martin S

2008-05-15

Decisions regarding whether to start combination antiretroviral therapy (cART) during primary infection and when to initiate treatment during chronic infection continue to evolve. Although current data suggest that there may be a benefit to therapy during primary infection, results are inconclusive. Once begun, treatment probably should be continued indefinitely, since its potential advantages disappear over time if treatment is stopped. Recent studies suggest that cART may be useful at higher CD4 cell count thresholds than are currently recommended in several guidelines. Several regimens are acceptable as initial therapy, with tenofovir/emtricitabine/efavirenz favored by many because of potency and ease of administration. Other favored regimens include combinations of 2 nucleoside (or nucleotide) reverse-transcriptase inhibitors and a ritonavir-boosted protease inhibitor. Some new antiretroviral drugs under study, particularly integrase inhibitors, may prove useful in treatment-naive patients.

Volitional Control of Movement: The Physiology of Free Will

PubMed Central

Hallett, Mark

2007-01-01

This review deals with the physiology of the initiation of a voluntary movement and the appreciation of whether it is voluntary or not. I argue that free will is not a driving force for movement, but a conscious awareness concerning the nature of the movement. Movement initiation and the perception of willing the movement can be separately manipulated. Movement is generated subconsciously, and the conscious sense of volition comes later, but the exact time of this event is difficult to assess because of the potentially illusory nature of introspection. Neurological disorders of volition are also reviewed. The evidence suggests that movement is initiated in frontal lobe, particularly the mesial areas, and the sense of volition arises as the result of a corollary discharge likely involving multiple areas with reciprocal connections including those in the parietal lobe and insular cortex. PMID:17466580

Global warming at the summit

NASA Astrophysics Data System (ADS)

Showstack, Randy

During the recent summit meeting between Russian President Vladimir Putin and U.S. President Bill Clinton, the two leaders reaffirmed their concerns about global warming and the need to continue to take actions to try to reduce the threat.In a June 4 joint statement, they stressed the need to develop flexibility mechanisms, including international emissions trading, under the Kyoto Protocol to the United Nations Framework Convention on Climate Change. They also noted that initiatives to reduce the risk of greenhouse warming, including specific mechanisms of the Kyoto Protocol, could potentially promote economic growth.

Use of drinking water treatment solids for arsenate removal from desalination concentrate.

PubMed

Xu, Xuesong; Lin, Lu; Papelis, Charalambos; Myint, Maung; Cath, Tzahi Y; Xu, Pei

2015-05-01

Desalination of impaired water can be hindered by the limited options for concentrate disposal. Selective removal of specific contaminants using inexpensive adsorbents is an attractive option to address the challenges of concentrate management. In this study, two types of ferric-based drinking water treatment solids (DWTS) were examined for arsenate removal from reverse osmosis concentrate during continuous-flow once-through column experiments. Arsenate sorption was investigated under different operating conditions including pH, arsenate concentration, hydraulic retention time, loading rate, temperature, and moisture content of the DWTS. Arsenate removal by the DWTS was affected primarily by surface complexation, electrostatic interactions, and arsenate speciation. Results indicated that arsenate sorption was highly dependent on initial pH and initial arsenate concentration. Acidic conditions enhanced arsenate sorption as a result of weaker electrostatic repulsion between predominantly monovalent H2AsO4(-) and negatively charged particles in the DWTS. High initial arsenate concentration increased the driving force for arsenate sorption to the DWTS surface. Tests revealed that the potential risks associated with the use of DWTS include the leaching of organic contaminants and ammonia, which can be alleviated by using wet DWTS or discarding the initially treated effluent that contains high organic concentration. Copyright © 2015 Elsevier Inc. All rights reserved.

Report to Congress on Sustainable Ranges

DTIC Science & Technology

2014-02-01

with the potential to impact Army training and testing. These energy initiatives include wind turbines , new energy corridors for gas/oil pipelines and...the capability to effectively test and train inside the range boundaries. This is particularly evident when the Doppler Effect from wind turbines ...adverse impacts from wind turbine installation. These “High Risk of Adverse Impact Zones” will provide developers with advance information on

Methods for Using Ab Initio Potential Energy Surfaces in Studies of Gas-Phase Reactions of Energetic Molecules

DTIC Science & Technology

2014-08-20

including zero-point energy ( ZPE ) corrections, 43.21 kcal/mol and 50.46 kcal/mol, respectively. The decomposition initiated by trans-HONO elimination can...CCSD(T)/cc-pVTZ level with ZPE corrections) of 47.00 kcal/mol and 48.27 kcal/mol, respectively. Thus, at the CCSD(T)/cc-pVTZ level, the ordering of

Measuring and managing the environmental cost of coffee production in Latin America

Treesearch

Victor Chavez Arce; Raul Raudales; Rich Trubey; David I. King; Richard B. Chandler; Carlin C. Chandler

2009-01-01

Coffee is a major international commodity, and because of this, coffee production has the potential for considerable global impacts on the environment. These impacts can include the consumption of energy, water, land and the loss of native forest. Here we quantify these costs using Costa Rica as a case study, and describe an initiative undertaken at the Montes de Oro...

The Collective Impact Model and Its Potential for Health Promotion: Overview and Case Study of a Healthy Retail Initiative in San Francisco

ERIC Educational Resources Information Center

Flood, Johnna; Minkler, Meredith; Lavery, Susana Hennessey; Estrada, Jessica; Falbe, Jennifer

2015-01-01

As resources for health promotion become more constricted, it is increasingly important to collaborate across sectors, including the private sector. Although many excellent models for cross-sector collaboration have shown promise in the health field, collective impact (CI), an emerging model for creating larger scale change, has yet to receive…

Effect of dilution and ash supplement on the bio-methane potential of palm oil mill effluent (POME)

NASA Astrophysics Data System (ADS)

Jijai, Sunwanee; Muleng, Saina; Siripatana, Chairat

2017-08-01

This study aimed to evaluate the bio-methane potential of POME at different dilutions (100, 80, 60, 40, and 20 percent of initial POME) and different pH dues to different levels of ash supplement. Five different amounts of ash were added to digesters (0, 2, 4, 6, and 8 grams of ash were added to 170 ml of POME respectively). The digesters were operated in batch anaerobic digestion systems at room temperature (28-30 °C) and the experiments were performed in duplicate manner. The results showed that POME without dilution gave highest cumulative biogas (950 ml). However, 80% dilution from original POME gave the highest methane yield (45.83 mL CH4/ gCODadded or 103.13 mL CH4/ gCODremoved). Finally, the results of experiment 2, this adding ash into POME increased pH as well as enhanced the biogas production. It was found that adding ash at the ash:POME ratio of 2 g: 170 ml gave the highest both the cumulative biogas and methane yield (1,520 mL and 218.79 mL CH4/ gCODremoved respectively). The addition of ash in the raw waste of POME gave the pH in the range of criteria and highest bio-methane potential. The modified Gompertz equation, Schnute as well as Monod kinetic models were used to compare the data from the experiments. It was found that the factors that affected included, the bio-methane production and the kinetic parameters (the maximum specific methane production rates (Rm ml/day) and the methane production potential (P, mL)), initial COD, nutrients, levels of dilution, and initial pH (by adding different level of ash). However, λ (lag phase period) was not affected by initial COD and other factors. While Monod kinetics provides valuable insight in explaining what could happen behind the systematic trends.

The Presidential Initiative on Shared Early Warning

NASA Astrophysics Data System (ADS)

Pettis, Roy

2000-04-01

In September 1998, President Clinton and President Yeltsin issued a statement that our two countries would develop a system to share data from our respective early warning systems. The purpose of the initiative is to further reduce the risk of ballistic missile launches occurring in response to a misunderstanding about the data from such systems. The proposal includes a permanent center for sharing such data, located in Moscow, separate from but communicating with the strategic command-and-control centers of each country. It also includes development of a system of pre-launch notifications, which is expected to eventually provide notification of a broad class of launches, on a voluntary basis, including launches by all the countries that engage in missile and space activities. The status, progress, and prognosis for the work will be discussed. The presentation will address the experience gained from the operation of the Center for Y2K Strategic Stability in Colorado Springs (12/99 - 01/00), which tested many of our ideas for a joint center sharing both pre- launch and sensor data on worldwide launches. In addition, the potential of the initiative -- the first arms control effort involving active and continuing U.S.-Russian joint operations -- to provide a model for future arms control opportunities will be discussed.

Immunoproteomic identification of immunogenic proteins in Cronobacter sakazakii strain BAA-894.

PubMed

Wang, Jian; Du, Xin-Jun; Lu, Xiao-Nan; Wang, Shuo

2013-03-01

Cronobacter spp. are emerging opportunistic pathogens. Cronobacter sakazakii is considered as the predominant species in all infections. So far, our understanding of the species' immunogens and potential virulence factors of Cronobacter spp. remains limited. In this study, an immunoproteomic approach was used to investigate soluble and insoluble proteins from the genome-sequenced strain C. sakazakii ATCC BAA-894. Proteins were separated using two-dimensional electrophoresis, detected by Western blotting with polyclonal antibodies of C. sakazakii BAA-894, and identified using tandem mass spectrometry (MALDI-MS and MALDI-MS/MS, MS/MSMS). A total of 11 immunoreactive proteins were initially identified in C. sakazakii BAA-894, including two outer membrane proteins, four periplasmic proteins, and five cytoplasmic proteins. In silico functional analysis of the 11 identified proteins indicated three proteins that were initially described as immunogens of pathogenic bacteria. For the remaining eight proteins, one protein was categorized as a potential virulence factor involved in protection against reactive oxygen species, and seven proteins were considered to play potential roles in adhesion, invasion, and biofilm formation. To our knowledge, this is the first time that immunogenic proteins of C. sakazakii BAA-894 have been identified as immunogens and potential virulence factors by an immunoproteomics approach. Future studies should investigate the roles of these proteins in bacterial pathogenesis and modulation of host immune responses during infection to identify their potential as molecular therapeutic targets.

Nonlinear guided wave propagation in prestressed plates.

PubMed

Pau, Annamaria; Lanza di Scalea, Francesco

2015-03-01

The measurement of stress in a structure presents considerable interest in many fields of engineering. In this paper, the diagnostic potential of nonlinear elastic guided waves in a prestressed plate is investigated. To do so, an analytical model is formulated accounting for different aspects involved in the phenomenon. The fact that the initial strains can be finite is considered using the Green Lagrange strain tensor, and initial and final configurations are not merged, as it would be assumed in the infinitesimal strain theory. Moreover, an appropriate third-order expression of the strain energy of the hyperelastic body is adopted to account for the material nonlinearities. The model obtained enables to investigate both the linearized case, which gives the variation of phase and group velocity as a function of the initial stress, and the nonlinear case, involving second-harmonic generation as a function of the initial state of stress. The analysis is limited to Rayleigh-Lamb waves propagating in a plate. Three cases of initial prestress are considered, including prestress in the direction of the wave propagation, prestress orthogonal to the direction of wave propagation, and plane isotropic stress.

Descent Assisted Split Habitat Lunar Lander Concept

NASA Technical Reports Server (NTRS)

Mazanek, Daniel D.; Goodliff, Kandyce; Cornelius, David M.

2008-01-01

The Descent Assisted Split Habitat (DASH) lunar lander concept utilizes a disposable braking stage for descent and a minimally sized pressurized volume for crew transport to and from the lunar surface. The lander can also be configured to perform autonomous cargo missions. Although a braking-stage approach represents a significantly different operational concept compared with a traditional two-stage lander, the DASH lander offers many important benefits. These benefits include improved crew egress/ingress and large-cargo unloading; excellent surface visibility during landing; elimination of the need for deep-throttling descent engines; potentially reduced plume-surface interactions and lower vertical touchdown velocity; and reduced lander gross mass through efficient mass staging and volume segmentation. This paper documents the conceptual study on various aspects of the design, including development of sortie and outpost lander configurations and a mission concept of operations; the initial descent trajectory design; the initial spacecraft sizing estimates and subsystem design; and the identification of technology needs

Beginning inflation in an inhomogeneous universe

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

East, William E.; Kleban, Matthew; Linde, Andrei

Using numerical solutions of the full Einstein field equations coupled to a scalar inflaton field in 3+1 dimensions, we study the conditions under which a universe that is initially expanding, highly inhomogeneous and dominated by gradient energy can transition to an inflationary period. If the initial scalar field variations are contained within a sufficiently flat region of the inflaton potential, and the universe is spatially flat or open on average, inflation will occur following the dilution of the gradient and kinetic energy due to expansion. This is the case even when the scale of the inhomogeneities is comparable to themore » initial Hubble length, and overdense regions collapse and form black holes, because underdense regions continue expanding, allowing inflation to eventually begin. In conclusion, this establishes that inflation can arise from highly inhomogeneous initial conditions and solve the horizon and flatness problems, at least as long as the variations in the scalar field do not include values that exceed the inflationary plateau.« less

Beginning inflation in an inhomogeneous universe

DOE PAGES

East, William E.; Kleban, Matthew; Linde, Andrei; ...

2016-09-06

Using numerical solutions of the full Einstein field equations coupled to a scalar inflaton field in 3+1 dimensions, we study the conditions under which a universe that is initially expanding, highly inhomogeneous and dominated by gradient energy can transition to an inflationary period. If the initial scalar field variations are contained within a sufficiently flat region of the inflaton potential, and the universe is spatially flat or open on average, inflation will occur following the dilution of the gradient and kinetic energy due to expansion. This is the case even when the scale of the inhomogeneities is comparable to themore » initial Hubble length, and overdense regions collapse and form black holes, because underdense regions continue expanding, allowing inflation to eventually begin. In conclusion, this establishes that inflation can arise from highly inhomogeneous initial conditions and solve the horizon and flatness problems, at least as long as the variations in the scalar field do not include values that exceed the inflationary plateau.« less

Beginning inflation in an inhomogeneous universe

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

East, William E.; Kleban, Matthew; Linde, Andrei

Using numerical solutions of the full Einstein field equations coupled to a scalar inflaton field in 3+1 dimensions, we study the conditions under which a universe that is initially expanding, highly inhomogeneous and dominated by gradient energy can transition to an inflationary period. If the initial scalar field variations are contained within a sufficiently flat region of the inflaton potential, and the universe is spatially flat or open on average, inflation will occur following the dilution of the gradient and kinetic energy due to expansion. This is the case even when the scale of the inhomogeneities is comparable to themore » initial Hubble length, and overdense regions collapse and form black holes, because underdense regions continue expanding, allowing inflation to eventually begin. This establishes that inflation can arise from highly inhomogeneous initial conditions and solve the horizon and flatness problems, at least as long as the variations in the scalar field do not include values that exceed the inflationary plateau.« less

Adolescent Online Romantic Relationship Initiation: Differences by Sexual and Gender Identification

PubMed Central

Korchmaros, Josephine D.; Ybarra, Michele L.; Mitchell, Kimberly J.

2015-01-01

Data from the national Teen Health and Technology Study of adolescents 13-18 years old (N = 5,091) were used to examine online formation of romantic relationships. Results show that lesbian, gay, bisexual, transgender, and queer (LGBTQ) and non-LGBTQ adolescents similarly were most likely to have met their most recent boy/girlfriend in the past 12 months at school. However, they differed on many characteristics of romantic relationship initiation, including the extent to which they initiated romantic relationships online. LGBTQ and non-LGBTQ adolescents also differed on level of offline access to potential partners, offline popularity, and numerous other factors possibly related to online relationship initiation (e.g., Internet use and demographic factors). Even after adjusting for differences in these factors, LGBTQ adolescents were more likely than non-LGBTQ adolescents to find boy/girlfriends online in the past 12 months. The results support the rich-get-richer hypothesis as well as the social compensation hypothesis. PMID:25625753

Oil sands thickened froth treatment tailings exhibit acid rock drainage potential during evaporative drying.

PubMed

Kuznetsov, Petr; Kuznetsova, Alsu; Foght, Julia M; Siddique, Tariq

2015-02-01

Bitumen extraction from oil sands ores after surface mining produces different tailings waste streams: 'froth treatment tailings' are enriched in pyrite relative to other streams. Tailings treatment can include addition of organic polymers to produce thickened tailings (TT). TT may be further de-watered by deposition into geotechnical cells for evaporative drying to increase shear strength prior to reclamation. To examine the acid rock drainage (ARD) potential of TT, we performed predictive analyses and laboratory experiments on material from field trials of two types of thickened froth treatment tailings (TT1 and TT2). Acid-base accounting (ABA) of initial samples showed that both TT1 and TT2 initially had net acid-producing potential, with ABA values of -141 and -230 t CaCO₃ equiv. 1000 t(-1) of TT, respectively. In long-term kinetic experiments, duplicate ~2-kg samples of TT were incubated in shallow trays and intermittently irrigated under air flow for 459 days to simulate evaporative field drying. Leachates collected from both TT samples initially had pH~6.8 that began decreasing after ~50 days (TT2) or ~250 days (TT1), stabilizing at pH~2. Correspondingly, the redox potential of leachates increased from 100-200 mV to 500-580 mV and electrical conductivity increased from 2-5 dS m(-1) to 26 dS m(-1), indicating dissolution of minerals during ARD. The rapid onset and prolonged ARD observed with TT2 is attributed to its greater pyrite (13.4%) and lower carbonate (1.4%) contents versus the slower onset of ARD in TT1 (initially 6.0% pyrite and 2.5% carbonates). 16S rRNA gene pyrosequencing analysis revealed rapid shift in microbial community when conditions became strongly acidic (pH~2) favoring the enrichment of Acidithiobacillus and Sulfobacillus bacteria in TT. This is the first report showing ARD potential of TT and the results have significant implications for effective management of pyrite-enriched oil sands tailings streams/deposits. Copyright © 2014 Elsevier B.V. All rights reserved.

Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation.

PubMed

Merenstein, Daniel; Yang, Yang; Schneider, Michael F; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M; Sharp, Gerald B; Gandhi, Monica; Liu, Chenglong

2008-01-01

To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)-infected participants of the Women's Interagency HIV Study. Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non-CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. MAIN OUTCOME AND EXPOSURES: Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non-CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non-CAM users. Female CAM users initiated HAART regimens earlier than non-CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression.

betaFIT: A computer program to fit pointwise potentials to selected analytic functions

NASA Astrophysics Data System (ADS)

Le Roy, Robert J.; Pashov, Asen

2017-01-01

This paper describes program betaFIT, which performs least-squares fits of sets of one-dimensional (or radial) potential function values to four different types of sophisticated analytic potential energy functional forms. These families of potential energy functions are: the Expanded Morse Oscillator (EMO) potential [J Mol Spectrosc 1999;194:197], the Morse/Long-Range (MLR) potential [Mol Phys 2007;105:663], the Double Exponential/Long-Range (DELR) potential [J Chem Phys 2003;119:7398], and the "Generalized Potential Energy Function (GPEF)" form introduced by Šurkus et al. [Chem Phys Lett 1984;105:291], which includes a wide variety of polynomial potentials, such as the Dunham [Phys Rev 1932;41:713], Simons-Parr-Finlan [J Chem Phys 1973;59:3229], and Ogilvie-Tipping [Proc R Soc A 1991;378:287] polynomials, as special cases. This code will be useful for providing the realistic sets of potential function shape parameters that are required to initiate direct fits of selected analytic potential functions to experimental data, and for providing better analytical representations of sets of ab initio results.

Preliminary identification of potential markets for off-grid electrification: tool development and a case study of Ghana

NASA Astrophysics Data System (ADS)

Descoqs, Benoit; Bhattacharyya, Subhes

2018-02-01

With more than one billion people lacking access to electricity in the world, ensuring universal access to electricity by 2030 remains a major challenge which cannot be left to the government initiatives alone. Access to local information and identification of potential areas for investment can be a challenge for investors. This paper provides a tool for preliminary assessment of potential markets for off-grid electrification in developing countries and applies this to Ghana to demonstrate its applicability. A multi-criteria approach is used to rank the districts according to the overall potential and the best markets and least favourable areas for investment are identified. The tool offers flexibility to include new inputs to the analysis and the factor weights can be adjusted as appropriate. The case study shows that the tool can effectively identify potential areas from a list of candidates and offers support to analysts.

Surgeon specialization and use of sentinel lymph node biopsy for breast cancer.

PubMed

Yen, Tina W F; Laud, Purushuttom W; Sparapani, Rodney A; Nattinger, Ann B

2014-02-01

Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in patients with clinically node-negative breast cancer. It is not known whether SLNB rates differ by surgeon expertise. If surgeons with less breast cancer expertise are less likely to offer SLNB to these patients, this practice pattern could lead to unnecessary axillary lymph node dissections and lymphedema. To explore potential measures of surgical expertise (including a novel objective specialization measure: percentage of a surgeon's operations performed for breast cancer determined from Medicare claims) on the use of SLNB for invasive breast cancer. A population-based prospective cohort study was conducted in California, Florida, and Illinois. Participants included elderly (65-89 years) women identified from Medicare claims as having had incident invasive breast cancer surgery in 2003. Patient, tumor, treatment, and surgeon characteristics were examined. Type of axillary surgery performed. Of 1703 women who received treatment by 863 surgeons, 56.4% underwent an initial SLNB, 37.2% initial axillary lymph node dissection, and 6.3% no axillary surgery. The median annual surgeon Medicare volume of breast cancer cases was 6.0 (range, 1.5-57.0); the median surgeon percentage of breast cancer cases was 4.5% (range, 0.4%-100.0%). After multivariable adjustment of patient and surgeon factors, women operated on by surgeons with higher volumes and percentages of breast cancer cases had a higher likelihood of undergoing SLNB. Specifically, women were most likely to undergo SLNB if the operation was performed by high-volume surgeons (regardless of percentage) or by lower-volume surgeons with a high percentage of breast cancer cases. In addition, membership in the American Society of Breast Surgeons (odds ratio, 1.98; 95% CI, 1.51-2.60) and Society of Surgical Oncology (1.59; 1.09-2.30) were independent predictors of women undergoing an initial SLNB. Patients who receive treatment from surgeons with more experience with and focus on breast cancer are significantly more likely to undergo SLNB, highlighting the importance of receiving initial treatment by specialized providers. Factors relating to specialization in a particular area, including our novel surgeon percentage measure, require further investigation as potential indicators of quality of care.

Overview of the U.S. Nuclear Regulatory Commission collaborative research program to assess tsunami hazard for nuclear power plants on the Atlantic and Gulf Coasts

USGS Publications Warehouse

Kammerer, A.M.; ten Brink, Uri S.; Titov, V.V.

2017-01-01

In response to the 2004 Indian Ocean Tsunami, the United States Nuclear Regulatory Commission (US NRC) initiated a long-term research program to improve understanding of tsunami hazard levels for nuclear facilities in the United States. For this effort, the US NRC organized a collaborative research program with the United States Geological Survey (USGS) and the National Oceanic and Atmospheric Administration (NOAA) with a goal of assessing tsunami hazard on the Atlantic and Gulf Coasts of the United States. Necessarily, the US NRC research program includes both seismic- and landslide-based tsunamigenic sources in both the near and the far fields. The inclusion of tsunamigenic landslides, an important category of sources that impact tsunami hazard levels for the Atlantic and Gulf Coasts is a key difference between this program and most other tsunami hazard assessment programs. The initial phase of this work consisted of collection, interpretation, and analysis of available offshore data, with significant effort focused on characterizing offshore near-field landslides and analyzing their tsunamigenic potential and properties. In the next phase of research, additional field investigations will be conducted in key locations of interest and additional analysis will be undertaken. Simultaneously, the MOST tsunami generation and propagation model used by NOAA will first be enhanced to include landslide-based initiation mechanisms and then will be used to investigate the impact of the tsunamigenic sources identified and characterized by the USGS. The potential for probabilistic tsunami hazard assessment will also be explore in the final phases of the program.

Capacity for Physical Activity Predicts Weight Loss After Roux-en-Y Gastric Bypass

PubMed Central

Hatoum, Ida J.; Stein, Heather K.; Merrifield, Benjamin F.; Kaplan, Lee M.

2014-01-01

Despite its overall excellent outcomes, weight loss after Roux-en-Y gastric bypass (RYGB) is highly variable. We conducted this study to identify clinical predictors of weight loss after RYGB. We reviewed charts from 300 consecutive patients who underwent RYGB from August 1999 to November 2002. Data collected included patient demographics, medical comorbidities, and diet history. Of the 20 variables selected for univariate analysis, 9 with univariate P values ≤ 0.15 were entered into a multivariable regression analysis. Using backward selection, covariates with P < 0.05 were retained. Potential confounders were added back into the model and assessed for effect on all model variables. Complete records were available for 246 of the 300 patients (82%). The patient characteristics were 75% female, 93% white, mean age of 45 years, and mean initial BMI of 52.3 kg/m2. One year after surgery, patients lost an average of 64.8% of their excess weight (s.d. = 20.5%). The multivariable regression analysis revealed that limited physical activity, higher initial BMI, lower educational level, diabetes, and decreased attendance at postoperative appointments had an adverse effect on weight loss after RYGB. A model including these five factors accounts for 41% of the observed variability in weight loss (adjusted r2 = 0.41). In this cohort, higher initial BMI and limited physical activity were the strongest predictors of decreased excess weight loss following RYGB. Limited physical activity may be particularly important because it represents an opportunity for potentially meaningful pre- and postsurgical intervention to maximize weight loss following RYGB. PMID:18997674

Potential SSP Perfluorooctanoic Acid Related Fluoropolymer Materials Obsolescence

NASA Technical Reports Server (NTRS)

Segars, Matt G.

2006-01-01

The Shuttle Environmental Assurance Initiative (SEA) has identified a potential for the Space Shuttle Program (SSP) to incur materials obsolescence issues due to agreements between the fluoro-chemical industry and the United States Environmental Protection Agency (USEPA) to participate in a Global Stewardship Program for perfluorooctanoic acid (PFOA). This presentation will include discussions of the chemistry, regulatory drivers, affected types of fluoropolymer and fluoroelastomer products, timeline for reformulations, and methodology for addressing the issue. It will cover the coordination of assessment efforts with the International Space Station and Head Quarters Air Force Space Command, along with some examples of impacted materials. The presentation is directed at all members of the international aerospace community concerned with identifying potential environmentally driven materials obsolescence issues.

Demand Response and Energy Storage Integration Study

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

Ma, Ookie; Cheung, Kerry; Olsen, Daniel J.

2016-03-01

Demand response and energy storage resources present potentially important sources of bulk power system services that can aid in integrating variable renewable generation. While renewable integration studies have evaluated many of the challenges associated with deploying large amounts of variable wind and solar generation technologies, integration analyses have not yet fully incorporated demand response and energy storage resources. This report represents an initial effort in analyzing the potential integration value of demand response and energy storage, focusing on the western United States. It evaluates two major aspects of increased deployment of demand response and energy storage: (1) Their operational valuemore » in providing bulk power system services and (2) Market and regulatory issues, including potential barriers to deployment.« less

Demand Response and Energy Storage Integration Study

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

Ma, Ookie; Cheung, Kerry

Demand response and energy storage resources present potentially important sources of bulk power system services that can aid in integrating variable renewable generation. While renewable integration studies have evaluated many of the challenges associated with deploying large amounts of variable wind and solar generation technologies, integration analyses have not yet fully incorporated demand response and energy storage resources. This report represents an initial effort in analyzing the potential integration value of demand response and energy storage, focusing on the western United States. It evaluates two major aspects of increased deployment of demand response and energy storage: (1) Their operational valuemore » in providing bulk power system services and (2) Market and regulatory issues, including potential barriers to deployment.« less

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

Barbee, D; McCarthy, A; Galavis, P

Purpose: Errors found during initial physics plan checks frequently require replanning and reprinting, resulting decreased departmental efficiency. Additionally, errors may be missed during physics checks, resulting in potential treatment errors or interruption. This work presents a process control created using the Eclipse Scripting API (ESAPI) enabling dosimetrists and physicists to detect potential errors in the Eclipse treatment planning system prior to performing any plan approvals or printing. Methods: Potential failure modes for five categories were generated based on available ESAPI (v11) patient object properties: Images, Contours, Plans, Beams, and Dose. An Eclipse script plugin (PlanCheck) was written in C# tomore » check errors most frequently observed clinically in each of the categories. The PlanCheck algorithms were devised to check technical aspects of plans, such as deliverability (e.g. minimum EDW MUs), in addition to ensuring that policy and procedures relating to planning were being followed. The effect on clinical workflow efficiency was measured by tracking the plan document error rate and plan revision/retirement rates in the Aria database over monthly intervals. Results: The number of potential failure modes the PlanCheck script is currently capable of checking for in the following categories: Images (6), Contours (7), Plans (8), Beams (17), and Dose (4). Prior to implementation of the PlanCheck plugin, the observed error rates in errored plan documents and revised/retired plans in the Aria database was 20% and 22%, respectively. Error rates were seen to decrease gradually over time as adoption of the script improved. Conclusion: A process control created using the Eclipse scripting API enabled plan checks to occur within the planning system, resulting in reduction in error rates and improved efficiency. Future work includes: initiating full FMEA for planning workflow, extending categories to include additional checks outside of ESAPI via Aria database queries, and eventual automated plan checks.« less

Gas potential of the Rome Trough in Kentucky: Results of recent Cambrian exploration

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

Harris, D.C.; Drahovzal, J.A.

1996-09-01

A recent gas discovery in the Rome Trough suggests the need to re-evaluate the deep Cambrian potential of eastern Kentucky. A new phase of Cambrian exploration began in mid-1994 with a new pool discovery by the Carson Associates No. 1 Kazee well in Elliott County, Ky. This well blew out and initially flowed 11 MMcfd of gas from the upper Conasauga Group/Rome Formation at 6,258 to 6,270 feet. After this discovery, a second exploratory well (the Blue Ridge No. 1Greene) was drilled on a separate structure in Elliott County in late 1995. The Blue Ridge well was temporarily abandoned, butmore » had shows of gas and condensate. In early 1996, Carson Associates offset their initial discovery well with the No. 33 Lawson Heirs well. This activity follows a frustrating exploration history in the Rome Trough that is marked by numerous gas and oil shows, but rare commercial production. Only three single-well pools have produced commercial gas from the trough, including the recent Kazee well. Stratigraphic units below the Cambrian-Ordovician Knox Group in the Rome Trough are dramatically thicker than their equivalents on the shelf to the north. The interval in the trough is thought to include rocks as old as Early Cambrian, consisting of a basal sandstone, equivalents of the Shady/Tomstown Dolomite, the Rome Formation, and the Conasauga Formation. Sandstones and fractured shales have been responsible for most of the production to date, but dolostone intervals may also have potential. Limited seismic data indicate possible fan-delta and basin-floor fan deposits that may have reservoir potential.« less

Diagnosis and initial management of cerebellar infarction.

PubMed

Edlow, Jonathan A; Newman-Toker, David E; Savitz, Sean I

2008-10-01

Cerebellar infarction is an important cause of stroke that often presents with common and non-specific symptoms such as dizziness, nausea and vomiting, unsteady gait, and headache. Accurate diagnosis frequently relies on careful attention to patients' coordination, gait, and eye movements--components of the neurological physical examination that are sometimes omitted or abridged if cerebellar stroke is not specifically being considered. The differential diagnosis is broad, and includes many common and benign causes. Furthermore, early-stage posterior fossa ischaemia is rarely seen with brain CT--the most commonly available initial imaging test that is used for stroke. Insufficient examination and imaging can result in misdiagnosis. However, early correct diagnosis is crucial to help prevent treatable but potentially fatal complications, such as brainstem compression and obstructive hydrocephalus. The identification and treatment of the underlying vascular lesions at an early stage can also prevent subsequent occurrences of stroke and improve patients' outcomes. Here, we review the clinical presentation of cerebellar infarction, from diagnosis and misdiagnosis to patients' monitoring, treatment, and potential complications.

Cultural Resource Protection Plan for the Remote-Handled Low-Level Waste Disposal Facility at the Idaho National Laboratory

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

Pace, Brenda Ringe; Gilbert, Hollie Kae

2015-05-01

This plan addresses cultural resource protection procedures to be implemented during construction of the Remote Handled Low Level Waste project at the Idaho National Laboratory. The plan proposes pre-construction review of proposed ground disturbing activities to confirm avoidance of cultural resources. Depending on the final project footprint, cultural resource protection strategies might also include additional survey, protective fencing, cultural resource mapping and relocation of surface artifacts, collection of surface artifacts for permanent curation, confirmation of undisturbed historic canal segments outside the area of potential effects for construction, and/or archaeological test excavations to assess potential subsurface cultural deposits at known culturalmore » resource locations. Additionally, all initial ground disturbing activities will be monitored for subsurface cultural resource finds, cultural resource sensitivity training will be conducted for all construction field personnel, and a stop work procedure will be implemented to guide assessment and protection of any unanticipated discoveries after initial monitoring of ground disturbance.« less

Impact of anticipation in dynamical systems

NASA Astrophysics Data System (ADS)

Gerlee, P.; Tunstrøm, K.; Lundh, T.; Wennberg, B.

2017-12-01

Many animals, including humans, have predictive capabilities and, presumably, base their behavioral decisions—at least partially—upon an anticipated state of their environment. We explore a minimal version of this idea in the context of particles that interact according to a pairwise potential. Anticipation enters the picture by calculating the interparticle forces from linear extrapolations of the particle positions some time τ in the future. Simulations show that for intermediate values of τ , compared to a transient time scale defined by the potential and the initial conditions, the particles form rotating clusters in which the particles are arranged in a hexagonal pattern. Analysis of the system shows that anticipation induces energy dissipation and we show that the kinetic energy asymptotically decays as 1 /t . Furthermore, we show that the angular momentum is not necessarily conserved for τ >0 , and that asymmetries in the initial condition therefore can cause rotational movement. These results suggest that anticipation could play an important role in collective behavior, since it may induce pattern formation and stabilizes the dynamics of the system.

A Summary of NASA Research Exploring the Acoustics of Small Unmanned Aerial Systems

NASA Technical Reports Server (NTRS)

Zawodny, Nikolas S.; Christian, Andrew; Cabell, Randolph

2018-01-01

Proposed uses of small unmanned aerial systems (sUAS) have the potential to expose large portions of communities to a new noise source. In order to understand the potential noise impact of sUAS, NASA initiated acoustics research as one component of the 3-year DELIVER project, with the goal of documenting the feasibility of using existing aircraft design tools and methods on this class of vehicles. This paper summarizes the acoustics research conducted within the DELIVER project. The research described here represents an initial study, and subsequent research building on the findings of this work has been proposed for other NASA projects. The paper summarizes acoustics research in four areas: measurements of noise generated by flyovers of small unmanned aerial vehicles, measurements in controlled test facilities to understand the noise generated by components of these vehicles, computational predictions of component and full vehicle noise, and psychoacoustic tests including auralizations conducted to assess human annoyance to the noise generated by these vehicles.

Tropic Lightning: Myth or Menace?

PubMed Central

2014-01-01

Lightning is one of the leading causes of death related to environmental disaster. Of all lightning fatalities documented between 2006 and 2012, leisure activities contributed the largest proportion of deaths, with water-associated, sports, and camping being the most common. Despite the prevalence of these activities throughout the islands, Hawai‘i has had zero documented lightning fatalities since weather data tracking was initiated in 1959. There is a common misconception that lightning does not strike the ground in Hawai‘i. This myth may contribute to a potentially dangerous false sense of security, and recognition of warning signs and risk factor modification remain the most important prevention strategies. Lightning damage occurs on a spectrum, from minor burns to multi-organ dysfunction. After injury, initial treatment should focus on “reverse triage” and immediate cardiopulmonary resuscitation when indicated, followed by transfer to a healthcare facility. Definitive treatment entails monitoring and management of potential sequelae, to include cardiovascular, neurologic, dermatologic, ophthalmologic, audiovestibular, and psychiatric complications. PMID:25478304

The State of Space Propulsion Research

NASA Technical Reports Server (NTRS)

Sackheim, R. L.; Cole, J. W.; Litchford, R. J.

2006-01-01

The current state of space propulsion research is assessed from both a historical perspective, spanning the decades since Apollo, and a forward-looking perspective, as defined by the enabling technologies required for a meaningful and sustainable human and robotic exploration program over the forthcoming decades. Previous research and technology investment approaches are examined and a course of action suggested for obtaining a more balanced portfolio of basic and applied research. The central recommendation is the establishment of a robust national Space Propulsion Research Initiative that would run parallel with systems development and include basic research activities. The basic framework and technical approach for this proposed initiative are defined and a potential implementation approach is recommended.

Advanced Fuel Cycle Technology: Special Session in Honor of Dr. Michael Lineberry

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

D.M. Wachs; N. Woolstenhulme

2014-06-01

The US DOE recently initiated an effort to develop accident tolerant fuel designs for potential use in commercial power reactors. Evaluation of various fuel design concepts will require a broad array of testing that will include performance attributes at both steady state and transient irradiation conditions. The first stage of the transient testing program is intended to establish the relative performance limits of each proposed concept and to support development of first-draft fuel performance models. It is anticipated that this data can subsequently be used as the basis for larger scale qualification testing. This initial stage of the testing programmore » is outlined in this paper.« less

The induction of reentry in cardiac tissue. The missing link: How electric fields alter transmembrane potential

NASA Astrophysics Data System (ADS)

Roth, Bradley J.; Krassowska, Wanda

1998-03-01

This review examines the initiation of reentry in cardiac muscle by strong electric shocks. Specifically, it concentrates on the mechanisms by which electric shocks change the transmembrane potential of the cardiac membrane and create the physiological substrate required by the critical point theory for the initiation of rotors. The mechanisms examined include (1) direct polarization of the tissue by the stimulating current, as described by the one-dimensional cable model and its two- and three-dimensional extensions, (2) the presence of virtual anodes and cathodes, as described by the bidomain model with unequal anisotropy ratios of the intra- and extracellular spaces, (3) polarization of the tissue due to changing orientation of cardiac fibers, and (4) polarization of individual cells or groups of cells by the electric field ("sawtooth potential"). The importance of these mechanisms in the initiation of reentry is examined in two case studies: the induction of rotors using successive stimulation with a unipolar electrode, and the induction of rotors using cross-field stimulation. These cases reveal that the mechanism by which a unipolar stimulation induces arrhythmias can be explained in the framework of the bidomain model with unequal anisotropy ratios. In contrast, none of the examined mechanisms provide an adequate explanation for the induction of rotors by cross-field stimulation. Hence, this study emphasizes the need for further experimental and theoretical work directed toward explaining the mechanism of field stimulation.

Brain-derived neurotrophic factor/neurotrophin 3 regulate axon initial segment location and affect neuronal excitability in cultured hippocampal neurons.

PubMed

Guo, Yu; Su, Zi-Jun; Chen, Yi-Kun; Chai, Zhen

2017-07-01

Plasticity of the axon initial segment (AIS) has aroused great interest in recent years because it regulates action potential initiation and neuronal excitability. AIS plasticity manifests as modulation of ion channels or variation in AIS structure. However, the mechanisms underlying structural plasticity of the AIS are not well understood. Here, we combined immunofluorescence, patch-clamp recordings, and pharmacological methods in cultured hippocampal neurons to investigate the factors participating in AIS structural plasticity during development. With lowered neuronal density, the distance between the AIS and the soma increased, while neuronal excitability decreased, as shown by the increased action potential threshold and current threshold for firing an action potential. This variation in the location of the AIS was associated with cellular secretory substances, including brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT3). Indeed, blocking BDNF and NT3 with TrkB-Fc eliminated the effect of conditioned medium collected from high-density cultures on AIS relocation. Elevating the extracellular concentration of BDNF or NT3 promoted movement of the AIS proximally to the soma and increased neuronal excitability. Furthermore, knockdown of neurotrophin receptors TrkB and TrkC caused distal movement of the AIS. Our results demonstrate that BDNF and NT3 regulate AIS location and neuronal excitability. These regulatory functions of neurotrophic factors provide insight into the molecular mechanisms underlying AIS biology. © 2017 International Society for Neurochemistry.

Misdiagnosis of cerebellar hemorrhage - features of 'pseudo-gastroenteritis' clinical presentations to the ED and primary care.

PubMed

Lee, Seung-Han; Stanton, Victoria; Rothman, Richard E; Crain, Barbara; Wityk, Robert; Wang, Zheyu; Newman-Toker, David E

2017-03-01

Early-stage cerebellar hemorrhage can present with nausea or vomiting absent other neurological symptoms or signs, potentially leading to an incorrect diagnosis of gastroenteritis. We sought to determine the frequency of gastroenteritis-like presentations and delayed or missed diagnoses among patients with spontaneous cerebellar hemorrhage. This is a retrospective, case-control analysis of atraumatic, primary cerebellar hemorrhages derived from a systematic search of surgical pathology and autopsy databases at two large urban, academic medical centers from 1984 to 2006. Hospital visit and clinical symptom data were abstracted from electronic and paper medical records for included patients. Delayed or missed diagnoses were defined as those at least one previous visit for relevant clinical symptoms in the 7 days prior to the correct diagnosis being confirmed. Among 254 records captured by our search filter, we identified 35 cases of pathologically proven primary cerebellar hemorrhage. Four patients (11%) were misdiagnosed initially - three with "gastroenteritis" and one with "hypertension". In this small sample, misdiagnosed patients presented more often with normal mental state (100% vs. 35%, p=0.07) and nausea/vomiting (100% vs. 58%, p=0.22). Although patients deteriorated clinically after the initial misdiagnosis, and potentially dangerous diagnostic tests and treatment strategies were instituted as a result of misdiagnosis, none of the misdiagnosed patients died or suffered major permanent harms due to diagnostic delay. Our study is limited by the small number of identified cases. Nevertheless, it appears that patients with cerebellar hemorrhages can present with relatively unimpressive clinical findings without obvious neurological manifestations. Such individuals are sometimes misdiagnosed with gastroenteritis or other benign disorders initially, possibly when neurologic examination, particularly gait testing, is omitted or abridged. A careful search for subtle cerebellar signs, including dysarthria, limb ataxia, nystagmus or tandem gait instability, absent in true gastroenteritis cases, could potentially reduce misdiagnosis.

Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes.

PubMed

Norman, Jessica L; Fixen, Danielle R; Saseen, Joseph J; Saba, Laura M; Linnebur, Sunny A

2017-01-01

Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release) or 6.25 mg (controlled release) per night in women. The primary objective of this study was to compare prescribing practices before and after the 2013 zolpidem labeling change. A secondary objective was to evaluate serious adverse events potentially related to zolpidem. Electronic medical records of adults receiving care through the University of Colorado Health system were accessed for study inclusion if patients were provided a first-time prescription for zolpidem either prior to or after the Food and Drug Administration labeling change. Patients were randomly chosen from eight strata based on age, gender, and date of zolpidem initiation (before/after the labeling change). Demographic and zolpidem prescribing data were collected. Low-dose zolpidem was considered 5 mg (immediate release) or 6.25 mg (controlled release) daily or less. Documentation of potentially related serious adverse events within the patients' records was also evaluated. A total of 400 patients were included in the study. The overall percentage of patients prescribed low-dose zolpidem increased from 44% to 58% after the labeling change (p = 0.0020). In a pre-specified subgroup analysis, the percentage of patients prescribed low-dose zolpidem increased in all groups, including young men (38%-50%, p = 0.23), elderly men (34%-40%, p = 0.53), and elderly women (60%-74%, p = 0.14), but the change was only significant in young women (42%-70%, p = 0.0045). After Food and Drug Administration-mandated labeling changes for zolpidem in 2013, the percentage of overall patients in our health system, and specifically young women, with initial prescriptions for low-dose zolpidem significantly increased as compared to before the labeling change.

Potential impact of initialization on decadal predictions as assessed for CMIP5 models

NASA Astrophysics Data System (ADS)

Branstator, Grant; Teng, Haiyan

2012-06-01

To investigate the potential for initialization to improve decadal range predictions, we quantify the initial value predictability of upper 300 m temperature in the two northern ocean basins for 12 models from Coupled Model Intercomparison Project phase 5 (CMIP5), and we contrast it with the forced predictability in Representative Concentration Pathways (RCP) 4.5 climate change projections. We use a recently introduced method that produces predictability estimates from long control runs. Many initial states are considered, and we find on average 1) initialization has the potential to improve skill in the first 5 years in the North Pacific and the first 9 years in the North Atlantic, and 2) the impact from initialization becomes secondary compared to the impact of RCP4.5 forcing after 6 1/2 and 8 years in the two basins, respectively. Model-to-model and spatial variations in these limits are, however, substantial.

A house officer-sponsored quality improvement initiative: leadership lessons and liabilities.

PubMed

Weingart, S N

1998-07-01

House officers play an important role in the care of hospitalized patients, yet they are infrequent participants in quality improvement (QI) activities. A grassroots QI initiative among medical house officers was implemented at Beth Israel Deaconess Medical Center's East Campus in Boston from 1995 through 1997. A group of house officer volunteers completed five of nine projects, including a survey that demonstrated frequent failures of cardiac monitor-defibrillators in the emergency room. Reaching out to key administrators produced several quick fixes. Developing effective, ongoing partnerships with clinical departments and QI professionals proved more problematic. Residency training programs that provide experience in QI give house officers a potentially valuable skill and an additional means to improve the quality of patient care. Yet many obstacles work against house officers' participation in QI initiatives, including long hours and the daily demands of patient care, rotating monthly assignments, and clinical leaders' assumption that they have little interest in QI. The organizers of the officer problem-solving group over-estimated the hospital resources at their disposal and failed to build mechanisms to ensure the initiative's continuation into its second year, when their own interest waned and no new group of leaders emerged to take their place. House officers represent an underused resource for QI. They are skilled at identifying problems but have difficulty executing sustained and complex QI initiatives. Peer leadership is a potent means to mobilize resident-physician participation but may require faculty or staff involvement and support to guarantee its continuity.

Surgical Missteps in the Management of Venous Thoracic Outlet Syndrome Which Lead to Reoperation.

PubMed

Archie, Meena M; Rollo, Johnathon C; Gelabert, Hugh A

2018-05-01

Surgical management of spontaneous subclavian thrombosis due to venous thoracic outlet syndrome (vTOS) results in durable relief of symptoms. The need to reoperate is rare. We report our experience with reoperation for vTOS. Patients evaluated for vTOS between 1996 and 2016 were identified in a prospective database. Data recorded included demographics, initial presentation, initial surgery, recurrent presentation, reoperation, and final outcomes. In all, 261 patients were evaluated for vTOS, of these, 246 patients underwent first rib resections. Ten (3.8%) patients required evaluation for recurrent vTOS symptoms. Prior management included thrombolysis (4) and anticoagulation alone (6). Prior surgical approaches included infraclavicular (2), supraclavicular (2) and transaxillary (6). One operation was complicated by a hemothorax, and one a brachial plexus injury. Indication for reoperation included congestive symptoms (6) and recurrent thrombosis (4). Evaluation included chest X-rays (10), venogram (8), intra-venous ultrasound (2), and computed tomography venography (3). Significant compression by remaining rib segments were identified in all: inadequate resection of the anterior first rib (7), inadequate resection of posterior rib segment (1), and erroneous resection of second rib (2). Reoperations include 7 transaxillary approaches, 1 medial claviculectomy, and 1 paraclavicular decompression. One phrenic nerve palsy occurred following paraclavicular decompression. All underwent postoperative venography and angioplasty. At final evaluation, 8 veins are patent and congestive symptoms resolved, and 1 crushed stent could not be reopened despite decompression. The incidence of reoperation for first rib resection in cases of vTOS is low and appears largely due to missteps during the initial operation. Awareness of potential errors including inadequacy of resection, intraoperative disorientation, and misunderstanding of the limitations of surgical approaches will result in fewer reoperations. Published by Elsevier Inc.

The EducEO project

NASA Astrophysics Data System (ADS)

Fritz, Steffen; Dias, Eduardo; Zeug, Guenther; Vescovi, Fabio; See, Linda; Sturn, Tobias; McCallum, Ian; Stammes, Piet; Snik, Frans; Hendriks, Elise

2015-04-01

The ESA funded EducEO project is aimed at demonstrating the potential of citizen science and crowdsourcing for Earth Observation (EO), where citizen science and crowdsourcing refer to the involvement of citizens in tasks such as data collection. The potential for using citizens in the calibration and validation of satellite imagery through in-situ measurements and image recognition is largely untapped. The EducEO project will aim to achieve good integration with networks such as GLOBE (primary and secondary education) and COST (higher education) to involve students in four different applications that will be piloted as part of the EducEO project. The presentation will provide a brief overview and initial results of these applications, which include: the iSpex tool for measuring air pollution using an iPhone; a game to classify cropland and deforested areas from high resolution satellite imagery; an application to monitor areas of forest change using radar data from Sentinel-1; and the collection of in-situ yield and production data from both farmers (using high-tech farming equipment) and students. In particular initial results and future potential of the serious game on land cover and forest change monitoring will be discussed.

Demonstration Assessment of Light-Emitting Diode (LED) Roadway Lighting, I-35W Bridge, Minneapolis, Minnesota, Phase I Report

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

Kinzey, B. R.; Myer, M. A.

2009-08-01

On the I-35W Bridge in Minneapolis, Minnesota, the GATEWAY program conducted a two-phase demonstration of LED roadway lighting on the main span, which is one of the country's oldest continuously operated exterior LED lighting installations. The Phase I report provides an overview of initial project results including lighting performance, economic performance, and potential energy savings.

Factors affecting microbial adhesion to stainless steel and other materials used in medical devices.

PubMed

Verran, J; Whitehead, K

2005-11-01

The role of biofilm in medical device associated infections is well documented. Biofilms are more resistant to antibiotics than planktonic cells, these are extremely difficult to treat. Prevention strategies include efforts to insert implants under stringent aseptic conditions, and also encompass the development of novel materials which interfere with the initial attachment of microorganisms to the surface of the device. Microbial cells also attach onto hygienic surfaces in the hospital setting, and thereby pose a cross-infection problem. In this case, vigorous cleaning and sanitizing regimes may be employed in addition to any surface modifications. Many factors affect the initial attachment of organisms to inert substrata, and their subsequent retention or removal/detachment, including the physical and chemical nature and location of the substratum, the type of organic material and microorganisms potentially fouling the surface, and the nature of the interface (solid-liquid in the body; solid-air on environmental surfaces). Focusing on one factor, surface topography, it is apparent that many further variables need to be defined in order to fully understand the interactions occurring between the cell and surface. It is therefore important when modifying one substratum surface property in order to reduce adhesion, to also consider other potentially confounding factors.

Exploring the multifunctionality of thioflavin- and deferiprone-based molecules as acetylcholinesterase inhibitors for potential application in Alzheimer's disease.

PubMed

Telpoukhovskaia, Maria A; Patrick, Brian O; Rodríguez-Rodríguez, Cristina; Orvig, Chris

2013-04-05

Alzheimer's disease (AD) is a devastating neurodegenerative disease that affects millions of people worldwide. With no prevention or cure available, this progressive disease has a significant impact on society - dementia patients and their caretakers, healthcare systems, and the economy. Previously, we have reported initial developments of multifunctional drug candidates for AD based on two scaffolds - thioflavin-T and deferiprone. Individually, these molecules have shown several favorable functionalities, including dissociation of toxic amyloid-β aggregates, antioxidant and/or metal chelating ability that can pacify reactive oxygen species, plaque targeting, and blood-brain barrier penetration. In this work, the two scaffolds are augmented with a new functionality - acetylcholinesterase inhibition. This functionality is incorporated by derivatization with a carbamate group, which is the active group in some AD drugs currently in the market. We present the rationale for designing three novel compounds, their synthesis and characterization, including X-ray crystallographic data, and encouraging results from in vitro and computational acetylcholinesterase inhibition studies. Also, we evaluate the compounds as potential drug candidates by Lipinski's rules and cytotoxicity studies in a neuronal cell line. Overall, we demonstrate the feasibility of improving on two well established scaffolds, as well as show in vitro efficacy plus initial mode of action and biological compatibility data.

The Breakthrough Listen Initiative and the Future of the Search for Intelligent Life

NASA Astrophysics Data System (ADS)

Enriquez, J. Emilio; Siemion, Andrew; Croft, Steve; Hellbourg, Greg; Lebofsky, Matt; MacMahon, David; Price, Danny; DeBoer, David; Werthimer, Dan

2017-05-01

Unprecedented recent results in the fields of exoplanets and astrobiology have dramatically increased the interest in the potential existence of intelligent life elsewhere in the galaxy. Additionally, the capabilities of modern Searches for Extraterrestrial Intelligence (SETI) have increased tremendously. Much of this improvement is due to the ongoing development of wide bandwidth radio instruments and the Moore's Law increase in computing power over the previous decades. Together, these instrumentation improvements allow for narrow band signal searches of billions of frequency channels at once.The Breakthrough Listen Initiative (BL) was launched on July 20, 2015 at the Royal Society in London, UK with the goal to conduct the most comprehensive and sensitive search for advanced life in humanity's history. Here we detail important milestones achieved during the first year and a half of the program. We describe the key BL SETI surveys and briefly describe current facilities, including the Green Bank Telescope, the Automated Planet Finder and the Parkes Observatory. We also mention the ongoing and potential collaborations focused on complementary sciences, these include pulse searches of pulsars and FRBs, as well as astrophysically powered radio emission from stars targeted by our program.We conclude with a brief view towards future SETI searches with upcoming next-generation radio facilities such as SKA and ngVLA.

Are multidose drug dispensing systems initiated for the appropriate patients?

PubMed

Mertens, Bram J; Kwint, H F; van Marum, Rob J; Bouvy, Marcel L

2018-05-16

It is unknown if multidose drug dispensing (MDD) systems are initiated for the appropriate patients. Therefore, the objective of this study was to compare the medication management problems of patients who were about to start with a MDD system (MDD patients) and patients who continued manually dispensed medication (non-MDD users) in order to identify if the appropriate patients receive a MDD system. Patient interviews (semi-structured) were conducted by 44 community pharmacists at the patient's home. Patients over 65 years of age, home dwelling and using at least five chronic drugs, were eligible for the study. An assessment tool was developed including 22 potential medication management problems, covering four domains: functional (7), organizational (7), medication adherence (6), and medication knowledge (2). Median scores were calculated with the interquartile range. Additionally, cognitive function was assessed with the Mini-Cog and frailty using the Groningen Frailty Indicator. One hundred eighty-eight MDD users and 230 non-MDD users were interviewed. MDD users were older, more often female, and using more drugs. Forty-two percent of the MDD users were possibly cognitively impaired and 63% were assessed as frail compared to 20 and 27% respectively of the non-MDD users. MDD users had more potential organizational problems (3 vs. 1; p < 0.01), functional problems (2 vs. 1; p < 0.01), medication adherence problems (1 vs. 0; p < 0.01), and medication knowledge problems (1 vs. 0; p < 0.01) compared to non-MDD users. Seventy percent of the MDD users scored six or more potential medication management problems while this was 22% among non-MDD users. The majority of MDD systems were initiated for patients who experienced multiple potential medication management problems suggesting a decreased medication management capacity.

Patient initiated clinics for patients with chronic or recurrent conditions managed in secondary care: a systematic review of patient reported outcomes and patient and clinician satisfaction

PubMed Central

2013-01-01

Background The cost to the NHS of missed or inappropriate hospital appointments is considerable. Alternative methods of appointment scheduling might be more flexible to patients’ needs without jeopardising health and service quality. The objective was to systematically review evidence of patient initiated clinics in secondary care on patient reported outcomes among patients with chronic/recurrent conditions. Methods Seven databases were searched from inception to June 2013. Hand searching of included studies references was also conducted. Studies comparing the effects of patient initiated clinics with traditional consultant led clinics in secondary care for patients with long term chronic or recurrent diseases on health related quality of life and/or patient satisfaction were included. Data was extracted by one reviewer and checked by a second. Results were synthesised narratively. Results Seven studies were included in the review, these covered a total of 1,655 participants across three conditions: breast cancer, inflammatory bowel disease and rheumatoid arthritis. Quality of reporting was variable. Results showed no significant differences between the intervention and control groups for psychological and health related quality of life outcomes indicating no evidence of harm. Some patients reported significantly more satisfaction using patient-initiated clinics than usual care (p < 0.001). Conclusions The results show potential for patient initiated clinics to result in greater patient and clinician satisfaction. The patient-consultant relationship appeared to play an important part in patient satisfaction and should be considered an important area of future research as should the presence or absence of a guidebook to aid self-management. Patient initiated clinics fit the models of care suggested by policy makers and so further research into long term outcomes for patients and service use in this area of practice is both relevant and timely. PMID:24289832

"Symptoms of something all around us": Mental health, Inuit culture, and criminal justice in Arctic communities in Nunavut, Canada.

PubMed

Ferrazzi, Priscilla; Krupa, Terry

2016-09-01

Rehabilitation-oriented criminal court mental health initiatives to reduce the number of people with mental illness caught in the criminal justice system exist in many North American cities and elsewhere but not in the mainly Inuit Canadian Arctic territory of Nunavut. This study explores whether the therapeutic aims of these resource-intensive, mainly urban initiatives can be achieved in criminal courts in Nunavut's resource constrained, culturally distinct and geographically remote communities. A qualitative multiple-case study in the communities of Iqaluit, Arviat and Qikiqtarjuaq involved 55 semi-structured interviews and three focus groups with participants representing four sectors essential to these initiatives: justice, health, community organizations and community members. These interviews explored whether the therapeutic jurisprudence (TJ) principles that guide criminal court mental health initiatives and the component objectives of these principles could be used to improve the criminal court response to people with mental illness in Nunavut. Interviews revealed 13 themes reflecting perceptions of Inuit culture's influence on the identification of people with mental illness, treatment, and collaboration between the court and others. These themes include cultural differences in defining mental illness, differences in traditional and contemporary treatment models, and the importance of mutual cultural respect. The findings suggest Inuit culture, including its recent history of cultural disruption and change, affects the vulnerability of Nunavut communities to the potential moral and legal pitfalls associated with TJ and criminal court mental health initiatives. These pitfalls include the dominance of biomedical approaches when identifying a target population, the medicalization of behaviour and culture, the risk of "paternalism" in therapeutic interventions, and shortcomings in interdisciplinary collaboration that limit considerations of Inuit culture. The pitfalls are not fatal to efforts to bring the rehabilitative benefits of these initiatives to Nunavut, but they require careful vigilance when employing TJ principles in an Indigenous circumpolar context. Copyright © 2016. Published by Elsevier Ltd.

Financial preconditions for successful community initiatives for the uninsured.

PubMed

Song, Paula H; Smith, Dean G

2007-01-01

Community-based initiatives are increasingly being implemented as a strategy to address the health needs of the community, with a growing body of evidence on successes of various initiatives. This study addresses financial status indicators (preconditions) that might predict where community-based initiatives might have a better chance for success. We evaluated five community-based initiatives funded by the Communities in Charge (CIC) program sponsored by the Robert Wood Johnson Foundation. These initiatives focus on increasing access by easing financial barriers to care for the uninsured. At each site, we collected information on financial status indicators and interviewed key personnel from health services delivery and financing organizations. With full acknowledgment of the caveats associated with generalizations based on a small number of observations, we suggest four financial preconditions associated with successful initiation of CIC programs: (1) uncompensated care levels that negatively affect profitability, (2) reasonable financial stability of providers, (3) stable health insurance market, and (4) the potential to create new sources of funding. In general, sites that demonstrate successful program initiation are financially stressed enough by uncompensated care to gain the attention of local healthcare providers. However, they are not so strained and so concerned about revenue sources that they cannot afford to participate in the initiative. In addition to political and managerial indicators, we suggest that planning for community-based initiatives should include financial indicators of current health services delivery and financing organizations and consideration of whether they meet preconditions for success.

Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.

PubMed

Khamaysi, Iyad; Gralnek, Ian M

2013-10-01

Acute upper gastrointestinal bleeding (UGIB) is the most common reason that the 'on-call' gastroenterologist is consulted. Despite the diagnostic and therapeutic capabilities of upper endoscopy, there is still significant associated morbidity and mortality in patients experiencing acute UGIB, thus this is a true GI emergency. Acute UGIB is divided into non-variceal and variceal causes. The most common type of acute UGIB is 'non-variceal' and includes diagnoses such as peptic ulcer (gastric and duodenal), gastroduodenal erosions, Mallory-Weiss tears, erosive oesophagitis, arterio-venous malformations, Dieulafoy's lesion, and upper GI tract tumours and malignancies. This article focuses exclusively on initial management strategies for acute upper GI bleeding. We discuss up to date and evidence-based strategies for patient risk stratification, initial patient management prior to endoscopy, potential causes of UGIB, role of proton pump inhibitors, prokinetic agents, prophylactic antibiotics, vasoactive pharmacotherapies, and timing of endoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effects of premature stimulation on HERG K+ channels

PubMed Central

Lu, Yu; Mahaut-Smith, Martyn P; Varghese, Anthony; Huang, Christopher L-H; Kemp, Paul R; Vandenberg, Jamie I

2001-01-01

The unusual kinetics of human ether-à-go-go-related gene (HERG) K+ channels are consistent with a role in the suppression of arrhythmias initiated by premature beats. Action potential clamp protocols were used to investigate the effect of premature stimulation on HERG K+ channels, transfected in Chinese hamster ovary cells, at 37 °C. HERG K+ channel currents peaked during the terminal repolarization phase of normally paced action potential waveforms. However, the magnitude of the current and the time point at which conductance was maximal depended on the type of action potential waveform used (epicardial, endocardial, Purkinje fibre or atrial). HERG K+ channel currents recorded during premature action potentials consisted of an early transient outward current followed by a sustained outward current. The magnitude of the transient current component showed a biphasic dependence on the coupling interval between the normally paced and premature action potentials and was maximal at a coupling interval equivalent to 90% repolarization (APD90) for ventricular action potentials. The largest transient current response occurred at shorter coupling intervals for Purkinje fibre (APD90– 20 ms) and atrial (APD90– 30 ms) action potentials. The magnitude of the sustained current response following premature stimulation was similar to that recorded during the first action potential for ventricular action potential waveforms. However, for Purkinje and atrial action potentials the sustained current response was significantly larger during the premature action potential than during the normally paced action potential. A Markov model that included three closed states, one open and one inactivated state with transitions permitted between the pre-open closed state and the inactivated state, successfully reproduced our results for the effects of premature stimuli, both during square pulse and action potential clamp waveforms. These properties of HERG K+ channels may help to suppress arrhythmias initiated by early afterdepolarizations and premature beats in the ventricles, Purkinje fibres or atria. PMID:11744759

Nanotechnology in food processing sector-An assessment of emerging trends.

PubMed

Kalpana Sastry, R; Anshul, Shrivastava; Rao, N H

2013-10-01

Use of nanoscience based technology in the food industry is fast emerging as new area for research and development. Several research groups including private companies in the industry have initiated research programmes for exploring the wide scope of nanotechnology into the value chain of food processing and manufacturing. This paper discusses the current focus of research in this area and assesses its potential impacts. Using the developed relational database framework with R&D indicators like literature and patent documents for assessment of the potential of nanotechnology in food sector, a model to organize and map nanoresearch areas to the food processing sector was developed. The study indicates that the about five basic categories of nanotechnology applications and functionalities currently in the development of food sector, include food processing, packaging, nutraceuticals delivery, food safety and functional foods.

Quantum technology past, present, future: quantum energetics (Conference Presentation)

NASA Astrophysics Data System (ADS)

Choi, Sang H.

2017-04-01

Since the development of quantum physics in the early part of the 1900s, this field of study has made remarkable contributions to our civilization. Some of these advances include lasers, light-emitting diodes (LED), sensors, spectroscopy, quantum dots, quantum gravity and quantum entanglements. In 1998, the NASA Langley Research Center established a quantum technology committee to monitor the progress in this area and initiated research to determine the potential of quantum technology for future NASA missions. The areas of interest in quantum technology at NASA included fundamental quantum-optics materials associated with quantum dots and quantum wells, device-oriented photonic crystals, smart optics, quantum conductors, quantum information and computing, teleportation theorem, and quantum energetics. A brief review of the work performed, the progress made in advancing these technologies, and the potential NASA applications of quantum technology will be presented.

Assessment of Biodosimetry Methods for a Mass-Casualty Radiological Incident: Medical Response and Management Considerations

PubMed Central

Sullivan, Julie M.; Prasanna, Pataje G. S.; Grace, Marcy B.; Wathen, Lynne; Wallace, Rodney L.; Koerner, John F.; Coleman, C. Norman

2013-01-01

Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual’s radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual’s dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a stand-alone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, we reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point. PMID:24162058

Action Potentials Initiate in the Axon Initial Segment and Propagate Through Axon Collaterals Reliably in Cerebellar Purkinje Neurons

PubMed Central

Foust, Amanda; Popovic, Marko; Zecevic, Dejan; McCormick, David A.

2010-01-01

Purkinje neurons are the output cells of the cerebellar cortex and generate spikes in two distinct modes, known as simple and complex spikes. Revealing the point of origin of these action potentials, and how they conduct into local axon collaterals, is important for understanding local and distal neuronal processing and communication. By utilizing a recent improvement in voltage sensitive dye imaging technique that provided exceptional spatial and temporal resolution, we were able to resolve the region of spike initiation as well as follow spike propagation into axon collaterals for each action potential initiated on single trials. All fast action potentials, for both simple and complex spikes, whether occurring spontaneously or in response to a somatic current pulse or synaptic input, initiated in the axon initial segment. At discharge frequencies of less than approximately 250 Hz, spikes propagated faithfully through the axon and axon collaterals, in a saltatory manner. Propagation failures were only observed for very high frequencies or for the spikelets associated with complex spikes. These results demonstrate that the axon initial segment is a critical decision point in Purkinje cell processing and that the properties of axon branch points are adjusted to maintain faithful transmission. PMID:20484631

mHealth Assessment: Conceptualization of a Global Framework

PubMed Central

2017-01-01

Background The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. Objective We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment. Methods Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group’s diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts. Results As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries. Conclusions A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the specifics of each context, to bridge the gap between health authorities, patients, and mHealth developers. We aim to foster a more trusting and collaborative environment to safeguard the well-being of patients and citizens while encouraging innovation of technology and policy. PMID:28465282

State and location dependence of action potential metabolic cost in cortical pyramidal neurons.

PubMed

Hallermann, Stefan; de Kock, Christiaan P J; Stuart, Greg J; Kole, Maarten H P

2012-06-03

Action potential generation and conduction requires large quantities of energy to restore Na(+) and K(+) ion gradients. We investigated the subcellular location and voltage dependence of this metabolic cost in rat neocortical pyramidal neurons. Using Na(+)/K(+) charge overlap as a measure of action potential energy efficiency, we found that action potential initiation in the axon initial segment (AIS) and forward propagation into the axon were energetically inefficient, depending on the resting membrane potential. In contrast, action potential backpropagation into dendrites was efficient. Computer simulations predicted that, although the AIS and nodes of Ranvier had the highest metabolic cost per membrane area, action potential backpropagation into the dendrites and forward propagation into axon collaterals dominated energy consumption in cortical pyramidal neurons. Finally, we found that the high metabolic cost of action potential initiation and propagation down the axon is a trade-off between energy minimization and maximization of the conduction reliability of high-frequency action potentials.

Collaboration and conquest: MTD as viewed by voice teacher (singing voice specialist) and speech-language pathologist.

PubMed

Goffi-Fynn, Jeanne C; Carroll, Linda M

2013-05-01

This study was designed as a qualitative case study to demonstrate the process of diagnosis and treatment between a voice team to manage a singer diagnosed with muscular tension dysphonia (MTD). Traditionally, literature suggests that MTD is challenging to treat and little in the literature directly addresses singers with MTD. Data collected included initial medical screening with laryngologist, referral to speech-language pathologist (SLP) specializing in voice disorders among singers, and adjunctive voice training with voice teacher trained in vocology (singing voice specialist or SVS). Initial target goals with SLP included reducing extrinsic laryngeal tension, using a relaxed laryngeal posture, and effective abdominal-diaphragmatic support for all phonation events. Balance of respiratory forces, laryngeal coordination, and use of optimum filtering of the source signal through resonance and articulatory awareness was emphasized. Further work with SVS included three main goals including a lowered breathing pattern to aid in decreasing subglottic air pressure, vertical laryngeal position to lower to allow for a relaxed laryngeal position, and a top-down singing approach to encourage an easier, more balanced registration, and better resonance. Initial results also emphasize the retraining of subject toward a sensory rather than auditory mode of monitoring. Other areas of consideration include singers' training and vocal use, the psychological effects of MTD, the personalities potentially associated with it, and its relationship with stress. Finally, the results emphasize that a positive rapport with the subject and collaboration between all professionals involved in a singer's care are essential for recovery. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Three-dimensional Printing in Developing Countries

PubMed Central

Ibrahim, Ahmed M. S.; Jose, Rod R.; Rabie, Amr N.; Gerstle, Theodore L.; Lee, Bernard T.

2015-01-01

Summary: The advent of 3-dimensional (3D) printing technology has facilitated the creation of customized objects. The lack of regulation in developing countries renders conventional means of addressing various healthcare issues challenging. 3D printing may provide a venue for addressing many of these concerns in an inexpensive and easily accessible fashion. These may potentially include the production of basic medical supplies, vaccination beads, laboratory equipment, and prosthetic limbs. As this technology continues to improve and prices are reduced, 3D printing has the potential ability to promote initiatives across the entire developing world, resulting in improved surgical care and providing a higher quality of healthcare to its residents. PMID:26301132

Three-dimensional Printing in Developing Countries.

PubMed

Ibrahim, Ahmed M S; Jose, Rod R; Rabie, Amr N; Gerstle, Theodore L; Lee, Bernard T; Lin, Samuel J

2015-07-01

The advent of 3-dimensional (3D) printing technology has facilitated the creation of customized objects. The lack of regulation in developing countries renders conventional means of addressing various healthcare issues challenging. 3D printing may provide a venue for addressing many of these concerns in an inexpensive and easily accessible fashion. These may potentially include the production of basic medical supplies, vaccination beads, laboratory equipment, and prosthetic limbs. As this technology continues to improve and prices are reduced, 3D printing has the potential ability to promote initiatives across the entire developing world, resulting in improved surgical care and providing a higher quality of healthcare to its residents.

Solutions for research data from a publisher's perspective

NASA Astrophysics Data System (ADS)

Cotroneo, P.

2015-12-01

Sharing research data has the potential to make research more efficient and reproducible. Elsevier has developed several initiatives to address the different needs of research data users. These include PANGEA Linked data, which provides geo-referenced, citable datasets from earth and life sciences, archived as supplementary data from publications by the PANGEA data repository; Mendeley Data, which allows users to freely upload and share their data; a database linking program that creates links between articles on ScienceDirect and datasets held in external data repositories such as EarthRef and EarthChem; a pilot for searching for research data through a map interface; an open data pilot that allows authors publishing in Elsevier journals to store and share research data and make this publicly available as a supplementary file alongside their article; and data journals, including Data in Brief, which allow researchers to share their data open access. Through these initiatives, researchers are not only encouraged to share their research data, but also supported in optimizing their research data management. By making data more readily citable and visible, and hence generating citations for authors, these initiatives also aim to ensure that researchers get the recognition they deserve for publishing their data.

[The Mechanism of Free-Floating Discussion in a Psychiatric/Mental Health Nursing Supervisory Group].

PubMed

Chiang, Hsien-Hsien

2015-06-01

Although the free-floating discussion format is widely used in group therapy, the application of this format in the context of supervisory groups has yet to be clarified. The purpose of this study was to explore the mechanisms involved in facilitating and learning the free-floating discussion format in a supervisory group. A phenomenological approach was used to investigate the group content and personal feedback of a psychiatric-nurse supervisory group. The group held on 12 sessions. Each session was conducted once weekly and lasting 150 minutes. The findings identified the functions of free-floating discussions in the context of supervisory groups as: embodied interaction and initiation by handling. Embodied interaction included: reflection on the experience of the other, sense of body, and present action. Initiation by handling included: facilitating the self-narrative, following the lead of the group, and reflecting in accordance with the group. The role of the facilitator is to parallel process rather than to lead in order to produce practical wisdom. Free-floating discussion and self-evidence from initiation by handling has the potential to promote spontaneity, creativity, and self-confidence in clinical practice and to promote deep learning.

COordination of Standards in MetabOlomicS (COSMOS): facilitating integrated metabolomics data access.

PubMed

Salek, Reza M; Neumann, Steffen; Schober, Daniel; Hummel, Jan; Billiau, Kenny; Kopka, Joachim; Correa, Elon; Reijmers, Theo; Rosato, Antonio; Tenori, Leonardo; Turano, Paola; Marin, Silvia; Deborde, Catherine; Jacob, Daniel; Rolin, Dominique; Dartigues, Benjamin; Conesa, Pablo; Haug, Kenneth; Rocca-Serra, Philippe; O'Hagan, Steve; Hao, Jie; van Vliet, Michael; Sysi-Aho, Marko; Ludwig, Christian; Bouwman, Jildau; Cascante, Marta; Ebbels, Timothy; Griffin, Julian L; Moing, Annick; Nikolski, Macha; Oresic, Matej; Sansone, Susanna-Assunta; Viant, Mark R; Goodacre, Royston; Günther, Ulrich L; Hankemeier, Thomas; Luchinat, Claudio; Walther, Dirk; Steinbeck, Christoph

Metabolomics has become a crucial phenotyping technique in a range of research fields including medicine, the life sciences, biotechnology and the environmental sciences. This necessitates the transfer of experimental information between research groups, as well as potentially to publishers and funders. After the initial efforts of the metabolomics standards initiative, minimum reporting standards were proposed which included the concepts for metabolomics databases. Built by the community, standards and infrastructure for metabolomics are still needed to allow storage, exchange, comparison and re-utilization of metabolomics data. The Framework Programme 7 EU Initiative 'coordination of standards in metabolomics' (COSMOS) is developing a robust data infrastructure and exchange standards for metabolomics data and metadata. This is to support workflows for a broad range of metabolomics applications within the European metabolomics community and the wider metabolomics and biomedical communities' participation. Here we announce our concepts and efforts asking for re-engagement of the metabolomics community, academics and industry, journal publishers, software and hardware vendors, as well as those interested in standardisation worldwide (addressing missing metabolomics ontologies, complex-metadata capturing and XML based open source data exchange format), to join and work towards updating and implementing metabolomics standards.

Microbial Monitoring of Pathogens by Comparing Multiple Real-Time PCR Platforms for Potential Space Applications

NASA Technical Reports Server (NTRS)

Birmele, Michele

2012-01-01

The International Space Station (ISS) is a closed environment wih rotations of crew and equipment each introducing their own microbial flora making it necessary to monitor the air, surfaces, and water for microbial contamination. Current microbial monitoring includes labor and time intensive methods to enumerate total bacterial and fungal cells with limited characterization during in-flight testing. Although this culture-based method has been sufficient for monitoring the ISS, future long duration missions will need to perform more comprehensive characterization in-flight, since sample return and ground characterization may not be available. A workshop was held in 2011 at the Johnson Space Center to discuss alternative methodologies and technologies suitable for microbial monitoring for these longterm exploration missions where molecular-based methodologies, such as polymerase chain reaction (PCR), were recommended. In response, a multi-center (Marshall Space Flight Center, Johnson Space Center, Jet Propulsion Laboratory, and Kennedy Space Center) collaborative research effort was initiated to explore novel commercial-off-the-shelf hardware options for spaceflight environmental monitoring. The goal was to evaluate quantitative/semi-quantitative PCR approaches to space applications for low cost in-flight rapid identification of microorganisms affecting crew safety. The initial phase of this project identified commercially available platforms that could be minimally modified to perform nominally in microgravity followed by proof-of-concept testing on the highest qualifying candidates with a universally available test organism, Salmonella enterica. The platforms evaluated during proof-of-concept testing included the iCubate 2.0(TradeMark) (iCubate, Huntsville, AL), RAZOR EX (BioFire Diagnostics; Salt Lake City, Utah) and SmartCycler(TradeMark) (Cepheid; Sunnyvale, CA). The analysis identified two potential technologies (iCubate 2.0 and RAZOR EX) that were able to perform sample-to-answer testing with cell sample concentrations between SO to 400 cells. In addition, the commercial systems were evaluated for initial flight safety and readiness, sample concentration needs were reviewed, and a competitive procurement of commercially available platforms was initiated.

Substance Use among Male Sex Workers in Vietnam: Prevalence, Onset, and Interactions with Sexual Risk

PubMed Central

Yu, Gary; Clatts, Michael C.; Goldsamt, Lloyd A.; Giang, Le Minh

2014-01-01

Background HIV research in Vietnam has focused primarily on its large heroin injector population. Data on men who have sex with men [MSM], particularly the large and growing population of men who exchange sex for money or other material rewards, male sex workers [MSWs], is very limited. Methods Data derive from a cross-sectional study of MSW, age 16-35, recruited using community sampling methods in three cities in 2010-2011, including Hanoi, Ho Chi Minh City [HCMC], and Nha Trang City (n=710). Assessments included demographic characteristics, substance use, sexual risk, and use of health services. A series of “event” questions were used to assess the influence of alcohol and drugs on sexual risk. Results Both tobacco and alcohol are initiated at a young age and most participants currently use both substances overall across all three cities. While alcohol and tobacco use precede the initiation of sex work, stimulant and opiate use are initiated following the initiation of sex work. There was substantial overlap between substance use and sexual risk, and this overlap was strongest in sexual events involving male and female elective partners rather than sex work clients. Conclusion Although rates of HIV infection in this group are low, this may be an artifact of the young age of the sample. High rates of drug use, including alcohol, tobacco and illicit drugs, coupled with high rates of ulcerative STIs such as HPV, suggest the potential for rapid amplification of STI/HIV risk among MSW and their complex sex partnering networks. PMID:25488636

The impact of globalization on vaccine development and availability.

PubMed

Milstien, Julie B; Kaddar, Miloud; Kieny, Marie Paule

2006-01-01

Globalization is likely to affect many aspects of public health, one of which is vaccine-preventable communicable diseases. Important forces include increased funding initiatives supporting immunization at the global level; regulatory harmonization; widespread intellectual property rights provisions through the World Trade Organization agreements; the emergence of developing-country manufacturers as major players in vaccine supply; and the appearance of new communicable disease threats, including those potentially linked to bioterrorism. All of these forces can affect, either positively and negatively, the development and availability of vaccines. Harnessing these will be a challenge for policymakers and immunization stakeholders.

Management of a hyperactive teen and cardiac safety.

PubMed

Sowinski, Heather; Karpawich, Peter P

2014-02-01

Since the earliest descriptions of the condition, controversy has prevailed as to the existence of as well as appropriate management of attention deficit hyperactivity disorder. Often diagnosed in childhood, symptoms of attention deficit hyperactivity disorder can continue into adolescence and adulthood, requiring lifelong therapy. Effective therapeutic interventions include stimulant medications with all their respective potential side effects, including the cardiovascular system. However, although initial studies raised concerns for an increase in serious adverse cardiovascular effects among children receiving these drugs, more recent and extensive reports have failed to substantiate those findings among young patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Proposed NASA Budget Includes Asteroid Capture but Cuts Planetary Science and Education

NASA Astrophysics Data System (ADS)

Balcerak, Ernie

2013-04-01

The Obama administration's proposed 17.7 billion budget for NASA for fiscal year (FY) 2014 provides 105 million for several asteroid-related initiatives, including preliminary studies for a potential mission that would capture an asteroid and drag it into orbit around the Moon. The agency's total proposed budget is down slightly compared to FY 2012 (see Table ; comparisons are to FY 2012 because government agencies had been operating on a continuing resolution for 2013 and final spending levels for 2013 were not available at the time the president released his proposed 2014 budget).

Barriers and facilitators to implementing the Baby-Friendly hospital initiative in neonatal intensive care units.

PubMed

Benoit, Britney; Semenic, Sonia

2014-01-01

To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU). Qualitative, descriptive design. Two university-affiliated level-III NICUs in Canada. A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners. In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis. Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration. Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Efferocytosis and Outside-In Signaling by Cardiac Phagocytes. Links to Repair, Cellular Programming, and Intercellular Crosstalk in Heart

PubMed Central

DeBerge, Matthew; Zhang, Shuang; Glinton, Kristofor; Grigoryeva, Luba; Hussein, Islam; Vorovich, Esther; Ho, Karen; Luo, Xunrong; Thorp, Edward B.

2017-01-01

Phagocytic sensing and engulfment of dying cells and extracellular bodies initiate an intracellular signaling cascade within the phagocyte that can polarize cellular function and promote communication with neighboring non-phagocytes. Accumulating evidence links phagocytic signaling in the heart to cardiac development, adult myocardial homeostasis, and the resolution of cardiac inflammation of infectious, ischemic, and aging-associated etiology. Phagocytic clearance in the heart may be carried out by professional phagocytes, such as macrophages, and non-professional cells, including myofibrolasts and potentially epithelial cells. During cardiac development, phagocytosis initiates growth cues for early cardiac morphogenesis. In diseases of aging, including myocardial infarction, heightened levels of cell death require efficient phagocytic debridement to salvage further loss of terminally differentiated adult cardiomyocytes. Additional risk factors, including insulin resistance and other systemic risk factors, contribute to inefficient phagocytosis, altered phagocytic signaling, and delayed cardiac inflammation resolution. Under such conditions, inflammatory presentation of myocardial antigen may lead to autoimmunity and even possible rejection of transplanted heart allografts. Increased understanding of these basic mechanisms offers therapeutic opportunities. PMID:29163503

Facile preparation of fluorescent layered double hydroxide polymeric composites through the photo-induced surface-initiated controlled living polymerization

NASA Astrophysics Data System (ADS)

Chen, Junyu; Liu, Meiying; Huang, Qiang; Jiang, Ruming; Huang, Hongye; Deng, Fengjie; Wen, Yuanqing; Tian, Jianwen; Zhang, Xiaoyong; Wei, Yen

2018-05-01

(Zn/Al) layered double hydroxide (LDH) based fluorescence probes have been facilely fabricated via photo-induced surface-initiated reversible addition-fragmentation chain transfer (RAFT) polymerization, which demonstrated green fluorescence, good biocompatibility and excellent dispersion performance in aqueous solution. The as prepared (Zn/Al)LDH polymeric composites were modified with 2-methacryloyloxyethyl phosphorylcholine (MPC), acrylic acid (AA) and diacroloyl-fluorescein (Ac-Fl). Among them, the comonomers MPC and AA were used to endow their water dispersibility, biocompatibility and potential drug carriers, while the Ac-Fl was served both as the fluorescence signal and photocatalyst for RAFT polymerization. A series of characterization methods, including 1H nuclear magnetic resonance spectroscopy, Fourier transform infrared spectroscopy, transmission electronic microscopy, thermogravimetric analyses, X-ray photoelectron spectroscopy were employed to conform the successful of surface modification of LDH through photo-induced surface-initiated RAFT polymerization. Besides, UV-vis absorption spectra and fluorescence spectra were adopted to evaluate the optical characteristics of as prepared (Zn/Al)LDH-co-Poly(MPC-AA-Fl) composites, which exhibited high intense green fluorescence. Furthermore, the endocytosis behavior indicates that (Zn/Al)LDH-co-Poly(MPC-AA-Fl) composites could be potentially used in cell imaging and even drug delivery application for their excellent biocompatibility and all advantages described above.

Optimization of the photoelectrocatalytic oxidation of landfill leachate using copper and nitrate co-doped TiO2 (Ti) by response surface methodology

PubMed Central

Zhou, Shaoqi; Feng, Xinbin

2017-01-01

In this paper, a statistically-based experimental design with response surface methodology (RSM) was employed to examine the effects of functional conditions on the photoelectrocatalytic oxidation of landfill leachate using a Cu/N co-doped TiO2 (Ti) electrode. The experimental design method was applied to response surface modeling and the optimization of the operational parameters of the photoelectro-catalytic degradation of landfill leachate using TiO2 as a photo-anode. The variables considered were the initial chemical oxygen demand (COD) concentration, pH and the potential bias. Two dependent parameters were either directly measured or calculated as responses: chemical oxygen demand (COD) removal and total organic carbon (TOC) removal. The results of this investigation reveal that the optimum conditions are an initial pH of 10.0, 4377.98mgL-1 initial COD concentration and 25.0 V of potential bias. The model predictions and the test data were in satisfactory agreement. COD and TOC removals of 67% and 82.5%, respectively, were demonstrated. Under the optimal conditions, GC/MS showed 73 organic micro-pollutants in the raw landfill leachate which included hydrocarbons, aromatic compounds and esters. After the landfill leachate treatment processes, 38 organic micro-pollutants disappeared completely in the photoelectrocatalytic process. PMID:28671943

An approach for finding long period elliptical orbits for precursor SEI missions

NASA Technical Reports Server (NTRS)

Fraietta, Michael F.; Bond, Victor R.

1993-01-01

Precursors for Solar System Exploration Initiative (SEI) missions may require long period elliptical orbits about a planet. These orbits will typically have periods on the order of tens to hundreds of days. Some potential uses for these orbits may include the following: studying the effects of galactic cosmic radiation, parking orbits for engineering and operational test of systems, and ferrying orbits between libration points and low altitude orbits. This report presents an approach that can be used to find these orbits. The approach consists of three major steps. First, it uses a restricted three-body targeting algorithm to determine the initial conditions which satisfy certain desired final conditions in a system of two massive primaries. Then the initial conditions are transformed to an inertial coordinate system for use by a special perturbation method. Finally, using the special perturbation method, other perturbations (e.g., sun third body and solar radiation pressure) can be easily incorporated to determine their effects on the nominal trajectory. An algorithm potentially suitable for on-board guidance will also be discussed. This algorithm uses an analytic method relying on Chebyshev polynomials to compute the desired position and velocity of the satellite as a function of time. Together with navigation updates, this algorithm can be implemented to predict the size and timing for AV corrections.

Support for the existence of invertible maps between electronic densities and non-analytic 1-body external potentials in non-relativistic time-dependent quantum mechanics

NASA Astrophysics Data System (ADS)

Mosquera, Martín A.

2017-10-01

Provided the initial state, the Runge-Gross theorem establishes that the time-dependent (TD) external potential of a system of non-relativistic electrons determines uniquely their TD electronic density, and vice versa (up to a constant in the potential). This theorem requires the TD external potential and density to be Taylor-expandable around the initial time of the propagation. This paper presents an extension without this restriction. Given the initial state of the system and evolution of the density due to some TD scalar potential, we show that a perturbative (not necessarily weak) TD potential that induces a non-zero divergence of the external force-density, inside a small spatial subset and immediately after the initial propagation time, will cause a change in the density within that subset, implying that the TD potential uniquely determines the TD density. In this proof, we assume unitary evolution of wavefunctions and first-order differentiability (which does not imply analyticity) in time of the internal and external force-densities, electronic density, current density, and their spatial derivatives over the small spatial subset and short time interval.

Variable frequency iteration MPPT for resonant power converters

DOEpatents

Zhang, Qian; Bataresh, Issa; Chen, Lin

2015-06-30

A method of maximum power point tracking (MPPT) uses an MPPT algorithm to determine a switching frequency for a resonant power converter, including initializing by setting an initial boundary frequency range that is divided into initial frequency sub-ranges bounded by initial frequencies including an initial center frequency and first and second initial bounding frequencies. A first iteration includes measuring initial powers at the initial frequencies to determine a maximum power initial frequency that is used to set a first reduced frequency search range centered or bounded by the maximum power initial frequency including at least a first additional bounding frequency. A second iteration includes calculating first and second center frequencies by averaging adjacent frequent values in the first reduced frequency search range and measuring second power values at the first and second center frequencies. The switching frequency is determined from measured power values including the second power values.

The Project Data Sphere Initiative: Accelerating Cancer Research by Sharing Data

PubMed Central

Reeder-Hayes, Katherine E.; Corty, Robert W.; Basch, Ethan; Milowsky, Mathew I.; Dusetzina, Stacie B.; Bennett, Antonia V.; Wood, William A.

2015-01-01

Background. In this paper, we provide background and context regarding the potential for a new data-sharing platform, the Project Data Sphere (PDS) initiative, funded by financial and in-kind contributions from the CEO Roundtable on Cancer, to transform cancer research and improve patient outcomes. Given the relatively modest decline in cancer death rates over the past several years, a new research paradigm is needed to accelerate therapeutic approaches for oncologic diseases. Phase III clinical trials generate large volumes of potentially usable information, often on hundreds of patients, including patients treated with standard of care therapies (i.e., controls). Both nationally and internationally, a variety of stakeholders have pursued data-sharing efforts to make individual patient-level clinical trial data available to the scientific research community. Potential Benefits and Risks of Data Sharing. For researchers, shared data have the potential to foster a more collaborative environment, to answer research questions in a shorter time frame than traditional randomized control trials, to reduce duplication of effort, and to improve efficiency. For industry participants, use of trial data to answer additional clinical questions could increase research and development efficiency and guide future projects through validation of surrogate end points, development of prognostic or predictive models, selection of patients for phase II trials, stratification in phase III studies, and identification of patient subgroups for development of novel therapies. Data transparency also helps promote a public image of collaboration and altruism among industry participants. For patient participants, data sharing maximizes their contribution to public health and increases access to information that may be used to develop better treatments. Concerns about data-sharing efforts include protection of patient privacy and confidentiality. To alleviate these concerns, data sets are deidentified to maintain anonymity. To address industry concerns about protection of intellectual property and competitiveness, we illustrate several models for data sharing with varying levels of access to the data and varying relationships between trial sponsors and data access sponsors. The Project Data Sphere Initiative. PDS is an independent initiative of the CEO Roundtable on Cancer Life Sciences Consortium, built to voluntarily share, integrate, and analyze comparator arms of historical cancer clinical trial data sets to advance future cancer research. The aim is to provide a neutral, broad-access platform for industry and academia to share raw, deidentified data from late-phase oncology clinical trials using comparator-arm data sets. These data are likely to be hypothesis generating or hypothesis confirming but, notably, do not take the place of performing a well-designed trial to address a specific hypothesis. Prospective providers of data to PDS complete and sign a data sharing agreement that includes a description of the data they propose to upload, and then they follow easy instructions on the website for uploading their deidentified data. The SAS Institute has also collaborated with the initiative to provide intrinsic analytic tools accessible within the website itself. As of October 2014, the PDS website has available data from 14 cancer clinical trials covering 9,000 subjects, with hopes to further expand the database to include more than 25,000 subject accruals within the next year. PDS differentiates itself from other data-sharing initiatives by its degree of openness, requiring submission of only a brief application with background information of the individual requesting access and agreement to terms of use. Data from several different sponsors may be pooled to develop a comprehensive cohort for analysis. In order to protect patient privacy, data providers in the U.S. are responsible for deidentifying data according to standards set forth by the Privacy Rule of the U.S. Health Insurance Portability and Accountability Act of 1996. Using Data Sharing to Improve Outcomes in Cancer: The “Prostate Cancer Challenge.” Control-arm data of several studies among patients with metastatic castration-resistant prostate cancer (mCRPC) are currently available through PDS. These data sets have multiple potential uses. The “Prostate Cancer Challenge” will ask the cancer research community to use clinical trial data deposited in the PDS website to address key research questions regarding mCRPC. General themes that could be explored by the cancer community are described in this article: prognostic models evaluating the influence of pretreatment factors on survival and patient-reported outcomes; comparative effectiveness research evaluating the efficacy of standard of care therapies, as illustrated in our companion article comparing mitoxantrone plus prednisone with prednisone alone; effects of practice variation in dose, frequency, and duration of therapy; level of patient adherence to elements of trial protocols to inform the design of future clinical trials; and age of subjects, regional differences in health care, and other confounding factors that might affect outcomes. Potential Limitations and Methodological Challenges. The number of data sets available and the lack of experimental-arm data limit the potential scope of research using the current PDS. The number of trials is expected to grow exponentially over the next year and may include multiple cancer settings, such as breast, colorectal, lung, hematologic malignancy, and bone marrow transplantation. Other potential limitations include the retrospective nature of the data analyses performed using PDS and its generalizability, given that clinical trials are often conducted among younger, healthier, and less racially diverse patient populations. Methodological challenges exist when combining individual patient data from multiple clinical trials; however, advancements in statistical methods for secondary database analysis offer many tools for reanalyzing data arising from disparate trials, such as propensity score matching. Despite these concerns, few if any comparable data sets include this level of detail across multiple clinical trials and populations. Conclusion. Access to large, late-phase, cancer-trial data sets has the potential to transform cancer research by optimizing research efficiency and accelerating progress toward meaningful improvements in cancer care. This type of platform provides opportunities for unique research projects that can examine relatively neglected areas and that can construct models necessitating large amounts of detailed data. The full potential of PDS will be realized only when multiple tumor types and larger numbers of data sets are available through the website. PMID:25876994

[Impact of volatile sulphur compounds in periodontal pockets on initial periodontal therapy].

PubMed

Li, Xiao-Jun; Dong, Ling-Ling; Kong, Jing-Jia

2008-07-01

To investigate the relationship of volatile sulphur compounds((VSC)levels in periodontal pockets with severity of periodontitis, and the impact of VSC on the result of initial periodontal therapy. Twenty-five patients with chronic periodontitis(CP)(13 males and 12 females with average age of 35) were included in this study. Clinical periodontal parameters, plaque index, probing depth(PD), attachment loss(AL), and bleeding on probing(BOP) were recorded before and 3 months after the initial therapy. VSC levels were measured with a portable monitor in a digital score ranging from 0.0 to 5.0. All of 5 054 sites for 840 teeth were included in this study. Before treatment the percentage of VSC-positive sites was 17.1%, 52.3% and 86.0% for shallow (PD<3 mm), moderate(PD 4-6 mm) and deep (PD>7 mm) pocket, respectively (P<0.001). In most VSC-positive sites the VSC levels were<1.0. Percentage of sites with a high VSC levels was significantly different among three groups (P<0.01). All clinical parameters in VSC-negative sites were reduced significantly following the initial therapy. The reduction of PD and AL in VSC-positive sites by treatment was less marked than that in VSC-negative sites. VSC in periodontal pockets may be a potential indicator for detecting severity of CP and a useful predictor for therapeutic success.

The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit

PubMed Central

Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

2017-01-01

The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care. PMID:28288104

Evaluating Channel Head Conditions for Environmental Impact Assessment in Northwestern Sonoma County, California

NASA Astrophysics Data System (ADS)

Sherwood, M. N.; O'Connor, M.; Pennington, R.

2007-12-01

Erosion and sedimentation have been identified as processes significantly affecting water quality in northern California Coast Range watersheds. These watersheds, including the Gualala River watershed in northwestern Sonoma County, have been designated as having water quality impaired by sediment under provisions of the Clean Water Act Section 303(d). A study was performed to estimate potential increases in erosion rates resulting from proposed vineyard development of ridge top forestland in the Gualala River watershed. The study area has an extensive history of logging, with substantial ground disturbance from tractors. The study area is characterized by flat ridge tops with steeply incised drainages shaped by debris slides, rock slides and earth flows. Jurassic age sedimentary and meta-sedimentary rocks of the coastal and central belt Franciscan formation comprise the underlying bedrock. Channel head development and advancement has long been understood to play a key role in sediment delivery and is possibly the most sensitive to changes in the external factors such as changes in climate or land use (Dietrich and Dunne 1993). Quantifying the amount of sediment contributed by potential channel head incision and/or initiation is an objective of environmental analysis for the project. Field surveys were performed during the field seasons of 2005 and 2006 to acquire measurements of channel head locations and slope, channel dimensions and substrate associated with the proposed development sites. Analysis of this field data, including the use of ArcGIS, allowed us to examine the local relationships between variables that influence channel initiation. Variables considered include drainage area, slope, soil type, geology and vegetation. An initial analysis of a selection of area-slope data failed to produce an inverse area-slope relationship as has been found in previous studies by Montgomery and Dietrich (1988). A more complete evaluation of the entire data set is presented here.

Surface charge control for zwitterionic polymer brushes: Tailoring surface properties to antifouling applications.

PubMed

Guo, Shanshan; Jańczewski, Dominik; Zhu, Xiaoying; Quintana, Robert; He, Tao; Neoh, Koon Gee

2015-08-15

Electrostatic interactions play an important role in adhesion phenomena particularly for biomacromolecules and microorganisms. Zero charge valence of zwitterions has been claimed as the key to their antifouling properties. However, due to the differences in the relative strength of their acid and base components, zwitterionic materials may not be charge neutral in aqueous environments. Thus, their charge on surfaces should be further adjusted for a specific pH environment, e.g. physiological pH typical in biomedical applications. Surface zeta potential for thin polymeric films composed of polysulfobetaine methacrylate (pSBMA) brushes is controlled through copolymerizing zwitterionic SBMA and cationic methacryloyloxyethyltrimethyl ammonium chloride (METAC) via surface-initiated atom transfer polymerization. Surface properties including zeta potential, roughness, free energy and thickness are measured and the antifouling performance of these surfaces is assessed. The zeta potential of pSBMA brushes is -40 mV across a broad pH range. By adding 2% METAC, the zeta potential of pSBMA can be tuned to zero at physiological pH while minimally affecting other physicochemical properties including dry brush thickness, surface free energy and surface roughness. Surfaces with zero and negative zeta potential best resist fouling by bovine serum albumin, Escherichia coli and Staphylococcus aureus. Surfaces with zero zeta potential also reduce fouling by lysozyme more effectively than surfaces with negative and positive zeta potential. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of 2015 Update to the Beers Criteria on Estimates of Prevalence and Costs Associated with Potentially Inappropriate Use of Antimuscarinics for Overactive Bladder.

PubMed

Suehs, Brandon T; Davis, Cralen; Ng, Daniel B; Gooch, Katherine

2017-07-01

Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB). A retrospective database analysis was conducted using a historical cohort design and including data collected between 2007 and 2013. Claims data were used to identify Medicare Advantage patients aged ≥65 years newly initiated on antimuscarinic OAB treatment. Patients were classified with potentially inappropriate use of antimuscarinic OAB drugs based on either the 2012 Beers Criteria or the 2015 Beers Criteria. Prevalence of PIM at the time of antimuscarinic initiation was determined. Bivariate comparisons of healthcare costs and medical condition burden were conducted to compare the marginal groups of patients (who qualified based on the 2012 Beers Criteria only or the 2015 Beers Criteria only). Differences in healthcare costs for patients with and without potentially inappropriate use of urinary antimuscarinics based on the 2012 and 2015 Beers Criteria were also examined. Of 66,275 patients, overall prevalence of potentially inappropriate use of OAB antimuscarinics was higher using 2015 Beers Criteria than when using the 2012 Beers Criteria (25.0 vs. 20.6%). Dementia was the most common PIM-qualifying condition under both versions. The 2015 Beers Criteria identified more females, more White people, and a younger population with PIM. Comorbid medical condition burden was lower using the 2015 Beers Criteria. The 2015 Beers Criteria only group had lower median unadjusted healthcare costs ($7104 vs. 8301; p < 0.001). The incremental net cost associated with potentially inappropriate use of antimuscarinic medication was higher under the 2012 Beers Criteria than under the 2015 Beers Criteria. In this cohort of patients newly initiated on antimuscarinic OAB treatment, substantial overlap of patients identified with PIM based on the 2015 Beers Criteria compared with the 2012 Beers Criteria was observed. In addition, the findings suggest that, when applied to antimuscarinic initiators, the 2015 Beers Criteria result in a greater prevalence of PIM and the identification of patients with less overall medical morbidity than the 2012 Beers Criteria.

Cortical Action Potential Backpropagation Explains Spike Threshold Variability and Rapid-Onset Kinetics

PubMed Central

Yu, Yuguo; Shu, Yousheng; McCormick, David A.

2008-01-01

Neocortical action potential responses in vivo are characterized by considerable threshold variability, and thus timing and rate variability, even under seemingly identical conditions. This finding suggests that cortical ensembles are required for accurate sensorimotor integration and processing. Intracellularly, trial-to-trial variability results not only from variation in synaptic activities, but also in the transformation of these into patterns of action potentials. Through simultaneous axonal and somatic recordings and computational simulations, we demonstrate that the initiation of action potentials in the axon initial segment followed by backpropagation of these spikes throughout the neuron results in a distortion of the relationship between the timing of synaptic and action potential events. In addition, this backpropagation also results in an unusually high rate of rise of membrane potential at the foot of the action potential. The distortion of the relationship between the amplitude time course of synaptic inputs and action potential output caused by spike back-propagation results in the appearance of high spike threshold variability at the level of the soma. At the point of spike initiation, the axon initial segment, threshold variability is considerably less. Our results indicate that spike generation in cortical neurons is largely as expected by Hodgkin—Huxley theory and is more precise than previously thought. PMID:18632930

ASSOCIATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY INITIATION

PubMed Central

Merenstein, Daniel; Yang, Yang; Schneider, Michael F.; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M.; Sharp, Gerald B.; Gandhi, Monica; Liu, Chenglong

2009-01-01

Objective To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)–infected participants of the Women’s Interagency HIV Study. Study Methods Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non–CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. Main Outcome and Exposures Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. Results One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non–CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non–CAM users. Conclusion Female CAM users initiated HAART regimens earlier than non–CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression. PMID:18780580

Let's Talk About Breastfeeding: The Importance of Delivering a Message in a Home Visiting Program.

PubMed

McGinnis, Sandra; Lee, Eunju; Kirkland, Kristen; Miranda-Julian, Claudia; Greene, Rose

2018-05-01

To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population. A secondary analysis of program data from a statewide home visitation program. Thirty-six Healthy Families New York sites across New York State. A total of 3521 pregnant mothers at risk of poor child health and developmental outcomes. Home visitors deliver a multifaceted intervention that includes educating high-risk mothers on benefits of breastfeeding, encouraging them to breastfeed and supporting their efforts during prenatal and postnatal periods. Home visitor-reported content and frequency of home visits, participant-reported breastfeeding initiation and duration, and covariates (Kempe Family Stress Index, race and ethnicity, region, nativity, marital status, age, and education). Logistic regression. Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum. Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.

Five-city economics of a solar hot-water-system

NASA Technical Reports Server (NTRS)

1981-01-01

Report projects energy savings and system costs for five sites using analysis of actual solar energy installation performance in Togus, Maine. Maine system supplies 75 percent of hot water needed for single-family residence; economic payback period is 19 years. Benefits for all sites depend on maintenance or decrease of initial investment required and continuing increase in cost of conventional energy. Report includes analysis weighing potential changes in variables used to evaluate system profitability.

How Can the United States Army and the Interagency Community Better Define and Develop Rule of Law Doctrine and Initiatives to Include Projects Which Will Impact the Human Rights of Women in Afghanistan and Iraq?

DTIC Science & Technology

2009-06-12

prosecuting and punishing criminal acts. 76 In the area of family law, some Muslim countries now prohibit polygamy and divorce by the husband’s...relations.” 198 Therefore, practices of polygamy would be inconsistent with the CEDAW because it undermines women‟s equality with men and potentially

Data documentation for the bare soil experiment at the University of Arkansas

NASA Technical Reports Server (NTRS)

Waite, W. P.; Scott, H. D. (Principal Investigator); Hancock, G. D.

1980-01-01

The reflectivities of several controlled moisture test plots were investigated. These test plots were of a similar soil texture which was clay loam and were prepared to give a desired initial soil moisture and density profile. Measurements were conducted on the plots as the soil water redistributed for both long term and diurnal cycles. These measurements included reflectivity, gravimetric and volumetric soil moisture, soil moisture potential, and soil temperature.

Marine Corps Close Air Support Development from Guadalcanal to Okinawa

DTIC Science & Technology

2011-03-05

air support (CAS) of troops in contact with the enemy came of age . While the capability clearly had potential, issues of coordination, accurate...including the first use of an Air Support Control Unit ( ASCU ), predecessor of the Fire S.upport Coordination Center.71 The Command Ship initially...which artillery had to cease fire for low- level napalm air strikes. When two or more battalions fired on the same location, the ASCU used maximum

Outcomes of HIV-positive patients with cryptococcal meningitis in the Americas.

PubMed

Crabtree Ramírez, B; Caro Vega, Y; Shepherd, B E; Le, C; Turner, M; Frola, C; Grinsztejn, B; Cortes, C; Padgett, D; Sterling, T R; McGowan, C C; Person, A

2017-10-01

Cryptococcal meningitis (CM) is associated with substantial mortality in HIV-infected patients. Optimal timing of antiretroviral therapy (ART) in persons with CM represents a clinical challenge, and the burden of CM in Latin America has not been well described. Studies suggest that early ART initiation is associated with higher mortality, but data from the Americas are scarce. HIV-infected adults in care between 1985-2014 at participating sites in the Latin America (the Caribbean, Central and South America network (CCASAnet)) and the Vanderbilt Comprehensive Care Clinic (VCCC) and who had CM were included. Survival probabilities were estimated. Risk of death when initiating ART within the first 2 weeks after CM diagnosis versus initiating between 2-8 weeks was assessed using dynamic marginal structural models adjusting for site, age, sex, year of CM, CD4 count, and route of HIV transmission. 340 patients were included (Argentina 58, Brazil 138, Chile 28, Honduras 27, Mexico 34, VCCC 55) and 142 (42%) died during the observation period. Among 151 patients with CM prior to ART 56 (37%) patients died compared to 86 (45%) of 189 with CM after ART initiation (p=0.14). Patients diagnosed with CM after ART had a higher risk of death (p=0.03, log-rank test). The probability of survival was not statistically different between patients who started ART within 2 weeks of CM (7/24, 29%) vs. those initiating between 2-8 weeks (14/53, 26%) (p=0.96), potentially due to lack of power. In this large Latin-American cohort, patients with CM had very high mortality rates, especially those diagnosed after ART initiation. This study reflects the overwhelming burden of CM in HIV-infected patients in Latin America. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

GAP Analysis. Bulletin Number 11

DTIC Science & Technology

2002-01-01

Potential to Support Conservation Initiatives in the Republic of Georgia IRAKLI GORADZE Environmental management and the conservation of biological di- Geo...52 INTERNATIONAL Gap Analysis Program: Potential to Support Conservation Initiatives in the Republic of Georgia Irakli G oradze

The Far Ultraviolet M-dwarf Evolution Survey (FUMES): Overview and Initial Results

NASA Astrophysics Data System (ADS)

Pineda, J. Sebastian; France, Kevin; Youngblood, Allison

2018-01-01

M-dwarf stars are prime targets for exoplanet searches because of their close proximity and favorable properties for both planet detection and characterization, with current searches around these targets having already discovered several Earth-sized planets within their star’s habitable zones. However, the atmospheric characterization and potential habitability of these exoplanetary systems depends critically on the high-energy stellar radiation environment from X-rays to NUV. Strong radiation at these energies can lead to atmospheric mass loss and is a strong driver of photochemistry in planetary atmospheres. Recently, the MUSCLES Treasury Survey provided the first comprehensive assessment of the high-energy radiation field around old, planet hosting M-dwarfs. However, the habitability and potential for such exoplanetary atmospheres to develop life also depends on the evolution of the atmosphere and hence the evolution of the incident radiation field. The strong high-energy spectrum of young M-dwarfs can have devastating consequences for the potential habitability of a given system. We, thus, introduce the Far Ultraviolet M-dwarf Evolution Survey (FUMES), a new HST-STIS observing campaign targeting 10 early-mid M dwarfs with known rotation periods, including 6 targets with known ages, to assess the evolution of the FUV radiation, including Lyα, of M-dwarf stars with stellar rotation period. We present the initial results of our survey characterizing the FUV emission features of our targets and the implications of our measurements for the evolution of the entire high-energy radiation environment around M-dwarfs from youth to old age.

Petrology and reservoir quality of the Gaikema Sandstone: Initial impressions

USGS Publications Warehouse

Helmold, Kenneth P.; Stanley, Richard G.

2015-01-01

The Division of Geological & Geophysical Surveys (DGGS) and Division of Oil & Gas (DOG) are currently conducting a study of the hydrocarbon potential of Cook Inlet basin (LePain and others, 2011). The Tertiary stratigraphic section of the basin includes coal-bearing units that are prolific gas reservoirs, particularly the Neogene sandstones. The Paleogene sandstones are locally prolific oil reservoirs that are sourced largely from the underlying Middle Jurassic Tuxedni Group. Several large structures act as hydrocarbon traps and the possibility exists for stratigraphic traps although this potential has not been fully exploited. As part of this study a significant number of Tertiary sandstones from the basin have been already collected and analyzed (Helmold and others, 2013). Recent field programs have shifted attention to the Mesozoic stratigraphic section to ascertain whether it contains potential hydrocarbon reservoirs. During the 2013 Cook Inlet field season, two days were spent on the Iniskin Peninsula examining outcrops of the Middle Jurassic Gaikema Sandstone along the south shore of Chinitna Bay (fig. 7-1). A stratigraphic section approximately 34 m in thickness was measured and a detailed description was initiated (Stanley and others, 2015), but due to deteriorating weather it was not possible to complete the description. During the 2014 field season two additional days were spent completing work on the Gaikema section. Analyses of thin sections from six of the samples collected in 2013 are available for incorporation in this report (table 7-1). Data from samples collected during the 2014 field season will be included in future reports.

A tungsten-rhenium interatomic potential for point defect studies

DOE PAGES

Setyawan, Wahyu; Gao, Ning; Kurtz, Richard J.

2018-05-28

A tungsten-rhenium (W-Re) classical interatomic potential is developed within the embedded atom method (EAM) interaction framework. A force-matching method is employed to fit the potential to ab initio forces, energies, and stresses. Simulated annealing is combined with the conjugate gradient technique to search for an optimum potential from over 1000 initial trial sets. The potential is designed for studying point defects in W-Re systems. It gives good predictions of the formation energies of Re defects in W and the binding energies of W self-interstitial clusters with Re. The potential is further evaluated for describing the formation energy of structures inmore » the σ and χ intermetallic phases. The predicted convex-hulls of formation energy are in excellent agreement with ab initio data. In pure Re, the potential can reproduce the formation energies of vacancy and self-interstitial defects sufficiently accurately, and gives the correct ground state self-interstitial configuration. Furthermore, by including liquid structures in the fit, the potential yields a Re melting temperature (3130 K) that is close to the experimental value (3459 K).« less

A tungsten-rhenium interatomic potential for point defect studies

NASA Astrophysics Data System (ADS)

Setyawan, Wahyu; Gao, Ning; Kurtz, Richard J.

2018-05-01

A tungsten-rhenium (W-Re) classical interatomic potential is developed within the embedded atom method interaction framework. A force-matching method is employed to fit the potential to ab initio forces, energies, and stresses. Simulated annealing is combined with the conjugate gradient technique to search for an optimum potential from over 1000 initial trial sets. The potential is designed for studying point defects in W-Re systems. It gives good predictions of the formation energies of Re defects in W and the binding energies of W self-interstitial clusters with Re. The potential is further evaluated for describing the formation energy of structures in the σ and χ intermetallic phases. The predicted convex-hulls of formation energy are in excellent agreement with ab initio data. In pure Re, the potential can reproduce the formation energies of vacancies and self-interstitial defects sufficiently accurately and gives the correct ground state self-interstitial configuration. Furthermore, by including liquid structures in the fit, the potential yields a Re melting temperature (3130 K) that is close to the experimental value (3459 K).

A tungsten-rhenium interatomic potential for point defect studies

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

Setyawan, Wahyu; Gao, Ning; Kurtz, Richard J.

A tungsten-rhenium (W-Re) classical interatomic potential is developed within the embedded atom method (EAM) interaction framework. A force-matching method is employed to fit the potential to ab initio forces, energies, and stresses. Simulated annealing is combined with the conjugate gradient technique to search for an optimum potential from over 1000 initial trial sets. The potential is designed for studying point defects in W-Re systems. It gives good predictions of the formation energies of Re defects in W and the binding energies of W self-interstitial clusters with Re. The potential is further evaluated for describing the formation energy of structures inmore » the σ and χ intermetallic phases. The predicted convex-hulls of formation energy are in excellent agreement with ab initio data. In pure Re, the potential can reproduce the formation energies of vacancy and self-interstitial defects sufficiently accurately, and gives the correct ground state self-interstitial configuration. Furthermore, by including liquid structures in the fit, the potential yields a Re melting temperature (3130 K) that is close to the experimental value (3459 K).« less

State-of-the-art molecular imaging in esophageal cancer management: implications for diagnosis, prognosis, and treatment

PubMed Central

Lin, Jolinta; Kligerman, Seth; Goel, Rakhi; Sajedi, Payam; Suntharalingam, Mohan

2015-01-01

Molecular imaging techniques are increasingly being used in addition to standard imaging methods such as endoscopic ultrasound (EUS) and computed tomography (CT) for many cancers including those of the esophagus. In this review, we will discuss the utility of the most widely used molecular imaging technique, 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET). 18F-FDG PET has a variety of potential applications ranging from improving staging accuracy at the time of initial diagnosis to assisting in radiation target volume delineation. Furthermore, 18F-FDG PET can be used to evaluate treatment response after completion of neoadjuvant therapy or potentially during neoadjuvant therapy. Finally, we will also discuss other novel molecular imaging techniques that have potential to further improve cancer care. PMID:25642333

Automated quantitative micro-mineralogical characterization for environmental applications

USGS Publications Warehouse

Smith, Kathleen S.; Hoal, K.O.; Walton-Day, Katherine; Stammer, J.G.; Pietersen, K.

2013-01-01

Characterization of ore and waste-rock material using automated quantitative micro-mineralogical techniques (e.g., QEMSCAN® and MLA) has the potential to complement traditional acid-base accounting and humidity cell techniques when predicting acid generation and metal release. These characterization techniques, which most commonly are used for metallurgical, mineral-processing, and geometallurgical applications, can be broadly applied throughout the mine-life cycle to include numerous environmental applications. Critical insights into mineral liberation, mineral associations, particle size, particle texture, and mineralogical residence phase(s) of environmentally important elements can be used to anticipate potential environmental challenges. Resources spent on initial characterization result in lower uncertainties of potential environmental impacts and possible cost savings associated with remediation and closure. Examples illustrate mineralogical and textural characterization of fluvial tailings material from the upper Arkansas River in Colorado.

Initiation devices, initiation systems including initiation devices and related methods

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

Daniels, Michael A.; Condit, Reston A.; Rasmussen, Nikki

Initiation devices may include at least one substrate, an initiation element positioned on a first side of the at least one substrate, and a spark gap electrically coupled to the initiation element and positioned on a second side of the at least one substrate. Initiation devices may include a plurality of substrates where at least one substrate of the plurality of substrates is electrically connected to at least one adjacent substrate of the plurality of substrates with at least one via extending through the at least one substrate. Initiation systems may include such initiation devices. Methods of igniting energetic materialsmore » include passing a current through a spark gap formed on at least one substrate of the initiation device, passing the current through at least one via formed through the at least one substrate, and passing the current through an explosive bridge wire of the initiation device.« less

Retrieval enhances eyewitness suggestibility to misinformation in free and cued recall.

PubMed

Wilford, Miko M; Chan, Jason C K; Tuhn, Sam J

2014-03-01

Immediately recalling a witnessed event can increase people's susceptibility to later postevent misinformation. But this retrieval-enhanced suggestibility (RES) effect has been shown only when the initial recall test included specific questions that reappeared on the final test. Moreover, it is unclear whether this phenomenon is affected by the centrality of event details. These limitations make it difficult to generalize RES to criminal investigations, which often begin with free recall prior to more specific queries from legal officials and attorneys. In 3 experiments, we examined the influence of test formats (free recall vs. cued recall) and centrality of event details (central vs. peripheral) on RES. In Experiment 1, both the initial and final tests were cued recall. In Experiment 2, the initial test was free recall and the final test was cued recall. In Experiment 3, both the initial and final tests were free recall. Initial testing increased misinformation reporting on the final test for peripheral details in all experiments, but the effect was significant for central details only after aggregating the data from all 3 experiments. These results show that initial free recall can produce RES, and more broadly, that free recall can potentiate subsequent learning of complex prose materials. © 2013 American Psychological Association

Respiratory insufficiency with preserved diaphragmatic function in amyotrophic lateral sclerosis.

PubMed

Yamauchi, Rika; Imai, Tomihiro; Tsuda, Emiko; Hozuki, Takayoshi; Yamamoto, Daisuke; Shimohama, Shun

2014-01-01

We performed a longitudinal study to elucidate the correlation between respiratory insufficiency and respiratory biomarkers, including diaphragmatic compound muscle action potential (DCMAP), at the initiation of noninvasive ventilation (NIV) in patients with amyotrophic lateral sclerosis (ALS). The patients were assessed at least every six months. Additional assessments were performed at the start of respiratory therapy when the patients met the criteria for the initiation of NIV. Each assessment consisted of a full neurological examination, a phrenic nerve conduction study, respiratory function tests, and nocturnal pulsed oximetry. We enrolled 43 patients with either definite or probable ALS as defined by the revised El Escorial criteria. The patients were divided into two groups according to the timing of the initiation of respiratory therapy. Seventeen patients (group A) met the criteria for NIV initiation when their DCMAP remained normal. Twenty-six patients (group B) met the criteria when their DCMAP decreased below normal limits. Although respiratory function parameters were significantly worse in group B compared with group A at NIV initiation, more than 80% of the patients in both groups developed nocturnal desaturation during sleep. DCMAP is not always a reliable indicator for determining the optimal timing for NIV initiation during the progression of respiratory insufficiency in ALS. Physicians should be aware of the risk of respiratory insufficiency during sleep in patients with ALS.

Reducing socioeconomic inequalities in COPD care in the hospital outpatient setting - A nationwide initiative.

PubMed

Tøttenborg, Sandra S; Lange, Peter; Thomsen, Reimar W; Nielsen, Henrik; Johnsen, Søren P

2017-04-01

Socioeconomic differences in quality of care have been suggested to contribute to inequality in clinical prognosis of COPD. We examined socioeconomic differences in the quality of COPD outpatient care and the potential of a systematic quality improvement initiative in reducing potential socioeconomic differences. A mandatory national quality improvement initiative has since 2008 monitored the quality of COPD care at all national pulmonary specialized outpatient clinics in Denmark using six evidence-based process performance measures. We followed patients aged ≥30 years with a first-ever outpatient contact for COPD during 2008-2012 (N = 23,741). Adjusted year-specific relative risks (RR) of fulfilling all relevant process performance measures was compared according to ethnicity, education, income, employment, and cohabitation using Poisson regression. Quality of care improved following the implementation of the clinical improvement initiative with 11% of COPD patients receiving optimal care in 2008 compared to 57% in 2012. Substantial socioeconomic differences were observed the first year: immigrants (RR 0.41, 95% CI 0.21-0.82), the unemployed (RR 0.37, 95% CI 0.18-0.74), disability pensioners (RR 0.63, 95% CI 0.46-0.87) and patients living alone (RR 0.80, 95% CI 0.60-0.97) were less likely to receive all relevant care processes, whereas those with highest education (RR 1.22, 95% CI 0.92-1.63) were more likely to receive these processes. These differences were eliminated during the study period. A systematic quality improvement initiative including regular audits, knowledge sharing, and detailed disease-specific recommendations for care improvement may increase the overall quality of care and considerably modify the substantial socioeconomic inequalities in COPD management. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of DNA repair in herpesvirus pathogenesis.

PubMed

Brown, Jay C

2014-10-01

In cells latently infected with a herpesvirus, the viral DNA is present in the cell nucleus, but it is not extensively replicated or transcribed. In this suppressed state the virus DNA is vulnerable to mutagenic events that affect the host cell and have the potential to destroy the virus' genetic integrity. Despite the potential for genetic damage, however, herpesvirus sequences are well conserved after reactivation from latency. To account for this apparent paradox, I have tested the idea that host cell-encoded mechanisms of DNA repair are able to control genetic damage to latent herpesviruses. Studies were focused on homologous recombination-dependent DNA repair (HR). Methods of DNA sequence analysis were employed to scan herpesvirus genomes for DNA features able to activate HR. Analyses were carried out with a total of 39 herpesvirus DNA sequences, a group that included viruses from the alpha-, beta- and gamma-subfamilies. The results showed that all 39 genome sequences were enriched in two or more of the eight recombination-initiating features examined. The results were interpreted to indicate that HR can stabilize latent herpesvirus genomes. The results also showed, unexpectedly, that repair-initiating DNA features differed in alpha- compared to gamma-herpesviruses. Whereas inverted and tandem repeats predominated in alpha-herpesviruses, gamma-herpesviruses were enriched in short, GC-rich initiation sequences such as CCCAG and depleted in repeats. In alpha-herpesviruses, repair-initiating repeat sequences were found to be concentrated in a specific region (the S segment) of the genome while repair-initiating short sequences were distributed more uniformly in gamma-herpesviruses. The results suggest that repair pathways are activated differently in alpha- compared to gamma-herpesviruses. Copyright © 2014. Published by Elsevier Inc.

International Year of Planet Earth Cooperating with Other Years in 2007-2009

NASA Astrophysics Data System (ADS)

de Mulder, E. F.

2006-05-01

After its inception in 2001, the International Year of Planet Earth was proclaimed for 2008 by the UN General Assembly in December 2005. The UN Year will be in the core of a triennium, starting in January 2007 and closing by the end of 2009. Through UN proclamation, it has gained the political support by 191 UN nations. The International Year of Planet Earth was initiated by the International Union of Geological Sciences (IUGS) finding UNESCO's Earth Sciences Division ready as co-initiator. It enjoys the backing of all relevant IUGS's sister unions in ICSU, including IUGG, IGU, IUSS, ISPRS and INQUA among its 12 Founding Partners and AGI, AAPG and AIPG as major USA based international geoscientific organizations. Moreover, the initiative is supported by 26 more geoscientific and other relevant bodies. The aim of the Year, encapsulated in its subtitle Earth sciences for Society, is to build awareness of the relationship between humankind and Planet Earth, and to demonstrate that geoscientists are key players in creating a balanced, sustainable future for both. In this respect it aims to convince politicians to apply the wealth of geodata and information in day-to-day policy making. The International Year includes a Science and an Outreach Programme, both of equal financial size. The ten Science Themes (Groundwater, Hazards, Health, Climate, Resources, Deep Earth, Ocean, Megacities, Soils, and Life) in the Science Programme were selected for their societal impact, their potential for outreach, as well as their multidisciplinary nature and high scientific potential. Brochures with key questions and invitations for scientists to submit project proposals have been printed for each Theme and can be downloaded from www.yearofplanetearth.org. The same bottom-up mode is applied for the Outreach Programme which will operate as a funding body, receiving bids for financial support - for anything from web-based educational resources to commissioning works of art that will help reinforce to the general public the central message of the Year. There are good potential interfaces and links between this initiative and the other science years (eGY, IPY and IHY) running in the same time interval, both in terms of cooperation in outreach and in science programmes. Some of these will be highlighted during the presentation.

Strategic Defense Initiative Organization adaptive structures program overview

NASA Astrophysics Data System (ADS)

Obal, Michael; Sater, Janet M.

In the currently envisioned architecture none of the Strategic Defense System (SDS) elements to be deployed will receive scheduled maintenance. Assessments of performance capability due to changes caused by the uncertain effects of environments will be difficult, at best. In addition, the system will have limited ability to adjust in order to maintain its required performance levels. The Materials and Structures Office of the Strategic Defense Initiative Organization (SDIO) has begun to address solutions to these potential difficulties via an adaptive structures technology program that combines health and environment monitoring with static and dynamic structural control. Conceivable system benefits include improved target tracking and hit-to-kill performance, on-orbit system health monitoring and reporting, and threat attack warning and assessment.

Characterization of potential driver mutations involved in human breast cancer by computational approaches

PubMed Central

Rajendran, Barani Kumar; Deng, Chu-Xia

2017-01-01

Breast cancer is the second most frequently occurring form of cancer and is also the second most lethal cancer in women worldwide. A genetic mutation is one of the key factors that alter multiple cellular regulatory pathways and drive breast cancer initiation and progression yet nature of these cancer drivers remains elusive. In this article, we have reviewed various computational perspectives and algorithms for exploring breast cancer driver mutation genes. Using both frequency based and mutational exclusivity based approaches, we identified 195 driver genes and shortlisted 63 of them as candidate drivers for breast cancer using various computational approaches. Finally, we conducted network and pathway analysis to explore their functions in breast tumorigenesis including tumor initiation, progression, and metastasis. PMID:28477017

The potential impact of accountable care organizations with respect to cost and quality with special attention to imaging.

PubMed

Mukherji, Suresh K

2014-04-01

An accountable care organization is a form of a managed care organization in which a group of networked health care providers, which may include hospitals, group practices, networks of practices, hospital-provider partnerships, or joint ventures, are accountable for the health care of a defined group of patients. Initial results of the institutions participating in CMS's Physician Group Demonstration Project did not demonstrate a substantial reduction in imaging that could be directly attributed to the accountable care organization model. However, the initial results suggest that incentive-based methodology appears to be successful for increasing compliance for measuring quality metrics. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Advances in the role of oxytocin receptors in human parturition.

PubMed

Kim, Sung Hye; Bennett, Phillip R; Terzidou, Vasso

2017-07-05

Oxytocin (OT) is a neurohypophysial hormone which has been found to play a central role in the regulation of human parturition. The most established role of oxytocin/oxytocin receptor (OT/OTR) system in human parturition is the initiation of uterine contractions, however, recent evidence have demonstrated that it may have a more complex role including initiation of inflammation, regulation of miRNA expression, as well as mediation of other non-classical oxytocin actions via receptor crosstalk with other G protein-coupled receptors (GPCRs). In this review we highlight both established and newly emerging roles of OT/OTR system in human parturition and discuss the expanding potential for OTRs as pharmacological targets in the management of preterm labour. Copyright © 2017. Published by Elsevier B.V.

The Potential Benefit of Radiotherapy with Protons in Head and Neck Cancer with Respect to Normal Tissue Sparing: A Systematic Review of Literature

PubMed Central

Bijl, Hendrik P.; Schilstra, Cornelis; Pijls-Johannesma, Madelon; Langendijk, Johannes A.

2011-01-01

Purpose. Clinical studies concerning head and neck cancer patients treated with protons reporting on radiation-induced side effects are scarce. Therefore, we reviewed the literature regarding the potential benefits of protons compared with the currently used photons in terms of lower doses to normal tissue and the potential for fewer subsequent radiation-induced side effects, with the main focus on in silico planning comparative (ISPC) studies. Materials and Methods. A literature search was performed by two independent researchers on ISPC studies that included proton-based and photon-based irradiation techniques. Results. Initially, 877 papers were retrieved and 14 relevant and eligible ISPC studies were identified and included in this review. Four studies included paranasal sinus cancer cases, three included nasopharyngeal cancer cases, and seven included oropharyngeal, hypopharyngeal, and/or laryngeal cancer cases. Seven studies compared the most sophisticated photon and proton techniques: intensity-modulated photon therapy versus intensity-modulated proton therapy (IMPT). Four studies compared different proton techniques. All studies showed that protons had a lower normal tissue dose, while keeping similar or better target coverage. Two studies found that these lower doses theoretically translated into a significantly lower incidence of salivary dysfunction. Conclusion. The results of ISPC studies indicate that protons have the potential for a significantly lower normal tissue dose, while keeping similar or better target coverage. Scanned IMPT probably offers the most advantage and will allow for a substantially lower probability of radiation-induced side effects. The results of these ISPC studies should be confirmed in properly designed clinical trials. PMID:21349950

Resistance to Cell Death and Its Modulation in Cancer Stem Cells

PubMed Central

Safa, Ahmad R.

2017-01-01

Accumulating evidence has demonstrated that human cancers arise from various tissues of origin that initiate from cancer stem cells (CSCs) or cancer-initiating cells. The extrinsic and intrinsic apoptotic pathways are dysregulated in CSCs, and these cells play crucial roles in tumor initiation, progression, cell death resistance, chemo- and radiotherapy resistance, and tumor recurrence. Understanding CSC-specific signaling proteins and pathways is necessary to identify specific therapeutic targets that may lead to the development of more efficient therapies selectively targeting CSCs. Several signaling pathways—including the phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR), maternal embryonic leucine zipper kinase (MELK), NOTCH1, and Wnt/β-catenin—and expression of the CSC markers CD133, CD24, CD44, Oct4, Sox2, Nanog, and ALDH1A1 maintain CSC properties. Studying such pathways may help to understand CSC biology and lead to the development of potential therapeutic interventions to render CSCs more sensitive to cell death triggered by chemotherapy and radiation therapy. Moreover, recent demonstrations of dedifferentiation of differentiated cancer cells into CSC-like cells have created significant complexity in the CSCs hypothesis. Therefore, any successful therapeutic agent or combination of drugs for cancer therapy must eliminate not only CSCs but differentiated cancer cells and the entire bulk of tumor cells. This review article expands on the CSC hypothesis and paradigm with respect to major signaling pathways and effectors that regulate CSC apoptosis resistance. Moreover, selective CSC apoptotic modulators and their therapeutic potential for making tumors more responsive to therapy are discussed. The use of novel therapies, including small-molecule inhibitors of specific proteins in signaling pathways that regulate stemness, proliferation and migration of CSCs, immunotherapy, and noncoding microRNAs may provide better means of treating CSCs. PMID:27915972

Elevated systemic glutamic acid level in the non-obese diabetic mouse is Idd linked and induces beta cell apoptosis.

PubMed

Banday, Viqar Showkat; Lejon, Kristina

2017-02-01

Although type 1 diabetes (T1D) is a T-cell-mediated disease in the effector stage, the mechanism behind the initial beta cell assault is less understood. Metabolomic differences, including elevated levels of glutamic acid, have been observed in patients with T1D before disease onset, as well as in pre-diabetic non-obese diabetic (NOD) mice. Increased levels of glutamic acid damage both neurons and beta cells, implying that this could contribute to the initial events of T1D pathogenesis. We investigated the underlying genetic factors and consequences of the increased levels of glutamic acid in NOD mice. Serum glutamic acid levels from a (NOD×B6)F 2 cohort (n = 182) were measured. By genome-wide and Idd region targeted microsatellite mapping, genetic association was detected for six regions including Idd2, Idd4 and Idd22. In silico analysis of potential enzymes and transporters located in and around the mapped regions that are involved in glutamic acid metabolism consisted of alanine aminotransferase, glutamic-oxaloacetic transaminase, aldehyde dehydrogenase 18 family, alutamyl-prolyl-tRNA synthetase, glutamic acid transporters GLAST and EAAC1. Increased EAAC1 protein expression was observed in lysates from livers of NOD mice compared with B6 mice. Functional consequence of the elevated glutamic acid level in NOD mice was tested by culturing NOD. Rag2 -/- Langerhans' islets with glutamic acid. Induction of apoptosis of the islets was detected upon glutamic acid challenge using TUNEL assay. Our results support the notion that a dysregulated metabolome could contribute to the initiation of T1D. We suggest that targeting of the increased glutamic acid in pre-diabetic patients could be used as a potential therapy. © 2016 John Wiley & Sons Ltd.

The Relevance of Geriatric Impairments in Patients Starting Dialysis: A Systematic Review.

PubMed

van Loon, Ismay N; Wouters, Tom R; Boereboom, Franciscus T J; Bots, Michiel L; Verhaar, Marianne C; Hamaker, Marije E

2016-07-07

With aging of the general population, patients who enter dialysis therapy will more frequently have geriatric impairments and a considerable comorbidity burden. The most vulnerable among these patients might benefit from conservative therapy. Whether assessment of geriatric impairments would contribute to the decision-making process of dialysis initiation is unknown. A systematic Medline and Embase search was performed on December 1, 2015 to identify studies assessing the association between risk of mortality or hospitalization and one or more geriatric impairments at the start of dialysis therapy, including impairment of cognitive function, mood, performance status or (instrumental) activities of daily living, mobility (including falls), social environment, or nutritional status. Twenty-seven studies were identified that assessed one or more geriatric impairments with respect to prognosis. The quality of most studies was moderate. Only seven studies carried out an analysis of elderly patients (≥70 years old). Malnutrition and frailty were systematically assessed, and their relation with mortality was clear. In addition, cognitive impairment and functional outcomes at the initiation of dialysis were related to an increased mortality in most studies. However, not all studies applied systematic assessment tools, thereby potentially missing relevant impairment. None of the studies applied a geriatric assessment across multiple domains. Geriatric impairment across multiple domains at dialysis initiation is related to poor outcome. However, information in the elderly is sparse, and a systematic approach of multiple domains with respect to poor outcome has not been performed. Because a geriatric assessment has proved useful in predicting outcome in other medical fields, its potential role in the ESRD population should be the subject of future research. Copyright © 2016 by the American Society of Nephrology.

The Relevance of Geriatric Impairments in Patients Starting Dialysis: A Systematic Review

PubMed Central

Wouters, Tom R.; Boereboom, Franciscus T.J.; Bots, Michiel L.; Verhaar, Marianne C.; Hamaker, Marije E.

2016-01-01

Background and objectives With aging of the general population, patients who enter dialysis therapy will more frequently have geriatric impairments and a considerable comorbidity burden. The most vulnerable among these patients might benefit from conservative therapy. Whether assessment of geriatric impairments would contribute to the decision-making process of dialysis initiation is unknown. Design, setting, participants, & measurements A systematic Medline and Embase search was performed on December 1, 2015 to identify studies assessing the association between risk of mortality or hospitalization and one or more geriatric impairments at the start of dialysis therapy, including impairment of cognitive function, mood, performance status or (instrumental) activities of daily living, mobility (including falls), social environment, or nutritional status. Results Twenty-seven studies were identified that assessed one or more geriatric impairments with respect to prognosis. The quality of most studies was moderate. Only seven studies carried out an analysis of elderly patients (≥70 years old). Malnutrition and frailty were systematically assessed, and their relation with mortality was clear. In addition, cognitive impairment and functional outcomes at the initiation of dialysis were related to an increased mortality in most studies. However, not all studies applied systematic assessment tools, thereby potentially missing relevant impairment. None of the studies applied a geriatric assessment across multiple domains. Conclusions Geriatric impairment across multiple domains at dialysis initiation is related to poor outcome. However, information in the elderly is sparse, and a systematic approach of multiple domains with respect to poor outcome has not been performed. Because a geriatric assessment has proved useful in predicting outcome in other medical fields, its potential role in the ESRD population should be the subject of future research. PMID:27117581

Which Patients in the Emergency Department Should Receive Preexposure Prophylaxis? Implementation of a Predictive Analytics Approach.

PubMed

Ridgway, Jessica P; Almirol, Ellen A; Bender, Alvie; Richardson, Andrew; Schmitt, Jessica; Friedman, Eleanor; Lancki, Nicola; Leroux, Ivan; Pieroni, Nina; Dehlin, Jessica; Schneider, John A

2018-05-01

Emergency Departments (EDs) have the potential to play a crucial role in HIV prevention by identifying and linking high-risk HIV-negative clients to preexposure prophylaxis (PrEP) care, but it is difficult to perform HIV risk assessment for all ED patients. We aimed to develop and implement an electronic risk score to identify ED patients who are potential candidates for PrEP. Using electronic medical record (EMR) data, we used logistic regression to model the outcome of PrEP eligibility. We converted the model into an electronic risk score and incorporated it into the EMR. The risk score is automatically calculated at triage. For patients whose risk score is above a given threshold, an automated electronic alert is sent to an HIV prevention counselor who performs real time HIV prevention counseling, risk assessment, and PrEP linkage as appropriate. The electronic risk score includes the following EMR variables: age, gender, gender of sexual partner, chief complaint, and positive test for sexually transmitted infection in the prior 6 months. A risk score ≥21 has specificity of 80.6% and sensitivity of 50%. In the first 5.5 months of implementation, the alert fired for 180 patients, 34.4% (62/180) of whom were women. Of the 51 patients who completed risk assessment, 68.6% (35/51) were interested in PrEP, 17.6% (9/51) scheduled a PrEP appointment, and 7.8% (4/51) successfully initiated PrEP. The measured number of successful PrEP initiations is likely an underestimate, as it does include patients who initiated PrEP with outside providers or referred acquaintances for PrEP care.

Opportunities for the Cardiovascular Community in the Precision Medicine Initiative.

PubMed

Shah, Svati H; Arnett, Donna; Houser, Steven R; Ginsburg, Geoffrey S; MacRae, Calum; Mital, Seema; Loscalzo, Joseph; Hall, Jennifer L

2016-01-12

The Precision Medicine Initiative recently announced by President Barack Obama seeks to move the field of precision medicine more rapidly into clinical care. Precision medicine revolves around the concept of integrating individual-level data including genomics, biomarkers, lifestyle and other environmental factors, wearable device physiological data, and information from electronic health records to ultimately provide better clinical care to individual patients. The Precision Medicine Initiative as currently structured will primarily fund efforts in cancer genomics with longer-term goals of advancing precision medicine to all areas of health, and will be supported through creation of a 1 million person cohort study across the United States. This focused effort on precision medicine provides scientists, clinicians, and patients within the cardiovascular community an opportunity to work together boldly to advance clinical care; the community needs to be aware and engaged in the process as it progresses. This article provides a framework for potential involvement of the cardiovascular community in the Precision Medicine Initiative, while highlighting significant challenges for its successful implementation. © 2016 American Heart Association, Inc.

Strategies for Selecting Routes through Real-World Environments: Relative Topography, Initial Route Straightness, and Cardinal Direction

PubMed Central

Brunyé, Tad T.; Collier, Zachary A.; Cantelon, Julie; Holmes, Amanda; Wood, Matthew D.; Linkov, Igor; Taylor, Holly A.

2015-01-01

Previous research has demonstrated that route planners use several reliable strategies for selecting between alternate routes. Strategies include selecting straight rather than winding routes leaving an origin, selecting generally south- rather than north-going routes, and selecting routes that avoid traversal of complex topography. The contribution of this paper is characterizing the relative influence and potential interactions of these strategies. We also examine whether individual differences would predict any strategy reliance. Results showed evidence for independent and additive influences of all three strategies, with a strong influence of topography and initial segment straightness, and relatively weak influence of cardinal direction. Additively, routes were also disproportionately selected when they traversed relatively flat regions, had relatively straight initial segments, and went generally south rather than north. Two individual differences, extraversion and sense of direction, predicted the extent of some effects. Under real-world conditions navigators indeed consider a route’s initial straightness, cardinal direction, and topography, but these cues differ in relative influence and vary in their application across individuals. PMID:25992685

MEDICAL BRIGADES, GLOBAL HEALTH AND THE UNITED NATIONS: MILLENNIUM DEVELOPMENT GOALS AND DEVELOPING NATIONS.

PubMed

Portman, Mark T; Martin, Edward J

2015-01-01

Recently, recommendations have been made that global health initiatives change their focus from disease specific intervention to bolstering health systems and general health care. The aim of this is to ultimately increase access to primary care, clean water, education, hygiene, and prevent malnutrition, among other goals. While many major global health initiatives have followed this trend, so have many smaller scale programs including short-term medical brigades. Despite a trending increase in the number of privately run short-term medical brigades, until recently, little research has been done on the potential positive and negative effects that can arise from such programs. Now, guidelines have been initiated to create well-structured programs. When followed, these smaller scale initiatives can be successful in helping increase access to healthcare, sustainably strengthening communities in terms of general health. While recent legislation in the United States has addressed domestic policy in the Patient Protection Affordable Care Act of 2010 (ACA), the ACA should also consider some of the basic "sustainable" policies being implemented by international health care providers.

Prolactin receptor in regulation of neuronal excitability and channels

PubMed Central

Patil, Mayur J; Henry, Michael A; Akopian, Armen N

2014-01-01

Prolactin (PRL) activates PRL receptor isoforms to exert regulation of specific neuronal circuitries, and to control numerous physiological and clinically-relevant functions including; maternal behavior, energy balance and food intake, stress and trauma responses, anxiety, neurogenesis, migraine and pain. PRL controls these critical functions by regulating receptor potential thresholds, neuronal excitability and/or neurotransmission efficiency. PRL also influences neuronal functions via activation of certain neurons, resulting in Ca2+ influx and/or electrical firing with subsequent release of neurotransmitters. Although PRL was identified almost a century ago, very little specific information is known about how PRL regulates neuronal functions. Nevertheless, important initial steps have recently been made including the identification of PRL-induced transient signaling pathways in neurons and the modulation of neuronal transient receptor potential (TRP) and Ca2+-dependent K+ channels by PRL. In this review, we summarize current knowledge and recent progress in understanding the regulation of neuronal excitability and channels by PRL. PMID:24758841

Rethinking Nuclear Receptors as Potential Therapeutic Targets for Retinal Diseases.

PubMed

Choudhary, Mayur; Malek, Goldis

2016-12-01

Collectively, retinal diseases, including age-related macular degeneration, retinitis pigmentosa, and diabetic retinopathy, result in severe vision impairment worldwide. The absence and/or limited availability of successful drug therapies for these blinding disorders necessitates further understanding their pathobiology and identifying new targetable signaling pathways. Nuclear receptors are transcription regulators of many key aspects of human physiology, as well as pathophysiology, with reported roles in development, aging, and disease. Some of the pathways regulated by nuclear receptors include, but are not limited to, angiogenesis, inflammation, and lipid metabolic dysregulation, mechanisms also important in the initiation and development of several retinal diseases. Herein, we present an overview of the biology of three diseases affecting the posterior eye, summarize a growing body of evidence that suggests direct or indirect involvement of nuclear receptors in disease progression, and discuss the therapeutic potential of targeting nuclear receptors for treatment.

Rethinking Nuclear Receptors as Potential Therapeutic Targets for Retinal Diseases

PubMed Central

Choudhary, Mayur; Malek, Goldis

2017-01-01

Collectively, retinal diseases, including age-related macular degeneration, retinitis pigmentosa, and diabetic retinopathy, result in severe vision impairment worldwide. The absence and/or limited availability of successful drug therapies for these blinding disorders necessitates further understanding their pathobiology and identifying new targetable signaling pathways. Nuclear receptors are transcription regulators of many key aspects of human physiology, as well as pathophysiology, with reported roles in development, aging, and disease. Some of the pathways regulated by nuclear receptors include, but are not limited to, angiogenesis, inflammation, and lipid metabolic dysregulation, mechanisms also important in the initiation and development of several retinal diseases. Herein, we present an overview of the biology of three diseases affecting the posterior eye, summarize a growing body of evidence that suggests direct or indirect involvement of nuclear receptors in disease progression, and discuss the therapeutic potential of targeting nuclear receptors for treatment. PMID:27455994

Transferable Force Field for Metal–Organic Frameworks from First-Principles: BTW-FF

PubMed Central

2014-01-01

We present an ab-initio derived force field to describe the structural and mechanical properties of metal–organic frameworks (or coordination polymers). The aim is a transferable interatomic potential that can be applied to MOFs regardless of metal or ligand identity. The initial parametrization set includes MOF-5, IRMOF-10, IRMOF-14, UiO-66, UiO-67, and HKUST-1. The force field describes the periodic crystal and considers effective atomic charges based on topological analysis of the Bloch states of the extended materials. Transferable potentials were developed for the four organic ligands comprising the test set and for the associated Cu, Zn, and Zr metal nodes. The predicted materials properties, including bulk moduli and vibrational frequencies, are in agreement with explicit density functional theory calculations. The modal heat capacity and lattice thermal expansion are also predicted. PMID:25574157

Potential Use of Salivary Markers for Longitudinal Monitoring of Inflammatory Immune Responses to Vaccination

PubMed Central

Garssen, Johan; Sandalova, Elena

2016-01-01

Vaccination, designed to trigger a protective immune response against infection, is a trigger for mild inflammatory responses. Vaccination studies can address the question of inflammation initiation, levels, and resolution as well as its regulation for respective studied pathogens. Such studies largely based on analyzing the blood components including specific antibodies and cytokines were usually constrained by number of participants and volume of collected blood sample. Hence, blood-based studies may not be able to cover the full dynamic range of inflammation responses induced by vaccination. In this review, the potential of using saliva in addition to blood for studying the kinetics of inflammatory response studies was assessed. Saliva sampling is noninvasive and has a great potential to be used for studies aimed at analysing the magnitude, time course, and variance in immune responses, including inflammation after vaccination. Based on a literature survey of inflammatory biomarkers that can be determined in saliva and an analysis of how these biomarkers could help to understand the mechanisms and dynamics of immune reactivity and inflammation, we propose that the saliva-based approach might have potential to add substantial value to clinical studies, particularly in vulnerable populations such as infants, toddlers, and ill individuals. PMID:27022211

Full recovery from a potentially lethal dose of mercuric chloride.

PubMed

Beasley, D Michael G; Schep, Leo J; Slaughter, Robin J; Temple, Wayne A; Michel, Jonathan M

2014-03-01

Mercuric chloride poisoning is rare yet potentially life-threatening. We report a case of poisoning with a potentially significant amount of mercuric chloride which responded to aggressive management. A 19-year-old female presented to the Emergency Department with nausea, abdominal discomfort, vomiting of blood-stained fluid, and diarrhea following suicidal ingestion of 2-4 g of mercuric chloride powder. An abdominal radiograph showed radio-opaque material within the gastric antrum and the patient's initial blood mercury concentration was 17.9 μmol/L (or 3.58 mg/L) at 3 h post-ingestion. Given the potential toxicity of inorganic mercury, the patient was admitted to the intensive care unit and chelation with dimercaprol was undertaken. Further clinical effects included mild hemodynamic instability, acidosis, hypokalemia, leukocytosis, and fever. The patient's symptoms began to improve 48 h after admission and resolved fully within a week. Mercuric chloride has an estimated human fatal dose of between 1 and 4 g. Despite a reported ingestion of a potentially lethal dose and a high blood concentration, this patient experienced mild to moderate poisoning only and she responded to early and appropriate intervention. Mercuric chloride can produce a range of toxic effects including corrosive injury, severe gastrointestinal disturbances, acute renal failure, circulatory collapse, and eventual death. Treatment includes close observation and aggressive supportive care along with chelation, preferably with 2,3-dimercapto-1-propane sulfonate or 2,3-meso-dimercaptosuccinic acid.

Hematoma Expansion Following Acute Intracerebral Hemorrhage

PubMed Central

Brouwers, H. Bart; Greenberg, Steven M.

2013-01-01

Intracerebral hemorrhage, the most devastating form of stroke, has no specific therapy proven to improve outcome by randomized controlled trial. Location and baseline hematoma volume are strong predictors of mortality, but are non-modifiable by the time of diagnosis. Expansion of the initial hematoma is a further marker of poor prognosis that may be at least partly preventable. Several risk factors for hematoma expansion have been identified, including baseline ICH volume, early presentation after symptom onset, anticoagulation, and the CT angiography spot sign. Although the biological mechanisms of hematoma expansion remain unclear, accumulating evidence supports a model of ongoing secondary bleeding from ruptured adjacent vessels surrounding the initial bleeding site. Several large clinical trials testing therapies aimed at preventing hematoma expansion are in progress, including aggressive blood pressure reduction, treatment with recombinant factor VIIa guided by CT angiography findings, and surgical intervention for superficial hematomas without intraventricular extension. Hematoma expansion is so far the only marker of outcome that is amenable to treatment and thus a potentially important therapeutic target. PMID:23466430

Advanced Space Suit Insulation Feasibility Study

NASA Technical Reports Server (NTRS)

Trevino, Luis A.; Orndoff, Evelyne S.

2000-01-01

For planetary applications, the space suit insulation has unique requirements because it must perform in a dynamic mode to protect humans in the harsh dust, pressure and temperature environments. Since the presence of a gaseous planetary atmosphere adds significant thermal conductance to the suit insulation, the current multi-layer flexible insulation designed for vacuum applications is not suitable in reduced pressure planetary environments such as that of Mars. Therefore a feasibility study has been conducted at NASA to identify the most promising insulation concepts that can be developed to provide an acceptable suit insulation. Insulation concepts surveyed include foams, microspheres, microfibers, and vacuum jackets. The feasibility study includes a literature survey of potential concepts, an evaluation of test results for initial insulation concepts, and a development philosophy to be pursued as a result of the initial testing and conceptual surveys. The recommended focus is on microfibers due to the versatility of fiber structure configurations, the wide choice of fiber materials available, the maturity of the fiber processing industry, and past experience with fibers in insulation applications

Seasonal Drought Prediction: Advances, Challenges, and Future Prospects

NASA Astrophysics Data System (ADS)

Hao, Zengchao; Singh, Vijay P.; Xia, Youlong

2018-03-01

Drought prediction is of critical importance to early warning for drought managements. This review provides a synthesis of drought prediction based on statistical, dynamical, and hybrid methods. Statistical drought prediction is achieved by modeling the relationship between drought indices of interest and a suite of potential predictors, including large-scale climate indices, local climate variables, and land initial conditions. Dynamical meteorological drought prediction relies on seasonal climate forecast from general circulation models (GCMs), which can be employed to drive hydrological models for agricultural and hydrological drought prediction with the predictability determined by both climate forcings and initial conditions. Challenges still exist in drought prediction at long lead time and under a changing environment resulting from natural and anthropogenic factors. Future research prospects to improve drought prediction include, but are not limited to, high-quality data assimilation, improved model development with key processes related to drought occurrence, optimal ensemble forecast to select or weight ensembles, and hybrid drought prediction to merge statistical and dynamical forecasts.

Biomarker-guided antibiotic therapy—strengths and limitations

PubMed Central

Salluh, Jorge; Martin-Loeches, Ignacio; Póvoa, Pedro

2017-01-01

Biomarkers as C-reactive protein (CRP) and procalcitonin (PCT) emerged as tools to help clinicians to diagnose infection and to properly initiate and define the duration of antibiotic therapy. Several randomized controlled trials, including adult critically ill patients, showed that PCT-guided antibiotic stewardship was repeatedly associated with a decrease in the duration of antibiotic therapy with no apparent harm. There are however some relevant limitations in these trials namely the low rate of compliance of PCT-guided algorithms, the high rate of exclusion (without including common clinical situations and pathogens) and the long duration of antibiotic therapy in control groups. Such limitations weakened the real impact of such algorithms in the clinical decision-making process and strengthened the concept that the initiation and the duration of antibiotic therapy cannot depend solely on a biomarker. Future efforts should address these limitations in order to better clarify the role of biomarkers on the complex and multifactorial issue of antibiotic management and to deeply understand its potential effect on mortality. PMID:28603723

Biomarker-guided antibiotic therapy-strengths and limitations.

PubMed

Nora, David; Salluh, Jorge; Martin-Loeches, Ignacio; Póvoa, Pedro

2017-05-01

Biomarkers as C-reactive protein (CRP) and procalcitonin (PCT) emerged as tools to help clinicians to diagnose infection and to properly initiate and define the duration of antibiotic therapy. Several randomized controlled trials, including adult critically ill patients, showed that PCT-guided antibiotic stewardship was repeatedly associated with a decrease in the duration of antibiotic therapy with no apparent harm. There are however some relevant limitations in these trials namely the low rate of compliance of PCT-guided algorithms, the high rate of exclusion (without including common clinical situations and pathogens) and the long duration of antibiotic therapy in control groups. Such limitations weakened the real impact of such algorithms in the clinical decision-making process and strengthened the concept that the initiation and the duration of antibiotic therapy cannot depend solely on a biomarker. Future efforts should address these limitations in order to better clarify the role of biomarkers on the complex and multifactorial issue of antibiotic management and to deeply understand its potential effect on mortality.

Hydrotreater/Distillation Column Hazard Analysis Report Rev. 2

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

Lowry, Peter P.; Wagner, Katie A.

This project Hazard and Risk Analysis Report contains the results of several hazard analyses and risk assessments. An initial assessment was conducted in 2012, which included a multi-step approach ranging from design reviews to a formal What-If hazard analysis. A second What-If hazard analysis was completed during February 2013 to evaluate the operation of the hydrotreater/distillation column processes to be installed in a process enclosure within the Process Development Laboratory West (PDL-West) facility located on the PNNL campus. The qualitative analysis included participation of project and operations personnel and applicable subject matter experts. The analysis identified potential hazardous scenarios, eachmore » based on an initiating event coupled with a postulated upset condition. The unmitigated consequences of each hazardous scenario were generally characterized as a process upset; the exposure of personnel to steam, vapors or hazardous material; a spray or spill of hazardous material; the creation of a flammable atmosphere; or an energetic release from a pressure boundary.« less

Reaching out in new Ways: Bridging the gap Between Science and Media Through the National Oceanic and Atmospheric Administration's Office of Ocean Exploration

NASA Astrophysics Data System (ADS)

Gorell, F. R.; Martinez, C.

2006-12-01

NOAA's Office of Ocean Exploration (OE) was created in response to the recommendations of the President's Panel on Ocean Exploration in 2000. With the establishment of OE, NOAA developed a great opportunity to reach out to teachers, students, and the general public to share the excitement of discovery. As exciting expeditions are the core of our NOAA program, outreach efforts are focused around these cruises. Through various initiatives, OE works with the science community to share the excitement of ocean science and discovery with a wide variety of audiences. Initiatives include media events held during port calls, media conference calls arranged with scientists at sea, journalists' participation in expeditions, and select interviews with scientist-explorers. NOAA OE is now poised to initiate a major ongoing satellite-based education and public outreach program from its new dedicated research vessel, the Okeanos Explorer that will become operational in 2008. Through telepresence technology designed by the Institute for Exploration (IFE) in Mystic, CT, expeditions can be managed `virtually' by scientists working from Science Command Centers on land, live education broadcasts can be produced in real-time, and media events can be held through shore-based consoles connected to scientists at sea. Three pilot programs were successfully completed in the past few years demonstrating the potential for this new technology to allow for unlimited access to data, including video, from expeditions, sharing in real-time the excitement of discovery through multiple virtual pathways. News media provide a powerful means to inform and educate the public. In some cases, scientists may believe that interaction with media representatives poses risks unmatched by rewards. While it is important to serve the public's right to know, scientist-explorers on NOAA-sponsored ocean expeditions have a recognized interest in protecting certain data, including images, for a number of legitimate reasons including the potential for further research to gain greater understanding, and the potential for publishing discoveries in scientific journals. At the same time, NOAA has an interest in informing the public in a timely manner about expedition findings, and seeks to do so via Web site coverage, news releases, embarked media, and news conferences ashore and at sea. These sometimes competing interests require advance planning, understandings and agreements, in a delicate balance of cooperation that serves the interests of all. This is especially true in light of the rapidly developing telepresence technology that allows for immediate transmission of information in real-time.

Building a potential wetland restoration indicator for the contiguous United States

PubMed Central

Horvath, Elena K.; Christensen, Jay R.; Mehaffey, Megan H.; Neale, Anne C.

2018-01-01

Wetlands provide key functions in the landscape from improving water quality, to regulating flows, to providing wildlife habitat. Over half of the wetlands in the contiguous United States (CONUS) have been converted to agricultural and urban land uses. However, over the last several decades, research has shown the benefits of wetlands to hydrologic, chemical, biological processes, spurring the creation of government programs and private initiatives to restore wetlands. Initiatives tend to focus on individual wetland creation, yet the greatest benefits are achieved when strategic restoration planning occurs across a watershed or multiple watersheds. For watershed-level wetland restoration planning to occur, informative data layers on potential wetland areas are needed. We created an indicator of potential wetland areas (PWA), using nationally available datasets to identify characteristics that could support wetland ecosystems, including: poorly drained soils and low-relief landscape positions as indicated by a derived topographic data layer. We compared our PWA with the National Wetlands Inventory (NWI) from 11 states throughout the CONUS to evaluate their alignment. The state-level percentage of NWI-designated wetlands directly overlapping the PWA ranged from 39 to 95%. When we included NWI that was immediately adjacent to the overlapping NWI, our range of correspondence to NWI ranged from 60 to 99%. Wetland restoration is more likely on certain landscapes (e.g., agriculture) than others due to the lack of substantive infrastructure and the potential for the restoration of hydrology; therefore, we combined the National Land Cover Dataset (NLCD) with the PWA to identify potentially restorable wetlands on agricultural land (PRW-Ag). The PRW-Ag identified a total of over 46 million ha with the potential to support wetlands. The largest concentrations of PRW-Ag occurred in the glaciated corn belt of the upper Mississippi River from Ohio to the Dakotas and in the Mississippi Alluvial Valley. The PRW-Ag layer could assist land managers in identifying sites that may qualify for enrollment in conservation programs, where planners can coordinate restoration efforts, or where decision makers can target resources to optimize the services provided across a watershed or multiple watersheds. PMID:29706804

Building a potential wetland restoration indicator for the contiguous United States.

PubMed

Horvath, Elena K; Christensen, Jay R; Mehaffey, Megan H; Neale, Anne C

2017-01-01

Wetlands provide key functions in the landscape from improving water quality, to regulating flows, to providing wildlife habitat. Over half of the wetlands in the contiguous United States (CONUS) have been converted to agricultural and urban land uses. However, over the last several decades, research has shown the benefits of wetlands to hydrologic, chemical, biological processes, spurring the creation of government programs and private initiatives to restore wetlands. Initiatives tend to focus on individual wetland creation, yet the greatest benefits are achieved when strategic restoration planning occurs across a watershed or multiple watersheds. For watershed-level wetland restoration planning to occur, informative data layers on potential wetland areas are needed. We created an indicator of potential wetland areas (PWA), using nationally available datasets to identify characteristics that could support wetland ecosystems, including: poorly drained soils and low-relief landscape positions as indicated by a derived topographic data layer. We compared our PWA with the National Wetlands Inventory (NWI) from 11 states throughout the CONUS to evaluate their alignment. The state-level percentage of NWI-designated wetlands directly overlapping the PWA ranged from 39 to 95%. When we included NWI that was immediately adjacent to the overlapping NWI, our range of correspondence to NWI ranged from 60 to 99%. Wetland restoration is more likely on certain landscapes (e.g., agriculture) than others due to the lack of substantive infrastructure and the potential for the restoration of hydrology; therefore, we combined the National Land Cover Dataset (NLCD) with the PWA to identify potentially restorable wetlands on agricultural land (PRW-Ag). The PRW-Ag identified a total of over 46 million ha with the potential to support wetlands. The largest concentrations of PRW-Ag occurred in the glaciated corn belt of the upper Mississippi River from Ohio to the Dakotas and in the Mississippi Alluvial Valley. The PRW-Ag layer could assist land managers in identifying sites that may qualify for enrollment in conservation programs, where planners can coordinate restoration efforts, or where decision makers can target resources to optimize the services provided across a watershed or multiple watersheds.

Simultaneous measurement of adenosine triphosphate release and aggregation potentiates human platelet aggregation responses for some subjects, including persons with Quebec platelet disorder.

PubMed

Hayward, C P M; Moffat, K A; Castilloux, J-F; Liu, Y; Seecharan, J; Tasneem, S; Carlino, S; Cormier, A; Rivard, G E

2012-04-01

Platelet aggregometry and dense granule adenosine triphosphate (ATP) release assays are helpful to diagnose platelet disorders. Some laboratories simultaneously measure aggregation and ATP release using Chronolume® a commercial reagent containing D-luciferin, firefly luciferase and magnesium. Chronolume® can potentiate sub-maximal aggregation responses, normalising canine platelet disorder findings. We investigated if Chronolume® potentiates human platelet aggregation responses after observing discrepancies suspicious of potentiation. Among patients simultaneously tested by light transmission aggregometry (LTA) on two instruments, 18/43 (42%), including 14/24 (58%) with platelet disorders, showed full secondary aggregation with one or more agonists only in tests with Chronolume®. As subjects with Quebec platelet disorder (QPD) did not show the expected absent secondary aggregation responses to epinephrine in tests with Chronolume®, the reason for the discrepancy was investigated using samples from 10 QPD subjects. Like sub-threshold ADP (0.75 μM), Chronolume® significantly increased QPD LTA responses to epinephrine (p<0.0001) and it increased both initial and secondary aggregation responses, leading to dense granule release. This potentiation was not restricted to QPD and it was mimicked adding 1-2 mM magnesium, but not D-luciferin or firefly luciferase, to LTA assays. Chronolume® potentiated the ADP aggregation responses of QPD subjects with a reduced response. Furthermore, it increased whole blood aggregation responses of healthy control samples to multiple agonists, tested at concentrations used for the diagnosis of platelet disorders (p values <0.05). Laboratories should be aware that measuring ATP release with Chronolume® can potentiate LTA and whole blood aggregation responses, which alters findings for some human platelet disorders, including QPD.

Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

PubMed Central

Kissam, Stephanie; Gifford, David; Parks, Peggy; Patry, Gail; Palmer, Laura; Wilkes, Linda; Fitzgerald, Matthew; Petrulis, Alice Stollenwerk; Barnette, Leslie

2003-01-01

Background In November 2002, the Centers for Medicare & Medicaid Services (CMS) launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs) that led quality improvement efforts in nursing homes from the six pilot states. Results QIOs in the six pilot states found several key outcomes of the Nursing Home Quality Initiative that help to maximize the potential of public reporting to leverage effective improvement in nursing home quality of care. First, public reporting focuses the attention of all stakeholders in the nursing home industry on achieving good quality outcomes on a defined set of measures, and creates an incentive for partnership formation. Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly. Third, the lessons learned by QIOs in the pilot of this Initiative indicate that certain approaches to providing quality improvement assistance are key to guiding nursing home providers' desire and enthusiasm to improve towards a using a systematic approach to quality improvement. Conclusion The Nursing Home Quality Initiative has already demonstrated the potential of public reporting to foster collaboration and coordination among nursing home stakeholders and to heighten interest of nursing homes in quality improvement techniques. The lessons learned from this pilot project have implications for any organizations or individuals planning quality improvement projects in the nursing home setting. PMID:12753699

A Content Analysis of Television Ads: Does Current Practice Maximize Cognitive Processing?

DTIC Science & Technology

2008-12-11

ads with arousing content such as sexual imagery and fatty/sweet food imagery have the potential to stress the cognitive processing system. When the...to examine differences in content arousal , this study included variables shown to elicit arousal —loved brands, sexual images, and fatty/sweet food...loved brands as well as ads with sexual and fatty/food images are not all the same—they are not likely to be equally arousing . Initially, brands were

Passengers, Crew, Life Support, and Insurance Considerations

NASA Technical Reports Server (NTRS)

ONeil, Daniel A.; Young, Lawrence R.

1999-01-01

This section describes the key issues, barriers, opportunities, and potential trip packages related to the needs and expectations of initial space adventure travelers. A variety of ideas to overcome barriers is presented that address financial, psychological, and sociological problems expected to be encountered in establishing a general PST and tourism business. Tour package descriptions range from near-term surface training facilities to far-term lunar ones. Recommendations include requirements pertaining to human factors in design and needed technology.

Who Needs to Fit In? Who Gets to Stand Out? Communication Technologies Including Brain-Machine Interfaces Revealed from the Perspectives of Special Education School Teachers through an Ableism Lens

ERIC Educational Resources Information Center

Diep, Lucy; Wolbring, Gregor

2013-01-01

Some new and envisioned technologies such as brain machine interfaces (BMI) that are being developed initially for people with disabilities, but whose use can also be expanded to the general public have the potential to change body ability expectations of disabled and non-disabled people beyond the species-typical. The ways in which this dynamic…

Endoscopic urethroplasty: an alternative to surgical reconstruction for complete urethral obliteration.

PubMed

Krishnamurthi, V; Spirnak, J P

1995-02-01

Urethral obliteration is an uncommon complication of urethral injury and is usually associated with pelvic fracture. Until recently, surgical reconstruction was the only means available to restore urethral continuity. Although formal urethroplasty may be associated with excellent success rates, impotence and incontinence are potential complications. Endoscopic urethroplasty has recently evolved into a suitable alternative to surgical reconstruction in selected cases. We review here the technique of endoscopic urethroplasty and include our initial results.

The French Version of the Modified-Checklist for Autism in Toddlers (M-CHAT): A Validation Study on a French Sample of 24 Month-Old Children

ERIC Educational Resources Information Center

Baduel, Sophie; Guillon, Quentin; Afzali, Mohammad H.; Foudon, Nadège; Kruck, Jeanne; Rogé, Bernadette

2017-01-01

Early ASD screening has the potential to reduce delays between initial parental concerns and diagnosis, and promote early intervention. The aim of this study was to validate the M-CHAT on a French population sample of 24 month-old children. This study included a low-risk sample of 1,227 children. A total of 20 children screened positive on the…

Weapon System Acquisitions: Opportunities Exist to Improve the Department of Defense’s Portfolio Management

DTIC Science & Technology

2015-08-01

Acknowledgments 55 Tables Table 1: Key Elements to Include in Portfolio Reviews and How They May Help the Portfolio Manager 9 Table 2: Key...and in some cases, potentially duplicative investments. We and others have found that leading commercial companies use portfolio management—a...law have authority to organize, train, and equip their services.5 They make initial decisions regarding what to buy, how to buy it, and how much it

Linking Pesticide Exposure with Pediatric Leukemia: Potential Underlying Mechanisms

PubMed Central

Hernández, Antonio F.; Menéndez, Pablo

2016-01-01

Leukemia is the most common cancer in children, representing 30% of all childhood cancers. The disease arises from recurrent genetic insults that block differentiation of hematopoietic stem and/or progenitor cells (HSPCs) and drives uncontrolled proliferation and survival of the differentiation-blocked clone. Pediatric leukemia is phenotypically and genetically heterogeneous with an obscure etiology. The interaction between genetic factors and environmental agents represents a potential etiological driver. Although information is limited, the principal toxic mechanisms of potential leukemogenic agents (e.g., etoposide, benzene metabolites, bioflavonoids and some pesticides) include topoisomerase II inhibition and/or excessive generation of free radicals, which may induce DNA single- and double-strand breaks (DNA-DSBs) in early HSPCs. Chromosomal rearrangements (duplications, deletions and translocations) may occur if these lesions are not properly repaired. The initiating hit usually occurs in utero and commonly leads to the expression of oncogenic fusion proteins. Subsequent cooperating hits define the disease latency and occur after birth and may be of a genetic, epigenetic or immune nature (i.e., delayed infection-mediated immune deregulation). Here, we review the available experimental and epidemiological evidence linking pesticide exposure to infant and childhood leukemia and provide a mechanistic basis to support the association, focusing on early initiating molecular events. PMID:27043530

Upregulation of mitochondrial NAD+ levels impairs the clonogenicity of SSEA1+ glioblastoma tumor-initiating cells.

PubMed

Son, Myung Jin; Ryu, Jae-Sung; Kim, Jae Yun; Kwon, Youjeong; Chung, Kyung-Sook; Mun, Seon Ju; Cho, Yee Sook

2017-06-09

Emerging evidence has emphasized the importance of cancer therapies targeting an abnormal metabolic state of tumor-initiating cells (TICs) in which they retain stem cell-like phenotypes and nicotinamide adenine dinucleotide (NAD + ) metabolism. However, the functional role of NAD + metabolism in regulating the characteristics of TICs is not known. In this study, we provide evidence that the mitochondrial NAD + levels affect the characteristics of glioma-driven SSEA1 + TICs, including clonogenic growth potential. An increase in the mitochondrial NAD + levels by the overexpression of the mitochondrial enzyme nicotinamide nucleotide transhydrogenase (NNT) significantly suppressed the sphere-forming ability and induced differentiation of TICs, suggesting a loss of the characteristics of TICs. In addition, increased SIRT3 activity and reduced lactate production, which are mainly observed in healthy and young cells, appeared following NNT-overexpressed TICs. Moreover, in vivo tumorigenic potential was substantially abolished by NNT overexpression. Conversely, the short interfering RNA-mediated knockdown of NNT facilitated the maintenance of TIC characteristics, as evidenced by the increased numbers of large tumor spheres and in vivo tumorigenic potential. Our results demonstrated that targeting the maintenance of healthy mitochondria with increased mitochondrial NAD + levels and SIRT3 activity could be a promising strategy for abolishing the development of TICs as a new therapeutic approach to treating aging-associated tumors.

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

PubMed

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

2016-08-01

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

Business Context of Space Tourism

NASA Astrophysics Data System (ADS)

Schmitt, Harrison H.

2003-01-01

Broadly speaking, two types of potential commercial activity in space can be defined. First, there are those activities that represent an expansion and improvement on services with broad existing commercial foundations such as telecommunications. The second type of potential commercial activity in space is one that may offer a type of service with few or any existing commercial foundations such as space-based remote sensing. Space tourism clearly belongs in the first category of potential commercial activity in space. Roles in cooperation with the private sector that might be considered for NASA include 1) acceleration of the ``Professional-in Space'' initiative, 2) research and technology developments related to a) a ``Tourist Destination Module'' for the Space Station, b) an ``Extra Passengers Module'' for the payload bay of the Space Shuttle, and c) a ``Passenger-rated Expendable Launch Vehicle,'' 3) definition of criteria for qualifying candidate space tourists, and 4) initiatives to protect space tourism from unreasonable tort litigation. As baseline information for establishing fees, the cost of a possible tourist flight should be fully and objectively delineated. If it is correct that the marginal cost of each Space Shuttle flight to Earth-orbit is about $100 million and the effective Shuttle payload is about 50,000 pounds, then the marginal cost would be roughly $2,000 per pound.

Providing Geospatial Education and Real World Applications of Data across the Climate Initiative Themes

NASA Astrophysics Data System (ADS)

Weigel, A. M.; Griffin, R.; Bugbee, K.

2015-12-01

Various organizations such as the Group on Earth Observations (GEO) have developed a structure for general thematic areas in Earth science research, however the Climate Data Initiative (CDI) is addressing the challenging goal of organizing such datasets around core themes specifically related to climate change impacts. These thematic areas, which currently include coastal flooding, food resilience, ecosystem vulnerability, water, transportation, energy infrastructure, and human health, form the core of a new college course at the University of Alabama in Huntsville developed around real-world applications in the Earth sciences. The goal of this course is to educate students on the data available and scope of GIS applications in Earth science across the CDI climate themes. Real world applications and datasets serve as a pedagogical tool that provide a useful medium for instruction in scientific geospatial analysis and GIS software. With a wide range of potential research areas that fall under the rubric of "Earth science", thematic foci can help to structure a student's understanding of the potential uses of GIS across sub-disciplines, while communicating core data processing concepts. The learning modules and use-case scenarios for this course demonstrate the potential applications of CDI data to undergraduate and graduate Earth science students.

Bicarbonate in diabetic ketoacidosis - a systematic review

PubMed Central

2011-01-01

Objective This study was designed to examine the efficacy and risk of bicarbonate administration in the emergent treatment of severe acidemia in diabetic ketoacidosis (DKA). Methods PUBMED database was used to identify potentially relevant articles in the pediatric and adult DKA populations. DKA intervention studies on bicarbonate administration versus no bicarbonate in the emergent therapy, acid-base studies, studies on risk association with cerebral edema, and related case reports, were selected for review. Two reviewers independently conducted data extraction and assessed the citation relevance for inclusion. Results From 508 potentially relevant articles, 44 were included in the systematic review, including three adult randomized controlled trials (RCT) on bicarbonate administration versus no bicarbonate in DKA. We observed a marked heterogeneity in pH threshold, concentration, amount, and timing for bicarbonate administration in various studies. Two RCTs demonstrated transient improvement in metabolic acidosis with bicarbonate treatment within the initial 2 hours. There was no evidence of improved glycemic control or clinical efficacy. There was retrospective evidence of increased risk for cerebral edema and prolonged hospitalization in children who received bicarbonate, and weak evidence of transient paradoxical worsening of ketosis, and increased need for potassium supplementation. No studies involved patients with an initial pH < 6.85. Conclusions The evidence to date does not justify the administration of bicarbonate for the emergent treatment of DKA, especially in the pediatric population, in view of possible clinical harm and lack of sustained benefits. PMID:21906367

The World Climate Project: Bringing the UN Climate Negotiations to Classrooms, Boardrooms, and Living Rooms Near You

NASA Astrophysics Data System (ADS)

Rath, K.; Rooney-varga, J. N.; Jones, A.; Johnston, E.; Sterman, J.

2015-12-01

As a simulation-based role-playing exercise, World Climate provides an opportunity for participants to have an immersive experience in which they learn first-hand about both the social dynamics of climate change decision-making, through role-play, and the geophysical dynamics of the climate system, through an interactive computer simulation. In June 2015, we launched the World Climate Project with the intent of bringing this powerful tool to students, citizens, and decision-makers across government, NGO, and private sectors around the world. Within a period of six weeks from the launch date, 440 educators from 36 states and 56 countries have enrolled in the initiative, offering the potential to reach tens of thousands of participants around the world. While this project is clearly in its infancy, we see several characteristics that may be contributing to widespread interest in it. These factors include the ease-of-use, real-world relevance, and scientific rigor of the decision-support simulation, C-ROADS, that frames the World Climate Exercise. Other characteristics of World Climate include its potential to evoke an emotional response that is arousing and inspirational and its use of positive framing and a call to action. Similarly, the World Climate Project takes a collaborative approach, enabling educators to be innovators and valued contributors and regularly communicating with people who join the initiative through webinars, social media, and resources.

Towards a Global Greenhouse Gas Information System (GHGIS)

NASA Astrophysics Data System (ADS)

Duren, Riley; Butler, James; Rotman, Doug; Miller, Charles; Decola, Phil; Sheffner, Edwin; Tucker, Compton; Mitchiner, John; Jonietz, Karl; Dimotakis, Paul

2010-05-01

Over the next few years, an increasing number of entities ranging from international, national, and regional governments, to businesses and private land-owners, are likely to become more involved in efforts to limit atmospheric concentrations of greenhouse gases. In such a world, geospatially resolved information about the location, amount, and rate of greenhouse gas (GHG) emissions will be needed, as well as the stocks and flows of all forms of carbon through terrestrial ecosystems and in the oceans. The ability to implement policies that limit GHG concentrations would be enhanced by a global, open, and transparent greenhouse gas information system (GHGIS). An operational and scientifically robust GHGIS would combine ground-based and space-based observations, carbon-cycle modeling, GHG inventories, meta-analysis, and an extensive data integration and distribution system, to provide information about sources, sinks, and fluxes of greenhouse gases at policy-relevant temporal and spatial scales. The GHGIS effort was initiated in 2008 as a grassroots inter-agency collaboration intended to rigorously identify the needs for such a system, assess the capabilities of current assets, and suggest priorities for future research and development. We will present a status of the GHGIS effort including our latest analysis and ideas for potential near-term pilot projects with potential relevance to European initiatives including the Global Monitoring for Environment and Security (GMES) and the Integrated Carbon Observing System (ICOS).

Applying Behavioral Economics to Public Health Policy

PubMed Central

Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

2016-01-01

Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

Dealing With an Innovative Industry: A Look at Flavored Cigarettes Promoted by Mainstream Brands

PubMed Central

Lewis, M. Jane; Wackowski, Olivia

2006-01-01

Product and marketing innovation is key to the tobacco industry’s success. One recent innovation was the development and marketing of flavored cigarettes as line extensions of 3 popular brands (Camel, Salem, and Kool). These products have distinctive blends and marketing as well as innovative packaging and have raised concerns in the public health community that they are targeted at youths. Several policy initiatives have aimed at banning or limiting these types of products on that basis. We describe examples of the products and their marketing and discuss their potential implications (including increased smoking experimentation, consumption, and “someday smoking”), as well as their potential impact on young adults. PMID:16380563

Primary screen for potential sheep scab control agents.

PubMed

Dunn, J A; Prickett, J C; Collins, D A; Weaver, R J

2016-07-15

The efficacy of potential acaricidal agents were assessed against the sheep scab mite Psoroptes ovis using a series of in vitro assays in modified test arenas designed initially to maintain P. ovis off-host. The mortality effects of 45 control agents, including essential oils, detergents, desiccants, growth regulators, lipid synthesis inhibitors, nerve action/energy metabolism disruptors and ecdysteroids were assessed against adults and nymphs. The most effective candidates were the desiccants (diatomaceous earth, nanoclay and sorex), the growth regulators (buprofezin, hexythiazox and teflubenzuron), the lipid synthesis inhibitors (spirodiclofen, spirotetramat and spiromesifen) and the nerve action and energy metabolism inhibitors (fenpyroximate, spinosad, tolfenpyrad, and chlorantraniliprole). Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Endoplasmic Reticulum Stress and Unfolded Protein Response Pathways: Potential for Treating Age-related Retinal Degeneration

PubMed Central

Haeri, Mohammad; Knox, Barry E

2012-01-01

Accumulation of misfolded proteins in the endoplasmic reticulum (ER) and their aggregation impair normal cellular function and can be toxic, leading to cell death. Prolonged expression of misfolded proteins triggers ER stress, which initiates a cascade of reactions called the unfolded protein response (UPR). Protein misfolding is the basis for a variety of disorders known as ER storage or conformational diseases. There are an increasing number of eye disorders associated with misfolded proteins and pathologic ER responses, including retinitis pigmentosa (RP). Herein we review the basic cellular and molecular biology of UPR with focus on pathways that could be potential targets for treating retinal degenerative diseases. PMID:22737387

Mesenchymal Stem Cell Transplantation in Multiple Sclerosis

PubMed Central

Cohen, Jeffrey A.

2013-01-01

Mesenchymal stem cells (MSCs) are a pluripotent non-hematopoietic precursor cells that can be isolated from bone marrow and numerous other tissues, culture-expanded to purity, and induced to differentiate in vitro and in vivo into mesodermal derivatives. MSCs exhibit many phenotypic and functional similarities to pericytes. The immunomodulatory, tissue protective, and repair-promoting properties of MSCs demonstrated both in vitro and in animal models make them an attractive potential therapy for MS and other conditions characterized by inflammation and/or tissue injury. Other potential advantages of MSCs as a therapeutic include the relative ease of culture expansion, relative immunoprivilege allowing allogeneic transplantation, and their ability to traffic from blood to areas of tissue allowing intravascular administration. The overall published experience with MSC transplantation in MS is modest, but several small case series and preliminary studies yielded promising results. Several groups, including us, recently initiated formal studies of autologous, culture-expanded, bone-marrow-derived MSC transplantation in MS. Although there are several potential safety concerns, to date, the procedure has been well tolerated. Future studies that more definitively assess efficacy also will need to address several technical issues. PMID:23294498

Impact of aging immune system on neurodegeneration and potential immunotherapies.

PubMed

Liang, Zhanfeng; Zhao, Yang; Ruan, Linhui; Zhu, Linnan; Jin, Kunlin; Zhuge, Qichuan; Su, Dong-Ming; Zhao, Yong

2017-10-01

The interaction between the nervous and immune systems during aging is an area of avid interest, but many aspects remain unclear. This is due, not only to the complexity of the aging process, but also to a mutual dependency and reciprocal causation of alterations and diseases between both the nervous and immune systems. Aging of the brain drives whole body systemic aging, including aging-related changes of the immune system. In turn, the immune system aging, particularly immunosenescence and T cell aging initiated by thymic involution that are sources of chronic inflammation in the elderly (termed inflammaging), potentially induces brain aging and memory loss in a reciprocal manner. Therefore, immunotherapeutics including modulation of inflammation, vaccination, cellular immune therapies and "protective autoimmunity" provide promising approaches to rejuvenate neuroinflammatory disorders and repair brain injury. In this review, we summarize recent discoveries linking the aging immune system with the development of neurodegeneration. Additionally, we discuss potential rejuvenation strategies, focusing aimed at targeting the aging immune system in an effort to prevent acute brain injury and chronic neurodegeneration during aging. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of human disturbance on waterbird nesting and reproductive success at restoration pond SF2, south San Francisco Bay, California

USGS Publications Warehouse

Ackerman, Joshua T.; Herzog, Mark P.; Hartman, Christopher A.

2014-01-01

To determine the effects that human disturbance may have on waterbirds nesting on these newly constructed islands in Pond SF2, we assessed the potential effects of human disturbance features (specifically, access trails, viewing platforms, internal pond berms, exterior levees, and highways) on breeding waterbirds in 2011 and 2012. We found no clear pattern of potential disturbance features on a group of reproductive factors, including nest survival, nest initiation date, and clutch size. Because all the islands were constructed greater than 90 meters from the nearest disturbance feature, Pond SF2 alone did not provide adequate variation in the distance of disturbance features to detect potential detrimental effects for islands closer to disturbance features in other areas of the SBSP Restoration Project. If there is a need for SBSP Restoration Project Management Team to understand how close islands can be built to disturbance features in the future, we suggest a more comprehensive study that includes multiple ponds, other than SF2, with islands at varying distances to disturbance features.

Assessing the current state of dental informatics in saudi arabia: the new frontier.

PubMed

Al-Nasser, Lubna; Al-Ehaideb, Ali; Househ, Mowafa

2014-01-01

Dental informatics is an emerging field that has the potential to transform the dental profession. This study aims to summarize the current applications of dental informatics in Saudi Arabia and to identify the challenges facing expansion of dental informatics in the Saudi context. Search for published articles and specialized forum entries was conducted, as well as interviews with dental professionals familiar with the topic. Results indicated that digital radiography/analysis and administrative management of dental practice are the commonest applications used. Applications in Saudi dental education included: web-based learning systems, computer-based assessments and virtual technology for clinical skills' teaching. Patients' education software, electronic dental/oral health records and the potential of dental research output from electronic databases are yet to be achieved in Saudi Arabia. Challenges facing Saudi dental informatics include: lack of IT infrastructure/support, social acceptability and financial cost. Several initiatives are taken towards the research in dental informatics. Still, more investments are needed to fully achieve the potential of various application of informatics in dental education, practice and research.

Benefits of a European project on diagnostics of highly pathogenic agents and assessment of potential "dual use" issues.

PubMed

Grunow, Roland; Ippolito, G; Jacob, D; Sauer, U; Rohleder, A; Di Caro, A; Iacovino, R

2014-01-01

Quality assurance exercises and networking on the detection of highly infectious pathogens (QUANDHIP) is a joint action initiative set up in 2011 that has successfully unified the primary objectives of the European Network on Highly Pathogenic Bacteria (ENHPB) and of P4-laboratories (ENP4-Lab) both of which aimed to improve the efficiency, effectiveness, and response capabilities of laboratories directed at protecting the health of European citizens against high consequence bacteria and viruses of significant public health concern. Both networks have established a common collaborative consortium of 37 nationally and internationally recognized institutions with laboratory facilities from 22 European countries. The specific objectives and achievements include the initiation and establishment of a recognized and acceptable quality assurance scheme, including practical external quality assurance exercises, comprising living agents, that aims to improve laboratory performance, accuracy, and detection capabilities in support of patient management and public health responses; recognized training schemes for diagnostics and handling of highly pathogenic agents; international repositories comprising highly pathogenic bacteria and viruses for the development of standardized reference material; a standardized and transparent Biosafety and Biosecurity strategy protecting healthcare personnel and the community in dealing with high consequence pathogens; the design and organization of response capabilities dealing with cross-border events with highly infectious pathogens including the consideration of diagnostic capabilities of individual European laboratories. The project tackled several sensitive issues regarding Biosafety, Biosecurity and "dual use" concerns. The article will give an overview of the project outcomes and discuss the assessment of potential "dual use" issues.

How We Identify and Manage Patients with Inadequately Controlled Polycythemia Vera.

PubMed

Reiter, Andreas; Harrison, Claire

2016-10-01

Polycythemia vera (PV) is a chronic myeloproliferative neoplasm (MPN) characterized by an overactive Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway through mutations in JAK2 exons 12 or 14 (JAK2 V617F). The dominant clinical characteristics include erythrocytosis (with or without leukocytosis/thrombocytosis), thrombotic events, and symptoms. Increased risk of mortality is mainly caused by thrombotic events and progression to post-polycythemia vera myelofibrosis (PPV-MF) or secondary acute myeloid leukemia (sAML). The most important prognostic factors include age and a history of thrombotic events, although recent evidence has indicated that leukocytosis and additional cytogenetic aberrations may also be of significant prognostic value. First-line therapies include aspirin and phlebotomies, which significantly reduce the incidence of thrombotic events and prolong survival. Cytoreductive treatment with hydroxyurea (approved) and conventional or pegylated interferon-α (effective, but not approved in many countries) is initiated for high-risk or inadequately controlled disease, e.g., uncontrolled hematocrit, leukocytosis, thrombocytosis, thrombotic events, splenomegaly, or symptoms. However, some patients may not receive initial benefit from first-line therapy or may become resistant or intolerant in due course. Although second-line treatment options are limited, clinical trials have shown the efficacy of ruxolitinib toward improving blood counts, enlarged spleen, and symptoms and potentially reducing thrombotic events. Identification of patients with uncontrolled PV is important for clinical care, as such patients have a high risk of complications, and future studies with JAK inhibitors or other agents alone or in combination are needed to test their potential to reduce rates of thrombotic events and transformation to PPV-MF or sAML.

Increases in reactive oxygen species enhance vascular endothelial cell migration through a mechanism dependent on the transient receptor potential melastatin 4 ion channel.

PubMed

Sarmiento, Daniela; Montorfano, Ignacio; Cerda, Oscar; Cáceres, Mónica; Becerra, Alvaro; Cabello-Verrugio, Claudio; Elorza, Alvaro A; Riedel, Claudia; Tapia, Pablo; Velásquez, Luis A; Varela, Diego; Simon, Felipe

2015-03-01

A hallmark of severe inflammation is reactive oxygen species (ROS) overproduction induced by increased inflammatory mediators secretion. During systemic inflammation, inflammation mediators circulating in the bloodstream interact with endothelial cells (ECs) raising intracellular oxidative stress at the endothelial monolayer. Oxidative stress mediates several pathological functions, including an exacerbated EC migration. Because cell migration critically depends on calcium channel-mediated Ca(2+) influx, the molecular identification of the calcium channel involved in oxidative stress-modulated EC migration has been the subject of intense investigation. The transient receptor potential melastatin 4 (TRPM4) protein is a ROS-modulated non-selective cationic channel that performs several cell functions, including regulating intracellular Ca(2+) overload and Ca(2+) oscillation. This channel is expressed in multiple tissues, including ECs, and contributes to the migration of certain immune cells. However, whether the TRPM4 ion channel participates in oxidative stress-mediated EC migration is not known. Herein, we investigate whether oxidative stress initiates or enhances EC migration and study the role played by the ROS-modulated TRPM4 ion channel in oxidative stress-mediated EC migration. We demonstrate that oxidative stress enhances, but does not initiate, EC migration in a dose-dependent manner. Notably, we demonstrate that the TRPM4 ion channel is critical in promoting H2O2-enhanced EC migration. These results show that TRPM4 is a novel pharmacological target for the possible treatment of severe inflammation and other oxidative stress-mediated inflammatory diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

Atherosclerosis. Potential targets for stabilization and regression.

PubMed

Schwartz, C J; Valente, A J; Sprague, E A; Kelley, J L; Cayatte, A J; Mowery, J

1992-12-01

Reviewed are various aspects of atherosclerotic plaque stabilization and regression in humans and experimental animals. Plaque regression is a function of the dynamic balance among initiation, progression, stabilization, and removal of plaque constituents. Pseudoregression, the result of the triad thrombolysis, age- or lesion-dependent arterial dilatation, and relaxation of vasospasm, may readily give rise to angiographic misinterpretation. Although lowering of plasma cholesterol and low density lipoprotein-cholesterol has demonstrated significant clinical benefits in a number of clinical trials, the magnitude of angiographic regressive changes is relatively small despite aggressive lipid-lowering regimens. The emerging need for alternative or complementary therapeutic interventions has been emphasized. In particular, they should be targeted to pivotal cellular or molecular mechanisms in initiation, progression, or stabilization. Potentially important therapeutic targets include the use of antioxidants or free radical scavengers such as Probucol or its analogues, butylated hydroxytoluene, tocopherols, and possibly the tocotrienols. Other therapeutic targets include intimal monocyte-macrophage recruitment, macrophage cholesterol acyltransferase inhibition, stimulation of the high density lipoprotein-mediated reverse cholesterol transport system, smooth muscle cell migration to and proliferation in the arterial intima, and intimal connective tissue synthesis. Whether the isoprenylated proteins associated with the cholesterol biosynthetic pathway will give rise to compounds regulating smooth muscle cell growth has yet to be determined. Because of the importance of thrombosis in the pathogenesis and progression of lesions, the need to develop interventional strategies targeted at endothelial cell thromboresistance and thromboregulation must assume a high priority in future research and development. Other areas of therapeutic promise include the calcium channel blockers and angiotensin converting enzyme inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS)

Developmental Regression, Depression, and Psychosocial Stress in an Adolescent with Down Syndrome

PubMed Central

Stein, David S.; Munir, Kerim M.; Karweck, Andrea J.; Davidson, Emily J.; Stein, Martin T.

2013-01-01

CASE: Kristen is a 13-year-old girl with Down syndrome (DS) who was seen urgently with concerns of cognitive and developmental regression including loss of language, social, and toileting skills. The evaluation in the DS clinic focused on potential medical diagnoses including atlantoaxial joint instability, vitamin deficiency, obstructive sleep apnea (OSA), and seizures. A comprehensive medical evaluation yielded only a finding of moderate OSA. A reactive depression was considered in association with several psychosocial factors including moving homes, entering puberty/onset of menses, and classroom change from an integrated setting to a self-contained classroom comprising unfamiliar peers with behavior challenges. Urgent referrals for psychological and psychiatric evaluations were initiated. Neuropsychological testing did not suggest true regression in cognitive, language, and academic skills, although decreases in motivation and performance were noted with a reaction to stress and multiple environmental changes as a potential causative factor. Psychiatry consultation supported this finding in that psychosocial stress temporally correlated with Kristen’s regression in skills. Working collaboratively, the team determined that Kristen’s presentation was consistent with a reactive form of depression (DSM-IV-TR: depressive disorder, not otherwise specified). Kristen’s presentation was exacerbated by salient environmental stress and sleep apnea, rather than a cognitive regression associated with a medical cause. Treatment consisted of an antidepressant medication, continuous positive airway pressure for OSA, and increased psychosocial supports. Her school initiated a change in classroom placement. With this multimodal approach to evaluation and intervention, Kristen steadily improved and she returned to her baseline function. PMID:23572173

Developmental Regression, Depression, and Psychosocial Stress in an Adolescent with Down Syndrome

PubMed Central

Stein, David S.; Munir, Kerim M.; Karweck, Andrea J.; Davidson, Emily J.; Stein, Martin T.

2017-01-01

CASE Kristen is a 13-year-old girl with Down syndrome (DS) who was seen urgently with concerns of cognitive and developmental regression including loss of language, social, and toileting skills. The evaluation in the DS clinic focused on potential medical diagnoses including atlantoaxial joint instability, vitamin deficiency, obstructive sleep apnea (OSA), and seizures. A comprehensive medical evaluation yielded only a finding of moderate OSA. A reactive depression was considered in association with several psychosocial factors including moving homes, entering puberty/onset of menses, and classroom change from an integrated setting to a self- contained classroom comprising unfamiliar peers with behavior challenges. Urgent referrals for psychological and psychiatric evaluations were initiated. Neuropsychological testing did not suggest true regression in cognitive, language, and academic skills, although decreases in motivation and performance were noted with a reaction to stress and multiple environmental changes as a potential causative factor. Psychiatry consultation supported this finding in that psychosocial stress temporally correlated with Kristen’s regression in skills. Working collaboratively, the team determined that Kristen’s presentation was consistent with a reactive form of depression (DSM-IV-TR: depressive disorder, not otherwise specified). Kristen’s presentation was exacerbated by salient environmental stress and sleep apnea, rather than a cognitive regression associated with a medical cause. Treatment consisted of an antidepressant medication, continuous positive airway pressure for OSA, and increased psychosocial supports. Her school initiated a change in classroom placement. With this multimodal approach to evaluation and intervention, Kristen steadily improved and she returned to her baseline function. PMID:28141713

Integrating expert knowledge in a GIS to optimize siting decisions for small-scale healthy food retail interventions.

PubMed

Sadler, Richard Casey

2016-06-16

The availability of healthy foods in a neighborhood remains a key determinant of diet and diet-related disease in disadvantaged communities. Innovative solutions to the 'food desert' problem include the deployment of mobile markets and healthy corner store initiatives. Such initiatives, however, do not always capitalize on the principles guiding retail development and the possibilities of GIS-based data. Simultaneously, community partners are not always engaged effectively in the planning for such interventions, which limits acceptability and suitability of such work. This paper highlights the results of a participatory mapping exercise to optimize the siting of a planned healthy food retail intervention in Flint, Michigan. Potential sites are chosen by engaging experts in a three-stage mapping process that includes the analytic hierarchy process and point allocation of five key variables (including food access, socioeconomic distress, population density, access to transit, and proximity to neighborhood centers), as well as direct mapping of suitable sites. Results suggest a discrete set of areas-primarily in the northwestern quadrant of the city-where small-scale healthy food retail interventions might be most strategically located. Areas with the most consistent overlap between directly mapped sites and very high levels of suitability align well with neighborhoods which are distant from existing grocery stores. As a community-based strategy, this increases the opportunity for effectively improving neighborhood access to healthy foods by optimizing the potential sites for healthy food interventions. Community partners have already been active in using these results in project planning for just such an intervention.

Benefits of a European Project on Diagnostics of Highly Pathogenic Agents and Assessment of Potential “Dual Use” Issues

PubMed Central

Grunow, Roland; Ippolito, G.; Jacob, D.; Sauer, U.; Rohleder, A.; Di Caro, A.; Iacovino, R.

2014-01-01

Quality assurance exercises and networking on the detection of highly infectious pathogens (QUANDHIP) is a joint action initiative set up in 2011 that has successfully unified the primary objectives of the European Network on Highly Pathogenic Bacteria (ENHPB) and of P4-laboratories (ENP4-Lab) both of which aimed to improve the efficiency, effectiveness, and response capabilities of laboratories directed at protecting the health of European citizens against high consequence bacteria and viruses of significant public health concern. Both networks have established a common collaborative consortium of 37 nationally and internationally recognized institutions with laboratory facilities from 22 European countries. The specific objectives and achievements include the initiation and establishment of a recognized and acceptable quality assurance scheme, including practical external quality assurance exercises, comprising living agents, that aims to improve laboratory performance, accuracy, and detection capabilities in support of patient management and public health responses; recognized training schemes for diagnostics and handling of highly pathogenic agents; international repositories comprising highly pathogenic bacteria and viruses for the development of standardized reference material; a standardized and transparent Biosafety and Biosecurity strategy protecting healthcare personnel and the community in dealing with high consequence pathogens; the design and organization of response capabilities dealing with cross-border events with highly infectious pathogens including the consideration of diagnostic capabilities of individual European laboratories. The project tackled several sensitive issues regarding Biosafety, Biosecurity and “dual use” concerns. The article will give an overview of the project outcomes and discuss the assessment of potential “dual use” issues. PMID:25426479

Resurfacing Damaged Articular Cartilage to Restore Compressive Properties

PubMed Central

Grenier, Stephanie; Donnelly, Patrick E.; Gittens, Jamila; Torzilli, Peter A.

2014-01-01

Surface damage to articular cartilage is recognized as the initial underlying process causing the loss of mechanical function in early-stage osteoarthritis. In this study, we developed structure-modifying treatments to potentially prevent, stabilize or reverse the loss in mechanical function. Various polymers (chondroitin sulfate, carboxymethylcellulose, sodium hyaluronate) and photoinitiators (riboflavin, irgacure 2959) were applied to the surface of collagenase-degraded cartilage and crosslinked in situ using UV light irradiation. While matrix permeability and deformation significantly increased following collagenase-induced degradation of the superficial zone, resurfacing using tyramine-substituted sodium hyaluronate and riboflavin decreased both values to a level comparable to that of intact cartilage. Repetitive loading of resurfaced cartilage showed minimal variation in the mechanical response over a 7 day period. Cartilage resurfaced using a low concentration of riboflavin had viable cells in all zones while a higher concentration resulted in a thin layer of cell death in the uppermost superficial zone. Our approach to repair surface damage initiates a new therapeutic advance in the treatment of injured articular cartilage with potential benefits that include enhanced mechanical properties, reduced susceptibility to enzymatic degradation and reduced adhesion of macrophages. PMID:25468298

An assessment of potential degradation products in the gas-phase reactions of alternative fluorocarbons in the troposphere

NASA Technical Reports Server (NTRS)

Niki, Hiromi

1990-01-01

Tropospheric chemical transformations of alternative hydrofluorocarbons (HCF's) and hydrochlorofluorocarbons (HCFC's) are governed by hydroxyl radical initiated oxidation processes, which are likely to be analogous to those known for alkanes and chloroalkanes. A schematic diagram is used to illustrate plausible reaction mechanisms for their atmospheric degradation, where R, R', and R'' denote the F- and/or Cl-substituted alkyl groups derived from HCF's and HCFC's subsequent th the initial H atom abstraction by HO radicals. At present, virtually no kinetic data exist for the majority of these reactions, particularly for those involving RO. Potential degradation intermediates and final products include a large variety of fluorine- and/or chlorine-containing carbonyls, acids, peroxy acids, alcohols, hydrogen peroxides, nitrates and peroxy nitrates, as summarized in the attached table. Probably atmospheric lifetimes of these compounds were also estimated. For some carbonyl and nitrate products shown in this table, there seem to be no significant gas-phase removal mechanisms. Further chemical kinetics and photochemical data are needed to quantitatively assess the atmospheric fate of HCF's and HCFC's, and of the degradation products postulated in this report.

Broader Societal Issues of Nanotechnology

NASA Astrophysics Data System (ADS)

Roco, M. C.

2003-08-01

Nanoscale science and engineering are providing unprecedented understanding and control over the basic building blocks of matter, leading to increased coherence in knowledge, technology, and education. The main reason for developing nanotechnology is to advance broad societal goals such as improved comprehension of nature, increased productivity, better healthcare, and extending the limits of sustainable development and of human potential. This paper outlines societal implication activities in nanotechnology R&D programs. The US National Nanotechnology Initiative annual investment in research with educational and societal implications is estimated at about 30 million (of which National Science Foundation (NSF) awards about 23 million including contributions to student fellowships), and in nanoscale research with relevance to environment at about 50 million (of which NSF awards about 30 million and EPA about 6 million). An appeal is made to researchers and funding organizations worldwide to take timely and responsible advantage of the new technology for economic and sustainable development, to initiate societal implications studies from the beginning of the nanotechnology programs, and to communicate effectively the goals and potential risks with research users and the public.

Strategic enhancement of Desertifilum tharense MSAK01 on dairy wastewater: an integrated approach for remediation and biomass production

NASA Astrophysics Data System (ADS)

Khemka, Ankita; Saraf, Meenu

2017-10-01

The present study is an integrated approach to study the potential of Desertifilum tharense MSAK01 for treatment of dairy wastewater (DWW) and enrichment of biomass. The present research includes the experiment designed for treatment of DWW. The physical and chemical parameters of wastewater quality, such as nitrate, phosphate, chloride, sulphur, and hardness, were studied. The level of nitrate and phosphate in water bodies was reduced by 94 and 98% in the effluent, respectively. The level of BOD and COD, measure of organic contaminants, were reduced to 70% (BOD5, initial level of 1840 mg O2 L-1) and 56% (COD, initial level of 2470 mg O2 L-1). The second module of the experiment was designed for biochemical extractions by harvesting the biomass (algal strain) grown in DWW. The result of this study shows that algal strain D. tharense is not only an agent for mitigation of pollutant load, but it can also be used as potential source for lipid, protein and carbohydrate.

A logistics and potential hazard study of propellant systems for a Saturn 5 derived heavy lift (three-stage core) launch vehicle

NASA Technical Reports Server (NTRS)

Whitney, E. Dow

1992-01-01

The Bush Administration has directed NASA to prepare for a return to the Moon and on to Mars - the Space Exploration Initiative. To meet this directive, powerful rocket boosters will be required in order to lift payloads that may reach the half-million pound range into low earth orbit. In this report an analysis is presented on logistics and potential hazards of the propellant systems envisioned for future Saturn 5 derived heavy lift launch vehicles. In discussing propellant logistics, particular attention has been given to possible problems associated with procurement, transportation, and storage of RP-1, HL2, and LOX, the heavy lift launch vehicle propellants. Current LOX producing facilities will need to be expanded and propellant storage and some support facilities will require relocation if current Launch Pads 39A and/or 39B are to be used for future heavy noise-abatement measures. Included in the report is a discussion of suggested additional studies, primarily economic and environmental, which should be undertaken in support of the goals of the Space Exploration Initiative.

Motherhood Preconceived: The Emergence of the Preconception Health and Health Care Initiative

PubMed Central

Waggoner, Miranda R.

2013-01-01

Since the 1980s, maternal and child health experts have sought to redefine maternity care to include the period prior to pregnancy, essentially by expanding the concept of prenatal care to encompass the time before conception. In 2004, the Centers for Disease Control and Prevention endorsed and promoted this new definition when it launched the Preconception Health and Health Care Initiative. In arguing that prenatal care was often too little too late, a group of maternal and child health experts in the United States attempted to spur improvements in population health and address systemic problems in health care access and health disparities. By changing the terms of pregnancy risk and by using maternalism as a social policy strategy, the preconception health and health care paradigm promoted an ethic of anticipatory motherhood and conflated women’s health with maternal health, sparking public debate about the potential social and clinical consequences of preconception care. This article tracks the construction of this policy idea and its ultimate potential utility in health and health policy discussions. PMID:23262764

Contribution of the Axon Initial Segment to Action Potentials Recorded Extracellularly.

PubMed

Teleńczuk, Maria; Brette, Romain; Destexhe, Alain; Teleńczuk, Bartosz

2018-01-01

Action potentials (APs) are electric phenomena that are recorded both intracellularly and extracellularly. APs are usually initiated in the short segment of the axon called the axon initial segment (AIS). It was recently proposed that at the onset of an AP the soma and the AIS form a dipole. We study the extracellular signature [the extracellular AP (EAP)] generated by such a dipole. First, we demonstrate the formation of the dipole and its extracellular signature in detailed morphological models of a reconstructed pyramidal neuron. Then, we study the EAP waveform and its spatial dependence in models with axonal AP initiation and contrast it with the EAP obtained in models with somatic AP initiation. We show that in the models with axonal AP initiation the dipole forms between somatodendritic compartments and the AIS, and not between soma and dendrites as in the classical models. The soma-dendrites dipole is present only in models with somatic AP initiation. Our study has consequences for interpreting extracellular recordings of single-neuron activity and determining electrophysiological neuron types, but also for better understanding the origins of the high-frequency macroscopic extracellular potentials recorded in the brain.

Getting right to the point: identifying Australian outpatients' priorities and preferences for patient-centred quality improvement in chronic disease care.

PubMed

Fradgley, Elizabeth A; Paul, Christine L; Bryant, Jamie; Oldmeadow, Christopher

2016-09-01

To identify specific actions for patient-centred quality improvement in chronic disease outpatient settings, this study identified patients' general and specific preferences among a comprehensive suite of initiatives for change. A cross-sectional survey was conducted in three hospital-based clinics specializing in oncology, neurology and cardiology care located in New South Wales, Australia. Adult English-speaking outpatients completed the touch-screen Consumer Preferences Survey in waiting rooms or treatment areas. Participants selected up to 23 general initiatives that would improve their experience. Using adaptive branching, participants could select an additional 110 detailed initiatives and complete a relative prioritization exercise. A total of 541 individuals completed the survey (71.1% consent, 73.1% completion). Commonly selected general initiatives, presented in order of decreasing priority (along with sample proportion), included: improved parking (60.3%), up-to-date information provision (15.0%), ease of clinic contact (12.9%), access to information at home (12.8%), convenient appointment scheduling (14.2%), reduced wait-times (19.8%) and information on medical emergencies (11.1%). To address these general initiatives, 40 detailed initiatives were selected by respondents. Initiatives targeting service accessibility and information provision, such as parking and up-to-date information on patient prognoses and progress, were commonly selected and perceived to be of relatively greater priority. Specific preferences included the need for clinics to provide patient-designated parking in close proximity to the clinic, information on treatment progress and test results (potentially in the form of designated brief appointments or via telehealth) and comprehensive and trustworthy lists of information sources to access at home. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Building upon the Great Waters Initiative: Scoping study for potential polyaromatic hydrocarbon deposition into San Diego Bay

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

Koehler, J.; Sylte, W.W.

1997-12-31

The deposition of atmospheric polyaromatic hydrocarbons (PAHs) into San Diego Bay was evaluated at an initial study level. This study was part of an overall initial estimate of PAH waste loading to San Diego Bay from all environmental pathways. The study of air pollutant deposition to water bodies has gained increased attention both as a component of Total Maximum Daily Load (TMDL) determinations required under the Clean Water Act and pursuant to federal funding authorized by the 1990 Clean Air Act Amendments to study the atmospheric deposition of hazardous air pollutants to the Great Waters, which includes coastal waters. Tomore » date, studies under the Clean Air Act have included the Great Lakes, Chesapeake Bay, Lake Champlain, and Delaware Bay. Given the limited resources of this initial study for San Diego Bay, the focus was on maximizing the use of existing data and information. The approach developed included the statistical evaluation of measured atmospheric PAH concentrations in the San Diego area, the extrapolation of EPA study results of atmospheric PAH concentrations above Lake Michigan to supplement the San Diego data, the estimation of dry and wet deposition with published calculation methods considering local wind and rainfall data, and the comparison of resulting PAH deposition estimates for San Diego Bay with estimated PAH emissions from ship and commercial boat activity in the San Diego area. The resulting PAH deposition and ship emission estimates were within the same order of magnitude. Since a significant contributor to the atmospheric deposition of PAHs to the Bay is expected to be from shipping traffic, this result provides a check on the order of magnitude on the PAH deposition estimate. Also, when compared against initial estimates of PAH loading to San Diego Bay from other environmental pathways, the atmospheric deposition pathway appears to be a significant contributor.« less

Developing community-driven quality improvement initiatives to enhance chronic disease care in Indigenous communities in Canada: the FORGE AHEAD program protocol.

PubMed

Naqshbandi Hayward, Mariam; Paquette-Warren, Jann; Harris, Stewart B

2016-07-26

Given the dramatic rise and impact of chronic diseases and gaps in care in Indigenous peoples in Canada, a shift from the dominant episodic and responsive healthcare model most common in First Nations communities to one that places emphasis on proactive prevention and chronic disease management is urgently needed. The Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD) Program partners with 11 First Nations communities across six provinces in Canada to develop and evaluate community-driven quality improvement (QI) initiatives to enhance chronic disease care. FORGE AHEAD is a 5-year research program (2013-2017) that utilizes a pre-post mixed-methods observational design rooted in participatory research principles to work with communities in developing culturally relevant innovations and improved access to available services. This intensive program incorporates a series of 10 inter-related and progressive program activities designed to foster community-driven initiatives with type 2 diabetes mellitus as the action disease. Preparatory activities include a national community profile survey, best practice and policy literature review, and readiness tool development. Community-level intervention activities include community and clinical readiness consultations, development of a diabetes registry and surveillance system, and QI activities. With a focus on capacity building, all community-level activities are driven by trained community members who champion QI initiatives in their community. Program wrap-up activities include readiness tool validation, cost-analysis and process evaluation. In collaboration with Health Canada and the Aboriginal Diabetes Initiative, scale-up toolkits will be developed in order to build on lessons-learned, tools and methods, and to fuel sustainability and spread of successful innovations. The outcomes of this research program, its related cost and the subsequent policy recommendations, will have the potential to significantly affect future policy decisions pertaining to chronic disease care in First Nations communities in Canada. Current ClinicalTrial.gov protocol ID NCT02234973 . Date of Registration: July 30, 2014.

Limited capacity in US pediatric drug trials: qualitative analysis of expert interviews.

PubMed

Wasserman, Richard; Bocian, Alison; Harris, Donna; Slora, Eric

2011-04-01

The recently renewed Best Pharmaceuticals for Children and Pediatric Research Equity Acts (BPCA/PREA) have continued industry incentives and opportunities for pediatric drug trials (PDTs). However, there is no current assessment of the capacity to perform PDTs. The aim of this study was to deepen understanding of the capacity for US PDTs by assessing PDT infrastructure, present barriers to PDTs, and potential approaches and solutions to identified issues. Pediatric clinical research experts participated in semi-structured interviews on current US pediatric research capacity (February-July 2007). An initial informant list was developed using purposive sampling, and supplemented and refined to generate a group of respondents to explore emerging themes. Each phone interview included a physician researcher and two health researchers who took notes and recorded the calls. Health researchers produced detailed summaries, which were verified by the physician researcher and informants. We then undertook qualitative analysis of the summaries, employing multiple coding, with the two health researchers and the physician researcher independently coding each summary for themes and subthemes. Coding variations were resolved by physician researcher/health researcher discussion and consensus achieved on themes and subthemes. The 33 informants' primary or secondary roles included academia (n = 21), federal official (5), industry medical officer (8), pediatric research network leader (10), pediatric specialist leader (8), pediatric clinical pharmacologist (5), and practitioner/research site director (9). While most experts noted an increase in PDTs since the initial passage of BPCA/PREA, a dominant theme of insufficient US PDT capacity emerged. Subthemes included (i) lack of systems for finding, incentivizing, and/or maintaining trial sites; (ii) complexity/demands of conducting PDTs in clinical settings; (iii) inadequate numbers of qualified pediatric pharmacologists and clinician investigators trained in FDA Good Clinical Practice; and (iv) poor PDT protocol design resulting in operational and enrollment difficulties in the pediatric population. Suggested potential solutions for insufficient PDT capacity included (i) consensus-building among stakeholders to create PDT systems; (ii) initiatives to train more pediatric pharmacologists and educate clinicians in Good Clinical Practice; (iii) advocacy for PDT protocols designed by individuals sensitive to pediatric issues; and (iv) physician and public education on the importance of PDTs. Insufficient US PDT capacity may hinder the development of new drugs for children and limit studies on the safety and efficacy of drugs presently used to treat pediatric conditions. Further public policy initiatives may be needed to achieve the full promise of BPCA/PREA.

A prospective study of endothelial activation biomarkers, including plasma angiopoietin-1 and angiopoietin-2, in Kenyan women initiating antiretroviral therapy.

PubMed

Graham, Susan M; Rajwans, Nimerta; Tapia, Kenneth A; Jaoko, Walter; Estambale, Benson B A; McClelland, R Scott; Overbaugh, Julie; Liles, W Conrad

2013-06-04

HIV-1-related inflammation is associated with increased levels of biomarkers of vascular adhesion and endothelial activation, and may increase production of the inflammatory protein angiopoietin-2 (ANG-2), an adverse prognostic biomarker in severe systemic infection. We hypothesized that antiretroviral therapy (ART) initiation would decrease endothelial activation, reducing plasma levels of ANG-2. Antiretroviral-naïve Kenyan women with advanced HIV infection were followed prospectively. Endothelial activation biomarkers including soluble intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), and E-selectin, and plasma ANG-2 and angiopoietin-1 (ANG-1) were tested in stored plasma samples from 0, 6, and 12 months after ART initiation. We used Wilcoxon matched-pairs signed rank tests to compare endothelial activation biomarkers across time-points, generalized estimating equations to analyze associations with change in log10-transformed biomarkers after ART initiation, and Cox proportional-hazards regression to analyze associations with mortality. The 102 HIV-1-seropositive women studied had advanced infection (median CD4 count, 124 cells/μL). Soluble ICAM-1 and plasma ANG-2 levels decreased at both time-points after ART initiation, with concomitant increases in the beneficial protein ANG-1. Higher ANG-2 levels after ART initiation were associated with higher plasma HIV-1 RNA, oral contraceptive pill use, pregnancy, severe malnutrition, and tuberculosis. Baseline ANG-2 levels were higher among five women who died after ART initiation than among women who did not (median 2.85 ng/mL [inter-quartile range (IQR) 2.47-5.74 ng/mL] versus median 1.32 ng/mL [IQR 0.35-2.18 ng/mL], p = 0.01). Both soluble ICAM-1 and plasma ANG-2 levels predicted mortality after ART initiation. Biomarkers of endothelial activation decreased after ART initiation in women with advanced HIV-1 infection. Changes in plasma ANG-2 were associated with HIV-1 RNA levels over 12 months of follow-up. Soluble ICAM-1 and plasma ANG-2 levels represent potential biomarkers for adverse outcomes in advanced HIV-1 infection.

Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

PubMed

Engels, Melanie J; Chaffee, Bruce W; Clark, John S

2015-12-01

An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Developing the Safety of Atrial Fibrillation Ablation Registry Initiative (SAFARI) as a collaborative pan-stakeholder critical path registry model: a Cardiac Safety Research Consortium "Incubator" Think Tank.

PubMed

Al-Khatib, Sana M; Calkins, Hugh; Eloff, Benjamin C; Kowey, Peter; Hammill, Stephen C; Ellenbogen, Kenneth A; Marinac-Dabic, Danica; Waldo, Albert L; Brindis, Ralph G; Wilbur, David J; Jackman, Warren M; Yaross, Marcia S; Russo, Andrea M; Prystowsky, Eric; Varosy, Paul D; Gross, Thomas; Pinnow, Ellen; Turakhia, Mintu P; Krucoff, Mitchell W

2010-10-01

Although several randomized clinical trials have demonstrated the safety and efficacy of catheter ablation of atrial fibrillation (AF) in experienced centers, the outcomes of this procedure in routine clinical practice and in patients with persistent and long-standing persistent AF remain uncertain. Brisk adoption of this therapy by physicians with diverse training and experience highlights potential concerns regarding the safety and effectiveness of this procedure. Some of these concerns could be addressed by a national registry of AF ablation procedures such as the Safety of Atrial Fibrillation Ablation Registry Initiative that was initially proposed at a Cardiac Safety Research Consortium Think Tank meeting in April 2009. In January 2010, the Cardiac Safety Research Consortium, in collaboration with the Duke Clinical Research Institute, the US Food and Drug Administration, the American College of Cardiology, and the Heart Rhythm Society, held a follow-up meeting of experts in the field to review the construct and progress to date. Other participants included the National Heart, Lung, and Blood Institute; the Centers for Medicare and Medicaid Services; the Agency for Healthcare Research and Quality; the AdvaMed AF working group; and additional industry representatives. This article summarizes the discussions that occurred at the meeting of the state of the Safety of Atrial Fibrillation Ablation Registry Initiative, the identification of a clear pathway for its implementation, and the exploration of solutions to potential issues in the execution of this registry. Copyright © 2010 Mosby, Inc. All rights reserved.

Energy Savings Calculations for Heat Island Reduction Strategies in Baton Rouge, Sacramento and Salt Lake City

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

Konopacki, S.; Akbari, H.

2000-03-01

In 1997, the US Environmental Protection Agency (EPA) established the ''Heat Island Reduction Initiative'', to quantify the potential benefits of Heat Island Reduction (HIR) strategies (i.e., shade trees, reflective roofs, reflective pavements and urban vegetation) to reduce cooling energy use in buildings, lower the ambient air temperature and improve urban air quality in cities, and reduce CO2 emissions from power plants. Under this initiative, the Urban Heat Island Pilot Project (UHIPP) was created with the objective to investigate the potential of HIR strategies in residential and commercial buildings in three initial UHIPP cities: Baton Rouge, Sacramento and Salt Lake City.more » This paper summarizes our efforts to calculate the annual energy savings, peak power avoidance and annual C02 reduction of HIR strategies in the three initial cities. In this analysis, we focused on three building types that offer most savings potential: single-family residence, office and retail store. Each building type was characterized in detail by old or new construction and with a gas furnace or an electric heat pump. We defined prototypical building characteristics for each building type and simulated the impact of HIR strategies on building cooling and heating energy use and peak power demand using the DOE-2.IE model. Our simulations included the impact of (1) strategically-placed shade trees near buildings [direct effect], (2) use of high-albedo roofing material on building [direct effect], (3) combined strategies I and 2 [direct effect], (4) urban reforestation with high-albedo pavements and building surfaces [indirect effect] and (5) combined strategies 1, 2 and 4 [direct and indirect effects]. We then estimated the total roof area of air-conditioned buildings in each city using readily obtainable data to calculate the metropolitan-wide impact of HIR strategies. The results show, that in Baton Rouge, potential annual energy savings of $15M could be realized by rate-payers from the combined direct and indirect effects of HIR strategies. Additionally, peak power avoidance is estimated at 133 MW and the reduction in annual carbon emissions at 41 kt. In Sacramento, the potential annual energy savings is estimated at $26M, with an avoidance of 486 MW in peak power and a reduction in annual carbon of 92 kt. In Salt Lake City, the potential annual energy savings is estimated at $4M, with an avoidance of 85 MW in peak power and a reduction in annual carbon of 20 kt.« less

Initial assessment of the ground-water resources in the Monterey Bay region, California

USGS Publications Warehouse

Muir, K.S.

1977-01-01

Because urban growth has placed an increasing demand on the ground-water resources of the Monterey Bay region, Calif., an assessment of the ground-water conditions was made to aid the development of local and regional plans. Ground water provides 80 percent of the water used in the region, which includes six ground-water subbasins. In several of the subbasins, pumpage exceeds safe yield. Existing water-quality degradation results from seawater intrusion, septic-tank effluent, and irrigation-return water. Potential sources of degradation include municipal sewage disposal, leachates from solid-waste disposal sites, and poor-quality connate water. High-priority items for future study include location of recharge areas, detection of seawater intrusion, and well-monitoring of landfill sites. (Woodard-USGS)

Pilot In Command: A Feasibility Assessment of Autonomous Flight Management Operations

NASA Technical Reports Server (NTRS)

Wing, David J.; Ballin, Mark G.; Krishnamurthy, Karthik

2004-01-01

Several years of NASA research have produced the air traffic management operational concept of Autonomous Flight Management with high potential for operational feasibility, significant system and user benefits, and safety. Among the chief potential benefits are demand-adaptive or scalable capacity, user flexibility and autonomy that may finally enable truly successful business strategies, and compatibility with current-day operations such that the implementation rate can be driven from within the user community. A concept summary of Autonomous Flight Management is provided, including a description of how these operations would integrate in shared airspace with existing ground-controlled flight operations. The mechanisms enabling the primary benefits are discussed, and key findings of a feasibility assessment of airborne autonomous operations are summarized. Concept characteristics that impact safety are presented, and the potential for initially implementing Autonomous Flight Management is discussed.

Cosmic bubble and domain wall instabilities III: the role of oscillons in three-dimensional bubble collisions

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

Bond, J. Richard; Braden, Jonathan; Mersini-Houghton, Laura, E-mail: bond@cita.utoronto.ca, E-mail: j.braden@ucl.ac.uk, E-mail: mersini@physics.unc.edu

2015-09-01

We study collisions between pairs of bubbles nucleated in an ambient false vacuum. For the first time, we include the effects of small initial (quantum) fluctuations around the instanton profiles describing the most likely initial bubble profile. Past studies of this problem neglect these fluctuations and work under the assumption that the collisions posess an exact SO(2,1) symmetry. We use three-dimensional lattice simulations to demonstrate that for double-well potentials, small initial perturbations to this symmetry can be amplified as the system evolves. Initially the amplification is well-described by linear perturbation theory around the SO(2,1) background, but the onset of strongmore » nonlinearities amongst the fluctuations quickly leads to a drastic breaking of the original SO(2,1) symmetry and the production of oscillons in the collision region. We explore several single-field models, and we find it is hard to both realize inflation inside of a bubble and produce oscillons in a collision. Finally, we extend our results to a simple two-field model. The additional freedom allowed by the second field allows us to construct viable inflationary models that allow oscillon production in collisions. The breaking of the SO(2,1) symmetry allows for a new class of observational signatures from bubble collisions that do not posess azimuthal symmetry, including the production of gravitational waves which cannot be supported by an SO(2,1) spacetime.« less

Testing and screening for chlamydia in general practice: a cross-sectional analysis.

PubMed

Thomson, Allison; Morgan, Simon; Henderson, Kim; Tapley, Amanda; Spike, Neil; Scott, John; van Driel, Mieke; Magin, Parker

2014-12-01

Chlamydia screening is widely advocated. General practice registrars are an important stage of clinical behaviour development. This study aimed to determine rates of, and factors associated with, registrars' chlamydia testing including asymptomatic screening. A cross-sectional analysis of data from Registrars Clinical Encounters in Training (ReCEnT), a cohort study of registrars' consultations. Registrars record details of 60 consecutive consultations in each GP-term of training. Outcome factors were chlamydia testing, asymptomatic screening and doctor-initiated screening. Testing occurred in 2.5% of 29,112 consultations (398 registrars) and in 5.8% of patients aged 15-25. Asymptomatic screening comprised 47.5% of chlamydia tests, and 55.6% of screening tests were doctor-initiated. Chlamydia testing was associated with female gender of doctor and patient, younger patient age, and patients new to doctor or practice. Asymptomatic screening was associated with practices where patients incur no fees, and in patients new to doctor or practice. Screening of female patients was more often doctor-initiated. GP registrars screen for chlamydia disproportionately in younger females and new patients. Our findings highlight potential opportunities to improve uptake of screening for chlamydia, including targeted education and training for registrars, campaigns targeting male patients, and addressing financial barriers to accessing screening services. © 2014 Public Health Association of Australia.

Different corticospinal control between discrete and rhythmic movement of the ankle.

PubMed

Goto, Yumeno; Jono, Yasutomo; Hatanaka, Ryota; Nomura, Yoshifumi; Tani, Keisuke; Chujo, Yuta; Hiraoka, Koichi

2014-01-01

We investigated differences in corticospinal and spinal control between discrete and rhythmic ankle movements. Motor evoked potentials (MEPs) in the tibialis anterior and soleus muscles and soleus H-reflex were elicited in the middle of the plantar flexion phase during discrete ankle movement or in the initial or later cycles of rhythmic ankle movement. The H-reflex was evoked at an intensity eliciting a small M-wave and MEPs were elicited at an intensity of 1.2 times the motor threshold of the soleus MEPs. Only trials in which background EMG level, ankle angle, and ankle velocity were similar among the movement conditions were included for data analysis. In addition, only trials with a similar M-wave were included for data analysis in the experiment evoking H-reflexes. Results showed that H reflex and MEP amplitudes in the soleus muscle during discrete movement were not significantly different from those during rhythmic movement. MEP amplitude in the tibialis anterior muscle during the later cycles of rhythmic movement was significantly larger than that during the initial cycle of the rhythmic movement or during discrete movement. Higher corticospinal excitability in the tibialis anterior muscle during the later cycles of rhythmic movement may reflect changes in corticospinal control from the initial cycle to the later cycles of rhythmic movement.

Different corticospinal control between discrete and rhythmic movement of the ankle

PubMed Central

Goto, Yumeno; Jono, Yasutomo; Hatanaka, Ryota; Nomura, Yoshifumi; Tani, Keisuke; Chujo, Yuta; Hiraoka, Koichi

2014-01-01

We investigated differences in corticospinal and spinal control between discrete and rhythmic ankle movements. Motor evoked potentials (MEPs) in the tibialis anterior and soleus muscles and soleus H-reflex were elicited in the middle of the plantar flexion phase during discrete ankle movement or in the initial or later cycles of rhythmic ankle movement. The H-reflex was evoked at an intensity eliciting a small M-wave and MEPs were elicited at an intensity of 1.2 times the motor threshold of the soleus MEPs. Only trials in which background EMG level, ankle angle, and ankle velocity were similar among the movement conditions were included for data analysis. In addition, only trials with a similar M-wave were included for data analysis in the experiment evoking H-reflexes. Results showed that H reflex and MEP amplitudes in the soleus muscle during discrete movement were not significantly different from those during rhythmic movement. MEP amplitude in the tibialis anterior muscle during the later cycles of rhythmic movement was significantly larger than that during the initial cycle of the rhythmic movement or during discrete movement. Higher corticospinal excitability in the tibialis anterior muscle during the later cycles of rhythmic movement may reflect changes in corticospinal control from the initial cycle to the later cycles of rhythmic movement. PMID:25126066

Financial incentives, quality improvement programs, and the adoption of clinical information technology.

PubMed

Robinson, James C; Casalino, Lawrence P; Gillies, Robin R; Rittenhouse, Diane R; Shortell, Stephen S; Fernandes-Taylor, Sara

2009-04-01

Physician use of clinical information technology (CIT) is important for the management of chronic illness, but has lagged behind expectations. We studied the role of health insurers' financial incentives (including pay-for-performance) and quality improvement initiatives in accelerating adoption of CIT in large physician practices. National survey of all medical groups and independent practice association (IPA) physician organizations with 20 or more physicians in the United States in 2006 to 2007. The response rate was 60.3%. Use of 19 CIT capabilities was measured. Multivariate statistical analysis of financial and organizational factors associated with adoption and use of CIT. Use of information technology varied across physician organizations, including electronic access to laboratory test results (medical groups, 49.3%; IPAs, 19.6%), alerts for potential drug interactions (medical groups, 33.9%; IPAs, 9.5%), electronic drug prescribing (medical groups, 41.9%; IPAs, 25.1%), and physician use of e-mail with patients (medical groups, 34.2%; IPAs, 29.1%). Adoption of CIT was stronger for physician organizations evaluated by external entities for pay-for-performance and public reporting purposes (P = 0.042) and for those participating in quality improvement initiatives (P < 0.001). External incentives and participation in quality improvement initiatives are associated with greater use of CIT by large physician practices.

Global teaching and training initiatives for emerging cohort studies

PubMed Central

Paulus, Jessica K.; Santoyo-Vistrain, Rocío; Havelick, David; Cohen, Amy; Kalyesubula, Robert; Ajayi, Ikeoluwapo O.; Mattsson, Jens G.; Adami, Hans-Olov; Dalal, Shona

2015-01-01

A striking disparity exists across the globe, with essentially no large-scale longitudinal studies ongoing in regions that will be significantly affected by the oncoming non-communicable disease epidemic. The successful implementation of cohort studies in most low-resource research environments presents unique challenges that may be aided by coordinated training programs. Leaders of emerging cohort studies attending the First World Cohort Integration Workshop were surveyed about training priorities, unmet needs and potential cross-cohort solutions to these barriers through an electronic pre-workshop questionnaire and focus groups. Cohort studies representing India, Mexico, Nigeria, South Africa, Sweden, Tanzania and Uganda described similar training needs, including on-the-job training, data analysis software instruction, and database and bio-bank management. A lack of funding and protected time for training activities were commonly identified constraints. Proposed solutions include a collaborative cross-cohort teaching platform with web-based content and interactive teaching methods for a range of research personnel. An international network for research mentorship and idea exchange, and modifying the graduate thesis structure were also identified as key initiatives. Cross-cohort integrated educational initiatives will efficiently meet shared needs, catalyze the development of emerging cohorts, speed closure of the global disparity in cohort research, and may fortify scientific capacity development in low-resource settings. PMID:23856451

Implementation of a clinical pharmacy specialist-managed telephonic hospital discharge follow-up program in a patient-centered medical home.

PubMed

Anderson, Sarah L; Marrs, Joel C; Vande Griend, Joseph P; Hanratty, Rebecca

2013-08-01

The objectives of this retrospective study were to examine the feasibility and characteristics that define successful implementation of a Clinical Pharmacy Specialist (CPS) telephonic hospital discharge follow-up quality improvement initiative, as well as the impact of this initiative. Adult patients who were discharged from a safety-net hospital between July 1, 2010 and June 30, 2011 and who were part of a patient-centered medical home were included in this quality improvement initiative. CPSs attempted to contact 470 patients; of those, 207 received the intervention and 263 did not. Patients in the contacted group were more likely to attend a hospital discharge follow-up appointment (66.2% vs. 44.5%, P<0.01) and had lower rates of 30-day readmission (22 vs. 52, P<0.01) compared to those who were not contacted. Institutions should consider allocating resources for pharmacist-managed posthospital discharge follow-up services because of the potential for positive clinical and financial impact.

OverView of Space Applications for Environment (SAFE) initiative

NASA Astrophysics Data System (ADS)

Hamamoto, Ko; Fukuda, Toru; Tajima, Yoshimitsu; Takeuchi, Wataru; Sobue, Shinichi; Nukui, Tomoyuki

2014-06-01

Climate change and human activities have a direc or indirect influence on the acceleration of environmental problems and natural hazards such as forest fires, draughts and floods in the Asia-Pacific countries. Satellite technology has become one of the key information sources in assessment, monitoring and mitigation of these disasters and related phenomenon. However, there are still gaps between science and application of satellite technology in real-world usage. Asia-Pacific Regional Space Agency Forum (APRSAF) recommended to initiate the Space Applications for Environment (SAFE) proposal providing opportunity to potential user agencies in the Asia Pacific region to develop prototype applications of satellite technology for number of key issues including forest resources management, coastal monitoring and management, agriculture and food security, water resource management and development user-friendly tools for application of satellite technology. This paper describes the overview of SAFE initiative and outcomes of two selected prototypes; agricultural drought monitoring in Indonesia and coastal management in Sri Lanka, as well as the current status of on-going prototypes.

Investigator initiated IBD trials in the US: Facts, obstacles and answers

PubMed Central

Herfarth, Hans H; Jackson, Susan; Schliebe, Barbara G.; Martin, Christopher; Ivanova, Anastasia; Anton, Kristen; Sandler, Robert S; Long, Millie D; Isaacs, Kim L; Osterman, Mark T; Sands, Bruce E; Higgins, Peter D; Lewis, James D

2016-01-01

Investigator initiated randomized clinical trials (IITs) are the backbone of academic clinical research. IITs complement the large clinical studies sponsored by industry and address questions, which are usually not the main focus of a commercially directed research but have the purpose to confirm, improve or refute clinically important questions with regard to diagnostic and therapeutic approaches in patient care. The aim of this review is to illustrate the necessary steps to start and complete an IIT in the field of inflammatory bowel diseases (IBD) in the US. The initial milestones for an investigator include structuring a protocol, planning and building of the trial infrastructure, accurately estimating the costs of the trial and gauging the time span for recruitment. Once the trial has begun it is important to keep patient recruitment on target, monitor of the data quality, and document treatment emergent adverse events. This article provides a framework for the different phases of an IIT and outlines potential hurdles, which could hinder a successful execution. PMID:27598744

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report.

PubMed

Soghaier, Mohammed A; Hagar, Ahmed; Abbas, Mohammed A; Elmangory, Mutasim M; Eltahir, Khalid M; Sall, Amadou A

2013-10-01

Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF), which is considered to be a very serious illness. Yellow Fever (YF) outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. The field investigation confirmed the outbreak and identified its cause to be YF. National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs) are usually very high among the index cases. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Using technology to enhance the quality of home health care: three case studies of health information technology initiatives at the visiting nurse service of New York.

PubMed

Russell, David; Rosenfeld, Peri; Ames, Sylvia; Rosati, Robert J

2010-01-01

There is a growing recognition among health services researchers and policy makers that Health Information Technology (HIT) has the potential to address challenging issues that face patients and providers of healthcare. The Visiting Nurse Service of New York (VNSNY), a large not-for-profit home healthcare agency, has integrated technology applications into the service delivery model of several programs. Case studies, including the development and implementation, of three informatics initiatives at VNSNY are presented on: (1) Quality Scorecards that utilize process, outcomes, cost, and satisfaction measures to assess performance among clinical staff and programs; (2) a tool to identify patients at risk of being hospitalized, and (3) a predictive model that identifies patients who are eligible for physical rehabilitation services. Following a description of these initiatives, we discuss their impact on quality and process indicators, as well as the opportunities and challenges to implementation. © 2010 National Association for Healthcare Quality.

Clinical pathways for acute coronary syndromes in China: protocol for a hospital quality improvement initiative.

PubMed

Rong, Ye; Turnbull, Fiona; Patel, Anushka; Du, Xin; Wu, Yangfeng; Gao, Runlin

2010-09-01

Clinical pathways have been shown to be effective in improving quality of care for patients admitted to hospital for acute coronary syndromes (ACS) in high-income countries. However, their utility has not formally been evaluated in low- or middle-income countries. The Clinical Pathways for Acute Coronary Syndromes in China program is a 7-year study with the overall goal of reducing evidence-practice gaps in the management of patients admitted to hospitals in China with suspected ACS. The program comprises 2 phases: a prospective survey of current management of ACS patients to identify the areas that evidence-based patient care can be potentially improved, and a quality care initiative to maximize the use of evidence-based investigations and treatments for ACS patients in China. In this article, we outline the details of the study protocol, including key aspects of the development, implementation, and evaluation of the quality improvement initiative (clinical pathway) for management of patients with suspected ACS.

Self-Consistent Model of Magnetospheric Electric Field, Ring Current, Plasmasphere, and Electromagnetic Ion Cyclotron Waves: Initial Results

NASA Technical Reports Server (NTRS)

Gamayunov, K. V.; Khazanov, G. V.; Liemohn, M. W.; Fok, M.-C.; Ridley, A. J.

2009-01-01

Further development of our self-consistent model of interacting ring current (RC) ions and electromagnetic ion cyclotron (EMIC) waves is presented. This model incorporates large scale magnetosphere-ionosphere coupling and treats self-consistently not only EMIC waves and RC ions, but also the magnetospheric electric field, RC, and plasmasphere. Initial simulations indicate that the region beyond geostationary orbit should be included in the simulation of the magnetosphere-ionosphere coupling. Additionally, a self-consistent description, based on first principles, of the ionospheric conductance is required. These initial simulations further show that in order to model the EMIC wave distribution and wave spectral properties accurately, the plasmasphere should also be simulated self-consistently, since its fine structure requires as much care as that of the RC. Finally, an effect of the finite time needed to reestablish a new potential pattern throughout the ionosphere and to communicate between the ionosphere and the equatorial magnetosphere cannot be ignored.

Opportunities for Woman-Initiated HIV Prevention Methods among Female Sex Workers in Southern China

PubMed Central

Weeks, Margaret R.; Liao, Susu; Abbott, Maryann; He, Bin; Zhou, Yuejiang; Jiang, Jingmei; Wei, Liu; Yu, Wang

2010-01-01

Rapid changes in China over the past two decades have led to significant problems associated with population migration and changing social attitudes, including a growing sex industry and concurrent increases in STIs and HIV. This article reports results of an exploratory study of microbicide acceptability and readiness and current HIV prevention efforts among female sex workers in two rural and one urban town in Hainan and Guangxi Provinces in southern China. The study focused on these women’s knowledge and cultural understandings of options for protecting themselves from exposure to STIs and HIV, and the potential viability and acceptability of woman-initiated prevention methods. We report on ethnographic elicitation interviews conducted with women working within informal sex-work establishments (hotels, massage and beauty parlors, roadside restaurants, boarding houses). We discuss implications of these findings for further promotion of woman-initiated prevention methods such as microbicides and female condoms among female sex workers in China. PMID:17599276

PMCA2 silencing potentiates MDA-MB-231 breast cancer cell death initiated with the Bcl-2 inhibitor ABT-263.

PubMed

Curry, Merril; Roberts-Thomson, Sarah J; Monteith, Gregory R

2016-09-30

PMCA2 overexpression in some breast cancers suggests that this calcium pump isoform may play a role in breast pathophysiology. To investigate PMCA2 as a potential drug target for breast cancer therapy, we assessed the functional consequence of PMCA2 silencing on cell death pathways and calcium signals in the basal-like MDA-MB-231 breast cancer cell line. Silencing PMCA2 expression alone has no effect on MDA-MB-231 cell viability, however, PMCA2 silencing promotes calcium-induced cell death initiated with the calcium ionophore ionomycin. Assessment of cytoplasmic calcium responses generated with various agents including ionomycin demonstrates that in MDA-MB-231 cells, PMCA2 does not play a major role in shaping global calcium signals. We also examined the ability of PMCA2 silencing to modulate caspase-dependent cell death triggered by a Bcl-2 inhibitor that is in clinical development for the treatment of various cancers, ABT-263 (Navitoclax). Despite the lack of effect on global calcium responses, PMCA2 silencing augmented Bcl-2 inhibitor (ABT-263)-mediated MDA-MB-231 breast cancer cell death. These studies provide evidence that PMCA2 inhibitors could sensitize PMCA2-positive breast cancers to cell death initiators that work through mechanisms involving the Bcl-2 survival pathway. Copyright © 2016 Elsevier Inc. All rights reserved.

Large Igneous Provinces, Sulfur Aerosols, and Initiation of Snowball Earth

NASA Astrophysics Data System (ADS)

Macdonald, F. A.; Wordsworth, R. D.

2015-12-01

The events that led to the initiation of Snowball Earth remain poorly understood. Proposed scenarios include a methane addiction, a biological innovation that led to an increase in organic carbon burial and anaerobic remineralization, or an increase in global weatherability due to a paleogeography with a preponderance of low latitude continents, and the subareal implacement of large igneous provinces (LIPs) at the equator. The Franklin LIP was emplaced between 730 and 710 Ma and covers an area of over 2.25 Mkm2 with lavas, sills, and dikes extending over much of northern Laurentia from Alaska through northern Canada to Greenland and potentially to Siberia. The most precise geochronological constraints on the Franklin LIP overlap with the onset of the Sturtian Snowball Earth glaciation, which began between 717 and 716 Ma and marked the first glaciation in over 1 billion years. The Franklin LIP is the largest preserved Neoproterozoic LIP and one of the largest in Earth History. Additionally, it was emplaced at equatorial latitudes with associated sills that invaded epicontinental sulfur evaporite basins, potentially maximizing environmental effects. Here we explore the hypothesis that the Sturtian Snowball Earth was initiated in part by an increase in planetary albedo from the conversion of volcanic SO2/H2S emissions to tropospheric and stratospheric sulfate aerosols through a combination of geochemical and modeling studies.

Increasing the health promotion practices of workplaces in Australia with a proactive telephone-based intervention.

PubMed

Daly, Justine; Licata, Milly; Gillham, Karen; Wiggers, John

2005-01-01

The aim of this study was to explore the potential effectiveness of a proactive telephone-based intervention in increasing workplace adoption of health promotion initiatives. A telephone-based direct marketing strategy was used to contact a sample of Australian workplaces to encourage the adoption of health promotion initiatives. Workplaces were offered free services and resources designed to facilitate adoption of health promotion initiatives. A total of 227 (71%) workplaces provided informed consent to participate in both baseline and 4-year follow-up surveys. Significant increases were evident for seven of the eight health promotion initiatives. The findings of this study suggest that a proactive telephone-based intervention has the potential to be effective in increasing the prevalence of health promotion initiatives across a range of health topics in a large population of workplaces. Given the capacity to reach an entire population of workplaces, this approach represents a promising means of achieving the established potential of workplace health promotion.

Wireless technologies and accessibility for people with disabilities: findings from a policy research instrument.

PubMed

Baker, Paul M A; Moon, Nathan W

2008-01-01

The near universal deployment in the United States of a wide variety of information and communications technologies, both wired and wireless, creates potential barriers to use for several key populations, including the poor, people with disabilities, and the aging. Equal access to wireless technologies and services can be achieved through a variety of mechanisms, including legislation and regulations, market-based solutions, and awareness and outreach-based approaches. This article discusses the results of policy research conducted by the Rehabilitation Engineering Research Center on Wireless Technologies (Wireless RERC) using policy Delphi polling methodology to probe stakeholders' opinions on key access barrier issues and to explore potential policy responses. Participants included disability advocates, disability/wireless technology policy makers, and product developers/manufacturers. Respondent input informed subsequent development of potential policy initiatives to increase access to these technologies. The findings from the Delphi suggest that awareness issues remain most important, especially manufacturer awareness of user needs and availability of consumer information for selecting the most appropriate wireless devices and services. Other key issues included the ability of people with disabilities to afford technologies and inadequacies in legislation and policy making for ensuring their general accessibility, as well as usefulness in emergencies. Technical issues, including interoperability, speech-to-text conversion, and hearing aid compatibility, were also identified by participating stakeholders as important. To address all these issues, Delphi respondents favored goals and options congruent with voluntary market-driven solutions where possible but also supported federal involvement, where necessary, to aid this process.

Is Cognitive Rehabilitation Needed in Verbal Adults with Autism? Insights From Initial Enrollment in a Trial of Cognitive Enhancement Therapy

PubMed Central

Eack, Shaun M.; Bahorik, Amber L.; Hogarty, Susan S.; Greenwald, Deborah P.; Litschge, Maralee Y.; Mazefsky, Carla A.; Minshew, Nancy J.

2013-01-01

Cognitive rehabilitation is an emerging set of potentially effective interventions for the treatment of autism spectrum disorder, yet the applicability of these approaches for “high functioning” adults who have normative levels of intelligence remains unexplored. This study examined the initial cognitive performance characteristics of 40 verbal adults with autism enrolled in a pilot trial of Cognitive Enhancement Therapy to investigate the need for cognitive rehabilitation in this population. Results revealed marked and broad deficits across neurocognitive and social-cognitive domains, despite above-average IQ. Areas of greatest impairment included processing speed, cognitive flexibility, and emotion perception and management. These findings indicate the need for comprehensive interventions designed to enhance cognition among verbal adults with autism who have intact intellectual functioning. PMID:23381484

Primary brain tumors, neural stem cell, and brain tumor cancer cells: where is the link?

PubMed Central

Germano, Isabelle; Swiss, Victoria; Casaccia, Patrizia

2010-01-01

The discovery of brain tumor-derived cells (BTSC) with the properties of stem cells has led to the formulation of the hypothesis that neural stem cells could be the cell of origin of primary brain tumors (PBT). In this review we present the most common molecular changes in PBT, define the criteria of identification of BTSC and discuss the similarities between the characteristics of these cells and those of the endogenous population of neural stem cells (NPCs) residing in germinal areas of the adult brain. Finally, we propose possible mechanisms of cancer initiation and progression and suggest a model of tumor initiation that includes intrinsic changes of resident NSC and potential changes in the microenvironment defining the niche where the NSC reside. PMID:20045420

The OH-initiated atmospheric oxidation of divinyl sulfoxide: A theoretical investigation on the reaction mechanism

NASA Astrophysics Data System (ADS)

Zhang, Weichao; Zhang, Dongju

2012-08-01

The potential energy surfaces for the OH + divinyl sulfoxide reaction in the presence of O2/NO are theoretically characterized at the CCSD(T)/6-311+G(d,p)//BH&HLYP/6-311++G(d,p)+ZPE level of theory. Various possible pathways including the direct hydrogen abstraction channels and the addition-elimination channels are considered. The calculations show that the exclusive feasible entrance channel is the formation of adduct CH2(OH)CHS(O)CHdbnd CH2 (IM1) in the initial reaction pathways. In the atmosphere, the newly formed adduct IM1 can further react with O2/NO to form the dominant products HCHO + C(O)HS(O)CHdbnd CH2 (P9). The calculated results confirm the experimental studies.

Experimental investigation of an axisymmetric free jet with an initially uniform velocity profile

NASA Technical Reports Server (NTRS)

Labus, T. L.; Symons, E. P.

1972-01-01

An experimental investigation was conducted to determine the flow characteristics of a circular free helium jet having an initially uniform velocity profile. Complete velocity profiles are presented at Reynolds numbers of 1027 and 4571 at 0, 3, 6, 10, 15, and 20 nozzle diameters (where possible) from the nozzle exit. Centerline velocity decay and potential core length were obtained over a range of Reynolds numbers from 155 to 5349 at distances up to and including 25 nozzle diameters from the nozzle exit. The angles of spread associated with the diffusion of the jet downstream of the nozzle are also given. Axial jet momentum flux and entrained mass flux, at various distances downstream of the nozzle, are presented as a function of the jet Reynolds number.

Physics perspectives of heavy-ion collisions at very high energy

DOE PAGES

Chang, Ning-bo; Cao, ShanShan; Chen, Bao-yi; ...

2016-01-15

We expect heavy-ion collisions at very high colliding energies to produce a quark-gluon plasma (QGP) at the highest temperature obtainable in a laboratory setting. Experimental studies of these reactions can provide an unprecedented range of information on properties of the QGP at high temperatures. We also report theoretical investigations of the physics perspectives of heavy-ion collisions at a future high-energy collider. These include initial parton production, collective expansion of the dense medium, jet quenching, heavy-quark transport, dissociation and regeneration of quarkonia, photon and dilepton production. Here, we illustrate the potential of future experimental studies of the initial particle production andmore » formation of QGP at the highest temperature to provide constraints on properties of strongly interaction matter.« less

Benefits of slush hydrogen for space missions

NASA Technical Reports Server (NTRS)

Friedlander, Alan; Zubrin, Robert; Hardy, Terry L.

1991-01-01

A study was performed to quantify the benefits of using slush hydrogen instead of normal boiling point liquid hydrogen as a fuel for several space missions. Vehicles considered in the study included the Space Shuttle/Shuttle-C, LEO to GEO transfer vehicles, Lunar and Mars transfer vehicles, and cryogenic depots in low Earth orbit. The advantages of using slush hydrogen were expressed in terms of initial mass differences at a constant payload, payload differences at a constant tank volume, and increases in fuel storage time for cryogenic depots. Both chemical oxygen/hydrogen and hydrogen nuclear thermal rocket propulsion were considered in the study. The results indicated that slush hydrogen offers the potential for significant decreases in initial mass and increases in payload for most missions studied. These advantages increase as the mission difficulty, or energy, increases.

The SWAN Scientific Discourse Ontology

PubMed Central

Ciccarese, Paolo; Wu, Elizabeth; Kinoshita, June; Wong, Gwendolyn T.; Ocana, Marco; Ruttenberg, Alan

2015-01-01

SWAN (Semantic Web Application in Neuromedicine) is a project to construct a semantically-organized, community-curated, distributed knowledge base of Theory, Evidence, and Discussion in biomedicine. Unlike Wikipedia and similar approaches, SWAN’s ontology is designed to represent and foreground both harmonizing and contradictory assertions within the total community discourse. Releases of the software, content and ontology will be initially by and for the Alzheimer Disease (AD) research community, with the obvious potential for extension into other disease research areas. The Alzheimer Research Forum, a 4,000-member web community for AD researchers, will host SWAN’s initial public release, currently scheduled for late 2007. This paper presents the current version of SWAN’s ontology of scientific discourse and presents our current thinking about its evolution including extensions and alignment with related communities, projects and ontologies. PMID:18583197

Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes

PubMed Central

Norman, Jessica L; Fixen, Danielle R; Saseen, Joseph J; Saba, Laura M; Linnebur, Sunny A

2017-01-01

Background: Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release) or 6.25 mg (controlled release) per night in women. Objectives: The primary objective of this study was to compare prescribing practices before and after the 2013 zolpidem labeling change. A secondary objective was to evaluate serious adverse events potentially related to zolpidem. Methods: Electronic medical records of adults receiving care through the University of Colorado Health system were accessed for study inclusion if patients were provided a first-time prescription for zolpidem either prior to or after the Food and Drug Administration labeling change. Patients were randomly chosen from eight strata based on age, gender, and date of zolpidem initiation (before/after the labeling change). Demographic and zolpidem prescribing data were collected. Low-dose zolpidem was considered 5 mg (immediate release) or 6.25 mg (controlled release) daily or less. Documentation of potentially related serious adverse events within the patients’ records was also evaluated. Results: A total of 400 patients were included in the study. The overall percentage of patients prescribed low-dose zolpidem increased from 44% to 58% after the labeling change (p = 0.0020). In a pre-specified subgroup analysis, the percentage of patients prescribed low-dose zolpidem increased in all groups, including young men (38%–50%, p = 0.23), elderly men (34%–40%, p = 0.53), and elderly women (60%–74%, p = 0.14), but the change was only significant in young women (42%–70%, p = 0.0045). Conclusion: After Food and Drug Administration–mandated labeling changes for zolpidem in 2013, the percentage of overall patients in our health system, and specifically young women, with initial prescriptions for low-dose zolpidem significantly increased as compared to before the labeling change. PMID:28515934

Comparison of Uncultured Marrow Mononuclear Cells and Culture-Expanded Mesenchymal Stem Cells in 3D Collagen-Chitosan Microbeads for Orthopedic Tissue Engineering

PubMed Central

Wise, Joel K.; Alford, Andrea I.; Goldstein, Steven A.

2014-01-01

Stem cell-based therapies have shown promise in enhancing repair of bone and cartilage. Marrow-derived mesenchymal stem cells (MSC) are typically expanded in vitro to increase cell number, but this process is lengthy, costly, and there is a risk of contamination and altered cellular properties. Potential advantages of using fresh uncultured bone marrow mononuclear cells (BMMC) include heterotypic cell and paracrine interactions between MSC and other marrow-derived cells including hematopoietic, endothelial, and other progenitor cells. In the present study, we compared the osteogenic and chondrogenic potential of freshly isolated BMMC to that of cultured-expanded MSC, when encapsulated in three-dimensional (3D) collagen-chitosan microbeads. The effect of low and high oxygen tension on cell function and differentiation into orthopedic lineages was also examined. Freshly isolated rat BMMC (25×106 cells/mL, containing an estimated 5×104 MSC/mL) or purified and culture-expanded rat bone marrow-derived MSC (2×105 cells/mL) were added to a 65–35 wt% collagen-chitosan hydrogel mixture and fabricated into 3D microbeads by emulsification and thermal gelation. Microbeads were cultured in control MSC growth media in either 20% O2 (normoxia) or 5% O2 (hypoxia) for an initial 3 days, and then in control, osteogenic, or chondrogenic media for an additional 21 days. Microbead preparations were evaluated for viability, total DNA content, calcium deposition, and osteocalcin and sulfated glycosaminoglycan expression, and they were examined histologically. Hypoxia enhanced initial progenitor cell survival in fresh BMMC-microbeads, but it did not enhance osteogenic potential. Fresh uncultured BMMC-microbeads showed a similar degree of osteogenesis as culture-expanded MSC-microbeads, even though they initially contained only 1/10th the number of MSC. Chondrogenic differentiation was not strongly supported in any of the microbead formulations. This study demonstrates the microbead-based approach to culturing and delivering cells for tissue regeneration, and suggests that fresh BMMC may be an alternative to using culture-expanded MSC for bone tissue engineering. PMID:23879621

Comparison of uncultured marrow mononuclear cells and culture-expanded mesenchymal stem cells in 3D collagen-chitosan microbeads for orthopedic tissue engineering.

PubMed

Wise, Joel K; Alford, Andrea I; Goldstein, Steven A; Stegemann, Jan P

2014-01-01

Stem cell-based therapies have shown promise in enhancing repair of bone and cartilage. Marrow-derived mesenchymal stem cells (MSC) are typically expanded in vitro to increase cell number, but this process is lengthy, costly, and there is a risk of contamination and altered cellular properties. Potential advantages of using fresh uncultured bone marrow mononuclear cells (BMMC) include heterotypic cell and paracrine interactions between MSC and other marrow-derived cells including hematopoietic, endothelial, and other progenitor cells. In the present study, we compared the osteogenic and chondrogenic potential of freshly isolated BMMC to that of cultured-expanded MSC, when encapsulated in three-dimensional (3D) collagen-chitosan microbeads. The effect of low and high oxygen tension on cell function and differentiation into orthopedic lineages was also examined. Freshly isolated rat BMMC (25 × 10(6) cells/mL, containing an estimated 5 × 10(4) MSC/mL) or purified and culture-expanded rat bone marrow-derived MSC (2 × 10(5) cells/mL) were added to a 65-35 wt% collagen-chitosan hydrogel mixture and fabricated into 3D microbeads by emulsification and thermal gelation. Microbeads were cultured in control MSC growth media in either 20% O2 (normoxia) or 5% O2 (hypoxia) for an initial 3 days, and then in control, osteogenic, or chondrogenic media for an additional 21 days. Microbead preparations were evaluated for viability, total DNA content, calcium deposition, and osteocalcin and sulfated glycosaminoglycan expression, and they were examined histologically. Hypoxia enhanced initial progenitor cell survival in fresh BMMC-microbeads, but it did not enhance osteogenic potential. Fresh uncultured BMMC-microbeads showed a similar degree of osteogenesis as culture-expanded MSC-microbeads, even though they initially contained only 1/10th the number of MSC. Chondrogenic differentiation was not strongly supported in any of the microbead formulations. This study demonstrates the microbead-based approach to culturing and delivering cells for tissue regeneration, and suggests that fresh BMMC may be an alternative to using culture-expanded MSC for bone tissue engineering.

Initial metformin or sulphonylurea exposure and cancer occurrence among patients with type 2 diabetes mellitus.

PubMed

Qiu, H; Rhoads, G G; Berlin, J A; Marcella, S W; Demissie, K

2013-04-01

This was a retrospective cohort study of type 2 diabetes patients, to evaluate the association between initial metformin or sulphonylurea treatment and cancer incidence. Patients identified in the UK Clinical Practice Research Datalink (CPRD), previously General Practice Research Database, during 1995-2008 who were initially stabilized on OHA monotherapy, including metformin, sulphonylurea, thiazolidinediones (TZDs) or meglitinides, were included in the cohort. New diagnoses of cancer, including malignant solid tumours and haematological malignancies, occurring during the follow-up were identified from the cohort. Age-standardized incidence rates were estimated and compared between metformin and sulphonylurea exposure groups. The age standardized incidences of cancer were 7.5 and 8.5 per 1000 person-years for the metformin and sulphonylurea exposure groups, respectively. After adjusting for potential confounders, the hazard ratios (HR) for malignant solid tumours and haematological malignancies were 1.06 (95% CI: 0.98, 1.15) and 0.98 (95% CI: 0.67, 1.43) for sulphonylurea group as compared to the metformin group, respectively. For individual cancers, the HRs were 1.17 (95% CI: 0.95, 1.44), 1.04 (95% CI: 0.83, 1.31) and 0.88 (95% CI: 0.71, 1.11) for colorectal cancer, breast cancer and prostate cancer, respectively. This study provides evidence that cancer incidence in the first few years after starting metformin or sulphonylurea therapy in type 2 diabetes patients is not much affected by choice of hypoglycaemic drug class. © 2012 Blackwell Publishing Ltd.

Initial study of Schroedinger eigenmaps for spectral target detection

NASA Astrophysics Data System (ADS)

Dorado-Munoz, Leidy P.; Messinger, David W.

2016-08-01

Spectral target detection refers to the process of searching for a specific material with a known spectrum over a large area containing materials with different spectral signatures. Traditional target detection methods in hyperspectral imagery (HSI) require assuming the data fit some statistical or geometric models and based on the model, to estimate parameters for defining a hypothesis test, where one class (i.e., target class) is chosen over the other classes (i.e., background class). Nonlinear manifold learning methods such as Laplacian eigenmaps (LE) have extensively shown their potential use in HSI processing, specifically in classification or segmentation. Recently, Schroedinger eigenmaps (SE), which is built upon LE, has been introduced as a semisupervised classification method. In SE, the former Laplacian operator is replaced by the Schroedinger operator. The Schroedinger operator includes by definition, a potential term V that steers the transformation in certain directions improving the separability between classes. In this regard, we propose a methodology for target detection that is not based on the traditional schemes and that does not need the estimation of statistical or geometric parameters. This method is based on SE, where the potential term V is taken into consideration to include the prior knowledge about the target class and use it to steer the transformation in directions where the target location in the new space is known and the separability between target and background is augmented. An initial study of how SE can be used in a target detection scheme for HSI is shown here. In-scene pixel and spectral signature detection approaches are presented. The HSI data used comprise various target panels for testing simultaneous detection of multiple objects with different complexities.

Transparency and translation of science in a modern world.

PubMed

Grandjean, Philippe; Ozonoff, David

2013-08-27

The co-Editors-in-Chief of Environmental Health respond to an unusual initiative taken by editors of 14 toxicology journals to influence pending decisions by the European Commission to establish a framework for regulating chemicals that pose a hazard to normal function of the endocrine system. This initiative is also the subject of this Commentary in this journal by authors who recently reviewed the subject and who point out inaccuracies in the toxicology editors' critique. The dispute is about potential public policy development, rather than on science translation and research opportunities and priorities. The toxicology journal editors recommend that chemicals be examined in depth one by one, ignoring modern achievements in biomedical research that would allow new understanding of the effects of classes of toxic substances in complex biological systems. Concerns about policy positions framed as scientific ones are especially important in a time with shrinking public support for biomedical research affects priorities. In such a setting, conflict of interest declarations are important, especially in research publications that address issues of public concern and where financial and other interests may play a role. Science relies on trust, and reasonable disclosure of financial or other potential conflicts is therefore essential. This need has been emphasized by recent discoveries of hidden financial conflicts in publications in toxicology journals, thus misleading readers and the public about the safety of particular industrial products. The transparency provided by Environmental Health includes open access and open peer review, with reader access to reviews, including the identity of reviewers and their statements on possible conflicts of interest. However, the editors of the 14 toxicology journals did not provide any information on potential conflicts of interest, an oversight that needs to be corrected.

Morphological Characterization of the Action Potential Initiation Segment in GnRH Neuron Dendrites and Axons of Male Mice.

PubMed

Herde, Michel K; Herbison, Allan E

2015-11-01

GnRH neurons are the final output neurons of the hypothalamic network controlling fertility in mammals. In the present study, we used ankyrin G immunohistochemistry and neurobiotin filling of live GnRH neurons in brain slices from GnRH-green fluorescent protein transgenic male mice to examine in detail the location of action potential initiation in GnRH neurons with somata residing at different locations in the basal forebrain. We found that the vast majority of GnRH neurons are bipolar in morphology, elaborating a thick (primary) and thinner (secondary) dendrite from opposite poles of the soma. In addition, an axon-like process arising predominantly from a proximal dendrite was observed in a subpopulation of GnRH neurons. Ankyrin G immunohistochemistry revealed the presence of a single action potential initiation zone ∼27 μm in length primarily in the secondary dendrite of GnRH neurons and located 30 to 140 μm distant from the cell soma, depending on the type of process and location of the cell body. In addition to dendrites, the GnRH neurons with cell bodies located close to hypothalamic circumventricular organs often elaborated ankyrin G-positive axon-like structures. Almost all GnRH neurons (>90%) had their action potential initiation site in a process that initially, or ultimately after a hairpin loop, was coursing in the direction of the median eminence. These studies indicate that action potentials are initiated in different dendritic and axonal compartments of the GnRH neuron in a manner that is dependent partly on the neuroanatomical location of the cell body.

Vision training methods for sports concussion mitigation and management.

PubMed

Clark, Joseph F; Colosimo, Angelo; Ellis, James K; Mangine, Robert; Bixenmann, Benjamin; Hasselfeld, Kimberly; Graman, Patricia; Elgendy, Hagar; Myer, Gregory; Divine, Jon

2015-05-05

There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool and potentially as a supportive component to concussion prevention strategies. This paper is focused on providing detailed methods for select vision training tools and reporting normative data for comparison when vision training is a part of a sports management program. The overall program includes standard vision training methods including tachistoscope, Brock's string, and strobe glasses, as well as specialized light board training algorithms. Stereopsis is measured as a means to monitor vision training affects. In addition, quantitative results for vision training methods as well as baseline and post-testing *A and Reaction Test measures with progressive scores are reported. Collegiate athletes consistently improve after six weeks of training in their stereopsis, *A and Reaction Test scores. When vision training is initiated as a team wide exercise, the incidence of concussion decreases in players who participate in training compared to players who do not receive the vision training. Vision training produces functional and performance changes that, when monitored, can be used to assess the success of the vision training and can be initiated as part of a sports medical intervention for concussion prevention.

Holmium laser use in debridement of stable labral lesions: two-year experience in initial 50 patients

NASA Astrophysics Data System (ADS)

Dew, Douglas K.; Risch, E. David

1994-09-01

The purpose of this study is to determine the laser related complication rate for shoulder arthroscopy in the initial clinical experience of 50 patients, and to identify potential advantages of laser use in shoulder arthroscopy. Fifty patients spanning ages 25 to 87 were treated. Surgical debridement was selective and conservative creating a smooth post resection rim. In those that included rotator cuff tears, in addition to arthroscopic debridement, a mini arthrotomy and open acromioplasty were performed. Changes in arthroscopic technique due to laser use included no arthroscopic pump use and use of the shaver only when the fiber could not be easily seen with severe synovitis. We found that the hyper-vascular synovium did not need to be resected last, it could be resected at any point during the procedure. Four hundred and 600 micron fiberoptics were used as well as 20 watts average power. Technical advantage of the laser was felt to be the size of the instrument probe and the availability of excellent hemostasis. Complications include one case of arthroscope damage and one case with a broken fiber tip which was removed with a grasper. Long term follow up of these patients is now underway.

Using Lidar and Radar measurements to constrain predictions of forest ecosystem structure and function.

PubMed

Antonarakis, Alexander S; Saatchi, Sassan S; Chazdon, Robin L; Moorcroft, Paul R

2011-06-01

Insights into vegetation and aboveground biomass dynamics within terrestrial ecosystems have come almost exclusively from ground-based forest inventories that are limited in their spatial extent. Lidar and synthetic-aperture Radar are promising remote-sensing-based techniques for obtaining comprehensive measurements of forest structure at regional to global scales. In this study we investigate how Lidar-derived forest heights and Radar-derived aboveground biomass can be used to constrain the dynamics of the ED2 terrestrial biosphere model. Four-year simulations initialized with Lidar and Radar structure variables were compared against simulations initialized from forest-inventory data and output from a long-term potential-vegtation simulation. Both height and biomass initializations from Lidar and Radar measurements significantly improved the representation of forest structure within the model, eliminating the bias of too many large trees that arose in the potential-vegtation-initialized simulation. The Lidar and Radar initializations decreased the proportion of larger trees estimated by the potential vegetation by approximately 20-30%, matching the forest inventory. This resulted in improved predictions of ecosystem-scale carbon fluxes and structural dynamics compared to predictions from the potential-vegtation simulation. The Radar initialization produced biomass values that were 75% closer to the forest inventory, with Lidar initializations producing canopy height values closest to the forest inventory. Net primary production values for the Radar and Lidar initializations were around 6-8% closer to the forest inventory. Correcting the Lidar and Radar initializations for forest composition resulted in improved biomass and basal-area dynamics as well as leaf-area index. Correcting the Lidar and Radar initializations for forest composition and fine-scale structure by combining the remote-sensing measurements with ground-based inventory data further improved predictions, suggesting that further improvements of structural and carbon-flux metrics will also depend on obtaining reliable estimates of forest composition and accurate representation of the fine-scale vertical and horizontal structure of plant canopies.

Speed of CMEs and the Magnetic Non-Potentiality of their Source Active Regions

NASA Technical Reports Server (NTRS)

Tiwari, Sanjiv Kumar; Falconer, David Allen; Moore, Ronald L.; Venkatakrishnan, P.; Winebarger, Amy R.; Khazanov, Igor G.

2014-01-01

Most fast coronal mass ejections (CMEs) originate from solar active regions (ARs). Non-potentiality of ARs plausibly determines the speed of CMEs in the outer corona. Several other unexplored parameters might be important as well. To find out the relation between the intial speed of CMEs and the non-potentiality of source ARs, we identified over a hundred of CMEs with source ARs via their co-produced flares. The speed of the CMEs are collected from the SOHO LASCO CME catalog. We have used vector magnetograms obtained with HMI/SDO, to evaluate various magnetic non-potentiality parameters, e.g. magnetic free-energy proxies, twist, shear angle, signed shear angle, net current etc. We have also included several other parameters e.g. total unsigned flux, magnetic area of ARs, area of sunspots, to investigate their correlation, if any, with the initial speeds of CMEs. Our preliminary results show that the ARs with larger non-potentiality and area produce faster CMEs but they can also produce slow ones. The ARs with lesser non-potentiality and area generally produce only slower CMEs.

Adaptive Treatment Strategies in Youth Mental Health: A Commentary on Advantages, Challenges, and Potential Directions.

PubMed

Sherrill, Joel T

2016-01-01

This commentary underscores the importance and potential of the research approaches and intervention strategies described in the JCCAP special issue on the Science of Adaptive Treatment Strategies in Child and Adolescent Mental Health for addressing the widely observed heterogeneity in response to even our most promising research-informed interventions. First, the commentary briefly summarizes the advantages of these approaches and highlights how these programs of research are responsive to widely agreed-upon calls for more personalized, prescriptive interventions. Next, the commentary briefly discusses key common challenges and gaps in our knowledge that might be addressed to advance the development, testing, and implementation of adaptive intervention strategies. For example, research to identify robust moderators that might serve as potential tailoring variables for initial assignment and sequencing of interventions, efforts to operationalize surrogate endpoints for early identification of individuals who are unlikely to respond to first-line interventions, and research that helps define what constitutes an adequate exposure (i.e., dose) or response threshold (e.g., response that suggests the need to intensify, switch, or augment interventions) would inform decision rules for adaptive algorithms. The commentary concludes with a discussion of potential strategies and current initiatives that might ultimately help facilitate research on more targeted, prescriptive approaches to intervening, including efforts to encourage investigators to use common data elements, to share and integrate data across trials, and to employ a more mechanism-based approach to intervention development and testing.

Role of HIV Infection Duration and CD4 Cell Level at Initiation of Combination Anti-Retroviral Therapy on Risk of Failure

PubMed Central

Lodi, Sara; Phillips, Andrew; Fidler, Sarah; Hawkins, David; Gilson, Richard; McLean, Ken; Fisher, Martin; Post, Frank; Johnson, Anne M.; Walker-Nthenda, Louise; Dunn, David; Porter, Kholoud

2013-01-01

Background The development of HIV drug resistance and subsequent virological failure are often cited as potential disadvantages of early cART initiation. However, their long-term probability is not known, and neither is the role of duration of infection at the time of initiation. Methods Patients enrolled in the UK Register of HIV seroconverters were followed-up from cART initiation to last HIV-RNA measurement. Through survival analysis we examined predictors of virologic failure (2HIV-RNA ≥400 c/l while on cART) including CD4 count and HIV duration at initiation. We also estimated the cumulative probabilities of failure and drug resistance (from the available HIV nucleotide sequences) for early initiators (cART within 12 months of seroconversion). Results Of 1075 starting cART at a median (IQR) CD4 count 272 (190,370) cells/mm3 and HIV duration 3 (1,6) years, virological failure occurred in 163 (15%). Higher CD4 count at initiation, but not HIV infection duration at cART initiation, was independently associated with lower risk of failure (p=0.033 and 0.592 respectively). Among 230 patients initiating cART early, 97 (42%) discontinued it after a median of 7 months; cumulative probabilities of resistance and failure by 8 years were 7% (95% CI 4,11) and 19% (13,25), respectively. Conclusion Although the rate of discontinuation of early cART in our cohort was high, the long-term rate of virological failure was low. Our data do not support early cART initiation being associated with increased risk of failure and drug resistance. PMID:24086588

Barriers and enablers to a physician-delivered educational initiative to reduce low-acuity visits to the pediatric emergency department.

PubMed

Huyer, Gregory; Chreim, Samia; Michalowski, Wojtek; Farion, Ken J

2018-01-01

Use of the pediatric emergency department (PED) for low-acuity health issues is a growing problem, contributing to overcrowding, longer waits and higher health system costs. This study examines an educational initiative aimed at reducing low-acuity PED visits. The initiative, implemented at an academic pediatric hospital, saw PED physicians share a pamphlet with caregivers to educate them about appropriate PED use and alternatives. Despite early impacts, the initiative was not sustained. This study analyzes the barriers and enablers to physician participation in the initiative, and offers strategies to improve implementation and sustainability of similar future initiatives. Forty-two PED physicians were invited to participate in a semi-structured individual interview assessing their views about low-acuity visits, their pamphlet use, barriers and enablers to pamphlet use, and the initiative's potential for reducing low-acuity visits. Suggestions were solicited for improving the initiative and reducing low-acuity visits. Constant comparative method was used during analysis. Codes were developed inductively and iteratively, then grouped according to the Theoretical Domains Framework (TDF). Efforts to ensure study credibility included seeking participant feedback on the findings. Twenty-three PED physicians were interviewed (55%). Barriers and enablers for pamphlet use were identified and grouped according to five of the 14 TDF domains: social/professional role and identity; beliefs about consequences; environmental context and resources; social influences; and emotions. The TDF provided an effective approach to identify the key elements influencing physician participation in the educational initiative. This information will help inform behavior change interventions to improve the implementation of similar future initiatives that involve physicians as the primary educators of caregivers.

Use of histamine H2 receptor antagonists and outcomes in patients with heart failure: a nationwide population-based cohort study.

PubMed

Adelborg, Kasper; Sundbøll, Jens; Schmidt, Morten; Bøtker, Hans Erik; Weiss, Noel S; Pedersen, Lars; Sørensen, Henrik Toft

2018-01-01

Histamine H 2 receptor activation promotes cardiac fibrosis and apoptosis in mice. However, the potential effectiveness of histamine H 2 receptor antagonists (H2RAs) in humans with heart failure is largely unknown. We examined the association between H2RA initiation and all-cause mortality among patients with heart failure. Using Danish medical registries, we conducted a nationwide population-based active-comparator cohort study of new users of H2RAs and proton pump inhibitors (PPIs) after first-time hospitalization for heart failure during the period 1995-2014. Hazard ratios (HRs) for all-cause mortality and hospitalization due to worsening of heart failure, adjusting for age, sex, and time between heart failure diagnosis and initiation of PPI or H2RA therapy, index year, comorbidity, cardiac surgery, comedications, and socioeconomic status were computed based on Cox regression analysis. Our analysis included 42,902 PPI initiators (median age 78 years, 46% female) and 3,296 H2RA initiators (median age 76 years, 48% female). Mortality risk was lower among H2RA initiators than PPI initiators after 1 year (26% vs 31%) and 5 years (60% vs 66%). In multivariable analyses, the 1-year HR was 0.80 (95% CI, 0.74-0.86) and the 5-year HR was 0.85 (95% CI, 0.80-0.89). These findings were consistent after propensity score matching and for ischemic and nonischemic heart failure, as for sex and age groups. The rate of hospitalization due to worsening of heart failure was lower among H2RA initiators than PPI initiators. In patients with heart failure, H2RA initiation was associated with 15%-20% lower mortality than PPI initiation.

Initiation of sexual intercourse among middle school adolescents: the influence of psychosocial factors.

PubMed

Santelli, John S; Kaiser, Javaid; Hirsch, Lesley; Radosh, Alice; Simkin, Linda; Middlestadt, Susan

2004-03-01

To explore potential psychosocial predictors for initiation of sexual intercourse among middle-school, inner-city youth, using longitudinal data from the Healthy and Alive! project. We conducted hierarchical, logistic regression with adjustment for intraclass correlation over two sequential periods, including seventh and eighth grades (N = 3163), to assess the independent influence of psychosocial and demographic factors. Internally reliable scales to assess psychosocial influences were created, based on major theories of behavior. The sample was 52% female, 51% black, 30% Hispanic, 9% white, and 3% Asian. At baseline, 13% of girls and 39% of boys reported already having initiated sexual intercourse. Personal and perceived peer norms about refraining from sex were a strong and consistent protective factor. Alcohol and other drug use, poor academic performance, male gender, and black race were consistent risk factors. Self-efficacy showed a mixed effect: protective in the seventh grade but increasing risk in the eighth grade. Speaking a language other than English was a protective factor in seventh grade. Both psychosocial and demographic factors provided independent explanatory power. Psychosocial factors, particularly norms about having sex, influence initiation of sexual intercourse. These data suggest that programs to delay initiation of sexual intercourse should reinforce norms about refraining from sex.

Culturally Safe Health Initiatives for Indigenous Peoples in Canada: A Scoping Review.

PubMed

Brooks-Cleator, Lauren; Phillipps, Breanna; Giles, Audrey

2018-01-01

Background Cultural safety has the potential to improve the health disparities between Indigenous and non-Indigenous Canadians, yet practical applications of the concept are lacking in the literature. Purpose This study aims to identify the key components of culturally safe health initiatives for the Indigenous population of Canada to refine its application in health-care settings. Methods We conducted a scoping review of the literature pertaining to culturally safe health promotion programs, initiatives, services, or care for the Indigenous population in Canada. Our initial search yielded 501 publications, but after full review of 44 publications, 30 were included in the review. After charting the data, we used thematic analysis to identify themes in the data. Results We identified six themes: collaboration/partnerships, power sharing, address the broader context of the patient's life, safe environment, organizational and individual level self-reflection, and training for health-care providers. Conclusion While it is important to recognize that the provision of culturally safe initiatives depend on the specific interaction between the health-care provider and the patient, having a common understanding of the components of cultural safety, such as those that we identified through this research, will help in the transition of cultural safety from theory into practice.

Legal implications of monitoring workers for carcinogenic and mutagenic risk.

PubMed

Damme, C J

1982-01-01

Many industries have initiated testing programs designed to identify workers who are especially vulnerable to workplace assaults by carcinogenic or mutagenic agents. This paper examines a number of legal issues attendant on such programs, including disclosure and consent, confidentiality, and other potential liability-producing factors. This paper also briefly looks at the legal issues that might arise if the federal government were to mandate similar programs. Finally, the basic rationale of industrial monitoring programs is discussed within the context of the emerging legal issues.

A new model for care population management.

PubMed

Williams, Jeni

2013-03-01

Steps toward building a population management model of care should include: Identifying the population that would be cared for through a population management initiative. Conducting an actuarial analysis for this population, reviewing historical utilization and cost data and projecting changes in utilization. Investing in data infrastructure that supports the exchange of data among providers and with payers. Determining potential exposure to downside risk and organizational capacity to assume this risk. Experimenting with payment models and care delivery approaches Hiring care coordinators to manage care for high-risk patients.

A Common Lunar Lander (CLL) for the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

Bailey, Stephen

1991-01-01

Information is given in viewgraph form on the Artemis project, a plan to establish a permanent base on the Moon. Information includes a summary of past and future events, the program rationale, a summary of potential payloads, the physical characteristics of experiments, sketches of equipment, design study objectives, and details of such payloads as the Geophysical Station Network, teleoperated rovers, astronomical telescopes, a Moon-Earth radio interferometer, very low frequency radio antennas, the Lunar Polar Crater Telescope, Lunar Resource Utilization Experiments, and biological experiments.

Burkholderia Mallei tssM Encodes a Secreted Deubiquitinase that is Expressed Inside Infected RAW 264.7 Murine Macrophages

DTIC Science & Technology

2008-10-13

Furthermore, the encoded protein of this gene is only 30 kDa. A potential GTG start codon at position 625 also encodes a protein that is too small...horizontal bar and putative alternate translation initiation sites (ATG, GTG , and TTG) are indicated. The sizes and locations of the proteins encoded... gray line with rounded rectangles showing sequence features and motifs, including the Ala- and Pro-rich N-terminal region and the C-terminal Cys and

Biology of Nanobots

NASA Astrophysics Data System (ADS)

Duan, Wentao; Pavlick, Ryan; Sen, Ayusman

2013-12-01

One of the more interesting recent discoveries has been the ability to design nano/microbots which catalytically harness the chemical energy in their environment to move autonomously. Their potential applications include delivery of materials, self-assembly of superstructures, and roving sensors. One emergent area of research is the study of their collective behavior and how they emulate living systems. The aim of this chapter is to describe the "biology" of nanobots, summarizing the fundamentals physics behind their motion and how the bots interact with each other to initiate complex emergent behavior.

Long-Term Management Strategy for Dredged Material Disposal for Naval Facilities at Pearl Harbor, Hawaii Phase III - Analysis of Alternatives and Development of an LTMS

DTIC Science & Technology

2000-03-01

are needed to restrict contaminants losses via the leachate and volatilization pathways. Plant uptake testing indicated a potential need to restrict...or control future use of the site, to amend the material with soil additives, to phytoremediate , or to provide a final surface cover of clean...initial release including toxicity and bioaccumulation, effluent, runoff, leachate , plant uptake, upland and aquatic animal uptake, and

THE POSSIBLE IMPACT OF L5 MAGNETOGRAMS ON NON-POTENTIAL SOLAR CORONAL MAGNETIC FIELD SIMULATIONS

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

Weinzierl, Marion; Yeates, Anthony R.; Mackay, Duncan H.

The proposed Carrington-L5 mission would bring instruments to the L5 Lagrange point to provide us with crucial data for space weather prediction. To assess the importance of including a magnetograph, we consider the possible differences in non-potential solar coronal magnetic field simulations when magnetograph observations are available from the L5 point, compared with an L1-based field of view (FOV). A timeseries of synoptic radial magnetic field maps is constructed to capture the emergence of two active regions from the L5 FOV. These regions are initially absent in the L1 magnetic field maps, but are included once they rotate into themore » L1 FOV. Non-potential simulations for these two sets of input data are compared in detail. Within the bipolar active regions themselves, differences in the magnetic field structure can exist between the two simulations once the active regions are included in both. These differences tend to reduce within 5 days of the active region being included in L1. The delayed emergence in L1 can, however, lead to significant persistent differences in long-range connectivity between the active regions and the surrounding fields, and also in the global magnetic energy. In particular, the open magnetic flux and the location of open magnetic footpoints, are sensitive to capturing the real-time of emergence. These results suggest that a magnetograph at L5 could significantly improve predictions of the non-potential corona, the interplanetary magnetic field, and of solar wind source regions on the Sun.« less

Heteromeric Kv7.2/7.3 channels differentially regulate action potential initiation and conduction in neocortical myelinated axons.

PubMed

Battefeld, Arne; Tran, Baouyen T; Gavrilis, Jason; Cooper, Edward C; Kole, Maarten H P

2014-03-05

Rapid energy-efficient signaling along vertebrate axons is achieved through intricate subcellular arrangements of voltage-gated ion channels and myelination. One recently appreciated example is the tight colocalization of K(v)7 potassium channels and voltage-gated sodium (Na(v)) channels in the axonal initial segment and nodes of Ranvier. The local biophysical properties of these K(v)7 channels and the functional impact of colocalization with Na(v) channels remain poorly understood. Here, we quantitatively examined K(v)7 channels in myelinated axons of rat neocortical pyramidal neurons using high-resolution confocal imaging and patch-clamp recording. K(v)7.2 and 7.3 immunoreactivity steeply increased within the distal two-thirds of the axon initial segment and was mirrored by the conductance density estimates, which increased from ~12 (proximal) to 150 pS μm(-2) (distal). The axonal initial segment and nodal M-currents were similar in voltage dependence and kinetics, carried by K(v)7.2/7.3 heterotetramers, 4% activated at the resting membrane potential and rapidly activated with single-exponential time constants (~15 ms at 28 mV). Experiments and computational modeling showed that while somatodendritic K(v)7 channels are strongly activated by the backpropagating action potential to attenuate the afterdepolarization and repetitive firing, axonal K(v)7 channels are minimally recruited by the forward-propagating action potential. Instead, in nodal domains K(v)7.2/7.3 channels were found to increase Na(v) channel availability and action potential amplitude by stabilizing the resting membrane potential. Thus, K(v)7 clustering near axonal Na(v) channels serves specific and context-dependent roles, both restraining initiation and enhancing conduction of the action potential.

Heteromeric Kv7.2/7.3 Channels Differentially Regulate Action Potential Initiation and Conduction in Neocortical Myelinated Axons

PubMed Central

Battefeld, Arne; Tran, Baouyen T.; Gavrilis, Jason; Cooper, Edward C.

2014-01-01

Rapid energy-efficient signaling along vertebrate axons is achieved through intricate subcellular arrangements of voltage-gated ion channels and myelination. One recently appreciated example is the tight colocalization of Kv7 potassium channels and voltage-gated sodium (Nav) channels in the axonal initial segment and nodes of Ranvier. The local biophysical properties of these Kv7 channels and the functional impact of colocalization with Nav channels remain poorly understood. Here, we quantitatively examined Kv7 channels in myelinated axons of rat neocortical pyramidal neurons using high-resolution confocal imaging and patch-clamp recording. Kv7.2 and 7.3 immunoreactivity steeply increased within the distal two-thirds of the axon initial segment and was mirrored by the conductance density estimates, which increased from ∼12 (proximal) to 150 pS μm−2 (distal). The axonal initial segment and nodal M-currents were similar in voltage dependence and kinetics, carried by Kv7.2/7.3 heterotetramers, 4% activated at the resting membrane potential and rapidly activated with single-exponential time constants (∼15 ms at 28 mV). Experiments and computational modeling showed that while somatodendritic Kv7 channels are strongly activated by the backpropagating action potential to attenuate the afterdepolarization and repetitive firing, axonal Kv7 channels are minimally recruited by the forward-propagating action potential. Instead, in nodal domains Kv7.2/7.3 channels were found to increase Nav channel availability and action potential amplitude by stabilizing the resting membrane potential. Thus, Kv7 clustering near axonal Nav channels serves specific and context-dependent roles, both restraining initiation and enhancing conduction of the action potential. PMID:24599470

75 FR 67983 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

...] Agency Information Collection Activities; Announcement of Office of Management and Budget Approval; Evaluation of Potential Data Sources for the Sentinel Initiative AGENCY: Food and Drug Administration, HHS... information entitled ``Evaluation of Potential Data Sources for the Sentinel Initiative'' has been approved by...

Brain Activity in Fairness Consideration during Asset Distribution: Does the Initial Ownership Play a Role?

PubMed Central

Wu, Yin; Hu, Jie; van Dijk, Eric; Leliveld, Marijke C.; Zhou, Xiaolin

2012-01-01

Previous behavioral studies have shown that initial ownership influences individuals’ fairness consideration and other-regarding behavior. However, it is not entirely clear whether initial ownership influences the brain activity when a recipient evaluates the fairness of asset distribution. In this study, we randomly assigned the bargaining property (monetary reward) to either the allocator or the recipient in the ultimatum game and let participants of the study, acting as recipients, receive either disadvantageous unequal, equal, or advantageous unequal offers from allocators while the event-related potentials (ERPs) were recorded. Behavioral results showed that participants were more likely to reject disadvantageous unequal and equal offers when they initially owned the property as compared to when they did not. The two types of unequal offers evoked more negative going ERPs (the MFN) than the equal offers in an early time window and the differences were not modulated by the initial ownership. In a late time window, however, the P300 responses to division schemes were affected not only by the type of unequal offers but also by whom the property was initially assigned to. These findings suggest that while the MFN may function as a general mechanism that evaluates whether the offer is consistent or inconsistent with the equity rule, the P300 is sensitive to top-down controlled processes, into which factors related to the allocation of attentional resources, including initial ownership and personal interests, come to play. PMID:22761850

Cardiovascular (CV) Risk after Initiation of Abatacept versus TNF Inhibitors in Rheumatoid Arthritis Patients with and without Baseline CV Disease.

PubMed

Jin, Yinzhu; Kang, Eun Ha; Brill, Gregory; Desai, Rishi J; Kim, Seoyoung C

2018-05-15

To evaluate the cardiovascular safety of abatacept (ABA) versus tumor necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA) patients with and without underlying cardiovascular disease (CVD). We identified RA patients with and without baseline CVD who initiated ABA or TNFi by using data from 2 large US insurance claims databases: Medicare (2008-2013) and Truven MarketScan (2006-2015). After stratifying by baseline CVD, ABA initiators were 1:1 propensity score (PS) matched to TNFi initiators to control for > 60 baseline covariates. Cox proportional hazards regression estimated the HR and 95% CI for a composite endpoint of CVD including myocardial infarction, stroke/transient ischemic stroke, or coronary revascularization in the PS-matched cohorts. HR from 2 databases were combined through an inverse variance-weighted fixed-effects model. We included 6102 PS-matched pairs of ABA and TNFi initiators from Medicare and 6934 pairs from MarketScan. Of these, 35.3% in Medicare and 14.0% in MarketScan had baseline CVD. HR (95% CI) for composite CVD in the overall ABA group versus TNFi was 0.67 (0.55-0.81) in Medicare and 1.08 (0.83-1.41) in MarketScan with the combined HR of 0.79 (0.67-0.92). Among patients with baseline CVD, the HR (95% CI) was 0.71 (0.55-0.92) in Medicare and 1.02 (0.68-1.51) in MarketScan, with the combined HR of 0.79 (0.64-0.98). In this large cohort of publicly or privately insured patients with RA in the United States, ABA was associated with a 20% reduced risk of CVD versus TNFi. While this observational study is subject to potential residual confounding, our results were consistent in patients with baseline CVD.

Initial segment Kv2.2 channels mediate a slow delayed rectifier and maintain high frequency action potential firing in medial nucleus of the trapezoid body neurons

PubMed Central

Johnston, Jamie; Griffin, Sarah J; Baker, Claire; Skrzypiec, Anna; Chernova, Tatanya; Forsythe, Ian D

2008-01-01

The medial nucleus of the trapezoid body (MNTB) is specialized for high frequency firing by expression of Kv3 channels, which minimize action potential (AP) duration, and Kv1 channels, which suppress multiple AP firing, during each calyceal giant EPSC. However, the outward K+ current in MNTB neurons is dominated by another unidentified delayed rectifier. It has slow kinetics and a peak conductance of ∼37 nS; it is half-activated at −9.2 ± 2.1 mV and half-inactivated at −35.9 ± 1.5 mV. It is blocked by several non-specific potassium channel antagonists including quinine (100 μm) and high concentrations of extracellular tetraethylammonium (TEA; IC50 = 11.8 mm), but no specific antagonists were found. These characteristics are similar to recombinant Kv2-mediated currents. Quantitative RT-PCR showed that Kv2.2 mRNA was much more prevalent than Kv2.1 in the MNTB. A Kv2.2 antibody showed specific staining and Western blots confirmed that it recognized a protein ∼110 kDa which was absent in brainstem tissue from a Kv2.2 knockout mouse. Confocal imaging showed that Kv2.2 was highly expressed in axon initial segments of MNTB neurons. In the absence of a specific antagonist, Hodgkin–Huxley modelling of voltage-gated conductances showed that Kv2.2 has a minor role during single APs (due to its slow activation) but assists recovery of voltage-gated sodium channels (Nav) from inactivation by hyperpolarizing interspike potentials during repetitive AP firing. Current-clamp recordings during high frequency firing and characterization of Nav inactivation confirmed this hypothesis. We conclude that Kv2.2-containing channels have a distinctive initial segment location and crucial function in maintaining AP amplitude by regulating the interspike potential during high frequency firing. PMID:18511484

Cost analysis of large-scale implementation of the 'Helping Babies Breathe' newborn resuscitation-training program in Tanzania.

PubMed

Chaudhury, Sumona; Arlington, Lauren; Brenan, Shelby; Kairuki, Allan Kaijunga; Meda, Amunga Robson; Isangula, Kahabi G; Mponzi, Victor; Bishanga, Dunstan; Thomas, Erica; Msemo, Georgina; Azayo, Mary; Molinier, Alice; Nelson, Brett D

2016-12-01

Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2%), followed by central program administration (37.2%), and follow-up visits (17.6%). Within Mbeya, 49 training sessions were undertaken, involving the training of 1,341 health providers from 336 health facilities in eight districts. To similarly expand the HBB program across the 25 regions of mainland Tanzania, the total economic cost is projected to be around $4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between $2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost $2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention.

mHealth Assessment: Conceptualization of a Global Framework.

PubMed

Bradway, Meghan; Carrion, Carme; Vallespin, Bárbara; Saadatfard, Omid; Puigdomènech, Elisa; Espallargues, Mireia; Kotzeva, Anna

2017-05-02

The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment. Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group's diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts. As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries. A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the specifics of each context, to bridge the gap between health authorities, patients, and mHealth developers. We aim to foster a more trusting and collaborative environment to safeguard the well-being of patients and citizens while encouraging innovation of technology and policy. ©Meghan Bradway, Carme Carrion, Bárbara Vallespin, Omid Saadatfard, Elisa Puigdomènech, Mireia Espallargues, Anna Kotzeva. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 02.05.2017.

Vision-related research priorities and how to finance them.

PubMed

McCarty, Catherine A

2012-01-01

A number of organizations have employed a consultative process with the vision community to engage relevant parties in identifying needs and opportunities for vision research. The National Eye Institute in the US and the European Commission are currently undergoing consultation to develop priorities for vision research. Once these priorities have been established, the challenge will be to identify the resources to advance these research agendas. Success rates for Federal funding for research have decreased recently in the USA, UK, and Australia. Researchers should consider various potential funding sources for their research. The universal consideration for funding is that the reason for funding should align with the mission of the funding organization. In addition to Federal research organizations that fund investigator-initiated research, other potential funding sources include nongovernmental organizations, for-profit companies, individual philanthropy, and service organizations. In addition to aligning with organizational funding priorities, researchers need to consider turn-around time and total funds available including whether an organization will cover institutional indirect costs. Websites are useful tools to find information about organizations that fund research, including grant deadlines. Collaboration is encouraged.

Frontotemporal Dementia in Eight Chinese Individuals

PubMed Central

Chao, Steven Z.; Rosen, Howard J.; Azor, Virgina; Ong, Hilary; Tse, Marian M.; Lai, Ngan Betty; Hou, Craig E.; Seeley, William W.; Miller, Bruce L.; Matthews, Brandy R.

2012-01-01

Frontotemporal dementia (FTD) has rarely been reported in Chinese populations. There are many potential reasons for this, including possible hesitancy on the part of patients or families to bring FTD-related symptoms to medical attention. Here, we present data on eight Chinese individuals, all of whom met criteria for the behavioral variant of FTD or the semantic variant of primary progressive aphasia. These patients presented for neurological evaluation at a relatively advanced stage. The mean MMSE score at initial presentation was 15. Behavioral symptoms were common and usually elicited during the medical history only after direct questioning. Delay in presentation was attributed to a variety of issues, including family disagreements about whether the symptoms represented a disease and lack of medical insurance. These cases illustrate that the symptoms of FTD in Chinese Americans are similar to those in Caucasians but various factors, some potentially culturally-relevant, may influence the likelihood and timing of clinical presentation for FTD, as well as other dementias. Additional study of FTD in diverse ethnic groups needs to address barriers to clinical presentation, including factors that may be culturally specific. PMID:23311888

Vision-related research priorities and how to finance them

PubMed Central

McCarty, Catherine A

2012-01-01

A number of organizations have employed a consultative process with the vision community to engage relevant parties in identifying needs and opportunities for vision research. The National Eye Institute in the US and the European Commission are currently undergoing consultation to develop priorities for vision research. Once these priorities have been established, the challenge will be to identify the resources to advance these research agendas. Success rates for Federal funding for research have decreased recently in the USA, UK, and Australia. Researchers should consider various potential funding sources for their research. The universal consideration for funding is that the reason for funding should align with the mission of the funding organization. In addition to Federal research organizations that fund investigator-initiated research, other potential funding sources include nongovernmental organizations, for-profit companies, individual philanthropy, and service organizations. In addition to aligning with organizational funding priorities, researchers need to consider turn-around time and total funds available including whether an organization will cover institutional indirect costs. Websites are useful tools to find information about organizations that fund research, including grant deadlines. Collaboration is encouraged. PMID:22944760

Evaluation of advanced propulsion options for the next manned transportation system: Propulsion evolution study

NASA Technical Reports Server (NTRS)

Spears, L. T.; Kramer, R. D.

1990-01-01

The objectives were to examine launch vehicle applications and propulsion requirements for potential future manned space transportation systems and to support planning toward the evolution of Space Shuttle Main Engine (SSME) and Space Transportation Main Engine (STME) engines beyond their current or initial launch vehicle applications. As a basis for examinations of potential future manned launch vehicle applications, we used three classes of manned space transportation concepts currently under study: Space Transportation System Evolution, Personal Launch System (PLS), and Advanced Manned Launch System (AMLS). Tasks included studies of launch vehicle applications and requirements for hydrogen-oxygen rocket engines; the development of suggestions for STME engine evolution beyond the mid-1990's; the development of suggestions for STME evolution beyond the Advanced Launch System (ALS) application; the study of booster propulsion options, including LOX-Hydrocarbon options; the analysis of the prospects and requirements for utilization of a single engine configuration over the full range of vehicle applications, including manned vehicles plus ALS and Shuttle C; and a brief review of on-going and planned LOX-Hydrogen propulsion technology activities.

Hip hopping the gap--performing arts approaches to sexual health disadvantage in young people in remote settings.

PubMed

Crouch, Alan; Robertson, Heather; Fagan, Patricia

2011-07-01

Closing the gap in Indigenous health and wellbeing in remote settings in the Torres Strait and Northern Peninsula Area of Far North Queensland (FNQ) includes addressing a well-documented sexual health disadvantage among young people. Community mobilization around the underlying risk factors influencing sexual health is required. Performing-arts-based workshops were conducted in schools and after-school venues in four remote Aboriginal and Torres Strait islander locations in FNQ in early 2010, to initiate consciousness-raising around the real dimensions of youth sexual health risk. Specific objectives included strengthening operational partnerships at school-level and developing ongoing consultative processes in each location for sexual health reference group development. Results include a significantly strengthened productive partnership with primary and high schools in each location and sixteen production-ready hip hop songs exploring a range of physical, emotional and sexual health themes authored by the students and recorded on site. Additional outcomes included the willingness of community councils and civil society organizations to support local sexual health reference group activity. This initiative, the Indigenous Hip Hop Project, although accompanied by opportunity costs including alternative, more core business uses of staff time and program budget, has demonstrated the power of tapping the creative energy of young people at risk and the potential for mobilizing communities to activism around sexual health disadvantage.

Axonal Membranes and Their Domains: Assembly and Function of the Axon Initial Segment and Node of Ranvier

PubMed Central

Nelson, Andrew D.; Jenkins, Paul M.

2017-01-01

Neurons are highly specialized cells of the nervous system that receive, process and transmit electrical signals critical for normal brain function. Here, we review the intricate organization of axonal membrane domains that facilitate rapid action potential conduction underlying communication between complex neuronal circuits. Two critical excitable domains of vertebrate axons are the axon initial segment (AIS) and the nodes of Ranvier, which are characterized by the high concentrations of voltage-gated ion channels, cell adhesion molecules and specialized cytoskeletal networks. The AIS is located at the proximal region of the axon and serves as the site of action potential initiation, while nodes of Ranvier, gaps between adjacent myelin sheaths, allow rapid propagation of the action potential through saltatory conduction. The AIS and nodes of Ranvier are assembled by ankyrins, spectrins and their associated binding partners through the clustering of membrane proteins and connection to the underlying cytoskeleton network. Although the AIS and nodes of Ranvier share similar protein composition, their mechanisms of assembly are strikingly different. Here we will cover the mechanisms of formation and maintenance of these axonal excitable membrane domains, specifically highlighting the similarities and differences between them. We will also discuss recent advances in super resolution fluorescence imaging which have elucidated the arrangement of the submembranous axonal cytoskeleton revealing a surprising structural organization necessary to maintain axonal organization and function. Finally, human mutations in axonal domain components have been associated with a growing number of neurological disorders including severe cognitive dysfunction, epilepsy, autism, neurodegenerative diseases and psychiatric disorders. Overall, this review highlights the assembly, maintenance and function of axonal excitable domains, particularly the AIS and nodes of Ranvier, and how abnormalities in these processes may contribute to disease. PMID:28536506

Latent Presentation of Decompression Sickness After Altitude Chamber Training in an Active Duty Flier.

PubMed

Gentry, James; Rango, Juan; Zhang, Jianzhong; Biedermann, Shane

2017-04-01

Decompression sickness (DCS) is a potential danger and risk for both divers and aircrew alike. DCS is also a potential side effect of altitude (hypobaric) chamber training as well and can present long after training occurs. Literature review shows that altitude chamber induced DCS has approximately a 0.25% incidence. A 32-yr-old, active duty military member developed symptoms of DCS 3 h after his hypobaric chamber training. Unfortunately, he did not seek treatment for DCS until 48 h after the exposure. His initial treatment included ground level oxygen therapy for 30 min at 12 L of oxygen per minute using a nonrebreathing mask. He achieved complete symptom resolution and was returned to duty. However, 12 d after his initial Flight Medicine evaluation, the patient returned complaining of a right temporal headache, multijoint pains, and fatigue. He was treated in the hyperbaric chamber and had complete resolution of symptoms. He was returned to flying status and 5 mo later denied any return of symptoms. Hypobaric chamber familiarity training is a requirement for all military aircrew personnel to allow them assess their ability to identify symptoms of hypoxia. This training method is not only costly to maintain, but it also places aircrew and chamber technicians at risk for potential long-term side effects from failed recompression treatment of DCS. We are presenting a case of recurrent DCS symptoms 12 d after initial ground level oxygen therapy.Gentry J, Rango J, Zhang J, Biedermann S. Latent presentation of decompression sickness after altitude chamber training in an active duty flier. Aerosp Med Hum Perform. 2017; 88(4):427-430.

Research on curcumin: A meta-analysis of potentially malignant disorders.

PubMed

Ara, Syeda Arshiya; Mudda, Jayashree A; Lingappa, Ashok; Rao, Purushottam

2016-01-01

Turmeric has been described in ayurveda, and is referred by different names in different cultures, the active principle called curcumin or diferuloylmethane, has been shown to exhibit numerous activities. Extensive research over the last half century has revealed several important functions of curcumin. It binds to a variety of proteins and inhibits the activity of various kinases. By modulating the activation of various transcription factors, curcumin regulates the expression of inflammatory enzymes, cytokines, adhesion molecules, and cell survival proteins. Various preclinical, clinical, and animal studies suggest that curcumin has potential as an antiproliferative, anti-invasive, and antiangiogenic, as a mediator of chemoresistance, chemopreventive, and as a therapeutic agent. Thus, curcumin a spice once relegated to the kitchen shelf has moved into the clinic and may prove to be "Curecumin." Methodology and Objectives: The focus of this publication is to provide research on curcumin with scientific publications on curcumin indexed in PubMed, Google J-Gate including systematic reviews, randomized controlled trials (RCT's), observational studies, or case series reports for various potentially malignant disorders (PMD's) with special attention to studies on oral submucous fibrosis. This research will be valuable in terms of identifying opportunities to provide recommendations for future research, in terms of the populations to research, the types of interventions needed, the types of outcomes to be measured, the study designs needed, to initiate a pathway for a low-cost research plan for future clinical trials in this field with an emphasis on conducting studies in regions of the world where PMD's are prevalent. There is a lacunae for scientific review of curcumin for PMDs specially on OSMF. Appropriate therapeutic interventions are needed for the initial, intermediate, and advanced stages of the disease. High-quality RCTs should be initiated.

Evaluation of Potential Continuation Rules for Mepolizumab Treatment of Severe Eosinophilic Asthma.

PubMed

Gunsoy, Necdet B; Cockle, Sarah M; Yancey, Steven W; Keene, Oliver N; Bradford, Eric S; Albers, Frank C; Pavord, Ian D

Mepolizumab significantly reduces exacerbations in patients with severe eosinophilic asthma. The early identification of patients likely to receive long-term benefit from treatment could ensure effective resource allocation. To assess potential continuation rules for mepolizumab in addition to initiation criteria defined as 2 or more exacerbations in the previous year and blood eosinophil counts of 150 cells/μL or more at initiation or 300 cells/μL or more in the previous year. This post hoc analysis included data from 2 randomized, double-blind, placebo-controlled studies (NCT01000506 and NCT01691521) of mepolizumab in patients with severe eosinophilic asthma (N = 1,192). Rules based on blood eosinophils, physician-rated response to treatment, FEV 1 , Asthma Control Questionnaire (ACQ-5) score, and exacerbation reduction were assessed at week 16. To assess these rules, 2 key metrics accounting for the effects observed in the placebo arm were developed. Patients not meeting continuation rules based on physician-rated response, FEV 1 , and the ACQ-5 score still derived long-term benefit from mepolizumab. Nearly all patients failing to reduce blood eosinophils had counts of 150 cells/μL or less at baseline. For exacerbations, assessment after 16 weeks was potentially premature for predicting future exacerbations. There was no evidence of a reliable physician-rated response, ACQ-5 score, or lung function-based continuation rule. The added value of changes in blood eosinophils at week 16 over baseline was marginal. Initiation criteria for mepolizumab treatment provide the best method for assessing patient benefit from mepolizumab treatment, and treatment continuation should be reviewed on the basis of a predefined reduction in long-term exacerbation frequency and/or oral corticosteroid dose. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Progressive Damage Analysis of Bonded Composite Joints

NASA Technical Reports Server (NTRS)

Leone, Frank A., Jr.; Girolamo, Donato; Davila, Carlos G.

2012-01-01

The present work is related to the development and application of progressive damage modeling techniques to bonded joint technology. The joint designs studied in this work include a conventional composite splice joint and a NASA-patented durable redundant joint. Both designs involve honeycomb sandwich structures with carbon/epoxy facesheets joined using adhesively bonded doublers.Progressive damage modeling allows for the prediction of the initiation and evolution of damage within a structure. For structures that include multiple material systems, such as the joint designs under consideration, the number of potential failure mechanisms that must be accounted for drastically increases the complexity of the analyses. Potential failure mechanisms include fiber fracture, intraply matrix cracking, delamination, core crushing, adhesive failure, and their interactions. The bonded joints were modeled using highly parametric, explicitly solved finite element models, with damage modeling implemented via custom user-written subroutines. Each ply was discretely meshed using three-dimensional solid elements. Layers of cohesive elements were included between each ply to account for the possibility of delaminations and were used to model the adhesive layers forming the joint. Good correlation with experimental results was achieved both in terms of load-displacement history and the predicted failure mechanism(s).

Low physical activity as a key differentiating factor in the potential high-risk profile for depressive symptoms in older adults.

PubMed

Holmquist, Sofie; Mattsson, Sabina; Schele, Ingrid; Nordström, Peter; Nordström, Anna

2017-09-01

The identification of potential high-risk groups for depression is of importance. The purpose of the present study was to identify high-risk profiles for depressive symptoms in older individuals, with a focus on functional performance. The population-based Healthy Ageing Initiative included 2,084 community-dwelling individuals (49% women) aged 70. Explorative cluster analysis was used to group participants according to functional performance level, using measures of basic mobility skills, gait variability, and grip strength. Intercluster differences in depressive symptoms (measured by the Geriatric Depression Scale [GDS]-15), physical activity (PA; measured objectively with the ActiGraph GT3X+), and a rich set of covariates were examined. The cluster analysis yielded a seven-cluster solution. One potential high-risk cluster was identified, with overrepresentation of individuals with GDS scores >5 (15.1 vs. 2.7% expected; relative risk = 6.99, P < .001); the prevalence of depressive symptoms was significantly lower in the other clusters (all P < .01). The potential high-risk cluster had significant overrepresentations of obese individuals (39.7 vs. 17.4% expected) and those with type 2 diabetes (24.7 vs. 8.5% expected), and underrepresentation of individuals who fulfilled the World Health Organization's PA recommendations (15.6 vs. 59.1% expected; all P < .01), as well as low levels of functional performance. The present study provided a potential high-risk profile for depressive symptoms among elderly community-dwelling individuals, which included low levels functional performance combined with low levels of PA. Including PA in medical screening of the elderly may aid in identification of potential high-risk individuals for depressive symptoms. © 2017 Wiley Periodicals, Inc.

Dynamics of action potential initiation in the GABAergic thalamic reticular nucleus in vivo.

PubMed

Muñoz, Fabián; Fuentealba, Pablo

2012-01-01

Understanding the neural mechanisms of action potential generation is critical to establish the way neural circuits generate and coordinate activity. Accordingly, we investigated the dynamics of action potential initiation in the GABAergic thalamic reticular nucleus (TRN) using in vivo intracellular recordings in cats in order to preserve anatomically-intact axo-dendritic distributions and naturally-occurring spatiotemporal patterns of synaptic activity in this structure that regulates the thalamic relay to neocortex. We found a wide operational range of voltage thresholds for action potentials, mostly due to intrinsic voltage-gated conductances and not synaptic activity driven by network oscillations. Varying levels of synchronous synaptic inputs produced fast rates of membrane potential depolarization preceding the action potential onset that were associated with lower thresholds and increased excitability, consistent with TRN neurons performing as coincidence detectors. On the other hand the presence of action potentials preceding any given spike was associated with more depolarized thresholds. The phase-plane trajectory of the action potential showed somato-dendritic propagation, but no obvious axon initial segment component, prominent in other neuronal classes and allegedly responsible for the high onset speed. Overall, our results suggest that TRN neurons could flexibly integrate synaptic inputs to discharge action potentials over wide voltage ranges, and perform as coincidence detectors and temporal integrators, supported by a dynamic action potential threshold.

The Association of Individual and Regional Socioeconomic Status on Initial Peritonitis and Outcomes in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Study.

PubMed

Wang, Qin; Hu, Ke-Jie; Ren, Ye-Ping; Dong, Jie; Han, Qing-Feng; Zhu, Tong-Ying; Chen, Jiang-Hua; Zhao, Hui-Ping; Chen, Meng-Hua; Xu, Rong; Wang, Yue; Hao, Chuan-Ming; Zhang, Xiao-Hui; Wang, Mei; Tian, Na; Wang, Hai-Yan

2016-01-01

♦ Research indicates that the socioeconomic status (SES) of individuals and the area where they live are related to initial peritonitis and outcomes in peritoneal dialysis (PD). We conducted a retrospective, multi-center cohort study in China to examine these associations. ♦ Data on 2,171 PD patients were collected from 7 centers, including baseline demographic, socioeconomic, and laboratory data. We explored the potential risk factors for initial peritonitis and outcomes using univariate Cox regression and unadjusted binary logistic regression. Then, we used propensity score matching to balance statistically significant risk factors for initial peritonitis and outcomes, and Kaplan-Meier survival analysis to compare differences in peritonitis-free rates between different groups of participants after matching. ♦ A total of 563 (25.9%) initial episodes of peritonitis occurred during the study period. The Kaplan-Meier peritonitis-free rate curve showed high-income patients had a significantly lower risk than low-income patients (p = 0.007) after matching for age, hemoglobin, albumin, and regional SES and PD center. The risk of treatment failure was significantly lower in the high-income than the low-income group after matching for the organism causing peritonitis and PD center: odds ratio (OR) = 0.27 (0.09 - 0.80, p = 0.018). Regional SES and education were not associated with initial peritonitis and outcomes. ♦ Our study demonstrates low individual income is a risk factor for the initial onset of peritonitis and treatment failure after initial peritonitis. Copyright © 2016 International Society for Peritoneal Dialysis.

Universal potential-barrier penetration by initially confined wave packets

NASA Astrophysics Data System (ADS)

Granot, Er'El; Marchewka, Avi

2007-07-01

The dynamics of an initially sharp-boundary wave packet in the presence of an arbitrary potential barrier is investigated. It is shown that the penetration through the barrier is universal in the sense that it depends only on the values of the wave function and its derivatives at the boundary. The dependence on the derivatives vanishes at long distances from the barrier, where the dynamics is governed solely by the initial value of the wave function at the boundary.

Overall Impact of Speed-Related Initiatives and Factors on Crash Outcomes

PubMed Central

D’Elia, A.; Newstead, S.; Cameron, M.

2007-01-01

From December 2000 until July 2002 a package of speed-related initiatives and factors took place in Victoria, Australia. The broad aim of this study was to evaluate the overall impact of the package on crash outcomes. Monthly crash counts and injury severity proportions were assessed using Poisson and logistic regression models respectively. The model measured the overall effect of the package after adjusting as far as possible for non-speed road safety initiatives and socio-economic factors. The speed-related package was associated with statistically significant estimated reductions in casualty crashes and suggested reductions in injury severity with trends towards increased reductions over time. From December 2000 until July 2002, three new speed enforcement initiatives were implemented in Victoria, Australia. These initiatives were introduced in stages and involved the following key components: More covert operations of mobile speed cameras, including flash-less operations; 50% increase in speed camera operating hours; and lowering of cameras’ speed detection threshold. In addition, during the period 2001 to 2002, the 50 km/h General Urban Speed Limit (GUSL) was introduced (January 2001), there was an increase in speed-related advertising including the “Wipe Off 5” campaign, media announcements were made related to the above enforcement initiatives and there was a speeding penalty restructure. The above elements combine to make up a package of speed-related initiatives and factors. The package represents a broad, long term program by Victorian government agencies to reduce speed based on three linked strategies: more intensive Police enforcement of speed limits to deter potential offenders, i.e. the three new speed enforcement initiatives just described - supported by higher penalties; a reduction in the speed limit on local streets throughout Victoria from 60 km/h to 50 km/h; and provision of information using the mass media (television, radio and billboard) to reinforce the benefits of reducing low level speeding - the central message of “Wipe Off 5”. These strategies were implemented across the entire state of Victoria with the intention of covering as many road users as possible. PMID:18184508

Initial arch wires for tooth alignment during orthodontic treatment with fixed appliances.

PubMed

Jian, Fan; Lai, Wenli; Furness, Susan; McIntyre, Grant T; Millett, Declan T; Hickman, Joy; Wang, Yan

2013-04-30

Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review 'Initial arch wires for alignment of crooked teeth with fixed orthodontic braces' first published in the Cochrane Database of Systematic Reviews 2010, Issue 4. To assess the effects of initial arch wires for alignment of teeth with fixed orthodontic braces in relation to alignment speed, root resorption and pain intensity. We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 2 August 2012), CENTRAL (The Cochrane Library 2012, Issue 7), MEDLINE via OVID (1950 to 2 August 2012) and EMBASE via OVID (1980 to 2 August 2012). We also searched the reference lists of relevant articles. There was no restriction with regard to publication status or language of publication. We contacted all authors of included studies to identify additional studies. We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. Only studies involving participants with upper and/or lower full arch fixed orthodontic appliances were included. Two review authors were responsible for study selection, validity assessment and data extraction. All disagreements were resolved by discussion amongst the review team. Corresponding authors of included studies were contacted to obtain missing information. Nine RCTs with 571 participants were included in this review. All trials were at high risk of bias and a number of methodological limitations were identified. All trials had at least one potentially confounding factor (such as bracket type, slot size, ligation method, extraction of teeth) which is likely to have influenced the outcome and was not controlled in the trial. None of the trials reported the important adverse outcome of root resorption.Three groups of comparisons were made.(1) Multistrand stainless steel initial arch wires compared to superelastic nickel titanium (NiTi) initial arch wires. There were four trials in this group, with different comparisons and outcomes reported at different times. No meta-analysis was possible. There is insufficient evidence from these trials to determine whether or not there is a difference in either rate of alignment or pain between stainless steel and NiTi initial arch wires.(2) Conventional (stabilised) NiTi initial arch wires compared to superelastic NiTi initial arch wires. There were two trials in this group, one reporting the outcome of alignment over 6 months and the other reporting pain over 1 week. There is insufficient evidence from these trials to determine whether or not there is any difference between conventional (stabilised) and superelastic NiTi initial arch wires with regard to either alignment or pain.(3) Single-strand superelastic NiTi initial arch wires compared to other NiTi (coaxial, copper NiTi (CuNiTi) or thermoelastic) initial arch wires. The three trials in this comparison each compared a different product against single-strand superelastic NiTi. There is very weak unreliable evidence, based on one very small study (n = 24) at high risk of bias, that coaxial superelastic NiTi may produce greater tooth movement over 12 weeks, but no information on associated pain or root resorption. This result should be interpreted with caution until further research evidence is available. There is insufficient evidence to determine whether or not there is a difference between either thermoelastic or CuNiTi and superelastic NiTi initial arch wires. There is no reliable evidence from the trials included in this review that any specific initial arch wire material is better or worse than another with regard to speed of alignment or pain. There is no evidence at all about the effect of initial arch wire materials on the important adverse effect of root resorption. Further well-designed and conducted, adequately-powered, RCTs are required to determine whether the performance of initial arch wire materials as demonstrated in the laboratory, makes a clinically important difference to the alignment of teeth in the initial stage of orthodontic treatment in patients.

Effects of mother-son incest and positive perceptions of sexual abuse experiences on the psychosocial adjustment of clinic-referred men.

PubMed

Kelly, Robert J; Wood, Jeffrey J; Gonzalez, Lauren S; MacDonald, Virginia; Waterman, Jill

2002-04-01

The primary objective was to examine the long-term impact of mother-son incest and positive initial perceptions of sexual abuse experiences on adult male psychosocial functioning. Sixty-seven clinic-referred men with a history of sexual abuse participated. The participants completed self-report measures regarding their current psychosocial functioning and described the nature of their sexual and physical abuse experiences during childhood. Seventeen men reported mother-son incest, and these men endorsed more trauma symptoms than did other sexually abused men, even after controlling for a history of multiple perpetrators and physical abuse. Mother-son incest was likely to be subtle, involving behaviors that may be difficult to distinguish from normal caregiving (e.g., genital touching), despite the potentially serious long-term consequences. Twenty-seven men recalled positive or mixed initial perceptions of the abuse, including about half of the men who had been abused by their mothers. These men reported more adjustment problems than did men who recalled purely negative initial perceptions. Mother-son incest and positive initial perceptions of sexual abuse experiences both appear to be risk factors for more severe psychosocial adjustment problems among clinic-referred men.

Particle number dependence in the non-linear evolution of N-body self-gravitating systems

NASA Astrophysics Data System (ADS)

Benhaiem, D.; Joyce, M.; Sylos Labini, F.; Worrakitpoonpon, T.

2018-01-01

Simulations of purely self-gravitating N-body systems are often used in astrophysics and cosmology to study the collisionless limit of such systems. Their results for macroscopic quantities should then converge well for sufficiently large N. Using a study of the evolution from a simple space of spherical initial conditions - including a region characterized by so-called 'radial orbit instability' - we illustrate that the values of N at which such convergence is obtained can vary enormously. In the family of initial conditions we study, good convergence can be obtained up to a few dynamical times with N ∼ 103 - just large enough to suppress two body relaxation - for certain initial conditions, while in other cases such convergence is not attained at this time even in our largest simulations with N ∼ 105. The qualitative difference is due to the stability properties of fluctuations introduced by the N-body discretisation, of which the initial amplitude depends on N. We discuss briefly why the crucial role which such fluctuations can potentially play in the evolution of the N body system could, in particular, constitute a serious problem in cosmological simulations of dark matter.

Bioavailability of dissolved organic nitrogen (DON) in wastewaters from animal feedlots and storage lagoons.

PubMed

Sun, Jingyi; Khan, Eakalak; Simsek, Senay; Ohm, Jae-Bom; Simsek, Halis

2017-11-01

Dissolved organic nitrogen (DON) from animal wastes can contribute to pollution of surface waters. Bioavailable DON (ABDON) is a portion of DON utilized by algae with or without bacteria. This study determined DON and ABDON levels in animal wastewater collected from two different sources: an animal feedlot wastewater storage tank and a sheep wastewater storage lagoon. Inocula for the ABDON bioassays were comprised of individual species and several combinations involving two algae (Chlamydomonas reinhardtii and Chlorella vulgaris) and a mixed liquor suspended solids (MLSS) bacterial culture. The ratio of initial DON to initial total dissolved nitrogen was 18% in the feedlot wastewater samples and 70% in the lagoon wastewater samples. The results showed that between 1.6 and 4.5 mg-NL-1 DON (45-79% of initial DON) in the feedlot samples and between 3.4 and 7.5 mg-NL-1 DON (36%-79% of initial DON) in the lagoon samples were bioavailable with the inocula tested. These results suggest that when considering eutrophication potential of livestock wastewater, organic nitrogen should be included in addition to the obvious culprits, ammonia and nitrate. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mesoscale Simulation Data for Initializing Fast-Time Wake Transport and Decay Models

NASA Technical Reports Server (NTRS)

Ahmad, Nashat N.; Proctor, Fred H.; Vanvalkenburg, Randal L.; Pruis, Mathew J.; LimonDuparcmeur, Fanny M.

2012-01-01

The fast-time wake transport and decay models require vertical profiles of crosswinds, potential temperature and the eddy dissipation rate as initial conditions. These inputs are normally obtained from various field sensors. In case of data-denied scenarios or operational use, these initial conditions can be provided by mesoscale model simulations. In this study, the vertical profiles of potential temperature from a mesoscale model were used as initial conditions for the fast-time wake models. The mesoscale model simulations were compared against available observations and the wake model predictions were compared with the Lidar measurements from three wake vortex field experiments.

Spikelets in Pyramidal Neurons: Action Potentials Initiated in the Axon Initial Segment That Do Not Activate the Soma.

PubMed

Michalikova, Martina; Remme, Michiel W H; Kempter, Richard

2017-01-01

Spikelets are small spike-like depolarizations that can be measured in somatic intracellular recordings. Their origin in pyramidal neurons remains controversial. To explain spikelet generation, we propose a novel single-cell mechanism: somato-dendritic input generates action potentials at the axon initial segment that may fail to activate the soma and manifest as somatic spikelets. Using mathematical analysis and numerical simulations of compartmental neuron models, we identified four key factors controlling spikelet generation: (1) difference in firing threshold, (2) impedance mismatch, and (3) electrotonic separation between the soma and the axon initial segment, as well as (4) input amplitude. Because spikelets involve forward propagation of action potentials along the axon while they avoid full depolarization of the somato-dendritic compartments, we conjecture that this mode of operation saves energy and regulates dendritic plasticity while still allowing for a read-out of results of neuronal computations.

A qualitative study of methamphetamine initiation in Cape Town, South Africa

PubMed Central

Hobkirk, Andréa L.; Watt, Melissa H.; Myers, Bronwyn; Skinner, Donald; Meade, Christina S.

2015-01-01

Background Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals’ initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa. Methods In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes. Results On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered “trendy”, which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town. Conclusion The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for community-level interventions to address the availability and perceived normality of methamphetamine use, and to provide young people opportunities for recreation. On an individual level, addressing mental health and misconceptions about the dangers and benefits of methamphetamine could ameliorate willingness for initiation. Potential points of intervention include mass media campaigns and school-based interventions to raise awareness of the physical and social impacts of methamphetamine, and structural interventions to create safer neighborhoods, provide opportunities for employment and recreation, and expand mental health services to improve emotional health and coping skills. PMID:26614737

A qualitative study of methamphetamine initiation in Cape Town, South Africa.

PubMed

Hobkirk, Andréa L; Watt, Melissa H; Myers, Bronwyn; Skinner, Donald; Meade, Christina S

2016-04-01

Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals' initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa. In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes. On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered "trendy", which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town. The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for community-level interventions to address the availability and perceived normality of methamphetamine use, and to provide young people opportunities for recreation. On an individual level, addressing mental health and misconceptions about the dangers and benefits of methamphetamine could ameliorate willingness for initiation. Potential points of intervention include mass media campaigns and school-based interventions to raise awareness of the physical and social impacts of methamphetamine, and structural interventions to create safer neighborhoods, provide opportunities for employment and recreation, and expand mental health services to improve emotional health and coping skills. Copyright © 2015 Elsevier B.V. All rights reserved.

Mitochondrial genetic haplogroups and incident obesity: a longitudinal cohort study.

PubMed

Veronese, Nicola; Stubbs, Brendon; Koyanagi, Ai; Vaona, Alberto; Demurtas, Jacopo; Schofield, Patricia; Thompson, Trevor; Maggi, Stefania

2018-04-01

A small number of case-control studies have suggested that mitochondrial haplogroups could be associated with obesity. We examined whether obesity risk was influenced by mitochondrial haplogroup in a large North American cohort across an 8-year period. We conducted a longitudinal cohort study including individuals from the Osteoarthritis Initiative. Mitochondrial haplogroups were determined by sequencing and PCR-RFLP techniques using this nomenclature: HV, JT, KU, IWX, and super HV/others. The strength of the association between mitochondrial haplogroups and incident obesity was quantified with hazard ratios (HRs), adjusted for potential confounders using a Cox's regression analysis. Overall, 2342 non-obese Caucasian participants (56.7% women) with a mean ± SD age of 62.0 ± 9.5 years at baseline were included. During a median follow-up of 8 years, 334 individuals ( = 14.3% of baseline population) became obese. After adjusting for nine potential confounders, the haplogroups IWX carried a significant 48% higher risk of obesity (HR = 1.48; 95% CI: 1.02-2.39) compared to the HV haplotype (the most frequent type). Only the presence of the IWX haplogroups appears to be linked to increased obesity risk, independent of potential baseline confounders. Future cohort studies are needed to confirm these findings and to determine potential underlying mechanisms.

Domain epitaxy for thin film growth

DOEpatents

Narayan, Jagdish

2005-10-18

A method of forming an epitaxial film on a substrate includes growing an initial layer of a film on a substrate at a temperature T.sub.growth, said initial layer having a thickness h and annealing the initial layer of the film at a temperature T.sub.anneal, thereby relaxing the initial layer, wherein said thickness h of the initial layer of the film is greater than a critical thickness h.sub.c. The method further includes growing additional layers of the epitaxial film on the initial layer subsequent to annealing. In some embodiments, the method further includes growing a layer of the film that includes at least one amorphous island.

The (Missed) Potential of the Patient-centered Medical Home for Disparities.

PubMed

Reibling, Nadine; Rosenthal, Meredith B

2016-01-01

Disparities in health care and health outcomes are a significant problem in the United States. Delivery system reforms such as the patient-centered medical home (PCMH) could have important implications for disparities. To investigate what role disparities play in current PCMH initiatives and how their set-up might impact on disparities. We selected 4 state-based PCMH initiatives (Colorado, Massachusetts, Pennsylvania, and Rhode Island), 1 regional initiative in New Orleans, and 1 multistate initiative. We interviewed 30 key actors in these initiatives and 3 health policy experts on disparities in the context of PCMH. Interview data were coded using the constant comparative method. We find that disparities are not an explicit priority in PCMH initiatives. Nevertheless, many policymakers, providers, and initiative leaders believe that the model has the potential to reduce disparities. However, because of the funding structure of initiatives and the lack of adjustment of quality metrics, health policy experts do not share this optimism and safety-net providers report concerns and frustration. Even though disparities are currently not a priority in the PCMH community, the design of initiatives has important implications for disparities.

Refining the approach to vaccines against influenza A viruses with pandemic potential

PubMed Central

Czako, Rita; Subbarao, Kanta

2015-01-01

Vaccination is the most effective strategy for prevention and control of influenza. Timely production and deployment of seasonal influenza vaccines is based on an understanding of the epidemiology of influenza and on global disease and virologic surveillance. Experience with seasonal influenza vaccines guided the initial development of pandemic influenza vaccines. A large investment in pandemic influenza vaccines in the last decade has resulted in much progress and a body of information that can now be applied to refine the established paradigm. Critical and complementary considerations for pandemic influenza vaccines include improved assessment of the pandemic potential of animal influenza viruses, proactive development and deployment of pandemic influenza vaccines, and application of novel platforms and strategies for vaccine production and administration. PMID:26587050

Optimal protocol for maximum work extraction in a feedback process with a time-varying potential

NASA Astrophysics Data System (ADS)

Kwon, Chulan

2017-12-01

The nonequilibrium nature of information thermodynamics is characterized by the inequality or non-negativity of the total entropy change of the system, memory, and reservoir. Mutual information change plays a crucial role in the inequality, in particular if work is extracted and the paradox of Maxwell's demon is raised. We consider the Brownian information engine where the protocol set of the harmonic potential is initially chosen by the measurement and varies in time. We confirm the inequality of the total entropy change by calculating, in detail, the entropic terms including the mutual information change. We rigorously find the optimal values of the time-dependent protocol for maximum extraction of work both for the finite-time and the quasi-static process.

Size and habit evolution of PETN crystals - a lattice Monte Carlo study

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

Zepeda-Ruiz, L A; Maiti, A; Gee, R

2006-02-28

Starting from an accurate inter-atomic potential we develop a simple scheme of generating an ''on-lattice'' molecular potential of short range, which is then incorporated into a lattice Monte Carlo code for simulating size and shape evolution of nanocrystallites. As a specific example, we test such a procedure on the morphological evolution of a molecular crystal of interest to us, e.g., Pentaerythritol Tetranitrate, or PETN, and obtain realistic facetted structures in excellent agreement with experimental morphologies. We investigate several interesting effects including, the evolution of the initial shape of a ''seed'' to an equilibrium configuration, and the variation of growth morphologymore » as a function of the rate of particle addition relative to diffusion.« less

Design Evolutuion of Hot Isotatic Press Cans for NTP Cermet Fuel Fabrication

NASA Technical Reports Server (NTRS)

Mireles, O. R.; Broadway, J.; Hickman, R.

2014-01-01

Nuclear Thermal Propulsion (NTP) is under consideration for potential use in deep space exploration missions due to desirable performance properties such as a high specific impulse (> 850 seconds). Tungsten (W)-60vol%UO2 cermet fuel elements are under development, with efforts emphasizing fabrication, performance testing and process optimization to meet NTP service life requirements [1]. Fuel elements incorporate design features that provide redundant protection from crack initiation, crack propagation potentially resulting in hot hydrogen (H2) reduction of UO2 kernels. Fuel erosion and fission product retention barriers include W coated UO2 fuel kernels, W clad internal flow channels and fuel element external W clad resulting in a fully encapsulated fuel element design as shown.

Initial Investigation into the Potential of CSP Industrial Process Heat for the Southwest United States

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

Kurup, Parthiv; Turchi, Craig

2015-11-01

After significant interest in the 1970s, but relatively few deployments, the use of solar technologies for thermal applications, including enhanced oil recovery (EOR), desalination, and industrial process heat (IPH), is again receiving global interest. In particular, the European Union (EU) has been a leader in the use, development, deployment, and tracking of Solar Industrial Process Heat (SIPH) plants. The objective of this study is to ascertain U.S. market potential of IPH for concentrating collector technologies that have been developed and promoted through the U.S. Department of Energy's Concentrating Solar Power (CSP) Program. For this study, the solar-thermal collector technologies ofmore » interest are parabolic trough collectors (PTCs) and linear Fresnel (LF) systems.« less

Adult Onset Still’s Disease Presenting with Acute Respiratory Distress Syndrome: Case Report and Review of the Literature

PubMed Central

Dua, Anisha B.; Manadan, Augustine M.; Case, John P.

2013-01-01

Introduction: Adult-onset Still’s disease (AOSD) is a systemic inflammatory disorder characterized by rash, leukocytosis, fevers, and arthralgias. Pulmonary involvement has been reported rarely in AOSD, but acute respiratory distress syndrome (ARDS) is extremely rare and potentially fatal and must be recognized as potential manifestation of underlying AOSD. Methods: We present a case of AOSD manifested by ARDS and review the previously reported cases in Medline/Pub med. Results: Including this case, 19 cases of AOSD complicated with ARDS have been reported in the literature. Conclusions: It is important to recognize ARDS as a manifestation of AOSD so that proper diagnostic and therapeutic management can be initiated promptly. PMID:24459537

Utilization of non-conventional systems for conversion of biomass to food components

NASA Technical Reports Server (NTRS)

Karel, M.; Nakhost, Z.

1989-01-01

The potential use of micro-algae in yielding useful macronutrients for the CELSS is investigated. Algal proteins were isolated and characterized from green algae (Scenedesmus obliquus) grown under controlled conditions. The RNA and DNA contents were determined, and methodology for reduction of the nucleic acid content to acceptable levels developed. Lipid extraction procedures using supercritical fluids were tailored to removal of undesirable lipids and pigments. Initial steps toward preparation of model foods for potential use in the CELSS were taken. The goal was to fabricate food products which contain isolated algal macronutrients such as proteins and lipids and also some components derived from higher plants including wheat flour, soy flour, potato powder (flakes), soy oil, and corn syrup.

Space Tug systems study. Volume 2: Compendium

NASA Technical Reports Server (NTRS)

1974-01-01

Possible storable propellant configurations and program plans are evaluated for the space tug. Alternatives examined include: use of existing expendable stages modified for use with shuttle, followed by a space tug at a later date; use of a modified growth version of existing expendable stages for greater performance and potential reuse, followed by a space tug at a later date; use of a low development cost, reusable, interim space tug available at shuttle initial operational capability (IOC) that could be evolved to greater system capabilities at a later date; and use a direct developed tug with maximum potential to be available at some specified time after space shuttle IOC. The capability options were narrowed down to three final options for detailed program definition.

Data science, learning, and applications to biomedical and health sciences.

PubMed

Adam, Nabil R; Wieder, Robert; Ghosh, Debopriya

2017-01-01

The last decade has seen an unprecedented increase in the volume and variety of electronic data related to research and development, health records, and patient self-tracking, collectively referred to as Big Data. Properly harnessed, Big Data can provide insights and drive discovery that will accelerate biomedical advances, improve patient outcomes, and reduce costs. However, the considerable potential of Big Data remains unrealized owing to obstacles including a limited ability to standardize and consolidate data and challenges in sharing data, among a variety of sources, providers, and facilities. Here, we discuss some of these challenges and potential solutions, as well as initiatives that are already underway to take advantage of Big Data. © 2017 New York Academy of Sciences.

Evidence of reducing ethanol content in beverages to reduce harmful use of alcohol.

PubMed

Rehm, Jürgen; Lachenmeier, Dirk W; Llopis, Eva Jané; Imtiaz, Sameer; Anderson, Peter

2016-09-01

Alcohol use is a major contributor to the burden of gastrointestinal disease. WHO's global strategy to reduce harmful use of alcohol encourages the alcohol industry to contribute to this effort. However, evidence that alcohol producers have contributed to the reduction of harmful use of alcohol is scarce. Reduction of alcoholic strength of beer has been proposed and initiated as one potential way forward. We examine the evidence base for the success of such an initiative. Direct evidence from natural experiments or other controlled studies is scarce. We identified three potential mechanisms for how reduction of alcoholic strength could affect harmful use of alcohol: by current drinkers replacing standard alcoholic beverages with similar beverages of lower alcoholic strength, without increasing the quantity of liquid consumed; by current drinkers switching to no alcohol alternatives for part of the time, thereby reducing their average amount of ethanol consumed; and by initiating alcohol use in current abstainers. The first mechanism seems to be the most promising to potentially reduce harm, but much will depend on actual implementation, and only an independent assessment will be able to identify effects on harmful drinking. The potential of alcoholic strength reduction is independent of initiation by law or by self-initiative of the industry. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Examination of the Transformative Learning Potential of Alternative Spring Breaks

ERIC Educational Resources Information Center

Mann, Jessica; DeAngelo, Linda

2016-01-01

As institutions seek to offer students an educational experience equipped with opportunities to develop as not only active learners but also engaged citizens, service-learning initiatives in the form of alternative spring breaks (ASB) have become prevalent. This study examines the potential of ASBs, as service-learning initiatives, to deliver a…

Transient anomalous diffusion in periodic systems: ergodicity, symmetry breaking and velocity relaxation

PubMed Central

Spiechowicz, Jakub; Łuczka, Jerzy; Hänggi, Peter

2016-01-01

We study far from equilibrium transport of a periodically driven inertial Brownian particle moving in a periodic potential. As detected for a SQUID ratchet dynamics, the mean square deviation of the particle position from its average may involve three distinct intermediate, although extended diffusive regimes: initially as superdiffusion, followed by subdiffusion and finally, normal diffusion in the asymptotic long time limit. Even though these anomalies are transient effects, their lifetime can be many, many orders of magnitude longer than the characteristic time scale of the setup and turns out to be extraordinarily sensitive to the system parameters like temperature or the potential asymmetry. In the paper we reveal mechanisms of diffusion anomalies related to ergodicity of the system, symmetry breaking of the periodic potential and ultraslow relaxation of the particle velocity towards its steady state. Similar sequences of the diffusive behaviours could be detected in various systems including, among others, colloidal particles in random potentials, glass forming liquids and granular gases. PMID:27492219

Advancing nursing practice through social media: a global perspective.

PubMed

Barry, Jean; Hardiker, Nicholas R

2012-08-14

Social media has been used globally as a key vehicle for communication. As members of an innovative profession, many nurses have embraced social media and are actively utilizing its potential to enhance practice and improve health. The ubiquity of the Internet provides social media with the potential to improve both access to health information and services and equity in health care. Thus there are a number of successful nurse-led initiatives. However, the open and democratising nature of social media creates a number of potential risks, both individual and organisational. This article considers the use of social media within nursing from a global perspective, including discussion of policy and guidance documents. The impact of social media on both healthcare consumers and nurses is reviewed, followed by discussion of selected risks associated with social media. To help nurses make the most of social media tools and avoid potential pitfalls, the article conclusion suggests implications appropriate for global level practice based on available published guidance.

Global Sequestration Potential of Increased Organic Carbon in Cropland Soils.

PubMed

Zomer, Robert J; Bossio, Deborah A; Sommer, Rolf; Verchot, Louis V

2017-11-14

The role of soil organic carbon in global carbon cycles is receiving increasing attention both as a potentially large and uncertain source of CO 2 emissions in response to predicted global temperature rises, and as a natural sink for carbon able to reduce atmospheric CO 2 . There is general agreement that the technical potential for sequestration of carbon in soil is significant, and some consensus on the magnitude of that potential. Croplands worldwide could sequester between 0.90 and 1.85 Pg C/yr, i.e. 26-53% of the target of the "4p1000 Initiative: Soils for Food Security and Climate". The importance of intensively cultivated regions such as North America, Europe, India and intensively cultivated areas in Africa, such as Ethiopia, is highlighted. Soil carbon sequestration and the conservation of existing soil carbon stocks, given its multiple benefits including improved food production, is an important mitigation pathway to achieve the less than 2 °C global target of the Paris Climate Agreement.

Pathways into mental health care for UK veterans: a qualitative study.

PubMed

Mellotte, Harriet; Murphy, Dominic; Rafferty, Laura; Greenberg, Neil

2017-01-01

Background : It is well established that veterans suffering from mental health difficulties under use mental health services. Objective : This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans' help-seeking and pathways to care. Method : The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews. The resultant data were analysed using grounded theory. Results : Participants described two distinct stages to their help-seeking: initial help-seeking and pathways through treatment. Specific barriers and enablers to help-seeking were identified at each stage. Initial barriers included recognizing that there is a problem, self-stigma and anticipated public stigma. Initial enablers included being in crisis, social support, motivation and the media. Treatment pathway barriers included practical factors and negative beliefs about health services and professionals. Treatment pathway enablers included having a diagnosis, being seen in a veteran-specific service and establishing a good therapeutic relationship. Participants provided some suggestions for interventions to improve veterans' help-seeking in future; these focussed on enhancing both veterans and health professionals' knowledge regarding mental health difficulties. Conclusions : This study identified a number of barriers and enablers that may impact a veteran's journey in seeking help from professional services for mental health difficulties. Enablers such as reaching a crisis point, social support, the media, having a diagnosis of PTSD and veteran-specific mental health services appeared to be important in opposing stigma-related beliefs and in supporting veterans to engage in help-seeking behaviours.

Pathways into mental health care for UK veterans: a qualitative study

PubMed Central

Mellotte, Harriet; Murphy, Dominic; Rafferty, Laura; Greenberg, Neil

2017-01-01

ABSTRACT Background: It is well established that veterans suffering from mental health difficulties under use mental health services. Objective: This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans’ help-seeking and pathways to care. Method: The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews. The resultant data were analysed using grounded theory. Results: Participants described two distinct stages to their help-seeking: initial help-seeking and pathways through treatment. Specific barriers and enablers to help-seeking were identified at each stage. Initial barriers included recognizing that there is a problem, self-stigma and anticipated public stigma. Initial enablers included being in crisis, social support, motivation and the media. Treatment pathway barriers included practical factors and negative beliefs about health services and professionals. Treatment pathway enablers included having a diagnosis, being seen in a veteran-specific service and establishing a good therapeutic relationship. Participants provided some suggestions for interventions to improve veterans’ help-seeking in future; these focussed on enhancing both veterans and health professionals’ knowledge regarding mental health difficulties. Conclusions: This study identified a number of barriers and enablers that may impact a veteran’s journey in seeking help from professional services for mental health difficulties. Enablers such as reaching a crisis point, social support, the media, having a diagnosis of PTSD and veteran-specific mental health services appeared to be important in opposing stigma-related beliefs and in supporting veterans to engage in help-seeking behaviours. PMID:29163864

Marketing considerations in home health care.

PubMed

Tanner, D J

1985-12-01

Methods for conducting a comprehensive analysis of the potential for strategic entry or expansion in the home health-care (HHC) market are discussed. By conducting a comprehensive analysis of the HHC market, hospital pharmacists can evaluate the feasibility of developing and implementing a hospital-based HHC service. A comprehensive market analysis should include an initial assessment of potential product-line offerings, development of strengths-and-weaknesses and opportunities-and-threats profiles, evaluations of competing providers of HHC and regulatory issues, and formulation of a business plan. The potential impact of program structure, operations management, product pricing, advertising and promotion, and marketing controls should also be considered. The hospital pharmacist has a unique opportunity to further the organizational objectives of the hospital by participating in the provision of HHC; a comprehensive market analysis represents a useful method of assessing the benefits and costs associated with providing integrated HHC services.

Induced pluripotent stem cells for the treatment of stroke: the potential and the pitfalls.

PubMed

Yu, Fenggang; Li, Yingying; Morshead, Cindi M

2013-09-01

The extraordinary discovery of induced pluripotent stem cells (iPSCs) has led to the very real possibility that patient-specific cell therapy can be realized. The potential to develop cell replacement therapies outside the ethical and legal limitations, has initiated a new era of hope for regenerative strategies to treat human neurological disease including stroke. In this article, we will review and compare the current approaches to derive iPSCs from different somatic cells, and the induction into neuronal phenotypes, considering the advantages and disadvantages to the methodologies of derivation. We will highlight the work relating to the use of iPSC-based therapies in models of stroke and their potential use in clinical trials. Finally, we will consider future directions and areas of exploration which may promote the realization of iPSC-based cell replacement strategies for the treatment of stroke.

Virulence properties of cariogenic bacteria

PubMed Central

Kuramitsu, Howard K; Wang, Bing-Yan

2006-01-01

The importance of Streptococcus mutans in the etiology of dental caries has been well documented. However, there is growing recognition that the cariogenic potential of dental plaque may be determined by the composite interactions of the total plaque bacteria rather than solely the virulence properties of a single organism. This study will examine how the interactions of S. mutans with other biofilm constituents may influence the cariogenicity of plaque samples. In order to begin to investigate the effects of nonmutans streptococci on the cariogenic potential of S. mutans, we have examined the effects of Streptococcus gordonii on the virulence properties of the former organisms. These studies have indicated that S.gordonii can attenuate several potential virulence properties of S. mutans including bacteriocin production, genetic transformation, and biofilm formation. Therefore, modulation of the interactions between plaque bacteria might be a novel approach for attenuating dental caries initiation. PMID:16934112

PRESYNAPTIC DOPAMINE MODULATION BY STIMULANT SELF ADMINISTRATION

PubMed Central

España, Rodrigo A.; Jones, Sara R.

2013-01-01

The mesolimbic dopamine system is an essential participant in the initiation and modulation of various forms of goal-directed behavior, including drug reinforcement and addiction processes. Dopamine neurotransmission is increased by acute administration of all drugs of abuse, including the stimulants cocaine and amphetamine. Chronic exposure to these drugs via voluntary self-administration provides a model of stimulant abuse that is useful in evaluating potential behavioral and neurochemical adaptations that occur during addiction. This review describes commonly used methodologies to measure dopamine and baseline parameters of presynaptic dopamine regulation, including exocytotic release and reuptake through the dopamine transporter in the nucleus accumbens core, as well as dramatic adaptations in dopamine neurotransmission and drug sensitivity that occur with acute non-contingent and chronic, contingent self-administration of cocaine and amphetamine. PMID:23277050

C-Band Airport Surface Communications System Standards Development. Phase II Final Report. Volume 2: Test Bed Performance Evaluation and Final AeroMACS Recommendations

NASA Technical Reports Server (NTRS)

Hall, Edward; Magner, James

2011-01-01

This report is provided as part of ITT s NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract NNC05CA85C, Task 7: New ATM Requirements-Future Communications, C-Band and L-Band Communications Standard Development and was based on direction provided by FAA project-level agreements for New ATM Requirements-Future Communications. Task 7 included two subtasks. Subtask 7-1 addressed C-band (5091- to 5150-MHz) airport surface data communications standards development, systems engineering, test bed and prototype development, and tests and demonstrations to establish operational capability for the Aeronautical Mobile Airport Communications System (AeroMACS). Subtask 7-2 focused on systems engineering and development support of the L-band digital aeronautical communications system (L-DACS). Subtask 7-1 consisted of two phases. Phase I included development of AeroMACS concepts of use, requirements, architecture, and initial high-level safety risk assessment. Phase II builds on Phase I results and is presented in two volumes. Volume I is devoted to concepts of use, system requirements, and architecture, including AeroMACS design considerations. Volume II (this document) describes an AeroMACS prototype evaluation and presents final AeroMACS recommendations. This report also describes airport categorization and channelization methodologies. The purposes of the airport categorization task were (1) to facilitate initial AeroMACS architecture designs and enable budgetary projections by creating a set of airport categories based on common airport characteristics and design objectives, and (2) to offer high-level guidance to potential AeroMACS technology and policy development sponsors and service providers. A channelization plan methodology was developed because a common global methodology is needed to assure seamless interoperability among diverse AeroMACS services potentially supplied by multiple service providers.

Response of transposable elements to environmental stressors.

PubMed

Miousse, Isabelle R; Chalbot, Marie-Cecile G; Lumen, Annie; Ferguson, Alesia; Kavouras, Ilias G; Koturbash, Igor

2015-01-01

Transposable elements (TEs) comprise a group of repetitive sequences that bring positive, negative, as well as neutral effects to the host organism. Earlier considered as "junk DNA," TEs are now well-accepted driving forces of evolution and critical regulators of the expression of genetic information. Their activity is regulated by epigenetic mechanisms, including methylation of DNA and histone modifications. The loss of epigenetic control over TEs, exhibited as loss of DNA methylation and decondensation of the chromatin structure, may result in TEs reactivation, initiation of their insertional mutagenesis (retrotransposition) and has been reported in numerous human diseases, including cancer. Accumulating evidence suggests that these alterations are not the simple consequences of the disease, but often may drive the pathogenesis, as they can be detected early during disease development. Knowledge derived from the in vitro, in vivo, and epidemiological studies, clearly demonstrates that exposure to ubiquitous environmental stressors, many of which are carcinogens or suspected carcinogens, are capable of causing alterations in methylation and expression of TEs and initiate retrotransposition events. Evidence summarized in this review suggests that TEs are the sensitive endpoints for detection of effects caused by such environmental stressors, as ionizing radiation (terrestrial, space, and UV-radiation), air pollution (including particulate matter [PM]-derived and gaseous), persistent organic pollutants, and metals. Furthermore, the significance of these effects is characterized by their early appearance, persistence and presence in both, target organs and peripheral blood. Altogether, these findings suggest that TEs may potentially be introduced into safety and risk assessment and serve as biomarkers of exposure to environmental stressors. Furthermore, TEs also show significant potential to become invaluable surrogate biomarkers in clinic and possible targets for therapeutic modalities for disease treatment and prevention. Copyright © 2015 Elsevier B.V. All rights reserved.

Transposable elements in response to environmental stressors&

PubMed Central

Miousse, Isabelle R.; Chalbot, Marie-Cecile G.; Lumen, Annie; Ferguson, Alesia; Kavouras, Ilias G.; Koturbash, Igor

2015-01-01

Transposable elements (TEs) comprise a group of repetitive sequences that bring positive, negative, as well as neutral effects to the host organism. Earlier considered as “junk DNA,” TEs are now well-accepted driving forces of evolution and critical regulators the of expression of genetic information. Their activity is regulated by epigenetic mechanisms, including methylation of DNA and histone modifications. The loss of epigenetic control over TEs, exhibited as loss of DNA methylation and decondensation of the chromatin structure, may result in TEs reactivation, initiation of their insertional mutagenesis (retrotransposition) and has been reported in numerous human diseases, including cancer. Accumulating evidence suggests that these alterations are not the simple consequences of the disease, but often may drive the pathogenesis, as they can be detected early during disease development. Knowledge derived from the in vitro, in vivo, and epidemiological studies, clearly demonstrates that exposure to ubiquitous environmental stressors, many of which are carcinogens or suspected carcinogens, are capable of causing alterations in methylation and expression of TEs and initiate retrotransposition events. Evidence summarized in this review suggests that TEs are the sensitive endpoints for detection of effects caused by such environmental stressors, as ionizing radiation (terrestrial, space, and UV-radiation), air pollution (including particulate matter [PM]-derived and gaseous), persistent organic pollutants, and metals. Furthermore, the significance of these effects is characterized by their early appearance, persistence and presence in both, target organs and peripheral blood. Altogether, these findings suggest that TEs may potentially be introduced into safety and risk assessment and serve as biomarkers of exposure to environmental stressors. Furthermore, TEs also show significant potential to become invaluable surrogate biomarkers in clinic and possible targets for therapeutic modalities for disease treatment and prevention. PMID:26281766

Potential Hydrogeomechanical Impacts of Geological CO2 Sequestration

NASA Astrophysics Data System (ADS)

McPherson, B. J.; Haerer, D.; Han, W.; Heath, J.; Morse, J.

2006-12-01

Long-term sequestration of anthropogenic "greenhouse gases" such as CO2 is a proposed approach to managing climate change. Deep brine reservoirs in sedimentary basins are possible sites for sequestration, given their ubiquitous nature. We used a mathematical sedimentary basin model, including coupling of multiphase CO2-groundwater flow and rock deformation, to evaluate residence times in possible brine reservoir storage sites, migration patterns and rates away from such sites, and effects of CO2 injection on fluid pressures and rock strain. Study areas include the Uinta and Paradox basins of Utah, the San Juan basin of New Mexico, and the Permian basin of west Texas. Regional-scale hydrologic and mechanical properties, including the presence of fracture zones, were calibrated using laboratory and field data. Our initial results suggest that, in general, long-term (~100 years or more) sequestration in deep brine reservoirs is possible, if guided by robust structural and hydrologic data. However, specific processes must be addressed to characterize and minimize risks. In addition to CO2 migration from target sequestration reservoirs into other reservoirs or to the land surface, another environmental issue is displacement of brines into freshwater aquifers. We evaluated the potential for such unintended aquifer contamination by displacement of brines out of adjacent sealing layers such as marine shales. Results suggest that sustained injection of CO2 may incur significant brine displacement out of adjacent sealing layers, depending on the injection history, initial brine composition, and hydrologic properties of both reservoirs and seals. Model simulations also suggest that as injection-induced overpressures migrate, effective stresses may follow this migration under some conditions, as will associated rock strain. Such "strain migration" may lead to induced or reactivated fractures or faults, but can be controlled through reservoir engineering.

Atrial fibrillation detected by continuous electrocardiographic monitoring using implantable loop recorder to prevent stroke in individuals at risk (the LOOP study): Rationale and design of a large randomized controlled trial.

PubMed

Diederichsen, Søren Zöga; Haugan, Ketil Jørgen; Køber, Lars; Højberg, Søren; Brandes, Axel; Kronborg, Christian; Graff, Claus; Holst, Anders Gaarsdal; Nielsen, Jonas Bille; Krieger, Derk; Svendsen, Jesper Hastrup

2017-05-01

Atrial fibrillation (AF) increases the rate of stroke 5-fold, and AF-related strokes have a poorer prognosis compared with non-AF-related strokes. Atrial fibrillation and stroke constitute an intensifying challenge, and health care organizations are calling for awareness on the topic. Previous studies have demonstrated that AF is often asymptomatic and consequently undiagnosed. The implantable loop recorder (ILR) allows for continuous, long-term electrocardiographic monitoring with daily transmission of arrhythmia information, potentially leading to improvement in AF detection and stroke prevention. The LOOP study is an investigator-initiated, randomized controlled trial with 6,000 participants randomized 3:1 to a control group or to receive an ILR with continuous electrocardiographic monitoring. Participants are identified from Danish registries and are eligible for inclusion if 70years or older and previously diagnosed as having at least one of the following conditions: hypertension, diabetes mellitus, heart failure, or previous stroke. Exclusion criteria include history of AF and current oral anticoagulation treatment. When an AF episode lasting ≥6minutes is detected, oral anticoagulation will be initiated according to guidelines. Expected follow-up is 4years. The primary end point is time to stroke or systemic embolism, whereas secondary end points include time to AF diagnosis and death. The LOOP study will evaluate health benefits and cost-effectiveness of ILR as a screening tool for AF to prevent stroke in patients at risk. Secondary objectives include identification of risk factors for the development of AF and characterization of arrhythmias in the population. The trial holds the potential to influence the future of stroke prevention. Copyright © 2017 Elsevier Inc. All rights reserved.

Harmonized patient-reported data elements in the electronic health record: supporting meaningful use by primary care action on health behaviors and key psychosocial factors

PubMed Central

Boyle, Maureen; Emmons, Karen M; Glasgow, Russell E; Hesse, Bradford W; Kaplan, Robert M; Krist, Alexander H; Moser, Richard P; Taylor, Martina V

2012-01-01

Background Electronic health records (EHR) have the potential to improve patient care through efficient access to complete patient health information. This potential may not be reached because many of the most important determinants of health outcome are rarely included. Successful health promotion and disease prevention requires patient-reported data reflecting health behaviors and psychosocial issues. Furthermore, there is a need to harmonize this information across different EHR systems. Methods To fill this gap a three-phased process was used to conceptualize, identify and recommend patient-reported data elements on health behaviors and psychosocial factors for the EHR. Expert panels (n=13) identified candidate measures (phase 1) that were reviewed and rated by a wide range of health professionals (n=93) using the grid-enabled measures wiki social media platform (phase 2). Recommendations were finalized through a town hall meeting with key stakeholders including patients, providers, researchers, policy makers, and representatives from healthcare settings (phase 3). Results Nine key elements from three areas emerged as the initial critical patient-reported elements to incorporate systematically into EHR—health behaviors (eg, exercise), psychosocial issues (eg, distress), and patient-centered factors (eg, demographics). Recommendations were also made regarding the frequency of collection ranging from a single assessment (eg, demographic characteristics), to annual assessment (eg, health behaviors), or more frequent (eg, patient goals). Conclusions There was strong stakeholder support for this initiative reflecting the perceived value of incorporating patient-reported elements into EHR. The next steps will include testing the feasibility of incorporating these elements into the EHR across diverse primary care settings. PMID:22511015

Super NiCd Open-Circuit Storage and Low Earth Orbit (LEO) Life Test Evaluation

NASA Technical Reports Server (NTRS)

Baer, Jean Marie; Hwang, Warren C.; Ang, Valerie J.; Hayden, Jeff; Rao, Gopalakrishna; Day, John H. (Technical Monitor)

2002-01-01

This presentation discusses Air Force tests performed on super NiCd cells to measure their performance under conditions simulating Low Earth Orbit (LEO) conditions. Super NiCd cells offer potential advantages over existing NiCd cell designs including advanced cell design with improved separator material and electrode making processes, but handling and storage requires active charging. These tests conclude that the super NiCd cells support generic Air Force qualifications for conventional LEO missions (up to five years duration) and that handling and storage may not actually require active charging as previously assumed. Topics covered include: Test Plan, Initial Characterization Tests, Open-Circuit Storage Tests, and post storage capacities.

Numerical method and FORTRAN program for the solution of an axisymmetric electrostatic collector design problem

NASA Technical Reports Server (NTRS)

Reese, O. W.

1972-01-01

The numerical calculation is described of the steady-state flow of electrons in an axisymmetric, spherical, electrostatic collector for a range of boundary conditions. The trajectory equations of motion are solved alternately with Poisson's equation for the potential field until convergence is achieved. A direct (noniterative) numerical technique is used to obtain the solution to Poisson's equation. Space charge effects are included for initial current densities as large as 100 A/sq cm. Ways of dealing successfully with the difficulties associated with these high densities are discussed. A description of the mathematical model, a discussion of numerical techniques, results from two typical runs, and the FORTRAN computer program are included.

Antenatal Breastfeeding Education and Support: Summary and Analysis of 2 Cochrane Publications.

PubMed

Jacobsen, Noelle

Key breastfeeding outcomes identified by the World Health Organization, the United Nations Children's Fund, the American Academy of Pediatrics, and Healthy People 2020 include early initiation, any such feeding at 6 months of age, and exclusivity. Broader themes in the current literature include infants who ever breastfed and overall duration. Healthcare providers need to know what current practices demonstrate effectiveness. A review of 2 Cochrane articles on which interventions impact these selected outcomes does not reveal any significant implications for clinical practice. Scant evidence exists to support any specific support efforts or educational outreach to improve these outcomes. A discussion of potential strategies to consider for future research and clinical practice is put forth.

C9orf72 expansion presenting as an eating disorder.

PubMed

Sanders, Peter; Ewing, Isobel; Ahmad, Kate

2016-03-01

This report describes a 64-year-old woman with a strong family history of motor neuron disease, whose diagnosis of behavioural variant frontotemporal dementia was delayed due to her initial presentation with atypical manifestations, including restriction of oral intake resulting in low weight, disordered eating and anxiety. Upon investigation, she was found to be a carrier of the C9orf72 hexanucleotide repeat expansion. Our case supports previous publications asserting that C9orf72 mutation carriers manifest with diverse clinical syndromes, and expands the phenotype to include anorexia and food refusal as potential features of the condition. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Response to Early AED Therapy and Its Prognostic Implications

PubMed Central

French, Jacqueline A.

2002-01-01

Determining the prognosis of patients when they first present with epilepsy is a difficult task. Several clinical studies have shed light on this very important topic. Potential predictors of the refractory state, including seizure etiology, duration of epilepsy before treatment, and epilepsy type, have not been successful indicators of long-term outcome. One predictor of the refractory state appears to be early response to AED therapy. Inadequate seizure control after initial treatment is a poor prognostic sign. Recent research into genetic causes of the refractory state has included investigation of the multiple drug resistance gene, and polymorphisms at drug targets. More work is needed to determine the causes and predictors of drug resistance. PMID:15309146

Asthma: NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases

PubMed Central

Hartert, Tina V.; Martinez, Fernando D.; Weiss, Scott T.; Fahy, John V.

2014-01-01

Asthma is a common disease with enormous public health costs, and its primary prevention is an ambitious and important goal. Understanding of how host and environmental factors interact to cause asthma is incomplete, but persistent questions about mechanisms should not stop clinical research efforts aimed at reducing the prevalence of childhood asthma. Achieving the goal of primary prevention of asthma will involve integrated and parallel sets of research activities in which mechanism-oriented studies of asthma inception proceed alongside clinical intervention studies to test biologically plausible prevention ideas. For example, continued research is needed, particularly in young children, to uncover biomarkers that identify asthma risk and provide potential targets of intervention, and to improve understanding of the role of microbial factors in asthma risk and disease initiation. In terms of clinical trials that could be initiated now or in the near future, we recommend three interventions for testing: (1) preventing asthma through prophylaxis against respiratory syncytial virus and human rhinovirus infections of the airway; (2) immune modulation, using prebiotics, probiotics, and bacterial lysates; and (3) prevention of allergen sensitization and allergic inflammation, using anti-IgE. These interventions should be tested while other, more universal prevention measures that may promote lung health are also investigated. These potential universal lung health measures include prevention of preterm delivery; reduced exposure of the fetus and young infant to environmental pollutants, including tobacco smoke; prevention of maternal and child obesity; and management of psychosocial stress. PMID:24754822

The Immunology of Posttransplant CMV Infection: Potential Effect of CMV Immunoglobulins on Distinct Components of the Immune Response to CMV

PubMed Central

Carbone, Javier

2016-01-01

Abstract The immune response to cytomegalovirus (CMV) infection is highly complex, including humoral, cellular, innate, and adaptive immune responses. Detection of CMV by the innate immune system triggers production of type I IFNs and inflammatory cytokines which initiate cellular and humoral responses that are critical during the early viremic phase of CMV infection. Sustained control of CMV infection is largely accounted for by cellular immunity, involving various T-cell and B-cell subsets. In solid organ transplant patients, global suppression of innate and adaptive immunities by immunosuppressive agents limits immunological defense, including inhibition of natural killer cell activity with ongoing lowering of Ig levels and CMV-specific antibody titers. This is coupled with a short-term suppression of CMV-specific T cells, the extent and duration of which can predict risk of progression to CMV viremia. CMV immunoglobulin (CMVIG) preparations have the potential to exert immunomodulatory effects as well as providing passive immunization. Specific CMVIG antibodies and virus neutralization might be enhanced by modulation of dendritic cell activity and by a decrease in T-cell activation, effects which are of importance during the initial phase of infection. In summary, the role of CMVIG in reconstituting specific anti-CMV antibodies may be enhanced by some degree of modulation of the innate and adaptive immune responses, which could help to control some of the direct and indirect effects of CMV infection. PMID:26900990

The Immunology of Posttransplant CMV Infection: Potential Effect of CMV Immunoglobulins on Distinct Components of the Immune Response to CMV.

PubMed

Carbone, Javier

2016-03-01

The immune response to cytomegalovirus (CMV) infection is highly complex, including humoral, cellular, innate, and adaptive immune responses. Detection of CMV by the innate immune system triggers production of type I IFNs and inflammatory cytokines which initiate cellular and humoral responses that are critical during the early viremic phase of CMV infection. Sustained control of CMV infection is largely accounted for by cellular immunity, involving various T-cell and B-cell subsets. In solid organ transplant patients, global suppression of innate and adaptive immunities by immunosuppressive agents limits immunological defense, including inhibition of natural killer cell activity with ongoing lowering of Ig levels and CMV-specific antibody titers. This is coupled with a short-term suppression of CMV-specific T cells, the extent and duration of which can predict risk of progression to CMV viremia. CMV immunoglobulin (CMVIG) preparations have the potential to exert immunomodulatory effects as well as providing passive immunization. Specific CMVIG antibodies and virus neutralization might be enhanced by modulation of dendritic cell activity and by a decrease in T-cell activation, effects which are of importance during the initial phase of infection. In summary, the role of CMVIG in reconstituting specific anti-CMV antibodies may be enhanced by some degree of modulation of the innate and adaptive immune responses, which could help to control some of the direct and indirect effects of CMV infection.

Potentially induced earthquakes in Oklahoma, USA: links between wastewater injection and the 2011 Mw 5.7 earthquake sequence

USGS Publications Warehouse

Keranen, Katie M.; Savage, Heather M.; Abers, Geoffrey A.; Cochran, Elizabeth S.

2013-01-01

Significant earthquakes are increasingly occurring within the continental interior of the United States, including five of moment magnitude (Mw) ≥ 5.0 in 2011 alone. Concurrently, the volume of fluid injected into the subsurface related to the production of unconventional resources continues to rise. Here we identify the largest earthquake potentially related to injection, an Mw 5.7 earthquake in November 2011 in Oklahoma. The earthquake was felt in at least 17 states and caused damage in the epicentral region. It occurred in a sequence, with 2 earthquakes of Mw 5.0 and a prolific sequence of aftershocks. We use the aftershocks to illuminate the faults that ruptured in the sequence, and show that the tip of the initial rupture plane is within ~200 m of active injection wells and within ~1 km of the surface; 30% of early aftershocks occur within the sedimentary section. Subsurface data indicate that fluid was injected into effectively sealed compartments, and we interpret that a net fluid volume increase after 18 yr of injection lowered effective stress on reservoir-bounding faults. Significantly, this case indicates that decades-long lags between the commencement of fluid injection and the onset of induced earthquakes are possible, and modifies our common criteria for fluid-induced events. The progressive rupture of three fault planes in this sequence suggests that stress changes from the initial rupture triggered the successive earthquakes, including one larger than the first.